Context: Femoroacetabular impingement syndrome (FAIS) is a painfully debilitating hip condition disproportionately affecting active individuals. Mental health disorders are an important determinant of treatment outcomes for individuals with FAIS. Self-efficacy, kinesiophobia, and pain catastrophizing are psychosocial factors that have been linked to inferior outcomes for a variety of orthopedic conditions. However, these psychosocial factors and their relationships with mental health disorders, pain, and function have not been examined in individuals with FAIS. Objective: (1) To examine relationships between self-efficacy, kinesiophobia, pain catastrophizing, pain, and function in patients with FAIS and (2) to determine if these variables differ between patients with and without a self-reported depression and/or anxiety. Design: Cross-sectional. Setting: University health center. Participants: Fifty-one individuals with FAIS (42 females/9 males; age 35.7 [11.6] y; body mass index 27.1 [4.9] kg/m2). Main Outcome Measures: Participants completed the Pain Self-Efficacy Questionnaire, Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, visual analog scale for hip pain at rest and during activity, and the 12-item International Hip Outcome Tool. Self-reported depression and/or anxiety were recorded. The relationships between psychosocial factors, pain, and function were examined using Spearman rank-order correlations. Independent t tests and Mann–Whitney U tests were used to evaluate the effect of self-reported depression and/or anxiety on psychosocial factors, pain and function. Results: The 12-item International Hip Outcome Tool was correlated with pain during activity (ρ = −.57, P ≤ .001), Tampa Scale for Kinesiophobia (ρ = −.52, P ≤ .001), and Pain Self-Efficacy Questionnaire (ρ = .71, P ≤ .001). The Pain Self-Efficacy Questionnaire was also correlated with pain at rest (ρ = −.43, P = .002) and pain during activity (ρ = −.46, P = .001). Individuals with self-reported depression and/or anxiety (18/51; 35.3%) had worse self-efficacy and pain catastrophizing (P ≤ .01). Conclusion: Self-reported depression and/or anxiety, low self-efficacy, and high kinesiophobia were associated with more hip pain and worse function for patients with FAIS. These findings warrant further examination including psychosocial treatment strategies to improve the likelihood of a successful clinical outcome for this at-risk population.
Kate N. Jochimsen, Carl G. Mattacola, Brian Noehren, Kelsey J. Picha, Stephen T. Duncan, and Cale A. Jacobs
Caitlin Brinkman, Shelby E. Baez, Carolina Quintana, Morgan L. Andrews, Nick R. Heebner, Matthew C. Hoch, and Johanna M. Hoch
Context: Fast visuomotor reaction time (VMRT), the time required to recognize and respond to sequentially appearing visual stimuli, allows an athlete to successfully respond to stimuli during sports participation, while slower VMRT has been associated with increased injury risk. Light-based systems are capable of measuring both upper- and lower-extremity VMRT; however, the reliability of these assessments are not known. Objective: To determine the reliability of an upper- and lower-extremity VMRT task using a light-based trainer system. Design: Reliability study. Setting: Laboratory. Patients (or Other Participants): Twenty participants with no history of injury in the last 12 months. Methods: Participants reported to the laboratory on 2 separate testing sessions separated by 1 week. For both tasks, participants were instructed to extinguish a random sequence of illuminated light-emitting diode disks, which appeared one at a time as quickly as possible. Participants were provided a series of practice trials before completing the test trials. VMRT was calculated as the time in seconds between target hits, where higher VMRT represented slower reaction time. Main Outcome Measures: Separate intraclass correlation coefficients (ICCs) with corresponding 95% confidence intervals (CIs) were calculated to determine test–retest reliability for each task. The SEM and minimal detectable change values were determined to examine clinical applicability. Results: The right limb lower-extremity reliability was excellent (ICC2,1 = .92; 95% CI, .81–.97). Both the left limb (ICC2,1 = .80; 95% CI, .56–.92) and upper-extremity task (ICC2,1 = .86; 95% CI, .65–.95) had good reliability. Conclusions: Both VMRT tasks had clinically acceptable reliability in a healthy, active population. Future research should explore further applications of these tests as an outcome measure following rehabilitation for health conditions with known VMRT deficits.
Rafael E.A. Muchaxo, Sonja de Groot, Lucas H.V. van der Woude, Thomas W.J. Janssen, and Carla Nooijen
The classification system for handcycling groups athletes into five hierarchical classes, based on how much their impairment affects performance. Athletes in class H5, with the least impairments, compete in a kneeling position, while athletes in classes H1 to H4 compete in a recumbent position. This study investigated the average time-trial velocity of athletes in different classes. A total of 1,807 results from 353 athletes who competed at 20 international competitions (2014–2018) were analyzed. Multilevel regression was performed to analyze differences in average velocities between adjacent pairs of classes, while correcting for gender, age, and event distance. The average velocity of adjacent classes was significantly different (p < .01), with higher classes being faster, except for H4 and H5. However, the effect size of the differences between H3 and H4 was smaller (d = 0.12). Hence, results indicated a need for research in evaluating and developing evidence-based classification in handcycling, yielding a class structure with meaningful performance differences between adjacent classes.
Nathan Waite, John Goetschius, and Jakob D. Lauver
Runners experience repeated impact forces during training, and the culmination of these forces can contribute to overuse injuries. The purpose of this study was to compare peak vertical tibial acceleration (TA) in trained distance runners on 3 surface types (grass, asphalt, and concrete) and 3 grades (incline, decline, and level). During visit 1, subjects completed a 1-mile time trial to determine their pace for all running trials: 80% (5%) of the average time trial velocity. During visit 2, subjects were outfitted with a skin-mounted accelerometer and performed 18 separate running trials during which peak TA was assessed during the stance phase. Each subject ran 2 trials for each condition with 2 minutes of rest between trials. Peak TA was different between decline (8.04 [0.12] g) and incline running (7.31 [0.35] g; P = .020). On the level grade, peak TA was greater during grass (8.22 [1.22] g) compared with concrete (7.47 [1.65] g; P = .017). On the incline grade, grass (7.68 [1.44] g) resulted in higher peak TA than asphalt (6.99 [1.69] g; P = .030). These results suggest that under certain grade conditions grass may result in higher TA compared with either concrete or asphalt.
Rena F. Hale, Sandor Dorgo, Roger V. Gonzalez, and Jerome Hausselle
Auditory feedback is a simple, low-cost training solution that can be used in rehabilitation, motor learning, and performance development. The use has been limited to the instruction of a single kinematic or kinetic target. The goal of this study was to determine if auditory feedback could be used to simultaneously train 2 lower-extremity parameters to perform a bodyweight back squat. A total of 42 healthy, young, recreationally active males participated in a 4-week training program to improve squat biomechanics. The Trained group (n = 22) received 4 weeks of auditory feedback. Feedback focused on knee flexion angle and center of pressure under the foot at maximum squat depth. The Control group (n = 20) performed squats without feedback. Subjects were tested pre, post, and 1 week after training. The Trained group achieved average target knee flexion angle within 1.73 (1.31) deg (P < .001) after training and 5.36 (3.29) deg (P < .01) at retention. While achieving target knee flexion angle, the Trained group maintained target center of pressure (P < .001). The Control group improved knee range of motion, but were not able to achieve both parameter targets at maximum squat depth (P < .90). Results from this study demonstrate that auditory feedback is an effective way to train 2 independent biomechanical targets simultaneously.
Faezeh Mohammadi Sanjani, Abbas Bahram, Moslem Bahmani, Mina Arvin, and John van der Kamp
It has been shown that texting degrades driving performance, but the extent to which this is mediated by the driver’s age and postural stability has not been addressed. Hence, the present study examined the effects of texting, sitting surface stability, and balance training in young and older adults’ driving performance. Fifteen young (mean age = 24.3 years) and 13 older (mean age = 62.8 years) participants were tested in a driving simulator with and without texting on a smartphone and while sitting on a stable or unstable surface (i.e., a plastic wobble board), before and after a 30-min sitting balance training. Analyses of variance showed that texting deteriorated driving performance but irrespective of sitting surface stability. Balance training decreased the negative effects of texting on driving, especially in older adults. Perceived workload increased when drivers were texting, and balance training reduced perceived workload. Perceived workload was higher while sitting on the unstable surface, but less so after balance training. Path analyses showed that the effects on driving performance and perceived workload were (indirectly) associated with changes in postural stability (i.e., postural sway). The study confirms that texting threatens safe driving performance by challenging postural stability, especially in older adults. The study also suggests that it is important to further investigate the role balance training can play in reducing these negative effects of texting.
Fabio Bertapelli, Stamatis Agiovlasitis, Robert W. Motl, Roberto A. Soares, Marcos M. de Barros-Filho, Wilson D. do Amaral-Junior, and Gil Guerra-Junior
The purpose of this study was to develop and cross-validate an equation for estimating percentage body fat (%BF) from body mass index and other potential independent variables among young persons with intellectual disability. Participants were 128 persons with intellectual disability (62 women; age 16–24 years) split between development (n = 98) and cross-validation (n = 30) samples. Dual-energy X-ray absorptiometry served as the reference method for %BF. An equation including 1/body mass index and sex (0 = male; 1 = female) was highly accurate in estimating %BF (p < .001; R 2 = .82; standard error of estimate = 5.22%). Mean absolute and root mean square errors were small (3.1% and 3.9%, respectively). A Bland–Altman plot indicated nearly zero mean difference between actual and predicted %BF with modest 95% confidence intervals. The prediction equation was %BF = 56.708 − (729.200 × [1/body mass index]) + (12.134 × sex). Health care professionals may use the prediction equation for monitoring %BF among young people with intellectual disability.