scholarly journals Short-term recovery of physical activity and knee function after an acute knee injury

2020 ◽  
Vol 6 (1) ◽  
pp. e000950
Author(s):  
Sanne Fomin ◽  
Håkan Gauffin ◽  
Joanna Kvist
Keyword(s):  
Physical Activity ◽  
Knee Injury ◽  
Knee Injuries ◽  
Acl Injury ◽  
Knee Function ◽  
Physical Activity Participation ◽  
Activity Participation ◽  
Acute Knee ◽  
Acute Knee Injury

ObjectivesTo describe self-reported knee function, participation in physical activity and the number of knee surgeries at 3 and 6 months following acute knee injury.MethodsProspective cohort study. Participants, aged 15–40 years with an acute knee injury sustained no more than 6 weeks prior to inclusion, were recruited. There were 279 participants with ACL injury and 101 participants with other acute knee injuries included. Follow-up questionnaires were sent at 3 and 6 months after injury. Demographic information, activity participation, International Knee Documentation Committee subjective knee form (IKDC-SKF) and the Single Assessment Numeric Evaluation (SANE) score were collected. Additional knee injuries were obtained from self-report and medical charts.ResultsThe IKDC-SKF, SANE and physical activity participation were reduced at 3-month and 6-month follow-up. The number of participants who achieved health-promoting physical activity levels was reduced by 50% at 6-month follow-up compared with before injury. Seventeen per cent of participants with ACL injury and 41% of participants with other acute knee injuries had returned to their preinjury physical activity at 6 months. Participants with ACL injury reported worse knee function, lower physical activity participation and had more surgeries (128 surgeries, including 109 ACL-reconstructions) compared with participants with other acute knee injuries (six surgeries).ConclusionAcute knee injuries, including ACL injuries, affected self-reported knee function and physical activity participation for at least 6 months after index injury. More research is needed to understand how best to help people with acute knee injuries return to physical activity and achieve satisfactory knee function.

scholarly journals The Role of Clinical Examination in Predicting Relevant MRI Findings in Acute Knee Injuries: A Retrospective Study

2018 ◽  
Vol 32 (03) ◽  
pp. 280-283
Author(s):  
Daoud Makki ◽  
Daniel Ness ◽  
Raghuram Thonse ◽  
Saleem Mastan
Keyword(s):  
Clinical Examination ◽  
Knee Injury ◽  
Knee Injuries ◽  
Joint Effusion ◽  
Range Of Movement ◽  
Mri Findings ◽  
Mri Scan ◽  
Time Period ◽  
Acute Knee ◽  
Acute Knee Injury

AbstractThe objective of this study was to delineate the usefulness of clinical examination and magnetic resonance imaging (MRI) in acute knee injuries. We aim to establish whether the time period post acute knee injury is related to the diagnostic accuracy of clinical examination and to investigate the strength of specific clinical examination findings in predicting a clinically relevant MRI abnormality. Seventy patients were referred to fracture clinic with an acute knee injury who subsequently went on to be investigated with MRI over 12 months. These patients were retrospectively analyzed looking at the time period they were reviewed, the components that were assessed at physical examination, and the results of their eventual MRI scan looking for any correlation. A greater proportion of patients who were examined at 2 weeks had relevant positive findings on MRI scan, p = 0.03. Range of movement and lateral joint line tenderness were not associated with a positive MRI scan at any period after injury. The presence of a moderate to large effusion was not associated with an MRI abnormality if the examination was within 2 weeks of injury but was if present 2 weeks after injury, p = 0.0001. Range of movement should not form part of the decision making on whether an injury should be investigated with MRI. Joint effusion in isolation within 2 weeks after injury should not be an indication for MRI but a repeat clinical examination in 2 weeks, where if still present, should be investigated with MRI.

Decision Rule for Imaging Acute Knee Injuries

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Decision Rule ◽  
Knee Injury ◽  
Knee Injuries ◽  
Clinical Implications ◽  
Emergency Physicians ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology ◽  
Acute Knee ◽  
Acute Knee Injury

This chapter, found in the bone, joint, and extremity pain section of the book, provides a succinct synopsis of a key study examining the use of the Ottawa knee rules for imaging acute knee injuries. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The Ottawa Knee Rule was found to be highly accurate, reliable, and acceptable to emergency physicians. Adherence to the decision rule has the potential to reduce unnecessary radiography in acute knee injury cases by 28%. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

scholarly journals Biochemical Response to a Moderate Running Bout in Participants With or Without a History of Acute Knee Injury

2017 ◽  
Vol 52 (6) ◽  
pp. 567-574 ◽  
Author(s):  
Nicole M. Cattano ◽  
Jeffrey B. Driban ◽  
Mary F. Barbe ◽  
Ryan T. Tierney ◽  
Mamta Amin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Knee Injury ◽  
Type Ii Collagen ◽  
Serum Biomarker ◽  
Moderate Intensity ◽  
Type Ii ◽  
Physically Active ◽  
Healthy Control ◽  
Acute Knee ◽  
Acute Knee Injury

Context:  Individuals with an acute knee-injury history are 4 times more likely to develop knee osteoarthritis than those without a prior knee injury, and it is unknown why. Individuals with an injury history may exhibit aberrant changes in tissue turnover after physical activity (eg, running), which could lead to osteoarthritis, but this has yet to be determined among young, physically active individuals. Objective:  To determine collagen degradation and synthesis and inflammatory biomarker concentration levels before exercise and changes in response to an acute running bout in injured participants compared with healthy control participants. Design:  Cohort study. Setting:  Research laboratory. Patients or Other Participants:  A total of 22 physically active individuals between 18 and 25 years of age were recruited for the study: 11 injured participants (knee injury within 4 years of the study) who were medically cleared for physical activity and 11 matched healthy control participants. Main Outcome Measure(s):  The independent variable was group (injured or control). Dependent variables were serum biomarker concentrations for cartilage oligomeric matrix protein, matrix metalloproteinase-13, proinflammatory marker interleukin-1β, c-terminal cross-linking telopeptide of type II collagen, and type II collagen synthesis marker. Each participant provided prerun and postrun blood samples for biomarker-concentration analysis. Results:  No group differences existed in serum biomarker concentrations before exercise or in serum biomarker changes from pre-exercise to postexercise. Conclusions:  After an acute bout of moderate-intensity running, young, active individuals in a high-risk postinjury population had similar biochemical responses as matched healthy controls. However, the external generalizability of these findings to other exercises and populations has yet to be determined.

scholarly journals Return to Sports and Physical Activities after First Metatarsophalangeal Joint Arthrodesis in Young Patients

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0004
Author(s):  
Rachael Da Cunha ◽  
Scott Ellis ◽  
Mackenzie Jones
Keyword(s):  
Physical Activity ◽  
Clinical Outcomes ◽  
Young Patients ◽  
Physical Activities ◽  
Physical Activity Participation ◽  
Activity Participation ◽  
Exclusion Criteria ◽  
Physically Active ◽  
Patient Counselling

Category: Midfoot/Forefoot Introduction/Purpose: Arthrodesis of the first metatarsophalangeal (MTP) joint has been shown to be effective and reliable in alleviating pain and correcting deformity. However, the effect on patient participation in specific sports and physical activities has not been well established. For this reason, younger patients that are more physically active may be less likely to undergo this procedure, despite significant first MTP joint pathology and symptoms. The aim of this study was to assess specific sports and physical activities in young patients following first MTP joint arthrodesis as well as clinical outcomes. Methods: This was a single-center study conducted from a review of a prospectively collected registry. Eligible patients were contacted for final follow up. All cases of first MTP arthrodesis in skeletally mature patients age 55 and under between October 2006 and December 2014 were included. Exclusion criteria included concomitant metatarsal osteotomies, midfoot or hindfoot fusions, and systemic or other musculoskeletal disease that would otherwise impact physical activity participation. Clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS). Physical activity participation was evaluated with a physical activity and sports-specific, patient-administered questionnaire. Seventy-three eligible patients were identified that met the inclusion and exclusion criteria. Fifty patients (68%) were reached for follow up and were included in this study. The mean age at the time of surgery was 49.7 (23-55) years. Thirty-four percent of patients were male and 66% female. The average follow up was 5.1 (2.2-10.2) years. Results: There was significant improvement in all FAOS subcategories, including pain (49.9-84.1, p<0.001), other symptoms (64.1- 77.8, p<0.001), function in daily activities (67.0-89.0, p<0.001), function in sport and recreation (38.7-68.5, p<0.001) and quality of life (20.7-63.9, p<0.001). There was no difference between male and female patients (p>0.05). Patients reported participation in 14 different sports and physical activities. The most common were walking, cycling, weight lifting, swimming, running and aerobics. Compared to preoperatively, patients rated 26% of activities as less difficult, 54% as the same, and 20% as more difficult. Patients returned to 84% of their activities in < 12 months and 42% in < 6 months, with 61% reaching their peak performance level in < 12 months. Ninety-two percent of patients were satisfied with their outcome. Conclusion: First MTP joint arthrodesis is a reasonable option in young, physically active patients. Improved clinical outcomes and satisfactory pain reduction were achieved in all patients. The majority of patients were able to return to a wide variety of physical activities and sports, and were satisfied with their level attained. A small group of patients that participated in more high impact sports reported increased difficulty post-operatively, however, there was an increased number of patients that reported decreased difficulty in these same activities. This may be beneficial in patient counselling and aid in treatment decision making.

scholarly journals Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711882245
Author(s):  
Eduardo Frois Temponi ◽  
Adnan Saithna ◽  
Lúcio Honório de Carvalho ◽  
Bruno Presses Teixeira ◽  
Bertrand Sonnery-Cottet
Keyword(s):  
Knee Injury ◽  
Nonoperative Management ◽  
Nonoperative Treatment ◽  
Anterolateral Ligament ◽  
Injury Pattern ◽  
Functional Scores ◽  
The Mean ◽  
Acute Knee ◽  
Acute Knee Injury

Background: Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian jiu-jitsu (BJJ) because of the knee varus-flexion mechanism that frequently occurs during grappling. Purpose/Hypothesis: The purpose of this study was to evaluate the incidence of this injury pattern in a series of BJJ athletes with an acute knee injury and to evaluate clinical and functional outcomes after nonoperative management at a minimum follow-up of 1 year. Our hypotheses were that PLCCALL injuries are common in BJJ and that nonoperative treatment is associated with excellent clinical outcomes and return to the preinjury level of sport. Study Design: Case series; Level of evidence, 4. Methods: All BJJ athletes who presented with an acute knee injury between July 2013 and June 2017 and who underwent magnetic resonance imaging (MRI) of the knee were included. A specific emphasis was placed on identifying those whose imaging demonstrated PLCCALL injury. Clinical evaluation included physical examination as well as Lysholm and International Knee Documentation Committee (IKDC) scores. Results: Of the 27 patients analyzed, 7 (25.9%) had MRI-proven PLCCALL injuries. The mean follow-up after nonoperative management was 41.3 months. The mean IKDC and Lysholm scores were 94 and 92 before the injury, 26 and 36 at the initial assessment after the injury, and 83 and 78 at 12-month follow-up, respectively ( P < .00001). All 7 patients had returned to their preinjury level of sports by the 12-month follow-up. The mean time between injury and return to competition level was 4.7 months (range, 4-6 months). Conclusion: PLCCALL injury is a specific but infrequent injury pattern in BJJ. The prognosis of this injury after nonoperative treatment appears to be excellent. Improved functional scores (IKDC and Lysholm) and changes on MRI demonstrated that the anterolateral ligament has intrinsic healing potential, as the images showed complete healing of the previously documented rupture of the anterolateral ligament from its proximal attachment.

Modifiable Factors Associated With Poststroke Physical Activity at Discharge From Rehabilitation: Prospective Cohort Study

2020 ◽  
Vol 100 (5) ◽  
pp. 818-828 ◽  
Author(s):  
Shamala Thilarajah ◽  
Kelly J Bower ◽  
Yong-Hao Pua ◽  
Dawn Tan ◽  
Gavin Williams ◽  
...  
Keyword(s):  
Physical Activity ◽  
Regression Models ◽  
Inpatient Rehabilitation ◽  
Physical Activity Participation ◽  
Activity Participation ◽  
Activity Levels ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Physical Activity Levels

Abstract Background People with stroke are not meeting recommended levels of physical activity. The modifiable factors associated with poststroke physical activity levels need to be identified to develop targeted interventions. Objective The objective of this study was to investigate the factors at discharge from inpatient rehabilitation that are associated with physical activity levels at 3 months following discharge. Design This was a prospective cohort study. Methods Sixty-four people with stroke completed baseline assessments at discharge from inpatient rehabilitation and 55 completed the follow-up 3 months later. The candidate factors (ie, gait speed, balance, strength, cognition, mood, and motivation) were measured at discharge. The primary outcome measure at follow-up was walking-related activity (measured by wrist-worn accelerometer). Secondary outcome measures were physical activity participation (Activity Card Sort) and intensity of physical activity (International Physical Activity Questionnaire–Short 7 days). Adjusted separate multivariable linear regression models or proportional odds regression models were used to evaluate the associations between candidate factors and physical activity. Results Gait speed and balance were associated with all aspects of physical activity. Higher level of intrinsic motivation was also associated with higher physical activity participation. Anxiety demonstrated a significant nonlinear relationship with physical activity participation. Limitations Inclusion of fatigue and individual muscle strength could have provided further insights into associations with steps per day. Conclusion The results demonstrated that better physical function at discharge from inpatient rehabilitation was associated with future increased levels of physical activity. Additionally, higher levels of motivation impacted on increased physical activity participation. The influence of anxiety on physical activity participation requires further exploration. Mixed-method study designs can be utilized to further understand the factors associated with poststroke physical activity.

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