FRONTAL PLANE ALIGNMENT DURING FOREHAND AND BACKHAND LAWN BOWLS DELIVERIES

There is very little research on the biomechancis of the lawn bowls delivery. Bowls are commonly delivered using either a forehand or backhand technique. The purpose of this study was to compare the pelvis, trunk and upper limb kinematics of the forehand and backhand lawn bowls delivery. Elite lawn bowlers (n=18) who were competing at international level performed a series of forehand and backhand lawn bowls deliveries on a simulated indoor bowling rink. Differences were found between the delivery types for pelvis and trunk segment angles but there were no differences in upper limb frontal plane joint angles at the shoulder, elbow or wrist. It was concluded that the backhand delivery is executed with a more upright technique, possibly affecting weight transfer during the delivery stride. The similarity in upper limb kinematics suggests coaching drills that focus on the upper limb can benefit deliveries on both the forehand and backhand

DIFFERENCES IN ACCURACY AND CONSISTENCY IN ELITE LAWN BOWLERS

The purpose of this study was to compare the accuracy and consistency of repeated lawn bowls deliveries across four different bowling conditions, as well as the bias in displacement of bowls that did not hit the target. Twenty-seven national and international representative lawn bowls athletes completed 16 forehand and backhand deliveries at two different bowling lengths. The resting position of each bowl in relation to the target was used to calculate width, length and absolute displacement of bowls from the target for each participant in each condition. Accuracy was not different between conditions, but athletes were less consistent in delivering forehand bowls. Athletes also had greater displacement in bowling width during forehand deliveries. The results of this study can be used as a guide for targeting training strategies that improve lawn bowling performance

Mechanical differences between men and women during overground load carriage at self-selected walking speeds

Few studies have directly compared physical responses to relative loading strategies between men and women during overground walking. This study aimed to compare gait mechanics of men and women during overground load carriage. A total of 30 participants (15 male, 15 female) completed three 10-min walking trials while carrying external loads of 0%, 20% and 40% of body mass at a self-selected walking speed. Lower-body motion and ground reaction forces were collected using a three-dimensional motion capture system and force plates, respectively. Female participants walked with a higher cadence (p = 0.002) and spent less absolute time in stance (p = 0.010) but had similar self-selected walking speed (p = 0.750), which was likely due to the female participants being shorter than the male participants. Except for ankle plantarflexion moments, there were no sex differences in spatiotemporal, kinematic, or kinetic variables (p > 0.05). Increasing loads resulted in significantly lower self-selected walking speed, greater stance time, and changes in all joint kinematics and kinetics across the gait cycle (p 0.05). In conclusion, there were few differences between sexes in walking mechanics during overground load carriage. The changes identified in this study may inform training programs to increase load carriage performance

The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians

BackgroundDespite calf muscle strain injuries (CMSI) being problematic in many sports, there is a dearth of research to guide clinicians dealing with these injuries. The aim of this study was to evaluate the current practices and perspectives of a select group of international experts regarding the assessment, management and prevention of CMSI using in-depth semi-structured interviews.ResultsTwenty expert clinicians working in elite sport and/or clinician-researchers specialising in the field completed interviews. A number of key points emerged from the interviews. Characteristics of CMSI were considered unique compared to other muscle strains. Rigor in the clinical approach clarifies the diagnosis, whereas ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. Athlete intrinsic characteristics, injury factors and sport demands shaped rehabilitation across six management phases, which were guided by key principles to optimise performance at return to play (RTP) while avoiding subsequent injury or recurrence. To prevent CMSI, periodic monitoring is common, but practices vary and data are collected to inform load-management and exercise selection rather than predict future CMSI. A universal injury prevention program for CMSI may not exist. Instead, individualised strategies should reflect athlete intrinsic characteristics and sport demands.ConclusionsInformation provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. Principles for optimal management after CMSI were also identified, which involved a systematic approach to rehabilitation and the RTP decision. Although CMSI were reportedly difficult to prevent, on- and off-field strategies were implemented by experts to mitigate risk, particularly in susceptible athletes

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Rehabilitation exercises for the gluteus medius muscle segments: An electromyography study

Context: Many different rehabilitation exercises have been recommended in the literature to target the gluteus medius (GMed) muscle based mainly on single-electrode, surface electromyography (EMG) measures. With the GMed consisting of 3 structurally and functionally independent segments, there is uncertainty on whether these exercises will target the individual segments effectively. Objective: To measure individual GMed segmental activity during 6 common, lower-limb rehabilitation exercises in healthy young adults, and determine if there are significant differences between the exercises for each segment. Method: With fine-wire EMG electrodes inserted into the anterior, middle, and posterior segments of the GMed muscle, 10 healthy young adults performed 6 common, lower-limb rehabilitation exercises. Main Outcome Measures: Recorded EMG activity was normalized, then reported and compared with median activity for each of the GMed segments across the 6 exercises. Results: For the anterior GMed segment, high activity was recorded for the single-leg squat (48% maximum voluntary isometric contraction [MVIC]), the single-leg bridge (44% MVIC), and the resisted hip abduction-extension exercise (41% MVIC). No exercises recorded high activity for the middle GMed segment, but for the posterior GMed segment very high activity was recorded by the resisted hip abduction-extension exercise (69% MVIC), and high activity was generated by the single-leg squat (48% MVIC) and side-lie hip abduction (43% MVIC). For each of the GMed segments, there were significant differences (P < .05) in the median EMG activity levels between some of the exercises and the side-lie clam with large effect sizes favoring these exercises over the side-lie clam. Conclusions: Open-chain hip abduction and single-limb support exercises appear to be effective options for recruiting the individual GMed segments with selection dependent on individual requirements. However, the side-lie clam does not appear to be effective at recruiting the GMed segments, particularly the anterior and middle segments

Symmetry of squatting and the effect of fatigue following anterior cruciate ligament reconstruction

Purpose: To evaluate weight-bearing and joint symmetry during the double-leg squat exercise at baseline and after fatigue in patients who have undergone anterior cruciate ligament reconstruction (ACLR) compared to uninjured controls. Methods: Ten males who had returned to sport after primary ACLR participated along with ten uninjured male controls. Lower limb kinematic, kinetic and ground reaction force (GRF) data were collected during double-leg squats at baseline and after a generalised fatigue protocol. Symmetry indices were calculated for hip and knee external flexion moments and the vertical GRF (weight-bearing symmetry) at maximum squat depth. These were compared between ACLR and control groups before and after fatigue using ANOVA models. Results: The ACL group preferentially unloaded the reconstructed limb at baseline, but changed to a more symmetrical load distribution to perform the squat exercise in the fatigue condition. This same loading pattern was seen at both the knee and hip joints. The control group did not show any effect of fatigue. For both groups, symmetry indices were closer to zero (which indicated perfect symmetry) in the fatigue condition. Conclusions: When prescribing squat exercises, it should be recognised that initially, patients with ACLR tend to unload the affected knee. More symmetrical loading patterns may be achieved by inducing bilateral fatigue. When fatigued, loading symmetry was similar between this patient group and controls. This is relevant information for those who implement rehabilitation training programmes