International Journal of Sports Physical Therapy最新文献

Pre-participation and return to activity functional assessments are commonly used in clinical practice to assess movement quality and identify athletes' limitations. While there are slight differences between each specific test battery, general guidelines suggest that the tests be completed without a warm-up. This has been suggested because dynamic stretching may improve range of motion and athletic performance. However, athletes typically warm up prior to participating in sport. Therefore, researchers should investigate the acute effects of dynamic stretching on functional tests and movement screens and evaluate other factors that may influence performance on these test batteries. Scientific evidence for standardized implementation of various movement screens is lacking, and future research should aim to identify gaps in the literature to allow clinicians to properly implement evidence-based practice functional assessments. The purpose of this commentary is to discuss various considerations for implementing movement screens and assessment tools into clinical practice.

Level of evidence: 5.

Background: Verbal and tactile cues can increase muscle activity, force production, and kinematics. Several studies demonstrate the effects of verbal and tactile cues on upper extremity muscles, while relatively few examined lower extremity muscles, specifically the gluteals. Studies that observed changes in gluteal function from verbal and tactile cues examined muscle activity via electromyography rather than force production or functional activities such as jumping.

Purpose: The purpose of this study was to measure the effects of verbal and tactile cues on gluteal force production and broad jump distance.

Study design: Cross-Sectional cohort.

Methods: Gluteus maximus force production and broad jump distance were tested in forty-two healthy male and female university students at baseline and after verbal and tactile cues given in random order. Gluteus maximus force was measured using handheld dynamometry and reported in kilograms. Verbal cues included "push, push, push" before both tests. The examiner provided tactile cues to the gluteus maximus before force production testing, and the participant provided tactile cues to both gluteus maximus muscles before performing the broad jump. Performance on the broad jump was measured in centimeters. Descriptive statistics and test-retest reliability via Pearson correlation coefficients were calculated, differences in performance between sexes were analyzed with an independent t-test, and changes in force production and jump distance from baseline were analyzed using a one-way ANOVA.

Results: Mean gluteus maximus force production following verbal cues significantly increased (p = 0.000) by 13.48% (3.83 kg) compared to the control condition, while gluteal force production following the tactile cues was not significantly different. Broad jump distance following the verbal cues significantly increased (p = 0.000) 3.99% (7.71 cm) compared to the control condition and significantly increased (p = 0.000) by 2.95% (5.71 cm) following the tactile cues. There were no significant differences in performances between males and females. The test-retest reliability of all measurements was 0.97-0.99.

Conclusion: Verbal cues significantly increased gluteus maximus force production and broad jump distance. Tactile cues significantly increased broad jump distance but had no significant effect on gluteus maximus force. These results have implications for clinical testing and athletic performance when gluteus maximus force and jump distance are concerned.

Level of evidence: 3.

Background: Fatigue is common in sports, impairing performance and increasing injury risk, yet little is known regarding fatigue and concussion. Impaired neck neuromuscular function may contribute to concussion at baseline, where central fatigue may further impair neck function resulting in increased concussion risk. These effects may be magnified in athletes with a history of concussion.

Purpose: To determine the effect of exercise induced central fatigue on neck joint position error, strength, and endurance in healthy subjects and those with a history of concussion. The investigators hypothesized that EICF would have a negative effect on all variables.

Study design: Healthy subjects were examined using a single factor, within-subjects repeated measures design. Concussion history subjects were examined using a single-subject design.

Methods: Nineteen healthy subjects and five subjects with a history of concussion were recruited for the study. Cervical joint position error, muscle strength, and neck flexor endurance were tested before and after exercise induced fatigue.

Results: There was a significant increase in constant (p = 0.0027) and absolute joint position error (JPE) (p < 0.001); decrease in neck flexor endurance (p < 0.001); and decrease neck strength into cervical flexion (p = 0.01) in healthy subjects following fatigue. Among concussion history subjects, five demonstrated a significant increase in absolute and constant JPE (p < 0.05); four demonstrated a significant decrease in neck flexor endurance (p < 0.05); one in neck flexion muscle strength (p < 0.05); and three in neck extension and rotation muscle strength (p < 0.05) following fatigue.

Conclusions: Cervical neuromuscular function deteriorated following fatigue in healthy subjects. Resulting impairments may affect force alterations in cervical control, potentially increasing concussion risk. Concussion history subjects descriptively demonstrated similar results, however further research should examine formal comparisons involving subjects with and without concussion history.

Level of evidence: 3b.

Background: Isokinetic dynamometers are widely used when assessing neuromuscular function including knee extension kinetics. However, these dynamometers are often prohibitively expensive and are not portable. Thus strain-gauge technology has grown in popularity.

Purpose: The purpose of this study was to compare kinetic data captured via an isokinetic dynamometer against an affordable and portable strain-gauge with a treatment plinth during maximal isometric knee extensions.

Study design: Cross-sectional study.

Methods: Healthy participants (8 males and 6 females; age 30.2±7.1 years) volunteered and performed knee extensions at a 90° knee angle on a dynamometer and a treatment plinth with a portable strain-gauge. Peak force (PF), peak rate of force development (PRFD), rate of force development (RFD₂₀₈₀) and impulse (IMP₂₀₈₀) from 20-80% of onset to peak force were assessed using both strain-gauge and isokinetic dynamometer. Between-device differences were evaluated by the Wilcoxon signed-rank test, Cohen's d effect sizes (ES), Pearson's correlation coefficients (r), and Bland-Altman plots.

Results: No significant or meaningful differences were identified between isokinetic and strain-gauge devices (all p≥0.268, ES≤0.35). However, slightly greater (2.5-9.5%) outputs were observed with the isokinetic dynamometer. Very large significant between-device correlations were found for PF (r=0.77, p=0.001) and PRFD (r=0.73, p=0.003), while small and moderate non-significant between-device correlations were found for RFD₂₀₈₀ (r=0.48, p=0.079) and IMP₂₀₈₀ (r=0.59, p=0.060). Bland-Altman plots did not reveal apparent biases from high to low performers.

Conclusions: These results indicate that the strain-gauge device can produce valid maximal and rapid force expression measurements. Similar results, such as those quantified via an isokinetic device, can be obtained without extreme rigour and constraint. The study's findings support using the practically relevant treatment plinth and strain-gauge combination as a suitable alternative to the isokinetic dynamometry for measuring PF and PRFD. Therefore, more rehabilitation and sports performance practitioners can confidently assess knee extension kinetics.

Level of evidence: 3.

Introduction: Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. .

Study design: Qualitative study.

Methods: Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. .

Results: Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). .

Conclusion: The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. .

Level of evidence: Not applicable.

Hip OA is becoming more common, with a greater number of younger individuals undergoing total hip arthroplasty (THA). These individuals have the desire to return to considerable loading and in some instances return to sport. The purpose of this review was to investigate the current guidelines and/or protocols for hypertrophy or strengthening in individuals who have undergone total hip arthroplasty. A total of 16 papers were identified, some of which also addressed total knee arthroplasty. There is no consensus for the best practice for a hypertrophy program following THA especially regarding when a direct anterior approach was used during hip arthroplasty. Further research is needed as this is a growing area in rehabilitation. This review aims to bridge the gap by offering a comprehensive synthesis of the available literature on postoperative rehabilitation after THA, with a specific emphasis on identifying the most effective muscular strengthening and hypertrophy training programs for patients undergoing anterior approach hip surgery.

Background: The benefit of performing the Nordic Hamstring Exercise (NHE) on an inclined board has been described, however, isometric hamstring activation in different knee and hip angles has not yet been thoroughly explored.

Purpose: This study investigated the effect of variations in knee and hip angles during the isometric performance of the NHE on electromyographic activity of the hamstring muscles.

Study design: Crossover study.

Methods: Thirteen male volunteers performed isometric contractions during the NHE with the knee (30°, 50°, 60°) and the hip (0°, 30°, and 45°) in various angles of flexion on a leg support platform which was inclined at 30°. An electrical goniometer was used to monitor the knee and hip joint angles during 5-s isometric contractions. A multivariate analysis of variance with repeated measures was used to compare normalized electromyographic values of each muscle across different knee and hip angles, followed by pairwise comparisons.

Results: The electromyographic activity of the biceps femoris, semitendinosus, and semimembranosus at a knee angle of 30° and hip angle of 0° were significantly higher than those observed with a knee angle of 50° and hip angle of 0°, or a knee angle of 60° and hip angle of 0° (p<0.05). The electromyographic activity of the semimembranosus at a knee angle of 60° and hip angle of 45° was significantly higher than values obtained with knee and hip angles of 60° and 0°, respectively (p<0.05).

Conclusions: The results indicate that using a knee flexion of 30° and a hip flexion of 0°, while isometrically performing the NHE on a platform inclined at 30°, may optimize electromyographic activity of the hamstrings.

Level of evidence: 3.

Background: Adolescent dancers are at high risk for injuries due to the physical demands of dance training and the physiological changes that occur during adolescence. Though studies report high injury rates, there are few standardized screening tools available for adolescent dancers.

Hypothesis/purpose: To develop and describe a standardized, feasible, evidence-based, and clinically relevant screen for adolescent dancers.

Study design: Descriptive Epidemiology Study.

Methods: Dancers at two suburban pre-professional dance studios, in two cohorts, participated in the Columbia Adolescent Dancer Screen (CADS) that includes dance injury history, health questionnaires (EAT-26, SF-36, DFOS), aerobic capacity, range of motion, strength, balance/orthopedic special tests, and dance technique. Participants were asked to complete a weekly injury surveillance questionnaire derived from the Dance-Specific Oslo Sports Trauma Research Centre Questionnaire on Health Problems for 14 weeks following the screening. Feasibility was assessed using process and content analysis in four areas: practicality, demand, implementation, and adaptation.

Results: Descriptive data were collected from 32 female dancers aged 11-17 with cohort one averaging 18.57 dance hours per week and cohort two averaging 10.6 dance hours per week. The screen was practical, able to screen seven to eight dancers per hour utilizing nine assessors and requiring a one-hour commitment from dancers. Cost and space requirements were considered and kept to a minimum while utilizing portable equipment. All screening slots were filled with all dancers agreeing to follow-up injury surveillance, indicating high demand. The screen was implemented with two cohorts with revisions to improve efficiency applied for the second cohort.

Conclusion: The CADS is a feasible screening tool for adolescent dancers that overcomes barriers by being pragmatic, evidence-based, and efficient. Screening can be implemented to obtain baseline values, inform wellness recommendations, and establish relationships with medical professionals.

Level of evidence: Level 3b.

Accurately diagnosing pectoralis major injuries, particularly in athletes, often presents a challenge for healthcare practitioners. Although pectoralis muscle injuries are relatively uncommon, the diagnosis of a tear may be overlooked without careful screening by a thorough physical examination of both the injured and uninjured sides. While magnetic resonance imaging (MRI) has traditionally held the gold standard, musculoskeletal ultrasound (MSKUS) has emerged as a viable alternative. This article delves into the power of MSKUS in evaluating and diagnosing pectoralis major injuries, highlighting its dynamic capabilities, real-time visualization, and cost-effectiveness in comparison to MRI. By equipping healthcare professionals with a thorough understanding of MSKUS's potential, this article aims to empower them to confidently diagnose and manage pectoralis major injuries, ultimately improving patient outcomes and facilitating a faster return to function.

After anterior cruciate ligament reconstruction (ACLR), return to sprint is poorly documented in the literature. In soccer, return to sprint is an essential component of return to play and performance after ACLR. The characteristics of running in soccer are specific (velocity differences, nonlinear, intensity). It is important to address these particularities, such as curvilinear running, acceleration, deceleration, changes of direction, and variations in velocity, in the patient's rehabilitation program. Force, velocity, and acceleration capacities are key elements to sprint performance. Velocity-based training (VBT) has gained much interest in recent years and may have a role to play in optimizing return to play and return to sprint after ACLR. Force, velocity, and acceleration can be assessed using force-velocity-power and acceleration-speed profiles, which should inform rehabilitation. The purpose of this commentary is to describe a velocity-based return to sprint program which can be used during ACLR rehabilitation.