ORCID Profile
0000-0001-8102-3631
Current Organisations
Linköpings universitet Institutionen för medicin och hälsa
,
University of British Columbia Faculty of Medicine
,
Karolinska Institutet
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Publisher: Springer Science and Business Media LLC
Date: 22-02-2022
DOI: 10.1186/S40798-021-00405-8
Abstract: Complex systems are open systems consisting of many components that can interact among themselves and the environment. New forms of behaviours and patterns often emerge as a result. There is a growing recognition that most sporting environments are complex adaptive systems. This acknowledgement extends to sports injury and is reflected in the in idual responses of athletes to both injury and rehabilitation protocols. Consequently, practitioners involved in return to sport decision making (RTS) are encouraged to view return to sport decisions through the complex systems lens to improve decision-making in rehabilitation. It is important to clarify the characteristics of this theoretical framework and provide concrete ex les to which practitioners can easily relate. This review builds on previous literature by providing an overview of the hallmark features of complex systems and their relevance to RTS research and daily practice. An ex le of how characteristics of complex systems are exhibited is provided through a case of anterior cruciate ligament injury rehabilitation. Alternative forms of scientific inquiry, such as the use of computational and simulation-based techniques, are also discussed—to move the complex systems approach from the theoretical to the practical level.
Publisher: BMJ
Date: 11-10-2017
Publisher: BMJ
Date: 25-05-2016
DOI: 10.1136/BJSPORTS-2016-096278
Abstract: Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of in idual factors that may influence the athlete's return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.
Publisher: Wiley
Date: 23-06-2016
DOI: 10.1111/SMS.12707
Abstract: The aim of our study was to cross-sectionally compare patient-reported knee function outcomes between people who chose non-surgical treatment for ACL injury and those who chose ACL reconstruction. We extracted Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQoL-5D data entered into the Swedish National ACL Registry by patients with a non-surgically treated ACL injury within 180 days of injury (n = 306), 1 (n = 350), 2 (n = 358), and 5 years (n = 114) after injury. These data were compared cross-sectionally to data collected pre-operatively (n = 306) and at 1 (n = 350), 2 (n = 358), and 5 years (n = 114) post-operatively from age- and gender-matched groups of patients with primary ACL reconstruction. At the 1 and 2 year comparisons, patients who chose surgical treatment reported superior quality of life and function in sports (1 year mean difference 12.4 and 13.2 points, respectively 2 year mean difference 4.5 and 6.9 points, respectively) compared to those who chose non-surgical treatment. Patients who chose ACL reconstruction reported superior outcomes for knee symptoms and function, and in knee-specific and health-related quality of life, compared to patients who chose non-surgical treatment.
Publisher: BMJ
Date: 10-06-2020
DOI: 10.1136/BJSPORTS-2019-101872
Abstract: To provide a consistently updated overview of the comparative effectiveness of treatments for Achilles tendinopathy. Living systematic review and network meta-analysis. Multiple databases including grey literature sources were searched up to February 2019. Randomised controlled trials examining the effectiveness of any treatment in patients with both insertional and/or midportion Achilles tendinopathy. We excluded trials with 10 or fewer participants per treatment arm or trials investigating tendon ruptures. Reviewers independently extracted data and assessed the risk of bias. We used the Grading of Recommendations Assessment, Development and Evaluation to appraise the certainty of evidence. The validated patient-reported Victorian Institute of Sport Assessment-Achilles questionnaire. 29 trials investigating 42 different treatments were included. 22 trials (76%) were at high risk of bias and 7 (24%) had some concerns. Most trials included patients with midportion tendinopathy (86%). Any treatment class seemed superior to wait-and-see for midportion Achilles tendinopathy at 3 months (very low to low certainty of evidence). At 12 months, exercise therapy, exercise+injection therapy and exercise+night splint therapy were all comparable with injection therapy for midportion tendinopathy (very low to low certainty). No network meta-analysis could be performed for insertional Achilles tendinopathy. In our living network meta-analysis no trials were at low risk of bias and there was large uncertainty in the comparative estimates. For midportion Achilles tendinopathy, wait-and-see is not recommended as all active treatments seemed superior at 3-month follow-up. There seems to be no clinically relevant difference in effectiveness between different active treatments at either 3-month or 12-month follow-up. As exercise therapy is easy to prescribe, can be of low cost and has few harms, clinicians could consider starting treatment with a calf-muscle exercise programme. CRD42018086467.
Publisher: SAGE Publications
Date: 03-06-2013
Abstract: Up to two-thirds of athletes may not return to their preinjury level of sport by 12 months after anterior cruciate ligament (ACL) reconstruction surgery, despite being physically recovered. This has led to questions about what other factors may influence return to sport. To determine whether psychological factors predicted return to preinjury level of sport by 12 months after ACL reconstruction surgery. Case control study Level of evidence, 3. Recreational and competitive-level athletes seen at a private orthopaedic clinic with an ACL injury were consecutively recruited. The primary outcome was return to the preinjury level of sports participation. The psychological factors evaluated were psychological readiness to return to sport, fear of reinjury, mood, emotions, sport locus of control, and recovery expectations. Participants were followed up preoperatively and at 4 and 12 months postoperatively. In total, 187 athletes participated. At 12 months, 56 athletes (31%) had returned to their preinjury level of sports participation. Significant independent contributions to returning to the preinjury level by 12 months after surgery were made by psychological readiness to return to sport, fear of reinjury, sport locus of control, and the athlete’s estimate of the number of months it would take to return to sport, as measured preoperatively (χ 2 2 = 18.3, P .001, classification accuracy = 70%) and at 4 months postoperatively (χ 2 4 = 38.7, P .001, classification accuracy = 86%). Psychological responses before surgery and in early recovery were associated with returning to preinjury level of sport at 12 months, suggesting that attention to psychological recovery in addition to physical recovery after ACL injury and reconstruction surgery may be warranted. Clinical screening for maladaptive psychological responses in athletes before and soon after surgery may help clinicians identify athletes at risk of not returning to their preinjury level of sport by 12 months.
Publisher: Springer Science and Business Media LLC
Date: 11-12-2019
Publisher: BMJ
Date: 02-02-2019
DOI: 10.1136/BJSPORTS-2018-099982
Abstract: To describe the criteria used to clear athletes to return to sport (RTS) following primary ACL reconstruction. Scoping review. MEDLINE, Embase, CINAHL and SPORTDiscus electronic databases were searched using keywords related to ACL and RTS. Prospective or retrospective studies reporting at least one RTS criterion for athletes who had primary ACL reconstruction with an autograft. In total, 209 studies fulfilled the inclusion criteria. RTS criteria were categorised into six domains: time, strength, hop testing, clinical examination, patient-report and performance-based criteria. From the 209 included studies, time was used in 178 studies (85%), and in 88 studies (42%) was the sole RTS criterion. Strength tests were reported in 86 studies (41%). Sixteen different hop tests were used in 31 studies (15%). Clinical examination was used in 54 studies (26%), patient report in 26 studies (12%) and performance-based criteria in 41 studies (20%). Time and impairment-based measures dominated RTS criteria, despite sport being a complex physical and biopsychosocial activity with demands across all aspects of function. Time was included as a criterion in 85% of studies, and over 80% of studies allowed RTS before 9 months. Whether RTS tests are valid—do they predict successful RTS?—is largely unknown.
Publisher: BMJ
Date: 15-09-2016
Publisher: BMJ
Date: 25-09-2018
Publisher: BMJ
Date: 26-11-2015
Publisher: Springer Science and Business Media LLC
Date: 13-04-2022
DOI: 10.1186/S40798-022-00440-Z
Abstract: Return-to-sport (RTS) decisions are critical to clinical sports medicine and are often characterised by uncertainties, such as re-injury risk, time pressure induced by competition schedule and social stress from coaches, families and supporters. RTS decisions have implications not only for the health and performance of an athlete, but also the sports organisation. RTS decision-making is a complex process, which relies on evaluating multiple biopsychosocial factors, and is influenced by contextual factors. In this narrative review, we outline how RTS decision-making of clinicians could be evaluated from a decision analysis perspective. To begin with, the RTS decision could be explained as a sequence of steps, with a decision basis as the core component. We first elucidate the methodological considerations in gathering information from RTS tests. Second, we identify how decision-making frameworks have evolved and adapt decision-making theories to the RTS context. Third, we discuss the preferences and perspectives of the athlete, performance coach and manager. We conclude by proposing a framework for clinicians to improve the quality of RTS decisions and make recommendations for daily practice and research.
Publisher: BMJ
Date: 08-03-2021
DOI: 10.1136/BJSPORTS-2020-103385
Abstract: To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. The scope of the consensus statement included epidemiology biomechanics management the athlete’s voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
Publisher: BMJ
Date: 25-08-2014
DOI: 10.1136/BJSPORTS-2013-093398
Abstract: The aim of this study was to update our original systematic review of return to sport rates following anterior cruciate ligament (ACL) reconstruction surgery. Electronic databases were searched from April 2010 to November 2013 for articles reporting the number of patients returning to sport following ACL reconstruction surgery. Return to sport rates, physical functioning and contextual data were extracted and combined using random-effects meta-analyses. Data from the original review (articles published up to April 2010) were combined with data from the updated search. Sixty-nine articles, reporting on 7556 participants, were reviewed. On average, 81% of people returned to any sport, 65% returned to their preinjury level of sport and 55% returned to competitive level sport after surgery. Symmetrical hopping performance (d=0.3) and the contextual factors of younger age (d=-0.3), male gender (OR=1.4), playing elite sport (OR=2.5) and having a positive psychological response (d=0.3) favoured returning to the preinjury level sport. Receiving a hamstring tendon autograft favoured returning to competitive level sport (OR=2.4), whereas receiving a patellar tendon autograft favoured returning to the preinjury level sport (OR=1.2). Returning to sport varied according to different physical functioning and contextual factors, which could warrant additional emphasis in postoperative rehabilitation programmes to maximise participation.
Publisher: BMJ
Date: 11-03-2011
Abstract: An athlete's intention to return to sport following anterior cruciate ligament (ACL) injury is a major indication for surgical intervention. The purpose of this review was to determine postoperative return-to-sport outcomes after ACL reconstruction surgery. Meta-analysis and systematic review Electronic databases including Medline, Embase, SPORTDiscus and CINAHL were searched from the earliest possible entry to April 2010. Studies were included that reported the number of patients returning to sports participation following ACL reconstruction surgery. The results were presented using the World Health Organization's International Classification of Functioning, Disability and Health as a framework and combined using proportion meta-analyses. Forty-eight studies evaluating 5770 participants at a mean follow-up of 41.5 months were included for review. Overall, 82% of participants had returned to some kind of sports participation, 63% had returned to their preinjury level of participation, and 44% had returned to competitive sport at final follow-up. Approximately 90% of participants achieved normal or nearly normal knee function when assessed postoperatively using impairment-based outcomes such as laxity and strength, and 85% when using activity-based outcomes such as the International Knee Documentation Committee knee evaluation form. Fear of reinjury was the most common reason cited for a postoperative reduction in or cessation of sports participation. The relatively low rate of return to competitive sport despite the high rates of successful outcome in terms of knee impairment-based function suggests that other factors such as psychological factors may be contributing to return-to-sport outcomes.
Publisher: BMJ
Date: 24-12-2020
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.ARTHRO.2009.08.018
Abstract: The purpose of this study was to investigate hamstring strength after harvest of 1 or 2 hamstring tendons for anterior cruciate ligament reconstruction. We recruited 50 in iduals who had returned to regular sporting activity to participate in a comparative study at a mean of 32.5 months after anterior cruciate ligament reconstructive surgery (30 in semitendinosus-gracilis group and 20 in semitendinosus group). Isokinetic hamstring strength (at 60 degrees/s and 180 degrees/s with the peak torque and torque produced at 60 degrees, 90 degrees, and 105 degrees of knee flexion recorded) and isometric hamstring strength (at 30 degrees, 90 degrees, and 105 degrees of knee flexion) were measured, and the standing knee flexion angle was used to evaluate functional hamstring strength recovery. No significant differences between the groups were found in any of the isometric or isokinetic strength measures or in the standing knee flexion angle. No relation was found between the standing knee flexion angle and the isometric hamstring strength results obtained at 105 degrees of knee flexion (r(2) = 0.034). These findings show that the choice of hamstring tendon graft-that is, semitendinosus alone or semitendinosus and gracilis-is unlikely to significantly influence postoperative hamstring strength outcomes in athletes returning to sports postoperatively. Both graft choices showed strength deficits of between 3% and 27% compared with the nonoperated limb, indicating that hamstring strength deficits persist despite successful completion of rehabilitation. The results also show that the standing knee flexion angle should not be used as a surrogate clinical measure of hamstring strength. Level III, retrospective comparative study.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.JSAMS.2012.03.015
Abstract: To examine fear of re-injury in athletes who had returned to regular sports participation following anterior cruciate ligament reconstruction surgery. Cross-sectional case series. A self-report questionnaire was used to collect data 2-7 years following surgery. Key inclusion criteria were regular participation in sport prior to injury and participation in sport at the time of the study. A s le of 209 (88 females, 121 males) at a mean of 39.6 ± 13.8 months post surgery participated. Overall, participants did not express fear of re-injury, scoring >6/10 (where 10 was the most positive response) on all questions. In terms of the total score and for six out of eight questions, participants who returned to their pre-injury sports level had significantly less fear of re-injury than those who had not returned to their pre-injury level. Females had significantly more concern than males about the environmental conditions experienced while playing (mean 6.1 compared to 7.5). On three out of eight questions, in iduals who had surgery more than 3 months after injury had a greater fear of re-injury than those who had their surgery closer to the time of injury. Athletes participating in sport 2-7 years following their anterior cruciate ligament reconstruction generally appear to do so without fear of re-injury. However, gender, the timing of surgery following injury and the level of sport the athletes returned to may be associated with fear of re-injury following surgery.
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.JSAMS.2019.10.021
Abstract: This systematic review had 3 key objectives: (1) to investigate whether psychological factors were associated with future football performance (e.g., progression to professional football, better game statistics during the next season) (2) to critically review the methodological approaches used in the included studies and summarize the evidence for the current research question (3) to provide guidelines for future studies. Systematic review. Electronic databases (SPORTDiscus, PubMed and PsycINFO) and previously published systematic and scoping reviews were searched. Only prospective studies were considered for inclusion. Eleven published studies that reported 39 effect sizes were included. Psychological factors task orientation, task-oriented coping strategies and perceptual-cognitive functions had small effects on future performance in football (ds=0.20-0.29). Due to high risk of bias there were low certainty of evidence for psychological factors relationship with future football performance. Psychological factors investigated showed small effects on future football performance, however, there was overall uncertainty in this evidence due to various sources of bias in the included studies. Therefore psychological factors cannot be used as a sole deciding factor in player recruitment, retention, release strategies, however it would appear appropriate to include these in the overall decision-making process. Future, studies with more appropriate and robust research designs are urgently needed to provide more certainty around their actual role.
Publisher: Cold Spring Harbor Laboratory
Date: 28-06-2022
DOI: 10.1101/2022.06.27.22276964
Abstract: Mandates and recommendations related to embedding open science practices within the research lifecycle are increasingly common. Few stakeholders, however, are monitoring compliance to their mandates or recommendations. It is necessary to monitor the current state of open science to track changes over time and to identify areas to create interventions to drive improvements. Monitoring open science practices requires that they are defined and operationalized. Involving the biomedical community, we sought to reach consensus on a core set of open science practices to monitor at biomedical research institutions. To establish consensus in a structured and systematic fashion, we conducted a modified 3-round Delphi study. Participants in Round 1 were 80 in iduals from 20 biomedical research institutions that exhibit interest in or actively support open science. Participants were research administrators, researchers, specialists in dedicated open science roles, and librarians. In Rounds 1 and 2, participants completed an online survey evaluating a set of potential open science practices that could be important and meaningful to monitor in an automated institutional open science dashboard. Participants voted on the inclusion of each item and provided a rationale for their choice. We defined consensus as 80% agreement. Between rounds, participants received aggregated voting scores for each item and anonymized comments from all participants, and were asked to re-vote on items that did not reach consensus. For Round 3, we hosted two half- day virtual meetings with 21 and 17 participants respectively to discuss and vote on all items that had not reached consensus after Round 2. Ultimately, participants reached consensus to include a 19 open science practices. A group of international stakeholders used a modified Delphi process to agree upon open science practices to monitor in a proposed open science dashboard for biomedical institutions. The core set of 19 open science practices identified by participants will form the foundation for institutional dashboards that display compliance with open science practices. They will now be assessed and tested for automatic inclusion in terms of technical feasibility. Using user-centered design, participating institutions will be involved in creating a dashboard prototype, which can then be implemented to monitor rates of open science practices at biomedical institutions. Our methods and approach may also transfer to other research settings–other disciplines could consider using our consensus list as a starting point for agreement upon a discipline-specific set of open science practices to monitor. The findings may also be of broader value to the development of policy, education, and interventions.
Publisher: SAGE Publications
Date: 23-09-2011
Abstract: Background: Most people have not returned to their preinjury level of sports participation at 12 months after anterior cruciate ligament (ACL) reconstruction surgery. Twelve months’ follow-up may be too early to assess return-to-sport outcomes accurately. Purpose: This study was undertaken to evaluate the medium-term return-to-sport outcomes after ACL reconstruction surgery. Study Design: Case series Level of evidence, 3. Methods: A self-report questionnaire was used to collect data at 2 to 7 years after ACL reconstruction surgery regarding preinjury sports participation, postoperative sports participation, and subjective knee function. The main inclusion criteria were participation in regular sports activity before injury and the attendance at routine surgical follow-up appointments. Results: A total of 314 participants (mean age, 32.5 ± 10.2 years) were included at a mean 39.6 ± 13.8 months after ACL reconstruction surgery. At follow-up, 45% were playing sport at their preinjury level and 29% were playing competitive sport. Ninety-three percent of the study s le had attempted sport at some time after their ACL reconstruction surgery. Those who had not attempted their preinjury level of sport by 12 months after surgery were just as likely to have returned to preinjury level by 39 months after surgery as those who had played sport by 12 months (risk ratio, 1.1 95% confidence interval, 0.76-1.6). Conclusion: Less than 50% of the study s le had returned to playing sport at their preinjury level or returned to participating in competitive sport when surveyed at 2 to 7 years after ACL reconstruction surgery. Return to the preinjury level of sport at 12 months after surgery was not predictive of participation at the preinjury level in the medium term, which suggests that people who return to sport within 12 months may not maintain their sports participation.
Publisher: BMJ
Date: 19-07-2021
DOI: 10.1136/BJSPORTS-2020-103308
Abstract: Cam morphology, a distinct bony morphology of the hip, is prevalent in many athletes, and a risk factor for hip-related pain and osteoarthritis. Secondary cam morphology, due to existing or previous hip disease (eg, Legg-Calve-Perthes disease), is well-described. Cam morphology not clearly associated with a disease is a challenging concept for clinicians, scientists and patients. We propose this morphology, which likely develops during skeletal maturation as a physiological response to load, should be referred to as primary cam morphology. The aim of this study was to introduce and clarify the concept of primary cam morphology. We conducted a concept analysis of primary cam morphology using articles that reported risk factors associated with primary cam morphology we excluded articles on secondary cam morphology. The concept analysis method is a rigorous eight-step process designed to clarify complex ‘concepts’ the end product is a precise definition that supports the theoretical basis of the chosen concept. We propose five defining attributes of primary cam morphology—tissue type, size, site, shape and ownership—in a new conceptual and operational definition. Primary cam morphology is a cartilage or bony prominence (bump) of varying size at the femoral head-neck junction, which changes the shape of the femoral head from spherical to aspherical. It often occurs in asymptomatic male athletes in both hips. The cartilage or bone alpha angle (calculated from radiographs, CT or MRI) is the most common method to measure cam morphology. We found inconsistent reporting of primary cam morphology taxonomy, terminology, and how the morphology is operationalised. We introduce and clarify primary cam morphology, and propose a new conceptual and operational definition. Several elements of the concept of primary cam morphology remain unclear and contested. Experts need to agree on the new taxonomy, terminology and definition that better reflect the primary cam morphology landscape—a bog-standard bump in most athletic hips, and a possible hip disease burden in a selected few.
Publisher: BMJ
Date: 19-10-2020
DOI: 10.1136/BJSPORTS-2020-102537
Abstract: We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes. Systematic review with meta-analysis. Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching. Studies evaluating prevalence of LBP in adult athletes across all sports. Eighty-six studies were included (30 732, range 20–5958, participants), of which 45 were of ‘high’ quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42% range 18%–80% (95% CI 27% to 58%, I 2 =97%). Lifetime prevalence across 13 studies was 63% range 36%–88% (95% CI 51% to 74%, I 2 =99%). Twelve-month LBP prevalence from 22 studies was 51% range 12%–94% (95% CI 41% to 61%, I 2 =98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5 range 1.6–4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport. LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.
Publisher: BMJ
Date: 08-10-2021
DOI: 10.1136/BJSPORTS-2021-103987
Abstract: Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting ex les for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify ex les of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.
Publisher: Wiley
Date: 18-01-2012
DOI: 10.1111/J.1600-0838.2011.01438.X
Abstract: Psychological factors may be a hindrance for returning to sport after an anterior cruciate ligament (ACL) reconstruction. The ACL-Return to Sport after Injury scale (ACL-RSI) measures athletes' emotions, confidence in performance, and risk appraisal in relation to return to sport. The aim of this study was to translate the ACL-RSI scale from English to Swedish and to examine some of the measurement properties of the Swedish version. The ACL-RSI was translated and culturally adapted. A professional expert group and five patients evaluated face validity. One hundred and eighty-two patients completed the translated ACL-RSI, a project-specific questionnaire, the T a Scale of Kinesiophobia (TSK), the Knee-Self-Efficacy Scale (K-SES), the Multidimensional Health Locus of Control (MHLC-C), the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Anterior Cruciate Ligament-Quality of Life (ACL-QoL) questionnaires. Fifty-three patients answered the ACL-RSI twice to examine reproducibility. The ACL-RSI showed good face validity, internal consistency (Cronbach's alpha = 0.948), low floor and ceiling effects and high construct validity when evaluated against the TSK, K-SES, MHLC-C, KOOS, and ACL-QoL scales. The reproducibility was also high (intra-class correlation = 0.893). Therefore, the ACL-RSI can be used to evaluate psychological factors relevant to returning to sport after ACL reconstruction surgery.
Publisher: BMJ
Date: 26-08-2016
Publisher: Elsevier BV
Date: 03-2018
Publisher: BMJ
Date: 02-03-2018
DOI: 10.1136/BJSPORTS-2018-099079
Abstract: The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, in idual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement’s themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published.
Publisher: BMJ
Date: 11-01-2023
DOI: 10.1136/BJSPORTS-2022-106055
Abstract: We aimed to determine (1) the proportion of women authors overall, in first (lead) and last (senior) author positions, (2) the proportion of women research participants and (3) the association between women in first and/or last author positions and the proportion of women research participants in original research articles and editorials/opinion pieces in four sport and exercise medicine hysiotherapy journals. The journals evaluated were the British Journal of Sports Medicine , Journal of Orthopaedic and Sports Physical Therapy , Physical Therapy in Sport and International Journal of Sports Physical Therapy . We reviewed all original research articles and editorials/opinion pieces published in 2008, 2009, 2018 and 2019. For each, we aimed to determine the gender/sex of all authors (through gender pronouns, Google Scholar, ResearchGate, institutional profiles, personal websites, photographs and/or social media), and the gender/sex of study participants reported as ‘female’ or ‘male’ or ‘women’ or ‘men’ or ‘girls’ or ‘boys’. We included 952 original studies and 219 editorials/opinion pieces. There were 5146 authors of original studies and 706 authors of editorials/opinion pieces. Compared with 2008/2009, the proportion of women as first and last authors was 3.6% (33.0% compared with 29.4%) and 4.8% (33.2% compared with 27.4%) higher respectively in 2018/2019. On average, the proportion of women participants in original studies remained largely unchanged over the 10-year period, only 10% of all participants were women in studies. Women are strikingly under-represented in first and last author positions, as are women participants in sports and exercise medicine hysiotherapy journals.
Publisher: BMJ
Date: 13-10-2012
DOI: 10.1136/BJSPORTS-2012-091203
Abstract: Psychological factors have been shown to be associated with the recovery and rehabilitation period following sports injury, but less is known about the psychological response associated with returning to sport after injury. The aim of this review was to identify psychological factors associated with returning to sport following sports injury evaluated with the self-determination theory framework. Systematic review. Electronic databases were searched from the earliest possible entry to March 2012. Quantitative studies were reviewed that included athletes who had sustained an athletic injury, reported the return to sport rate and measured at least one psychological variable. The risk of bias in each study was appraised with a quality checklist. Eleven studies that evaluated 983 athletes and 15 psychological factors were included for review. The three central elements of self-determination theory-autonomy, competence and relatedness were found to be related to returning to sport following injury. Positive psychological responses including motivation, confidence and low fear were associated with a greater likelihood of returning to the preinjury level of participation and returning to sport more quickly. Fear was a prominent emotional response at the time of returning to sport despite the fact that overall emotions became more positive as recovery and rehabilitation progressed. There is preliminary evidence that positive psychological responses are associated with a higher rate of returning to sport following athletic injury, and should be taken into account by clinicians during rehabilitation.
Publisher: BMJ
Date: 11-03-2016
Publisher: BMJ
Date: 25-07-2018
Publisher: BMJ
Date: 02-05-2018
DOI: 10.1136/BJSPORTS-2017-098602
Abstract: To describe the criteria used to guide clinical decision-making regarding when a patient is ready to return to running (RTR) after ACL reconstruction. Scoping review. The MEDLINE (PubMed), EMBASE, Web of Science, PEDro, SPORTDiscus and Cochrane Library electronic databases. We also screened the reference lists of included studies and conducted forward citation tracking. Reported at least one criterion for permitting adult patients with primary ACL reconstruction to commence running postoperatively. 201 studies fulfilled the inclusion criteria and reported 205 time-based criteria for RTR. The median time from when RTR was permitted was 12 postoperative weeks (IQR=3.3, range 5-39 weeks). Fewer than one in five studies used additional clinical, strength or performance-based criteria for decision-making regarding RTR. Aside from time, the most frequently reported criteria for RTR were: full knee range of motion or >95% of the non-injured knee plus no pain or pain 70% plus extensor and flexor LSI>70% and hop test LSI>70%. Fewer than one in five studies reported clinical, strength or performance-based criteria for RTR even though best evidence recommends performance-based criteria combined with time-based criteria to commence running activities following ACL reconstruction.
Publisher: BMJ
Date: 17-01-2023
Publisher: BMJ
Date: 29-07-2016
Publisher: BMJ
Date: 25-12-2012
DOI: 10.1136/BJSPORTS-2012-091525
Abstract: Postural control impairments may persist following anterior cruciate ligament (ACL) reconstruction. The effect of a secondary task on postural control has, however, not been determined. The purpose of this case-control study was to compare postural control in patients following ACL reconstruction with healthy in iduals with and without a secondary task. 45 patients (30 men and 15 women) participated at least 6 months following primary ACL reconstruction surgery. Participants were in idually matched by age, gender and sports activity to healthy controls. Postural control was measured using a Nintendo Wii Balance Board and customised software during static single-leg stance and with the addition of a secondary task. The secondary task required participants to match the movement of an oscillating marker by adducting and abducting their arm. Centre of pressure (CoP) path length in both medial-lateral and anterior-posterior directions, and CoP total path length. When compared with the control group, the anterior-posterior path length significantly increased in the ACL reconstruction patients' operated (12.3%, p=0.02) and non-operated limbs (12.8%, p=0.02) for the single-task condition, and the non-operated limb (11.5%, p=0.006) for the secondary task condition. The addition of a secondary task significantly increased CoP path lengths in all measures (p<0.001), although the magnitude of the increase was similar in both the ACL reconstruction and control groups. ACL reconstruction patients showed a reduced ability in both limbs to control the movement of the body in the anterior-posterior direction. The secondary task affected postural control by comparable amounts in patients after ACL reconstruction and healthy controls. Devices for the objective measurement of postural control, such as the one used in this study, may help clinicians to more accurately identify patients with deficits who may benefit from targeted neuromuscular training programs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2015
Publisher: BMJ
Date: 06-12-2022
DOI: 10.1136/BJSPORTS-2022-106092
Abstract: Primary cam morphology is highly prevalent in many athlete populations, causing debilitating hip osteoarthritis in some. Existing research is mired in confusion partly because stakeholders have not agreed on key primary cam morphology elements or a prioritised research agenda. We aimed to inform a more rigorous, inclusive and evidence-based approach to research on primary cam morphology and its natural history by working towards agreement on a set of research priorities for conditions affecting the young person’s hip. An international expert panel—the Young Athlete’s Hip Research (YAHiR) Collaborative—rated research priority statements through an online two-round Delphi exercise and met online to explore areas of tension and dissent. Panellists ranked the prioritised research statements according to the Essential National Health Research (ENHR) ranking strategy. Reporting of results followed REPRISE (REporting guideline for PRIority SEtting of health). A erse Delphi panel (n=65, Delphi rounds 1 and 2 three ENHR strategy surveys: n=49 n=44 n=42) from 18 countries representing six stakeholder groups, prioritised and ranked 18 of 38 research priority statements. The prioritised statements outlined seven research domains: (1) best practice physiotherapy, (2) rehabilitation progression and return to sport, (3) exercise intervention and load management, (4) primary cam morphology prognosis and aetiology, (5) femoroacetabular impingement syndrome prognosis and aetiology, (6) diagnostic criteria, and (7) screening. The panel recommended areas of tension and dissent for the research community to focus on immediately. While informing more rigorous, inclusive and evidence-based research, this consensus is a roadmap for researchers, policy-makers and funders to implement research dedicated to reducing the cost and burden of hip disease related to primary cam morphology.
Publisher: SAGE Publications
Date: 23-11-2010
Abstract: Background: An athlete’s desire to return to sport after anterior cruciate ligament (ACL) injury is a major indication for ACL reconstruction surgery. Typical clearance to return is 6 to 12 months postoperatively. Purpose: To investigate the return-to-sport rate and participation level of a large cohort at 12 months after ACL reconstruction surgery. Study Design: Case series Level of evidence, 4. Methods: Data were analyzed for 503 patients who participated in competitive-level Australian football, basketball, netball, or soccer after ACL reconstruction surgery using a quadruple-strand hamstring autograft. Inclusion criteria included participation in competitive sport before the ACL injury and clearance from the orthopaedic surgeon to return to sport postoperatively. Patients completed a self-report questionnaire regarding preoperative and postoperative sports participation and the Cincinnati Sports Activity Scale. The International Knee Documentation Committee (IKDC) knee evaluation form and hop tests were used to evaluate knee function. Results: Sixty-seven percent of patients attempted some form of sports activity by 12 months postoperatively 33% attempted competitive sport. Of those who did not attempt any sports activity by 12 months, 47% indicated that they were planning to return. Men were significantly more likely than women to return. Patients who played sports with a seasonal competition, versus a year-round competition, were significantly more likely to return by 12 months. Patients with normal postoperative knee function (IKDC category A), versus those with nearly normal function (IKDC category B), were no more likely to return, but patients with good hop test results (≥85% limb symmetry index) were more likely to return than patients with poor results ( %). Conclusion: People may require a longer postoperative rehabilitation period than that typically advocated to facilitate a successful return to competitive sport after ACL reconstruction surgery. The relationship between postoperative knee function and return-to-sport outcomes at 12 months after surgery was inconclusive.
Publisher: Wiley
Date: 19-03-2017
DOI: 10.1111/SMS.12861
Abstract: To translate to Swedish language and cross-culturally adapt the IKDC-SKF and to test the measurement properties of the Swedish version of IKDC-SKF in ACL-injured patients undergoing reconstruction surgery.The translation and cross-cultural adaption was performed according to guidelines. Seventy-six patients with an ACL injury filled out the IKDC-SKF and other questionnaires before ACL reconstruction and at 4, 6, and 12 months after surgery. A total of 203 patients from the Swedish ACL Registry participated at 8 months post-operative. Measurement properties were tested according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.The Swedish IKDC-SKF had high internal consistency (Cronbach's alpha=0.90) and test-retest reliability (ICC
Publisher: BMJ
Date: 22-02-2022
DOI: 10.1136/BJSPORTS-2021-105058
Abstract: The REPORT guide is a ‘How to’ guide to help you report your clinical research in an effective and transparent way. It is intended to supplement established first choice reporting tools, such as Consolidated Standards of Reporting Trials (CONSORT), by adding tacit knowledge (ie, learnt, informal or implicit knowledge) about reporting topics that we have struggled with as authors or see others struggle with as journal reviewers or editors. We focus on the randomised controlled trial, but the guide also applies to other study designs. Topics included in the REPORT guide cover reporting checklists, trial report structure, choice of title, writing style, trial registry and reporting consistency, spin or reporting bias, transparent data presentation (figures), open access considerations, data sharing and more. Preprint (open access): 0.31219/osf.io/qsxdz .
Publisher: BMJ
Date: 15-01-2020
DOI: 10.1136/BJSPORTS-2018-100486
Abstract: To determine the benefits and harms of subacromial decompression surgery in adult patients with subacromial pain syndrome lasting for more than 3 months. Systematic review with meta-analysis. Pain, physical function and health-related quality of life. Systematic searches for benefits and harms were conducted to 23 July 2018 in MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Database of Abstracts of Reviews of Effects, and Health Technology Assessment. Randomised controlled trials comparing subacromial decompression surgery for subacromial pain syndrome with any other treatment(s). For harms, we included prospective cohort studies. Two reviewers independently determined eligibility, extracted the data and assessed the risk of bias of eligible studies. Thirty patients seeking primary or outpatient care for subacromial pain syndrome and a parallel guideline committee ( There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery (mean difference [MD] -0.26, 95% CI -0.84 to 0.33, minimally important difference [MID] 1.5) or improving physical function at 1-2 years (MD 2.8, 95% CI -1.4 to 6.9, MID 8.3). There was moderate certainty evidence for no additional benefit of subacromial decompression surgery on health-related quality of life at 1 year (MD -0.03 points, 95% CI -0.11 to 0.06, MID 0.07). There was moderate certainty evidence for six serious harms per 1000 (95% CI 5 to 7) patients undergoing subacromial decompression. Subacromial decompression surgery provided no important benefit compared with placebo surgery or exercise therapy, and probably carries a small risk of serious harms. CRD42018086862.
Publisher: BMJ
Date: 23-12-2020
Publisher: Elsevier BV
Date: 11-2021
Publisher: Center for Open Science
Date: 11-08-2021
Abstract: The REPORT guide is a “How to” guide to help you report your clinical research in an effective and transparent way. It is intended to supplement established first choice reporting tools, such as CONSORT, by adding tacit knowledge (i.e., learned, informal, or implicit knowledge) about reporting topics that we have struggled with as authors or see others struggle with as journal reviewers or editors. We focus on the randomised controlled trial, but the guide also applies to other study designs. Topics included in the REPORT guide cover reporting checklists, trial report structure, choice of title, writing style, trial registry and reporting consistency, spin or reporting bias, transparent data presentation (figures), open access considerations, data sharing, and more. Preprint (open access): 0.31219/osf.io/qsxdz
Publisher: BMJ
Date: 21-12-2020
DOI: 10.1136/BJSPORTS-2020-102723
Abstract: To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement. Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS). Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments. While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
Publisher: Wiley
Date: 17-01-2019
Publisher: BMJ
Date: 19-11-2015
Publisher: BMJ
Date: 09-03-2018
Publisher: BMJ
Date: 12-2016
Publisher: Canadian Science Publishing
Date: 2023
Abstract: The Canadian Institutes of Health Research (CIHR) commenced a Quality Assurance Program in 2019 to monitor the quality of peer review in its Project Grant Competition Peer Review Committees. Our primary aim was to describe the performance of CIHR grant peer reviewers, based on the assessments made by CIHR peer review leaders during the first 3 years of the Research Quality Assurance Program. All Peer Review Committee Chairs and (or) Scientific Officers who led peer review for CIHR in 2019, 2020, and 2021 completed Reviewer Quality Feedback forms immediately following Peer Review Committee meetings. The form assessed Performance, Future potential, Review quality, Participation, and Responsiveness. We summarised and descriptively synthesised data from assessments conducted after each of the four grant competitions. The performance of peer reviewers on 4438 occasions was rated by Chairs and Scientific Officers. Approximately one in three peer reviewers submitted outstanding reviews or discussed additional applications and one in 10 demonstrated potential as a future Peer Review Committee leader. At most, one in 20 peer reviewers was considered to have not performed adequately with respect to review quality, participation, or responsiveness. There is a need for more research on the processes involved in allocating research grant funding.
Publisher: BMJ
Date: 22-07-2020
DOI: 10.1136/BJSPORTS-2018-100164
Abstract: To determine whether in iduals who sustained a sports concussion would exhibit persistent impairments in gait and quiet standing compared to non-injured controls during a dual-task assessment . Systematic review and meta-analysis using in idual participant data (IPD). The search strategy was applied across seven electronic bibliographic and grey literature databases: MEDLINE, EMBASE, CINAHL, SportDISCUS, PsycINFO, PsycARTICLES and Web of Science, from database inception until June 2017. Studies were included if in iduals with a sports concussion and non-injured controls were included as participants a steady-state walking or static postural balance task was used as the primary motor task dual-task performance was assessed with the addition of a secondary cognitive task spatiotemporal, kinematic or kinetic outcome variables were reported, and included studies comprised an observational study design with case-control matching. Our review is reported in line with the Preferred Reporting Items for Systematic review and Meta-Analyses-IPD Statement. We implemented the Risk of Bias Assessment tool for Non-randomised Studies to undertake an outcome-level risk of bias assessment using a domain-based tool. Study-level data were synthesised in one of three tiers depending on the availability and quality of data: (1) homogeneous IPD (2) heterogeneous IPD and (3) aggregate data for inclusion in a descriptive synthesis. IPD were aggregated using a 'one-stage', random-effects model. 26 studies were included. IPD were available for 20 included studies. Consistently high and unclear risk of bias was identified for selection, detection, attrition, and reporting biases across studies. In iduals with a recent sports concussion walked with slower average walking speed (χ Our IPD evidence synthesis identifies that, when evaluated using a dual-task assessment, in iduals who had incurred a sports concussion exhibited impairments in gait that persisted beyond reported standard clinical recovery timelines of 7-10 days. Dual-task assessment (with motion capture) may be a useful clinical assessment to evaluate recovery after sports concussion. This systematic review was prospectively registered in PROSPERO CRD42017064861.
Publisher: BMJ
Date: 17-02-2017
Publisher: BMJ
Date: 06-12-2022
DOI: 10.1136/BJSPORTS-2022-106085
Abstract: Primary cam morphology is a mostly benign bony prominence that develops at the femoral head-neck junction of the hip, but it is highly prevalent in many athlete populations. In the small proportion of athletes for whom it is not benign, the resulting hip osteoarthritis can be debilitating. Clinicians, athletes, patients and researchers do not yet agree on important primary cam morphology elements. We aimed to ascertain and improve the level of agreement on primary cam morphology definitions, terminology, taxonomy and imaging outcome measures. To collect and aggregate informed opinions, an expert panel—the Young Athlete’s Hip Research Collaborative—rated primary cam morphology definition, terminology, taxonomy and imaging outcome statements through an online Delphi exercise followed by an online meeting to explore areas of tension and dissent. Reporting followed Conducting and REporting DElphi Studies. A erse and inclusive Delphi panel (n=65 for rounds 1 and 2, representing 18 countries 6 stakeholder groups 40% women) agreed on 35 of 47 statements in 4 domains, while surfacing areas of tension and dissent. This Delphi panel agreed on four key issues essential to moving research and clinical care forward around primary cam morphology. They agreed on: (1) definition, confirming its conceptual attributes (tissue type, size, location, shape and ownership) (2) terminology—use ‘morphology’ and not terms with a negative connotation like ‘lesion’, ‘abnormality’ or ‘deformity’ (3) taxonomy, distinguishing between primary and secondary cam morphology, and (4) imaging outcomes, a continuous bone/cartilage alpha angle on radial femoral head-neck MRI for primary cam morphology aetiology research. This consensus provides athletes, patients, clinicians and researchers with a strong foundation to guide more precise communication, better clinical decision-making and higher value research about primary cam morphology and its natural history.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.ARTHRO.2021.04.068
Abstract: To investigate the patient-reported outcome measures (PROMs) and graft survival of combined anterior cruciate ligament reconstruction (ACLR) and lateral extra-articular tenodesis (ACLR-LET) compared with a matched cohort having ACLR alone. Patients were retrospectively recruited from a consecutive series of primary ACLR-LET, between 1996 and 2015, with a minimum postsurgical time of 4 years. ACLR-LET were matched with isolated ACLR for age, gender, and operation year. The indications for adding lateral extra-articular tenodesis were lateral laxity of grade 1 or 2, hyperextension laxity, and/or increased rotational laxity of 5° to 10°. The technique used involved detaching a strip of iliotibial band proximally, before being passed deep to the lateral collateral ligament, looped through Kaplan's fibers, and sutured back onto itself at physiological tension. The PROMs used were the Lysholm Knee Scoring Scale, Tegner Activity Scale, Oxford Knee Score, and International Knee Documentation Committee subjective knee form. Failure was defined as graft rupture. Student's t-test was used to compare the matched groups and Kaplan-Meier analysis for survivorship. Eighty-three patients had ACLR-LET between 1996 and 2015. Nine revision cases and 2 with less than 4 years follow-up were excluded. The remaining 72 ACLR-LET patients were matched and included in the survival analysis. Seventy percent of patients completed the PROMs. In both groups, 76% were males, and the mean age was 25 years (standard deviation ± 8.5). The median follow-up was 10 years (interquartile range, 6.7 years). There was no significant change of PROMs (Lysholm Knee Scoring Scale: P = .82, 95% confidence interval (CI) -13 to 11 International Knee Documentation Committee: P = .07, CI -1 to 24 Oxford Knee Score: P = .5, CI -8 to 4 Tegner Activity Scale: P = .5, CI -1 to 3) between the groups. The pre- to postoperative PROMs, except the Tegner Activity Scale, improved significantly, clinically and statistically. There was no statistically significant difference in graft failure between the ACLR-LET group (n = 4, 5%) and the ACLR group (n = 9, 11%) (log-rank P = .099). ACLR-LET shows good graft survival and PROMs in a high-risk population. This suggests that lateral extra-articular tenodesis is an effective technique to restore joint stability to a knee with additional features of laxity. III, matched cohort study.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2020
DOI: 10.1186/S12891-020-03508-7
Abstract: Sustaining injury is a common consequence of playing sport. At least one in every three recreational athletes with anterior cruciate ligament (ACL) reconstruction do not return to their preinjury sport following treatment. Psychological factors including confidence and fear of new injury exert large effects on returning to sport. The primary aim of this trial is to test whether a custom smartphone application delivering cognitive-behavioural therapy is effective for improving the number of people who return to their preinjury sport and level following ACL reconstruction. Participants scheduled for primary ACL reconstruction are recruited prior to surgery from one of six trial sites in Sweden. We aim to recruit 222 participants (111 in each group) for the BANG trial. Participants are randomly allocated to receive either usual rehabilitation care alone or usual rehabilitation care plus the Back in the Game smartphone application intervention. Back in the Game is a 24-week Internet-delivered programme, based on cognitive-behavioural therapy. The primary outcome is return to the preinjury sport and level at 12 months follow-up. The secondary outcomes assess physical activity participation, new knee injuries, psychological factors, quality of life and physical function. Physical activity participation and new injuries are self-reported every two weeks for 12 months, then every 4 weeks to 24 months follow-up. Psychological readiness to return to sport, knee self-efficacy, motivation to participate in leisure time physical activity, knee-related quality of life, and self-reported knee function are also assessed at 3, 6, 9, 12 and 24 months after surgery. A clinical assessment of strength, knee range of motion, effusion and hopping performance is completed by a blinded assessor at 12 months to assess physical function. This protocol outlines how we plan to assess the efficacy of a custom smartphone application, delivering cognitive-behavioural therapy to address fear, confidence and recovery expectations, for improving return to sport following serious sports-related musculoskeletal injury. The BANG trial employs a pragmatic design to best reflect the reality of, and inform, clinical practice. ClinicalTrials.gov, NCT03959215 . Registered 22 May 2019.
Publisher: Cold Spring Harbor Laboratory
Date: 02-09-2022
DOI: 10.1101/2022.09.01.22279512
Abstract: Adherence to study registration and reporting best practices are vital to foster evidence-based medicine. Poor adherence to these standards in clinical trials conducted in Canada would be detrimental to patients, researchers, and the public alike. All registered clinical trials on ClinicalTrials.gov conducted in Canada as of 2009 and completed by 2019 were identified. A cross-sectional analysis of those trials assessed prospective registration, subsequent result reporting in the registry, and subsequent publication of study findings. The lead sponsor, phase of study, clinical trial site location, total patient enrollment, number of arms, type of masking, type of allocation, year of completion, and patient demographics were examined as potential effect modifiers to these best practices. A total of 6,720 trials met the inclusion criteria. From 2009-2019, 59% (n=3,967) of them were registered prospectively and 39% (n=2,642) reported their results in the registry. Of the trials registered between 2009-2014, 55% (n=1,482) were subsequently published in an academic journal. Of the 3,763 trials conducted exclusively in Canada, 3% (n=123) met all 3 criteria of: prospective registration, reporting in the registry, and publishing findings. In contrast, of the remaining 2,957 trials with both Canadian and international sites, 41% (n=1,238) had an overall compliance to these three criteria. Overall, the odds of having adherence to all three practices concurrently in Canadian trials decreases by 95% when compared to international trials (OR = 0.05 95CI: 0.04 – 0.06). Canadian clinical trials substantially lacked adherence to study registration and reporting best practices. Knowledge of this widespread non-compliance should motivate stakeholders in the Canadian clinical trials ecosystem to address and continue to monitor this problem. The data presented provides a baseline against which to compare any improvement in the registration and reporting of clinical trials in Canada.
Publisher: Elsevier BV
Date: 09-2013
Publisher: Springer Science and Business Media LLC
Date: 08-10-2019
DOI: 10.1007/S40279-019-01199-2
Abstract: Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.
Publisher: Springer Science and Business Media LLC
Date: 08-02-2023
Publisher: Elsevier BV
Date: 12-2022
Publisher: BMJ
Date: 17-05-2018
Publisher: Elsevier BV
Date: 2021
Publisher: BMJ
Date: 04-05-2020
DOI: 10.1136/BJSPORTS-2019-101323
Abstract: High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.
Publisher: Open Medical Publishing
Date: 10-10-2009
DOI: 10.4081/OR.2009.E12
Publisher: Public Library of Science (PLoS)
Date: 05-10-2023
Publisher: BMJ
Date: 23-09-2021
Publisher: BMJ
Date: 20-01-2020
DOI: 10.1136/BJSPORTS-2019-100956
Abstract: To investigate the risk of new meniscal tears after treatment for anterior cruciate ligament (ACL) injury, in children and adults with and without ACL reconstruction. Prognosis systematic review (PROSPERO registration number CRD42016036788). We searched Embase, Ovid Medline, Cochrane, CINAHL, SPORTDiscus, PEDro and Google Scholar from inception to 3rd May 2018. Eligible articles included patients with ACL injury (diagnosis confirmed by MRI and/or diagnostic arthroscopy), reported the number of meniscal tears at the time of ACL injury diagnosis/start of treatment and reported the number of new meniscal tears that subsequently occurred. Articles with fewer than 20 patients at follow-up, and articles limited to ACL revision surgery or multi-ligament knee injuries were excluded. Two independent reviewers screened articles, assessed eligibility, assessed risk of bias and extracted data. We judged the certainty of evidence using the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group methodology. Of 75 studies included in the systematic review, 54 studies with 9624 patients and 501 new meniscal tears were appropriate for quantitative analysis. Heterogeneity precluded data pooling. The risk of new meniscal tears was 0%–21% when follow-up was years, 0%–29% when follow-up was 2 to 5 years, 5%–52% when follow-up was 5 to 10 years and 4%–31% when follow-up was longer than 10 years. The proportion of studies with high risk of selection, misclassification and detection bias was 84%, 69% and 68%, respectively. Certainty of evidence was very low. New meniscal tears occurred in 0%–52% of patients between 4 months and 20 years (mean 4.9±4.4 years) following treatment for ACL injury. The certainty of evidence was too low to guide surgical treatment decisions. This review cannot conclude that the incidence of new meniscal tears is lower if ACL injury is treated with surgery compared with treatment with rehabilitation only.
Publisher: Cold Spring Harbor Laboratory
Date: 03-03-2021
DOI: 10.1101/2021.03.01.21252681
Abstract: After serious knee injury, up to half of athletes do not return to competitive sport, despite recovering sufficient physical function. Athletes often desire psychological support to return to sport, but rehabilitation clinicians feel ill-equipped to deliver adequate support. To design and develop an Internet-delivered psychological support programme for athletes recovering from knee ligament surgery. Our work developing and designing the Back in the Game intervention was guided by a blend of theory & evidence-based and target population-based strategies to developing complex interventions. We systematically searched for qualitative evidence related to athletes’ experiences, perspectives and needs for recovery and return to sport after anterior cruciate ligament (ACL) injury. Two reviewers coded and synthesised the results using thematic meta-synthesis. We systematically searched for randomised controlled trials (RCTs) reporting on psychological support interventions for improving ACL rehabilitation outcomes in athletes. One reviewer extracted the data (including effect estimates) a second reviewer checked the data for accuracy. The results were synthesised descriptively. We conducted feasibility testing in two phases: (1) technical assessment, and (2) feasibility and useability testing. For phase 1, we recruited clinicians and people with lived experience of ACL injury. For phase 2, we recruited patients aged between 15 and 30 years, who were within 8 weeks of ACL reconstruction surgery. Participants completed a 10-week version of the intervention, and semi-structured interviews evaluating acceptability, demand, practicality and integration. The project was approved by the Swedish Ethical Review Authority (2018/45-31). Three analytic themes emerged from the meta-synthesis ( n = 16 studies, 164 participants): (1) tools/strategies to support rehabilitation progress, (2) barriers and facilitators for physical readiness to return to sport, and (3) barriers and facilitators to psychological readiness to return to sport. Coping strategies, relaxation and goal setting may have a positive effect on rehabilitation outcomes after ACL reconstruction ( n = 7 RCTs, 430 participants). There were no trials of psychological support interventions for improving return to sport. Eleven people completed phase 1 of feasibility testing (technical assessment) and identified 4 types of software errors that we fixed. Six participants completed feasibility and useability testing. Their feedback suggested the intervention was easy to access and addressed the needs of athletes who want to return to sport after ACL reconstruction. We refined the intervention to include more multimedia content, and support to access and use the intervention features. The Back in the Game intervention is a 24-week Internet-delivered self-guided programme comprising 7 modules that complements usual rehabilitation, changes focus as rehabilitation progresses, is easy to access and use, and includes different psychological support strategies.
Publisher: SAGE Publications
Date: 12-01-2015
Abstract: A return to their preinjury level of sport is frequently expected within 1 year after anterior cruciate ligament (ACL) reconstruction, yet up to two-thirds of athletes may not have achieved this milestone. The subsequent sports participation outcomes of athletes who have not returned to their preinjury level sport by 1 year after surgery have not previously been investigated. To investigate return-to-sport rates at 2 years after surgery in athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction. Case series Level of evidence, 4. A consecutive cohort of competitive- and recreational-level athletes was recruited prospectively before undergoing ACL reconstruction at a private orthopaedic clinic. Participants were followed up at 1 and 2 years after surgery with a sports activity questionnaire that collected information regarding returning to sport, sports participation, and psychological responses. An independent physical therapist evaluated physical function at 1 year using hop tests and the International Knee Documentation Committee knee examination form and subjective knee evaluation. A group of 122 competitive- and recreational-level athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction participated. Ninety-one percent of the athletes returned to some form of sport after surgery. At 2 years after surgery, 66% were playing sport, with 41% playing their preinjury level of sport and 25% playing a lower level of sport. Having a previous ACL reconstruction to either knee, poorer hop-test symmetry and subjective knee function, and more negative psychological responses were associated with not playing the preinjury level sport at 2 years. Most athletes who were not playing sport at 1 year had returned to some form of sport within 2 years after ACL reconstruction, which may suggest that athletes can take longer than the clinically expected time of 1 year to return to sport. However, only 2 of every 5 athletes were playing their preinjury level of sport at 2 years after surgery. When the results of the current study were combined with the results of athletes who had returned to sport at 1 year, the overall rate of return to the preinjury level sport at 2 years was 60%. Demographics, physical function, and psychological factors were related to playing the preinjury level sport at 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial.
Publisher: Springer Science and Business Media LLC
Date: 23-02-2011
DOI: 10.1007/S00167-011-1444-X
Abstract: The aim of this systematic review was to determine whether lower limb postural control is restored in patients following anterior cruciate ligament (ACL) reconstruction surgery when compared to healthy controls. A systematic review was conducted. Electronic databases including Medline, Embase, SPORTDiscus and CINAHL were searched from the earliest possible entry to April 2010. Studies that evaluated postural control in patients following ACL reconstruction surgery with a control group using a force platform were included. Ten studies evaluating 644 participants at a mean 29 months follow-up were included in this review. In static balance tasks, there was a trend towards improved postural control in the control group for eyes-open but not eyes-closed conditions. Only four studies evaluated dynamic balance, and the results from these were somewhat mixed. Nonetheless, there was evidence to suggest impaired postural control in patients following ACL reconstruction surgery when compared to controls, particularly for more challenging tasks. Although there appears to be a trend towards impaired static and dynamic postural control in patients following ACL reconstruction surgery, the limited number of studies and differing methodologies makes conclusions tentative. Deficits in dynamic tasks may be more relevant to people intending to return to sport following surgery due to the inherently dynamic nature of sport and should perhaps be the focus of future research.
Publisher: JMIR Publications Inc.
Date: 09-08-2022
DOI: 10.2196/28851
Abstract: After a serious knee injury, up to half of athletes do not return to competitive sport, despite recovering sufficient physical function. Athletes often desire psychological support for the return to sport, but rehabilitation clinicians feel ill-equipped to deliver adequate support. We aimed to design and develop an internet-delivered psychological support program for athletes recovering from knee ligament surgery. Our work for developing and designing the Back in the Game intervention was guided by a blend of theory-, evidence-, and target population-based strategies for developing complex interventions. We systematically searched for qualitative evidence related to athletes' experiences with, perspectives on, and needs for recovery and return to sport after anterior cruciate ligament (ACL) injury. Two reviewers coded and synthesized the results via thematic meta-synthesis. We systematically searched for randomized controlled trials reporting on psychological support interventions for improving ACL rehabilitation outcomes in athletes. One reviewer extracted the data, including effect estimates a second reviewer checked the data for accuracy. The results were synthesized descriptively. We conducted feasibility testing in two phases-(1) technical assessment and (2) feasibility and usability testing. For phase 1, we recruited clinicians and people with lived experience of ACL injury. For phase 2, we recruited patients aged between 15 and 30 years who were within 8 weeks of ACL reconstruction surgery. Participants completed a 10-week version of the intervention and semistructured interviews for evaluating acceptability, demand, practicality, and integration. This project was approved by the Swedish Ethical Review Authority (approval number: 2018/45-31). The following three analytic themes emerged from the meta-synthesis (studies: n=16 participants: n=164): (1) tools or strategies for supporting rehabilitation progress, (2) barriers and facilitators for the physical readiness to return to sport, and (3) barriers and facilitators for the psychological readiness to return to sport. Coping strategies, relaxation, and goal setting may have a positive effect on rehabilitation outcomes after ACL reconstruction (randomized controlled trials: n=7 participants: n=430). There were no trials of psychological support interventions for improving the return to sport. Eleven people completed phase 1 of feasibility testing (technical assessment) and identified 4 types of software errors, which we fixed. Six participants completed the feasibility and usability testing phase. Their feedback suggested that the intervention was easy to access and addressed the needs of athletes who want to return to sport after ACL reconstruction. We refined the intervention to include more multimedia content and support access to and the use of the intervention features. The Back in the Game intervention is a 24-week, internet-delivered, self-guided program that comprises 7 modules that complement usual rehabilitation, changes focus as rehabilitation progresses, is easy to access and use, and includes different psychological support strategies.
Publisher: Springer Science and Business Media LLC
Date: 17-02-2018
Publisher: BMJ
Date: 20-11-2015
Publisher: BMJ
Date: 17-08-2017
Publisher: BMJ
Date: 12-04-2018
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.RIDD.2013.02.029
Abstract: We compared participation in out-of-school activities between children with intellectual disability and children with typical development using the Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children questionnaires. Thirty-eight pairs of children were matched for age (mean age 12.3 ± 2.7 years), sex (17 female, 21 male), location (32 metropolitan, 6 regional) and socioeconomic background (mean SEIFA score 1021 ± 70 and 1024 ± 66). When compared to their typically developing peers, children with intellectual disability participated in fewer Active-Physical and Skill-Based activities and in more Recreational activities. Children with intellectual disability participated less frequently in Skilled-Based activities, had a higher preference for Recreational and Self-Improvement activities, enjoyed Self-Improvement activities more, and participated in a higher proportion of Social activities at home and in a lower proportion of Recreational, Active-Physical, Skill-Based, and Self-Improvement activities alone. These differences may be due to reduced physical, cognitive and social skills in children with intellectual disability, or a lack of supportive environments.
Publisher: BMJ
Date: 07-10-2014
DOI: 10.1136/BJSPORTS-2014-093842
Abstract: This cross-sectional study aimed to examine whether appraisal of knee function, psychological and demographic factors were related to returning to the preinjury sport and recreational activity following anterior cruciate ligament (ACL) reconstruction. 164 participants completed a questionnaire battery at 1-7 years after primary ACL reconstruction. The battery included questionnaires evaluating knee self-efficacy, health locus of control, psychological readiness to return to sport and recreational activity, and fear of reinjury and self-reported knee function in sport-specific tasks, knee-related quality of life and satisfaction with knee function. The primary outcome was returning to the preinjury sport or recreational activity. At follow-up, 40% (66/164) had returned to their preinjury activity. Those who returned had more positive psychological responses, reported better knee function in sport and recreational activities, perceived a higher knee-related quality of life and were more satisfied with their current knee function. The main reasons for not returning were not trusting the knee (28%), fear of a new injury (24%) and poor knee function (22%). Psychological readiness to return to sport and recreational activity, measured with the ACL-Return to Sport after Injury scale (was most strongly associated with returning to the preinjury activity). Age, sex and preinjury activity level were not related. Less than 50% returned to their preinjury sport or recreational activity after ACL reconstruction. Psychological readiness to return to sport and recreation was the factor most strongly associated with returning to the preinjury activity. Including interventions aimed at improving this in postoperative rehabilitation programmes could be warranted to improve the rate of return to sport and recreational activities.
Publisher: BMJ
Date: 23-12-2020
Publisher: BMJ
Date: 11-01-2019
Publisher: BMJ
Date: 28-10-2020
Publisher: BMJ
Date: 25-01-2016
DOI: 10.1136/BJSPORTS-2015-094948
Abstract: To compare patient-reported and clinician-reported outcomes, and radiographic results between patients who had had revision ACL reconstruction and those who had had primary ACL reconstruction. Systematic review and meta-analysis The MEDLINE, CINAHL, EMBASE and SPORTDiscus electronic databases were searched on 6 August 2015, using 3 main concepts: (1) revision ACL reconstruction, (2) primary ACL reconstruction and (3) treatment outcomes. Articles that compared patient-reported or clinician-reported outcomes or radiographic results between patients who had had revision ACL reconstruction and those who had had primary surgery with a minimum of 2 years follow-up were included. The outcomes evaluated were the Lysholm Knee Scoring Scale, objective International Knee Documentation Committee (IKDC) classification, Tegner Activity Scale, side-to-side difference in anterior tibial translation measured with KT-1000/2000 arthrometer, pivot shift test, tibiofemoral osteoarthritis grading on plain radiographs and subsequent knee surgeries. 8 studies (300 revision ACL reconstructions and 413 primary ACL reconstructions) were included in the meta-analysis. Patients who had had revision surgery reported inferior Lysholm Knee Scoring Scale scores (mean difference: 7.8 points), had inferior clinician-reported knee function as assessed with the objective IKDC classification (IKDC category A: 27% vs 57% IKDC category C or D: 22% vs 8%) and pivot shift test (grade II or III: 7% vs 2%), and more radiographic evidence of tibiofemoral osteoarthritis (50% vs 25%) compared with patients who had had primary surgery. Revision ACL reconstruction restored similar anterior-posterior knee laxity compared with primary ACL reconstruction. Patients who had had revision surgery reported inferior Lysholm Knee Scoring Scale scores, had inferior clinician-reported knee function and more radiographic signs of tibiofemoral osteoarthritis compared with patients with primary ACL reconstruction.
Publisher: BMJ
Date: 06-02-2019
DOI: 10.1136/BMJ.L294
Abstract: Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery. SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations. The guideline panel makes a strong recommendation against surgery. A guideline panel including patients, clinicians, and methodologists produced this recommendation in adherence with standards for trustworthy guidelines and the GRADE system. The recommendation is based on two linked systematic reviews on ( a ) the benefits and harms of subacromial decompression surgery and ( b ) the minimally important differences for patient reported outcome measures. Recommendations are made actionable for clinicians and their patients through visual overviews. These provide the relative and absolute benefits and harms of surgery in multilayered evidence summaries and decision aids available in MAGIC ( www.magicapp.org ) to support shared decisions and adaptation. Surgery did not provide important improvements in pain, function, or quality of life compared with placebo surgery or other options. Frozen shoulder may be more common with surgery. The panel concluded that almost all informed patients would choose to avoid surgery because there is no benefit but there are harms and it is burdensome. Subacromial decompression surgery should not be offered to patients with SAPS. However, there is substantial uncertainty in what alternative treatment is best.
Publisher: BMJ
Date: 05-12-2022
DOI: 10.1136/BJSPORTS-2022-105650
Abstract: This scoping review examines how different levels and types of partial foot utation affect gait and explores how these findings may affect the minimal impairment criteria for wheelchair tennis. Four databases (PubMed, Embase, CINAHL and SPORTDiscus) were systematically searched in February 2021 for terms related to partial foot utation and ambulation. The search was updated in February 2022. All study designs investigating gait-related outcomes in in iduals with partial foot utation were included and independently screened by two reviewers based on Arksey and O’Malley’s methodological framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Twenty-nine publications with data from 252 participants with partial foot utation in 25 studies were analysed. Toe utations were associated with minor gait abnormalities, and great toe utations caused loss of push-off in a forward and lateral direction. Metatarsophalangeal utations were associated with loss of stability and decreased gait speed. Ray utations were associated with decreased gait speed and reduced lower extremity range of motion. Transmetatarsal utations and more proximal utations were associated with abnormal gait, substantial loss of power generation across the ankle and impaired mobility. Partial foot utation was associated with various gait changes, depending on the type of utation. Different levels and types of foot utation are likely to affect tennis performance. We recommend including first ray, transmetatarsal, Chopart and Lisfranc utations in the minimum impairment criteria, excluding toe utations (digits two to five), and we are unsure whether to include or exclude great toe, ray (two to five) and metatarsophalangeal utations. The protocol of this scoping review was previously registered at the Open Science Framework Registry ( osf.io/8gh9y ) and published.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.JSAMS.2012.05.017
Abstract: Shoulder injuries associated with the throwing and fielding demands of the game are common in elite cricketers. This study aimed to identify the factors associated with shoulder injuries in an elite junior squad. Cross-sectional study. Sixty players aged 15-19 years, from the Cricket Victoria elite junior male squads completed questionnaires and 46 completed clinical assessments conducted by a physiotherapist that included shoulder strength, range of movement and scapula position. Participants were classified into two groups players currently reporting shoulder problems (SP) and those not reporting shoulder problems (NSP) on the basis of their response to the question 'Have you had any problems with your shoulder in the last 12 months that have affected you training for or playing cricket?'. Fifteen percent (9 of 60) of participants reported shoulder problems (SP). The level of shoulder disability in participants with SP, classified on standard self-report scales, was mild to moderate. The major difference between groups was that the SP group displayed a significant downward rotation of the scapula in almost all shoulder positions. There were no differences between the two groups for training factors, range of motion, or in clinical test results. However, contrary to expectations the SP group exhibited greater strength than the NSP group on some variables. A consistently downwardly rotated scapula associated with young cricketers with SP may predispose these cricketers to ongoing injury through impingement and also through increased load on the rotator cuff muscles acting at the glenohumeral joint during throwing.
Publisher: BMJ
Date: 24-02-2018
DOI: 10.1136/BJSPORTS-2018-099060
Abstract: In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
Publisher: BMJ
Date: 16-03-2018
Publisher: Center for Open Science
Date: 24-05-2022
Abstract: Consensus is an often neglected but important part of the scientific process. Consensus agreement allows researchers to agree on fundamentals such as terminology and taxonomy, to establish core outcome sets for reporting on medical conditions, and to set research priorities. Consensus methods are invoked by the scientific community to provide answers on topics with little to no previous research, or to provide further guidance when the available evidence is unclear. In the medical literature the most common methods for assessing consensus are the Delphi, RAND-UCLA and Nominal Group Technique. However, consensus methods and their subsequent published 'consensus statements' often: exclude relevant stakeholders or fail to justify their expert panel selection neglect to use systematic/scoping reviews to inform what questions or recommendations their consensus panel will rank or vote upon and often omit the levels of agreement amongst panel members, or worse suppress the existance of important minority views. Given their importance in providing direction to the scientific community, methods of consensus development and their subsequent reporting require further scrutiny. We propose to use the methods of consensus development within the patellofemoral pain field to review: how consensus has been generated who has been invited/involved whether formal literature reviews have supported statements and recommendations and how subsequent agreements/dissent has been reported. By studying the subset of statements on patellofemoral pain we hope to inform future recommendations on the production of rigorous consensus development and reporting.
Location: Sweden
Location: Qatar
No related grants have been discovered for Clare Ardern.