METHODS/DESIGN: This study is a phase II, double-blind, randomised controlled trial with concealed allocation, blinding of patients and assessors, and intention-to-treat analysis. Patients (n = 72) will be recruited following cardiac surgery via a median sternotomy. Sample size calculations were based on the minimal important difference (two points) for the primary outcome: Short Physical Performance Battery. Thirty-six participants are required per group to counter dropout (20%). All participants will be randomised to receive either standard or modified sternal precautions. The intervention group will receive guidelines encouraging the safe use of the upper limbs. Secondary outcomes are upper limb function, pain, kinesiophobia and health-related quality of life. Descriptive statistics will be used to summarise data. The primary hypothesis will be examined by repeated-measures analysis of variance to evaluate the changes from baseline to 4 weeks post-operatively in the intervention arm compared with the usual-care arm. In all tests to be conducted, a p value <0.05 (two-tailed) will be considered statistically significant, and confidence intervals will be reported.
DISCUSSION: The Sternal Management Accelerated Recovery Trial (S.M.A.R.T.) is a two-centre randomised controlled trial powered and designed to investigate whether the effects of modifying sternal precautions to include the safe use of the upper limbs and trunk impact patients' physical function and recovery following cardiac surgery via median sternotomy.
TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry identifier: ACTRN12615000968572 . Registered on 16 September 2015 (prospectively registered).
METHODS AND DESIGN: A randomised, single blind controlled trial will be conducted. Twenty-eight patients aged 18 years and above with a recent grade-2 hamstring injury will be invited to take part. Participants will be randomised to receive either autologous PRP injection with rehabilitation programme, or rehabilitation programme only. Participants will be followed up at day three of study and then weekly for 16 weeks. At each follow up visit, participants will be assessed on readiness to return-to-play using a set of criteria. The primary end-point is when participants have fulfilled the return-to-play criteria or end of 16 weeks.The main outcome measure of this study is the duration to return-to-play after injury.
CONCLUSION: This study protocol proposes a rigorous and potential significant evaluation of PRP use for grade-2 hamstring injury. If proven effective such findings could be of great benefit for patients with similar injuries.
TRIAL REGISTRATION: Current Controlled Trials ISCRTN66528592.
METHODS: Articles published between 2010 and 2023 were searched from five electronic databases. 59 papers were included for analysis with regards to: i). types of motion tested (functional vs. purposeful ankle movement); ii) types of biomechanical parameters measured (kinetic vs kinematic); iii) types of sensor systems used (lab-based vs field-based); and, iv) AI techniques used.
FINDINGS: Most studies (83.1%) examined biomechanics during functional motion. Single kinematic parameter, specifically ankle range of motion, could obtain accuracy up to 100% in identifying injury status. Wearable sensor exhibited high reliability for use in both laboratory and on-field/clinical settings. AI algorithms primarily utilized electromyography and joint angle information as input data. Support vector machine was the most used supervised learning algorithm (18.64%), while artificial neural network demonstrated the highest accuracy in eight studies.
INTERPRETATIONS: The potential for remote patient monitoring is evident with the adoption of field-based devices. Nevertheless, AI-based sensors are underutilized in detecting ankle motions at risk of sprain. We identify three key challenges: sensor designs, the controllability of AI models, and the integration of AI-sensor models, providing valuable insights for future research.