Browse

Context: Chronic ankle instability (CAI) is a common consequence of a lateral ankle sprain. Sex differences in functional outcomes exist, but there is a lack of female-specific intervention studies. Hop stabilization training is effective in male athletes with CAI but has not been investigated in female athletes. Therefore, the purpose of this investigation was to describe the effect of hop stabilization exercises on functional movement patterns and patient-reported outcomes in female athletes with CAI. We also compared the current effect sizes with those observed in an all-male cohort following an identical intervention. Design: Randomized controlled trial. Methods: Fourteen female CAI participants completed hop stabilization training (age = 25.29 [5.86] y), and 14 female CAI participants were in the control group (age = 24.73 [6.97] y). Inclusion criteria were consistent with the International Ankle Consortium recommendations. The hop stabilization program consisted of three 20-minute sessions per week for 6 weeks. Sessions consisted of increasing foot-to-ground contacts each week until a taper in the final week. Exercise difficulty was also modified throughout the program. Functional movement patterns via the Functional Movement Screen and Fusionetics Scores, dorsiflexion range of motion, and select region-specific patient-reported outcomes were captured. Results: The hop training group (pre: 12.68 [1.32] cm, post: 13.42 [1.35] cm) had a significant improvement (P< .001) in dorsiflexion range of motion relative to the control group (pre: 13.62 [1.22] cm, post: 13.68 [1.16] cm). Hop training also significantly improved (P,<0.01) functional movement patterns and all patient-reported outcomes. Relative to an all-male cohort who previously underwent the same hop stabilization program, the current female cohort demonstrated larger effect sizes, but all 95% CIs overlapped. Conclusions: A 6-week hop training program significantly improves patient-reported outcomes, dorsiflexion range of motion, and functional movement patterns in female athletes with CAI .

Context: Those with chronic ankle instability (CAI) rely more on visual information to maintain postural control. Plantar massage and ankle joint mobilization are moderately successful at improving CAI-associated postural control impairments. Manual therapies may have a larger influence on the underlying sensory strategy used to maintain postural control, but their effect on these strategies remains unknown. Objective: To evaluate the effects of separate 2-week plantar massage and ankle joint mobilization interventions on estimates of visual reliance during single-limb stance in those with CAI and determine whether changes in visual reliance estimates were driven by concurrent changes in peripheral- or spinal-level sensorimotor function. Design: Randomized controlled clinical trial. Setting: Research laboratory. Patients: Sixty participants with CAI. Interventions: Participants were equally randomized into plantar massage, ankle joint mobilization, and control (no intervention) groups. The manual therapy groups received six 5-minute treatments of their respective interventions over a 2-week period. Main Outcome Measure: A percentage modulation outcome quantified an individual’s reliance on visual information by estimating the weight given to visual information during eyes-open stance based on the magnitude of postural instability that occurs with vision removed. Secondary measures included joint position sense, plantar light-touch thresholds, and the H-reflex. Outcomes were captured before (baseline), immediately after (post), and 1-month (follow-up) after the 2-week intervention. Results: Plantar massage resulted in significant percentage modulation changes in sagittal (P ≤ .046) but not frontal plane outcomes (P ≥ .069) relative to the control group. Joint mobilization did not alter percentage modulation changes (P ≥ .413). Significant correlations between percentage modulation changes and peripheral sensorimotor function were noted primarily at the 1-month follow-up. Conclusions: A 2-week plantar massage but not an ankle joint mobilization intervention alters sagittal plane percentage modulation values during single-limb stance in those with CAI. These changes may be driven by changes in peripheral sensorimotor function.

Javelin throwers cannot safely throw with a long approach run often per training session. Therefore, implements of different shapes and masses are thrown from short run-ups to emulate the demands of achieving high throwing distances. This study examined the effects of different implements, thrown from various approaches, on the kinematics and kinetics of the throwing arm. The throwing motions of 6 athletes, each throwing 6 different implements were recorded using 12 infrared cameras. Kinematics and kinetics of the shoulder and elbow joints were calculated and statistically compared. The results show that lighter implement throws achieved higher release speeds, while heavier implements required greater work to be done on them. We identified significant differences for the shoulder external rotation angle (P < .001), the shoulder internal rotation (P = .040), and elbow extension (P = .003) angular velocities and the torques of the shoulder internal rotation (P = .006), horizontal flexion (P = .004), and the elbow varus (P = .008). It can be concluded that throws with balls of different masses have different angular velocities and joint torques, and therefore can be used to train speed and strength aspects of the javelin throw while using lower run-up speeds.

Background: To investigate how physiotherapists approach lateral ankle sprain (LAS) rehabilitation and their rationale for exercise progression. We also sought to determine typical exercise dosage prescribed and the extent to which they rely on objective outcomes for guiding rehabilitation progression and return-to-sports decisions. Methods: We distributed an online survey using Qualtrics. The survey comprised a combination of 23 open and 8 closed questions to capture data on: participant demographics and clinical experience, typical caseload, LAS rehabilitation dosage, with clinical vignettes used to determine the time taken to reach key rehabilitation milestones, use of objective markers to inform rehabilitation progress, and progression to each milestone. Data were analyzed descriptively; open questions were inventoried and categorized. Proportions were then calculated per category. Results: Ninety-six physiotherapists from Belgium, the Netherlands, and the United Kingdom responded to the survey, of which 23 completed all sections. On average, less than half (46%) of the responding therapists use objective measurements to guide rehabilitation progress. The estimated time to reach key clinical milestones is equivocal among participating physiotherapists. Most physiotherapists use pain and ankle impairments (eg, range of motion and muscle strength) to guide rehabilitation progress. Conclusion: This study indicates that progress in LAS rehabilitation is determined subjectively and that not the entire spectrum of impairments is assessed. Physiotherapists should implement more objective measures throughout LAS rehabilitation.

Although research has shown the benefit of physical activity (PA) on executive functions (EFs) in typically developing populations, the efficacy of such interventions among individuals with Down syndrome (DS) is less understood. Therefore, the aim of the review was to systematically examine the empirical literature on the influence of PA interventions on EF in individuals with DS. The search strategy identified 10 eligible articles, which were systematically reviewed following PRISMA guidelines. Relevant data (i.e., study characteristics and major findings) were charted, and risk of bias was assessed. Study findings indicate some positive effects of PA on the EF of individuals with DS, namely, inhibition and cognitive shifting. However, risk-of-bias assessment uncovered critical methodological issues that make results difficult to interpret. Taken together, results suggest that while PA interventions may be beneficial, more high-quality intervention studies are needed to further elucidate the potential impact on the EF of individuals with DS.

Physical education (PE) has failed to meet the inclusive ideals of equity and participation for all students. Questions on the role of PE in the schools and its official knowledge, curriculum, and values are critical concerns given the exclusion experienced by disabled students. In this viewpoint, we propose a critical reflection on school PE and the role of ableism constraining the engagement of disabled students in PE and sports. Our discussion is grounded in a critical disability-studies framework and takes two major points into account: (a) the legitimate knowledge within PE and (b) its underlying ability system. The pursuit of equitable education for disabled students demands consideration not only of meaningful pedagogical practices but, above all, of meaningful knowledge provision. Such changes mandate the recognition and affirmation of disabled identity and their individual and collective expression through PE and sports.

Context: Musculoskeletal ultrasound imaging is a valid and reliable tool to measure muscle morphology, but minimal research explores its utility in assessing acute morphology changes after exercise in active populations. The purpose of this study was to assess changes in ultrasound-based measures of muscle thickness (MT) and quality (MQ) in response to a single bout of short-duration, high-intensity bodyweight exercise in the acute and postacute recovery timeframe. Design: Interventional study. Methods: Nineteen healthy, recreationally active young men and women (27.1 [8.3] y) completed a dynamic bodyweight exercise circuit primarily focused on the lower body. B-mode ultrasound images were obtained of the rectus femoris in resting and contracted conditions preexercise, ∼15 minutes, and 24 hours postexercise. Knee-extensor strength and MQ (muscle strength [in newtons]/resting MT [in centimeters]) were also assessed at the same timepoints. Results: Resting and contracted MT increased (13.0%; 6.9%) from pre- to 15 minute postexercise, returning to baseline at 24 hours postexercise. Δ MT decreased (−24.5%) from pre- to 15 minutes postexercise and was not different from either 15 minutes postexercise or baseline by the 24-hour timepoint. Knee extension strength and MQ decreased (−15.6%; 24.2%) from pre- to 15 minutes postexercise and remained below baseline at 24 hours postexercise. Conclusion: MT measures alone suggested faster recovery from an exercise circuit than knee-extensor strength or MQ, though the combined metric of MQ may be useful for longitudinal monitoring of muscle recovery timelines in rehabilitation programs.

Context: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Turkish version (CAIT-T) and to evaluate the validity, reliability, and cutoff score of CAIT-T for Turkish athletic population. Design: The English version of CAIT was translated to CAIT-T based on a guideline of cross-cultural adaptation. Fifty-two athletes with chronic ankle instability and 63 athletes without chronic ankle instability were included in the study. Construct validity was evaluated with correlations between the CAIT-T, Turkish version of Foot Ankle Ability Measure (FAAM-T), and Numeric Rating Scale. CAIT-T was completed twice by each participant at 7 to 10 days intervals to assess test–retest reliability based on the intraclass correlation coefficient, whereas Cronbach alpha evaluated internal consistency. Discriminative validity and content validity of the CAIT-T also evaluated. Results: In construct validity, strong positive correlation was found between CAIT-T and Numeric Rating Scale perceived ankle instability (rho = −.771, P < .001), as well as moderate negative correlations with FAAM-T-activities of daily living and FAAM-T-sports (rho = −.448, P < .001 and rho = −0.541, P < .001, respectively). The CAIT-T demonstrated strong test–retest reliability (intraclass correlation coefficient score of .98) with a good internal consistency (Cronbach α: .85). Receiver operating characteristic curve showed a cutoff score of 26.5 (Youden index: 0.78, sensitivity: 0.57, specificity: 0.90.5). No ceiling or floor effects were observed. Conclusions: CAIT-T is a valid and reliable questionnaire for the assessment of chronic ankle instability in the Turkish athletic population.