Injury Questionnaire Research Articles

The Effect of Shoulder and Knee Exercise Programmes on the Risk of Shoulder and Knee Injuries in Adolescent Elite Handball Players: A Three-Armed Cluster Randomised Controlled Trial

BackgroundThe risk of injury in adolescent handball is high, and shoulder and knee injuries are among the most frequent and burdensome. The Swedish Knee Control programme reduced the risk of anterior cruciate ligament injuries in female youth football players and traumatic knee injuries in male and female youth floorball players. However, to date, Knee Control has not been evaluated in an elite youth sport setting. The literature on the prevention of shoulder injuries in sport is scarce, and there are to our knowledge no previous studies evaluating the preventative efficacy of injury prevention exercise programmes (IPEPs) on shoulder injuries in adolescent handball players.ObjectivesTo study the preventive efficacy of IPEPs on shoulder and knee injuries in adolescent elite handball players.MethodsEighteen Swedish handball-profiled secondary schools (clusters) with players aged 15–19 years, 54% males were randomised into either the Shoulder Group or Knee Group (interventions) or a Control Group. Players in the Shoulder Group were instructed to perform the Shoulder Control programme, and players in the Knee Group to perform the Knee Control programme, three times per week during May 2018 to May 2019. Control Group players continued their usual training. Outcomes were shoulder and knee injuries defined by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Intention-to-treat analyses were performed using Cox regression models with hazard rate ratios (HRRs) with corresponding 95% confidence intervals (CI).ResultsSix clusters (199 players) in the Shoulder Group, six clusters (216 players) in the Knee Group and six clusters (212 players) in the Control Group were included. There were 100 shoulder injuries and 156 knee injuries. The Shoulder Group had a 56% lower shoulder injury rate, HRR 0.44 (95% CI 0.29 to 0.68), and the Knee Group had a 31% lower knee injury rate, HRR 0.69 (95% CI 0.49 to 0.97) than the Control Group. The absolute risk reduction was 11% and 8%, and the number needed to treat was 9 and 13, respectively.ConclusionsAdolescent elite handball players who performed the Shoulder Control and the Knee Control programmes had a lower risk of shoulder and knee injuries, respectively, than players who continued their usual training. Further research on how these two programmes can be combined to reduce knee and shoulder injuries in a time effective way is warranted.Trial registration ISRCTN15946352.Key pointsThe burden of knee and shoulder injuries in handball is high.The Shoulder Control programme reduces the risk and overall burden of shoulder injuries in adolescent elite handball players.The Knee Control programme reduces the risk and overall burden of knee injuries in adolescent elite handball players.

Evaluation of the vestibular/ocular motor screening assessment in active combat sport athletes: an exploratory study

ABSTRACT Objective The first aim of this study was to compare the results of the vestibular/ocular motor screening (VOMS) in combat sport athletes with a healthy control population. Second, to explore differences between athletes with and without a concussion history. Third, to examine the relationship between VOMS and the Post-Concussion Symptom Scale (PCSS) in combat sport athletes. Participants Forty active male combat sport athletes and 40 healthy male control participants were recruited from 4 clubs and a University in Australia. Methods Participants completed the VOMS in a primary care physiotherapy clinic. Participants completed an injury questionnaire and the PCSS. Results An “abnormal” score in at least one subtest or near point convergence (NPC) was recorded in 45% of the combat group compared with 22.5% of the control group. All VOMS scores and NPC distance were greater in the combat group compared with control group (p < 0.05). The VOMS scores were found to be moderately positively correlated with the PCSS. There was no difference in VOMS between athletes with and without a history of concussion (p > 0.05). Conclusion VOMS scores differed between combat sport athletes and control participants. The PCSS may aid clinicians in identifying athletes who have underlying vestibular/oculomotor impairment.

One-Year Follow-Up of Patients Admitted for Emergency Coronary Angiography after Resuscitated Cardiac Arrest.

(1) Background: Despite the improvement of the in-hospital survival rate after aborted sudden cardiac death (SCD), cerebral anoxia may have severe neurologic consequences and may impair long-term outcome and quality of life of surviving patients. The aim of this study was to assess neurological outcomes at one year after resuscitated cardiac arrest; (2) Methods: This prospective, observational, and multicentre study included patients >18 yo admitted in the catheterisation laboratory for coronary angiography after aborted SCD between 1 May 2018 and 31 May 2020. Only patients who were discharged alive from hospital were evaluated. The primary endpoint was survival without neurological sequelae at one-year follow-up defined by a cerebral performance category (CPC) of one or two. Secondary end points included all-cause mortality, New York Heart Association (NYHA) functional class, neurologic evaluation at discharge, three-month and one-year follow-up using the CPC scale, and quality of life at 1 year using the Quality of Life after Brain Injury (QOLIBRI) questionnaire; (3) Results: Among 143 patients admitted for SCD within the study period, 61 (42.7%) were discharged alive from hospital, among whom 55 (90.1%) completed the one-year follow-up. No flow and low flow times were 1.9 ± 2.4 min and 16.5 ± 10.4 min, respectively. For 93.4% of the surviving patients, an initial shockable rhythm (n = 57) was observed and acute coronary syndrome was diagnosed in 75.4% of them (n = 46). At 1 year, survival rate without neurologic sequelae was 87.2% (n = 48). Patients with poor outcome were older (69.3 vs. 57.4 yo; p = 0.04) and had lower body mass index (22.4 vs. 26.7; p = 0.013) and a lower initial Left Ventricle Ejection Fraction (LVEF) (32.1% vs. 40.3%; p = 0.046). During follow-up, neurological status improved in 36.8% of patients presenting sequelae at discharge, and overall quality of life was satisfying for 66.7% of patients according to the QOLIBRI questionnaire; (4) Conclusions: Among patients admitted to the catheterisation laboratory for aborted SCD, mainly related to Acute Coronary Syndrom (ACS), less than a half of them were alive at discharge. However, the one-year survival rate without neurological sequelae was high and overall quality of life was good.

Indonesian Version of the Anterior Cruciate Ligament-Return to Sport After Injury Questionnaire Through Cross-Cultural Adaptation, Validity, and Reliability Testing

Background: This study aimed to produce the Indonesian version of the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) questionnaire and determine the value of content validity, construct validity, known-groups validity, and internal consistency reliability.&#x0D; Methods: First, the ACL-RSI questionnaire was translated through a cross-cultural adaptation process. Six experts in related fields assessed the adapted questionnaire by giving scores on four criteria: relevance, clarity, simplicity, and ambiguity, which will be calculated into content validity value. Seventy-one participants who experienced ACL injury because of sporting activities and had undergone reconstruction who joined the online community for Knee Injury Patients Support Group filled out the ACL-RSI to determine the known-groups validity and internal consistency reliability. The participants also filled out the Indonesian version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) as a comparison to test construct validity.&#x0D; Results: The calculated content validity value obtained from the experts’ scoring was S-CVI/Ave = 0.97. Construct validity between ACL-RSI and all KOOS subscales showed a strong positive correlation with r = 0.78-0.87. Two hypotheses for known-groups validity were proven, with the group that had returned to their specific sport having a better ACL-RSI score than the group that had not returned (70.2 ± 10.0 vs. 49.3 ± 18.8, p&lt;0.001), and the group planned to return to their specific sport as before the injury had a better ACL-RSI score than the group who did not intend to return (60.3 ± 16.5 vs. 32.6 ± 2.4, p&lt;0.001). Internal consistency ACL-RSI showed very good reliability with Cronbach’s alpha = 0.96.&#x0D; Conclusions: The Indonesian version of ACL-RSI is valid and reliable for evaluating psychological readiness to return to sports after ACL reconstruction. However, a seemingly further similar study is necessary to fix the weaknesses in this study to produce a more representative Indonesian version of the ACL-RSI questionnaire.

Goal adjustment and well-being after an acquired brain injury: the role of cognitive flexibility and personality traits.

ObjectiveThe tendency to flexibly adjust goals that are hindered by chronic illness is related to indicators of wellbeing. However, cognitive flexibility is often impaired in persons with an acquired brain injury (ABI), possibly affecting the ability to flexibly adjust goals. In this study we examined whether cognitive flexibility is positively related with the ability to disengage from goals to reengage with goals in persons with ABI. Second, we explored whether goal adjustment abilities are predictive of a unique proportion of the variance inabilities are predictive of quality of life and life satisfaction after controlling for personality traits.MethodSeventy-eight persons with an ABI completed a set of questionnaires. Goal disengagement and goal reengagement were assessed using the Wrosch Goal Adjustment Scale (GAS). Indicators of wellbeing were measured with the European Brain Injury Questionnaire (EBIQ) and the Satisfaction with Life Scale (SWLS). The percentage of perseverative errors on the Wisconsin Card Sorting Test (WCST) was used as an indicator of cognitive inflexibility. Big Five personality traits were assessed via the NEO Five Factor Inventory (NEO-FFI). Four hierarchical multiple regression analyses were then conducted. The first two analyses tested the effect of cognitive flexibility on goal adjustment tendencies. The second two analyses tested whether goal adjustment has a predictive value for life satisfaction and QOL beyond personality.ResultsCognitive flexibility was positively related to goal reengagement, but not to goal disengagement. Goal reengagement was positively associated with both quality of life and life satisfaction after controlling for demographic, illness characteristics and personality factors. Goal disengagement was negatively related to life satisfaction.ConclusionFlexible goal adjustment abilities have a unique explanatory value for indicators of wellbeing, beyond personality traits. The findings indicate that in persons with lower cognitive flexibility, goal reengagement ability might be negatively affected, and should be taking into account during rehabilitation.

Which Functional Tests and Self-Reported Questionnaires Can Help Clinicians Make Valid Return to Sport Decisions in Patients With Chronic Ankle Instability? A Narrative Review and Expert Opinion.

Lateral ankle sprain is the most common injury in sports, with up to 40% of patients developing chronic ankle instability (CAI). One possible cause underlying this high rate of recurrence or feeling of giving way may be a premature return to sport (RTS). Indeed, except for time-based parameters, there are no specific criteria to guide clinicians in their RTS decisions in patients with CAI. A recent international consensus highlighted the relevance and importance of including patient-reported ankle function questionnaires combined with functional tests targeting ankle impairments in this population. Thus, the aim of this narrative review and expert opinion was to identify the most relevant functional performance tests and self-reported questionnaires to help clinicians in their RTS decision-making process following recurrent ankle sprains or surgical ankle stabilization. The PubMed (MEDLINE), PEDro, Cochrane Library and ScienceDirect databases were searched to identify published articles. Results showed that the single leg stance test on firm surfaces, the modified version of the star excursion balance test, the side hop test and the figure-of-8 test appeared to be the most relevant functional performance tests to target ankle impairments in patients with CAI. A combination of the Foot and Ankle Ability Measure (FAAM) and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) questionnaires were the most relevant self-reported questionnaires to assess patient function in the context of CAI. Although these functional tests and questionnaires provide a solid foundation for clinicians to validate their RTS decisions in patient with CAI, objective scientific criteria with cut-off scores are still lacking. In addition to the proposed test cluster, an analysis of the context, in particular characteristics related to sports (e.g., fatigue, cognitive constraints), to obtain more information about the patient's risk of recurrent injury could be of added value when making a RTS decision in patients with CAI. In order to evaluate the strength of evertors under ecological conditions, it would also be interesting to assess the ability to control weight-bearing ankle inversion in a unipodal stance. Further studies are needed to assess the relevance of this proposed test cluster in RTS decision-making following lateral ankle sprain injury and CAI.

Predicted and actual 2-year structural and pain progression in the IMI-APPROACH knee osteoarthritis cohort.

The IMI-APPROACH knee osteoarthritis study used machine learning (ML) to predict structural and/or pain progression, expressed by a structural (S) and pain (P) predicted-progression score, to select patients from existing cohorts. This study evaluates the actual 2-year progression within the IMI-APPROACH, in relation to the predicted-progression scores. Actual structural progression was measured using minimum joint space width (minJSW). Actual pain (progression) was evaluated using the Knee injury and Osteoarthritis Outcomes Score (KOOS) pain questionnaire. Progression was presented as actual change (Δ) after 2 years, and as progression over 2 years based on a per patient fitted regression line using 0, 0.5, 1 and 2-year values. Differences in predicted-progression scores between actual progressors and non-progressors were evaluated. Receiver operating characteristic (ROC) curves were constructed and corresponding area under the curve (AUC) reported. Using Youden's index, optimal cut-offs were chosen to enable evaluation of both predicted-progression scores to identify actual progressors. Actual structural progressors were initially assigned higher S predicted-progression scores compared with structural non-progressors. Likewise, actual pain progressors were assigned higher P predicted-progression scores compared with pain non-progressors. The AUC-ROC for the S predicted-progression score to identify actual structural progressors was poor (0.612 and 0.599 for Δ and regression minJSW, respectively). The AUC-ROC for the P predicted-progression score to identify actual pain progressors were good (0.817 and 0.830 for Δ and regression KOOS pain, respectively). The S and P predicted-progression scores as provided by the ML models developed and used for the selection of IMI-APPROACH patients were to some degree able to distinguish between actual progressors and non-progressors. ClinicalTrials.gov, https://clinicaltrials.gov, NCT03883568.

Knee Injury and Osteoarthritis Outcome Score Patellofemoral Questionnaire: Psychometric Properties among Females of Kingdom of Saudi Arabia.

Patellofemoral joint osteoarthritis (PFJ-OA), being a subset of knee osteoarthritis (KOA), is evident in adults, and its prevalence is greater in women in Saudi Arabia too. To assess its disease dimensions, the ‘Knee Injury and Osteoarthritis Outcome Score Patellofemoral’ questionnaire (KOOS-PF) is frequently used to measure symptoms and function among the people with PFJ-OA. Cross-cultural validation is ongoing in several languages, and it needed to be validated among females in Arabic. Therefore, aiming to translate, cross-culturally adapt and validate its psychometric properties, a cross-sectional study was designed where the Ar-KOOS-PF-F was administered among 105 females. The demographic characteristics of recruited females were 51.62 (8.49) years and 30.12 (3.70) kg/m2. Cronbach’s alpha was used for internal consistency (IC) and the questionnaire was re-administered after 48 h to estimate the test–retest reliability (92 females, 87.61% compliance rate). Concurrent validity was also established with a visual analog scale (VAS). Factorial validity was established by principal component analysis (PCA). The psychometric properties were: excellent internal consistency of Cronbach’s alpha (α) = 0.930, intraclass correlation coefficient (ICC) for intra-ratter reliability = 0.960 (0.915–0.999), test–retest reliability, ICC = 0.893 (0.889–0.970), standard error of measurement (SEM) = 2.46, relative standard deviation/coefficient of variance (RSD/CV) = 29.9%, minimal detectable change (MDC%) = 22.96% and good concurrent validity with VAS (r = −0.783; p = 0.023). The best-fit four-factor model for confirming overall item communalities ranged from 0.529 to 0.867, which indicates moderate to high communalities, and confirms the homogeneity of Ar-KOOS-PF-F using PCA. The floor (0.9%) and ceiling effects (13.6%) were also within the limits. This scale can be used among females, as it has acceptable psychometric properties of scale validation.

Cross-cultural adaptation and evaluation of the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S)

ObjectiveTo cross-culturally adapt and evaluate the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S) in Chilean runners with a running-related injury. DesignCross-cultural adaptation and validation study, following the Consensus-based Standards for selecting health Measurement Instruments (COSMIN) recommendations. SettingOutpatient sports medicine clinic and running clubs. ParticipantsUWRI was forward and backward translated, and culturally adapted. Thirty-one runners participated in the content validity of the UWRI-S; and fifty-seven in the assessment of psychometric properties. Main outcome measuresRunners seeking care from a physiotherapist completed the UWRI-S (baseline and after 48–72 h for reliability), Lower Extremity Functional Scale (LEFS), Patient Specific Functional Scale (PSFS), Global Rating of Change scale (GROC), and Numeric Pain Rating Scale (NPRS). ResultsSuggestions about accuracy of wording and understanding of items were incorporated. UWRI-S showed a positive moderate correlation with LEFS (r = 0.6; p < 0.05), positive fair with GROC (r = 0.5, p < 0.05), negative fair with NPRS (r = −0.4; p < 0.05) and no correlation with PSFS (r = 0.3; p = 0.1). UWRI-S demonstrated acceptable internal consistency (α = 0.87) and test-retest reliability (ICC = 0.87). ConclusionUWRI-S is a valid and reliable measure to evaluate running ability of Chilean runners during recovery from a running-related injury.

The Association Between Physical Competence and Psychological Response Among Young Athletes Following ACL Reconstruction

Background:The traditional index of return to sport (RTS) readiness following anterior cruciate ligament reconstruction (ACLR) is the achievement of physical competence criteria. Emerging research indicates that psychological response and self-perceptions of physical competence may be critical for successful RTS among young athletes.Hypothesis/Purpose:The purpose of this study was to test the hypothesis that young athletes with higher actual and perceived physical competence will demonstrate a more positive psychological response at time of RTS after ACLR.Methods:Thirty-eight athletes (median age=16.9 years [IQR: 16.1, 18.8]) following primary ACLR completed testing within 8 weeks of medical clearance to RTS. All participants completed isokinetic knee extension strength (180°/s) and single-limb crossover hop for distance, in addition to the Knee injury and Osteoarthritis Outcome Score (KOOS), Self-Perception Profile Athletic Competence, and ACL Return to Sport after Injury (ACL-RSI) questionnaires. Criteria for the achievement of actual (APC) and perceived physical competence (PPC) were operationally defined based on established age- and activity-relevant cutoff scores (Table 1). Psychological response was assessed with ACL-RSI overall score, in addition to each ACL-RSI subscale score (Emotions, Confidence, Risk Appraisal). Multiple linear regression analyses were used to determine differences in ACL-RSI scores based on achievement of APC and PPC, while adjusting for age and sex.Results:Of the 38 participants, 9 (23.7%) were able to meet all criteria for High APC, while 29 (76.3%) participants were categorized as Low APC. Twenty-one (55.3%) of the 38 participants were categorized as Very Good PPC, and 17 (44.7%) were categorized as Somewhat Good PPC. The regression model for overall ACL-RSI score was significant (F (4,33) = 5.224, p=0.002, adj. R2 = 0.313), with age explaining 26.4% of the total variance (p=0.001). In evaluating the ACL-RSI subscales, the regression model for the ACL-RSI Emotions score was significant (F(4,33) = 7.760, p<0.001, adj. R2 = 0.422), with age, sex, and PPC explaining 33.9% (p<0.001), 7.0% (p=0.04), and 7.7% (p=0.03) of the total variance, respectively. Lastly, the regression model for ACL-RSI Risk Appraisal score (F(4,33) = 3.416, p=0.019, adj. R2 = 0.207) was significant, with age and PPC explaining 10.5% (p=0.034) and 12.9% (p=0.02) of the total variance, respectively (Table 2).Conclusion:In partial accordance with our hypothesis, higher PPC, but not APC, was significantly associated with a more positive psychological response among young athletes after ACLR. Interventions to improve self-perceptions of competence may optimize psychological readiness to RTS.Table 1.Actual and Perceived Physical Competence CriteriaTable 2.Results of Standard Multiple Regression of Competence on ACL-RSI Scores

Prevalence of Training-related Knee Injuries among Jazan University Students with Determining Possible Related Risk Factors

Background: The articulating surface of the knee is the most commonly injured joint in athletes. However, there is a lack of proper prevalence and determinant estimations for knee injury among Jazan University students.&#x0D; Materials and Methods: This cross-sectional study aimed to determine the prevalence of knee injury among students at Jazan University, Saudi Arabia and to identify the associated risk factors. An online self-administered modified Arabic version of the Knee Injury and Osteoarthritis Outcome Score questionnaire was distributed to collect data from the students. 884 participants were included and met our inclusion criteria.&#x0D; Results: The overall prevalence of knee injuries was 18% (n = 156). Ninety-two injuries were due to sports activity. Men were 2.7 more likely to have a knee injury than women. Performing 2–3 hours of training every week increased the likelihood of knee injury by 1.7 times more than being inactive or performing only 1 hour of activity per week. An increase in the body mass index was associated with knee injury.&#x0D; Conclusion: Our study highlights the high prevalence of knee injury among male students with a high body mass index, especially those studying in medical colleges. Further large-scale research is needed to address the limitations of this study and generalize the results to a larger population.

Treatment of Persistent Postconcussion Syndrome With Repetitive Transcranial Magnetic Stimulation Using Functional Near-Infrared Spectroscopy as a Biomarker of Response: Protocol for a Randomized Controlled Clinical Trial.

BackgroundApproximately one-third of all concussions lead to persistent postconcussion syndrome (PPCS). Repetitive transcranial magnetic stimulation (rTMS) is a form of noninvasive brain stimulation that has been extensively used to treat refractory major depressive disorder and has a strong potential to be used as a treatment for patients with PPCS. Functional near-infrared spectroscopy (fNIRS) has already been used as a tool to assess patients with PPCS and may provide insight into the pathophysiology of rTMS treatment in patients with PPCS.ObjectiveThe primary objective of this research is to determine whether rTMS treatment improves symptom burden in patients with PPCS compared to sham treatment using the Rivermead postconcussion symptom questionnaire. The secondary objective is to explore the neuropathophysiological changes that occur following rTMS in participants with PPCS using fNIRS. Exploratory objectives include determining whether rTMS treatment in participants with PPCS will also improve quality of life, anxiety, depressive symptoms, cognition, posttraumatic stress, and function secondary to headaches.MethodsA total of 44 adults (18-65 years old) with PPCS (>3 months to 5 years) will participate in a double-blind, sham-controlled, concealed allocation, randomized clinical trial. The participants will engage in either a 4-week rTMS treatment protocol or sham rTMS protocol (20 treatments). The left dorsolateral prefrontal cortex will be located through Montreal Neurologic Institute coordinates. The intensity of the rTMS treatment over the left dorsolateral prefrontal cortex will be 120% of resting motor threshold, with a frequency of 10 Hz, 10 trains of 60 pulses per train (total of 600 pulses), and intertrain interval of 45 seconds. Prior to starting the rTMS treatment, participant and injury characteristics, questionnaires (symptom burden, quality of life, depression, anxiety, cognition, and headache), and fNIRS assessment will be collected. Repeat questionnaires and fNIRS will occur immediately after rTMS treatment and at 1 month and 3 months post rTMS. Outcome parameters will be analyzed by a 2-way (treatment × time) mixed analysis of variance.ResultsAs of May 6, 2021, 5 participants have been recruited for the study, and 3 have completed the rTMS protocol. The estimated completion date of the trial is May 2022.ConclusionsThis trial will expand our knowledge of how rTMS can be used as a treatment option of PPCS and will explore the neuropathophysiological response of rTMS through fNIRS analysis.Trial RegistrationClinicalTrials.gov NCT04568369; https://clinicaltrials.gov/ct2/show/NCT04568369International Registered Report Identifier (IRRID)DERR1-10.2196/31308

The Power of Perception: Beliefs About Memory Ability Uniquely Contribute to Memory Performance and Quality of Life in Adults Aging with Traumatic Brain Injury.

Personal beliefs about memory ability, which comprise memory self-efficacy (MSE), can influence memory performance in healthy older adults. Self-efficacy theory also predicts that MSE biases self-perceptions of functioning more globally, potentially impacting daily activity beyond cognitive performance. People with traumatic brain injury (PwTBI) frequently report debilitating memory problems long after acute recovery, but little is known about how MSE affects health outcomes in this population. We examined demographic and clinical correlates of MSE, as well as its relationship to memory test performance and health-related quality of life (QOL), in older adults with chronic moderate-to-severe TBI (msTBI). One hundred fourteen adults, aged 50+ and at least 1 year post-msTBI, underwent neuropsychological testing to assess their memory functioning. Participants also self-reported levels of psychological distress, MSE (Cognitive Confidence subscale of the Metacognitions Questionnaire), and health-related QOL (Quality of Life after Brain Injury questionnaire). Demographic and injury-related predictors showed weak correlations with MSE. Although the relationship between MSE and general psychological distress was robust, only the former significantly predicted memory performance. Bivariate analyses revealed significant relationships between MSE and five out of the six QOL domains assessed. Multivariate linear regression revealed a significant impact of MSE on overall QOL independent of demographic and clinical variables. Our findings support a unique role for MSE in both the objective cognitive performance and subjective health of PwTBI. Increased focus on self-perceptions of ability and their impact on measured outcomes is an important step towards personalized rehabilitation for adults with chronic msTBI.

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes.

To assess the association between clinical features and magnetic resonance imaging (MRI) findings in posterior ankle impingement syndrome (PAIS) and to compare the prevalence of imaging findings between participants with and without a clinical diagnosis of PAIS. Case-control study. Elite ballet and sport. Eighty-two male (54%) and female participants comprising ballet dancers (n = 43), cricket fast bowlers (n = 24), and football (soccer) players (n = 15). Clinical: posterior ankle pain on body chart, passive plantarflexion pain provocation test. Patient-reported outcome measures: Oslo Sports Trauma Research Center Overuse Injury Questionnaire, Foot and Ankle Ability Measure Sports subscale. Imaging findings including posterior ankle bone marrow edema, os trigonum (± bone marrow edema, and increased signal at synchondrosis), Stieda process (± bone marrow edema), talocrural and subtalar joint effusion-synovitis size, flexor hallucis longus tendinopathy, and tenosynovitis identified as present or absent on 3.0-Tesla MRI. Imaging findings were not associated with posterior ankle pain or a positive ankle plantarflexion pain provocation test. Imaging findings were not associated with patient-reported outcome measures. Imaging findings did not differ between PAIS-positive and PAIS-negative groups. Os trigonum and Stieda process were prevalent despite clinical status. The lack of association between imaging findings and clinical features questions the role of imaging in PAIS. Clinicians should rely primarily on clinical assessment in the diagnosis and management of patients with PAIS.

Influence of pain quality on physical performance in subjects with osteoarthritis of knee

Objectives Neuropathic pain features are frequently observed in subjects with knee osteoarthritis, which reduces their physical performance. This study was done to compare the physical performance between the subjects with neuropathic and nociceptive pain features. In addition, to assess the relationship between pain quality and physical performance in subjects with osteoarthritis of the knee. Methods Eighty subjects, ranging from 40 − 70 years of both genders with symptomatic and radiologically verified unilateral knee osteoarthritis (OA) were included for the study. Before having them in the study, all the subjects completed baseline interviews and demographic data. The subjects were categorized under neuropathic and nociceptive groups using Pain Detect Questionnaire (PDQ). One-time measurement of pain intensity, isometric strength of Quadriceps & hamstrings, and knee joint range of motion were assessed in both groups. Physical performance was measured using Osteoarthritis Research Society International recommended physical performance tests for knee osteoarthritis (40 m Fast Paced Walk Test, 6 min walk test, 30 s chair stand test, Timed up and Go Test, Stair Climb Test) and OA knee-related disability using Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Results Of the eighty subjects, forty subjects were included in the neuropathic group (44%), forty in the nociceptive group based on PDQ. Physical performance (p < 0.05) was significantly reduced in the neuropathic group. There existed a weak negative correlation between pain quality and variables measured (p < 0.05). Conclusion Physical performance was significantly reduced in OA knee subjects with neuropathic pain features. There is a negative correlation between pain quality and most of the physical performance variables.

Adaptation of the Brain Injury Questionnaire of Sexuality Into Bangla and Initial Findings From a Sample Of Bangladeshi Traumatic Brain Injury Patients

Bangladesh is an over populated country with a high incidence of traumaticbrain injury (TBI) for which neuropsychological services are only just emerging.In this context the present study undertook in a culturally sensitive manner totranslate into Bangla (Bengali) the Brain Injury Questionnaire of Sexuality (BIQS)and to present findings from a sample of TBI patients. Standard proceduresincluding back translation for scale adaptation were followed. The Banglaversion of BIQS (BIQS-B) were applied on 30 TBI and 53 healthy sample. Factorand principle component analysis of the BIQS-B yielded three components as inthe original scale explaining 75.3% of the total variance. Reliability is satisfactory,matching that of the English version. The TBI sample scored lower on the BIQS-Bthan did the healthy controls by virtue of not reporting the positive changes insexuality over time that the health controls reported (means of 43.90 vs 52.02, p &lt;0.001). In a very different culture, the factor structure of the BIQS-B is in factsimilar to the English version and has acceptable reliability and validity, hencecontributing to the goal of improving access to services not just in Bangladeshbut in Bangla speaking minority ethnic groups in other countries. Dhaka Univ. J. Biol. Sci. 31(1): 183-191, 2022 (January)

Quantifying External Load and Injury Occurrence in Women's Collegiate Volleyball Players Across a Competitive Season.

Taylor, JB, Barnes, HC, Gombatto, SP, Greenwood, D, and Ford, KR. Quantifying external load and injury occurrence in women's collegiate volleyball players across a competitive season. J Strength Cond Res 36(3): 805-812, 2022-Volleyball demands repetitive jumping, with high loads linked to risk of injury. The purpose of this study was to examine jumping demands and injury patterns throughout a women's volleyball season. Sixteen Division-I female volleyball players wore an accelerometer to record jump count (JC) and jump height during every practice and match throughout the season. Physical health was documented using a weekly modified Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSLO) and time-loss injuries were recorded. Multivariate analyses of variance were used to compare measures across phases of the season, between types of session (practice vs. match), and between injured and noninjured players (α = 0.05). Results showed the greatest training demands in the preseason with larger jump counts than during the nonconference, conference schedule, and postseason schedules (p < 0.001). Performance increased throughout the season with greater jump heights in the nonconference and conference schedule than in the preseason (p = 0.01). There were no significant differences in JC between practices (65.5 ± 30.5) and matches (67.5 ± 46.4). An injury incidence of 5.49 injures per 1,000 athletic exposures was identified, with injuries accounting for 31 days lost, or 2.1% of total exposures. Injuries affected performance throughout the season, as noted by an average weekly OSLO score of 15.1 ± 13.9%. Injured players had significantly lower jump counts per exposure (p = 0.03) and a larger variation in training load than uninjured players (coefficient of variation: injured = 54%, uninjured = 41%; p = 0.006). These data help provide coaches and clinicians for training and rehabilitation program designs.

Proximal hamstring tendon avulsions: comparable clinical outcomes of operative and non-operative treatment at 1-year follow-up using a shared decision-making model

ObjectiveTo prospectively evaluate 1-year clinical and radiological outcomes after operative and non-operative treatment of proximal hamstring tendon avulsions.MethodsPatients with an MRI-confirmed proximal hamstring tendon avulsion were included. Operative or non-operative...

Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: the Karolinska football Injury Cohort (KIC)

IntroductionFootball is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify...

Feasibility of Concussion Rehabilitation Approaches Tailored to Psychological Coping Styles: A Randomized Controlled Trial

ObjectiveTo evaluate the feasibility of a clinical trial involving participants with concussion randomized to treatments designed to address fear avoidance or endurance coping, which are risk factors for disability. A secondary objective was to evaluate whether each treatment could affect selective change on targeted coping outcomes. DesignRandomized controlled trial. SettingOutpatient concussion clinics. ParticipantsAdults (N=73, mean age=42.5y) who had persistent postconcussion symptoms and high avoidance or endurance behavior were enrolled at a mean of 12.9 weeks post injury. Ten participants did not complete treatment. InterventionsParticipants were randomized to an interdisciplinary rehabilitation program delivered via videoconferencing and tailored to avoidance coping (graded exposure therapy [GET]) or endurance coping (operant condition-based pacing strategies plus mindfulness training [Pacing+]). Main Outcome MeasuresFeasibility outcomes included screening efficiency, accrual, credibility, treatment fidelity, adherence, and retention. Avoidance was measured with the Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire and endurance behavior with the Behavioral Response to Illness Questionnaire. ResultsScreening efficiency, or the proportion of clinic patients who were assessed for eligibility, was 44.5% (275 of 618). A total of 65.8% (73 of 111) of eligible patients were randomized (37 to GET, 36 to Pacing+), meeting accrual targets; 91.7% (55 of 60) of participants perceived treatment as credible. Therapists covered a mean of 96.8% of essential prescribed elements, indicating excellent fidelity. The majority (71.2%; 47 of 66) of participants consistently attended treatment sessions and completed between-session homework. Retention was strong, with 65 of 73 (89%) randomized participants completing the outcome assessment. GET was associated with greater posttreatment reductions in avoidance behavior compared with Pacing+ (Cohen's drepeated measures, 0.81), whereas the treatment approach-specific effect of Pacing+ on endurance behavior was less pronounced (Cohen's drepeated measures, 0.39). ConclusionsThese findings support a future efficacy-focused clinical trial. GET has the potential to selectively reduce fear avoidance behavior after concussion, and, via this mechanism, to prevent or reduce disability.