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Cosgrave C, Fuller C, Kung S, Cosgrave M, McFadden C, Franklyn-Miller A. A comparison of clinical assessment with common diagnostic tools for monitoring concussion recovery in adolescent rugby union players. Phys Ther Sport 2023; 61:165-171. [PMID: 37068386 DOI: 10.1016/j.ptsp.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVES To characterise the incidence, severity and recovery of sport-related concussion (SRC) in schoolboy rugby players and explore whether the Sports Concussion Assessment Tool (SCAT), Cogstate Brief Battery (CBB) and the King-Devick test (K-D test) can be used to monitor concussion status through to full recovery. DESIGN Prospective cohort study. SETTING Rugby union has a high rate of SRC; however, there is little research investigating how concussion affects adolescent rugby players. PARTICIPANTS Schoolboy rugby players. MAIN OUTCOME MEASURES Participants completed baseline tests in the preseason. Participants diagnosed with SRC during the season attended for post-concussion testing on a weekly basis until recovered. RESULTS 135 schoolboy rugby players (16.7 ± 0.82y) participated in the study. There were 18 SRCs in 16 participants. Concussion incidence was 9/1000 player hours. CBB and K-D tests were poorly associated with clinical assessment and produced high false negative rates (0.58 and 0.52 respectively). CONCLUSIONS This study reports a relatively high match SRC incidence for an adolescent population. Analysis of clinical recovery with CBB and K-D test revealed a relatively poor ability to accurately monitor concussion status compared to clinical assessment suggesting that these tools should not be used in isolation for monitoring SRC recovery in adolescents.
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Affiliation(s)
| | - Colm Fuller
- Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland.
| | - Stacey Kung
- Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland.
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The association between size and symmetry of the lumbar multifidus muscle, and injuries in adolescent rugby union players. Phys Ther Sport 2023; 60:98-103. [PMID: 36753830 DOI: 10.1016/j.ptsp.2023.02.001] [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: 12/19/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study aimed to investigate the association between size and symmetry of the lumbar multifidus muscle, and season injuries in adolescent rugby union players. DESIGN Prospective longitudinal cohort study. SETTING Pre-season assessment of the size (cross-sectional area) of the lumbar multifidus (L2-5) muscles using ultrasound imaging. PARTICIPANTS Seventy-one adolescent rugby union players (aged 15-18 years). MAIN OUTCOME MEASURES "Time-loss" injuries were recorded during the season and divided into four injury regions (head and neck, upper limb, trunk and lower limb). RESULTS Thirty-nine injuries were recorded during the season. Players who sustained an upper limb injury during the season had smaller lumbar multifidus muscles at the L5 vertebral level (effect size = 0.7, p = 0.03) and asymmetry in muscle size at the L2 (p = 0.05) and L5 (p = 0.04) in the pre-season. There was no association between size of the lumbar multifidus muscle and other injuries (p > 0.05). CONCLUSION Lumbar multifidus muscle size and symmetry may impact lumbopelvic control which may increase the risk of sustaining an upper limb injury during rugby union. Future research should aim to identify whether lumbar multifidus muscle size is a modifiable risk factor for rugby union injuries to guide future intervention programs.
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Page P, Manske RC, Voight M, Wolfe C. MSK Ultrasound - An IJSPT Perspective. Int J Sports Phys Ther 2023; 18:1-10. [PMID: 36793557 PMCID: PMC9897034 DOI: 10.26603/001c.68184] [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] [Indexed: 02/04/2023] Open
Abstract
MSK ultrasound is a valuable imaging technique which has become increasingly popular in recent years. This efficient technique proves beneficial in a variety of ways. MSK ultrasound effectively streamlines the process by enabling practitioners to securely and accurately image and assess structures all in one simple step. By allowing healthcare providers to access critical information quickly and conveniently, MSK ultrasound can help identify conditions early when interventions are most effective. Moreover, it may be able to shorten diagnostic times and reduce costs through more cost-effective use of resources such as imaging and laboratory testing. Furthermore, MSK ultrasound can provide additional insights into musculoskeletal anatomy and help improve patient care and outcomes. In addition, utilizing this method reduces exposure to radiation and provides enhanced patient comfort with its quick scan duration. MSK ultrasound has a high potential to provide quick and accurate diagnosis of MSK disturbances when used correctly. As clinicians become more comfortable and familiar with this technology, we will continue to see its use expand for various MSK assessments. In this commentary we'll explore how ultrasound can be used in physical therapy, specifically for musculoskeletal assessment. We'll also look at some of the potential benefits and limitations of using ultrasound in PT practice.
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Affiliation(s)
- Phil Page
- Doctor of Physical Therapy Program Franciscan University
| | | | | | - Chris Wolfe
- School of Physical Therapy Belmont University
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Watanabe K, Kitamura T, Takasaki H. Preseason Prognostic Factors for Injuries and Match Loss in Collision Sports: A Systematic Review. Int J Sports Med 2023; 44:3-8. [PMID: 36063824 DOI: 10.1055/a-1847-7108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study aimed to identify which preseason factors had strong evidence of risks for physical injury during the season of collision sports including rugby, American football, and Australian rules football using qualitative synthesis. Pubmed, EMBASE, MEDLINE, SPORTDiscus, Scopus, and the Cochrane Library were reviewed. Eligibility criteria for selecting studies were: studies involving the collision sports; prospective cohort studies; and studies with outcomes of relative risks, odds ratios, and correlations between players' preseason conditions and injury during the season. The risk of bias based on the Scottish Intercollegiate Guidelines Network quality checklists for cohort studies was assessed in 57 studies. The current study identified strong evidence that 1) anthropometric characteristics (body mass index and estimated mass moment of inertia of the body around a horizontal axis through the ankle), which are calculated with weight and height; 2) physical function, in particular for the trunk and lower limb (trunk-flexion hold and wall-sit hold); and 3) Oswestry Disability Index disability, which is a patient-reported outcome measure for disability due to low back pain, were positive prognostic factors for injury during the collision sports season, regardless of playing experience.
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Affiliation(s)
- Kento Watanabe
- Graduate school of Rehabilitation Science, Saitama Prefectural University, Koshigaya, Japan
| | - Tomoya Kitamura
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan
| | - Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan
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Bonilla DA, Cardozo LA, Vélez-Gutiérrez JM, Arévalo-Rodríguez A, Vargas-Molina S, Stout JR, Kreider RB, Petro JL. Exercise Selection and Common Injuries in Fitness Centers: A Systematic Integrative Review and Practical Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12710. [PMID: 36232010 PMCID: PMC9565175 DOI: 10.3390/ijerph191912710] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/25/2022] [Accepted: 10/02/2022] [Indexed: 05/08/2023]
Abstract
Weight resistance training (RT) is an essential component of physical conditioning programs to improve the quality of life and physical fitness in different ages and populations. This integrative review aimed to analyze the scientific evidence on the relationship between exercise selection and the appearance of musculoskeletal injuries in physical fitness centers (PFC). The PubMed or Medline, EMBASE or Science Direct, Google Scholar and PEDro databases were selected to examine the available literature using a Boolean algorithm with search terms. The review process was performed using the five-stage approach for an integrative review and it was reported according to the PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science (PERSiST) guidelines. A total of 39 peer-reviewed articles (Price index = 71.7%) met the inclusion criteria and evaluated the link between exercise selection and the incidence of injuries in exercisers who regularly attend PFC. Most injuries occur to the shoulders, elbows, vertebrae of the spine, and knees. Although the injury etiologies are multifactorial, the findings of the reviewed articles include the impacts of overuse, short post-exercise recovery periods, poor conditioning in the exercised body areas, frequent use of heavy loads, improper technique in certain exercises, and the abuse of performance- and image-enhancing drugs. Practical recommendations addressed to clinical exercise physiologists, exercise professionals, and health professionals are given in this paper. The exercise selection in RT programs requires professional supervision and adhering to proper lifting techniques and training habits that consider the anatomical and biomechanical patterns of the musculoskeletal structures, as well as genetic, pedagogical, and methodological aspects directly related to the stimulus-response process to mitigate the occurrence of RT-related injuries in PFC.
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Affiliation(s)
- Diego A. Bonilla
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia
- Research Group in Physical Activity, Sports and Health Sciences—GICAFS, Universidad de Córdoba, Montería 230002, Colombia
- Research Group in Biochemistry and Molecular Biology, Faculty of Sciences and Education, Universidad Distrital Francisco José de Caldas, Bogotá 110311, Colombia
- Sport Genomics Research Group, Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Luis A. Cardozo
- Research and Measurement Group in Sports Training (IMED), Faculty of Health Sciences and Sports, Fundación Universitaria del Área Andina, Bogotá 111221, Colombia
| | - Jorge M. Vélez-Gutiérrez
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia
- ARTHROS Centro de Fisioterapia y Ejercicio, Medellín 050012, Colombia
| | - Adrián Arévalo-Rodríguez
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia
- Centro de Capacitación en Acondicionamiento y Preparación Física (CCAPF), Bogotá 111511, Colombia
| | - Salvador Vargas-Molina
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia
- Faculty of Sport Sciences, EADE-University of Wales Trinity Saint David, 29018 Málaga, Spain
| | - Jeffrey R. Stout
- Physiology of Work and Exercise Response (POWER) Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - Richard B. Kreider
- Exercise & Sport Nutrition Laboratory, Human Clinical Research Facility, Texas A&M University, College Station, TX 77843, USA
| | - Jorge L. Petro
- Research Division, Dynamical Business & Science Society—DBSS International SAS, Bogotá 110311, Colombia
- Research Group in Physical Activity, Sports and Health Sciences—GICAFS, Universidad de Córdoba, Montería 230002, Colombia
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Trunk muscle size and function in volleyball players with and without injuries to the head, neck and upper limb. Phys Ther Sport 2021; 54:1-7. [PMID: 34922033 DOI: 10.1016/j.ptsp.2021.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate trunk muscle size and function in elite and community volleyball players with and without a history of head, neck or upper limb injury. DESIGN Cross-sectional observational study. SETTING Volleyball training camp or training sessions. PARTICIPANTS 86 volleyball players (elite = 29; community = 57). MAIN OUTCOME MEASURES Information regarding history of head, neck or upper limb injuries was collected by self-report questionnaires. Trunk muscle size (multifidus, transversus abdominis, internal oblique and quadratus lumborum) and voluntary contraction (multifidus, transversus abdominis, internal oblique) were assessed using ultrasound imaging. RESULTS For trunk muscle size, no significant differences were found between elite and community volleyball players with and without a history of injury (all p > 0.05). A significant difference was found for voluntary contraction of the multifidus and transversus abdominis muscles for elite and community volleyball players with and without a history of injury (all p < 0.05). CONCLUSION A difference in trunk muscle contraction but no change in trunk muscle size in players with a history of head, neck or upper limb injuries may represent an altered muscle recruitment pattern rather than a deficiency in trunk muscle strength. Prospective studies are required to determine if these adaptations are compensatory (and protective) or predispose players to further injuries.
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Schwab LM, McGhee D, Franettovich Smith MM, Mendis MD, Hides J. Pre-season screening of the upper body and trunk in Australian football players: A prospective study. Phys Ther Sport 2020; 46:120-130. [PMID: 32942242 DOI: 10.1016/j.ptsp.2020.06.013] [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: 04/12/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine whether screening tests of upper body, trunk region, and of whole-body function could prospectively identify community AFL players who sustain in-season shoulder/head/neck injuries. Additionally, to present screening test reference values. DESIGN Prospective cohort; SETTING: Community sport; PARTICIPANTS: 142 male community AFL players (range 15-37 years). MAIN OUTCOME MEASURES (i) isometric shoulder external and internal rotation (ER/IR) strength; (ii) upper body combined elevation functional ROM; (iii/iv) whole-body functional jump ROM; (v) static thoracic spine angle; (vi) cervical joint proprioception, and (vii) trunk muscle size and function. Results were compared among players with (n = 21) and without (n = 121) an in-season shoulder, head, or neck injury. ROC analysis and odds ratios were used to determine the predictive values. RESULTS Two screening tests predicted an in-season shoulder, head, or neck injury; dominant and non-dominant isometric ER strength (AUC 0.629, 95%CI 0.51-0.74; optimal cut point 182 N and AUC 0.619, 95%CI 0.50-0.74; optimal cut point 184 N, respectively). The adjusted odds ratio for the strongest predictor: dominant ER muscle strength was 6.02 (95%CI 1.8-19.9). CONCLUSION Greater ER strength was associated with in-season shoulder/head/neck injuries in community AFL players; however, further research is required to determine the clinical significance of this finding.
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Affiliation(s)
- Laura M Schwab
- Griffith University, School of Allied Health, Brisbane, QLD, Australia.
| | - Deirdre McGhee
- University of Wollongong, School of Medicine, Wollongong, NSW, Australia
| | | | - M Dilani Mendis
- Griffith University, School of Allied Health, Brisbane, QLD, Australia
| | - Julie Hides
- Griffith University, School of Allied Health, Brisbane, QLD, Australia
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Pfluegler G, Kasper J, Luedtke K. The immediate effects of passive joint mobilisation on local muscle function. A systematic review of the literature. Musculoskelet Sci Pract 2020; 45:102106. [PMID: 32056830 DOI: 10.1016/j.msksp.2019.102106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/20/2019] [Accepted: 12/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Passive joint mobilisation is popular among healthcare providers and their patients; however, its effectiveness for improving muscle function is not well researched and the mechanisms of action involved are unclear. OBJECTIVES To assess the effect of passive joint mobilisations on the function of muscles surrounding the targeted joints in symptomatic as well as asymptomatic individuals. SELECTION CRITERIA Controlled experimental trials assessing the immediate effect of passive joint mobilisation on outcomes associated with local muscle function. DATA COLLECTION Two authors independently assessed trial quality and extracted data. MAIN RESULTS A total of seventeen studies were included, of which ten studies reported data on asymptomatic individuals and seven studies reported data on symptomatic individuals with various conditions. There is a moderate level of evidence that joint mobilisation immediately decreases the activation of superficial muscles during low load conditions in symptomatic individuals. For asymptomatic individuals, there is a low level of evidence that passive joint mobilisation improves maximum muscle strength when compared to sham mobilisation, opposed to a very low level of evidence suggesting no effect in symptomatic individuals. The five studies reporting data on both, changes in muscle function as well as changes in pain, suggest that other, not pain-related mechanisms may play an important role regarding the reported improvement in muscle function. CONCLUSION Current best evidence suggests that passive joint mobilisation has the ability to immediately alter muscle function. The specific mechanisms of action involved require further basic science investigations. Registration number (PROSPERO): CRD42018117033.
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Affiliation(s)
- Georg Pfluegler
- Faculty of Health and Well Being, Sheffield Hallam University, Broomhall Road, Sheffield, S10 2BP, United Kingdom
| | - Johanna Kasper
- Private Physiotherapy Practice "teamphysios", Kreuzgasse 37, 1180, Vienna, Austria
| | - Kerstin Luedtke
- Academic Physiotherapy, Pain and Exercise Research, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
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Rummens S, Robben E, De Groef A, Van Wambeke P, Janssens L, Brumagne S, Desloovere K, Peers K. Factors Associated With the Ultrasound Characteristics of the Lumbar Multifidus: A Systematic Review. PM R 2019; 12:82-100. [PMID: 31264799 DOI: 10.1002/pmrj.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/21/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The first aim of this review was to investigate the association between age, sex, height, weight, physical activity level, posture, lumbar level and body side, and structural characteristics (cross-sectional area [CSA], thickness, linear dimensions, and echo intensity) of the lumbar multifidus (LM) measured by ultrasound. Second, differences between healthy individuals and patients with chronic low back pain (CLBP) were investigated. TYPE: Systematic review. LITERATURE SURVEY PubMed, Embase and Web of Science were searched until September 2018. METHODOLOGY Studies were included if (a) full text was available in English, Dutch, or French; (b) participants were older than 18 years of age and were asymptomatic or had nonspecific CLBP; and (c) the relation between structural characteristics of the LM, measured by ultrasound, and at least one of the above-mentioned factors was described, and/or a comparison between a CLBP and control group was made. Data were extracted independently by two reviewers. Quality of studies was assessed using an adapted version of the Downs and Black checklist. SYNTHESIS Twenty-seven studies were included. Thickness and CSA of the LM do not correlate with age. Males have a larger LM size than females. Thickness and CSA of left and right LM are highly correlated in healthy subjects. More significant side-to-side differences are present in subjects with CLBP than in those without. Muscle size increases from proximal to caudal lumbar levels. The presence of CLBP is associated with muscle size and function. CONCLUSIONS The association between the factors age, sex, height, weight, physical activity level, posture, lumbar level, body side, and presence of CLBP, and the ultrasound characteristics of the LM is discussed. These factors should be taken into account in future research on structural muscle characteristics, or when correlating with functional behavior or investigating the effect of a targeted intervention. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Sofie Rummens
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Elise Robben
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - An De Groef
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Peter Van Wambeke
- Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Lotte Janssens
- REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Koen Peers
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
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Convergence and Divergence of Exercise-Based Approaches That Incorporate Motor Control for the Management of Low Back Pain. J Orthop Sports Phys Ther 2019; 49:437-452. [PMID: 31092126 DOI: 10.2519/jospt.2019.8451] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory, and central processes for control of posture and movement. A common assumption across approaches is that the way an individual loads the spine by typical postures, movements, and muscle activation strategies contributes to LBP symptom onset, persistence, and recovery. However, there are also divergent features from one approach to another. This commentary presents key principles of 4 clinical physical therapy approaches, including how each incorporates motor control in LBP management, the convergence and divergence of these approaches, and how they interface with medical LBP management. The approaches considered are movement system impairment syndromes of the lumbar spine, Mechanical Diagnosis and Therapy, motor control training, and the integrated systems model. These were selected to represent the diversity of applications, including approaches using motor control as a central or an adjunct feature, and approaches that are evidence based or evidence informed. This identification of areas of convergence and divergence of approaches is designed to clarify the key aspects of each approach and thereby serve as a guide for the clinician and to provide a platform for considering a hybrid approach tailored to the individual patient. J Orthop Sports Phys Ther 2019;49(6):437-452. Epub 15 May 2019. doi:10.2519/jospt.2019.8451.
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Bussey M, McLean M, Pinfold J, Anderson N, Kiely R, Romanchuk J, Salmon D. History of concussion is associated with higher head acceleration and reduced cervical muscle activity during simulated rugby tackle: An exploratory study. Phys Ther Sport 2019; 37:105-112. [DOI: 10.1016/j.ptsp.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
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Whittaker JL, Ellis R, Hodges PW, OSullivan C, Hides J, Fernandez-Carnero S, Arias-Buria JL, Teyhen DS, Stokes MJ. Imaging with ultrasound in physical therapy: What is the PT's scope of practice? A competency-based educational model and training recommendations. Br J Sports Med 2019; 53:1447-1453. [PMID: 31023858 PMCID: PMC6900235 DOI: 10.1136/bjsports-2018-100193] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2019] [Indexed: 11/14/2022]
Abstract
Physical therapists employ ultrasound (US) imaging technology for a broad range of clinical and research purposes. Despite this, few physical therapy regulatory bodies guide the use of US imaging, and there are limited continuing education opportunities for physical therapists to become proficient in using US within their professional scope of practice. Here, we (i) outline the current status of US use by physical therapists; (ii) define and describe four broad categories of physical therapy US applications (ie, rehabilitation, diagnostic, intervention and research US); (iii) discuss how US use relates to the scope of high value physical therapy practice and (iv) propose a broad framework for a competency-based education model for training physical therapists in US. This paper only discusses US imaging—not ‘therapeutic’ US. Thus, ‘imaging’ is implicit anywhere the term ‘ultrasound’ is used.
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Affiliation(s)
- Jackie L Whittaker
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Ellis
- Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Paul William Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Cliona OSullivan
- Department of Physiotherapy and Performance Science, University College Dublin, Dublin, Ireland
| | - Julie Hides
- School of Allied Health Sciences, Griffith University, Brisbane, Queensland, Australia
| | | | | | - Deydre S Teyhen
- Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Maria J Stokes
- School of Health Professions and Rehabilitation Sciences, University of Southampton, Southampton, UK
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Cosgrave C, Fuller C, Franklyn-Miller A, Falvey E, Beirne C, Ryan J, McCrory P. Concussion in adolescent rugby union players: comprehensive acute assessment protocol and development of the SSC concussion passport to monitor long-term health. BMJ Open Sport Exerc Med 2018; 4:e000455. [PMID: 30498576 PMCID: PMC6241986 DOI: 10.1136/bmjsem-2018-000455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Sports-related concussion (SRC) can be challenging to diagnose, assess and manage. Much of the SRC research is conducted on adults. The assessment of SRC should aim to identify deficits using a detailed multimodal assessment; however, most studies investigating the effects of SRC use diagnostic tools in isolation. It is likely that a combination of diagnostic tests will improve diagnostic accuracy. In this study, we aim to investigate how concussion affects adolescent rugby players and how a variety of diagnostic tools interact with each other as participants recover from their injury. The study will also determine the logistics of recording an individual’s concussion history on a virtual ‘Concussion Passport’ that would remain with the individual throughout their sporting career to allow monitoring of long-term health. Methods and analysis All rugby players (n=211) from the Senior Cup Teams of five schools in Dublin, Ireland will be invited to participate in the study. Baseline testing will be performed at the Sports Surgery Clinic, Dublin (SSC) before the rugby season commences. Participants will be followed up over the course of the rugby season. At baseline and at each postconcussion visit, participants will complete the following: Questionnaire, Sports Concussion Assessment Tool 3, Balance Error Scoring System, Computerised Neurocognitive Testing, Vestibulo-ocular assessment, King Devick test, Graded exercise test, Blood tests, Neck strength, FitBit. Ethics and dissemination Ethical approval was obtained from the Sports Surgery Clinic Research Ethics Committee (Approval number: SSC 0020). On completion of the study, further papers will be written and published to present the results of the various tests. Trial registration number NCT03624634.
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Affiliation(s)
- Ciaran Cosgrave
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
| | - Colm Fuller
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
| | - Andy Franklyn-Miller
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- Centre for Health Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
| | - Eanna Falvey
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Cliff Beirne
- Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
| | - John Ryan
- Emergency Department, St. Vincent’s University Hospital, Dublin, Ireland
| | - Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
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HIDES JULIEA, FRANETTOVICH SMITH MELINDAM, MENDIS MDILANI, TRELEAVEN JULIA, ROTSTEIN ANDREWH, SEXTON CHRISTOPHERT, LOW CHOY NANCY, MCCRORY PAUL. Self-reported Concussion History and Sensorimotor Tests Predict Head/Neck Injuries. Med Sci Sports Exerc 2017; 49:2385-2393. [DOI: 10.1249/mss.0000000000001372] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hides JA, Franettovich Smith MM, Mendis MD, Smith NA, Cooper AJ, Treleaven J, Leung F, Gardner AJ, McCrory P, Low Choy NL. A prospective investigation of changes in the sensorimotor system following sports concussion. An exploratory study. Musculoskelet Sci Pract 2017; 29:7-19. [PMID: 28259770 DOI: 10.1016/j.msksp.2017.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/10/2017] [Accepted: 02/16/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sports concussion is a risk for players involved in high impact, collision sports. Post-concussion, the majority of symptoms subside within 7-10 days, but can persist in 10-20% of athletes. Understanding the effects of sports concussion on sensorimotor systems could inform physiotherapy treatment. OBJECTIVE To explore changes in sensorimotor function in the acute phase following sports concussion. DESIGN Prospective cohort study. METHODS Fifty-four players from elite rugby union and league teams were assessed at the start of the playing season. Players who sustained a concussion were assessed three to five days later. Measures included assessments of balance (sway velocity), vestibular system function (vestibular ocular reflex gain; right-left asymmetry), cervical proprioception (joint position error) and trunk muscle size and function. RESULTS During the playing season, 14 post-concussion assessments were performed within 3-5 days of injury. Significantly decreased sway velocity and increased size/contraction of trunk muscles, were identified. Whilst not significant overall, large inter-individual variation of test results for cervical proprioception and the vestibular system was observed. LIMITATIONS The number of players who sustained a concussion was not large, but numbers were comparable with other studies in this field. There was missing baseline data for vestibular and cervical proprioception testing for some players. CONCLUSIONS Preliminary findings post-concussion suggest an altered balance strategy and trunk muscle control with splinting/over-holding requiring consideration as part of the development of appropriate physiotherapy management strategies.
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Affiliation(s)
- Julie A Hides
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia.
| | - Melinda M Franettovich Smith
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia
| | - M Dilani Mendis
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia; Physiotherapy Department, Mater Health Services, South Brisbane, 4101, Australia
| | - Nigel A Smith
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia
| | - Andrew J Cooper
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia
| | - Julia Treleaven
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Australia
| | - Felix Leung
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, QLD, 4102, Australia
| | - Andrew J Gardner
- Priority Research Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2310, Australia; Hunter New England Local Health District Sports Concussion Program, John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia
| | - Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Nancy L Low Choy
- School of Physiotherapy, Australian Catholic University, Brisbane, QLD, 4014, Australia
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Hides J, Lambrecht G, Ramdharry G, Cusack R, Bloomberg J, Stokes M. Parallels between astronauts and terrestrial patients - Taking physiotherapy rehabilitation "To infinity and beyond". Musculoskelet Sci Pract 2017; 27 Suppl 1:S32-S37. [PMID: 28279266 DOI: 10.1016/j.msksp.2016.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 09/29/2016] [Accepted: 11/06/2016] [Indexed: 12/31/2022]
Abstract
Exposure to the microgravity environment induces physiological changes in the cardiovascular, musculoskeletal and sensorimotor systems in healthy astronauts. As space agencies prepare for extended duration missions, it is difficult to predict the extent of the effects that prolonged exposure to microgravity will have on astronauts. Prolonged bed rest is a model used by space agencies to simulate the effects of spaceflight on the human body, and bed rest studies have provided some insights into the effects of immobilisation and inactivity. Whilst microgravity exposure is confined to a relatively small population, on return to Earth, the physiological changes seen in astronauts parallel many changes routinely seen by physiotherapists on Earth in people with low back pain (LBP), muscle wasting diseases, exposure to prolonged bed rest, elite athletes and critically ill patients in intensive care. The medical operations team at the European Space Agency are currently involved in preparing astronauts for spaceflight, advising on exercises whilst astronauts are on the International Space Station, and reconditioning astronauts following their return. There are a number of parallels between this role and contemporary roles performed by physiotherapists working with elite athletes and muscle wasting conditions. This clinical commentary will draw parallels between changes which occur to the neuromuscular system in the absence of gravity and conditions which occur on Earth. Implications for physiotherapy management of astronauts and terrestrial patients will be discussed.
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Affiliation(s)
- Julie Hides
- Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane 4102, Australia; Mater/ACU Back Stability Research Clinic, Mater Health Services, South Brisbane, QLD 4101, Australia.
| | - Gunda Lambrecht
- European Space Agency Space-Medicine Office, European Astronaut Centre, Linder Hoehe, 51147 Cologne, Germany; Germany Praxis fur Physiotherapie und Osteopathische Techniken, Kaiserstrasse 34, 53721 Siegburg, Germany
| | - Gita Ramdharry
- Faculty of Health, Social Science and Education, Kingston University/St George's University of London, London SW17 0RE, UK
| | - Rebecca Cusack
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK; Integrative Physiology and Critical Illness Group, Faculty of Medicine, University of Southampton, UK
| | - Jacob Bloomberg
- Neuroscience Laboratories, NASA/Johnson Space Center, Houston, TX, USA
| | - Maria Stokes
- Faculty of Health Sciences, University of Southampton Highfield Campus, Southampton, SO17 1BJ, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
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