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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.

The aim of this study was to provide a comparative analysis of running responses in official matches in different sport classes of football players with cerebral palsy considering the contextual factors of geographical competition and level. One hundred ninety-one international footballers with cerebral palsy divided according to the tournament geographical competition and level participated in this study. Higher medium- and high-intensity match-running responses were found for the Asia-Oceania tournament in comparison with the American, European, and world competitions. Similarly, players from the World Cup performed more moderate accelerations and decelerations compared with the players in the America’s Cup, and players competing in the Asia-Oceania region realized more moderate decelerations than in the America’s Cup. Thus, classifiers and coaches may consider the tournament level due to possible differences in the match’s physical demands regarding the class status allocation and the physical preparation for those competitions.

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.

The objective of this study was to examine the influence of relative hamstring flexibility and lumbar extensor strength on lumbar flexion during a stoop lift. Lumbar flexion during stoop lifting has been associated with increased bending stress and load on the lumbar spine. The potential impairments that contribute to a flexed lumbar lifting posture during stoop lifting are unclear. Forty-nine healthy individuals (27 females and 22 males) between the ages of 18 and 40 participated. Strength of the lumbar extensors was measured with a motor-driven dynamometer, and relative hamstring flexibility was estimated with the passive knee extension test. Peak lumbar flexion and pelvis anterior rotation were quantified with 3D motion capture during a stoop lift. There was a positive correlation between relative hamstring flexibility and peak pelvis anterior rotation angle during the stoop lift (r = .544, P < .001). Meanwhile, there was a negative correlation between middle lumbar spine peak flexion and relative hamstring flexibility (r = −.538, P < .001) and a negative correlation between lumbar extensor strength and lower lumbar peak flexion (r = −.288, P = .045). Individuals with decreased strength and limited relative hamstring flexibility tended to exhibit increased lumbar flexion during stoop lifting.

A higher risk of knee osteoarthritis (OA) has been identified in patients with slower walking speeds following anterior cruciate ligament reconstruction (ACLR). Given that altered loading of the surgical knee has been the most proposed mechanism for early knee OA post-ACLR, understanding how modulating walking speed may modify knee joint loading is essential for developing strategies to reduce the risk of knee OA in ACLR patients. The purpose of this study was to determine how modulation of walking speed affects knee joint loading during overground walking post-ACLR. Lower extremity kinematics and kinetics were recorded during overground walking at a self-selected, slower, and faster speed from 16 patients with unilateral ACLR. The results showed that ACLR patients demonstrated lesser peak knee flexion and adduction moments of the surgical knees when walking at slower speeds. However, modulating walking speed did not alter between-limb knee loading asymmetry. The ACLR limbs had lower peak knee flexion moments than the uninjured limbs across all 3 walking speeds. Although interventions that increase walking speed may deter the onset of knee OA by elevating the mechanical stimulation at the surgical knee, additional gait training strategies may be needed to restore the between-limb loading symmetry in ACLR patients.

The effect of gait speed on minimum toe clearance (MTC) amount may vary across the lifespan due to changes in joint relationships, potentially affecting trip-related fall risk in older adults. We evaluated whether age influences the relationship between gait speed and MTC amount, as well as between joint movements and MTC amount. Optical motion capture data was collected on 62 participants between the ages of 20 and 83 years during 25 gait trials at self-selected normal, fast, and slow speeds. Multilevel models were used for data analysis. Gait speed was associated with a 0.13 cm increase in MTC amount for every meter per second increase in gait speed with other factors constant and was unaffected by age. Ankle dorsi–plantarflexion, knee and hip flexion–extension, and stance hip abduction–adduction changed the MTC amount by 0.05, 0.02, 0.04, and 0.04 cm, respectively, for each degree of joint movement, with other factors constant, and was unaffected by age. Age did not affect the relationship between gait speed and MTC amount, nor the relationship of joint moments with MTC, indicating that these factors may not be associated with trip-related fall risk with healthy aging.