共查询到20条相似文献,搜索用时 15 毫秒
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Jenny L. Toonstra Jennifer S. Howard Timothy L. Uhl Robert A. English Carl G. Mattacola 《International Journal of Sports Physical Therapy》2013,8(5):670-679
Purpose/Background:
Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post‐operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population’s demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post‐operative rehabilitation in order to provide information and guide initiatives for improving the quality of rehabilitation practices following ACI.Methods:
The medical records of patients treated for chondral defect(s) of the knee who subsequently underwent the ACI procedure were retrospectively reviewed. A systematic review of medical, surgical, and rehabilitation records was performed. In addition, patient‐reported outcome measures (IKDC, WOMAC, Lysholm, SF‐36) recorded pre‐operatively, and 3, 6, and 12 months post‐operatively were extracted from an existing database.Results:
20 medical charts (35.9 ± 6.8 years; 9 male, 11 female) were systematically reviewed. The average IKDC, WOMAC, Lysholm, and SF‐36 scores all improved from baseline to 3, 6 and 12 months post‐operatively, with the greatest changes occurring at 6 and 12 months. There was inconsistent documentation relative to post‐operative rehabilitation, including CPM use, weight‐bearing progression, home‐exercise compliance, and strength progressions.Conclusions:
Due to variations in the documentation process, the authors were unable to determine what specific components of rehabilitation influence the recovery process. In order to further understand how rehabilitation practices influence outcomes following ACI, specific components of the rehabilitation process must be consistently and systematically documented over time.Level of Evidence:
2C 相似文献4.
Jessica Fulton Kathryn Wright Margaret Kelly Britanee Zebrosky Matthew Zanis Corey Drvol Robert Butler 《International Journal of Sports Physical Therapy》2014,9(5):583-595
Background:
Active adults commonly present with lower extremity (LE) injuries from a variety of professional and amateur sports activities. Decreased LE function significantly alters daily life and subsequent injuries increase this impact. The purpose of this systematic review was to examine the association between previous injury and the risk of re‐injury, and to describe the changes in kinematics and motor programming that may contribute to this relationship.Methods:
A preliminary search was conducted to determine the four most common LE injuries on PubMed, CINAHL and Web of Science. These injuries, in a healthy active adult population, were hamstring strain (HS), anterior cruciate ligament injury (ACL), achilles tendon pathology, and ankle sprain. After these injuries were established, the search for this systematic review found evidence relating these injuries to re‐injury. Articles related to degenerative changes were excluded. Twenty‐six articles were included in the systematic review detailing the risk of re‐injury from a previous injury and were graded for quality.Results:
ACL injury was linked to a successive injury of the same ACL, and other injuries in the LE. HS was associated with subsequent ipsilateral HS and knee injuries. Previous achilles tendon rupture increased the risk of an analogous injury on the contralateral side. An ankle sprain was associated with a re‐injury of either the ipsilateral or the contralateral ankle. Post‐injury changes were present in strength, proprioception, and kinematics, which may have led to overall changes in motor control and function.Conclusion:
This review provides insight into the changes occurring following common LE injuries, how these changes potentially affect risk for future injury, and address the needs of the active adult population in rehabilitation.Clinical Relevance:
Current research on previous injury and re‐injury is of high quality, but scarce quantity. Deficits following an injury are known, but how these deficits correlate or lead to re‐injury requires further exploration.Level of Evidence:
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Background
Upper extremity physical performance measures exist but none have been universally accepted as the primary means of gauging readiness to return to activity following rehabilitation. Few reports have described reliability and/or differences in outcome with physical performance measures between individuals with and without shoulder symptoms.Hypotheses/Purpose
The purpose of this study was to establish the reliability of traditional upper extremity strength testing and the CKCUEST in persons with and without shoulder symptoms as well as to determine if the testing maneuvers could discriminate between individuals with and without shoulder symptoms. The authors hypothesized that strength and physical performance testing would have excellent test/re‐test reliability for individuals with and without shoulder symptoms and that the physical performance maneuver would be able to discriminate between individuals with and without shoulder symptoms.Methods
Male and female subjects 18‐50 years of age were recruited for testing. Subjects were screened and placed into groups based on the presence (Symptomatic Group) or absence of shoulder symptoms (Asymptomatic Group). Each subject performed an isometric strength task, a task designed to estimate 1‐repetition maximum (RM) lifting in the plane of the scapula, and the closed kinetic chain upper extremity stability test (CKCUEST) during two sessions 7‐10 days apart. Test/re‐test reliability was calculated for all three tasks. Independent t‐tests were utilized for between group comparisons to determine if a performance task could discriminate between persons with and without shoulder symptoms.Results
Thirty‐six subjects (18/group) completed both sessions. Test/re‐test reliability for each task was excellent for both groups (intraclass correlations ≥ .85 for all tasks). Neither strength task could discriminate between subjects in either group. Subjects with shoulder symptoms had 3% less touches per kilogram of body weight on the CKCUEST compared to subjects without shoulder symptoms but this was not statistically significantly different (p=.064).Conclusions
The excellent test/re‐test reliability has now been expanded to include individuals with various reasons for shoulder symptoms. Traditional strength testing does not appear to be the ideal assessment method for making discharge and/or return to activity decisions due to the inability to discriminate between the groups. The CKCUEST could be utilized to determine readiness for activity as it was trending towards being discriminatory between known groups.Level of Evidence
Basic Science Reliability Study, Level 3 相似文献11.
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Abigail A. Ellsworth Mark P. Zoland Timothy F. Tyler 《International Journal of Sports Physical Therapy》2014,9(6):774-784
Background:
Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non‐specific referral of “groin pain” or “sports hernia.” The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term “sports hernia” is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology.Treatment:
Both non‐operative and post‐operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post‐operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption.Conclusion:
Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non‐operative or post‐operative allows for a focused rehabilitative program. As more information is obtained through MRI imaging and the diagnosis and treatment of inguinal disruption and athletic pubalgia becomes increasingly frequent, more research is warranted in this field to better improve the evidence based practice and rehabilitation of patients.Levels of Evidence:
5 相似文献15.
Neal R. Glaviano William T. Langston Joseph M. Hart Susan Saliba 《International Journal of Sports Physical Therapy》2014,9(7):915-923
Background:
Neuromuscular Electrical Stimulation is a common intervention to address muscle weakness, however presents with many limitations such as fatigue, muscle damage, and patient discomfort that may influence its effectiveness. One novel form of electrical stimulation purported to improve neuromuscular re‐education is Patterned Electrical Neuromuscular Stimulation (PENS), which is proposed to mimic muscle‐firing patterns of healthy individuals. PENS provides patterned stimulating to the agonist muscle, antagonist muscle and then agonist muscle again in an effort to replicate firing patterns.Purpose:
The purpose of this study was to determine the effect of a single PENS treatment on knee extension torque and quadriceps activation in individuals with quadriceps inhibition.Methods:
18 subjects (10 males and 8 females: 24.2±3.4 years, 175.3±11.8cm, 81.8±12.4kg) with a history of knee injury/pain participated in this double‐blinded randomized controlled laboratory trial. Participants demonstrated quadriceps inhibition with a central activation ratio of ≤90%. Maximal voluntary isometric contraction of the quadriceps and central activation ratio were measured before and after treatment. The treatment intervention was a 15‐minute patterned electrical stimulation applied to the quadriceps and hamstring muscles with a strong motor contraction or a sham group, who received an identical set up as the PENS group, but received a 1mA subsensory stimulation. A 2×2 (group × time) ANCOVA was used to determine differences in maximal voluntary isometric contraction and central activation ratio between groups. The maximal voluntary isometric contraction was selected as a covariate due to baseline differences.Results:
There were no differences in change scores between pre‐ and post‐intervention for maximal voluntary isometric contraction: (PENS: 0.09±0.32Nm/kg and Sham 0.15±0.18Nm/kg, p=0.713), or central activation ratio:(PENS: ‐1.22±6.06 and Sham: 1.48±3.7, p=0.270).Conclusions:
A single Patterned Electrical Neuromuscular Stimulation treatment did not alter quadriceps central activation ratio or maximal voluntary isometric contraction. Unlike other types of muscle stimulation, PENS did not result in a reduction of quadriceps torque.Level of Evidence:
Level III 相似文献16.
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Daniel P. Bien Thomas J. Dubuque 《International Journal of Sports Physical Therapy》2015,10(2):256-271
Purpose/Background:
Despite recent advances in anterior cruciate ligament reconstruction (ACL) surgical techniques, an improved understanding of the ACL’s biomechanical role, and expanding research on optimal rehabilitation practices in ACL‐reconstructed (ACLR) patients, the re‐tear rate remains alarmingly high and athletic performance deficits persist after completion of the rehabilitation course in a large percentage of patients. Significant deficits may persist in strength, muscular activation, power, postural stability, lower extremity mechanics, and psychological preparedness. Many patients may continue to demonstrate altered movement mechanics associated with increased injury risk. The purpose of this clinical commentary and literature review is to provide a summary of current evidence to assist the rehabilitation professional in recognizing, assessing, and addressing factors which may have been previously underappreciated or unrecognized as having significant influence on ACLR rehabilitation outcomes.Methods:
A literature review was completed using PubMed, Medline, and Cochrane Database with results limited to peer‐reviewed articles published in English. 136 articles were reviewed and included in this commentary.Conclusions:
Barriers to successful return to previous level of activity following ACLR are multifactorial.Recent research suggests that changes to the neuromuscular system, movement mechanics, psychological preparedness, and motor learning deficits may be important considerations during late stage rehabilitation.Level of evidence:
Level 5‐ Clinical Commentary 相似文献19.
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Christiana Blume Sharon Wang‐Price Elaine Trudelle‐Jackson Alexis Ortiz 《International Journal of Sports Physical Therapy》2015,10(4):441-455