International Journal of Sports Physical Therapy最新文献

{"title":"A Novel Dynamic Ultrasound Assessment of T-Junction Hamstring Injury during Gym-Based Exercises: A Case Report in an Elite Football Player.","authors":"Massimo Zanovello, Javier Franco Cordero, Luis Suarez-Arrones, Luca Vergani, Carles Pedret","doi":"10.26603/001c.165041","DOIUrl":"10.26603/001c.165041","url":null,"abstract":"<p><strong>Background: </strong>\"T-Junction\" or distal musculotendinous junction (DMTJ) hamstring injuries have become a true enigma for clinicians as demonstrated by the high recurrence rate. Magnetic Resonance Imaging (MRI) can sometimes fail to provide an accurate assessment of these injuries, probably because of the dynamic function that this structure provides to offer stability at the synchronous movement of the two heads of biceps femoris. The aim of the present case report was to describe a novel method for dynamic ultrasound evaluation of the DMTJ performed during functional loading exercises and to explore its potential role in return-to-play (RTP) decision-making.</p><p><strong>Study design: </strong>Case Report.</p><p><strong>Case description: </strong>A 23-year-old male elite football player sustained a DMTJ injury. MRI revealed a complete rupture of the superficial portion (myotendinous) and the deep portion (myoaponeurotic) of the T-Junction. The injury occurred initially during high speed non-linear running action.The initial diagnosis was made using a 3T MRI scan. Subsequently, three dynamic ultrasound evaluations were performed at weeks 3, 6 and 9 during two different gym-based exercises: the single-leg barbell Romanian deadlift and the single-leg hamstrings slider with ipsilateral trunk rotation. Additional 3Tesla MRIs were conducted to assess healing and structural changes at weeks 5,8 and 14.</p><p><strong>Outcomes: </strong>The player returned to competitive activity 10 weeks after the injury and experienced no re-injury during the subsequent 4-month follow-up period. Improvements in the synchronous movement between BFlh and BFsh were seen on the progressive evaluations as well as the scar healing progression. Dynamic ultrasound assessment during the SL-RDL appeared to provide clearer visualization of interhead hamstring movement than during the slider exercise. Further investigation in larger cohorts is warranted to establish the reliability, validity, and prognostic utility of this novel assessment modality for athletes with this injury.</p><p><strong>Conclusions: </strong>In this single case, dynamic ultrasound of the DMTJ provided valuable information regarding interhead synchrony of the biceps femoris. This approach may complement MRI and support informed return to play decision-making following T-Junction hamstring injuries.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 8","pages":"774-782"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670839","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":"Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Carpal Tunnel and Median Nerve.","authors":"Robert C Manske, Chris Wolfe, Phil Page, Michael L Voight","doi":"10.26603/001c.165287","DOIUrl":"10.26603/001c.165287","url":null,"abstract":"<p><p>The carpal tunnel is a fibro-osseous canal at the wrist that is formed by the retinaculum and bony structures. The superficial border is composed of the flexor retinaculum, the floor of the tunnel is formed by the carpal bones, the medial (ulnar) border by the hamate, and the lateral (radial) border by the trapezium. Contents that originate in the forearm and run distally through the carpal tunnel include the finger and thumb flexors and the median nerve. Carpal tunnel syndrome, when the median nerve becomes compressed or entrapped, occurs due to various issues that will be discussed in this paper. Diagnostic musculoskeletal ultrasound (MSKUS) offers a portable, real-time, and cost-effective alternative that is gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating the size of the carpal tunnel and median nerve at the level of the wrist. MSKUS is excellent at detecting changes in carpal tunnel size, median nerve composition, thickness, and continuity. This manuscript will review the utility of MSKUS in evaluating carpal tunnel syndrome, including anatomy, common injury mechanisms, sonographic techniques, and clinical implications for those in the rehabilitation profession. Due to the confined area within the carpal tunnel and the number of structures that traverse through it, it is a very common site of pathology and symptoms. With a proper medical history and clinical examination, diagnosis is straightforward for this pathology. By integrating MSKUS into clinical practice, providers can improve the accuracy of diagnosis, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to optimal patient outcomes for those with carpal tunnel overuse or injury.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 8","pages":"802-807"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670876","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 an Elastic Toe-Tube Exercise on Intrinsic Foot Muscle Size and Reactive Strength in Healthy Young Men: A Randomized Crossover Study.","authors":"Yuki Nakai, Yasufumi Takeshita, Makoto Komiya","doi":"10.26603/001c.165043","DOIUrl":"10.26603/001c.165043","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic foot muscles (IFMs) contribute to plantar stiffness regulation and force transmission during dynamic tasks. Although the short-foot exercise (SF-ex) is commonly prescribed to strengthen IFMs, its immediate effects on muscle morphology and reactive performance remain unclear.</p><p><strong>Purpose: </strong>To examine the acute effects of an elastic toe-tube exercise (Tube-ex) on IFM cross-sectional area (CSA) and reactive strength compared with SF-ex and a control condition.</p><p><strong>Study design: </strong>Randomized crossover study.</p><p><strong>Methods: </strong>Twenty healthy recreationally active young men completed three conditions (Tube-ex, SF-ex, and control) in randomized order with a washout period of at least one week. Ultrasound-derived CSA of the abductor hallucis, flexor hallucis brevis, and flexor digitorum brevis was assessed before and immediately after each condition. Reactive performance was evaluated using the reactive strength index (RSI) obtained from repeated rebound jump tests. Two-way repeated-measures analysis of variance was used to examine time × condition effects.</p><p><strong>Results: </strong>Significant time × condition interactions were observed for all IFMs (p ≤ 0.019, partial η² = 0.21-0.61), with the greatest increases following Tube-ex (approximately 6-13%). CSA changes exceeded minimal detectable change thresholds after Tube-ex. A significant interaction was also found for RSI (p = 0.035, partial η² = 0.16), with improvement observed only after Tube-ex (Cohen's d = 0.66-0.80).</p><p><strong>Conclusion: </strong>Tube-ex elicited greater acute increases in IFM size and reactive strength than SF-ex and control. These findings support its potential as a practical neuromuscular priming strategy for athletic preparation and early-stage rehabilitation.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 8","pages":"707-717"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670919","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":"Contralateral Trunk Tilt in High School Baseball Pitchers: Comparison and Relationship with Trunk Rotational Mobility, Compensatory Lateral Flexion, and Performance.","authors":"Hiromu Tanaka, Yoshinori Kagaya","doi":"10.26603/001c.165035","DOIUrl":"10.26603/001c.165035","url":null,"abstract":"<p><strong>Background: </strong>Excessive contralateral trunk tilt (CLT), the lateral flexion angle of the trunk during pitching, increases torque on the shoulder and elbow. Although core muscle strength is known to influence CLT, the relationship between limited trunk rotational mobility and throwing injuries is unclear.</p><p><strong>Purpose: </strong>To compare trunk rotational mobility and compensatory lateral flexion between pitchers with high and low CLT, and to examine the relationships between these factors, player characteristics, ball velocity, and elbow valgus torque.</p><p><strong>Study design: </strong>Cross-sectional comparison study.</p><p><strong>Methods: </strong>This study evaluated 19 male adolescent pitchers (aged 15-18 years) with ≥1 year of experience and no pain or surgical history. Participants were stratified into high (>30°) and low (≤30°) CLT groups based on two-dimensional analysis. Trunk rotational mobility was assessed using inclinometers in hand-to-knee and lumbar-locked positions. Compensatory contralateral trunk flexion during rotation was analyzed photographically in the hand to knee position. Primary outcomes compared were differences in trunk rotational mobility and compensatory trunk flexion between groups; secondary outcomes were correlations between primary outcomes and ball velocity and elbow valgus torque.</p><p><strong>Results: </strong>No significant differences were observed between the high (n = 9) and low (n = 10) CLT groups in trunk rotational mobility in the LLP position on the dominant (62.8° ± 11.5° vs 64.5° ± 11.2°, p = 0.745) and non-dominant (58.3° ± 9.0° vs 60.0° ± 8.5°, p = 0.684) sides, nor in compensatory contralateral trunk flexion during rotation on the dominant (17.1° ± 7.6° vs 18.0° ± 2.5°, p = 0.705) and non-dominant (18.2° ± 7.6° vs 20.1° ± 6.5°, p = 0.576) sides. CLT at MER moderately correlated positively with ball velocity (r = 0.47, p = 0.004), which correlated strongly with elbow valgus torque (r = 0.69, p < 0.001).</p><p><strong>Conclusion: </strong>Excessive CLT at MER in adolescent pitchers is not associated with limited trunk rotation or compensatory lateral trunk flexion.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 8","pages":"746-755"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670834","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":"Mixed-Nerve Silent Period Characteristics During Muscle Output Regulation in Healthy Athletes: Preliminary Findings and Comparison with a Single Postoperative Case.","authors":"Shinichi Daikuya, Yumi Okayama","doi":"10.26603/001c.165045","DOIUrl":"10.26603/001c.165045","url":null,"abstract":"<p><strong>Background/purpose: </strong>Sports injury induces peripheral and central neurophysiological alterations that influence motor control and recovery. The mixed-nerve silent period (SP), a transient suppression of voluntary muscle activity after electrical stimulation, reflects multilevel neural inhibitory mechanisms involving spinal and cortical pathways. This study aimed to elucidate central nervous system (CNS) excitability during muscle output regulation and explore neurophysiological characteristics in healthy athletes and contrast with findings from an athlete with delayed return to play.</p><p><strong>Study type: </strong>Case report with observational reference data.</p><p><strong>Methods: </strong>Fourteen female university basketball players participated; The thirteen participants are healthy individuals, able to play without any problems, and one was three months post-meniscal repair who was unable to run since her surgery. All participants were instructed to maintain 25% maximal voluntary isometric contraction of knee extensors for 60 s without visual feedback while seated on the seat of the isokinetic muscle strength measurement device. During the task, SP was recorded from the ipsilateral opponens pollicis muscle. SP was compared between dominant and nondominant leg conditions among healthy participants and contrasted with the postoperative case. Differences between limbs were analyzed using paired t-tests, and the postoperative case was compared with healthy athletes using a Crawford-Howell modified t-test (p < 0.05).</p><p><strong>Results: </strong>The SPs in healthy athletes were 106.3 ± 7.5 and 103.2 ± 6.5 ms for the dominant and nondominant sides, with no significant difference between sides. In the postoperative case, the injured (dominant) side exhibited prolonged SP (123.7 ms), deviating by >2 SD from healthy values, whereas the noninjured side remained within the normal range.</p><p><strong>Conclusion: </strong>Prolonged SP may reflect enhanced cortical or brainstem inhibition associated with neuromuscular control impairment. SP assessment may serve as a neurophysiological indicator for evaluating central recovery and readiness to return to sport following injury.However, larger prospective studies are needed to confirm its clinical utility.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 8","pages":"764-773"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670858","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":"Triceps Surae Neuromuscular Activity During Single-leg Jumping Tasks in Individuals After Anterior Cruciate Ligament Reconstruction.","authors":"Florian Forelli, Ayrton Moiroux-Sahraoui, Jean Mazeas, Yoann Demangeot, Vasileios Korakakis, Alexandre Jm Rambaud","doi":"10.26603/001c.163279","DOIUrl":"10.26603/001c.163279","url":null,"abstract":"<p><strong>Background: </strong>Modifiable risk factors for anterior cruciate ligament (ACL) injury and re-injury have been widely investigated to inform rehabilitation strategies and return-to-sport decision-making. However, less attention has been given to the electromyographic (EMG) activity of the triceps surae after ACL injury and reconstruction.</p><p><strong>Hypothesis/purpose: </strong>The primary objective of this study was to compare triceps surae EMG activity during single-leg jumping tasks between individuals who had undergone ACLR and healthy controls. The secondary objective was to examine whether any observed neuromuscular differences were present bilaterally within the ACLR group. It was hypothesized that individuals after ACLR would demonstrate lower triceps surae EMG activity compared with healthy controls and that any observed differences would also be present in the non-operated limb.</p><p><strong>Study design: </strong>Cross-sectional case-control study.</p><p><strong>Methods: </strong>Twelve individuals with ACLR (mean 5.6 ± 0.7 months postoperatively) and nine healthy controls performed four trials of single-leg countermovement jump (SLCMJ) and single-leg drop jump (SLDJ) tasks. Bilateral surface EMG activity of the triceps surae muscles (gastrocnemius medialis, gastrocnemius lateralis, and soleus) was recorded and normalized to maximal voluntary isometric contraction (% MVIC). For the SLCMJ, peak EMG activity during the propulsion phase was analyzed, whereas for the SLDJ, mean EMG activity was computed over a 0.5-second window preceding peak EMG following ground contact. Between-group and between-limb comparisons were performed using independent and paired t-tests (α = 0.05).</p><p><strong>Results: </strong>Compared with controls, individuals after ACLR demonstrated significantly lower soleus EMG activity during both SLCMJ (p < 0.01) and SLDJ (p = 0.02). Gastrocnemius medialis activity was also significantly lower in the ACLR group during the SLDJ (p < 0.01), whereas no significant differences were observed for gastrocnemius lateralis. No statistically significant differences were found between the operated and non-operated limbs within the ACLR group (all p > 0.05).</p><p><strong>Conclusion: </strong>Individuals with ACLR demonstrate lower triceps surae EMG activity during single-leg jumping tasks, particularly for the soleus. These findings suggest the presence of altered neuromuscular patterns that may be bilateral and muscle specific.</p><p><strong>Level of evidence: </strong>Level 3, cross-sectional case-control study.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 7","pages":"635-643"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392183","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":"Sensorimotor and Molecular Mechanisms of Non-Contact ACL Injury: An Integrative Hypothesis.","authors":"Mikołaj Stańczak, Bram Swinnen, Norbert Kapiński, Adam Kozłowski, Bartłomiej Kacprzak, Magdalena Hagner-Derengowska, Robert Trybulski","doi":"10.26603/001c.163662","DOIUrl":"10.26603/001c.163662","url":null,"abstract":"<p><p>Non-contact anterior cruciate ligament (ACL) ruptures occur in the blink of an eye: peak ligament strain usually coincides with the first 30-50 ms after foot strike, long before reflex feedback can intervene. The model proposed herein integrates findings from previously published studies to formulate a testable framework. The proposed model assigns the decisive protective role to feed-forward hamstring tension and the calcium-dependent stiffening of titin, both of which are fully established before ground contact. Once impact occurs, short-range muscle stiffness and residual force enhancement dominate load absorption, but their buffering capacity is finite; if anterior shear and valgus torque exceed this molecular \"spring-damper\" threshold within ~60 ms, the ACL ruptures. Reflex-mediated hamstring activity arrives ≥35 ms after impact and transcortical corrections even later, rendering feedback too slow for primary protection. By mapping the cascade from cortical pre-activation to titin nano-mechanics, the model clarifies why pre-contact landing strategies and eccentric-strength training are the cornerstones of injury prevention, and it identifies specific molecular adaptations faster Ca²⁺ release, larger titin-actin binding capacity, and enhanced short-range stiffness as novel therapeutic targets. The purpose of this clinical commentary is to provide a theoretical model intended to guide future empirical investigations. # Level of Evidence 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 10","pages":"1034-1056"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216888","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":"Factors Affecting Clinical Decision Making for Blood Flow Restriction Training in Pediatric and Adolescent Patients Following Anterior Cruciate Ligament Injury.","authors":"Nicholas Giampetruzzi, Lauren S Butler, Jennifer Prue, Elliot Greenberg","doi":"10.26603/001c.163281","DOIUrl":"10.26603/001c.163281","url":null,"abstract":"<p><strong>Background: </strong>Research evaluating the effectiveness of blood flow restriction training (BFRT) in patients post anterior cruciate ligament (ACL) injury is growing, but the application of BFRT within clinical settings remains unknown. Understanding how BFRT is used in the pediatric and adolescent populations and what exercise prescription is followed is necessary to discern if there is concordance between research and clinical practice.</p><p><strong>Hypothesis/purpose: </strong>To describe the influence of patient clinical presentation on BFRT use in pediatric and adolescent patients after anterior cruciate ligament reconstruction.</p><p><strong>Study design: </strong>Cross-sectional survey study.</p><p><strong>Methods: </strong>A web-based survey was sent to physical therapists (PTs) who treat pediatric and adolescent patients after ACL injury, via social media and email sent out by rehabilitation continuing education providers. Case vignettes were utilized to understand clinical decisions related to BFRT utilization. Descriptive statistics were utilized to summarize frequency of responses.</p><p><strong>Results: </strong>One hundred forty-seven PTs fully completed the survey. Nearly half (55%) of participants indicated they would not use BFRT on younger patients, mostly out of concern for patient tolerance (90%). Pain impacted BFRT application for 71% of participants, with only 19% of clinicians using BFRT with patients reporting pain greater than 6/10. Postoperatively, participants were most likely to initiate BFRT at week 4 with this population (97%), while only 52% of participants indicated that they have defined criteria for discontinuing BFRT.</p><p><strong>Conclusion: </strong>Younger age, pain, and time from surgery influenced decision making. There were no consistent criteria utilized to determine proper timing to discontinue use of BFRT. These findings support the need for additional research to identify optimal BFRT application within common clinical scenarios, which will help standardize practice and support clinical decision making when utilizing BFRT in adolescents after ACL reconstruction.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 7","pages":"617-626"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392172","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":"Investigation of a Low-cost Portable Inline Dynamometer for Measuring Isometric Knee Extensor Strength.","authors":"Amantej Sran, Elira Leake, Sydney Yott, Julie E Brandon, Geoffrey A Power, Scott C E Brandon","doi":"10.26603/001c.163287","DOIUrl":"10.26603/001c.163287","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;Isometric strength testing is an important tool for detecting deficits in injured populations and monitoring strength changes during rehabilitation and training. However, it is unclear whether strength measurements obtained from low-cost, inline force sensors match measurements from large, expensive, lab-based dynamometers. Therefore, the purpose of this study was to investigate agreement in maximum voluntary isometric knee extension torque measurements between a lab-based dynamometer, a low-cost wireless inline force sensor, and a wired inline force sensor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Prospective cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Laboratory.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fourteen healthy adult participants (age &gt;18 years) were recruited from the university community using posters, email, and social media advertisements. Peak isometric knee extension torque was measured for two repetitions at each of three knee angles (90°, 45° and 15°) using a lab-based dynamometer (Humac, CSMI Medical Solutions, USA). Then, all six trials were repeated while simultaneously recording strength using a low-cost wireless inline force sensor (Tindeq, Trondheim, Norway) and a wired inline force sensor wired (MLP, Transducer Techniques, CA, USA). Peak electromyography (EMG) magnitude was recorded for knee extensors and flexors, and electrical stimulation was used to quantify the level of voluntary activation (VA) for knee extensors. Agreement between torque measurement systems was assessed using Pearson's Correlation (r), Interclass Correlation Coefficients (ICC3,1, absolute agreement), Minimum Detectable Change, and Bland-Altman Limits of Agreement (LOA). Additionally, peak torque was compared at each knee angle using a repeated measures ANOVA, and peak EMG outputs were compared using paired t-tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fourteen participants completed the study (3 male, 11 female; 26 ± 8.97 years; 1.71 ± 0.11 m; 66.75 ± 15.9 kg). The mean (95% CI) difference in torque between Tindeq and Humac dynamometers was 0.16 Nm/kg (-0.07 to 0.26 Nm/kg) at a knee angle of 15 degrees, -0.02 Nm/kg (-0.19 to 0.14 Nm/kg) at 45 degrees, and -0.10 Nm/kg (-0.32 to 0.13 Nm/kg) at 90 degrees. Bland-Altman LOA were -0.86 to 0.67 Nm/kg at 15 degrees, -0.60 to 0.55 Nm/kg at 45 degrees, and -0.86 to 0.67 Nm/kg at 90 degrees. Bias and LOA were similar for the MLP device. All participants achieved &gt;90% VA. Results were more similar between Tindeq and MLP inline force sensors (r = 1.0, ICC3,1 = 0.94-1.00) than between inline force sensors and the Humac device (r &lt;0.81, ICC3,1 = 0.37-0.80).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although sample size was small and only a single testing session was performed, the Tindeq device showed small measurement bias, underestimating the Humac torque by less than 0.1 Nm at 45 and 90 degrees. However, relatively large LOA indicated that individual measurement errors could exceed 25","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 7","pages":"644-654"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392131","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 Effect of In-Game Cervical Exercises on Shoulder Internal Rotation Range of Motion and External Rotator Strength in Baseball Pitchers.","authors":"Vincent Ceasrine, Christine Ferraro, Jason Grimes","doi":"10.26603/001c.163525","DOIUrl":"10.26603/001c.163525","url":null,"abstract":"<p><strong>Background: </strong>Consensus is lacking regarding the underlying cause of two prevalent risk factors for shoulder and elbow pain in overhead throwing athletes: loss of shoulder internal rotation (IR) range of motion (ROM) and strength of the external rotators (ER). Consideration of cervical spine contribution may have important implications for rehabilitation and coaching of overhead throwers.</p><p><strong>Purpose: </strong>The purpose of this study was to investigate the effect of performing active cervical retraction and retraction with extension exercises between innings of pitching a simulated game on shoulder IR ROM and ER strength following completion of the game.</p><p><strong>Study design: </strong>Randomized controlled study.</p><p><strong>Methods: </strong>Passive shoulder IR ROM at 90° of abduction and ER strength at 0° of abduction were assessed in healthy male baseball pitchers. Participants were randomized to a control or experimental group and completed a simulated game totaling 60 pitches. Those in the experimental group performed 10 repetitions of active cervical retraction and retraction with extension exercises with a 3-second hold at end-range between innings, while those in the control group rested. Shoulder IR ROM and ER strength were re-assessed immediately following the simulated game. Independent samples t-test was used to assess for between-group differences and effect sizes were calculated using Cohen's d.</p><p><strong>Results: </strong>Twenty pitchers (mean age=19.2 ± 3.3) completed the study. All 10 pitchers in the experimental group demonstrated an increase in shoulder IR ROM (mean gain 7.7° ± 4.9) while all 10 pitchers in the control group demonstrated a loss of ROM (mean loss 8.4° ± 5.3), resulting in a significant between-group difference of 16.1° (p<0.001). Though the experimental group demonstrated a mean ER strength loss of 0.5kg compared to a 1.0kg loss in the control group, this difference was not statistically significant (p=0.399).</p><p><strong>Conclusion: </strong>Active cervical retraction and retraction with extension exercises performed between innings during a simulated game resulted in increased shoulder IR ROM compared to controls. Although ER strength loss was attenuated in the experimental group, this finding did not reach significance and is worthy of further exploration.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 7","pages":"664-672"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392186","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}