Browse

You are looking at 11 - 20 of 463 items for :

  • Athletic Training, Therapy, and Rehabilitation x
  • Refine by Access: Content accessible to me x
Clear All
Open access

Hangue Park, Alexander N. Klishko, Kyunggeune Oh, Celina Zhang, Gina Grenga, Kinsey R. Herrin, John F. Dalton IV, Robert S. Kistenberg, Michel A. Lemay, Mark Pitkin, Stephen P. DeWeerth, and Boris I. Prilutsky

Cutaneous feedback from feet is involved in regulation of muscle activity during locomotion, and the lack of this feedback results in motor deficits. We tested the hypothesis that locomotor changes caused by local unilateral anesthesia of paw pads in the cat could be reduced/reversed by electrical stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve during stance. Several split-belt conditions were investigated in four adult female cats. In addition, we investigated the effects of similar distal tibial nerve stimulation on overground walking of one male cat that had a transtibial, bone-anchored prosthesis for 29 months and, thus, had no cutaneous/proprioceptive feedback from the foot. In all treadmill conditions, cats walked with intact cutaneous feedback (control), with right fore- and hindpaw pads anesthetized by lidocaine injections, and with a combination of anesthesia and electrical stimulation of the ipsilateral distal tibial nerve during the stance phase at 1.2× threshold of afferent activation. Electrical stimulation of the distal tibial nerve during the stance phase of walking with anesthetized ipsilateral paw pads reversed or significantly reduced the effects of paw pad anesthesia on several kinematic variables, including lateral center of mass shift, cycle and swing durations, and duty factor. We also found that stimulation of the residual distal tibial nerve in the prosthetic hindlimb often had different effects on kinematics compared with stimulation of the intact hindlimb with paw anesthetized. We suggest that stimulation of cutaneous and proprioceptive afferents in the distal tibial nerve provides functionally meaningful motion-dependent sensory feedback, and stimulation responses depend on limb conditions.

Open access

Matthew R. Kutz

Athletic training and the environment in which it is practiced is constantly changing. The emergent environment is volatile, uncertain, complex, and ambiguous. This new environment necessitates an adjustment to athletic training education particularly as it pertains to the instruction and development of the nonclinical skills (meta-skills) needed for clinical settings. One such meta-skill is contextual intelligence. Contextual intelligence is the capacity to recognize the convergence of different variables and respond to the emerging context as it is developing. Practicing contextual intelligence includes integrating 12 specific behaviors and the 3D thinking framework of hindsight, insight, and foresight into clinical decision making.

Open access

Adam J. Petway, Matthew J. Jordan, Scott Epsley, and Philip Anloague

A systematic search was performed of online databases for any Achilles tendon (AT) injuries occurring within the National Basketball Association (NBA). Video was obtained of injuries occurring during competition and downloaded for analysis in Dartfish. NBA athletes (n = 27) were identified with AT rupture over a 30-year period (1991–2021). Of the 27 NBA athletes found to have AT ruptures (mean age: 29.3 [3.3] y; average time in the NBA: 8.5 [3.8] y), 15 in-game videos were obtained for analysis. Noncontact rupture was presumed to have occurred in 12/13 cases. Eight of the 13 athletes had possession of the ball during time of injury. The ankle joint of the injured limb for all 13 athletes was in a dorsiflexed position during the time of injury (47.9° [6.5°]). All 13 athletes performed a false-step mechanism at time of injury where they initiated the movement by taking a rearward step posterior to their center of mass with the injured limb before translating forward. NBA basketball players that suffered AT ruptures appeared to present with a distinct sequence of events, including initiating a false step with ankle dorsiflexion of the injured limb at the time of injury.

Open access

Dayuan Xu, Jiwon Park, Jiseop Lee, Sungjune Lee, and Jaebum Park

Gravity provides critical information for the adjustment of body movement or manipulation of the handheld object. Indeed, the changes in gravity modify the mechanical constraints of prehensile actions, which may be accompanied by the changes in control strategies. The current study examined the effect of the gravitational force of a handheld object on the control strategies for subactions of multidigit prehension. A total of eight subjects performed prehensile tasks while grasping and lifting the handle by about 250 mm along the vertical direction. The experiment consisted of two conditions: lifting gravity-induced (1g) and weightless (0g) handheld objects. The weightless object condition was implemented utilizing a robot arm that produced a constant antigravitational force of the handle. The current analysis was limited to the two-dimensional grasping plane, and the notion of the virtual finger was employed to formulate the cause–effect chain of elemental variables during the prehensile action. The results of correlation analyses confirmed that decoupled organization of two subsets of mechanical variables was observed in both 1g and 0g conditions. While lifting the handle, the two subsets of variables were assumed to contribute to the grasping and rotational equilibrium, respectively. Notably, the normal forces of the thumb and virtual finger had strong positive correlations. In contrast, the normal forces had no significant relationship with the variables as to the moment of force. We conclude that the gravitational force had no detrimental effect on adjustments of the mechanical variables for the rotational action and its decoupling from the grasping equilibrium.

Full access

Ian Robertson, Marina Lazarides, and Cody R. Butler

Clinical Scenario: Blood flow restriction (BFR) therapy has emerged as a viable treatment option to enhance clinical recovery in patients with primarily muscular injuries. However, BFR therapy has been rarely investigated in patients with osseous injuries to include extremity fracture. Focused Clinical Question: Does BFR-enhanced therapy improve clinical outcomes in patients during the acute to subacute rehabilitation period after extremity fracture? Summary of Key Findings: (1) In cases of 2 high-performing athletes with talus and osteochondral fracture of the knee, BFR was well tolerated and an effective rehabilitation regimen. (2) In 2 randomized controlled trials evaluating BFR use in patients after operative and nonoperative management of distal radius fractures, pain with activity and self-perceived function were improved in BFR-enhanced therapy as compared with a standard rehabilitation regimen. (3) Objective clinical outcomes including radiographic healing, extremity range of motion, and grip strength evaluated by the randomized controlled trials did not differ significantly between the BFR-enhanced and standard rehabilitation groups. Clinical Bottom Line: BFR-enhanced therapy may improve pain and self-perceived function of the injured extremity during the acute to subacute rehabilitation period after fracture. However, there is not yet a demonstrated benefit of BFR on hastening objective measures of clinical recovery. Large-scale clinical trials comparing BFR-enhanced rehabilitation with standard rehabilitation regimens are needed to better characterize BFR use in patients with osseous injuries. Strength of Recommendation: Two case reports and 2 randomized controlled trials provide level IIB evidence suggesting that BFR may improve pain in the acute rehabilitative stage and improve the patient’s perceived function of the injured extremity, without greater improvement in objectively measured clinical parameters as compared with a standard rehabilitation regimen.

Open access

Cindy H.P. Sit, Wendy Y.J. Huang, Stephen H.S. Wong, Martin C.S. Wong, Raymond K.W. Sum, and Venus M.H. Li

Background: Following the 2019 Hong Kong Para Report Card, the 2022 Hong Kong Para Report Card aimed to provide an updated and evidence-based assessment for nine indicators related to physical activity in children and adolescents with special educational needs and to assess the results using a SWOT (strengths, weaknesses, opportunities, and threats) analysis. Methods: Using a systematic process, the best available data on nine indicators were searched from the past 10 years and were assessed by a research work group. Letter grades were assigned and considered by stakeholders and auditors. Results: Four indicators were assigned a letter grade (overall physical activity: F [mixed device-measured and self-reported data]; sedentary behaviors: D [device-measured data]; active transportation: D−; government strategies & investment: C+). SWOT analysis highlighted opportunities for facilitating children and adolescents with special educational needs to achieve health recommendations. Conclusion: There were deteriorating trends in physical activity and sedentary behaviors. Effective, multilevel, and cross-sector interventions are recommended to promote active behavior in children and adolescents with special educational needs.

Open access

Susann Arnell, Kajsa Jerlinder, and Lars-Olov Lundqvist

Background: Participation in physical activity among adolescents with autism is often conditional. However, there is a lack of methods for identifying these specific conditions. Therefore, the purpose of this study was to develop and investigate the feasibility of a Q-sort tool to map individual-specific conditions for participation in physical activity among adolescents with autism and to identify different viewpoints regarding conditions for such participation. Method: An exploratory mixed-methods design was employed to investigate the feasibility of using Q methodology and the Q-sort procedure to identify what individual-specific conditions are important for participation in physical activity for adolescents with autism. Results: The adolescents ranked the statements with varying levels of ease. Two viewpoints were identified: Autonomous participation without surprises and Enjoyment of activity in a safe social context. Conclusion: Q-sort is a feasible method for mapping conditions for participation, which can guide the development of tailored physical activity interventions.

Open access

Jeffrey J. Martin