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We aimed to determine the usefulness of release push test (RPT) in detecting shoulder pain in baseball players with throwing shoulder injury. Fifty-five baseball players with throwing shoulder injury were recruited. RPT entailed pushing the examiner's hand while simulating the hand position of releasing the ball during throwing. Full can, empty can test, hyper-external rotation test (HERT), Neer impingement sign, Hawkins impingement sign, and O'Brien test were also performed. All tests were considered positive if shoulder pain was provoked during the test. The RPT positivity rate was 51%, which was the highest among all the tests. Ten patients had only RPT positive during the examination; it had the highest single positivity which was also seen with HERT. The players with RPT positivity reported significantly more shoulder pain after the cocking phase of throwing compared to players with HERT positivity who reported more shoulder pain in the cocking phase. This study suggested that RPT may be a useful pain provocation test to assess the start or change in strength of throwing because it showed high positivity rate and could detect specific pain in players with throwing shoulder injury. [ABSTRACT FROM AUTHOR]

Chronic ankle instability (CAI) causes impairment in proprioception, such as ankle joint position sense and plantar cutaneous sensation. Although plantar vibration stimulation may be effective as a means of enhancing proprioception, its efficacy remains ambiguous. This study aimed to clarify the immediate effects of plantar vibration stimulation on healthy athletes and athletes with CAI. Eight healthy and eight CAI athletes participated in this study, and their joint position sense and cutaneous sensation were evaluated before and after the intervention of plantar vibration stimulation or non-intervention, designed as a cross-over study. There were no significant differences between the healthy group and the CAI group in both joint position and plantar cutaneous sensation. Also, there were no statistically significant changes in either group before or after the intervention. One possible explanation for the absence of differences between the healthy and CAI groups could be attributed to a high Foot and Ankle Ability Measure score. Neither group exhibited any changes in joint position or plantar cutaneous sensation following the vibration intervention. The frequency and amplitude of the vibration stimulation affecting proprioceptors may be different, and the joint position and plantar cutaneous sensation of CAI groups may be comparable with those of healthy participants. [ABSTRACT FROM AUTHOR]

Ankle brace is commonly used to treat and prevent ankle sprain. Its main aim is to restrict supination of the ankle. However, some braces restrict ankle dorsiflexion and plantar flexion. In addition, loosening and loss of restriction after exercise have also been reported. The purpose of this study was to reveal if thin-type ankle brace for ankle sprain restricts ankle dorsiflexion and plantar flexion and its effect of exercise. Five male adults (average age of 30.8 ± 5.2 years) were included in the study. Dorsiflexion and plantar flexion of subjects' right ankle was measured before and after wearing the brace, and before and after exercises. Exercises consisted of performing 20 times of calf raise, full squat, maximum vertical jump, and 5-minute running on a treadmill. Measurement was performed thrice, and their average was statistically analyzed between with and without the brace, and before and after each exercise. The results showed that there was no significant difference between all measured angles of with and without the brace and before and after each exercise. Thin-type ankle brace for ankle sprain have been reported to restrict supination. Considering our results, this brace does not restrict ankle dorsiflexion and plantar flexion. [ABSTRACT FROM AUTHOR]

Background: Sports injuries often occur during landing, necessitating postural stability for injury prevention. Electrical stimulation of the plantar foot induces activities of the intrinsic foot muscles and improves somatosensory and postural stability during landing. However, this effect remains unclear. Therefore, the aim of this study was to investigate the immediate effects of electrical stimulation on the activities of the intrinsic foot muscles, plantar somatosensory system, and postural stability during landing., Methods: Twenty-two college athletes were divided into an electrical stimulation group and a control group. Electrical stimulation was applied to the plantar foot using a commercial device. The toe function and plantar tactile sensations were evaluated. The activities of the intrinsic muscles and the parameters of the ground reaction force were measured and calculated. We compared pre- and postintervention outcomes., Results: In the electrical stimulation group, two subjects showed improvement in toe function, and plantar tactile sensation improved significantly postintervention. The control group exhibited no significant change in plantar tactile sensation. A significant interaction was observed in anteroposterior postural stability during landing, notably improving in the electrical stimulation group., Conclusions: Electrical stimulation of the plantar foot immediately improved toe function, plantar tactile sensation, and postural stability during landing. Such stimulation would be beneficial in preventing sports injuries.

The FLOW program assists mental health providers in transitioning recovered and stabilized specialty mental health (SMH) patients to primary care to increase access to SMH care. In a recent cluster-randomized stepped-wedge trial, nine VA sites implemented the FLOW program with wide variation in implementation success. The goal of this study is to identify site-level factors associated with successful implementation of the FLOW program, guided by the Consolidated Framework for Implementation Research (CFIR). We used the Matrixed Multiple Case Study method, a mixed-methods approach, to compare key metrics hypothesized to impact implementation that were aligned with CFIR. Based upon the number of veterans transitioned at each site, we categorized two sites as higher implementation success, three as medium, and four as lower implementation success. Themes associated with more successful implementation included perceptions of the intervention itself (CFIR domain Innovation), having a culture of recovery-oriented care and prioritizing implementation over competing demands (CFIR domain Inner Setting), had lower mental health provider turnover, and had an internal facilitator who was well-positioned for FLOW implementation, such as having a leadership role or connections across several clinics (CFIR domain Characteristics of Individuals). Other variables, including staffing levels, leadership support, and organizational readiness to change did not have a consistent relationship to implementation success. These data may assist in identifying sites that are likely to need additional implementation support to succeed at implementing FLOW., (Published by Oxford University Press on behalf of the Society of Behavioral Medicine 2024.)

Toe flexor strength is generated primarily by the flexor hallucis longus (FHL) of the extrinsic foot muscles (EFMs) and the plantar intrinsic foot muscles (PIFMs) of the great toe. Toe flexion methods can be broadly classified into toe grip (TG) and toe push-down (TP). Additionally, TP's interphalangeal joint (IPJ) position may influence the FHL and PIFMs activity ratios. This study aimed to elucidate the differences in the muscle activity and muscle activity ratios of the FHL and AbdH during TG, TP with IPJ flexion (TPIF), and TP with IPJ extension (TPIE). Surface electromyography and a custom-made instrument were used to measure the FHL and AbdH muscle activity during TG, TPIF, and TPIE of the great toe in 28 healthy men. The muscle activity and AbdH/FHL muscle activity ratio in the three conditions were statistically compared. The FHL activity was significantly higher during TG and TPIF than during TPIE. The AbdH muscle activity was significantly higher during TPIF and TPIE than that during TG. The AbdH/FHL muscle activity ratio was significantly higher for TPIE, TPIF, and TG in that order. This study showed that the FHL and AbdH muscle activity differed depending on the TG and TP of the great toe, and that the AbdH/FHL muscle activity ratio was different in the IPJ position. These results suggest that selecting a toe flexion method according to the target muscle when measuring and training the great toe flexor strength is important., Competing Interests: Declaration of Competing Interest There are no conflicts of interest regarding this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We report three cases of young athletes with symptomatic ossicles of the medial malleolus who underwent arthroscopic resections of the ossicle combined with deltoid ligament repair. A differential diagnosis of the ossicles beneath the medial malleolus, accessory ossification center, avulsion fracture resulting in pseudoarthrosis, and accessory bone such as os subtibiale has been proposed. However, it is difficult to differentiate them clearly. Most of these ossicles are asymptomatic, although they can cause chronic medial ankle pain, especially in young athletes who require surgical treatment. All three patients had pain in the distal part of the medial malleolus, which restricted their sports activities. Plain radiographs of all three cases revealed a well-defined, round-shaped bony lesion beneath the medial malleolus. Ultrasonographic imaging, magnetic resonance imaging, and arthroscopic findings revealed that ligament attachment to the ossicle varies in volume and type according to the cases. In other words, the mechanisms through which the existence of the ossicles affects the stability of the ankle joint and foot alignment are different in each case, indicating that deltoid ligament repair is necessary according to the cases. In all three cases, we performed arthroscopic resections of ossicles combined with deltoid ligament repairs, achieving favorable short-term clinical outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yabiku et al.)

The FLOW program was designed to facilitate appropriate and safe transitions of patients from specialty mental health (SMH) to primary care (PC) as a method of improving access and reducing appointment burden on veterans who have improved or remitted. In this study, the team evaluated the implementation of FLOW across nine Veterans Affairs (VA) sites using a mixed-methods evaluation in a cluster-randomized stepped wedge trial design. Outcome assessments used data from VA databases, dashboards, and semi-structured interviews and were guided by the Reach, Adoption, Effectiveness, Implementation, and Maintenance (RE-AIM) framework. Across the sites, mean level reach was 1.36% of all specialty mental health patients transitioned to primary care (standard deviation [SD] = 1.05). Mean provider adoption was 10.2% (SD = 8.3%). Approximately 75% of veterans were fully satisfied with their transition and reported shared decision-making in the decision to transition. Rates of transitions did not decrease over the 6-month maintenance period following implementation. These data suggest that FLOW can be successfully implemented and maintained, although there was wide variation in implementation across sites. Future research should examine how to support sites that struggle with implementation., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Introduction: The menstrual cycle is an important indicator of health in female athletes. Female elite adolescent dancers are expected to control their weight while also training intensely, which can lead to menstrual disorders. This study aimed to investigate the relationship between body composition and menstrual status in female elite adolescent dancers. Methods : In total, 131 female elite adolescent dancers (age: 15.9 ± 1.5 years) were enrolled in this study. We measured the height, weight, and body fat percentage (BFP) for each participant and calculated their body mass index (BMI). We gathered information on individual menstruation patterns and the participants' menstrual cycles over the previous year using recall methods. We then compared the differences between dancers with menstrual cycle disorders and those without. Primary amenorrhea was defined as menarche occurring after the age of 15, while secondary amenorrhe was defined as experiencing fewer than 5 or no menstrual periods for at least 3 of the previous 12 months. We conducted a reliability test using the same questionnaire 2 weeks later. Statistical significance was defined as P  < .05, and we calculated the effect sizes (d) and 95% confidence intervals (95% CI). Results : The average BMI and BFP were 22.6 ± 3.0% and 19.4 ± 2.2 kg/m 2 , respectively. Low BFP and low BMI were observed in 51 (38.6%) and 47 (35.6%) participants, respectively. Primary amenorrhea in 3 participants (2.3%) and 29 (22.1%) reported experiencing secondary amenorrhea; they had lower BFP than the dancers who did not experience amenorrhea ( P  = .041, 95% CI, -2.51 to -0.05). Conclusion : Female elite adolescent dancers in China may have lower BFP and menstrual problems. Given that lower BFP may contribute to the occurrence of menstruation disorders, it is essential to pay an attention to both BFP and the menstruation status in female elite adolescent dancers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.