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Jailton Thulher do Rosario, Natalia Santos da Fonseca Martins, Carolina Carneiro Peixinho, and Liliam Fernandes Oliveira

This study aimed to determine the effects of a functional training and ankle stretching program in triceps surae torque, passive stiffness index, and in the risk for fall indicators in older adults. Twenty women (73.4 ± 7.3 years) were allocated into an intervention or control group. The 12-week intervention consisted of functional training and calf stretching exercises performed twice a week. Measurements of peak passive and active torque, passive stiffness, maximum dorsiflexion angle, and indexes of risk for falls (Timed Up and Go, functional reach test, QuickScreen-test) were collected. There were no significant differences for all variables, except the maximum dorsiflexion angle, which increased in the intervention group from 33.78 ± 8.57° to 38.89 ± 7.52°. The exercise program was not sufficient to enhance performance on functional tests and decrease the risk for falls in older adults. The significant increase in the maximum dorsiflexion indicates a positive impact of stretching exercises.

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Afshin Moghadasi, Gholamali Ghasemi, Ebrahim Sadeghi-Demneh, and Masoud Etemadifar

performing functional training, especially on unstable surfaces that are more challenging for the neuromuscular control. Functional training seems to have favorous effects for motor control, especially if these exercises are similar and within the context of targeted activities within the exercise therapy

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Erik A. Willis, Amanda N. Szabo-Reed, Lauren T. Ptomey, Jeffery J. Honas, Felicia L. Steger, Richard A. Washburn, and Joseph E. Donnelly

Recent fitness trends have moved toward programs described as high-intensity functional training (HIFT), such as Tabata, CrossFit, workout videos (ie, P90x, Insanity), and group-based exercise classes, which offer a greater variety of activities compared with traditional aerobic exercise and single

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Paul A. Borsa, Eric L. Sauers, and Scott M. Lephart

Functional training for the purpose of restoring dynamic joint stability has received considerable interest in recent years. Contemporary functional training programs are being designed to complement, rather than replace, traditional rehabilitation protocols. The purpose of this clinical commentary is to present a management strategy for restoring dynamic stability in the posterior cruciate ligament (PCL)-injured knee. The strategy presented integrates five key concepts: (a) planned variation of exercise, (b) outcomes-based assessment, (c) kinetic chain exercise, (d) proprioception and neuromuscular control, and (e) specificity of activity. Pertinent research findings and a clinical rationale are provided for using functional training in the restoration of dynamic stability in the PCL-injured knee.

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Kathleen A. Swanik, C. Buz Swanik, Scott M. Lephart, and Kellie Huxel

Objective:

To determine whether functional training reduces the incidence of shoulder pain and increases strength in intercollegiate swimmers.

Design:

Pretest–posttest.

Setting:

Laboratory and weight room.

Participants:

26 intercollegiate swimmers (13 men, 13 women).

Intervention:

6-wk functional training program.

Main Outcome Measures:

Incidence of shoulder pain was recorded throughout the study. Isokinetic shoulder strength was assessed before and after training.

Results:

A t test showed significant differences (P < .05) for the incidence of shoulder pain between the experimental (mean episodes = 1.8 ± 2.1) and control (mean episodes = 4.6 ± 4.7) groups. ANOVA with repeated measures revealed no significant strength differences between groups but exhibited significant within-group increases.

Conclusions:

Incorporating functional exercises might reduce incidence of shoulder pain in swimmers. The results also validate the need to modify preventive programs as the demands of the sport change throughout the season.

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Gina Sobrero, Scott Arnett, Mark Schafer, Whitley Stone, T. A. Tolbert, Amanda Salyer-Funk, Jason Crandall, Lauren B. Farley, Josh Brown, Scott Lyons, Travis Esslinger, Keri Esslinger, and Jill Maples

High intensity functional training (HIFT) emphasizes constantly varied, high intensity, functional activity by programming strength and conditioning exercises, gymnastics, Olympic weightlifting, and specialty movements. Conversely, traditional circuit training (TCT) programs aim to improve muscular fitness by utilizing the progressive overload principle, similar movements weekly, and specified work-to-rest ratios. The purpose of this investigation was to determine if differences exist in health and performance measures in women participating in HIFT or TCT after a six-week training program. Recreationally active women were randomly assigned to a HIFT (n = 8, age 26.0 + 7.3 yrs) or TCT (n = 11, age 26.3 + 9.6 yrs) group. Participants trained three days a week for six weeks with certified trainers. Investigators examined body composition (BC), aerobic and anaerobic capacity, muscular strength, endurance, flexibility, power, and agility. Repeated-measures ANOVA were used for statistical analyses with an alpha level of 0.05. Both groups increased body mass (p = .011), and improved muscular endurance (p < .000), upper body strength (p = .007), lower body power (p = .029) and agility (p = .003). In addition, the HIFT group decreased body fat (BF) %, while the TCT group increased BF% (p = .011). No changes were observed in aerobic or anaerobic capacity, flexibility, upper body power, or lower body stair climbing power. Newer, high intensity functional exercise programs such as HIFT may have better results on BC and similar effects when compared with TCT programs on health and fitness variables such as musculoskeletal strength and performance.

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Chelsey Klimek, Christopher Ashbeck, Alexander J. Brook, and Chris Durall

Clinical Scenario: CrossFit is a form of exercise that incorporates rapid and successive high-intensity ballistic movements. As CrossFit is an increasingly popular fitness option, it is important to determine how rates of injury compare to more traditional forms of exercise. This review was conducted to ascertain the incidence of injury with CrossFit relative to other forms of exercise. Focused Clinical Question: Are injuries more common with CrossFit training than other forms of exercise? Summary of Key Findings: (1) The literature was searched for studies that compared injury rates among individuals who participated in CrossFit fitness programs to participants in other exercise programs. (2) The search initially yielded >100 results, which were narrowed down to 3 level 2b retrospective cohort studies that were deemed to have met inclusion/exclusion criteria. (3) In all 3 reviewed studies, the reported incidences of injuries associated with CrossFit training programs were comparable or lower than rates of injury in Olympic weightlifting, distance running, track and field, rugby, or gymnastics. Clinical Bottom Line: Current evidence suggests that the injury risk from CrossFit training is comparable to Olympic weightlifting, distance running, track and field, rugby, football, ice hockey, soccer, or gymnastics. Injuries to the shoulder(s) appear to be somewhat common with CrossFit. However, the certitude of these conclusions is questionable given the lack of randomization, control, or uniform training in the reviewed studies. Clinicians should be aware that injury is more prevalent in cases where supervision is not always available to athletes. This is more often the case for male participants who may not actively seek supervision during CrossFit exercise. Strength of Recommendation: Level 2b evidence from 3 retrospective cohort studies indicates that the risk of injury from participation in CrossFit is comparable to or lower than some common forms of exercise or strength training.

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Jinger S. Gottschall, Bryce Hastings, and Zachary Becker

-ups. Thus, closed chain exercises may be preferred for functional training. Beginning with our first hypothesis focused on the comparison between closed and open chain exercises, anterior deltoid activity was significantly greater during the narrow and middle hand position bench press than a push-up at the

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Ricardo Augusto Silva de Souza, André Guedes da Silva, Magda Ferreira de Souza, Liliana Kataryne Ferreira Souza, Hamilton Roschel, Sandro Fernandes da Silva, and Bryan Saunders

CrossFit ® is one of the fastest growing high-intensity functional training methods in the world, consisting of daily workouts commonly termed “workout of the day” (WODs; Glassman, 2007 ). These WODs focus on functional movements with numerous variations, implementing a unique blend of gymnastics

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Hooman Minoonejad, Mohammad Karimizadeh Ardakani, Reza Rajabi, Erik A. Wikstrom, and Ali Sharifnezhad

Context: Neuromuscular control deficit has been reported in people with chronic ankle instability (CAI) and hopping exercises have been recommended as a functional training tool to prevent lower limb injury, but its effects on lower-extremity neuromuscular control in those with CAI are unclear. Objective: To investigate the effect of hop stabilization training on neuromuscular control and self-reported function in college basketball players with CAI. Study Design: A randomized controlled trial. Setting: Research Laboratory. Patients (or Other Participants): A total of 28 college basketball players with CAI were randomly assigned to the experimental hop stabilization group (age = 22.78 [3.09] y, weight = 82.59 [9.51] kg, and height = 187.96 [7.93] cm) or the control group (age = 22.57 [2.76] y, weight = 78.35 [7.02] kg, and height = 185.69 [7.28] cm). Intervention: Participants in the experimental group performed supervised hop stabilization exercises 3 times per week for 6 weeks. The control group received no intervention. Main Outcome Measures: Preparatory and reactive muscle activation levels and muscle onset time were assessed from 8 lower-extremity muscles during a jump-landing task before and after the 6-week training program. Results: Significant improvements in preparatory muscle activation, reactive muscle activation, and muscle onset time were noted across the lower-extremity in the experimental group relative to the control group (P < .05). Self-reported function also improved in the experimental group relative to the control group (P < .05). Conclusions: These findings demonstrate that 6 weeks of hop stabilization training is effective in improving neuromuscular control and self-reported function in college basketball players with CAI. Hop stabilization exercises can be incorporated into the rehabilitation program for CAI.