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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.

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Pavlos Angelopoulos, Konstantinos Mylonas, Elias Tsepis, Evdokia Billis, Nikolaos Vaitsis, and Konstantinos Fousekis

Context: Instrument-assisted soft tissue mobilization (IASTM), tissue flossing, and kinesiology taping are increasingly popular treatments among athletes for improving functional performance, despite limited evidence for their efficacy. Objective: Previous research regarding the efficacy of soft tissues and neuromuscular techniques on improving functional capacity of shoulder joints in athletes has yielded conflicting results. We examined the immediate and short-term effects of IASTM, flossing, and kinesiology taping on the functional capacities of amateur athletes’ shoulders. Design: Randomized controlled study. Setting: Clinical assessment laboratory. Participants: Eighty amateur overhead athletes (mean [SD]: age = 23.03 [1.89]; weight = 78.36 [5.32]; height = 1.77 [.11]). Interventions: We randomly assigned participants to 4 research sub-groups in which they received the following treatments on their dominant shoulders: IASTM (n = 20), flossing (n = 20), both IASTM and flossing (n = 20), and kinesiology tape (n = 20). Nondominant shoulders served as controls. Main Outcome Measure: We evaluated participants—before, immediately after, and 45 minutes after the therapeutic interventions—with the following tests: internal and external shoulder rotation range of motion, isokinetic strength and total work, the functional throwing performance index, and the one-arm seated shot put throw performance. Results: All therapeutic interventions significantly improved the strength and functional performance of the dominant shoulder in comparison with the control (P < .005) immediately after and 45 minutes after the treatment. The IASTM led to significantly greater improvement in shoulder internal rotation than kinesiology taping immediately after (P = .049) and 45 minutes after the treatment (P = .049). We observed no significant differences between the other treatment interventions (P > .05). Conclusion: Findings from the current study support the use of novel soft tissue and neuromuscular techniques for the immediate and short-term improvement of the shoulder functional capacities in amateur overhead athletes.

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Whitney N. Neal, Emma Richardson, and Robert W. Motl

The uptake and benefits of the Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis (PAGs) have been validated, but there is limited understanding regarding the knowledge, needs, and preferences of people with multiple sclerosis (MS) for implementing the PAGs outside of clinical research. The authors conducted online, semistructured interviews with 40 persons with MS from across the United States seeking information on awareness of and potential approaches for increasing the uptake of the PAGs. They identified first impressions and potential approaches for increasing the uptake of the PAGs through inductive, semantic thematic analysis. Participants perceived the PAGs as a good introduction for structured exercise but desired more information on how to meet the PAGs. Participants further believed that modifying the PAGs for inclusivity and applying a multifaceted approach for dissemination and implementation may increase uptake of exercise behavior. Physical activity research in MS should include both analyzing the effects of exercise and the unique challenges faced by persons with MS in putting the PAGs into practice.

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Frédéric Dierick, Fabien Buisseret, Loreda Filiputti, and Nathalie Roussel

The objective of this study was to explore the effects of static and dynamic hamstring muscles stretching on kinematics and esthetics of grand battement (high velocity kicks) in adolescent recreational dancers. Sixteen participants were assessed before and immediately after both stretching modalities. Kinematics of movement was measured by an optoelectronic system and esthetics was scored by a jury of professional dancers. Both stretching modalities led to significant kinematic differences compared with without stretching. Significant linear correlations between kinematic parameters and esthetic scores have been observed: improving dancers’ physical performances has noticeable impact on the perception of their movements.

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John J. Fraser, Rachel Koldenhoven, and Jay Hertel

Context: Tibial nerve impairment and reduced plantarflexion, hallux flexion, and lesser toe flexion strength have been observed in individuals with recent lateral ankle sprain (LAS) and chronic ankle instability (CAI). Diminished plantar intrinsic foot muscles (IFMs) size and contraction are a likely consequence. Objectives: To assess the effects of ankle injury on IFM size at rest and during contraction in young adults with and without LAS and CAI. Setting: Laboratory. Design: Cross-sectional. Patients: A total of 22 healthy (13 females; age = 19.6 [0.9], body mass index [BMI] = 22.5 [3.2]), 17 LAS (9 females; age =21.8 [4.1], BMI = 24.1 [3.7]), 21 Copers (13 females; age = 20.8 [2.9], BMI = 23.7 [2.9]), and 20 CAI (15 females; age = 20.9 [4.7], BMI = 25.1 [4.5]). Main Outcome Measures: Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis, flexor digitorum brevis, quadratus plantae, and flexor hallucis brevis were assessed at rest, and during nonresisted and resisted contraction. Results: Multiple linear regression analyses assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (B = 0.45; P < .001), BMI (B = 0.05; P = .01), FPI (B = 0.07; P = .05), and FMM × FPI interaction (B = −0.04; P = .008) accounted for 19% of the variance (P = .002) in resting abductor hallucis measures. Sex (B = 0.42, P < .001) and BMI (B = 0.03, P = .02) explained 24% of resting flexor digitorum brevis measures (P < .001). Having a recent LAS (B = 0.06, P = .03) and FMM (B = 0.04, P = .02) predicted 11% of nonresisted quadratus plantae contraction measures (P = .04), with sex (P < .001) explaining 13% of resting quadratus plantae measures (B = 0.24, P = .02). Both sex (B = 0.35, P = .01) and FMM (B = 0.15, P = .03) predicted 16% of resting flexor hallucis brevis measures (P = .01). There were no other statistically significant findings. Conclusions: IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. Routine ultrasound imaging of the IFM following LAS and CAI cannot be recommended at this time but may be considered if neuromotor impairment is suspected.

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Sergio Jiménez-Rubio, José Luis Estévez Rodríguez, and Archit Navandar

Context: The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport. Objective: The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer. Design: A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players. Setting: Soccer pitch and indoor gym. Participants: Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga). Interventions: The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury. Main Outcome Measures: Aiken V for each item of the program and number of days taken by the players to return to full team training. Results: The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61–0.98) for all drills, and the return to training was in 13.08 (±1.42) days. Conclusion: This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training.

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Sima Mohammad Amoli, Peyman Aghaie Ataabadi, Amir Letafatkar, Gary B. Wilkerson, and Misagh B. Mansouri

Anterior cruciate ligament (ACL) injury is prevalent during the single-leg jump landing in various sports. The effects of cognitive loading and how it affects risk of ACL injury are not well understood. The purpose of this study is to examine how landing kinetics change in the presence of cognitive loading during a volleyball block. Cognitive loading decreased activations in vastus lateralis and rectus femoris, and increased activation in biceps femoris and medial gastrocnemius muscles. During landing, the first and second peaks of ground reaction forces were 13% and 11% lower under cognitive loading, suggesting that cognitive loading alters landing biomechanics and muscle activations.

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Gina E. McAlear and Jennifer K. Popp

An 18-year-old female, Division I soccer player was diagnosed with complex regional pain syndrome approximately 2 weeks after tarsal tunnel release surgery. Postsurgically, the patient reported a significant increase in neuropathic pain, swelling, paresthesia, skin temperature asymmetry, and allodynia of the plantar and dorsal aspects of the foot, which were initially attributed to other causes. The intense pain and delayed diagnosis led to a decline in mental health and suicide ideation. Once diagnosed with complex regional pain syndrome, an epidural was placed at L5/S1 with a continuous flow of lidocaine, resulting in functional restoration. The patient’s diagnosis and recovery were based on the collaborative efforts of the surgeon, sports medicine physician, pain management specialist, and athletic trainer. She returned to soccer participation with minimal symptoms. This case is unique because the symptoms of complex regional pain syndrome were attributed to other causes, resulting in a delayed diagnosis and appropriate treatment. This delay resulted in the patient threatening self-harm.

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Jeffrey Martin

The goal of this study was to determine if emotional expressions at the end of swimmers’ 2016 Paralympic races varied according to medal won and if their race wins and losses were close or not close. Using FaceReader software, videos of 46 races of medal-winning Paralympic (M age = 24.6; SD = 5.4) swimmers’ faces (78 males and 60 females) from 22 countries were analyzed. Silver medalists were angrier and sadder than gold medalists and angrier and more disgusted than bronze medalists. Swimmers who swam slower than their 2015 best time were angrier than Paralympians who swam faster. Paralympians who finished lower than their 2015 world ranking had more neutral emotions and were less happy than Paralympians who finished higher. Gold medalists who narrowly defeated silver medalists were less happy and more fearful than gold medalists who won easily. Bronze medalists with close wins had fewer neutral emotions and were happier, less angry, and more surprised than bronze medalists with not-close wins. All medalists with close wins were more surprised than medalists with easier wins. Bronze medalists with close losses to silver medalists were happier and less angry than bronze medalists who lost more easily. Effect sizes ranged from d = 0.27 to 1.01. These results provide theoretical support to basic emotion theory and confirm the anecdotal observations that Paralympic competition generates wide-ranging and diverse emotions.