International Journal of Sports Physical Therapy最新文献

{"title":"Consensus on the Use of Therapeutic Interventions in Pain Management, Recovery, and Athletic Performance: A Delphi Study.","authors":"Bailey McLagan, Kyle Silvey, Timothy Roberts, David Erceg, Jonathan C Sum, E Todd Schroeder","doi":"10.26603/001c.129968","DOIUrl":"10.26603/001c.129968","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic interventions are widely used in clinical practice to prepare individuals for movement, recover from exercise, and mediate pain and inflammation associated with injury. However, there has yet to be cited consensus regarding when to use such interventions.</p><p><strong>Purpose: </strong>Using the Delphi method, this study aimed to develop consensus among physical therapists (PTs) and athletic trainers (ATs) regarding the use of percussive, vibration, infrared, heat, and cryotherapy in a variety of treatment circumstances. These included preparation and recovery from physical activity, treatment of acute and chronic joint pain, and treatment of acute and chronic soft tissue/muscle pain.</p><p><strong>Methods: </strong>Four rounds of surveys were delivered to individuals who were licensed or certified PTs/ATs, with more than 1,000 hours of experience working with athletic populations and experience using at least one of the interventions of interest in the prior five years. Consensus was defined as a greater than 70% agreement, and consideration for use was defined as selecting \"In Some Instances'' and\"In Most Instances.\"</p><p><strong>Results: </strong>Ninety-four individuals responded to the screening survey (n₁ = 74, n₂ = 68, n₃ = 44, n₄ = 32). The individuals who participated agreed that they would consider using the following therapeutic interventions in treatment: 1) percussive therapy, local vibration, and local heat therapy in the preparation for physical activity; 2) local cryotherapy in recovery from physical activity; 3) local cryotherapy for the treatment of acute joint pain and acute soft tissue/muscle pain; 4) local heat and local cryotherapy for the treatment of chronic joint pain; and 5) percussive, local vibration, local heat, and local cryotherapy in the treatment of chronic soft tissue/muscle pain.</p><p><strong>Conclusion: </strong>Clinical intervention often relies on patient presentation and preference. This study provides a consensus on the use of common therapeutic interventions for the management of athletic recovery, pain, and inflammation among ATs and PTs.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"420-428"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558371","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":"Post-Acute Concussion-Related Differences in Neuromotor Control Measured Using a Low-Cost Movement Assessment System: A Feasibility Study.","authors":"Jacob Thomas, Rebecca Bliss, Caitlin Fields, Tristan Farnen, Trent Guess","doi":"10.26603/001c.129888","DOIUrl":"10.26603/001c.129888","url":null,"abstract":"<p><strong>Background: </strong>Athletes prematurely cleared to play following concussion increase their risk for subsequent concussion and musculoskeletal injury, leading practitioners to call for low-cost and objective tools to identify lingering neuromotor control deficits following concussion. # PurposeThe purpose of this feasibility study was to determine the usefulness of Mizzou Point-of-care Assessment System (MPASS) measures for creating a discriminant model classifying individuals as being either healthy or in the post-acute phase of concussion (having suffered a concussion within the prior three months).</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>Ten participants with concussion injury (Mean = 3.9 ± 1.66 wks. post-concussion) and twelve with no concussion within the prior year participated in this study. All participants completed walking (normal, serial subtraction by seven, and head shaking), Romberg balance (eyes open and eyes closed on firm surface), and reaction time tasks while MPASS recorded kinematics, kinetics, and reaction time. Principal component analysis (PCA) was used to reduce the dimensionality of MPASS data.</p><p><strong>Results: </strong>Using four retained principal components (PCs), the LDA model achieved a statistically significant (p = 0.007) accuracy of 82% with 80% sensitivity and 83% specificity for classifying participants into groups.</p><p><strong>Conclusion: </strong>This work presents a framework for assessing the discriminative power of multidimensional and clinically feasible tools for assessing human movement.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"392-399"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558391","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 Relationship Between Tensor Fascia Latae and Gluteus Maximus Has the Potential to Indicate Early Intra-articular and Degenerative Pathologies of the Femoral-Acetabular Joint: A Narrative Review.","authors":"Matt P R Duke, Ashley Jones, Amir Takla, Mark I Johnson","doi":"10.26603/001c.129974","DOIUrl":"10.26603/001c.129974","url":null,"abstract":"<p><p>Intra-articular and degenerative hip pathologies have become common place with the number of total hip replacements rising year on year in the United Kingdom (UK). Pathology is identified by clinicians using special tests which are researched maneuvers used by clinicians to rule in or rule out specific musculoskeletal pathologies. Special tests used for hip pathology usually have high specificity to exclude degenerative and intraarticular pathology but vary in sensitivity. These special tests are usually only conducted when a person is symptomatic and typically require radiological confirmation to diagnose. The aim of this review was to appraise research to determine whether functional changes in the TFL and UGM muscle complex could indicate degenerative and/or intra articular pathology, with a specific focus on the utility of the ratio in strength of TFL and UGM to assist clinical diagnosis. The hypothesis was that the ratio of the strength of Tensor Fascia Latae (TFL) and the upper fibres of Gluteus Maximus (UGM) could suggest early intra-articular hip pathology, and that changes to this ratio could indicate deterioration of the hip joint before symptoms present/progress.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"476-484"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558417","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":"Exploring Trends between Dance Experience, Athletic Participation, and Injury History.","authors":"Evyn Callahan, L Colby Mangum","doi":"10.26603/001c.129805","DOIUrl":"10.26603/001c.129805","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dancers sustain substantial injury rates ranging from 0.62-5.6 injuries per 1000 dance exposure hours with 72% of these injuries attributed to overuse mechanisms. Highly technical activities like dance often require high training volumes incorporating deliberate practice from a young age which may contribute to these high percentages of overuse injuries. The purpose of this study was to determine trends between dance participation, athletic participation, and injury history.</p><p><strong>Study design: </strong>Cross-sectional survey.</p><p><strong>Methods: </strong>Dancers over 18 years old with at least one year of dance experience were recruited from across the United States to complete a survey via Qualtrics. The survey included five sections addressing basic demographic information, dance experience, athletic activity history, and injury history. Relationships between variables were analyzed using the Mann-Whitney U test or the Wilcoxon Signed Rank test. Factorial ANOVAs were also used to observe relationships between three or more groups.</p><p><strong>Results: </strong>Of 424 total responses, 339 were deemed complete for analysis. Nearly 75% of respondents reported experiencing at least one injury that inhibited their dance ability. Greater total injuries were reported by participants who had more years of dance experience, those who practiced ballet, and individuals who began dance before age 12. Approximately one-third of participants exclusively participated in dance with no involvement with other athletic activities. Respondents starting dance prior to age 12 reported participation in fewer athletic activities. However, no difference in the number of injuries was observed between individuals involved in athletic activity compared to those practicing dance alone.</p><p><strong>Conclusion: </strong>Increased dance exposure and associated high training volumes and repetitive movements may represent a greater risk for overuse injuries than sport specialization in dancers.</p><p><strong>Level of evidence: </strong>3B.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"410-419"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558373","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":"Risk Factors Associated with New Onset of Shoulder Pain and Injury Among the Athletic Population: A Systematic Review of the Literature.","authors":"Paul Salamh, Garrett Bullock, Rachel Chester, Helena Daniell, Chad Cook, Matthew DeLang, Hannah-Rose Tucker, Douglas Walker, Jeremy Lewis","doi":"10.26603/001c.129462","DOIUrl":"10.26603/001c.129462","url":null,"abstract":"<p><strong>Introduction: </strong>There is a high incidence of shoulder injuries among overhead athletes. Identifying and understanding risk factors for these injuries, particularly those that can be modified, is a necessary step towards being able to effectively develop and implement shoulder specific injury prevention programs. Therefore, the purpose of this systematic review was to identify risk factors associated with a new onset of shoulder pain and injury among the athletic population.</p><p><strong>Design: </strong>Systematic Review.</p><p><strong>Methods: </strong>A systematic review of the literature was performed within PubMed, Embase, AMED, CINAHL, and EmCare databases. Studies were screened utilizing the following inclusion criteria; (a) athletes currently pain free or no history of pain at baseline, (b) athletes with shoulder and or arm pain originating from a musculoskeletal shoulder problem (c) risk factors captured prospectively (d) pathoanatomy and biomechanics in isolation or in addition to personal characteristics, etc. (e) reporting relative risk, odds ratios, and/or hazard ratios and (f) follow up ≥ 6 months. Due to data heterogeneity, only a descriptive data synthesis was performed. Data were extracted and underwent risk of bias assessment utilizing the Quality in Prognosis Studies (QUIPS) tool. PRISMA guidelines were utilized throughout.</p><p><strong>Results: </strong>Nineteen papers were included. A total of four studies investigated baseball, five handball, three swimming, two tennis, two military, one cricket, one American football, and one with multiple sports, totaling 7,802 athletes. The risk of bias among the included studies was rated from moderate to low overall with no single study being identified as high risk of bias. All studies designs were a level of evidence of II except for two studies that were level III. The most significant risk factors included range of motion, reduced strength, history of local/regional musculoskeletal pain, previous injury, and training load. There are inconsistencies in how injury and pain are defined within studies.</p><p><strong>Conclusion: </strong>Many risk factors are easily objectifiable and modifiable which may help in developing shoulder injury mitigation strategies. Three of the five significant risk factors for injury can be identified by objective pre-screening measures. While previous pain and injury cannot be mitigated, training loads should be closely monitored and adapted according to other risk factors and the athlete's response.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"315-332"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558393","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 Impact of Real-Time Biofeedback on Partial Weightbearing Training: A Comparative Study.","authors":"Leonard Lisitano, Zarek Hezrrai DaSilva, Nicholas Koch, Willie Dong, Tyler Thorne, Timon Röttinger, Daniel Pfeufer, Justin Haller","doi":"10.26603/001c.129259","DOIUrl":"10.26603/001c.129259","url":null,"abstract":"<p><strong>Introduction: </strong>Partial Weight Bearing (PWB) is integral to rehabilitation protocols following orthopedic and trauma surgeries. Standard of Care (SOC) for PWB training often involves using a bathroom scale, a method criticized for its inaccuracy. This study aimed to compare SOC training in PWB with a biofeedback device (insole).</p><p><strong>Methods: </strong>Sixty healthy participants were randomized into SOC or Biofeedback (BF) training groups, practicing 20 kg PWB using a standardized protocol. Gait data, including compliance with weightbearing restrictions (not exceeding 150% of the set weightbearing limit), was monitored using Loadsol® insole force sensors. Participant satisfaction and usability were assessed through questionnaires. Training duration and walking speed were also measured.</p><p><strong>Results: </strong>The BF group's peak force averaged 330 Newtons, significantly lower than the SOC group's 600 Newtons, which exceeded the prescribed limit by over three times (p ≤ 0.001). Compliance with weightbearing restrictions was substantially higher in the BF group (88% or 29/33 participants) compared to the SOC group (19% or 5/27 participants) (p ≤ 0.001). The BF group also required less training time to learn PWB, averaging 9:00 ± 3:06 minutes, versus 12:49 ± 3:01 minutes in the SOC group (p ≤ 0.001). Questionnaire responses showed no significant differences between groups.</p><p><strong>Conclusion: </strong>Real-time audio-visual Biofeedback significantly enhances compliance with weightbearing restrictions in PWB training while reducing the training duration. Based on these findings, the implementation of biofeedback devices in PWB training is recommended.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"364-372"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558397","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 Recognition, Utilization Rates, Barriers, and Application Accuracy of the Hamstring Strain Clinical Practice Guidelines.","authors":"Edward Mulligan, Liana Wooten, Tara Dickson, Eric Hegedus, Benjamin Stern","doi":"10.26603/001c.129705","DOIUrl":"10.26603/001c.129705","url":null,"abstract":"<p><strong>Background and purpose: </strong>Clinical practice guidelines (CPGs) are systematically developed statements designed to promote evidence-based practice, assist in decision-making, and reduce unwarranted deviations in practice. The purpose of this study was to describe the awareness and attitudes of physical therapists (PTs) towards using the Hamstring Strain Injury in Athletes (HSIA) CPG and determine the relationship between barriers, utility, and knowledge of practice guidelines with the behavioral characteristics and clinical care patterns of PTs.</p><p><strong>Study design: </strong>Explorative survey.</p><p><strong>Methods: </strong>Members of the American Academy of Sports Physical Therapy (AASPT) were surveyed regarding their perceived value and application of the HSIA CPG. Descriptive measures of central tendencies and nonparametric analysis were used to describe the data and identify differences. A forward stepwise regression was used to identify variables to explain if the level of CPG awareness and frequency of use were related to selected attitudes, beliefs, and barriers to utilization of the CPG.</p><p><strong>Results: </strong>Eighty-seven percent of respondents were aware of the CPG resource. Fifty-six percent had read, reviewed, and/or integrated the recommendations into clinical practice. The respondents had a substantial positive opinion regarding its necessity, assistance in decision-making, ease of implementation, ability to improve outcomes, and reduction of unwarranted practice variation. Only 15% of respondents believed the CPG did not provide adequate evidence to adopt its recommendations. Barriers to utilization were the CPG's ability to account for provider expertise and its shortcomings in universally applying its findings to all patients' needs and expectations. Given a specific hamstring injury vignette, respondents accurately chose evidence-based examination, intervention, and injury prevention strategies in the vast majority of cases.</p><p><strong>Conclusion: </strong>The HSIA CPG is a valuable resource for PTs in managing athletic injuries. The guideline clearly describes the aims, objectives, population, and evidence that contributes to each recommendation and is being used to improve rehabilitative care.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"373-383"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558399","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":"Isokinetic Strength Profiles Among Youth after Medial Patellofemoral Ligament Reconstruction.","authors":"Christin M Zwolski, Grant R Poston, Laine A Anthony, Kristin L Bastian, Megan M Sayre, Kathleen M Hugentobler, Alyson R Filipa","doi":"10.26603/001c.129257","DOIUrl":"10.26603/001c.129257","url":null,"abstract":"<p><strong>Background: </strong>Knee strength is a critical measure of successful rehabilitation following medial patellofemoral ligament reconstruction (MPFLR). Yet, strength outcomes of youth following MPFLR are not widely reported.</p><p><strong>Hypothesis/purpose: </strong>The primary purpose was to profile isokinetic strength outcomes by sex and age among youth following MPFLR. A secondary purpose was to determine the relationship between normalized isokinetic strength values and patient-reported outcome scores by age and sex. The hypotheses were that 1) males would demonstrate higher normalized strength, and that 2) a higher proportion of males would achieve ≥90% limb symmetry when compared to females.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>At 6.9±2.1 months after MPFLR, 162 patients completed isokinetic assessment of knee extension (KE) and flexion (KF) strength at 180°/s and 300°/s on both limbs (uninvolved [UN], involved [INV]). Strength data and patient-reported outcome scores, including the International Knee Documentation Committee (IKDC) Subjective Knee Form and Pediatric Quality of Life Inventory (PedsQL) were extracted from electronic medical records. Descriptive statistics were used to categorize data by age (Pre-adolescent, Early Adolescent, Late Adolescent, Young Adult) and sex. Independent-samples t-tests and chi-square analyses were used to determine sex-based differences in strength. Multiple linear regression analyses were used to determine the relationship between strength and patient-reported function.</p><p><strong>Results: </strong>Among Early Adolescents, males demonstrated higher normalized KE strength at 300°/s compared to females (UN: 1.27±0.3 vs. 1.07±0.3 [p=0.01]; INV: 1.07±0.2 vs. 0.92±0.3 [p=0.03]). Among Late Adolescents, males demonstrated higher INV limb strength for KE 180°/s (1.55±0.53 vs. 1.24±0.5; p=0.02), KE 300°/s (1.25±0.4 vs. 1.00±0.4; p=0.01), and KF 180°/s (0.98±0.4 vs. 0.82±0.3; p=0.05). A higher proportion of Late Adolescent and Young Adult males achieved ≥90% LSI compared to females (p=<0.01-0.04). Regression models estimating IKDC and PedsQL scores were significant with INV KE strength as an independent variable (p=0.01-0.03).</p><p><strong>Conclusions: </strong>Males demonstrated higher normalized strength and symmetry compared to females following MPFLR. Higher INV KE strength was associated with higher patient-reported function.</p><p><strong>Level of evidence: </strong>2b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"333-343"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558389","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":"Increased Gait Speed Changes Knee Mechanics Following Anterior Cruciate Ligament Reconstruction: Implications and Caution for Treadmill Training in Early Rehabilitation.","authors":"Sara Y Almansouri, Susan M Sigward","doi":"10.26603/001c.129803","DOIUrl":"10.26603/001c.129803","url":null,"abstract":"<p><strong>Background: </strong>Current rehabilitation practices following anterior cruciate ligament reconstruction (ACLr) do not guarantee recovery of gait mechanics suggesting that gait specific interventions are needed. Increasing gait speed implicitly increases lower extremity demands; however, it is not known if increased treadmill speed will result in improved knee mechanics in early recovery post-ACLr. Therefore, the purpose of this study was to determine how individuals four months post-ACLr respond to the demands of increased speed during treadmill gait.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>Ten individuals 109.2±19.9 days post-ACLr and twelve uninjured individuals participated. Participants walked on a treadmill at self-selected (SS), 25% faster (SS25) and 50% faster (SS50) speeds. Kinematic and kinetic data were used to calculate net joint moments using standard inverse dynamic equations. Knee power was calculated as the scalar product of angular velocity and sagittal plane net joint moment. Knee flexion excursion was calculated from initial contact to the subsequent knee flexion peak. A 3 X 2 ANOVA assessed the effect of group and speed (SS, SS25, SS50) on surgical (or control) knee extensor moment, power absorption, knee excursion, GRFs and between limb symmetry.</p><p><strong>Results: </strong>For controls, knee extensor moment, power absorption, excursion, and GRFs increased at each speed. For ACLr, knee loading variables increased between SS to SS25 without changes in limb symmetry. No further increase in knee moments were observed between SS25 and SS50, but limb symmetry decreased in extensor moment, power, and GRFs.</p><p><strong>Conclusion: </strong>At four months post-ACLr, a moderate increase in treadmill speed may provide a stimulus to improve knee loading without increased asymmetries. Larger increases in speed should be exercised with caution to avoid undesirable between limb compensations. A progressive increase in demand to improve knee loading deficits during early recovery of ACLr is warranted.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"354-363"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558375","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":"A Multimodal Chiropractic Approach to the Treatment and Management of Medial Elbow Injuries in Elite Javelin Throwers: A Case Series.","authors":"Angus S McEntyre, Natalie C Clohesy, David J Steven","doi":"10.26603/001c.129970","DOIUrl":"10.26603/001c.129970","url":null,"abstract":"<p><strong>Background: </strong>Sports chiropractors are increasingly being consulted in the assessment, treatment and rehabilitation of athletes. The purpose of this case series was to describe a multimodal chiropractic treatment approach to address medial elbow injuries in amateur/elite javelin throwers.</p><p><strong>Case descriptions: </strong>Five javelin throwers (3 Males & 2 Females) aged 15-24 years presented to two chiropractic clinics with signs/symptoms including pain, instability, postural dysfunction, and dysfunctional range of motion of the glenohumeral and elbow joints. Diagnoses included tear/rupture of the ulnar collateral ligament, medial epicondylitis, valgus extension overload syndrome (posteromedial impingement), reactive bone formation of the olecranon fossa, avulsion fracture of the medial epicondyle/sublime tubercle, distal triceps tendinopathy, scapular dyskinesis, glenohumeral internal rotation deficit, anterior glenohumeral capsulitis, instability of the glenohumeral joint, rotator cuff pathology, and subacromial impingement.</p><p><strong>Interventions and outcomes: </strong>A multimodal treatment approach was utilized for all five athletes which included; soft tissue therapy (active release techniques [ART]), ischemic pressure, cross-friction massage, dry needling, low level laser therapy (LLLT)/Photobiomodulation (PBM), spinal and peripheral joint manipulation/mobilization and a rehabilitation program that included proprioceptive and postural retraining, strength and Javelin specific technical retraining. Numeric rating scale (NRS), Conway scale, activities of daily living (ADL's) and sport specific functions were used to assess change. All javelin throwers returned to above pre-injury performance 12-26 weeks post injury presentation. At six and 12 month follow up all patients continued to be symptom free, performing normal ADL's and sport specific functions.</p><p><strong>Conclusions: </strong>This case series presents results which demonstrate positive outcomes after using a multimodal chiropractic treatment and management approach in five javelin throwers with medial elbow injuries.</p><p><strong>Level of evidence: </strong>5 (case series).</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 3","pages":"429-447"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558363","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}