Context Understanding the factors that predict return to sport (RTS) after anterior cruciate ligament reconstruction facilitates clinical decision making. Objective To develop a clinical decision algorithm that could predict RTS and non-RTS based on the differences in the variables after anterior cruciate ligament reconstruction. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants A total of 150 athletes in any sport involving deceleration, jumping, cutting, or turning enrolled in the study. All participants answered the International Knee Documentation Committee and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) questionnaires and performed balance and isokinetic tests. Main Outcome Measure(s) The classification and regression tree (CART) was used to determine the clinical decision algorithm associated with RTS at any level and RTS at the preinjury level. The diagnostic accuracy of the CART was verified. Results Of the 150 participants, 57.3% (n = 86) returned to sport at any level and 12% (n = 18) returned to sport at the preinjury level. The interactions among the peak torque extension at 300°/s >93.55 Nm, ACL-RSI score at >27.05 (P = .06), and postoperative time at >7.50 months were associated with RTS at any level identified by CART and were factors associated with RTS. An ACL-RSI score >72.85% was the main variable associated with RTS at the preinjury level. The interaction among an ACL-RSI score of 50.40% to 72.85%, agonist:antagonist ratio at 300°/s ≤63.6%, and anteroposterior stability index ≤2.4 in these participants was the second factor associated with RTS at the preinjury level. Conclusions Athletes who had more quadriceps strength tended to return to sport at any level more quickly. even with less-than-expected psychological readiness. Regarding a return at the preinjury level, psychological readiness was the most important factor in not returning, followed by a better agonist:antagonist ratio and better balance.

Despite significant, the increased safety rate reflected the quantitative reduction of errors, with no observed difference in severity between the studied periods. Our results suggest the institutional steps taken could reduce the number of errors, but they were ineffective in reducing the severity of the errors.

Background: Patients after anterior cruciate ligament reconstruction (ACLR) have decreased health-related quality of life (QoL) compared with healthy control participants. Few studies have verified the predictors of QoL using Quality of Life Outcome Measure Questionnaire for Chronic Anterior Cruciate Ligament Deficiency (ACL-QoL), and no study has verified the relationship of psychological factors and knee function with ACL-QoL in patients after ACLR. Hypothesis: Knee functional status, muscle strength, performance in hop tests, postural stability, and psychological factors would be the predictors of QoL after ACLR. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: A total of 131 participants who had undergone ACLR at least 6 months previously were evaluated. QoL was assessed using ACL-QoL; knee functional status, using International Knee Documentation Committee Subjective Knee (IKDC) and global rating scale (GRS); psychological readiness, using Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI); kinesiophobia, using Tampa Scale for Kinesiophobia (TSK-17); knee strength, using isokinetic dynamometer; performance, using single-leg hop tests; and postural stability, using Biodex Balance System. Pearson’s linear correlation and stepwise hierarchical multiple linear regression analyses were performed to verify the predictors of QoL. Results: ACL-QoL showed a moderate correlation with IKDC ( r = 0.69), GRS ( r = 0.55), ACL-RSI ( r = 0.50), and TSK-17 ( r = -0.49). ACL-QoL presented none to low correlations with the variables of muscle strength, postural stability, and performance in hop tests. The variables related to the knee functional status and psychological factors (IKDC, GRS, ACL-RSI, and TSK-17) were found to be the predictors of QoL ( R2 = 0.56; P = 0.01). Conclusion: Knee functional status, psychological readiness, and kinesiophobia were the predictors of knee-related QoL in patients after ACLR. Clinical Relevance: These results can assist clinicians in the therapeutic monitoring of the factors that may interfere with QoL in patients after ACLR.

SummaryObjective: To analyze the conventional biventricular pacing (BV) and the bifocal (BF) right ventricular (RV) pacing, and to perform a comparative analysis of these two techniques in relation to clinical, functional and echocardiographic parameters in a population without the exclusion criteria of the major studies.Methods: A prospective non-randomized analysis of 36 patients undergoing surgery for multisite pacemaker implantation due to QRS ≥ 130 ms, severe left ventricular dysfunction, and NYHA functional class III or ambulatory class IV congestive heart failure was performed.Results: Favorable results of resynchronization were obtained with both techniques, with no significant differences in the comparison of the two groups, except for a higher QRS narrowing in the BV group, and a trend of a lower number or hospital admissions in the BV group. When the groups were analyzed separately and compared before and after the procedures, we observed that improvement was much more significant in the biventricular group, as were the more statistically relevant rates.Conclusion: Cardiac resynchronization therapy proved to be an efficient therapy in both groups analyzed, although with more significant outcomes in the biventricular group. (Arq Bras Cardiol 2007;88(6):596-603)

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