S153 S290
Poster 40:
Determinants of Return to Play After the
Nonoperative Management of Hamstring Injuries in
Athletes: A Systematic Review
Camille Fournier-Farley, MD (University of Montreal),
Martin ML. Lamontagne, MD, Patrick Gendron, PT, Dany H. Gagnon,
PT, PhD
Disclosures:
Camille Fournier-Farley: I Have No Relevant Financial
Relationships To Disclose
Objective:
To summarize the current literature on factors that in-
fluence return to play after a hamstring injury in athletes.
Design:
Systematic review.
Setting:
N/A.
Participants:
N/A.
Interventions:
A computer-assisted literature search of CINAHL,
MEDLINE, Embase, and EBM Reviews databases was conducted using
keywords related to hamstring injuries and return to play. The liter-
ature review criteria included (1) patients with an acute hamstring or
posterior thigh injury; (2) a randomized controlled trial, cohort study,
case-control study, case series, or prospective or retrospective design;
(3) information on rehabilitation, physical therapy, clinical assess-
ment, imaging techniques, and return to play; and (4) studies written
in English or French.
Main Outcome Measures:
Prognostic factors of recovery.
Results:
Of 914 potential articles, 24 met the inclusion criteria
(4: level 2, 1: level 3, 19: level 4). The following factors were associ-
ated with a longer recovery time: stretching-type injuries, recrea-
tional-level sports, structural versus functional injuries, greater range
of motion deficit with the hip flexed at 90 , time to first consultation
>
1 week, increased pain on the visual analog scale, and
>
1 day to be
able to walk pain free after the injury. As for magnetic resonance
imaging studies, the following factors correlated with a longer recov-
ery time: positive findings; higher grade of injury; muscle involvement
>
75%; complete transection; retraction; central tendon disruption of
the biceps femoris; proximal tendon involvement; shorter distance to
the ischial tuberosity; length of the hamstring injury; and depth,
volume, and large cross-sectional area. With respect to ultrasound
studies, the following factors were associated with a poor prognosis:
large cross-sectional area, injury outside the musculotendinous junc-
tion, hematoma, structural injury, and injury involving the biceps
femoris. Lastly, rehabilitation approaches that included hamstring
loading during extensive lengthening or 4 daily sessions of static
hamstring stretching led to shorter rehabilitation times.
Conclusions:
Numerous determinants have an effect on return to play
after a hamstring injury.
Level of Evidence:
Level III
Poster 41:
An Epidemiologic Pilot Study of Non-Elite Adaptive
Athletes in Seattle
Jennifer A. Soo Hoo (University of Washington PM&R Program,
Seattle, WA, USA), Erek W. Latzka, MD, Mark Harrast, MD
Disclosures:
Jennifer Soo Hoo: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To understand the demographics, injury burden, and
medical care received by Seattle area non-elite adaptive athletes.
Adaptive sports programs are increasing across the country and there
is a paucity of research investigating the epidemiology and sports
injury risk factors in these athletes.
Design:
Descriptive, retrospective survey.
Setting:
Seattle area adaptive sports teams and programs.
Participants:
Local athletes who participated in Seattle area adaptive
sports teams or programs.
Interventions:
Survey.
Main Outcome Measures:
Completion of survey.
Results:
Of 61 total athletes surveyed, 70.5% (43 athletes)
responded. The majority of athletes surveyed were age 18 or older
(72.1%) and male (79.1%). Participation was varied across sports to
include wheelchair basketball (58%), wheelchair rugby (16.3%), sled
hockey (14%), and adaptive rowing (11.6%). 86% practiced, trained,
or competed in their main sport 9-12 months per year. 41.9%
trained over 8 hours/week with another 37.2% training about 4-8
hours/week. In the last 12 months, 39.5% of athletes surveyed
sustained an injury that required them to miss practice or a
competition with 58.8% of these athletes sustaining an injury
requiring them to miss
>
1 week from their sport. 64.7% of those
injured were not involved in an injury prevention/strengthening
program. Injury prevalence by sport is 42.9% in wheelchair rugby,
60% in sled hockey, 44% wheelchair basketball, and 0% in adaptive
rowing. 23.5% of those injured did not seek medical care with 25%
of these stating that they did not know what type of practitioner to
seek for care.
Conclusions:
The majority of athletes trained and competed greater
than 9 months per year and more than 4 hours/week with 39.5% of
these athletes sustaining an injury in the last year. This area will
require future study especially investigating injury risk factors within
specific sports and diagnoses.
Level of Evidence:
Level IV
Poster 42:
Identifying the Most Common Treatment Modalities
for Posterior Tibial Tendon and Patellar Tendon
Injuries in High Level Basketball Players
Kirill Alekseyev, MD, EMBA (Kingsbrook Jewish Med Cntr, Brooklyn,
NY, United States), Nikhil Verma, Alex John, Medical student,
Joshua Chen, MSIV
Disclosures:
Kirill Alekseyev: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To identify the most common treatment modalities for
posterior tibial tendon and patellar tendon injuries in individuals who
play basketball at different competitive levels.
Design:
Cross-Sectional Study.
Setting:
Online-based survey questionnaire.
Participants:
High level basketball athletes.
Interventions:
Treatment plan.
Main Outcome Measures:
Survey-Based Questionnaire.
Results:
Survey results showed a total of 350 participants with
competition experience ranging from the NBA to high school junior
varsity team play. 120/335 (35.8%) experienced patellar tendon in-
juries 85/335 (25.1%) and 35/335 (10.7%) experienced posterior tibial
tendon injuries. Of those injured, 117/155 (75.5%) were diagnosed by a
physician. 98/335 (30%) indicated being flat-footed. The most
commonly used treatment modalities were physical therapy (29.1%),
oral pain medication (14.7%), knee braces (15.3%), tape (14.7%),
jumper knee straps (11.3%), and self-resolving (8.6%). Despite treat-
ment, 62.6% still complained of ongoing issues. Of those who stated
injuries, 59.5% of those stated recurrence. 22.2% reported recurrence
once per year, 50.8% multiple times per year, and 25.4% couple times
per time month. 49.2% of those injured stated that their pain levels
improved, 38.5% stated no improvement, and 12.3% reported
regression.
Conclusions:
With the results illustrated it is evident there needs to
be further data to support our conclusions and we will continue the
study to establish larger power and validity with goal of 1000 partici-
pants that will demonstrate the treatment utilized by physicians
across the country. Guidelines for treatment will be established as
well.
Level of Evidence:
Level II
S153
Abstracts / PM R 9 (2017) S131-S290