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2.
Int J Sports Phys Ther ; 17(3): 456-465, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35391867

RESUMO

Background: Current clinical screening tools assessing risky movements during cutting maneuvers do not adequately address sagittal plane foot and ankle evaluations. The Cutting Alignment Scoring Tool (CAST) is reliable in evaluating frontal plane trunk and lower extremity alignment during a 45-degree side-step cut. The Expanded Cutting Alignment Scoring Tool (E-CAST) includes two new sagittal plane variables, knee flexion and ankle plantarflexion angle. Hypothesis/Purpose: To assess the inter-and intra-rater reliability of the E-CAST to evaluate trunk and lower extremity alignment during a 45-degree side-step cut. Study Design: Repeated Measures. Methods: Participants included 25 healthy females (13.8 ± 1.4 years) regularly participating in cutting or pivoting sports. Participants were recorded performing a side-step cut in frontal and sagittal planes. One trial was randomly selected for analysis. Two physical therapists independently scored each video using the E-CAST on two separate occasions, with randomization and a two-week wash-out between rounds. Observed movement variables were awarded a score of "1", with higher scores representing poorer technique. Intraclass correlation coefficients (ICC) and 95% confident intervals (95% CI) were calculated for the total score, and a kappa coefficient (k) was calculated for each variable. Results: The cumulative intra-rater reliability was good (ICC=0.78, 95% CI 0.59-0.96) and the cumulative inter-rater reliability was moderate (ICC=0.71, 95% CI 0.50-0.91). Intra-rater kappa coefficients ranged from moderate to excellent for all variables (k= 0.50-0.84) and inter-rater kappa coefficients ranged from slight to excellent for all variables (k=0.20-0.90). Conclusion: The addition of two sagittal plane variables resulted in lower inter-rater ICC compared to the CAST (ICC= 0.81, 95% CI 0.64-0.91). The E-CAST is a reliable tool to evaluate trunk and LE alignment during a 45-degree side-step cut, with good intra-rater and moderate inter-rater reliability. Level of Evidence: Level 2, Diagnosis.

3.
J Phys Ther Sci ; 34(4): 327-334, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35400840

RESUMO

[Purpose] To identify running gait biomechanics associated with sacroiliac (SI) joint pain in female runners compared to healthy controls. [Participants and Methods] In this case-control study, treadmill running gait biomechanics of female runners diagnosed SI joint pain, (by ultrasound-guided diagnostic SI joint injection and/or ≥2 positive SI physical exam maneuvers) were compared with age, height, mass, and BMI matched healthy female runners. Sagittal and coronal plane treadmill running video angles were measured and compared. [Results] Eighteen female runners with SI pain, and 63 matched controls, were analyzed. There was no difference in age, height, mass, or BMI between groups. At the point of initial contact, runners with SI joint pain demonstrated less knee flexion, greater tibial overstride, and greater ankle dorsiflexion, compared to controls. In midstance, runners with SI pain had greater contralateral pelvic drop compared to controls. For unilateral SI joint pain cases (N=15), greater contralateral pelvic drop was observed when loading their affected side compared to the unaffected side. [Conclusion] Female runners with SI joint pain demonstrated greater contralateral pelvic drop during midstance phase; along with less knee flexion, greater "tibial overstride", and greater ankle dorsiflexion at initial contact compared to controls.

4.
PM R ; 2022 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-35212171

RESUMO

BACKGROUND: The identified domains of child physical literacy include knowledge/understanding, behavior, motivation/confidence, and physical competency. Understanding physical literacy is critical to moving forward intervention efforts surrounding physical inactivity. OBJECTIVES: To investigate physical literacy domains by presenting responses to the Play, Lifestyle & Activity in Youth (PLAY) questionnaire and analyze the relationship between comparable questions in the child and parent sections. DESIGN: Cross-sectional questionnaire study. SETTING: Suburban youth program, United States. MAIN OUTCOME MEASURE: Parent and child responses to the PLAY questionnaire. RESULTS: Questionnaire data were collected for 106 children 6-11 years old and 91 parents. Children (93.3%, 83/91) reported enjoyment in physical education, despite 70% participation in physical education 0-1 day/week. 66.6% (26/91) of children preferred active to passive play and played outside most days/week (5.0 median). Similarly, a high proportion of children (93.3%, 83/91) reported feeling that they physically performed similar to or higher than their peers and took ownership to improve motor competency versus taking a more passive approach. Most children (96.7%, 87/91) reported feeling happy when they were able to play sports/run around, enjoyed gym class (93.3%, 83/91), and reported feeling sad if they cannot play sports/run around during the day (75.6%, 68/91). Parents and children reported rules around screen time and bed time, and reinforced these rules often. Child and parent responses were associated for comparable questions about bedtime and screen-time/media rules, moderate-to-vigorous physical activity per day, sport camp preference, and play equipment use (Fisher's p = .051 screen time, p < .001 other questions). CONCLUSIONS: PLAY questionnaire internal validity showed agreement between comparable parent and child responses and an association for select comparable questions.

5.
Orthop J Sports Med ; 10(1): 23259671211065063, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35097142

RESUMO

BACKGROUND: Apophyseal injuries are common in children and adolescent athletes. These injuries are believed to be caused by repetitive overloading, which can create inflammatory and degenerative conditions in growing bone prominences. However, their prevalence, diagnosis, and treatment in young soccer players have been understudied. PURPOSE: To evaluate characteristics of apophyseal injuries in adolescent athletes at an elite soccer academy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All apophyseal injuries between July 2008 and June 2015 were evaluated. For each injury, the authors recorded the type and location, age of the player, injury date, imaging modalities, and time absent from training/competition. RESULTS: Over the 7 seasons of this study, 210 apophyseal injuries were documented, including 172 simple apophyseal injuries and 38 apophyseal avulsion fractures. The rate of apophyseal injuries was 0.35 per 1000 hours of training exposure. A total of 196 (93.3%) cases were primary injuries, and the rest (6.7%) were reinjuries. Ultrasonography was the most commonly used imaging modality for diagnosis (172 cases; 81.9%). The most common location of apophyseal injuries was the anterior inferior iliac spine (AIIS). Return to sport was faster in athletes with apophyseal injury at the ischiopubic ramus, those with simple apophyseal injuries, and younger athletes. CONCLUSION: The most common location for apophyseal injury among soccer players was the AIIS. Return to training and competition differed according to injury location, type of apophyseal injury, and age.

6.
Pediatr Phys Ther ; 34(1): 56-61, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34873120

RESUMO

PURPOSE: To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum. METHODS: A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis. RESULTS: Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at: http://links.lww.com/PPT/A342).


Assuntos
Alfabetização , Educação Física e Treinamento , Criança , Estudos Transversais , Exercício Físico , Humanos , Instituições Acadêmicas , Inquéritos e Questionários
7.
Clin J Sport Med ; 32(3): e276-e280, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852435

RESUMO

OBJECTIVE: To investigate clinical diagnoses, sports participation, and return to sport timeline associated with hallux sesamoid injuries with sex comparisons. DESIGN: Descriptive epidemiology study. SETTING: Sports medicine clinics at a tertiary-level pediatric medical center. PATIENTS: Six hundred eighty-three young athletes (546 women and 137 men). INDEPENDENT VARIABLES: Sex (women vs men). MAIN OUTCOME MEASURES: Clinical diagnoses, participating sports, and injury timeline. RESULTS: The most common diagnosis was sesamoiditis (62.6%). The top 3 primary sports were dance (34.6%), running (13.7%), and soccer (11.7%). When stratified by sex, dance (40.1%), running (13.6%), and soccer (10.7%) were the top primary sports for women while running (19.4%), soccer (18.5%), and basketball (11.3%) were the leading diagnoses for male athletes. The mean time between injury occurrence and first clinic visit was 135.5 ± 229.3 days. The mean time between the first clinic visit and return to sport was 104.3 ± 128.2 days. Comparison by sex showed that women had a longer mean time than men (women: 111.5 ± 132.5 days, men: 67.2 ± 96.3 days, P = 0.001). The mean time from injury occurrence to return to sport was 235.2 ± 281.0 days. Women showed a longer mean timeline for return to sport compared with men (women: 245.2 ± 288.2 days, men: 179.3 ± 231.9 days, P = 0.014). CONCLUSION: Sesamoiditis was the most common diagnosis, and dance, running, and soccer were top 3 sports. The most salient finding was that women taking almost twice as long to return the sport or activity compared with men, which likely stems from delay of reporting symptom onset to clinics.


Assuntos
Basquetebol , Hallux , Futebol , Medicina Esportiva , Atletas , Basquetebol/lesões , Criança , Feminino , Humanos , Masculino , Futebol/lesões
8.
Orthop J Sports Med ; 9(11): 23259671211054804, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34881338

RESUMO

BACKGROUND: Differences in postoperative recovery after anterior cruciate ligament reconstruction (ACLR) between men and women have been demonstrated in the adult population. Sex-based differences have been incompletely investigated in adolescents, which represent the subpopulation most affected by ACL injury. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the 6-month postoperative functional recovery after ACLR between adolescent boys and girls. It was hypothesized that significant differences in postoperative strength, dynamic balance, and functional hop test performance would be seen between the sexes. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included in this study were athletes aged 12 to 19 years with closed or closing growth plates who underwent ACLR with hamstring autograft between May 2014 and May 2018 at a single institution. All athletes had undergone strength and functional testing between 5 and 8 months postoperatively. Exclusion criteria were previous knee surgery (contralateral or ipsilateral knee), concomitant injury/surgery other than meniscal tear/repair, allograft supplementation, and incomplete medical records. The limb symmetry index (LSI) for strength (measured with handheld dynamometer), as well as dynamic Y-balance and functional hop test performance, was compared between groups. To account for differences in physical characteristics between the sexes, 1-way between-group multivariate analysis of covariance was used to analyze the data. RESULTS: Overall, 543 patients (211 boys, 332 girls) were included. There was no significant difference in age, body mass index, incidence of concomitant meniscal pathology, use of regional anesthesia, or time to functional testing between cohorts. Female athletes demonstrated a statistically significantly greater deficit in quadriceps strength LSI compared with male athletes (boys, +3.4%; girls, -2.3%; P = .011). Both male and female athletes demonstrated 33% hamstring strength deficits, with no statistically significant sex-based differences in dynamic balance or functional hop testing. CONCLUSION: Female athletes demonstrated greater quadriceps strength deficits than male athletes at 6 months after ACLR with hamstring autograft. Severe hamstring strength deficits persisted in both male and female patients at this time point. The correlation of such deficits to risk of ACL retear warrants continued study in the adolescent population and may support a delay in return to sports, which has been suggested in the more recent literature.

9.
Int J Sports Phys Ther ; 16(6): 1523-1531, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34909257

RESUMO

BACKGROUND: Improper pitching mechanics are a risk factor for arm injuries. While 3-dimensional (3D) motion analysis remains the gold standard for evaluation, most pitchers and clinicians do not have access to this costly technology. Recent advances in 2-dimensional (2D) video technology provide acceptable resolution for clinical analysis. However, no systematic assessment tools for pitching analysis exist. PURPOSE: To determine the reliability of the Assessment of biomeChanical Efficiency System (ACES) screening tool using 2D video analysis to identify common biomechanical errors in adolescent pitchers. STUDY DESIGN: Cross-sectional. METHODS: Adolescent baseball pitchers underwent analysis using 2D video in indoor settings. Observational mechanics were collected using a 20-item scoring tool (ACES) based on 2D video analysis. Fleiss' kappa, interclass correlation coefficients (ICC), and frequencies were used to examine intra-/interrater reliability based on common pitching errors. RESULTS: Twenty asymptomatic pitchers ages 12-18 years were included. Total ACES scores ranged from 1 to 13, normally distributed. ACES total score demonstrated excellent intra-rater reliability within each rater (ICC for rater 1 = 0.99 (95% CI; 0.98, 0.99); ICC for rater 2 = 0.94; 95% CI: 0.84, 0.97); ICC for rater 3 = 0.98 (95% CI: 0.96, 0.99)). There was excellent interrater reliability across the trials and raters (ICC = 0.91; 95% CI: 0.82, 0.96). The ACES tool demonstrated acceptable kappas for individual items and strong ICC 0.91 (95% CI: 0.82, 0.96) for total scores across the trials. Regarding identification of biomechanical errors, "front side position" was rated erroneous in 84/120 ratings (70%), stride length in 52/120 ratings (43.3%) and lead hip position in 53/120 ratings (44.2%). CONCLUSIONS: The 20-item ACES scoring tool with 2D video analysis demonstrated excellent intra- and interrater reliability when utilized by raters of different musculoskeletal disciplines. Future studies validating 2D vs. 3D methodology are warranted before ACES is widely disseminated and utilized for adolescent pitchers. ACES is a practical and reliable clinical assessment tool utilizing 2D video analysis for coaches, instructors, and sports medicine providers to screen adolescent pitchers for common biomechanical errors. LEVEL OF EVIDENCE: 3b.

10.
Orthop J Sports Med ; 9(11): 23259671211046608, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34778471

RESUMO

BACKGROUND: The effect of concomitant meniscal tears, and their associated treatment, on strength and functional recovery after anterior cruciate ligament reconstruction (ACLR) has not been adequately investigated in young populations. HYPOTHESIS: Concomitant meniscal tears, treated with or without repair, would not adversely affect strength, balance, or functional hop test performance at 6 months postoperatively. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The authors retrospectively analyzed return-to-sports (RTS) assessments prospectively collected 6 months after ACLR with hamstring autograft in 165 patients ≤25 years of age. Descriptive, surgical, and RTS testing data were analyzed, and subgroups were compared using analysis of covariance models designed to assess the effects of sex, meniscal tear, and meniscal repair on RTS performance. RESULTS: Included were 115 female (70%) and 50 male (30%) patients with a mean age of 16.4 years (range, 12.3-25 years). Of these patients, 58% had concomitant meniscal tears (59% lateral, 27% medial, 14% lateral + medial), comprising 53% of the female and 70% of the male patients. The authors treated 61% of the tears with repair, with range of motion (ROM) and weightbearing limitations imposed within the first 6 weeks postoperatively, whereas 39% were treated with partial meniscectomy, rasping, or trephination (no ROM or weightbearing restrictions). The mean deficit in hamstring strength at 6 months postoperatively was significantly greater in the meniscal tear group than in those without a tear (32.3% vs 24.6%; P = .028). The meniscal repair group had greater hamstring strength deficits than the group with meniscectomy, rasping or trephination (34.3% vs 26.2%; P = .023). Performance on dynamic balance and functional hop tests was similar among all meniscus subgroups. There were no sex-based effects on any subgroup comparisons. CONCLUSION: At 6 months postoperatively, both young male and young female patients who underwent ACLR with hamstring autograft demonstrated significant hamstring strength deficits compared with their nonoperative leg. The presence of a meniscal tear and subsequent repair, or its related rehabilitation restrictions, appears to have adverse effects on the postoperative recovery of hamstring strength.

11.
Clin J Sport Med ; 2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34407063

RESUMO

OBJECTIVE: (1) To examine the effect of social media (SM) use on sleep quality and (2) to determine the effect of SM on competition performance among college athletes. DESIGN: Cross-sectional study. SETTING: Two local Division III colleges, MA, USA. PARTICIPANTS: National Collegiate Athletic Association Division III swim and track and field athletes. INTERVENTION: Data were collected onsite through an SM use form, the lifestyle survey, and the Patient-Reported Outcomes Measurement Information System Sleep Disturbance Questionnaire. Participants were divided into 3 groups based on their SM volume: (1) less active SM users (≤2 h/d), (2) moderately active SM users (>2-≤5 h/d), and (3) active SM users (>5 h/d) for analysis. MAIN OUTCOME MEASURES: Sleep quality and sport performance data collected through publicly available competition results. The independent variable, SM volume (hours of SM use per day over 7 days), was collected using the iPhone screen time function. RESULTS: The cohort consisted of 40 male track and field athletes and 47 female track and field (37, 79%) and swimming (10, 21%) athletes. Mean SM use was 4.6 ± 3.4 h/d. The sleep quality of active SM users was worse than less active SM users (P = 0.033). There was an independent association between increased Facebook time and poor performance after adjusting confounders (adjusted odds ratio: 0.990, 95% confidence interval: 0.981-0.999, P = 0.049). CONCLUSIONS: High SM use has a negative impact on sleep quality and may hinder competition performance among college athletes. These findings may have implications for developing SM use guidelines for college athletes to improve their sleep quality and performance.

12.
J Foot Ankle Surg ; 60(4): 706-711, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33839009

RESUMO

This case series reports the outcome of posterior ankle decompression and os trigonum or Stieda process resection utilizing an open posterolateral approach in 54 professional, pre-professional, and dedicated recreational dancers. All procedures were performed by a single surgeon at the same facility between 2008 and 2018. The surgical technique is described in detail. Data related to results of the surgery were gathered via follow-up questionnaire and verified by referencing the patients' medical records. Outcomes were self-assessed in terms of categories ranging from excellent through moderate to poor. Eighty-nine percent of the dancers (N = 48 of 54) chose excellent or good, 11% (N = 6) chose moderate, and none selected poor. These results were compared with those achieved in 17 previous studies reporting the use of both open (posterolateral and posteromedial) and arthroscopic/endoscopic techniques in dancers. This comparison found similarly favorable reported outcomes, but also great variation in methodology for determining patient reported outcomes (PROs). While the preferred surgical technique for posterior ankle decompression remains controversial, the open posterolateral approach utilized in this series resulted in high expectation of return to dance with minimal complications. The need for a dancer-specific PRO tool is discussed.


Assuntos
Tálus , Tornozelo , Articulação do Tornozelo , Artroscopia , Descompressão , Endoscopia , Humanos
13.
Int J Sports Phys Ther ; 16(2): 312-321, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33842027

RESUMO

BACKGROUND: Three-dimensional (3D) motion analysis is considered the gold standard for evaluating human movement. However, its clinical utility is limited due to cost, operating expertise, and lengthy data processing time. Numerous qualitative scoring systems have been introduced to assess trunk and lower extremity biomechanics during functional tasks. However, the reliability of qualitative scoring systems to evaluate cutting movements is understudied. Purpose/Hypotheses: To assess the inter-rater and intra-rater reliability of the Cutting Alignment Scoring Tool (CAST) among sports medicine providers and to evaluate rater agreement of each component of the CAST. The hypotheses were: 1) there would be good-to-excellent inter-rater and intra-rater reliability among sports medicine providers, 2) there would be good to almost perfect agreement for cut width and trunk lean variables and moderate to good agreement for valgus variables of the CAST. STUDY DESIGN: Repeated Measures. METHODS: Ten videos of a 45-degree side-step cut performed by adolescent athletes were independently rated on two occasions by six raters (2 medical doctors, 2 physical therapists, and 2 athletic trainers). The variables assessed include trunk lean to the opposite direction of the cut, increased cut width, knee valgus at initial load acceptance (static), and knee valgus throughout the task (dynamic). Variables were scored as either present, which were given a score of "1", or not present, which were given a score of "0". Video sequence was randomized in each rating session, and a two-week wash out period was given. RESULTS: The cumulative inter-rater and intra-rater reliabilities were good (ICC: 0.808 and ICC: 0.753). Almost perfect kappa coefficients were recorded for cut width (k=0.949). Moderate kappa coefficients were found for trunk lean (k= 0.632) and fair kappa coefficients were noted for dynamic and static valgus (k=0.462 and k= 0.533 respectively). CONCLUSION: These findings suggest that the CAST is a reliable tool to evaluate trunk and LE alignment during a cutting task by sports medicine providers. LEVEL OF EVIDENCE: Level 2 Diagnosis.

14.
J Evid Based Integr Med ; 26: 2515690X211006031, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33904781

RESUMO

BACKGROUND: Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not. METHODS: A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate. RESULTS: There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999). CONCLUSION: Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration: ClinicalTrials.gov NCT02690194.


Assuntos
Meditação , Adulto , Ansiedade/terapia , Transtornos de Ansiedade , Frequência Cardíaca , Humanos , Estudos Prospectivos
15.
Contemp Clin Trials ; 103: 106321, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33618033

RESUMO

OBJECTIVE: Juvenile-onset fibromyalgia (JFM) is a chronic debilitating pain condition that negatively impacts physical, social and academic functioning. Cognitive-behavioral therapy (CBT) is beneficial in reducing functional disability among adolescents with JFM but has only a modest impact on pain reduction and does not improve physical exercise participation. This randomized controlled trial (RCT) aims to test whether a novel intervention that combines CBT with specialized neuromuscular exercise training (the Fibromyalgia Integrative Training program for Teens "FIT Teens") is superior to CBT alone or a graded aerobic exercise (GAE) program. DESIGN/METHODS: This 3-arm multi-site RCT will examine the efficacy of the FIT Teens intervention in reducing functional disability (primary outcome) and pain intensity (secondary outcome), relative to CBT or GAE. All interventions are 8-weeks (16 sessions) in duration and are delivered in small groups of 4-6 adolescents with JFM. A total of 420 participants are anticipated to be enrolled across seven sites with approximately equal allocation to each treatment arm. Functional disability and average pain intensity in the past week will be assessed at baseline, post-treatment and at 3-, 6-, 9- and 12-month follow-up. The 3-month follow-up is the primary endpoint to evaluate treatment efficacy; longitudinal assessments will determine maintenance of treatment gains. Changes in coping, fear of movement, biomechanical changes and physical fitness will also be evaluated. CONCLUSIONS: This multi-site RCT is designed to evaluate whether the combined FIT Teens intervention will have significantly greater effects on disability and pain reduction than CBT or GAE alone for youth with JFM. Clinical trials.gov registration: NCT03268421.


Assuntos
Terapia Cognitivo-Comportamental , Fibromialgia , Adaptação Psicológica , Adolescente , Terapia por Exercício , Fibromialgia/terapia , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
16.
Orthop J Sports Med ; 9(1): 2325967120973593, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33614794

RESUMO

BACKGROUND: There is a lack of research on the effects of a postoperative rehabilitation program on anterior cruciate ligament (ACL) graft rupture. HYPOTHESIS: We hypothesized that a hip-focused rehabilitation protocol with graft rupture education and avoidance training (HIP-GREAT program) would demonstrate lower ACL graft rupture rates compared with a traditional physical therapy (PT) program. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study consisted of young athletes who had undergone ACL reconstruction at a single institution. Postoperatively, 136 participants (mean age, 16.9 ± 2.4 years) were enrolled in a traditional PT protocol between 2006 and 2010, and 153 participants (mean age, 17.0 ± 2.3 years) were enrolled in the HIP-GREAT protocol between 2011 and 2015. Follow-up rates were 31% (42/136) and 27% (41/153) in the traditional PT and HIP-GREAT groups, respectively, at 3 years postoperatively. The hazard ratio was calculated, and absolute risk reduction (ARR) and number-needed-to-treat (NNT) analyses were performed to compare the 2 protocols. RESULTS: ACL graft rupture occurred in 10 patients (7.4%) in the traditional PT group and 5 patients (3.3%) in the HIP-GREAT group. This difference was not statistically significant (hazard ratio, 0.39; 95% CI, 0.14 to 1.16; P = .09). The ARR was 0.041 (95% CI, -0.011 to 0.093), and the NNT was 24.5. CONCLUSION: This study did not demonstrate a statistically significant reduction of ACL graft rupture in patients in the HIP-GREAT group. However, high ARR values and low NNT values were found, which suggests the possible effectiveness of the HIP-GREAT protocol to reduce ACL graft ruptures in young athletes.

17.
Clin J Sport Med ; 31(2): e64-e79, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30589745

RESUMO

BACKGROUND: Ballet dancers have a high prevalence of injuries to the lower extremity. Many studies have investigated the relationship between dance injury and risk factors. However, risk factors for lower-extremity injury comparing recreational- and elite-level ballet dancers are scarce. OBJECTIVE: To systematically review available original studies to assess risk factors for lower-extremity injury in female ballet dancers between recreational and elite ballet dancers. DATA SOURCES: Five online databases [Web of Science, PubMed, OVID (Medline), EBSCO, and ProQuest] were searched systematically. STUDY SELECTION: Included studies had an analytic study design published in the past 11 years and investigated an association between potential risk factors and lower-extremity injury in female ballet dancers. STUDY APPRAISAL: Assessed independently by 2 reviewers using the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine. RESULTS: Seventeen studies were included. Alignment was a risk factor for lower-extremity injury in both recreational and elite ballet dancers. In elite ballet dancers, poor lumbopelvic movement control, inappropriate transversus abdominis contraction, decreased lower-extremity strength, and poor aerobic fitness were risk factors for lower-extremity injury. In recreational ballet dancers, hypermobility of the hip and ankle and longer training hours were risk factors for lower-extremity injury. Mean DB score was 15.94 (SD 1.57). The majority of studies were retrospective cohort studies or had poor follow-up, with 7 level 2b studies, 6 level 3b studies (cross-sectional), and 4 level 1b studies (prospective cohort with good follow-up). CONCLUSIONS: Alignment was identified as a common risk factor for recreational and elite ballet dancers. Other risk factors differed between recreational ballet dancers and elite ballet dancers. Future studies are warranted to use a prospective study design, identify dance level-specific risk factors, and implement evidence-based prevention strategies.


Assuntos
Dança/lesões , Extremidade Inferior/lesões , Músculos Abdominais/fisiologia , Estudos Transversais , Feminino , Humanos , Destreza Motora/fisiologia , Movimento , Contração Muscular , Força Muscular , Pelve/fisiologia , Condicionamento Físico Humano/efeitos adversos , Postura/fisiologia , Fatores de Risco , Coluna Vertebral/fisiologia , Fatores de Tempo
18.
Phys Sportsmed ; 49(1): 37-44, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32281468

RESUMO

Introduction: To determine clinical parameters that are related to abnormal cardiac symptoms in physically active youth. Methods: We used Simon's Heart Heartbytes National Youth Cardiac Registry to collect data from adolescent athletes in southeastern Pennsylvania. We collected age, race/ethnicity, abnormal cardiac symptoms, medical history, medication use, caffeine intake, and family history. We obtained height, weight, blood pressure, cardiac murmur findings, and ECGs. Echocardiogram was obtained if necessary. Binary logistic regression analysis was performed to identify independent associations between abnormal cardiac symptoms and collected variables. The odds ratio (OR), 95% confidence interval (95% CI), and p-values were used as statistical values. Results: Of the 887 athletes (543 males and 344 females, age = 16.9 ± 2.1 years, height = 166.9 ± 11.4 cm, weight = 62.0 ± 16.0 kg), 186 (21%) had abnormal cardiac symptoms including chest pain, passing out, difficulty breathing, extreme fatigue, and heart race. There was an independent association between abnormal symptoms and a past medical history (OR: 4.77, 95%CI: 3.18, 7.17, p = 0.001) and medication use (OR: 1.74, 95%CI: 1.08, 2.79, p = 0.022). In medical history, young athletes with asthma showed a greater propensity of abnormal cardiac symptoms (48.9%) compared to young athletes without (14.0%, p = 0.001). Additionally, young athletes with anxiety or depression demonstrated a higher proportion of abnormal cardiac symptoms (48.9%) than those without (19.5%, p = 0.001). Although the association between the presence of abnormal symptoms and African-American race (OR: 2.04, 95%CI: 0.96, 4.35, p = 0.065) and average daily consumption of at least 2 caffeine drinks (OR: 2.08, 95%CI: 0.86, 5.02, p = 0.103) were not significant, there was a trend to reach the a priori significance level. Conclusions: This study identified several clinical parameters that are associated with symptoms suggestive of abnormal cardiac conditions. Larger studies need to be done to better sort out the clinical history that may contribute to false positives to further reduce false positives at heart screenings.


Assuntos
Cardiopatias/diagnóstico , Sistema de Registros , Esportes Juvenis , Adolescente , Ansiedade , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Asma/complicações , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Depressão , Dispneia/diagnóstico , Dispneia/etiologia , Ecocardiografia , Eletrocardiografia , Feminino , Cardiopatias/complicações , Cardiopatias/diagnóstico por imagem , Cardiopatias/psicologia , Humanos , Masculino , Programas de Rastreamento/métodos , Anamnese , Esportes Juvenis/psicologia
19.
Clin J Sport Med ; 31(3): 295-303, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30985309

RESUMO

OBJECTIVE: To analyze the characteristics of injuries sustained by young figure skaters who were evaluated at regional pediatric sports medicine clinics. DESIGN: Retrospective chart review (2003-2017). SETTING: Sports medicine clinics at a tertiary-level pediatric medical center. PATIENTS: Two hundred ninety-four figure skaters (271 female and 23 male). Age rage: 9 to 19 years. Mean age: 14.2 ± 2.3 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Mechanism of injury (acute vs overuse), injured body areas, diagnoses for most commonly injured body areas, and distribution of bone stress injuries. RESULTS: Eight hundred sixty-four figure skating-related injuries were identified. Approximately 68.9% were overuse and 31.1% were acute. In female figure skaters, the most frequently injured body areas were foot/ankle (29.6%), knee (19.3%), and back (15.8%). In male figure skaters, they were foot/ankle (25.4%), hip (16.4%), and knee (14.9%). Most common diagnoses at these body areas were tendinopathy (foot/ankle), extensor mechanism (knee), and posterior column bone stress injuries (back). All injuries to anterior knee structures, excluding bone contusions, were categorized as extensor mechanism injuries. About 11.8% of all injuries were bone stress reactions/fractures with the majority occurring at the back (42.2%), foot/ankle (32.4%), and lower leg (15.7%). CONCLUSION: Most injuries sustained by figure skaters were overuse and occurred most commonly at the foot/ankle (29.6%), knee (19.3%), and back (15.8%). Approximately 1 in 10 injuries were bone stress reactions/fractures, and nearly 1 in every 3 skaters who presented with back pain was diagnosed with a posterior column bone stress injury. Health care providers who take care of young figure skaters need to maintain a high index of suspicion for overuse injuries, especially bone stress reactions/fractures.


Assuntos
Traumatismos em Atletas , Transtornos Traumáticos Cumulativos , Fraturas de Estresse , Patinação , Adolescente , Traumatismos em Atletas/epidemiologia , Criança , Transtornos Traumáticos Cumulativos/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Patinação/lesões , Medicina Esportiva , Adulto Jovem
20.
Phys Sportsmed ; 49(4): 463-468, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33337938

RESUMO

Objective: 1) to determine the proportion of sport specialization among female figure skaters, 2) to compare proportion of low back injuries between specialized female figure skaters and non-specialized female figure skaters, and 3) to identify an independent risk factor(s) for low back injuries in female figure skaters.Methods: A cross-sectional questionnaire study was used. Young female figure skaters were asked questions related to sport specialization and any history of low back injuries. The primary outcome variables were status of sport specialization, weekly training hours, and low back injury. Descriptive statistics, t-test, chi-square analyses, and binary logistic regressions were used.Results: Responses from 132 female figure skaters (mean age: 16.3 ± 2.7 years, age range: 8-22 years) were analyzed. Sixty-two percent (82/132) of figure skaters were specialized. Specialized female figure skaters spent more time in training (11.3 ± 6.5 hours/week) than non-specialized skaters (7.6 ± 4.9 hours/week, p = 0.001). No statistical differences were found in proportion of low back injury history between specialized (25.6%) and non-specialized female figure skaters (24.0%, p = 0.836). Chronological age was also identified as an independent risk factor for low back injuries in female figure skaters (aOR: 1.24, 95%CI: 1.00, 1.54, p = 0.048).Conclusions: The majority of female figure skaters in this cohort were specialized. An association between chronological age and low back injuries, found in the current study, may be a result of cumulative effects of participating in figure skating over time.


Assuntos
Traumatismos em Atletas , Lesões nas Costas , Transtornos Traumáticos Cumulativos , Esportes , Adolescente , Adulto , Traumatismos em Atletas/complicações , Traumatismos em Atletas/epidemiologia , Lesões nas Costas/complicações , Criança , Estudos Transversais , Transtornos Traumáticos Cumulativos/etiologia , Feminino , Humanos , Adulto Jovem
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