Active Living Leaders Training Program for adults with spinal cord injury: a pilot study.

STUDY DESIGN: Quasi-experimental pre-post design with 6-month follow-up. OBJECTIVES: Active Living Leaders Training Program (ALLTP) equips individuals with knowledge and skills to encourage those with spinal cord injury (SCI) to increase their leisure-time physical activity (LTPA). The purpose of this pilot study was to, first, (i) evaluate participants' perceptions of the relevance/usefulness of ALLTP material/presentation, (ii) examine changes in participants' self-efficacy to promote LTPA, (iii) identify program components associated with greater self-efficacy and, second, measure participants' use of ALLTP skills and resources over the subsequent 6 months. SETTING: Canada. METHODS: Six SCI fitness trainers and six adults with SCI completed the three sections of ALLTP and, after each section, provided feedback. Six months later, participants' use of resources and skills was assessed. Means, standard deviations, repeated measures analysis of variance and Pearson's correlations were computed. RESULTS: Relevance/usefulness of the program was rated favorably. Self-efficacy to speak about and encourage LTPA remained high throughout the ALLTP and was positively correlated with the relevance/usefulness of program content and presentation. At follow-up, participants had discussed LTPA with an average of seven people with disabilities and reported using at least one skill and resource from the ALLTP during those discussions. CONCLUSIONS: Users had positive perceptions of ALLTP and reported using the training to promote LTPA to others with disabilities. Participant feedback has been used to improve ALLTP. ALLTP can now be used to train people with SCI and SCI fitness trainers to promote LTPA to others with disabilities.

Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques.

PURPOSE: Several case series have been published exploring a variety of surgical treatments for osteochondritis dissecans (OCD) in patients 18 years and younger, but a systematic review is currently lacking. This systemic review identifies the various surgical techniques reported in the literature for treating OCD and assesses the effectiveness of these treatments based on functional outcomes and radiographic healing. METHODS: A search of the EMBASE and MEDLINE databases was performed to identify clinical studies reporting outcomes of surgical management of OCD in the knee. A quality assessment of the included articles was conducted independently by 2 reviewers using a quality assessment tool developed by Yang et al. RESULTS: A total of 25 papers including 470 patients aged ≤18 years (516 lesions) met the eligibility criteria and were reviewed. Surgical techniques for stable lesions included (arthroscopic and open) transarticular drilling, either alone (41%) or with bioabsorbable pin fixation (3%), extra-articular drilling (29%) and fixation with bioabsorbable screws (4%) or bone pegs (4%). For unstable lesions, surgical techniques included (arthroscopic and open) fixation with bioabsorbable pins (9%), metal screws (4%), bone pegs (4 %), osteochondral plugs (3%) or bioabsorbable screws (2%), as well as transarticular drilling with bioabsorbable pin fixation (3%) and drilling with metal screw fixation (2%). CONCLUSION: The most common techniques were transarticular drilling for stable lesions and bioabsorbable pin fixation for unstable lesions. The key findings were that the vast majority of lesions healed postoperatively, regardless of technique, and that high-quality trials are required to more appropriately compare the effectiveness of techniques. LEVEL OF EVIDENCE: Systematic review, Level IV.