ECSS Paris 2023: OP-MH17
INTRODUCTION: With the advancement of medical technology and sports science, postoperative rehabilitation options for patients are diversifying. After knee surgery, rehabilitation not only restores joint function but also athletic performance and daily activity. For active individuals or athletes, satisfaction with the rehabilitation process plays a crucial role, as it influences engagement and adherence to rehabilitation programs. This study aims to evaluate the efficacy and satisfaction of telerehabilitation for knee surgery patients (including knee arthroplasty, meniscectomy, and ACL reconstruction) and compare telerehabilitation with traditional outpatient and face-to-face rehabilitation in terms of motor function restoration and athletic performance improvement. METHODS: We conducted electronic searches in six major databases (Web of Science, PubMed, MEDLINE, ScienceDirect, EMBASE, and Cochrane Library) and manually reviewed references in relevant journals to identify randomized controlled trials (RCTs) on telerehabilitations impact on motor function recovery and satisfaction for knee surgery patients. Data extraction and quality evaluation were performed by two independent evaluators. Data were analyzed using RevMan 5.4 software. RESULTS: Twenty RCTs involving 2242 patients were included. The primary endpoint was patient satisfaction, with secondary endpoints including KOOS, WOMAC, TUG, and ROM. Telerehabilitation showed no significant difference in overall patient satisfaction compared to traditional rehabilitation (mean difference = 0.15; 95% CI = -0.23 to 0.53; p = 0.44). However, satisfaction was significantly higher for interventions using software or web-based platforms (mean difference = 0.56; 95% CI = 0.08 to 1.03; p = 0.02), while videoconferencing and telephone interventions showed lower satisfaction (mean difference = -0.52; 95% CI = -1.02 to -0.02; p = 0.04). Telerehabilitation also outperformed traditional rehabilitation in motor function recovery, especially in knee extension (p = 0.003) and motor performance (p = 0.02), as measured by the TUG test. It also significantly improved WOMAC and KOOS scores (p=0.007 and p=0.01), but the improvement in knee flexion was not significant (p=0.47). CONCLUSION: Telerehabilitation is superior to traditional rehabilitation in improving motor function and performance after knee surgery, both in objective metrics (TUG, ROM) and subjective scores (WOMAC, KOOS). Using web-based platforms for telerehabilitation not only enhances motor recovery but also increases patient satisfaction. For active individuals or athletes seeking rapid recovery of motor abilities, telerehabilitation using web-based platforms shows great potential as an effective alternative to traditional rehabilitation, especially in improving athletic performance and enhancing motor ability.
Read CV Yuang WangECSS Paris 2023: OP-MH17
INTRODUCTION: Knee extension deficits are common following anterior cruciate ligament tear and reconstruction (ACLR) and may remain for multiple years [1]. However, limited literature exists on other knee and lower extremity motions, such as knee flexion and valgus/varus following ACLR. While range of motion (ROM) is commonly recorded in clinical practice statically, using handheld goniometers, recent advancements in technology enable clinicians to analyze ROM and screen for imbalances during dynamic movements. The purpose of this project was to compare long-term knee and lower extremity ROM between ACLR and non-ACLR limbs during an air squat in former secondary school athletes using motion capture technology. We hypothesized that ACLR limbs would have deficits in knee, tibial, and ankle ROM when compared to the non-ACLR limb. METHODS: Twenty (18 female, 2 male) former secondary school athletes (age=20.2±1.6 years) who had prior ACLR during sport and were medically cleared for unrestricted activity/return-to-sport (range=1-5 years post), completed a 5-repetition, double leg, air squat while being recorded using the TRAZER motion capture system [2]. Measures consisted of average degrees (°) of ROM across the 5 repetitions for knee flexion, knee valgus/varus, tibial angle, and ankle dorsiflexion between the ACLR and non-ACLR limbs. A series of Wilcoxon Signed Rank Tests were used to compare ROM between limbs. RESULTS: Significant deficits were observed on knee flexion with decreased ROM in the ACLR limb (108.0±9.8°) as compared to the non-ACLR limb (109.7±10.3°; p=0.03). No ROM differences were observed between limbs on knee valgus/varus (ACLR=1.3±4.0° vs. non-ACLR=2.8±4.6°; p=0.10), tibial angle (ACLR=26.1±4.4° vs. non-ACLR=27.0±4.2°; p=0.09), or ankle dorsiflexion (ACLR=10.3±5.5° vs. non-ACLR=11.3±5.3°; p=0.023). CONCLUSION: Long-term ROM deficits were observed in knee flexion only with less ROM in the ACLR limb. It is possible that these knee flexion deficits mirror knee extension lag, however it is unclear whether these limb disparities become apparent in years following medical clearance or persisted throughout the ACLR rehabilitation. Additionally, knee flexion limb disparities may also only exist in more dynamic tasks and therefore, future research is needed to compare motion capture and goniometer measures. References: 1. Scholes C, Ektas N, Harrison-Brown M, et al. Persistent knee extension deficits are common after anterior cruciate ligament reconstruction: a systematic review and meta-analysis of randomised controlled trials. Knee Surg Sports Traumatol Arthrosc. 2023;31(8):3172-3185. 2. Hogg JA, Carlson LM, Rogers A, Briles MW, Acocello SN, Wilkerson GB. Reliability and concurrent validity of TRAZER compared to three-dimensional motion capture. J Clin Transl Res. 2021;7(1):100-107.
Read CV Ryan MoranECSS Paris 2023: OP-MH17
INTRODUCTION: Youth football players are particularly vulnerable to apophyseal injuries, which can have long-term consequences for health and performance. The objective was to assess the incidence, severity, and burden of apophyseal injuries among U9–U21 academy football players over two seasons. METHODS: Time-loss injuries and match and training exposure minutes were tracked in male academy football players (U9–U21) from Premier League and Category One Academies (29 academies in the 2021-22 season and 31 in the 2022/23 season). Apophyseal injuries were identified using OSICS codes, and their incidence, severity, and burden were analysed. RESULTS: A total of 10,589 injuries were reported, including 603 apophyseal injuries. These injuries followed a distal-to-proximal progression with age, occurring most frequently in the ankle (U9–U11), followed by the knee (U12) and hip/groin (U15–U18). The incidence (~0.4 injuries/1000 h) and burden (~20 days/1000 h) of apophyseal injuries during match and training sessions were highest in the U12–U16 group. A statistically significant trend of increasing injury severity was observed with age: U9–U11 (median: 20 days), U12–U14 (median: 29 days), U15–U16 (median: 38 days), and U18–U21 (median: 35 days). Ankle and knee apophyseal injuries resulted in the second highest injury burden, compared with all musculoskeletal injuries sustained in the U9–U11 and U12–U14 groups, respectively. CONCLUSION: Apophyseal injuries exhibit a distal-to-proximal progression with age, with the highest injury burden observed in the U12–U16 groups. These findings can help inform injury mitigation strategies adopted in youth academy football.
Read CV Chelsea Louise OxendaleECSS Paris 2023: OP-MH17