A Systematic Review of Sensorimotor Function during Adolescence: A Developmental Stage of Increased Motor Awkwardness?

Background Although adolescent motor awkwardness and increased injury susceptibility have often been speculated and researched, studies regarding adolescent regressions in motor control have yielded inconsistent conclusions. Thus, the relationship between adolescent maturation and injury risk remains unclear. The purpose of this study was to systematically review the literature relative to two questions: (1) Which sensorimotor mechanisms are not fully mature by the time children reach adolescence? and (2) Is adolescence a period when children exhibit delays or regressions in sensorimotor mechanisms

The relationship between range of motion and injuries in adolescent dancers and sportspersons: A systematic review

Background: The frequent and intensive training and performance of pre-professional ballet dancers and sportspersons is offered at a time when young ballet dancers and young athletes may be vulnerable to injury due to the progress through adolescence and growth spurts. Hypothesis: There are changes in range of motion during the progress through adolescence and growth periods in dancers and sportspersons. These changes in ROM can be linked to the increase of injury. Objectives: The primary aim of this systematic review is to determine whether there are changes in ROM during the progress through adolescence and growth spurts in dancers and sportspersons. The secondary aim is to determine whether these changes can predict the risk of injuries for adolescent dancers and sportspersons. Search strategy: Pubmed, Cochrane Register of Controlled Trails (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), EBSCO Host databases: CINAHL Plus, MEDLINE, SPORTDiscus, Embase were searched using MeSH terms. Manual search in the Journal of Dance Medicine and Science and screening of the reference lists of identified studies and reviews was conducted. Selection criteria: Studies included adolescent dancers and sportspersons, aged 8–18, both sexes, growth spurt related to changes in ROM and injury incidence. Data collection and analysis: Search strategy was performed in the flow diagram of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently appraised each included study using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for methodological quality of the included studies. For data extraction, the following information was systematically extracted: first author and year of publication, study design, participants (sample size of mean age), age, maturation (if assessed), intervention, outcome(s), and some notes of each study. For evaluation of the risk of bias and precision the Research Triangle Institute Item Bank (RTI-IB) is included. Main results: Seven observational studies met the inclusion criteria of this current review. The results of this review suggest that there are changes in ROM during the progress through adolescence and growth spurts in dancers and sportspersons. These changes may lead to an increase in injury incidence. Conclusion: There is evidence linking to changes in ROM during the progress through adolescence and growth spurts in dancers and sportspersons. These changes in ROM may be related to injury incidence

Physical therapy Consultation in the Emergency Department For Older adults With Falls: a Qualitative Study

OBJECTIVES: Little is known about current practices in consulting physical therapy (PT) in the emergency department (ED) for older adults with falls, a practice that can reduce fall-related ED revisits. This qualitative study aimed to understand perspectives of ED staff about ED PT consultation for older adults with falls and fall-related complaints, specifically regarding perceived value and associated challenges and strategies. METHODS: We performed focus groups and key informant interviews with emergency physicians, advanced practice clinicians, nurses, physical therapists, occupational therapists, and technicians who perform ED geriatric screenings. We used rapid qualitative analysis to identify common themes related to decisions to consult PT from the ED, perceived value of PT, and common challenges and strategies in ED PT consultation. RESULTS: Twenty-five participants in 4 focus groups and 3 interviews represented 22 distinct institutions with ED PT consultation available for older adults with falls. About two thirds of EDs represented relied on clinician gestalt to request PT consultation (n = 15, 68%), whereas one third used formal consultation pathways (n = 7, 32%). Participants valued physical therapists\u27 expertise, time, and facilitation of hospital throughput by developing safe discharge plans and contact with patients to improve outpatient follow-up. Common challenges included limited ED PT staffing and space for PT evaluations; strategies to promote ED PT consultation included advocating for leadership buy-in and using ED observation units to monitor patients and avoid admission until PT consultation was available. CONCLUSION: ED PT consultation for older adults with falls may benefit patients, ED staff, and hospital throughput. Uncertainty remains over whether geriatric screening-triggered consultation versus emergency clinician gestalt successfully identifies patients likeliest to benefit from ED PT evaluation. Leadership buy-in, designated consultation space, and formalized consultation pathways are strategies to address current challenges in ED PT consultation

Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring, and gastrocnemius muscle‐tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment, and internal or external tibial torque) was applied to the distal tibia while recording the 3D knee loads and tibofemoral kinematics. AM‐ACL relative strain was measured using a 3 mm DVRT. In this repeated measures experiment, the Wilcoxon signed‐rank test was used to test the null hypotheses with p  < 0.05 considered significant. The mean (±SD) peak AM‐ACL relative strains were 5.4 ± 3.7% and 3.1 ± 2.8% under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM‐ACL strain rates reached 254.4 ± 160.1%/s and 179.4 ± 109.9%/s, respectively. The hypotheses were supported in that the normalized mean peak AM‐ACL relative strain and strain rate were 70 and 42% greater under internal than under external tibial torque, respectively ( p  = 0.023, p  = 0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM‐ACL than does a corresponding external tibial torque. © 2011 Orthopaedic Research Society. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:528–534, 2012Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90222/1/21572_ftp.pd

A comparison of catch phase force-time characteristics during clean derivatives from the knee

The aim of this study was to compare load-absorption force-time characteristics of the clean from the knee (CK), power clean from the knee (PCK) and clean pull from the knee (CPK). Ten collegiate athletes (age 27.5 ± 4.2 years; height 180.4 ± 6.7 cm; mass 84.4 ± 7.8 kg), performed three repetitions each of the CK, PCK and CPK with 90% of their 1RM power clean on a force platform. The CK load-absorption duration (0.95 ± 0.35 s) was significantly longer compared to the CPK (0.44 ± 0.15 s; p 0.05, d = 1.08), with no differences between PCK and CPK (p > 0.05, d = 0.91). The CPK demonstrated the greatest mean force (2039 ± 394 N), which was significantly greater than the PCK (1771 ± 325 N; p = 0.012, d = 0.83), but not significantly different to the CK (1830 ± 331 N; p > 0.05, d = 0.60); CK and PCK were not different (p > 0.05, d = 0.18). Significantly more load-absorption work was performed during the CK (655 ± 276 J) compared to the PCK (288 ± 109 J; d = 1.75, p 0.05). Additionally, more load-absorption work was performed during the CPK compared to the PCK (d = 1.90, p = 0.032). Inclusion of the catch phase during the CK does not provide any additional stimulus in terms of mean force or work during the load-absorption phase compared to the CPK, while the CPK may be beneficial in training rapid force absorption due to high force and a short duration

Warm-ups for Youth Athletes: Making the First 15-Minutes Count

Warm-up procedures have been found to have a significant influence on fitness performance in youth athletes. As such, warming up before exercise and competition is encouraged and is a widely accepted practice with children and adolescents. Differences in structure, type, duration, intensity, and content of warm-up protocols have led to considerable variation in warm-up procedures. As a result, there is a lack of consensus on the ideal method for preparing youth athletes for exercise and sport. This article, therefore, aims to review current warm-up classifications and considerations of youth athletes, while providing a template of appropriate exercises that can be used safely and effectively in individuals of varying capabilities

Consistency of Field-Based Measures of Neuromuscular Control Using Force Plate Diagnostics in Elite Male Youth Soccer Players

Consistency of field-based measures of neuromuscular control using force-plate diagnostics in elite male youth soccer players. J Strength Cond Res 30(12): 3304–3311, 2016—Deficits in neuromuscular control during movement patterns such as landing are suggested pathomechanics that underlie sport-related injury. A common mode of assessment is measurement of landing forces during jumping tasks; however, these measures have been used less frequently in male youth soccer players, and reliability data are sparse. The aim of this study was to examine the reliability of a field-based neuromuscular control screening battery using force-plate diagnostics in this cohort. Twenty-six pre–peak height velocity (PHV) and 25 post-PHV elite male youth soccer players completed a drop vertical jump (DVJ), single-leg 75% horizontal hop and stick (75%HOP), and single-leg countermovement jump (SLCMJ). Measures of peak landing vertical ground reaction force (pVGRF), time to stabilization, time to pVGRF, and pVGRF asymmetry were recorded. A test-retest design was used, and reliability statistics included change in mean, intraclass correlation coefficient, and coefficient of variation (CV). No significant differences in mean score were reported for any of the assessed variables between test sessions. In both groups, pVGRF and asymmetry during the 75%HOP and SLCMJ demonstrated largely acceptable reliability (CV ≤ 10%). Greater variability was evident in DVJ pVGRF and all other assessed variables, across the 3 protocols (CV range = 13.8–49.7%). Intraclass correlation coefficient values ranged from small to large and were generally higher in the post-PHV players. The results of this study suggest that pVGRF and asymmetry can be reliably assessed using a 75%HOP and SLCMJ in this cohort. These measures could be used to support a screening battery for elite male youth soccer players and for test-retest comparison

Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity

Generalized joint laxity is a genetically determined component of overall joint flexibility. The incidence of joint laxity in the overall population is approximately 5% to 20%, and its prevalence is higher in females. Recently it was noticed that individuals with generalized joint laxity are not only prone to anterior cruciate ligament injuries but also have inferior results after a reconstruction. Therefore, an anterior cruciate ligament reconstruction in patients with generalized laxity should be undertaken with caution due to the higher expected failure rate from the complexity of problems associated with this condition. It is also necessary to identify the risk factors for the injury as well as for the post operative outcome in this population. A criterion that includes all the associated components is necessary for the proper screening of individuals for generalized joint laxity. Graft selection for an anterior cruciate reconstruction in patients with ligament laxity is a challenge. According to the senior author, a hamstring autograft is an inferior choice and a double bundle reconstruction with a quadriceps tendon-bone autograft yields better results than a single bundle bone-patella tendon-bone autograft. Future studies comparing the different grafts available might be needed to determine the preferred graft for this subset of patients. Improved results after an anterior cruciate ligament reconstruction can be achieved by proper planning and careful attention to each step beginning from the clinical examination to the postoperative rehabilitation