Context: Joint hypermobility has a high prevalence in dancers and may be associated with injury and performance. Objectives: To investigate whether total Beighton score can predict injury and to determine the relationship between joint hypermobility and injury, and to report injury demographics. Design: A prospective cohort injury study. Setting: Edge Hill University dance injury clinic. Participants: Eighty-two dancers (62 females, 20 males). Main Outcome Measures: Joint hypermobility via the Beighton score ≥4 with lumbar flexion included and removed. Results: A total of 61 dancers were classified as hypermobile, which was reduced to 50 dancers with lumbar flexion removed. A significant difference existed between pooled total days injured in hypermobile dancers and nonhypermobile dancers with lumbar flexion included (P = .02) and removed (P = .03). No significant differences existed for total Beighton score between injured and noninjured groups with lumbar flexion included (P = .11) and removed (P = .13). Total Beighton score was a weak predictor of total days injured (r2 = .06, P = .51). In total, 47 injuries occurred in 34 dancers, and pooled injury rate was 1.03 injuries/1000 hours. Receiver operating characteristic curve analysis demonstrated an area under the curve of 0.83 for male dancers with lumbar flexion removed, which was considered diagnostic for injury. Conclusions: The Beighton score can be utilized to identify dancers who may develop injury. Clinicians should consider the role of lumbar flexion in total Beighton score when identifying those dancers at risk of injury. Different injury thresholds in female and male dancers may aid injury management.
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Kylie McNeill, Natalie Durand-Bush and Pierre-Nicolas Lemyre
While coaches are considered at risk of experiencing burnout, there is an absence of intervention studies addressing this syndrome. The purpose of this qualitative study was to conduct a self-regulation intervention with five Canadian developmental (n = 2) and elite (n = 3) sport coaches (three men, two women) experiencing moderate to high levels of burnout and examine the perceived impact of this intervention on their self-regulation capacity and experiences of burnout and well-being. The content analysis of the coaches’ outtake interviews and five bi-weekly journals revealed that all five of them learned to self-regulate more effectively by developing various competencies (e.g., strategic planning for their well-being, self-monitoring) and strategies (e.g., task delegation, facilitative self-talk). Four of the coaches also perceived improvements in their symptoms of burnout and well-being. Sport psychology interventions individualized for coaches are a promising means for helping them manage burnout and enhance their overall functioning.
Connor Burk, Jesse Perry, Sam Lis, Steve Dischiavi and Chris Bleakley
Context: Anatomical and in vivo studies suggest that muscles function synergistically as part of a myofascial chain. A related theory is that certain myofascial techniques have a remote and clinically important effect on range of motion (ROM). Objective: To determine if remote myofascial techniques can effectively increase the range of motion at a distant body segment. Evidence Acquisition: In November 2018, the authors searched 3 electronic databases (CENTRAL, MEDLINE, and PEDro) and hand-searched journals and conference proceedings. Inclusion criteria were randomized controlled trials comparing remote myofascial techniques with passive intervention (rest/sham) or local treatment intervention. The primary outcome of interest was ROM. Quality assessment was performed using the PEDro Scale. Three authors independently evaluated study quality and extracted data. RevMan software was used to pool data using a fixed-effect model. Evidence Synthesis: Eight randomized controlled trials, comprising N = 354 participants were included (mean age range 22–36 y; 50% female). Study quality was low with PEDro scores ranging from 2 to 7 (median scores 4.5/10). None of the studies incorporated adequate allocation concealment and just 2 used blinded assessment of outcomes. In all studies, treatments and outcomes were developed around the same myofascial chain (superficial back line). Five studies included comparisons between remote interventions to sham or inactive controls; pooled results for ROM showed trends in favor of remote interventions (standard mean difference 0.23; 95% confidence intervals; −0.09 to 0.55; 4 studies) at immediate follow-ups. Effects sizes were small, corresponding to mean differences of 9% or 5° in cervical spine ROM, and 1 to 3 cm in sit and reach distance. Four studies compared remote interventions to local treatments, but there were few differences between groups. Conclusions: Remote exercise interventions may increase ROM at distant body segments. However, effect sizes are small and the current evidence base is limited by selection and measurement bias.
Rodrigo Cappato de Araújo, Vinícius Yan Santos Nascimento, Rafaela Joyce Barbosa Torres, Francis Trombini-Souza, David Behm and Ana Carolina Rodarti Pitangui
Context: It is believed that conscious abdominal contraction (CAC) during exercise encourages greater periscapular activation through existing myofascial connections. On the other hand, it is postulated that the use of unstable surfaces would promote greater neuromuscular demand. Objective: To analyze the effect of CAC on periscapular muscle activity during push-up plus exercise on stable and unstable surfaces and to evaluate the correlation between electromyographic (EMG) activity of the serratus anterior (SA) and abdominal oblique muscles. Design: Repeated-measures design in a single group, pre–post CAC. Setting: Biomechanics laboratory. Participants: Twenty-three male volunteers without a history of lesions in the upper limbs participated in the study. Main Outcome Measures: Five repetitions of push-ups on stable and unstable surfaces were performed with and without instruction for CAC. The normalized amplitude of the EMG activity was obtained from the muscles of the upper, middle, and lower trapezius, SA upper (SA_5th) and lower (SA_7th) portions, external oblique (EO), and internal oblique. Results: CAC increased the activity of the EO, internal oblique, middle trapezius, and SA (P < .05) in both surfaces. The use of the unstable surface increased the EMG activity of the EO, SA_7th, and middle trapezius and decreased the EMG activity of the SA_5th. However, all changes observed in EMG signals were of low magnitude, with effect sizes lower than 0.45. There was a weak correlation between the EMG activity of the EO and SA_5th (r = .24) and a strong correlation between the EO and SA_7th (r = .70). Conclusion: The isolated use of CAC or unstable surface during push-up seems to present no practical relevance, but the combined use of these strategies may increase activation of the SA_7th and middle trapezius muscles.
Yumeng Li, He Wang and Kathy J. Simpson
The purpose of the study was to compare the tibiofemoral contact forces of participants with chronic ankle instability versus controls during landings using a computer-simulated musculoskeletal model. A total of 21 female participants with chronic ankle instability and 21 pair-matched controls performed a drop landing task on a tilted force plate. A 7-camera motion capture system and 2 force plates were used to test participants’ lower-extremity biomechanics. A musculoskeletal model was used to calculate the tibiofemoral contact forces (femur on tibia). No significant between-group differences were observed for the peak tibiofemoral contact forces (P = .25–.48) during the landing phase based on paired t tests. The group differences ranged from 0.05 to 0.58 body weight (BW). Most participants demonstrated a posterior force (peak, ∼1.1 BW) for most duration of the landing phase and a medial force (peak, ∼0.9 BW) and large compressive force (peak, ∼10 BW) in the landing phase. The authors conclude that chronic ankle instability may not be related to the increased tibiofemoral contact forces or knee injury mechanisms during landings on the tilted surface.
İlker Eren, Nazan Canbulat, Ata Can Atalar, Şule Meral Eren, Ayla Uçak, Önder Çerezci and Mehmet Demirhan
Context: Ideal rehabilitation method following arthroscopic capsulolabral repair surgery for anterior shoulder instability has not been proven yet. Although rapid or slow protocols were compared previously, home- or hospital-based protocols were not questioned before. Objective: The aim of this prospective unrandomized controlled clinical trial is to compare the clinical outcomes of home-based and hospital-based rehabilitation programs following arthroscopic Bankart repair. Design: Nonrandomized controlled trial. Setting: Orthopedics and physical therapy units of a single institution. Patients: Fifty-four patients (49 males and 5 females) with an average age of 30.5 (9.1) years, who underwent arthroscopic capsulolabral repair and met the inclusion criteria, with at least 1-year follow-up were allocated into 2 groups: home-based (n = 33) and hospital-based (n = 21) groups. Interventions: Both groups received identical rehabilitation programs. Patients in the home-based group were called for follow-up every 3 weeks. Patients in the hospital-based group admitted for therapy every other day for a total of 6 to 8 weeks. Both groups were followed identically after the eighth week and the rehabilitation program continued for 6 months. Main Outcome Measures: Clinical outcomes were assessed using Disabilities of Arm Shoulder Hand, Constant, and Rowe scores. Mann–Whitney U test was used to compare the results in both groups. Wilcoxon test was used for determining the progress in each group. Results: Groups were age and gender matched (P = .61, P = .69). Average number of treatment sessions was 13.8 (7.3) for patients in the hospital-based group. Preoperative Disabilities of Arm Shoulder Hand (27.46 [11.81] vs 32.53 [16.42], P = .22), Constant (58.23 [14.23] vs 54.17 [10.46], P = .13), and Rowe (51.72 [15.36] vs 43.81 [19.16], P = .12) scores were similar between groups. Postoperative scores at sixth month were significantly improved in each group (P = .001, P = .001, and P = .001). No significant difference was observed between 2 groups regarding clinical scores in any time point. Conclusions: We have, therefore, concluded that a controlled home-based exercise program is as effective as hospital-based rehabilitation following arthroscopic capsulolabral repair for anterior shoulder instability.
Sofia W. Manta, Paula F. Sandreschi, Thiago S. Matias, Camila Tomicki and Tânia R.B. Benedetti
This study aimed to investigate the clustering patterns of physical activity, sedentary time (ST), and breaks in ST, and the association between the identified clusters at risk for metabolic syndrome associated with obesity in older adults. Participants included 212 users of community health centers in Brazil. A questionnaire about sociodemographic characteristics was used to describe the sample, and physical activity, ST, and breaks in ST were evaluated using accelerometers. Waist circumference was measured as an indicator of the risk for metabolic syndrome. A two-step cluster analysis and logistic regression analysis were conducted. The following four clusters were identified: sitters (37.7%), inactive (28.3%), active (25.5%), and all-day sitters/lightly active (8.5%). Participants in the active cluster were 60% less likely to be at risk for metabolic syndrome. This study may contribute to a comprehensive understanding of which older adult groups need more attention in the context of community health centers.
Freja Gheysen, Karel Herman and Delfien Van Dyck
Objective: To investigate whether the relationship of neighborhood environmental factors with physical activity (PA) is moderated by cognitive functioning in Belgian older adults. Methods: Seventy-one older adults completed validated questionnaires on PA and environmental perceptions, wore an accelerometer, and completed a computerized assessment of cognitive functioning. Moderated linear regression analyses were conducted in SPSS 24.0. Results: Overall cognitive functioning significantly moderated the associations of traffic safety and street connectivity with PA. Detailed analyses showed that these factors were only positively associated with PA in older adults with lower cognitive functioning. In addition, particularly, performance on tests assessing visuospatial and episodic memory moderated these associations. Discussion: Living in traffic-safe neighborhoods with short and many alternative routes might motivate older adults with lower cognitive functioning to be active. As such, the increase in PA might improve their cognitive abilities. This knowledge is crucial for health practitioners to develop effective PA promotion initiatives.
Jesús Seco-Calvo, Juan Mielgo-Ayuso, César Calvo-Lobo and Alfredo Córdova
Context: Despite prior studies that have addressed the recovery effects of cold-water immersion (CWI) in different sports, there is a lack of knowledge about longitudinal studies across a full season of competition assessing these effects. Objective: To analyze the CWI effects, as a muscle recovery strategy, in professional basketball players throughout a competitive season. Design: A prospective cohort design. Setting: Elite basketball teams. Participants: A total of 28 professional male basketball players divided into 2 groups: CWI (n = 12) and control (n = 16) groups. Main Outcome Measures: Muscle metabolism serum markers were measured during the season in September—T1, November—T2, March—T3, and April—T4. Isokinetic peak torque strength and ratings of perceived exertion were measured at the beginning and at the end of the season. CWI was applied immediately after every match and after every training session before matches. Results: All serum muscular markers, except myoglobin, were higher in the CWI group than the control group (P < .05). The time course of changes in muscle markers over the season also differed between the groups (P < .05). In the CWI group, ratings of perceived exertion decreased significantly from the beginning (T1–T2) to the end (T3–T4). Isokinetic torque differed between groups at the end of the season (60°/s peak torque: P < .001 and
Rhodri S. Lloyd, Jon L. Oliver, Gregory D. Myer, Mark B. De Ste Croix, Josh Wass and Paul J. Read
Context: Despite the popularity of jump-landing tasks being used to identify injury risk factors, minimal data currently exist examining differences in knee kinematics during commonly used bilateral jumping tasks. This is especially the case for rebounding-based protocols involving young athletes. Objective: To compare the frontal plane projection angles (FPPAs) during the drop vertical jump (DVJ) and tuck jump assessment (TJA) in a cohort of elite male youth soccer players of varying maturity status. Methods: A total of 57 male youth soccer players from an English championship soccer club participated in this study. Participants performed 3 trials of the DVJ and TJA, during which movement was recorded with 2-dimensional video cameras. FPPA for both right (FPPA-r) and left (FPPA-l) legs, with values <180° indicative of medial knee displacement. Results: On a whole-group level, FPPA-r (172.7° [7.4°] vs 177.2° [11.7°]; P < .05; effect size [ES] = 0.46) and FPPA-l (173.4° [7.3°] vs 179.2° [11.0°]; P < .05; ES = 0.62) were significantly greater for both limbs in the TJA compared with the DVJ; however, these differences were less consistent when grouped by maturity status. FPPA-r during the TJA was significantly and moderately greater in the circa-peak height velocity (PHV) group compared with the post-PHV cohorts (169.4° [6.4°] vs 175.3° [7.8°]; P < .05; ES = 0.49). Whole-group data showed moderate relationships for FPPA-r and FPPA-l between the TJA and DVJ; however, stronger relationships were shown in circa- and post-PHV players compared with the pre-PHV cohort. Conclusions: Considering that the TJA exposed players to a larger FPPA and was sensitive to between-group differences in FPPA-r, the TJA could be viewed as a more suitable screen for identifying FPPA in young male soccer players.