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- Meredith, S. J., et al.
(författare)
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Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group
- 2020
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Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 28, s. 2403-2414
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Tidskriftsartikel (refereegranskat)abstract
- Purpose A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS and description of the RTS continuum, as well as to provide clinical guidance on RTS testing and decision-making. Methods An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results Key points include that RTS is characterized by achievement of the pre-injury level of sport and involves a criteria-based progression from return to participation to return to sport, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along a RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries. Conclusion The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biologic assessment of healing and recovery.
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3. |
- Meredith, S. J., et al.
(författare)
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Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group
- 2021
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Ingår i: Journal of Isakos Joint Disorders & Orthopaedic Sports Medicine. - : Elsevier BV. - 2059-7754. ; 6:3, s. 138-146
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Tidskriftsartikel (refereegranskat)abstract
- Objectives A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS after ACL injury and description of the RTS continuum, as well as provide clinical guidance on RTS testing and decision-making. Methods An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results Key points include that RTS is characterised by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries. Conclusion The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biological assessment of healing and recovery.
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4. |
- Pitkänen, Timo, 1979-, et al.
(författare)
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Statistical Survey of Magnetic Forces Associated With Earthward Bursty Bulk Flows Measured by MMS 2017-2021
- 2023
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Ingår i: Journal of Geophysical Research - Space Physics. - : American Geophysical Union (AGU). - 2169-9380 .- 2169-9402. ; 128:5
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the magnetic forces (the magnetic pressure gradient force, the curvature force, and their sum the j x B-force) associated with earthward bursty bulk flows (BBFs) using Magnetospheric Multiscale (MMS) data from five tail seasons (2017-2021). For the first time, the magnetic forces are inferred downtail of XGSM = -20 R-E and in the GSM XY and YZ planes. The results suggest that BBFs tend to be accelerated earthward by the magnetic pressure gradient force tailward of similar to 19 R-E and decelerated closer to that distance in the 2017-2018 data. The force magnitudes increase with distance. This is in accordance with earlier Cluster results. In the 2019-2021 data, the pressure gradient force magnitudes are generally smaller and no clear distance for the acceleration reversal can be determined. The curvature forces for both 2017-2018 and 2019-2021 BBFs indicate earthward acceleration independent of distance, consistent with the Cluster measurements. The sum, the j x B-force, suggests for the 2017-2018 BBFs earthward acceleration tailward of XGSM similar to 15 R-E and deceleration within that distance, also consistent with Cluster. In contrast, the 2019-2021 BBFs show general earthward acceleration by j x B independent of distance. In the GSM XY plane, the average (j x B)(xy) vectors are earthward, and in the premidnight and postmidnight dawnward for the 2017-2018 BBFs. For 2019-2021, the average (j x B)(xy) vectors have components toward the tail center. In the GSM YZ plane, the average (j x B)(yz) vectors are toward the neutral sheet.
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- Xiao, Y.C., et al.
(författare)
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Statistical properties of the distribution and generation of kinetic-scale flux ropes in the terrestrial dayside magnetosheath
- 2023
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Ingår i: Geophysical Research Letters. - : American Geophysical Union (AGU). - 0094-8276 .- 1944-8007. ; 50:23
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Tidskriftsartikel (refereegranskat)abstract
- The generation of kinetic-scale flux ropes (KSFRs) is closely related to magnetic reconnection. Both flux ropes and reconnection sites are detected in the magnetosheath and can impact the dynamics upstream of the magnetopause. In this study, using the Magnetospheric Multiscale satellite, 12,623 KSFRs with a scale <20 RCi are statistically studied in the Earth's dayside magnetosheath. It is found that they are mostly generated near the bow shock (BS), and propagate downstream in the magnetosheath. Their quantity significantly increases as the scale decreases, consistent with a flux rope coalescence model. Moreover, the solar wind parameters can control the occurrence rate of KSFRs. They are more easily generated at high Mach number, large proton density, and weak magnetic field strength of the solar wind, similar to the conditions that favor BS reconnection. Our study shows a close connection between KSFR generation and BS reconnection.
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- Yao, S. T., et al.
(författare)
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Propagating and Dynamic Properties of Magnetic Dips in the Dayside Magnetosheath : MMS Observations
- 2020
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Ingår i: Journal of Geophysical Research - Space Physics. - : American Geophysical Union (AGU). - 2169-9380 .- 2169-9402. ; 125:6
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Tidskriftsartikel (refereegranskat)abstract
- The magnetosheath is inherently complex and rich, exhibiting various kinds of structures and perturbations. It is important to understand how these structures propagate and evolve and how they relate to the perturbations. Here we investigate a kind of magnetosheath structure known as a magnetic dip (MD). As far as we are aware, there have been no previous studies concerning the evolution (contracting or expanding) of these types of structures, and their propagation properties cannot be unambiguously determined. In this study, using Magnetospheric MultiScale (MMS) high-temporal resolution data and multispacecraft analysis methods, we obtain the propagation and dynamic features of a set of MDs. Four different types of MDs are identified: "frozen-in," "expanding," "contracting," and "stable-propagating." Significantly, a stable-propagation event is observed with a sunward propagation component. This indicates that the source of the structure in this case is closely associated with the magnetopause, which provides strong support to the contention in earlier research. We further reveal the mechanism leading to the MD contraction or expansion. The motion of the MDs boundary is found closely related with the dynamic pressure. The scale of the contracting and expanding events are typically similar to 5-20 rho(i) (ion gyroradius), significantly smaller than that of frozen-in events (similar to 40 rho(i)). The observations could relate large-scale (more than several tens of rho(i)) and kinetic-scale (less than rho(i)) MDs, by revealing an evolution that spans these different scales, and help us better understand the variation and dynamics of magnetosheath structures and plasmas.
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- Chong, Ghai Siung, et al.
(författare)
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Tailward Flows in the Vicinity of Fast Earthward Flows
- 2021
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Ingår i: Journal of Geophysical Research - Space Physics. - : Blackwell Publishing. - 2169-9380 .- 2169-9402. ; 126:4
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of tailward flows in the magnetotail plasma sheet is closely linked to the dynamics of earthward bursty bulk flows (BBFs). Tailward flows that are observed in the vicinity of these BBFs (or TWABs – Tailward flows around BBFs) may hold unique information on its origin. In this study, we conduct a statistical survey on TWABs by using data from the Cluster mission. We find that TWABs are observed in the vicinity of ∼75% of the BBFs and their occurrence does not depend on BBF velocity magnitude. TWABs have a flow convection pattern consistent with the general tailward flows (GTWs) in the plasma sheet and they do not resemble vortical-like flows. However, TWABs have a flow velocity magnitude twice larger than the GTWs. The plasma density and temperature of TWABs are comparable with BBFs. It is more common to observe a TWAB succeeding than preceding a BBF. However, there is no distinctive difference (in flow pattern, plasma density and temperature) between preceding and succeeding TWABs. We suggest that TWABs are likely the “freshly” rebounded BBFs from the near-Earth region where the magnetic field is stronger. TWABs may represent the early stage of the evolution of tailward flows in the plasma sheet. We also discuss and argue that other mechanisms such as shear-induced vortical flows and tailward slipping of depleted flux tubes cannot be the principal causes of TWABs.
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8. |
- Diermeier, T. A., et al.
(författare)
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Treatment after ACL injury: Panther Symposium ACL Treatment Consensus Group
- 2021
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 55:1, s. 14-22
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Tidskriftsartikel (refereegranskat)abstract
- Treatment strategies for ACL injuries continue to evolve. Evidence supporting best practice guidelines to manage ACL injury is largely based on studies with low-level evidence. An international consensus group of experts was convened determine consensus regarding best available evidence on operative versus non-operative treatment for ACL injury. The purpose of this study is to report the consensus statements on operative versus non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organising Committee and Session Chairs. Panel participants reviewed preliminary statements prior to the meeting and provided initial agreement and comments on the statement via online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty per cent agreement was defined a priori as consensus. A total of 11 of 13 statements on operative versus non-operative treatment of ACL injury reached consensus during the Symposium. Nine statements achieved unanimous support, two reached strong consensus, one did not achieve consensus, and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting and pivoting sports, early anatomical ACL reconstruction is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomical ACL reconstruction is indicated. The consensus statements derived from international leaders in the field may assist clinicians in deciding between operative and non-operative treatment with patients after an ACL injury.
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9. |
- Diermeier, T., et al.
(författare)
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Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group
- 2020
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 28, s. 2390-2402
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Tidskriftsartikel (refereegranskat)abstract
- Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance toward consensus opinions regarding the best available evidence on operative vs. non-operative treatment for ACL injury. The purpose of this study is to report the consensus statements on operative vs. non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, were convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organizing Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided the initial agreement and comments on the statement via an online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty percent agreement was defined a-priori as consensus. A total of 11 of 13 statements on operative v. non-operative treatment of ACL injury reached the consensus during the Symposium. Nine statements achieved unanimous support, two reached strong consensus, one did not achieve consensus, and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting, and pivoting sports, early anatomic ACL reconstruction is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability, or when episodes of giving way occur, anatomic ACL reconstruction is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatments with patients after an ACL injury. Level of evidence V. © 2020, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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10. |
- Diermeier, T., et al.
(författare)
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Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group
- 2021
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Ingår i: Journal of Isakos Joint Disorders & Orthopaedic Sports Medicine. - : Elsevier BV. - 2059-7754. ; 6:3, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance towards consensus opinions regarding the best available evidence on operative versus non-operative treatment for ACL injury. The purpose of this study was to report the consensus statements on operative versus non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organising Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided initial agreement and comments on the statement via online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty per cent agreement was defined a priori as consensus. A total of 11 of 13 statements on operative veresus non-operative treatment of ACL injury reached consensus during the symposium. Nine statements achieved unanimous support; two reached strong consensus; one did not achieve consensus; and one was removed due to redundancy in the information provided. In highly active patients engaged in jumping, cutting and pivoting sports, early anatomical anterior cruciate ligament reconstruction (ACLR) is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability or when episodes of giving way occur, anatomical ACLR is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatment with patients after an ACL injury. Level of evidence: V
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