Rehabilitation and return-to-sport after anterior cruciate ligament injury and reconstruction: Exploring physical therapists' approaches in Argentina.

OBJECTIVES: To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional design. Online survey. SETTING: Survey platform. PARTICIPANTS: Argentinian physical therapists (PTs). OUTCOME MEASURES: The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS. RESULTS: A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS. CONCLUSIONS: Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

Differences and correlations between horizontal and vertical single-leg jump performance, dynamic balance, and ankle dorsiflexion range of motion in male amateur rugby players according to playing positions.

OBJECTIVES: To explore the differences and correlations in the Y-Balance Test (YBT) scores, ankle-dorsiflexion range of motion (ADFROM), single-leg drop jump (SLDJ) and single-leg hop for distance (SLHD) in amateur male rugby players by playing positions and limb dominance. DESIGN: Cross-sectional study. SETTING: Argentinian amateur rugby club. PARTICIPANTS: Male (n = 58) senior amateur rugby players. MAIN OUTCOME MEASURES: ADFROM, YBT (anterior [AN], posteromedial, posterolateral, and composite [COM]), SLDJ and SLHD performances. RESULTS: Forwards demonstrated different anthropometric traits than backs (p < 0.001 to 0.003; ES: -0.508 to -1.331), whereas the latter attained better jump performance (p < 0.001-0.05; ES: 0.297-1.349) and YBTCOM scores compared to the former, irrespective of limb dominance (p: 0.007-0.034; ES: 0.569-0.730). With regards to the associations, forwards' BMI (rho: -0.35 to -0.52, ES: 0.184) and ADFROM values (rho: 0.41 to 0.53, ES: 0.184; r: 0.43 to 0.50, ES: 0.184) were associated to jump performance among both limbs. In contrast, for the backs, leg length was associated with SLHD (rho: 0.42-0.45, ES: 0.214) and YBTCOM (rho: -0.67 to -0.76, ES: 0.215). Likewise, ADFROM values (r: 0.44-0.56, ES: 0.185) were moderately associated to YBTAN in both limbs. CONCLUSIONS: Backs attained better dynamic balance, wider ADFROM, and better unilateral vertical and horizontal jumps performances in dominant and non-dominant limb, compared to forwards. Additionally, ADFROM maybe an important aspect to consider when aiming to improve balance and jump performance among forwards and backs.

Effect of COVID-19 lockdown on injury incidence and burden in amateur rugby union.

OBJECTIVES: To analyse match and training injury incidence rates and burden from pre-(2019) and post-COVID-19 (2021) seasons; To analyse injury related variables as mechanisms, type, body locations, severity and the differences of the most common injuries according to playing positions. DESIGN: An observational study was performed according to the consensus statement on injury definitions and data collection from World Rugby. Injury variables were collected retrospectively for 2019 season and prospectively during 2021 season. SETTING: Argentinian amateur rugby club. PARTICIPANTS: Male (n = 110) senior amateur rugby players. MAIN OUTCOME MEASURES: Match and training time loss injuries, time of exposures and injury related variables. RESULTS: Training incidence rate during post-lockdown season (4.2/1000 player-training-hours) was significantly higher (p < 0.001) than the pre-lockdown season (0.9/1000 player match hours). Post-lockdown hamstring strain injury (HSI) and concussions match incidence rates were significantly (p < 0.001; p < 0.05 respectively) higher in comparison with 2019 season. Regarding playing positions, backs showed a significantly increase (p < 0.05) in HSI match incidence rate post lockdown. CONCLUSIONS: After the COVID-19 lockdown, training incidence rate was significantly higher than previous season (2019), showing the impact of the lockdown restrictions. Coaches and medical staff must consider that players probably need more lead-in time for conditioning and more monitoring after periods of no rugby.

Impact, incidence and prevalence of musculoskeletal injuries in senior amateur male rugby: epidemiological study.

OBJECTIVES: Exposure to different types of injuries in rugby union is common. It is important to know about the injury epidemiology for medical teams care in order to optimize players´ performance and the treatment of common injuries, but there is limited specific information related to amateur rugby union. The purpose of this study is to determine the incidence, prevalence, injury burden, severity, nature of injuries sustained by senior amateur male rugby players from three clubs in Argentina during a given season. METHODS: An observational, analytical, prospective, multicenter study was developed. Data collection was conducted from 15 March 2019 to 2 November 2019, during a complete season under the applicable standards of the Rugby Injury Consensus Group according to the Orchard Sports Injury and Illness Classification System.Incidence (injuries/1000 player-match-hours), prevalence (%), severity (time loss), injury burden (days lost/1000 player-match-hours), injured location and type of injury (%) were estimated. RESULTS: 250 players and 180 injuries were assessed. Injury prevalence was 52.4%. Incidence rate per match and training was 30.9/1000 player-match-hours, and 0.77/1000 player-training-hours, respectively.The median injury severity score was 23 (IQR 12.7-52) days lost accounting for an injury burden of 97.3/1000 player-hours. Of the total, 113 (62.8%) injuries were contact injuries. The lower limbs were the most commonly affected (58.9%). Hamstring strain injury had the highest incidence and anterior cruciate ligament tear was the most severe injury. CONCLUSION: The prevalence, incidence, and injury burden reported in this study are unprecedented and would add knowledge for the amateur rugby union community. Trainers, physicians, and physical therapists, should consider it to improve their clinical practice.