Articles de revues 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.

Rotator cuff tear (RCT) is one of the most common shoulder disorders in orthopaedic surgery. When conservative treatment fails, arthroscopic rotator cuff repair (RCR) has become the most common procedure to achieve a functional shoulder. Success of rotator cuff repair on athletes is measured by their capability to return to sports (RTS) and return to play (RTP). Most athletes were able to return to the state of preinjury level of play after arthroscopic RCR. Arthroscopic rotator cuff repair has rate of RTS in 75% of patients within an average of 6.4 months. Recreational sports participants was associated with higher rate of RTS, up to more than 90%, even on the patients aged >40 years old. On the contrary, competitive sports and overhead sports athletes were associated with lower rate of RTS. Of all athletes who RTS, only around half of them returned to the equivalent or a higher level of competition. Professional overhead athletes are at higher risk of not returning to their prior level of play. The trends can be observed on performance decline among professional baseball players who underwent RTS. Study on professional football players found no significance difference in RTP rates, performance score, or career longevity between operative and nonoperative group. There are some criteria for RTP after RTS following RCR, namely: time from surgery, pain, range of motion, functional recovery, proprioception, strength and muscular balance, patient perception, psychological readiness, sport-specific training program. Customized rehab protocols for large to massive rotator cuff repairs and patients at increased risk of stiffness should be considered.

Background: The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and the Sports Concussion Assessment Tool (SCAT) are widely used self-report tools assessing the type, number, and severity of concussion symptoms. There are overlapping symptoms and domains, though they are scored differently. The SCAT consists of 22 questions with a 7-point Likert scale for a total possible score 132. The RPQ has 16 questions and a 5-point Likert scale for a total of 64 possible points. Being able to convert between the two scores would facilitate comparison of results in the concussion literature.Objectives: To develop equations to convert scores on the SCAT to the RPQ and vice versa.Methods: Adults (17–85 years) diagnosed with a concussion at a referring emergency department were seen in the Hull-Ellis Concussion and Research Clinic, a rapid access concussion clinic at Toronto Rehab–University Health Network (UHN) Toronto Canada, within 7 days of injury. The RPQ and SCAT symptom checklists as well as demographic questionnaires were administered to all participants at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 12, 16.Results: 215 participants had 1,168 matched RPQ and SCAT assessments. Total scores of the RPQ and the SCAT had a rho = 0.91 (p &lt; 0.001); correlations were lower for sub-scores of specific symptom domains (range 0.74–0.87, p &lt; 0.001 for all domain comparisons). An equation was derived to calculate SCAT scores using the number and severity of symptoms on the RPQ. Estimated scores were within 3 points of the observed total score on the SCAT. A second equation was derived to calculate the RPQ from the proportion weighted total score of the SCAT. This equation estimated corresponding scores within 3 points of the observed score on the RPQ.Conclusions: The RPQ and SCAT symptom checklists total scores are highly correlated and can be used to estimate the total score on the corresponding assessment. The symptom subdomains are also strongly correlated between the 2 scales however not as strongly correlated as the total score. The equations will enable researchers and clinicians to quickly convert between the scales and to directly compare concussion research findings.

Objectives: Despite attaining satisfactory knee function following anterior cruciate ligament (ACL) reconstruction, many athletes are unable to return to their pre-injury level of play. ACL tears are known to take a significant psychological toll on the injured athlete and an athlete’s “psychological readiness” may play a large role in their ability to return to sport. The Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale is the only questionnaire to specifically assess the psychological readiness to return to sport after ACL reconstruction. Several factors have been identified to affect an athlete’s psychological readiness to return to sport including age and sex. However, the effect of graft choice on psychological readiness to return to sport have not been studied. The purpose of this study was to evaluate the effect of graft choice on the athlete’s psychological readiness to return to sport. We hypothesized that patients undergoing ACL reconstruction with quadriceps autograft (QA) would reach higher ACL-RSI scores earlier than patients using hamstring autograft (HA) and bone-patellar tendon- bone (BTB) autografts. Methods: The study was a prospective, non-randomized study involving high-level athletes undergoing primary ACL reconstruction with or without meniscal surgery. The participants were involved in varsity high-school, college or professional sports. Each athlete was placed in a group depending on if an all- soft-tissue quadriceps autograft (QA Group), bone-patellar tendon-bone autograft (BTB Group) or hamstring autograft (HA Group) was used for their reconstruction. Graft choice was made by the athlete after the benefits and risks of each graft were discussed in detail. Over the study period, thirty consecutive athletes in each group undergoing primary ACL reconstruction with each specific graft were entered into the study. Athletes undergoing concomitant surgery other than meniscal surgery were excluded from the study. The athletes were asked to fill out the ACL-RSI scale 6-months following surgery, at the time of release to full sport and 2-years following surgery. Current literature shows an ACL-RSI score of 65 or higher as being the score that best predicts return to sport. In addition to comparing the ACL-RSI raw scores between groups, we also compared the percentage of patients reaching an ACL-RSI score of 65 (A-R 65) between the graft types. In addition, patient reported outcomes (PROs) including the International Knee Documentation Committee (IKDC) and Lysholm surveys were completed at the same time points as the ACL-RSI scores. Clinical outcomes included return to sport (RTS), RTS at the same or higher level, time to RTS and graft re-tear. All patients underwent the same rehabilitation protocol regardless of the graft used. RTS was allowed based on appropriate progression through the rehab program, quadriceps strength 90% that of the non-operated leg and triple-hop test 90% the non-operative leg. Return to sport was defined as participation in an official game within the chosen sport of the athlete. Results: The demographics between the three groups was homogenous with the overall average age of the group being 19.1 years. The study included 43.3% high school, 50% college and 6.7% professional athletes with no difference between the groups. The HA group had an ACL-RSI score of 49.2 at 6- months, 59.2 at RTP and 61.7 at the 2-year follow up. The BTB group had scores of 48.1, 64.7 and 63.1 at 6-month, RTP and 2-years postoperatively. The QA group had significantly higher scores than both the HA and BTB groups at the 6-month time period (65.3), and RTP time point (70.6) and similar scores compared to the other two groups at the 2-year follow up (72.7). The HA and BTB groups had similar ACL-RSI raw scores throughout the study. The QA group had a higher percentage of patients reaching the A-R 65 level (53.3%) compared to the HA group (23.3%) and the BTB group (13.3%) at the 6-month postoperative time point. At the RTS time point, the QA group again had a significantly higher rate of patients reaching the A-R 65 level (65.4%) than the other two groups (33.3% HA and 36% BTB group). At the 2-year time point, there was no difference between the three groups with regards to reaching the A- R 65 level. The percentage of athletes reaching the A-R 65 level was not different between the HA and BTB groups at any time point. The IKDC and Lysholm scores were similar between the three groups at all time points. The overall RTP for the study was 82.2% and RTP at the same or higher level was 62.2%. There was no significant difference in return to play between the three groups (HA group 77%, BTB group 83.3% and QA group 87%). Likewise, RTP at the same or higher level was similar between the groups at 57%, 63% and 67% for the HA, BTB and QA groups respectively. There was a significant difference between the QA group and the HA and BTB groups with respect to time to RTS. The average time to RTS for the QA group was 8.1 months compared to 10.5 months for the HA group and 9.6 months for the BTB group. All three groups showed a significant intragroup difference in the ACL-RSI score at all time points between the cohort of patients in each group who were able to return to sport at the same or higher level and those who could not. Clinically, graft re-tears occurred in 17% of the HA group, 10% of the BTB group and 0% of the QA group (p=.02). Conclusions: The QA lead to a higher ACL-RSI score and higher percentages of athletes reaching the A-R 65 level at the 6-month and RTS time points compared to both the hamstring and BTB groups. This fact may explain why the quad group was able to return to sport in significantly less time than the other two groups. The higher ACL-RSI score may be an indication of an athlete’s confidence in their reconstructed knee. This confidence after surgery may allow the athlete to break through the psychological barriers that can make return to sport difficult.

Abstract Objective To promote antimicrobial stewardship, many institutions have implemented a policy of reflexing to a urine culture based on a positive urinalysis result. The rehab patient population, including individuals with brain and spinal cord injuries, may have atypical presentations of UTIs. The study objective is to determine the effects of implementing a urine culture reflex policy in this specific patient population. Design In an inpatient rehabilitation unit, 348 urinalyses were analyzed from August 2019 to June 2021. Urinalysis with greater than or equal to ten white blood cells per high power field (WBC/HPF) was automatically reflexed to a urine culture in this prospective study. Primary outcome was return to acute care related to urinary tract infection. Secondary outcomes included adherence to reflex protocol, antibiotic utilization and appropriateness, adverse outcomes related to antibiotic use, and reduction in urine cultures processed and the associated reduction in healthcare costs. Results There was no statistically significant difference pre- and post-intervention related to the primary outcome. Urine cultures processed were reduced by 58% post-intervention. Conclusions Urine culture reflex policy is likely an effective intervention to reduce the frequency of urine cultures without significantly affecting the need to transfer patients from inpatient rehab back to the acute care setting.

There are some major advancements trending in Physical therapy field including wearable vibrating posture sensors, gait-correcting insoles monitoring devices such as Fitbit video games programmed to make treatment sessions moreenjoyable, and sensors for helmets that warn sports persons and physiotherapists of possible impacts causing concussion1. With the invention of the Ekso suit, an aluminum and titanium exoskeleton that allows patients/clients facing different stages of paralysis or hemiparesis with movement, the Berkeley-based Ekso Bionics Company set new standards in rehabilitation facilities and gait training. Moreover for patients/clients suffering from neurologicalimpairments which are traumatic brain injury, strokes, and cerebral paralysis, another promising option for rehab therapists are therapy robots, which help therapists with exercises and can accelerate recovery. More andmore clinicians have begun integrating the Xbox Kinect and Nintendo Wii into therapy plans over the past few years. Wii games are designed to use motion-sensitive controls and repeated motions equivalent to physical therapy. In addition tohelping victims of stroke and people suffering from knee surgery, video game workouts have been found to help people recover from brain injury and patients in ICUs. The application of virtual reality technology in PT has expanded afascinating, interactive treatment session in a virtual world to virtual reality rehab. The CAREN-Computer Assisted Rehabilitation Environment (CAREN) VR system is designed to support stroke patients or patients with seriousinjuries, geriatric population with disability and improve their sense of stability and mobility2. The Recovery Tracker software from Reflexing Health offers advised client-specific videos with proper instructions and guidelines, trainingresources, and exercises. The software allowstherapists to track client's success plus monitor his/her progress in real time and in addition allows them to visually check their clients carrying out the exercises with the help of Kinectcamera. In 2010, Chase Curtiss created “Sway”, a solution for concussion management that highlights the forever present risks linked with chronic or untreated head injuries, to assist "health professionals manage objective balanceand reaction time virtually testing in any setting.” Rocky Mountain University of Health Professions, Utah is working on wearables that notify when the gait speed of a patient decreases, so that they can intervene before a patient falls.These devices can be used within and outside of the clinic to monitor patients, while offering actual measures which avoid exhaustion or injury.Physical therapy is a hands-on field, and will always be, but for sure technology canalways play a significant part. Progresses in r o b o t i c s a n d b i o n i c s a r e h e l p i n g physiotherapists to diagnose more reliably and boost treatment efficiencies which in addition enhance patient/client involvement andcompliance with Home Exercise Program(HEP). All of this results in an improved patient/client experience, eventually leading to enhanced and long-term outcomes in return.

Background: Elite tennis athletes experience injuries throughout the entire body. Impairments in trunk stability, lower limb flexibility, and hip range of motion (ROM) are modifiable risk factors that can impact injuries and performance. Information on nonmodifiable risk factors such as age and gender is limited. The purpose of this investigation was to provide information on risk factors to direct clinical decision-making and injury prevention and rehab programming in this population. Hypothesis: Prevalence and location of injuries will differ by age group and gender. Trunk stability, lower limb flexibility, and hip ROM will differ by age group and gender. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A de-identified database (n = 237; females = 126) from the United States Tennis Association High Performance Profile (HPP) 2014-2015 was used for the analysis. Subjects were elite junior and professional tennis players (mean age 14.6 [range, 9-27] years). The HPP is a tennis-specific assessment and questionnaire that includes retrospective information on injury history. Subjects were categorized by injury, gender, and age. Injury locations were classified by region. Trunk stability measures included drop vertical jump (DVJ), single-leg squat, and prone and side planks. Lower limb measures included hamstring, quadriceps and hip flexor flexibility, and hip rotation ROM. Results: A total of 46% of athletes reported an injury. Significant differences were found for injury prevalence and location by age group. Adolescent athletes (age 13-17 years) had more trunk injuries, while adult athletes (age ≥18 years) had more lower limb injuries. Adolescent athletes performed worse on DVJ, dominant side plank, and hamstring flexibility compared with young (age ≤12 years) and adult athletes. Significant gender differences in hip ROM included internal rotation on both the dominant and nondominant sides. Conclusion: Impairments in trunk stability, lower limb flexibility, and hip rotation ROM may affect both health and performance outcomes in this population. Elite tennis athletes may benefit from additional off court programming to address trunk and lower limb impairments. Clinical Relevance: Adolescent elite tennis athletes may be at higher risk of trunk injuries. Age, gender, injury history, and impairments should be considered with all assessments and programming.

Introduction. The significant prevalence of vascular diseases of the brain, the complexity of dysfunc- tion, put the problems of their treatment, rehabilitation and prevention into the focus of attention of modern neurology. A stroke occurs in the United States every 45 seconds. Approximately 750,000 people a year suffer from a stroke in the United States. According to statistics from the Ministry of Health of Ukraine, more than 110,000 primary strokes are recorded annually in the country. No less serious disease of the human central nervous system is Alzheimer’s disease. Each year, more than 500,000 Americans die from this disease, making it the third leading cause of death in the United States. Traffic accidents, local military conflicts, some sports form a very numerous specific group of patients with craniocerebral injuries. Aim — to develop a phototherapeutic hardware complex for the prevention, treatment and rehabilitation of vascular, inflammatory, degenerative, post-traumatic and other brain diseases that are difficult amenable to medical treatment including pharmacoresistant indomitable pain syndromes. Materials and methods. The low-intensity electromagnetic radiation of the optical range of the spectrum and the magnetic field of a permanent magnet are physical factors that are used in phototherapeutic complex devices. Results. A phototherapy apparatus complex has been developed for the prevention, treatment and reha- bilitation of vascular, inflammatory, degenerative, post-traumatic and other brain diseases that are difficult to treat with drugs. The phototherapeutic hardware complex includes three devices: the modified photon-mag- netic apparatus Korobov-Posokhov “Barva-CNS/FM”, the photon-magnetic matrices A.Korobov - V.Korobov “Barva-Laryngologist/FM” and flexible photon-magnetic matrices A.Korobov - V.Korobov “Barva-Flex/24FM”. Conclusions. The presented clinical observations obtained using the developed phototherapeutic hard-ware complex for the treatment and prevention of diseases of the brain indicate high efficacy and safety of long-term low-intensity phototherapy in patients with dyscirculatory encephalopathy, with suffered ischemic and hemorrhagic strokes, with hypertensive disease.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Surgical treatment options for symptomatic, full-thickness articular cartilage loss in the ankle are not consistently effective in restoring ankle function. Osteochondral allograft transplantation provides a standard-of-care alternative for patients, however, outcomes reported to date have been only fair, with a high incidence of reoperation and revision. However, recent cartilage storage and preservation techniques have significantly improved the percent viable chondrocytes at the time of implantation in OCAs. These high-chondrocyte-viability allografts should lead to improved survivability of OCAs and improved outcome measures. This study aimed to document the initial outcomes for patients undergoing bipolar OCA transplantation in the ankle after advances in tissue preservation, transplantation techniques, and patient management strategies. Methods: Patients with symptomatic tibiotalar arthritis were prospectively enrolled into a registry designed to follow outcomes after OCA surgeries in the ankle. All patients underwent complete OCA replacement of their tibial plafond and talar dome, with most undergoing fibular articular resurfacing. All OCA were size and side matched and preserved in Missouri Osteochondral Allograft Preservation System (MOPS). Patients followed a standardized, procedure-specific rehabilitation protocol after surgery, including remaining non-weight bearing for 8 weeks, weekly therapy visits, limited step count during recovery, and avoidance of high impact activities until 1 year after surgery. Patients followed-up with their physician at regular post-operative timepoints. Radiographs and patient reported outcome measures (VAS, AAOS Foot and Ankle, PROMIS PF, PROMIS Mobility) were obtained at each follow-up visit. Demographic and operative data were collected from the electronic medical record. All reported complications, reoperations, revisions, and failures were recorded in the EMR. Results: 14 patients were included for analyses with 12 undergoing primary OCA transplantation, and 2 undergoing revision OCA transplantation. Mean age and follow up was 36 and 44.1 months, respectively. All patients underwent tibia and talus OCA transplantation, with 10/14 including a fibula OCA transplantation. Initial success was 92.9% with one documented failure (tibial OCA collapse). Radiographic assessments indicated OCA integration and maintenance of joint space in 12 patients (85.7%). AAOS and VAS pain scores improved significantly from preoperative measures at each timepoint (p=.002, p=.03), while postoperative improvements in PROMIS Mobility and PROMIS Physical Function scores did not reach significance (p>0.15) (Table 1). Patients that were non-adherent to postoperative restriction and rehabilitation protocols, all 1-year postoperative PROs were significantly lower than for patients who were adherent. Conclusion: Ankle osteoarthritis in young patients continues to present a challenging dilemma. Previous attempts at large bipolar OCAs in the ankle have yielded fair, to poor, results. However, recent advances in bulk osteochondral allograft preservation has improved chondrocyte viability. Based on the results of our study, the use of high-chondrocyte-viability allografts for OCA transplantation is a viable option for the treatment of symptomatic bipolar osteochondral defects in the ankle joint. However, post operative rehab protocols are equally important in determining outcomes, and patient selection and education is key to ensuring successful outcomes. Longer term follow up is ongoing.

How do we challenge a streaming “golden age” characterized by the ceaseless production of expression that repeats and reinforces injustice and inequality? Our media and tech systems prioritize developing stories and platforms to target distinct audiences for profit, but our communities need to cultivate interdependence and solidarity. Healing these injustices, including racism, misogyny, xenophobia, homophobia, classism, ableism, and other forms of hate, requires a specific method of repair: re-distributing power more equitably to the historically disempowered. In the last decade in the U.S., what Aymar Jean Christian terms “reparative media,” responding to the social upheaval that political polarization, misinformation, and climate and racial reckoning has burgeoned. Christian writes, “[R]epairing our culture means healing how we make media, how we connect through technology, and how we generate knowledge.” This panel analyzes the concept of reparative media, examines case studies, and analyzes counterrevolutionary pushback. Grounded in U.S. experience, the panel is designed to open a conversation more widely, and create terms under which these issues can be engaged elsewhere. Unlike previous eras, this era’s reparative media work is grounded in responses to the realities of a digital culture shaped by mega-platforms and instant reaction times. In audio-visual media, streamers (building upon past example in broadcast and cable) have funded or showcased extractive and exploitative programming, such as much of true crime, reality shows, and unapologetically offensive comedy. Scandals about ethics—Yazidi women protesting invasion of privacy in the documentary Sabaya, MENASA filmmakers protesting errors and putting participants at risk in Jihad Rehab, BIPOC filmmakers protesting the all-white, male production crew for a forthcoming film about BIPOC sports star Tiger Woods--have multiplied. The reparative media movement is also informed, in the U.S., by the tide of racial reckoning since 2014. This movement has also been joined by other minoritized voices, including those of people living with disabilities, gender-nonconforming makers, and those experiencing consequences of lacking appropriate immigration status. However, the reparative work also builds upon efforts in previous eras in self-styled movements for alternative media, community media, public-service media, and activist media. These movements were accompanied by extensive communications research—much of it done in a collaborative way with practitioners—that allows us to understand today’s reparative media in context. These movements have shared common expectations that media produced by and for underheard members of society are essential parts of movements for social change. The panel provides both theoretical and practice-oriented roads into the discussion, which we expect to be between a third and a half of the time allotted. Panelists also strive to provide examples and illustrations relevant to the conference venue of Philadelphia. The first speaker will address the concepts of reparative media and reparative research and development. Reparative research is work that is not only about but with reparative media communities, using both quantitative and qualitative research. Reparative story development is about the practice of developing narratives that confront, challenge, and provide alternatives to systemically oppressive storytelling. Reparative platform development is the work of building training, distribution and showcasing alternatives to today’s digital mega-platforms. This presentation will use case studies to illustrate the three categories. The second speaker will use a cultural-production analysis to focus upon reparative story development practices, looking closely at a two-year process to create standards for values-driven documentary production, a process triggered in part by alarm at streamer fecklessness. The process, which itself included reparative research, is analyzed for its challenges as well as its conclusions. Reception within the documentary community of the resulting document, a values-based framework for a six-part production process, is discussed, as is engagement by gatekeepers such as streamers, broadcasters and production companies. The presentation then focuses on attacks, benefiting from a veneer of legitimacy from centrist mainstream media, that leverage a conservative activists’ invocation on of “woke cancel culture,” to demonize the assertion of such values. The third speaker will address reparative platform development. In the U.S., community media centers, based in cable systems and offering educational, governmental, and public access channels, have their origins in 1970s citizen activism. But CMCs have shown an ability not only to survive but to reinvent themselves both technologically and in terms of community reparative work. The paper focuses on one such example, in Philadelphia, where communities of color have been actively working to address systemic harms and bolster community strength with hyperlocal media. In discussing the work of creating content for such systems, the paper also reveals the infrastructural affordances and limitations mediamakers encounter. Such forces reveal the systemic forces that threaten the evolution of such media. The discussant, with deep experience in reparative research in the Philadelphia media community and nationally, will infuse their commentary with location-specific references. Finally, panelists will provide in closing a brief, slideshow mini-tour of Philadelphia sites of reparative media work.