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Volume 19 (2025): Issue 1 (Mar 2025)

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Cartilage Deformation, Outcomes, and Running Force Comparisons in Females With and Without Knee Injuries

Nicole M. Cattano, Danielle Magee, Kenneth P. Clark, and John Smith

Context: Anterior cruciate ligament reconstruction (ACLR) is a known risk factor for knee osteoarthritis (OA). Since no disease-modifying treatments for OA exist, it is critical to understand joint responses to physical activity following an ACLR. Understanding knee cartilage deformation through ultrasound may provide a better understanding of how knee cartilage responds to running, and how this may contribute to OA pathophysiology and risk. Objective: To compare medial femoral cartilage deformation, outcomes, and forces during running in females with and without a unilateral ACLR knee. Design: Cross-sectional laboratory study. Methods: Sixteen females (8 ACLR history, 8 controls) participated. ACLR participants had an average age of 20.75 (1.83) years, height of 165.07 (7.43) cm, mass of 65.97 (8.55) kg, and were 36.13 (18.74) months postsurgery; controls had an average age of 20.62 (1.84) years, height of 166.00 (5.76) cm, and mass of 63.18 (4.94) kg. Independent variables were group and limb, with dependent variables including patient reported outcomes Knee Injury and Osteoarthritis Outcome Score (KOOS), medial femoral cartilage thickness changes, and indirect measures of stance-averaged vertical ground reaction forces and vertical rate of loading normalized to body weight during treadmill running. Data were analyzed using nonparametric statistics with significance defined as P ≤ .05. Results: All participants exhibited cartilage thickness reduction after 30 minutes of running (P < .001), with no significant group or limb differences in cartilage deformation, vertical ground reaction forces, or vertical rate of loading. ACLR participants reported significantly poorer patient reported outcome scores across all KOOS subscales. Moderate negative correlations were found between involved cartilage percent change and KOOS Symptoms (P = .025) and Sport/Rec (P = .043). Conclusions: Cartilage thickness significantly decreased in all participants after running, with no group or limb differences observed despite lower patient-reported outcomes in the ACLR group. Exploring the relationship between KOOS scores and cartilage response to activity may inform future research and strategies to mitigate OA risk.

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How Does Push-Off Distance Influence Force–Velocity Profile and Performance During Vertical Jumping?

Félicie Pommerell, Sébastien Boyas, Pierre Samozino, Baptiste Morel, Jérémie Begue, Abderrahmane Rahmani, and Nicolas Peyrot

In many sports, practitioners must reach their maximal jump height (h max) under time constraints. This requires a reduction of the countermovement depth and so of the push-off distance (h PO). The purpose of this study was to investigate how h PO influences force–velocity (Fv) profiles ( F ¯ 0 , v ¯ 0 , P ¯ max , and S Fv ) and performance. Eleven participants (age: 26 [5] y, height: 175.6 [11.2] cm, mass: 76 [15] kg; squat 1RM: 129 [34] kg) performed maximal countermovement jumps. Kinetic and kinematic measurements were used to assess individual Fv profiles for 3 different h PO conditions (h PO-SMALL, h PO-MEDIUM, h PO-LARGE) from countermovement jumps performed under different load conditions (bodyweight [BW], BW + 8 kg, BW + 17 kg, BW + 40%1RM, BW + 70%1RM). Results indicated that F ¯ 0 and P ¯ max changed across h PO conditions, while v ¯ 0 remained constant. A lower h PO led to a significantly higher F ¯ 0 and P ¯ max . These changes resulted in a steeper S Fv leading to a more force-oriented profile, a lower optimal S Fv and a greater Fv imbalance. Reducing h PO and modifying Fv profile led, to some extent, to a reduction in h max. Performance is a compromise between h PO, P ¯ max , and Fv imbalance, all influenced by countermovement depth. This explains why reducing countermovement depth to meet time constraint may lower performance.

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Intrasession and Intersession Reliability of Neck Retraction Strength Using a Strain Gauge Device

Josh Burkitt, Chloe Ryan, Dana Ye-Lee, and John Cronin

Neck pain ranks among the most prevalent musculoskeletal conditions and is commonly accompanied by altered physical function. With 10.8% of sports-related injuries affecting the head and neck, evaluating neck strength is vital for detecting muscle weakness and monitoring rehabilitation progress. The purpose of this study was to determine the intrasession and intersession reliability of a strain gauge for measuring neck retraction strength in healthy adult men. Ten male participants (age, 22.7 [2.6] y; body mass, 90.8 [13.3] kg; height, 184.2 [7.1] cm) completed a neck retraction isometric test across 3 testing occasions separated by 7 days. Contraction duration, peak and mean force, impulse, and peak rate of force development were quantified within and between sessions. Contraction duration, peak force, and impulse demonstrated moderate to excellent intra- (intraclass correlation coefficient [ICC] [3,1] = .72–.98, coefficient of variation [CV] = 2.7%–2.1%) and intersession reliability (ICC [3,k] = .66–.89, CV = 4.8%–7.1%); however, only acceptable intrasession reliability was found for peak rate of force development and mean force (ICC = .71–.99, CV = 3.4%–22.7%). It appears that a portable fixed strain gauge can be used to reliably measure neck retraction strength in a healthy male population.

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Rehabilitation and Implementation of a Continuum for Return to Sport in an Amateur Basketball Player With Subtalar Dislocation: A Case Report

Santiago Soliño, Franco Fabani, Tomás Bossio, Joaquín López, and Juan Cruz Porollan

Context: Subtalar dislocation is a rare but severe condition that usually requires emergency attention and could be associated with secondary injuries. Most of the research about this injury is case reports focused on the medical management, so there are no guidelines for rehabilitation and return to sport (RTS). This case report describes the rehabilitation and RTS in an amateur basketball player with an isolated medial subtalar dislocation on his right foot. Case Presentation: A 20-year-old amateur basketball player suffered a forced foot inversion after landing on an opponent’s foot. The patient was taken to the emergency department for a closed reduction under anesthesia, followed by 2 weeks in a cast and 3 weeks in a walker boot. Management and Outcomes: Rehabilitation started after the immobilization period with the main objective of returning to the same level of competition. It was organized through a 4 phase continuum with a stepwise approach. After 16 weeks since injury, the patient returned to team training. Conclusions: To our knowledge, this is the first report to inform on rehabilitation and RTS of medial subtalar dislocation. The 4 phases continuum model could be useful for clinicians for safe progression in this rare condition.

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Convergent Validity and Test–Retest Reliability of Daily Athlete Health Surveys in Collegiate Athletes

Brett S. Pexa, Nikki E. Barczak-Scarboro, Malia N.M. Blue, Christopher J. Johnston, and Kevin R. Ford

Context: Short daily surveys are common in elite sports to capture psychological outcomes, but there is no information on the surveys convergent validity and test–retest reliability. Therefore, the purpose of this study is to determine the validity and test–retest reliability of daily athlete health surveys in collegiate athletes. Design: Descriptive study. Methods: Participants (n = 193, 74 males and 119 females; age = 20.3 [1.4] y) responded daily to sliding scale questions regarding readiness (scored from 0 to 100), fatigue, stress, and sleep quality (−5 [indicating low or poor scores] to +5 [indicating high or “good” scores]). At pre- and midseason times, participants completed the Perceived Stress Scale, Pittsburgh Sleep Quality Index, Athlete Sleep Screening Questionnaire, Overuse Injury Scale, and the Acute Recovery and Stress Scale. To assess validity, Spearman rho (ρ) correlation coefficients were used to assess the relationship between each athlete health variable and the corresponding validated survey. Reliability and precision were assessed with the intraclass correlation coefficient and the standard error of measurement, respectively. Results: Daily stress was correlated with the Perceived Stress Scale (ρ = −.40, P < .001); daily sleep quality was associated with the Pittsburgh Sleep Quality Index (ρ = −.44, P < .001) and the Athlete Sleep Screening Questionnaire (ρ = −0.46, P < .001), and daily readiness was associated with the Overuse Injury Scale (ρ = −.21, P = .003). Daily fatigue was associated with the recovery (ρ = .37, P < .001) and stress dimensions (ρ = −.36, P < .001) of the Acute Recovery and Stress Scale. All daily athlete health variables demonstrated either good or excellent reliability (intraclass correlation coefficient = .85–.94; standard error of measurement = 0.87–4.94). Conclusions: All daily health variables demonstrated acceptable reliability and precision. Sleep quality and stress were most strongly correlated with the outcome scores of their validated surveys. Fatigue was related to the Acute Recovery and Stress Scale, and readiness demonstrated a weak correlation to the Overuse Injury Scale. Clinicians should feel comfortable using these single-question daily health surveys in clinical care but exert caution when using readiness, and fatigue.

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Effect of Multicomponent Dual-Task Training on Gait in People With Intellectual Disability

Carmen Gutiérrez Cruz, Francisco Javier Ruiz Peralvarez, Pedro Ángel Latorre Román, Juan Antonio Párraga Montilla, Karina E. Andrade-Lara, and José Carlos Cabrera Linares

Purpose: Gait is a complex task that requires the interaction between motor and cognitive demand, being usually assessed using the dual-task (DT) paradigm. The aim of this study was to identify the effect of 21 weeks of application of multicomponent DT training on the spatiotemporal gait parameters, coefficients of variation, and DT cost in people with intellectual disability. Methods: A controlled longitudinal pre–post design with random assignment to two groups (experimental and control) was used. Fifty-seven participants with intellectual disability joined in this study (age: 39 ± 9 years). The OptoGait system was used to register spatiotemporal gait parameters in two different conditions: single task and DT. Results: The main findings revealed that in both conditions, the multicomponent DT training significantly reduced the coefficients of variation of spatiotemporal gait parameters (p < .001), whereas there was no effect on DT cost. Conclusions: These findings suggest that the multicomponent DT training elicited a more stable and confident gait pattern.

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Evaluation of the Application of BOth Sides Up Ball Training Combined With Resistance Training in Joint Stability Improvement Following Anterior Cruciate Ligament Reconstruction Surgery in Teenage Athletes

Xiaodong Cao, Junlian Liu, Jinwei Zhao, Shuolei Feng, and Zijian Zhao

Adolescent athletes participating in sports involving sudden directional changes, pivoting, and jumping frequently sustain anterior cruciate ligament (ACL) ruptures. ACL reconstruction (ACLR) surgery is often required, followed by a lengthy rehabilitation period. This study aims to evaluate the effectiveness of combining BOth Sides Up (BOSU) ball exercises with conventional resistance training in the recovery of joint stability and function after ACLR in adolescent athletes. Thirty adolescent athletes (ages 14–18) who underwent ACLR were randomly allocated to either the control group receiving traditional postoperative rehabilitation (n = 15) or the intervention group combining BOSU ball training with resistance exercises (n = 15). Joint stability, proprioception, strength, and functional outcomes were assessed before the procedure, as well as 3, 6, and 12 months after the operation using the KT-1000 arthrometer, Y-balance test, isokinetic dynamometry, and the ACL-Return to Sport after Injury ACL-Return to Sport after Injury (ACL-RSI) scale. The intervention group demonstrated notably better anterior-posterior knee joint stability (P < .05) than the control group at the 6-month and 12-month follow-ups after the surgery, greater reach distances in the Star Excursion Balance Test (P < .05), higher quadriceps and hamstring strength ratios (P < .05), and superior ACL-RSI scores (P < .01). Incorporating BOSU ball training with resistance exercises appears to be more effective than traditional rehabilitation alone in enhancing joint stability and neuromuscular control after ACLR in adolescent athletes. These results provide evidence supporting the incorporation of unstable surfaces into a comprehensive rehabilitation program to optimize recovery and safe return to sports.

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A Tai Chi Program Improves Physical Performance Measures in Adolescents With Down Syndrome and Enhances Their Parents’ Psychological Well-Being: A Randomized Controlled Trial

Ala Cherni, Nejmeddine Ouerghi, Nidhal Jebabli, Hatem Ghouili, Houda Bougrine, Nicola Luigi Bragazzi, and Anissa Bouassida

To investigate the effect of a 6-week tai chi (TC) training program on physical performance in adolescents with Down syndrome and its influence on the psychological well-being of their parents, in a randomized controlled design, 25 male adolescents with Down syndrome (age 14.4 ± 1.30 years) were randomly assigned to a control group (n = 10) or a training group (n = 15). Before and after the training period, lower limb explosive strength, upper limb strength, flexibility, and balance were assessed in all participants, as well as their parents’ psychological well-being. Using 2 × 2 repeated-measures analysis of variance, significant Group × Time interactions (p < .05; .33 < η p 2 < .87 ) were found for physical measures and parents’ depression, anxiety, and stress symptoms. A 6-week TC program significantly improved lower limb explosive strength (p < .001; d = 1.21), upper limb strength (p < .001; d = 1.49), flexibility (p < .001; d = 1.11), and static balance (p < .001; d = 1.99) and reduced depression (p < .001; d = 1.89), anxiety (p < .001; d = 1.74), and stress scores (p < .001; d = 1.88) in parents in the training group compared with those in the control group. TC programs improve physical measures in adolescents with Down syndrome and psychological well-being of their parents. Establishing TC programs in sport associations could positively impact this population’s physical performance.

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Balancing the Load: Perceived Stress, Burnout, and Coping in Irish Athletic Therapy Students

Siobhán O’Connor, Maftei Ionut Tarmure, and Sinéad O’Keeffe

Prolonged stress, poor coping skills, and a lack of engagement in self-care activities can contribute to burnout. We investigated perceived stress, burnout, and coping in Irish athletic therapy students. Moderate stress (20.5 ± 6.7), personal (57.5 ± 20.4), and work-related burnout (52.7 ± 18.1), along with low resilient coping (13.7 ± 2.4), overall (46.0 ± 15.6) and client-related (26.7 ± 17.2) burnout were noted. Women athletic therapy students presented with higher overall (r = .17, p = .04), personal (r = .20, p = .02), and work-related (r = .17, p = .03) burnout and lower resilient coping (r = .20, p = .02). Students working longer hours in employment had higher work- (r = .19, p = .04) and client-related (r = .19, p = .04) burnout scores. Thus, interventions to alleviate stress and burnout and enhance coping skills in students embarking on their career are urgently needed. Targeted strategies for women and those working a high number of hours in external employment are particularly required.