Search

Patellofemoral pain (PFP) is a common source of knee pain in active individuals, accounting for a large number of knee injuries examined in sports medicine clinics. As a chronic condition, PFP can affect mental health. However, this effect has not yet been studied in individuals with PFP. To determine how subjective physical and mental health measures in individuals with PFP differed from those measures in pain-free individuals. Case-control study. Laboratory. Volunteers for the study were 30 people with PFP (19 women, 11 men; age = 20.23 ± 3.32 years, height = 166.69 ± 6.41 cm, mass = 69.55 ± 13.15 kg) and 30 matched pain-free individuals (19 women, 11 men; age = 20.33 ± 3.37 years, height = 169.31 ± 9.30 cm, mass = 64.02 ± 11.00 kg). Current and worst pain levels in the past 24 hours were determined using a visual analog scale (VAS). The Anterior Knee Pain Scale, Fear Avoidance Belief Questionnaire, and Lower Extremity Functional Scale were administered. Physical and mental health measures were obtained using a modified 12-item Short Form Health Survey. Scores for 2 subscales on the modified Short Form-12 were weighted and calculated: physical component and mental component. Independent t tests were calculated to compare variables between groups. Coefficient correlations were used to measure the associations between the variables. Individuals with PFP reported lower levels of physical (pain free: 56.13 ± 1.63, PFP: 50.54 ± 7.10, P <.001) and mental (pain-free: 53.32 ± 4.71, PFP: 48.64 ± 10.53, P =.03) health. In the PFP group, we found moderate negative correlations between the VAS score for current pain and mental health (r = −0.52, P <.01) and between the VAS score for worst pain in the past 24 hours and mental health (r = −0.46, P =.01) and between activity limitations in individuals with PFP and fear avoidance beliefs (r = −0.61, P <.01). Our results should encourage clinicians, especially musculoskeletal rehabilitation professionals, to acknowledge the importance of a whole-person approach when treating or planning rehabilitation programs for individuals with PFP. [ABSTRACT FROM AUTHOR]

Hip strength may influence the energy flow through the kinematic chain during baseball pitching, affecting athlete performance as well as the risk for injury. To identify associations between hip strength and pitching biomechanics in adolescent baseball pitchers during 3 key events of the pitching cycle. Cross-sectional study. Biomechanics laboratory. A total of 26 adolescent male baseball pitchers (age = 16.1 ± 0.8 years, height = 184.29 ± 5.5 cm, mass = 77.5 ± 8.5 kg). The main outcome measure was hip strength (external rotation, internal rotation, flexion, abduction, adduction, and extension). After strength measurements were acquired, motion capture was used to obtain a full-body biomechanical analysis at 3 events during the pitching cycle (foot contact, maximal external rotation, and ball release). We then evaluated these values for associations between hip strength and pitching biomechanics. Scatterplots were examined for linearity to identify an appropriate correlation test. The associations were linear; thus, 2-tailed Pearson correlation coefficients were used to determine correlations between biomechanical metrics. An α level of.01 was chosen. Ten strong correlations were found between pitching biomechanics and hip strength: 8 correlations between hip strength and kinematics at key points during the pitch and 2 correlations of hip strength with peak elbow-varus torque. Several correlations were noted between lower extremity strength and pitching biomechanics. This information provides data that may be used to improve performance or reduce injury (or both) in pitchers. Increased hip strength in adolescent pitchers may both improve performance and decrease the risk of injury. [ABSTRACT FROM AUTHOR]

Traditional nonweight-bearing (NWB) hip-strength assessments may not directly translate to functional strength during weight-bearing (WB) activity. How NWB assessments of hip muscle strength compare with WB assessments in various positions is currently unknown. To determine the magnitude of the differences and correlations between NWB hip strength and WB functional strength during the squatting and lunge (LNG) positions in female athletes. Crossover design. Laboratory. Female athletes (N = 51, age = 16.2 ± 3.5 years, height = 161.5 ± 8.3 cm, mass = 58.3 ± 11.6 kg). Isometric resistance (N/kg) was determined for the dominant and nondominant limbs via WB assessments (squat-bilateral [legs tested simultaneously], squat-unilateral, and lunge positions) and NWB assessments (hip external rotation [HER], hip extension [HEXT], and hip abduction [HAB]). To compare differences between positions (P ≤.05), we used effect sizes (d) and matched-pairs t tests, and we calculated Pearson r and R2 values. During the squat-bilateral on the dominant limb, females produced the most hip torque (6.13 ± 1.12 N/kg). The magnitudes of differences were very large compared with HER (3.96 ± 0.83, d = 2.2), HEXT (3.22 ± 0.69, d = 3.2), and HAB (3.80 ± 1.01, d = 2.2; all P values ≤.01), and positions were moderately correlated (r = 0.347–0.419, R2 = 0.12–0.18). The lunge position produced the least amount of torque in the dominant limb (2.44 ± 0.48 N/kg) compared with HER (d = −2.3), HEXT (d = −1.3), and HAB (d = −1.7; all P values ≤.001), and correlations were small to moderate (r = 0.236–0.310, R2 = 0.06–0.10). Strength in WB positions was different than strength evaluated using traditional NWB assessments in female athletes. Weight-bearing tests may provide clinicians with additional information regarding strength and function. [ABSTRACT FROM AUTHOR]

Context: Recent employment data from collegiate athletic training settings have demonstrated departure trends among men and women. These trends have been hypothesized to be related to work-life balance. However, work-life balance is only 1 aspect of a myriad of factors. Due to the complex nature of the work-life interface, a multilevel examination is needed to better understand the precipitators of departure. Objective: To quantitatively examine factors that may influence collegiate athletic trainers' (ATs') job satisfaction and career intentions via a multilevel examination of the work-life interface. Design: Cross-sectional study. Setting: Web-based questionnaire. Patients or Other Participants: Athletic trainers employed in National Collegiate Athletic Association Division I, II, or III or National Association of Intercollegiate Athletics colleges or universities (N =299: 56.5% female, 43.5% male). The average age of participants was 33.6±8.3 years, and their average experience was 10.3±7.6 years. Data Collection and Analysis: Participants responded to an online questionnaire consisting of demographic questions, 9 Likert-scale surveys, and open-ended questions. Job-satisfaction Scores (JSSs) and intention-to-leave scores (ITLSs) served as the dependent variables and factors from individual, organizational, and sociocultural levels were the independent variables. Hierarchical regression analysis was run to determine the predictability of factors. Results: No sex differences in ITLS or JSS were found in our sample. Independent variables explained 68.5% of the variance in JSS and 28.8% of the variance in ITLS. Additions of factor levels increased the percentage of explained variance in both scores. Conclusions: A combination of individual-, organizational-, and sociocultural-level factors was able to best predict JSS and ITLS among collegiate ATs. [ABSTRACT FROM AUTHOR]

Context: Increased pitch volume and altered glenohumeral (GH) and hip range of motion (ROM) and strength contribute to injury risk in baseball pitchers. Although these factors affect one another, whether they are related is unknown. Objective: To examine relationships among cumulative and seasonal pitch volume, ROM, and strength of the GH and hip joints in youth baseball pitchers. Design: Cross-sectional study. Setting: Baseball practice facilities. Patients or Other Participants: A total of 28 healthy baseball pitchers (age = 13.9 ± 2.9 years). Main Outcome Measure(s): A demographic and pitching questionnaire was used to quantify pitch volume. Glenohumeral internal-rotation (IR) and external-rotation (ER) ROM and strength of the throwing arm; total arc of motion (IR + ER ROM); and bilateral hip IR, ER, and total arc of motion ROM and strength in IR, ER, and abduction were measured. A goniometer was used to assess ROM; a handheld dynamometer, to assess strength. Frequency analyses and bivariate correlations (age covariate) described data and identified relationships. Results: Correlations between years of competitive play and increased strength in lead-leg hip IR (r =0.52, P = .02) and abduction (r=0.48, P=.04) and stance-leg hip IR (r=0.45, P= .05) were fair to good. The number of months played in the last year had a fair correlation with decreased GH IR strength (r = -0.39, P = .04) and increased stance-leg hip IR strength (r = 0.44, P = .05). Limited pitch time had a fair correlation with increased GH ER ROM (r = 0.40, P = .04) and an excellent correlation with increased lead-leg hip IR ROM (r = 0.79, P < .001). Increased innings pitched per game had a fair to good correlation with decreased GH IR strength (r =-0.41, P = .04) and stance-leg hip ER ROM (r =-0.53, P = .03). More pitches per game had a fair to good correlation with increased GH ER ROM (r=0.44, P=.05) and decreased stance-leg hip ER ROM (r =-0.62, P = .008). Conclusions: The significant relationships identified in this study suggest the need to further examine youth and adolescent cumulative and seasonal pitch guidelines. [ABSTRACT FROM AUTHOR]

Context: Diminished hip-abductor strength has been suggested to increase the risk of noncontact lateral ankle sprains. Objective: To determine prospectively whether baseline hip-abductor strength predicts future noncontact lateral ankle sprains in competitive male soccer players. Design: Prospective cohort study. Setting: Athletic training facilities and various athletic fields. Patients or Other Participants: Two hundred ten competitive male soccer players. Main Outcome Measure(s): Before the start of the sport season, isometric hip-abductor strength was measured bilaterally using a handheld dynamometer. Any previous history of ankle sprain, body mass index, age, height, and weight were documented. During the sport season (30 weeks), ankle injury status was recorded by team medical providers. Injured athletes were further classified based on the mechanism of injury. Only data from injured athletes who sustained noncontact lateral ankle sprains were used for analysis. Postseason, logistic regression was used to determine whether baseline hip strength predicted future noncontact lateral ankle sprains. A receiver operating characteristic curve was constructed for hip strength to determine the cutoff value for distinguishing between high-risk and low-risk outcomes. Results: A total of 25 noncontact lateral ankle sprains were confirmed, for an overall annual incidence of 11.9%. Baseline hip-abductor strength was lower in injured players than in uninjured players (P = .008). Logistic regression indicated that impaired hip-abductor strength increased the future injury risk (odds ratio = 1.10 [95% confidence interval = 1.02, 1.18], P = .010). The strength cutoff to define high risk was -33.8% body weight, as determined by receiver operating characteristic curve analysis. For athletes classified as high risk, the probability of injury increased from 11.9% to 26.7%. Conclusions: Reduced isometric hip-abductor strength predisposed competitive male soccer players to noncontact lateral ankle sprains. [ABSTRACT FROM AUTHOR]

Context: Spinal axial rotation is required for many functional and sporting activities. Eighty percent of axial rotation occurs in the thoracic spine. Existing measures of thoracic spine rotation commonly involve laboratory equipment, use a seated position, and include lumbar motion. A simple performance-based outcome measure would allow clinicians to evaluate isolated thoracic spine rotation. Currently, no valid measure exists. Objective: To explore the criterion and concurrent validity of a digital inclinometer (DI) and iPhone Clinometer app (iPhone) for measuring thoracic spine rotation using the heel-sit position. Design: Controlled laboratory study. Setting: University laboratory. Patients or Other Participants: A total of 23 asymptomatic healthy participants (14 men, 9 women; age = 25.82 ± 4.28 years, height = 170.26 ± 8.01 cm, mass = 67.50 ± 9.46 kg, body mass index = 23.26 ± 2.79) were recruited from a student population. Main Outcome Measure(s): We took DI and iPhone measurements of thoracic spine rotation in the heel-sit position concurrently with dual-motion analysis (laboratory measure) and ultrasound imaging of the underlying bony tissue motion (reference standard). To determine the criterion and concurrent validity, we used the Pearson product moment correlation coefficient (r, 2 tailed) and Bland-Altman plots. Results: The DI (r = 0.88, P < .001) and iPhone (r = 0.88, P < .001) demonstrated strong criterion validity. Both also had strong concurrent validity (r = 0.98, P < .001). Bland-Altman plots illustrated mean differences of 5.82° (95% confidence interval [CI] = 20.37°, -8.73°) and 4.94° (95% CI = 19.23°, -9.35°) between the DI and iPhone, respectively, and the reference standard and 0.87° (95% CI = 6.79°, -5.05°) between the DI and iPhone. Conclusions: The DI and iPhone provided valid measures of thoracic spine rotation in the heel-sit position. Both can be used in clinical practice to assess thoracic spine rotation, which may be valuable when evaluating thoracic dysfunction. [ABSTRACT FROM AUTHOR]

Context: Concussions in student-athletes are a serious problem. Most states have enacted legislation mandating concussion education for student-athletes, under the assumption that education leads to better self-reporting of concussions and improved knowledge of symptoms. Objectives: (1) To determine the effect of state-based concussion legislation on the proportion of student-athletes receiving concussion education and to assess the moderation of this effect by gender and sport and (2) to assess the effect of concussion education on student-athletes' knowledge of concussion symptoms and likelihood of seeking treatment after a concussion. Design: Cross-sectional study. Setting: Private university. Patients or Other Participants: A total of 249 National Association of Intercollegiate Athletics collegiate athletes attending St Xavier University; 160 were surveyed prelegislation and 89 were surveyed postlegislation. Main Outcome Measure(s): Participants completed an anonymous survey that assessed previous involvement in concussion-education programs, degree of self-reporting after a concussion, and ability to enumerate symptoms. Results: The number of athletes who reported having received education increased after the implementation of concussion legislation; however, almost 25% still reported not having received education. Athletes who played football were more likely to report having received education than those who played volleyball. The student-athletes' ability to name a diversity of concussion symptoms or to report seeking medical attention after a concussion did not improve in the postlegislation period relative to the prelegislation period. Conclusions: Legislation has been passed in all 50 states to address concussions in student-athletes; however, improvements are still needed. Concussion education must be delivered in a uniform, effective manner to all student-athletes across sports and genders. Concussion education should emphasize the diversity of symptoms, especially cognitive and behavioral symptoms. We must develop and disseminate evidence-based educational programs that are clinically proven to be effective in improving athletes' knowledge and behaviors. [ABSTRACT FROM AUTHOR]

Context: Researchers have identified high exposure to game conditions, low back dysfunction, and poor endurance of the core musculature as strong predictors for the occurrence of sprains and strains among collegiate football players. Objective: To refine a previously developed injury-prediction model through analysis of 3 consecutive seasons of data. Design: Cohort study. Setting: National Collegiate Athletic Association Division I Football Championship Subdivision football program. Setting: National Collegiate Athletic Association Division I Football Championship Subdivision football program. Main Outcome Measure(s): Associations between preseason measurements and the subsequent occurrence of a core or lower extremity sprain or strain were established for 256 playerseasons of data. We used receiver operating characteristic analysis to identify optimal cut points for dichotomous categorizations of cases as high risk or low risk. Both logistic regression and Cox regression analyses were used to identify a multivariable injury-prediction model with optimal discriminatory power. Results: Exceptionally good discrimination between injured and uninjured cases was found for a 3-factor prediction model that included equal to or greater than 1 game as a starter, Oswestry Disability Index score equal to or greater than 4, and poor wall-sit--hold performance. The existence of at least 2 of the 3 risk factors demonstrated 56% sensitivity, 80% specificity, an odds ratio of 5.28 (90% confidence interval = 3.31, 8.44), and a hazard ratio of 2.97 (90% confidence interval = 2.14, 4.12). Conclusions: High exposure to game conditions was the dominant injury risk factor for collegiate football players, but a surprisingly mild degree of low back dysfunction and poor coremuscle endurance appeared to be important modifiable risk factors that should be identified and addressed before participation. [ABSTRACT FROM AUTHOR]

Context: No researchers, to our knowledge, have investigated the immediate postinjury-movement strategies associated with acute first-time lateral ankle sprain (LAS) as quantified by center of pressure (COP) and kinematic analyses during performance of the Star Excursion Balance Test (SEBT). Objective: To analyze the kinematic and COP patterns of a group with acute first-time LAS and a noninjured control group during performance of the SEBT. Design: Case-control study. Setting: University biomechanics laboratory. Patients or Other Participants: A total of 81 participants with acute first-time LAS (53 men, 28 women; age = 23.22 ± 4.93 years, height = 1.73 ± 0.09 m, mass = 75.72 ± 13.86 kg) and 19 noninjured controls (15 men, 4 women; age = 22.53 ± 1.68 years, height = 1.74 ± 0.08 m, mass = 71.55 ± 11.31 kg). Intervention: Participants performed the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the SEBT. Main Outcome Measure(s): We assessed 3-dimensional kinematics of the lower extremity joints and associated fractal dimension (FD) of the COP path during performance of the SEBT. Results: The LAS group had decreased normalized reach distances in the ANT, PL, and PM directions when compared with the control group on their injured (ANT: 58.16% ± 6.86% versus 64.86% ± 5.99%; PL: 85.64% ± 10.62% versus 101.14% ± 8.39%; PM: 94.89% ± 9.26% versus 107.29 ± 6.02%) and noninjured (ANT: 60.98% ± 6.74% versus 64.76% ± 5.02%; PL: 88.95% ± 11.45% versus 102.36% ± 8.53%; PM: 97.13% ± 8.76% versus 106.62% ± 5.78%) limbs (P < .01). This observation was associated with altered temporal sagittal-plane kinematic profiles throughout each reach attempt and at the point of maximum reach (P < .05). This result was associated with a reduced FD of the COP path for each reach direction on the injured limb only (P < .05). Conclusions: Acute first-time LAS was associated with bilateral deficits in postural control, as evidenced by the bilateral reduction in angular displacement of the lower extremity joints and reduced reach distances and FD of the COP path on the injured limb during performance of the SEBT. [ABSTRACT FROM AUTHOR]

Context: The ability to generate, absorb, and transmit forces through the proximal segments of the pelvis, spine, and trunk has been proposed to influence sport performance, yet traditional training techniques targeting the proximal segments have had limited success improving sport-specific performance. Objective: To investigate the effects of a traditional endurance- training program and a sport-specific power-training program targeting the muscles that support the proximal segments and throwing velocity. Design: Randomized controlled clinical trial. Setting: University research laboratory and gymnasium. Patients or Other Participants: A total of 46 (age = 20 ± 1.3 years, height = 175.7 ± 8.7 cm) healthy National Collegiate Athletic Association Division III female softball (n = 17) and male baseball (n = 29) players. Intervention(s): Blocked stratification for sex and position was used to randomly assign participants to 1 of 2 training groups for 7 weeks: a traditional endurance-training group (ET group; n = 21) or a power-stability-training group (PS group; n = 25). Mean Outcome Measure(s): The change score in peak throwing velocity (km/h) normalized for body weight (BW; kilograms) and change score in tests that challenge the muscles of the proximal segments normalized for BW (kilograms). We used 2-tailed independent-samples t tests to compare differences between the change scores. Results: The peak throwing velocity (ET group = 0.01 ± 0.1 km/h/kg of BW, PS group = 0.08 ± 0.03 km/h/kg of BW; P < .001) and muscle power outputs for the chop (ET group = 0.22 ± 0.91 W/kg of BW, PS group = 1.3 ± 0.91 W/kg of BW; P < .001) and lift (ET group = 0.59 ± 0.67 W/kg of BW, PS group = 1.4 ± 0.87 W/kg of BW; P < .001) tests were higher at postintervention in the PT than in the ET group. Conclusions: An improvement in throwing velocity occurred simultaneously with measures of muscular endurance and power after a sport-specific training regimen targeting the proximal segments. [ABSTRACT FROM AUTHOR]

Context: Self-report questionnaires are an important method of evaluating lifespan health, exercise, and health-related quality of life (HRQL) outcomes among elite, competitive athletes. Few instruments, however, have undergone formal characterization of their psychometric properties within this population. Objective: To evaluate the validity and reliability of a novel health and exercise questionnaire, the Trojan Lifetime Champions (TLC) Health Survey. Design: Descriptive laboratory study. Setting: A large National Collegiate Athletic Association Division I university. Patients or Other Participants: A total of 63 university alumni (age range, 24 to 84 years), including former varsity collegiate athletes and a control group of nonathletes. Intervention(s): Participants completed the TLC Health Survey twice at a mean interval of 23 days with randomization to the paper or electronic version of the instrument. Main Outcome Measure(s): Content validity, feasibility of administration, test-retest reliability, parallel-form reliability between paper and electronic forms, and estimates of systematic and typical error versus differences of clinical interest were assessed across a broad range of health, exercise, and HRQL measures. Results: Correlation coefficients, including intraclass correlation coefficients (ICCs) for continuous variables and K agreement statistics for ordinal variables, for test-retest reliability averaged 0.86, 0.90, 0.80, and 0.74 for HRQL, lifetime health, recent health, and exercise variables, respectively. Correlation coefficients, again ICCs and K, for parallel-form reliability (ie, equivalence) between paper and electronic versions averaged 0.90, 0.85, 0.85, and 0.81 for HRQL, lifetime health, recent health, and exercise variables, respectively. Typical measurement error was less than the a priori thresholds of clinical interest, and we found minimal evidence of systematic testretest error. We found strong evidence of content validity, convergent construct validity with the Short-Form 12 Version 2 HRQL instrument, and feasibility of administration in an elite, competitive athletic population. Conclusions: These data suggest that the TLC Health Survey is a valid and reliable instrument for assessing lifetime and recent health, exercise, and HRQL, among elite competitive athletes. Generalizability of the instrument may be enhanced by additional, larger-scale studies in diverse populations. [ABSTRACT FROM AUTHOR]

Context: As evidence-based practice (EBP) becomes a necessity in athletic training, Web-based modules have been developed and made available to the National Athletic Trainers' Association membership as a mechanism to educate athletic trainers (ATs) on concepts of EBP. Objective: To assess the effect of an educational intervention on enhancing knowledge of EBP among ATs. Design: Randomized controlled trial. Setting: Web-based modules and knowledge assessment. Patients or Other Participants: A total of 164 of 473 ATs (34.7% response rate), including professional athletic training students, graduate students, clinical preceptors, educators, and clinicians, were randomized into a control group (40 men, 42 women) or experimental group (33 men, 49 women). Intervention(s): Ten Web-based modules were developed that covered concepts involved in the EBP process. Both groups completed the Evidence-Based Practice Knowledge Assessment before and after the intervention phase. During the intervention phase, the experimental group had access to the Web-based modules for 4 weeks, whereas the control group had no direct responsibilities for the investigation. The knowledge assessment consisted of 60 multiple choice questions pertaining to concepts presented in the 10 modules. Test-retest reliability was determined to be good (intraclass correlation coefficient [2,1] = 0.726, 95% confidence interval = 0.605, 0.814). Main Outcome Measure(s): Independent variables consisted of group (control, experimental) and time (preassessment, postassessment). Knowledge scores were tabulated by awarding 1 point for each correct answer (maximum = 60). Between-group and within-group differences were calculated using a 2 3 2 repeated-measures analysis of variance (P ≤ .05), post hoc t tests, and Hedges g effect size with 95% confidence intervals. Results: We found a group 3 time interaction (F1,162 = 26.29, P < .001). No differences were identified between the control (30.12 ± 5.73) and experimental (30.65 ± 5.93) groups during the preassessment (t162 = 0.58, P = .84). The experimental group (36.35 6 8.58) obtained higher scores on the postassessment than the control group (30.99 ± 6.33; t162 = 4.55, P = .01). No differences were identified among time instances within the control group (t81 =1.77, P=.08); however, the experimental group obtained higher scores on the postassessment than the preassessment (t81 = 7.07, P < .001). Conclusions: An educational intervention consisting of 10 Web-based modules was an effective mechanism to increase knowledge of foundational EBP concepts among ATs. However, it is not known whether ATs are integrating EBP into daily clinical practice. Researchers should determine whether increased knowledge of EBP affects the daily clinical decision making of ATs. [ABSTRACT FROM AUTHOR]

Context: This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain. Objective: To examine ankle-complex motion and stiffness in a group of athletes with reported history of lateral ankle sprain. Design: Cross-sectional study. Setting: University research laboratory. Patients or Other Participants: Twenty-five female college athletes (age = 19.4 ± 1.4 years, height = 170.2 ± 7.4 cm, mass = 67.3 ± 10.0 kg) with histories of unilateral ankle sprain. Intervention(s): All ankles underwent loading with an ankle arthrometer. Ankles were tested bilaterally. Main Outcome Measure(s): The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Results: Anterior displacement of the ankle complex did not differ between the uninjured and sprained ankles (P = .37), whereas ankle-complex rotation was greater for the sprained ankles (P = .03). The sprained ankles had less anterior and inversion end-range stiffness than the uninjured ankles (P < .01). Conclusions: Changes in ankle-complex laxity and end-range stiffness were detected in ankles with histories of sprain. These results indicate the presence of altered mechanical characteristics in the soft tissues of the sprained ankles. [ABSTRACT FROM AUTHOR]

Context: Chronic ankle instability (CAI) is characterized by repeated ankle sprains, which have been linked to postural instability. Therefore, it is important for clinicians to identify individuals with CAI who can benefit from rehabilitation. Objective: To assess the likelihood that CAI participants will exhibit impaired postural stability and that healthy control participants will exhibit better test performance values. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: People with CAI (n = 17, age = 23 ± 4 years, height = 168 ± 9 cm, weight = 68 ± 12 kg) who reported ankle "giving-way" sensations and healthy volunteers (n = 17, age = 23 ± 3 years, height = 168 ± 8 cm, weight = 66 ± 12 kg). Intervention(s): Participants performed 7 balance tests: Balance Error Scoring System (BESS), time in balance, foot lift, single-legged stance on a force plate, Star Excursion Balance Test, side hop, and figure-of-8 hop. Main Outcome Measure(s): Balance was quantified with errors (score) for the BESS, length of time balancing (seconds) for time-in-balance test, frequency of foot lifts (score) for foot-lift test, velocity (cm/s) for all center-of-pressure velocity measures, excursion (cm) for center-of-pressure excursion measures, area (cm²) for 95% confidence ellipse center-of-pressure area and center-of-pressure rectangular area, time (seconds) for anterior-posterior and medial-lateral time-to-boundary (TTB) measures, distance reached (cm) for Star Excursion Balance Test, and time (seconds) to complete side-hop and figure-of-8 hop tests. We calculated area-under-the-curve values and cutoff scores and used the odds ratio to determine if those with and without CAI could be distinguished using cutoff scores. Results: We found significant area-under-the-curve values for 4 static noninstrumented measures, 3 force-plate measures, and 3 functional measures. Significant cutoff scores were noted for the time-in-balance test (≤25.89 seconds), foot-lift test (≥5), single-legged stance on the firm surface (3 errors) and total (≥14 errors) on the BESS, center-of-pressure resultant velocity (≥1.56 cm/s), standard deviations for medial-lateral (≤1.56 seconds) time-to-boundary and anterior-posterior (≤3.78 seconds) time-to-boundary test, posteromedial direction on the Star Excursion Balance Test (≤0.91), side-hop test (≥12.88 seconds), and figure-of-8 hop test (≥17.36 seconds). Conclusions: Clinicians can use any of the 10 significant measures with their associated cutoff scores to identify those who could benefit from rehabilitation that reestablishes postural stability. [ABSTRACT FROM AUTHOR]

The article discusses a study to compare Pediatric Quality of Life Generic Core Scale (PedsQL) scores between adolescent athletes (ATH) and general, healthy adolescents (GEN). The study concluded that the ATH group scored higher than the GEN group for total and psychosocial summary scores, emotional and social functioning subscale scores, and physical functioning. Adolescent ATH also reported better health-related quality of life (HRQOL) than GEN, particularly in emotional functioning.

The article reports a study which examined injury risk factors of strength and jump biomechanics in elite and recreational female youth soccer players. The results revealed that elite players were similar to recreational players in all measures of hip and knee strength, vertical jump height, and normalized knee separation. This suggests that recommendations generated from research with elite youth soccer players could be generalized to recreational players.

The article discusses a study evaluating variations in corticomotor excitability of the fibularis longus (FL) between individuals with unilateral chronic ankle instability (CAI) and matched control participants without CAI. Participants included 10 people with CAI, of which 6 were women and 4 men. The study found higher resting motor threshold (RMTs) indicate deficits in FL corticomotor excitability in people with CAI and cortical excitability deficits may lead to altering function.

The article presents the findings of a case-control study which examines the effect of 2 weeks of abdominal draw-in maneuver (ADIM) and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with low back pain (LBP). The study showed an interaction between the LBP and control groups. It revealed that cocontraction of the ankle dorsiflexors with ADIM training might result in associated pain management in LBF patients.

Context: Poor core stability is believed to increase vulnerability to uncontrolled joint displacements throughout the kinetic chain between the foot and the lumbar spine. Objective: To assess the value of preparticipation measurements as predictors of core or lower extremity strains or sprains in collegiate football players. Design: Cohort study. Setting: National Collegiate Athletic Association Division I Football Championship Subdivision football program. Patients or Other Participants: All team members who were present for a mandatory physical examination on the day before preseason practice sessions began (n = 83). Main Outcome Measure(s): Preparticipation administration of surveys to assess low back, knee, and ankle function; documentation of knee and ankle injury history; determination of body mass index; 4 different assessments of core muscle endurance; and measurement of step-test recovery heart rate. All injuries were documented throughout the preseason practice period and 11-game season. Receiver operating characteristic analysis and logistic regression analysis were used to identify dichotomized predictive factors that best discriminated injured from uninjured status. The 75th and 50th percentiles were evaluated as alternative cutpoints for dichotomization of injury predictors. Results: Players with &2 of 3 potentially modifiable risk factors related to core function had 2 times greater risk for injury than those with <2 factors (95% confidence interval = 1.27,4.22), and adding a high level of exposure to game conditions increased the injury risk to 3 times greater (95% confidence interval = 1.95, 4.98). Prediction models that used the 75th and 50th percentile cutpoints yielded results that were very similar to those for the model that used receiver operating characteristic-derived cutpoints. Conclusions: Low back dysfunction and suboptimal endurance of the core musculature appear to be important modifiable football injury risk factors that can be identified on preparticipation screening. These predictors need to be assessed in a prospective manner with a larger sample of collegiate football players. [ABSTRACT FROM AUTHOR]