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Context: Male ice hockey players face a high risk of hip and groin symptoms. It is not known how symptoms change over the course of a single season. The purpose of this study was to determine the change in hip and groin symptoms over the course of a season in male ice hockey players and to identify the relationship between a brief preseason physical screen for future hip and groin symptoms. Design: Prospective cohort study. Methods: Members of 2 collegiate male ice hockey clubs (n = 51, 19.47 [1.30] y) underwent preseason physical screens of hip strength and range of motion. They also completed the Quality of Life (QoL) and Sport subscales of the Hip and Groin Outcome Score (HAGOS) preseason and postseason. Paired samples t tests were conducted to determine the change in subscale scores from preseason to postseason. Linear regression models were conducted to identify the relationship between symptoms and the results of the preseason screens. Results: There was a decline in the HAGOS QoL (−3.6; 95% CI, 0.8–6.3; P = .01) and the HAGOS Sport (−4.1; 95% CI, 0.1–8.3; P = .05) over the course of the competitive season. Lower preseason scores were associated with having lower postseason QoL (β = 0.74; 95% CI, 0.43–1.04; P < .01) and Sport (β = 0.58; 95% CI, 0.26–0.89; P < .01) subscale scores. Preseason screens were not significantly associated with end-of-season HAGOS Sport (R ² = .05, P = .25) or QoL (R ² = .09, P = .09) scores. Conclusions: Hip and groin symptoms worsened over the course of a competitive season in male ice hockey players without preventative measures in place. Preseason physical screens of hip strength and range of motion were not associated with future disability. Hip and groin symptoms are not self-limiting and are likely to worsen over the course of a single season in male ice hockey players.

Context: It is recommended that arterial occlusion pressure (AOP) should be measured prior to the use of blood flow restriction training. Previous studies have not compared measures of AOP when using 2 methods of cuff inflation commonly reported in the literature. Design: A cross-sectional observational study was used to compare the measurement of brachial artery AOP as measured using pulse wave Doppler ultrasound (PWDOP) and continuous wave Doppler ultrasound (CWDOP) devices when inflating the cuff with a research/clinical-grade Hokanson (HOK) rapid cuff inflation system and manually (MAN) with a hand pump and gauge. Methods: We made simultaneous measures of brachial artery AOP in 20 males and 21 females using PWDOP and CWDOP devices when using HOK and MAN cuff inflation methods. Data were analyzed with a linear mixed model analysis of variance and Bland–Altman plots. Results: There was not a significant main effect for the overall differences in AOP as measured using PWDOP (121.7 ± 14.7 mmHg) and CWDOP (121.3 ± 14.5 mmHg; P = .3641). There was a significant overall main effect for AOP measured using the HOK (122.7 ± 14.6 mmHg) and MAN (120.3 ± 14.6 mmHg) cuff inflation methods (P < .0001) and between males (128.2 ± 13.7 mmHg) and females (115.2 ± 12.5 mmHg; P = .0034). Bland–Altman plots revealed minimal bias and reasonable limits of agreement between PWDOP and CWDOP measures of AOP when using HOK (0.8 mmHg; 95% CI, −4.7 to 3.0 mmHg) and MAN (0.4 mmHg; 95% CI, −5.3 to 4.5 mmHg) cuff inflation methods. Conclusions: The cessation of an audible pulse using CWDOP is in agreement with the complete obstruction of the arterial blood flow observed using PWDOP. Although statistically significant, small differences in PWDOP and CWDOP measures of AOP when using HOK and MAN cuff inflation methods are of little practical significance. A hand-held CWDOP device and a handpump/gauge can be used to measure AOP.

Context: Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure after injury. However, ACLR contributes to aberrant biomechanical movement patterns that influence secondary injury or joint degeneration. Higher body size may influence gait and landing biomechanics differently between males and females. The purpose of this study was to investigate the influence of sex on the association between body mass index (BMI) and knee biomechanics long-term after ACLR recovery. Design: Sixteen female (BMI: 27.7 [5.4]) and 14 male (BMI: 24.2 [5.5]) participants who had a history of ACLR performed walking and drop vertical jump tasks. Methods: The knee-flexion angle (KFA), external knee flexion moment, knee abduction moment (landing), and knee adduction moment (gait) were measured using 3D motion capture. Body fat percentage was assessed using a BOD POD. Moderated regression evaluated the influence of sex on the association between BMI and biomechanical outcomes after adjusting for body fat percentage. Results: There was a significant interaction between sex and BMI on the KFA at heel contact (P = .01), peak KFA (P = .04), and peak external knee flexion moment (P = .05) during gait and on the KFA at ground contact during landing (P = .04). Higher BMI was associated with smaller KFAs at heel contact (P = .03), smaller peak KFAs during gait (P = .02), and smaller external knee flexion moments (P = .01) but only in females. Similarly, a higher BMI was associated with a smaller KFA at ground contact during landing (P = .03) but only in females. There was no sex by BMI interaction on the knee adduction moment during gait (P = .657) or on the knee abduction moment during landing (P = .643). Moreover, sex and BMI were not independent predictors of the knee adduction moment during gait or the knee abduction moment during landing (all P > .05). Conclusions: The association between sex and BMI may have implications for posttraumatic knee osteoarthritis and ACL reinjury, and female sex and high BMI should be considered when designing individualized rehabilitation programs. These findings suggest that females with high BMI may benefit from interventions to improve knee flexion during landing and gait.

To compare the activation patterns of the shoulder muscles between 2 effort conditions, 8 participants without physical or motor impairment performed the Parabadminton-specific adapted shuttle run test in wheelchairs composed of 3 minutes moderately and intensely, under 2 counterbalanced conditions: with and without the racket. The electromyographic peak data of the anterior deltoid muscle (AD) and posterior deltoid muscle (PD) were collected and normalized by the maximum voluntary isometric contraction previously evaluated. The Wilcoxon test was used to compare conditions (P < .05). The AD showed lower activation during intense effort with the racket (153.76 vs 80.58; P < .05). It was observed that during effort with the racket, there was greater activation of the 2 portions of the deltoid during intense effort (AD: 50.36 vs 67.71; PD: 119.75 vs 148.09). Similarly, when analyzing the condition without a racket, greater activations for both portions of the deltoid muscle were observed for intense effort (AD: 46.70 vs 132.16; PD: 100.04 vs 191.51). It is observed that the use of rackets in Parabadminton in a wheelchair can decrease the pace of recruitment of muscle fibers of AD and PD.

Context: Following a lateral ankle sprain, chronic ankle instability (CAI) subjects show recurrent episodes of giving way, while copers do not exhibit giving way and overcome the challenging condition of postural control. During gait initiation (GI), individuals with CAI reveal shorter center of pressure (COP) displacement and earlier muscle activity compared with healthy controls. Copers have not been previously compared with healthy controls and individuals with CAI during GI. Design: The study design was cross-sectional. Method: Sixty participants (20 CAI, 20 copers, and 20 healthy controls) with a right (dominant) limb injury participated in the study based on inclusion and exclusion criteria. The short form of the Tampa Scale of Kinesiophobia was filled out. Participants performed GI with the nonaffected leg on the force plate that was synchronized with Electromyography Megawin for 2 strides. GI was divided into 3 phases based on COP excursion (S1, S2, and S3). Onset time and electromyography activity of both soleus and tibialis anterior muscles were analyzed along with maximum and mean excursion and velocity of COP excursion in the anterior–posterior and medial–lateral directions and the total phases of GI. Results: The results indicated that the copers had a significantly higher peak of COP excursion in the medial–lateral direction during S2 (P = .029), S3 (P = .018), and total phases (P = .018) of GI compared with the individuals with CAI. Additionally, individuals with CAI showed earlier activation of the right soleus compared with healthy controls (P = .022). There was a significant difference in short form of the Tampa Scale of Kinesiophobia scores between individuals with CAI and other groups (P < .001). Conclusion: The findings demonstrated that individuals with CAI had earlier soleus activation and supraspinal alteration compared with controls. Copers who had lower Tampa Scale of Kinesiophobia scores exhibited an increased peak of COP excursion in the medial–lateral direction during GI compared with individuals with CAI.

Clinical Scenario: Anterior cruciate ligament (ACL) injuries remain one of the most common and debilitating injuries that physically active individuals experience. Pain-related fear of movement and/or reinjury, or kinesiophobia, is the most frequently cited reason for not returning to sport after ACL reconstruction. Understanding how kinesiophobia may impact recovery of physical performance is essential to guide targeted rehabilitation. Clinical Question: Does kinesiophobia associate with physical performance in patients with a history of ACL reconstruction? Summary of Key Findings: Five cross-sectional studies investigating bivariate relationships between kinesiophobia and metrics of physical performance among individuals with a history of primary, unilateral ACL reconstruction were included. From a strength perspective, greater kinesiophobia associated with lesser isometric knee flexion torque (n = 1, negligible association) but did not associate with isokinetic or isometric knee extension torque (n = 2). In terms of functional movement, greater kinesiophobia associated with asymmetric single-leg step-down performance (n = 1, high association) and shorter single-leg hop distance (n = 1, negligible association). Biomechanically, greater kinesiophobia associated with worse drop jump landing, characterized by greater frontal plane motion and lesser sagittal plane motion at the hip and knee joints (n = 1, low to high association). Clinical Bottom Line: Very low-quality evidence suggests a muscle-specific association between kinesiophobia and strength. Low- to moderate-quality evidence suggests that greater kinesiophobia associates with worse functional movement and landing biomechanics. Strength of Recommendation: Considering the consistency and level of evidence among the included studies, we offer the following grades for each construct of physical performance evaluated: strength, D; functional movement, B; and biomechanics, B.

Context: Football players aged 15–20 years experience injury incidence rates similar to those of professionals, with players injured in this age group being significantly less likely to reach the professional level. Understanding the factors that influence young footballers’ acceptance, adoption, and compliance with injury prevention programs is crucial. Therefore, this study aimed to describe the perceptions of male football players from premier league academies regarding injury risk factors and prevention strategies. Design: Cross-sectional observational study. Methods: An online survey was used to explore perceptions of injury risk factors and prevention strategies among young football players (under-17 and under-20 teams) from premier league academies. Results: A total of 504 footballers (mean age: 18 [2] y) across 9 academies in 8 different cities participated in this study. No risk factor was elected as very important by at least half of participants. The top 5 injury risk factors elected by players were “poor hydration,” “inadequate warm-up,” “poor rest/sleep,” “inadequate diet,” and “poor strength/power.” At least 1 quarter of participants considered “genetics,” “advanced age,” “attention level,” “wheatear conditions,” and “alcohol consumption” as irrelevant factors for injury. There was no consensus for any prevention strategy. Fourteen strategies were ranked as efficient by at least 3 quarters of participants. The top 5 prevention strategies elected by players were “warm-up before training/matches,” “functional training,” “hydration before and during training/matches,” “flexibility training,” and “workload monitoring.” Lower than a half of participants endorsed “ankle braces” and “thermal shorts” for injury prevention. Conclusions: The results of this study offer valuable insights into the perceptions of elite young football players regarding injury risk factors and the effectiveness of preventive strategies. These perceptions are essential for understanding how athletes view injury prevention approaches in their daily routines.