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Alpalhão V, Vaz JR, Cordeiro N, de Pezarat Correia P. Are the Cross-Culturally Adapted Versions of the Tampa Scale for Kinesiophobia 11-Item Valid, Reliable, and Responsive? A COSMIN-Informed Systematic Review of Measurement Properties. THE JOURNAL OF PAIN 2024:104602. [PMID: 38866123 DOI: 10.1016/j.jpain.2024.104602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/09/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
Numerous cultural adaptations of the Tampa Scale of Kinesiophobia 11-item version (TSK-11) scale have emerged since the original version was introduced. We conducted a (COnsensus-based Standards for the selection of health Measurement INstruments) COSMIN-informed systematic review of measurement properties to identify the cross-cultural adaptation of the TSK-11 and report, critically appraise, and systematize its measurement properties. Six databases were searched for studies published since 2005. Studies reporting on the measurement properties of culturally adapted versions of the TSK-11, published in English, Portuguese, and Spanish, were considered for inclusion. The results were synthesized by measurement properties and rated against the COSMIN criteria for good measurement properties. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach and presented in a summary of findings table. Twenty-three studies were included, and cultural adaptations for 15 languages were identified: English, Chinese, Cantonese, Swedish, German, Dutch, Arabic, Turkish, Danish, Spanish, Japanese, Brazilian Portuguese, Marathi, Thai, and Persian. There is "high" certainty in the evidence for "sufficient" criterion validity (TSK-17, r = .84) and "insufficient" measurement error (small detectable change range 5.6-6.16). "Moderate" certainty in the evidence for "sufficient" construct validity (87.8% of hypotheses confirmed), test-retest reliability (intraclass correlation coefficient2,1 = .747-.87), and "low" certainty in evidence for "sufficient" responsiveness. The numerous sources of heterogeneity prevent conclusions from being drawn regarding structural validity. Measurement error, responsiveness, and structural validity of the TSK-11 require further investigation. Clinicians should complement the use of TSK-11 with other instruments. Future studies on the structural validity of the questionnaire should standardize the data analysis methods. PERSPECTIVE: This article presents the measurement properties of the cross-cultural adaptations of the TSK-11. Clinicians should be aware that cultural and clinical aspects may influence the structural validity of the questionnaire. Using the TSK-11 as a stand-alone instrument may omit relevant clinical progression in the patient's condition.
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Affiliation(s)
- Vanessa Alpalhão
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Lisbon, Portugal; Physical Therapy Department, Polytechnic Institute of Castelo Branco, Superior Health School, Castelo Branco, Portugal.
| | - João R Vaz
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Lisbon, Portugal
| | - Nuno Cordeiro
- Physical Therapy Department, Polytechnic Institute of Castelo Branco, Superior Health School, Castelo Branco, Portugal; AGE.COMM-Interdisciplinary Research Unit-On Building Functional Ageing Communities, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Pedro de Pezarat Correia
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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Hung YC, Chuang CA, Yao SY, Lin KY, Hung SF, Chen YJ, Chiu CH, Ho CS, Yang CP, Chan YS. Correlation between higher lateral tibial slope and inferior long term subjective outcomes following single bundle anterior cruciate ligament reconstruction. J Orthop Surg Res 2024; 19:315. [PMID: 38807173 PMCID: PMC11131331 DOI: 10.1186/s13018-024-04795-9] [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: 03/14/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The impact of anatomical factors, such as the lateral tibial slope (LTS), on outcomes following anterior cruciate ligament (ACL) reconstruction is an area of growing interest. This study was led by the observation that patients with a higher LTS may have different recovery trajectories. HYPOTHESIS/PURPOSE The purpose of this study was to investigate the correlation between a higher LTS and long term subjective outcomes following single-bundle ACL reconstruction. STUDY DESIGN This study was designed as a retrospective cohort study. METHODS The study comprised 138 patients who underwent single-bundle ACL reconstruction. The LTS was measured on preoperative radiographs. Patient-reported outcome measures (PROMs) were collected, which included the Lysholm Knee Score, UCLA Activity Score, IKDC Score, and Tegner Activity Score, over a mean follow-up duration of 137 months. RESULTS A significant negative correlation was found between LTS and all measured PROMs (p < 0.001). The established cut-off value of LTS distinguishing between "Good" and "Fair" Lysholm scores was 8.35 degrees. Female patients have statistically significant higher LTS and lower PROMs scores than male. Patients with LTS greater than or equal to 8.35 had significantly lower PROMs, indicative of poorer functional and subjective outcomes. CONCLUSION Our findings suggest that a higher LTS is associated with inferior subjective outcomes following single-bundle ACL reconstruction in long term. The LTS cut-off value of 8.35 degrees could potentially be used as a reference in preoperative planning and patient counseling. CLINICAL RELEVANCE Understanding the relationship between LTS and ACL reconstruction outcomes could inform surgical planning and postoperative management. These findings highlight the need to consider anatomical variances, such as LTS, when assessing patient-specific risks and recovery expectations, contributing to the advancement of personalized care in sports medicine.
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Affiliation(s)
- Yu-Chieh Hung
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chieh-An Chuang
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Shang-Yu Yao
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Keng-Yi Lin
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Shih-Feng Hung
- Department of Orthopedic Surgery, Taoyuan Hospital, Ministry of Health and Welfare, Taoyuan City, 333, Taiwan
| | - Yi-Jou Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chih-Hao Chiu
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, 333, Taiwan
| | - Cheng-Pang Yang
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung City, 204, Taiwan.
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
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Hart HF, Crossley KM, Culvenor AG, Khan MCM, West TJ, Kennedy JB, Couch JL, Whittaker JL. Knee Confidence, Fear of Movement, and Psychological Readiness for Sport in Individuals With Knee Conditions: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2024; 54:1-14. [PMID: 38284344 DOI: 10.2519/jospt.2024.12070] [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: 01/30/2024]
Abstract
OBJECTIVES: To (1) compare activity-related psychological factors between individuals with and without knee conditions, and (2) assess associations between these factors and objective measures of function in individuals with knee conditions. DESIGN: A priori registered systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE-Ovid, Embase-Ovid, Scopus-Elsevier, CINAHL-EBSCO, SPORTDiscus-EBSCO, and Cochrane Library were searched to May 27, 2022. STUDY SELECTION CRITERIA: We included peer-reviewed primary data studies (observational and experimental) of human participants with and without knee conditions reporting knee confidence, fear of movement/avoidance beliefs, and/or psychological readiness to return to sport (RTS) or reporting correlations between these factors and objective measures of function in knee conditions. DATA SYNTHESIS: Where possible, data were pooled by knee conditions, otherwise performed narrative syntheses. The Downs and Black checklist assessed the methodological quality of the included studies. RESULTS: Forty studies (3546 participants with knee conditions; 616 participants without knee conditions) were included. There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis (standardized mean difference [SMD], 0.46; 95% confidence interval [CI]: 0.41, 0.52), but not in individuals with patellofemoral pain (SMD, 0.66; 95% CI: -7.98, 9.29) when compared with those without knee conditions. There was very low-certainty evidence of no differences in psychological readiness to RTS after anterior cruciate ligament reconstruction (SMD, -1.14; 95% CI: -2.97, 0.70) compared to no knee condition, and negligible to weak positive correlations between psychological readiness to RTS and objective measures of function. CONCLUSION: There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis compared to those without, and very low-certainty evidence of no correlations between these factors and objective measures of function following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2024;54(4):1-14. Epub 29 January 2024. doi:10.2519/jospt.2024.12070.
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Hoch JM, Swann A, Kleis R, Hoch MC, Baker C, Dlugonski D. Health-Related Quality of Life and Psychological Outcomes in Participants with Symptomatic and Non-Symptomatic Knees after ACL Reconstruction. Int J Sports Phys Ther 2024; 19:206-214. [PMID: 38313672 PMCID: PMC10837830 DOI: 10.26603/001c.91649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/16/2023] [Indexed: 02/06/2024] Open
Abstract
Background Individuals who sustain an ACL injury and undergo reconstruction (ACLR) are at risk for the development of osteoarthritis. Recent investigations have applied the Englund criteria to categorize people with a history of ACLR as someone with a symptomatic or asymptomatic knee. Purpose/Hypothesis The purpose of this study was to examine differences in health-related quality of life (HRQL) and psychological outcomes in people with a history of ACLR who were categorized as symptomatic or non-symptomatic by application of the Englund criteria. The authors' hypothesized participants classified as symptomatic would have lower HRQL, increased fear-avoidance beliefs, and decreased resilience compared to participants classified as non-symptomatic. Study design Cross-sectional, survey. Methods Participants at least one-year after ACLR were recruited for the study and completed the Tegner Activity Scale, the Brief Resilience Scale (BRS), the modified Disablement in the Physically Active Scale (mDPA), and the Fear-Avoidance Belief Questionnaire (FABQ) at one time-point. Descriptive statistics were summarized using median [interquartile range] and differences between groups were examined using separate Mann-Whitney U tests. Results Participants with symptomatic knees had a significantly higher BMI (24.8 [6.4]) than the non-symptomatic group (21.2 [4.3], p=0.013). Participants in the symptomatic group had worse HRQL on the physical subscale (12.5 [16.3] vs. 0.0 [2.5], p<0.001) and mental subscale (2.0 [1] vs. 0.0 [1], p=0.031), higher scores on the FABQ-Sport (14.5 [11] vs. 0.0 [6], p<0.001) and FABQ-Physical Activity (20 [24] vs. 1 [4], p<0.001) and less resilience (3.7[0.42] vs. 4.0 [0.83], p=0.028) compared to those participants in the non-symptomatic group. There were no differences in current physical activity (p=0.285) or change in physical activity (p=0.124) levels between the two groups. Conclusions This series of differences may represent a cascade of events that can continue to negatively impact health outcomes across the lifespan for individuals with a history of ACLR. Future research should consider longitudinal investigations of these outcomes after injury and throughout the post-surgical and post-rehabilitation timeframe. Level of Evidence Level 3b.
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Affiliation(s)
- Johanna M Hoch
- Athletic Training and Clinical Nutrition University of Kentucky
| | | | - Rachel Kleis
- Department of Kinesiology University of Wisconsin-Eau Claire
| | - Matthew C Hoch
- Department of Athletic Training and Clinical Nutrition University of Kentucky
- Sports Medicine Research Institute University of Kentucky
| | - Carrie Baker
- Department of Athletic Training and Clinical Nutrition University of Kentucky
| | - Dee Dlugonski
- Department of Athletic Training and Clinical Nutrition University of Kentucky
- Sports Medicine Research Institute University of Kentucky
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Wang W, Li X, Shi R, Wang C, Zhang K, Ren X, Wei H. Abnormal balance control mechanisms during dynamic reaching forward and quiet standing in patients with anterior cruciate ligament reconstruction. Front Physiol 2023; 14:1176222. [PMID: 37520821 PMCID: PMC10375014 DOI: 10.3389/fphys.2023.1176222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose: Postural instability and decreased balance control ability have been observed in patients after anterior cruciate ligament (ACL) reconstruction. Herein, we examined the abnormal balance control mechanisms of these patients during dynamic reaching forward and quiet standing, providing a quantitative index for rehabilitation assessment. Methods: We enrolled ACL reconstruction patients 6-8 months after surgery, and 14 gender- and age-matched healthy volunteers. The IKDC and Lysholm were applied in each patient after ACL reconstruction. All participants conducted the quiet standing and reaching forward (RF) tests at the specified locations on force plates. The ground reaction force, center of pressure (COP), and kinematics signals were recorded. The maximal reach distance (MRD), speed of RF, length of COP, peak speed of COP in anterior-posterior direction (AP-COP), and weight bearing ratio (WBR) of the affected limb were calculated in the RF test. The COP speed, COP amplitude, frequency components of COP and WBR were extracted during quiet standing. Results: We observed that the speed of RF in the patients after ACL reconstruction was significantly lower than that of controls (p < 0.05). The COP length during RF was positively correlated with the Lysholm scale in the affected limb of patients (r = 0.604, p < 0.05). The peak of AP-COP speed during RF in the affected limb of patients was significantly lower than that of the healthy controls (p < 0.05), and positively correlated with the IKDC scale (r = 0.651, p < 0.05). WBR on the affected limb of patients during RF were significantly lower than that of controls (p < 0.05). The mean (r = -0.633, p < 0.05) and peak (r = -0.643, p < 0.05) speeds of COP during quiet standing were negatively correlated with the IKDC scale value. The amplitude of AP-COP on the contralateral side of patients was significantly higher than that of controls during quiet standing (p < 0.05). Conclusion: Patients after ACL reconstruction performed decreased postural control capacity, especially in dynamic balance, and were accompanied by deficiencies in proprioception. The COP length, peak speed of COP during RF and COP speed during quiet standing could be considered as quantitative index of balance function assessment after ACL reconstruction.
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Affiliation(s)
- Wei Wang
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xudong Li
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Runxiu Shi
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Cheng Wang
- Department of Orthopedics, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Ke Zhang
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xiaomin Ren
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hui Wei
- Department of Physical Medicine and Rehabilitation, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Tavares MLA, Lima PODP, Albano TR, Rodrigues CAS, Almeida GPL. The Relationship of Knee-related Quality of Life With Function, Psychological Factors, Strength, Performance, and Postural Stability After ACL Reconstruction: A Cross-Sectional Study. Sports Health 2023; 15:192-198. [PMID: 36154529 PMCID: PMC9950995 DOI: 10.1177/19417381221123517] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients after anterior cruciate ligament reconstruction (ACLR) have decreased health-related quality of life (QoL) compared with healthy control participants. Few studies have verified the predictors of QoL using Quality of Life Outcome Measure Questionnaire for Chronic Anterior Cruciate Ligament Deficiency (ACL-QoL), and no study has verified the relationship of psychological factors and knee function with ACL-QoL in patients after ACLR. HYPOTHESIS Knee functional status, muscle strength, performance in hop tests, postural stability, and psychological factors would be the predictors of QoL after ACLR. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS A total of 131 participants who had undergone ACLR at least 6 months previously were evaluated. QoL was assessed using ACL-QoL; knee functional status, using International Knee Documentation Committee Subjective Knee (IKDC) and global rating scale (GRS); psychological readiness, using Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI); kinesiophobia, using Tampa Scale for Kinesiophobia (TSK-17); knee strength, using isokinetic dynamometer; performance, using single-leg hop tests; and postural stability, using Biodex Balance System. Pearson's linear correlation and stepwise hierarchical multiple linear regression analyses were performed to verify the predictors of QoL. RESULTS ACL-QoL showed a moderate correlation with IKDC (r = 0.69), GRS (r = 0.55), ACL-RSI (r = 0.50), and TSK-17 (r = -0.49). ACL-QoL presented none to low correlations with the variables of muscle strength, postural stability, and performance in hop tests. The variables related to the knee functional status and psychological factors (IKDC, GRS, ACL-RSI, and TSK-17) were found to be the predictors of QoL (R2 = 0.56; P = 0.01). CONCLUSION Knee functional status, psychological readiness, and kinesiophobia were the predictors of knee-related QoL in patients after ACLR. CLINICAL RELEVANCE These results can assist clinicians in the therapeutic monitoring of the factors that may interfere with QoL in patients after ACLR.
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Affiliation(s)
- Maria Larissa Azevedo Tavares
- Knee and Sports Research Group,
Physical Therapy Department, School of Medicine, Federal University of Ceará,
Fortaleza, CE, Brazil
- Master Program in Physical Therapy and
Functioning, Physical Therapy Department, School of Medicine, Federal University of
Ceará, Fortaleza, CE, Brazil
| | - Pedro Olavo de Paula Lima
- Knee and Sports Research Group,
Physical Therapy Department, School of Medicine, Federal University of Ceará,
Fortaleza, CE, Brazil
- Master Program in Physical Therapy and
Functioning, Physical Therapy Department, School of Medicine, Federal University of
Ceará, Fortaleza, CE, Brazil
| | - Thamyla Rocha Albano
- Knee and Sports Research Group,
Physical Therapy Department, School of Medicine, Federal University of Ceará,
Fortaleza, CE, Brazil
- Master Program in Physical Therapy and
Functioning, Physical Therapy Department, School of Medicine, Federal University of
Ceará, Fortaleza, CE, Brazil
| | - Carlos Augusto Silva Rodrigues
- Knee and Sports Research Group,
Physical Therapy Department, School of Medicine, Federal University of Ceará,
Fortaleza, CE, Brazil
- Master Program in Physical Therapy and
Functioning, Physical Therapy Department, School of Medicine, Federal University of
Ceará, Fortaleza, CE, Brazil
| | - Gabriel Peixoto Leão Almeida
- Knee and Sports Research Group,
Physical Therapy Department, School of Medicine, Federal University of Ceará,
Fortaleza, CE, Brazil
- Master Program in Physical Therapy and
Functioning, Physical Therapy Department, School of Medicine, Federal University of
Ceará, Fortaleza, CE, Brazil
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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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Caccese JB, Teel E, Van Patten R, Muzeau MA, Iverson GL, VanRavenhorst-Bell HA. Test-Retest reliability and preliminary reliable change estimates for Sway Balance tests administered remotely in community-dwelling adults. Front Digit Health 2022; 4:999250. [PMID: 36405418 PMCID: PMC9667020 DOI: 10.3389/fdgth.2022.999250] [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: 07/20/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Impaired balance and postural stability can occur with advanced age, following traumatic brain injury, in association with neurological disorders and diseases, and as the result of acute or chronic orthopedic problems. The remote assessment of balance and postural stability could be of value in clinical practice and research. We examined the test-retest reliability and reliable change estimates for Sway Balance Mobile Application tests (Sway Medical, Tulsa OK, USA) administered remotely from the participant's home. METHOD Primarily young, healthy community-dwelling adults completed Sway Balance Mobile Application tests remotely on their personal mobile devices once per week for three consecutive weeks while being supervised with a video-based virtual connection. Sway Balance tests include five stances (i.e., feet together, tandem right foot forward, tandem left foot forward, single leg right foot, single leg left foot), which are averaged to compute a Sway Balance composite score from 0 to 100, with higher scores indicating better postural stability. We examined test-retest reliability (measured with intraclass correlation coefficients, ICCs) and preliminary reliable change estimates for 70%, 80%, and 90% confidence intervals. RESULTS Participants included 55 healthy adults (ages = 26.7 ± 9.9 years, interquartile range = 20-30, range = 18-58; 38 [69%] women). Test-retest reliability for the Sway Balance composite score across three weeks was.88. Test-retest reliability for individual stances ranged from 62 to 83 (all ps < 0.001). At the 80% confidence interval, preliminary reliable changes estimates were 9 points for the Sway Balance composite score. CONCLUSIONS For a remote administration, test-retest reliability was moderate-to-good for all Sway Balance stances, as well as for the Sway Balance composite score. Reliable change estimates may allow clinicians to determine whether an improvement or decline in performance is greater than the expected improvement or decline due to measurement error in young adults.
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Affiliation(s)
- Jaclyn B. Caccese
- School of Health & Rehabilitation Sciences and Chronic Brain Injury Program, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Elizabeth Teel
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Ryan Van Patten
- Providence Veterans Administration Medical Center,Providen, RI, United States,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Mélissa A. Muzeau
- Sporttesting, Grenoble, France,Human Performance Laboratory, Wichita State University, Wichita, KS, United States
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States,Sports Concussion Program, MassGeneral Hospital for Children, Boston, MA, United States,Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute as Spaulding Rehabilitation, Charlestown, MA, United States,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United States
| | - Heidi A. VanRavenhorst-Bell
- Human Performance Laboratory, Wichita State University, Wichita, KS, United States,Department of Human Performance Studies, Wichita State University, Wichita, KS, United States
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Bullock GS, Sell TC, Zarega R, Reiter C, King V, Wrona H, Mills N, Ganderton C, Duhig S, Räisäsen A, Ledbetter L, Collins GS, Kvist J, Filbay SR. Kinesiophobia, Knee Self-Efficacy, and Fear Avoidance Beliefs in People with ACL Injury: A Systematic Review and Meta-Analysis. Sports Med 2022; 52:3001-3019. [PMID: 35963980 DOI: 10.1007/s40279-022-01739-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury is needed. OBJECTIVE The aim of this systematic review was to investigate knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury, and compare these outcomes following management with rehabilitation alone, early and delayed ACL reconstruction (ACLR). METHODS Seven databases were searched from inception to April 14, 2022. Articles were included if they assessed Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scale (KSES), or Fear Avoidance Beliefs Questionnaire (FABQ). Risk of bias (RoB) was assessed using domain-based RoB tools (ROBINS-1, RoB 2, RoBANS), and GRADE-assessed certainty of evidence. Random-effects meta-analyses pooled outcomes, stratified by time post-injury (pre-operative, 3-6 months, 7-12 months, > 1-2 years, > 2-5 years, > 5 years). RESULTS Seventy-three studies (70% high RoB) were included (study outcomes: TSK: 55; KSES: 22; FABQ: 5). Meta-analysis demonstrated worse kinesiophobia and self-efficacy pre-operatively (pooled mean [95% CI], TSK-11: 23.8 [22.2-25.3]; KSES: 5.0 [4.4-5.5]) compared with 3-6 months following ACLR (TSK-11: 19.6 [18.7-20.6]; KSES: 19.6 [18.6-20.6]). Meta-analysis suggests similar kinesiophobia > 3-6 months following early ACLR (19.8 [4.9]) versus delayed ACLR (17.2 [5.0]). Only one study assessed outcomes comparing ACLR with rehabilitation only. CONCLUSIONS Knee self-efficacy and kinesiophobia improved from pre-ACLR to 3-6 months following ACLR, with similar outcomes after 6 months. Since the overall evidence was weak, there is a need for high-quality observational and intervention studies focusing on psychological outcomes following ACL injury.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Charlotte, NC, USA. .,Centre for Sport, Exercise and Osteoarthritis Research-Versus Arthritis, University of Oxford, Oxford, UK.
| | | | | | | | | | | | - Nilani Mills
- Atrium Health, Charlotte, NC, USA.,University of New South Wales, Sydney, NSW, Australia
| | | | - Steven Duhig
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Australia
| | - Anu Räisäsen
- Department of Physical Therapy, Western University of Health Sciences, Lebanon, OR, USA.,Department of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Joanna Kvist
- Unit of Physiotherapy, Department of Health, Medicine, and Caring Medicine, Linkoping University, Linköping, Sweden.,Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Stephanie R Filbay
- Centre of Health, Exercise, and Sport Medicine, University of Melbourne, Melbourne, VIC, Australia
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Walsh BM, Kosik KB, Bain KA, Houston MN, Hoch MC, Gribble P, Hoch JM. Exploratory factor analysis of the fear-avoidance beliefs questionnaire in patients with chronic ankle instability. Foot (Edinb) 2022; 51:101902. [PMID: 35255408 DOI: 10.1016/j.foot.2021.101902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/22/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE To perform an exploratory factor analysis of the Fear-Avoidance Beliefs Questionnaire in patients with chronic ankle instability. METHODS A cross-sectional survey study was utilized. The Fear-Avoidance Beliefs Questionnaire was administered to patients with chronic ankle instability who met the inclusion criteria. Both an unrestricted and restricted factor analysis with varimax rotation were utilized to explore the factor structure of the instrument. Kaiser-Meyer-Olkin values were used to determine sampling adequacy. Bartlett's test of sphericity was used to justify that the correlations were suitable for the principal component analysis. RESULTS The restricted two-factor analysis resulted in two factors with acceptable internal consistency values. The Keiser-Meyer-Olkin value was acceptable (0.81), and Bartlett's test of sphericity was significant (χ2 (55) = 515.59, p < 0.001). CONCLUSION The ankle-specific Fear-Avoidance Beliefs Questionnaire consists of two stable factors and should be used to further examine fear-avoidance beliefs in people with chronic ankle instability.
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Affiliation(s)
- Bridget M Walsh
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Kyle B Kosik
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Katherine A Bain
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Megan N Houston
- John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, West Point, NY 10996, USA
| | - Matthew C Hoch
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Phillip Gribble
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Johanna M Hoch
- College of Health Sciences, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA.
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11
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Kinetic measurement system use in individuals following anterior cruciate ligament reconstruction: a scoping review of methodological approaches. J Exp Orthop 2021; 8:81. [PMID: 34568996 PMCID: PMC8473525 DOI: 10.1186/s40634-021-00397-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/27/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose Our primary objectives were to (1) describe current approaches for kinetic measurements in individuals following anterior cruciate ligament reconstruction (ACLR) and (2) suggest considerations for methodological reporting. Secondarily, we explored the relationship between kinetic measurement system findings and patient-reported outcome measures (PROMs). Methods We followed the PRISMA extension for scoping reviews and Arksey and O’Malley’s 6-stage framework. Seven electronic databases were systematically searched from inception to June 2020. Original research papers reporting parameters measured by kinetic measurement systems in individuals at least 6-months post primary ACLR were included. Results In 158 included studies, 7 kinetic measurement systems (force plates, balance platforms, pressure mats, force-measuring treadmills, Wii balance boards, contact mats connected to jump systems, and single-sensor insoles) were identified 4 main movement categories (landing/jumping, standing balance, gait, and other functional tasks). Substantial heterogeneity was noted in the methods used and outcomes assessed; this review highlighted common methodological reporting gaps for essential items related to movement tasks, kinetic system features, justification and operationalization of selected outcome parameters, participant preparation, and testing protocol details. Accordingly, we suggest considerations for methodological reporting in future research. Only 6 studies included PROMs with inconsistency in the reported parameters and/or PROMs. Conclusion Clear and accurate reporting is vital to facilitate cross-study comparisons and improve the clinical application of kinetic measurement systems after ACLR. Based on the current evidence, we suggest methodological considerations to guide reporting in future research. Future studies are needed to examine potential correlations between kinetic parameters and PROMs. Supplementary Information The online version contains supplementary material available at 10.1186/s40634-021-00397-0.
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12
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Roe C, Jacobs C, Kline P, Lucas K, Johnson D, Ireland ML, Lattermann C, Noehren B. Correlations of Single-Leg Performance Tests to Patient-Reported Outcomes After Primary Anterior Cruciate Ligament Reconstruction. Clin J Sport Med 2021; 31:e265-e270. [PMID: 32032156 PMCID: PMC7415502 DOI: 10.1097/jsm.0000000000000780] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 06/19/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the relationship between patient-reported outcomes (PROs) to the single-leg step-down test (SLSD) and the Y-balance anterior reach (YB-A) 6 months after primary anterior cruciate ligament reconstruction (ACLR). DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Sixty-six patients 6 months after ACLR participated. INTERVENTIONS Patients performed the SLSD, YB-A, and completed PROs after ACLR. MAIN OUTCOME MEASURES Patients completed the International Knee Documentation Committee Score (IKDC), the Lysholm Activity Scale, the Tampa Scale of Kinesiophobia (TSK-11), and the Knee Injury and Osteoarthritis Outcome Score (KOOS)-Symptom, -Sport, and -Quality of Life (QOL) subscales. The SLSD requires subjects to complete as many single-leg step-downs as possible in 60 seconds, and the YB-A involves reaching anteriorly on a single limb. Pearson product moment correlations were used to assess relationships between the YB-A and SLSD performance to each PRO. RESULTS Single-leg step-down test symmetry was significantly correlated with the TSK-11 (r = -0.70), KOOS-Sport (r = 0.40), -Symptom (r = 0.46), and -QOL (r = 0.42). The YB-A symmetry was significantly correlated with the KOOS-Symptom (r = 0.30) and KOOS-Sport (r = 0.30). CONCLUSIONS Single-leg step-down test performance demonstrated stronger relationships to patient-reported knee function than the YB-A. Furthermore, the SLSD symmetry was strongly correlated with fear of movement. The SLSD provides a robust method for clinicians to assess dynamic knee function and may aid in identifying patients who could benefit from intervention to reduce fear of movement or reinjury.
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Affiliation(s)
- Chelsey Roe
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky, Lexington, KY
| | - Cale Jacobs
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY
| | - Paul Kline
- Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Denver, Colorado
| | - Kathryn Lucas
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky, Lexington, KY
| | - Darren Johnson
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY
| | - Mary Lloyd Ireland
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY
| | - Christian Lattermann
- Department of Orthopaedic Surgery, Harvard Medical School and Brigham and Women’s Hospital, Chestnut Hill, MA
| | - Brian Noehren
- Division of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY
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13
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Barchek AR, Dlugonski D, Baez SE, Hoch MC, Hoch J. The relationship between injury-related fear and physical activity in people with a history of anterior cruciate ligament reconstruction. Phys Ther Sport 2021; 50:201-205. [PMID: 34098326 DOI: 10.1016/j.ptsp.2021.05.010] [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: 10/27/2020] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationship between fear-avoidance beliefs and physical activity (PA) in people with a history of anterior cruciate ligament reconstruction (ACLR). DESIGN Modified cross-sectional. SETTING Research laboratory Participants: A total of 19 participants with a history of unilateral ACLR. MAIN OUTCOME MEASURES Participants completed the Fear-Avoidance Beliefs Questionnaire (FABQ), a valid and reliable measure of FAB measured across two subscales (FABQ-Sport and FABQ-Physical Activity (PA)). Higher scores indicated greater FAB. The participants were provided a wearable accelerometer to wear on the wrist for one-week to capture PA outcomes (vertical counts per minute and average steps/day). RESULTS Weak, non-statistically significant positive correlations were identified between average daily steps per day (11,237.7 ± 5667.7), FABQ-PA (6 ± 8; r = 0.12, p = .63) and FABQ-S (8 ± 15; r = 0.26, p = .35). Weak, non-statistically significant negative correlations were identified between vertical counts per minute (131.4 ± 141.4) and FABQ-PA (r = -0.13, p = .59) and no relationship was observed with FABQ-Sports (r = 0.00, p = .98). CONCLUSIONS There were no significant relationships between FABs and PA. The ability for individuals to remain physically active, with measurable levels of FABs (greater than 0), may be due to other psychological variables that should be further examined.
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Affiliation(s)
- Amy R Barchek
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, 900 South Limestone Street, Lexington, KY, 40536, USA.
| | - Dee Dlugonski
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, 900 South Limestone Street, Lexington, KY, 40536, USA.
| | - Shelby E Baez
- Department of Kinesiology, Michigan State University, 308 W Circle Dr, East Lansing, MI, 48824, USA.
| | - Matthew C Hoch
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, 900 South Limestone Street, Lexington, KY, 40536, USA.
| | - Johanna Hoch
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, 900 South Limestone Street, Lexington, KY, 40536, USA.
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Fear-Avoidance Beliefs and Health-Related Quality of Life in Post-ACL Reconstruction and Healthy Athletes: A Case–Control Study. J Sport Rehabil 2020; 29:772-776. [DOI: 10.1123/jsr.2018-0491] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/30/2019] [Accepted: 06/09/2019] [Indexed: 11/18/2022]
Abstract
Context: Many athletes return to sport after anterior cruciate ligament reconstruction (ACLR) with lingering physical or mental health impairments. Examining health-related quality of life (HRQL) and fear-avoidance beliefs across the spectrum of noninjured athletes and athletes with a history of ACLR may provide further insight into targeted therapies warranted for this population. Objective: The purpose of this study was to examine differences in fear-avoidance beliefs and HRQL in college athletes with a history of ACLR not participating in sport (ACLR-NPS), participating in sport (ACLR-PS), and healthy controls (Control) with no history of injury participating in sport. Design: Cross-sectional. Setting: Laboratory. Patients (or Other Participants): A total of 10 college athletes per group (ACLR-NPS, ACLR-PS, and Control) were included. Participants were included if on a roster of a Division I or III athletic team during data collection. Interventions: Participants completed a demographic survey, the modified Disablement in the Physically Active Scale (mDPA) to assess HRQL, and Fear-Avoidance Beliefs Questionnaire (FABQ) to assess fear-avoidance beliefs. Main Outcome Measures: Scores on the mDPA (Physical and Mental) and FABQ subscales (Sport and Physical Activity) were calculated, a 1-way Kruskal–Wallis test and separate Mann–Whitney U post hoc tests were performed (P < .05). Results: ACLR-NPS (30.00 [26.00]) had higher FABQ-Sport scores than ACLR-PS (18.00 [26.00]; P < .001) and Controls (0.00 [2.50]; P < .001). ACLR-NPS (21.50 [6.25]) had higher FABQ-Physical Activity scores than ACLR-PS (12.50 [13.00]; P = .001) and Controls (0.00 [1.00]; P < .001). Interestingly, ACLR-PS scores for FABQ-Sport (P = .01) and FABQ-Physical Activity (P = .04) were elevated compared with Controls. ACLR-NPS had higher scores on the mDPA-Physical compared with the ACLR-PS (P < .001) and Controls (P < .001), and mDPA-Mental compared with ACLR-PS (P = .01), indicating decreased HRQL. Conclusions: The ACLR-NPS had greater fear-avoidance beliefs and lower HRQL compared with ACLR-PS and Controls. However, the ACLR-PS had higher scores for both FABQ subscales compared with Controls. These findings support the need for additional psychosocial therapies to address fear-avoidance beliefs in the returned to sport population.
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15
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[Effects of knee pain on postural control excluding the musculature of the craniomandibular system]. DER ORTHOPADE 2020; 49:510-521. [PMID: 31720704 DOI: 10.1007/s00132-019-03831-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Knee pain can influence postural control in addition to changes in the anatomical structure of the knee joints. OBJECTIVE Because the influence of imbalances in the craniomandibular system has been proven multiple times, it is the aim of the present work to investigate the influence of various knee diagnoses on postural control excluding occlusal information by means of symmetrical packing using cotton rolls. MATERIALS AND METHODS One hundred and fifteen patients (74 male/41 female) aged 18-75 years with an average BMI of 25.13 ± 3.66 kg/m2 took part in the study, among them 34 patients (26 male/8 female) with cruciate ligament injury, 26 (16 male/10 female) with meniscal lesions, 24 (13 male/11 female) with arthrosis, 21 (11 male/10 female) with patellar pain, and 10 (8 male/2 female) with other painful knee complaints. Postural control was increased using a force platform, the degree of severity of the disorder was recorded using the "Knee Injury and Osteoarthritis Outcome" questionnaire, and the occlusion packed on both sides with cotton rolls in the premolar area. RESULTS With increasing age, patients with knee arthrosis are more likely to stand on the hindfoot. In those with patellar disorder, increased weight-bearing on the forefoot correlates with increasing BMI. An increase in weight-bearing on the forefoot on the side of the uninjured knee in people with patellar disorder results not only in a reduction in quality of life but also level of daily activity. DISCUSSION The percentage weight-bearing on the zones of the feet differs in unilateral knee injuries (in particular, comparison of the side with the knee injury and the uninjured side). Age, BMI or gender are influencing factors. Because various correlations and/or effects in the subgroups of knee injuries are generated, an injury-specific analysis should be carried out. These effects are also identifiable in the subjective assessment of quality of life.
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The Relationship Between Injury-Related Fear and Visuomotor Reaction Time in Individuals With a History of Anterior Cruciate Ligament Reconstruction. J Sport Rehabil 2020; 30:353-359. [PMID: 32473583 DOI: 10.1123/jsr.2019-0511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/10/2020] [Accepted: 03/21/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Deficits in reaction time, decreased self-reported knee function, and elevated levels of injury-related fear have been observed in individuals who sustain anterior cruciate ligament injury. Understanding the relationship between these variables may provide the impetus to further investigate effective intervention strategies to address these deficits in individuals after anterior cruciate ligament reconstruction (ACLR). OBJECTIVE To examine the relationship between injury-related fear and lower-extremity visuomotor reaction time (VMRT) in individuals with a history of ACLR. A secondary purpose was to determine the relationship between self-reported knee function and lower-extremity VMRT in individuals with a history of ACLR. DESIGN Cross-sectional study. SETTING Laboratory. PARTICIPANTS Twenty participants between the ages of 18-35 years, with history of unilateral ACLR within the last 10 years, who injured their knee playing or training for organized or recreational sports. MAIN OUTCOME MEASURES Scores on the athlete fear avoidance questionnaire, the fear-avoidance beliefs questionnaire (FABQ), the knee injury and osteoarthritis outcome score, and reaction time (in seconds) on the lower-extremity VMRT task using the FitLight Trainer™, bilaterally. Spearman Rho correlations examined the relationship between the dependent variables. RESULTS There was a moderate positive correlation between VMRT and FABQ-total (r = .62, P < .01), FABQ-sport (r = .56, P = .01), and FABQ-physical activity (r = .64, P < .01) for the injured limb. Correlations between FABQ scores and VMRT for the uninjured limb were weak positive correlations (r = .36-.41, P > .05). Weak correlations between the osteoarthritis outcome score subscales, athlete fear avoidance questionnaire, and VMRT were observed for the injured limb (P > .05). CONCLUSIONS Individuals with a history of ACLR who exhibited elevated levels of injury-related fear demonstrated slower VMRT. There were no relationships between self-reported knee function and VMRT. Future research should explore interventions to address injury-related fear and VMRT in individuals after ACLR.
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Norte GE, Solaas H, Saliba SA, Goetschius J, Slater LV, Hart JM. The relationships between kinesiophobia and clinical outcomes after ACL reconstruction differ by self-reported physical activity engagement. Phys Ther Sport 2019; 40:1-9. [PMID: 31421282 DOI: 10.1016/j.ptsp.2019.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate whether relationships between kinesiophobia, lower extremity function, and patient-reported function differ by self-reported physical activity engagement after ACL reconstruction (ACLR). DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Seventy-seven patients with a primary, unilateral ACLR. MAIN OUTCOME MEASURES Kinesiophobia (TSK-17) was the primary outcome. Lower extremity function included quadriceps and hamstrings strength, fatigue, and hop performance. Patient-reported function included regional function (IKDC, KOOS subscales) and physical activity engagement (Godin Leisure-Time Exercise). Patients were evaluated together, then stratified by LOW and HIGH physical activity. Correlations and multiple regression analyses identified relationships between kinesiophobia and outcome measures. RESULTS Greater kinesiophobia was associated with lesser hamstrings strength, hop performance, and patient-reported function. Greater hamstrings fatigue and lesser KOOSADL explained greater kinesiophobia in patients reporting LOW physical activity. Lesser triple hop symmetry, crossover hop distance, and IKDC explained greater kinesiophobia in patients reporting HIGH physical activity. CONCLUSIONS Greater kinesiophobia associated with worse outcomes after ACLR. Relationships differed by self-reported physical activity engagement. Interventions that improve the ability to perform knee-related activities of daily living may be appropriate to minimize the impact of fear in less active patients, while those targeting hop performance and knee-related sport activities may be better suited for more active patients.
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Affiliation(s)
- Grant E Norte
- University of Toledo, School of Exercise and Rehabilitation Sciences, Athletic Training Program, 2801 W. Bancroft St.Health and Human Services 2505H, Mail Stop 119, Toledo, OH, 43606, United States.
| | - Haley Solaas
- University of Virginia, Kinesiology Department, Sports Medicine Program, 210 Emmet Street North, Memorial Gymnasium, 209 PO Box 400407, Charlottesville, VA, 22904, United States.
| | - Susan A Saliba
- University of Virginia, Kinesiology Department, Sports Medicine Program, 210 Emmet Street North, Memorial Gymnasium, 209 PO Box 400407, Charlottesville, VA, 22904, United States; University of Virginia, Department of Orthopedic Surgery, Sports Medicine Division, 400 Ray C. Hunt Drive, Suite 330 PO Box 800159, Charlottesville, VA, 22908, United States.
| | - John Goetschius
- Adrian College Exercise Science & Athletic Training Department, 110 S. Madison Street Merillat 209, Adrian, MI, 49221, United States.
| | - Lindsay V Slater
- Shirley Ryan AbilityLab, Neuromechanics of Impaired Locomotion Lab, 355 East Erie, Chicago, IL, 60611, United States.
| | - Joseph M Hart
- University of Virginia, Kinesiology Department, Sports Medicine Program, 210 Emmet Street North, Memorial Gymnasium, 209 PO Box 400407, Charlottesville, VA, 22904, United States; University of Virginia, Department of Orthopedic Surgery, Sports Medicine Division, 400 Ray C. Hunt Drive, Suite 330 PO Box 800159, Charlottesville, VA, 22908, United States.
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18
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Hoch JM, Baez SE, Hoch MC. Examination of ankle function in individuals with a history of ACL reconstruction. Phys Ther Sport 2019; 36:55-61. [PMID: 30660900 DOI: 10.1016/j.ptsp.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/31/2018] [Accepted: 01/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine the relationship between self-reported ankle and knee function, and to examine differences in ankle function between healthy and injured limbs in individuals with a history of ACL reconstruction (ACLR). DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS A total of 18 adults with a history of ACLR. MAIN OUTCOME MEASURES Participants completed four patient-reported outcomes: the Knee Injury and Osteoarthritis Outcome (KOOS), the Fear-Avoidance Belief Questionnaire, the modified Disablement in the Physically Active Scale, and the Quick-Foot and Ankle Ability Measure (Quick-FAAM). Additional ankle function measures collected bilaterally included plantar cutaneous sensation, dorsiflexion range of motion and dorsiflexion and plantarflexion strength. RESULTS Three KOOS-subscales were significantly, moderately correlated to the Quick-FAAM for the injured limb. There were differences in the uninjured and injured Quick-FAAM scores. No other differences were observed in ankle function measures. CONCLUSIONS Self-reported ankle and knee function are correlated in participants with a history of ACLR. Clinicians should be made aware of the influence of this health condition on the distal joint, and treatment strategies to address these perceived impairments should be considered.
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Affiliation(s)
- Johanna M Hoch
- University of Kentucky, 206A Charles T Wethington Building, Lexington, KY, 40536, USA.
| | - Shelby E Baez
- University of Kentucky, 206 Charles T Wethington Building, Lexington, KY, 40536, USA
| | - Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40536, USA
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The Association of Fear-Avoidance Beliefs and Self-Reported Knee Function in Patients With a Knee Injury: A Critically Appraised Topic. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY & TRAINING 2018. [DOI: 10.1123/ijatt.2017-0108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical Question: Are fear-avoidance beliefs associated with self-reported knee function in patients with a knee injury? Clinical Bottom Line: There is currently consistent, good-quality, patient-oriented evidence that demonstrates an association between fear-avoidance beliefs and self-reported knee function in patients with a knee injury. Future research should longitudinally examine the association of fear-avoidance beliefs and self-reported knee function in patients with a knee injury.
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