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Diagnostic Musculoskeletal Ultrasound for Medial Collateral Ligament Injuries: Applications in Rehabilitation. 内侧副韧带损伤的诊断性肌肉骨骼超声波:康复应用。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-09-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.122931
Robert C Manske, Michael Voight, Chris Wolfe, Phil Page

Medial collateral ligament (MCL) injuries are prevalent in sports and other physical activities and constitute a significant cause of knee pain and dysfunction. Traditional diagnostic modalities such as magnetic resonance imaging (MRI) are often utilized for their detailed visualization capabilities. However, musculoskeletal ultrasound (MSK-US) has emerged as a pivotal diagnostic tool in the evaluation of MCL injuries due to its non-invasive nature, cost-effectiveness, and dynamic imaging capabilities. This article reviews the utility and advantages of MSK-US in diagnosing MCL injuries, with a specific focus on its implications for rehabilitation providers. We discuss the technical aspects of ultrasound (US) imaging, including the sonographic appearance of MCL injuries across various grades, and compare its diagnostic accuracy with other imaging modalities such as MRI. Additionally, the role of US in monitoring the healing process and guiding rehabilitation strategies is explored. This review emphasizes the practical application of MSK-US in clinical settings, offering rehabilitation providers a comprehensive understanding of how US can be integrated into patient management protocols to enhance outcomes in patients with MCL injuries.

内侧副韧带(MCL)损伤在运动和其他体育活动中十分常见,是造成膝关节疼痛和功能障碍的重要原因。磁共振成像(MRI)等传统诊断方法因其详细的可视化功能而被广泛使用。然而,肌肉骨骼超声(MSK-US)因其无创性、成本效益和动态成像功能,已成为评估 MCL 损伤的重要诊断工具。本文回顾了 MSK-US 在诊断 MCL 损伤方面的实用性和优势,并特别关注其对康复服务提供者的影响。我们讨论了超声(US)成像的技术方面,包括不同等级 MCL 损伤的声像图外观,并将其诊断准确性与核磁共振成像等其他成像方式进行了比较。此外,还探讨了 US 在监测愈合过程和指导康复策略方面的作用。这篇综述强调了 MSK-US 在临床环境中的实际应用,让康复服务提供者全面了解如何将 US 纳入患者管理方案,以提高 MCL 损伤患者的治疗效果。
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引用次数: 0
Assessing the Relationship of Psychological Sport Readiness, Single-leg Vertical Jump, and Non-Sagittal Single-Leg Hops to Quadriceps Strength After Anterior Cruciate Ligament Reconstruction. 评估前十字韧带重建后运动心理准备、单腿垂直跳跃和非矢状单腿跳与股四头肌力量的关系。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121597
Paul Kuwik, Erin Florkiewicz, Timothy Benedict, John Mason, Jamie Morris, Michael Crowell

Background: Limitations exist with current ACLR functional testing assessments that may be mitigated by including single-leg multi-directional testing.

Hypothesis/purpose: To compare Anterior Cruciate Ligament-Return to Sport after Injury Scale (ACL-RSI) scores, limb symmetry index (LSI) of the single-leg vertical jump (SLVJ), single-leg medial rotation hop (SLMRH), single-leg lateral hop (SLLH), and isokinetic quadriceps strength between participants with an ACLR and healthy controls and assess predictors of quadriceps strength asymmetry. It was hypothesized that ACL-RSI scores and LSIs for all tests would differ between ACLR and healthy control groups and within the ACLR group a strong correlation would exist between all outcome measures and quadriceps strength.

Study design: Cross-Sectional Study.

Methods: Twenty-six participants with an ACLR (median 13 months after surgery) and twenty-six matched healthy controls were recruited to participate in this study. Performance was assessed via SLVJ, SLMRH, SLLH, and isokinetic quadriceps strength. Between-group comparisons were made with independent t-tests and Mann-Whitney U test. Within the ACLR group, bivariate correlation and multivariate regression analysis were performed to assess the relationship between the outcome measures and quadriceps strength asymmetry.

Results: Significant between-limb differences were only identified in the ACLR group (p< 0.05): SLVJ LSI: 88.5%, SLMRH LSI: 93.6%, SLLH LSI: 92.7%, quadriceps strength LSI 80.9% - 83.9%, which were significantly lower (p <0.05) than the healthy control group. Within the ACLR group, a moderate-strong significant (p < 0.05) correlations existed with quadriceps strength and SLVJ (r=0.44-0.65), SLMRH (r =0.43-0.83), and SLLH (r=0.54-0.63); while ACL-RSI had a weak non-significant (p > 0.05) correlation with quadriceps strength (r= 0.12-0.30).

Conclusion: Single-leg multidirectional test LSIs were less in ACLR participants than matched healthy controls and all were directly related to quadriceps strength. Psychological readiness to return to sport was not related to quadriceps strength.

背景:目前的前交叉韧带损伤后恢复运动功能测试评估存在一些局限性,而纳入单腿多方向测试可能会缓解这些局限性。假设/目的:比较前交叉韧带损伤后运动恢复量表(ACL-RSI)得分、单腿垂直跳(SLVJ)、单腿内侧旋转跳(SLMRH)、单腿外侧跳(SLLH)的肢体对称性指数(LSI)以及前交叉韧带损伤参与者和健康对照组之间的等速股四头肌力量,并评估股四头肌力量不对称的预测因素。研究假设:前交叉韧带损伤组和健康对照组的 ACL-RSI 评分和所有测试的 LSI 都不同,而在 ACLR 组中,所有结果测量和股四头肌力量之间存在很强的相关性:研究设计:横断面研究:本研究招募了 26 名前交叉韧带损伤患者(中位数为术后 13 个月)和 26 名匹配的健康对照者。通过SLVJ、SLMRH、SLLH和等速股四头肌力量评估其表现。组间比较采用独立 t 检验和 Mann-Whitney U 检验。在 ACLR 组内,进行了双变量相关分析和多变量回归分析,以评估结果测量与股四头肌力量不对称之间的关系:结果:仅在 ACLR 组发现了肢体间的显著差异(P< 0.05):SLVJ LSI:88.5%,SLMRH LSI:93.6%,SLLH LSI:92.7%,股四头肌力量LSI为80.9% - 83.9%,与股四头肌力量的相关性(r= 0.12-0.30)显著降低(p 0.05):结论:与匹配的健康对照组相比,ACLR 参与者的单腿多向测试 LSI 值较低,且所有 LSI 值均与股四头肌力量直接相关。恢复运动的心理准备与股四头肌力量无关。
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引用次数: 0
Hop Distance Symmetry Moderately Reflects Knee Biomechanics Symmetry During Landing But Not For Controlled Propulsions. 跳跃距离的对称性适度反映了着地时膝关节生物力学的对称性,但对于受控推进却并非如此。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121599
Stefano Di Paolo, Naoaki Ito, Kayla D Seymore, Haraldur B Sigurðsson, Laura Bragonzoni, Stefano Zaffagnini, Lynn Snyder-Mackler, Karin Gravare Silbernagel

Background: Landing with poor knee sagittal plane biomechanics has been identified as a risk factor for Anterior Cruciate Ligament (ACL) injury. However, it is unclear if the horizontal hop test battery reflects knee function and biomechanics.

Hypothesis/purpose: To investigate the correlation between clinical limb symmetry index (LSI) and landing and propulsion knee biomechanics during the hop test battery using markerless motion capture.

Study design: Cross-sectional biomechanics laboratory study.

Methods: Forty-two participants with and without knee surgery (age 28.0 ± 8.0 years) performed the hop test battery which consisted of a single hop for distance, crossover hop, triple hop, and 6-m timed hop in the order listed. Eight high speed cameras were used to collect simultaneous 3D motion data and Theia 3D (Theia Markerless Inc.) was used to generate 3D body model files. Lower limb joint kinematics were calculated in Visual3D. Correlation (Spearman's ρ) was computed between clinical LSI and symmetry in peak and initial contact (IC) knee flexion angle during propulsion and landing phases of each movement.

Results: In the single hop, clinical LSI showed positive correlation with kinematic LSI at peak landing (ρ= 0.39, p=0.011), but no correlation at peak propulsion (ρ= -0.03, p=0.851). In the crossover hop, non-significant correlations were found in both propulsion and landing. In the triple hop, positive correlation was found at peak propulsion (ρ= 0.38, p=0.027), peak landing (ρ= 0.48 - 0.66, p<0.001), and last landing IC (ρ= 0.45, p=0.009). In the timed hop, peak propulsion showed positive correlation (ρ= 0.51, p=0.003).

Conclusions: Single hop and triple hop distance symmetry reflected landing biomechanical symmetry better than propulsion symmetry. Poor scores on the hop test battery reflect asymmetrical knee landing biomechanics, emphasizing the importance of continuing to use the hop test battery as part of clinical decision making.

Level of evidence: 3b.

背景:着地时膝关节矢状面生物力学不良已被确定为前十字韧带(ACL)损伤的风险因素。假设/目的:利用无标记运动捕捉技术,研究临床肢体对称指数(LSI)与跳跃测试中着地和推进膝关节生物力学之间的相关性:研究设计:横断面生物力学实验室研究:42名接受和未接受膝关节手术的参与者(年龄为28.0 ± 8.0岁)按照所列顺序进行了跳跃测试,包括单跳距离、交叉跳、三跳和6米计时跳。八台高速摄像机用于收集同步三维运动数据,Theia 3D(Theia Markerless Inc.)下肢关节运动学在 Visual3D 中进行计算。在每个动作的推进和着地阶段,计算临床 LSI 与膝关节屈伸角度峰值和初始接触(IC)角度对称性之间的相关性(Spearman's ρ):在单跳中,临床 LSI 与着地峰值的运动学 LSI 呈正相关(ρ= 0.39,p=0.011),但与推进峰值无相关性(ρ= -0.03,p=0.851)。在交叉跳跃中,推进和着陆均无显著相关性。在三重跳跃中,推进峰值(ρ= 0.38,p=0.027)、着陆峰值(ρ= 0.48 - 0.66,p结论)均呈正相关:单跳和三跳距离对称性比推进对称性更好地反映了着陆生物力学对称性。跳跃测试的差分反映了不对称的膝关节着地生物力学,强调了继续使用跳跃测试作为临床决策的一部分的重要性:3b.
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引用次数: 0
Acute Effects of Handheld Vibration Massage on Posterior Shoulder Soft Tissues. 手持振动按摩对肩后软组织的急性影响
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121299
Takaki Imai, Takashi Nagamatsu, Yushin Yoshizato, Kodai Miyara, Megumi Sumizono, Masatoshi Nakamura

Background: Interventions using vibration stimulation have been recognized for their potential for increasing range of motion (ROM) without compromising muscle strength. Handheld vibration massagers can efficiently deliver vibration therapy to the shoulder joint and may be a potential treatment.

Purpose: To evaluate the effects of vibration massage using a handheld device on the soft tissues of the posterior shoulder joint, particularly on internal rotation (IR) passive ROM and external rotation (ER) muscle strength.

Study design: Crossover study design.

Methods: A crossover study with a 5-min vibration massage and passive control condition was conducted in healthy male volunteers (mean age 20.5 ± 1.7 years). Vibration massage was applied to the posterior shoulder soft tissues of the dominant arm, with no intervention under control conditions. IR-ROM (vertebral level and in abduction) and strength of the external rotators (isometric and isokinetic) were measured before and immediately after the intervention. Vertebral levels were calculated as a ratio of lengths (ratio decreases with increased mobility). IR-ROM in abduction, the angle was measured. Statistical analysis was performed with two-way repeated measures ANOVA and paired t-test (Bonferroni correction).

Results: Vibration application decreased (improved) vertebral level IR ROM by -4.1% (p < 0.01, d = 0.445) and increased abduction position IR ROM by 11.4° (p < 0.01, d = 0.694). These changes exceeded the 95% confidence interval for the minimum detectable change. By contrast, the control condition produced no changes. IR-ROM (vertebral level and abduction) immediately after the intervention showed significant differences between the control and vibration conditions (p = 0.036, d = 0.273; p = 0.048, d = 0.483, respectively). Muscle strength did not show any interaction, time, or between-condition effects.

Conclusions: A massage using a handheld vibration massager applied to the posterior shoulder soft tissues increased IR-ROM without negatively affecting muscle strength, suggesting its potential use as a means of warming up.

Level of evidence: Level 3.

背景:使用振动刺激进行干预具有在不影响肌肉力量的情况下增加运动范围(ROM)的潜力,这一点已得到认可。目的:评估使用手持设备进行振动按摩对肩关节后部软组织的影响,尤其是对内旋(IR)被动活动范围和外旋(ER)肌肉力量的影响:研究设计:交叉研究设计:在健康男性志愿者(平均年龄为 20.5 ± 1.7 岁)中进行了一项为期 5 分钟的振动按摩和被动控制条件的交叉研究。振动按摩作用于优势手臂的肩部后侧软组织,对照组不进行任何干预。干预前和干预后立即测量 IR-ROM(椎体水平和外展)和外旋肌力量(等长和等动)。椎体水平是以长度比来计算的(随着活动度的增加,比值减小)。测量外展时的 IR-ROM 角度。统计分析采用双向重复测量方差分析和配对 t 检验(Bonferroni 校正):结果:振动使椎体水平 IR ROM 减少(改善)-4.1%(p < 0.01,d = 0.445),外展位置 IR ROM 增加 11.4°(p < 0.01,d = 0.694)。这些变化超过了最小可检测变化的 95% 置信区间。相比之下,对照组则没有任何变化。干预后立即进行的 IR-ROM(椎体水平和外展)在对照组和振动组之间存在显著差异(分别为 p = 0.036,d = 0.273;p = 0.048,d = 0.483)。肌肉力量未显示出任何交互作用、时间或条件间效应:结论:使用手持振动按摩器对肩部后侧软组织进行按摩可增加 IR-ROM,而不会对肌肉力量产生负面影响,这表明振动按摩器有可能用作热身手段:证据等级:3 级。
{"title":"Acute Effects of Handheld Vibration Massage on Posterior Shoulder Soft Tissues.","authors":"Takaki Imai, Takashi Nagamatsu, Yushin Yoshizato, Kodai Miyara, Megumi Sumizono, Masatoshi Nakamura","doi":"10.26603/001c.121299","DOIUrl":"10.26603/001c.121299","url":null,"abstract":"<p><strong>Background: </strong>Interventions using vibration stimulation have been recognized for their potential for increasing range of motion (ROM) without compromising muscle strength. Handheld vibration massagers can efficiently deliver vibration therapy to the shoulder joint and may be a potential treatment.</p><p><strong>Purpose: </strong>To evaluate the effects of vibration massage using a handheld device on the soft tissues of the posterior shoulder joint, particularly on internal rotation (IR) passive ROM and external rotation (ER) muscle strength.</p><p><strong>Study design: </strong>Crossover study design.</p><p><strong>Methods: </strong>A crossover study with a 5-min vibration massage and passive control condition was conducted in healthy male volunteers (mean age 20.5 ± 1.7 years). Vibration massage was applied to the posterior shoulder soft tissues of the dominant arm, with no intervention under control conditions. IR-ROM (vertebral level and in abduction) and strength of the external rotators (isometric and isokinetic) were measured before and immediately after the intervention. Vertebral levels were calculated as a ratio of lengths (ratio decreases with increased mobility). IR-ROM in abduction, the angle was measured. Statistical analysis was performed with two-way repeated measures ANOVA and paired t-test (Bonferroni correction).</p><p><strong>Results: </strong>Vibration application decreased (improved) vertebral level IR ROM by -4.1% (p < 0.01, d = 0.445) and increased abduction position IR ROM by 11.4° (p < 0.01, d = 0.694). These changes exceeded the 95% confidence interval for the minimum detectable change. By contrast, the control condition produced no changes. IR-ROM (vertebral level and abduction) immediately after the intervention showed significant differences between the control and vibration conditions (p = 0.036, d = 0.273; p = 0.048, d = 0.483, respectively). Muscle strength did not show any interaction, time, or between-condition effects.</p><p><strong>Conclusions: </strong>A massage using a handheld vibration massager applied to the posterior shoulder soft tissues increased IR-ROM without negatively affecting muscle strength, suggesting its potential use as a means of warming up.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 8","pages":"1003-1011"},"PeriodicalIF":1.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Point of Care Ultrasound Guided Management of Lateral Ankle Sprains: A Case Series. 超声波引导下的外侧踝关节扭伤治疗:病例系列。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121601
Matthew Bush, Jon Umlauf, Bryan Pickens

Background: Lateral ankle sprain (LAS) is a common injury with incidence rates reported at 7.2 per 1000 person-years. Physical examination strategies provide limited information to guide rehabilitation that can maximize clinical outcomes. Early and accurate diagnostic information using ultrasound imaging enables individualized care and the ability to monitor healing along with its response to activity and rehabilitation.

Purpose: The purpose of this study was to describe and observe the outcomes associated with Point of Care Ultrasound (POCUS) guided early management of acute and sub-acute lateral ankle sprains.

Study design: Case series.

Methods: Individuals with a LAS within the prior 28 days underwent a clinical evaluation to include a POCUS exam to assess ligamentous integrity. Objective and POCUS findings were integrated to classify each LAS into one of four categories. Each grade of ankle sprain corresponded to levels of bracing for the protection of injured structures with each patient receiving physical therapy care based on rehabilitation guidelines. Participants completed the Foot and Ankle Ability Measure (FAAM) activities of daily living and Sports subscale, the Foot and Ankle Outcome Score (FAOS), Patient Reported Outcomes Measurement Information Systems Global Health, Tampa Scale of Kinesiophobia (TSK-11), Cumberland Ankle Instability Tool (CAIT), and the Numeric Pain Rating Scale as well as the Ankle Lunge Test and Figure 8 measurements at baseline, 4 weeks, 8 weeks and 12 weeks post enrollment. The FAAM Sport subscale, all FAOS subscales, and the TSK-11 were also collected at 24 weeks while the CAIT was collected at baseline and 24 weeks.

Results: Fourteen participants were enrolled with 11 participants completing all data collection. FAAM Sport scores significantly improved at 4, 8, 12 and 24 weeks. All components of the FAOS significantly increased except for Sport scores at four weeks and Quality of Life scores at four and eight weeks.

Conclusion: POCUS guided early management and ligamentous protection of LASs resulted in significant short and long-term improvement in function and return to sporting activity. This case series highlights the feasibility of using ultrasound imaging to assess the severity of ligamentous injury and align bracing strategies for ligamentous protection. The observations from this case series suggest that functional bracing strategies focused on ligamentous protection to promote healing and reduce re-injury rates does not delay improvement in functional outcomes.

Level of evidence: Level IV, Case Series.

背景:外踝扭伤(LAS)是一种常见损伤,据报道其发病率为每千人年 7.2 例。体格检查策略只能提供有限的信息来指导康复治疗,从而最大限度地提高临床疗效。目的:本研究旨在描述和观察在护理点超声(POCUS)指导下对急性和亚急性外侧踝关节扭伤进行早期治疗的相关结果:研究设计:病例系列:研究设计:病例系列。方法:对 28 天内发生过外侧踝关节扭伤的患者进行临床评估,其中包括评估韧带完整性的 POCUS 检查。综合客观检查和 POCUS 检查结果,将每个 LAS 分为四类。每个踝关节扭伤等级都对应不同程度的支撑,以保护受伤结构,每位患者都将根据康复指南接受物理治疗。参与者在入组后的基线、4周、8周和12周分别完成了足踝能力测量(FAAM)日常生活活动和运动分量表、足踝结果评分(FAOS)、患者报告结果测量信息系统全球健康状况、坦帕运动恐惧症量表(TSK-11)、坎伯兰踝关节不稳定性工具(CAIT)、数字疼痛评分量表以及踝关节跳跃测试和图8测量。在 24 周时还收集了 FAAM 运动分量表、所有 FAOS 分量表和 TSK-11 量表,并在基线和 24 周时收集了 CAIT 量表:结果:共有 14 名参与者参加,其中 11 人完成了所有数据收集。在 4、8、12 和 24 周时,FAAM 运动得分明显提高。除了四周时的运动得分以及四周和八周时的生活质量得分外,FAOS 的所有组成部分均有明显提高:结论:在 POCUS 的指导下,对 LAS 进行早期管理和韧带保护,可在短期和长期内明显改善其功能并恢复运动能力。本系列病例强调了使用超声成像评估韧带损伤严重程度和调整韧带保护支撑策略的可行性。本系列病例的观察结果表明,以韧带保护为重点的功能性支撑策略可促进愈合并降低再次受伤率,但不会延迟功能性结果的改善:证据等级:IV 级,病例系列。
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引用次数: 0
A Pre and Postnatal Physical Therapy Protocol for Recreational Athletes: A Case Series. 休闲运动员产前产后物理治疗方案:病例系列。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121421
Rachel Selman, Kate S Early

Background and purpose: Recent changes to medical recommendations for exercise in pregnancy and postpartum have expanded to include recreational athletes. While women are transitioning into motherhood at the height of their athletic careers, there is limited guidance on musculoskeletal training from pregnancy through safe return to activity. The lack of education and support in this population may lead to increased prevalence of symptoms and delay of treatment, ultimately hindering athletic performance. The purpose of this case series is to assess pelvic floor symptoms through implementing a new pre- and postnatal exercise training paradigm in a group of women aiming to return to recreational athletics.

Study design: Case series.

Methods: Six recreationally athletic women between 25-35 years of age were referred to physical therapy during pregnancy to participate in this protocol. The women completed a standardized pregnancy and postpartum rehabilitation plan focused on core and pelvic floor control in addition to specific strength and mobility training.

Results: Pain, urinary dysfunction, and pelvic floor muscle strength were assessed at six weeks postpartum and at discharge. Meaningful improvement was noted in pain, urinary dysfunction, and muscle strength by the time of discharge.

Conclusion: The decrease in symptoms and improvements in measures of musculoskeletal health suggests that a physical therapist guided rehabilitation protocol may be useful as part of the standard of care to reduce prevalence of pain and dysfunction, particularly in the recreational athlete population. Improving understanding of exercise training in this population may minimize musculoskeletal symptoms and encourage additional research to improve the standard of care for this group of patients.

Level of evidence: Level 4.

背景和目的:最近,孕期和产后运动的医学建议发生了变化,休闲运动员也被纳入其中。虽然妇女们在运动生涯最辉煌的时候过渡到了母亲的角色,但从怀孕到安全恢复运动,有关肌肉骨骼训练的指导却很有限。这部分人群缺乏教育和支持,可能会导致症状更加普遍和治疗延迟,最终影响运动成绩。本病例系列的目的是通过在一群希望恢复休闲运动的女性中实施新的产前和产后运动训练范例来评估盆底症状:研究设计:病例系列:研究设计:病例系列。方法:六名年龄在 25-35 岁之间的休闲运动女性在怀孕期间被转介到物理治疗中心参与该方案。这些妇女完成了一个标准化的孕期和产后康复计划,除了特定的力量和活动能力训练外,该计划还侧重于核心和骨盆底控制:结果:产后六周和出院时对疼痛、排尿功能障碍和骨盆底肌肉力量进行了评估。到出院时,疼痛、排尿功能障碍和肌肉力量均有明显改善:症状的减轻和肌肉骨骼健康指标的改善表明,理疗师指导的康复方案可作为标准护理的一部分,有助于减少疼痛和功能障碍的发生,尤其是在休闲运动员群体中。加深对这一人群运动训练的了解可最大限度地减少肌肉骨骼症状,并鼓励开展更多研究,以改进对这一群体患者的标准护理:证据等级:4 级。
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引用次数: 0
Reliability of Goniometric Techniques for Measuring Hip Flexor Length Using the Modified Thomas Test. 使用改良托马斯测试法测量髋关节屈肌长度的动态关节角度测量技术的可靠性
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120899
Kira Eimiller, Emma Stoddard, Briana Janes, Mason Smith, Andrew Vincek

Background: The modified Thomas test (MTT) is commonly used to assess the flexibility of hip musculature, including the iliopsoas, rectus femoris, and tensor fascia latae. This measurement is important to include in a comprehensive musculoskeletal examination. However, existing research shows conflicting results regarding its reliability, particularly due to variations in controlling pelvic tilt during testing, which may lead to inaccurate measurements of hip extension when quantifying the test outcomes.

Purpose/hypothesis: This study aimed to evaluate the intra- and inter-rater reliability of the Modified Thomas Test (MTT) in assessing hip flexor length using a goniometer. It was hypothesized that controlling for pelvic tilt would enhance the reliability of these measurements.

Study design: Intra- and inter-rater reliability study.

Methods: Sixty-four healthy individuals were recruited to participate in this study. The MTT was performed twice on each leg by both an experienced and a student physical therapist. Blinded goniometric measurements for hip extension range of motion (ROM) in the MTT position were taken with neutral pelvic tilt being enforced via palpation. A double-blind protocol was used where both examiners were unaware of each other's measurements and the goniometer was covered to blind the measuring therapist to the values as well. ROM values were entered into a Microsoft Excel spreadsheet and quantified using SPSS software. Statistical analysis included calculating Intraclass Correlation Coefficients (ICCs) and Standard Errors of Measurement (SEMs) using SPSS software.

Results: The study included 64 participants (mean age = 23.7 ± 4.34 years). The MTT demonstrated high intra-rater reliability (ICC = 0.911) and inter-rater reliability (ICC = 0.851). The SEMs indicated minimal variability around the mean scores. The average hip extension ROM measured was 5.43± 9.73 degrees.

Conclusion: These results suggest that the MTT is a reliable tool for assessing hip flexor length in clinical practice, particularly when pelvic tilt is controlled. These results have important implications for accurately testing orthopedic limitations that can contribute to low back, hip, and knee pain.

Level of evidence: 3.

背景:改良托马斯试验(MTT)通常用于评估髋关节肌肉组织的柔韧性,包括髂腰肌、股直肌和张力筋膜。这种测量方法在全面的肌肉骨骼检查中非常重要。然而,现有研究显示,其可靠性方面的结果相互矛盾,特别是由于在测试过程中控制骨盆倾斜的变化,这可能导致在量化测试结果时对髋关节伸展的测量不准确:本研究旨在评估改良托马斯测试(MTT)在使用动态关节角度计评估髋关节屈肌长度时的评分者内部和评分者之间的可靠性。研究假设,控制骨盆倾斜将提高这些测量的可靠性:研究设计:内部和评分者之间的可靠性研究:本研究招募了 64 名健康人。由一名经验丰富的理疗师和一名学生分别对每条腿进行两次 MTT 测量。在 MTT 体位下对髋关节伸展运动范围(ROM)进行盲测角测量,并通过触诊来强制骨盆中性倾斜。测量采用双盲方案,两位检查者都不知道对方的测量结果,而且动态关节角度计被盖住,使测量治疗师也看不到测量值。ROM 值被输入 Microsoft Excel 电子表格,并使用 SPSS 软件进行量化。统计分析包括使用 SPSS 软件计算类内相关系数(ICC)和测量标准误差(SEM):研究包括 64 名参与者(平均年龄 = 23.7 ± 4.34 岁)。MTT 显示了较高的评分者内部可靠性(ICC = 0.911)和评分者之间可靠性(ICC = 0.851)。SEM显示平均分的变化极小。所测得的平均髋关节伸展 ROM 为 5.43±9.73 度:这些结果表明,MTT 是临床实践中评估髋关节屈肌长度的可靠工具,尤其是在骨盆倾斜得到控制的情况下。这些结果对于准确测试可能导致腰背、髋关节和膝关节疼痛的矫形限制具有重要意义:3.
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引用次数: 0
Shoulder Pain in Competitive Swimmers: A Multi-Site Survey Study. 竞技游泳运动员的肩部疼痛:多站点调查研究
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121114
Brian D Stirling, Jonathan C Sum, Lisa Baek, Lori A Michener, Adam J Barrack, Angela R Tate

Background: There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers.

Purpose: To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction.

Study design: Multi-site cross-sectional design.

Methods: Six-hundred and seventy-one swimmers aged 9-17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability.

Results: Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001).

Conclusion: Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability.

Level of evidence: III.

背景:目的:确定青少年竞技游泳运动员肩痛、残疾和不满意的发生率。次要目的是确定年龄、游泳竞技经验和以前的肩痛或受伤史对肩痛、残疾和不满意度的影响,最后确定性别、地理区域和参加第二项运动是否与肩痛、残疾和不满意度有关:研究设计:多地点横断面设计:来自美国 6 个州的 671 名 9-17 岁游泳运动员填写了调查问卷,其中包括人口统计数据、宾大肩部评分(PSS)和手臂肩部手部残疾(DASH)运动。对疼痛、残疾、不满意度以及年龄、性别、参加第二项运动、地理区域和肩部疼痛史的影响进行了独立 t 检验。还进行了线性回归分析,以确定这些变量与所报告的疼痛和残疾之间的相互作用:结果:49%的游泳运动员有肩部症状。与 9 至 10 岁的游泳者相比,15 至 17 岁的游泳者肩部疼痛和残疾程度更高(疼痛和残疾程度:p):在接受调查的游泳运动员中,近一半的人有肩痛症状,年龄越大、游泳经验越丰富以及曾有过肩痛或外伤的人肩痛发生率越高。进一步的研究应该对肩痛预防计划进行调查,并建议采用监测方法来识别有症状的游泳者,这些人可能会从转诊中受益,以防止进一步的疼痛和残疾:证据等级:III。
{"title":"Shoulder Pain in Competitive Swimmers: A Multi-Site Survey Study.","authors":"Brian D Stirling, Jonathan C Sum, Lisa Baek, Lori A Michener, Adam J Barrack, Angela R Tate","doi":"10.26603/001c.121114","DOIUrl":"10.26603/001c.121114","url":null,"abstract":"<p><strong>Background: </strong>There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers.</p><p><strong>Purpose: </strong>To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction.</p><p><strong>Study design: </strong>Multi-site cross-sectional design.</p><p><strong>Methods: </strong>Six-hundred and seventy-one swimmers aged 9-17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability.</p><p><strong>Results: </strong>Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001).</p><p><strong>Conclusion: </strong>Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 8","pages":"965-975"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11297363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quadriceps Activation After Anterior Cruciate Ligament Reconstruction: The Early Bird Gets the Worm! 前十字韧带重建后的股四头肌激活:早起的鸟儿有虫吃!
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.121423
Ayrton Moiroux-Sahraoui, Florian Forelli, Jean Mazeas, Alexandre Jm Rambaud, Andreas Bjerregaard, Jérôme Riera

Arthrogenic Muscle Inhibition (AMI) is a phenomenon observed in individuals with joint injury or pathology, characterized by a reflexive inhibition of surrounding musculature, altered neuromuscular control, and compromised functional performance. After anterior cruciate ligament reconstruction (ACLR) one of the most obvious consequences of AMI is the lack of quadriceps activation and strength. Understanding the underlying mechanisms of AMI is crucial for developing effective therapeutic interventions. The surgical procedure needed to reconstruct the ACL has biochemical et physiological consequences such as inflammation, pain, and altered proprioception. These alterations contribute to the development of AMI. Therapeutic interventions aimed at addressing AMI encompass a multidimensional approach targeting pain reduction, inflammation management, proprioceptive training, and quadriceps activation. Early management focusing on pain modulation through modalities like ice, compression, and pharmacological agents help mitigate the inflammatory response and alleviate pain, thereby reducing the reflexive inhibition of quadriceps. Quadriceps activation techniques such as neuromuscular electrical stimulation (NMES) and biofeedback training aid in overcoming muscle inhibition and restoring muscle strength. NMES elicits muscle contractions through electrical stimulation, bypassing the inhibitory mechanisms associated with AMI, thus facilitating muscle activation and strength gains. Comprehensive rehabilitation programs tailored to individual needs and stage of recovery are essential for optimizing outcomes in AMI. The objective of this clinical viewpoint is to delineate the significance of adopting a multimodal approach for the effective management of AMI, emphasizing the integration of pain modulation, proprioceptive training, muscle activation techniques, and manual therapy interventions. Highlighting the critical role of early intervention and targeted rehabilitation programs, this article aims to underscore their importance in restoring optimal function and mitigating long-term complications associated with AMI.

关节源性肌肉抑制(AMI)是一种在关节损伤或病变患者身上观察到的现象,其特征是对周围肌肉组织的反射性抑制、神经肌肉控制的改变以及功能表现的受损。在前十字韧带重建(ACLR)后,AMI 最明显的后果之一就是股四头肌缺乏激活和力量。了解 AMI 的基本机制对于制定有效的治疗干预措施至关重要。重建前交叉韧带所需的手术过程会产生生化和生理后果,如炎症、疼痛和本体感觉改变。这些改变会导致 AMI 的发生。针对 AMI 的治疗干预措施包括针对减轻疼痛、炎症控制、本体感觉训练和股四头肌激活的多维方法。早期治疗的重点是通过冰敷、压迫和药物等方式调节疼痛,这有助于减轻炎症反应和缓解疼痛,从而减少对股四头肌的反射性抑制。神经肌肉电刺激(NMES)和生物反馈训练等股四头肌激活技术有助于克服肌肉抑制和恢复肌肉力量。神经肌肉电刺激通过电刺激引起肌肉收缩,绕过与 AMI 相关的抑制机制,从而促进肌肉激活和力量增强。根据个人需求和康复阶段量身定制的综合康复计划对于优化急性心肌梗死的治疗效果至关重要。本临床观点旨在阐明采用多模式方法有效治疗急性心肌梗死的意义,强调疼痛调节、本体感觉训练、肌肉激活技术和徒手治疗干预的整合。本文强调早期干预和有针对性的康复计划的关键作用,旨在强调它们在恢复最佳功能和减轻急性心肌梗死相关长期并发症方面的重要性。
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引用次数: 0
Lower-Quarter Y-Balance Test Differs by Age: Younger Athletes May Not Be Generalized to High School-Aged Counterparts. 低季度 Y 平衡测试因年龄而异:年龄较小的运动员可能无法推广到高中年龄段的运动员。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120898
James J McGinley, Ben Randoing, Laura Saleem, Caroline Podvin, Henry B Ellis, Philip L Wilson, Sophia Ulman

Background: Given rising youth sport participation, 8 to 10-year-olds increasingly display comparable lower-extremity injury incidence to 11 to 17-year-olds and require effective return to sport criteria. One such criterion which quantifies dynamic stability is the Y-Balance Test (YBT), though it has not been validated in children under age 11.

Hypothesis/purpose: The purpose of this study was to examine the performance of 8 to 10-year-old patients on the YBT after lower-extremity injury and determine how these results compare to larger samples of age-grouped athletes within the validated 11 to 17-year-old range. It was hypothesized that 8 to 10-year-olds would display different normalized YBT distances compared to 11 to 17-year-olds.

Study design: Cross-sectional Study.

Methods: Patients (N=1093) aged 8 to 17 who presented to a pediatric sports medicine practice with a lower-extremity injury and completed the YBT between December 2015-May 2021 were included. Anterior, posteromedial, and posterolateral YBT scores were collected at return-to-sport for affected and unaffected limbs. Scores were normalized to limb length, and composite scores were created. Between-limb differences were calculated in groups of ages 8-10, 11-12, 13-14, and 15-17. Groups were also evaluated for differences by sex.

Results: A rise in performance was observed in unaffected limb anterior reach from ages 8 to 10 years to 11 to 12 years followed by a subsequent significant decrease at older ages (p<0.001). Affected limb anterior reach differed between the youngest group and two oldest groups (p=0.004). Anterior and composite difference were significantly different between the oldest three groups (p=0.014 anterior; p=0.024 composite). No differences were observed between sexes in 8 to 10-year-olds, though 11 to 12-year-old females reached further during all eight distances. In the older three groups, males generally displayed greater between-limb differences.

Conclusion: YBT scores, specifically anterior reach, demonstrated inconsistency by age and sex across a large adolescent cohort. Existing return-to-sport standards should not be used with younger athletes, and individual validation is required.

Level of evidence: Level III.

背景:鉴于青少年参与体育运动的人数不断增加,8 至 10 岁儿童下肢受伤的发生率日益与 11 至 17 岁儿童相当,因此需要制定有效的重返运动场标准。假设/目的:本研究的目的是检查 8 至 10 岁患者在下肢受伤后在 YBT 中的表现,并确定这些结果如何与 11 至 17 岁年龄组运动员的更大样本进行比较。研究假设:与 11-17 岁的青少年相比,8-10 岁的青少年将表现出不同的标准化 YBT 距离:研究设计:横断面研究:纳入2015年12月至2021年5月期间因下肢受伤到儿科运动医学诊所就诊并完成YBT的8至17岁患者(N=1093)。在恢复运动时收集患肢和未受影响肢体的前侧、后内侧和后外侧 YBT 分数。根据肢体长度对得分进行归一化处理,并创建综合得分。按 8-10 岁、11-12 岁、13-14 岁和 15-17 岁年龄组计算肢体间差异。同时还评估了各组的性别差异:结果:非受影响肢体的前伸能力在 8-10 岁至 11-12 岁期间有所提高,但在较大年龄段则显著下降(p):在一个庞大的青少年群体中,YBT 分数,特别是前伸能力,显示出不同年龄和性别的不一致性。现有的重返运动场标准不适用于年龄较小的运动员,需要进行个体验证:证据等级:III 级。
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引用次数: 0
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International Journal of Sports Physical Therapy
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