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Rehabilitation of an Upper Extremity Weight-Bearing Athlete with an Ulnar Collateral Ligament Injury: A Case Report. 上肢负重运动员尺侧副韧带损伤的康复治疗:病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120900
Annemieke D Corbitt, William D Bandy

Background and purpose: Ulnar collateral ligament (UCL) injury is a common elbow injury among overhead athletes, particularly baseball pitchers. However, limited research exists for non-throwing athletes, especially regarding rehabilitation. The purpose of this case report is to illustrate the use of early weight-bearing activities into the rehabilitation protocol for non-operative management of athletes with a UCL injury.

Case description: The subject was a 17-year-old female competitive cheerleader. Two weeks prior, during the performance of an acrobatic skill in which she transitioned to full upper extremity (UE) weight-bearing, she sustained an injury to her right elbow. Physical therapy examination findings indicated a diagnosis of a UCL sprain. Self-reported outcome measures revealed a FOTO score of 69/100 and a Quick Dash score of 43/100. The subject attended 14 therapy sessions over nine weeks to address physical function and performance, which were assessed at intervals during her therapy program. Rehabilitation consisted of therapeutic exercise for the progression of UE functional weight-bearing including planks, ball push-ups, handstands, crab walks, stool pulls, handstand walks, and UE plyometric jumps.

Outcomes: Along with documented improvement of the standard musculoskeletal examination measures of range of motion, strength, and functional performance, the subject demonstrated no elbow instability and improved FOTO and Quick Dash scores of 98 and 0, respectively. The subject demonstrated 105% limb symmetry index with the return to sport (RTS) UE functional testing of one-armed seated shot-put throw (SSPT) and achieved normative values with the closed kinetic chain upper extremity stability test (CKCUEST).

Conclusion: This case report highlights the successful treatment of a subject with a UCL injury and the integration of therapy interventions with a focus on UE weight-bearing. Further research on performing high level UE weight-bearing activities during rehabilitation and RTS guidelines is needed.

背景和目的:尺侧副韧带(UCL)损伤是高空运动员,尤其是棒球投手常见的肘部损伤。然而,针对非投掷运动员的研究却很有限,尤其是在康复方面。本病例报告旨在说明在非手术治疗 UCL 损伤运动员的康复方案中使用早期负重活动的情况:受试者是一名 17 岁的拉拉队女队员。两周前,在一次杂技表演中,她在上肢完全负重的情况下右肘受伤。理疗检查结果显示,她被诊断为 UCL 扭伤。自我报告结果显示,FOTO 评分为 69/100,Quick Dash 评分为 43/100。受试者在九周的时间里接受了14次治疗,以改善身体功能和表现,并在治疗过程中每隔一段时间对身体功能和表现进行评估。康复治疗包括促进上肢功能性负重的治疗性运动,包括平板支撑、球俯卧撑、倒立、螃蟹行走、凳子牵引、倒立行走和上肢负重跳跃:除了运动范围、力量和功能表现等标准肌肉骨骼检查指标有明显改善外,受试者的肘部没有出现不稳定现象,FOTO 和 Quick Dash 分数也分别提高到 98 分和 0 分。在单臂坐姿铅球投掷(SSPT)的恢复运动(RTS)UE功能测试中,受试者的肢体对称指数达到了105%,在闭合动能链上肢稳定性测试(CKCUEST)中达到了正常值:本病例报告强调了对 UCL 损伤患者的成功治疗,以及以 UE 负重为重点的综合治疗干预。需要进一步研究在康复期间进行高水平上肢负重活动的方法和 RTS 指南。
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引用次数: 0
Screening for Incidence and Effect of Pelvic Floor Dysfunction in College-Aged Athletes. 筛查大学生运动员盆底功能障碍的发生率和影响。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120211
Charles J Salvo, Ashlie Crewe, Dillon Estes, Jessica Kroboth, Celia Yost

Background: Pelvic floor dysfunction (PFD) occurs when muscles of the pelvic floor become weakened, impaired, or experience tension leading to a variety of complications. Due to the reactive nature and high demands of many sports, athletes are at increased susceptibility and of particular interest concerning PFD.

Hypothesis/purpose: The purpose of this study was to explore the prevalence of PFD among college-aged athletes, assess how PFD impacted athletic performance, and identify contributing factors for increased likelihood of PFD in athletes.

Study design: Cross-Sectional Study.

Methods: All fully active LVC NCAA Division 3 athletes were recruited for screening for PFD using the Cozean Pelvic Dysfunction Screening Protocol and were surveyed on their self-knowledge of PFD. Athletes who scored ≥ 3 on this tool completed an additional survey, created by the investigators, to identify the impact PFD had on their athletic performance and personal life and were then randomly assigned to one of three investigators to undergo a noninvasive coccygeal assessment to determine underactive, overactive, or normal pelvic floor muscle (PFM) activity.

Results: Fifty-three Division III male and female athletes between the ages of 18-25 years old participated in the study. Statistically significant differences were found between Cozean scores and demographic factors of age (p <0.001), gender (p <0.05), self-knowledge of PFD (p <0.001), and sport (p <0.001) among all participants that contributed to the increased likelihood of PFD. Thirteen athletes scored ≥ 3 on the Cozean with the 92.3% experiencing under/over active PFM activity and the majority indicating that PFD significantly impacted their athletic performance and quality of life.

Conclusion: The results indicate that older female NCAA Division III college athletes who participate in swimming and who possess self-knowledge of PFD are more likely to experience PFD. Additionally, these athletes are likely to encounter a significant impact on their athletic performance and quality of life. These results provide preliminary evidence on the need of PFD awareness and assessment among college athletes.

Level of evidence: Level 3b.

背景:盆底功能障碍(PFD)是指盆底肌肉变弱、受损或紧张,从而导致各种并发症。假设/目的:本研究的目的是探讨骨盆底功能障碍在大学年龄运动员中的患病率,评估骨盆底功能障碍对运动成绩的影响,并确定导致运动员骨盆底功能障碍患病率增加的因素:研究设计:横断面研究:采用 Cozean 骨盆功能障碍筛查方案对所有完全活跃的 LVC NCAA 第 3 组运动员进行 PFD 筛查,并调查他们对 PFD 的自我认识。在这一工具上得分≥3分的运动员完成了由调查人员制作的附加调查,以确定PFD对其运动表现和个人生活的影响,然后被随机分配给三名调查人员中的一人进行无创尾骨评估,以确定盆底肌肉(PFM)活动不足、过度活跃或正常:53 名年龄在 18-25 岁之间的第三组男女运动员参加了这项研究。Cozean评分与年龄等人口统计学因素之间存在统计学意义上的显著差异(p p p p):研究结果表明,年龄较大的 NCAA 第三分部大学女运动员参加游泳运动,并且对 PFD 有自知之明,她们更有可能经历 PFD。此外,这些运动员的运动表现和生活质量可能会受到严重影响。这些结果提供了初步证据,说明大学运动员需要对 PFD 有所认识和评估:证据等级:3b 级。
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引用次数: 0
Center of Pressure Velocity and Dynamic Postural Control Strategies Vary During Y-Balance and Star Excursion Balance Testing. 在 Y 型平衡和星形激振平衡测试中,压力中心速度和动态姿势控制策略各不相同。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.118943
Kristen L Jagger, Brent Harper

Background: Dynamic postural control (DPC) describes an individual's ability to maintain balance within their base of support in both anticipatory and reactive balance situations and has been measured using center of pressure (COP) velocity. Common standardized DPC assessments for active adults include the modified Star Excursion Balance Test (MSEBT) and the Y-Balance Test (YBT).

Hypothesis/purpose: The purpose of this study was to explore DPC during performance of the MSEBT, the YBT, and a modified version of the YBT, the MYBT. It was hypothesized that feedback from the YBT/MYBT reach indicator would enhance DPC.

Study design: Cross-sectional study.

Methods: Twenty-one participants (9 females, 12 males, mean age 24.5±1.2 years) performed three trials in each direction (anterior-AN, posteromedial-PM, and posterolateral-PL) on each balance test during one session. The YBT frame was placed atop a force plate for all testing. Frontal and sagittal plane COP velocities (COPx and COPy, respectively) were recorded throughout each trial and resultant COP (COPr) velocities were calculated.

Results: Significant main effects were present for test (F=4.485, p<0.001) and reach direction (F=61.594, p<0.001). Post hoc analyses for test indicated significant differences in COPy between YBT and MSEBT (p=0.034) and between MYBT and MSEBT (p<0.001), as well as significant differences in COPr between MYBT and MSEBT (p=0.002). Post hoc analyses for reach direction revealed significant differences in COPx between AN and both PM (p<0.001) and PL (p<0.001) directions, in COPy between AN and PM (p<0.001) and PL (p<0.001) directions, and COPr between AN and PL (p=0.043) directions only.

Conclusion: External proprioceptive feedback from the reach indicator improved DPC during the YBT and MYBT when compared to the MSEBT. Sagittal plane COP velocities were reduced when external proprioceptive feedback from the reach indicator was present, while frontal plane COP velocities were not affected in this group of participants.

Level of evidence: 2b.

背景:动态姿势控制(Dynamic Postural Control,DPC)描述的是一个人在预期和反应平衡情况下在其支撑基础内保持平衡的能力,其测量方法是压力中心(COP)速度。针对活跃成人的常见标准化 DPC 评估包括改良的星际激增平衡测试(MSEBT)和 Y 平衡测试(YBT)。假设/目的:本研究的目的是探索在进行 MSEBT、YBT 和改良版 YBT(MYBT)时的 DPC。研究假设,YBT/MYBT达标指标的反馈将增强DPC:研究设计:横断面研究:21 名参与者(9 名女性,12 名男性,平均年龄(24.5±1.2)岁)在一次训练中的每次平衡测试中,在每个方向(前方-AN、后内侧-PM 和后外侧-PL)进行了三次试验。在所有测试中,YBT 框架都放置在受力板上。在每次测试过程中记录额面和矢状面的 COP 速度(分别为 COPx 和 COPy),并计算出 COP 的结果(COPr):测试(F=4.485,pF=61.594,pp=0.034)以及MYBT和MSEBT之间(pp=0.002)存在显著的主效应。对伸手方向的事后分析表明,仅在AN和两个PM(pppp=0.043)方向之间,COPx存在显著差异:结论:与MSEBT相比,在YBT和MYBT中,来自伸展指标的外部本体感觉反馈改善了DPC。当外部本体感觉反馈出现时,矢状面COP速度降低,而在这组参与者中,额状面COP速度不受影响。
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引用次数: 0
Comparing the Scores of The Functional Movement Screen™ in Individuals with Low Back Pain versus Healthy Individuals: A Systematic Review and Meta-Analysis. 比较腰背痛患者与健康人的功能性运动筛查™得分:系统回顾与元分析》。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120199
Khalid M Alkhathami, Bijad Alqahtani

Background: The Functional Movement Screen™ (FMS™) is widely used to assess functional movement patterns and illuminate movement dysfunctions that may have a role in injury risk. However, the association between FMS™ scores and LBP remains uncertain.

Objective: The purpose of this systematic review and meta-analysis was to examine functional movement scores among patients with low back pain (LBP) and healthy subjects with no LBP and review the validity of the FMS™ tool for screening functional movement among LBP patients.

Methods: The systematic review and meta-analysis included papers assessing functional movement among adult patients with LBP using the FMS™ through a literature review of five databases. The search strategy focused used relevant keywords: Functional movement screen AND low back pain. The review included all papers assessing functional movement among LBP adult patients (>18 years old) using the FMS™ published between 2003 to 2023. The risk of bias in the involved studies was evaluated using the updated Cochrane ROB 2 tool. Statistical analysis was conducted using Review Manager software, version 5.4. The meta-analysis included the total FMS™ score and the scores of the seven FMS™ movement patterns.

Results: Seven studies were included in this systematic review were considered to have low to unclear risk of bias. The meta-analysis revealed that the LBP group had a significantly lower total FMS™ score than the control group by 1.81 points (95% CI (-3.02, -0.59), p= 0.004). Patients with LBP had a significantly lower score than the control group regarding FMS™ movement patterns, the deep squat (p <0.01), the hurdle step (p <0.01), the inline lunge (P value <0.01), the active straight leg raise (p <0.01), the trunk stability push-up (p=0.02), and the rotational stability screens (p <0.01).

Conclusion: Lower scores on the FMS™ are associated with impaired functional movement. Identifying the specific functional movement impairments linked to LBP can assist in the creation of personalized treatment plans and interventions. Further research is needed to assess the association of cofounders, such as age, gender, and body mass index, with the FMS™ score among LBP patients and controls.

Level of evidence: 1.

背景:功能性运动筛查™(FMS™)被广泛用于评估功能性运动模式,并揭示可能与受伤风险有关的运动功能障碍。然而,FMS™评分与枸杞痛之间的关系仍不确定:本系统综述和荟萃分析旨在研究腰背痛(LBP)患者和无腰背痛的健康受试者的功能性运动评分,并审查 FMS™ 工具在筛查腰背痛患者功能性运动方面的有效性:该系统性综述和荟萃分析通过对五个数据库的文献综述,纳入了使用 FMS™ 评估成年腰背痛患者功能运动的论文。检索策略使用了相关关键词:功能性运动筛查和腰背痛。综述包括 2003 年至 2023 年间发表的所有使用 FMS™ 评估腰背痛成年患者(大于 18 岁)功能运动情况的论文。使用最新的 Cochrane ROB 2 工具评估了相关研究的偏倚风险。统计分析使用 5.4 版的 Review Manager 软件进行。荟萃分析包括 FMS™ 总分和七种 FMS™ 运动模式的得分:本系统综述共纳入了七项研究,这些研究的偏倚风险较低或不明确。荟萃分析显示,LBP 组的 FMS™ 总分明显低于对照组 1.81 分(95% CI (-3.02, -0.59),P= 0.004)。在 FMS™ 运动模式方面,腰椎间盘突出症患者的深蹲得分明显低于对照组(P= 0.004):FMS™得分较低与功能性运动受损有关。确定与枸杞痛相关的特定功能性运动障碍有助于制定个性化的治疗计划和干预措施。需要进一步开展研究,以评估枸杞痛患者和对照组中年龄、性别和体重指数等共因子与 FMS™ 评分的关联:1.
{"title":"Comparing the Scores of The Functional Movement Screen™ in Individuals with Low Back Pain versus Healthy Individuals: A Systematic Review and Meta-Analysis.","authors":"Khalid M Alkhathami, Bijad Alqahtani","doi":"10.26603/001c.120199","DOIUrl":"10.26603/001c.120199","url":null,"abstract":"<p><strong>Background: </strong>The Functional Movement Screen™ (FMS™) is widely used to assess functional movement patterns and illuminate movement dysfunctions that may have a role in injury risk. However, the association between FMS™ scores and LBP remains uncertain.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to examine functional movement scores among patients with low back pain (LBP) and healthy subjects with no LBP and review the validity of the FMS™ tool for screening functional movement among LBP patients.</p><p><strong>Methods: </strong>The systematic review and meta-analysis included papers assessing functional movement among adult patients with LBP using the FMS™ through a literature review of five databases. The search strategy focused used relevant keywords: Functional movement screen AND low back pain. The review included all papers assessing functional movement among LBP adult patients (>18 years old) using the FMS™ published between 2003 to 2023. The risk of bias in the involved studies was evaluated using the updated Cochrane ROB 2 tool. Statistical analysis was conducted using Review Manager software, version 5.4. The meta-analysis included the total FMS™ score and the scores of the seven FMS™ movement patterns.</p><p><strong>Results: </strong>Seven studies were included in this systematic review were considered to have low to unclear risk of bias. The meta-analysis revealed that the LBP group had a significantly lower total FMS™ score than the control group by 1.81 points (95% CI (-3.02, -0.59), p= 0.004). Patients with LBP had a significantly lower score than the control group regarding FMS™ movement patterns, the deep squat (p <0.01), the hurdle step (p <0.01), the inline lunge (P value <0.01), the active straight leg raise (p <0.01), the trunk stability push-up (p=0.02), and the rotational stability screens (p <0.01).</p><p><strong>Conclusion: </strong>Lower scores on the FMS™ are associated with impaired functional movement. Identifying the specific functional movement impairments linked to LBP can assist in the creation of personalized treatment plans and interventions. Further research is needed to assess the association of cofounders, such as age, gender, and body mass index, with the FMS™ score among LBP patients and controls.</p><p><strong>Level of evidence: </strong>1.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 7","pages":"834-848"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535580","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 Effects of TMR® Fab 6 on Hamstring Flexibility in Healthy Subjects; An Exploratory Observational Investigation. TMR® Fab 6 对健康受试者腘绳肌柔韧性的影响;一项探索性观察调查。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120203
Richard D Patterson, Alexander Zettlemoyer, Mary Plackowski, Russell Baker, Scott W Cheatham, Alan Nasypany

Background: Stretching programs are designed to improve hamstring flexibility by attempting to mechanically increase the length of the target tissue. However, other manual treatment approaches such as those utilized in Total Motion Release (TMR®), could be beneficial by identifying body asymmetries to assess and treat soft tissue impairments leading to diminished extensibility.

Purpose: The purpose of this study was to determine the effectiveness of the TMR® Fab 6 assessment and treatment to increase hamstring flexibility in healthy participants following one session of TMR®.

Study design: Observational Cohort study.

Methods: A convenience sample of 20 healthy participants (10 males, 10 females) were recruited from three institutions. Following collection of demographic information and a brief medical history, each participant performed a five minute warm-up on the stationary bike at a moderate intensity (80-90 RPMs) followed immediately by the bilateral performance of the Active Knee Extension Test (AKET) and Passive Straight Leg Raise (PSLR) to assess hamstring muscle length. Participants were randomly placed in the TMR® or control group. The TMR® group completed the "Fab 6" evaluation and treatment, while the control group performed one repetition of standing active hip flexion every 30-seconds for 15-minutes with both knees in full extension. Upon completion of treatment, control and TMR® groups were immediately re-evaluated on the AKET and the PSLR in the same order and fashion as baseline testing. Participants were asked to return in 24-hours for the same objective measurements as previously described.

Results: A significant time by group interaction was identified across all variables (p ≤ 0.001) for AKET and PSLR except the PSLR preferred leg from post-treatment to 24hr follow-up. The most significant increase in the AKET occurred in the TMR® group between baseline and post-treatment of the non-preferred leg (12.15°±2.94) when compared to the control group (7.15°±1.56).

Conclusion: The results of the study suggest that implementing a regionally interdependent treatment approach like TMR® results in significant improvements in hamstring extensibility and hip ROM compared to the control group.

Level of evidence: 3.

背景:拉伸计划旨在通过机械方式增加目标组织的长度,从而提高腿筋的灵活性。目的:本研究旨在确定 TMR® Fab 6 评估和治疗的有效性,以提高健康参与者在接受一次 TMR® 训练后的腘绳肌柔韧性:研究设计:观察性队列研究:研究方法:观察性队列研究。方法:从三个机构招募 20 名健康参与者(10 名男性,10 名女性)。在收集人口统计学信息和简短病史后,每位参与者以中等强度(80-90 转/分)在固定自行车上进行 5 分钟热身,然后立即进行双侧主动伸膝测试 (AKET) 和被动直腿抬高测试 (PSLR),以评估腘绳肌长度。参与者被随机分为 TMR® 组和对照组。TMR® 组完成 "Fab 6 "评估和治疗,而对照组则在双膝完全伸展的情况下,每 30 秒重复一次站立主动屈髋运动,持续 15 分钟。治疗结束后,对照组和 TMR® 组立即按照与基线测试相同的顺序和方式对 AKET 和 PSLR 进行重新评估。参与者被要求在 24 小时后再次接受与之前所述相同的客观测量:结果:除了 PSLR 从治疗后到 24 小时随访期间的首选腿部外,AKET 和 PSLR 的所有变量都存在明显的组间时间交互作用(p ≤ 0.001)。与对照组(7.15°±1.56)相比,TMR® 组非首选腿从基线到治疗后的 AKET 增长最为明显(12.15°±2.94):研究结果表明,与对照组相比,采用TMR®这种区域相互依存的治疗方法可显著改善腿筋伸展性和髋关节活动度:3.
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引用次数: 0
Nonsurgical Management of Adductor-related groin pain with Ultrasound-Guided Platelet-Rich Plasma Injection and Physical Therapy in a Competitive Soccer Player: A Case Report. 通过超声引导富血小板血浆注射和物理疗法对一名足球运动员腹股沟内收肌相关疼痛进行非手术治疗:病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120209
Giorgio Zeppieri, Micheal S Smith, Ryan P Roach

Introduction: Adductor-related groin pain involves an injury to the common aponeurosis connecting the rectus abdominus and adductor longus to the pubis. It commonly occurs in sports that require cutting and pivoting and can result in significant loss of playing time. Platelet-Rich Plasma (PRP) is often indicated for treatment of musculoskeletal disorders and may represent an alternative treatment for patients with adductor-related groin pain. The purpose of this case report is to describe the non-surgical management of adductor-related groin pain in a competitive soccer player with a with an ultrasound (US)-guided PRP injection and physical therapy management.

Case description: A 17-year-old male competitive soccer player with right-sided adductor-related groin pain was treated with an US-guided PRP and a multi-phased physical therapy regimen based on tissue healing and individual patient/criteria progression. The patient completed 12 physical therapy sessions over six weeks post PRP injection.

Outcomes: At the end of treatment, clinically meaningful improvements were observed in pain intensity, passive range of motion, strength (handheld dynamometry, Biodex), functional tests, psychosocial (OSPRO-YF) and patient-reported outcomes (HAGOS, LEFS). The subject returned to sport at six weeks post injection without limitation and at three months follow up, the subject reported that he had returned to 95% of his previous level of play.

Discussion: This case report may offer support for PRP as an alternative treatment in the management of adductor-related groin pain. Incorporation of PRP as an adjunct to physical therapy led to improvements on all outcomes that surpassed the clinical significance change criteria.

Level of evidence: 5.

简介:与内收肌相关的腹股沟疼痛是指连接腹直肌和长内收肌与耻骨的共同肌腱受伤。它通常发生在需要切入和旋转的运动中,并可能导致大量比赛时间的损失。富血小板血浆(PRP)通常用于治疗肌肉骨骼疾病,可能是内收肌相关腹股沟疼痛患者的另一种治疗方法。本病例报告旨在描述一名竞技足球运动员腹股沟内收肌相关疼痛的非手术治疗方法,即在超声波(US)引导下注射富血小板血浆并进行物理治疗:一名 17 岁的男性竞技足球运动员患有右侧内收肌相关性腹股沟疼痛,他接受了 US 引导的 PRP 治疗,并根据组织愈合情况和患者个体/标准进展情况接受了多阶段理疗。患者在注射 PRP 后的六周内完成了 12 次理疗:治疗结束时,患者的疼痛强度、被动活动范围、力量(手持式测力计、Biodex)、功能测试、社会心理(OSPRO-YF)和患者报告结果(HAGOS、LEFS)均有明显改善。受试者在注射后六周无限制地恢复了运动,在三个月的随访中,受试者称自己的运动水平恢复到了之前的 95%:本病例报告支持将 PRP 作为治疗内收肌相关腹股沟疼痛的替代疗法。将 PRP 作为物理疗法的辅助疗法可改善所有结果,其变化超过了临床意义标准:5.
{"title":"Nonsurgical Management of Adductor-related groin pain with Ultrasound-Guided Platelet-Rich Plasma Injection and Physical Therapy in a Competitive Soccer Player: A Case Report.","authors":"Giorgio Zeppieri, Micheal S Smith, Ryan P Roach","doi":"10.26603/001c.120209","DOIUrl":"10.26603/001c.120209","url":null,"abstract":"<p><strong>Introduction: </strong>Adductor-related groin pain involves an injury to the common aponeurosis connecting the rectus abdominus and adductor longus to the pubis. It commonly occurs in sports that require cutting and pivoting and can result in significant loss of playing time. Platelet-Rich Plasma (PRP) is often indicated for treatment of musculoskeletal disorders and may represent an alternative treatment for patients with adductor-related groin pain. The purpose of this case report is to describe the non-surgical management of adductor-related groin pain in a competitive soccer player with a with an ultrasound (US)-guided PRP injection and physical therapy management.</p><p><strong>Case description: </strong>A 17-year-old male competitive soccer player with right-sided adductor-related groin pain was treated with an US-guided PRP and a multi-phased physical therapy regimen based on tissue healing and individual patient/criteria progression. The patient completed 12 physical therapy sessions over six weeks post PRP injection.</p><p><strong>Outcomes: </strong>At the end of treatment, clinically meaningful improvements were observed in pain intensity, passive range of motion, strength (handheld dynamometry, Biodex), functional tests, psychosocial (OSPRO-YF) and patient-reported outcomes (HAGOS, LEFS). The subject returned to sport at six weeks post injection without limitation and at three months follow up, the subject reported that he had returned to 95% of his previous level of play.</p><p><strong>Discussion: </strong>This case report may offer support for PRP as an alternative treatment in the management of adductor-related groin pain. Incorporation of PRP as an adjunct to physical therapy led to improvements on all outcomes that surpassed the clinical significance change criteria.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 7","pages":"898-909"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535582","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
Utilizing Diagnostic Musculoskeletal Ultrasound for Assessment of the Infraspinatus Muscle and Tendon: Implications for Rehabilitation Professionals. 利用诊断性肌肉骨骼超声评估冈下肌和肌腱:对康复专业人员的启示。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120405
Robert C Manske, Michael Voight, Chris Wolfe, Phil Page

The rotator cuff, comprising the subscapularis, supraspinatus, infraspinatus, and teres minor muscles, plays a crucial role in stabilizing the glenohumeral joint by securing the head of the humerus within the glenoid cavity of the scapula. The tendinous insertions of these muscles generate tension within the capsule, enhancing joint stability during muscular activity. The rotator cuff is susceptible to damage from disease, injury, or trauma, which can result in tears or ruptures of one or more tendons. The evaluation of the infraspinatus muscle and tendon is vital for diagnosing and managing various shoulder pathologies. Accurate imaging to determine the specific muscle involvement and injury severity significantly impacts treatment decisions. Diagnostic musculoskeletal ultrasound (MSK-US) has emerged as a valuable tool for assessing the infraspinatus muscle and tendon, offering real-time, dynamic assessment capabilities essential for precise diagnosis and effective rehabilitation planning. This article reviews the utility and advantages of MSK-US in evaluating the infraspinatus muscle and tendon, emphasizing technique specifics, diagnostic accuracy, and comparative efficacy against other imaging modalities. It details a systematic approach to the ultrasound examination technique for the infraspinatus, including patient positioning and identification of common pathologies such as tears, tendinopathy, and calcifications. With recent advancements in transducer strength, image resolution, and operator training, ultrasound serves as an excellent alternative imaging modality for diagnosing rotator cuff tears. This article aims to equip rehabilitation professionals with a comprehensive understanding of MSK-US as a diagnostic tool for the infraspinatus, promoting more precise diagnosis, treatment planning and improved patient outcomes.

肩袖由肩胛下肌、冈上肌、冈下肌和小圆肌组成,通过将肱骨头固定在肩胛骨的盂腔内,在稳定盂肱关节方面发挥着至关重要的作用。这些肌肉的肌腱插入处会在关节囊内产生张力,从而在肌肉活动时增强关节的稳定性。肩袖很容易受到疾病、损伤或外伤的损害,从而导致一条或多条肌腱撕裂或断裂。对冈下肌和肌腱的评估对于诊断和治疗各种肩部病症至关重要。通过精确的成像来确定肌肉受累的具体部位和损伤的严重程度,对治疗决策具有重要影响。诊断性肌肉骨骼超声(MSK-US)已成为评估冈下肌和肌腱的重要工具,可提供精确诊断和有效康复计划所必需的实时动态评估功能。本文回顾了 MSK-US 在评估冈下肌和肌腱方面的实用性和优势,强调了技术的特殊性、诊断的准确性以及与其他成像方式的比较效果。它详细介绍了冈下肌超声检查技术的系统方法,包括患者定位和常见病理的识别,如撕裂、肌腱病变和钙化。随着近来换能器强度、图像分辨率和操作员培训方面的进步,超声波已成为诊断肩袖撕裂的一种出色的替代成像方式。本文旨在让康复专业人员全面了解 MSK-US 作为冈下肌诊断工具的作用,从而促进更精确的诊断、治疗规划和改善患者预后。
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引用次数: 0
Publicly Available Anatomic Total Shoulder Arthroplasty Rehabilitation Protocols Show High Variability and Frequent Divergence from the 2020 ASSET Recommendations. 公开发布的解剖全肩关节置换术康复方案与 2020 ASSET 建议存在很大差异,且经常出现分歧。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.118926
Nabil Mehta, Alexander J Acuna, Johnathon R McCormick, William E Harkin, Hasani W Swindell, Steven F Defroda, Mike Reinold, Gregory P Nicholson, Grant E Garrigues

Background: In 2020, the American Society of Shoulder and Elbow Therapists (ASSET) published an evidence-based consensus statement outlining postoperative rehabilitation guidelines following anatomic total shoulder arthroplasty (TSA).

Purpose: The purpose of this study was to (1) quantify the variability in online anatomic TSA rehabilitation protocols, and (2) assess their congruence with the ASSET consensus guidelines.

Methods: This study was a cross-sectional investigation of publicly available, online rehabilitation protocols for anatomic TSA. A web-based search was conducted in April 2022 of publicly available rehabilitation protocols for TSA. Each collected protocol was independently reviewed by two authors to identify recommendations regarding immobilization, initiation, and progression of passive (PROM) and active range of motion (AROM), as well as the initiation and progression of strengthening and post-operative exercises and activities. The time to initiation of various components of rehabilitation was recorded as the time at which the activity or motion threshold was permitted by the protocol. Comparisons between ASSET start dates and mean start dates from included protocols were performed.

Results: Of the 191 academic institutions included, 46 (24.08%) had publicly available protocols online, and a total of 91 unique protocols were included in the final analysis. There were large variations seen among included protocols for the duration and type of immobilization post-operatively, as well as for the initiation of early stretching, PROM, AROM, resistance exercises, and return to sport. Of the 37 recommendations reported by both the ASSET and included protocols, 31 (83.78%) were found to be significantly different between groups (p<0.05).

Conclusion: Considerable variability was found among online post-operative protocols for TSA with substantial deviation from the ASSET guidelines. These findings highlight the lack of standardization in rehabilitation protocols following anatomic TSA.

Level of evidence: 3b.

背景:2020年,美国肩肘治疗师协会(ASSET)发布了一份循证共识声明,概述了解剖型全肩关节置换术(TSA)术后康复指南。目的:本研究旨在(1)量化在线解剖型TSA康复方案的差异性,(2)评估其与ASSET共识指南的一致性:本研究是一项横断面调查,调查对象是可公开获得的在线解剖 TSA 康复方案。2022 年 4 月,我们在网上搜索了可公开获得的 TSA 康复方案。每份收集到的方案都由两位作者独立审核,以确定有关固定、被动活动范围(PROM)和主动活动范围(AROM)的启动和进展,以及加强和术后锻炼和活动的启动和进展的建议。各种康复项目的开始时间记录为方案允许的活动或运动阈值的时间。对 ASSET 的开始时间和所纳入方案的平均开始时间进行了比较:结果:在纳入的 191 家学术机构中,有 46 家(24.08%)在网上公开了协议,共有 91 份独特的协议被纳入最终分析。所纳入的方案在术后固定的持续时间和类型、开始早期拉伸、PROM、AROM、阻力练习和恢复运动方面存在很大差异。在 ASSET 和收录方案报告的 37 项建议中,有 31 项(83.78%)在组间存在显著差异(P/结论:发现在线 TSA 术后方案之间存在很大差异,与 ASSET 指南有很大偏差。这些发现凸显了解剖TSA术后康复方案缺乏标准化:3b.
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引用次数: 0
Apprehension-Based Training: A Novel Treatment Concept for Anterior Shoulder Dislocation - A Case Report. 基于理解的训练:肩关节前脱位的新治疗理念--病例报告。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.118928
Alon Rabin, Livneh Noyman, Noa Yaakobi, Efi Kazum

Background and purpose: Conservative management of anterior shoulder dislocation (ASD) is associated with greater recurrence compared with surgical management. Current rehabilitation protocols may not adequately challenge shoulder stability to encourage adaptive coping strategies. Apprehension-based training (ABT) is a new treatment concept derived from the supine moving apprehension test (SMAT), a previously validated performance measure among patients with ASD. The purpose of this case report is to describe the application of ABT in a patient with recurrent ASD.

Study design: Case report.

Case description: The subject was a 23-year-old male with bilateral recurrent ASD. The subject underwent a 17-week exercise program involving gradual exposure to increased anterior instability loads based on the SMAT movement pattern. The Western Ontario Shoulder Instability Index (WOSI), Patient-Specific Functional Scale (PFPS), Tampa Scale of Kinesiophobia, SMAT, shoulder internal and external rotation muscle strength were measured via hand-held dynomometry before and after training.

Outcomes: Following treatment, clinically meaningful gains in quality of life (WOSI) and shoulder function (PSFS) were noted. Kinesiophobia decreased, SMAT and shoulder internal rotator strength increased beyond their respective minimal detectable change. Four months after treatment, quality of life and shoulder function remained improved, and the subject reported a reduced rate of ASD.

Discussion: Apprehension-based training involving gradual exposure to shoulder instability loads may hold potential for improving the management of patients with ASD. Further testing of this concept is warranted.

Level of evidence: 4, single case report.

背景和目的:与手术治疗相比,保守治疗肩关节前脱位(ASD)的复发率更高。目前的康复方案可能无法充分挑战肩关节的稳定性,从而鼓励采取适应性应对策略。基于忧虑的训练(ABT)是一种新的治疗理念,它源于仰卧位移动忧虑测试(SMAT),该测试之前已在 ASD 患者中得到验证。本病例报告旨在描述 ABT 在一名复发性 ASD 患者身上的应用:研究设计:病例报告:研究对象是一名 23 岁的男性,患有双侧复发性 ASD。受试者接受了为期 17 周的锻炼计划,其中包括根据 SMAT 运动模式逐步增加前方不稳定负荷。在训练前后,通过手持测力计测量了西安大略省肩关节不稳定指数(WOSI)、患者特定功能量表(PFPS)、坦帕运动恐惧量表、SMAT、肩关节内旋和外旋肌力:治疗后,生活质量(WOSI)和肩关节功能(PSFS)均有临床意义的提高。运动恐惧症有所减轻,SMAT和肩关节内旋肌力量的增加超过了各自的最小可检测变化。治疗四个月后,患者的生活质量和肩部功能仍然有所改善,而且其 ASD 发生率也有所下降:讨论:逐渐暴露于肩部不稳定负荷的忧虑训练可能会改善 ASD 患者的治疗。证据级别:4,单例报告:4,单一病例报告。
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引用次数: 0
Return to Play Assessment After Lateral Ankle Sprains - German Male Elite Youth Football (Soccer) Academy Baseline Data. 外侧踝关节扭伤后重返赛场评估 - 德国男子青年精英足球(足球)学院基线数据。
IF 1.6 Q3 SPORT SCIENCES Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.26603/001c.120201
Zacharias Flore, Götz Welsch, Hendrik Bloch

Background: Lateral ankle sprain (LAS) is one of the most common types of injury in football (soccer). Normative baseline data of performance tests for Return to Play (RTP) decision are still lacking.

Purpose: The primary aim of this study was to generate baseline values for uninjured elite youth football players for a multifactorial RTP assessment and compare with previously published data. A secondary aim was to investigate the use of the Limb Symmetry Index (LSI) as a method to determine whether an athlete passes a performance test or not.

Study design: Observational Cohort study.

Methods: Baseline data of performance tests (Y-Balance [YBT-LQ], Heel Rise [HRT]; Singe Leg Squat [SLST]; Single Leg Drop Jump [SLDJ]; Side Hop [SHT]; Figure of 8 Hop [F-8]; Modified Agility T-Test [MAT]) were assessed in 20 elite youth football players, aged 16-21 years. Additionally, the traditional LSI (dividing the result of the non-dominant leg by the result of the dominant leg and multiplying by 100) and directionally corrected LSI (the worst value is divided by the better value and multiplied by 100) were calculated. The test values were compared to previously reported study results. LSI and side-to-side comparisons between dominant and non-dominant leg sides were analyzed using the Wilcoxon test.

Results: Male elite youth football players achieved better results in the dynamic performance tests (SHT, F-8, and MAT) compared to reference values of the cohorts previously described in the literature: YBT-LQ total score (cm) dominant (dom) 99.3±8.3, non-dominant (ND) 99.5±10.4; HRT (average number) dom. 27.1±5.4, ND 25.2±5.1); SLDJ height (cm) dom 15±5, ND 15±5 and contact time (sec) dom 0.29±0.08, ND 0.29±0.07, Reactive Strength Index (RSI) dom 0.52±0.12, ND 0.50±0.13); SHT (sec) dom 7.12±0.73, ND 7.39±0.93; F-8 (sec) dom 10.52±1.02, ND 10.37±1.04; and MAT (sec) 5.82±0.22. Directionally corrected LSI differed significantly from the traditional calculated LSI (p<0.05).

Conclusion: The findings of this study highlight the need to determine specific baseline data for RTP testing in male elite youth football players after LAS. The traditional LSI should not be used as a "stand alone method" for determining RTP. LSI calculations should consider the direction of asymmetry to determine passing a performance test or not.

Level of evidence: 3b.

背景:外侧踝关节扭伤(LAS)是足球运动中最常见的损伤类型之一。目的:本研究的主要目的是为未受伤的青少年精英足球运动员生成多因素 RTP 评估的基线值,并与之前公布的数据进行比较。研究设计:观察性队列研究:观察性队列研究:方法:对 20 名 16-21 岁的青少年精英足球运动员的成绩测试(Y-平衡 [YBT-LQ]、脚跟抬高 [HRT]、单腿深蹲 [SLST]、单腿下蹲跳 [SLDJ]、侧跳 [SHT]、8 字形跳 [F-8]、修正敏捷性 T 测试 [MAT])基线数据进行评估。此外,还计算了传统 LSI(用非优势腿的结果除以优势腿的结果再乘以 100)和方向校正 LSI(最差值除以较好值再乘以 100)。测试值与之前报告的研究结果进行了比较。使用 Wilcoxon 检验对优势腿侧和非优势腿侧的 LSI 和侧对侧比较进行分析:结果:与之前文献中描述的参考值相比,男性青少年精英足球运动员在动态表现测试(SHT、F-8 和 MAT)中取得了更好的成绩:YBT-LQ总分(厘米)优势(dom)99.3±8.3,非优势(ND)99.5±10.4;HRT(平均数)优势(dom)27.1±5.4,非优势(ND)27.1±5.4。27.1±5.4,ND 25.2±5.1);SLDJ 高度(厘米)dom 15±5,ND 15±5;接触时间(秒)dom 0.29±0.08,ND 0.29±0.07;反应强度指数(RSI)dom 0.52±0.12,ND 0.50±0.13);SHT(秒)dom 7.12±0.73,ND 7.39±0.93;F-8(秒)dom 10.52±1.02,ND 10.37±1.04;MAT(秒)5.82±0.22。经方向校正的 LSI 与传统计算的 LSI 有显著差异(p 结论:本研究的结果突出表明,有必要在 LAS 后确定男性精英青少年足球运动员 RTP 测试的具体基线数据。传统的 LSI 不应作为确定 RTP 的 "独立方法"。LSI 计算应考虑不对称的方向,以确定是否通过性能测试:3b.
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引用次数: 0
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International Journal of Sports Physical Therapy
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