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Context: Piriformis syndrome is often associated with muscle spasms and shortening of the piriformis muscle (PM). Physical therapy, including static stretching of the PM, is one of the treatments for this syndrome. However, the effective stretching position ofthe PM is unclear in vivo. This study aimed to determine the effective stretching positions of the PM using ultrasonic shear wave elastography. Design: Observational study. Methods: Twenty-one healthy young men (22.7 [2.41 y) participated in this study. The shear elastic modulus of the PM was measured at 12 stretching positions using shear wave elastography. Three of the 12 positions were tested with maximum internal rotation at 0°, 20°, or 40° hip adduction in 90° hip flexion. Nine of the 12 positions were tested with maximum external rotation at positions combined with 3 hip-flexion angles (70°, 90°, and 110°) and 3 hip-adduction angles (0°, 20°, and 40°). Results.' The shear elastic modulus of the PM was significantly higher in the order of 40°, 20°, and 0° of adduction and higher in external rotation than in internal rotation. The shear elastic modulus of the PM was significantly greater in combined 110° hip flexion and 40° adduction with maximum external rotation than in all other positions. Conclusion.- This study revealed that the position in which the PM was most stretched was maximum external rotation with 110° hip ftexion and 40° hip adduction. [ABSTRACT FROM AUTHOR]

Context: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult . Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. Design: Cross-sectional study . Methods.· The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis . Floor and ceiling effects (< 15%) were also assessed. Results : Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1 -factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. Conclusions : Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS- TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes. [ABSTRACT FROM AUTHOR]

Context: Decreased trunk neuromuscular control is a risk factor for both upper- and lower-extremity injuries, yet there are few reliable and valid clinical tests to identify deficits. Objective: The purpose of this study was to determine the reliability and known-groups validity of a novel clinical test, the seated trunk control test (STCT). Design: Cross-sectional reliability and known-groups validity study. Setting: Laboratory. Participants: 89 unique participants: 34 were 3 months postoperative anterior cruciate ligament reconstruction (ACLR) and 55 healthy controls. Methods: For the STCT, participants sat on a balance board with their eyes closed for three 30-second trials while investigators counted balance errors. Intraclass correlations (ICCs) were used to assess interrater reliability (N = 20) and test–retest reliability (N = 40). To assess known-groups validity, independent t tests were used to compare STCT errors at 3 months post-ACLR with healthy matched controls (N = 34/group). Area under a receiver operating characteristic curve identified an optimal cutoff for distinguishing between groups. Results: The STCT had perfect interrater reliability (ICC2,3 = 1.00) and good test–retest reliability (ICC3,3 =.79; 95% confidence interval =.61–.89). The ACLR group made significantly more errors on the STCT (mean [SD] = 15.5 [5.4]) than controls (mean [SD] = 8.2 [4.1]; P <.001, Cohen d = 1.52). The STCT's ability to distinguish between groups was excellent (area under a ROC curve = 0.86). A cutoff of 12 errors maximized sensitivity (76%) and specificity (85%). Conclusions: The STCT is reliable between raters and across days. It also has excellent ability to distinguish between individuals with a recent ACLR and healthy matched controls, which provides initial evidence to suggest that the STCT may be clinically useful for identifying deficits in trunk neuromuscular control. [ABSTRACT FROM AUTHOR]

Context: Blood flow restriction (BFR) is a rehabilitation tool which may introduce a constraint, similar to muscle fatigue, that challenge patients' sensorimotor system during balance exercises. The purpose of our study was to examine whether adding BFR to dynamic balance exercises produced a decrease in balance performance and an increase in ratings of perceived exertion and instability in individuals with chronic ankle instability (CAI) compared with dynamic balance exercises without BFR. Designs: Crossover design. Methods: Our sample included N = 25 young adults with a history of CAI. Participants completed 2 laboratory visits. At each visit, participants completed 4 sets (30×-15×-15×-15×) of dynamic balance exercises, performed similar to the modified star excursion balance test (SEBT), once with BFR and once with control (no BFR) conditions. We measured composite SEBT scores at baseline and during the final repetitions of each set of balance exercise (sets 1–4). We also measured ratings of perceived exertion and instability following each balance exercise set. Results: We observed no difference in composite SEBT scores between conditions at baseline; however, composite SEBT scores were significantly lower during all balance exercises sets 1 to 4 with the BFR condition compared with control. During the BFR condition, composite SEBT scores were significantly lower during all balance exercise sets compared with baseline. During the control condition, composite SEBT scores did not significantly change between baseline and each balance exercise set. Ratings of perceived exertion and instability scores were significantly greater in the BFR group compared with the control group during all balance exercise sets. Conclusions: Individuals with CAI demonstrated lower composite SEBT scores and greater perceived instability and exertion during dynamic balance exercise with BFR compared to without BFR. BFR introduced a novel muscle fatigue constraint during dynamic balance exercises in individuals with CAI. Additional research is needed to determine if adding BFR to balance training could improve clinical outcomes in CAI patients. [ABSTRACT FROM AUTHOR]

We examined the sweat characteristics and fluid balance of elite female field hockey players during two heat training camps. Fourteen elite female field hockey players from the Australian national squad participated in two heat training camps held ∼6 months apart, following winter- (Camp 1) and summer-based training (Camp 2). Daily waking body mass (BM) and urine specific gravity (USG) were collected, along with several markers of sweat and fluid balance across two matches per camp. There was a 19% mean reduction in estimated whole-body sweat sodium concentration from Camp 1 (45.8 ± 6.5 mmol/L) to Camp 2 (37.0 ± 5.0 mmol/L; p <.001). Waking urine specific gravity ≥ 1.020 was observed in 31% of samples, with no significant differences in mean urine specific gravity or BM between camps (p >.05), but with substantial interindividual variation. Intramatch sweat rates were high (1.2–1.8 L/hr), with greater BM losses in Camp 1 (p =.030), resulting in fewer players losing ≥2% BM in Camp 2 (0%–8%), as compared with Camp 1 (36%–43%; p =.017). Our field data suggest that elite female field hockey players experience substantial sweat losses during competition in the heat regardless of the season. In agreement with previous findings, we observed substantial interindividual variation in sweat and hydration indices, supporting the use of individualized athlete hydration strategies. [ABSTRACT FROM AUTHOR]

To operationalize the extent to which firms place a strategic emphasis on human capital and human resource management (HRM), we draw on the strategy field's dominant logic theory and on the emerging literature on executive compensation for the heads of major firm functions, such as HRM. Specifically, we investigate whether the pay of human resource executives (HREs) relative to other members of top management teams (TMTs) is related to firm performance. After controlling for the endogeneity of HRE status as one of the highest paid executives on the TMT, we find in a comprehensive sample of the largest US firms that HRE relative pay is positively related to firm financial performance, specifically Tobin's Q. We also find that the relationship of HRE relative pay with Tobin's Q is stronger in relatively smaller and younger firms in our sample. The findings suggest that a strategic emphasis on human capital and HRM leads to higher firm value. [ABSTRACT FROM AUTHOR]

This study investigated the impact of multimorbidity patterns on physical activity and capacity outcomes over the course of a year-long exercise intervention, and on physical activity 1 year later. Participants were 314 physically inactive community-dwelling men and women aged 70–85 years, with no contraindications for exercise at baseline. Physical activity was self-reported. Physical capacity measurements included five-time chair-stand time, 6-minute walking distance, and maximal isometric knee-extension strength. The intervention included supervised and home-based strength, balance, and walking exercises. Multimorbidity patterns comprised physician-diagnosed chronic disease conditions as a predictor cluster and body mass index as a measure of obesity. Multimorbidity patterns explained 0%–12% of baseline variance and 0%–3% of the change in outcomes. The magnitude and direction of the impact of unique conditions varied by outcome, time point, and sex. Multimorbid older adults with no contraindications for exercise may benefit from multimodal physical training. [ABSTRACT FROM AUTHOR]

Purpose: To validate an innovative 3D volumetric method of evaluating tissue changes proposed by Lee et al in 2020 by comparing the results of this method--in which the scanned peri-implant surfaces were transformed, visualized, and analyzed as 3D objects--to the results reported by an existing method based on calculation of the mean distance between measured surfaces. The null hypothesis was that there was no statistically significant difference between the two methods. Additionally, the present study evaluated peri-implant tissue changes 5 years after single implant placement in the esthetic zone. Materials and Methods: Both methods were applied to 11 oral implant site casts (6 maxillary central incisor sites, 5 maxillary lateral incisor sites) taken from 11 patients at crown placement and at follow-up examinations 5 years later. The methods are based on digital workflows in which the reference and 5-year casts are scanned and the resulting STL files are superimposed and analyzed for three regions of interest (mesial papilla, central area, and distal papilla). The volumetric changes reported by the Lee et al method and the mean distance method were calculated and compared using the Spearman rank correlation coefficient (P < .01) and the Wilcoxon signed-rank test (P < .05). Results: The correlation between the two sets of measurements was very high (Spearman rank correlation coefficient = 0.885). The new volumetric method indicated a mean volume loss of 2.82 mm3 (SD: 5.06), while the method based on the measurement of mean distance showed a mean volume loss of 2.92 mm3 (SD: 4.43; Wilcoxon signed-rank test result: P = .77). No statistically significant difference was found. The two methods gave equivalent results, and the null hypothesis was accepted. Conclusions: The new volumetric method was validated and can be considered a trustworthy tool. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate peri-implant tissue health and bone resorption in patients with implant-supported fixed partial rehabilitations. In particular, possible correlations between plaque accumulation and bone loss, as well as other periimplant health parameters, were investigated. Materials and Methods: A total of 44 patients rehabilitated with fixed implant-supported partial rehabilitations were included. The following parameters were recorded: spontaneous bleeding (SB), suppuration, bleeding on probing (BOP), plaque index (PI), and probing depth (PD). Periapical radiographs were taken to measure crestal bone loss (BL). A nonparametric test (Spearman rank coefficient; rs) was used to identify possible correlations between the clinical parameters recorded. Results: A total of 121 implants were analyzed. Global PI and BOP were 49.58% and 20.25%, respectively. There were no cases of suppuration, and only 2 implants showed spontaneous bleeding. Mean BL was 1.53 mm (SD: 0.98). No implants showed peri-implantitis. There was a weak, statistically significant correlation between PI and BL (rs = 0.27, P [2-tailed] = .99) and between PI and the other peri-implant parameters (BOP: rs = 0.14, P = .14; PD: rs = 0.04, P = .65; SB: rs = --0.08, P = .34). A very weak correlation was also found between BL and BOP (rs = 0.1, P = .2) and between BL and PD (rs = 0.02, P = .7). Correlation was found between BL and age (rs = 0.13, P = .81) and between the other peri-implant parameters and age using dichotomization (> or < 65 years; PI: rs = --0.14, P = .11; PD: rs = --0.21, P = .01; BOP: rs = --0.21, P = .01; SB: rs = 0.05, P = .53). No statistically significant correlations were found between the clinical parameters evaluated and the sex or the dental arch treated (maxilla vs mandible). In contrast, the correlation between periodontal parameters and years elapsed since surgery (follow-up) was significant. Conclusions: The present research suggests that in implant-supported fixed partial rehabilitations, dental implants with greater plaque accumulation are more likely to present augmented probing depth, peri-implant inflammation, and bone loss, although the correlation is statistically very weak. Patient age and time of follow-up also significantly affected peri-implant health parameters. [ABSTRACT FROM AUTHOR]

Purpose: This study examined performance and physiological adaptations following 3 weeks of repeated-sprint training (RST) with blood-flow restriction (BFR) or without (non-BFR). Methods: Twenty-six semiprofessional and amateur adult male team-sport players were assessed for repeated-sprint ability, anaerobic capacity, leg lean mass, neuromuscular function, and maximal aerobic capacity before and after RST. Participants completed 9 cycling RST sessions (3 sets of 5–7 × 5-s sprints, 25-s passive recovery, 3-min rest) over a 3-week period with BFR or non-BFR. Results: During RST sessions, the BFR group demonstrated lower mean power output compared with non-BFR (−14.5%; g = 1.48; P =.001). Significant improvements (P <.05) in mean and peak power output during repeated-sprint ability (+4.1%; g = 0.42, and + 2.2%; g = 0.25, respectively) and anaerobic capacity (+4.8%; g = 0.47, and + 4.7%; g = 0.32, respectively) tests, leg lean mass (+2.0%; g = 0.16), and peak aerobic power (+3.3%; g = 0.25) were observed from pretesting to posttesting without any between-groups differences. No significant changes (P >.05) were observed for maximal isometric voluntary contraction and maximal aerobic capacity. Peak rate of force development decreased (P =.003) in both groups following RST (−14.6%; g = 0.65), without any between-groups differences. Conclusions: Repeated-sprint ability, anaerobic capacity, leg lean mass, and peak aerobic power improved following 3 weeks of RST; however, the addition of BFR did not further enhance adaptations. Interestingly, comparable improvements were achieved between groups despite lower external loads experienced during RST sessions with BFR. [ABSTRACT FROM AUTHOR]

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P<.001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P<.001 and P = . 001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Context: The aim of this study was to analyze the muscle activity of the hamstring muscles and the lateral gastrocnemius during different variants of the single-leg bridge (SLB) in futsal players. Design: Cross-sectional study. Methods: Twenty-two futsal players (age = 24.8 [3.9] y) volunteered to participate in this study. The participants performed 3 variations of the SLB with the knee flexed at 45°. The first position was performed with the ankle in plantar position with flat support, the second with the ankle in dorsiflexion (DF) with heel support, and the third with the ankle in DF and external rotation (ER) with heel support. The Wilcoxon rank-sum test assessed the difference between variables for samples with the rank-biserial correlation effect size. Spearman correlation coefficients were used to examine the associations of the percentage maximal voluntary isometric contraction for each muscle with peak force and rate of force development with 3 different variances of the SLB. Results: The variation of ankle DF and ER with heel support generated higher muscle activity in BF in concentric (P<.01, effect size [ES] = -0.613); isometric (P<.042, ES = -0.494); and eccentric (P<.005, ES = -0.668) contraction than ankle DF with heel support. In contrast, the variation of ankle DF and ER with heel support generated fewer muscle activity in lateral gastrocnemius in concentric (P < .001, ES = 0.779); isometric (P < .003, ES = 0.708); and eccentric (P < .014, ES = 0.589) contraction than ankle DF with heel support. Conclusions: The position of DF and ER was the best position in SLB to train the BF. It could be convenient to start rehabilitation of the BF with flat foot postition or ankle in DF with heel support and progress with the position of the ankle in DF and ER with heel support. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Context: Nordic hamstring strength (NH strength) and single leg bridge test (SLBT) scores are used to predict the risk of hamstring strain injury. Although NH strength and SLBT scores may be related, the relationship between NH strength and SLBT score remains unknown. Objectives: This study investigated the relationship between NH strength and SLBT scores in university soccer players. Design: Cross-sectional study. Setting: Research laboratory. Participants: 38 male university soccer players. Main Outcome Measures: NH strength and SLBT scores. Interventions: A participant was instructed to lean forward gradually at the slowest possible speed from a kneeling posture with the knee joint flexed 90° for the NH strength measurement. Participants in the SLBT crossed their arms over their chests, pushed down from their heels, and lifted their hips off the ground as many times as they could until they failed. We investigated the relationship between NH strength and SLBT scores in the left and right sides using Spearman rank correlation coefficient. Additionally, we calculated the percentage of left–right asymmetry in NH strength and SLBT scores and investigated the relationship between these variables using Pearson correlation coefficient. Results: There were no significant correlations between NH strength and SLBT scores in the right (rs =.239, P =.16) and left (rs =.311, P =.065) legs. Furthermore, there was no significant relationship between NH strength and SLBT between-limb asymmetry (r =.073, P =.671). Conclusions: NH strength and SLBT scores could be different indexes, indicating either maximal muscle strength or muscle endurance. Thus, the findings suggested that when assessing risk factors for hamstring strain injury, both NH strength and SLBT scores should be measured. [ABSTRACT FROM AUTHOR]

Context: Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury. Design: Single-blinded randomized control trial design. Methods: We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process. Results: We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P =.030), and average power during both the 60°/s (P =.041) and 180°/s (P ≤.001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively. Conclusions: The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model. [ABSTRACT FROM AUTHOR]

This research provides a review of seated shot put alongside new data from the Tokyo 2020 Paralympic Games with the aim to understand the latest trends in equipment within a recently established rule set and how key equipment variables may impact performance for athletes in different classifications. First, a review of the literature found that the throwing pole is a key equipment aid that is not well understood, in part due to limitations in testing design. New data from the 2020 Paralympic Games showed inconsistent trends for the use of the throwing pole among athletes, particularly in transitionary classes (F33–34 and F54–55). A two-way analysis of variance found a main effect of classification on performance (p <.001), as well as an interaction effect between pole use and classification on performance (p <.05). Notably, pole users are seen to perform better than non–pole users in Class F32 (p <.05). [ABSTRACT FROM AUTHOR]

Purpose: To investigate the validity of the Physical Activity Questionnaire for Older Children (PAQ-C) to assess the moderate- to vigorous-intensity physical activity (MVPA) level of children and adolescents diagnosed with HIV and propose cut-points, with accelerometer measures as the reference method. Method: Children and adolescents, aged 8–14 years (mean age = 12.21 y, SD = 2.09), diagnosed with HIV by vertical transmission, participated in the study. MVPA was investigated through the PAQ-C and triaxial accelerometer (ActiGraph GT3X+). Receiver operating characteristic curve and sensitivity and specificity values were used to identify a cut-point for PAQ-C to distinguish participants meeting MVPA guidelines. Results: Fifty-six children and adolescents participated in the study. Among those, 16 met MVPA guidelines. The PAQ-C score was significantly related to accelerometry-derived MVPA (ρ =.506, P <.001). The PAQ-C score cut-point of 2.151 (sensitivity = 0.625, specificity = 0.875) was able to discriminate between those who met MVPA guidelines and those that did not (area under the curve = 0.751, 95% confidence interval, 0.616–0.886). Conclusion: The PAQ-C was useful to investigate MVPA among children and adolescents diagnosed with HIV and to identify those who meet MVPA guidelines. [ABSTRACT FROM AUTHOR]

Purpose: To report the prevalence of early implant failure and evaluate factors that contribute to the early failure of dental implants placed at a teaching clinic. The study also aims to identify risk indicators for early implant loss to better predict and prevent early implant loss in the future. Materials and Methods: This retrospective study included all patients with a dental implant placed by the Section of Oral Surgery and Oral Medicine, Department of Clinical Dentistry, University of Bergen, between January 2011 and December 2018. All information was collected from operation logbooks and from patient records. A failed implant in this study was defined as an implant lost before functional loading. Results: A total of 1,005 dental implants were placed in the studied time period, of which 54 failed early, giving an early failure rate (EFR) of 5.4%, with functional loading obtained for the remaining 94.6%. Analysis showed an increased hazard for early implant failure among smokers, men, and younger patients. With an age increase of 10 years, the risk of implant failure was reduced by 14% (hazard ratio [HRR] = 0.86, P = .037). A higher failure rate was found in anterior maxillary implants than in posterior maxillary implants (7.79% vs 3.29%, respectively; HRR = 0.47; P = .041). The probability for early failure in the posterior mandible was significantly increased compared to the posterior maxilla (HRR = 3.68, P = .005). If the first implant failed, it was more likely that the consecutive implant would also fail (HRR = 1.82). In the study, 53.4% of the placed implants were Straumann (EFR = 5.2%), 30.3% were Nobel Biocare (EFR = 7.2%), and 16.3% were Astra Tech (EFR = 2.5%). Conclusions: This study found that younger, male, and smoker patients were associated with an increase in early failure of dental implants. Significantly increased failure rates were also seen for implants placed in the mandible, and there were differences with respect to implant system. Although differences were found in early failure both for patient- and implant-related factors, the overall early failure rate (5.4%) in this study was low. [ABSTRACT FROM AUTHOR]

Objectives: Microneedling and injectable platelet-rich fibrin (i-PRF) have been proposed as relatively less invasive alternatives to surgical procedures for augmentation of thin periodontal phenotype. The present study was conducted to evaluate the effect of microneedling and i-PRF alone on gingival thickness in thin periodontal phenotype individuals. Method and materials: Systemically healthy individuals with thin periodontal phenotype in mandibular anterior teeth (n = 21) were treated with microneedling on one side and i-PRF on the contralateral side. Assessment of gingival thickness, keratinized tissue width, and periodontal parameters was done at baseline, and at 1, 3, and 6 months. Results: In intergroup comparison, a statistically significant increase in gingival thickness was observed with microneedling as compared to i-PRF at 6 months (P < .02). Intragroup comparison from baseline to 6 months showed a statistically significant increase in gingival thickness within both the groups: microneedling from 0.78 ± 0.12 mm to 1.00 ± 0.14 mm (P < .000), and i-PRF from 0.77 ± 0.10 mm to 0.93 ± 0.12 mm (P < .000). Intragroup comparison showed a statistically significant increase in keratinized tissue width in the microneedling group (P < .000). A statistically significant decrease in periodontal parameters was observed on intragroup comparison (P < .000). Conclusion: Considering the higher gain in gingival thickness and the added advantage of eliminating need for autologous blood withdrawal, microneedling is potentially better than i-PRF for phenotype modification in thin periodontal phenotype individuals. [ABSTRACT FROM AUTHOR]

Objective: Inflammatory pathogenesis is common to periodontitis and oral lichen planus. This study was conducted to assess and compare the periodontal status of patients with and without oral lichen planus. Method and materials: 108 patients comprising 54 with oral lichen planus and 54 age-matched systemically healthy participants without oral lichen planus were selected. Periodontal parameters, ie Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, clinical attachment level, and periodontal phenotype were measured. Results: On comparing the test and control groups, statistically significant differences were observed in respect to Plaque Index (P = .00), Gingival Index (P = .00), and bleeding on probing (P = .00). A higher proportion of sites with deeper pockets was observed in the test group (P = .00). On comparison of various oral lichen planus subtypes, significant difference was observed in respect to Gingival Index (P = .00) and bleeding on probing (P = .00). A higher proportion of sites with deeper pockets (P = .01) and greater CAL (P = .00) was observed in the erosive/atrophic subgroup compared to the reticular group. However, the differences between the reticular (a less severe form of oral lichen planus) and control group in terms of Gingival Index (P = .94), Plaque Index (P = .05), bleeding on probing (P = .17), probing pocket depth (P = .56), and clinical attachment level (P = .23) were not statistically significant. Statistically significant differences were observed in terms of Gingival Index (P = .01) and bleeding on probing (P = .00) between thin and thick periodontal phenotypes in the oral lichen planus group. Statistically significant positive correlations in periodontal parameters with increased gingival involvement and severity were observed using Spearman rank correlation coefficient. Conclusion: Significantly greater periodontal inflammation in the test group means there is a risk of greater attachment loss in future. Thus, increased attention towards periodontal health in these patients might reduce the rate of disease progression. [ABSTRACT FROM AUTHOR]

Purpose: To assess the core temperature fluctuations during 10-km open-water swimming (OWS) in cool water and the relationship between thermal sensation (TS) after 10-km OWS, core temperature, and local skin thermal sensitivity. Methods: Nine highly trained OWS swimmers (4 female; age 22 [3] y) completed a single 10-km trial in cool water (22.3 °C) wearing swimsuits for OWS. During the trial, core temperature was continuously recorded via ingestible temperature sensors, and TS after trial was also measured. Then, local skin warm/cool sensitivity was measured in the forearm. Results: All swimmers completed the 10-km OWS. Mean swimming speed for males and females were 1.39 (1.37–1.42 m/s) and 1.33 m/s (1.29–1.38 m/s), respectively. Core temperature increased in 8 out of 9 swimmers during 10-km OWS (P =.047), with an average increase of 0.8 °C. TS after 10-km OWS varied among swimmers. There were no correlations between post-OWS TS and post-OWS core temperature (P =.9333), whereas there was a negative correlation between post-OWS TS and local skin cool sensitivity (P =.0056). Conclusion: These results suggest that core temperature in elite swimmers might not decrease during 10-km OWS in the cool water temperature of official OWS. In addition, individual differences in TS after 10-km OWS may be related to skin cool sensitivity rather than core temperature. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the reliability and validity of the UMOVE Mobility Screen in older adults living with dementia using a Rasch analysis and hypothesis testing. The UMOVE Mobility Screen (UMOVE) focuses on nine activities: following commands, muscle strength, and basic functional mobility tasks. Trained evaluators completed assessments on 244 patients, the majority of whom were female (62%), and White (71%). Based on Rasch Analysis, there was evidence of good item and person reliability (indexes > 0.80), good INFIT statistics, and only one item fitting the model based on OUTFIT statistics. Validity was supported based on hypothesis testing. There was no evidence of Differential Item Functioning between races and genders. Item mapping raised concerns about the spread of the items across the full spectrum of mobility assessed in the UMOVE Mobility Screen. Future testing should consider adding some easier and some more difficult items. [ABSTRACT FROM AUTHOR]

Purpose: To determine the minimum number of events (training or matches) for producing valid acceleration–speed (AS) profiles from global navigation satellite system (GNSS) data. Methods: Nine elite female soccer players participated in a 4-week training camp consisting of 19 events. AS profile metrics calculated from different combinations of athlete events were compared to force–velocity (FV) profile metrics from 2 × 40-m stand-alone sprint effort trials, using the same GNSS 10-Hz technology. Force–velocity profiles were calculated, from which AS profiles were obtained. AS profiles from training and matches were generated by plotting acceleration and speed points and performing a regression through the maximal points to obtain the AS metrics (theoretical maximal speed, x-intercept [in meters per second], theoretical maximal acceleration, y-intercept [in meters per second squared], and the slope per second). A linear mixed model was performed with the AS metrics as the outcome variables, the number of events as a fixed effect, and the participant identifier as a mixed effect. Dunnett post hoc multiple comparisons were used to compare the means of each number of event grouping (1–19 events) to those estimated from the dedicated sprint test. Results: Theoretical maximal speed and theoretical maximal acceleration means were no longer significantly different from the isolated sprint reference with 9 to 19 (small to trivial differences = −0.31 to −0.04 m·s−1, P =.12–.99) and 6 to 19 (small differences = −0.4 to −0.28 m·s−2, P =.06–.79) events, and the slopes were no longer different with 1 to 19 events (trivial differences = 0.06–0.03 s−1, P =.35–.99). Conclusions: AS profiles can be estimated from a minimum of 9 days of tracking data. Future research should investigate methodology resulting in AS profiles estimated from fewer events. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of a Nordic hamstring exercise intervention on biceps femoris long head, semitendinosus, and semimembranosus muscle's activity and relative contributions through multichannel electromyography. Twenty-four injury-free male basketball players (mean age 20 [3] y) were randomly assigned to a 12-week intervention (n = 13) or control group (n = 11). The primary outcome measures were normalized muscle activity (percentage of maximal voluntary isometric contraction, %MVIC) and relative contribution of hamstring muscles over 12 weeks. No effects were found on any of the primary outcome measures. Between-group differences over 12 weeks were 2.7%MVIC (95% confidence interval 95% CI, −0.7 to 6.1) for the biceps femoris long head, 3.4%MVIC (95% CI, −1.4 to 8.2) for the semitendinosus, and 0.8%MVIC (95% CI, −3.0 to 4.6) for the semimembranosus, P =.366. Between-group differences over 12 weeks were 1.0% relative contribution (%con; 95% CI, −3.0 to 5.1) for the biceps femoris long head, 2.2% relative contribution (95% CI, −2.8 to 7.2) for the semitendinosus, and −3.3% relative contribution (95% CI, −6.4 to −0.1) for the semimembranosus P =.258. A positive value implies a higher value for the Nordic group. A Nordic hamstring exercise intervention did not affect the level of muscle activity and relative contribution of hamstring muscles in performance of the Nordic hamstring exercise. [ABSTRACT FROM AUTHOR]

We aimed to examine exercise intensity among older adults participating from home in remotely delivered EnhanceFitness (Tele-EF). Exercise intensity was assessed through Fitbit-measured heart rate and the Borg 10-point rating of perceived exertion over 1 week of a 16-week exercise program. Outcomes included mean minutes spent at or above the heart rate reserve calculated threshold for moderate intensity and mean rating of perceived exertion. Pearson and Spearman rank correlations were used to examine associations between baseline characteristics with exercise intensity. During the 60-min classes, the 55 participants achieved moderate intensity for a mean of 21.0 min (SD = 13.5) and had a mean rating of perceived exertion of 4.9 (SD = 1.2). There were no significant associations between baseline characteristics and exercise intensity. Older adults can achieve sustained moderate-intensity exercise during Tele-EF supervised classes. Baseline physical function, physical activity, and other health characteristics did not limit ability to exercise at a moderate intensity, though further investigation is warranted. [ABSTRACT FROM AUTHOR]

Context: Single- and dual-task walking gait assessments have been used to identify persistent movement and cognitive dysfunction among athletes with concussions. However, it is unclear whether previous ankle sprain injuries confound these outcomes during baseline testing. The purpose of this study was to determine the effects of (1) ankle sprain history and (2) time since prior ankle sprain injury on single- and dual-task spatiotemporal gait outcomes and cognitive measures. Design: Cross- sectional study. Methods: We assessed 60 college Division-I athletes (31 with ankle sprain history; 13 females and 18 males, 19.3 [0.8] y; 29 with no ankle sprain history, 14 females and 15 males, 19.7 [0.9] y) who completed injury history forms and underwent concussion baseline testing. Athletes completed single- and dual-task gait assessments by walking back and forth along an 8-m walkway for 40 seconds. Athletes wore a smartphone with an associated mobile application on their lumbar spine to record spatiotemporal gait parameters and dual-task cognitive performance. Separate multivariate analyses of variance were used to assess the effects of ankle sprain injury history on spatiotemporal measures, gait variability, and cognitive performance. We performed a multivariate regression subanalysis on athletes who reported time since injury (n = 23) to assess temporal effects on gait and cognitive performance. Results: Athletes with and without a histoiy of ankle sprains had comparable spatiotemporal and gait variability outcomes during single- (P = .42; P = .13) and dual-task (P = .75; P = .55) conditions. Additionally, ankle sprain injury history did not significantly influence cognitive performance (P = .35). Finally, time since ankle sprain did not significantly affect single- (P = .75) and dual-task gait (P = .69), nor cognitive performance (P = 19). Conclusions: Ankle sprain injury history did not significantly alter spatiotemporal gait outcomes nor cognitive performance during this common clinical assessment. Future studies may consider including athletes with ankle sprain injury history during concussion assessments. [ABSTRACT FROM AUTHOR]

Context: An easy-to-administer, function-based questionnaire to assess patients with various foot problems was required for a Greek-speaking population. This study aimed to translate and cross-culturally adapt the Quick Foot and Ankle Ability Measure (Quick-FAAM) into Greek and evaluate its reliability and validity. Design: Cross-sectional study. Methods: Established international guidelines for the cross-cultural adaptation of questionnaires were followed. The face and content validity of the Greek version of the Quick-FAAM (Quick-FAAM-GR), as well as the internal consistency and test-retest reliability upon repeated administration after 5 days, were examined. In addition, the construct validity of the scale was examined via exploratory factor analysis as well as by testing for associations with the Manchester Foot Pain and Disability Index, the 12-item Short-Form Survey (version 2), and a functional balance assessment test--the Y-Balance Test. Results: Sixty participants (18 women) with self-reported chronic ankle instability symptoms, with a median (interquartile range) age of 27 (7.7) years, participated in the study. Half of the participants were included in the test-retest reliability study. The Quick-FAAM-GR demonstrated face and content validity. Excellent internal consistency (Cronbach a =.961) and intrarater test-retest reliability (intraclass correlation coefficient ICC[2,1] = .93) were demonstrated, with a comparable error margin to the original version (standard error of the measurement = 2.1, 95% minimum detectable change = 5.9). Associations of the Quick-FAAM-GR scores to other questionnaires ranged from weak to strong (Spearman rho), all being statistically significant (Manchester Foot Pain and Disability Index from -.26, P = .04, to -.67, P< .001, and 12-item Short-Form Survey, version 2, between .41 and .72, P<.001), and to the Y-Balance Test between lower-limb differences (-.35 to -.58, P< .001). The exploratory factor analysis confirmed the single- factor structure of this scale. No floor/ceiling effects were observed. Conclusions: The Greek Quick-FAAM has proven to be a valid and reliable tool for evaluating chronic ankle instability and can be used for clinical and research purposes in Greek- speaking individuals. [ABSTRACT FROM AUTHOR]

Context: To assess the reliability of a remote 2D markerless motion tracking method (Kinovea) to quantify knee and hip angles during dynamic tasks. Methods: Fourteen healthy adults performed body weight squats and lateral lunges while video recording themselves at home. Knee and hip angles were quantified in the sagittal plane for the squats and in the frontal plane for the lateral lunges. Two students each performed the video analysis procedure twice, 2 weeks apart. Intraclass correlation coefficients were used to calculate the intrarater and interrater reliability for angles at maximum depth. The intrarater and interrater agreement over the joint angle-time signals were quantified using a validation metric; an acceptable agreement threshold was set at a validation metric of 0.803 or higher. Standard error of measurement (SEM) was also calculated. Results: Reliability was good to excellent (intraclass correlation coefficients = .80-.98) for all angle comparisons at maximum depth. The agreement over the entire joint angle-time signal was acceptable for all squat variables except for the interrater hip angle comparison (validation metric = 0.797). None of the lateral lunge variables met the threshold of acceptable agreement. The mean SEM across participants for all joint angle-time signal and for maximum depth was acceptable (<5°) for all measurements (SEM = 1.2°-4.9°). Conclusions: Overall, the reliability, agreement, and SEM quantified in this study support the integration of remote methods to quantify lower-extremity kinematics into research and clinical practice. [ABSTRACT FROM AUTHOR]

This study explored the acute effects of different running intensities on cognitive and motor performances in individuals with intellectual disability (ID). An ID group (age, M = 15.25 years, SD = 2.76) and a control group without ID (age, M = 15.11 years, SD = 1.54) performed visual simple and choice reaction times, auditory simple reaction time, and finger tapping tests before and after running at low or moderate intensity (30% and 60% of heart rate reserve [HRR], respectively). Visual simple reaction time values decreased (p <.001) after both intensities at all time points with higher (p =.007) extend after the 60% HRR intensity for both groups. After both intensities, the VCRT decreased (p <.001) in the ID group at all time points compared with preexercise (Pre-EX) while, in the control group, these values decreased (p <.001) only immediately (IM-EX) and after 10 min (Post-10) of exercise cessation. Compared withs Pre-EX, in the ID group, the auditory simple reaction time values decreased (p <.001) at all time points after the 30% HHR intensity whereas, after the 60% HRR, these values decreased only at IM-EX (p <.001), Post-10 (p =.001) and Post-20 (p <.001). In the control group, auditory simple reaction time values decreased (p =.002) only after the 30% HRR intensity at IM-EX. The finger tapping test increased at IM-EX (p <.001) and at Post-20 (p =.001) compared to Pre-EX in both groups only after the 30% HHR intensity and for the dominant hand. The effect of physical exercise on cognitive performances in individuals with ID seems to depend on the cognitive test type as well as the exercise intensity. [ABSTRACT FROM AUTHOR]

Context: Bridge exercises are extensively used in trunk-strengthening programs. The aim of this study was to investigate the effect of bridging duration on lateral abdominal muscle thickness and gluteus maximus activation. Design: Cross-sectional. Methods: Twenty-five young males participated in this study. Transversus abdominal (TrA), external and internal oblique ultrasound thickness, gluteus maximus electromyographic activation, and sacral tilt angle were simultaneously measured for every second during 30-second bridging exercise. The contraction thickness ratio and root mean squared signal (normalized to maximum isometric contraction signal) during 6 exercise durations (from 0 to 5, 10, 15, 20, 25, and 30 s) were also calculated and compared using analysis of variance designs. Results: TrA and internal oblique contraction thickness ratio and gluteus maximus root mean squared increased during the first 8 to 10 seconds and remained elevated until the end of the 30-second exercise (P <.05). External oblique contraction thickness ratio declined during exercise (P <.05). Five-second bridging showed less TrA thickness and anteroposterior and mediolateral sacral tilt angle and a lower anteroposterior tilt variability compared with bridges, which lasted more than 10 seconds (P <.05). Conclusions: Bridge exercises longer than 10 seconds may be better for promoting TrA recruitment than bridges of shorter duration. Clinicians and exercise specialists could adjust the duration of bridge exercise based on the aims of the exercise program. [ABSTRACT FROM AUTHOR]

Purpose: To compare the standard 360-degree CBCT acquisition protocol to the low dose 180-degree CBCT protocol for implant planning. Materials and Methods: Two groups of patients, each consisting of 35 patients, were included in the study. The first group was imaged with the conventional 360-degree CBCT protocol, and the second group was imaged with the low dose 180-degree CBCT protocol. The primary outcome of this study was the number of scans that needed to be repeated due to poor image quality. In addition, six secondary parameters were evaluated quantitatively and qualitatively. Results: The results showed that there was no need to repeat any of the CBCT scans that were obtained in either group, which showed that 360-degree and 180-degree protocols had comparable image quality. As for the secondary parameters, the results showed that the evaluators were able to evaluate the six chosen parameters in a comparable manner. Conclusions: The 180-degree low dose CBCT scan is a viable option for dental implant treatment planning in the posterior mandible as it provides comparable and adequate information regarding accuracy of measurements, identification of critical structures, evaluation of bone quality, and any pathology. [ABSTRACT FROM AUTHOR]

Background: Children with inflammatory bowel disease (IBD) experience extraintestinal side effects including altered body composition, impaired muscle strength, and aerobic capacity. Exercise training may remedy these issues. Purpose: To assess the feasibility, safety, participant satisfaction, and efficacy of a training program for youth with IBD. Methods: Children with IBD completed 16 weeks of training (2 supervised + 1 home sessions per week). Feasibility was assessed by tracking recruitment, adherence, and compliance rates. Safety was assessed by tracking symptoms and adverse events. Posttraining interviews gauged satisfaction. Circulating inflammatory markers, body composition, muscle strength, aerobic fitness, and habitual physical activity were measured at baseline, midtraining (8 wk), and posttraining. Results: Eleven youth were recruited and 10 completed the study. Participants adhered to 28 (1) of 32 prescribed supervised sessions and 8 (4) of 16 prescribed home sessions. There were no adverse events, and overall feedback on training was positive. Posttraining, we observed an increase in lean mass (+2.4 [1.1] kg), bone density (+0.0124 [0.015] g·cm−2), aerobic fitness (+2.8 [5.7] mL·kg LM−1· min−1), and vigorous physical activity levels (+13.09 [8.95] min·h−1) but no change in inflammation or muscle strength. Conclusion: Supervised exercise training is feasible, safe, and effective for youth with IBD and should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed physical activity (PA) and body composition of ambulatory children and adolescents with cerebral palsy (CP) and their typically developing peers. Methods: Participants included youth with CP (ages 8–18 y and Gross Motor Function Classification System [GMFCS] levels I–III) and their typically developing peers. Outcomes included PA (actigraphy) and fat/lean mass index (FMI/LMI; dual-energy X-ray absorptiometry). Statistical analyses included linear mixed effects models with Bonferroni adjustment. Fixed effects were study group (CP and typically developing); random effects were participant clusters (sex and age). Exploratory analyses included association of body composition and PA, GMFCS level, and CP involvement (unilateral and bilateral). Results: Seventy-eight participants (CP: n = 40, girls: n = 29; GMFCS I: n = 20; GMFCS II: n = 14; GMFCS III: n = 6) met inclusion criteria. Individuals with CP had lower moderate to vigorous PA (MVPA; β = −12.5; 98.3% confidence interval, −22.6 to −2.5 min; P =.004) and lower LMI (β = −1.1; 97.5% confidence interval, −2.1 to −0.0 kg/m2; P =.020). Exploratory analyses indicated increased LMI with greater MVPA (P =.001), reduced MVPA for GMFCS II (P =.005) and III (P =.001), increased sedentary time for GMFCS III (P =.006), and greater fat mass index with unilateral motor impairment (P =.026). Conclusions: The findings contribute to the knowledge base of increasing MVPA and LMI deficits with the greater functional impact of CP. Associations of increasing LMI with greater MVPA support efforts targeting enhanced PA participation to promote independent mobility. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of desensitizing MI Varnish (GC America) applied before or after bleaching on the mineral component of enamel and surface topography. The coronal portions of 10 freshly extracted bovine teeth were segmented for a total of 40 specimens. Enamel specimens obtained from each tooth were randomly divided into four groups (n = 10): Group A = no bleaching; Group B = bleaching with 40% hydrogen peroxide (HP); Group C = MI Varnish applied before bleaching; and Group D = MI Varnish applied after bleaching. The calcium (Ca) and phosphorus (P) levels of the specimens in each group were determined by energy dispersive spectroscopy (EDS). Morphologic changes were observed using scanning electron microscopy (SEM). One-way ANOVA and Tukey HSD tests were used for statistical analyses (α = .05). The mean Ca content of Group B was significantly lower than those of Groups A, C, and D (P < .05). The mean Ca content of Group C was significantly lower than that of Group A (P < .05). There was no significant difference in Ca content between the other groups (P > .05). The mean P content of Group A was significantly higher than those of Groups B to D (P < .05). There was no significant difference in P content between Groups B to D (P > .05). Application of MI Varnish before or after in-office bleaching was effective in reducing mineral loss. However, applying MI Varnish after bleaching was more effective. [ABSTRACT FROM AUTHOR]

This retrospective study evaluated the survival rate and the clinical outcome of an endosseous implant system, as well as the marginal bone level (MBL) and the impact of the machined collar neck position on crestal bone level changes up to 2 years later. A total of 96 implants were placed in 57 patients and loaded with a final restoration after at least 3 months of healing: 15 implants were immediately placed into fresh extraction sockets, and 81 were placed in healed ridges. Marginal bone loss around implants was determined radiographically at 12 to 24 months postloading. The effects on marginal bone loss of the site (mandible vs maxilla), location (anterior vs posterior), immediate vs delayed implant, smoking habit, sex, implant length and diameter, prosthesis type (screw-retained/cemented), and the machined collar position were evaluated. The implant survival rate was 98.96% at 1 year. The mean MBL decreased significantly (0.238 mm) between baseline and loading (P < .001; post hoc test) and decreased by 0.154 mm between loading and 1 year, but this was not significant (P = .085; post hoc tests). After 2 years, the mean MBL decreased significantly (0.263 mm) between baseline and loading (P < .001) and decreased by 0.111 mm between loading and 1 year and by 0.199 mm between loading and 2 years, but these were not significant (P > .05; post hoc tests). The mean bone loss after 1 and 2 years was not significantly associated with implant type or site, smoking habit, or type of implant surgery (P = .792). However, the mean bone loss was significantly associated with the type of prosthesis and was significantly greater for cemented prostheses compared to screw-retained prostheses. A supracrestal position of the machined collar (tissue level) was associated with no bone loss, while placing the collar below the alveolar crest led to bone loss over 2 years. Of the factors evaluated, marginal bone loss after 1 and 2 years was significantly associated with prosthesis type and the machined collar position. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of graded hypoxia during exhaustive intermittent cycling on subsequent rapid and maximal torque-production capacity. Methods: Fifteen well-trained cyclists repeated intermittent cycling bouts (15 s at 30% of anaerobic power reserve; rest = 45 s) until exhaustion at sea level (FiO2 ∼0.21/end-exercise arterial oxygen saturation ∼96%), moderate hypoxia (FiO2 ∼0.16/∼90%), and severe hypoxia (FiO2 ∼0.12/∼79%). Rapid (rate of torque development [RTD]) and maximal isometric torque-production capacities of the knee extensors were assessed at baseline (visit 1) and exhaustion (visits 2–4). Results: Exercise capacity decreased with hypoxia severity (39 [30], 22 [13], and 13 [6] cycle efforts in sea level, moderate hypoxia, and severe hypoxia, respectively; P =.002). Changes in maximal-voluntary-contraction torque between baseline and postexercise in all conditions were not statistically significant (pooled values: −2.6% [5.7%]; P =.162). Peak RTD measured postexercise was reduced below baseline in all conditions (–21.5% [5.1%]; P ≤.015). Compared with baseline, absolute RTD values were lower at 0- to 30-millisecond (–35.1% [5.3%], P ≤.020), 0- to 50-millisecond (–40.0% [3.9%], P ≤.002), 0- to 100-millisecond (–30.7% [3.7%], P ≤.001), and 0- to 200-millisecond (–18.1% [2.4%], P ≤.004) time intervals in all conditions. Conclusions: Exhaustive intermittent cycling induces substantial yet comparable impairments in RTD of knee extensors between normoxia and moderate to severe hypoxia. [ABSTRACT FROM AUTHOR]

Purpose: Laboratory-based indicators are commonly used for performance assessment in young cyclists. However, evidence supporting the use of these indicators mostly comes from cross-sectional research, and their validity as predictors of potential future performance remains unclear. We aimed to assess the role of laboratory variables for predicting transition from U23 (under 23 y) to professional category in young cyclists. Methods: Sixty-five U23 male road cyclists (19.6 [1.5] y) were studied. Endurance (maximal graded test and simulated 8-min time trial [TT]), muscle strength/power (squat, lunge, and hip thrust), and body composition (assessed with dual-energy X-ray absorptiometry) indicators were determined. Participants were subsequently followed and categorized attending to whether they had transitioned ("Pro") or not ("Non-Pro") to the professional category during the study period. Results: The median follow-up period was 3 years. Pro cyclists (n = 16) showed significantly higher values than Non-Pro riders (n = 49) for ventilatory thresholds, peak power output, peak oxygen uptake, and TT performance (all P <.05, effect size > 0.69) and lower levels of fat mass and bone mineral content/density (P <.05, effect size > 0.63). However, no significant differences were found for muscle strength/power indicators (P >.05, effect size < 49). The most accurate individual predictor was TT performance (overall predictive value = 76% for a cutoff value of 5.6 W·kg−1). However, some variables that did not reach statistical significance in univariate analyses contributed significantly to a multivariate model (R2 =.79, overall predictive value = 94%). Conclusions: Although different "classic" laboratory-based endurance indicators can predict the potential of reaching the professional category in U23 cyclists, a practical indicator such as 8-minute TT performance showed the highest prediction accuracy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate differences in time to exhaustion (TTE), O2 uptake ( V ˙ O 2 ), and accumulated O2 deficit ( O 2 def ) between competitive and recreational cross-country (XC) skiers during an intermittent-interval protocol standardized for maximal aerobic power (MAP). Methods: Twelve competitive (maximal V ˙ O 2 [ V ˙ O 2 max ] = 76.5 ± 3.8 mL · kg − 1 · min − 1 ) and 10 recreational ( V ˙ O 2 max = 63.5 ± 6.3 mL · kg − 1 · min − 1 ) male XC skiers participated. All tests were performed on a rollerski treadmill in the V2 ski-skating technique. To quantify MAP and maximal accumulated oxygen deficit (MAOD), the skiers performed a steady-state submaximal test followed by a 1000-m time trial. After a 60-minute break, TTE, V ˙ O 2 , and accumulated O 2 def were measured during an intermittent-interval protocol (40-s work and 20-s recovery), which was individually tailored to 120% and 60% of each subject's MAP. Results: During the 1000-m time trial, the competitive skiers had 21% (95% CI, 12%–30%) shorter finish time and 24% (95% CI, 14%–34%) higher MAP (all P <.01) than the recreational skiers. No difference was observed in relative exercise intensity (average power/MAP; P =.28), MAOD (P =.18), or fractional utilization of V ˙ O 2 max. During the intermittent-interval protocol, the competitive skiers had 34% (95% CI, 3%–65%) longer TTE (P =.03) and accumulated 61% (95% CI, 27%–95%) more O 2 def (P =.001) than the recreational skiers during work phases. Conclusions: Competitive XC skiers have longer TTE and accumulate more O 2 def than recreational XC skiers during an intermittent-interval protocol at similar intensity relative to MAP. This implies that performance in intermittent endurance sports is related to the ability to repeatedly recharge fractions of MAOD. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the effect of a 6-day basketball tournament on the physical demands, perceptual–physiological responses, well-being, and game statistics of elite under-18 (years of age) players. Methods: Physical demands (player load [PL], steps, impacts, and jumps, all normalized by playing time), perceptual–physiological responses (heart rate and rating of perceived exertion), well-being (Hooper index), and game statistics of 12 basketball players were monitored during 6 consecutive games. Linear mixed models and Cohen d effect sizes were used to assess differences among games. Results: Significant changes were found for PL per minute, steps per minute, impacts per minute, peak heart rate, and Hooper index over the tournament. Pairwise comparisons showed that PL per minute was higher in game #1 than in games #4 (P =.011, large), #5 (P <.001, very large), and #6 (P <.001, very large). PL per minute recorded during game #5 was also lower than in games #2 (P =.041, large) and #3 (P =.035, large). The number of steps per minute was higher in game #1 than in all other games (all P <.05, large to very large). Impacts per minute were significantly higher in game #3 than in games #1 (P =.035, large) and #2 (P =.004, large). The only physiological variable that varied significantly was peak heart rate (higher in game #3 than in game #6; P =.025, large). The Hooper index gradually increased throughout the tournament, indicating poorer player well-being as the tournament advanced. Game statistics did not significantly change among games. Conclusions: The average intensities of each game and the players' well-being gradually decreased throughout the tournament. Conversely, physiological responses were mostly unaffected, and game statistics were unaffected. [ABSTRACT FROM AUTHOR]

Studies on postactivation performance enhancement (PAPE) have used different exercises as a conditioning activity to investigate potentiation, but exclusively in upper limbs (UL) or lower (LL) limbs, or contralateral potentiation. A single exercise capable of inducing PAPE in both UL and LL is currently unknown. The present study explored the effect of the clean and jerk (C&J) as a conditioning activity for simultaneously producing PAPE interlimbs at the fourth, seventh, and 12th minutes postintervention. Twelve male weightlifters with 1-repetition maximum (1RM) in the C&J equivalent to ≥1.15 × body mass were randomly submitted to 2 experimental conditions (C&J and control [CON]). The C&J condition consisted of general warm-up (running on a treadmill and self-selected preparatory exercises) and 4 sets of 3 repetitions of C&J with 2 minutes between them (30%1RM, 50%1RM, 65%1RM, and 80%1RM) followed by a countermovement jump and a bench-press throw on a Smith machine after 4, 7, and 12 minutes, to measure the magnitude of PAPE in UL and LL. No previous exercise preceded countermovement-jump and bench-press-throw tests in the CON besides general warm-up. The main finding was that, regardless of time, the C&J resulted in greater height on countermovement jump and Smith machine bench-press throw when compared with the CON, presenting a similar effect size between UL and LL (34.6 [3.9] vs 33.4 [4.1] cm [+3.66%]; P =.038; effect size = 0.30 and 30.3 [4.7] vs 29.0 [5.1] cm [+4.44%]; P =.039; effect size = 0.26), respectively. Thus, C&J can be useful to produce PAPE simultaneously among members. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the contribution of splenius capitis, sternocleidomastoid, and upper fibers of trapezius activation to the gains in rate of force development (RFD) of the head and neck during maximum voluntary ballistic contractions. Methods: RFD gain was facilitated by a single-session intervention for maximum voluntary ballistic contractions in the anterior direction, oriented at 45° to the midsagittal plane, which require active restraint of axial rotation. Muscle activation for the agonist (sternocleidomastoid) and 2 antagonists (splenius capitis and upper fibers of trapezius) was evaluated. The study sample included 12 physically active men (mean age, 22.6 y). RFD (N·m·s−1; 0–100 ms) and integrated muscle activity (50 ms before and 100 ms after force onset) were measured at 10 minutes, 20 minutes, and 2 days postintervention, relative to baseline. Muscle activation predictive of RFD gains was evaluated by linear regression analysis. RFD reproducibility was evaluated using the coefficient of variation of the typical error. Results: The intervention yielded a 1.95- to 2.39-fold RFD gain (P ≤.05), with greater RFD gain for participants with a lower peak moment of force (<10.9 N·m) than those with a higher peak moment (≥10.9 N·m) at baseline (P ≤.002). For the low group, 65% to 74% of the RFD gain was predicted by ipsilateral sternocleidomastoid activation, with ipsilateral splenius capitis activation predicting 77% to 92% of RFD gain for the high group. Absolute peak and impulse of static force were greater for the high than for the low group (P ≤.04). RFD reproducibility was high (coefficient of variation of the typical error ≤ 14.4%). Conclusions: The agonist- and antagonist-focused synergies might reflect different functional priorities, higher RFD gain compared with higher head–neck force. [ABSTRACT FROM AUTHOR]

Purpose: This study examined posttravel perceptual responses of national-team footballers (soccer) following different flight paths, arrival/departure times, and trip contexts. Methods: Details of 396 flights from national-team players (N = 68) were obtained and verified via an online flight database. Each player provided ratings of perceptual fatigue, sleep, soreness, stress, and jet lag for 2 days before and after each trip. The flight path (continents of departure and arrival), travel context (into vs out of national team), and arrival and departure times were obtained for each trip. Linear mixed models compared the pretravel with posttravel change in perceptual responses based on flight path, context, and schedule. Results: Perceived jet-lag ratings were more responsive to travel variables (R2 =.48) than other perceptual ratings (R2 <.26). Travel from Asia to Europe (P <.05) and Europe to Australia (P <.001) had significantly higher jet-lag ratings than all other paths. Fatigue scores were worst following Asia to Europe (P <.05) and Europe to Australia (P <.05) travel, while sleep scores were worst following Europe to Australia travel (P <.01). Perceptual responses were poorer following travel from national team to club compared with all other travel contexts (P <.05). Arrival during the daytime (11 AM to 5 PM) resulted in better perceptual responses than early-morning or late-night arrivals (P <.05). Conclusions: Perceived jet-lag ratings are more responsive to travel demands than perceptual wellness scales in national-team football athletes. Poorer perceptual responses may be expected when travel is longer in nature, ends later in the day, or involves travel out of the national team back to club. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the survival rate (primary outcome) and the marginal bone loss (secondary outcome) of the OsseoSpeed EV Implants (Astra Tech Implant System, Dentsply Sirona Implants; hereinafter EV implants) used in a wide range of clinical scenarios and followed up to 8 years in a nonuniversity setting. Materials and Methods: All EV implants consecutively placed from 2013 to 2021 in a private dental clinic were included, and medical and radiologic records were retrospectively investigated. Independent reviewers collected 11 data types as potential influencing variables and measured the mesial and distal marginal bone levels to the nearest 0.5 mm on available radiographs, either panoramic or periapical. Tables of descriptive statistics were made at implant and patient levels. Univariate and multiple Cox regression models were adjusted for clustering effects and determined the hazard ratio (HR) and odds ratio (OR) for each independent variable collected. Results: The study sample consisted of 597 EV implants and 235 patients. During a mean follow-up of 42.1 ± 23 months (range: 10 to 94 months), 44 implants were lost (7.4%)--34 early (5.7%) and 10 late (1.7%)--in 38 patients (16.1%). The overall survival rate (SR) was 92.6% (CI: 90.5% to 94.7%), and the proportion of patients with all their implants surviving was 83.8% (CI: 79.1% to 88.5%). At the end of the study, the probability of survival of an implant that did not fail early was 98.2% (CI: 97.1% to 99.3%). Implant-level analysis identified two significant variables: implant diameter (HR 0.37, P = .009**) and immediate postextraction placement (HR 2.35, P = .025*). At the patient level, bruxism (OR = 3.29; P = .009**), history of periodontitis (OR = 2.18, P = .030*), and the number of implants placed (OR = 1.43; P = .001**) were found to be statistically significant. After removing dropouts and early failures from a sample of 528 implants, 412 (78%) had a marginal bone loss (MBL) = 0 mm at the end of the observation time, and 106 surviving implants (22%) showed a mean MBL of 1.42 ± 1.08 mm (range: 0.25 to 6.75 mm). Conclusions: An overall medium-term SR of the EV implants was 92.6%. Four of five EV implants showed a mid-term MBL = 0 mm, and 91.86% of implants completed the observation period with an MBL < 2 mm. Thus, the EV implant system was shown to be a valid alternative for routine use in a nonuniversity setting. Clinicians should remember that there is no 100% implant survival in everyday practice and that bruxism, periodontitis, narrow-diameter implants, and immediate placement are risk factors for a higher failure rate. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the survival and success rates of short (> 6 mm and = 8.5 mm) implants after at least 2 years of functional loading. Implants were assessed using clinical parameters such as marginal bone loss (MBL), pocket depth (PD), keratinized mucosa width (KMW), bleeding on probing (BoP), and the peri-implant condition (mucositis or periimplantitis). Any correlations between clinical parameters were analyzed. Materials and Methods: This observational and retrospective study included 114 posterior maxillary and mandibular implants placed in 27 women and 38 men with a mean age of 68.04 ± 9.07 years. Patients included in the study had received at least one short implant between 2001 and 2013, such that each implant was in occlusal function for at least 2 years by 2015. Patients with only long (= 10 mm) implants, patients with any systemic condition, and smokers were excluded from the study. PD, KMW, periimplant condition, BoP, and MBL were the clinical parameters assessed in the study. Data on prosthesis type (single or splinted) and implant features were also obtained. All data were submitted to analysis via Mann-Whitney unpaired test, with a significance level of P < .05. Spearman correlation coefficient was also measured to verify the negative or positive correlation. Results: The mean follow-up time was 74.08 months, and mean implant success and survival rates were 87.63% and 94.74%, respectively. There were 6 implant failures (5.26%). A total of 66 (59.46%) prostheses were screw-retained implant-supported restorations, and 45 (40.54%) were cemented. A total of 93 (86.49%) short implants were splinted to another implant, and 15 out of 111 (13.51%) restorations were single implants. Keratinized mucosa was missing around 43 (39%) implants, whereas PD was measured to be between 0 and 3 mm in 64.86% of implants and = 4 mm in 31.53% of implants. MBL was = 1.5 mm in 71.17% of cases and > two-thirds the length of the implant in 2.71% of cases. Mucositis and peri-implantitis were found in 22.52% and 7.21% of implants, respectively. The correlation coefficient showed a positive result for PD and MBL (0.11; P = .368) and negative results for PD and KMW (-0.42; P = .002) and KMW and MBL (-0.19; P = .183). Conclusions: Within the limitations of this study, it is possible to conclude that short implants are a feasible treatment option for dental rehabilitation. They are considered an excellent alternative to complex procedures and have high survival rates after at least 2 years of follow-up, with compatible peri-implant local tissue response. Moreover, a significant negative correlation between KMW and PD was observed. [ABSTRACT FROM AUTHOR]

Purpose: To explore complex system behavior and subsequent team performance in professional rugby union. Methods: Here, we present 2 studies. In the first, we used global positioning system technology to measure player clustering during stoppages in play in nearly 100 games of professional rugby union to explore team (complex system) behavior and performance. In the second, we measured stress hormones (cortisol and testosterone) prior to team meetings and analyzed these relative to amount of time and the frequency with which players looked at peer presenters, as well as subsequent training performance, to explain how stress may lead to behaviors observed in the first study and subsequent match performance. Results: No link between player clustering during stoppages of play and performance was observed. When players (complex system agents) demonstrated greater levels of stress (as indicated by greater cortisol-awakening response and a greater decline in testosterone-to-cortisol ratio across the morning), they tended to look at peer presenters more; however, training quality declined (P =.02). Correlational analysis also showed that training quality was related to testosterone-to-cortisol ratio (P =.04). Conclusions: Team behavior is complex and can be unpredictable. It is possible that under stress, complex system agents (ie, rugby union players) look at (and cluster toward) their teammates more; however, meaningful interaction may not necessarily occur. Furthermore, while complex system (team) analysis may be valuable strategically in rugby union in the context of describing behavior, without understanding "how" or "why" intrateam/interagent behaviors emerge it may have little meaning. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to quantify the within-individual relationships between spatiotemporal variables and initial acceleration sprint performance in elite rugby backs and to establish a normative data set of relevant strength-based measures. Methods: First, the spatiotemporal variables, ratios of step length to step rate and of contact time to flight time, and initial acceleration performance were obtained from 35 elite male rugby backs (mean [SD] age 25 [3] y) over the first 4 steps of 3 sprints. Angular and linear kinematic aspects of technique and strength-based qualities were collected from 25 of these participants. Second, the same spatiotemporal variables were collected from 19 of the participants on 3 further occasions (12 trials in total) to determine the within-individual associations of these variables and initial acceleration performance. Results: Moderate to very large meaningful within-individual relationships (|r| =.43–.88) were found between spatiotemporal variables and initial acceleration performance in 17 of the 19 participants. From these relationships, a theoretically "desirable" change in whole-body kinematic strategy was individually determined for each participant, and normative strength-based measures to contextualize these were established. Conclusions: Meaningful within-individual relationships are evident between sprint spatiotemporal variables and initial acceleration performance in elite rugby backs. Individualized approaches are therefore necessary to understand how aspects of technique relate to initial acceleration performance. This study provides an objective, evidence-based approach for applied practitioners to identify the initial acceleration technical needs of individual rugby backs. [ABSTRACT FROM AUTHOR]

Context: Slideboards are commonly used in exercise programs, but there is limited information about how they affect muscle activities during exercise. We aim to compare the activation levels of quadriceps and hamstring muscles and hip- and knee-flexion angles during lunge and single-leg squat exercises between normal ground and slideboard in physically active individuals. Design: Cross-sectional study. Methods: Thirty healthy individuals (age: 23.83 [2.84] y, body mass index: 21.75 [1.72] kg/m2) were included in the study. Surface electromyography was used to measure vastus medialis, vastus lateralis, biceps femoris, and semitendinosus activation levels during reaching and returning phases of the forward, lateral, and back lunges and squats that were performed on the normal ground and slideboard. Exercises were performed at a slow pace (60 beats/min). Hip- and knee-flexion angles during the exercises were evaluated by using 2-dimensional motion analysis. Repeated measures of analysis of variance were used for statistical analysis. Results: Vastus medialis and vastus lateralis activation levels were greater during reaching and returning phases of the exercises on slideboard compared with normal ground (P <.05). However, semitendinosus and biceps femoris activity were greater only during the returning phase of the forward lunge (P <.001) and the returning phase of the back squat (P =.002, P =.009, respectively). Hip-to-knee flexion ratios were closer to 1 when the forward lunge (P <.001), back lunge (P =.004), and forward squat (P =.001) exercises were performed on a slideboard. Conclusion: In exercise programs that target the quadriceps and hamstring muscles, slideboards can be effectively used in exercise progressions as they can increase muscle activity. Moreover, squat and lunge exercises on slideboard with a slow pace may also be helpful for improving the balance between hip- and knee-flexion angles. [ABSTRACT FROM AUTHOR]

Context: The Disablement in the Physically Active Scale (DPAS) was recently developed to evaluate the disability process and health-related quality of life. The aim of this study was to investigate the validity and reliability of the Turkish version of the DPAS in physically active individuals with musculoskeletal injury. Methods: The study sample comprised 64 physically active individuals with musculoskeletal injury aged 16–40 years. The DPAS was translated into Turkish according to the guidelines for cross-cultural adaptation. Short Form-36 was used concurrently to test the construct validity. The test–retest reliability of the Turkish version of the scale assessed by intraclass correlation coefficient and Cronbach α was calculated for internal consistency. Results: Confirmatory factor analysis carried out on the Turkish version of the DPAS was confirmed. Cronbach α was calculated to be.946. The intraclass correlation coefficients ranged between.593 and.924 (P <.001). The Turkish version of the scale showed significant correlations with domains of the Short Form-36 (P <.05). When the sensitivity of the study was evaluated, the highest correlation was found between DPAS total score and impairments (r =.906, P =.001), and the lowest correlation was between DPAS total score and quality of life (r =.637, P =.001). Conclusion: The Turkish version of the DPAS is a reliable, valid, and practical tool. The Turkish version of the DPAS can be used by health professionals to understand quality of life, the disability process, and activity limitations in Turkish-speaking physically active people after musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

Background: Only 55% of anterior cruciate ligament-reconstructed (ACLR) athletes return to competitive sports. This brings into question the usefulness of current return to sport (RTS) criteria. High cognitive demand of sport environment clarifies the value of incorporating neurocognitive tests when making decisions regarding the time of RTS. This preliminary study aimed to compare the neurocognitive functions between healthy controls and ACLR male athletes who passed or failed RTS criteria. Methods: A total of 45 male football players, including 15 ACLR who passed RTS criteria, 15 ACLR who did not pass, and 15 healthy controls participated in this cross-sectional study. The Cambridge Neuropsychological Test Automated Battery was used to measure a battery of neurocognitive tasks, including speed of response, sustained attention, working memory, cognitive flexibility, and response inhibition. Results: The results revealed that compared with both the ACLR-passed and healthy groups, the ACLR-failed group showed greater values of 5-choice movement time (P =.02, P =.01, respectively) but lower values of stop signal reaction time (P =.03, P =.001, respectively) and proportion of successful stops variables (P =.02). In addition, compared with the healthy group, both the ACLR-failed and ACLR-passed groups indicated greater values in between errors (P <.001, P =.008, respectively) and reaction latency variables (P =.002, P =.01, respectively) but lower values of A′ (P <.001, P =.007, respectively), probability of hit (P <.001, P =.03, respectively), and percent correct trials variables (P =.006, P =.02, respectively). Conclusions: Our findings indicated deficits in neurocognitive functions in ACLR male athletes. In addition, poor performance in sustained attention, working memory, and cognitive flexibility measures observed in the ACLR-passed group highlighted the necessity for using a multimodal approach via implementation of neurocognitive measures in conjunction with the functional and muscular assessments when making RTS decisions. [ABSTRACT FROM AUTHOR]