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1.
Artigo em Inglês | MEDLINE | ID: mdl-38863416

RESUMO

BACKGROUND: The aim of this study is to study the clinical decision-making practice of Italian physiotherapists in return to running (RTR) after anterior cruciate ligament (ACL) reconstruction, and the differences in decision-making in relation to physiotherapist's characteristics. METHODS: An online survey was developed, 1404 physiotherapists were contacted by email, via chartered association, or via social media. RESULTS: Most respondents (83%) indicated that the RTR decision should be made by a multidisciplinary team with RTR clearance around 3-4 months after surgery (47%). The most important criteria guiding the RTR decision were knee flexion range of motion (ROM) >130° (50%), complete extension ROM (95%), no pain (45%) and no effusion (68%). A Limb Symmetry Index (LSI) >70% for quadriceps (49%), hamstring (48%) and LSI >90% for posterolateral hip (45%) and triceps surae strength (42%) should be achieved for RTR. Approximately half of the participants (49%) do not consider ACL laxity tests to be used for RTR decisions. Response differences were found between sample subgroups. More experienced physiotherapists and those with post graduate training had lower thresholds to clear RTR. CONCLUSIONS: Experienced physiotherapists who treated a higher number of patients after ACL reconstruction, who had certified specialist training and a specific interest towards ACL rehabilitation, generally reported clinical practice modalities more in line with current evidence.

2.
J Exp Orthop ; 11(1): e12009, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38455453

RESUMO

Purpose: According to the homeostasis model, patellofemoral pain (PFP) arises as a consequence of disturbed homeostasis of anterior structures of the knee due to vascular insufficiency. Near-infrared spectroscopy (NIRS) allows to measure changes of concentrations (µmol/cm2) of (de)-oxygenated hemoglobine (HHb and O2Hb). The aim was to study differences in patellar hemodynamics between patients and healthy controls. Methods: Hemodynamics of patients (n = 30 [female = 20, age = 21.5, BMI = 22.9]) and controls (n = 30 (female = 18, age = 21.4, BMI = 22.4]) were evaluated for two activities ('Prolonged Sitting' and 'Stair Descent'). Blinding for health status was implemented. Results: During 'Prolonged Sitting', PFP patients exhibited smaller decreases in mean changes for HHb (PFP [M = -1.5 to -1.9], healthy controls [M = -2.0 to -2.3]) and O2Hb (PFP [M = -2.0 to -3.2], healthy controls [M = -3.4 to -4.1]). However, these differences were statistically non-significant (p = 0.14-0.82 and p = 0.056-0.18, respectively). Conversely, for 'Stair Descent', PFP patients showed statistically significant smaller decreases in mean changes for HHb (PFP [M = -1.9, SD = 1.8], healthy controls [M = -2.5, SD = 1.7], p = 0.043) and O2Hb (PFP [M = -3.2, SD = 3.2], healthy controls [M = -4.9, SD = 2.7], p = 0.004). Conclusions: The differences suggest potential impairment in patellar hemodynamics in PFP patients, providing support for the homeostasis model. Evidence-based treatment strategies targeting patellar hemodynamics should be further refined and subjected to evaluation in clinical trials. Level of Evidence: Level III.

3.
Knee Surg Sports Traumatol Arthrosc ; 32(2): 334-343, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38294080

RESUMO

PURPOSE: A treatment-specific rehabilitation protocol and well-defined return-to-play criteria guide clinical decision-making on return to normal function, activity, sports and performance after surgical treatment for osteochondral lesion of the talus (OLT). The optimal rehabilitation protocols in the current literature remain unclear. The purpose of this study was to explore the existing literature on rehabilitation protocols from the early postoperative phase to return to sport onwards after different types of surgical treatment of OLTs. METHODS: PubMed, Embase, CDSR, DARE and Central were searched systematically from inception to February 2023 according to the PRISMA 2020 guidelines. All clinical studies with a description of postoperative rehabilitation criteria after surgical treatment of OLTs were included. The primary outcome of this study is the extent of reportage for each rehabilitation parameter expressed in percentage. The secondary outcome is the reported median time for each parameter in rehabilitation protocols for all different treatment modalities (type of surgery). The median time, expressed as number of weeks, for each parameter was compared between different types of surgery. RESULTS: A total of 227 articles were included reporting on 255 different rehabilitation protocols from seven different types of surgery. Weight-bearing instructions were reported in 84%-100% and the use of a cast or walker was prescribed in 27%-100%. Range of motion exercises were described in 54%-100% whereas physical therapy was advised in 21%-67% of the protocols. Any advice on return to sport was described in 0%-67% protocols. A nonparametric analysis of variance showed significant differences between the different surgical treatment modalities for the following parameters between the treatment groups: time to full weight-bearing (p < 0.0003) and return to high impact level of sports (p < 0.0003). Subjective or objective criteria for progression during rehabilitation were reported in only 24% of the studies. CONCLUSION: An in-depth exploration of the current literature showed substantial variation in postoperative rehabilitation guidelines with an associated underreporting of the most important rehabilitation parameters in postoperative protocols after surgical treatment of OLTs. Furthermore, nearly all rehabilitation protocols were constructed according to a time-based approach. Only one out of four reported either objective or subjective criteria. LEVEL OF EVIDENCE: Level IV, systematic review.


Assuntos
Esportes , Tálus , Humanos , Tálus/cirurgia , Tálus/patologia , Transplante Autólogo , Resultado do Tratamento , Metanálise como Assunto , Revisões Sistemáticas como Assunto
4.
J Bodyw Mov Ther ; 36: 203-209, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37949561

RESUMO

INTRODUCTION: Patellofemoral pain (PFP) is a common musculoskeletal condition. Lower limb range of motion (LLROM) evaluates soft tissue flexibility over multiple joints as part of the kinetic chain. The aims were to study: 1) the reliability of a new LLROM test; 2) differences in LLROM between PFP patients and controls; and 3) the relationship between LLROM and pain-free knee function. METHODS: Patients with PFP and matched controls were recruited from a university campus and private physiotherapy clinics, while observers were blinded for health status. Testing LLROM for maximal knee flexion and hip adduction and the sum of these (total ROM) were performed. Measures of reliability (ICC2,1) were established. Univariate linear regression between LLROM and health status and multivariate analysis between LLROM and knee function were performed. RESULTS: Patients (n = 32 (7 male/25 female, age = 22, BMI = 22.7)) and controls (n = 32 (7 male/25 female, age = 20, BMI = 22.3)) were included. The ICC's for intra- and interobserver reliability ranged from 0.83 (95%CI 0.30-0.93) to 0.89 (0.72-0.95). Symptomatic legs had 7°(3-11, p = 0.014) lower knee flexion, 6°(4-8, p ≤ 0.001) lower hip adduction and 13°(8-17, p ≤ 0.001) lower total ROM than non-symptomatic legs. Multivariate analysis revealed an association between total ROM and pain-free knee function (R2 = 0.438, F = 6.544, p ≤ 0.001). CONCLUSIONS: The new LLROM test was found to be reliable. Patients with PFP had lower LLROM, which was associated with impaired pain-free knee function. Whether improving soft tissue flexibility results in enhanced pain-free knee function should be the subject of future research.


Assuntos
Síndrome da Dor Patelofemoral , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Estudos de Casos e Controles , Reprodutibilidade dos Testes , Fenômenos Biomecânicos , Articulação do Joelho , Dor
5.
J Exp Orthop ; 10(1): 124, 2023 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-38017345

RESUMO

PURPOSE: According to the homeostasis model, patellofemoral pain (PFP) results from disturbed homeostasis due to vascular insufficiency in the anterior knee. Near-Infrared Spectroscopy (NIRS) measures relative changes in concentrations (in µmol/cm2) of (de-)oxygenated hemoglobine (HHb and O2Hb). The aims were to: 1) investigate the characteristics of the NIRS signal derived from the patella during experiments affecting hemodynamics in healthy controls, and 2) determine the test-retest reliability of NIRS in positions clinically relevant for PFP patients. METHODS: Two experiments were conducted on 10 healthy controls and analysed using Student's t-test. Reliability (ICC2,1) was evaluated for two activities ('Prolonged Sitting' and 'Stair Descent') in five PFP patients and 15 healthy controls, performed twice within five days. RESULTS: The NIRS signal (HHb and O2Hb) showed a statistically significant increase (p < .001 - .002) on all optodes (30, 35, 40 mm) during 'Venous Occlusion' (M = 1.0 - 2.0), while it showed no statistically significant change (p = .075 - .61) during 'Skin Compression' (M = -0.9 - 0.9) on the 30 and 35 mm optode. Reliability of NIRS (HHb and O2Hb) ranged from moderate to almost perfect (ICC2,1 = .47 - .95) on the 30 mm optode for 'Prolonged Sitting', and from moderate to substantial (ICC2,1 = .50 - .68) on the 35 mm optode for 'Stair Descent'. CONCLUSIONS: Patella NIRS measurements are affected by venous occlusion, but not by skin compression, and are sufficiently reliable as research application to compare real-time patellar bone hemodynamics. These insights may assist to improve effectiveness of evidence-based treatment strategies for PFP. TRIAL REGISTRATION: ISRCTN Trial Registration under number: 90377123.

6.
Sports Biomech ; : 1-30, 2023 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-37227255

RESUMO

The drag-flick is a highly relevant skill to enlarge scoring opportunities during penalty corners in field hockey. Understanding drag-flick biomechanics will likely assist in optimising training and performance of drag-flickers. The purpose of this study was to identify the biomechanical parameters related to drag-flicking performance. Five electronic databases were systematically searched from inception to 10 February 2022. Studies were included if quantified biomechanical parameters of the drag-flick were assessed and related to performance outcomes. Quality assessment of the studies was performed according to the Joanna Briggs Institute critical appraisal checklist. Study type, study design, participants' characteristics, biomechanical parameters, measurement instrumentation and results were extracted from all included studies. The search yielded 16 eligible studies (142 drag-flickers). Many different single kinematic parameters were associated with drag-flick performance and related to biomechanical aspects described in this study. Nonetheless, this review identified a lack of a solid body of knowledge on this topic due to a low number of studies as well as low study quality and strength of evidence. Future high-quality research is needed to develop a clear biomechanical blueprint of the drag-flick to better understand this complex motor skill.

7.
Sports Health ; 15(6): 898-907, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36715226

RESUMO

CONTEXT: Up to 90% of pediatric athletes return to sport (RTS) after anterior cruciate ligament reconstruction (ACL-R); however, <50% RTS at the same level and second ACL injury rates are up to 32%. OBJECTIVES: (1) Determine which physical and patient-reported outcome measures guide clinical decision-making on RTS in pediatric athletes after ACL-R and (2) present a framework with insights from cognitive and neurophysiological domains to enhance rehabilitation outcomes. DATA SOURCES: PubMed, CINAHL, Embrase, and Cochrane library databases and gray literature. STUDY SELECTION: Data on pediatric (<18 years) ACL-R patients, RTS, tests, and decision-making were reported in 1214 studies. Two authors independently reviewed titles and abstract, excluding 962 studies. Gray literature and cross-reference checking resulted in 7 extra studies for full-text screening of 259 studies. Final data extraction was from 63 eligible studies. STUDY DESIGN: Scoping review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Details on study population, aims, methodology, intervention, outcome measures, and important results were collected in a data chart. RESULTS: Studies included 4456 patients (mean age, 14 years). Quadriceps and hamstring strength (n = 25), knee ligament arthrometer (n = 24), and hop tests (n = 22) were the most-reported physical outcome measures guiding RTS in <30% of studies with cutoff scores of limb symmetry index (LSI) ≥85% or arthrometer difference <3 mm. There were 19 different patient-reported outcome measures, most often reporting the International Knee Documentation Committee (IKDC) (n = 24), Lysholm (n = 23), and Tegner (n = 15) scales. Only for the IKDC was a cutoff value of 85% reported. CONCLUSION: RTS clearance in pediatric ACL-R patients is not based on clear criteria. If RTS tests were performed, outcomes did not influence time of RTS. Postoperative LSI thresholds likely overestimate knee function since biomechanics are impaired despite achieving RTS criteria. RTS should be considered a continuum, and biomechanical parameters and contextual rehab should be pursued with attention to the individual, task, and environment. There is a need for psychological monitoring of the ACL-R pediatric population.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Humanos , Criança , Adolescente , Lesões do Ligamento Cruzado Anterior/cirurgia , Volta ao Esporte/psicologia , Força Muscular/fisiologia , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/cirurgia , Extremidade Inferior/fisiologia
9.
BMJ Open Sport Exerc Med ; 8(4): e001415, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36213759

RESUMO

Objectives: To investigate the influence of sports/activity types and their distribution over the curriculum years on intracurricular injury risk differences between curriculum years and sexes in Physical Education Teacher Education (PETE) studies. Methods: In a cohort study over 14 years (2000-2014), injuries reported at the medical facility of a Dutch vocational institute by PETE students who completed their full curriculum were registered. Intracurricular injury rates (IR) per 1000 hours and 95% CIs were calculated per sport, sex and curriculum year and compared with injury rate ratios (RR) and 95% CI. Exposure times per sports category per curriculum year were compared with the χ2 test. Results: Intracurricular IR was highest for gymnastics, team ball sports and track and field (0.76-1.23, 95% CI 0.65 to 1.45). IRs were higher for female compared with male students (RR 2.38, 95% CI 1.97 to 2.87). Comparisons for all individual sports and for all three curriculum years showed the same pattern. IR for the first year was higher than for the second (RR 1.79, 95% CI 1.45 to 2.21) and third year (RR 2.74, 95% CI 2.13 to 3.54) with similar patterns for all sports categories. Over the curriculum years, exposure time distributions per sport showed small differences (p<0.001, Cramer's V=0.07). Conclusion: Curriculum year, sex and sports types are risk factors to be independently targeted for preventive and rehabilitative measures in PETE studies. The nature and aetiology of injuries in mixed sports, and the adaption to increased loads in first-year and female PETE students, need further investigation.

10.
J Exp Orthop ; 9(1): 73, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35907095

RESUMO

BACKGROUND: The outcome after ACL reconstruction (ACLR) is in general disappointing with unacceptable number of athletes that do not return to pre-injury level of sports, high re-injury rates, early development of osteoarthritis and shorter careers. Athletes after ACLR have high expectation to return to sports which is in contrast with the current outcomes. The aim of this manuscript is to present an overview of factors that are needed to be incorporated and to personalize the rehabilitation process for an athlete who has undergone an ACLR.

11.
Phys Ther Sport ; 55: 146-154, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35421834

RESUMO

OBJECTIVE: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. DESIGN: Delphi. SETTING: LimeSurvey platform. PARTICIPANTS: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. MAIN OUTCOME MEASURES: Factors related to sports IPP planning, organization and implementation. RESULTS: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement). CONCLUSION: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist.


Assuntos
Traumatismos em Atletas , Fisioterapeutas , Esportes , Exercício de Aquecimento , Traumatismos em Atletas/prevenção & controle , Humanos
13.
J Bodyw Mov Ther ; 26: 300-308, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33992263

RESUMO

INTRODUCTION: Patellofemoral pain (PFP) is a common and often long-standing musculoskeletal condition. Evidence of the effectiveness of interventions addressing soft tissue flexibility is conflicting and of inconsistent scientific quality. However, reduced soft tissue flexibility can negatively affect patellofemoral joint kinematics. Lower limb range of motion (LLROM) reflects soft tissue flexibility throughout the kinetic chain. The aim was to evaluate the short-term effectiveness of an intervention targeting LLROM on pain and disability in patients with PFP. METHODS: A randomized, non-concurrent, multiple-baseline single-case design with a two-week intervention phase and baseline and postintervention phase with varying length was conducted. Eight participants (5 females, 3 males) of age 19(±1.6) years, weekly sports participation 12(±3.1) hours and 17(±14) months symptom duration were included. The Anterior Knee Pain Scale - Dutch Version (AKPS-DV) and the Patient Specific Complaint Scale (PSCS) were administered twice a week. After allocating participants to one of four subgroups of reduced LLROM the intervention was applied. The intervention consisted of soft tissue techniques (mobilization, taping, and stretching). RESULTS: Participant 3 and 6 showed a medium and small but statistically significant positive effect on the AKPS-DV. Participant 2 showed a large and statistically significant positive effect on the PSCS. CONCLUSIONS: This study provides moderate evidence that an intervention targeting LLROM in patients with PFP reduces pain and disability in the short-term. Further research is needed to evaluate the long-term effectiveness and optimize individual treatment outcomes.


Assuntos
Síndrome da Dor Patelofemoral , Adolescente , Adulto , Feminino , Humanos , Extremidade Inferior , Masculino , Dor , Medição da Dor , Síndrome da Dor Patelofemoral/terapia , Amplitude de Movimento Articular , Adulto Jovem
14.
Eur J Radiol ; 134: 109452, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33310551

RESUMO

PURPOSE: To develop a specified radiographic scoring system for the pubic symphysis and adjacent bones, and to examine the intra- and inter-rater reproducibility of this system. METHOD: Development of the scoring protocol was performed in three stages using AP pelvis radiographs of 102 male adult athletes. The final protocol included 5 overall scoring items, which included further specification of locations: 1) bone lucency (erosion-like configuration and cysts), 2) proliferation, 3) fragmentation, 4) sclerosis, and 5) joint space width. Intra- and inter-rater reproducibility were determined using Cohen's kappa statistic (κ) and intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and minimal detectable difference (MDD) were also determined. RESULTS: We present a radiographic scoring protocol with clear definitions and examples to improve clinical usability. Intra-rater reproducibility was: bone lucency (erosion-like configuration or cysts): κ = 0.67 (95 %CI 0.56-0.78), proliferation: κ = 0.54 (95 %CI 0.38-0.70), fragmentation: κ = 0.80 (95 %CI 0.67-0.93), sclerosis: κ = 0.60 (95 %CI 0.49-0.71), and joint space width: ICC(2.1) 0.85 (95 %CI 0.78-0.89), SEM 0.4 mm, MDD 1.2 mm. Inter-rater reproducibility was: bone lucency: κ = 0.61 (95 %CI 0.50-0.72), proliferation: κ = 0.34 (95 %CI 0.20-0.48), fragmentation: κ = 0.67 (95 %CI 0.50-0.84), sclerosis: κ = 0.30 (95 %CI 0.17-0.43), and joint space width: ICC(2.1) 0.72 (95 %CI 0.59-0.81), SEM 0.5 mm., MDD 1.5 mm. CONCLUSIONS: The Aspetar pubic symphysis radiographic scoring protocol contains five overall scoring items, with additional specifications. These five items showed moderate to almost perfect intra-rater reproducibility, and fair to substantial inter-rater reproducibility. This protocol provides the basis for use in clinical practice, and will allow future investigations of the clinical significance of radiographic changes at the pubic symphysis in athletes.


Assuntos
Sínfise Pubiana , Adulto , Atletas , Humanos , Masculino , Variações Dependentes do Observador , Sínfise Pubiana/diagnóstico por imagem , Reprodutibilidade dos Testes
15.
Phys Ther Sport ; 46: 169-176, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32957033

RESUMO

OBJECTIVES: To determine normal values for hip strength and range of motion (ROM) of elite, sub-elite and amateur male field hockey players and to examine the effect of age, leg dominance, playing position, playing level and non-time-loss groin pain on hip strength and ROM. DESIGN: Cross-sectional study. SETTING: Physical testing took place at field hockey clubs. PARTICIPANTS: Male field hockey players competing in the three highest Dutch field hockey leagues (n = 104). MAIN OUTCOME MEASURES: Eccentric adduction, eccentric abduction, adductor squeeze strength, adduction/abduction ratio, internal rotation, external rotation and bent knee fall out (BKFO). RESULTS: Strength and ROM values (mean ± standard deviation) were: adduction = 2.8 ± 0.4 Nm/kg, abduction = 2.6 ± 0.4 Nm/kg, adduction/abduction ratio = 1.1 ± 0.2, squeeze test = 4.5 ± 0.8 N/kg, internal rotation = 34° ± 11°, external rotation = 47° ± 9°, BKFO = 15 ± 4 cm. Age, leg dominance, playing position, playing level and non-time-loss groin pain had no effect on these profiles. CONCLUSIONS: Normal values were established for hip strength and ROM of male field hockey players and showed to be independent of age, leg dominance, playing position, playing level and non-time-loss groin pain.


Assuntos
Articulação do Quadril/fisiologia , Hóquei/fisiologia , Força Muscular , Amplitude de Movimento Articular , Adulto , Fatores Etários , Estudos Transversais , Virilha , Quadril/fisiologia , Humanos , Articulação do Joelho/fisiologia , Perna (Membro)/fisiologia , Masculino , Músculo Esquelético/fisiologia , Dor/fisiopatologia , Valores de Referência , Adulto Jovem
16.
Sensors (Basel) ; 20(16)2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32823657

RESUMO

AIM: Study concurrent validity of a new sensor-based 3D motion capture (MoCap) tool to register knee, hip and spine joint angles during the single leg squat. DESIGN: Cross-sectional. SETTING: University laboratory. PARTICIPANTS: Forty-four physically active (Tegner ≥ 5) subjects (age 22.8 (±3.3)) Main outcome measures: Sagittal and frontal plane trunk, hip and knee angles at peak knee flexion. The sensor-based system consisted of 4 active (triaxial accelerometric, gyroscopic and geomagnetic) sensors wirelessly connected with an iPad. A conventional passive tracking 3D MoCap (OptiTrack) system served as gold standard. RESULTS: All sagittal plane measurement correlations observed were very strong for the knee and hip (r = 0.929-0.988, p < 0.001). For sagittal plane spine assessment, the correlations were moderate (r = 0.708-0.728, p < 0.001). Frontal plane measurement correlations were moderate in size for the hip (ρ = 0.646-0.818, p < 0.001) and spine (ρ = 0.613-0.827, p < 0.001). CONCLUSIONS: The 3-D MoCap tool has good to excellent criterion validity for sagittal and frontal plane angles occurring in the knee, hip and spine during the single leg squat. This allows bringing this type of easily accessible MoCap technology outside laboratory settings.


Assuntos
Articulação do Quadril , Articulação do Joelho , Monitorização Fisiológica , Coluna Vertebral , Adulto , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Humanos , Perna (Membro) , Masculino , Amplitude de Movimento Articular , Adulto Jovem
17.
Physiother Theory Pract ; 36(9): 1009-1018, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30307775

RESUMO

OBJECTIVES: To study the clinical course including return to sport success rates of football players with adductor-related groin pain (ARGP) after manual therapy of the adductor muscles. DESIGN: Prospective case series. METHODS: Thirty-four football players with ARGP with median pre-injury Tegner scores of 9 (IQR 25-75: 9-9) were treated with manual therapy of the adductor muscles. Main outcome measures were numeric pain rating scale (NPRS), Hip and Groin Outcome Score (HAGOS) and global perceived effect (GPE) for treatment and patient satisfaction at 2, 6 and 12 weeks. Return to sport was documented. RESULTS: Pain during (NPRS 7 (6-8) and after (NPRS 8 (6-8) sports decreased to NPRS 1 (0.2-3) and 1 (0.8-3), respectively (p < 0.001). Within 2 weeks 82% of the players returned to pre-injury playing levels with improved (p < 0.001) HAGOS subscale scores. Eighty-five percent reported clinically relevant improvement, 82% reported to be satisfied. At 12 weeks, 88% had returned to pre-injury playing levels. HAGOS showed symptoms were still present. CONCLUSION: Early return to sport seems possible and safe after manual therapy of the adductor muscles in football players with ARGP in the short term. While the majority of injured football players return to sport within two weeks, caution is advised regarding effectiveness as hip and groin symptoms were still present and no control groups were available.


Assuntos
Traumatismos em Atletas/terapia , Virilha/lesões , Músculo Esquelético/lesões , Manipulações Musculoesqueléticas/métodos , Volta ao Esporte , Futebol/lesões , Adulto , Humanos , Masculino , Medição da Dor , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
18.
Phys Ther Sport ; 40: 225-230, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31627075

RESUMO

OBJECTIVE: To study the preseason prevalence of groin injury with normal and reduced performance. DESIGN: Cross-sectional cohort. SETTINGS: Online survey. PARTICIPANTS: 383 Dutch female amateur football players (35 teams). MAIN OUTCOME MEASURES: Prevalence of groin injury per injury group (timeloss or non-timeloss) using a general questionnaire and per performance group (groin pain with normal or reduced performance) using subscales Pain and Participation in Physical Activities of the Hip And Groin Outcome Score (HAGOS). Levels and between-group differences of groin-related symptoms and problems (HAGOS) for injury and performance groups. The injury groups from which players with groin pain and normal performance originate. RESULTS: Prevalence of non-timeloss groin injury was 22% (95% confidence interval (95%CI) = 18-26) (n = 84), 7% (95%CI = 5-10) (n = 26) for timeloss groin injury, 21% (95%CI = 17-25) (n = 80) for pain + normal performance and 16% (95%CI = 12-20) (n = 61) for pain + reduced performance. HAGOS-scores differed between injury (P < .022) and performance groups (p < .043). Twenty-three players (27%) with pain + normal performance originated from the non-timeloss groin injury group (100%). CONCLUSION: As female amateur football players with groin pain and normal performance are considered non-injured, the prevalence of non-timeloss groin injury lowers by a quarter. These players have lower HAGOS scores than non-injured players without pain yet higher scores than those with non-timeloss groin injury.


Assuntos
Traumatismos em Atletas/epidemiologia , Virilha/lesões , Dor/diagnóstico , Futebol/lesões , Adolescente , Adulto , Atletas , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Países Baixos , Prevalência , Inquéritos e Questionários , Adulto Jovem
19.
Phys Ther Sport ; 38: 87-95, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31071660

RESUMO

OBJECTIVE: To investigate the effects of compression shorts on pain and performance in football players with groin pain. STUDY DESIGN: Double blinded randomized controlled trial. SETTING: Soccer pitch. PARTICIPANTS: Thirty-four male football players with groin pain. MAIN OUTCOME MEASURES: The effect of wearing zoned high compression shorts (ZHC-shorts), non-zoned low compression shorts (NZLC-shorts), and normal sports clothes on pain measured with the Numeric Pain Rating Scale (NPRS) and performance during the Copenhagen 5-s squeeze test (CS), the Illinois Agility test (IAT), and maximum shooting (ST). The effects of wearing ZHC versus NZLC shorts on symptoms were measured using the Hip and groin outcome score (HAGOS) during actual football activities. RESULTS: Wearing ZHC-shorts reduced pain during the IAT (1.4, ES = 0.58, p= <0.01) and ST (1.2, ES = 0.47, p= <0.01) compared to wearing normal sports clothes, but did not negatively affect performance. Compared to the baseline HAGOS scores a clinically significant improvement in the symptoms (9.7, ES = 0.63, p= <0.01) and sport/recreation (13.2, ES = 0.68, p = 0.01) subscales was found when wearing the ZHC-short during football activities. CONCLUSION: Wearing zoned high compression shorts could be useful in reducing groin pain in football players during their football activities.


Assuntos
Futebol Americano/lesões , Atividade Motora/fisiologia , Manejo da Dor/métodos , Dor Pélvica/terapia , Modalidades de Fisioterapia , Adolescente , Adulto , Método Duplo-Cego , Virilha , Humanos , Masculino , Dor Pélvica/fisiopatologia , Pressão , Adulto Jovem
20.
Phys Ther Sport ; 36: 43-50, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30641448

RESUMO

OBJECTIVES: Patients with patellofemoral pain (PFP) experience pain while descending stairs. To date no reliable and valid performance-test exists to assess the maximum pain-free knee flexion angle (MPFFA) as outcome measure during a step-down task. Therefore, the intra- and inter-observer reliability and construct validity of the decline step-down test (DSDT) measuring the MPFFA in patients with PFP were evaluated. DESIGN: Reliability and construct validity. SETTING: Private practices in Nijmegen and Utrecht, the Netherlands. PARTICIPANTS: Patients with PFP. MAIN OUTCOME MEASURES: The reliability was assessed by repeated measurements of the MPFFA during the DSDT. The construct validity was assessed by correlating the measurements on the DSDT with the Anterior Knee Pain Scale Dutch Version (AKPS-DV) based on a pre-set hypothesis. RESULTS: Thirty-two participants (forty-eight knees) were eligible for inclusion. The intraclass correlation coefficient (ICC) for intra-observer reliability was ICC2,1 = 0.83 and ICC2,1 = 0.85 for inter-observer reliability. The 95% limits of agreement (LoA) showed a width of 27.56° for intra-observer reliability and a width of 24.42° for inter-observer reliability. There was an average positive correlation between the DSDT and the total score on the AKPS-DV (rs = 0.31, p = 0.030). CONCLUSION: The DSDT measuring the MPFFA is reliable and valid in patients with PFP.


Assuntos
Artralgia/diagnóstico , Teste de Esforço/métodos , Articulação Patelofemoral/fisiopatologia , Adolescente , Adulto , Artralgia/fisiopatologia , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
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