Journal of Sport Rehabilitation最新文献

Context: The Balance Error Scoring System (BESS) is the most commonly used balance test during concussion assessment; however, the test has known limitations related to fatigue. Jumping and landing along with running are common athletic activities that adversely affect postural control. However, the effect of neither subexertional running nor jumping and landing tasks on the BESS is known. Therefore, the purpose of this study was to investigate the effects of a brief exercise bout of running or jumping on BESS performance.

Design: We recruited 52 recreationally active participants who were divided into 3 groups: (1) Drop Jump (Landing), Treadmill Running (Run), and Control.

Methods: All participants performed a preintervention BESS test and were then randomly assigned to a group. The jumping group performed 10 drop jumps from a 50 cm box, 30 seconds between trials, the running group performed a 3-minute treadmill run, and the control group sat quietly for 5 minutes. All participants then completed a second BESS test. The primary analysis was a 2 (time) by 3 (group) repeated-measure analysis of variance with sex as a covariate.

Results: There was a significant interaction (F = 7.396, P = .002). On post hoc, there was a significant improvement (lower) score in the Control group (PRE: 13.9 [4.5]; POST: 10.5 [2.9]; P = .019, d = 0.89) but no significant differences in either the running (P = .579) or landing (P = .849) groups.

Conclusions: A relatively brief exercise intervention resulted in participants failing to improve a subsequent BESS assessment, whereas control participants who rested for 5 minutes committed fewer (3.4) errors. These results suggest that sports health care providers should recognize that even low- to moderate-intensity brief exercise can result in a failure to improve with repeat BESS administration.

Purpose: Trunk function is not only related to physical fitness performance, but also important for the balance, and stability of the whole body. This study aimed to investigate the effects of 2 training methods on trunk stability and athletic performance in adolescent female basketball players.

Methods: Fifty-one healthy elite female basketball players (age: 14.76 [1.84] y, body mass index: 21.41 [1.96] kg/m2) were assigned to TRX training (n = 17), Swiss ball training (n = 17), or control groups (n = 17). Participants performed a progressive program of unstable core muscle training consisting of 8 different exercises, with each exercise performed in 3 sets, twice a week for 8 weeks. The outcome measures were a plank test, the modified double leg lowering task, and athletic performance including jumping, speed, agility, cardiopulmonary endurance, and the ankle proprioception.

Results: Significant group and time interaction were identified in the modified double leg lowering task (P = .032, η2 = .134), with post hoc comparisons revealing improvements in the TRX group (P = .014). The TRX group (8.6%) improved significantly more than the Swiss ball group (2.9%) when it comes to the modified double leg lowering average change percentage. The plank test also exhibited a significant group and time interaction (P = .033, partial η2 = .133), with notable improvements in both the Swiss ball (P = .001) and the TRX groups (P = .001). Athletic performance measures showed no significant differences among groups.

Conclusions: The results indicate that both TRX and Swiss ball training can increase core muscle strength and stability without compromising athletic performance after 8 weeks of training. Furthermore, incorporating core muscle training enhances power transmission capabilities. Nevertheless, considering the goal was to improve speed and ankle proprioception during preseason training, careful consideration must be given to the timing and intensity of any intervention involving unstable core muscle training.

Context: The baseball athlete incorporates the use of the entire kinetic chain while throwing. Hip range of motion (ROM) and strength have been previously studied in its relation to injury development. It is a clinical necessity to understand the normative profiles of hip musculoskeletal function across the playing career.

Objectives: To identify the normative hip ROM and strength profiles of baseball players across level of play.

Evidence acquisition: The researchers searched the electronic databases MEDLINE, SPORTDiscus, CINAHL, and Embase using a custom search strategy. After applying inclusion and exclusion criteria, 31 articles were reviewed. Of these 31 articles, 22 examined hip ROM and/or strength in uninjured baseball athletes. A manual search of the references of those 22 articles revealed 4 additional articles that met the inclusion criteria. In total, 26 articles were included in data collection.

Evidence synthesis: Articles were assessed for quality using the appraisal tool for cross-sectional studies. The appropriate hip ROM and strength data, along with player demographics, were extracted and reviewed to ensure accuracy. Articles were also categorized based on level of play and player position.

Conclusions: Hip ROM and strength profiles of baseball athletes across all levels of play were identified and presented to comprehensively summarize the available data on normative musculoskeletal hip profiles. Observed differences between positions and across levels of play were documented. In general, hip external rotation ROM was greater than internal rotation across all levels and between the stance and lead limbs. As age and level of play increased, the difference between hip external rotation and internal rotation ROM also increased. Hip strength increased as level of play (and subsequently age) increased. These summarized data can be used as benchmarks to compare clinical populations.

Context: Kinesiophobia is a substantial psychological factor that may impact sport performance and activities of daily living for individuals with chronic ankle instability (CAI). The purpose of this study was to determine the levels of kinesiophobia between collegiate athletes and nonathletes with and without CAI using quantitative and qualitative analyses.

Design: Cross-sectional survey.

Methods: A Qualtrics survey was distributed to college students. Ankle health status was evaluated using the Foot and Ankle Ability Measure Sport subscale, Identification of Functional Ankle Instability, and history questions. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia-11. A 4 × 2 analysis of variance was used to assess differences in athlete status (NCAA Division 1, intramural, club, and nonathlete) and ankle health status (CAI and healthy). An open-ended question was added to understand how kinesiophobia impacts individuals CAI. Data were analyzed via content analysis.

Results: Of the 531 respondents who completed the survey, 140 (116 = CAI and 24 = healthy) met the inclusion criteria for the study. There was a significant main effect for ankle health status for the Foot and Ankle Ability Measure Sport (CAI = 62.68 [15.11]%, healthy = 99.57 [0.01]%), Identification of Functional Ankle Instability (CAI = 21.63 [5.34], healthy = 2.42 [2.93]), and Tampa Scale of Kinesiophobia-11 (CAI = 26.04 [6.22], healthy = 16.75 [5.50]). There were no significant main effects for athlete status or interactions for any variables. Perceptual and behavioral responses were to major categories identified with the qualitative analysis. Fear, pain, and instability were higher order themes within perceptual responses. Activity avoidance and bracing were higher order themes within behavioral responses.

Conclusion: This study highlights the significant role of kinesiophobia in individuals with CAI, with those affected reporting higher levels of fear, pain, and instability compared with healthy individuals. Behavioral adaptations such as activity avoidance and bracing were common among qualitative responses. While no differences were observed across athlete statuses, these findings underscore the need for tailored interventions addressing both physical and psychological factors to improve outcomes for individuals with CAI.

Adolescent athletes participating in sports involving sudden directional changes, pivoting, and jumping frequently sustain anterior cruciate ligament (ACL) ruptures. ACL reconstruction (ACLR) surgery is often required, followed by a lengthy rehabilitation period. This study aims to evaluate the effectiveness of combining BOth Sides Up (BOSU) ball exercises with conventional resistance training in the recovery of joint stability and function after ACLR in adolescent athletes. Thirty adolescent athletes (ages 14-18) who underwent ACLR were randomly allocated to either the control group receiving traditional postoperative rehabilitation (n = 15) or the intervention group combining BOSU ball training with resistance exercises (n = 15). Joint stability, proprioception, strength, and functional outcomes were assessed before the procedure, as well as 3, 6, and 12 months after the operation using the KT-1000 arthrometer, Y-balance test, isokinetic dynamometry, and the ACL-Return to Sport after Injury ACL-Return to Sport after Injury (ACL-RSI) scale. The intervention group demonstrated notably better anterior-posterior knee joint stability (P < .05) than the control group at the 6-month and 12-month follow-ups after the surgery, greater reach distances in the Star Excursion Balance Test (P < .05), higher quadriceps and hamstring strength ratios (P < .05), and superior ACL-RSI scores (P < .01). Incorporating BOSU ball training with resistance exercises appears to be more effective than traditional rehabilitation alone in enhancing joint stability and neuromuscular control after ACLR in adolescent athletes. These results provide evidence supporting the incorporation of unstable surfaces into a comprehensive rehabilitation program to optimize recovery and safe return to sports.

Context: Short daily surveys are common in elite sports to capture psychological outcomes, but there is no information on the surveys convergent validity and test-retest reliability. Therefore, the purpose of this study is to determine the validity and test-retest reliability of daily athlete health surveys in collegiate athletes.

Design: Descriptive study.

Methods: Participants (n = 193, 74 males and 119 females; age = 20.3 [1.4] y) responded daily to sliding scale questions regarding readiness (scored from 0 to 100), fatigue, stress, and sleep quality (-5 [indicating low or poor scores] to +5 [indicating high or "good" scores]). At pre- and midseason times, participants completed the Perceived Stress Scale, Pittsburgh Sleep Quality Index, Athlete Sleep Screening Questionnaire, Overuse Injury Scale, and the Acute Recovery and Stress Scale. To assess validity, Spearman rho (ρ) correlation coefficients were used to assess the relationship between each athlete health variable and the corresponding validated survey. Reliability and precision were assessed with the intraclass correlation coefficient and the standard error of measurement, respectively.

Results: Daily stress was correlated with the Perceived Stress Scale (ρ = -.40, P < .001); daily sleep quality was associated with the Pittsburgh Sleep Quality Index (ρ = -.44, P < .001) and the Athlete Sleep Screening Questionnaire (ρ = -0.46, P < .001), and daily readiness was associated with the Overuse Injury Scale (ρ = -.21, P = .003). Daily fatigue was associated with the recovery (ρ = .37, P < .001) and stress dimensions (ρ = -.36, P < .001) of the Acute Recovery and Stress Scale. All daily athlete health variables demonstrated either good or excellent reliability (intraclass correlation coefficient = .85-.94; standard error of measurement = 0.87-4.94).

Conclusions: All daily health variables demonstrated acceptable reliability and precision. Sleep quality and stress were most strongly correlated with the outcome scores of their validated surveys. Fatigue was related to the Acute Recovery and Stress Scale, and readiness demonstrated a weak correlation to the Overuse Injury Scale. Clinicians should feel comfortable using these single-question daily health surveys in clinical care but exert caution when using readiness, and fatigue.

Introduction: Running overuse injuries are among the most common running-related musculoskeletal injuries. Modifying gait has been recognized as an effective strategy for preventing running overuse injuries. This study investigates whether gentle heel strike (GHS) running decreases the impact loading rate during 30-minute runs in healthy participants.

Methods: In this prospective cohort interventional study, 20 male participants underwent gait modification in a controlled laboratory setting, with the goal of reducing heel impact through real-time visual feedback. Comprehensive measurements, including plantar contact, force, pressure, and detailed kinetic and kinematic analyses, were employed to assess changes in gait dynamics.

Results: GHS significantly shifted plantar pressure, reducing heel forces and increasing forefoot load. Mean heel force decreased by 0.32 (0.1) body weight (BW) and heel pressure reduced by 0.1 kPa/BW. Although peak vertical ground reaction force and anterior-posterior ground reaction force did not change significantly across the entire stance phase, early stance vertical ground reaction force (7%-12% of the gait cycle) was reduced, leading to the disappearance of the vertical impact peak. Vertical impact peak dropped from 1.45 (0.23) to 1.27 (0.25) BW. Significant reductions were also seen in the vertical instantaneous loading rate, which decreased from 68.32 (14.20) to 46.77 (13.95) BW/s, and the vertical average loading rate, which fell from 54.96 (14.38) to 38.84 (12.62) BW/s (P < .001).

Discussion: GHS has the potential to modify running mechanics by redistributing plantar pressure and diminishing heel impact force. This reduction in heel impact force could lead to a change in landing pattern anteriorly and a decrease in loading rates, potentially reducing the risk of running overuse injuries.

Conclusion: Visual biofeedback-guided GHS is feasible in healthy participants, and it effectively reduces the loading rate during running for 30 minutes.

This study elucidated how previous surgery experience, coping, and optimism influenced the mood of patients who underwent anterior cruciate ligament (ACL) reconstruction surgery. Additionally, it examined the relationships among age, preoperative mood, and postoperative mood. Sixty-four patients (n = 42 men, n = 22 women; age range = 18-51 y) who underwent ACL reconstruction surgery at one hospital in western Japan completed questionnaires before and after surgery. Results revealed that patients who underwent previous ACL reconstruction surgery reported higher tension-anxiety (P < .01) and total mood disturbance (TMD) (P < .05) than did patients who underwent primary surgery. Additionally, tension-anxiety, anger-hostility, TMD (P < .001), depression-dejection, fatigue, and confusion (P < .01) assessed before surgery were significantly reduced after surgery, and preoperative mood was positively related to postoperative mood. Furthermore, positive interpretation was negatively related to TMD before surgery (P < .05), and evading one's responsibility was positively related to TMD after surgery (P < .05). Therefore, psychological support might be necessary for patients who underwent previous ACL reconstruction surgery and patients who evade responsibility. The results of this study will help sport medicine professionals identify several individual factors that are related to psychological responses of patients who underwent ACL reconstruction surgery.

Context: In lateral elbow pain (LEP), it is important to improve pain, grip strength, and function. The aim of this study is to compare the effects of Instrument-Assisted Soft Tissue Mobilization (IASTM) and extracorporeal shock wave therapy (ESWT) methods on pain, grip strength, and function in LEP.

Design: Randomized single-blind clinical trial.

Methods: Forty-eight adults with LEP were randomly assigned to the IASTM, ESWT, and control groups. Home exercise consisting of special static stretching and eccentric strengthening exercises was given to the control group. The ESWT group received a total of 8 sessions of ESWT in addition to home exercise. The IASTM group received a total of 8 sessions of IASTM in addition to home exercise. The visual analog scale for pain, hydraulic hand dynamometer for grip strength, and Patient-Rated Tennis Elbow Evaluation scale for functionality were used for assessment. Data were collected at baseline, after intervention, and at 4-weeks postintervention.

Results: At the end of the treatment and the 4-week follow-up, a decrease in pain scores and improvement in muscle strength and functionality was detected in all 3 groups (P < .001). IASTM applications were more effective than ESWT and control groups in reducing pain both after application and at follow-up (P < .001), whereas ESWT application was also effective compared with the control group (P < .001). IASTM applications were more effective than the ESWT and control groups in reducing Patient-Rated Tennis Elbow Evaluation total scores both after the applications and follow-up (P < .001). IASTM was more effective in grip strength than ESWT and control groups (P < .001).

Conclusion: It was determined that IASTM and ESWT treatments were effective in reducing pain and increasing grip strength and functionality in both the short and long term in patients with LEP. It was determined that IASTM treatment was superior to ESWT treatment in reducing pain and improving grip strength and functionality.