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Nae JÄ, Cronström A. Association between sensorimotor function and visual assessment of postural orientation in patients with ACL injury. Phys Ther Sport 2022; 55:160-167. [DOI: 10.1016/j.ptsp.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
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Strong A, Arumugam A, Tengman E, Röijezon U, Häger CK. Properties of tests for knee joint threshold to detect passive motion following anterior cruciate ligament injury: a systematic review and meta-analysis. J Orthop Surg Res 2022; 17:134. [PMID: 35246192 PMCID: PMC8895768 DOI: 10.1186/s13018-022-03033-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Threshold to detect passive motion (TTDPM) tests of the knee joint are commonly implemented among individuals with anterior cruciate ligament (ACL) injury to assess proprioceptive acuity. Their psychometric properties (PMPs), i.e. reliability, validity and responsiveness, are however unclear. This systematic review aimed to establish the PMPs of existing knee joint TTDPM tests among individuals with ACL injury. METHODS The databases PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, CENTRAL and ProQuest were searched to identify studies that assessed the properties of knee joint TTDPM tests in individuals with ACL injury. The risk of bias for each included study was assessed at the outcome level for each test. Overall quality and levels of evidence for each property were rated according to established criteria. Meta-analyses with mean differences were conducted using random-effects models when adequate data were available. RESULTS Fifty-one studies covering 108 TTDPM tests and 1632 individuals with unilateral ACL injury were included. A moderate-to-strong level of evidence indicated insufficient quality for all of the following: convergent validity, known-groups validity, discriminative validity, responsiveness between subgroups, and responsiveness to intervention. Subgroup meta-analyses for known-groups validity did however find that a starting angle of 15° resulted in significantly worse TTDPM for knees with ACL injury compared to those of asymptomatic persons (mean difference 0.28°; 95% CI 0.03 to 0.53; P = 0.03), albeit based on only three studies. Due to the lack of evidence, it was not possible to estimate the quality of reliability, measurement error, and criterion validity, nor responsiveness from a criterion and construct approach. CONCLUSIONS Among persons with ACL injury, existing tests of knee joint TTDPM lack either sufficient quality or evidence for their reliability, validity and responsiveness. Significantly worse thresholds for ACL-injured knees compared to those of asymptomatic controls from a 15° starting angle and trends towards significance for some validity measures nevertheless encourage the development of standardised tests. Further research investigating the influence of modifiable test components (e.g. starting angle and motion direction) on the PMPs of knee joint TTDPM tests following ACL injury is warranted.
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Affiliation(s)
- Andrew Strong
- Department of Community Medicine and Rehabilitation, Physiotherapy Section, Umeå University, Umeå, Sweden.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Eva Tengman
- Department of Community Medicine and Rehabilitation, Physiotherapy Section, Umeå University, Umeå, Sweden
| | - Ulrik Röijezon
- Department of Health, Learning and Technology, Physiotherapy Section, Luleå University of Technology, Luleå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy Section, Umeå University, Umeå, Sweden
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Keller M, Diemer F, Kurz E. [Judging movement quality in patients who sustained a knee ligament injury: a systematic review]. SPORTVERLETZUNG-SPORTSCHADEN 2022; 36:38-48. [PMID: 34983071 DOI: 10.1055/a-1551-4388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Knee joint injury statistics are dominated by ruptures of the capsular ligament structures. Post-traumatic deficits in dynamic movement patterns are assessed quantitatively as well as qualitatively. The aim of this review was to compile tools that are used to assess the quality of movement after knee ligament injuries in adults. METHODS A systematic search for original papers was carried out in the following primary sources: Ovid, PubMed, Scopus and Web of Science. Both conservative and surgical treatment options were considered. PROSPERO registration of the study protocol: CRD42020175359. RESULTS A total of 1153 papers were identified. Eleven original papers from four different working groups were included in this work. All papers assessed the quality of movement in adults after anterior cruciate ligament (ACL) injury. A total of 348 (70 deficient, 278 reconstructed) patients after an ACL injury and 119 adults with an intact ACL were examined in the studies included. CONCLUSION It is possible to assess movement quality after a knee ligament injury with a low temporal and technical effort. The changes recorded result in a functional valgus, which, based on the study results, may be further differentiated into isolated knee valgus, medial collapse or postural collapse.
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Affiliation(s)
| | - Frank Diemer
- DIGOTOR GbR, Fortbildungen für Orthopädische Medizin und Manuelle Therapie, Brackenheim, Germany
| | - Eduard Kurz
- OSINSTITUT ortho & sport, München, Germany.,Universitätsklinikum Halle, Halle (Saale), Germany
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Lucas K, Todd P, Ness BM. A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System. Int J Sports Phys Ther 2021; 17:74-80. [PMID: 35024207 PMCID: PMC8720252 DOI: 10.26603/001c.29454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Postoperative management of anterior cruciate ligament (ACL) reconstruction has traditionally focused on the evaluation and intervention of musculoskeletal components such as range of motion and patients' reports of function. The integumentary system can provide early indications that rehabilitation may be prolonged due to protracted or poor healing of the incision sites. Full evaluation of the reconstruction over time, including direction of the incisions, appearance of surgical sites, level of residual innervation, and health of the individual should be considered when determining time-based goals and plans for returning an athlete to activity. Skin care techniques should be used to minimize strain and promote wound healing at the surgical sites, which in turn allows for implementation of other interventions that target other body systems such as locomotion, strength training, and cardiopulmonary conditioning. The integration of the integumentary system with cardiovascular, neurological, and muscular systems is required for a successful return to activity. A multi-physiologic systems approach may provide a unique viewpoint when aiming to attain a greater appreciation of the integumentary system and its integration with other body systems following ACL reconstruction. The purpose of this clinical commentary is to discuss integumentary considerations within a multi-physiologic systems approach to human movement after ACL reconstruction, including an anatomical review, key elements of assessment, and integrated intervention strategies. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Kathryn Lucas
- Kosair Charities Center for Pediatric NeuroRecovery, University of Louisville; Kentucky Spinal Cord Injury Research Center; Department of Neurological Surgery, University of Louisville
| | - Patricia Todd
- Department of Pediatrics, University of Louisville School of Medicine, Norton Children's Pediatric Dermatology
| | - Brandon M Ness
- Doctor of Physical Therapy Program, Tufts University School of Medicine
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Nae J, Creaby MW, Cronström A, Ageberg E. Sex differences in postural orientation errors and association with objective and patient-reported function in patients with ACL injury: an exploratory cross-sectional study. BMJ Open Sport Exerc Med 2021; 7:e001045. [PMID: 34079620 PMCID: PMC8137201 DOI: 10.1136/bmjsem-2021-001045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives There is limited research on sex differences in postural orientation (ie, alignment between body segments) in people with knee injury measured with a clinically applicable method. An understanding of the relationship between postural orientation and physical function may help guide decision making in rehabilitation. The aims were to evaluate (1) sex differences in visual assessment of Postural Orientation Errors (POEs) and (2) the association between POEs and objective and patient-reported physical function, in men and women with anterior cruciate ligament reconstruction (ACLR). Methods Twenty-four women and 29 men (mean 26.7 (SD 6.5) years) with ACLR were included. Six POEs (lower extremity and trunk) were scored from a video of five tasks with varying difficulty to compute POE scores (total and subscores). Objective physical function was evaluated with the single-leg hop for distance and side hop. Patient-reported physical function was evaluated using patient-reported outcome measures (PROMs). Results Women had significantly more POEs than men (median difference 5.5–25, p≤0.028). More POEs were associated with shorter hop distance and fewer side hops in women (rs= −0.425 to −0.518, p<0.038), but not in men (rs<0.301, p>0.05). No associations were found between POE scores and PROMs, in either sex (rs< –0.246, p>0.05). Conclusions Women with ACLR seem to have more POEs compared with men, indicating worse postural orientation. More POEs were associated with worse hop performance, suggesting that POE scores may be used as criteria for rehabilitation progression. The lack of associations between POE scores and PROMs indicate that these measures complement each other.
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Affiliation(s)
- Jenny Nae
- Health Sciences, Lund University, Lund, Sweden
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, Queensland, Australia
| | - Anna Cronström
- Health Sciences, Lund University, Lund, Sweden.,Department of Community Medicine and Rehabilitation, Umeå Univerisity, Umeå, Sweden
| | - Eva Ageberg
- Health Sciences, Lund University, Lund, Sweden
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Neuromuscular training improves knee proprioception in athletes with a history of anterior cruciate ligament reconstruction: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2020; 80:105157. [PMID: 32871397 DOI: 10.1016/j.clinbiomech.2020.105157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/19/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Athletes exhibit deficits in knee proprioception following anterior cruciate ligament reconstruction. Neuromuscular training programs improve knee proprioception in uninjured athletes; however, the effects on knee proprioception in athletes who have undergone anterior cruciate ligament reconstruction is not well understood. The purpose of this study was to examine the effects of a neuromuscular training program on knee proprioception in athletes who have returned to sport following anterior cruciate ligament reconstruction. METHODS Twenty-four male athletes, who had undergone anterior cruciate ligament reconstruction within the previous 6-12 months and returned to sport, participated in this randomized controlled trial. Athletes were randomly allocated to an experimental group (n = 12) that took part in an 8-week neuromuscular training program or a control group (n = 12) that simply continued their typical training routine. Knee position sense was assessed at baseline and after the 8-week period (post-testing). One-way analysis of covariance, with baseline performance included as a covariate, was used to compare knee position sense errors for the reconstructed limbs of the experimental and control groups at the post-testing time point. FINDINGS Knee position sense errors decreased by 51.7% for the experimental group and only 4.4% for the control group over the 8-week period. As a result, the experimental group demonstrated lower knee position sense errors, compared to the control group, at the post-testing time point (P < .001). INTERPRETATION Athletes with a history of anterior cruciate ligament reconstruction may benefit from participation in a neuromuscular training program, even after completing post-operative rehabilitation.
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Strong A, Tengman E, Srinivasan D, Häger CK. One-leg rise performance and associated knee kinematics in ACL-deficient and ACL-reconstructed persons 23 years post-injury. BMC Musculoskelet Disord 2019; 20:476. [PMID: 31653212 PMCID: PMC6814967 DOI: 10.1186/s12891-019-2887-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research indicates reduced knee function and stability decades after anterior cruciate ligament (ACL) injury. Assessment requires reliable functional tests that discriminate such outcomes from asymptomatic knees, while providing suitable loading for different populations. The One-leg rise (OLR) test is common in clinics and research but lacks scientific evidence for its implementation. Our cross-sectional study compared performance including knee kinematics of the OLR between ACL-injured persons in the very long term to controls and between legs within these groups, and assessed the within-session reliability of the kinematics. METHODS Seventy ACL-injured individuals (mean age 46.9 ± 5.4 years) treated with either reconstructive surgery and physiotherapy (ACLR; n = 33) or physiotherapy alone (ACLPT; n = 37), on average 23 years post-injury, and 33 age- and sex-matched controls (CTRL) attempted the OLR. Participants completed as many repetitions as possible to a maximum of 50 while recorded by motion capture. We compared between all groups and between legs within groups for total repetitions and decomposed the OLR into movement phases to compare phase completion times, maximum and range of knee abduction and adduction angles, and mediolateral knee control in up to 10 repetitions per participant. RESULTS ACLPT performed significantly fewer OLR repetitions with their injured leg compared to the CTRL non-dominant leg (medians 15 and 32, respectively) and showed significantly greater knee abduction than ACLR and CTRL (average 2.56°-3.69° depending on phase and leg). Distribution of repetitions differed between groups, revealing 59% of ACLPT unable to complete more than 20 repetitions on their injured leg compared to 33% ACLR and 36% CTRL for their injured and non-dominant leg, respectively. Within-session reliability of all kinematic variables for all groups and legs was high (ICC 3,10 0.97-1.00, 95% CI 0.95-1.00, SEM 0.93-1.95°). CONCLUSIONS Negative outcomes of OLR performance, particularly among ACLPT, confirm the need to address aberrant knee function and stability even decades post-ACL injury. Knee kinematics derived from the OLR were reliable for asymptomatic and ACL-injured knees. Development of the OLR protocol and analysis methods may improve its discriminative ability in identifying reduced knee function and stability among a range of clinical populations.
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Affiliation(s)
- Andrew Strong
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187, Umeå, Sweden.
| | - Eva Tengman
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187, Umeå, Sweden
| | - Divya Srinivasan
- Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, SE-90187, Umeå, Sweden
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Cronström A. Is poor proprioception associated with worse movement quality of the knee in individuals with anterior cruciate ligament deficiency or reconstruction? J Phys Ther Sci 2018; 30:1278-1283. [PMID: 30349164 PMCID: PMC6181672 DOI: 10.1589/jpts.30.1278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/26/2018] [Indexed: 01/13/2023] Open
Abstract
[Purpose] To investigate the association between proprioception and a knee medial to
foot position during weight-bearing activities in patients with anterior cruciate ligament
reconstruction and anterior cruciate ligament deficiency. [Participants and Methods]
Thirty-eight patients with anterior cruciate ligament reconstruction and 13 patients with
anterior cruciate ligament deficiency aged 18–40 years were included. Proprioception was
assessed by knee kinesthesia measured by the threshold to detection of passive motion.
Movement quality was assessed by visual observation of the position of the knee in
relation to the foot during the mini squat, the single-leg hop for distance, and the
cross-over hop for distance. [Results] In patients with anterior cruciate ligament
deficiency, worse kinesthesia was significantly associated with a knee medial to foot
position during the single-leg hop for distance. No statistically significant associations
were observed between kinesthesia and a knee medial to foot position during the three
tasks in patients with anterior cruciate ligament reconstruction. [Conclusion] Poor
proprioception may be associated with worse movement quality of the knee in patients with
anterior cruciate ligament deficiency, but not in patients with anterior cruciate ligament
reconstruction. Differences in sensorimotor function between patients with reconstructed
and non-reconstructed anterior cruciate ligament should be considered in training and
rehabilitation regimens aiming to enhance performance and prevent further injuries in
these patients.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University: PO Box 157, SE-221 00 Lund, Sweden
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Cronström A, Creaby MW, Nae J, Ageberg E. Modifiable Factors Associated with Knee Abduction During Weight-Bearing Activities: A Systematic Review and Meta-Analysis. Sports Med 2018; 46:1647-1662. [PMID: 27048463 DOI: 10.1007/s40279-016-0519-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Increased knee abduction angle during activity is suggested to be a risk factor for sustaining an anterior cruciate ligament (ACL) injury or developing patellofemoral pain syndrome (PFPS). Knowledge of the modifiable mechanisms that are associated with increased knee abduction will aid in the appropriate design of preventive and rehabilitative strategies for these injuries. OBJECTIVE Our objective was to systematically review modifiable mechanisms contributing to increased knee abduction in healthy people and in individuals with an ACL injury or PFPS. METHODS We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the databases MEDLINE, CINAHL, and Embase until September 2015. Inclusion criteria were studies in healthy individuals and/or those with ACL injury or PFPS reporting (1) muscle strength, muscle activation, proprioception, and/or range of motion (ROM) and (2) knee abduction angle assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS In total, 33 articles were included. Reduced trunk strength, reduced gluteus maximus amplitude, decreased ankle ROM, and increased hip external rotation ROM were moderately associated with increased knee abduction angle (r -0.34 or higher, standardized difference in means (SDM) greater than -0.39, p < 0.05, articles n = 3, total sample size n = 101-114) in healthy individuals. Decreased strength of hip abductors, external rotators, and extensors and knee flexors were at most weakly associated with increased knee abduction angle (r ≤ 0.21, p = 0.013-0.426, articles n = 2-9, total sample size n = 80-311). Too few articles included patients with knee injury to be included in any meta-analysis. CONCLUSION The associations identified in this review indicate that investigation of strengthening of the trunk muscles, and improvement of gluteus maximus activation and ankle ROM to change knee kinematics is merited. Studies on modifiable factors associated with increased knee abduction angle in people with knee injury are needed.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, QLD, Australia
| | - Jenny Nae
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
| | - Eva Ageberg
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
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Wikstrom EA, Song K, Pietrosimone BG, Blackburn JT, Padua DA. Visual Utilization During Postural Control in Anterior Cruciate Ligament- Deficient and -Reconstructed Patients: Systematic Reviews and Meta-Analyses. Arch Phys Med Rehabil 2017; 98:2052-2065. [PMID: 28483655 DOI: 10.1016/j.apmr.2017.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine whether anterior cruciate ligament-deficient (ACL-D) individuals and individuals with a reconstructed anterior cruciate ligament (ACL-R) rely more heavily on visual information to maintain postural control. DATA SOURCES PubMed, CINAHL, and SPORTDiscus databases were searched from their earliest available date to May 24, 2016, using a combination of keywords. STUDY SELECTION Articles were included if they reported any instrumented static single-leg balance outcome in both a patient and control sample. The means and SDs of these outcomes must have been reported with both eyes open and eyes closed. DATA EXTRACTION Sample sizes, means, and SDs of single-leg balance measures for each group's eyes open and eyes closed testing conditions were extracted. The methodological quality of included studies was independently evaluated by multiple authors using an adapted version of the Quality Index. DATA SYNTHESIS Effect sizes were calculated by dividing the differences in change between eyes closed and eyes open in the ACL-D and control group and the ACL-R and control group by the pooled SD from the eyes closed trials for each analysis. Significant differences between the ACL-D and control group (effect size, -1.66; 95% confidence interval [CI], -2.90 to -.41) were noted. The ACL-R and control group were not different (effect size, -.61; 95% CI, -2.17 to .95). CONCLUSIONS ACL-D individuals but not individuals with ACL-R demonstrate a greater reliance on visual information during single-leg stance compared with healthy individuals.
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Affiliation(s)
- Erik A Wikstrom
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Kyeongtak Song
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian G Pietrosimone
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J Troy Blackburn
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Darin A Padua
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Cronström A, Roos EM, Ageberg E. Association between sensory function and hop performance and self-reported outcomes in patients with anterior cruciate ligament injury. Open Access J Sports Med 2017; 8:1-8. [PMID: 28176927 PMCID: PMC5261846 DOI: 10.2147/oajsm.s120058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In patients with anterior cruciate ligament (ACL) deficiency (ACLD) or reconstruction (ACLR), sensory deficits are commonly assessed as knee kinesthesia using time-consuming laboratory equipment. Portable equipment such as that used for evaluation of vibration sense would be preferable. In contrast to kinesthesia, vibration sense is not well studied in these patients. Objectives 1) To study the association between kinesthesia and vibration sense to investigate if one sensory measurement can replace the other; and 2) to determine the clinical relevance by investigating associations between the sensory measurements and functional performance and patient-reported outcomes in patients with ACLD or ACLR. Methods Twenty patients with ACLD and 33 patients with ACLR were assessed with knee kinesthesia, vibration sense, the one-leg hop test for distance, as well as the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Tegner Activity Scale. Results There were no significant correlations between kinesthesia and vibration sense (r= −0.267, p>0.269) or between the sensory measures and hop performance (r= −0.351, p>0.199). In patients with ACLD, worse knee kinesthesia was associated with worse scores on KOOS subscales pain (r= −0.464, p=0.046) and activities of daily living (r= −0.491, p=0.033), and worse vibration sense was associated with worse scores on KOOS subscale quality of life (r= −0.469, p=0.037) and worse knee confidence (item Q3 from subscale quality of life) (rs=0.436, p=0.054). In patients with ACLR, worse vibration sense was associated with worse scores on KOOS subscales pain (r= −0.402, p=0.020) and activities of daily living (r= −0.385, p=0.027). Conclusion Kinesthesia and vibration sense cannot be used interchangeably as measures of sensory function in patients with ACLD or ACLR. Both sensory measurements were weakly related to hop performance. Adequate sensory function appears to have importance for perceived function in patients with ACLD or ACLR and may therefore be a factor that needs to be addressed in rehabilitation programs for these patients.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden
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Knee joint position sense ability in elite athletes who have returned to international level play following ACL reconstruction: A cross-sectional study. Knee 2016; 23:1029-1034. [PMID: 27712856 DOI: 10.1016/j.knee.2016.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/15/2016] [Accepted: 09/01/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Following an ACL injury, reconstruction (ACL-R) and rehabilitation, athletes may return to play with a proprioceptive deficit. However, literature is lacking to support this hypothesis in elite athletic groups who have returned to international levels of performance. It is possible the potentially heightened proprioceptive ability evidenced in athletes may negate a deficit following injury. The purpose of this study was to consider the effects of ACL injury, reconstruction and rehabilitation on knee joint position sense (JPS) on a group of elite athletes who had returned to international performance. METHODS Using a cross-sectional design ten elite athletes with ACL-R and ten controls were evaluated. JPS was tested into knee extension and flexion using absolute error scores. Average data with 95% confidence intervals between the reconstructed, contralateral and uninjured control knees were analyzed using t-tests and effect sizes. RESULTS The reconstructed knee of the injured group demonstrated significantly greater angle of error scores when compared to the contralateral and uninjured control into knee flexion (p=0.0001, r=0.98) and knee extension (p=0.0001, r=0.91). There were no significant differences between the contralateral uninjured knee of the injured group and the uninjured control group. CONCLUSIONS Elite athletes who have had an ACL injury, reconstruction, rehabilitation and returned to international play demonstrate lower JPS ability compared to control groups. It is unclear if this deficiency affects long-term performance or secondary injury and re-injury problems. In the future physical therapists should monitor athletes longitudinally when they return to play.
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Hoch JM, Perkins WO, Hartman JR, Hoch MC. Somatosensory deficits in post‐ACL reconstruction patients: A case–control study. Muscle Nerve 2016; 55:5-8. [DOI: 10.1002/mus.25167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/20/2016] [Accepted: 04/27/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Johanna M. Hoch
- School of Physical Therapy and Athletic TrainingOld Dominion UniversityNorfolk Virginia USA
| | - William O. Perkins
- School of Physical Therapy and Athletic TrainingOld Dominion UniversityNorfolk Virginia USA
| | - Jonathan R. Hartman
- School of Physical Therapy and Athletic TrainingOld Dominion UniversityNorfolk Virginia USA
| | - Matthew C. Hoch
- School of Physical Therapy and Athletic TrainingOld Dominion UniversityNorfolk Virginia USA
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Cronström A, Creaby MW, Nae J, Ageberg E. Gender differences in knee abduction during weight-bearing activities: A systematic review and meta-analysis. Gait Posture 2016; 49:315-328. [PMID: 27479217 DOI: 10.1016/j.gaitpost.2016.07.107] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 07/20/2016] [Accepted: 07/22/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Increased knee abduction during weight-bearing activities is suggested to be a contributing factor for the high knee injury risk reported in women. However, studies investigating gender difference in knee abduction are inconclusive. OBJECTIVE To systematically review gender-differences in knee abduction during weight-bearing activities in individuals with or without knee injury. METHODS A systematic review and meta-analysis were conducted according to the PRISMA guidelines. A search in the databases Medline, CINAHL and EMBASE was performed until September 2015. Inclusion criteria were studies that reported (1) gender differences, (2) healthy individuals and/or those with anterior cruciate ligament (ACL) deficiency or reconstruction or patellofemoral pain PFP, and (3) knee abduction assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS Fifty-eight articles met the inclusion criteria. Women with PFP had greater peak knee abduction compared to men (Std diff in mean; -1.34, 95%CI; -1.83 to -0.84). In healthy individuals, women performed weight-bearing tasks with greater knee abduction throughout the movement (initial contact, peak abduction, excursion) (Std diff in mean; -0.68 to -0.79, 95%CI; -1.04 to -0.37). In subgroup analyses by task, differences in knee abduction between genders were present for most tasks, including running, jump landings and cutting movements. There were too few studies in individuals with ACL injury to perform meta-analysis. CONCLUSION The gender difference in knee abduction during weight-bearing activities should be considered in training programs aimed at preventing or treating knee injury.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, Australia.
| | - Jenny Nae
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden.
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McGowan CM, Cottriall S. Introduction to Equine Physical Therapy and Rehabilitation. Vet Clin North Am Equine Pract 2016; 32:1-12. [PMID: 26906262 DOI: 10.1016/j.cveq.2015.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Physical therapy (physiotherapy, or PT) can be broadly defined as the restoration of movement and function and includes assessment, treatment, and rehabilitation. This review outlines the history, definition, and regulation of PT, followed by the core scientific principles of PT. Because musculoskeletal physiotherapy is the predominant subdiscipline in equine PT, encompassing poor performance, back pain syndromes, other musculoskeletal disorders, and some neuromuscular disorders, the sciences of functional biomechanics, neuromotor control, and the sensorimotor system in the spine, pelvis, and peripheral joints are reviewed. Equine PT also may involve PT assessment and treatment of riders.
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Affiliation(s)
- Catherine M McGowan
- Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease, The University of Liverpool, Leahurst Campus, Neston, Wirral CH64 7TE, UK.
| | - Suzanne Cottriall
- School of Veterinary Science, The University of Liverpool, Leahurst Campus, Neston, Wirral CH64 7TE, UK
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