1
|
Picot B, Fourchet F, Rauline G, Freiha K, Wikstrom E, Lopes R, Hardy A. Ankle-GO score is associated with the probability of becoming coper after lateral ankle sprain: a 1-year prospective cohort study. Br J Sports Med 2024:bjsports-2024-108361. [PMID: 39122369 DOI: 10.1136/bjsports-2024-108361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE To analyse the association between Ankle-GO score during the return to sport process and the probability of becoming a coper 1 year after lateral ankle sprain (LAS). Copers were defined as patients returning to their preinjury sport without loss of function and reporting no episodes of reinjury or giving-way. METHODS Two months after a LAS, patients performed the Ankle-GO assessment which includes a cluster of four functional tests and two self-reported questionnaires for a maximum score of 25 points. One year after injury, participants were classified as copers or non-copers. Eight potential predictive variables associated with coper status were compared between the groups. Receiver operating characteristic curves (area under the curve (AUC)) and multivariable logistic regression models with OR and 95% CIs were used to determine the association of potential factors, including the Ankle-GO score, with copers. RESULTS 64 patients (56% females; age 33.7±13.2 years) completed the Ankle-GO-GO at 2 months postinjury. At 1 year postinjury, 10 patients (15%) were lost to follow-up, and only 17 of 54 patients (31%) became copers. Two-month Ankle-GO score was higher among copers (9.9±4.9 points vs 6.9±3.7, p=0.015) and was associated with future coper status at 1 year (AUC=0.70). Patients with an Ankle-GO score above 11 points and male patients were more likely to become copers (OR=12.1; 95% CI 2.5 to 59, p=0.002 and OR=5.2; 95% CI 1.2 to 22.4, p=0.026, respectively). CONCLUSION The Ankle-GO may help identify patients more likely to become copers within a year of injury. Those with low Ankle-GO scores and female patients should receive additional rehabilitation to increase the odds of becoming a coper.
Collapse
Affiliation(s)
- Brice Picot
- Interuniversity Laboratory of Human Movement Sciences, EA 7424, F-73000, C, University Savoie Mont Blanc, Chambery, France
- French Society of Sports Physical Therapist, Pierrefitte-sur-Seine, France
| | - François Fourchet
- French Society of Sports Physical Therapist, Pierrefitte-sur-Seine, France
- Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Switzerland
| | | | | | - Erik Wikstrom
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | |
Collapse
|
2
|
Dury J, Sagawa Y, Michel F, Ravier G. Neuromuscular fatigue and cognitive constraints independently modify lower extremity landing biomechanics in healthy and chronic ankle instability individuals. J Sports Sci 2024; 42:1341-1354. [PMID: 39136418 DOI: 10.1080/02640414.2024.2391209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 08/05/2024] [Indexed: 09/01/2024]
Abstract
The purpose was to determine the impact of both cognitive constraint and neuromuscular fatigue on landing biomechanics in healthy and chronic ankle instability (CAI) participants. Twenty-three male volunteers (13 Control and 10 CAI) performed a single-leg landing task before and immediately after a fatiguing exercise with and without cognitive constraints. Ground Reaction Force (GRF) and Time to Stabilization (TTS) were determined at landing in vertical, anteroposterior (ap) and mediolateral (ml) axes using a force plate. Three-dimensional movements of the hip, knee and ankle were recorded during landing using a motion capture system. Exercise-induced fatigue decreased ankle plantar flexion and inversion and increased knee flexion. Neuromuscular fatigue decreased vertical GRF and increased ml GRF and ap TTS. Cognitive constraint decreased ankle internal rotation and increased knee and hip flexion during the flight phase of landing. Cognitive constraint increased ml GRF and TTS in all three axes. No interaction between factors (group, fatigue, cognitive) were observed. Fatigue and cognitive constraint induced greater knee and hip flexion, revealing higher proximal control during landing. Ankle kinematic suggests a protective strategy in response to fatigue and cognitive constraints. Finally, these two constraints impair dynamic stability that could increase the risk of ankle sprain.
Collapse
Affiliation(s)
- Jeanne Dury
- Université de Franche-Comté, Laboratoire Culture Sport Santé Société (C3S-UR 4660), Equipe Sport et Performance, UFR STAPS, Besançon, France
| | - Yoshimasa Sagawa
- Université de Franche-Comté, CHU Besançon, LINC, Besançon, France
| | - Fabrice Michel
- Laboratoire de Nanomédecine, Université de Franche Comté, Imagerie, Thérapeutique (EA 4662), Besançon, France
| | - Gilles Ravier
- Université de Franche-Comté, Laboratoire Culture Sport Santé Société (C3S-UR 4660), Equipe Sport et Performance, UFR STAPS, Besançon, France
| |
Collapse
|
3
|
Picot B, Grimaud O, Rauline G, Haidar I, Moussa MK, Hardy A. Validity and reproducibility of the ARL-RSI score to assess psychological readiness before returning to sport after lateral ankle sprain. J Exp Orthop 2024; 11:e12073. [PMID: 38957229 PMCID: PMC11217666 DOI: 10.1002/jeo2.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024] Open
Abstract
Purpose Although multiple scales exist to evaluate psychological readiness before returning to sport post-lateral ankle sprain (LAS), no score has been validated specifically for LAS or chronic ankle instability. The main aim of the study is to evaluate the validity and reproducibility of the ankle ligament reconstruction-return to sport injury (ALR-RSI) scale in assessing psychological readiness after LAS and its ability to identify patients who can return to their preinjury level. Methods A total of 64 patients (35 females and 29 males; 33.8 ± 13.2 years) who recently experienced an acute LAS were included in this study. All patients participated in a predictive validation component of the study and were assessed at 2 and 4 months following an LAS. The ALR-RSI was completed twice by 20 patients at a 7-day interval to evaluate the reliability of the score in patients suffering from LAS. Results The ALR-RSI was significantly (p < 0.001) and positively correlated with the other scores. The correlation was strong with the Foot and Ankle Ability Measure Sports: r = 0.77; 95% confidence interval [CI]: 0.78-0.83) and moderate with the American Orthopaedic Foot and Ankle Society (r = 0.69; 95% CI: 0.60-0.78) and the Foot and Ankle Ability Measure Activities of Daily Living Scores (r = 0.63; 95% CI: 0.51-0.72). Two-month ALR-RSI scores had good ability for predicting nonreturners at 4 months (area under the curve = 0.76; 95% CI: 0.6-0.9; p = 0.005). A Youden index of 0.51 was observed at an ALR-RSI score of 46%, corresponding to a sensitivity of 67% and specificity of 83%. Test-retest reliability of the ALR-RSI was excellent, with an ICC of 0.98 (95% CI: 0.96-0.99), a standard error of measurement of 3.02% and a minimum detectable change of 8.37%. Conclusions The results of the current study validated the ALR-RSI as an important questionnaire to assess psychological readiness to return to sport after LAS. Level of Evidence Level II prospective cohort study.
Collapse
Affiliation(s)
- Brice Picot
- Interuniversity Laboratory of Human Movement SciencesSavoie MontBlanc UniversityChambéryFrance
- French Society of Sports Physical Therapist (SFMKS Lab)Pierrefitte‐surSeineFrance
| | | | | | - Ibrahim Haidar
- Department of Orthopedic SurgeryEmirates HospitalDubaiUnited Arab Emirates
| | - Mohamad K. Moussa
- Department of Orthopedic SurgeryGroup Hospitalier Sélestat‐ObernaiSélestatFrance
| | | |
Collapse
|
4
|
Flore Z, Hambly K, De Coninck K, Welsch G. A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines. Int J Sports Phys Ther 2024; 19:910-922. [PMID: 38966831 PMCID: PMC11221331 DOI: 10.26603/001c.120205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/20/2024] [Indexed: 07/06/2024] Open
Abstract
Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.
Collapse
Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise SciencesUniversity of Kent
- Medical Department1. FC Magdeburg
| | - Karen Hambly
- School of Sport and Exercise SciencesUniversity of Kent
| | | | - Götz Welsch
- UKE-AthleticumUniversity Medical Center Hamburg-Eppendorf
- Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg-Eppendorf
| |
Collapse
|
5
|
Pi-Rusiñol R, Verhagen E, Blanch M, Rodas Font G. Process mining to investigate the relationship between clinical antecedents and injury risk, severity and return to play in professional sports. BMJ Open Sport Exerc Med 2024; 10:e001890. [PMID: 38835540 PMCID: PMC11149139 DOI: 10.1136/bmjsem-2024-001890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/06/2024] Open
Abstract
Objective This paper presents an exploratory case study focusing on the applicability and value of process mining in a professional sports healthcare setting. We explore whether process mining can be retrospectively applied to readily available data at a professional sports club (Football Club Barcelona) and whether it can be used to obtain insights related to care flows. Design Our study used discovery process mining to detect patterns and trends in athletes' Post-Pre-Participation Medical Evaluation injury route, encompassing five phases for analysis and interpretation. Results We examined preprocessed data in event log format to determine the injury status of athletes in respective baseline groups (healthy or pathological). Our analysis found a link between thigh muscle injuries and later ankle joint problems. The process model found three loops with recurring injuries, the most common of which were thigh muscle injuries. There were no differences in injury rates or the median number of days to return to play between the healthy and pathological groups. Conclusions This study explored the applicability and value of process mining in a professional sports healthcare setting. We established that process mining can be retrospectively applied to readily available data at a professional sports club and that this approach can be used to obtain insights related to sports healthcare flows.
Collapse
Affiliation(s)
- Ramon Pi-Rusiñol
- FC Barcelona Medical Department, FIFA Medical Excellence Center, and Barça Innovation Hub, Barcelona, Spain
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Miriam Blanch
- ITEREM BPM Consulting Barcelona Spain, Barcelona, Spain
| | - Gil Rodas Font
- FC Barcelona Medical Department, FIFA Medical Excellence Center, and Barça Innovation Hub, Barcelona, Spain
- Barnaclinic Sports Medicine Unit, Barcelona, Spain
| |
Collapse
|
6
|
Picot B, Fourchet F, Lopes R, Rauline G, Freiha K, D'hooghe P, Valentin E, Hardy A. Low Ankle-GO Score While Returning to Sport After Lateral Ankle Sprain Leads to a 9-fold Increased Risk of Recurrence: A Two-year Prospective Cohort Study. SPORTS MEDICINE - OPEN 2024; 10:23. [PMID: 38453775 PMCID: PMC10920508 DOI: 10.1186/s40798-024-00693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Lateral ankle sprain (LAS) is the most common sports injury, leading to a high rate of recurrence and the development of chronic ankle instability. One possible explanation is the lack of objective, evidence-based criteria to inform return to sport decisions following LAS. The aim of this study was therefore to assess the efficacy of a new functional score to distinguish patients at risk of recurrent LAS within two years after the initial injury. METHODS The Ankle-GO score was used in 64 active patients two months after LAS. This composite score includes 2 self-reported questionnaires and 4 functional tests, for a maximum score of 25 points. The rate of reinjury was prospectively recorded 2 years after inclusion. Potential predictive variables for reinjury were tested using the Chi-square and independent t-tests. The area under the receiver operating characteristics curve (AUC) with the optimal cut-off score was determined to assess the predictive value of the Ankle-GO score for the risk of reinjury. Multivariate logistic regression was then used to determine the influence of risk factors of reinjury. RESULTS Fifty-four (85%) patients were included (23 men and 31 women, 34.7 ± 13 years old) including 18 (33.3%) with a reinjury. The two-month Ankle-GO score was lower in patients with a recurrent LAS (5.4 ± 2.8 points vs. 9.1 ± 4.5, p = 0.002) and predicted the risk of reinjury (AUC = 0.75). Patients with < 8 points were found to have a significantly higher risk of reinjury (OR = 8.6; 95%CI: 2-37.2, p = 0.001). Women also tend to have a higher risk of recurrence (OR = 3.8; 95%CI: 0.9-15.5, p = 0.065). CONCLUSION The Ankle-GO score is a new objective criterion for RTS after LAS. Patients with a low score at two months have a 9-fold greater risk of recurrence within two years.
Collapse
Affiliation(s)
- Brice Picot
- Interuniversity Laboratory of Human Movement Sciences, Savoie Mont-Blanc University, Chambéry, 7424, F-73000, EA, France.
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France.
- Département STAPS, Campus Technolac, Le Bourget-du-Lac, 73370, France.
| | - François Fourchet
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Physiotherapy Department, La Tour Hospital Swiss Olympic Medical Center, Meyrin, Switzerland
| | - Ronny Lopes
- Centre Orthopédique Santy, FIFA Medical Center of Excellence, Hôpital Privé Jean Mermoz, Groupe Ramsay, Lyon, France
| | | | | | - Pieter D'hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | | |
Collapse
|
7
|
Mohrsen A, Sørensen T, Lund H, Rasmussen SZ, Jensen A, Skov KB, Rathleff MS. "I Feel Like I Have Lost Part Of My Identity" - A Qualitative Study Exploring The Impact Of Chronic Ankle Instability. Int J Sports Phys Ther 2024; 19:316-325. [PMID: 38439771 PMCID: PMC10909303 DOI: 10.26603/001c.92908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/15/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. . Study Design Qualitative study. Methods Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. . Results Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). . Conclusion The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. . Level of Evidence Not applicable.
Collapse
Affiliation(s)
- Anders Mohrsen
- Department of Health Science and Technology Aalborg University
| | - Thomas Sørensen
- Department of Health Science and Technology Aalborg University
| | - Henrik Lund
- Department of Health Science and Technology Aalborg University
| | | | - Asger Jensen
- Department of Health Science and Technology Aalborg University
| | | | | |
Collapse
|
8
|
Maricot A, Lathouwers E, Verschueren J, De Pauw K, Meeusen R, Roelands B, Tassignon B. Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability. Front Neurol 2024; 15:1320043. [PMID: 38434204 PMCID: PMC10906270 DOI: 10.3389/fneur.2024.1320043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/23/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. Methods We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland-Altman plots, to evaluate the reliability of the RBT's outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. Results The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Conclusion Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI.
Collapse
Affiliation(s)
- Alexandre Maricot
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sports, Recreation, Exercise and Sciences (SRES), Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Bart Roelands
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
9
|
Li Y, Su T, Hu Y, Jiao C, Guo Q, Jiang Y, Jiang D. Return to Sport After Anatomic Lateral Ankle Stabilization Surgery for Chronic Ankle Instability: A Systematic Review and Meta-analysis. Am J Sports Med 2024; 52:555-566. [PMID: 37252803 DOI: 10.1177/03635465231170699] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Chronic lateral ankle instability that develops after ankle sprains has a severe, negative influence on the patient's lower extremity function. Anatomic repair or reconstruction of the lateral ankle ligament is an effective treatment for people with chronic lateral ankle instability who want to regain their preinjury levels of work and sport. PURPOSE To determine the rate of return to sport (RTS) and related factors after anatomic lateral ankle stabilization (ALAS) surgery. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 4. METHODS Electronic databases including Medline, Embase, the Cochrane Library, and EBSCO Rehabilitation & Sports Medicine Source were searched from the earliest feasible entrance until August 2021. Articles reporting the number of patients who returned to sport after ALAS surgery and analyzing the relevant factors were included. The results were combined using proportion meta-analyses. RESULTS A total of 25 publications were reviewed, with a total of 1384 participants. Results showed that 95% of patients (95% CI, 91%-99%) returned to any sport, 83% (95% CI, 73%-91%) returned to their preinjury level of sport, and 87% (95% CI, 71%-98%) returned to competitive sport after surgery. The mean time to RTS was 12.45 weeks (95% CI, 10.8-14.1 weeks). Each decade of age increased the likelihood of RTS failure by 6%, and increases in body mass index (BMI) of 5 kg/m2 raised the risk of RTS failure by 4%. The rate of RTS was higher in professional and competitive athletes (93%; 95% CI, 73%-100%) than in recreational athletes (83%; 95% CI, 76%-89%). Analysis showed no differences for arthroscopy versus open surgery, repair versus reconstruction, and early versus late weightbearing. CONCLUSION In most cases, patients may return to some kind of sport after ALAS surgery, and some patients RTS at their preinjury level. The relative risk of RTS failure increases according to the magnitude of the increase in age and BMI. Elite athletes are more likely to return compared with nonelite athletes.
Collapse
Affiliation(s)
- Yanzhang Li
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Tong Su
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Yuelin Hu
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Chen Jiao
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Qinwei Guo
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Yanfang Jiang
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| | - Dong Jiang
- Department of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Engineering Research Center of Sports Trauma Treatment Technology and Devices of Ministry of Education, Beijing, China
| |
Collapse
|
10
|
Picot B, Lopes R, Rauline G, Fourchet F, Hardy A. Development and Validation of the Ankle-GO Score for Discriminating and Predicting Return-to-Sport Outcomes After Lateral Ankle Sprain. Sports Health 2024; 16:47-57. [PMID: 37434508 PMCID: PMC10732116 DOI: 10.1177/19417381231183647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Lateral ankle sprain (LAS) is the most common sports-related injury. However, there are currently no published evidence-based criteria to guide the patient's return to sport (RTS) and this decision is generally time-based. The aim of this study was to assess the psychometric properties of a new score (Ankle-GO) and its predictive ability for RTS at the same level of play after LAS. HYPOTHESIS The Ankle-GO is robust for discriminating and predicting RTS outcomes. STUDY DESIGN Prospective diagnostic study. LEVEL OF EVIDENCE Level 2. METHODS The Ankle-GO was administered to 30 healthy participants and 64 patients at 2 and 4 months after LAS. The score was calculated as the sum of 6 tests for a maximum of 25 points. Construct validity, internal consistency, discriminant validity, and test-retest reliability were used to validate the score. The predictive value for the RTS was also validated based on the receiver operating characteristic (ROC) curve. RESULTS The internal consistency of the score was good (Cronbach's alpha coefficient of 0.79) with no ceiling or floor effect. Test-retest reliability was excellent (intraclass coefficient correlation = 0.99) with a minimum detectable change of 1.2 points. The 2-month scores were significantly lower than 4-month and control group scores (7.7 ± 4, 13.9 ± 4.6, and 19.6 ± 3.4 points, respectively, P < 0.01). Ankle-GO values were also significantly higher in patients who returned to their preinjury level at 4 months compared with those who did not (P < 0.01). The predictive value of the 2-month Ankle-GO score was fair for a RTS at the same or higher than preinjury level at 4 months (area under ROC curve, 0.77; 95% CI, 0.65-0.89; P < 0.01). CONCLUSION The Ankle-GO appears to be a valid and robust score for clinicians to predict and discriminate RTS in patients after LAS. CLINICAL RELEVANCE Ankle-GO is the first objective score to help in the decision-making of the RTS after LAS. At 2 months, patients with an Ankle-GO score <8 points are unlikely to RTS at the same preinjury level.
Collapse
Affiliation(s)
- Brice Picot
- Inter-University Laboratory of Human Movement Biology (LIBM), Savoie Mont-Blanc University, Chambéry, France
- French Society of Sports Physical Therapy (SFMKS Lab), Pierrefitte-sur-Seine, France
| | - Ronny Lopes
- Santé Atlantique, Pied Cheville Nantes Atlantique, Nantes, France
| | | | - François Fourchet
- French Society of Sports Physical Therapy (SFMKS Lab), Pierrefitte-sur-Seine, France
- Physiotherapy Department, La Tour Hospital Swiss Olympic Medical Center, Meyrin, Switzerland
| | | |
Collapse
|
11
|
Jamshidi AH, Mofateh R, Orakifar N, Seyedtabib M, Najarzadeh Z, Behdarvandan A. Immediate effects of local muscle vibration on static and dynamic balance control in individuals with chronic ankle instability. Phys Ther Sport 2024; 65:113-121. [PMID: 38128288 DOI: 10.1016/j.ptsp.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To investigate the immediate effects of local muscle vibration (LMV) on static and dynamic balance control in individuals with and without chronic ankle instability (CAI). DESIGN Quasi-experimental study. SETTING Research laboratory. PARTICIPANTS Twenty-six individuals with CAI and 26 healthy controls. MAIN OUTCOME MEASURES Center of pressure variables (mean total velocity and displacement in anteroposterior (AP) and mediolateral (ML) directions) during single-leg standing with eyes open and eyes closed and also reach distances in anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the modified star excursion balance test (MSEBT) were assessed before and after LMV. RESULTS Statistical analyses showed a significant decrease in mean total velocity and displacement in AP direction from before to after LMV in eyes open condition for both individuals with CAI (p = 0.025, p = 0.041, respectively) and healthy controls (p = 0.001, p = 0.003, respectively). Similar results were observed in eyes closed condition for both individuals with CAI (p < 0.001, p < 0.001, respectively) and healthy controls (p = 0.040, p = 0.014, respectively). The results also showed increased reach distances in ANT (p < 0.001), PM (p < 0.001), and PL directions (p < 0.001) in all participants after LMV. CONCLUSION Our results suggest that LMV may be a useful tool in rehabilitation of static and dynamic balance deficits in individuals with CAI.
Collapse
Affiliation(s)
- Amir Hossein Jamshidi
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Student Research Committee, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Razieh Mofateh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Neda Orakifar
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Najarzadeh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Amin Behdarvandan
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| |
Collapse
|
12
|
Noda Y, Horibe S, Hiramatsu K, Takao R, Fujita K. Single-Leg Loading Test to Predict Time to Jog and Return to Sports after Acute Lateral Ankle Sprain in Competitive Athletes. Kurume Med J 2023; 69:81-87. [PMID: 37793891 DOI: 10.2739/kurumemedj.ms69120014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
In a previous study, the utility of a single-leg loading (SLL) test after acute lateral ankle sprain (LAS) was reported. However, whether the severity level assessed by the SLL test is associated with the time to jog and return to sports (RTS) remains unclear. Therefore, this study aimed to examine whether the time to jog and RTS differ depending on the severity level. A total of 240 athletes after sustaining acute LAS were included in this study. The SLL test was performed at the first visit, and the patients were classified into four levels (Levels 1-4). The Steel-Dwass multiple comparison method and multiple regression analysis was performed to verify whether the SLL test can predict the time to jog and RTS. On examining the relationship between the severity levels assessed by the SLL test and time to jog and RTS, significant differences were found among almost all the severity levels. Moreover, the multiple regression analysis revealed that only the SLL test showed a significant correlation with both the time to jog and RTS. This study suggested that the time to jog and RTS can be predicted by conducting the SLL test for acute LAS and dividing the severity into four levels.
Collapse
Affiliation(s)
- Yuki Noda
- Department of Rehabilitation, Naragakuen University
| | | | | | - Rikio Takao
- Graduate School of Human Life and Ecology, Osaka Metropolitan University
| | | |
Collapse
|
13
|
Porter KH, Hoch MC. A Model for Applying Situational Awareness Theory to the Return to Sport Continuum. Int J Sports Phys Ther 2023; 18:1009-1015. [PMID: 37547828 PMCID: PMC10399126 DOI: 10.26603/001c.83946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Background Despite developing and implementing return to sport guidelines, high rates of re-injury remain. The return to sport continuum is a three-phase, criterion-based progression based on physical and psychological factors used to guide the sports medicine team in return to sport decision making. Situational awareness (SA) pertains to an athlete's knowledge of the dynamic environment (i.e., their ability to perceive the components in the environment, comprehend the meaning of the perceived information, and predict future actions based on that comprehension). SA can be applied on a cognitive continuum that encompasses three levels, each stage becoming more challenging with additional time constraints and increased uncertainty. Integrating the cognitive continuum with the return to sport continuum may optimize the return to sport process and enhance the athletes' preparedness for competition by incorporating cognitive challenges aligned with live competition. The purpose of this clinical commentary is to describe a return to sport model that integrates SA theory on the cognitive continuum with additional consideration for surrounding contextual factors. Level of Evidence 5©The Author(s).
Collapse
Affiliation(s)
- Ke'La H Porter
- Department of Athletic Training and Clinical Nutrition University of Kentucky
| | - Matthew C Hoch
- Department of Athletic Training and Clinical Nutrition University of Kentucky
| |
Collapse
|
14
|
Rowe PL, Hinman RS, Bryant AL, Paterson KL. Health-seeking behaviors, management practices, and return to play decisions after an ankle sprain in netball: An international cross-sectional survey of 1592 non-elite netballers. J Sci Med Sport 2023; 26:415-420. [PMID: 37400287 DOI: 10.1016/j.jsams.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Evaluate if non-elite netballers sought health care, treatments received, and return-to-play decisions after an ankle sprain, including intercountry differences. DESIGN Cross-sectional survey. METHODS Non-elite netballers aged >14 years were recruited from Australia, United Kingdom, and New Zealand. Participants completed an online survey regarding their last ankle sprain and were queried regarding health care sought, health professionals consulted, treatments received, time missed, and return-to-play clearance. Data were described using number (proportion) for the overall cohort and countries. Between-country differences in health care use were compared using chi-square tests. Descriptive statistics were presented for management practices. RESULTS We received 1592 responses from Australian (n = 846), United Kingdom (n = 454), and New Zealand (n = 292) netballers. Three in five (n = 951, 60 %) sought health care. Of those, most consulted a physiotherapist (n = 728, 76 %), received strengthening exercises (n = 771, 81 %), balance exercises (N = 665, 70 %) and taping (n = 636, 67 %). Few received return-to-play clearance (n = 362, 23 %). Comparing countries, fewer United Kingdom netballers sought health care than Australian and New Zealand netballers (Australia: 60 % vs United Kingdom: 53 % vs New Zealand: 68 %, p < 0.001), consulted a physiotherapist (Australia: 79 %, United Kingdom: 63 %, New Zealand: 87 %), received strengthening (Australia: 84 %, United Kingdom: 73 %, New Zealand: 84 %) or balance exercises (Australia: 71 %, United Kingdom: 60 %, New Zealand: 80 %) or taping (Australia: 74 %, United Kingdom: 39 %, New Zealand: 82 %). More Australian netballers returned to play within 1-7 days (Australia: 25 %, United Kingdom: 15 %, New Zealand: 21 %) and fewer United Kingdom netballers received return-to-play clearance (Australia: 28 %, United Kingdom: 10 %, New Zealand: 28 %). CONCLUSIONS Health-seeking behaviours are adopted by some, but not all netballers after an ankle sprain. For those who sought care, most consulted a physiotherapist and were prescribed exercise-based interventions and external ankle support, but few received return-to-play clearance. Comparing countries, United Kingdom netballers had lower health-seeking behaviours and received less best-practice management than Australian and New Zealand netballers.
Collapse
Affiliation(s)
- Patrick L Rowe
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/patrickrowe94
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/HinmanRana
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Kade L Paterson
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| |
Collapse
|
15
|
Maricot A, Dick E, Walravens A, Pluym B, Lathouwers E, De Pauw K, Verschueren J, Roelands B, Meeusen R, Tassignon B. Brain Neuroplasticity Related to Lateral Ankle Ligamentous Injuries: A Systematic Review. Sports Med 2023; 53:1423-1443. [PMID: 37155129 DOI: 10.1007/s40279-023-01834-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Lateral ankle sprains are the most common ankle injuries in sports and have the highest recurrence rates. Almost half of the patients experiencing lateral ankle sprains develop chronic ankle instability. Patients with chronic ankle instability experience persistent ankle dysfunctions and detrimental long-term sequelae. Changes at the brain level are put forward to explain these undesirable consequences and high recurrence rates partially. However, an overview of possible brain adaptations related to lateral ankle sprains and chronic ankle instability is currently lacking. OBJECTIVE The primary purpose of this systematic review is to provide a comprehensive overview of the literature on structural and functional brain adaptations related to lateral ankle sprains and in patients with chronic ankle instability. METHODS PubMed, Web of Science, Scopus, Embase, EBSCO-SPORTDiscus and Cochrane Central Register of Controlled Trials were systematically searched until 14 December, 2022. Meta-analyses, systematic reviews and narrative reviews were excluded. Included studies investigated functional or structural brain adaptations in patients who experienced a lateral ankle sprain or with chronic ankle instability and who were at least 18 years of age. Lateral ankle sprains and chronic ankle instability were defined following the recommendation of the International Ankle Consortium. Three authors independently extracted the data. They extracted the authors' name, publication year, study design, inclusion criteria, participant characteristics, the sample size of the intervention and control groups, methods of neuroplasticity testing, as well as all means and standard deviations of primary and secondary neuroplasticity outcomes from each study. Data reported on copers were considered as part of the control group. The quality assessment tool for observational and cross-sectional studies was used for the risk of bias assessment. This study is registered on PROSPERO, number CRD42021281956. RESULTS Twenty articles were included, of which only one investigated individuals who experienced a lateral ankle sprain. In all studies combined, 356 patients with chronic ankle instability, 10 who experienced a lateral ankle sprain and 46 copers were included. White matter microstructure changes in the cerebellum have been related to lateral ankle sprains. Fifteen studies reported functional brain adaptations in patients with chronic ankle instability, and five articles found structural brain outcomes. Alterations in the sensorimotor network (precentral gyrus and supplementary motor area, postcentral gyrus and middle frontal gyrus) and dorsal anterior cingulate cortex were mainly found in patients with chronic ankle instability. DISCUSSION The included studies demonstrated structural and functional brain adaptations related to lateral ankle sprains and chronic ankle instability compared to healthy individuals or copers. These adaptations correlate with clinical outcomes (e.g. patients' self-reported function and different clinical assessments) and might contribute to the persisting dysfunctions, increased re-injury risk and long-term sequelae seen in these patients. Thus, rehabilitation programmes should integrate sensorimotor and motor control strategies to cope with neuroplasticity related to ligamentous ankle injuries.
Collapse
Affiliation(s)
- Alexandre Maricot
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Emilie Dick
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Annemiek Walravens
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bert Pluym
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Elke Lathouwers
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Kevin De Pauw
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Jo Verschueren
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bart Roelands
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Romain Meeusen
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.
| |
Collapse
|
16
|
Wagemans J, Taeymans J, Kuppens K, Baur H, Bleakley C, Vissers D. Determining key clinical predictors for chronic ankle instability and return to sports with cost of illness analysis: protocol of a prospective cohort study. BMJ Open 2023; 13:e069867. [PMID: 37164478 PMCID: PMC10174038 DOI: 10.1136/bmjopen-2022-069867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Ankle sprains are common in sports and the general population. Although considered innocuous, a large proportion has residual complaints such as recurrent ankle sprains and develop chronic ankle instability. Although some predicting factors are identified, there is no unequivocality regarding the development of chronic ankle instability, nor about the optimal rehabilitation for an acute ankle sprain. Alongside the biomechanical impairments, ankle sprains are a burden on society due to substantial economic costs. Therefore, we aim to identify key clinical predictors of chronic ankle instability or recovery after acute lateral ankle sprain. Additionally, we aim to determine cost-of-illness of patients who developed chronic ankle instability. METHODS AND ANALYSIS This prospective cohort study (Clinicaltrials.gov: NCT05637008 - pre-results) aims to recruit adult (18-55 years) patients with an acute lateral ankle sprain who are active in sports. Clinical assessments and patient-reported outcome measures will be used to collect data at 7-14 days, 6 weeks, 12 weeks and 12 months after enrolment in the study. The primary outcome will be chronic ankle instability at 12-month follow-up. Salient outcomes will be analysed by logistic regression to determine association with the development of chronic ankle instability. Participants will fill in a cost diary containing direct and indirect costs related to their injury. ETHICS AND DISSEMINATIONS The ethical committee of the Antwerp University Hospital (B3002022000138) has given approval of the protocol and consent forms on 10 October 2022. We perform this study according to the Helsinki Declaration. We will present results at conferences or webinars and publish in peer-reviewed articles.NCT05637008.
Collapse
Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Jan Taeymans
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Heiner Baur
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Chris Bleakley
- School of Health Sciences, Faculty of Life and Health Science, Ulster University, Newtownabbey, UK
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| |
Collapse
|
17
|
Kubala JT, Pannill HL, Fasczewski KS, Rivera LA, Bouldin ED, Howard JS. Comparing the Primary Concerns of Injured Collegiate Athletes With the Content of Patient-Reported Outcome Measures. J Athl Train 2023; 58:252-260. [PMID: 35622954 PMCID: PMC10176840 DOI: 10.4085/1062-6050-0516.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Patient-reported outcome measures (PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations. OBJECTIVE To identify the primary concerns of collegiate athletes experiencing injury and compare those with the content of established PROMs. DESIGN Cross-sectional study. SETTING Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS Collegiate athletes experiencing injury (N = 149). MAIN OUTCOME MEASURE(S) Open-ended responses to the Measure Yourself Medical Outcome Profile were used to identify primary concerns, which were linked to International Classification of Functioning, Disability and Health taxonomy codes. Items of the Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; Lower Extremity Functional Scale; Knee injury and Osteoarthritis Outcome Score (KOOS); International Knee Documentation Committee Subjective Knee Form (IKDC); Foot and Ankle Ability Measure; Disabilities of the Arm, Shoulder, and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire were linked to International Classification of Functioning, Disability and Health codes. We calculated χ2 single-sample goodness-of-fit tests to determine if 70% of the content was shared between PROMs and participant-generated codes. RESULTS Participant-generated concerns were primarily related to sport participation (16%) and pain (23%). Chi-square tests showed that the Lower Extremity Functional Scale and Foot and Ankle Ability Measure presented significant content differences, with common participant-generated lower extremity responses at all levels. The Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; KOOS; IKDC; Disabilities of the Arm, Shoulder and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire did not have significant content differences for level 2 codes; still, significant differences were present for level 3 analyses except for the KOOS and IKDC (P < .001). All measures except the IKDC contained significant superfluous content (P < .05). CONCLUSIONS The presence of significant content differences supports clinician-perceived barriers regarding the relevance of established PROMs. However, the IKDC was a relevant and efficient PROM for evaluating the primary concerns of collegiate athletes experiencing lower extremity injury. Clinicians should consider using patient-generated measures to support coverage of patient-specific concerns in care.
Collapse
Affiliation(s)
| | - Heather L Pannill
- Rehabilitation Services, Appalachian Regional Healthcare System, Boone, NC
| | - Kimberly S Fasczewski
- Department of Public Health and Exercise Science, Appalachian State University, Boone, NC
| | - Laurie A Rivera
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
| | - Erin D Bouldin
- Department of Internal Medicine, University of Utah, Salt Lake City
| | - Jennifer S Howard
- Department of Rehabilitation Science, Appalachian State University, Boone, NC
| |
Collapse
|
18
|
Wagemans J, Bleakley C, Taeymans J, Kuppens K, Schurz AP, Baur H, Vissers D. Rehabilitation strategies for lateral ankle sprain do not reflect established mechanisms of re-injury: A systematic review. Phys Ther Sport 2023; 60:75-83. [PMID: 36716507 DOI: 10.1016/j.ptsp.2023.01.008] [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: 10/07/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES 1) determine the primary impairment addressed by each exercise included in exercise-based rehabilitation programs for patients with an acute ankle sprain; 2) Determine whether prescribed exercises incorporate complex tasks associated with ankle sprain injury mechanisms? METHODS We searched databases CINAHL, Web of Science, SPORTDiscus, Cochrane Register of Controlled Trials, PEDro, Google Scholar for RCT's including patients with acute ankle sprains, managed through exercise-based rehabilitation. Risk of bias was assessed by the Risk of Bias 2 tool. Exercises were analysed based on: the primary impairment(s) addressed; direction of movement; base of support; weightbearing status; flight phase. (PROSPERO: CRD42020210858) RESULTS: We included fourteen RCT's comprising 177 exercises. Neuromuscular function was addressed in 44% of exercises, followed by performance tasks (23%), and muscle strengthening (20%). Exercises were limited to movements across the sagittal plane (48%), with 31% incorporating multiplanar movements. Weight bearing exercises were almost divided equally between single-limb (59/122) and double leg stance exercises (61/122). Eighteen percent of all exercises incorporated a flight phase. CONCLUSIONS Rehabilitation after LAS comprises simple exercises in the sagittal plane that do not reflect mechanisms of re-injury. Future interventions should incorporate more open chain joint position sense training, multiplanar single limb challenges, and jumping and landing exercises.
Collapse
Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland. https://twitter.com/jentewagemans
| | - Chris Bleakley
- School of Health Science, Ulster University, Newtownabbey, Northern Ireland, UK
| | - Jan Taeymans
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; SOMT University of Physiotherpy Education, Amersfort, the Netherlands
| | | | - Heiner Baur
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| |
Collapse
|
19
|
Peroneal muscle activity during stable and unstable load exercises. A cross-sectional study. Phys Ther Sport 2023; 60:84-90. [PMID: 36738669 DOI: 10.1016/j.ptsp.2023.01.010] [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: 12/01/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the muscle activity of the peroneus longus during the execution of different unstable load exercises compared to stable load exercises. DESIGN Cross-sectional study. SETTING Functional Anatomy Laboratory. PARTICIPANTS 28 healthy athletes. MAIN OUTCOME MEASURES Surface electromyography (sEMG), unstable load (water tank), Stable Load (Sandbag), type of exercise (Isometric single leg stance, single-leg Romanian deadlift, front rack forward lunge and lateral lunge). RESULTS The repeated measures ANOVA revealed significant Group ∗ Time interaction in Root Mean Square (RMS) (F = 51.307, P < 0.001, ŋ2 = 0.70). In the between-group analysis there were statistically significant differences in RMS isometric single leg stance in favor to unstable load (P < 0.001, ŋ2 = 0.07). In the within-group analysis of RMS statistically significant differences were found in the stable load group between isometric single leg stance and single-leg Romanian deadlift (P < 0.001, ŋ2 = 0.05). CONCLUSIONS Single leg stance exercise with unstable load showed higher peroneus muscle activity than stable load. However, no peroneus muscle activity differences were found between unstable and stable loads for single-leg Romanian deadlift, frontal rack forward lunge and lateral lunge. Single-leg Romanian deadlift with stable load showed higher peroneus muscle activity than isometric single leg stance with stable load.
Collapse
|
20
|
Impairment-based assessments for patients with lateral ankle sprain: A systematic review of measurement properties. PLoS One 2023; 18:e0280388. [PMID: 36812288 PMCID: PMC9946235 DOI: 10.1371/journal.pone.0280388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023] Open
Abstract
STUDY DESIGN Systematic review. BACKGROUND AND OBJECTIVE The International Ankle Consortium developed a core outcome set for the assessment of impairments in patients with lateral ankle sprain (LAS) without consideration of measurement properties (MP). Therefore, the aim of this study is to investigate MPs of assessments for the evaluation of individuals with a history of LAS. METHODS This systematic review of measurement properties follows PRISMA and COSMIN guidelines. Databases Pubmed, CINAHL, Embase, Web of Science, Cochrane Library and SPORTDiscus were searched for eligible studies (last search: July 2022). Studies on MP of specific tests and patient-reported outcome measurements (PROMs) in patients with acute and history of LAS (>4 weeks post injury) were deemed eligible. RESULTS Ten studies of acute LAS and 39 studies of history of LAS patients with a total of 3313 participants met the inclusion criteria. Anterior Drawer Test (ADT) in supine position five days post injury and Reverse Anterolateral Drawer Test are recommended in acute settings in single studies. In the history of LAS patients, Cumberland Ankle Instability Tool (CAIT) (4 studies) as a PROM, Multiple Hop (3 studies) and Star Excursion Balance Tests (SEBT) (3 studies) for dynamic postural balance testing showed good MPs. No studies investigated pain, physical activity level and gait. Only single studies reported on swelling, range of motion, strength, arthrokinematics, and static postural balance. Limited data existed on responsiveness of the tests in both subgroups. CONCLUSION There was good evidence to support the use of CAIT as PROM, Multiple Hop, and SEBT for dynamic postural balance testing. Insufficient evidence exists in relation to test responsiveness, especially in the acute situation. Future research should assess MPs of assessments of other impairments associated with LAS.
Collapse
|
21
|
Patients Experience Significant and Meaningful Changes in Self-Report of Function During the First 2 Weeks After an Ankle Sprain Injury: A Report From the Athletic Training Practice-Based Research Network. J Sport Rehabil 2023; 32:117-123. [PMID: 35926848 DOI: 10.1123/jsr.2022-0014] [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: 01/11/2022] [Revised: 05/11/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT Ankle sprains are common during sport participation and associated with long-term deficits in self-report of function. However, little is known of short-term changes in self-report of function following injury. The authors aimed to assess statistical and clinically meaningful changes in self-report of function, as measured by the Foot and Ankle Ability Measure (FAAM), during the first 2 weeks after an ankle sprain injury. DESIGN A retrospective analysis of electronic medical records. METHODS Eighty-eight patients, who were diagnosed with an ankle sprain injury by an athletic trainer, received usual care from an athletic trainer, and completed the FAAM during treatment at weeks 1 and 2 postinjury. The authors calculated the percentage of patients who reported clinically meaningful changes and used Wilcoxon signed-rank tests to compare differences in FAAM scores between time points. RESULTS Between weeks 1 and 2, significant differences were noted for the FAAM Activities of Daily Living (FAAM-ADL) (P < .001) and FAAM Sport (FAAM-Sport) (P < .001). At the patient level, 86.5% (64/74) and 85.2% (69/81) of patients reported changes that exceeded the minimal clinically important difference value for the FAAM-ADL and FAAM-Sport, respectively, between weeks 1 and 2. At week 2, 31.8% (28/88) and 47.7% (42/88) of patients reported a score below 90% on the FAAM-ADL and below 80% on the FAAM-Sport subscale, respectively. Also, 36.4% (32/88) and 25.0% (22/88) of patients reported a score of 100% on the FAAM-ADL and FAAM-Sport subscales, respectively, at week 2. CONCLUSIONS Patients report statistically significant and meaningful improvements in self-report of function during the first 2 weeks following ankle sprain injury. However, almost half of patients still report deficits in sport function at 2 weeks postinjury. Patient-reported outcome measures such as the FAAM, can help capture the patient's perception of function and inform patient care decisions. Research efforts should explore individual response patterns to treatment.
Collapse
|
22
|
Short S, Tuttle M, Youngman D. A Clinically-Reasoned Approach to Manual Therapy in Sports Physical Therapy. Int J Sports Phys Ther 2023; 18:262-271. [PMID: 36793565 PMCID: PMC9897024 DOI: 10.26603/001c.67936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/03/2022] [Indexed: 02/05/2023] Open
Abstract
Symptom modification techniques have been recently dichotomously labeled as either passive or active therapies. Active therapy such as exercise has been rightfully advocated for while "passive" therapies, mainly manual therapy have been regarded as low value within the physical therapy treatment spectrum. In sporting environments where physical activity and exercise are inherent to the athletic experience, the utilization of exercise-only strategies to manage pain and injury can be challenging when considering the demands and qualities of a sporting career which include chronically high internal and external workloads. Participation may be impacted by pain and its influence on related factors such as training and competition performance, career length, financial earning potential, educational opportunity, social pressures, influence of family, friends, and other key stakeholders of their athletic activity. Though highly polarizing viewpoints regarding different therapies create black and white "sides," a pragmatic gray area regarding manual therapy exists in which proper clinical reasoning can serve to improve athlete pain and injury management. This gray area includes both historic positive reported short-term outcomes and negative historical biomechanical underpinnings that have created unfounded dogma and inappropriate overutilization. Applying symptom modification strategies to safely allow the continuation of sport and exercise requires critical thinking utilizing not only the evidence-base, but also the multi-factorial nature of sports participation and pain management. Given the risks associated with pharmacological pain management, the cost of passive modalities like biophysical agents (electrical stimulation, photobiomodulation, ultrasound, etc), and the indications from the evidence-base when combined with active therapies, manual therapy can be a safe and effective treatment strategy to keep athletes active. Level of Evidence 5.
Collapse
|
23
|
Acute and Overuse, Time-Loss and Non-Time-Loss Lateral Ankle Sprains and Health Care Utilization in Collegiate Student-Athletes. J Sport Rehabil 2023; 32:133-144. [PMID: 36070860 DOI: 10.1123/jsr.2022-0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/08/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT Health care utilization and the occurrence of non-time-loss (NTL) lateral ankle sprains is not well documented in collegiate athletes but could provide better estimates of injury burden and inform clinician workload. DESIGN Descriptive epidemiologic study. METHODS Lateral ankle sprain injury occurrence for Division I collegiate student-athletes in a conference with 32 sports representing 732 team seasons was collected during the 2018-2019 through 2020-2021 academic years. Injuries were designated as acute or overuse, and time-loss (TL) or NTL. Associated health care utilization, including athletic training services (AT services), and physician encounters were reported along with anatomical structures involved and season of occurrence. RESULTS A total of 1242 lateral ankle sprains were reported over the 3 years from 732 team seasons and 17,431 player seasons, resulting in 12,728 AT services and 370 physician encounters. Most lateral ankle sprains were acute-TL (59.7%), which were associated with the majority of AT services (74.1%) and physician encounters (70.0%). Acute-NTL sprains represented 37.8% of lateral ankle sprains and were associated with 22.3% of AT services and 27.0% of physician encounters. On average, there were 12.7 (5.8) AT services per acute-TL sprain and 6.0 (3.6) per acute-NTL sprain. Most sprains involved "ankle lateral ligaments" (45.6%), and very few were attributed to overuse mechanisms (2.4%). CONCLUSIONS Lateral ligament sprains are a common injury across many sports and result in substantial health care utilization from ATs and physicians, including NTL lateral ankle sprains. Although TL injuries were the majority of sprains, a substantial proportion of sprains were NTL and accounted for a considerable proportion of health care utilization.
Collapse
|
24
|
Geldenhuys AG, Burgess T, Roche S, Hendricks S. Return to rugby following musculoskeletal injuries: A survey of views, practices and barriers among health and sport practitioners. Phys Ther Sport 2023; 59:49-59. [PMID: 36508771 DOI: 10.1016/j.ptsp.2022.11.009] [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: 10/10/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
STUDY DESIGN AND SETTING Returning rugby players to the sport following musculoskeletal injuries is a multi-factorial and challenging process. A cross-sectional observational study was conducted among health and sport practitioners involved with injured rugby players in South Africa. OBJECTIVES AND OUTCOME MEASURES The views, current practices and barriers encountered by health and sport practitioners during return to rugby were investigated using a self-developed online survey. RESULTS 64 practitioners participated in the survey including physiotherapists, orthopaedic surgeons, biokineticists and sports physicians. Return to sport (RTS) protocols were considered important, however, participants also indicated that they were slightly more likely to use anecdotal protocols compared to published protocols. Time frames, stages of healing, pain and subjective ratings along with functional outcome measures (such as range of motion, muscle function and proprioception) and sport-specific skills were rated as important and commonly utilised in different RTS phases (i.e., return to non-contact, return to contact and return to matches). The most commonly perceived barriers encountered were related to lack of access and time-constraints. CONCLUSION Return to rugby guidelines with consideration of a broad range of criteria and common barriers encountered should be developed to facilitate safe, practical and time-efficient return to rugby following musculoskeletal injuries.
Collapse
Affiliation(s)
- A Grethe Geldenhuys
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Theresa Burgess
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Centre for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephen Roche
- Orthopaedic Research Unit, Department of Orthopaedic Surgery, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sharief Hendricks
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Health through Physical Activity, Lifestyle and Sport (HPALS) Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Carnegie Applied Rugby Research (CARR) Centre, Institute for Sport Physical Activity and Leisure, Leeds Beckett University, Leeds, United Kingdom
| |
Collapse
|
25
|
Flore Z, Hambly K, De Coninck K, Welsch G. Time-loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta-analysis. Scand J Med Sci Sports 2022; 32:1690-1709. [PMID: 35904448 PMCID: PMC9804772 DOI: 10.1111/sms.14217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 01/09/2023]
Abstract
A literature search was conducted to systematically review and meta-analyze time-loss and recurrence rate of lateral ankle sprains (LAS) in male professional football players. Six electronic databases (PubMed, Scopus, Web of Science, PEDRO, CINAHL, and Cochrane) were searched independently, separately both for time-loss and recurrence from inception until April 30, 2021. In addition, reference lists were screened manually to find additional literature. Cohort studies, case reports, case-control studies and RCT in English language of male professional football players (aged more than 16 years) for which data on time-loss or recurrence rates of LAS were available were included. A total of 13 (recurrence) and 12 (time-loss) studies met the inclusion criteria. The total sample size of the recurrence studies was 36,201 participants (44,404 overall initial injuries; 7944 initial ankle sprain [AS] injuries, 1193 recurrent AS injuries). 16,442 professional football players (4893 initial AS injuries; 748 recurrent AS injuries) were meta-analyzed. A recurrence rate of 17.11% (95% CI: 13.31-20.92%; df = 12; Q = 19.53; I2 = 38.57%) based on the random-effects model was determined. A total of 7736 participants were part of the time-loss studies (35,888 total injuries; 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time-loss was 15 days (weighted mean: 15.92; median: 14.95; min: 9.55; max: 52.9). We determined a priori considerable heterogeneity (CI: 18.15-22.08; df = 11; Q = 158; I2 = 93%), so that the data on time-loss are only presented descriptively. There is an average time-loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with higher recurrence rates than ACL injuries (9%-12%) in professional football players. Nevertheless, the focus of research in recent years has been mostly on ACL injuries. However, the high recurrence rates and long-term consequences show the necessity for research in the field of LAS in elite football. Yet, heterogeneous data lead to difficulties concerning the aspect of comparability.
Collapse
Affiliation(s)
- Zacharias Flore
- University of Kent, School of Sport and Exercise SciencesCanterburyUK,Hamburger SV, Fußball AGHamburgGermany,University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany
| | - Karen Hambly
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Kyra De Coninck
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Götz Welsch
- University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany,Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| |
Collapse
|
26
|
Ruan Y, Song SJ, Yin ZF, Wang M, Huang N, Gu W, Ling CQ. Comprehensive evaluation of military training-induced fatigue among soldiers in China: A Delphi consensus study. Front Public Health 2022; 10:1004910. [PMID: 36523578 PMCID: PMC9745162 DOI: 10.3389/fpubh.2022.1004910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Military training-induced fatigue (MIF) often results into non-combat attrition. However, standard evaluation of MIF is unavailable. This study aimed to provide credible suggestions about MIF-evaluation. Methods A 3-round Delphi study was performed. The authority of the experts was assessed by the authority coefficient (Aa). In round 1, categories of indicators were collected via anonymous survey of experts, then potential indicators were selected via literature search. In round 2, experts should evaluate the clinical implication, practical value, and importance of each potential indicators, or recommend new indicators based on feedback of round 1. Indicators with recommendation proportions ≥ 70% and new recommended indicators would be included in round 3 to be rated on a 5-point Likert scale. "Consensus in" was achieved when coefficient of concordance (Kendall's W) of a round was between 0.2 and 0.5 and the coefficient of variation (CV) of each aspect for an indicator was < 0.5. If round 3 could not achieve "consensus in," more rounds would be conducted iteratively based on round 3. Indicators included in the recommendation set were ultimately classified into grade I (highly recommended) or grade II (recommended) according to the mean score and CV of the aspects. Results Twenty-three experts participated with credible authority coefficient (mean Aa = 0.733). "Consensus in" was achieved in round 3 (Kendall's W = 0.435, p < 0.001; all CV < 0.5). Round 1 recommended 10 categories with 73 indicators identified from 2,971 articles. After 3-round consultation, consensus was reached on 28 indicators focusing on the cardiovascular system (n = 4), oxygen transport system (n = 5), energy metabolism/metabolite level (n = 6), muscle/tissue damage level (n = 3), neurological function (n = 2), neuropsychological/psychological function (n = 3), endocrine function (n = 3), and exercise capacity (n = 2). Among these, 11 indicators were recommended as grade I: basic heart rate, heart-rate recovery time, heart rate variability, hemoglobin, blood lactic acid, urine protein, creatine kinase, reaction time, Borg Rating of Perceived Exertion Scale, testosterone/cortisol, and vertical jump height. Conclusion This study developed a reliable foundation for the comprehensive evaluation of MIF among soldiers.
Collapse
Affiliation(s)
- Yi Ruan
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,PLA Naval Medical Center, Shanghai, China
| | - Shang-jin Song
- Department of Traditional Chinese Medicine, Xingcheng Sanatorium of PLA Strategic Support Force, Xingcheng, China
| | - Zi-fei Yin
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Man Wang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Nian Huang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,*Correspondence: Wei Gu ;
| | - Chang-quan Ling
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China,Chang-quan Ling
| |
Collapse
|
27
|
Koshino Y, Kobayashi T. Effects of Conservative Interventions on Static and Dynamic Balance in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2022; 104:673-685. [PMID: 36417970 DOI: 10.1016/j.apmr.2022.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine which conservative interventions are effective for static and dynamic balance in patients with chronic ankle instability (CAI). DATA SOURCES PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to March 20, 2022. STUDY SELECTION Randomized controlled trials investigating the effects of conservative interventions on static and/or dynamic balance in patients with CAI compared with those of different conservative interventions or controls were included. DATA EXTRACTION Two independent reviewers extracted the data. Certainty of the evidence was assessed using the GRADE approach. DATA SYNTHESIS Forty-eight studies (1906 participants) were included. Whole-body vibration training (WBVT) was significantly more effective than controls for both static (standardized mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance training (BT) and joint mobilization were significantly more effective than controls for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively), but not for static balance (very low to low-certainty evidence). Adding other interventions to BT had no significant effect on either type of balance compared with that of BT alone (moderate to low-certainty evidence). Strength training (ST) and taping had no significant effect on either type of balance (very low- to low-certainty evidence). Multimodal interventions were significantly effective in improving dynamic balance (0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current stimulation to ST was significantly more effective for dynamic balance than ST (0.81; CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly different among BT, ST, and WBVT (very low- to low-certainty evidence). CONCLUSIONS The significantly effective interventions reviewed may be treatment options for balance impairments associated with CAI. However, interventions should be chosen carefully, as much of the certainty of evidence is very low to low.
Collapse
Affiliation(s)
- Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Takumi Kobayashi
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| |
Collapse
|
28
|
Picot B, Hardy A, Terrier R, Tassignon B, Lopes R, Fourchet F. Which Functional Tests and Self-Reported Questionnaires Can Help Clinicians Make Valid Return to Sport Decisions in Patients With Chronic Ankle Instability? A Narrative Review and Expert Opinion. Front Sports Act Living 2022; 4:902886. [PMID: 35721875 PMCID: PMC9204606 DOI: 10.3389/fspor.2022.902886] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/04/2022] [Indexed: 12/26/2022] Open
Abstract
Lateral ankle sprain is the most common injury in sports, with up to 40% of patients developing chronic ankle instability (CAI). One possible cause underlying this high rate of recurrence or feeling of giving way may be a premature return to sport (RTS). Indeed, except for time-based parameters, there are no specific criteria to guide clinicians in their RTS decisions in patients with CAI. A recent international consensus highlighted the relevance and importance of including patient-reported ankle function questionnaires combined with functional tests targeting ankle impairments in this population. Thus, the aim of this narrative review and expert opinion was to identify the most relevant functional performance tests and self-reported questionnaires to help clinicians in their RTS decision-making process following recurrent ankle sprains or surgical ankle stabilization. The PubMed (MEDLINE), PEDro, Cochrane Library and ScienceDirect databases were searched to identify published articles. Results showed that the single leg stance test on firm surfaces, the modified version of the star excursion balance test, the side hop test and the figure-of-8 test appeared to be the most relevant functional performance tests to target ankle impairments in patients with CAI. A combination of the Foot and Ankle Ability Measure (FAAM) and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) questionnaires were the most relevant self-reported questionnaires to assess patient function in the context of CAI. Although these functional tests and questionnaires provide a solid foundation for clinicians to validate their RTS decisions in patient with CAI, objective scientific criteria with cut-off scores are still lacking. In addition to the proposed test cluster, an analysis of the context, in particular characteristics related to sports (e.g., fatigue, cognitive constraints), to obtain more information about the patient's risk of recurrent injury could be of added value when making a RTS decision in patients with CAI. In order to evaluate the strength of evertors under ecological conditions, it would also be interesting to assess the ability to control weight-bearing ankle inversion in a unipodal stance. Further studies are needed to assess the relevance of this proposed test cluster in RTS decision-making following lateral ankle sprain injury and CAI.
Collapse
Affiliation(s)
- Brice Picot
- French Handball Federation, Creteil, France
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Inter-University Laboratory of Human Movement Biology (LIBM), Savoie Mont-Blanc University, Chambéry, France
- *Correspondence: Brice Picot
| | | | - Romain Terrier
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Inter-University Laboratory of Human Movement Biology (LIBM), Savoie Mont-Blanc University, Chambéry, France
- SARL Whergo, Savoie Technolac (BP 80218), La Motte-Servolex, France
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronny Lopes
- Santé Atlantique, Pied Cheville Nantes Atlantique, Nantes, France
| | - François Fourchet
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Motion Analysis Lab, Physiotherapy Department, La Tour Hospital, Swiss Olympic Medical Center, Meyrin, Switzerland
| |
Collapse
|
29
|
Mendonça LDM, Schuermans J, Denolf S, Napier C, Bittencourt NF, Romanuk A, Tak I, Thorborg K, Bizzini M, Ramponi C, Paterson C, Hägglund M, Malisoux L, Al Attar WSA, Samukawa M, Esteve E, Bakare U, Constantinou M, Schneiders A, Cavallieri Gomes A, Florentz D, Ozer Kaya D, Indra Lesmana S, Harøy J, Kuparinen V, Philips N, Jenkins W, Wezenbeek E, Witvrouw E. Sports injury prevention programmes from the sports physical therapist's perspective: An international expert Delphi approach. Phys Ther Sport 2022; 55:146-154. [DOI: 10.1016/j.ptsp.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
|
30
|
Toyoshima Y, Akagi R, Nabeshima K. Isometric exercise during immobilization reduces the time to return to play after lateral ankle sprain. Phys Ther Sport 2021; 52:168-172. [PMID: 34547600 DOI: 10.1016/j.ptsp.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
[Objectives] Immobilization reduces symptoms after lateral ankle sprain but may worsen the range of motion (ROM) of the ankle and delay return to play (RTP). We aimed to elucidate the correlation between ankle ROM and time to RTP following immobilization for lateral ankle sprain and investigated if isometric exercise during immobilization would increase ROM and shorten the time to RTP. [Participants and outcome measures] Eighty-two patients with acute lateral ankle sprain were treated by a short-leg cast with or without isometric exercise and electrical muscle stimulation (EMS); intervention group or control group, respectively. The correlation between ankle ROM at cast removal and time to RTP was analyzed. The total and side-to-side ankle ROM and the time to RTP were compared between the two groups. [Results] Side-to-side difference in total ankle ROM significantly correlated with time to RTP (r = 0.38, p = 0.02). The intervention reduced the side-to-side difference in total ROM (20° versus 31°, p = 0.01) and time to RTP (46 versus 65 days, p = 0.01) compared to the control group. [Conclusion] Increased deficiency in ankle ROM led to a longer time to RTP, and isometric exercise combined with EMS during immobilization increased the total ankle ROM and shortened the time to RTP.
Collapse
Affiliation(s)
- Yasunao Toyoshima
- Health and Sports Association Nabeshima Orthopaedic Clinic, 4-23-2 Matsunami, Chuo-ku, Chiba, Chiba, 260-0044, Japan
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan; Sportsmedics Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
| | - Kazuo Nabeshima
- Health and Sports Association Nabeshima Orthopaedic Clinic, 4-23-2 Matsunami, Chuo-ku, Chiba, Chiba, 260-0044, Japan
| |
Collapse
|
31
|
Rowe PL, Bryant AL, Paterson KL. Current ankle sprain prevention and management strategies of netball athletes: a scoping review of the literature and comparison with best-practice recommendations. BMC Sports Sci Med Rehabil 2021; 13:113. [PMID: 34537083 PMCID: PMC8449445 DOI: 10.1186/s13102-021-00342-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/11/2021] [Indexed: 11/20/2022]
Abstract
Background Ankle sprains are the most commonly reported injury in netball. Approximately four in five netball athletes will sustain an ankle sprain, up to half will go on to sustain recurrent ankle sprains, and nine in ten report perceived ankle instability. Historically, prevention and management strategies of ankle sprains and injuries have been investigated for a variety of sports, however, no literature reviews have investigated these in netball athletes, or compared these with current best-practice within the literature. Therefore, this scoping review aims to understand how netball athletes currently prevent and manage ankle sprains and to compare these approaches with best-practice recommendations. Methods A literature search was conducted using MEDLINE, CINAHL, and SPORTDiscus databases using keywords to capture studies with data or information related to the prevention and management of ankle sprains and injuries in netball. Results The search strategy captured 982 studies across all databases, with 30 netball studies included in this scoping review. Studies suggest netball athletes are not commonly referred to health professionals, do not undertake adequate rehabilitation, and almost immediately return to court following an ankle sprain or injury. Current best-practices suggest injury prevention programs and external ankle support effectively reduce ankle sprains and injuries; however, poor compliance and implementation may be a significant barrier. Currently, there is a lack of evidence that netball-specific footwear reduces the risk of ankle sprains. Conclusion The findings suggest netball athletes do not implement current best-practice prevention and management strategies following an ankle sprain. This is despite evidence of the effectiveness of injury prevention programs, external ankle support, and adequate rehabilitation in reducing ankle sprain rates. Current-best practice prevention and management of ankle sprains should be considered by clinicians, coaches, and athletes to reduce the prevalence and chronicity of ankle sprains in netball. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00342-9.
Collapse
Affiliation(s)
- Patrick L Rowe
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Adam L Bryant
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Kade L Paterson
- Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|