Objective. A systematic scoping review of the literature to identify functional performance tests and patient reported outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction and rehabilitation that are used in clinical practice and research during the last decade. Methods. A literature search was conducted. Electronic databases used included Medline, PubMed, Cochrane Library, EMBASE, CINAHL, SPORTDiscus, PEDro, and AMED. The inclusion criteria were English language, publication between April 2004 and April 2014, and primary ACL reconstruction with objective and/or subjective outcomes used. Two authors screened the selected papers for title, abstract, and full-text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all papers was assessed by a checklist of the Critical Appraisal Skills Programme (CASP). Results. A total of 16 papers were included with full-text. Different authors used different study designs for functional performance testing which led to different outcomes that could not be compared. All papers used a measurement for quantity of functional performance except one study which used both quantity and quality outcomes. Several functional performance tests and patient reported outcomes were identified in this review. Conclusion. No extensive research has been carried out over the past 10 years to measure the quality of functional performance testing and control stability of patients following ACL reconstruction. However this study found that the measurement of functional performance following ACL reconstruction consisting of a one-leg hop for a set distance or a combination of different hops using limb symmetry index (LSI) was a main outcome parameter of several studies. A more extensive series of tests is suggested to measure both the quantitative and qualitative aspects of functional performance after the ACL reconstruction. The KOOS and the IKDC questionnaires are both measures that are increasingly being used for ACL reconstruction throughout the last decade.

Objective: To assess the inter-and intra-observer reliability of a qualitative scale of the limb alignment during the single-leg squat (SLS) test. Design: Repeated measures. Setting: University Human Performance laboratory. Participants: Four subjects (Two female, two male). Main outcome measures: Qualitative score from the video assessment of the SLS test by four independent assessors on two separate occasions. Results: The percent agreement (PA) for the four observers across all scoring criteria for all subjects was excellent (ranged 83-100%). All observers were in 100% agreement in 5 out of 10 of all of the scoring criteria of all subjects. The kappa measure of agreement ranged from k=0.63 to 1.0 which is good/substantial to almost perfect/excellent. The intra-observers PA ranged 95%-100%, with kappa values of k=0.89-1.0. Conclusion:The study showed very good to excellent inter-and intra-observer reliability for all examiners when comparing their individual scores of the SLS test across two analysis sessions using the assessment tool. The findings indicate that this qualitative evaluation method may allow clinicians and researchers to standardise the categorization of functional movements of single-leg loading such as the SLS regardless of the equipment, time and venue.

The aim of the current study is to assess the intra-rater and inter-rater reliability of real time ultrasound scanning in measuring static humeral head position. Real time ultrasound scanning, an experimental clinical measurement, was used to record measurements of the humeral head position in a sample of (20) healthy volunteers [9 male, 11 female]. While the participant was seated in a standardized chair, Hips and knees were positioned at 90 degrees of flexion. The humeral head position of each subject was imaged at three ultrasound view [anterior, posterior and superior] in a different arm positions; images were repeated three times for each position by the same examiner on the same day to assess Intra-rater reliability. The Images were then analysed by the researcher and a second investigator to assess inter-tester reliability. Intra-rater and inter-rater reliability were quantified by using the intraclass correlation coefficient and standard error of measurement, the smallest detectable difference values were calculated and were used to estimate the magnitude of change that is predictable to exceed measurement error. The intra-rater reliability for all positions was found to be excellent for all tests ranged from 0.83 to 0.99 respectively. Inter -rater reliability between examiners was found to be good to excellent for all test positions ranged from 0.66 to 0.98, and the standard error of measurement for all positions was less than the calculated mean. This study demonstrates that real time ultrasound scanning is a reliable method of assessing the location of the humeral head in a number of arm positions in healthy subjects when measured by the same examiner and this may suggest that RTUS could be used to assess the impact of rehabilitation programme or surgical interventions for shoulder pathology.

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Low back pain (LBP) is a common and elusive disorder. It cannot be comfortably diagnosed through clinical procedures, and little is understood about its etiology. From a public health perspective, it would be important to know if lifestyle factors, such as body weight, play an important role in its genesis. However, a look at the literature reveals some misperceptions. There are several hypotheses relating to a link between obesity and LBP. Increased mechanical demands resulting from obesity have been suspected of causing LBP through excessive wear and tear, and it has been suggested that metabolic factors associated with obesity may be detrimental. Thus, some consider it possible, but not particularly strong contributing factor of LBP, whereas others do not think that it is a risk factor of LBP. It has also been postulated that obesity may be a marker or an organizer for some other factors that are considered the causes of LBP. This study aims to measure the relationship between body weight and low back pain (LBP).

Background: Arthroscopic ACL reconstruction surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain. Objectives: We aimed to find out the effects of intra-articular ropivacaine-morphine on postoperative pain in patients undergoing elective arthroscopic ACL reconstruction surgery. Materials and Methods: A total of 46 patients undergoing elective arthroscopic ACL reconstruction under spinal anaesthesia were enrolled. The participants were allocated to two groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group I, 20 mL of saline, Group II, 0.25% Ropivacaine and 5 mg morphine 20 mL in volume. Visual analogue scale (VAS) values were recorded at 1, 3, 6, 12 and 24 hours postoperatively, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated. Results: VAS was significantly higher in group I in comparison to other groups. Duration of analgesia was significantly longer in Group II than in Group I. Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group II. Conclusions: Intraarticular ropivacaine-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular ropivacaineclonidine combination and saline after arthroscopic ACL reconstruction surgery.

ObjectivesThe purpose of the present study is to review the existing literature regarding the response of the Vastus medialis oblique (VMO) and Vastus lateralis (VL) muscles of patients with Patellofemoral pain syndrome (PFPS) to open and closed kinetic chain exercises. Search methodsA search was conducted for randomised and non-randomised controlled trials published by July 2016 and involving comparative analysis of exercise treatment with control groups or various exercise treatment types. The following resources were searched: the Cochrane Bone, Joint and Muscle Trauma Group and Cochrane Rehabilitation and Related Therapies Field specialised registers, the Cochrane Controlled Trials Register, The Physiotherapy Evidence Database (PEDro), MEDLINE, EMBASE, and CINAHL. Data collection and analysisTrials were excluded if they were not concerned with exercise therapy in individuals with PFPS. Thus, only nine out of 91 trials found were included and they all employed statistical techniques to assess the response of VMO and VL muscles to open and closed kinetic chain exercises. Main resultsThe trials under review are too few in number and are inconsistent with regard to rehabilitation strategies and outcome assessment. They underline the necessity for reviewing RCT trials on a wider scale as the evidence they supply in support of use of open and closed kinetic chain exercises is insufficient. Trials have to be comparable in terms of participant traits, intervention and outcome assessment to improve the validity of the conclusions drawn. It was not possible to definitely say whether one intervention was better than another, because different interventions were implemented in the reviewed trials. Furthermore, future research should also include placebo-controlled trials to ascertain the efficiency of various interventions. Keywords