A prospective investigation of changes in the sensorimotor system following sports concussion. An exploratory study

Background Sports concussion is a risk for players involved in high impact, collision sports. Post-concussion, the majority of symptoms subside within 7–10 days, but can persist in 10–20% of athletes. Understanding the effects of sports concussion on sensorimotor systems could inform physiotherapy treatment. Objective To explore changes in sensorimotor function in the acute phase following sports concussion. Design Prospective cohort study. Methods Fifty-four players from elite rugby union and league teams were assessed at the start of the playing season. Players who sustained a concussion were assessed three to five days later. Measures included assessments of balance (sway velocity), vestibular system function (vestibular ocular reflex gain; right-left asymmetry), cervical proprioception (joint position error) and trunk muscle size and function. Results During the playing season, 14 post-concussion assessments were performed within 3–5 days of injury. Significantly decreased sway velocity and increased size/contraction of trunk muscles, were identified. Whilst not significant overall, large inter-individual variation of test results for cervical proprioception and the vestibular system was observed. Limitations The number of players who sustained a concussion was not large, but numbers were comparable with other studies in this field. There was missing baseline data for vestibular and cervical proprioception testing for some players. Conclusions Preliminary findings post-concussion suggest an altered balance strategy and trunk muscle control with splinting/over-holding requiring consideration as part of the development of appropriate physiotherapy management strategies

HAPPi Kneecaps! Protocol for a participant- and assessor-blinded, randomised, parallel group feasibility trial of foot orthoses for adolescents with patellofemoral pain

BACKGROUND: Patellofemoral pain (PFP) is a common cause of knee pain in adolescents, but there are limited evidence-based treatment options for this population. Foot orthoses can improve pain and function in adults with PFP, and may be effective for adolescents. The primary aim of th

Retraining running gait to reduce tibial loads with clinician or accelerometry guided feedback

Reducing tibial acceleration through gait retraining is thought to reduce the risk of stress fracture development, however current approaches require the use of advanced accelerometry equipment not readily available in the clinical setting. The aim was to compare the effect of clinician guided feedback with accelerometry guided feedback on peak tibial accelerations during running

Initial neuromotor and postural effects of augmented low-dye taping

Augmented low-dye (ALD) tape increases medial longitudinal arch height, reduces calcaneal eversion and tibial internal rotation, alters plantar pressure distribution, and reduces leg muscle activity. This study evaluated continual wear of ALD tape and its initial effect on foot posture and mobility, three-dimensional motion, and muscle recruitment patterns of the lower limb in 28 individuals. Participants were then randomly allocated for an intervention period to either a group that was exposed to ALD tape continually or a group that was not exposed. Following the intervention period, all participants attended a second test session, which reevaluated the initial physiological effects of tape. Analysis of differences in exposure status revealed minimal changes in the initial physiological effects of ALD tape, and those differences were likely due to natural variation. The initial physiological effects of ALD tape appear to be consistent, even after continual use over approximately 11 days

Differential Activation Of Medial And Lateral Hamstring Muscles In Loading Challenges: A Pilot Study: 1615: Board #105

Hamstring strain injuries are the most common muscle injury in Australian Rules Football. 80% of these involve the lateral hamstring group. Recurrence rate on return to play is reported to be 30%. Many exercises utilised in rehabilitation treat the hamstring muscles as a single group with sagittal plane exercise. Recent studies have identified differential activation of the medial and lateral hamstring groups in cutting manoeuvres similar to those encountered in Australian Rules Football. PURPOSE: To evaluate a variety of exercise challenges to determine if differential activation of the medial and lateral hamstring muscles can be achieved during rehabilitation. We hypothesised increased specificity may better optimise activation and possibly loading of the lateral hamstring group in particular, which has little in the way of synergists over the hip and knee. METHODS: Healthy adult participants with no history of hamstring muscle injury undertook a variety of isometric exercise challenges in random order. Two of these exercises comprised resisted knee flexion (at 80° knee flexion) in 0° and 45°hip flexion. Further exercises involved a hamstring bridge on a stable or unstable surface (Swiss Ball). A single leg trunk flexion exercise was also included. All exercises were performed with neutral, internal and external rotation of the knee. Activation of the biceps femoris (lateral hamstring) and semimembranosus (medial hamstring) was measured using surface electromyography (EMG) during maximal 5 s isometric holds. RESULTS: Challenges that elicited greatest activation of the lateral hamstring group were a hamstring bridge with external rotation of the hip and knee followed by a hamstring bridge in neutral. Greatest activation of the medial hamstring occurred during prone knee flexion in 0° hip flexion and internal rotation, followed by hamstring bridging on a Swiss ball with internal rotation. CONCLUSION: This pilot study identified hamstring loading challenges that offer greater specificity in activation of the medial and lateral hamstring muscles. These challenges may be useful in targeted rehabilitation of the lateral or medial hamstring muscles. In interpreting our findings it should be noted that activation levels do not necessarily correspond to muscle loads