The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2018;48(5):A1–A38. doi:10.2519/jospt.2018.0302
The relationship between a static measure of dorsal first ray mobility and dynamic motion of the first ray, midfoot, and hindfoot during the stance phase of walking was investigated in healthy, asymptomatic subjects who represented the spectrum of static flexibility. Static first ray mobility of 15 subjects was measured by a load cell device and ranged from stiff (3.1 mm) to lax (8.0 mm). Using three-dimensional motion analysis, mean first ray dorsiflexion/eversion and mid-/hindfoot eversion peak motion, time-to-peak, and eversion excursion were evaluated. Subjects with greater static dorsal mobility of the first ray demonstrated significantly greater time-to-peak hindfoot eversion and eversion excursion (p <.01), and midfoot peak eversion and eversion excursion (p <.01). No significant association was found between static first ray mobility and first ray motion during gait. This research provides evidence that the dynamic response of the foot may modulate the consequences of first ray mobility and that compensory strategies are most effective when static measures of dorsal mobility are most extreme.
This analysis suggests the PROMIS and GRNF scales are able to characterize PASS status with moderate accuracy (∼70%) for a large portion of patients (∼70%). New to this study is the association of self-efficacy with PASS status. PROMIS scales at or slightly worse than the US population average characterized PASS status.
Context
Patellar tendinopathy (PT) is a degenerative condition known to affect athletes who participate in sports such as basketball and volleyball. Patellar tendinopathy is a challenging condition to treat and may cause an athlete to prematurely retire from sport. The prevalence of PT in male collegiate basketball players is unknown.
Objective
To determine the prevalence of PT and patellar tendon abnormality (PTA) in a population of male collegiate basketball players.
Design
Cross-sectional study.
Setting
National Collegiate Athletic Association Divisions II and III, National Association of Intercollegiate Athletics, and Northwest Athletic Conference male collegiate basketball teams were assessed in a university laboratory setting.
Patients or Other Participants
Ninety-five male collegiate basketball players (age = 20.0 ± 1.7 years).
Main Outcome Measure(s)
A diagnostic ultrasound image of an athlete's patellar tendon was obtained from each knee. Patellar tendinopathy was identified based on a player's symptoms (pain with palpation) and the presence of a hypoechoic region on an ultrasonographic image.
Results
A majority of participants, 53 of 95 (55.8%), did not present with pain during palpation or ultrasonographic evidence of PTA. Thirty-two basketball players (33.7%) displayed ultrasonographic evidence of PTA in at least 1 knee; 20 of those athletes (21.1%) had PT (pain and tendon abnormality). Nonstarters were 3.5 times more likely to present with PTA (odds ratio = 3.5, 95% confidence interval = 1.3, 9.6; P = .017) and 4 times more likely to present with PT (odds ratio = 4.0, 95% confidence interval = 1.1, 14.8; P = .038) at the start of the season.
Conclusions
One in 3 male collegiate basketball players presented with either PT or PTA. Sports medicine professionals should evaluate basketball athletes for PT and PTA as part of a preseason screening protocol.
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