ABSTRACT
BACKGROUND: Collegiate distance runners often suffer from running overuse injuries (ROI). The Y-Balance Test (YBT) has the potential to predict ROI risk in collegiate runners. PURPOSE: To investigate whether a preseason clinical assessment of dynamic balance, through a modified version of the YBT (mYBT), can predict risk of ROIs during one NCAA Division I cross-country (XC) season. STUDY DESIGN: Prospective case-control study. METHODS: Participants from a Division I XC team were screened for mYBT performance in four directions: anterior (AN), posteromedial (PM), posterolateral (PL), and posterior (PO). ROIs were tracked over the course of the XC season. Receiver operating characteristic (ROC) curve analysis (α = 0.05) was utilized to investigate the effectiveness of the mYBT in predicting injury risk. RESULTS: Nine (5 female, 4 male) of 29 runners developed an ROI during the XC season. Five components of the mYBT were found to predict injuries, including normalized nondominant PO score (AUC = 0.756, p = 0.03; RR = 1.90), AN raw difference and limb asymmetry (AUC = 0.808, p = 0.01), and PM raw difference and limb asymmetry in males (AUC = 0.958, p = 0.02). CONCLUSION: Specific components of the mYBT can help predict the risk of developing a running overuse injury over one Division I XC season. LEVEL OF EVIDENCE: Screening, Level 3.
ABSTRACT
BACKGROUND: Impaired balance and strength commonly affect athletes with conditions like chronic ankle instability (CAI). Yet, clinical research surrounding the relationship between balance, strength, and CAI is still growing. Deeper investigation of these relationships is warranted to better inform clinical practice patterns when managing athletes with balance deficits. PURPOSE: To investigate the relationship between single leg balance, ankle strength, and hip strength in healthy, active adults. STUDY DESIGN: Observational study. METHODS: Forty healthy participants (age 23.7 ± 4.9 years) were assessed for static balance, using a modified version of the Balance Error Scoring System (mBESS), as well as isometric strength of ankle and hip musculature via handheld dynamometry. Pearson's correlations were used to analyze relationships between balance and strength measures. Paired t-tests were utilized to compare dominant and non-dominant limb performance. RESULTS: Negligible to low, negative correlations were found between balance scores and hip extension strength (r = -0.24 to -0.38, p<0.05). High, positive correlations were found between ankle and hip strength measures (r = 0.75 to 0.84, p<0.05). When comparing dominant to non-dominant limbs, only minimal differences were noted in ankle eversion strength (mean difference = 6.0%, p<0.01) and hip extension strength (mean difference = 5.5%, p<0.01). CONCLUSIONS: Minimal relationships were identified between static balance and isometric ankle and hip strength. Comparison of dominant and non-dominant limbs suggests that clinicians should expect relative symmetry in balance and strength in healthy adults. Thus, asymmetries found during clinical examination should raise suspicion of specific impairments that may lead to dysfunction. LEVEL OF EVIDENCE: 2c.
ABSTRACT
STUDY DESIGN: Repeated measures. BACKGROUND: Both clinicians and researchers often utilize treadmills to analyze spatiotemporal and biomechanical factors during running. However, there is question of whether or not treadmill running mimics overground running. The development of new wearable technology, such as pressure sensor insoles, presents an opportunity to compare the two running conditions. PURPOSE: To compare the spatiotemporal factors between overground and treadmill running in collegiate runners, using pressure sensor insoles. METHODS: Twenty-one collegiate runners (age 20.1 ± 1.5 years, 81% female) were recruited from a Division I Cross Country team. Subjects participated in two 15-minute testing sessions. During the first session, subjects ran at their "easy run pace" for 200 meters, while wearing pressure sensor insoles. During the second session, subjects ran at a speed-matched pace on a treadmill for one minute at a level grade, and one minute at a 1% incline. Cadence, stance duration and swing duration were processed using Moticon Science Pro + software (Munich, DE). Data between overground and treadmill running was compared using repeated measures analysis of variance with α = 0.05. RESULTS: Compared to overground running, level and incline treadmill running was associated with increased cadence (mean difference [MD] = 3.55-3.22 strides per minute; p < 0.01), decreased stance duration (MD = 14-16 ms; p < 0.01), and decreased swing duration (MD = 11-12 ms; p < 0.05). CONCLUSION: In collegiate runners, overground and treadmill running differ in spatiotemporal comparisons. LEVELS OF EVIDENCE: 3.
ABSTRACT
BACKGROUND: Monitoring the volume of activity (i.e. pitch counts) and tracking upper extremity (UE) performance changes is common in overhead athletes; however, a lack of evidence exists for volleyball players.Purpose: The purpose of this study was to investigate changes in shoulder mobility, strength, and pain, along with UE swing count volume in Division I collegiate female volleyball athletes over a competitive season.Study Design: Observational, longitudinal study. METHODS: Swing count data was collected during two separate days of practice during weeks 1, 7, and 14 of the competitive season. Perceived swing counts were collected after each practice from athletes and two coaches. Actual swing counts were tallied by retrospective viewing of video footage. Dominant shoulder internal (IR) and external rotation (ER) range of motion (ROM) and isometric strength, along with UE pain, were assessed on five occasions: baseline, in-season (weeks 1, 7, 14) and post-season (week 22). RESULTS: Five Division I female volleyball athletes participated. Perceived UE swing counts among coaching staff were significantly correlated with actual swing count (r = 0.93 - 0.98, p<.05), while athlete perceived swing count was moderately correlated and was not statistically significant (r = 0.64, p = .25). Shoulder IR ROM decreased from baseline to week 14 (-5.6 ± 10.6, 95% CI: -18.76, 7.6; p = .03), with a large effect size (d = 1.0). Large effect sizes were observed for increases in UE pain, shoulder ER ROM, and IR strength (d = 0.8 - 2.3). An increase in shoulder IR strength occurred from baseline to week 14 (p = .001), but decreased during the eight weeks of post-season relative rest (p = .02). CONCLUSIONS: UE swing count estimates by coaching staff demonstrated higher correlation with actual swing counts obtained through video recording, as compared to volleyball athlete self-report. This cohort experienced increased shoulder IR strength and ER ROM over a competitive season. Shoulder IR ROM decreased during the first 14 weeks with a large effect size. Monitoring UE performance changes and swing count volume may have implications for injury prevention and program development for volleyball athletes. LEVEL OF EVIDENCE: Level 2B.
ABSTRACT
BACKGROUND: Ankle plantarflexion (PF) active range of motion (ROM) is traditionally assessed in a non-weight-bearing (NWB) position with a universal goniometer. However, a convenient, reliable, low-cost means of assessing functional PF active ROM in a weight-bearing (WB) position has yet to be established. PURPOSE: To compare the intra- and interrater reliability of PF active ROM measurements obtained from a goniometric NWB assessment, and a functional heel-rise test (FHRT) performed in WB. STUDY DESIGN: Reliability study. METHODS: Two physical therapy student examiners, blinded to each other's measurements, assessed PF active ROM through a NWB goniometric technique and a FHRT on all subjects within the same test session. Intra- and interrater reliability values were calculated using an intraclass correlation coefficient (ICC2,1, ICC2,k) and 95% confidence intervals. Standard error of measurement (SEM) and minimal detectable change (MDC) were recorded for each method. RESULTS: 43 healthy participants (mean ± SD, age: 22.7 ± 1.7 years, height: 1.7 ± 0.1 m, mass: 77.8 ± 17.2 kg) completed testing procedures. The within-session intrarater reliability (ICC2,1) estimates were observed for goniometry (right: 0.96, left: 0.95 - 0.97) and FHRT (right: 0.99, left: 0.99), as well as the interrater reliability (ICC2,k) of goniometry (right: 0.79, left: 0.79) and FHRT (right: 0.79, left: 0.87). Goniometry SEM (3.3 - 3.6 °) and MDC (9.2 - 9.8 °) were observed, in addition to FHRT SEM (0.6 cm) and MDC (1.6 - 1.7 cm). A weak correlation was found between FHRT and goniometric measurements (r = -0.03 - 0.13). CONCLUSIONS: The FHRT was found to have good to excellent intra- and interrater reliability, similar to goniometric measurement. The lack of agreement between these measurements requires further exploration of a WB assessment of ankle PF active ROM. LEVEL OF EVIDENCE: 2b.
ABSTRACT
Evidenced-based-wound management continues to be a cornerstone for advancing patient care. The purpose of this article is to review the use of whirlpool as a wound treatment in light of evidence, outcomes, and potential harm. Whirlpool was initially harnessed as a means to impart biophysical energy to a wound or burn to enhance mechanical debridement and cleansing. Other credible single-patient-use technologies which provide an alternative to whirlpool in wound care are presented.
