{"title":"“Effects of ankle orthoses on postural balance and gait parameters in athletes with ankle injuries: A systematic review”","authors":"Zeinab Gasavi Nezhad , Majid Ansari , Mahmood Bahramizadeh","doi":"10.1016/j.ptsp.2025.09.005","DOIUrl":"10.1016/j.ptsp.2025.09.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Ankle injuries in athletes often impair balance and gait, affecting performance. Although ankle orthoses are used to improve stability, their effects on postural control and gait remain unclear. This review investigates the impact of ankle orthoses on balance and gait in injured athletes.</div></div><div><h3>Methods</h3><div>This systematic review, registered in PROSPERO (XXXXXX) and conducted following PRISMA 2020 guidelines, included interventional and observational studies up to April 30, 2025. Databases searched were PubMed, Scopus, Web of Science, and CINAHL. Two independent reviewers conducted screening, data extraction, and quality assessment using the EPHPP tool. Certainty of evidence was evaluated using GRADE, and results were narratively synthesized due to study heterogeneity.</div></div><div><h3>Results</h3><div>Thirty-three studies involving 736 athletes with ankle injuries were included. Semi-rigid orthoses improved postural balance and gait by reducing peak inversion angles (10–15 %) and enhancing dynamic stability. Soft braces improved dynamic stability, measured by tests such as the Star Excursion Balance Test. Rigid braces often limited joint motion and compromised performance. Overall, evidence certainty was low (GRADE rating) due to methodological limitations, especially in blinding and confounder control.</div></div><div><h3>Conclusion</h3><div>Semi-rigid ankle orthoses appear most effective in improving balance and gait post–ankle injury, with clinical relevance for sport-specific rehabilitation to enhance stability and reduce recurrence risks. High-quality randomized trials are needed to strengthen the evidence and guide sport-specific orthotic use.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 56-74"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Center of mass displacement and lower limb kinematics during the side hop test in individuals with and without chronic ankle instability","authors":"Shojiro Nozu , Tadamitsu Matsuda , Yuji Takazawa","doi":"10.1016/j.ptsp.2025.09.009","DOIUrl":"10.1016/j.ptsp.2025.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>To examine differences in center of mass (COM) displacement and joint kinematics during the side hop test (SHT) between individuals with and without chronic ankle instability (CAI).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Biomechanics laboratory.</div></div><div><h3>Participants</h3><div>Twelve healthy individuals (age: 19.8 ± 1.3 y; height: 162.6 ± 10.0 cm; weight: 57.1 ± 6.3 kg) and 12 with CAI (age: 20.0 ± 1.3 y; height: 162.4 ± 5.9 cm; weight: 55.7 ± 6.9 kg).</div></div><div><h3>Main outcome measures</h3><div>SHT completion time, COM displacement, and ankle, knee, and hip joint angles in sagittal, frontal, and transverse planes during SHT. Statistical parametric mapping visualized between-group differences.</div></div><div><h3>Results</h3><div>The CAI group demonstrated significantly longer SHT times than the control group (Mean Difference: 1.4 s, p < 0.001). Vertical COM displacement was significantly lower in the CAI group during 10–16 % (p = 0.03) and 55–70 % (p = 0.006) of the SHT cycle. Hip flexion angles were significantly greater in the CAI group during 17–20 % (p = 0.04) and 57–72 % (p = 0.004).</div></div><div><h3>Conclusions</h3><div>Compared with healthy individuals, those with CAI exhibited longer SHT times, likely due to a characteristic movement pattern involving increased COM lowering and greater hip flexion during the landing phase.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 50-55"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qian Qian , Hengshuo Zhang , Zongchen Hou , Patrick C. Wheeler , Daniel T.P. Fong
{"title":"Simplified Tai Chi exercises to improve function in people with chronic ankle instability","authors":"Qian Qian , Hengshuo Zhang , Zongchen Hou , Patrick C. Wheeler , Daniel T.P. Fong","doi":"10.1016/j.ptsp.2025.09.006","DOIUrl":"10.1016/j.ptsp.2025.09.006","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify 12 forms from the traditional 108-form Tai Chi with the highest muscle activation values in the peroneus longus, peroneus brevis, and tibialis anterior and to design a Tai Chi training routine suitable for individuals with chronic ankle instability.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Sports Biomechanics Laboratory.</div></div><div><h3>Participants</h3><div>Eight Tai Chi instructors were recruited, with data from six used for analysis.</div></div><div><h3>Main outcome measures</h3><div>The independent variable was the Tai Chi forms, while the dependent variable was the muscle activation measured using electromyography. The Vicon motion capture system recorded kinematic changes for form segmentation. Electromyography values from different segments were normalised to the maximum voluntary isometric contraction ratio for comparison.</div></div><div><h3>Results</h3><div>In the 12 Tai Chi forms, peroneus longus, peroneus brevis, and tibialis anterior exhibited muscle activation exceeding 55 %, 55 %, and 30 % of maximum voluntary isometric contraction in integrated electromyography, respectively, with root mean square reaching 116.9 %, 111.7 %, and 60.3 %. Adding transition stages expanded these into a 16-form routine, with no significant side differences.</div></div><div><h3>Conclusions</h3><div>The 16-form Tai Chi has the potential to enhance ankle stability by selectively training the muscles that counter ankle inversion. Randomised controlled trials are needed to assess its effectiveness in chronic ankle instability.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 101-109"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony P. Sharp , Jonathon Neville , John B. Cronin
{"title":"Masterclass: Are you getting the most out of your triple hop testing?","authors":"Anthony P. Sharp , Jonathon Neville , John B. Cronin","doi":"10.1016/j.ptsp.2025.09.016","DOIUrl":"10.1016/j.ptsp.2025.09.016","url":null,"abstract":"<div><div>The triple hop test is a widely used, practical tool that allows physical therapists to assess an athlete's readiness to return-to-sport (RTS) following injury. However, recent consensus statements have raised concerns that hop distance alone may be insufficient to capture the complexity of functional recovery or to fully assess inter-limb symmetry, potentially masking readiness and increasing the risk of reinjury. In this Masterclass: exemplar kinetic and kinematic data for the triple hop are detailed; the utility of the quintuple hop introduced; the distinction between outcome and movement strategy variables discussed within an asymmetry context; and, the integration of accessible, cost-effective technologies within a tier-based framework for RTS assessment outlined. The aim of the article is to enhance the evaluation of movement strategies and support clinicians in making more informed and confident RTS decisions.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 111-119"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natanael P. Batista , Amanda M. Murray , Grant E. Norte , Neal R. Glaviano , Jaini H. Kothari , Emma G. Streetman , Andrew L. Geers , David M. Bazett-Jones
{"title":"Test-related psychological responses and quadriceps neuromuscular outcomes in people with and without patellofemoral pain","authors":"Natanael P. Batista , Amanda M. Murray , Grant E. Norte , Neal R. Glaviano , Jaini H. Kothari , Emma G. Streetman , Andrew L. Geers , David M. Bazett-Jones","doi":"10.1016/j.ptsp.2025.10.041","DOIUrl":"10.1016/j.ptsp.2025.10.041","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate test-related psychological responses during quadriceps neuromuscular assessments in individuals with and without patellofemoral pain (PFP), and examine their relationship with test outcomes.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Laboratory.</div></div><div><h3>Participants</h3><div>Forty-six individuals (23 with PFP, 23 pain-free controls).</div></div><div><h3>Main outcome measures</h3><div>We assessed knee extension peak torque, early and late rate of torque development (RTD) during maximal voluntary isometric contractions (MVICs). Central activation ratio was assessed using the superimposed burst (SIB) technique, and active motor threshold using transcranial magnetic stimulation (TMS). Psychological responses (discomfort, thigh pain, knee pain, anxiety, and fear) were rated on a 0–100 visual analogue scale for each test.</div></div><div><h3>Results</h3><div>Compared to controls, the PFP group reported greater discomfort (adjusted p = 0.007) and knee pain (adjusted p = 0.007) during MVICs, and greater knee pain during SIB (adjusted p = 0.011) and TMS (adjusted p = 0.011). There were no significant correlations between test-related psychological responses and test outcomes.</div></div><div><h3>Conclusions</h3><div>Psychological responses were generally similar between groups, except that those with PFP reported greater knee pain in all tests. Although elevated in both groups, these responses were not significantly associated with poorer test outcomes. These findings support the utility of these assessments and underscore the importance of monitoring patient comfort during testing.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 169-176"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. van Rozendaal , I. Tak , M. Barendrecht , N. Jongerius , A. Gokeler
{"title":"Effect of stroboscopic vision on single leg hop for distance performance in athletes after anterior cruciate ligament reconstruction: a case-control study","authors":"N. van Rozendaal , I. Tak , M. Barendrecht , N. Jongerius , A. Gokeler","doi":"10.1016/j.ptsp.2025.09.003","DOIUrl":"10.1016/j.ptsp.2025.09.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Following an anterior cruciate ligament (ACL) injury, athletes may become more reliant on their vision to maintain postural control. Wearing stroboscopic glasses, which intermittently disrupt visual input, can result in decreased vision. However, it remains unclear whether this affects single-leg hopping distance in athletes after ACL reconstruction (ACLR).</div></div><div><h3>Design</h3><div>Case-control study.</div></div><div><h3>Setting</h3><div>Sports physiotherapy clinics and sports clubs.</div></div><div><h3>Participants</h3><div>Athletes (Tegner-score >5) who were (mean (standard deviation)) 16.9 (4.6) months after ACLR (n = 17, age:24.7 (4.6) years), and uninjured matched controls (n = 17, age:26.1 (3.6) years).</div></div><div><h3>Main outcome measures</h3><div>Differences in jump distance (mean (95 % confidence intervals)) in the single-leg hop for distance (SLHD) test in normal and stroboscopic vision.</div></div><div><h3>Results</h3><div>Overall, the SLHD performance was significantly lower (p = 0.001) under stroboscopic vision 116 (95 % confidence interval (CI): 106,125) cm than under normal vision 125 (95 %CI: 116,135) cm. The difference in SLHD performance between the two vison conditions was significantly greater for the ACLR group (p = 0.003): for ACLR athletes, it was 125 (95 %CI: 115,135) cm to 111 (95 %CI: 99,122) cm, and for controls, it was 126 (95 %CI: 112,139) cm to 121 (95 %CI: 107,135) cm.</div></div><div><h3>Conclusion</h3><div>Stroboscopic vision significantly reduces SLHD outcomes. Greater reductions in hop performance were found in ACLR athletes compared to the control group under stroboscopic conditions. This suggests that the ACLR athletes rely more on visual input, which may be important to improve rehabilitation outcomes.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 13-20"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The progression of shoulder functional profile in male rugby union players from the academy to the professional level","authors":"Isabelle Rogowski , Matthieu Degot , Olivier Capel , Grégory Vigne , Romain Loursac , Jean-Philippe Hager , Yoann Blache , Lionel Neyton","doi":"10.1016/j.ptsp.2025.09.012","DOIUrl":"10.1016/j.ptsp.2025.09.012","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the changes in shoulder functions with age, playing position, dominance and injury history in elite male rugby union players.</div></div><div><h3>Design</h3><div>Observational.</div></div><div><h3>Setting</h3><div>Sport setting.</div></div><div><h3>Participants</h3><div>162 players in U16, U18, U21 and professional squads.</div></div><div><h3>Main outcome measures</h3><div>Participant-reported outcome measures, maximal isometric internal and external rotation strength at glenohumeral joint, stability using Upper Quarter Y-Balance Test, power using Seated Single-Arm Horizontal Push Test (SSAHPT), and speed, power and resistance-to-fatigue using modified-Closed Kinetic Chain Upper Extremity Stability Test.</div></div><div><h3>Results</h3><div>The strength (η<sup>2</sup> = [0.24; 0.25]; p < 0.001) and power (η<sup>2</sup> = [0.36; 0.47]; p < 0.001) increased with increase in age, while stability and resistance-to-fatigue remained similar, and speed abilities decreased at professional level (η<sup>2</sup> = 0.10; p < 0.001). The forwards' shoulders were stronger (η<sup>2</sup> = [0.02; 0.14]; p = [<0.001; 0.02]) and more powerful (η<sup>2</sup> = 0.12; p < 0.001) than those of backs, while backs’ shoulders presented higher speed abilities (η<sup>2</sup> = 0.22; p < 0.001) and resistance-to-fatigue (η2 = 0.04; p = 0.02). No bilateral differences were found, except for SSAHPT, for which dominant side presented higher performance than nondominant one (η<sup>2</sup> = 0.12; p < 0.001). The injury history only affected the perceived functions (η<sup>2</sup> = [0.15; 0.18]; p < 0.001).</div></div><div><h3>Conclusion</h3><div>Understanding the progression of shoulder functions in male rugby union players is useful for designing injury prevention and performance enhancement programs from the academy to professional levels.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 83-92"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Séverine Abellaneda , Malgorzata Klass , Bruno Bonnechère , Joachim Van Cant
{"title":"Influence of pre-surgery characteristics and sports practice level on return to sport after ACL reconstruction","authors":"Séverine Abellaneda , Malgorzata Klass , Bruno Bonnechère , Joachim Van Cant","doi":"10.1016/j.ptsp.2025.09.014","DOIUrl":"10.1016/j.ptsp.2025.09.014","url":null,"abstract":"<div><h3>Objectives</h3><div>1) To compare pre-surgery characteristics, pre-injury sports level, and 6-month recovery outcomes between patients with successful (sRTS) and unsuccessful (noRTS) return to sport at 24 months post-ACLR; 2) To identify whether pre-surgical characteristics or pre-injury sports level predict noRTS.</div></div><div><h3>Design</h3><div>Longitudinal cohort study.</div></div><div><h3>Participants</h3><div>40 patients with ACLR.</div></div><div><h3>Main outcome measures</h3><div>Pre-surgery characteristics were collected and the level of sports practice was assessed using Tegner and Marx questionnaires, and the Noyes Sports Activity Rating Scale (NSARS). At 6 months a second evaluation was conducted. At 24 months, patients were divided into two groups: sRTS and noRTS.</div></div><div><h3>Results</h3><div>Pre-injury NSARS score was higher in noRTS (92.5 [80; 100]) compared to sRTS group (85 [72.5; 86.2]; p = 0.03). The multivariate model that best predicts noRTS (AUC = 0.83; p = 0.011) combines a higher pre-injury NSARS (AOR = 1.07 [1.01–1.14]; p = 0.001), more associated injuries (AOR = 1.55 [0.98–2.42]; p = 0.043), and longer injury to surgery time interval (AOR = 1.15 [0.91–1.46]; p = 0.21).</div></div><div><h3>Conclusion</h3><div>Clinicians should consider key risk factors (e.g. high pre-injury NSARS score, multiple associated injuries, delayed surgery) to tailor rehabilitation and improve return to pre-injury sports level 24 months post-ACLR.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 93-100"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proceedings of the 2023 SONAFE International Congress","authors":"","doi":"10.1016/j.ptsp.2025.10.022","DOIUrl":"10.1016/j.ptsp.2025.10.022","url":null,"abstract":"","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages e1-e8"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Return to sport after graft rupture of anterior cruciate ligament with a nonoperative management in a collegiate athlete: a case report","authors":"Bo-Jhen Chen","doi":"10.1016/j.ptsp.2025.09.007","DOIUrl":"10.1016/j.ptsp.2025.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Athletes who undergo anterior cruciate ligament (ACL) reconstruction may encounter subsequent graft rupture and revision. The current literature is limited to investigating the sports performance and reinjury rate after revision ACL. Whether a nonoperative approach achieves successful clinical outcomes after graft rupture has not yet been reported.</div></div><div><h3>Case description</h3><div>The patient was a 20-year-old male athlete who initially tore the left ACL when playing volleyball. By eight months after receiving ACL reconstruction and meniscal repair, the patient returned to the national collegiate tournament. However, the patient ruptured the graft 15 months postoperatively. Rehabilitation rather than a revision was elected, which focused on movement associated fear and volleyball-specific movements.</div></div><div><h3>Outcomes</h3><div>By 7 months after the second injury, the patient achieved >90 % symmetry in a battery of hop distance tests and shuttle run speed. The functional score on the Knee Outcome Survey Sports Activities Scale improved from 37/55 to 55/55. The psychological readiness improved from 56/120 to 117/120 on the ACL–Return to Sport after Injury scale. The patient then returned to full competition.</div></div><div><h3>Conclusion</h3><div>Personalized physical therapy may provide an option to promote return to sport after reinjuries. This case report illustrates the importance of addressing biopsychosocial factors in sport rehabilitation.</div></div>","PeriodicalId":49698,"journal":{"name":"Physical Therapy in Sport","volume":"76 ","pages":"Pages 21-26"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}