1
|
Fernandes CA, Norte GE, Schwab SM, Gokeler A, Murray A, Bazett-Jones DM, Sherman DA. Interpersonal Coordination between Female Soccer Players: Leader-Follower Roles within a Collision-Avoidance Task. Int J Sports Phys Ther 2024; 19:548-560. [PMID: 38707861 PMCID: PMC11065781 DOI: 10.26603/001c.116156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/29/2024] [Indexed: 05/07/2024] Open
Abstract
Background/Purpose Return to sport decision-making may be improved by assessing an athlete's ability to coordinate movement with opponents in sport. The purpose was to investigate whether previous injuries associated with female soccer players' interpersonal coordination during a collision avoidance task. The authors hypothesized that external perturbations would disrupt the strength and stability of coordinated movement, and that individuals with a history of injury would be less likely to recover coordinated movement. Study Design Cross-Sectional. Methods Nine female athletes with a history of lower extremity injuries and nine without injuries were paired into dyads. Each dyad completed twenty trials of an externally paced collision-avoidance agility task with an unanticipated perturbation. Participant trajectories were digitized and analyzed using cross-recurrence quantification analysis (CRQA) to determine the strength and stability of interpersonal coordination dynamics. Trials in which participants with injury history assumed leader or follower roles within each dyad were then used to study how dyadic coordination varied across task stages (early, perturbation, and late) using linear mixed effect models. Cohen's d effect sizes were calculated to demonstrate magnitude of differences. In exploratory analysis, psychological readiness (i.e., self-reported knee functioning, fear of injury, and risk-taking propensity) was evaluated for their association with leader-follower status. Results Perturbation disrupted the strength (R2=0.65, p<0.001, early=49.7±1.7, perturbation=41.1±1.7, d=0.39) and stability (R2=0.71, p < 0.001, early=65.0±1.6, perturbation=58.0±1.7, d=0.38) of interpersonal coordination regardless of leader-follower status. Individuals with injury history failed to restore coordination after the perturbation compared to control participants (injury=44.2.0±2.1, control=50.8±2.6, d=0.39). Neither demographic nor psychological measures were associated with leader-follower roles (B=0.039, p=0.224). Conclusion Individuals with a history of lower extremity injury may have a diminished ability to adapt interpersonal coordination to perturbations, possibly contributing to a higher risk of re-injury. Level of Evidence 3.
Collapse
Affiliation(s)
| | - Grant E Norte
- Cognition Neuroplasticity and Sarcopenia LaboratoryUniversity of Central Florida
| | - Sarah M Schwab
- 3. Department of Rehabilitation, Exercise, & Nutrition SciencesUniversity of Cincinnati
| | - Alli Gokeler
- 4. Exercise Science and Neuroscience, Department of Exercise & HealthPaderborn University
| | - Amanda Murray
- College of Health and Human ServicesUniversity of Toledo
| | | | - David A Sherman
- Chobanian & Avedisian School of MedicineBoston University
- Live4 Physical Therapy and Wellness
| |
Collapse
|
2
|
Wilk KE, Arrigo CA, Davies GJ. Isokinetic Testing: Why it is More Important Today than Ever. Int J Sports Phys Ther 2024; 19:374-380. [PMID: 38576833 PMCID: PMC10987309 DOI: 10.26603/001c.95038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Isokinetics is a proven method to train and objectively assess the capability of muscle groups, particularly at the knee. The current re-injury rates and less than optimal return to sport percentages seen following anterior cruciate ligament surgery highlights the need for greater focus on what tests and methods are used to make these critical decisions. Isokinetics remains the best single method to objectively determine dynamic muscle strength, power, rate of force development and endurance. These factors make it well-suited to play a crucial role in influencing the appropriate patient progression through a rehabilitation program and assisting in determining return to play readiness following injury or surgery. In this article we will discuss why we believe isokinetics is a useful and necessary testing method, and elucidate testing parameters and goals used during knee extension/flexion assessment.
Collapse
|
3
|
May KH, Espinoza WC, Guccione AA. Sport-Specific AMCaMP: New Modular Tools for Measuring Adolescent Self-Confidence In Sport-Specific Movement. Int J Sports Phys Ther 2024; 19:148-158. [PMID: 38313663 PMCID: PMC10837816 DOI: 10.26603/001c.92012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024] Open
Abstract
Background Despite increasing interest in psychological factors that affect the impact of self-efficacy on readiness to return to play, few clinical tools are available to assess self-confidence in performing sports-specific movement patterns in the pediatric/adolescent population. Hypothesis/Purpose The purpose of this study was to test the psychometric properties of sports-specific modules to supplement a general measure of movement self-efficacy, the Adolescent Measure of Confidence and Movement Performance (AMCaMP). Study Design Quasi-experimental cross-sectional validation. Methods After preliminary testing for readability and ease of administration, one of 12 sport-specific modules pertinent to the individual's sport (baseball, softball, basketball, football, gymnastics, cheerleading, soccer, ballet, swimming, lacrosse, tennis, and cross country) were administered to 14,744 patients, 11-18 years of age, drawn from 12 pediatric sports physical therapy facilities in a single health care system. Respondents completed the assigned sport-specific self-report questionnaire at initial visit and conclusion of the episode of care. Results Based on sample sizes, Bartlett's Test of Sphericity, and Kaiser-Myer-Olkin measures, nine modules (baseball, softball, basketball, football, gymnastics, cheerleading, soccer, ballet, and swimming) were deemed suitable for factor analysis. Each module sample was divided into test validation samples. Exploratory factor analysis revealed an underlying structure ranging from one to three factors depending upon the module. Subsequent confirmatory factor analyses fully supported the hypothesized factor structures for each module except swimming. Additional analyses to determine coefficient alpha (range=0.8-0.976), Standard Error of Measurement (range=1.12-2.33), and Minimum Detectable Change (range=3.1-6.47) confirmed the reliability of each of these modules. Conclusion AMCAMP sport-specific modules are reliable and valid self-report tools to capture self-confidence in performing sport-specific movements to supplement AMCAMP's evaluation of self-efficacy in performing the general movements of everyday life. The results of this study support using these modules as part of the overall clinical evaluation of psychological readiness to return to sport. Level of Evidence Level 3b.
Collapse
Affiliation(s)
- Keith H May
- Sports Medicine Children's Healthcare of Atlanta
| | | | | |
Collapse
|
4
|
Wille CM, Hurley SA, Joachim MR, Lee K, Kijowski R, Heiderscheit BC. Association of quantitative diffusion tensor imaging measures with time to return to sport and reinjury incidence following acute hamstring strain injury. J Biomech 2024; 163:111960. [PMID: 38290304 PMCID: PMC10923138 DOI: 10.1016/j.jbiomech.2024.111960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
Hamstring strain injuries (HSI) are a common occurrence in athletics and complicated by limited prognostic indicators and high rates of reinjury. Assessment of injury characteristics at the time of injury (TOI) may be used to manage athlete expectations for time to return to sport (RTS) and mitigate reinjury risk. Magnetic resonance imaging (MRI) is routinely used in soft tissue injury management, but its prognostic value for HSI is widely debated. Recent advancements in musculoskeletal MRI, such as diffusion tensor imaging (DTI), have allowed for quantitative measures of muscle microstructure assessment. The purpose of this study was to determine the association of TOI MRI-based measures, including the British Athletic Muscle Injury Classification (BAMIC) system, edema volume, and DTI metrics, with time to RTS and reinjury incidence. Negative binomial regressions and generalized estimating equations were used to determine relationships between imaging measures and time to RTS and reinjury, respectively. Twenty-six index injuries were observed, with five recorded reinjuries. A significant association was not detected between BAMIC score and edema volume at TOI with days to RTS (p-values ≥ 0.15) or reinjury (p-values ≥ 0.13). Similarly, a significant association between DTI metrics and days to RTS was not detected (p-values ≥ 0.11). Although diffusivity metrics are expected to increase following injury, decreased values were observed in those who reinjured (mean diffusivity, p = 0.016; radial diffusivity, p = 0.02; principal effective diffusivity eigenvalues, p-values = 0.007-0.057). Additional work to further understand the directional relationship observed between DTI metrics and reinjury status and the influence of external factors is warranted.
Collapse
Affiliation(s)
- Christa M Wille
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, the United States of America; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, the United States of America; Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, the United States of America
| | - Samuel A Hurley
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, the United States of America
| | - Mikel R Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, the United States of America; Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, the United States of America
| | - Kenneth Lee
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, the United States of America
| | - Richard Kijowski
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, the United States of America
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, the United States of America; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, the United States of America; Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, the United States of America.
| |
Collapse
|
5
|
Lauwers F, Poulet V, Turblin P, Sans N, Prevost A. From Ambulatory Surgery to Enhanced Recovery After Surgery: Lessons from the Rugby World Cup in France. J Stomatol Oral Maxillofac Surg 2023; 124:101678. [PMID: 38000877 DOI: 10.1016/j.jormas.2023.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Affiliation(s)
- Frédéric Lauwers
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Place du Docteur Baylac, 31059 Toulouse, France
| | - Vinciane Poulet
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Place du Docteur Baylac, 31059 Toulouse, France
| | - Philippe Turblin
- Medical Director of the French national rugby union team, "Le XV de France", Clinique du Sport Médipole Garonne, 45 rue de Gironis, 31100 Toulouse France
| | - Nicolas Sans
- Department of Radiology, University Hospital Center of Toulouse, Place du Docteur Baylac, 31059 Toulouse, France
| | - Alice Prevost
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Place du Docteur Baylac, 31059 Toulouse, France.
| |
Collapse
|
6
|
Riemann BL, Wilk KE, Davies GJ. Reliability of Upper Extremity Functional Performance Tests for Overhead Sports Activities. Int J Sports Phys Ther 2023; V18:687-697. [PMID: 37425106 PMCID: PMC10324288 DOI: 10.26603/001c.74368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/26/2023] [Indexed: 07/11/2023] Open
Abstract
Background There is lack of consensus on which tests, particularly upper extremity functional performance tests (FPT) that should be used for clinical decision making to progress a patient through a rehabilitation program or criteria for return to sport (RTS). Consequently, there is a need for tests with good psychometric properties that can be administered with minimal equipment and time. Purpose (1) To establish the intersession reliability of several open kinetic chain FPT in healthy young adults with a history of overhead sport participation. (2) To examine the intersession reliability of the limb symmetry indices (LSI) from each test. Study Design Test-retest reliability, single cohort study. Methods Forty adults (20 males, 20 females) completed four upper extremity FPT during two data collection sessions three to seven days apart: 1) prone medicine ball drop test 90°shoulder abduction (PMBDT 90°), 2) prone medicine ball drop test 90°shoulder abduction/90° elbow flexion (PMBDT 90°-90°), 3) half-kneeling medicine ball rebound test (HKMBRT), 4) seated single arm shot put test (SSASPT). Measures of systematic bias, absolute reliability and relative reliability were computed between the sessions for both the original test scores and LSI. Results Except for the SSASPT, all tests demonstrated significant (p ≤ 0.030) improvements in performance during the second session. Generally, for the medicine ball drop/rebound tests, the absolute reliability was the highest (less random error) for the HKMBRT, next the PMBDT 90°followed by PMBDT 90°-90°. Excellent relative reliability existed for the PMBDT 90°, HKMBRT, and SSASPT, whereas fair to excellent relative reliability for the PMBDT 90°-90°. The SSASPT LSI revealed the highest relative and absolute reliability. Conclusion Two tests, HKMBRT and SSASPT demonstrated sufficient reliability; therefore, the authors' recommend those tests can be used for serial assessments to advance a patient through a rehabilitation program as well as criteria for progression to RTS. Level of Evidence 3.
Collapse
|
7
|
Snegireva N, Derman W, Patricios J, Welman KE. Blink duration is increased in concussed youth athletes: a validity study using eye tracking in male youth and adult athletes of selected contact sports. Physiol Meas 2022; 43. [PMID: 35709708 DOI: 10.1088/1361-6579/ac799b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diagnosing a sports-related concussion (SRC) remains challenging, and research into diagnostic tools is limited. This study investigated whether selected eye tracking variables would be a valid tool to diagnose and monitor SRC in adult and youth participants in selected contact sports, such as Rugby Union (rugby) and football (soccer). METHODS This prospective cohort study, with 70 concussed and 92 non-concussed adult and youth athletes, assessed the validity of five previously selected eye tracking variables for SRC diagnostics and management. The performance between concussed and age-matched control (non-concussed) athletes, as well as between three successive testing sessions in the concussed athletes were compared. Self-paced saccade count in adult group; blink duration in the memory-guided saccade and sinusoidal smooth pursuit tasks, proportion of antisaccade errors, and gain of diagonal smooth pursuit in the youth group were assessed. RESULTS The youth concussed group had higher blink duration in the fast memory-guided saccades task (p = 0.001, η2 = 0.17) and a tendency for higher blink duration in the sinusoidal smooth pursuit task (p = 0.016, η2 = 0.06) compared to the youth control group. In both tasks the blink duration in the concussed youth group decreased from session 1 to session 2 by 24% and 18%, accordingly, although statistical significance was not reached. The concussed adult group demonstrated a lower number of self-paced saccades compared to controls (p = 0.05, η2 = 0.09), which gradually increased, with the largest difference between session 1 and session 3 (p = 0.02). CONCLUSIONS Blink duration in youth athletes holds promise as a valid metric for concussion diagnostics and monitoring. It is recommended to focus future studies on comparing eye tracking performance within the same concussed athletes over time rather than comparing them to healthy controls.
Collapse
Affiliation(s)
- Nadja Snegireva
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Francie Van Zijl Dr, Parow, Cape Town, Western Cape, 7505, SOUTH AFRICA
| | - Jon Patricios
- Wits Institute for Sport and Health, University of the Witwatersrand Faculty of Health Sciences, 27 St Andrews Rd, Parktown, Johannesburg, Gauteng, 2193, SOUTH AFRICA
| | - Karen Estelle Welman
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
| |
Collapse
|
8
|
Kurien T, Stragier B, Senevirathna S, Geutjens G. Excellent outcomes with combined single stage Physica ZUK medial unicompartment knee replacement and anterior cruciate ligament reconstruction results in young, active patients with instability and osteoarthritis with a mean follow up of 5 years. Knee 2022; 36:114-119. [PMID: 35605336 DOI: 10.1016/j.knee.2022.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 01/14/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND (INCLUDING THE AIM OF THE STUDY) Young and more active patients with medial compartment osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency are difficult to treat. The aim of this study was to explore the outcomes of combined fixed bearing Physica ZUK medial unicompartmental knee replacement (UKR) (Lima Corporate, Udine Italy) with ACL reconstruction for patients presenting with isolated medial compartment OA and symptomatic ACL deficiency. METHODS Patients who underwent simultaneous single stage ACL reconstruction and medial UKR between 2012 and 2020 by a single surgeon (GG) were included. Preoperative outcome measures including Lysholm, Tegner, Oxford Knee Score and VAS pain score were evaluated and were repeated postoperatively at the most recent follow up appointment. RESULTS Twenty four patients underwent simultaneous combined ACL and ZUK Medial UKR with a mean follow up of 5.1 years. Significant improvements in Lysholm (p < 0.001), Tegner (p < 0.001), Oxford Knee Score (p < 0.001) and VAS pain scores (p < 0.001) were seen with this combined approach with all patients returning to sport. Two patients had a minor peri-operative complication, which was treated conservatively. There were no revision procedures, and no evidence of implant loosening, however one patient had deceased due to an unrelated illness. CONCLUSION UKR combined with ACL reconstruction can be an effective treatment option for selected patients suffering from medial unicompartmental knee osteoarthritis and symptomatic ACL deficiency. This allowed active patients to return to sports, addressing both instability and OA pain in a specific patient population.
Collapse
Affiliation(s)
- Thomas Kurien
- Derby Sports Knee and Arthroplasty Fellow, Royal Derby Hospital, Derby, England, UK; Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, UK.
| | - Bruno Stragier
- Derby Sports Knee and Arthroplasty Fellow, Royal Derby Hospital, Derby, England, UK; Orthopaedic Trainee, Leuven, Belgium
| | - Shanaka Senevirathna
- Derby Sports Knee and Arthroplasty Fellow, Royal Derby Hospital, Derby, England, UK
| | - Guido Geutjens
- Consultant Sports Knee and Arthroplasty Surgeon, Royal Derby Hospital, Derby, England, UK
| |
Collapse
|
9
|
Aghajanzadeh M, Ashoobi MT, Ziabari SMZ, Asgary MR, Ebrahimiyan R, Fomani AA, Jafarnejad A, Tangestaninejad A. Evaluation of the Relationship Between Primary Spontaneous Pneumothorax and Exercise and Return to Previous Activities in Patients Referring to Hospitals of Rasht during 2015-2017. Ethiop J Health Sci 2021; 31:619-624. [PMID: 34483619 PMCID: PMC8365484 DOI: 10.4314/ejhs.v31i3.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/04/2020] [Indexed: 11/17/2022] Open
Abstract
Background The most common cause of primary spontaneous pneumothorax (PSP) is subpleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise the time. In this study, we tend to investigate the relationship between training and PSP and time of return to exercise and previous activities. Method This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2017 based on inclusion criteria. Variables were analyzed using Fisher's exact test, Chi-square, Mann Whitney U and t-test (p<0.05). Results The most common treatment type in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after four weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had a recurrence; of non-athletes, 9.8% had a recurrence. Of athletes, 4.8% did not tolerate returning to their last activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant. Conclusion Our study showed no significant difference between clinical manifestations and image findings and the frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity.
Collapse
Affiliation(s)
- Manouchehr Aghajanzadeh
- Department of Thoracic and general Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | | | | | - Mohammad Reza Asgary
- Department of Thoracic and general Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ramin Ebrahimiyan
- Department of Thoracic and general Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Alavi Fomani
- Inflammatory Lung Diseases Research Center, Guilan University of Medical Science, iran
| | - Alirza Jafarnejad
- Inflammatory Lung Diseases Research Center, Guilan University of Medical Science, iran
| | - Azita Tangestaninejad
- Inflammatory Lung Diseases Research Center, Guilan University of Medical Science, iran
| |
Collapse
|
10
|
Snyder AR, Greif SM, Clugston JR, FitzGerald DB, Yarrow JF, Babikian T, Giza CC, Thompson FJ, Bauer RM. The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial. J Int Neuropsychol Soc 2021; 27:790-804. [PMID: 34548116 DOI: 10.1017/S1355617721000886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to pilot safety and tolerability of a 1-week aerobic exercise program during the post-acute phase of concussion (14-25 days post-injury) by examining adherence, symptom response, and key functional outcomes (e.g., cognition, mood, sleep, postural stability, and neurocognitive performance) in young adults. METHOD A randomized, non-blinded pilot clinical trial was performed to compare the effects of aerobic versus non-aerobic exercise (placebo) in concussion patients. The study enrolled three groups: 1) patients with concussion/mild traumatic brain injury (mTBI) randomized to an aerobic exercise intervention performed daily for 1-week, 2) patients with concussion/mTBI randomized to a non-aerobic (stretching and calisthenics) exercise program performed daily for 1-week, and 3) non-injured, no intervention reference group. RESULTS Mixed-model analysis of variance results indicated a significant decrease in symptom severity scores from pre- to post-intervention (mean difference = -7.44, 95% CI [-12.37, -2.20]) for both concussion groups. However, the pre- to post-change was not different between groups. Secondary outcomes all showed improvements by post-intervention, but no differences in trajectory between the groups. By three months post-injury, all outcomes in the concussion groups were within ranges of the non-injured reference group. CONCLUSIONS Results from this study indicate that the feasibility and tolerability of administering aerobic exercise via stationary cycling in the post-acute time frame following post-concussion (14-25 days) period are tentatively favorable. Aerobic exercise does not appear to negatively impact recovery trajectories of neurobehavioral outcomes; however, tolerability may be poorer for patients with high symptom burden.
Collapse
|
11
|
Bodkin SG, Hertel J, Diduch DR, Saliba SA, Novicoff WM, Brockmeier SF, Miller MD, Gwathmey FW, Werner BC, Hart JM. Predicting ACL Reinjury from Return to Activity Assessments at 6-months Post-Surgery: A Prospective Cohort Study. J Athl Train 2021; 57:325-333. [PMID: 35439312 PMCID: PMC9020598 DOI: 10.4085/1062-6050-0407.20] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Return to activity(RTA) assessments are commonly administered following ACL-Reconstruction(ACLR) to manage post-operative progressions back to activity. To date, there is little knowledge on the clinical utility of these assessments to predict patient outcomes such as secondary ACL injury once returned to activity. OBJECTIVE To identify what measures of patient function at 6-months post-ACLR best predict return to activity and second ACL injury at a minimum of 2-years following ACLR. DESIGN Prospective-cohort Setting: Laboratory Patients: A total of 234 patients with primary, unilateral ACLR completed functional assessments at approximately 6-months post-ACLR. A total of 192(82%) completed follow-up ≥ 2-years post ACLR. MAIN OUTCOME MEASURES Six-month functional assessments consisted of patient reported outcomes, isokinetic knee flexor and extensor strength, and single-leg hopping. The ability to return to activity and secondary ACL injury were collected at a minimum of two-years following ACLR. RESULTS In patients who did RTA(n=155), a total of 44(28%) individuals had a subsequent ACL injury; graft n=24(15.5%), contralateral ACL n=20(13%). A greater proportion of females had a secondary injury to the contralateral ACL(15/24, 63%) whereas a greater proportion of males reinjured the ipsilateral ACL graft(15/20, 75%, P=.017) Greater knee extension symmetry at 6-months increased the probability of reinjury(B=.016, P=.048). In patients who RTA before 8-months, every 1% increase in quadriceps strength symmetry at 6-months increased the risk of reinjury by 2.1%(B=.021, P=.05). In patients who RTA after 8-months, every month that RTA was delayed reduced the risk of reinjury by 28.4%(B=-284, P=.042). CONCLUSIONS Patients with more symmetric quadriceps strength at 6-months post ACLR were more likely to experience another ACL rupture, especially in those who returned to sport earlier than 8-months after the index surgery. Clinicians should be cognizant that returning high functioning patients to activity earlier than 8-months post-ACLR may place them at an increased risk for reinjury.
Collapse
Affiliation(s)
- S G Bodkin
- Department of Physical Medicine and Rehabilitation. University of Colorado Anschutz Medical Campus. Aurora, CO
| | - J Hertel
- Department of Kinesiology. University of Virginia, Charlottesville, VA
| | - D R Diduch
- Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| | - S A Saliba
- Department of Kinesiology. University of Virginia, Charlottesville, VA
| | - W M Novicoff
- Public Health Sciences, University of Virginia, Charlottesville, VA
| | - S F Brockmeier
- Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| | - M D Miller
- Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| | - F W Gwathmey
- Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| | - B C Werner
- Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| | - J M Hart
- Department of Kinesiology. University of Virginia, Charlottesville, VA.,Department of Orthopaedic Surgery. University of Virginia, Charlottesville, VA
| |
Collapse
|
12
|
Allen T, Wilson S, Cohen DD, Taberner M. Drill design using the 'control-chaos continuum': Blending science and art during return to sport following knee injury in elite football. Phys Ther Sport 2021; 50:22-35. [PMID: 33862346 DOI: 10.1016/j.ptsp.2021.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/31/2021] [Accepted: 02/16/2021] [Indexed: 11/15/2022]
Abstract
Establishing the level of risk, planning and adapting the return to sport (RTS) process following a complex knee injury involves drawing on a combination of relevant high-quality evidence and practitioner experience. On-pitch rehabilitation is a critical element of this process, providing an effective transition from rehabilitation to team training. The 'control-chaos continuum' (CCC) is an adaptable framework for on-pitch rehabilitation moving from high control to high chaos, progressively increasing running load demands and incorporating greater perceptual and neurocognitive challenges within sport-specific drills. Drills are a key element of the CCC, and are designed to ensure specificity, ecological validity and maintaining player interest. We showcase drill progression through the phases of the CCC, highlighting the use of constraints to create drills that incorporate the physical, technical, tactical and injury-specific needs of the player. We also provide recommendations to help practitioners create training session content using the CCC to help replicate the demands of team training within their own environment.
Collapse
Affiliation(s)
- T Allen
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK; Institute of Coaching and Performance, University of Central Lancashire, Preston, UK.
| | - S Wilson
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
| | - D D Cohen
- Masira Research Institute, University of Santander (UDES), Bucaramanga, Colombia; Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Colombia
| | - M Taberner
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
| |
Collapse
|
13
|
Stahl RA, Eckenrode BJ. THE NONOPERATIVE REHABILITATION OF A TRAUMATIC COMPLETE ULNAR COLLATERAL LIGAMENT TEAR OF THE ELBOW IN A HIGH SCHOOL WRESTLER: A CASE REPORT. Int J Sports Phys Ther 2020; 15:1211-21. [PMID: 33344036 DOI: 10.26603/ijspt20201211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Injuries frequently occur in competitive wrestling, with the elbow joint representing about 25% of all injuries. Specific to the elbow, the ulnar collateral ligament (UCL) can be injured traumatically from takedowns in wrestling. In athletes with complete UCL tears, surgical management is often recommended with nonoperative management resulting in less favorable outcomes. The purpose of this case report is to present a nonoperative criterion-based rehabilitation program for a high school wrestler with a complete UCL tear of the elbow. Case Description A 17-year-old male wrestler presented to outpatient physical therapy with a complete UCL tear sustained from falling on an outstretched hand during a wrestling match. He presented with limited elbow range of motion (ROM), medial elbow instability, and weakness of the involved shoulder and forearm musculature. A three staged criterion-based rehabilitation protocol was developed for this subject based on specific criteria, including pain, elbow ROM, arm strength, and functional outcomes. Outcomes The subject was treated for nine visits over six weeks, and demonstrated improvements in all strength tests of the involved upper extremity, with elbow flexion strength improving the most by 58%. Return to sport (RTS) tests were used to assess the subject's ability to return to practice. At approximately eight weeks after initial injury, the subject was able to return to full participation in competitive wrestling with no reports of elbow pain or instability. Discussion Through the utilization of a criterion-based rehabilitation protocol for the nonoperative management of an UCL injury, this high school wrestler was able to safely progress back to wrestling without pain or instability in an accelerated time frame. Previously, no detailed rehabilitation guidelines for nonoperative management of UCL injuries in contact sports have been described. Additionally, few studies exist which report on the inclusion of RTS testing following an injury to the UCL of the elbow, as RTS testing is optimal for determining readiness for sport. Level of Evidence 4, Case Report.
Collapse
|
14
|
Abstract
Injuries to the hamstring muscle complex are common in athletes, accounting for between 12% and 26% of all injuries sustained during sporting activities. Acute hamstring injuries often occur during sports that involve repetitive kicking or high-speed sprinting, such as American football, soccer, rugby, and athletics. They are also common in watersports, including waterskiing and surfing. Hamstring injuries can be career-threatening in elite athletes and are associated with an estimated risk of recurrence in between 14% and 63% of patients. The variability in prognosis and treatment of the different injury patterns highlights the importance of prompt diagnosis with magnetic resonance imaging (MRI) in order to classify injuries accurately and plan the appropriate management. Low-grade hamstring injuries may be treated with nonoperative measures including pain relief, eccentric lengthening exercises, and a graduated return to sport-specific activities. Nonoperative management is associated with highly variable times for convalescence and return to a pre-injury level of sporting function. Nonoperative management of high-grade hamstring injuries is associated with poor return to baseline function, residual muscle weakness and a high-risk of recurrence. Proximal hamstring avulsion injuries, high-grade musculotendinous tears, and chronic injuries with persistent weakness or functional compromise require surgical repair to enable return to a pre-injury level of sporting function and minimize the risk of recurrent injury. This article reviews the optimal diagnostic imaging methods and common classification systems used to guide the treatment of hamstring injuries. In addition, the indications and outcomes for both nonoperative and operative treatment are analyzed to provide an evidence-based management framework for these patients. Cite this article: Bone Joint J 2020;102-B(10):1281-1288.
Collapse
Affiliation(s)
- Justin S Chang
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK
| | - Babar Kayani
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK.,The Princess Grace Hospital, London, UK
| | - Ricci Plastow
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK
| | - Sandeep Singh
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK
| | - Ahmed Magan
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK.,The Princess Grace Hospital, London, UK
| |
Collapse
|