Sports Health-A Multidisciplinary Approach最新文献

{"title":"How Does Physical and Psychological Recovery Vary Among Competitive and Recreational Athletes After Anterior Cruciate Ligament Reconstruction?","authors":"Mandeep Kaur, Terese L Chmielewski, Susan Saliba, Joe Hart","doi":"10.1177/19417381241249413","DOIUrl":"10.1177/19417381241249413","url":null,"abstract":"<p><strong>Background: </strong>The recovery and rehabilitation journey after anterior cruciate ligament reconstruction (ACLR) surgery can be different for competitive and recreational athletes as their motivation and goals toward sports are different.</p><p><strong>Hypothesis: </strong>Competitive athletes would present with better patient-reported outcomes and higher muscle strength compared with recreational athletes postsurgery. Second, competitive athletes would recover better (patient-reported outcome [PRO] measures and muscle strength) compared with recreational athletes at later stages.</p><p><strong>Study design: </strong>Cross-sectional laboratory-based study.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>A total of 245 patients with unilateral ACLR were categorized as competitive or recreational athletes and grouped into early (4-6.9 months) or late (7-10 months) stages of recovery. PRO were collected for psychological response (Tampa Scale Kinesiophobia; Anterior Cruciate Ligament-Return to Sport after Injury), perceived knee function (International Knee Documentation Committee subjective form [IKDC]), and quality of life (Knee injury and Osteoarthritis Outcome Score; Veteran Rand-12). Isokinetic, concentric knee extension strength was measured bilaterally with a multimodal dynamometer (System 4, Biodex Medical Systems) at a speed of 90° and 180°/s.</p><p><strong>Results: </strong>Competitive athletes had significantly higher scores for IKDC (<i>P</i> = 0.03), and quadriceps peak torque at 90°/s (<i>P</i> = 0.01) and 180°/s (<i>P</i> < 0.01) compared with recreational athletes. Competitive athletes had higher quadriceps strength at 90°/s (<i>P</i> < 0.01) and 180°/s (<i>P</i> = 0.02) in the late group. Recreational athletes displayed higher sports participation in the late group.</p><p><strong>Conclusion: </strong>Outcomes of ACLR may differ based on preinjury athletic level. Whereas competitive athletes had higher knee and muscle function than recreational athletes, psychological measures were not different among groups.</p><p><strong>Clinical relevance: </strong>There is a need for more individualized care for patients with ACLR since there is variability among patient goals postsurgery. This information might help set realistic expectations for competitive and recreational athletes after surgery.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"272-280"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake.","authors":"Ryan A Dunn, Lauren A Fry, Yasuki Sekiguchi, Courteney L Benjamin, Ciara N Manning, Robert A Huggins, Rebecca L Stearns, Douglas J Casa","doi":"10.1177/19417381241249470","DOIUrl":"10.1177/19417381241249470","url":null,"abstract":"<p><strong>Background: </strong>Maximal oxygen uptake (VO_2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO_2max responses are unknown.</p><p><strong>Hypothesis: </strong>VO_2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA.</p><p><strong>Study design: </strong>Interventional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO_2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT₄, IHT₈). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO_2max, velocity at VO_2max (vVO₂), and maximal heart rate (HR_max) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc.</p><p><strong>Results: </strong>No significant VO_2max or vVO₂ differences were observed between baseline, post-HAz, or post-HA (<i>P</i> = 0.36 and <i>P</i> = 0.09, respectively). No significant group or time effects were identified for VO_2max or vVO₂ at post-HA, IHT₄, and IHT₈ (<i>P</i> = 0.67 and <i>P</i> = 0.21, respectively). Significant HR_max differences were observed between baseline and post-HA tests (<i>P</i> < 0.01). No significant group or time HR_max differences shown for post-HA, IHT₄, and IHT₈ (<i>P</i> = 0.59).</p><p><strong>Conclusion: </strong>VO_2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants' similar aerobic training status and high aerobic fitness levels.</p><p><strong>Clinical relevance: </strong>HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HR_max.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"305-311"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Therapy Intervention Effects on Alteration of Spinal Excitability in Patients With Chronic Ankle Instability: A Systematic Review and Meta-analysis.","authors":"Chia-Wei Lin, Amornthep Jankaew, Cheng-Feng Lin","doi":"10.1177/19417381241253248","DOIUrl":"10.1177/19417381241253248","url":null,"abstract":"<p><strong>Context: </strong>Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI.</p><p><strong>Data sources: </strong>Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022.</p><p><strong>Study selection: </strong>A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Level of evidence: </strong>Level 3a.</p><p><strong>Data extraction: </strong>A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale.</p><p><strong>Results: </strong>The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus (<i>P</i> = 0.44, <i>I</i>² = 0%) and soleus (<i>P</i> = 0.56,<i>I</i>² = 22%) muscles were not changed by physical therapy in patients with CAI.</p><p><strong>Conclusion: </strong>The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy.</p><p><strong>Prospero registration: </strong>CRD42022372998.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"394-403"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Factors Are Related to Neuromuscular Asymmetries After Anterior Cruciate Ligament Reconstruction.","authors":"Joanna Borawski, Richard Arthur Brindle, Erin Florkiewicz, John S Mason, Will Pitt, Kenneth L Cameron, Michael S Crowell","doi":"10.1177/19417381241246754","DOIUrl":"10.1177/19417381241246754","url":null,"abstract":"<p><strong>Background: </strong>After an anterior cruciate ligament reconstruction (ACLR), only 47% of military members return to full duty, possibly due to persistent neuromuscular asymmetries. Psychological factors may also contribute to reduced return to duty in military members.</p><p><strong>Hypothesis: </strong>Psychological factors and time since surgery would be associated negatively with neuromuscular asymmetries, asymmetries would be greater in cadets postsurgery when compared with healthy controls, and asymmetries would be greater at earlier timepoints after ACLR.</p><p><strong>Study design: </strong>Case control.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>This study examined the relationship between psychological factors and time since surgery with neuromuscular asymmetry, compared neuromuscular asymmetries between cadets with and without a history of ACLR, and explored differences in neuromuscular asymmetries at different timepoints in cadets with a history of ACLR. A total of 37 cadets post-ACLR (18.3 ± 9 months) and 28 controls participated. Psychological factors were assessed using the Tampa Scale of Kinesiophobia and Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI). Participants performed a drop-jump landing, joint positioning sense (JPS), and isometric quadriceps strength testing. Peak vertical ground-reaction forces (vGRF), absolute angle of replication, peak quadriceps torque, rate of torque development (RTD), and RTD time torque interval 200 ms (TTI₂₀₀) were analyzed.</p><p><strong>Results: </strong>The ACL-RSI score was significantly related to limb symmetry index (LSI) peak quadriceps torque (<i>r</i> = 0.617, <i>P</i> < 0.01), LSI RTD (r = 0.367, <i>P</i> = 0.05), and LSI TTI₂₀₀ (r = 0.0489, <i>P</i> < 0.01), but not time since surgery, JPS, or LSI peak vGRF. Cadets with a history of ACLR had significantly lesser ACL-RSI scores and greater asymmetries compared with controls.</p><p><strong>Conclusion: </strong>Reduced psychological readiness was associated with increased neuromuscular asymmetries after ACLR.</p><p><strong>Clinical relevance: </strong>Clinicians should assess psychological readiness during rehabilitation after ACLR.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"262-271"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Hormone Profiles and ACL Injury - It's Time for Study Designs to Match the Complexity of the Problem.","authors":"Sandra J Shultz, Laurie Wideman","doi":"10.1177/19417381251319506","DOIUrl":"10.1177/19417381251319506","url":null,"abstract":"","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":"17 2","pages":"223-225"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Eccentric Versus Concentric Strengthening in Patients With Subacromial Pain Syndrome: A Randomized Controlled Trial.","authors":"Damla Karabay, Sevgi Sevi Yeşilyaprak, Mehmet Erduran, Cem Ozcan","doi":"10.1177/19417381241236817","DOIUrl":"10.1177/19417381241236817","url":null,"abstract":"<p><strong>Background: </strong>Subacromial pain syndrome (SPS) is the most common cause of shoulder pain. Therapeutic exercise is the first-line treatment for SPS; however, the ideal exercise type remains unclear. Here, we compared the effects of eccentric and concentric strengthening in patients with SPS.</p><p><strong>Hypothesis: </strong>Adding isolated eccentric strengthening to a multimodal physiotherapy program (MPP) would lead to greater improvements in outcomes compared with either MPP alone or adding isolated concentric strengthening to the MPP.</p><p><strong>Study design: </strong>Randomized controlled trial.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>A total of 45 patients were randomized to eccentric strengthening (ESG), concentric strengthening (CSG), and control (CG) groups; all groups received the MPP. The strengthening groups also performed group-specific strengthening. Shoulder pain, abduction and external rotation (ER) strength, joint position sense (JPS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand score were collected at baseline, after 12 weeks of treatment, and at week 24.</p><p><strong>Results: </strong>For CMS, ESG exhibited a greater, but not clinically meaningful, improvement than CSG and CG (<i>P</i> < 0.05). Eccentric abduction strength increased in ESG compared with CG. From baseline to follow-up, abduction strength increased in ESG compared with CSG and CG. Eccentric abduction strength increased in CSG compared with CG. JPS at abduction improved in the ESG compared with CG. Other between-group comparisons were not significant (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>In SPS, eccentric strengthening provided added benefits, improving shoulder abduction strength and JPS at abduction, and was superior to concentric strengthening for improving shoulder abduction strength. Neither strengthening approach had an additional effect on shoulder function, pain, ER strength, or rotational JPS.</p><p><strong>Clinical relevance: </strong>Clinicians could implement eccentric strengthening as a motor control retraining for strength and proprioception gain rather than for pain relief and reducing disability.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"322-331"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditioning of Motor Evoked Responses After Anterior Cruciate Ligament Reconstruction: Effects of Stimulus Intensity.","authors":"Kazandra M Rodriguez, Jungsun Moon, Chandramouli Krishnan, Riann M Palmieri-Smith","doi":"10.1177/19417381241257258","DOIUrl":"10.1177/19417381241257258","url":null,"abstract":"<p><strong>Background: </strong>Operant conditioning of motor evoked torque (MEP_TORQUE) can directly target the corticospinal pathway in patients with anterior cruciate ligament (ACL) reconstruction. However, it remains unclear whether operant conditioning can elicit short-term improvements in corticospinal excitability and whether these improvements are influenced by stimulus intensity.</p><p><strong>Hypothesis: </strong>Quadriceps MEP_TORQUE responses can be upconditioned in a single session and will elicit short-term adaptations in corticospinal excitability, with higher stimulus intensities eliciting greater effects.</p><p><strong>Study design: </strong>Randomized controlled laboratory study.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>Thirty-six participants were assessed during a single session of an operant conditioning protocol. Participants were randomized into 1 of 3 groups for stimulus intensity used during operant conditioning based on the participant's active motor threshold (AMT: 100%, 120%, and 140%). Quadriceps MEP_TORQUE amplitude was evaluated during a block of control transcranial magnetic stimulation trials (CTRL) to establish baseline corticospinal excitability, and 3 blocks of conditioning trials (COND) during which participants trained to upcondition their MEP_TORQUE. MEP_TORQUE recruitment curves were collected to evaluate the effect of operant conditioning on acute corticospinal adaptations.</p><p><strong>Results: </strong>Participants with ACL reconstruction could upcondition their MEP_TORQUE in a single session (<i>P</i> < 0.01; CTRL, 17.27 ± 1.28; COND, 21.35 ± 1.28 [mean ± standard error [SE] in N·m]), but this ability was not influenced by the stimulus intensity used during training (<i>P</i> = 0.84). Furthermore, significant improvements in corticospinal excitability were observed (<i>P</i> = 0.05; PRE, 687.91 ± 50.15; POST, 761.08 ± 50.15 [mean ± SE in N·m %AMT]), but stimulus intensity did not influence corticospinal adaptations (<i>P</i> = 0.67).</p><p><strong>Conclusion: </strong>Operant conditioning can elicit short-term neural adaptations in ACL-reconstructed patients. Future operant conditioning paradigms may effectively use any of the 3 stimulus intensities studied herein.</p><p><strong>Clinical relevance: </strong>Operant conditioning may be a feasible approach to improve corticospinal excitability after ACL reconstruction.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"281-290"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does It Matter? Isometric or Isokinetic Assessment of Quadriceps Strength Symmetry 9 Months After ACLR in Collegiate Athletes.","authors":"Daniel G Cobian, Keith A Knurr, Mikel R Joachim, Amy L Bednarek, Andrew M Broderick, Bryan C Heiderscheit","doi":"10.1177/19417381241247819","DOIUrl":"10.1177/19417381241247819","url":null,"abstract":"<p><strong>Background: </strong>Greater quadriceps strength symmetry is associated with better outcomes after anterior cruciate ligament reconstruction (ACLR). Isometric and isokinetic assessments of quadriceps strength inform therapeutic exercise prescription and return-to-sport decisions. It is unclear whether isometric and isokinetic measures provide similar information post-ACLR.</p><p><strong>Hypothesis: </strong>Quadriceps strength symmetry is similar between isometric and isokinetic assessments. Isokinetic and isometric strength symmetries have similar associations to functional knee kinetics and self-reported knee function.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>NCAA Division I athletes (N = 35), 8.9 ± 2.5 months post-ACLR completed isometric and isokinetic quadriceps strength assessments, countermovement jumps (CMJs), and treadmill running. Self-reported knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC). Agreement between isometric and isokinetic strength symmetry was assessed using Bland-Altman analysis, with associations to functional knee kinetics and IKDC assessed using Pearson correlations and linear regressions.</p><p><strong>Results: </strong>Mean difference in quadriceps strength symmetry between isokinetic and isometric assessments was 1.0% (95% limits of agreement of -25.1% to 23.0%). Functional knee kinetics during running and CMJ were moderately to strongly associated with isometric strength symmetry (<i>r</i> = 0.64-0.80, <i>P</i> < 0.01) and moderately associated with isokinetic strength symmetry (<i>r</i> = 0.41-0.58, <i>P</i> < 0.01). IKDC scores were weakly to moderately associated with isometric (<i>r</i> = 0.39, <i>P</i> = 0.02) and isokinetic (<i>r</i> = 0.49, <i>P</i> < 0.01) strength symmetry.</p><p><strong>Conclusion: </strong>Isokinetic and isometric assessments of quadriceps strength symmetry in collegiate athletes 9 months post-ACLR demonstrated strong agreement. Quadriceps strength symmetry is associated with functional knee kinetic symmetry post-ACLR.</p><p><strong>Clinical relevance: </strong>Considerable individual variation suggests mode of contraction should be consistent throughout postoperative assessment. Isometric strength symmetry may be a better indicator of functional knee kinetic symmetry, while isokinetic strength symmetry may be associated more closely with patient-reported outcomes.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"365-373"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Psychological Factors on Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review.","authors":"Victoria J Nedder, Akash G Raju, Andrew J Moyal, Jacob G Calcei, James E Voos","doi":"10.1177/19417381241256930","DOIUrl":"10.1177/19417381241256930","url":null,"abstract":"<p><strong>Context: </strong>Anterior cruciate ligament (ACL) tears are a common orthopaedic injury, and the incidence of ACL reconstruction (ACLR) continues to increase. Current clinical practice guidelines (CPGs) recognize the role of psychological factors in rehabilitation, but patient-reported outcome measures (PROs) and psychological readiness are rarely incorporated into rehabilitation.</p><p><strong>Objective: </strong>The purpose of this review was to highlight the importance of psychological health after ACL injury, understand the current metrics used to monitor psychological recovery, and outline how psychological recovery can be better incorporated in current CPGs.</p><p><strong>Data sources: </strong>A systematic review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA); 63 studies were identified with a PubMed search using the term \"ACL Injuries/psychology\".</p><p><strong>Study selection: </strong>Exclusion criteria included lack of consideration of psychological effects or studies validating PROs after ACLR. Studies were reviewed by multiple reviewers, and a total of 38 studies were included after applying exclusion criteria.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Level of evidence: </strong>Level 3b.</p><p><strong>Data extraction: </strong>Two independent reviewers analyzed the included articles to extract sample size, psychological readiness scale or other measures used, and key results.</p><p><strong>Results: </strong>Psychological outcomes, especially kinesiophobia and fear of reinjury, are seen commonly after ACLR. Psychological factors were shown to impede return to sport (RTS), alter measurable knee biomechanics, and potentially increase the risk for re-rupture. Targeted interventions such as kinesiotaping, knee bracing, and imagery training can help improve psychological and functional testing after ACLR.</p><p><strong>Conclusion: </strong>ACLR is often complicated by psychological factors. Psychological readiness is a crucial yet often unincorporated part of rehabilitation. Patients with higher levels of kinesiophobia and lower psychological readiness to RTS specifically should be identified to allow for administration of interventions, such as imagery training, knee bracing, or kinesiotaping, that can mitigate the negative effects of psychological outcomes and improve recovery.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"291-298"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Tibiofibular Syndesmosis Injuries in the National Football League (NFL): A Spectrum of Pathology That Correlates With Time to Return to Full Participation.","authors":"Andrew W Kuhn, Michael J Coughlin, Shane J McGonegle, Mackenzie M Herzog, Nate Weir, E Meade Spratley, Cody M O'Cain, Robert B Anderson","doi":"10.1177/19417381241253223","DOIUrl":"10.1177/19417381241253223","url":null,"abstract":"<p><strong>Background: </strong>Studies routinely evaluate high ankle sprains in isolation, but recent data suggest that these injuries are often associated with concomitant pathology, potentially influencing return to full participation.</p><p><strong>Hypothesis: </strong>In National Football League (NFL) players, isolated high ankle sprains are rare and syndesmosis injuries with concomitant pathology will result in increased time to return to full participation.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Distal tibiofibular syndesmosis injuries sustained by NFL players between 2017 and 2019 were identified through NFL Injury Surveillance Database queries and verified with video analysis. Each injury underwent a comprehensive magnetic resonance imaging (MRI) review. Regression modeling was utilized to explore the influence of numerous imaging findings on time to return to full participation.</p><p><strong>Results: </strong>There were 83 external rotation ankle injuries involving the syndesmosis. Isolated distal tibiofibular syndesmosis injuries were rare (n = 11; 13%) and more often associated with other ligamentous injury (deltoid ligament and lateral ligamentous complex) and/or fractures. Regression modeling resulted in clustering of 3 injury pattern groups for time to return to full participation across numerous imaging findings: syndesmosis injury-fracture combinations (250 days [interquartile range [IQR,] 142-266 days]), syndesmosis injury with complete deep deltoid tear or acute diastasis (175 days [IQR, 20-248 days]), and all other syndesmosis injuries (27 days [IQR, 18-46 days]).</p><p><strong>Conclusion: </strong>In NFL athletes with external rotation ankle injuries, isolated distal tibiofibular syndesmosis injuries were rare and more often associated with concomitant pathology. Time to return to full participation was affected by an associated fracture and complete deep deltoid ligament tear or diastasis but no other relevant MRI variables such as lateral ligament complex involvement or the presence of osteochondral lesions or bone contusions.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"404-411"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}