bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHARACTERISTICS OF SPORTS BRA PREFERENCES IN ADOLESCENT FEMALES
Authors: Rizzone Katherine H. , Edison Bianca , Chung Jane , Ichesco Ingrid K. , Coleman Nailah 
Published: July 2021

Background: For many active females, a sports bra is an essential piece of equipment to comfortably participate in sports. Appropriately fitted, it allows the wearer to focus on the physical activity, rather than their body. While the number of young females participating in sports has continued to increase over recent decades, there is a paucity of literature on this important element of sports gear. Purpose: To characterize the usage and preferences of specific sports bra characteristics in an active female cohort Methods: This cross-sectional, multiceter survey study was conducted at five geographically distinct academic centers. The 19-item measure was administered via REDCap during sports medicine clinic visits. Face and content validity were established through iterative editing of the measure after feedback from area experts and a small sample of the targeted study cohort prior to initial administration. Females aged 13-22 were recruited. Chi-square and t-tests were utilized to assess differences between subgroups. Results: A total of 244 respondents completed the questionnaire. Mean age was 15.9 +/-2.8 years, 17.6% of the cohort was non-white and 10.3% identified as Latina. Mean BMI was 22.9 +/- 4.9, 25.8% were overweight and 11.9% were obese. The most common non-sports bra cup sizes were B (32.0%), A (17.3%) and C (17.3%). Nearly a fourth (23.7%) of the respondents reported that lack of bra support or breast discomfort had prevented them from exercising or being physically active. This was more commonly reported by those who were overweight (28.6%, BMI=25-29) or obese (37.9%, BMI>30) (p=0.08). Almost a quarter of white respondents reported breast discomfort preventing physical activity (23.6%); 20% of Black respondents and 32% of Latina respondents answered affirmatively to this question (p=0.11). Respondents that were bra size C or larger reported that their physical activity was negatively impacted by breast discomfort or lack of support 47.4% of the time, whereas only 15.8% of those with a bra size B or smaller reported the same (p<0.01). The most important factor in sports bra selection was amount of support (44.8%). Conclusions: Breast discomfort and lack of bra support may be an important barrier for young females of specific populations in meeting physical activity recommendations, which could lead to increased weight accrual, thus perpetuating the cycle of discomfort and lack of activity. Further research is needed to understand the issues related to sports bra preferences and usage to help inform future enhancement initiatives for this essential piece of sporting equipment.
EARLY STRENGTH TESTING AFTER ACL RECONSTRUCTION IMPACTS ISOKINETIC STRENGTH PERFORMANCE AT TIME OF RETURN TO SPORT
Authors: Weaver Adam , Roman Dylan , Mosha Maua , Giampetruzzi Nicholas 
Published: July 2021

Background: The standard of care in ACL reconstruction (ACLR) typically involves standardized strength testing at 6 months or later to assess a patient’s readiness to return to play (RTP) using isokinetic and isometric testing, and functional strength testing. Recent literature suggests that isokinetic knee extension strength should demonstrate 89% limb symmetry index (LSI) or greater prior to returning to sport. However, there is little known on the effects of strength testing early in the rehabilitation process and the relationship to strength test performance at time of RTP. Purpose: The purpose of this study was to examine how early post-operative strength test performance impacts isokinetic strength outcomes at RTP testing in adolescents. Methods: The retrospective cohort study included patients undergoing primary ACLR between 12 and 18 years of age, early post-operative strength measures, and isokinetic dynamometer strength at RTP from July 2017 and April 2019. Data was dichotomized into desired outcomes at 3 months: >70% isometric knee extension LSI, > 20 repetitions on anterior stepdown test (AST), > 90% LSI Y Balance. At RTP testing, isokinetic knee extension strength data was categorized into >89% LSI at 3 speeds (300, 180, 60°/sec). Chi square testing and odds ratio statistics were used to examine association and its magnitude. Results: 63 patients met inclusion criteria (38 females; 15.37±1.66 years old). >70% LSI isometric knee extension strength at 3 months showed a significant association (Table 2) and demonstrated the strongest odds of having >89% LSI on isokinetic strength tests at all 3 speeds at RTP with 180°/sec being the highest (OR=14.5; 95% CI=4.25,49.43; p= <0.001). Performance on AST showed a significant association (χ2 (1, n=63) = 17.00, p <0.001), and highest odds at 180°/sec (OR=4.61; 95% CI = 1.59, 13.39, p=<0.001) and 60°/sec (OR= 3.07; 95% CI = 1.10, 8.63, p= 0.04). Combination of performance on isometric strength tests and AST showed a significant association to isokinetic strength at all three speeds, but less predictive then isometrics in isolation. (Table 2). There was no significant relationship between YBR LSI at 3 months and isokinetic strength at 6 months. Conclusion: Standardized strength testing early in rehabilitation can help identify patients that will successfully complete RTP testing. Our results suggest that isometric knee extension strength and timed anterior stepdown test provide meaningful clinical information early in the rehabilitation process. This data also suggests that the use of YBAL for predicting isokinetic strength performance is limited. [Table: see text][Table: see text]
ESTIMATED PERFORMANCE FOR AGE: A NOVEL CRITERION FOR RETURN TO SPORT AFTER ANTERIOR CRUCIATE RECONSTRUCTION AND ITS PERFORMANCE COMPARED TO LIMB SYMMETRY INDICES
Authors: Magill John , Vance Danica , Risoli Thomas , Green Cynthia , Reinke Emily , Reiman Michael , Thorburg Kristian , Riboh Jonathan 
Published: July 2021

INTRODUCTION: The use of physical performance tests (PPT) for assessing readiness for return to sport (RTS) after ACL reconstruction in children is typically assessed based on a limb symmetry index (LSI). However, recent data show that: 1) healthy pediatric athletes have significant limb asymmetries at baseline and 2) the non-operative limb deconditions after ACLR, so return of LSI is not synonymous with return to pre-injury performance. We previously established a cohort of 100 healthy pediatric athletes and created growth curves for performance on 7 common PPT, allowing for the calculation of a performance percentile (PP) for any given individual based on their age. The current study explores the use of PP in a cohort of pediatric patients 6 months out from ACLR. We hypothesized that return to expected performance for age (EPFA, defined as the 50th percentile of performance among healthy volunteers of a given age) would be a more stringent criterion than 90% LSI. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients (< 19 years) undergoing ACL reconstruction between 2016-2019. Patients were excluded if they did not have RTS testing 6 months after surgery (+/- 6 weeks). RTS testing consisted of 7 PPT (Figure 1). Patients were then categorized into passing and failing groups based on two cutoffs: 1) LSI > 90% and 2) PP > EPFA (50th percentile). The prevalence of passing based on these two criteria were compared using contingency analysis. A multivariable linear regression was performed to assess the effects of demographic variables on PP. RESULTS: Sixty-three patients were included (57% male, mean age 14.2 ± 2.4 years). Mean time from surgery to RTS testing was 181.5 ± 15.1 days. More patients were able to achieve 90% LSI than EPFA for all PPT except the timed hop (Figure 1). On average, 58% met LSI > 90% compared to only 41% meeting EPFA. Reaching 90% LSI correlated weakly with reaching EPFA for 4 of the 7 PPTs. However, of patients that would have passed based LSI, only 36.2-63.2% would have passed based on meeting EPFA (Figure 2). There was no consistent effect of age, sex, or graft type on PP. CONCLUSION: Six months after ACL reconstruction, fewer pediatric athletes can meet EPFA than can meet 90% LSI. Additionally, PP does not clearly correlate with LSI, suggesting that these criteria provide complementary information. Future studies investigating the use of EPFA as a cutoff for RTS are warranted. [Figure: see text][Figure: see text]
PATELLOFEMORAL JOINT CARTILAGE RESTORATION WITH PARTICULATED JUVENILE ALLOGRAFT IN PATIENTS UNDER 21 YEARS OLD: POSTOPERATIVE MRI ANALYSIS AND RETURN TO SPORT RATES
Authors: Dawkins Brody J. , Stein Beth E. Shubin , Mintz Douglas N. , Fabricant Peter D. , Gomoll Andreas H. , Strickland Sabrina M. , Aitchison Alexandra H. , Green Daniel W. 
Published: July 2021

Background: Patellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography. Numerous cartilage restoration techniques are available to surgeons treating articular cartilage defects. However, patellofemoral joint restoration historically produces worse outcomes than tibiofemoral joint restoration. One cell-based option is particulated juvenile allograft cartilage (PJAC), though literature regarding the efficacy of this treatment is sparse, especially in patients under the age of 21 years. Hypothesis/ Purpose: The aim of this study is to investigate postoperative outcomes of PJAC for patellofemoral chondral defects using MRI and return to sport rates in this active, high-demand patient population. Methods: Patients at an urban tertiary care musculoskeletal institution who underwent PJAC for patellofemoral joint cartilage restoration were identified through records review. Patients 21 years old or younger with minimum clinical follow-up of 1 year and postoperative MRI at a minimum of 6 months after surgery were included. Cartilage restoration was assessed by MRI using the International Cartilage Repair Society’s standardized system. Sport activity was collected from medical records. Results: Thirty-six knees in 34 patients with a mean age of 16.1 ± 3.1 years old (range 10—21 years old) were analyzed. Mean follow-up was 32.1 months. Defects were located on the patella in 25 knees, and trochlea in 11 knees (Figure 1). There were no bipolar lesions in the cohort. Mean defect size was 2.47 cm2. Twenty-four knees (66.7%) were graded either ‘normal’ or ‘nearly normal’, and 28 knees (77.8%) had greater than 50% of the defect filled on follow-up imaging. Return to sport rates among patients who participated in a sport preoperatively was 100%. Conclusion: Restoration of patellofemoral chondral defects in young patients with particulated juvenile allograft can be performed with satisfactory short-term efficacy, excellent postoperative MRI appearance, and very high rates of return to sport. Tables/Figures: [Figure: see text]
THREE-DIMENSIONAL PREDICTORS OF FAI DISEASE PROGRESSION IN THE CONTRALATERAL HIP
Authors: Fowler Lucas M. , Clohisy John C. , Abu-Amer Wahid , Garrido Cecilia Pascual , Nepple Jeffrey J. 
Published: July 2021

Background: Bony morphologies contributing to femoroacetabular impingement (FAI) are relatively common in the general population, but drivers of symptom development are not well understood. Hypothesis/Purpose: The purpose of this study was to determine the role of three-dimensional bony morphology in symptom development in the contralateral hip in patients undergoing ipsilateral surgical treatment for FAI. Methods: The study included a prospective cohort of 161 consecutive patients (101 females, 60 males) who presented for ipsilateral FAI surgical treatment from 2013-2018. The average age was 29.1 years. Minimum follow-up was 1 year (mean, 2.3 years; range, 1-6 years). Low-dose CT scans were obtained prior to surgical treatment. Three-dimensional hip analysis of the contralateral hip was performed relative to normative data and allowed measurements of 15 key parameters. Prior to surgery and at routine follow-up, patients completed standardized questionnaires that included pain in the contralateral hip. Univariate and multivariate analyses were performed to identify independent predictors. Results: There were 133 patients (83%) with follow-up. Significant levels of pain in the contralateral hip were reported in 25 (18.8%) patients at presentation and 50 (35.3%) patients at follow-up. Twenty-six (19.5%) patients progressed to surgery at an average of 1.12 years. Significant predictors of symptom development were alpha angle >55° at 1:00 (p=0.037), femoral version <0° or > 20° (p=0.027), and decreased central acetabular version at 3:00 (p=0.048). Significant predictors of surgery were age <30 years (p=0.023) and alpha angle >55° at 1:00 (p=0.005). Conclusion: We found that roughly 1 in 5 patients undergoing surgical treatment for ipsilateral FAI experienced pain in the contralateral hip at presentation, over one third reported pain at follow-up, and 1 in 5 progressed to surgery. Higher alpha angle, abnormal femoral version, and decreased acetabular version were correlated with symptom development, while higher alpha angle and age under 30 were associated with progression to surgery.
LOOSE BODY VERSUS TROCHLEAR BIOPSY MATRIX-INDUCED AUTOLOGOUS CHONDROCYTE IMPLANTATION (MACI) MOCART SCORES AND IKDC REPORTED OUTCOMES IN PEDIATRIC PATIENTS
Authors: Hill Z , Delman C , Vandervoort W , Shelton TJ , Haus BM 
Published: July 2021

Background: Third generation autologous chondrocyte implantation (ACI) has traditionally used biopsies from non-weightbearing sites within the knee for culture and growth. Given the potential risk of functional deficits from this procedure, other donor sites are being investigated. A recent study showed no difference in the viability of the MACI implant using biopsies from the standard intercondylar region compared to biopsies from the osteochondral loose body. However, clinical outcomes using these two different donor sites remains unknown. The purpose of this study was to asses differences in clinical outcomes as measured by Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART 2.0) and International Knee Documentation Committee (IKDC) scores at a minimum of 2 years post-implantation in patients who underwent a MACI procedure in the knee using cartilage grown from either the intercondylar notch or the osteochondral loose bodies. Methods: A retrospective study was performed on all ACI procedures from 2014 to 2017 at a single institution. Patients were split into two groups: one group having their cartilage derived from a standard intercondylar biopsy while the other group had their cartilage derived from osteochondral loose bodies. At a minimum 1-year post-implantation, MRIs of the implantation site were performed and three individual orthopaedic surgeons used the MOCART 2.0 knee score to assess the cartilage. Interclass correlation coefficients (ICC) were calculated between the 2 groups. IKDC scores were determined at a minimum 2 years after implantation. Differences between outcomes were compared using a Wilcoxon rank-sum test. Results: The intraclass coefficient between examiners for the MOCART scoring was excellent at 0.94. With regards to the MOCART score, the loose body group had a statistically insignificant 15-point lower median score at 65 (IQR 61-83) compared to the intercondylar group at 80 (IQR 60-89) (p=0.46). With regards to the IKDC, the loose body group had a statistically insignificant 1-point higher median score at 85 (IQR 69-96) compared to the intercondylar group at 84 (IQR 53-99) (p=0.79). Conclusions: This study demonstrates no difference in MOCART and patient reported outcomes in patients who had MACI from cartilage derived from either a standard intercondylar biopsy or an osteochondral loose body. Surgeons should be aware that using cartilage derived from osteochondral loose bodies is a viable option for MACI as it eliminates donor site morbidity and has comparable MOCART and functional outcomes at 2 years post-implantation compared to the standard intercondylar biopsy. Level of evidence: Level III
NEURAL ACTIVITY PROFILES ASSOCIATED WITH ACL INJURY-RISK MECHANICS IN ECOLOGICAL SPORT SPECIFIC VIRTUAL REALITY
Authors: Grooms Dustin R. , Diekfuss Jed A. , Slutsky-Ganesh Alexis B. , Criss Cody R. , Anand Manish , DiCesare Christopher A. , Kiefer Adam W. , Riley Michael A. , Thomas Staci , Kitchen Katie , Riehm Christopher , Bonnette Scott , Gadd Brooke , Foss Kim D. Barber , Myer Gregory D. 
Published: July 2021

Background: Anterior cruciate ligament (ACL) injury is secondary to a multifactorial etiology encompassing anatomical, biological, mechanical, and neurological factors. The nature of the injury being primarily due to non-contact mechanics further implicates neural control as a key injury-risk factor, though it has received considerably less study. Purpose: To determine the contribution of neural activity to injury-risk mechanics in ecological sport-specific VR landing scenarios. Methods: Ten female high-school soccer players (15.5±0.85 years; 165.0±6.09 cm; 59.1±11.84 kg) completed a neuroimaging session to capture neural activity during a bilateral leg press and a 3D biomechanics session performing a header within a VR soccer scenario. The bilateral leg press involved four 30 s blocks of repeated bilateral leg presses paced to a metronome beat of 1.2 Hz with 30 s rest between blocks. The VR soccer scenario simulated a corner-kick, requiring the participant to jump and head a virtual soccer ball into a virtual goal (Figure 1A-E). Initial contact and peak knee flexion and abduction angles were extracted during the landing from the header as injury-risk variables of interest and were correlated with neural activity. Results: Evidenced in Table 1 and Figure 1 (bottom row), increased initial contact abduction, increased peak abduction, and decreased peak flexion were associated with increased sensory, visual-spatial, and cerebellar activity (r2= 0.42-0.57, p corrected < .05, z max > 3.1, table & figure 1). Decreased initial contact flexion was associated with increased frontal cortex activity (r2= 0.68, p corrected < .05, z max > 3.1). Conclusion: Reduced neural efficiency (increased activation) of key regions that integrate proprioceptive, visual-spatial, and neurocognitive activity for motor control may influence injury-risk mechanics in sport. The regions found to increase in activity in relation to higher injury-risk mechanics are typically activated to assist with spatial navigation, environmental interaction, and precise motor control. The requirement for athletes to increase their activity for more basic knee motor control may result in fewer neural resources available to maintain knee joint alignment, allocate environmental attention, and handle increased motor coordination demands. These data indicate that strategies to enhance efficiency of visual-spatial and cognitive-motor control during high demand sporting activities is warranted to improve ACL injury-risk reduction. [Figure: see text][Table: see text]
VESTIBULAR TESTING IN CHILDREN WITH DIZZINESS AND BALANCE CONCERNS AFTER CONCUSSION: LABORATORY AND CLINICAL RESULTS
Authors: Karl Michael S , Darvin Arielle , O’Reilly Robert C , Beam Megan , Dillon Karen 
Published: July 2021

Background: Dizziness is the second most common symptom in people who sustain a concussion and there are few reports on vestibular laboratory findings in the concussed pediatric population. Studies to date have shown conflicting findings regarding incidence of peripheral vestibular disorders. Hypothesis/Purpose: The purpose of this study is to report vestibular laboratory and clinical examination findings in concussed youth referred to a multidisciplinary vestibular clinic. Methods: A retrospective chart review was performed for all patients (n=474) seen from August 2017 to March 2020 for a single comprehensive examination in a multidisciplinary pediatric vestibular specialty clinic. Data was extracted from the charts of patients (n=64) with a history of concussion referred because of chronic dizziness and/or imbalance. Each patient was examined by a neurotologist, physical therapist, and audiologist with specialized training in vestibular disorders. Vestibular laboratory testing performed by audiologists included video nystagmography (VNG) evaluation of oculomotor function and BPPV, rotational chair, video head impulse test (vHIT), vestibular evoked myogenic potentials (VEMPs), post-headshake nystagmus, and caloric irrigation. Physical therapy clinical examination included dynamic visual acuity testing (DVA), vestibular/oculomotor screening (VOMS), and sensory organization test (SOT). Not all tests were performed on every patient secondary to factors such as insurance coverage, patient tolerance, and young age. Results: 1 or more components of VOMS was abnormal in 30 of 53 patients examined. DVA was completed on 40 patients, 23 of which were reported as abnormal. SOT was completed on 46 patients, 18 of which demonstrated below normal composite equilibrium scores. Laboratory findings were as follows: VEMPs (n=50) were normal in all but 1 patient, vHIT (n=59), caloric irrigation (n=26), post-headshake nystagmus (n=49), and positional testing (n=55) were normal on all patients tested. Rotational chair (n=60) was performed at 4 different frequencies and revealed low gain in 3 patients. Conclusion: Vestibular laboratory examination was normal in nearly all subjects tested. These results suggest that in concussed youth with chronic dizziness and/or imbalance, laboratory vestibular test outcomes indicative of peripheral dysfunction are rare, which contradicts previous research in this population. In contrast, clinical vestibular assessment was abnormal in more than 50% of subjects examined which suggests that clinicians should use caution interpreting clinical examination findings for diagnosing peripheral vestibular dysfunction. Abnormal clinical examination findings may be indicative of central vestibular conditions such as space and motion intolerance and PPPD in chronically dizzy pediatric patients after concussion. Tables/Figures: [Table: see text][Table: see text]