Clinical efficacy of photodynamic therapy adjunctive to scaling and root planing in the treatment of chronic periodontitis: A systematic review and meta-analysis

PurposeTo evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence.MethodsMEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I² test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed.ResultsEleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD = 0.13, CI:0.02–0.24, p = 0.02) and marginal significant improvement in CAL gain (MD = 0.18, CI:−0.005–0.363, p = 0.056) were observed in favor of SRP+PDT at 3 months. When evaluated at 6 months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD = 0.40, CI:0.05–0.74, p = 0.03), but not in CAL gain (MD = 0.37, CI:−0.18–0.93, p = 0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3 months nor 6 months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies.ConclusionsPooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6 months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration.     

The use of the dual-task paradigm in detecting gait performance deficits following a sports-related concussion: A systematic review and meta-analysis

ObjectivesThe purpose of this systematic review was to determine the viability of the dual-task paradigm in the evaluation of a sports-related concussion.DesignSystematic review and meta-analysis.MethodsEight electronic databases were searched from their inception until the 11^th of April 2011. Studies were grouped according to their reported gait performance variables and their time(s) of assessment(s). Raw mean differences (MD) and 95% confidence intervals (CI) were calculated based on raw means and standard deviations for gait performance measures in both single- and dual-task conditions. Dual-task deficits were pooled using a random effects model and heterogeneity (I²) between studies was assessed.ResultsTen studies representing a total sample of 168 concussed and 167 matched (age and gender) non-concussed participants met the inclusion criteria. Meta-analysis demonstrated that dual-task performance deficits were detected (p < 0.05) in the concussed group for gait velocity (GV) (MD = ?0.133; 95% CI ?0.197, ?0.069) and range of motion of the centre of mass in the coronal plane (ML-ROM) (MD = 0.007; 95% CI 0.002, 0.011), but not in the non-concussed group; GV (MD = ?0.048; 95% CI ?0.101, 0.006), ML-ROM (MD = 0.002; 95% CI ?0.001, 0.005).ConclusionsThe results of this study indicate that GV and ML-ROM are sensitive measures of dual-task related changes in concussed patients and should be considered as part of a comprehensive assessment for a sports-related concussion.     

Femoroacetabular impingement alters hip and pelvic biomechanics during gait: Walking biomechanics of FAI

Femoroacetabular impingement (FAI) has been reported to cause hip pain in a variety of daily activities including walking. However, the biomechanics of level gait has not been compared between FAI patients and a control group. This study quantified the affect of cam FAI on the three-dimensional (3-D) kinematics of the hip and pelvis, as well as the 3-D kinetics generated at the hip during walking. A unilateral cam impingement group (n = 17) was compared to a matched control group (n = 14) using between-group one-way ANOVAs. The FAI group had significantly lower peak hip abduction (p = 0.009), frontal range of motion (ROM) (p = 0.003), as well as attenuated pelvic frontal ROM (pelvic roll) (p = 0.004) compared to the controls during level gait. There was also a trend of the impinged group having a lower sagittal ROM (p = 0.047) than the controls. However, there were no kinetic differences between the two groups. Attenuated hip abduction, frontal ROM and sagittal ROM during gait in FAI individuals may be caused by soft tissue restriction, and decreased frontal pelvic ROM could result from limited mobility at the sacro-lumbar joint.     

Sensorimotor posture control in the blind: Superior ankle proprioceptive acuity does not compensate for vision loss

To better understand sensorimotor posture control differences between blind and sighted individuals, we examined the role of ankle joint proprioception and ankle muscle strength on postural control in healthy blind (n = 13, 25–58 years) and age- and sex-matched sighted (n = 15, 20–65 years) volunteers. We measured ankle joint proprioceptive acuity and isokinetic muscle strength in plantarflexion and dorsiflexion using an isokinetic dynamometer. We also assessed postural control performance during quiet bipedal stance with and without sudden postural perturbations, and during quiet unipedal stance. We found that while our blind subjects exhibited significantly better proprioceptive acuity than our sighted subjects their postural control performance was significantly poorer than that of the sighted group with eyes open, and no different from that of the sighted group with eyes closed suggesting that their superior proprioceptive acuity does not translate to improved balance control.     

Exercise-based injury prevention for community-level adolescent cricket pace bowlers: A cluster-randomised controlled trial

ObjectivesTo investigate if an exercise-based injury prevention program (IPP) can modify risk factors for injury in community-level adolescent cricket pace bowlers.DesignCluster-randomised controlled trial.MethodsEight cricket organisations (training two times per week and no previous involvement in a structured IPP) participated in this cluster-randomised trial. Participants were aged 14–17 years, injury free, and not currently performing a rehabilitation/exercise program. Cricket organisations (clusters) were block-randomised by computerised number generation into an intervention group (performed an eight-week IPP at training) or control group (continued their usual cricket activity). Participants were not blinded to group allocation. Strength, endurance, and neuromuscular control were assessed at baseline and follow-up. Treatment effects were estimated using linear mixed models.ResultsSixty-five male adolescent pace bowlers (intervention n = 32 and control n = 33) were randomised. There were significant treatment effects favouring the intervention group for shoulder strength (90°/s) 0.05 (95% CI 0.02–0.09) N m/kg, hamstring strength (60°/s) 0.32 (95% CI 0.13–0.50) N m/kg, hip adductor strength dominant 0.40 (95% CI 0.26–0.55) N m/kg and non-dominant 0.33 (95% CI 0.20–0.47) N m/kg, SEBT reach distance dominant 3.80 (95% CI 1.63–6.04) percent of leg length (%LL) and non-dominant 3.60 (95% CI 1.43–5.78) %LL, and back endurance 20.4 (95% CI 4.80–36.0) seconds. No differences were observed for shoulder strength (180°/s) (p = 0.09), hamstring strength (180°/s) (p = 0.07), lumbopelvic stability (p = 0.90), and single leg squat knee valgus angle (dominant p = 0.06, non-dominant p = 0.15).ConclusionsExercise-based IPPs can modify risk factors for injury in community-level adolescent pace bowlers. Future research is needed to confirm if IPPs can also reduce injury risk in this population.     

The effects of localized muscle and whole-body fatigue on single-leg balance between healthy men and women

The purpose was to examine the effects of localized muscle and whole-body fatigue on indices of single-leg balance between healthy young men (n = 10) and women (n = 10). Subjects performed 10, 10-s single-leg balance trials on a force platform prior to performing each of three conditions (local, whole-body, and control), in a randomized order, on separate days. Localized muscle and whole-body fatigue consisted of single-leg, weight-bearing heel raises on an inclined platform, and exercise on a rowing ergometer, respectively, to the point of volitional failure. During the control condition, subjects remained in a seated position for 5 min. Immediately following each condition, five, 10-s, single-leg balance trials were performed. The localized muscle and whole-body fatigue protocols produced significant (p < 0.05) increases in medial/lateral (M/L) and total sway (TS). Men experienced a greater (p < 0.05) increase in anterior/posterior (A/P) sway following the localized muscle, than whole-body, fatigue protocol, whereas A/P sway increased more following the whole-body, than localized muscle, fatigue protocol for the women. Total sway variability increased significantly (p < 0.05) more following the localized muscle fatigue protocol than the whole-body fatigue protocol for both men and women. The major findings of the present investigation demonstrated that measures of postural control, namely M/L, A/P sway and total sway, were adversely affected following fatiguing exercise, with differential effects between men and women.     

Altered postural sway persists after anterior cruciate ligament reconstruction and return to sport

Postural sway is defined as the movement of a body's center of mass within the base of support to maintain postural equilibrium. Deficits in postural sway are present after ACL injury; however, current evidence linking it to future injury risk is unclear. The purpose of this study was to determine if postural sway deficits persist after ACL reconstruction (ACLR). The hypothesis tested was that after ACLR, patients who return to sport (RTS) would demonstrate differences in postural sway compared to control (CTRL) subjects. Fifty-six subjects with unilateral ACLR released to RTS, and 42 uninjured CTRL subjects participated. Dynamic postural sway was assessed and 3-way (2 × 2 × 2) ANOVA was used to analyze the variables. A side × group × sex (p = 0.044) interaction in postural sway was observed. A side × group analysis also revealed an interaction (p = 0.04) however, no effect of sex was observed (p = 0.23). Analysis within the ACLR cohort showed less (p = 0.001) postural sway on the involved side (1.82 ± 0.84°) versus the uninvolved side (2.07 ± 0.96°). No side-to-side differences (p = 0.73) were observed in the CTRL group. The involved limb of subjects after ACLR demonstrated the least postural sway. In conclusion, these findings indicate that dynamic postural sway may be significantly altered in a population of athletes after ACLR and RTS compared to CTRL subjects. Further investigation is needed to determine if deficits in postural sway can be used as an effective criterion to assist in the decision to safely RTS after ACLR.     

Double-leg stance and dynamic balance in individuals with functional ankle instability

To investigate whether double-leg stance could reveal balance deficits in subjects with functional ankle instability (FAI) and whether such an assessment of static balance would be correlated with measures of dynamic instability, 16 individuals with FAI and 16 healthy controls participated in this study. Static postural control was tested using double-leg stance (either with the eyes open (EO) or closed (EC)) on a dual-plate force platform. Dynamic balance was evaluated using the Multiple Hop Test (MHT) and a weight-shifting task. FAI subjects were significantly less stable in the anteroposterior direction during double-leg stance (as assessed by velocity of centre of pressure, VCP), both for the EO and EC condition. In the mediolateral direction the VCP values were also higher in FAI, but significance was only found for the EC condition (p = .02). FAI subjects made significantly more balance errors compared to healthy controls (p < .001) on both the affected and less affected leg during MHT. There were no significant differences between FAI and healthy subjects during the weight-shifting task. No relationship was found between double-leg stance and MHT measures (all correlations (r_s) less than .30). This study suggests that static postural control during double-leg stance is impaired in FAI subjects. Although dynamic balance during MHT is also affected, no significant relationship was found between static and dynamic measurements, which indicate that they are most probably related to different aspects of postural control.     

A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis

This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n = 17) and adolescents with idiopathic scoliosis (n = 52) with either mild (Cobb angle ≥ 15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis.     

Attentional requirements of walking according to the gait phase and onset of auditory stimuli

A dual-task paradigm was used to examine the influence of an attention demanding cognitive task on each phase of gait. Twenty-three participants (aged 18–27) walked on a treadmill at a 20% increase of their self-selected speed, either alone or while performing a cognitive task. Muscle activity was measured with electromyography (iEMG) for eight muscles of the dominant leg. The cognitive task consisted of subtracting one (EASY) or seven (HARD) from aurally presented numbers. Reaction time (RT) and accuracy were recorded. iEMG events were selected according to stimulus onset (0–150 ms, 150–300 ms and 300–450 ms) prior to phases of gait (double-leg stance, single-leg stance and swing). There was a decrease in iEMG amplitude of fibularis longus (p = .013) and a trend in the same direction for vastus lateralis (p = .065) while walking and performing the cognitive task. When stimulus onset was considered, iEMG of medial gastrocnemius (p = .021) and lateral gastrocnemius (p = .004) were reduced during single-leg stance, when stimuli occurred between 300 and 450 ms prior to this phase. Cognitive performance was affected by task difficulty (RT, accuracy) and by dual-task load (RT). Dual-task costs were observed in both the motor and the cognitive tasks, suggesting that walking requires attention. There was a specific moment (300 ms after stimulus onset) during single-leg stance when dual-task costs were most pronounced, corroborating supraspinal involvement in the control of normal walking. Time-based approaches should be considered when analyzing attentional demands of a dynamic task such as gait.     

Injury risk is different in team and individual youth sport

ObjectivesThis study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries.DesignProspective cohort follow-up.MethodsPupils from a public sports school (12–19 years) were recruited over two separate school years (2008–2009: 42 weeks, n = 199 athletes; 2009–2010: 40 weeks, n = 89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire.ResultsInjury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic (RR = 2.17; CI95% = 1.75–2.70; p < 0.001), and overuse injuries (RR = 2.06; CI95% = 1.46–2.91; p < 0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95% = 1.49–2.68; p < 0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR = 1.072; CI95% [1.033; 1.113]; p < 0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR = 0.940; CI95% [0.893; 0.989]; p = 0.017).ConclusionsTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation.     

Accelerometer detected lateral sway during a submaximal running test correlates with endurance exercise performance in elite Australian male cricket players

ObjectiveTo identify whether movement patterns during a standardized submaximal running test (SSRT), assessed by accelerometry, were associated with improvements in endurance exercise performance.DesignA retrospective analysis of data collected from the 2018–2019 Australian cricket preseason.MethodsThirty-nine high-performance male cricket players were studied (25 ± 3 years, 82 ± 6 kg, 183 ± 6 cm). SSRT was performed monthly prior to a two kilometre (km) running time trial (2 kmTT). SSRT involved running between markers, positioned twenty metres apart, for three minutes. Foot strikes were timed to a metronome (154 beats/min) to elicit a running speed of ˜eight km/h. Triaxial accelerometers were worn in vests on the upper back and used to assess PlayerLoad medio-lateral vector (PL1D_side%), vertical vector (PL1D_up%) and anterior-posterior vector (PL1D_fwd%) were assessed.Results2 kmTT performance improved over the study period (p < 0.05). PlayerLoad vectors during the first minute of SSRT were not related to 2 kmTT performance (p > 0.23). During the second and third minutes there were positive associations between 2 kmTT (run time) and PL1D_side% (SSRT_2min, β 2.12, p < 0.03, 95% CI: 0.22–4.01; SSRT3_min, β 2.30, p < 0.03, 95% CI:0.32–4.29), but not PL1D_up% (SSRT_2min, β −0.15, p = 0.77, 95% CI: −1.13–0.83; SSRT_3min, β −0.15, p = 0.77, 95% CI: −1.11–0.87) or PL1D_fwd% (SSRT_2min, β −0.45, p = 0.42, 95% CI: −1.49–0.62; SSRT_3min, B−0.45, p = 0.40, 95% CI: −1.51–0.60).ConclusionAssessment of PL1D_side% during the second or third minutes of SSRT may inform how an athlete’s endurance exercise performance is responding to changes in training load.     

Do high radiation doses in locally advanced prostate cancer patients treated with 103Pd implant plus external beam irradiation cause increased urinary,rectal, and sexual morbidity?

PurposeTo investigate the morbidity of higher radiation doses in prostate cancer patients.Methods and MaterialsFive hundred eighty-five men treated with seed implantation and external beam irradiation were followed a median of 5 years (range, 2–11). Hormonal therapy (HT) of 9 months duration was used in 504 (86.2%) patients. The biologic effective dose (BED) was calculated using an α/β of 2. Urinary incontinence (UI) and symptoms (IPSS) were prospectively collected. Rectal morbidity was scored according to the Radiation Therapy Oncology Group (RTOG) scale. Two BED dose groups of ≤220 Gy (n = 449) and >220 Gy (n = 136) were used. Comparisons of means were made by Student's t test, and the associations were tested by chi-square analysis (Pearson).ResultsUrinary retention developed in 36 (6.2%) and was not associated with BED or IPSS. Retention occurred more often with prostate volume >50 cc (17%, p = 0.001). The median change in urinary symptoms (IPSS) was 1. Sixty-one percent with high BED were more likely to have increased postimplant symptoms compared with 39% with lower BED (p = 0.025; odds ratio [OR], 1.107; 95% confidence interval [CI], 1.10–1.21). UI occurred in 25 patients (4.3%) and was only associated with a postimplant transurethral resection of the prostate (TURP) (n = 25), 16% vs. 2.3% for no TURP (p = 0.001; OR, 8; 95% CI, 2.4–27). Of the 373 patients initially potent, 204 (54.7%) maintained potency. Impotence was only associated with age at implant (p = 0.001) and HT (p = 0.004). Sixty-two (10.6%) patients had Grade 1–2 and 4 patients had Grade 3–4 (0.7%, 2 ulcers and 2 fistulas) rectal complications. Three of the Grade 3/4 complications occurred with a dose ≤220 Gy.ConclusionA BED >220 Gy does not seem to increase morbidity.     

The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: An observational study

ObjectiveTo investigate whether amateur golfers with self-reported low back pain have reduced hip rotation compared to asymptomatic controls.DesignObservational case-control study.SettingData collection took place at 2 amateur golf clubs in southern England.ParticipantsOn initial contact, all participants completed a screening questionnaire used to allocate participants into LBP (n = 28) and control groups (n = 36). LBP group were found to be heavier than controls (t = 2.242, 95% CI 0.763–13.332) but were matched for age, height, handedness, handicap, rounds played per week and years of play.Main outcome measuresPrimary outcome measures were lead and non-lead hip medial and lateral rotation in 0° of flexion as measured by inclinometer. Secondary measures included inter and intra-rater reliability.ResultsThe LBP group had significantly reduced lead hip passive (LBP 21.14 ± 10.17°; controls 31.06 ± 8.06°, t = ?4.228, 95% CI ?14.621–?5.205) and lead hip active medial rotation (LBP 21.46 ± 10.01; controls 28.06 ± 7.49°, t = ?2.908, 95% CI ?11.147–?2.036) compared to controls. No between group differences were found in non-lead hips or any passive or active lateral rotation measures.ConclusionAlthough there is lack of causality between LBP and hip rotation, the deficit in lead leg medial hip rotation in amateur golfers who suffer LBP may be relevant for screening or treatment selection.     

Effects of emotional videos on postural control in children

The link between emotions and postural control has been rather unexplored in children. The objective of the present study was to establish whether the projection of pleasant and unpleasant videos with similar arousal would lead to specific postural responses such as postural freezing, aversive or appetitive behaviours as a function of age. We hypothesized that postural sway would similarly increase with the viewing of high arousal videos in children and adults, whatever the emotional context. 40 children participated in the study and were divided into two groups of age: group 7–9 years (n = 23; mean age = 8 years ± 0.7) and group 10–12 years (n = 17; mean age = 11 years ± 0.7). 19 adults (mean age = 25.8 years ± 4.4) also took part in the experiment. They viewed emotional videos while standing still on a force platform. Centre of foot pressure (CoP) displacements were analysed. Antero-posterior, medio-lateral mean speed and sway path length increased similarly with the viewing of high arousal movies in the younger, older children, and adults. Our findings suggest that the development of postural control is not influenced by the maturation of the emotional processing.     

Nutrient intake,meal timing and sleep in elite male Australian football players

ObjectivesTo investigate the relationship between dietary intake, meal timing and sleep in elite male Australian football players.DesignProspective cohort study.MethodsSleep and dietary intake were assessed in 36 elite male Australian Football League (AFL) players for 10 consecutive days in pre-season. Sleep was examined using wrist activity monitors and sleep diaries. Dietary intake was analysed using the smartphone application MealLogger and FoodWorks. Generalised linear mixed models examined the associations between diet [total daily and evening (>6 pm) energy, protein, carbohydrate, sugar and fat intake] and sleep [total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO) and sleep onset latency (SOL)].ResultsTotal daily energy intake (MJ) was associated with a longer WASO [β = 3, 95%CI: 0.2–5; p = 0.03] and SOL [β = 5, 95%CI: 1?9; p = 0.01]. Total daily protein intake (g kg^?1) was associated with longer WASO [β = 4, 95%CI: 0.8?7; p = 0.01] and reduced SE [β = ?0.7 CI: ?1.3 to ?0.2; p = 0.006], while evening protein intake (g kg^?1) was associated with shortened SOL [β = ?2, 95%CI: ?4 to ?0.4), p = 0.02]. Evening sugar intake (g kg^?1) was associated with shorter TST [β = ?5, 95%CI: ?10 to ?0.6; p = 0.03] and WASO [β = ?1, 95%CI: ?2 to ?0.3; p = 0.005]. A longer period between the evening meal consumption and bedtime was associated with a shorter TST [β = ?8, 95%CI: ?16 to ?0.3; p = 0.04].ConclusionsEvening dietary factors, including sugar and protein intake, had the greatest association with sleep in elite male AFL players. Future research manipulating these dietary variables to determine cause and effect relationships, could guide dietary recommendations to improve sleep in athletes.     

Altered postural control strategies in quiet standing more than 20 years after rupture of the anterior cruciate ligament

AimTo explore long-term consequences of anterior cruciate ligament (ACL) rupture on postural sway and control strategies during bilateral quiet standing, in subjects treated with or without reconstructive surgery compared to uninjured controls.Method70 individuals who had unilateral ACL rupture 23 ± 2.4 years ago (33 received ACL reconstructive surgery, ACL_R, and 37 had physiotherapy only, ACL_PT) and 33 uninjured matched controls (CTRL) (mean age 46 ± 5.3) stood quietly with eyes closed for 3 min on a firm and on a compliant surface, respectively. Center of pressure (CoP) was registered with a force plate and postural sway was calculated from center of mass (CoM) derived from 3D kinematics. Sway density (SD) analyses of CoP assessed distance and duration of stable phases. The torque controlling postural sway was estimated from CoP-CoM.ResultsComparisons across conditions to CTRL revealed larger CoP-CoM-area in ACL_R (p = 0.017, CI: 10.95, 143.10), but not in ACL_PT. Mean distance between SD-peaks was greater for ACL_R (p < 0.001, CI: 1.73, 5.31) than for ACL_PT (p = 0.006, CI: 0.56, 4.12) relative to CTRL. Duration of SD-peaks was smaller for both ACL_R and ACL_PT (p < 0.001, CI: −4.04, −1.23 and −3.82, −1.03, respectively) compared to CTRL. CoM-area in the ACL-groups did not differ from CTRL.ConclusionsACL-injured subjects demonstrated greater postural control efforts than CTRL but without significant differences in postural sway. Control efforts were thus not directly associated with sway and further research should be focused on variance in postural control strategies.     

Evaluation of shoulder joint position sense in both asymptomatic and rehabilitated professional rugby players and matched controls

ObjectiveTo assess if joint position sense (JPS) in the shoulder differed between un-injured rugby players, matched control subjects and previously injured rehabilitated rugby players.DesignMixed design.SettingUniversity biomechanics laboratory.Participants15 asymptomatic professional rugby union players, 15 previously injured professional rugby union players, 15 asymptomatic matched non-rugby playing controls had their JPS assessed.Main outcome measuresJPS was assessed using two criterion angles in the 90° shoulder abduction position (45° and 80° external rotation).ResultsThe study found a significant difference between groups in error score (p = 0.02). The testing angle also had a significant effect on error score (p = 0.002), with greater error scores occurring in the mid range position.ConclusionThis study showed rugby players to have better JPS than controls, indicating JPS might not be related to injury risk. Poor JPS appears to be related to injury, players having sustained an injury have decreased JPS despite surgery and/or rehabilitation and returning to sport without incident.     

Effects of a hip brace on biomechanics and pain in people with femoroacetabular impingement

Objectives

This study evaluates whether hip bracing in patients with femoroacetabular impingement (FAI) (a) immediately reduces range of hip internal rotation, flexion, adduction, and pain during functional tasks; and (b) improves patient-reported outcomes when worn daily over 4 weeks.

Reliability,precision, and gender differences in knee internal/external rotation proprioception measurements

ObjectiveTo develop and assess the reliability and precision of knee internal/external rotation (IR/ER) threshold to detect passive motion (TTDPM) and determine if gender differences exist.DesignTest–retest for the reliability/precision and cross-sectional for gender comparisons.SettingUniversity neuromuscular and human performance research laboratory.ParticipantsTen subjects for the reliability and precision aim. Twenty subjects (10 males and 10 females) for gender comparisons.InterventionAll TTDPM tests were performed using a multi-mode dynamometer. Subjects performed TTDPM at two knee positions (near IR or ER end-range). Intraclass correlation coefficient (ICC (3,k)) and standard error of measurement (SEM) were used to evaluate the reliability and precision. Independent t-tests were used to compare genders.Main outcome measurementsTTDPM toward IR and ER at two knee positions.ResultsIntrasession and intersession reliability and precision were good (ICC = 0.68–0.86; SEM = 0.22°–0.37°). Females had significantly diminished TTDPM toward IR at IR-test position (males: 0.77° ± 0.14°, females: 1.18° ± 0.46°, p = 0.021) and TTDPM toward IR at the ER-test position (males: 0.87° ± 0.13°, females: 1.36° ± 0.58°, p = 0.026). No other significant gender differences were found (p > 0.05).ConclusionsThe current IR/ER TTDPM methods are reliable and accurate for the test–retest or cross-section research design. Gender differences were found toward IR where the ACL acts as the secondary restraint.