Physical fitness profile of a large urban fire department: Exploring age and rank dynamics.

BACKGROUND: Firefighter physical fitness (PF) plays a crucial role in mitigating health issues and supporting occupational performance. The influence of rank on firefighter PF remains understudied and previous research is often limited by small sample sizes of firefighters volunteering for research studies, potentially biasing results towards fitter firefighters not representative of entire departments. OBJECTIVE: To examine the PF profile of firefighters in a large urban fire department and the influence of age and rank on PF. METHODS: Data, including muscular fitness, estimated aerobic capacity (VO2max), and body fat percentage (BF%) measures from 1361 firefighters (90% male; age: 37.4±10.1yrs; 60 recruits, 973 firefighters, 290 lieutenants/captains, 38 chiefs) were analyzed. Correlation and ANCOVAs were conducted to examine the impact of rank on PF while controlling for age. Score distributions were scrutinized to profile the PF of the department. RESULTS: Age was negatively associated with pull-ups (r = - 0.39), sit-ups (r = - 0.39), and push-ups (r = - 0.32), but positively associated with relative VO2max (r = 0.17) and BF% (r = 0.39). Rank had a statistically significant, but trivial effect size, on pull-ups (p = 0.028, η2 = 0.007) and sit-ups (p = 0.034, η2 = 0.005). Firefighters with lower PF levels were older, had higher BF%, lower fat-free mass, and were a greater proportion of females. CONCLUSIONS: Firefighters exhibited diverse levels of PF. Age, not rank, appeared to influence firefighters' PF. The findings that firefighters who were older, female, with poorer body composition are more likely to have lower PF levels highlights the need for individualized PF training to enhance occupational performance and health across the fire department.

The Nature of Rehabilitation Programs to Improve Musculoskeletal, Biomechanical, Functional, and Patient-Reported Outcomes in Athletes With ACL Reconstruction: A Scoping Review.

CONTEXT: After anterior cruciate ligament (ACL) reconstruction (ACLR), athletes commonly undergo prolonged rehabilitation (eg, 9-12 months), but few actually return to preinjury sports activities. The nature (composition, configuration) of an ACL rehabilitation program (ACL-RP) is an important factor in determining rehabilitation outcomes; however, details about the nature of ACL-RPs are reported inconsistently in research studies. To guide future research reporting to support clinical translation and implementation of ACL-RPs, it is necessary to describe the nature, reporting, and outcomes of ACL-RPs in the current literature. OBJECTIVE: The purpose of this scoping review was to understand the nature and reporting of various ACL-RPs that address musculoskeletal, biomechanical, functional, or patient-reported outcome measures in adult and pediatric athletes with ACLR. DATA SOURCES: Articles were selected from searches in 5 electronic databases (PubMed, EbscoHost [MEDLINE, SportDiscus, CINAHL Plus], PROQuest, Cochrane, and Embase). STUDY SELECTION: Studies were included if they evaluated a post-ACL-RP that implemented strength, balance, plyometric, change of direction running, and/or agility running and included self-reported physical function, quality of life, or pain outcomes. STUDY DESIGN: Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Data were extracted and synthesized to evaluate the reporting of acute program variables (APVs) and exercise descriptors (EDs); 17 studies were included in the final synthesis. RESULTS: Studies reported between 0% and 67% of the APVs and EDs combined. Only 2 studies were considered to have adequate reporting of both APVs and EDs. CONCLUSION: Inadequate reporting of APVs and EDs in past studies restricts the translation and implementation of existing research-based ACL-RPs to present-day clinical contexts.

Test-retest reliability of quantitative sensory testing, active joint position sense, and functional hop testing in amateur adult athletes with unilateral anterior cruciate ligament reconstruction.

OBJECTIVES: The somatosensory system fulfils a critical role in functional knee joint stability (FKJS) by providing afferent feedback necessary for neuromuscular control. Individuals with anterior cruciate ligament reconstruction (ACLr) have altered somatosensory function. Somatosensory characteristics are assessed by proprioception and quantitative sensory testing. The purpose of the study was to examine intra-rater and inter-rater reliability of methods used to assess somatosensory characteristics and FKJS in amateur adult athletes with unilateral ACLr. DESIGN: Repeated measures. SETTING: University. PARTICIPANTS: 8 female, 4 male with unilateral autogenous ACLr. MAIN OUTCOME MEASURES: Bilateral measurements at 5 lower extremity locations and the anterior forearm: light touch (LT), vibration sense (VS), pressure pain threshold (PPT); knee active joint position sense (AJPS); adapted crossover hop for distance (ACHD). Intraclass correlation coefficients (ICC) determined reliability, defined as: poor (<0.50), moderate (0.50-0.75), good (0.75-0.90). RESULTS: ACLr-side intra-rater/inter-rater ICCs ranged: LT, -0.27-0.80/-0.01-0.84; VS, 0.12-0.90/0.25-0.90; PPT, 0.49-0.98/0.86-0.99; AJPS, 0.15-0.79/0.55-0.87; ACHD, 0.98/0.99. Uninjured-side intra-rater/inter-rater ICCs ranged: LT, 0.12-0.66/-0.09-0.64; VS, 0.35-0.89/0.05-0.81; PPT, 0.65-0.99/0.45-0.95; AJPS, 0.07-0.81/0.37-0.99; ACHD, 0.99/0.98. CONCLUSIONS: Intra-rater and inter-rater reliability was poor to good for both limbs. Overall, PPT and the ACHD demonstrated the highest ICCs. Some somatosensory assessments can be employed with confidence, while others should be used with caution.

Sex differences in knee extensor torque control.

There is currently equivocal evidence regarding sex-related differences in measures of muscle force and torque control. To that end, we investigated sex differences in knee extensor muscle torque control, using both magnitude- and complexity-based measures, across contraction intensities typical of activities of daily living. 50 participants (25 male, median age [and interquartile range] 23.0 [20.0-33.0]; 25 female, median age [and interquartile range] 21.0 [20.0-40.5]) performed a series of intermittent isometric knee extensor contractions at 10, 20 and 40% maximal voluntary contraction (MVC). Torque was measured in N·m and torque control was quantified according to the magnitude (standard deviation [SD], coefficient of variation [CV]) and complexity (approximate entropy [ApEn], detrended fluctuation analysis [DFA] α) of torque fluctuations. Males exhibited a significantly greater absolute magnitude (i.e., SD) of knee extensor torque fluctuations during contractions at 10% (P = 0.011), 20% (P = 0.002) and 40% MVC (P = 0.003), though no sex differences were evident when fluctuations were normalised to mean torque output (i.e., CV). Males exhibited significantly lower ApEn during contractions at 10% (P = 0.002) and 20% MVC (P = 0.024) and significantly greater DFA α during contractions at 10% (P = 0.003) and 20% MVC (P = 0.001). These data suggest sex differences in muscle torque control strategies and highlight the need to consider both the magnitude and complexity of torque fluctuations when examining sex differences in muscle force control.

Measuring complexity of muscle force control: Theoretical principles and clinical relevance in musculoskeletal research and practice.

Musculoskeletal conditions affect bones, joints, and muscles of the locomotor system and are a leading cause of disability worldwide. This suggests that current musculoskeletal rehabilitation techniques fail to target the characteristics (e.g., physiological/physical/psychological) most influential for long-term musculoskeletal health. To identify whether a physiological characteristic is impaired, it must be measured. In neuromuscular control, traditional research approaches use magnitude-based measurements (e.g., peak force/standard deviation of force/coefficient of variation of force). However, magnitude-based measurements miss 'hidden information' regarding a physiological system's status across time. To better identify physiological characteristics that are clinically-important for long-term musculoskeletal health, other measurement approaches currently less applied in musculoskeletal research may be helpful. The purpose of this article is to present an introduction to technical and measurement principles for quantifying the 'complexity' of muscle force control as one representation of peripheral joint neuromuscular control. Complexity measurements are time-based and consider the irregular temporal structure of physiological signals. We review theoretical principles underlying measuring complexity of muscle force control and explain its clinical relevance for musculoskeletal scientists and clinicians. The principles include sensorimotor control of peripheral joints, muscle force signal construction and features, muscle force control measurement procedures, and variability and complexity variables. We propose the potential utility of measuring the complexity of muscle force control for diagnosing sensorimotor system impairment and prognosis following musculoskeletal disease or injury. This article will serve as an educational asset and a scientific resource that will inform future research directions to optimise rehabilitation for people with peripheral joint disease and injury.

The feasibility, safety, and efficacy of lower limb garment-integrated blood flow restriction training in healthy adults.

OBJECTIVES: Explore the feasibility of lower-limb garment-integrated BFR-training. DESIGN: Observational study. SETTING: Human performance laboratory. PARTICIPANTS: Healthy males with no experience of BFR-training. MAIN OUTCOME MEASURES: Feasibility was determined by a priori thresholds for recruitment, adherence, and data collection. Safety was determined by measuring BFR torniquet pressure and the incidence of side effects. Efficacy was determined by measuring body anthropometry and knee isokinetic dynamometry. Feasibility and safety outcomes were reported descriptively or as a proportion with 95% confidence intervals (95% CI), with mean change, 95% CIs, and effect sizes for efficacy outcomes. RESULTS: Twelve participants (mean age 24.8 years [6.5]) were successfully recruited; 11 completed the study. 134/136 sessions were completed (adherence = 98.5%) and 100% of data were collected. There was one event of excessive pain during exercise (0.7%, 95% CI 0.0%, 4.0%), two events of excessive pain post-exercise (1.5%, 95% CI 0.4%, 5.5%), and one event of persistent paraesthesia post-exercise (0.7%, 95% CI 0.0%, 4.0%). Mean maximal BFR torniquet pressure was <200 mmHg. We observed an increase in knee extension peak torque (mean change 12.4 Nm), but no notable changes in body anthropometry. CONCLUSIONS: Lower-limb garment-integrated BFR-training is feasible, has no signal of important harm, and could be used independently.

A cross-sectional retrospective survey of injury situation and prevalence in female recreational netball players with a focus on knee injuries.

OBJECTIVES: To examine situations of injury and injury prevalence in female adult recreational netball players with a focus on knee injuries. DESIGN: Cross sectional retrospective online survey. PARTICIPANTS: 193 female adult recreational netball players. MAIN OUTCOME MEASURES: Any injury sustained in the previous 12 months, situation of injury, any knee injuries sustained in the previous five years, the length of time unable to play netball, and knee injury management. RESULTS: In the previous 12 months, 61% of respondents sustained injury to the lower limb, and 27% to the upper limb. Lower limb injury situations were mostly landings (46%). Upper limb injury situations were mostly collisions with an opponent (27%). 46% reported sustaining a knee injury in the previous five years. Following knee injury, players were unable to play netball for 6.8 ± 7.0 months (training); and 8.2 ± 7.4 months (matches) respectively. CONCLUSIONS: Lower limb injury is more common than upper limb injury in recreational adult female adult netball players. Landing was the most common situation of injury for the lower limb including knee injuries. In the previous five years, nearly half of the players had sustained a knee injury resulting in more than six months out of the game.

Alterations in peripheral joint muscle force control in adults with musculoskeletal disease, injury, surgery, or arthroplasty: A systematic review and meta-analysis.

PURPOSE: To systematically review and analyse whether musculoskeletal conditions affect peripheral joint muscle force control (i.e. magnitude and/or complexity of force fluctuations). METHODS: A literature search was conducted using MEDLINE, CINAHL and SPORTDiscus databases (from inception-8th April 2021) for studies involving: 1) participants with musculoskeletal disease, injury, surgery, or arthroplasty in the peripheral joints of the upper/lower limb; 2) comparison with an unaffected control group or unaffected contralateral limb; and 3) measures of the magnitude and/or complexity of force fluctuations during targeted isometric contractions. The methodological quality of studies was evaluated using a modified Downs and Black Quality Index. Studies were combined using the standardized mean difference (SMD) in a random-effects model. RESULTS: 14 studies (investigating 694 participants) were included in the meta-analysis. There was a significant effect of musculoskeletal conditions on peripheral joint muscle force coefficient of variation (CV; SMD = 0.19 [95 % CI 0.06, 0.32]), whereby individuals with musculoskeletal conditions exhibited greater CV than controls. Subgroup analyses revealed that CV was only greater: 1) when comparison was made between symptomatic and asymptomatic individuals (rather than between affected and contralateral limbs; SMD = 0.22 [95 % CI 0.07, 0.38]); 2) for conditions of the knee (SMD = 0.29 [95 % CI 0.14, 0.44]); and 3) for ACL injury post-surgery (SMD = 0.56 [95 % CI 0.36, 0.75]). CONCLUSION: Musculoskeletal conditions result in an increase in peripheral joint muscle force CV, with this effect dependent on study design, peripheral joint, and surgical status. The greater force CV is indicative of decreased force steadiness and could have implications for long-term tissue health/day-to-day function.

Sex Differences in Pre-Season Anthropometric, Balance and Range-of-Motion Characteristics in Elite Youth Soccer Players.

In soccer, injury epidemiology differs between males and females. It is clinically useful to know whether there are between-sex differences in selected characteristics relevant to primary injury risk and injury prevention practices. The purpose of this study was to explore between-sex differences in anthropometric, balance, and range-of-motion characteristics in Spanish elite male and female youth soccer players. This was a pre-season cross-sectional study. Sixty-nine males (age 16.8 ± 0.9 yr; height 175.9 ± 6.8 cm; mass 67.9 ± 6.3 kg) and thirty-seven females (age 17.2 ± 1.7 yr; height 164.0 ± 6.3 cm; mass 59.0 ± 5.8 kg) participated. Anthropometrics (standing/sitting height, bodymass, right/left leg length) and right/left anterior reach test (ART), hip internal/external active range of motion, active knee extension (AKE), and weightbearing lunge test (WBLT) were measured. Between-sex differences were assessed with Bonferroni-corrected Mann−Whitney U tests and Cliff's delta (d). Between-sex significant differences (p < 0.003, d ≥ 0.50) were observed for anthropometric data and for hip internal rotation. No between-sex significant differences were observed for ART/AKE/WBLT measures. Between-sex significant differences with large effect sizes were identified for anthropometric data and right/left hip internal rotation. The present study adds new data to the literature for young Spanish male and female soccer players. The present findings will help inform clinical reasoning processes and future injury prevention research for elite male and female youth soccer players.

Specificity of isokinetic assessment in noncontact knee injury prevention screening: A novel assessment procedure with relationships between variables in amateur adult agility-sport athletes.

OBJECTIVES: To present a new knee isokinetic assessment procedure linked to noncontact knee injury mechanisms and examine correlations between variables relevant to noncontact knee injury prevention screening (peak torque [PT, Nm], time-to-peak torque [TTPT, ms], angle-of-peak torque [APT, °], mean PT [MPT, Nm]). DESIGN: Cross-sectional. SETTING: Sports medicine laboratory. PARTICIPANTS: Thirty-four agility-sport athletes (male/female n = 18/16, age 24.1 ± 3.5yr, height 171.8 ± 9.6 cm, mass 70.6 ± 12 kg). MAIN OUTCOME MEASURES: Pearson's/Spearman's correlation (r/rs), coefficient of determination (r2/rs2). RESULTS: Most correlations were statistically non-significant or statistically-significant with only weak-to-moderate coefficients. For both knee extension and flexion, PT and MPT were significantly and strongly correlated (r = 0.99, r2 = 0.98, p = 0.001). Graphical analyses revealed two datapoint clusters for knee flexion TTPT and APT. One cluster indicated some participants could generate knee flexor PT rapidly (<150 ms) at low knee flexion angles (<45°) and the other cluster indicated that other participants could not (>200 ms, >50°). CONCLUSIONS: In this study, most isokinetic variables represented distinct knee neuromuscular characteristics. For both knee extension and flexion, only PT or MPT need be used to represent isokinetic maximal strength. Knee flexion TTPT and APT may have utility in noncontact knee injury prevention screening with amateur adult agility-sport athletes.

Preseason weight-bearing ankle dorsiflexion in male professional football players with and without a history of severe ankle injury: A novel analysis in an English Premier League club.

OBJECTIVES: Ankle injuries are common in professional football and have profound player/team/club consequences. The weight-bearing lunge-test (WBLT) assesses ankle dorsiflexion range-of-motion in football primary/secondary injury prevention and performance contexts. Data for uninjured and previously ankle-injured players in the English Premier League (EPL) is not available. This study analysed WBLT measurements (cm) within and between uninjured and previously severe ankle-injured players (injured-stiff group, injured-lax group) in one EPL club. DESIGN: Cross-sectional. SETTING: Preseason. PARTICIPANTS: Forty-nine players (age 22.9 ± 4.6 yr; height 181.6 ± 5.2 cm; mass 77.7 ± 7.6 kg). MAIN OUTCOME MEASURES: Prevalence (%) of previous unilateral severe ankle injury (USAI). Side-to-side (right/left, dominant/nondominant, injured/uninjured) WBLT comparisons at group-level (t-test [within-group]; Welch's ANOVA [between-group]; effect sizes [within-/between-group]) and individual-level (limb symmetry index [%]; absolute-asymmetry [%]). RESULTS: Prevalence of USAI was 38.7%. There were no statistically-significant side-to-side differences for within-/between-group comparisons. Effect sizes: just-below-large (injured-stiff) and extremely-large (injured-lax) for within-group injured-side/uninjured-side comparisons; just-below-medium (injured-lax) to just-above-medium (injured-stiff) for injured-side comparisons to uninjured players. Absolute-asymmetries: uninjured players, 15.4±13.2%; injured-stiff, 21.8±33.6%; injured-lax 20.4±13.6%. CONCLUSIONS: Over one-third of players had previous USAI. Effect sizes indicate substantial within-group side-to-side differences and less substantial between-group differences. Across groups, some players had absolute-asymmetries that may elicit concern in ankle primary/secondary injury prevention and performance contexts.

Noncontact Knee Ligament Injury Prevention Screening in Netball: A Clinical Commentary with Clinical Practice Suggestions for Community-Level Players.

Netball is a predominantly female team court-sport which is played worldwide. Netball is becoming more popular in the United States following its countrywide introduction to schools and community centers. A unique characteristic of netball is the footwork rule which restricts players to a one-step landing after catching the ball. Most netball landings are single-leg landings resulting in high vertical ground reaction forces and high skeletal tissue forces. Thus, high-risk landing events that have the biomechanical potential for injury occur frequently. Noncontact knee ligament injuries are common following a knee abduction collapse when landing. Because the consequences of noncontact knee ligament injury are profound, strategies are needed to mitigate the burden of such injury for players, teams, and society. The purpose of this clinical commentary is to demonstrate how theoretical principles, different types of research, and different levels of evidence underpin a rational clinical reasoning process for developing noncontact knee ligament injury prevention screening procedures in netball. The theoretical principles that are discussed in this commentary include injury control, the sequence of prevention, principles of screening in injury prevention, the multifactorial model of injury etiology, complex systems theory, and systems science. The different types of research that are reviewed include descriptive and analytic-observational studies. The different levels of evidence that are discussed include prospective studies, cross-sectional studies, and clinicians' own kinesiological modelling. Subsequently, an integrated approach to the evidence-informed development of noncontact knee ligament injury prevention screening procedures is presented. Clinical practice suggestions include a selection of evidence-informed screening tests that are quickly and easily implemented with netball players in local communities. The need for repeated screening at strategic timepoints across a season/year is explained. Sports physical therapists will find this commentary useful as an example for how to undertake clinical reasoning processes that justify the content of screening procedures contributing to noncontact knee ligament injury prevention in community-level netball. LEVEL OF EVIDENCE: 5.

Relationship Between 3 Single-Leg Functional Performance Tests for Netball Noncontact Knee Injury Prevention Screening in Uninjured Female Adult Players.

CONTEXT: Single- versus double-leg landing events occur the majority of the time in a netball match. Landings are involved in large proportions of netball noncontact knee injury events. Of all landing-induced anterior cruciate ligament injuries, most occur during single-leg landings. Knowledge of whether different single-leg functional performance tests capture the same or different aspects of lower-limb motor performance will therefore inform clinicians' reasoning processes and assist in netball noncontact knee injury prevention screening. OBJECTIVE: To determine the correlation between the triple hop for distance (THD), single hop for distance (SHD), and vertical hop (VH) for the right and left lower limbs in adult female netball players. DESIGN: Cross-sectional. SETTING: Local community netball club. PARTICIPANTS: A total of 23 players (age 28.7 [6.2] y; height 171.6 [7.0] cm; mass 68.2 [9.8] kg). INTERVENTIONS: There were 3 measured trials (right and left) for THD, SHD, and VH, respectively. MAIN OUTCOME MEASURES: Mean hop distance (percentage of leg length [%LL]), Pearson intertest correlation (r), and coefficient of determination (r2). RESULTS: Values (right and left; mean [SD]) were as follows: THD, 508.5 (71.8) %LL and 510.9 (56.7) %LL; SHD, 183.4 (24.6) %LL and 183.0 (21.5) %LL; and VH, 21.3 (5.2) %LL and 20.6 (5.0) %LL. All correlations were significant (P ≤ .05), r/r2 values (right and left) were THD-SHD, .91/.83 and .87/.76; THD-VH, .59/.35 and .51/.26; and SHD-VH, .50/.25 and .37/.17. A very large proportion of variance (76%-83%) was shared between the THD and SHD. A small proportion of variance was shared between the THD and VH (25%-35%) and SHD and VH (17%-25%). CONCLUSION: The THD and SHD capture highly similar aspects of lower-limb motor performance. In contrast, the VH captures aspects of lower-limb motor performance different to the THD or SHD. Either the THD or the SHD can be chosen for use within netball knee injury prevention screening protocols according to which is reasoned as most appropriate at a specific point in time. The VH, however, should be employed consistently alongside rather than in place of the THD or SHD.

Situations and mechanisms of non-contact knee injury in adult netball: A systematic review.

OBJECTIVES: Noncontact knee injuries in netball are a concern due to a range of negative consequences. To reduce the number of injuries, identifying the situation and mechanism of injury is important. This systematic review examined the literature reporting the situation and mechanism of noncontact knee injury in netball. DESIGN: Systematic Review. METHODS: PRISMA guidelines were followed and specific key-term combinations used to search databases. Descriptive and analytic-observational studies reporting the situation or mechanism of noncontact knee injury in females playing netball were included (evaluated using frequency counts). RESULTS: Six articles were included (combined sample 11,401). Players self-reported the situation of injury in five studies, only one study reported both the situation and mechanism of injury. Landing was the most reported situation of knee injury, representing 46.6% of all knee injuries whilst knee abduction (valgus) collapse was the most observed mechanism. Situation and mechanism of noncontact knee injury in netball were not adequately reported. CONCLUSIONS: Despite the variations in reporting methods, landing is the most common situation of injury. As only one study reported mechanism of injury, it is difficult to draw conclusions but the mechanism of noncontact knee injury in netball appears similar to those identified in other female athletes.

Lower-limb motor-performance asymmetries in English community-level female field hockey players: Implications for knee and ankle injury prevention.

OBJECTIVES: Side-to-side asymmetry of lower-limb motor-performance is associated with increased agility-sport noncontact injury-risk. Left leg preferential use (unilaterality) in hockey may influence lower-limb motor-performance asymmetry. Symmetry-analyses have not been reported for female hockey players. This study performed symmetry-analyses using the eyes-closed-balance test (ECB), anterior reach test (ART), triple-hop-for-distance (THD), and six-metre hop-for-time (6MHT). DESIGN: Cross-sectional. SETTING: Community-level club. PARTICIPANTS: Thirty players (age 25.6 ± 4.5yr; height 165.6 ± 5.9 cm; mass 64.8 ± 5.5 kg). MAIN OUTCOME MEASURES: Right-left group-level (t-test with Bonferroni adjustment) and individual-level (absolute-asymmetry (%)) comparisons. A limb symmetry index (LSI) was computed for each player and a clinically-significant absolute-asymmetry defined >10% as per previous literature. Clinically-significant absolute-asymmetry prevalence (%) was calculated across tests. For unilaterality, prevalence of superior left-side performance was calculated. RESULTS: There were no right-left significant differences across tests. Findings for ECB, ART, THD, and 6MHT were: absolute-asymmetry, 28.7 ± 26.9%, 3.5 ± 2.8%, 3.5 ± 3.4%, 6.1 ± 4.7%; prevalence of clinically-significant absolute-asymmetries, 70.0%, 3.3%, 6.7%, 26.7%; prevalence of superior left-side performance, 46.7%, 53.0%, 50.0%, 47.0%. CONCLUSIONS: Statistical tests fail to expose clinically-significant absolute-asymmetries. Many players demonstrated clinically-significant absolute-asymmetries for ECB and 6MHT tests. Clinical interpretation of LSIs and absolute-asymmetries need not consider unilaterality. Clinically-significant absolute-asymmetries previously linked to injury-risk are common in a community-level, adult female hockey players.

Intra-rater reliability, measurement precision, and inter-test correlations of 1RM single-leg leg-press, knee-flexion, and knee-extension in uninjured adult agility-sport athletes: Considerations for right and left unilateral measurements in knee injury control.

OBJECTIVES: Knowledge of single-leg knee strength test reliability for the right and left limb is critical for between-limb clinical decision-making. Knowledge of between-test correlations is essential for understanding whether tests measure similar or different aspects of muscle strength. This study investigated the intra-rater, test-retest reliability and measurement precision of one repetition maximum (1RM) single-leg leg-press (LP), knee-flexion (KF), and knee-extension (KE) for both limbs, and inter-test correlations. DESIGN: Repeated measures; SETTING: University. PARTICIPANTS: Six males, seven females (age 25.6 ±â€¯5.5 yr; height 171.4 ±â€¯8.4 cm; mass 71.8 ±â€¯13.4 kg). MAIN OUTCOME MEASURES: Normalised 1RM (percent body-mass (%BM)), intraclass correlation coefficient (ICC) (2,1), standard error of measurement (SEM; %BM), Pearson's correlation (r), coefficient of determination (r2). RESULTS: Mean 1RM test-retest values were (right, left): LP, 214.2-218.5%BM, 213.5-215.4%BM; KF, 35.9-38.9%BM, 37.7-38.2%BM; KE, 43.3-44.6%BM, 36.2-39.3%BM. The ICCs/SEMs were (right, left): LP, 0.98/7.3%BM, 0.94/14.2%BM; KF, 0.75/4.9%BM, 0.95/1.9%BM; KE, 0.87/3.4%BM, 0.78/4.4%BM. Correlations were significant (P < 0.01), r/r2 values were: LP-KF, 0.60/0.36; LP-KE, 0.59/0.35; KF-KE, 0.50/0.25. CONCLUSIONS: Tests demonstrated good reliability and measurement precision, although ICCs and SEMs were different between limbs. Tests were correlated, but only one-third of the variance was shared between tests. Practitioners should be cognisant of between-limb differences in reliability and include all tests for knee clinical decision-making.

Prevalence and magnitude of preseason clinically-significant single-leg balance and hop test asymmetries in an English adult netball club.

OBJECTIVES: Side-to-side asymmetry of lower-limb motor-performance is associated with increased noncontact injury risk in agility-sports. Side-to-side symmetry-analyses using single-leg balance and hop tests has not been reported for community-level adult netball players. The purpose of this study was to perform preseason side-to-side symmetry-analyses using eyes-closed-balance (ECB), triple-hop-for-distance (THD), single-hop-for-distance (SHD), and vertical-hop (VH) tests. DESIGN: Cross-sectional; SETTING: Community-level adult netball club. PARTICIPANTS: Twenty-three female players (age 28.7 ±â€¯6.2yr; height 171.6 ±â€¯7.0 cm; mass 68.2 ±â€¯9.8 kg). MAIN OUTCOME MEASURES: Right-left group-level comparisons (paired t-test) and individual-level comparisons (absolute-asymmetry (%)). A limb symmetry index was calculated for each test and a clinically-significant absolute-asymmetry defined as >10%. Clinically-significant absolute-asymmetry prevalence (%) was computed for each test. RESULTS: There were no right-left significant differences for any test. Maximum absolute-asymmetries for the ECB, THD, SHD, and VH were 93.3%, 15.2%, 16.7%, and 60.3%, respectively. The prevalence of clinically-significant absolute-asymmetries for the ECB, THD, SHD, and VH was 91.3%, 8.7%, 8.7%, and 52.2%, respectively. CONCLUSIONS: Group-level comparisons with statistical tests fail to expose the extent of clinically-significant absolute-asymmetries. Most players demonstrated preseason clinically-significant absolute-asymmetries for the ECB and VH tests. Preseason clinically-significant absolute-asymmetries that may predispose increased lower-limb noncontact injury risk are widespread in a community-level adult netball club.

Reporting of acute programme variables and exercise descriptors in rehabilitation strength training for tibiofemoral joint soft tissue injury: A systematic review.

OBJECTIVE: Strength training acute programme variables (APVs) can impact tibiofemoral joint injury outcomes. Exercise descriptors (EDs; e.g. patient-position) specify configurations within which APVs are applied. Evidence-based practice depends on adequate reporting of APVs and EDs to replicate strength training interventions in clinical practice. This systematic review assessed APV and ED reporting for adults with tibiofemoral joint injury (anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL)/medial collateral ligament (MCL)/lateral collateral ligament (LCL)/meniscus/hyaline cartilage (HC)). METHODS: PRISMA guidelines were followed. Specific key-term combinations were employed and database searches performed. Descriptive/observational/experimental studies were included (2006-2018). Studies needed to report pre-defined APVs or EDs for ≥51% of all exercises to be included. Frequency counts were made of studies adequately reporting APVs and EDs. RESULTS: Sixteen articles were included (ACL = 13; meniscus = 3). No PCL/MCL/LCL/HC articles were identified. Of nine APVs, five and four were consistently reported by the majority of ACL (≥7) and meniscal (≥2) studies, respectively. Of eight EDs, four were consistently reported by the majority of both ACL (≥8) and meniscal (≥2) studies. CONCLUSION: Many APVs and EDs were not adequately reported. Future studies should better document APVs and EDs for higher standards of intervention reporting and enhanced translation of research to clinical practice.

Reliability and measurement precision of concentric-to-isometric and eccentric-to-isometric knee active joint position sense tests in uninjured physically active adults.

OBJECTIVES: Proprioception is important because it is used by the central nervous system to mediate muscle control of joint stability, posture, and movement. Knee active joint position sense (AJPS) is one representation of knee proprioception. The purpose of this study was to establish the intra-tester, inter-session, test-retest reliability of concentric-to-isometric (seated knee extension; prone knee flexion) and eccentric-to-isometric (seated knee flexion; prone knee extension) knee AJPS tests in uninjured adults. DESIGN: Descriptive. SETTING: University laboratory. PARTICIPANTS: Six males, six females (age 26.2 ± 5.7 years; height 171.1 ± 9.6 cm; mass 71.1 ± 16.6 kg). MAIN OUTCOME MEASURES: Mean absolute error (AE; °); intraclass correlation coefficient (ICC) (2,1); standard error of measurement (SEM; °). RESULTS: Mean AE ranged from 3.18° to 5.97° across tests. The ICCs and SEMs were: seated knee extension 0.13, 1.3°; prone knee flexion 0.51, 1.2°; seated knee flexion 0.31, 1.7°; prone knee extension 0.87, 1.4°. CONCLUSIONS: The prone knee flexion and prone knee extension tests demonstrated moderate to good reliability. Prone knee flexion and prone knee extension AJPS tests may be useful in cross-sectional studies estimating how proprioception contributes to knee functional joint stability or prospective studies estimating the role of proprioception in the onset of knee injury.