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Bibliometric Analysis of Studies on The Rehabilitation of Disabled Athletes Through Visual Mapping

Muhammed Yildiz

Context: The rehabilitation of disabled athletes is a critical area of research aimed at improving athletes’ performance and well-being. This bibliometric analysis examines scientific studies related to the rehabilitation of disabled athletes, focusing on trends, authors, publications and interdisciplinary collaborations. Objective: This study seeks to provide quantitative and qualitative insights into the trends, interdisciplinary collaborations, and significant contributions in the rehabilitation of disabled athletes. Design: Bibliometric analysis of 660 scientific publications related to the rehabilitation of disabled athletes, from 1975 to 2023. Setting: The analysis reveals that research in this field is multidisciplinary, encompassing sports, medicine, rehabilitation and education. Studies focused on disabled athletes and their rehabilitation. Intervention: Rehabilitation plays a vital role in disabled athletes’ lives, aiding in injury recovery and enhancing overall health and performance. Results: The United States leads in research output. Collaborative networks among authors are evident, indicating joint research efforts. Identification of research trends, prominent authors  Bartosz Molik and Natalia Morgulec-Adamowicz), collaborative networks and common keywords (e.g., adaptive sports, disability, rehabilitation). Keywords such as adaptive sports, disability and rehabilitation are frequently mentioned, reflecting the focus of research. Conclusions: The rehabilitation of disabled athletes is a growing field with significant contributions from researchers worldwide. Collaborative efforts and interdisciplinary approaches are essential for advancing knowledge and improving the lives of disabled athletes.

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Eccentric Force and Regional Biceps Femoris Muscle Excitation During Conventional and 80° Hip-Flexed Nordic Curl

Arthur Ferreira Esquírio, Maressa da Rocha, Maria de Cássia Macedo, Kariny Realino Ferreira, Mayra Evelise dos Santos, Michelle Almeida Barbosa, and Alexandre Carvalho Barbosa

Context: Hamstring injuries are prevalent in high-intensity sports. The lesion often occurs with concomitant knee extension and hip flexion. The Nordic curl has been suggested to prevent such injury, mainly due to its eccentric hamstring activation. Objective: The objective of this study is to assess the eccentric force output and the regional biceps femoris excitation (proximal, mid, and distal) during conventional and 80° of hip flexion of Nordic curl. Methods: Thirty-nine participants (17 men: 22.6 [2.03] y, 1.71 [0.09] m, 73.6 [13.3] kg; and 22 women: 24.4 [6.02] y; 1.64 [0.08] m; 62.2 [10.5] kg) were included in the study. Hamstring strength was analyzed through a load cell and muscle activation assessed with an electromyographer in 3 muscle portions (proximal, mid, and distal). Mixed factorial analysis of variance was used to rate the differences. Results: The conventional Nordic curl showed higher muscle activation compared with the hip-flexed Nordic curl (P = .001). No differences were observed in other factorial analysis. Conclusions: The findings suggest that conventional Nordic curl induces higher biceps femoris muscle excitation across compared with 80° hip-flexed Nordic curl. No differences were noted in muscle strength. The same force output with distinct levels of muscle activation may provide a progression system to implement hamstring training for injury prevention or even for exercise routine.

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Two-Stage Surgical Treatment of Combined Lumbar Spine Stenosis in a Professional Football Player

Dmitriy Dzukaev, Anton Borzenkov, Georgiy Malyakin, Islam Muzyshev, Yuri Kuklin, Alina Reutova, and Eduard Bezuglov

Introduction: Playing football (American soccer) at the elite level places extremely high demands on the spine. The choice of treatment for lumbar spinal canal stenosis combined with spondylolysis and anterolisthesis is challenging for surgeons, physicians, and clinicians. Case Presentation: A 28-year-old elite football player from the leading Russian football club is the focus of this case study. Patient complained of constant low back pain radiating to the posterior surface of the right thigh and limited mobility in the lumbar spine. Diagnosis: The patient was diagnosed with degenerative stenosis of the spinal canal at the L5 to S1 level, L4 to L5 disc herniation, spondylolysis, and anterolisthesis of L5 vertebra. Management and Outcomes: Two-stage surgery of combined lumbar spine pathology was performed in May 2021. The first stage of surgical treatment included the spinal and foraminal canals decompression at the L4 to L5 and L5 to S1 levels, as well as posterior fusion with rigid pedicle screws. The second stage involved the subsequent replacement of the rigid to dynamic semirigid rods as signs of the bone defect healing appeared. The athlete returned to team training 6 months after the first stage of surgery and was able to play football at the elite level without restrictions 1 year after the first stage and just 30 days following the second stage of surgical treatment. The athlete continues his career as of the last manuscript’s revision. Conclusions: This method holds potential as an effective approach in the treatment of combined lumbar spine pathology among elite athletes.

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Alterations in Foot Positioning During Ankle Taping and Its Effects on Range of Motion and Jump Performance in Dancers

Eilish Anderson, Justin Stanek, Todd McLoda, Adam Jagodinsky, and Benjamin Heiman

A closed basketweave ankle tape application is common throughout sports, yet less prevalent in the performing arts. This may be due to aesthetics and potential compromises to performance. The purpose of this study was to examine the effects of foot positioning (dorsiflexed or neutral/resting) during tape application on static range of motion (ROM), kinematic ROM, and jump ability while performing a maximum sauté jump. A randomized crossover cohort study design was used to evaluate ankle active ROM, kinematic ROM, and ground reaction force during a dance bipedal vertical jump. Results showed the application of tape caused significant differences in active ROM when compared with the no-tape condition. No significant differences in ground reaction force were found and inconsistent kinematic changes were found from the peak ROM data. Foot position during ankle taping does not appear to affect jump performance but does show similar active ROM restrictions, particularly in plantarflexion and inversion.

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Assessing the Knee Extensor’s Rate of Force Development Using a Fixed Handheld Dynamometer: An Inter- and Intrasession Reliability Study

Tomer Yona and Arielle G. Fischer

Context: The rate of force development (RFD), defined as the ability to rapidly generate muscle force, is commonly tested using an electromechanical dynamometer in isometric mode. However, these devices are expensive and not readily available. Therefore, this study aims to evaluate the interrater reliability of a fixed handheld dynamometer to measure the knee extensors’ RFD and provide reference values using the proposed method. Design: This study used a cross-sectional study design. Methods: Using a fixed handheld dynamometer (microFET2) and a 3-dimensional-printed adapter, we evaluated the knee extensor muscles  in participants seated at the edge of a treatment bed. Each participant performed a standardized warm-up, followed by 3 maximal isometric knee extension trials. The outcome measures were peak force and early and late phase RFD (0–100 and 0–200 ms, respectively). The study consisted of 3 sessions: Visit one comprised of an initial session (session 1A) followed by a second session (session 1B) after 30 minutes for intrasession reliability; and visit two, conducted on week later, comprised the third session (session 2) for intersession reliability. Results: Fifty-one participants were enrolled in the study. The in-session intraclass correlation coefficient for the early phase RFD was .87 (95% CI, .74–.92) and .91 to .92 (95% CI, .87–.94) for the late phase. The between-session intraclass correlation coefficient for the early phase RFD was .83 to .86 (95% CI, .74–.91) and .87 to .90 (95% CI, .80–.94) for the late phase. Finally, the peak force’s intraclass correlation coefficient was .95 (95% CI, .92–.97) for the in-session and .91 to .92 (95% CI, .86–.95) for the between-session reliability. Conclusions: Our approach provides a reliable, cost-effective, and quick method to evaluate the knee extensor muscles’ RFD and peak force.

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Comparing Vibration Foam Rolling and Static Stretching for Enhancing Muscle Recovery in Professional Male Soccer Players: A Counterbalanced Crossover Study

Francisco J. Corredoira, Miguel Lorenzo-Martínez, Samuel Carrera, Pablo B. Costa, and Ezequiel Rey

Context: Professional soccer players frequently experience fatigue due to the demanding nature of the sport. In this context, effective recovery strategies are essential for maintaining performance. Static stretching (SS) is commonly used in soccer, but its efficacy is debated. Vibration foam rolling (VFR) is a novel recovery technique that has not been extensively studied in soccer. Objective : This research aimed to investigate the acute effects of VFR (3 sets of 45 s of rolling and 15 s of rest between sets) and SS (3 sets of 45 s and 15 s of rest between sets) on muscle contractile properties in professional soccer players. Design : Eighteen players participated in this counterbalanced crossover study.  Settings : After a 1-week washout period between sessions, the subjects completed the 2 condition trials (VFR or SS) in counterbalanced order following a training session, which had a duration of 77 min and a total distance of 6500 m covered. Main Outcome Measures : Muscle contractile properties of the rectus femoris were assessed with tensiomyography before training (pre), immediately after training (post 1), and postrecovery intervention (post 2). Tensiomyography parameters included maximal radial muscle-belly displacement and contraction time and velocity. Data were analyzed using repeated-measures analysis of variance. Results : There were no significant differences in the training load between groups during the training sessions (P > .05). Results showed that maximal radial muscle-belly displacement (P = .004) and contractiontime (P = .007) significantly decrease from pre (before training) to post 1 (after training). No significant main effects for group were obtained for all the variables (P > .05). However, both VFR and SS interventions effectively restored maximal radialmuscle-belly displacement (P = .011) and contraction time (P = .008) from post 1 (after) to post 2 (postrecovery intervention), suggesting reduced muscular stiffness. Contraction velocity remained unchanged after both interventions (P > .05). Conclusions : Therefore, these interventions could offer valuable advantages for posttraining neuromuscular acute recovery in professional soccer players.

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The Effect of Step Frequency and Running Speed on the Coordination of the Pelvis and Thigh Segments During Running

Raphael M. Mesquita, Jean-Benoit Morin, and Arthur H. Dewolf

This study investigates the specific influence of step frequency (SF) and speed on the coordination between pelvic and thigh movements. Eight recreational male runners ran at different SFs and speeds on an instrumented treadmill. The coordination between the pelvis and thigh segments was analyzed using modified vector coding in the sagittal and frontal planes (FPs). Our findings show that hip range of motion increases as a function of SF in the sagittal plane. Pelvic tilt plays a compensatory role in hip extension, particularly at lower SFs. In the FP, pelvic roll increased at lower SFs, whereas the thigh abduction angle was participant dependant. Coordination analysis showed that thigh movements dominated the sagittal plane motion, which was simplified at higher SF. At low SF, the pelvic movements were increased and anticipated, playing a more dominant role in explaining motion. In the FP, pelvic movements dominated the motion. The increase in pelvic motion at low SFs stretches the hip flexors further and for a longer period. The link between SF, pelvic motion, and the risks of running-related injuries in the sagittal and FP is considered. Understanding these could help athletes and sports professionals optimize performance and reduce injury risk.

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How Medial Tibial Stress Syndrome Is Affected by Alignment, Range of Motion, Strength, and Gait Biomechanics: A Systematic Review and Meta-Analysis

Inje Lee, Hyung Gyu Jeon, Sunghe Ha, Heeseong Jeong, and Sae Yong Lee

Context: Medial tibial stress syndrome (MTSS) is a common chronic injury of the lower-extremity in the physically active population. However, the risk factors for MTSS remain unclear. Objective: This study identified the risk factors for MTSS and established the continuum model of lower-extremity alignments, range of motion, muscular strength, and gait kinematics affecting each other and MTSS development. Evidence Acquisition: Online databases including PubMed, CINAHL, SPORTDiscus, and Web of Science were used to retrieve studies related to risk factors for MTSS. The study eligibility criteria were studies that used the MTSS definition of the Yates and White criteria, or included participants with MTSS, except for stress fracture and compartment syndrome. A total of 2099 papers were retrieved during the initial search stage. After screening, based on eligibility criteria and cross-reference, 21 papers were included in this study. Data on lower-extremity alignments, range of motion, muscular strength, and gait biomechanics were extracted as outcome variables for this meta-analysis. Publication bias was assessed using funnel plots and Egger’s regression analysis. Evidence Synthesis: Foot posture index (standardized mean difference [SMD] = 1.23; 95% CI, 0.02–2.43), intercondylar interval (SMD = 0.29; 95% CI, 0.10–0.48), inversion range of motion (SMD = 0.37; 95% CI, 0.10–0.63), eversion strength (SMD = 0.37; 95% CI, 0.10–0.65), and dynamic arch height change during walking (SMD = 1.05; 95% CI, 0.49–1.60) were significant risk factors for MTSS. Egger’s regression analysis revealed asymmetry in several variables, which indicates publication bias. The trim-and-fill method was applied to these variables. A comparison between the SMD and adjusted SMD showed that the variables had minimal impacts on the meta-analysis. Conclusions: Based on our results, health care professionals should assess the significant risk factors in patients before participation in physical activities and treat them to prevent and rehabilitate MTSS.

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Influence of Sport Specialization on Quality of Life, Physical Literacy, and Injury History in Hockey Players

Kendall Marshall, Nicole J. Chimera, and Tamara Valovich McLeod

Sport specialization and its effect on health-related quality of life, physical literacy, and injury among ice hockey players is poorly understood. We examined specialization patterns, quality of life, physical literacy, and injury history in a sample of 63 high school-aged hockey players. Thirty-eight percent of participants reported moderate specialization; over half of the sample reported high specialization. Highly specialized players spent a greater amount of weekly time per week in hockey activities (21.14 hr, 95% confidence interval [17.4, 24.88]) and reported a greater number of injuries when compared with moderate and low specializers (χ2 = 0.026). Acute injuries were more prevalent than chronic or overuse injuries across all groups. No differences were observed on physical literacy or quality of life scores. Despite their increased participation and greater frequency of injuries, specialization did not significantly impact health-related quality of life.

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Psychosocial Factors on Athlete Return to Sport Readiness After Anterior Cruciate Ligament Reconstruction: A Critically Appraised Topic

Kala Robinson and Melissa K. Kossman

Clinical Scenario: Anterior cruciate ligament (ACL) injuries are a common injury experienced by athletes and often involve lengthy and invasive treatments. Given the literature that exists supporting psychosocial response to injury, it is important to understand how these factors influence the recovery process ultimately influencing readiness to return to play. Clinical Question: What is the impact of psychosocial factors on athlete readiness to return to sport participation post-ACL reconstruction (ACLR)? Summary of Key Findings: All studies found that psychosocial factors, including athletic identity, motivation, anxiety, control, and fear, impacted perceived readiness to return to play. Several studies found various levels of influence in both a positive (eg, motivation and resilience) and negative (eg, fear and anxiety) direction. Furthermore, despite presenting more psychosocial barriers than physical, these factors do not appear to influence actual physical recovery. Clinical Bottom Line: Psychosocial factors have both direct and indirect effects, positive and negative, on an athlete’s perceived readiness to return to the play. ACLR rehabilitation protocols are well developed, well established, and known to be effective; however, athletes still do not feel ready to return, and there are physical and mental risks associated with that uncertainty. Therefore, psychosocial factors are important to include and prioritize as part of the ACLR recovery process to ensure athletes are physically and psychosocially ready to return to play. Strength of Recommendation: Grade B evidence exists that psychosocial factors positively and negatively impact physical recovery and perceptions of recovery on return-to-play post-ACLR.