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Rehabilitation Following ACL Repair with Internal Brace Ligament Augmentation in Female Gymnast: A Resident's Case Report. 女体操运动员前交叉韧带修复术后的康复与内支架韧带增强术:一名住院医师的病例报告。
IF 1.7 Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117773
Colten Haack, Giorgio Zeppieri, Micheal W Moser

Introduction: Anterior Cruciate Ligament (ACL) injuries continue to be a major source of morbidity in gymnastics. The gold standard is to perform an ACL Reconstruction (ACLR). However, injuries to the proximal femoral attachment of the ACL have demonstrated an ability to regenerate. An alternative surgical intervention to the ACLR in this ACL tear subgroup is an ACL repair. The purpose of this case report is to provide a rehabilitation progression for a female gymnast after an ACL repair with Internal Brace Ligament Augmentation (IBLA).

Case description: The subject was a 16-year-old female who presented with a Sherman Type 1 proximal avulsion of her ACL. She underwent an ACL repair with IBLA. Physical therapy interventions followed a sequential and multi-phased approach based on time for tissue physiologic healing and individual progression. Patient reported outcomes including the International Knee Documentation Committee (IKDC), the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) were assessed in conjunction with isokinetic strength and hop performance testing to determine return to sport readiness.

Outcomes: The subject completed 42 sessions over the course of 26 weeks in addition to a home exercise program. At return to sport, clinically meaningful improvement was observed in patient reported outcomes including the IKDC, ACL-RSI, and OSPRO-YF. Additionally, strength and hop performance surpassed established thresholds of clinical significance. The subject returned to sport at six months post-operatively.

Conclusion: The subject in this case report returned to full participation in gymnastics six months after an ACL repair with internal bracing following a sequential and multi-phased rehabilitation. The primary ACL repair with IBLA appeared beneficial to this patient and could benefit from additional study in other athletes and athletic populations.

Level of evidence: Level 5.

导言:前十字韧带(ACL)损伤仍然是体操运动中的主要发病原因。金标准是进行前交叉韧带重建术(ACLR)。然而,前交叉韧带股骨近端附着处的损伤已被证明具有再生能力。在前交叉韧带撕裂亚组中,前交叉韧带修复术是替代前交叉韧带重建术的另一种手术疗法。本病例报告的目的是为一名体操女运动员提供前交叉韧带修复术(IBLA)后的康复进展情况:病例描述:患者是一名 16 岁的女性,前十字韧带谢尔曼 1 型近端撕脱。她接受了前交叉韧带修补术和 IBLA。物理治疗干预根据组织生理愈合时间和个体进展情况采取了有序、多阶段的方法。患者报告的结果包括国际膝关节文献委员会(IKDC)、前交叉韧带损伤后恢复运动(ACL-RSI)和转诊和结果黄旗预测最佳筛查(OSPRO-YF),并结合等动力量和跳跃性能测试进行评估,以确定恢复运动的准备情况:受试者在 26 周内完成了 42 次训练,此外还参加了家庭锻炼计划。在恢复运动时,患者报告的结果(包括IKDC、ACL-RSI和OSPRO-YF)均有临床意义的改善。此外,力量和跳跃表现也超过了既定的临床意义阈值。受试者在术后六个月重返运动场:结论:本病例报告中的受试者在前交叉韧带修复术后 6 个月,经过有序、多阶段的康复治疗后,完全恢复了体操运动。采用 IBLA 进行前交叉韧带初次修复似乎对该患者有益,可在其他运动员和运动人群中进行更多研究:证据等级:5 级。
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引用次数: 0
Postural Control During Single-Leg Landing in Female Athletes After Anterior Cruciate Ligament Reconstruction. 前十字韧带重建后女运动员单腿着地时的姿势控制。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117400
Ayane Ogura, Terumitsu Miyazaki, Hirofumi Ida, Satoshi Shibata, Masahiro Takemura

Background: Secondary anterior cruciate ligament (ACL) injury is a complication of ACL reconstruction (ACLR), which may result from altered neuromuscular control affecting anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) required for maintaining balance during movement. However, it remains unclear how APAs and CPAs differ in single-leg landings post-ACLR compared to healthy subjects.

Purpose: The purpose of this study was to clarify the differences in muscle activities of APAs and CPAs, lower limb kinematics, and kinetics between athletes with a history of ACLR and healthy athletes during single-leg landing.

Study design: Cross-sectional study.

Methods: Eighteen female athletes were recruited and divided into ACLR (n = 9) and control groups (n = 9). The experimental task involved a single-leg landing from a 30 cm box. Joint angles and moments were determined using a 3-dimensional motion analysis system, while muscle activity was assessed using surface electromyography. Analysis intervals were divided into two phases: the APA phase (-150 ms to 50 ms) and the CPA phase (50 ms to 250 ms), with initial contact (0 ms) as the reference point. Muscle activity onset time was defined as the time when the baseline exceeded by the sum of mean values and 2 standard deviations.

Results: No significant differences were observed in muscle activity or onset time between the ACLR and control groups. However, an increased hip external rotation moment was observed during the CPA phase in the ACLR group.

Conclusion: These findings suggest that APAs and CPAs of athletes who returned to sports more than 1 year post-ACLR may be similar. The increased hip external rotation moment in the ACLR group during the CPA phase could represent a specific compensatory strategy to decrease the hip internal rotation angle post-ACLR.

Level of evidence: III.

背景:继发性前交叉韧带(ACL)损伤是前交叉韧带重建术(ACLR)的并发症之一,其原因可能是神经肌肉控制发生了改变,影响了运动过程中保持平衡所需的预期姿势调整(APA)和补偿姿势调整(CPA)。目的:本研究旨在阐明前交叉韧带损伤后运动员与健康运动员在单腿着地时,前交叉韧带损伤后运动员的前交叉韧带损伤后肌肉活动、下肢运动学和动力学方面的差异:研究设计:横断面研究:招募 18 名女运动员,分为前交叉韧带损伤组(9 人)和对照组(9 人)。实验任务包括从一个 30 厘米的箱子中单脚着地。使用三维运动分析系统测定关节角度和力矩,同时使用表面肌电图评估肌肉活动。分析间隔分为两个阶段:APA 阶段(-150 毫秒至 50 毫秒)和 CPA 阶段(50 毫秒至 250 毫秒),以初始接触(0 毫秒)为参考点。肌肉活动开始时间定义为基线超过平均值和 2 个标准差之和的时间:结果:前交叉韧带置换组和对照组的肌肉活动或开始时间没有明显差异。然而,在前交叉韧带撕裂矫正组的 CPA 阶段,观察到髋关节外旋力矩增加:这些研究结果表明,前交叉韧带修复术后一年以上恢复运动的运动员的APA和CPA可能相似。ACLR组在CPA阶段髋关节外旋力矩的增加可能是ACLR后减少髋关节内旋角的一种特殊补偿策略:证据等级:III。
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引用次数: 0
Periscapular Strength Profile Changes in Collegiate Baseball Pitchers Over the Course of a Season. 大学棒球投手在一个赛季中的肩胛骨力量曲线变化。
IF 1.7 Q3 Medicine Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117398
Patrick S Pabian, Victoria Roach, Roselin Howard, Lauren Johnston, Ryan McGuire

Background: Repetitive application of high forces to the shoulder and scapular musculature during the pitching motion over the course of a collegiate baseball season may lead to changes in strength and increased fatigue, potentially predisposing pitching athletes to injury. The purpose of this study was to investigate periscapular strength profiles of Division I collegiate baseball players over the course of a season.

Methods: This study was a retrospective data analysis of 18 Division I baseball pitchers. Isometric scapular plane abduction (scaption), external rotator, internal rotator, middle trapezius, and lower trapezius isometric strength was measured on throwing arm of each subject using a MicroFET 2 handheld dynamometer. Data were collected in a single session at the preseason, midseason, and postseason of the college baseball season, which spanned a five-month period. A repeated measures ANOVA was utilized to determine if there was a significant change in periscapular strength across the baseball season.

Results: Over the three time-points, all strength values decreased for each muscle group, with decreases ranging from 3-14%. Changes in scaption strength values were statistically significant (p=0.018, partial eta squared =0.284) with an 8% reduction over the entire season, specifically with a 5% decline from mid-season to post-season. While external rotator, internal rotator, middle trapezius, and lower trapezius strength values all decreased over the course of the season (range 0.02kg to 1.8kg), these differences were not statistically significant. However, the middle trapezius strength value change (1.3kg loss) exceeded the minimal detectible change.

Conclusion: Periscapular muscles in baseball pitchers diminish in strength over the course of a collegiate baseball season. Understanding strength changes over the course of a season may influence training and therapeutic interventions.

Level of evidence: 3b.

背景:在大学棒球赛季的投球运动中,肩部和肩胛骨肌肉组织反复承受高强度的力量,可能会导致力量变化和疲劳增加,从而使投球运动员容易受伤。本研究的目的是调查第一组大学棒球运动员在一个赛季中的肩胛周围力量概况:本研究对 18 名 I 组棒球投手进行了回顾性数据分析。使用 MicroFET 2 手持式测力计测量了每位受试者投掷臂的等长肩胛平面外展(肩胛)、外旋肌、内旋肌、斜方肌中部和斜方肌下部的等长力量。数据是在大学棒球赛季的季前赛、季中赛和季后赛的一次训练中收集的,为期五个月。采用重复测量方差分析来确定整个棒球赛季中肩胛骨周围力量是否有显著变化:结果:在三个时间点上,每个肌群的所有力量值都有所下降,降幅在 3-14% 之间。肩胛骨力量值的变化具有统计学意义(P=0.018,部分 eta 平方 =0.284),整个赛季下降了 8%,特别是从赛季中期到赛季后下降了 5%。虽然外旋肌、内旋肌、斜方肌中段和斜方肌下段的力量值在整个赛季中都有所下降(范围为 0.02 千克至 1.8 千克),但这些差异在统计学上并不显著。然而,斜方肌中部力量值的变化(减少 1.3 千克)超过了可检测到的最小变化:结论:在大学棒球赛季中,棒球投手肩胛周围肌肉的力量会减弱。了解一个赛季中的力量变化可能会对训练和治疗干预产生影响:3b.
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引用次数: 0
Effects of Low-Load Blood Flow Restriction Training on Rotator Cuff Strength and Hypertrophy: Case Series. 低负荷血流限制训练对肩袖力量和肥厚的影响:病例系列。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.118143
Daniel W Safford, Kshamata M Shah, Frederic Breidenbach, Philip W McClure

Background: The rotator cuff (RC) plays a pivotal role in the performance and health of the shoulder and upper extremity. Blood flow restriction training (BFRT) is a modality to improve strength and muscle hypertrophy with even low-load training in healthy and injured individuals. There is minimal evidence examining its effect proximal to the occluded area, and particularly on the RC.

Hypothesis & purpose: The purpose of this case series is to explore the effects of low-load BFRT on RC strength, hypertrophy, and tendon thickness in asymptomatic individuals.

Study design: Case series.

Methods: Fourteen participants with asymptomatic, untrained shoulders were recruited to participate. They performed an eight-week low-load shoulder exercise regimen where BFR was applied to the dominant arm only during exercise. The dependent variables were maximal isometric strength of the shoulder external rotators(ER) and elevators (in the scapular plane in full can position) (FC) measured via handheld dynamometry, cross sectional area (CSA) of the supraspinatus and infraspinatus muscles, and supraspinatus tendon thickness measured via ultrasound imaging (US). Mean changes within and between arms were compared after training using paired t-tests. Cohen's d was used to determine effect sizes.

Results: All participants were able to complete the BFRT regimen without adverse effects. Mean strength and CSA increased for all variables in both arms, however this increase was only significant (p<0.01) for FC strength bilaterally and CSA for the supraspinatus and infraspinatus on the BFRT side. The effect sizes for increased supraspinatus and infraspinatus CSA on the BFRT side were 0.40 (9.8% increase) and 0.46 (11.7% increase) respectively. There were no significant differences when comparing the mean changes of the BFRT side to the non-BFRT side for strength or muscle CSA. There were no significant changes to supraspinatus tendon thickness.

Conclusion: These results suggest variability in response of the RC musculature to low-load BFRT in asymptomatic individuals. The potential for a confounding systemic response in the study design makes determining whether low-load BFRT is more beneficial than low-load non-BFRT difficult. The hypertrophy seen on the BFRT side warrants further study.

Level of evidence: 4.

背景:肩袖(RC)对肩部和上肢的表现和健康起着举足轻重的作用。血流限制训练(BFRT)是一种通过低负荷训练提高健康和受伤人员力量和肌肉肥大的方法。假设与目的:本病例系列旨在探讨低负荷 BFRT 对无症状个体的 RC 力量、肥大和肌腱厚度的影响:研究设计:病例系列:研究设计:病例系列。方法:招募 14 名无症状、未接受过肩部训练的参与者。他们进行了为期八周的低负荷肩部锻炼,在锻炼过程中仅在优势臂上施加 BFR。因变量是通过手持测力计测量的肩关节外旋肌(ER)和上举肌(在肩胛平面完全可动位置)的最大等长力量(FC)、冈上肌和冈下肌的横截面积(CSA)以及通过超声波成像(US)测量的冈上肌腱厚度。使用配对 t 检验比较训练后臂内和臂间的平均变化。结果:结果:所有参与者都能完成 BFRT 训练,无不良反应。两组所有变量的平均力量和CSA均有所增加,但这种增加仅具有显著性(p/结论:这些结果表明,在无症状的个体中,RC 肌肉对低负荷 BFRT 的反应存在差异。由于研究设计中可能存在混杂的全身反应,因此很难确定低负荷 BFRT 是否比低负荷非 BFRT 更有益。BFRT侧的肥大值得进一步研究:4.
{"title":"Effects of Low-Load Blood Flow Restriction Training on Rotator Cuff Strength and Hypertrophy: Case Series.","authors":"Daniel W Safford, Kshamata M Shah, Frederic Breidenbach, Philip W McClure","doi":"10.26603/001c.118143","DOIUrl":"10.26603/001c.118143","url":null,"abstract":"<p><strong>Background: </strong>The rotator cuff (RC) plays a pivotal role in the performance and health of the shoulder and upper extremity. Blood flow restriction training (BFRT) is a modality to improve strength and muscle hypertrophy with even low-load training in healthy and injured individuals. There is minimal evidence examining its effect proximal to the occluded area, and particularly on the RC.</p><p><strong>Hypothesis & purpose: </strong>The purpose of this case series is to explore the effects of low-load BFRT on RC strength, hypertrophy, and tendon thickness in asymptomatic individuals.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Methods: </strong>Fourteen participants with asymptomatic, untrained shoulders were recruited to participate. They performed an eight-week low-load shoulder exercise regimen where BFR was applied to the dominant arm only during exercise. The dependent variables were maximal isometric strength of the shoulder external rotators(ER) and elevators (in the scapular plane in full can position) (FC) measured via handheld dynamometry, cross sectional area (CSA) of the supraspinatus and infraspinatus muscles, and supraspinatus tendon thickness measured via ultrasound imaging (US). Mean changes within and between arms were compared after training using paired t-tests. Cohen's d was used to determine effect sizes.</p><p><strong>Results: </strong>All participants were able to complete the BFRT regimen without adverse effects. Mean strength and CSA increased for all variables in both arms, however this increase was only significant (p<0.01) for FC strength bilaterally and CSA for the supraspinatus and infraspinatus on the BFRT side. The effect sizes for increased supraspinatus and infraspinatus CSA on the BFRT side were 0.40 (9.8% increase) and 0.46 (11.7% increase) respectively. There were no significant differences when comparing the mean changes of the BFRT side to the non-BFRT side for strength or muscle CSA. There were no significant changes to supraspinatus tendon thickness.</p><p><strong>Conclusion: </strong>These results suggest variability in response of the RC musculature to low-load BFRT in asymptomatic individuals. The potential for a confounding systemic response in the study design makes determining whether low-load BFRT is more beneficial than low-load non-BFRT difficult. The hypertrophy seen on the BFRT side warrants further study.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248960","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
Reliability of Spatiotemporal Characteristics During Single-Legged Hop and Bilateral Drop Jump Tasks Using an Instrumented Pressure Walkway. 使用仪器压力步行道进行单脚跳和双侧落跳任务时的时空特征的可靠性。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117401
Matthew McManigal, Austin Post, Michael Allen, Alyx Jorgensen, MIke Rosenthal, Michael Wellsandt, Matthew Tao, Elizabeth Wellsandt

Background: Single-legged hop tests have been widely used to assess performance-based outcomes after anterior cruciate ligament (ACL) reconstruction. Traditional single, triple, or 6-meter (6m) timed hop tests only measure distance or time as the principal variables, neglecting other variables, such as individual hop distances within a series of hops, flight time, and stance time. The development of portable instrumented pressure walkways has made it possible to collect parameters such as hop velocity, flight time, stance time, distance, and pressure outside of a laboratory setting. However, the reliability of instrumented pressure walkways in measuring spatial and temporal variables during single-legged hop tests is unknown. This study aimed to determine if the Zeno walkway can reliably measure spatiotemporal (ST) characteristics of hop tests.

Study design: Cross-Sectional Study.

Methods: Individuals (n=38) in this cross-sectional study performed single, triple, and 6m hop tests on a pressure-sensitive Zeno walkway. Twenty-one participants completed follow-up testing between one and 14 days later. Intraclass correlation coefficients (ICC(3,k)) were used to assess test-retest reliability of ST variables. The accuracy of vertical jump height and 6m hop timing were also measured.

Results: All ST variables demonstrated excellent test-retest reliability (ICC > 0.86) with small minimal detectable change (MDC) values during single-legged hop tests. Six-meter hop time and jump height during a bilateral drop jump were also accurately measured by the walkway.

Conclusion: An instrumented pressure walkway is a novel tool to reliably assess non-traditional parameters of clinically relevant hop and jump tests such as flight time, stance time, and jump height after lower extremity injury, surgery, and rehabilitation.

Level of evidence: 3b.

背景:单腿跳跃测试已被广泛用于评估前交叉韧带(ACL)重建后的性能结果。传统的单次、三次或 6 米计时跳跃测试仅测量距离或时间作为主要变量,而忽略了其他变量,如一系列跳跃中的单次跳跃距离、飞行时间和站立时间。便携式压力步道仪器的开发使得在实验室外收集跳跃速度、飞行时间、站立时间、距离和压力等参数成为可能。然而,在单腿跳跃测试中,压力步行道测量空间和时间变量的可靠性尚不清楚。本研究旨在确定 Zeno 步道能否可靠地测量跳跃测试的时空(ST)特征:研究设计:横断面研究:在这项横断面研究中,参与者(人数=38)在压力敏感型泽诺步道上进行了单跳、三跳和6米跳测试。21名参与者在1至14天后完成了后续测试。类内相关系数(ICC(3,k))用于评估ST变量的测试-再测可靠性。此外,还测量了垂直跳跃高度和 6 米跳计时的准确性:结果:在单腿跳跃测试中,所有 ST 变量均表现出极佳的重测可靠性(ICC > 0.86),且最小可检测变化(MDC)值较小。此外,压力步行道还能精确测量双侧下落式跳跃的六米跳跃时间和跳跃高度:带仪器的压力走道是一种新型工具,可用于可靠评估临床相关跳跃测试的非传统参数,如下肢损伤、手术和康复后的飞行时间、站立时间和跳跃高度:3b.
{"title":"Reliability of Spatiotemporal Characteristics During Single-Legged Hop and Bilateral Drop Jump Tasks Using an Instrumented Pressure Walkway.","authors":"Matthew McManigal, Austin Post, Michael Allen, Alyx Jorgensen, MIke Rosenthal, Michael Wellsandt, Matthew Tao, Elizabeth Wellsandt","doi":"10.26603/001c.117401","DOIUrl":"10.26603/001c.117401","url":null,"abstract":"<p><strong>Background: </strong>Single-legged hop tests have been widely used to assess performance-based outcomes after anterior cruciate ligament (ACL) reconstruction. Traditional single, triple, or 6-meter (6m) timed hop tests only measure distance or time as the principal variables, neglecting other variables, such as individual hop distances within a series of hops, flight time, and stance time. The development of portable instrumented pressure walkways has made it possible to collect parameters such as hop velocity, flight time, stance time, distance, and pressure outside of a laboratory setting. However, the reliability of instrumented pressure walkways in measuring spatial and temporal variables during single-legged hop tests is unknown. This study aimed to determine if the Zeno walkway can reliably measure spatiotemporal (ST) characteristics of hop tests.</p><p><strong>Study design: </strong>Cross-Sectional Study.</p><p><strong>Methods: </strong>Individuals (n=38) in this cross-sectional study performed single, triple, and 6m hop tests on a pressure-sensitive Zeno walkway. Twenty-one participants completed follow-up testing between one and 14 days later. Intraclass correlation coefficients (ICC(3,k)) were used to assess test-retest reliability of ST variables. The accuracy of vertical jump height and 6m hop timing were also measured.</p><p><strong>Results: </strong>All ST variables demonstrated excellent test-retest reliability (ICC > 0.86) with small minimal detectable change (MDC) values during single-legged hop tests. Six-meter hop time and jump height during a bilateral drop jump were also accurately measured by the walkway.</p><p><strong>Conclusion: </strong>An instrumented pressure walkway is a novel tool to reliably assess non-traditional parameters of clinically relevant hop and jump tests such as flight time, stance time, and jump height after lower extremity injury, surgery, and rehabilitation.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247010","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
Strength of the Uninvolved Limb Following Return to Activity After ACL Injury: Implications for Symmetry as a Marker of Sufficient Strength. 前交叉韧带损伤后恢复活动时未受累肢体的力量:对称性作为足够力量标志的意义。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.117547
Matthew T Hartshorne, Jeffrey A Turner, Kenneth L Cameron, Darin A Padua

Background: Muscular strength deficits are common after ACL injury. While the Limb Symmetry Index (LSI), using the uninvolved limb as a reference, is widely used, negative strength adaptations may affect both limbs post-injury. It is uncertain how the strength of the uninvolved limb in those with an ACL injury compares to uninjured individuals, making it unclear whether it is appropriate as a benchmark for determining sufficient strength.

Purpose: To compare the strength of key lower extremity muscles of the uninvolved limb in those with history of ACL injury (ACL-I) to the dominant limb in individuals with no history of ACL injury (control).

Study design: Cross-sectional study. Methods: A total of 5,727 military cadets were examined, with 82 females and 126 males in the ACL-I group and 2,146 females and 3,373 males in the control group. Maximum isometric strength was assessed for six muscle groups measured with a hand-held dynamometer. Separate two-way ANOVAs with limb and sex were performed for each muscle group.

Results: Significant main effects for limb were observed with the uninvolved limb in the ACL-I group displaying greater strength compared to the dominant limb in the control group for the quadriceps, hamstrings, and gluteus medius, but effect sizes were small (Cohen's d <0.25). Significant main effects for sex were observed with greater male muscular strength in all six muscle groups with small to large effect sizes (Cohen's d 0.49-1.46). No limb-by-sex interactions were observed.

Conclusions: There was no evidence of reduced strength in the uninvolved limb in those with a history of ACL injury compared to the dominant limb in those with no prior ACL injury. This finding suggests that, after clearance to return to activities, the uninvolved limb can be used as a standard for comparison of sufficient strength, including when using the LSI. Level of Evidence: Level 3.

背景:前交叉韧带损伤后常见肌肉力量不足。虽然肢体对称指数(LSI)以未受累肢体为参考,但受伤后的负性力量适应可能会影响双侧肢体,因此该指数被广泛使用。目的:比较有前交叉韧带损伤史(ACL-I)的患者的未受累肢体与无前交叉韧带损伤史(对照组)的优势肢体的主要下肢肌肉力量:研究设计:横断面研究。研究方法:横断面研究:共有5727名军校学员接受了研究,其中前交叉韧带损伤(ACL-I)组有82名女性和126名男性,对照组有2146名女性和3373名男性。用手持式测力计测量了六组肌肉的最大等长力量。对每组肌肉分别进行了肢体和性别的双向方差分析:结果:观察到肢体有显著的主效应,与对照组的优势肢体相比,ACL-I 组的非优势肢体显示出更大的股四头肌、腘绳肌和臀中肌力量,但效应大小较小(Cohen's d 结论):与前交叉韧带未受伤者的优势肢体相比,前交叉韧带曾受伤者的非受累肢体力量并没有减弱的迹象。这一结果表明,在获准恢复活动后,未受累肢体可用作比较足够力量的标准,包括在使用 LSI 时。证据等级:3 级。
{"title":"Strength of the Uninvolved Limb Following Return to Activity After ACL Injury: Implications for Symmetry as a Marker of Sufficient Strength.","authors":"Matthew T Hartshorne, Jeffrey A Turner, Kenneth L Cameron, Darin A Padua","doi":"10.26603/001c.117547","DOIUrl":"10.26603/001c.117547","url":null,"abstract":"<p><strong>Background: </strong>Muscular strength deficits are common after ACL injury. While the Limb Symmetry Index (LSI), using the uninvolved limb as a reference, is widely used, negative strength adaptations may affect both limbs post-injury. It is uncertain how the strength of the uninvolved limb in those with an ACL injury compares to uninjured individuals, making it unclear whether it is appropriate as a benchmark for determining sufficient strength.</p><p><strong>Purpose: </strong>To compare the strength of key lower extremity muscles of the uninvolved limb in those with history of ACL injury (ACL-I) to the dominant limb in individuals with no history of ACL injury (control).</p><p><strong>Study design: </strong>Cross-sectional study. Methods: A total of 5,727 military cadets were examined, with 82 females and 126 males in the ACL-I group and 2,146 females and 3,373 males in the control group. Maximum isometric strength was assessed for six muscle groups measured with a hand-held dynamometer. Separate two-way ANOVAs with limb and sex were performed for each muscle group.</p><p><strong>Results: </strong>Significant main effects for limb were observed with the uninvolved limb in the ACL-I group displaying greater strength compared to the dominant limb in the control group for the quadriceps, hamstrings, and gluteus medius, but effect sizes were small (Cohen's d <0.25). Significant main effects for sex were observed with greater male muscular strength in all six muscle groups with small to large effect sizes (Cohen's d 0.49-1.46). No limb-by-sex interactions were observed.</p><p><strong>Conclusions: </strong>There was no evidence of reduced strength in the uninvolved limb in those with a history of ACL injury compared to the dominant limb in those with no prior ACL injury. This finding suggests that, after clearance to return to activities, the uninvolved limb can be used as a standard for comparison of sufficient strength, including when using the LSI. Level of Evidence: Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247546","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
Author Response - Letter to the Editor Concerning: "An Interval Throwing Program for Baseball Pitchers Based upon Workload Data". 作者回复--致编辑的信,内容涉及:"基于工作量数据的棒球投手间歇投掷计划":"基于工作量数据的棒球投手间歇投掷计划"。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.116858
Michael M Reinold, Brittany Dowling, Glenn S Fleisig, Leonard C Macrina, Kevin E Wilk, John T Streepy, James R Andrews
{"title":"Author Response - Letter to the Editor Concerning: \"An Interval Throwing Program for Baseball Pitchers Based upon Workload Data\".","authors":"Michael M Reinold, Brittany Dowling, Glenn S Fleisig, Leonard C Macrina, Kevin E Wilk, John T Streepy, James R Andrews","doi":"10.26603/001c.116858","DOIUrl":"10.26603/001c.116858","url":null,"abstract":"","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868578","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
The SportsComp Erasmus+ project. An initial WP2 Protocol Overview: The International and Multidisciplinary Delphi and Qualitative Study. SportsComp Erasmus+ 项目。WP2 初步协议概述:国际多学科德尔菲和定性研究。
IF 1.7 Q3 Medicine Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.116582
Bruno Tassignon, Carlo Ramponi, Armi Hirvonen, Mati Arend, Eleni Kapreli, Jo Verschueren
{"title":"The SportsComp Erasmus+ project. An initial WP2 Protocol Overview: The International and Multidisciplinary Delphi and Qualitative Study.","authors":"Bruno Tassignon, Carlo Ramponi, Armi Hirvonen, Mati Arend, Eleni Kapreli, Jo Verschueren","doi":"10.26603/001c.116582","DOIUrl":"https://doi.org/10.26603/001c.116582","url":null,"abstract":"","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858754","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
Clinical Progression and Load Management For Proximal Hamstring Tendinopathy In A Long-Distance Runner: A Case Report. 一名长跑运动员腘绳肌腱近端病变的临床进展和负荷管理:病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.116578
Cristina Campos-Villegas, Lucía Ortega-Pérez de Villar, Javier Gámez-Payá, Jorge Alarcón-Jiménez, Nieves de Bernardo

Background and purpose: The characteristics of Proximal Hamstring Tendinopathy (PHT) include deep, localized pain in the region of the ischial tuberosity. Chronic lesions are often found in long-distance runners. Compression of the tendon and shear force at its insertion at the ischial tuberosity during hip flexion/adduction is a key etiologic factor. The aim of this case report is to analyze the effectiveness of an exercise protocol with progression of tendon loading in PHT in an amateur runner, by assessing pain and functional capacity.

Case description: The subject was a 30-year-old male runner. After participating in a 10km race, he experienced an insidious onset of deep buttock pain in the right ischial tuberosity. His pain was aggravated by running on sloped roads and prolonged sitting on hard surfaces, particularly while driving. The visual analog scale (VAS) for pain, the Puranen-Orave test (PO), the Bent-Knee stretch test (BK stretch), the supine plank test, the Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) questionnaire, and the sciatic nerve mobility (via the Slump test) were assessed. The intervention involved a 12-week progressive loading exercise program divided into four phases.

Outcomes: The initial pain was reduced at 6 weeks of intervention and further decreased at 12 weeks (VAS from 7, to 5 and to 1). Function increased at 6 weeks and at 12 weeks (VISA-H from 23, to 53, to 80). Sciatic nerve mobility was normal.

Conclusion: The progression of training in a subject with PHT tendon injury based on isometric exercise, concentric/eccentric, energy storage, progressively increasing hip flexion was beneficial, increasing function and decreasing pain. Studies with a larger sample size and a more precise methodological design would be necessary to support this type of intervention in clinical practice.

Level of evidence: 5.

背景和目的:腘绳肌腱近端病(PHT)的特征包括跗骨结节区域的深层局部疼痛。慢性病变通常发生在长跑运动员身上。髋关节屈曲/外展时肌腱受压以及肌腱插入峡部结节处的剪切力是一个关键的致病因素。本病例报告旨在通过评估疼痛和功能能力,分析业余跑者在 PHT 中肌腱负荷逐渐增加的锻炼方案的有效性:受试者是一名 30 岁的男性跑步者。在参加完一场 10 公里的比赛后,他隐隐感到右侧胯骨结节处臀部深部疼痛。在倾斜的道路上跑步和长时间坐在坚硬的地面上,尤其是开车时,疼痛会加剧。对他进行了疼痛视觉模拟量表(VAS)、普拉宁-奥拉夫试验(PO)、屈膝伸展试验(BK 伸展)、仰卧平板试验、维多利亚体育学院评估-腿筋腱近端(VISA-H)问卷调查以及坐骨神经活动度(通过坍塌试验)评估。干预措施包括为期 12 周的渐进加载锻炼计划,分为四个阶段:结果:最初的疼痛在干预 6 周时减轻,12 周时进一步减轻(VAS 从 7 降到 5,再降到 1)。功能在 6 周和 12 周时有所增加(VISA-H 从 23 到 53 再到 80)。坐骨神经活动度正常:结论:在等长运动、同心/半同心、能量储存、逐步增加髋关节屈曲的基础上,对 PHT 肌腱损伤患者进行循序渐进的训练是有益的,可以增强功能,减轻疼痛。在临床实践中,有必要进行样本量更大、方法设计更精确的研究,以支持此类干预措施:5.
{"title":"Clinical Progression and Load Management For Proximal Hamstring Tendinopathy In A Long-Distance Runner: A Case Report.","authors":"Cristina Campos-Villegas, Lucía Ortega-Pérez de Villar, Javier Gámez-Payá, Jorge Alarcón-Jiménez, Nieves de Bernardo","doi":"10.26603/001c.116578","DOIUrl":"10.26603/001c.116578","url":null,"abstract":"<p><strong>Background and purpose: </strong>The characteristics of Proximal Hamstring Tendinopathy (PHT) include deep, localized pain in the region of the ischial tuberosity. Chronic lesions are often found in long-distance runners. Compression of the tendon and shear force at its insertion at the ischial tuberosity during hip flexion/adduction is a key etiologic factor. The aim of this case report is to analyze the effectiveness of an exercise protocol with progression of tendon loading in PHT in an amateur runner, by assessing pain and functional capacity.</p><p><strong>Case description: </strong>The subject was a 30-year-old male runner. After participating in a 10km race, he experienced an insidious onset of deep buttock pain in the right ischial tuberosity. His pain was aggravated by running on sloped roads and prolonged sitting on hard surfaces, particularly while driving. The visual analog scale (VAS) for pain, the Puranen-Orave test (PO), the Bent-Knee stretch test (BK stretch), the supine plank test, the Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) questionnaire, and the sciatic nerve mobility (via the Slump test) were assessed. The intervention involved a 12-week progressive loading exercise program divided into four phases.</p><p><strong>Outcomes: </strong>The initial pain was reduced at 6 weeks of intervention and further decreased at 12 weeks (VAS from 7, to 5 and to 1). Function increased at 6 weeks and at 12 weeks (VISA-H from 23, to 53, to 80). Sciatic nerve mobility was normal.</p><p><strong>Conclusion: </strong>The progression of training in a subject with PHT tendon injury based on isometric exercise, concentric/eccentric, energy storage, progressively increasing hip flexion was beneficial, increasing function and decreasing pain. Studies with a larger sample size and a more precise methodological design would be necessary to support this type of intervention in clinical practice.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867855","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
Management of High Ankle Sprains Utilizing the Tightrope Surgical Procedure - A Novel Approach for a Rapid Return to Play. 利用 Tightrope 手术方法治疗高位踝关节扭伤--一种快速恢复比赛能力的新方法。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.26603/001c.116862
Michael L Voight, Connor Norman, Kevin E Wilk, Matthew Lucas, Chris Wolfe

The distal tibiofibular joint is described as a syndesmosis. The syndesmosis is important to the structural integrity of the ankle joint by maintaining the proximity of the tibia, fibula, and talus. Syndesmotic or high ankle sprains, involving the syndesmotic ligaments, pose a significant rehabilitative challenge due to their intricate anatomy, prolonged recovery periods following injury, and high susceptibility to persistent disability. Traditional management strategies have often been conservative, marked by lengthy periods of immobilization and a gradual return to activity. Severe syndesmotic injuries with diastasis have been treated surgically with screw fixation which may require a second intervention to remove the hardware and carries an inherent risk of breaking the screw during rehabilitation. Another fixation technique, the Tightrope™, has gained popularity in treating ankle syndesmosis injuries. The TightRope™ involves inserting Fiberwire® through the tibia and fibula, which allows for stabilization of the ankle mortise and normal range of motion. The accelerated rehabilitation protocol promotes early weight-bearing and has been shown to expedite the return to sport. This emerging strategy has shown promise in reducing recovery time as it is now possible to return to sport in less than 2 months after a tightrope repair and accelerated rehabilitation, compared with 3-6 months post screw fixation. This clinical commentary delves into this novel approach, highlighting the procedure, rehabilitation protocols, and the implications for physical therapy practice.

Level of evidence: V.

胫腓骨远端关节被描述为联合关节。胫腓联合通过保持胫骨、腓骨和距骨之间的距离,对踝关节的结构完整性非常重要。踝关节联合或高位扭伤涉及踝关节联合韧带,由于其复杂的解剖结构、伤后恢复期较长以及极易造成持续性残疾,给康复治疗带来了巨大挑战。传统的治疗策略通常比较保守,以长时间的固定和逐渐恢复活动为特征。严重的联合韧带损伤和舒张期损伤一直采用螺钉固定的手术治疗方法,这种方法可能需要二次手术才能取出硬件,而且在康复过程中存在螺钉断裂的固有风险。另一种固定技术 Tightrope™ 在治疗踝关节巩膜损伤方面越来越受欢迎。TightRope™ 包括将 Fiberwire® 纤维丝插入胫骨和腓骨,从而稳定踝关节臼和正常活动范围。加速康复方案可促进早期负重,并已证明可加快恢复运动。与螺钉固定术后 3-6 个月的恢复时间相比,这种新出现的策略在缩短恢复时间方面大有可为,因为现在在紧索修复和加速康复后不到 2 个月就可以恢复运动。本临床评论深入探讨了这种新方法,重点介绍了手术、康复方案以及对物理治疗实践的影响:V.
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引用次数: 0
期刊
International Journal of Sports Physical Therapy
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