Search Results (243)

Background: The Ankle-GO is a composite score integrating physical, functional, and psychological recovery after lateral ankle sprain (LAS). Its psychometric properties have been validated prospectively, but no large-scale data describe how it is used in routine practice. We aimed to characterise real-world usage patterns, score distributions, and the gap between intended and actual clinical use. Methods: Retrospective observational analysis of all Ankle-GO web-application sessions recorded between 1 February and 31 December 2024. Patients with at least one valid session and a single injured ankle were included. Quantitative variables were summarised as mean (SD) or median (IQR); proportions are reported with 95% Wilson confidence intervals (CIs). No inferential testing was performed. Results: Of 8988 registered patients, 6934 (77.1%) were analysed; 88.5% were assessed after ankle sprain (mean age 26.0 ± 10.0 years; 92.5% in France). Only 14.0% of sessions were follow-ups. Injured-ankle scores were consistently lower than contralateral scores and improved modestly across sessions. Notably, 20.4% (95% CI 19.4–21.4) of patients had already returned to sport before their first assessment. Conclusions: Real-world Ankle-GO implementation diverges substantially from its intended prospective use, defining clear priorities for future standardised, outcome-driven studies. Full article

Background/Objectives: Falls and upper limb injuries (ULI) are prevalent in older adults, yet whether ULI independently predisposes to subsequent falls remains poorly characterized. This nationwide cohort study evaluated the association between ULI and future fall risk using Taiwan’s National Health Insurance Research Database (2011–2019, follow-up through 2020). Methods: Adults aged ≥ 50 years with newly diagnosed ULI—defined as fractures (clavicle, scapula, humerus, radius, ulna, hand), sprains, strains, or open wounds of the shoulder, arm, elbow, forearm, wrist, or hand—were propensity score-matched 1:1 to controls by age, sex, and eight major comorbidities. Fall occurrence was identified by validated ICD codes, and Cox regression estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Results: The cohort included 110,600 participants (mean follow-up 4.4 years). Fall incidence was 2.8 versus 1.6 per 1000 person-years in ULI versus control groups. Patients with ULI had 62% higher fall risk (adjusted HR 1.62, 95% CI: 1.43–1.84, p < 0.001), corresponding to 1.2 additional falls per 1000 person-years. Kaplan–Meier curves showed early divergence sustained throughout follow-up. Conclusions: ULI is independently associated with subsequent fall risk in older adults and may serve as a sentinel marker warranting fall-prevention strategies in clinical practice. Full article

Background: Functional testing after an ankle sprain may help identify patients who later develop mechanical instability and require surgery. This study aimed to identify early clinical and functional predictors of surgical stabilization for chronic ankle instability (CAI) after acute sprains and to develop a simple composite predictive score (TALAR). Methods: This prospective observational study included 197 patients with acute lateral ankle sprains. Comprehensive clinical and functional assessments, including range of motion (ROM), strength, and pain, were performed two weeks post-injury. The primary outcome was subsequent surgical management for instability within a 24-month follow-up period. Results: Eight patients (4%) ultimately underwent surgical stabilization. Univariable analysis identified three significant predictors of surgical outcome: eversion mobility ≥ 20°, plantar flexor strength ≤ 17 kg, and the presence of pain during dorsiflexion (VAS > 0). These variables were integrated into the 0–3 TALAR (Triage Assessment of Lateral Ankle sprain Surgical Risk) score, which demonstrated promising exploratory discrimination with an AUC of 0.889 (95% CI: 0.799–0.954). An optimal cut-off of ≥2 yielded a sensitivity of 0.875 and a specificity of 0.822. While the baseline surgical risk was 4%, patients with a TALAR score ≥2 had a 17.5% conversion rate to surgery, representing a significantly higher risk (OR: 32.24; p < 0.001). Conclusion: The TALAR score represents a promising exploratory tool for early risk stratification after an acute ankle sprain. As an exploratory study, it highlights that early functional red flags, though formal internal and external validation, along with robust calibration on longer follow-up cohorts, are required before clinical implementation. Full article

Background/Objectives: Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain and is characterized by recurrent episodes of giving way, sensorimotor deficits, impaired postural control, and diminished functional performance. While exercise-based rehabilitation, including neuromuscular training and proprioceptive exercises, remains the gold standard for managing CAI, patients often require additional support during daily activities. Orthotic interventions predominantly address mechanical instability, yet there is a clinical gap in providing integrated solutions that simultaneously offer mechanical support and sensory feedback to enhance postural control. This study aimed to investigate the effects of a semi-rigid ankle brace combined with vibro-stimulation on tactile sensation and center of pressure excursion in individuals with CAI. Methods: A randomized clinical trial was designed with two parallel groups and repeated measurements over time. Thirty adults (n = 15 per group) aged 18–35 years, who met the International Ankle Consortium criteria for CAI, were recruited. Participants in the experimental group received a semi-rigid ankle brace integrated with a wearable vibro-stimulation system, whereas those in the comparison group used the ankle brace alone. Outcome measures were collected at baseline, after 10 min, and after 2 and 4 weeks. Primary outcomes included Vibration Detection Rate and phase plane portraits assessed using a 128 Hz tuning fork and a force plate. Results: The ankle bracing plus vibration band group demonstrated significantly greater improvement at 4 weeks than the orthosis group in Vibration Detection Rate (F (3,26) = 31.93, p < 0.001, η² = 0.78). Also, the largest effect was observed for the anteroposterior phase plane portrait at 4 weeks (MD = −2.10 ± 0.42, 95% CI: −2.96 to −1.23, p < 0.001, d = −1.79). Conclusions: The findings suggest that combining a semi-rigid ankle bracing with vibro-stimulation provides additional benefits over the use of bracing alone in individuals with CAI. Full article

Background/Objectives: The purpose of this study was to analyze the demographics and injury patterns of children with transportation-related non-fatal injuries occurring on public roads, streets and highways using a nationwide emergency department (ED) database. Methods: Data from the National Electronic Injury Surveillance System (NEISS) All Injury Program (AIP) 2005–2021 was used. Five transportation methods (motor vehicle occupant, bicyclist, pedestrian, motorcyclist, other) occurring on a public highway, street, or road were analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software to obtain national estimates. Results: There were an estimated 8,188,810 ED visits for traffic-related injuries in children; the median age is 14.3 years. Sex distribution was equal; 93.4% were discharged from the ED, and the head/neck was the most injured area (51.9%). The most common diagnoses were contusion (35.7%), strain/sprain (28.0%), internal organ injuries (13.3%), fracture (8.4%), lacerations (7.4%) and concussions (4.1%). Predictor variable of not being discharged from the ED was the presence of a fracture (OR = 119.7 [71.3, 200.7], p < 0.0001), injury to the trunk (OR = 3.2 [2.7, 3.8], p < 0.0001), a pedestrian (OR = 3.9 [2.8, 5.3], p < 0.0001), those <1.5 years old (OR = 4.3 [2.8, 6.6], p < 0.001), and males (OR 1.5 [1.4, 1.6], p < 0.0001). The greatest prevalence of head/neck fractures was in motor vehicle occupants (23.3%), upper extremity fractures in bicyclists (73.1%) and motorcyclists (49.2%), and lower extremity fractures in pedestrians (56.6%). Conclusions: This detailed study can be used to compare/contrast these injuries to other countries regarding road traffic injuries in children. This data can be used to assess the outcomes of prevention strategies introduced in the future. Full article

Purpose: Traditional plaster and fiberglass casts remain widely used for fracture immobilization but are associated with recognized challenges, including skin irritation, hygiene limitations, and distress during cast removal, particularly in pediatric populations. Light-cured polymer immobilization (LCPI) systems have been introduced as an alternative method of fracture support. The primary objective of this study was to describe radiographic healing and alignment outcomes among patients treated with an LCPI system. Secondary objectives were to document skin- and device-related events and to identify any unplanned removals or subsequent re-interventions. Methods: A 6-month retrospective cohort study was conducted involving 108 consecutive patients treated with an LCPI system between January and June 2025 at a single orthopaedic clinic. Clinical and radiographic records were reviewed to extract demographic information, injury characteristics, treatment details, immobilization duration, healing outcomes, alignment status, and recorded adverse events. Outcomes were summarized using descriptive statistics. Results: Immobilization was applied for 104 fractures (96.3%), three sprains (2.8%), and one elbow dislocation (0.9%). The cohort (76 males, 32 females; mean age: 13.4 years; range: 4–53) demonstrated radiographic union or progression toward union among fracture cases with available follow-up imaging. Mean immobilization duration was 29.2 days (SD: 6.2; range: 10–48). Alignment at device removal was documented as anatomic or near-anatomic in 103 of 104 fractures (99.1%) based on treating clinician assessment (99.1%). Device breakage was documented in 12 cases (11.1%), of which 3 required additional immobilization. Two patients (1.9%) experienced mild cutaneous reactions that resolved with conservative management. No severe device-related complications were documented. Conclusions: Healing outcomes and recorded adverse events were consistent with expected clinical patterns for this patient population in this descriptive retrospective cohort of patients treated with an LCPI system. These findings provide descriptive real-world data regarding clinical utilization and short-term outcomes in selected patients. Prospective comparative studies are needed to further define effectiveness, safety, cost considerations, and broader applicability across diverse fracture populations. Full article

Frisbee has gained increasing popularity and is characterized by high-intensity running, rapid changes in direction, jumping, and indirect physical contact, exposing players to a risk of injury. This study aimed to determine the epidemiology of musculoskeletal injuries in frisbee athletes who participated in the World Beach Ultimate Championship in Portugal, and the risk factors associated with these injuries. The sample included 484 athletes aged 18–64 years, of whom 275 (56.8%) were male. Data was collected using a digital questionnaire. Across their frisbee practice, 391 (80.8%) athletes reported at least one injury, totalling 1685 injuries. A total of 49 (10.1%) athletes reported an injury in the last 7 days. Over the past 12 months, 211 (43.6%) athletes sustained injuries, totalling 358 cases. The injury proportion was 0.44 (95% CI: 39.2–48.0), and the injury rate was 0.67 injuries per 1000 h of training. The most frequent injuries were muscle strains (18.86%) and sprains (13.43%), mainly affecting the ankle (62; 17.71%) and knee (54; 15.43%). Repetitive movements (84; 22.11%) and changes in direction (62; 16.32%) were the most common mechanisms. Athletes with equal or more than 11 years of practice had a higher injury risk (OR = 1.84; 95% CI: 1.16–2.91; p = 0.009). Frisbee athletes present a considerable risk of injuries. Preventive strategies are recommended. Full article

Background: Chronic ankle instability (CAI) post-sprain leads to persistent functional deficits. This study evaluated CAI’s specific impact on ankle dorsiflexion, heel lift function, stability, broader functional impairments, and quality of life. Methods: A case–control study enrolled 100 CAI patients (post-ankle sprain) and 100 healthy controls. Ankle strength (isokinetic dynamometer), stability (pressure plate), maximum dorsiflexion/plantar flexion ROM (mobility meter), functional limitations (0–10 activity scale), pain (VAS), coordination (Agility T-test, figure-of-eight test), and quality of life (FAOS) were compared. ANOVA and Mann–Whitney U tests were used. Results: Compared to controls, the CAI group showed significantly reduced ankle dorsiflexion strength (114.53 ± 10.47 N vs. 156.34 ± 13.26 N), heel lift strength (78.69 ± 5.44 N vs. 105.45 ± 8.28 N), stability scores (4.73 ± 0.52 vs. 8.65 ± 0.71 points), and ROM (dorsiflexion: 16.49° ± 1.23° vs. 22.35° ± 1.65°; plantar flexion: 27.58° ± 6.51° vs. 43.27° ± 5.45°). CAI patients reported higher activity limitation (6.34 ± 1.25 vs. 2.16 ± 0.55) and pain (5.37 ± 1.02 vs. 0.23 ± 0.01) and prolonged Agility T-test (11.24 ± 1.37 s vs. 7.51 ± 1.16 s) and figure-of-eight (16.35 ± 1.67 s vs. 12.43 ± 1.39 s) times. FAOS subscale scores (symptoms, daily activities, sports, pain) were significantly lower in the CAI group. All p < 0.05. Conclusions: CAI significantly compromises ankle dorsiflexion, heel lift strength, stability, and functional mobility, correlating with increased pain, activity restriction, and diminished quality of life. Rehabilitation should prioritize neuromuscular re-education, strength restoration, and dynamic stability training to improve outcomes. Full article

Background: Digital health has accelerated telehealth uptake, yet evidence comparing video-based musculoskeletal assessment with traditional in-person examination is limited. This study evaluated the concurrent validity and interrater reliability of video-based physiotherapy assessment versus face-to-face assessment in patients with knee pain. Methods: Patients with knee pain underwent randomized consecutive in-person and video-based assessments by experienced musculoskeletal physiotherapists. Clinical diagnoses were categorized into seven groups (red flag, yellow flag, arthrogenic, tendinopathy, patellofemoral pain, muscle sprain, neurogenic). Primary outcomes were intermethod agreement and Cohen’s kappa; sensitivity, specificity, PPV, NPV, and interrater reliability for video assessments were also reported. Results: Forty-five participants (mean age 38 ± 6.5 years; 55.6% female) completed the study. In-person and video-based assessments produced identical diagnoses in 43/45 cases (Cohen’s κ = 0.92, p < 0.001). Telehealth accuracy was high across all diagnostic categories (90–100%). Interrater agreement between video-based assessors was 93.3% (κ = 0.89, p < 0.001). Agreement between assessments was moderately associated with KOOS (r = 0.312, p = 0.037). Conclusions: In this selected pragmatic sample, video-based physiotherapy assessment demonstrated high concurrent agreement and excellent interrater reliability with face-to-face assessment. Given the study’s sample size, repeated-measures design, and lack of an independent reference standard, these results indicate feasibility and intermethod agreement rather than diagnostic equivalence. Video assessment may be a feasible option for triage and management in selected settings, but further research in larger, more diverse populations and evaluation against independent reference standards is required. Full article

Background: Artistic skating involves high mechanical demands (e.g., jumps and spins) that may increase injury frequency, yet discipline-specific evidence remains limited. Objective: The aim of this study is to describe injury characteristics in federated artistic skaters and to explore factors associated with injury frequency. Methods: A descriptive cross-sectional study was conducted using an online survey distributed to federated clubs. Eligible participants practiced show and/or free skating, were federated athletes, and had competed at least once in an official competition. Results: Fifty artistic skaters participated (90% women; age 18.37 ± 3.58 years), recruited from 13 clubs; 28% competed in show, 30% in free, and 42% in both disciplines. All participants reported at least one injury; 58% occurred on the right side, and injuries most frequently affected the lower limb. The most commonly reported injury types were muscle injuries (26%), sprains (20%), tendon injuries (18%), and single-bone fractures (12%). Jumping was the most frequent action at the time of injury (40%), followed by spins (20%). Injuries most often occurred on parquet (42%) and polished concrete (38%), and 54% of athletes required physiotherapy. Time-loss was ≤7 days in 44% of cases, while 28% reported >28 days. A significant association was found between time since first menstruation and having sustained >1 injury (p = 0.034). No significant differences were observed in other demographic variables, training/competition characteristics, or preventive practices between groups (p > 0.05). Conclusions: Injuries in federated Spanish artistic skaters were predominantly lower-limb and commonly occurred during jumping, frequently requiring physiotherapy and, in a substantial proportion, leading to prolonged time-loss. Injury frequency was associated with time since first menstruation, while training load indicators and preventive practices did not differ between skaters with one versus multiple injuries. Full article

Talocalcaneal coalition is a frequent cause of painful rigid flatfoot in adolescents and young adults, resulting from congenital failure of segmentation with fibrous, cartilaginous, or osseous bridging of the subtalar joint. Clinical presentation typically coincides with skeletal maturation and includes hindfoot pain, recurrent ankle sprains, progressive stiffness, and characteristic planovalgus deformity. Although prevalence is likely underestimated, advances in imaging have improved recognition and characterization. Diagnosis relies on the integration of clinical findings with imaging, where computed tomography (CT) remains the reference standard, while magnetic resonance imaging (MRI) enables accurate detection of both osseous and non-osseous coalitions and associated soft-tissue changes. This narrative review aims to provide a comprehensive and updated synthesis of current concepts in talocalcaneal coalition, with specific focus on its clinical implications and contemporary management strategies. We critically analyze diagnostic pathways, including emerging modalities such as weight-bearing CT, and discuss evidence-based indications for conservative treatment, coalition resection, and arthrodesis. Particular attention is devoted to patient selection, prognostic factors, and evolving minimally invasive techniques. Current limitations and areas of controversy are highlighted, emphasizing the need for standardized imaging criteria and optimized treatment algorithms to improve long-term functional outcomes. Full article

Background and Objectives: Functional Ankle Instability (FAI) is a sequela of ankle sprains; however, its associated variables in volleyballers have not been studied. This study aimed to determine the prevalence of FAI and the association between FAI and its associated variables in volleyball players. Materials and Methods: An observational study with a sample size of 128 male volleyballers, aged 18 years and older, was conducted using the Arabic-Identification of Functional Ankle Instability (Ar-IdFAI) questionnaire. The prevalence of FAI was analyzed in terms of frequency and percentage. The Mann–Whitney U test, Spearman’s test, and t-test were used to analyze the associations between the demographic variables and the categorical variables, and a logistic regression model was applied to identify the independent associations with FAI. Statistical significance was set at p < 0.05. Results: The prevalence of FAI in the sample was 44.53%. Bivariate analysis and the regression model indicated no significant direct association between FAI and age, Body Mass Index (BMI), playing duration, weekly training hours, or limb dominance in this sample. Conversely, historical injury burden showed strong and statistically significant associations with FAI (Cramér’s V = 0.59–1.00), with “giving way” demonstrating perfect separation. The logistic regression model showed an acceptable fit (p = 0.676) and moderate explanatory power (Nagelkerke R² = 0.540), with excellent discriminatory performance Area Under the Curve (AUC = 0.855) driven primarily by injury-related variables. Conclusions: FAI is highly prevalent among male volleyball players and is linked to injury history rather than demographic or training characteristics. Injury-related characteristics, including previous ankle injury, reinjury, and episodes of ankle “giving way”, demonstrated strong associations with the presence of Functional Ankle Instability, to be interpreted as descriptive associations rather than a causal link due to methodological structure. Full article

Background/Objectives: Mixed martial arts (MMA) is a popular full-contact combat sport. The aim of this study was to determine injury mechanisms, rates, severity, patterns, circumstances, and the resulting economic healthcare consequences by conducting a detailed survey of competitive and recreational athletes. Methods: In 2023, MMA athletes were retrospectively questioned regarding their injuries in the last 24 months and the resulting healthcare impact (medical attention, hospitalization, incapacity to work). An injury was defined as any physical complaint resulting from MMA exposure. The severity of the injury was categorized according to the resulting restriction of sport participation (i.e., ‘severe’: more than four weeks of restriction). Results: A total of 112 participants (93% male; 41% non-competitive and 59% competitive) were included. All in all, 93,857 h of MMA activities were performed, and 127 injuries were recorded, resulting in an overall injury rate of 1.4 injuries per 1000 h of exposure. Non-competitive athletes reported significantly fewer total injuries in the past 24 months (95% CI 0.87–2.04; p = 0.003) and had significantly fewer severe or even critical injuries compared to competitive athletes (OR 0.55; 95% CI 0.21–1.43; p = 0.042). Head- and neck lesions (20%) were the most common injuries. The most common types of injury were joint sprains (21%) and ligament strains (17%). The healthcare burden of these sports-related injuries was minimal: By median, injuries led to zero days of hospitalization and incapacity to work, with no statistically significant differences between recreational and competitive athletes. Conclusions: Competitive athletes suffer more severe injuries compared to recreational athletes. Overall, injuries in MMA are rare, and the economic impact and burden on the healthcare system are negligible compared to other sport disciplines. Full article

Background/Objectives: Noncontact knee ligament injuries, including anterior cruciate ligament (ACL) ruptures and medial collateral ligament (MCL) sprains, are prevalent in sports that involve frequent cutting and pivoting. Conventional rigid knee braces can offer stability but often compromise comfort and performance, whereas soft sleeve-type supports provide minimal mechanical protection. The purpose of this study was to evaluate the acute biomechanical effects of a tensioned cable knee bracing system on peak knee valgus angle and external knee abduction moment during a controlled lateral shuffle task. Methods: Ten physically active adults (mean age 21.7 ± 3.8 years) performed submaximal lateral shuffle movements under three conditions: unbraced, sleeve-only (zero-tension), and a novel tensioned cable brace. Three-dimensional knee kinematics and ground reaction forces were collected, and peak knee valgus angle and external abduction moment were calculated during the eccentric phase of each movement. Results: Wearing the knee brace under tension significantly reduced knee valgus angle (4.5° vs. 7.9°) and peak external knee abduction moment (1.6 vs. 2.0–2.1 Nm/kg) compared to the unbraced condition. Conclusions: These findings indicate that the tensioned cable brace effectively reduced frontal plane knee loading during a lateral shuffle task, indicating its potential as an effective bracing approach. Full article

Functional ankle instability (FAI) is a common consequence of lateral ankle sprains, characterized by impaired sensorimotor control. While orthoses and localized vibration have shown individual benefits for FAI, their combined application in a wearable device has not been previously investigated. This pilot randomized trial compared the effects of a vibrotactile foot orthosis (VFO) and a vibrotactile ankle orthosis (VAO) on joint position sense (JPS) and postural control in individuals with FAI. Sixteen participants were randomized to receive either a VFO or a VAO, both delivering 30–50 Hz pulsed vibration in 20 min sessions, three times a week, for two weeks. Outcome measures included joint position sense (JPS) error (°), center of pressure (COP) velocity (mm/s), the Star Excursion Balance Test (SEBT), and the Six-Meter Hop Test (SMHT), which were assessed pre-intervention, immediately post-intervention, and after two weeks of use. The analysis showed a statistically significant interaction between time and intervention group for JPS error (p = 0.02, η² = 0.42). Specifically, the VFO group improved JPS significantly more than VAO at two weeks follow-up (MD = −1.75°, p = 0.005, d = −1.68). Both groups significantly reduced in anteroposterior COP velocity after two weeks (VFO: MD = 1, p = 0.003, d = 1.47; VAO: MD = 1.39, p ˂ 0.001, d = 2.05) with no between-group differences. No changes were observed in the SEBT or SMHT. Plantar-based vibrotactile stimulation was more effective than ankle-based stimulation in enhancing proprioceptive acuity in individuals with FAI. Both interventions improved static postural stability, supporting the potential of integrated vibrotactile orthoses in FAI rehabilitation. No major practical issues were reported during the intervention. Two participants experienced minor discomfort related to the electronic housing bulk in the first week, which was resolved by week two. No further complaints regarding device weight or usability were observed. Full article