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A 17-year-old right-handed high school pitcher sustained a first-time anterior shoulder dislocation. The patient’s imaging revealed a small Hill–Sachs lesion; however, the clinical team’s decision was to manage it nonoperatively. In this case, the patient underwent 7 weeks of rehabilitation, which included general upper extremity strengthening exercises, a modified interval throwing program, and a pitching progression adapted specifically for the patient. After rehabilitation, the patient returned to live pitching with improvements in his pitching statistics. The uniqueness of this case is that it is a less common intervention approach posttreatment.

The Modified Balance Error Scoring System (mBESS) remains the standard balance tool for evaluating sport-related concussion. Discrepancies between error and objective sway scoring remain a topic of assessment measures. The purpose was to examine sex differences between error and sway index scores and association between scores on the mBESS in collegiate and high school athletes. 119 athletes completed the mBESS on a Biodex BioSway. Measures consisted of mBESS errors and sway index scores produced by the BioSway. No sex differences were observed on mBESS errors and sway index scores by competition level and the overall sample. Moderate associations were observed between error and sway index scoring for single and tandem stances.

Four adolescent female athletes across four grades were diagnosed with either psychogenic nonepileptic seizures or conversion disorder. The females underwent thorough evaluations with their primary care providers and episode and symptom tracking by their athletic trainer. Through different applications of cognitive behavioral therapy and one-on-one counseling, the disorders resolved. Teaching athletes the importance of choosing healthy coping mechanisms to stress is vital to quality mental health. It is recommended that more research be done on psychogenic nonepileptic seizures and provide an understanding to those working with the adolescent population on triggers and treatments for psychogenic nonepileptic seizures.

Clinical Scenario: Ankle sprains are highly common and can lead to chronic ankle instability (CAI). Individuals with CAI have a variety of sensorimotor impairments including poor postural control and altered sensory organization strategies. Visual occlusion modalities, if worn during neuromuscular control exercises, may facilitate greater postural control gains and a more appropriate sensory organization strategy. However, a cumulative review of the ability of visual occlusion modalities (e.g., stroboscopic goggles) to impair postural control and thus demonstrate the potential to facilitate greater postural gains has not yet been completed. Clinical Question: Does stroboscopic vision impair postural control in those with and without CAI, and if so, is the impairment comparable between the groups? Summary of Key Findings: Regardless of how postural control was assessed, stroboscopic vision impaired postural control relative to an eyes open (i.e., no goggles) condition. All studies demonstrated that those with and without CAI were impacted equally. Stroboscopic vision resulted in postural control impairments comparable to an eyes closed in some but not all studies. Clinical Bottom Line: Stroboscopic vision impairs postural control in both those with CAI and uninjured controls. Strength of Recommendation: There is moderate-quality evidence (Grade B) that stroboscopic vision impairs postural control in those with CAI and uninjured controls.

This pilot study assessed the feasibility and functional benefits of a twice-weekly, 12-week, virtual, seated, group-based Pilates program in persons with mild to severe multiple sclerosis (MS). Participants were randomized into either a Pilates-only group or a Pilates group, which also incorporated hip and shoulder-cuff activation exercises. Process, management, and scientific-feasibility metrics were analyzed descriptively. Functional outcomes, physical activity, and MS-related outcomes (impact, fatigue, and quality of life) were measured pre- and postintervention and analyzed using mixed-effects models, analysis of variance, and cluster analysis. Twenty-two participants completed baseline testing. Sixteen completed the intervention and postintervention testing. Collapsed across groups, analyses demonstrated improvements in the Timed 25-Foot Walk (36%), Timed Up-and-Go (13%), and the Berg Balance Scale (10%, statistically significant). Neither between-groups differences nor physical activity or MS outcome changes were significant. Participants reported high satisfaction. Findings suggest that virtual, seated Pilates is feasible and may confer balance benefits to individuals with MS.

Dog therapy is implemented in various healthcare fields because of its unique ability to reduce perceived anxiety and hormonal stress, increase positive patient relationships with practitioners, and assist with demonstrating procedures. However, implementation of dog therapy in a clinical athletic training setting is not frequently discussed in relevant literature. This article outlines recommendations for the use and efficacy of therapy dogs in an athletic training facility, based on data from several studies across various healthcare fields. We provide information regarding best practice recommendations to incorporate therapy dogs into athletic training services, as well as the necessary administrative aspects and safeguards. Athletic trainers can use these recommendations and framework to explore the implementation of dog therapy into clinical practice.

Context: Analyzing flick movement kinematics biomechanically is important to prevent sport-related injuries in underwater hockey players since the aquatic-based flick movement is completely different from land-based flick movements. The study aimed to describe the flick movement kinematic biomechanically in underwater hockey players. Moreover, this study further aimed to investigate the effect of the Thrower’s Ten exercises on flick movement kinematics in underwater hockey players. Design: Descriptive laboratory study. Methods: Seventeen underwater hockey players (age: 26.2 [4.3] y; sports age: 6.2 [4.5] y) were included. First, 2 underwater cameras using motion capture video analysis MATLAB were used to biomechanically analyze the angular changes on the shoulder, elbow, wrist, and body while players were performing the flick movements. Players were then recruited to the Thrower’s Ten exercise program for 6 weeks. Flick movement kinematics and flick-throwing distance were recorded at baseline and 6 weeks. Results: The flick movement kinematic patterns demonstrated increased shoulder flexion (from 102.5° to 144.9°), wrist extension (from 9.5° to 10.8°), and upper-extremity rotation (from 5.7° to 56.8°) while decreased elbow extension (from 107.7° to 159.2°) from the stick met the puck until the competition of the movement. The Thrower’s Ten exercises improved the elbow extension (P = .04), wrist extension (P = .01), body rotation (P < .001), and flick-throwing distance (P < .001) from baseline to 6 weeks. Conclusion: This study describes the underwater flick kinematic technique biomechanically and interprets preliminary findings for the first time. Thus, 6 weeks of Thrower’s Ten exercise program provides more body muscle movements than the smaller ones during the flick movements and higher flick-throwing distance in underwater hockey players.

Context: The best current evidence supports the effectiveness of neuromuscular training in reducing the risk of injury; however, the rate of anterior cruciate ligament (ACL) injuries is still high. Neurocognitive training (NT) has successfully improved biomechanical risk factors, but they have been considered in only a few studies. Objective: To review the literature to determine the effect of NT on biomechanical risk factors related to ACL injury in athletes. Evidence Acquisition: We searched PubMed, Google Scholar, Scopus, Science Direct, and the Physiotherapy Evidence Database from inception to August 2011. We included randomized controlled trials that used motor learning approaches and injury prevention programs to investigate kinematic and kinetic risk factors related to ACL injury. The quality of each clinical trial study was evaluated by the Physiotherapy Evidence Database scale. The eligibility criteria were checked based on the PICOS (population, intervention, comparison, outcome, and study type) framework. Evidence Synthesis: A total of 9 studies were included in the final analysis. Motor learning approaches include internal and external focus of attention, dual tasks, visual motor training, self-control feedback, differential learning, and linear and nonlinear pedagogy, combined with exercise programs. In most of the studies that used NT, a significant decrease in knee valgus; tibial abduction and external rotation; ground reaction force; and an increase in knee-, trunk-, hip-, and knee-flexion moment was observed. Conclusion: In classical NT, deviation from the ideal movement pattern especially emphasizing variability and self-discovery processes is functional in injury prevention and may mitigate biomechanical risk factors of ACL injuries in athletes. Practitioners are advised to use sport-specific cognitive tasks in combination with neuromuscular training to simulate loads of the competitive environment. This may improve ACL injury risk reduction and rehabilitation programs.

The limited sample size in gait studies has hampered progress in the field. This challenge could be addressed through multicenter studies, thereby leveraging data sets from different laboratories. This study compared 3-dimensional lower-extremity running kinematics between the Biomechanics and Motor Control Laboratory, Federal University of ABC (Brazil), and the Running Injury Clinic, University of Calgary (Canada). Three-dimensional lower-extremity kinematics from 23 male runners were collected from each laboratory using comparable instrumentation and experimental procedures. The 3-dimensional hip, knee, and ankle angles were compared within and between centers using root-mean-square deviation. Two-sample t tests Statistical Parametric Mapping tested the hypothesis that the data from both laboratories were not different. The sagittal plane hip, knee, and ankle angles were similar between laboratories, while notable differences were observed for frontal (hip and ankle) and transverse (hip and knee) plane angles. The average interlaboratory root-mean-square deviation (2.6°) was lower than the intralaboratory root-mean-square deviation (Biomechanics and Motor Control = 4.8°, Running Injury Clinic = 5.6°), with the ankle transverse angle displaying the smallest, and the knee transverse angle displaying the largest variability. This study demonstrates the potential of combining gait kinematics data from different laboratories to increase sample size, but frontal and transverse plane data should be considered with caution.