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Giacomo Farì, Stefano Di Paolo, Domenico Ungaro, Gianluca Luperto, Eleonora Farì, and Francesca Latino

Background: Sport activities were interrupted due to a quarantine imposed to limit the spread of Coronavirus disease 2019 (COVID-19) in Italy. This study aimed to describe the impact of COVID-19 on sports and on daily activities in an Italian cohort of school children signed up in a football school. Methods: A total of 44 children from an Italian football school were enrolled. An online survey was distributed to these children and their parents in May 2020. The questionnaire collected information on the daily use of electronic devices and on the number of hours per week spent in activities regarding nonsport activities, highlighting the differences between those who interrupted sports and those who continued driven remotely by their instructors during the lockdown. Results: A total of 26 players continued practicing sports during the COVID-19 quarantine, while 18 players suspended their sports. Daily time spent on electronic devices increased significantly in both groups during the pandemic (p < .0001), regardless of whether they continued to practice sports (p > .05). On the other hand, in the group of children who interrupted sports, the time spent on activities regarding nonsport physical activity significantly changed during pandemic, with a 50% decrease (p = .0027) of those who spent more than 3 hr per week before the quarantine in favor of those who spent less than 3 hr per week. Conclusion: Quarantine increases screen time, which is a sedentary behavior that represents a risk factor for the health of children. Maintaining regular physical activity during quarantine due to COVID-19 was important to preserve some aspects of a healthy lifestyle in children, such as physical activity regardless of sport. While reducing physical activity and adapting it remotely, it is desirable that it be encouraged by experienced instructors in order to limit potential physical and psychological harm to children.

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Dana Vander Wal, Brenda Potter, Shannon L. David, and Nicole German

Ulnar collateral ligament (UCL) injuries have become increasingly more common over the years. Reconstruction and nonoperative treatment have been the conventional treatment for athletes, especially for overhead athletes. This case study presents a 16-year-old female, competitive Level 10 gymnast, with a complete distal tear of her UCL with a full thickness, Grade 3, ulnar sided avulsion off of the sublime tubercle. She underwent medial UCL repair with internal brace augmentation with the goal of faster return to gymnastics. To the author’s knowledge, this is the second gymnast reported in the literature to have an internal brace augmentation completed on the UCL.

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Katelyn M. Christian and Matthew F. Moran

The upper quarter Y-balance test is an upper extremity, closed kinetic chain assessment that requires individuals to reach in three directions while in a three-point plank position. The upper quarter Y-balance test was performed in 22 collegiate softball players (19.95 ± 1.52 years) to determine the (a) differences between throwing and nonthrowing (NT) sides and (b) influence of reach sequence. While stabilizing on the NT side, participants reached significantly further in the inferolateral direction than the throwing side (NT: 83.7 ± 12.2% arm length; throwing: 80.1 ± 10.5% arm length; p = .03; effect size = −0.57). Altering reach sequence significantly influenced medial reach (p < .01, effect size = 0.66) and composite score (p = .017, effect size = 1.03) when stabilizing on the NT side. Asymmetries in upper quarter Y-balance test in collegiate softball players should be interpreted cautiously, and an ordered test sequence should be consistently followed.

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Kyle B. Kosik, Kathryn Lucas, Matthew C. Hoch, Jacob T. Hartzell, Katherine A. Bain, and Phillip A. Gribble

Studies have demonstrated that individuals with chronic ankle instability (CAI) have diminished dynamic stability. Jerk-based measures have been utilized to examine dynamic balance because of their ability to quantify changes in acceleration and may provide an understanding of the postural corrections that occur during stabilizing following a jumping task. The purpose of this study was to compare acceleration and jerk following a jump stabilization task between individuals with CAI and the uninjured controls. Thirty-nine participants volunteered to participate in this case control study. Participants completed a jump stabilization task requiring them to jump off 2 feet, touch a marker set at 50% of their maximal vertical jump height, land on a single limb, and maintain balance for 3 seconds. Acceleration was calculated as the second derivative, and jerk was calculated as the third derivative of the displacement of the resultant vector position. Participants with CAI had greater acceleration (mean difference = 55.6 cm/s2; 95% confidence interval, 10.3 to 100.90; P = .017) and jerk compared with the uninjured controls (mean difference = 1804.5 cm/s3; 95% confidence interval, 98.7 to 3510.3; P = .039). These results suggest that individuals with CAI made faster and more frequent active postural control corrections to regain balance following a jump compared with the uninjured controls.

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ZáNean McClain, Jill Pawlowski, and Daniel W. Tindall

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Ling Zhang, Shao-bai Wang, Shuai Fan, Jiling Ye, and Bin Cai

Context: Performance in strength and assessment of patellar tracking is important for patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction. Objective: The study was to examine the difference of patellofemoral kinematics between the affected and the contralateral limb and to evaluate the relationship between knee extensor strength and patellofemoral kinematics in patients with arthrofibrosis after ACL reconstruction. Design: Cohort study (diagnosis); level of evidence, 3. Setting: Laboratory. Patients: A prospective cohort of 20 patients with arthrofibrosis after ACL reconstruction was recruited. Interventions: A total of 20 patients who underwent arthroscopic reconstruction of the double-bundle ACL with a hamstring tendon autograft received standardized patellofemoral kinematics testing and knee extensor strength testing within 6 months after primary ACL reconstruction. Computed tomography and dual fluoroscopic imaging were used to evaluate in vivo patellofemoral kinematics of affected and contralateral knees during a lunge task. Knee extensor mechanism strength was measured using a handheld dynamometer. Main Outcome Measures: A limb symmetry index of knee strength and patellar mobility was calculated and satisfactory performance defined as ≥90%. Results: There was a statistically significant decrease in the range of patellar inferior shift (P = .020; d = 0.81), flexion (P = .026; d = 0.95), lateral tilt (P = .001; d = 1.04), and lateral rotation (P < .001; d = 0.89) in the affected knee compared with the contralateral knee from 15° to 75° of knee flexion. There was a strong positive linear correlation between knee extensor strength and patellar inferior shift (r = .747; P = .008). A knee extensor strength limb symmetry index <90% was 89% sensitive and 9% specific for limited patellar inferior shift. Conclusions: Patients with arthrofibrosis after ACL reconstruction presented decreased patellar mobility in the arthrofibrotic knee compared with the contralateral knee. The strong correlation between knee extensor strength and patellar inferior shift of the arthrofibrotic knee demonstrates the importance of knee extensor strength in the diagnosis and treatment of patients with knee arthrofibrosis. The knee extensor mechanism strength has high sensitivity but low specificity in identifying a decrease in patellar inferior shift in patients with arthrofibrosis after ACL reconstruction.

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Katie L. Kowalski, Ali Boolani, and Anita D. Christie

Compromised attentional resources during perceived fatigue has been suggested to alter motor control. The authors determined if measures of postural control and gait are predicted by state and trait physical and mental fatigue and energy, and how these relationships are modified by sex, sleep quality, and physical activity. Young adults (n = 119) completed the Modified Clinical Test of Sensory Integration, overground walking, and questionnaires to quantify fatigue and energy, sleep quality, and physical activity. Regression models indicated that trait fatigue, trait energy, and sleep quality were predictors of postural control (p ≤ .02, R 2 ≥ .04). State fatigue, state energy, and sex were predictors of gait (p ≤ .05, R 2 ≥ .03). While the variance explained was low (3–13%), the results demonstrate perceptions of fatigue and energy may influence posture and gait.

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Jessica Murphy, Karen A. Patte, Philip Sullivan, and Scott T. Leatherdale

The mental health benefits of physical activity may relate more to the context of the behavior, rather than the behavior of being active itself. The association between varsity sport (VS) participation, depression, and anxiety symptoms was explored using data from 70,449 high school students from the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior study. The model adjusted for potential covariates; interactions by sex and participation in outside of school sport (OSS) were explored. Overall, 70% and 24% of respondents met or exceeded cutoff values for depression and anxiety, respectively. Students participating in VS had lower symptoms of anxiety and depression compared with nonparticipants. Results were consistent regardless of OSS participation; associations were strongest among students who participated in both VS and OSS and males. Participation in VS may prove beneficial for the prevention and/or management of depression or anxiety symptoms, particularly among males. An additive beneficial effect of OSS on depression and anxiety scores may exist.