| 1. |
- Aasa, Björn, et al.
(författare)
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Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain : a randomized controlled trial
- 2015
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 45:2, s. 77-85
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Tidskriftsartikel (refereegranskat)abstract
- Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.
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| 2. |
- Ageberg, Eva, et al.
(författare)
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The association between knee confidence and muscle power, hop performance, and postural orientation in people with anterior cruciate ligament injury
- 2016
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 46:6, s. 477-482
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. BACKGROUND: The association between muscle function and lack of knee confidence in people with anterior cruciate ligament (ACL) injury has not been well investigated. Such knowledge would help in the design of training programs for this population. OBJECTIVE: To investigate associations between self-reported knee confidence and muscle function in patients with ACL injury. METHODS: Cross-sectional data from 54 patients (mean age, 30 years; range, 20-39 years; 28% women) with ACL injury, treated with training and reconstructive surgery (n = 36) or training only (n = 18), were assessed 3 ± 1 years after injury. Univariate and multivariable ordinal regression analyses were conducted to test the association between the patient's knee confidence (question 3 from the Knee injury and Osteoarthritis Outcome Score as the dependent variable) and performance on tests of muscle power, hop performance, and postural orientation (test for substitution patterns score) as independent variables (absolute value on the injured leg, and limb symmetry index [LSI; injured leg/uninjured leg × 100] or absolute difference between the injured and uninjured legs). RESULTS: Sixteen patients reported no trouble with lack of knee confidence, 24 mild trouble, 10 moderate trouble, and 4 severe or extreme trouble. Univariate analyses revealed significant associations between worse knee confidence and lower (worse) LSIs for knee extension power, vertical jump, and side hop, and worse test for substitution patterns scores. In the multivariable analysis, worse vertical jump LSI (P =.043) and worse side hop LSI (P =.012) significantly accounted for 25% of the variation in perceived knee confidence. CONCLUSION: Between-leg differences during demanding tasks are associated with knee confidence in individuals with ACL injury.
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| 3. |
- Alentorn-Geli, E., et al.
(författare)
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The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis
- 2017
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Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 47:6, s. 373-390
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Systematic review and meta-analysis. BACKGROUND: Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting. OBJECTIVES: To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association. METHODS: PubMed, Embase, and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. A meta-analysis of studies comparing this occurrence between runners and controls (sedentary, nonrunning individuals) was conducted. Runners were regarded as "competitive" if they were reported as professional/elite athletes or participated in international competitions. Recreational runners were individuals running in a nonprofessional (amateur) context. The prevalence rate and odds ratio (with 95% confidence interval [CI]) for OA between runners (at competitive and recreational levels) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), sex, and years of exposure to running (less or more than 15 years). RESULTS: Twenty-five studies (n = 125 810 individuals) were included and 17 (n = 114 829 individuals) were meta-analyzed. The overall prevalence of hip and knee OA was 13.3% (95% CI: 11.6%, 15.2%) in competitive runners, 3.5% (95% CI: 3.4%, 3.6%) in recreational runners, and 10.2% (95% CI: 9.9%, 10.6%) in controls. The odds ratio for hip and/or knee OA in competitive runners was higher than that in recreational runners (1.34; 95% CI: 0.97, 1.86 and 0.86; 95% CI: 0.69, 1.07, respectively; controls as reference group; for difference, P<.001). Exposure to running of less than 15 years was associated with a lower association with hip and/or knee OA compared with controls (OR = 0.6; 95% CI: 0.49, 0.73). CONCLUSION: Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations were causative or confounded by other risk factors, such as previous injury.
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| 4. |
- Ardern, CL
(författare)
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Break On Through (To the Digital Side)-JOSPT's Digital Future
- 2019
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Ingår i: The Journal of orthopaedic and sports physical therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 1938-1344 .- 0190-6011. ; 49:7, s. 485-486
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Ardern, Clare, et al.
(författare)
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Satisfaction With the Outcome of Physical Therapist-Prescribed Exercise in Chronic Whiplash-Associated Disorders : Secondary Analysis of a Randomized Clinical Trial
- 2016
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 46:8, s. 640-649
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Secondary analysis of a randomized clinical trial.BACKGROUND: Patient perception of the benefits gained from treatment is important, yet satisfaction with the outcome of treatment for chronic whiplash-associated disorders (WADs) has not been investigated.OBJECTIVES: To investigate whether satisfaction with the outcome of treatment for chronic WAD changed over time, and whether there were group differences.METHODS: Two hundred sixteen people with chronic WAD (66% women; mean age, 40.4 years) participated in a 3-month program of physical therapist-led neck-specific exercises with or without a behavioral approach, or received a prescription of general physical activity. The main outcome was satisfaction with the outcome of treatment, assessed at baseline and 3, 6, and 12 months later. Additional outcomes were enablement and expectation fulfillment.RESULTS: Satisfaction improved over time in the 3 groups (odds ratio = 1.15; 95% confidence interval: 1.10, 1.20; P < .001). There was a significant group-by-time interaction (P < 001), with increased odds of being satisfied in the groups receiving neck-specific exercises compared to general physical activity. Enablement increased after completion of the intervention in all groups (P < .001). People who received neck-specific exercises reported greater enablement and expectation fulfillment than people prescribed general physical activity (P < .01).CONCLUSION: Exercise interventions for chronic WAD led to increased satisfaction for 12 months following treatment that was unrelated to the type of exercise intervention received.
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| 6. |
- Ardern, CL, et al.
(författare)
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Three New Digital Features From JOSPT in 2020
- 2020
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Ingår i: The Journal of orthopaedic and sports physical therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 1938-1344 .- 0190-6011. ; 50:9, s. 471-472
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Arumugam, Ashokan
(författare)
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Sacral Osteosarcoma Masquerading as Posterior Thigh Pain
- 2018
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 48:8, s. 665-665
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 8. |
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| 9. |
- Asker, Martin, et al.
(författare)
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Preseason clinical shoulder test results and shoulder injury rate in adolescent elite handball players : a prospective study
- 2020
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:2, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Prospective cohort study.BACKGROUND: Shoulder injuries are common in handball. Shoulder weakness, scapular dyskinesia and range of motion (ROM) deficits are associated with shoulder injury in adults, but studies of adolescent players are scarce.OBJECTIVE: To investigate if elite adolescent female and male handball players with shoulder muscle weakness, deficits in shoulder rotation ROM or joint position sense (JPS), or scapular dyskinesia in preseason have an increased shoulder injury rate compared to players not having these characteristics.METHODS: 341 uninjured players (452 player-seasons, 50% females) had isometric external rotational (IER), internal rotational (IIR), abduction (IABD) and eccentric external rotational (EER) shoulder strength, shoulder ROM, JPS, and scapular dyskinesia measured during pre-season. Players were monitored weekly regarding match- and training hours and shoulder injuries during one or two seasons. We used multivariable Cox proportional hazard models to calculate hazard rate ratios (HRR) related to the first injury with 95% confidence intervals (95% CI).RESULTS: 48 new shoulder injuries were reported during the two seasons. In females, the HRR for IER was 2.37 (95% CI 1.03-5.44), for IIR 2.44 (95% CI 1.06-5.61), and for scapular dyskinesia 1.53 (95% CI 0.36-6.52). In males, the HRR for IER was 1.02 (95% CI 0.44-2.36), for IIR 0.74 (95% CI 0.31-1.75), and for scapular dyskinesia 3.43 (95% CI 1.49-7.92). There were no associations between new shoulder injuries and deficits in ROM or JPS.CONCLUSION: In adolescent elite handball, male players with pre-season scapula dyskinesia, and female players with pre-season internal or external rotation shoulder weakness, had an increased shoulder injury rate. J Orthop Sports Phys Ther, Epub 27 Nov 2019. doi:10.2519/jospt.2020.9044.
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| 10. |
- Beischer, Susanne, et al.
(författare)
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Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return
- 2020
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Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:2, s. 83-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the association between sustaining a second anterior cruciate ligament (ACL) injury and (1) time to return to sport, (2) symmetrical muscle function, and (3) symmetrical quadriceps strength at the time of return to sport in young athletes after primary ACL reconstruction. DESIGN: Prospective cohort study. METHODS: Patient demographics and results from 5 tests of muscle function (2 strength tests and 3 hop tests) were extracted from a rehabilitation registry. A questionnaire was sent to athletes (1530 years old) who were involved in knee-strenuous sport before the injury and had undergone primary ACL reconstruction to determine time of return to knee-strenuous sport (preinjury Tegner Activity Scale score of 6 or greater). We used the Cox proportional hazard regression model to analyze time to event. RESULTS: One hundred fifty-nine (32% of initial sample) athletes (mean +/- SD age, 21.5 +/- 4.4 years; 64% female) were included. Athletes with a higher preinjury Tegner Activity Scale score had a higher rate of second ACL injury (hazard ratio = 2.1; 95% confidence interval: 1.2, 3.6; P<.01). Athletes who returned to knee-strenuous sport before 9 months after reconstruction had a higher rate of second ACL injury (hazard ratio = 6.7; 95% confidence interval: 2.6,16.7; P<.001). There was no association between symmetrical muscle function or quadriceps strength and second ACL injury. CONCLUSION: Returning to knee-strenuous sport before 9 months after ACL reconstruction was associated with an approximately 7-fold increased rate of sustaining a second ACL injury. Achieving symmetrical muscle function or quadriceps strength was not associated with new ACL injury in young athletes.
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| 11. |
- Belton, J, et al.
(författare)
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Patients as Partners in Research: It's the Right Thing to Do
- 2019
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Ingår i: The Journal of orthopaedic and sports physical therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 1938-1344 .- 0190-6011. ; 49:9, s. 623-626
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 12. |
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| 13. |
- Culvenor, Adam G, et al.
(författare)
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Dynamic Single-Leg Postural Control is Impaired Bilaterally Following ACL Reconstruction : Implications for Reinjury Risk
- 2016
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 46:5, s. 357-364
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Tidskriftsartikel (refereegranskat)abstract
- Study Design Controlled laboratory study; cross-sectional. Background Postural control following anterior cruciate ligament reconstruction (ACLR) primarily has been investigated during static single-leg balance tasks. Little is known about dynamic postural control deficits post-ACLR. Objectives To compare dynamic postural control (bilaterally) in persons who have undergone ACLR and healthy controls, and to evaluate the relationship between dynamic postural control and self-reported and objective function. Methods 97 participants (66 males, median age 28 years) 12 months post-ACLR and 48 healthy controls (20 males, median age 30 years) underwent balance assessment using a Nintendo Wii Balance Board during a single-leg squat. Center of pressure (CoP) path velocity, as well as CoP amplitude and standard deviation (SD) in both mediolateral (ML) and anteroposterior (AP) directions, were recorded. Self-reported function was assessed with the International Knee Documentation Committee Subjective form (IKDC), while hop-for-distance was used to evaluate functional status. Results Compared to healthy controls, the ACLR group had greater mean CoP path velocity (16% higher, p=0.004), ML range (23%, p<0.001), ML SD (28%, p<0.001), AP range (14%, p=0.009) and AP SD (15%, p=0.013) indicating worse dynamic balance post-ACLR. Dynamic balance performance was similar between the ACLR limb and the uninjured contralateral limb. AP SD was weakly associated with hop performance (β -0.2, p=0.046); no balance measures were associated with the IKDC score. Conclusion Individuals who have undergone ACLR demonstrate impaired dynamic balance bilaterally when performing a single-leg squat which may have implications for physical function and future injury risk. Routine dynamic balance assessment may help identify patients who could benefit from targeted neuromuscular training programs to improve objective function and potentially lower re-injury risk. J Orthop Sports Phys Ther, Epub 21 Mar 2016. doi:10.2519/jospt.2016.6305.
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| 14. |
- Eshuis, Rienk, et al.
(författare)
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Dutch Translation and Cross-cultural Adaption of the Lysholm Score and Tegner Activity Scale for Patients With Anterior Cruciate Ligament Injuries
- 2016
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 46:11, s. 976-983
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Tidskriftsartikel (refereegranskat)abstract
- Study Design Clinical measurement. Background The Lysholm score and Tegner Activity Scale are frequently used patient-reported instruments to determine the functional status and activity level after anterior cruciate ligament (ACL) reconstruction. Objectives To translate and cross-culturally adapt the Lysholm score and Tegner Activity Scale for use in the Dutch population and to evaluate reliability and validity of these questionnaires in individuals after ACL reconstruction. Methods The translation and adaptation was conducted in several steps according to the guidelines in the literature. The measurement properties of the Lysholm score and Tegner Activity Scale (internal consistency, construct validity, and floor and ceiling effects) were tested in 96 patients. Reproducibility was tested in 69 patients, for patient with anterior cruciate ligament injuries. On the first occasion, the International Knee Documentation Committee (IKDC) and RAND-36 item Health Survey (RAND-36) were also administered. Results The Lysholm score and Tegner Activity Scale showed good test-retest reliability between repeated measures (respectively ICC 0.93 and 0.97). Internal consistency was reasonable to good (Cronbach's α=0.70-0.83). The Lysholm score had a very strong correlation with the IKDC (r= 0.83, p<0.01) and moderate correlation with the RAND-36 (r=0.55, p<0.01). The Tegner Activity Scale had a moderate correlation with both IKDC and the RAND-36 (r= 0.42 p<0.01 respectively r= 0.48 p<0.01). Conclusion This study demonstrated acceptable psychometric performances for the Lysholm score and the Tegner scale as outcome measures for Dutch patients after ACL reconstruction. J Orthop Sports Phys Ther, Epub 28 Sep 2016. doi:10.2519/jospt.2016.6566.
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| 15. |
- Grinberg, Adam, 1980-
(författare)
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Reinjury fear and anxiety following anterior cruciate ligament injury. Let’s get our constructs straight!
- 2024
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : JOSPT Open. - 0190-6011 .- 1938-1344. ; 2:1, s. 4-7
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Tidskriftsartikel (refereegranskat)abstract
- here is increasing attention in the literature to psychological consequences of anterior cruciate ligament injury, particularly those related to reinjury fear/anxiety. However, noticeable knowledge gaps exist, pertaining to how different fear-related constructs (eg, kinesiophobia, reinjury anxiety) are defined and consequently assessed. This editorial tackles some fundamental issues: first regarding the distinction between reinjury anxiety, which is assessed using questionnaires, and fear of reinjury, which is an acute response to injury-relevant scenarios. Next, the frequent focus of practitioners on pain as the major injury-instigated threat, which oversimplifies the complex injury experience and, in turn, the individual anxiety perceived by patients. A call to researchers and clinicians is issued to further consider the constructs they evaluate and related assessment tools. While fear is more challenging to assess and requires individual exposure to threatening situations, anxiety-relevant questionnaires should be carefully selected rather than using common ones that may not suit the population.
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| 16. |
- Grindem, H, et al.
(författare)
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Be a Champion for Your Athlete's Health
- 2020
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Ingår i: The Journal of orthopaedic and sports physical therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 1938-1344 .- 0190-6011. ; 50:4, s. 173-175
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Tidskriftsartikel (refereegranskat)
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| 17. |
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| 18. |
- Hébert-Losier, Kim, et al.
(författare)
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Analysis of knee flexion angles during 2 clinical versions of the heel raise test to assess soleus and gastrocnemius function.
- 2011
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 41:7, s. 505-13
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Controlled laboratory study, using a repeated-measures, counterbalanced design. OBJECTIVES: To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test. BACKGROUND: The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test. METHODS: Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) of desired knee flexion. The average angle maintained and absolute error at the knee during the 2 versions, and total heel raise repetitions, were measured using motion analysis. Participants' kinematic measures were fitted into a generalized estimation equation model to provide estimates on EHRT and FHRT performance applicable to the general population. RESULTS: The model estimates that average angles of 2.2° and 30.7° will be maintained at the knee by the general population during the EHRT and the FHRT, with an absolute angle error of 3.4° and 2.5°, respectively. In both versions, 40 repetitions should be completed. However, the average angles maintained by participants ranged from -6.3° to 21.6° during the EHRT and from 22.0° to 43.0° during the FHRT, with the highest absolute errors in knee position being 25.9° and 33.5°, respectively. CONCLUSION: On average, select knee angles will be maintained by the general population during the select heel raise test versions, but individualized performance is variable and total repetitions do not distinguish between versions. Clinicians should, therefore, interpret select heel raise test outcomes with caution when used to respectively assess and rehabilitate soleus and gastrocnemius function.
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| 19. |
- Hébert-Losier, Kim, et al.
(författare)
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December 2011 Letters to the Editor-in-Chief : Differentiating the Soleus From the Gastrocnemius With the Heel Raise Test
- 2011
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011 .- 1938-1344. ; 41:12, s. 983-7
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Tidskriftsartikel (refereegranskat)abstract
- Letters to the Editor-in-Chief of JOSPT as follows:"Early Prognostic Factors in Patients With Whiplash" and Author's Response "Staying Current in the Use of Ultrasound Imaging" and Author's Response"Differentiating the Soleus From the Gastrocnemius With the Heel Raise Test" and Author's ResponseJ Orthop Sports Phys Ther 2011;41(12):983-987. doi:10.2519/jospt.2011.0202.
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| 20. |
- Hébert-Losier, Kim, et al.
(författare)
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December 2011 Letters to the Editor-in-Chief.
- 2011
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 41:12, s. 983-7
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Tidskriftsartikel (refereegranskat)abstract
- Letters to the Editor-in-Chief of JOSPT as follows:"Early Prognostic Factors in Patients With Whiplash" and Author's Response "Staying Current in the Use of Ultrasound Imaging" and Author's Response"Differentiating the Soleus From the Gastrocnemius With the Heel Raise Test" and Author's ResponseJ Orthop Sports Phys Ther 2011;41(12):983-987. doi:10.2519/jospt.2011.0202.
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| 21. |
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| 22. |
- Holm, Patur M., et al.
(författare)
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The Effects of Different Management Strategies or Rehabilitation Approaches on Knee Joint Structural and Molecular Biomarkers Following Traumatic Knee Injury : A Systematic Review of Randomized Controlled Trials for the OPTIKNEE Consensus
- 2023
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 53:4, s. 172-193
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To summarize the effectiveness of management strategies and rehabilitation approaches for knee joint structural and molecular biomarker outcomes following anterior cruciate ligament (ACL) and/or meniscal tear. DESIGN: Intervention systematic review. LITERATURE SEARCH: We searched the MEDLINE, Embase, CINAHL, CENTRAL, and SPORTDiscus databases from their inception up to November 3, 2021. STUDY SELECTION CRITERIA: We included randomized controlled trials (RCTs) investigating the effectiveness of management strategies or rehabilitation approaches for structural/molecular biomarkers of knee joint health following ACL and/or meniscal tear. DATA SYNTHESIS: We included 5 RCTs (9 papers) with primary ACL tear (n = 365). Two RCTs compared initial management strategies (rehabilitation plus early vs optional delayed ACL surgery), reporting on structural biomarkers (radiographic osteoarthritis, cartilage thickness, meniscal damage) in 5 papers and molecular biomarkers (inflammation, cartilage turnover) in 1 paper. Three RCTs compared different post-ACL reconstruction (ACLR) rehabilitation approaches (high vs low intensity plyometric exercises, accelerated vs nonaccelerated rehabilitation, continuous passive vs active motion), reporting on structural biomarkers (joint space narrowing) in 1 paper and molecular biomarkers (inflammation, cartilage turnover) in 2 papers. RESULTS: There were no differences in structural or molecular biomarkers between post-ACLR rehabilitation approaches. One RCT comparing initial management strategies demonstrated that rehabilitation plus early ACLR was associated with greater patellofemoral cartilage thinning, elevated inflammatory cytokine response, and reduced incidence of medial meniscal damage over 5 years compared to rehabilitation with no/delayed ACLR. CONCLUSION: Very low-certainty evidence suggests that different initial management strategies (rehabilitation plus early vs optional delayed ACL surgery) but not postoperative rehabilitation approaches may influence the incidence of meniscal damage, patellofemoral cartilage loss and cytokine concentrations over 5 years post-ACL tear.
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| 23. |
- Karlsson, Anette, et al.
(författare)
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An Investigation of Fat Infiltration of the Multifidus Muscle in Patients With Severe Neck Symptoms Associated With Chronic Whiplash-Associated Disorder
- 2016
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 46:10, s. 886-893
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional study. BACKGROUND: Findings of fat infiltration in cervical spine multifidus, as a sign of degenerative morphometric changes due to whiplash injury, need to be verified. OBJECTIVES: To develop a method using water/fat magnetic resonance imaging (MRI) to investigate fat infiltration and cross-sectional area of multifidus muscle in individuals with whiplash associated disorders (WADS) compared to healthy controls. METHODS: Fat infiltration and cross-sectional area in the multifidus muscles spanning the C4 to C7 segmental levels were investigated by manual segmentation using water/fat-separated MRI in 31 participants with WAD and 31 controls, matched for age and sex. RESULTS: Based on average values for data spanning C4 to C7, participants with severe disability related to WAD had 38% greater muscular fat infiltration compared to healthy controls (P = .03) and 45% greater fat infiltration compared to those with mild to moderate disability related to WAD (P = .02). There were no significant differences between those with mild to moderate disability and healthy controls. No significant differences between groups were found for multifidus cross-sectional area. Significant differences were observed for both cross-sectional area and fat infiltration between segmental levels. CONCLUSION: Participants with severe disability after a whiplash injury had higher fat infiltration in the multifidus compared to controls and to those with mild/moderate disability secondary to WAD. Earlier reported findings using T1-weighted MRI were reproduced using refined imaging technology. The results of the study also indicate a risk when segmenting single cross-sectional slices, as both cross-sectional area and fat infiltration differ between cervical levels.
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| 24. |
- Kvist, Joanna, 1967-, et al.
(författare)
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Anterior tibial translation during different isokinetic quadriceps torque in anterior cruciate ligament deficient and nonimpaired individuals
- 2001
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011 .- 1938-1344. ; 31:1, s. 4-15
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Factorial quasi-experimental design.Objectives: To quantify the effect of different levels of isokinetic concentric and eccentric knee extensor torques on the anterior tibial translation in subjects with anterior cruciate ligament (ACL) deficiency. Electromyogram (EMG) activity of 4 leg muscles was recorded in order to detect any co-activation of extensors and flexors.Background: The rehabilitation after an ACL injury is of importance for the functional outcome of the patient. In order to construct a rehabilitation program after that injury, it is important to understand the in vivo relationships between muscle force and tibial translation.Methods and Measures: Twelve patients with unilateral ACL injury and 11 uninjured volunteers performed 36 repetitions of a quadriceps contraction at different isokinetic concentric and eccentric torque levels, on a KinCom machine (60°•s-1), with simultaneous recordings of tibial translation (CA-4000) and EMG activity from quadriceps and hamstrings muscles. Tibial translations and EMG levels were normalized to the maximum of each subject.Results: The individual anterior tibial translation increased with increased quadriceps torque in a similar manner in both quadriceps contraction modes in all legs tested. During concentric mode, translation was similar in all groups, but during eccentric mode, the mean translation was 38% larger in the ACL injured knees. No quadriceps-hamstrings co-activation occurred in any test or group.Conclusions: An ACL deficient knee can limit the translation within a normal space during concentric muscle activity but not during eccentric activity. That limitation depends on other mechanisms than hamstrings co-activation.
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| 25. |
- Kvist, Joanna, 1967-
(författare)
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Sagittal plane knee motion in the ACL-deficient knee during body weight shift exercises on different support surfaces
- 2006
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 36:12, s. 954-962
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Experimental design with group comparisons. Objectives: To compare anterior tibial translation and muscle activity among different exercises for early weight-bearing and neuromuscular training in individuals with a unilateral anterior cruciate ligament (ACL) injury and in uninjured controls. Background: The effects of exercise and activity on tibial translation must be taken into consideration during rehabilitation after ACL injury. Methods and Measures: Twelve patients with an ACL-deficient knee and 12 age- and gender-matched controls participated in the study. Sagittal tibial translation and muscle activity were registered during the Lachman test (static translation) and 4 body weight shift exercises (dynamic translation). A Student t test with Bonferroni correction and analysis of variance were used for the statistical analysis. Results: Forward-backward body weight shift exercise resulted in smaller anterior tibial translation compared to body weight shift from side to side. Analysis of EMG activity could not explain this difference in anterior tibial translation. The amount of anterior tibial translation or EMG activity did not change when the exercises were performed on a trampoline compared to a firm surface. Conclusions: Forward-backward weight shifting may be preferable in initial rehabilitation after ACL injury compared to body weight shift from side to side.
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| 26. |
- Leemans, L., et al.
(författare)
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It Hurts to Move! Intervention Effects and Assessment Methods for Movement-Evoked Pain in Patients With Musculoskeletal Pain: A Systematic Review with Meta-analysis
- 2022
-
Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 52:6, s. 345-374
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To estimate the effects of musculoskeletal rehabilitation interventions on movementevoked pain and to explore the assessment methods/protocols used to evaluate movement-evoked pain in adults with musculoskeletal pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: Three electronic databases (PubMed, Web of Science, and Scopus) were searched. STUDY SELECTION CRITERIA: Randomized controlled trials investigating musculoskeletal rehabilitation interventions for movement-evoked pain in adults with musculoskeletal pain were included. DATA SYNTHESIS: Meta-analysis was conducted for outcomes with homogeneous data from at least 2 trials. The mean change in movementevoked pain was the primary outcome measure. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. RESULTS: Thirty-eight trials were included, and 60 different interventions were assessed. There was moderate-certainty evidence of a beneficial effect of exercise therapy compared to no treatment (standardized mean difference [SMD], -0.65; 95% confidence interval [CI]: -0.83, -0.47; P<.001) on movement-evoked pain in adults with musculoskeletal pain. There was low-certainty evidence of a beneficial effect of transcutaneous electrical nerve stimulation compared to no treatment (SMD, -0.46; 95% CI: -0.71, -0.21; P=.0004). There was no benefit of transcutaneous electrical nerve stimulation when compared to sham transcutaneous electrical nerve stimulation (SMD, -0.28; 95% CI: -0.60, 0.05; P=.09; moderate-certainty evidence). CONCLUSION: There was moderate-certainty evidence that exercise therapy is effective for reducing movement-evoked pain in patients with musculoskeletal pain compared to no treatment. Consider exercise therapy as the first-choice treatment for movement-evoked pain in clinical practice.
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| 27. |
- Nae, Jenny, et al.
(författare)
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Measurement properties of a test battery to assess postural orientation during functional tasks in patients undergoing anterior cruciate ligament injury rehabilitation
- 2017
-
Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 47:11, s. 863-873
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional study. BACKGROUND: Visual rating of postural orientation during functional tasks may be a valuable tool to track rehabilitation progress following anterior cruciate ligament (ACL) injury. A valid test battery assessing postural orientation as a separate construct is lacking. OBJECTIVES: To evaluate measurement properties of a test battery to assess postural orientation in patients with ACL injury. METHODS: The content validity of functional tasks was assessed by expert focus group discussions. Fifty-one patients (45% women) with ACL injury performed 9 functional tasks of varying difficulty. Interpretability, internal consistency, interrater reliability, and measurement error were assessed for segment-specific postural orientation errors (POEs), within-task POEs, and total POE score. Postural orientation errors were scored on video on an ordinal scale from 0 (no POEs) to 3 (major POEs). RESULTS: Stair ascent, deep squat, and crossover hop for distance were excluded in focus group discussions. Postural orientation errors in some tasks were excluded due to floor effects. The minisquat and drop jump were excluded due to poor internal consistency (α≤.184). Interrater reliability values for segment-specific POEs and within-task POEs yielded fair to almost perfect agreement (κ = 0.429-0.875) and almost perfect agreement for total POE score (intraclass correlation coefficient = 0.842), without systematic differences between raters. The smallest detectable changes were 0.7 and 5 points for groups and individuals, respectively. CONCLUSION: The final test battery (single-leg mini-squat, stair descent, forward lunge, singleleg hop for distance) of 4 POEs (foot pronation, medial knee-to-foot position, hip joint POEs, and trunk segment POEs) demonstrated good measurement properties in people with ACL injury.
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| 28. |
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| 29. |
- Nielsen, Rasmus Ostergaard, et al.
(författare)
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Statement on Methods in Sport Injury Research From the First METHODS MATTER Meeting, Copenhagen, 2019
- 2020
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : J O S P T. - 0190-6011 .- 1938-1344. ; 50:5, s. 226-233
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- SYNOPSIS: High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy.
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| 30. |
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| 31. |
- Olsson Wållgren, Jonas, et al.
(författare)
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Does Playing Football (Soccer) Really Increase the Risk of Knee Osteoarthritis? A Systematic Review and Meta-analysis
- 2024
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Ingår i: JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY. - 0190-6011 .- 1938-1344. ; 54:5, s. 328-339
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To evaluate the relationship between football (soccer) participation and tibiofemoral knee osteoarthritis (OA), considering the influence of competitive level and previous knee injuries. O DESIGN: Etiology systematic review with meta -analysis. O LITERATURE SEARCH: PubMed, Embase, AMED, and Cochrane were searched for relevant publications. STUDY SELECTION CRITERIA: Studies of football players that included a control group consisting of mainly sedentary nonfootball players, and the relationship of knee OA, were considered. The studies had to report radiographically verified knee OA and specify football activity. DATA SYNTHESIS: Eleven studies, involving 1805 football players and 4022 control individuals were included. Subgroups consisting of data regarding level of play and previous injuries were also synthesized. RESULTS: The overall prevalence of knee OA among football players was increased among professional and recreational players, compared with controls. When knee injuries were excluded, there was no difference in knee OA between football players and controls (OR = 1.25; 95% CI: 0.61, 2.54). Football players with a previous knee injury had a greater risk of knee OA when compared with football players with no history of previous knee injury (OR = 4.16; 95% CI: 1.97, 8.77). CONCLUSION: Football players were at increased risk of knee OA. However, after excluding participants with a history of previous knee injury, there were no differences in knee OA between football players and controls. Previous knee injury was important for developing knee OA. Playing football, in the absence of major knee injuries, did not increase the risk of knee OA. J Orthop Sports Phys Ther 2024;54(5):328-339. Epub 26 February 2024. doi:10.2519/jospt.2024.12029
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| 32. |
- Pedersen, Marie, et al.
(författare)
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Meniscus or Cartilage Injury at the Time of Anterior Cruciate Ligament Tear Is Associated With Worse Prognosis for Patient-Reported Outcome 2 to 10 Years After Anterior Cruciate Ligament Injury : A Systematic Review
- 2020
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 50:9, s. 490-502
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVES: (1) To assess prognostic factors for patient-reported outcome measures (PROMs) and physical activity 2 to 10 years after anterior cruciate ligament reconstruction (ACLR) or anterior cruciate ligament (ACL) injury, and (2) to assess differences in prognostic factors between patients treated with ACLR and with rehabilitation alone.DESIGN: Prognosis systematic review.LITERATURE SEARCH: Systematic searches were performed in PubMed, Web of Science, and SPORTDiscus.STUDY SELECTION CRITERIA: We selected prospective cohort studies and randomized clinical trials that included adults or adolescents undergoing either ACLR or rehabilitation alone after ACL rupture. Studies had to assess the statistical association between potential prognostic factors (factors related to patient characteristics, injury, or knee symptoms/function measured at baseline or within 1 year) and outcomes (PROMs and physical activity).DATA SYNTHESIS: Our search yielded 997 references. Twenty studies met the inclusion criteria. Seven studies with low or moderate risk of bias remained for data synthesis.RESULTS: Moderate-certainty evidence indicated that concomitant meniscus and cartilage injuries were prognostic factors for worse PROMs 2 to 10 years after ACLR. Very low-certainty evidence suggested that body mass index, smoking, and baseline PROMs were prognostic factors for worse outcome. Very low-certainty evidence suggested that female sex and a worse baseline Marx Activity Rating Scale score were prognostic factors for a worse Marx Activity Rating Scale score 2 to 10 years after ACLR. There was a lack of studies on prognostic factors after rehabilitation alone.CONCLUSION: Concomitant meniscus and cartilage injuries were prognostic factors for worse long-term PROMs after ACLR. The certainty was very low for other prognostic factors. J Orthop Sports Phys Ther 2020;50(9):490-502. Epub 1 Aug 2020. doi:10.2519/jospt.2020.9451.
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| 33. |
- Powell, H. C., et al.
(författare)
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Individuals post achilles tendon rupture exhibit asymmetrical knee and ankle kinetics and loading rates during a drop countermovement jump
- 2018
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 48:1, s. 34-43
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional laboratory study. BACKGROUND: Asymmetrical knee loading during jogging and hopping has been reported in individuals who have ruptured their Achilles tendon. No studies have examined knee loads in individuals post Achilles tendon rupture during high-demand tasks, such as single-limb landings. OBJECTIVES: We sought to determine whether individuals post Achilles tendon rupture demonstrated asymmetrical knee loads and impact forces during drop countermovement jumps (CMJs). METHODS: Achilles tendon length and the single-leg heel-rise test for endurance were assessed in 34 individuals (31 male) 6.1 ± 2.0 years post Achilles tendon rupture. Movement patterns were assessed during a drop CMJ. Data were analyzed via repeated-measures analyses of variance, with comparisons between limbs and prior treatment history (surgery versus nonsurgery). RESULTS: An 8.6% longer Achilles tendon (P<.001) was found in the involved limb. During the single-leg heel-rise test, the involved limb demonstrated 22.4% less endurance and 14.6% lower heel-rise height (all, P<.001). During the landing phase of the drop CMJ, the involved limb exhibited 39.6% greater loading rate (P<.001), 16.8% greater eccentric knee power (P = .048), but 21.6% lower eccentric ankle power (P<.001). During the take-off phase, the involved limb exhibited 12.1% lower jump height and 19.9% lower concentric ankle power (both, P<.001). CONCLUSION: Elevated eccentric knee joint power and higher loading rates during a drop CMJ in individuals who experienced Achilles tendon rupture several years earlier may be a compensation pattern for reduced plantar flexor function. This movement pattern may place individuals who have had an Achilles tendon rupture at greater risk for knee injuries. © 2018 Journal of Orthopaedic & Sports Physical Therapy®.
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| 34. |
- Risberg, May Arna, et al.
(författare)
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Arthroscopic surgical procedures versus sham surgery for patients with femoroacetabular impingement and/or labral tears : Study protocol for a randomized controlled trial (HIPARTI) and a prospective cohort study (HARP)
- 2018
-
Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 48:4, s. 325-335
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Study protocol for a randomized controlled trial and a prospective cohort. BACKGROUND: The number of arthroscopic surgical procedures for patients with femoroacetabular impingement syndrome (FAIS) has significantly increased worldwide, but high-quality evidence of the effect of such interventions is lacking. OBJECTIVES: The primary objective will be to determine the efficacy of hip arthroscopic procedures compared to sham surgery on patient-reported outcomes for patients with FAIS (HIP ARThroscopy International [HIPARTI] Study). The secondary objective will be to evaluate prognostic factors for long-term outcome after arthroscopic surgical interventions in patients with FAIS (Hip ARthroscopy Prospective [HARP] Study). METHODS: The HIPARTI Study will include 140 patients and the HARP Study will include 100 patients. The international Hip Outcome Tool-33 will be the primary outcome measure at 1 year. Secondary outcome measures will be the Hip disability and Osteoarthritis Outcome Score, Arthritis Self-Efficacy Scale, fear of movement (Tampa Scale of Kinesiophobia), Patient-Specific Functional Scale, global rating of change score, and expectations. Other outcomes will include active hip range of motion, hip muscle strength tests, functional performance tests, as well as radiological assessments using radiographs and magnetic resonance imaging. CONCLUSION: To determine the true effect of surgery, beyond that of placebo, double-blinded placebo-controlled trials including sham surgery are needed. The HIPARTI Study will direct future evidence-based treatment of FAIS. Predictors for long-term development and progression of degenrative changes in the hip are also needed for this young patient group with FAIS; hence, responders and nonresponders to treatment could be determined.
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| 35. |
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| 36. |
- Sandlund, Jonas, et al.
(författare)
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Classification accuracy of motor control tests of the lumbar spine for subgroups of mechanical low back pain
- 2012
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 42:10, s. A57-A57
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the classification accuracy of motor control testsof the lumbar spine in discriminating 5 subgroups of peripherally mediated mechanical low back pain (LBP) suggested in the classification system developed by Peter O’Sullivan.RELEVANCE: Identifying clinically relevant subgroups is considered a prioritized area of LBP research. The current study addresses the issue of using accurate, reliable, and standardized tests to guide such classifications.METHODS: Seventy subjects with nonspecific LBP were classified by anexpert clinician into 5 subgroups based on the direction of motor control impairment and the assumed mechanism underlying the pain disorder (ie, flexion, lateral shift, active extension, passive extension, andmultidirectional pattern). Thereafter, 5 standardized tests of motor control were performed under the supervision of 2 therapists blinded tothe subgroup classification: “waiters bow,” bilateral and unilateral sitting knee extension, and bilateral and unilateral prone knee flexion. Alack of ability to prevent a compensatory movement (motion give) when instructed to maintain neutral lumbar posture was judged as test failure. Multinomial logistic regression was used to analyze the association between tests and subgroups and to determine the tests’ joint classification accuracy.RESULTS: The motor control tests showed significant associations to thedifferent subgroups (χ2 = 37.08, P = .002, Nagelkerke pseudo R2 = 0.431)and displayed significant discriminative ability, increasing the classification accuracy substantially, 95% above chance level overall, and for allsubgroups except for the multidirectional pattern. The different subgroups were characterized by different association patterns, indicating different tests to be important for different subgroups.CONCLUSIONS AND CLINICAL IMPLICATIONS: The results indicate a clinical utility of the motor control tests and suggest them to be useful to supplement in subgroup classification of what traditionally have been considered nonspecific mechanical LBP. The findings also support the clinical validity of the approach to subgroup patients according to the direction of motorcontrol impairment.
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| 37. |
- Schwank, Ariane, et al.
(författare)
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2022 Bern Consensus Statement on shoulder injury prevention, rehabilitation, and return to sport for athletes at all participation levels
- 2022
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 52:1, s. 11-28
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Tidskriftsartikel (refereegranskat)abstract
- SYNOPSIS: There is an absence of high-quality evidence to support rehabilitation and return-to-sport decisions following shoulder injuries in athletes. The Athlete Shoulder Consensus Group was convened to lead a consensus process that aimed to produce best-practice guidance for clinicians, athletes, and coaches for managing shoulder injuries in sport. We developed the consensus via a 2-round Delphi process (involving more than 40 content and methods experts) and an in-person meeting. This consensus statement provides guidance with respect to load and risk management, supporting athlete shoulder rehabilitation, and decision making during the return-to-sport process. This statement is designed to offer clinicians the flexibility to apply principle-based approaches to managing the return-to-sport process within a variety of sporting backgrounds. The principles and consensus of experts working across multiple sports may provide a template for developing additional sport-specific guidance in the future. J Orthop Sports Phys Ther 2022;52(1):11-28. doi:10.2519/jospt.2022.10952.
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| 38. |
- Scott, Alex, et al.
(författare)
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Tendinopathy : Update on Pathophysiology
- 2015
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 45:11, s. 833-841
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Tidskriftsartikel (refereegranskat)abstract
- Tendinopathy has become the accepted term to describe a spectrum of changes that occur in-damaged and/or diseased tendons. Over the past 2 decades, there have been new insights into tendon pathophysiology of relevance to clinicians, including (1) better characterization of the overuse injury process and the resultant structural and functional disruption in chronically painful tendons, (2) improved understanding of the pathomechanics associated with chronic tendon injury, and (3) greater knowledge about the influence of lifestyle factors and drugs on tendon pathology. The implications of these new insights are discussed.
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| 39. |
- SKOU, SØREN T., et al.
(författare)
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Benefits and Harms of Interventions With Surgery Compared to Interventions Without Surgery for Musculoskeletal Conditions : A Systematic Review With Meta-analysis
- 2022
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 52:6, s. 312-344
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To estimate the benefits and harms of interventions with and without surgery for musculoskeletal (MSK) conditions. DESIGN: Intervention systematic review with meta-analysis of randomized controlled trials (RCTs). LITERATURE SEARCH: MEDLINE, EMBASE, CINAHL, Web of Science, and CENTRAL, all up to January 7, 2021. STUDY SELECTION CRITERIA: RCTs (English, German, Danish, Swedish, and Norwegian) of interventions with and without surgery conducted in any setting for any non-fracture MSK condition in adults (mean age: 18+ years) evaluating the outcomes on a continuous (benefits) or count (harms) scale. Outcomes were pain, self-reported physical function, quality of life, serious adverse events (SAEs), and death at 1 year. DATA SYNTHESIS: Random-effects metaanalyses for MSK conditions where there were data from at least 2 trials. RESULTS: One hundred RCTs (n = 12 645 patients) across 28 different conditions at 9 body sites were included. For 9 out of 13 conditions with data on pain (exceptions include some spine conditions), 11 out of 11 for function, and 9 out of 9 for quality of life, there were no clinically relevant differences (standardized mean difference of 0.50 or above) between interventions with and without surgery. For 13 out of 16 conditions with data on SAEs and 16 out of 16 for death, there were no differences in harms. Only 6 trials were at low risk of bias. CONCLUSION: The low certainty of evidence does not support recommending surgery over nonsurgical alternatives for most MSK conditions with available RCTs. Further high-quality RCTs may change this conclusion.
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| 40. |
- Van Bogaert, Wouter, et al.
(författare)
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Influence of Preoperative Pain, Cognitions, and Quantitative Sensory Testing Measures on the Effects of Perioperative Pain Neuroscience Education for People Receiving Surgery for of a Randomized Controlled Trial
- 2024
-
Ingår i: JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY. - 0190-6011 .- 1938-1344. ; 54:4, s. 279-288
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the established effectiveness of perioperative pain neuroscience education (PPNE) on health-related quality of life at 1 year after surgery for lumbar radiculopathy. DESIGN: Secondary analysis of a triple-blinded randomized controlled trial. METHODS: Participants (n = 90) were Dutch-speaking adults (18-65 years) who were scheduled for surgery for lumbar radiculopathy in 3 Belgian hospitals. They were randomized (1:1) to receive PPNE (n = 41) or perioperative biomedical education (n = 49). Linear mixed models were built for health-related quality of life (ie, SF-6D utility values, Physical and Mental Component of the 36-item Short Form Health Survey) using the following independent variables: therapy, time, and preoperative scores for back and leg pain intensity, pain catastrophizing, kinesiophobia, hypervigilance, and quantitative sensory measures. RESULTS: The impact of PPNE on SF-6D utility values over time was influenced by kinesiophobia (F = 3.30, P = .02) and leg pain intensity (F = 3.48, P = .02). Regardless of the intervention, back pain intensity negatively influenced SF-6D values over time (F = 3.99, P = .009). The Physical Component scores were negatively impacted by back pain intensity (F = 9.08, P = .003) and were influenced over time by leg pain intensity (F = 2.87, P = .04). The Mental Component scores were negatively impacted by back pain intensity (F = 6.64, P = .01) and pain catastrophizing (F = 5.42, P = .02), as well as hypervigilance (F = 3.16, P = .03) and leg pain intensity (F = 3.12, P = .03) over time. CONCLUSION: PPNE may be more effective than perioperative biomedical education in improving postoperative health utility values in patients who reported higher kinesiophobia and leg pain intensity before surgery for lumbar radiculopathy.
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| 41. |
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| 42. |
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| 43. |
- Österberg, Annika, et al.
(författare)
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Ways of experiencing participation and factors affecting the activity level after nonreconstructed anterior cruciate ligament injury : a qualitative study
- 2013
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 43:3, s. 172-183
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Phenomenographic, cross-sectional. OBJECTIVES: To describe ways of experiencing participation in activities of individuals with a nonreconstructed anterior cruciate ligament injury and to describe the emotional aspects related to participation. Further, the objective was to explore factors affecting the activity level. BACKGROUND: The importance of assessing different factors (knee status, muscle performance, psychological factors, performance-based tests, and subjective rating of knee function) after an anterior cruciate ligament injury has been emphasized. However, the results of these assessments do not answer the question of how the individuals themselves experience their participation in activities. METHODS: Semi-structured interviews were conducted with 19 strategically selected informants (age range, 18-43 years) who had sustained an anterior cruciate ligament injury 18 to 67 months previously. A phenomenographic approach, which describes individuals' ways of experiencing a phenomenon, was used. RESULTS: Five qualitatively different categories were identified: (A) unconditioned participation, (B) participation as conditioned by risk appraisal, (C) participation as conditioned by experienced control of the knee, (D) participation as conditioned by experienced knee impairment, and (E) participation as conditioned by neglecting the knee injury. Within each category, 5 interrelated aspects were discerned: focus, level of performance, activities, strategies, and feelings. Categories A, C, and E reflected experiences of full participation, whereas categories B and D reflected experiences of modified participation. There were mostly positive feelings regarding participation. Negative feelings were expressed in category D. Factors affecting the activity level were grouped according to the framework of the International Classification of Functioning, Disability and Health and described as facilitating or hindering the activity level. Facilitating factors included regaining and maintaining physical function, regaining confidence in knee function, and learning/relearning movement patterns. Hindering factors included fear of injury/reinjury, uncontrollable giving way, and loss of motivation. CONCLUSION: With different strategies, most of the informants achieved a satisfactory activity level, despite impairments and decreased activity level. Both physical and psychological factors were described to affect the activity level, as well as time since injury.
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| 44. |
- Ageberg, Eva, et al.
(författare)
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Influence of supervised and nonsupervised training on postural control after an acute anterior cruciate ligament rupture: a three-year longitudinal prospective study
- 2001
-
Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011. ; 31:11, s. 632-644
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Prospective randomized longitudinal clinical trial with matched controls. OBJECTIVES: To investigate the long-term effect of training on postural control and extremity function after an acute anterior cruciate ligament (ACL) injury. BACKGROUND: ACL injuries may cause severe problems with recurrent giving way of the knee and reduced functional capacity. The effect of an acute ACL injury and the effect of various training programs on postural control, as well as the relation between postural control and extremity function after such an injury, have not been studied longitudinally. METHODS: Sixty-three consecutive patients, 35 men and 28 women (median age 24 years, quartiles 19-33 years), with an acute nonoperated ACL injury, randomized to neuromuscular supervised or self-monitored training, were examined with stabilometry (amplitude and average speed of center of pressure movements) and a one-leg hop test for distance after 6 weeks (stabilometry only), and after 3, 12, and 36 months, and were compared to a control group. RESULTS: Regardless of treatment, center of pressure amplitude was persistently higher in both the injured and uninjured legs during the 3-year follow-up, but average speed was less affected or unaffected compared to the control group. The one-leg hop had normalized in the neuromuscular group at the 12-month follow-up, but was shorter in both legs throughout the 3-year period in the self-monitored group. The median value (quartiles) for injured/uninjured legs at 3 months was 150 cm (120-174 cm)/177 cm (140-199 cm), at 12 months was 174 cm (140-200 cm)/180 cm (150-202 cm), and at 36 months was 172 cm (146-200 cm)/178 cm (150-200 cm) in the self-monitored group, compared to the control group (median 186 cm, quartiles 177-216 cm). CONCLUSIONS: The higher center of pressure amplitude in both legs over the 3-year period indicate persistently impaired postural control in single-limb stance. However, functional performance, as measured with the one-leg hop test, was restored by neuromuscular training, but not by self-monitored training.
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| 45. |
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| 46. |
- Ardern, C. L., et al.
(författare)
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2018 International Olympic Committee consensus statement
- 2019
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Elsevier BV. - 0190-6011. ; 35:2, s. 98-122
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Tidskriftsartikel (refereegranskat)abstract
- - In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. © 2019
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| 47. |
- Desai, Pia, et al.
(författare)
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Recreational Runners With a History of Injury Are Twice as Likely to Sustain a Running-Related Injury as Runners With No History of Injury: A 1-Year Prospective Cohort Study
- 2021
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011. ; 51:3, s. 144-150
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Tidskriftsartikel (refereegranskat)abstract
- To investigate (1) the cumulative incidence proportion and the most common anatomical locations of running-related injuries in recreational runners, and (2) the associations between running-related injuries and previous injury, running experience, weekly running distance, age, gender and body mass index (BMI).A one-year prospective cohort study.224 recreational runners (average of 15km weekly running distance for the past 12 months) were included (89 women, 135 men). Pain information was reported weekly for one year and all running-related injuries with time-loss or requiring medical consultation were recorded. We accounted for censoring when calculating cumulative incidence proportion, and used crude Cox proportional hazards regression to evaluate if the variables of interest were associated with running-related injuries.The one-year cumulative incidence proportion of running-related injuries was 46% (95% CI: 38.4-54.1). The most common anatomical locations were the knee (20 of 75, 27%) and Achilles tendon/calf (19 of 75, 25%). Previous injury was associated with a higher injury rate (hazard ratio: 1.9, 95% CI: 1.2-3.2), while the other variables had no statistically significant association with injury.There were 75 running-related injuries during the one-year surveillance period for a cumulative incidence proportion of 46%. The most common injuries were to the knee and Achilles tendon/calf. Recreational runners with a previous injury were twice as likely to sustain a running-related injury than runners with no previous injury.
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| 48. |
- Friden, T, et al.
(författare)
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Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture
- 2001
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - 0190-6011. ; 31:10, s. 567-576
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Tidskriftsartikel (refereegranskat)abstract
- Several tests of human conscious knee proprioception have been described, but there is no consensus or reference standard established. Difficulties remain in the separation of information originating from muscles, tendons, and joints, and the tests cannot discriminate between loss of afferent signals or altered activity in the remaining receptors. There is convincing evidence from several descriptive studies that the afferent information is altered after a knee ligament injury and severely disturbed in some patients with anterior cruciate ligament (ACL) injuries. However, an inherent inferior proprioceptive ability may also exist in some individuals, which makes them vulnerable to injuries. The deficits in proprioception have mostly been studied and related to the consciously registered sense, whereas the extent of possible disturbances of the unconscious or reflectory mechanisms is largely unknown. The latter may, at least from a theoretical point of view, be predominantly contributing to the overall afferent regulation, and a possibility for major defects thus exists, since there is no knowledge of the quantified relation between the conscious and unconscious part. The clinical importance of the altered afferent information has not been evaluated properly, and the role of proprioception that contributes to function has yet to be investigated. A higher physiological sensitivity to detecting a passive joint motion closer to full extension has been found both experimentally and clinically, which may protect the joint due to the close proximity to the limit of joint motion. Proprioception has been found to have a relation to subjective knee function, and patients with symptomatic ACL deficiency seem to have larger deficits than asymptomatic individuals. Little is known about whether training can restore defects in sensory information or by which mechanisms possible compensatory pathways are established. In rehabilitation, each patient must, however, create muscle strength, alertness, and stiffness in harmony with the disturbed mechanics of the knee, which are present both after nonoperative treatment of the ACL and after a reconstruction of the ACL.
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| 49. |
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| 50. |
- Piussi, Ramana, 1988, et al.
(författare)
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Better safe than sorry? A systematic review and meta-analysis on time to return to sport after ACL reconstruction as a risk factor for second ACL injury.
- 2024
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Ingår i: The Journal of orthopaedic and sports physical therapy. - 1938-1344. ; 54:3, s. 161-175
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the timing of Return to Sports (RTS) as a potential risk factor for a second anterior cruciate ligament (ACL) injury after ACL reconstruction. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: The Cochrane Library, EMbase, MEDLINE, AMED and PEDro databases were searched in August 2021 and November 2022. STUDY SELECTION CRITERIA: Clinical studies published in English in peer-reviewed journals, that reported time to RTS after ACL reconstruction and occurrence of second ACL injury were eligible. DATA SYNTHESIS: We pooled continuous data with random-effects meta-analyses, and pooled estimates were summarised in forest plots. A qualitative data synthesis was performed for data not included in meta-analysis. RESULTS: Twenty-one studies were included in the meta-analysis and 33 were included in the qualitative synthesis. Pooled incidence of a second ACL injury was 16.9% (95% Confidence Interval [CI] 12.8-21.6). Patients who suffered a second ACL injury returned to sport significantly earlier (0.77 months [95% CI 0.26-1.28]). CONCLUSION: Time to RTS was a risk factor for a second ACL injury, where patients who suffered a second ACL injury returned to sport almost one month earlier compared with patients who did not suffer a second ACL injury: 9.1 compared with 8.7 months. There was no difference in time to RTS between professional athletes who suffered a second ACL injury and athletes who did not. The certainty of evidence in the results was graded as "very low".
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