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前交叉韧带损伤和重建后的康复和重返运动:探索阿根廷物理治疗师的方法。

Rehabilitation and return-to-sport after anterior cruciate ligament injury and reconstruction: Exploring physical therapists' approaches in Argentina.

机构信息

Sport Physiotherapy, Faculty of Medical Sciences, Pontifical Catholic University of Argentina, Buenos Aires, Argentina; Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina.

Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina; Functional Anatomy and Biomechanics, Faculty of Medical Sciences, Favaloro University, Buenos Aires, Argentina.

出版信息

Phys Ther Sport. 2024 May;67:131-140. doi: 10.1016/j.ptsp.2024.04.007. Epub 2024 Apr 23.

Abstract

OBJECTIVES

To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR).

DESIGN

Cross-sectional design. Online survey.

SETTING

Survey platform.

PARTICIPANTS

Argentinian physical therapists (PTs).

OUTCOME MEASURES

The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS.

RESULTS

A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS.

CONCLUSIONS

Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

摘要

目的

调查阿根廷物理治疗师(PT)在前交叉韧带重建(ACLR)后,关于术前和术后康复以及重返运动(RTS)标准的当前临床实践情况。

设计

横断面设计。在线调查。

地点

调查平台。

参与者

阿根廷物理治疗师(PT)。

结果测量

调查由 39 个开放式和封闭式问题的组合组成,分为 3 个部分:(1)人口统计学和专业信息,(2)临床实践和康复策略,以及(3)重返跑步(RTR)和 RTS。

结果

共有 619 名 PT 完成了调查。在术前康复、康复进展标准和 PT 用于 RTS 决策的标准方面,观察到相当大的差异。在接受调查的总数中,有 336 名(54.3%)在临床实践中进行了 RTS 评估。大多数 PT(53.3%)使用目测评估来评估膝关节活动范围。只有 20%的 PT 报告在决策中使用患者报告的结果测量。在将力量评估用作 RTS 标准的 PT 中(68.8%),有 16.6%从跳跃测试推断,有 15.3%使用手动肌肉测试。建议患者 RTS 的时间不到 9 个月的 PT 不足 50%。

结论

阿根廷 PT 在前交叉韧带重建后进行的当前康复实践存在很大差异,与当前的证据和科学指南不一致。为了实现更好的康复和 RTS 实践,需要更好地传播和实施知识。

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