The Test Re-Test Reliability of A Novel Single Leg Hop Test (T-Drill Hop Test).

BACKGROUND: Functional training and testing are an important part of a comprehensive rehabilitation program stressing the neuromuscular system in ways that simulate athletic performance to help determine criteria for return to sport. There are numerous single leg hop tests that have been used for these purposes, however, the validity and clinical relevance has been questioned. Many of the functional performance tests assess only the sagittal plane or forward direction and may only partially assess a person's athletic abilities. There is a need for reliable and valid functional tests to assess in a multi-directional manner. PURPOSE/HYPOTHESIS: The purpose of this study is to determine the test re-test reliability of a novel multi-directional timed single leg hop test (T-Drill Hop Test) for use in rehabilitation and performance assessments. STUDY DESIGN: Cross-sectional reliability study. METHODS: Fifty healthy recreationally active college age subjects, (23 males and 27 females) between the ages of 18 and 35, (mean age 23.48 with SD 3.82) consented to perform the test. The subjects hopped along a 10ft. x 10ft. "T" shaped course. Subjects performed two timed maximum effort trials of the T-Drill Hop Test on each leg with an interval of 3-7 days between the two testing days. Intraclass Correlation Coefficients (ICC) were calculated to determine intersession reliability. RESULTS: The inter-rater reliability (ICC's) for the entire group of 50 subjects ranged between .98 and 1.00 suggesting excellent reliability. The bilateral comparison, utilizing paired t-tests, of the T-Drill Hop Test demonstrated no significant differences between the time scores for the dominant and non-dominant legs for either males or females (p>.05). CONCLUSION: This study demonstrates the T-Drill Hop Test has excellent test re-test reliability. These results are important prior to validation and utilization as a clinical functional performance test. LEVELS OF EVIDENCE: Level 2.

Substantiating the Use of Ultrasound Tissue Characterization in the Analysis of Tendon Structure: A Systematic Review.

OBJECTIVE: To determine the role of ultrasound tissue characterization (UTC) in predicting, diagnosing, and monitoring tendon structure and/or tendinopathy. In addition, this study aims to provide recommendations for standardized methodology of UTC administration and analysis. DATA SOURCE: The PubMed, Embase, and Web of Science databases were searched (up to September 2018). All scientific literature concerning the use of UTC in assessing tendons was collected. The initial search resulted in a total of 1972 hits, and after screening by eligibility criteria, 27 articles were included. RESULTS: In total, 18 investigating the Achilles tendon, 5 the patellar tendon, and 4 both Achilles and patellar tendons were included. The methods of UTC administration and analysis differed and were not uniform. The studies showed that the use of UTC to predict Achilles tendinopathy (AT) is inconclusive, but that a higher amount of tendon disorganization increases the risk of developing patellar tendinopathy (PT). In terms of diagnosis, UTC might provide additional information in AT cases. In addition, promising results were found for the use of UTC in both AT and PT in monitoring the effect of load or treatment on tendon structure. CONCLUSION: More research regarding the use of UTC in predicting tendon pathology is required. Ultrasound tissue characterization seems useful as an adjunct diagnostic modality because it can be used to differentiate symptomatic from asymptomatic tendons. In addition, UTC is a promising device to be used to monitor changes in tendon structure in response to load or treatment. Moreover, we provide recommendations of a standardized protocol concerning the methods of UTC measurement and analysis.

Running a Marathon-Its Influence on Achilles Tendon Structure.

CONTEXT: Several studies have been conducted to better understand the effect of load on the Achilles tendon structure. However, the effect of a high cumulative load consisting of repetitive cyclic movements, such as those that occur during the running of a marathon, on Achilles tendon structure is not yet clear. Clinicians, coaches, and athletes will benefit from knowledge about the effects of a marathon on the structure of the Achilles tendon. OBJECTIVE: To investigate the short-term response of the Achilles tendon structure to running a marathon. DESIGN: Case series (prospective). SETTING: Sports medicine centers. PATIENTS OR OTHER PARTICIPANTS: Ten male nonelite runners who ran in a marathon. MAIN OUTCOMES MEASURE(S): Tendon structure was assessed before and 2 and 7 days after a marathon using ultrasound tissue characterization (UTC), an imaging tool that quantifies tendon organization in 4 echo types (I-IV). Echo type I represents the most stable echo pattern, and echo type IV, the least stable. RESULTS: At 7 days postmarathon, both the insertional and midportion structure changed significantly. At both sites, the percentage of echo type II increased (insertion P < .01; midportion P = .02) and the percentages of echo types III and IV decreased (type III: insertion P = .01; midportion P = .02; type IV: insertion P = .01; midportion P < .01). Additionally, at the insertion, the percentage of echo type I decreased (P < .01). CONCLUSIONS: We observed the effects of running a marathon on the Achilles tendon structure 7 days after the event. Running the marathon combined with the activity performed shortly thereafter might have caused the changes in tendon structure. This result emphasizes the importance of sufficient recovery time after running a marathon to prevent overuse injuries.

Association Between Clinical and Imaging Outcomes After Therapeutic Loading Exercise in Patients Diagnosed With Achilles or Patellar Tendinopathy at Short- and Long-Term Follow-up: A Systematic Review.

OBJECTIVE: To determine the association between clinical and imaging outcomes after therapeutic loading exercise in Achilles tendinopathy (AT) and patellar tendinopathy (PT) populations at both short- and long-term follow-up. DATA SOURCES: The PUBMED and EMBASE databases were searched (up to June 2017) to identify articles that meet the inclusion criteria: (1) patients diagnosed with AT (insertional or midportion) or PT; (2) rehabilitation based on therapeutic loading exercise; and (3) assessment of clinical outcomes and tendon structure using an imaging modality. MAIN RESULTS: Two independent reviewers screened 2894 search results, identifying 21 suitable studies. According to the studies included in this review, clinical results showed significant improvements for patients with AT and PT after eccentric exercise (ECC) and heavy slow resistance (HSR) at short- and long-term follow-up. Imaging outcomes were not consistent. Moderate-to-strong evidence for patients with AT suggested an association between clinical outcomes and imaging outcomes (tendon thickness and tendon neovascularization) after ECC at long-term follow-up. For patients with PT, there was moderate evidence supporting an association between clinical outcomes (questionnaire score and pain) and imaging (tendon thickness and tendon neovascularization) after ECC at short-term follow-up. For both the AT and PT groups, there was moderate evidence for an association between clinical outcomes and tendon thickness and neovascularization after HSR exercise. Results related to the HSR exercise should be interpreted with caution because of the small number of studies. CONCLUSIONS: Based on the findings of the present review, the use of imaging outcomes as a complementary examination to the clinical assessment was confirmed. Overall, an improvement in clinical outcomes seems to be associated with a reduction in tendon thickness and tendon neovascularization. Clinicians should be aware that during the interpretation of the imaging outcomes, factors such as tendinopathy location, exercise modality performed, and a follow-up period should be considered.

Bilateral changes in tendon structure of patients diagnosed with unilateral insertional or midportion achilles tendinopathy or patellar tendinopathy.

PURPOSE: Changes in tendon structure are commonly seen in patients with unilateral achilles (AT) or patellar (PT) tendinopathy but might also be present on the asymptomatic side, indicating a higher risk for developing symptoms. The aim of this study is to compare tendon structure of the symptomatic side with the asymptomatic side in AT and PT patients and control subjects. METHODS: A total of 46 patients with unilateral AT (16 insertional and 30 midportion) and 38 with unilateral PT were included. For the control group, a total of 18 Achilles tendons and 25 patellar tendons were scanned. Tendon structure was assessed using ultrasound tissue characterisation (UTC), which quantifies tendon organisation dividing the structure into four different echo types (I-IV). RESULTS: There were significant differences in echo types I, III, and IV between symptomatic and asymptomatic sides and controls. Additionally, there was a significant difference between the symptomatic and the asymptomatic side for all tendinopathy locations. In the insertional AT tendon portion, the symptomatic side showed a higher percentage of echo type III. For the midportion AT, the symptomatic side showed a lower percentage of echo type I and a higher percentage of echo types III and IV. For the patellar tendon, the symptomatic side showed a higher percentage of echo types III and IV. All differences were higher than the minimal detectable changes. CONCLUSION: Although patients have symptoms unilaterally, the tendon structures are compromised on both sides. These results stress the importance of monitoring both symptomatic and asymptomatic tendon structures and in addition highlight that the asymptomatic side should not be used as reference in clinical practice. LEVEL OF EVIDENCE: III.

Inter- and intra-rater reliability of ultrasound tissue characterization (UTC) in patellar tendons.

PURPOSE: Ultrasound tissue characterization (UTC) is used in research and clinical practice to quantify tendon structure of the patellar tendon. This is the first study to investigate the inter- and intra-rater reliability for UTC of the patellar tendon on a large scale. METHOD: Fifty participants (25 patellar tendinopathy, 25 asymptomatic) were recruited. The affected patellar tendons in symptomatic and right tendons in asymptomatic participants were scanned with UTC twice by one researcher and once by another. The same was done for contour marking (needed to analyze a UTC scan) of the tendon. Intraclass correlation coefficient (ICC (2,1)) for echo-types I, II, III, IV, aligned fibrillar structure (echo-types I + II), and disorganized structure (echo-types III + IV) were calculated. This was done for UTC scans as well as solely marking contours. RESULTS: Inter-rater reliability showed fair to good ICC values for echo-types I (0.65) and II (0.46) and excellent ICC values for echo-type III (0.81), echo-type IV (0.83), aligned fibrillar structure (0.82), and disorganized structure (0.82). Intra-rater reliability showed excellent ICC values for echo-types I (0.76), III (0.88), IV (0.85), aligned fibrillar structure (0.88), and disorganized fibrillar structure (0.88) and a fair to good value for echo-type II (0.61). Contour marking showed excellent ICC values for all echo-types. CONCLUSION: This study showed that UTC scans for patellar tendons have overall good intra-rater and inter-rater reliability. To optimize reliability of UTC scans of the patellar tendon, using the same rater and using aligned fibrillar structure (echo-types I + II combined) and disorganized structure (echo-types III + IV combined) as outcome measures can be considered.

Patellar tendon structure responds to load over a 7-week preseason in elite male volleyball players.

The purpose of this study was to investigate the relation between external and internal load and the response of the patellar tendon structure assessed with ultrasound tissue characterization (UTC) in elite male volleyball players during preseason. Eighteen players were followed over 7 weeks, measuring four load parameters during every training and match: volume (minutes played), rating of perceived exertion (RPE) (ranging from 6 to 20), weekly load (RPE*volume), and jump frequency (number of jumps). Patellar tendon structure was measured biweekly using UTC, which quantifies tendon matrix stability resulting in four different echo types (I-IV). On average, players spent 615 min/wk on training and matches with an RPE of 13.9 and a jump frequency of 269. Load evaluation shows significant changes over the 7 weeks: Volume and weekly load parameters were significantly higher in week 3 than week 7 and in week 4 than week 2. Weekly load performed in week 4 was significantly higher than week 7. No significant changes were observed in tendon structure. On the non-dominant side, no significant correlations were found between changes in load parameters and echo types. At the dominant side, a higher weekly volume and weekly load resulted in a decrease of echo type I and a higher mean RPE in an increase of echo type II. The results of this study show that both external and internal load influence changes in patellar tendon structure of elite male volleyball players. Monitoring load and the effect on patellar tendon structure may play an important role in injury prevention.

The effect of load on Achilles tendon structure in novice runners.

OBJECTIVES: To observe the changes in Achilles tendon structure in novice runners, with loading prescriptions of 100% body weight compared to 20% body weight. DESIGN: Randomised crossover. METHODS: Twenty novice runners participated in two separate running bouts spaced 14days apart, one of high load at 100% body weight, and one of low load at 20% body weight. Tendon structure was measured by ultrasonographic tissue characterisation on 6 occasions; immediately prior to each run, 2 and 7days after each run. RESULTS: The interaction effect of time and condition was not found to be significant for echotypes I-IV [Wald chi-square=2.8, d.f.=2, P=0.247; Wald chi-square=2.888, d.f.=2, P=0.236; Wald chi-square=1.385, d.f.=2, P=0.5; Wald chi-square=4.19, d.f.=2, P=0.123], respectively. A significant effect of time was found for echotypes III [Wald chi-square=6.785, d.f.=2, P=0.0.034] and IV [Wald chi-square=7.491, d.f.=2, P=0.0.024]. CONCLUSIONS: The decrease in echotypes III and IV suggest that moderate loads can be applied to the Achilles tendon without compromising tendon structure. Low to moderate loads may be beneficial in the management of Achilles tendinopathy. Further studies should focus on protocols with higher loading and/or repetitive loading in athletic populations with and without Achilles tendinopathy to assess any differences in tendon structure.

External abdominal oblique muscle ultrasonographic thickness changes is not an appropriate surrogate measure of electromyographic activity during isometric trunk contractions.

BACKGROUND: The function of specific abdominal muscles can be assessed using both electromyography (EMG) and ultrasound imaging (USI) thickness measures. However, the relationship between these two measurements is not conclusive during sitting isometric trunk efforts. OBJECTIVE: This study was conducted to assess the relationship between USI thickness and EMG amplitude measures of the right external oblique (EO) muscle during isometric efforts in the sitting position. METHOD: Eighteen subjects performed ramp isometric efforts progressing from 0 to 50% of their maximal voluntary contraction (MVC) in three trunk directions on a dynamometer: (1) forward flexion; (2) right lateral flexion; and (3) left axial rotation. USI and surface EMG amplitude measures of the EO muscle were recorded concomitantly and both normalized against rest values and maximal EMG, respectively. RESULTS: EO muscle was significantly more activated (p < 0.001) during forward flexion (42% on average) and axial rotation (35%) than during lateral flexion (24%). Non-significant (r=0.01; P=0.979) to highly significant (r=0.98; P < 0.0001) and negative and positive Pearson correlations were observed between EMG and EO thickness measures for both flexion and rotation directions. CONCLUSION: The negative correlations between EMG and USI measures as well as the great variability of these correlations across individuals suggest that USI is not a valid measures of EO muscle activity. USI thickness measures should be interpreted with great caution in research and clinical settings.

Relação entre testes funcionais e plataforma de força nas medidas de equilíbrio em atletas / Relationship between functional tests and force platform measurements in athletes' balance / Relación entre pruebas funcionales y plataforma de fuerzas en las medidas de balance de los atletas

INTRODUÇÃO: Poucos estudos correlacionaram as medidas de equilíbrio entre os principais testes funcionais e a plataforma de força em atletas. OBJETIVO: Determinar a relação entre três testes funcionais de equilíbrio com as principais medidas da plataforma de força em atletas. MÉTODO: Quinze atletas do sexo feminino praticantes de futebol de salão (futsal) e handebol, com idades entre 13 a 17 anos participaram do estudo. As atletas realizaram três testes funcionais: 1) Star excursion balance test, 2) Salto lateral e 3) Figura em oito; além de um teste em apoio unipodal sobre uma plataforma de força com os olhos abertos durante 30 segundos. Os parâmetros do centro de pressão dos pés (COP) foram calculados por análise estabilográfica. Para todos os testes (funcionais e plataforma), três tentativas foram realizadas e a média foi retida para as análises. RESULTADOS: As correlações entre os testes funcionais e a plataforma de força foram de r = 0,01 a -0,69 (fraca a moderada), dependendo da variável do COP. As melhores correlações (r = -0,69) foram encontradas entre o Star Excursion Balance Test de alcance e a área do COP, indicando que quanto maior a distância alcançada, melhor o equilíbrio. Segundo, uma correlação de fraca a moderada foi encontrada entre o teste da figura em oito e a área do COP (p. ex: r = 0.43). O teste de salto lateral não apresentou boa correlação com os obtidos na plataforma de força. CONCLUSÃO: Este estudo demonstrou que para a avaliação do equilíbrio em atletas de futsal e handebol feminino o teste Star Excursion Balance Test pode ser usados na ausência da plataforma de força para identificação de possíveis déficits de equilíbrio. .

INTRODUCTION: Few studies have correlated the balance measurements based in functional tests and force platform in athletes. OBJECTIVE: to determine the relationship between three functional balance tests with the main measurements of the force platform in athletes. METHODOLOGY: Fifteen female athletes, indoor soccer and handball players, aged between 13 and 17 years, participated of this study. The athletes performed tree functional tests: 1) the star excursion balance test, 2) the lateral jump, and 3) the figure eight test; as well as the one leg-stance test on a force platform with the eyes open for 30 seconds. The parameters of center of pressure (COP) of the foot were calculated by stabilographic analysis. For all the tests (functional and platform), tree trials attempts were made, and the mean value retained for the analyses. RESULTS: The correlations between the functional tests and the force platform were from r = 0.01 to -0.69 (weak to moderate), depending on the COP variable. The best correlations (r = -0.69) were found between the star excursion balance test and the COP area, indicating that when a greater distance was reached, the better the postural balance. Secondly, a weak to moderate correlation was found between the figure eight test and COP area (e.g. r = 0.43). The side hop test did not present good correlation with the values obtained on the force platform. CONCLUSION: This study shows that to evaluate balance in athletes practicing indoor soccer and handball, the Star excursion balance test may be used in the absence of a force platform, to identify possible balance deficits. .

INTRODUCCIÓN: Pocos estudios han correlacionado las medidas de equilibrio entre las principales pruebas funcionales y la plataforma de fuerza en los atletas. OBJETIVO: Determinar la relación entre tres pruebas de equilibrio funcionales con las principales medidas de la fuerza en la plataforma de los atletas. MÉTODO: Quince atletas del sexo femenino que practican el fútbol de salón y balonmano, entre 13 y 17 años participaron en el estudio. Los atletas realizaron tres pruebas funcionales: 1) Star excursion balance test, 2) salto lateral y 3) salto figura ocho, además de una prueba unipodal sobre una plataforma de fuerza con los ojos abiertos durante 30 segundos. Los parámetros del centro de la presión de los pies (COP) se calcularon por análisis estabilográfica. Para todas las pruebas (funcionales y plataforma), se llevaron a cabo tres ensayos y el promedio fue utilizado para su análisis. RESULTADOS: Las correlaciones entre las pruebas funcionales y la plataforma de fuerza fueron r = 0,01 a -0,69 (leve a moderada), en función de la variable COP. La mejor correlación (r = -0,69) se encontró entre el rango de la prueba Star Excursion Balance y el área del COP, lo que indica que cuanto mayor es la distancia que se logra, mejor es el equilibrio. En segundo lugar, se encontró correlación débil a moderada entre la prueba en figura de ocho y el área del COP (por ejemplo, r = 0,43). La prueba de salto lateral mostró una buena correlación con las pruebas en la plataforma de fuerza. CONCLUSIÓN: Este estudio demostró que para la evaluación del equilibrio de los atletas del sexo femenino de fútbol de salón y balonmano, el Star excursion balance test se puede utilizar en la ausencia de una plataforma de fuerza para identificar posibles deficiencias en el equilibrio. .

Comparison of postural balance between professional tae kwon do athletes and young adults / Comparación del equilibrio postural entre los atletas profesionales en tae kwon do y adultos jóvenes

This study aimed to compare the postural balance of professional tae kwon do athletes with a non-tae kwon do adult group. Nineteen participants (nine tae kwon do practitioners and ten non-tae kwon do practitioners) were tested. To measure the postural sway, a force platform was used and the equipment recorded the main parameters: area of center of pressure; mean frequency, and velocity of center of pressure for both anteroposterior and mediolateral directions were measured for all participants. Before starting the assessment, the subjects received instructions and performed familiarization with the equipment and protocol. Participants were instructed to carry out three balance tests on a single-leg stance position with eyes opened. Values obtained in the postural assessment of professional athletes with the force platform were lower for all parameters compared to non-practitioners, except the frequency of center of pressure in the mediolateral direction. However, a significant difference (p=0.021) between the groups was found only in the center of pressure velocity parameter in the anteroposterior direction. These results have any implications on sport rehabilitation programs for balance assessments in athletes.

Este estudio tuvo como objetivo comparar el equilibrio postural de atletas de tae kwon do profesionales con un grupo de adultos que no practican esto deporte. Diecinueve participantes (nueve practicantes profesionales de tae kwon do y diez no practicantes) se pusieron a prueba. Para evaluar la oscilación postural, se utilizó una plataforma de fuerza y el equipo registró los parámetros principales: el centro de la zona de presión; la frecuencia y la velocidad del centro de la presión tanto para la dirección anteroposterior, y para la medio-lateral. Estas mediciones se registraron para todos los participantes. Antes de iniciar la evaluación, los sujetos recibieron instrucciones y se familiarizaron con el equipo y el protocolo. También fueron instruidos para realizar tres pruebas de equilibrio en un solo pie con los ojos abiertos. Los valores obtenidos en la evaluación postural de los atletas profesionales utilizando la plataforma de fuerza eran más bajos para todos los parámetros en comparación con aquellos de los no profesionales, con la excepción de la frecuencia del centro de presión de la dirección medial-lateral. Sin embargo, se encontró una diferencia significativa (p=0,021) entre los grupos sólo con respecto a la velocidad anteroposterior del centro de presión. Esos resultados tienen implicaciones para los deportes de los programas de rehabilitación para la evaluación del equilibrio postural en los atletas.

Análise comparativa do equilíbrio unipodal de atletas de ginástica rítmica / Comparative analysis of one-foot balance in rhythmic gymnastics athletes

INTRODUÇÃO: A ginástica rítmica (GR) requer alto nível de qualidade física; assim, o bom desempenho é dependente da força e resistência muscular, coordenação motora e equilíbrio postural. OBJETIVO: Desenvolver uma análise comparativa do equilíbrio unipodal de atletas de GR. MÉTODOS: Foram avaliadas dez atletas de GR, do sexo feminino, por meio de uma plataforma de força em apoio unipodal e testes funcionais de equilíbrio (Side Hop Test e Figure of Eight Hop Teste). Para a plataforma, os parâmetros do Centro de Pressão (COP) nas direções anteroposterior e mediolateral foram utilizados para análise, enquanto para os testes funcionais, o tempo-segundos de performance. RESULTADOS: Diferença significativa (p = 0,01) foi encontrada entre os membros inferiores no parâmetro de frequência média na direção mediolateral, no qual o membro inferior não dominante apresentou maior estabilidade postural do que o dominante. Para os testes funcionais não houve diferença significativa entre os membros. CONCLUSÃO: A diferença encontrada no controle do equilíbrio na direção mediolateral pode estar relacionada às diferenças nas ações musculares da região do quadril, na qual durante a prática do esporte para estabilização, manutenção do tronco e execução de manobras com os membros inferiores estão presentes. Estes resultados indicam a necessidade de um programa de reequilíbrio e estabilização pélvica para as atletas analisadas no intuito de preservar a simetria muscular dos membros para o bom desempenho esportivo.

INTRODUCTION: Rhythmic gymnastics requires a high level of physical quality; therefore, good performance depends on muscular strength and endurance, motor coordination and postural balance. OBJECTIVE: To develop a comparative analysis of postural balance in rhythmic gymnasts. METHODS: 10 female rhythmic gymnasts were evaluated by a force platform on one foot and balance functional tests (Side Hop Test and Figure of Eight Hop Test). The following data of the force platform were analyzed: anteroposterior and mediolateral of the center of pressure parameters, while for the functional tests, the time in seconds was analyzed. RESULTS: Significant difference (p = 0.01) was found between lower limbs in the median frequency parameter in the mediolateral direction, in which non dominant lower limb showed higher postural stability than the dominant one. For functional tests, there was no significant difference between limbs. CONCLUSION: The difference found in the balance control of mediolateral direction may be related to different muscular actions of the hip region, which is present during the sport practice for stabilization, trunk maintenance, and movement performance with lower limbs. These results indicate the need of a balance program and pelvic stabilization for the analyzed athletes in order to maintain muscular symmetry of the limbs for high sports performance.

Age-related differences in center of pressure measures during one-leg stance are time dependent.

The aim of this study was to evaluate the changes in center of pressure (COP) movement in four time intervals (5, 10, 15 and 30 s) during a one-leg stance test performed by young and elderly adults. Twelve young adults (mean 20 years) and 12 elderly subjects (mean 68 years) participated in this study. The subjects performed three 30 s trials of an eyes open one-leg stance test on a force platform, in which the COP parameter was computed at four points in time from same original COP signal. Significant differences were found between the young and elderly adults (P < .007) only at the 10, 15 and 30 s intervals. For both groups, COP changes were significantly different between the 5 s time interval and other intervals (10, 15 and 30 s). In conclusion, these results pointed out that age-related difference in COP changes were time dependent. This suggests that the use of longer durations increases the possibility of distinguishing more subtle differences in postural strategy among different groups of subjects.

Avaliação físico - funcional de atletas da ginástica rítmica: histórico de lesões e estabilidade postural / Physical - functional evaluation of athletes rhythmic gymnastics: a history of injuries and postural stability

Poucas pesquisas têm avaliado o perfil físico e os riscos de lesão de atletas da ginástica rítmica (GR), principalmente no aspecto de lesões ortopédicas. O estudo teve como objetivo traçar o perfil físico-funcional, histórico de lesão e avaliar a estabilidade postural de atletas da GR. A amostra foi composta por sete atletas praticantes de GR. Utilizou-se o questionário FAOS (Foot and Ankle Outcome Score) para avaliação da função e sintomas de tornozelo e pé. Para avaliação do equilíbrio postural estático utilizou-se a plataforma de força e para avaliação do equilíbrio postural dinâmico foram utilizados dois testes funcionais, Star Excursion Balance Test (SEBT) e teste de figura em oito. Para o questionário FAOS, foi obtido em média uma pontuação de 90±11 para domínio de dor, e de 96±5 para outros sintomas. No teste SEBT obteve uma porcentagem de alcance de 95±9 para o membro inferior direito e 96±9 para o esquerdo, e para a figura em oito um tempo de 13±3 segundos para membro direito e 12±3 segundos para esquerdo. Com relação às medidas da plataforma de força, a média para a variável de velocidade do membro direito foi de 2,41±0,49 cm/s na direção ântero posterior (A/P) e 2,83±0,67 cm/s para direção médio-lateral (M/L), enquanto para o esquerdo de 2,69±0,46 cm/s A/P e 2,57±0,33 cm/s M/L. Embora não comparado com um grupo controle, os resultados do presente estudo para as atletas de GR caracterizaram-se por uma estabilidade postural adequada observada pelos dados obtidos nos testes funcionais e na plataforma de força.

Few studies have examined the physical profile and the risk of injury to athletes of Rhythmic Gymnastics (RG), especially in the aspect of orthopedic. The study aimed to evaluation physical and functional history of injury and to evaluate postural stability of the RG athletes. The sample was composed of seven in RG athletes. We used the FAOS (Foot and Ankle Outcome Score) to assess the function and symptoms of ankle and foot. To evaluate the static postural balance used the force platform assessment of balance and dynamic postural tests were used two functional tests, Star Excursion Balance Test (SEBT) and figure of eight. For functionality of the ankle evaluated by means of the FAOS, we obtained an average score of 90±11 for the area of pain, and 95±5 for the other symptoms, the SEBT test got the range of 95±9 to the right lower limb and 96±9 to the left, and the figure eight in a time of 13±3 s to the right limb and 12±3 seconds to the left. With the measurements of the force platform, the average for the right limb was 2,41±0,49 cm/s in the anteroposterior (A/P) direction and 2,83±0,67 cm/s in the mediolateral (M/L) direction, while to the left of 2,69±0,46 cm/s A/P and 2,57±0,33 cm/s M/L. Although not compared to control group, the results of the present study for RG athletes related to a suitable postural stability observed with data from functional tests and force platform measurements.

Relação entre o encurtamento de cadeia muscular posterior e a anteriorização da cabeça e ombros em atletas infanto-juvenis do gênero feminino / Relationship between the shortening of the posterior muscle chain and the forward shift of the head and shoulder in female athletes from the youth category

Analisou-se a relação entre o encurtamento da cadeia muscular posterior, os m¨²sculos isquitibiais, e a anteriorização de cabeça e ombros, em atletas de n¨ªvel competitivo. A amostra foi composta por 59 atletas, do sexo feminino e categoria infanto-juvenil, praticantes de diversas modalidades, divididos em dois grupos: o grupo 1 formado por 35 atletas com encurtamento significativo dos m¨²sculos isquiotibiais na postura de urso; o grupo-controle, com 24 atletas sem encurtamento dos isquiotibiais. Realizou-se, por an¨¢lise digital, fotografias em perfil e na postura de urso. Fixaram-se marcadores luminosos na articulação temporomandibular, acrômio (lateral), trocanter maior do f¨ºmur, côndilo femoral externo e mal¨¦olo lateral. Realizou-se a an¨¢lise cinem¨¢tica angular computadorizada com o Software para Avaliação Postural (SAPO), versão 0.68. Para a an¨¢lise estat¨ªstica, aplicaram-se os testes de Shapiro Wilk, t para amostras independentes e de correção de Pearson. O n¨ªvel de significância foi estabelecido em 5%. Como resultado, foi observado, no grupo 1, 2,5 graus (DP=1,12) de inclinação anterior na vista lateral e 43,15 graus (DP=9,41) de flexão do joelho na postura do urso. Para o grupo 2, obteve-se o resultado de 2,77 (DP=1,02) graus para a an¨¢lise do perfil, e -2,19 (DP=4,05) para a postura do urso. A an¨¢lise estat¨ªstica entre os grupos apresentou p=0,50 na comparação do desequil¨ªbrio anterior do tronco em vista lateral e p=0,00 para a comparação da postura do urso. A correlação entre o desequil¨ªbrio anterior do tronco e o encurtamento da cadeia posterior, apresentou r=0,04 para o grupo com encurtamento da cadeia posterior e r=0,1 para o controle. Assim, o encurtamento dos m¨²sculos isquitibiais não apresentou relação com a anteriorização da cabeça e ombros. Porem, no grupo com maior flexibilidade, observou-se maior anteriorização da cabeça e ombros, sem resultado significativo. .

The aim of the present study was to analyze the relationship between the shortening of the posterior muscle chain, mainly the hamstrings and the forward shift of the head and shoulder, as a possible adaptation in high level/performance athletes. The sample involved 59 female athletes from the youth category of different sports modalities. Group 1: 35 athletes with significant hamstrings¡¯ shortening evaluated by the ¡°bear¡¯s position¡±; Control group: 24 athletes without hamstrings¡¯ shortening, evaluated by the same position. Data collection was performed using digital analysis of pictures taken with the athlete standing (lateral vision) in the ¡°bear¡¯s position¡±. Luminous markers were placed in the temporomandibular joint, lateral region of the acromio, femur great trochanter, external femoral condyle and lateral malleolus. Variables were measured by the computerized angular cinematic analysis, using the software for posture evaluation SAPO, 0.68 version, always performed by the same rater. Statistical analysis was performed with the Shapiro Wilk test, Unpaired t test and Pearson¡¯s correlation coefficient. The level of significance was set at p¡Ü0.05. Group 1 showed 2.5 degrees (SD=1,12) of forward inclination in the lateral view and 43.15 degrees (SD=9,41) of knee flexion in the ¡°bear¡¯s position¡±. In group 2, there was 2.77 (DP=1.02) degrees in the lateral analysis and -2.19 (DP=4.05) degrees in the ¡°bear¡¯s position¡±. The statistical analysis between the two groups showed p=0.50 for the comparison of the anterior trunk imbalance in the lateral view and p=0,00 for the comparison of the ¡°bear¡¯s position¡±. The correlation analysis between the anterior trunk imbalance and the posterior muscle chain shortening, emphasizing the hamstrings, showed r=0.04 in the group with posterior chain shortening and r=0.1 in the control group. It can be concluded that the hamstrings¡¯ muscle shortening did not show any relation with the forward shift of the head and shoulde...