A Study on the Role of Proprioceptive Training in Non Operative ACL Injury Rehabilitation

Over 100,000 anterior cruciate ligament (ACL) injuries occur annually in the United States [1]. Of these, 70% are classified as non-contact, many of which occur subsequent to a landing from a jump [2]. While most agree that quadriceps (Q) and hamstrings (H) have a significant contribution in knee biomechanics, the role of quadriceps and hamstrings muscle loads and their ratio (Q/H) in ACL injury remains controversial. Understanding muscle recruitment in high risk activities may improve our knowledge of ACL injury mechanisms. Such insight may improve current prevention strategies to decrease the risk of ACL injury and damage to secondary anatomical structures, all of which may in turn minimize associated posttraumatic knee osteoarthritis. As in vivo quantification of muscle loads remains challenging, especially under dynamic conditions, validated finite element (FE) models of the knee can be used to characterize the role of muscle loads in ACL injury. FE analysis has provided considerable insight into knee joint biomechanics, including ligament function, ligament reconstruction technique and implant design. This study utilized a validated FE model of the knee joint to study the effects of quadriceps to hamstrings ratio (Q/H) on ACL strain during a simulated landing from a jump. We hypothesized that both the ratio and magnitude of muscle loads are critical determinants of ACL loading. Further, a threshold may be reached as the magnitude of quadriceps load exceeds hamstrings load.

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ACL Injuries Aren’t Just for Girls: The Role of Age in Predicting Pediatric ACL Injury

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120935429 ◽

2020 ◽

Vol 12 (6) ◽

pp. 559-563

Author(s):

David A. Bloom ◽

Adam J. Wolfert ◽

Andrew Michalowitz ◽

Laith M. Jazrawi ◽

Cordelia W. Carter

Keyword(s):

Female Athletes ◽

Statistical Significance ◽

Acl Injury ◽

Childhood And Adolescence ◽

Chi Square ◽

Acl Injuries ◽

Acl Tear ◽

Chi Square Analysis ◽

Age And Sex

Background: Female athletes have a higher rate of anterior cruciate ligament (ACL) injuries than male athletes; however, the role of age in mediating this injury risk has not been explored. The purpose of this study was to characterize the relationship between age and sex in predicting ACL injury in the pediatric population. Hypothesis: Prepubescent boys are more likely to sustain an ACL injury than prepubescent girls. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Data were collected from the Statewide Planning and Research Cooperative System database for the state of New York from 1996 to 2016. The database was queried for patients aged ≤19 years who had been diagnosed with an ACL tear using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 844.2 or the ICD-10 (10th Revision) codes S83.512A/S83.511A/S83.519A. Patient age and sex at time of ACL injury diagnosis were recorded. Chi-square analysis was used to compare the frequency of ACL injury between groups, with statistical significance set at P < 0.05. Results: A total of 20,128 patients aged ≤19 years were diagnosed with an ACL tear (10,830 males, 9298 females; male:female, 1.16:1). In all, 129 patients aged <12 years sustained an ACL tear (85 boys, 44 girls; male:female, 1.93:1), and 19,999 of those patients were aged 12 to 19 years (10,745 males, 9254 females; male:female, 1.16:1). Chi-square analysis demonstrated a significant relationship between sex and age group ( P < 0.006). Additional analysis revealed that female athletes were most at risk for ACL injury from ages 12 to 16 years, with 4025 male and 5095 female athletes sustaining ACL injuries in this group (male:female, 1:1.27; P < 0.0001). Conclusion: Prepubescent boys (aged <12 years) are more likely to sustain an ACL injury than same-aged female peers. Clinical Relevance: This study demonstrates that the risk of ACL injury varies with age and sex throughout childhood and adolescence, further guiding treatment and prevention for these pediatric athletes.

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Measurement Properties of a Test Battery to Assess Postural Orientation During Functional Tasks in Patients Undergoing ACL Injury Rehabilitation

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2017.7270 ◽

2017 ◽

pp. 1-42 ◽

Cited By ~ 1

Author(s):

Jenny Nae ◽

Mark W. Creaby ◽

Gustav Nilsson ◽

Kay M. Crossley ◽

Eva Ageberg

Keyword(s):

Acl Injury ◽

Test Battery ◽

Measurement Properties ◽

Injury Rehabilitation ◽

Postural Orientation

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Importance of the Student Therapist/Athlete Relationship and Goal-Setting in Injury Rehabilitation

The Qualitative Report ◽

10.46743/2160-3715/2015.2395 ◽

2015 ◽

Author(s):

Colin Deal ◽

Chris Shields

Keyword(s):

Peer Relationships ◽

Goal Setting ◽

Structured Interviews ◽

Injury Rehabilitation ◽

Senior Student ◽

Rehabilitation Outcomes ◽

Student Therapists ◽

Varsity Athletes ◽

The Relationship

Previous research has highlighted the importance of relationships (e.g., athletic therapist/client) and psychological skill use to manage negative emotions (e.g., frustration, anger) in order to obtain optimal adherence and injury rehabilitation outcomes. However, the relationship between student athletic therapists and varsity athletes has not been examined. Thus, the objective was to examine the relationship between student therapists and varsity athletes and psychological skill use in injury rehabilitation in relation to adherence. Two senior student therapists and three varsity athletes who had completed injury rehabilitation were recruited to participate in semi-structured interviews. Transcripts were analysed using thematic analysis. Both groups of participants described the role of the student therapists as being primarily focused on injury prevention and management. Furthermore, the peer relationships that developed were valued. Goal-setting was used in injury rehabilitation to guide progress, improve adherence, and frame injuries as temporary setbacks. Participants were familiar with imagery from use in other context, however did not report using it in injury rehabilitation. Finally, participants acknowledged that adherence was not perfect, but acknowledged the peer relationships and collaborative goal-setting as helpful. These findings highlight the importance of the relationship between student therapists and athletes and suggest these relationships may support athlete adherence.

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