ORCID Profile
0000-0002-9624-0791
Current Organisations
University of Oxford
,
University of Melbourne
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Publisher: Elsevier
Date: 2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
Publisher: BMJ
Date: 17-05-2017
DOI: 10.1136/BJSPORTS-2016-097124
Abstract: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured in iduals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. Exploratory analysis of the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial ( ISRCTN84752559 ). Relationships between prognostic factors (baseline cartilage, meniscus and osteochondral damage, baseline extension deficit, baseline patient-reported outcomes, number of rehabilitation visits, graft/contralateral ACL rupture, non-ACL surgery and ACL treatment strategy) and 5-year Knee Injury and Osteoarthritis Outcome Score (KOOS) pain, symptoms, sport/recreation and quality of life (QOL) scores were explored using multivariable linear regression. Estimates were adjusted for sex, age, body mass index, preinjury activity level, education and smoking. For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (−14.4, 95% CI −27.6 to –1.3) and osteochondral lesions were associated with worse QOL (−12.3, 95% CI −24.3 to –0.4) following early reconstruction plus exercise therapy. In the same group, undergoing additional non-ACL surgery and worse baseline KOOS scores were prognostic for worse outcome on all KOOS subscales. Following delayed reconstruction, baseline meniscus damage was a prognostic factor for less pain (14.3, 95% CI 0.7 to 27.9). Following exercise therapy alone, undergoing non-ACL surgery was prognostic for worse pain. Treatment-dependent differences in prognostic factors for 5-year outcomes may support in idualised treatment after acute ACL rupture in young active in iduals. Current Controlled Trials ISRCTN84752559 .
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 13-08-2022
DOI: 10.1007/S40279-022-01739-3
Abstract: To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury is needed. The aim of this systematic review was to investigate knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury, and compare these outcomes following management with rehabilitation alone, early and delayed ACL reconstruction (ACLR). Seven databases were searched from inception to April 14, 2022. Articles were included if they assessed T a Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scale (KSES), or Fear Avoidance Beliefs Questionnaire (FABQ). Risk of bias (RoB) was assessed using domain-based RoB tools (ROBINS-1, RoB 2, RoBANS), and GRADE-assessed certainty of evidence. Random-effects meta-analyses pooled outcomes, stratified by time post-injury (pre-operative, 3-6 months, 7-12 months, > 1-2 years, > 2-5 years, > 5 years). Seventy-three studies (70% high RoB) were included (study outcomes: TSK: 55 KSES: 22 FABQ: 5). Meta-analysis demonstrated worse kinesiophobia and self-efficacy pre-operatively (pooled mean [95% CI], TSK-11: 23.8 [22.2-25.3] KSES: 5.0 [4.4-5.5]) compared with 3-6 months following ACLR (TSK-11: 19.6 [18.7-20.6] KSES: 19.6 [18.6-20.6]). Meta-analysis suggests similar kinesiophobia > 3-6 months following early ACLR (19.8 [4.9]) versus delayed ACLR (17.2 [5.0]). Only one study assessed outcomes comparing ACLR with rehabilitation only. Knee self-efficacy and kinesiophobia improved from pre-ACLR to 3-6 months following ACLR, with similar outcomes after 6 months. Since the overall evidence was weak, there is a need for high-quality observational and intervention studies focusing on psychological outcomes following ACL injury.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12891-019-2956-7
Abstract: Sport participants are at increased risk of joint pain and osteoarthritis. A better understanding of factors associated with joint pain and osteoarthritis in this population could inform the development of strategies to optimise their long-term joint health. The purpose of the study was to describe the prevalence of joint pain and osteoarthritis in former cricketers, and determine whether playing position, playing standard (i.e. elite or recreational standard) and length-of-play are associated with region-specific joint pain. The data were from the Cricket Health and Wellbeing Study (CHWS), a cohort of 2294 current and former cricketers (played ≥1 season) in England and Wales. For this study, eligible in iduals had to be aged ≥30 years and be a former cricket participant. Joint pain was defined as region-specific (hip/knee/ankle/shoulder/hand/back) pain on most days of the last month. Osteoarthritis was defined as joint-specific doctor-diagnosed osteoarthritis. Logistic regression was used to calculate unadjusted and adjusted (for history of joint injury resulting in 4 weeks of reduced activity +/− age) odds ratios (ORs) and 95% confidence intervals (95% CIs). 846 in iduals from the CHWS were former cricketers aged ≥30 years (3% female, aged median 62(IQR 54–69) years, 62% played cricket recreationally, median 33(IQR 21–41) cricket seasons). One-in-two (48%) reported joint pain and 38% had been diagnosed with osteoarthritis. Joint pain and OA were most common in the knee (23% pain, 22% osteoarthritis), followed by the back (14% pain, 10% osteoarthritis) and hand (12% pain, 6% osteoarthritis). After adjusting for injury, bowlers had greater odds of shoulder pain (OR (95% CI) 3.1(1.3, 7.4)) and back pain (3.6(1.8, 7.4)), and all-rounders had greater odds of knee (1.7(1.0, 2.7)) and back pain (2.1(1.0, 4.2)), compared to batters. Former elite cricketers had greater odds of hand pain (1.6(1.0, 2.5)) than former recreational cricketers. Playing standard was not related to pain at other sites, and length-of-play was not associated with joint pain in former cricketers. Every second former cricketer experienced joint pain on most days of the last month, and more than one in three had been diagnosed with osteoarthritis. Compared with batters, bowlers had higher odds of shoulder and back pain and all-rounders had higher odds of back and knee pain. Elite cricket participation was only related to higher odds of hand pain compared with recreational cricket participation.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 04-2023
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 04-2020
Publisher: BMJ
Date: 15-11-2022
DOI: 10.1136/BJSPORTS-2022-106299
Abstract: The goal of the OPTIKNEE consensus is to improve knee and overall health, to prevent osteoarthritis (OA) after a traumatic knee injury. The consensus followed a seven-step hybrid process. Expert groups conducted 7 systematic reviews to synthesise the current evidence and inform recommendations on the burden of knee injuries risk factors for post-traumatic knee OA rehabilitation to prevent post-traumatic knee OA and patient-reported outcomes, muscle function and functional performance tests to monitor people at risk of post-traumatic knee OA. Draft consensus definitions, and clinical and research recommendations were generated, iteratively refined, and discussed at 6, tri-weekly, 2-hour videoconferencing meetings. After each meeting, items were finalised before the expert group (n=36) rated the level of appropriateness for each using a 9-point Likert scale, and recorded dissenting viewpoints through an anonymous online survey. Seven definitions, and 8 clinical recommendations (who to target, what to target and when, rehabilitation approach and interventions, what outcomes to monitor and how) and 6 research recommendations (research priorities, study design considerations, what outcomes to monitor and how) were voted on. All definitions and recommendations were rated appropriate (median appropriateness scores of 7-9) except for two subcomponents of one clinical recommendation, which were rated uncertain (median appropriateness score of 4.5-5.5). Varying levels of evidence supported each recommendation. Clinicians, patients, researchers and other stakeholders may use the definitions and recommendations to advocate for, guide, develop, test and implement person-centred evidence-based rehabilitation programmes following traumatic knee injury, and facilitate data synthesis to reduce the burden of knee post-traumatic knee OA.
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2019-032070
Abstract: Cricket is a popular sport played by 2.5 billion people of all ages and abilities. However, cricket participation is decreasing in the UK, despite an increased focus of governments on increasing sport participation to enhance public health. Understanding the health benefits and mitigating the health risks of cricket participation may help cricket organisations promote cricket participation while optimising the long-term health of cricket participants. Currently, there is no literature review on the relationship between cricket participation, health and well-being thus, this relationship remains unclear. Therefore, the aims of this scoping review were (1) to investigate the relationship between cricket participation, health and well-being and (ii) to identify the research gaps related to cricket, health and well-being. Due to the broad nature of our research question and the large number of health outcomes assessed within the cricket literature and to facilitate identification of research gaps, a scoping review methodology was used. The methodology of this paper was informed by previous scoping review protocols and best practice methodological frameworks. MEDLINE, CINAHL, Embase, Scopus, PsycINFO, SPORTDiscus, Cochrane Library, EBSCO, Web of Science and PEDro and grey literature sources (Google Scholar, ClinicalTrials.gov, ISRCTN Registry and ProQuest) will be systematically searched. Studies that assess a construct related to health and/or well-being in current and/or former cricketers from all ages and standards of play will be eligible. Two reviewers will independently screen full texts of identified studies for eligibility and will perform data extraction. Results will be presented in tabular and graphical forms and will be reported descriptively. This research is exempt from ethics approval due to the data being available through published and public available resources. Results will be published in a peer-reviewed sports and exercise medicine journal regardless of positive or negative findings. In addition, results will be disseminated through multiple platforms, including conference presentations and social media using multimedia resources (eg, infographics, animations, videos, podcasts and blogs), to engage stakeholder groups, including cricketers, cricket coaches, sporting bodies, sports medicine professionals and policy makers. There findings will inform clinical decision making, policy changes and future research agendas.
Publisher: Elsevier BV
Date: 09-2021
Publisher: BMJ
Date: 14-06-2023
DOI: 10.1136/BJSPORTS-2023-106931
Abstract: Investigate MRI evidence of anterior cruciate ligament (ACL) healing, patient-reported outcomes and knee laxity in patients with acute ACL rupture managed non-surgically with the Cross Bracing Protocol (CBP). Eighty consecutive patients within 4 weeks of ACL rupture were managed with CBP (knee immobilisation at 90° flexion in brace for 4 weeks, followed by progressive increases in range-of-motion until brace removal at 12 weeks, and physiotherapist-supervised goal-oriented rehabilitation). MRIs (3 months and 6 months) were graded using the ACL OsteoArthritis Score (ACLOAS) by three radiologists. Mann-Whitney U tests compared Lysholm Scale and ACL quality of life (ACLQOL) scores evaluated at median (IQR) of 12 months (7–16 months) post-injury, and χ 2 tests compared knee laxity (3-month Lachman’s test and 6-month Pivot-shift test), and return-to-sport at 12 months between groups (ACLOAS grades 0–1 (continuous±thickened ligament and/or high intraligamentous signal) versus ACLOAS grades 2–3 (continuous but thinned/elongated or complete discontinuity)). Participants were aged 26±10 years at injury, 39% were female, 49% had concomitant meniscal injury. At 3 months, 90% (n=72) had evidence of ACL healing (ACLOAS grade 1: 50% grade 2: 40% grade 3: 10%). Participants with ACLOAS grade 1 reported better Lysholm Scale (median (IQR): 98 (94–100) vs 94 (85–100)) and ACLQOL (89 (76–96) vs 70 (64–82)) scores, compared with ACLOAS grades 2–3. More participants with ACLOAS grade 1 had normal 3-month knee laxity (100% vs 40%) and returned to pre-injury sport (92% vs 64%), compared with participants with an ACLOAS grades 2–3. Eleven patients (14%) re-injured their ACL. After management of acute ACL rupture with the CBP, 90% of patients had evidence of healing on 3-month MRI (continuity of the ACL). More ACL healing on 3-month MRI was associated with better outcomes. Longer-term follow-up and clinical trials are needed to inform clinical practice.
Publisher: Oxford University Press (OUP)
Date: 22-12-2021
DOI: 10.1093/PTJ/PZAB273
Abstract: The purpose of this study was to compare fear and certainty of reinjury between follow-up time points and treatment groups (no anterior cruciate ligament [ACL] reconstruction [no ACLR], pre-ACLR, post-ACLR) and to identify prognostic factors for fear of reinjury at 3 and 12 months following injury or ACLR. An exploratory analysis of the Natural Corollaries and Recovery After ACL-injury multicenter longitudinal cohort study was conducted. Patients (n = 275) with primary ACL injury and 15 to 40 years of age received usual care (initial physical therapist–supervised rehabilitation, before considering ACLR). Fear of reinjury (as measured with the Anterior Cruciate Ligament Quality of Life instrument [ACL-QOL] item 31 and the Anterior Cruciate Ligament Return to Sport After Injury instrument [ACL-RSI] item 9) and certainty of reinjury (as measured with the Knee Self-Efficacy Scale item D2) were evaluated at baseline and at 3, 6, and 12 months following ACL injury or ACLR. Comparisons were performed with linear mixed models. Linear regression assessed potential prognostic factors (age, sex, preinjury activity, baseline knee function, baseline general self-efficacy, and expected recovery time) for fear of reinjury (ACL-QOL item 31) at the 3- and 12-month follow-up assessments. Fear of reinjury was common regardless of ACL treatment. Fear of reinjury decreased between 3 and 6 months and 3 and 12 months (mean difference: ACL-QOL = 9 [95% CI = 2 to 15] ACL-RSI = 21 [95% CI = 13 to 28]) after injury. This improvement was not observed in patients who later underwent ACLR, who reported worse fear of reinjury at 3 months (ACL-QOL = 10 [95% CI = 3 to 18]) and at 12 months (ACL-RSI = 22 [95% CI = 2 to 42]) postinjury compared with those who did not proceed to ACLR. Following ACLR, fear of reinjury decreased between the 3- and 12-month follow-up assessments (ACL-QOL = 10 [95% CI = 4 to 16] ACL-RSI = 12 [95% CI = 5 to 19]). Greater baseline general self-efficacy was associated with reduced fear of reinjury at 12 months after injury (adjusted coefficient = 1.7 [95% CI = 0.0 to 3.5]). Female sex was related to more fear of reinjury 3 months after ACLR (−14.5 [95% CI = −25.9 to −3.1]), and better baseline knee function was related to reduced fear of reinjury 12 months after ACLR (0.3 [95% CI = 0.0 to 0.7]). People who had ACLR reported worse fear of reinjury before surgery than those who did not proceed to ACLR. Different prognostic factors for fear of reinjury were identified in people treated with ACLR and those treated with rehabilitation alone. Fear of reinjury is a concern following ACL injury. Clinicians should evaluate and address reinjury fears. These results may assist in identifying in iduals at risk of fear of reinjury following surgical and nonsurgical management of ACL injury.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2020
DOI: 10.1186/S12955-020-01301-7
Abstract: Health related quality of life (HRQoL) and flourishing are constructs that encompasses a holistic representation of physical, psychological, and social health. The underlying psychological factors that can affect HRQoL and flourishing in sports participants is poorly understood. The purpose of this study was to i) evaluate HRQoL (physical and mental-components) and flourishing in recreational and elite and current and former cricketers ii) determine the effect of resilience, playing-standard, and playing status on HRQoL and flourishing in cricketers. The Cricket Health and Wellbeing Study ( n = 2598 current and former cricketers, aged ≥18 years) collected cross-sectional questionnaire data including the Flourishing Scale, Short Form-8 (physical (PCS) and mental (MCS) component scores), resilience (European Social Survey), highest standard-of-play, and playing status. Multivariable linear regressions with fractional polynomials were utilised, adjusted for age, gender, total cricket-seasons, comorbidity, ≥ 4-week time-loss injury, and orthopaedic surgery. Two thousand two hundred eighty in iduals (aged (mean (SD)) 51.7(14.7) years, 61% played recreationally, 37% former cricketers) were included in analyses. The median (IQR) PCS was 51.4(46.9–55.9), MCS was 54.3(50.0–58.6), and Flourishing Scale score was 48 [ (1–7)] .Greater resilience was associated with better PCS (effect (95% CI) 1.41(0.70–2.11)), MCS (4.78(4.09–5.48)), and flourishing (2.07(2.55–3.59)) compared to less resilience. Playing standard was not associated with HRQoL. Playing at an elite standard was associated with greater flourishing (1.21(0.68, 1.73)), compared with playing recreationally. Current cricket participation was associated with better PCS (3.61(2.92–4.30)) and flourishing scores (0.53(0.02–1.04)), compared to former cricket participation. Cricketers reported high levels of mental-components of HRQoL and flourishing, and this was similar in recreational, elite, current and former cricketers. Current cricket participation and a higher standard-of-play was associated with greater flourishing. Current cricket participation was also associated with better PCS, however playing-status was not related to MCS. Further research is needed to understand if cricket participation may have psychological benefits that persist beyond cricket retirement.
Publisher: Elsevier BV
Date: 06-2023
Publisher: BMJ
Date: 07-2017
Publisher: BMJ
Date: 07-2023
DOI: 10.1136/BMJSEM-2023-001597
Abstract: To estimate the age-specific lifetime prevalence of skin cancer in a s le of Australian golf participants and estimate skin cancer risk in golf participants compared with a general population-based s le. Golf participants in Australia (n=336) completed the Australian Golf Health Survey which collected data on skin cancer diagnosis (self-reported history), physical activity levels and participant demographics. Data were compared with a s le of the Australian general population (n=15780, Australian Health Survey). Age-specific lifetime prevalence of skin cancer in golf and general population-based s les was determined, and modified Poisson regression (adjusted for age, sex, education and smoking status) was used to estimate the association between playing golf and the risk of a current or past skin cancer diagnosis. One in four golf participants (n=91 27%) had received a skin cancer diagnosis compared with 7% (n=1173) of the general population. Golf participants were 2.42 (2.01 to 2.91) (relative risk (95% CI)) times more likely to report a skin cancer diagnosis than the general population after adjusting for age, sex, education and smoking status. Playing golf in Australia is associated with a higher age-specific lifetime prevalence of skin cancer compared with the general population. Golf organisations, clubs and facilities should inform golf participants about the risk of skin cancer and promote preventive strategies including use of high-Sun Protection Factor (SPF) sunscreen, appropriate hats and clothing.
Publisher: Elsevier BV
Date: 10-2019
Publisher: Elsevier BV
Date: 10-2019
Publisher: BMJ
Date: 27-03-2018
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 09-08-2023
DOI: 10.1186/S40634-023-00638-4
Abstract: To identify potential prognostic factors for patient-reported outcomes in an Icelandic cohort of ACL injured subjects. All knee MRI reports written in Iceland between the years 2001 to 2011 were read to identify in iduals with a possible ACL injury. These in iduals were contacted and asked to complete an online questionnaire regarding their injury and current knee related health. The questionnaire collected information on years since surgery, injury circumstance, brace use, physiotherapy, ACL surgery, second ACL injury and current smoking status. In addition, the baseline status of their meniscii were assessed from the original MRI report and medical records were used to identify any subsequent, non-ACL surgery. The patient-reported Knee Osteoarthritis and Injury Outcome Score (KOOS) was used assess current knee related health. A Bayesian proportional odds model was used to assess the effect of all potential prognostic factors above as well as age and sex on KOOS outcomes. A total of 408 subjects completed the questionnaire indicating that they did rupture their ACL. The following variables were associated with worse outcomes across all KOOS subscales: having a subsequent arthroscopy, reinjury to your ACL, and smoking. Having physiotherapy for 9 months was associated with worse KOOS pain scores than having 6 months of physiotherapy. Conversely KOOS pain score tended to be higher if you injured your knee during sports. Reinjuring your ACL, smoking and having subsequent (non-ACLR) surgery predict your knee related health following an ACL injury. Strategies should be implemented to reduce the risk of secondary ACL injury, and patients should be strongly advised not to smoke.
Publisher: BMJ
Date: 03-11-2022
DOI: 10.1136/BJSPORTS-2022-105473
Abstract: Evaluate the natural course of anterior cruciate ligament (ACL) healing on MRI within 5 years of acute ACL rupture and compare 2-year and 5-year outcomes based on healing status and treatment group. Secondary analysis of 120 Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) trial participants randomised to rehabilitation and optional delayed ACL reconstruction (ACLR) or early ACLR and rehabilitation. ACL continuity on MRI (Anterior Cruciate Ligament OsteoArthritis Score 0–2) was considered evidence of ACL healing. Outcomes included Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS patient acceptable symptomatic state (PASS) and treatment failure criteria. Linear mixed models were used to estimate adjusted mean differences (95% CIs) in patient-reported sport and recreational function (KOOS-Sport/Rec) and quality of life (KOOS-QOL) at 2 and 5 years, between participants with MRI evidence of ACL healing and those who had (1) no evidence of ACL healing, (2) delayed ACLR or (3) early ACLR. MRI evidence of ACL healing at 2-year follow-up was observed in 16 of 54 (30%, 95% CI 19 to 43%) participants randomised to optional delayed ACLR. Excluding participants who had delayed ACLR, 16 of 30 (53%, 36–70%) participants managed with rehabilitation-alone displayed MRI evidence of ACL healing. Two-year outcomes were better in the healed ACL group (n=16) compared with the non-healed (n=14) (mean difference (95% CI) KOOS-Sport/Rec: 25.1 (8.6–41.5) KOOS-QOL: 27.5 (13.2–41.8)), delayed ACLR (n=24) (KOOS-Sport/Rec: 24.9 (10.2–39.6) KOOS-QOL: 18.1 (5.4–30.8)) and early ACLR (n=62) (KOOS-Sport/Rec: 17.4 (4.1–30.7) KOOS-QOL: 11.4 (0.0–22.9)) groups. Five-year KOOS-QOL was better in the healed versus non-healed group (25.3 (9.4–41.2)). Of participants with MRI evidence of ACL healing, 63–94% met the PASS criteria for each KOOS subscale, compared with 29–61% in the non-healed or reconstructed groups. MRI appearance of ACL healing after ACL rupture occurred in one in three adults randomised to initial rehabilitation and one in two who did not cross-over to delayed ACLR and was associated with favourable outcomes. The potential for spontaneous healing of the ACL to facilitate better clinical outcomes may be greater than previously considered. NCT84752559 .
Publisher: Elsevier BV
Date: 03-2023
Publisher: University of Queensland Library
Publisher: SAGE Publications
Date: 31-07-2020
Abstract: The long-term prevalence of knee osteoarthritis (OA) after anterior cruciate ligament (ACL) injury is unknown, especially in patients without a history of ACL surgery. To (1) describe the prevalence of radiographic OA, symptomatic OA, and knee replacement surgery 32 to 37 years after acute ACL injury and to (2) compare the prevalence of radiographic OA, symptomatic OA, and knee symptoms between patients allocated to early ACL surgery or no ACL surgery and patients who crossed over to ACL surgery. Cohort study Level of evidence, 2. Participants aged 15 to 40 years at the time of ACL injury were allocated to surgical (augmented or nonaugmented ACL repair) or nonsurgical ACL treatment within 14 days of injury. At 32 to 37 years after the initial injury, 153 participants were followed up with plain weightbearing radiographs and completed 4 subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic OA was defined as Kellgren and Lawrence grade 2 or higher. Symptomatic OA was defined as radiographic OA plus knee symptoms measured with the KOOS. Participants allocated to ACL surgery (n = 64) underwent surgery at a mean ± SD of 5 ± 4 days (range, 0-11 days) after injury. Of the 89 participants allocated to no ACL surgery, 53 remained nonsurgically treated, 27 had ACL surgery within 2 years, and 9 had ACL surgery between 3 and 21 years after injury. In the total s le, 95 participants (62%) had radiographic tibiofemoral OA, including 11 (7%) who had knee replacement. The prevalence of radiographic tibiofemoral OA was lower in the group allocated to ACL surgery compared with the group who never had ACL surgery (50% vs 75% P = .005). The prevalence of symptomatic OA (50% in the total s le) and patellofemoral radiographic OA (35% in the total s le) was similar between groups. Patients allocated to early ACL surgery, performed a mean 5 days after injury, had a lower prevalence of tibiofemoral radiographic OA at 32 to 37 years after injury compared with patients who never had ACL surgery. The prevalences of symptomatic OA, radiographic patellofemoral OA, and knee symptoms were similar irrespective of ACL treatment. Overall, the prevalence of OA after ACL injury was high. NCT03182647 (ClinicalTrials.gov identifier)
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JOCA.2021.08.009
Abstract: Explore prognostic factors for tibiofemoral (TFJ) and patellofemoral (PFJ) radiographic osteoarthritis (ROA) and 'symptoms plus ROA' (SOA), 32-37 years following anterior cruciate ligament (ACL) injury. Exploratory analysis, longitudinal cohort. In 1980-1985, 251 patients aged 15-40 years with acute ACL rupture were allocated to early augmented or non-augmented repair (5 ± 4 days post-injury) plus rehabilitation, or rehabilitation alone. 127 of 190 participants who completed follow-up questionnaires were eligible. We classified ROA as TFJ/PFJ K&L Grade ≥2, and SOA as ROA plus pain and/or symptoms. Multivariable age-adjusted logistic regression investigated potential prognostic factors (assessed at 4 ± 1 year follow-up: ACL treatment, isokinetic quadriceps/hamstrings strength, single-leg-hop for distance, knee flexion/extension deficit, knee laxity, Tegner Activity Scale, Lysholm Scale sex, baseline meniscus status). 127 patients were aged 58 ± 6 years BMI 27 ± 4 kg/m These findings are hypothesis generating, research is needed to determine whether ACL-injured in iduals with these characteristics benefit from interventions to prevent or delay the onset of osteoarthritis.
Publisher: BMJ
Date: 30-10-2019
Publisher: Elsevier BV
Date: 07-2018
Publisher: Informa UK Limited
Date: 10-07-2018
Publisher: Elsevier BV
Date: 04-2020
Publisher: SAGE Publications
Date: 08-2021
DOI: 10.1177/23259671211021592
Abstract: Knowledge to inform the identification of in iduals with a poor long-term prognosis after anterior cruciate ligament (ACL) injury is limited. Identifying prognostic factors for long-term outcomes after ACL injury may inform targeted interventions to improve outcomes for those with a poor long-term prognosis. To determine whether ACL treatment (early augmented or nonaugmented ACL repair plus rehabilitation, rehabilitation alone, or rehabilitation plus delayed ACL reconstruction [ACLR]) and 4-year measures (quadriceps and hamstrings strength, single-leg hop, knee laxity, flexion and extension deficit, self-reported knee function, activity level) are prognostic factors for patient-reported outcomes at 32 to 37 years after acute ACL injury. Cohort study Level of evidence, 2. A total of 251 patients aged 15 to 40 years with acute ACL rupture between 1980 and 1985 were allocated to early ACL repair (augmented or nonaugmented) plus rehabilitation or to rehabilitation alone, based on birth year. One hundred ninety of 234 completed 32- to 37-year follow-up questionnaires (response rate, 81%) 18 people were excluded, resulting in 172 patients available for analysis (mean age, 59 ± 6 years 28% female). Potential prognostic factors assessed 4 years after ACL injury were ACL treatment (early ACL repair, rehabilitation alone, or delayed ACLR), isokinetic quadriceps and hamstrings strength, single-leg hop performance, knee flexion and extension deficit, knee laxity, Tegner activity scale, and Lysholm score. Outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and the Anterior Cruciate Ligament Quality of Life (ACL-QOL) measure. Linear regression adjusted for age, sex, baseline meniscal injury, and contralateral ACL injury was used to assess potential prognostic factors for 32- to 37-year outcomes. Multiple imputation accounted for missing data. A fair oor Lysholm score (vs excellent/good) at 4 years was a prognostic factor for worse KOOS Pain (adjusted regression coefficient, −12 [95% confidence interval (CI), −19 to −4]), KOOS Symptoms (−15 [95% CI, −23 to −7]), KOOS Sport and Recreation (−19 [95% CI, −31 to −8]), and ACL QOL (−9 [95% CI, −18 to −1]) scores. A 4-year single-leg hop limb symmetry index % was a prognostic factor for worse KOOS Pain (adjusted regression coefficient, −9 [95% CI, −17 to −1]) and ACL QOL (−13 [95% CI, −22 to −3]) scores at long-term follow-up. A lower activity level, delayed ACLR, and increased knee laxity were prognostic factors in the crude analysis. Rehabilitation alone versus early repair, quadriceps and hamstring strength, and flexion and extension deficit were not related to 32- to 37-year outcomes. Reduced self-reported knee function and single-leg hop performance 4 years after ACL injury were prognostic factors for worse 32- to 37-year outcomes. Estimates exceeded clinically important thresholds, highlighting the importance of assessing these constructs when managing in iduals with ACL injuries. NCT03182647 ( ClinicalTrials.gov identifier).
Publisher: Springer Science and Business Media LLC
Date: 24-08-2020
DOI: 10.1007/S00296-020-04687-1
Abstract: Progressive hand interphalangeal joint (IPJ) osteoarthritis is associated with pain, reduced function and impaired quality of life. However, the evidence surrounding risk factors for IPJ osteoarthritis progression is unclear. Identifying risk factors for IPJ osteoarthritis progression may inform preventative strategies and early interventions to improve long-term outcomes for in iduals at risk of IPJ osteoarthritis progression. The objectives of the study were to describe methods used to measure the progression of IPJ osteoarthritis and identify risk factors for IPJ osteoarthritis progression. MEDLINE, EMBASE, Scopus, and The Cochrane Library were searched from inception to 19th February 2020 (PROSPERO CRD42019121034). Eligible studies assessed potential risk factor/s associated with IPJ osteoarthritis progression. Risk of bias was assessed using a modified QUIPS Tool, and a best evidence synthesis was performed. Of eight eligible studies, all measured osteoarthritis progression radiographically, and none considered symptoms. Eighteen potential risk factors were assessed. Diabetes (adjusted mean difference between 2.06 and 7.78), and larger finger epiphyseal index in males (regression coefficient β = 0.202) and females ( β = 0.325) were identified as risk factors (limited evidence). Older age in men and women showed mixed results 13 variables were not risk factors (all limited evidence). Patients with diabetes and larger finger epiphyseal index might be at higher risk of radiographic IPJ osteoarthritis progression, though evidence is limited and studies are biased. Studies assessing symptomatic IPJ osteoarthritis progression are lacking.
Publisher: Center for Open Science
Date: 25-01-2023
Abstract: The primary objective of this systematic review is to determine the long-term burden of anterior cruciate ligament andmeniscal injury. The secondary objective is to determine the burden of living with radiographic and/orsymptomatic osteoarthritis, following anterior cruciate ligament and/or meniscal injury.
Publisher: Wiley
Date: 11-05-2016
DOI: 10.1111/SMS.12698
Abstract: Many in iduals experience long-term quality of life (QOL) impairment following anterior cruciate ligament reconstruction (ACLR). Factors contributing to poor QOL and psychological health >5 years after ACLR remain unclear. This study aimed to describe QOL and psychological health outcomes in people with knee difficulties (pain, symptoms, or functional limitations) 5-20 years following ACLR and identify factors explaining variability in these outcomes. Participants with knee difficulties 5-20 years following ACLR completed a battery of validated patient-reported outcomes [including the Knee injury and Osteoarthritis Outcome Score (KOOS), ACL-QOL, and the Assessment of QOL (AQoL-8D) instrument]. Multivariable linear regression was used to identify factors explaining variability in outcomes. One hundred sixty-two participants aged 38 ± 9 (mean ± SD) years completed questionnaires 9 ± 4 (range 5-20) years following ACLR. Thirty-nine percent of participants returned to competitive sport, 28% returned to a lower level, and 32% did not return to sport after ACLR. Not returning to sport after ACLR was associated with worse KOOS-QOL (β = 0.29, P = 0.001 [mean ± SD (55 ± 20)], ACL-QOL [β = 0.48, P < 0.001 (57 ± 21)], and AQoL-8D [β = 0.22, P = 0.02 (0.80 ± 0.14)]) scores. Increased body mass index (56% were overweight/obese) was related to worse QOL and more depressive symptoms. Subsequent knee surgery and contralateral ACLR were also associated with poorer QOL outcomes in these in iduals.
Publisher: SAGE Publications
Date: 06-12-2013
Abstract: Anterior cruciate ligament reconstructions (ACLRs) are frequently performed on young, active patients and can result in persistent knee symptoms and activity limitations that may affect health-related quality of life (HRQoL). To date, there has been no systematic review of HRQoL outcomes after ACLR. The objectives of this study were to report HRQoL ≥5 years after ACLR, compare HRQoL outcomes with available population norms, and describe factors that may affect HRQoL in this population. Systematic review. All studies reporting HRQoL ≥5 years after ACLR with hamstring or patellar tendon autografts were eligible for review. Common HRQoL outcomes were pooled using a random-effects meta-analysis and compared with published population norms. The Spearman rank correlation coefficient (ρ) was used to identify variables associated with HRQoL outcomes. Where insufficient data were available, outcomes were reported descriptively. Fourteen studies were eligible for review, and HRQoL was reported for 2493 patients at a mean of 9 years (range, 5-16 years) after ACLR. Pooling of knee-related quality of life outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS]–QOL) found impairments after ACLR when compared with population norms. In comparison, studies using the Short Form–36 (SF-36) reported similar or better HRQoL compared with normative data. The KOOS-QOL subscores correlated strongly with KOOS-sport/recreation (ρ = .70, P = .04) and KOOS-pain (ρ = .85, P = .003) subscores. Severe radiographic osteoarthritis, meniscal injuries sustained after surgery, and revision ACLR were associated with poorer HRQoL outcomes at a minimum 5-year follow-up. The negative influence of concomitant meniscal surgery on HRQoL became apparent more than 10 years after ACLR. This review found that patients assessed using a knee-specific measure (KOOS-QOL) were more likely to report poorer HRQoL values, compared with population norms, than those assessed using a generic HRQoL measure (SF-36). Revision surgeries, meniscal injuries, and severe radiographic osteoarthritis were associated with poorer HRQoL outcomes after ACLR. However, these relationships should be interpreted with caution, as they were only investigated in a small number of studies. These results can be used by clinicians to educate patients about potential long-term outcomes after ACLR and to develop strategies for optimizing postoperative HRQoL.
Publisher: Elsevier BV
Date: 02-2019
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2022-065600
Abstract: In people with a disability, or their caregivers, who reported suboptimal experiences, the objectives were to explore: (1) challenges with telehealth-delivered allied health services during the COVID-19 pandemic and (2) suggestions to improve such services. Qualitative study based on an interpretivist paradigm and a phenomenological approach. Participants who accessed allied healthcare via telehealth during the pandemic. Data saturation was achieved after 12 interviews. The s le comprised three people with permanent or significant disabilities, and nine carers artners/family members of people with permanent or significant disabilities, who were funded by the Australian National Disability Insurance Scheme and had suboptimal experiences with telehealth. Semistructured one-on-one interviews explored experiences with telehealth and suggestions on how such services could be improved. An inductive thematic analysis was performed. Six themes relating to the first study objective (challenges with telehealth) were developed: (1) evoked behavioural issues in children (2) reliant on caregiver facilitation (3) inhibits clinician feedback (4) difficulty building rapport and trust (5) lack of access to resources and (6) children disengaged/distracted. Five themes relating to the second study objective (suggestions to improve telehealth services) were developed: (1) establish expectations (2) increase exposure to telehealth (3) assess suitability of specific services (4) access to support workers and (5) prepare for telehealth sessions. Some people with permanent and significant disabilities who accessed allied healthcare via telehealth during the pandemic experienced challenges, particularly children. These unique barriers to telehealth need customised solutions so that people with disabilities are not left behind when telehealth services become more mainstream. Increasing experience with telehealth, setting expectations before consultations, supplying resources for therapy and assessing the suitability of clients for telehealth may help overcome some of the challenges experienced.
Publisher: SAGE Publications
Date: 07-2018
Publisher: Elsevier BV
Date: 04-2020
Publisher: BMJ
Date: 2021
DOI: 10.1136/BMJOPEN-2020-041037
Abstract: Rugby football (Union and League) provides physical activity (PA) with related physical and mental health benefits. However, as a collision sport, rugby research and media coverage predominantly focus on injuries in elite players while the overall impact on health and well-being remains unclear. This study aims to provide a greater understanding of the risks and benefits of rugby participation in a erse s le of men and women, current and former rugby Union and League players from recreational to the elite level of play. We will explore: (1) joint-specific injuries and concussion (2) joint pain and osteoarthritis (OA) (3) medical and mental health conditions (4) PA and sedentary behaviour and (5) well-being (quality of life, flourishing and resilience). The Rugby Health and Well-being Study is designed in two phases: (1) a UK-wide cross-sectional survey and (2) cross-validation using health register data from Scotland. Participants will be at least 16 years old, current or former rugby players who have played rugby for at least one season. We will report standardised, level of play-, sex- and age-stratified prevalence of joint injury, concussion, medical conditions and PA. We will describe injury/concussion prevention expectations and protective equipment use. Rugby-related factors associated with injury, pain, OA, PA, health and well-being will be explored in regression models. We will compare joint pain intensity and duration, elements of pain perception and well-being between recreational and elite players and further investigate these associations in regression models while controlling for confounding variables. In the second phase, we will validate self-reported with health register data, and provide further information on healthcare use. The Yorkshire and the Humber—Leeds East Research Ethics Committee (REC reference: 19/HY/0377) has approved this study (IRAS project ID 269424). The results will be disseminated through scientific publications, conferences and social media.
Publisher: Springer Science and Business Media LLC
Date: 22-04-2021
DOI: 10.1007/S00296-021-04823-5
Abstract: A correction to this paper has been published: 0.1007/s00296-021-04823-5
Publisher: BMJ
Date: 28-09-2022
DOI: 10.1136/BJSPORTS-2022-105626
Abstract: Determine the long-term health-related quality-of-life (HRQoL), work limitation, physical activity, health/economic cost and disease burden of traumatic ACL and/or meniscal injury. Findings will inform OPTIKNEE evidence-based consensus recommendations. Random-effects meta-analysis evaluated HRQoL (SF-36/SF-12/VR-12 Physical Component Scores (PCS) and Mental Component Scores (MCS), EuroQol-5D (EQ-5D)) stratified by time postinjury, and pooled mean differences (95% CI) between ACL-injured and uninjured controls. Other outcomes were synthesised descriptively. Risk-of-bias (RoB) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) were assessed. MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched inception: 22 November 2021. Studies reporting HRQoL, work limitations, physical activity levels, health/economic costs or disease burden, ≥2 years post-ACL and/or meniscal injury. Fifty studies were included (10 high-RoB, 28 susceptible-to-some-bias and 12 low-RoB). Meta-analysis (27 studies, very low certainty of evidence) estimated a pooled mean (95% CI) PCS of 52.4 (51.4 to 53.4) and MCS of 54.0 (53.0 to 55.0) 2–14 years post-ACL injury. Pooled PCS scores were worse years (50.8 (48.7 to 52.9)) compared with 2–5 years (53.9 (53.1 to 54.7)) postinjury. Excluding high-RoB studies, PCS scores were worse in ACL-injured compared with uninjured controls (−1.5 (−2.9 to –0.1)). Six studies (low certainty of evidence) informed a pooled EQ-5D score of 0.83 (0.81 to 0.84). Some in iduals experienced prolonged work absenteeism and modified activities ≥2 years post-ACL injury. ACL injury was associated with significant direct and indirect costs, and early ACL reconstruction may be less cost-effective than rehabilitation. Only three studies evaluated meniscal injury outcomes (all evaluated HRQoL). There is a very-low certainty of evidence that PCS scores ≥2 years post-ACL injury are worse than uninjured controls and decline over time, whereas MCS scores remain high. ACL injury can result in prolonged work absenteeism and high health/economic costs. Further studies are needed to determine the long-term burden of traumatic meniscal injury.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.PTSP.2021.12.002
Abstract: To investigate the knowledge and management of Relative Energy Deficiency in Sport (RED-S), from the perspective of lightweight rowers and physiotherapists. Semi-structured in idual qualitative interviews. Physiotherapists who had worked with lightweight rowers, and current and former lightweight rowers (who had experienced at least one symptom of RED-S), undertook audio-recorded semi-structured telephone interviews. An inductive thematic analysis was performed, facilitated by NVivo software. Twelve physiotherapists (n = 6 females, 1-20 years of experience managing lightweight rowers) and twelve lightweight rowers (n = 8 females, 1-8 years lightweight rowing experience, intermediate to elite/international level) were interviewed. Five key themes were identified: insufficient knowledge of RED-S, inadequate RED-S education, inappropriate management of RED-S, referral to other health professionals, prioritising performance over health. Participants provided suggestions for improving knowledge and management of RED-S in lightweight rowers, including formal physiotherapy education and training, and targeted education for athletes and coaches. There was a significant lack of awareness of RED-S amongst physiotherapists and lightweight rowers. Most physiotherapists were not confident discussing or managing RED-S in athletes, and lightweight rowers were dissatisfied with the management they received. Improving RED-S education for physiotherapists and athletes may have important health implications for lightweight rowers.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 05-2018
Abstract: Study Design Clinical measurement, cross-sectional. Background In iduals who have undergone anterior cruciate ligament (ACL) reconstruction commonly experience long-term impairments in quality of life (QoL), which may be related to persistent knee symptoms or radiographic osteoarthritis (ROA). Understanding the impact of knee symptoms and ROA on QoL after ACL reconstruction may assist in the development of appropriate management strategies. Objectives To (1) compare QoL between groups of in iduals after ACL reconstruction (including those who are symptomatic with ROA, symptomatic without ROA, and asymptomatic [unknown ROA status]), and (2) identify specific aspects of QoL impairment in symptomatic in iduals with and without ROA post ACL reconstruction. Methods One hundred thirteen participants completed QoL measures (Knee injury and Osteoarthritis Outcome Score QoL subscale [KOOS-QoL], Anterior Cruciate Ligament Quality of Life [ACL-QoL], Assessment of Quality of Life-8 Dimensions [AQoL-8D]) 5 to 20 years after ACL reconstruction. Eighty-one symptomatic in iduals underwent radiographs, and 32 asymptomatic in iduals formed a comparison group. Radiographic osteoarthritis was defined as a Kellgren-Lawrence grade of 2 or greater for the tibiofemoral and/or patellofemoral joints. Mann-Whitney U tests compared outcomes between groups. In idual ACL-QoL items were used to explore specific aspects of QoL. Results In symptomatic in iduals after ACL reconstruction, ROA was related to worse knee-related outcomes on the KOOS-QoL (median, 50 interquartile range [IQR], 38-69 versus median, 69 IQR, 56-81 P<.001) and the ACL-QoL (median, 51 IQR, 38-71 versus median, 66 IQR, 50-82 P = .04). The AQoL-8D scores showed that health-related QoL was impaired in both symptomatic groups compared to the asymptomatic group. The ACL-QoL item scores revealed greater limitations and concern surrounding sport and exercise and social/emotional difficulties in the symptomatic group with ROA. Conclusion Osteoarthritis is associated with worse knee-related QoL in symptomatic in iduals after ACL reconstruction. Diagnosing ROA in symptomatic in iduals after ACL reconstruction may be valuable, because these in iduals may require unique management. Targeted strategies to facilitate participation in satisfying activities have potential to improve QoL in symptomatic people with ROA after ACL reconstruction. J Orthop Sports Phys Ther 2018 (5):398-408. doi:10.2519/jospt.2018.7830.
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.JPHYS.2016.02.011
Abstract: How do people with knee symptoms describe their quality of life and experiences 5 to 20 years after anterior cruciate ligament reconstruction (ACLR)? What factors impact upon the quality of life of these people? Qualitative study. Seventeen people with knee symptoms 5 to 20 years after ACLR and high (n=8) or low (n=9) quality of life scores were recruited from a cross-sectional study. Semi-structured telephone interviews were conducted and transcribed. The data obtained from the interventions underwent inductive coding and thematic analysis. Four consistent themes emerged from the interviews as common determinants of quality of life following ACLR: physical activity preferences lifestyle modifications adaptation and acceptance and fear of re-injury. All participants described the importance of maintaining a physically active lifestyle and the relationship between physical activity and quality of life. Participants who avoided sport or activity reported experiencing reduced quality of life. Participants who suppressed or overcame re-injury fears to continue sport participation described experiencing a satisfactory quality of life while taking part in sport despite knee symptoms. For some participants, resuming competitive sport resulted in subsequent knee trauma, anterior cruciate ligament re-rupture or progressive deterioration of knee function, with negative impacts on quality of life following sport cessation. Participants who enjoyed recreational exercise often adapted their lifestyle early after ACLR, while others described adapting their lifestyle at a later stage to accommodate knee impairments this was associated with feelings of acceptance and satisfaction, irrespective of knee symptoms. Activity preferences, lifestyle modifications and fear of re-injury influenced quality of life in people with knee symptoms up to 20 years following ACLR. People with a preference for competitive sport who do not enjoy recreational exercise might be at heightened risk of poor quality of life outcomes and could benefit from support to facilitate a transition to a physically active, satisfying lifestyle.
Publisher: Elsevier BV
Date: 10-2019
Publisher: Springer Science and Business Media LLC
Date: 19-02-2020
DOI: 10.1186/S12891-020-3136-5
Abstract: Sports participants are faced with the decision to continue or cease play when injured. The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain and compare findings in elite and recreational cricketers. The Cricket Health and Wellbeing Study cohort was used for this study. Inclusion criteria were: age ≥ 18 years, played ≥1 cricket season. Questionnaire data collected included a history of playing sport injured, SF-8 (physical (PCS) and mental (MCS) component scores), physician-diagnosed osteoarthritis, and persistent joint pain (most days of the last month). Multivariable linear regressions and logistic regressions were performed. Continuous covariates were handled using fractional polynomials. Models were adjusted for age, sex, cricket-seasons played, playing status, joint injury, and orthopaedic surgery. All participants ( n = 2233) were included in HRQoL analyses, only participants aged ≥30 years ( n = 2071) were included in osteoarthritis ain analyses. Of the 2233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally median PCS: 51.4 IQR 9.0 MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. People who had played sport injured reported worse adjusted PCS (Effect(95% CI): − 1.78(− 2.62, − 0.93) and MCS (− 1.40(− 2.25, − 0.54), had greater odds of osteoarthritis (adjusted OR(95% CI): 1.86(1.39, 2.51) and persistent joint pain (2.34(1.85, 2.96)), compared to people who had not played sport injured. Similar relationships were observed regarding PCS, osteoarthritis and pain in elite and recreational subgroups. Playing injured was only related to worse MCS scores for elite cricketers (− 2.07(− 3.52, − 0.63)) no relationship was observed in recreational cricketers (− 0.70(− 1.79, 0.39)). Cricketers that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite cricketers. The long-term impact of playing while injured on musculoskeletal health, should be considered when advising athletes on their ability to compete following injury.
Publisher: Public Library of Science (PLoS)
Date: 17-03-2022
DOI: 10.1371/JOURNAL.PONE.0265268
Abstract: To compete in lightweight rowing, strict limits are placed on the maximum body weight of each in idual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers. Semi-structured in idual qualitative interviews. Adults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S. Audio-recorded semi-structured in idual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software. Twelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems. This study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-05-2023
Publisher: Medical Journals Sweden AB
Date: 19-11-2018
Publisher: Elsevier BV
Date: 10-2019
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2019-032606
Abstract: To evaluate and compare physical activity (PA) and health-related quality of life (HRQoL) in former elite and recreational cricketers with upper extremity (UE), lower extremity (LE) or no joint pain. Cross-sectional cohort. Despite the high prevalence of joint pain in former athletes, the impact of UE pain and LE pain on PA and HRQoL and potential differences between former recreational and elite athletes are poorly understood. 703 former cricketers aged ≥18 years (mean age 58.7, SD 12.9, played an average of 30 (IQR 20–40) seasons, 72% of whom had played at a recreational level) were recruited through the Cricket Health and Wellbeing Study and met eligibility requirements (UE pain, LE pain or no joint pain (defined as pain on most days of the past month)). The International Physical Activity Questionnaire-Short Form collected weekly metabolic equivalents (METS), while the Short-Form 8 collected physical (PCS) and mental (MCS) component scores. Kruskal-Wallis tests with Dunn’s post-hoc and multivariable linear regressions were performed. Weekly METS were similar in former cricketers with UE pain (median (IQR) 2560 (722–4398)), LE pain (2215 (527–3903)) and no pain (2449 (695–4203), p=0.39). MCS were similar between groups (UE pain 56.0 (52.1–60.0) LE pain 55.2 (51.1–59.4) no pain 54.7 (50.7–58.7), p=0.38). PCS were more impaired in former cricketers with UE pain (49.8 (44.9–54.8)) or LE pain (46.7 (41.0–51.9)) compared with no pain (54.2 (51.5–56.9), p .0001). Former cricketers with LE pain reported worse PCS than those with UE pain (p=0.04). Similar relationships were observed in former elite and recreational cricketers. Despite impaired physical components of HRQoL in former cricketers with UE pain or LE pain, pain was not related to PA levels or mental components of HRQoL. Physical components of HRQoL were most impaired in those with LE pain, and findings were similar among former elite and recreational cricketers.
Publisher: Springer Science and Business Media LLC
Date: 19-08-2019
Publisher: BMJ
Date: 29-07-2015
DOI: 10.1136/BJSPORTS-2015-094864
Abstract: Physical and psychological impairments impacting quality of life (QOL) are common following ACL reconstruction. Rehabilitation alone is an effective alternative to reconstruction for some patients, warranting the investigation of QOL in ACL-deficient in iduals. To report and compare QOL in ACL-deficient in iduals with population norms and ACL-reconstructed groups, and investigate relationships between participant characteristics and QOL. Systematic review and meta-analysis. We systematically identified and methodologically appraised all studies reporting QOL in ACL-deficient in iduals ≥5 years following ACL rupture. Knee-related and health-related QOL scores in ACL-deficient cohorts were compared to ACL-reconstructed groups using a random-effects meta-analysis. Descriptive comparisons were made with population norms. Eleven studies reported QOL in 473 ACL-deficient in iduals, a mean of 10 (range 5-23) years following ACL rupture. Eight studies reported knee-related QOL using the Knee injury and Osteoarthritis Outcome Score QOL subscale (KOOS-QOL) scores (mean±SD) ranging from 54±17 to 77±22 were impaired compared to population norms. Health-related QOL, measured with the SF-36 domain scores in five studies, was similar to population norms, but impaired compared to physically active populations. Meta-analysis revealed no significant differences in KOOS-QOL (mean difference (95% CI) 2.9 (-3.3 to 9.1)) and SF-36 scores (for all SF-36 domains except Vitality) between ACL-deficient and ACL-reconstructed groups. This systematic review found impaired knee-related QOL in ACL-deficient in iduals ≥5 years after ACL rupture, compared to population norms. Meta-analysis revealed similar knee-related QOL in ACL-deficient and ACL-reconstructed groups, and no difference in health-related QOL scores for seven of the eight SF-36 domains.
Publisher: Elsevier BV
Date: 04-2020
Publisher: Informa UK Limited
Date: 08-08-2012
DOI: 10.3109/09593985.2011.582231
Abstract: The efficacy of physiotherapy techniques used for patients following uncomplicated coronary artery bypass surgery (CABG) is well documented. Previous research showed that some of this evidence was not rapidly adopted into practice by cardiothoracic physiotherapists however, there has been no recent evaluation of the uptake of evidence. Our aim was to identify current physiotherapy interventions in use for patients following uncomplicated CABG surgery. A survey was sent to senior cardiothoracic physiotherapists from all Australian and New Zealand hospitals that perform CABG surgery. Fifty-four surveys were returned (response rate 88%). The most common treatments used were mobilisation (94% of hospitals), range of motion exercises (79%), deep breathing and/or cough (77%), cardiovascular exercise (42%), and incentive spirometry (40%). Respondents with a bachelor or diploma in physiotherapy were more likely to implement deep breathing exercises or coughing than those who obtained a postgraduate degree (p = 0.045). Respondents perceived personal experience as the most influential factor on postoperative treatment choices. Physiotherapists treating patients following uncomplicated CABG surgery continue to use interventions such as deep breathing exercises that are not supported by best available evidence. Standardised guidelines may be required to better match clinical practice with current literature.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.PTSP.2018.06.006
Abstract: The aim of this systematic review is to describe QoL in in iduals with PFP, and determine the impact of PFP interventions on QoL. Five databases were searched for studies reporting QoL in in iduals with PFP, with mean age under 50 years. Data were pooled based on QoL tool (e.g. Knee Injury and Osteoarthritis Outcome Score [KOOS] QoL subscale, Short-Form 36 item health survey [SF-36]) using random-effects models, or through narrative synthesis where inadequate data were available. In iduals with PFP, had worse KOOS-QOL scores (pooled mean: 47[95% CI: 34 to 61] and health-related QoL (pooled SF-36 PCS and MCS: 47[95% CI: 41 to 53] and 54[95% CI: 47 to 62], respectively) compared with pain-free controls and population norms. Physical interventions were associated with improvements in knee- and health-related QoL in in iduals with PFP in repeated measures studies. However, the effect of physical interventions compared to a control treatment was conflicting. In iduals with PFP aged under 50 years, have markedly reduced knee- and health-related QoL compared to pain-free controls and population norms. Knee- and health-related QoL may improve following intervention, but it is unclear if these improvements are greater than that which occur in a control group.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Springer Science and Business Media LLC
Date: 13-10-2022
DOI: 10.1007/S11136-022-03265-1
Abstract: To translate the ACL-QOL from English to Swedish and evaluate measurement properties for use after surgical and non-surgical management of anterior cruciate ligament (ACL) injury. The ACL-QOL was translated from English to Swedish and data were pooled from 13 cohorts to enable a comprehensive evaluation of measurement properties in line with COSMIN guidelines. We evaluated internal consistency, test–re-test reliability, measurement error, structural validity [confirmatory factor analysis (CFA)], construct validity and responsiveness (hypothesis testing), and floor/ceiling effects. Results were stratified by time since injury (≤ 1.5 years 2–10 years, 15–25 years 30 years) and ACL management strategy [surgical ( n = 1163), non-surgical ( n = 570)]. The Swedish ACL-QOL had sufficient internal consistency (total and domain scores) for use in surgically managed (Cronbach’s alpha ≥ 0.744) and non-surgically managed (≥ 0.770) ACL-injured in iduals at all time-points. Test–re-test reliability was sufficient [intraclass correlation coefficients: all domains 0.80, total score 0.93 (95% CI 0.86–0.96)]. The standard error of measurement was 5.6 for the total score and ranged from 7.0 to 10.3 for each domain. CFA indicated sufficient SRMR values when using the total score or five domains however, CFI and RMSEA values did not meet cut-offs for good model fit. Hypothesis testing indicated sufficient construct validity and responsiveness. Floor effects were negligible and ceiling effects were negligible or minor. The Swedish version of the ACL-QOL has sufficient internal consistency, test–re-test reliability, construct validity and responsiveness, for use in people with ACL injury managed with or without ACL surgery. Model fit could be improved and investigation into the source of misfit is warranted.
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-052014
Abstract: Former sports participants do not necessarily maintain high levels of physical activity (PA) across their lifespan. Considering physical inactivity in former athletes is associated with an increased susceptibility to inactivity-related chronic diseases, research into PA behaviours in cricketers of all playing-standards is needed. The objective was to (1) describe PA and sedentary behaviour in current and former cricketers, and (2) determine the odds of current, former, recreational and elite cricketers meeting PA guidelines and health-enhancing PA (HEPA) compared with the general population. Cross-sectional survey. Questionnaire response, UK. 2267 current and former cricketers (age: 52±15 years, male: 97%, current: 59%, recreational: 45%) participated. Cricketers were recruited through the Cricket Health and Wellbeing Study and met eligibility requirements (aged ≥18 years played ≥1 year of cricket). Age-matched and sex-matched data from Health Survey for England 2015 (n=3201) was used as the general population-based s le. The International Physical Activity Questionnaire Short-Form assessed PA. Logistic regression, adjusted for age, sex, body mass index, alcohol consumption, smoking, education and ethnicity were used to meet the second aim. 90% of current and 82% of former cricketers met UK PA guidelines. Current (OR 1.26, 95% CI 1.06 to 1.49)) and elite (OR 1.35, 95% CI 1.01 to 1.78) cricketers had greater odds of meeting UK PA guidelines, and elite cricketers had greater odds of HEPA (OR 1.19, 95% CI 1.02 to 1.42), compared with the general population. Former cricketers had reduced odds (OR 0.78, 95% CI 0.62 to 0.99) of meeting the UK PA guidelines compared with the general population. Elite cricketers had a greater odds of meeting the PA guidelines and HEPA, compared with the general population. Former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population. Strategies are needed to transition cricketers to an active lifestyle after retirement, since former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population.
Publisher: BMJ
Date: 11-2017
DOI: 10.1136/BMJOPEN-2017-017785
Abstract: The health benefits of professional sport dissipate after retirement unless an active lifestyle is adopted, yet reasons for adopting an active or inactive lifestyle after retirement from sport are poorly understood. Elite cricket is all-encompassing, requiring a high volume of activity and unique physical demands. We aimed to identify influences on physical activity behaviours in active and insufficiently active former elite cricketers and provide practical strategies for promoting physical activity after cricket retirement. 18 audio-recorded semistructured telephone interviews were performed. An inductive thematic approach was used and coding was iterative and data-driven facilitated by NVivo software. Themes were compared between sufficiently active and insufficiently active participants. All participants formerly played professional cricket in the UK. Participants were male, mean age 57±11 (range 34–77) years, participated in professional cricket for 12±7 seasons and retired on average 23±9 years previously. Ten participants (56%) were classified as sufficiently active according to the UK Physical Activity Guidelines (moderate-intensity activity ≥150 min per week or vigorous-intensity activity ≥75 min per week). Eight participants did not meet these guidelines and were classified as insufficiently active. Key physical activity influences were time constraints, habit formation, intrinsic and extrinsic motivation, physical activity preferences, pain hysical impairment and cricket coaching. Recommendations for optimising physical activity across the lifespan after cricket retirement included prioritise physical activity, establish a physical activity plan prior to cricket retirement and don’t take a break from physical activity, evaluate sources of physical activity motivation and incorporate into a physical activity plan, find multiple forms of satisfying physical activity that can be adapted to accommodate fluctuations in physical capabilities across the lifespan and coach cricket. Physically active and less active retired cricketers shared contrasting attributes that informed recommendations for promoting a sustainable, physically active lifestyle after retirement from professional cricket.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 02-2020
Abstract: To investigate the relationship between baseball participation and health (musculoskeletal, general, and psychological health) and to identify research gaps in the existing literature. Systematic scoping review. Medical databases and gray literature were systematically searched from inception to November 2018. All studies that investigated constructs related to the health of current or former baseball players were included. Data were extracted for thematic summaries. Ten thousand five hundred seventy-four titles/abstracts were screened, and 678 studies were included. Ninety percent of articles included only baseball players playing in the United States, 34% of articles investigated professional baseball players, and 11% studied college baseball players. Five hundred eighty-three (86%) studies investigated musculoskeletal health, 77 (11%) general health, and 18 (3%) psychological health. Injury incidence (injuries per 1000 athlete exposures) ranged from 0.7 to 3.6 in professional, 4.7 to 5.8 in college, and 0.8 to 4.0 in high school baseball. Among baseball players, 31% to 50% reported regular tobacco use. There was limited research investigating psychological health in current or former baseball players at all competition levels. Almost 90% of all articles investigated musculoskeletal health, with few articles studying general or psychological health. Baseball players have high tobacco, alcohol, and drug use compared to the general population, which may have negative health outcomes. Little is understood about the long-term musculoskeletal, general, and psychological health of baseball players.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 29-04-2021
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2021
End Date: 2025
Funder: National Health and Medical Research Council
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