International Journal of Sports Physical Therapy最新文献

Background: Recent technological advances have led to the development of user-friendly force plate systems that provide clinicians with the ability to analyze movement with precision that was previously only available within a biomechanics laboratory. While this development is promising, there is limited evidence supporting the concurrent validity of the range of variables provided by these devices, making it difficult for clinicians to interpret how values obtained within a clinical environment compare to published research.

Purpose: To compare the concurrent validity of specific performance metrics obtained during a countermovement (CMJ) jump between a clinical grade force plate system and a laboratory grade system.

Study design: Laboratory Based Cohort Study.

Methods: Sixty youth basketball athletes performed a CMJ jump on a clinical grade and a laboratory grade force plate system. Raw data from each device was utilized to calculate the following measures: jump height, peak ground reaction force (GRF), eccentric rate of force development (RFD), and concentric and eccentric impulse. Wilcoxon signed-rank tests evaluated differences between measures. Spearman correlations and Bland-Altman plots analyzed the relationship and accuracy between devices across all measures.

Results: There were no statistically significant differences and good agreement between devices for jump height, peak GRF, and eccentric RFD (p>0.05, percent difference range -3.35% to 6.14%). Other measures of jump performance, including concentric RFD measures, eccentric impulse, and concentric impulse, were moderately to poorly correlated (R-value range 0.296-0.447) and significantly different (p<0.05) between devices.

Conclusion: Measurements between the clinical grade and laboratory grade force plates for jump height, peak ground reaction force, and eccentric RFD were comparable and showed good agreement. Clinicians should exercise caution when comparing data related to impulse measures between these systems.

Level of evidence: 3.

Background: Chronic low back pain (CLBP) is common among adolescent athletes, particularly baseball players; however, its association with body composition remains unclear.

Purpose: To investigate the relationship between body composition parameters and the presence of CLBP in high-school baseball players.

Study design: Retrospective cohort study.

Methods: Male high-school baseball players were recruited and divided into the CLBP and non-CLBP groups. CLBP was defined as low back pain rated ≥3 on the numerical rating scale (NRS) and lasting >12 weeks. Body composition was measured using bioelectrical impedance analysis in the first year of high school. Logistic regression was used to identify the factors associated with CLBP.

Results: Ninety male baseball players participated (mean age: 16.8±0.4 years, during second year). The CLBP group (n=31) showed significantly higher percentage body fat (PBF), body fat mass (BFM), BFM index, and trunk fat mass compared with the non-LBP group (n=59). Logistic regression analysis identified first-year NRS scores (odds ratio [OR]: 2.10; 95% confidence interval [CI]: 1.46-3.21) and PBF (OR: 1.26; 95% CI: 1.05-1.51) as significant predictors of CLBP.

Conclusion: Elevated body fat percentage and elevated pain intensity in early high-school years were associated with the development of CLBP among high-school baseball players. Regular monitoring of body composition and early intervention based on pain levels may effectively prevent CLBP in adolescent baseball players, thereby supporting better long-term athletic performance and health outcomes.

Level of evidence: 3b.

Background/purpose: Chronic low back pain affects how individuals bend. Whether pain self-efficacy, a term describing one's confidence in their ability to perform activities despite experiencing pain, affects how much people with chronic low back pain bend their lumbar spine and hips in response to exercise is unknown. The aim of this study was to investigate whether baseline pain self-efficacy influenced either lumbar or hip flexion range of motion over the first quarter of forward bending post-exercise intervention.

Study design: Cohort study. # MethodsNew patients (aged 18-65 years old) presenting to a physiotherapy clinic with moderate-severe chronic low back pain-related disability who had not undergone spinal or lower limb surgery underwent assessment of pain self-efficacy (using the Pain Self-Efficacy Questionnaire; range 0-60 points; higher indicates better), pain intensity and kinesiophobia prior to 12-weeks of an exercise rehabilitation program. Two outcome measures (lumbar and hip flexion range of motion over the first quarter of forward bending from stance) were assessed at baseline, 6 and 12-weeks. Multivariable linear mixed-effects modelling was performed for each outcome.

Results: Sixty-nine participants were recruited. At baseline, mean pain self-efficacy score was 44.0 (SD=10.0; range 22 to 60) points. For every 10-point increase in baseline pain self-efficacy, lumbar flexion range of motion during initial forward bending decreased by a mean 1.47 (95% CI: -2.68, -0.27), 0.51 (95% CI: -1.41, 0.39) and 0.94 (95% CI: -1.75, -0.13) degrees, while hip flexion range of motion decreased by a mean 1.74 (95% CI: -3.68, 0.21), 1.64 (95% CI: -3.70, 0.41) and 1.43 (95% CI: -3.34, 0.48) degrees at baseline, 6 and 12-weeks, respectively.

Conclusions: At baseline, higher pain self-efficacy was associated with reduced lumbar flexion during initial forward bending. However, pain self-efficacy did not influence initial forward bending following a 12-week exercise intervention.

Level of evidence: 2.

Background: Understanding previous experiences of athletes regarding treatments is important for preparation for major sporting events. However, there is little evidence regarding the description of physiotherapy services provided at Olympic Games. Providing data may assist with better understanding of the physiotherapy services provided during major sporting events such as the Summer Olympics.

Purpose: To describe the injuries, injured body regions, most affected sports, and the procedures performed by the Brazilian Olympic Committee (COB) physiotherapy department to help injured athletes recover. This study also aims to provide data to better understand the physiotherapy services provided during the Summer Olympic Games. # Study Design Descriptive Epidemiology Study # Methods This observational descriptive study, uses information collected during the Olympic Summer Games based in the city of Rio de Janeiro, in August 2016. Reported injuries treated and procedures performed by physiotherapy professionals are detailed. Furthermore, the sports in which athletes competed and anatomical regions of the injuries treated are reported, through evaluation forms completed by the health team during the service provided by the BOC. A quantitative and qualitative analysis of the results obtained was performed. Descriptive variables are reported, and a qualitative analysis of the results obtained was also performed. # Results A total of 422 athletes (90.7%) from the Brazilian team, competing in 35 sports, were referred by the medical department to the physiotherapy department. These athletes underwent physiotherapy treatment for 1,021 injuries diagnosed by the medical department of the BOC. Most of the injuries occurred in Judo athletes (n=358, 14.3%), followed by Handball athletes (n=153, 6.1%) and Artistic gymnasts (n=149, 6.0%). The most treated anatomical region was the shoulder region (n=167, 16.4%), followed by the knee region (n=152, 14.9%) and lumbar spine (n=126, 12.3%). The most frequently observed types of injuries were tendinopathies (n=207, 20.3%), sprains (n=198, 19.4%) and contusions (n=120, 11.7%). There were 3,539 physiotherapeutic treatments performed. The most utilized procedures were manual therapy (n=973, 27.5%), followed by electrotherapy therapeutic resources (n=876, 24.8%) and exercises (n=375, 10.6%). # Conclusion A large number of athletes who represented Brazil at the Rio 2016 Summer Olympic Games sought medical care at the Brazilian Olympic Committee's physiotherapy department. Athletes from judo, handball, and artistic gymnastics were those who most frequently sought physiotherapy services. The main injuries treated by physiotherapy professionals were tendinopathies, followed by sprains and contusions. The body regions most frequently treated for injuries were the shoulder, knee, and lumbar spine. The most commonly used procedures in the physiotherapy service were manual therapy, electrot

Background and purpose: The medial elbow joint undergoes changes after repeated pitching; however, the relationship with elbow valgus torque remains unclear. This study aimed to investigate the relationship between the rate of change in medial elbow conditions and the factors related to physical characteristics, including the maximum elbow valgus torque (MEVT) after 100 repetitive pitches.

Study design: Descriptive laboratory study.

Methods: This controlled laboratory study included 26 male high school baseball players from a baseball team. Participants were instructed to throw 100 pitches (20 pitches × five sets). After pitching, the rate of change in the medial elbow joint width, ulnar collateral ligament (UCL), and stiffness of the forearm flexor pronator muscles (FPMs) were examined using ultrasound imaging. The primary outcome was the post-to-pre pitching change ratio of medial elbow tissue; associated factors were evaluated using stepwise multiple regression analysis.

Results: Immediately after pitching, the medial elbow joint width significantly increased, whereas the UCL and FPMs stiffness significantly decreased. The change rate in the medial elbow joint width was associated with the pre-pitch medial elbow joint width. The change rate in UCL stiffness correlated with the nMEVT and shoulder abduction strength. In addition, the change rate in FPM stiffness was associated with the thoracic kyphosis angle at maximum shoulder flexion and change in thoracic kyphosis angle.

Conclusion: Completion of 100 pitches resulted in changes in the medial elbow. Only the rate of change in UCL stiffness after repetitive pitching was related to nMEVT. These findings support monitoring ultrasound-based medial elbow changes after pitching and warrant prospective evaluation of whether their magnitude and the IMU-derived metric relate to later symptoms or injury.

Levels of evidence: 3.

Glenohumeral osteoarthritis (GHOA) presents significant challenges for patients, often resulting in debilitating pain, stiffness, and progressive loss of function. While conventional non-operative treatments such as physical therapy, medications, and corticosteroid injections can provide relief, their benefits may diminish over time. For many patients, total shoulder arthroplasty may not be a viable option due to associated risks or the demands of an extensive recovery process. This leaves a critical need for alternative innovative and effective treatment options. The synergistic pairing of brisement and PT aims to improve range of motion, reduce pain, and enhance strength and function. This approach has the potential to fill gaps in the current treatment landscape for GHOA. The purpose of this clinical commentary is to introduce a novel treatment approach combining brisement, an ultrasound-guided hydrodilatation procedure, with a structured physical therapy program to manage GHOA.

Background: Shoulder injuries are very prevalent in youth adolescent swimmers. As a result, there has been increasing focus on testing athletes post injury using functional testing to assess whether the athlete is ready to return to sports activity. Specifically, the closed kinetic chain upper extremity stability test (CKCUEST) and two versions of a prone ball drop test with elbow straight and elbow bent have been suggested. In order for these functional tests to be used for return to activity decision making normative values for different populations must first be established.

Hypothesis/purpose: The purpose of this study was to establish normative values for the CKCUEST and prone ball drop tests in the elbow extended and elbow bent positions in a population of uninjured competitive youth swimmers.

Study design: Observational Cross-Sectional Study.

Methods: Fifty-three swimmers without active shoulder pain were recruited from a single competitive swimming club. The CKCUEST as well as prone ball drop at 90 degrees of abduction with elbow straight and with elbow bent at 90 degrees were performed in a randomized order. All subjects were tested prior to the beginning of competition for the year. Participants were then categorized into subgroups by sex and age(10-14 or 15-18). Descriptive statistics were analyzed for all tests and groups were compared using two sample t-tests.

Results: Among this youth population CKCUEST demonstrated mean of 17.8 ± 3.5 touches with increased ball drop with elbow extended on the dominant vs non-dominant arm (31.8 ± 12.1 vs 28.6 ± 11.0 reps) as well as with elbow bent to 90 degrees (43.7 ± 13.6 vs 39.6 ± 15.4 reps). Additionally, there were differences in repetitions when groups were split by age with the 15-18 year old group demonstrating significant (p<0.05) increase vs the younger group across all testing.

Conclusion: Baseline values in an uninjured competitive youth swimming population are provided for three commonly described upper extremity functional tests.

Level of evidence: Level 3.

Given the unique demands which combine the nuance of training and competition venues as well as speed and dynamics of "playing" surface, sliding sport athletes are exposed to a variety of physiological and environmental demands which heighten injury risk and challenge performance. Despite these considerations, literature highlighting both the sports demands and needs of the sliding athlete is scarce. The purpose of this commentary is to describe the unique challenges associated with the medical management of sliding sport athletes and offer recommendations for developing an integrated approach for mitigating injury risk and optimizing performance within this population. Additionally, the commentary aims to inform the reader of the variance of technique, from the technical start to sliding finish, as well as injury patterns and performance considerations across the three sliding sports of Bobsled, Luge, and Skeleton. Further, strategies to optimize performance outcomes, such as mental imagery and visualization, and implementation of an integrated support team model will be discussed. # Level of Evidence 5.

Background: Anterior cruciate ligament (ACL) tears are one of the leading injuries in soccer players, especially among female athletes. Prior research has investigated risk factors associated with the swing limb during a soccer kick, but limited research has focused on biomechanical risk factors of the stance limb that may contribute to elevated injury risk when kicking.

Hypothesis/purpose: The purpose of this study was to quantify the relationship between strike stance angle (SSA) and lower extremity kinematics and kinetics during a soccer kick. SSA is the coronal angle created by the hip joint center to the ankle joint center of the stance limb from vertical. It was hypothesized that a greater SSA would be correlated to greater biomechanical risk factors and that correlated findings would differ by dominance.

Study design: Cross-sectional study.

Methods: Nineteen healthy female soccer players (15.2±0.9 years) were tested performing a soccer kick on each limb in a motion capture laboratory. Kinematics and kinetics from the stance limb were captured at ball contact. Spearman correlations were performed to identify significant associations with SSA.

Results: During the stance limb-dominant kick, greater ankle dorsiflexion (r=0.72, p=0.018) was associated with greater SSA. Non-significant trends towards increased hip adduction and knee flexion were also observed. For the stance-limb-non-dominant kick, knee valgus moment (r=-0.81, p=0.002) and external knee rotation moment (r=-0.66, p=0.038) were also associated with greater SSA. A non-significant correlation was also observed between increased knee flexion and greater SSA.

Conclusions: Altered hip mechanics and knee loading risk factors were associated with greater SSA, and associations differed by limb dominance. Additional research is needed to better define the relationship between SSA and lower extremity injury risk of healthy youth soccer players and to explore the potential impact on injury prevention.

Level of evidence: Level 3.

There are many approaches to physiotherapy and exercise-based rehabilitation following surgical treatment of femoroacetabular impingement syndrome (FAIS). Focus on a multidimensional approach, integrating tissue healing timelines with patient-specific functional recovery strategies is important. Key surgical considerations, such as labral- and/or capsular management and cartilage regeneration, alongside their implications for postoperative rehabilitation must be considered. The purpose of this clinical commentary by the Society for Cartilage Regeneration and Joint Preservation (QKG) is to provide a comprehensive framework for the physiotherapy and exercise-based rehabilitation following surgical treatment of FAIS. The framework outlines distinct time- and criteria-based phases of rehabilitation, from preoperative preparation (prehabilitation) to long-term recovery, emphasizing an individualized assessment and care, supported by recent research linking musculoskeletal outcomes to psychosocial drivers, emphasizing the need for personalized rehabilitation strategies. # Level of evidence 5.