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Azahara Fort-Vanmeerhaeghe, Ariadna Benet, Sergi Mirada, Alicia M. Montalvo and Gregory D. Myer

Context: Understanding how neuromuscular and biomechanical deficits that are associated with knee injuries change as youth mature may improve injury prevention strategies in this population. Objective: To investigate sex and maturation differences in jump-landing technique performance in youths using a practical clinical tool. Design: Cross-sectional study. Setting: High Performance Center Laboratory. Participants: A total of 165 youth athletes were included in this study. Main Outcome Measures: The main outcome measures were each of the 10 items of the modified tuck jump assessment and the total score. These measures include (1) knee valgus at landing, (2) thighs do not reach parallel, (3) thighs not equal side to side, (4) foot placement not shoulder width apart, (5) foot placement not parallel, (6) foot contact timing not equal, (7) excessive landing contact noise, (8) pause between jumps, (9) technique declines prior to 10 seconds, and (10) does not land in same footprint. Results: Only knee valgus at landing had a significant sex × maturation interaction. The main effect of maturation was significant for items 2, 3, 6, 7, 9, and total score. Plyometric technique performance improved with increasing maturation. The main effect of sex was significant for items 1 and 9, with males performing better than females. Conclusions: Female athletes demonstrate increased knee valgus at landing and fatigue relative to males during jump-landing performance. Overall, there was a trend of improved jump-landing performance with maturation.

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Sergio Jiménez-Rubio, Archit Navandar, Jesús Rivilla-García and Victor Paredes-Hernández

Context: Despite the presence of various injury prevention programs, the rate of hamstring injuries and reinjuries is increasing in soccer, warranting the need for a soccer-specific rehabilitation program. Objective: To develop and validate a new, functional on-field program for the rehabilitation and readaptation of soccer players after a hamstring strain injury through a panel of experts; and determine the usefulness of the program through its application in professional soccer players. Design: A 13-item program was developed, which was validated by a panel of experts and later applied to professional soccer players. Setting: Soccer training ground. Participants: Fifteen strength and conditioning and rehabilitation fitness coaches with a professional experience of 15.40 (1.57) years in elite clubs and national teams in Europe validated the program. The program was later applied to 19 professional soccer players of the Spanish First Division (La Liga). Interventions: Once a player sustained a clinically diagnosed injury, the player would first be subject to mobilization and strengthening exercises in the gym after undergoing treatment by percutaneous needle electrolysis. The player would then complete an on-field readaptation program consisting of 13 drills arranged in a progressive manner in terms of complexity. The drills integrated various aspects of repeated sprint abilities, retraining and reeducation of biomechanical patterns, and neuromuscular control of the core and lower limbs. Main Outcome Measures: Aiken’s V for each item of the program and number of days taken by the players to return to play. Results: The experts evaluated all items of the program very highly, as seen from Aiken’s V values between 0.78 and 0.98 (0.63–0.99) for all drills, while the return to play was in 22.42 (2.32) days. Conclusion: This program has the potential to help a player suffering from a hamstring strain injury to adapt to real-match conditions in the readaptation phase through the application of sports-specific drills that were very similar to the different injury mechanisms.

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Yuko Kuramatsu, Yuji Yamamoto and Shin-Ichi Izumi

This study investigated the sensorimotor strategies for dynamic balance control in individuals with stroke by restricting sensory input that might influence task accomplishment. Sit-to-stand movements were performed with restricted vision by participants with hemiparesis and healthy controls. The authors evaluated the variability in the position of participants’ center of mass and velocity, and the center-of-pressure position, in each orthogonal direction at the lift-off point. When vision was restricted, the variability in the mediolateral center-of-pressure position decreased significantly in individuals with hemiparesis, but not in healthy controls. Participants with hemiparesis adopted strategies that explicitly differed from those used by healthy individuals. Variability may be decreased in the direction that most requires accuracy. Individuals with hemiparesis have been reported to have asymmetrical balance deficits, and that meant they had to prioritize mediolateral motion control to prevent falling. This study suggests that individuals with hemiparesis adopt strategies appropriate to their characteristics.

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Ana F. Silva, Pedro Figueiredo, Sara Morais, João P. Vilas-Boas, Ricardo J. Fernandes and Ludovic Seifert

This study aimed to examine young swimmers’ behavioral flexibility when facing different task constraints, such as swimming speed and stroke frequency. Eighteen (five boys and 13 girls) 13- to 15-year-old swimmers performed a 15 × 50-m front crawl with five trials, at 100%, 90%, and 70% each of their 50 m maximal swimming speed and randomly at 90%, 95%, 100%, 105%, and 110% of their preferred stroke frequency. Seven aerial and six underwater cameras were used to assess kinematics (one cycle), with upper-limb coordination computed through a continuous relative phase and index of coordination. A cluster analysis identified six patterns of coordination used by swimmers when facing various speed and stroke frequency constraints. The patterns’ nature and the way the swimmers shifted between them are more important than getting the highest number of patterns (range of repertoire), that is, a change in the motor pattern in order to adapt correctly is more important than being able to execute a great number of patterns.

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Fatemeh Azadinia, Ismail Ebrahimi-Takamjani, Mojtaba Kamyab, Morteza Asgari and Mohamad Parnianpour

The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower sample entropy and a higher correlation dimension in the patients with low back pain compared with the healthy subjects. The results of this study demonstrate the greater regularity and higher dimensionality of the center of pressure fluctuations in patients with nonspecific chronic low back pain, which suggests that these patients adopt different postural control strategies to maintain an upright stance.

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Christopher A. DiCesare, Scott Bonnette, Gregory D. Myer and Adam W. Kiefer

Biomechanical analysis can effectively identify factors associated with task performance and injury risk, but often does not account for the interaction among the components that underlie task execution. Uncontrolled manifold (UCM) analyses were applied to data from 38 female, adolescent athletes performing single-leg drop landings and were used to differentiate successful and unsuccessful task performance by examining the frontal plane joint variance within the UCM (V UCM) that stabilized the horizontal center of mass position (V UCM) and within the orthogonal subspace (V ORT). The UCM revealed stronger coordination, indicated by the V UCM/V ORT ratio, in the successful condition. This may inform future research examining reduced motor coordination in failed movement tasks and its relation to injury risk and allow for targeted interventions that consider coordination processes rather than joint-specific outcomes.

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Leah S. Goudy, Brandon Rhett Rigby, Lisa Silliman-French and Kevin A. Becker

The purpose of this study was to determine changes in balance, postural sway, and quality of life after 6 wk of simulated horseback riding in adults diagnosed with Parkinson’s disease. Eight older adults completed two 60-min riding sessions weekly for 6 wk. Variables of balance, postural sway, and quality of life were measured 6 wks before and within 1 wk before and after the intervention. Berg Balance Scale scores decreased from baseline to preintervention (48.36 ± 5.97 vs. 45.86 ± 6.42, p = .050) and increased from preintervention to postintervention (45.86 ± 6.42 vs. 50.00 ± 4.38, p = .002). Cognitive impairment, a dimension of quality of life, improved from baseline to postintervention (37.5 ± 20.5 vs. 21.5 ± 14.4, p = .007). Six weeks of simulated horseback riding may improve balance and cognitive impairment in older adults with Parkinson’s disease.

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Grace C. Bellinger, Kristen A. Pickett and Andrea H. Mason

Reaching and grasping are often completed while walking, yet the interlimb coordination required for such a combined task is not fully understood. Previous studies have produced contradictory evidence regarding preference for support of the lower limb ipsilateral or contralateral to the upper limb when performing a reaching task. This coordinative aspect of the combined task provides insight into whether the two tasks are mutually modified or if the reach is superimposed upon normal arm swinging. Collectively, 18 right-handed young adults walked slower, took shorter steps, and spent more time in double support during the combined task compared with walking alone. The peak grasp aperture was larger in walking reach-to-grasp trials compared with standing trials. There was not a strong trend for lower limb support preferences at the reach initiation or object contact. The participants could begin walking with either foot and demonstrated variability of preferred gait initiation patterns. There was a range of interlimb coordination patterns, none of which could be generalized to all young adults. The variability with which healthy right-handed young adults execute a combined walking reach-to-grasp task suggests that the cyclical (walking) and discrete (prehension) motor tasks may have separate motor control mechanisms, as proposed in the two primitives theory.

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James Hackney, Jade McFarland, David Smith and Clinton Wallis

Most studies of high-speed lower body movements include practice repetitions for facilitating consistency between the trials. We investigated whether 20 repetitions of drop landing (from a 30.5-cm platform onto a force plate) could improve consistency in maximum ground reaction force, linear lower body stiffness, depth of landing, and jump height in 20 healthy, young adults. Coefficient of variation was the construct for variability used to compare the first to the last five repetitions for each variable. We found that the practice had the greatest effect on maximum ground reaction force (p = .017), and had smaller and similar effects on lower body stiffness and depth of landing (p values = .074 and .044, respectively), and no measurable effect on jump height. These findings suggest that the effect of practice on drop landing differs depending upon the variable measure and that 20 repetitions significantly improve consistency in ground reaction force.

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Rafael Squillantini, Brielle Ringle and Julie Cavallario

Clinical Question: In patients with acute knee injuries, is there evidence to support that the lever sign test is more accurate in diagnosing an anterior cruciate ligament sprain than the Lachman test? Clinical Bottom Line: The evidence does not indicate that the lever sign test can be used in isolation in lieu of the Lachman test, but there is sufficient evidence to support adding the lever sign test to the examination of potential anterior cruciate ligament sprains.