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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.

Context: Triathlons are a popular endurance sport with an elevated injury risk. Prevalence for injuries in triathletes varies greatly and is thought to be related to racing distance. The most common injuries in triathletes occur in the lower-extremities and are considered overuse in nature. The primary purpose of this study was to examine injury patterns and prevalence among triathletes during the 2022 season. Design: This study adopts an epidemiological approach using a retrospective survey to better understand the prevalence, nature, and patterns of injuries among triathletes. Methods: A live online questionnaire was developed that collected information about demographics, triathlon racing, and injury epidemiology. The survey was posted to social media and emailed to large triathlon clubs and international federations at the beginning of 2023 and was left open for 75 days. Results: Two hundred nineteen triathletes reported at least 1 injury, with 58.5% classified as overuse. Eighty-one percent were reported as triathlon related. The most frequent area of injury was to the lower-extremity (73.8%). Triathletes sought advice from a health care provider 64.6% of the time. Eighty-seven percent of triathletes had to miss or modify training because of their injury. Those triathletes not reporting injury indicated that strength training (72.2%) and stretching/foam rolling (64.9%) were believed to help prevent injury. Conclusion: The risk of injury while training for a triathlon is significant and can be severe enough to require modifications to the training program. The most vulnerable area for injury is the lower-extremities, and such injuries are usually caused by overuse. To reduce the risk of injury, there is a need to examine preventive strategies further and determine their effectiveness.

Clinical Scenario: Anterior cruciate ligament (ACL) injury risk may increase when certain movements are noted during landings. Initial ACL injury produces poor long-term outcomes for patients. Movement assessments may help predict risk of initial ACL injuries. Clinical Question: Are movement assessments predictive of initial ACL injuries in college/high school athletes? Summary of Key Findings: Six articles met the inclusion criteria. Some movement assessments did not predict ACL injury. However, the functional movement screen composite score of 14 or less and landing error scoring system scores of 5 or greater were found to be associated with an increased risk of an ACL injury. Knee valgus angles of ≥6.5 cm were associated with future knee injury but only had fair predictive validity. Clinical Bottom Line: There are conflicting results on whether movement assessments can accurately predict primary ACL injuries. However, clinicians can consider the use of the functional movement screen composite score (14 or less) and the landing error scoring system score (5 or greater) as both may predict a future ACL injury. More research is needed to uncover movement assessments that better predict ACL injury. Strength of Recommendation: A grade B recommendation can be given that movement assessments may be used for screening for initial ACL injury.

Background: Compression socks are a popular feature for runners and are widely advertised by the industry. Limited high-quality evidence has summarized the effects of compression socks during running. We aimed to investigate the effects of wearing compression socks compared with placebo or regular socks during running on physiological parameters, running performance, and perceptual outcomes. Methods: The protocol was registered at PROSPERO (CRD42022330437). Five databases (MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science) were searched. Clinical trials exploring the effect of compression socks during running on physiological parameters, performance, and perceptual outcomes were included. The Cochrane risk of bias 2 tool was used to assess the risk of bias. Results: We included 28 trials (600 runners), with 16 trials (284 runners) contributing to meta-analysis. For physiological outcomes (eg, heart rate mean difference [95% CI = 0.82 [−0.39 to 2.03] and blood lactate concentration mean difference [95% CI] = 0.30 [−0.39 to 0.98]), pooled analysis indicated low to moderate-certainty evidence that compression socks do not differ from regular socks. For running performance (eg, running speed mean difference [95% CI] = −0.24 [−0.79 to 0.31] and time to exhaustion standardized mean difference [95% CI] = −0.26 [−0.65 to 0.13]), pooled analysis indicated very low to low-certainty evidence that compression socks do not differ from regular socks. For perceptual outcomes (eg, perceived exertion standardized mean difference [95% CI] = 0.06 [−0.17 to 0.29] and lower limb muscle soreness standardized mean difference [95% CI] = 0.08 [−0.35 to 0.51]), pooled analysis indicated very low to moderate-certainty evidence that compression socks do not differ from regular socks. Conclusion: There is very low to moderate-certainty evidence that wearing compression socks during running does not benefit physiological, running performance, or perceptual outcomes compared with regular socks.

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.