Introduction Return to sports (RTS) clearance after anterior cruciate ligament (ACL) reconstruction typically includes multiple assessments. The ability of these tests to assess the risk of a reinjury remains unknown. Purpose To assess and rate RTS self-reported function and functional tests on prognostic value for reinjury risk after ACL reconstruction and RTS. Study Design: Systematic review on level 2 studies. Methods PubMed, Web of Knowledge, Cochrane Library, and Google Scholar databases were searched for articles published before March 2018. Original articles in English or German that examined reinjury risks/rates after primary (index) ACL injury, ACL reconstruction, and RTS were included. All RTS functional tests used in the included studies were analyzed by retrieving an effect size with predictive value (odds ratio, relative risk (risk ratio), positive predictive value, positive likelihood ratio, or hazard rate). Results A total of 276 potential studies were found; eight studies (moderate to high quality) on 6140 patients were included in the final analysis. The reinjury incidence recorded in the included studies ranged from 1.5% to 37.5%. Four studies reported a combination of isokinetic quadriceps strength at different velocities and a number of hop tests as predictive with various effect sizes. One reported isokinetic hamstring to quadriceps ratio (hazard rate = 10.6) as predictive. Two studies reported functional questionnaires (knee injury and osteoarthritis outcome score and Tampa Scale of Kinesiophobia-11; RR = 3.7–13) and one study showed that kinetic and kinematic measures during drop vertical jumps were predictive (odds ratio, 2.3–8.4) for reinjury and/or future revision surgery. Conclusions Based on level 2 evidence, passing a combination of functional tests with predetermined cutoff points used as RTS criteria is associated with reduced reinjury rates. A combination of isokinetic strength and hop tests is recommended during RTS testing.

BACKGROUND: Physical activity (PA) offers considerable health benefits for diabetic patients. However, extensive high levels of inactivity has been reported among diabetic patients. This study sought to assess the patterns of physical activity and its relationship with two management-relevant outcomes (glycaemic and blood pressure control)among people living with diabetes in the Ho Municipality, Ghana.METHODS: A hospital-based cross-sectional study was carried out from January 2017 to April 2017 among 150 purposively recruited diabetic patients who were receiving care at the diabetes clinics of the Volta Regional Hospital and the Ho Municipal Hospital. A semi structured questionnaire was used in capturing socio-demographic information. Physical activity was assessed using the International Physical Activity Questionnaire Short Form. Glycaemic and blood pressure control were evaluated within a three-month period from patients’ records.RESULTS: Physical activity estimates among participants were 21.33%, 48% and 30.67% for high, moderate and low PA respectively. Glycaemic control among the study participants was 33.33% and blood pressure control was 58.67%. Both glycaemic and blood pressure control were significantly associated with PA.CONCLUSION:In this group of PLWD in the Ho Municipality, high levels of inactivity, uncontrolled glycaemia and blood pressure exist. However, glycaemic and blood pressure control may be modulated by moderate-intensity physical activity.

BackgroundAccessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life.ObjectiveThis study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006).MethodsEighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers’ counters were measured and computed.ResultsOut of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors.ConclusionThe results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users.

BackgroundThe devastating impact of musculoskeletal injury (MSI) on human lives, the economy, and health services cannot be overemphasised. This has ignited discussion at international fora, as countries have been exhorted to prioritise management of MSI in order to maintain a healthy society. In the Ghanaian context, the knowledge base management of MSI is very low, which has provided the impetus to explore the management of MSI and the rehabilitation systems at a tertiary hospital in Ghana.MethodsThe study was a retrospective cross-sectional study, using the consecutive sampling method to recruit patients who were discharged after admission at the accident and emergency unit, as well as patients undergoing orthopaedic review, at the St. Joseph’s Orthopaedic Hospital in Koforidua over a six-month period.ResultsA total of 269 musculoskeletal injury patients were recruited for the study. Half of the participants (51%) had had surgery in addition to pain medication. The overall mean recovery days were 26.81 ± 33.94 days, and the average disability days spent in the hospital were estimated at 16.54 ± 27.97 days. Individuals reported financial constraints as a major challenge to their full participation in rehabilitation.ConclusionThe findings of this study have implications for policymaking in Ghana. Particularly, the need to improve health facilities to enable MSI patients to seek treatment is highlighted. Also, the need to train health professionals who will be able to administer appropriate medication for MSI patients is discussed extensively.