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Sagittal Plane Gait Kinematics in Individuals With Chronic Ankle Instability

Matthew C. Hoch, David R. Mullineaux, Kyoungkyu Jeon, and Patrick O. McKeon

Single joint kinematic alterations have been identified during gait in those with chronic ankle instability (CAI). The purpose of this study was to compare sagittal plane hip, knee, and ankle kinematics during walking in participants with and without CAI. Twelve individuals with CAI and 12 healthy individuals walked on a treadmill at 1.5 m/s. Three-dimensional kinematics were analyzed using mean ensemble curves and independent t tests. Participants with CAI demonstrated less lower extremity flexion during the absorption phase of stance and the limb placement phase of swing, which may have implications for limb placement at initial contact.

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The Use of Maximum Strength Measures as a Predictor of Rapid Force Production and Strength Endurance

Roger O. Kollock, Bonnie Van Lunen, Stacie I. Ringleb, and James Onate

The ability to produce force rapidly and to maintain it is essential to sports performance. Although rapid force production and endurance are indispensable characteristics of optimal health and performance, assessing these qualities of strength is difficult because of clinician time constraints. The purpose of this study was to determine if peak force is a predictor of rate of force production and strength endurance. The results indicated peak force is a predictor of rate of force development, but not strength endurance. Clinicians should assess both maximum strength and endurance to gain a more complete picture of lower extremity strength deficits.

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Effect of Cardiovascular Fatigue on Postural Stability

Hamid Bateni, Gina Leno, Rebeca Manjarres, Bailey Ouellette, and Mark Wolber

Context:

Previous research has demonstrated that localized leg muscle fatigue induced by lower extremity exercises (e.g., squat jumps, sprints, and treadmill running) has an adverse effect on postural stability.

Objective:

To assess the effect of cardiovascular fatigue induced by upper extremity exercise on postural stability.

Design:

Repeated measures.

Participants:

Fourteen healthy young adults between the ages of 22 and 30 years (7 male and 7 female).

Intervention:

Participants performed an exercise protocol on an upper-body ergometer to induce cardiovascular fatigue.

Main Outcome Measures:

Postural sway, represented by center of pressure excursion, during bilateral standing in two different foot positions.

Results:

In a tandem standing position, mediolateral mean distance, root mean square distance, resultant power, and centroidal frequency increased signifcantly after inducement of cardiovascular fatigue.

Conclusion:

Cardiovascular fatigue adversely affects postural stability.

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The Effects of Walking on Gastrocnemius Cooling During an Ice Bag Treatment

Stephanie J. Guzzo, Susan W. Yeargin, Jeffery S. Carr, Timothy J. Demchak, and Jeffrey E. Edwards

Context:

Many athletic trainers use “ice to go” to treat their athletes. However, researchers have reported that icing a working muscle may negate intramuscular (IM) cooling.

Objective:

The purpose of our study was to determine the length of time needed to cool the gastrocnemius while walking followed by rest.

Design:

A randomized crossover study design was used.

Setting:

Exercise Physiology Laboratory.

Patients or Other Participants:

Nine healthy, physically active males and females (males 5, females 4; age 24.0 ± 2.0 years; height 174.0 ± 8.0 cm; weight 86.3 ± 6.5 kg; skinfold taken at center of gastrocnemius greatest girth, R leg 20.3 ± 4.4 mm, L leg 19.6 ± 4.1 mm) without lower extremity injury or cold allergy volunteered to complete the study.

Intervention:

Participants randomly experienced three treatment conditions on separate days: rest (R), walk for 15 minutes followed by rest (W15R), or walk for 30 minutes followed by rest (W30R). During each treatment, participants wore a 1 kg ice bag secured to their right gastrocnemius muscle. Participants walked at a 4.5km/hr pace on a treadmill during the W15R and W30R trials.

Main Outcome Measures:

A 1 × 3 within groups ANOVA was used to determine the effect of activity on cooling time needed for the gastrocnemius temperature to decrease 6 °C below baseline.

Results:

The R condition cooled faster (25.9 ± 5.5 min) than both W15R (33.7 ± 9.3 min; P = .002) and W30R (49.4 ± 8.4 min; P < .001). Average time to decrease 6 °C after W15R was 18.7 ± 9.3 minutes and after W30R was 19.4 ± 8.4 minutes.

Conclusions:

Clinicians should instruct their patients to stay and ice or to keep the ice on for an additional 20 minutes after they stop walking and begin to rest.

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Pain Mechanosensitivity in Individuals With and Without a History of Lateral Ankle Sprain: A Critically Appraised Topic

Ilana Patlan, Elisabeth Ohrnberger, and Kyle B. Kosik

Clinical Scenario: Pain is a common symptom experienced by individuals who sustain an acute lateral ankle sprain and can continue to persist among those who develop chronic ankle instability. Most rehabilitation protocols for individuals with acute ankle sprains or chronic ankle instability focus on restoring physical impairments and have largely omitted any pain-relieving therapies. This impairment-based focus has led pain to be an understudied symptom among individuals with an ankle sprain history. Overlooking the role of pain has also left clinicians with little insight into whether pain experienced after an ankle sprain is local (i.e., peripheral sensitization) or widespread (i.e., central sensitization). Understanding the pain profiles for those with an ankle sprain history may represent an unexploited area for clinicians and future research to improve health outcomes for this patient population. Clinical Question: Is there evidence to suggest that pain mechanosensitivity levels are different between those with and without a history of lateral ankle sprain? Summary of Key Findings: The literature was systematically searched for Level 4 evidence or higher. The search yielded two cross-sectional case-control studies and one cross-sectional study that met the inclusion and exclusion criteria. Based on the available evidence, pain mechanosensitivity levels are lower across ligamentous stabilizers immediately after an acute ankle sprain and over lower extremity neuromuscular structures among individuals with chronic ankle instability. Clinical Bottom Line: There is weak evidence to support an ankle sprain history can affect local pain mechanosensitivity levels of structures surrounding the ankle but not at distant locations. Strength of Recommendation: Level 4 evidence is available according to the Center for Evidence-Based Medicine.

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Anterior Reach and Symmetry on the Y-Balance Test are Related to Dorsiflexion Range of Motion but not Single-Limb Balance in Physically Active Young Adults

Matthew C. Hoch, Johanna M. Hoch, Cameron J. Powden, Emily H. Gabriel, and Lauren A. Welsch

-related injuries occur in the lower extremity, with the ankle representing the most common site of injury. 1 A recent meta-analysis revealed a cumulative incidence rate of 13.6 ankle sprains per 1,000 athlete exposures for females and 6.94 ankle sprains per 1,000 athlete exposures for males, which corresponds to

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Popliteal Artery Entrapment Syndrome: A Diagnostic Enigma. Case Report and Current Concepts Review

Timothy L. Miller and Rose Backs

images indicated that following provocation, the right popliteal artery was more severely narrowed than the left, and this test was felt to be confirmatory of the diagnosis of PAES. Figure 1 —Right lower extremity digital subtraction arteriogram demonstrating narrowing of the popliteal artery at the

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Intra- and Interrater Reliability of the Directional Balance and Reach Tests With and Without Rotation

Larry R. Munger, Jean-Michel Brismée, Phillip S. Sizer, and C. Roger James

a predictor of lower extremity injury and deficiencies. 15 – 18 However, it provides information primarily about linear motion control without incorporating segmental rotation. The DBR tests used in this study included a rotational component with the reach leg, which increases the athlete’s demand

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The Relationship Between Isometric Hip Strength and Incidence of Noncontact Anterior Cruciate Ligament Injuries in Female Athletes: A Critically Appraised Topic

Cayla A. Lee, Jessica L. Jacobs, and Jennifer L. Volberding

dysfunctional trunk, hip, knee, and ankle movement patterns. 1 , 5 These risk factors can be mitigated through programs that focus on neuromuscular and stabilization training of the lower extremity, which have been shown to be effective in reducing the risk of sustaining an ACL injury. 9 Quadriceps and

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Common Peroneal Neuropathy Secondary to Repetitive Direct Blow Contusion Injuries in a Cheerleader: A Case Report

Lauren M. Harte, James J. Czyrny, Sonja Pavlesen, and Michael R. Ferrick

injury diagnosis and prevention. Peroneal neuropathy is the most common mononeuropathy in the lower extremity, but the incidence among athletes in various sports including cheerleading is unknown. Clinical presentation after injury to the peroneal nerve varies based on the location and severity