bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences, Hormone Fluctuations, Ankle Stability, and Dynamic Postural Control
Authors: Ericksen Hayley , Gribble Phillip A. 
Published: March 2017

Context:
Hormonal fluctuation as a risk factor in anterior cruciate ligament injury has been investigated with conflicting results. However, the influence of hormone fluctuations on ankle laxity and function has not been thoroughly examined.

Objective:
To examine the potential hormone contributions to ankle laxity and dynamic postural control during the preovulatory and postovulatory phases of the menstrual cycle using an ankle arthrometer and the Star Excursion Balance Test in healthy women. The cohort group consisted of male control participants.

Design:
Cohort study.

Setting:
Research laboratory.

Patients or Other Participants:
Twenty healthy women (age = 23.8 ± 6.50 years, height = 163.88 ± 8.28 cm, mass = 63.08 ± 12.38 kg) and 20 healthy men (age = 23.90 ± 4.15 years, height = 177.07 ± 7.60 cm, mass = 80.57 ± 12.20 kg).

Intervention(s):
Ankle stability was assessed with anterior-posterior and inversion-eversion loading. Dynamic postural control was assessed with the posteromedial reaching distance of the Star Excursion Balance Test.

Main Outcome Measure(s):
Female participants used ovulation kits for 3 months to determine the time of ovulation; during their preovulatory and postovulatory phases, they were tested in the laboratory with an ankle arthrometer and the Star Excursion Balance Test. Male participants were tested on similar dates as controls. For each dependent variable, a time by side by sex repeated-measures analysis of variance was performed. Statistical significance was set a priori at P &lt; .05.

Results:
For anterior-posterior laxity, a side main effect was noted (F1,38 = 10.93, P = .002). For inversion-eversion laxity, a sex main effect was seen (F1,38 = 10.75, P = .002). For the posteromedial reaching task, a sex main effect was demonstrated (F1,38 = 8.72, P = .005). No influences of time on the dependent variables were evident.

Conclusions:
Although women presented with more ankle inversion-eversion laxity and less dynamic postural control, hormonal fluctuations during the menstrual cycle (preovulatory compared with postovulatory) did not affect ankle laxity or dynamic postural control, 2 factors that are associated with ankle instability.
Limb Blood Flow After Class 4 Laser Therapy
Authors: Larkin Kelly A. , Martin Jeffrey S. , Zeanah Elizabeth H. , True Jerry M. , Braith Randy W. , Borsa Paul A. 
Published: March 2017

Context:
Laser therapy is purported to improve blood flow in soft tissues. Modulating circulation would promote healing by controlling postinjury ischemia, hypoxia, edema, and secondary tissue damage. However, no studies have quantified these responses to laser therapy.

Objective:
To determine a therapeutic dose range for laser therapy for increasing blood flow to the forearm.

Design:
Crossover study.

Setting:
Controlled laboratory setting.

Patients or Other Participants:
Ten healthy, college-aged men (age = 20.80 ± 2.16 years, height = 177.93 ± 3.38 cm, weight = 73.64 ± 9.10 kg) with no current history of injury to the upper extremity or cardiovascular conditions.

Intervention(s):
A class 4 laser device was used to treat the biceps brachii muscle. Each grid point was treated for 3 to 4 seconds, for a total of 4 minutes. Each participant received 4 doses of laser therapy: sham, 1 W, 3 W, and 6 W.

Main Outcome Measure(s):
The dependent variables were changes in blood flow, measured using venous occlusion plethysmography. We used a repeated-measures analysis of variance to analyze changes in blood flow for each dose at 2, 3, and 4 minutes and at 1, 2, 3, 4, and 5 minutes after treatment. The Huynh-Feldt test was conducted to examine differences over time.

Results:
Compared with baseline, blood flow increased over time with the 3-W treatment (F3,9 = 3.468, P &lt; .011) at minute 4 of treatment (2.417 ± 0.342 versus 2.794 ± 0.351 mL/min per 100 mL tissue, P = .032), and at 1 minute (2.767 ± 0.358 mL/min per 100 mL tissue, P &lt; .01) and 2 minutes (2.657 ± 0.369 mL/min per 100 mL tissue, P = .022) after treatment. The sham, 1-W, and 6-W treatment doses did not change blood flow from baseline at any time point.

Conclusions:
Laser therapy at the 3-W (360-J) dose level was an effective treatment modality to increase blood flow in the soft tissues.
Left Ventricle Fibrosis Associated With Nonsustained Ventricular Tachycardia in an Elite Athlete: Is Exercise Responsible? A Case Report
Authors: Poussel Mathias , Djaballah Karim , Laroppe Julien , Brembilla-Perrot Béatrice , Marie Pierre-Yves , Chenuel Bruno 
Published: March 2017

Objective:
To emphasize the potentially harmful effects of high-intensity exercise on cardiac health and the fine line between physiologic and pathologic adaptation to chronic exercise in the elite athlete. This case also highlights the crucial need for regular evaluation of symptoms that suggest cardiac abnormality in athletes.

Background:
Sudden cardiac death (SCD) of young athletes is always a tragedy because they epitomize health. However, chronic, high-intensity exercise sometimes has harmful effects on cardiac health, and pathologic changes, such as myocardial fibrosis, have been observed in endurance athletes. In this case, a highly trained 30-year-old cyclist reported brief palpitations followed by presyncope feeling while exercising. Immediate investigations revealed nonsustained ventricular tachycardia originating from the left ventricle on a stress test associated with myocardial fibrosis of the left ventricle as shown with magnetic resonance imaging. Despite complete cessation of exercise, life-threatening arrhythmia and fibrosis persisted, leading to complete restriction from competition.

Differential Diagnosis:
Hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, myocarditis, postmyocarditis, use of drugs and toxic agents, doping, and systemic disease.

Treatment:
The arrhythmia could not be treated with catheter ablation procedure or drug suppression. Therefore, the athlete was instructed to withdraw completely from sport participation and to have a medical follow-up twice each year.

Uniqueness:
To our knowledge, no other report of left ventricle exercise-induced fibrosis associated with life-threatening arrhythmia in a living young elite athlete exists. Only postmortem evidence supports such myocardial pathologic adaptation to exercise.

Conclusions:
To prevent SCD in young athletes, careful attention must be paid to exercise-related symptoms that suggest a cardiac abnormality because they more often are linked to life-threatening cardiovascular disease.
Hydration Behaviors Before and After an Educational and Prescribed Hydration Intervention in Adolescent Athletes
Authors: Cleary Michelle A. , Hetzler Ronald K. , Wasson Darcy , Wages Jennifer J. , Stickley Christopher , Kimura Iris F. 
Published: March 2017

Context:
The effectiveness of education in modifying hydration behaviors in adolescent athletes is unclear.

Objective:
To assess the hydration status and behaviors of female athletes before and after a 1-time educational intervention and prescribed hydration intervention in a warm, humid, tropical environment.

Design:
Cohort study.

Setting:
Non–air-conditioned gymnasium in a tropical environment (indoor wet bulb globe temperature  =  24.0 ± 0.2°C).

Patient or Other Participants:
Thirty-six female adolescent elite volleyball players (age  =  14.8 ± 0.8 years, height  =  168.2 ± 8.2 cm, mass  =  60.8 ± 9.0 kg, body mass index  =  21.7 ± 2.7, body surface area  =  1.65 ± 0.14 m2, body surface area to mass ratio  =  2.71 ± 0.18 m2·kg−1·10−2) participated.

Intervention(s):
Four observational periods consisting of 3 practices per observational period separated by 48 hours. The 4 periods included a control period, educational intervention, prescribed hydration intervention (PHI), and observational follow-up (OF-U). After the control period, an educational intervention consisting of a slide presentation was provided to the participants, followed by a week of observation. In the PHI, a precalculated volume of water based on individual sweat rate was consumed every 20 minutes during each 2-hour practice. During all other periods, participants consumed their fluid of choice ad libitum. The order of the treatment periods was not randomized and was the same for all participants.

Main Outcome Measure(s):
Prepractice to postpractice changes in body mass (ΔBM), percentage of body mass lost (%BML), urine specific gravity, urine color, urine osmolality, sweat rate, and volume of fluid consumed (Fvol).

Results:
The PHI was the only period during which participants maintained body mass (ΔBM  =  0.05 ± 1.3%); Fvol consumed was greatest during this time (Fvol  =  1.3 ± 0.4 L; F1,3  =  34.869, P ≤ .001). The ΔBM was less for the PHI (ΔBM  =  0.05 ± 0.9 kg, %BML  =  0.04 ± 1.3%) than the OF-U period (ΔBM  =  −0.7 ± 1.1 kg, %BML  =  −1.2 ± 1.9%; F1,3  =  6.220, P  =  .01). The Fvol (1.3 ± 0.4 L) and percentage of fluid consumed (143.7 ± 110.8%) to restore sweat loss for the PHI period were higher than for any other period (F1,3  =  34.869, P ≤ .001). None of the participants experienced serious dehydration in any of the conditions.

Conclusions:
A 1-time education session alone was not successful in changing hydration behaviors. However, prescribing individualized hydration protocols improved hydration for adolescents exercising in a warm, humid environment.
Ankle Strength and Force Sense After a Progressive, 6-Week Strength-Training Program in People With Functional Ankle Instability
Authors: Smith Brent I. , Docherty Carrie L. , Simon Janet , Klossner Joanne , Schrader John 
Published: March 2017

Context:
Although strength training is commonly used to rehabilitate ankle injuries, studies investigating the effects of strength training on proprioception have shown conflicting results.

Objective:
To determine the effects of a 6-week strength-training protocol on force sense and strength development in participants with functional ankle instability.

Design:
Randomized controlled clinical trial.

Setting:
University athletic training research laboratory.

Patients or Other Participants:
A total of 40 participants with functional ankle instability were recruited. They were randomly placed into a training group (10 men, 10 women: age  =  20.9 ± 2.2 years, height  =  76.4 ± 16.1 cm, mass  =  173.0 ± 7.9 kg) or control group (10 men, 10 women: age  =  20.2 ± 2.1 years, height  =  78.8 ± 24.5 cm, mass  =  173.7 ± 8.2 kg).

Intervention(s):
Participants in the training group performed strength exercises with the injured ankle 3 times per week for 6 weeks. The protocol consisted of a combination of rubber exercise bands and the Multiaxial Ankle Exerciser, both clinically accepted strengthening methods for ankle rehabilitation. The progression of this protocol provided increasingly resistive exercise as participants changed either the number of sets or resistance of the Thera-Band or Multiaxial Ankle Exerciser.

Main Outcome Measure(s):
A load cell was used to measure strength and force sense. Inversion and eversion strength was recorded to the nearest 0.01 N. Force-sense reproduction was measured at 2 loads: 20% and 30% of maximal voluntary isometric contraction.

Results:
Increases in inversion (F1,38  =  11.59, P &lt; 0.01, ηp2  =  0.23, power  =  0.91) and eversion (F1,38  =  57.68, P &lt; .01, ηp2  =  0.60, power  =  0.99) strength were found in the training group at the posttest when compared with the control group. No significant improvements were noted in force-sense reproduction for either group.

Conclusions:
Strength training at the ankle increased strength but did not improve force sense.
Glenohumeral Rotational Motion and Strength and Baseball Pitching Biomechanics
Authors: Hurd Wendy J. , Kaufman Kenton R. 
Published: March 2017

Context:
Addressing loss of shoulder range of motion and rotator cuff weakness in injury-prevention programs might be an effective strategy for preventing throwing arm injuries in baseball pitchers. However, the influence of these clinical measures on pitching biomechanics is unclear.

Objective:
To evaluate the relationships among clinical measures of shoulder rotational motion and strength and 3-dimensional pitching biomechanics and to evaluate the presence of coupling between the shoulder and the elbow during pitching to provide insight into the influence of clinical shoulder characteristics on elbow biomechanics.

Design:
Cross-sectional study.

Setting:
Biomechanics laboratory.

Patients or Other Participants:
A total of 27 uninjured male high school baseball pitchers (age  =  16 ± 1.1 years, height  =  183 ± 7 cm, mass  =  83 ± 12 kg).

Main Outcome Measure(s):
Clinical measures included shoulder internal- and external-rotation range of motion and peak isometric internal- and external-rotator strength. Three-dimensional upper extremity biomechanics were assessed as participants threw from an indoor pitching mound to a target at regulation distance. Linear regressions were used to assess the influence of clinical measures on the peak shoulder internal and external rotation moments and the peak elbow-adduction moment.

Results:
We found a positive relationship between clinically measured internal-rotator strength and shoulder external-rotation moment (R2  =  0.181, P  =  .04) during pitching. We also noted an inverse relationship between clinically measured external-rotation motion and the elbow-adduction moment (R2  =  0.160, P  =  .04) and shoulder internal-rotation moment (R2  =  0.250, P  =  .008) during pitching. We found a positive relationship between peak shoulder internal-rotation moment and the peak elbow-adduction moment (R2  =  0.815, P &lt; .001) during pitching.

Conclusions:
This study provides insight into the effects of shoulder strength and motion on pitching biomechanics and how these clinical measures might contribute to throwing arm injuries in the baseball pitcher. A relationship also was identified between peak shoulder and elbow moments in the throwing arm during pitching, providing biomechanical support for addressing clinical shoulder characteristics as a potential strategy for preventing elbow injury.
Trunk-Rotation Flexibility in Collegiate Softball Players With or Without a History of Shoulder or Elbow Injury
Authors: Aragon Veronica J. , Oyama Sakiko , Oliaro Scott M. , Padua Darin A. , Myers Joseph B. 
Published: March 2017

Context:
Throwing is a whole-body motion that requires the transfer of momentum from the lower extremity to the upper extremity via the trunk. No research to date examines the association between a history of shoulder or elbow injury and trunk flexibility in overhead athletes.

Objective:
To determine if injury history and trunk-rotation flexibility are associated and to compare trunk-rotation flexibility measured using 3 clinical tests: half-kneeling rotation test with the bar in the back, half-kneeling rotation test with the bar in the front, and seated rotation test in softball position players with or without a history of shoulder or elbow injury.

Design:
Cross-sectional design.

Setting:
University softball facilities.

Patients or Other Participants:
Sixty-five female National Collegiate Athletic Association Division I softball position players.

Intervention(s):
Trunk-rotation flexibility was measured with 3 clinical tests. Recent injury history was obtained using a questionnaire and verified by the certified athletic trainer.

Main Outcome Measure(s):
Binomial regression models were used to determine if injury history was associated with flexibility categories (high, normal, or limited tertiles) for each of the 6 (3 tests × 2 directions) trunk-rotation flexibility measures. Trunk-rotation flexibility measures from 3 clinical tests were compared between participants with and without a history of shoulder or elbow injury using analysis-of-variance models.

Results:
When measured using the half-kneeling rotation test with the bar in the back and the seated rotation test, injury history and forward trunk-rotation flexibility were associated. However, no mean group differences were seen in trunk-rotation flexibility between participants with and without a history of shoulder or elbow injury.

Conclusions:
Limited forward trunk-rotation flexibility may be a risk factor for shoulder or elbow injuries. However, further study is needed to confirm the study finding.
Recovery After High-Intensity Intermittent Exercise in Elite Soccer Players Using VEINOPLUS Sport Technology for Blood-Flow Stimulation
Authors: Bieuzen François , Pournot Hervé , Roulland Rémy , Hausswirth Christophe 
Published: March 2017

Context
Electric muscle stimulation has been suggested to enhance recovery after exhaustive exercise by inducing an increase in blood flow to the stimulated area. Previous studies have failed to support this hypothesis. We hypothesized that the lack of effect shown in previous studies could be attributed to the technique or device used.

Objective
To investigate the effectiveness of a recovery intervention using an electric blood-flow stimulator on anaerobic performance and muscle damage in professional soccer players after intermittent, exhaustive exercise.

Design
Randomized controlled clinical trial.

Setting
National Institute of Sport, Expertise, and Performance (INSEP).

Patients or Other Participants
Twenty-six healthy professional male soccer players.

Intervention(s)
The athletes performed an intermittent fatiguing exercise followed by a 1-hour recovery period, either passive or using an electric blood-flow stimulator (VEINOPLUS). Participants were randomly assigned to a group before the experiment started.

Main Outcome Measures(s)
Performances during a 30-second all-out exercise test, maximal vertical countermovement jump, and maximal voluntary contraction of the knee extensor muscles were measured at rest, immediately after the exercise, and 1 hour and 24 hours later. Muscle enzymes indicating muscle damage (creatine kinase, lactate dehydrogenase) and hematologic profiles were analyzed before and 1 hour and 24 hours after the intermittent fatigue exercise.

Results
The electric-stimulation group had better 30-second all-out performances at 1 hour after exercise (P = .03) in comparison with the passive-recovery group. However, no differences were observed in muscle damage markers, maximal vertical countermovement jump, or maximal voluntary contraction between groups (P &gt; .05).

Conclusions
Compared with passive recovery, electric stimulation using this blood-flow stimulator improved anaerobic performance at 1 hour postintervention. No changes in muscle damage markers or maximal voluntary contraction were detected. These responses may be considered beneficial for athletes engaged in sports with successive rounds interspersed with short, passive recovery periods.
A Comparison Between Performance on Selected Directions of the Star Excursion Balance Test and the Y Balance Test
Authors: Coughlan Garrett F. , Fullam Karl , Delahunt Eamonn , Gissane Conor , Caulfield Brian M. , Sci Med 
Published: March 2017

Context:
The Star Excursion Balance Test (SEBT) is a widely accepted method of assessing dynamic postural stability. The Y Balance Test (YBT) is a commercially available device for measuring balance that uses 3 (anterior, posteromedial, and posterolateral) of the 8 SEBT directions and has been advocated as a method for assessing dynamic balance. To date, no studies have compared reach performance in these tests in a healthy population.

Objective:
To determine whether any differences exist between reach distance performance for the anterior, posteromedial, and posterolateral directions of the SEBT and the YBT.

Design:
Descriptive laboratory study.

Setting:
University motion analysis laboratory.

Patients or Other Participants:
A total of 20 healthy active male participants (age = 22.50 ± 3.05 years, height = 1.78 ± 0.82 m, weight = 79.48 ± 11.32 kg, body mass index = 24.96 ± 2.56 kg/m2).

Intervention(s):
Participants carried out 3 trials in each reach direction on each leg on the SEBT and the YBT a minimum of 1 week apart.

Main Outcome Measure(s):
The means of the 3 trials in each direction on each leg on both tests were calculated. Data were collected after 4 practice trials in each direction. Paired t tests and Bland-Altman plots were used to compare reach distances between the SEBT and the YBT.

Results:
Participants reached farther in the anterior direction on the SEBT than on the YBT. No differences were observed in the posteromedial and posterolateral directions.

Conclusions:
Differing postural-control strategies may be used to complete these tasks. This finding has implications for the implementation and interpretation of these dynamic balance tests.
Expected Prevalence From the Differential Diagnosis of Anterior Knee Pain in Adolescent Female Athletes During Preparticipation Screening
Authors: Foss Kim D. Barber , Myer Gregory D. , Chen Stephen S. , Hewett Timothy E. 
Published: March 2017

Context
Anterior knee pain is a common disorder in female athletes with an undefined cause. The relative prevalence of specific patellofemoral disorders associated with anterior knee pain in adolescent females remains undetermined.

Objective
To determine the prevalence of specific patellofemoral disorders obtained using the differential diagnosis of anterior knee pain in adolescent female athletes during preparticipation screening.

Design
Descriptive epidemiology study.

Setting
Preparticipation screening evaluations at a county public school district in Kentucky.

Patients or Other Participants
A total of 419 unique middle and high school–aged female athletes.

Main Outcome Measure(s)
Participants were evaluated by physicians for anterior knee pain over 3 consecutive basketball seasons. Given the longitudinal nature of this study, some participants were tested longitudinally over multiple years.

Results
Over the course of 3 basketball seasons, 688 patient evaluations were performed. Of these, 183 (26.6%) were positive for anterior knee pain. A statistically significant difference was noted in the prevalence of anterior knee pain by school level, with 34.4% (n = 67) in high school–aged athletes versus 23.5% (n = 116) in middle school–aged athletes (P &lt; .05). In the 1376 knees evaluated, patellofemoral dysfunction was the most common diagnosis, with an overall prevalence of 7.3% (n = 100). The only diagnosis shown to be statistically different between age levels was Sinding-Larsen-Johansson disease or patellar tendinopathy, with 38 cases (9.7%) in high school–aged and 31 (3.1%) in middle school–aged athletes (P &lt; .05).

Conclusions
Anterior knee pain was present in 26.6% of the adolescent female athletes screened over 3 years. Symptoms of anterior knee pain likely persist after middle school–aged onset and reach peak prevalence during the high school years.