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Giampietro L. Vairo, Nicole M. McBrier, Sayers John Miller and William E. Buckley

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Elaine Leonezi Guimarães, Andréa Baraldi Cunha, Daniele de Almeida Soares and Eloisa Tudella

The aim of this systematic literature review was to examine and discuss studies that investigated reaching in preterm infants during the first year of life. Databases were searched using keywords such as reaching, grasping, preterm, and premature, in addition to specific terms from the Medical Subject Headings (MeSH) (motor skills, infant, movement, premature birth, hands) regardless of year of publication. One hundred thirty-five studies were identified, 9 of which were selected. The results showed that preterm infants adopt strategies (bimanual reaches and reaches with less rectilinear trajectories toward an object in motion, reaches with semi-open and open hand, reaches at lower speeds, with increased movement units, and variable postural muscle activity) compared with full-term infants. However, the results on how intrinsic factors (e.g., prematurity) and extrinsic factors (e.g., body position, physical properties of the object) influence early reaching are still limited.

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Monika Grygorowicz, Martyna Michałowska, Paulina Jurga, Tomasz Piontek, Honorata Jakubowska and Tomasz Kotwicki

girls quitting football prematurely. Thus, this study was designed to analyze what are the main causes that make female players quit playing football. The aim of the study was to find the reasons for sports career termination in female football players in country-specific conditions. We hypothesize that

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Ian J. Dempsey, Grant E. Norte, Matthew Hall, John Goetschius, Lindsay V. Slater, Jourdan M. Cancienne, Brian C. Werner, David R. Diduch and Joseph M. Hart

with respect to the contralateral limb. However, this finding is somewhat counterintuitive when considering return-to-sport status and may suggest that patients are returning to activity prematurely or that patients who return to their preinjury activity level are not doing so because of strength alone

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Stephanie L. Di Stasi, Erin H. Hartigan and Lynn Snyder-Mackler

Aberrant movement strategies are characteristic of ACL-deficient athletes with recurrent knee instability (non-copers), and may instigate premature or accelerate joint degradation. Biomechanical evaluation of kinematic changes over time may elucidate noncopers’ responses to neuromuscular intervention and ACL reconstruction (ACLR). Forty noncopers were randomized into a perturbation group or a strength training only group. We evaluated the effects of perturbation training, and then gender on knee angle and tibial position during a unilateral standing task before and after ACLR. No statistically significant interactions were found. Before surgery, the strength training only group demonstrated knee angle asymmetry, but 6 months after ACLR, both groups presented with similar knee flexion between limbs. Aberrant and asymmetrical tibial position was found only in females following injury and ACLR. Neither treatment group showed distinct unilateral standing strategies following intervention; however, males and female noncopers appear to respond uniquely to physical therapy and surgery.

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Steven J. Elmer, John McDaniel and James C. Martin

One-legged cycling has served as a valuable research tool and as a training and rehabilitation modality. Biomechanics of onelegged cycling are unnatural because the individual must actively lift the leg during flexion, which can be difficult to coordinate and cause premature fatigue. We compared ankle, knee, and hip biomechanics between two-legged, one-legged, and counterweighted (11.64 kg) one-legged cycling. Ten cyclists performed two-legged (240 W), one-legged (120 W), and counterweighted one-legged (120 W) cycling (80 rpm). Pedal forces and limb kinematics were recorded to determine work during extension and flexion. During counterweighted one-legged cycling relative ankle dorsiflexion, knee flexion, and hip flexion work were less than one-legged but greater than two-legged cycling (all P < .05). Relative ankle plantar flexion and hip extension work for counterweighted one-legged cycling were greater than one-legged but less than two-legged cycling (all P < .05). Relative knee extension work did not differ across conditions. Counterweighted one-legged cycling reduced but did not eliminate differences in joint flexion and extension actions between one- and two-legged cycling. Even with these differences, counterweighted one-legged cycling seemed to have advantages over one-legged cycling. These results, along with previous work highlighting physiological characteristics and training adaptations to counterweighted one-legged cycling, demonstrate that this exercise is a viable alternative to one-legged cycling.

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Matthew S. Tenan, Andrew J. Tweedell and Courtney A. Haynes

The onset of muscle activity, as measured by electromyography (EMG), is a commonly applied metric in biomechanics. Intramuscular EMG is often used to examine deep musculature and there are currently no studies examining the effectiveness of algorithms for intramuscular EMG onset. The present study examines standard surface EMG onset algorithms (linear envelope, Teager-Kaiser Energy Operator, and sample entropy) and novel algorithms (time series mean-variance analysis, sequential/batch processing with parametric and nonparametric methods, and Bayesian changepoint analysis). Thirteen male and 5 female subjects had intramuscular EMG collected during isolated biceps brachii and vastus lateralis contractions, resulting in 103 trials. EMG onset was visually determined twice by 3 blinded reviewers. Since the reliability of visual onset was high (ICC(1,1): 0.92), the mean of the 6 visual assessments was contrasted with the algorithmic approaches. Poorly performing algorithms were stepwise eliminated via (1) root mean square error analysis, (2) algorithm failure to identify onset/premature onset, (3) linear regression analysis, and (4) Bland-Altman plots. The top performing algorithms were all based on Bayesian changepoint analysis of rectified EMG and were statistically indistinguishable from visual analysis. Bayesian changepoint analysis has the potential to produce more reliable, accurate, and objective intramuscular EMG onset results than standard methodologies.

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Lynne Halley Johnston and Douglas Carroll

This study used grounded theory to describe the emotional responses of athletes following injury and their situational and temporal contexts. Sixteen seriously injured athletes were interviewed. The NUD*IST (Nonnumerical Unstructured Data Indexing Searching and Theorizing) computer program was used to search, store, explore, and organize the qualitative material. The main emotional responses, appraisals, events, and behaviors that emerged from the analysis were represented diagrammatically. Frustration and depression were the prevalent emotional responses throughout rehabilitation, although the situational corollaries differed as recovery progressed. In the early phase of rehabilitation, frustration and depression resulted from disruption to normal function, in the middle phase they were provoked by a negative appraisal of rehabilitation progress, and. at the end of rehabilitation the main instigator was impatience to return to sport. Whether to risk returning prematurely to sport emerged as a key theme, as did the confounding effects of exercise withdrawal. symptoms in extremely committed athletes. The results were considered in terms of both cognitive appraisal and risk models.

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Robert L. Sainburg

The purpose of this commentary is to discuss factors that limit consideration of the equilibrium point hypothesis as a scientific theory. The EPH describes control of motor neuron threshold through the variable lambda, which corresponds to a unique referent configuration for a muscle, joint, or combination of joints. One of the most compelling features of the equilibrium point hypothesis is the integration of posture and movement control into a single mechanism. While the essential core of the hypothesis is based upon spinal circuitry interacting with peripheral mechanics, the proponents have extended the theory to include the higher-level processes that generate lambda, and in doing so, imposed an injunction against the supraspinal nervous system modeling, computing, or predicting dynamics. This limitation contradicts evidence that humans take account of body and environmental dynamics in motor selection, motor control, and motor adaptation processes. A number of unresolved limitations to the EPH have been debated in the literature for many years, including whether muscle resistance to displacement, measured during movement, is adequate to support this form of control, violations in equifinality predictions, spinal circuits that alter the proposed invariant characteristic for muscles, and limitations in the description of how the complexity of spinal circuitry might be integrated to yield a unique and stable equilibrium position for a given motor neuron threshold. In addition, an important empirical limitation of EPH is the measurement of the invariant characteristic, which needs to be done under a constant central state. While there is no question that the EPH is an elegant and generative hypothesis for motor control research, the claim that this hypothesis has reached the status of a scientific theory is premature.

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Enda F. Whyte, Nicola Gibbons, Grainne Kerr and Kieran A. Moran

Context: Determination of return to play (RTP) after sport-related concussion (SRC) is critical given the potential consequences of premature RTP. Current RTP guidelines may not identify persistent exercise-induced neurocognitive deficits in asymptomatic athletes after SRC. Therefore, postexercise neurocognitive testing has been recommended to further inform RTP determination. To implement this recommendation, the effect of exercise on neurocognitive function in healthy athletes should be understood. Objective: To examine the acute effects of a high-intensity intermittent-exercise protocol (HIIP) on neurocognitive function assessed by the Symbol Digits Modality Test (SDMT) and Stroop Interference Test. Design: Cohort study. Setting: University laboratory. Participants 40 healthy male athletes (age 21.25 ± 1.29 y, education 16.95 ± 1.37 y). Intervention: Each participant completed the SDMT and Stroop Interference Test at baseline and after random allocation to a condition (HIIP vs control). A mixed between-within-subjects ANOVA assessed time- (pre- vs postcondition) -by-condition interaction effects. Main Outcome Measures: SDMT and Stroop Interference Test scores. Results: There was a significant time-by-condition interaction effect (P < .001, η 2 = .364) for the Stroop Interference Test scores, indicating that the HIIP group scored significantly lower (56.05 ± 9.34) postcondition than the control group (66.39 ± 19.6). There was no significant time-by-condition effect (P = .997, η 2 < .001) for the SDMT, indicating that there was no difference between SDMT scores for the HIIP and control groups (59.95 ± 10.7 vs 58.56 ± 14.02). Conclusions: In healthy athletes, the HIIP results in a reduction in neurocognitive function as assessed by the Stroop Interference Test, with no effect on function as assessed by the SDMT. Testing should also be considered after high-intensity exercise in determining RTP decisions for athletes after SRC in conjunction with the existing recommended RTP protocol. These results may provide an initial reference point for future research investigating the effects of an HIIP on the neurocognitive function of athletes recovering from SRC.