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High Tibial Osteotomy to Correct Complications of a Proximal Tibial Salter-Harris I Fracture in an Adolescent Athlete
Matthew T. Sims and Aric J. Warren
Blood Flow Restriction Training Improves Muscular Outcomes in Patients With Chronic Ankle Instability: A Critically Appraised Topic
Jared Spencer, Cheyann Sales, and Aric J. Warren
Clinical Scenario: The high recurrence of lateral ankle sprains progresses to chronic ankle instability (CAI) and can affect many athletes in all sports. CAI is often associated with a decrease in muscle strength, an increase in pain, a decrease in the range of motion, and a decrease in balance or neuromuscular control. The use of blood flow restriction (BFR) with CAI can increase muscular outcomes and be used as a rehabilitation tool. Clinical Question: Is there evidence to suggest that BFR improves strength, muscle activation, and/or cross-sectional area of the lower leg musculature in those with CAI? Clinical Bottom Line: There is moderate evidence to support therapeutic exercise with low-intensity BFR in patients with CAI. The evidence concluded a significant improvement in BFR to increase muscle activation of the fibularis longus, anterior tibialis, vastus lateralis, and soleus. There is moderate evidence suggesting BFR can induce strength gains in the muscles of the lower extremity in patients with CAI. Strength of Recommendation: The comprehensive evidence is a Strength of Recommendation Taxonomy (SORT) Grade B, with a level of evidence of 2, according to the Centre for Evidence-Based Medicine (CEBM) for the studies included.
Does Blood Flow Restriction Training Improve Quadriceps Measures After Arthroscopic Knee Surgery? A Critically Appraised Topic
Erik H. Arve, Emily Madrak, and Aric J. Warren
Focused Clinical Question: Is there evidence to suggest that blood flow restriction (BFR) training improves strength, cross-sectional area, and thigh girth of the quadriceps musculature in patients after arthroscopic surgical procedures of the knee? Clinical Bottom Line: There is moderate consistent, but low-level, evidence supporting the use of BFR training to improve knee extensor muscular outcomes (strength, cross-sectional area, and/or thigh girth) immediately after arthroscopic knee surgery.
Compromised Vitamin D Status Negatively Affects Muscular Strength and Power of Collegiate Athletes
Rachel A. Hildebrand, Bridget Miller, Aric Warren, Deana Hildebrand, and Brenda J. Smith
Increasing evidence indicates that compromised vitamin D status, as indicated by serum 25-hydroxyvitamin D (25-OH D), is associated with decreased muscle function. The purpose of this study was to determine the vitamin D status of collegiate athletes residing in the southern U.S. and its effects on muscular strength and anaerobic power. Collegiate athletes (n = 103) from three separate NCAA athletic programs were recruited for the study. Anthropometrics, vitamin D and calcium intake, and sun exposure data were collected along with serum 25-OH D and physical performance measures (Vertical Jump Test, Shuttle Run Test, Triple Hop for Distance Test and the 1 Repetition Maximum Squat Test) to determine the influence of vitamin D status on muscular strength and anaerobic power. Approximately 68% of the study participants were vitamin D adequate (>75 nmol/L), whereas 23% were insufficient (75–50 nmol/L) and 9%, predominantly non-Caucasian athletes, were deficient (<50 nmol/L). Athletes who had lower vitamin D status had reduced performance scores (p < .01) with odds ratios of 0.85 on the Vertical Jump Test, 0.82 on the Shuttle Run Test, 0.28 on the Triple Hop for Distance Test, and 0.23 on the 1 RM Squat Test. These findings demonstrate that even NCAA athletes living in the southern US are at risk for vitamin D insufficiency and deficiency and that maintaining adequate vitamin D status may be important for these athletes to optimize their muscular strength and power.
Seasonal Changes of Body Mass, Body Composition, and Muscular Performance in Collegiate Wrestlers
Thomas W. Buford, Douglas B. Smith, Matthew S. O’Brien, Aric J. Warren, and Stephen J. Rossi
Purpose:
The purpose of the present investigation was to examine the physiological response of collegiate wrestlers to their competitive season.
Methods:
Eleven Division I collegiate wrestlers (mean ± SD; 19.45 ± 1.13 y) volunteered and completed 4 testing sessions throughout the course of the collegiate wrestling season. Testing sessions were conducted pre-, mid-, and postseason, as well as before the national tournament. Testing consisted of weigh-in, skinfold body composition testing, and a 50-rep concentric, isokinetic leg extension muscle endurance test (180°/s). Muscular performance variables measured included peak torque, peak torque at fatigue, percent decline, and peak torque/body mass ratio.
Results:
A significant increase (P < .05) of 2.9% was observed for body mass between midseason and postseason (2.38 kg). From pre- to postseason, a mean increase of 3.8% (3.1 kg) was observed for body mass. An increase (P < .05) in BF% of 2.9% was observed between prenationals and postseason. No significant differences (P > .05) were observed between consecutive time points for quadriceps peak torque; however, there was a significant increase (P < .05) between preseason and prenationals (23.39 N·m). Peak torque at fatigue was greater (P < .05) at midseason than preseason, representing an increase of 9.82 N·m. Between midseason and prenationals testing, we observed an 11% increase (P < .05) in %DCLN. Finally, we noted an increase (P < .05) from 0.6 to 0.69 in peak torque/body mass ratio between preseason and prenationals.
Conclusions:
Our results indicate that while force values seem to suffer at midseason, the wrestlers compensated and were strongest just before their national competition.
Dry Needling Compared With Manual Pressure Trigger Point Manual Therapy for Improving Pain in Patients Experiencing Myofascial Neck Pain: A Critically Appraised Topic
Alicea E. Taylor-Meza, Kelsey N. Bahe, Michael A. Trevino, Jennifer L. Volberding, and Aric J. Warren
Focused Clinical Question: What is the efficacy of dry needling (DN) compared to ischemic compression point therapy for improving pain and pain pressure threshold (PPT) in patients experiencing myofascial neck pain? Clinical Bottom Line: There is low-level evidence suggesting DN has the potential to elicit greater improvements in pain and PPT relief compared to ischemic compression techniques for individuals with myofascial neck pain.
