Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, October 26, 2016

Running Fatigue Exacerbates Plantar Pressures

Effects of running-induced fatigue on plantar pressure distribution in novice runners with different foot types

Anbarian, M & Esmaeili H.  Gait & Posture. 2016; 48: 52-56. doi: 10.1016/j.gaitpost.2016.04.029
Take Home Message: A fatigue running protocol caused increases in forefoot push-off time in all participants, but caused increases in different foot regions based on arch height.

Running is a common form of physical activity that has largely positive effects, but due to the repetitive motions it can result in injury.  The question remains what role does fatigue play in injury and how might an individual’s foot structure relate to fatigue and injury.  The researcher of this study investigated the effects of fatigue on plantar pressure among 42 novice runners with bilateral high or low medial longitudinal arch height.
Monday, October 24, 2016

The Role of “Roll-Off” During Gait in Patients Recovering from a Lateral Ankle Sprain

Center of pressure during stance and gait in subjects with or without persistent complaints after a lateral ankle sprain.

Kros W, Keijsers NL, van Ochten JM, Bierma-Zeinstra SM, van Middelkoop M. Gait Posture. 2016 Jul;48:24-9. doi: 10.1016/j.gaitpost.2016.04.022. Epub 2016 Apr 29.

Take Home Message: People with persistent complaints 6 to 12 months after an ankle sprain walk differently than those without persistent complaints.

Following a lateral ankle sprain, many patients may suffer deficits acutely that linger long after an initial injury. We can identify people with chronic ankle instability – one aspect of persistent symptoms – by measuring center of pressure (COP) during certain tasks. Unfortunately, it is unclear if this is true for a larger group of patients with persistent symptoms after a lateral ankle sprain. The authors of this study explored if COP measures during single-leg stance and gait differ between people with and without persistent complaints 6 to 12 months after a lateral ankle sprain.
Wednesday, October 19, 2016

A Winning Combination: Manual Therapy and Exercises for Recurrent Ankle Sprains

Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial.

Plaza-Manzano G, Vergara-Vila M, Val-Otero S, Rivera-Prieto C, Pecos-Martin D, Gallego-Izquierdo T, Ferragut-Garcías A, Romero-Franco N. Manual Therapy. 2016;26:141-149. doi:10.1016/j.math.2016.08.006.

Take Home Message: Patients with chronic ankle instability who received a 4-week supervised rehabilitation program consisting of therapeutic exercise, joint mobilization, and neural mobilizations had greater clinical improvements compared with patients who were treated with therapeutic exercise alone.

Forty percent of people with lateral ankle sprains develop chronic ankle instability (CAI). One possible cause of CAI is peripheral nerve injury, which is a common consequence of lateral ankle sprains. Manual therapy and therapeutic exercise (to include balance and proprioceptive training) are beneficial in treating CAI; however, no one has investigated the effectiveness of neural mobilization for these patients. The purpose of this single-blinded randomized control trial was to compare the effects of a 4-week rehabilitation program consisting of strengthening and balance exercises with and without the addition of manual therapy (joint and neural mobilizations) on self-reported pain and function, pain-pressure thresholds, range of motion, and strength in physically active individuals with CAI.
Monday, October 17, 2016

Comprehensive Services Improve Care for Adolescents with Persistent Postconcussive Symptoms

Collaborative Care for Adolescents With Persistent Postconcussive Symptoms: A Randomized Trial

McCarty CA, Zatzick D, Stein E, Wang J, Hilt R, Rivara FP. Pediatrics 2016;138(4):e20160459

Take Home Message: Adolescents with persistent postconcussive symptoms experienced greater improvements in symptoms and quality of life after receiving a collaborative care treatment compared with adolescents who received the standard of care.

Pediatric patients with persistent concussive symptoms can sustain significant impairments and comorbidities such as depression and anxiety. Watchful waiting remains the standard of care. An active intervention like cognitive behavior therapy is an option; however, there are limited studies that examine the efficacy of this rehabilitation program. Therefore, the authors developed a randomized trial to compare collaborative care (standard care, cognitive-behavioral therapy, and psychopharmacological consultation) with standard of care management for patients aged 11 to 17 with persistent symptoms (> 1 month) following a sports-related concussion.
Friday, October 14, 2016

Identifying Risk of Persistent Symptoms Following Acute Musculoskeletal Injury

The Traumatic Injuries Distress Scale: A New Tool That Quantifies Distress and Has Predictive Validity With Patient-Reported Outcomes

Walton DM, Krebs D, Moulden D, Wade P, Levesque L, Elliott J, MacDermid JC. J Orthop Sports Phys Ther. 2016 Sep 3:1-19.

Take Home Message: The Traumatic Injuries Distress Scale (TIDS) may be a short (12-item) tool to assess early risk for persistent symptoms following acute musculoskeletal injury.

Outcomes following an acute musculoskeletal injury is suboptimal for up to 50% of patients. A succinct and focused patient-reported outcome tool geared toward emotional lability, sense of uncontrollability, and intrusion or hyperarousal may allow clinicians to identify a patient with an acute injury who is at risk for persistent symptoms. The purpose of this study was to develop and evaluate the utility of the Traumatic Injuries Distress Scale (TIDS) among individuals within 30 days of an acute musculoskeletal injury. The new instrument is intended to help identify patients at risk for persistent problems following a variety of acute injuries (e.g., ankle sprain, low back pain).
Wednesday, October 12, 2016

Cleared for Landing? Pre-Landing Strategies among Athletes with Chronic Ankle Instability

Muscle Activation During Landing Before and After Fatigue in Individuals With or Without Chronic Ankle Instability

Webster KA, Pietrosimone BG, & Gribble PA.  J Athl Train. 2016; 51 (10): 000. doi: 10.4085/1062-6050-51.10.01
Take Home Message: Individuals with chronic ankle instability have higher pre-activation of peroneus longus and gluteus maximus compared with controls.  A functional fatigue protocol affected both groups similarly.

Despite chronic ankle instability (CAI) being common among physically active individuals, it remains unclear why some patients develop it.  Fatigue can influence muscle activation patterns, which could contribute to recurrent ankle sprains.  However, it is unknown if fatigue affects individuals with CAI differently than those without CAI.   Therefore, these researchers investigated hip and ankle muscle activity pre and post fatigue among individuals with or without CAI.
Monday, October 10, 2016

Therapist-Directed Cognitive Rehabilitation Improved Functional Cognitive Outcomes

Cognitive Rehabilitation for Military Service Members With Mild Traumatic Brain Injury: A Randomized Clinical Trial

Cooper DB, Bowles AO, Kennedy JE, Curtiss G, French LM, Tate DF, Vanderploeg RD. J Head Trauma Rehabil. 2016;ahead of print.

Take Home Message: Four treatment strategies for chronic symptoms after a mild traumatic brain injury (mTBI) improved symptoms; however, those with therapist-directed cognitive rehabilitation demonstrated superior improvements in functional cognitive scores compared with standard of care and computer-based rehabilitation.

Many US military service members and veterans report postconcussive symptoms well beyond a normal period of recovery. Psychoeducation, behavioral health, and cognitive rehabilitation interventions for chronic postconcussive symptoms are used to treat those suffering from memory and other cognitive impairments. However, prior studies were small and only looked at acute recovery. Therefore, the authors developed a randomized control trial to compare cognitive rehabilitation interventions with standard of care management for service members who had chronic symptoms after an mTBI.