Anterior Talofibular Ligament and Superior Extensor Ankle Retinaculum Thicknesses: Relationship with Balance

Purpose This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results

Differences across Playing Levels for Match-Play Physical Demands in Women’s Professional and Collegiate Soccer: A Narrative Review

Advancements in sport technology have made quantifying match-play external load (e.g., total distance, sprint distance, number of sprints) a popular option for athletics personnel. These variables of volume and intensity are useful for both objectively monitoring training in field-based sports and for designing training programs. As physical abilities differ across playing levels, match-play demands likely also differ. This narrative review compiles and compares the match-play external load data for women’s soccer at the professional and collegiate levels. Databases were searched through July 2022, yielding 13 primary articles that assessed the match-play demands of women’s soccer (3 professional, 8 Division I, 1 Division II, and 1 Division III). The results indicate that the average total distance covered were similar between the professional, Division I and Division III levels, but the variability was greater among Division III compared to professional and Division I players. Data for Division II are scarce, but the total distance covered appears to be less than for professional, Division I and Division III. There was also large variability for sprint distance and number of sprints across data at all playing levels. Considering the lack of studies of Division II and Division III players, more research is necessary to determine how playing level may affect external load profiles, as isolated studies likely only reflect data from isolated teams

Scoring Performance Variations Between the Y Balance Test, A Modified Y Balance Test, and the Modified Star Excursion Balance Test

Background The Modified Star Excursion Balance Test (MSEBT) and the Y-Balance Test- Lower Quarter (YBT-LQ) are utilized to assess dynamic postural stability. These assessments cannot be used interchangeably secondary to kinematic variations and performance differences. A Modified Y-Balance Test-Lower Quarter (MYBT-LQ) was developed to determine if a modification allows performance scores to be directly compared to the MSEBT. Purpose The purpose of this research was to determine if reach distances were similar for young, healthy individuals between three different balance tests: the YBT-LQ, the MYBT-LQ, and the MSEBT. Study Design Repeated measures, descriptive cohort study Methods Twenty-eight participants (17 males, 11 females) were recruited from a convenience sample of young, healthy adults. Participants completed all testing within a single session and performed three trials in each direction, on each leg, for all balance tests. Scoring performance was calculated for each balance test using the average normalized reach distance in the anterior, posterolateral, and posteromedial directions. A one-way ANOVA was used to compare between-subject posteromedial and posterolateral scores, while anterior scores were analyzed using a Kruskal Wallis test. The intraclass correlation coefficient (ICC) was used to determine within-subject participant performance reliability. Results Analyses indicated significant differences in the posterolateral and posteromedial reach directions between the YBT-LQ and MSEBT and between the MYBT-LQ and MSEBT, while no significant difference was found between the YBT-LQ and MYBT-LQ in any direction. No anterior reach differences were noted between any of the tests. Within-subject ICCs showed a very strong level of agreement between right and left anterior and right posteromedial reaches between all three tests, while only the YBT-LQ and MYBT-LQ demonstrated very strong agreement in all directions. Conclusion Reach performance on the MSEBT differed from the performance on the YBT-LQ and MYBT-LQ in the anterior, posteromedial and posterolateral directions in this population. These findings further support the difference in motor control strategies used during these tests

Best Practice for the Administration of Daratumumab in Multiple Myeloma: Australian Myeloma Nurse Expert Opinion

Patients with multiple myeloma (MM) are typically of an advanced age and may have significant co-existing medical conditions. They have often had multiple lines of therapy and as such experience disease-related effects alongside associated treatment toxicities. Daratumumab is a monoclonal antibody approved for the treatment of MM in the relapsed/refractory setting. Clinical studies found that daratumumab showed good tolerability as a monotherapy and in combination with current standard therapies. However, the administration of daratumumab does require specific management considerations. It is administered as an intravenous infusion and infusion-related reactions (IRRs) may occur. Daratumumab also interferes with routine blood transfusion tests, giving false positives for the indirect antiglobulin test. This article highlights key nursing care considerations and practical management aspects to improve the treatment experience of patients receiving daratumumab infusions. Pretreatment aspects, patient education, pre- and post-medication, daratumumab administration, and the management of IRRs are discussed. An IRR management sheet that could be used by nurses and a patient information sheet are located at the end of this article

A comparison of clinical spinal mobility measures to experimentally derived lumbar spine passive stiffness

Spinal stiffness andmobility assessments vary between clinical and research settings, potentially hindering the understanding and treatment of low back pain. A total of 71 healthy participants were evaluated using 2 clinical assessments (posteroanterior spring and passive intervertebral motion) and 2 quantitative measures: Lumped mechanical stiffness of the lumbar spine and local tissue stiffness (lumbar erector spinae and supraspinous ligament) measured via myotonometry. The authors hypothesized that clinical, mechanical, and local tissue measures would be correlated, that clinical tests would not alter mechanical stiffness, and that males would demonstrate greater lumbar stiffness than females. Clinical, lumped mechanical, and tissue stiffness were not correlated; however, gradings from the posteroanterior spring and passive intervertebral motion tests were positively correlated with each other. Clinical assessments had no effect on lumped mechanical stiffness. The males had greater lumped mechanical and lumbar erector spinae stiffness compared with the females. The lack of correlation between clinical, tissue, and lumped mechanical measures of spinal stiffness indicates that the use of the term stiffness by clinicians may require reevaluation; clinicians should be confident that they are not altering mechanical stiffness of the spine through segmental mobility assessments; and greater resting lumbar erector stiffness in males suggests that sex should be considered in the assessment and treatment of the low back

Developing an international standard set of patient-reported outcome measures for psychotic disorders

Objective: The objective of this project was to develop a set of patient-reported outcome measures for adolescents and adults who meet criteria for a psychotic disorder. Methods: A research team and an international consensus working group, including service users, clinicians, and researchers, worked together in an iterative process by using a modified Delphi consensus technique that included videoconferencing calls, online surveys, and focus groups. The research team conducted systematic literature searches to identify outcomes, outcome measures, and risk adjustment factors. After identifying outcomes important to service users, the consensus working group selected outcome measures, risk adjustment factors, and the final set of outcome measures. International stakeholder groups consisting of >100 professionals and service users reviewed and commented on the final set. Results: The consensus working group identified four outcome domains: symptoms, recovery, functioning, and treatment. The domains encompassed 14 outcomes of importance to service users. The research team identified 131 measures from the literature. The consensus working group selected nine measures in an outcome set that takes approximately 35 minutes to complete. Conclusions: A set of patient-reported outcome measures for use in routine clinical practice was identified. The set is free to service users, is available in at least two languages, and reflects outcomes important to users. Clinicians can use the set to improve clinical decision making, and administrators and researchers can use it to learn from comparing program outcomes