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Rafael Gnat, Agata Dziewońska, Maciej Biały and Martyna Wieczorek

Low back pain constitutes a multidimensional problem of largely unknown origin. One of the recent theories explaining its frequent occurrence includes speculative statements on patterns of central nervous system activity associated with the control of so-called local and global muscles of the lower trunk. The objective of the study was to verify whether there is a difference in the activity of the brain during selective, voluntary contraction of the local and global abdominal muscles as assessed by functional MRI. Twenty healthy subjects participated. An experimental design was applied with repeated measurements of the blood-oxygen-level–dependent signal from the brain during voluntary contraction of the local and global abdominal muscles, performed in random order. Prior to registration, a 2-week training period was introduced, aiming to master the experimental motor tasks. The magnetic resonance imaging (MRI) data were processed using the FMRIB Software Library (Oxford, UK). Brain areas showing significant activations/deactivations were identified and averaged across all participants, and intercondition differential maps were computed. Areas of significant intercondition differences were linked to the corresponding anatomical structures and ascribed to the default mode functional brain network and to the sensorimotor network. Contraction of the local abdominal muscles elicited more pronounced activity of the brain cortex, basal ganglia, and cerebellum. This suggests that motor control of the abdominal musculature consists of two modes of brain activity and that control of the local muscles may be a more challenging task for the brain. Moreover, contraction of the local muscles elicited more distinct deactivation of the default mode network, which may have implications for diagnostics and therapy of low back pain.

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Adam E. Jagodinsky, Rebecca Angles, Christopher Wilburn and Wendi H. Weimar

Current theoretical models suggest that ankle sprain copers exhibit movement adaptations contributing to the avoidance of chronic ankle instability. However, few studies have examined adaptations at the level of biomechanical motor synergies. The purpose was to examine characteristics of the support moment synergy between individuals with chronic ankle instability, copers, and healthy individuals. A total of 48 individuals participated in the study. Lower-extremity kinetics and variability in the moment of force patterns were assessed during the stance phase of walking trials. The copers exhibited reductions in the support moment during the load response and preswing phase compared with the chronic ankle instability group, as well as during the terminal stance and preswing phase compared the healthy group. The copers also exhibited reductions in the hip extensor moment and ankle plantarflexion moment compared with healthy and chronic ankle instability groups during intervals of stance phase. Variability of the support moment and knee moment was greater in the copers compared with the chronic ankle instability group. Dampening of the support moment and select joint moments exhibited by the copers may indicate an adaptive mechanism to mitigate loading perturbations on the previously injured ankle. Heightened motor variability in copers may be indicative of a more adaptable motor synergy compared with individuals with chronic ankle instability.

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David C. Nieman, Francesca Ferrara, Alessandra Pecorelli, Brittany Woodby, Andrew T. Hoyle, Andrew Simonson and Giuseppe Valacchi

Inflammasomes are multiprotein signaling platforms of the innate immune system that detect markers of physiological stress and promote the maturation of caspase-1 and interleukin 1 beta (IL-1β), IL-18, and gasdermin D. This randomized, cross-over trial investigated the influence of 2-week mixed flavonoid (FLAV) versus placebo (PL) supplementation on inflammasome activation and IL-1β and IL-18 production after 75-km cycling in 22 cyclists (42 ± 1.7 years). Blood samples were collected before and after the 2-week supplementation, and then 0 hr, 1.5 hr, and 21 hr postexercise (176 ± 5.4 min, 73.4 ± 2.0 %VO2max). The supplement (678 mg FLAVs) included quercetin, green tea catechins, and bilberry anthocyanins. The pattern of change in the plasma levels of the inflammasome adaptor oligomer ASC (apoptosis-associated speck-like protein containing caspase recruitment domain) was different between the FLAV and PL trials, with the FLAV ASC levels 52% lower (Cohen’s d = 1.06) than PL immediately following 75-km cycling (interaction effect, p = .012). The plasma IL-1β levels in FLAV were significantly lower than PL (23–42%; Cohen’s d = 0.293–0.644) throughout 21 hr of recovery (interaction effect, p = .004). The change in plasma gasdermin D levels were lower immediately postexercise in FLAV versus PL (15% contrast, p = .023; Cohen’s d = 0.450). The patterns of change in plasma IL-18 and IL-37 did not differ between the FLAV and PL trials (interaction effects, p = .388, .716, respectively). These data indicate that 2-week FLAV ingestion mitigated inflammasome activation, with a corresponding decrease in IL-1β release in cyclists after a 75-km cycling time trial. The data from this study support the strategy of ingesting high amounts of FLAV to mitigate postexercise inflammation.

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Marco J. Konings and Florentina J. Hettinga

Purpose: The behavior of an opponent has been shown to alter pacing and performance. To advance our understanding of the impact of perceptual stimuli such as an opponent on pacing and performance, this study examined the effect of a preexercise cycling protocol on exercise regulation with and without an opponent. Methods: Twelve trained cyclists performed 4 experimental, self-paced 4-km time-trial conditions on an advanced cycle ergometer in a randomized, counterbalanced order. Participants started the time trial in rested state (RS) or performed a 10-min cycling protocol at 67% peak power output (CP) before the time trial. During the time trials, participants had to ride alone (NO) or against a virtual opponent (OP). The experimental conditions were (1) RS-NO, (2) RS-OP, (3) CP-NO, and (4) CP-OP. Repeated-measures analyses of variance (P < .05) were used to examine differences in pacing and performance in terms of power output. Results: A faster pace was adopted in the first kilometer during RS-OP (318 [72] W) compared with RS-NO (291 [81] W; P = .03), leading to an improved finishing time during RS-OP compared with RS-NO (P = .046). No differences in either pacing or performance were found between CP-NO and CP-OP. Conclusions: The evoked response by the opponent to adopt a faster initial pace in the 4-km time trial disappeared when cyclists had to perform a preceding cycling protocol. The outcomes of this study highlight that perceived exertion alters the responsiveness to perceptual stimuli of cyclists during competition.

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Christanie Monreal, Lindsay Luinstra, Lindsay Larkins and James May

Context: Technological advances have given smartphones the capabilities of sensitive clinical measurement equipment at lesser cost and higher availability. The Clinometer is a smartphone application that can be used to measure the joint range of motion in a clinical setting, but psychometric properties of the tool’s use measuring cervical range of motion (CROM) are not established. Objectives: The purpose of this study was to examine the validity and intrarater reliability of the Clinometer application for the measurement of CROM (ie, flexion, extension, rotation, lateral flexion) and to determine the minimal detectable change and SEM. Design: A blinded, repeated-measures correlational design was employed. Setting: The study was conducted collaboratively between 2 athletic training clinics. Participants: A convenience sample of healthy adults ages 18–30 years were recruited. Participants with any history in the last 3 months of cervical or thoracic pathology, pain, or any musculoskeletal injury were excluded. Main Outcome Measures: Three repetitions of each motion were measured by a primary researcher with a goniometer. The same researcher then conducted 3 blinded measurements with the Clinometer application following the same procedure. A second researcher, blinded to the goniometer measurements, recorded the results. Thirty minutes later, testing was repeated with the application. The Pearson correlation was calculated to determine validity of the application compared with goniometry. Results: The measurements between devices had moderate to excellent concurrent validity, with the coefficients ranging between 0.544 and 0.888, P < .01. Test–retest reliability of the CROM measurement using the application was moderate to excellent, with intraclass correlation coefficients ranging between .774 and .928. Across all movements, the SEM ranged from 1.17° to 2.01°, and the minimal detectable change ranged from 1.18° to 2.02°. Conclusion: The Clinometer application is a valid and reliable instrument for measuring active CROM. Level of evidence: clinical measurement, level 1b.

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Brad Thatcher, Georgi Ivanov, Mihaly Szerovay and Graham Mills

Virtual reality (VR) technology has the potential to become the next performance measure in coaching by enhancing players’ perceptual ability. This paper aims to analyze elite coaches’ and performance analysts’ perceptions of barriers to and opportunities for the adaptation of VR technology in football coaching. Following a pilot study, interviews were conducted with six elite coaches and performance analysts. Perceptions of the key barriers to VR’s widespread adoption were the following: lack of conclusive evidence, practicality, quality of software, and cognitive overload. VR needs to overcome these barriers to be successfully integrated into contemporary coaching. Key opportunities included virtual models of play, for example, a virtual environment created by VR technology that exposes players to situations experienced in real environments. In addition, VR may be used to enhance player development by facilitating an environment in which players can develop their visual exploratory behavior and can acquire task-relevant information, resulting in faster decision making. Opportunities regarding player rehabilitation and solving isolated incidents were also identified. The authors conclude that VR technology has a developing role in coaching and has the potential to become a valuable supplement to current coaching methods for those actively seeking competitive advantage through technological advancement.

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Ben Langley, Nick Knight and Stewart C. Morrison

Medial tibial stress syndrome (MTSS) is a common running-related injury. Alterations in movement patterns and movement coordination patterns have been linked to the development of overuse injuries. The aim of this study was to compare transverse plane tibial and frontal plane rearfoot motion and the coordination of these movements between runners with MTSS and healthy controls. A total of 10 recreational runners with MTSS and 10 healthy controls ran at 11 km/h on a treadmill. A 3-camera motion analysis system operating at 200 Hz was used to calculate tibia and rearfoot motion. Stance phase motion patterns were compared between groups using multivariate analysis, specifically, Hotelling T 2 test with statistical parametric mapping. A modified vector coding technique was used to classify the coordination of transverse plane tibial and frontal plane rearfoot motion. The frequency of each coordination pattern displayed by each group was compared using independent samples t tests. Individuals with MTSS displayed significantly (P = .037, d = 1.00) more antiphase coordination (tibial internal rotation with rearfoot inversion) despite no significant (P > .05) differences in stance phase kinematics. The increased antiphase movement may increase the torsional stress placed upon the medial aspect of the tibia, contributing to the development of MTSS.

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Ryan Zerega, Carolyn Killelea, Justin Losciale, Mallory Faherty and Timothy Sell

Rupture of the anterior cruciate ligament (ACL) remains extremely common, with over 250,000 injuries annually. Currently, clinical tests have poor utility to accurately screen for ACL injury risk in athletes. In this study, the position of a knee marker was tracked in 2-dimensional planes to predict biomechanical variables associated with ACL injury risk. Three-dimensional kinematics and ground reaction forces were collected during bilateral, single-leg stop-jump tasks for 44 healthy male military personnel. Knee marker position data were extracted to construct 2-dimensional 95% prediction ellipses in each anatomical plane. Knee marker variables included: ellipse areas, major/minor axes lengths, orientation of ellipse axes, absolute ranges of knee position, and medial knee collapse. These variables were then used as predictor variables in stepwise multiple linear regression analyses for 7 biomechanical variables associated with ACL injury risk. Knee flexion excursion, normalized peak vertical ground reaction forces, and knee flexion angle at initial contact were the response variables that generated the highest adjusted R 2 values: .71, .37, and .31, respectively. The results of this study provide initial support for the hypothesis that tracking a single marker during 2-dimensional analysis can accurately reflect the information gathered from 3-dimensional motion analysis during a task assessing knee joint stability.

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Janet Lok Chun Lee and Rainbow Tin Hung Ho

In response to demographic changes in recent years, an increasing number of parks have established exercise spaces for older adults. However, limited research has been conducted to investigate how older adults utilize, experience, and perceive these spaces. This study aims to explore their experiences of using these spaces and their perspectives on these spaces by using a qualitative descriptive research design. In-depth interviews were conducted with 32 users in three Hong Kong parks with low, medium, and high area-based socioeconomic statuses. The findings highlight that exercise spaces in parks can cultivate a positive environment allowing older adults with varying physical abilities and health statuses to remain active together as well as to support each other socially and emotionally in a natural outdoor setting. The participants’ perspectives on the exercise space discussed in this study suggest that future plans for constructing such spaces in parks might benefit from a co-design approach.

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Kimberly Bigelow and Michael L. Madigan