Annals of Physical and Rehabilitation Medicine最新文献

Background: A variety of criteria are used to make return to sport decisions after anterior cruciate ligament (ACL) reconstruction.

Objectives: This systematic review summarized and evaluated prognostic factors and clinical prognostic models for returning to sports after ACL reconstruction.

Methods: Independent pairs of reviewers assessed eligibility, extracted data, and evaluated risk of bias and certainty of evidence. A systematic literature search was conducted in key electronic databases.

Inclusion criteria: studies published in English, longitudinal cohort or case-control design, reporting outcomes on return to sport or Tegner Activity Score (TAS), participants aged ≥16 years undergoing primary ACL reconstruction, and defined as athletes/sport players or having a pre-injury TAS ≥5. Only associations between predictors and outcomes that were analyzed in ≥3 studies and had consistent results in the same direction in ≥75 % of the studies were considered and reported. Risk of bias was evaluated using the QUIPS or PROBAST tools, and certainty of evidence was evaluated using the GRADE framework.

Results: 37 studies (5 low, 6 moderate, and 26 high risk of bias) on prognostic factors and 1 study on prognostic models (low risk of bias), representing 6278 participants, were included. Six prognostic factors were identified and rated as very low certainty evidence: fewer concomitant meniscal injuries, shorter time between injury and surgery, higher jump test scores, better physical functioning, higher muscle strength, and greater psychological readiness to return to sport. Two prognostic models with AUC 0.77-0.78 and 70 % accuracy for predicting return to sport were identified.

Conclusion: There is a very low certainty of evidence that returning to sport is associated with both physical, psychological and demographic prognostic factors. More methodologically sound research on prognostic factors and prognostic models for return to sport in athletes after ACL reconstruction is needed.

Background: Inaccurate perception of one's physical abilities is potentially related to age-related declines in motor planning and can lead to changes in walking. Motor imagery training is effective at improving balance and walking in older adults, but most research has been conducted on older adults following surgery or in those with a history of falls. Deficits in motor imagery ability are associated with reduced executive function in older adults with cognitive impairment.

Objectives: To determine whether walking-specific motor imagery training could improve walking performance (physical and imagined) in healthy older adults, and identify the relationship between actual and imagined movement, motor imagery accuracy and executive function across 5 different walking tasks in healthy older adults.

Methods: A cohort of 53 community dwelling older adults took part in a 4-wk randomized controlled trial to assess the effect of motor imagery training on the physical and imagined performance of 5 walking-related tasks (3 narrow path walking tasks, Timed-up and go and step-over test), together with motor imagery clarity using the kinesthetic and visual imagery questionnaire (KVIQ-10). The association between physical performance, motor imagery accuracy and executive function were identified at baseline.

Results: Four weeks of motor imagery training did not improve walking-specific performance (imagined or physical) compared to no-training. Motor imagery training did improve the visual clarity of imagined non-walking tasks. Executive function was significantly correlated with 2 out of 5 imagined walking tasks and 4 out of 5 physical walking tasks but was not associated with motor imagery accuracy.

Conclusion: Four weeks of motor imagery training is not effective at improving performance in walking-related tasks in healthy older adults. This lack of improvement may be due in part to the high functional ability of the cohort. Future research should assess the relationship between motor planning and executive function with more complex walking tasks.

Trial registration: ANZCTR registration (ACTRN12619001784101).

Background: In the context of neck pain, neck muscle activity adapts through diverse regional coordination modifications during tasks. Although patterns of cervical flexor muscle impairment are well-documented, patterns in the cervical extensor muscles are less clear, hindering assessment and treatment. Despite studies revealing adaptations in the cervical extensor muscles, outcome measure heterogeneity complicates interpretation, particularly between superficial and deep muscles. To address this, we conducted a systematic review comparing neck extensor muscle activity between symptomatic and asymptomatic groups during tasks, aiming to inform clinical practice.

Objectives: To compare the cervical extensor muscle activity during neck tasks between symptomatic and asymptomatic groups, using complementary examination tools.

Methods: Up to January 2024, experimental studies assessing cervical extensor muscle activity during neck tasks in adults with idiopathic or traumatic neck pain, or cervicogenic headache compared to healthy controls were included. Study selection involved 2 blinded reviewers. Electronic databases (Medline, Scopus, and Embase), reference lists, and relevant reviews were screened. Data extraction focused on the results of the between-group motor activity comparisons. Critical appraisal used the JBI appraisal checklist for analytical cross-sectional studies.

Results: Twenty-three studies met the inclusion criteria, involving 932 participants and reporting 170 comparative assessments of 8 muscle groups, encompassing 4 main motor activity outcomes: recruitment, timing, fatigue, and directional activation. Significant differences were noted for motor recruitment in 51 % of comparisons, for timing in 35 %, and fatigue in 33 %, with consistent differences in directional activation. Impaired activity in individuals with neck pain compared to those without was found in 47 % of comparisons for superficial muscles and 65 % for deep muscles.

Conclusions: Motor activity adaptations during neck tasks appear to be unpredictable in individuals with neck pain, with a tendency for change in the deep cervical extensor muscles. Further high-quality studies are needed to confirm these findings, considering various contraction parameters, multiple muscle analyses, and several motor activity outcomes.

Trial registration: PROSPERO International Prospective Register of Systematic Review CRD42022285864.