TY - JOUR
T1 - Young athletes cleared for sports participation after anterior cruciate ligament reconstruction
T2 - How many actually meet recommended return-to-sport criterion cutoffs?
AU - Toole, Allison R.
AU - Ithurburn, Matthew P.
AU - Rauh, Mitchell J.
AU - Hewett, Timothy E.
AU - Paterno, Mark V.
AU - Schmitt, Laura C.
N1 - Funding Information:
1OSU Sports Medicine, The Ohio State University Wexner Medical Center, Columbus, OH. 2Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL. 3Doctor of Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA. 4Biomechanics Laboratories and Sports Medicine, Departments of Orthopaedic Surgery, Physical Medicine and Physiology and Biomedical Engineering, Mayo Clinic, Rochester and Minneapolis, MN. 5Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. 6Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. 7Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH. 8School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH. 9Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH. 10Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH. Investigation performed at the Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. The Cincinnati Children’s Hospital Medical Center Institutional Review Board approved the protocol for this study. This work was funded by support from National Institutes of Health grant F32-AR055844, the National Football League Charities Medical Research grants 2007, 2008, 2009, 2011, and the Foundation for Physical Therapy. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Laura C. Schmitt, 453 West 10th Avenue, 516 Atwell Hall, Columbus, OH 43210. E-mail: laura.schmitt@osumc.edu U Copyright 2017
Publisher Copyright:
Copyright © 2017 Journal of Orthopaedic & Sports Physical Therapy.
PY - 2017/11
Y1 - 2017/11
N2 - STUDY DESIGN: Prospective cohort study. BACKGROUND: While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. OBJECTIVES: To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. METHODS: At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following returnto- sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. RESULTS: Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-tosport clearance than those who did not (81.3% versus 60.2%, P = .02). CONCLUSION: The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not.
AB - STUDY DESIGN: Prospective cohort study. BACKGROUND: While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. OBJECTIVES: To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. METHODS: At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following returnto- sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. RESULTS: Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-tosport clearance than those who did not (81.3% versus 60.2%, P = .02). CONCLUSION: The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not.
KW - ACL
KW - Athletic performance
KW - Knee injury
KW - Limb symmetry
KW - Rehabilitation
KW - Return to sports
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U2 - 10.2519/jospt.2017.7227
DO - 10.2519/jospt.2017.7227
M3 - Article
C2 - 28990491
AN - SCOPUS:85032658482
SN - 0190-6011
VL - 47
SP - 825
EP - 833
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 11
ER -