Are Elite Collegiate Female Athletes PRIME for a Safe Return to Sport after ACLR? An Investigation of Physical Readiness and Integrated Movement Efficiency (PRIME)

Chaaban, Courtney R; Hearn, Darren; Goerger, Benjamin M.; Padua, Darin A.

doi:10.26603/001c.32529

Cited by 6 publications

(5 citation statements)

References 49 publications

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“…They defined a threshold of 90% on the knee-specific SANE score to identify a successful outcome after ACLR, and they found that even amongst athletes who successfully returned to elite level athletics without reinjury, approximately half of the cohort rated their knee function at lower than 90%. 36 Their other findings demonstrated higher quality movements based on their Landing Error Scoring System (LESS) score compared with their uninjured teammates and with the scores of recreational athletes in similar studies. 36 These findings suggest that athletes who compete at high levels may be able to play competitively at their preoperative level despite lower-self reported knee function.…”

Section: Patient Reported Outcomesmentioning

confidence: 80%

“…36 Their other findings demonstrated higher quality movements based on their Landing Error Scoring System (LESS) score compared with their uninjured teammates and with the scores of recreational athletes in similar studies. 36 These findings suggest that athletes who compete at high levels may be able to play competitively at their preoperative level despite lower-self reported knee function.…”

Section: Patient Reported Outcomesmentioning

confidence: 80%

“…Various objective return to play criteria exists and are a topic of debate in and of themselves, the role of patient reported outcomes, and how these pertain to, and influence return to play readiness has yet to be elucidated. Chaaban et al, 36 compared elite collegiate female athletes who were able to successfully return to sport to their uninjured counterparts with respect to patient-reported knee function, as well as objective data on their movement. Patients reported their knee-specific single assessment numeric evaluation (SANE) score and completed three trials of a double-limb jump landing-movement assessment prior to the start of their season.…”

Section: Patient Reported Outcomesmentioning

confidence: 99%

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Anterior Cruciate Ligament Return to Play: Where Are We Now?

et al. 2023

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Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure, and it is crucial to assess an athlete’s readiness to safely return to sports following ACLR in order to minimize the risk of reinjury. Despite this, determining optimal return to play (RTP) criteria following ACLR that is accurate, accessible, and reproducible remains challenging. This review aims to discuss commonly employed RTP criteria domains, including functional assessments, patient-reported outcomes, and psychological tests, as well as emerging technologies such as MRI imaging that may play a role as a gold standard in RTP assessment. The findings of this review suggest return to play decision making after ACL surgery is nuanced and traditionally used objective measures do not perfectly predict RTS rates or clinical outcomes. In the future, a standardized MRI screening tool could help predict reinjury. The role of functional and psychological PROMs needs to defined, and objective criteria should be rigorously evaluated for whether they accurately screen an athlete’s physical readiness and should be expanded to include more sport specific movement analysis.

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Section: Patient Reported Outcomesmentioning

confidence: 80%

Section: Patient Reported Outcomesmentioning

confidence: 80%

Section: Patient Reported Outcomesmentioning

confidence: 99%

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Anterior Cruciate Ligament Return to Play: Where Are We Now?

et al. 2023

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“…Another study did not find any biomechanical risk factors for primary ACL injury risk ( 32 ). Following ACL injury, the ACL-injured limb demonstrates decreased knee extension moment and decreased vertical ground reaction force ( 33 , 34 ), suggestive of an underloading of the involved knee. Furthermore, those who go on to sustain a second ACL injury also demonstrate sagittal plane knee biomechanical differences relative to those who do not ( 35 – 37 ).…”

Section: Current Functional Performance Testingmentioning

confidence: 99%

“…There is conflicting evidence regarding whether the LESS has predictive capabilities in prospectively identifying ACL injury risk ( 43 , 44 ). Following ACL injury, there is also conflicting evidence regarding LESS scores, with one study finding lower LESS scores (fewer errors) in elite female athletes after ACLR compared to their teammates ( 33 ), and other studies finding higher LESS scores (more errors) in recreationally active athletes after ACLR compared to matched control athletes ( 45 , 46 ).…”

Section: Current Functional Performance Testingmentioning

confidence: 99%

Think outside the box: Incorporating secondary cognitive tasks into return to sport testing after ACL reconstruction

Chaaban

Turner

Padua

2023

Front. Sports Act. Living

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The optimal set of return to sport (RTS) tests after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) remains elusive. Many athletes fail to pass current RTS test batteries, fail to RTS, or sustain secondary ACL injuries if they do RTS. The purpose of this review is to summarize current literature regarding functional RTS testing after ACLR and to encourage clinicians to have patients “think” (add a secondary cognitive task) outside the “box” (in reference to the box used during the drop vertical jump task) when performing functional RTS tests. We review important criteria for functional tests in RTS testing, including task-specificity and measurability. Firstly, tests should replicate the sport-specific demands the athlete will encounter when they RTS. Many ACL injuries occur when the athlete is performing a dual cognitive-motor task (e.g., attending to an opponent while performing a cutting maneuver). However, most functional RTS tests do not incorporate a secondary cognitive load. Secondly, tests should be measurable, both through the athlete’s ability to complete the task safely (through biomechanical analyses) and efficiently (through measures of performance). We highlight and critically examine three examples of functional tests that are commonly used for RTS testing: the drop vertical jump, single-leg hop tests, and cutting tasks. We discuss how biomechanics and performance can be measured during these tasks, including the relationship these variables may have with injury. We then discuss how cognitive demands can be added to these tasks, and how these demands influence both biomechanics and performance. Lastly, we provide clinicians with practical recommendations on how to implement secondary cognitive tasks into functional testing and how to assess athletes’ biomechanics and performance.

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