Physical Therapy in Sport最新文献_第2页

Updating the 300 standards of the International Sports Physiotherapy Competencies and Standards from 11 countries in 2005 to 38 countries in 2025: An international Delphi study 从2005年11个国家的300项国际运动物理治疗能力和标准更新到2025年的38个国家：一项国际德尔菲研究。

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-12-05 DOI: 10.1016/j.ptsp.2025.12.001

Bruno Tassignon , Emilie Dick , Jo Verschueren , Elke Lathouwers , Carlo Ramponi , Maria Constantinou , Mati Arend , Laura Lepasalu , Armi Hirvonen , Sanna Sihvonen , Sanna Paasu-Hynynen , Eleni Kapreli , Aristi Tsokani , Nikolaos Strimpakos , Luciana De Michelis Mendonça

Objectives

To update the 300 standards of the International Sports Physiotherapy Competencies and Standards document.

Design

A three-round Delphi study.

Setting

Online international survey.

Participants

Sports physiotherapists (SPTs) with a national registration/licensure recognised by their national SPT member organisation, at least 5 years of professional experience in SPT and/or equivalent teaching or research experience, and direct involvement with athletes in treatment, prevention or research contexts.

Maint outcome measures

Participants rated each of the original 300 standards on a three-point scale (Agree, Disagree, Unsure). Consensus was defined a priori as ≥80 % agreement.

Results

A total of 197 SPTs representing 46 countries were invited; 143 participants from 38 countries completed Round 1 (72.6 % response rate), and 101 completed all three rounds (70.6 % of Round 1 participants). After three rounds, 296 (98.7 %) standards reached a consensus. Four standards did not reach a consensus; all pertained to the Professionalism and Management competency, specifically aspects of financial and organisational management (Behaviour 1, item 2; foundational knowledge standards 7A:3 and 7A:5; and action/intervention standard 7E:2).

Conclusion

This Delphi study updated the 300 standards from the International Sports Physiotherapy Competencies and Standards with contributions from 11 countries in 2005 to 38 countries in 2025. Consensus on 296 of 300 standards affirms their continued global relevance. The four standards lacking consensus, all related to managerial roles.

目的：更新国际运动物理治疗能力和标准文件的300个标准。设计：三轮德尔菲研究。设置：在线国际调查。参与者：具有国家注册/执照的运动物理治疗师（SPT），由其国家SPT成员组织认可，至少5年的SPT专业经验和/或同等的教学或研究经验，并直接参与运动员的治疗，预防或研究背景。维持结果测量：参与者对最初的300个标准中的每一个标准进行打分，满分为3分（同意、不同意、不确定）。共识被先验地定义为≥80%的一致性。结果：共邀请了46个国家的197个小组专家；来自38个国家的143名参与者完成了第一轮（反应率为72.6%），101名参与者完成了所有三轮（第一轮参与者的70.6%）。经过三轮协商，296项标准（98.7%）达成共识。四项标准未达成共识；都与专业和管理能力有关，特别是财务和组织管理方面（行为1，第2项；基础知识标准7A:3和7A:5；以及行动/干预标准7E:2）。结论：德尔菲研究将国际运动物理治疗能力和标准中的300个标准从2005年的11个国家更新到2025年的38个国家。在300项标准中，有296项达成了共识，确认了它们继续具有全球相关性。这四个标准缺乏共识，都与管理角色有关。

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引用次数: 0

Relationship between quadriceps strength performance and knee joint function during single-leg hop test in runners with patellofemoral pain 髌骨股痛跑步者单腿跳跃试验中股四头肌力量表现与膝关节功能的关系

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-22 DOI: 10.1016/j.ptsp.2025.11.009

Hang Pan, Shengxing Fu, Yulin Zhou, Hanjun Li, Huijuan Shi

Objectives

To investigate differences in isokinetic quadriceps strength and knee joint function during single-leg hop test between runners with patellofemoral pain (PFP) and healthy runners, and their relationship.

Design

Controlled and correlational study.

Setting

Biomechanics laboratory.

Participants

24 runners with PFP and 17 healthy individuals.

Main outcome measures

Quadriceps torque and power were assessed by the isokinetic dynamometer. Kinematics and kinetics, including joint moment, power, and joint work were collected via 3D motion capture and force plates during the hop test. Group differences were tested with Two-way ANOVA, and Partial correlation assessed the relationship between quadriceps strength and hop biomechanics.

Results

No group differences in quadriceps strength were identified (p ≥ 0.618). PFP group displayed increased hip work (p = 0.020) and contribution (p = 0.016), but reduced knee work contribution (p = 0.029) during single-leg hop test. Quadriceps strength correlated with knee function during the hop test in controls (r ≥ 0.485, p ≤ 0.048) but not in PFP group (r ≤ 0.287, p ≥ 0.208).

Conclusions

Runners with PFP exhibited no quadriceps weakness but used a more hip-dominant strategy. Quadriceps strength was correlated with hop biomechanics in healthy individuals, but this relationship was disrupted in runners with PFP.

目的探讨髌股疼痛（PFP）跑步者与健康跑步者单腿跳测试中等速股四头肌力量和膝关节功能的差异及其关系。设计对照和相关研究。SettingBiomechanics实验室。参与者包括24名患有PFP的跑步者和17名健康的人。主要结果测量：用等速测功机评估股四头肌扭矩和力量。在跳跃测试期间，通过3D运动捕捉和力板收集了运动学和动力学数据，包括关节力矩、功率和关节功。采用双向方差分析检验组间差异，偏相关评估股四头肌力量与跳跃生物力学之间的关系。结果组间股四头肌力量无差异（p≥0.618）。单腿跳试验中，PFP组髋部功增加（p = 0.020），贡献量增加（p = 0.016），膝关节功减少（p = 0.029）。在对照组的跳跃试验中，股四头肌力量与膝关节功能相关（r≥0.485,p≤0.048），而在PFP组中不相关（r≤0.287,p≥0.208）。结论：PFP的跑步者没有表现出股四头肌无力，但使用更多的髋部优势策略。在健康个体中，股四头肌力量与跳跃生物力学相关，但这种关系在PFP跑步者中被破坏。

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引用次数: 0

Development of a graded pelvic loading pathway using external pelvic acceleration variables to aid return to running postpartum 使用骨盆外加速变量的分级骨盆负荷途径的发展，以帮助恢复产后跑步

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-22 DOI: 10.1016/j.ptsp.2025.11.008

Megan L. James , Victoria H. Stiles , Lynne Evans , Diane M. Crone , Gráinne M. Donnelly , Isabel S. Moore

Objectives

To assess the basis for developing a graded loading pathway that is specific to the pelvis, to aid return to running postpartum.

Participants

Seventeen runners (28.4 ± 7.0 years, 63.7 ± 9.2 kg, 1.63 ± 0.06 m) completed five treadmill running conditions and eight overground activities.

Main outcome measures

Repeated measures ANOVA/Friedman tests assessed differences in pelvic acceleration variables between treadmill running conditions. Correlations assessed relationships between pelvic acceleration, kinetic variables and ratings of perceived pelvic impact. Activities were ranked according to pelvic acceleration variables. Means±SDs and medians (IQR) were calculated as appropriate.

Results

Grounded running had lower peak pelvic acceleration (2.8 ± 0.5 g), average (18.5(14.2–26.5) gs⁻¹) and instantaneous (32.2(25.3–44.5) gs⁻¹) jerk and area under acceleration curve (0.58(0.56–0.62 gs) compared to habitual running per step. However, per kilometre, grounded running was not always lower. Relationships between variables differed across activities. A graded pelvic loading pathway was presented, spanning from walking to double leg high hopping.

Conclusions

A graded pelvic loading pathway was developed that could be further refined to aid postpartum return to running. Grounded running demonstrated lower pelvic acceleration loading than habitual running and may provide a suitable transition prior to returning to running. Localised variables may be needed to adequately inform pelvic activity progressions.

目的：评估制定骨盆分级负荷途径的基础，以帮助产后恢复跑步。17名跑步者（28.4±7.0岁，63.7±9.2公斤，1.63±0.06米）完成了5种跑步机跑步工况和8种地上跑步工况。主要结果测量：重复测量方差分析/弗里德曼测试评估了不同跑步机运行条件下盆腔加速变量的差异。相关性评估盆腔加速度、动力学变量和感知盆腔冲击评分之间的关系。根据骨盆加速变量对活动进行排序。根据需要计算平均值±标准差和中位数（IQR）。结果与常规跑步相比，接地跑步的骨盆加速度峰值（2.8±0.5 g）、平均加速度（18.5(14.2-26.5)gs−1）和瞬时加速度（32.2(25.3-44.5)gs−1）和加速度曲线下面积(0.58（0.56-0.62 g）均较常规跑步低。然而，每公里，接地跑并不总是更低。变量之间的关系因活动而异。提出了一个分级的骨盆负荷途径，从步行到双腿高跳。结论建立了一个分级的骨盆负荷通路，可以进一步完善，以帮助产后恢复跑步。脚踏实地的跑步比习惯性的跑步表现出更低的骨盆加速度负荷，并且可能在回到跑步之前提供合适的过渡。局部变量可能需要充分告知骨盆活动进展。

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引用次数: 0

Strength recovery trajectories in young adults with and without generalized joint hypermobility during the first two years after anterior cruciate ligament reconstruction: a registry study 前交叉韧带重建后头两年有或无广泛性关节过度活动的年轻人的力量恢复轨迹：一项登记研究

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-20 DOI: 10.1016/j.ptsp.2025.11.007

Jakob Lindskog , Behnam Liaghat , Rebecca Hamrin Senorski , Kristian Samuelsson , Roland Thomeé , Eric Hamrin Senorski

Objective

Compare muscle strength and hop performance trajectories between patients with and without generalized joint hypermobility (GJH) during the first two years after anterior cruciate ligament (ACL) reconstruction.

Design

Retrospective study using prospective registry data.

Setting

Rehabilitation-specific registry.

Participants

1223 patients (23.8 % GJH; mean age 22.5 ± 5.2 years; 52 % female) underwent hamstring tendon (HT) or bone–patellar tendon–bone (BPTB) autograft ACL reconstruction.

Main outcome measures

Quadriceps and hamstring strength limb symmetry index (LSI) and body weight-normalized strength, and vertical-, distance-, and 30-s side hop LSI at 10 weeks, 4, 8, 12, 18 months, and 2 years were analyzed. Linear mixed-effects models, adjusted for age and sex, compared trajectories stratified by autograft.

Results

No differences in strength or hop performance trajectories were observed between groups. At 2 years, quadriceps and hamstrings LSIs were comparable (HT: quadriceps 99–100 %, hamstrings 99 %; BPTB: quadriceps 94–99 %, hamstrings 103–104 %).

Conclusion

There was no difference in muscle strength recovery trajectories, evaluated as LSI and body weight-normalized strength for the quadriceps and hamstrings muscles, or in the vertical hop, hop for distance, and 30-s side hop test LSIs between patients with and without GJH during the first two years after ACL reconstruction, regardless of whether HT or BPTB was used.

目的比较前交叉韧带（ACL）重建后的头两年，有和没有广泛性关节过动症（GJH）患者的肌肉力量和跳跃表现轨迹。设计采用前瞻性登记资料进行回顾性研究。SettingRehabilitation-specific注册表。参与者1223例患者（23.8%为GJH；平均年龄22.5±5.2岁；52%为女性）接受了腿筋肌腱（HT）或骨-髌腱-骨（BPTB）自体移植ACL重建。主要结果测量指标为：股四头肌和腘绳肌力量、肢体对称指数（LSI）和体重标准化力量，以及10周、4、8、12、18个月和2年的垂直、距离和30秒侧跳LSI。线性混合效应模型，调整了年龄和性别，比较了由自体移植物分层的轨迹。结果两组之间的力量和跳跃运动轨迹没有差异。2年后，股四头肌和腘绳肌的lsi具有可比性（HT：股四头肌99% - 100%，腘绳肌99%；BPTB：股四头肌94 - 99%，腘绳肌103 - 104%）。结论：无论是HT还是BPTB，在ACL重建后的前两年，GJH患者和非GJH患者的肌肉力量恢复轨迹（以LSI和体重归一化的股四头肌和腘绳肌的力量来评估）、垂直跳跃、距离跳跃和30秒侧跳测试LSI没有差异。

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引用次数: 0

Differences in calf-raise exercise and short-foot exercise on feedforward and feedback activation in healthy young 犊牛运动和短足运动对健康青年前馈和反馈激活的差异。

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-19 DOI: 10.1016/j.ptsp.2025.11.004

Jinyuan Guo , Yujia Li , Qiuchen Huang , Xueqin Rong , Pengcui Li

Objectives

To compare the effects of short-foot exercise (SFE) and calf-raise exercise (CRE) on feedforward and feedback mechanisms of dynamic postural control in healthy young adults.

Design

Randomized controlled trial with assessments pre-training (PRE), immediately post-training (POST1), and after 4 weeks (POST2). Participants performed SFE or CRE (3 × 15 reps, 3–4 times/week for 4 weeks).

Setting

Laboratory-based balance assessment using instrumented posturography.

Participants

50 healthy adults (23.9 ± 1.92 years; 23 males) randomly assigned to SFE or CRE groups; 46 completed the study.

Main outcome measures

Sit-to-stand test (Weight Transfer, Rising Index, Sway Velocity), Reaction Time test (Pre-motor Time, Motor Time), Adaptation Test (toes-up and toes-down balance scores).

Results

Both groups showed improved postural stability: reduced Sway Velocity (p < 0.05), shorter Pre-motor and Motor Times (p < 0.05), and better Adaptation Test scores (p < 0.05). SFE led to greater long-term improvement in Rising Index (p < 0.05) and toes-up adaptation, indicating enhanced feedforward control and center of gravity transfer.

Conclusions

Both exercises improve dynamic balance, but SFE offers superior long-term benefits in feedforward control and stability against sagittal plane perturbations.

目的：比较短足运动（SFE）和犊牛运动（CRE）对健康青壮年动态姿势控制前馈和反馈机制的影响。设计：随机对照试验，包括训练前（PRE）、训练后立即（POST1）和4周后（POST2）的评估。参与者进行SFE或CRE （3 × 15次，每周3-4次，持续4周）。设置：基于实验室的平衡评估使用仪器姿势。参与者：50名健康成人（23.9±1.92岁；23名男性）随机分为SFE组或CRE组；46人完成了研究。主要结果测量：坐立测试（重量转移，上升指数，摇摆速度），反应时间测试（运动前时间，运动时间），适应测试（脚趾上和脚趾下平衡分数）。结果：两组均表现出改善的姿势稳定性：降低的摇摆速度(p)结论：两种运动都改善了动态平衡，但SFE在前馈控制和稳定矢状面扰动方面具有更大的长期益处。

{"title":"Differences in calf-raise exercise and short-foot exercise on feedforward and feedback activation in healthy young","authors":"Jinyuan Guo , Yujia Li , Qiuchen Huang , Xueqin Rong , Pengcui Li","doi":"10.1016/j.ptsp.2025.11.004","DOIUrl":"10.1016/j.ptsp.2025.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the effects of short-foot exercise (SFE) and calf-raise exercise (CRE) on feedforward and feedback mechanisms of dynamic postural control in healthy young adults.</div></div><div><h3>Design</h3><div>Randomized controlled trial with assessments pre-training (PRE), immediately post-training (POST1), and after 4 weeks (POST2). Participants performed SFE or CRE (3 × 15 reps, 3–4 times/week for 4 weeks).</div></div><div><h3>Setting</h3><div>Laboratory-based balance assessment using instrumented posturography.</div></div><div><h3>Participants</h3><div>50 healthy adults (23.9 ± 1.92 years; 23 males) randomly assigned to SFE or CRE groups; 46 completed the study.</div></div><div><h3>Main outcome measures</h3><div>Sit-to-stand test (Weight Transfer, Rising Index, Sway Velocity), Reaction Time test (Pre-motor Time, Motor Time), Adaptation Test (toes-up and toes-down balance scores).</div></div><div><h3>Results</h3><div>Both groups showed improved postural stability: reduced Sway Velocity (p < 0.05), shorter Pre-motor and Motor Times (p < 0.05), and better Adaptation Test scores (p < 0.05). SFE led to greater long-term improvement in Rising Index (p < 0.05) and toes-up adaptation, indicating enhanced feedforward control and center of gravity transfer.</div></div><div><h3>Conclusions</h3><div>Both exercises improve dynamic balance, but SFE offers superior long-term benefits in feedforward control and stability against sagittal plane perturbations.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"77 ","pages":"Pages 104-112"},"PeriodicalIF":2.2,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835955","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}

引用次数: 0

Prognostic indicators of lower extremity functional recovery after anterior cruciate ligament reconstruction 前交叉韧带重建术后下肢功能恢复的预后指标。

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-17 DOI: 10.1016/j.ptsp.2025.11.006

Hayden Price , Sonu Bae , Gabriel Alain , Laura Schmitt , Tyler Barker

Objective

To create a predictive model of early post-operative function after anterior cruciate ligament reconstruction (ACLR) using demographic and surgical prognostic indicators.

Design

Retrospective cohort study.

Setting

Outpatient academic hospital.

Participants

962 adult patients with ACLR.

Main outcome measure

The longitudinal trajectory of Lower Extremity Functional Scale (LEFS) scores over the first 26 weeks post-ACLR was modeled using a negative exponential function with three parameters: an initial functional status immediately after ACLR (pseudo-intercept), a recovery rate constant, and a recovery plateau (asymptote). Associations of demographic (age, sex, body mass index [BMI]) and surgical factors (graft type, concomitant surgical procedures) with each of the parameters were evaluated. A multivariate model was created from significant prognostic indicators identified.

Results

Lower initial function was associated with quadriceps tendon autografts and concomitant procedures. Female sex, quadriceps tendon autografts, and concomitant procedures were associated with slower recovery rates. Older age and higher BMI were associated with lower recovery plateaus. Inclusion of demographic and surgical predictors improved model performance compared to time post-ACLR alone.

Conclusions

Demographic and surgical factors are prognostic of early post-operative function after ACLR, and a predictive model for postoperative LEFS scores created using these factors may provide insights useful for rehabilitation planning.

目的：利用人口学和手术预后指标建立前交叉韧带重建（ACLR）术后早期功能预测模型。设计：回顾性队列研究。单位：学术医院门诊。参与者：962例ACLR成年患者。主要结果测量：ACLR后前26周的下肢功能量表（LEFS）评分的纵向轨迹使用带有三个参数的负指数函数建模：ACLR后立即的初始功能状态（伪截距），恢复速率常数和恢复平台（渐近线）。评估人口统计学（年龄、性别、体重指数[BMI]）和手术因素（移植物类型、伴随手术）与每项参数的关系。从确定的重要预后指标创建了一个多变量模型。结果：较低的初始功能与自体股四头肌肌腱移植和伴随手术有关。女性、自体股四头肌肌腱移植及伴随手术与较慢的恢复率相关。年龄越大和BMI越高，恢复平台期越低。与单纯aclr后相比，纳入人口统计学和外科预测因素可提高模型的性能。结论：人口统计学和手术因素是ACLR术后早期功能的预后因素，利用这些因素建立的术后LEFS评分预测模型可能为康复计划提供有用的见解。

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引用次数: 0

Males with chronic ankle instability exhibit sex-specific force sense deficits 患有慢性踝关节不稳的男性表现出性别特异性的力感缺陷

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-14 DOI: 10.1016/j.ptsp.2025.11.005

Xin Liang , Bin Shen , Songlin Xiao , Zhen Xu , Chuyi Zhang , Xuekai Zong , Jingjing Li , Jia Han , Weijie Fu

Objective

To explore whether there are differences in sensorimotor function between sexes in individuals with and without chronic ankle instability (CAI).

Design

Cross-sectional study.

Setting

Laboratory.

Participants

50 (26 males/24 females) individuals with CAI and 40 (17 males/23 females) healthy controls (HC).

Main outcome measures

Ankle muscle strength and proprioception were assessed using an isokinetic dynamometer. Static balance performance was assessed by a one-leg standing task, and dynamic balance performance was tested using the Y-Balance test.

Results

Compared with healthy controls, both males and females with CAI exhibited worse proprioception and balance control, but no difference in muscle strength. A significant group and sex interaction effect was observed of force sense in the dorsiflexion direction (F = 5.14, p = 0.026,

η_{p}^{2}

= 0.057). Post-hoc analysis showed that, the absolute error of force sense in males was significantly larger than females in the CAI group (p < 0.001), while there was no difference in the HC (p = 0.536).

Conclusion

This finding indicated that among individuals with CAI, males are more likely to experience a greater impairment in the dorsiflexion direction of force sense than females. Future rehabilitation programs should consider targeted proprioceptive interventions for males to address this deficit effectively.

目的探讨慢性踝关节不稳定（CAI）患者的感觉运动功能是否存在性别差异。DesignCross-sectional study.SettingLaboratory。参与者50例（26男/24女）CAI患者和40例（17男/23女）健康对照（HC）。主要结果测量：踝关节肌力和本体感觉采用等速测功仪进行评估。静态平衡性能通过单腿站立任务进行评估，动态平衡性能使用Y-Balance测试。结果与健康对照组相比，CAI患者的本体感觉和平衡控制能力较差，但肌肉力量无显著差异。背屈方向的力感存在显著的组性交互作用（F = 5.14, p = 0.026, ηp2 = 0.057）。事后分析显示，CAI组男性的力感绝对误差显著大于女性（p < 0.001），而HC组无差异（p = 0.536）。结论在CAI患者中，男性的力感背屈方向损伤明显大于女性。未来的康复计划应考虑针对男性本体感觉干预，以有效解决这一缺陷。

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引用次数: 0

Clinical predictors of ACL reinjury after reconstruction: Insights from a Brazilian cohort ACL重建后再损伤的临床预测因素：来自巴西队列的见解。

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-08 DOI: 10.1016/j.ptsp.2025.11.003

Andrea Forgas Sallum , Rene Jorge Abdalla , Rogério Teixeira de Carvalho , Carlos Eduardo Franciozi

Objectives

To investigate predictors of anterior cruciate ligament (ACL) reinjury in a cohort of 234 patients who underwent isolated ACL reconstruction.

Design

Retrospective cohort study with prospective follow-up.

Setting

Medical records of 1155 patients were screened. Patients were followed up via phone interviews and evaluated with functional scales and clinical data.

Participants

234 patients with isolated, primary ACL injuries. Data collected included demographics, graft type, isokinetic strength deficits, dynamic knee valgus tests, and follow-up duration.

Main outcome measures

ACL reinjury (ipsilateral graft rupture or contralateral), confirmed through medical documentation. Functional outcomes assessed with Tegner and Lysholm scores.

Results

Reinjury was observed in 27 patients (contralateral), 29 (ipsilateral), and 7 (bilateral). Age at primary injury was the only significant predictor of reinjury (OR = 0.97, p = 0.028). Muscle strength deficits and dynamic valgus were not associated with reinjury risk. Patients with >5 years of follow-up had significantly lower Tegner scores (p = 0.039), though Lysholm scores showed no significant difference.

Conclusions

Younger age is a significant predictor of ACL reinjury. Functional scores decline over time, likely due to aging rather than graft failure. These results highlight the importance of long-term follow-up, particularly in younger patients.

目的：探讨234例前交叉韧带（ACL）孤立重建患者再损伤的预测因素。设计：前瞻性随访的回顾性队列研究。设定：筛选1155例患者的病历。通过电话访谈对患者进行随访，并用功能量表和临床数据对患者进行评估。参与者：234例孤立的原发性ACL损伤患者。收集的数据包括人口统计学、移植物类型、等速力量缺陷、动态膝外翻试验和随访时间。主要观察指标：ACL再损伤（同侧移植物断裂或对侧），经医学文献证实。用Tegner和Lysholm评分评估功能结局。结果：27例（对侧）、29例（同侧）、7例（双侧）出现再损伤。初次损伤年龄是再次损伤的唯一显著预测因子（OR = 0.97, p = 0.028）。肌肉力量不足和动态外翻与再损伤风险无关。随访5年的患者Tegner评分显著降低（p = 0.039）， Lysholm评分差异无统计学意义。结论：年轻是前交叉韧带再损伤的重要预测因素。功能评分随着时间的推移而下降，可能是由于衰老而不是移植物衰竭。这些结果强调了长期随访的重要性，特别是对年轻患者。

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引用次数: 0

Use of concurrent auditory, tactile, and visual cueing and estimated cadence increases on Achilles tendon loading in running 同时使用听觉、触觉和视觉提示和估计节奏增加跑步时跟腱负荷。

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-07 DOI: 10.1016/j.ptsp.2025.11.002

Grace Rudek , Emma Heinert , C. Nathan Vannatta , Drew Rutherford , Thomas W. Kernozek

Objective

If self-estimated cadence increases or real-time cueing using auditory, tactile, and visual cues increases cadence and reduces Achilles tendon (AT) loading in runners.

Design

Controlled laboratory.

Participants

35 recreational runners (age: 22.4 ± 1.9 years, mass: 74.5 ± 12.0 kg, height: 1.76 ± 0.09 m)

Main outcome measures

Cadence was measured at preferred running cadence (baseline), self-estimated 10 % cadence increase, and 10 % increased real-time cadence cues, on an instrumented treadmill where kinematics and kinetics were obtained. Inverse dynamics and static optimization were applied to a 16-segment musculoskeletal model for kinematics and kinetics related to AT loading.

Results

Cueing methods increased cadence from the baseline run (4.9 %–9.6 %) (p < 0.05). Foot inclination angle was unchanged (p > 0.05). Auditory cueing and visual cueing increased cadence to reduce AT Force by 10.9 % and 7.7 %, respectively. Step time and peak soleus force decreased for all conditions (p < 0.05). Peak ground reaction force decreased with visual cues (p < 0.05). Gastrocnemius force was unchanged.

Conclusion

Auditory and visual cues effectively influenced cadence, altering AT loading. Runners responded to auditory and visual cuing. Clinicians may consider these strategies when targeting cadence manipulation in runners with AT injuries in treadmill running.

目的：如果自我估计的节奏增加或使用听觉、触觉和视觉线索的实时提示增加节奏并减少跑步者跟腱（AT）负荷。设计：受控实验室。参与者：35名休闲跑步者（年龄：22.4±1.9岁，体重：74.5±12.0 kg，身高：1.76±0.09 m）主要结果测量：在仪器化的跑步机上，以首选的跑步节奏（基线）、自我估计的10%的节奏增加和10%的实时节奏提示来测量节奏，并获得运动学和动力学。对一个16节段肌肉骨骼模型进行了逆动力学和静态优化，以研究与AT加载相关的运动学和动力学。结果：与基线相比，提示方法增加了节奏（4.9% - 9.6%）（p 0.05）。听觉提示和视觉提示分别增加了节奏，减少了10.9%和7.7%的AT力。在所有情况下，步幅时间和比目鱼肌力峰值都有所下降(p)。结论：听觉和视觉提示有效地影响了节奏，改变了AT负荷。跑步者会对听觉和视觉提示做出反应。临床医生在针对在跑步机上有AT损伤的跑步者的节奏控制时，可能会考虑这些策略。

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引用次数: 0

Diagnostic value of the lower leg muscle stiffness in professional skiers with medial tibial stress syndrome: A retrospective shear wave elastography study 专业滑雪运动员胫骨内侧应力综合征下肢肌肉僵硬的诊断价值：回顾性横波弹性成像研究

IF 2.2 3区医学 Q1 REHABILITATION

Physical Therapy in Sport

Pub Date : 2025-11-07 DOI: 10.1016/j.ptsp.2025.11.001

Esedullah Akaras , Buket Sevindik Aktas , Bahar Yilmaz Cankaya , Bilgehan Oztop , Hasan Abbasguliyev , Necip Fazil Kishali , Gokhan Yagiz

Objectives

This study aims to assess the diagnostic value of tibialis anterior (TA) and gastrocnemius muscle elasticity using shear wave elastography (SWE) in professional skiers diagnosed with medial tibial stress syndrome (MTSS).

Methods

A retrospective case-control study involved 16 professional male skiers diagnosed with medial tibial stress syndrome (MTSS) and 20 healthy skiers. Shear wave elastography (SWE) assessed the stiffness of the TA and gastrocnemius muscles bilaterally. Receiver operating characteristic (ROC) analysis and logistic regression evaluated the diagnostic utility. Reliability was appraised using intraclass correlation coefficients (ICC).

Results

Affected side TA stiffness was significantly higher in the MTSS group (p = 0.019, Cohen's d = 0.87). The ROC analysis revealed that TA stiffness is the most effective indicator for diagnosing MTSS (AUC = 0.72), followed by the gastrocnemius medialis at 0.60 and lateralis at 0.54. Compared to TA elasticity (AUC = 0.72), the gastrocnemius muscles do not significantly serve as biomarkers for MTSS diagnosis. Logistic regression confirmed affected side TA stiffness as a significant predictor for MTSS (p = 0.033, OR = 1.12).

Conclusion

SWE-derived TA stiffness demonstrated preliminary discriminative ability for MTSS in elite skiers. SWE can improve objective musculoskeletal assessment and injury screening.

目的探讨剪切波弹性成像（SWE）对专业滑雪运动员胫前肌（TA）和腓肠肌弹性的诊断价值。方法采用回顾性病例对照研究，对16名诊断为胫骨内侧应激综合征（MTSS）的男性专业滑雪者和20名健康滑雪者进行研究。剪切波弹性成像（SWE）评估TA和腓肠肌双侧的刚度。受试者工作特征（ROC）分析和逻辑回归评估诊断效用。采用类内相关系数（ICC）评价信度。结果MTSS组患侧TA僵硬度显著高于MTSS组（p = 0.019, Cohen’s d = 0.87）。ROC分析显示TA刚度是诊断MTSS最有效的指标（AUC = 0.72），其次是腓肠肌内侧肌（0.60）和腓肠肌外侧肌（0.54）。与TA弹性（AUC = 0.72）相比，腓肠肌不能作为诊断MTSS的显著生物标志物。Logistic回归证实患侧TA僵硬度是MTSS的重要预测因子（p = 0.033, OR = 1.12）。结论swe导出的TA刚度对优秀滑雪运动员的MTSS具有初步的判别能力。SWE可以改善客观的肌肉骨骼评估和损伤筛查。

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