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Context: Musculoskeletal ultrasound imaging is a valid and reliable tool to measure muscle morphology, but minimal research explores its utility in assessing acute morphology changes after exercise in active populations. The purpose of this study was to assess changes in ultrasound-based measures of muscle thickness (MT) and quality (MQ) in response to a single bout of short-duration, high-intensity bodyweight exercise in the acute and postacute recovery timeframe. Design: Interventional study. Methods: Nineteen healthy, recreationally active young men and women (27.1 [8.3] y) completed a dynamic bodyweight exercise circuit primarily focused on the lower body. B-mode ultrasound images were obtained of the rectus femoris in resting and contracted conditions preexercise, ∼15 minutes, and 24 hours postexercise. Knee-extensor strength and MQ (muscle strength [in newtons]/resting MT [in centimeters]) were also assessed at the same timepoints. Results: Resting and contracted MT increased (13.0%; 6.9%) from pre- to 15 minute postexercise, returning to baseline at 24 hours postexercise. Δ MT decreased (−24.5%) from pre- to 15 minutes postexercise and was not different from either 15 minutes postexercise or baseline by the 24-hour timepoint. Knee extension strength and MQ decreased (−15.6%; 24.2%) from pre- to 15 minutes postexercise and remained below baseline at 24 hours postexercise. Conclusion: MT measures alone suggested faster recovery from an exercise circuit than knee-extensor strength or MQ, though the combined metric of MQ may be useful for longitudinal monitoring of muscle recovery timelines in rehabilitation programs.

Context: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Turkish version (CAIT-T) and to evaluate the validity, reliability, and cutoff score of CAIT-T for Turkish athletic population. Design: The English version of CAIT was translated to CAIT-T based on a guideline of cross-cultural adaptation. Fifty-two athletes with chronic ankle instability and 63 athletes without chronic ankle instability were included in the study. Construct validity was evaluated with correlations between the CAIT-T, Turkish version of Foot Ankle Ability Measure (FAAM-T), and Numeric Rating Scale. CAIT-T was completed twice by each participant at 7 to 10 days intervals to assess test–retest reliability based on the intraclass correlation coefficient, whereas Cronbach alpha evaluated internal consistency. Discriminative validity and content validity of the CAIT-T also evaluated. Results: In construct validity, strong positive correlation was found between CAIT-T and Numeric Rating Scale perceived ankle instability (rho = −.771, P < .001), as well as moderate negative correlations with FAAM-T-activities of daily living and FAAM-T-sports (rho = −.448, P < .001 and rho = −0.541, P < .001, respectively). The CAIT-T demonstrated strong test–retest reliability (intraclass correlation coefficient score of .98) with a good internal consistency (Cronbach α: .85). Receiver operating characteristic curve showed a cutoff score of 26.5 (Youden index: 0.78, sensitivity: 0.57, specificity: 0.90.5). No ceiling or floor effects were observed. Conclusions: CAIT-T is a valid and reliable questionnaire for the assessment of chronic ankle instability in the Turkish athletic population.

Clinical Scenario: Sacroiliac joint dysfunction (SIJD) is pain in the sacroiliac region that can be debilitating and difficult to treat. Many interventions can be used to treat SIJD, including exercise and manual manipulation. The effectiveness of these treatments by themselves, or in conjunction, is not well understood. Clinical Question: In active individuals with SIJD, is an exercise intervention, manual manipulation, or a combination of the 2 effective in reducing pain and improving function? Summary of Key Findings: Three studies were included in this critically appraised topic. One study found that both exercise therapy and manipulation therapy decreased pain and improved function, but found no between-group differences. The other 2 studies found that exercise therapy, manipulation therapy, and the combination of the 2 were effective in decreasing pain and improving function in the participants. Clinical Bottom Line: The results of the studies suggested that exercise therapy, manual therapy, and a combination of the 2 therapies can be effective in reducing pain and dysfunction in patients with SIJD. While manual therapy techniques alone may be effective in reducing SIJD pain short term, exercise therapy or a combination of the 2 may be more effective in reducing pain long term. Strength of Recommendation: There appears to be level B evidence supporting the use of exercise therapy, manual therapy, or a combination of the 2 for the treatment of SIJD. This recommendation is based on the inconsistent or limited quality patient-oriented evidence presented in the 3 included studies, as defined by the Strength of Recommendation Taxonomy.

Historically, obstacle crossing has been studied in a laboratory setting using a dowel rod as a modality to understand how and why individuals trip and subsequently fall. The dowel features several characteristics that are optimal for research in a laboratory setting, however, it lacks applicability in real-life situations. The purpose of this study was to compare measures of obstacle crossing for the traditional laboratory obstacle (the dowel) to several real-world obstacles. Thirty healthy, young adults (23 [4] y, range: 19–35 y) completed 6 barefoot walking conditions over an 8-m instrumented walkway while motion was recorded in 3D. Participants performed unobstructed walking as familiarization trials and 5 obstructed walking conditions were presented in a randomized order: (1) dowel, (2) branch, (3) parking curb, (4) puddle, and (5) caution rope. Measures of vertical and horizontal obstacle clearance indicate that healthy young adults cross the dowel obstacle differently than they cross real-world obstacles, such as a curb, a puddle, and a caution rope but most similar to a branch. Since dowel rods have historically been used to assess obstacle crossing strategies, we encourage researchers and readers to exercise caution when extrapolating findings to real-world obstacles found in everyday life.

Low back pain is a frequent injury in golfers which impacts trunk muscle activity patterns. The primary purpose of this study was to bilaterally compare thickness of the external obliques and internal obliques across three positions (supine, golf setup, and swing peak) in 16 adult golfers with a history of low back pain via ultrasound. There were no significant differences between lead and trail external obliques thickness in supine (Z = 0.982, p = .326), setup (Z = 1.758, p = .079), or peak (Z = 1.396, p = .163). There were no significant differences between lead and trail internal obliques thickness in supine (Z = 1.448, p = .148), setup (Z = 0.078, p = .938), or peak (Z = 1.086, p = .278). Golfers with a history of low back pain do not demonstrate asymmetrical oblique adaptations.

Exertional heat stroke (EHS) is prevalent across the entire United States but more commonly occurs in the Southern part of the country. Recent studies have identified a low adoption rate of athletic trainers (ATs) using best practices in managing EHS. This study aimed to identify AT’s use of rectal thermometry and cold-water immersion. We surveyed 116 ATs in Heat Safety Category Region 3 practicing in: secondary schools, universities/colleges, youth sports, professional sports, performing arts, or military/government. We identified a statistically significant difference between ATs’ actual and planned use of rectal thermometry and cold-water immersion. Athletic trainers who used EHS best practices felt confident in differentiating EHS from other conditions.

Greater knee adduction moment is associated with increased risk and progression of knee osteoarthritis, and this biomechanical risk factor is modulated through kinematic gait modifications. Emotions are known to influence walking kinematics and speed, but the effect of different emotions on knee mechanics is unclear. To test this, 20 healthy participants walked while instrumented gait data was recorded. Participants initially walked naturally (baseline) and then acting 4 emotional walking conditions: Anger, Happy, Fear, and Sad, in randomized order. Statistical parametric mapping with an analysis of variance model determined the extent to which emotions influenced knee joint mechanics. Results indicated both the happy (P = .009) and sad (P < .001) condition resulted in lower knee adduction moment compared with baseline. Walking both happy and sad also resulted in walking speed changes from baseline (P < .001). A secondary analysis of covariance model with speed as the covariate indicated no significant effect of emotional condition on knee adduction moment (P > .05), which suggests that the changes from baseline can be attributed to the changes in walking speed. Decreased knee adduction is associated with reduced osteoarthritis progression and increased knee function, suggesting that walking while acting different emotions, specifically happy and sad, may moderate knee osteoarthritis risk.

Context: The Balance Error Scoring System (BESS) is the most commonly used balance test during concussion assessment; however, the test has known limitations related to fatigue. Jumping and landing along with running are common athletic activities that adversely affect postural control. However, the effect of neither subexertional running nor jumping and landing tasks on the BESS is known. Therefore, the purpose of this study was to investigate the effects of a brief exercise bout of running or jumping on BESS performance. Design: We recruited 52 recreationally active participants who were divided into 3 groups: (1) Drop Jump (Landing), Treadmill Running (Run), and Control. Methods: All participants performed a preintervention BESS test and were then randomly assigned to a group. The jumping group performed 10 drop jumps from a 50 cm box, 30 seconds between trials, the running group performed a 3-minute treadmill run, and the control group sat quietly for 5 minutes. All participants then completed a second BESS test. The primary analysis was a 2 (time) by 3 (group) repeated-measure analysis of variance with sex as a covariate. Results: There was a significant interaction (F = 7.396, P = .002). On post hoc, there was a significant improvement (lower) score in the Control group (PRE: 13.9 [4.5]; POST: 10.5 [2.9]; P = .019, d = 0.89) but no significant differences in either the running (P = .579) or landing (P = .849) groups. Conclusions: A relatively brief exercise intervention resulted in participants failing to improve a subsequent BESS assessment, whereas control participants who rested for 5 minutes committed fewer (3.4) errors. These results suggest that sports health care providers should recognize that even low- to moderate-intensity brief exercise can result in a failure to improve with repeat BESS administration.