Physical Therapy in Sport最新文献

Objective

The aim of this review is to synthesise qualitative studies examining adolescents' experience with pain and injury arising from sports participation.

Methods

This review was registered on Open Science Framework prior to data extraction. A systematic search of PubMed, Embase, and SPORTDiscus was conducted. Studies were appraised using the CASP (critical appraisal skills programme) checklist. Data was synthesised using a meta aggregation.

Study selection criteria

Inclusion criteria included studies related to adolescents aged 14–19yrs with sports related pain/injury, employed a qualitative design, full text publications in English.

Results

Sixteen studies of 216 participants were included. Studies investigated severe knee injuries, concussion, or other musculoskeletal injuries. Synthesised findings show that, regardless of injury type, adolescents experience a mix of positive (motivation to rehab and return to sport, optimism) and negative emotions (fear of re-injury, isolation, depressive responses) throughout recovery. Common coping strategies were to ignore symptoms, modify activity levels, or seek support.

Conclusion

Sports-related pain and injury has a multifaceted effect on the adolescent athlete. There is a pervasive fear of re-injury and social isolation, but the desire to return to sports is facilitated through motivation and support. Peer motivation effects the willingness of the adolescent to persist with rehabilitation.

Objectives

To compare the timeline for post-operative quadriceps and hamstrings strength recovery following anterior cruciate ligament reconstruction (ACLR) using either a quadriceps tendon (QT) or hamstring tendon (HT) autograft.

Methods

Patients (≤18 years) who underwent ACLR using autograft QT or HT were included. Isokinetic strength was extracted at 3, 6, and 12 months post-operatively. Effects of time and graft type on quadriceps or hamstring limb symmetry index (qLSI/hLSI) was assessed with two-way repeated measures ANOVA. Between group differences at each time point were assessed with unpaired t-tests. Chi-square and Kaplan-Meir analysis analyzed the proportions of subjects able to achieve ≥90% LSI.

Results

A total of 75 subjects (QT n = 38 HT n = 37,15.8 years) were included. There were significant differences in qLSI, with greater symmetry within the HT group at all time points. A higher proportion of subjects with HT grafts were able to achieve ≥90% qLSI within 12 months of surgery (81% vs 45%, p = 0.001).

Conclusion

Compared to those with HT autografts, adolescents with QT autografts demonstrate a prolonged timeline for quadriceps recovery. While mean strength values above 90% are achieved, a significantly lower percentage of QT patients are able to achieve 90% qLSI by 12 months post-op.

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

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.

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.

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.