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Ke’La Porter, Carolina Quintana and Matthew Hoch

Clinical Scenario: Neurocognitive performance may put individuals at a greater risk for lower-extremity musculoskeletal injuries. Research has observed the relationship between lower-extremity musculoskeletal injury and baseline neurocognitive performance; however, the understanding of this relationship is lacking. Exploring this relationship may give further insight into musculoskeletal injury and provide innovative directions for musculoskeletal injury prevention. Clinical Question: Is there a relationship between neurocognitive performance and lower-extremity biomechanics during a jumping or cutting task in healthy adult athletes? Summary of Key Findings: The literature was searched for articles that examined the relationship of a baseline neurocognitive test and a biomechanical analysis following a sports-related task. A total of 3 cross-sectional articles were included. All 3 studies concluded that poorer neurocognitive performance was associated with biomechanical faults that are linked to increased risk or rate of lower-extremity musculoskeletal injury. Clinical Bottom Line: Based on the evidence included, there is a moderate-level evidence to support the relationship between neurocognition and lower-extremity biomechanics in healthy adult athletes. Strength of Recommendation: In accordance with the van Tulder approach, there is a moderate level of evidence due to consistent findings from a combination of high- and limited-quality articles.

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Luca Puce, Ilaria Pallecchi, Lucio Marinelli, Maria May, Laura Mori, Piero Ruggeri and Marco Bove

Context: Kinesio Taping (KT) produces several clinical effects, including pain relief, edema absorption, and improved muscle performance. When applied in the insertion to origin mode, it is claimed to inhibit excessive muscle contractions. Objective: Investigate whether KT applied in the insertion to origin mode could reduce the exaggerated reflex contraction of spastic muscles. Design: Randomized crossover trial, with a restricted block randomization. Setting: Clinical laboratory and swimming pool. Patients: Seven para-swimmers. Intervention: KT, applied in inhibitory mode, to investigate its effect on knee extensor spasticity. Main Outcome Measures: Primary outcome is stretch reflex, as compared with clinical assessment of spasticity by Modified Ashworth Scale and self-perceived spasticity by numeric rating scale. Secondary outcomes were Medical Research Council for strength of knee extensor muscles and chronometric swimming performance in 100-m freestyle. Results: KT significantly decreased the amplitude of stretch reflex (P < .001), whereas the placebo treatment produced no significant effects. Scores of Medical Research Council for strength and Modified Ashworth Scale did not change after KT, whereas numeric rating scale scores for spasticity significantly decreased (P = .001). The swimming performance was significantly improved after KT treatment as compared with baseline (P < .01). Conclusions: This exploratory study performed on para-athletes suggests that KT could reduce spasticity. This outcome has 3-fold implications for clinical, rehabilitation, and sport methods.

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Kellie C. Huxel Bliven

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Kathryn A. Coniglio and Edward A. Selby

Pathological exercise behavior is pervasive in eating disorder psychopathology, yet minimal treatment guidance exists for extinguishing it as little is known about how to differentiate pathological from healthy exercise. The purpose of this study was to characterize pathological exercise in terms of motivation to increase the specificity with which both pathological and healthy exercise is described and to inform treatment interventions. Latent profile analysis characterized homogenous groups based on exercise motivation in two samples: college women (n = 200) and women with eating psychopathology (n = 211). These profiles were compared on levels of eating and general psychopathology and emotion dysregulation. Three profiles emerged describing sedentary, pathological exercise, and athlete groups in the first sample, and five profiles describing neutral, sedentary, weight loss, athlete, and pathological exercise groups emerged in the second sample. Findings indicate that motivation style is salient in defining pathological exercise and may, therefore, be a clinically useful treatment target.

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Rachel M. Koldenhoven, Kelly Martin, Abbis H. Jaffri, Susan Saliba and Jay Hertel

Context: Many individuals who suffer a lateral ankle sprain will develop chronic ankle instability (CAI). Individuals with CAI demonstrate kinematic differences in walking gait, as well as somatosensory alterations compared with healthy individuals. However, the role of vision during walking gait in this population remains unclear. Objective: To evaluate ankle kinematics, gaze deviations, and gaze velocity between participants with CAI and healthy controls while walking on a treadmill during 3 separate visual conditions (no target, fixed target, and moving target). Design: Case-control study. Setting: Laboratory. Patients (or Other Participants): Ten CAI participants and 10 healthy matched controls participated. Main Outcome Measures: Ankle sagittal and frontal plane kinematics were analyzed for the entire gait cycle. Average and standard deviation (SD) for gaze deviation and gaze velocity were calculated in the horizontal (X) and vertical (Y) planes. Results: No significant differences were found between groups for either ankle kinematics or gaze variables; however, large effect sizes were found in the no target condition for average deviation of X (healthy 0.05 [0.02], CAI 0.12 [0.11]). Moderate effect sizes were identified in the no target condition for SD of Y (healthy 0.04 [0.03], CAI 0.11 [0.15]) and the moving target condition for average velocity of X (healthy 1.56 [0.73], CAI 2.27 [1.15]) and Y (healthy 1.07 [0.51], CAI 1.47 [0.52]). Conclusions: Although no significant differences were found between groups, it is possible that the role of vision in individuals with CAI may be altered with a more difficult task.

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Daniel W. Sample, Tanner A. Thorsen, Joshua T. Weinhandl, Kelley A. Strohacker and Songning Zhang

The purpose of this study was to investigate effects of preferred step width and increased step width modification on knee biomechanics of obese and healthy-weight participants during incline and decline walking. Seven healthy-weight participants and 6 participants who are obese (body mass index ≥ 30) performed 5 walking trials on level ground and a 10° inclined and declined instrumented ramp system at both preferred and wide step-widths. A 2 × 2 (step-width × group) mixed-model analysis of variance was used to examine selected variables. There were significant increases in step-width between the preferred and wide step-width conditions for all 3 walking conditions (all P < .001). An interaction was found for peak knee extension moment (P = .048) and internal knee abduction moment (KAM) (P = .025) in uphill walking. During downhill walking, there were no interaction effects. As step-width increased, KAM was reduced (P = .007). In level walking, there were no interaction effects for peak medial ground reaction force and KAM (P = .007). There was a step-width main effect for KAM (P = .007). As step-width increased, peak medial ground reaction force and peak knee extension moment increased, while KAM decreased for both healthy weight and individuals who are obese. The results suggest that increasing step-width may be a useful strategy for reducing KAM in healthy and young populations.

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Kevin G. Aubol, Jillian L. Hawkins and Clare E. Milner

Measurements of tibial acceleration during running must be reliable to ensure valid results and reduce errors. The purpose of this study was to determine the reliability and minimal detectable difference (MDD) of peak axial and peak resultant tibial acceleration during overground and treadmill running. The authors also compared reliability and MDDs when peak tibial accelerations were determined by averaging 5 or 10 trials. Tibial acceleration was measured during overground and treadmill running of 19 participants using a lightweight accelerometer mounted to the tibia. Peak axial and peak resultant tibial accelerations were determined for each trial. Intraclass correlation coefficients determined within-session reliability, and MDDs were also calculated. Within-session reliability was excellent for all conditions (intraclass correlation coefficients = .95–.99). The MDDs ranged from 0.6 to 1.4 g for peak axial acceleration and from 1.6 to 2.0 g for peak resultant acceleration and were lowest for peak axial tibial acceleration during overground running. Averaging 10 trials did not improve reliability compared to averaging 5 trials but did result in small reductions in MDDs. For peak axial tibial acceleration only, lower MDDs indicate that overground running may be the better option for detecting small differences.

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Matthew C. Hoch, Johanna M. Hoch, Cameron J. Powden, Emily H. Gabriel and Lauren A. Welsch

Background: The anterior reach distance and symmetry of the Y-Balance Test (YBT) has been associated with increased injury risk in collegiate athletes. Examining the influence of dorsiflexion range of motion (DROM) and single-limb balance (SLB) on YBT performance may identify underlying factors associated with injury risk. Objective: The purpose of this study is to determine if YBT anterior reach is related to DROM or SLB in collegiate varsity and club sport athletes. Methods: A convenience sample of 124 university varsity and club sport athletes (females: 99, age: 20.0 ± 1.6 years, height: 168.9 ± 12.5 kg, body mass: 68.8 ± 14.0 kg) completed the anterior direction of the YBT, weight-bearing DROM, and SLB components (firm and foam surface) of the Balance Error Scoring System on both limbs at one testing session. Relative symmetry was calculated by subtracting values of the left limb from the right limb. Results: For the left and right limb, normalized anterior reach distance was moderately correlated to DROM (R = .55, p < .001). Anterior reach distance and symmetry was weakly correlated to SLB and SLB symmetry (R = −.16 to −.03). Conclusion: There was a positive relationship between YBT anterior reach and weight-bearing DROM which was also observed in the between-limb symmetry. However, weak relationships were exhibited between YBT anterior reach and SLB. These findings may be useful for future injury prevention initiatives in athletic settings.

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Nadège Tebbache and Alain Hamaoui

The sit-to-stand transfer can be separated into a postural phase (trunk flexion) and a focal phase (whole-body extension). The aim of this study was to analyze the as yet little known whole-body muscular activity characterizing each phase of this task and its variations with backrest inclination and execution speed. Fifteen muscles of the trunk and lower limbs of 10 participants were investigated using surface EMG. Results showed that backrest-induced modifications were mostly confined to the postural phase: reclining the backrest increased its duration and the activity level of the sternocleidomastoideus, the rectus and obliquus externus abdominis, and the semitendinosus. Speed-induced variations were also predominant during the postural phase, which was shortened with an increased activity of most muscles at maximal speed.