CLINICAL IMPLICATIONS FROM DAILY PHYSIOTHERAPY EXAMINATION OF 131 ACUTE HAMSTRING INJURIES AND THEIR ASSOCIATION WITH RUNNING SPEED AND REHABILITATION PROGRESSION

Review written by Dr Nicol van Dyk info

BACKGROUND & OBJECTIVE

After a hamstring injury, we are immediately concerned with the question "When can the athlete play again?". Return to sport criteria are often debated, and it is unclear how to use documented outcome measures throughout the rehabilitation process (including high speed running progression) to guide optimal loading of the hamstrings. The aim of this study was to document the association of a series of clinical measures with both the progress of rehabilitation to return to sport, and to determine whether any of these measures correlate with running effort to better inform clinical practice.

METHODS

131 athletes with an MRI-confirmed acute hamstring injury underwent a standardized criteria-based rehabilitation protocol. The association between daily clinical subjective and objective measures and both the progression of rehabilitation and perceived running effort were analyzed and described. These measures included different strength, palpation, flexibility, and functional tests. Inter- and intra-rater reliability and minimal detectable change (the smallest amount of change required to distinguish a true performance difference from variability due to measurement error) was established for the clinical measures of strength and flexibility by examining measures taken on consecutive days for the uninjured leg.

Outer range strength (in the supine position) and flexibility (with the maximum hip flexion active knee extension (MHFAKE) position)... were associated with rehabilitation progression

RESULTS

The progression of the daily measures was found to be non-linear, meaning that the change in return to sport time was not proportional to the different measures. The variance was also different for the different measures. However, intra-rater reliability for

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