scholarly journals Outcome Measures After ACL Injury in Pediatric Patients: A Scoping Review

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711986180
Author(s):  
Mette K. Zebis ◽  
Susan Warming ◽  
Maria B. Pedersen ◽  
Marie H. Kraft ◽  
S. Peter Magnusson ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Pediatric Patients ◽  
Acl Injury ◽  
Structure And Function ◽  
Body Structure ◽  
Acl Injuries ◽  
Knee Joint Laxity ◽  
Health Domains ◽  
And Function ◽  
Objective Outcome

Background:The incidence of anterior cruciate ligament (ACL) injuries in children is increasing. However, no standardized core set of outcome measures exists for evaluating pediatric ACL injuries.Purpose:To perform a scoping review of the literature to identify patient-reported outcome measures (PROMs) and objective outcome measures used to evaluate pediatric patients after ACL injury and to classify these in accordance with the International Classification of Functioning, Disability, and Health (ICF) domains.Study Design:Systematic review; Level of evidence, 4.Methods:The literature was systematically searched with the PubMed, EMBASE, CINAHL, and PEDro databases. The inclusion criteria were Danish, Norwegian, Swedish, German, or English language; publication between 2010 and 2018; pediatric ACL injury (patients ≤15 years old); and outcome measures. The selected papers were screened for title, abstract, and full text in accordance with predefined inclusion and exclusion criteria.Results:A total of 68 papers (4286 patients; mean ± SD age, 12.2 ± 2.3 years) were included. Nineteen PROMs and 11 objective outcome measures were identified. The most frequently reported PROMs were the International Knee Documentation Committee (IKDC) Subjective Knee Form (51% of studies), Lysholm scoring scale (46% of studies) and Tegner activity rating scale (37% of studies). Additionally, return to sport was reported in 41% of studies. The most frequent objective measures were knee laxity (76% of studies), growth disturbances (69% of studies), range of motion (41% of studies), and muscle strength (21% of studies). With respect to the ICF domains, the IKDC covered all 3 ICF health domains, the Lysholm score covered the Body Structure and Function and the Activity Limitation domains, while the Tegner score covered the Participation Restriction domain. Objectively measured knee joint laxity, range of motion, and muscle strength covered 1 domain (Body Structure and Function).Conclusion:Pediatric patients with ACL injury were mainly evaluated subjectively with the IKDC and objectively by knee joint laxity. No consensus exists in the evaluation of children after ACL injury. The majority of applied outcome measures are developed for adults. To cover the ICF health domains, future research needs to consider reliable and valid outcome measures relevant for pediatric patients with ACL injury.

scholarly journals Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110050
Author(s):  
Hanna Tigerstrand Grevnerts ◽  
Sofi Sonesson ◽  
Håkan Gauffin ◽  
Clare L. Ardern ◽  
Anders Stålman ◽  
...  
Keyword(s):  
Decision Making ◽  
High Activity ◽  
Treatment Decision ◽  
Acl Injury ◽  
Treatment Decisions ◽  
Activity Level ◽  
Knee Instability ◽  
Acl Injuries ◽  
Patient Reported ◽  
And Function

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).

scholarly journals Electromyogram-Related Neuromuscular Electrical Stimulation for Restoring Wrist and Hand Movement in Poststroke Hemiplegia: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 33 (2) ◽  
pp. 96-111 ◽  
Author(s):  
Katia Monte-Silva ◽  
Daniele Piscitelli ◽  
Nahid Norouzi-Gheidari ◽  
Marc Aureli Pique Batalla ◽  
Philippe Archambault ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Electrical Stimulation ◽  
Meta Analysis ◽  
Neuromuscular Electrical Stimulation ◽  
Structure And Function ◽  
Motor Recovery ◽  
Body Structure ◽  
Short Term ◽  
And Function

Background. Clinical trials have demonstrated some benefits of electromyogram-triggered/controlled neuromuscular electrical stimulation (EMG-NMES) on motor recovery of upper limb (UL) function in patients with stroke. However, EMG-NMES use in clinical practice is limited due to a lack of evidence supporting its effectiveness. Objective. To perform a systematic review and meta-analysis to determine the effects of EMG-NMES on stroke UL recovery based on each of the International Classification of Functioning, Disability, and Health (ICF) domains. Methods. Database searches identified clinical trials comparing the effect of EMG-NMES versus no treatment or another treatment on stroke upper extremity motor recovery. A meta-analysis was done for outcomes at each ICF domain (Body Structure and Function, Activity and Participation) at posttest (short-term) and follow-up periods. Subgroup analyses were conducted based on stroke chronicity (acute/subacute, chronic phases). Sensitivity analysis was done by removing studies rated as poor or fair quality (PEDro score <6). Results. Twenty-six studies (782 patients) met the inclusion criteria. Fifty percent of them were considered to be of high quality. The meta-analysis showed that EMG-NMES has a robust short-term effect on improving UL motor impairment in the Body Structure and Function domain. No evidence was found in favor of EMG-NMES for the Activity and Participation domain. EMG-NMES had a stronger effect for each ICF domain in chronic (≥3 months) compared to acute/subacute phases. Conclusion. EMG-NMES is effective in the short term in improving UL impairment in individuals with chronic stroke.

The Relationship Between Early-Stage Knee Osteoarthritis and Lower-Extremity Alignment, Joint Laxity, and Subjective Scores of Pain, Stiffness, and Function

2016 ◽  
Vol 25 (3) ◽  
pp. 213-218
Author(s):  
Charlie A. Hicks-Little ◽  
Richard D. Peindl ◽  
Tricia J. Hubbard-Turner ◽  
Mitchell L. Cordova
Keyword(s):  
Knee Joint ◽  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Early Stage ◽  
Joint Laxity ◽  
Knee Oa ◽  
Lower Extremity Alignment ◽  
Knee Joint Laxity ◽  
And Function

Context:Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lowerextremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear.Objective:To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures.Design:Case control.Setting:Sports-medicine research laboratory.Participants:18 participants with knee OA and 18 healthy matched controls.Intervention:Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN).Main Outcome Measures:WOMAC scores, A-P (mm), and ALIGN (°).Results:A significant multivariate main effect for group (Wilks’ Λ = 0.30, F7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures.Conclusion:These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants’ subjective scores, ALIGN, or A-P measures in this study.

scholarly journals The relationship between parenting and development of toddlers aged 1-5 years in the working area of Rawang public health center, Padang city

2021 ◽  
Vol 5 (1) ◽  
pp. 22
Author(s):  
Miranie Safaringga ◽  
Uliy Iffah ◽  
Adinda Permata Sari
Keyword(s):  
Data Collection ◽  
Cross Section ◽  
Structure And Function ◽  
Body Structure ◽  
Children Under Five ◽  
Under Five ◽  
Number Of Children ◽  
Quantitative Design ◽  
And Function ◽  
The Relationship

Children under five years of age when the increase in body structure and function becomes more complex and the ability to move fine, fine motion, language, and independence. The number of children under five who do not develop according to their age is triggered by parental care, where this care aims to meet the basic needs of toddlers so that they can grow and develop more optimally. The purpose of this study was to determine the relationship between parenting and the development of children aged 1-5 years in the working area of Puskesmas Rawang, Padang City. This research uses quantitative design with a cross section. This research was conducted in the working area of Puskesmas Rawang, Padang City. Data collection was carried out in March 2020. The sample of this study is mothers who have children aged 1-5 years who are in the working area of Puskesmas Rawang, Padang City, amounting to 79 people. The technique used in this study is proportional random sampling, for data collection using a questionnaire. The results of this study obtained 79 respondents consisting of mothers and toddlers with an average age of 12-24 months. Descriptively democratic parenting has a proportion of under five development in accordance with the highest value, namely 95.6% while authoritarian is 11.5%. Democratic parenting style affects the optimal development of toddlers.

scholarly journals Postural asymmetries in transfemoral amputees

2011 ◽  
Vol 35 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Ignacio Gaunaurd ◽  
Robert Gailey ◽  
Brian J Hafner ◽  
Orlando Gomez-Marin ◽  
Neva Kirk-Sanchez
Keyword(s):  
Chronic Conditions ◽  
Limb Length Discrepancy ◽  
Structure And Function ◽  
Limb Length ◽  
Body Structure ◽  
Trunk Flexion ◽  
Length Discrepancy ◽  
Transfemoral Amputees ◽  
And Function ◽  
Hip Extension

Background: Postural asymmetries are thought to lead to impairment of body structure and function such as muscle imbalance, gait asymmetry and possible chronic conditions, which result in limitation of mobility and restriction of daily activity for transfemoral amputees (TFAs). Despite the potential clinical impact, postural asymmetries have not been confirmed or quantified in TFAs.Objectives: To identify the presence of postural asymmetries in TFAs utilizing clinical evaluation measures.Study design: An observational cross-sectional study in which participants were evaluated at a single time point without intervention or follow-up.Methods: Forty-seven unilateral TFAs were measured for standing limb length, pelvic innominate inclination (PII), lateral trunk flexion and hip extension.Results: Limb length discrepancy was present in 66% of participants and 57% had a short prosthetic limb. PII was greater than has been reported in the literature, and the shorter the prosthetic lower limb, the greater the PII on the amputated side (r = −0.422, p = 0.004). Limb length discrepancy and decreased lateral trunk flexion accounted for 26% of the variance in amputated side PII.Conclusion: Three postural measurements, namely leg length, pelvic innominate inclination and hip extension, were found to differ between the intact and amputated limb in this study sample.Clinical relevanceClinicians should include postural assessment as part of their routine evaluation of TFAs in an effort to achieve postural symmetry and reduce the risk of chronic conditions associated with impairment of body structure and function.

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