Context: Balance testing is a vital component in the evaluation and management of sport-related concussion. Few studies have examined the use of objective, low-cost, force-plate balance systems and changes in balance after a competitive season. Objective: To examine the extent of preseason versus postseason static balance changes using the Balance Tracking System (BTrackS) force plate in college athletes. Design: Pretest, posttest design. Setting: Athletic training facility. Participants: A total of 47 healthy, Division-I student-athletes (33 males and 14 females; age 18.4 [0.5] y, height 71.8 [10.8] cm, weight 85.6 [21.7] kg) participated in this study. Main Outcome Measures: Total center of pressure path length was measured preseason and postseason using the BTrackS force plate. A Wilcoxon signed-rank test was conducted to examine preseason and postseason changes. SEM and minimal detectable change were also calculated. Results: There was a significant difference in center of pressure path length differed between preseason (24.6 [6.8] cm) and postseason (22.7 [5.4] cm) intervals (P = .03), with an SEM of 3.8 cm and minimal detectable change of 10.5 cm. Conclusions: Significant improvements occurred for center of pressure path length after a competitive season, when assessed using the BTrackS in a sample of college athletes. Further research is warranted to determine the effectiveness of the BTrackS as a reliable, low-cost alternative to force-plate balance systems. In addition, clinicians may need to update baseline balance assessments more frequently to account for improvements.
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Ryan Morrison, Kyle M. Petit, Chris Kuenze, Ryan N. Moran and Tracey Covassin
James A. Betts, Javier T. Gonzalez, Louise M. Burke, Graeme L. Close, Ina Garthe, Lewis J. James, Asker E. Jeukendrup, James P. Morton, David C. Nieman, Peter Peeling, Stuart M. Phillips, Trent Stellingwerff, Luc J.C. van Loon, Clyde Williams, Kathleen Woolf, Ron Maughan and Greg Atkinson
Nenad Ponorac, Mira Popović, Dea Karaba-Jakovljević, Zorislava Bajić, Aaron Scanlan, Emilija Stojanović and Dragan Radovanović
This study primarily aimed to quantify and compare iron status in professional female athletes and nonathletes. Furthermore, this study also aimed to identify differences in iron status according to sporting discipline and explore the relationship between ferritin concentration and weekly training volume in professional athletes. A total of 152 participants were included in this study, including 85 athletes who were members of senior teams (handball, n = 24; volleyball, n = 36; soccer, n = 19; and judo, n = 6) involved at the highest level of competition and 67 nonathletes. A significantly greater proportion (p = .05) of athletes (27%) demonstrated iron-deficient erythropoiesis (IDE) compared with nonathletes (13%). There were nonsignificant differences (p > .05) in the prevalence of iron deficiency (ID; 49% vs. 46%) and iron deficiency anemia (IDA; 2% vs. 4%) between athletes and nonathletes. Similarly, the prevalence of ID, IDE, and IDA was not significantly different between sports (p > .05). Furthermore, training volume was negatively correlated with ferritin concentration in athletes (r: −.464, moderate, p < .001). Professional female athletes are at a heightened risk of IDE compared with nonathletes; therefore, they should be periodically screened for ID to reduce the deleterious effects on training and performance. The similar prevalence of ID, IDE, and IDA found across athletes competing in different sports suggests that overlaps exist between handball, volleyball, soccer, and judo athletes regarding risk of disturbance in iron metabolism.
Janelle Prince, Eric Schussler and Ryan McCann
Clinical Scenario: A sport-related concussion is a common injury to the brain that may cause a variety of symptoms ranging in duration and severity. The mainstay of treatment for concussion has been rest, followed by a stepwise return to activity. This recovery process may be lengthy when symptoms persist. Aerobic exercise conducted at subsymptom and submaximal intensities has been proposed as a potential intervention for symptoms following a concussion. Therefore, the purpose of this critically appraised topic is to examine the safety of varying aerobic exercise intensities in patients with a concussion. Focused Clinical Question: Are subsymptom and submaximal exercise programs safe when implemented in a population with a symptomatic sports-related concussion when compared with traditional rest? Summary of Key Findings: Four randomized controlled trials were included for critical appraisal. The 4 studies investigated supervised and controlled aerobic exercise as early as within 1 week of with a concussion; all studies conclude that exercise is safe and may be of benefit to individuals with a concussion. Two studies support the use of submaximal exercise as a therapeutic intervention for adolescents with persistent concussion symptoms. Clinical Bottom Line: The authors conclude that controlled exercise performed within the symptom or exertion threshold of patients with concussion is safe compared with rest. It was noted that symptom changes may occur; however, the changes did not have a negative impact on long-term recovery. This research should ease concerns about prescribing physical activity when an athlete with concussion is still experiencing lingering symptoms. While specific parameters of the activity performed have not been described in detail, the individualization of each exercise program was stressed. Strength of Recommendation: Grade A.
Jeffrey G. Williams, Lauryn Darnall and Conrad Schumann
Baseball players have demonstrated greater thoracolumbar rotation (TLR) range of motion (ROM) toward their nonthrowing arm sides. This imbalance is thought to be compensatory to ROM deficiencies at the throwing arm’s shoulder. The purpose of this study was to examine the relationship between TLR and glenohumeral (GH) ROM measures (internal rotation, external rotation, horizontal adduction) among collegiate baseball players. Findings demonstrated limited and no relationships between TLR and GH ROM. Future research should advance these findings by examining symptomatic participants and hip ROM as additional variables. Doing so may enhance clinicians’ abilities to comprehensively predict, prevent, detect, and treat movement deficiencies, and subsequent injuries, suffered by competitive baseball players.
Claire J. Brady, Andrew J. Harrison, Eamonn P. Flanagan, G. Gregory Haff and Thomas M. Comyns
Purpose: To examine the relationships between the isometric midthigh pull (IMTP), isometric squat (ISqT), and sprint acceleration performance in track-and-field sprinters and to determine whether there are differences between men and women. Methods: Fifteen male and 10 female sprinters performed 3 maximal-effort IMTPs, ISqTs, and 3 × 30-m sprints from blocks. Results: Among the men, the results showed significant negative correlations between IMTP and ISqT peak force; relative peak force; force at 100, 150, and 200 ms; rate of force development (0–150 and 0–200 ms); and impulse (0–200 ms) and 0- to 5-m time (r = −.517 to −.714; P < .05). IMTP impulse (B = −0.582, P = .023) and ISqT relative peak force (B = −0.606, P = .017) significantly predicted 0- to 5-m time. Among the women, no IMTP or ISqT variables significantly correlated with any sprint times. Men measured significantly higher than women for all IMTP measures except relative peak force. Men were significantly faster than women at all splits. When comparing measures of the ISqT, there were no significant differences between men and women. Conclusions: Variables measured during the IMTP and ISqT significantly correlated with 0- to 5-m sprint performance in male athletes. Isometric strength can have a sizable influence on 0- to 5-m time, but in some cases, the maximum effect could be very small.
K. Andrew R. Richards, Wesley J. Wilson, Steven K. Holland and Justin A. Haegele
Although much has been learned about the workplace experiences of physical education teachers, less is known about the unique experiences of adapted physical educators (APEs). Grounded in role socialization theory, the purpose of this study was to understand the relationships among perceived organizational support, resilience, perceived mattering, emotional exhaustion, and job satisfaction in APEs. The participants included 237 APEs from the United States, who completed an online survey. The primary data analyses included confirmatory factor analysis and structural equation modeling. The final structural model was a good fit for the data, χ2(199) = 327.25, p < .001, χ2/df = 1.64; root-mean-square error of approximation = .052 (90% confidence interval [.042, .062], p = .354); standardized root-mean-square residual = .050; nonnormed fit index = .959; comparative-fit index = .964. The results of this study highlight the importance of developing a workplace environment in which APEs feel supported in developing perceptions of matter, reducing emotional exhaustion, and improving job satisfaction.
Richard Ebreo, Louis Passfield and James Hopker
Purpose: To evaluate the reliability of calculating gross efficiency (GE) conventionally and using a back extrapolation (BE) method during high-intensity exercise (HIE). Methods: A total of 12 trained participants completed 2 HIE bouts (P1 = 4 min at 80% maximal aerobic power [MAP]; P2 = 4 min at 100%MAP). GE was calculated conventionally in the last 3 minutes of submaximal (50%MAP) cycling bouts performed before and after HIE (Pre50%MAP and Post50%MAP). To calculate GE using BE (BGE), a linear regression of GE submaximal values post-HIE were back extrapolated to the end of the HIE bout. Results: BGE was significantly correlated with Post50%MAP GE in P1 (r = .63; P = .01) and in P2 (r = .85; P = .002). Reliability data for P1 and P2 BGE demonstrate a mean coefficient of variation of 7.8% and 9.8% with limits of agreement of 4.3% and 4.5% in relative GE units, respectively. P2 BGE was significantly lower than P2 Post50%MAP GE (18.1% [1.6%] vs 20.3% [1.7%]; P = .01). Using a declining GE from the BE method, there was a 44% greater anaerobic contribution compared with assuming a constant GE during 4-minute HIE at 100%MAP. Conclusion: HIE acutely reduced BGE at 100%MAP. A greater anaerobic contribution to exercise as well as excess postexercise oxygen consumption at 100%MAP may contribute to this decline in efficiency. The BE method may be a reliable and valid tool in both estimating GE during HIE and calculating aerobic and anaerobic contributions.
Megan Q. Beard, Samantha A. Boland and Phillip A. Gribble
Decreased hip strength is often present in patients with chronic overuse lower extremity injuries. The hand-held dynamometer (HHD) can be used in a clinical setting to quantify hip strength; however, reliability of the device remains unclear. The purpose of this study was to determine the interexaminer and intersession reliability of a HHD when measuring isometric hip abduction (HABD) and external rotation (HER) strength, both with and without a fixed strap. The HHD had good to high reliability regardless of examiner, session, or stabilization when measuring HABD (ICC = 0.885–0.977) and HER (ICC = 0.879–0.958) isometric strength. HHD is an appropriate instrument for measuring isometric hip strength.
Andrea Nicolò, Marco Montini, Michele Girardi, Francesco Felici, Ilenia Bazzucchi and Massimo Sacchetti
Purpose: Variables currently used in soccer training monitoring fail to represent the physiological demand of the player during movements like accelerations, decelerations, and directional changes performed at high intensity. We tested the hypothesis that respiratory frequency (f R) is a marker of physical effort during soccer-related high-intensity exercise. Methods: A total of 12 male soccer players performed a preliminary intermittent incremental test and 2 shuttle-run high-intensity interval training (HIIT) protocols, in separate visits. The 2 HIIT protocols consisted of 12 repetitions over 9 minutes and differed in the work-to-recovery ratio (15:30 vs 30:15 s). Work rate was self-paced by participants to achieve the longest possible total distance in each HIIT protocol. Results: Work-phase average metabolic power was higher (P < .001) in the 15:30-second protocol (31.7 [3.0] W·kg−1) compared with the 30:15-second protocol (22.8 [2.0] W·kg−1). Unlike heart rate and oxygen uptake, f R showed a fast response to the work–recovery alternation during both HIIT protocols, resembling changes in metabolic power even at supramaximal intensities. Large correlations (P < .001) were observed between f R and rating of perceived exertion during both 15:30-second (r = .87) and 30:15-second protocols (r = .85). Conclusions: Our findings suggest that f R is a good marker of physical effort during shuttle-run HIIT in soccer players. These findings have implications for monitoring training in soccer and other team sports.