Browse

This study examined concussion-related outcomes among emerging adults (18–24 years) who participated in organized sport and are at risk for both sport-related concussion (SRC) and non-SRC. An online survey on SRC/non-SRC history and reporting behaviors grouped a convenience sample of 146 individuals as: no concussion history, those with only SRCs, and those with ≥1 non-SRC (including those with and without SRCs). Participants also noted whether ≥1 concussions were sustained with medical presence or had delayed reporting to someone in authority (e.g., medical professional, coach, and parent). No differences by concussion history were observed. However, among those with both SRC and non-SRC (n = 20), there were higher odds of ≥1 SRC versus ≥1 non-SRC occurring with medical presence (McNemar odds ratio = 12.0, 95% confidence interval [1.6, 92.3]) and having delayed reporting (McNemar odds ratio = 5.0, 95% confidence interval [0.6, 42.8]). Findings highlight the need for multiple pathways to help at-risk individuals report and seek care for concussions.

Adapted physical activity has been critiqued for its lack of attention to assumptions underlying both research and practice. In response to these critiques, the purpose of this paper was to perform a secondary analysis of a recent systematic literature review to examine the axiological and ethical assumptions of physical activity intervention research involving adults with Down syndrome since 1990 in light of the possibilities of critical disability studies. Findings revealed the dominance of normative movement ideologies and a focus on physical activity performance. Participants were not afforded research roles beyond that of subjects, and there was no evidence of results being communicated to them. In future, we hope scholars will consider the use of emancipatory frameworks where power is situated within the community involved and more inquiry that expands our understanding of the benefits of physical activity for individuals with intellectual impairment that decenters the focus on normative ways of being.

Context: Plantar fasciopathy (PF) is a common, self-limiting condition with notable economic impact and multifactorial origins. Clinical tests help clinicians to identify specific dysfunction and limitations influencing PF’s clinical course. This study aims to investigate whether body mass index (BMI) influences the performance of clinical tests and clinical presentation of individuals with PF and to determine whether BMI and clinical tests predict the clinical course of PF over a 3-month follow-up period. Design: This study is a longitudinal observational study. Participants were grouped, according to the median BMI, into low and high BMI. Setting: Healthcare centers and physiotherapy clinics. Participants: Fifty-two individuals with PF participated in this study. Main Outcome Measures: Baseline: Ankle dorsiflexion range of motion and navicular drop, heel-rise, and step-down tests were administered. Pain intensity and function were measured at baseline and at 3-month follow-up. Results: Low BMI group showed better function (mean difference = 11.8; 95% CI, 1.9 to 21.6) and lower pain intensity (mean difference = −1.5; 95% CI, −2.6 to −0.3) than the high BMI group. In the multivariable regression model, higher BMI predicted lower function (beta coefficient = −1.20; 95% CI, −2.3 to −0.3). Conclusions: In individuals with PF, BMI levels influenced PF clinical presentation. The high BMI group showed more severe pain and lower function. Higher BMI was found to be a poor prognostic factor for function in individuals with PF.

Context: Sport-related concussion management often requires referral to physical therapy (PT). Objectives: To (1) outline the role of PT in the management of sport-related concussion, (2) describe patients who underwent PT, and (3) discuss outcomes of athletes who underwent PT. Design: Retrospective cohort study. Setting: Single institution. Methods: Adolescent athletes aged 14–19 years old who sustained a sport-related concussion from November 2017 to April 2022 were evaluated. The cohort was dichotomized into 2 groups: PT versus no PT. The outcomes were days from initial PT visit to symptom resolution (SR) and return-to-play. Subgroup analyses compared recovery metrics between those initiating PT before and after 30 (1 mo) and 90 days (3 mo) of injury. A univariable and multivariable regression was used to determine predictors of recovery. Results: Of 1010 concussed athletes, 205 (20.3%) received referral for rehabilitation, and 58 (28.3%) patients received PT at the parent institution. Those who received PT had a higher number of prior concussions compared with those who did not (PT: 1.0 [1.2]; non-PT: 0.6 + 1.0; χ ² = 19.37, P = .007). A large proportion of PT recipients reported headache (n = 45, 81.0%); visual disturbances (n = 32, 65.5%); and vestibular (n = 37, 63.8%), cervical (n = 25, 43.1%), or oculomotor dysfunction (n = 25, 43.1%). Most patients received exertional therapy (n = 32, 55.1%), vestibular therapy (n = 31, 53.4%), and/or cervical therapy (n = 30, 51.7%). Those initiating PT before 1 and 3 months had significantly shorter median times to SR compared with those initiating after 1 and 3 months, respectively. Multivariable regression showed that a shorter time between injury and the initial PT visit was predictive of faster SR (β = 1.66, P = .048). Conclusions: Headache, dizziness, and visual disturbances were commonly reported symptoms by patients who received PT. Cervical, vestibular, and oculomotor deficits were common objective findings by physical therapists, and cervical, vestibular, and exertional therapy were common interventions. Delayed time to PT was independently associated with a longer time to SR.

Purpose: Poor posture has a negative impact on physical capability and is associated with changes in biomechanics and motor control. The purpose of this study was to assess the effect of corrective exercises on ground reaction forces (GRFs) in male student handball players with upper crossed syndrome (UCS) during throwing. Methods: Thirty male handball students with UCS participated in this single-blind randomized controlled trial (IRCT20200622047888N2; IR.HUMS.REC.1402.135). Fifteen received an 8-week corrective exercise intervention (exercise-intervention group [EG]), consisting of exercise targeting muscles involved in the UCS, and 15 served as the control group (CG). During handball throwing, GRF was measured by force plate. The forward head and rounded shoulder angles were measured with a photogrammetric method. All measurements were repeated 8 weeks later. Results: Significant interactions for virtually all parameters indicated that changes over 8 weeks differed between the CG and EG. A reduction in GRFs and a delayed occurrence of peak GRFs were observed in the EG, but not in the CG (P < .05). This was accompanied by a significant reduction in forward head (P < .03; effect size: 0.87; 95% confidence interval, −2.34 to 0.13), rounded shoulder (P < .05; effect size: 0.68; 95% confidence interval, 0.32 to 1.22) and thoracic kyphosis (P < .02; effect size: 0.64; 95% confidence interval, 0.54 to 1.25) angles in the EG (P < .05) with no significant change over 8 weeks in the CG. Conclusion: Corrective exercises targeting muscles directly involved in UCS induces functional and postural improvements in male student handball players with UCS.

Calibrating inertial measurement units (IMUs) involves converting orientation data from a local reference frame into a clinically meaningful reference system. Several solutions exist but little work has been done to compare different calibration methods with each other and an optical motion capture system. Thirteen healthy subjects with no signs of upper limb injury were recruited for this study and instrumented with IMU sensors and optical markers. Three IMU calibration methods were compared: N-pose calibration, functional calibration, and manual alignment. Subjects executed simple single-plane single-joint tasks for each upper limb joint as well as more complex multijoint tasks. We performed a 3-way analysis of variance on range of motion error, root mean squared error, and offset to assess differences between calibrations, tasks, and anatomical axes. Differences in the 3 IMU calibrations are minor and not statistically significant for most tasks and anatomical axes, with the exception of the offset interaction calibration × axes (P < .001, ${\eta }_{\mathrm{G}}^2=.056$ ). Specifically, manual alignment gives the best offset estimation on the abduction/adduction and internal/external rotation axes. Therefore, we recommend the use of a static N-pose calibration procedure as the preferred IMU calibration method to model the humerothoracic joint, as this setup is the simplest as it only requires accurate positioning of the trunk sensor.

Context: Clinical balance assessments vary in reliability due to subjectivity in their scoring. A valid and objective accelerometer-based smartphone evaluation could benefit patients, clinicians, and researchers. Objective: Our objective was to assess the validity and reliability of smartphone-based standing balance. Design: A repeated-measures study was conducted with 23 healthy young adult participants across 2 sessions ∼7 days apart. Methods: Participants completed 30-second standing trials during tandem-stance eyes-open, tandem-stance eyes-closed, single-leg eyes-open, and single-leg eyes-closed conditions. Android and iOS smartphones were placed vertically on the lower back via a belt with 3 retroreflective markers attached and tracked by an 8-camera motion capture system. Sway path, range, and area were calculated from smartphone accelerometer and marker data. We assessed reliability using intraclass correlation coefficients (ICC[_2,k]) and validity using Pearson r correlations between the marker and smartphones from visit 1. Results: Across eyes-open conditions, Android (ICC = .84–.96), iOS (ICC = .82–.98), and marker-based (ICC = .84–.95) assessments demonstrated good to excellent reliability. Across eyes-closed conditions, Android (ICC = .41–.87), iOS (ICC = .34–.79), and marker-based (ICC = .31–.87) assessments demonstrated poor to good reliability. Correlations between smartphones and the marker data were moderate to very high (r = .56–.97). Conclusions: The smartphone-based assessment was valid and reliable, indicating that clinicians and researchers can implement this method to measure balance with the opportunity for remote administration and increased patient tracking across various recovery timepoints.

Objective : Walking is one of the most complex human movements that can be affected by various sources of attention. Dual tasks reduce attention, increase information processing, and may alter control mechanisms such as synergy. However, the effect of dual tasks on muscle synergy remains unknown. Therefore, this study aimed to investigate the effect of cognitive and motor dual tasks on the synergy of lower limb muscles during walking. Methods: Twenty-four participants were selected voluntarily. The activity of the eight lower limb muscles was recorded under three different conditions: normal walking without a dual task, walking with a cognitive dual task, and walking with a motor dual task. A nonnegative matrix factorization algorithm and the variance accounted for were used to extract muscle synergy. The repeated-measures analysis of variance test and Pearson’s correlation coefficient were performed to analyze the data. Results: In this study, five muscle synergies were extracted from electromyography data using the variance accounted for method under three different conditions. The pattern of muscle synergies showed moderate to strong correlations. Peaks of synergies changed, and a time shift in synergy peaks during walking was observed. However, the number of extracted synergies did not change. Conclusion: The number of recruited muscle synergies remained consistent across different conditions. Dual tasks affect the higher levels of the motor control system, causing interference in information processing that leads to a shift in the tendency of synergy and weight coefficients of the muscles, ultimately resulting in a change in walking mechanics.

Repeated-sprint ability is a significant factor in football performance. Notably, hamstring injuries in football players often occur during sprinting activities and fatigue-inducing conditions. Therefore, the aim of this study was to examine the impact of repeated-sprint training (RST) on repeated-sprint ability variables and sprint kinematics. Fourteen semiprofessional men’s soccer players performed 8 weeks of RST, consisting of 1 to 2 sets of 5 to 8 × 30 m repeated sprints separated by 20 to 30 seconds of recovery. Sprint performance was computed from running speed data, and a high-frequency camera (240 Hz) was used to study kinematic data. Paired samples t test and repeated-measures analysis of variance were conducted for each performance and kinematic variable, respectively. After the RST period, moderate to large improvements were observed for 0 to 20 m time, 0 to 30 m time, and 20 to 30 m time. All the repeated-sprint ability-related variables were significantly improved (P < .05). In addition, during fatigue conditions, a decrease in trunk flexion and kick-back mechanism and a reduced overstriding pattern was found after RST. The findings of this study suggest that incorporating RST may lead to improved sprint performance and promote a “safer” sprint pattern, particularly during periods of fatigue.