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Steven Eustace, Richard Michael Page and Matt Greig

changeable through rehabilitation. A study in professional male soccer reported that only 65% of players who sustain an anterior cruciate ligament (ACL) injury return to previous competitive levels 3 years after injury. 1 Secondary ACL injuries are also common among professional soccer players, attributed

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Mark De Carlo, Thomas E. Klootwyk and K. Donald Shelbourne

Rehabilitation following intraarticular anterior cruciate ligament (ACL) reconstruction has undergone a dramatic evolution during the last decade. This paper describes our accelerated rehabilitation program, which is divided into four phases. The preoperative phase begins immediately after injury and emphasizes control of swelling and restoration of full range of motion (ROM) and strength before surgery. Phase II, which includes the first 2 weeks after surgery, emphasizes helping the patient obtain full terminal knee extension and weight bearing. The final two phases focus on improving lower extremity strength and full return to daily and athletic activities. This accelerated program has resulted in an earlier return of ROM and strength as well as a decrease in postoperative procedures, without compromising ligamentous stability.

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Maria Grazia Benedetti, Lisa Berti, Antonio Frizziero, Donata Ferrarese and Sandro Giannini

Context:

Surface replacement of the hip is aimed especially at active patients, and it seems to achieve optimal functional results in a short time if associated with a tailored rehabilitation protocol.

Objective:

To assess the functional outcome in a group of active patients after hip resurfacing.

Design:

Clinical measurement and controlled laboratory study in a case series.

Setting:

Gait-analysis laboratory.

Participants:

8 patients and a control group of 10 subjects.

Interventions:

Patients treated with Birmingham hip-resurfacing system and a tailored rehabilitation protocol

Main Outcome Measures:

Clinical assessment (Harris Hip Score [HHS]) and instrumented gait analysis including muscular electromyographic assessment. Patients were assessed preoperatively and at 3 and 9 mo follow-up after surgery.

Results:

HHS showed a significant increase from the baseline to 3- (P = .008) and 9-month (P = .014) follow-up; 5 patients returned to sport. Gait pattern in the presented case series of patients improved substantially 3 mo postoperatively, and minimal further changes were present 9 months postoperatively. Residual abnormalities of time-distance and hip-kinematics parameters were consistent with a slow gait. A complete restoration of the muscle-activation pattern during gait was achieved.

Conclusion:

Hip resurfacing associated with a rehabilitation protocol based on the characteristics of the implant provides excellent clinical and functional outcome, especially for very active patients.

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Alis Bonsignore, David Field, Rebecca Speare, Lianne Dolan, Paul Oh and Daniel Santa Mina

of exercise in reducing treatment-related side effects and increasing the well-being of cancer survivors. 10 , 11 Major oncology and rehabilitation organizations have also identified the importance of incorporating exercise-based programs in comprehensive cancer care; however, access to these

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Martin J. Kelley

Rehabilitation following injury or surgery for the athlete who employs overhead motion is extremely challenging. Shoulder pathophysiology and the repetitive intense demands required during athletic activity need to be fully appreciated for successful rehabilitation. This article discusses new anatomic and biomechanical concepts that require the rehabilitation specialist to reconsider previously accepted notions. Treatment rationale is discussed based on these concepts. Rehabilitation principles and phases are described in a sequentially progressive program based on tissue reactivity and signs and symptoms.

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Lynne Evans and Lew Hardy

There is an increasing awareness within the sport-related literature of the importance of psychological factors in the rehabilitation of injured athletes. This awareness and subsequent investigations have led to the proposed application of grief response models to injury. However, to date limited attention has been paid to the clinical psychology literature on grief. The purpose of this paper is to redress this oversight by providing a review of the most relevant literature on the psychological responses of injured athletes in light of the philosophical and empirical research into loss and grief in the clinical literature. As a result of this review, a number of issues are raised for future research into grief models of injury.

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Mitchell L. Cordova, Lisa S. Jutte and J. Ty Hopkins

Many types of rehabilitation exercises are used to reestablish lower extremity neuromuscular function and strength following ankle injuries. It has not been established which exercise induces the greatest leg muscle activity, which might allow patients to recover more quickly from their injuries. The purpose of this investigation was to establish which exercises induce the most muscle activity in the medial gastrocnemius (MG), peroneus longus (PL), and tibialis anterior (TA), as measured by integrated electromyography (I-EMG). Participants (N = 24, age = 22 ± .59, mass = 63.5 ± 2.1 kg, ht = 165.7 ± 1.2 cm) conducted five repetitions of each of four exercise conditions for 30 s: one-legged stance (OLS), OLS on trampoline (OLST), T-Band kicks (TBK), and OLS perturbations (OLSP). It was found that the TBK exercise induces greater I-EMG in all three muscles, the OLST exercise stimulates more I-EMG activity in the MG and TA, and the OLSP exercise induces greater I-EMG activity in the TA.

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Barry Braun

The concept that participation in exercise/physical activity reduces the risk for a host of chronic diseases is undisputed. Along with adaptations to habitual activity, each bout of exercise induces beneficial changes that last for a finite period of time, requiring subsequent exercise bouts to sustain the benefits. In this respect, exercise/physical activity is similar to other “medications” and the idea of “Exercise as Medicine” is becoming embedded in the popular lexicon. Like other medications, exercise has an optimal dose and frequency of application specific to each health outcome, as well as interactions with food and other medications. Using the prevention of type-2 diabetes as an exemplar, the application of exercise/physical activity as a medication for metabolic “rehabilitation” is considered in these terms. Some recommendations that are specific to diabetes prevention emerge, showing the process by which exercise can be prescribed to achieve health goals tailored to individual disease prevention outcomes.

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Barıs Seven, Gamze Cobanoglu, Deran Oskay and Nevin Atalay-Guzel

and researchers information about effectiveness of their rehabilitation protocol or helps diagnosis of various neuromuscular and somatosensorial disorders. 4 , 5 One of the frequently used methods is manual muscle testing because it is easy and fast to use in clinics. However, it is a subjective

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Diane M. Wiese-Bjornstal, Kristin N. Wood, Andrew C. White, Amanda J. Wambach and Victor J. Rubio

response to the sport injury and rehabilitation process posits and research supports that sport injuries are stressful life events triggering the use of a wide variety of coping strategies, including R/S coping ( Wiese-Bjornstal et al., 1998 ). Within this model, personal factors such as religious