This week we discuss wearable technology! This systematic review of systematic reviews is unique in that the authors plan to continue updating it every 6 months as more new research comes out on the validity and accuracy of consumer wearable technology. The most common consumer wearable technology are watches and rings which measure things like heart rate, sleep, and step count, among many other possible variables. The authors identified 310 different devices, and to appropriately validate the devices would require a separate validation study for each biometric on each device. This would require 1500+ validation studies! Most consumer wearables underestimate biometrics (like heart rate, oxygen saturation, and step count), however VO2max and total sleep time appear to be overestimated. Some wearables are able to track cardiac arrythmias, and data shows they are 97% accurate. This could be helpful to remotely monitor at-risk populations. One of our biggest takeaways from this is to not place too much stock into the data from the wearables, and try to correlate how you are feeling subjectively with the numbers that the device is giving you. This is how you can get the most out of your wearable technology without letting it rule your life.

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/39080098/

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This week we discuss outcomes with femoroacetabular impingement syndrome FAIS), defined as "as a clinical triad of symptoms, signs, and imaging findings related to the underlying hip pathology." There are three bony morphologies associated with FAIS: cam, pincer, and mixed. Cam morpohlogy is a bony growth on the femoral head/neck, while a pincer morphology is bony growth of the acetabulum. Mixed morphology is the presence of both cam and pincer changes. Symptoms of FAIS include hip/groin pain, pain worse with motion or certain positions, clicking/locking/stiffness, decreased hip strength/ROM, and impaired balance. The FADDIR test, commonly associated with a clinical diagnosis of FAIS, actually has poor sensitivity and specificity (41% and 47%). Early activity modifications may be necessary to manage symptoms, which involves generally avoiding repetitive hip flexion and internal rotation and limiting end-range stretching of the hip, especially in the presence of pain. Studies also demonstrate hip muscle weakness in the presence of FAIS symptoms, which could be a focus of rehab interventions. Conservative management of FAIS for a minimum of 3 months has shown to be successful in 39-82% of FAIS cases, and it is likely successful conservative management is related to the radiographic severity of morphology. Most reviews demonstrate that surgery has improved short term outcomes (<1 year) compared to physical therapy in young, active populations. Although, the return to play rate after hip arthroscopy was 85.4%, which took an average of 6.6 months. One article found that 1 in 4 athletes don’t return to previous level of sport participation after hip arthroscopy for FAIS.

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/37650998/

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This week we discuss considerations when utilizing the limb symmetry index (LSI) as a metric for return to sport testing following ACL reconstruction. Limb symmetry index is a popular metric which compares the performance of the involved limb to the uninvolved limb during a test. Commonly, a 90% threshold is used to determine if there is acceptable levels of asymmetry. However, there are a few points to consider when utilizing this metric. First, after an ACL rupture the contralateral side also loses strength and functional capacity. Therefore, comparing to the post-surgical performance of the uninvolved side can give an artificially inflated LSI, so it is important to ground the test outcomes in normative data or benchmark data. Second, variability in movement is a "hallmark of normal function" and understand humnas, and sport, are not always symmetrical. Although, an argument can be made that the test is to see if you have the capacity to be symmetrical, which does not mean you have to be symmetrical all the time, especially at submaximal efforts. Is your maximal effort symmetric on each side? If not, then you may be more likely to be hurt. Third, biomechanical asymmetries can persist past 9 months post ACLR, so don't just look at the numbers: look at the movement strategy. Finally, assess the functional capacity across a load continuum via testing considering the end goal as the sport.

The abstract can be found here: https://journals.lww.com/nsca-scj/abstract/2024/08000/testing_limb_symmetry_and_asymmetry_after_anterior.3.aspx

As always, if you enjoy what you hear, be sure to follow us on your favorite podcast platform and on Instagram @readingrehabpod. If you have any article recommendations be sure to send them our way!