Browse

You are looking at 31 - 40 of 268 items for :

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

Jack P. Callaghan

Open access

Samuel C. Fischer, Darren Q. Calley, and John H. Hollman

Clinical Scenario: Low back pain is a common condition for the general population with 29% of adults having low back pain within the last 3 months. A deadlift is described as a free weight exercise in which a barbell is lifted from the floor in a continuous motion by extending the knees and hips. For those without low back pain, the deadlift was found to have the highest muscle activation of paraspinal musculature compared with other exercises. There are a limited number of studies that investigate the usefulness of incorporating deadlifts as part of a rehabilitation program for low back pain. Clinical Question: For those who live with low back pain, is an exercise routine that includes a deadlift a viable treatment option to improve pain and/or function? Summary of Key Findings: The literature search yielded 3 total studies meeting the inclusion and exclusion criteria: 1 randomized control trial, 1 secondary analysis of a randomized control trial, and 1 cohort study. Exercise programs that include deadlifts can yield improvements in both pain and function for those living with low back pain but were not found to be more beneficial than low load motor control exercises. Those with lower pain levels and higher baseline lumbar extension strength may be most appropriate to participate in an exercise program that includes deadlifts. Further research is needed to compare exercise programs that include deadlifts to other interventions for those living with low back pain. Clinical Bottom Line: There is minimal evidence that exercise programs that included deadlifts are a clinically effective option for the treatment of low back pain for both pain scores and functional outcome measures. Strength of Recommendation: Level B evidence exists that exercise programs that include deadlifts are a clinically effective option for the treatment of low back pain for both pain scores and functional outcome measures.

Open access

Scott Benson Street, Matthew Rawlins, and Jason Miller

Clinical Scenario: Ankle fractures are a frequent occurrence, and they carry the potential for syndesmosis injury. The syndesmosis is important to the structural integrity of the ankle joint by maintaining the proximity of the tibia, fibula, and talus. Presently, the gold standard for treating an ankle syndesmosis injury is to insert a metallic screw through the fibula and into the tibia. This technique requires a second intervention to remove the hardware, but also carries an inherent risk of breaking the screw during rehabilitation. Another fixation technique, the Tightrope, has gained popularity in treating ankle syndesmosis injuries. The TightRope involves inserting Fiberwire® through the tibia and fibula, which allows for stabilization of the ankle mortise and normal range of motion. Clinical Question: In patients suffering from ankle syndesmosis injuries, is the Tightrope ankle syndesmosis fixation system more effective than conventional screw fixation at improving return to work, pain, and patient-reported outcome measures? Summary of Key Findings: Five studies were selected to be critically appraised. The PEDro checklist was used to score 2 randomized control trials, and the Downs & Black checklist was used to score the cohort study on methodology and consistency. Two systematic reviews were also appraised. All 5 articles demonstrated support for using the TightRope fixation. Clinical Bottom Line: There is moderate evidence to support the use of the TightRope syndesmosis fixation system, as it provides both clinician- and patient-reported outcomes that are similar to those using the conventional metallic screw, with a shortened time to recover and return to activity. Strength of Recommendation: Grade A evidence exists in support of using the TightRope fixation system in place of the metallic screw following ankle syndesmosis injury.

Open access

Dhinu J. Jayaseelan, Cesar Fernandez-de-las-Penas, Taylor Blattenberger, and Dean Bonneau

Clinical Scenario: Plantar heel pain is a common condition frequently associated with persistent symptoms and functional limitations affecting both the athletic and nonathletic populations. Common interventions target impairments at the foot and ankle and local drivers of symptoms. If symptoms are predominantly perpetuated by alterations in central pain processing, addressing peripheral impairments alone may not be sufficient. Clinical Question: Do individuals with chronic plantar heel pain demonstrate signs potentially associated with altered central pain processing? Summary of Key Findings: After searching 6 electronic databases (PubMed, CINAHL, Scopus, SportDiscus, Cochrane, and PEDro) and filtering titles based on predetermined inclusion and exclusion criteria, 4 case-control studies were included. All studies scored highly on the Newcastle-Ottawa Scale for quality assessment. Using pressure pain thresholds, each study found decreased pressure pain hypersensitivity locally and at a remote site compared to control groups, suggesting the presence, to some extent, of altered nociceptive pain processing. Clinical Bottom Line: In the studies reviewed, reported results suggest a possible presence of centrally mediated symptoms in persons with plantar heel pain. However, despite findings from these studies, limitations in appropriate matching based on body mass index and measures used suggest additional investigation is warranted. Strength of Recommendation: According to the Oxford Centre for Evidence-Based Medicine, there is evidence level C to suggest chronic plantar heel pain is associated with alterations in central pain processing.

Open access

Karin Weman Josefsson

Sweden has adopted a somewhat different approach to handle the corona pandemic, which has been widely debated both on national and international levels. The Swedish model involves more individual responsibility and reliance on voluntary civic liability than law enforcement, while common measures in other countries are based on more controlling strategies, such as restrictive lockdowns, quarantines, closed borders, and mandatory behavior constraints. This commentary aims to give a brief overview of the foundations of the Swedish model as well as a discussion on how and why it has been adopted in the Swedish society based on Swedish legislations, culture, and traditions. Finally, perspectives on how the Swedish model could be connected to the tenets of self-determination theory will be discussed.

Full access

Zachary Y. Kerr, Julianna Prim, J.D. DeFreese, Leah C. Thomas, Janet E. Simon, Kevin A. Carneiro, Stephen W. Marshall, and Kevin M. Guskiewicz

Context: Little research has examined health-related quality of life in former National Football League (NFL) players. Objective: Examine the association of musculoskeletal injury history and current self-reported physical and mental health in former NFL players. Setting: Cross-sectional questionnaire. Patients or Other Participants: Historical cohort of 2,103 former NFL players that played at least one season between 1940 and 2001. Intervention: Players were grouped by self-reported professional career musculoskeletal injury history and whether injuries affected current health: (1) no musculoskeletal injury history; (2) musculoskeletal injury history, currently affected by injuries; and (3) musculoskeletal injury history, not currently affected by injuries. Main Outcome Measure: The Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being (SF-36) yielded physical and mental health composite scores (PCS and MCS, respectively); higher scores indicated better health. Multivariable linear regression computed mean differences (MD) among injury groups. Covariates included demographics, playing history characteristics, surgical intervention for musculoskeletal injuries, and whether injury resulted in premature end to career. MD with 95% CI excluding 0.00 were deemed significant. Results: Overall, 90.3% reported at least one musculoskeletal injury during their professional football careers, of which 74.8% reported being affected by their injuries at time of survey completion. Adjusting for covariates, mean PCS in the “injury and affected” group was lower than the “no injury” (MD = −3.2; 95% CI: −4.8, −1.7) and “injury and not affected” groups (MD = −4.3; 95% CI: −5.4, −3.3); mean MCS did not differ. Conclusion: Many players reported musculoskeletal injuries, highlighting the need for developing and evaluating injury management interventions.

Full access

Landon B. Lempke, Jeonghoon Oh, Rachel S. Johnson, Julianne D. Schmidt, and Robert C. Lynall

Context: Laboratory-based movement assessments are commonly performed without cognitive stimuli (ie, single-task) despite the simultaneous cognitive processing and movement (ie, dual task) demands required during sport. Cognitive loading may critically alter human movement and be an important consideration for truly assessing functional movement and understanding injury risk in the laboratory, but limited investigations exist. Objective: To comprehensively examine and compare kinematics and kinetics between single- and dual-task functional movement among healthy participants while controlling for sex. Design: Cross-sectional study. Setting: Laboratory. Patients (or Other Participants): Forty-one healthy, physically active participants (49% female; 22.5 ± 2.1 y; 172.5 ± 11.9 cm; 71.0 ± 13.7 kg) enrolled in and completed the study. Intervention(s): All participants completed the functional movement protocol under single- and dual-task (subtracting by 6s or 7s) conditions in a randomized order. Participants jumped forward from a 30-cm tall box and performed (1) maximum vertical jump landings and (2) dominant and (3) nondominant leg, single-leg 45° cuts after landing. Main Outcome Measures: The authors used mixed-model analysis of variances (α = .05) to compare peak hip, knee, and ankle joint angles (degrees) and moments (N·m/BW) in the sagittal and frontal planes, and peak vertical ground reaction force (N/BW) and vertical impulse (Ns/BW) between cognitive conditions and sex. Results: Dual-task resulted in greater peak vertical ground reaction force compared with single-task during jump landing (mean difference = 0.06 N/BW; 95% confidence interval [CI], 0.01 to 0.12; P = .025) but less force during dominant leg cutting (mean difference = −0.08 N/BW; 95% CI, −0.14 to −0.02; P = .015). Less hip-flexion torque occurred during dual task than single task (mean difference = −0.09 N/BW; 95% CI, −0.17 to −0.02). No other outcomes were different between single and dual task (P ≥ .053). Conclusions: Slight, but potentially important, kinematic and kinetic differences were observed between single- and dual-task that may have implications for functional movement assessments and injury risk research. More research examining how various cognitive and movement tasks interact to alter functional movement among pathological populations is warranted before clinical implementation.

Open access

Bin Chen, Lifen Liu, Lincoln Bin Chen, Xianxin Cao, Peng Han, Chenhao Wang, and Qi Qi

Context: Measuring isometric shoulder rotational strength is clinically important for evaluating motor disability in athletes with shoulder injuries. Recent evidence suggests that handheld dynamometry may provide a low-cost and portable method for the clinical assessment of isometric shoulder strength. Objective: To investigate the concurrent validity and the intrarater and interrater reliability of handheld dynamometry for measuring isometric shoulder rotational strength. Design: Cross-sectional study. Setting: Biomechanics laboratory. Participants: Thirty-nine young, healthy participants. Main Outcome Measures: The peak isometric strength of the internal rotators and external rotators, measured by handheld dynamometry (in newton) and isokinetic dynamometry (in newton meter). Interventions: Maximal isometric shoulder rotational strength was measured as participants lay supine with 90° shoulder abduction, neutral rotation, 90° elbow flexion, and forearm pronation. Measurements were performed independently by 2 different physiotherapists and in 3 different sessions to evaluate interrater and intrarater reliability. The data obtained by handheld dynamometry were compared with those obtained by isokinetic testing to evaluate concurrent validity. Results: The intraclass correlation coefficients for interrater reliability in measuring maximum isometric shoulder external and internal rotation strength were .914 (95% confidence interval [CI], .842–.954) and .842 (95% CI, .720–.914), respectively. The intrarater reliability values of the method for measuring maximal shoulder external and internal rotation strength were 0.865 (95% CI, 0.757–0.927) and 0.901 (95% CI, 0.820–0.947), respectively. The Pearson correlation coefficients between the handheld and isokinetic dynamometer measurements were .792 (95% CI, .575–.905) for external rotation strength and .664 (95% CI, .419–.839) for internal rotation strength. Conclusions: The handheld dynamometer showed good to excellent reliability and moderate to good validity in measuring maximum isometric shoulder rotational strength. Therefore, handheld dynamometry could be acceptable for health and sports professionals in field situations to evaluate maximum isometric shoulder rotational strength.

Open access

Bin Chen, Lifen Liu, Lincoln Bin Chen, Xianxin Cao, Peng Han, Chenhao Wang, and Qi Qi

Context: Measuring isometric shoulder rotational strength is clinically important for evaluating motor disability in athletes with shoulder injuries. Recent evidence suggests that handheld dynamometry may provide a low-cost and portable method for the clinical assessment of isometric shoulder strength. Objective: To investigate the concurrent validity and the intrarater and interrater reliability of handheld dynamometry for measuring isometric shoulder rotational strength. Design: Cross-sectional study. Setting: Biomechanics laboratory. Participants: Thirty-nine young, healthy participants. Main Outcome Measures: The peak isometric strength of the internal rotators and external rotators, measured by handheld dynamometry (in newton) and isokinetic dynamometry (in newton meter). Interventions: Maximal isometric shoulder rotational strength was measured as participants lay supine with 90° shoulder abduction, neutral rotation, 90° elbow flexion, and forearm pronation. Measurements were performed independently by 2 different physiotherapists and in 3 different sessions to evaluate interrater and intrarater reliability. The data obtained by handheld dynamometry were compared with those obtained by isokinetic testing to evaluate concurrent validity. Results: The intraclass correlation coefficients for interrater reliability in measuring maximum isometric shoulder external and internal rotation strength were .914 (95% confidence interval [CI], .842–.954) and .842 (95% CI, .720–.914), respectively. The intrarater reliability values of the method for measuring maximal shoulder external and internal rotation strength were 0.865 (95% CI, 0.757–0.927) and 0.901 (95% CI, 0.820–0.947), respectively. The Pearson correlation coefficients between the handheld and isokinetic dynamometer measurements were .792 (95% CI, .575–.905) for external rotation strength and .664 (95% CI, .419–.839) for internal rotation strength. Conclusions: The handheld dynamometer showed good to excellent reliability and moderate to good validity in measuring maximum isometric shoulder rotational strength. Therefore, handheld dynamometry could be acceptable for health and sports professionals in field situations to evaluate maximum isometric shoulder rotational strength.