The Relationship Between Musculoskeletal Injury and Objectively Measured Physical Activity Levels: A Critically Appraised Topic

Objectively evaluated physical activity among individuals following anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Objective

To compare time spent in moderate-to-vigorous physical activity (MVPA) per week, MVPA per day, and steps per day between individuals that were subjected to the anterior cruciate ligament reconstruction (ACLR) and healthy control group.

Design

Systematic review and meta-analysis of observational studies.

Data sources

Web of Science, Scopus, and PubMed have been comprehensively searched to identify relevant investigations.

Eligibility criteria for selecting studies

An observational research that objectively evaluated physical activity among respondents with a history of ACLR.

Results

Of 302 records, a total of 12 studies fulfilled the eligibility criteria. Four hundred and forty-three participants underwent the ACLR, 153 men and 290 women. The mean time between anterior cruciate ligament (ACL) surgery and evaluation of analysed outcomes was 34.8 months. The main findings demonstrated that the ACLR group spent less time in weekly MVPA (standardised mean differences (SMD)=-0.43 (95% CI -0.66 to -0.20); mean = -55.86 min (95% CI -86.45 to -25.27); p=0.0003; τ2=0.00), in daily MVPA (SMD=-0.51 95% CI -0.76 to -0.26]; mean = -15.59 min (95% CI -22.93 to -8.25); p<0.0001; τ2=0.00), and they had fewer daily steps (SMD=-0.60 95% CI -0.90 to -0.30); mean = -1724.39 steps (95% CI -2552.27 to -896.50); p<0.0001; τ2=0.00) relative to their non-injured counterparts. Additionally, available investigations indicated that individuals with a history of ACLR participated in 316.8 min of MVPA per week, 67 min in MVPA per day, and 8337 steps per day.

Conclusion

Long-term after ACLR, participants undergoing ACL surgery were less physically active compared with their non-injured peers, and they did not satisfy recommendations regarding steps per day.

PROSPERO registration number

CRD42023431991.

Effects of Virtual Reality on Transtibial Amputation Rehabilitation Outcomes: A Randomized Study

Purpose: Virtual reality is widely used in patients with chronic musculoskeletal problems. However, the short-term effects on individuals with transtibial (TT) amputation during this process remain unclear. This study aimed at investigating the effects of virtual reality on rehabilitation outcomes in TT amputees. Methods: The study included 20 TT amputees who were using TT prostheses. The participants were divided into two groups randomly as follows: physiotherapy (PT) and virtual reality (VR). Participants were treated 3 days a week, for 4 weeks, and evaluations were made before and after treatment; a 6-minute walk test was used for performance, a single-leg balance test for balance, Trinity Amputation Prosthesis Experience Scale for prosthesis satisfaction, a 10-meter walking test for gait speed, and a wearable smart t-shirt to determine cadence. Results: It was found that there was a statistically significant difference in performance, balance, prosthesis satisfaction, cadence, and gait speed before and after PT (P < 0.05). There were differences in terms of performance, prosthesis satisfaction, balance, cadence, and gait speed before and after VR (P < 0.05). There was no statistically significant difference between PT and VR (P > 0.05). Conclusion: The 4 weeks of VR training improved performance, prosthesis satisfaction, balance, cadence, and gait speed in TT amputation rehabilitation similar to physiotherapy methods. The addition of VR training to amputation rehabilitation will bring improvements since it is a fun and safe intervention. Clinical Trial Registration: The trial is registered at Clinical Trials.gov, Trial No: NCT03872193.

Fitbit Activity, Quota-Based Pacing, and Physical and Emotional Functioning Among Adults With Chronic Pain

Physical activity can improve function in patients with chronic pain, however, adherence is low, in part due to inconsistent activity patterns. Smart wearable activity trackers, such as Fitbits, may help promote activity. In our program for chronic pain, we examined: 1) Fitbit activity patterns (ie, step count, moderate-to-vigorous physical activity (MVPA), sedentary behavior), and 2) whether achievement of weekly, individualized Fitbit step goals was associated with functional outcomes. We conducted a secondary analysis of Fitbit data from our 10-week mind-body activity program for chronic pain (GetActive-Fitbit arm, N = 41). Participants self-reported emotional and physical function and completed performance-based and accelerometer-based assessments. From week 1 to week 10, 30% of participants increased >800 steps; 32.5% increased MVPA; and 30% decreased sedentary behavior. Only step count significantly changed across time with mean steps peaking at week 8 (M = +1897.60, SD = 467.67). Fitbit step goal achievement was associated with improvements in anxiety (ß = -.35, CI [-2.80, -.43]), self-reported physical function (ß = -.34, CI [-5.17, 8.05]), and performance-based physical function (ß = .29, CI [-71.93, 28.38]), but not accelerometer-based physical function or depression. Adhering to individualized Fitbit step goals in the context of a mind-body activity program may improve anxiety and self-reported and performance-based physical function. PERSPECTIVE: We examine Fitbit activity patterns and the association between quota-based pacing and functional outcomes within a mind-body activity program for adults with chronic pain. Complementing quota-based pacing and coping skills with Fitbits may be a useful approach to promote activity engagement and behavior change in chronic pain populations.

Physical activity and risk of sudden cardiac death in individuals at high risk for cardiovascular disease: A protocol for systematic review and meta-analysis

BACKGROUND

Regular physical exercise is recommended for lowering the risk of coronary events and all-cause mortality. However, there is a variety of exercise options, and their relative effectiveness and hierarchy remain unclear. Herein, we present a systematic review and meta-analysis protocol that aims to compare the impact of different types of physical activity on the risk of sudden cardiac death.

METHODS AND ANALYSIS

English language articles reporting on randomized controlled trials will be searched in MEDLINE, Cochrane Library, CINAHL, and PubMed databases by two reviewers. A snowball approach will be used for literature retrieval. Reviewers will independently screen the literature, extract data, evaluate study quality and risk of bias, and perform a meta-analysis. In the presence of heterogeneity, a random effects model will be used for meta-analysis; otherwise, a fixed effect model will be used.

ETHICS AND DISSEMINATION

This study is a secondary analysis and does not require ethical review. The results of this study will be disseminated through peer-reviewed publications, journals, and academic conferences and other forms of exchange.

SYSTEMATIC REVIEW REGISTRATION NUMBER

INPLASY202140033.

Characterizing body composition, cardiorespiratory fitness, and physical activity in women with anterior cruciate ligament reconstruction

OBJECTIVES

The purpose was to compare body composition, cardiorespiratory fitness, and physical activity (PA) engagement between women with ACLR and healthy controls.

DESIGN

Cross-sectional study.

SETTING

University laboratory.

PARTICIPANTS

Ten women with ACLR (time since surgery = 33.0 ± 18.3 months; age = 21.4 ± 3.8 years) and 10 healthy women (age = 21.9 ± 3.1 years) matched based on age (±2 years) and Tegner Activity Level (±2) participated.

MAIN OUTCOME MEASURES

Body fat percentage (%BF) was estimated using air displacement plethysmography, cardiorespiratory fitness was assessed via a graded cycle test, and PA was assessed using accelerometers worn for 7 days. Groups were compared using Mann-Whitney U tests. Time (minutes/week) spent in moderate-to-vigorous PA and step count (steps/day) were compared between groups using a one-way ANCOVA with 7-day total wear time as the only covariate. Statistical significance was established a priori as α ≤ 0.05.

RESULTS

Women with ACLR had significantly higher %BF than controls (ACLR = 32.7 ± 6.7%, healthy = 22.6 ± 4.9%; p < 0.01) and participated in less steps per day (ACLR = 6650 ± 3227 steps/day, healthy = 9361 ± 2626 steps/day; p = 0.02).

CONCLUSIONS

There may be persistent negative effects on body composition and PA engagement for women following ACLR. Low PA and high %BF have adverse consequences for premature mortality and morbidity; therefore, it is crucial to assess these characteristics and determine interventions to maintain PA and healthy body composition following ACLR.