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The incidence of lower extremity injuries in collegiate distance runners is ∼20%. Identification of a runner sustaining a potential injury remains challenging. This exploratory, cross-institutional study sought to determine whether ground reaction force (GRF) characteristics during steady-state running could identify competitive collegiate distance runners who would later sustain lower extremity injuries. Normative boundaries for 10 GRF variables during braking and propulsion were established for noninjured runners using median ± scaled median absolute deviation. A subanalysis was conducted on runners with and without impact peaks in vertical GRF to mitigate the influence of impact peaks on GRF variables. We hypothesized that prior to injury, runners who later developed an injury would have more GRF variables outside of the normative boundaries than noninjured runners. Using Cliff’s method, a rank-based, nonparametric method for comparing 2 independent groups, we found no statistically significant difference between the number of variables outside the boundaries for injured and noninjured runners overall (P = .17). However, injured runners without impact peaks had more variables outside the normative boundaries than noninjured runners (P < .001). This novel analytical approach demonstrates the potential for preidentifying collegiate distance runners without impact peaks who may be at risk for injury.

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.