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DeJong Lempke AF, Stephens SL, Thompson XD, Hart JM, Hryvniak DJ, Rodu JS, Hertel J. Transference of outdoor gait-training to treadmill running biomechanics and strength measures: A randomized controlled trial. J Biomech 2024; 168:112095. [PMID: 38636111 DOI: 10.1016/j.jbiomech.2024.112095] [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: 01/17/2024] [Revised: 03/12/2024] [Accepted: 04/14/2024] [Indexed: 04/20/2024]
Abstract
Outdoor gait-training has been successful in improving pain and reducing contact time during outdoor running for runners with exercise-related lower leg pain (ERLLP). However, it is unclear if these adaptations translate to gold standard treadmill running and clinical strength assessments. The study purpose was to assess the influence of a 4-week outdoor gait-training intervention with home exercises (FBHE) on treadmill running biomechanics and lower extremity strength compared to home exercises alone (HE) among runners with ERLLP. Seventeen runners with ERLLP were randomly allocated to FBHE and HE groups (FBHE: 3 M, 6F, 23 ± 4 years, 22.0 ± 4.6 kg/m2; HE: 3 M, 5F, 25 ± 5 years, 24.0 ± 4.0 kg/m2). Both groups completed eight sessions of home exercises over 4 weeks. The FBHE group received gait-training through wearable sensors to reduce contact time. Treadmill running gait and clinical strength assessments were conducted at baseline and 4-weeks. Multivariate repeated measures analyses of variance were used to assess the influence of group and timepoint for all outcomes. The FBHE group demonstrated significantly decreased contact time at 4-weeks compared to baseline and the HE group (Mean Difference [MD] range: -42 ms - -39 ms; p-range: <0.001-0.02). The FBHE group had significantly increased cadence (MD: +21 steps/min; p = 0.003) and decreased loading impulse (MD: -51, p < 0.001) during treadmill running at 4-weeks compared to the HE group. Strength did not significantly differ adjusting for multiple comparisons (p > 0.007). The outdoor FBHE intervention transferred to favorable changes in treadmill running biomechanics. Clinicians treating runners with ERLLP patients should implement data-driven outdoor gait-training to maximize patient benefits across running locations.
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Affiliation(s)
- Alexandra F DeJong Lempke
- Virginia Commonwealth University, School of Medicine, Department of Physical Medicine and Rehabilitation, Richmond, VA, USA.
| | - Stephanie L Stephens
- Plymouth State University, Health and Human Performance, Plymouth, New Hampshire, USA
| | - Xavier D Thompson
- University of Virginia, School of Education and Human Development Department of Kinesiology, Charlottesville, VA, USA
| | - Joseph M Hart
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
| | - David J Hryvniak
- University of Virginia Health Systems, Outpatient Physical and Occupational Therapy at Fontaine Building 515, Charlottesville, VA, USA
| | - Jordan S Rodu
- University of Virginia, College of Arts and Sciences Department of Statistics, Charlottesville, VA, USA
| | - Jay Hertel
- University of Virginia, School of Education and Human Development Department of Kinesiology, Charlottesville, VA, USA
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Dong Y, Cao S, Qian D, Yu H, Song Z, Jia C, Hu W, Zhang X. Simplified Chinese version of the core outcome measures index (COMI) for patients with neck pain: cross-cultural adaptation and validation. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:386-393. [PMID: 38180515 DOI: 10.1007/s00586-023-08088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 08/30/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE The aim of this study was to translate and cross-culturally adapt the Core Outcome Measures Index for (COMI) into a Simplified Chinese version (COMI-SC) and to evaluate the reliability and validity of COMI-SC in patients with neck pain. METHODS The COMI-neck was translated into Chinese according to established methods. The COMI-neck questionnaire was then completed by 122 patients with a hospital diagnosis of neck pain. Reliability was assessed by calculating Cronbach's alpha and intraclass correlation coefficient (ICC). Construct validity was assessed by correlating the COMI-neck with the Neck Pain and Disability Scale (NPDS), the Neck Disability Index (NDI), the VAS and the Short Form (36) Health Survey (SF-36). Using confirmatory factor analysis to validate the structural, convergent and discriminant validity of the questionnaire. RESULTS The COMI-neck total scores were well distributed, with no floor or ceiling effects. Internal consistency was excellent (Cronbach's alpha = 0.861). Moderate to substantial correlations were found between COMI-neck and NPDS (r = 0.420/0.416/0.437, P < 0.001), NDI (r = 0.890, P < 0.001), VAS (r = 0.845, P < 0.001), as well as physical function (r = - 0.989, P < 0.001), physical role (r = - 0.597, P < 0.001), bodily pain (r = - 0. 639, P < 0.001), general health (r = - 0.563, P < 0.001), vitality (r = - 0.702, P < 0.001), social functioning (r = - 0.764, P < 0.001), role emotional (r = - 0.675, P < 0.001) and mental health (r = - 0.507, P < 0.001) subscales of the SF-36. An exploratory factor analysis revealed that the 3-factor loading explained 71.558% of the total variance [Kaiser-Mayer-Olkin (KMO) = 0.780, C2 = 502.82, P < 0.001]. CMIN/DF = 1.813, Tucker-Lewis index (TLI) = 0.966 (> 0.9), Comparative Fit Index (CFI) = 0.982 (> 0.9), Normed Fit Index (NFI) = 0.961 (> 0.9), RMSEA = 0.082 (< 0.5) indicating that the model fits well. CONCLUSION COMI-neck was shown to have acceptable reliability and validity in patients with non-specific chronic neck pain and could be recommended for patients in mainland China. LEVEL OF EVIDENCE Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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Affiliation(s)
- Yuan Dong
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
- Chinese PLA Medical School, Beijing, People's Republic of China
| | - Shiqi Cao
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
- Department of Orthopaedics of TCM Clinical Unit, 6th Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Dingfei Qian
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
- Chinese PLA Medical School, Beijing, People's Republic of China
| | - Haichao Yu
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
- School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Zelong Song
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
- School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Chengqi Jia
- Department of Orthopedics, Beijing Jishuitan Hospital, Beijing, 100035, People's Republic of China
| | - Wenhao Hu
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China
| | - Xuesong Zhang
- Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
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DeJong Lempke AF, Jackson S, Stracciolini A, D'Hemecourt PA, Meehan WP, Whitney KE. Adolescent exercise-related lower leg pain musculotendinous characteristics. PM R 2023; 15:1392-1402. [PMID: 36749145 DOI: 10.1002/pmrj.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/18/2023] [Accepted: 01/29/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Exercise-related lower leg pain (ERLLP) is one of the most common injuries among adolescent runners; however, there is limited information available on lower extremity musculotendinous characteristics in relationship to injury. Ultrasound imaging has previously been used to evaluate musculotendinous structures among adults with chronic lower limb injuries. Similar measurement approaches may be adopted to assess young runners with ERLLP. OBJECTIVE To compare ultrasound-derived lower extremity musculotendinous thickness, echogenicity, and muscle fiber pennation angles between adolescent runners with and without ERLLP. DESIGN Cross-sectional design. SETTING Hospital-affiliated sports injury prevention center. PARTICIPANTS Twenty-eight adolescent runners with (N = 14) and without ERLLP (N = 14). INTERVENTIONS Runners' patellar and Achilles tendons, and tibialis anterior, medial gastrocnemius, abductor hallicus, and flexor digitorum brevis muscles were assessed with ultrasound imaging using standardized procedures. MAIN OUTCOME MEASURES Separate repeated measures multivariate analyses of covariance (covariate: gender) were used to compare groups and limbs for mass-normalized musculotendinous thickness, musculotendinous echogenicity, and extrinsic ankle muscle fiber pennation angles. RESULTS The adolescent ERLLP group had reduced average muscle size for all structures except the tibialis anterior compared to the uninjured group (mean difference [MD] range: -0.12-0.49 mm/kg; p range: .002-.05), and reduced average medial gastrocnemius pennation angles on their case limb compared to their contralateral limb and the uninjured group (MD range: -3.7-6.4°; p < .001). The ERLLP group additionally had reduced average patellar and Achilles tendon size (MD range: -0.14--0.15 mm/kg; p range: .02-.03), and lower Achilles tendon echogenicity compared to uninjured counterparts (MD: -18; p = .02). CONCLUSIONS Adolescent runners with ERLLP exhibited morphological musculotendinous changes that may occur either as a result of or as a contributing factor to pain and persistent dysfunction. The findings highlight key targets for rehabilitation for young, injured runners, particularly intrinsic foot muscle strengthening.
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Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sarah Jackson
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Pierre A D'Hemecourt
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Jia CQ, Wu YJ, Hu FQ, Yang XQ, Zhang Z, Cao SQ, Zhang XS. Cross-cultural adaptation and validation of the simplified Chinese version of the Exercise-Induced Leg Pain Questionnaire (EILP). Disabil Rehabil 2023; 45:3930-3936. [PMID: 36286230 DOI: 10.1080/09638288.2022.2138991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 10/09/2022] [Accepted: 10/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the Exercise-Induced Leg Pain Questionnaire (SC-EILP) for evaluating the severity of symptoms and sports ability among individuals with exercise-induced leg pain. MATERIALS AND METHODS One hundred and fourteen participants with exercise-induced leg pain were included. To assess reliability, we calculated Cronbach's α and intra-class correlation coefficient (ICC). Construct validity was analysed by assessing the correlations between SC-EILP and visual analogue scale (VAS), University of California Los Angeles activity score (UCLA), and short form (36) health survey (SF-36). Factorial validity was used to establish the factor structure of the questionnaire. RESULTS The EILP was cross-culturally well-adapted and translated into simplified Chinese. Each item was appropriately correlated with the total items. SC-EILP had nearly good reliability [Cronbach's α = 0.798, ICC = 0.897, 95% confidence interval 0.851-0.929]. The elimination of any one item in all did not result in a value of Cronbach's α of <0.80. SC-EILP had a very good correlation with VAS (-0.607, p < 0.01) and a moderate correlation with UCLA (0.581, p < 0.01) and physical domains of SF-36 (0.499-0.528, p < 0.01). Exploratory factor analysis revealed the 3-factor loading explained 74.736% of the total variance [Kaiser-Mayer-Olkin (KMO) = 0.672, C2 = 665.34, p < 0.001]. CONCLUSIONS SC-EILP showed excellent acceptability, internal consistency, reliability, and construct validity, and could be recommended for individuals in Mainland China.
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Affiliation(s)
- Cheng-Qi Jia
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yu-Jie Wu
- Department of Nursing, The Third People's Hospital of Datong, Datong, China
| | - Fan-Qi Hu
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Qing Yang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Zhen Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Shi-Qi Cao
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics of TCM Clinical Unit, 6th Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xue-Song Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
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Lohrer H, Wagner S, Wenning M, Kühle J, Schmal H, Gollhofer A. Development and validation of a questionnaire to measure the severity of pain, functional limitations, and reduction of sports ability for german-speaking patients with osteochondral lesions of the ankle (OCLA-G). BMC Musculoskelet Disord 2023; 24:340. [PMID: 37127617 PMCID: PMC10150525 DOI: 10.1186/s12891-023-06445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND There is no patient-reported functional scale specific for osteochondral lesion of the ankle (OCLA). Therefore, the objectives of this study were to develop a questionnaire that measures symptom severity, function, and sports capacity in patients with osteochondral lesions of the ankle and to determine the psychometric properties of the tool in German language (OCLA-G). METHODS The OCLA-G questionnaire was developed according to the COSMIN guidelines. Scalable items were generated from a literature search, based on an evaluation of 71 own OCLA patients, and from expert opinions. Following a twofold item reduction the questionnaire underwent explorative data analysis and principal component analysis. Validity and reliability were analysed in four groups of participants (40 patients with OCLA, 40 patients with other foot and ankle injuries, 40 asymptomatic athletes serving as a population at risk, and 40 asymptomatic persons playing sports not at risk). The minimum age for participation in the study was set at 18 years. The mean age was 39.3 ± 15.1 years. RESULTS The final OCLA-G questionnaire consists of eight and five questions to mirror activities of daily life (ADL) and sports, respectively. Excellent internal consistency (Cronbach's α = 0.950 for the ADL subscore and 0.965 for the sport subscale, respectively) was found. Spearman's rank correlation coefficients for test-retest reliability were 0.992 for the ADL subscore and 0.999 for the sport subscale (p < 0.001). The results of the exploratory and confirmatory factor analyses indicated that item difficulty was between 23.4 and 62.8. The Pearson correlation for the OCLA subscales ADL and sport was 0.853 (p < 0.001). Construct validity as tested against the SF-12 questionnaire subscales (Physical and Mental component scale) were r = -0.164 to -0.663 (p < 0.05). Statistically, there was no ADL and sport OCLA mean score difference between OCLA patients and patients with other foot and ankle injuries (p = 0.993 and 0.179, respectively), but both groups differed from the uninjured control groups (p < 0.001). There were no ceiling or floor effects. CONCLUSIONS The OCLA-G was successfully developed as the first patient reported and injury specific outcome scale to measure the impact of OCLA induced symptoms on activities of daily living and sport. This study provides evidence for the reliability and validity of the OCLA-G assessing patients with OCLA. TRIAL REGISTRATION The registration trial number is DRKS00009401 on DRKS. 'Retrospectively registered'. Date of registration: 10/12/2015.
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Affiliation(s)
- Heinz Lohrer
- Department for Sports and Sport Science, University of Freiburg, Schwarzwaldstraße 175, Freiburg, 79117, Germany.
- European SportsCare Network (ESN), Zentrum für Sportorthopädie, Borsigstrasse 2, Wiesbaden-Nordenstadt, 65205, Germany.
| | - Stephanie Wagner
- BDH Klinik Waldkirch gGmbH, Heitere Weg 10, Waldkirch, 79183, Germany
| | - Markus Wenning
- Department of Orthopedics and Trauma Surgery, Medical Center, University of Freiburg, Hugstetter Straße 55, Freiburg, 79106, Germany
| | - Jan Kühle
- Department of Orthopedics and Trauma Surgery, Medical Center, University of Freiburg, Hugstetter Straße 55, Freiburg, 79106, Germany
| | - Hagen Schmal
- Department of Orthopedics and Trauma Surgery, Medical Center, University of Freiburg, Hugstetter Straße 55, Freiburg, 79106, Germany
| | - Albert Gollhofer
- Department for Sports and Sport Science, University of Freiburg, Schwarzwaldstraße 175, Freiburg, 79117, Germany
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DeJong Lempke AF, Stephens SL, Fish PN, Thompson XD, Hart JM, Hryvniak DJ, Rodu JS, Hertel J. Sensor-based gait training to reduce contact time for runners with exercise-related lower leg pain: a randomised controlled trial. BMJ Open Sport Exerc Med 2022; 8:e001293. [PMID: 36353183 PMCID: PMC9639130 DOI: 10.1136/bmjsem-2021-001293] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives To assess the effects of a 4-week randomised controlled trial comparing an outdoor gait-training programme to reduce contact time in conjunction with home exercises (contact time gait-training feedback with home exercises (FBHE)) to home exercises (HEs) alone for runners with exercise-related lower leg pain on sensor-derived biomechanics and patient-reported outcomes. Design Randomised controlled trial. Setting Laboratory and field-based study. Participants 20 runners with exercise-related lower leg pain were randomly allocated into FBHE (4 male (M), 6 female (F), 23±4 years, 22.0±4.3 kg/m2) or HE groups (3 M, 7 F, 25±5 years, 23.6±3.9 kg/m2). Interventions Both groups completed eight sessions of HEs over 4 weeks. The FBHE group received vibrotactile feedback through wearable sensors to reduce contact time during outdoor running. Primary and secondary outcome measures Patient-reported outcome measures (PROMs) and outdoor gait assessments were conducted for both groups at baseline and 4 weeks. PROMs were repeated at 6 weeks, and feedback retention was assessed at 6 weeks for the FBHE group. Repeated measures analyses of variance were used to assess the influence of group and timepoint on primary outcomes. Results The FBHE group reported increased function and recovery on PROMs beyond the HE group at 6 weeks (p<0.001). There was a significant group by time interaction for Global Rating of Change (p=0.004) and contact time (p=0.002); the FBHE group reported greater subjective improvement and reduced contact time at 4 and 6 weeks compared with the HE group and compared with baseline. The FBHE group had increased cadence (mean difference: 7 steps/min, p=0.01) at 4 weeks during outdoor running compared with baseline. Conclusion FBHE was more effective than HE alone for runners with exercise-related lower leg pain, manifested with improved PROMs, reduced contact time and increased cadence. Trial registration number NCT04270565.
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Affiliation(s)
| | | | - Pamela N Fish
- Kidney Center, Fresenius Medical Care, Knoxville, Tennessee, USA
| | | | - Joseph M Hart
- Orthopaedics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David J Hryvniak
- Physical Medicine & Rehabilitation, University of Virginia Medical Center, Charlottesville, Virginia, USA
| | - Jordan S Rodu
- Statistics, University of Virginia, Charlottesville, Virginia, USA
| | - Jay Hertel
- Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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Castillo-Domínguez A, García-Romero JC, Alvero-Cruz JR, Ponce-García T, Benítez-Porres J, Páez-Moguer J. Systematic Review of Patient-Reported Outcome Measures for Patients with Exercise-Induced Leg Pain. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:841. [PMID: 35888560 PMCID: PMC9318164 DOI: 10.3390/medicina58070841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Background and Objectives: To determine the most commonly used patient-reported outcome measures (PROMs) in exercise-induced leg pain (EILP) and to identify specific PROMs for EILP in order to evaluate their psychometric properties and methodological quality. Materials and Methods: A strategic search was performed in different databases to identify and extract the characteristics of studies based on the use of PROMs in patients with EILP. Specific PROMs were evaluated according to the Terwee et al. and COSMIN criteria. Results: Fifty-six studies were included in the review. The Medial Tibial Stress Syndrome Score (MTSSS), Lower Extremity Functional Scale (LEFS) and Exercise-Induced Leg Pain Questionnaire (EILP-Q) were identified as specific PROMs for EILP. The Visual Analog Scale (VAS) was the most widely used instrument in the assessment of EILP. The methodological quality assessment showed six positive values for the LEFS, four for the MTSSS and three for the EILP-Q for the eight psychometric properties analyzed according to the COSMIN criteria. The evaluation of the nine psychometric properties according to Terwee showed five positive values for the LEFS and MTSSS, and three for the EILP-Q. Conclusions: The overall methodological quality of the PROMs used was low. The VAS was the most widely used instrument in the assessment of EILP, and the LEFS was the highest quality PROM available for EILP, followed by the MTSSS and EILP-Q, respectively.
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Affiliation(s)
| | - Jerónimo C. García-Romero
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, University of Malaga, 29071 Malaga, Spain; (J.C.G.-R.); (J.R.A.-C.); (T.P.-G.); (J.B.-P.)
| | - José Ramón Alvero-Cruz
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, University of Malaga, 29071 Malaga, Spain; (J.C.G.-R.); (J.R.A.-C.); (T.P.-G.); (J.B.-P.)
| | - Tomás Ponce-García
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, University of Malaga, 29071 Malaga, Spain; (J.C.G.-R.); (J.R.A.-C.); (T.P.-G.); (J.B.-P.)
| | - Javier Benítez-Porres
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, University of Malaga, 29071 Malaga, Spain; (J.C.G.-R.); (J.R.A.-C.); (T.P.-G.); (J.B.-P.)
| | - Joaquín Páez-Moguer
- Department of Nursing and Podiatry, University of Malaga, 29071 Malaga, Spain;
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Turkish Translation, Cultural Adaptation, Reliability, and Validity of the Exercise-Induced Leg Pain Questionnaire. J Sport Rehabil 2022; 31:835-841. [PMID: 35508306 DOI: 10.1123/jsr.2021-0348] [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: 09/21/2021] [Revised: 02/09/2022] [Accepted: 03/02/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT Exercise-induced leg pain (EILP) is a chronic condition that generally arises in elite and recreational athletes' lower quarter of the legs. OBJECTIVES The study aimed to translate and culturally adapt the EILP questionnaire into Turkish (T-EILP) and evaluate its reliability and validity. DESIGN A cross-sectional study. METHODS Established guidelines were preferred for translation and adaptation. T-EILP was filled twice with a 1-week interval. In the first assessment, patients were also evaluated with Short Form-36 and Visual Analog Scale, both for preexercise and postexercise. Test-retest reliability and internal consistency of the T-EILP were measured with the intraclass correlation coefficient and Cronbach α coefficient, respectively. The construct validity was demonstrated with the Pearson correlation coefficient (r). Further, the minimum detectable change and standard error of measurement with 95% confidence were calculated. RESULTS A total of 121 participants (23.0 [3.59] y) were included in the study. The test-retest reliability was excellent and internal consistency was acceptable (intraclass correlation coefficient = .821, α = .808). T-EILP was highly correlated with the physical function subscore of the Short Form-36 (r = .509, P < .01). There was a moderate correlation between T-EILP with the bodily pain subscore of the Short Form-36 and Visual Analog Scale (postexercise; r1 = .436, r2 = -.355, P < .01). The standard error of measurement and minimum detectable change with 95% confidence were 3.54 and 9.81, respectively. CONCLUSION T-EILP is a reliable and valid tool in Turkish-speaking participants. The minimum detectable change with 95% confidence of the T-EILP provides an essential reference for monitoring EILP.
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Castillo-Domínguez A, Alvero-Cruz JR, Páez-Moguer J, Nauck T, Lohrer H, Scheer V, García-Romero J. Cross-Cultural adaptation and validation of the Exercise-Induced Leg Pain questionnaire for Spanish speaking patients. Clin Rehabil 2022; 36:968-979. [PMID: 35350924 DOI: 10.1177/02692155221088933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To cross-culturally adapt and validate a Spanish version of the Exercise-Induced Leg Pain questionnaire. DESIGN Clinical measurement study. PARTICIPANTS The validity and reliability of the adapted version were assessed in four groups of 40 patients with exercise-induced leg pain, 40 physically active healthy individuals (control group), 40 athletes with other leg conditions and 40 athletes, military personnel and candidates with no history of injury (risk group). MAIN MEASURE Exercise-Induced Leg Pain questionnaire. REFERENCE MEASURES Spanish version of the Short-Form 36 and Schepsis postsurgical classification scale. RESULTS In patients with exercise-induced leg pain, the mean age was 24.9 (± 6.7) years and the mean score of the questionnaire was 62.8 (± 10.9). The standard error of measurement and minimum detectable change threshold were 1.67 and 4.63 points, respectively. Excellent internal consistency (Cronbach's α = 0.942) and test-retest reliability (intraclass correlation coefficient = 0.995) were found. The exploratory and confirmatory factor analyses indicated that a one-factor solution explained 66.84% of the variance. For construct validity, 87.5% of the previously stated hypotheses were fulfilled between the total score of the questionnaire and Short-Form 36 dimensions. Concurrent validity, assessed by the Schepsis scale, was almost perfect (r = 0.92, p < 0.001). The predictive validity of the questionnaire was demonstrated using the receiving operating curve (area of 0.992; 95% CI: 0.983-1, p < 0.001). CONCLUSION The Spanish version of the Exercise-Induced Leg Pain questionnaire resulted in a reliable and valid instrument to assess patients with exercise-induced leg pain.
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Affiliation(s)
| | - José Ramón Alvero-Cruz
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, 16752University of Málaga, 29071, Spain
| | | | - Tanja Nauck
- European SportsCare Network (ESN), Zentrum für Sportorthopädie, Borsigstrasse 2, 65205, Germany
| | - Heinz Lohrer
- European SportsCare Network (ESN), Zentrum für Sportorthopädie, Borsigstrasse 2, 65205, Germany.,Department of Sport and Sport Science, Albert-Ludwigs-Universität Freiburg i. Brsg., Schwarzwaldstraße 175, 79117, Germany
| | - Volker Scheer
- Ultra Sports Science Foundation, 109 Boulevard de l'Europe, 69310, France
| | - Jerónimo García-Romero
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, 16752University of Málaga, 29071, Spain
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Daskalakis I, Sperelakis I, Sidiropoulou B, Kontakis G, Tosounidis T. Patient-Reported Outcome Measures (PROMs) Relevant to Musculoskeletal Conditions Translated and Validated in the Greek Language: A COSMIN-Based Systematic Review of Measurement Properties. Mediterr J Rheumatol 2021; 32:200-217. [PMID: 34964024 PMCID: PMC8693298 DOI: 10.31138/mjr.32.3.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The use of patient-reported outcome measures (PROMs) constitutes a valuable tool in evaluating the quality of care offered in orthopaedic surgery. The aim of this review is to identify the PROMs that have been translated into and validated in the Greek language, summarise their measurement properties, and evaluate their methodological quality according to the COSMIN Risk of Bias Checklist. METHODS A structured literature search was conducted using the databases PubMED/MEDLINE, Embase, Scopus, and the Cochrane Library in order to identify PROMs relevant to musculoskeletal conditions translated and validated in the Greek language. The methodological quality of the studies was assessed according to the COSMIN Risk of Bias Checklist, and the quality of measurement properties according to the COMSIN criteria. RESULTS Literature search yielded 6743 articles. After removal of duplicates and screening of the articles, 32 studies including PROMs related to musculoskeletal conditions were identified. The studies included 31 PROMs and reported 171 measurement properties. Methodological quality was adequate for 81 of them (47.3%). The most commonly reported measurement properties were internal consistency, reliability, construct validity and responsiveness. CONCLUSION The majority of PROMs translated into Greek involves the lower extremity and especially knee pathologies. The search revealed that there are areas of Musculoskeletal Medicine such as skeletal trauma, musculoskeletal oncology, and paediatric orthopaedics in which patient reported-outcome measures have not been translated into Greek. Translation and validation of new outcome measures is encouraged, using studies designed in compliance with the COSMIN guidelines, and further validation of the translated instruments.
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Affiliation(s)
- Ioannis Daskalakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Ioannis Sperelakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | - Georgios Kontakis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Theodoros Tosounidis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece
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DeJong Lempke AF, Hart JM, Hryvniak DJ, Rodu JS, Hertel J. Use of wearable sensors to identify biomechanical alterations in runners with Exercise-Related lower leg pain. J Biomech 2021; 126:110646. [PMID: 34329881 DOI: 10.1016/j.jbiomech.2021.110646] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Abstract
Exercise-related lower leg pain (ERLLP) is one of the most prevalent running-related injuries, however little is known about injured runners' mechanics during outdoor running. Establishing biomechanical alterations among ERLLP runners would help guide clinical interventions. Therefore, we sought to a) identify defining biomechanical features among ERLLP runners compared to healthy runners during outdoor running, and b) identify biomechanical thresholds to generate objective gait-training recommendations. Thirty-two ERLLP (13 M, age: 21 ± 5 years, BMI: 22.69 ± 2.25 kg/m2) and 32 healthy runners (13 M, age: 23 ± 6 years, BMI: 22.33 ± 3.20 kg/m2) were assessed using wearable sensors during one week of typical outdoor training. Step-by-step data were extracted to assess kinetic, kinematic, and spatiotemporal measures. Preliminary feature extraction analyses were conducted to determine key biomechanical differences between healthy and ERLLP groups. Analyses of covariance (ANCOVA) and variability assessments were used compare groups on the identified features. Participants were split into 3 pace bands, and mean differences across groups were calculated to establish biomechanical thresholds. Contact time was the key differentiating feature for ERRLP runners. ANCOVA assessments reflected that the ERLLP group had increased contact time (Mean Difference [95% Confidence Interval] = 8 ms [6.9,9.1], p < .001), and approximate entropy analyses reflected greater contact time variability. Contact time differences were dependent upon running pace, with larger between-group differences being exhibited at faster paces. In all, ERLLP runners demonstrated longer contact time than healthy runners during outdoor training. Clinicians should consider contact time when assessing and treating these ERLLP runner patients.
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Affiliation(s)
- Alexandra F DeJong Lempke
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States; Micheli Center for Sports Injury Prevention, Waltham, MA, United States.
| | - Joseph M Hart
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States
| | - David J Hryvniak
- University of Virginia Health Systems Outpatient Physical and Occupational Therapy at Fontaine Building 515, Fontaine Research Park, 515 Ray C. Hunt Drive, Charlottesville, VA 22903, USA
| | - Jordan S Rodu
- University of Virginia College of Arts and Sciences Department of Statistics, Halsey Hall 104, 148 Amphitheater Way, Charlottesville, VA 22904, USA
| | - Jay Hertel
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA
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12
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Koldenhoven RM, Virostek A, DeJong AF, Higgins M, Hertel J. Increased Contact Time and Strength Deficits in Runners With Exercise-Related Lower Leg Pain. J Athl Train 2021; 55:1247-1254. [PMID: 33064822 DOI: 10.4085/1062-6050-0514.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Exercise-related lower leg pain (ERLLP) is common in runners. OBJECTIVE To compare biomechanical (kinematic, kinetic, and spatiotemporal) measures obtained from wearable sensors as well as lower extremity alignment, range of motion, and strength during running between runners with and those without ERLLP. DESIGN Case-control study. SETTING Field and laboratory. PATIENTS OR OTHER PARTICIPANTS Of 32 young adults who had been running regularly (>10 mi [16 km] per week) for ≥3 months, 16 had ERLLP for ≥2 weeks and 16 were healthy control participants. MAIN OUTCOME MEASURE(S) Both field and laboratory measures were collected at the initial visit. The laboratory measures consisted of alignment (arch height index, foot posture index, navicular drop, tibial torsion, Q-angle, and hip anteversion), range of motion (great toe, ankle, knee, and hip), and strength. Participants then completed a 1.67-mi (2.69-km) run along a predetermined route to calibrate the RunScribe devices. The RunScribe wearable sensors collected kinematic (pronation excursion and maximum pronation velocity), kinetic (impact g and braking g), and spatiotemporal (stride length, step length, contact time, stride pace, and flight ratio) measures. Participants then wore the sensors during at least 3 training runs in the next week. RESULTS The ERLLP group had a slower stride pace than the healthy group, which was accounted for as a covariate in subsequent analyses. The ERLLP group had a longer contact time during the stance phase of running (mean difference [MD] = 18.00 ± 8.27 milliseconds) and decreased stride length (MD = -0.11 ± 0.05 m) than the control group. For the clinical measures, the ERLLP group demonstrated increased range of motion for great-toe flexion (MD = 13.9 ± 4.6°) and ankle eversion (MD = 6.3 ± 2.7°) and decreased strength for ankle inversion (MD = -0.49 ± 0.23 N/kg), ankle eversion (MD = -0.57 ± 0.27 N/kg), and hip flexion (MD = -0.99 ± 0.39 N/kg). CONCLUSIONS The ERLLP group exhibited a longer contact time and decreased stride length during running as well as strength deficits at the ankle and hip. Gait retraining and lower extremity strengthening may be warranted as clinical interventions in runners with ERLLP.
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Padhiar N, Curtin M, Aweid O, Aweid B, Morrissey D, Chan O, Malliaras P, Crisp T. The effectiveness of PROLOTHERAPY for recalcitrant Medial TIBIAL Stress Syndrome: a prospective consecutive CASE series. J Foot Ankle Res 2021; 14:32. [PMID: 33863355 PMCID: PMC8052809 DOI: 10.1186/s13047-021-00453-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6 and 16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degrees of success. In recalcitrant cases, surgery is often the only option. OBJECTIVE To evaluate whether ultrasound-guided injection of 15% dextrose for treatment of recalcitrant MTSS decreases pain and facilitates a return to desired activity levels for those who may otherwise be considering surgery or giving up the sport. METHOD The study design was a prospective consecutive case series involving eighteen patients: fifteen male and three female; (mean age = 31.2 years) with recalcitrant MTSS. They were referred from sports injury clinics across the UK, having failed all available conservative treatment. INTERVENTION An ultrasound-guided sub-periosteal injection of 15% dextrose was administered by the same clinician (NP) along the length of the symptomatic area. Typically, 1 mL of solution was injected per cm of the symptomatic area. MAIN OUTCOME MEASURES Pain was assessed using a 10-cm visual analog scale (VAS) at baseline, short-term, medium-term (mean 18 weeks), and long-term (mean 52 weeks) follow-up. Symptom resolution and return to activity were measured using a Likert scale at medium and long-term follow-up. Statistical analyses were performed using SPSS for Mac version 19.0.0 (IBM, New York, NY, US). The Shapiro-Wilk test was used to evaluate the normality of the distribution of data. Friedman's non-parametric test was used to compare the within-patient treatment response over time. Post-hoc Wilcoxon signed-rank tests with Bonferroni corrections were performed to determine VAS average pain response to treatment over five paired periods. RESULTS Patients reported a significant (p < 0.01) reduction in median VAS pain score at medium and long-term follow-up compared to baseline. Median improvement per patient was 4.5/10. Patients rated their condition as 'much improved' at medium-term follow-up and the median return to sports score was 'returned to desired but not pre-injury level' at medium-term and long-term follow-up. No adverse events were reported. CONCLUSIONS Ultrasound-guided 15% dextrose prolotherapy injection has a significant medium-term effect on pain in MTSS. This benefit may be maintained long-term; however, more robust trials are required to validate these findings in the absence of controls. CLINICAL RELEVANCE Clinicians should consider the use of ultrasound-guided injection of 15% dextrose as a viable treatment option to reduce pain and aid return to activity for patients with recalcitrant MTSS.
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Affiliation(s)
- Nat Padhiar
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
- London SportsCare, London Independent Hospital, London, UK
- European SportsCare, London, UK
| | - Mark Curtin
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Osama Aweid
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Bashaar Aweid
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Dylan Morrissey
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Otto Chan
- London SportsCare, London Independent Hospital, London, UK
| | - Peter Malliaras
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
- Monash University, Melbourne, Australia
| | - Tom Crisp
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
- London SportsCare, London Independent Hospital, London, UK
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Korakakis V, Abassi M, Kotsifak A, Manai H, AbuEsba A. Cross-cultural adaptation and psychometric properties' evaluation of the modern standard Arabic version of Cumberland Ankle Instability Tool (CAIT) in professional athletes. PLoS One 2019; 14:e0217987. [PMID: 31185034 PMCID: PMC6559661 DOI: 10.1371/journal.pone.0217987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To cross-culturally adapt the Cumberland Ankle Instability Tool into modern standard Arabic and to assess its psychometric properties. Method Cross-cultural adaptation followed a combination of guidelines and for psychometric evaluation a sample of 107 athletes as recruited. All recommended measurement properties by the Consensus-based Standards for the selection of health status Measurement Instruments were evaluated, including face, structural, convergent, and discriminant validity; reproducibility; distribution-based responsiveness, and interpretability. We also used a structured content analytic method to evaluate content validity. Results The tool presented excellent internal consistency (α = 0.92) and reliability (ICC 0.75–0.98), and good convergent validity compared with Lower Extremity Functional Scale (ρ = 0.67). For reproducibility testing: Minimal detectable change ranged from 0.41 to 6.0 points; for responsiveness assessment: the effect sizes were large (Glass’Δ range 2.03–2.08, Cohen’s d range 2.22 to 2.53) and the Area under the Curve was 0.869. Its unidimensionality was proved by a 1-factor solution explaining 63.8% of the variance. Conclusion The Arabic version of Cumberland Ankle Instability Tool presented acceptable psychometric properties comparable to the original version. The questionnaire is understood across most of the Arabic speaking world and can be used in research and clinical practice to assess patients suffering from chronic ankle instability.
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Affiliation(s)
| | - Mohsen Abassi
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Argyro Kotsifak
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Hassine Manai
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Anas AbuEsba
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Korakakis V, Saretsky M, Whiteley R, Azzopardi MC, Klauznicer J, Itani A, Al Sayrafi O, Giakas G, Malliaropoulos N. Translation into modern standard Arabic, cross-cultural adaptation and psychometric properties' evaluation of the Lower Extremity Functional Scale (LEFS) in Arabic-speaking athletes with Anterior Cruciate Ligament (ACL) injury. PLoS One 2019; 14:e0217791. [PMID: 31181087 PMCID: PMC6557503 DOI: 10.1371/journal.pone.0217791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Lower Extremity Functional Scale evaluates the functional status of patients that have lower extremity conditions of musculoskeletal origin. Regional Arabic dialects often create barriers to clear communication and comparative research. We aimed to cross-culturally adapt the Lower Extremity Functional Scale in modern standard Arabic that is widely used and understood in the Middle East and North Africa region, and assess its psychometric properties. METHODS Cross-cultural adaptation followed a combination of recommended guidelines. For psychometric evaluation 150 patients with anterior cruciate ligament injury and 65 asymptomatic individuals were recruited. All measurement properties as indicated by the Consensus-based Standards for the selection of health status Measurement Instruments recommendations were evaluated, including content-relevance analysis, structural validity, longitudinal reproducibility, anchor- and distribution-based methods of responsiveness, as well as the longitudinal pattern of change of Lower Extremity Functional Scale in anterior cruciate ligament injured patients' functional status. RESULTS The questionnaire presented excellent internal consistency (α = 0.96), reliability (0.80-0.98), and good convergent validity (ρ = 0.85). For reproducibility testing: minimal detectable change was 9.26 points; for responsiveness assessment: minimal clinically important difference was 9 points and presented moderate effect sizes (Glass'Δ = 0.71, Cohen's d = 0.81). Its unidimensionality was not confirmed and an exploratory factor analysis indicated a 2-factor solution explaining 78.1% of the variance. CONCLUSION The Arabic Lower Extremity Functional Scale presented acceptable psychometric properties comparable to the original version. The Arabic version of Lower Extremity Functional Scale can be used in research and clinical practice to assess the functional status of Arabic-patients suffering an anterior cruciate ligament injury.
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Affiliation(s)
- Vasileios Korakakis
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
- * E-mail:
| | | | - Rodney Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | | | - Abdallah Itani
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Omar Al Sayrafi
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Giannis Giakas
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Nikolaos Malliaropoulos
- Sports and Exercise Medicine Clinic, Thessaloniki, Greece
- National Track & Field Centre, Sports Medicine Clinic, Thessaloniki, Greece
- European Sports Care, London, United Kingdom
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Park J, Kim T. Acute effect of taping on plantar pressure characteristics in athletes with exercise-induced leg pain: a description and comparison of groups. PHYSICIAN SPORTSMED 2019; 47:212-219. [PMID: 30462925 DOI: 10.1080/00913847.2018.1547085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Foot pronation is considered as a potential risk factor of lower leg overuse injury. This study aimed to identify plantar pressure characteristics of elite athletes with exercise-induced leg pain in throwing athletic disciplines, and to verify the acute effect of taping for restricting foot pronation by analyzing the plantar pressure characteristics. METHODS This study was designed as a description and comparison of throwing athletic athletes. Participants were divided into exercise-induced leg pain (ELP group, n = 17) and control groups (CON group, n = 14). Plantar pressure variables (contact area, maximum force, and peak pressure) at eight-foot regions in athletes' supporting leg were recorded during standing on one leg and a natural walk before and after applying anti-pronation or sham taping techniques. RESULTS There are significant difference of contact area, maximal force, and peak pressure in some regions of their foot between the ELP and CON groups. But the anti-pronation taping decreased only the peak pressure in lateral midfoot of CON group during a natural walk (p = 0.002). CONCLUSION The anti-pronation taping technique may not be effective preventive strategy from the exercise-induced leg pain, such as shin splints.
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Affiliation(s)
- JaeMyoung Park
- a Research Institute of Physical Education and Sport Science , Korea National Sport University , Seoul , Republic of Korea
| | - Taegyu Kim
- b Department of Marine Sports , Pukyoung National University , Busan , Republic of Korea
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Lohrer H, Malliaropoulos N, Korakakis V, Padhiar N. Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies. PHYSICIAN SPORTSMED 2019; 47:47-59. [PMID: 30345867 DOI: 10.1080/00913847.2018.1537861] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of this review is to describe and critically evaluate current knowledge regarding diagnosis, assessment, and management of chronic overload leg injuries which are often non-specific and misleadingly referred to as 'shin splints'. We aimed to review clinical entities that come under the umbrella term 'Exercise-induced leg pain' (EILP) based on current literature and systematically searched the literature. Specifically, systematic reviews were included. Our analyses demonstrated that current knowledge on EILP is based on a low level of evidence. EILP has to be subdivided into those with pain from bone stress injuries, pain of osteo-fascial origin, pain of muscular origin, pain due to nerve compression and pain due to a temporary vascular compromise. The history is most important. Questions include the onset of symptoms, whether worse with activity, at rest or at night? What exacerbates it and what relieves it? Is the sleep disturbed? Investigations merely confirm the clinical diagnosis and/or differential diagnosis; they should not be solely relied upon. The mainstay of diagnosing bone stress injury is MRI scan. Treatment is based on unloading strategies. A standard for confirming chronic exertional compartment syndrome (CECS) is the dynamic intra-compartmental pressure study performed with specific exercises that provoke the symptoms. Surgery provides the best outcome. Medial tibial stress syndrome (MTSS) presents a challenge in both diagnosis and treatment especially where there is a substantial overlap of symptoms with deep posterior CECS. Conservative therapy should initially aim to correct functional, gait, and biomechanical overload factors. Surgery should be considered in recalcitrant cases. MRI and MR angiography are the primary investigative tools for functional popliteal artery entrapment syndrome and when confirmed, surgery provides the most satisfactory outcome. Nerve compression is induced by various factors, e.g., localized fascial entrapment, unstable proximal tibiofibular joint (intrinsic) or secondary by external compromise of the nerve, e.g., tight hosiery (extrinsic). Conservative is the treatment of choice. The localized fasciotomy is reserved for recalcitrant cases.
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Affiliation(s)
- Heinz Lohrer
- a European SportsCare Network (ESN) - Zentrum für Sportorthopädie , Wiesbaden-Nordenstadt , Germany
| | | | - Vasileios Korakakis
- c Department of Rehabilitation , Aspetar, Orthopaedic and Sports Medicine Hospital , Doha , Qatar
| | - Nat Padhiar
- d William Harvey Research Institute, Centre for Sports & Exercise Medicine , Queen Mary University of London , London , UK
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Beaudart C, Hagelstein T, Van Beveren J, Godon B, Bruyère O, Kaux JF. French translation and validation of the exercise-induced leg pain Questionnaire. Disabil Rehabil 2018; 42:857-862. [PMID: 30507325 DOI: 10.1080/09638288.2018.1508512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The "Exercise-Induced Leg Pain" questionnaire was developed (in German) for the evaluation of the severity of symptoms and sports ability in individuals with exercise-induced leg pain. The purpose of the present study was to translate and cross-culturally adapt this questionnaire into French and to study the reliability and validity of this French-language version.Methods: The translation and cross-cultural adaptation of the original "Exercise-Induced Leg Pain" was performed according to established guidelines. The translation part was carried out in six stages: (i) two initial translations from German to French; (ii) synthesis of the two translations; (iii) backward translations; (iv) comparison between the backward translations and the original questionnaire by an expert committee; (v) pretest; and (vi) approval of the final version of the French-language "Exercise-Induced Leg Pain" questionnaire. To validate this questionnaire, 84 subjects were recruited (28 pathological patients with a confirmed diagnosis of chronic leg pain, 28 asymptomatic sport students, and 28 healthy control athletes). The discriminative power of the questionnaire was tested, as well as its reliability (internal consistency and test-retest reliability after a 7-10-day interval), construct validity and floor/ceiling effects.Results: The French version of the "Exercise-Induced Leg Pain" questionnaire was generated without any major difficulties. The ability of the questionnaire to discriminate between the three groups of subjects was demonstrated with a total score of 61.0 ± 18.5 for the pathologic group; 93.9 ± 7.57 for the asymptomatic group and 94.1 ± 9.79 for the control group. A high internal consistency (Cronbach's alpha of 0.93) and an excellent test-retest reliability [intraclass coefficient correlation: 0.98 (95% confidence interval: 0.97-0.99, p < 0.001)] indicated that the "Exercise-Induced Leg Pain" is reliable. The questionnaire also demonstrated good construct validity against different subscales of the Short Form-36 questionnaire, a generic quality of life questionnaire, with more than 87% of the prespecified hypotheses confirmed. Finally, no floor effects or ceiling effects were observed.Conclusion: The French version of the « Exercise-Induced Leg Pain » was successfully translated and cross-culturally adapted. The questionnaire is consistent, valid and reliable for evaluating French-speaking patients with chronic exercise-induced leg pain.Implications for rehabilitationThe "Exercise-Induced Leg Pain" questionnaire aims to assess the severity of symptoms that impact the function and sports ability of patients with exercise-induced leg pain;The French version of the « Exercise-Induced Leg Pain » was successfully translated and cross-culturally adapted. The questionnaire is consistent, valid and reliable for evaluating French-speaking patients with chronic exercise-induced leg pain.
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Affiliation(s)
- Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Liège, Belgium
| | - Thibaut Hagelstein
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | | | - Bernard Godon
- Physical Medicine and Sports Traumatology Department, SportS2, FIFA Medical Centre of Excellence, University and University Hospital of Liège, Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Liège, Belgium.,Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Jean-François Kaux
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium.,Physical Medicine and Sports Traumatology Department, SportS2, FIFA Medical Centre of Excellence, University and University Hospital of Liège, Liège, Belgium
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Lohrer H, Nauck T, Lohrer L. Endoscopic-assisted Release of Lower Leg Chronic Exertional Compartment Syndromes. Sports Med Arthrosc Rev 2016; 24:19-23. [DOI: 10.1097/jsa.0000000000000106] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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