Journal of Orthopaedic & Sports Physical Therapy最新文献

{"title":"Are Women Less Likely to Return to Sport Compared to Men Following Hip Arthroscopy. A Systematic Review and Meta-analysis.","authors":"Matthew G King, Pim Van Klij, Fan Hoak, Signe Kierkegaard-Brøchner, Thomas J West, Mark J Scholes, Joshua J Heerey, Adam I Semciw, Charlotte Ganderton, Rachael M McMillan, Andrea M Bruder","doi":"10.2519/jospt.2025.12813","DOIUrl":"10.2519/jospt.2025.12813","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare return-to-sport outcomes between females/women/girls and males/men/boys undergoing hip arthroscopy and explore social and structural determinants of health that may influence return to sport. <b>DESIGN:</b> Systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, SPORTDiscus, and Web of Science from inception to February 2024. <b>STUDY SELECTION CRITERIA:</b> Studies were included if they assessed return to sport after hip arthroscopy and analyzed the influence of sex/gender on return-to-sport outcomes, or reported sex- or gender-stratified return-to-sport rates. <b>DATA SYNTHESIS:</b> We used a random effects model to calculate pooled odds ratios and conducted meta-regressions to compare return-to-sport outcomes between females/women/girls and males/men/boys. <b>RESULTS:</b> Forty-five studies were included, with all pooled results deemed as very low-certainty evidence. Compared to males/men/boys, females/women/girls had inferior return to sport at the same or higher level between 1 and 3 years postoperatively (pooled OR = 0.53; 95% CI: 0.34, 0.81; <i>P</i> = .004), and at any level of sport at >3 years postoperatively (pooled OR = 0.46; 95% CI: 0.25, 0.86; <i>P</i> = .014). Sports participation decreased over time, with ~5.5% to 10% lower proportions observed in females/women/girls compared to males/men/boys. The reporting of determinants of returning to sport was minimal, precluding further exploration of their effects. <b>CONCLUSION</b>: Females/women/girls had lower odds of return to sport, especially during longer follow-up periods, than males/men/boys. The lack of reporting of social and structural determinants of health influencing return-to-sport outcomes makes the reasons for this disparity unclear. <i>J Orthop Sports Phys Ther 2025;55(3):1-13. Epub 10 February 2025. doi:10.2519/jospt.2025.12813</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 3","pages":"1-13"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Manual Joint Mobilization Techniques in the Treatment of Nonspecific Neck Pain: Systematic Review With Meta-Analysis and Meta-Regression of Randomized Controlled Trials.","authors":"Alessia Benetton, Simone Battista, Gianluca Bertoni, Giacomo Rossettini, Luca Falsiroli Maistrello","doi":"10.2519/jospt.2025.12836","DOIUrl":"https://doi.org/10.2519/jospt.2025.12836","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> The purpose of this study was to investigate the effects of cervical joint mobilization techniques (JMTs) on pain and disability in adults with nonspecific neck pain. <b>DESIGN:</b> This study is an intervention systematic review with meta-analysis and meta-regression of randomized controlled trials (RCTs). <b>LITERATURE SEARCH:</b> We searched MEDLINE, Cochrane CENTRAL, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Web of Science databases, including references from other reviews or clinical practice guidelines up to October 16, 2024. <b>STUDY SELECTION CRITERIA:</b> Eligible RCTs evaluated JMTs compared to routine physiotherapy, minimally active interventions, or no treatment. The primary outcome was pain; secondary outcomes were disability, Global Perceived Effect (GPE), quality of life, psychosocial status, and adverse events. <b>DATA SYNTHESIS:</b> Meta-analyses and meta-regression were conducted for pain, disability, and GPE. The risk of bias was assessed with Cochrane RoB 2.0 Tool; the certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluations approach. We used The Template for the Intervention Description and Replication checklist to evaluate the quality of reporting of interventions delivered. <b>RESULTS:</b> Results from 16 RCTs were pooled (<i>n</i> = 1,157 participants), reporting nonclinically positive results on pain reduction (mean difference [MD] = -0.86 (95% confidence interval [-1.35, -0.36])), disability (MD=-2.11 [-3.31, -0.91]), and GPE (standardized mean difference = 0.11 ([-0.15, 0.37]) and high heterogeneity. The meta-regressions did not identify any covariates associated with the treatment effects. Minor side effects (increased neck pain and headache) were reported. <b>CONCLUSION:</b> There was very low certainty evidence supporting the efficacy of JTMs for reducing pain and improving disability in people with NSNP. <i>J Orthop Sports Phys Ther 2025;55(3):1-20. Epub 12 February 2025. doi:10.2519/jospt.2025.12836</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 3","pages":"1-20"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shouldering Our Way Into a More Meaningful Research Agenda for Atraumatic Shoulder Pain: <i>A Priority Setting Study</i>.","authors":"Kristian Damgaard Lyng, Torben Krejberg Børsting, Mikkel Bek Clausen, Annelene Houen Larsen, Behnam Liaghat, Kim Gordon Ingwersen, Marcus Bateman, Amar Rangan, Karen Toftdahl Bjørnholdt, David Høyrup Christiansen, Steen Lund Jensen, Janus Laust Thomsen, Kristian Thorborg, Connie Ziegler, Jens Lykkegaard Olesen, Michael Skovdal Rathleff","doi":"10.2519/jospt.2025.13059","DOIUrl":"https://doi.org/10.2519/jospt.2025.13059","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To amplify the voices of people living with atraumatic shoulder pain, their relatives, and health care practitioners, and to establish research questions. <b>DESIGN:</b> A priority-setting study using a modified approach originally formulated by the James Lind Alliance (JLA). <b>METHODS:</b> The process consisted of 6 phases (initiation, consultation, collation, prioritization, validation, and reporting), and included 2 e-surveys and 2 separate virtual workshops. We included people with atraumatic shoulder pain, relatives, health care practitioners managing shoulder pain, and researchers conducting research within the field. <b>RESULTS:</b> Six hundred and eight people participated (n = 383 [63%] patients, n = 213 [35%] health care practitioners, and n = 12 [2%] carers). In the first survey, 297 participants submitted 1080 potential research questions, which were collated into 16 main themes and 94 subthemes and transformed into research questions. These research questions were featured in the second survey, where 290 participants prioritized the questions, resulting in a compilation of the top 25 questions. Based on discussions from 2 separate online workshops with a total of 21 participants, a top-10 list was created. <b>CONCLUSION:</b> In the final priority list, the 3 research questions with the highest ranking were, first, \"how can we improve the translation of research into clinical practice?\"; second, \"how can we prevent atraumatic shoulder pain?\"; and third, \"who benefits from surgery, and who does not?\" <i>J Orthop Sports Phys Ther 2025;55(3):1-12. Epub 12 February 2025. doi:10.2519/jospt.2025.13059</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 3","pages":"1-12"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving the Control-Chaos Continuum: Part 1 - Translating Knowledge to Enhance On-Pitch Rehabilitation.","authors":"Matt Taberner, Tom Allen, Jason O'keefe, Meredith Chaput, Dustin Grooms, Daniel Dylan Cohen","doi":"10.2519/jospt.2025.13158","DOIUrl":"10.2519/jospt.2025.13158","url":null,"abstract":"<p><p><b>BACKGROUND:</b> On-pitch rehabilitation is a crucial part of returning to sport after injury in elite soccer. The <i>control-chaos continuum</i> (<i>CCC</i>) initially offered a framework for practitioners to plan on-pitch rehabilitation, focusing on physical preparation and sport specificity. However, our experiences with the <i>CCC</i>, combined with recent research in injury neurophysiology, point to a need for an updated model that integrates practice design and physical-cognitive interactions. <b>CLINICAL QUESTION:</b> What are the insights from injury neurophysiology, soccer performance, and coaching science needed to update the <i>CCC</i> and improve the planning, delivery, and progression of on-pitch rehabilitation in elite soccer? <b>KEY RESULTS:</b> Drawing on extensive experience in elite sport, we explain how recent research on neurophysiological recovery from injury, game models, and practice design has been applied to update the <i>CCC</i> and evolve the existing framework. <b>CLINICAL APPLICATION:</b> The evolution of the <i>CCC</i> expands on the original model to enhance planning, delivery, and progression of on-pitch rehabilitation. The updated framework incorporates elements of visual cognition, attentional challenges, decision-making, and progressive representation of the game model to enhance sport-specific preparation for returning to sport. <i>J Orthop Sports Phys Ther 2025;55(2):1-11. Epub 3 January 2025. doi:10.2519/jospt.2025.13158</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"78-88"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Spinal Manipulative Therapy in Treating Spinal Pain Does Not Depend on the Application Procedures: A Systematic Review and Network Meta-analysis.","authors":"Casper Nim, Sasha L Aspinall, Chad E Cook, Leticia A Corrêa, Megan Donaldson, Aron S Downie, Steen Harsted, Simone Hansen, Hazel J Jenkins, David McNaughton, Luana Nyirö, Stephen M Perle, Eric J Roseen, James J Young, Anika Young, Gong-He Zhao, Jan Hartvigsen, Carsten B Juhl","doi":"10.2519/jospt.2025.12707","DOIUrl":"10.2519/jospt.2025.12707","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To assess whether spinal manipulative therapy (SMT) application procedures (ie, target, thrust, and region) impacted changes in pain and disability for adults with spine pain. <b>DESIGN:</b> Systematic review with network meta-analysis. <b>LITERATURE SEARCH:</b> We searched PubMed and Epistemonikos for systematic reviews indexed up to February 2022 and conducted a systematic search of 5 databases (MEDLINE, EMBASE, CENTRAL [Cochrane Central Register of Controlled Trials], PEDro [Physiotherapy Evidence Database], and Index to Chiropractic Literature) from January 1, 2018, to September 12, 2023. We included randomized controlled trials (RCTs) from recent systematic reviews and newly identified RCTs published during the review process and employed artificial intelligence to identify potentially relevant articles not retrieved through our electronic database searches. <b>STUDY SELECTION CRITERIA:</b> We included RCTs of the effects of high-velocity, low-amplitude SMT, compared to other SMT approaches, interventions, or controls, in adults with spine pain. <b>DATA SYNTHESIS:</b> The outcomes were spinal pain intensity and disability measured at short-term (end of treatment) and long-term (closest to 12 months) follow-ups. Risk of bias (RoB) was assessed using version 2 of the Cochrane RoB tool. Results were presented as network plots, evidence rankings, and league tables. <b>RESULTS:</b> We included 161 RCTs (11 849 participants). Most SMT procedures were equal to clinical guideline interventions and were slightly more effective than other treatments. When comparing inter-SMT procedures, effects were small and not clinically relevant. A general and nonspecific rather than a specific and targeted SMT approach had the highest probability of achieving the largest effects. Results were based on very low- to low-certainty evidence, mainly downgraded owing to large within-study heterogeneity, high RoB, and an absence of direct comparisons. <b>CONCLUSION:</b> There was low-certainty evidence that clinicians could apply SMT according to their preferences and the patients' preferences and comfort. Differences between SMT approaches appear small and likely not clinically relevant. <i>J Orthop Sports Phys Ther 2025;55(2):1-14. Epub 7 January 2025.</i> <i>https://doi.org/10.2519/jospt.2025.12707</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"109-122"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do Women (With Serious Knee Injury) Want to Know About Knee Health? Identifying Research Priorities With a Consumer Advisory Group.","authors":"Melissa J Haberfield, Kay M Crossley, Brooke E Patterson, Andrea M Bruder","doi":"10.2519/jospt.2025.12869","DOIUrl":"10.2519/jospt.2025.12869","url":null,"abstract":"<p><p><b>OBJECTIVES:</b> To (1) establish a women's knee health consumer advisory group (CAG) via an evidence-informed process and (2) identify the CAG's research priorities to inform future projects. <b>DESIGN:</b> Mixed-methods priority-setting study. <b>METHODS:</b> The CAG was established, grounded in a participatory action research approach and using the Patient Engagement in Research Framework, to inform a 4-phase process: (1) understand, (2) plan, (3) undertake, and (4) evaluate. We identified the CAG's priorities for knee health research via a mixed-methods approach using the nominal group technique (NGT). We adopted a constructivist epistemology, using reflexive thematic analysis to construct codes and themes inductively. <b>RESULTS:</b> Six women (mean age of 35 years) joined the CAG, generating, reviewing, and discussing 70 ideas during NGT phases 1 to 3. We constructed 14 codes, grouped into 3 key themes: (1) best practice management and support for serious knee injury and rehabilitation, (2) social and gendered factors; and (3) physical, psychological, and personal factors. Voting and ranking (NGT phases 3-6) revealed the CAG's highest priority for future research was \"Knowledge of, and access to specialised knee rehabilitation and practitioners.\" <b>CONCLUSION:</b> Establishing a CAG was an achievable and novel approach to identifying consumer priorities to enhance women's knee health outcomes. Women wanted improved access to information and best-practice care via genuine therapeutic relationships with practitioners who understand the gendered-social rehabilitation environment. <i>J Orthop Sports Phys Ther 2025;55(2):1-14. Epub 15 January 2025. doi:10.2519/jospt.2025.12869</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"148-161"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exercise-Based ACL Injury Prevention Interventions on Knee Motion in Athletes: A Systematic Review and Bayesian Network Meta-Analysis.","authors":"Di Wang, Anu M Valtonen, Tom Thiel, Lauri Stenroth, Ying Gao, Juha-Pekka Kulmala","doi":"10.2519/jospt.2024.12720","DOIUrl":"10.2519/jospt.2024.12720","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare the effectiveness of injury prevention programs (IPPs) for improving high-risk knee motion patterns in the context of reducing the risk of noncontact anterior cruciate ligament injury. <b>DESIGN:</b> Systematic review with Bayesian network meta-analysis. <b>DATA SOURCES:</b> PubMed, Embase, Web of Science, Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched until September 10, 2023. <b>ELIGIBILITY CRITERIA:</b> We included randomized controlled trials involving athletes without prior anterior cruciate ligament injury. The trials had to provide data on peak knee flexion and valgus angles, obtained from 2-leg drop vertical jump, single-leg drop vertical jump, or side-step cutting test. <b>RESULTS:</b> The network meta-analysis synthesized data from 22 randomized controlled trials involving 878 participants, evaluating 12 different IPPs. Results of meta-analyses indicated that, in jumping tests, the external focus instructions (mean difference [MD] = 26; credible interval [CrI] = 7.5, 44; surface under the cumulative ranking curve [SUCRA] = 0.94) and internal focus of attention (MD = 19; CrI = 0.19, 37; SUCRA = 0.81) was effective for increasing peak knee flexion, and core stability training ranked first for reducing knee valgus (MD = -4.40; CrI = -7.7, -1.1; SUCRA = 0.96). None of the IPPs revealed statistically significant effects for the cutting test. <b>CONCLUSION:</b> The external focus instructions and internal focus of attention increased knee flexion, while core stability exercise reduced knee valgus in jumping tests. Intervention effects were inconsistent for cutting tests. <i>J Orthop Sports Phys Ther 2025;55(2):1-14. Epub 20 December 2024. doi:10.2519/jospt.2024.12720</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"123-136"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Tailored Interventions to Modifiable Psychosocial Risk Factors Effective in Reducing Pain Intensity and Disability in Low Back Pain? A Systematic Review with Meta-Analysis of Randomized Trials.","authors":"Pouya Rabiei, Catelyn Keough, Philippe Patricio, Claudia Côté-Picard, Amélie Desgagnés, Hugo Massé-Alarie","doi":"10.2519/jospt.2025.12777","DOIUrl":"10.2519/jospt.2025.12777","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To determine whether tailored interventions based on patients' psychological profiles enhanced the outcomes of interventions in people with nonspecific low back pain, compared to usual care. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> Embase, Cochrane, Medline, Web of Science, CINAHL, and PsycINFO were searched from their inception until November 2, 2023. <b>STUDY SELECTION CRITERIA:</b> We included randomized clinical trials that compared psychological interventions to any alternatives without psychological components in patients with nonspecific low back pain who were stratified based on their psychological risk factors using the cutoff of the questionnaires measuring a psychological construct. <b>DATA SYNTHESIS:</b> The outcomes were pain intensity and disability. The revised Cochrane risk-of-bias tool for randomized trials was used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to judge certainty of evidence. <b>RESULTS:</b> Twenty-nine trials were included, most presenting some concerns for the risk of bias. The certainty of evidence was mostly low, with moderate to substantial heterogeneity. Using psychological stratification, individuals who received a psychological intervention (versus usual care) reported lower pain intensity at the short term (MD, -0.22; 95% confidence interval [CI]: -0.41, -0.02) and midterm (MD, -0.37; 95% CI: -0.57, -0.16). For disability, there was a larger improvement with psychological interventions versus usual care at short-term (SMD, -0.17; 95% CI: -0.32, -0.02), midterm (SMD, -0.16; 95% CI: -0.28, -0.05), and long-term (SMD, -0.17; 95% CI: -0.29, -0.04) follow-ups. <b>CONCLUSIONS:</b> Psychological interventions had a positive impact, although small, on reducing pain intensity and disability in patients with low back pain and psychological risk factors. <i>J Orthop Sports Phys Ther 2025;55(2):1-20. Epub 3 January 2025. doi:10.2519/jospt.2025.12777</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"89-108"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the Culprit: Reframing Pain in Research and Management of Patellofemoral Pain.","authors":"Joachim Van Cant","doi":"10.2519/jospt.2025.12883","DOIUrl":"10.2519/jospt.2025.12883","url":null,"abstract":"<p><p><b>SYNOPSIS:</b> This editorial draws an analogy between the literary genre of the 'whodunit' and the complexities of patellofemoral pain (PFP). Traditionally, PFP management has centered on biomechanical factors such as hip muscle weakness, foot pronation, and patellar tracking issues. However, long-term outcomes often remain unsatisfactory, highlighting the need for alternative strategies. The editorial underscores the significance of addressing the predominant pain pathway rather than relying solely on biomechanical assessments. It calls for future research to integrate pain characteristics into clinical practice to enhance outcomes.Just as a mystery is difficult to solve by focusing on 1 suspect, PFP is a multifaceted condition arising from a variety of contributing factors, including pain pathways that are often overshadowed by biomechanics. By thoroughly examining the dimensions and characteristics of pain, clinicians and researchers can refine clinical strategies and advance patient care, and ensure a tailored approach to managing this challenging condition. <i>J Orthop Sports Phys Ther 2025;55(2):1-3. Epub 15 January 2025. doi:10.2519/jospt.2025.12883</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"75-77"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strength Setbacks: The Impact of Youth Sport-Related Knee Joint Injuries on Thigh Muscle Strength. A 24-Month Prospective Cohort Study.","authors":"Justin M Losciale, Christina Y Le, Núria E J Jansen, Leo Lu, Hui Xie, Cameron Mitchell, Michael A Hunt, Jackie L Whittaker","doi":"10.2519/jospt.2024.12663","DOIUrl":"10.2519/jospt.2024.12663","url":null,"abstract":"<p><p><b>OBJECTIVE:</b> To compare injured and uninjured limb knee extensor and flexor peak torque between youth who experienced a sport-related, traumatic knee joint injury and comparable uninjured youth, at baseline (≤4 months of injury) and semiannually for 2 years. Differences by injury type and sex were also explored. <b>DESIGN:</b> Prospective cohort study. <b>METHODS:</b> Bilateral knee extensor and flexor concentric isokinetic peak torque at 90° per second was assessed semiannually in 186 youth (106 injured, 80 controls) for 2 years. Between-group differences in strength over time were estimated with generalized estimating equations (95% confidence interval [CI]). Confounding was controlled using inverse probability weighting. Strength differences between those with anterior cruciate ligament (ACL) tears and those with non-ACL tear injuries as well as between male and female participants were explored. <b>RESULTS:</b> Compared to uninjured controls, injured limb knee extensor strength was lowest at baseline (-37.1 Nm; 95% CI, -45.3 to -28.9) and 6-month follow-up (-13.3 Nm; 95% CI, -20.4 to -6.2), with minimal strength gain beyond the 12-month follow-up (1.7 Nm; 95% CI, -14.3 to 17.6). Knee flexor strength of the injured limb was lowest at baseline (-24.6 Nm; 95% CI, -31.5 to -17.8), and there was minimal strength gain beyond 6 months (2.3 Nm; 95% CI, -7.7 to 12.3). The average residual deficit was similar to the knee extensors (10% to 11%) at 24 months. Exploratory analysis suggested no difference based on injury type or sex. <b>CONCLUSION:</b> Injured limb knee extensor and flexor weakness was present after different youth sport-related knee joint injuries. Strength deficits peaked early after injury, improved over time, and plateaued after 12 months, with lingering deficits at 24 months. Thigh muscle strength trajectory was similar across injury types and sex. <i>J Orthop Sports Phys Ther 2025;55(2):1-11. Epub 20 December 2024. doi:10.2519/jospt.2024.12663</i>.</p>","PeriodicalId":50099,"journal":{"name":"Journal of Orthopaedic & Sports Physical Therapy","volume":"55 2","pages":"137-147"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}