Journal of Sport Rehabilitation最新文献

{"title":"Return-to-Play With R2Play: Protocol for Evaluating Cross-Site Feasibility, Face Validity, and Content Validity of a Multidomain Concussion Assessment Tool for Youth.","authors":"Shannon Scratch, Josh Shore, Danielle DuPlessis, Andrew Lovell, Andrea Hickling, Pavreet Gill, Kylie Mallory, Emily Lam, Fanny Hotze, Roger Zemek, Carolyn Emery, Kathryn Schneider, Michael Hutchison, Isabelle Gagnon, Jeffrey Caron, Nick Reed, Elaine Biddiss","doi":"10.1123/jsr.2024-0106","DOIUrl":"https://doi.org/10.1123/jsr.2024-0106","url":null,"abstract":"<p><strong>Context: </strong>Clinical concussion assessments do not typically simulate the speed or complexity of sport. Performance changes arising from combined physical, cognitive, and sensory demands of sport may thus remain undetected during rehabilitation. We developed R2Play, a multidomain return-to-play assessment tool for youth with concussions. R2Play involves levels and conditions that vary in physical, cognitive, and sensory load to simulate the multidomain demands of sport.</p><p><strong>Objectives: </strong>To explore cross-site feasibility, face validity, and content validity of R2Play by integrating quantitative and qualitative data.</p><p><strong>Methods: </strong>Convergent mixed-methods feasibility study. Five sites will each recruit 5 clinicians (total nc = 25) and 10 youth sport participants (ages 10-25 y) with a history of concussion in the previous year (total ny = 50). Feasibility will be evaluated using quantitative criteria for acceptability, demand, implementation, practicality, and integration, and qualitative investigated data from content analysis of postassessment interviews with youth and clinician participants. Face validity will be investigated in postassessment interviews. Content validity will be established through (1) changes in performance metrics (time to completion, errors, and heart rate) across R2Play levels, (2) youth-perceived physical and cognitive exertion for each level, and (3) overall clinician perceptions determined through postassessment interviews. Qualitative and quantitative data will be merged through joint display to identify areas of convergence, divergence, and complementarity, and to establish meta-inferences about feasibility, face validity, and content validity.</p><p><strong>Discussion: </strong>This study aims to demonstrate the face and content validity of R2Play, and its feasibility for cross-site implementation. Findings will guide further iteration of R2Play and establish the foundation for a larger multicenter validation study to establish the psychometric properties of R2Play. This work represents an important first step toward the implementation of an ecologically valid multidomain assessment tool designed to support a safe and efficient return-to-play after concussion, ultimately reducing the risk of recurrent concussion and subsequent injury.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Markerless Kinematic Data in the Frontal Plane Contributions to Movement Quality in the Single-Leg Squat Test: A Comparison and Decision Tree Approach.","authors":"Juhyun Park, Yongwook Kim, Sujin Kim, Kyuenam Park","doi":"10.1123/jsr.2024-0182","DOIUrl":"https://doi.org/10.1123/jsr.2024-0182","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to compare kinematic data of the frontal trunk, pelvis, knee, and summated angles (trunk plus knee) among categorized grades using the single-leg squat (SLS) test, to classify the SLS grade, and to investigate the association between the SLS grade and the frontal angles using smartphone-based markerless motion capture.</p><p><strong>Methods: </strong>Ninety-one participants were categorized into 3 grades (good, reduced, and poor) based on the quality of the SLS test. An automated pose estimation algorithm was employed to assess the frontal joint angles during SLS, which were captured by a single smartphone camera. Analysis of variance and a decision tree model using classification and regression tree analysis were utilized to investigate intergroup differences, classify the SLS grades, and identify associations between the SLS grade and frontal angles, respectively.</p><p><strong>Results: </strong>In the poor group, each frontal trunk, knee, and summated angle was significantly larger than in the good group. Classification and regression tree analysis showed that frontal knee and summated angles could classify the SLS grades with a 76.9% accuracy. Additionally, the classification and regression tree analysis established cutoff points for each frontal knee (11.34°) and summated angles (28.4°), which could be used in clinical practice to identify individuals who have a reduced or poor grade in the SLS test.</p><p><strong>Conclusions: </strong>The quality of SLS was found to be associated with interactions among frontal knee and summated angles. With an automated pose estimation algorithm, a single smartphone computer vision method can be utilized to compare and distinguish the quality of SLS movement for remote clinical and sports assessments.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Effects of Progressive Balance and Hip Strengthening Rehabilitation in Individuals With Chronic Ankle Instability.","authors":"Ashley M B Suttmiller, Kelly R Johnson, Sunghoon Chung, Vanessa M Gruskiewicz, Niara N Foreman, Matthew C Reyes, Ryan S McCann","doi":"10.1123/jsr.2024-0049","DOIUrl":"https://doi.org/10.1123/jsr.2024-0049","url":null,"abstract":"<p><strong>Context: </strong>Chronic ankle instability (CAI) is associated with motor-behavioral and sensory-perceptual impairments, including reduced balance performance, hip strength, and ankle function, and increased disablement, and injury-related fear. Progressive balance training (BAL) and hip strengthening (HIP) can both improve balance and function, but their comparative effects are unknown. Our objective was to compare the effects of progressive BAL and HIP on balance, hip strength, and patient-reported outcomes in those with CAI.</p><p><strong>Methods: </strong>Forty-five individuals with CAI volunteered for this randomized control study. Participants were randomly allocated to BAL, HIP, and control (CON) groups (n = 15 per group). BAL and HIP each participated in 8-week interventions while CON did not. Participants' involved limbs underwent testing of patient-reported outcomes (Foot and Ankle Ability Measure [FAAM-ADL, FAAM-S], modified Disablement in the Physically Active Scale [mDPA], Tampa Scale of Kinesiophobia-11 [TSK-11], Fear-Avoidance Beliefs Questionnaire [FABQ], and Self-Efficacy of Balance Scale [SEBS]), Star Excursion Balance Test (SEBT), and isometric hip strength (extension [EXT], abduction [ABD], and external rotation [ER]) before and after the intervention. Multiple imputation was used for missing data. Multivariate repeated-measures analyses of variance analyzed effects of the interventions.</p><p><strong>Results: </strong>A significant group × time interaction existed for psychosocial outcomes (P = .008), but not for balance (P = .159), strength (P = .492), or ankle function and disability (P = .128). Time main effects existed for balance (P = .003), strength (P < .001), function and disability (P < .001), and psychosocial outcomes (P = .006). BAL significantly improved in SEBT, EXT, ABD, and all patient-reported outcomes. HIP significantly improved in EXT, ABD, ER, FAAM-S, mDPA, FABQ, and SEBS.</p><p><strong>Conclusions: </strong>Balance training and hip strengthening can both improve motor-behavioral and sensory-perceptual impairments in individuals with CAI; however, balance training remains the most effective option for clinicians.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Social Support in Concussion Rehabilitation: A Prospective Mixed Methods Study of Canadian University Athletes' Return to Sport.","authors":"Carley B Jewell, Jeffrey G Caron, J Paige Pope, Scott Rathwell","doi":"10.1123/jsr.2024-0002","DOIUrl":"https://doi.org/10.1123/jsr.2024-0002","url":null,"abstract":"<p><strong>Context: </strong>Social support is an important consideration during athletes' rehabilitation following a concussion. Yet, its influence during the return-to-sport (RTS) strategy has been underexplored.</p><p><strong>Design: </strong>Concussed athletes' experiences with social support during RTS were explored prospectively using an explanatory sequential mixed methods design.</p><p><strong>Methods: </strong>University rugby, basketball, and track and field athletes (N = 8) from a single Canadian institution, 19-23 years of age (mean = 20.63, SD = 1.51), completed concentric circles maps, the Perceived Available Support in Sport Questionnaire, and 2 semistructured interviews during their RTS. We analyzed concentric circles maps and questionnaire data descriptively and interview data using codebook thematic analysis.</p><p><strong>Results: </strong>Athletes identified 16 different social support agents. The 5 most important agents during RTS were athletic therapists, student therapists, head coaches, significant others, and teammates/friends. Significant others provided the most emotional (mean = 2.82, SD = 1.85) and esteem (mean = 2.63, SD = 1.85) support, and the athletic therapist (mean = 1.82, SD = 1.35) and head coaches (mean = 0.93, SD = 1.19) provided the most informational and tangible support. We generated 4 themes from athletes' interviews: social support behaviors, contextual factors, concussion and RTS factors, and psychological readiness factors.</p><p><strong>Conclusions: </strong>The number of social support agents present, frequency of support types, and demonstration of support behaviors decreased across the concussion RTS strategy. Contextual (ie, toughness), concussion (ie, visibility), and RTS (ie, prognosis uncertainty) factors influenced athletes' perceptions of social support agents' support behaviors. Results add to our limited understanding of athletes' social support during RTS following a concussion and suggest exploring the integration of behavior-specific (eg, checking in, providing reassurance, and demonstrating compassion) social support strategies to promote concussion rehabilitation and readiness to RTS.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Length of Care in Physical Therapy After Pediatric and Adolescent Concussion.","authors":"Michael Karl, Daniele Fedonni, Christina L Master, Kristy B Arbogast, Elliot Greenberg, James Wilkes","doi":"10.1123/jsr.2024-0113","DOIUrl":"https://doi.org/10.1123/jsr.2024-0113","url":null,"abstract":"<p><strong>Context: </strong>Social determinants of health including insurance type, income, race, and ethnicity have been shown to influence the utilization of physical therapy and recovery after an orthopedic injury. The influence of social determinants of health on the utilization of physical therapy and recovery from concussion is not well understood.</p><p><strong>Design: </strong>Prospective observational registry study in a specialty concussion program.</p><p><strong>Methods: </strong>Patients diagnosed with a concussion using the Postconcussion Symptom Inventory and the visio-vestibular examination (VVE) who were also referred to physical therapy were included. The main outcomes of interest were the number of days from referral to initial physical therapy evaluation and the number of physical therapy visits completed. Information related to patients' age, race, ethnicity, sex, insurance type, and Child Opportunity Index was extracted from the registry. Multivariate and univariate regressions were used to assess the associations of each sociodemographic characteristic with the outcomes.</p><p><strong>Results: </strong>A total of 341 patients diagnosed with concussion between January 2017 and December 2023 met inclusion criteria. The average age was 14.77, and 64% were female. Patients' age, race, ethnicity, insurance type, and Child Opportunity Index were not associated with days to evaluation or length of care in physical therapy. Higher PCSI scores in children under 12 years (coefficient: 0.17, 95% CI, 0.06-0.29) and female sex (coefficient: 1.2, 95% CI, 0.26-2.1) were associated with a longer course of care in physical therapy. Patients with an abnormal VVE score had on average 2.1 more physical therapy visits than those with a normal VVE score (coefficient: 2.1, 95% CI, 0.73-3.5).</p><p><strong>Conclusions: </strong>Higher PCSI scores in children, female sex, and higher VVE scores in general predicted a longer course of care in physical therapy. Implementation of a clinical care pathway for concussion care using the PCSI and the VVE may be one strategy to help mitigate systemic factors that might otherwise negatively influence access to physical therapy.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Study of Track-and-Field Meets On-Field Medical Care.","authors":"Yosuke Hiroshige, Hodaka Watanabe, Shinji Tomiyama, Hajime Kato","doi":"10.1123/jsr.2023-0316","DOIUrl":"https://doi.org/10.1123/jsr.2023-0316","url":null,"abstract":"<p><strong>Background: </strong>Most epidemiological studies on track-and-field meets have been limited to the Olympics and world championships. These are meets in which only high-performance athletes participate at a certain time of the year. In contrast, epidemiological studies on athletes of various ages and across different seasons may provide health care providers with valuable insights into injury prevention and on-field medical care. The study aims to determine the trends and locations of injuries during track-and-field meets in athletes of various ages and seasons based on on-field medical care records.</p><p><strong>Methods: </strong>The number and incidence of injuries requiring on-field medical care during or after the event were obtained from 39 track-and-field meets. Injuries were defined as cases that required on-field medical care. The incidence was defined as the number of injuries per 1000 athlete exposures wherein 1 athlete exposure is the athlete's participation in one event. We also recorded the number of injuries at each location and whether transportation to a medical station was required.</p><p><strong>Results: </strong>A total of 191 injuries were reported. This study identified a population with a high incidence of injury (middle- and long-distance events, combined events, and athletes over the age of 19), areas within the stadium where injuries were more likely to occur (finish line and first turn), and a high rate of transport to the medical station (approximately 70%); most of them were transported to wheelchairs.</p><p><strong>Conclusion: </strong>The results provide insights into the trends, locations, and transport of injured athletes during track-and-field meets. Professionals will better understand the injuries occurring during track-and-field meets and can improve the efficiency of on-field medical care activities. They will also assist organizers in track-and-field meets to improve the safety of their meet operations.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Manual Lymph Drainage Be Considered as a Passive Recovery Strategy?","authors":"Humeyra Kiloatar, Aylin Aydogdu Delibay, Nisa Turutgen, Mihri Baris Karavelioglu","doi":"10.1123/jsr.2024-0121","DOIUrl":"https://doi.org/10.1123/jsr.2024-0121","url":null,"abstract":"<p><strong>Context: </strong>The aim of this study was to investigate the acute effects of Swedish massage and manual lymph drainage (MLD) on performance parameters related to jumping, walking, and blood lactic acid levels after Nordic hamstring exercises.</p><p><strong>Design: </strong>This study was designed as a controlled crossover study.</p><p><strong>Methods: </strong>The study included 16 young trained men. Participants' lactic acid levels, gait-related parameters, and jumping performance were assessed. Assessments were performed at baseline, after Nordic hamstring exercises, and after 3 different passive recovery strategies: resting, Swedish massage, and MLD for 3 weeks.</p><p><strong>Results: </strong>As a result of the study, it was observed that lactic acid levels after the MLD and massage intervention were significantly lower in both MLD and massage conditions compared with the control condition (P < .05). There was no within- and between-conditions difference in jumping parameters after the MLD and massage interventions (P > .05). Walking speed in the MLD condition was statistically higher following the intervention compared with both before and after exercise (P < .05). Step time in the massage condition was statistically lower after the intervention compared with after Nordic hamstring exercise (P < .05).</p><p><strong>Conclusions: </strong>Although MLD and massage interventions have positive effects on lactic acid levels and walking and jumping parameters, they are not superior to each other. MLD can be used as a passive recovery technique after exercise.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Neuromuscular Training Among Physically Active Young Adults: A Feasibility Study.","authors":"Samantha N Magliato, Mathew J Wingerson, Katherine L Smulligan, Casey C Little, Vipul Lugade, Julie C Wilson, David R Howell","doi":"10.1123/jsr.2024-0082","DOIUrl":"https://doi.org/10.1123/jsr.2024-0082","url":null,"abstract":"<p><strong>Context: </strong>Evidence indicates a 2 to 3 times increased risk of musculoskeletal injury after return to play from concussion. Undetected neuromuscular control deficits at return to play may relate to increased musculoskeletal injury risk. Rehabilitation to improve neuromuscular control may benefit patients with concussion, but access to rehabilitation professionals and/or poor adherence may limit efficacy. Our purpose was to determine the feasibility of an 8-week virtual neuromuscular training (NMT) program administered through a novel smartphone application among physically active, uninjured adults.</p><p><strong>Design: </strong>Feasibility trial.</p><p><strong>Methods: </strong>Participants were instructed to complete an NMT program administered via a smartphone application and returned for follow-up questionnaires 8 weeks later. They were instructed to complete 3 asynchronous self-guided workouts per week during the 8-week intervention period. Workouts included balance, plyometrics, strengthening, and dual-task exercises. The application provided instructions for each exercise using video, text, and audio descriptions. Our primary feasibility measure was participant adherence, calculated as the percentage of workouts completed out of the total possible 24 workouts. We recorded the average duration of each workout using start/stop/advance features within the application.</p><p><strong>Results: </strong>Twenty participants were enrolled, of which 15 (age = 26.3 [2.7] y, 67% female) returned for follow-up (75% retention). Participant adherence was 57.2% (25.0%; range: 16.7%-91.7%). Participants spent 17.3 (8.0) minutes per workout (range: 7.4-37.9 min). There were no adverse reactions or injuries. Most participants (60%) reported time availability as a primary barrier to intervention completion.</p><p><strong>Conclusions: </strong>Participants were moderately (>50%) adherent to a virtual NMT program, without any reported injuries. We identified several barriers to participation and pathways for improved adherence in the future. The virtual NMT program completed by uninjured adults provides evidence of its feasibility and future scalability to those with a recent concussion to address neuromuscular control deficits and reduce future injury risk.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confidence to Return to Play After Concussion.","authors":"Regan Crofts, Amanda J Morris, David L Quammen, Tessa L Petersell, Spencer W Liebel, Leslie Podlog, Peter C Fino","doi":"10.1123/jsr.2023-0383","DOIUrl":"https://doi.org/10.1123/jsr.2023-0383","url":null,"abstract":"<p><strong>Context: </strong>The sequelae of concussion may have psychological consequences that affect an athlete's ability to return to play (RTP). However, confidence of RTP readiness is rarely monitored after a concussion.</p><p><strong>Design: </strong>This study examined the acute and longitudinal implications of concussion on an athlete's confidence to RTP, the relationship between self-reported symptoms and athlete confidence to RTP, and interactions between concussion symptoms, sex, sport type (contact vs noncontact), and confidence to RTP.</p><p><strong>Methods: </strong>Forty-six college athletes (65% female) sustained a concussion and completed the Injury Psychological Readiness to Return to Sport (I-PRRS) scale at 3 timepoints: within 72 hours of injury (acute), within 72 hours of beginning the RTP protocol (pre-RTP), and within 72 hours of being fully cleared to RTP (post-RTP).</p><p><strong>Results: </strong>Athletes reported acute low confidence after concussion (I-PRRS mean [SD] = 32.59 [18.45]), which improved over time (pre-RTP mean [SD] = 52.11 [9.60]; post-RTP mean [SD] = 57.45 [5.96]). Some athletes returned to competition (post-RTP) with lingering confidence concerns (ie, I-PRRS < 50; 95% CI = 0.03-0.26). Acute symptom severity was associated with worse confidence (P < .001). Sex and sport type (contact vs noncontact) had no relationship with confidence (P = .406, P = .3314, respectively). These results indicate that athletes lack confidence acutely (within 72 h) following concussion.</p><p><strong>Conclusions: </strong>Although confidence improves over time, those who report greater acute symptoms also exhibit decreased confidence, and some athletes are returning to play with lingering concerns about their confidence (I-PRRS < 50). This preliminary evidence of heterogeneous confidence following concussion encourages the assessment and monitoring of confidence throughout concussion rehabilitation.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Knowledge Translation Action Framework to Improve Physical Therapy Rehabilitation Outcomes in Concussion Management.","authors":"Rebecca A Bliss, Lindsay Holland, Caitlin Fields, Kayley Stock","doi":"10.1123/jsr.2024-0078","DOIUrl":"https://doi.org/10.1123/jsr.2024-0078","url":null,"abstract":"<p><strong>Context: </strong>Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework.</p><p><strong>Design: </strong>Pretraining and posttraining intervention study.</p><p><strong>Methods: </strong>Rehabilitation professionals were electronically surveyed pre-post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre-post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know-do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28).</p><p><strong>Results: </strong>Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre-post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001).</p><p><strong>Conclusions: </strong>Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.</p>","PeriodicalId":50041,"journal":{"name":"Journal of Sport Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}