Background Barriers and facilitators to research in sports medicine (SM) by physicians and allied health (AH) professions such as physical therapists and athletic trainers are understudied. The purpose of this research was to examine and compare research barriers, facilitators, and other research related facets including interests, comfort, knowledge, and resources among SM physicians and AH practitioners. Study Design Cross-sectional survey Methods The survey was sent to Pediatric Research in Sports Medicine (PRiSM) members. The survey was designed to ask respondents to identify their top barrier and facilitator to conducting research. Research interest (binary), self-rated comfort reading research articles (0-100 scale), self-rated knowledge conducting research independently (0-100 scale), and available research resources were evaluated. Descriptive statistics, chi-square, and t-tests were used to compare the responses between SM physicians and AH practitioners. The value of p<0.05 was set as a statistically significant criterion. Results The response rate was 35.7% (N=100). For both SM physicians and AH practitioners, the greatest research barrier was a lack of time. However, the leading research facilitators differed in the two professions. The top research facilitator for SM physicians was availability of research personnel, while availability of research mentoring was selected as a prime facilitator by AH practitioners. There were no differences in research interest between SM physicians (87.0%) and AH practitioners (95.5%, p=0.267). However, self-rated comfort reading research articles was higher in SM physicians (75.6±20.6) than AH practitioners (60.6±28.3, p=0.018). There were no differences in self-rated knowledge conducting research independently between SM physicians (70.2±18.6) and AH practitioners (63.4±24.6, p=0.163). Conclusion Lack of time was the top research barrier for both SM physicians and AH practitioners. Regarding research facilitators, having available time was the main facilitator for SM physicians while availability of mentoring was the leading facilitator in AH practitioners. Level of Evidence: 3

Background: Anterior cruciate ligament (ACL) injuries in adolescents continue to rise. Given that muscles are the only modifiable contributors to knee joint control, there has been a focus on their management in rehabilitation research. After an ACL injury, increased co-activation of the thigh muscles is considered a hallmark characteristic in stabilising the knee joint among adults with ACL injuries. However, increasing co-activation to improve joint stiffness should not be the rehabilitation goal after an ACL injury since a prolonged increase in co-activation about the joint alters knee joint loads and is associated with the onset and progression of knee osteoarthritis in adults. Purpose: Co-activation information currently does not exist among adolescents, therefore this study set out to address this gap. Methods: Twelve female patients with ACL-deficiency (ACLd) and 12 matched controls (CON) performed countermovement jumps while having the following muscle activations recorded for both limbs: rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST), lateral (LG) and medial gastrocnemii (MG), and gluteus medius (GM). During the landing phase of the task, co-activation indices were calculated for the lateral thigh muscles (VL and ST), medial thigh muscles (VM and BF), and the total thigh muscles (VL&VM and BF&ST). Independent-sample t-tests ( p=.05) evaluated mean group differences for each of the three co-activation indices. Results: A significant difference was found in medial co-activation ( p=.019), while a trend towards significance ( p=.071) was found in total thigh co-activation, with ACLd females having higher co-activations indices in both compared to matched controls (Figure 1). No differences were observed between groups in their demographics or lateral co-activation indices. Conclusion: Failure to appropriately adapt one’s neuromuscular control strategies may explain why some individuals continue to have knee instability and difficulty returning to their pre-ACL injury activity levels after rehabilitation. This is evidenced by our findings among this cohort of females with ACL injuries who displayed higher co-activations, specifically in the medial thigh musculature. Moreover, our findings highlight the need to target individual muscles during rehabilitation and to avoid generalization of segment muscles (i.e. quadriceps and hamstrings) where vital information in knee joint stabilization may be missed. [Figure: see text]

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Background: Paediatric patients undergoing Anterior Cruciate Ligament (ACL) reconstruction often present with a repairable meniscus tear. When a conservative early post-operative rehabilitation protocol is used to protect the meniscus repair, some have wondered whether this has an effect on functional and subjective outcomes, or time required, at return to activity. Purpose: The goal of this study was to compare the quantitative lower limb functional measures and subjective patient reported outcome scores at Return to Activity (RTA) in paediatric patients undergoing ACL reconstruction, with or without meniscus repair. Methods: This study was performed as a retrospective comparative cohort analysis of prospectively collected data in paediatric patients undergoing ACL reconstruction. Inclusion criteria for this study included a full data set and a visit to our biomechanics lab post-operatively, after being cleared for RTA by their attending surgeon. If a repairable meniscus injury was present, it was repaired concurrently with ACL reconstruction. Patients with a meniscus repair were provided rehabilitation guidelines that included partial weightbearing and limited range of motion (ROM) for six weeks, whereas full weightbearing and unrestricted ROM was recommended for the non-meniscal repair group. Postoperative quantitative knee functional outcome variables (drop vertical jump ground reaction forces, isometric knee extension/flexion strength, and hip abduction strength) were expressed as limb symmetry indices (LSIs; reconstructed limb/uninjured limb). Patient reported subjective knee outcome scores (Tegner and HSS Pedi-FABS) were also obtained. Differences in outcome measures were assessed using Mann-Whitney U-test and independent T-tests. Results: Twenty-four paediatric ACL reconstruction patients met criteria for inclusion in this study. Thirteen patients had a meniscus repair (median age 15 (13-17)) and 11 patients did not (median age 15.8 (14-17)). The median days between surgery and follow-up was 267 (168-460) days for the meniscus repair group and 251 (167-435) days for the non-meniscus repair group. There were no differences between the groups for the postoperative drop vertical jump test (p=0.21), knee extension/flexion strength (p=0.88/0.46) and hip abduction strength (p=0.46). Both groups also displayed similar Tegner (6.1/6.2) and Pedi-FABS (12.5/12.8) scores. Conclusion: Despite conservative weight-bearing and range of motion restrictions, repair of the meniscus in combination with ACL reconstruction in pediatric patients does not appear to induce a meaningful strength deficit at the return-to-activity evaluation phase, and is therefore not expected to influence return to activity in comparison with non-meniscus repair patients. This is important guidance for paediatric patients, families, and rehabilitation professionals involved in the care of young athletes. [Table: see text][Table: see text]

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