Symmetry does not Indicate Recovery: Single-Leg Hop Before and After a Lower Extremity Injury

2020 ◽  
Author(s):  
Janet E Simon ◽  
Jae Yom ◽  
Dustin R Grooms
Keyword(s):  
Lower Extremity ◽  
Sports Participation ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Adolescent Athletes ◽  
Post Injury ◽  
Injured Limb ◽  
Before And After ◽  
And Performance

AbstractCurrent recommendations for return-to-play decision-making involve comparison of the injured limb to the uninjured limb. However, the use of the uninjured limb as a comparison for hop testing lacks empirical evidence. Thus, the purpose of this study was to determine the effects of lower extremity injury on limb symmetry and performance on the single-leg hop for distance. Two-hundred thirty-six adolescent athletes completed the single-leg hop for distance before the beginning of the season (pre-injury). Forty-four adolescent athletes sustained a lower extremity injury (22 ankle and 12 knee) and missed at least three days of sports participation. All individuals had completed the single-leg hop for distance before the beginning of the season (pre-injury) and at discharge (post-injury). Injured limb single-leg hop for distance significantly decreased at return-to-play from pre-injury with a mean decrease of 48.9 centimeters; the uninjured limb also significantly decreased, with a mean decrease of 33.8 centimeters. Limb symmetry did not significantly change pre- to post-injury with a mean difference of 1.5%. Following a lower extremity injury, single-leg hop for distance performance degrades not only for the injured limb but also the uninjured limb. However, limb symmetry did not change following a lower extremity injury.

scholarly journals SINGLE-LEG HOP PERFORMANCE IS A PREDICTOR FOR PATIENT-REPORTED OUTCOMES FOLLOWING A LOWER EXTREMITY INJURY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0017
Author(s):  
Janet E. Simon ◽  
Jae Yom ◽  
Dustin R. Grooms
Keyword(s):  
Lower Extremity ◽  
Patient Reported Outcomes ◽  
Functional Performance ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Adolescent Athletes ◽  
Injured Limb ◽  
Patient Reported

Background: The single-leg hop for distance (SLHOP) is a commonly used functional performance measure to determine return-to-play readiness. However, it is unknown if functional performance at return-to-play can predict future patient outcomes. Therefore, the purpose of this study was to determine if SLHOP performance and symmetry at return-to-play following a lower extremity injury would predict lower extremity patient-reported outcomes six months post-injury. Methods: Two-hundred thirty-six adolescent athletes (15.7±1.4 years, 171.1±7.6 cm, 70.3±15.3 kg) were recruited for this study. If an individual sustained a non-surgical lower extremity injury during their sports season and missed three days of sports participation they were eligible for follow-up functional and patient outcome assessment Thirty-two adolescent athletes were eligible and completed the follow-up testing (15.0±1.1 years, 166.5±4.9 cm, 67.3±10.4 kg; 14 American football, 8 volleyball, 4 girls’ basketball, 6 boys’ basketball athletes). The SLHOP was completed by affixing a tape measure to the ground and instructing the participant to hop on one leg as far as possible. Each participant performed three trials per leg at return-to-play (alternating legs). To be counted as a successful trial the participant maintained postural stability for 2 seconds after the landing and the contralateral leg was not allowed to touch the ground. The Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Lower Extremity scale was completed six months after return-to-play as the patient-reported outcome measure. A stepwise multiple linear regression was conducted to predict PROMIS Lower Extremity scale score from SLHOP distance on the injured and uninjured leg (cm), and limb symmetry (%). Results: At step one of the analysis, injured limb SLHOP distance was entered into the regression equation and was significantly related to the PROMIS Lower Extremity scale F(1,31)=20.8, p<.001. The multiple correlation coefficient was 0.79, indicating approximately 62% of the variance of the PROMIS Lower Extremity scale scores could be accounted for by the injured limb SLHOP distance. Specifically, for every increase in one cm of SLHOP performance there would be an increase of 0.6 points on the PROMIS Lower Extremity scale. Uninjured limb SLHOP distance and limb symmetry did not enter into the equation at step two of the analysis (p>.05). Conclusion: The SLHOP conducted at time of return-to-play following a lower extremity injury can predict lower extremity patient-reported outcomes six months later. This indicates that clinicians may be able to use the SLHOP following an injury to not only determine return-to-play readiness but a successful long-term outcome.

scholarly journals Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha
Keyword(s):  
Lower Extremity ◽  
National Football League ◽  
Field Performance ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
And Control

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.

scholarly journals Return to Play (RTP) and Performance in the Women’s National Basketball Association (WNBA) Following Anterior Cruciate Ligament (ACL) Reconstruction (194)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
Joseph Tramer ◽  
Lafi Khalil ◽  
Alexander Ziedas ◽  
Muhammad Abbas ◽  
Nima Mehran ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Post Injury ◽  
Acl Injuries ◽  
Post Surgery ◽  
Before And After ◽  
Playing Time ◽  
Anterior Cruciate ◽  
And Performance

Objectives: The incidence of ACL injuries in WNBA athletes has been on the rise, despite the high rates of ACL injury there is a paucity of recent research examining the effect of ACL reconstruction on RTP and performance in these athletes. This cohort study seeks to quantify the effect of ACL reconstruction on RTP and performance on WNBA athletes. Methods: All ACL tears sustained in the WNBA from 1997-2018 were identified. BMI, age and position at the time of injury were collected for each player. RTP rates were calculated and performance data was collected for each player before and after injury to determine changes in playing time and statistical performance. Players who successfully RTP after ACL reconstruction were compared to a group of healthy controls who were matched by age, years of experience, position, height, and BMI. Statistics at one year and three years’ post-injury were compared to assess acute and longitudinal changes in performance relative to pre-injury baseline. Results: A total of fifty-nine WNBA players sustained an isolated ACL tear during the study period. Forty-one (69.5%) were able to RTP. There was no difference in demographic characteristics between forty-one players and matched controls. Following RTP athletes played an average of 7.5±12.8 fewer games, 5.1±9.2 fewer minutes per game, and scored 3.7±5.0 less points per game in their first year compared to the year prior to injury. (Table1) When compared to matched controls, WNBA players returning from ACL reconstruction demonstrated a significant decline in games played, games started, minutes per game, rebounds, assists, and blocks per game in their first season after RTP. These differences resolved by year three post-surgery (Table 2). Conclusions: There is a high RTP rate following ACL reconstruction in WNBA athletes. Players may experience a decrease in playing time and performance initially when returning to play, however these variables were found to return to baseline over time.

Musculoskeletal Injuries and Their Association With Previous Concussion History: A Prospective Study of High School Volleyball and Soccer Players

2021 ◽  
pp. 036354652199711
Author(s):  
Kevin M. Biese ◽  
Stephanie A. Kliethermes ◽  
Andrew M. Watson ◽  
Timothy A. McGuine ◽  
Pamela J. Lang ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Female Athletes ◽  
Musculoskeletal Injury ◽  
Musculoskeletal Injuries ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
Adolescent Athletes ◽  
Injury Rates ◽  
The Past

Background: Sports-related concussions may have a neurobiological recovery period that exceeds the period of clinical recovery, and one consequence of an extended neurobiological recovery may be the risk of subsequent musculoskeletal injuries. Most literature citing an increased risk of musculoskeletal injury after a sports-related concussion has been reported in populations other than adolescent athletes. Purpose/Hypothesis: The purpose was to prospectively determine if incidence rates of musculoskeletal injury differ between adolescent athletes with and without a previous sports-related concussion, while controlling for sex, sport, and age. A secondary aim was to determine if this relationship differs between male and female athletes of the same sport. Our hypotheses were that acute-noncontact injury rates would be higher in athletes with a previous sports-related concussion when compared with athletes without a previous sports-related concussion, and that this relationship would exist only in female athletes and not male athletes. Study Design: Cohort study; Level of evidence, 2. Methods: High school soccer and volleyball players were recruited in 2 prospective cohort studies that observed 4837 athletes during their sporting season (females, 80%; soccer, 57%; mean [SD] age, 15.6 [1.1] years). At preseason, all participants self-reported demographics and previous sports-related concussion within the past 12 months. During the sport season, team athletic trainers electronically recorded athlete exposures and injury data, including injury characteristics. Injury rates per 1000 athlete exposures and injury rate ratios (IRRs) with 95% confidence intervals were calculated. All injury rates and IRRs were adjusted for sex, age, and sport. Results: The rate of acute-noncontact lower extremity injury was 87% greater (IRR, 1.87; 95% CI, 1.29-2.74) in participants with a previous sports-related concussion versus those without one. The acute-noncontact lower extremity injury rates (IRRs) for females and males with a previous sports-related concussion were 1.76 (95% CI, 1.19-2.59) and 2.83 (95% CI, 0.85-9.50), respectively. No difference was detected in acute-contact (IRR, 0.98; 95% CI, 0.56-1.73) or overuse (IRR, 1.09; 95% CI, 0.51-2.37) lower extremity injury rates by previous sports-related concussion. Conclusion: Female adolescent athletes who reported a sports-related concussion within the past 12 months were more likely to sustain an acute-noncontact lower extremity injury during their high school sports season when compared with female athletes without a previous sport-related concussion.

Multiple Concussions Increase Odds and Rate of Lower Extremity Injury in National Collegiate Athletic Association Athletes After Return to Play

2019 ◽  
Vol 47 (13) ◽  
pp. 3256-3262 ◽  
Author(s):  
Garrett K. Harada ◽  
Caitlin M. Rugg ◽  
Armin Arshi ◽  
Jeremy Vail ◽  
Sharon L. Hame
Keyword(s):  
Lower Extremity ◽  
National Collegiate Athletic Association ◽  
Collegiate Athletes ◽  
Neuromuscular Control ◽  
The United States ◽  
Return To Play ◽  
Lower Extremity Injury ◽  
Rank Test ◽  
Extremity Injury ◽  
Level Of Evidence

Background: Concussion in collegiate athletics is one of the most prevalent sport-related injuries in the United States, with recent studies suggesting persistent deficits in neuromuscular control after a concussion and an associated increase in risk of lower extremity injury. Purpose: To expand on the relationship between concussion and lower extremity injury by examining the effect of multiple concussions (MC) on rate and odds of future lower extremity injury in collegiate athletes after return to play (RTP) compared with matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: From 2001 to 2016, 48 National Collegiate Athletic Association Division I athletes sustaining multiple concussions at a single institution were identified. Athletes with multiple concussions (MC) were matched directly to athletes with a single concussion (SC) and to athletes with no concussion history (NC) by sex, sport, position, and games played. Incidence of, time to, and location of lower extremity injury were recorded for each group after RTP from their first reported concussion until completion of their collegiate career. Logistic regression was used to analyze odds ratios (ORs) for sustaining lower extremity injury, whereas time to injury was summarized by use of Kaplan-Meier curves and log rank test analysis. Results: The incidence of lower extremity injury after RTP was significantly greater ( P = .049) in the MC cohort (36/48, 75%) than in SC athletes (25/48 = 52%) and NC athletes (27/48 = 56%). Similarly, odds of lower extremity injury were significantly greater in the MC cohort than in SC athletes (OR, 3.00; 95% CI, 1.26-7.12; P = .01) and NC athletes (OR, 1.66; 95% CI, 1.07-2.56; P = .02). Time to lower extremity injury was significantly shorter in the MC group compared with matched controls ( P = .01). No difference was found in odds of lower extremity injury or time to lower extremity injury between SC and NC athletes. Conclusion: Collegiate athletes with MC were more likely to sustain a lower extremity injury after RTP in a shorter time frame than were the matched SC and NC athletes. This may suggest the presence of a cohort more susceptible to neuromuscular deficits after concussion or more injury prone due to player behavior, and it may imply the need for more stringent RTP protocols for athletes experiencing MC.

scholarly journals Relationship between Brazilian Thoroughbred race horses performance and lay-up period after osseous thoracic limb diseases

2013 ◽  
Vol 43 (7) ◽  
pp. 1288-1293
Author(s):  
Marsel de Carvalho Pereira ◽  
Carlos Augusto Araújo Valadão ◽  
Antonio Sergio Ferraudo ◽  
Carolina Berkman ◽  
Guilherme de Camargo Ferraz ◽  
...  
Keyword(s):  
Bone Repair ◽  
Healing Process ◽  
Post Injury ◽  
Injury Rehabilitation ◽  
Subsequent Performance ◽  
Perceptual Maps ◽  
Before And After ◽  
Performance Decline ◽  
History Of ◽  
And Performance

It is well established in the literature that musculoskeletal injuries are important compromising agents in the performance of Thoroughbred horses. In Brazil, there are no studies on the interrelation between lay-up period post-injury and retirement of racehorses due to musculoskeletal injures. The aim of this study is to determine the relationship between rehabilitation times of track injures and variables of prior race performance and later return to competitions. The radiographic reports and athletic history of 416 thoroughbreds during the period between 2003 and 2006 were examined; they were selected based on continued presentations after injury diagnosis. The temporal variables (post-injury rehabilitation time) and performance variables (race score before and after injury) were evaluated by multivariate correspondence analysis of the data and represented in perceptual maps. Correspondence was observed between most of the animals that had a short lay-up post-injury and variables that denote decline in subsequent performance. Considering the integrity of the bone healing process as crucial for the horse to be able to handle later training routines and competitions, shortening this period could lead to an imbalance of the bone repair metabolism, thus resulting in performance decline and compromise of the horse athletic career.

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