Purpose: The aim of this study was to assess physiotherapists’ clinical use and acceptance of a novel telemonitoring platform to facilitate the recording of measurements during rehabilitation of patients following anterior cruciate ligament reconstruction. Additionally, suggestions for platform improvement were explored. Methods: Physiotherapists from seven Dutch private physiotherapy practices participated in the study. Data were collected through log files, a technology acceptance questionnaire and focus group meetings using the “buy a feature” method. Data regarding platform use and acceptance (7-point/11-point numeric rating scale) were descriptively analysed. Total scores were calculated for the features suggested to improve the platform, based on the priority rating (1 = nice to have, 2 = should have, 3 = must have). Results: Participating physiotherapists (N = 15, mean [SD] age 33.1 [9.1] years) together treated 52 patients during the study period. Platform use by the therapists was generally limited, with the number of log-ins per patient varying from 3 to 73. Overall, therapists’ acceptance of the platform was low to moderate, with average (SD) scores ranging from 2.5 (1.1) to 4.9 (1.5) on the 7-point Likert scale. The three most important suggestions for platform improvement were: (1) development of a native app, (2) system interoperability, and (3) flexibility regarding type and frequency of measurements. Conclusions: Even though health care professionals were involved in the design of the telemonitoring platform, use in routine care was limited. Physiotherapists recognized the relevance of using health technology, but there are still barriers to overcome in order to successfully implement eHealth in routine care.
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PURPOSE: It has been reported that there is no correlation between anterior tibia translation (ATT) in passive and dynamic situations. Passive ATT (ATTp) may be different to dynamic ATT (ATTd) due to muscle activation patterns. This study aimed to investigate whether muscle activation during jumping can control ATT in healthy participants.METHODS: ATTp of twenty-one healthy participants was measured using a KT-1000 arthrometer. All participants performed single leg hops for distance during which ATTd, knee flexion angles and knee flexion moments were measured using a 3D motion capture system. During both tests, sEMG signals were recorded.RESULTS: A negative correlation was found between ATTp and the maximal ATTd (r = - 0.47, p = 0.028). An N-Way ANOVA showed that larger semitendinosus activity was seen when ATTd was larger, while less biceps femoris activity and rectus femoris activity were seen. Moreover, larger knee extension moment, knee flexion angle and ground reaction force in the anterior-posterior direction were seen when ATTd was larger.CONCLUSION: Participants with more ATTp showed smaller ATTd during jump landing. Muscle activation did not contribute to reduce ATTd during impact of a jump-landing at the observed knee angles. However, subjects with large ATTp landed with less knee flexion and consequently showed less ATTd. The results of this study give information on how healthy people control knee laxity during jump-landing.LEVEL OF EVIDENCE: III.
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Hop tests are frequently used to determine return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). Given that bilateral deficits are present after ACLR, this may result in a falsely high limb symmetry index (LSI), since LSI is calculated as a ratio between the values of the limbs.HypothesisAthletes after ACLR would achieve LSI > 90% for the hop test. Secondly, athletes after ACLR demonstrate decreased jump distance on the single hop for distance (SLH) and triple leg hop for distance (TLH) and decreased number of hops for the side hop (SH) for both involved and uninvolved limbs compared to normative data of sex, age and type of sports matched healthy athletes.Materials and MethodsFifty-two patients (38 males mean age 23.9 ±3.5 yrs; 14 females mean age 21.7±3.5 years) who had undergone an ACLR participated in this study. Patients performed the 3 hop tests at a mean time of 7.0 months after ACLR. Hop distance, number of side hops and LSI were compared with normative data of 188 healthy athletes.ResultsThe differences between the involved limb and the uninvolved limb were significant in all hop tests (SLH p=0.003, TLH p=0.003 , SH p=0.018). For females, only significant between limb differences were found in the SLH (p=0.049). For both the SLH and the TLH, significant differences were found between the involved limb and the normative data (males; SLH p<0.001, TLH p<0.001; females; SLH p<0.001, TLH p=0.006) and between the uninvolved limb and the normative data for both males and females (males; SLH p<0.001, TLH p<0.001; females; SLH p=0.003, TLH p=0.038). For the SH, only significant differences were found between the involved limb and the normative values in males (p=0.033).ConclusionAthletes who have undergone an ACLR demonstrate bilateral deficits on hop tests in comparison to age and sex matched normative data of healthy controls. Using the LSI may underestimate performance deficits and should therefore be analyzed with caution when used as a criterion for RTS after ACLR.
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