International Journal of Sports Physical Therapy最新文献

{"title":"From Force Plates to AI: Establishing Validity and Reliability of a 2D AI-Camera System for Quantifying Sit-to-Stand Power Measurement.","authors":"Michael Jeanfavre, Joy Xiao","doi":"10.26603/001c.158667","DOIUrl":"https://doi.org/10.26603/001c.158667","url":null,"abstract":"<p><strong>Background: </strong>Muscle power is a critical determinant of functional capacity and overall health, particularly in aging and athletic populations. The 30-second Sit to Stand Power Test (30STSPT) offers a practical means of assessing lower limb power, yet its widespread clinical adoption is limited by the need for specialized equipment. Emerging technologies, such as 2D Artificial Intelligence (AI)-based camera systems, may offer scalable and accessible alternatives for power assessment. # PURPOSEThe purpose of this study was to determine (1) the concurrent validity against a dual force plate system and (2) the test-retest reliability of a 2D AI-camera for capturing and calculating the muscle power for a 30STSPT. It was hypothesized that the 2D AI-camera would have high test-retest reliability and strong concurrent validity with the power measured by a dual force plate system and inertial measurement unit (IMU). # STUDY DESIGNValidation and reliability study # METHODSA convenience sample of 24 healthy adults (20-55 years) completed two maximal-effort trials of the 30-second Sit-to-Stand Power Test (30STSPT). During each trial, repetitions were counted by research personnel, the AI-based camera system, and the criterion system (dual force plates synchronized with an inertial measurement unit [IMU]). The AI system automatically calculated trial-level mean power (W·kg<sup>-1</sup>) using body mass, stature, chair height, and performance time via a validated equation. The criterion method computed power from average peak vertical ground-reaction forces and IMU-derived vertical displacement. Concurrent validity between AI and criterion power was assessed using Pearson's correlation coefficient (r) with 95% confidence intervals (CI) and Bland-Altman analysis. Test-retest reliability for AI and criterion measures was evaluated using a two-way mixed-effects intraclass correlation coefficient (ICC(3,1)) with 95% CI, and measurement error was quantified via the standard error of measurement (SEM) and minimal detectable change at 95% confidence (MDC₉₅).</p><p><strong>Results: </strong>A total of 24 individuals (M:F, 9:15) with a mean age of 34.4 ± 9.4 years and an average BMI of 24.9 ± 4.1 kg·m<sup>-2</sup> completed two trials of the 30STSPT. AI-derived power demonstrated excellent correlation with the criterion method for Trial 1 (r = 0.945, 95% CI 0.861-0.979) and Trial 2 (r = 0.934, 95% CI 0.833-0.975). Bland-Altman analysis showed a mean bias of +0.66 W·kg<sup>-1</sup> (LoA: -0.51 to +1.83) for Trial 1 and +0.53 W·kg<sup>-1</sup> (LoA: -1.07 to +2.12) for Trial 2, with proportional bias evident in both trials (Trial 1 slope = -0.195, p = 0.027; Trial 2 slope = -0.285, p = 0.0049). Test-retest reliability of AI-derived power was excellent (ICC(3,1) = 0.942, 95% CI 0.860-0.977), with SEM = 0.362 W·kg<sup>-1</sup> (7.13%) and MDC₉₅ = 1.004 W·kg<sup>-1</sup> (19.8%). Criterion reliability was good-to-excellent (ICC(3,1) = 0.916, 95% CI 0.790-","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"352-362"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Therapeutic Exercises and Ultrasound for Rehabilitation of Partially Injured Hamstring Muscles in Elite Soccer (Football) Players: A Study Protocol for a Randomized Controlled Trial.","authors":"Kamal Hadib Abdulridha, Iman Kadhim Hani Al-Tameemi, Alhasan Hadi Abdulhameed Alzaidi, Juan Nicolás Cuenca-Zaldivar, Alejandra Aguilar Latorre, Isabel Gómez-Soria, Estela Calatayud","doi":"10.26603/001c.156100","DOIUrl":"https://doi.org/10.26603/001c.156100","url":null,"abstract":"<p><strong>Introduction: </strong>Hamstring injuries are common among athletes, particularly in high-intensity sports such as soccer (football), which involves rapid acceleration and frequent changes of direction. Reported risk factors include neuromuscular fatigue, older age, low muscle strength, and reduced flexibility. Recurrent injuries are often related to previous tears, especially smaller tears in the biceps femoris muscle.</p><p><strong>Objective: </strong>The primary objective is to describe the protocol for a randomized controlled trial designed to assess the efficacy of a combined program of therapeutic exercises and therapeutic ultrasound (TUS) compared with therapeutic exercises alone for the rehabilitation of partially injured hamstring muscles in elite soccer players.</p><p><strong>Design: </strong>Study protocol for a parallel-group randomized controlled trial.</p><p><strong>Methods: </strong>A total of 150 elite soccer players with a history of hamstring injury from eight professional clubs will be randomly allocated to two groups: 75 players in the intervention group will receive TUS combined with a structured therapeutic exercise program, and 75 players in the control group will follow the same exercise program without TUS. All participants will be actively engaged in training and matches and will have clinically and radiologically confirmed partial hamstring strains without other relevant medical conditions. The trial will evaluate whether combining TUS with exercises improves rehabilitation outcomes, reduces time to return to full team training, and contributes to injury prevention in high-performance athletes.</p><p><strong>Conclusion: </strong>This protocol describes a randomized controlled trial that will evaluate the effects of therapeutic exercises with and without TUS in the rehabilitation of partially injured hamstring muscles in elite soccer players. The findings are expected to inform sports medicine practitioners about the potential role of TUS as an adjunct to exercise-based rehabilitation. Given the mixed evidence regarding the effectiveness of TUS in musculoskeletal conditions, this study will contribute additional data on its possible benefits in this specific athletic population. Trial registration: NCT06165783.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"440-452"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Proximal Hamstrings at the Ischial Tuberosity.","authors":"Robert C Manske, Chris Wolfe, Phil Page, Michael Voight","doi":"10.26603/001c.158832","DOIUrl":"https://doi.org/10.26603/001c.158832","url":null,"abstract":"<p><p>The hamstring muscle complex comprises several biarticular posterior thigh muscles. These muscles originate from the ischial tuberosity and attach distally to the knee. Hamstring muscle injuries are among the most common in the lower extremities of active individuals. Hamstring injuries follow a consistent pattern and medical history, including a sudden, explosive movement (sprinting, kicking, jumping, or lunging). The onset of pain is usually acute in the proximal posterior aspect of the upper thigh. Injured individuals may describe a \"pop\" or \"snap\" or a sensation as if someone kicked them in the back of the thigh. An accurate diagnosis of proximal hamstring overuse, partial tears, or ruptures is essential for appropriate treatment planning and optimizing patient outcomes. Diagnostic musculoskeletal ultrasound (MSKUS) offers a portable, real-time, and cost-effective alternative, gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating proximal hamstring injuries, including tendinopathy, muscle strains (partial tears), and ruptures. MSKUS is excellent at detecting changes in tendon and muscle composition and continuity. This manuscript will review the utility of MSKUS in evaluating proximal hamstring tendon and muscle injury, including anatomy, common injury patterns, sonographic techniques, and clinical implications for rehabilitation professionals. By integrating MSKUS into clinical practice, providers can improve diagnostic accuracy, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to achieve optimal patient outcomes for those with hamstring injuries.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"477-482"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation Following a Distal Semitendinosus Excision in a Collegiate American Football Player: A Resident's Case Report.","authors":"Miles Moore, Matt Redd, Rodney Hill, Kevin Farmer, Giorgio Zeppieri","doi":"10.26603/001c.158671","DOIUrl":"https://doi.org/10.26603/001c.158671","url":null,"abstract":"<p><strong>Introduction: </strong>Hamstring injuries are a common time-loss injury in American football. Conservative management is often attempted but possesses high rates of reinjury. In the presence of distal semitendinosus tendon avulsions with retraction, excision procedures have shown increased return to sport success rates with less time loss compared to conservative management. The purpose of this case report is to describe the surgical management and postoperative rehabilitation program for a collegiate American football player after a distal semitendinosus excision procedure. # Case Description The subject was a 20-year-old male collegiate American football player who presented with a left distal semitendinosus tendon avulsion with retraction. Due to significant pain and limitations from the initial injury, attempts to conservatively rehab failed and the subject underwent a distal semitendinosus tendon excision procedure. Post-operative physical therapy interventions followed a multi-phase approach based on physiological tissue healing and patient response to exercise. Patient reported outcomes including the Functional Assessment Scale for Acute Hamstring Injuries (FASH), Single Assessment Numeric Evaluation (SANE), and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) were utilized along with isometric and eccentric dynamometry, force plate and Global Positioning System (GPS) analysis to determine readiness to return to sport. # Outcomes The subject completed 24 physical therapy sessions over the course of 12 weeks in addition to 36 treatment sessions with the athletic training staff and a weightroom exercise program. At return to sport, clinically meaningful improvement was observed in patient reported outcomes including FASH, SANE, and OSPRO-YF. Additionally, strength and functional task performance superseded pre-injury levels and thresholds of clinical significance. The subject returned to sport at 12 weeks post-operatively.</p><p><strong>Conclusion: </strong>The subject in this case effectively returned to participation in collegiate American football 12-weeks after distal semitendinosus tendon excision procedure and participation in a multi-phased rehabilitation program. The distal semitendinosus excision procedure and rehabilitation approach presented in this case report would benefit from continued research in other athletes.</p><p><strong>Level of evidence: </strong>Level 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"453-466"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb Dominance Does Not Affect Y-Balance Performance in Young Athletes 12 Weeks After Anterior Cruciate Ligament Reconstruction.","authors":"Matt Turner, Joseph Hannon, Shiho Goto, Sharon Wang-Price, Craig Garrison, Steven Singleton","doi":"10.26603/001c.158828","DOIUrl":"https://doi.org/10.26603/001c.158828","url":null,"abstract":"<p><strong>Background: </strong>The Lower Quarter Y-Balance Test (YBT-LQ) has been shown to be a reliable and valid tool for assessing lower extremity balance in the athletic populations. It is commonly included in the test battery used to determine athletes' readiness for return to sport. As the dominant limb has been associated with a lower rate of second anterior cruciate ligament (ACL) injury in athletes after ACL reconstruction (ACLR), early detection of the effects of limb dominance on YBT-LQ performance can provide insight into athletes' rehabilitation progression and prognosis after ACLR.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to determine whether limb dominance would affect YBT-LQ performance in young athletes 12 weeks after ACLR. It was hypothesized that limb dominance would have a significant effect on YBT-LQ performance in this patient population.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>A total of 110 athletes following ACLR were included in this secondary analysis. The dominant limb was defined as the limb that participants would choose to kick a ball. Participants were grouped based on whether the ACLR limb was their self-reported dominant limb (n = 50) or non-dominant limb (n = 60). YBT-LQ performance was assessed at 12 weeks postoperatively as part of a battery of tests. Two separate 2 (group) x 4 (YBT-LQ score) mixed ANOVAs were performed for the surgical and non-surgical limbs.</p><p><strong>Results: </strong>There were no significant group x direction interactions or main effects of surgical limb dominance for the surgical limb (p = 0.527) or non-surgical limb (p = 0.207). Effect sizes were trivial (Cohen's d = 0.03 - 0.17).</p><p><strong>Conclusion: </strong>Limb dominance does not seem to affect YBT-LQ performance in a young athletic population at 12 weeks after ACLR.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"397-403"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-rater and Intra-rater Reliability of the Cutting Movement Assessment Score Among Physical Therapists.","authors":"Evan Andreyo, Casey Unverzagt, Thomas Dos'Santos, Jay Dawes","doi":"10.26603/001c.158830","DOIUrl":"https://doi.org/10.26603/001c.158830","url":null,"abstract":"<p><strong>Background: </strong>Women's basketball has a high incidence of anterior cruciate ligament (ACL) injuries, many of which occur during change of direction (COD) movements. Evaluating movement quality during these maneuvers can provide valuable insight into an athlete's ACL injury risk.</p><p><strong>Purpose: </strong>The primary aim of this study was to assess the reliability of the Cutting Movement Assessment Score (CMAS) in female basketball players when utilized by physical therapists (PTs) with varying levels of clinical experience and expertise.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Qualitative movement assessment was conducted using 2-dimensional video recording of a 45° change of direction (COD) task of 20 female basketball players and scored using the CMAS. Intra-rater and inter-rater reliability were assessed across two experts with ≥8 years of clinical experience and orthopaedic and sports clinical specializations, and one novice rater with <2 years of clinical experience and no board certifications. Intra- and inter-rater reliability for total CMAS scores were evaluated using intraclass correlation coefficients (ICCs). Agreement for individual CMAS items was assessed using percent agreement and kappa coefficients.</p><p><strong>Results: </strong>The CMAS demonstrated excellent intra-rater reliability (ICC = 0.96) and moderate inter-rater reliability (ICC = 0.67) for total scores across all three raters. For individual CMAS items, intra-rater percentage agreement was excellent (80-100%), and kappa coefficients were moderate to excellent (k = 0.59-1.00). Inter-rater percentage agreement for individual items was moderate to excellent (60-90%), and kappa coefficients were slight to excellent (k = 0.12-0.79).</p><p><strong>Conclusion: </strong>The CMAS can be a reliable tool for evaluating COD movement quality among PTs at various levels of clinical experience and expertise, although the identification of movement faults may have a relationship with years of clinical experience. The findings of this investigation suggest stronger intra-rater reliability than inter-rater reliability.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"415-427"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of a Novel Qualitative Assessment Tool for Evaluating a Run Plant Task.","authors":"Lauren Butler, Ashley Erdman, Alexa Martinez, Sierra Tate, Amie DeVerna, Sophia Ulman","doi":"10.26603/001c.156437","DOIUrl":"https://doi.org/10.26603/001c.156437","url":null,"abstract":"<p><strong>Background: </strong>Young female athletes have a substantial risk of suffering an anterior cruciate ligament (ACL) injury, in part due to sex-specific movement patterns. Injury prevention strategies targeting movement errors during a deceleration task may help decrease the associated risk. In order to enhance preventive interventions, screening tools to identify at-risk individuals are vital.</p><p><strong>Hypothesis/purpose: </strong>To assess intra- and inter-rater reliability of a qualitative assessment of trunk and lower extremity alignment during a run plant task. It was hypothesized that the tool would demonstrate good to excellent intra- and inter-rater reliability.</p><p><strong>Study design: </strong>Repeated measures.</p><p><strong>Methods: </strong>Two Raters assessed videos of 25 healthy female athletes (ages 12-17 years) performing a run plant task. Female athletes were chosen due to their increased ACL injury risk. Raters used a qualitative checklist to assess trunk and lower extremity alignment, awarding one point for each observed movement fault. Item scores were then summed to generate a total score. Each video was scored twice with a two-week washout period in-between. Intraclass correlation coefficients (ICC) for each scoring item and the overall total score were calculated with a 2-way mixed-effect model and 95% confidence intervals (95% CIs) for inter- and intra-rater reliability.</p><p><strong>Results: </strong>Intra-rater reliability was poor to moderate (Rater 1 ICC = 0.43, 95% CI 0.12-0.73; Rater 2 ICC = 0.54, 95% CI 0.20-0.87). Inter-rater reliability was moderate in round one (ICC = 0.66, 95% CI 0.41-0.90) and poor in round two (ICC = 0.32, 95% CI 0.02-0.63). Medial foot position was the only item to achieve good intra- and inter-rater reliability. Sagittal alignment also demonstrated good inter-rater reliability. In both rounds, dynamic valgus and preparatory deceleration steps were consistently marked as present (100% agreement), and lateral foot position was consistently marked as not present (100% agreement), by both Raters for all athletes.</p><p><strong>Conclusion: </strong>While some individual items showed good reliability, several items and the total score failed to achieve acceptable reliability. Despite lower ICC values for dynamic valgus, preparatory deceleration steps, and lateral foot position, percent agreement was high. The skew and limited variability in these items likely influenced ICC estimates, suggesting that Rater consistency may be underestimated. Refinement of scoring item definitions for these items is needed prior to clinical application of the tool.</p><p><strong>Level of evidence: </strong>Level 2, diagnosis.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 3","pages":"281-290"},"PeriodicalIF":2.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insertional Achilles Tendinopathy with Haglund's Deformity: A Progressive Approach to Post-Operative Rehabilitation in Athletes.","authors":"Mark Dudek, Anastasia Bj Robinson, Meghan Newcomer, C Thomas Haytmanek","doi":"10.26603/001c.156435","DOIUrl":"https://doi.org/10.26603/001c.156435","url":null,"abstract":"<p><p>Haglund's Syndrome is characterized by posterior superior calcaneal prominence with associated retrocalcaneal bursitis and insertional Achilles tendinopathy (IAT). Conservative management with physical therapy demonstrates strong evidence for efficacy and takes time. It is typically trialed for over a year, and if pain and dysfunction persist, surgical intervention is considered. Post-operative rehabilitation protocols described in the literature vary widely, with many restricting weightbearing for extended periods of time. This protocol emphasizes an expedited yet safe return to weightbearing for the patient to quickly normalize gait and return to evidence-based loading strategies. By aligning rehabilitation milestones with physiological healing timelines and objective criteria, this rehabilitation approach aims to optimize efficiency in recovery and facilitate a safe return to sport. The purpose of this clinical commentary is to review current literature and propose a criterion-based protocol recommending early weight bearing when significant repair of the tendon is not necessary. # Level of Evidence 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 3","pages":"312-323"},"PeriodicalIF":2.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiligamentous Knee Reconstruction Complicated by Septic Arthritis Following Cosmetic Surgery, A Case Report.","authors":"Miles Moore, Giorgio Zeppieri, Ryan Roach, Maria Rademacher","doi":"10.26603/001c.157583","DOIUrl":"https://doi.org/10.26603/001c.157583","url":null,"abstract":"<p><strong>Background and purpose: </strong>Multiligamentous knee injuries present challenges to surgeons and rehabilitation specialists. Challenges can be complicated by postoperative infections, which impact patient outcomes. The knee stability and movement coordination impairments in this case are consistent with the Knee Ligament Sprain Clinical Practice Guideline, which provides a clinical framework for rehabilitation decision making following complex ligament reconstructions. This case report describes the rehabilitation management and outcomes following multiligament knee reconstruction complicated by septic arthritis after elective cosmetic surgery performed shortly after an orthopedic surgery.</p><p><strong>Case description: </strong>A 22-year-old female recreational athlete (runner and gymnast) sustained a right tibiofemoral dislocation after a motor vehicle accident. A staged surgical approach was performed with posterolateral corner reconstruction followed by anterior and posterior cruciate ligament reconstruction four months later. Eight weeks after cruciate ligament reconstruction, the patient underwent elective cosmetic surgery with autologous fat grafting from the thigh. She developed a sudden onset of right knee pain and swelling and was diagnosed with septic arthritis. Arthroscopic irrigation, debridement, synovectomy, and intravenous antibiotics were administered. Rehabilitation progressed through a multi-phased protocol based on tissue healing and clinical readiness. Patient-reported outcomes included the International Knee Documentation Committee (IKDC), the ACL Return to Sport After Injury (ACL-RSI), and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and isokinetic testing.</p><p><strong>Outcomes: </strong>The patient completed 36 sessions over 63 weeks from arthroscopic irrigation to the final physical therapy visit. IKDC increased by 17.24 points (MCID = 9.5), and ACL-RSI improved by 30 points (MIC = 15.1). OSPRO-YF decreased from five yellow flags to three. Isokinetic testing revealed a quadriceps peak torque-to-body weight ratio of 84.2%, with a limb symmetry index of 96.6%, surpassing normative values. She returned to an interval running program at 16 weeks and resumed coaching gymnastics at 28 weeks post-irrigation.</p><p><strong>Discussion: </strong>This case highlights infection as a critical differential diagnosis in patients presenting with a painful knee effusion and describes septic arthritis occurring after an elective procedure performed shortly following orthopedic surgery.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 3","pages":"303-311"},"PeriodicalIF":2.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of the Abdominal Drawing-In Maneuver on Intra-Abdominal Pressure and Torque During Trunk Rotation.","authors":"Asuka Kimura, Ryota Kurokawa, Reoto Fukuyama, Takuya Shimizu","doi":"10.26603/001c.156439","DOIUrl":"https://doi.org/10.26603/001c.156439","url":null,"abstract":"<p><strong>Background: </strong>The abdominal drawing-in maneuver (ADIM) is widely used in sports physical therapy and rehabilitation to selectively activate deep trunk muscles. Although the ADIM is effective for motor control retraining, previous studies suggest that it may be unsuitable as a breathing strategy during high-load tasks because it limits intra-abdominal pressure (IAP) generation. Trunk rotation in the horizontal plane is a fundamental component of many functional and sport-related movements and requires coordinated trunk stability and force production; however, the effects of the ADIM on IAP and torque during trunk rotation remain unclear.</p><p><strong>Purpose: </strong>The purpose of the present study was to clarify the effects of the ADIM on IAP and trunk rotational torque during trunk rotation.</p><p><strong>Study design: </strong>Crossover, randomized controlled study.</p><p><strong>Methods: </strong>Fifteen healthy young adult males performed seated isometric trunk rotation tasks under two conditions: spontaneous rotation (SR) and trunk rotation with the ADIM (DIR). IAP was measured using a catheter-type pressure sensor. Trunk rotational torque was measured with a custom-manufactured trunk rotation dynamometer. Inspiratory volume was normalized as %inspiratory volume. Outcomes were compared between conditions.</p><p><strong>Results: </strong>IAP was significantly greater in SR (96.7 ± 31.4 mmHg) than in DIR (34.9 ± 15.9 mmHg) (p < 0.01, d = 2.48). Torque was also significantly greater in SR (68.7 ± 20.2 Nm) than in DIR (49.1 ± 17.7 Nm) (p < 0.01, d = 1.03). %inspiratory volume was significantly greater in SR (66.9 ± 16.2%) compared with DIR (26.4 ± 17.4%) (p < 0.01, d = 2.41). Large effect sizes were observed for all outcomes.</p><p><strong>Conclusion: </strong>Performing trunk rotation with the ADIM attenuated increases in IAP and trunk rotational torque. These findings indicate that ADIM influences both pressure generation and mechanical output during trunk rotation.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 3","pages":"262-271"},"PeriodicalIF":2.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}