International Journal of Sports Physical Therapy最新文献

{"title":"Beyond Physical Recovery: Psychological Factors and Assessment Tools in Return to Sport Decision-making after Anterior Cruciate Ligament Reconstruction - A Scoping Review.","authors":"Dannyelle Long, Smita Rao","doi":"10.26603/001c.171296","DOIUrl":"10.26603/001c.171296","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament reconstruction (ACLR) is among the most common surgical interventions following sport-related knee injury, yet fewer than two-thirds of athletes return to their pre-injury level of sport. Psychological factors are increasingly recognized as critical determinants of successful return to sport (RTS), yet psychological instruments remain inconsistently integrated into RTS decision-making and no consensus exists on which tools best capture the multidimensional nature of psychological readiness. The purpose of this review was to examine the psychological instruments used in RTS decision-making among athletes recovering from ACLR and identify gaps in current assessment practices.</p><p><strong>Study design: </strong>Scoping Review.</p><p><strong>Methods: </strong>A comprehensive search was conducted across MEDLINE (via PubMed), SPORTDiscus, Web of Science, Scopus, and CINAHL for peer-reviewed English-language studies published between 1999 and 2024 involving athletes who underwent ACLR and reported psychological factors or assessment tools relevant to RTS. Title, abstract, and full-text screening were independently conducted by two reviewers, with discrepancies resolved through discussion and, when necessary, referral to a third reviewer. The review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. Forty-four studies met eligibility criteria and were included.</p><p><strong>Results: </strong>Twelve psychological assessment tools were identified across 44 studies. The Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale was the most frequently used instrument, appearing in 35 of 44 studies. The Tampa Scale of Kinesiophobia (TSK) appeared in 11 studies and the Knee Self-Efficacy Scale (K-SES) in 8 studies. No single instrument captured the full psychological complexity of RTS readiness.</p><p><strong>Conclusion: </strong>Psychological readiness is a multidimensional construct requiring assessment beyond a single instrument. The ACL-RSI, TSK, and K-SES₁₈ each capture distinct dimensions of psychological readiness, and considering them together may help clinicians identify psychological barriers that may not be captured by a single instrument. However, whether a combined assessment approach improves RTS decision-making or outcomes has not been directly tested and warrants prospective investigation.</p><p><strong>Level of evidence: </strong>2a.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"923-933"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reliability and Validity of a Novel Isometric Trunk Rotation Strength Test.","authors":"Kari Arnason, Hildur H Sigmarsdottir, Rosey Bjorgvinsdottir, Kristin Briem","doi":"10.26603/001c.171300","DOIUrl":"10.26603/001c.171300","url":null,"abstract":"<p><strong>Background: </strong>Trunk rotation (TR) strength and power play an important role in overhead sports for both sport-specific performance and injury risk-reduction. However, clinically applicable, reliable and valid methods to measure isometric TR strength have not been previously described.</p><p><strong>Purpose: </strong>To assess a) the test-retest reliability of a novel isometric TR strength test, performed in a half-kneeling position, and b) the convergent validity of the isometric TR strength test by assessing its correlation with a seated dynamic TR power test.</p><p><strong>Study design: </strong>Cross-sectional cohort study.</p><p><strong>Methods: </strong>Eighteen participants, recruited from the general public, took part in this study. Isometric TR strength was measured over two consecutive days in a half-kneeling position using a digital dynamometer. Dynamic TR power was measured once in a seated position, using a pulley system and inertial sensors. The test-retest reliability of the isometric TR strength test was assessed with Intraclass Correlation Coefficient (ICC) 3.3, and standard error of measurement (SEM) and minimal detectable change (MDC90) were calculated. The convergent validity was interpreted based on the correlation between peak values of the isometric TR strength test and the dynamic TR power test.</p><p><strong>Results: </strong>The results showed excellent test-retest reliability for the isometric TR strength test (ICC 3.3 = 0.95, 95% CI 0.91-0.98), with a SEM of 6.7 N, and a MDC90 value of 15.6 N. A strong correlation was found between the peak values for the isometric TR strength test and the dynamic TR power test (rs = 0.73, p < 0.001, 95% bootstrap confidence interval 0.40- 0.89).</p><p><strong>Conclusions: </strong>This study addresses a gap in the literature regarding reliable and valid methods to measure isometric TR strength, thus contributing to our understanding of injuries and performance in overhead sports. The results provide professionals working with overhead athletes with a convenient and practical test to measure isometric TR strength.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"996-1002"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal Hip Strength Monitoring in Division I Women's Ice Hockey with Strength Ratios and Implementation Considerations.","authors":"Roy G Nelson, Erin J Moore, Audrey L Wethington, Jonathan R Washatka, Justin L Staker","doi":"10.26603/001c.171304","DOIUrl":"10.26603/001c.171304","url":null,"abstract":"<p><strong>Background: </strong>Groin strains are common noncontact injuries in women's collegiate hockey, and hip strength and the ADD:ABD ratio are commonly considered in groin-injury prevention and strength-monitoring programs. Female-specific longitudinal data on seasonal hip strength and practical guidance for repeated team-based testing are limited.</p><p><strong>Purpose: </strong>To characterize changes in isokinetic hip adduction and abduction strength and the isometric adductor-to-abductor (ADD:ABD) ratio in NCAA Division I women's hockey players over more than two seasons. Secondary purposes were to examine between-limb differences and describe practical considerations for repeated team-based testing.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Methods: </strong>Forty-six NCAA Division I women's ice hockey athletes from a single program voluntarily participated in longitudinal testing at five time points spanning two competitive seasons and the subsequent pre-season (S1-Pre, S1-Post, S2-Pre, S2-Post, S3-Pre). After collecting demographic information via survey, body-mass-normalized hip adduction and abduction peak torque (Nm·kg⁻¹) was assessed bilaterally in standing with an isokinetic dynamometer at 90°·s⁻¹ and 120°·s⁻¹. Isometric peak torque was collected using the same dynamometer and used to calculate the ADD:ABD ratio. Leg dominance was self-reported. Linear mixed-effects models (random intercept for athlete) tested effects of time point and side; speed was retained for isokinetic outcomes to evaluate higher-order interactions.</p><p><strong>Results: </strong>Isokinetic hip adduction (F(4,419)=30.45, p < 0.001) and abduction strength (F(4,420)=24.07, p < 0.001) varied across time points, with no main effects of side and no significant interactions among time point, speed, and side. Variation in isokinetic adductor and abductor strength included decreases during both off-seasons (S1-Post to S2-Pre and S2-Post to S3-Pre), while in-season strength decreased in the first season and increased in the second. The isometric ADD:ABD ratio showed effects of time point (F(4,208.19)=3.37, p = 0.01) and side (F(1,172.40)=5.54, p = 0.02), with slightly higher ratios in the dominant limb. One prioritized seasonal contrast for the ADD:ABD ratio was significant (S1-Post to S2-Pre).</p><p><strong>Conclusion: </strong>Isokinetic hip adduction and abduction strength decreased during both off-seasons and changed inconsistently in-season. The isometric ADD:ABD ratio was slightly higher in the dominant limb and varied less across time, with only one prioritized seasonal contrast reaching significance.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"950-960"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Golf Rehabilitation Progression after Anterior Cruciate Ligament Reconstruction Using an Evidence-Based Foundation.","authors":"Sean Hazzard, Michael Young, Danielle Lonati, Peter Asnis","doi":"10.26603/001c.167451","DOIUrl":"10.26603/001c.167451","url":null,"abstract":"<p><strong>Background: </strong>Golf is commonly regarded as a low-impact sport, yet the golf swing generates multiplanar loads across both knees. No validated return-to-golf protocol after anterior cruciate ligament reconstruction (ACLR) has been published, and general return-to-sport timelines do not address golf-specific swing volume, club progression, lead- versus trail-knee demands, or return-to-course exposure.</p><p><strong>Purpose: </strong>The purpose of this clinical commentary is to synthesize the available golf-biomechanics and ACLR-rehabilitation evidence and present an evidence-informed, criteria-based progression from putting through unrestricted course play.</p><p><strong>Study design: </strong>Clinical Commentary/Current Concept Review.</p><p><strong>Methods: </strong>A targeted narrative search of PubMed/MEDLINE and reference lists was performed through June 2026 for literature addressing golf and knee biomechanics, golf-swing modifications, ACLR rehabilitation and return-to-sport criteria, and graft healing. Recommendations were classified as direct golf-biomechanics evidence, indirect ACLR-rehabilitation evidence, or author-consensus guidance when direct evidence was unavailable.</p><p><strong>Results: </strong>No study prospectively evaluated a staged return-to-golf protocol after ACLR. Available evidence indicates that both knees experience meaningful loading throughout the golf swing, with the lead knee subjected to substantial frontal-plane moments and transverse-plane rotational loading during impact and follow-through, while the trail knee also experiences meaningful loading during the backswing and transition. Longer clubs, greater clubhead speed, and larger or faster pressure shifts may increase loading demands across both lower extremities. A six-phase progression is proposed using universal symptom and range-of-motion requirements, objective strength and movement criteria, prescribed swing volumes, lead- and trail-knee considerations, and a separate return-to-course phase.</p><p><strong>Conclusion: </strong>Return to golf after ACLR should be managed as a continuum rather than a single clearance decision. Time from surgery provides a biologic safeguard but should not replace assessment of effusion, pain, motion, gait, strength, movement quality, workload tolerance, and confidence. The proposed protocol is intended to guide clinical decision-making and requires prospective validation.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"906-916"},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Mental Barriers in Rehabilitation after ACL Reconstruction: A Qualitative Interview Study.","authors":"Ingunn Fleten Mo, Nicky van Melick, Trine Hysing-Dahl, Liv H Magnussen, Per H Randsborg, Rob Bogie, Anne Gro H Faleide, Eivind Inderhaug","doi":"10.26603/001c.167447","DOIUrl":"10.26603/001c.167447","url":null,"abstract":"<p><strong>Background: </strong>Recovery after anterior cruciate ligament reconstruction (ACLR) involves both physical and psychological challenges. Although psychological readiness for return to sport (RTS) is increasingly recognized as important, less is known about how patients experience psychological barriers during rehabilitation and how interactions with physiotherapists (PTs) may shape this process.</p><p><strong>Purpose: </strong>To explore how patients recovering from ACLR navigate potential psychological barriers, what helps them overcome these barriers, and how they experience the role of PTs in enhancing their psychological readiness.</p><p><strong>Study design: </strong>Qualitative interview.</p><p><strong>Methods: </strong>Nine patients (5 women, 4 men), aged 19-45 years, from Norway and the Netherlands, 5-9 months post-ACLR, were recruited for individual semi-structured interviews. Data were analyzed using systematic text condensation.</p><p><strong>Results: </strong>Three themes emerged: (1) The Mental Landscape of Rehabilitation - confidence builds through physical progress amidst emotional setbacks; (2) Pillars of Support - professional and social support, especially from PTs, helps manage fear and build trust; (3) Lessons Learned Along the Way - patients develop insight, resilience, and personalized strategies for mental recovery. Psychological readiness was experienced as a dynamic process shaped by physical progress, emotional responses, support systems, and interactions with PTs.</p><p><strong>Conclusion: </strong>Psychological readiness should be viewed as an evolving component of ACLR recovery, shaped by patients' experiences, support systems, and interactions with PTs. These findings highlight the importance of a holistic and individualized rehabilitation approach that acknowledges mental barriers, supports confidence-building, and considers referral to mental health professionals when needed.</p><p><strong>Level of evidence: </strong>5 (Qualitative Study).</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"821-831"},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcific Patellar Tendinopathy. A Case Report Integrating Diagnostic Ultrasound Throughout a Multi-Modal Treatment Approach.","authors":"Ian Young, Adam Salzman, James Dunning, Joshua Prall, Sam Fischer, Brittany Forbes, James Escaloni","doi":"10.26603/001c.167449","DOIUrl":"10.26603/001c.167449","url":null,"abstract":"<p><strong>Background: </strong>Calcific tendinopathy can be difficult to diagnose and manage from a traditional, non-invasive physical therapy perspective. However, there is preliminary evidence supporting the use of diagnostic ultrasound and dry needling interventions to evaluate and treat the pain and disability associated with this chronic condition. The purpose of this case report was to describe the integration of diagnostic ultrasound in the successful evaluation and multi-modal treatment of a patient with calcific patellar tendinopathy.</p><p><strong>Case presentation: </strong>A 46-year-old active female with a six-week history of anterior knee pain, presented to the physical therapy clinic for a direct-access evaluation. The history and physical examination were consistent with the diagnosis of patellar tendinopathy. Diagnostic ultrasound confirmed the presence of patellar tendinopathy with multiple calcifications at the inferior pole of the patella. Treatment progression included spinal/extremity manipulation, ultrasound guided needle fenestration, electrical dry needling, and exercise. Outcomes included the numeric pain rating scale (NPRS), lower extremity functional scale (LEFS), Global Rating of Change (GROC), strength, and assessment of tissue healing with diagnostic ultrasound.</p><p><strong>Outcomes: </strong>The patient was treated for 18 visits over 24 weeks. The multi-modal intervention resulted in clinically meaningful reductions in the NPRS and LEFS, with optimal recovery to strength training. Reductions in calcific foci and tendon tissue healing was also confirmed with diagnostic ultrasound. Outcomes were tracked at 3, 6, 9, and 11-months.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"879-889"},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of the Functional Lower Extremity Evaluation (FLEE) in Return-to-Sport Rehabilitation Protocol Following Hip Arthroscopy in Collegiate Athletes: A Case Series.","authors":"Yazdan Raji, Rebecca E Luft, Kinsley J Pierre, Floyd VitoCruz, Marc R Safran","doi":"10.26603/001c.167445","DOIUrl":"10.26603/001c.167445","url":null,"abstract":"<p><strong>Background: </strong>The Functional Lower Extremity Evaluation (FLEE) is a validated assessment tool designed to assess lower limb function and symmetry. There is a gap in knowledge in return to sport (RTS) regarding the application of the FLEE in RTS rehabilitation protocols following hip arthroscopy. The purpose of this case series was to assess the utility of the FLEE in guiding RTS rehabilitation protocols for collegiate athletes after hip arthroscopy and to evaluate lower limb symmetry using FLEE components.</p><p><strong>Hypothesis: </strong>Among collegiate athletes recovering from hip arthroscopy, the Functional Lower Extremity Evaluation (FLEE) will detect measurable differences in limb symmetry and will provide clinically meaningful guidance for return-to-sport rehabilitation. Study design: Retrospective case series.</p><p><strong>Methods: </strong>A retrospective review of collegiate athletes who had undergone hip arthroscopy for femoroacetabular impingement (FAI) was performed at a single institution between January 2012 to January 2024. Inclusion criteria were completion of post-operative rehabilitation with full FLEE testing at return-to-sport clearance. The eight-task FLEE assessment was administered postoperatively beginning at 4 months. Percent limb symmetry was calculated for each component. RTS, re-injury and re-operations rates were monitored for a mean of 52.9 weeks postoperatively. Descriptive statistics were calculated for demographic variables, FLEE component scores, and percent limb symmetry. Continuous variables were summarized as means and standard deviations, while categorical variables were presented as frequencies and percentages.</p><p><strong>Results: </strong>Four collegiate athletes (3 males, 1 female; mean age - 19 years) were included, representing football (n=2), basketball (n=1) and swimming and diving (n=1). Athletes demonstrated improvements in all FLEE components following rehabilitation, achieving RTS clearance at a mean of 5.75 months ± 1.44 months. All athletes returned to competitive sports at the same or higher level. No re-injuries or re-operations occurred at a mean follow-up of 52.89 months. Limb symmetry ranged from 97.95% to 110.04% across FLEE components.</p><p><strong>Conclusion: </strong>The FLEE may be a valuable instrument for assessing lower extremity function and symmetry in college athletes undergoing RTS rehabilitation after hip arthroscopy. These findings suggest that the FLEE may aid in guiding individualized rehabilitation programs and monitoring progress towards RTS goals. Larger, prospective studies are warranted to validate these findings.</p><p><strong>Level of evidence: </strong>Level IV Case Series.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"871-878"},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Effects of Contract-Relax PNF With and Without Neuromuscular Electrical Stimulation on Hamstring Flexibility and Jump Performance in Adolescent Soccer Players: A Randomized Controlled Trial.","authors":"Carlos Salvador-Huerta, Pedro Azanon-Nogueira, Eloi Suárez-Pazos, Valeria Betancourt-Cabeza, Irene Lazcano-Nogueira, Andrea Porcu, Ángel Manuel de la Hera-Sastre, Juan J Amer-Cuenca, Juan Francisco Lisón","doi":"10.26603/001c.166783","DOIUrl":"10.26603/001c.166783","url":null,"abstract":"<p><p>The additional value of neuromuscular electrical stimulation (NMES) during contract-relax proprioceptive neuromuscular facilitation (PNF-CR) stretching remains unclear, particularly in adolescent athletes. It is also unknown whether combining PNF-CR with motor-threshold NMES improves hamstring flexibility more than a sensory-threshold comparator without impairing vertical jump performance. # Purpose To compare the acute effects of PNF-CR combined with motor-threshold NMES versus sensory-threshold NMES on hamstring flexibility and to assess the impact of both interventions on vertical jump performance. # Study Design Randomized controlled trial. # Methods Forty-seven youth soccer players (mean age: 13.2 ± 1.8 years) were randomly assigned to one of two groups. Both groups received the same single-session PNF-CR stretching protocol. The experimental group (n = 23) received motor-level NMES during the contraction phases, whereas the placebo group (n = 24) received sensory-level NMES during the same PNF-CR protocol. Hamstring flexibility was assessed using the Popliteal Angle (PA) and Sit-and-Reach (SR) tests, while vertical jump performance was evaluated via the Countermovement Jump (CMJ) test. Analyses followed an intention-to-treat approach. Time, group, and time × group effects were examined using two-way repeated-measures ANOVA with Bonferroni-adjusted post hoc comparisons; CMJ was additionally analyzed using ANCOVA adjusted for baseline values. # Results Both groups showed statistically significant pre-post improvements in SR and PA scores. Specifically, PA decreased in the experimental group by 4.0° (95% CI: 1.4 to 6.5; p = 0.003) and by 3.1° (95% CI: 0.5 to 6.0; p = 0.018) in the placebo group. SR increased by 2.7 cm (95% CI: 1.9 to 3.6; p < 0.001) in the experimental group and 2.8 cm (95% CI: 1.9 to 3.7; p < 0.001) in the placebo group. No significant between-group differences were found for either flexibility outcome. Regarding CMJ, no significant intra- or intergroup changes were observed (p > 0.05). # Conclusion The addition of motor-threshold NMES to a PNF-CR stretching protocol does not yield superior acute flexibility gains. Moreover, neither intervention negatively affected jump performance in this athletic population, supporting their safe and potentially beneficial application in pre-training contexts for adolescent soccer players. # Level of Evidence 1b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"808-820"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard Versus Arm-Length-Normalized Conditions for Assessment of the Closed Kinetic Chain Upper Extremity Stability Test in Healthy Youth Athletes.","authors":"Katie Sloma, John Arvesen, Ava Davis, Ashley Erdman, Alex Loewen, Joshua Riesenberg, Henry Ellis, Philip Wilson, Sophia Ulman","doi":"10.26603/001c.166780","DOIUrl":"10.26603/001c.166780","url":null,"abstract":"<p><strong>Background: </strong>Criterion-based assessment of shoulder function includes screenings, such as the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), to help identify deficits in stability, neuromuscular control, and proprioception. However, normative performance for the CKCUEST has been predominantly established in elite and collegiate athletes, and it has been shown that arm length, sex, and weight may influence performance.</p><p><strong>Purpose: </strong>To compare performance and establish agreement between standard versus arm-length-normalized testing positions in adolescent athletes and establish population-specific reference values.</p><p><strong>Study design: </strong>Cross Sectional.</p><p><strong>Methods: </strong>Healthy athletes (ages 14-18 years) recruited from local teams, clubs, and youth sports organizations performed two conditions of the CKCUEST, standard and arm-length-normalized. Performance differences were evaluated using a Wilcoxon signed-rank test, with effect sizes (<i>r</i>), while agreement between conditions was assessed using intraclass correlation coefficients and Bland-Altman analysis. Spearman correlations were used to assess associations with participant demographics and Mann-Whitney U tests were performed to compare contact versus overhead athletes.</p><p><strong>Results: </strong>One hundred fifty-four athletes (120 male, 16.5±1.2 years, 75.8±18.0 kg) participating in baseball, football, lacrosse, volleyball, basketball, water polo, and tennis were included for analysis. Performance was greater on the arm-length-normalized condition (standard: 23.0±5.8 taps; normalized: 23.9±5.5 taps, <i>p</i><0.001). Agreement between conditions was good (ICC=0.86, 95%CI=0.80-0.90). The average change between conditions was -0.86±2.92 [-12.00-8.00], and 53.9% of participants performed better on the arm-length-normalized condition. Contact athletes performed more taps (standard: 25.0±6.0 taps; normalized: 25.3±5.9 taps) than overhead (standard: 20.2±4.2 taps; normalized: 21.9±4.5 taps, <i>p</i><0.001) athletes.</p><p><strong>Conclusion: </strong>Performance on the arm-length-normalized condition was greater than performance at the standard distance condition in healthy adolescent athletes. The influence of arm length, body mass, and sport type suggests the arm-length-normalized condition is more suitable for assessment and differences between sport types highlights the importance of population-specific measures and reference values.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"862-870"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peroneal Muscle Size and Quality Changes after Impairment-Based Rehabilitation in Patients with Chronic Ankle Instability.","authors":"Abbis Jaffri, Rachel Koldenhoven, Alexandra Lempke, Joseph Park, Joe Hart, Jay Hertel, Susan Saliba","doi":"10.26603/001c.167120","DOIUrl":"10.26603/001c.167120","url":null,"abstract":"<p><strong>Background: </strong>Peroneal muscles are the primary stabilizers against ankle inversion movements associated with lateral ankle sprains. Individuals with chronic ankle instability (CAI) demonstrate peroneal muscle deficits including decreased strength, slower nerve conduction velocity, and reduced cross-sectional area. Ultrasound (US) imaging provides a valid, cost-effective method to assess peroneal muscle size and quality following rehabilitation.</p><p><strong>Hypothesis/purpose: </strong>To determine peroneal muscle size and quality changes using US imaging following impairment-based rehabilitation in patients with CAI.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Twenty-six patients with CAI (age: 21.9 ± 3.5 years; 18 females, 8 males) completed an 8-session, 4-week impairment-based rehabilitation program addressing range of motion, balance, strength, and functional performance deficits with emphasis on peroneal activation exercises. US imaging assessed peroneal muscle cross-sectional area (CSA) in sidelying and bipedal stance positions and echogenicity (a measure of muscle quality) in bipedal stance for both limbs before and after rehabilitation. Paired t-tests were used to compare pre- and post-rehabilitation values.</p><p><strong>Results: </strong>Significant (p < 0.01) increases in CSA were observed in the trained limb during sidelying (3.44 ± 0.99 to 3.72 ± 0.98 cm²) and bipedal stance (3.46 ± 1.05 to 4.31 ± 0.98 cm²) positions. Similar CSA increases occurred in the untrained limb. Echogenicity significantly decreased in the trained limb (70.2 ± 9.91 to 65.7 ± 8.68, p = 0.01), indicating improved muscle quality, with no significant changes in the untrained limb.</p><p><strong>Conclusion: </strong>An 8-session, 4-week impairment-based rehabilitation program resulted in significant peroneal muscle CSA increases in patients with CAI, with cross-education effects observed in the untrained limb. Muscle quality, as measured by echogenicity, improved in the trained limb, supporting neuromuscular benefits of targeted rehabilitation. Impairment-based rehabilitation should be incorporated into CAI management programs.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 9","pages":"843-851"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}