Physical Therapy in Sport最新文献

A successful return to sports (RTS) after an anterior cruciate ligament reconstruction (ACLR) is multifactorial, and therefore difficult and challenging. Unfortunately, low percentages of patients RTS, and for those who succeed, one-fifth of patients will sustain a second ACL injury. Over the past years, test batteries were developed to assess whether patients can RTS with a low risk for a second ACL injury risk. Low rates of patients who meet RTS criteria were found, coupled with the insufficiency of current RTS test batteries in predicting second ACL injuries suggesting poor sensitivity. The result of an RTS test is likely to reflect the content of a rehabilitation program, raising critical questions regarding what we are offering patients within the rehabilitation programme. Are we preparing our patients well enough for the high demands of complex situations within pivoting team sports? This narrative review offers insights from key lessons of the last 15 years on 1) RTS testing, 2) the content of rehabilitation, and 3) the RTS continuum, all from a “helicopter perspective”.

Objectives

To evaluate the reliability of the Enhanced Paper Grip Test (EPGT) for assessing foot strength in volleyball and soccer players.

Design

A cross-sectional observational study with repeated measurements.

Setting

Field-based study.

Participants

A convenience sample of 28 athletes (13 volleyball players and 15 soccer players) participated in the study.

Main outcome measures

The main outcome measures were the intraclass correlation coefficients (ICC) for intra-visit and inter-visit reliability, typical error, and coefficient of variation for the force (N) recorded in EPGT test.

Results

The EPGT demonstrated good to excellent relative reliability (ICC values ranged from 0.93 to 0.97) and acceptable absolute reliability (typical error = 5–8 % of the mean). Significant inter-limb asymmetries were observed in both volleyball (16.0 ± 10.2%) and soccer players (15.3 ± 9.8%).

Conclusions

The EPGT is a reliable tool for assessing foot strength in volleyball and soccer players. Further research is required to explore the applicability of EPGT in different athletic and clinical contexts, and its potential role in athletic performance and injury prevention.

Objectives

To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR).

Design

Cross-sectional design. Online survey.

Setting

Survey platform.

Participants

Argentinian physical therapists (PTs).

Outcome measures

The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS.

Results

A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS.

Conclusions

Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

Objective

The purpose of this study was to examine factors correlated with psychological readiness to return to activity after ACLR.

Design

cross sectional study.

Setting

controlled laboratory.

Participants

164 patients (82 M/82 F, 22.5 ± 8.9yr, 171.6 ± 11.0 cm, 77.4 ± 18.6 kg, 8.6 ± 3.4 months post-ACLR) participated in this study after a primary, isolated, and uncomplicated ACLR.

Main outcome measures

ACL Return to Sport Index (ACL-RSI).

Results

ACL-RSI scores demonstrated a weak positive correlation with activity level at the time of injury and a fair positive correlation with activity level at the time of post-operative testing (p-values: 0.004, <0.001). ACL-RSI scores showed a statistically significant fair negative correlation with pain and a moderate negative correlation with kinesiophobia during rehabilitation (p-values: <0.001, <0.001). There was no statistical significance between ACL-RSI and the surgical variables (p-value range: 0.10–0.61).

Conclusions

Outcomes from testing during postoperative rehabilitation were most correlated with psychological readiness to return to activity after ACLR. Increased pain and kinesiophobia were associated with a decreased psychological readiness. Increased activity level prior to injury and activity level at the time of testing during rehabilitation were both correlated with increased psychological readiness. Psychological readiness to return to activity may need to be customized based on potentially modifiable patient-specific factors during the post-operative rehabilitation.

Objective

To determine the association between change in physical activity level, as defined as the change from pre-to post-operative Tegner Activity Scale, and quality of life (QOL) after anterior cruciate ligament reconstruction (ACLR), before patients are cleared for return to sport.

Participants

1198 participants (42.9% male; 18.7 ± 3.6 years; 7.1 ± 3.7 months post-ACLR).

Main outcome measures

Surveys included Knee Injury and Osteoarthritis Outcome Score QOL (KOOS-QOL) subscale and Tegner Activity Scale. KOOS-QOL score ≥62.5 is considered as meeting a previously established patient acceptable symptom state.

Results

The acceptable KOOS-QOL group reported a significantly smaller decrease in activity level from pre-injury to time of data collection (median: 2.00, IQR: 2.00) than the unacceptable KOOS-QOL group (median: 3.00, IQR: 3.00). Across the full cohort, for every one-point larger decrease in Tegner score from pre-to post-ACLR, there is a 52% increase in the odds of having an unacceptable KOOS-QOL score. For adolescents, the odds increase to 60% while the odds for adults were lower at 39%.

Conclusions

Following ACLR, greater decreases in physical activity level are associated with poorer QOL for both adolescents and adults at short-term follow-up, and this effect is larger amongst adolescents.

Introduction

The rise in participation in sports, like women's cricket, is linked with increased injury risk. Providing high-level longitudinal data is the first step in implementing evidence-based injury prevention strategies.

Design

Prospective cohort study.

Objective

This cohort study aims to describe the injury profiles in sub-elite women's cricket in South Africa during the 2022/23 season.

Methods

Injuries were prospectively recorded using injury surveillance questionnaires, injury surveillance database, and logbooks completed by each team's medical staff. Injury rates were investigated for match and training days, body region, player role, nature, and activity at the time of injury.

Results

Three teams with a total of 44 players (20.86 ± 1.6 years) were included in the study. Injury incidence was 85.23 per 1000 player match days, 15.91 for match time-loss and 69.32 for non-time-loss, with 2.95% of players unavailable for match selection on any day. Fast bowlers had the highest injury incidence. Fielding caused 46.67% of all injuries. Injury incidence was higher in training than in matches. The wrist/hand had the highest injury incidence and caused the most match time-loss.

Conclusion

This study provides valuable insights regarding the current injury rates in sub-elite female cricket players.

Objective

Assess the validity of hand-held dynamometry (HHD) and the Tindeq Progressor (TP) in assessing peak isometric knee extension torque and limb symmetry index (LSI) versus isokinetic dynamometer (IKD).

Design

Prospective cross-sectional study.

Setting

Laboratory.

Participants

31 individuals with unilateral knee disorders (21 female; 28.3 ± 11 years).

Main outcome measures

Peak isometric knee extension torque; Knee extension LSI.

Results

Strong to almost perfect (p < 0.001) correlations (Cohen's Kappa k) with IKD were found for both devices for peak torque of the uninvolved limb (HHD [k = 0.84], TP [k = 0.91]) and involved limb (HHD [k = 0.93], TP [k = 0.98]). For LSI, moderate to strong (p < 0.001) correlations with IKD were found for HHD (k = 0.79) and TP (k = 0.89). Mean bias errors were equivalent for determining LSI (HHD = 0.02%; TP = 0.03%). Both HHD and TP were highly sensitive (96.2–100.0%) and specific (100.0%) at the 70% LSI threshold. TP showed higher sensitivity and specificity at the 90% LSI threshold.

Conclusion

HHD and TP are valid in measuring isometric knee extension torque with the reference standard IKD. TP showed superior validity in identifying LSI. TP also shows greater specificity in identifying the 90% LSI threshold.

Background

This study aimed to investigate the association between psychosocial factors and the severity of Achilles tendinopathy, along with exploring their potential link to the pain's duration.

Methods

A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. Methods: A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. Various psychological factors were assessed using the Pain Catastrophizing Scale, Chronic Pain Self-Efficacy Scale (CPSS), Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scale (HAD). Additionally, the severity of Achilles tendon pain was evaluated using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A-Br). Regression analyses were employed to determine the association of these psychosocial factors with pain severity and duration.

Results

Self-efficacy for chronic pain showed a slight association with Achilles tendon pain severity (β = 0.42 [95% CI: 0.06 to 0.16], p = 0.001), explaining only 19% of the dependent variable. The other variables, including anxiety, depression, pain catastrophizing, and fear of movement, did not exhibit significant associations.

Conclusion

The study suggests that psychological factors demonstrate limited association with the severity of Achilles tendinopathy. While self-efficacy for chronic pain was weakly associated, its clinical relevance remains uncertain. Future research, particularly longitudinal studies, should explore the influence of psychosocial factors on treatment adherence and response to enhance management strategies for Achilles tendon pain.

Objective

Assess inter- and intra-rater reliability of the Qualitative Analysis of Single Leg Squat (QASLS) during a single-leg triple hop landing in subjects following anterior cruciate ligament reconstruction (ACLR). Explore if differences in reliability existed between novice and experienced clinicians. Determine if QASLS scores differed between the surgical and nonsurgical limbs.

Design

Repeated Measures.

Participants

20 subjects ≥6 months post-ACLR.

Methods

Subjects were recorded performing a single-leg triple hop bilaterally. Videos were independently rated by five raters (2 physical therapists and 3 physical therapy students). Intraclass correlation coefficient (ICC) was calculated to measure reliability of the QASLS on the surgical limb. Wilcoxon signed-rank test was utilized to assess if differences in QASLS scores existed between limbs.

Results

The cumulative inter-rater reliability was moderate (ICC (2,1): 0.703) and the cumulative intra-rater reliability was good (ICC (3,1): 0.857). Little difference was found between experienced and novice raters for inter- and intra-rater reliability. There was no statistically significant difference in QASLS scores between limbs (P = 0.64).

Conclusion

The QASLS tool offers moderate inter- and good intra-rater reliability for evaluating movement quality during a single-leg triple hop landing, irrespective of rater experience. Additionally, there was no observed difference in QASLS scores between surgical and nonsurgical limbs.

Objective

Floorball is a swift sport; players perform multiple quick turns during practices and games. The aim of this study was to examine the incidence of floorball injuries. In addition, we aimed to examine the differences in the incidences between sexes and anatomical locations.

Methods

The PubMed (National Library of Medicine), Web of Science (Clarivate), Scopus (Elsevier), and SPORTDiscus (EBSCO) databases were searched from inception to January 6th, 2023. A study was eligible for analysis if the number of injuries per exposure time was reported. The study protocol was prospectively registered in the PROSPERO database (CRD42023390659).

Results

The total pooled incidence of floorball injuries was 2.28 (confidence interval [CI] 1.27 to 4.10) injuries per 1000 h for all included studies. For females, the pooled incidence was 2.33 (CI 1.22 to 4.46) injuries per 1000 h, and for males, the incidence was 1.98 (CI 1.83 to 2.14) injuries per 1000-h. For adults, the pooled incidence was 3.11 (CI 1.58 to 6.12) injuries per 1000 h and for youths, the incidence was 1.40 (CI 0.50 to 3.94) injuries per 1000 h.

Conclusions

The incidence of floorball injuries is high, especially among women. When considering the growing popularity of floorball, these pooled incidences serve as reference values for future injury prevention programs.