Τρίτη 16 Φεβρουαρίου 2016
Regulation of Oncoprotein 18/Stathmin Signaling by ERK Concerns the Resistance to Taxol in Nonsmall Cell Lung Cancer Cells
Cancer Biotherapy & Radiopharmaceuticals , Vol. 0, No. 0.
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Regulation of Oncoprotein 18/Stathmin Signaling by ERK Concerns the Resistance to Taxol in Nonsmall Cell Lung Cancer Cells
Cancer Biotherapy & Radiopharmaceuticals , Vol. 0, No. 0.
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High Resolution MEG Source Imaging Approach to Accurately Localize Broca’s Area in Patients with Brain Tumor or Epilepsy
Currently, magnetoencephalography (MEG) has been routinely used as a non-invasive pre-surgical functional mapping tool in patients with brain tumors and/or epilepsies. This is mainly due to MEG's better localization accuracy (in several millimeters for cortical areas) (Huang et al., 2006; Leahy et al., 1998; Niranjan et al., 2013) than scalp electroencephalography (EEG), and MEG's higher temporal resolution (in 1 millisecond) than several other commonly known functional mapping techniques, such as functional magnetic resonance imaging (fMRI, in seconds) and Positron emission topography (PET, in minutes).
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Muscle weakness and perceived disability of upper limbs in persons with late effects of polio
Muscle weakness in one or both upper limbs is common in persons with prior polio, but there is very limited knowledge how it influences daily life.
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Advanced Signal Processing on Brain Event-Related Potentials
This book introduces different approaches for the analysis of event related potential (ERP) by processing the electroencephalographic signal (EEG), from the traditional and basic methods to the more complex and innovative ones. The analysis and interpretation of ERP is extremely important in cognitive neuroscience but at the same time it is complex and challenging, due to the need for separating efficiently the ERP from the surrounding EEG activity, and difficulties in distinguishing among its various components.
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The impaired balance systems identified by the BESTest in older patients with knee osteoarthritis
Balance decreases and activities of daily living (ADL) deteriorate in older people with knee osteoarthritis (KOA). However, little is known about the systems underlying poor balance control and how those impaired systems are related to decreased ADL.
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Prevent errors during medication administration
Review common paramedic drug errors and how to prevent them.
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Animated infographic: What you need to know about Zika virus
This World Health Organization animated infographic presents essential facts about the virus that is rapidly spreading through Latin America.
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Prevent errors during medication administration
Review common paramedic drug errors and how to prevent them.
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Animated infographic: What you need to know about Zika virus
This World Health Organization animated infographic presents essential facts about the virus that is rapidly spreading through Latin America.
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Prevent errors during medication administration
Review common paramedic drug errors and how to prevent them.
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Geleitwort zu „Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation für Patienten mit einem Herzunterstützungssystem (VAD Ventricular Assist Device)“
Animated infographic: What you need to know about Zika virus
This World Health Organization animated infographic presents essential facts about the virus that is rapidly spreading through Latin America.
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Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)
Abstract
The increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication).
In Germany, the post-implant treatment and rehabilitation of VAD Patients working group was founded in 2012. This working group has developed clear recommendations for the rehabilitation of VAD patients according to the available literature. All facets of VAD patients' rehabilitation are covered. The present paper is unique in Europe and represents a milestone to overcome the heterogeneity of VAD patient rehabilitation.
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Prevent errors during medication administration
Review common paramedic drug errors and how to prevent them.
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Animated infographic: What you need to know about Zika virus
This World Health Organization animated infographic presents essential facts about the virus that is rapidly spreading through Latin America.
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Firefighter / Paramedic - Sanford Fire Department
SANFORD FIRE DEPARTMENT 1303 William Clark Avenue SANFORD, FLORIDA 32771 Updated: February 12, 2016 Job Classification: Firefighter/Paramedic The Sanford Fire Department is currently hiring for Firefighter/Paramedic. This position requires CPAT and FireTEAM testing. All testing must be completed by February 25, 2016. The department requires the candidate PHQ. You can access the questionnaire through ...
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Research analysis: Capnography to assess effectiveness of pediatric ventilation
Anesthesiologists compare mask ventilation adequacy with endotracheal intubation and laryngeal mask airway for pediatric patients
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Research analysis: Capnography to assess effectiveness of pediatric ventilation
By Greg Friese, EMS1 Editor-in-Chief
Capnographs from pediatric patients undergoing elective surgery were analyzed to assess the effectiveness of ventilation. The objective of the research, reported in the American Journal of Emergency Medicine, was to compare capnographs from three airway management techniques [1]. Data, which was a 10- to 14-second capnography, was collected on 29 patients who received ventilation with two types of masks and then ventilation with either an laryngeal mask airway or endotracheal tube.
Two board certified pediatric anesthesiologists, blinded to the patients and procedures, reviewed four capnographs from each patient (116 total capnographs). The reviewers were unable to differentiate the type of airway management from the capnographs. They also rated bag-valve mask ventilation inadequate more frequently than LMA and ETT ventilation.
The researchers recommend capnography for all types of pediatric ventilation and airway management. They also recommended capnography training for EMS providers and the use of monitors large enough to display capnographs from several ventilations, as well as the numerical ETCO2 data.
Memorable quotes on pediatric airway management and ventilation
These three quotes from Freeman et al. stood out.
"Regardless of which advanced airway modality is used, confirmation of proper placement, adequate ventilation, and prompt recognition of device displacement are central to improving outcomes in prehospital pediatric advanced airway management."
"Infrequency of ventilation and prolonged expiratory phase were the most common concerns identified."
"Continuous capnography appears to be a useful tool for assessing ventilation via ETT, LMA, and mask ventilation and may help facilitate high-quality ventilation of any type."
Key takeaways: Capnography to monitor pediatric patient ventilation
Here are four takeaways for prehospital providers from this research on the use of capnography to monitor pediatric patient ventilation.
1. Always use capnography
Paramedics absolutely need to use capnography to continuously confirm airway placement in the trachea and the effectiveness of ventilations, regardless of the patient's age or the device used.
2. Capnography for mask-only ventilation works
This study showed that capnographs can be generated for pediatric patients receiving mask only ventilation. The difference in capnography between mask ventilation and ETT or LMA ventilation was "indiscernible" to the reviewers.
3. Practice and improve mask ventilation
Mask ventilations were most frequently rated as "inadequate" which may point to need for more effective mask ventilation technique, as well as being prepared to switch from mask to LMA or ETT ventilation quickly.
4. Review capnographs during paramedic training
The research methods asked reviewers to select the type of airway (BVM, LMA, ETT) and subjectively rate the adequacy of ventilations based on the capnography is a replicable exercise EMS instructors could use for pediatric airway management continuing education.
Finally, the researchers used a convenience sample of children undergoing elective surgery. They excluded patients undergoing airway, cardiothoracic or abdominal surgeries. They also excluded neonates and children with preexisting cardiac or pulmonary disease. The findings, while interesting and relevant, excluded study subjects — sick kids — who are potentially most likely to need prehospital airway management and ventilator support. Airway management and effective ventilation on sick and injured children is inherently more difficult than the controlled conditions of the operating room.
After reading the study, share your key takeaways and questions in the comments.
References
1. Use of capnographs to assess quality of pediatric ventilation with 3 different airway modalities. Freeman, Julia Fuzak et al. The American Journal of Emergency Medicine, Volume 34, Issue 1, 69 - 74
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Firefighter Paramedic - City of Fremont
FREMONT, CITY OF 3300 CAPITOL AVE FREMONT, CALIFORNIA 94538 Updated: January 13, 2016 Classification: Firefighter/Paramedic (entry level) The City of Fremont is currently accepting scores for Firefighter/Paramedic. All testing through National Testing Network (NTN) must be completed between March 8, 2015 and March 7, 2016. The application process will close on March 11, 2016 at 12 noon. Please go to ...
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Stryker to buy Physio-Control for $1.28B
Stryker hopes to expand its product offerings and broaden its global reach with the acquisition
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New pediatric device delivers oxygen through a lollipop
The paramedic-designed product is a self-administering medication device that looks and tastes like a lollipop
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Firefighter - Orange City Fire Department
ORANGE CITY FIRE DEPARTMENT 300 EAST CHAPMAN AVENUE ORANGE, CALIFORNIA 92866 http://ift.tt/1PDjqEt Updated: February 16, 2016 Job Classification: Firefighter The Orange City Fire Department is currently hiring for Firefighter. All testing through National Testing Network (NTN) must be completed by March 28, 2016. Salary Information: $68,088 - $82, 752 Scheduled 3% salary increase effective August ...
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Responsive Respiratory Publishes Comprehensive Oxygen Solutions Catalog
St. Louis, Missouri – (February 2016) – Responsive Respiratory introduces a new oxygen solutions catalog for 2016. The comprehensive oxygen catalog highlights RRI's commitment to high pressure oxygen products and includes conservers, regulators and cases, carts, racks, cylinders and accessory items. "We've enriched our offering for 2016 with targeted solutions for Providers ...
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How to buy body armor for EMS personnel
The need for ballistic vests as an all-hazard PPE for EMS personnel reflects their changing role and the constant threat of violent patient encounters
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Impact of anesthetic technique on the stress response elicited by laparoscopic cholecystectomy: a randomized trial
Abstract
The aim of this randomized, double-blind clinical trial was to elucidate the impact of general anesthesia alone (GA) or supplemented with epidural anesthesia (EpiGA) on surgical stress response during laparoscopic cholecystectomy, using stress hormones, glucose, and C-reactive protein (CRP), as potential markers. Sixty-two patients scheduled to undergo elective laparoscopic cholecystectomy were randomly assigned into two groups to receive either GA or EpiGA. Stress hormones [cortisol (COR), human growth hormone (hGH), prolactine (PRL)], glucose, and CRP were determined 1 day before surgery, intraoperatively, and upon first postoperative day (POD1). Plasma COR, hGH, PRL, and glucose levels were maximized intraoperatively in GA and EpiGA groups and reverted almost to baseline on POD1. Significant between-group differences were detected for COR and glucose either intraoperatively or postoperatively, but this was not the case for hGH. PRL was elevated in GA group only intraoperatively. Although, CRP was minimally affected intraoperatively, a notable augmentation on POD1, comparable in both groups, was recorded. These results indicate that hormonal and metabolic stress response is slightly modulated by the use of epidural block supplemented by general anesthesia, in patients undergoing laparoscopic cholecystectomy cholecystectomy. Nevertheless, inflammatory reaction as assessed by CRP seems to be unaffected by the anesthesia regimen.
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Lead through needle technique for placing spinal cord stimulator leads: a novel alternative to the loss of resistance technique
The loss of resistance (LOR) technique has been the traditional technique used to place the percutaneous spinal cord stimulator (SCS) leads into the epidural space under fluoroscopic guidance. The LOR technique was developed long before the use of fluoroscopy in guiding the placement. The technique depends on sudden LOR once the needle tip passes through the ligamentum flavum [1,2].
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EMS battalion chief talks about his heart attack and rescue
Minutes mattered when Howard County Fire & Rescue Battalion Chief Jimmy Brothers suffered a massive heart attack. Ironically, he had helped train the first responders on the lifesaving cardiac protocol that would save his life.
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Spinal Cord Injury – Quality of Life Resilience
SCI-QOL Resilience |
Assess attributes of resilience in individuals with spinal cord injury. |
The SCI-QOL Resilience measure is an item response theory (IRT)-calibrated item bank with 21 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). |
5 minutes |
Depends on the mode of administration.
|
Calculated from SEM
|
Not Established |
Not Established |
Traumatic spinal cord injury . The normative data are calibrated on adults with traumatic spinal cord injury so the mean score (T = 50) indicates a score that is normal for an adult with a traumatic SCI. Deviations from the mean indicate deviations from what is normal for an individual with a traumatic SCI. For example, a respondent with a score of T=60 reported more attributes of resilience than +1 standard deviation (84%) of individuals with traumatic SCI. |
Traumatic SCI (Victorson et al., 2015; n=717, mean age = 43.0(15.3); time post injury = 7.1 years (10.0); 45% paraplegia, 55% tetraplegia)• Excellent test-retest reliability (ICC = .79) |
Traumatic SCI (Victorson et al., 2015)• Excellent internal consistency (Chronbach's alpha = .95) |
Not Established |
Traumatic SCI (in preparation)• The SCI-QOL Resilience item bank demonstrated good convergent validity by correlating strongly with measures of depression (PHQ-9 r = .-.57), satisfaction with life (Satisfaction with Life Scale r = .69), and positive affect (SCI-QOL Positive Affect r = .75). The SCI-QOL Resilience item bank demonstrated good discriminant validity by weakly correlating with measures of fine motor functioning (SCI-QOL Fine Motor r = .16), |
Items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42) |
Not formally established, but content was generated from individuals with SCI and expert clinicians, so face validity is strong. |
Excellent: minimal floor or ceiling effects. 0.14% of participants in the validation sample (Victorson et al., 2015) who completed the full item bank scored at floor; 5.6% scored at ceiling. |
Not Established |
Victorson et al. (2015). Measuring resilience after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Resilience item bank and short form. Journal of Spinal Cord Medicine, 38(3), 366-376. |
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Spinal Cord Injury – Quality of Life Anxiety
Assess symptoms of anxiety in individuals with spinal cord injury. |
The SCI-QOL Anxiety measure is an item response theory (IRT)-calibrated item bank with 25 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (15 of 25 items) and Neuro-QOL (20 of 25 items) Anxiety item banks. |
5 minutes |
Depends on the mode of administration.
|
Calculated from SEM).
|
Not Established |
Kisala et al. (2015) created a "cross-walk" table to transform SCI-QOL Anxiety scores to scores on the GAD-7, a gold standard measure of anxiety with well-established cut scores. The SCI-QOL Anxiety scores below are the equivalent of GAD-7 cutoff scores. • T49-T55: Mild anxiety • T56-61: Moderate anxiety • T62+ Severe anxiety |
General population (2000 U.S. Census). The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census. |
Traumatic SCI (Kisala et al., 2015; n=716, mean age = 43.0(15.3); time post injury = 7.1 years (10.0); 45% paraplegia, 54% tetraplegia) Excellent test-retest reliability (ICC = .80) |
Traumatic SCI (Kisala et al., 2015) Excellent internal consistency (Cronbach's alpha = .95) |
Traumatic SCI (Kisala et al., 2015) Excellent concurrent validity predicting the GAD-7 score (r = .67) |
Traumatic SCI (Tulsky et al., in preparation) The SCI-QOL Anxiety item bank demonstrated good convergent validity by correlating strongly with measures of depression (PHQ-9 r = .61), satisfaction with life (Satisfaction with Life Scale r = -.53), resilience (SCI-QOL Resilience r = -.68), and positive affect (SCI-QOL Positive Affect r = -.59). The SCI-QOL Anxiety item bank demonstrated good discriminant validity by not correlating with measures of fine motor functioning (SCI-QOL Fine Motor r = -.046), |
Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised 64 patients with neurological illness and 19 caregivers. Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42). |
Not formally established, but content was generated from individuals with SCI and expert clinicians, so face validity is strong. |
Excellent: minimal floor or ceiling effects. 2.8% of participants in the validation sample (Kisala et al., 2015) who completed the full item bank scored at floor; 0.1% scored at ceiling. |
Not Established |
Kisala et al. (2015). Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7. Journal of Spinal Cord Medicine, 38(3), 315-325. |
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Spinal Cord Injury – Quality of Life Depression
SCI-QOL Depression |
Assess symptoms of depression in individuals with spinal cord injury. |
The SCI-QOL Depression measure is an item response theory (IRT)-calibrated item bank with 28 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (18 of 28 items) and Neuro-QOL (23 of 28 items) Depression item banks. |
5 minutes |
Depends on the mode of administration.
|
|
Not Established. |
Holdnack et al. (in preparation) created a "cross-walk" table to transform SCI-QOL Depression scores to scores on the PHQ-9, a gold standard measure of depression with well-established cut scores. The SCI-QOL Depression scores below are the equivalent of PHQ-9 cutoff scores.
|
General population (2000 U.S. Census) . The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census. |
Traumatic SCI (Tulsky et al., 2015; n=716, mean age = 43.0(15.3); time post injury = 7.1 years (10.0); 45% paraplegia, 54% tetraplegia)
|
Traumatic SCI (Tulsky et al., 2015)
|
Traumatic SCI (Tulsky et al., 2015)
|
Traumatic SCI (Tulsky et al., in preparation) The SCI-QOL Depression item bank demonstrated good convergent validity by correlating strongly with measures of anxiety (GAD-7 r = .59), satisfaction with life (Satisfaction with Life Scale r = -.62), resilience (SCI-QOL Resilience r = -.73), and positive affect (SCI-QOL Positive Affect r = -.68). The SCI-QOL Depression item bank demonstrated good discriminant validity by weakly correlating with measures of fine motor functioning (SCI-QOL Fine Motor r = -.16), |
Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised 64 patients with neurological illness and 19 caregivers. Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42). |
Not formally established, but content was generated from individuals with SCI and expert clinicians, so face validity is strong. |
Excellent: minimal floor or ceiling effects (Tulsky et al., 2015). With the full item bank, 0.1% of respondents were at floor and 3.1% were at ceiling. |
Not Established
The PHQ-9 contains 4 items related to somatic concerns (fatigue, sleep, appetite, and motor slowing). Recent data suggests that when |
Tulsky et al. (2015). Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9. Journal of Spinal Cord Medicine, 38(3), 335-346. |
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Spinal Cord Injury – Quality of Life Satisfaction with Social Roles and Activities
- Mean SEM of full item bank = 0.09 (range = 0.06 – 0.53).
- Mean SEM of 10-item short form = 0.16 (range = 0.10 – 0.57).
- Mean SEM of variable-length CAT (min = 4, max = 12 items) = 0.20 (range = 0.15 – 0.54).
(Calculated from SEM).
- MDC of the full item bank = 0.25.
- MDC of an 8-item fixed-length CAT = 0.44.
- MDC of a variable-length CAT = 0.55
- Scores on the SCI-QOL Ability to Participate in SRA reference the Neuro-QOL sample, which comprise a mixed sample of neurological healthy adults and adults with neurological illnesses (stroke, Parkinson's disease, multiple sclerosis, epilepsy, or amyotrophic lateral sclerosis).
Traumatic SCI (Heinemann et al., 2015; n=641, mean age = 42.9(15.3); time post injury = 7.1 years (9.8); 44% paraplegia, 55% tetraplegia) |
- Excellent test-retest reliability (ICC = .77)
Traumatic SCI (Heinemann et al., 2015) |
- Excellent internal consistency (Chronbach's alpha = .XX)
Traumatic SCI (data in preparation) |
- Excellent concurrent validity predicting the Satisfaction with Life Scales; r = .65) and Adequate concurrent validity predicting the Craig Handicap Assessment and Reporting Technique (CHART; r = .36).
Traumatic SCI (manuscript in preparation) |
- The SCI-QOL Satisfaction with SRA item bank demonstrated good validity by correlating strongly with measures of self-esteem (Excellent: SCI-QOL Self-Esteem r = .67), depression (Excellent: PHQ-9 r = -.60), psychological trauma (Adequate: SCI-QOL Psychological Trauma r = .51), and independence (Excellent: SCI-QOL Independence = .70).
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Spinal Cord Injury – Quality of Life Ability to Participate in Social Roles and Activities
- Mean SEM of full item bank = 0.19 (range = 0.12 – 0.57).
- Mean SEM of 10-item fixed-length CAT = 0.18 (range = 0.11 – 0.56).
- Mean SEM of variable-length CAT (min = 4, max = 12 items) = 0.17 (range = 0.12 – 0.55).
(Calculated from SEM)
- MDC of the full item bank = 0.53.
- MDC of an 8-item fixed-length CAT = 0.50.
- MDC of a variable-length CAT = 0.47
- Scores on the SCI-QOL Ability to Participate in SRA reference the Neuro-QOL sample, which comprise a mixed sample of neurological healthy adults and adults with neurological illnesses (stroke, Parkinson's disease, multiple sclerosis, epilepsy, or amyotrophic lateral sclerosis).
Traumatic SCI (Heinemann et al., 2015; n=641, mean age = 42.9(15.3); time post injury = 7.1 years (9.8); 44% paraplegia, 55% tetraplegia) |
- Adequate test-retest reliability (ICC = .74)
Traumatic SCI (Heinemann et al., 2015) |
- Excellent internal consistency (Chronbach's alpha = .XX)
Traumatic SCI (data in preparation) |
- Adequate concurrent validity predicting the Craig Handicap Assessment and Reporting Technique (CHART; r = .47).
Traumatic SCI (manuscript in preparation) |
- The SCI-QOL Ability to Participate in SRA item bank demonstrated good convergent validity by correlating strongly with measures of satisfaction with life (Satisfaction with Life Scale r = .61), independence (SCI-QOL Independence r = .70), and depression (PHQ-9 r = -.57).
- Excellent: minimal floor or ceiling effects (Heinemann et al., 2015). With a 10-item fixed-length CAT, 3.4% of respondents were at ceiling and 0.2% were at floor.
Gershon et al. (2012). Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing. Quality of Life Research, 21(3), 476-486 |
Heinemann et al. (2015). Development and psychometric characteristics of the SCI-QOL Ability to Participate and Satisfaction with Social Roles and Activities item banks and short forms. Journal of Spinal Cord Medicine, 38(3), 397-408.
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Single Limb Hop Tests
- One leg single hop for distance - hop forward on one leg as far as possible
- One leg triple hop for distance - hop forward three times on one leg as far as possible
- 6 m timed hop - hop on one leg as quickly as possible for 6m
- Crossover hop for distance - hop forward as far as possible three times, each time crossing over a line
- Triple jump - in a continuous manner, complete three phases of movement: hop, step, and jump, as far as possible
- Single leg vertical jump - jump as high as possible off of one leg
- Lateral Hop - using dominant leg, hop as far as possible laterally (landing on same leg)
- Medial Hop - using dominant leg, hop as far as possible medially (landing on same leg)
- Figure 8 Hop – subjects hop in figure 8 over 5 m distance for time (2 consecutive laps)
- Up-down hop – subjects hop up onto a 20 cm high step and back down 10 times as fast as they can
- Side hop – subjects hop transversely (more than 30 cm) for ten hops as quickly as possible
- Stair hop – subjects hop up and down 3 steps, then they turn around and repeat
- Vertical hop – single hop for maximum height on a force plate
• Hegedus et al
o Recreational athletes ages 12-adult (no limit)
• Kea et al.
o Twenty-seven non-impaired professional or elite amateur hockey players
• Munro & Herrington
o Twenty-two recreational athletes
• Ross et al
o Eighteen physically active young adult male cadets enrolled at the U.S. Air Force Academy (average age 20.2 +/- 1.2 years)
• Hopper et al
o Nineteen subjects presenting at 12 months post ACL reconstruction
• Logerstedt et al.
o 120 subjects with ACL reconstruction.
• Petschnig et al.
55 male subjects with ACL reconstruction (group B: N=30, mean age=27.8+/- 9 years; group C: N=25, mean age=29.9+/- 5.8 years)
• Reinke et al
o Sixty-nine subjects participated between 24 and 39 months after ACL reconstruction
• Booher et al
o Eighteen subjects (4 males and 14 females)
• Fitzgerald et al
o via Borsa et al
50 subjects with ACL deficiency
o via Carter et al
50 subjects with ACL deficiency
o via Eastlack et al
50 subjects with ACL deficiency
o via Kennedy et al
29 subjects with ACL deficiency
o via Risberg et al
50 subjects with ACL reconstruction
o via Sernert
50 subjects with ACL reconstruction
o via Wilk et al
50 subjects with ACL reconstruction
• Grindem et al.
o 91 nonoperatively treated patients with an ACL injury
• Itoh et al.
o 50 patients with chronic ACL-deficient knees with a mean age of 23.1 years.
• Noyes et al.
o Sixty seven patients with "ACL deficient knees" or a chronic ACL rupture and of 97 normal patients with no injury
Single Leg Hop for Distance
● Munro & Herrington
○ Male: 7.87(% leg length x 100)
○ Female: 7.93 (% leg length x 100)
● Ross et al
○ 4.61 cm
Triple Hop
● Munro & Herrington
○ Male: 17.17 (% leg length x 100)
○ Female: 23.18 (% leg length x 100)
● Ross et al
○ 11.17 cm
6 m Timed Hop
● Munro & Herrington
○ Male: 0.084 s
○ Female: 0.076 s
● Ross et al
○ 0.06 s
Cross Over Hop
● Munro & Herrington
○ Male: 21.16 (% leg length x 100)
○ Female: 19.73 (% leg length x 100)
● Ross et al
○ 17.74 cm
Lateral Hop
● Kea et al
○ Mean after 2 occasions: 4 cm
Medial Hop
● Kea et al
Mean after 2 occasions: 5 cmSingle Leg Hop for Distance
● Munro & Herrington
○ Male: 21.81 (% leg length x 100)
○ Female: 21.98 (% leg length x 100)
Triple Hop
● Munro & Herrington
○ Male: 47.59 (% leg length x 100)
○ Female: 64.25 (% leg length x 100)
6 m Timed Hop
● Munro & Herrington
○ Male: 0.233 s
○ Female: 0.211 s
Cross Over Hop
● Munro & Herrington
○ Male: 58.65 (% leg length x 100)
○ Female: 54.69 (% leg length x 100)
Lateral Hop
● Kea et al
○ 95% MDC: 11.1 cm
Medial Hop
● Kea et al
95% MDC: 13.9 cmSingle Leg Hop for Distance
● Grindem et al
○ Less than 85% on limb symmetry score was classified as having self-reported knee function below normal ranges
● Hopper et al (ACL)
○ Difference in limb performance >15% is classified as abnormal.
● Ito et al. (ACL deficient knees)
○ ≤ 0.20m difference between limbs is classified as normal.
● Logerstedt et al
○ An optimum cut off score 89.3% of LSI was found.
● Munro & Herrington (healthy recreational athletes)
○ 100% of subjects had a limb symmetry index (LSI) > 90%
○ 73% of subjects had a LSI > 95%
● Noyes et al (ACL deficient knees)
○ Less than 85% on limb symmetry score is classified as abnormal ( )
● Petschnig et al (ACL)
○ Group A had a 97.4% LSI with a SD of 3.4
○ Group B had a 73.0% LSI with a SD of 9.9
○ Group C had a 88.4% LSI with a SD of 8.4
Triple Hop
● Grindem et al
○ Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
● Logerstedt et al
An optimum score of 95.2% of LSI was found to be optimal
● Munro & Herrington (healthy recreational athletes)
○ 100% of subjects had a LSI > 90%
○ 68% of subjects had a LSI > 95%
● Noyes et al (ACL deficient knees)
○ Less than 85% on limb symmetry score is classified as abnormal (
● Petschnig et al (ACL)
○ Group A had a 98.3% LSI with a SD of 4.1
○ Group B had a 71.0% LSI with a SD of 12.9
○ Group C had a 89.5% LSI with a SD of 12.0
6 m Timed Hop
● Grindem et al
○ Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
● Logerstedt et al
○ A LSI of 87.7% of LSI was found to be optimum
● Munro & Herrington (healthy recreational athletes)
○ 100% of subjects had a LSI > 90%
○ 86% of subjects had a LSI > 95%
● Noyes et al (ACL deficient knees)
○ Less than 85% on limb symmetry score is classified as abnormal ( )
Cross Over Hop
● Grindem et al
○ Less than 85% on limb symmetry score were classified as having self-reported knee function below normal ranges
● Logerstedt et al.
○ A LSI of 94.9% was found to be optimum
● Munro & Herrington (healthy recreational athletes)
○ 100% of subjects had a LSI > 90%
○ 64% of subjects had a LSI > 95%
● Noyes et al (ACL deficient knees)
○ Less than 85% on limb symmetry score is classified as abnormal ( )
Vertical Hop
● Petschnig et al (ACL)
○ Group A had a 95.2% LSI with a SD of 8.5
○ Group B had a 46.3% LSI with a SD of 12.9
○ Group C had a 74.9% LSI with a SD of 13.3
Figure-eight hop test
● Ito et al. (ACL deficient knees)
○ ≤ 0.81s difference between limbs.
Up-down Hop Test
● Ito et al. (ACL deficient knees)
○ ≤ 0.72s difference between limbs.
Side hop test
● Ito et al. (ACL deficient knees)
≤ 0.78s difference between limbs.Single Hop for Distance
● Booher et al. 0.77 - 0.99 ICC
● Munro & Herrington
○ Males 0.80 ICC
○ Females 0.80 ICC
● Ross et al
○ ICC 0.92
Triple Hop
● Munro & Herrington
○ Males 0.92 ICC
○ Females 0.8 ICC
● Ross et al
○ ICC 0.97
6 m Timed Hop
● Booher et al. 0.77 - 0.99 ICC
● Hopper et al (ACL)
○ Reconstructed 0.96 ICC
○ Uninjured 0.95 ICC
● Munro & Herrington
○ Males 0.6 ICC
○ Females 0.84 ICC
● Ross et al
○ ICC 0.92
Cross Over Hop
● Hopper et al (ACL)
○ Reconstructed 0.98 ICC
○ Uninjured 0.95 ICC
● Munro & Herrington
○ Males 0.86 ICC
○ Females 0.87 ICC
● Ross et al
○ ICC 0.93
Stair Hop
● Hopper et al (ACL)
○ Reconstructed 0.96 ICC
○ Uninjured 0.96 ICC
Vertical Hop
● Hopper et al (ACL)
○ Reconstructed 0.94 ICC
○ Uninjured 0.92 ICC
● Petschnig et al (ACL)
○ Group A (healthy males) 0.89 ICC (indicates good reliability)
Lateral Hop
● Kea et al
○ 0.95 ICC
Medial Hop
● Kea et al
○ 0.93 ICC
30 m Agility Hop
Booher et al. 0.77 - 0.99 ICCVertical Hop
● Hegedus et al (Knee injury)
Inter-rater reliability:0.75Single Hop for Distance
● Petschnig et al (ACL)
○ Specificity for the single hop test was 98 (false-positive rate=2). The sensitivity for group B was 93 (false-negative rate=7) and 28 (false-positive rate=73) for group C.
Triple Hop
● Petschnig et al (ACL)
○ Specificity for the triple hop test was 96 (false-positive rate=4). The sensitivity for group B was 90 (false-negative rate=10) and 16 (false-positive rate=84) for group C.
6 m Timed Hop
● Logerstedt et al.
○ The 6m timed hop had the strongest predictor validity of the four hop tests (single hop for distance, crossover hop, triple hop, and 6m timed hop). Patients with decreased knee function were over five times more likely to be below the optimum cutoff score of 87.7% (rounded to 88%) compared to subjects with acceptable knee function, quantified by the IKDC 2000.
Cross Over Hop
● Logerstedt et al.
○ The cross over hop had high predictive validity, similar to the 6m timed hop test. Subjects were 4x's as likely to have impaired knee function when below the cutoff score, compared to subjects with acceptable knee function.
Vertical Hop
● Hegedus et al (Knee injury)
○ Evidence quality for criterion validity was mixed with one study of poor and one of good quality
● Petschnig et al (ACL)
○ Specificity for the vertical jump was 96 (false-positive rate=4). The sensitivity for group B was 100 (false-negative rate=0) and 72 (false-positive rate=28) for group C.
○ One-legged vertical jump is sensitive enough to detect functional limitations for the lower limb following knee ligament reconstruction. Sensitivity of the vertical jump decreases when both legs are used, as people may be compensating with the uninvolved leg.
Lower limb symmetry (chronic ACL tear)
● Noyes et al
○ The study used a combination of hop tests (single hop and timed hop) to determine the predictability of chronic ACL tear. Using any two tests together (also including triple hop and cross over hop) was found to be a better predictor of ACL dysfunction (62% performed abnormally on at least one) than one test alone (half of the participants failed each test alone). The study concluded that one-legged function tests (single hop, timed hop) had low sensitivity (52, 49). However high specificity (97, 94) and low false positive rates (3, 6) indicated that these tests can be used to help confirm abnormal limb symmetry.
Single Leg Hop for Distance
● Hegedus et al (Knee injury)
○ The quality rating of construct validity for the hop test is generally positive when examining discriminant validity and generally negative when describing convergent validity.
Single Leg Hop and Triple Leg Hop Test
● Reinke et al
○ The strongest relationship was found to be a moderate, positive correlation between the IKDC scores and the single hop test (o.3) and triple hop test (0.4). The KOOS Sports and Recreation subscore was weakly correlated with the triple hop test (0.2) and single hop test (0.2). For the KOOS Knee Related Quality of Life, only the correlation with the triple-hop ratio was significant and it had a moderate rho value of 0.31.
Hegedus et al
● Five studies reported on the responsiveness of five PPTs at the knee, however only one study demonstrated good methodological quality.
Kea et al
● Effect size for lateral hop test = 0.15
● Effect size for medial hop test = 0.26
Munro & Herrington
Effect sizes comparing males and females were high for all tests, ranging from 1.08-2.00, with the exception of the timed hop which had an effect size of 0.47. Therefore, genders were separated for analysis.Booher, L., Hench, K., Worrell, T., & Stikeleather, J. (1993). Reliability of Three Single-Leg Hop Tests. Journal of Sport Rehabilitation, 2(3), 165-170.
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Petschnig, R., Baron, R., & Albrecht, M. (1998). The relationship between isokinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy, 28(1), 23-31.
Reinke, Emily K, et al. "Hop Tests correlate with IKDC and KOOS at Minimum of 2 years after Primary ACL Reconstruction." Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA 19.11 (2o11): 1806-1816. PMV. Web. 9 July 2015.
Ross, M.D., B. Langford, and P.J. Whelan. Test-retest reliability of 4 single leg horizontal hop tests. Journal of Strength and Conditioning Research. 16(4):617-622. 2002.
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