AltMetrics

Dr. Carl Mattacola addresses the perceptions of altmetrics from the perspectives of faculty, administrator, and journal editor. The above video is available for download in mp4 format by clicking the relevant link listed under the additional files shown below. The slide deck is available by clicking the Download button on the right

Patient-oriented and performance-based outcomes after knee autologous chondrocyte implantation: a timeline for the first year of recovery

It is well established that autologous chondrocyte implantation (ACI) can require extended recovery postoperatively; however, little information exists to provide clinicians and patients with a timeline for anticipated function during the first year after ACI. Objective: To document the recovery of functional performance of activities of daily living after ACI. Patients: ACI patients (n = 48, 29 male 35.1 ± 8.0 y). Intervention: All patients completed functional tests (weight-bearing squat, walk-across, sit-to-stand, step-up/over, and forward lunge) using the NeuroCom long force plate (Clackamas, OR) and completed patient-reported outcome measures (International Knee Documentation Committee Subjective Knee Evaluation Form, Lysholm, Western Ontario and McMaster Osteoarthritis Index WOMAC, and 36-Item Short-Form Health Survey) preoperatively and 3, 6, and 12 mo postoperatively. Main Outcome Measures: A covariance pattern model was used to compare performance and self-reported outcome across time and provide a timeline for functional recovery after ACI. Results: Participants demonstrated significant improvement in walk-across stride length from baseline (42.0% ± 8.9% height) at 6 (46.8% ± 8.1%) and 12 mo (46.6% ± 7.6%). Weight bearing on the involved limb during squatting at 30°, 60°, and 90° was significantly less at 3 mo than presurgery. Step-up/over time was significantly slower at 3 mo (1.67 ± 0.69 s) than at baseline (1.49 ± 0.33 s), 6 mo (1.51 ± 0.36 s), and 12 mo (1.40 ± 0.26 s). Step-up/over lift-up index was increased from baseline (41.0% ± 11.3% body weight BW) at 3 (45.0% ± 11.7% BW), 6 (47.0% ± 11.3% BW), and 12 mo (47.3% ± 11.6% BW). Forward-lunge time was decreased at 3 mo (1.51 ± 0.44 s) compared with baseline (1.39 ± 0.43 s), 6 mo (1.32 ± 0.05 s), and 12 mo (1.27 ± 0.06). Similarly, forward-lunge impact force was decreased at 3 mo (22.2% ± 1.4% BW) compared with baseline (25.4% ± 1.5% BW). The WOMAC demonstrated significant improvements at 3 mo. All patient-reported outcomes were improved from baseline at 6 and 12 mo postsurgery. Conclusions: Patients' perceptions of improvements may outpace physical changes in function. Decreased function for at least the first 3 mo after ACI should be anticipated, and improvement in performance of tasks requiring weight-bearing knee flexion, such as squatting, going down stairs, or lunging, may not occur for a year or more after surgery

An Exploration of ‘Fitspiration’ content on YouTube and its impacts on consumers

The ‘Fitspiration’ movement may endorse problematic body image and behaviour. This study aims to expand the understanding of ‘fitspiration’ by examining its presence on YouTube. Analysis was conducted in accordance with Tiggeman & Zaccardo (2015) and Santarossa et al. (2016). Thematic analysis of videos revealed three themes; ‘Fitness and beauty’, ‘Trust me-I’m a YouTuber’, and ‘Health for the right reasons’. Thematic analysis of comments revealed themes ‘YouTube fitness community’, ‘Body appearance dissatisfaction,’ and ‘YouTuber fitness role models’. Fitness YouTubers were found to promote unhealthy behaviours to achieve fitness, and commenters expressed belief in and replication of their advice

“They think it’s helpful, but it’s not”: A qualitative analysis of the experience of social support provided by peers in adolescents with type 1 diabetes

Background Adherence in type 1 diabetes has previously been found to be improved with effective social support. However, research has so far been unable to elucidate the effect of social support from peers in adolescents with type 1 diabetes, with studies concluding they may be both positively and negatively related to self-care and glycaemic control. The present study explores the experience of social support from peers in adolescents with type 1 diabetes using a qualitative methodology to address this lack of consensus in the literature, using the research question: “what is the meaning and experience of social support from peers in adolescents with type 1 diabetes?” Methods Semi-structured interviews using the Diabetes Social Support Interview schedule were employed. Twelve participants aged 15-18 were recruited from paediatric outpatient services. Transcripts were analysed using thematic analysis. Results Two overarching themes were noted within transcripts; A Sense of Normality and "They Think It’s Helpful, But It’s Not". Overall, participants reported a desire for global support from peers, and explored how and why diabetes-specific support behaviours were more likely to be interpreted as harassing. Conclusions These findings suggest that diabetes-specific support may not always be advantageous in aiding adolescents to reach and maintain optimal self-care. In addition, participants emphasise the acceptability of advice provided by peers with type 1 diabetes, making peer support and mentoring programmes an excellent candidate for future research

Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability

We examined the effect of a 2-week anterior-to-posterior ankle joint mobilization intervention on weight-bearing dorsiflexion range of motion (ROM), dynamic balance, and self-reported function in subjects with chronic ankle instability (CAI). In this prospective cohort study, subjects received six Maitland Grade III anterior-to-posterior joint mobilization treatments over 2 weeks. Weightbearing dorsiflexion ROM, the anterior, posteromedial, and posterolateral reach directions of the Star Excursion Balance Test (SEBT), and self-reported function on the Foot and Ankle Ability Measure (FAAM) were assessed 1 week before the intervention (baseline), prior to the first treatment (pre-intervention), 24–48 h following the final treatment (post-intervention), and 1 week later (1-week follow-up) in 12 adults (6 males and 6 females) with CAI. The results indicate that dorsiflexion ROM, reach distance in all directions of the SEBT, and the FAAM improved (p < 0.05 for all) in all measures following the intervention compared to those prior to the intervention. No differences were observed in any assessments between the baseline and pre-intervention measures or between the postintervention and 1-week follow-up measures (p > 0.05). These results indicate that the joint mobilization intervention that targeted posterior talar glide was able to improve measures of function in adults with CAI for at least 1 week

Self-Perceptions of Proximal Stability as Measured by the Functional Movement Screen

This mixed method study was designed to investigate self-perceptions before and after experiencing an activity that dynamically and statically challenges proximal stability of the pelvis, spine, and trunk. Twenty-eight, healthy Division II female soccer and volleyball collegiate players (17 soccer, 11 volley-ball) completed a self-reported Tegner activity scale, pretest questionnaire and posttest interview. A self-perceived numeric rating of the athletes’ proximal stability and performance on a functional movement screen (FMS) were recorded. A guided interview was used to examine the self perceptions of proximal stability after the FMS testing session. Differences and correlations between the pretest and posttest ratings of proximal stability and FMS scores were analyzed using a 1-sample Kolmogorov-Smirnov test and Spearman’s rank order correlation test, respectively. Residual standard error from a 1-way analysis of variance was used to explore the association between variables. Qualitative data were recorded and transcribed. There were significant differences between the pretest (3.4 6 0.63) and posttest ratings (3.16 0.49) of proximal stability (p= 0.01). The relationship between the pretest proximal stability ratings and the FMS scores was low (r=0.19, p = 0.33), whereas posttest rating and FMS scores had a moderately high (r= 0.68, p= 0.00) correlation. There was a smaller residual standard error for the posttest ratings (1.7) when compared with the pretest ratings (3.2) with the FMS. Four qualitative themes emerged: (a) wanting to do well, (b) expectations of performance, (c) focused mental mindset, and (d) body control. Self-perceptions of proximal stability in female athletes were influenced by undergoing a test that stressed the proximal stabilizers. Combining assessments of self-perceptions and proximal stability may assist clinicians and athletes in targeting components of training

Influence of Varied, Controlled Distances from the Crank Axis on Peak Physiological Responses During Arm Crank Ergometry

The purpose of the study was to determine the influence of varied, controlled distances from the crank axis during arm crank ergometry (ACE) on peak physiological responses and physical work capacity (PWC). Physiological responses to ACE were evaluated using three controlled distances from the crank axis based on 0°, 15°, and 30° from full extension in the elbow while at the furthest point in the crank rotation. Eleven adult, able-bodied women (age = 24.5 ± 4.7 yrs) performed graded maximal ACE tests at each of three distances from the crank axis. Data were analyzed for differences in peak physiological responses and PWC between the three positions. VO2peak at 30° (1.33 L/min) was lower (F(2,20) = 7.171, p \u3c 0.01) than at 0° (1.42 L/min) or at 15° (1.41 L/min). No differences existed between the three distances for any other dependent variable. We conclude that distance from the crank axis during ACE influences VO2peak values, and thus should be controlled for when using ACE to predict aerobic fitness

Response Shift Theory: An Application for Health-related Quality of Life in Rehabilitation Research and Practice

Evaluating change in patients over time can be challenging to any health care provider. Response shift theory is based on the change typology of alpha, beta, and gamma change and proposes that residual changes in self-response measures occur over time. These changes are the result of recalibration, reconceptualization, and reprioritization of internal standards and references utilized for self-appraisal. Failing to account for response shift may result in over- or under-reporting of true physiologic change. The purpose of this paper is to review the components of response shift, identify research designs used to detect it, and present a model for its practical application to rehabilitation of both acute and chronic disabilities. Awareness of response shifts throughout the rehabilitation process may be beneficial in guiding patient goal-setting, treatment, and education. Of particular emphasis is the role that the rehabilitation specialist can have in using the response shift process to result in the highest possible perceived quality of life for each individual patient. J Allied Health 2011; 40(1):31–38

Patient Experiences of Recovery After Autologous Chondrocyte Implantation: A Qualitative Study

Context: The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients\u27 experiences during the recovery process may assist clinicians in providing more individualized care. Objective: To explore and describe patients\u27 experiences during the recovery process after ACI. Design: Qualitative study. Setting: Orthopaedic clinic. Patients or Other Participants: Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected. Data Collection and Analysis: Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. Data were analyzed using the process of horizontalization. Results: Seven patients (2 men, 5 women; age = 40.7 ± 7.5 years, time from surgery = 8.7 ± 4.2 months) participated. Four themes and 6 subthemes emerged from the data and suggested that the recovery process is a lengthy and emotional experience. Therapy provides optimism for the future but requires a collaborative effort among the patient, surgeon, rehabilitation provider, and patient\u27s caregiver(s). Furthermore, patients expressed frustration that their expectations for recovery did not match the reality of the process, including greater dependence on caregivers than expected. Conclusions: Patients\u27 expectations should be elicited before surgery and managed throughout the recovery process. Providing preoperative patient and caregiver education and encouraging preoperative rehabilitation can assist in managing expectations. Establishing realistic goals and expectations may improve rehabilitation adherence, encourage optimism for recovery, and improve outcomes in the long term

The Role of Rehabilitation Following Autologous Chondrocyte Implantation: A Retrospective Chart Review

PURPOSE/BACKGROUND: Clinical outcomes following autologous chondrocyte implantation (ACI) are influenced by multiple factors, including patient demographics, lesion characteristics, quality of the surgical repair, and post-operative rehabilitation. However, it is currently unknown what specific characteristics of rehabilitation have the greatest influence on clinical outcomes following ACI. The purpose of this study was to conduct a retrospective chart review of patients undergoing ACI with the intent to describe this patient population\u27s demographics, clinical outcomes, and rehabilitation practices. This study aimed to assess the consistency of the documentation process relative to post-operative rehabilitation in order to provide information and guide initiatives for improving the quality of rehabilitation practices following ACI. METHODS: The medical records of patients treated for chondral defect(s) of the knee who subsequently underwent the ACI procedure were retrospectively reviewed. A systematic review of medical, surgical, and rehabilitation records was performed. In addition, patient-reported outcome measures (IKDC, WOMAC, Lysholm, SF-36) recorded pre-operatively, and 3, 6, and 12 months post-operatively were extracted from an existing database. RESULTS: 20 medical charts (35.9 ± 6.8 years; 9 male, 11 female) were systematically reviewed. The average IKDC, WOMAC, Lysholm, and SF-36 scores all improved from baseline to 3, 6 and 12 months post-operatively, with the greatest changes occurring at 6 and 12 months. There was inconsistent documentation relative to post-operative rehabilitation, including CPM use, weight-bearing progression, home-exercise compliance, and strength progressions. CONCLUSIONS: Due to variations in the documentation process, the authors were unable to determine what specific components of rehabilitation influence the recovery process. In order to further understand how rehabilitation practices influence outcomes following ACI, specific components of the rehabilitation process must be consistently and systematically documented over time. LEVEL OF EVIDENCE: 2C