Preseason Functional Test Scores are Associated with Future Sports Injury in Female Collegiate Athletes

Brumitt, J, Heiderscheit, B, Manske, R, Niemuth, PE, Mattocks, A, and Rauh, MJ. Preseason functional test scores are associated with future sports injury in female collegiate athletes. J Strength Cond Res 32(6): 1692–1701, 2018—Recent prospective cohort studies have reported preseason functional performance test (FPT) measures and associations with future risk of injury; however, the findings associated with these studies have been equivocal. The purpose of this study was to determine the ability of a battery of FPTs as a preseason screening tool to identify female Division III (D III) collegiate athletes who may be at risk for a noncontact time-loss injury to the lower quadrant (LQ = low back and lower extremities). One hundred six female D III athletes were recruited for this study. Athletes performed 3 FPTs: standing long jump (SLJ), single-leg hop (SLH) for distance, and the lower extremity functional test (LEFT). Time-loss sport-related injuries were tracked during the season. Thirty-two (24 initial and 8 subsequent) time-loss LQ injuries were sustained during the study. Ten of the 24 initial injuries occurred at the thigh and knee. At-risk athletes with suboptimal FPT measures (SLJ #79% ht; (B) SLH #64% ht; LEFT $118 seconds) had significantly greater rates of initial (7.2 per 1,000 athletic exposures [AEs]) and total (7.6 per 1,000 AEs) time-loss thigh or knee injuries than the referent group (0.9 per 1,000 AEs; 1.0 per 1,000 AEs, respectively). At-risk athletes were 9 times more likely to experience a thigh or knee injury (odds ratio [OR] = 9.7, confidence interval [CI]: 2.3–39.9; p = 0.002) than athletes in the referent group. At-risk athletes with a history of LQ sports injury and lower off-season training habits had an 18-fold increased risk of a time-loss thigh or knee injury during the season (adjusted OR = 18.7, CI: 3.0–118.1; p = 0.002). This battery of FPTs appears useful as a tool for identifying female D III athletes at risk of an LQ injury, especially to the thigh or knee region

Lower Extremity Functional Tests and Risk of Injury in Division III Collegiate Athletes

Purpose/Background: Functional tests have been used primarily to assess an athlete’s fitness or readiness to return to sport. The purpose of this prospective cohort study was to determine the ability of the standing long jump (SLJ) test, the single-leg hop (SLH) for distance test, and the lower extremity functional test (LEFT) as preseason screening tools to identify collegiate athletes who may be at increased risk for a time-loss sports-related low back or lower extremity injury. Methods: A total of 193 Division III athletes from 15 university teams (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 y) were tested prior to their sports seasons. Athletes performed the functional tests in the following sequence: SLJ, SLH, LEFT. The athletes were then prospectively followed during their sports season for occurrence of low back or LE injury. Results: Female athletes who completed the LEFT in 118 s were 6 times more likely (OR=6.4, 95% CI: 1.3, 31.7) to sustain a thigh or knee injury. Male athletes who completed the LEFT in 100 s were more likely to experience a time-loss injury to the low back or LE (OR=3.2, 95% CI: 1.1, 9.5) or a foot or ankle injury (OR=6.7, 95% CI: 1.5, 29.7) than male athletes who completed the LEFT in 101 s or more. Female athletes with a greater than 10% side-to-side asymmetry between SLH distances had a 4-fold increase in foot or ankle injury (cut point: \u3e10%; OR=4.4, 95% CI: 1.2, 15.4). Male athletes with SLH distances (either leg) at least 75% of their height had at least a 3-fold increase (OR=3.6, 95% CI: 1.2, 11.2 for the right LE; OR=3.6, 95% CI: 1.2, 11.2 for left LE) in low back or LE injury. Conclusions: The LEFT and the SLH tests appear useful in identifying Division III athletes at risk for a low back or lower extremity sports injury. Thus, these tests warrant further consideration as preparticipatory screening examination tools for sport injury in this population. Clinical Relevance: The single-leg hop for distance and the lower extremity functional test, when administered to Division III athletes during the preseason, may help identify those at risk for a time-loss low back or lower extremity injury

The Lower-Extremity Functional Test and Lower-Quadrant Injury in NCAA Division III Athletes: A Descriptive and Epidemiologic Report

Context: The Lower-Extremity Functional Test (LEFT) has been used to assess readiness to return to sport after a lower extremity injury. Current recommendations suggest that women should complete the LEFT in 135 s (average; range 120-150 s) and men should complete the test in 100 s (average; range 90-125 s). However, these estimates are based on limited data and may not be reflective of college athletes. Thus, additional assessment, including normative data, of the LEFT in sport populations is warranted. Objective: To examine LEFT times based on descriptive information and off-season training habits in NCAA Division III (Dill) athletes. In addition, this study prospectively examined the LEFT’S ability to discriminate sport-related injury occurrence. Design: Descriptive epidemiology. Setting: Dill university. Subjects: 189 Dill college athletes (106 women, 83 men) from 15 teams. Main Outcome Measures: LEFT times, preseason questionnaire, and time-loss injuries during the sport season. Results: Men completed the LEFT (105 ± 9 s) significantly faster than their female counterparts (117 ± 10 s) (P \u3c .0001). Female athletes who reported \u3e3-5 h/wk of plyometric training during the off-season had significantly slower LEFT scores than those who performed \u3c3 h/wk of plyometric training (P - -03). The overall incidence of a lower-quadrant (LQ) time-loss injury for female athletes was 4.5/1000 athletic exposures (AEs) and 3.7/1000 AEs for male athletes. Female athletes with slower LEFT scores (\u3e118 s) experienced a higher rate of LQ time-loss injuries than those with faster LEFT scores (\u3c117 s) (P = .03). Conclusion: Only off-season plyometric training practices seem to affect LEFT score times among female athletes. Women with slower LEFT scores are more likely to be injured than those with faster LEFT scores. Injury rates in men were not influenced by performance on the LEFT

A Comparison of Resting Scapular Posture and the Davies Closed Kinetic Chain Upper Extremity Stability Test

# BACKGROUND In orthopaedic practice, it is well established that weak scapular stabilizers and an unstable scapula is related to shoulder dysfunction. Faulty scapular position has been linked to decreased scapular stability and is thought to be a result of weak or unbalanced timing in the recruitment of scapulothoracic dynamic stabilizing muscles. Kibler has described a four-type classification of scapulothoracic dysfunction. Functional performance testing is used to objectively measure activities that simulate various desired activities. The reliability of assessing the four static scapular positions may be important in diagnosing shoulder dysfunction. An understanding of the scapular position and its relationship to functional performance testing is needed. # PURPOSE The purpose of this study was to determine if a static scapular test, the Kibler scapula classification, in healthy participants affects the ability to perform a closed chain functional test that involves the use of the scapula and the upper extremity, the Davies Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). A secondary analysis was performed to evaluate the reliability of a student physical therapist and an experienced physical therapist to identify scapular type by observation. # STUDY DESIGN Multicenter, single session descriptive cohort # METHODS Sixty-one healthy participants (33 males, 28 females; mean age 24.19±2.61) completed testing across two locations in one testing session. Blood pressure and heart rate as well as height and weight were measured for each participant. Participants were classified by visual observation of Kibler scapular classification. The average number of CKUEST touches, a normalized score, and a power score were calculated for each participant. Three trials were performed and participants were required to take a 45-second rest break between each CKCUEST trial. # RESULTS One way analysis of variance (ANOVA) showed statistically significant differences in Type I and Type IV Kibler scapula classification for the CKCUEST power score, however when an ANCOVA controlled for body mass index, there was no statistically significant difference. A strong correlation r=.94 was observed between student and experienced physical therapist in evaluating all four types of Kibler scapular classification. # CONCLUSIONS Visually observed Kibler scapular position does not affect the ability to perform the Davies CKCUEST in healthy young adults. The ability to identify Kibler scapular position was reliable between student and experienced physical therapists. Additional studies are required to identify the usefulness of the Kibler scapular position classification. # LEVEL OF EVIDENCE 2b: Individual Cohort Stud

The Application of Musculoskeletal Ultrasound in the Diagnosis of Supraspinatus Injuries

Musculoskeletal (MSK) diagnostic ultrasound has become an invaluable tool in the assessment of musculoskeletal pathologies, including rotator cuff injuries, notably the supraspinatus tendon. MSK ultrasound, characterized by high-resolution and real-time imaging capabilities, presents a cost-effective, safe, and patient-friendly alternative. This modality allows precise visualization of the supraspinatus tendon's structure and function, aiding in the identification of pathological alterations, such as thickening, thinning, or disruption, critical in diagnosing conditions like tendonitis, partial tears, and ruptures. In this manuscript, we detail the diagnostic utility of MSK ultrasound in assessing supraspinatus injuries, discussing the indications, techniques, and findings relevant to the supraspinatus tendon. Moreover, we examine the advantages and limitations of this imaging modality and provide a step-by-step guide for accurate supraspinatus tendon evaluation. The evidence suggests that MSK ultrasound is a dependable and cost-effective imaging technique for diagnosing supraspinatus injuries when executed by skilled operators

The Use of MSK Ultrasound in the Evaluation of Elbow Ulnar Collateral Ligament Injuries

As physical therapists, understanding the anatomy and biomechanics of the musculoskeletal system is essential for accurate diagnosis and effective treatment outcomes. Musculoskeletal ultrasound (MSK-US) is one tool that has revolutionized the way physical therapists evaluate musculoskeletal pathology. Specific to the elbow, assessing the ulnar collateral ligament (UCL) proves especially beneficial for providing both diagnosis and treatment planning. By directly visualizing static and dynamic loads to the ligament, physical therapists can gain valuable information about underlying pathology and guide the therapeutic decision-making process. In this sound byte, we will look at how incorporating MSK-US imaging into your patient assessments can provide you with more comprehensive data to make informed clinical decisions when treating UCL injuries in the elbow

Musculoskeletal Ultrasound: An Essential Tool in Diagnosing Patellar Tendon Injuries

Musculoskeletal (MSK) ultrasound has emerged as a vital tool in diagnosing patellar tendon injuries. Traditional imaging techniques, such as X-rays and Magnetic Resonance Imaging, have certain limitations in assessing soft tissue structures or may not be easily accessible. MSK ultrasound, with its high-resolution, real-time imaging capabilities, offers a cost-effective, safe, and patient-friendly alternative. It allows for accurate visualization of the patellar tendon's structure and function, thereby facilitating the identification of pathological changes such as thickening, thinning, or disruption which aids in diagnosing conditions such as tendonitis, partial tears, and ruptures. Furthermore, MSK ultrasound serves as an invaluable tool for guiding interventions like injections, as it provides real-time imaging. This article explores the role and benefits of MSK ultrasound in diagnosing patellar tendon injuries, highlighting its cost-effectiveness, accessibility, real-time assessment capabilities, and reduced patient burden compared to other imaging modalities. Despite its numerous benefits, the need for ongoing research to enhance its utility is highlighted. As technology advances, MSK ultrasound is set to revolutionize the early detection and management of patellar tendon injuries. ©The Author(s

Search for the isotropic stochastic background using data from Advanced LIGO's second observing run

The stochastic gravitational-wave background is a superposition of sources that are either too weak or too numerous to detect individually. In this study, we present the results from a cross-correlation analysis on data from Advanced LIGO’s second observing run (O2), which we combine with the results of the first observing run (O1). We do not find evidence for a stochastic background, so we place upper limits on the normalized energy density in gravitational waves at the 95% credible level of ΩGW < 6.0 × 10−8 for a frequency-independent (flat) background and ΩGW < 4.8 × 10−8 at 25 Hz for a background of compact binary coalescences. The upper limit improves over the O1 result by a factor of 2.8. Additionally, we place upper limits on the energy density in an isotropic background of scalar- and vector-polarized gravitational waves, and we discuss the implication of these results for models of compact binaries and cosmic string backgrounds. Finally, we present a conservative estimate of the correlated broadband noise due to the magnetic Schumann resonances in O2, based on magnetometer measurements at both the LIGO Hanford and LIGO Livingston observatories. We find that correlated noise is well below the O2 sensitivity

Diagnosis and management of adhesive capsulitis

Adhesive capsulitis is a musculoskeletal condition that has a disabling capability. This review discusses the diagnosis and both operative and nonoperative management of this shoulder condition that causes significant morbidity. Issues related to medications, rehabilitation, and post surgical considerations are discussed