International Journal of Sports Physical Therapy最新文献

Background: Proprioception is crucial for shoulder stability, yet clinical methods for assessing all aspects, particularly the sense of force (SOF) -the ability to perceive, interpret, and reproduce force at a joint-are limited. The purpose of this study was to test a new SOF protocol with a handheld dynamometer (HHD) and examine its agreement with an isokinetic dynamometer (IKD), as well as its reliability and the effect of contraction intensity.

Design: Cross-sectional measurement study.

Methods: Fifty-one healthy participants were assessed for SOF using an Isokinetic dynamometer (IKD) and a HHD to evaluate the agreement between the two methods. Of the initial sample, 25 participants completed a second session with the HHD, enabling the evaluation of the protocol's reliability exclusively with this device. Error score were also compared between three different contraction intensities: 10%, 30% and 50% of maximal voluntary isometric contraction (MVIC). Intra-class correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) for intra-rater (within-day and between-day) and inter-rater (within-day) reliability while agreement between the tools was assessed using regression line method.

Results: Agreement between devices was low with a poor correlation observed between measurements. The HHD SOF protocol showed low to moderate reliability for intra-rater between-day assessments, with ICCs from 0.44 to 0.64. The absolute reliability MDC95 ranged from 12% to 42%. Inter-rater within-day reliability was low, with ICCs from 0.007 to 0.43. Significant differences in error scores were observed between the HHD and IKD at 30% and 50% MVIC, and higher error scores were noted at Target 10% MVIC compared to 30% and 50%.

Conclusions: The SOF protocol using HHD demonstrates moderate reliability but low inter-rater reliability. Different tools yield varying results, with force intensity impacting SOF error scores, while rotation does not.

Level of evidence: 2b.

Exercise targeting the trunk and hip (core) musculature is common practice in rehabilitation and performance training. Historical underpinnings of core exercise focus on providing stability to the spine, thus improving the function of the spine and extremities, while instability has been postulated to result in pathology and impaired performance. Mechanistic studies on the topic are often conflicting and indeterminate, suggesting the theoretical underpinnings of targeted core exercise may be over assumed in common practice. The best modes of intervention also remain undefined, with combined methods having potential to optimize outcomes. This includes moving beyond isolated exercise camps and being inclusive of both targeted exercise and progressive multi-joint movements. The purpose of this clinical commentary is to describe the historical mechanisms of the stability-instability continuum and the role of exercise intervention. A spectrum of ideologies related to core exercise are examined, while appreciating positive outcomes of exercise interventions across healthy and pathological populations. Finally, exercise summaries were compiled to improve critical reasoning within current practice and inspire future investigations.

Level of evidence: 5.

Background: Soccer is a contact sport during which participants risk injury, including due to concussion. Interestingly, the task most frequently associated with concussions is the act of heading the ball. This study seeks to answer the following research question: Does an acute playing of purposeful soccer heading in female football players lead to changes in BESS normative outcomes and balance? Additionally, we aim to explore the relationship between a gold-standard BESS Test and a Balance Test performed on a force plate.

Methods: This project involved twenty-eight female soccer players (age = 19.6 + 2.96 years, mass = 60.4+ 5.3 kg, and height = 163.6 + 6.4 cm). pre and post the heading condition and the results of the Wilcoxon Signed Ranks Test. The participants were healthy and underwent BESS monitoring on a force plate before and after heading and footing training. Standard 450 g soccer balls were utilized. Participants performed ten headers for the header condition and ten footers for the footer condition. Resultant sway velocity and BESS error outcomes were calculated before and after heading and footing training. I need a brief description of the statistical approach here.

Results: Statistically significant increases after the heading condition were found for Single Leg Stance (COP PATH) score (Z = -3.986, p = 0.000), BESS score on foam surface (Z = -2.511, p = 0.012), BESS score on firm surface (Z = -2.353, p = 0.019). A statistically significant increase after the footer condition was found for the Tandem Stance (mm2) score (Z = -2.900, p = 0.004). A statistically significant difference between the group conditions was found in the post-BESS score foam difference (U = 268.500, p = 0.042). BESS score foam mean increase was 1.93 after the heading condition and 0.21 after the footer condition.

Conclusion: This pilot study not only tests the feasibility of using force plates to measure BESS outcomes after heading in female soccer but also underscores the effectiveness of using BESS parameters to evaluate changes in balance function following heading compared to a control footer condition. The findings of this study provide valuable insights into the potential effects of soccer on balance in female players, contributing to the body of knowledge in sports medicine and physical education.

Level of evidence: 3.

Background: Muscle power is an important physical capability across all age groups and health statuses. Typically, assessing lower limb muscle power requires expensive and sophisticated equipment to ensure reliability and validity of power. Hence, there exists a clear need to identify a simple and effective functional performance test that can serve as a proxy for evaluating muscle power when equipment is unavailable. Thus, this study aimed to identify an easily administered, functional performance test to assess unilateral muscle power.

Methods: Correlations between maximal leg extensor power (LEP) were measured using the Nottingham Power Rig, and several functional tests (i) unilateral 5-repetition Sit-To-Stand (5STS), (ii) unilateral 30-second Sit-To-Stand (30STS), and (iii) unilateral Hop For Distance (HFD), as well as (iv) self-reported physical activity assessed by the Short Questionnaire to AsseS Health-enhancing physical activity (SQUASH). Pearson's correlation coefficients were calculated between LEP and the functional tests for both legs, as well as self-reported activity, among 52 healthy participants with a mean age of 31.1 years (ranging 19-49 years).

Results: A negligible correlation was found between LEP and SQUASH score. Negligible correlations were found between LEP and unilateral 5STS, unilateral 30STS, and HFD on the dominant leg. Positive low correlations were found between LEP and Unilateral 30STS (r=0.43, p=<0.01) and HFD (r=0.44, p=<0.01) on the non-dominant leg, as well as an inverse low correlation between LEP and unilateral 5STS (-0.42, p=0.01) on the non-dominant leg.

Conclusion: All correlations produced were negligible to low, suggesting that the functional tests investigated in this study may not be indicative of lower limb muscle power.

Level of evidence: 3b.

Background: Therapeutic interventions are widely used in clinical practice to prepare individuals for movement, recover from exercise, and mediate pain and inflammation associated with injury. However, there has yet to be cited consensus regarding when to use such interventions.

Purpose: Using the Delphi method, this study aimed to develop consensus among physical therapists (PTs) and athletic trainers (ATs) regarding the use of percussive, vibration, infrared, heat, and cryotherapy in a variety of treatment circumstances. These included preparation and recovery from physical activity, treatment of acute and chronic joint pain, and treatment of acute and chronic soft tissue/muscle pain.

Methods: Four rounds of surveys were delivered to individuals who were licensed or certified PTs/ATs, with more than 1,000 hours of experience working with athletic populations and experience using at least one of the interventions of interest in the prior five years. Consensus was defined as a greater than 70% agreement, and consideration for use was defined as selecting "In Some Instances'' and"In Most Instances."

Results: Ninety-four individuals responded to the screening survey (n₁ = 74, n₂ = 68, n₃ = 44, n₄ = 32). The individuals who participated agreed that they would consider using the following therapeutic interventions in treatment: 1) percussive therapy, local vibration, and local heat therapy in the preparation for physical activity; 2) local cryotherapy in recovery from physical activity; 3) local cryotherapy for the treatment of acute joint pain and acute soft tissue/muscle pain; 4) local heat and local cryotherapy for the treatment of chronic joint pain; and 5) percussive, local vibration, local heat, and local cryotherapy in the treatment of chronic soft tissue/muscle pain.

Conclusion: Clinical intervention often relies on patient presentation and preference. This study provides a consensus on the use of common therapeutic interventions for the management of athletic recovery, pain, and inflammation among ATs and PTs.

Level of evidence: 3.

Background: Athletes prematurely cleared to play following concussion increase their risk for subsequent concussion and musculoskeletal injury, leading practitioners to call for low-cost and objective tools to identify lingering neuromotor control deficits following concussion. # PurposeThe purpose of this feasibility study was to determine the usefulness of Mizzou Point-of-care Assessment System (MPASS) measures for creating a discriminant model classifying individuals as being either healthy or in the post-acute phase of concussion (having suffered a concussion within the prior three months).

Study design: Cross-sectional.

Methods: Ten participants with concussion injury (Mean = 3.9 ± 1.66 wks. post-concussion) and twelve with no concussion within the prior year participated in this study. All participants completed walking (normal, serial subtraction by seven, and head shaking), Romberg balance (eyes open and eyes closed on firm surface), and reaction time tasks while MPASS recorded kinematics, kinetics, and reaction time. Principal component analysis (PCA) was used to reduce the dimensionality of MPASS data.

Results: Using four retained principal components (PCs), the LDA model achieved a statistically significant (p = 0.007) accuracy of 82% with 80% sensitivity and 83% specificity for classifying participants into groups.

Conclusion: This work presents a framework for assessing the discriminative power of multidimensional and clinically feasible tools for assessing human movement.

Level of evidence: 3.

Intra-articular and degenerative hip pathologies have become common place with the number of total hip replacements rising year on year in the United Kingdom (UK). Pathology is identified by clinicians using special tests which are researched maneuvers used by clinicians to rule in or rule out specific musculoskeletal pathologies. Special tests used for hip pathology usually have high specificity to exclude degenerative and intraarticular pathology but vary in sensitivity. These special tests are usually only conducted when a person is symptomatic and typically require radiological confirmation to diagnose. The aim of this review was to appraise research to determine whether functional changes in the TFL and UGM muscle complex could indicate degenerative and/or intra articular pathology, with a specific focus on the utility of the ratio in strength of TFL and UGM to assist clinical diagnosis. The hypothesis was that the ratio of the strength of Tensor Fascia Latae (TFL) and the upper fibres of Gluteus Maximus (UGM) could suggest early intra-articular hip pathology, and that changes to this ratio could indicate deterioration of the hip joint before symptoms present/progress.

Level of evidence: 5.

Background and purpose: Dancers sustain substantial injury rates ranging from 0.62-5.6 injuries per 1000 dance exposure hours with 72% of these injuries attributed to overuse mechanisms. Highly technical activities like dance often require high training volumes incorporating deliberate practice from a young age which may contribute to these high percentages of overuse injuries. The purpose of this study was to determine trends between dance participation, athletic participation, and injury history.

Study design: Cross-sectional survey.

Methods: Dancers over 18 years old with at least one year of dance experience were recruited from across the United States to complete a survey via Qualtrics. The survey included five sections addressing basic demographic information, dance experience, athletic activity history, and injury history. Relationships between variables were analyzed using the Mann-Whitney U test or the Wilcoxon Signed Rank test. Factorial ANOVAs were also used to observe relationships between three or more groups.

Results: Of 424 total responses, 339 were deemed complete for analysis. Nearly 75% of respondents reported experiencing at least one injury that inhibited their dance ability. Greater total injuries were reported by participants who had more years of dance experience, those who practiced ballet, and individuals who began dance before age 12. Approximately one-third of participants exclusively participated in dance with no involvement with other athletic activities. Respondents starting dance prior to age 12 reported participation in fewer athletic activities. However, no difference in the number of injuries was observed between individuals involved in athletic activity compared to those practicing dance alone.

Conclusion: Increased dance exposure and associated high training volumes and repetitive movements may represent a greater risk for overuse injuries than sport specialization in dancers.

Level of evidence: 3B.

Introduction: There is a high incidence of shoulder injuries among overhead athletes. Identifying and understanding risk factors for these injuries, particularly those that can be modified, is a necessary step towards being able to effectively develop and implement shoulder specific injury prevention programs. Therefore, the purpose of this systematic review was to identify risk factors associated with a new onset of shoulder pain and injury among the athletic population.

Design: Systematic Review.

Methods: A systematic review of the literature was performed within PubMed, Embase, AMED, CINAHL, and EmCare databases. Studies were screened utilizing the following inclusion criteria; (a) athletes currently pain free or no history of pain at baseline, (b) athletes with shoulder and or arm pain originating from a musculoskeletal shoulder problem (c) risk factors captured prospectively (d) pathoanatomy and biomechanics in isolation or in addition to personal characteristics, etc. (e) reporting relative risk, odds ratios, and/or hazard ratios and (f) follow up ≥ 6 months. Due to data heterogeneity, only a descriptive data synthesis was performed. Data were extracted and underwent risk of bias assessment utilizing the Quality in Prognosis Studies (QUIPS) tool. PRISMA guidelines were utilized throughout.

Results: Nineteen papers were included. A total of four studies investigated baseball, five handball, three swimming, two tennis, two military, one cricket, one American football, and one with multiple sports, totaling 7,802 athletes. The risk of bias among the included studies was rated from moderate to low overall with no single study being identified as high risk of bias. All studies designs were a level of evidence of II except for two studies that were level III. The most significant risk factors included range of motion, reduced strength, history of local/regional musculoskeletal pain, previous injury, and training load. There are inconsistencies in how injury and pain are defined within studies.

Conclusion: Many risk factors are easily objectifiable and modifiable which may help in developing shoulder injury mitigation strategies. Three of the five significant risk factors for injury can be identified by objective pre-screening measures. While previous pain and injury cannot be mitigated, training loads should be closely monitored and adapted according to other risk factors and the athlete's response.

Level of evidence: 2.

Introduction: Partial Weight Bearing (PWB) is integral to rehabilitation protocols following orthopedic and trauma surgeries. Standard of Care (SOC) for PWB training often involves using a bathroom scale, a method criticized for its inaccuracy. This study aimed to compare SOC training in PWB with a biofeedback device (insole).

Methods: Sixty healthy participants were randomized into SOC or Biofeedback (BF) training groups, practicing 20 kg PWB using a standardized protocol. Gait data, including compliance with weightbearing restrictions (not exceeding 150% of the set weightbearing limit), was monitored using Loadsol® insole force sensors. Participant satisfaction and usability were assessed through questionnaires. Training duration and walking speed were also measured.

Results: The BF group's peak force averaged 330 Newtons, significantly lower than the SOC group's 600 Newtons, which exceeded the prescribed limit by over three times (p ≤ 0.001). Compliance with weightbearing restrictions was substantially higher in the BF group (88% or 29/33 participants) compared to the SOC group (19% or 5/27 participants) (p ≤ 0.001). The BF group also required less training time to learn PWB, averaging 9:00 ± 3:06 minutes, versus 12:49 ± 3:01 minutes in the SOC group (p ≤ 0.001). Questionnaire responses showed no significant differences between groups.

Conclusion: Real-time audio-visual Biofeedback significantly enhances compliance with weightbearing restrictions in PWB training while reducing the training duration. Based on these findings, the implementation of biofeedback devices in PWB training is recommended.

Level of evidence: 3.