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Context: Understanding the factors that predict return to sport (RTS) after anterior cruciate ligament reconstruction facilitates clinical decision making. Objective: To develop a clinical decision algorithm that could predict RTS and non-RTS based on the differences in the variables after anterior cruciate ligament reconstruction. Design: Cross-sectional study. Setting: University laboratory. Patients or other participants: A total of 150 athletes in any sport involving deceleration, jumping, cutting, or turning enrolled in the study. All participants answered the International Knee Documentation Committee and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) questionnaires and performed balance and isokinetic tests. Main outcome measure(s): The classification and regression tree (CART) was used to determine the clinical decision algorithm associated with RTS at any level and RTS at the preinjury level. The diagnostic accuracy of the CART was verified. Results: Of the 150 participants, 57.3% (n = 86) returned to sport at any level and 12% (n = 18) returned to sport at the preinjury level. The interactions among the peak torque extension at 300°/s >93.55 Nm, ACL-RSI score >27.05 (P = .06), and postoperative time >7.50 months were associated with RTS at any level identified by CART and were factors associated with RTS. An ACL-RSI score >72.85% was the main variable associated with RTS at the preinjury level. The interaction among an ACL-RSI score of 50.40% to 72.85%, agonist : antagonist ratio at 300°/s ≤63.6%, and anteroposterior stability index ≤2.4 in these participants was the second factor associated with RTS at the preinjury level. Conclusions: Athletes who had more quadriceps strength tended to RTS at any level more quickly, even with less-than-expected psychological readiness. Regarding a return at the preinjury level, psychological readiness was the most important factor in not returning, followed by a better agonist : antagonist ratio and better balance. [ABSTRACT FROM AUTHOR]

* STUDY DESIGN: Cross-sectional study. * BACKGROUND: The Hip Stability Isometric Test (HipSIT) evaluates the strength of the hip posterolateral stabilizers in a position that favors greater activation of the gluteus maximus and gluteus medius and lower activation of the tensor fascia lata. * OBJECTIVES: To check the validity and reliability of the HipSIT and to evaluate the HipSIT in women with patellofemoral pain (PFP). * METHODS: The HipSIT was evaluated with a handheld dynamometer. During testing, the participants were sidelying, with their legs positioned at 45° of hip flexion and 90° of knee flexion. Participants were instructed to raise the knee of the upper leg while keeping the upper and lower heels in contact. To establish reliability and validity, 49 women were tested with the HipSIT by 2 different evaluators on day 1, and then again 7 days later. The strength of the hip extensors, abductors, and external rotators was also evaluated. Twenty women with unilateral PFP were also evaluated. * RESULTS: The HipSIT has excellent intrarater and interrater reliability. The standard error of measurement was 0.01 kgf/kg, and the minimal detectable change was 0.036 kgf/kg. The HipSIT showed good validity in isolated hip abduction, external rotation, and extension (P<.01). Women with PFP showed a 10% deficit in the HipSIT results for the symptomatic limb (P = .01). * CONCLUSION: The HipSIT showed excellent interrater and intrarater reliability, moderate to good validity in women, and was able to identify strength deficits in women with PFP. [ABSTRACT FROM AUTHOR]

Background: Running has been one of the main choices of physical activity in people seeking an active lifestyle. The Functional Movement Screen (FMS™) is a screening tool that aims to discern movement competency. Purpose: The purposes of this study were to compare biomechanical characteristics between two groups rated using the composite FMS™ score, and to analyze the influence of specific individual tests. The hypothesis was that the group that scored above 14 would demonstrate better performance on biomechanical tests than the group that scored below 14. Study Design: Cross-Sectional Study. Methods: Runners were screened using the FMS™ and were dichotomized into groups based on final score: Functional, where the subjects scored a 14 or greater (G≥14, n=16) and dysfunctional, when the subjects scored less than 14 (G< 14, n=16). All runners were evaluated using measures for flexibility, postural balance, muscle strength, knee dynamic valgus during forward step down test and time for the electromyographic response of the transversus abdominis and fibularis longus muscles. All data were analyzed with SPSS (p≤0.05) and the index of asymmetry (IS) was calculated with the mean score of nondominant limb divided by the mean score of the dominant limb, multiplied by 100. Results: There were no statistically significant differences in flexibility, muscle strength, knee dynamic valgus, or myoelectric response time of the transversus abdominis and long fibular muscles. Index of asymmetry (IS) of global stability was 3.26±26.79% in G≥14 and 31.72±52.69% in G<14 (p=0.02). In-line lunge and active straight-leg raise tests showed no significant difference between the groups (p>0.05). Conclusions: Overall, there were no biomechanical differences between the groups of runners as classified by the FMS™. In addition, in-line lunge and active strength-leg raise tests did not influence on the FMS™ final score. Level of Evidence: 2b [ABSTRACT FROM AUTHOR]

BACKGROUND: It is theorized that increased dynamic knee valgus relates to decreased hip posterolateral muscle strength. OBJECTIVE: The aim here was to assess the relationship between the frontal plane projection angle (FPPA) of the knee and hip and trunk muscle strength in women with and without patellofemoral pain (PFP). METHODS: The sample comprised 43 women: Patellofemoral Pain Group (PPG, n = 22) and Control Group (CG, n = 21). Muscle strength for hip abduction, extension, external rotation and lateral core were measured using a handheld dynamometer. The FPPA was recorded during step-down. RESULTS: The PPG showed a deficit for hip muscles torque and increased FPPA (P <0.05). Negative correlation of the FPPAPeak was found in the CG for the hip abductor (r = -0.31) and posterolateral complex (r = -0.32) (P <0.05). In the PPG, the FPPA-Peak showed a moderate negative correlation to the torque of external rotators and posterolateral hip muscles, although this correlation did not reach statistical significance. CONCLUSIONS: These findings suggest that women with patellofemoral pain present greater dynamic knee valgus and hip muscle weakness. Abductor and posterolateral hip muscles strength are associated with increased FPPA only in the pain-free population. [ABSTRACT FROM AUTHOR]

Background: Scales to assess the quality of life and return-to-sport after reconstruction of the anterior cruciate ligament (ACL) may help the clinical decision-making process. Objective: To cross-culturally adapt and determine the validity of the Brazilian versions of the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) and the Quality of Life Questionnaire (ACL-QoL). Methods: The process of translation and cross-cultural adaptation followed the recommendations of international guidelines. One hundred participants filled out the Brazilian versions of these instruments, the Tampa Scale for Kinesiophobia (TSK), the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and the 36-Item Short Form Health Survey (SF-36). The measurement properties of reliability, internal consistency and construct validity were measured. Results: The ACL-RSI and the ACL-QoL were successfully translated and cross-culturally adapted. Both questionnaires showed good test--retest reliability (ICC2,1 = 0.78, 95% CI = 0.67-0.85 for the ACL-RSI; and ICC2,1 = 0.84, 95% CI = 0.76-0.90 for the ACL-QoL) and good internal consistency (Cronbach's alpha = 0.87 for the ACL-RSI; and Cronbach's alpha = 0.96 for the ACL-QoL). A reasonable correlation was found between both questionnaires and the TSK, and a low to reasonable correlation was found between the questionnaires and the SF-36 in terms of validity. Compared to the IKDC Subjective Knee Evaluation Form, the ACL-RSI had a reasonable correlation and the ACL-QoL had a good correlation. Conclusion: The Brazilian versions of the ACL-RSI and the ACL-QoL have adequate measurement properties and may be used in assessing Brazilians after ACL reconstruction. [ABSTRACT FROM AUTHOR]

Background: Capoeira is a cultural practice with Brazilian roots that combines several elements including dance, fighting and body rhythm. Because of the diverse elements involved in its practice, capoeira is excellent at developing the physical and social abilities of its players. The aim of this study was to compare the biomechanical profile of muscle strength, plantar pressure distribution, and postural balance between players and non-players of capoeira. Methods: We evaluated 51 subjects who were allocated into two groups: capoeira group and control group. Subjects were evaluated using a baropodometer (Diasu®) and an isokinetic dynamometer (Biodex®). Results: When comparing plantar pressure distribution between groups and limbs, there were significant differences in mean load of forefoot (p=0.008) and total load (p=0.001). There were no significant differences between groups and limbs in balance and muscle strength; however, a significant difference was found in quadriceps torque peak (p=0.001) and agonist/antagonist ratio (p=0.001) when comparing these variables between the groups. Conclusion: Capoeira players displayed a tendency to have an asymmetric profile in plantar pressure distribution. No difference was found in balance between groups. Despite the fact that capoeira players showed increased strength of the quadriceps muscle, their agonist/antagonist ratio was more asymmetrical than the control group. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Background: Running has been one of the main choices of physical activity in people seeking an active lifestyle. The Functional Movement Screen (FMS™) is a screening tool that aims to discern movement competency., Purpose: The purposes of this study were to compare biomechanical characteristics between two groups rated using the composite FMS™ score, and to analyze the influence of specific individual tests. The hypothesis was that the group that scored above 14 would demonstrate better performance on biomechanical tests than the group that scored below 14., Study Design: Cross-Sectional Study., Methods: Runners were screened using the FMS™ and were dichotomized into groups based on final score: Functional, where the subjects scored a 14 or greater (G≥14, n = 16) and dysfunctional, when the subjects scored less than 14 (G < 14, n = 16). All runners were evaluated using measures for flexibility, postural balance, muscle strength, knee dynamic valgus during forward step down test and time for the electromyographic response of the transversus abdominis and fibularis longus muscles. All data were analyzed with SPSS ( p  ≤ 0.05) and the index of asymmetry (IS) was calculated with the mean score of nondominant limb divided by the mean score of the dominant limb, multiplied by 100., Results: There were no statistically significant differences in flexibility, muscle strength, knee dynamic valgus, or myoelectric response time of the transversus abdominis and long fibular muscles. Index of asymmetry (IS) of global stability was 3.26 ± 26.79% in G≥14 and 31.72 ± 52.69% in G<14 ( p  = 0.02). In-line lunge and active straight-leg raise tests showed no significant difference between the groups ( p  > 0.05)., Conclusions: Overall, there were no biomechanical differences between the groups of runners as classified by the FMS™. In addition, in-line lunge and active strength-leg raise tests did not influence on the FMS™ final score., Level of Evidence: 2b.