简介:Background:Preventinganteriorcruciateligament(ACL)injuriesisimportanttoavoidlong-termadversehealthconsequences.Identifyingbarrierstoimplementationofthesepreventionprogramsiscrucialtoreducingtheincidenceoftheseinjuries.OurpurposewastoidentifybarriersofimplementationforACLinjurypreventionprogramsandsuggestmechanismsforreducingthebarriersthroughapplicationofaSocioEcologicalModel(SEM).Methods:StudiesinvestigatingACLpreventionprogrameffectivenessweresearchedinMedlineviaPubMedandtheCochraneLibrary,andasubsequentreviewofthereferencesoftheidentifiedarticles,yielded15articlestotal.Inclusioncriteriaencompassedprospectivecontrolledtrials,publishedinEnglish,withACLinjuriesastheprimaryoutcome.Studieswereindependentlyappraisedby2reviewersformethodologicalqualityusingthePEDroscale.Barrierstoimplementationwereidentifiedwhenreportedinatleast2separatestudies.ASEMwasusedtosuggestwaystoreducetheidentifiedbarriers.Results:Fivebarrierswereidentified:motivation,timerequirements,skillrequirementsforprogramfacilitators,compliance,andcost.TheSEMsuggestedwaystominimizethebarriersatalllevelsofthemodelfromtheindividualthroughpolicylevels.Conclusion:IdentificationofbarrierstoprogramimplementationandsuggestinghowtoreducethemthroughtheSEMisacriticalfirststeptowardenablingACLpreventionprogramstobemoreeffectiveandultimatelyreducingtheincidenceoftheseinjuries.
简介:Background:Thegreatertrochantermarkeriscommonlyusedin3-dimensional(3D)models;however,itsinfluenceonhipandkneekinematicsduringgaitisunclear.Understandingtheinfluenceofthegreatertrochantermarkerisimportantwhenquantifyingfrontalandtransverseplanehipandkneekinematics,parameterswhichareparticularlyrelevanttoinvestigateinindividualswithconditionssuchaspatellofemoralpain,kneeosteoarthritis,anteriorcruciateligament(ACL)injury,andhippain.Theaimofthisstudywastoevaluatetheeffectofincludingthegreatertrochanterintheconstructionofthethighsegmentonhipandkneekinematicsduringgait.Methods:3Dkinematicswerecollectedin19healthysubjectsduringwalkingusingasurfacemarkersystem.Hipandkneeangleswerecomparedacrosstwothighsegmentdefinitions(withandwithoutgreatertrochanter)attwotimepointsduringstance:peakkneeflexion(PKF)andminimumkneeflexion(MinKF).Results:Hipandkneeanglesdifferedinmagnitudeanddirectioninthetransverseplaneatbothtimepoints.Inthethighmodelwiththegreatertrochanterthehipwasmoreexternallyrotatedthaninthethighmodelwithoutthegreatertrochanter(PKF:-9.34°±5.21°vs.1.40°±5.22°,MinKF:-5.68°±4.24°vs.5.01°±4.86°;p<0.001).Inthethighmodelwiththegreatertrochanter,thekneeanglewasmoreinternallyrotatedcomparedtothekneeanglecalculatedusingthethighdefinitionwithoutthegreatertrochanter(PKF:14.67°±6.78°vs.4.33°±4.18°,MinKF:10.54°±6.71°vs.-0.01°±2.69°;p<0.001).Smallbutsignificantdifferencesweredetectedinthesagittalandfrontalplaneanglesatbothtimepoints(p<0.001).Conclusion:Hipandkneekinematicsdifferedacrossdifferentsegmentdefinitionsincludingorexcludingthegreatertrochantermarker,especiallyinthetransverseplane.Thereforewhenconsideringwhethertoincludethegreatertrochanterinthethighsegmentmodelwhenusingasurfacemarkerstocalculate3Dkinematicsformovementassessment,iti