ObjectiveTo explore the role of psychological, social and contextual factors across the recovery stages (ie, acute, rehabilitation or return to sport (RTS)) following a traumatic time-loss sport-related knee injury.Material and methodsThis review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Arksey and O’Malley framework. Six databases were searched using predetermined search terms. Included studies consisted of original data written in English that identified or described a psychological, social or contextual factor related to recovery after a traumatic time-loss sport-related knee injury. Two authors independently conducted title–abstract and full-text reviews. Study quality was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was undertaken.ResultsOf 7289 records, 77 studies representing 5540 participants (37% women, 84% anterior cruciate ligament tears, aged 14–60 years) were included. Psychological factors were investigated across all studies, while social and contextual factors were assessed in 39% and 21% of included studies, respectively. A cross-cutting concept of individualisation was present across four psychological (barriers to progress, active coping, independence and recovery expectations), two social (social support and engagement in care) and two contextual (environmental influences and sport culture) themes. Athletes report multiple barriers to recovery and valued their autonomy, having an active role in their recovery and diverse social support.ConclusionDiverse psychological, social and contextual factors are present and influence all stages of recovery following a traumatic sport-related knee injury. A better understanding of these factors at the time of injury and throughout rehabilitation could assist with optimising injury management, promoting RTS, and long-term health-related quality-of-life.

Trigramin (Mr weight 10 kDa), an acidic, cysteine rich peptide purified into homogeneity from Trimeresurus gramineus snake venom contained a single protein chain with EAGE at the NH2 terminal end. It inhibited platelet aggregation induced by various agents without affecting release reaction. It blocked competitively the binding of 125I-fibrincgen to AEP stimulated and chymotrypsin treated platelets (Ki= 2 × 10−8). 125-I trigramin bound to intact and to AEP stimulated platelets in a saturable manner (approx. 16,000 sites per platelet). However, AEP increased 5 fold, the binding affinity of trigramin to platelets (to Kd = 4 × 10−8M) suggesting that AEP is changing the conformation of receptors associated with GPIIb/GPIIIa complex. The binding of trigramin to thran-basthenic platelets was markedly reduced. The binding to normal platelets was significantly inhibited by EDTA and by monoclonal antibodies directed against GPIIb/GPIIIa complex but not by the antibodies directed against GPIIb or GPIIIa molecules. The binding of 125I-trigramin to AEP-stimulated platelets was inhibited by RGES (IC50 = 125 μM) and by YHHLGGAKOAGDV (C-terminal fragment of fibrinogen gamma chain, IC50 = 250 μM) suggesting that these or similar peptide sequences are required for interactions of various ligands with GPIIb/GPIIIa complex

their association with future musculoskeletal pain, 31,35,74 obesity, 92 osteoarthritis, 95 cardiovascular disease, 45 and all-cause mortality. 1,98 Additionally, musculoskeletal pain in adolescence can reduce participation in school and sport 42 and alter career choice later in life. 74 These long-term consequences underlie the importance of appropriate care for youth (ie, children and adolescents) with musculoskeletal conditions. An essential treatment component for musculoskeletal conditions is exercise therapy. Distinct from general physical activity, "exercise therapy" is a regimen or plan of physical activities designed and prescribed in a precise dose to address specific therapeutic goals. 62 In youth with musculoskeletal conditions, exercise therapy effectiveness is associated with adherence, 10,49,76,78 defined as the extent to which someone's behavior corresponds with agreed recommendations from a health care provider. 100 Despite the importance of adherence, consensus on how to define, measure, or improve adherence to exercise therapy is lacking. 5 T he worldwide burden of musculoskeletal conditions (ie, diseases and injuries) is high and impacts people of all ages. 28,33,82 In adolescence, the high prevalence of musculoskeletal pain (estimated to be between 20% and 40%) 17,34,47 and incidence of musculoskeletal injuries (estimated at 30.9 injuries per 100 adolescents per year) 20 are concerning, given

Objective To identify the most suitable existing generic and condition-specific health-related quality of life (HRQoL) patient-reported outcome measures (PROMs) for active youth with and without a musculoskeletal injury, based on measurement properties, interpretability, and feasibility. Design Systematic review of clinimetrics. Literature Search We searched MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO, and Scopus from inception to April 30, 2020. Study Selection Criteria Records with original data describing the evaluation of a PROM or PROM subscale in active youth (15–24 years old) with or without a musculoskeletal injury were included. Non-English studies and those including individuals with a cognitive, developmental, or systemic condition were excluded. Data Synthesis This review was conducted according to the COSMIN user manual for systematic reviews of PROMs and the PRISMA guidelines. The COSMIN user manual guided our measurement property evaluation and interpretability and feasibility description. Results Of 6931 potential records, 21 studies were included. Eleven generic and 7 condition-specific PROMs were identified. No PROM received a final COSMIN recommendation of “A” because all lacked sufficient content validity. The 8-item Disablement in the Physically Active scale-mental summary component Short Form (DPA-MSC SF-8), Quality of Life Survey, and Functional Arm Scale for Throwers (FAST) were the most suitable existing PROMs, given their high-quality evidence for sufficient structural validity and internal consistency. Conclusion No definitively robust PROM for measuring generic or condition-specific HRQoL of active youth was identified. Until one exists, we recommend the DPA-MSC SF-8, the Quality of Life Survey, or the FAST and applying mixed methods to best characterize the HRQoL of active youth. J Orthop Sports Phys Ther 2021;51(10):478–491. doi:10.2519/jospt.2021.10412

Purpose: To describe the development of a new measure of therapeutic relationship for use in physiotherapythe Physiotherapy Therapeutic RElationship Measure (P-TREM). Methods: We adopted the methodology of Devellis in Scale Development: Theory and Applications for constructing the P-TREM. We developed a measurement framework based on Miciak's Physiotherapy Therapeutic Relationship Conceptual Framework. We generated a pool of items by extracting items from existing measures and writing new items. These were reviewed by a panel of experts and then formatted into a draft measurement instrument. The draft instrument was tested for relevancy and comprehensibility in potential respondents from our target populations using cognitive interview techniques. Finally, we pilot tested the full administration of the P-TREM. Results and conclusions: We systematically constructed the P-TREM with 49 items in 3 subscales. Our rigorous instrument development approach ensures its content validity, which was also demonstrated in the cognitive interviews and pilot testing. The quality of the items and construct validity will be assessed in a subsequent validation study.