scholarly journals LIMB SYMMETRY IS NOT ENOUGH: ESTABLISHMENT OF HEIGHT NORMALIZED HOP DISTANCES WITHIN HEALTHY YOUTH ATHLETES

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0019
Author(s):  
Elliot M. Greenberg ◽  
Michael Karl ◽  
Anne Leung ◽  
J. Todd Lawrence ◽  
Theodore Ganley
Keyword(s):  
Test Performance ◽  
Cruciate Ligament ◽  
Body Height ◽  
Age Groups ◽  
Future Research ◽  
Return To Sports ◽  
Cross Sectional ◽  
Sample Mean ◽  
Youth Athletes ◽  
Main Effect

Background: Most experts recommend utilizing single leg hop tests to help determine an athlete’s readiness to return to sports after anterior cruciate ligament reconstruction (ACLR). A limb symmetry index (LSI =involved limb/uninvolved limb) of ≥90% is typically required by most contemporary protocols. However, limb symmetry may underestimate continued post-operative deficits due to performance declines within the uninvolved limb after ACLR. Additionally, LSI may not accurately identify those at risk of repeat injury, and doesn’t assist in ensuring maximal patient effort. Comparing height normalized hop distances to uninjured controls has been suggested as an additional criteria to better recognize performance deficits after ACLR. Purpose: To characterize single leg hop test performance in a large group of healthy youth athletes and determine the relationships of sex or age on hop performance. Methods: This was a cross-sectional study of healthy youth athletes aged 8-14 years-old, who were currently participating in organized sports. Using their dominant leg, each subject performed a triple hop (TrH) in which they quickly hopped on one leg three times, achieving maximal linear distance, while holding their balance after the last hop. Distance from starting line to the heel was recorded in centimeters. Each subject’s hop distance was normalized to body height and served as the dependent variable. A two-way ANOVA analyzed any effects of age and sex. A-priori alpha was set at p≤0.05. Results: A total of 340 subjects (Male [n=184], mean age 10.9±1.5 years) were included. Across the entire sample, mean TrH distance was 2.2 times body height. ANOVA demonstrated no differences for main effect of sex (mean TrH/height, Males=2.2, Females=2.1, p=0.212). (Figure 1) Main effect of age was significant (p<0.001) with Bonferroni post-hoc analysis indicating 13 year-olds normalized TrH distance (2.6 times body height) was greater than all other age groups (8 yrs=1.9, 9yrs=2.0, 10yrs=2.1, 11yrs=2.2, 12yrs=2.3). (Figure 2) The 12 year-old performance was significantly greater than 8-9 year-olds only (2.3 vs 1.9-2.0). Conclusions: When normalized to body height, TrH performance increases around the ages of 12-13 years. Regardless of sex, athletes aged 8-11 can be expected to TrH approximately 2 times body height, while athletes near age 13 should have TrH values of 2.6 times body height. Due to post-operative deconditioning within the healthy limb, the use of age-matched hopping norms in addition to LSI may offer better determination of functional recovery or effort. As performance changes with age, future research should focus on establishing normative performance in older subjects. Figures/Tables: [Figure: see text][Figure: see text]

scholarly journals Single-leg hop distance normalized to body height is associated with the return to sports after anterior cruciate ligament reconstruction

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Shunsuke Ohji ◽  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Takehiro Ohmi ◽  
Sho Mitomo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Body Height ◽  
Cross Sectional Study ◽  
Return To Sports ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Abstract Purpose To investigate the relationship between single-leg hop distance (SLHD), normalized body height, and return-to-sports (RTS) status after anterior cruciate ligament reconstruction (ACLR) and to identify the cut-off value for SLHD on the operated side. Methods Seventy-three patients after primary ACLR (median 13.5 months) participated in this cross-sectional study. Participants were divided into ‘‘Yes-RTS’’ (YRTS) or ‘‘No-RTS’’ (NRTS) groups based on a self-reported questionnaire. SLHD was measured, and the limb symmetry index (LSI) and SLHD (%body height) were calculated. A minimum p-value approach was used to calculate the SLHD cut-off points (%body height) on the operated side that were strongly associated with the RTS status. Logistic regression analysis was used to analyse the association between RTS status and SLHD cut-off point (%body height). Isokinetic strength and Tampa scale for kinesiophobia (TSK) were measured as covariates. Results Among 73 patients, 43 (59%) were assigned to the YRTS and 30 (41%) to the NRTS group. The 70% body height cut-off point for SLHD on the operated side was most strongly associated with RTS status. In a logistic regression analysis including other covariates, SLHD (%body height) < 70% and TSK were negatively associated with RTS status. Except for two participants, the LSI of the SLHD exceeded 90% and there was no significant association between the LSI of the SLHD and RTS status. Conclusion Even after improvement in the LSI of the SLHD, planning rehabilitation with the goal of achieving SLHD over 70% body height may be important for supporting RTS after ACLR. Level of evidence Cross-sectional study, Level IV

scholarly journals The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Turki M. AlHarbi ◽  
Abdullaziz AlGarni ◽  
Fasial AlGamdi ◽  
Mona Jawish ◽  
Tariq Ahmad Wani ◽  
...  
Keyword(s):  
Body Weight ◽  
Pediatric Population ◽  
Body Height ◽  
Age Groups ◽  
Cross Sectional Study ◽  
The Body ◽  
Accurate Estimation ◽  
Cross Sectional ◽  
Actual Weight ◽  
Medical City

Objective.To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population.Methods.A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child’s height produce an estimated weight, which was compared with the actual weight.Results.A total of 3537 children were recruited. The height (cm) of the subjects was97.7±24.1and the actual weight (kg) was16.07±8.9, whereas the estimated weight determined by BT 2007 was15.87±7.56and by BT 2011 was16.38±7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms.Conclusions.Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight.

scholarly journals EVALUATION OF THE UTILITY OF THE ANTERIOR CRUCIATE LIGAMENT RETURN TO SPORT AFTER INJURY (ACL-RSI) SCALE WITHIN PEDIATRIC ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Elliot Greenberg ◽  
Miranda Dabbous ◽  
Anne Leung ◽  
Gabriella Marinaccio ◽  
Benjamin Ruley ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Pediatric Population ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
The United States ◽  
Return To Play ◽  
Return To Sports ◽  
Youth Athletes ◽  
The Mean ◽  
Anterior Cruciate

Background: The incidence of anterior cruciate ligament (ACL) injury and surgical reconstruction in youth athletes is increasing. In the United States, most athletes elect to undergo ACL reconstruction (ACLR), with the goal of returning to their previous level of athletic performance. Although surgery and rehabilitation address the underlying impairments in knee stability and function, recent literature indicates psychological or emotional factors, such as fear or confidence, may be contributing factors limiting successful return to play. The Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) is a 12-item scale designed to assess an athlete’s psychological readiness to return to sports across three separate domains (emotions, confidence in performance and risk appraisal). In adults, the ACL-RSI is reliable and valid, and several studies have documented that athletes with higher scores are more likely to successfully return to their pre-injury level of sports participation. The predictive abilities of this scale, have led many experts to advocate for the ACL-RSI to be used as part of rehabilitation guidelines, in order to identify those athletes that may benefit from a modified course of post-operative rehabilitation or additional emotional or psychological support. Although the information from the ACL-RSI is valuable in adults, the utility of this scale has never been explored within the pediatric population. Thus, the purpose of this study is to evaluate the utility of the ACL-RSI within the pediatric population and establish normative values among healthy children. Hypothesis: As all of these subjects were currently healthy, we hypothesized that mean scores should demonstrate a positive skew towards higher levels of confidence (ceiling effect) with values of 80-100 on each question. Methods: A group of 84 healthy, youth athletes between the ages of 8-14, completed the ACL-RSI. All subjects were currently involved in competitive sports at the time of participation. The athletes were instructed to complete the 12-item ACL-RSI questionnaire and were able to seek assistance from parents as necessary. Each item is scored on a scale ranging from 0-100 and a total score is calculated from summing all responses and expressing them a percentage of 100%. Higher scores indicate a greater degree of athletic confidence or more positive psychological response to injury. Mean and variability measures for each question and total score were calculated and compared to existing literature. Results: A total of 83 subjects (mean age 11.1 ± 1.2) completed the questionnaire in full. There were slightly more females (n=46, 54.8%) than males. The majority of participants were White (70%), African American (13%) or more than one race (10%). The most frequent primary sport was soccer (38%), followed by baseball (27%) and basketball (26%). The mean ACL-RSI score for the entire sample was 79.9 (SD 14.1). Individual question analysis revealed lower than expected mean scores (<80%) with large standard deviations for 7 out of 12 questions. (Table 1) With the exception of only question #1 and #12, responses demonstrated such large variability that both the maximum and minimum (0-100) scores were selected, indicating both ceiling and floor effects. (Table 1) Conclusions/Significance: The mean ACL-RSI score (79.9) within this group of uninjured pediatric athletes was similar to previous values for post-ACLR adults that successfully return to sports. However, it was surprising that the mean score wasn’t higher, as this was a healthy population of un-injured youth athletes, and we hypothesized that our data would demonstrate a positive skew towards the upper range of this scale. Response ranges including 0 (indicating either high fear or severe lack of confidence) within nearly all questions was unexpected. Additionally, there were particularly low mean scores and high variability within 7 of the 12 questions. All of these factors raise the suspicion that children may not fully comprehend the material or have difficulty interpreting the response system of the ACL-RSI and thus calls into question the validity of this scale in youth athletes. Similar to other research efforts that have modified adult outcome scales to be utilized within the pediatric population, our results support further exploration of the utility of the ACL-RSI within pediatric athletes and may possibly suggest that a pediatric specific version should be created. [Table: see text]

Is the ratio of flow-mediated dilation and shear rate a statistically sound approach to normalization in cross-sectional studies on endothelial function?

2009 ◽  
Vol 107 (6) ◽  
pp. 1893-1899 ◽  
Author(s):  
Greg Atkinson ◽  
Alan M. Batterham ◽  
Mark A. Black ◽  
Nigel T. Cable ◽  
Nicola D. Hopkins ◽  
...  
Keyword(s):  
Shear Rate ◽  
Endothelial Function ◽  
Age Differences ◽  
Age Groups ◽  
Area Under The Curve ◽  
Future Research ◽  
Flow Mediated Dilation ◽  
Cross Sectional ◽  
Age Cohorts ◽  
Statistical Assumptions

It has been deemed important to normalize flow-mediated dilation (FMD), a marker of endothelial function, for between-subject differences in the eliciting shear rate (SR) stimulus. Conventionally, FMD is divided by the area under the curve of the SR stimulus. In the context of a cross-sectional comparison across different age cohorts, we examined whether this ratio approach adhered to established statistical assumptions necessary for reliable normalization. To quantify brachial artery FMD and area under the curve of SR, forearm cuff inflation to suprasystolic pressure was administered for 5 min to 16 boys aged 10.9 yr (SD 0.3), 48 young men aged 25.3 yr (SD 4.2), and 15 older men aged 57.5 yr (SD 4.3). Mean differences between age groups were statistically significant ( P < 0.001) for nonnormalized FMD [children: 10.4% (SD 5.4), young adults: 7.5% (SD 2.9), older adults: 5.6% (SD 2.0)] but not for ratio-normalized FMD ( P = 0.10). Moreover, all assumptions necessary for reliable use of ratio-normalization were violated, including regression slopes between SR and FMD that had y-intercepts greater than zero ( P < 0.05), nonlinear and unstable relations between the normalized ratios and SR, skewed data distributions, and heteroscedastic variance. Logarithmic transformation of SR and FMD before ratio calculation improved adherence to these assumptions and resulted in age differences similar to the nonnormalized data ( P = 0.03). In conclusion, although ratio normalization of FMD altered findings about age differences in endothelial function, this could be explained by violation of statistical assumptions. We recommend that exploration of these assumptions should be routine in future research. If the relationship between SR and FMD is generally found to be weak or nonlinear or variable between samples, then ratio normalization should not be applied.

scholarly journals The COL5A1 gene and musculoskeletal soft-tissue injuries

2010 ◽  
Vol 22 (2) ◽  
pp. 38
Author(s):  
M Posthumus ◽  
AV September ◽  
MP Schwellnus ◽  
M Collins
Keyword(s):  
Soft Tissue ◽  
Practical Implication ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Soft Tissue Injuries ◽  
Linear Increase ◽  
Tendon Injuries ◽  
Genotype Frequency ◽  
Future Research ◽  
Tissue Injuries

Background. It has been shown that there is an association between various genetic variants and Achilles tendon injuries as well as anterior cruciate ligament (ACL) ruptures. Among other variants the BstUI restriction fragment length polymorphism (RFLP) within the COL5A1 gene has been shown to be over-represented in asymptomatic participants when compared with those with chronic Achilles tendinopathy, and in asymptomatic female participants when compared with those with ACL ruptures. The male asymptomatic control participants in the ACL study, which were 10 years younger than previously investigated cohorts, had a distinctly different genotype frequency. Aim. The aim of this study was therefore to determine whether the distribution of the COL5A1 BstUI RFLP in the combined asymptomatic participants without any known history of tendon injuries is age dependent, particularly among males. Results. When the 265 male asymptomatic participants from all studies were pooled and divided into age-group tertiles, there was a significant linear increase in the CC genotype frequency (p=0.032) among the male age groups, with the youngest group having the lowest frequency (CC genotype frequency, 13%) and the oldest group having the highest (CC genotype frequency, 27%) frequency. There was however a similar CC genotype content in all three female (N=231) age groups (CC genotype frequency, 24 - 27%; p=0.795). Conclusion. The practical implication is that the selection of asymptomatic groups is of critical importance when future studies of this nature are designed. Future research investigating this genetic variant as a risk factor for soft-tissue injuries should consider these findings when selecting asymptomatic participants.

scholarly journals A nationwide survey on the use of Heated Humidified High Flow Oxygen therapy on the paediatric wards in the UK: Current practice and research priorities.

2020 ◽  
Author(s):  
Osama Hosheh ◽  
Christopher T Edwards ◽  
Padmanabhan Ramnarayan
Keyword(s):  
Online Survey ◽  
Oxygen Therapy ◽  
Current Practice ◽  
Age Groups ◽  
Research Priorities ◽  
High Flow ◽  
Future Research ◽  
Cross Sectional ◽  
High Dependency ◽  
High Flow Oxygen

Abstract Background: Heated Humidified High Flow Nasal Cannula Oxygen Therapy (HHFNC) is increasingly used on the paediatric wards and High Dependency Units (HDU) for different types of pathologies and different age groups. We aimed to describe current practice related to the use of HHFNC on the paediatric wards and HDUs, weaning practices and preferred outcome measures for future research. Methods: We carried out a cross-sectional online survey of UK paediatric consultants or their delegates working on the paediatric wards. Descriptive analysis of their geographical, and organizational characteristics, their specialties, and their level of experience was investigated. Reasons for HHFNC initiation, weaning criteria, patients’ characteristics and their primary pathologies were also analysed. Results: Participation of 218 paediatricians from 81 hospitals (Median: 2.7, Range: 1-11) was registered. HHFNC was provided in most of the surveyed hospitals (93%, 75/81). A High Dependency Unit (HDU) was available in 47 hospitals (58%); less than a third of those have a dedicated paediatrician. Decisions around HHFNC were made solely by paediatricians in (75%) of the cases, mostly at hospitals with no HDU compared to those with dedicated HDUs (70.3% VS 36.6%, 95%CI:22.6%-50.4%, P< .001). Nearly two-thirds (68%) of the practitioners who used HHFNC on the wards reported that its effectiveness is either the same or superior to CPAP (Continuous Positive Airway Pressure) with fewer complications. Failure rate while on HHFNC was identified as the most important outcome measure in any future research followed by the length of need for HHFNC support (37.1%, and 28% respectively). Conclusion: This survey showed support for developing paediatric-specific national guidance on the use of HHFNC on the wards. Our list of defined research priorities may help guide further collaborative research efforts in this field.

scholarly journals Insomnia among Medical and Paramedical Students in Jordan: Impact on Academic Performance

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Mohammad Alqudah ◽  
Samar A. M. Balousha ◽  
Othman Al-Shboul ◽  
Ahmed Al-Dwairi ◽  
Mahmoud A. Alfaqih ◽  
...  
Keyword(s):  
College Students ◽  
Academic Performance ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Age Groups ◽  
Deep Understanding ◽  
Social Consequences ◽  
Future Research ◽  
Cross Sectional ◽  
Grade Point

Background. Insomnia is a problem that is common in all societies and age groups. However, its importance is increasing between students especially with the highly competitive and demanding environment surrounding them even after their graduation. In spite of the deep understanding of its health and social consequences, the frequency of insomnia among medical students in Jordan was not determined. Aim. To determine the prevalence of sleep disturbances among college students and to look for any association between sleep disturbances and students’ academic achievement. Methods. This is a cross-sectional self-administered questionnaire-based study. The participants were college students of the medical and paramedical specialties. Insomnia Severity Index (ISI) was used and the academic performance was assessed using students’ Cumulative Grade Point Average (CGPA). Results. There were 977 responses. Prevalence of clinical insomnia was 26.0%. Students who self-reported good sleep quality had significantly lower ISI scores compared with those who self-reported bad quality of sleep. Students who slept >7 hours had significantly less ISI scores than students who slept <6 hours. Students who had a CGPA more than or equal to 3 had significantly lower ISI scores compared with those who had a CGPA less than 2.5. Self-reported sleep quality was associated with the CGPA. Conclusion. A high prevalence of insomnia was found in this group of students. Academic performance was significantly associated with ISI scores and self-reported sleep quality. These results might be useful for future research into the development of interventional strategies to help students get enough sleep quality and quantity.

scholarly journals GDM Acts as a Moderator Between Pregnancy BMI and Metabolic Syndrome Severity Score

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1613-1613
Author(s):  
Makenzie Callahan ◽  
Samantha Martin ◽  
Greg Pavela ◽  
Timothy Garvey ◽  
Paula Chandler-Laney
Keyword(s):  
Metabolic Syndrome ◽  
Disease Risk ◽  
Future Research ◽  
Blood Draw ◽  
Cross Sectional ◽  
Sample Mean ◽  
Modifiable Factors ◽  
Z Scores ◽  
Overweight Or Obesity ◽  
In Pregnancy

Abstract Objectives Overweight or obesity is a risk factor for Metabolic Syndrome (MetS), as is a history of gestational diabetes (GDM). Many women with GDM are overweight in pregnancy, and so it is difficult to disentangle the effects of pregnancy BMI (pregBMI) from GDM. The purpose of this study was to examine whether GDM moderates the association between pregBMI and MetS severity Z-scores 4–10 years following pregnancy. We hypothesized that the positive association between pregBMI and MetS Z-scores would be stronger in women with GDM compared to women without GDM. Methods Data for this analysis were drawn from N = 179 women enrolled in a cross-sectional study examining obesity and cardiometabolic disease risk in mother-child dyads. Women with GDM were oversampled relative to the prevalence in the general population. Women were eligible for inclusion if they delivered a healthy term infant 4–10 years prior to enrolling in this study, and were aged 20–36 years at delivery. PregBMI was calculated using measured body weight recorded in the medical record from their first prenatal visit. GDM status was retrieved from medical records. Waist circumference and blood pressure were measured using standard clinical procedures, and a fasting blood draw was obtained to measure glucose, triglycerides, and HDL-cholesterol. MetS Z-scores were measured using the method of Gurka and DeBoer (Metabolism, 63(2), 218–225; Clinical and Translational Science – Informatics and Technology group). Results The association between pregBMI and MetS was significantly modified by GDM status (P &lt; 0.001) such that pregBMI was more strongly associated with MetS in women with GDM. Among women with a pregBMI of 30.9 (the sample mean), the mean difference in MetS Z-scores between conditions (those with or without GDM) is 0.65 SD units, a difference that grows larger at higher levels of pregBMI. Conclusions These results suggest greater MetS severity in women with GDM and a high pregBMI compared to women with a high pregBMI but without GDM. Future research should prospectively examine whether MetS is present in early pregnancy for women who develop GDM, and whether there are other modifiable factors that could reduce the risk for MetS among women with overweight or obesity in pregnancy. Funding Sources American Heart Association, NHLBI T32 training grant.

scholarly journals PRE-OPERATIVE EXPECTATIONS FOR RETURN TO SPORTS AND OUTCOMES FOLLOWING ACL RECONSTRUCTION: A SURVEY OF ADOLESCENT PATIENTS AND THEIR PARENTS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0017
Author(s):  
Shing Varakitsomboon ◽  
Michael Saper
Keyword(s):  
Cruciate Ligament ◽  
Private Insurance ◽  
Tertiary Care ◽  
Outcome Expectations ◽  
Return To Sports ◽  
Adolescent Athletes ◽  
Cross Sectional ◽  
Graft Rupture ◽  
Adolescent Patients ◽  
The Difference

Background: There is limited data regarding patient and parent expectations regarding return to sport (RTS) and outcomes following anterior cruciate ligament reconstruction (ACLR) in adolescent athletes. Purpose: To investigate RTS and outcome expectations of adolescent patients and their parents before ACLR and determine any differences between groups. Methods: For this cross-sectional study, sets of patients (aged 10 to 18 years) and parents were separately asked to complete the same questionnaire relating to knowledge and expectations regarding the patient’s upcoming ACLR. The custom survey consisted of 12 questions and was administered before being seen by a single sports medicine surgeon in the clinical setting of a tertiary care referral center from June 2019 through June 2020. Statistical analysis was performed to compare differences between patient and parent/guardian responses. Results: 28 sets of patients (53.6% female) and parents (64.3% female) completed the survey with average ages of 14.5 ± 2.0 years and 45.6 ± 7.0 years, respectively. 75% of families were Caucasian and 85.2% had private insurance. The most common sports played were basketball (25%) and soccer (17.9%). Overall, nearly 68% of consults were for a second opinion. 50% of patients and 82.1% of parents researched or read of ACL injuries and/or surgery prior to the visit. Most patients (46.4%) and parents (51.9%) expected the surgeon to consider full, unrestricted RTS/activities at 9 months. Only 7.1% of patients and 3.7% of parents believed full RTS would occur >12 months. 50% of patients and 67.9% of parents expected RTS at the same level. Both patients (53.6%) and parents (64.3%) believed fear of re-injury was the most common reason for not returning to sport or returning at a decreased level. There were no statistically significant differences in RTS expectations between patients and parents ( p>0.05). Most patients (38.5%) believed the risk of graft rupture in adolescent athletes was 5%, whereas most parents (37%) believed the risk to be at 25%, but the difference was not statistically significant ( p>0.05). Both patients and parents believed the risk of graft rupture was highest within the first 6 months (77.8% vs. 50%, respectively). More parents felt the risk of graft rupture was highest within the first year (39.3% vs. 22.2%), but the difference was not statistically significant ( p>0.05). Conclusion: Adolescent patients and their parents had similar knowledge and expectations regarding RTS and outcomes following ACLR. Further study is needed to better understand factors affecting those expectations.

scholarly journals Telerehabilitation to Address the Rehabilitation Gap in Anterior Cruciate Ligament Care: Survey of Patients

10.2196/19296 ◽  
2020 ◽  
Vol 4 (9) ◽  
pp. e19296
Author(s):  
Emma Dunphy ◽  
Elizabeth C Gardner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Private Insurance ◽  
Return To Sports ◽  
Resource Saving ◽  
Quality Of Reporting ◽  
Cross Sectional ◽  
Anterior Cruciate

Background Evidence shows that after anterior cruciate ligament (ACL) reconstruction, patients may have varied access to physical therapy. In particular, physical therapy input may end many months before patients reach full recovery. Telerehabilitation may provide an opportunity to address this rehabilitation gap and improve access to evidence-based rehabilitation alongside physical therapy at all stages of care. Objective This study aims to understand the opinions of patients who have undergone ACL surgery and rehabilitation on the use of telerehabilitation as part of ACL care and define the population and explore their experiences and views on the acceptability of telerehabilitation after ACL reconstruction. Methods This study was a cross-sectional, voluntary, web-based survey combining both closed and open questions. Ethical approval was obtained from the Yale School of Medicine Institutional Review Board. Participants were aged 16 years or older at the time of recruitment and had undergone ACL reconstruction within the past 5 years. A 26-item survey was developed using the Qualtrics survey platform. No items were mandatory. Responses were multiple choice, binary, and qualitative. The CHERRIES (Checklist for Reporting Results of Internet E-Surveys) was used to ensure the quality of reporting of surveys in the medical literature. Data were analyzed using Stata version 15. Qualitative data were analyzed using NVivo 11. The theoretical framework for this analysis is based on the Capability, Opportunity, and Motivation-Behavior model of behavior change. Results A total of 100 participants opened the survey. All completers were unique. The participation and completion rates were each 96% (96/100). Patients reported their physical therapy care ended at an average of 6.4 months and that they felt fully recovered at an average of 13.2 months. Only 26% (25/96) of patients felt fully recovered at the end of physical therapy. Of these 96 patients, 54 (60%) were younger than 30 years, 71 (74%) were recreational athletes, 24 (24%) were competitive athletes, 72 (75%) had private insurance, 74 (77%) were not familiar at all with telerehabilitation, and 89% (85/96) felt capable. They preferred to use telerehabilitation at different stages of care. Reported benefits included resource saving, improved access to care, improved learning, and greater engagement. Concerns included incorrect performance of exercises or unmanaged pain being missed and less access to manual therapy, motivation, and opportunities to ask questions. Participants’ priorities for a future telerehabilitation intervention included its use as an adjunct to physical therapy rather than a replacement, with content available for each stage of care, especially return to sports. Participants stressed that the intervention should be personalized to them and include measures of progress. Conclusions These findings helped understand and define the ACL reconstruction population. Participants found telerehabilitation acceptable in principle and highlighted the key user requirements and scope of future interventions.

Sign in / Sign up

Export Citation Format

Share Document