Context: One of the primary training variables, although often overlooked, is recovery level achieved before starting subsequent training sessions. To find a more practical measurement that is consonant with the daily training routine, the Perceived Recovery Status (PRS) scale is proposed. In this perspective, the present study aimed to translate and culturally adapt the PRS scale into Brazilian Portuguese. Design: This was a clinical measurement. Methods: The cross-cultural translation was performed according to guidelines. Linguistic validation consisted of 5 stages: forward translation, translation synthesis, back translation, analysis of inconsistencies, and cognitive debriefing. Results: During forward translation, different interpretations were obtained from the 2 translators (versions V1 and V2). Supported by an expert committee, a combined version (V3) was obtained from V1 and V2. During back translation, different interpretations were obtained from the 2 translators (versions V4 and V5). Discrepancies, applicability, and cultural equivalence were documented and analyzed by the expert committee participating in the cross-cultural translation procedure. During the cognitive debriefing, a group of 5 Brazilian people from the general population were asked to participate in a cognitive debriefing to assess the comprehensibility of the translated items. Conclusions: The PRS was translated and culturally adapted to Brazilian Portuguese (PRS-Brasil).
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Rodrigo Rodrigues Gomes Costa, Matt Laurent, Frederico Ribeiro Neto, Luis Felipe Castelli Correa de Campos, and Ciro Winckler
Mingke You, Lingcheng Wang, Ruipeng Huang, Kaibo Zhang, Yunhe Mao, Gang Chen, and Jian Li
Context: Meniscal injury is a common pathology, and the postoperative rehabilitation program is essential to patients after surgery. However, the optimal rehabilitation plan after meniscus suture is still controversial. Objective: To compare the clinical outcomes between accelerated rehabilitation and restricted programs in patients with meniscus suture (with or without anterior cruciate ligament reconstruction, ACLR). Evidence Acquisition: Four databases, including PubMed, Ovid, Embase, and the Cochrane Library, were searched up to November 2021. This study only included studies comparing the clinical outcomes between accelerated (immediate range of motion and weight-bearing) and restricted rehabilitation (immobilization and progressive weight-bearing) for meniscus suture. All selected studies were divided into 2 subgroups: isolated meniscus suture or combined with ACLR. The Lysholm score, Tegner score, and Knee Injury and Osteoarthritis Outcome Score were evaluated in simple meniscus sutures no less than 1 year. Failure rate was evaluated in both groups, and the tunnel enlargement was additionally evaluated in patients who underwent ACLR. Evidence Synthesis: Eleven studies with 612 patients were eligible for analysis. The accelerated group included 4 studies with 330 participants, while the restricted group included 7 studies with 282 participants. For the patients after isolated meniscus suture, the accelerated group achieved higher Lysholm scores (mean difference = −4.66; 95% confidence interval, −8.6 to −0.73; P = .02; I 2 = 88%) than the restricted group. For the patients after meniscus suture with ACLR, patients undergoing accelerated rehabilitation were associated with a significantly larger tibial tunnel enlargement in the anterior–posterior view (mean difference = −7.08; 95% confidence interval, −10.92 to −3.24; P = .0003; I 2 = 0%) and lateral view (mean difference = −10.33; 95% confidence interval, −16.9 to −3.75; P = .002; I 2 = 17%). Conclusion: This meta-analysis evaluated the effects of postoperative rehabilitation in either accelerated or restricted programs in patients with meniscus lesions after repair. A significant higher mean self-reported function was discovered at final follow-ups in the accelerated group. However, a significant increase in tibial tunnel enlargement was also found in accelerated group.
Ian Brewer, Josh Zimmerman, Marcie Fyock-Martin, Nelson Cortes, and Joel Martin
Clinical Question: Does reactive neuromuscular training (RNT) increase gluteal muscle activation during squatting movements? Clinical Bottom Line: The current best evidence suggests RNT may result in acute increases of gluteus maximus and gluteus medius muscle activation when performing the barbell back squat exercise; however, the findings were inconsistent and unclear for other types of squatting movements. Grades B and D evidence exists on the effects of RNT to increase gluteus maximus and medius muscle activation, respectively, during squatting movements. Given the methodological differences and mixed findings reported in this critically appraised topic, practitioners should carefully consider whether using RNT would be appropriate for a given clinical scenario.
Masumeh Hessam, Koroush Fathalipour, Amin Behdarvandan, and Shahin Goharpey
Context: Core stability training has been recommended as a vital element in improving movement’s pattern and athletic performance. The main objective of this study was to investigate the effect of 12-week McGill core stability training on movement patterns, shooting accuracy, and throwing performance. Design: Randomized controlled clinical trial. Setting: University research laboratory. Methods: Forty male basketball players were randomly assigned to experimental and control groups. The experimental group completed 12-week McGill core stability training, while the control group completed routine exercise training. Patterns of functional movements was measured through functional movement screen (FMS), shooting accuracy measured by static 3-point shooting (S3P) and dynamic 60-second 3-point shooting test, and throwing performance measured by Functional Throwing Performance Index. Results: Comparison revealed that regardless of received training, after 12 weeks both groups showed significant improvement in all outcome measures. However, experimental group had significantly higher post test scores in FMS (P = .02), S3P (P = .007), and dynamic 60-second 3-point shooting test (P = .01). For Functional Throwing Performance Index, there was no group differences (P = .96). The results of follow-up assessments showed for all measurements including FMS (P = .03), S3P (P = .004), dynamic 60-second 3-point shooting test (P < .001), and Functional Throwing Performance Index (P = .005); experimental group had higher scores than the control group. Conclusions: According to the results, implementing McGill core stability training in basketball routine training would be advisable since significant improvement can be obtained in the measured parameters.
Eleftherios Paraskevopoulos, George Koumantakis, and Maria Papandreou
Context: Neuromobilization exercises (NE) could be a useful therapeutic tool to induce analgesia and increase function and range of motion (ROM) in patients with musculoskeletal pathologies with neuropathic components; however, the effectiveness of this intervention in patients with cervical radiculopathy (CR) is unknown. Objective: To determine the effectiveness of NE in CR on pain, function, and ROM. Design: Systematic review and meta-analysis. Evidence Acquisition: An electronic search was performed in the MEDLINE, Scopus, PEDro, and EBSCO databases from inception until June 2022. The authors included randomized clinical trials that evaluated the effectiveness of NE against control groups or other interventions that aimed to treat patients with CR. Evidence Synthesis: Seven clinical trials met the eligibility criteria, and for the quantitative synthesis, 5 studies were included. For the studies that compared NE with a control group, the standardized mean difference for pain was −1.33/10 (95% confidence interval [CI], −1.80 to −0.86; P < .01; I 2 = 0%), for function with the Neck Disability Index was −1.21/50 (95% CI, −1.67 to −0.75; P < .01; I 2 = 0%), and for neck flexion and extensions was 0.66 (95% CI, 0.23 to 1.10; P < .01; I 2 = 0%) and 0.47 (95% CI, 0.04 to 0.90; P < .01; I 2 = 0%), respectively, with evidence of clinical effectiveness. These findings were based on moderate-quality evidence according to the Grading of Recommendation, Assessment, Development, and Evaluation rating. In studies that compared NE with other interventions, the meta-analysis failed to demonstrate the statistical or clinical superiority of NE. Conclusions: Moderate quality of evidence suggests that NE may be superior to no treatment for pain, function, and ROM in patients with CR. In contrast, NE are not superior to other interventions in the same outcomes, based on low- to very low-quality evidence. More high-quality research is needed to assess the consistency of these results.
Gulcan Harput, Ugur Toprak, Fatma Filiz Colakoglu, Emirhan Temel, Suzan Saylisoy, and Gul Baltaci
The aim of this study was to investigate the effects of plyometric training on vastus lateralis (VL) and patellar tendon size, quadriceps isokinetic strength, and vertical jump height in adolescent female volleyball players. Thirty players (age mean ± SD: 15.7 ± 1.1 years) participated in a 6-week Sportsmetrics™ plyometric training program. VL thickness, echo intensity, and patellar tendon cross-sectional area were assessed by real-time ultrasound. Isokinetic quadriceps strength and vertical jump were assessed. The VL thickness, quadriceps strength, and VJ height increased and VL–echo intensity decreased after training. We recommended that 6-week Sportmetrics plyometric training program may be implemented in adolescent female volleyball programs especially before the beginning of the volleyball season.
Jacqueline A. Augustine, Sarah Rothstein, Larissa True, and Kevin D. Dames
Context: A variety of gait retraining interventions are available to modify running mechanics associated with musculoskeletal injuries. These often require specialized equipment and/or personnel to prompt the runner toward specific strategies. Objective: To determine whether instructing female recreational runners to “run quietly” could decrease impact force characteristics. Design: Cohort. Setting: Research laboratory. Participants: Fifteen healthy female recreational runners (24 [7] y) volunteered. Interventions: Baseline testing occurred on day 1 (baseline), a posttraining assessment occurred on day 2 (training), and a final assessment occurred 1 week after training on day 3 (follow-up). A smartphone decibel measuring app was used to provide biofeedback on the decibel level of foot strike on day 2 (training). Main Outcomes: Peak vertical force, impact transient, peak and average vertical loading rate, ground contact time, and running economy were collected on each day and compared via repeated-measures analyses of variance. Results: Vertical ground reaction force was lower at follow-up (2.30 bodyweights [BW]) versus baseline (2.39 BW, P = .023) and training (2.34 BW, P = .047). Maximal loading rate decreased from baseline (69.70 BW·s−1) to training (62.24 BW·s−1, P = .021) and follow-up (60.35 BW·s−1, P = .031). There was no change in running economy. Conclusions: Our findings demonstrate that simple instructions to “run quietly” can yield immediate and sustained reductions in impact force profiles, which do not influence running economy.
Carrie B. Scherzer, Jeremy Trenchuk, Meaghan Peters, and Robert Mazury
Athletes can be at elevated risk for developing eating disorders, the effects of which can be devastating. Few researchers have examined the influence of a predisposition toward an eating disorder on athletic injury. Exercise dependence might bridge the gap toward understanding this relationship. This study sought to examine the relationship between predisposition toward an eating disorder and exercise dependence and looked at both as predictors of athletic injury. College students (n = 132) completed the Eating Disorders Inventory and the Exercise Dependence Questionnaire, as well as provided demographic, activity, and injury information. Subscales of the Eating Disorders Inventory and Exercise Dependence Questionnaire were significant predictors of having at least one athletic injury in the preceding year. These findings suggest that both predisposition toward an eating disorder and exercise dependence may be contributing factors to injury.
Karissa L. Johnson, Danielle L. Cormier, Kent C. Kowalski, and Amber D. Mosewich
Helping athletes cope effectively with injury is likely of great interest to many sport stakeholders. Mental toughness is one psychological factor positively associated with resilience and sport performance, though stubborn persistence through injury might not always be conducive to adaptive athlete outcomes. Self-compassion—a balanced, nonjudgmental approach in relating to oneself when experiencing suffering—might help circumvent these pitfalls and complement injury recovery. The purpose of this study was to explore the relationship between mental toughness and self-compassion in a sport injury context. This study consisted of 2 phases—phase I quantitatively assessed the relationships between mental toughness, self-compassion, and other psychological constructs, while phase II used qualitative interviews to corroborate and inform these findings. In phase I, competitive athletes who were injured at the time of data collection (n = 81) completed mental toughness, self-compassion, coping resources, self-esteem, and self-criticism questionnaires. Self-compassion was positively correlated with mental toughness (r = .48, P < .01), coping resources (r = .54, P < .05), and self-esteem (r = .60, P < .01). Self-compassion and self-criticism were negatively correlated with each other (r = –.52, P < .01). Results from hierarchical multiple regression analyses revealed that self-compassion was a significant predictor of mental toughness (ΔR2 = .07, P < .01), coping resources (ΔR2 = .10, P < .01), and self-criticism (ΔR2 = .06, P < .01), beyond the effects of self-esteem. Four injured athletes who scored above the median on mental toughness and self-compassion measures were interviewed in phase II. Thematic analysis generated 2 themes: (1) self-compassion grants access to wise mental toughness and (2) mental toughness helps activate self-compassionate actions during injury. These findings are consistent with recent research and suggest that both mental toughness and self-compassion can work together to help athletes cope with sport injury.
Michelle A. Sandrey
Introduction/Clinical Scenario : As many hamstring injuries occur when the hamstrings are in a lengthened state during the deceleration phase of running when the muscle is eccentrically contracting to slow the body down this functional aspect needs to be addressed. Thus, a rehabilitation program with a focus on progressive targeted eccentric hamstring exercises by gradually placing and exposing the muscle to eccentric force in a lengthened state supplemented with progressive running drills should be evaluated. Focused Clinical Question : Does the inclusion of a complementary running progression program for the rehabilitation of an acute hamstring injury reduce the time to safe return to sport with less hamstring reinjury occurrence for an athletic population? Summary of Key Findings: Three studies assessed the inclusion of a progressive running program with several types of running progression parameters addressed. Progressive running drills will load the hamstring in a functional manner, with a gradual increase in velocity of movement and lengthening of the muscle. Clinical Bottom Line : It appears that a complementary progressive running program within an acute hamstring rehabilitation program should be included as it caused no further harm and does not tend to increase hamstring reinjury occurrence. Strength of Recommendation : There is grade B evidence to include a complementary running progression program within an acute hamstring rehabilitation program.
