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Kelly Cheever, Jeffrey T. Howard and Keisuke Kawata

to long-term changes in cervical spine sensorimotor function following contact sport exposure. 23 , 25 However, whether, and to what extent, CJPET can detect neuromuscular deficits following an acute bout of subconcussive impacts remains unexplored. Laboratory instrumented soccer headers have been

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Steven M. Davi, Colleen K. Woxholdt, Justin L. Rush, Adam S. Lepley and Lindsey K. Lepley

; CAR, central activation ratio; SampEn, sample entropy; VL, vastus lateralis; VM, vastus medialis. Discussion The purpose of our study was to apply SampEn analyses to quadriceps EMG activity in order to more comprehensively characterize neuromuscular deficits after ACLR. The major advantage of over

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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.

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Michelle M. McLeod, Phillip Gribble, Kate R. Pfile and Brian G. Pietrosimone


Arthroscopic partial meniscectomy (APM) after meniscal tear has been widely accepted and associated with quick return to activity. Unfortunately, meniscectomy is associated with risk for knee osteoarthritis, which may be attributed to postsurgical quadriceps weakness. This has important implications, as the quadriceps play a prominent role in knee stabilization and energy attenuation in the lower extremity.


To determine the magnitude of interlimb quadriceps strength deficits in people with unilateral APM by systematically reviewing the current literature.

Evidence Acquisition:

The Web of Knowledge databases were searched on September 22, 2010, using terms meniscus OR meniscectomy AND quadriceps strength OR quadriceps weakness. Included articles were written in English, reporting means and SDs of isokinetic peak torque at 60° and 180°/s for both limbs.

Evidence Synthesis:

Four articles were included in the final analysis. Effect sizes and 95% confidence intervals (CI) were calculated between limbs for periods less than 1 mo, 1–3 mo, 3–6 mo, and more than 6 mo.


Homogeneous effect sizes indicate quadriceps weakness in the involved limb. Effects were strong at less than 1 mo (d = −1.01 to −1.62), while weak to strong effects were found for 1–3 mo (d = −0.40 to −8.04) and 3–6 mo (d = −0.40 to −5.11). Weak effects were found at more than 6 mo (d = −0.30 to −0.37). Definitive effects with a CI not crossing zero were found in 65% of the data. Although APM patients return to function within weeks after surgery, prolonged quadriceps strength deficits may increase the risk of knee-joint degeneration. Furthermore, evidence of bilateral dysfunction after unilateral injury may suggest that neuromuscular deficits post-APM are greater than the interlimb differences found in this review. Further research should be conducted to determine the nature of strength deficits and the best methods for restoring strength after APM.

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Azahara Fort-Vanmeerhaeghe, Ariadna Benet, Sergi Mirada, Alicia M. Montalvo and Gregory D. Myer

. The tuck jump assessment (TJA) 14 – 16 is a user-friendly clinical tool that evaluates neuromuscular deficits and identifies landing technique flaws during a repetitive plyometric activity. 17 This test consists of continuous maximal height tuck jumps for 10 seconds and involves the analysis of 10

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Daniel Hamacher, Dennis Hamacher, Roy Müller, Lutz Schega and Astrid Zech

( 5 ), 1158 – 1165 . doi:10.1016/j.clinph.2008.01.020 10.1016/j.clinph.2008.01.020 Singh , N. B. , Konig , N. , Arampatzis , A. , Heller , M. O. , & Taylor , W. R. ( 2012 ). Extreme levels of noise constitute a key neuromuscular deficit in the elderly . PLoS ONE, 7 ( 11 ), 48449

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Erik A. Wikstrom, Sajad Bagherian, Gary Allen and Kyeongtak Song

impaired in patients with CAI compared to uninjured healthy individuals, especially during dynamic tasks. 2 This seems to be due to proprioceptive and neuromuscular deficits in the injured ankle. 3 Further, decreased postural control is a risk factor for recurrent ankle sprains as it is a quantifiable

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Mary Lynn Manduca and Stephen J. Straub

demands associated with such sports. 3 , 4 Despite its prevalence, a universal treatment plan has yet to be established, but typically involves conservative treatment addressing strength, flexibility, and neuromuscular deficits as well as potential risk factors for hamstring injury through price

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Karinna Sonálya Aires da Costa, Daniel Tezoni Borges, Liane de Brito Macedo, Caio Alano de Almeida Lins and Jamilson Simões Brasileiro

implications for the clinic, since these patients will have numerous neuromuscular deficits, both from the injury and the surgical procedure, as well as the postoperative rehabilitation process. References 1. Majewski M , Susanne H , Klaus S . Epidemiology of athletic knee injuries: a 10-year study

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Hong-Wen Wu, Cheng-Feng Tsai, Kai-Han Liang and Yi-Wen Chang

could be recommended from squat to lunge based on sequential activation level. References 1. Fagan V , Delahunt E . Patellofemoral pain syndrome—a review on the associated neuromuscular deficits and current treatment options . Br J Sports Med . 2008 ; 42 : 789 – 795 . PubMed ID: 18424487 doi:10