Showing papers in "Journal of Sport Rehabilitation in 2017"

Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching During Warm-ups on Muscular Flexibility and Strength in Young Adults.

Abstract: Context:Foam rolling has been proposed to improve muscle function, performance, and joint range of motion (ROM). However, whether a foam rolling protocol can be adopted as a warm-up to improve flexibility and muscle strength is unclear. Objectives:To examine and compare the acute effects of foam rolling, static stretching, and dynamic stretching used as part of a warm-up on flexibility and muscle strength of knee flexion and extension. Design:Crossover study. Setting:University research laboratory. Participants:15 male and 15 female college students (age 21.43 ± 1.48 y, weight 65.13 ± 12.29 kg, height 166.90 ± 6.99 cm). Main Outcome Measures:Isokinetic peak torque was measured during knee extension and flexion at an angular velocity of 60°/second. Flexibility of the quadriceps was assessed by the modified Thomas test, while flexibility of the hamstrings was assessed using the sit-and-reach test. The 3 interventions were performed by all participants in random order on 3 days separated by 48–72 hours. Resu...

The Relationship Between Hip Strength and the Y-Balance Test

Abstract: Context: The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. However, the relationship between hip strength and performance on the Y Balance Test has not been fully elucidated. Objective: The goal of this study was to identify the relationship between components of isometric hip strength and the Y Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y Balance Test. Design: Laboratory study. Setting: Biomechanics laboratory. Participants: A total of 73 healthy participants (40 males and 33 females) volunteered for this study. Intervention: None. Main Outcome Measures: Participants completed the Y Balance Test on the right leg. The authors then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass and Y Balance Test performance. S...

Assessment and Training of Visuomotor Reaction Time for Football Injury Prevention

Abstract: CONTEXT: Neurocognitive reaction time has been associated with musculoskeletal injury risk, but visuomotor reaction time (VMRT) derived from tests that present greater challenges to visual stimulus detection and motor response execution may have a stronger association. OBJECTIVE: The purposes of this study were to assess VMRT as a predictor of injury and the extent to which improvement may result from VMRT training. DESIGN: Cohort study. SETTING: University athletic performance center. PARTICIPANTS: Seventy-six NCAA Division-I FCS American football players (19.5 ±1.4 years; 1.85 ± 0.06 m; 102.98 ±19.06 kg). INTERVENTIONS: Pre-participation and post-season assessments. A subset of players who exhibited slowest VMRT in relation to the cohort's post-season median value participated in a 6-week training program. MAIN OUTCOME MEASURES: Injury occurrence was related to pre-participation VMRT, which was represented by both number of target hits in 60 s and average elapsed time between hits (ms). Receiver operating characteristic analysis identified the optimum cut point for a binary injury risk classification. A non-parametric repeated measures analysis of ranks procedure was used to compare post-training VMRT values for slow players who completed at least half of the training sessions (n=15) to those for untrained fast players (n=27). RESULTS: A pre-participation cut point of ≤ 85 hits (≥ 705 ms) discriminated injured from non-injured players with OR = 2.30 (90% CI: 1.05, 5.06). Slow players who completed the training exhibited significant improvement in visuomotor performance compared to baseline (SRM = 2.53), whereas untrained players exhibited a small performance decrement (group x trial interaction effect, L2 = 28.74; P CONCLUSIONS: Slow VMRT appears to be an important and modifiable injury risk factor for college football players. More research is needed to refine visuomotor reaction time screening and training methods and to determine the extent to which improved performance values can reduce injury incidence. Language: en

Are Injuries More Common With CrossFit Training Than Other Forms of Exercise

Abstract: Clinical Scenario: CrossFit is a form of exercise that incorporates rapid and successive high-intensity ballistic movements. As CrossFit is an increasingly popular fitness option, it is important to determine how rates of injury compare to more traditional forms of exercise. This review was conducted to ascertain the incidence of injury with CrossFit relative to other forms of exercise. Focused Clinical Question: Are injuries more common with CrossFit training than other forms of exercise? Summary of Key Findings: (1) The literature was searched for studies that compared injury rates among individuals who participated in CrossFit fitness programs to participants in other exercise programs. (2) The search initially yielded >100 results, which were narrowed down to 3 level 2b retrospective cohort studies that were deemed to have met inclusion/exclusion criteria. (3) In all 3 reviewed studies, the reported incidences of injuries associated with CrossFit training programs were comparable or lower than rates of injury in Olympic weightlifting, distance running, track and field, rugby, or gymnastics. Clinical Bottom Line: Current evidence suggests that the injury risk from CrossFit training is comparable to Olympic weightlifting, distance running, track and field, rugby, football, ice hockey, soccer, or gymnastics. Injuries to the shoulder(s) appear to be somewhat common with CrossFit. However, the certitude of these conclusions is questionable given the lack of randomization, control, or uniform training in the reviewed studies. Clinicians should be aware that injury is more prevalent in cases where supervision is not always available to athletes. This is more often the case for male participants who may not actively seek supervision during CrossFit exercise. Strength of Recommendation: Level 2b evidence from 3 retrospective cohort studies indicates that the risk of injury from participation in CrossFit is comparable to or lower than some common forms of exercise or strength training.

A Randomized Controlled Trial Comparing Rehabilitation Efficacy in Chronic Ankle Instability.

Abstract: Context: There is minimal patient-oriented evidence regarding the effectiveness of interventions targeted to reduce symptoms associated with chronic ankle instability (CAI). Additionally, clinicians aiming to prioritize care by implementing only the most effective components of a rehabilitative program have very little evidence on comparative efficacy. Objective: To assess the comparative efficacy of two common ankle rehabilitation techniques [wobble board (WB) balance training and ankle strengthening using resistance tubing (RT)] using patient-oriented outcomes. Design: Randomized controlled trial. Setting: Laboratory. Patients: Forty patients with CAI were randomized into two treatment groups: RT and WB. CAI inclusion criteria included a history of an ankle sprain, recurrent giving way, and a Cumberland Ankle Instability Tool (CAIT) score ≤ 25. Interventions: Participants completed 5 clinician-oriented tests (Foot lift test, Time-in-balance, Star Excursion Balance Test, Figure of 8 hop, and Side hop) an...

Rehabilitation After Hamstring-Strain Injury Emphasizing Eccentric Strengthening at Long Muscle Lengths: Results of Long-Term Follow-Up

Abstract: Context:Hamstring-strain injuries have a high recurrence rate. Objective:To determine if a protocol emphasizing eccentric strength training with the hamstrings in a lengthened position resulted in a low recurrence rate. Design:Longitudinal cohort study. Setting:Sports-medicine physical therapy clinic. Participants:Fifty athletes with hamstring-strain injury (age 36 ± 16 y; 30 men, 20 women; 3 G1, 43 G2, 4 G3; 25 recurrent injuries) followed a 3-phase rehabilitation protocol emphasizing eccentric strengthening with the hamstrings in a lengthened position. Main Outcome Measures:Injury recurrence; isometric hamstring strength at 80°, 60°, 40°, and 20° knee flexion in sitting with the thigh flexed to 40° above the horizontal and the seat back at 90° to the horizontal (strength tested before return to sport). Results:Four of the 50 athletes sustained reinjuries between 3 and 12 mo after return to sport (8% recurrence rate). The other 42 athletes had not sustained a reinjury at an average of 24 ± 12 mo after re...

MRI-Based Assessment of Lower-Extremity Muscle Volumes in Patients Before and After ACL Reconstruction.

Abstract: Context: Study of muscle volumes in patients after anterior cruciate ligament (ACL) injury and reconstruction (ACL-R) is largely limited to cross-sectional assessment of the thigh musculature, which may inadequately describe posttraumatic and postsurgical muscle function. No studies have prospectively examined the influence of ACL injury and reconstruction on lower-extremity muscle volumes. Objective: Assess magnetic resonance imaging-derived lower-extremity muscle volumes, and quantify quadriceps strength and activation in patients following ACL injury and reconstruction. Design: Prospective case series. Setting: Research laboratory and magnetic resonance imaging facility. Patients (or Other Participants): Four patients (2 men and 2 women; age = 27.4 (7.4) y, height = 169.2 (8.1) cm, and mass = 74.3 (18.5) kg) scheduled for ACL-R. Intervention(s): Thirty-five muscle volumes were obtained from a bilateral lower-extremity magnetic resonance imaging before and after ACL-R. Main Outcome Measures: Muscle volu...

Comparison of a Vibration Roller and a Nonvibration Roller Intervention on Knee Range of Motion and Pressure Pain Threshold: A Randomized Controlled Trial

Abstract: Background:The use of foam rollers to provide soft-tissue massage has become a common intervention among health and fitness professionals. Recently, manufacturers have merged the science of vibration therapy and foam rolling with the development of vibrating foam rollers. To date, no peer reviewed investigations have been published on this technology.Purpose:The purpose of this study was to compare the effects of a vibrating roller and non-vibrating roller intervention on prone knee flexion passive range of motion (ROM) and pressure pain thresholds (PPT) of the quadriceps musculature.Methods:Forty-five recreationally active adults were randomly allocated to one of three groups: vibrating roller, non-vibrating roller, and control. Each roll intervention lasted a total of 2 minutes. The control group did not roll. Dependent variables included prone knee flexion ROM and PPT measures. Statistical analysis included parametric and non-parametric tests to measure changes among groups.Results:The vibrating roller...

Strength Training Using Elastic Bands: Improvement of Muscle Power and Throwing Performance in Young Female Handball Players

Abstract: Context: Imbalance in shoulder rotator muscles has been considered a risk factor for injuries in handball. Strength training programs (STP) may play an important preventive role. Objective: To verify the effects of an STP by using elastic band on shoulder muscles and ball throwing speed. Design: Randomized and prospective controlled trial. Setting: Exercise Physiology Laboratory. Participants: Thirty nine female handball players were randomly assigned to experimental (EG, n=21, 15.3±1.1yrs) or control (CG, n=18, 15.0±0.8yrs) groups. Intervention: The EG performed the STP with elastic band progressive exercises for six weeks before regular handball training and the CG underwent only their regular training. Main outcome measures: Before and after the STP, both groups underwent a ball throwing speed test and isokinetic test to assess shoulder internal (IR) and external rotator (ER) muscular performance. Results: Average power values for IR muscles presented a significant group vs. time interaction e...

Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials.

Abstract: Context: Posterior shoulder tightness (PST) and glenohumeral internal rotation deficit (GIRD) are common physical impairments in overhead sports, such as baseball, cricket and tennis.1-4) PST is clinically measured by passive shoulder horizontal adduction with scapula stabilized in supine or side lying.5,6) GIRD is generally characterised as concurrent deficits of internal rotation (IR) and total arc of motion in dominant side.7,8) Although the mechanisms of PST and GIRD are not clear, it is speculated that they derive from tight posterior glenohumeral capsule and posterior muscles, such as posterior deltoid, infraspinatus and teres minor muscles.8-10) Some authors suggest that repetitive tensile stress to posterior structures in follow-through phase in throwing movements could lead to inflammation, scar formation and subsequent tightness in posterior tissues, resulting in PST and GIRD.8) Since both PST and GIRD are thought to reflect tightness of posterior structures in the shoulder, the term PST is occa...

Does Roller Massage With a Foam Roll Change Pressure Pain Threshold of the Ipsilateral Lower Extremity Antagonist and Contralateral Muscle Groups? An Exploratory Study.

Abstract: Context:Foam rolling is a popular intervention used by allied health professionals and the general population. Current research suggests that foam rolling may have an effect on the ipsilateral antagonist muscle group and produce a cross-over effect in the muscles of the contralateral limb. The purpose of this study was to examine the acute effects of foam rolling to the left quadriceps on ipsilateral antagonist hamstrings and contralateral quadriceps muscle group pressure pain threshold (PPT). Through this research, we sought to gather data to further develop the methodology for future studies of this intervention.Design:A pretest, posttest exploratory study.Setting:University kinesiology laboratory.Participants:Twenty-one healthy adults (age= 27.52 ± 8.9 years).Intervention:Video-guided foam roll intervention on the left quadriceps musculature.Main Outcome Measures:Ipsilateral hamstring (antagonist) and contralateral quadriceps muscle PPT.Results:A significant difference was found between pretest to post...

Validity and Reliability of a Digital Inclinometer to Assess Knee Joint-Position Sense in a Closed Kinetic Chain

Abstract: Context.New methods are being validated to easily evaluate the knee joint position sense (JPS) due to its role in sports movement and the risk of injury. However, no studies to date have considered the open kinetic chain (OKC) technique, despite the biomechanical differences compared to closed kinetic chain movements. Objective.To analyze the validity and reliability of a digital inclinometer to measure the knee JPS in the OKC movement. Design.The validity, inter-tester and intra-tester reliability of a digital inclinometer for measuring knee JPS were evaluated. Setting.Sports research laboratory. Participants.Eighteen athletes (11 males and 7 females; 28.4 ± 6.6 years; 71.9 ± 14.0 kg; 1.77 ± 0.09 m; 22.8 ± 3.2 kg/m2) voluntary participated in this study. Main Outcomes Measures.Absolute angular error (AAE), relative angular error (RAE) and variable angular error (VAE) of knee JPS in an OKC. Results.Intraclass correlation coefficient (ICC) and standard error of the mean (SEM) were calculated to determine t...

A Systematic Review of Rehabilitation Exercises to Progressively Load the Gluteus Medius.

Abstract: Context:Gluteus medius rehabilitation is of critical importance given its role in pelvic and lower limb stability, and the known link between gluteus medius weakness and many lower limb conditions. Objective:To systematically review the literature and present an evidence-based graduated series of exercises to progressively load gluteus medius. Evidence Acquisition:A systematic literature search was conducted in January 2016 to identify studies reporting gluteus medius muscle activity as a percentage of maximal volitional isometric contraction (MVIC), during rehabilitation exercises. Studies that investigated injury free participants were included. No restrictions were placed on the type or mode of exercise, though exercises that could not be accurately replicated or performed within an independent setting were excluded. Studies that did not normalize electromyographic activity to a side lying MVIC were excluded. Exercises were stratified based on exercise type and %MVIC: low (0% to 20%), moderate (21% to ...

The Effectiveness of PNF Versus Static Stretching on Increasing Hip-Flexion Range of Motion

Abstract: Clinical Scenario: Stretching is applied for the purposes of injury prevention, increasing joint range of motion (ROM), and increasing muscle extensibility. Many researchers have investigated various methods and techniques to determine the most effective way to increase joint ROM and muscle extensibility. Despite the numerous studies conducted, controversy still remains within clinical practice and the literature regarding the best methods and techniques for stretching. Focused Clinical Question: Is proprioceptive neuromuscular facilitation (PNF) stretching more effective than static stretching for increasing hamstring muscle extensibility through increased hip ROM or increased knee extension angle (KEA) in a physically active population? Summary of Key Findings: Five studies met the inclusion criteria and were included. All 5 studies were randomized control trials examining mobility of the hamstring group. The studies measured hamstring ROM in a variety of ways. Three studies measured active KEA, 1 study measured passive KEA, and 1 study measured hip ROM via the single-leg raise test. Of the 5 studies, 1 study found greater improvements using PNF over static stretching for increasing hip flexion, and the remaining 4 studies found no significant difference between PNF stretching and static stretching in increasing muscle extensibility, active KEA, or hip ROM. Clinical Bottom Line: PNF stretching was not demonstrated to be more effective at increasing hamstring extensibility compared to static stretching. The literature reviewed suggests both are effective methods for increasing hip-flexion ROM. Strength of Recommendation: Using level 2 evidence and higher, the results show both static and PNF stretching effectively increase ROM; however, one does not appear to be more effective than the other.

Changes in Passive Properties of the Gastrocnemius Muscle-Tendon Unit During a 4-Week Routine Static-Stretching Program.

Abstract: Context: Static Stretching (SS) is commonly performed within a warm-up routine to increase the range of motion (ROM) of a joint and to decrease muscle stiffness. However, the time course of changes in ankle dorsiflexion (DF) ROM and muscle stiffness during a routine SS program is unclear. Objective: The present study investigated changes in ankle DF ROM, passive torque at DF ROM, and muscle stiffness during a routine SS program performed three times weekly for 4 weeks. Design: A quasi-randomized controlled trial design. Participants: The subjects comprised 24 male volunteers (age 23.8 ± 2.3 years; height 172.0 ± 4.3 cm; body mass 63.1 ± 4.5 kg) randomly assigned to either a group performing a 4-week stretching intervention program (SS group) or a control group. Main Outcome Measures: The DF ROM, passive torque, and muscle stiffness were measured during passive ankle dorsiflexion in both groups using a dynamometer and ultrasonography once weekly during the 4-week intervention period. Results: In the SS gro...

Balance Training Versus Balance Training With STARS in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

Abstract: Context:Both balance training and selected interventions meant to target sensory structures (STARS) have been shown to be effective at restoring deficits associated with chronic ankle instability (CAI). Clinicians often use multiple treatment modalities in patients with CAI. However, evidence for combined intervention effectiveness in CAI patients remains limited. Objective:To determine if augmenting a balance-training protocol with STARS (BTS) results in greater improvements than balance training (BT) alone in those with CAI. Design:Randomized-controlled trial. Setting:Research laboratory. Patients:24 CAI participants (age 21.3 ± 2.0 y; height 169.8 ± 12.9 cm; mass 72.5 ± 22.2 kg) were randomized into 2 groups: BT and BTS. Interventions:Participants completed a 4-week progression-based balance-training protocol consisting of 3 20-min sessions per week. The experimental group also received a 5-min set of STARS treatments consisting of calf stretching, plantar massage, ankle joint mobilizations, and ankle ...

The Relationship Between 2-Dimensional Knee-Valgus Angles During Single-Leg Squat, Single-Leg-Land, and Drop-Jump Screening Tests.

Abstract: Context: Injuries to the anterior cruciate ligament (ACL) and patellofemoral joint (PFJ) are a significant problem in female athletes. A number of screening tasks have been used in the literature to identify those at greatest risk of injury. To date, no study has examined the relationship in 2-dimensional (2D) knee valgus between common screening tasks to determine whether individuals exhibit similar movement patterns across tasks. Objective: To establish whether frontal-plane projection angle (FPPA) during the single-leg squat (SLS), single-leg land (SLL), and drop jump (DJ) are related. Design: Cross-sectional study. Setting: University laboratory. Participants: 52 national-league female football players and 36 national-league female basketball players. Main Outcome Measures: 2D FPPA during the SLS, SLL, and DJ screening tasks. Results: Significant correlations were found between tasks. FPPA in the SLS was significantly correlated with SLL (r = .52) and DJ (r = .30), whereas FPPA in the SLL was also significantly correlated to DJ (r = .33). FPPA was significantly greater in the SLS than in the SLL (P Conclusion: The results showed that 2D FPPA is correlated across the SLS, SLL, and DJ tasks. However, significantly greater FPPA values in the unilateral tasks suggest that the DJ may not identify risk of injury in sports where primary injury mechanisms are during unilateral loading tasks. Therefore, it is recommended that both unilateral and bilateral tasks be included when screening for ACL and PFJ injury risk.

Acute Effect of 2 Self-Myofascial Release Protocols on Hip and Ankle Range of Motion

Abstract: Context:Self-myofascial release (SMR) is an intervention popularly used by rehabilitation, fitness, and sports professionals to improve recovery and performance. In SMR, the athlete/patient himself applies pressure to the muscle and fascia, using various tools such as balls, rods, foam rolls and massagers. Objective:This study aimed to evaluate the acute effect of two SMR protocols (short- and long-term) of the posterior thigh and calf muscles on hip and ankle range of motion (ROM) in physically active men. Participants:Fourteen adult males (24.9±3.2 years, 77.2±13.2 kg and 1.75±0.06 m) who exercise regularly (at least twice a week, 45 min per session). Interventions:Participants performed a short-term SMR protocol (2 x 10 repetitions, SSMR) and a long-term SMR protocol (2 x 20 repetitions, LSMR) of the posterior thigh (using a foam-roller) and calf (using a massage stick) muscles in counterbalanced order, on two different days with a 48-h interval. Main Outcome Measures:Ankle dorsiflexion and hip flexion...

Achilles Tendon Properties of Minimalist and Traditionally Shod Runners.

Abstract: Context:Tendon adapts to load through alterations in its composition and mechanical properties. Mechanical adaptation to increased load often involves increases in cross-sectional area (CSA), stiffness, and modulus. Runners exhibit these adaptations. Objective:To determine if runners wearing minimalist shoes had larger and stiffer Achilles tendons (AT) than traditionally shod runners. Design:Cross-sectional study of well-trained, traditionally and minimally shod runners. Setting:Laboratory assessment of trained runners. Participants: 23 men (11 traditional, 12 minimalist) and 8 women (6 traditional, 2 minimalist). Runners wearing minimalist shoes had 4.2 ± 1.6 y of training experience in minimalist shoes. Main Outcome Measures:The authors used diagnostic ultrasound and isokinetic dynamometry to generate a force-elongation curve and its derivatives. Results: Minimalist runners had a greater CSA: mean difference (MD) = 9.2 mm2, stiffness (MD = 268.1 N/mm), and modulus (MD = 202.9 MPa). ATs of minimalist run...

Isokinetic Evaluation of the Hip Flexor and Extensor Muscles: A Systematic Review.

Abstract: Introduction:Isokinetic dynamometry testing is a safe and reliable method accepted as the “gold standard” in the evaluation of muscle strength in the open kinetic chain. Isokinetic hip examinations face problems in the standardization of the position of the equipment axis; in the individual being examined; in the adjustment of the lever arm and in stabilization strategies for the patients during the tests. Identification of the methodologic procedures with best reproducibility is also needed. Objective:The objective of this study was to review the literature to evaluate the parameters used for the isokinetic evaluation of the hip flexor and extensor muscles and its reproducibility. Method:This is a systematic literature review of the Cochrane, LILACS, PEDro, PubMed, and SciELO databases. The inclusion criteria were papers on the evaluation of hip flexor and/or extensor muscular strength with an isokinetic dynamometer and papers that analyzed the ICC or Pearson’s reproducibility. The information extracted ...

Validity of a Smartphone Application for Measuring Ankle Plantar Flexion.

Abstract: Context: Range of motion is a component of a physical examination used in the diagnostic and rehabilitative processes. Following ankle injury and/or during research, it is common to measure plantar...

Self-Mobilization Using a Foam Roller Versus a Roller Massager: Which Is More Effective for Increasing Hamstrings Flexibility?

Abstract: Clinical Scenario:Increasing the length of the muscle–tendon unit may prevent musculotendinous injury. Various methods have been proposed to increase muscle–tendon flexibility, including self-mobilization using foam rollers or roller massagers, although the effectiveness of these devices is uncertain. This review was conducted to determine if the use of foam rollers or roller massagers to improve hamstrings flexibility is supported by moderate- to high-quality evidence. Clinical Question:Are foam rollers or roller massagers effective for increasing hamstrings flexibility in asymptomatic physically active adults? Summary of Key Findings:The literature was searched for studies on the effects of using foam rollers or roller massagers to increase hamstrings flexibility in asymptomatic physically active adults. Four randomized controlled trials were included; 2 studies provided level 2 or 3 evidence regarding foam rollers and 2 studies provided level 2 or 3 evidence regarding roller massagers. Both roller-mass...

Effects of Hip Strengthening on Neuromuscular Control, Hip Strength, and Self-Reported Functional Deficits in Individuals With Chronic Ankle Instability.

Abstract: Context: Deficits in ankle and hip strength and lower-extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control, and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population are not well understood. Objective: To examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. Design: Prospective randomized controlled clinical trial. Setting: Athletic training facility. Participants: Twenty-six participants with CAI (12 males and 14 females; age = 20.9 [1.5] y, height = 170.0 [12.7] cm, and mass = 77.5 [17.5] kg) were randomly assigned to training or control groups. Intervention: Participants completed either 4 weeks of supervised hip strengthening (resistance bands 3 times a week) or no intervention. Mai...

Biomechanical Analysis of the Closed Kinetic Chain Upper-Extremity Stability Test.

Abstract: Context:The closed kinetic chain upper-extremity stability (CKCUES) test is a functional test for the upper extremity performed in the push-up position, where individuals support their body weight on 1 hand placed on the ground and swing the opposite hand until touching the hand on the ground, then switch hands and repeat the process as fast as possible for 15 s. Objective:To study scapular kinematic and kinetic measures during the CKCUES test for 3 different distances between hands. Design:Experimental. Setting:Laboratory. Participants:30 healthy individuals (15 male, 15 female). Main Outcome Measures:Participants performed 3 repetitions of the test at 3 distance conditions: original (36 in), interacromial, and 150% interacromial distance between hands. Participants completed a questionnaire on pain intensity and perceived exertion before and after the procedures. Scapular internal/external rotation, upward/downward rotation, and posterior/anterior tilting kinematics and kinetic data on maximum force and...

The Impact of Injury on Health-Related Quality of Life in Collegiate Athletes

Abstract: Context: Health-related quality of life (HRQOL) is a broad term for the impact of injury or illness on physical, psychological, and social health dimensions. Injury has been associated with decreased HRQOL in athletes. However, the influence of injury history, participation status, time since last injury, and injury severity on HRQOL remains unclear. Objective: To compare HRQOL in collegiate athletes based on injury history, participation status, time since last injury, and injury severity and to examine relationships between HRQOL outcomes. Design: Cross-sectional. Setting: Three National Collegiate Athletic Association (NCAA) institutions. Participants: Four hundred and sixty-seven collegiate athletes (199 males, 268 females; 19.5±1.3 y, 173.9±10.5 cm, 71.9±13.6 kg) were recruited from NCAA Division-I (n=299) and Division-III (n=168) institutions. Athletes were included regardless of participation status creating a diverse sample of current and past injury histories. Main outcome measures: During a sing...

Regeneration of Skeletal Muscle After Eccentric Injury.

Abstract: Eccentric-contraction-induced skeletal muscle injuries, included in what is clinically referred to as muscle strains, are among the most common injuries treated in the sports medicine setting. Although patients with mild injuries often fully recover to their preinjury levels, patients who suffer moderate or severe injuries can have a persistent weakness and loss of function that is refractory to rehabilitation exercises and currently available therapeutic interventions. The objectives of this review were to describe the fundamental biophysics of force transmission in muscle and the mechanism of muscle-strain injuries, as well as the cellular and molecular processes that underlie the repair and regeneration of injured muscle tissue. The review also summarizes how commonly used therapeutic modalities affect muscle regeneration and opportunities to further improve our treatment of skeletal muscle strain injuries.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain.

Abstract: Clinical Scenario: Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain. Focused Clinical Question: In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life? Summary of Key Findings: Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention. Clinical Bottom Line: Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2-3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician's own judgment and clinical expertise and the patient's preferences and values. Strength of Recommendation: Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

Validating Center-of-Pressure Balance Measurements Using the MatScan® Pressure Mat.

Abstract: Context: Measurements of center-of-pressure (COP) excursions during balance are common practice in clinical and research settings to evaluate adaptations in postural control due to pathological or environmental conditions. Traditionally measured using laboratory force plates, pressure-mat devices may be a suitable option for clinicians and scientist to measure COP excursions. Objective: Compare COP measures and changes during balance between MatScan® pressure mat and force plate. Design: Validation study. Setting: Laboratory. Participants: 30 healthy, young adults (19 female, 11 male, 22.7 ± 3.4 y, 70.3 ± SD kg, 1.71 ± 0.09 m). Main Outcomes: COP excursions were simultaneously measured using pressure-mat and force-plate devices. Participants completed 3 eyes-open and 3 eyes-closed single-leg balance trials (10 s). Mean of the 3 trials was used to calculate 4 COP variables: medial-lateral and anterior-posterior excursion, total distance, and area with eyes open and eyes closed. Percent change and effect si...

Relationship Between Physical Activity and Clinical Outcomes After ACL Reconstruction

Abstract: Context:Reductions in objectively measured moderate-to-vigorous physical activity (MVPA) have been reported among individuals with ACLR. Self-reported measures of physical activity are commonly utilized to assess participation in physical activity after ACLR despite the lack of evidence to support the validity of such measures within this population. Objective:The objective of this research was to determine the relationships between objectively measured MVPA, self-reported physical activity, and knee function among individuals with ACLR. Setting:University laboratory. Patients (or Other Participants):Thirty-one participants with a history of ACLR (sex = 23F/8M, age = 19.8±1.4 years) and 31 matched controls (sex = 23F/8M, age = 20.6±1.7 years) enrolled in this study. Intervention(s):None. Main Outcome Measures:Participants completed self-reported physical activity using the Tegner Activity Scale and the Marx Activity Scale. Participant MVPA was objectively measured using an ActiGraph wGT3X-BT accelerometer...

College Athletes With Ankle Sprain History Exhibit Greater Fear-Avoidance Beliefs

Abstract: Context: Postinjury, college athletes have reported elevated levels of fear. However, it is unclear how a history of ankle sprain impacts injury-related fear. Objective: The aim of this study was t...