- Risk Factors for Groin Injury and Symptoms in Elite Level Soccer Players: A Cohort Study in the Dutch Professional Leagues. [Journal Article]
- JOJ Orthop Sports Phys Ther 2018 May 23; :1-30
- Study Design Cohort study with prospective and retrospective elements. Background Groin injury and symptoms are common in soccer players. Their relationship with reduced hip range of motion (ROM) and...
Study Design Cohort study with prospective and retrospective elements. Background Groin injury and symptoms are common in soccer players. Their relationship with reduced hip range of motion (ROM) and previous injury is unclear. Objectives To conduct a retrospective assessment of associations between previous injury and pre-season hip ROM and pre-season prevalence of severe groin symptoms; and prospective identification of risk factors for within-season groin injury. Methods During 2015-2016, 190 players from 9 Dutch professional soccer clubs participated. Univariate and multivariate logistic regression were used to predict pre-season severe groin symptoms, identified using the Copenhagen Hip And Groin Outcome Score, from a history of previous groin injury, general injury (minimum 1 week duration) in previous season, and hip ROM. Cox regression was used to predict within-season groin injury. Results Point-prevalence of severe groin symptoms was 24% and within-season incidence of groin injury 11%. Total/training/match groin injury incidence was 0.5/0.2/2.6 injuries/1000 playing hours. A history of more than 1 previous groin injury was associated with current severe groin symptoms (Odds Ratio=3.0; 95% CI=1.0, 8.3; P=.038). General injury sustained in the previous season (ankle, knee, thigh, shoulder; median 9 weeks time-loss) was a risk factor for groin injury (Hazard Ratio=5.1; 95% CI=1.1, 14.6; P=.003). Conclusion Severe injuries in the previous season to locations other than the groin increase the risk of groin injury the next season. A history of groin injury is associated with current severe groin symptoms. Pre-season hip ROM does not identify players at risk for groin injury. Level of Evidence Prevention, level 2b. J Orthop Sports Phys Ther, Epub 23 May 2018. doi:10.2519/jospt.2018.7990.
- Association of Hip and Foot Factors With Patellar Tendinopathy (Jumper's Knee) in Athletes. [Journal Article]
- JOJ Orthop Sports Phys Ther 2018 May 23; :1-29
- Study Design Clinical measurement, cross-sectional. Background Investigations on the causes of patellar tendinopathy (PT) should consider impairments at the hip and foot/ankle since they are known to...
Study Design Clinical measurement, cross-sectional. Background Investigations on the causes of patellar tendinopathy (PT) should consider impairments at the hip and foot/ankle since they are known to influence movement patterns and affect patellar tendon loading. Objectives To investigate, by means of CART analysis, impairments of the hip and foot/ankle that are associated with PT in volleyball and basketball athletes. Methods One-hundred and ninety athletes were assessed for impairments of the hip and foot/ankle including: shank-forefoot alignment (SFA), ankle dorsiflexion range of motion (DF ROM), iliotibial band flexibility, passive hip internal rotation (IR) ROM, and hip external rotator (ER) and hip abductor isometric strength. Athletes with tenderness and/or pain at the inferior pole of the patella were considered as having PT. Athletes with VISA-P scores above 95 points, no pain at single-leg decline squat and no history of patellar tendon pain history were considered as not having PT. CART analysis was performed to identify interacting factors associated with PT. Results Interactions among passive hip IR ROM, SFA, hip ER and abductor strength identified athletes with and without PT. The model achieved 71.2% sensitivity and 74.4% specificity. The area under the ROC curve was 0.77 (95% confidence interval: 0.70 - 0.84; p<0.0001). Conclusion Impairments of the hip and foot/ankle are associated with the presence of PT in volleyball and basketball athletes. Future studies should evaluate the role of these impairments in the etiology of PT. J Orthop Sports Phys Ther, Epub 23 May 2018. doi:10.2519/jospt.2018.7426.
- Treatment Outcome of Reconstruction for Isolated Posterior Cruciate Injury: Subjective and Objective Evaluations. [Journal Article]
- JKJ Knee Surg 2018 May 23
- There is no consensus regarding the treatment method and outcome of posterior cruciate ligament (PCL) injury. We hypothesized that although the outcome of PCL reconstruction was favorable in terms of...
There is no consensus regarding the treatment method and outcome of posterior cruciate ligament (PCL) injury. We hypothesized that although the outcome of PCL reconstruction was favorable in terms of knee stability, the outcome was unsatisfactory in terms of patient-based assessments. The purpose of this study is to evaluate the treatment outcomes of knees that underwent reconstruction for PCL injury by subjective and objective assessments, and to analyze the correlation between various assessments. Twenty-three patients who underwent PCL reconstruction were studied. All reconstructions were performed arthroscopically by the single-bundle technique using a hamstring tendon autograft. Patients were evaluated clinically before operation and 24 months after operation using the 36-Item Short Form Health Survey (SF-36) which is a patient-based health assessment survey, Lysholm score, tibial translation ratio, Visual Analogue Scale (VAS) for pain, and range of motion (ROM) in the knee. The correlation of these assessment methods was analyzed. For the SF-36 survey, significant improvement was observed after operation in only 3 of 7 subscales compared with before surgery. Furthermore, the scores reached the national standard scores in only 3 subscales. While the Lysholm score and tibial translation ratio were improved significantly, no significant improvement in the VAS pain score was observed. For ROM assessment, approximately 30% of the patients had flexion restriction after operation, and the degree of restriction correlated positively with the VAS score. The present results indicated that although the outcome of PCL reconstruction was favorable in terms of knee stability and motor function, the outcome was unsatisfactory in terms of patient-based assessments. Since pain associated with flexion restriction appears to be a poor prognostic factor and there is a dissociation between subjective and objective assessments, improvement of the surgical method is necessary.
- Use of Neuromuscular Electrical Stimulation During Physical Therapy May Reduce the Incidence of Arthrofibrosis After Total Knee Arthroplasty. [Journal Article]
- STSurg Technol Int 2018 Jun 01; 32:356-360
- CONCLUSIONS: This study demonstrated that the use of NMES during PT may reduce the incidence of arthrofibrosis and improve patient ROM. Prospective, randomized controlled, and larger-scale studies are needed to validate these results. Nevertheless, this novel report demonstrated the positive outcomes for a new application of the NMES therapy.
- A Comparative Effectiveness Study for Non-Operative Treatment Methods for Knee Osteoarthritis. [Journal Article]
- STSurg Technol Int 2018 Jun 01; 32:325-330
- A number of non-operative treatment options are commonly prescribed for patients presenting with degenerative osteoarthritis of the knee, where surgery is not yet recommended. However, there is a pau...
A number of non-operative treatment options are commonly prescribed for patients presenting with degenerative osteoarthritis of the knee, where surgery is not yet recommended. However, there is a paucity of studies evaluating the comparative effectiveness of these treatment options to best inform both patients and providers. This study examined the comparative effectiveness of a home exercise program versus bracing or a combination of the two (brace-only, exercise-only, and brace and exercise cohorts) on the following: 1) objective functional measures (quadriceps muscle strength, Self-Paced Walk Test [SPWT], and Timed "Up & Go" [TUG] Test); 2) subjective functional measures (Lower Extremity Function Scale [LEFS] and Health Survey [VR-12] outcomes); 3) pain using Visual Analog Scale [VAS-10]; 4) patient metrics (patient treatment preference, perceptions, and compliance); and 5) progression to total knee arthroplasty (TKA) over a 12-week period. Subjects exhibited significant improvements from baseline on all measures regardless of group assignment; however, the only significant difference between groups was the larger improvement in pain scores between the brace-only and the exercise-only cohorts (p = 0.022). The brace-only regimen may be more efficacious; however, larger studies are needed to confirm this. These findings suggest that patients who are provided with either treatment option may be able to achieve a better quality of life and return to activity that may delay an elective joint arthroplasty surgery.
- Immediate effects of a distal gait modification during stair descent in individuals with patellofemoral pain. [Journal Article]
- PTPhysiother Theory Pract 2018 May 23; :1-7
- CONCLUSIONS: The distal gait modification session changed the lower extremity kinetic chain strategy of movement, increasing foot and ankle movement contribution and decreasing knee contribution to the task. An immediate decrease in patellofemoral pain intensity during stair descent was also observed. To emphasize forefoot landing may be a useful intervention to immediately relieve pain in patients with patellofemoral pain during stair descent. Clinical studies are needed to verify the gait modification session effects in medium and long terms.
- The effect of 12-week garlic supplementation on symptom relief in overweight or obese women with knee osteoarthritis. [Journal Article]
- IJInt J Clin Pract 2018 May 23; :e13208
- CONCLUSIONS: Although pre- to postintervention knee OA symptoms were improved in overweight or obese women receiving 12 weeks garlic supplement, there was no significant difference in WOMAC changes compared with the placebo group. Further clinical trials are required to investigate the therapeutic value of garlic ingredients, and the potential role of placebo effect, in the management of OA symptoms.
- The Relationship between Self-reported Restless Sleep and Objectively Measured Physical Activity in Adults with Knee Osteoarthritis. [Journal Article]
- ACArthritis Care Res (Hoboken) 2018 May 22
- CONCLUSIONS: Poor sleep quality is associated with less physical activity in persons with or at risk for KOA. Future studies are needed to determine the mechanisms of how poor sleep and physical activity are related, how energy and depression mediate these relationships, and whether interventions that improve sleep quality might result in increased physical activity. This article is protected by copyright. All rights reserved.
- Outcome of arthroscopic SLAP repair using knot-tying-suture anchors compared with knotless-suture anchors in athletes. [Journal Article]
- AOArch Orthop Trauma Surg 2018 May 22
- CONCLUSIONS: After SLAP repair, athletes showed underestimated impairment of shoulder sport resumption and proficiency with high rates of shoulder sports cessation. The present data favor the knotless fixation technique, because this fixation technique allowed bilaterally equivalent ranges of motions. The uninjured shoulder athletes also showed functional deficits with significant shoulder sport impairments, which must be considered in outcome analysis and for the rehabilitation program.
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- Revision knee arthroplasty with rotating hinge systems in patients with gross ligament instability. [Journal Article]
- IOInt Orthop 2018 May 22
- CONCLUSIONS: Both prosthetic designs provide significant improvement in pain and function scores after TKA revision for gross instability. We found slight advantages in favor of the Endo-Model; however, no design yielded superior results throughout the study.