Context: The lower quarter Y-Balance Test (YBT-LQ) is associated with injury risk; however, ankle range of motion impacts YBT-LQ. Arch height and foot sensation impact static balance, but these characteristics have not yet been evaluated relative to YBT-LQ. Objective: Determine if arch height index (AHI), forefoot sensation (SEN), and ankle dorsiflexion predict YBT-LQ composite score (CS). Design: Descriptive cohort. Setting: Athletic training laboratory. Participants: Twenty general population (14 females and 6 males; mean [SD]: age 35  y, weight 70.02 [16.76] kg, height 1.68 [0.12] m) participated in this study. Interventions: AHI measurement system assessed arch height in 10% (AHI10) and 90% (AHI90) weight-bearing. Two-point discrim-a-gon discs assessed sensation (SEN) at the plantar great toe, third and fifth metatarsal heads. Biplane goniometer and weight-bearing lunge tests were used to measure static and weight-bearing dorsiflexion, respectively. The YBT-LQ assessed dynamic single-leg balance. Results: For right-limb dynamic single-leg balance, AHI90 and SEN were included in the final sequential prediction equation; however, neither model significantly (P = .052 and .074) predicted variance in YBT-LQ CS. For left-limb dynamic single-leg balance, both SEN and weight-bearing lunge test were included in the final sequential prediction equation. The regression model (SEN and weight-bearing lunge test) significantly (P = .047) predicted 22% of the variance in YBT-LQ CS. Conclusions: This study demonstrates that foot characteristics may play a role in YBT-LQ CS. The authors did not assess limb dominance in this study; therefore, the authors are unable to determine which limb would be the stance versus kicking limb. However, altered SEN and weight-bearing dorsiflexion appear to be contributing factors to YBT-LQ CS.
Nicole J. Chimera and Mallorie Larson
Meghan Warren, Craig A. Smith and Nicole J. Chimera
The Functional Movement Screen (FMS) evaluates performance in 7 fundamental movement patterns using a 4-point scale. Previous studies have reported increased injury risk with a composite score (CS) of 14/21 or less; these studies were limited to specific sports and injury definition.
To examine the association between FMS CS and movement pattern scores and acute noncontact and overuse musculoskeletal injuries in division I college athletes. An exploratory objective was to assess the association between injury and FMS movement pattern asymmetry.
College athletic facilities.
167 injury-free, college basketball, football, volleyball, cross country, track and field, swimming/diving, soccer, golf, and tennis athletes (males = 89).
The FMS was administered during preparticipation examination.
Main Outcome Measure:
Noncontact or overuse injuries that required intervention from the athletic trainer during the sport season.
FMS CS was not different between those injured (n = 74; 14.3 ± 2.5) and those not (14.1 ± 2.4; P = .57). No point on the ROC curve maximized sensitivity and specificity; therefore previously published cut-point was used for analysis with injury (≤14 [n = 92]). After adjustment, no statistically significant association between FMS CS and injury (odds ratio [OR] = 1.01, 95% CI 0.53–1.91) existed. Lunge was the only movement pattern that was associated with injury; those scoring 2 were less likely to have an injury vs those who scored 3 (OR = 0.21, 95% CI 0.08–0.59). There was also no association between FMS movement pattern asymmetry and injury.
FMS CS, movement patterns, and asymmetry were poor predictors of noncontact and overuse injury in this cohort of division I athletes.
Marissa L. Mason, Marissa N. Clemons, Kaylyn B. LaBarre, Nicole R. Szymczak and Nicole J. Chimera
Clinical Scenario: Lower-extremity injuries in the United States costs millions of dollars each year. Athletes should be screened for neuromuscular deficits and trained to correct them. The tuck jump assessment (TJA) is a plyometric tool that can be used with athletes. Clinical Question: Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals? Summary of Key Findings: Four of the 5 articles included in this critically appraised topic showed good to excellent reliability; however, caution should be taken in interpreting these results. Although composite scores of the TJA were found to be reliable, individual flaws do not demonstrate reliability on their own, with the exception of knee valgus at landing. Aspects of the TJA itself, including rater training, scoring system, playback speed, volume, and number of views allotted, need to be standardized before the reliability of this clinical assessment can be further researched. Clinical Bottom Line: The TJA has shown varying levels of reliability, from poor to excellent, for both interrater and intrarater reliability, given current research. Strength of Recommendation: According to the Centre for Evidence Based Medicine levels of evidence, there is level 2b evidence for research into the reliability of the TJA. This evidence has been demonstrated in elite, adolescent, and college-level athletics in the United Kingdom, Spain, and the United States. The recommendation of level 2b was chosen because these studies utilized cohort design for interrater and intrarater reliability across populations. An overall grade of B was recommended because there were consistent level 2 studies.
Nicole J. Chimera, Monica R. Lininger and Meghan Warren
Clinical Question: Can text message be used for epidemiologic data collection and accurate injury reporting in recreational and club sport participation? Clinical Bottom Line: Text message may be advantageous for injury surveillance in recreational exercise and club sport participation. This novel method may provide a more complete understanding of injury rates as this tool allows for more immediate recall of injury exposures and incidences. Further, data suggest that injuries are reported more often via text message compared to those reported to health care personnel.
Nicole J. Chimera, Monica R. Lininger, Bethany Hudson, Christopher Kendall, Lindsay Plucknette, Timothy Szalkowski and Meghan Warren
A novel technique of short message service (SMS), or text message, has examined injuries in elite handball and female football and community Australian football with a response rate of over 75%. The purpose of this study was to determine if text message is a feasible method of prospectively collecting injury density data in club sports teams in the United States. Participants received a weekly text message with four questions asking about pain and participation in the past week. If the participant indicated pain in the past week, a follow-up phone interview was conducted to determine the nature of the pain/injury. The overall text message response rate was 89.8%; there were 281 responses out of 313 participant contacts over the 12-week study period. Semi-structured follow-up phone interviews were completed for 37 of the 55 reports of pain that were indicated through text message response, resulting in further injury information for 65.5% of injuries. Incidence density of reporting pain over the 12-week study was 0.88 (95% CI: 0.68–1.15) per 1,000 min of activity. In this sample, text message response rates were similar to previous studies; however, we did lose nine (25.7%) participants to follow-up.