Thiago Jambo Alves Lopes

The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis:

Background: Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. Purpose: To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Study Design: Meta-analysis. Methods: Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. Results: The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased (P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact (P = .009), peak hip flexion (P = .002), and peak knee flexion (P = .007) increased, while knee flexion at initial contact did not change (P = .18). Moreover, peak knee flexion moment decreased (P = .005) and peak vertical ground-reaction force did not change (P = .10). Conclusion: The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants’ baseline profile deficits, highlighting the need to deliver an individualized and task-specific IPP.

Outpatient versus inpatient anterior cruciate ligament reconstruction: A systematic review with meta-analysis

BACKGROUND Efforts to reduce the financial costs related to anterior cruciate ligament reconstruction (ACLR) include reducing the length of hospitalization of the patient undergoing ACLR. However, it is unclear if inpatient and outpatient ACLR differ in terms of safety, satisfaction, costs and clinical outcomes. AIM To systematically review and synthesize the literature that directly compared costs and outcomes after outpatient and inpatient ACLR. METHODS Studies that directly compared outcomes of inpatient and outpatient ACLR were retrieved via searches in MEDLINE, EMBASE, CINAHL, AMED, Cochrane, SPORTDiscus, Web of Science and SCOPUS databases. Random effects meta-analysis and descriptive analysis were performed for relevant outcomes. RESULTS Costs analysis suggests that outpatient ACLR may be a cost effective procedure with savings ranging from

EPIDEMIOLOGY OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN BRAZIL'S PUBLIC HEALTH SYSTEM

1371 to

Reliability and Validity of Frontal Plane Kinematics of the Trunk and Lower Extremity Measured With 2-Dimensional Cameras During Athletic Tasks: A Systematic Review With Meta-analysis

7390. There were no differences for systemic and local complications p=0.64 (odds ratio 1.65, 95% confidence interval 0.20 to 13.49) and p=0.72 (0.81, 0.26 to 2.56) respectively, or pain in the second and seventh days after surgery, p=0.78 (mean difference -0.16; 95% confidence interval -1.28 to 0.96) and p=0.44 (0.48, -0.75 to 1.71), respectively. However, the outpatient group had less pain than the inpatient group in the first and third days after surgery, p=0.0001 (-0.39, -0.57 to -0.21) and p=0.0001(-0.39, -0.39 to -0.20), respectively. Descriptive analysis revealed that the outpatient group experienced similar or better satisfaction, strength and knee function compared to the inpatient group. CONCLUSION AND KEY FINDINGS Complications, pain, satisfaction, knee function and strength are similar or better after outpatient compared to inpatient ACLR. Furthermore, cost savings may be achieved with outpatient ACLR. However, included studies presented low methodological quality and the quality of evidence was very low, so these results need to be confirmed by future studies. REGISTRATION NUMBER PROSPERO (CRD42015024990).

The development and validation of a custom built device for assessing frontal knee joint laxity

Introducao: Varios estudos tem relatado a epidemiologia da reconstrucao do ligamento cruzado anterior (RLCA) na Europa e America do Norte, no entanto, nao ha atualmente dados referentes ao Brasil. Objetivo: Descrever a incidencia de RLCA no Brasil e investigar tendencias temporais e diferencas entre os grupos de idade e sexo. Metodos: Todos os casos relatados de RLCA no sistema publico de saude do Brasil entre janeiro de 2008 e dezembro 2014 foram extraidos do Departamento de Informatica do Ministerio da Saude do Brasil. A analise de regressao linear foi usada para avaliar as mudancas na incidencia de RLCA na populacao total e entre grupos de sexo e idade, tempo de internacao e custos hospitalares. Resultados: Um total de 48,241 RLCA foi reportado entre 2008 e 2014, com incidencia geral de 3,49 por 100.000 pessoas/ano. Homens foram responsaveis por 82% dos procedimentos. A incidencia de RLCA aumentou 56% entre os homens (p = 0,01) e 112% entre as mulheres (p = 0,001). O tempo medio de permanencia hospitalar diminuiu de 2,4 dias em 2008 para 1,8 dia em 2014 (R2 = 0,883, p = 0,002). O custo total em todos os anos foi de US

EPIDEMIOLOGÍA DE LA RECONSTRUCCIÓN DEL LIGAMENTO CRUZADO ANTERIOR EN EL SISTEMA DE SALUD PÚBLICA DE BRASIL

56 milhoes, com media de US

EPIDEMIOLOGIA DA RECONSTRUÇÃO DO LIGAMENTO CRUZADO ANTERIOR NO SISTEMA PÚBLICO DE SAÚDE DO BRASIL

1.145 por RLCA. Conclusao: Apesar da incidencia total de RLCA no Brasil ser menor em comparacao com outros paises, ela tem aumentado ao longo dos anos, principalmente em mulheres. A criacao de um registro de RLCA se faz necessaria no futuro para um controle mais acurado e novas investigacoes.Introduction: Several studies have reported on the epidemiology of Anterior Cruciate Ligament Reconstruction (ACLR) in Europe and North America; however, there is currently no data relating to Brazil. Objective: To describe the incidence of ACLR in Brazil and investigate temporal trends and differences between age and sex groups. Methods: All reported ACLR cases in the public hospital system between January 2008 and December 2014 were extracted from the Information Technology Department of the Brazilian Ministry of Health. Linear regression analysis was used to assess changes in ACLR incidence in the overall population and among sex and age groups, hospitalization time, and health care costs. Results: A total of 48,241 ACLR were reported from 2008-2014 with an overall incidence of 3.49 per 100,000 persons/year. Males accounted for 82% of the procedures. The incidence of ACLR increased by 56% among males (p=0.01) and by 112% among females (p=0.001). The mean hospitalization time decreased from 2.4 days in 2008 to 1.8 day in 2014 (R2 = 0.883, p= 0.002). The total cost across all years was US

Physical Performance Measures of Flexibility, Hip Strength, Lower Limb Power and Trunk Endurance in Healthy Navy Cadets: Normative Data and Differences Between Sex and Limb Dominance

56 million, with a mean of US

Prevalence of Musculoskeletal Symptoms Among Brazilian Merchant Navy Cadets: Differences Between Sexes and School Years

1,145 per ACLR. Conclusion: Although the total incidence of ACLR in Brazil is lower compared to other countries, it has increased over the years, especially in females. The creation of an ACLR registry is necessary in the future, for more accurate control and new investigations.

Are there differences between men and women or limb dominance during physical performance tests in healthy Navy cadets

BACKGROUND: Two‐dimensional (2‐D) analysis is commonly used to quantify frontal plane kinematics of the trunk and lower extremity. However, there are conflicting results regarding the reliability and validity of these measurements. OBJECTIVE: To synthesize the current literature to determine whether 2‐D analysis is a reliable and valid method of measuring frontal plane kinematics of the trunk and lower extremity during squatting, landing, and cutting tasks. METHODS: For this systematic review with metaanalysis, MEDLINE, CINAHL, Embase, Scopus, and SPORTDiscus databases were searched from inception until March 2017. The authors included 16 studies that evaluated the reliability and/or validity of 2‐D measurements of frontal plane trunk and/or lower extremity kinematics when compared to 3‐D measurements during any of the following tasks: squatting, landing, or cutting. RESULTS: Intrarater reliability (intraday and interday) and interrater reliability of the 2‐D video measurements varied from moderate to excellent. In terms of validity, there was poor agreement between the 2‐D and 3‐D methods, with no correlation between 2‐D knee frontal plane projection angle and 3‐D knee frontal plane angles (r = 0.127, P = .094) for the single‐leg squat, but a moderate to good relationship (r = 0.619, P<.001) for the landing task. CONCLUSION: Two‐dimensional video analysis of frontal plane trunk and lower extremity kinematics is reliable, but this appears to be dependent on the task and the type of reliability evaluated. The current evidence does not support the use of 2‐D video analysis for measuring trunk and lower extremity frontal plane kinematics when accurate measures are required. LEVEL OF EVIDENCE: Diagnosis, level 3.