bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability in the Athlete – Key Considerations for Rehabilitation
Authors: Bradley Helen , Lacheta Lucca , Goldenberg Brandon T. , Rosenberg Samuel I. , Provencher Matthew T. , Millett Peter J. 
Published: February 2021

The Latarjet procedure with transfer of the coracoid process and its attached conjoint tendon is a well-established surgical technique for the treatment of anterior glenohumeral instability in patients with anteroinferior bone loss and/or high risk for recurrence. Biomechanical and clinical studies have shown excellent results and high rates of return to sports. However, there is an absence of standardized, objective criteria to accurately assess an athlete’s ability to progress through each phase of rehabilitation. Return to sports rehabilitation, progressed by quantitatively measured functional goals, may improve the athlete’s integration back to sports participation. Therefore, the purpose of this clinical commentary is to provide a rehabilitation protocol for the Latarjet procedure, progressing through clearly defined phases, with guidance for safe and effective return to sport. Recommended criteria are highlighted which allows the clinician to progress the patient through each phase appropriately rather than purely following timeframes from surgery. This progression ensures the patient has completed a thorough rehabilitation program that addresses ROM, strength, power, neuromuscular control and a graded return to play. Level of Evidence: 5
Patients Walking Faster After Anterior Cruciate Ligament Reconstruction Have More Gait Asymmetry
Authors: Knobel Rachel J. , Ito Naoaki , Arhos Elanna K. , Capin Jacob J. , Buchanan Thomas S. , Snyder-Mackler Lynn 
Published: February 2021

Background Gait asymmetries after anterior cruciate ligament reconstruction (ACLR) may lead to radiographic knee osteoarthritis. Slower walking speeds have been associated with biomarkers suggesting cartilage breakdown. The relationship between walking speed and gait symmetry after ACLR is unknown. Hypothesis/Purpose To determine the relationship between self-selected walking speeds and gait symmetry in athletes after primary, unilateral ACLR. Study Design Secondary analysis of a clinical trial. Methods Athletes 24±8 weeks after primary ACLR walked at self-selected speeds as kinematics, kinetics, and electromyography data were collected. An EMG-driven musculoskeletal model was used to calculate peak medial compartment contact force (pMCCF). Variables of interest were peak knee flexion moment (pKFM) and angle (pKFA), knee flexion and extension (KEE) excursions, peak knee adduction moment (pKAM), and pMCCF. Univariate correlations were run for walking speed and each variable in the ACLR knee, contralateral knee, and interlimb difference (ILD). Results Weak to moderate positive correlations were observed for walking speed and all variables of interest in the contralateral knee (Pearson’s r=.301-.505, p≤0.01). In the ACLR knee, weak positive correlations were observed for only pKFM (r=.280, p=0.02) and pKFA (r=.263, p=0.03). Weak negative correlations were found for ILDs in pKFM (r=-0.248, p=0.04), KEE (r=-.260, p=0.03), pKAM (r=-.323, p<0.01), and pMCCF (r=-.286, p=0.02). Conclusion Those who walk faster after ACLR have more asymmetries, which are associated with the development of early OA. This data suggests that interventions that solely increase walking speed may accentuate gait symmetry in athletes early after ACLR. Gait-specific, unilateral, neuromuscular interventions for the ACLR knee may be needed to target gait asymmetries after ACLR. Level of Evidence III
Individual Baseline Balance Assessments in a Large Sample of Incoming NCAA Division I Athletes Using a Force Plate System
Authors: Weismiller Scott A. , Monaco Robert , Womack Jason , Alderman Brandon , Esopenko Carrie , Conway Fiona N. , Brostrand Kyle , Brown Allison , de Souza Nicola L. , Buckman Jennifer F. 
Published: February 2021

BACKGROUND Individualized baseline testing is resource and time intensive. The use of normative data to approximate changes after a suspected concussion is thus an appealing alternative. Yet, few peer-reviewed, large-sample studies are available from which to develop accurate normative averages of balance using force-plate technology. PURPOSE This study sought to validate a normative dataset from the force-plate manufacturer and examine the magnitude and nature of sample variability. STUDY DESIGN Cross-sectional. METHODS Baseline balance and self-reported sex, sport, and concussion history were assessed in 533 prospective collegiate athletes (45% female) during pre-participation physical examinations. Balance was measured using four stances from the modified Clinical Test of Sensory Interaction and Balance and quantified as Sway Index Scores with the Biodex Biosway Portable Balance System. Group averages are contrasted to data from the force-plate manufacturer. Individual variability around these averages was visualized and analyzed by sex and sport. RESULTS Male student athletes showed significantly more sway in the eyes open, soft stance condition than female athletes. These differences were maintained when concussion history was included as a covariate. Athletes, particularly male athletes, in the high versus low contact sport group showed significantly more sway in the eyes open, soft surface and the eyes closed, hard and soft surface stances. CONCLUSION There was substantial individual variability that was partially explained by sex differences and sport differences. The development of normative averages for sway may benefit from consideration of sex and sport. Further studies should characterize other factors that influence baseline balance in collegiate athletes. LEVEL OF EVIDENCE 2b
Does the Direction of Kinesiology Tape Application Influence Muscle Activation in Asymptomatic Individuals?
Authors: Dolphin Michelle , Brooks Gary , Calancie Blair , Rufa Adam 
Published: February 2021

Background Despite the popularity of tape among athletes and rehabilitation practitioners, there is controversy regarding the specific effects of kinesiology tape. Based on conflicting results and limitations of the literature, a well-designed study was desired to examine kinesiology tape application direction on muscle activation. Hypothesis/Purpose The purpose of this pilot study was to determine if the direction of kinesiology tape application influences quadriceps activation. This study compared taping techniques with outcome measures selected to assess quadriceps muscle activation. The outcome measures included EMG, isokinetic strength, and functional hop and jump performance. Study Design Double-blind Crossover study Methods A total of fifteen asymptomatic participants (10 females and 5 males) completed the study. Mean age was 23.3 years. KinesioⓇ Tex GoldTM was applied to the dominant lower extremity of each participant using a Y-strip method. Two taping conditions (proximal to distal, distal to proximal) were applied to the quadriceps. Participants and testers were blinded to tape condition. Pretest and posttest measures included electromyographic output during isokinetic testing of quadriceps muscle torque at 60°s-1 and 120°s-1, single leg triple hop for distance, and vertical jump. Results Two-way, repeated measures analysis of variance resulted in no significant differences in baseline to taped condition for quadriceps electromyographic output, quadriceps isokinetic knee extension muscle torque at 60°s-1 and 120°s-1, single leg triple-hop distance or vertical jump height. Conclusion The results of this pilot study do not support the hypothesis that kinesiology tape application direction influences muscle performance as measured in this study. Levels of Evidence Level 1 – Controlled Clinical Trial Clinical Relevance Kinesiology tape is commonly used as an intervention for a wide range of musculoskeletal conditions and for promoting performance including sporting activities. Kinesiology tape is popular among athletes and health care providers yet the specific effects of tape are not well understood.
Risk Factors for Stress Fractures in Female Runners: Results of a Survey
Authors: Johnston Therese E , Jakavick Allison E , Mancuso Caroline A , McGee Kathleen C , Wei Lily , Wright Morgan L , Close Jeremy , Shimada Ayako , Leiby Benjamin E 
Published: February 2021

Background Few studies compare women with and without stress fractures and most focus on younger, elite runners. Hypothesis/Purpose Compare risk factors between female runners with and without a stress fracture history. Study Design Case control Methods An online survey targeting women age ≥18 years was distributed primarily via social media. Questions included demographics, running details, cross training, nutrition, injury history, medical/menstrual history, and medications. Women with stress fracture histories answered questions about location, number, and changes made. Data were compared between groups using t-tests, chi-square tests, or Fisher’s exact tests. Multivariable logistic regression models simultaneously investigated associations of multiple factors using backward variable selection. Results Data from 1648 respondents were analyzed. Mean age was 40 years, and 25.4% reported stress fractures. Significant differences were found between groups for days/week running, mileage/week, running pace, years running, having a coach, cycling or swimming, calorie consumption for activity, other running injuries, medical history, medication/supplement intake, age at menarche, and going ≥6 months without a menstrual period. Odds of having a stress fracture were increased with osteopenia (OR 4.14), shin splints (OR 3.24), tendon injuries (OR 1.49), running >20 miles/week (OR 1.74-1.77) compared to 11-20 miles/week, having a coach (OR 1.86), and cycling (OR 1.15). Women running 11:00-11:59 minutes/mile or slower were less likely to have a stress fracture compared to those running 9:00-9:59 minutes/mile (OR 0.43-0.54). The odds of having a stress fracture were 1.43 times higher for going ≥ 6 months without a menstrual period. Use of calcium, probiotics, and vitamin D increased odds. Post fracture, common changes made were with cross training (49%), mileage (49%), and strength training (35%). Conclusions Multiple intrinsic and extrinsic factors were identified for female runners who sustained one or more stress fracture during running. Prospective studies are warranted to infer a cause and effect relationship amongst these variables and stress fracture risk. Level of Evidence Level IV
Prediction of ACL Injuries from Vertical Jump Kinetics in Division 1 Collegiate Athletes
Authors: Pontillo Marisa , Hines Shawn M , Sennett Brian J 
Published: February 2021

Background The incidence of ACL injuries continues to rise secondary to an increase in sport participation. Evidence supports the use of force plate testing to quantify kinetics during rehabilitation after injury and recovery; however, there is limited current research regarding if jump kinetics can identify athletes who are at higher risk for injury. Altered kinetics could potentially lead to abnormal force dissipation and resultant injury. Purpose The purpose of this investigation was to identify whether the force-time variables from vertical jumps could predict ACL injuries in collegiate athletes. Study Design Retrospective cohort. Methods Vertical jump testing is performed by all healthy varsity collegiate athletes at several intervals throughout the athletic year at a Division I institution using a commercially available force plate system with dedicated software. Athletes who sustained an ACL injury between 1/1/15 and 6/1/19 were identified (n=16) and compared to healthy athletes who participated in the same sports (n = 262). ACL injuries were considered for this study if they occurred no more than 10 weeks after a jump test. The outcome variables were load, explode, and drive, operationally defined as the average eccentric rate of force development, average relative concentric force, and concentric relative impulse, respectively, which the system normalized to T scores. Mann-Whitney U tests were used to assess group differences for load, explode, drive, and the ratio between the variables. Logistic regression was used to determine if the battery of variables could predict whether or not an athlete would sustain an ACL injury. The p-value was set to 0.10 for the Mann-Whitney U tests, and 0.05 for the logistic regression. Results Significant differences between the ACL and healthy groups were seen for explode (p=0.08), drive (p=0.06), load:explode ratio (p=0.06), and explode:drive ratio (p=0.03). Explode and drive, when entered into the regression equation, showed the ability to predict injury, χ2= 6.8, df = 2, p=0.03. Conclusions The vertical jump force plate variables were able to identify athletes who sustained an ACL injury within 66 days of testing. Athletes who sustained an ACL injury demonstrated altered kinetics and less ability to transmit forces during the vertical jump. Level of Evidence 3.
Differences in Lower Extremity Kinematics Between High School Cross-Country and Young Adult Recreational Runners
Authors: Reinking Mark F , Carson Nina M , End Bridget M , Miller Olivia K , Munter Joshua D , McPoil Thomas G 
Published: February 2021

Background While previous research has assessed running kinematics for age-related differences that could increase the risk of a running-related injury, none of these studies have included high school aged runners or assessed running kinematics using 2-dimensional video analysis. Purpose The purpose of this study was to compare sagittal plane kinematics during treadmill running in high school cross-country and young adult recreational runners using 2-dimensional motion analysis techniques. Methods Twenty-five high school cross-country runners (13 women, 12 men) and 25 young adult recreational runners (12 women, 13 men) consented to participate in this study. Reflective markers were placed on each lower extremity over multiple anatomical landmarks. After a five-minute acclimation period in which the participants ran on a treadmill at their preferred running speed, video data were recorded at 240 frames per second for all participants while they continued to run on the treadmill. Results There were no significant differences between left and right extremities. The young adult recreational runners exhibited significantly greater vertical excursion of the center of mass (t = 4.64, p = .0001) compared to the high school runners. There was no significant difference between the two age groups regarding the six other sagittal plane variables. Conclusions The young adult recreational runners demonstrated an increased center-of-mass vertical excursion in comparison to high school cross-country runners. In addition, the results obtained in this study for kinematic variables using 2-dimensional motion analysis were similar to previously reported studies using 3-dimensional motion analysis, demonstrating that 2-dimensional motion analysis could be used for analyzing sagittal plane running kinematics in clinical settings. Level of Evidence 4, Controlled laboratory study
Sequencing and Integration of Cervical Manual Therapy and Vestibulo-oculomotor Therapy for Concussion Symptoms: Retrospective Analysis
Authors: Wong Christopher Kevin , Ziaks Lauren , Vargas Samantha , DeMattos Tessia , Brown Chelsea 
Published: February 2021

Background After concussion many people have cervicogenic headache, visual dysfunction, and vestibular deficits that can be attributed to brain injury, cervical injury, or both. While clinical practice guidelines outline treatments to address the symptoms that arise from the multiple involved systems, no preferred treatment sequence for post-concussion syndrome has emerged. Purpose This study sought to describe the clinical and patient-reported outcomes for people with post-concussion symptoms after a protocol sequenced to address cervical dysfunction and benign paroxysmal positional vertigo within the first three weeks of injury, followed by integrated vision and vestibular therapy. Study Design Retrospective longitudinal cohort analysis Methods Records from a concussion clinic for 38 patients (25 male 13 female, aged 26.9±19.7 years) with post-concussion symptoms due to sports, falls, assaults, and motor vehicle accident injuries were analyzed. Musculoskeletal, vision, and vestibular system functions were assessed after pragmatic treatment including early cervical manual therapy and canalith repositioning treatment—when indicated—integrated with advanced vision and vestibular rehabilitation. Patient-reported outcomes included the Post-Concussion Symptom Scale (PCSS) for general symptoms; and for specific symptoms, the Dizziness Handicap Index (DHI), Convergence Insufficiency Symptom Scale (CISS), Activities-specific Balance Confidence scale (ABC), and the Brain Injury Vision Symptom Survey (BIVSS). Paired t-tests with Bonferroni correction to minimize familywise error (p<0.05) were used to analyze the clinical and patient-reported outcomes. Results After 10.4±4.8 sessions over 57.6±34.0 days, general symptoms improved on the PCSS (p=0.001, 95%CI=12.4-30.6); and specific symptoms on the DHI (p<0.001, 95%CI=14.5-33.2), CISS (p<0.002, 95%CI=7.1-18.3), ABC (p<0.024, 95%CI=-.3 - -.1), and BIVSS (p<0.001, 95%CI=13.4-28.0). Clinical measures improved including cervical range-of-motion (55.6% fully restored), benign paroxysmal positional vertigo symptoms (28/28, fully resolved), Brock string visual convergence (p<0.001, 95%CI=3.3-6.3), and score on the Balance Error Scoring System (p<0.001, 95%CI=5.5-11.6). Conclusion A rehabilitation approach for post-concussion syndrome that sequenced cervical dysfunction and benign paroxysmal positional vertigo treatment within the first three weeks of injury followed by integrated vision and vestibular therapy improved clinical and patient-reported outcomes. <br>Level of Evidence: 2b
Comparison of the Effects of Static-Stretching and Tubing Exercises on Acute Shoulder Range of Motion in Collegiate Baseball Players
Authors: Busch Andrew M , Browstein Jackson , Ulm Richard 
Published: February 2021

Background The overhead throwing motion repetitively stresses the dominant arm in baseball players, frequently altering normal range of motion (ROM) in multiple directions. Baseball players regularly perform a combination of static stretches (SS) and dynamic tubing (DT) resistance exercises in pre-throwing warm-up routines intended to improve shoulder ROM and reduce injuries. Purpose The purpose of this study was to compare acute changes in dominant shoulder ROM improvements between SS and DT warm-up exercise protocols. The DT exercises were hypothesized to elicit greater improvements in shoulder ROM. Study Design Two-way crossover study. Methods Twenty-five healthy collegiate baseball players (mean age = 19.8 ±1.0 years) presenting with glenohumeral internal rotation deficit (GIRD) >20° and total rotational range of motion (TRROM) losses >5° completed the SS and DT interventions on different days. Dominant arm internal rotation (IR), external rotation (ER) and TRROM were measured before, immediately after, 30-minutes after, and 60-minutes after each treatment session. A two-way repeated measures analysis of variance (ANOVA) compared the effect of SS and DT over time on IR, ER and TRROM. Results IR improved on average 10.68 ± 0.82° (p < .001) post intervention, 11.18 ± 0.79° (p < .001) 30-min post intervention, and 9.03 ± 0.95° (p < .001) 60-min post intervention. ER improved on average 8.60 ± 0.67° (p < .001) post intervention, 8.25 ± 0.85° (p < .001) 30-min post intervention, and 6.65 ± 0.91° (p < .001) 60-min post intervention. TRROM improved on average 19.28 ± 1.09° (p < .001) post intervention, 19.43 ± 1.36° (p < .001) 30-min post intervention, and 15.68 ± 1.55° (p < .001) 60-min post intervention. There were no significant differences between the main effects of treatment and time for IR, ER, and TRROM. For IR, SS improved by an average of 1.73 ± 0.55° (p = .005) more than DT. For ER and TRROM, there were no differences between SS and DT. Conclusion Both SS and DT exercises improve glenohumeral IR, ER and TRROM up to one-hour post intervention, with no significant differences noted between interventions for treatment or time. Baseball players can benefit equally from performing SS or DT exercises to acutely improve shoulder ROM. Level of Evidence Level 3
Physical Therapists’ Assessment of Patient Self-Efficacy for Home Exercise Programs
Authors: Picha Kelsey J , Valier Alison Snyder , Heebner Nicholas R , Abt John P , Usher Ellen L , Capilouto Gilson , Uhl Tim L 
Published: February 2021

Background Patient adherence to home exercise programs (HEPs) is low, and poor patient self-efficacy is a barrier clinicians can influence. However, little evidence suggests that clinicians assess level of patient self-efficacy before prescribing HEPs. Purpose To determine the importance of patient self-efficacy to physical therapists (PTs) when addressing patient barriers, determine how PTs assess and use patient self-efficacy for HEPs, and describe the barriers facing PTs when assessing patient self-efficacy for HEPs. Study Design Survey. Methods Practicing PTs were recruited from the American Physical Therapy Association’s Orthopedic Section and emailed the electronic survey. Results Email invitations were sent to 17730 potential participants, and 462 PTs completed the survey over one month. PTs rated self-efficacy as “very” to “extremely” important for patient adherence (58%, 265/454). Most (71%, 328/462) reported assessing self-efficacy before prescribing HEPs and did so through verbal discussion and observation of the patient (50% and 38% respectively). Half of respondents individualized HEPs through self-efficacy related themes. PTs not assessing self-efficacy reported not knowing how (51%, 68/134), being unsure what to do with the information (24%, 32/134), or reporting other barriers (21%, 28/134). Conclusions Most PTs indicated that self-efficacy was important for patient adherence, but assessment strategies reported, such as verbal discussion and observation, may not be the most accurate. PTs who did not assess self-efficacy reported not knowing how or what to do with the information once collected. These findings suggest that there is a gap in knowledge related to how to evaluate self-efficacy for HEPs. Better assessment of self-efficacy may lead to more appropriate and effective implementation strategies. Level of Evidence Level II
Amebiasis Pleuro Pulmonar
Authors: Rodriguez Jorge 
Published: February 2021

Complementariamente a una revisión anterior sobre amebiasis hépatopulmonar, se presentan 19 casos y más de amebiasis pleuro-pulmonar diagnosticados en el Dispensario N° 1 de Liga Ecuatoriana Antituberculosa de Quito, en los últimos 9 años.
El cuadro clínico se caracterizó por tos y expectoración hemoptoica y/o hemoptisis, hepatomegalia dolorosa, elevación y borramiento del hemidiafragma derecho e infiltración neumónica del mismo lado.
Como la identificación del agente etiológico es muy difícil, la prueba terapéutica con emetina sigue siendo el mejor método de confirmación diagnóstica.
Se anota como hecho importante la prevalencia en el sexo masculino y la ausencia en la infancia, sin que dispongamos hasta la presente de una explicación satisfactoria.
Se insiste en la importancia práctica de pensar en la etiología amebiana en los procesos pulmonares de base derecha en los que concurren algunos de los otros factores antes anotados.
Hasta el presento año se han recopilado 40 casos, en total, en dos servicios de Neumología de esta ciudad