Progressing On-Court Rehabilitation After Injury: The Control-Chaos Continuum Adapted to Basketball.

BACKGROUND: Sport-specific training is an integral component of returning to sport following injury. Frameworks designed to guide sport-specific rehabilitation need to integrate and adapt to the specific context of elite sport. The control-chaos continuum (CCC) is a flexible framework originally designed for on-pitch rehabilitation in elite football (soccer). The concepts underpinning the CCC transfer to other elite sport rehabilitation environments. CLINICAL QUESTION: How can practitioners and clinicians transfer the CCC to elite basketball, to support planning and return to sport? On-court rehabilitation is a critical sport-specific rehabilitation component of return to sport, yet there are no frameworks to guide practitioners when planning and delivering on-court rehabilitation. KEY RESULTS: Based on our experience working in the National Basketball Association, we report how the CCC framework can apply to elite basketball. We focus on the design and delivery of progressive training in the presence of injury in this basketball-specific edition of the CCC. Given the challenges when quantifying "load" in basketball, we encourage practitioners and clinicians to consider the qualitative aspects of performance such as skill, sport-specific movement, contact, and decision making. CLINICAL APPLICATION: The 5-phase framework describes training progression from high control, a return to on-court running, to high chaos, a return to "live" unrestricted basketball. The model can be adapted to both short- and long-term injuries based on injury and progression criteria. Strength and power "diagnostics" can be strategically implemented to enhance decision making throughout the return to sport continuum. J Orthop Sports Phys Ther 2023;53(9):1-12. Epub: 9 August 2023. doi:10.2519/jospt.2023.11981.

Auditory detection learning is accompanied by plasticity in the auditory evoked potential.

Auditory detection can improve with practice. These improvements are often assumed to arise from selective attention processes, but longer-term plasticity as a result of training may also play a role. Here, listeners were trained to detect either an 861-Hz or 1058-Hz tone (counterbalanced across participants) presented in noise at SNRs varying from -10 to -24 dB. On the following day, they were tasked with detecting 861-Hz and 1058-Hz tones at an SNR of -21 dB. In between blocks of this active task, EEG was recorded during passive presentation of trained and untrained frequency tones in quiet. Detection accuracy and confidence ratings were higher for trials at listeners' trained, than untrained-frequency (i.e., learning occurred). During passive exposure to sounds, the P2 component of the auditory evoked potential (∼150 - 200 ms post tone onset) was larger in amplitude for the trained compared to the untrained frequency. An analysis of global field power similarly yielded a stronger response for trained tones in the P2 time window. These effects were obtained during passive exposure, suggesting that training induced improvements in detection are not solely related to changes in selective attention. Rather, there may be an important role for changes in the long-term neural representations of sounds.