Pub Date : 2023-12-03DOI: 10.1016/j.ptsp.2023.11.005
Sonya Moore , Chris Musgrave , Jonathan Sandler , Ben Bradley , Jennifer R.A. Jones
Objective
International guidelines support a repertoire of therapeutic interventions that may assist recovery following concussion. We aimed to systematically review the efficacy of early pharmacological and non-pharmacological interventions initiated within two weeks of injury on symptoms and functional recovery of adults with concussion.
Methods
We conducted a Systematic Review (SR) of Randomised Controlled Trials (RCTs) without meta-analysis utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed of four databases. Study inclusion criteria were adult participants diagnosed with concussion and commencing active intervention within 14 days of injury.
Results and conclusions
Of 7531 studies identified, 11 were included in the final review. Six studies were rated as high-risk of bias, three with some concerns and two as low-risk of bias. We found no evidence to support specific pharmacotherapeutic management to hasten the natural recovery time-course. Two studies reported significant improvement in selected concussion symptoms following manual therapy (at 48–72 hours post-treatment) or telephone counselling interventions (at 6 months post-injury). No high quality RCTs demonstrate superior effects of early therapeutic interventions on concussion recovery in the first 2 weeks. We advocate future research to examine impacts of health-clinician contact points aligned with symptom-specific interventions.
{"title":"Early intervention treatment in the first 2 weeks following concussion in adults: A systematic review of randomised controlled trials","authors":"Sonya Moore , Chris Musgrave , Jonathan Sandler , Ben Bradley , Jennifer R.A. Jones","doi":"10.1016/j.ptsp.2023.11.005","DOIUrl":"10.1016/j.ptsp.2023.11.005","url":null,"abstract":"<div><h3>Objective</h3><p>International guidelines support a repertoire of therapeutic interventions that may assist recovery following concussion. We aimed to systematically review the efficacy of early pharmacological and non-pharmacological interventions initiated within two weeks of injury on symptoms and functional recovery of adults with concussion.</p></div><div><h3>Methods</h3><p>We conducted a Systematic Review (SR) of Randomised Controlled Trials (RCTs) without meta-analysis utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed of four databases. Study inclusion criteria were adult participants diagnosed with concussion and commencing active intervention within 14 days of injury.</p></div><div><h3>Results and conclusions</h3><p>Of 7531 studies identified, 11 were included in the final review. Six studies were rated as high-risk of bias, three with some concerns and two as low-risk of bias. We found no evidence to support specific pharmacotherapeutic management to hasten the natural recovery time-course. Two studies reported significant improvement in selected concussion symptoms following manual therapy (at 48–72 hours post-treatment) or telephone counselling interventions (at 6 months post-injury). No high quality RCTs demonstrate superior effects of early therapeutic interventions on concussion recovery in the first 2 weeks. We advocate future research to examine impacts of health-clinician contact points aligned with symptom-specific interventions.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 59-73"},"PeriodicalIF":2.4,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1466853X2300144X/pdfft?md5=994c056bf897e81c2de775f727c33c43&pid=1-s2.0-S1466853X2300144X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138529338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.1016/j.ptsp.2023.11.003
Masoumeh Baghban Baghdadabad , Shahram Mohaghegh
Background
The Star Excursion Balance Test (SEBT) and its modification(mSEBT) as dynamic tests have been shown to have high reliability and validity for the prediction of lower extremities injuries including ACL ones. No previous study has compared mSEBT performance measures in different hormonal statuses of the menstrual cycle in naturally menstruating women. So aim of the study was comparison of mSEBT performance measures in days of the menstruation cycle with the peak of estrogen and progesterone hormones in naturally menstruating women.
Methods
After a pilot study for estimation of sample size, mSEBT performance measures in a sample of 18 healthy women with regular menstrual cycles were compared two times in their cycles, first in the peak of estrogen (mid-cycle) and second in time of peak of progesterone (one week later). The test was performed 2 times using either the right or left leg as the stance and reach limb.
Findings
No significant difference between days with estrogen and progesterone peaks with right or left reach limb was seen for the percentage of reach in any direction or the composite reach on the mSEBT performance.
Conclusion
It seems that there is the same risk for lower extremities injuries in estradiol and progesterone peak days of normal menstruating women.
{"title":"Balance test results in different hormonal statuses of the menstruation cycle. Are females more susceptible to lower extremities injuries on different days of their menstruation cycles?","authors":"Masoumeh Baghban Baghdadabad , Shahram Mohaghegh","doi":"10.1016/j.ptsp.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.ptsp.2023.11.003","url":null,"abstract":"<div><h3>Background</h3><p>The Star Excursion Balance Test (SEBT) and its modification(mSEBT) as dynamic tests have been shown to have high reliability and validity for the prediction of lower extremities injuries including ACL<span><span> ones. No previous study has compared mSEBT performance measures in different hormonal statuses of the menstrual cycle in naturally menstruating women. So aim of the study was comparison of mSEBT performance measures in days of the menstruation cycle with the peak of estrogen and </span>progesterone hormones in naturally menstruating women.</span></p></div><div><h3>Methods</h3><p>After a pilot study for estimation of sample size, mSEBT performance measures in a sample of 18 healthy women with regular menstrual cycles were compared two times in their cycles, first in the peak of estrogen (mid-cycle) and second in time of peak of progesterone (one week later). The test was performed 2 times using either the right or left leg as the stance and reach limb.</p></div><div><h3>Findings</h3><p>No significant difference between days with estrogen and progesterone peaks with right or left reach limb was seen for the percentage of reach in any direction or the composite reach on the mSEBT performance.</p></div><div><h3>Conclusion</h3><p>It seems that there is the same risk for lower extremities injuries in estradiol and progesterone peak days of normal menstruating women.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 54-58"},"PeriodicalIF":2.4,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138475054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study was to compare muscle strength, balance, and physical activity between children with chronic ankle instability and copers.
Design
Cross-sectional study.
Setting
Pediatric Physical Therapy laboratory.
Participants
Children aged between 7 and 12 years old from regular schools who had a history of unilateral ankle sprain.
Main outcome measures
Lower extremity strength, Static and dynamic standing balance, and Level of physical activity.
Results
Fifteen children with chronic ankle instability and 15 copers were recruited. Demographic data showed no differences between group except for sex and the Cumberland Ankle Instability Tool-Youth (CAITY) score. Children with CAI had a significantly lower score during the standing long jump test (p < 0.05), poorer performance of single leg stance test (p < 0.001) and Y-Balance test in the anterior, posteromedial, and posterolateral directions (p < 0.05) when compared to copers. Total METs per week was significantly higher in the copers (p < 0.05).
Conclusion
Children with chronic ankle instability exhibited weaker lower limb strength, poorer static and dynamic standing balance, and participate in less physical activity compared to those in a coper group which may have future negative health consequences. Knowledge about the differences between the two groups may provide guidance for physical educators and physical therapists. (200 words)
{"title":"Balance, strength and physical activity after ankle sprain: Comparison between children with chronic ankle instability and copers","authors":"Thitirat Suphasubtrakul, Raweewan Lekskulchai, Chutima Jalayondeja","doi":"10.1016/j.ptsp.2023.11.004","DOIUrl":"https://doi.org/10.1016/j.ptsp.2023.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to compare muscle strength, balance, and physical activity between children with chronic ankle instability and copers.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>Pediatric Physical Therapy laboratory.</p></div><div><h3>Participants</h3><p>Children aged between 7 and 12 years old from regular schools who had a history of unilateral ankle sprain.</p></div><div><h3>Main outcome measures</h3><p>Lower extremity strength, Static and dynamic standing balance, and Level of physical activity.</p></div><div><h3>Results</h3><p>Fifteen children with chronic ankle instability and 15 copers were recruited. Demographic data showed no differences between group except for sex and the Cumberland Ankle Instability Tool-Youth (CAITY) score. Children with CAI had a significantly lower score during the standing long jump test (p < 0.05), poorer performance of single leg stance test (p < 0.001) and Y-Balance test in the anterior, posteromedial, and posterolateral directions (p < 0.05) when compared to copers. Total METs per week was significantly higher in the copers (p < 0.05).</p></div><div><h3>Conclusion</h3><p>Children with chronic ankle instability exhibited weaker lower limb strength, poorer static and dynamic standing balance, and participate in less physical activity compared to those in a coper group which may have future negative health consequences. Knowledge about the differences between the two groups may provide guidance for physical educators and physical therapists. (200 words)</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 49-53"},"PeriodicalIF":2.4,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1466853X23001438/pdfft?md5=a4e26a9b779a9cdf998a45664a07ad80&pid=1-s2.0-S1466853X23001438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138437891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-19DOI: 10.1016/j.ptsp.2023.11.002
Rajiv P. Reddy, Matthew Como, Shaquille Charles, Zachary J. Herman, Ehab M. Nazzal, Christopher J. Como, Anya Singh-Varma, Alex Fails, Adam Popchak, Albert Lin
Objective
The purpose of this study was to assess the use of a criteria-based return to sport (CBRTS) test to evaluate readiness for return to play (RTP) in competitive athletes that underwent open Latarjet.
Design
Retrospective case series.
Methods
Ten competitive athletes (mean age 19.9 years) treated with open Latarjet for recurrent glenohumeral instability underwent CBRTS testing at a mean of 5.3 months postoperatively. Testing consisted of four components: 1. isometric strength, 2. isokinetic strength, 3. endurance, and 4. function. Patients failing 0 or 1 component of the test were cleared to RTP. Patients failing multiple components underwent additional deficit-based rehabilitation.
Results
Of the 10 patients that tested, 4 passed their overall CBRTS test and were cleared to RTP. The remaining 6 patients failed the overall CBRTS test. Seven patients (70%) failed at least one section of the strength testing, two patients (20%) failed endurance testing, and two patients (20%) failed functional testing. At final follow-up (mean 3.6 years), 1 patient had recurrent instability (10%) and 9 patients returned to play (90%).
Conclusions
CBRTS testing may be clinically useful for return to play clearance decisions after open Latarjet procedure, as it can reveal deficits that may not be identified with time-based clearance alone.
{"title":"Criteria-based return to sport testing after open Latarjet reveals residual deficits and can be utilized for sports clearance with excellent outcomes at mean 3.6 year follow-up: A small case series of competitive athletes","authors":"Rajiv P. Reddy, Matthew Como, Shaquille Charles, Zachary J. Herman, Ehab M. Nazzal, Christopher J. Como, Anya Singh-Varma, Alex Fails, Adam Popchak, Albert Lin","doi":"10.1016/j.ptsp.2023.11.002","DOIUrl":"10.1016/j.ptsp.2023.11.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess the use of a criteria-based return to sport (CBRTS) test to evaluate readiness for return to play (RTP) in competitive athletes that underwent open Latarjet.</p></div><div><h3>Design</h3><p>Retrospective case series.</p></div><div><h3>Methods</h3><p>Ten competitive athletes (mean age 19.9 years) treated with open Latarjet for recurrent glenohumeral instability underwent CBRTS testing at a mean of 5.3 months postoperatively. Testing consisted of four components: 1. isometric strength, 2. isokinetic strength, 3. endurance, and 4. function. Patients failing 0 or 1 component of the test were cleared to RTP. Patients failing multiple components underwent additional deficit-based rehabilitation.</p></div><div><h3>Results</h3><p>Of the 10 patients that tested, 4 passed their overall CBRTS test and were cleared to RTP. The remaining 6 patients failed the overall CBRTS test. Seven patients (70%) failed at least one section of the strength testing, two patients (20%) failed endurance testing, and two patients (20%) failed functional testing. At final follow-up (mean 3.6 years), 1 patient had recurrent instability (10%) and 9 patients returned to play (90%).</p></div><div><h3>Conclusions</h3><p>CBRTS testing may be clinically useful for return to play clearance decisions after open Latarjet procedure, as it can reveal deficits that may not be identified with time-based clearance alone.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 23-29"},"PeriodicalIF":2.4,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-16DOI: 10.1016/j.ptsp.2023.11.001
Rachel Lau, Swarup Mukherjee
Objectives
To develop the Singapore Youth Shoulder Overuse Injury Prevention Program specifically for competitive overhead youth athletes in Singapore.
Design
Two-round online Delphi technique with experts and a feasibility assessment questionnaire with youth athletes who represented end-users.
Setting
Volleyball for youth athletes.
Participants
Experts were recruited through purposive sampling based on their knowledge and experience. Youth athletes were recruited though a volleyball club.
Main outcome measures
The main outcome measure was the level of consensus on the proposed (1) exercise program for the overhead youth athletes, (2) education program regarding overuse injuries for coaches of overhead youth athletes, and (3) education program regarding overuse injuries for overhead youth athletes. Consensus was set at 75% agreement in this study.
Results
Eighteen experts completed the two Delphi rounds with 100% response rate. Consensus was achieved for the exercise program and both education programs. Twelve youth athletes completed the feasibility assessment questionnaire and found the exercises to be feasible in terms of usefulness, practical use, instructions, duration, and ease of execution.
Conclusion
Consensus was reached for the Singapore Youth Shoulder Overuse Injury Prevention Program, and feasibility of execution by end-users was successfully determined.
{"title":"Developing the Singapore youth shoulder overuse injury prevention program","authors":"Rachel Lau, Swarup Mukherjee","doi":"10.1016/j.ptsp.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.ptsp.2023.11.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To develop the Singapore Youth Shoulder Overuse Injury Prevention Program specifically for competitive overhead youth athletes in Singapore.</p></div><div><h3>Design</h3><p>Two-round online Delphi technique with experts and a feasibility assessment questionnaire with youth athletes who represented end-users.</p></div><div><h3>Setting</h3><p>Volleyball for youth athletes.</p></div><div><h3>Participants</h3><p>Experts were recruited through purposive sampling based on their knowledge and experience. Youth athletes were recruited though a volleyball club.</p></div><div><h3>Main outcome measures</h3><p>The main outcome measure was the level of consensus on the proposed (1) exercise program for the overhead youth athletes, (2) education program regarding overuse injuries for coaches of overhead youth athletes, and (3) education program regarding overuse injuries for overhead youth athletes. Consensus was set at 75% agreement in this study.</p></div><div><h3>Results</h3><p>Eighteen experts completed the two Delphi rounds with 100% response rate. Consensus was achieved for the exercise program and both education programs. Twelve youth athletes completed the feasibility assessment questionnaire and found the exercises to be feasible in terms of usefulness, practical use, instructions, duration, and ease of execution.</p></div><div><h3>Conclusion</h3><p>Consensus was reached for the Singapore Youth Shoulder Overuse Injury Prevention Program, and feasibility of execution by end-users was successfully determined.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 30-37"},"PeriodicalIF":2.4,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138413109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-09DOI: 10.1016/j.ptsp.2023.10.006
Zhen Wei , Xihe Hou , Yujie Qi , Lin Wang
Objectives
This study aimed to determine the effect of foot strike patterns and cadences in male runners with patellofemoral pain (PFP).
Design
Cross-sectional study.
Setting
Biomechanics lab.
Methods
20 male runners with PFP were instructed to randomly complete six running conditions (three cadence conditions in rearfoot strike pattern (RFS) or forefoot strike (FFS)) under a preferred running speed.
Main outcome measures
The primary outcomes were peak knee joint and moment, and secondary outcomes were patellofemoral joint stress.
Results
Running with increased cadence has a lower flexion angle (P = 0.027, η2 = 0.45), lower extension moment (P = 0.011, η2 = 0.29), lower internal rotation moment (P = 0.040, η2 = 0.17), lower patellofemoral stress (P = 0.029, η2 = 0.52) than preferred cadence. FFS running performed significantly lower flexion angle (P = 0.003, η2 = 0.39), lower extension moment (P < 0.001, η2 = 0.91), lower adduction moment (P = 0.020, η2 = 0.25) lower patellofemoral stress (P < 0.001, η2 = 0.81) than RFS running for all cadence.
Conclusions
Preliminary findings provide new perspectives for male runners with PFP to unload patellofemoral joint stress in managing PFP through the combination of the FFS pattern and increased cadence.
{"title":"Influence of foot strike patterns and cadences on patellofemoral joint stress in male runners with patellofemoral pain","authors":"Zhen Wei , Xihe Hou , Yujie Qi , Lin Wang","doi":"10.1016/j.ptsp.2023.10.006","DOIUrl":"10.1016/j.ptsp.2023.10.006","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to determine the effect of foot strike patterns and cadences in male runners with patellofemoral pain (PFP).</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>Biomechanics lab.</p></div><div><h3>Methods</h3><p>20 male runners with PFP were instructed to randomly complete six running conditions (three cadence conditions in rearfoot strike pattern (RFS) or forefoot strike (FFS)) under a preferred running speed.</p></div><div><h3>Main outcome measures</h3><p>The primary outcomes were peak knee joint and moment, and secondary outcomes were patellofemoral joint stress.</p></div><div><h3>Results</h3><p>Running with increased cadence has a lower flexion angle (P = 0.027, η<sup>2</sup> = 0.45), lower extension moment (P = 0.011, η<sup>2</sup> = 0.29), lower internal rotation moment (P = 0.040, η<sup>2</sup> = 0.17), lower patellofemoral stress (P = 0.029, η<sup>2</sup> = 0.52) than preferred cadence. FFS running performed significantly lower flexion angle (P = 0.003, η<sup>2</sup> = 0.39), lower extension moment (P < 0.001, η<sup>2</sup> = 0.91), lower adduction moment (P = 0.020, η<sup>2</sup> = 0.25) lower patellofemoral stress (P < 0.001, η<sup>2</sup> = 0.81) than RFS running for all cadence.</p></div><div><h3>Conclusions</h3><p>Preliminary findings provide new perspectives for male runners with PFP to unload patellofemoral joint stress in managing PFP through the combination of the FFS pattern and increased cadence.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 1-6"},"PeriodicalIF":2.4,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1466853X23001323/pdfft?md5=45285481c3240ff9e8db7f9b3148b0e6&pid=1-s2.0-S1466853X23001323-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cohen's d effect sizes (ESs) were calculated to compare KAM and KFM values of the surgical legs to the non-surgical and to healthy control legs.
Results
When compared to healthy controls, meniscectomy patients' surgical legs demonstrated a significantly greater KAM (ES = 0.310; P = 0.002) but no significant difference in KFM (ES = −0.182; P = 0.051). When compared to the patients' non-surgical legs, however, the surgical legs showed no difference in KAM (ES = −0.024; P = 0.716) but a significantly lower KFM (ES = −0.422; P < 0.001). High heterogeneity among study ESs was observed in patients’ between-limb comparison for KAM (Q-value = 20.08, P = 0.005; I2 = 65.1%) and KFM (Q-value = 43.96, P < 0.001; I2 = 79.5%). However, no significant differences in study ESs (all P > 0.102) of KFM and KAM were identified when comparing studies with various times post-surgery, weight-bearing tasks, walking speeds, or patient demographics.
Conclusion
Elevated KAM and reduced/asymmetrical KFM observed in meniscectomy patients may contribute to the increased risk of knee OA. Rehabilitation should focus on movement education to restore between-limb KFM symmetry and reduce KAM bilaterally post-meniscectomy.
{"title":"Persistent altered knee loading in patients with meniscectomy: A systematic review and meta-analysis","authors":"Kyle T. Falvey, Chad M. Kinshaw, Gordon L. Warren, Liang-Ching Tsai","doi":"10.1016/j.ptsp.2023.10.005","DOIUrl":"10.1016/j.ptsp.2023.10.005","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the changes in knee flexion moment (KFM) and knee adduction<span> moment (KAM) during weight-bearing activities following meniscectomy.</span></p></div><div><h3>Design</h3><p>Meta-Analysis.</p></div><div><h3>Setting</h3><p>Laboratory.</p></div><div><h3>Participants</h3><p>332 meniscectomy patients and 137 healthy controls (from 13 qualified studies)</p></div><div><h3>Main outcome measures</h3><p>Cohen's d effect sizes (ESs) were calculated to compare KAM and KFM values of the surgical legs to the non-surgical and to healthy control legs.</p></div><div><h3>Results</h3><p>When compared to healthy controls, meniscectomy patients' surgical legs demonstrated a significantly greater KAM (ES = 0.310; <em>P</em> = 0.002) but no significant difference in KFM (ES = −0.182; <em>P</em> = 0.051). When compared to the patients' non-surgical legs, however, the surgical legs showed no difference in KAM (ES = −0.024; <em>P</em> = 0.716) but a significantly lower KFM (ES = −0.422; <em>P</em> < 0.001). High heterogeneity among study ESs was observed in patients’ between-limb comparison for KAM (Q-value = 20.08, <em>P =</em> 0.005; I<sup>2</sup> = 65.1%) and KFM (Q-value = 43.96, <em>P</em> < 0.001; I<sup>2</sup> = 79.5%). However, no significant differences in study ESs (all <em>P</em> > 0.102) of KFM and KAM were identified when comparing studies with various times post-surgery, weight-bearing tasks, walking speeds, or patient demographics.</p></div><div><h3>Conclusion</h3><p>Elevated KAM and reduced/asymmetrical KFM observed in meniscectomy patients may contribute to the increased risk of knee OA. Rehabilitation should focus on movement education to restore between-limb KFM symmetry and reduce KAM bilaterally post-meniscectomy.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 14-22"},"PeriodicalIF":2.4,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.1016/j.ptsp.2023.10.007
Mathieu Pulver , Roger Hilfiker , Mario Bizzini , Nicolas Mathieu , Stephan Meyer , Lara Allet
Objectives
To investigate current clinical practice of Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction (ACLR) from pre-operative rehabilitation until return to sport (RTS). We assessed optimisation strategies in daily practice and the perceived barriers to these optimisations, and evaluated whether there was a relevant difference in clinical practice for physiotherapists with post-graduate certification in sports physiotherapy or deep clinical experience and those without such experience.
Design
Cross-sectional survey.
Setting
Online survey platform.
Participants
Swiss physiotherapists.
Main outcome measures
The survey comprised six sections: participant information, pre-operative rehabilitation, post-operative rehabilitation, RTS, re-injury prevention, and optimisation strategies and barriers.
Results
A minority of physiotherapists treated ACLR patients pre-operatively. Overall, 91% included quadriceps open kinetic chain exercise in their treatment, 37% used patient-reported outcomes measures (PROMs) and 39% considered psychological criteria when making decisions about RTS. Most physiotherapists (67%) felt limited due to the time available, the number of prescriptions and the tariffication system.
Conclusion
This study highlights areas within ACLR rehabilitation practice in Switzerland that could be improve. Improvements in understanding of the barriers to implementation of best evidence in practice and a redefinition of the clinical process around ACLR rehabilitation in Switzerland are necessary.
{"title":"Clinical practice and barriers among Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction: A survey of pre-operative rehabilitation to return to sport","authors":"Mathieu Pulver , Roger Hilfiker , Mario Bizzini , Nicolas Mathieu , Stephan Meyer , Lara Allet","doi":"10.1016/j.ptsp.2023.10.007","DOIUrl":"10.1016/j.ptsp.2023.10.007","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate current clinical practice of Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction (ACLR) from pre-operative rehabilitation until return to sport (RTS). We assessed optimisation strategies in daily practice and the perceived barriers to these optimisations, and evaluated whether there was a relevant difference in clinical practice for physiotherapists with post-graduate certification in sports physiotherapy or deep clinical experience and those without such experience.</p></div><div><h3>Design</h3><p>Cross-sectional survey.</p></div><div><h3>Setting</h3><p>Online survey platform.</p></div><div><h3>Participants</h3><p>Swiss physiotherapists.</p></div><div><h3>Main outcome measures</h3><p>The survey comprised six sections: participant information, pre-operative rehabilitation, post-operative rehabilitation, RTS, re-injury prevention, and optimisation strategies and barriers.</p></div><div><h3>Results</h3><p>A minority of physiotherapists treated ACLR patients pre-operatively. Overall, 91% included quadriceps open kinetic chain exercise in their treatment, 37% used patient-reported outcomes measures (PROMs) and 39% considered psychological criteria when making decisions about RTS. Most physiotherapists (67%) felt limited due to the time available, the number of prescriptions and the tariffication system.</p></div><div><h3>Conclusion</h3><p>This study highlights areas within ACLR rehabilitation practice in Switzerland that could be improve. Improvements in understanding of the barriers to implementation of best evidence in practice and a redefinition of the clinical process around ACLR rehabilitation in Switzerland are necessary.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 38-48"},"PeriodicalIF":2.4,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1466853X23001335/pdfft?md5=4820bf9d4e6031eb9d407dcaf808b858&pid=1-s2.0-S1466853X23001335-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-04DOI: 10.1016/j.ptsp.2023.10.004
Carel Viljoen , Eileen du Toit , Tyla van Niekerk , Sylvester Mashaba , Zinhle Ndaba , Michelle Verster , Andre Bellingan , Dimakatso Ramagole , Audrey Jansen van Rensburg , Tanita Botha , Dina C. Janse van Rensburg
Objectives
Determine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances.
Design
Retrospective cross-sectional study.
Setting
The six months training period before the 2022 Mac Ultra races (46 km, 80 km, 161 km and 322 km).
Participants
Of the 245 race entrants, 162 (66% of Mac ultra-trail runners) consented to analyse their data.
Outcome measures
Injury rate (injuries per 1000 h of running), point prevalence (% of currently injured participants), injury severity (time loss), and the frequency (n, %) of injuries reported during pre-race medical screening in the six months before the race. Using inferential statistics, we compared the injury rates between the different race distance categories (46 km, 80 km, 161 km, 322 km). All tests were performed at a 5% level of significance.
Results
We reported a statistically significantly higher injury rate among 46 km study participants (3.09 injuries per 1000 h) compared to the injury rates reported among 80 km (0.68 injuries per 1000 h; p = 0.001) and 161 km (1.09 injuries per 1000 h; p = 0.028) participants. The lower limb (89%) was the most injured anatomical region, with only 46 km study participants reporting upper limb, trunk, and head injuries (11%). Muscle/tendon was the most reported injured tissue type (56%), with muscle injuries (31%) the most reported pathology type. Shorter distance ultra-trail runners reported the highest injury severity.
Conclusion
Ultra-trail runners training towards shorter ultra-trail distance races presented with a higher injury rate, more diverse injury profile, and a higher injury severity.
{"title":"Training for shorter ultra-trail races results in a higher injury rate, a more diverse injury profile, and more severe injuries: 2022 Mac ultra races","authors":"Carel Viljoen , Eileen du Toit , Tyla van Niekerk , Sylvester Mashaba , Zinhle Ndaba , Michelle Verster , Andre Bellingan , Dimakatso Ramagole , Audrey Jansen van Rensburg , Tanita Botha , Dina C. Janse van Rensburg","doi":"10.1016/j.ptsp.2023.10.004","DOIUrl":"10.1016/j.ptsp.2023.10.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Determine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances.</p></div><div><h3>Design</h3><p>Retrospective cross-sectional study.</p></div><div><h3>Setting</h3><p>The six months training period before the 2022 Mac Ultra races (46 km, 80 km, 161 km and 322 km).</p></div><div><h3>Participants</h3><p>Of the 245 race entrants, 162 (66% of Mac ultra-trail runners) consented to analyse their data.</p></div><div><h3>Outcome measures</h3><p>Injury rate (injuries per 1000 h of running), point prevalence (% of currently injured participants), injury severity (time loss), and the frequency (n, %) of injuries reported during pre-race medical screening in the six months before the race. Using inferential statistics, we compared the injury rates between the different race distance categories (46 km, 80 km, 161 km, 322 km). All tests were performed at a 5% level of significance.</p></div><div><h3>Results</h3><p>We reported a statistically significantly higher injury rate among 46 km study participants (3.09 injuries per 1000 h) compared to the injury rates reported among 80 km (0.68 injuries per 1000 h; p = 0.001) and 161 km (1.09 injuries per 1000 h; p = 0.028) participants. The lower limb (89%) was the most injured anatomical region, with only 46 km study participants reporting upper limb, trunk, and head injuries<span> (11%). Muscle/tendon was the most reported injured tissue type (56%), with muscle injuries (31%) the most reported pathology type. Shorter distance ultra-trail runners reported the highest injury severity.</span></p></div><div><h3>Conclusion</h3><p>Ultra-trail runners training towards shorter ultra-trail distance races presented with a higher injury rate, more diverse injury profile, and a higher injury severity.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"65 ","pages":"Pages 7-13"},"PeriodicalIF":2.4,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135412276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.ptsp.2023.10.001
Joshua D. Rigg , Nirmala Kanthi Panagodage Perera , Liam A. Toohey , Jennifer Cooke , David Hughes
Objectives
To report anterior cruciate ligament (ACL) injury occurrence, return to sport (RTS) timeframes and ACL subsequent injuries recorded in the Australian High Performance Sports System according to athlete sex.
Methods
ACL injury data of injured athletes were prospectively collected by the treating sports and exercise physicians and physiotherapists within the Australian High Performance Sports System between January 1, 2015 and May 31, 2020. RTS time frames for ACL injuries and the proportion of subsequent ACL injuries were calculated. The RTS time was compared between sexes, age groups and ACL injury categories using the Mann-Whitney U test and the Kruskal-Wallis test.
Results
A total of 132 ACL injuries were reported in 108 athletes (77 female, 31 male). ACL injuries accounted for 6.4% of all reported knee injuries, with almost half (48.5%) of the ACL injuries reported to occur during training. Median RTS time was 369 days (IQR = 273–487), with RTS times reducing with increasing age (X2 (Zbrojkiewicz et al., 2018) = 11.781, p = 0.008). The presence of concurrent knee pathology did not significantly affect the RTS timeframes. ACL injuries were most frequently reported in netball, winter sports, basketball, field hockey and gymnastics. One quarter of the ACL reported (n = 34, 25.8%) were subsequent to a prior ACL injury, with the majority of these injuries occurring to the ipsilateral knee (n = 26) as opposed to contralateral knee (n = 6).
Conclusions
Despite ACL injuries accounting for a small proportion of all knee injuries reported in the Australian High Performance Sports System, more than a quarter are subsequent to a previous ACL injury. Shorter RTS times were observed in older athletes; however, considerable periods of time-loss occur as a consequence of ACL injuries. Effective primary prevention, rehabilitation processes, and ongoing tertiary prevention strategies are warranted in this population.
{"title":"Anterior cruciate ligament injury occurrence, return to sport and subsequent injury in the Australian High Performance Sports System: A 5-year retrospective analysis","authors":"Joshua D. Rigg , Nirmala Kanthi Panagodage Perera , Liam A. Toohey , Jennifer Cooke , David Hughes","doi":"10.1016/j.ptsp.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.ptsp.2023.10.001","url":null,"abstract":"<div><h3>Objectives</h3><p><span>To report anterior cruciate ligament (ACL) injury occurrence, return to sport (RTS) timeframes and </span>ACL subsequent injuries recorded in the Australian High Performance Sports System according to athlete sex.</p></div><div><h3>Methods</h3><p>ACL injury data of injured athletes were prospectively collected by the treating sports and exercise physicians and physiotherapists within the Australian High Performance Sports System between January 1, 2015 and May 31, 2020. RTS time frames for ACL injuries and the proportion of subsequent ACL injuries were calculated. The RTS time was compared between sexes, age groups and ACL injury categories using the Mann-Whitney <em>U</em> test and the Kruskal-Wallis test.</p></div><div><h3>Results</h3><p>A total of 132 ACL injuries were reported in 108 athletes (77 female, 31 male). ACL injuries accounted for 6.4% of all reported knee injuries, with almost half (48.5%) of the ACL injuries reported to occur during training. Median RTS time was 369 days (IQR = 273–487), with RTS times reducing with increasing age (<em>X</em><sup>2</sup><span> (Zbrojkiewicz et al., 2018) = 11.781, p = 0.008). The presence of concurrent knee pathology did not significantly affect the RTS timeframes. ACL injuries were most frequently reported in netball, winter sports, basketball, field hockey and gymnastics. One quarter of the ACL reported (n = 34, 25.8%) were subsequent to a prior ACL injury, with the majority of these injuries occurring to the ipsilateral knee (n = 26) as opposed to contralateral knee (n = 6).</span></p></div><div><h3>Conclusions</h3><p>Despite ACL injuries accounting for a small proportion of all knee injuries reported in the Australian High Performance Sports System, more than a quarter are subsequent to a previous ACL injury. Shorter RTS times were observed in older athletes; however, considerable periods of time-loss occur as a consequence of ACL injuries. Effective primary prevention, rehabilitation processes, and ongoing tertiary prevention strategies are warranted in this population.</p></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"64 ","pages":"Pages 140-146"},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92103007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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