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Erika Zemková, Alena Cepková, and José M. Muyor

This study investigates postural responses to unexpected perturbations induced by a load release of different weights. Groups of 26 men (age 22.6 ± 2.4 years, height 178.0 ± 9.1 cm, and body mass 86.9 ± 11.5 kg) and 21 women (age 21.9 ± 2.7 years, height 168.8 ± 6.8 cm, and body mass 65.3 ± 8.7 kg) underwent load-triggered postural perturbations by 1 and 2 kg while standing on a force plate with either eyes open or eyes closed. Postural perturbations induced by a heavier load, representing about 2% and 3% of body weight in men and women, respectively, led to significantly higher peak anterior and peak posterior center of pressure displacements when compared with a lighter load (29.6% and 45.4%, respectively) both with eyes open (36.9%) and closed (42.1%). Their values were significantly lower in men than women only when a higher load was used (∼25%). However, there were no significant differences in time to peak anterior and posterior center of pressure displacements. These findings indicate that heavier load-induced postural perturbations are greater in women than men regardless of visual conditions. This underlines the importance of loading dose in the magnitude of postural responses to externally induced perturbations.

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W. Tolentino-Castro, L. Mochizuki, and H. Wagner

According to the literature, persons with intellectual disabilities have poor motor control in tasks in which motor anticipation is needed. Our study aimed to assess their motor behavior during interceptive tasks (a tennis ball interception with external-and-oneself throw conditions). A stick-bar was used as a reference or to support cloth to occlude a ball’s trajectory. Catch performance and interceptive behavior were analyzed (26 persons). The results show that high/low values of the initial approaching movement led to successful/successful catches, respectively. Our results are in line with the literature about the impact of poor motor control on performance in those with intellectual disabilities. We suggest that low anticipation may relate to problems in real-life situations.

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Chris M. Edwards

Clinical Scenerio: Neck pain is a costly symptom in both civilian and military worlds. While traditional treatments include deep neck flexor stabilizing exercises, manual therapy, electrical therapy, and other nonsurgical interventions, scapular orientation and stability training has emerged as a possible tool to reduce neck pain severity. Methods that can be coached at a distance could be of value in virtual appointments or circumstances where access to a qualified manual therapist is limited. Focused Clinical Question: What is the effectiveness of including exercise programs targeting scapular kinematics and stability to decrease neck pain? Summary of Key Findings: Exercise programs targeting scapular kinematics and stability, with coaching and individualized progressions, appear to reduce neck pain severity. Clinical Bottom Line: Evidence supports the inclusion of exercises for scapular kinematics and stability at a prescription of 3 sessions per week, with a duration of 4 or 6 weeks. Exercise programs should include a “learning” or coaching phase to ensure exercises are performed as intended, and exercise progressions should be based on participant ability rather than predetermined timelines. Further research is needed to better understand the benefits of this potential strategy and the statistical impact of scapular-focused exercise interventions on neck pain in specific populations like military and athletes. Strength of Recommendation: There is ‘Fair’ to ‘Good’ evidence from 2 level 1b single-blind randomized control studies and 1 level 2b pre-post test control design study supporting the inclusion of exercise programs targeting scapular kinematics and stability to decrease chronic neck pain severity.

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Rodrigo Rodrigues Gomes Costa, Jefferson Rodrigues Dorneles, Guilherme Henrique Lopes, José Irineu Gorla, and Frederico Ribeiro Neto

Context: Monitoring training loads and consequent fatigue responses are usually a result of personal trainers’ experiences and an adaptation of methods used in sports for people without disabilities. Currently, there is little scientific evidence on the relationship between training load and fatigue resulting from training sessions in wheelchair sports. Analogous to the vertical jump, which has been associated with competitive performance and used to assess fatigue in Olympic sports, the medicine ball throw (MBT) is a fast, feasible, and accessible test that might be used to measure performance outcomes in Paralympic athletes. Objective: To test the MBT responsiveness to detect meaningful changes after training sessions in beginner wheelchair basketball players (WBP). Design: Cross-sectional study. Setting: Rehabilitation Hospital Network, Paralympic Program. Participants: Twelve male WBP. Main Outcomes Measures: The participants performed 3 consecutive days of training sessions involving exercises of wheelchair basketball skills, strength, and power. The MBT test was performed pre and post training sessions. Results: The smallest worthwhile change for MBT was 0.10 cm, and the lower and upper limits were 3.54 and 3.75 m, respectively. On the first day, the MBT started below the smallest worthwhile change lower limit and increased above the upper limit (3.53 and 3.78 m, respectively). On the second day, the MBT pretraining and posttraining session results were near the sample mean (3.62 and 3.59 m, respectively). On the third day, the WBP started the MBT test training higher than the upper limit (3.78 m) and decreased to near the mean (3.58 m). Conclusions: During 3 consecutive days of training sessions, the magnitude-based inference model presented meaningful changes in MBT test performance. The accurate association of the magnitude-based inference model with the MBT allows coaches and sports team staff to interpret the correct magnitude of change in WBP performance.

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Guillermo Mendez-Rebolledo, Romina Figueroa-Ureta, Fernanda Moya-Mura, Eduardo Guzmán-Muñoz, Rodrigo Ramirez-Campillo, and Rhodri S. Lloyd

Context: Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track-and-field athletes. Objective: To determine the effects of NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump performance, balance, 30-m sprint, and joint position sense in youth female track-and-field athletes. Design: Single-blind, randomized controlled clinical trial. Setting:Sports research laboratory. Participants: Twenty-two female athletes were allocated into 2 groups: Conventional (CONV) training (n = 11; age = 15.3 [2.1] y) and NM training (n = 11; age = 15.0 [2.7] y). Interventions: Interventions were performed during the preseason of 6 weeks. The CONV training included anaerobic, strength, and aerobic training. The NM training consisted of a multicomponent program that integrated jumps, landings, and running with strength, endurance, agility, balance, and CORE training. Main Outcome Measures: A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7–18). Secondary outcomes were measured before and after the intervention: Y-balance test, active joint repositioning, ground reaction force, and countermovement jump height. Results: The injury incidence rate was 17.89 injuries per 1000 hours athlete-exposure in CONV training, and 6.58 in NM training (relative risk = 0.38; 95% confidence interval,  0.18 to 0.82; P = .044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 hours athlete-exposure in CONV training and 0.82 in NM training (relative risk = 0.17; 95% confidence interval, 0.02 to 1.12; P = .012). In addition, a significant training × time interaction was noted, favoring improvements in 30-m sprint and countermovement jump height after NM. Conclusion: The NM training may improve youth female athlete’s physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.

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Ernst Albin Hansen

Investigations of behavior and control of voluntary stereotyped rhythmic movement contribute to the enhancement of motor function and performance of disabled, sick, injured, healthy, and exercising humans. The present article presents examples of unprompted alteration of freely chosen movement rate during voluntary stereotyped rhythmic movements. The examples, in the form of both increases and decreases of movement rate, are taken from activities of cycling, finger tapping, and locomotion. It is described that, for example, strength training, changed power output, repeated bouts, and changed locomotion speed can elicit an unprompted alteration of freely chosen movement rate. The discussion of the examples is based on a tripartite interplay between descending drive, rhythm-generating spinal neural networks, and sensory feedback, as well as terminology from dynamic systems theory.

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Karlee Naumann, Jocelyn Kernot, Gaynor Parfitt, Bethany Gower, and Kade Davison

The purpose of this study was to produce a descriptive overview of the types of water-based interventions for people with neurological disability, autism, and intellectual disability and to determine how outcomes have been evaluated. Literature was searched through MEDLINE, EMBASE, Ovid Emcare, SPORTDiscus, Google Scholar, and Google. One hundred fifty-three papers met the inclusion criteria, 115 hydrotherapy, 62 swimming, 18 SCUBA (self-contained underwater breathing apparatus), and 18 other water-based interventions. Common conditions included cerebral palsy, spinal cord injury, Parkinson’s disease, and intellectual disability. Fifty-four papers explored physical outcomes, 36 psychosocial outcomes, and 24 both physical and psychosocial outcomes, with 180 different outcome measures reported. Overall, there is a lack of high-quality evidence for all intervention types. This review provides a broad picture of water-based interventions and associated research. Future research, guided by this scoping review, will allow a greater understanding of the potential benefits for people with neurological disability, autism, and intellectual disability.

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Megan Nye and Paul A. Cacolice

Clinical question: Do mild jugular compression (MJC) devices reduce white matter alterations in high school-aged males playing collision sports? Clinical bottom line: There is moderate evidence at Strength of Recommendation B to support that MJC reduces WMAs in high school-aged males playing collision sports.