scholarly journals Efficacy of Serial Ultrasonographic Examinations in Predicting Return to Play in Agility Dogs with Shoulder Lameness

Animals ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 78
Author(s):  
Maria Grazia Entani ◽  
Alessio Franini ◽  
Ludovica Dragone ◽  
Gabriele Barella ◽  
Fabio De Rensis ◽  
...  
Keyword(s):  
Return To Play ◽  
Partial Recovery ◽  
Shoulder Injury ◽  
Rehabilitation Protocol ◽  
Telephone Interviews ◽  
Ultrasonographic Diagnosis ◽  
Muscular Injury ◽  
A Prospective Study ◽  
Valuable Predictor ◽  
Satisfactory Recovery

The aim of this study is to investigate the use of shoulder ultrasound as a method of predicting the likelihood of returning to competition in agility dogs with shoulder teno-muscular injuries after a standardised rehabilitation protocol. Thirty-two agility dogs with a clinical and ultrasonographic diagnosis of shoulder teno-muscular injury were included in a prospective study with physical and ultrasound examinations at the time of diagnosis (T0) and at two (T2), four (T4) and six (T6) months; during this period, the dogs received rehabilitation treatments. The endpoint of the study was to obtain information regarding participation in agility competitions 12 months after diagnosis, based on telephone interviews with the owners. The clinical lameness score (CLS) and the ultrasound lesion score (ULS) were used as outcome measurements. The CLS indicated partial recovery from a shoulder injury at T2 (78%), while the ULS indicated no satisfactory recovery at T2 in any patient. At 4 months, the CLS alone was not a valuable predictor of full recovery from a shoulder injury in agility dogs. Relative Risk indicated that, at T2, ultrasound was 23.8 times more valuable in identifying a shoulder lesion as compared to clinical lameness score (CLS), and it was 2.53 times more valuable at T4.

scholarly journals Ulnar Collateral Ligament Repair with Internal Brace Augmentation in Amateur Overhead Throwing Athletes

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0008 ◽  
Author(s):  
Jeffrey R. Dugas ◽  
Christopher A. Looze ◽  
Christopher Michael Jones ◽  
Brian L. Walters ◽  
Marcus A. Rothermich ◽  
...  
Keyword(s):  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Time Frame ◽  
Return To Play ◽  
Overhead Athletes ◽  
Late Failure ◽  
Internal Brace ◽  
Overhead Throwing ◽  
A Prospective Study

Objectives: There has been a renewed interest in UCL repair in overhead athletes. This is largely due to greater understanding of UCL pathology, improvement in fixation technology and the extensive rehab required to return from UCL reconstruction. Initial data regarding UCL repair in overhead athletes was poor and therefore UCL repair was largely abandoned in favor of reconstruction. However, recent literature examining UCL repair with anchor only fixation demonstrated an excellent rate of return to play, reduced time to return to play and a low complication rate. Based on this promising data, we have developed a novel technique of UCL repair with internal brace augmentation that we have used in overhead throwing athletes. We performed a prospective study evaluating the outcomes of this procedure with respect to return to play, time to return to play, functional outcome score and complications. Methods: Overhead athletes undergoing UCL repair with internal brace augmentation were prospectively followed for a minimum of one year. Patients were carefully selected from those who would traditionally be considered for UCL reconstruction. Initially, patients were considered if they had an avulsion of the UCL with otherwise healthy UCL tissue and had a vested interest in shortened rehab. As the study progressed, interest in shortened rehab became a less stringent criteria. Demographic and operative data were collected at the time surgery. This data was compiled for both desciption and comparison between subgroups. Patients were then contacted 1 year postoperatively and assessed for return to play, time to return to play and KJOC scores. Complications were documented and patients having complications were detailed. Results: 66 overhead athletes underwent UCL repair with internal brace augmentation during the study period. 8 were lost to follow up, leaving 58 athletes included in the study. Average age at the time of surgery was 17.9 years old. There were 43 baseball pitchers, 8 baseball position players, 4 softball players, 2 football quaterbacks, and 1 javelin thrower. 96% (54/56) of those who desired to return to the same or higher level of competition were able to do so at an average time of 6.1 months (range 3.2-12 months). 65% of these were able to return in less than 6 months. Many of those who took longer than 6 months did so due to timing within the season. Average KJOC score was 90.2 at 1-year follow-up. 3 patients required return to the operating room, 2 of which were eventually able to return to their previous level of play. There was 1 late failure over 3 years from the index procedure. Comparative subgroup data is presented in table 1. Conclusion: UCL repair with internal brace augmentation is a viable option for overhead throwers with selected UCL pathology who wish to return to sport in a shorter time frame than allowed by traditional UCL reconstruction. [Table: see text]

Depression of cardiovascular autonomic function is more pronounced after mitral valve surgery: evidence for direct trauma

2009 ◽  
Vol 367 (1892) ◽  
pp. 1251-1263 ◽  
Author(s):  
Beatrice Retzlaff ◽  
Robert Bauernschmitt ◽  
Hagen Malberg ◽  
Gernot Brockmann ◽  
Christian Uhl ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Autonomic Function ◽  
Mitral Valve Surgery ◽  
Partial Recovery ◽  
Ongoing Research ◽  
Sequence Method ◽  
Standard Linear ◽  
Male Patients ◽  
Operative Recovery ◽  
A Prospective Study

The analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV) leads to additional insights into patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the post-operative recovery of autonomic regulation after mitral valve (MV) and aortic valve (AV) surgery with a heart–lung machine. Among the 43 consecutive male patients enrolled in a prospective study, 26 underwent isolated AV surgery and 17 isolated MV surgery. Blood pressure as well as ECG signals were recorded the day before, 24 hours after and one week after surgery. BRS was calculated according to the dual sequence method, and HRV was calculated using standard linear as well as nonlinear parameters. There were no major differences between the two groups in the pre-operative values. At 24 hours a comparable depression of HRV and BRS in both groups was observed, while at 7 days there was partial recovery in AV patients, which was absent in MV patients: p (AV versus MV)<0.001. While the response of the autonomic system to surgery is similar in AV and MV patients, there is obviously a decreased ability to recover in MV patients, probably attributed to traumatic lesions of the autonomic nervous system by opening the atria. Ongoing research is required for further clarification of the pathophysiology of this phenomenon and to establish strategies to restore autonomic function.

Return-to-Play Guidelines After Medial Patellofemoral Ligament Surgery for Recurrent Patellar Instability: A Systematic Review

2017 ◽  
Vol 46 (10) ◽  
pp. 2530-2539 ◽  
Author(s):  
Saif Zaman ◽  
Alex White ◽  
Weilong J. Shi ◽  
Kevin B. Freedman ◽  
Christopher C. Dodson
Keyword(s):  
Systematic Review ◽  
Patellar Instability ◽  
Medial Patellofemoral Ligament ◽  
Treatment Options ◽  
Mpfl Reconstruction ◽  
Return To Play ◽  
Return To Sports ◽  
Rehabilitation Protocol ◽  
Recurrent Patellar Instability

Background: Medial patellofemoral ligament (MPFL) reconstruction and repair continue to gain acceptance as viable treatment options for recurrent patellar instability in patients who wish to return to sports after surgery. Return-to-play guidelines with objective or subjective criteria for athletes after MPFL surgery, however, have not been uniformly defined. Purpose: To determine whether a concise and objective protocol exists that may help athletes return to their sport more safely after MPFL surgery. Study Design: Systematic review. Methods: The clinical evidence for return to play after MPFL reconstruction was evaluated through a systematic review of the literature. Studies that measured outcomes for isolated MPFL surgery with greater than a 12-month follow-up were included in our study. We analyzed each study for a return-to-play timeline, rehabilitation protocol, and any measurements used to determine a safe return to play after surgery. Results: Fifty-three studies met the inclusion criteria, with a total of 1756 patients and 1838 knees. The most commonly cited rehabilitation guidelines included weightbearing restrictions and range of motion restrictions in 90.6% and 84.9% of studies, respectively. Thirty-five of 53 studies (66.0%) included an expected timeline for either return to play or return to full activity. Ten of 53 studies (18.9%) in our analysis included either objective or subjective criteria to determine return to activity within their rehabilitation protocol. Conclusion: Most studies in our analysis utilized time-based criteria for determining return to play after MPFL surgery, while only a minority utilized objective or subjective patient-centric criteria. Further investigation is needed to determine safe and effective guidelines for return to play after MPFL reconstruction and repair.

scholarly journals Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110538
Author(s):  
Samuel S. Rudisill ◽  
Michael P. Kucharik ◽  
Nathan H. Varady ◽  
Scott D. Martin
Keyword(s):  
Knee Extension ◽  
Risk Of Bias ◽  
Return To Play ◽  
Hamstring Injury ◽  
Controlled Trials ◽  
Factors Associated ◽  
Randomized Controlled ◽  
Hamstring Injuries ◽  
Muscular Injury ◽  
Proximal Hamstring

Background: Considering the lengthy recovery and high recurrence risk after a hamstring injury, effective rehabilitation and accurate prognosis are fundamental to timely and safe return to play (RTP) for athletes. Purpose: To analyze methods of rehabilitation for acute proximal and muscular hamstring injuries and summarize prognostic factors associated with RTP. Study Design: Systematic review; Level of evidence, 4. Methods: In August 2020, MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus were queried for studies examining management and factors affecting RTP after acute hamstring injury. Included were randomized controlled trials, cohort studies, case-control studies, and case series appraising treatment effects on RTP, reinjury rate, strength, flexibility, hamstrings-to-quadriceps ratio, or functional assessment, as well as studies associating clinical and magnetic resonance imaging factors with RTP. Risk of bias was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials or the Methodological Index for Non-Randomized Studies (MINORS). Results: Of 1289 identified articles, 75 were included. The comparative and noncomparative studies earned MINORS scores of 18.8 ± 1.3 and 11.4 ± 3.4, respectively, and 12 of the 17 randomized controlled trials exhibited low risk of bias. Collectively, studies of muscular injury included younger patients and a greater proportion of male athletes compared with studies of proximal injury. Surgery for proximal hamstring ruptures achieved superior outcomes to nonoperative treatment, whereas physiotherapy incorporating eccentric training, progressive agility, and trunk stabilization restored function and hastened RTP after muscular injuries. Platelet-rich plasma injection for muscular injury yielded inconsistent results. The following initial clinical findings were associated with delayed RTP: greater passive knee extension of the uninjured leg, greater knee extension peak torque angle, biceps femoris injury, greater pain at injury and initial examination, “popping” sound, bruising, and pain on resisted knee flexion. Imaging factors associated with delayed RTP included magnetic resonance imaging-positive injury, longer lesion relative to patient height, greater muscle/tendon involvement, complete central tendon or myotendinous junction rupture, and greater number of muscles injured. Conclusion: Surgery enabled earlier RTP and improved strength and flexibility for proximal hamstring injuries, while muscular injuries were effectively managed nonoperatively. Rehabilitation and athlete expectations may be managed by considering several suitable prognostic factors derived from initial clinical and imaging examination.

Type IV Acromioclavicular Joint Separation in a Collegiate Basketball Player

2016 ◽  
Vol 21 (6) ◽  
pp. 16-20
Author(s):  
Gail M. Ronchetti ◽  
Christopher A. Welch ◽  
Brent I. Smith ◽  
Danielle E. Blair
Keyword(s):  
Return To Play ◽  
Surgical Reconstruction ◽  
Basketball Player ◽  
Shoulder Injury ◽  
Unique Type ◽  
Type Iv ◽  
Successful Recovery ◽  
Slow Progression ◽  
Acromioclavicular Separation ◽  
Joint Separation

A 19-year-old female basketball athlete sustained a right shoulder injury during collegiate competition resulting from a collision causing severe pain and discomfort. The patient was diagnosed with a unique type IV acromioclavicular (AC) separation. Surgical stabilization of the AC joint and slow progression in rehabilitation with immobilization assisted in protecting the reconstruction. Accurate diagnosis and appropriate intervention helped to lead to the successful recovery and return to play for this patient. There are few cases of type IV acromioclavicular separation reported in the literature and none related to basketball. This case presents the challenges related to the diagnosis and rehabilitation following surgical reconstruction of a type IV acromioclavicular separation.

scholarly journals A Prospective Study of Physical Therapy in Facial Nerve Paralysis: Experience at a Multispeciality Hospital of Kashmir

JMS SKIMS ◽  
2012 ◽  
Vol 15 (2) ◽  
pp. 145-148
Author(s):  
Sheikh Javeed Ahmad ◽  
Abdul Hamid Rather
Keyword(s):  
Physical Therapy ◽  
Facial Nerve ◽  
Prospective Study ◽  
Facial Nerve Paralysis ◽  
Partial Recovery ◽  
Early Management ◽  
Nerve Paralysis ◽  
Seventh Cranial Nerve ◽  
The Face ◽  
A Prospective Study

BACKGROUND: Bell's palsy is an acute weakness of seventh cranial nerve leading to loss of movement on one side of the face. It usually recovers of its own without treatment in most of the patients but not all. Physical therapy in the form of electrotherapy, massage and facial exercises is used as adjuvant to hasten recovery. OBJECTIVES: To analyze the role of physiotherapy in the form of electrotherapy in patients with peripheral facial paralysis attending multispecialty hospital in Kashmir. METHODS: A prospective study was carried out on 50 patients of facial nerve paralysis attending OPD between Jan 2009 and Jan 2010. All of the patients were subjected to medical treatment. The patients were put to Physical Therapy in the form of electrotherapy followed by facial exercises. All patients received electrotherapy to the paralyzed facial muscles for a period of 2 weeks but some were given extended doses for 4 weeks. 20 patients presented for the treatment in the first week, 12 in second week and 18 presented after three weeks or later. RESULTS: Fifty patients (30 female, 20 male) of facial nerve paralysis were included. Time span between medical diagnosis and physical therapy was from 1 week to 4 weeks. Patients were assessed at 4 weeks, 2 months and 6 months after the treatment. Out of 20 patients who presented in 1st week and received steroids and electrotherapy 19(95%) had fully recovered except for one case that was irregular for treatment. Out of 12 Patients who presented in 2nd week of illness, 8(66.6%) patients had full recovery and partial recovery in rest of 4 (33.4%) patients. Eighteen patients (100%) who presented in third week onwards of illness had partial recovery. CONCLUSION: Physiotherapy in the form of electrotherapy and facial exercises has a effective role in the early management of peripheral facial palarlysis. JMS 2012;15(2):145-48

scholarly journals Long-standing pubic-related groin pain in professional academy soccer players: a prospective cohort study on possible risk factors, rehabilitation and return to play

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Helge Eberbach ◽  
David Fürst-Meroth ◽  
Ferdinand Kloos ◽  
Magnus Leible ◽  
Valentin Bohsung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort ◽  
Groin Pain ◽  
Return To Play ◽  
Soccer Players ◽  
Age Group ◽  
Rehabilitation Protocol ◽  
Youth Soccer

Abstract Background Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. Methods Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club’s youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play. Results A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players. Conclusions Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence. Trial registration The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021.

scholarly journals Shoulder Muscle Imbalance as a Risk for Shoulder Injury in Elite Adolescent Swimmers: A Prospective Study

2020 ◽  
Vol 75 (1) ◽  
pp. 103-113
Author(s):  
Joffrey Drigny ◽  
Antoine Gauthier ◽  
Emmanuel Reboursière ◽  
Henri Guermont ◽  
Vincent Gremeaux ◽  
...  
Keyword(s):  
Predictive Power ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Shoulder Injuries ◽  
Shoulder Injury ◽  
Shoulder Muscle ◽  
Increased Risk ◽  
A Prospective Study ◽  
External Rotator

Abstract Muscle strength imbalances between the internal and external rotators of the shoulder are frequent in swimmers, but their role in shoulder injury remains unknown. We aimed to evaluate the association of shoulder rotator strength and injury in elite adolescent swimmers. Eighteen adolescent swimmers performed preseason isokinetic tests of the internal and external rotator muscles in concentric (con) and eccentric (ecc) modes. Conventional (conER:conIR and eccER:eccIR) and functional ratios (eccER:conIR and eccIR:conER) were calculated. Thirteen swimmers completed a weekly questionnaire about swimming habits and shoulder injuries throughout the season. Preseason testing showed a significant negative association between the functional eccER:conIR ratio and years of practice (p < 0.05). Over the season, 46% of athletes experienced at least one shoulder injury. At the end of the season, peak torques increased for both internal and external rotator muscles strength, but only concentrically, resulting in a decrease in the eccER:conIR functional ratio (p < 0.05). The receiver operating characteristic curve analysis highlighted good predictive power for the preseason functional eccER:conIR ratio, as values below 0.68 were associated with a 4.5-fold (95% CI 1.33-15.28, p < 0.05) increased risk of shoulder injuries during the season.

scholarly journals The Lived Experiences of Retired Collegiate Athletes With a History of 1 or More Concussions

2018 ◽  
Vol 53 (7) ◽  
pp. 646-656 ◽  
Author(s):  
Rebecca Cover ◽  
Trevor Roiger ◽  
Mary Beth Zwart
Keyword(s):  
Quality Of Life ◽  
Lived Experiences ◽  
Injury Severity ◽  
Collegiate Athletes ◽  
Adverse Outcomes ◽  
Return To Play ◽  
Telephone Interviews ◽  
Persistent Symptoms ◽  
History Of

Context: Concussions remain misunderstood, underreported, and undiagnosed. Although most concussion symptoms resolve within 2 weeks, some patients experience persistent symptoms that adversely affect physical, emotional, social, or cognitive functioning or a combination of these. Minimal evidence delineating the effect of concussions on recently retired collegiate athletes currently exists.Objective: To examine the lived experiences of retired collegiate athletes with a history of 1 or more concussions to discern individual concussion histories, knowledge and perceptions of concussions, and postconcussion quality of life.Design: Qualitative study.Setting: Telephone interviews.Patients or Other Participants: Former National Collegiate Athletic Association Division I athletes (n = 14) with a history of 1 or more concussions and retired from 1 to 5 years.Data Collection and Analysis: Fourteen semistructured telephone interviews (8 men and 6 women) were audiotaped. Interviews were transcribed and inductively analyzed by 3 athletic trainers with 34 combined years of professional experience. Themes were negotiated through consensual review. Participant checks were completed to ensure trustworthiness of the findings.Results: Participants sustained their first concussion during adolescence and often experienced difficulties transitioning back into the postconcussion academic environment. Judgments of injury severity were clearly evident in participants' knowledge and perceptions of concussions. Participants experienced an array of emotional, physical, cognitive, and social challenges during the immediate postconcussion period but did not feel their concussion history decreased their current quality of life.Conclusions: Adolescent exposure to concussions is of concern due to the risk imposed on the developing brain and the potential for adverse outcomes later in life. Although a graduated return to play is heavily emphasized in concussion management, researchers need to investigate barriers inhibiting the implementation of return-to-learn protocols. Concussion education should aim to modify indifferent attitudes toward concussive injuries. Additionally, investigators should continue to assess how a history of concussion affects quality of life in recently retired collegiate athletes.

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