Neural-Targeted Rehabilitation Strategies to Address Neuroplasticity After Joint Injury.

In patients with musculoskeletal injury, changes have been observed within the central nervous system that contribute to altered movement planning. This maladaptive neuroplasticity potentially explains the clinical disconnect where residual neuromuscular dysfunction and high rates of reinjury are often observed even after individuals clear return-to-activity functional testing. An improved understanding of these neural changes could therefore serve as a guide for facilitating a more complete recovery and minimizing risk of reinjury.

The effects of neuromuscular electrical stimulation to the ankle pronators on neural excitability & functional status in patients with chronic ankle instability.

Objectives: Chronic ankle instability (CAI) is associated with decreased neural excitability that negatively impacts function. This study assessed a 2-week neuromuscular electrical stimulation (NMES) or transcutaneous electrical nerve stimulation (TENS) intervention over the ankle pronators on neural excitability, performance, and patient-reported function in patients with CAI.

Study Design: Randomized controlled trial.

Comparing the Primary Concerns of Injured Collegiate Athletes With the Content of Patient-Reported Outcome Measures.

Context: Patient-reported outcome measures (PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations.

Objective: To identify the primary concerns of collegiate athletes experiencing injury and compare those with the content of established PROMs.

Mindfulness Matters: Use and Perceptions of Mindfulness Practices Among Athletic Trainers.

Context: Mindfulness practices are effective for injury or illness recovery, decreasing stress and anxiety, and strengthening emotional resilience. They are also beneficial for health care professionals' wellbeing and improving patient outcomes and safety. However, mindfulness has not been studied in athletic trainers.

A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review.

Context: Postoperative quadriceps strength weakness after knee surgery is a persistent issue patients and health care providers encounter.

Objective: To investigate the effect of neuromuscular electrical stimulation (NMES) parameters on quadriceps strength after knee surgery.

Data Sources: CINAHL, MEDLINE, SPORTDiscus, and PubMed were systematically searched in December 2018.

Prevalence and domains of disability within and outside Appalachian North Carolina: 2013-2016 Behavioral Risk Factor Surveillance System.

Background: The health and social conditions of the Appalachian region generally are poorer than in the US overall, and this gap is widening, suggesting disability may be higher in Appalachia.

Objective: To describe the prevalence of disability overall and by domain in Appalachian and non-Appalachian regions in North Carolina (NC) and describe the characteristics of people with and without disability in each region.

Methods: We conducted a cross-sectional study using data from the NC Behavioral Risk Factor Surveillance System from 2013 to 2016 which assessed disability in five domains: vision, cognitive, mobility, self-care, and independent living.

Psychosocial Barriers After Anterior Cruciate Ligament Reconstruction: A Clinical Review of Factors Influencing Postoperative Success.

Context: Psychosocial factors arising after anterior cruciate ligament (ACL) injury may have a direct influence on an individual's decision to return to sport after ACL reconstruction (ACLR). While there is ample evidence to suggest that deficits in quadriceps strength, neuromuscular control, and clinical functional tasks exist after ACLR, the root and contribution of psychological dysfunction to an individual's success or return to sport after ACLR is still largely uncertain and unexplored. Given the discrepancy between successful functional outcomes and the percentage of athletes who return to sport, it is important to thoroughly address underlying factors, aside from physical function, that may be contributing to these lower return rates.

The Effects of Transcranial Direct Current Stimulation on Chronic Ankle Instability.

Purpose: Given maladaptive neuroplasticity after musculoskeletal injury, interventions capable of restoring corticospinal excitability should be considered. We therefore aimed to determine if a 4-wk intervention of anodal transcranial direct current stimulation (aTDCS) with eccentric exercise would improve neural excitability, functional performance, and patient-reported function in individuals with chronic ankle instability (CAI).

Methods: Twenty-six individuals with CAI were recruited to undergo 4 wk of eccentric evertor strengthening.

Decision to Return to Sport Participation After Anterior Cruciate Ligament Reconstruction, Part II: Self-Reported and Functional Performance Outcomes.

Context:   Anterior cruciate ligament (ACL) reconstruction (ACLR) is the most commonly used method for helping athletes regain function and return to preinjury activity levels after ACL injury. Outcomes after ACLR have suggested that athletes return to a level of function that would support a return to sport participation; however, in a recent meta-analysis, pooled return rates were only 55%. It is unclear whether this discrepancy is a result of functional impairments.

Decision to Return to Sport After Anterior Cruciate Ligament Reconstruction, Part I: A Qualitative Investigation of Psychosocial Factors.

Context:   Return-to-sport criteria after anterior cruciate ligament (ACL) injury are often based on "satisfactory" functional and patient-reported outcomes. However, an individual's decision to return to sport is likely multifactorial; psychological and physical readiness to return may not be synonymous.

Objective:   To determine the psychosocial factors that influence the decision to return to sport in athletes 1 year post-ACL reconstruction (ACLR).

Comparison of Muscle Activation Levels Between Healthy Individuals and Persons Who Have Undergone Anterior Cruciate Ligament Reconstruction During Different Phases of Weight-Bearing Exercises.

Study Design Cross-sectional, controlled laboratory study. Background Quantification of muscular activation during different phases of functional activities is important to understand activation deficits in individuals who have undergone anterior cruciate ligament reconstruction (ACLR). Objectives To compare activation levels of the vastus medialis (VM), medial hamstrings (MH), and gluteus medius (GMed) muscles during the different phases of weight-bearing tasks between individuals who had undergone ACLR and healthy controls.

Feasibility of conducting a web-based survey of patient-reported outcomes and rehabilitation progress.

Background: Web-based surveys provide an efficient means to track clinical outcomes over time without the use of clinician time for additional paperwork. Our purpose was to determine the feasibility of utilizing web-based surveys to capture rehabilitation compliance and clinical outcomes among postoperative orthopedic patients. The study hypotheses were that (a) recruitment rate would be high (>90%), (b) patients receiving surveys every two weeks would demonstrate higher response rates than patients that receive surveys every four weeks, and (c) response rates would decrease over time.

Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Transfer: A Systematic Review of Outcomes and Complications.

Purpose: To examine the outcomes and complications of medial patellofemoral ligament (MPFL) reconstruction and concomitant tibial tubercle (TT) transfer.

Methods: A systematic review of published literature on MPFL reconstruction and TT transfer was performed using the following databases: PubMed/Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, and Cochrane. To be included, studies were required to present outcomes and/or complication data for MPFL reconstruction performed in combination with TT transfer.

Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in National Collegiate Athletic Association Division I Soccer Athletes: A Study of the Southeastern Conference.

Background: Factors and details regarding return to play in elite, collegiate female soccer athletes after an anterior cruciate ligament (ACL) injury and reconstruction have not been well studied.

Purpose: To evaluate return to play among collegiate female soccer players, specifically examining the effect of surgical and individual athlete characteristics on the return-to-play rate.

Study Design: Descriptive epidemiology study.

Comparison of Graft Failure Rate Between Autografts Placed via an Anatomic Anterior Cruciate Ligament Reconstruction Technique: A Systematic Review, Meta-analysis, and Meta-regression.

Background: Recent data from the Danish anterior cruciate ligament (ACL) registry demonstrated increased reoperation rates for hamstring tendon autografts when an anatomic ACL reconstruction is performed. This is consistent with reports of greater time needed for hamstring tendon autografts to mature compared with other autografts.

Purpose: To review the literature comparing graft failure rate between patellar and hamstring tendon autografts placed anatomically and to determine if there are differences in return to preinjury activity levels between autografts.

Patient-oriented and performance-based outcomes after knee autologous chondrocyte implantation: a timeline for the first year of recovery.

Context: It is well established that autologous chondrocyte implantation (ACI) can require extended recovery postoperatively; however, little information exists to provide clinicians and patients with a timeline for anticipated function during the first year after ACI.

Objective: To document the recovery of functional performance of activities of daily living after ACI.

Patients: ACI patients (n = 48, 29 male; 35.

The role of rehabilitation following autologous chondrocyte implantation: a retrospective chart review.

Purpose/background: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population's demographics, clinical outcomes, and rehabilitation practices.

Influence of response shift on early patient-reported outcomes following autologous chondrocyte implantation.

Purpose: Response shift is the phenomenon by which an individual's standards for evaluation change over time. The purpose of this study was to determine whether patients undergoing autologous chondrocyte implantation (ACI) experience response shift.

Methods: Forty-eight patients undergoing ACI participated.

Comparing Responsiveness of Six Common Patient-Reported Outcomes to Changes Following Autologous Chondrocyte Implantation: A Systematic Review and Meta-Analysis of Prospective Studies.

Objective: To compare the responsiveness of six common patient-reported outcomes (PROs) following autologous chondrocyte implantation (ACI).

Design: A systematic search was conducted to identify reports of PROs following ACI. Study quality was evaluated using the modified Coleman Methodology Score (mCMS).

A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation.

Background: Patellofemoral instability affects activities of daily living and hinders athletic participation. Over the past 2 decades, more attention has been paid to medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocations/subluxations. Numerous techniques have been reported; however, there is no consensus regarding optimal reconstruction.

Structure, sex, and strength and knee and hip kinematics during landing.

Context: Researchers have observed that medial knee collapse is a mechanism of knee injury. Lower extremity alignment, sex, and strength have been cited as contributing to landing mechanics.

Objective: To determine the relationship among measurements of asymmetry of unilateral hip rotation (AUHR); mobility of the foot, which we described as relative arch deformity (RAD); hip abduction-external rotation strength; sex; and medial collapse of the knee during a single-leg jump landing.

Response shift theory: an application for health-related quality of life in rehabilitation research and practice.

Evaluating change in patients over time can be challenging to any health care provider. Response shift theory is based on the change typology of alpha, beta, and gamma change and proposes that residual changes in self-response measures occur over time. These changes are the result of recalibration, reconceptualization, and reprioritization of internal standards and references utilized for self-appraisal.

Continuous Passive Motion, Early Weight Bearing, and Active Motion following Knee Articular Cartilage Repair: Evidence for Clinical Practice.

Objective: To systematically review the literature regarding postoperative rehabilitation for articular cartilage repair: (1) does the use of continuous passive motion (CPM) enhance healing, and if so, what parameters should be applied? (2) Can active range of motion (AROM) be used in place of or with CPM? (3) When can individuals safely resume weight bearing (WB) following repair?

Data Sources: A search using Medline, SportsDiscus, and CINAHL databases was performed with the following keywords: articular cartilage, AROM, CPM, microfracture, osteochondral allograft, autologous chondrocyte implantation, rehabilitation, weight bearing, and knee.

Study Selection: Basic science or clinical outcomes examining the effects of CPM, AROM, or WB on knee articular cartilage healing.

Data Extraction: Selected articles were rated using the Strength of Recommendation Taxonomy (SORT) to determine evidence for clinical application.