Rehabilitation Perspective Research Articles

Living Group Climate in Kosovo and Albania: Internal Structure and Reliability of the Prison Group Climate Instrument (PGCI)

ABSTRACT This study examined the internal structure and internal consistency reliability of the Prison Group Climate Instrument (PGCI), by means of confirmatory factor analysis (CFA) and reliability analyses in a sample of 195 minors (92.8% male; aged 14–24; M = 17.6, SD = 1.52) in Kosovo and Albania. Findings showed an acceptable model fit for a three-factor model consisting of three correlated factors with good internal consistency reliability: Support (ω = .93), Growth (ω = .86), and Atmosphere (ω = .83), rather than the original four-factor model. The repression subscale did not fit participant’s perception, possibly due to cultural values favoring authority and respect for the rules. PGCI can be used to assess and monitor living group climate from the perspective of rehabilitation, facilitating future scientific research and continuous improvement of forensic residential care in these countries.

Recommendations and future perspective for follow-up and rehabilitation after surviving cardiac arrest

Cardiac arrest (CA) survivorship is associated with risk of cognitive deficits, emotional and social consequences. Early recognition of these symptoms and referral to rehabilitation is considered to be the fifth link in the chain of survival. This review highlights the need for a national standardized care plan for CA survivors based on a multidisciplinary approach. A patient-tailored law-bound rehabilitation form is essential to proper services in Denmark and should be mandatory. Further research within different rehabilitation areas following CA is warranted to support clinical practice.

Using eye tracking to assess learning of a multifunction prosthetic hand: an exploratory study from a rehabilitation perspective

BackgroundEye tracking technology not only reveals the acquisition of visual information at fixation but also has the potential to unveil underlying cognitive processes involved in learning to use a multifunction prosthetic hand. It also reveals gaze behaviours observed during standardized tasks and self-chosen tasks. The aim of the study was to explore the use of eye tracking to track learning progress of multifunction hands at two different time points in prosthetic rehabilitation.MethodsThree amputees received control training of a multifunction hand with new control strategy. Detailed description of control training was collected first. They wore Tobii Pro2 eye-tracking glasses and performed a set of standardized tasks (required to switch to different grips for each task) after one day of training and at one-year-follow-up (missing data for Subject 3 at the follow up due to socket problem). They also performed a self-chosen task (free to use any grip for any object) and were instructed to perform the task in a way how they would normally do at home. The gaze-overlaid videos were analysed using the Tobii Pro Lab and the following metrics were extracted: fixation duration, saccade amplitude, eye-hand latency, fixation count and time to first fixation.ResultsDuring control training, the subjects learned 3 to 4 grips. Some grips were easier, and others were more difficult because they forgot or were confused with the switching strategies. At the one-year-follow-up, a decrease in performance time, fixation duration, eye-hand latency, and fixation count was observed in Subject 1 and 2, indicating an improvement in the ability to control the multifunction hand and a reduction of cognitive load. An increase in saccade amplitude was observed in both subjects, suggesting a decrease in difficulty to control the prosthetic hand. During the standardized tasks, the first fixation of all three subjects were on the multifunction hand in all objects. During the self-chosen tasks, the first fixations were mostly on the objects first.ConclusionThe qualitative data from control training and the quantitative eye tracking data from clinical standardized tasks provided a rich exploration of cognitive processing in learning to control a multifunction hand. Many prosthesis users prefer multifunction hands and with this study we have demonstrated that a targeted prosthetic training protocol with reliable assessment methods will help to lay the foundation for measuring functional benefits of multifunction hands.

Application framework and model of Jingjin therapy in rehabilitation medicine

The Jingjin therapy and rehabilitation medicine share commonalities and complement each other. The application of Jingjin therapy from a rehabilitation perspective can broaden the development path of traditional Chinese medicine (TCM) rehabilitation. This paper, based on relevant literature and research findings, elaborates on the connection between Jingjin syndrome differentiation acupuncture and rehabilitation assessment and treatment. It discusses the application framework of Jingjin's preventive treatment theory in disease prevention and rehabilitation, and forecasts the research model of Jingjin rehabilitation medicine from an integrative perspective of Chinese and western medicine. This study aims to improve the rehabilitation application thinking of Jingjin therapy and enrich the application methods and treatment approaches of TCM rehabilitation medicine.

Respiratory Muscle Training in Para-Athletes: A Systematic Review on the Training Protocols and Effects on Reported Outcomes.

Respiratory muscle training (RMT) is considered an effective tool to improve cardiorespiratory limitations in athletes. The goals of this systematic review were to explore the role of RMT and its implementation within sport rehabilitation programs in para-athletes. Several databases were searched until January 2024. Eligible studies were independently reviewed by 2 reviewers. Quality assessment was made using the PEDro scale and version 2 of the Cochrane Risk-of-Bias Tool for Randomized Trials. Eight studies (a total of 108 participants) were selected for the analysis. Five studies preferred using resistive loading, while 2 studies used normocapnic hyperpnea, and 1 study used threshold inspiratory muscle training. Respiratory functions (respiratory muscle strength and endurance, spirometry measures) and exercise performance were assessed as the main outcomes. Significant increases in respiratory muscle strength were reported in 5 studies. Two studies observed improvement in respiratory muscle endurance and 3 studies reported increased exercise capacity. This review suggests that although RMT can enhance respiratory muscle strength and endurance, it should not be considered the primary method for boosting the exercise performance of para-athletes. Additional research is necessary to explore the impact of various RMT techniques on different outcomes from the perspective of sport rehabilitation in para-athletes.

Psychomotric Perspectives of Rehabilitation in Chronic Brachial Plexus Palsies

Background. The perspective of ongoing electric signals within the motor cortex, conditioned by continuous rehabilitation strategies (doubled by adherence to the treatment protocol), is of interest related to understanding how cerebral plasticity is being modulated in adult traumatic brachial plexus (BP) lesions. Very often, patients with chronic BP lesions tend to be less compliant to rehabilitation therapy over time, since multiple reconstructive microsurgery interventions may not always offer a proper upper limb functionality, especially in severe, complex BP cases. Material and methods. In order to asses the ongoing psychomotric projection of the limb’s representation among the motor cortex, in relation with long term rehabilitation protocol we followed up a group of 11 chronic patients, by transcranial magnetic stimulation (TMS) during a time-lapse of two years. Results. Although modest in relation with amelioration of the deficit on the MRC scale, the patients had mild improvements of the parameter latency, but more important, by assessing the amplitude of the motor evoked potential (MEP), we observed a dynamism of the motor area. This we consider suggestive for ongoing psychomotor components stimulated by rehabilitation: ideomotricity, perceptual-motor coordination, laterality and body representation, as a foundation in maintaining a proven measurable potential of continuous neuroplasticity. Conclusion. From clinical perspective, since psychomotricity actually means interdisciplinarity, this is the common denominator found in the collaboration between medical specialties: plastic surgery and reconstructive microsurgery, clinical neurology, electrodiagnostic and neuromotor rehabilitation.

P-465 Rehabilitation services and the infertility journey: a study on women’s experiences in Ethiopia

Abstract Study question How does infertility affect women in Ethiopia, and can rehabilitation service providers mitigate its impact? Summary answer Introducing rehabilitation services for women with infertility in Ethiopia could mitigate the frequent adverse psychosocial consequences and maintain women’s integration into family and community structures. What is known already Infertility is a disease that generates a disability as an impairment of function. Globally, millions of people are affected, and women bear the brunt of its consequences. In Ethiopia, infertility can cause significant distress and burden for women who are unable to meet societal expectations of motherhood. Despite this impact, no previous research has been conducted in Ethiopia to explore the role of rehabilitation services in providing support for these women. Study design, size, duration We followed a sequential mixed methods design that consisted of three parts: The national prevalence of infertility in Ethiopia was first determined using data from the 2016 Ethiopian Demographic and Health Survey (DHS); using Interpretive Phenomenology, the lived experiences of Ethiopian women living with infertility was explored; and finally, an Interpretive Description approach was applied to evaluate the role of rehabilitation services in assisting women with infertility. Data were collected between 2022 and 2023. Participants/materials, setting, methods For the first part, we performed secondary data analysis from 15,683 women in Ethiopia through the 2016 Ethiopian DHS. The data were analyzed using two approaches to infertility – the demographic and current duration. In the second part, 13 women undergoing treatment at a fertility center were interviewed. In the third part, 14 rehabilitation, medical, and policy service providers were purposefully selected from diverse institutions across three different geographical locations in Ethiopia. Main results and the role of chance Using the demographic definition, the overall prevalence of infertility was 7.6% (95% CI 6.6-8.8), with a prevalence of primary and secondary infertility of 1.4% (95% CI 1.0-1.9) and 8.7% (95% CI 7.5-10.1), respectively. The current duration approach resulted in a prevalence of overall infertility of 24.1% (95% CI 18.8-34.0) at 12-months, 13.4% (95% CI 10.1-18.6) at 24-months, and 8.8% (95% CI 6.5- 12.3) at 36-months. Thus, the demographic definition resulted in a lower estimate compared to the current duration approach which could be more appropriate for the early detection and management of infertility in Ethiopia. According to participants, infertility had far-reaching consequences that substantially affected women’s psychological, socio-cultural, and spiritual lives. Despite this, women developed various coping mechanisms and resilience. Women had minimal access to psychosocial and financial support and no access to rehabilitation services. Finally, interviewees recognized the potential of rehabilitation services to maximize the day-to-day functioning and overall well-being of women with infertility. Limitations, reasons for caution Using demographic proxies to determine exposure to pregnancy can make estimation unreliable. The fertility center only treated married couples; hence, single, separated, or divorced women were not included. Results are context-specific and cannot be extrapolated to all infertility cases in Ethiopia or elsewhere. Wider implications of the findings This is the first study to explore infertility in Ethiopia from a rehabilitation perspective. Based on the prevalence and impact, infertility in Ethiopia represents a major public health issue. Strengthening policies, integrating rehabilitation services into fertility care, and recognizing infertility as a disabling condition are crucial steps toward addressing infertility. Trial registration number not applicable

Electroacupuncture activates the peroxisome proliferators-activated receptor pathway to improve thephenotype of cerebral palsy.

This study explores the efficacy of electroacupuncture (EA) in treating cerebral palsy (CP) in Sprague-Dawley (SD) pups, specifically CP animal models, and its molecular mechanisms. Gait analysis and Y-maze were used to detect the improvement of motor ability and cognitive function of CP rats after EA treatment. Transcription sequencing was used to determine the key pathway for EA to improve the symptoms of CP. PPAR agonists were used to verify the causal relationship between the pathway and the improvement of CP phenotype. The motor ability and cognitive function of CP pups were improved after EA treatment. The results of transcriptome sequencing suggest that the improvement of CP phenotype may be caused by the activation of PPAR pathway. PPAR pathway is widely activated in the epithelium of CP pups treated with EA, which is verified by qPCR. Rosiglitazone (Ros), a PPAR agonist, can improve CP phenotype while activating PPAR pathway, which proves the causal relationship between PPAR pathway activation and CP phenotype improvement. Our study demonstrated behavioral improvements and enhanced cognitive functions in CP models after EA treatment by activating PPAR pathway, suggesting new perspectives for CP rehabilitation, and providing theoretical support for acupuncture treatment of CP.

On the embodied nature of knowledge: From neurons to numbers.

Interdisciplinary investigations of the human mind through the cognitive sciences have identified a key role of the body in representing knowledge. After characterizing knowledge at grounded, embodied, and situated levels, number knowledge is analyzed from this hierarchical perspective. Lateralized cortical processing of coarse versus fine detail is identified as a grounding substrate for the population stereotype few/left, many/right, which then contributes to number-related sensory and motor biases at the embodied and situated levels. Implications of this perspective for education and rehabilitation are discussed.

Subacromial balloon spacer massive rotator cuff tear treatment systematic review and meta-analysis: Patient selection and physical therapy may be keys to outcome success.

Subacromial balloon spacer implantation (SBSI) efficacy for massive rotator cuff tear treatment was evaluated based on perceived shoulder function, active shoulder mobility, pain, complications and research study methodological quality. The purpose was to better discern the efficacy of this device from both surgical and rehabilitative perspectives to improve patient outcomes. PubMed, EMBASE and Cochrane Library databases were searched (1 January 2010 to 1 June 2024) using 'balloon spacer', 'subacromial spacer', 'subacromial balloon spacer', 'shoulder spacer' and 'inspace' terms. Pre-surgery (baseline), 12-month (12-m) and 24-month (24-m) post-SBSI mean changes were compared using one-way ANOVA and Scheffe post hoc tests, and comparative study effect sizes were calculated (p ≤ 0.05). This review consists of 27 studies with 894 patients (67.8 ± 5 years of age) and 29.4 ± 17-month follow-up. Modified Coleman Methodology Scores (MCMS) revealed fair overall quality (mean = 61.4 ± 11). Constant-Murley scores improved from 34.8 ± 6 (baseline), to 64.2 ± 9 (12-m) and 67.9 ± 8 (24-m) (12-m, 24-m > baseline, p < 0.001). ASES scores improved from 35.1 ± 14 (baseline), to 83.3 ± 7 (12-m) and 81.8 ± 5 (24-m)(12-m, 24-m > baseline, p < 0.001). VAS pain scores improved from 6.6 ± 1 (baseline), to 2.6 ± 1 (12-m) and 2.0 ± 1 (24-m) (12-m, 24-m < baseline, p < 0.001). Flexion increased from 108.5 ± 25° (baseline), to 128.5 ± 30° (12-m) and 151.2 ± 14° (24-m) (24-m > 12-m, baseline, p = 0.01). Abduction increased from 97.7 ± 24° (baseline) to 116.3 ± 23° (12-m) and 142.3 ± 15° (24-m) (24-m > 12-m, baseline, p = 0.02). External rotation (ER) in adduction changed from 33.1 ± 7° (baseline) to 32.5 ± 4° (12-m) and 53.9 ± 9° (24-m)(24-m > 12-m, baseline, p = 0.01). ER at 90° abduction increased from 56.3 ± 3° (baseline) to 83.5 ± 5° (12-m) and 77.1 ± 4° (24-m) (24-m, 12-m > baseline, p = 0.01). Comparison studies, however, displayed insignificant results with small effect sizes. Despite overall fair MCMS scores, at 24-m post-SBSI, shoulder function improved and pain decreased. More rigorous comparative studies, however, revealed insignificant findings. Patients with the potential to re-establish the essential glenohumeral joint force couple that depresses the humeral head on the glenoid fossa and who comply with physical therapy may be more likely to achieve success following SBSI. Level IV.

კროს-რეგიონული თანამშრომლობის როლი შიგარეგიონული დისპროპორციების დაძლევაში პოსტ-კრიზისულ საქართველოში

Regionalism and regional studies are one of the most topical issues and research directions at the current stage. Therefore, it is quite difficult to find an issue in the relevant space that has not yet been studied by Georgian or foreign researchers. However, it should be noted here that the rapidly changing world full of contradictions will constantly activate new challenges, which require re-examination of the problem that has been analyzed many times and its study in relation to the changed environmental conditions. The aim of the present paper was to study the discussions related to the expediency of further regionalization in Georgia, strengthening of inter-regional ties, and the analysis of the current processes, to determine the expediency of transforming its results into the reality of our country, to outline the future perspectives of rapid post-crisis rehabilitation and development, and to develop appropriate recommendations. In the process of working on this article, as methodological material, the authors reviewed research papers, analytical materials, reports and regulatory documents of governmental or international organizations, and others that were related to the problem posed in the paper. We paid special attention to the examples of the Baltic states, the Scandinavian countries, and the Eastern Partnership countries, because we think that studying and sharing their experiences can positively affect the development and implementation of relevant policies in our country, in one hand, and the outline of the perspectives of regional cooperation, in other hand.

Safety First! Residential Group Climate and Antisocial Behavior: A Multilevel Meta-analysis

A systematic review and multilevel meta-analysis was performed (28 studies and 313 effect sizes) on the relation between residential group climate (i.e., safety, atmosphere, repression, support, growth, structure) and antisocial behavior, including aggression and criminal recidivism. A systematic search was conducted in PsychINFO, ERIC, and OVID Medline up to February 2023. Results showed a small but significant association ( r = .20) between residential group climate and antisocial behavior, equivalent to a 23% reduction of antisocial behavior in all clients receiving care in a residential facility with a therapeutic group climate. Moderator analyses showed that experienced safety was more strongly related to antisocial behavior ( r = .30) than the other dimensions of group climate (.17 &lt; r &lt; .20), while the effect size was somewhat larger for adults ( r = .24) than for youth ( r = .15). We conclude that residential facilities should consider safety as a priority and should involve clients in a positive process of change through the development of a therapeutic environment and delivery of evidence-based treatment, addressing their needs from the perspective of rehabilitation.

Challenged by the jaw – an interview study on patients’ experiences of temporomandibular disorders in rheumatic inflammatory diseases

Purpose Rheumatic inflammatory diseases affecting the temporomandibular joint and the masticatory system (TMD) have been described as painful and limiting. However, the condition is often overlooked in primary care. The objective of this qualitative study was to explore and describe TMD-related experiences and perceptions of persons with rheumatic inflammatory disease, and to put this into a rehabilitation perspective. Materials and methods Seven participants with rheumatic inflammatory disease and concomitant TMD were interviewed using a semi-structured interview guide. Giorgi’s phenomenological method was used for analysis of the material. Results The general structure of the results after phenomenological reduction indicated that the phenomenon could be described as the process of being challenged by the jaw. Five themes emerged from the analysis; 1. Physical challenges of the jaw and the struggle to retain control, 2. Shame and social challenges, 3. Worrying about the future, frustration, grief, and loss of freedom, 4. Defiance, endurance, and efforts to maintain self-esteem, and 5. Health-care experiences. Conclusions TMD in rheumatic inflammatory diseases are complex problems associated with various challenges to the sufferer. An increased awareness of the condition and earlier interventions could reduce both suffering and worsening of the condition.

The early career resilience experience of generation Z newly graduated registered nurses in standardized training in the emergency department: a qualitative study in Shanghai

BackgroundThe period of standardized training is a transitional stage when Generation Z newly graduated registered nurses (Gen Z NGRNs) change their role from student to nurse. Affected by the COVID-19, they lack clinical practice and practicum experience in emergency departments in their university studies. At the beginning of career, they are under great pressure. Resilience is one of the factors that reduce their stress level and increases endurance. It is of interest to understand how this representative group of nurses gained and played the experience of resilience early in their careers.ObjectiveTo explore Gen Z NGRNs’ experience and process of resilience, to provide a new perspective and theoretical basis for psychological rehabilitation or intervention of medical staff who experienced transition shock.MethodsThis study employed a qualitative design based on the phenomenological approach. 18 nurses from a third-level class-A hospital in Shanghai who participated in standardized training in emergency department were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation.ResultsThe investigation uncovered three themes and ten subthemes. Pressure and challenge contained high workload and high risk coexist, death’s stress response, more emergencies and high professional requirements. Coping and adaptation contained team help, psychological restructuring, peer support, transformational leadership. Reflection and planning contained enhance learning, appreciate life.ConclusionsOur study described the embodiment and coping experience of the physical and mental stress faced by Gen Z NGRNs during their standardized training in the emergency department. It is emphasized that nurse educators should pay attention to the character and actual needs of Gen Z NGRNs, explore and formulate strategies, so as to guide NGRNs to quickly adapt and grow in the new role. The ultimate goal is to increase nurse retention and improve the quality of nursing.

Rare case of massive middle cerebral artery infarct after bronchial artery embolisation

Bronchial artery embolization (BAE) is a procedure that aims to control bleeding from bronchial arteries in massive and chronic haemoptysis. It is considered to be a life-saving measure in severe life-threating haemoptysis. Although it is minimally invasive and has a high success rate, it still carries a list of complications. These include post-embolisation syndrome, chest pain, back pain, dysphagia, vascular injury at the site of the embolisation leading to dissection, perforation, pseudoaneurysm and, very rarely, embolic infarction to non-target vessels. Stroke is one of the rare complications post BAE, and it can be severe and fatal. Few cases of stroke post BAE have been reported in the literature, and they were mainly due to posterior cerebral circulation infarction. Here, we report a case of a stroke post BAE due to massive middle cerebral artery (MCA) infarction and to our knowledge it seems to be the first reported case of MCA infarction post BAE. The discussion will cover the possible mechanisms of embolic passage, the outcome of the case including rehabilitation perspectives and the learning points. These will also highlight the importance of early recognition, which can save patients from a disabling stroke in the future.

The role of Artificial Intelligence (AI) in rehabilitation and in the reduction of the use of imprisonment

Over the past few decades, the criminal justice system has experienced a shift towards risk management (actuarial justice). The New Public Management ideology has also entered the field of criminal policy and currently there is a growing recognition of the importance of adopting an Offender Management System. This new way of managing the criminal justice is increasingly supported by Artificial Intelligence and related digital technologies. The use of these technologies has enormous potential from a rehabilitation perspective. However, the current trend is to use them mainly for security and control purposes. This analysis examines whether the goal of rehabilitation can still be accommodated in a criminal justice system with the aforementioned characteristics. Criminal policy has the responsibility to ensure that the control it imposes on citizens can be balanced by an ethical use of digital technologies, which effectively contributes to rehabilitation and to the reduction in the resort to imprisonment.

Nonsurgical Rehabilitation Perspectives for a Type I Salter-Harris Fracture With Lipohemarthrosis and Concomitant Grade II Anterior Cruciate Ligament (ACL) Tear in a Volleyball Athlete: A Case Report

Nonsurgical Rehabilitation Perspectives for a Type I Salter-Harris Fracture With Lipohemarthrosis and Concomitant Grade II Anterior Cruciate Ligament (ACL) Tear in a Volleyball Athlete: A Case Report

What are the effects of pharmacological, non-invasive brain stimulation and psychological interventions, and their combination, in the treatment of post-stroke depression? A Cochrane Review summary with commentary.

Post-stroke depression (PSD) is a prevalent condition that can significantly influence the recovery process. To assess the effects of pharmacological, non-invasive brain stimulation and psychological interventions, and their combination on PSD. A summary of the Cochrane Review by Allida et al. (2023), with comments from a rehabilitation perspective. Sixty-one studies with 5831 participants were included in the Cochrane Review. Very low-certainty evidence indicated favorable treatment effects of pharmacological interventions, psychological therapies, and the combination of pharmacological intervention and non-invasive brain stimulation on PSD. Pharmacological intervention has resulted in increased side effects associated with the central nervous system and gastrointestinal system, with very low-certainty evidence. Evidence for the effectiveness of pharmacological, psychological, and combination therapies for the management of PSD is uncertain, as the quality of the evidence has been assessed as very low. Therefore, further studies with improved methods should investigate pharmacological and non-pharmacological interventions for the treatment of depression in stroke survivors.

779 Burn Therapists’ Perspective of Rehabilitation and Recovery Post Primary Closure of a Burn Wound

779 Burn Therapists’ Perspective of Rehabilitation and Recovery Post Primary Closure of a Burn Wound

Additional suture augmentation to anterior cruciate ligament reconstruction with hamstring autografts bring no benefits to clinical results, graft maturation and graft-bone interface healing

BackgroundFrom the perspective of graft protection and early rehabilitation during the maturation and remodeling phases of graft healing, suture augmentation (SA) for anterior cruciate ligament reconstruction (ACLR) has attracted more and more attention.Study DesignRetrospective study.PurposeTo determine whether the additional SA affects clinical results, graft maturation and graft-bone interface healing during two years follow-up after ACLR.Methods20 ACLRs with additional SA (ACLR-SA group) and 20 ACLRs without additional SA (ACLR group) were performed between January 2020 and December 2021 by the same surgeon and were retrospectively analyzed. Pre- and postoperative International Knee Documentation Committee (IKDC) scores, Lysholm scores, graft failure and reoperation were evaluated. The signal/noise quotient (SNQ) of autografts and the signal intensity of graft-bone interface were analyzed. All 40 patients in ACLR-SA group and ACLR group completed 2-years follow-up.ResultsThere was no patient in the two cohorts experienced graft failure and reoperation. The postoperative IKDC and Lysholm scores have been significantly improved compared with preoperative scored in both ACLR-SA group and ACLR group, however, there was no significant difference between two groups. The SNQ of proximal graft of ACLR-SA group (14.78 ± 8.62 vs. 8.1 ± 5.5, p = 0.041) was significantly greater while the grades of graft-bone interface healing of posterior tibial was significantly lower than that of ACLR group at 1-year postoperatively (p = 0.03), respectively. There were no significant differences between the two groups of the SNQ of proximal, distal medial graft segments, and the graft-bone interface healing grades of anterior femoral, posterior femoral, anterior tibial and posterior tibial at other time points (p>0.05).ConclusionsThe additional SA in ACLR had no effect on IKDC scores, Lysholm scores, graft maturation and graft-bone interface healing at 2-year postoperatively. Our research does not support the routine use of SA in ACLR.