bluuebunny/crossref_metadata_2025 huggingface dataset:
A Reversal Theory Analysis of Psychological Responses during Sports Injury Rehabilitation
Authors: Thatcher Joanne , Kerr John , Amies Kristy , Day Melissa
Published: August 2016

Context:

Few studies have examined psychological and emotional processes in injury rehabilitation from a longitudinal, theoretically framed perspective.

Objective:

This study explored the applicability of Reversal Theory to examine these processes.

Setting:

University of Wales, Aberystwyth, UK.

Participants:

Three severely injured athletes; two were female (karate and judo) and one was male (hockey), aged 20 to 28.

Main Outcome Measures:

Fortnightly interviews after participant’s initial consultation with a sports therapist, until complete physical rehabilitation.

Results:

Supported the use of Reversal Theory in this context (eg, as a means of understanding the origins of athletes’ emotional responses to injury and changes in these responses throughout rehabilitation).

Conclusions:

Suggestions for future research are made (eg, examining the consequences of emotional and metamotivational states for athlete behavior and recovery outcomes during rehabilitation).
Anterior Shoulder Laxity Is Not Correlated with Medial Elbow Laxity in High School Baseball Players
Authors: Friscia Brian A. , Hammill Robert R. , McGuire Brian A. , Hertel Jay N. , Ingersoll Christopher D.
Published: August 2016

Context:

Uninjured baseball players have been shown to have increased anterior glenohumeral joint laxity, which may result in adaptive changes at the medial elbow.

Objective:

To determine the relationship between anterior shoulder laxity and medial elbow laxity in both arms of baseball and nonbaseball high school athletes and compare the laxity of dominant and nondominant shoulders and elbows of high school baseball and nonbaseball players.

Design:

Cohort design.

Setting:

Local high schools.

Participants:

Thirty healthy high school male athletes.

Outcome Measures:

Anterior shoulder and medial elbow laxity measurements were taken bilaterally with the Ligmaster™.

Results:

Dominant and nondominant shoulder laxity was significantly greater in the nonbaseball players than the baseball players. No other significant relationships existed.

Conclusions:

High school baseball players exhibit less anterior shoulder laxity than do nonbaseball players. No relationship exists between anterior shoulder and medial elbow laxity in high school baseball players.
Neural Gliding Techniques for the Treatment of Carpal Tunnel Syndrome: A Systematic Review
Authors: McKeon Jennifer M. Medina , Yancosek Kathleen E.
Published: August 2016

Context:

There are discrepancies regarding the efficacy of neural gliding exercises for the management of carpal tunnel syndrome (CTS).

Objective:

To conduct a systematic review assessing the efficacy of neural gliding in comparison to alternative nonsurgical treatment for the management of CTS.

Evidence Acquisition:

A computerized search was performed in April 2008. Criteria for inclusion required that studies (1) were written in English, (2) examined the efficacy of neural gliding techniques for treatment of CTS, and (3) included at least one of the selected patient-oriented outcomes. Effect sizes, relative risk, and 95% confidence intervals were calculated to compare neural gliding to alternative treatment.

Evidence Synthesis:

Six studies met inclusion criteria. For all variables, none were consistently favorable toward neural gliding over alternative treatment. However, comparisons across studies revealed a possible trend toward improved outcomes with the use neural gliding.

Conclusions:

The efficacy of neural gliding is not clear. More research is necessary to determine the population that may respond optimally to this treatment.
Kinematic Predictors of Performance on the Star Excursion Balance Test
Authors: Robinson Richard , Gribble Phillip
Published: August 2016

Context:

The Star Excursion Balance Test (SEBT) is composed of 8 reaching directions that are potentially measuring the same functional component, leading to the suggestion that the number of reach directions could be reduced without compromising the assessment of dynamic postural control.

Objective:

To determine whether the relationship of stance-leg angular displacement on normalized reach distance is a source of dynamic-postural-control measurement redundancy.

Design:

Single-session within-subjects design.

Setting:

Athletic training research laboratory.

Participants:

10 women and 10 men.

Interventions:

None.

Main Outcome Measures:

Normalized reach distance and angular displacement at the knee and hip.

Results:

Stepwise regression revealed that hip flexion and knee flexion, separately and in combination, accounted for 62% to 95% of the variance in reach distances.

Conclusion:

Similarity in lower extremity function could account for the previously observed measurement redundancy in the SEBT.
The Effects of Gender and Fatigue on Dynamic Postural Control
Authors: Gribble Phillip A. , Robinson Richard H. , Hertel Jay , Denegar Craig R.
Published: August 2016

Context:

Deficits in static postural control related to fatigue have been investigated previously, but there is little evidence to link fatigue to performance measures of dynamic postural control.

Objective:

To investigate the effects of fatigue and gender on performance measures of the Star Excursion Balance Test (SEBT).

Design:

Mixed-model design.

Setting:

Research laboratory.

Participants:

16 healthy young adults.

Intervention:

Subjects performed the SEBT before and after 4 different fatiguing conditions.

Main Outcome Measures:

The normalized reach distances and sagittal-plane kinematics of the knee and hip were recorded.

Results:

Fatigue produced deficits in normalized reach distances and decreased knee flexion in all 3 reaching directions. Overall, women were able to reach farther than men while simultaneously demonstrating a greater amount of knee flexion.

Conclusions:

Gender differences were observed during performance of the SEBT, with women demonstrating greater reach distances and knee flexion, and fatigue amplified these differences.
The Effects of 6-Week Training Programs on Throwing Accuracy, Proprioception, and Core Endurance in Baseball
Authors: Lust Kathleen R. , Sandrey Michelle A. , Bulger Sean M. , Wilder Nathan
Published: August 2016

Context:

With a limited number of outcomes-based studies, only recommendations for strength-training and rehabilitation programs can be made.

Objective:

To determine the extent to which throwing accuracy, core stability, and proprioception improved after completion of a 6-week training program that included open kinetic chain (OKC), closed kinetic chain (CKC), and/or core-stability exercises.

Design:

A 2 × 3 factorial design.

Setting:

Division III college.

Participants:

19 healthy baseball athletes with a control group of 15.

Interventions:

Two 6-week programs including OKC, CKC, and core-stabilization exercises that were progressed each week.

Main Outcome Measures:

Functional throwing-performance index, closed kinetic chain upper extremity stability test, back-extensor test, 45° abdominal-fatigue test, and right- and left-side bridging test.

Results:

There was no significant difference between groups. An increase was evident in all pretest-to-posttest results, with improvement ranging from 1.36% to 140%.

Conclusion:

Both of the 6-week training programs could be used to increase throwing accuracy, core stability, and proprioception in baseball.
Influence of External Ankle Support on Lower Extremity Joint Mechanics During Drop Landings
Authors: Cordova Mitchell L. , Takahashi Yosuke , Kress Gregory M. , Brucker Jody B. , Finch Alfred E.
Published: August 2016

Objective:

To investigate the effects of external ankle support (EAS) on lower extremity joint mechanics and vertical ground-reaction forces (VGRF) during drop landings.

Design:

A 1 × 3 repeated-measures, crossover design.

Setting:

Biomechanics research laboratory.

Patients:

13 male recreationally active basketball players (age 22.3 ± 2.2 y, height 177.5 ± 7.5 cm, mass 72.2 ± 11.4 kg) free from lower extremity pathology for the 12 mo before the study.

Interventions:

Subjects performed a 1-legged drop landing from a standardized height under 3 different ankle-support conditions.

Main Outcome Measures:

Hip, knee, and ankle angular displacement along with specific temporal (TGRFz1, TGRFz2; s) and spatial (GRFz1, GRFz2; body-weight units [BW]) characteristics of the VGRF vector were measured during a drop landing.

Results:

The tape condition (1.08 ± 0.09 BW) demonstrated less GRFz1 than the control (1.28 ± 0.16 BW) and semirigid conditions (1.28 ± 0.21 BW; P < .0001), and GRFz2 was unaffected. For TGRFz1, no-support displayed slower time (0.017 ± 0.004 s) than the semirigid (0.014 ± 0.001 s) and tape conditions (0.014 ± 0.002 s; P < .05). For TGRFz2, no-support displayed slower time (0.054 ±.006 s) than the semirigid (0.050 ± 0.006 s) and tape conditions (0.045 ± 0.004 s; P < .05). Semirigid bracing was slower than the tape condition, as well (P < .05). Ankle-joint displacement was less in the tape (34.6° ± 7.7°) and semirigid (36.8° ± 9.3°) conditions than in no-support (45.7° ± 7.3°; P < .05). Knee-joint displacement was larger in the no-support (45.1° ± 9.0°) than in the semirigid (42.6° ± 6.8°; P < .05) condition. Tape support (43.8° ± 8.7°) did not differ from the semirigid condition (P > .05). Hip angular displacement was not affected by EAS (F2,24 = 1.47, P = .25).

Conclusions:

EAS reduces ankle- and knee-joint displacement, which appear to influence the spatial and temporal characteristics of GRFz1 during drop landings.
The Effects of Jump-Rope Training on Shoulder Isokinetic Strength in Adolescent Volleyball Players
Authors: Duzgun Irem , Baltaci Gul , Colakoglu Filiz , Tunay Volga Bayrakci , Ozer Derya
Published: August 2016

Objective:

To investigate the effect of a 12-wk weighted-jump-rope training program on shoulder strength.

Design:

Pretest to posttest experimental design.

Setting:

University sports physiotherapy laboratory.

Participants:

24 healthy volleyball players age 13-16 y.

Intervention:

Group 1 took weighted-rope training (n = 9), group 2 took unweighted-rope training (n = 8), and group 3 did not train with any specific program (n = 7).

Main Outcome Measures:

Players’ strength determined with an isokinetic dynamometer (Isomed 2000) at 180 and 60°/s on external and internal rotators, supraspinatus peak torque, and total work of the dominant shoulder. Kruskal–Wallis and Mann–Whitney U tests were used to determine the difference among the groups.

Results:

At pretraining evaluation, there were no significant differences in the test scores of the isokinetic test of full can and empty can between the groups at 60 and 180°/s. There was no statistically significant difference for 60 and 180°/s between pretraining and posttraining assessment (P > .05) except that total eccentric work increased in groups 1 and 3 but decreased in group 2 at 180°/s during the full can (P < .05). There was no significant difference among the groups between the pretraining and posttraining testing at both 180 and 60°/s for the empty can (P > .05). Internal-rotation values at 60 and 180°/s decreased for both peak torque and total work for all groups. External-rotation peak torque and total work at 60°/s increased for group 1. External-rotation peak torque and total work at 180°/s increased for all groups.

Conclusions:

The results indicate that a jump-rope training program is a good conditioning method for overhead athletes because of its potential benefits to shoulder strength.
Effect of High-Voltage Pulsed Current on Recovery After Grades I and II Lateral Ankle Sprains
Authors: Mendel Frank C. , Dolan Michael G. , Fish Dale R. , Marzo John , Wilding Gregory E.
Published: August 2016

Context:

High-voltage pulsed current (HVPC), a form of electrical stimulation, is known to curb edema formation in laboratory animals and is commonly applied for ankle sprains, but the clinical effects remain undocumented.

Objective:

To determine whether, as an adjunct to routine acute and subacute care, subsensory HVPC applied nearly continuously for the first 72 h after lateral ankle sprains affected time lost to injury.

Design:

Multicenter, randomized, double-blind, placebo-controlled trial.

Setting:

Data were collected at 9 colleges and universities and 1 professional training site.

Participants:

50 intercollegiate and professional athletes.

Interventions:

Near-continuous live or placebo HVPC for 72 h postinjury in addition to routine acute and subacute care.

Main Outcome Measure:

Time lost to injury measured from time of injury until declared fit to play.

Results:

Overall, time lost to injury was not different between treated and control groups (P = .55). However, grade of injury was a significant factor. Time lost to injury after grade I lateral ankle sprains was greater for athletes receiving live HVPC than for those receiving placebo HVPC (P = .049), but no differences were found between groups for grade II sprains (P = .079).

Conclusions:

Application of subsensory HVPC had no clinically meaningful effect on return to play after lateral ankle sprain.
Reusable Prophylactic Ankle Support: A Review of the Literature
Authors: Reisberg Scott , Verstraete Mary C.
Published: August 2016

An investigation of the literature on the use of prophylactic ankle braces for preventing lateral ankle sprains revealed methodological flaws and frequently inappropriate extrapolation of results. Existing research is inadequate and not definitive enough to warrant confident use of particular supportive modes. It is therefore apparent that more reliable scientific functional data and empirical conclusions are necessary when researching this topic. Suggestions for further research are offered and encouraged.
A Case Study of an Accelerated Rehabilitation Program on Knee Function Following Anterior Cruciate Ligament Reconstruction
Authors: Nyland John A. , Currier Dean P. , Ray J. Michael , Duby Mitchell J.
Published: August 2016

This paper discusses function changes during an accelerated rehabilitation program at 6, 10, and 52 weeks postsurgery for a college athlete following anterior cruciate ligament reconstruction/meniscectomy of the left knee. The effects of combined pulsed electromagnetic field (PEMF) and neuromuscular electrical stimulation (NMES) on knee extensor torque, thigh girth, and pain level are presented. PEMF-NMES decreased stimulation pain by 76%. Knee extensor isometric torque increased by 23%, and thigh girth decreased less than 5% at 6 weeks. Knee extensor isokinetic torque was 13% and 3% deficient at 90°/s and 240°/s, and standing single-leg broad jump distance was 19% deficient at 10 weeks. Knee extensor isokinetic torque was 1% and 1.5% greater at 90°/s and 240°/s, and standing single-leg broad jump distance was 11% deficient at 52 weeks. Knee anterior laxity was 2 mm at 10 weeks and 3 mm at 52 weeks. PEMF-NMES appears to comfortably enhance knee extensor torque gains and diminish thigh girth loss. Despite early return to practice, functional deficit remained and anterior laxity was increased at 52 weeks.
Effects of Continuous Passive Motion on Anterior Laxity Following ACL Reconstruction with Autogenous Patellar Tendon Grafts
Authors: McCarthy Michael R. , Buxton Barton P. , Yates Carlan K.
Published: August 2016

Continuous passive motion (CPM) is a modality used in the treatment, management, and rehabilitation of a variety of orthopedic problems. Recently, CPM devices have been therapeutically employed immediately after autogenous patellar tendon reconstruction of the anterior cruciate ligament (ACL). Whereas the concept of early motion is indicated, there is a concomitant concern that the implementation of immediate passive motion may stretch or rupture the graft. Twenty subjects scheduled to undergo ACL reconstruction were randomized into two groups (10 CPM and 10 non-CPM). All subjects performed the same postoperative rehabilitation with the exception of the CPM. Objective anterior tibial translation measurements were recorded with a KT-1000 for a 30-1b (133.5-N) Lachman test at 1 year postreconstruction. The results of this study indicated that the implementation of immediate continuous passive motion did not have any deleterious effects on the stability of the ligament reconstruction.
The Effects of Vacuum-Molded Orthotics on Lower Extremity Overuse injuries
Authors: Callahan Matthew P. , Denegar Craig R. , Segree Craig A.
Published: August 2016

Orthotics are commonly prescribed for the treatment of lower extremity injuries secondary to hyperpronation. However, the efficacy of vacuum-molded orthotics has not been established. We assessed the effects of vacuum-molded orthotics on pain and level of function in athletes suffering from plantar fasciitis, medial tibial stress syndrome, or knee pain secondary to hyperpronation. Fourteen athletes assessed their pain and level of function during athletic activity before being fitted for orthotics (Professional Rx, SuperFeet In-Shoe Systems Inc.) and weekly for 7 weeks following break-in. Five athletes (36%) reported complete pain resolution and eight (57%) reported substantial improvement. Eight athletes (57%) reported full return to athletic participation and five (36%) reported substantial improvement in athletic function. One athlete failed to respond to treatment. Results indicate that vacuum-molded orthotics are an effective treatment for lower extremity overuse injuries secondary to hyperpronation.
Bilateral Isokinetic Knee Rehabilitation Following Bilateral Total Knee Replacement Surgery
Authors: Brown Lee E. , Whitehurst Michael , Buchalter David N.
Published: August 2016

A 67-year-old male underwent bilateral total knee replacement surgery and was subsequently placed on a bilateral isokinetic knee rehabilitation program. Isokinetic knee testing was performed on unilateral dominant (UD; right) and nondominant (UND; left) limbs as well as bilateral limbs (BLs) before and after a three-times-per-week, 8-week protocol during which the patient followed a bilateral isokinetic velocity spectrum (60 to 300°/s) rehabilitation program. The protocol was made possible by the introduction of a new bilateral isokinetic knee attachment developed by the authors. The BL extension and flexion peak torque increased 41% and 51% at 60°/s, respectively. The UD and UND extension peak torque increased 22% and 37%, respectively, while flexion peak torque increased 68% and 52%, respectively. The bilateral deficit decreased with increasing velocity for both extension and flexion. These results demonstrate that a bilateral isokinetic approach to rehabilitation may be a legitimate technique to increase knee extension and flexion peak torque both unilaterally and bilaterally following bilateral total knee replacement surgery.
Upper Extremity Injury History, Current Pain Rating, and Health-Related Quality of Life in Female Softball Pitchers
Authors: Sauers Eric L. , Dykstra Danelle L. , Bay R. Curtis , Bliven Kellie Huxel , Snyder Alison R.
Published: August 2016

Context:

Throwing-related arm injuries are common in softball pitchers and may lead to diminished health-related quality of life (HRQOL). Arm symptoms such as pain have been reported to be more common in healthy overhead athletes than nonoverhead athletes. Furthermore, more frequent shoulder symptoms and lower shoulder function have been demonstrated in athletes with self-reported history of shoulder injury.

Objective:

To evaluate the relationship between arm injury history, current pain rating, and HRQOL assessed via 2 region-specific patient self-report scales in high school and college softball pitchers.

Design:

Cross-sectional.

Setting:

High school and college athletic training facilities.

Participants:

25 female softball pitchers (10 high school, 15 college; 18 ± 2 y, 169 ± 7.6 cm, 67.5 ± 10.3 kg).

Intervention:

Self-reported arm injury history and rating of current pain and HRQOL were collected during the late season.

Main Outcome Measures:

A self-report questionnaire of arm injury history and current pain rating was used, and HRQOL was assessed via 2 region-specific scales: the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Functional Arm Scale for Throwers© (FAST©). Correlational analysis was used to evaluate the relationships between arm injury history, current pain rating, and the DASH total score and sport module and the FAST total score, pitching module, and subscales.

Results:

A history of arm injury from throwing was reported by 64% of participants, 31% of whom had to cease activity for more than 10 d. The most common site of arm time-loss injury was the shoulder (81%). Mild to severe shoulder pain during the competitive season was reported by 60% of respondents. The DASH and the FAST total scores were significantly correlated (r = .79, P < .001). Respondent rating of shoulder pain correlated significantly with the DASH total (r = .69) and sports module (r = .69) and the FAST total (r = .71), pitching module (r = .65), and pain (r = .73), impairment (r = .76), functional-limitation (r = .79), disability (r = .52), and societal-limitations (r = .46) subscales.

Conclusion:

History of arm injury is common in female high school and college softball pitchers. Severe injury and elevated pain are associated with lower HRQOL that extends beyond the playing field.
Reliability of Isokinetic Assessment of Shoulder-Rotator Strength: A Systematic Review of the Effect of Position
Authors: Edouard Pascal , Samozino Pierre , Julia Marc , Cervera Sophie Gleizes , Vanbiervliet William , Calmels Paul , Gremeaux Vincent
Published: August 2016

Context:

Isokinetic assessment of shoulder internal- (IR) and external-rotator (ER) strength is commonly used with many different postures (sitting, standing, or supine) and shoulder positions (frontal or scapular plane with 45° or 90° of abduction).

Objective:

To conduct a systematic review to determine the influence of position on the intersession reliability of the assessment of IR and ER isokinetic strength, to identify the most reliable position, and to determine which isokinetic variable appears to be most stable in intersession reliability.

Evidence Acquisition:

A systematic literature search through MEDLINE and Pascal Biomed databases was performed in October 2009. Criteria for inclusion were that studies be written in English or French, describe the isokinetic evaluation methods, and describe statistical analysis.

Evidence Synthesis:

Sixteen studies meeting the inclusion criteria were included. Variable reliability of ER and IR peak torque (PT) were generally reported for all assessment positions; intraclass correlation coefficients were .44–.98 in the seated position with 45° of shoulder abduction, .09–.77 in the seated position with 90° of shoulder abduction, .86–.99 (coefficient of variation: 7.5–29.8%) in the supine position with 90° of shoulder abduction, .82–.84 in the supine position with 45° of shoulder abduction, and .75–.94 in standing. The ER:IR ratio reliability was low for all positions.

Conclusions:

The seated position with 45° of shoulder abduction in the scapular plane seemed the most reliable for IR and ER strength assessment. The standing position or a shoulder posture with 90° of shoulder abduction or in the frontal plane must be used with caution given the low reliability for peak torque. Good reliability of ER and IR PT was generally reported, but ER:IR ratio reliability was low.
Lack of a Relationship Between Glenohumeral External-Rotation Strength and Posterior Shoulder Tightness in Baseball Players
Authors: Laudner Kevin G. , Moline Mike , Meister Keith
Published: August 2016

Context:

Posterior shoulder tightness has been associated with altered shoulder range of motion (ROM) and several pathologic entities in baseball players. This tightness is hypothesized to be the result of the cumulative stress placed on the posterior shoulder during the deceleration phase of the throwing motion. The role of the posterior shoulder static restraints is to absorb this load while the glenohumeral (GH) external rotators eccentrically decelerate the arm after ball release and therefore also help dissipate this force. As such, the authors hypothesized that if the GH external rotators are weak, an excessive amount of this deceleration force is placed on the static restraints, which may lead to subsequent tightness.

Objective:

To compare the relationship between GH external-rotation strength and posterior shoulder tightness as measured by GH horizontal-adduction and internal-rotation ROM.

Design:

Descriptive study.

Setting:

Laboratory.

Participants:

45 professional baseball players.

Main Outcome Measures:

GH external-rotation strength and GH horizontal-adduction and internalrotation ROM.

Results:

GH external-rotation strength showed no relationship with either GH horizontal-adduction ROM (r2 = .02, P = .40) or GH internal-rotation ROM (r2 = .002, P = .77).

Conclusion:

There is little to no relationship between GH external-rotation strength and posterior shoulder tightness in professional baseball players. The posterior static restraints of the shoulder may absorb a large majority of the deceleration forces during the throwing motion. Although strengthening of the posterior shoulder dynamic restraints should not be overlooked, routine stretching of the static restraints may be more beneficial for decreasing posterior shoulder tightness and the subsequent risks associated with this tightness, although future research is warranted.
Posterior Glenohumeral Thermal Capsulorraphy, Capsular Imbrication, and Labral Repair With Complication of Adhesive Capsulitis: A Modified Rehabilitation Approach
Authors: Podraza Jeffery T. , White Scott C.
Published: August 2016

Background:

Isolated atraumatic posterior glenohumeral instability is rare. Use of thermal capsulorraphy for glenohumeral instability is considered controversial. This case study describes a modified rehabilitation protocol for a patient who underwent a multistep arthroscopic procedure for isolated posterior glenohumeral instability with a postoperative complication of adhesive capsulitis.

Case Description:

A 30-y-old man with a 15-y history of bilateral posterior glenohumeral instability related to generalized hypermobility underwent right-shoulder arthroscopy consisting of a combined posterior labral repair, capsular imbrication, and thermal capsulorraphy. A gunslinger orthosis was prescribed for 6 wk of immobilization. Adhesive capsulitis was diagnosed at the 5-wk postoperative visit and immobilization was discontinued. A modified treatment protocol was devised to address both the surgical procedures performed and the adhesive capsulitis. Residual symptoms resolved with release of an adhesion while stretching 10 months postoperatively.

Outcomes:

Scores of 5 shoulder-assessment tools improved from poor to excellent/good with subjective report of a very good outcome.

Discussion:

The complication of adhesive capsulitis required an individualized treatment protocol. In contrast to the standard protocol, our modified approach allowed more time to be spent in each phase of the program, was aggressive with restoring range of motion (ROM) without excessively stressing the posterior capsule, and allowed the patient to progress to activities that were tolerated regardless of protocol phase. Shoulder stiffness or frank adhesive capsulitis after stabilization, as in this case, requires a more aggressive modification to prevent permanent ROM limitations. Conversely, patients with early rapid gains in ROM must be protected from overstretching the repaired tissue with a program that allows functional motion to be incorporated over a longer time frame. This study indicates the use of thermal capsulorraphy as a viable surgical modality when it is used judiciously with the proper postoperative restrictions and rehabilitation.
Autologous Blood Injection to Treat Achilles Tendinopathy? A Randomized Controlled Trial
Authors: Pearson Jake , Rowlands David , Highet Ruth
Published: August 2016

Context:

Achilles tendinopathy is a common and often debilitating condition, and autologous blood injection is a promising treatment option.

Objective:

To determine whether autologous blood injection added to standard management was effective in alleviating symptoms of Achilles tendinopathy.

Design:

A prospective randomized controlled trial.

Setting:

Private sports medicine clinic.

Patients:

33 patients (18 women, 15 men) of mean age 50 y (SD 9) with 40 cases of Achilles tendinopathy of mean duration of 11 mo (SD 7).

Intervention:

Participants were randomized to blind peritendinous autologous blood injection added to standard treatment (eccentric-loading exercises) or standard treatment alone for 12 wk.

Main Outcome Measure:

Victorian Institute of Sport Assessment for Achilles (VISA-A) score and ratings of discomfort during and after the injection were measured at baseline and 6 and 12 wk. Analytically derived effect-size thresholds of 5 (small) and 15 (moderate) VISA-A units were used as the reference values for clinical inference.

Results:

Improvements in VISA-A of 7.7 units (95%CL: ± 6.7) and 8.7 units (± 8.8) were observed in the treatment and control groups, respectively, at 6 wk relative to baseline, with no clear effect of blood injection. At 12 wk VISA-A score improved to 18.9 units (± 7.4) in the treatment group, revealing a blood-injection effect of 9.6 units (± 11.5), relative to a comparatively unchanged condition in control (9.4 units; ± 9.0). Predictors of response to treatment were unremarkable, and a 21% rate of postinjection flare was the only noteworthy side effect.

Conclusions:

There is some evidence for small short-term symptomatic improvements with the addition of autologous blood injection to standard treatment for Achilles tendinopathy, although double-blinded studies with longer follow-up and larger sample size are required.
Passive Knee-Extension Test to Measure Hamstring Tightness: Influence of Gravity Correction
Authors: Guex Kenny , Fourchet Francois , Loepelt Heiko , Millet Gregoire P.
Published: August 2016

Context:

A passive knee-extension test has been shown to be a reliable method of assessing hamstring tightness, but this method does not take into account the potential effect of gravity on the tested leg.

Objective:

To compare an original passive knee-extension test with 2 adapted methods including gravity’s effect on the lower leg.

Design:

Repeated measures.

Setting:

Laboratory.

Participants:

20 young track and field athletes (16.6 ± 1.6 y, 177.6 ± 9.2 cm, 75.9 ± 24.8 kg).

Intervention:

Each subject was tested in a randomized order with 3 different methods: In the original one (M1), passive knee angle was measured with a standard force of 68.7 N (7 kg) applied proximal to the lateral malleolus. The second (M2) and third (M3) methods took into account the relative lower-leg weight (measured respectively by handheld dynamometer and anthropometrical table) to individualize the force applied to assess passive knee angle.

Main Outcome Measures:

Passive knee angles measured with video-analysis software.

Results:

No difference in mean individualized applied force was found between M2 and M3, so the authors assessed passive knee angle only with M2. The mean knee angle was different between M1 and M2 (68.8 ± 12.4 vs 73.1 ± 10.6, P < .001). Knee angles in M1 and M2 were correlated (r = .93, P < .001).

Conclusions:

Differences in knee angle were found between the original passive knee-extension test and a method with gravity correction. M2 is an improved version of the original method (M1) since it minimizes the effect of gravity. Therefore, we recommend using it rather than M1.
Effect of a 6-Week Strengthening Program on Shoulder and Scapular-Stabilizer Strength and Scapular Kinematics in Division I Collegiate Swimmers
Authors: Hibberd Elizabeth E. , Oyama Sakiko , Spang Jeffrey T. , Prentice William , Myers Joseph B.
Published: August 2016

Context:

Shoulder injuries are common in swimmers because of the demands of the sport. Muscle imbalances frequently exist due to the biomechanics of the sport, which predispose swimmers to injury. To date, an effective shoulder-injury-prevention program for competitive swimmers has not been established.

Objective:

To assess the effectiveness of a 6-wk strengthening and stretching intervention program on improving glenohumeral and scapular muscle strength and scapular kinematics in collegiate swimmers.

Design:

Randomized control trial.

Setting:

University biomechanics research laboratory.

Participants:

Forty-four Division I collegiate swimmers.

Interventions:

The intervention program was completed 3 times per week for 6 wk. The program included strengthening exercises completed using resistance tubing—scapular retraction (Ts), scapular retraction with upward rotation (Ys), scapular retraction with downward rotation (Ws), shoulder flexion, low rows, throwing acceleration and deceleration, scapular punches, shoulder internal rotation at 90° abduction, and external rotation at 90° abduction—and 2 stretching exercises: corner stretch and sleeper stretch.

Main Outcome Measurements:

Scapular kinematics and glenohumeral and scapular muscle strength assessed preintervention and postintervention.

Results:

There were no significant between-groups differences in strength variables at pre/post tests, although shoulder-extension and internal-rotation strength significantly increased in all subjects regardless of group assignment. Scapular kinematic data revealed increased scapular internal rotation, protraction, and elevation in all subjects at posttesting but no significant effect of group on the individual kinematic variables.

Conclusions:

The current strengthening and stretching program was not effective in altering strength and scapular kinematic variables but may serve as a framework for future programs. Adding more stretching exercises, eliminating exercises that overlap with weight-room training and swim training, and timing of implementation may yield a more beneficial program for collegiate swimmers.
Electromyographic Evaluation of Abdominal-Muscle Function With and Without Concomitant Pelvic-Floor-Muscle Contraction
Authors: Tahan Nahid , Arab Amir Massoud , Vaseghi Bita , Khademi Khosro
Published: August 2016

Context:

Coactivation of abdominal and pelvic-floor muscles (PFM) is an issue considered by researchers recently. Electromyography (EMG) studies have shown that the abdominal-muscle activity is a normal response to PFM activity, and increase in EMG activity of the PFM concomitant with abdominal-muscle contraction was also reported.

Objective:

The purpose of this study was to compare the changes in EMG activity of the deep abdominal muscles during abdominal-muscle contraction (abdominal hollowing and bracing) with and without concomitant PFM contraction in healthy and low-back-pain (LBP) subjects.

Design:

A 2 × 2 repeated-measures design.

Setting:

Laboratory.

Participants:

30 subjects (15 with LBP, 15 without LBP).

Main Outcome Measures:

Peak rectified EMG of abdominal muscles.

Results:

No difference in EMG of abdominal muscles with and without concomitant PFM contraction in abdominal hollowing (P = .84) and abdominal bracing (P = .53). No difference in EMG signal of abdominal muscles with and without PFM contraction between LBP and healthy subjects in both abdominal hollowing (P = .88) and abdominal bracing (P = .98) maneuvers.

Conclusion:

Adding PFM contraction had no significant effect on abdominal-muscle contraction in subjects with and without LBP.
The Effect of Prophylactic Ankle Support During Simulated Soccer Activity
Authors: Forbes Hollie , Thrussell Sarah , Haycock Nick , Lohkamp Monika , White Matthew
Published: August 2016

Objective:

Ankle injuries are common in soccer and may result in ongoing functional deficiency. Ankle-joint prophylactic support is hypothesized to reduce the risk of injury. Analysis of the effects of prophylactic support has so far lacked application to soccer. Therefore, the purpose of this study was to illustrate the effects of tape and brace on selected proprioceptive components and range of motion (ROM) before, after, and during a soccer-match-simulation protocol.

Design and Setting:

A crossover study design was used to investigate plantarflexion (PF) ROM, inversion (INV) ROM, and joint-position sense (weight bearing and non-weight-bearing [NWBJPS]; ± °error) in tape, brace, and control conditions. Measures were gathered from the dominant leg in a biomechanics laboratory at 0, 15, 30, and 45 min of a soccer-specific aerobic field test 90-min (SAFT90) protocol.

Participants:

Eight healthy male subjects (age 20.5 ± 0.5 y) experienced the 3 conditions in random order with 7 d between conditions.

Intervention:

The tape condition used an open basket-weave technique; the brace was an AirCast AirSport brace. For the control condition no prophylactic support was applied.

Results:

Application of prophylactic support significantly decreased active ROM in PF and INV (P < .05), with tape performing better than the brace (0 min). Tape lost its restrictive benefits by 15 min (P < .001) and was no different than control, while the brace maintained some effect until 45 min. Application of prophylactic support increased NWBJPS performance (P < .01; 0 min); by 15 min the tape had lost its proprioceptive benefit (P < .01) compared with the brace.

Conclusions:

Our findings suggest that the clinical usefulness of ankle-joint prophylactic support is limited if the aim is to restrict ROM and improve proprioceptive capability under soccer-specific conditions. The relative benefits of each type of support need to be considered in the context of the time-specific nature of the activity.
Effect of Functional Fatigue on Vertical Ground-Reaction Force in Individuals With Flat Feet
Authors: Boozari Sahar , Jamshidi Ali Ashraf , Sanjari Mohammad Ali , Jafari Hassan
Published: August 2016

Context:

Flat foot is one of the lower extremity deformities that might change kinetic variables of gait. Fatigue is one of the factors that can alter the vertical ground-reaction force (GRF). The effect of a fatiguing condition on vertical GRF has not been documented in individuals with flat feet.

Objective:

To examine the fatigue effect on vertical GRF in individuals with flat feet compared with a normal group during barefoot walking.

Design:

Repeated-measure ANOVA for the effects of fatigue on individuals with flat feet and normal feet.

Setting:

Biomechanics laboratory.

Participants:

17 subjects with flat feet and 17 normal subjects (recruited according to their arch-height ratio).

Main Outcome Measures:

Three vertical GRF measures (F1, the first peak force; F2, minimum force; and F3, the second peak force) were extracted before and after a functional fatigue protocol.

Results:

No significant interaction between fatigue and group was observed for the 3 vertical GRF measures. For F2, fatigue and group effects were significant (P = .001 and P = .02, respectively). Furthermore, F2 was higher in the flat-feet group than in the normal group; F2 also increased after fatigue. For F3, only a significant fatigue effect was observed (P = .004). F3 decreased after fatigue in both groups.

Conclusions:

In the flat-feet group, a decrease in the variation of vertical GRF might be due to more flexible foot joints. After fatigue, muscles might lose their ability to control the foot joints and cause higher F2 in the flat-feet group.
Improvement in Dynamic Balance and Core Endurance After a 6-Week Core-Stability-Training Program in High School Track and Field Athletes
Authors: Sandrey Michelle A. , Mitzel Jonathan G.
Published: August 2016

Context:

Core training specifically for track and field athletes is vague, and it is not clear how it affects dynamic balance and core-endurance measures.

Objective:

To determine the effects of a 6-week core-stabilization-training program for high school track and field athletes on dynamic balance and core endurance.

Design:

Test–retest.

Setting:

High school in north central West Virginia.

Participants:

Thirteen healthy high school student athletes from 1 track and field team volunteered for the study.

Interventions:

Subjects completed pretesting 1 wk before data collection. They completed a 6-wk core-stabilization program designed specifically for track and field athletes. The program consisted of 3 levels with 6 exercises per level and lasted for 30 min each session 3 times per week. Subjects progressed to the next level at 2-wk intervals. After 6 wk, posttesting was conducted

Main Outcome Measures:

The subjects were evaluated using the Star Excursion Balance Test (SEBT) for posteromedial (PM), medial (M), and anteromedial (AM) directions; abdominal-fatigue test (AFT); back-extensor test (BET); and side-bridge test (SBT) for the right and left sides.

Results:

Posttest results significantly improved for all 3 directions of the SEBT (PM, M, and AM), AFT, BET, right SBT, and left SBT. Effect size was large for all variables except for PM and AM, where a moderate effect was noted. Minimal-detectable-change scores exceeded the error of the measurements for all dependent variables.

Conclusion:

After the 6-wk core-stabilization-training program, measures of the SEBT, AFT, BET, and SBT improved, thus advocating the use of this core-stabilization-training program for track and field athletes.
Relationship Between Knee Walking Kinematics and Muscle Flexibility in Runners
Authors: Gaudreault Nathaly , Fuentes Alex , Mezghani Neila , Gauthier Virginie O. , Turcot Katia
Published: August 2016

Context:

Decreased flexibility in muscles and joints of lower extremities is commonly observed in runners. Understanding the effect of decreased flexibility on knee walking kinematics in runners is important because, over time, altered gait patterns can make runners vulnerable to overuse injuries or degenerative pathologies.

Objectives:

To compare hamstring and iliotibial-band (ITB) flexibility and knee kinematics in runners and nonrunners.

Design:

A descriptive, comparative laboratory study.

Setting:

Hamstring and ITB flexibility were measured with the active knee-extension test and the modified Ober test, respectively, in both groups of participants. Three-dimensional (3D) walking kinematic data were then recorded at the knee using a motiontracking system.

Participants:

18 runners and 16 nonrunners.

Main Outcome Measures:

Knee-extension angle (hamstring flexibility) and hip-adduction angle (ITB flexibility). Knee kinematic parameters of interest included knee angle at initial contact, peak knee angles, and knee-angle range in all planes of movement.

Results:

The runners had a significantly less flexible ITB than the nonrunners (hip adduction [−] and adduction [+] angles, 3.1° ± 5.6° vs −6.4° ± 4.5°; P < .001). The runners demonstrated a greater mean tibial external-rotation angle at initial contact (7.3° ± 5.8° vs 2.0° ± 4.0°; P = .01) and a smaller mean peak tibial internal-rotation angle (−1.6° ± 3.0° vs −4.2° ± 3.2°; P = .04) than the nonrunners.

Conclusion:

This study provides new insight into the relationship between muscle flexibility and 3D knee kinematics in runners. This supports the premise that there is an association between muscle flexibility and transverse-plane knee kinematics in this population.
Open Chain Isokinetic Assessment and Exercise of the Knee
Authors: Perrin David H.
Published: August 2016

This paper reviews the concepts associated with isokinetic open chain assessment and exercise of the quadriceps and hamstring muscle groups. Following a review of the isokinetic concept of exercise, the paper addresses principles of assessment and exercise of the knee, including the importance of musculoskeletal and cardiovascular screening, warm-up, body position, stabilization, and joint alignment. Gravity correction, test and exercise velocity, and duration of exercise are also addressed. Interpretation of an isokinetic evaluation of the knee is also addressed within the context of force-velocity relationships, peak torque relative to body weight, and bilateral and reciprocal muscle group relationships. Joint range of motion and test velocity are also discussed with respect to patellofemoral and tibiofemoral joint forces. Finally, recommended protocols for isokinetic assessment and exercise of the quadriceps and hamstring muscle groups are presented.
A New Protective Soft Splint for Contact Sports
Authors: Bouvette Christopher M. , Malanga Gerard A. , Cooney William P. , Stuart Michael J. , Miller Richard W.
Published: August 2016

Athletes who sustain metacarpal injuries such as nondisplaced and minimally displaced fractures or metacarpophalangeal dislocation have benefited from the use of a newly developed Plastizote hand/wrist orthotic device. This orthosis allows appropriate immobilization as well as early, safe, and effective return to contact sports during the healing process. Three case reports are presented along with applications and methods for fabricating this lightweight splint.
Principles and Techniques of Open Kinetic Chain Rehabilitation: The Upper Extremity
Authors: Hillman Sue
Published: August 2016

The kinetic chain is open in the upper extremity skills used in most sports. Although closed chain exercises will increase stability, open chain strengthening is more sport specific. This article addresses general concepts of upper extremity rehabilitation, including exercises to restore normal range of motion, joint mechanics, and muscle strength. The roles of proprioceptive neuromuscular facilitation, plyometric training, and elastic band exercises are also discussed. Finally, a progression of specificity training is presented to return the athlete to successful sport performance.
Snapping Scapula Syndrome
Authors: Mattocks Larry W. , Whitney Susan L.
Published: August 2016

Snapping scapula syndrome is a symptom, not a diagnosis. Soft tissue pathology and bony abnormalities can lead to scapular noise. Anatomy and biomechanics of the scapulothoracic mechanism are reviewed prior to discussion of the possible pathology that may lead to scapular noise and pain. Key points concerning the differential diagnosis are covered briefly. Guidelines are presented for rehabilitation of the patient with soft tissue lesions causing scapular pain and noise.
Comparison of Open Kinetic Chain Knee and Hip Extension to Closed Kinetic Chain Leg Press Performance
Authors: LaFree John , Mozingo Amy , Worrell Teddy
Published: August 2016

The purposes of this study were to determine the relationship of isokinetic quadriceps and hip extensor peak torque to isokinetic leg press peak torque and to determine the influence of hip position (seated vs. supine) on leg press peak torque. Forty subjects (20 males and 20 females) were tested bilaterally on the isokinetic dynamometer. Subjects were tested during knee extension, hip extension, seated leg press, and supine leg press. Intraclass correlation coefficient and standard error of measurement values revealed acceptable reliability for all tests. An analysis of variance revealed significant dominant versus nondominant differences in all tests except hip extension. A repeated measures analysis of variance revealed no significant difference between seated and supine leg press peak torque. Finally, stepwise regression revealed a significant relationship between knee extension and leg press peak torques, with hip extension adding only minimally to the explained variance. These data suggest that knee extension and leg press peak torque assess similar muscle performance characteristics. Further research involving electromyographic analysis is recommended to determine the influence of other muscles on leg press force performance.