International Journal of Sports Physical Therapy最新文献

Background: Belt-stabilized handheld dynamometers (HHD) assess hip rate of torque development (RTD) and strength in research and clinical practice. However, the reliability of HHD with push and pull configurations to measure hip muscles RTD and peak torque is unclear.

Purpose/hypothesis: To determine the intra- and inter-reliability of HHD utilizing push and pull configurations to measure hip abduction and extension early (0-100ms) and late (100-200ms) phases RTD and peak torque. We hypothesized HHD with both configurations would be reliable for measuring hip extension and abduction RTD and peak torque.

Study design: Cross-sectional study.

Methods: Twenty healthy adults (10 females) performed three consecutive maximal isometric contraction trials of hip abduction and extension, utilizing an HHD with push and pull configurations by two raters. Each rater's average early and late phases RTD and peak torque of hip abduction and extension were utilized for analysis.

Results: Intra-rater reliability of hip abduction with push and pull configurations ranged moderate-to-good for early and late RTD phases (push: ICC2,1=0.61-0.88; pull: ICC2,1=0.59-0.75). Peak hip abduction torque showed good reliability in both configurations (ICC2,1≥0.79). Hip extension ranged moderate-to-good reliability for early and late RTD phases in push configuration (ICC2,1=0.72-0.87), with good-to-excellent reliability in pull (ICC2,1=0.77-0.91). Peak hip extension torque showed moderate-to-excellent reliability for push configuration (ICC2,1=0.73-0.92) and excellent reliability for pull (ICC2,1≥0.91). Inter-rater reliability for hip abduction showed moderate in push (ICC3,k≥0.72) and good in pull (ICC3,k≥0.78) configurations for both RTD phases, while hip extension showed good reliability in push (ICC3,k≥0.82) and excellent reliability in pull (ICC3,k≥0.95) configurations. Peak torque showed good reliability for hip abduction (ICC3,k≥0.83) and excellent reliability for extension (ICC3,k≥0.94) in both configurations.

Conclusions: HHD with push and pull configurations is a reliable and cost-effective method for assessing RTD and strength of hip abductors and extensors in healthy adults.

Level of evidence: Level 3.

Background: Scapular kinematics and stabilization are crucial for optimal upper extremity function. Disruptions in normal scapular motion, also rereferred to as dyskinesis, are associated with injuries like subacromial impingement and glenohumeral instability. Clinically feasible methods to assess dynamic scapular motion are essential for accurate diagnosis and rehabilitation but remain limited in both reliability and functionality.

Purpose: The purpose of this scoping review was to systematically identify and summarize the existing literature on clinically feasible quantitative methods that assess active dynamic scapular motion in at least one plane. It seeks to identify tools, technologies, and protocols used in clinical settings, highlighting gaps in current research.

Study design: Scoping Review.

Methods: A systematic search was conducted in PubMed, CINAHL, and SPORTDiscus databases. Studies that utilized clinically feasible methods to assess scapular motion in at least one plane, and with continuous motion or at least two actively achieved and maintained positions (dynamic), were included. Data were extracted regarding instrument types, measurement methods, dynamic motions assessed, and reliability/validity results.

Results: Of the 62 studies meeting inclusion criteria, digital inclinometers were the most frequently used tools, followed by gravity inclinometers and measuring tapes. Scapular upward rotation was the most commonly assessed motion, with a majority of studies focusing on static or basic dynamic tasks rather than functional or sport-specific activities. Validity results varied, with moderate to strong correlations in some tools, but reliability was inconsistent, particularly in dynamic settings.

Conclusions: Clinically feasible methods for assessing dynamic scapular motion exist, but their reliability and ability to capture continuous motion during functional movements are limited. Further research is needed to develop tools that can assess scapular motion during dynamic, multi-planar, and functional tasks, enhancing clinical decision-making for injury prevention and rehabilitation.

Level of evidence: 2b.

Background: Injuries are common in soccer as it is a contact sport. However, longitudinal studies spanning multiple seasons, focused on injuries in female university soccer players in Japan, are lacking. Additionally, broader comparisons on injury patterns remain unexplored. The purpose of this study was to prospectively investigate injuries among female university soccer players over three seasons.

Study design: Descriptive epidemiological study.

Methods: A total of 108 players from a university women's soccer team were included. A qualified athletic trainer assessed injury type (injury or disability), site and severity according to injury occurrence (game or practice) over three seasons. An orthopedic surgeon confirmed the resulting injury.

Results: The overall injury rate was 1.62/1000 athlete exposures. The game injury rate (9.86/1000 athlete exposures) was higher than the practice injury rate (1.39/1000 athlete exposures). Sprains were the most common injury in games and practices; concussions and meniscal tears were also common during games. The lower limbs, particularly the ankles and feet, were the most common anatomical injury sites in both games and practices. Severe injuries requiring long-term withdrawal were frequently observed during games and practices. These included anterior cruciate ligament (ACL) tears, meniscal injuries, and severe concussions, all of which necessitated prolonged recovery periods and withdrawal from team activities.

Conclusion: Injury prevention measures should be prioritized for female university soccer players, especially to address the high injury rate during games and the frequent occurrence of severe injuries.

Level of evidence: 3b.

Background: Portable dynamometers (PD) are widely used to assess hip muscle strength; however, few studies have explored their validity and agreement when evaluating the rate of torque development (RTD) of hip muscles, particularly with different fixation methods.

Hypothesis/purpose: The purpose of this study was to determine the validity and agreement of isometric hip strength and RTD using the PD with two fixation methods: placing the PD on the body (PDpush) or a treatment table (PDpull), compared to an isokinetic dynamometer (IKD). It was hypothesized that an PD would be a valid tool for assessing hip strength and RTD, with PDpull demonstrating strong validity and PDpush showing moderate validity; and its assessments would yield higher values than those obtained from IKD.

Study design: Cross-sectional study.

Methods: Twenty healthy, physically active individuals (10 females and 10 males) were included in this study. Hip abduction and extension strength (peak torque) and RTD (early phase: RTD0-100 ms and late phase: RTD100-200 ms) were assessed using PDpush, PDpull, and an IKD.

Results: Moderate-to-strong correlations were found between PD (both PDpush and PDpull) and IKD for all hip strength (r=0.46-0.73; p<0.05) and RTD (r=0.45-0.73, ρ=0.80; p<0.05) measures. PDpull demonstrated strong correlations for hip abduction RTD0-100 ms and hip extension strength and RTD100-200 ms (r=0.70-0.73; p<0.001), whereas PDpush showed moderate correlations (r=0.45-0.58; p<0.05). Bland-Altman plots with mean differences ± 95% limits of agreement indicated that the PDpush method overestimated all hip abduction and extension strength and RTD as compared to IKD. The PDpull method overestimated hip abduction and extension strength but had mixed results for RTD, either underestimating hip abduction RTD while overestimating hip extension RTD.

Conclusion: The PD is valid tool for evaluating hip strength and RTD, with PDpull offering strong validity for certain measures; however, PD measurements did not agree with the absolute values obtained from IKD.

Level of evidence: Level 3.

Background: Physical therapists and athletic trainers play an important role in promoting physical activity to patients and may utilize the 2018 United States Physical Activity Guidelines (PAG). Currently, there is little data regarding how physical therapists and athletic trainers maintain their personal fitness based upon these guidelines.

Purpose: To analyze how physical therapists and athletic trainers maintain their physical fitness based upon the 2018 United States Physical Activity Guidelines.

Study design: Cross-sectional descriptive survey.

Methods: A 20-question electronic survey was emailed to members of the Academy of Orthopedic Physical Therapy and National Athletic Trainers Association. Professionals were also informed through a recruitment post in different private healthcare Facebook® groups. Survey inclusion criteria included respondents being a physical therapist or athletic trainer and being in clinical practice. Respondents were excluded if they did not meet the inclusions. The 2018 PAG were used as a minimum standard comparison for respondents to report their physical activity. The survey was developed using Qualtrics and underwent two rounds of pilot testing to establish face validity. The survey covered respondent demographics, exercise behaviors, reasons for exercise, exercise programming and assessment, exercise barriers, monitoring health & wellness, and respondent satisfaction with how they have maintained their own physical fitness. Descriptive statistics were used to calculate total responses, frequency count, and percentages.

Results: One thousand one hundred and forty seven professionals (Women =58%, N= 665; Men = 41%, N=472; other = 1%, N=10) (mean age = 48 ± 15.75 years-old) completed the survey. Most respondents (~ 82%) reported meeting or exceeding the PAG for aerobic and muscle-strengthening while using an integrated exercise approach with self-guided workouts (73%) in different settings such as home (65%) or fitness facility (30%). Respondents dedicated an average of 14 hours per week to exercise. A smaller portion of respondents did not meet the PAG and reported displeasure with their current fitness program which may be related to different exercise barriers such as work schedule, lack of time, family commitments, low intrinsic motivation, and lack of energy.

Conclusion: These survey results provide insight into how physical therapists and athletic trainers maintain their physical fitness. The majority of respondents demonstrated good exercise behaviors by exceeding or meeting the 2018 PAG while a smaller portion did not meet the guidelines due to various exercise barriers and displeasure. Future research should investigate strategies to help professionals find optimal work-life balance and time for weekly physical activity.

Level of evidence: 3.

Background: It is unknown if differences exist for normalized velocity (m/s) and step length (m) when measured using clinically accessible tools, such as the 10-Meter Walk Test (10MWT) and a timed gait analysis (TGA), and costly equipment, such as the GAITRite® electronic walkway system, in healthy adolescent athletes.

Purpose: The purpose of this study was to compare normalized velocity and step length data using low- and high-tech equipment during single- and dual-task gait. The investigators hypothesized that there would be no significant differences between data collected using the 10MWT, TGA, and GAITRite®.

Study design: Cross-sectional, repeated-measures study design.

Methods: A convenience sample of healthy male (n=23) and female (n=20) adolescent athletes aged 14-18 years were recruited from a local high school. A three-way mixed analysis of variance analyzed normalized velocity (m/s) and step length (m) data measured with the 10MWT, TGA, and GAITRite® while participants walked at a self-selected speed with and without a visuospatial cognitive task. All data were collected in the participants' school setting. A three-way mixed ANOVA was used to analyze data.

Results: No significant interactions between assessment tool, walk condition, or sex were found. A main effect of walk condition (p<0.0001) and sex (p<0.0004) was found for normalized velocity (i.e., females walked faster than males). Normalized velocity was also significantly decreased when measured with the 10MWT compared to the GAITRite® (p<0.007) and the TGA (p<0.03).

Conclusions: Normalized velocity may be generalizable between the TGA and GAITRite®, but not the 10MWT. Therefore, the TGA may be a viable adjunct to current multimodal assessments of gait following concussion in the absence of costly equipment.

Level of evidence: Level 2.

Background: TECAR (Transfer of Energy Capacitive and Resistive) therapy is a novel electrotherapy modality gaining traction in orthopedic and sports rehabilitation. This technique utilizes radiofrequency energy to promote tissue healing, pain management, and functional recovery, offering a unique approach to address musculoskeletal injuries and conditions.

Purpose: The purpose of this clinical commentary is to delve into the current body of literature on TECAR therapy, meticulously examining both its strengths and the gaps that remain.

Methods: A comprehensive literature review was conducted, focusing on the evolving role of TECAR therapy in managing various orthopedic and sports-related injuries. Key studies, including randomized controlled trials and meta-analyses, were evaluated to assess the effectiveness of TECAR therapy in pain reduction, tissue repair, and enhancement of athletic performance.

Results: Current evidence suggests that TECAR therapy may effectively reduce pain, improve range of motion, and facilitate tissue regeneration. Notably, it has shown promise in treating conditions such as tendonitis, ligament sprains, and spasticity in stroke survivors. Furthermore, studies indicate that TECAR therapy can enhance biomechanical parameters and running economy, potentially leading to improved athletic performance. Limitations in the current research such as small sample sizes, lack of long-term efficacy studies, and variability in treatment protocols hinder definitive conclusions regarding its clinical utility.

Discussion: The authors suggest that integration of TECAR therapy into rehabilitation programs presents opportunities for optimizing patient outcomes and enhancing athletic performance. By incorporating TECAR, athletes may experience faster recovery times, reduced injury risk, and improved performance metrics, making it a potentially valuable addition to sports rehabilitation strategies. Future research should focus on standardizing treatment protocols, exploring long-term effects, and assessing cost-effectiveness to enhance accessibility and implementation in diverse clinical settings. Additionally, mechanistic studies are essential for elucidating the underlying biological processes that contribute to TECAR's therapeutic effects.

Conclusion: TECAR therapy represents a promising yet underexplored modality in rehabilitation. As evidence accumulates, its integration into standard clinical practice could revolutionize approaches to pain management and recovery in patients, especially athletes. Continued exploration and validation of TECAR therapy will advance the field of sports physical therapy, unlocking new possibilities for enhancing rehabilitation outcomes and athletic performance.

Level of evidence: 5.

Background: Due to cost barriers and/or space constraints, electromechanical and hand-held dynamometry are underutilized in rehabilitation settings. As a result, clinicians often rely on semi-quantitative methods that may fail to detect deficits in upper or lower extremity strength. The purpose of this study was to examine the between-trials test-retest reliability and concurrent criterion validity of an accessible crane scale for measuring isometric knee and shoulder strength.

Study design: Observational cohort, Cross-sectional study.

Methods: Twenty healthy, recreationally active adults underwent isometric knee and shoulder strength testing using a crane scale, electromechanical dynamometer, and hand-held dynamometer during a single session. Knee extension and flexion, and shoulder internal rotation, external rotation, and abduction were tested. Three maximal effort trials were performed per device and motion, with the order of device testing randomized. Between-trials test-retest reliability of the crane scale was assessed using intraclass correlation coefficients (ICCs). Concurrent criterion validity was examined using ICCs, absolute and relative error, Bland-Altman plots, and simple linear regression.

Results: Test-retest reliability of the crane scale was excellent for all motions (ICCs ≥ 0.90). Concurrent validity was poor to moderate with the electromechanical dynamometer (ICCs = 0.36-0.72) but excellent with the hand-held dynamometer (ICCs ≥ 0.90). There was a negative bias for the crane scale compared to alternative devices and evidence of a proportional bias for knee extension and shoulder abduction.

Conclusions: A crane scale provides values similar to hand-held dynamometry but is not comparable to results from electromechanical dynamometry. The lack of concurrent validity between the crane scale and electromechanical dynamometry may be partially attributable to differences in stabilization and participant positioning.

Level of evidence: 3b, reliablity and validity study.

Introduction: Basketball has one of the highest injury rates among team sports, however, published data investigating basketball-related musculoskeletal injuries (BRMIs) in professional players in Brazil are limited. The purpose of this study was to investigate the clinical incidence, rate, location, type(s), severity, and nature of BRMIs in Brazilian professional basketball players, and to quantify their impact on sports performance.

Study design: Prospective cohort study.

Methods: Athletes over 18 years old who were registered and active in the professional category of each participating team that signed the Consent Form were included in this study. Over the course of 22 weeks the Team's Physical Therapist collected data weekly through an online questionnaire. The Orchard Sports Injury Classification System (OSICS) was used to provide anatomical and diagnostic classification of BRMIs and the injury severity was evaluated using the Oslo Sports Trauma Research Center questionnaire (OSTRC) score. Qualitative variables were represented by frequency and proportions, and quantitative variables by mean and standard deviation.

Results: A total of 103 athletes with a mean age of 28.8 years +/- 5.4 years reported 164 BRMI's with a clinical injury incidence of 1.6 over the 22-week study. Of these, 122 (74.4%) occurred in the lower limbs and 22 (13.4%) in the upper limbs. The BRMI rate was 5.1 injuries per 1,000 hours/practice and 79.6 injuries per 1,000 hours/game. The knee was the most affected area (19.5%), followed by hip/groin (15.2%). Muscle injuries were the most frequent (33.5%) and the most severe (4070 points OSTRC).

Conclusion: These findings show the importance of implementing injury monitoring measures in basketball using a standardized, low-cost and easy-to-use questionnaire to monitor the impact of BRMIs on practice and game performance.

Level of evidence: 3b (Epidemiology).

Background: Acute exercise may induce a reduction in pain sensitivity, termed exercise-induced hypoalgesia (EIH). The 45-degree Roman Chair (low back extension) is a dynamic resistance exercise that may be beneficial for low back pain as it allows for direct overload of the spinal flexors and extensors. However, the ability of this exercise to reliably produce EIH has not been examined.

Purpose: The purposes of this study were to determine the reliability of heat pain threshold (HPT) and pressure pain threshold (PPT) measures, examine local and systemic EIH effects after a 45-degree Roman chair exercise, and determine if EIH was produced reliably between sessions.

Study design: Observational Cohort, Crossover.

Methods: Thirty-five healthy participants (mean(SD) age: 21(1.39) years, 16 male) completed two identical sessions at least two days apart. HPT and PPT at the upper trapezius (UT) and low back (LB) were assessed pre/post quiet rest to examine reliability of these measures. HPT and PPT were repeated pre/post one set of the Roman chair exercise until failure to examine reliability of EIH. Intraclass Correlation Coefficients (ICC) examined reliability, and a three-way repeated measures ANOVA compared changes in HPT and PPT among quiet rest and exercise conditions.

Results: HPT and PPT demonstrated good (HPT: ICC_3,1 >0.741) to excellent reliability (PPT: ICC_3,1 >0.810). Significant EIH as assessed by PPT was demonstrated at both sites (p UT<0.025, LB<0.001) with larger effect sizes at the LB (ηp² >0.413). When assessed with HPT, significant EIH was observed over the LB (p<0.002) but not the UT (p=0.059) EIH can be reliably induced across sessions over the LB (ICC_3,1 HPT=0.903, PPT=0.815)(r HPT=0.903, PPT=0.814) and UT (ICC_3,1 HPT=0.867, PPT=0.729)(r HPT=0.877 and PPT=0.744).

Conclusion: The 45-degree Roman Chair may reliably induce significant hypoalgesia over the LB assessed with HPT and PPT in healthy participants.

Level of evidence: 3.