Littérature scientifique sur le sujet « Specific sport rehab »

Introduction: Overhead athletes frequently have SLAP lesions, which can be difficult to diagnose because of vague exam results and related shoulder disorders. Advances in arthroscopic procedures have drawn attention to the intricate anatomy at play, underscoring the importance of an accurate diagnosis. Classification systems facilitate the knowledge of SLAP pathology, and diagnostic techniques like as ultrasound and MRI improve the precision of detection. Customized rehabilitation plans are feasible, but little is known about the rates of healing and return to sport for overhead athletes following SLAP injuries, which calls for a systematic review to close this knowledge gap. Aim: To review the past rehabilitation and return to sport rates studies in overhead athletes with SLAP tear/lesion. Objective: To compile recent rehabilitation methods and return to sports criteria and rates in post-SLAP tear overhead athletes. Methodology: A systematic review with a focus on papers published in the past ten years was carried out, adhering to PRISMA principles. To evaluate the quality, the Methodological Index for Non-Randomized Studies (MINORS) tool was used. Studies describing RTS rates and rehabilitation strategies in overhead athletes following SLAP injuries met the inclusion criteria. Rehab efficacy and RTS results were assessed through data extraction and analysis. Conclusion: An overall RTS rate of 67.25% was found in the review, underscoring the difficulties and developments in the therapy of SLAP lesions. While rehabilitation procedures varied, certain themes surfaced, including phased programs with an emphasis on strengthening the rotator cuff and sport-specific training. To improve treatment methods and guarantee a safe return to sport for overhead athletes with SLAP lesions, more studies are necessary. The significance of evidence-based rehabilitation catered to the specific requirements of each athlete is highlighted by this study. Key words: Rehabilitation post slap lesion, SLAP lesion in overhead athletes, return to sports rates, and RTS criteria.

Anterior cruciate ligament (ACL) injury is a devastating injury that occurs at high frequency during involvement in competitive sporting activity. Typical treatment of ACL damage is a reconstruction of the anterior cruciate ligament (ACLR). It is projected that between 50 percent and 60 percent of ACL injured athletes will return to competitive sport. Athletes undergoing ACLR surgery are recommended for comprehensive rehab and preparedness to rebuild knee joint integrity and specific functional criteria to direct the comeback to sport to protect against secondary ACL damage.Patient main concerns were pain, with loss of strength and stability at the knee joint, the clinical findings found that there was a marked decrease in range of motion (ROM), and decreased strength of the quadriceps and the hamstrings.Diagnosis of case was grade 2 ACL tear which was confirmed by the MRI reports.The patient showed a great co-operation during the intervention period and now the subject is able to maintain his consistency in his sport. The outcome measures of physical therapy intervention progressed him in an enhanced athlete with return to his sport.

Achilles tendon ruptures in collegiate gymnastics have significantly increased in the past few years, with 20 ruptures in the first three weeks of competition alone in 2020 according to Bonanno et al., 2022. Female gymnasts are ten times more likely to tear their Achilles than any other college athletes, with an incidence of 16.73/100,000. Men’s basketball has the next highest incidence at 4.26/100,000 (Bonanno et al., 2022). Contributing factors for the increase in ruptures are not well researched or understood. This paper will explore the relevant literature on the risk factors of tears and return to sport protocols. It will touch on early rehab but mainly focus on return to sport testing and progression for gymnastics from a physical therapy perspective. It will explore topics discussed in interviews with numerous sports physical therapists with extensive gymnastics or collegiate athletics experience. Gymnastics is a very technical sport where each athlete has individual skills with different biomechanical requirements; therefore, needs vary between athletes. This paper aims to address the transition phase between the time when surgical protocols allow a return to sport and the actual return to performance during recovery. In this specific domain, there is an ongoing need for prospective, longitudinal studies to investigate testing and outcome measures tailored to gymnastics. These studies can play a crucial role in guiding athletes, trainers, coaches, and therapists in facilitating a safe and effective return to performance after surgery.

Category: Sports; Ankle; Other Introduction/Purpose: A uniform criterion has not been established for return to sport (RTS) testing which is complicated by the lack of a standardized definition of the term RTS. Most commonly, RTS is defined as playing in at least one game of the athletes' respective sport, or the first game played after treatment.1 However, the timeline from the injury and/or treatment date to RTS varies amongst each physician or institution. Regarding the ankle, there is an enormous paucity of functional testing research. Therefore, the purpose of this project is to review current literature for joint-specific and global lower extremity testing to determine the most valid functional test that can be utilized to prevent re-injury as athletes RTS. Methods: A systematic search of PubMed, PubMed Central, Cochrane Library, OVID, and Embase databases was conducted to identify clinical studies that included evaluation of a return to sport test or functional test (single test or test battery) for the lower extremities. Both operative and non-operative treatments included in this review. Only studies that had patients between the ages of 14 years old and 40 years old were included. Specfici rehab protocik or treatment plan, non-English publications, non- human or cadaver studies, and studies that did not evaluate return to sport test or function test were excluded. Results: Of 8,705 studies, 65 (0.7%) studies published through October of 2021 met inclusion criteria and were analyzed. 52 out of 65 (80%) articles discussed RTS for the knee. Furthermore, 50 out of the 52 (96%) specifically analzyed RTS following ACLR. With this said, we did not abandon ankle and hip RTS cases. Discussed herein, are numerous RTS tests including the most common, isokinetic dynamometry testing which is seen in 38 out of the 52 (73%) of the knee RTS cases. Unfortunately, only 4 out of 65 (6.2%) studies analyzed RTS for the hip and 1 out of the 65 (1.5%) barely touched on the ankle. The remaining studies analyzed healthy participants only. Conclusion: More research is clearly required to identify the most valid functional test batteries for joint-specific RTS lower extremity testing. Even with the enormous amount of literature that exists regarding ACL injuries and testing there is no standardized criterion for RTS clearance. As seen in this review, the research available for the hip and ankle is substantially scarcer in regards functional testing. We hope that the suggested test batteries from this review can serve as a framework for future research and validation for joint-specific RTS functional testing.

Background and Objectives: Urinary incontinence (UI) prevalence reaches the 80% rate in female athletes involved in high-impact sports. In this context, although conservative treatment represents the first therapeutic choice, there is still a lack of knowledge on the efficacy of conservative programs in young female athletes. Therefore, the aim of this study was to investigate the role of pelvic floor rehabilitation in the treatment of UI in young nulliparous female athletes. We performed a literature search using PubMed, Medline, Cochrane Library, Web of Science, and Scopus. The selection of articles was conducted using a specific search string: “[((pelvic floor dysfunction) OR (urinary incontinence) OR (dyspareunia) OR (dysuria)) AND ((sport) OR (sports)) AND ((female) OR (woman) OR (women) OR (girl)) AND ((rehabilitation) OR (rehab) OR (pelvic rehabilitation) OR (exercise))]”. The review protocol was registered in PROSPERO with the ID CRD42024559990. A total of 1018 articles were found in all searches of the databases. After removing duplicates, 663 papers were reviewed in terms of title and abstract. Finally, a total of six studies were included in the present review. The results of this review show that conservative treatment with a personalised pelvic floor muscle training program (PFMTP) represents an effective treatment for UI, decreasing urine loss and improving maximum voluntary pelvic contraction; this is linked with an improvement in quality of life and sports performance, in particular when supervised by a physical therapist. Moreover, due to the reluctance of athletes to talk about UI, an educational program should be considered as part of a prevention programme in pre-season training.

Rectus femoris muscle strains are one of the most common injuries occurring in sports such as soccer. The purpose of this study was to describe the safety and feasibility of a combination of percutaneous needle electrolysis (PNE) and a specific rehab and reconditioning program (RRP) following an injury to the rectus femoris in professional soccer players. Thirteen professional soccer players received PNE treatment 48 h after a grade II rectus femoris muscle injury, followed by a the RRP 24 h later. Assessment of recovery from injury was done by registering the days taken to return to train (RTT), return to play (RTP), and structural and functional progress of the injured muscle was registered through ultrasound imaging and match-GPS parameters. Also, adverse events and reinjuries were recorded in the follow up period of twenty weeks. The RTT registered was 15.62 ± 1.80 days and RTP was 20.15 ± 2.79 days. After fourteen days, the ultrasound image showed optimal repair. Match-GPS parameters were similar before and after injury. There were no relapses nor were any serious adverse effects reported during the 20-week follow-up after the RTP. A combination of PNE and a specific RRP facilitated a faster RTP in previously injured professional soccer players enabling them to sustain performance and avoid reinjuries.

Background: Anterior cruciate ligament is one of the two ligaments inside the middle section of the knee joint that forms an “X” shape. Its main function is to prevent the tibia from sliding forward relative to the femur. The ACL also assists with preventing excessive knee extension, knee varus and valgus movements, and tibial rotation. Kinect works in almost all room lighting conditions and can simultaneously track two active users. For full-body, head-to-feet tracking, the recommended user distance from the sensor is approximately 1.8 m for a single user; when two people are to track simultaneously, they should stand approximately 2.5 m away from the device. Kinect requires a minimum user height of 1 m. With the players themselves becoming the ‘game controller’ via their body movements and gestures, Kinect-enabled game titles lend themselves comfortably to the class of exergames (‘exercise games’), although the amount of physical activity involved and calories burned can vary significantly from title to title Materials and method: Twenty-six participated in the study. These subjects were divided into two groups, 13 subjects in each. Group A was administrated with the traditional training, and Group B was administrated with the X BOX Kinect training. Results: Comparison of mean and standard deviation of subjects aged (18-25) between Group A (Traditional Training) and Group B (X box Kinect 360 Training). The mean age of Group A was 20.7143±1.98278, and Group Bs was 20.6571±2.21711, respectively. The paired t-test value was 15.728. There was no significant difference between age groups. But in both Kujala score and muscle girth scores with p-value <0.001** (i.e., p <0.05 at 95 % confidence interval), the pre and post-values of Kujala score and muscle girth were statistically significant. Conclusion: Comparing traditional treatments with or without adding extra Kinect 360 training sessions would be very interesting, being that it may be a good addition to the treatment for post-operative ACL rehab, ACL sprains conservative management, and maintaining Knee joint fitness when sports players in a home without exposure of COVID -19. KEYWORDS: Xbox Kinect-360, ACL Sprain, Home-Based Exercises, Kujala Scale, COVID-19, Remote Rehabilitation.

Introduction: Several studies have focused on the return to play rate after ACL reconstruction. Whereas most studies just report the rate as a result, only few studies evaluate specific parameters and tests to further investigate the conditions of when the patients should return to sports. Hypotheses: Aim of this study was to compare the return to competition rate of patients 12 months after ACL reconstruction and correlate the rate and re-rupture fate to the assessed multifactorial “return-to-sports” test 3 months after ACL reconstruction at our institution. Methods: A total of 51 Patients undergoing ACL reconstruction are prospectively evaluated using a “return-to-sports” test 3 months following ACL reconstruction. Inclusion criteria was isolated ACL rupture, Level 1 sports participation, free range of motion at FU 3 months, age >18 and <50, no associated ligamentous or meniscal injury influencing the rehab protocol and intact contralateral leg. ACL reconstructions were performed by a single surgeon with semitendinosus graft and standardized rehabilitation protocol. Follow-up at 3 months postoperatively was performed using a functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests) and a 3d-motion analysis (myomotion, Noraxon) during bilateral drop jumps and single leg hop tests. To evaluate the return to play rate and recurrent instability problems a survey was used at timepoint 12 months postoperatively (n=43 at abstract submission). Results: At timepoint 12 months following ACL reconstruction 6 of 43 currently evaluated patients did not return to competition (6/43). A total of 5 patients were evaluated as moderate to high risk for ACL recurrent instability in the return-to-sports analysis at three months whereas one patient not returning to competition showed a not elevated risk for ACL recurrent instability in the analysis. The was a high correlation of patients revealing better functional results in the functional analysis (isokinetic strength, proprioceptive test and a 3d-motion analysis) and returning to sports. A total of 8 patients (4/43) suffered a recurrent instability after returning to sports. Conclusion: This prospective analysis of patients following semitendinosus ACL reconstruction with one single surgeon implicates that the rate of returning to sports in patients using a multifactorial “return-to-sports” analysis at 3 months postoperatively is higher compared to the rate of patients without such an analysis in the literature. We found a high correlation between better functional results and return to play rate as well as a re-rupture rate of 10% in patients after returning to sports.

Background: Specific guidelines for therapeutic exercises following an Achilles tendon repair are lacking. Hypothesis: A hierarchical progression of triceps surae exercises can be determined on the basis of electromyographic (EMG) activity. Study Design: Randomized laboratory trial. Methods: Bipolar surface electrodes were applied over the medial and lateral heads of the gastrocnemius as well as the soleus on 20 healthy lower extremities (10 participants, 27 ± 5 years old). Muscle activity was recorded during 8 therapeutic exercises commonly used following an Achilles repair. Maximal voluntary isometric contractions (MVICs) were also performed on an isokinetic device. The effect of exercise on EMG activity (% MVIC) was assessed using repeated measures analysis of variance with Bonferroni corrections for planned pairwise comparisons. Results: Seated toe raises (11% MVIC) had the least amount of activity compared with all other exercises ( P < 0.01), followed by single-leg balance on wobble board (25% MVIC), prone ankle pumps (38% MVIC), supine plantarflexion with red elastic resistance (45% MVIC), normal gait (47% MVIC), lateral step-ups (60% MVIC), single-leg heel raises (112% MVIC), and single-leg jumping (129% MVIC). Conclusion: There is an increasing progression of EMG activity for exercises that target the triceps surae muscle complex during common exercises prescribed in an Achilles tendon rehabilitation program. Seated toe raises offer relatively low EMG activity and can be utilized as an early rehabilitative exercise. In contrast, the single-leg heel raise and single-leg jumping should be utilized only during later-stage rehabilitation. Clinical Relevance: EMG activity in the triceps surae is variable with common rehab exercises.

Context: The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport. Objective: The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer. Design: A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players. Setting: Soccer pitch and indoor gym. Participants: Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga). Interventions: The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury. Main Outcome Measures: Aiken V for each item of the program and number of days taken by the players to return to full team training. Results: The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61–0.98) for all drills, and the return to training was in 13.08 (±1.42) days. Conclusion: This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training.

L'objectif de cette thèse était double : i) objectiver les effets de la réathlétisation sur le contrôle neuromoteur de footballeurs de haut-niveau; ii) développer un modèle théorique prédictif de la survenue de blessure chez l'athlète sain. Le modèle expérimental du countermovement-jump (CMJ) a été utilisé pour tester les hypothèses spécifiques à chacune des 5 études réalisées. Les paramètres cinétiques, cinématiques et électromyographiques (EMG) du CMJ étaient calculés au moyen de plateforme de force, caméra rapide et électrodes de surface, respectivement. Trois pathologies des membres inférieurs ont été considérées: rupture du ligament croisé antérieur du genou, chondropathie de genou et lésions musculaires de la cuisse. Dans une 1ère étude, les résultats ont montré que les paramètres biomécaniques et EMG du CMJ de la jambe blessée et de la jambe non blessée étaient altérés dans tous les groupes pathologiques. Le programme SSR (specific sport rehabilitation) de trois semaines a permis d'améliorer significativement ces paramètres caractéristiques du contrôle neuromoteur. Dans une 2ème étude, le niveau de récupération fonctionnelle des footballeurs a été évalué par le biais de deux méthodes: la méthode LSI (limb symmetry index) et la méthode Norm-Values. Les résultats ont montré que la méthode Norm-Values était la plus discriminante. Dans une 3ème étude, la comparaison inter-groupes des paramètres biomécaniques et EMG a permis de mettre en évidence une « signature neuromotrice » spécifique à chaque pathologie. Dans une 4ème étude, les résultats ont montré que la superposition d'une tâche de prise d'information visuelle (tâche secondaire) avait un effet bénéfique sur les paramètres du CMJ (tâche primaire), probablement dû à une « défocalisation » de l'attention des athlètes blessés vers la tâche secondaire. Enfin, dans une dernière étude, le suivi longitudinal de joueurs sains au cours d'une saison a été réalisé avec pour objectif de développer un modèle théorique prédictif de blessure. Ce modèle, basé sur une méthode de machine learning a permis de mettre en évidence des tendances (non significatives) à la survenue de blessures en fonction des caractéristiques neuromotrices des joueurs. Globalement, l'ensemble de ces résultats contribue à l'amélioration des connaissances et des pratiques dans le domaine de la réathlétisation
This thesis had two principal objectives: i), to provide an objective analysis of the impact of sport-specific-rehab (SSR) on the neuromotor control of high-level soccer players ; ii) to develop a theoretical model that could predict the likelihood of injury in healthy athletes. The experimental countermovement jump (CMJ) model was employed to test the specific hypotheses associated with each of the five studies. The kinetic, kinematic and electromyographic (EMG) parameters of the CMJ were calculate using a force platform, a high-speed camera and surface electrodes, respectively. Three pathologies of the lower-limb were considered: anterior cruciate ligament rupture of the knee, knee chondropathy and muscular lesions of the thigh. The initial study demonstrated that the biomechanical and electromyographic parameters of the CMJ of the injured leg and the non-injured leg were altered in all pathological groups. The three-week SSR programme led to a notable improvement in these parameters, which are indicative of neuromotor control. In a second study, the level of functional recovery of the soccer players was evaluated using two methods: the LSI (limb symmetry index) and the Norm-Values method. The findings indicated that the Norm-Values method was the most effective in discriminating between the groups. In a third study, an intergroup comparison of biomechanical and EMG parameters revealed the existence of a 'neuromotor signature' specific to each pathology. In a fourth study, the results demonstrated that superimposing a visual information-gathering task (secondary task) had a beneficial effect on CMJ parameters (primary task). This was likely due to the injured athletes' attention being defocused towards the secondary task. In a final study, healthy players were monitored over the course of a season with the objective of developing a theoretical predictive model of injury. This model, based on a machine learning method, revealed non-significant trends in the occurrence of injuries as a function of the neuromotor characteristics of the players. Overall, these results contribute to advancing knowledge and practices in the field of rehabilitation