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  • 1.
    Andrade, Renato
    et al.
    FIFA Med Ctr Excellence, Portugal; Univ Porto, Portugal; Dom Henrique Res Ctr, Portugal.
    Pereira, Rogerio
    FIFA Med Ctr Excellence, Portugal; Univ Porto, Portugal; Dom Henrique Res Ctr, Portugal; Fernando Pessoa Univ, Portugal.
    Weir, Adam
    Erasmus MC, Netherlands; Aspetar Orthopaed and Sports Med Hosp, Qatar.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Espregueira-Mendes, Joao
    FIFA Med Ctr Excellence, Portugal; Dom Henrique Res Ctr, Portugal; Minho Univ, Portugal; Univ Minho, Portugal; ICVS 3Bs PT Govt Associate Lab, Portugal.
    Zombie reviews taking over the PROSPERO systematic review registry. Its time to fight back!2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 15, p. 919-921Article in journal (Other academic)
    Abstract [en]

    n/a

  • 2.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Editorial Material: Systematic review hacks for the sports and exercise clinician: five essential methodological elements in BRITISH JOURNAL OF SPORTS MEDICINE, vol 50, issue 8, pp 447-4492016In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 8, p. 447-449Article in journal (Other academic)
    Abstract [en]

    n/a

  • 3.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Serving the clinician and the patient: three ways that quality clinical guidelines can build on expert consensus statements and systematic reviews2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 7, p. 557-+Article in journal (Other academic)
    Abstract [en]

    n/a

  • 4.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Bizzini, Mario
    Schulthess Clin, Switzerland.
    Bahr, Roald
    Aspetar Orthopaed and Sports Medical Hospital, Qatar; Norwegian School Sports Science, Norway.
    Editorial Material: It is time for consensus on return to play after injury: five key questions in BRITISH JOURNAL OF SPORTS MEDICINE, vol 50, issue 9, pp 506-5082016In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 9, p. 506-508Article in journal (Other academic)
    Abstract [en]

    n/a

  • 5.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Dupont, Gregory
    Edinburgh Napier Univ, Scotland; FFF, France.
    Impellizzeri, Franco M.
    Univ Technol Sydney, Australia.
    ODriscoll, Gary
    Arsenal Football Club, England.
    Reurink, Guus
    Sports Phys Grp, Netherlands.
    Lewin, Colin
    Arsenal Football Club, England.
    McCall, Alan
    Edinburgh Napier Univ, Scotland; Arsenal Football Club, England.
    Infographic. Unravelling confusion in sports medicine and science practice: a systematic approach2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 13, p. 835-836Article in journal (Other academic)
    Abstract [en]

    n/a

  • 6.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Dupont, Gregory
    Edinburgh Napier Univ, Scotland; Univ Lille, France.
    Impellizzeri, Franco M.
    Schulthess Clin, Switzerland.
    ODriscoll, Gary
    Arsenal Football Club, England.
    Reurink, Guus
    OLVG, Netherlands.
    Lewin, Colin
    Arsenal Football Club, England.
    McCall, Alan
    Edinburgh Napier Univ, Scotland; Arsenal Football Club, England.
    Unravelling confusion in sports medicine and sports science practice: a systematic approach to using the best of research and practice-based evidence to make a quality decision2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 1, p. 50-56Article in journal (Other academic)
    Abstract [en]

    n/a

  • 7.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Ekas, Guri
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    Grindem, Hege
    Norwegian Sch Sport Sci, Norway.
    Moksnes, Havard
    Norwegian Sch Sport Sci, Norway.
    Anderson, Allen
    Not Found:[Ardern, Clare L.] Linkoping Univ, Div Physiotherapy, Linkoping, Sweden; [Ardern, Clare L.] La Trobe Univ, Sch Allied Hlth, Melbourne, Vic, Australia; [Ekas, Guri; Engebretsen, Lars] Oslo Univ Hosp, Div Orthopaed Surg, Oslo, Norway; [Ekas, Guri; Moksnes, Havard; Engebretsen, Lars] Norwegian Sch Sport Sci, Oslo Sports Trauma Res Ctr OSTRC, Oslo, Norway; [Ekas, Guri; Engebretsen, Lars] Univ Oslo, Inst Clin Med, Oslo, Norway; [Grindem, Hege] Norwegian Sch Sport Sci, Dept Sports Med, Oslo, Norway; [Chotel, Franck] Hop Femme Mere Enfant, Dept Pediat Orthopaed Surg, Lyon, France; [Cohen, Moises] Univ Fed Sao Paulo, Dept Orthoped, Sao Paulo, Brazil; [Forssblad, Magnus] Karolinska Inst, Stockholm Sports Trauma Res Ctr, Stockholm, Sweden; [Ganley, Theodore J.] Childrens Hosp Philadelphia, Dept Orthopaed, Philadelphia, PA 19104 USA; [Feller, Julian A.] Epworth Healthcare, OrthoSport Victoria Res Unit, Melbourne, Vic, Australia; [Feller, Julian A.] La Trobe Univ, Coll Sci Hlth and Engn, Melbourne, Vic, Australia; [Karlsson, Jon] Univ Gothenburg, Sahlgrenska Acad, Dept Orthopaed, Gothenburg, Sweden; [Kocher, Mininder S.; Micheli, Lyle] Boston Childrens Hosp, Div Sports Med, Boston, MA USA; [Kocher, Mininder S.; Micheli, Lyle] Harvard Med Sch, Boston, MA USA; [LaPrade, Robert F.] Steadman Philippon Res Inst, Vail, CO USA; [LaPrade, Robert F.] Steadman Clin, Vail, CO USA; [McNamee, Mike] Swansea Univ, Coll Engn, Swansea, W Glam, Wales; [Mandelbaum, Bert] Santa Monica Orthopaed and Sports Med Grp, Los Angeles, CA USA; [Micheli, Lyle] Micheli Ctr Sports Injury Prevent, Waltham, MA USA; [Mohtadi, Nicholas] Univ Calgary, Ctr Sports Med, Calgary, AB, Canada; [Reider, Bruce] Univ Chicago, Dept Orthopaed and Rehabil Med, Chicago, IL 60637 USA; [Roe, Justin] North Sydney Orthopaed and Sports Med Ctr, Sydney, NSW, Australia; [Seil, Romain] Ctr Hosp Luxembourg, Dept Orthopaed Surg, Luxembourg, Luxembourg; [Seil, Romain] Luxembourg Inst Hlth, Sports Med Res Lab, Luxembourg, Luxembourg; [Siebold, Rainer] Ruprecht Karls Univ Heidelberg, Inst Anat and Cell Biol, Heidelberg, Germany; [Siebold, Rainer] HKF Int Ctr Hip Knee Foot Surg and Sportstraumatol, ATOS Klin, Heidelberg, Germany; [Silvers-Granelli, Holly J.] FIFA Med Ctr Excellence, Veloc Phys Therapy, Los Angeles, CA USA; [Soligard, Torbjorn; Engebretsen, Lars] Int Olymp Comm, Med and Sci Dept, Lausanne, Switzerland; [Soligard, Torbjorn] Univ Calgary, Fac Kinesiol, Sports Injury Prevent Ctr, Calgary, AB, Canada; [Witvrouw, Erik] Univ Ghent, Fac Med and Healthsci, Dept Rehabil Sci and Physiotherapy, Ghent, Belgium;.
    Chotel, Franck
    Hop Femme Mere Enfant, France.
    Cohen, Moises
    Univ Fed Sao Paulo, Brazil.
    Forssblad, Magnus
    Karolinska Inst, Sweden.
    Ganley, Theodore J.
    Childrens Hosp Philadelphia, PA 19104 USA.
    Feller, Julian A.
    Epworth Healthcare, Australia; La Trobe Univ, Australia.
    Karlsson, Jon
    Univ Gothenburg, Sweden.
    Kocher, Mininder S.
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA.
    LaPrade, Robert F.
    Steadman Philippon Res Inst, CO USA; Steadman Clin, CO USA.
    McNamee, Mike
    Swansea Univ, Wales.
    Mandelbaum, Bert
    Santa Monica Orthopaed and Sports Med Grp, CA USA.
    Micheli, Lyle
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA; Micheli Ctr Sports Injury Prevent, MA USA.
    Mohtadi, Nicholas
    Univ Calgary, Canada.
    Reider, Bruce
    Univ Chicago, IL 60637 USA.
    Roe, Justin
    North Sydney Orthopaed and Sports Med Ctr, Australia.
    Seil, Romain
    Ctr Hosp Luxembourg, Luxembourg; Luxembourg Inst Hlth, Luxembourg.
    Siebold, Rainer
    Ruprecht Karls Univ Heidelberg, Germany; HKF Int Ctr Hip Knee Foot Surg and Sportstraumatol, Germany.
    Silvers-Granelli, Holly J.
    FIFA Med Ctr Excellence, CA USA.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland; Univ Calgary, Canada.
    Witvrouw, Erik
    Univ Ghent, Belgium.
    Engebretsen, Lars
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway; Int Olymp Comm, Switzerland.
    2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries2018In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 26, no 4, p. 989-1010Article in journal (Refereed)
    Abstract [en]

    In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.

  • 8.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Ekas, Guri Ranum
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    Grindem, Hege
    Norwegian Sch Sport Sci, Norway.
    Moksnes, Havard
    Norwegian Sch Sport Sci, Norway.
    Anderson, Allen
    Tennessee Orthopaed Alliance, TN USA.
    Chotel, Franck
    Hop Femme Mere Enfant, France.
    Cohen, Moises
    Univ Fed Sao Paulo, Brazil.
    Forssblad, Magnus
    Karolinska Inst, Sweden.
    Ganley, Theodore J.
    Childrens Hosp Philadelphia, PA 19104 USA.
    Feller, Julian A.
    Epworth Healthcare, Australia; La Trobe Univ, Australia.
    Karlsson, Jon
    Univ Gothenburg, Sweden.
    Kocher, Mininder S.
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA.
    LaPrade, Robert F.
    Steadman Philippon Res Inst, CO USA; Steadman Clin, CO USA.
    McNamee, Michael
    Swansea Univ, Wales.
    Mandelbaum, Bert
    Santa Monica Orthopaed and Sports Med Grp, CA USA.
    Micheli, Lyle
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA; Micheli Ctr Sports Injury Prevent, MA USA.
    Mohtadi, Nicholas G. H.
    Univ Calgary, Canada.
    Reider, Bruce
    Univ Chicago, IL 60637 USA.
    Roe, Justin P.
    North Sydney Orthopaed and Sports Med Ctr, Australia.
    Seil, Romain
    Ctr Hosp Luxembourg, Luxembourg; Luxembourg Inst Hlth, Luxembourg.
    Siebold, Rainer
    Ruprecht Karls Univ Heidelberg, Germany; ATOS Klin, Germany.
    Silvers-Granelli, Holly J.
    FIFA Med Ctr Excellence, CA USA.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland; Univ Calgary, Canada.
    Witvrouw, Erik
    Univ Ghent, Belgium.
    Engebretsen, Lars
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway; Int Olymp Comm, Switzerland.
    Prevention, diagnosis and management of paediatric ACL injuries2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 20, p. 1297-1298Article in journal (Other academic)
    Abstract [en]

    n/a

  • 9.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Ekas, Guri Ranum
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    Grindem, Hege
    Norwegian Sch Sport Sci, Norway.
    Moksnes, Havard
    Norwegian Sch Sport Sci, Norway.
    Anderson, Allen F.
    Tennessee Orthopaed Alliance, TN USA.
    Chotel, Franck
    Hop Femme Mere Enfant, France.
    Cohen, Moises
    Univ Fed Sao Paulo, Brazil.
    Forssblad, Magnus
    Karolinska Inst, Sweden.
    Ganley, Theodore J.
    Childrens Hosp Philadelphia, PA 19104 USA.
    Feller, Julian A.
    Epworth Healthcare, Australia; La Trobe Univ, Australia.
    Karlsson, Jon
    Univ Gothenburg, Sweden.
    Kocher, Minider S.
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA.
    LaPrade, Robert F.
    Steadman Philippon Res Inst, CO USA; Steadman Clin, CO USA.
    McNamee, Michael
    Swansea Univ, Wales.
    Mandelbaum, Bert
    Santa Monica Orthopaed and Sports Med Grp, CA USA.
    Micheli, Lyle
    Boston Childrens Hosp, MA USA; Harvard Med Sch, MA USA; Micheli Ctr Sports Injury Prevent, MA USA.
    Mohtadi, Nicholas
    Univ Calgary, Canada.
    Reider, Bruce
    Univ Chicago, IL 60637 USA.
    Roe, Justin
    North Sydney Orthopaed and Sports Med Ctr, Australia.
    Seil, Romain
    Ctr Hosp Luxembourg, Luxembourg; Luxembourg Inst Hlth, Luxembourg.
    Siebold, Rainer
    Ruprecht Karls Univ Heidelberg, Germany; ATOS Klin, Germany.
    Silvers-Granelli, Holly J.
    FIFA Med Ctr Excellence Veloc Phys Therapy, CA USA.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland; Univ Calgary, Canada.
    Witvrouw, Erik
    Univ Ghent, Belgium.
    Engebretsen, Lars
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway; Int Olymp Comm, Switzerland.
    2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 7, p. 422-438Article in journal (Refereed)
    Abstract [en]

    In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery amp; Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/ guardians make the best possible decisions.

  • 10.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe University, Melbourne, Australia.
    Glasgow, Philip
    Sports Medicine, Sports Institute of Northern Ireland, Newtownabbey, UK.
    Schneiders, Anthony G
    School of Human, Health and Social Sciences, Central Queensland University, Branyan, Australia.
    Witvrouw, Erik
    Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Clarsen, Benjamin
    Oslo Sports Trauma Research Center, Oslo, Norway.
    Cools, Ann Mj
    Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
    Gojanovic, Boris
    Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Switzerland; Sports Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
    Griffin, Steffan
    College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
    Khan, Karim
    Department of Family Practice, The University of British Columbia, Vancouver, Canada; Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada.
    Moksnes, Håvard
    Oslo Sports Trauma Research Center, Oslo, Norway.
    Mutch, Stephen
    SPACE Clinics, Edinburgh, UK; Scottish Rugby, Edinburgh, UK.
    Phillips, Nicola
    Postgraduate Healthcare Studies, Cardiff University, Cardiff, UK.
    Reurink, Guus
    Sports Medicine, Sports Physicians Group, Amsterdam, The Netherlands.
    Sadler, Robin
    Sports Medicine, Manchester City Football Club Ltd, Manchester, UK; Derby County FC, Derby, UK.
    Gravare Silbernagel, Karin
    Department of Physical Therapy, University of Delaware, Newark, USA.
    Thorborg, Kristian
    Sports Orthopaedic Research Center Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen, Denmark; Department of Orthopaedic Surgery and Physical Therapy, Amager-Hvidovre Hospital, Copenhagen, Denmark.
    Wangensteen, Arnlaug
    Oslo Sports Trauma Research Center, Oslo, Norway; Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Wilk, Kevin
    Champion Sports Medicine, Birmingham, USA.
    Bizzini, Mario
    Schulthess Clinic, Zürich, Switzerland.
    Infographic: 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 13, p. 995-995Article in journal (Refereed)
  • 11.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Glasgow, Philip
    Sport Northern Ireland Sports Institute, North Ireland; University of Ulster, North Ireland.
    Schneiders, Anthony
    Central Queensland University, Australia.
    Witvrouw, Erik
    Aspetar Orthopaed and Sports Medical Hospital, Qatar; University of Ghent, Belgium.
    Clarsen, Benjamin
    Norwegian School Sports Science, Norway; Olymp Elite Sports Program Olympiatoppen, Norway.
    Cools, Ann
    University of Ghent, Belgium.
    Gojanovic, Boris
    Hop La Tour, Switzerland; Lausanne University of and Hospital, Switzerland.
    Griffin, Steffan
    University of Birmingham, England.
    Khan, Karim M.
    University of British Columbia, Canada.
    Moksnes, Havard
    Norwegian School Sports Science, Norway; Olymp Elite Sports Program Olympiatoppen, Norway.
    Mutch, Stephen A.
    SPACE Clin, Scotland; Murrayfield Stadium, Scotland.
    Phillips, Nicola
    Cardiff University, Wales.
    Reurink, Gustaaf
    Sports Phys Grp, Netherlands.
    Sadler, Robin
    Manchester City Football Club, England.
    Gravare Silbernagel, Karin
    University of Delaware, DE USA.
    Thorborg, Kristian
    University of Copenhagen, Denmark.
    Wangensteen, Arnlaug
    Aspetar Orthopaed and Sports Medical Hospital, Qatar; Norwegian School Sports Science, Norway.
    Wilk, Kevin E.
    Champ Sports Med, AL USA.
    Bizzini, Mario
    Schulthess Clin, Switzerland.
    2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern2016In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 14, p. 853-864Article in journal (Refereed)
    Abstract [en]

    Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athletes return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.

  • 12.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Grindem, Hege
    Norwegian Sch Sport Sci, Norway.
    Ekas, Guri Ranum
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    Seil, Romain
    Ctr Hosp Luxembourg, Luxembourg; Luxembourg Inst Hlth, Luxembourg.
    McNamee, Michael
    Swansea Univ, Wales.
    Applying ethical standards to guide shared decision-making with youth athletes2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 20, p. 1289-1290Article in journal (Other academic)
    Abstract [en]

    n/a

  • 13.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Khan, Karim M.
    Aspetar Orthopaed and Sports Medical Hospital, Qatar; University of British Columbia, Canada.
    Editorial Material: The old knee in the young athlete: knowns and unknowns in the return to play conversation in BRITISH JOURNAL OF SPORTS MEDICINE, vol 50, issue 9, pp 505-U892016In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 9, p. 505-U89Article in journal (Other academic)
    Abstract [en]

    n/a

  • 14.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    What is the evidence to support a psychological component to rehabilitation programs after anterior cruciate ligament reconstruction?2016In: Current Orthopaedic Practice, ISSN 1940-7041, Vol. 27, no 3, p. 263-268Article, review/survey (Refereed)
    Abstract [en]

    One of the main indications for anterior cruciate ligament reconstruction is the athlete’s desire to return to his or her preinjury level of sports. Postoperative rehabilitation has a strong focus on recovery of the physical capabilities necessary to manage a return to sports. On average, athletes achieve good physical function after surgery, based on standard impairment-based and activity-based measures. Yet the return to sports rate is disappointingly low; only two in every three return to their preinjury level sport and only half of the athletes return to competitive sports after surgery. There are a range of factors, many of them nonmodifiable (e.g. age, sex, and preinjury level of competition), that affect returning to a specific sport. However, recent research has identified psychological factors as key influences on returning to sports after anterior cruciate ligament reconstruction. This is particularly important for clinicians given that these factors may be modifiable with appropriate intervention. However, they are not systematically discussed during standard postoperative rehabilitation. In this review, we examine the evidence for the effect of psychological factors on return to sport outcomes after anterior cruciate ligament reconstruction and provide a rationale for the inclusion of interventions that specifically and systematically affect these factors during postoperative rehabilitation.

  • 15.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. School of Allied Health, La Trobe University, Melbourne, Australia.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Webster, Kate E.
    School of Allied Health, La Trobe University, Melbourne, Australia.
    Psychological Aspects of Anterior Cruciate Ligament Injuries2016In: Operative techniques in sports medicine, ISSN 1060-1872, E-ISSN 1557-9794, Vol. 24, no 1, p. 77-83Article in journal (Refereed)
    Abstract [en]

    Impairment-based evaluation has, until recently, been the mainstay of orthopaedic research in anterior cruciate ligament (ACL) reconstruction. However, participation-based outcomes, in particular returning to sport, have lately garnered increased research attention. This is important because returning to sport is typically a main concern of injured athletes. Recent metaanalyses have demonstrated that the return to sport rate after ACL reconstruction is disappointingly low, and that a range of contextual factors including age, sex, sport participation level, and psychological factors may affect the return to sport rate. Moderate to large effect sizes have been demonstrated for greater psychological readiness to return to sport, and lower fear of reinjury favoring returning to the preinjury level sport after ACL reconstruction. Understanding the relationship between psychological factors and returning to sport is essential in light of the fact that most athletes recover good physical function after surgery, and many athletes with good knee function do not return to sport. Psychological factors are potentially modifiable with appropriate intervention, yet these factors are not systematically addressed in routine postoperative rehabilitation. This review summarizes the recent evidence for the relationship between psychological factors and ACL injury, including recovery from injury and returning to sport. Oper Tech Sports Med 24:77-83 Crown Copyright (C) 2015 Published by Elsevier Inc. All rights reserved.

  • 16.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia; Uppsala University, Sweden.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Landén Ludvigsson, Maria
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala. Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Satisfaction With the Outcome of Physical Therapist-Prescribed Exercise in Chronic Whiplash-Associated Disorders: Secondary Analysis of a Randomized Clinical Trial2016In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 46, no 8, p. 640-+Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Secondary analysis of a randomized clinical trial. BACKGROUND: Patient perception of the benefits gained from treatment is important, yet satisfaction with the outcome of treatment for chronic whiplash-associated disorders (WADs) has not been investigated. OBJECTIVES: To investigate whether satisfaction with the outcome of treatment for chronic WAD changed over time, and whether there were group differences. METHODS: Two hundred sixteen people with chronic WAD (66% women; mean age, 40.4 years) participated in a 3-month program of physical therapist-led neck-specific exercises with or without a behavioral approach, or received a prescription of general physical activity. The main outcome was satisfaction with the outcome of treatment, assessed at baseline and 3, 6, and 12 months later. Additional outcomes were enablement and expectation fulfillment. RESULTS: Satisfaction improved over time in the 3 groups (odds ratio = 1.15; 95% confidence interval: 1.10, 1.20; P amp;lt; .001). There was a significant group-by-time interaction (P amp;lt; 001), with increased odds of being satisfied in the groups receiving neck-specific exercises compared to general physical activity. Enablement increased after completion of the intervention in all groups (P amp;lt; .001). People who received neck-specific exercises reported greater enablement and expectation fulfillment than people prescribed general physical activity (P amp;lt; .01). CONCLUSION: Exercise interventions for chronic WAD led to increased satisfaction for 12 months following treatment that was unrelated to the type of exercise intervention received.

  • 17.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. School of Allied Health, La Trobe University, Melbourne, Australia, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Tagesson (Sonesson), Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Forssblad, M
    Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden. Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden..
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Comparison of patient-reported outcomes among those who chose ACL reconstruction or non-surgical treatment.2017In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, no 5, p. 535-544Article in journal (Refereed)
    Abstract [en]

    The aim of our study was to cross-sectionally compare patient-reported knee function outcomes between people who chose non-surgical treatment for ACL injury and those who chose ACL reconstruction. We extracted Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQoL-5D data entered into the Swedish National ACL Registry by patients with a non-surgically treated ACL injury within 180 days of injury (n = 306), 1 (n = 350), 2 (n = 358), and 5 years (n = 114) after injury. These data were compared cross-sectionally to data collected pre-operatively (n = 306) and at 1 (n = 350), 2 (n = 358), and 5 years (n = 114) post-operatively from age- and gender-matched groups of patients with primary ACL reconstruction. At the 1 and 2 year comparisons, patients who chose surgical treatment reported superior quality of life and function in sports (1 year mean difference 12.4 and 13.2 points, respectively; 2 year mean difference 4.5 and 6.9 points, respectively) compared to those who chose non-surgical treatment. Patients who chose ACL reconstruction reported superior outcomes for knee symptoms and function, and in knee-specific and health-related quality of life, compared to patients who chose non-surgical treatment.

  • 18.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Winters, Marinus
    Aalborg Univ, Denmark.
    Synthesising best evidence in systematic reviews when randomised controlled trials are absent: three tips for authors to add value for clinician readers2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 15, p. 948-+Article in journal (Other academic)
    Abstract [en]

    n/a

  • 19.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. School of Allied Health, La Trobe University, Melbourne, Australia.
    Österberg, Annika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Tagesson, Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Gauffin, Håkan
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Webster, Kate E.
    La Trobe University, Australia.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity2016In: Arthroscopy: The Journal of Arthroscopy And Related, ISSN 0749-8063, E-ISSN 1526-3231, Vol. 32, no 8, p. 1631-1638Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess whether patient-reported outcomes (psychological factors, appraisals of knee function, and physical activity participation) were associated with satisfaction with knee function after anterior cruciate ligament (ACL) reconstruction. Methods: Participants who were aged 18 to 45 years and a minimum 12 months post primary ACL reconstruction completed a questionnaire battery evaluating knee self-efficacy, knee-related quality of life, self-reported function, and physical activity participation. Participants responses to the question "If you were to spend the rest of your life with your knee just the way it has been in the last week, would you feel.... (7-point ordinal scale; 1 = happy, 7 = unhappy)" were categorized as satisfied, mostly satisfied, or dissatisfied and used as the primary outcome. Ordinal regression was used to examine associations between independent variables and the primary outcome. Results: A total of 177 participants were included at an average of 3 years after primary ACL reconstruction. At follow-up, 44% reported they would be satisfied, 28% mostly satisfied, and 28% dissatisfied with the outcome of ACL reconstruction. There were significant differences in psychological responses and appraisal of knee function between the 3 groups (P = .001), and significantly more people in the satisfied group had returned to their preinjury activity (58%) than in the mostly satisfied (28%) and dissatisfied (26%) groups (P = .001). Multivariable analysis demonstrated that the odds of being satisfied increased by a factor of 3 with higher self-efficacy, greater knee-related quality of life, and returning to the preinjury activity. Conclusions: People who had returned to their preinjury physical activity and who reported higher knee-related self-efficacy and quality of life were more likely to be satisfied with the outcome of ACL reconstruction.

  • 20.
    Ardern, Clare
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Österberg, Annika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.
    Tagesson (Sonesson), Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Gauffin, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Webster, Kate E.
    La Trobe University, Australia.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction2014In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, no 22, p. 1613-U50Article in journal (Refereed)
    Abstract [en]

    Background This cross-sectional study aimed to examine whether appraisal of knee function, psychological and demographic factors were related to returning to the preinjury sport and recreational activity following anterior cruciate ligament (ACL) reconstruction. Method 164 participants completed a questionnaire battery at 1-7 years after primary ACL reconstruction. The battery included questionnaires evaluating knee self-efficacy, health locus of control, psychological readiness to return to sport and recreational activity, and fear of reinjury; and self-reported knee function in sport-specific tasks, knee-related quality of life and satisfaction with knee function. The primary outcome was returning to the preinjury sport or recreational activity. Results At follow-up, 40% (66/164) had returned to their preinjury activity. Those who returned had more positive psychological responses, reported better knee function in sport and recreational activities, perceived a higher knee-related quality of life and were more satisfied with their current knee function. The main reasons for not returning were not trusting the knee (28%), fear of a new injury (24%) and poor knee function (22%). Psychological readiness to return to sport and recreational activity, measured with the ACL-Return to Sport after Injury scale (was most strongly associated with returning to the preinjury activity). Age, sex and preinjury activity level were not related. Conclusions Less than 50% returned to their preinjury sport or recreational activity after ACL reconstruction. Psychological readiness to return to sport and recreation was the factor most strongly associated with returning to the preinjury activity. Including interventions aimed at improving this in postoperative rehabilitation programmes could be warranted to improve the rate of return to sport and recreational activities.

  • 21.
    Devitt, Brian M
    et al.
    OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia; School of Allied Health, La Trobe University, Melbourne, Australia.
    Bell, Stuart W.
    OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hartwig, Taylor
    OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.
    Porter, Tabitha J
    OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.
    Feller, Julian A
    OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.
    Webster, Kate E
    School of Allied Health, La Trobe University, Melbourne, Australia.
    The Role of Lateral Extra-articular Tenodesis in Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis and Best-Evidence Synthesis2017In: The Orthopaedic Journal of Sports Medicine, ISSN 2325-9671, Vol. 5, no 10, article id 2325967117731767Article in journal (Refereed)
    Abstract [en]

    The role of lateral extra-articular tenodesis (LEAT) to augment primary anterior cruciate ligament reconstruction (ACLR) remains controversial.

  • 22.
    Ekas, Guri Ranum
    et al.
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Grindem, Hege
    Norwegian Sch Sport Sci, Norway.
    Engebretsen, Lars
    Oslo Univ Hosp, Norway; Norwegian Sch Sport Sci, Norway; Univ Oslo, Norway.
    New meniscal tears after ACL injury: what is the risk? A systematic review protocol2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 6, article id 386Article, review/survey (Refereed)
    Abstract [en]

    Background Secondary meniscal tears after ACL injuries increase the risk of knee osteoarthritis. The current literature on secondary meniscal injuries after ACL injury is not consistent and may have methodological shortcomings. This protocol describes the methods of a systematic review investigating the rate of secondary meniscal injuries in children and adults after treatment (operative or non-operative) for ACL injury. Methods We will search electronic databases (Embase, Ovid Medline, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, PEDro and Google Scholar) from database inception. Extracted data will include demographic data, methodology, intervention details and patient outcomes. Risk of bias will be assessed using the Newcastle Ottawa checklist for cohort studies. Article screening, eligibility assessment, risk of bias assessment and data extraction will be performed in duplicate by independent reviewers. A proportion meta-analysis will be performed if studies are homogeneous (I-2 amp;lt; 75%). If meta-analysis is precluded, data will be synthesised descriptively using best-evidence synthesis. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology. Ethics and dissemination This protocol is written according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses, and was registered in the International Prospective Register of Systematic Reviews on 22 March 2016.

  • 23.
    Forsdyke, Dale
    et al.
    York St John University, England.
    Gledhill, Adam
    Leeds Beckett University, England.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; Trobe University, Australia.
    Psychological readiness to return to sport: three key elements to help the practitioner decide whether the athlete is REALLY ready?2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 7, p. 555-556Article in journal (Other academic)
    Abstract [en]

    n/a

  • 24.
    Grassi, Alberto
    et al.
    Ist Ortoped Rizzoli, Italy.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Marcheggiani Muccioli, Giulio Maria
    Ist Ortoped Rizzoli, Italy.
    Neri, Maria Pia
    Ist Ortoped Rizzoli, Italy.
    Marcacci, Maurilio
    Ist Ortoped Rizzoli, Italy.
    Zaffagnini, Stefano
    Ist Ortoped Rizzoli, Italy.
    Does revision ACL reconstruction measure up to primary surgery? A meta-analysis comparing patient-reported and clinician-reported outcomes, and radiographic results2016In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 12, p. 716-724Article, review/survey (Refereed)
    Abstract [en]

    Purpose To compare patient-reported and clinician-reported outcomes, and radiographic results between patients who had had revision ACL reconstruction and those who had had primary ACL reconstruction. Design Systematic review and meta-analysis Data sources The MEDLINE, CINAHL, EMBASE and SPORTDiscus electronic databases were searched on 6 August 2015, using 3 main concepts: (1) revision ACL reconstruction, (2) primary ACL reconstruction and (3) treatment outcomes. Eligibility criteria for selecting studies Articles that compared patient-reported or clinician-reported outcomes or radiographic results between patients who had had revision ACL reconstruction and those who had had primary surgery with a minimum of 2 years follow-up were included. The outcomes evaluated were the Lysholm Knee Scoring Scale, objective International Knee Documentation Committee (IKDC) classification, Tegner Activity Scale, side-to-side difference in anterior tibial translation measured with KT-1000/2000 arthrometer, pivot shift test, tibiofemoral osteoarthritis grading on plain radiographs and subsequent knee surgeries. Results 8 studies (300 revision ACL reconstructions and 413 primary ACL reconstructions) were included in the meta-analysis. Patients who had had revision surgery reported inferior Lysholm Knee Scoring Scale scores (mean difference: 7.8 points), had inferior clinician-reported knee function as assessed with the objective IKDC classification (IKDC category A: 27% vs 57%; IKDC category C or D: 22% vs 8%) and pivot shift test (grade II or III: 7% vs 2%), and more radiographic evidence of tibiofemoral osteoarthritis (50% vs 25%) compared with patients who had had primary surgery. Conclusions Revision ACL reconstruction restored similar anterior-posterior knee laxity compared with primary ACL reconstruction. Patients who had had revision surgery reported inferior Lysholm Knee Scoring Scale scores, had inferior clinician-reported knee function and more radiographic signs of tibiofemoral osteoarthritis compared with patients with primary ACL reconstruction.

  • 25.
    Grindem, Hege
    et al.
    Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
    Arundale, Amelia
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Faculty of Health Sciences, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
    Alarming underutilisation of rehabilitation in athletes with anterior cruciate ligament reconstruction: four ways to change the game2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 18, p. 1162-1163Article in journal (Other academic)
    Abstract [en]

    To help clinicians improve outcomes through better utilisation of rehabilitation after ACLR, we offer four suggestions:

    1. The importance of regaining function after ACLR must be recognised by all stakeholders: policymakers (third-party payers), orthopaedic surgeons, rehabilitation clinicians, coaches and athletes (and their parents/guardians when under age).

    2. Orthopaedic surgeons and rehabilitation clinicians must join forces to promote evidence-based practice, including the use of objective measures for progression and RTS.

    3. Evidence-based patient education should occur before all surgical or rehabilitation decision-making, and continue as rehabilitation progresses. This will ensure that the athlete can make an informed commitment to a treatment plan.

    4. Orthopaedic surgeons and rehabilitation clinicians must acknowledge their roles in building and maintaining athlete motivation for rehabilitation.

  • 26.
    Grindem, Hege
    et al.
    Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
    Mansournia, Mohammad Ali
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
    Øiestad, Britt Elin
    Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
    Was it a good idea to combine the studies? Why clinicians should care about heterogeneity when making decisions based on systematic reviews2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 7, p. 399-401Article in journal (Other academic)
    Abstract [en]

    n/a

  • 27.
    Karjalainen, Teemu V.
    et al.
    Monash Univ, Australia; Monash Univ, Australia; Univ Helsinki, Finland.
    Jain, Nitin B.
    Vanderbilt Univ, TN 37212 USA; Vanderbilt Univ, TN 37212 USA.
    Page, Cristina M.
    Vanderbilt Univ, TN 37212 USA; Vanderbilt Univ, TN 37212 USA.
    Lahdeoja, Tuomas A.
    Univ Helsinki, Finland; Toolo Hosp, Finland.
    Johnston, Renea V.
    Monash Univ, Australia; Monash Univ, Australia.
    Salamh, Paul
    Univ Indianapolis, IN 46227 USA.
    Kavaja, Lauri
    Univ Helsinki, Finland; South Carelia Cent Hosp, Finland.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Agarwal, Arnav
    Univ Toronto, Canada.
    Vandvik, Per O.
    Lovisenberg Diaconal Hosp, Norway; Univ Oslo, Norway.
    Buchbinder, Rachelle
    Monash Univ, Australia; Monash Univ, Australia.
    Subacromial decompression surgery for rotator cuff disease2019In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 1, article id CD005619Article, review/survey (Refereed)
    Abstract [en]

    Background Surgery for rotator cuff disease is usually used after non-operative interventions have failed, although our Cochrane Review, first published in 2007, found that there was uncertain clinical benefit following subacromial decompression surgery. Objectives To synthesise the available evidence of the benefits and harms of subacromial decompression surgery compared with placebo, no intervention or non-surgical interventions in people with rotator cuff disease (excluding full thickness rotator cuff tears). Search methods We searched CENTRAL, MEDLINE, Embase, Clinicaltrials. gov and WHO ICRTP registry from 2006 until 22 October 2018, unrestricted by language. Selection criteria We included randomised and quasi-randomised controlled trials (RCTs) of adults with rotator cuff disease (excluding full-thickness tears), that compared subacromial decompression surgery with placebo, no treatment, or any other non-surgical interventions. As it is least prone to bias, subacromial decompression compared with placebo was the primary comparison. Other comparisons were subacromial decompression versus exercises or non-operative treatment. Major outcomes were mean pain scores, shoulder function, quality of life, participant global assessment of success, adverse events and serious adverse events. The primary endpoint for this review was one year. For serious adverse events, we also included data from prospective cohort studies designed to record harms that evaluated subacromial decompression surgery or shoulder arthroscopy. Data collection and analysis We used standard methodologic procedures expected by Cochrane. Main results We included eight trials, with a total of 1062 randomised participants with rotator cuff disease, all with subacromial impingement. Two trials (506 participants) compared arthroscopic subacromial decompression with arthroscopy only (placebo surgery), with all groups receiving postoperative exercises. These trials included a third treatment group: no treatment (active monitoring) in one and exercises in the other. Six trials (556 participants) compared arthroscopic subacromial decompression followed by exercises with exercises alone. Two of these trials included a third arm: sham laser in one and open subacromial decompression in the other. Trial size varied from 42 to 313 participants. Participant mean age ranged between 42 and 65 years. Only two trials reported mean symptom duration (18 to 22 months in one trial and 30 to 31 months in the other), two did not report duration and four reported it categorically. Both placebo-controlled trials were at low risk of bias for the comparison of surgery versus placebo surgery. The other trials were at high risk of bias for several criteria, most notably at risk of performance or detection bias due to lack of participant and personnel blinding. We have restricted the reporting of results of benefits in the Abstract to the placebo-controlled trials. Compared with placebo, high-certainty evidence indicates that subacromial decompression provides no improvement in pain, shoulder function, or health-related quality of life up to one year, and probably no improvement in global success (moderate-certainty evidence, downgraded due to imprecision). At one year, mean pain (on a scale zero to 10, higher scores indicate more pain), was 2.9 points after placebo surgery and 0.26 better (0.84 better to 0.33 worse), after subacromial decompression (284 participants), an absolute difference of 3%(8% better to 3% worse), and relative difference of 4% (12% better to 5% worse). At one year, mean function (on a scale 0 to 100, higher score indicating better outcome), was 69 points after placebo surgery and 2.8 better (1.4 worse to 6.9 better), after surgery (274 participants), an absolute difference of 3% (7% better to 1% worse), and relative difference of 9% (22% better to 4% worse). Global success rate was 97/148 (or 655 per 1000), after placebo and 101/142 (or 708 per 1000) after surgery corresponding to RR 1.08 (95% CI 0.93 to 1.27). Healthrelated quality of life was 0.73 units (European Quality of Life EQ-5D, -0.59 to 1, higher score indicating better quality of life), after placebo and 0.03 units worse (0.011 units worse to 0.06 units better), after subacromial decompression (285 participants), an absolute difference of 1.3% (5% worse to 2.5% better), and relative difference of 4% (15% worse to 7% better). Adverse events including frozen shoulder or transientminor complications of surgery were reported in approximately 3% of participants across treatment groups in two randomised controlled trials, but due to low event rates we are uncertain if the risks differ between groups: 5/165 (37 per 1000) reported adverse events with subacromial decompression and 9/241 (34 per 1000) with placebo or nonoperative treatment, RR 0.91 (95% CI 0.31 to 2.65) (moderate-certainty evidence, downgraded due to imprecision). The trials did not report serious adverse events. Based upon moderate-certainty evidence from two observational trials from the same prospective surgery registry, which also included other shoulder arthroscopic procedures (downgraded for indirectness), the incidence proportion of serious adverse events within 30 days following surgery was 0.5% (0.4% to 0.7%; data collected 2006 to 2011), or 0.6% (0.5 % to 0.7%; data collected 2011 to 2013). Serious adverse events such as deep infection, pulmonary embolism, nerve injury, and death have been observed in participants following shoulder surgery. Authors conclusions The data in this review do not support the use of subacromial decompression in the treatment of rotator cuff disease manifest as painful shoulder impingement. High-certainty evidence shows that subacromial decompression does not provide clinically important benefits over placebo in pain, function or health-related quality of life. Including results from open-label trials (with high risk of bias) did not change the estimates considerably. Due to imprecision, we downgraded the certainty of the evidence to moderate for global assessment of treatment success; there was probably no clinically important benefit in this outcome either compared with placebo, exercises or non-operative treatment. Adverse event rates were low, 3% or less across treatment groups in the trials, which is consistent with adverse event rates reported in the two observational studies. Although precise estimates are unknown, the risk of serious adverse events is likely less than 1%.

  • 28.
    King, Jonny
    et al.
    AFC Bournemouth, England.
    Roberts, Craig
    AFC Bournemouth, England.
    Hard, Steve
    AFC Bournemouth, England.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Want to improve return to sport outcomes following injury? Empower, engage, provide feedback and be transparent: 4 habits!2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 9, p. 527-Article in journal (Other academic)
    Abstract [en]

    n/a

  • 29.
    Kvist, Joanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Karolinska Inst, Sweden.
    Gauffin, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Tigerstrand Grevnerts, Hanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Stalman, Anders
    Capio ArtroClin, Sweden.
    Frobell, Richard
    Lund Univ, Sweden.
    Natural corollaries and recovery after acute ACL injury: the NACOX cohort study protocol2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 6, article id e020543Article in journal (Refereed)
    Abstract [en]

    Introduction Anterior cruciate ligament (ACL) injury can result in joint instability, decreased functional performance, reduced physical activity and quality of life and an increased risk for post-traumatic osteoarthritis. Despite the development of new treatment techniques and extensive research, the complex and multifaceted nature of ACL injury and its consequences are yet to be fully understood. The overall aim of the NACOX study is to evaluate the natural corollaries and recovery after an ACL injury. Methods and analysis The NACOX study is a multicentre prospective prognostic cohort study of patients with acute ACL injury. At seven sites in Sweden, we will include patients aged 15-40 years, within 6 weeks after primary ACL injury. Patients will complete questionnaires at multiple occasions over the 3 years following injury or the 3 years following ACL reconstruction (for participants who have surgical treatment). In addition, a subgroup of 130 patients will be followed with clinical examinations, several imaging modalities and biological samples. Data analyses will he specific to each aim. Ethics and dissemination This study has been approved by the regional Ethical committee in Linkoping, Sweden (Dnr 2016/44-31 and 2017/221-32). We plan to present the results at national and international conferences and in peer-reviewed scientific journals. Participants will receive a short summary of the results following completion of the study.

  • 30.
    Lai, Courtney C. H.
    et al.
    La Trobe University, Australia.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe University, Australia; Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Feller, Julian A.
    OrthoSport Victoria, Australia.
    Webster, Kate E.
    La Trobe University, Australia.
    Eighty-three per cent of elite athletes return to preinjury sport after anterior cruciate ligament reconstruction: a systematic review with meta-analysis of return to sport rates, graft rupture rates and performance outcomes2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 2, p. 128-138Article, review/survey (Refereed)
    Abstract [en]

    Objectives The primary objective was to calculate the rate of return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction in elite athletes. Secondary objectives were to estimate the time taken to RTS, calculate rates of ACL graft rupture, evaluate postsurgical athletic performance and identify determinants of RTS. Design Pooled RTS and graft rupture rates were calculated using random effects proportion meta-analysis. Time to RTS, performance data and determinants of RTS were synthesised descriptively. Data sources MEDLINE, EMBASE, AMED, CINAHL, AMI, PEDro, SPORTDiscus and The Cochrane Library were searched from inception to 19 January 2016. Hand searching of 10 sports medicine journals and reference checking were also performed. Eligibility criteria for selecting studies Studies were included if they reported the ratio of elite athletes who returned to their preinjury level of sport following ACL reconstruction. Twenty-four studies were included. Results The pooled RTS rate was 83% (95% CI 77% to 88%). The mean time to RTS ranged from 6 to 13 months. The pooled graft rupture rate was 5.2% (95% CI 2.8% to 8.3%). Six out of nine studies that included a noninjured control group found no significant deterioration in athletic performance following ACL reconstruction. Indicators of greater athletic skill or value to the team were associated with RTS. Summary and conclusions Eighty-three per cent of elite athletes returned to sport following ACL reconstruction, while 5.2% sustained a graft rupture. Most athletes who returned to sport performed comparably with matched, uninjured controls. This information may assist in guiding expectations of athletes and clinicians following ACL reconstruction.

  • 31.
    Levinger, Pazit
    et al.
    Victoria University, Australia; Australian Institute Musculoskeletal Science AIMSS, Australia.
    Hallam, Karen
    Victoria University, Australia.
    Fraser, Darren
    Western Hospital, Australia.
    Pile, Rebecca
    Western Hospital, Australia.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe University, Australia.
    Moreira, Brett
    Western Hospital, Australia.
    Talbot, Simon
    Western Hospital, Australia.
    A novel web-support intervention to promote recovery following Anterior Cruciate Ligament reconstruction: A pilot randomised controlled trial2017In: Physical Therapy in Sport, ISSN 1466-853X, E-ISSN 1873-1600, Vol. 27, p. 29-37Article in journal (Refereed)
    Abstract [en]

    Background: Self-efficacy is positively associated with adherence behaviours and rehabilitation outcomes following Anterior Cruciate Ligament (ACL) reconstruction. An internet resource can be an effective way to provide information, goal setting, patient monitoring and hence support overall self management. Purpose: This study examined the feasibility of a three month Internet-based intervention (mobile oriented site) to enhance recovery for patients, following ACL reconstruction. The potential effect of the internet-based intervention on knee pain, function, self-efficacy and fear of pain were also assessed. Method: This was a pilot randomised controlled trial (RCT) with pre and post intervention design (assessments at one week and three months following ACL reconstruction) comparing: (1) a control group and (2) an intervention group (internet-based intervention). A set of qualitative and quantitative assessments were included to evaluate potential improvements in self-efficacy, pain and function and perception of the internet intervention. Results and conclusion: Seventeen participants were available for analysis (n =10 intervention and n = 7 control group). Participants reported the internet-based intervention to be a useful tool for information, reminder and reinforcement for performing their exercise rehabilitation with 30.3% ( 35.3%) adherence to the internet-based intervention. No differences were observed between the groups over time on the outcome questionnaires (p amp;gt; 0.05). Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001379404. (C) 2017 Elsevier Ltd. All rights reserved.

  • 32.
    McCall, Alan
    et al.
    Arsenal Football Club, England; Edinburgh Napier University, Scotland.
    Lewin, Colin
    Arsenal Football Club, England.
    ODriscoll, Gary
    Arsenal Football Club, England.
    Witvrouw, Erik
    University of Ghent, Belgium.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar; La Trobe University, Australia.
    Return to play: the challenge of balancing research and practice2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 9, p. 702-703Article in journal (Other academic)
    Abstract [en]

    n/a

  • 33.
    McClean, Gavin
    et al.
    Athlete Health and Performance Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
    Riding, Nathan R.
    Athlete Health and Performance Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Athlete Health and Performance Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; School of Allied Health, La Trobe University, Melbourne, Australia .
    Farooq, Abdulaziz
    Athlete Health and Performance Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Pieles, Guido E.
    National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Unit, Congenital Heart Unit, Bristol Royal Hospital for Children and Bristol Heart Institute, Bristol, UK; School of Clinical Sciences, University of Bristol, Bristol, UK.
    Watt, Victoria
    Department of Sports Medicine, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Adamuz, Carmen
    Department of Sports Medicine, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    George, Keith P.
    Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
    Oxborough, David
    Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
    Wilson, Mathew G.
    Athlete Health and Performance Research Centre, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK; Research Institute of Sport and Exercise Sciences, University of Canberra, Australia.
    Electrical and structural adaptations of the paediatric athletes heart: a systematic review with meta-analysis2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 4, article id 230Article, review/survey (Refereed)
    Abstract [en]

    To describe the electrocardiographic (ECG) and echocardiographic manifestations of the paediatric athletes heart, and examine the impact of age, race and sex on cardiac remodelling responses to competitive sport.

  • 34.
    Mohtadi, Nicholas
    et al.
    Department of Surgery, University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Engebretsen, Lars
    Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
    Why all the fuss about paediatric ACL rupture: isnt the meniscus much more important?2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 7, p. 417-418Article in journal (Other academic)
    Abstract [en]

    n/a

  • 35.
    Patricios, Jon S.
    et al.
    Univ Pretoria, South Africa; Univ Witwatersrand, South Africa.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Hislop, Michael David
    World Rugby, Ireland.
    Aubry, Mark
    Int Ice Hockey Federat, Switzerland.
    Bloomfield, Paul
    Natl Rugby League, Australia.
    Broderick, Carolyn
    Natl Rugby League, Australia.
    Clifton, Patrick
    Australian Football League, Australia; Australian Inst Sport, Australia.
    Echemendia, Ruben J.
    Natl Hockey League, NY USA; Univ Orthoped Ctr, PA USA; Univ Missouri, MO 64110 USA.
    Ellenbogen, Richard G.
    Natl Football League, NY USA; Univ Washington, WA 98195 USA.
    Falvey, Eanna Cian
    Irish Rugby Football Union, Ireland.
    Fuller, Gordon Ward
    Univ Sheffield, England.
    Grand, Julie
    Natl Hockey League, NY USA.
    Hack, Dallas
    Natl Coll Athlet Assoc, IN USA.
    Harcourt, Peter Rex
    Australian Football League, Australia.
    Hughes, David
    Australian Football League, Australia; Australian Inst Sport, Australia.
    McGuirk, Nathan
    Natl Rugby League, Australia.
    Meeuwisse, Willem
    Natl Hockey League, NY USA.
    Miller, Jeffrey
    Natl Football League, NY USA.
    Parsons, John T.
    Natl Coll Athlet Assoc, IN USA.
    Richiger, Simona
    Int Ice Hockey Federat, Switzerland.
    Sills, Allen
    Natl Football League, NY USA; Federat Equestre Int, Switzerland.
    Moran, Kevin B.
    Gael Athlet Assoc, Ireland.
    Shute, Jenny
    Federat Int Ski, Switzerland; Federat Int Ski, Switzerland.
    Raftery, Martin
    World Rugby, Ireland.
    Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 10, p. 635-641Article in journal (Refereed)
    Abstract [en]

    The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statements themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published.

  • 36.
    Rambaud, Alexandre J. M.
    et al.
    Univ Jean Monnet, France; Sport Ctr, France.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Thoreux, Patricia
    Univ Paris, France; Arts and Metiers ParisTech, France.
    Regnaux, Jean-Philippe
    French Sch Publ Hlth EHESP, France; INSERM, France.
    Edouard, Pascal
    Univ Jean Monnet, France; Univ Hosp St Etienne, France.
    Criteria for return to running after anterior cruciate ligament reconstruction: a scoping review2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 22, p. 1437-1444Article, review/survey (Refereed)
    Abstract [en]

    Objective To describe the criteria used to guide clinical decision-making regarding when a patient is ready to return to running (RTR) after ACL reconstruction. Design Scoping review. Data sources The MEDLINE (PubMed), EMBASE, Web of Science, PEDro, SPORT Discus and Cochrane Library electronic databases. We also screened the reference lists of included studies and conducted forward citation tracking. Eligibility criteria for selecting studies Reported at least one criterion for permitting adult patients with primary ACL reconstruction to commence running postoperatively. Results 201 studies fulfilled the inclusion criteria and reported 205 time-based criteria for RTR. The median time from when RTR was permitted was 12 postoperative weeks (IQR=3.3, range 5-39 weeks). Fewer than one in five studies used additional clinical, strength or performance-based criteria for decision-making regarding RTR. Aside from time, the most frequently reported criteria for RTR were: full knee range of motion or amp;gt;95% of the non-injured knee plus no pain or pain amp;lt;2 on visual analogue scale; isometric extensor limb symmetry index (LSI)amp;gt; 70% plus extensor and flexor LSIamp;gt; 70%; and hop test LSIamp;gt; 70%. Conclusions Fewer than one in five studies reported clinical, strength or performance-based criteria for RTR even though best evidence recommends performance-based criteria combined with time-based criteria to commence running activities following ACL reconstruction.

  • 37.
    Tagesson (Sonesson), Sofi
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. School of Allied Health, La Trobe University, Melbourne, Australia, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Österberg, Annika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Grävare Silbernagel, Karin
    Department of Physical Therapy, University of Delaware, Newark, DE, USA..
    Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: expect and motivate to satisfy.2017In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, no 5, p. 1375-1384Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe individuals' expectations, motivation, and satisfaction before, during, and after rehabilitation for ACL reconstruction and to explore how these factors were associated with return to pre-injury sport activity at 1-year follow-up.

    METHODS: Sixty-five individuals (34 males), median age 22 (15-45) years, scheduled for ACL reconstruction participated. Participants completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and questions about expectations, satisfaction, and motivation pre-operatively and at 16 and 52 weeks after surgery.

    RESULTS: Prior to surgery, 86 % of participants stated that their goal was to return to their pre-injury sport activity. Those who had returned to their pre-injury sport activity at 52 weeks were more motivated during rehabilitation to return to their pre-injury activity level, more satisfied with their activity level and knee function at 52 weeks, and scored significantly higher on the IKDC-SKF [median 92.0 (range 66.7-100.0)] at 52 weeks, compared to those who had not returned [median 77.6 (range 50.6-97.7)].

    CONCLUSION: Prior to ACL reconstruction, most participants expected to return to their pre-injury activity level. Higher motivation during rehabilitation was associated with returning to the pre-injury sport activity. The participants who had returned to their pre-injury sport activity were more satisfied with their activity level and knee function 1 year after the ACL reconstruction. Facilitating motivation might be important to support individuals in achieving their participation goals after ACL reconstruction.

    LEVEL OF EVIDENCE: Prospective cohort study, Level II.

  • 38.
    Tigerstrand Grevnerts, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Gravare Silbernagel, K.
    University of Delaware, DE USA.
    Tagesson (Sonesson), Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Österberg, Annika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Gauffin, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form2017In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, no 5, p. 554-562Article in journal (Refereed)
    Abstract [en]

    To translate to Swedish language and cross-culturally adapt the IKDC-SKF and to test the measurement properties of the Swedish version of IKDC-SKF in ACL-injured patients undergoing reconstruction surgery.The translation and cross-cultural adaption was performed according to guidelines. Seventy-six patients with an ACL injury filled out the IKDC-SKF and other questionnaires before ACL reconstruction and at 4, 6, and 12months after surgery. A total of 203 patients from the Swedish ACL Registry participated at 8months post-operative. Measurement properties were tested according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.The Swedish IKDC-SKF had high internal consistency (Cronbachs alpha=0.90) and test-retest reliability (ICC2,1=0.92, CI 95%: 0.81-0.97, Pamp;lt;.001). A single factor solution accounted for 46.1% of the variance in IKDC-SKF scores. Criterion validity was moderate to high. All ten predefined hypotheses for hypothesis testing were confirmed. The six hypotheses for responsiveness testing were confirmed. The effect size was 1.8, the standardized response mean was 1.9, the and minimal clinically important difference was 13.9 points.The Swedish version of the IKDC-SKF had good measurement properties and can be recommended for use in a population of ACL-deficient patients undergoing ACL reconstruction.

  • 39.
    Vandvik, Per Olav
    et al.
    Lovisenberg Diaconal Hosp, Norway; Univ Oslo, Norway.
    Lahdeoja, Tuomas
    Univ Helsinki, Finland; HUS Helsinki Univ Hosp, Finland.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Buchbinder, Rachelle
    Monash Univ, Australia; Monash Univ, Australia.
    Moro, Jaydeep
    McMaster Univ, Canada.
    Brox, Jens Ivar
    Univ Oslo, Norway; Univ Oslo, Norway.
    Burgers, Jako
    Dutch Coll Gen Practitioners, Netherlands; Care and Publ Hlth Res Inst, Netherlands.
    Hao, Qiukui
    Sichuan Univ, Peoples R China; McMaster Univ, Canada.
    Karjalainen, Teemu
    Monash Univ, Australia; Monash Univ, Australia.
    van den Bekerom, Michel
    OLVG, Netherlands.
    Noorduyn, Julia
    OLVG, Netherlands.
    Lytvyn, Lyubov
    McMaster Univ, Canada.
    Siemieniuk, Reed A. C.
    McMaster Univ, Canada.
    Albin, Alexandra
    Society for Participatory Medicine Member, USA.
    Shunjie, Sean Chua
    MOH Holdings, Singapore.
    Fisch, Florian
    Gryphenhubeliweg 28, Switzerland.
    Proulx, Laurie
    Canadian Arthrit Patient Alliance, Canada.
    Guyatt, Gordon
    McMaster Univ, Canada.
    Agoritsas, Thomas
    Univ Hosp Geneva, Switzerland.
    Poolman, Rudolf W.
    OLVG, Netherlands.
    Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline2019In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 364, article id l294Article in journal (Refereed)
    Abstract [en]

    Clinical question Do adults with atraumatic shoulder pain for more than 3 months diagnosed as subacromial pain syndrome (SAPS), also labelled as rotator cuff disease, benefit from subacromial decompression surgery? This guideline builds on to two recent high quality trials of shoulder surgery. Current practice SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections. Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations. Recommendation The guideline panel makes a strong recommendation against surgery. How this guideline was created A guideline panel including patients, clinicians, and methodologists produced this recommendation in adherence with standards for trustworthy guidelines and the GRADE system. The recommendation is based on two linked systematic reviews on (a) the benefits and harms of subacromial decompression surgery and (b) the minimally important differences for patient reported outcome measures. Recommendations are made actionable for clinicians and their patients through visual overviews. These provide the relative and absolute benefits and harms of surgery in multilayered evidence summaries and decision aids available in MAGIC (www.magicapp.org) to support shared decisions and adaptation. The evidence Surgery did not provide important improvements in pain, function, or quality of life compared with placebo surgery or other options. Frozen shoulder may be more common with surgery. Understanding the recommendation The panel concluded that almost all informed patients would choose to avoid surgery because there is no benefit but there are harms and it is burdensome. Subacromial decompression surgery should not be offered to patients with SAPS. However, there is substantial uncertainty in what alternative treatment is best.

  • 40.
    Windt, Johann
    et al.
    Univ British Columbia, Canada; US Olymp Comm, CO 80909 USA; US Coalit Prevent Illness and Injury Sport, CO 80907 USA.
    Ardern, Clare
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. La Trobe Univ, Australia.
    Gabbett, Tim J.
    Gabbett Performance Solut, Australia; Univ Southern Queensland, Australia.
    Khan, Karim M.
    Univ British Columbia, Canada; Univ British Columbia, Canada.
    Cook, Chad E.
    Duke Univ, NC USA.
    Sporer, Ben C.
    Univ British Columbia, Canada; Vancouver Whitecaps Football Club, Canada.
    Zumbo, Bruno D.
    Univ British Columbia, Canada.
    Getting the most out of intensive longitudinal data: a methodological review of workload-injury studies2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 10, article id e022626Article, review/survey (Refereed)
    Abstract [en]

    Objectives To systematically identify and qualitatively review the statistical approaches used in prospective cohort studies of team sports that reported intensive longitudinal data (ILD) (amp;gt;20 observations per athlete) and examined the relationship between athletic workloads and injuries. Since longitudinal research can be improved by aligning the (1) theoretical model, (2) temporal design and (3) statistical approach, we reviewed the statistical approaches used in these studies to evaluate how closely they aligned these three components. Design Methodological review. Methods After finding 6 systematic reviews and 1 consensus statement in our systematic search, we extracted 34 original prospective cohort studies of team sports that reported ILD (amp;gt;20 observations per athlete) and examined the relationship between athletic workloads and injuries. Using Professor Linda Collins three-part framework of aligning the theoretical model, temporal design and statistical approach, we qualitatively assessed how well the statistical approaches aligned with the intensive longitudinal nature of the data, and with the underlying theoretical model. Finally, we discussed the implications of each statistical approach and provide recommendations for future research. Results Statistical methods such as correlations, t-tests and simple linear/logistic regression were commonly used. However, these methods did not adequately address the (1) themes of theoretical models underlying workloads and injury, nor the (2) temporal design challenges (ILD). Although time-to-event analyses (eg, Cox proportional hazards and frailty models) and multilevel modelling are better-suited for ILD, these were used in fewer than a 10% of the studies (n= 3). Conclusions Rapidly accelerating availability of ILD is the norm in many fields of healthcare delivery and thus health research. These data present an opportunity to better address research questions, especially when appropriate statistical analyses are chosen.

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