ORCID Profile
0000-0002-8340-0303
Current Organisation
University of Wollongong
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Publisher: Springer Science and Business Media LLC
Date: 03-10-2017
Publisher: Wiley
Date: 08-07-2009
Publisher: Elsevier BV
Date: 11-2007
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2005
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: BMJ
Date: 16-03-2018
DOI: 10.1136/BJSPORTS-2017-098099
Abstract: To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in in iduals with knee osteoarthritis (OA). Systematic review with meta-analysis. Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017. We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in in iduals with knee OA. Only RCTs considering these outcomes as primary were included. Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress. Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of in iduals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in in iduals with knee OA. CRD42016047602.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2013
Publisher: SAGE Publications
Date: 26-06-2009
Abstract: The incidence of anterior cruciate ligament injuries among dancers is much lower than that among team sport athletes and no clear gender disparity has been reported in the dance population. Although numerous studies have observed differences in lower extremity landing biomechanics between male and female athletes, there is currently little research examining the landing biomechanics of male and female dancers. Comparing landing biomechanics within this population may help explain the lower overall anterior cruciate ligament injury rates and the lack of gender disparity. Due to the fact that dancers receive jump-specific and balance-specific training from a very young age, we hypothesized that there would be no gender differences in drop-landing biomechanics in professional dancers. Controlled laboratory study. Kinematics and ground-reaction forces were recorded as 33 professional modern and ballet dancers (12 men and 21 women) performed single-legged drop landings from a 30-cm platform. Joint kinematics and kinetics were compared between genders. No gender differences in joint kinematics or kinetics were found during landings (multivariate analysis of variance: P = .490 and P = .175, respectively). A significant relationship was found between the age at which the dancers began training and the peak hip adduction angle during landing ( r = .358, P = .041). In executing a 30-cm drop landing, male and female dancers exhibited similar landing strategies and avoided landing patterns previously associated with increased injury rates. Commonly reported biomechanical differences between men and women, as well as the gender disparity among athletes in the incidence of ACL injuries, may be the result of inadequate experience in proper balance and landing technique rather than intrinsic gender factors. Beginning jump-specific and balance-specific training at an early age may counteract the potentially harmful adaptations in landing biomechanics observed in female athletes after maturity.
Publisher: Springer Science and Business Media LLC
Date: 15-09-2019
DOI: 10.1007/S00264-018-4140-3
Abstract: The purpose of the study is to determine the effectiveness of semi-active and active robotic hip and knee arthroplasty on post-operative patient-reported outcomes of function, pain, quality of life and satisfaction with surgery. PubMed, Medline, Embase and CENTRAL were searched. Included were comparative studies investigating the effectiveness of semi-active or active robotic hip or knee arthroplasty compared to any other surgical intervention on function, pain, quality of life and satisfaction with surgery. Risk of bias and the strength of the evidence were assessed using the Downs and Black tool and the GRADE system, respectively. Relative risks, mean differences and 95% CI were calculated using random-effects models. Fourteen studies involving 1342 patients were included. All studies compared robotic to conventional surgery, with active robotic surgery evaluated in total hip or knee arthroplasty and semi-active robotic surgery in total hip or unicompartmental knee arthroplasty. Most studies presented some risk of bias, and the strength of evidence was rated as low to very low quality. Random-effects meta-analyses showed that post-operative functional outcomes were comparable between active robotic and conventional total hip and knee arthroplasty at the short-, medium- and long-term follow-up. No significant difference in pain, quality of life and satisfaction with surgery were reported in in idual studies. This systematic and meta-analyses indicates that functional outcomes for patients undergoing active robotic total hip and knee arthroplasty were comparable to conventional surgery. Whether semi-active or active robotic hip or knee arthroplasty is effective in improving post-operative pain, quality of life and satisfaction with surgery is unclear. PROSPERO Registration Number: CRD42017059932.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2009
Publisher: SAGE Publications
Date: 06-01-2012
Abstract: Context: Patellofemoral pain syndrome (PFPS) is one of the most common overuse injuries. Objective: To assess the collective evidence of predisposing factors to PFPS. Data Sources: MEDLINE (1960–June 2010), EMBASE (1980–June 2010), and CINAHL (1982–June 2010). Study Selection: Studies were included if patients were asymptomatic at baseline testing (free of PFPS) and were prospectively followed for the development of the disorder. Only studies that assessed at least 1 variable that can be measured at a typical clinic were included. After duplicates were removed, 973 studies were assessed from their titles or abstracts, 20 from the full text, and from these, 7 met the inclusion criteria. Data Extraction: Data were extracted for age, weight, height, s le size, patient type (military vs civilian), follow-up periods, diagnostic methods, and diagnostic criteria. Means and standard deviations were extracted for all outcome variables. Results: Meta-analyses were performed for height, weight, leanness, Q angle, number of sit-ups, knee extension strength, and peak knee valgus angle during landing. Lower knee extension strength was the only variable that was predictive of PFPS ( P 0.01). Other variables that were identified as predictive of PFPS by single studies were vertical jump, push-ups, knee flexion and hip abduction strength, thumb-to-forearm flexibility, quadriceps and gastrocnemius flexibility, genu varum, navicular drop, knee valgus moment at initial contact during landing, social support, and palliative reaction. Conclusions: It appears that anthropometric variables are not associated with PFPS, while knee extension strength deficits appear to be predictors of PFPS.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 09-2020
Publisher: BMJ
Date: 29-04-2016
Publisher: Elsevier BV
Date: 04-2018
Publisher: SAGE Publications
Date: 31-07-2017
Abstract: Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Meta-analysis. Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants’ baseline profile deficits, highlighting the need to deliver an in idualized and task-specific IPP.
Publisher: Elsevier BV
Date: 04-2021
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 12-2017
DOI: 10.1302/0301-620X.99B12.BJJ-2017-0348.R1
Abstract: To synthesise the literature and perform a meta-analysis detailing the longitudinal recovery in the first two years following a distal radius fracture (DRF) managed with volar plate fixation. Three databases were searched to identify relevant articles. Following eligibility screening and quality assessment, data were extracted and outcomes were assimilated at the post-operative time points of interest. A state-of-the-art longitudinal mixed-effects meta-analysis model was employed to analyse the data. The search identified 5698 articles, of which 46 study reports met the selection criteria. High levels of disability and impairment were reported in the immediate post-operative period with subsequently a rapid initial improvement followed by more gradual improvement for up to one year. The results highlight that the period associated with the greatest physical recovery is in the first three months and suggest that the endpoint of treatment outcomes is best measured at one year post-surgery. Clinically meaningful improvements in outcomes can be expected for 12 months, after which progress plateaus and reaches normal values. This paper adopted a novel approach to meta-analyses in that the research question was of a longitudinal nature, which required a unique method of statistical analysis. Cite this article: Bone Joint J 2017 -B:1665–76.
Publisher: Science and Medicine, Inc.
Date: 09-2017
Abstract: Dance is a popular activity associated with many physical and mental health benefits, but injuries are a concern for all skill levels. Previous studies have focused on professional dancers or particular genres, meaning the population-wide characteristics of injuries is unknown. This study’s objective was to identify the incidence and types of dance-related injuries evaluated in emergency departments in the United States over the 14-year period 2000-2013. METHODS: Data were obtained from the nationally representative National Electronic Injury Surveillance System from 2000–2013. National estimates of injuries were determined using complex s le design. Trends using 2-year intervals were calculated using linear regression and injury proportion ratios using Pearson’s X2. RESULTS: The average annual incidence of dance-related injuries requiring emergency medical attention was 17,145 per year. The number of injuries grew from 14,204 in 2000/1 to 21,356 in 2012/3, a change of 33.4% after accounting for population growth. Lower limb injuries were most common, particularly ankle and knee sprains. Females presented with a greater proportion of ankle (injury proportion ratio [IPR]=1.34, p=0.029) and foot sprains (IPR=2.11, p .001) but a lower proportion of shoulder sprains (IPR=0.41, p .001) and face lacerations (IPR=0.13, p .001). Younger dancers presented with a lower proportion of knee (IPR=0.79, p=0.006) and low back sprains (IPR=0.68, p=0.019). CONCLUSIONS: The average annual incidence of dance-related injuries of a serious enough nature to require presentation to the emergency department in the United States was 17,145 per year, with ankle and knee sprains being the most common. Injury numbers have increased in recent years.
Publisher: Human Kinetics
Date: 08-2020
Abstract: Purpose : To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. Methods : In this randomized trial, 32 football players (18–23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week n = 15) and group 2 (twice a week n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. Results : Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155–164 vs 149–158 N·m P = .043 ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212–234 vs 198–221 N·m P = .098 ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56–0.59 vs 0.54–0.57 P = .089 ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76–0.84 vs 0.71–0.79 P = .076 ES = 0.50). No between-groups differences were found for muscle thickness ( P = .864 ES = 0.12), pennation angle ( P = .289 ES = 0.18), fascicle length ( P = .406 ES = 0.03), and quadriceps concentric peak torque ( P = .340 ES = 0.02). Conclusion : Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2016
DOI: 10.1007/S00167-016-4243-6
Abstract: The purpose of this study was to investigate the effect of chronic ankle instability (CAI) on electromechanical delay times (EMD) before and after fatigue. Understanding the mechanisms that contribute to CAI is essential for the development of effective rehabilitation programmes. It was hypothesized that patients with CAI will demonstrate prolonged EMD times compared to healthy subjects and that fatigue will cause greater increases in EMD times in the CAI group. Twenty-one male volunteers participated in the study providing data on 16 ankles with CAI and 26 with no history of ankle injury. EMD was measured on an isokinetic dynamometer. Measurements were taken with the ankle in neutral (0°) and at 30° of inversion. All subjects followed an isokinetic fatigue protocol until eversion torque fell below 50 % of initial torque for three consecutive repetitions. A 2 × 2 × 2 ANOVA was used to calculate the effect of ankle status (CAI vs. healthy), fatigue, angle (0° vs. 30°) and their interactions on EMD. Fatigue caused a significant increase on EMD [non-fatigued: 122(29)ms vs. fatigue 155(54)ms p < 0.001]. EMD times were shorter at 30° of inversion compared to neutral [neutral: 145(39)ms vs. 30° of inversion: 132(40)ms, p = 0.015]. An interaction effect for ankle status and angle was found (p = 0.026) with CAI ankles demonstrating longer EMD [CAI: 156(45)ms vs. healthy: 133(40)ms] in neutral but not at 30° of inversion [CAI: 133(46)ms vs. 132(33)ms]. Patients with CAI had longer EMD times in neutral, but not when the ankle was placed in inversion. This suggests that rehabilitation programmes may be more effective when retraining occurs with the ankle in neutral position. It is likely that low EMD times prevent ankle acceleration at the beginning of the mechanism of injury, but they are less important when the ankle has already inverted at 30°. Both CAI and healthy subjects demonstrated longer EMD after fatigue, emphasizing the importance of proper conditioning in the prevention of delayed peroneal response and subsequent ankle injury. Improving resistance to fatigue of the peroneals may prove to be an effective prevention tool of ankle sprain recurrence in patients with CAI. III.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Elsevier BV
Date: 11-2019
Publisher: BMJ
Date: 03-09-2023
Publisher: Elsevier
Date: 2018
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.KNEE.2017.08.053
Abstract: This study reports the development and validation of a quantitative technique of assessing frontal knee joint laxity through a custom built device named KLICP. The objectives of this study were to determine: (i) the intra- and inter-rater reliability and (ii) the validity of the device when compared to real time ultrasound. Twenty-five participants had their frontal knee joint laxity assessed by the KLICP, by manual varus/valgus tests and by ultrasound. Two raters independently assessed laxity manually by three repeated measurements, repeated at least 48h later. Results were validated by comparing them to the medial and lateral joint space opening measured by the ultrasound. Intraclass correlation coefficients and standard error of measurement reliability were calculated. Pearson's correlation coefficients were calculated to determine the correlation between the KLICP and the joint space. Intra-rater reliability (intra-session) for each rater was good on both sessions (0.91-0.98), intra-rater reliability (inter-sessions) was moderate to good (0.62-0.87), and inter-rater reliability (intra-session) was good (0.75-0.80). There is low agreement for intra-rater (inter-session) and for inter-rater (intra-session) reliability. The KLICP measurement has a significant positive fair to moderate correlation to the ultrasound measurement at the left (r: 0.61, p: 0.01) and right (r: 0.48, p: 0.02) knee in the valgus direction and at the left (r: 0.51, p: 0.01) and right (r: 0.39, p: 0.05) knee in the varus direction. There is low agreement between the KLICP and the RTU. Reliability and agreement was good only when measured for intra-rater, within session.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.SPINEE.2017.02.004
Abstract: The relationship between sedentary lifestyle and low back pain (LBP) remains unclear and previous research has not accounted for genetic and early environmental factors. Our aim was to investigate if sedentary behavior is associated with the lifetime prevalence of persistent LBP and the risk of developing persistent LBP, care-seeking due to LBP, and activity limiting LBP when genetics and early environmental factors are accounted for. Both cross-sectional and longitudinal designs with a within-pair twin case-control were implemented. There were 2,148 twins included in the cross-sectional analysis whereas 1,098 twins free of persistent LBP at baseline were included in the longitudinal analysis. Sedentary behavior was the explanatory variable. Lifetime prevalence of LBP was the outcome variable in the cross-sectional analysis. The incidence of persistent LBP, care-seeking due to LBP, and activity limiting LBP were the outcome variables for the longitudinal analysis. This observational study was supported by a grant in 2012. No competing interests were declared. In the cross-sectional analysis, sedentary behavior was slightly associated with an increased prevalence of persistent LBP in females but not in males. This association was not apparent when genetics and early environmental factors were accounted for. We acknowledge that the small s le included in the co-twin analyses have yielded wide confidence intervals, and that caution should be exercised when interpreting and an association may not be ruled out. In the longitudinal analysis, sedentary behavior did not significantly increase the risk of persistent LBP, care-seeking due to LBP, or activity limiting LBP. Sedentary behavior is associated with concurrent LBP. However, this association is weak it only appears in females and decreases when accounting for genetics. Future studies using a twin design with larger s les should be conducted to further test these findings.
Publisher: Informa UK Limited
Date: 10-02-2016
Publisher: SAGE Publications
Date: 05-2017
Abstract: The ideal implementation of soccer injury prevention programs is essential knowledge for soccer coaches. The objective of this study was to investigate and compare the implementation of injury prevention programs, specially the FIFA 11+ program, among Australian and Saudi Arabian soccer coaches. A Web-based survey was used to obtain information regarding the coaches’ implementation of injury prevention programs, the FIFA 11+ program, the Nordic hamstring exercise, pre- and post-training exercises. Sixty coaches—30 from both selected countries—responded to the survey (response rate = 75%). In Australia, 93% of the coaches implemented an injury prevention program while 73% implemented the FIFA 11+ program, only 51% implemented all the FIFA 11+ exercise components as recommended. In Saudi Arabia, 70% of the coaches stated that they followed an injury prevention program, but only 40% followed the FIFA 11+ program. However, 70% reported using all the FIFA 11+ exercise components in their current practices, which they may have adapted from different exercise-based injury prevention programs. The Australian coaches were significantly more likely to implement injury prevention programs ( p = 0.020) and the FIFA 11+ program ( p = 0.009). Nonetheless, no significant difference in the full implementation of the FIFA 11+ exercises components was found ( p = 0.114). The Australian coaches had greater awareness of injury prevention programs and more familiarity with the FIFA 11+ program than the Saudi Arabian coaches. Nevertheless, there was a gap between the coaches’ knowledge and their actual practice.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.JSAMS.2011.07.008
Abstract: Higher side-to-side asymmetry among female athletes compared to their male counterparts during bilateral athletic tasks such as landing from a jump has been proposed as a potential source of non contact knee injuries. However, the kinematic symmetry and potential sex differences during the initial (and most dangerous) phase of bilateral landings have not been examined. The objective of this project is to evaluate lower extremity kinematic asymmetry among recreational athletes during forward jump landing and drop landing tasks. Repeated measures laboratory experiment. Thirteen male and 15 female athletes performed landing tasks on a force plate while kinematic data were collected. Kinematic asymmetry between legs was calculated for the initial phase of landing for lower extremity kinematics. ANOVA tests and effect size calculations were used to measure the effect of sex, landing task and their interaction on kinematic asymmetry. Athletes exhibited higher asymmetry for knee valgus (d=0.5, p=0.006) and hip adduction (d=0.5, p=0.057) when performing forward compared to drop landings. Females landed with greater knee valgus asymmetry than males during forward landings (d=0.7, p=0.078) and with greater ankle abduction asymmetry during drop landings (d=0.5, 0.091). Female athletes exhibited greater frontal plane knee and ankle kinematic asymmetry than males during forward landings which may be related to the higher rate of ACL injury. Forward landings elicited greater hip adduction and knee valgus asymmetries than drop landings and, therefore it may be more appropriate for field testing when screening for asymmetries.
Publisher: SAGE Publications
Date: 06-2011
Abstract: Background: There is limited published research on the epidemiology of basketball injuries treated in US emergency departments (EDs). Hypothesis: Age and sex patterns exist for the most common pediatric basketball injuries treated in EDs. Study Design: Descriptive epidemiology study. Methods: Data from the National Electronic Injury Surveillance System and the National Sporting Goods Association were used to calculate national injury incidence rates and 95% confidence intervals of pediatric basketball injuries. Results: An estimated 325 465 annual visits were made to US EDs for pediatric basketball-related injuries from 2000 to 2006. The 5 most common injuries were ankle sprains (21.7%), finger sprains (8.0%), finger fractures (7.8%), knee sprains (3.9%), and facial lacerations (3.9%). Among persons aged 12 to 17 years, girls had a higher rate of knee sprains than boys (P 0.001), but this association did not exist among those aged 7 to 11 years (P = 0.27). Boys had a higher rate of facial lacerations than girls (P 0.01). Among persons aged 12 to 17 years, girls had a higher rate of finger sprains (P 0.01). For both boys and girls, the rate of the 5 most common basketball injuries was higher among those aged 12 to 17 years compared with those aged 7 to 11 years (P 0.01). Conclusions: The annual number of basketball-related pediatric ED visits approaches a third of a million and demonstrates the extent of the public health problem that injuries in this sport pose. Distinct sex and age patterns were observed. Clinical Relevance: The study findings provide important information on basketball injury rates that may be used for targeting prevention interventions by sex and age group.
Publisher: Society of Physical Therapy Science
Date: 2021
DOI: 10.1589/JPTS.33.554
Publisher: Wiley
Date: 16-10-2019
DOI: 10.1111/SMS.13309
Abstract: Repetition of jumps in dance and sport training poses a potential injury risk however, non-contact landing injuries are more common in athletes than dancers. This study aimed to compare the lower limb stiffness characteristics of dancers and athletes during drop landings to investigate possible mechanisms of impact-related injuries. Kinematics and kinetics were recorded as 39 elite modern and ballet dancers (19 men and 20 women) and 40 college-level team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Vertical leg stiffness and joint stiffness of the hip, knee, and ankle were calculated using a spring-mass model. Stiffness data, joint kinematics, and moments were compared with a group-by-sex 2-way analysis of variance. Multiple linear regression was used to assess the relative contribution of hip and knee and ankle joint stiffness to variance in overall vertical leg stiffness for dancers and athletes. Dancers had lower leg (P < 0.001), knee joint (P = 0.034), and ankle joint stiffness (P = 0.043) than athletes. This was facilitated by lower knee joint moments (P = 0.012) and greater knee (P = 0.029) and ankle joint (P = 0.048) range of motion in dancers. Males had higher leg (P < 0.001) and ankle joint stiffness (P < 0.001) than females. This occurred through lower ankle range of motion (P < 0.001) and greater ankle moment (P = 0.022) compared to females. Male and female dancers demonstrated reduced lower limb stiffness compared to athletes, indicating a more pliable landing technique. Dance training techniques could potentially inform approaches to injury prevention in athletes.
Publisher: Springer Science and Business Media LLC
Date: 04-10-2019
DOI: 10.1007/S40279-018-0995-0
Abstract: Following an anterior cruciate ligament (ACL) injury, patients are often reassured that timely surgery followed by intensive physiotherapy will "fix their knee". Not only does this message create a false perception of uncomplicated return to sport (RTS), it also ignores the large body of evidence demonstrating a high RTS re-injury rate following ACL reconstruction. In this article, we propose an in idualised approach to the management of ACL injuries that targets a shift away from early surgery and towards conservative management, with surgery 'as needed' and rehabilitation tailored to the patient's RTS goals. Education on the natural history of ACL injuries will ensure patients are not misguided into thinking surgery and intensive rehabilitation guarantees great outcomes. Further, understanding that conservative management is not inferior to surgery-and not more likely to cause knee osteoarthritis-will help the patient make an informed decision. For patients who opt for surgical management, rehabilitation must target strength and functional performance, avoid rapid increases in training load, and be guided by an RTS timeframe that is no shorter than 9 months. The content of rehabilitation should be similar for patients who opt for non-operative management, although the RTS timeframe will likely be shorter. All patients should receive education on the relationship between injury risk and training load, and understand that a home-exercise program is not inferior to intensive physiotherapist-led exercise.
Publisher: Elsevier BV
Date: 04-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2021
DOI: 10.1519/JSC.0000000000002849
Abstract: Severo-Silveira, L, Dornelles, MP, Lima-e-Silva, FX, Marchiori, CL, Medeiros, TM, Pappas, E, and Baroni, BM. Progressive workload periodization maximizes effects of Nordic hamstring exercise on muscle injury risk factors. J Strength Cond Res 35(4): 1006–1013, 2021—This study aimed to investigate the effect of 2 different Nordic hamstring exercise (NHE) training programs (constant workload vs. progressive workload) on multiple risk factors for hamstring strain injury in high competitive level athletes. Twenty-one premier league rugby union players (∼26 years) were randomized into 1 of 2 experimental groups and completed an 8-week NHE training program: constant training group (CTG) or progressive training group (PTG). Knee flexor/extensor strength and biceps femoris long head (BF LH ) muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Increased hamstring concentric (Δ = 8%, p = 0.004, d = 0.42) and eccentric (Δ = 7%, p = 0.041, d = 0.39) peak torques, as well as H:Q conventional (Δ = 7%, p = 0.015, d = 0.54) and functional (Δ = 6%, p = 0.026, d = 0.62) ratios were observed in the follow-up compared with baseline for the PTG group only. Nordic hamstring exercise training significantly increased BF LH muscle thickness (CTG: Δ = 7%, p = 0.001, d = 0.60 PTG: Δ = 7%, p 0.001, d = 0.54) and fascicle length (CTG: Δ = 8%, p 0.001, d = 0.29 PTG: Δ = 10%, p 0.001, d = 0.35) in both groups. Training adaptations on hamstring peak torque (concentric and eccentric) and H:Q ratio (conventional and functional) “likely favor” PTG, whereas changes in BF LH fascicle length “possibly favor” PTG. In conclusion, only PTG enhanced hamstring strength both NHE training programs increased BF LH muscle thickness and fascicle length, but progressive training generated greater changes on fascicle length than constant training. Medical/coaching staff should be aware that NHE with adequate training periodization with workload progression to maximize its benefits.
Publisher: Springer Berlin Heidelberg
Date: 2014
Publisher: FapUNIFESP (SciELO)
Date: 30-12-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2009
DOI: 10.1161/STROKEAHA.109.558940
Abstract: Background and Purpose— Overground gait training can be defined as a physical therapists’ observation and cueing of the patient’s walking pattern along with related exercises, but does not include high-technology aids such as functional electric stimulation or body weight support. This systematic review investigated the effects of overground physical therapy gait training on walking ability for chronic stroke patients with mobility deficits. Methods— A comprehensive literature search was performed as per the Cochrane group guidelines. Only randomized controlled trials that compared overground physical therapy gait training to a placebo intervention or no treatment for chronic stroke patients with mobility deficits were included. Results— Nine studies involving 499 participants matched the inclusion criteria and had moderate methodological quality. Results were mixed with no significant effect on the primary variable, gait function. Small effects for several performance variables were found: gait speed increased by 0.07 meters per second (95% confidence interval [CI]=0.05 to 0.10) based on 7 studies with 396 participants, timed up-and-go (TUG) test improved by 1.81 seconds (95% CI=−2.29 to −1.33) based on 3 studies and 118 participants, and 6-minute-walk test (6MWT) increased by 26.06 meters (95% CI=7.14 to 44.97) based on 4 studies with 181 participants. No significant differences in adverse events were found. Conclusions— There is insufficient evidence to determine whether overground gait training directly benefits broad measures of gait function. Results from recent studies, however, suggest that specific training protocols may provide limited benefits for more uni-dimensional performance variables like gait speed, TUG test, and 6MWT.
Publisher: Elsevier BV
Date: 11-2017
Publisher: Elsevier BV
Date: 06-2019
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.SPINEE.2017.04.008
Abstract: Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP) however, its effectiveness has not been investigated. The aim of this review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP. This is a systematic review with meta-analysis. Seven databases were searched from the earliest records to August 2015. Eligible studies were randomized controlled trials that investigated the effectiveness of telehealth-based interventions, solo or in combination with other interventions, for non-specific LBP compared with a control group. Trials deemed clinically homogeneous were grouped in meta-analyses. Eleven studies were included (n=2,280). In chronic LBP, telehealth interventions had no significant effect on pain at short-term follow-up (four trials: 1,089 participants, weighted mean difference [WMD]: -2.61 points, 95% confidence interval [CI]: -5.23 to 0.01) or medium-term follow-up (two trials: 441 participants, WMD: -0.94 points, 95% CI: -6.71 to 4.84) compared with a control group. Similarly, there was no significant effect for disability. Results from three in idual trials showed that telehealth was superior to a control intervention for improving quality of life. Interventions combining telehealth and usual care were more beneficial than usual care alone in people with recent onset of LBP symptoms. There is moderate-quality evidence that current telehealth interventions, alone, are not more effective than minimal interventions for reducing pain and disability in chronic LBP. To date, modern telehealth media (eg, apps) and telehealth as an adjunct to usual care remain understudied.
Publisher: Springer Science and Business Media LLC
Date: 17-07-2015
DOI: 10.1007/S00167-015-3688-3
Abstract: In total knee arthroplasty (TKA), dynamic knee loading may loosen the artificial joint and bone or cause polyethylene wear after prolonged use. TKA decreases knee adduction moment at 6 months, but this effect is lost by 1 year post-operatively. However, lateral thrust after TKA has not been clarified. We hypothesized that like knee adduction moment, lateral thrust would return to baseline levels by 1 year post-operatively. Participants were 15 patients who underwent TKA for medial knee OA. Japanese Orthopaedic Association (JOA) score, numeric rating scale, and gait analysis (measurement of peak knee adduction moment, knee varus angle at peak knee adduction moment, lateral thrust, and gait speed) were performed preoperatively (baseline) and 3 weeks, 3 and 6 months, and 1 year post-operatively. JOA score improved from 55 ± 9.8 to 78 ± 12.1 at 1 year post-operatively, and pain decreased significantly from baseline at each follow-up (p < 0.001). Significant increases in gait speed were observed at 6 months and 1 year (p < 0.001). Peak knee adduction moment during stance phase was significantly lower at 3 weeks, 3 months, and 6 months compared to baseline (p < 0.05), but no significant changes were seen at 1 year. Knee varus at peak knee adduction moment did not differ significantly between any measurement points, while lateral thrust was decreased at 6 months and 1 year compared to baseline (p < 0.05). Temporal courses of changes up to 1 year after TKA differed between knee adduction moment and lateral thrust, so our hypothesis was rejected. IV.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 2018
Publisher: SAGE Publications
Date: 28-07-2015
Abstract: The primary aim of this review was to identify literature that examined factors which influence driving performance following a wrist fracture. Given the known scarcity of research in this area, secondary aims were to detail current practices including the driving habits of patients following a wrist fracture and health professionals’ opinions on safe return to driving. We performed a search in April 2015 using three electronic databases to obtain relevant literature in the English language. Relevant studies including clinical trials, surveys and case reports were reviewed. The search identified 12 relevant studies. Five of these were clinical studies with a crossover design that investigated the driving ability of uninjured in iduals with the wrist immobilised in a cast. The remaining were survey-based studies. The clinical trials showed that the presence of a wrist cast reduced driving performance in uninjured in iduals. No studies investigated driving performance in in iduals with a wrist fracture. The surveys showed that this patient group returns to driving despite perceived safety risks. Inconsistency in expert opinions on whether in iduals with a wrist fracture are safe to drive was highlighted. There is evidence to suggest that driving performance is reduced in uninjured in iduals when wearing a cast immobilising the wrist however, the influence of wrist fracture is unknown. This, along with safety implications resulting from current driving behaviours and inconsistent information provided to patients regarding return to driving, highlights the need for further studies to ascertain which factors influence driving performance following wrist fracture.
Publisher: Springer Science and Business Media LLC
Date: 04-09-2019
Publisher: Elsevier
Date: 2018
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.KNEE.2019.02.011
Abstract: There is increasing evidence that motor imagery performance (MIP) is impaired in conditions that have a component of movement dysfunction. However, MIP has not been investigated in people with chronic anterior cruciate ligament (ACL) deficiency who experience limited disability and function at high levels. This study had three objectives: (1) to assess implicit MIP in in iduals with a chronic ACL deficient (ACLD) knee compared with healthy controls (i.e., intact anterior cruciate ligament) (2) to determine if the location of ACL deficiency affects MIP (dominant versus non-dominant leg) and (3) to determine if impairment in MIP is specific to the side (injured versus non-injured) of ACL deficiency. Forty-five participants with chronic ACLD knee and 44 healthy controls completed a left/right judgement task of pictured knees using the "Recognise" app to evaluate implicit MIP. Accuracy and reaction time of judgements were compared between groups. Additionally, within the chronic ACLD knee group, we made comparisons between the dominant ACLD knee and non-dominant ACLD knee subgroups and between the injured knee and the non-injured knee of the ACLD group. There were no differences in implicit MIP between the ACLD knee and the control group, the non-injured knee versus injured knee of the ACLD knee group, or the dominant ACLD knee versus non-dominant ACLD knee subgroups. Implicit MIP is not disrupted in high functioning in iduals with chronic ACLD knee.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2007
Publisher: Springer Science and Business Media LLC
Date: 21-12-2017
DOI: 10.1007/S40279-017-0853-5
Abstract: Physical inactivity is one of the key global health challenges as it is associated with adverse effects related to ageing, weight control, physical function, longevity, and quality of life. Dancing is a form of physical activity associated with health benefits across the lifespan, even at amateur levels of participation. However, it is unclear whether dance interventions are equally as effective as other forms of physical activity. The aim was to systematically review the literature on the effectiveness of structured dance interventions, in comparison to structured exercise programmes, on physical health outcome measures. Seven databases were searched from earliest records to 4 August 2017. Studies investigating dance interventions lasting > 4 weeks that included physical health outcomes and had a structured exercise comparison group were included in the study. Screening and data extraction were performed by two reviewers, with all disagreements resolved by the primary author. Where appropriate, meta-analysis was performed or an effect size estimate generated. Of 11,434 studies identified, 28 (total s le size 1276 participants) met the inclusion criteria. A variety of dance genres and structured exercise interventions were compared. Meta-analyses showed dance interventions significantly improved body composition, blood biomarkers, and musculoskeletal function. The effect of either intervention on cardiovascular function and self-perceived mobility was equivalent. Undertaking structured dance of any genre is equally and occasionally more effective than other types of structured exercise for improving a range of health outcome measures. Health practitioners can recommend structured dance as a safe and effective exercise alternative.
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.CLINBIOMECH.2016.04.002
Abstract: Altered joint motion that occurs in people with an anterior cruciate ligament deficient knee is proposed to play a role in the initiation of knee osteoarthritis, however, the exact mechanism is poorly understood. Although several studies have investigated gait deviations in in iduals with chronic anterior cruciate ligament deficient knee in the frontal and transverse planes, no systematic review has summarized the kinematic and kinetic deviations in these two planes. We searched five electronic databases from inception to 14th October 2013, with key words related to anterior cruciate ligament, biomechanics and gait, and limited to human studies only. Two independent reviewers assessed eligibility based on predetermined inclusion/exclusion criteria and methodological quality was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology statement checklist. We identified 16 studies, totaling 183 subjects with anterior cruciate ligament deficient knee and 211 healthy subjects. Due to the variability in reported outcomes, we could only perform meta-analysis for 13 sagittal plane outcomes. The only significant finding from our meta-analysis showed that in iduals with anterior cruciate ligament deficient knee demonstrated a significantly greater external hip flexor angular impulse compared to control (P=0.03). No consensus about what constitutes a typical walking pattern in in iduals with anterior cruciate ligament deficient knee can be made, nor can conclusions be derived to explain if gait deviations in the frontal and transverse plane contributed to the development of the knee osteoarthritis among this population.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2020
Publisher: Elsevier BV
Date: 04-2019
Publisher: FapUNIFESP (SciELO)
Date: 2020
DOI: 10.1590/1980-0037.2020V22E70430
Abstract: Abstract Despite the increase in the number of Ironman competitions worldwide, thousands of athletes have been joining Ironman experience but only a few studies have been published on the effects of this competition on postural control. This study aims to investigate the ability to maintain a static posture in three different positions before and after an Ironman competition and the blood glucose level behavior. Forty-nine volunteers underwent balance evaluation using the force plate VSRTM Sport. The area of the center of gravity (ACOG) was assessed pre- and post-competition in the bipodal, unipodal, and tandem postures. Glucose levels were also assessed concurrently. The ACOG findings showed a significant post-competition increase in the three postures assessed, with no significant interaction between the postures. The glucose test showed an increase in the post-competition glycemic levels. The findings showed reduced postural control, suggesting that prolonged exercise stimulation could lead to a disturbance in postural control.
Publisher: Informa UK Limited
Date: 26-06-2017
Publisher: Elsevier BV
Date: 04-2015
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.MSKSP.2019.05.009
Abstract: Orthopaedic physical therapists (PTs) who perform manual therapy are at high risk for wrist and hand pain. Studies that examine the magnitude, scope and causes of wrist and hand pain are needed so that prevention programs can be developed. The objective of this study was to determine the magnitude, scope, and impact of wrist and hand pain in orthopaedic PTs and to identify potential strategies for prevention. This was a sequential, mixed methods study including quantitative and qualitative components. The quantitative phase consisted of an online survey sent to members of the Academy of Orthopaedic Physical Therapy. The qualitative phase consisted of focus groups with Orthopaedic PTs who had wrist and hand pain. The survey included 962 PTs and the focus groups included 10 PTs. The one-year prevalence of wrist and hand pain was 75%. Increasing age, decreasing experience, female gender, performing more manual therapy and working more than 40 h per week were associated with an increased risk of moderate to severe wrist and hand pain. Soft-tissue mobilization was the most frequently cited causative factor. The most commonly mentioned strategy for prevention was altering body mechanics and technique. Focus group participants highlighted the importance of managing expectations for manual therapy by patients. Formal injury prevention programs for PT students and PTs are urgently needed. These programs should focus on improving body mechanics and technique, attention to workload, careful selection of manual techniques, and managing expectations for manual therapy.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2008
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JOCA.2016.05.011
Abstract: To determine the prevalence of radiographic patellofemoral osteoarthritis (OA) from population- and symptom-based cohorts and to evaluate if knee pain, physical function and quality of life (QOL) differ between people with isolated patellofemoral OA, isolated tibiofemoral OA and combined patellofemoral and tibiofemoral OA. Terms associated with "patellofemoral OA", "prevalence" and "clinical features" were used to search Medline, EMBASE, CINAHL, SCOPUS, AMED and Web of Science databases with no language restriction' from inception to August 2014. Two independent reviewers screened papers for eligibility. Studies were included if they reported prevalence of compartmental patterns of radiographic knee OA in population- or symptom-based cohorts. Studies were excluded if they evaluated a targeted s le (e.g., occupation-specific participants) or repeated already reported data from the same cohorts. Point prevalence estimates of patellofemoral OA were extracted from eligible studies, pooled and quantitatively analysed. A critical appraisal tool was used to evaluate methodological quality. The search yielded 1891 records. The inclusion criteria were met by 32 studies. The crude prevalence of patellofemoral OA was 25% in the population-based cohorts (aged >20 years) and 39% in the symptom-based cohorts (aged >30 years). Eight studies reported knee pain, physical function and QOL in people with different compartmental disease however no significant differences were found. These findings confirm the substantial prevalence of patellofemoral OA, demonstrating the need to specifically consider the patellofemoral joint in knee OA research and clinical settings.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Springer Science and Business Media LLC
Date: 23-03-2012
DOI: 10.1007/S00167-012-1955-0
Abstract: Technological advances in recent years have allowed the easy and accurate assessment of knee motion during athletic activities. Subsequently, thousands of studies have been published that greatly improved our understanding of the aetiology, surgical reconstruction techniques and prevention of anterior cruciate ligament (ACL) injuries. The purpose of this review is to summarize the evidence from biomechanical studies on ACL-related research. High-impact articles that enhanced understanding of ACL injury aetiology, rehabilitation, prevention and adaptations after reconstruction were selected. The importance of restoring internal tibial rotation after ACL reconstruction has emerged in several studies. Criteria-based, in idualized rehabilitation protocols have replaced the traditional time-based protocols. Excessive knee valgus, poor trunk control, excessive quadriceps forces and leg asymmetries have been identified as potential high risk biomechanical factors for ACL tear. Injury prevention programmes have emerged as low cost and effective means of preventing ACL injuries, particularly in female athletes. As a result of biomechanical research, clinicians have a better understanding of ACL injury aetiology, prevention and rehabilitation. Athletes exhibiting neuromuscular deficits predisposing them to ACL injury can be identified and enrolled into prevention programmes. Clinicians should assess ACL-reconstructed patients for excessive internal tibial rotation that may lead to poor outcomes.
Publisher: John Wiley & Sons, Ltd
Date: 19-07-2006
Publisher: Springer Science and Business Media LLC
Date: 17-10-2017
DOI: 10.1007/S40279-016-0638-2
Abstract: Hamstring injuries are among the most common non-contact injuries in sports. The Nordic hamstring (NH) exercise has been shown to decrease risk by increasing eccentric hamstring strength. The purpose of this systematic review and meta-analysis was to investigate the effectiveness of the injury prevention programs that included the NH exercise on reducing hamstring injury rates while factoring in athlete workload. Two researchers independently searched for eligible studies using the following databases: the Cochrane Central Register of Controlled Trials via OvidSP, AMED (Allied and Complementary Medicine) via OvidSP, EMBASE, PubMed, MEDLINE, SPORTDiscus, Web of Science, CINAHL and AusSportMed, from inception to December 2015. The keyword domains used during the search were Nordic, hamstring, injury prevention programs, sports and variations of these keywords. The initial search resulted in 3242 articles which were filtered to five articles that met the inclusion criteria. The main inclusion criteria were randomized controlled trials or interventional studies on use of an injury prevention program that included the NH exercise while the primary outcome was hamstring injury rate. Extracted data were subjected to meta-analysis using a random effects model. The pooled results based on total injuries per 1000 h of exposure showed that programs that included the NH exercise had a statistically significant reduction in hamstring injury risk ratio [IRR] of 0.490 (95 % confidence interval [CI] 0.291-0.827, p = 0.008). Teams using injury prevention programs that included the NH exercise reduced hamstring injury rates up to 51 % in the long term compared with the teams that did not use any injury prevention measures. This systematic review and meta-analysis demonstrates that injury prevention programs that include NH exercises decrease the risk of hamstring injuries among soccer players. A protocol was registered in the International Prospective Register of Systematic Reviews, PROSPERO (CRD42015019912).
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2018-022785
Abstract: To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. Prospective cohort study. We used family-linked longitudinal data from the Norwegian HUNT study collected in HUNT2 (1995–1997) and HUNT3 (2006–2008). A total of 1529 offspring who reported spinal pain in HUNT2 were linked with parental data and followed up in HUNT3. We estimated relative risk (RR) with 95% CI for recovery from chronic spinal pain, and also from activity limiting spinal pain, in offspring related to chronic spinal pain in parents. We also investigated whether offspring leisure time physical activity and BMI modified these intergenerational associations in spinal pain. A total of 540 (35%) offspring were defined as recovered after approximately 11 years of follow-up. Offspring with both parents reporting chronic spinal pain were less likely to recover from chronic spinal pain (RR 0.83, 95% CI 0.69 to 0.99) and activity limiting spinal pain (RR 0.71, 95% CI 0.54 to 0.94), compared with offspring of parents without chronic spinal pain. Analyses stratified by BMI and physical activity showed no strong evidence of effect modification on these associations. However, offspring who were overweight/obese and with both parents reporting chronic spinal pain had particularly low probability of recovery from activity limiting spinal pain, compared with those who were normal weight and had parents without chronic spinal pain (RR 0.57, 95% CI 0.39 to 0.84). Offspring with chronic spinal pain are less likely to recover if they have parents with chronic spinal pain, particularly if offspring are overweight/obese.
Publisher: SAGE Publications
Date: 03-03-2014
Abstract: The incidence of anterior cruciate ligament (ACL) injuries among dancers is much lower than among team sport athletes, and no clear disparity between sexes has been reported in the dance population. Although numerous studies have observed differences in landing biomechanics of the lower extremity between male and female team sport athletes, there is currently little research examining the landing biomechanics of male and female dancers and none comparing athletes to dancers. Comparing the landing biomechanics within these populations may help explain the lower overall ACL injury rates and lack of sex disparity. The purpose was to compare the effects of sex and group (dancer vs team sport athlete) on single-legged drop-landing biomechanics. The primary hypothesis was that female dancers would perform a drop-landing task without demonstrating typical sex-related risk factors associated with ACL injuries. A secondary hypothesis was that female team sport athletes would display typical ACL risk factors during the same task. Controlled laboratory study. Kinematics and kinetics were recorded as 40 elite modern and ballet dancers (20 men and 20 women) and 40 team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Joint kinematics and kinetics were compared between groups and sexes with a group-by-sex multivariate analysis of variance (MANOVA) followed by pairwise t tests. Dancers of both sexes and male team sport athletes landed similarly in terms of frontal-plane knee alignment, whereas female team sport athletes landed with a significantly greater peak knee valgus ( P = .007). Female dancers were found to have a lower hip adduction torque than those of the other 3 groups ( P = .003). Dancers (male and female) exhibited a lower trunk side flexion ( P = .002) and lower trunk forward flexion ( P = .032) compared with team sport athletes. In executing a 30-cm drop landing, female team sport athletes displayed a greater knee valgus than did the other 3 groups. Dancers exhibited better trunk stability than did athletes. These biomechanical findings may provide insight into the cause of the epidemiological differences in ACL injuries between dancers and athletes and the lack of a sex disparity within dancers.
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.APMR.2015.12.017
Abstract: To investigate whether vastus medialis (VM) Hoffmann reflexes (H-reflexes) differ on the basis of the presence or absence of patellofemoral pain (PFP) and to assess the capability of VM H-reflex measurements in accurately discriminating between women with and without PFP. Cross-sectional study. Laboratory of biomechanics and motor control. Women (N=30) aged 18 to 35 years were recruited, consisting of 2 groups: women with PFP (n=15) and asymptomatic controls (n=15). Not applicable. Maximum evoked responses were obtained by electrical stimulation applied to the femoral nerve, and peak-to-peak litudes of maximal Hoffmann reflex (Hmax) and maximal motor wave (Mmax) ratios were calculated. Independent s les t tests were performed to identify differences between groups, and a receiver operating characteristic curve was constructed to assess the discriminatory capability of VM H-reflex measurements. VM Hmax/Mmax ratios were significantly lower in participants with PFP than in pain-free participants (P=.007). In addition, the VM Hmax/Mmax ratios presented large and balanced discriminatory capability values (sensitivity, 73% specificity, 67%). This study is the first to show that VM H-reflexes are lower in women with PFP than in asymptomatic controls. Therefore, increasing the excitation of the spinal cord in PFP participants may be essential to maintaining the gains acquired during the rehabilitation programs.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.FOOT.2019.08.007
Abstract: Plantar heel pain is a common musculoskeletal foot disorder that can have a negative impact on activities of daily living and it is of multifactorial etiology. A variety of mechanical factors, which result in excessive load at the plantar fascia insertion, are thought to contribute to the onset of the condition. This review presents the evidence for associations between commonly assessed mechanical factors and plantar heel pain, which could guide management. Plantar heel pain is associated with a higher BMI in non-athletic groups, reduced dorsiflexion range of motion, as well as reduced strength in specific foot and ankle muscle groups. There is conflicting, or insufficient evidence regarding the importance of foot alignment and first metatarsophalangeal joint range of motion. Plantar heel pain appears to be common in runners, with limited evidence for greater risk being associated with higher mileage or previous injuries. Conflicting evidence exists regarding the relationship between work-related standing and plantar heel pain, however, longer standing duration may be associated with plantar heel pain in specific worker groups. The evidence presented has been generated through studies with cross-sectional designs, therefore it is not known whether any of these associated factors have a causative relationship with plantar heel pain. Longitudinal studies are needed to ascertain whether the strength and flexibility impairments associated with plantar heel pain are a cause or consequence of the condition, as well as to establish activity thresholds that increase risk. Intervention approaches should consider strategies that improve strength and flexibility, as well as those that influence plantar fascia loading such as body weight reduction, orthoses and management of athletic and occupational workload.
Publisher: Springer Science and Business Media LLC
Date: 04-09-2019
Publisher: SAGE Publications
Date: 11-12-2013
Abstract: The posterior cruciate ligament (PCL) index quantifies the curvature of the PCL seen on magnetic resonance imaging (MRI) that is caused by a change in tibiofemoral alignment in the anterior cruciate ligament (ACL)–deficient knee. It has been proposed that the PCL index may be useful in assessing the success of ACL reconstruction (ACLR). The purpose of this study was to test if the PCL index is predictive of in vivo rotational kinematics and joint laxity measures in knees of patients after single-bundle ACLR. The hypothesis was that the PCL index is predictive of rotational knee kinematics and objective laxity scores. Controlled laboratory study. At a mean of 18.1 months postoperatively, the PCL index was defined on MRI in 16 patients prospectively followed up after anatomic single-bundle ACLR and in 16 matched controls. The patients were evaluated with 3-dimensional motion analysis during (1) descending and pivoting as well as (2) landing and pivoting tasks. The side-to-side difference in tibial rotation range of motion between the reconstructed knee and the contralateral intact knee was calculated. The side-to-side difference in anterior tibial translation was measured with a KT-1000 arthrometer. Linear regression models were used with the PCL index as a predictor of the side-to-side difference in tibial rotation for each task and the side-to-side difference in anterior tibial translation. The PCL index of the reconstructed knees was significantly lower compared with that of the control knees ( P .001). The index was predictive of the side-to-side difference in tibial rotation during both tasks ( R 2 = 0.472 and 0.477, P = .003), with a lower index being indicative of increased rotational laxity. It was not predictive of anterior tibial translation (at 134 N: R 2 = 0.13, P = .17 at maximum force: R 2 = 0.009, P = .726). The PCL index after anatomic single-bundle ACLR using a bone–patellar tendon–bone graft is predictive of rotational kinematics during in vivo dynamic pivoting activities. The results show that the PCL index is correlated with the postoperative ability to control rotational kinematics of the knee joint. This study provides evidence regarding the interplay between restoration of the native ACL’s anatomy and the PCL’s appearance and suggests that the effective restoration of tibiofemoral alignment after ACLR that is reflected in the PCL index translates into better functional outcomes as measured by tibial rotation during pivoting activities.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 07-2019
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.ARTHRO.2011.08.285
Abstract: To investigate the effect of coronal- and sagittal-plane anterior cruciate ligament (ACL) graft obliquity on tibial rotation (TR) range of motion (ROM) during dynamic pivoting activities after ACL reconstruction with bone-patellar tendon-bone (BPTB) autograft. We evaluated 19 ACL-reconstructed patients (mean age, 29 years age range, 18 to 38 years mean time interval postoperatively, 19.9 months) and 19 matched control subjects (mean age, 30.6 years age range, 24 to 37 years) using motion analysis during (1) descending a stairway and pivoting and (2) landing from a jump and pivoting. Magnetic resonance imaging was used to measure the coronal and sagittal ACL graft angle. The dependent variables were TR ROM during pivoting and the side-to-side difference (SSD) in TR ROM between the reconstructed knee and the contralateral intact knee. TR ROM of the ACL-reconstructed knee was significantly increased compared with both the contralateral intact knee and the healthy control knee (P < .05). A significant positive correlation was observed between TR ROM and coronal ACL graft angle (r = 0.727, P = .0006 for descending and pivoting r = 0.795, P = .0001 for landing and pivoting) as well as between SSD of TR ROM and coronal ACL graft angle (r = 0.789, P < .0001 for descending and pivoting r = 0.799, P < .0001 for landing and pivoting). No correlation was found with the sagittal ACL graft angle. After ACL reconstruction with a BPTB graft, patients' knees showed higher TR values than their uninjured knees and the knees of uninjured control volunteers during dynamic pivoting activities. The findings of this study show that TR was better restored in ACL-reconstructed patients with a more oblique graft in the coronal plane. A similar relation was not observed for graft orientation in the sagittal plane. Although these data do not imply a cause-and-effect relation between the 2 variables, they may indicate that a more oblique placement of a single BPTB ACL graft in the coronal plane is correlated with better control of TR. Level IV, case series.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 02-2010
Publisher: Springer Science and Business Media LLC
Date: 12-2022
DOI: 10.1186/S40798-022-00536-6
Abstract: The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. In iduals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between in iduals with knee disorders and injury-free controls. Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between in iduals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). In iduals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58–1.18) and stepping tasks (SMD 0.56, 95% CI 0.13–.99) ipsilateral and contralateral trunk lean during walking (SMD 1.36 95% CI 0.60–2.11) and sit-to-stand (SMD 1.49 95% CI 0.90–2.08), respectively. Greater trunk flexion during landing tasks in in iduals with PFP (SMD 0.56 95% CI 0.01–1.12) or ACLR (SMD 0.48 95% CI 0.21–.75) and greater ipsilateral trunk lean during single-leg squat in in iduals with PFP (SMD 1.01 95% CI 0.33–1.70) were also identified. No alterations in trunk kinematics of in iduals with TKA were identified. Evidence gap maps outlined the lack of investigations for in iduals with PT or ACLD, as well as for trunk kinetics across knee disorders. In iduals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these in iduals in order to identify possible targets for rehabilitation and avoidance strategies. Trial registration: PROSPERO registration number: CRD42019129257.
Publisher: Elsevier BV
Date: 04-2016
Publisher: Springer Science and Business Media LLC
Date: 24-01-2012
DOI: 10.1007/S00167-012-1902-0
Abstract: The purpose of this study was to test whether rotational knee kinematics during dynamic pivoting activities are predictive of subjective functional outcome (IKDC, Lysholm), objective laxity scores (KT max), and activity levels (Tegner) in patients after anterior cruciate ligament reconstruction (ACLR). Thirty-one patients with single-bundle ACLR were evaluated prospectively with 3D-motion analysis during (1) descending a stairway and pivoting and (2) landing from a jump and pivoting. The side-to-side difference of tibial rotation range of motion (SSDTR) between the ACLR and the contralateral intact knee was calculated for the pivoting phase of each task. Linear regression models were applied with SSDTR, for each task predictors of the subjective IKDC score, Lysholm score, anterior tibial translation, and Tegner activity level. SSDTR for descending and landing were predictive of the IKDC subjective score (R(2) = 0.46, p < 0.001 and R(2) = 0.40, p < 0.001, respectively) with "medium" effect sizes and of the Lysholm score (R(2) = 0.13, p < 0.05 and R(2) = 0.09, n.s.) with "small" to "none" effect sizes. SSDTR was not predictive of anterior translation or Tegner activity level (n.s.). Restoring rotational kinematics during dynamic pivoting activities after ACLR is predictive of functional outcome. The ability of the athlete after ACLR to control tibial rotation during pivoting activities may be predictive of functional outcome. Case series study. Level IV.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2011
Publisher: Springer Science and Business Media LLC
Date: 24-10-2017
DOI: 10.1007/S00167-017-4742-0
Abstract: Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of pathological tibiofemoral joint movement that results from ACL deficiency (ACLD). Thirteen men with unilateral ACLD were prospectively evaluated before and at a mean follow-up of 14.9 (SD = 1.8) months after anatomic SB ACLR with bone patellar tendon bone autograft. The anatomic ACLR replicated the native ACL attachment site anatomy and graft orientation. Emphasis was placed on intraoperative correction of tibiofemoral subluxation by reducing anterior tibial translation (ATT) and internal tibial rotation. Function was measured with IKDC, Lysholm and the Tegner activity scale, ATT was measured with the KT-1000 arthrometer and tibial rotation (TR) kinematics were measured with 3Dmotion analysis during a high-demand pivoting task. The results showed significantly higher TR of the ACL-deficient knee when compared to the intact knee prior to surgery (12.2° ± 3.7° and 10.7° ± 2.6° respectively, P = 0.014). Postoperatively, the ACLR knee showed significantly lower TR as compared to the ACL-deficient knee (9.6°±3.1°, P = 0.001) but no difference as compared to the control knee (n.s.). All functional scores were significantly improved and ATT was restored within normal values (P < 0.001). Intraoperative correction of tibiofemoral subluxation that results after ACL injury is an important step during anatomic SB ACLR. The intraoperative correction of tibiofemoral subluxation along with the replication of native ACL anatomy results in restoration of rotational kinematics of ACLD patients to normal levels that are comparable to the control knee. These results indicate that the reestablishment of tibiofemoral alignment during ACLR may be an important step that facilitates normal knee kinematics postoperatively. Level II, prospective cohort study.
Publisher: OMICS Publishing Group
Date: 2012
Publisher: Elsevier BV
Date: 2017
Publisher: Wiley
Date: 23-03-2015
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.GAITPOST.2019.02.025
Abstract: Long-term gait adaptations after anterior cruciate ligament reconstruction (ACLR) have been reported. However, it is still unclear if they persist more than 4 years after surgery and if they are affected by gait speed. To investigate differences between groups, legs and walking speeds for ankle, knee and hip joint moments in three planes throughout the stance phase of gait. Reconstructed participants (n = 20 males, 32.5 years, 5.5 years post-ACLR) and healthy controls (n = 20 males, 30.6 years) took part in the study. Gait analysis was performed in two different speeds (self-selected and 30% faster). Sagittal, frontal and transverse plane external moments were measured for ankle, knee and hip and compared throughout the stance phase using 95% confidence intervals. Significant differences were established as a consecutive 5% of gait cycle in which 95% confidence interval did not overlap. The reconstructed leg did not demonstrate higher joint moments there were largely no differences while there was lower knee external rotation moment compared to the non-preferred leg of the control group. Higher joint moments were observed during fast speed walking on sagittal plane for knee and hip moments in both groups, and in the frontal and transverse plane for ankle moments. Gait kinetics appear to be largely normalized at a minimum of 4 years after ACLR. Faster walking speed increase lower extremity joint moments.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2005
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2018
Publisher: Elsevier BV
Date: 05-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2017
Publisher: Wiley
Date: 28-04-2017
DOI: 10.1016/J.PMRJ.2017.04.009
Abstract: Plantar heel pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months however, up to 20% of people remain symptomatic beyond this time frame. The level of pain and function in this chronic heel pain group is not well described. To identify clinical and functional characteristics associated with chronic plantar heel pain compared with heel pain of recent onset. Cross-sectional study. University research laboratory and private physiotherapy clinic. A total of 71 people with plantar heel pain for longer than 12 months and 64 people with plantar heel pain for less than 6 months were recruited from the general public. Functional characteristics of participants in both heel pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot pain severity, foot function and physical activity. Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. The chronic heel pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot pain, and physical activity. Chronic plantar heel pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with heel pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar heel pain. IV.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.JPHYS.2017.08.004
Abstract: Does adding a post-training Fédération Internationale de Football Association (FIFA) 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduce injury rates among male amateur soccer players? Cluster-randomised, controlled trial with concealed allocation. Twenty-one teams of male amateur soccer players aged 14 to 35 years were randomly assigned to the experimental group (n=10 teams, 160 players) or the control group (n=11 teams, 184 players). Both groups performed pre-training FIFA 11+ exercises for 20minutes. The experimental group also performed post-training FIFA 11+ exercises for 10minutes. The primary outcomes measures were incidence of overall injury, incidence of initial and recurrent injury, and injury severity. The secondary outcome measure was compliance to the experimental intervention (pre and post FIFA 11+ program) and the control intervention (pre FIFA 11+ program). During one season, 26 injuries (team mean=0.081 injuries/1000 exposure hours, SD=0.064) were reported in the experimental group, and 82 injuries were reported in the control group (team mean=0.324 injuries/1000hours, SD=0.084). Generalised Estimating Equations were applied with an intention-to-treat analysis. The pre and post FIFA 11+ program reduced the total number of injuries (χ Implementation of the FIFA 11+ program pre-training and post-training reduced overall injury rates in male amateur soccer players more than the pre FIFA 11+ program alone. ACTRN12615001206516. [Al Attar WSA, Soomro N, Pappas E, Sinclair PJ, Sanders RH (2017) Adding a post-training FIFA 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduces injury rates among male amateur soccer players: a cluster-randomised trial. Journal of Physiotherapy 63: 235-242].
Publisher: FapUNIFESP (SciELO)
Date: 08-2016
DOI: 10.1590/1517-869220162204159074
Abstract: ABSTRACT Introduction: Several studies have reported on the epidemiology of Anterior Cruciate Ligament Reconstruction (ACLR) in Europe and North America however, there is currently no data relating to Brazil. Objective: To describe the incidence of ACLR in Brazil and investigate temporal trends and differences between age and sex groups. Methods: All reported ACLR cases in the public hospital system between January 2008 and December 2014 were extracted from the Information Technology Department of the Brazilian Ministry of Health. Linear regression analysis was used to assess changes in ACLR incidence in the overall population and among sex and age groups, hospitalization time, and health care costs. Results: A total of 48,241 ACLR were reported from 2008-2014 with an overall incidence of 3.49 per 100,000 persons/year. Males accounted for 82% of the procedures. The incidence of ACLR increased by 56% among males (p=0.01) and by 112% among females (p=0.001). The mean hospitalization time decreased from 2.4 days in 2008 to 1.8 day in 2014 (R2 = 0.883, p= 0.002). The total cost across all years was US$56 million, with a mean of US$1,145 per ACLR. Conclusion: Although the total incidence of ACLR in Brazil is lower compared to other countries, it has increased over the years, especially in females. The creation of an ACLR registry is necessary in the future, for more accurate control and new investigations.
Publisher: BMJ
Date: 09-12-2014
DOI: 10.1136/BJSPORTS-2014-093796
Abstract: Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics. The three largest databases (Medline, EMBASE and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed. Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p ≤ 0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise in idualised biomechanical technique correction and target postpubertal women. The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise in idualised biomechanical technique correction and target postpubertal female athletes.
Publisher: SAGE Publications
Date: 22-08-2022
DOI: 10.1177/03635465221118081
Abstract: Despite knee extensor and flexor strength reportedly being associated with injury risk, including rupture of the anterior cruciate ligament in girls, there is limited evidence for the longitudinal changes in lower extremity strength. To investigate the sex-specific relationship with longitudinal changes of knee extensor and flexor strength associated with maturation. Cohort study Level of evidence, 2. Adolescent boys and girls (N = 257 208 adolsecent girls) participating in high school basketball, volleyball, and soccer were assessed longitudinally in at least 2 different pubertal stages. Pubertal status (prepubertal, pubertal, and postpubertal) was determined with the modified Pubertal Maturation Observation Scale questionnaire. After a warm-up of 5 submaximal repetitions, participants were tested for concentric peak isokinetic strength for knee extension and flexion at 300 deg/s over 10 repetitions and normalized to body weight. Linear mixed models were used to test for the effect of pubertal stage, sex, and their interaction. Significant interactions were identified that indicated different maturational trajectories for knee muscle strength for adolescent boys and girls, particularly between prepubertal and pubertal stages, in which boys demonstrated greater mass normalized knee extensor increases than girls (right, +12% vs +5% left, +13% vs +7% P .001). For knee flexors, boys demonstrated increased strength, while girls demonstrated decreased relative knee flexor strength (right, +4% vs −1%, P = .03 left, +3 vs −3%, P = .009). The findings of this study support a differential effect of sex and maturation on important knee strength outcomes that may have implications for knee injury reduction, particularly in adolescent girls as they mature.
Publisher: Informa UK Limited
Date: 27-11-2018
DOI: 10.1080/02640414.2018.1544538
Abstract: The purpose of this study was to systematically review the literature and synthesise the evidence on injury rates and characteristics in recreational, elite student, and professional dancers. Five online databases were searched from inception to January 2018 and screened by two independent reviewers. Primary research studies were eligible for inclusion if they reported injury rates in recreational, elite student, and/or professional dancers of any genre and measured in idual dance exposure at the hour, event, or day level. Sixteen studies were included, with only three studies incorporating recreational dancers. Reported injury incidence rates were less than 5 injuries per 1,000 dance hours, however substantially different definitions and methods for measuring injury and dance exposure were used. Based on the current evidence there is not an identifiable difference in injury rate or characteristics between recreational, elite student, and professional dancers. However, there remains a lack of high quality comprehensive data available across levels and genres of dance participation, and greater focus on consistency and completeness of reporting in dance injury research is still required.
Publisher: SAGE Publications
Date: 18-09-2015
Abstract: Despite the prevalence and impact of plantar heel pain, its etiology remains poorly understood, and there is no consensus regarding optimum management. The identification of musculoskeletal factors related to the presence of plantar heel pain could lead to the development of better targeted intervention strategies and potentially improve clinical outcomes. The aim of this study was to investigate relationships between a number of musculoskeletal and activity-related measures and plantar heel pain. In total, 202 people with plantar heel pain and 70 asymptomatic control participants were compared on a variety of musculoskeletal and activity-related measures, including body mass index (BMI), foot and ankle muscle strength, calf endurance, ankle and first metatarsophalangeal (MTP) joint range of motion, foot alignment, occupational standing time, exercise level, and generalized hypermobility. Following a comparison of groups for parity of age, analyses of covariance were performed to detect differences between the 2 groups for any of the variables measured. The plantar heel pain group displayed a higher BMI, reduced ankle dorsiflexion range of motion, reduced ankle evertor and toe flexor strength, and an altered inversion/eversion strength ratio. There were no differences between groups for foot alignment, dorsiflexor or invertor strength, ankle inversion or eversion range of motion, first MTP joint extension range of motion, generalized hypermobility, occupational standing time, or exercise level. Plantar heel pain is associated with higher BMI and reductions in some foot and ankle strength and flexibility measures. Although these factors could be either causal or consequential, they are all potentially modifiable and could be targeted in the management of plantar heel pain. Level III, comparative study.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 03-2013
Abstract: Within-subject and between-subject cross-sectional study. To investigate symmetry in hop-test performance, strength, and lower extremity kinematics 6 to 9 months following anterior cruciate ligament reconstruction (ACLR). Despite the extensive body of literature involving persons following ACLR, no study has comprehensively evaluated measures of strength, lower extremity kinematics, and functional performance of functional hop tests in this population. The subjects were 22 men (mean ± SD age, 28.8 ± 11.2 years) who had ACLR using a bone-patellar tendon-bone autograft 6 to 9 (7.01 ± 0.93) months previously and 22 healthy male controls (age, 24.8 ± 9.1 years). Participants completed a self-report questionnaire and underwent isokinetic strength testing and functional and kinematic assessment of the single-, triple-, and crossover-hop tests. Two-way analyses of variance were used to test for differences between the ACLR group and the control group, and between the 2 lower extremities of the ACLR group. Compared to the control group, the ACLR group had greater isokinetic knee extension torque deficits at all speeds (P ≤.001) and greater performance asymmetry for all 3 hop tests (P<.001). Compared to the noninvolved lower extremity, the involved lower extremity of the ACLR group exhibited less ankle dorsiflexion and knee flexion in the phases of propulsion (P ≤.014) and landing (P ≤.032). When compared to the control group, the involved lower extremity exhibited less ankle dorsiflexion in the propulsion phase (P<.001) but higher hip flexion in the landing phase (P = .014). Six to 9 months following ACLR, patients continue to demonstrate functional hop and isokinetic knee extension deficits, as well as kinematic differences, during the propulsion and landing phases of the hop tests.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
Publisher: SAGE Publications
Date: 10-12-2019
Abstract: Driving performance, as assessed using a driving simulator, after distal radius fracture has not been previously studied. Our aims were to undertake a pilot study to assess feasibility via: (i) acceptability of driving simulation for this assessment purpose, (ii) recruitment and retention, (iii) s le size calculation. Preliminary evaluations of differences in driving performance between in iduals recovering from distal radius fracture and controls were conducted to confirm if the methodology provided meaningful results to aid in justification for future studies. Driving performance of 22 current drivers (aged 21–81 years), recruited by convenience s ling, was assessed using a driving simulator. The fracture group included those recovering from distal radius fracture managed with open reduction and internal fixation using a volar plate. The control group were uninjured in iduals. Assessment was performed approximately five weeks post-surgery and follow-up assessment two weeks later. Acceptability outcome measures included pain and simulator sickness scores, feasibility measures included retention rates and measures of driving performance included time spent speeding, time spent out of the lane, standard deviation of lateral position and hazard reactions. The assessment was completed by 91% of participants two participants dropped out secondary to simulator sickness. Retention rates were 83%. Preliminary results suggest those with distal radius fracture spent more time out of the lane and less time speeding. This method was sensitive, acceptable and feasible according to the parameters of this pilot study. The results from this small s le suggest that between-group differences in driving performance are measurable using driving simulation five weeks following distal radius fracture.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.APMR.2018.06.024
Abstract: The aims of this study were threefold: (1) to compare the litude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls (2) to compare the litude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls (3) to investigate the association between the litude of patellar T-reflex and VM H-reflex in women with PFP and pain-free controls. Cross-sectional observational study. Laboratory of biomechanics and motor control. Thirty women with PFP and 30 pain-free women aged 18 to 35 years (N=60). Peak-to-peak litudes of maximal VM H-reflex (elicited via electrical stimulation on the femoral nerve) and patellar T-reflex (elicited via mechanical percussion on the patellar tendon) were estimated. Women with PFP had significant lower litude of patellar T-reflex (mean difference=0.086 95% confidence interval=0.020 to 0.151 P=.010 moderate effect) and VM H-reflex (mean difference=0.150 95% confidence interval =0.073 to 0.227 P<.001 large effect) compared to pain-free controls. The VM H-reflex was strongly correlated with patellar T-reflex in both PFP group (r=0.66 P<.001) and control group (r=0.72 P<.001). As the T-reflex is easier to perform than H-reflex assessments in a clinical setting, it represents a feasible option to assess the impaired excitability of the stretch reflex pathway associated with PFP.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2019
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJSEM-2017-000324
Abstract: Professional dancers are at significant risk of injury due to the physical demands of their career. Despite their high numbers, the experience of injury in freelance or part-time dancers is not well understood. Therefore, the aim of this study was to examine the occurrence and characteristics of injury in part-time compared with full-time Australian professional dancers. Data were collected using a cross-sectional survey distributed to employees of small and large dance companies and freelance dancers in Australia. Statistical comparisons between full-time and part-time dancer demographics, dance training, injury prevalence and characteristics were made using χ 2 , two-tailed Fisher’s exact tests, independent t-tests and Mann-Whitney U tests. A total of 89 full-time and 57 part-time dancers were included for analysis. A higher proportion of full-time dancers (79.8%) than part-time dancers (63.2%) experienced an injury that impacted on their ability to dance in the past 12 months (p=0.035). Injuries characteristics were similar between groups with fatigue being the most cited contributing factor. Part-time dancers took longer to seek treatment while a higher proportion of full-time dancers were unable to dance in any capacity following their injury. More full-time dancers sustained an injury in the past 12 months, and were unable to dance in any capacity following their injury. However injuries still commonly occurred in part-time dancers without necessarily a large volume of dance activity. Part-time dancers often access general community clinicians for treatment, who may need additional education to practically advise on appropriate return to dance.
Publisher: Informa UK Limited
Date: 26-08-2022
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.MEHY.2017.08.019
Abstract: Patellofemoral pain (PFP) is one of the most common conditions in orthopedic practice while recent evidence has suggested that it may be a predisposing factor to patellofemoral osteoarthritis. In addition to biomechanical alterations associated with the pathomechanisms underlying PFP, the investigation of neurophysiological alterations has provided novel information in the understanding of the pathophysiology of PFP. For instance, women with PFP present lower litude of the vastus medialis (VM) H-reflexes compared to pain-free controls, which suggests that the excitability of spinal reflexes might be a promising tool for discriminating woman with PFP in clinical practice. However, the cross-sectional design of the current research does not inform whether the reduced excitability predisposes to or is the consequence of PFP. Therefore, two hypotheses can be raised: (1) the reduction in excitability of the α-motoneurons is a risk factor for PFP Or, (2) the reduction in H-reflex excitability is a consequence of PFP due to pain. If the former hypothesis is proven correct, it may help in the early identification of in iduals with PFP. If the latter, it may help understand the reduced excitability as a consequence of the long-term pain, which may be interfering in the recovery of in iduals with PFP in a long-term basis. In addition, exploring such hypotheses may have direct rehabilitative and prevention implications for PFP and its putative progression to knee osteoarthritis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2017
Publisher: Elsevier BV
Date: 11-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2010
Publisher: Springer Science and Business Media LLC
Date: 30-04-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2021
DOI: 10.1519/JSC.0000000000003215
Abstract: Ferreira, AS, de Oliveira Silva, D, Ferrari, D, Magalhães, FH, Pappas, E, Briani, RV, Pazzinatto, MF, and de Azevedo, FM. Knee and hip isometric force steadiness are impaired in women with patellofemoral pain. J Strength Cond Res 35(10): 2878–2885, 2021—The purposes were as follows: to compare knee extension and hip abduction force steadiness and maximal strength between women with patellofemoral pain (PFP) and pain-free women and to investigate whether maximal strength, self-reported pain during force-matching tasks, self-reported knee function, symptoms duration, and physical activity level are associated with knee extension and hip abduction force steadiness. Thirty women with PFP and 30 pain-free women were recruited. Knee extension and hip abduction maximal voluntary isometric contractions and submaximal isometric force-matching tasks were evaluated using an isokinetic dynamometer. Subjects were asked to match a target force corresponding to 10% of their maximal isometric voluntary contraction while force steadiness was computed as the coefficient of variation (CV) of the exerted force. Women with PFP had significant 36% lower knee extension and 33% lower hip abduction peak strength. They also had significant 70% lower knee extension force steadiness and 60% lower hip abduction force steadiness (i.e., higher CV) than pain-free women. Self-reported pain and self-reported knee function were significantly associated ( r = 0.61, p 0.001 r = −0.35, p = 0.05) and able to predict 41% of the variance of knee extensor force steadiness. Hip abductor maximum strength was significantly associated ( r = −0.57 p = 0.001) and able to predict 32% of the variance of hip abductor force steadiness. These findings indicate that muscle impairments in PFP go beyond only low knee and hip muscle strength because women with PFP also present deficits in knee extension and hip abduction force steadiness. Evidence-based treatments aiming at improving force steadiness may be a promising addition to PFP rehabilitation programs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2021
DOI: 10.1519/JSC.0000000000002365
Abstract: Lopes, TJA, Simic, M, Alves, DdS, Bunn, PdS, Rodrigues, AI, Terra, BdS, Lima, MdS, Ribeiro, FM, Vilão, P, and Pappas, E. Physical performance measures of flexibility, hip strength, lower limb power, and trunk endurance in healthy navy cadets: Normative data and differences between sex and limb dominance. J Strength Cond Res 35(2): 458–464, 2021—The objectives were to provide normative data on commonly used physical performance tests that may be associated with musculoskeletal injuries in Navy cadets and assess for sex and limb dominance differences. A large cohort of Navy cadets were assessed for physical performance tests of flexibility (ankle dorsiflexion range of motion and sit and reach), isometric hip strength, lower limb power (single-leg hop), and trunk endurance (plank and side plank tests). Besides providing normative data tables, sex and limb dominance differences were assessed by a 2-way mixed analysis of variance. A total of 545 Brazilian Navy cadets (394 men) representing 79% of the cadets in the Academy participated. Normative reference values were reported as mean ± SD , 95% confidence interval and percentiles. For tests of muscle strength, power, and endurance, men performed better than women ( p 0.001). For flexibility tests, women achieved greater distances than men for the sit and reach test ( p 0.001), but no difference for ankle dorsiflexion ( p = 0.51). Overall, there were no clinically relevant differences between limbs. In conclusion, normative data for commonly used physical performance tests were provided. Although no clinically relevant side-to-side differences were found, men presented higher values for lower limb strength and power, as well as trunk endurance than women, whereas women demonstrated increased flexibility. Valuable normative data are provided to professionals who work with young, active populations from the injury prevention or rehabilitation perspective because the current study may help professionals to identify athletes or cadets whose performance is outside the normative values and may be at risk for injury.
Publisher: Elsevier BV
Date: 11-2017
Publisher: SAGE Publications
Date: 04-03-2014
Abstract: Fatigue is strongly linked to an increased risk of injuries, including anterior cruciate ligament (ACL) ruptures. Part 1 of this study identified differences in the biomechanics of landing from a jump between dancers and team athletes, particularly female athletes, which may explain the epidemiological differences in ACL injuries between dancers and team athletes and the lack of a sex disparity within dancers. However, it is not known if these biomechanical variables change differently between team athletes and dancers in the face of fatigue. The purpose of this study was to compare dancers’ and team athletes’ resistance to fatigue and its effect on the biomechanics of single-legged drop landings. The primary hypotheses were that dancers may be more resistant than team athletes to the onset of fatigue and/or may have different biomechanical responses than athletes in landing tasks once fatigue has been achieved. Controlled laboratory study. Kinematics and kinetics were recorded as 40 elite modern and ballet dancers (20 men and 20 women) and 40 team sport athletes (20 men and 20 women National Collegiate Athletic Association Division I-III) performed single-legged drop landings from a 30-cm platform before and after a fatigue protocol consisting of step-ups and vertical jumps. Unfatigued and fatigued joint kinematics and kinetics were compared between groups and sexes with multivariate analyses of variance, followed by pairwise t tests as appropriate. Dancers took longer ( P = .023) than team athletes to reach a similar state of fatigue. Multiple kinetic (eg, increased peak knee valgus moment P .001) and kinematic (eg, increased lateral and forward trunk flexion P .001 and P = .002, respectively) parameters of landing changed with fatigue, such that both fatigued dancers and athletes landed with mechanics that were more at risk for ACL injuries as compared with before fatigue. Dancers took significantly longer to reach fatigue than team athletes. Female athletes consistently exhibited landing patterns associated with a risk for ACL injuries when compared with the other 3 groups. Fatigue changed landing mechanics similarly in both dancers and athletes, such that all groups landed with worse alignment after being fatigued. Dancers are more resistant to lower extremity fatigue than athletes, and this may partially explain the lower incidence of ACL injuries in both male and female dancers compared to team athletes. The extensive training in landing technique and daily practice that dancers undergo from a young age may be responsible for the higher levels of endurance.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2009
Publisher: Springer Science and Business Media LLC
Date: 06-11-2017
DOI: 10.1007/S10067-017-3888-Y
Abstract: This work aimed to assess inter-rater reliability and agreement of a magnetic resonance imaging (MRI)-based Kellgren and Lawrence (K&L) grading for patellofemoral joint osteoarthritis (OA) and to validate it against the MRI Osteoarthritis Knee Score (MOAKS). MRI scans from people aged 45 to 75 years with chronic knee pain participating in a randomised clinical trial evaluating dietary supplements were utilised. Fifty participants were randomly selected and scored using the MRI-based K&L grading using axial and sagittal MRI scans. Raters conducted inter-rater reliability, blinded to clinical information, radiology reports and other rater results. Intra- and inter-rater reliability and agreement were evaluated using the intra-class correlation coefficient (ICC) and Cohen's weighted kappa. There was a 2-week interval between the first and second readings for intra-rater reliability. Validity was assessed using the MOAKS and evaluated using Spearman's correlation coefficient. Intra-rater reliability of the K&L system was excellent: ICC 0.91 (95% CI 0.82-0.95) weighted kappa (ĸ = 0.69). Inter-rater reliability was high (ICC 0.88 95% CI 0.79-0.93), while agreement between raters was moderate (ĸ = 0.49-0.57). Validity analysis demonstrated a strong correlation between the total MOAKS features score and the K&L grading system (ρ = 0.62-0.67) but weak correlations when compared with in idual MOAKS features (ρ = 0.19-0.61). The high reliability and good agreement show consistency in grading the severity of patellofemoral OA with the MRI-based K&L score. Our validity results suggest that the scale may be useful, particularly in the clinical environment. Future research should validate this method against clinical findings.
Publisher: Springer Science and Business Media LLC
Date: 13-12-2018
Publisher: Springer Science and Business Media LLC
Date: 17-10-2010
DOI: 10.1007/S00421-010-1672-7
Abstract: Combining accelerometry with heart rate monitoring has been suggested to improve energy estimates, however, it remains unclear whether the single, currently existing commercially available device combining these data streams (Actiheart) provides improved energy estimates compared to simpler and less expensive accelerometry-only devices. The purpose of this study was to compare the validity of the heart rate (HR), accelerometry (ACC), and combined ACC/HR estimates of the Actiheart to the ACC estimates of the Actical during low and moderate intensity activities. Twenty-seven participants (mean age 26.3 ± 7.3) wore an Actical, Actiheart and indirect calorimeter (K4b(2)) while performing card playing, sweeping, lifting weights, walking and jogging activities. All estimates tended to underestimate energy, sometimes by substantial amounts. Viewed across all activities studied, there was no significant difference in the ability of the waist-mounted Actical and torso-mounted Actiheart (ACC, HR, ACC/HR) estimates to predict energy expenditure. However, the Actiheart provided significantly better estimates than the Actical for the activities in which acceleration of the pelvis is not closely related to energy expenditure (card playing, sweeping, lifting weights) and the Actical provided significantly better estimates for level walking and level jogging. Similar to a previous study, the ACC component of the Actiheart was found to be the weakest predictor of energy suggesting it may be responsible for the failure of the combined ACC/HR estimate to equal or better the estimates derived solely from a waist mounted ACC device.
Publisher: Springer Science and Business Media LLC
Date: 18-08-2015
Publisher: Springer Science and Business Media LLC
Date: 19-01-2016
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.APMR.2016.06.011
Abstract: To determine the association between the litude of vastus medialis (VM) Hoffmann reflex (H-reflex) and pain level, self-reported physical function, and chronicity of pain in women with patellofemoral pain (PFP). Cross-sectional study. Laboratory of biomechanics and motor control. Women diagnosed with PFP (N=15) aged 18 to 35 years. Not applicable. Data on worst pain level during the previous month, self-reported physical function, and symptom duration (chronicity) were collected from the participants. Maximum evoked responses were obtained by electrical stimulation applied to the femoral nerve and peak-to-peak litudes of normalized maximal H-reflexes (maximal Hoffmann reflex/maximal motor wave ratios) of the VM were calculated. A Pearson product-moment correlation matrix (r) was used to explore the relations between the litude of VM H-reflex and worst pain during the previous month, self-reported function, and chronicity of pain. Strong negative correlations were found between the litude of VM H-reflex and worst pain in the previous month (r=-.71 P=.003) and chronicity (r=-.74 P=.001). A strong positive correlation was found between the litude of VM H-reflex and self-reported physical function (r=.62 P=.012). The strong and significant relations reported in this study suggest that women with PFP showing greater VM H-reflex excitability tend to have lower pain, better physical function, and more recent symptoms. Therefore, rehabilitation strategies designed to increase the excitability of the monosynaptic stretch reflex should be considered in the treatment of women with PFP if their effectiveness is demonstrated in future studies.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.KNEE.2017.01.002
Abstract: Efforts to reduce the financial costs related to anterior cruciate ligament reconstruction (ACLR) include reducing the length of hospitalization of the patient undergoing ACLR. However, it is unclear if inpatient and outpatient ACLR differ in terms of safety, satisfaction, costs and clinical outcomes. To systematically review and synthesize the literature that directly compared costs and outcomes after outpatient and inpatient ACLR. Studies that directly compared outcomes of inpatient and outpatient ACLR were retrieved via searches in MEDLINE, EMBASE, CINAHL, AMED, Cochrane, SPORTDiscus, Web of Science and SCOPUS databases. Random effects meta-analysis and descriptive analysis were performed for relevant outcomes. Costs analysis suggests that outpatient ACLR may be a cost effective procedure with savings ranging from $1371 to $7390. There were no differences for systemic and local complications p=0.64 (odds ratio 1.65, 95% confidence interval 0.20 to 13.49) and p=0.72 (0.81, 0.26 to 2.56) respectively, or pain in the second and seventh days after surgery, p=0.78 (mean difference -0.16 95% confidence interval -1.28 to 0.96) and p=0.44 (0.48, -0.75 to 1.71), respectively. However, the outpatient group had less pain than the inpatient group in the first and third days after surgery, p=0.0001 (-0.39, -0.57 to -0.21) and p=0.0001(-0.39, -0.39 to -0.20), respectively. Descriptive analysis revealed that the outpatient group experienced similar or better satisfaction, strength and knee function compared to the inpatient group. Complications, pain, satisfaction, knee function and strength are similar or better after outpatient compared to inpatient ACLR. Furthermore, cost savings may be achieved with outpatient ACLR. However, included studies presented low methodological quality and the quality of evidence was very low, so these results need to be confirmed by future studies. PROSPERO (CRD42015024990).
Publisher: Human Kinetics
Date: 05-2012
DOI: 10.1123/JAB.28.2.192
Abstract: Retrospective studies have suggested that dancers performing on inclined (“raked”) stages have increased injury risk. One study suggests that biomechanical differences exist between flat and inclined surfaces during bilateral landings however, no studies have examined whether such differences exist during unilateral landings. In addition, little is known regarding potential gender differences in landing mechanics of dancers. Professional dancers ( N = 41 14 male, 27 female) performed unilateral drop jumps from a 30 cm platform onto flat and inclined surfaces while extremity joint angles and moments were identified and analyzed. There were significant joint angle and moment effects due to the inclined flooring. Women had significantly decreased peak ankle dorsiflexion and hip adduction moment compared with men. Findings of the current study suggest that unilateral landings on inclined stages create measurable changes in lower extremity biomechanical variables. These findings provide a preliminary biomechanical rationale for differences in injury rates found in observational studies of raked stages.
Publisher: Georg Thieme Verlag KG
Date: 30-07-2008
Abstract: The present study investigated the crossover effect of three rehabilitation programs (isokinetic, isotonic and home exercise), that were focused on the involved extremity, on the isokinetic performance of knee flexors and extensors and the functional performance of the uninvolved leg in subjects who underwent arthroscopic partial meniscectomy. Twenty-eight patients (mean age: 28) were measured for isokinetic performance and functional performance with the single jump, triple jump and vertical jump 14 days and 33 days after surgery. Peak torque of hamstrings at 60 degrees /sec (p = .008), hamstrings at 180 degrees /sec (p < 0.001), quadriceps at 180 degrees /sec (p = 0.024), single jump (p < 0.001), triple jump (p = 0.002), and vertical jump (p = 0.005) were significantly increased during the final measurement session compared to the initial measurement session. The knee flexors exhibited higher gains than the knee extensors. There were no differences between the isokinetic, isotonic, and home exercise program group (p = 0.506). Researchers and clinicians are encouraged to obtain measurements of the uninvolved leg at consistent time points between groups in order to allow for accurate comparisons.
Publisher: Springer Science and Business Media LLC
Date: 28-11-2019
Publisher: Elsevier BV
Date: 05-2019
Publisher: Elsevier BV
Date: 09-2016
Publisher: Informa UK Limited
Date: 26-06-2023
Publisher: Elsevier BV
Date: 12-2016
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.JSAMS.2015.07.018
Abstract: Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method.
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.YPMED.2017.11.005
Abstract: The benefits of physical activity are established, however, increasing population physical activity levels remains a challenge. Participating in activities that are enjoyable and multidimensional, such as dancing, are associated with better adherence. However, the extent to which the general population participates in dancing and its temporal trends has not been well studied. The aim of this study was to investigate temporal trends and patterns and correlates of dance participation in England from 1994 to 2012 using a series of large nationally representative surveys. We used data from the Health Survey for England 1994, 1997, 1998, 1999, 2003, 2004, 2006, 2008 and 2012 to examine dance temporal trends. Temporal trends data were age-standardized and correlates of dance participation were examined for males and females over each study year. Changes in population prevalence of dance participation were determined using multiple logistical regression with 1997 as the reference year. Of all survey participants (n=98,178) 7.8% (95%CI: 7.63-7.96) reported dance participation. There was a marked steady decrease over time, with the steepest decline from 2003 onwards. The multivariable-adjusted odds ratios for dance participation were 0.51 for males (95%CI 0.408-0.630, p<0.001) and 0.69 for females (95%CI: 0.598-0.973, p<0.001) in 2012 compared to 1997. Dance participation in adults in England has decreased markedly over time. This study suggests that dance is not being adequately utilized as a health enhancing physical activity, and therefore further research and resources should be dedicated to supporting dance in the community.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 10-2018
Abstract: Two-dimensional (2-D) analysis is commonly used to quantify frontal plane kinematics of the trunk and lower extremity. However, there are conflicting results regarding the reliability and validity of these measurements. To synthesize the current literature to determine whether 2-D analysis is a reliable and valid method of measuring frontal plane kinematics of the trunk and lower extremity during squatting, landing, and cutting tasks. For this systematic review with meta-analysis, MEDLINE, CINAHL, Embase, Scopus, and SPORTDiscus databases were searched from inception until March 2017. The authors included 16 studies that evaluated the reliability and/or validity of 2-D measurements of frontal plane trunk and/or lower extremity kinematics when compared to 3-D measurements during any of the following tasks: squatting, landing, or cutting. Intrarater reliability (intraday and interday) and interrater reliability of the 2-D video measurements varied from moderate to excellent. In terms of validity, there was poor agreement between the 2-D and 3-D methods, with no correlation between 2-D knee frontal plane projection angle and 3-D knee frontal plane angles (r = 0.127, P = .094) for the single-leg squat, but a moderate to good relationship (r = 0.619, P<.001) for the landing task. Two-dimensional video analysis of frontal plane trunk and lower extremity kinematics is reliable, but this appears to be dependent on the task and the type of reliability evaluated. The current evidence does not support the use of 2-D video analysis for measuring trunk and lower extremity frontal plane kinematics when accurate measures are required. Diagnosis, level 3. J Orthop Sports Phys Ther 2018 (10):812-822. Epub 12 Jun 2018. doi:10.2519/jospt.2018.8006.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.ARTHRO.2013.07.258
Abstract: To test whether knee bracing restores normal rotational knee kinematics in anterior cruciate ligament (ACL)-reconstructed knees during high-demand, athletic activities. Twenty male patients who had undergone unilateral ACL reconstruction with a bone-patellar tendon-bone autograft were assessed in vivo. The mean time from surgery to data collection was 26 months (range, 25 to 28 months). An 8-camera optoelectronic system was used to collect kinematic data while each patient performed 2 demanding tasks: (1) immediate pivoting after descending from a stair and (2) immediate pivoting after landing from a platform. Each task was performed under 3 conditions for the reconstructed knee: (1) wearing a prophylactic brace (braced condition), (2) wearing a patellofemoral brace (sleeved condition), and (3) without a brace (non-braced condition). As a control group, patients with intact ACLs were tested without any bracing. This study protocol was identical to the protocol of a previous study that investigated the effect of bracing on ACL-deficient athletes. For both tasks, the range of motion of tibial rotation was significantly lower in the intact knee compared with all 3 conditions of the ACL-reconstructed knee (P ≤ .014). Placing a brace or a sleeve on the ACL-reconstructed knee resulted in lower rotation than the non-braced condition (P ≤ .022), whereas no significant differences were found between the sleeved and the braced conditions (P ≥ .110). Bracing limited the excessive tibial rotation in ACL-reconstructed knees during pivoting that occurs under high-demand activities. However, full restoration to normative values was not achieved. Thereby, braces have the potential to decrease rotational knee instability that still remains after ACL reconstruction.
Publisher: Elsevier BV
Date: 11-2017
Publisher: BMJ
Date: 11-2016
Publisher: Elsevier BV
Date: 07-2022
Publisher: Elsevier BV
Date: 2017
Publisher: Elsevier BV
Date: 05-2015
Publisher: Elsevier BV
Date: 2023
Publisher: Springer Science and Business Media LLC
Date: 02-09-2018
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 04-2019
Abstract: Mechanical Diagnosis and Therapy (MDT) is a treatment-based classification system founded on 3 core principles: classification into diagnostic syndromes, classification-based intervention, and appropriate application of force. Many randomized controlled trials have investigated the efficacy of MDT for low back pain however, results have varied. The inconsistent delivery of MDT across trials may explain the different findings. To compare treatment effect sizes for pain or disability between trials that delivered MDT consistent with the core principles of the approach and trials that met some or none of these principles. In this systematic review, databases were searched from inception to June 2018 for studies that delivered MDT compared to nonpharmacological, conservative control interventions in patients with low back pain and reported outcomes of pain or disability. Studies were classified as "adherent" (meeting the core principles of MDT) or "nonadherent" (using some or none of the principles of MDT). Data were extracted by 2 independent reviewers. Meta-regression procedures were used to analyze the effect of delivery mode on clinical outcomes, adjusting for covariates of symptom duration (less than or greater than 3 months) and control intervention (minimal or active). Studies classified as adherent to the MDT approach showed greater reductions in pain and disability of 15.0 (95% confidence interval: 7.3, 22.7) and 11.7 (95% confidence interval: 5.4, 18.0) points, respectively, on a 100-point scale compared to nonadherent trials. This review provides preliminary evidence that treatment effects of MDT are greater when the core principles are followed. Therapy, level 1a. J Orthop Sports Phys Ther 2019 (4):219-229. Epub 13 Feb 2019. doi:10.2519/jospt.2019.8734.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2009
Publisher: SAGE Publications
Date: 04-2014
Abstract: Asymmetries persist after anterior cruciate ligament reconstruction (ACLR). Physical performance tests such as the single-limb hop test have been used extensively to assess return-to-sport criteria, as they reproduce dynamic athletic maneuvers. The single-limb hop is associated with muscle strength and kinematic and kinetic asymmetries in ACLR patients 6 to 9 months after surgery. Controlled laboratory study. Twenty-two men with ACLR (mean age, 28.8 ± 11.2 years) at 6 to 9 months (mean, 7.01 ± 0.93 months) after surgery completed isokinetic testing in 3 velocities (120, 180, and 300 deg/s) and a kinetic, kinematic, and functional evaluation of the single-limb hop test. Pearson correlation coefficients were used to assess the relationship between the Limb Symmetry Index (LSI) of the single-limb hop distance and each of the outcome variables. There were significant positive correlations between the LSI of the single-limb hop distance and the LSI of the peak extension torque at 120 deg/s ( P = 0.044, r = 0.37) and the peak extension torque at 180 deg/s ( P = 0.042, r = 0.38) as well as a negative correlation with the peak flexion torque at 180 deg/s ( P = 0.043, r = −0.38). The LSI of the single-limb hop test was not correlated with any kinetic or kinematic variable ( P 0.05). The findings of the present study demonstrate that distance LSI of the single-limb hop test correlates with isokinetic extension peak torque LSI but not kinetic and kinematic asymmetry. The single-limb hop test can be used as an additional tool for the recognition of muscle strength asymmetries but not for kinetic or kinematic asymmetries 6 to 9 months after ACLR.
Publisher: BMJ
Date: 23-06-2019
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JBMT.2017.05.022
Abstract: Yoga is a popular complementary therapy for musculoskeletal pain. There are few studies however, that have examined the risks of recreational participation for causing musculoskeletal pain. To examine the relationship between musculoskeletal pain and recreational yoga participation. This was a prospective cohort study with one-year follow-up. Data were collected via electronic questionnaires, one year apart. Outcomes included incidence and impact of pain caused by yoga and prevalence of pain caused, exacerbated, unaffected, and improved by yoga. Predictors included age, experience, hours of participation, and intensity of participation. The final s le included 354 participants from two suburban yoga studios. The incidence rate of pain caused by yoga was 10.7%. More than one-third of incident cases resulted in lost yoga participation time and/or symptoms lasting more than 3 months. None of the risk factors at baseline increased the risk for subsequent incident cases of pain caused by yoga. Yoga can cause musculoskeletal pain. Participants may benefit from disclosure of practice to their healthcare professionals and by informing teachers of injuries they may have prior to participation. Yoga teachers should also discuss the risks for injury with their students.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.JELEKIN.2014.04.009
Abstract: ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the athlete away from training and competition, ACL tear is a risk factor for early-onset of knee osteoarthritis, and, therefore addressing strategies to avoid such injury is pertinent not only for competitive athletes, but for all physically active subjects. Imbalances in the prelanding myoelectric activity of the hamstrings and quadriceps muscles have been linked to ACL injuries. We investigated the effect of landing from different heights on prelanding myoelectric activity of the hamstrings and quadriceps muscles in recreational athletes. Thirty recreational athletes (15 male and 15 female) performed three bilateral drop jumps from two different heights 20cm and 40cm while myoelectric activity of the vastus medialis, rectus femoris, biceps femoris and medial hamstrings were collected. When increasing the height of drop landing tasks prelanding normalized myoelectric activity of the quadriceps was increased by 15-20% but no significant changes were found for the hamstrings. Female athletes exhibited higher activity of the medial hamstrings compared to their male counterparts. We concluded that increasing the height of drop landing tasks is associated with increased myoelectric activity of the quadriceps but not the hamstrings in recreational athletes. These differences in muscle activity may be related to increased risk for ACL injury when the height is increased. Female athletes demonstrated higher recruitment of the medial hamstrings.
Publisher: SAGE Publications
Date: 10-12-2019
Abstract: There is evidence that frontal plane knee joint motion plays a crucial role in the pathogenesis of knee osteoarthritis, yet investigation of in iduals with chronic anterior cruciate ligament–deficient (ACLD) knees remains sparse. To investigate (1) if in iduals with chronic ACLD knees demonstrate higher biomechanical measures of medial knee load as compared with their anterior cruciate ligament–intact (ACLI) knees, (2) if differences in static knee alignment of the ACLD knee will demonstrate a difference in the magnitude of biomechanical measures of medial knee load when compared with the ACLI knee, and (3) the side-to-side concordance of varus thrust among in iduals with chronic ACLD knees. Descriptive laboratory study. Participants were sourced from a metropolitan orthopaedic surgeon group. Those who met the inclusion criteria and agreed to participate underwent a 3-dimensional gait analysis assessment to measure knee adduction moment (KAM), knee flexion moment (KFM), KAM peaks, KAM impulse, and varus thrust. Frontal plane knee static alignment was measured with a digital inclinometer fixed to medical calipers. The participants were ided according to their static knee alignment (neutral, varus, and valgus) for subgroup analysis. Peak knee angular velocity and frontal plane knee angle were used to establish if a participant was walking with a knee thrust. An in idual was deemed to have knee thrust during gait if the largest frontal plane knee movement coincided with the peak knee angular velocity that occurred within the first 30% of stance phase. Forty-five participants were recruited. The mean (SD) time from injury was 34.5 (55.6) months. ACLD knees did not demonstrate higher mean KAM and KFM ( P .5) or early-stance peak KAM ( P = .3-.8) and KAM impulse ( P = .3-.9) as compared with ACLI knees as a whole group or when the varus, neutral, and valgus alignment subgroups were investigated separately. Twenty-three percent (n = 9) of the participants had a varus thrust at the ACLD or ACLI knee, 44% (n = 4) had a varus thrust at the ACLD knee, and 22% (n = 2) had varus thrust at both knees. There were no side-to-side differences in mean KAM and KFM and early-stance peak KAM and KAM impulse among high-functioning in iduals with chronic unilateral ACLD knees. There was a low prevalence of varus thrust among high-functioning in iduals with chronic unilateral ACLD knees.
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.GAITPOST.2015.01.025
Abstract: Plantar heel pain is aggravated by weight-bearing, yet limited evidence exists regarding how people with heel pain load their feet during walking. Knowledge of loading patterns in people with plantar heel pain would enhance the understanding of their foot function and assist in developing intervention strategies. Plantar pressure using the Emed-AT platform (Novel Gmbh, Germany) was collected from 198 people with plantar heel pain and 70 asymptomatic controls during normal walking. Maximum force, force-time integral, peak pressure, pressure-time integral and contact time were measured in four quadrants of the heel, the midfoot and the medial and lateral forefoot. The symptomatic group was sub- ided into equal low-pain and high-pain groups using the Foot Health Status Questionnaire pain score. Following age and body mass comparison, multivariate analyses of covariance were performed to compare the heel pain group to the controls, and the low-pain group to the high-pain group, for each loading variable. The heel pain group displayed lower maximum force beneath the heel, lower peak pressure beneath the postero-lateral heel and lower maximum force beneath the medial forefoot. Force-time integrals were lower beneath the posterior heel regions and higher at the lateral forefoot. People with heel pain also had longer midfoot and forefoot contact time. Higher pain level was associated with lower peak pressure and maximum force beneath regions of the heel. Compared to the controls, people with plantar heel pain demonstrated reduced heel loading and modified forefoot loading consistent with a strategy to offload the painful heel.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Oxford University Press (OUP)
Date: 11-2017
Publisher: Springer Science and Business Media LLC
Date: 12-2012
DOI: 10.1007/S00167-012-2323-9
Abstract: Several studies have suggested that drilling the femoral tunnel through an anteromedial arthroscopic portal during anterior cruciate ligament reconstruction allows more anatomic placement of the graft. However, no studies have investigated whether the anteromedial approach results in better outcomes compared to the traditional transtibial drilling approach when a hamstring autograft is used. The purpose of the present study is to investigate short-term functional and clinical outcome differences between male patients recovering from anterior cruciate ligament reconstruction with a hamstring autograft using the transtibial femoral tunnel drilling approach versus the anteromedial approach. Lysholm score, functional test and isokinetic data were collected at 3 and 6 months after surgery in 51 male patients who received a standardized rehabilitation in a large outpatient facility. Multivariate and univariate analyses of variance were used to assess group, time and interaction effects. All outcomes except isokinetic knee flexion at 180°/s improved from 3 to 6 months for both groups (p ≤ 0.05). The anteromedial approach group had better Lysholm scores at 3 months (p ≤ 0.05) and better performance in the timed lateral movement functional tests at 3 and 6 months (p ≤ 0.05). No other comparisons were significant (n.s). Both groups had comparable outcomes on most measures. The differences in the Lysholm score and lateral movement functional tests may suggest a quicker return of function and performance for the anteromedial approach group. Clinicians should take into consideration the surgical technique as they progress patients recovering from ACL reconstruction through the different phases of the rehabilitation protocol. Therapeutic study, Level II.
Publisher: Elsevier BV
Date: 10-2013
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/03091900512331304556
Abstract: Several motion analysis systems are used by researchers to quantify human motion and to perform accurate surgical procedures. The Optotrak 3020 is one of these systems and despite its widespread use there is not any published information on its precision and repeatability. We used a repeated measures design study to evaluate the precision and repeatability of the Optotrak 3020 by measuring distance and angle in three sessions, four distances and three conditions (motion, static vertical, and static tilted). Precision and repeatability were found to be excellent for both angle and distance although they decreased with increasing distance from the sensors and with tilt from the plane of the sensors. Motion did not have a significant effect on the precision of the measurements. In conclusion, the measurement error of the Optotrak is minimal. Further studies are needed to evaluate its precision and repeatability under human motion conditions.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.PHYSIO.2018.12.004
Abstract: The primary objective of this study was to compare the long-term (1-year follow-up) effects of the McKenzie method and motor control exercises on trunk muscle thickness in people with chronic low back pain (LBP) and a directional preference. Randomized controlled trial. A secondary public health facility in Sydney, Australia. Seventy adults with greater than 3-month history of LBP and a directional preference. Participants were randomized to receive 12 treatments of either the McKenzie method or motor control exercises over 8-weeks. Muscle thickness of the transversus abdominis, obliquus internus, and obliquus externus measured from ultrasound images. Secondary outcomes included function, perceived recovery, and pain. Outcomes were collected at baseline, post intervention at 8-weeks, and at 1-year follow-up by blinded assessors. The current paper focuses on the 1-year follow-up. Fifty-eight participants completed data collection for the primary outcome at 1-year. There were no significant between group differences for changes in trunk muscle thickness for any of the three investigated muscles: transversus abdominis [3%, 95% confidence interval (CI): -5%, 11%], obliquus internus [-4%, 95% CI: -9%, 2%] and obliquus externus [3%, 95% CI: -4%, 11%]. Similarly, there were no significant differences between groups for the secondary outcomes of function, perceived recovery and pain. Trunk muscle thickness, function, perceive recovery and pain are similar between patients receiving McKenzie method or motor control exercises at a 1-year follow-up in a population of people with chronic LBP and a directional preference. Clinical Trials Registration number CTRN12611000971932.
Publisher: SAGE Publications
Date: 26-11-2019
Abstract: It is well accepted that there is a higher incidence of repeat anterior cruciate ligament (ACL) injuries in the pediatric population after ACL reconstruction (ACLR) with autograft tissue compared with adults. Hamstring autograft harvest may contribute to the risk for repeat ACL injuries in this high functional demand group. A novel method is the use of a living donor hamstring tendon (LDHT) graft from a parent however, there is currently limited research on the outcomes of this technique, particularly beyond the short term. The purpose was to determine the medium-term survival of the ACL graft and the contralateral ACL (CACL) after primary ACLR with the use of an LDHT graft from a parent in those aged less than 18 years and to identify factors associated with subsequent ACL injuries. It was hypothesized that ACLR with the use of an LDHT provides acceptable midterm outcomes in pediatric patients. Case series Level of evidence, 4. Between 2005 and 2014, 247 (of 265 eligible) consecutive patients in a prospective database, having undergone primary ACLR with the use of an LDHT graft and aged less than 18 years, were included. Outcomes were assessed at a minimum of 2 years after surgery including data on ACL reinjuries, International Knee Documentation Committee (IKDC) scores, and current symptoms, as well as factors associated with the ACL reinjury risk were investigated. Patients were reviewed at a mean of 4.5 years (range, 24-127 months [10.6 years]) after ACLR with an LDHT graft. Fifty-one patients (20.6%) sustained an ACL graft rupture, 28 patients (11.3%) sustained a CACL rupture, and 2 patients sustained both an ACL graft rupture and a CACL rupture (0.8%). Survival of the ACL graft was 89%, 82%, and 76% at 1, 2, and 5 years, respectively. Survival of the CACL was 99%, 94%, and 86% at 1, 2, and 5 years, respectively. Survival of the ACL graft was favorable in patients with Tanner stage 1-2 at the time of surgery versus those with Tanner stage 3-5 at 5 years (87% vs 69%, respectively hazard ratio, 3.7 P = .01). The mean IKDC score was 91.7. A return to preinjury levels of activity was reported by 59.1%. After ACLR with an LDHT graft from a parent in those aged less than 18 years, a second ACL injury (ACL graft or CACL injury) occurred in 1 in 3 patients. The 5-year survival rate of the ACL graft was 76%, and the 5-year survival rate of the CACL was 86%. High IKDC scores and continued participation in sports were maintained over the medium term. Importantly, there was favorable survival of the ACL graft in patients with Tanner stage 1-2 compared with patients with Tanner stage 3-5 over 5 years. Patients with Tanner stage 1-2 also had a significantly lower incidence of second ACL injuries over 5 years compared with those with Tanner stage 3-5, occurring in 1 in 5 patients. Thus, an LDHT graft from a parent is an appropriate graft for physically immature children.
No related grants have been discovered for Evangelos Pappas.