Return To Sport Research Articles

Return to Soccer After Acute Anterior Cruciate Ligament Primary Repair: A 2-Year Minimum Follow-up Study of 50 Amateur Players.

Return to sport (RTS) after treatment of an anterior cruciate ligament (ACL) tear is a critical parameter to assess the outcome of a surgical procedure. However, few studies have investigated RTS after ACL repair. To evaluate RTS of a group of amateur soccer players at a minimum follow-up of 2 years after ACL repair. Case series; Level of evidence, 4. A retrospective review of all patients treated with acute ACL repair was conducted. A total of 50 amateur soccer players were included in the study. Patients were examined clinically or contacted to complete postoperative patient-reported outcome measures, namely the Knee injury and Osteoarthritis Outcome Score, the International Knee Documentation Committee questionnaire, the ACL-Return to Sport After Injury scale, and the Forgotten Joint Score-12. The patients' mean age was 25.8 ± 7.7 years (range, 14-47 years), and the mean follow-up was 34.3 ± 10.7 months (range, 24-51.3 months). The median Tegner Activity Scale score was 9. The ACL repair failure rate was 16% (8/50). The mean time from repair to failure was 23.1 ± 12.7 months (range, 6-44 months), and the mean age of patients who sustained ACL repair failure was 19.9 ± 3.3 years (range, 14-24 years), significantly lower compared with patients who did not experience ACL repair failure (26.9 ± 7.9 years; range, 16-47 years; P = .017). Multivariate analysis showed that age ≤21 years was the only significant risk factor for ACL repair failure (odds ratio, 5.45; confidence interval, 1.24-27.91; P = .041). Excluding the 8 patients who experienced repair failure, 31 of 42 patients (73.8%) returned to soccer after ACL repair, with 29 of the 31 (93.5%) returning at their preinjury level of play. Moreover, patients who played competitive soccer and returned to their preinjury level of play were significantly younger than those who did not return to their preinjury level of play (mean, 21.1 ± 3.4 vs 29.2 ± 9.5 years, respectively; P = .002) and had significantly better ACL-Return to Sport After Injury scores (mean, 96.6 ± 4 vs 87.8 ± 11, respectively; P = .044). In this study, 73.8% (n = 31) of patients returned to playing soccer, of whom 93.5% (n = 29) returned to their preinjury level after ACL repair. The failure rate was 16% (n = 8) and mainly involved patients ≤21 years old.

Validation of Camera Networks Used for the Assessment of Speech Movements

Abstract. The term speech sound disorder describes a range of speech difficulties in children that affect speech intelligibility. Differential diagnosis is difficult and reliant on access to validated and reliable measures. Technological advances aim to provide clinical access to measurements that have been identified as beneficial in diagnosing speech disorders. To generate objective measurements and, consequently, automatic scores, the output from multi-camera networks is required to produce quality results. The quality of photogrammetric results is usually expressed in terms of the precision and reliability of the network. Precision is determined at the design stage as a function of the geometry of the network. In this manuscript, we focus on the design of a photogrammetric camera network using three cameras. We adopted a similar workflow as Alsadika et al. (2012) and tested serval network configurations. As the distances from the camera stations to object points were fixed to 3500mm, only the horizontal and vertical placements of the cameras were varied. Horizontal angles were changed within an increment of 10º, and vertical angles were changed within an increment of 5º. The object space coordinates of GCPs for each camera configuration were assessed in terms of horizontal error ellipses and vertical precision. The best design was the maximum horizontal and vertical convergence angles of 90° and 30°. The existing camera network used to capture videos for speech assessment was approximately as good as the top third of tested designs. However, from a validation perspective, it can be concluded that the design is viable for continued use.

Do lower limb kinetic and kinematic differences in drop jump landings persist when players have returned to sport following knee ligamentous injuries?

Knee injuries (KI) are identified as one of the most burdensome lower limb injuries in football with long and complicated rehabilitation and high re-injury risk. Current research often describes technique deficits being present upon RTS, often being a result of poor return to sport (RTS) testing procedures. More recently, research has advocated the use of single leg vertical jump assessments, due to the specificity of the movement to injury mechanisms and the ability to consider different phases of the task to inform practitioners of joint contributions to the propulsion and landing phases. The aim of this research is to identify whether these functional deficits exist 12-24 months post RTS authorisation, to help inform future RTS in applied practice. Twenty-four semi-professional male footballers (mean ± SD: age 25 ± 4 years; stature 182 ± 7 cm; body mass 80 ± 8 kg) were recruited into a previously injured and a control group. Participants completed 5 repetitions of single leg drop jump (SLDJ). Jump height, ground contact time, reactive strength index, peak moments, angles and power contributions for the hip, knee and ankle were measured using Qualisys Track Manager then exported to Visual 3D. This study was approved by the Edge Hill University Ethics Committee. No significant findings were identified for landing one however, during the propulsion phase there was a difference between groups (P = 0.026, d=1.14) for knee flexion at take-off. Most differences were identified during landing two bilaterally in both groups. Within the injured group, differences were identified for peak hip (P = 0.011, d = 0.028) and knee powers (P < 0.001, d = 1.269), hip (P < 0.001, d = 1.924) and knee power contribution % (P < 0.001, d = 1.269). No differences were identified for the performance measures or through performing statistical parametric mapping for hip and knee powers for all three phases. Joint coupling analysis was conducted for the total ground contact time amalgamating the landing and propulsion phase, this was analysed as Hip-Knee, Hip-Ankle and Knee-Ankle, with significant findings in Hip-Knee and Hip-ankle. Both groups elicited bilateral differences however, no differences between the injured limb and dominant control limb were identified. To better apply this form of analysis to RTS testing, functional movements such should be undertaken when athletes are injury free to provide baseline measurements to refer to if undertaking rehabilitation from KI. Likewise, the current study identified that joint contributions could be identified in a more applied setting using the range of motion data from each joint.

An update on clinical gait analysis : Current developments and applications

The objective acquisition and assessment of joint movements and loads using instrumented gait analysis has become an established tool in clinical diagnostics. In particular, marker-based 3D gait analyses make use of an increasingly comprehensive database for the assessment of orthopaedic or neurological questions. Based on this data and medical-scientific experience, increasingly reliable approaches and evaluation strategies are emerging, which also draw on methods from artificial intelligence and musculoskeletal modelling. This article focusses on marker-based gait analyses of the lower extremity (hip, knee, foot) and how these can be used in aclinically relevant way using current methods, e.g. for determining indications or optimization of surgical planning. Finally, current developments and applications by using alternative methods from sensor technology and optical motion capture will be briefly discussed.

Meniscus Tears in Elite Athletes: Treatment Considerations, Clinical Outcomes, and Return to Play.

Management of meniscal injuries in the elite athlete is a difficult problem secondary to the high demands of athletic competition, the need for a timely return to sport, and the desire to maximize performance over time. The purpose of this review is to provide an up-to-date summary on the current literature and trends regarding the management of meniscus injuries with a special consideration for elite athletes. Historically, partial meniscectomy has been the primary treatment option for meniscus injuries. However, in recent years there has been an increased emphasis on meniscus preservation due to the increased risk of cartilage degeneration over time. Moreover, while partial meniscectomy still provides a quicker return to sport (RTS), recent literature has demonstrated similar rates of RTS and return to pre-injury levels between partial meniscectomy and meniscus repair. In the setting of symptomatic meniscal deficiency, meniscus allograft transplantation has become an increasingly utilized salvage procedure with promising yet variable outcomes on the ability to withstand elite competition. Currently, there is no uniform approach to treating meniscal injuries in elite athletes. Therefore, an individualized approach is required with consideration of the meniscus tear type, location, concomitant injuries, athlete expectations, rehabilitation timeline, and desire to prevent or delay knee osteoarthritis. In athletes with anatomically repairable tears, meniscus repair should be performed given the ability to restore native anatomy, provide high rates of RTS, and mitigate long-term chondral damage. However, partial meniscectomy can be indicated for unrepairable tears.

From Control to Chaos: Visual-Cognitive Progression During Recovery from ACL Reconstruction.

BACKGROUND: Anterior cruciate ligament tear is a serious knee injury with implications for central nervous system (CNS) plasticity. To perform simple knee movements, people with a history of ACL reconstruction (ACL-R) engage cross-modal brain regions and when challenged with cognitive-motor dual-tasks, physical performance deteriorates. Therefore, people with ACL-R may increase visual-cognitive neural processes for motor control. CLINICAL QUESTION: What components of CNS plasticity should the rehabilitation practitioner target with interventions, and how can practitioners augment rehabilitation exercises to target injury associated plasticity? KEY RESULTS: This clinical commentary (1) describes the neurophysiological foundation for visual-cognitive compensation after ACL-R, (2) provides a theoretical rationale for implementing visual-cognitive challenges throughout the return to sport (RTS) continuum, and (3) presents a framework for implementing visual-cognitive challenges from the acute phases of rehabilitation. The 'Visual-Cognitive Control Chaos Continuum (VC-CCC) framework consists of five training difficulties that progress visual-cognitive challenges from high control to high chaos, to better represent the demands of sport. CLINICAL APPLICATION: The VC-CCC framework augments traditional rehabilitation so that each exercise can progress to increase difficulty and promote sensorimotor and visual-cognitive adaptation after ACL-R.

Combined Effects of Manual Therapy and Functional Electrical Stimulation on Torticollis among Adults

Background: Acquired muscular torticollis is a common musculoskeletal disorder that occurs after birth due to various etiologies. This condition is characterized by the abnormal tilt and twist of the neck muscles, causing significant discomfort and functional impairment. Objective: This study aimed to investigate the combined effects of manual therapy and functional electrical stimulation (FES) on adults with acquired torticollis. Methods: A 45-year-old male patient with acquired torticollis was evaluated using a detailed general movement assessment and an arthrodial goniometer to measure cervical ranges of motion. The patient exhibited tightness of the right sternocleidomastoid (SCM) muscle with limited ranges of motion. The treatment protocol included both manual therapy and electrotherapy for three months, with sessions conducted four days per week, each lasting 40 minutes. Manual therapy consisted of soft tissue mobilization, stretching of the right SCM, and isometric exercises for the left SCM. Electrotherapy included transcutaneous electrical nerve stimulation (TENS), DL2 stimulator, infrared radiation therapy (IRR), and ultrasonic therapy. The patient’s cervical ranges of motion were measured before and after the intervention to assess the effectiveness of the combined therapy. Results: Significant improvements were observed in the patient’s cervical ranges of motion after the 12-week treatment protocol. The mean lateral flexion of the affected right SCM improved from 35 degrees to 20 degrees, and the mean rotation improved from 43 degrees to 28 degrees. These changes indicate a noticeable improvement in both the ranges of motion and posture of the patient. Conclusion: The combined effects of manual therapy and functional electrical stimulation significantly improved the cervical ranges of motion and overall posture in an adult patient with acquired torticollis. These findings suggest that integrating multiple therapeutic modalities can enhance treatment outcomes for musculoskeletal deformities.

Association of Patient-Surgeon and Patient-Physical Therapist Relationships With Return to Sports After ACL Reconstruction: The Untested Dimension in Outcome Assessments.

The Quality of Patient-Surgeon Relationship (QPASREL) is an 11-item questionnaire developed and validated to assess the relationship between practitioners and patients on recovery and return to work after surgery. To evaluate the association of patient-surgeon relationship (PSR) and patient-physical therapist relationship (PPR), as measured by QPASREL, with a patient's return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). Case-control study; Level of evidence, 3. This study targeted patients who underwent primary ACLR at a specialized sports surgery referral center between January and May 2021. Patients who had revision surgery, multiligamentous knee injury, and sedentary status were excluded from the study. Patients were grouped based on ability to RTS at the preinjury level 1 year postoperatively (RTS group and no-RTS group). The primary outcome was rate of RTS at 1 year postoperatively, and the primary dependent variables were the quality of PSR and PPR as measured by QPASREL scores at 6-month intervals. Secondary outcomes were the correlation and discriminative capacity of the QPASREL compared with the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scores (collected at 6-month intervals). The study included 243 patients. Patients in the RTS group exhibited a higher mean PPR QPASREL score (36.6 ± 5.1) compared with no-RTS patients (34.8 ± 5.2; P = .01) as well as a higher mean PSR score (35.7 ± 5.1) compared with no-RTS patients (33.8 ± 5.9; P = .01). Multivariate analysis showed that every 5-point increase in the QPASREL scores for PPR and PSR resulted in a 39% (odds ratio [OR] = 1.39; P = 0.014) and 35% (OR = 1.35, P = 0.021) increased odds of RTS, respectively. A weak yet positive correlation was found between QPASREL and ACL-RSI. The predictive capacity of the QPASREL (area under the curve [AUC] = 0.60 for PPR and 0.61 for PSR), although significant, was less powerful compared with that of the ACL-RSI (AUC = 0.73). The quality of the PPR and PSR, as measured by QPASREL scores, demonstrated a significant association with RTS rates at 1 year after ACLR. A weak yet positive correlation was found between QPASREL and ACL-RSI.

Comparable Clinical and Functional Outcomes Between Osteochondral Allograft Transplantation and Autologous Chondrocyte Implantation for Articular Cartilage Lesions in the Patellofemoral Joint at a Mean Follow-up of 5 Years

To assess clinical outcomes and return to sport (RTS) rates among patients who undergo osteochondral allograft (OCA) transplantation and autologous chondrocyte implantation (ACI) or matrix-induced autologous chondrocyte implantation (MACI), for patellofemoral articular cartilage defects. A retrospective review of patients who underwent an OCA or ACI/MACI from 2010 to 2020 was conducted. Patient-reported outcomes collected included visual analog scale for pain/satisfaction, Knee Injury and Osteoarthritis Outcome Score (KOOS), and RTS. The percentage of patients that met the patient acceptable symptom state for KOOS was recorded. Logistic regression was used to identify predictors of worse outcomes. A total of 95 patients were included (78% follow-up) with ACI or MACI performed in 55 cases (57.9%) and OCA in 40 (42.1%). A tibial tubercle osteotomy was the most common concomitant procedure for OCA (66%) and ACI/MACI (98%). Overall, KOOS pain was significantly poorer in OCA than ACI/MACI (74.7, 95% confidence interval 68.1-81.1 vs 83.6, 95% confidence interval 81.3, 88.4, P= .012), whereas the remaining KOOS subscores were nonsignificantly different (all P > .05). Overall, RTS rate was 54%, with no significant difference in return between OCA or ACI/MACI (52% vs 58%, P= .738). There were 26 (27%) reoperations and 5 (5%) graft failures in the entire group. Increasing age was associated with lower satisfaction in OCA and poorer outcomes in ACI/MACI, whereas larger lesion area was associated with lower satisfaction and poorer outcomes in ACI/MACI. Clinical and functional outcomes were similar in patients who underwent OCA or ACI/MACI for patellofemoral articular cartilage defects at a mean follow-up of 5 years. Patients who received OCA had a greater proportion of degenerative cartilage lesions and, among those with trochlear lesions, reported greater pain at final follow-up than their ACI/MACI counterparts. Overall, increasing age and a larger lesion size were associated with worse patient-reported outcomes. Level III, retrospective cohort study.

Blood Flow Restriction Therapy After Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament reconstruction (ACLR) rehabilitation necessitates restoration of quadriceps strength to minimize reinjury and optimize return to sport (RTS). Patients recovering from ACLR are limited by pain and activity restrictions, resulting in quadriceps muscle atrophy. Blood flow restriction (BFR) therapy involves performing exercises while a specialized blood pressure cuff is applied to the proximal aspect of the operative extremity and inflated to 40% to 90% of the arterial occlusion pressure, as determined using Doppler ultrasonography. BFR is theorized to induce an anaerobic environment and metabolic stress during exercise, promoting muscle hypertrophy and strength gains. Although the physiological mechanism has not been fully elucidated, it is theorized that BFR combined with low-load resistance training could yield muscle adaptations comparable to those of high-load resistance training. For ACLR patients with pain and restrictions precluding high-intensity strength training, incorporation of BFR into postoperative rehabilitation protocols could help mitigate quadriceps weakness and promote RTS. Randomized controlled trials report a prolonged, dose-dependent relation between BFR use and quadriceps and hamstring strength gains, improved bone and muscle mass, and earlier RTS, whereas other studies report no significant difference in quadriceps size, strength, or patient satisfaction compared with controls. Furthermore, although generally considered safe, there are rare reports of associated adverse events such as rhabdomyolysis, and BFR should be avoided in patients with a history of thromboembolic disease or peripheral vasculopathy. The literature examining BFR after ACLR is heterogeneous; lacks standardization; and contains broad variation in reported cuff pressures, as well as timing and duration of BFR use, among protocols. Although the use of BFR after ACLR shows promise, further study is necessary to elucidate the efficacy, safety, and optimal protocols.

Quantitative Assessment of True Vocal Fold Movement by the Lateral-Approach Laryngeal Ultrasonography: A Pilot Study

Background/ObjectivesUltrasonography is a new method for subjective and qualitative assessment of true vocal fold movement, and true vocal fold visualization with the lateral approach could be better than that with the anterior approach. Our aim was to explore the feasibility of the lateral-approach ultrasonography in objective and quantitative assessment of true vocal fold movement. MethodsThe lateral-approach laryngeal ultrasonography was performed during calm breathing and breath-holding in young healthy adult volunteers. The morphology and anatomical position of false vocal fold, true vocal fold and arytenoid cartilage were observed and measured through the ultrasonic self-contained measurement function. All parameters, including the distance from false vocal fold to thyroid cartilage lamina, true vocal fold length, and the distance from true vocal fold to thyroid cartilage lamina, were obtained at the end of the calm inspiratory and breath-holding phases. Data were analyzed using a t test (P <0.05). ResultsForty healthy adult volunteers (age 20-34 years, Body Mass Index 19.5-23.8 kg/m2, 20 males and 20 females) with satisfactory ultrasonic images were included in the study. There were no significant differences in all laryngeal parameters between the left and right sides in either phase (P > 0.05). From the end of the calm inspiratory phase to the breath-holding phase, changes in all laryngeal parameters were significantly different (P < 0.05), regardless of gender. ConclusionsThis study demonstrated that the lateral-approach laryngeal ultrasonography seemed feasible to quantify and objectively assess true vocal fold movement, utilizing differences between laryngeal parameters before and after true vocal fold movement.

Motor competence is related to acquisition of error-based but not reinforcement learning in children ages 6 to 12

BackgroundAn essential component of childhood development is increasing motor competence. Poor motor learning is often thought to underlie impaired motor competence, but this link is unclear in previous studies. AimsOur aim was to test the relationship between motor competence and motor learning in the acquisition phase. Both reinforcement learning (RL) and error-based learning (EBL) were tested. We hypothesized that slower RL and slower EBL acquisition rates would relate to lower motor competence. Methods and proceduresEighty-six participants ages 6–12 performed a target throwing task under RL and EBL conditions. The Movement Assessment Battery for Children – 2nd edition (MABC-2) provided a measure of motor competence. We assessed EBL and RL acquisition rates, baseline variability, and baseline bias from the throwing task. Outcomes and resultsIn a multiple linear regression model, baseline variability (β = −0.49, p = <0.001) and the EBL acquisition rate (β = −0.24, p = 0.018) significantly explained the MABC-2 score. Participants with higher baseline variability and slower EBL acquisition had lower motor competence scores. The RL acquisition rate was independent of MABC-2 score suggesting that RL may be less of a contributor to poor motor competence. Conclusions and implicationsChildren with slower EBL acquisition had lower motor competence scores but RL acquisition was unrelated to the level of motor competence. Emphasizing the unrelated reinforcement mechanisms over error-based mechanisms during motor skill interventions may help children with poor motor competence better acquire new motor skills.

Tablet-Based Cognitive and Eye Movement Measures as Accessible Tools for Schizophrenia Assessment: Multisite Usability Study.

Schizophrenia is a complex mental disorder characterized by significant cognitive and neurobiological alterations. Impairments in cognitive function and eye movement have been known to be promising biomarkers for schizophrenia. However, cognitive assessment methods require specialized expertise. To date, data on simplified measurement tools for assessing both cognitive function and eye movement in patients with schizophrenia are lacking. This study aims to assess the efficacy of a novel tablet-based platform combining cognitive and eye movement measures for classifying schizophrenia. Forty-four patients with schizophrenia, 67 healthy controls, and 41 patients with other psychiatric diagnoses participated in this study from 10 sites across Japan. A free-viewing eye movement task and 2 cognitive assessment tools (Codebreaker task from the THINC-integrated tool and the CognitiveFunctionTest app) were used for conducting assessments in a 12.9-inch iPad Pro. We performed comparative group and logistic regression analyses for evaluating the diagnostic efficacy of the 3 measures of interest. Cognitive and eye movement measures differed significantly between patients with schizophrenia and healthy controls (all 3 measures; P<.001). The Codebreaker task showed the highest classification effectiveness in distinguishing schizophrenia with an area under the receiver operating characteristic curve of 0.90. Combining cognitive and eye movement measures further improved accuracy with a maximum area under the receiver operating characteristic curve of 0.94. Cognitive measures were more effective in differentiating patients with schizophrenia from healthy controls, whereas eye movement measures better differentiated schizophrenia from other psychiatric conditions. This multisite study demonstrates the feasibility and effectiveness of a tablet-based app for assessing cognitive functioning and eye movements in patients with schizophrenia. Our results suggest the potential of tablet-based assessments of cognitive function and eye movement as simple and accessible evaluation tools, which may be useful for future clinical implementation.

Do Children with Co-Occurring ADHD and DCD Differ in Motor Performance?

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.

Preparation of Non Locomotor Basic Movement Assessment Instruments for Class III Moderate Mentally Retarded Children at SLB Negeri Luragung Kuningan

Assessment is an access used to determine the abilities, difficulties and needs of a child which is then used as a reference to develop an appropriate learning program. A teacher, especially a teacher who handles children with special needs, is required to be able to compile assessment instruments that are suitable for the children he handles. The purpose of this study was to develop a non-locomotor basic motion assessment instrument for class III moderate mental retardation child at SDLB SLB Negeri Luragung. Non-locomotor basic movements are used in learning activities usually in warming up or cooling down during sports that contain motion patterns such as bending, twisting, swinging and bending. This study used a qualitative approach and descriptive method. The data in this study were obtained from observations, interviews, FGDs, and validation. The results of observations made by research to three grade III moderate mental retardation child show that children experience obstacles in gross motor non-locomotor basic movements such as in sports lessons during warm-ups the child looks stiff and less able to maintain body balance so as not to fall, while in daily activities maintaining body balance while doing activities in place is very necessary. Therefore, researchers are interested in compiling a non-locomotor basic motion assessment instrument for grade III moderate disability children to find out more about what the child's difficulties are in basic non-locomotor movements, then the results of the assessment instruments that have been prepared are validated to determine readability and applicability.

'We did everything by phone': a qualitative study of mothers' experience of smartphone-aided screening of cerebral palsy in Kathmandu, Nepal.

International guidelines recommend early intervention to all children at risk of cerebral palsy, but targeted screening programs are often lacking in low- and middle-income settings with the highest burden of disease. Smartphone applications have the potential to improve access to early diagnostics by empowering parents to film their children at home followed by centralized evaluation of videos with General Movements Assessment. We explored mothers' perceptions about participating in a smartphone aided cerebral palsy screening program in Kathmandu, Nepal. This is an explorative qualitative study that used focus group discussions (n = 2) and individual interviews (n = 4) with mothers of term-born infants surviving birth asphyxia or neonatal seizures. Parents used the NeuroMotion™ smartphone app to film their children at home and the videos were analysed using Precthl's General Movements Assessment. Sekhon et al.'s framework on the acceptability of health care interventions guided the design of the group discussions and interviews, and the deductive qualitative content analysis. Mothers were interested in engaging with the programme and expressed hope it would benefit their children. Most felt using the app was intuitive. They were, however, unclear about the way the analysis was performed. Support from the research team was often needed to overcome an initial lack of self-confidence in using the technology, and to reduce anxiety related to the follow-up. The intervention was overall perceived as recommendable but should be supplemented by a face-to-face consultation. Smartphone aided remote screening of cerebral palsy is acceptable in a lower middle-income population but requires additional technical support.

A self-supervised spatio-temporal attention network for video-based 3D infant pose estimation

General movement and pose assessment of infants is crucial for the early detection of cerebral palsy (CP). Nevertheless, most human pose estimation methods, in 2D or 3D, focus on adults due to the lack of large datasets and pose annotations on infants. To solve these problems, here we present a model known as YOLO-infantPose, which has been fine-tuned, for infant pose estimation in 2D. We further propose a self-supervised model called STAPose3D for 3D infant pose estimation based on videos. We employ multi-view video data during the training process as a strategy to address the challenge posed by the absence of 3D pose annotations. STAPose3D combines temporal convolution, temporal attention, and graph attention to jointly learn spatio-temporal features of infant pose. Our methods are summarized into two stages: applying YOLO-infantPose on input videos, followed by lifting these 2D poses along with respective confidences for every joint to 3D. The employment of the best-performing 2D detector in the first stage significantly improves the precision of 3D pose estimation. We reveal that fine-tuned YOLO-infantPose outperforms other models tested on our clinical dataset as well as two public datasets MINI-RGBD and YouTube-Infant dataset. Results from our infant movement video dataset demonstrate that STAPose3D effectively comprehends the spatio-temporal features among different views and significantly improves the performance of 3D infant pose estimation in videos. Finally, we explore the clinical application of our method for general movement assessment (GMA) in a clinical dataset annotated as normal writhing movements or abnormal monotonic movements according to the GMA standards. We show that the 3D pose estimation results produced by our STAPose3D model significantly boost the GMA prediction performance than 2D pose estimation. Our code is available at github.com/wwYinYin/STAPose3D.

Early Detection and Intervention for Children with High Risk of Cerebral Palsy: A Survey of Physical Therapists and Occupational Therapists in Brazil

Aims The purpose of this study was to assess the current clinical practice of physiotherapists and occupational therapists on early detection and early intervention for children with cerebral palsy (CP) in Brazil. Methods This was a cross-sectional study. A purpose-developed electronic survey was disseminated across the country to physiotherapists and occupational therapists working with young children with or at risk of CP. Results A total of 205 anonymous respondents were included. Most participants (64.4%) agree that the diagnosis of CP can be made before 6 months of age. General Movements Assessment (26.8%) and Hammersmith Infant Neurological Examination (37.1%) were used infrequently. Infants at risk for CP receive therapy twice a week or more by 58.5% of therapists, 93.2% identified parents’ goals as the most important factor in customizing the early intervention program. The most frequent intervention strategies for this age group were active stimulation of the child (n = 182), family training (n = 161), strategies to optimize the environment (n = 143), and neurodevelopmental treatment/Bobath (n = 99). Conclusions Currently, pediatric physiotherapists and occupational therapists in Brazil do not fully incorporate best practice tools for early identification of children with CP, nor sufficient best evidence-based interventions.

Effect of osteopathic manipulation using SSDV protocol on improving motor coordination and hand eye coordination in children with developmental coordination disorder: a protocol for randomized controlled trial

Developmental Coordination Disorder (DCD) significantly impacts motor coordination and hand-eye coordination in children, affecting their daily activities and academic performance. This study aims to investigate the efficacy of Physical Rehabilitation utilizing the Sensory Stimulation and Developmental Vestibular (SSDV) protocol in improving motor coordination and hand-eye coordination in children diagnosed with DCD. Children diagnosed with DCD will be recruited and randomly allocated to either the intervention group receiving Physical Rehabilitation using the SSDV protocol or the control group receiving standard care. The intervention will involve a structured program incorporating sensory stimulation and developmental vestibular activities tailored to the individual needs of participants. Motor coordination and hand-eye coordination will be assessed using standardized measures such as the Movement Assessment Battery for Children (MABC) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI). Assessments will be conducted at baseline, post-intervention, and follow-up time points. This randomized controlled trial seeks to evaluate the effectiveness of Physical Rehabilitation using the SSDV protocol in enhancing motor coordination and hand-eye coordination in children with DCD. By employing standardized measures, this study aims to provide objective insights into the impact of the intervention. Findings from this trial may contribute to the development of evidence-based interventions for children with DCD, potentially improving their motor skills and overall functioning in daily life and academic settings. Registration: CTRI/2024/03/064467

Reliability and responsiveness of the Swedish short Hip-RSI.

The aim of this study was to examine test-retest reliability and responsiveness of the short version (6-item) Hip Return to Sport after Injury (Hip-RSI) scale in patients following hip arthroscopy. The study included 100 hip arthroscopy patients responding to a digital survey including the short version (6-item) Hip-RSI, International Hip Outcome Tool (short version) (iHOT-12) and RTS status 3, 6 and 9 months following surgery. The Hip-RSI was administered twice at 3-month follow-up. Test-retest reliability was evaluated using intraclass correlation coefficients. Responsiveness was tested by correlations between changes in Hip-RSI and iHOT-12 scores and by comparing change in Hip-RSI scores of patients who progressed on the return to sport (RTS) continuum (from return to any sport to return to performance) to patients who did not, using independent samples t-tests. Hip-RSI was found to have excellent test-retest reliability on the individual (intraclass correlation coefficient, ICC [95% confidence interval, CI]: 0.90 [0.83-0.94]) and group level (ICC [95% CI]: 0.95 [0.91-0.97]) with a standard error of measurement of 5.53 and smallest detectable change of 15.3 on the individual and 2.2 on the group level. Hip-RSI was found responsive to change through positive correlations of changes in scores with changes in iHOT-12 scores from 3 to 6 months (r [95% CI]: 0.51 [0.35-0.65]; p < 0.001) and from 3 to 9 months following arthroscopy (r [95% CI]: 0.61 [0.57-0.79); p < 0.001). Further responsiveness was shown by significant mean changes in scores among patients that progressed on the RTS-continuum (3-6 months: 8.6 [95% CI: 3.8- 13.5); 3-9 months: 12.6 [5.6-19.7]). The short version (6-item) Hip-RSI demonstrated excellent test-retest reliability and responsiveness to change in the evaluation of psychological readiness to RTS following hip arthroscopy. Level II.