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Walker A, Sattler L, Heyward S, Tedesco J, Jones Z, D'Lima C, Higham C, Cuthbert S, Hing W. An 8-week physiotherapist-led return to sport group program after anterior cruciate ligament reconstruction improves measures of physical and psychological function: A case series. Musculoskelet Sci Pract 2024; 73:103149. [PMID: 39047591 DOI: 10.1016/j.msksp.2024.103149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/15/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Low return to competitive sport, high reinjury rates and long-term functional impairment of anterior cruciate ligament reconstruction (ACLR) present significant challenges for patients. A program that facilitates a safe return to sport (RTS) following ACLR could potentially improve outcomes. STUDY DESIGN Case Series. METHODS Sixty participants (median 20-years-old (13-36), 43 males, 18 females, median 7.5 months (4-25) post-ACLR) completed an eight-week exercise program. A battery of physical tests and patient-reported outcome measures were assessed pre and post-program. The number of participants passing RTS criteria was evaluated, and RTS rates were determined. The correlation between the ACL-RSI and measures of physical function was explored. RESULTS Improvements in all isometric strength, hop tests, running T-test, and patient reported outcome measures were seen post-program. Five (8%) participants successfully passed all RTS criteria and eighty-five percent of participants returned to their previous level of sport. The ACL-RSI and the IKDC showed correlation across all time points (pre rs = 0.49; post rs = 0.40; change r = 0.40). CONCLUSIONS Our study demonstrated improvements in all RTS criteria tests upon completing the 8-week rehabilitation program; however, few participants (8%) passed all RTS criteria. Psychological readiness is more closely related to patient-reported function than functional tests.
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Affiliation(s)
- Adam Walker
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia; Gold Coast Knee Group, Gold Coast, Australia.
| | - Larissa Sattler
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia; Gold Coast Knee Group, Gold Coast, Australia
| | - Samuel Heyward
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Jordan Tedesco
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Zachariah Jones
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Corey D'Lima
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Caroline Higham
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Sophie Cuthbert
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
| | - Wayne Hing
- Bond Institute of Health and Sport, Bond University, Gold Coast, Australia
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Latifi S, Kafshgar Z, Yousefi A. Evaluation of hop tests based on Y-Balance test and FMS test outcomes in volleyball and basketball players to identify those prone to injury: a potential predictor of injury. BMC Sports Sci Med Rehabil 2024; 16:187. [PMID: 39243095 PMCID: PMC11380414 DOI: 10.1186/s13102-024-00976-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND The quest for a reliable and effective method to identify athletes at risk of injury holds the promise of significantly reducing injury rates and improving overall athletic performance. This research delved into the relationship between the Functional Movement Screen (FMS), Y-Balance Test (YBT), and Hop tests (Side hop, Medial triple hop, and Lateral step-down hop), aiming to determine the potential in predicting injuries of hop tests among division 1 volleyball and basketball players. METHODS This research was conducted with fifty-two participants from the Division 1 league, encompassing both volleyball and basketball players. The study rigorously employed the Functional Movement Screen (FMS), the Y-Balance Test (YBT), and various hop tests (side hop test, medial triple hop test, lateral step-down hop) to measure relevant variables. The data analysis used logistic regression, ensuring a comprehensive approach to the study. RESULTS Results showed no significant relationship between FMS and Hop test for predicting injuries, but there was a relationship between ΔY and side hop that shows side hop test can predict injury, but there was no relationship between Lateral step down, Medial triple hop, and ΔY. CONCLUSIONS Based on our findings, side hop, despite the medial triple hop and lateral step-down test, can be used as a sports injury predictor.
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Affiliation(s)
- Sepideh Latifi
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
| | - Zeinab Kafshgar
- Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Atiye Yousefi
- Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
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Gokeler A, Zandbergen MA, Hoogeslag RAG, Houten Van AV, Nijmeijer EM, Heuvelmans P. Neurocognitive demands reduce jump distance and coordination variability of the injured leg in athletes after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39189158 DOI: 10.1002/ksa.12439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/05/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE The study aimed to evaluate the impact of neurocognitive reliance on jump distance and lower extremity kinematics in individuals who had undergone anterior cruciate ligament reconstruction (ACLR). This was achieved by comparing hop performance under standard and neurocognitive conditions. METHODS Thirty-two patients after ACLR and 32 healthy controls (CTRL) participated. Both groups performed a single-leg hop for distance (SLHD) and two neurocognitive hop tests, each designed to evaluate distinct aspects of neurocognition. The neurocognitive tests included the reaction SLHD (R-SLHD), measuring reaction to a central stimulus and working memory SLHD (WM-SLHD) assessing response to a memorized stimulus amidst distractor stimuli. Distances were assessed for the three-hop tests. In addition, joint kinematics were collected to calculate lower extremity coordination of the lower extremity. SLHD performance was defined as the mean hop distance per condition per leg for each participant and was analyzed using a mixed ANOVA with condition and leg as the within-subjects factors and the group (ACLR or CTRL) as the between-subjects factor. Differences in joint coordination variability were analyzed using two-sample t-test statistical parametric mapping (SPM) with linear regression. RESULTS The WM-SLHD resulted in a significantly decreased jump distance compared with the standard hop test both for ACLR and CTRL. Furthermore, the leg difference within the ACLR group increased under higher cognitive load as tested with the WM-SLHD, indicating leg-specific adaptations in lower extremity coordination. CONCLUSIONS Neurocognitive single-leg hop tests resulted in reduced jump distance in CTRL and ACLR. The neurocognitive hop test revealed changes in coordination variability for the CTRL and the uninjured leg of ACLR individuals, whereas the injured leg's coordination variability remained unaltered, suggesting persistent cognitive control of movements post-ACLR. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Alli Gokeler
- Department of Exercise & Health, Exercise Science and Neuroscience, Paderborn, Germany
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Collaboration on Health and Safety in Sports, Amsterdam, the Netherlands
| | - Marit A Zandbergen
- Center for Orthopaedic Surgery and Sports Medicine OCON, Hengelo, the Netherlands
| | - Roy A G Hoogeslag
- Center for Orthopaedic Surgery and Sports Medicine OCON, Hengelo, the Netherlands
| | | | - Eline M Nijmeijer
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pieter Heuvelmans
- Department of Exercise & Health, Exercise Science and Neuroscience, Paderborn, Germany
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Khoygani MR, Esmaeili H. Hop distance to body height ratio outperforms limb symmetry index in predicting second anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39132709 DOI: 10.1002/ksa.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 08/13/2024]
Abstract
PURPOSE The ability of current return-to-sport (RTS) tests to predict second anterior cruciate ligament (ACL) injuries (ACLI) in athletes with a history of ACL reconstruction (ACLR) is unclear. This study aimed to prospectively assess the risk of a second ACLI by identifying the most significant deviation in hop test results in professional athletes after ACLR compared to healthy peers. METHODS A total of 30 professional athletes with a history of ACLR and 30 healthy professional athletes participated in this study. Participants performed 10 functional hop tests, and the subsequent limb symmetry index (LSI) was compared between the groups. After a 3-year follow-up, the re-injury rate was assessed among the ACLR group. Fourteen ACLR athletes who sustained a second ACLI were included and matched with 14 controls from the healthy group. The LSI and the hop distance to body height percentage (D/H) were compared between the groups. RESULTS Statistical analyses confirmed a significant decrease in LSI in the ACLR group compared to the healthy group in the triple hop for distance (p = .023). In re-injured ACLR athletes, seven different hop tests showed a significant decrease in the D/H index compared to the healthy controls. Meanwhile, for LSI, only the triple cross-over hop for distance (p = .045) showed a significant increase in the healthy group. CONCLUSION Before clearing athletes for RTS, assessing functional hop test results using the hop distance to body height ratio, aligned with normative data from healthy controls, could further enhance the prediction of reduced graft rupture risk. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Mohammad Rahimi Khoygani
- Departments of Experimental Medicine and Surgery, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy
| | - Hamed Esmaeili
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
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Kuwik P, Florkiewicz E, Benedict T, Mason J, Morris J, Crowell M. Assessing the Relationship of Psychological Sport Readiness, Single-leg Vertical Jump, and Non-Sagittal Single-Leg Hops to Quadriceps Strength After Anterior Cruciate Ligament Reconstruction. Int J Sports Phys Ther 2024; 19:942-955. [PMID: 39100937 PMCID: PMC11297365 DOI: 10.26603/001c.121597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/21/2024] [Indexed: 08/06/2024] Open
Abstract
Background Limitations exist with current ACLR functional testing assessments that may be mitigated by including single-leg multi-directional testing. Hypothesis/Purpose To compare Anterior Cruciate Ligament-Return to Sport after Injury Scale (ACL-RSI) scores, limb symmetry index (LSI) of the single-leg vertical jump (SLVJ), single-leg medial rotation hop (SLMRH), single-leg lateral hop (SLLH), and isokinetic quadriceps strength between participants with an ACLR and healthy controls and assess predictors of quadriceps strength asymmetry. It was hypothesized that ACL-RSI scores and LSIs for all tests would differ between ACLR and healthy control groups and within the ACLR group a strong correlation would exist between all outcome measures and quadriceps strength. Study Design Cross-Sectional Study. Methods Twenty-six participants with an ACLR (median 13 months after surgery) and twenty-six matched healthy controls were recruited to participate in this study. Performance was assessed via SLVJ, SLMRH, SLLH, and isokinetic quadriceps strength. Between-group comparisons were made with independent t-tests and Mann-Whitney U test. Within the ACLR group, bivariate correlation and multivariate regression analysis were performed to assess the relationship between the outcome measures and quadriceps strength asymmetry. Results Significant between-limb differences were only identified in the ACLR group (p< 0.05): SLVJ LSI: 88.5%, SLMRH LSI: 93.6%, SLLH LSI: 92.7%, quadriceps strength LSI 80.9% - 83.9%, which were significantly lower (p <0.05) than the healthy control group. Within the ACLR group, a moderate-strong significant (p < 0.05) correlations existed with quadriceps strength and SLVJ (r=0.44-0.65), SLMRH (r =0.43-0.83), and SLLH (r=0.54-0.63); while ACL-RSI had a weak non-significant (p > 0.05) correlation with quadriceps strength (r= 0.12-0.30). Conclusion Single-leg multidirectional test LSIs were less in ACLR participants than matched healthy controls and all were directly related to quadriceps strength. Psychological readiness to return to sport was not related to quadriceps strength.
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Affiliation(s)
- Paul Kuwik
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Erin Florkiewicz
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
- Doctor of Philosophy in Health Sciences ProgramRocky Mountain University of Health Professions, Provo, Utah
| | - Timothy Benedict
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - John Mason
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Jamie Morris
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Michael Crowell
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
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Petrucci A, Guglielmino D, Pecci J, Pareja-Galeano H. The effects of isokinetic training in athletes after knee surgery: a systematic review. PHYSICIAN SPORTSMED 2024; 52:309-316. [PMID: 38124233 DOI: 10.1080/00913847.2023.2297666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To review the effectiveness of isokinetic training as an alternative method to traditional isotonic resistance training. MATERIALS AND METHODS Researchers examined data from PubMed, CENTRAL, MEDLINE COMPLETE, and Web of Science until February 2023. A total of 365 entries were obtained from databases, including studies that analyzed the effects of isokinetic vs. isotonic-based rehabilitation in athletes (16-50 years) after a surgical knee intervention. Return to sport (RTS), strength of the flex/extensor compartment of the thigh, muscle mass of the thigh, and knee function were screened as main outcomes. Two reviewers independently screened the studies for eligibility and assessed the risk of bias of the included ones. RESULTS Six studies involving 181 athletes were included. Isokinetic training demonstrated significant benefits in peak torque for knee flexor-extensor muscles in four studies. Two studies favored isokinetic training over isotonic for strength. Muscle mass findings were mixed, with one study favoring isokinetic significantly and two showing no significant differences. In terms of returning to sport, the isotonic group displayed slightly better limb symmetry index values, but without significance. Isokinetic training outperformed isotonic in two functionality questionnaire studies, while two others showed no significant differences. CONCLUSIONS Isokinetic training appears equally, if not more effective than isotonic, for restoring strength balance between hamstrings and quadriceps. This could lead to more favorable muscle mass changes. Isokinetic training also parallels isotonic rehabilitation for functional outcomes and meeting return-to-sport criteria. Therefore, isokinetic training should be included as one of the main strength restoration strategies after knee surgery, especially in early and middle rehabilitation stages. REGISTRATION NUMBER The present systematic review was registered on PROSPERO (registration number: CRD42022370398).
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Affiliation(s)
- Angelo Petrucci
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Dario Guglielmino
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Javier Pecci
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
- Department of Physical Education and Sport, Universidad de Sevilla, Sevilla, Spain
| | - Helios Pareja-Galeano
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
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Smith C, Grooms DR, Bradley H. Enhancing Return to Alpine Skiing: Integrating Perceptual-Motor-Cognitive Considerations in Testing and Progressions: A Clinical Commentary. Int J Sports Phys Ther 2024; 19:923-934. [PMID: 38966833 PMCID: PMC11221336 DOI: 10.26603/001c.120285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 06/12/2024] [Indexed: 07/06/2024] Open
Abstract
Alpine skiing poses significant risks for anterior cruciate ligament (ACL) injury at both recreational and professional levels, which is compounded by high rates of re-injury. Despite the existence of return to sport (RTS) and return to snow protocols, the frequency of ACL re-injury has not been mitigated, raising doubts about protocol effectiveness. Current RTS protocols primarily focus on biomechanical and neuromuscular factors in isolation, neglecting the important perceptual-motor-cognitive changes associated with ACL injuries and the high cognitive demands of skiing. The purpose of this clinical commentary is to address the perceptual-motor-cognitive demands specific to alpine skiing, evaluate RTS testing for skiers, and propose updated standards for testing and return to snow progressions that incorporate these considerations. Level of Evidence 5.
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Affiliation(s)
| | - Dustin R Grooms
- Ohio Musculoskeletal and Neurological Institute Ohio University
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions Ohio University
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions Ohio University
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Lundgaard-Nielsen M, Herzog RB, Warming S, Rathcke MW, Magnusson SP, Krogsgaard MR. Good physical function but reduced quality of life in children 3 years after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2024; 32:1725-1733. [PMID: 38666741 DOI: 10.1002/ksa.12211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/30/2024] [Accepted: 04/09/2024] [Indexed: 07/21/2024]
Abstract
PURPOSE To assess children's physical function and subjective knee status 1 and 3 years after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that there was no difference between the operated and normal legs in relation to physical strength and function, that there was <-2 mm side-to-side difference in knee laxity, and that the subjective knee function was better 3 years after ACL reconstruction compared to 1 year after. METHODS Children (<16 years of age) who had an ACL reconstruction had follow-up with physical function tests (four hop tests and strength measurement in a power rig [PR]), anterior knee laxity (measured using a Rolimeter) and patient-reported outcome measures (Pedi-International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]-Child) 1 and 3 years postoperatively. Changes from 1- to 3-year follow-up were evaluated with a paired t test. RESULTS Out of 148 ACL reconstructed children, 60 had all measures. The four hop tests and the PR all yielded a Limb Symmetry Index >90% at both follow-ups. There was a significant improvement from 1- to 3-year follow-up in two-hop tests (6 m on time and crossover hop). Side-to-side knee laxity was >2 mm in four children at 1- and 3-year tests. Pedi-IKDC scores increased, and KOOS-Child improved significantly from 1 to 3 years in two of the five domains: 'Sport' and 'Quality of life', but scores were lower than in a cohort of normal children. CONCLUSION The children had good objective physical function 1 and 3 years after ACL reconstruction. However, scores from the KOOS-Child sport-specific function and quality of life domains were lower than in normal children. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Mathilde Lundgaard-Nielsen
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Robert Bennike Herzog
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Susan Warming
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Martin Wyman Rathcke
- Section for Sports Traumatology M51, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Stig Peter Magnusson
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
- Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Rindom Krogsgaard
- Section for Sports Traumatology M51, Copenhagen University Hospital, Bispebjerg-Frederiksberg, Copenhagen, Denmark
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He J, Geng B, Xu P, Xia Y. Do Age and Timing Influence the Outcomes of Single-stage Reconstruction of Multiple Ligament Knee Injuries? 5-10 Years Follow Up. Orthop Surg 2024; 16:1308-1316. [PMID: 38644618 PMCID: PMC11144514 DOI: 10.1111/os.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/21/2024] [Accepted: 03/30/2024] [Indexed: 04/23/2024] Open
Abstract
OBJECTIVES Multiple ligament knee injuries (MLKIs) are disruptive injuries, however, there are controversies in the results of acute and delayed reconstruction. Also, clinical outcomes between patients older or younger than 40 have not been compared in MLKIs. This study was designed to investigate the influence of age and timing of reconstruction on the outcomes of single-stage reconstruction of MLKIs. METHODS The patients who underwent reconstruction of multiple injured ligaments because of MLKIs between May 2013 and July 2019 were added to the cohort. The postoperative complications, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) 2000 score, Tegner activity level, patient satisfaction, and SF-36 score were compared between young (≤ 40 years old, n = 41) and old patients (n = 61); acute (≤ 3 weeks after injury, n = 75) and delayed reconstruction (n = 27), using Mann-Whitney U test or χ2 test. RESULTS A total of 102 MLKI patients managed by single-stage multi-ligament reconstruction were retrospectively reviewed. Patients were followed up after surgery for a mean of 7.3 years (5.2-10.7 years). At the last follow-up, no significant difference was found in knee ROM, functional scores, and patient-reported outcomes between patients older or younger than 40; acute and delayed reconstruction (p > 0.05). The rate of complications in the delayed reconstruction group was higher than that of the acute reconstruction group (22.2% vs 5.3%, p < 0.05). The IKDC objective scores reached grade A in 63.7%-80.4% of patients, and grade B in 11.8%-23.5% patients. CONCLUSION The single-stage reconstruction of MLKIs can obtain comparative long-term functional and objective outcomes regardless of patients older or younger than 40; acute and delayed reconstruction, however, delayed reconstruction is related to a high rate of postoperative complications.
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Affiliation(s)
- Jinwen He
- Department of Orthopaedics, Orthopaedics Clinical Medicine Research Center of Gansu Province, Intelligent Orthopedics Industry Technology Center of Gansu ProvinceLanzhou University Second HospitalLanzhouChina
| | - Bin Geng
- Department of Orthopaedics, Orthopaedics Clinical Medicine Research Center of Gansu Province, Intelligent Orthopedics Industry Technology Center of Gansu ProvinceLanzhou University Second HospitalLanzhouChina
| | - Peng Xu
- Department of Joint SurgeryHonghui Hospital, Xi'an Jiaotong UniversityShanghaiChina
| | - Yayi Xia
- Department of Orthopaedics, Orthopaedics Clinical Medicine Research Center of Gansu Province, Intelligent Orthopedics Industry Technology Center of Gansu ProvinceLanzhou University Second HospitalLanzhouChina
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McManigal M, Post A, Allen M, Jorgensen A, Rosenthal MI, Wellsandt M, Tao M, Wellsandt E. Reliability of Spatiotemporal Characteristics During Single-Legged Hop and Bilateral Drop Jump Tasks Using an Instrumented Pressure Walkway. Int J Sports Phys Ther 2024; 19:704-713. [PMID: 38835980 PMCID: PMC11144667 DOI: 10.26603/001c.117401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/12/2024] [Indexed: 06/06/2024] Open
Abstract
Background Single-legged hop tests have been widely used to assess performance-based outcomes after anterior cruciate ligament (ACL) reconstruction. Traditional single, triple, or 6-meter (6m) timed hop tests only measure distance or time as the principal variables, neglecting other variables, such as individual hop distances within a series of hops, flight time, and stance time. The development of portable instrumented pressure walkways has made it possible to collect parameters such as hop velocity, flight time, stance time, distance, and pressure outside of a laboratory setting. However, the reliability of instrumented pressure walkways in measuring spatial and temporal variables during single-legged hop tests is unknown. This study aimed to determine if the Zeno walkway can reliably measure spatiotemporal (ST) characteristics of hop tests. Study Design Cross-Sectional Study. Methods Individuals (n=38) in this cross-sectional study performed single, triple, and 6m hop tests on a pressure-sensitive Zeno walkway. Twenty-one participants completed follow-up testing between one and 14 days later. Intraclass correlation coefficients (ICC(3,k)) were used to assess test-retest reliability of ST variables. The accuracy of vertical jump height and 6m hop timing were also measured. Results All ST variables demonstrated excellent test-retest reliability (ICC > 0.86) with small minimal detectable change (MDC) values during single-legged hop tests. Six-meter hop time and jump height during a bilateral drop jump were also accurately measured by the walkway. Conclusion An instrumented pressure walkway is a novel tool to reliably assess non-traditional parameters of clinically relevant hop and jump tests such as flight time, stance time, and jump height after lower extremity injury, surgery, and rehabilitation. Level of Evidence 3b.
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Affiliation(s)
| | - Austin Post
- Department of Orthopaedic Surgery and RehabilitationUniversity of Nebraska Medical Center
| | - Michael Allen
- College of Education, Health, and Human SciencesUniversity of Nebraska at Omaha
| | - Alyx Jorgensen
- Department of Health and Rehabilitation SciencesUniversity of Nebraska Medical Center
| | - MIke Rosenthal
- Department of Health and Rehabilitation SciencesUniversity of Nebraska Medical Center
| | - Michael Wellsandt
- Department of Health and Rehabilitation SciencesUniversity of Nebraska Medical Center
| | - Matthew Tao
- Department of Orthopaedic Surgery and RehabilitationUniversity of Nebraska Medical Center
| | - Elizabeth Wellsandt
- Department of Health and Rehabilitation SciencesUniversity of Nebraska Medical Center
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van Melick N, van der Weegen W, van der Horst N, Bogie R. Double-Leg and Single-Leg Jump Test Reference Values for Athletes With and Without Anterior Cruciate Ligament Reconstruction Who Play Popular Pivoting Sports, Including Soccer and Basketball: A Scoping Review. J Orthop Sports Phys Ther 2024; 54:377-390. [PMID: 38506715 DOI: 10.2519/jospt.2024.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE: To synthesize and present reference values for double-leg and single-leg jump tests in healthy athletes who play pivoting sports, and athletes with anterior cruciate ligament reconstruction (ACLR) who play pivoting sports. DESIGN: Scoping review. LITERATURE SEARCH: We searched PubMed, the Cochrane Library, MEDLINE, Embase, and Web of Science until April 7, 2023. STUDY SELECTION CRITERIA: We included reference values in 2 different categories: (1) double-leg and/or single-leg jump test outcomes in pivoting-sport athletes with ACLR at a specific time point during rehabilitation, and (2) double-leg and/or single-leg jump test outcomes in healthy pivoting-sport athletes. DATA SYNTHESIS: We performed data synthesis for reference values from double-leg jump tests (squat jump and countermovement jump) and single-leg jump tests (vertical hop, single hop for distance, triple hop for distance, crossover hop for distance, medial triple hop for distance, lateral triple hop for distance, 6-m timed hop, side hop, drop jump, and 10-second repeated hop) that were performed according to a standardized test description. We summarized the data for type of sport, sex, sport participation level, and age group. RESULTS: Of the 27 included studies, nine reported reference values from healthy soccer players, six from healthy basketball players, and eleven from other healthy pivoting-sport athletes. LSI dominant/nondominant (LSI-D/ND) ranged between 97% and 106% for healthy soccer players, and between 99% and 120% for healthy basketball players. Four studies reported reference values from pivoting-sport athletes with ACLR from 7 to 10 months postsurgery. CONCLUSION: This scoping review summarizes double-leg and single-leg jump test reference values for athletes who play common pivoting sports, including soccer and basketball. J Orthop Sports Phys Ther 2024;54(6):1-14. Epub 20 March 2024. doi:10.2519/jospt.2024.12374.
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Kurz E, Keller M, Schoch W, Stein T, Hirschmüller A, Niederer D. Feasibility, Reliability, and Validity of the Modified Forward Hop Test After Anterior Cruciate Ligament Reconstruction: Double- Instead of Single-legged Landing is Reliable and Results in Greater Hopping Distance. Arch Phys Med Rehabil 2024; 105:710-716. [PMID: 38016495 DOI: 10.1016/j.apmr.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/10/2023] [Accepted: 11/10/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To investigate the feasibility, reliability, and validity of the Modified forward hop (MFH) test in participants after ACL reconstruction (ACLR). DESIGN Reliability study. SETTING Assessments were administered at different clinical locations in Germany and Switzerland by the same 2 investigators. PARTICIPANTS Forty-eight active individuals participated in this study (N=48). MAIN OUTCOME MEASURES The participants performed MFHs and Forward hops for distance in a predetermined order. The feasibility of the MFH was quantified with proportions of successfully executed attempts and Pearson's χ2 test. Its reliability was estimated using intraclass correlation coefficient (ICC) and standard error of measurement (SEM). Test validity was explored using Pearson's product moment correlation analyses. RESULTS Fewer failed attempts were recorded among the participants (age: 30 [Standard deviation 11] years; 22 women, 26 (13) months post-surgery) when compared with the Forward hop for distance test (25/288 trials; 9% vs 72/288 trials; 25%). Within-session ICC values were excellent (>0.95) for both types of Forward hop tests, independent of the side examined. The SEM values were comparable between the Modified (injured: 5.6 cm, uninjured: 5.9 cm) and the classic Forward hop (injured: 4.3 cm, uninjured: 7.2 cm). CONCLUSION The MFH is a feasible, reliable, and valid tool for judging neuromuscular performance after ACLR. If the aim of a hop for distance incorporates enhanced perceived or real landing safety, landing on both feet should be used.
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Affiliation(s)
- Eduard Kurz
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany; OSINSTITUT, ortho & sport, Munich, Germany.
| | | | - Wolfgang Schoch
- PULZ, Physiotherapie und Lauftherapie Zentrum im Rieselfeld, Freiburg, Germany
| | - Thomas Stein
- SPORTHOLOGICUM Frankfurt - Center for Sport and Joint Injuries, Frankfurt am Main, Germany
| | | | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Weber M, Müller M, Mathieu-Kälin M, Caminada S, Häberli M, Baur H. Evaluation of hop test movement quality to enhance return to sport testing. A cross-sectional study. Front Sports Act Living 2024; 6:1305817. [PMID: 38500546 PMCID: PMC10944867 DOI: 10.3389/fspor.2024.1305817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/08/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction Return to Sport tests with functional hop tests are often used to decide when a person is ready to return to sport after an anterior cruciate ligament (ACL) injury. Poor movement quality, such as knee valgus, hip adduction and hip internal rotation is considered a risk factor for ACL injury. However, it is unclear whether existing tests adequately cover the aspect of movement quality. This study aims to investigate whether there is a relationship between the calculated limb symmetry index (LSI) of hop tests as an indication of performance and the total score of the "Quality First" assessment (movement quality). The second aim is to examine the reliability of the newly developed "Quality First" assessment for evaluating movement quality in hop tests. Methods The cross-sectional study recruited 34 patients with an ACL reconstruction. The vertical hop, single-leg hop for distance, and side hop tests were performed and recorded. The video recordings were assessed using the "Quality First" assessment. The Spearman correlation coefficient was calculated using the LSI and the "Quality First" total score. Intraclass correlation coefficients (ICC) and standard error of measurements (SEM) were used to calculate intra- and interrater reliability. In addition, the minimal detectable change (MDC) was determined. Results The correlation test between the LSI and the "Quality First" total score showed no correlation for all three jumps (r = -0.1-0.02/p-value = 0.65-0.93). The interrater reliability of the "Quality First" assessment showed fair to good reliability (ICC2: 0.45-0.60), with SEM ranging from 1.46 to 1.73 and the MDC from 4.06 to 4.8. Intrarater reliability was good to excellent (ICC3: 0.73-0.85), with SEM values ranging from 0.89 to 1.09 and the MDC from 2.47 to 3.01. Conclusion The quality of movement, measured with the "Quality First" assessment, indicated no correlation with the calculated LSI from jump performance, therefore movement quality should also be examined in Return to Sport tests. The "Quality First" assessment shows fair to good reliability when used by different raters. When used multiple times by the same rater, the assessment has good to excellent reliability.
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Affiliation(s)
- Melanie Weber
- Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Mirjam Müller
- Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Moritz Mathieu-Kälin
- Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | | | - Marina Häberli
- Altius Swiss Sportmed CenterAG, Rheinfelden, Switzerland
| | - Heiner Baur
- Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Fallah Mohammadi M, Dashti Rostami K, Shabanzadeh S, Hosseininejad SE, Ghaffari S, Thomas A. Does core stability training improve hopping performance and kinetic asymmetries during single-leg landing in anterior cruciate ligament reconstructed patients? Res Sports Med 2024; 32:268-278. [PMID: 35860900 DOI: 10.1080/15438627.2022.2102919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
Safe return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) surgery is important. Core stabilization is common within rehabilitation, but its influence on hopping performance and single-leg landing kinetics among athletes post-ACLR is unclear. Twenty-four male professional athletes who had ACL reconstruction surgery (time since surgery = 11.47 ± 1.55 months) were recruited and randomly assigned to exercise (n = 12) and control (n = 12) groups. Exercise group received an 8-week core stability exercise program. Limb symmetry index (LSI) for single-leg hop for distance (SLH) and triple hop (TRH) tests, and single-leg landing kinetics (multidirectional ground reaction forces) were measured pre- and post-intervention. In post-test, the participants in exercise group were more symmetrical in SLH (P = .04, CI = 0.01-7.68) and TRH (P = .01, CI = 0.28-11.1) distances. They also improved their LSI values for vertical ground reaction force (vGRF), though not significantly (P < .05). LSI for anteroposterior (a-p) and mediolateral (m-l) GRFs remained unchanged for participants of both groups. Our findings indicate the positive effect of core exercise on decreasing between-limb asymmetries during SLH and TRH tests. Our results demonstrate that despite lack of change in kinetics, functional performance is more symmetrical following core stability training.
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Affiliation(s)
- Mohammad Fallah Mohammadi
- Department of Sports Sciences, Faculty of Humanities, Shafagh Institute of Higher Education, Tonekabon, Iran
| | - Komeil Dashti Rostami
- Department of Motor Behavior and Biomechanics, Faculty of Sports Sciences, University of Mazandaran, Babolsar, Iran
| | - Sedighe Shabanzadeh
- Department of Motor Behavior and Sports Biomechanics, Faculty Sports Sciences, University of Mazandaran, Babolsar, Iran
| | - Sayed Esmaeil Hosseininejad
- Department of Motor Behavior and Sports Biomechanics, Faculty Sports Sciences, University of Mazandaran, Babolsar, Iran
| | - Salman Ghaffari
- Orthopedic Research Center, Mazandaran University of Medical Science, Sari, Iran
| | - Abbey Thomas
- Department of Applied Physiology, Health, and Clinical Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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15
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Moler C, Cross KM, Kaur M, Bruce Leicht A, Hart J, Diduch D. Influence of Graft Type and Meniscal Involvement on Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction. J Sport Rehabil 2024; 33:79-87. [PMID: 38169456 DOI: 10.1123/jsr.2023-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/12/2023] [Accepted: 10/22/2023] [Indexed: 01/05/2024]
Abstract
CONTEXT The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. DESIGN This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. METHODS This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. RESULTS BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P = .02). Hamstring tendon: ACLR-only (P = .03) and ACLR-resect (P = .003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). CONCLUSIONS The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery.
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Affiliation(s)
- Casey Moler
- UVA Orthopedic Center Therapy Services, University of Virginia, Charlottesville, VA, USA
| | - Kevin M Cross
- UVA Orthopedic Center Therapy Services, University of Virginia, Charlottesville, VA, USA
| | - Mandeep Kaur
- Department of Physical Therapy and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Amelia Bruce Leicht
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Joe Hart
- Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA
| | - David Diduch
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
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Mitchell A, Greig M. Peak instantaneous PlayerLoad metrics highlight movement strategy deficits in professional male soccer players. Res Sports Med 2024; 32:61-71. [PMID: 35593507 DOI: 10.1080/15438627.2022.2079985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
To investigate the influence of task, limb dominance and previous injury on single leg hop task performance and loading response, 25 professional male soccer players completed anterior, medial and lateral hop tests with an accelerometer at mid-calf. Performance outcome was defined as hop distance with loading response defined as the magnitude of, and time to peak instantaneous planar PlayerLoad. The performance was sensitive to task and previous injury (P < 0.001) but not limb dominance, with no evidence of bilateral asymmetry (P = 0.668). Despite impaired performance, previously injured players did not exhibit lower peak instantaneous PlayerLoad after impact in any plane (P ≥ 0.110). There was however a significantly (P = 0.001) longer time to peak medio-lateral loading after impact in previously injured players' affected limb. This observation was exacerbated when the injury was to the non-dominant limb (P = 0.041). Lower-limb accelerometry enhances understanding of movement strategy beyond task outcome, with practical implications in player screening and objective rehabilitation.
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Affiliation(s)
- Andy Mitchell
- Medical Department, RB Leipzig Football Club, Leipzig, Germany
| | - Matt Greig
- Sports Injuries Research Group, Edge Hill University, Ormskirk, UK
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17
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Thorolfsson B, Piussi R, Snaebjornsson T, Karlsson J, Samuelsson K, Beischer S, Thomeé R, Hamrin Senorski E. Greater self-efficacy, psychological readiness and return to sport amongst paediatric patients compared with adolescents and young adults, 8 and 12 months after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2023; 31:5629-5640. [PMID: 37861790 PMCID: PMC10719146 DOI: 10.1007/s00167-023-07623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE The purpose of this study was to evaluate differences in rehabilitation-specific outcomes between paediatric patients, adolescents and young adults within the first 2 years after anterior cruciate ligament (ACL) reconstruction. A further aim was to determine whether patient age was associated with an increased risk of not achieving symmetrical muscle function within the first 2 years after ACL reconstruction. METHODS The patient data in the present study were extracted from the rehabilitation outcome registry, Project ACL. Patients aged 11-25 years registered for primary ACL reconstruction with a hamstring tendon autograft between April 1, 2013 and November 23, 2020 were included. A total of 691 patients met the inclusion criteria and were included in the study; 41 paediatric patients (females 11-13, males 11-15 years), 347 adolescents (females 14-19, males 16-19 years) and 303 young adults (females 20-25, males 20-25 years). RESULTS The comparison between groups revealed that 70% of paediatric patients, 39% of adolescents and 35% of young adults had returned to knee-strenuous sport at 8 months and that 90% of paediatric patients, 71% of adolescents and 62% of young adults had returned to sport at 12 months. Paediatric patients also reported higher scores compared with both the other patient groups on the Knee Self-Efficacy Scale (K-SES) and the Anterior Cruciate Ligament Return to Sport after Injury scale (ACL-RSI) at 8 and 12 months. CONCLUSIONS A larger proportion of paediatric patients had returned to sport compared with adolescents and young adults 8 and 12 months after ACL reconstruction. Paediatric patients also reported higher self-efficacy and greater psychological readiness to return to sport at 8 and 12 months than the other two groups. No differences in terms of muscle function tests when comparing paediatric patients, adolescents and young adults were found. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Baldur Thorolfsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden.
- Department of Orthopaedics, Sahlgrenska University Hospital, 43180, Mölndal, Sweden.
| | - Ramana Piussi
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sportrehab Sports Medicine Clinic, Gothenburg, Sweden
| | - Thorkell Snaebjornsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden
| | - Kristian Samuelsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden
| | - Susanne Beischer
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sportrehab Sports Medicine Clinic, Gothenburg, Sweden
| | - Roland Thomeé
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sportrehab Sports Medicine Clinic, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Sahlgrenska Sports Medicine Center, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sportrehab Sports Medicine Clinic, Gothenburg, Sweden
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Bühl L, Müller S, Nüesch C, Pagenstert G, Mündermann A, Egloff C. Functional leg performance 2 years after ACL surgery: a comparison between InternalBrace™-augmented repair versus reconstruction versus healthy controls. J Orthop Traumatol 2023; 24:52. [PMID: 37735271 PMCID: PMC10513977 DOI: 10.1186/s10195-023-00723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/21/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND While clinical and patient-reported outcomes have been investigated in patients after InternalBrace™-augmented anterior cruciate ligament repair (ACL-IB), less is known regarding restoration of functional performance. We aimed to determine differences in functional performance within and between patients 2 years after ACL-IB, patients 2 years after ACL reconstruction (ACL-R), and healthy controls. MATERIALS AND METHODS A total of 29 ACL-IB, 27 ACL-R (hamstring autograft), and 29 controls performed single-leg hop (maximum forward distance hop, SLH; side hop > 40 cm in 30 s, SH), proprioception (knee joint position sense at 30° and 60° flexion), and dynamic postural balance (Y Balance) tests. Differences were calculated within groups (side-to-side difference) and between the involved leg of patients and the non-dominant leg of controls, and were evaluated to predefined statistical (P < 0.05), clinically relevant, and methodological (smallest detectable change) thresholds. The number of exceeded thresholds represented no (0), small (1), moderate (2), or strong (3) differences. In addition, the relative number of participants achieving leg symmetry (≥ 90%) and normal performance (≥ 90% of the average performance of the non-dominant leg of controls) were compared between groups (chi-squared tests, P < 0.05). RESULTS We observed no-to-moderate leg differences within ACL-IB (moderate difference in hops) and within ACL-R (moderate difference in knee proprioception), no leg differences between patient groups, no-to-small leg differences between ACL-IB and controls, and no leg differences between ACL-R and controls in functional performance. However, two patients in ACL-IB and ACL-R, respectively, passed the hop pretest only with their uninvolved leg, and fewer patients after ACL-IB and ACL-R than controls reached a leg symmetry and normal leg performance of controls in SLH (P < 0.001). CONCLUSIONS Functional performance seems to be comparable 2 years postoperatively between ACL-IB and ACL-R for a specific subgroup of patients (i.e., proximal ACL tears, moderate activity level). However, the presumed advantage of comparable functional outcome with preserved knee structures after augmented ACL repair compared with ACL-R, and the tendency of both patient groups toward leg asymmetry and compromised single-leg hop performance in the involved legs, warrants further investigation. Level of Evidence Level III, case-control study. Trial registration clinicaltrials.gov, NCT04429165 (12/09/2020). Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04429165 .
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Affiliation(s)
- Linda Bühl
- Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
- Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - Sebastian Müller
- Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Corina Nüesch
- Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Geert Pagenstert
- Department of Clinical Research, University of Basel, Basel, Switzerland
- Clarahof Clinic of Orthopaedic Surgery, Basel, Switzerland
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Christian Egloff
- Department of Orthopaedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Jales MTM, Barbosa GDM, Gonçalves GV, Fonseca Fialho HR, Calixtre LB, Kamonseki DH. Lower Extremity Physical Performance Tests for the Assessment of Athletes via Telehealth are Reliable. J Sport Rehabil 2023:1-5. [PMID: 37146987 DOI: 10.1123/jsr.2022-0361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/12/2023] [Accepted: 02/24/2023] [Indexed: 05/07/2023]
Abstract
CONTEXT Lower extremity physical performance tests (PPTs) have been widely used in sports rehabilitation and are commonly performed in person. However, some situations may disrupt the in-person health care delivery, such as social distancing due to the pandemic, traveling, and living in remote locations. Those situations may require adjustments in planning and applying measurement tests, and telehealth has become an alternative. Nevertheless, the reliability of lower extremity PPT tests via telehealth is still unknown. OBJECTIVES To verify the test-retest reliability, SEM, and the minimum detectable change (MDC95) of PPTs via telehealth. METHODS Fifty asymptomatic athletes completed 2 assessment sessions 7 to 14 days apart. The assessment via telehealth consisted of warm-up exercises followed by the single-, triple-, and side-hop tests, and the long jump test, in random order. Intraclass correlation coefficient, SEM, and MDC95 were calculated for each PPT. RESULTS Single-hop test showed good to excellent reliability, with SEM and MDC95 ranging from 6.06 to 9.24 cm and 16.79 to 25.61 cm, respectively. The triple-hop test showed excellent reliability, with SEM and MDC95 ranging from 13.17 to 28.17 cm and 30.72 to 78.07 cm, respectively. Side-hop tests showed moderate reliability, with SEM and MDC95 ranging from 0.67 to 1.22 seconds and 2.00 to 3.39 seconds, respectively. The long jump test showed excellent reliability, with SEM and MDC95 ranging from 5.34 to 8.34 cm and 14.80 to 23.11 cm, respectively. CONCLUSION The test-retest reliability of those PPTs via telehealth was acceptable. The SEM and MDC were provided to assist clinicians in interpreting those PPTs.
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Affiliation(s)
- Maycon Thomas Moises Jales
- Faculty of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN,Brazil
| | - Germanna de Medeiros Barbosa
- Faculty of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN,Brazil
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN,Brazil
| | - Gustavo Viotto Gonçalves
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP,Brazil
| | | | | | - Danilo Harudy Kamonseki
- Department of Physical Therapy, Universidade Federal da Paraíba (UFPB), João Pessoa, PB,Brazil
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Gholami F, Letafatkar A, Moghadas Tabrizi Y, Gokeler A, Rossettini G, Ghanati HA, Schöllhorn WI. Comparing the Effects of Differential and Visuo-Motor Training on Functional Performance, Biomechanical, and Psychological Factors in Athletes after ACL Reconstruction: A Randomized Controlled Trial. J Clin Med 2023; 12:2845. [PMID: 37109182 PMCID: PMC10142379 DOI: 10.3390/jcm12082845] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Variation during practice is widely accepted to be advantageous for motor learning and is, therefore, a valuable strategy to effectively reduce high-risk landing mechanics and prevent primary anterior cruciate ligament (ACL) injury. Few attempts have examined the specific effects of variable training in athletes who have undergone ACL reconstruction. Thereby, it is still unclear to what extent the variations in different sensor areas lead to different effects. Accordingly, we compared the effects of versatile movement variations (DL) with variations of movements with emphasis on disrupting visual information (VMT) in athletes who had undergone ACL reconstruction. Forty-five interceptive sports athletes after ACL reconstruction were randomly allocated to a DL group (n = 15), VT group (n = 15), or control group (n = 15). The primary outcome was functional performance (Triple Hop Test). The secondary outcomes included dynamic balance (Star Excursion Balance Test (SEBT)), biomechanics during single-leg drop-landing task hip flexion (HF), knee flexion (KF), ankle dorsiflexion (AD), knee valgus (KV), and vertical ground reaction force (VGRF), and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)) assessed before and after the 8 weeks of interventions. Data were analyzed by means of 3 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. Significant group × time interaction effects, main effect of time, and main effect of group were found for the triple hop test and all eight directions, SEBT, HF, KF, AD, KV, VGRF, and TSK. There was no significant main effect of group in the HF and triple hop test. Additionally, significant differences in the triple hop test and the seven directions of SEBT, HF, KF, KV, VGRF, and TSK were found between the control group and the DL and VMT groups. Between group differences in AD and the medial direction of SEBT were not significant. Additionally, there were no significant differences between VMT and the control group in the triple hop test and HF variables. Both motor learning (DL and VMT) programs improved outcomes in patients after ACL reconstruction. The findings suggest that DL and VMT training programs lead to comparable improvements in rehabilitation.
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Affiliation(s)
- Fatemeh Gholami
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran; (F.G.); (H.A.G.)
| | - Amir Letafatkar
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran; (F.G.); (H.A.G.)
| | - Yousef Moghadas Tabrizi
- Department of health and sport medicine, Faculty of Sport Sciences and health, University of Tehran, Tehran 1439813141, Iran;
| | - Alli Gokeler
- Exercise Science and Neuroscience, Department Exercise & Health, Faculty of Science, Paderborn University, 33098 Paderborn, Germany
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, 1105 Amsterdam, The Netherlands
| | | | - Hadi Abbaszadeh Ghanati
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran; (F.G.); (H.A.G.)
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Dominguez-Navarro F, Casaña J, Perez-Dominguez B, Ricart-Luna B, Cotolí-Suárez P, Calatayud J. Dynamic balance and explosive strength appears to better explain single leg hop test results among young elite female basketball athletes. Sci Rep 2023; 13:5476. [PMID: 37016001 PMCID: PMC10073233 DOI: 10.1038/s41598-023-31178-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/07/2023] [Indexed: 04/06/2023] Open
Abstract
To analyze the impact of balance, lower-limb explosive strength and anthropometric variables on the result of the hop test in young elite female basketball athletes. Ninety young elite female basketball athletes (13-17 years), without current or recent lower-limb injury, were assessed in the off-season period of July 2021. Single leg hop test, countermovement jump, Y balance test and anthropometric outcomes were assessed. A correlation study and a regression model were performed to investigate the influence of such outcomes and the value of their participation on the hop test results. It was found a low-to-moderate correlation effect size for both countermovement jump (distance and power flight) and Y balance test values (except interlimb outcomes) with the single leg hop test results. Anthropometric outcomes did not show significant correlation (p > 0.05). Regression model revealed that for right hop test, countermovement jump values exhibited an adjusted determination coefficient of 0.408, (β = 0.249, p = 0.013), For left hop test, again the countermovement jump values (β = 0.229, p = 0.025), and left Y balance test values (β = 0.331, p = 0.011) jointly obtained an adjusted determination coefficient of 0.263 significant predictive value for countermovement jump outcomes in both right (β = 0.249, p = 0.013; β = 0.301; p = 0.031) and left leg (β = 0.229, p = 0.025; β = 0.365, p = 0.040), as well as certain Y balance outcomes values. Explosive strength, and dynamic balance although to a lesser extent, appear to be the most relevant physical-functional factors influencing the single leg hop test results among young elite female basketball athletes. These findings may a serve as a basis to implement targeted interventions, such as plyometric and balance training, for an enhancement on functional rehabilitation and reducing the risk of injury related to the hop test results.
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Affiliation(s)
- Fernando Dominguez-Navarro
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
| | - Jose Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain.
| | - Borja Perez-Dominguez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
| | - Borja Ricart-Luna
- I+D+I Alqueria LAB Department, Valencia Basket Club, Valencia, Spain
| | | | - Joaquin Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
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22
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Güzel N, Genç AS, Yılmaz AK, Kehribar L. The Relationship between Lower Extremity Functional Performance and Balance after Anterior Cruciate Ligament Reconstruction: Results of Patients Treated with the Modified All-Inside Technique. J Pers Med 2023; 13:466. [PMID: 36983648 PMCID: PMC10052949 DOI: 10.3390/jpm13030466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Anterior cruciate ligament (ACL) ruptures are common injuries, and ACL reconstruction (ACLR) is among the most common surgical procedures in sports surgery. Our research aims to compare the 6-month post-operative results of the modified all-inside (MAI) ACLR technique, single leg hop tests (SLHT), and Y balance tests applied in different directions on the operated and non-operated sides. MATERIALS AND METHODS A retrospective cohort of 22 male recreational athletes who underwent MAI ACLR techniques performed by the same surgeon were evaluated. The functional knee strengths of the participants on the operated and non-operated sides were evaluated with five different tests of SLHTs: single hop for distance (SH), triple hop for distance (TH), crossover triple hop for distance (CH), medial side triple hop for distance (MSTH), and medial rotation (90°) with hop for distance (MRH). Their dynamic balance was evaluated with the Y balance Test. RESULTS Compared to pre-operative levels, there was a significant improvement in the mean Lysholm, Tegner, and IKDC scores during the post-operative period (p < 0.05). There was a difference between SH, THD, CHD, MSTH, and MRH on the operated and non-operative sides (p < 0.05). There was no difference between Y balance scores on the operated and non-operative sides, and there were no differences between LSI scores resulting from SLHTs (p > 0.05). There were no significant relationships between YBT (composite scores) and SH, TH, CH, MSTH, and MRH distances in the healthy leg (p > 0.05), but a significant correlation with only CH in the ACL leg (p < 0.05). CONCLUSIONS Our research shows that sixth-month post-operative SLHT findings were lower on the ACL side compared to the healthy side in patients tested with the MAI ACLR technique. However, when these scores are evaluated in terms of balance, it can be seen that both sides reveal similar findings. The similarity of LSIs in SLHTs applied in different directions, and balance scores of ACL and healthy sides revealed that the MAI technique is also an ACLR technique that can be used in athletes from a functional point of view.
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Affiliation(s)
- Nizamettin Güzel
- Department of Orthopedics and Traumatology, Samsun Training and Research Hospital, 55090 Samsun, Türkiye
| | - Ahmet Serhat Genç
- Department of Orthopedics and Traumatology, Samsun Training and Research Hospital, 55090 Samsun, Türkiye
| | - Ali Kerim Yılmaz
- Departments of Recreation, Faculty of Yaşar Doğu Sport Sciences, Ondokuz Mayıs University, 55100 Samsun, Türkiye
| | - Lokman Kehribar
- Department of Orthopedics and Traumatology, Samsun University, 55090 Samsun, Türkiye
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23
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Genç AS, Güzel N. Patellofemoral Angle, Pelvis Diameter, Foot Posture Index, and Single Leg Hop in Post-Operative ACL Reconstruction. Medicina (B Aires) 2023; 59:medicina59030426. [PMID: 36984431 PMCID: PMC10055810 DOI: 10.3390/medicina59030426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Background and Objectives: Anterior cruciate ligament (ACL) injuries occur as a result of the deterioration of the static and dynamic stability of the knee. One of the structures involved in providing static stability is the patellofemoral angle (Q angle). The aim of this study was to investigate the relationships between Q angle, pelvis diameter, lower extremity length, and foot posture index (FPI) in patients who had undergone ACL reconstruction (ACLR) with the semitendinosus/gracilis (ST/G) technique on both the operated and non-operated sides. Materials and Methods: Twenty-five male recreational athletic patients between the ages of 18 and 35 who had undergone semitendinosus/gracilis (ST/G) anterior cruciate ligament reconstruction at least 6 months earlier were included in the study. Femur length, lower extremity length, pelvis diameter, and Q angle measurements, total foot posture index (FPI) scores, and single leg hop (SLH) and triple hop distance (THD) test results were determined on the operated and non-operated sides. Results: When the findings of the patients were evaluated statistically between the operated and non-operated sides, no significant differences were found in Q angle, femur length, and lower extremity length (p > 0.05). In terms of FPI scores, a significant difference was found only in the inversion/eversion of the calcaneus (CALC) parameter (p < 0.05). When the single hop test (SLHT) results were evaluated statistically on the operated and non-operated sides, the results were in favor of the non-operated side (p < 0.05). In the correlation analysis conducted for both the operated and non-operated sides, positive and significant correlations were found only between SLH and THD (p < 0.05). No significant difference was found in the other parameters. Conclusions: The fact that ST/G ACLR 6th month post-operative findings revealed similar results in Q angle, lower extremity length, and total FPI scores between the operated and non-operated sides showed that the 6-month process did not cause a difference in these parameters. However, it was found that the operated sides showed lower findings compared to non-operated sides for SLHTs, although these findings were within normal ranges in terms of the limb symmetry index.
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24
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De Oliveira Silva D, Johnston RTR, Mentiplay BF, Haberfield MJ, Culvenor AG, Bruder AM, Semciw AI, Girdwood M, Pappalardo PJ, Briggs C, West TJ, Hill JP, Patterson BE, Barton CJ, Sritharan P, Alexander JL, Carey DL, Schache AG, Souza RB, Pedoia V, Oei EH, Warden SJ, Telles GF, King MG, Hedger MP, Hulett M, Crossley KM. Trajectory of knee health in runners with and without heightened osteoarthritis risk: the TRAIL prospective cohort study protocol. BMJ Open 2023; 13:e068040. [PMID: 36759025 PMCID: PMC9923264 DOI: 10.1136/bmjopen-2022-068040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Running is one of the most popular recreational activities worldwide, due to its low cost and accessibility. However, little is known about the impact of running on knee joint health in runners with and without a history of knee surgery. The primary aim of this longitudinal cohort study is to compare knee joint structural features on MRI and knee symptoms at baseline and 4-year follow-up in runners with and without a history of knee surgery. Secondary aims are to explore the relationships between training load exposures (volume and/or intensity) and changes in knee joint structure and symptoms over 4 years; explore the relationship between baseline running biomechanics, and changes in knee joint structure and symptoms over 4 years. In addition, we will explore whether additional variables confound, modify or mediate these associations, including sex, baseline lower-limb functional performance, knee muscle strength, psychological and sociodemographic factors. METHODS AND ANALYSIS A convenience sample of at least 200 runners (sex/gender balanced) with (n=100) and without (n=100) a history of knee surgery will be recruited. Primary outcomes will be knee joint health (MRI) and knee symptoms (baseline; 4 years). Exposure variables for secondary outcomes include training load exposure, obtained daily throughout the study from wearable devices and three-dimensional running biomechanics (baseline). Additional variables include lower limb functional performance, knee extensor and flexor muscle strength, biomarkers, psychological and sociodemographic factors (baseline). Knowledge and beliefs about osteoarthritis will be obtained through predefined questions and semi-structured interviews with a subset of participants. Multivariable logistic and linear regression models, adjusting for potential confounding factors, will explore changes in knee joint structural features and symptoms, and the influence of potential modifiers and mediators. ETHICS AND DISSEMINATION Approved by the La Trobe University Ethics Committee (HEC-19524). Findings will be disseminated to stakeholders, peer-review journals and conferences.
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Affiliation(s)
- Danilo De Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Richard T R Johnston
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Melissa J Haberfield
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Andrea M Bruder
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Adam I Semciw
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Michael Girdwood
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Paula J Pappalardo
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Connie Briggs
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Thomas J West
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Joshua P Hill
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Prasanna Sritharan
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - James L Alexander
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - David L Carey
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Anthony G Schache
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Richard B Souza
- Department of Radiology and Biomedical Imagining, University of California San Francisco, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imagining, University of California San Francisco, San Francisco, California, USA
| | - Edwin H Oei
- Department of Radiology & Nuclear Medicine, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University, Indianapolis, Indiana, USA
| | - Gustavo F Telles
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Rehabilitation Science Postgraduation Program, Augusto Motta University Centre, Rio de Janeiro, Brazil
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Michael P Hedger
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
| | - Mark Hulett
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian International Olympic Committee (IOC) Research Centre, Melbourne, Victoria, Australia
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25
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Are Physical Function and Fear of Movement Risk Factors for Patellofemoral Pain? A 2-Year Prospective Study. J Sport Rehabil 2023; 32:24-30. [PMID: 35894902 DOI: 10.1123/jsr.2021-0392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 01/03/2023]
Abstract
CONTEXT To determine (1) whether physical function and fear of movement are prospectively associated with the risk of females developing patellofemoral pain (PFP) and (2) whether they change following development of PFP. DESIGN Prospective observational study. METHODS A total of 114 asymptomatic females (18-22 y old) completed assessment of physical function (forward step-down test and single-leg hop for distance) and fear of movement using the Tampa Scale for Kinesiophobia at baseline and 2-year follow-up. Presence of symptoms of PFP was monitored bimonthly. RESULTS Ninety participants (retention rate = 79%) completed the 2-year follow-up assessment, with 27 (24% of the cohort) developing PFP. Physical function, including forward step-down test (P = .659) and single-leg hop for distance (P = .825), and fear of movement (P = .479) were not associated with the risk of developing PFP. Females who developed PFP presented with reduced forward step-down repetitions (mean difference = 2.8; 95% confidence interval, 0.2 to 5.3) and single-leg hop for distance (10.2; 95% confidence interval, 2.7 to 17.7 cm) at 2-year follow-up. There was no statistically significant difference between those who did and did not develop PFP for fear of movement (-3.4; 95% confidence interval, -7.0 to 0.2). CONCLUSIONS Physical function and fear of movement were not associated with the risk of developing PFP in young females. However, the change over time in the step-down and single-leg hop for distance tests may suggest that, even in the early stages of PFP, young females present impaired physical function compared with females who did not develop symptoms. Fear of movement may develop due to persistent PFP, and does not appear to be a risk factor or key feature in females with PFP of short symptoms duration.
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26
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Jiang L, Zhang L, Huang W, Zeng Q, Huang G. The effect of proprioception training on knee kinematics after anterior cruciate ligament reconstruction: A randomized control trial. J Back Musculoskelet Rehabil 2022; 35:1085-1095. [PMID: 35213344 DOI: 10.3233/bmr-210201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Proprioception is essential for the normal movement of knee joints. How proprioception training affects the postoperative knee functional recovery after anterior cruciate ligament (ACL) reconstruction remains unknown. OBJECTIVE This study investigated the effect of proprioception training on the knee joint kinematics of patients after ACL reconstruction (ACLR). METHODS The randomized controlled study was performed at the Department of Orthopaedics and Traumatology of Guangdong Provincial People's Hospital between December 2019 and April 2021. Forty-five patients who underwent ACLR were randomly divided into a proprioception group (n= 23) and a control group (n= 22). The patients were randomly divided into an experimental group and a control group according to whether the final digits of their ID numbers were odd or even. All patients followed a common postoperative rehabilitation program. The outcome measures included the patients Lysholm scores, hop distances, and knee kinematics during unanticipated jump-cut maneuvering measured at different follow-up times. Knee joint kinematics were described as the positional and orientational changes of the femur relative to the tibia. RESULTS After surgery, the proprioception group did not exhibit significantly higher hop distances than the control group at the 6-month (114.8 ± 19.0 vs. 105.9 ± 20.7 cm, p= 0.137, 95% CI: -3.13 to 22.03 cm) and 1-year follow-ups (143.1 ± 19.3 vs. 133.9 ± 26.2 cm, p= 0.216, 95% CI: -5.57 to 23.87 cm). For knee joint kinematics, the members of the proprioception training group exhibited significantly reduced knee abduction (valgus) angles and external rotation and significantly increased knee flexion compared to those in the common training group. CONCLUSIONS The results suggested that proprioceptive rehabilitation training enhances knee joint functional performance and shows altered knee joint kinematics in ACL-reconstructed populations during unanticipated jump-cut maneuvering compared with the common rehabilitation training.
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Affiliation(s)
- Lisi Jiang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, Guangdong, China.,Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Zhang
- Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.,Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wenhan Huang
- Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Qing Zeng
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, Guangdong, China
| | - Guozhi Huang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, Guangdong, China
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27
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Farraye BT, Chaput M, Simon JE, Kim H, Grooms DR, Monfort SM. Development and reliability of a visual-cognitive medial side hop for return to sport testing. Phys Ther Sport 2022; 57:40-45. [PMID: 35921780 PMCID: PMC10871861 DOI: 10.1016/j.ptsp.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To develop and evaluate the reliability of a new visual-cognitive medial side hop (VCMH) test that challenges physical and cognitive performance to potentially improve return to sport testing. DESIGN Test-retest experimental design. SETTING Laboratory. PARTICIPANTS Twenty-two healthy college students participated (11 females; 23.5 ± 3.64 years; 172.9 ± 11.58 cm; 74.1 ± 17.25 kg; Tegner Score 5.6 ± 1.1). MAIN OUTCOME MEASURES Subjects performed a medial side hop for distance with and without a visual-cognitive task (VCMH). Maximum hop distance and cognitive errors were measured. RESULTS There was strong reliability for the traditional medial side hop (ICC3,1 = 0.88[0.72, 0.95]; SEM = 7.16 cm) and VCMH distances (ICC3,1 = 0.86[0.66, 0.94]; SEM = 6.82 cm). Maximum hop distance was significantly lower during the VCMH (86.9 ± 18.2 cm) compared to the traditional medial side hop (96.3 ± 20.7 cm; p < 0.05; d = 0.74), with a performance deficit of 9.69%. CONCLUSION The VCMH has high test-retest reliability and resulted in a significant dual-task cost with a reduction in physical performance when compared to the traditional medial side hop.
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Affiliation(s)
- Byrnadeen T Farraye
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, OH; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA.
| | - Meredith Chaput
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, OH; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Janet E Simon
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - HoWon Kim
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, OH; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Dustin R Grooms
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, OH; Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Scott M Monfort
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT, USA
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28
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Ebert JR, Edwards P, Annear PT. Selective bundle reconstruction for symptomatic partial anterior cruciate ligament tears demonstrates good functional scores, high return to sport rates and a low re-tear rate. Knee 2022; 36:53-64. [PMID: 35526349 DOI: 10.1016/j.knee.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/12/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The treatment of symptomatic partial anterior cruciate ligament (ACL) tears remains controversial. This study investigated the clinical and functional outcome of patients undergoing selective posterolateral (PLB) or anteromedial (AMB) bundle reconstruction. METHODS 55 consecutive patients underwent partial bundle reconstruction, of which 45 (AMB = 17, PLB = 28) were included in the current analysis (62% male, mean age of 29.1 years). Patients were assessed at 12 and 24 months with patient-reported outcome measures (PROMs), graft laxity (KT-1000), knee extensor and flexor torque and a 4-hop battery. Limb Symmetry Indices (LSIs) were calculated. Return to sport (RTS) rates, re-operations and re-injuries were evaluated. RESULTS High scoring PROMs were evident, with 62% and 84% of patients participating in pivoting sports at 12 and 24 months, respectively. Overall, 98% of patients demonstrated 'normal' knee laxity at 24 months. Mean LSIs for all hop tests were ≥ 90% at 12 and 24 months, with 76-87% of patients demonstrating LSIs ≥ 90% on the four hop tests employed at 12 months, which was 89-93% of patients at 24 months. A mean knee extensor torque LSI of 89% and 97% was observed at 12 and 24 months. Two ipsilateral re-tears (2/55, 3.6%, AMB = 1, PLB = 1) were observed over the 24-month period, with no contralateral ACL tears. CONCLUSIONS High levels of physical function and RTS were observed in patients following partial bundle reconstruction, higher than that reported in the literature in patients undergoing ACLR, without evidence of instability and a low re-injury rate.
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, Western Australia 6009, Australia; HFRC Rehabilitation Clinic, 117 Stirling Highway, Nedlands, Western Australia 6009, Australia.
| | - Peter Edwards
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter T Annear
- Perth Orthopaedic & Sports Medicine Centre, West Perth, Western Australia 6005, Australia
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29
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Pimenta L, Garcia NM, Zdravevski E, Chorbev I, Trajkovik V, Lameski P, Albuquerque C, Pires IM. Can the Eight Hop Test Be Measured with Sensors? A Systematic Review. SENSORS 2022; 22:s22093582. [PMID: 35591272 PMCID: PMC9105795 DOI: 10.3390/s22093582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023]
Abstract
Rehabilitation aims to increase the independence and physical function after injury, surgery, or other trauma, so that patients can recover to their previous ability as much as possible. To be able to measure the degree of recovery and impact of the treatment, various functional performance tests are used. The Eight Hop Test is a hop exercise that is directly linked to the rehabilitation of people suffering from tendon and ligament injuries on the lower limb. This paper presents a systematic review on the use of sensors for measuring functional movements during the execution of the Eight Hop Test, focusing primarily on the use of sensors, related diseases, and different methods implemented. Firstly, an automated search was performed on the publication databases: PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Secondly, the publications related to the Eight-Hop Test and sensors were filtered according to several search criteria and 15 papers were finally selected to be analyzed in detail. Our analysis found that the Eight Hop Test measurements can be performed with motion, force, and imaging sensors.
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Affiliation(s)
- Luís Pimenta
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal;
| | - Nuno M. Garcia
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
| | - Eftim Zdravevski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia; (E.Z.); (I.C.); (V.T.); (P.L.)
| | - Ivan Chorbev
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia; (E.Z.); (I.C.); (V.T.); (P.L.)
| | - Vladimir Trajkovik
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia; (E.Z.); (I.C.); (V.T.); (P.L.)
| | - Petre Lameski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, North Macedonia; (E.Z.); (I.C.); (V.T.); (P.L.)
| | - Carlos Albuquerque
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal;
- Higher School of Health, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal
- Child Studies Research Center (CIEC), University of Minho, 4710-057 Braga, Portugal
| | - Ivan Miguel Pires
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal;
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Correspondence: ; Tel.: +351-966-379-785
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Ebert JR, Edwards P, Joss B, Annear PT. A structured accelerated versus control rehabilitation pathway after anterior cruciate ligament reconstruction using autologous hamstrings demonstrates earlier improvement in physical outcomes without increasing graft laxity: A randomized controlled trial. Phys Ther Sport 2022; 55:271-281. [DOI: 10.1016/j.ptsp.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
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Robyn AD, Louw QA, Baumeister J. Return to play in elite rugby players after severe knee injuries. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1629. [PMID: 35547961 PMCID: PMC9082221 DOI: 10.4102/sajp.v78i1.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Medical professionals working in an elite sport environment have the challenging task to balance the athlete's readiness to return to the playing field after severe injury with other stakeholders' (coaches, sponsors, teammates) opinions and objectives. Objectives Our study aimed to evaluate differences in the physical profiles of elite rugby players at return to play (RTP) after a severe knee injury, compared with their pre-injury profiles and matched controls. Method Before the injury, participants performed four performance tests during their preseason screening. These tests were repeated and compared to baseline once a player was declared fit to play. Results Significant differences (p ≤ 0.05) were found in the injured players' group who were slower over 10 m speed, in their decision-making time and the total time of the reactive agility tests at RTP, whilst controls were significantly faster over 10 m and 30 m speed tests. The countermovement jump outcomes showed significant improvement in the uninjured participants (p ≤ 0.05). Conclusion Our study highlights that injured players' running speeds and decision-making times are slower after injury. The uninjured players have a positive outcome to training and match stimulus by improving their running speed and lower body explosive power during the season. Clinical implications Our study provides insight into the RTP profile of elite rugby players, and a novel finding was the decision-making time deficit. This highlights the importance of cognitive training during injury rehabilitation as athletes make numerous decisions in a pressured and uncontrolled environment during a match. Speed training development is recommended as the athletes were slower after severe knee injury.
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Affiliation(s)
- Aneurin D Robyn
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette A Louw
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jochen Baumeister
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Exercise and Health, Faculty of Science, Paderborn University, Paderborn, Germany
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Fang B, Kim YH, Choi MY. Effects of High-Intensity Aquatic or Bicycling Training in Athletes with Unilateral Patellofemoral Pain Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084675. [PMID: 35457543 PMCID: PMC9028389 DOI: 10.3390/ijerph19084675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
Patellofemoral pain syndrome (PFPS) is one of the most common overuse injuries experienced by athletes. It is characterized by pain and functional deficits that lead to decreased performance, thereby limiting sports activity. Therefore, optimal training interventions are required to improve physical fitness and function while minimizing pain due to PFPS. This study aimed to compare and analyze the effects of high-intensity aquatic training (AT) and bicycling training (BT) in male athletes with PFPS. Fifty-four athletes with PFPS were divided into AT and BT intervention groups. Intervention training was conducted three times per week for 8 weeks. Cardiorespiratory fitness was evaluated using the graded exercise test (GXT) based on peak oxygen uptake (VO2 peak), and anaerobic threshold. For the knee strength test, extension and flexion were performed and measured using isokinetic equipment. One-leg hop tests and the Y-balance test (YBT) were performed to evaluate dynamic balance, and the International Knee Documentation Committee (IKDC) scoring system was used for subjective knee evaluation. The GXT, YBT, and IKDC scores were reported according to the group and duration of the intervention. After training, VO2 peak, YBT, knee extension strength, and IKDC score improved significantly in both the AT and BT groups compared with the pre-training values. Furthermore, the AT group exhibited significant improvement compared with the BT group. We demonstrated that AT and BT effectively improved the symptoms and muscle strength of athletes with PFPS who were only able to engage in limited high-intensity field training. AT produced a modestly better effect than BT.
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Affiliation(s)
- Bin Fang
- College of Physical Education, Luoyang Normal University, Luoyang 471934, China;
| | - Yong-hwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Korea;
| | - Moon-young Choi
- Department of Sports Science Convergence, Dongguk University, Seoul 04620, Korea
- Correspondence: ; Tel.: +82-2-2260-8741; Fax: +82-2-2260-3741
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Kehribar L, Yılmaz AK, Karaduman E, Kabadayı M, Bostancı Ö, Sürücü S, Aydın M, Mahiroğulları M. Post-Operative Results of ACL Reconstruction Techniques on Single-Leg Hop Tests in Athletes: Hamstring Autograft vs. Hamstring Grafts Fixed Using Adjustable Cortical Suspension in Both the Femur and Tibia. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030435. [PMID: 35334611 PMCID: PMC8950666 DOI: 10.3390/medicina58030435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 01/13/2023]
Abstract
Background and Objectives: Anterior cruciate ligament (ACL) tears are common injuries in the athletic population, and accordingly, ACL reconstruction (ACLR) is among the most common orthopedic surgical procedures performed in sports medicine. This study aims to compare the semitendinosus/gracilis (ST/G) and ACL hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia (MAI) ACLR techniques. We aimed to compare the results of single-leg hop tests (SLHT) applied in different directions and limb symmetry indices (LSI) in athletes with a 6-month post-operative ACLR history. Materials and Methods: A retrospective cohort of 39 athletes from various sports branches who underwent MAI (n = 16) and ST/G (n = 23) ACLR techniques by the same surgeon were evaluated. The knee strength of the participants on the operated and non-operated sides was evaluated with five different SLHTs. The SLHT included the single hop for distance (SH), triple hop for distance (TH), crossover triple hop for distance (CH), medial side triple hop for distance (MSTH), and medial rotation (90°) hop for distance (MRH). Results: There was a significant improvement in the mean Lysholm, Tegner, and IKDC scores in the post-operative leg for both techniques (p < 0.05) compared to the pre-operative levels. When there was a difference between the SH of the operative and the non-operative legs in the ST/G technique (p < 0.05), there was no significant difference in the other hop distance for both ST/G and MAI (p > 0.05). There was no difference between the techniques regarding the LSI scores. Conclusions: The fact that our research revealed similar LSI rates of the SLHTs applied in different directions in the ST/G and MAI techniques assumes that the MAI technique can be an ACLR technique which can be functionally used in athletes.
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Affiliation(s)
- Lokman Kehribar
- Department of Orthopaedics and Traumatology, Samsun University, Samsun 55090, Turkey;
| | - Ali Kerim Yılmaz
- Faculty of Yaşar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Turkey; (E.K.); (M.K.); (Ö.B.)
- Correspondence: or ; Tel.: +90-542-495-3737
| | - Emre Karaduman
- Faculty of Yaşar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Turkey; (E.K.); (M.K.); (Ö.B.)
| | - Menderes Kabadayı
- Faculty of Yaşar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Turkey; (E.K.); (M.K.); (Ö.B.)
| | - Özgür Bostancı
- Faculty of Yaşar Doğu Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Turkey; (E.K.); (M.K.); (Ö.B.)
| | - Serkan Sürücü
- Department of Orthopaedics, University of Missouri, Kansas City, MO 64108, USA;
| | - Mahmud Aydın
- Haseki Training and Research Hospital, Orthopaedics and Traumatology, Istanbul 34096, Turkey;
| | - Mahir Mahiroğulları
- Memorial Sisli Hospital, Orthopaedics and Traumatology, Istanbul 34384, Turkey;
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Civilette MD, Rate WR, Haislup BD, Cohen AS, Camire L, Bodendorfer BM, Gould HP. The top 100 most impactful articles on the anterior cruciate ligament: An altmetric analysis of online media. SAGE Open Med 2022; 10:20503121221111694. [PMID: 35924141 PMCID: PMC9340895 DOI: 10.1177/20503121221111694] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/13/2022] [Indexed: 12/17/2022] Open
Abstract
Objectives: To identify the top 100 most impactful anterior cruciate ligament articles in online media as measured by the Altmetric Attention Score and compare their characteristics to the most-cited anterior cruciate ligament articles in the scientific literature. Methods: The Altmetric database was queried to identify all published articles pertaining to the anterior cruciate ligament. The search yielded 9445 articles, which were stratified by highest to lowest Altmetric Attention Score. The top 100 articles were included. Collected data included article type, article topic, journal name, and online mentions in news, blogs, Twitter, Facebook, Wikipedia, and other sources. The geographic origin of each article was also determined based on the institutional affiliation of the first author. Results: Altmetric Attention Score of the top 100 anterior cruciate ligament articles ranged from 109 to 2193 (median 172.0, interquartile range 137.5–271.5). Of the 100 articles, 65 were published in three journals: American Journal of Sports Medicine, British Journal of Sports Medicine, and Journal of Orthopaedic & Sports Physical Therapy. The most prevalent article type was original research (60%), followed by systematic review/meta-analysis (18%). The most prevalent article topic was rehabilitation and return to play after anterior cruciate ligament reconstruction (22%), followed by epidemiology/risk factors (16%), injury prevention (14%), and biomechanics of anterior cruciate ligament injuries (14%). Of the top 100 articles, 54% were American, 31% were European, and 15% were published in other countries outside of the United States and Europe. Conclusion: This study used Altmetric Attention Score to identify the 100 most engaged anterior cruciate ligament articles in online media. The characteristics of these articles differed substantially from the most-cited anterior cruciate ligament articles in the literature with regard to article type, article topic, geographic origin, and publication journal. These findings suggest that alternative metrics measure distinct components of anterior cruciate ligament article engagement and add an important dimension to understanding the overall impact of published research on the anterior cruciate ligament.
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Affiliation(s)
- Matthew D Civilette
- Georgetown University Medical Center, Washington, DC, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - William R Rate
- Georgetown University Medical Center, Washington, DC, USA
| | - Brett D Haislup
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Andrew S Cohen
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Lyn Camire
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Blake M Bodendorfer
- Division of Sports Medicine and Shoulder Surgery, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA
| | - Heath P Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
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Gokeler A, Dingenen B, Hewett TE. Rehabilitation and Return to Sport Testing After Anterior Cruciate Ligament Reconstruction: Where Are We in 2022? Arthrosc Sports Med Rehabil 2022; 4:e77-e82. [PMID: 35141539 PMCID: PMC8811523 DOI: 10.1016/j.asmr.2021.10.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/30/2021] [Indexed: 01/02/2023] Open
Abstract
Athletes who sustain an anterior cruciate ligament (ACL) injury often opt for an ACL reconstruction (ACLR) with the goal and expectation to return to sports at the preinjury level. The proportion of athletes who successfully return to preinjury-level sport is low and disappointing, whereas the rate of second ACL injury in athletes under the age of 20 has been reported to be as high as 40% after return to sport (RTS). Although in recent years, new insights pertaining to RTS have been published, the lack of validity of RTS criteria after ACLR remain. The purpose of this clinical commentary is to present a critical overview of the current literature on RTS testing after ACLR.
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Affiliation(s)
- Alli Gokeler
- OCON Centre of Orthopaedic Surgery and Sports Medicine, Hengelo, The Netherlands.,Exercise Science and Neuroscience Unit, Department Exercise & Health, Faculty of Science, University of Paderborn, Paderborn, Germany
| | - Bart Dingenen
- Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Timothy E Hewett
- Hewett Global Consultants, Rochester, Minnesota, U.S.A.,Rocky Mountain Consortium for Sports Research, Edwards, Colorado, U.S.A
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Fort-Vanmeerhaeghe A, Arboix-Alió J, Montalvo AM. Return-to-sport following anterior cruciate ligament reconstruction in team sport athletes. Part II: Progressive framework. APUNTS SPORTS MEDICINE 2022. [DOI: 10.1016/j.apunsm.2021.100361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nishida K, Xu C, Gale T, Anderst W, Fu F. Symmetry and sex differences in knee kinematics and ACL elongation in healthy collegiate athletes during high-impact activities revealed through dynamic biplane radiography. J Orthop Res 2022; 40:239-251. [PMID: 34387908 DOI: 10.1002/jor.25162] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 05/26/2021] [Accepted: 07/13/2021] [Indexed: 02/04/2023]
Abstract
The objectives of this study were to determine symmetry and sex differences in knee kinematics and anterior cruciate ligament (ACL) elongation waveforms in healthy athletes without a history of a knee injury during fast running, drop jump, and 180° internal/external rotation hops. It was hypothesized that knee abduction angle and ACL relative elongation would be greater in women than in men during all activities. Bilateral knee kinematics and ACL relative elongation were determined in 19 collegiate athletes using dynamic biplane radiography. Sex differences in kinematics and ACL relative elongation waveforms were identified using statistical parametric mapping. Average absolute side-to-side differences (SSDA ) in kinematics and ACL relative elongation waveforms were determined for each activity. Women had up to 2.3° (all p < 0.05) less knee adduction angle and had greater ACL relative elongation (max. 4.8%-9.2%; all p < 0.01) than men during all activities, in support of the hypotheses. SSDA in kinematics were 1.4 mm and 5.5° or less in all components of translation and rotation, respectively, while SSDA in ACL relative elongation was 3.6% or less across all activities. Greater ACL relative elongation across a variety of activities may make women more susceptible to ACL injury than men. This study provides valuable reference data for identifying abnormal asymmetry in knee kinematics and ACL elongation in athletes after the ACL injury. These novel results improve our understanding of ACL elongation during demanding athletic activities and may help guide the development of sex-specific risk screening metrics, return to play assessments, and rehabilitation protocols after the ACL injury.
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Affiliation(s)
- Kyohei Nishida
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caiqi Xu
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Tom Gale
- Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William Anderst
- Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Freddie Fu
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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The Single Hop for Distance Test: Reviewing the Methodology to Measure Maximum and Repeated Performance. J Sport Rehabil 2022; 31:657-663. [DOI: 10.1123/jsr.2021-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/19/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022]
Abstract
Context: The single hop for distance (SHD) and Limb Symmetry Index are often used to assess readiness for returning to sport postinjury. However, the sensitivity of SHD Limb Symmetry Index for detecting functional abnormalities is questionable due to the methodological inconsistencies in the literature. The common methods use few repetitions; lacking consideration of repeated maximum performance, or the effect of fatigue (or failed attempts) on repeated maximum performance, required for sport. The objectives were to review the SHD for evaluating repeated maximum performance, and the effect of failed attempts on consistency of performance, in a healthy population of sportspersons. Design: A quantitative, nonexperimental, same-subject, repeated-measures design with 15 healthy Cardiff University students. Method: Participants performed the SHD up to 30 times on each limb, with standardized rests. A failed attempt, if the landing was not controlled, was noted but distance not recorded. Participants stopped if 3 consecutive distances decreased, or 30 repetitions were achieved. Results: Average hop distance increased with each repetition. Only the 28th to 30th hops were between the maximum average value and 1 SD below. With failed repetitions included, the maximum average hop was at repetition 21 with more results falling between the maximum and 1 SD below, demonstrating more consistency in repeated performance. The number of failed repetitions had a trend to increase over time; whether subjects overreach in attempt to achieve maximum performance, or whether due to fatigue is unknown. Conclusion: Maximum performance of SHD is not achieved until multiple repetitions have been conducted. Repeated maximum performance does not drop-off until over 21 repetitions have been conducted. Consistency of repeated maximum performance varies depending on whether failed attempts are included in the analysis. Further investigation into the reasons for failed attempts is required to improve clinical decision making for return to sport postinjury.
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Moksnes H, Ardern CL, Kvist J, Engebretsen L, Risberg MA, Myklebust G, Grindem H. Assessing implementation, limited efficacy, and acceptability of the BEAST tool: A rehabilitation and return-to-sport decision tool for nonprofessional athletes with anterior cruciate ligament reconstruction. Phys Ther Sport 2021; 52:147-154. [PMID: 34492443 DOI: 10.1016/j.ptsp.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the implementation, limited efficacy, and acceptability of the BEAST (better and safer return to sport) tool - a rehabilitation and return-to-sport (RTS) decision tool after anterior cruciate ligament reconstruction (ACLR) in nonprofessional athletes. DESIGN Prospective cohort. PARTICIPANTS 43 nonprofessional pivoting sport athletes with ACLR. MAIN OUTCOME Clinician- and athlete-experienced implementation challenges (implementation), changes in quadriceps power, side hop and triple hop performance from 6 to 8 months after ACLR (limited efficacy), athletes' beliefs about the individual rehabilitation and RTS plans produced by the BEAST tool (acceptability). RESULTS The BEAST tool was developed and then implemented as planned for 39/43 (91%) athletes. Hop and quadriceps power performance improved significantly, with the largest improvement in involved quadriceps power (standardised response mean 1.4, 95% CI:1.1-1.8). Athletes believed the rehabilitation and RTS plan would facilitate RTS (8.2 [SD: 2.0]) and reduce injury risk (8.3 [SD: 1.2]; 0 = not likely at all, 10 = extremely likely). CONCLUSION The BEAST tool was implemented with few challenges and adjustments were rarely necessary. Athletes had large improvements in quadriceps power and hop performance on the involved leg. Athletes believed that the individual rehabilitation and RTS plans produced by the tool would facilitate RTS and reduce injury risk.
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Affiliation(s)
- Håvard Moksnes
- Oslo Sport Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806, Oslo, Norway.
| | - Clare L Ardern
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Box 5605, 114 86, Stockholm, Sweden; Sport and Exercise Medicine Research Centre, La Trobe University, Kingsbury Drive, Bundoora, Australia, 3086.
| | - Joanna Kvist
- Unit of Physiotherapy, Department of Health, Medicine and Caring Science, Linköping University, 581 83, Linköping, Sweden; Stockholm Sports Trauma Research Center, Dept of Molecular Medicine & Surgery, Karolinska Institute, 171 77, Stockholm, Sweden.
| | - Lars Engebretsen
- Oslo Sport Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806, Oslo, Norway; Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806, Oslo, Norway.
| | - Grethe Myklebust
- Oslo Sport Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806, Oslo, Norway.
| | - Hege Grindem
- Oslo Sport Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806, Oslo, Norway; Stockholm Sports Trauma Research Center, Dept of Molecular Medicine & Surgery, Karolinska Institute, 171 77, Stockholm, Sweden.
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Schelin L, Pini A, Markström JL, Häger CK. Test-retest reliability of entire time-series data from hip, knee and ankle kinematics and kinetics during one-leg hops for distance: Analyses using integrated pointwise indices. J Biomech 2021; 124:110546. [PMID: 34171677 DOI: 10.1016/j.jbiomech.2021.110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
Motion capture systems enable in-depth interpretations of human movements based on data from three-dimensional joint angles and moments. Such analyses carry important bearings for evaluation of movement control during for instance hop landings among sports-active individuals from a performance perspective but also in rehabilitation. Recent statistical development allows analysis of entire time-series of angle and moment during hops using functional data analysis, but the reliability of such multifaceted data is not established. We used integrated pointwise indices (intra-class correlation, ICC; standard error of measurement, SEM) to establish the test-retest reliability of three-dimensional hip, knee and ankle angle and moment curves during landings of one-leg hop for distance (OLHD) in 23 asymptomatic individuals aged 18-28. We contrasted these findings to reliability of discrete variables extracted at specific events (initial contact, peak value). We extended the calculations of ICC and SEM to handle unbalanced situations (varying number of repetitions) to include all available data. Hip and knee angle curves proved reliable with stable ICC curves throughout the landing, with integrated ICCs ≥ 0.71 for all planes except for knee internal/external rotation (ICC = 0.57). Hip and knee moment curves and ankle angle and moments were less reliable and less stable, particularly in the first ~ 10-25% of the landing (integrated ICCs 0.44-0.57). Curve data were generally not in agreement with the results for discrete event data, thus advocating analysis of curve data which contains more information. To conclude, hip and knee angle curve data during OLHD landings can reliably be evaluated, while moment curves necessitate careful consideration.
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Affiliation(s)
- Lina Schelin
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
| | - Alessia Pini
- Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Jonas L Markström
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Ebert JR, Edwards P, Preez LD, Furzer B, Joss B. Knee extensor strength, hop performance, patient-reported outcome and inter-test correlation in patients 9-12 months after anterior cruciate ligament reconstruction. Knee 2021; 30:176-184. [PMID: 33940305 DOI: 10.1016/j.knee.2021.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/23/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hop performance and isokinetic knee extensor strength (IKES) asymmetry are associated with re-injury after anterior cruciate ligament reconstruction (ACLR). This study investigated deficits after ACLR, and which hop tests are most correlated with IKES and patient-reported outcome measures (PROMs). METHODS 50 patients were assessed 9-12 months after ACLR using the International Knee Documentation Committee (IKDC) and ACL Return to Sport after Injury (ACL-RSI) scores. Peak IKES and eight hop tests were assessed: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6 m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (SHT). The percentage of patients with limb symmetry indices (LSIs) < 90% was reported. Pearson's correlations investigated the correlation between PROMs, IKES and hop LSIs. RESULTS The majority (80%) of patients had IKES LSIs < 90%. While 12-14% of patients demonstrated LSIs < 90% for the SHD, 6MTH, THD and TCHD, 52-80% demonstrated LSIs < 90% for the other hop tests. The IKES LSI was significantly different (p < 0.05) from all hop LSIs, besides the SLCMJ (p = 0.638). Large correlations were only observed between the IKES LSI and the SLCMJ (r = 0.82), MHD (r = 0.71) and LHD (r = 0.53). The SLCMJ, MHD and IKES LSIs demonstrated the largest significant correlations with the IKDC (r = 0.51-0.53) and ACL-RSI (r = 0.38-0.40). CONCLUSIONS Hop tests such as the MHD and SLCMJ may present a more practical alternative to quantifying peak IKES, especially in the absence of more sophisticated testing equipment. While not surrogates as such, these selective hop measures may better inform the clinician as to whether significant underlying quadriceps deficits are still present throughout the post-operative rehabilitation period.
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; HFRC, 117 Stirling Highway, Nedlands, Western Australia 6009, Australia.
| | - Peter Edwards
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Luke Du Preez
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Bonnie Furzer
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Brendan Joss
- HFRC, 117 Stirling Highway, Nedlands, Western Australia 6009, Australia
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Negrete R, Simms S, Gross J, Nunes Rabello L, Hixon M, Zeini IM, Jenkins WL, Davies GJ. The Test Re-Test Reliability of A Novel Single Leg Hop Test (T-Drill Hop Test). Int J Sports Phys Ther 2021; 16:724-731. [PMID: 34123525 PMCID: PMC8169018 DOI: 10.26603/001c.23677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/26/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Functional training and testing are an important part of a comprehensive rehabilitation program stressing the neuromuscular system in ways that simulate athletic performance to help determine criteria for return to sport. There are numerous single leg hop tests that have been used for these purposes, however, the validity and clinical relevance has been questioned. Many of the functional performance tests assess only the sagittal plane or forward direction and may only partially assess a person's athletic abilities. There is a need for reliable and valid functional tests to assess in a multi-directional manner. PURPOSE/HYPOTHESIS The purpose of this study is to determine the test re-test reliability of a novel multi-directional timed single leg hop test (T-Drill Hop Test) for use in rehabilitation and performance assessments. STUDY DESIGN Cross-sectional reliability study. METHODS Fifty healthy recreationally active college age subjects, (23 males and 27 females) between the ages of 18 and 35, (mean age 23.48 with SD 3.82) consented to perform the test. The subjects hopped along a 10ft. x 10ft. "T" shaped course. Subjects performed two timed maximum effort trials of the T-Drill Hop Test on each leg with an interval of 3-7 days between the two testing days. Intraclass Correlation Coefficients (ICC) were calculated to determine intersession reliability. RESULTS The inter-rater reliability (ICC's) for the entire group of 50 subjects ranged between .98 and 1.00 suggesting excellent reliability. The bilateral comparison, utilizing paired t-tests, of the T-Drill Hop Test demonstrated no significant differences between the time scores for the dominant and non-dominant legs for either males or females (p>.05). CONCLUSION This study demonstrates the T-Drill Hop Test has excellent test re-test reliability. These results are important prior to validation and utilization as a clinical functional performance test. LEVELS OF EVIDENCE Level 2.
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Fehske K, Lukas C, Bischoff A, Krutsch W, Hoos O, Latzel R. [Extended medical preparticipation screening as a useful option for injury prevention in professional sports]. SPORTVERLETZUNG-SPORTSCHADEN 2021; 35:88-94. [PMID: 34058785 DOI: 10.1055/a-1485-6726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Preparticipation screening is important in order to make a statement about an athlete's health. The evaluation includes both an internal medicine/cardiology and an orthopaedic section. In professional team sports, players have to undergo medical screening on an annual basis to obtain their license and be cleared for play. Screening delivers information about the acute health condition of the athlete but only gives an indirect statement on his/her functional status and performance. This gap has been tried to be closed with functional, sports-specific performance testing in the past few years. In the event of future injury, the collected data can be used as a baseline level to monitor the progress in an athlete's rehabilitation process. This provides a huge advantage in the return-to-play diagnosis. MATERIAL & METHODS Based on the assumption that only a healthy player can perform to the best of his or her ability, we have extended our medical screening for a professional basketball team. Since the 2012/2013 season, a test battery was added with a view to basketball-specific conditioning. The collected data was prospectively correlated to injury occurrence. RESULTS Seventy-one players were tested in 5 different categories. We have documented 142 injuries which lead to a downtime of 23 days (range 1-347 days). The injuries mainly involved the lower extremity, in particular the ankle, the knee and the thigh muscles. There was a clear trend indicating that players performing weaker in the agility tests sustained more injuries (r = 0.34, p = 0.029). Athletes who performed worse in the Yo-Yo test suffered from significantly more thigh muscle injuries (r = 0.266, p = 0.012). CONCLUSION Pre-participation screening is a useful tool in injury prevention, which helps to detect injuries or chronic stress complaints, especially in, but not limited to professional sports. Adding sports-specific performance testing may reveal potential deficits in agility and endurance which could lead to an increased injury risk. In addition, it allows to obtain baseline data which could be used to show the progress in rehabilitation in the event of an injury.
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Affiliation(s)
- Kai Fehske
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Würzburg
| | | | | | | | - Olaf Hoos
- Sportzentrum Julius-Maximilians-Universität, Würzburg
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Bakaraki A, Nastou E, Gkrilias P, Fousekis K, Xergia S, Matzaroglou C, Tsepis E. Preseason functional testing in young basketball players: asymmetries and intercorrelations. J Phys Ther Sci 2021; 33:369-374. [PMID: 33935363 PMCID: PMC8079892 DOI: 10.1589/jpts.33.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/30/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to examine the existence and degree of possible
asymmetries of functional test performance and their intercorrelations in the lower
extremities of young basketball players. [Participants and Methods] Twenty-seven healthy
male basketball players (age: 15.52 ± 1.37 years) were examined for the symmetric function
of their lower extremities using triple hop for distance tests in the sagittal and frontal
plane (medial-lateral), the Y-balance test and a vertical jump test. [Results]
Participants exhibited statistically significant side-to-side differences in only the
medial triple hop test, as they jumped further on their non-dominant for stability lower
limb. No other asymmetries were observed in the rest of the functional tests. Significant
correlations were also indicated between the vertical jumptest and the three directions of
the triple hop test for both lower limbs. [Conclusion] Our findings proved that young
basketball players present a symmetrical picture of functional performance, as revealed by
the evaluation of various functional tests. The only significant asymmetric adaptation
observed in the medial triple hop test will have to be strengthened by future studies to
be implemented in injury prevention programs.
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Affiliation(s)
- Akrivi Bakaraki
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
| | - Eftychia Nastou
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
| | - Panagiotis Gkrilias
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
| | - Konstantinos Fousekis
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
| | - Sofia Xergia
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
| | | | - Elias Tsepis
- Department of Physical Therapy, University of Patras: Psarron 6, Egio, Achaia 25100, Greece
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Davies WT, Myer GD, Read PJ. Is It Time We Better Understood the Tests We are Using for Return to Sport Decision Making Following ACL Reconstruction? A Critical Review of the Hop Tests. Sports Med 2021; 50:485-495. [PMID: 31745732 PMCID: PMC7018781 DOI: 10.1007/s40279-019-01221-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
There has been a move towards a criterion-based return to play in recent years, with 4 single-leg hop tests commonly used to assess functional performance. Despite their widespread integration, research indicates that relationships between ‘passing’ ‘hop test criteria and successful outcomes following rehabilitation are equivocal, and, therefore, require further investigation. This critical review includes key information to examine the evolution of these tests, their reliability, relationships with other constructs, and sensitivity to change over time. Recommendations for how measurement and administration of the tests can be improved are also discussed. The evidence presented in this review shows that hop tests display good reliability and are sensitive to change over time. However, the use of more than 2 hop tests does not appear to be necessary due to high collinearity and no greater sensitivity to detect abnormality. The inclusion of other hop tests in different planes may give greater information about the current function of the knee, particularly when measured over time using both relative and absolute measures of performance. It is recommended that the contralateral limb be tested prior to surgery for a more relevant benchmark for performance, and clinicians are strongly advised to measure movement quality, as hop distance alone appears to overestimate the recovery of the knee.
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Affiliation(s)
- William T Davies
- Aspetar, Orthopaedic and Sports Medicine Hospital, Sports City Street, P.O. Box 29222, Doha, Qatar.
| | - Gregory D Myer
- Division of Sports Medicine, The SPORT Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Departments of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Paul J Read
- Aspetar, Orthopaedic and Sports Medicine Hospital, Sports City Street, P.O. Box 29222, Doha, Qatar
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Ebert JR, Du Preez L, Furzer B, Edwards P, Joss B. Which Hop Tests Can Best Identify Functional Limb Asymmetry in Patients 9-12 Months After Anterior Cruciate Ligament Reconstruction Employing a Hamstrings Tendon Autograft? Int J Sports Phys Ther 2021; 16:393-403. [PMID: 33842035 PMCID: PMC8016443 DOI: 10.26603/001c.21140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 10/10/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hop tests are commonly employed to evaluate functional limb symmetry after anterior cruciate ligament reconstruction (ACLR). PURPOSE To investigate the ability of eight hop tests to identify functional limb asymmetry in patients after ACLR. STUDY DESIGN Prospective cohort. METHODS Fifty patients were assessed 9-12 months following ACLR. Functional performance on both the operated and non-operated limb was assessed via eight hop tests, assessed in a randomised order. These included the: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (TSHT). Differences in Limb Symmetry Indices (LSIs) across hop tests were compared, while Pearson's correlations were undertaken to investigate the significance and strength of the association between hop test LSIs. RESULTS Significant differences were observed across hop LSIs (p<0.0001). Mean LSIs for the SHD (95.0%), 6MTH (95.0%), THD (96.1%) and TCHD (95.3%) were ≥90% and significantly greater (p<0.05) than the MHD (87.3%), LHD (87.5%), SLCMJ (83.4%) and TSHT (86.5%), which were all <90%. The LSI for the SLCMJ was significantly lower (p<0.05) than all other hop tests. While significant correlations existed across the majority of hop LSIs, the strongest correlations existed between the SHD, THD and TCHD (r=0.70-0.80), and lowest correlations between the TSHT and the other hop tests (r=0.26-0.49). CONCLUSIONS The LHD, MHD and TSHT, as well as the SLCMJ in particular, were best able to demonstrate functional limb asymmetry in patients following ACLR. These hop measures should be incorporated into hop test batteries, if the purpose is to detect the presence of lingering functional deficits. LEVEL OF EVIDENCE Level 3.
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Fukuda W, Kawamura K, Yokoyama S, Kataoka Y, Ikeno Y, Chikaishi N, Gomi N. Joint movement variability during landing in patients with anterior cruciate ligament reconstruction. J Sports Med Phys Fitness 2021; 61:1629-1635. [PMID: 33555666 DOI: 10.23736/s0022-4707.21.11911-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Rapid knee valgus and knee internal rotation motions in the initial phase of landing are the known mechanisms for anterior cruciate ligament injury, and many studies have been investigated on knee joint peak angle during landing. However, the variability in joint movement during landing has not been fully investigated. This study aimed to compare the coefficient of variation of lower extremity range of motion in patients with anterior cruciate ligament reconstruction and healthy subjects during landing. METHODS In this cross-sectional study, 54 patients with anterior cruciate ligament reconstruction and 44 healthy subjects were enrolled. All participants underwent six trials of single-leg hop landing for maximum safe horizontal distance. The kinematic variables were the coefficient of variation during two discrete (0.05 after initial contact and maximum knee flexion) time points for selected three-dimensional hip and knee joint range of motion. Comparisons were performed between the two groups. RESULTS Compared with healthy subjects, patients with anterior cruciate ligament reconstruction had greater the coefficient of variation in hip internal/external rotation range of motion (patients with anterior cruciate ligament reconstruction had 41.9%, healthy subjects had 25.5%; P=0.0018; effect size: 0.32) and knee internal/external rotation range of motion (patients with anterior cruciate ligament reconstruction had 68.4%; healthy subjects had 48.1%; P=0.0014; effect size: 0.32) for periods that spanned 0.05 s from the initial contact. CONCLUSIONS Patients with anterior cruciate ligament reconstruction could be disadvantageous in ability to control and adapt hip and knee joint rotations when controlling landings.
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Affiliation(s)
- Wataru Fukuda
- Department of Physical Therapy, The Taijukai Foundation (Social Medical Corporation) Kaisei General Hospital, Sakaide-City, Kagawa, Japan -
| | - Kenji Kawamura
- Graduate School of Health Science, Kibi International University, Takahashi-City, Okayama, Japan
| | - Shigeki Yokoyama
- Faculty of Health Science, Kyoto Tachibana University, Kyoto-City, Kyoto, Japan
| | - Yusuke Kataoka
- Department of Physical Therapy, The Taijukai Foundation (Social Medical Corporation) Kaisei General Hospital, Sakaide-City, Kagawa, Japan
| | - Yutaro Ikeno
- Department of Physical Therapy, The Taijukai Foundation (Social Medical Corporation) Kaisei General Hospital, Sakaide-City, Kagawa, Japan
| | - Nobuhiro Chikaishi
- Center of Orthopaedic Surgery, The Taijukai Foundation (Social Medical Corporation) Kaisei General Hospital, Sakaide-City, Kagawa, Japan
| | - Noriyuki Gomi
- Center of Orthopaedic Surgery, The Taijukai Foundation (Social Medical Corporation) Kaisei General Hospital, Sakaide-City, Kagawa, Japan
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Briani RV, de Oliveira Silva D, Ducatti MHM, Lopes HS, Ferreira AS, Mentiplay BF, de Azevedo FM, Barton CJ. Knee flexor strength and rate of torque development deficits in women with patellofemoral pain are related to poor objective function. Gait Posture 2021; 83:100-106. [PMID: 33129169 DOI: 10.1016/j.gaitpost.2020.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/23/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Deficits in knee flexor strength and rate of torque development (RTD) might be present in women with patellofemoral pain (PFP). In addition, maximal strength and RTD of the knee flexors and extensors might be related with subjective and objective function in women with PFP. However, both conjectures are still poorly understood. RESEARCH QUESTION Do women with PFP have deficits in the maximal strength and RTD of the knee flexors and extensors during isometric, concentric, and eccentric contractions? Is there a relationship between maximal strength and RTD of the knee flexors and extensors with subjective and objective function in women with PFP? METHODS Fifty-six women with, and 46 women without, PFP participated. Maximal strength and RTD (to 30% and 60% maximal torque) during isometric, concentric, and eccentric contractions of the knee flexors and extensors were assessed using an isokinetic dynamometer. Objective assessment included single leg hop test (SLHT) and forward step-down test (FSDT). Subjective assessment involved the anterior knee pain scale. RESULTS Women with PFP had small to large deficits in maximal strength and RTD of the knee flexors and extensors during isometric, concentric and eccentric contractions (Effect sizes: -0.43 to -1.10; p ≤ 0.016). Small to moderate correlations of maximal concentric and eccentric knee flexor strength and RTD with SLHT and FSDT (r = 0.28 to 0.41; p ≤ 0.037) were identified. Subjective or objective function were not correlated with maximal isometric knee flexor strength and RTD, or any knee extensor measures (p > 0.05). SIGNIFICANCE Maximal strength and RTD deficits of the knee flexors and extensors were identified in this female PFP cohort, but they were unrelated to subjective function. The relationship of concentric and eccentric knee flexor strength and RTD deficits with poor objective function should be considered in future exercise trials for women with PFP.
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Affiliation(s)
- Ronaldo V Briani
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil; La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Danilo de Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Matheus H M Ducatti
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Helder S Lopes
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Amanda S Ferreira
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Fábio M de Azevedo
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Trunk endurance, posterior chain flexibility, and previous history of musculoskeletal pain predict overuse low back and lower extremity injury: a prospective cohort study of 545 Navy Cadets. J Sci Med Sport 2020; 24:555-560. [PMID: 33358586 DOI: 10.1016/j.jsams.2020.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate predictors of low back and lower extremity musculoskeletal injury in a cohort of Naval cadets. DESIGN Prospective Cohort Study METHODS: 545 Naval cadets (Males, n = 394, 72%) were followed-up over eight months. Nine variables were investigated as predictors: history of musculoskeletal symptoms in the last 12 months, ankle dorsiflexion range of motion, sit and reach test, isometric hip abduction and external rotation strength, alignment during the single leg squat test, single leg hop test for distance, prone plank and side plank tests. All injuries that required medical attention were registered. Predictive associations were examined using univariable and multivariable logistic regression analyses. RESULTS The incidence of all injuries was 7%. Cadets who failed the 60-second plank test (OR = 3.3; 95% CI, 1.2-8.8, P = 0.04), had ≤18 cm in the sit and reach test (OR = 4.0; 95% CI, 1.4-11.2, P = 0.01), or reported pain in the last 12 months in two or more body regions (OR = 2.7; 95% CI, 1.02-7.3, P = 0.04), had greater odds of sustaining an overuse injury. No predictors were identified for acute injuries. CONCLUSION Decreased trunk endurance on the prone plank test, reduced posterior chain flexibility on the sit and reach test, and a history of pain reported in two or more sites in the last 12 months were predictors of overuse injuries in Naval cadets. Assessment and intervention of these modifiable risk factors may be clinically relevant in injury screening and prevention.
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Tibial Accelerations During the Single-Leg Hop Test: Influence of Fixation. J Sport Rehabil 2020; 30:832-835. [PMID: 33291064 DOI: 10.1123/jsr.2020-0309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/07/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Performance on single-leg hopping (SLH) assessments is commonly included within return-to-sport criteria for rehabilitating athletes. Triaxial accelerometers have been used to quantify impact loading in a variety of movements, including hopping; however, they have never been attached to the tibia during SLH, and their method of fixation has not been investigated. OBJECTIVE The purpose of this study was to quantify triaxial accelerations and evaluate the influence of the fixation method of a lightweight inertial measurement unit (Blue Trident) mounted to the tibia during SLH performance. DESIGN Single cohort, repeated-measures experimental design. PARTICIPANTS Sixteen healthy participants (10 females and 6 males; 20 [0.9] y; 1.67 [0.08] m; 66.0 [8.5] kg) met the inclusion criteria, volunteered, and completed this study. INTERVENTIONS Participants performed 2 sets of 3 SLH trials with an inertial measurement unit (1500 Hz) fixated to the tibia, each set with 1 of 2 attachment methods (double-sided tape [DST] with athletic tape and silicon strap [SS] with Velcro adhesion). MAIN OUTCOME MEASURES Hop distance, peak tibial acceleration (PTA), time to PTA, and the acceleration slope were assessed during each hop landing. RESULTS Repeated-measures analysis of variance determined no significant effect of the attachment method on hop metrics (P = .252). Across 3 trials, both fixation methods (DST and SS) had excellent reliability values (intraclass correlation coefficient: .868-.941) for PTA and acceleration slope but not for time to PTA (intraclass correlation coefficient: .397-.768). The PTA for DST (27.22 [7.94] g) and SS (26.21 [10.48] g) was comparable and had a moderate, positive relationship (DST: r = .72, P < .01; SS: r = .77, P < .01) to SLH distance. CONCLUSIONS Tibial inertial measurement units with triaxial accelerometers can reliably assess PTA during performance of the SLH, and SS is a viable alternative tibial attachment to DST.
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