make up anywhere from 20% to 65% of injuries. Furthermore, approximately 70% of overuse injuries in high school and college athletes occurred in the lower-extremity. 1 Lower limb overuse injuries (LLOIs) can occur anywhere in the lower-extremity, spanning from the feet to the thighs. 2 Medial tibial
Janie L. Kelly and Alison R. Valier
Viviane Ribeiro de Ávila, Teresa Bento, Wellington Gomes, José Leitão and Nelson Fortuna de Sousa
Context Ankle fractures (AFs) are the most common injuries among the fractures of the lower limbs found in urgency and emergency services. 1 , 2 These fractures are a significant source of morbidity for both the young and elderly population. 3 , 4 At a young age, the incidence is higher in men
Marcos de Noronha, Eleisha K. Lay, Madelyn R. Mcphee, George Mnatzaganian and Guilherme S. Nunes
Context: Ankle sprains are common injuries in sports, but it is unclear whether they are more likely to occur in a specific period of a sporting game. Objective: To systematically review the literature investigating when in a match ankle sprains most likely occurred. Evidence Acquisition: The databases CINAHL, EMBASE, MEDLINE, and SPORTDiscus were searched up to August 2016, with no restriction of date or language. The search targeted studies that presented data on the time of occurrence of ankle sprains during sports matches. Data from included studies were analyzed as a percentage of ankle sprain occurrence by halftime and by quarters. Meta-analyses were run using a random effects model. The quality assessment tool for quantitative studies was used to assess the article’s quality. Evidence Synthesis: The searches identified 1142 studies, and 8 were included in this review. A total of 500 ankle sprains were reported during follow-up time, which ranged from 1 to 15 years, in 5 different sports (soccer, rugby, futsal, American football, and Gaelic football). The meta-analyses, including all 8 studies, showed that the proportion of ankle sprains during the first half (0.44; 95% confidence interval [CI], 0.38–0.50) was smaller than the second half (0.56; 95% CI, 0.50–0.62). For the analyses by quarters, the proportion of ankle sprains in the first quarter (0.14; 95% CI, 0.09–0.19) was considerably smaller than the second (0.28; 95% CI, 0.24–0.32), third (0.25; 95% CI, 0.17–0.34), and fourth (0.29; 95% CI, 0.22–0.36) quarters. Conclusion: The results of this review indicate that ankle sprains are more likely to occur later in the game during the second half or during the latter minutes of the first half.
Zhen Zeng, Christoph Centner, Albert Gollhofer and Daniel König
thus not allow adequate standardization across subjects. With respect to relative pressure intensities, some studies have adjusted the applied cuff pressure on the lower limbs on the subjects’ brachial blood pressure. 15 This procedure is, however, questionable, because the brachial blood pressure
Sergio Jiménez-Rubio, Archit Navandar, Jesús Rivilla-García and Victor Paredes-Hernández
, postinjury), the player would have to undergo sessions in the gym focusing on achieving a full range of motion in the hip and knee, 30 – 32 and performing controlled static and dynamic drills to strengthen the lower limbs (Figure 1 ). 30 Figure 1 —The rehabilitation program to be followed by the injured
Daniel Martínez-Silván, Jaime Díaz-Ocejo and Andrew Murray
To analyze the influence of training exposure and the utility of self-report questionnaires on predicting overuse injuries in adolescent endurance athletes.
Five adolescent male endurance athletes (15.7 ± 1.4 y) from a full-time sports academy answered 2 questionnaires (Recovery Cue; RC-q and Oslo Sports Trauma Research questionnaire; OSTRC-q) on a weekly basis for 1 season (37 wk) to detect signs of overtraining and underrecovery (RC-q) and early symptoms of lower-limb injuries (OSTRC-q). All overuse injuries were retrospectively analyzed to detect which variations in the questionnaires in the weeks preceding injury were best associated. Overuse incidence rates were calculated based on training exposure.
Lower-limb overuse injuries accounted for 73% of total injuries. The incidence rate for overuse training-related injuries was 10 injuries/1000 h. Strong correlations were observed between individual running exposure and overuse injury incidence (r 2 = .66), number of overuse injuries (r 2 = .69), and days lost (r 2 = .66). A change of 20% or more in the RC-q score in the preceding week was associated with 67% of the lower-limb overuse injuries. Musculoskeletal symptoms were only detected in advance by the OSTRC-q in 27% of the episodes.
Training exposure (especially running exposure) was shown to be related to overuse injuries, suggesting that monitoring training load is a key factor for injury prevention. Worsening scores in the RC-q (but not the OSTRC) may be an indicator of overuse injury in adolescent endurance runners when used longitudinally.
Damien Moore, Tania Pizzari, Jodie McClelland and Adam I. Semciw
Context: Many different rehabilitation exercises have been recommended in the literature to target the gluteus medius (GMed) muscle based mainly on single-electrode, surface electromyography (EMG) measures. With the GMed consisting of 3 structurally and functionally independent segments, there is uncertainty on whether these exercises will target the individual segments effectively. Objective: To measure individual GMed segmental activity during 6 common, lower-limb rehabilitation exercises in healthy young adults, and determine if there are significant differences between the exercises for each segment. Method: With fine-wire EMG electrodes inserted into the anterior, middle, and posterior segments of the GMed muscle, 10 healthy young adults performed 6 common, lower-limb rehabilitation exercises. Main Outcome Measures: Recorded EMG activity was normalized, then reported and compared with median activity for each of the GMed segments across the 6 exercises. Results: For the anterior GMed segment, high activity was recorded for the single-leg squat (48% maximum voluntary isometric contraction [MVIC]), the single-leg bridge (44% MVIC), and the resisted hip abduction–extension exercise (41% MVIC). No exercises recorded high activity for the middle GMed segment, but for the posterior GMed segment very high activity was recorded by the resisted hip abduction–extension exercise (69% MVIC), and high activity was generated by the single-leg squat (48% MVIC) and side-lie hip abduction (43% MVIC). For each of the GMed segments, there were significant differences (P < .05) in the median EMG activity levels between some of the exercises and the side-lie clam with large effect sizes favoring these exercises over the side-lie clam. Conclusions: Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual GMed segments with selection dependent on individual requirements. However, the side-lie clam does not appear to be effective at recruiting the GMed segments, particularly the anterior and middle segments.
Tomomasa Nakamura, Yuriko Yoshida, Hiroshi Churei, Junya Aizawa, Kenji Hirohata, Takehiro Ohmi, Shunsuke Ohji, Toshiyuki Takahashi, Mitsuhiro Enomoto, Toshiaki Ueno and Kazuyoshi Yagishita
studies have demonstrated that voluntary teeth clenching facilitated the H-reflex in both the agonist and antagonist muscles of the lower limb, 5 – 9 suggesting that teeth clenching contributed to stabilization of body orientation by strengthening the skeletal muscles of the limb. There were also several
Mhairi K. MacLean and Daniel P. Ferris
One goal for developing robotic lower limb exoskeletons is human performance augmentation. Robotic exoskeletons that can enhance the performance of able-bodied humans serving as firefighters, military personnel, and/or construction workers could reduce injuries and improve worker efficiency. To be
Maintaining high levels of lower limb muscle strength/size is important to prevent and delay the onset of disability, physical frailty, and dependency. 1 – 3 It is generally accepted that the loss of skeletal muscle strength and size with increased age, sarcopenia, is greater in the lower limbs