Victor V Prati, Beverly J Spray, Cody W Walker, Cord Sheehy, Augustina O Oguntola-Blount, Paul M Inclan, Brant C Sachleben
{"title":"儿童和青少年前交叉韧带重建后健康和股四头肌力量恢复的社会决定因素。","authors":"Victor V Prati, Beverly J Spray, Cody W Walker, Cord Sheehy, Augustina O Oguntola-Blount, Paul M Inclan, Brant C Sachleben","doi":"10.26603/001c.133918","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) contribute to delays in access to care and inferior outcomes following anterior cruciate ligament (ACL) reconstruction. The interplay between multiple SDOH factors has not been investigated in children and adolescents during rehabilitation.</p><p><strong>Purpose: </strong>To assess the relationships between SDOH variables, including demographics, singular surrogate indicators and multivariate indices, and quadriceps strength recovery at time of return-to-play testing following pediatric ACL reconstruction.</p><p><strong>Study design: </strong>Retrospective Cross-Sectional Study.</p><p><strong>Methods: </strong>Patients who underwent primary ACL reconstruction at a single pediatric tertiary-care center completed a standardized return-to-play battery of tests six months post-operatively. The associations and interactions between SDOH variables and knee extension peak torque limb symmetry index (LSI), obtained during isokinetic testing at 60 °/s, were explored statistically with both univariate and multivariate analyses.</p><p><strong>Results: </strong>Data on 259 White or Black/African American patients (43.2% female, mean age 15.3 ± 2.0 years) were utilized for analyses. Although several SDOH variables were significantly associated with knee extension peak torque LSI in univariate regression analyses, only sex, F (1, 253) = 11.15, p = 0.001, race, F (1, 253) = 12.06, p < 0.001 and their interaction, F (1, 253) = 6.53 , p = 0.011, remained statistically significant when entered in the final general linear model after controlling for age and graft type. Adjusted means (standard errors) for knee extension peak torque LSI were 74.6% (1.9) for White males, 72.8% (2.1) for White females, 72.5% (1.9) for Black or African American males, and 60.5% (2.2) for Black or African American females.</p><p><strong>Conclusions: </strong>Black or African American females demonstrated inferior quadriceps strength recovery six months following pediatric ACL reconstruction. The development of targeted interventions and multicomponent initiatives to reduce combined racial and sex disparities following pediatric ACL reconstruction are warranted to close the gap in pediatric orthopedic care.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 5","pages":"676-686"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048366/pdf/","citationCount":"0","resultStr":"{\"title\":\"Social Determinants of Health and Quadriceps Strength Recovery in Children and Adolescents following Anterior Cruciate Ligament Reconstruction.\",\"authors\":\"Victor V Prati, Beverly J Spray, Cody W Walker, Cord Sheehy, Augustina O Oguntola-Blount, Paul M Inclan, Brant C Sachleben\",\"doi\":\"10.26603/001c.133918\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Social determinants of health (SDOH) contribute to delays in access to care and inferior outcomes following anterior cruciate ligament (ACL) reconstruction. The interplay between multiple SDOH factors has not been investigated in children and adolescents during rehabilitation.</p><p><strong>Purpose: </strong>To assess the relationships between SDOH variables, including demographics, singular surrogate indicators and multivariate indices, and quadriceps strength recovery at time of return-to-play testing following pediatric ACL reconstruction.</p><p><strong>Study design: </strong>Retrospective Cross-Sectional Study.</p><p><strong>Methods: </strong>Patients who underwent primary ACL reconstruction at a single pediatric tertiary-care center completed a standardized return-to-play battery of tests six months post-operatively. The associations and interactions between SDOH variables and knee extension peak torque limb symmetry index (LSI), obtained during isokinetic testing at 60 °/s, were explored statistically with both univariate and multivariate analyses.</p><p><strong>Results: </strong>Data on 259 White or Black/African American patients (43.2% female, mean age 15.3 ± 2.0 years) were utilized for analyses. Although several SDOH variables were significantly associated with knee extension peak torque LSI in univariate regression analyses, only sex, F (1, 253) = 11.15, p = 0.001, race, F (1, 253) = 12.06, p < 0.001 and their interaction, F (1, 253) = 6.53 , p = 0.011, remained statistically significant when entered in the final general linear model after controlling for age and graft type. Adjusted means (standard errors) for knee extension peak torque LSI were 74.6% (1.9) for White males, 72.8% (2.1) for White females, 72.5% (1.9) for Black or African American males, and 60.5% (2.2) for Black or African American females.</p><p><strong>Conclusions: </strong>Black or African American females demonstrated inferior quadriceps strength recovery six months following pediatric ACL reconstruction. The development of targeted interventions and multicomponent initiatives to reduce combined racial and sex disparities following pediatric ACL reconstruction are warranted to close the gap in pediatric orthopedic care.</p><p><strong>Level of evidence: </strong>Level 3.</p>\",\"PeriodicalId\":47892,\"journal\":{\"name\":\"International Journal of Sports Physical Therapy\",\"volume\":\"20 5\",\"pages\":\"676-686\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-05-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048366/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Sports Physical Therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26603/001c.133918\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Sports Physical Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26603/001c.133918","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
背景：健康的社会决定因素（SDOH）导致前交叉韧带（ACL）重建后获得护理的延迟和不良结果。多种SDOH因素之间的相互作用尚未在儿童和青少年康复期间进行调查。目的：评估SDOH变量（包括人口统计学、单一替代指标和多变量指标）与小儿ACL重建后重返比赛测试时股四头肌力量恢复之间的关系。研究设计：回顾性横断面研究。方法：在单一儿科三级保健中心接受初级ACL重建的患者在术后6个月完成标准化的恢复测试。在60°/s的等速测试中获得的SDOH变量与膝关节伸展峰值扭矩肢体对称指数（LSI）之间的关联和相互作用，通过单变量和多变量分析进行了统计分析。结果：259例白人或黑人/非裔美国人患者（43.2%为女性，平均年龄15.3±2.0岁）的数据被用于分析。虽然在单变量回归分析中，几个SDOH变量与膝关节伸展峰值扭矩LSI显著相关，但在控制年龄和移植物类型后，进入最终的一般线性模型时，只有性别F (1,253) = 11.15, p = 0.001，种族F (1,253) = 12.06, p < 0.001及其相互作用F (1,253) = 6.53, p = 0.011仍然具有统计学意义。白人男性膝关节伸展峰值扭矩LSI的调整平均值（标准误差）为74.6%(1.9)，白人女性为72.8%(2.1)，黑人或非裔美国男性为72.5%(1.9)，黑人或非裔美国女性为60.5%（2.2）。结论：黑人或非裔美国女性在儿童ACL重建后6个月表现出股四头肌力量恢复。有针对性的干预措施和多成分举措的发展，以减少儿童前交叉韧带重建后的种族和性别差异，有必要缩小儿童骨科护理的差距。证据等级：三级。
Social Determinants of Health and Quadriceps Strength Recovery in Children and Adolescents following Anterior Cruciate Ligament Reconstruction.
Background: Social determinants of health (SDOH) contribute to delays in access to care and inferior outcomes following anterior cruciate ligament (ACL) reconstruction. The interplay between multiple SDOH factors has not been investigated in children and adolescents during rehabilitation.
Purpose: To assess the relationships between SDOH variables, including demographics, singular surrogate indicators and multivariate indices, and quadriceps strength recovery at time of return-to-play testing following pediatric ACL reconstruction.
Study design: Retrospective Cross-Sectional Study.
Methods: Patients who underwent primary ACL reconstruction at a single pediatric tertiary-care center completed a standardized return-to-play battery of tests six months post-operatively. The associations and interactions between SDOH variables and knee extension peak torque limb symmetry index (LSI), obtained during isokinetic testing at 60 °/s, were explored statistically with both univariate and multivariate analyses.
Results: Data on 259 White or Black/African American patients (43.2% female, mean age 15.3 ± 2.0 years) were utilized for analyses. Although several SDOH variables were significantly associated with knee extension peak torque LSI in univariate regression analyses, only sex, F (1, 253) = 11.15, p = 0.001, race, F (1, 253) = 12.06, p < 0.001 and their interaction, F (1, 253) = 6.53 , p = 0.011, remained statistically significant when entered in the final general linear model after controlling for age and graft type. Adjusted means (standard errors) for knee extension peak torque LSI were 74.6% (1.9) for White males, 72.8% (2.1) for White females, 72.5% (1.9) for Black or African American males, and 60.5% (2.2) for Black or African American females.
Conclusions: Black or African American females demonstrated inferior quadriceps strength recovery six months following pediatric ACL reconstruction. The development of targeted interventions and multicomponent initiatives to reduce combined racial and sex disparities following pediatric ACL reconstruction are warranted to close the gap in pediatric orthopedic care.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
