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A novel phone application (SOBER-EYE) was developed to quantify measures of pupillary light reflex (PLR) that extends beyond traditional PLR dichotomous measurement techniques. Prior to implementation into clinical practice, the test–retest reliability must be evaluated. The primary outcome measure was the intraclass correlation coefficient. Intraclass correlation coefficients for two PLR trials included: constriction amplitude (.825), constriction velocity (.693), initial pupil diameter (.888), latency (.962), and minimum size (.851). Clinical utility was found as all intraclass correlation coefficient values were >.60. The SOBER-EYE phone app has the potential to be used in the clinical environment to assess PLR.

When carrying out a motor task, the direction of the performer’s attentional focus can affect mechanical output and muscle activation. Cortical excitability increases with the observation of motor skills. However, it is unknown if this effect can be additive to that resulting from an internal attentional focus during resistance exercise. A crossover-study design was employed to examine the acute effects of combining mirror self-motor observation (MO) and internally focused verbal instructions on mechanical output and muscle activation during isokinetic concentric knee-extension exercise. Ten participants were tested in 2 different conditions: verbal alone and verbal + MO-mirror. The combination of verbal + MO-mirror attenuated the decrease in torque output in response to 6 sets of 10 isokinetic contractions (P = .043). Interestingly, this effect was paired by a lower-level antagonist/agonist coactivation with the verbal + MO-mirror condition (P = .031). No other differences between conditions were noted. Taken together, these results suggest that the combination of both cueing modalities elicits a more effective contraction strategy during knee-extension exercise. Ultimately, this provides preliminary evidence of better motor performance and heightened fatigue resistance in response to isokinetic exercise.

Context: The baseball athlete incorporates the use of the entire kinetic chain while throwing. Hip range of motion (ROM) and strength have been previously studied in its relation to injury development. It is a clinical necessity to understand the normative profiles of hip musculoskeletal function across the playing career. Objectives: To identify the normative hip ROM and strength profiles of baseball players across level of play. Evidence Acquisition: The researchers searched the electronic databases MEDLINE, SPORTDiscus, CINAHL, and Embase using a custom search strategy. After applying inclusion and exclusion criteria, 31 articles were reviewed. Of these 31 articles, 22 examined hip ROM and/or strength in uninjured baseball athletes. A manual search of the references of those 22 articles revealed 4 additional articles that met the inclusion criteria. In total, 26 articles were included in data collection. Evidence Synthesis: Articles were assessed for quality using the appraisal tool for cross-sectional studies. The appropriate hip ROM and strength data, along with player demographics, were extracted and reviewed to ensure accuracy. Articles were also categorized based on level of play and player position. Conclusions: Hip ROM and strength profiles of baseball athletes across all levels of play were identified and presented to comprehensively summarize the available data on normative musculoskeletal hip profiles. Observed differences between positions and across levels of play were documented. In general, hip external rotation ROM was greater than internal rotation across all levels and between the stance and lead limbs. As age and level of play increased, the difference between hip external rotation and internal rotation ROM also increased. Hip strength increased as level of play (and subsequently age) increased. These summarized data can be used as benchmarks to compare clinical populations.

The purpose of this study was to examine walking and running biomechanics with and without the addition of a cognitive task in athletes recently diagnosed with concussions. We sought to determine if deficits remained after athletes were asymptomatic, had returned to baseline in all common clinical tests, and had been cleared for full return to sport participation. Seven collegiate athletes with recent concussions (recently concussed) and seven healthy matched controls (controls) completed testing sessions 1–3 days after unrestricted clearance (S1) and 1-week postclearance (S2). Participants completed four gait conditions: (1) walking alone (single task), (2) walking while completing simple mental tasks (dual task), (3) running single task, and (4) running dual task. Participants completed a total of eight walking trials, followed by a total of eight running trials counterbalanced between single- and dual-task conditions. Runscribe™ wearable shoe sensors (Scribe Labs, Inc.) were utilized to assess walking and running gait biomechanics. No significant interaction was found between group (recently concussed, control) and session (S1, S2) for speed (m/s), stride length (m), or step rate (steps/min) during the four gait conditions (p ≥ .34). However, several moderate to large effect sizes were observed for pairwise comparisons (−0.09 ≤ d ≤ 1.72), suggesting clinically meaningful decreased performance in the recently concussed group that would benefit from further study with larger samples.

It is unknown if forward trunk lean during single-limb landing influences the Achilles tendon force (ATF). This study examined the effect of forward trunk lean during single-limb landing on the ATF in physically active females. Thirty physically active females (23.7 [3.6] y) performed 5 landing trials (0.25 m) using self-selected and forward trunk lean strategies. Dependent variables included peak ATF; average ATF development rate; and sagittal trunk, hip, knee, and ankle angles and moments at the time of peak ATF. The increased forward trunk lean (mean difference (MD) = 14.1°; 95% CI, 11.0 to 17.2; P < .001) caused a decrease in peak ATF (MD = −3.5 N/kg; 95% CI, −5.8 to −1.2; P = .004) and ankle plantar flexion moment (MD = −0.2 N·m/kg; 95% CI, −0.4 to −0.1; P = .002). In contrast, forward trunk lean resulted in greater hip (MD = 15.2°; 95% CI, 11.9 to 18.4; P < .001) and knee flexion (MD = 7.7°; 95% CI , 4.7 to 10.7; P < .001) angles, and hip extension moment (MD = 0.3 N·m/kg; 95% CI, 0.1 to 0.5; P = .002). Forward trunk lean changes predicted peak ATF changes (r = .33, P = .04). Sagittal trunk posture influences the ATF in physically active females during single-limb landing and may effectively alter loading in patients recovering from Achilles tendinopathy.

Context: Kinesiophobia is a substantial psychological factor that may impact sport performance and activities of daily living for individuals with chronic ankle instability (CAI). The purpose of this study was to determine the levels of kinesiophobia between collegiate athletes and nonathletes with and without CAI using quantitative and qualitative analyses. Design: Cross-sectional survey. Methods: A Qualtrics survey was distributed to college students. Ankle health status was evaluated using the Foot and Ankle Ability Measure Sport subscale, Identification of Functional Ankle Instability, and history questions. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia-11. A 4 × 2 analysis of variance was used to assess differences in athlete status (NCAA Division 1, intramural, club, and nonathlete) and ankle health status (CAI and healthy). An open-ended question was added to understand how kinesiophobia impacts individuals CAI. Data were analyzed via content analysis. Results: Of the 531 respondents who completed the survey, 140 (116 = CAI and 24 = healthy) met the inclusion criteria for the study. There was a significant main effect for ankle health status for the Foot and Ankle Ability Measure Sport (CAI = 62.68 [15.11]%, healthy = 99.57 [0.01]%), Identification of Functional Ankle Instability (CAI = 21.63 [5.34], healthy = 2.42 [2.93]), and Tampa Scale of Kinesiophobia-11 (CAI = 26.04 [6.22], healthy = 16.75 [5.50]). There were no significant main effects for athlete status or interactions for any variables. Perceptual and behavioral responses were to major categories identified with the qualitative analysis. Fear, pain, and instability were higher order themes within perceptual responses. Activity avoidance and bracing were higher order themes within behavioral responses. Conclusion: This study highlights the significant role of kinesiophobia in individuals with CAI, with those affected reporting higher levels of fear, pain, and instability compared with healthy individuals. Behavioral adaptations such as activity avoidance and bracing were common among qualitative responses. While no differences were observed across athlete statuses, these findings underscore the need for tailored interventions addressing both physical and psychological factors to improve outcomes for individuals with CAI.

This is a case of a 19-year-old female Division 1 volleyball athlete with right anterior knee pain assessed using evaluation and diagnostic ultrasound. Anterior knee pain symptomology is commonly found among female jumping athletes. The ultrasound was used to examine the intratendinous changes of the patellar tendon. Hypoechoic changes in the infrapatellar tendon were noted on the right patellar tendon. A 6-week therapeutic intervention was implemented. Postintervention ultrasound assessment showed decreased hypoechoic changes in the right anterior knee. The unique feature of this case is the use of point of care ultrasound in detecting hypoechoic changes within the patellar tendon with therapeutic interventions.