Journal of Sport Rehabilitation最新文献

Context: Advancements in portable load-cell technology have enabled high-quality assessment of shoulder internal (IR) and external rotation (ER) peak force (Fmax) and rate of force development (RFD). This study's purpose was to explore the reliability and differences between IR and ER Fmax and RFD in different testing positions using a novel load-cell device.

Design: A within-subjects repeated-measures design was employed to compare the intersession values and reliability of Fmax and RFD for both shoulder IR and ER across 3 positions: seated-0°, supine-0° and supine-90°.

Methods: National-level swimmers (n = 19; age = 16.8 [1.0] y) completed 3 testing occasions of each condition (combination of arm, rotation, and test position) separated by 7 to 14 days.

Results: IR superseded ER in all testing positions. The association between these positions across IR and ER was typically strong for both Fmax and RFD (r > .85, P < .001) except for IR RFD (r = .56-.73, P < .05). For sessions 2 to 3, Fmax intraclass correlation coefficient and CV (intraclass correlation coefficient = .89-.96, CV = 5.2%-8.8%) were typically within acceptable ranges, whereas RFD (intraclass correlation coefficient = .74-.90, CV = 11.5%-18.1%) often exhibited inflated error.

Conclusion: The supine (90°) position was the most consistent position across both measures. Load-cell technology can be confidently used to assess shoulder rotation Fmax in 3 different positions, whereas RFD should be used with caution without protocol refinement.

Context: Active management of modifiable factors during the early rehabilitation stage can help patients who have undergone anterior cruciate ligament (ACL) reconstruction successfully return to sports. This study aimed to determine predictors for performance on the single-leg hop test and Tegner activity score 12-month post-ACL reconstruction, based on knee function assessed 3-month postsurgery.

Design: Prospective cohort study.

Methods: Ninety-one patients who underwent ACL reconstruction were recruited. Multivariate logistic regression analysis was performed to identify predictors of the one hop test and Tegner activity score 12-month postsurgery, based on a knee examination performed 3 months after ACL reconstruction. Factors evaluated at 3 months included the Biodex balance system anteroposterior and mediolateral indexes; Y balance test anterior, posteromedial, and posterolateral reaches; knee extensors and flexors peak torque per body weight; and knee extensors and flexors average power per body weight.

Results: The knee extensor peak torque per body weight (PT/BW) and Biodex balance system-mediolateral index with cutoff values of 132 N·m/kg and 0.45, respectively were identified as predictors for achieving a limb symmetric index within 10% on the hop test. Furthermore, achieving a Tegner activity score over 6 was predicted by Y balance test-posteromedial reach and knee flexors average power per body weight, with cutoff values of 92.5 cm and 122 W/kg, respectively.

Conclusion: Three months following ACL reconstruction, knee extensor peak torque, and mediolateral balance predicted performance on the hop test, while dynamic posteromedial balance and knee flexors average power predicted rotational ability, at the 12-month assessment.

Context: In shoulder rehabilitation, exercises that reduce upper trapezius (UT) activity and optimize the trapezius muscle activation rate reduce the symptoms of shoulder pathologies. One such exercise, the lawn-mower (LM) exercise, is frequently used in scapular rehabilitation protocols due to its multijoint, multiplanar, and kinetic chain-based nature. Design/Objective: This study aimed to compare trapezius muscle activation levels and ratios during the LM exercise in standing and quadruped positions through a randomized controlled trial.

Methods: Eighteen healthy volunteers (mean age [SD] = 25 [5] y, 10 women and 8 men, mean body mass index [SD] = 22.91 [2.59] kg/m2) participated in the study, and surface electromyography was employed to measure trapezius muscle activity during quadruped LM (QLM) and standing LM (SLM) exercises. The data were normalized as a percentage of maximal voluntary contraction.

Results: The study revealed significantly lower UT activity (percentage of maximal voluntary contraction) during QLM compared with SLM (P < .05) in concentric and isometric phases. Conversely, QLM exhibited significantly higher activation of the middle trapezius (MT) and lower trapezius (LT) in all phases when compared with SLM (P < .05). UT/MT and UT/LT ratios were also significantly lower in all QLM phases compared with SLM (P < .05).

Conclusion: Study findings suggest that quadruped exercises reduce UT activation while promoting more balanced MT and LT muscle activation. This balance is essential for shoulder rehabilitation, especially in cases requiring minimal UT activation and maximal MT and LT activation. In cases where a balanced trapezius muscle activation pattern is required, including QLM exercises rather than SLM exercises may be more efficient.

Context: Interest in the effects of concurrently using neuromuscular electrical stimulation (NMES) and blood flow restriction (BFR) to improve muscle strength has risen, but limited studies and inconsistent findings have led to more questions. The 2 current projects aimed to systematically investigate how NMES waveform shape and BFR occlusion pressure acutely influence electrically elicited force (EEF) and tissue oxygen saturation (StO2) of the knee extensors.

Design: A single-session repeated-measures design was followed.

Methods: EEF and StO2 were measured in 2 different groups of 15 participants during 3 sets of NMES contractions. Ten NMES contractions per set were performed with 5 minutes of passive interset recovery. In the first project, different NMES waveforms (RUS, Russian burst-modulated alternating current; VMS, biphasic pulsed current; and VMS-Burst, burst-modulated biphasic pulsed current) were administered for each set, while BFR was applied at 60% limb occlusion pressure (LOP). During the second projet, VMS was administered, while a different BFR occlusion pressure (0% LOP, 40% LOP, and 80% LOP) was used during each set. Two-way repeated-measures analysis of variance examined if repetition and/or NMES waveform (first project) or BFR occlusion pressure (second project) significantly affected (P < .05) EEF or StO2.

Results: VMS (12% [7%] MVIF) and VMS-Burst (13% [10%] MVIF) led to higher EFF compared with RUS (6% [5%] MVIF) with 60% LOP; 80% LOP (20% [14%] MVIF) led to lower EEF compared with 0% LOP (29% [17%] MVIF) with VMS. No significant differences in StO2 were observed between NMES waveforms or BFR occlusion pressures.

Conclusions: If a clinician wanted to concurrently use NMES and BFR, the acute findings of the current projects would suggest the use of VMS or VMS-Burst with lower BFR occlusion pressure (40% LOP). However, further investigation into how these parameters would influence muscle strength subsequent to a training/rehabilitation intervention should be performed.

Context: This study compared landing impact between 3 landing heights on 3 landing surfaces by quantifying vertical ground reaction force (vGRF) profile and knee joint angle.

Design: Crossover.

Methods: Nineteen healthy male college Taekwondo (TKD) Gyeokpa players (age: 20.7 [2.6] y, height: 1.73 [0.05] m, mass: 65.5 [7.1] kg, and athletic careers: 5.9 [3.2] y) performed 2-leg landings from 3 different heights (0.45, 0.90, and 1.35 m) on 3 different surfaces (uncovered force plates on the ground, a 2-cm thick TKD or a 14-cm thick sponge mat over the force plates). Peak vGRF, time to peak vGRF, and knee joint angle in the dominant leg were analyzed using analysis of variance and functional data analysis (α = .05).

Results: There was a height by surface interaction in peak vGRF (F4,144 = 2.54, P = .04) and time to peak vGRF (F4,144 = 7.62, P < .0001), but not for knee joint angle (F4,144 = 0.51, P = .73). Increased peak vGRF and shortened time to peak vGRF were observed as landing height increased on each landing surface (P < .0001 for all tests). Functional data analysis revealed that landing on the TKD mat increased vGRF by 0.4× body weight (P < .0001) at a landing height of 0.90 m or higher, whereas landing on the sponge mat reduced vGRF (<0.9× body weight), delayed time to reach peak vGRF (<30 ms, P < .0001), and maintained knee flexion angle (<10.3°, P < .01), compared with landing on the ground.

Conclusions: The TKD mat was ineffective in reducing the landing impact as similar landing biomechanics were observed between landing on the ground and the TKD mat. We recommend the use of the sponge mat to reduce landing impact as it attenuated vGRF, delayed time to reach peak vGRF, and maintained sagittal plane landing posture, as compared with landing on the ground and the TKD mat.

Clinical scenario: Ballet dancers exhibit a high risk of musculoskeletal injuries with around 75% of all injuries attributed to overuse injuries. The high prevalence of chronic injuries suggests contributions caused by abnormal biomechanics in combination with repetitive stress common to ballet. Traditional sports settings implement movement screening tools including the Movement Competency Screen (MCS) and functional movement screen (FMS) to identify factors predisposing athletes to injury. However, unique training demands and movement patterns of ballet and contemporary pose challenges for fundamental movement screenings. Identifying relationships between movement screening scores and injury incidence in dancers may allow for early injury risk factors detection and injury prevention programs implementation to reduce overall injury rate.

Clinical question: Does implementation of the MCS improve prediction of injury incidence compared with use of the FMS™ in collegiate, preprofessional, and professional ballet, and contemporary dancers?

Summary of key findings: Three studies met the inclusion criteria for critical appraisal. One study utilized the MCS while the other 2 implemented the FMS™ to assess ballet and modern dancers. These studies concluded the MCS may predict injury when implemented as a preseason screening in ballet and contemporary. The FMS™ did not demonstrate predictive capability for injuries in ballet and contemporary dancers.

Clinical bottom line: While the MCS shows injury prediction potential, a dance-specific movement screening more accurately representing dance-related movement patterns may improve validity in this population. Continuation and standardization of dance injury research is imperative to understand movement compensations predisposing individuals to injury and injury prevention measures.

Recommendation: Grade B evidence suggests potential predictive ability of the MCS in identifying dance-related injury, while no association exists between the FMS™ and dance injuries. Additional research regarding dance-specific movement application to functional screenings shows potential for accurate and reliable injury prediction methods for ballet and modern dancers.

Context: Awareness regarding the importance of mental health in athletes has been increasing in recent years. Mental health has been investigated in relation to injury recovery and performance; however, less evidence has examined changes in mental health throughout a competitive season.

Objectives: This study aimed to: (1) evaluate the psychological factors of resilience and well-being over a National Collegiate Athletic Association Division I gymnastics season and examine changes over 4 time points: preseason, start of the competitive season, midseason, and postseason and (2) examine the relationships between these psychological measures at these 4 time points. We hypothesized that resilience and well-being would remain stable, and higher resilience would be related to a greater sense of well-being at all time points.

Design: This study utilized a retrospective chart review.

Setting: This study is conducted in a college setting.

Patients or other participants: Study participants were 17 Division I female gymnasts.

Methods: A retrospective chart review was conducted to evaluate the Brief Resilience Scale and 5-item World Health Organization Well-Being Index, which gymnasts had completed biweekly from preseason to postseason. Descriptive statistics were reported, a 1-way repeated measures analysis of variance was used to examine changes across 4 time points, and Pearson product-moment correlations were used to examine the relationships between Brief Resilience Scale and 5-item World Health Organization Well-Being Index scores.

Results: Brief Resilience Scale and 5-item World Health Organization Well-Being Index scores did not change throughout the season (P = .62, .52). No relationship between the variables was identified at the start of preseason or midseason (P > .17). However, at the start of the competitive season and postseason, resilience was positively correlated with well-being (r = .65, P = .006; r = .82, P = .006).

Conclusions: Higher resilience and well-being are related in Division I female gymnasts but do not fluctuate throughout the season. Sports medicine staff and coaches should be aware that there is room to improve resilience and well-being, making additional supports warranted, including coping skills and resilience training interventions.

Context: Ladies Gaelic Football (LGF) is the fastest growing female sport in Europe and camogie is among the most popular female team sports in Ireland. Intercounty is considered the elite level, with high physical and technical demands that inevitably involve a risk of injury. At the elite level, an injury incidence as high or higher as professional sports such as rugby and soccer has been reported. Inadequate injury surveillance (IS) can be a barrier to effective injury prevention. This study aimed to (i) explore perspectives on IS and (ii) examine perceived barriers and facilitators to injury reporting of elite LGF and camogie players.

Design: Qualitative descriptive study.

Methods: Six focus groups were conducted with elite LGF (n = 11) and camogie (n = 10) players representing a range of divisions and intercounty panels. Participants outlined their understanding of IS and described IS practices within their teams. Participants completed a written task, noting and discussing perceived barriers and facilitators to injury reporting. Focus groups were audio recorded, transcribed, and analyzed using reflexive thematic analysis.

Results: Participants' report of current IS practices for their team echoed closely their interpretation of IS, as the reporting of injury to health care professionals (HCPs) and broader team personnel. Injury reporting was influenced by factors related to the player, the organization, and the environment including player mindset, access to HCPs and club culture.

Conclusion: Enhanced and consistent access to appropriate HCPs is deemed key to monitoring and managing injuries. HCPs are central to fostering a culture of openness and trust, critical to facilitate the timely reporting and management of injuries in elite LGF and camogie. The influence of HCPs is powerful in players' perceptions of barriers and facilitators to reporting and future work should capture their thoughts.

Context: The COVID-19 pandemic had a significant impact on the world of sports due to the imposed quarantine and the postponement of regional, national, and international sporting events, which affected physical, socioeconomic, and psychological aspects of athletes. Thus, the present study aimed to evaluate changes in the mood state profile of Brazilian Para athletes at 2 different time points during the COVID-19 pandemic, specifically during their qualification for the Tokyo Paralympic Games.

Design: This study used a longitudinal study design.

Methods: The study included 83 Brazilian Para athletes from 14 sports, with a mean age of 34.64 (9.27) years, who were evaluated at 2 moments (March 2020 and April 2021) during the qualification period for the "Road to Tokyo Paralympic Games." The online survey included questions about disability, sport, and experience; the 24-item Brunel Mood Scale questionnaire; and a question about the athlete's perception of whether or not they had a chance of qualifying for the Tokyo Paralympics in April 2021.

Results: Para athletes had significantly higher vigor scores in 2021 than in 2020, with a medium effect size (z = -3.454, P < .001). In addition, Para athletes who perceived themselves as nonqualified for the Tokyo 2021 Paralympics Games had higher scores for depression (U = 409,000, z = -2397, P = .017) and tension (U = 425,000, z = -2194, P = .017) in 2021 when compared with those who perceived that they had qualified. There were no differences between men and women.

Conclusions: The COVID-19 pandemic significantly negatively impacted the mood of Brazilian Para athletes, especially those who perceived themselves as nonqualified for the Tokyo Paralympic Games. Para athletes in team sports exhibited higher potential symptoms of depression compared with those in individual sports.

Context: Hamstring injuries are prevalent in high-intensity sports. The lesion often occurs with concomitant knee extension and hip flexion. The Nordic curl has been suggested to prevent such injury, mainly due to its eccentric hamstring activation.

Objective: The objective of this study is to assess the eccentric force output and the regional biceps femoris excitation (proximal, mid, and distal) during conventional and 80° of hip flexion of Nordic curl.

Methods: Thirty-nine participants (17 men: 22.6 [2.03] y, 1.71 [0.09] m, 73.6 [13.3] kg; and 22 women: 24.4 [6.02] y; 1.64 [0.08] m; 62.2 [10.5] kg) were included in the study. Hamstring strength was analyzed through a load cell and muscle activation assessed with an electromyographer in 3 muscle portions (proximal, mid, and distal). Mixed factorial analysis of variance was used to rate the differences.

Results: The conventional Nordic curl showed higher muscle activation compared with the hip-flexed Nordic curl (P = .001). No differences were observed in other factorial analysis.

Conclusions: The findings suggest that conventional Nordic curl induces higher biceps femoris muscle excitation across compared with 80° hip-flexed Nordic curl. No differences were noted in muscle strength. The same force output with distinct levels of muscle activation may provide a progression system to implement hamstring training for injury prevention or even for exercise routine.