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Purpose: This study analyzed the effectiveness of net exchanges (ie, number of times the pairs exchange their zone on the court from the net zone to the back zone or vice versa) in men’s and women’s professional padel depending on the competition phase. Methods: Data were collected from 41 matches, comprising a total of 4829 points, from both the qualifying and the main draws of the World Padel Tour Finland Padel Open tournament. Descriptive analysis (frequency and percentage) and inferential tests (Pearson chi-square [χ ²], Cramer V coefficient [Vc], corrected standardized residuals, and chi-squared automatic interaction detection) were carried out. Results: There were significant differences (P < .05) in net exchanges between the main and qualifying draws, both in men’s (79.6% vs 72.1% for no exchanges) and women’s (62.2% vs 57.6% for no exchanges) padel. Additionally, differences in the likelihood of winning points based on whether the serving pair or the returning pair finished the rally at the net were highlighted. Indeed, finishing rallies at the net for the serving pairs increased the probability of scoring a winning shot (ie, in even-numbered net exchanges), while finishing rallies away from the net (ie, in odd-numbered net exchanges) was more likely to result in errors, for both male and female players and main and qualifying draws. Conclusion: This study provides valuable insights into the strategic behavior of professional padel matches, highlighting the importance of net dominance and its impact on match outcomes, particularly in relation to gender differences and phase of competition.

Context: Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework. Design: Pretraining and posttraining intervention study. Methods: Rehabilitation professionals were electronically surveyed pre–post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre–post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know–do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28). Results: Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre–post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001). Conclusions: Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.

Purpose: The long-term development of talent in endurance sports is a topic of interest. Among various factors, the importance of total hemoglobin mass (tHb_mass) and the potential benefits of being an altitude-native athlete remain unclear, particularly in young categories. This study aimed to investigate the impact of altitude and training content on hematological characteristics by comparing young male cyclists age 15–16 and 17–18 years who were born and trained at a moderate altitude (ie, greater than or equal to 2500 m; MA) and cyclists who were born and trained at low altitude (below 1000 m; LA). Methods: tHb_mass (in grams and grams per kilogram), measured by using the optimized carbon monoxide rebreathing method during an incremental test on a cycle ergometer; hematocrit percentage, hemoglobin concentration; and erythrocyte, blood, and plasma volume were measured in youth male cyclists age 15–16 years and junior cyclists age 17–18 years who were born and trained at MA versus LA. All variables were analyzed with a 2-way (age [youth cyclist vs junior cyclist] × altitude level [MA vs LA]) analysis of variance with subsequent Tuckey post hoc test. Results and Conclusion: Some altitude-induced benefits were reported in cyclists at age 15–16 years in the MA group with higher values in hematocrit percentage, hemoglobin concentration, and tHb_mass (grams per kilogram) (P < .05) than their LA counterparts. This was also observed at age 17–18 years (P < .001), except for tHb_mass, wherein no significant difference was found between MA and LA groups. In contrast, plasma volume was lower in MA than LA junior cyclists. New Findings : (1) The altitude of birth and residence could generate an advantage in tHb_mass in young male cyclists age 15–16 and 17–18 years who train at MA compared with cyclists who are born and train at LA. (2) Altitude-induced benefits in physiological variables (hematocrit percentage, hemoglobin concentration, tHb_mass in g·kg⁻¹) were reported in cyclists at age 15–16 years and partially at age 17–18 years. In contrast, plasma volume was lower in MA than in LA junior cyclists. This may impact the strategies for identifying and developing talent in cycling.

Context: Sport and physical activity (PA) programs are an important developmental resource for youth with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders. The purpose of this study is to assess sport participation rates, PA participation, and after-school supervision rates among African American children with ADHD and/or Disruptive Behavior Disorders. Design: In this cross-sectional study, parents of African American children with elevated symptoms of ADHD, oppositional defiant disorder, and/or conduct disorder (N = 175, 6- to 12-y-old, 31% female) reported after-school program participation over the past year. Methods: Logistic regression analyses tested relationships between ADHD symptoms, oppositional defiant disorder symptoms, and conduct disorder symptoms, likelihood of regular participation (≥2 d/wk) in sport, PA, and sedentary after-school programs, and likelihood of being supervised and unsupervised after school. All regressions controlled for age, sex, income, and medication status. Sample participation rates were descriptively compared with participation rates of same-aged peers regionally, and nationally, reported in 3 national surveys. Results: Parents in the local sample reported higher rates of sedentary after-school program participation (54%) but lower rates of PA program participation (31%), and sport participation (12%) compared with same-aged peers. The local sample was less likely to be unsupervised after-school compared with same-aged peers with only 27% of parents reporting that their child was unsupervised ≥ 2 days per week. Children endorsing oppositional defiant disorder (odds ratio = 2.05; P < .05) and conduct disorder (odds ratio = 5.74; P < .05) were more likely to be unsupervised more frequently after-school as compared with those not meeting endorsement. Conclusions: Given demonstrated benefits of youth sport programming and observed inequities in participation, there is a need to develop support models that connect parents, coaches, and social services agencies to facilitate inclusion. Sports medicine professionals are uniquely positioned to contribute to these efforts, as they are often key opinion leaders in both the youth sport and health care contexts.

Focused Clinical Question: In individuals reporting low back pain postpartum, is exercise an effective intervention to reduce symptoms? Clinical Bottom Line: There is moderate evidence to support the use of an exercise intervention to reduce pain and improve functional disability in postpartum females with low back pain.

Purpose: We examined the reliability of force parameters derived from the isometric midthigh pull (IMTP) and their correlation with the functional capacities of young soccer players. Methods: Data were collected from 20 young professional soccer players within and between 2 sessions (after 1 wk) using a 1000-Hz force plate. Results: Performance outputs in all IMTP parameters were consistent and showed moderate to excellent reliability (intraclass correlation coefficient = .72–1.00) within and between sessions. However, all parameters reported a marginal ability to detect chronic changes in performance (smallest worthwhile change [SWC] < standard error of measurement [SEM]) except for peak vertical force (PF) parameters, which showed good usefulness (SWC > SEM). Absolute PF was correlated with the countermovement-jump (CMJ) total impulse (CMJ-TI; r = .54), whereas relative PF (to body mass) was correlated with CMJ height, CMJ peak power, and the last speed of the 30:15 Intermittent Fitness Test (V _IFT; r = .40 to .63). IMTP time-dependent forces were correlated with CMJ-TI (r = .52 to .62). The IMTP impulse parameters were positively correlated with CMJ-TI (r = .48 to .58) and negatively with V _IFT (r = −.44 to −.38). None of the IMTP parameters were correlated either with the CMJ mean propulsive force or with any linear acceleration times. Conclusions: All IMTP parameters can be adopted by practitioners involved with testing young soccer players based on their acceptable reliability criteria. However, caution should be taken when interpreting the time-dependent variables based on their marginal usefulness when assessing performance. Generally, a greater PF was associated with a greater vertical power based on its correlation to CMJ.

A 24-year-old male collegiate tennis athlete presented with pain, weakness, and numbness consistent with the ulnar nerve distribution in the left distal upper extremity following excessive wrist and forearm flexion and pronation. The patient was diagnosed with lacertus syndrome after referral for imaging. Lacertus syndrome is an exertional compartment syndrome of the forearm, typically including median nerve entrapment and surgical intervention. The uniqueness of this case included ulnar nerve involvement and resolution with interprofessional conservative management. Athletic trainers should consider including other health care professionals to conservatively manage lacertus syndrome in patients with delayed symptom onset during repetitive wrist and forearm activities.

Context: The evaluation of quadriceps muscle inhibition with the interpolated twitch technique is usually performed by stimulating the femoral nerve (FN). However, there are some problems related to the use of this stimulation site, which may be partially overcome by delivering the stimulation over the motor point (MP). This study sought to compare MP to FN stimulation at different joint angles for the evaluation of quadriceps muscle inhibition, resting peak torque, and discomfort in healthy women. Design: Cross-sectional study. Methods: Sixteen healthy women (age: 28 [4] y; body mass: 60 [5] kg; height: 162 [5] cm) participated in this study. Supramaximal paired stimuli were delivered to the FN and to the rectus femoris MP before and during maximal voluntary contractions at different knee angles (15°, 30°, 45°, 60°, and 90° of knee flexion) to assess muscle inhibition and resting peak torque. Discomfort was also recorded for each stimulation site and knee angle. Results: Muscle inhibition was similar between the 2 stimulation sites (P > .05) and was higher at 45° than at 90° (P = .03). MP stimulation evoked lower resting peak torque at 30° (P = .004), 60° (P = .006), and 90° (P = .006) and higher discomfort at 30° (P = .008) and 90° (P = .027) compared to FN stimulation. Conclusions: Despite lower resting peak torque and higher discomfort at some angles, MP stimulation provided similar muscle inhibition to FN stimulation at all knee angles and is therefore a valid method to evaluate quadriceps muscle inhibition in healthy women. MP stimulation can be used as an alternative to FN stimulation for the evaluation of quadriceps muscle inhibition with no added discomfort at the angles where muscle inhibition is the highest.