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Xiyao Shan, Pavlos Evangelidis, Takaki Yamagishi, Shun Otsuka, Fumiko Tanaka, Shigenobu Shibata and Yasuo Kawakami

This study investigated (a) site- and direction-dependent variations of passive triceps surae aponeurosis stiffness and (b) the relationships between aponeurosis stiffness and muscle strength and walking performance in older individuals. Seventy-nine healthy older adults participated in this study. Shear wave velocities of the triceps surae aponeuroses at different sites and in two orthogonal directions were obtained in a prone position at rest using supersonic shear imaging. The maximal voluntary isometric contraction torque of the plantar flexors and normal (preferred) and fast (fastest possible) walking speeds (5-m distance) were also measured. The shear wave velocities of the adjoining aponeuroses were weakly associated with plantar flexion torque (r = .23–.34), normal (r = .26), and fast walking speed (r = .25). The results show clear spatial variations and anisotropy of the triceps surae aponeuroses stiffness in vivo, and the aponeurosis stiffness was associated with physical ability in older adults.

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Yumeng Li, Jupil Ko, Marika A. Walker, Cathleen N. Brown and Kathy J. Simpson

The purpose of the present study was to examine the effect of chronic ankle instability (CAI) on lower-extremity joint coordination and stiffness during landing. A total of 21 female participants with CAI and 21 pair-matched healthy controls participated in the study. Lower-extremity joint kinematics were collected using a 7-camera motion capture system, and ground reaction forces were collected using 2 force plates during drop landings. Coupling angles were computed based on the vector coding method to assess joint coordination. Coupling angles were compared between the CAI and control groups using circular Watson–Williams tests. Joint stiffness was compared between the groups using independent t tests. Participants with CAI exhibited strategies involving altered joint coordination including a knee flexion dominant pattern during 30% and 70% of their landing phase and a more in-phase motion pattern between the knee and hip joints during 30% and 40% and 90% and 100% of the landing phase. In addition, increased ankle inversion and knee flexion stiffness were observed in the CAI group. These altered joint coordination and stiffness could be considered as a protective strategy utilized to effectively absorb energy, stabilize the body and ankle, and prevent excessive ankle inversion. However, this strategy could result in greater mechanical demands on the knee joint.

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Matthew S. Briggs, Claire Spech, Rachel King, Mike McNally, Matthew Paponetti, Sharon Bout-Tabaku and Laura Schmitt

Obese (OB) youth demonstrate altered knee mechanics and worse lower-extremity performance compared with healthy weight (HW) youth. Our objectives were to compare sagittal plane knee landing mechanics between OB and HW youth and to examine the associations of knee and hip extension peak torque with landing mechanics in OB youth. Twenty-four OB and 24 age- and sex-matched HW youth participated. Peak torque was measured and normalized to leg lean mass. Peak knee flexion angle and peak internal knee extension moment were measured during a single-leg hop landing. Paired t tests, Pearson correlation coefficients, and Bonferroni corrections were used. OB youth demonstrated worse performance and lower knee extension (OB: 12.76 [1.38], HW: 14.03 [2.08], P = .03) and hip extension (OB: 8.59 [3.13], HW: 11.10 [2.89], P = .005) peak torque. Furthermore, OB youth demonstrated lower peak knee flexion angles (OB: 48.89 [45.41 to 52.37], HW: 56.07 [52.59 to 59.55], P = .02) and knee extension moments (OB: −1.73 [−1.89 to −1.57], HW: −2.21 [−2.37 to −2.05], P = .0001) during landing compared with HW youth. Peak torque measures were not correlated with peak knee flexion angle nor internal knee extension moment during landing in either group (P > .01). OB youth demonstrated altered landing mechanics compared with HW youth. However, no associations among peak torque measurements and knee landing mechanics were present.

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Jereme B. Outerleys, Michael J. Dunbar, Glen Richardson, Cheryl L. Hubley-Kozey and Janie L. Astephen Wilson

Total knee arthroplasty (TKA) surgery improves knee joint kinematics and kinetics during gait for most patients, but a lack of evidence exists for the level and incidence of improvement that is achieved. The objective of this study was to quantify patient-specific improvements in knee biomechanics relative to osteoarthritis (OA) severity levels. Seventy-two patients underwent 3-dimensional (3D) gait analysis before and 1 year after TKA surgery, as well as 72 asymptomatic adults and 72 with moderate knee OA. A combination of principal component analysis and discriminant analyses were used to categorize knee joint biomechanics for patients before and after surgery relative to asymptomatic, moderate, and severe OA. Post-TKA, 63% were categorized with knee biomechanics consistent with moderate OA, 29% with severe OA, and 8% asymptomatic. The magnitude and pattern of the knee adduction moment and angle (frontal plane features) were the most significant contributors in discriminating between pre-TKA and post-TKA knee biomechanics. Standard of care TKA improves knee biomechanics during gait to levels most consistent with moderate knee OA and predominately targets frontal plane features. These results provide evidence for the level of improvement in knee biomechanics that can be expected following surgery and highlight the biomechanics most targeted by surgery.

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Jennifer T. Coletti, Veronica Allan and Luc J. Martin

A child’s first contact with media and culture typically comes from books they are exposed to in the home and at school. The narratives presented contribute to the early reinforcement of gender roles and norms and can greatly influence the way that young girls perceive and experience sport. The purpose of this study was to explore the narratives within sport-based books geared toward a young female audience to determine the extent to which they promote the engagement of girls in sport. A pragmatic literature search was conducted to obtain books that met our inclusion criteria. Books (n = 28) were analyzed based on the age of their intended audience (aged 3–5, 6–8, and 9–12 years) using thematic narrative analysis. Although the authors promoted the engagement of girls in sport, underlying gender stereotypes were nevertheless salient. Across the books, themes involved the emphasis of “feminine” sports as a context for diversity and learning, the need to understand development as a process, the importance of relationships, and implications pertaining to perceptions of capability as female athletes. Most importantly, the application of a critical feminist lens enabled us to identify an underlying theme—the reinforcement of gender stereotypes—that permeated the storylines and served to undermine the potential adaptive messaging intended by authors. These findings suggest the need for greater attention toward the complexity of female sport and a cultural shift in thinking toward gender equity rather than simply increasing sport access for female participants.

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Emily A. Roper and José A. Santiago

The purpose of this study was to examine how and how often athletic girls were represented on the cover art of young adult (YA) sport fiction. In this research, 154 YA sport fiction books were analyzed using quantitative content analysis. Using existing sport research and theory focused on women’s representation in sport media, the researchers developed a coding scheme to assess cover art for each of the following categories: (a) presence and racial representation of female character/s on cover; (b) portrayal of female body on cover (whole body, partial body/with head, or partial body/without head); (c) portrayal of female character as active or passive; (d) portrayal of female character in or out of athletic uniform; (e) portrayal of female character in or out of the sport setting; (f) presence of sport equipment; and (g) type of cover. Findings revealed that 81% of the book covers had a female character in which 29% of the covers displayed the whole body, 47% displayed partial body/with head, and 23% displayed partial body/with no head of the female character. Only 0.06% of the book covers had a female character of color. Approximately 31% of the female characters were displayed in active positioning, 58% in athletic attire, and 44% in the sport setting. Of the books reviewed, 55% displayed equipment on the cover. The findings indicate that athletic girls have few images on YA sport fiction cover art that accurately represent their athleticism, and there is a clear absence of diverse representation. It is critical that those responsible for the design and layout of book covers clearly represent active females in action, in uniform, and in the sport context.

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Craig Pickering, Dylan Hicks and John Kiely

Elite sprint performances typically peak during an athlete’s 20s and decline thereafter with age. The mechanisms underpinning this sprint performance decline are often reported to be strength-based in nature with reductions in strength capacities driving increases in ground contact time and decreases in stride lengths and frequency. However, an as-of-yet underexplored aspect of Masters sprint performance is that of age-related degradation in neuromuscular infrastructure, which manifests as a decline in both strength and movement coordination. Here, the authors explore reductions in sprint performance in Masters athletes in a holistic fashion, blending discussion of strength and power changes with neuromuscular alterations along with mechanical and technical age-related alterations. In doing so, the authors provide recommendations to Masters sprinters—and the aging population, in general—as to how best to support sprint ability and general function with age, identifying nutritional interventions that support performance and function and suggesting useful programming strategies and injury-reduction techniques.

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Steven M. Davi, Colleen K. Woxholdt, Justin L. Rush, Adam S. Lepley and Lindsey K. Lepley

Context: Traditionally, quadriceps activation failure after anterior cruciate ligament reconstruction (ACLR) is estimated using discrete isometric torque values, providing only a snapshot of neuromuscular function. Sample entropy (SampEn) is a mathematical technique that can measure neurologic complexity during the entirety of contraction, elucidating qualities of neuromuscular control not previously captured. Objective: To apply SampEn analyses to quadriceps electromyographic activity in order to more comprehensively characterize neuromuscular deficits after ACLR. Design: Cross-sectional. Setting: Laboratory. Participants: ACLR: n = 18; controls: n = 24. Interventions: All participants underwent synchronized unilateral quadriceps isometric strength, activation, and electromyography testing during a superimposed electrical stimulus. Main Outcome Measures: Group differences in strength, activation, and SampEn were evaluated with t tests. Associations between SampEn and quadriceps function were evaluated with Pearson product–moment correlations and hierarchical linear regressions. Results: Vastus medialis SampEn was significantly reduced after ACLR compared with controls (P = .032). Vastus medialis and vastus lateralis SampEn predicted significant variance in activation after ACLR (r 2 = .444; P = .003). Conclusions: Loss of neurologic complexity correlates with worse activation after ACLR, particularly in the vastus medialis. Electromyographic SampEn is capable of detecting underlying patterns of variability that are associated with the loss of complexity between key neurophysiologic events after ACLR.

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Haiko B. Zimmermann, Débora Knihs, Fernando Diefenthaler, Brian MacIntosh and Juliano Dal Pupo

Purpose: The objective of this study was to analyze the effects of a conditioning activity (CA) composed of continuous countermovement jumps on twitch torque production and 30-m sprint times. Methods: A total of 12 sprint athletes, 10 men (23.5 [7.7] y) and 2 women (23.0 [2.8] y), volunteered to participate in this study. The participants were evaluated in 2 sessions as follows: (1) to determine the effects of the CA (3 sets of 5 continuous vertical jumps with a 1-min interval between sets) on 30-m sprint performance over time (2, 4, 6, 8, and 10 min) and (2) to evaluate twitch peak torque to determine the magnitude and time course of the induced postactivation potentiation at the same recovery intervals. Results: Mixed-model analysis of variance with Bonferroni post hoc verified that there was a decrease on the 30-m sprint time at 2 minutes (P = .01; Δ = 2.78%; effect size [ES] = 0.43) and 4 minutes (P = .02; Δ = 2%, ES = 0.30) compared with pre when the CA preceded the sprints. The peak torque of quadriceps also showed significant increase from pretest to 2 minutes (P < .01; Δ = 17.0% [12.2%]; ES = 0.45) and 4 minutes (P = .02; Δ = 7.2% [8.8%]; ES = 0.20). Conclusion: The inclusion of CA composed of continuous countermovement jumps in the warm-up routine improved 30-m sprint performance at 2- and 4-minute time intervals after the CA (postactivation performance enhancement). Since postactivation potentiation was confirmed with electrical stimulation at the time when sprint performance increased, it was concluded that postactivation potentiation may have contributed to the observed performance increases.

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Joseph M. Day, Ann M. Lucado, R. Barry Dale, Harold Merriman, Craig D. Marker and Tim L. Uhl

Context: There is a lack of consensus on the best management approach for lateral elbow tendinopathy (LET). Recently, scapular stabilizer strength impairments have been found in individuals with LET. Objective: The purpose of this study was to compare the effectiveness of local therapy (LT) treatment to LT treatment plus a scapular muscle-strengthening (LT + SMS) program in patients diagnosed with LET. Design: Prospective randomized clinical trial. Setting: Multisite outpatient physical therapy. Patients: Thirty-two individuals with LET who met the criteria were randomized to LT or LT + SMS. Interventions: Both groups received education, a nonarticulating forearm orthosis, therapeutic exercise, manual therapy, and thermal modalities as needed. Additionally, the LT + SMS group received SMS exercises. Main Outcome Measure: The primary outcome measure was the patient-rated tennis elbow evaluation; secondary outcomes included global rating of change (GROC), grip strength, and periscapular muscle strength. Outcomes were reassessed at discharge, 6, and 12 months from discharge. Linear mixed-effect models were used to analyze the differences between groups over time for each outcome measure. Results: The average duration of symptoms was 10.2 (16.1) months, and the average total number of visits was 8.0 (2.2) for both groups. There were no significant differences in gender, age, average visits, weight, or height between groups at baseline (P > .05). No statistical between-group differences were found for any of the outcome measures. There were significant within-group improvements in all outcome measures from baseline to all follow-up points (P < .05). Conclusion: The results of this pilot study suggest that both treatment approaches were equally effective in reducing pain, improving function, and increasing grip strength at discharge as well as the 6- and 12-month follow-ups. Our multimodal treatment programs were effective at reducing pain and improving function up to 1 year after treatment in a general population of individuals with LET.