Targeted Diagnosis, Physiotherapy, and Rehabilitation of Tailored Management Sport Injuries

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 8027

Special Issue Editors


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Guest Editor
1. Department of Human Neurosciences, “Sapienza” University of Rome, 00185 Rome, Italy
2. Sovrintendenza Sanitaria Regionale Puglia INAIL, 70126 Bari, Italy
Interests: differential diagnosis; screening for referral; physiotherapy; low back pain; spinal manipulation; musculoskeletal disorders; direct access in physiotherapy
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy
2. Fisio Analysis Mædica, 15121 Alessandria, Italy
3. Department Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
Interests: musculoskeletal disorders; biomechanics; rehabilitation; physical rehabilitation; sports Injuries; exercise science

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Guest Editor
1. Department of Clinical and Experimental Sciences, University of Brescia, 25133 Brescia, Italy
2. Laboratory of Neuromuscular Rehabilitation, Teresa Camplani Foundation—Domus Salutis Clinic, 25124 Brescia, Italy
Interests: rehabilitation

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Guest Editor
1. Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Differdange, Luxembourg
2. Health & Sport Sciences Research Institute, A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
Interests: differential diagnosis; screening for referral; physiotherapy; neck pain; spinal manipulation; musculoskeletal disorders; cervical serious pathology; philosophy of science
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sports injuries can be debilitating, causing significant pain and affecting performance. Proper diagnosis, physiotherapy and rehabilitation of these injuries is critical to restoring functionality and allowing athletes to return to their sport safely.

This Special Issue addresses targeted diagnosis, physiotherapy and rehabilitation approaches for sports injuries, using a comprehensive approach to provide the best possible care. It covers a range of topics, from standard diagnosis techniques and analysis of injury patterns to the latest breakthroughs in technology-driven solutions to sports injuries. It offers a multidisciplinary approach, with experts from various fields contributing to developing targeted physiotherapy and rehabilitation protocols that factor in an athlete's unique physical and physiological characteristics.

The Special Issue will also help identify risk factors that lead to specific injuries and offer suggestions regarding managing these risks to prevent future injuries. It will emphasize key research in injury prevention, such as biomechanics, nutrition, and psychology, and examine how these factors can be incorporated into a targeted rehabilitation plan for athletes.

Overall, this Special Issue offers evidence-based approaches to the diagnosis, physiotherapy and rehabilitation of sports injuries, accounting for biopsychosocial considerations and the latest techniques and technologies. By improving the diagnosis and treatment of sports injuries, we can help athletes recover faster, avoid reinjury, and return to their sports at optimal performance levels.

Dr. Filippo Maselli
Dr. Luigi Di Filippo
Dr. Firas Mourad
Dr. Massimiliano Gobbo
Guest Editors

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Keywords

  • sports injuries
  • diagnosis
  • physiotherapy
  • rehabilitation
  • performance
  • multidisciplinary
  • technology
  • injury prevention
  • evidence-based

Published Papers (6 papers)

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Research

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9 pages, 2605 KiB  
Article
Effectiveness of High-Power Laser Therapy via Shear Wave Speed Analysis on Pain and Functioning in Patients with Lateral Epicondylitis: A Proof-of-Concept Study
by Nicola Marotta, Alessandro de Sire, Lorenzo Lippi, Lucrezia Moggio, Paolo Mondardini, Maria Sgro, Isabella Bartalotta, Roberta Zito, Teobaldo Giroldini, Marco Invernizzi, Umile Giuseppe Longo and Antonio Ammendolia
J. Clin. Med. 2024, 13(7), 2014; https://doi.org/10.3390/jcm13072014 - 29 Mar 2024
Viewed by 657
Abstract
Background: Lateral epicondylitis (LE) causes lateral elbow pain due to the overuse of the common extensor tendon. Several therapies have been proposed for pain relief and functional recovery, including physical therapy, minimally invasive injection approaches, and physical agent modalities such as laser [...] Read more.
Background: Lateral epicondylitis (LE) causes lateral elbow pain due to the overuse of the common extensor tendon. Several therapies have been proposed for pain relief and functional recovery, including physical therapy, minimally invasive injection approaches, and physical agent modalities such as laser therapy. Methods: Our study evaluates the impact of high-power laser therapy (HPLT) on pain and functioning. The HPLT protocol consists of 10 daily sessions using a LASERIX PRO device. The healthy elbow of each participant was also considered as a control group. The outcomes assessed were the Numerical Rating Scale (NRS) for pain, QuickDASH questionnaire for functionality, and shear wave velocity (SWS) through ultrasonography. Assessments were conducted at baseline (T0), post-treatment (T1), and 2-week follow-up (T2). Results: Sixteen participants (81.2% male, mean age 40.4 ± 5.53 years) completed the study. Post-treatment, pain significantly decreased (NRS: T0 6.13 ± 0.96; T1 2.75 ± 1.69; p <  0.001), functionality improved (QuickDASH: T0 69.88 ± 10.75; T1 41.20 ± 3.78; p < 0.001), and shear wave velocity increased (SWS (m/s): T0 1.69 ± 0.35; T1 2.56 ± 0.36; p <  0.001). Conclusions: At the 2-week follow-up, pain relief was maintained, and shear wave velocity showed no further significant change. Shear wave velocity assessments might be considered a useful diagnostic tool. However, further research is needed to support the role of HPLT and shear wave velocity in the rehabilitation management of LE. Full article
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12 pages, 1198 KiB  
Article
The Impact of Injury on Career Progression in Elite Youth Football—Findings at 10 Years
by Yannic Bangert, Ayham Jaber, Raphael Trefzer, Severin Zietzschmann, Kevin-Arno Koch, Ralph Kern, Jan Spielmann, Tobias Renkawitz and Johannes Weishorn
J. Clin. Med. 2024, 13(7), 1915; https://doi.org/10.3390/jcm13071915 - 26 Mar 2024
Viewed by 625
Abstract
Background: There is a lack of evidence regarding the impact of time loss, match exposure, and age at injury on career progression in elite football. Therefore, the aim of this study was to identify injury characteristics and their influence on career progression [...] Read more.
Background: There is a lack of evidence regarding the impact of time loss, match exposure, and age at injury on career progression in elite football. Therefore, the aim of this study was to identify injury characteristics and their influence on career progression in a German youth academy. Methods: During the 2012/2013 season, a prospective cohort study reported 107 time-loss injuries among 130 young athletes from an elite German soccer academy. Individual career progression was analyzed using 10-year data. Results: Injuries and time loss were not associated with career progression (p > 0.05) in the overall cohort. In the U17 and U19 groups, 24% were able to reach the professional level, with injuries significantly decreasing this probability (p = 0.002). Injuries lasting more than 28 days had a negative impact on career progression compared to minor injuries (30% vs. 10%; p = 0.02). Conclusions: Not only the characteristics of injuries, but also their impact on career development, vary with age. In the U17 and U19 age groups, serious injuries resulting in more than 28 days of absence have a negative impact on career progression. It is important to be aware of these effects in order to focus on the prevention of long-term injuries to ensure the optimal development of young athletes. Full article
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11 pages, 953 KiB  
Article
Do Patient Sex and Age Affect Hemiepiphysiodesis Outcomes?
by Piotr Morasiewicz, Paweł Leyko, Łukasz Tomczyk and Krystian Kazubski
J. Clin. Med. 2024, 13(6), 1654; https://doi.org/10.3390/jcm13061654 - 14 Mar 2024
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Abstract
(1) Background: The purpose of this study was to assess the effects of sex and age on the outcomes of hemiepiphysiodesis performed for genu valgum and varum deformity correction. (2) Methods: We analyzed patients who had undergone O-Plate hemiepiphysiodesis due to [...] Read more.
(1) Background: The purpose of this study was to assess the effects of sex and age on the outcomes of hemiepiphysiodesis performed for genu valgum and varum deformity correction. (2) Methods: We analyzed patients who had undergone O-Plate hemiepiphysiodesis due to genu valgum or varum in the period of 2020–2023. The study group comprised 22 females and 20 males aged between 3 and 14 years at the time of surgery. Age-stratification yielded a subgroup of 3–10-year-olds (16 patients, 20 treated limbs) and a subgroup of 11–14-year-olds (26 patients, 28 treated limbs). We assessed the following parameters: hospital stay duration, deformity correction time, MAD correction, amount of angular correction, correction velocity, correction rate, complete deformity correction, deformity recurrence, surgery duration, and complications. (3) Results: The mean follow-up was 19 months. The mean surgery time in the subgroup of 3–10-year-olds (25.62 min) was significantly longer than that in the subgroup of 11–14-year-olds (22.81 min, p = 0.018). The mean deformity correction time in the male subgroup (11.33 months) was significantly shorter than that in the female subgroup (15.87 months, p = 0.013). A comparison of the subgroups stratified by age yielded a mean amount of angular correction of 10.5° in the younger children, which was significantly higher than that of 7.2° achieved in the older children; p = 0.027. The difference in mean correction velocity between 3–10-year-old children (4.03 mm/month) and that in 11–14-year-old children (1.39 mm/month) was statistically significant; p = 0.031. The mean rate of correction was 0.49°/month in females and 0.89°/month in males, with the latter rate significantly greater; p = 0.023. The difference in the mean rate of correction between the younger (1.08°/month) and the older subgroup (0.59°/month) was also significant; p = 0.018. A significant difference in terms of deformity recurrence rates was observed between the younger subgroup (66.67%) and older subgroup (only 10.53%); p = 0.005. (4) Conclusions: Patient sex had no significant effect on hemiepiphysiodesis outcomes; patient age has a considerable effect on hemiepiphysiodesis outcomes. Full article
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11 pages, 2098 KiB  
Article
Relationship between Anterior Cruciate Ligament Injury and Subtalar Pronation in Female Basketball Players: Case-Control Study
by Laura Carabasa García, Rubén Lorca-Gutiérrez, Juan Vicente-Mampel, Roser Part-Ferrer, Nadia Fernández-Ehrling and Javier Ferrer-Torregrosa
J. Clin. Med. 2023, 12(24), 7539; https://doi.org/10.3390/jcm12247539 - 6 Dec 2023
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Abstract
Anterior cruciate ligament (ACL) injuries are a common issue in basketball. Several studies point to subtalar pronation as a relevant risk factor for these injuries, despite their multiarticular and multiplanar nature. This study evaluated the correlation between subtalar pronation and ACL injuries in [...] Read more.
Anterior cruciate ligament (ACL) injuries are a common issue in basketball. Several studies point to subtalar pronation as a relevant risk factor for these injuries, despite their multiarticular and multiplanar nature. This study evaluated the correlation between subtalar pronation and ACL injuries in female basketball players. A total of 30 players were recruited and divided into two groups: 15 with previous ACL injury and 15 without injury. The navicular drop test (NDT) and drop vertical jump test were applied to quantify parameters such as navicular drop, calcaneal eversion, ankle dorsiflexion, knee flexion, and dynamic valgus. The results showed significantly higher NDT values (6.93 ± 1.64 mm vs. 5.41 ± 1.96 mm, p = 0.029) and maximum calcaneal eversion angle (10.94 ± 3.22° vs. 5.30 ± 3.33°, p < 0.001) in the injured group. There were also significant differences in maximum dynamic valgus (152.73 ± 15.00° vs. 165.26 ± 5.628°, p = 0.005) and knee flexion (93.70 ± 7.47° vs. 82.92 ± 11.14°, p = 0.004) between groups. These findings suggest that subtalar pronation, assessed by NDT, and calcaneal eversion could be indicators of higher susceptibility to ACL injuries in female basketball players. Full article
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13 pages, 1889 KiB  
Article
Jumping Mechanography: Reference Centiles in Childhood and Introduction of the Nerve–Muscle Index to Quantify Motor Efficiency
by Kyriakos Martakis, Ute Alexy, Christina Stark, Andreas Hahn, Rainer Rawer, Ibrahim Duran and Eckhard Schönau
J. Clin. Med. 2023, 12(18), 5984; https://doi.org/10.3390/jcm12185984 - 15 Sep 2023
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Abstract
Jumping mechanography provides robust motor function indicators among children. The study aim was to develop centiles for the single 2-leg jump (S2LJ) in German children and adolescents and to identify differences in children with obesity. Data were collected in 2004–2021 through the German [...] Read more.
Jumping mechanography provides robust motor function indicators among children. The study aim was to develop centiles for the single 2-leg jump (S2LJ) in German children and adolescents and to identify differences in children with obesity. Data were collected in 2004–2021 through the German DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. All participants (6–18 years, mean age 11.4) performed annually an S2LJ aiming for maximum height on a Ground Reaction Force Platform. LMS (lambda-mu-sigma), including resampling, was used to develop centiles for velocity (vmax), jump height (hmax), relative force (Fmax/BW), relative power (Pmax/mass), impulse asymmetry and a new parameter to describe jump efficiency, the Nerve–Muscle Index (NMI), defined as vmax/(Fmax/BW). Data from 882 children and adolescents were analyzed (3062 measurements, median 3 per individual). In females, Fmax/BW values were higher in younger age but remained constant in adolescence. vmax, hmax and Pmax/mass increased in childhood, reaching a plateau in adolescence. In males, vmax, hmax and Pmax/mass showed a constant increase and the Fmax/BW remained lower. Children with obesity showed lower Fmax/BW, hmax, vmax and the NMI, hence, lower velocity per relative force unit and less efficient jump. The centiles should be used to monitor motor development in childhood. The NMI is a surrogate for motor efficiency. Full article
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Review

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19 pages, 1170 KiB  
Review
Effectiveness and Consequences of Direct Access in Physiotherapy: A Systematic Review
by Marco Gallotti, Benedetta Campagnola, Antonello Cocchieri, Firas Mourad, John D. Heick and Filippo Maselli
J. Clin. Med. 2023, 12(18), 5832; https://doi.org/10.3390/jcm12185832 - 7 Sep 2023
Cited by 3 | Viewed by 3460
Abstract
Background. Direct access in physiotherapy (DAPT) occurs when a patient has the ability to self-refer to physical therapy without physician referral. This model of care in musculoskeletal diseases (MSDs) has shown better outcomes than the traditional-based medical model of care that requires physician [...] Read more.
Background. Direct access in physiotherapy (DAPT) occurs when a patient has the ability to self-refer to physical therapy without physician referral. This model of care in musculoskeletal diseases (MSDs) has shown better outcomes than the traditional-based medical model of care that requires physician referral to access physiotherapist services. This traditional physician referral often results in a delay in care. Unfortunately, DAPT is still not permitted in many countries. Objectives. The primary objective of this systematic review was to compare the effectiveness, safety, and the accuracy of DAPT compared to the physician-led model of care for the management of patients with musculoskeletal disorders. The secondary objective of the present study is to define the physiotherapists’ characteristics or qualifications involved in DAPT. Materials and methods. Databases searched included: Medline, Scopus and Web of Science. Databases were searched from their inception to July 2022. Research strings were developed according to the PICO model of clinical questions (patient, intervention, comparison, and outcome). Free terms or synonyms (e.g., physical therapy; primary health care; direct access; musculoskeletal disease; cost-effectiveness) and when possible MeSH (Medical Subject Headings) terms were used and combined with Boolean operators (AND, OR, NOT). Risk of bias assessment was carried out through Version 2 of the Cochrane risk-of-bias tool (ROB-2) for randomized controlled trials (RCTs) and the Newcastle Ottawa Scale (NOS) for observational studies. Authors conducted a qualitative analysis of the results through narrative analysis and narrative synthesis. The narrative analysis was provided for an extraction of the key concepts and common meanings of the different studies, while the summary narrative provided a textual combination of data. In addition, a quantitative analysis was conducted comparing the analysis of the mean and differences between the means. Results. Twenty-eight articles met the inclusion criteria and were analyzed. Results show that DAPT had a high referral accuracy and a reduction in the rate of return visits. The medical model had a higher use of imaging, drugs, and referral to another specialist. DAPT was found to be more cost-effective than the medical model. DAPT resulted in better work-related outcomes and was superior when considering patient satisfaction. There were no adverse events noted in any of the studies. In regard to health outcomes, there was no difference between models. ROB-2 shows an intermediate risk of bias risk for the RCTs with an average of 6/9 points for the NOS scale for observational studies. Conclusion. DAPT is a safe, less expensive, reliable triage and management model of care that results in higher levels of satisfaction for patients compared to the traditional medical model. Prospero Registration Number: CRD42022349261. Full article
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