bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Changes in Movement and Activity Limitation or Pain in People With Knee Osteoarthritis: A Systematic Review
Authors: Tan Jay-Shian , Tikoft Edward , O'Sullivan Peter , Smith Anne , Campbell Amity , Caneiro J.P. , Kent Peter 
Published: October 2021

Objective To report whether changes in knee joint movement parameters recorded during functional activities relate to change in activity limitation or pain after an exercise intervention in people with knee osteoarthritis (OA). Design Etiology systematic review. Literature Search Four databases (MEDLINE, Embase, CINAHL, and AMED) were searched up to January 22, 2021. Study Selection Criteria Randomized controlled trials or cohort studies of exercise interventions for people with knee OA that assessed change in knee joint movement parameters (moments, kinematics, or muscle activity) and clinical outcomes (activity limitation or pain). Data Synthesis A descriptive synthesis of functional activities, movement parameters, and clinical outcomes. Results From 3182 articles, 22 studies met the inclusion criteria, and almost all were of low quality. Gait was the only investigated functional activity. After exercise, gait parameters changed 26% of the time, and clinical outcomes improved 90% of the time. A relationship between group-level changes in gait parameters and clinical outcomes occurred 24.5% of the time. Two studies directly investigated an individual-level relationship, reporting only 1 significant association out of 8 correlations tested. Conclusion Most studies reported no change in gait-related movement parameters despite improvement in clinical outcomes, challenging the belief that changing movement parameters is always clinically important in people with knee OA. J Orthop Sports Phys Ther 2021;51(10):492–502. doi:10.2519/jospt.2021.10418
Clinical Prediction Models in Sports Medicine: A Guide for Clinicians and Researchers
Authors: Bullock Garrett S. , Hughes Tom , Sergeant Jamie C. , Callaghan Michael J. , Riley Richard D. , Collins Gary S. 
Published: October 2021

Synopsis Participating in sport carries inherent risk of injury. Clinicians execute high-level clinical reasoning and decision making to support athletes to achieve the best outcomes. Accurately diagnosing a problem, estimating prognosis, or selecting the most suitable intervention for each athlete is challenging. Clinical prediction models are tools to assist clinicians in estimating the risk or probability of a health outcome for an individual by using data from multiple predictors. Although common in general medical literature, clinical prediction models are rare in sports medicine. The purpose of this article was to (1) describe the steps required to develop and validate (ie, evaluate) a clinical prediction model for clinical researchers, and (2) help sports medicine clinicians understand and interpret clinical prediction model studies. Using a case study to illustrate how to implement clinical prediction models in practice, we address the following issues in developing and validating a clinical prediction model: study design and data, sample size, missing data, selecting predictors, handling continuous predictors, model fitting, internal and external validation, performance measures, reporting, and model presentation. Our work builds on initiatives to improve diagnostic and prognostic clinical research, including the PROGnosis RESearch Strategy (PROGRESS) series of papers and textbook and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement. J Orthop Sports Phys Ther 2021;51(10):517–525. doi:10.2519/jospt.2021.10697
Spontaneous spinal cerebrospinal fluid venous-fistula treated with transvenous embolization: A case report
Authors: Aljuboori Zaid , McGrath Margaret , Essibayi Muhammed Amir , Zaidi Saif , Hallam Danial , Ghodke Basavaraj 
Published: September 2021

Background:
Spinal cerebrospinal fluid venous fistula (CVF) is a recognized cause of chronic positional headache and spontaneous intracranial hypotension (SIH). It occurs due to an aberrant connection formed between the spinal subarachnoid space and an adjacent spinal epidural vein. The diagnosis of CVF can be difficult to establish but can be documented utilizing advanced imaging techniques (e.g., enhanced MR myelography/digital subtraction myelography). Their treatment involves surgical ligation of the involved nerve root, imaging-guided epidural blood patching, and/or endovascular embolization. Here, we report a 40-year-old male who presented with a symptomatic lumbar CVF successfully treated with transvenous embolization.

Case Description:
A 40-year-old male presented with several months of positional headaches. The MRI of the brain showed diffuse pachymeningeal enhancement consistent with the diagnosis of SIH. Although the MR of the lumbar spine was unremarkable, the MR myelogram with digital subtraction imaging showed a CVF at the L2 level. Following transvenous embolization (i.e., through the Azygous vein), the patient’s symptoms fully resolved.

Conclusion:
Spinal CVF are rare and may cause chronic headaches and symptoms/signs of SIH. In this case, an MR myelogram with digital subtraction images demonstrated the anomalous connection between the spinal subarachnoid space and an adjacent spinal epidural vein at the L2 level. Although open surgical ablation of this connection may be feasible, less invasive techniques such as endovascular embolization should become the treatment of choice for the future management of CVF.
Evaluation of patient satisfaction and the color difference between natural teeth and all-ceramic crowns fabricated from "Celtra press" treated with different surface finishing protocols. (Randomized controlled clinical trial)
Authors: Nourhan Sayed Saleh Ahmed, Mohamed Labib Zamzam, Maha Taymou Nourhan Sayed Saleh Ahmed, Mohamed Labib Zamzam, Maha Taymou 
Published: October 2021

All studies agree that glazing can produce a smooth porcelain surface, but although the glaze is an important factor in esthetics, with respect to light reflection, it can frequently change the color value of the restorations, reflecting more light than the natural teeth, thus creating an artificial effect on these restorations. A number of more recent studies have suggested that a polished surface may be as acceptable as a glazed surface. Many ceramists prefer polishing instead of glazing to control the surface luster. Other studies have reported no significant differences between polished and glazed surfaces.Since studies addressing the effect of surface finishing protocols on the color of ZLS ceramics are rare, thus our study is important to investigate this issue. Methodology: 20 teeth esthetic zone requiring full - coverage crown -with their contralateral are sound and not severely discolored - were prepared to receive an all -ceramic crown. The crowns are divided into two groups: Group I: Teeth received crowns fabricated from glazed Celtra Press ceramic Group II: Teeth received crowns fabricated from polished Celtra Press. The color difference ΔE was measured using an intraoral spectrophotometer and evaluated for each group. Shade matching to the contralateral tooth was evaluated by 2 experienced prosthodontists according (USPHS) criteria. Patient satisfaction of the two groups assessed using the (VAS) scale which is Binary and documented in the chart. Results: Patient satisfaction was graded according to the (VAS) scale. There was no statistically significant difference between (Group I) and (Group II). The color change was recorded according to the (ΔE), the polished Celtra Press group recorded statistically non-significant higher color changes than the glazed Celtra Press group. shade matching was graded according to USPHS, where in Glazed Celtra Press group most of the patients stated Alpha score (80%) while minority showed Bravo score (20%). In the Polished Celtra Press group, all of the patients informed Bravo score100%. Conclusion: Within the limitations of this clinical study: Glazed and polished Celtra Press full coverage restorations revealed excellent patient satisfaction. Glazed celtra restorations have a clinically more acceptable shade matching.
Congenital Cytomegalovirus Infection: Transmission, Diagnosis and Treatment.
Authors: Manan Muhammad Romail , Manan Hamna 
Published: October 2021

Introduction: Cytomegalovirus (CMV) is a linear, dsDNA virus that is regarded as the prototype of the Betaherpesvirinae subfamily of viruses. It has an established endemic status in certain locations around the globe, and is also reported to be the most prevalently occurring congenital infection in humans. Furthermore, Cytomegalovirus is notorious for being a persistent lifelong pathogen that poses a threat of reactivation as well.
Discussion: Congenital cytomegalovirus infection causes numerous ophthalmologic, and neurologic sequelae, and is also known for being the principal reason behind sensorineural hearing loss of non-genetic etiology in neonates. These symptoms, if present, may give rise to a premonition of congenital Cytomegalovirus disease, and so, a diagnosis can be established through serology, radiology, and PCR of salivary, urinary, or dried blood spot samples. Timely administration of ganciclovir or valganciclovir has proven to be effective in managing symptomatic cases of congenital CMV.
Conclusion: A well-timed delivery of pharmacological and non-pharmacological interventions is necessary to achieve healthy developmental outcomes for the neonate. Moreover, there is still a need to study the role of antiviral therapy in silent cases since asymptomatic patients are at a risk of developing long-term clinical sequelae as well.
Relevance: An estimated 60-90% of women of child-bearing age get infected with Cytomegalovirus, and Congenital CMV disease is reported in 0.2-2.4% of all live births. Therefore, in order to develop effective screening and management protocols, it is vital to educate healthcare professionals regarding the various aspects of this congenital infection.
Utilizing Hip Abduction Strength to Body-Weight Ratios in Return to Sport Decision-Making After ACL Reconstruction
Authors: Higbie Steven , Kleihege Jacquelyn , Duncan Brian , Lowe Walter R. , Bailey Lane 
Published: October 2021

Background Despite the association between hip abduction weakness and non-contact anterior cruciate ligament (ACL) injury, hip abduction strength is rarely considered in return to sport decision-making following ACL reconstruction (ACLR). Hypothesis/Purpose The purpose of this study was to compare self-reported function, objective functional test performance, and re-injury rates in patients with high (≥33%) versus low (<33% ) isometric hip abduction strength to body weight (BW) ratios when returning to activity following ACLR. Study Design Cohort study Methods Data were gathered from a single-surgeon database and included baseline demographics. Clinical outcomes were assessed at the time of release to activity and included self-reported outcomes and a functional testing battery. Isometric hip abduction strength was obtained using a handheld dynamometer. Groups were dichotomized into those with low vs high strength to BW ratios. Two-year follow-up was performed using the single assessment numeric evaluation (SANE). Data were analyzed using univariate general linear models with an alpha level of .05. Results Of the 528 enrolled patients, 364 (68.9%) demonstrated a low strength to BW ratio. Baseline comparisons revealed more females and higher BMI (P <.05) in the <33% group. At release to activity, the <33% BW group demonstrated lower International Knee Documentation Committee survey scores (88.2 ± 13.6 vs 93.5 ± 10.3, P<.01), ACL-Return to Sport After Injury (76.2 ± 15.4 vs 88.5 ± 16.9, P<.01) scores, and isokinetic hamstring peak torque (P=.04). At 2-years, the <33% group reported lower SANE scores (83.3 ± 21.1 vs 92.83 ± 11.4, P=.05) with no significant differences in re-injuries. Conclusion Patients with low hip abduction strength to BW ratios demonstrated lower subjective function, psychological readiness, and isokinetic hamstring peak torque when completing functional testing following ACLR. Subjective deficits remained at 2-years. Level of Evidence Level 3 Key Terms ACL injury, hip abduction strength, return to sport, strength ratio Clinical Relevance Assessing isometric hip abduction strength to body weight ratio may be beneficial in determining readiness to return to sport following ACL reconstruction. What is Known About the Subject Three prospective studies have provided conflicting evidence regarding the relationship between hip abduction strength and ACL injury. A clinical cut-point of hip abduction strength:BW ratio <35.4% has been suggested to identify athletes at risk of sustaining a non-contact ACL injury. To our knowledge no studies have examined isometric hip abduction strength:BW ratios in athletes attempting to return to sport following ACLR. What This Study Adds to Existing Knowledge This study examines the potential for hip abduction strength:BW ratio to be included as an additional metric in return to sport testing batteries.
Fractures and Chronic Recurrence are Commonly Associated with Ankle Sprains: a 5-year Population-level Cohort of Patients Seen in the U.S. Military Health System
Authors: Rhon Daniel I , Greenlee Tina A , Cook Chad E , Westrick Richard B , Umlauf Jon A , Fraser John J 
Published: October 2021

Background Whereas ankle-foot injuries are ubiquitous and affect ~16% of military service-members, granularity of information pertaining to ankle sprain subgroups and associated variables is lacking. The purpose of this study was to characterize and contextualize the burden of ankle sprain injuries in the U.S. Military Health System. Methods This was a retrospective cohort study of beneficiaries seeking care for ankle sprains, utilizing data from the Military Health System Data Repository from 2009 to 2013. Diagnosis and procedural codes were used to identify and categorize ankle sprains as isolated lateral, isolated medial, concomitant medial/lateral, unspecified, or concomitant ankle sprain with a malleolar or fibular fracture. Patient characteristics, frequency of recurrence, operative cases, and injury-related healthcare costs were analyzed. Results Of 30,910 patients included, 68.4% were diagnosed with unspecified ankle sprains, 22.8% with concomitant fractures, (6.9%) with isolated lateral sprains, (1.7%) with isolated medial sprains and 0.3% with combined medial/lateral sprains. Pertaining to recurrence, 44.2% had at least one recurrence. Sprains with fractures were ~2-4 times more likely to have surgery within one year following injury (36.2% with fractures; 9.7% with unspecified sprains) and had the highest ankle-related downstream costs. Conclusion Fractures were a common comorbidity of ankle sprain (one in five injuries), and operative care occurred in 16.4% of cases. Recurrence in this cohort approximates the 40% previously reported in individuals with first-time ankle sprain who progress to chronic ankle instability. Future epidemiological studies should consider reporting on subcategories of ankle sprain injuries to provide a more granular assessment of the distribution of severity. Level of evidence 3b
The Neuromuscular Effects of the Copenhagen Adductor Exercise: A Systematic Review
Authors: Schaber Morgan , Guiser Zachary , Brauer Logan , Jackson Rebecca , Banyasz John , Miletti Ryan , Hassen-Miller Amy 
Published: October 2021

Background Groin strains are one of the most common time-loss injuries in athletes. The Copenhagen Adductor Exercise (CAE) eccentrically strengthens the adductors and may function to prevent adductor strains, similar to the eccentric mechanism in which the Nordic Hamstrings exercise acts to prevent hamstring strains. Objective The purpose of this study was to systematically review the literature on the CAE and its effects on adductor muscle strength and muscle activity in athletes. Study Design Systematic Review Methods A systematic search of the literature was performed in the following databases: Pubmed; Medline (EBSCO); Sportdiscus; Scopus; Web of Science; CINAHL; Proquest; Cochrane Library; Physiotherapy Evidence Database (PEDro). Inclusion criteria consisted of 1) implements CAE, 2) includes athletes of any age participating in at least one sport, 3) study type is a cohort study or randomized control trial. Studies were excluded if they were not written in English or did not measure strength as an outcome. Data were extracted on eccentric hip adductor strength (EHAD), eccentric hip abductor strength (EHAB), EHAD:EHAB ratio, and electromyography (EMG) activity of the adductor muscles. Quality assessment was performed on all included studies using Quality Assessment Tool for Quantitative Studies. Results Five articles were identified for inclusion, four of which received a strong rating, and one a moderate rating on the Quality Assessment Tool for Quantitative Studies. The CAE significantly increased EHAD in four of the four studies that examined it; significantly increased EHAB and EHAD:EHAB in three of the three studies that examined them, and increased the EMG activity of the adductors in the dominant leg 108%. Conclusion Overall, the CAE increases EHAD, EHAB, EHAD:EHAB, and EMG activity in the hip adductors in male soccer players. The increase in strength may reduce adductor muscle injuries, although more research needs to be done in this area to identify a clear relationship between the CAE and groin injury prevention. Level of Evidence 1b
Effects of Sex and Age on Quadriceps and Hamstring Strength and Flexibility in High School Basketball Athletes
Authors: Nagai Takashi , Bates Nathaniel , McPherson April , Hale Rena , Hewett Timothy , Schilaty Nathan D. 
Published: October 2021

Background Eccentric hamstring strength and hamstring/quadriceps strength ratios have been identified as modifiable risk factors of hamstring strains. Additionally, those strength and flexibility characteristics are commonly used as clinical tests to monitor progress of athletes with acute or chronic hamstring strains. Although hamstring strains are common among basketball athletes, normative values of knee strength and flexibility characteristics are scarce. Normative values for these athletes would be important in prevention and management of hamstring strains. Purpose To establish quadriceps and hamstring isokinetic strength and flexibility values among high school basketball athletes and examine the effects of sex and age. Study Design Cross-sectional research Methods Isokinetic knee muscular strength (concentric quadriceps [QuadC], concentric hamstring [HamC], eccentric hamstring [HamE], and strength ratios ([HamC/QuadC and HamE/Quad]), flexibility of hip flexors and quadriceps during a Modified Thomas test, and flexibility of hip extensors and hamstring during passive straight leg raise (SLR) and passive knee extension (PKE) tests were measured. Effects of sex and age were analyzed using t-tests and analysis of variance, respectively with Bonferroni corrected post hoc tests (p≤0.01). Results A total of 172 high school basketball athletes (64 males/108 females; mean age (range): 15.7 (14-18) years old) participated in the study. Male athletes were significantly stronger than female athletes (QuadC: p<0.001; HamC: p<0.001) while no differences were observed in strength ratio (HamC/QuadC: p=0.759-0.816; HamE/QuadC: p=0.022-0.061). Among male athletes, a significant effect of age on quadriceps and hamstring strength was observed: older male athletes were stronger than younger male athletes. Contrarily, there were no effects of age on strength among female athletes. There were significant sex differences in quadriceps flexibility, SLR, and PKE (female athletes were more flexible; p=0.001-0.005) while no sex differences were found in hip flexor flexibility (p=0.105-0.164). There were no effects of age for any flexibility variables within male and female athletes (p=0.151-0.984). Conclusion The current results provide normative values for hamstring strength and flexibility in high school basketball athletes. These normative values may further assist sports medicine specialists to develop screening tests, interventions, and return-to-sport criteria in this population. Level of Evidence 3B
Grip Strength Measurement in Baseball Pitchers: A Clinical Examination to Indicate Stride Length Inefficiency
Authors: Crotin Ryan , Ramsey Dan 
Published: October 2021

Background Ulnar collateral ligament injuries are rampant in the sport of baseball where kinetic chain impacts, stemming from misappropriation of stride length or changes that occur in competition due to fatigue, have not been evaluated for dynamic elbow stability effects. Hypothesis/Purpose To examine the relationship between clinical measures of grip strength and altered stride length in baseball pitchers. It is believed that shorter stride lengths would reduce grip strength in baseball pitchers. Study Design Crossover Study Design Methods A total of 19 uninjured pitchers (15 collegiate and 4 high school) (age 18.63 ± 1.67 years, height 1.84 ± 0.054 m, mass 82.14 ± 0.054 kg) threw two simulated 80-pitch games at ±25% of their desired stride length recorded by motion capture with two force plates and a radar gun to track each throw. A handheld grip dynamometer was used to record the mean change in grip strength after games from baseline measures. Pairwise comparisons at baseline and post-game denoted grip strength changes and dominant grip strength offsets for stride length conditions. Results Subjects with shorter stride lengths revealed a significant decline in grip strength in the dominant arm from baseline (pre-game; 45.1 kg vs. post-game; 43.2 kg, p=0.017, ES=0.28), however all other tests involving dominant grip strength changes and offset analyses were not statistically different for under-stride and over-stride length conditions. Conclusions Clinical evaluation of grip strength has the potential to identify altered lower body mechanics and may be considered as a safe and effective monitoring strategy to integrate with motion capture in determining optimal stride lengths for baseball pitchers. Level of Evidence Level 3