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The purpose of the present study was to analyze Adapted Physical Activity Quarterly (APAQ) publications over the journal’s fourth decade (2014–2023) and compare them with previous documentary analyses of the first 3 decades. Consistent with prior documentary analyses, publications were coded and analyzed based on the use of theory, research participants, topic, whether the study was an intervention, first-author country affiliation, and research method. The total number of published research papers increased substantially (n = 61) from the third to the fourth decade. Similar to prior documentary analyses, most of the research was quantitative (n = 140; 57.5%), followed by qualitative research (n = 96; 39.5%). There were far more qualitative-research publications in the fourth decade compared with the third decade (n = 34). This may reflect the continued acceptance and growth of qualitative research compared with 10–20 years ago. It may also reflect the value of rich in-depth exploratory research using small samples. Additional trends included more review papers and meta-analyses, possibly reflecting the increased knowledge base in particular areas requiring synthesis. The diversity of topics also increased, with papers on dignity, classification, coaching, and the Paralympics playing more prominent roles. The number of international publications also grew substantially. In brief, the current paper outlines both similarities and differences in APAQ’s published research over the 4 decades of its existence.

Context: We designed this study to investigate the effects of 2 myofascial release techniques, Instrument-Assisted Soft Tissue Mobilization (IASTM) and Foam Roller (FR), on pain, joint range of motion, and muscle strength in athletes suffering from iliotibial band (ITB) tightness. Design: A total of 39 male soccer players were enrolled in this randomized controlled trial, aged between 18 and 23 years who were divided into 3 groups: Only Exercise, IASTM, and FR. Methods: All participants performed daily strengthening and stretching exercises, while 1 group added IASTM, and the other added FR to the exercise program. We evaluated ITB tightness with the Ober test and an inclinometer, pressure pain threshold, using an algometer, and we evaluated muscle strength with the Cybex Norm Isokinetic device. Results: We found that all 3 groups exhibited an increase in the Ober inclination angle after the interventions (P = .001), but the increase was greater for participants in the IASTM and FR groups, compared with exercise alone. Additionally, both the IASTM and FR groups displayed an increased pressure pain threshold (P = .001), whereas there was no change in the control group. Moreover, while all 3 groups experienced an increase in hip muscle strength (P = .001), the IASTM and FR groups exhibited a greater increase compared with exercise alone (P = .001). Conclusions: Based on these findings, exercise improves pain, range of motion, and muscle strength in athletes with ITB tightness, and IASTM, and FR techniques enhanced exercise effects but did not differ from one another. While our study demonstrated that both IASTM and FR techniques significantly enhance the benefits of exercise for athletes with ITB tightness, further research could delve into the long-term effects of these interventions.

Context: Foot/ankle pain is common among runners. Inadequate management of runners with foot/ankle pain can lead to lost training time, competition removal, and other activity limitations. Neurodynamics, which refers to the integrated biomechanical, physiological, and structural function of the nervous system during movement, can be overlooked in patients with foot/ankle pain. Although a link between the cervical spine, neurodynamics, and upper quarter pain has been studied, less is known about the relationship between the lumbar spine and lower quarter. This case series describes the successful management of 3 runners with foot/ankle pain. Case Presentations: Three female runners (ages 23, 24, and 45 y) presented to physical therapy with foot/ankle pain and difficulty running. Each patient had positive examination findings with local foot/ankle testing. A comprehensive lumbar spine examination demonstrated impairments in range of motion and joint mobility that were hypothesized to be contributing. Positive lower quarter neurodynamic tests were also found. Management and Outcomes: All patients were treated with nonthrust lumbar spine mobilization and lower quarter neural tissue mobilization. Changes in the Patient-Specific Functional Scale, Numerical Pain Rating Scale, Lower Extremity Functional Scale, and Global Rating of Change occurred after intervention targeting the lumbar spine and lower-extremity neurodynamics in all patients. Conclusions: This case series demonstrates the importance of including a thorough lumbar spine examination and neurodynamic testing to identify appropriate interventions while managing patients with foot/ankle pain, even when patients have signs indicative of local ankle/foot pathology. These examination procedures should be performed particularly when a patient is not responding to management targeting local foot/ankle structures.

Background: Beam walking is a highly studied assessment of walking balance. Recent research has demonstrated that brief intermittent visual rotations and occlusions can increase the efficacy of beam walking practice on subsequent beam walking without visual perturbations. We sought to examine the influence of full vision removal during practice walking on a treadmill-mounted balance beam. Although visual disruptions improved performance of this task, we hypothesized that removing visual feedback completely would lead to less balance improvements than with normal vision due to the specificity of practice. Methods: Twenty healthy young adults trained to walk at a fixed speed on a treadmill-mounted balance beam for 30 min, either with, or without, normal vision. We compared their balance pre-, during, and posttraining by calculating their step-offs per minute and the percentage change in step-offs per minute. Results: Balance improved in both groups after training, with no significant difference in percentage change in step-offs between the normal vision and the no vision participants. On average, the no vision participants had twice as many step-offs per minute as the normal vision group during training. Conclusion: Although previous experiments show that intermittent visual perturbations led to large enhancements of the effectiveness of beam walking training, completely removing visual feedback did not alter training effectiveness compared with normal vision training. It is likely a result of sensory reweighting in the absence of vision, where a greater weight was placed on proprioceptive, cutaneous, and vestibular inputs.

Context: The best current evidence supports the effectiveness of neuromuscular training in reducing the risk of injury; however, the rate of anterior cruciate ligament (ACL) injuries is still high. Neurocognitive training (NT) has successfully improved biomechanical risk factors, but they have been considered in only a few studies. Objective: To review the literature to determine the effect of NT on biomechanical risk factors related to ACL injury in athletes. Evidence Acquisition: We searched PubMed, Google Scholar, Scopus, Science Direct, and the Physiotherapy Evidence Database from inception to August 2011. We included randomized controlled trials that used motor learning approaches and injury prevention programs to investigate kinematic and kinetic risk factors related to ACL injury. The quality of each clinical trial study was evaluated by the Physiotherapy Evidence Database scale. The eligibility criteria were checked based on the PICOS (population, intervention, comparison, outcome, and study type) framework. Evidence Synthesis: A total of 9 studies were included in the final analysis. Motor learning approaches include internal and external focus of attention, dual tasks, visual motor training, self-control feedback, differential learning, and linear and nonlinear pedagogy, combined with exercise programs. In most of the studies that used NT, a significant decrease in knee valgus; tibial abduction and external rotation; ground reaction force; and an increase in knee-, trunk-, hip-, and knee-flexion moment was observed. Conclusion: In classical NT, deviation from the ideal movement pattern especially emphasizing variability and self-discovery processes is functional in injury prevention and may mitigate biomechanical risk factors of ACL injuries in athletes. Practitioners are advised to use sport-specific cognitive tasks in combination with neuromuscular training to simulate loads of the competitive environment. This may improve ACL injury risk reduction and rehabilitation programs.

Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P = .01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P = .03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk.

Context: Ankle sprains are a common injury in sports, for which use of external ankle support during rehabilitation has been suggested to improve clinical outcomes. Design: Cohort study. Methods: Thirteen soccer players experiencing acute lateral ankle sprain injury were provided a novel adaptive ankle brace or conventional ankle taping (control) as external ankle support throughout the injury rehabilitation process. All other clinical procedures were identical, and rehabilitation was supervised by the same team staff member. Time from injury to clearance to return to sport was tracked. Player experience with the ankle brace also was queried via electronic surveys. Results: The median time to return to sport was less for the Brace group (52.5 d) compared to the Control group (79.5 d), but the distributions of the 2 groups were not found to differ significantly (P = .109). Player surveys indicated they felt the brace to be comfortable or very comfortable, with better freedom of movement than other braces and the same freedom of movement as wearing no brace. All players reported wearing the brace to be the same or better experience as ankle taping. Discussion: These preliminary results indicate that the adaptive ankle brace is at least as effective as ankle taping for providing external support during the rehabilitation phase following acute lateral ankle sprain and suggest it may be a more effective ankle support solution in terms of patient compliance than conventional bracing or taping.

Context: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. Design: A randomized and controlled clinical study. Methods: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. Results: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P < .001), with no significant differences detected between the experimental groups (P > .665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P < .001), while no significant difference was observed between the experimental groups (P > .999). Conclusions: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities.