ORCID Profile
0000-0002-0728-6297
Current Organisations
University of British Columbia
,
Gastown Physios & Pilates
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Publisher: Elsevier BV
Date: 10-2020
Publisher: Center for Open Science
Date: 19-01-2023
Abstract: Objective To identify and quantify potential risk factors for osteoarthritis (OA) following traumatic knee injury.Design Systematic review and meta-analyses that estimated the odds of OA for in idual risk factors assessed in more than four studies using random-effects models. Remaining risk factors underwent semiquantitative synthesis. The modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for prognostic factors guided the assessment.Data sources MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to 2009–2021.Eligibility Randomised controlled trials and cohort studies assessing risk factors for symptomatic or structural OA in persons with a traumatic knee injury, mean injury age ≤30 years and minimum 2-year follow-up.Results Across 66 included studies, 81 unique potential risk factors were identified. High risk of bias due to attrition or confounding was present in 64% and 49% of studies, respectively. Ten risk factors for structural OA underwent meta-analysis (sex, rehabilitation for anterior cruciate ligament (ACL) tear, ACL reconstruction (ACLR), ACLR age, ACLR body mass index, ACLR graft source, ACLR graft augmentation, ACLR+cartilage injury, ACLR+partial meniscectomy, ACLR+total medial meniscectomy). Very-low certainty evidence suggests increased odds of structural OA related to ACLR+cartilage injury (OR=2.31 95% CI 1.35 to 3.94), ACLR+partial meniscectomy (OR=1.87 1.45 to 2.42) and ACLR+total medial meniscectomy (OR=3.14 2.20 to 4.48). Semiquantitative syntheses identified moderate-certainty evidence that cruciate ligament, collateral ligament, meniscal, chondral, patellar/tibiofemoral dislocation, fracture and multistructure injuries increase the odds of symptomatic OA.Conclusion Moderate-certainty evidence suggests that various single and multistructure knee injuries (beyond ACL tears) increase the odds of symptomatic OA. Risk factor heterogeneity, high risk of bias, and inconsistency in risk factors and OA definition make identifying treatment targets for preventing post-traumatic knee OA challenging.
Publisher: Oxford University Press (OUP)
Date: 12-2013
DOI: 10.2522/PTJ.20120379
Abstract: Physical therapy is commonly prescribed for patients with lumbar spinal stenosis (LSS) however, little is known about its effectiveness. The purpose of this study was to systematically review randomized controlled trials (RCTs), controlled trials, and cohort studies evaluating the effectiveness of physical therapy for LSS. Studies were searched on electronic databases to January 2012. Inclusion criteria were: clinical diagnosis of LSS with confirmatory imaging, evaluation of physical therapy treatment, presence of a comparison group, and outcomes of pain, disability, function, or quality of life. Outcomes were extracted and, when possible, pooled using RevMan 5, a freely available review program from the Cochrane Library. Ten studies were included: 5 RCTs, 2 controlled trials, 2 mixed-design studies, and 1 longitudinal cohort study. Pooled effects of 2 studies revealed that the addition of a physical therapy modality to exercise had no statistically significant effect on outcome. Pooled effects results of RCTs evaluating surgery versus physical therapy demonstrated that surgery was better than physical therapy for pain and disability at long term (2 years) only. Other results suggested that exercise is significantly better than no exercise, that cycling and body-weight–supported treadmill walking have similar effects, and that corsets are better than no corsets. The limitations of this review include the low quality and small number of studies, as well as the heterogeneity in outcomes and treatments. No conclusions could be drawn from the review regarding which physical therapy treatment is superior for LSS. There was low-quality evidence suggesting that modalities have no additional effect to exercise and that surgery leads to better long-term (2 years) outcomes for pain and disability, but not walking distance, than physical therapy in patients with LSS.
Publisher: BMJ
Date: 15-11-2022
DOI: 10.1136/BJSPORTS-2022-106299
Abstract: The goal of the OPTIKNEE consensus is to improve knee and overall health, to prevent osteoarthritis (OA) after a traumatic knee injury. The consensus followed a seven-step hybrid process. Expert groups conducted 7 systematic reviews to synthesise the current evidence and inform recommendations on the burden of knee injuries risk factors for post-traumatic knee OA rehabilitation to prevent post-traumatic knee OA and patient-reported outcomes, muscle function and functional performance tests to monitor people at risk of post-traumatic knee OA. Draft consensus definitions, and clinical and research recommendations were generated, iteratively refined, and discussed at 6, tri-weekly, 2-hour videoconferencing meetings. After each meeting, items were finalised before the expert group (n=36) rated the level of appropriateness for each using a 9-point Likert scale, and recorded dissenting viewpoints through an anonymous online survey. Seven definitions, and 8 clinical recommendations (who to target, what to target and when, rehabilitation approach and interventions, what outcomes to monitor and how) and 6 research recommendations (research priorities, study design considerations, what outcomes to monitor and how) were voted on. All definitions and recommendations were rated appropriate (median appropriateness scores of 7-9) except for two subcomponents of one clinical recommendation, which were rated uncertain (median appropriateness score of 4.5-5.5). Varying levels of evidence supported each recommendation. Clinicians, patients, researchers and other stakeholders may use the definitions and recommendations to advocate for, guide, develop, test and implement person-centred evidence-based rehabilitation programmes following traumatic knee injury, and facilitate data synthesis to reduce the burden of knee post-traumatic knee OA.
Publisher: BMJ
Date: 02-09-2022
DOI: 10.1136/BJSPORTS-2022-105496
Abstract: To identify and quantify potential risk factors for osteoarthritis (OA) following traumatic knee injury. Systematic review and meta-analyses that estimated the odds of OA for in idual risk factors assessed in more than four studies using random-effects models. Remaining risk factors underwent semiquantitative synthesis. The modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for prognostic factors guided the assessment. MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to 2009-2021. Randomised controlled trials and cohort studies assessing risk factors for symptomatic or structural OA in persons with a traumatic knee injury, mean injury age ≤30 years and minimum 2-year follow-up. Across 66 included studies, 81 unique potential risk factors were identified. High risk of bias due to attrition or confounding was present in 64% and 49% of studies, respectively. Ten risk factors for structural OA underwent meta-analysis (sex, rehabilitation for anterior cruciate ligament (ACL) tear, ACL reconstruction (ACLR), ACLR age, ACLR body mass index, ACLR graft source, ACLR graft augmentation, ACLR+cartilage injury, ACLR+partial meniscectomy, ACLR+total medial meniscectomy). Very-low certainty evidence suggests increased odds of structural OA related to ACLR+cartilage injury (OR=2.31 95% CI 1.35 to 3.94), ACLR+partial meniscectomy (OR=1.87 1.45 to 2.42) and ACLR+total medial meniscectomy (OR=3.14 2.20 to 4.48). Semiquantitative syntheses identified moderate-certainty evidence that cruciate ligament, collateral ligament, meniscal, chondral, patellar/tibiofemoral dislocation, fracture and multistructure injuries increase the odds of symptomatic OA. Moderate-certainty evidence suggests that various single and multistructure knee injuries (beyond ACL tears) increase the odds of symptomatic OA. Risk factor heterogeneity, high risk of bias, and inconsistency in risk factors and OA definition make identifying treatment targets for preventing post-traumatic knee OA challenging.
Publisher: Wiley
Date: 16-05-2021
DOI: 10.1002/JOR.25064
Abstract: Attitudes, priorities, and perceptions of exercise directly influence exercise behaviors. Despite the benefits of exercise‐based activities for future health, little is known about how youth who experience an ACL injury view exercise‐based activity beyond the immediate recovery period. A qualitative (interpretative description) approach with one‐to‐one semistructured interviews was used to probe the current attitudes, priorities, and perceptions of exercise‐therapy, physical activity, and sport participation with a purposive s le of youth from an ongoing inception cohort study who experienced an ACL tear or reconstruction in the past 12–24 months. Analyses followed an inductive approach guided by an analytic interpretative description process. Reflexive journaling, memoing, and a detailed audit trail promoted data trustworthiness. A patient‐partner was involved throughout. Ten youth (six women, four men), 15–19 years of age, and a median of 20‐months (16–26) from injury were interviewed. Three overarching themes were identified. ‘ Balancing physical activity and future knee health’ highlighted ongoing negotiations between what were perceived to be competing priorities for return‐to‐sport and future knee health. ‘ Reframing the value of exercise‐therapy and physical activity’ reflected the importance of reshaping attitudes toward exercise as positive and was linked to exercise adherence. ‘Overcoming unforeseen exercise challenges ’ encompassed persisting psychological and physical challenges perceived to limit exercise‐based activities. Clinical significance: reframing exercise‐based activities in a positive light and leveraging motivation for return‐to‐sport and life‐long knee health may be important strategies for encouraging ongoing exercise therapy and physical activity following a youth ACL injury.
Publisher: BMJ
Date: 14-02-2020
DOI: 10.1136/BJSPORTS-2019-101206
Abstract: To explore the role of psychological, social and contextual factors across the recovery stages (ie, acute, rehabilitation or return to sport (RTS)) following a traumatic time-loss sport-related knee injury. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Arksey and O’Malley framework. Six databases were searched using predetermined search terms. Included studies consisted of original data written in English that identified or described a psychological, social or contextual factor related to recovery after a traumatic time-loss sport-related knee injury. Two authors independently conducted title–abstract and full-text reviews. Study quality was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was undertaken. Of 7289 records, 77 studies representing 5540 participants (37% women, 84% anterior cruciate ligament tears, aged 14–60 years) were included. Psychological factors were investigated across all studies, while social and contextual factors were assessed in 39% and 21% of included studies, respectively. A cross-cutting concept of in idualisation was present across four psychological (barriers to progress, active coping, independence and recovery expectations), two social (social support and engagement in care) and two contextual (environmental influences and sport culture) themes. Athletes report multiple barriers to recovery and valued their autonomy, having an active role in their recovery and erse social support. Diverse psychological, social and contextual factors are present and influence all stages of recovery following a traumatic sport-related knee injury. A better understanding of these factors at the time of injury and throughout rehabilitation could assist with optimising injury management, promoting RTS, and long-term health-related quality-of-life.
Publisher: BMJ
Date: 12-11-2020
No related grants have been discovered for Linda Truong.