Karen Hambly
Karen qualified as a physiotherapist in 1998 from the University of Southampton having already completed a degree in sports science. Karen is currently Senior Lecturer in the Centre for Sports Studies at the University of Kent where she is a key member of the Centre’s Tissue Repair and Rehabilitation Research Group. Previously Karen has worked as the sports medicine coordinator for both British Cycling and UKSport.
Karen has developed a special interest in rehabilitation following articular cartilage repair and has recently completed her PhD in this area. Karen has published and presented widely on cartilage repair rehabilitation and in 2006 Karen was the lead author of the first published current concepts paper on rehabilitation following autologous chondrocyte implantation of the knee and in 2007 she was the co-director of the 1st International Cartilage Repair Society Rehabilitation Consensus Meeting.
Phone: +44 (0) 1634 888805
Address: School of Sport and Exercise Sciences
University of Kent
Medway Building
Chatham Maritime
Kent ME4 4AG
UK
Karen has developed a special interest in rehabilitation following articular cartilage repair and has recently completed her PhD in this area. Karen has published and presented widely on cartilage repair rehabilitation and in 2006 Karen was the lead author of the first published current concepts paper on rehabilitation following autologous chondrocyte implantation of the knee and in 2007 she was the co-director of the 1st International Cartilage Repair Society Rehabilitation Consensus Meeting.
Phone: +44 (0) 1634 888805
Address: School of Sport and Exercise Sciences
University of Kent
Medway Building
Chatham Maritime
Kent ME4 4AG
UK
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Objective: Our objective was to identify the characteristics and motivations of online health information-seekers accessing the online health community, KNEEguru (KG). The study was designed to obtain the respondents’ sociodemographic profile, together with their main reasons and motivations for joining such a community, their health information-seeking behavior, the extent of their knee problems, and their general Internet usage.
Methods: We undertook an online questionnaire survey, offered to users of the KG website from June to July 2012. A mix of open and closed questions was used to facilitate inductive enquiry. Quantitative responses were analyzed using univariate analysis; qualitative thematic analysis of the open responses was completed and a conceptual model was developed.
Results: One-hundred and fifty-two respondents took part (11.56% response rate, 152/1315), with a mean age of 40.1 years. Of this cohort, 61.2% were female, 68.4% were in domestic partnerships, 57.2% were employed, 75.0% had higher education qualifications, and 80.3% were of white/Caucasian ethnicity. Females were associated with joining KG in order to get emotional support from other users (OR 2.11, 95% CI 1.04 - 4.27, P=.04). Respondents’ self-perception of health was associated with reported quality of life (OR 10.86, 95% CI 3.85 - 30.43, P<.001). Facebook users were associated with joining KG to share experiences (OR 2.34, 95% CI 1.04 - 5.56, P=.03). Post-surgery respondents were associated with joining KG to compare symptoms with other users (OR 7.31, 95% CI 2.06 - 39.82, P<.001). Three key themes were induced: condition, emotion and support. Respondents expressed distress and frustration at uncertainty of prognosis around various knee conditions, with some users preferring to initially observe rather than engage. Conversely, a strong desire to inform and support other community members was stated with reciprocation of ideas and experiences. KG was conceptualized as a filter that takes an individual’s condition and emotional response to that condition as basis for support; this filter facilitated validation as the outcome of engagement.
Conclusions: This study, in line with wider literature, suggests that users of an online knee-specific community are typically female, middle-aged, white/Caucasian, married, employed, and have attained a level of higher education. These users demonstrate a pragmatic approach to health care information with altruistic motivations and a desire to share experiences as a means of validation. This finding emphasizes a means of promoting efficient and appropriate online health care, and demonstrates the benefits of the Internet as a viable complement to clinical engagement.
Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to non-athletes. The management of chondral defects in the football player is complex and multifactorial.
Objective:
The aim of this paper is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player.
Design:
A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee.
Conclusions:
Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation especially in the transition from therapy to performance care. It should be recognised that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas.
Key words:
Rehabilitation; articular cartilage repair; knee
Purpose: To establish a postoperative activity profile of users of an online health community who have undergone ACR of the knee and to compare this profile with those from the same community who have undergone initial anterior cruciate ligament reconstruction (ACLR).
Study Design: Cross-sectional.
Methods: Tegner Activity Scale ratings were collected via a self-reported online questionnaire from 201 participants of an online health community who had undergone tibiofemoral and/or patellofemoral ACR (n = 75) or ACLR (n = 126).
Results: A higher Tegner activity level was significantly correlated to time from surgery for ACR (P < 0.005) and ACLR (P < 0.01). At a minimum of 24 months’ follow-up, the ACR group had a median postoperative Tegner score of 3, compared with 6 for the ACLR group. Tegner score was significantly negatively correlated with age at time of surgery for ACLR (P < 0.05) but not for ACR. Men demonstrated significantly higher Tegner activity levels than did women for both ACLR and ACR (P < 0.05).
Conclusions: Activity levels after ACR in this population increased with postoperative time but remained lower than expected when compared with current published clinical and normative data.
Clinical Relevance: Engagement with an online health community may influence expectations regarding return to sports and exercise activities. Reporting of activity-level data within clinical studies should be differentiated on the basis of sex. Further research is needed to elucidate factors that determine return to sports and exercise activities after ACR.
METHODS: A systematic review was conducted using electronic databases (MEDLINE, CINAHL, SPORTDiscus™, NHS Evidence, ISI Web of Knowledge, AMED, BNI, PEDro and The Cochrane Collaboration of Systematic Reviews) and reference lists from extracted articles. Studies were selected that were published between 1984 and 2009 in which the TAS was reported for patients who had undergone ACR of the knee.
RESULTS: The search strategy identified 442 citations of which 34 articles met the inclusion criteria. There was a large degree of study heterogeneity especially regarding data reporting a wide variation in the number of participants (range 5-137), participant age (range 12-76 years), follow-up time (range 3-120 months) and male-to-female participant ratio. Where pre- to postoperative TAS change was analysed, 88% of studies demonstrated a significant improvement in postoperative TAS scores.
CONCLUSIONS: In general, TAS data were inconsistently reported and methodological detail was often lacking. Caution is advised in the interpretation of TAS scores following ACR of the knee where there are large ranges in postoperative follow-up times, mixed gender cohorts and wide ranges in participant ages. TAS data should be presented and analysed fully and ideally in a standardised fashion to facilitate the comparison of outcomes between studies.
Objective: Our objective was to identify the characteristics and motivations of online health information-seekers accessing the online health community, KNEEguru (KG). The study was designed to obtain the respondents’ sociodemographic profile, together with their main reasons and motivations for joining such a community, their health information-seeking behavior, the extent of their knee problems, and their general Internet usage.
Methods: We undertook an online questionnaire survey, offered to users of the KG website from June to July 2012. A mix of open and closed questions was used to facilitate inductive enquiry. Quantitative responses were analyzed using univariate analysis; qualitative thematic analysis of the open responses was completed and a conceptual model was developed.
Results: One-hundred and fifty-two respondents took part (11.56% response rate, 152/1315), with a mean age of 40.1 years. Of this cohort, 61.2% were female, 68.4% were in domestic partnerships, 57.2% were employed, 75.0% had higher education qualifications, and 80.3% were of white/Caucasian ethnicity. Females were associated with joining KG in order to get emotional support from other users (OR 2.11, 95% CI 1.04 - 4.27, P=.04). Respondents’ self-perception of health was associated with reported quality of life (OR 10.86, 95% CI 3.85 - 30.43, P<.001). Facebook users were associated with joining KG to share experiences (OR 2.34, 95% CI 1.04 - 5.56, P=.03). Post-surgery respondents were associated with joining KG to compare symptoms with other users (OR 7.31, 95% CI 2.06 - 39.82, P<.001). Three key themes were induced: condition, emotion and support. Respondents expressed distress and frustration at uncertainty of prognosis around various knee conditions, with some users preferring to initially observe rather than engage. Conversely, a strong desire to inform and support other community members was stated with reciprocation of ideas and experiences. KG was conceptualized as a filter that takes an individual’s condition and emotional response to that condition as basis for support; this filter facilitated validation as the outcome of engagement.
Conclusions: This study, in line with wider literature, suggests that users of an online knee-specific community are typically female, middle-aged, white/Caucasian, married, employed, and have attained a level of higher education. These users demonstrate a pragmatic approach to health care information with altruistic motivations and a desire to share experiences as a means of validation. This finding emphasizes a means of promoting efficient and appropriate online health care, and demonstrates the benefits of the Internet as a viable complement to clinical engagement.
Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to non-athletes. The management of chondral defects in the football player is complex and multifactorial.
Objective:
The aim of this paper is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player.
Design:
A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee.
Conclusions:
Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation especially in the transition from therapy to performance care. It should be recognised that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas.
Key words:
Rehabilitation; articular cartilage repair; knee
Purpose: To establish a postoperative activity profile of users of an online health community who have undergone ACR of the knee and to compare this profile with those from the same community who have undergone initial anterior cruciate ligament reconstruction (ACLR).
Study Design: Cross-sectional.
Methods: Tegner Activity Scale ratings were collected via a self-reported online questionnaire from 201 participants of an online health community who had undergone tibiofemoral and/or patellofemoral ACR (n = 75) or ACLR (n = 126).
Results: A higher Tegner activity level was significantly correlated to time from surgery for ACR (P < 0.005) and ACLR (P < 0.01). At a minimum of 24 months’ follow-up, the ACR group had a median postoperative Tegner score of 3, compared with 6 for the ACLR group. Tegner score was significantly negatively correlated with age at time of surgery for ACLR (P < 0.05) but not for ACR. Men demonstrated significantly higher Tegner activity levels than did women for both ACLR and ACR (P < 0.05).
Conclusions: Activity levels after ACR in this population increased with postoperative time but remained lower than expected when compared with current published clinical and normative data.
Clinical Relevance: Engagement with an online health community may influence expectations regarding return to sports and exercise activities. Reporting of activity-level data within clinical studies should be differentiated on the basis of sex. Further research is needed to elucidate factors that determine return to sports and exercise activities after ACR.
METHODS: A systematic review was conducted using electronic databases (MEDLINE, CINAHL, SPORTDiscus™, NHS Evidence, ISI Web of Knowledge, AMED, BNI, PEDro and The Cochrane Collaboration of Systematic Reviews) and reference lists from extracted articles. Studies were selected that were published between 1984 and 2009 in which the TAS was reported for patients who had undergone ACR of the knee.
RESULTS: The search strategy identified 442 citations of which 34 articles met the inclusion criteria. There was a large degree of study heterogeneity especially regarding data reporting a wide variation in the number of participants (range 5-137), participant age (range 12-76 years), follow-up time (range 3-120 months) and male-to-female participant ratio. Where pre- to postoperative TAS change was analysed, 88% of studies demonstrated a significant improvement in postoperative TAS scores.
CONCLUSIONS: In general, TAS data were inconsistently reported and methodological detail was often lacking. Caution is advised in the interpretation of TAS scores following ACR of the knee where there are large ranges in postoperative follow-up times, mixed gender cohorts and wide ranges in participant ages. TAS data should be presented and analysed fully and ideally in a standardised fashion to facilitate the comparison of outcomes between studies.