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Clinical Scenario: Sacroiliac joint dysfunction (SIJD) is pain in the sacroiliac region that can be debilitating and difficult to treat. Many interventions can be used to treat SIJD, including exercise and manual manipulation. The effectiveness of these treatments by themselves, or in conjunction, is not well understood. Clinical Question: In active individuals with SIJD, is an exercise intervention, manual manipulation, or a combination of the 2 effective in reducing pain and improving function? Summary of Key Findings: Three studies were included in this critically appraised topic. One study found that both exercise therapy and manipulation therapy decreased pain and improved function, but found no between-group differences. The other 2 studies found that exercise therapy, manipulation therapy, and the combination of the 2 were effective in decreasing pain and improving function in the participants. Clinical Bottom Line: The results of the studies suggested that exercise therapy, manual therapy, and a combination of the 2 therapies can be effective in reducing pain and dysfunction in patients with SIJD. While manual therapy techniques alone may be effective in reducing SIJD pain short term, exercise therapy or a combination of the 2 may be more effective in reducing pain long term. Strength of Recommendation: There appears to be level B evidence supporting the use of exercise therapy, manual therapy, or a combination of the 2 for the treatment of SIJD. This recommendation is based on the inconsistent or limited quality patient-oriented evidence presented in the 3 included studies, as defined by the Strength of Recommendation Taxonomy.

Historically, obstacle crossing has been studied in a laboratory setting using a dowel rod as a modality to understand how and why individuals trip and subsequently fall. The dowel features several characteristics that are optimal for research in a laboratory setting, however, it lacks applicability in real-life situations. The purpose of this study was to compare measures of obstacle crossing for the traditional laboratory obstacle (the dowel) to several real-world obstacles. Thirty healthy, young adults (23 [4] y, range: 19–35 y) completed 6 barefoot walking conditions over an 8-m instrumented walkway while motion was recorded in 3D. Participants performed unobstructed walking as familiarization trials and 5 obstructed walking conditions were presented in a randomized order: (1) dowel, (2) branch, (3) parking curb, (4) puddle, and (5) caution rope. Measures of vertical and horizontal obstacle clearance indicate that healthy young adults cross the dowel obstacle differently than they cross real-world obstacles, such as a curb, a puddle, and a caution rope but most similar to a branch. Since dowel rods have historically been used to assess obstacle crossing strategies, we encourage researchers and readers to exercise caution when extrapolating findings to real-world obstacles found in everyday life.

Low back pain is a frequent injury in golfers which impacts trunk muscle activity patterns. The primary purpose of this study was to bilaterally compare thickness of the external obliques and internal obliques across three positions (supine, golf setup, and swing peak) in 16 adult golfers with a history of low back pain via ultrasound. There were no significant differences between lead and trail external obliques thickness in supine (Z = 0.982, p = .326), setup (Z = 1.758, p = .079), or peak (Z = 1.396, p = .163). There were no significant differences between lead and trail internal obliques thickness in supine (Z = 1.448, p = .148), setup (Z = 0.078, p = .938), or peak (Z = 1.086, p = .278). Golfers with a history of low back pain do not demonstrate asymmetrical oblique adaptations.

Exertional heat stroke (EHS) is prevalent across the entire United States but more commonly occurs in the Southern part of the country. Recent studies have identified a low adoption rate of athletic trainers (ATs) using best practices in managing EHS. This study aimed to identify AT’s use of rectal thermometry and cold-water immersion. We surveyed 116 ATs in Heat Safety Category Region 3 practicing in: secondary schools, universities/colleges, youth sports, professional sports, performing arts, or military/government. We identified a statistically significant difference between ATs’ actual and planned use of rectal thermometry and cold-water immersion. Athletic trainers who used EHS best practices felt confident in differentiating EHS from other conditions.

Greater knee adduction moment is associated with increased risk and progression of knee osteoarthritis, and this biomechanical risk factor is modulated through kinematic gait modifications. Emotions are known to influence walking kinematics and speed, but the effect of different emotions on knee mechanics is unclear. To test this, 20 healthy participants walked while instrumented gait data was recorded. Participants initially walked naturally (baseline) and then acting 4 emotional walking conditions: Anger, Happy, Fear, and Sad, in randomized order. Statistical parametric mapping with an analysis of variance model determined the extent to which emotions influenced knee joint mechanics. Results indicated both the happy (P = .009) and sad (P < .001) condition resulted in lower knee adduction moment compared with baseline. Walking both happy and sad also resulted in walking speed changes from baseline (P < .001). A secondary analysis of covariance model with speed as the covariate indicated no significant effect of emotional condition on knee adduction moment (P > .05), which suggests that the changes from baseline can be attributed to the changes in walking speed. Decreased knee adduction is associated with reduced osteoarthritis progression and increased knee function, suggesting that walking while acting different emotions, specifically happy and sad, may moderate knee osteoarthritis risk.

Context: The Balance Error Scoring System (BESS) is the most commonly used balance test during concussion assessment; however, the test has known limitations related to fatigue. Jumping and landing along with running are common athletic activities that adversely affect postural control. However, the effect of neither subexertional running nor jumping and landing tasks on the BESS is known. Therefore, the purpose of this study was to investigate the effects of a brief exercise bout of running or jumping on BESS performance. Design: We recruited 52 recreationally active participants who were divided into 3 groups: (1) Drop Jump (Landing), Treadmill Running (Run), and Control. Methods: All participants performed a preintervention BESS test and were then randomly assigned to a group. The jumping group performed 10 drop jumps from a 50 cm box, 30 seconds between trials, the running group performed a 3-minute treadmill run, and the control group sat quietly for 5 minutes. All participants then completed a second BESS test. The primary analysis was a 2 (time) by 3 (group) repeated-measure analysis of variance with sex as a covariate. Results: There was a significant interaction (F = 7.396, P = .002). On post hoc, there was a significant improvement (lower) score in the Control group (PRE: 13.9 [4.5]; POST: 10.5 [2.9]; P = .019, d = 0.89) but no significant differences in either the running (P = .579) or landing (P = .849) groups. Conclusions: A relatively brief exercise intervention resulted in participants failing to improve a subsequent BESS assessment, whereas control participants who rested for 5 minutes committed fewer (3.4) errors. These results suggest that sports health care providers should recognize that even low- to moderate-intensity brief exercise can result in a failure to improve with repeat BESS administration.

Context: Running is a popular form of physical activity but can increase an individual’s lower-extremity injury risk. Running gait analysis via inertial measurement units (IMUs) is a method for collecting important gait data that is related to developing lower-extremity injuries, such as increased load from low step rate (SR), and long stride length (SL). IMU data can be derived from both foot- and shank-placed IMUs, but foot-placed sensors (RunScribe IMUs) need validation against shank-placed sensors. Purpose: Determine criterion validity of RunScribe foot-placed IMUs against MyoMotion shank-placed IMU for SR and SL. Design: cross-sectional laboratory study. Methods: Nine participants (5 males, 4 females; age: 28.33 [5.78]; height: 1.75 [0.11]; mass: 74.06 [16.24]) volunteered for our study. Following a 5-minute warm-up, participants ran on a treadmill for 5 minutes at a self-selected speed. After ∼2.5 minutes, MyoMotion data were collected for 10 seconds. The RunScribe IMUs collected data throughout the full duration of the run. Criterion validity of SR and SL between the foot- and shank-placed IMUs was determined using bivariate Pearson correlations, intraclass correlation coefficients (3,1), and Bland–Altman plots with 95% limits of agreement analysis. Results: A very strong correlation for SR (r = .90, N = 9, P ≤ .001), and a strong correlation for SL (r = .80, N = 9, P < .001) were found between the foot and shank-placed IMUs. Excellent reliability was found for SR (intraclass correlation coefficient = .91, P ≤ .001, 95% CI, .639–.978), and good reliability was found for SL (intraclass correlation coefficient = .800, P = .003, 95% CI, .340–.951) between the foot and shank-placed IMUs. The mean difference of SR and SL was −2.111 and −0.142, respectively, indicating good agreement between the foot and shank-placed IMUs. Conclusions: Foot-placed RunScribe IMUs are a valid alternative for measuring SR and SL compared with shank-placed IMUs.

Regular participation in physical activity (PA) has been linked to improved health and well-being outcomes. People with disability, however, are faced with many barriers and often require support to participate. This scoping review aimed to understand how the support needs of people with disability wanting to participate in PA are assessed. A scoping review was conducted as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension for Scoping Reviews, which involved the review of four databases. A total of 35 papers met the inclusion criteria for this review, which identified 11 standardized assessment tools. All tools measured support needs within a general health and participation assessment and included items relevant to PA. No tools were found specific to PA participation. This review suggests that a PA-specific assessment tool would be valuable in measuring the support needs of people with disability with a focus on participation-based outcomes.

In sports settings, it is important to understand and assess the effects of cognitive–motor interference on sport-specific tasks throughout strength and conditioning programs to better represent the athletic environment. This study used a low-cost movement assessment system, the Mizzou Point-of-care Assessment System, to measure the effects of visual and auditory cognitive–motor dual tasking on countermovement jump (CMJ) performance. Thirty-one recreationally active adults (21.1 [1.9] y, 168.9 [11.8] cm, 69.1 [13.6] kg) participated. Participants performed 3 trials of CMJ under 3 conditions: control, audio dual tasking, and visual dual tasking. Tasks were assessed using a low-cost system comprising a custom force plate, depth camera, and interface board. Repeated-measures analysis of variance with post hoc t tests revealed significant decreases in several kinematic and kinetic outcome measures, including time in the concentric phase (in seconds; 95% CI mean difference audio–control = −0.045 to 0.0054; visual–control = −0.045 to 0.0054), time to takeoff (in seconds; audio–control = −0.026 to 0.086; visual–control = −0.026 to 0.086), jump height (in meters; audio–control = −0.0081 to 0.048; visual–control = −0.01 to 0.05), maximum knee flexion (in degrees) at jump (audio–control = 1.47 to 9.89; visual–control = −1.58 to 9.66), hip flexion (in degrees) at maximum knee flexion during jump (audio–control = 0.00 [0.00 to 0.00]; visual–control = 0.00 [0.00 to 0.00]), and several others for both dual tasking conditions compared with control but not between audio and visual conditions. Results indicate that both dual task conditions negatively impact CMJ performance and that their effects can be effectively quantified using a low-cost assessment tool.

Due to inadequate commercial availability of sports bras designed with adequate breast support for full-busted women (cup size D and above), breast discomfort can be a significant barrier to exercise. In this study, postural characteristics during dynamic physical activities were evaluated for 20 full-busted women in 3 different sports bra conditions, 2 of which were bras designed specifically for full-busted women. Participants performed quiet standing, walking, jumping jacks, high knees, and running tasks on a force plate treadmill in each condition to collect postural measures associated with center of pressure (COP). COP measures were also evaluated with respect to body composition, metabolic health markers, and sex hormone profiles. COP measures were larger in high knees and jumping tasks with respect to quiet standing. Across running speeds, conventional bras were associated with the largest COP metrics. Analysis of covariance analysis indicated increased anthropometry measures such as mass and body fat percentage resulted in decreased COP area and favored mediolateral orientation. Luteinizing hormone, estradiol, progesterone, testosterone, and sex hormone-binding globulin were all found to impact statistical models, indicating the importance of incorporating a comprehensive hormone panel when considering the impact subject-level variations have on motor function.