International journal of sports physical therapy, 2015
The Functional Movement Screen (FMS™) has been suggested for use in predicting injury risk in act... more The Functional Movement Screen (FMS™) has been suggested for use in predicting injury risk in active populations, but time constraints may limit use of the screening test battery. Identifying one component of the FMS™ that can predict which individuals may perform poorly on the entire test, and therefore should undergo the full group of screening maneuvers, may reduce time constraints and increase pre-participation screening utilization. The purpose of this study was to determine if performance on the FMS™ overhead deep squat test (DS) could predict performance on the entire FMS™. Cohort study. One hundred and three collegiate athletes underwent offseason FMS™ testing. The DS and adjusted FMS™ composite scores were dichotomized into low performance and high performance groups with athletes scoring below 2 on the DS categorized as low performance, and athletes with adjusted FMS™ composite scores below 12 categorized as low performance. Scores of 2 or above and 12 or above were consid...
Many factors, including anatomy, neuromuscular control, hormonal regulation, and genetics, are kn... more Many factors, including anatomy, neuromuscular control, hormonal regulation, and genetics, are known to contribute to the noncontact anterior cruciate ligament (ACL) injury risk profile. The neurocognitive and neurophysiological influences on the noncontact ACL injury mechanism have received less attention despite their implications to maintain neuromuscular control. Sex-specific differences in neurocognition may also play a critical role in the elevated female ACL injury risk. This report serves to frame existing literature in a new light to consider neurocognition and its implications for movement control, visual-motor function, and injury susceptibility. Sources were obtained from PubMed, MEDLINE, Web of Science, and LISTA (EBSCO) databases from 1990 onward and ranged from diverse fields including psychological and neuroscience reviews to injury epidemiology and biomechanical reports. Clinical review. Level 5. Neurological factors may contribute to the multifactorial ACL injury r...
Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormon... more Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormonal, exposure, and anatomical factors. Alterations in the central nervous system also play a role, but their influence after injury, recovery, and recurrent injury remain unknown. Modern neuroimaging techniques can be used to elucidate the underlying functional and structural alterations of the brain that predicate the neuromuscular control adaptations associated with ACL injury. This knowledge will further our understanding of the neural adaptations after ACL injury and rehabilitation and in relation to injury risk. In this paper, we describe the measurement of brain activation during knee extension-flexion after ACL injury and reconstruction and 26 days before a contralateral ACL injury. Brain functional magnetic resonance imaging data for an ACL-injured participant and a matched control participant were collected and contrasted. Relative to the matched control participant, the ACL-inju...
Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, horm... more Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormonal, exposure, and anatomical factors. Alterations in the central nervous system also play a role, but their influence after injury, recovery, and recurrent injury remain unknown. Modern neuroimaging techniques can be used to elucidate the underlying functional and structural alterations of the brain that predicate the neuromuscular control adaptations associated with ACL injury. This knowledge will further our understanding of the neural adaptations after ACL injury and rehabilitation and in relation to future injury risk. In this paper, we describe the measurement of brain activation during knee extension-flexion after ACL injury and reconstruction and 26 days before a contralateral ACL injury. Brain functional magnetic resonance imaging data for an ACL-injured participant and a matched control participant were collected and contrasted. Relative to the matched control participant,...
The Journal of orthopaedic and sports physical therapy, Jan 10, 2015
Synopsis The neuroplastic effects of anterior cruciate ligament (ACL) injury have recently become... more Synopsis The neuroplastic effects of anterior cruciate ligament (ACL) injury have recently become more evident, demonstrating underlying nervous system changes in addition to the expected mechanical alterations associated with injury. Interventions to mitigate these detrimental neuroplastic effects along with the established biomechanical changes need to be considered in the rehabilitation process and return-to-play progressions. This commentary establishes a link between dynamic movement mechanics, neurocognition, and visual processing regarding ACL injury adaptations and injury risk. The proposed framework incorporates evidence from the disciplines of neuroscience, biomechanics, motor control, and psychology to support integrating neurocognitive and visual-motor approaches with traditional neuromuscular interventions during ACL injury rehabilitation. Physical therapists, athletic trainers, strength coaches, and other health care and performance professionals can capitalize on this...
Journal of occupational rehabilitation, Jan 29, 2014
Purpose The purpose of this study was to assess low back functional health among a group of nurse... more Purpose The purpose of this study was to assess low back functional health among a group of nurses with a history of low back pain symptoms in a university hospital using a direct measure of low back functional performance and compare to traditional low back disability and pain questionnaires. Methods Fifty-two nurses and patient care associates volunteered for the study. The clinical lumbar motion monitor (LMM) was used to directly measure low back functional performance. The participants performed a series of standard tasks involving trunk flexion and extension at different asymmetries. The LMM measures the motion signature of the participant (range of motion, velocity and acceleration) in all three planes of the body. The clinical LMM evaluation documented objective assessment of low back function normalized for age and gender. The Oswestry Disability Index (ODI) was used to evaluate self-reported disability and the McGill Pain Questionnaire visual analog scale assessed pain symp...
North American journal of sports physical therapy : NAJSPT, 2010
The transversus abdominis (TrA) is a spine stabilizer frequently targeted during rehabilitation e... more The transversus abdominis (TrA) is a spine stabilizer frequently targeted during rehabilitation exercises for individuals with low back pain (LBP). Performance of exercises on unstable surfaces is thought to increase muscle activation, however no research has investigated differences in TrA activation when stable or unstable surfaces are used. The purpose of this study was to investigate whether TrA activation in individuals with LBP is greater when performing bridging exercises on an unstable surface versus a stable surface. Fifty one adults (mean ± SD, age 23.1 ± 6.0 years, height 173.60 ± 10.5 cm, mass 74.7 ± 14.5 kg) with stabilization classification of LBP were randomly assigned to either exercise progression utilizing a sling bridge device or a traditional bridging exercise progression, each with 4 levels of increasing difficulty. TrA activation ratio (TrA contracted thickness/TrA resting thickness) was measured during each exercise using ultrasound imaging. The dependent vari...
A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effe... more A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. Cohort study. One American collegiate soccer team followed for 2 seasons. Forty-one male collegiate athletes aged 18-25 years. The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Lower extremity injury risk and time lost to lower extremity injury. The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.
International journal of sports physical therapy, 2015
The Functional Movement Screen (FMS™) has been suggested for use in predicting injury risk in act... more The Functional Movement Screen (FMS™) has been suggested for use in predicting injury risk in active populations, but time constraints may limit use of the screening test battery. Identifying one component of the FMS™ that can predict which individuals may perform poorly on the entire test, and therefore should undergo the full group of screening maneuvers, may reduce time constraints and increase pre-participation screening utilization. The purpose of this study was to determine if performance on the FMS™ overhead deep squat test (DS) could predict performance on the entire FMS™. Cohort study. One hundred and three collegiate athletes underwent offseason FMS™ testing. The DS and adjusted FMS™ composite scores were dichotomized into low performance and high performance groups with athletes scoring below 2 on the DS categorized as low performance, and athletes with adjusted FMS™ composite scores below 12 categorized as low performance. Scores of 2 or above and 12 or above were consid...
Many factors, including anatomy, neuromuscular control, hormonal regulation, and genetics, are kn... more Many factors, including anatomy, neuromuscular control, hormonal regulation, and genetics, are known to contribute to the noncontact anterior cruciate ligament (ACL) injury risk profile. The neurocognitive and neurophysiological influences on the noncontact ACL injury mechanism have received less attention despite their implications to maintain neuromuscular control. Sex-specific differences in neurocognition may also play a critical role in the elevated female ACL injury risk. This report serves to frame existing literature in a new light to consider neurocognition and its implications for movement control, visual-motor function, and injury susceptibility. Sources were obtained from PubMed, MEDLINE, Web of Science, and LISTA (EBSCO) databases from 1990 onward and ranged from diverse fields including psychological and neuroscience reviews to injury epidemiology and biomechanical reports. Clinical review. Level 5. Neurological factors may contribute to the multifactorial ACL injury r...
Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormon... more Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormonal, exposure, and anatomical factors. Alterations in the central nervous system also play a role, but their influence after injury, recovery, and recurrent injury remain unknown. Modern neuroimaging techniques can be used to elucidate the underlying functional and structural alterations of the brain that predicate the neuromuscular control adaptations associated with ACL injury. This knowledge will further our understanding of the neural adaptations after ACL injury and rehabilitation and in relation to injury risk. In this paper, we describe the measurement of brain activation during knee extension-flexion after ACL injury and reconstruction and 26 days before a contralateral ACL injury. Brain functional magnetic resonance imaging data for an ACL-injured participant and a matched control participant were collected and contrasted. Relative to the matched control participant, the ACL-inju...
Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, horm... more Anterior cruciate ligament (ACL) injury has multifactorial causes encompassing mechanical, hormonal, exposure, and anatomical factors. Alterations in the central nervous system also play a role, but their influence after injury, recovery, and recurrent injury remain unknown. Modern neuroimaging techniques can be used to elucidate the underlying functional and structural alterations of the brain that predicate the neuromuscular control adaptations associated with ACL injury. This knowledge will further our understanding of the neural adaptations after ACL injury and rehabilitation and in relation to future injury risk. In this paper, we describe the measurement of brain activation during knee extension-flexion after ACL injury and reconstruction and 26 days before a contralateral ACL injury. Brain functional magnetic resonance imaging data for an ACL-injured participant and a matched control participant were collected and contrasted. Relative to the matched control participant,...
The Journal of orthopaedic and sports physical therapy, Jan 10, 2015
Synopsis The neuroplastic effects of anterior cruciate ligament (ACL) injury have recently become... more Synopsis The neuroplastic effects of anterior cruciate ligament (ACL) injury have recently become more evident, demonstrating underlying nervous system changes in addition to the expected mechanical alterations associated with injury. Interventions to mitigate these detrimental neuroplastic effects along with the established biomechanical changes need to be considered in the rehabilitation process and return-to-play progressions. This commentary establishes a link between dynamic movement mechanics, neurocognition, and visual processing regarding ACL injury adaptations and injury risk. The proposed framework incorporates evidence from the disciplines of neuroscience, biomechanics, motor control, and psychology to support integrating neurocognitive and visual-motor approaches with traditional neuromuscular interventions during ACL injury rehabilitation. Physical therapists, athletic trainers, strength coaches, and other health care and performance professionals can capitalize on this...
Journal of occupational rehabilitation, Jan 29, 2014
Purpose The purpose of this study was to assess low back functional health among a group of nurse... more Purpose The purpose of this study was to assess low back functional health among a group of nurses with a history of low back pain symptoms in a university hospital using a direct measure of low back functional performance and compare to traditional low back disability and pain questionnaires. Methods Fifty-two nurses and patient care associates volunteered for the study. The clinical lumbar motion monitor (LMM) was used to directly measure low back functional performance. The participants performed a series of standard tasks involving trunk flexion and extension at different asymmetries. The LMM measures the motion signature of the participant (range of motion, velocity and acceleration) in all three planes of the body. The clinical LMM evaluation documented objective assessment of low back function normalized for age and gender. The Oswestry Disability Index (ODI) was used to evaluate self-reported disability and the McGill Pain Questionnaire visual analog scale assessed pain symp...
North American journal of sports physical therapy : NAJSPT, 2010
The transversus abdominis (TrA) is a spine stabilizer frequently targeted during rehabilitation e... more The transversus abdominis (TrA) is a spine stabilizer frequently targeted during rehabilitation exercises for individuals with low back pain (LBP). Performance of exercises on unstable surfaces is thought to increase muscle activation, however no research has investigated differences in TrA activation when stable or unstable surfaces are used. The purpose of this study was to investigate whether TrA activation in individuals with LBP is greater when performing bridging exercises on an unstable surface versus a stable surface. Fifty one adults (mean ± SD, age 23.1 ± 6.0 years, height 173.60 ± 10.5 cm, mass 74.7 ± 14.5 kg) with stabilization classification of LBP were randomly assigned to either exercise progression utilizing a sling bridge device or a traditional bridging exercise progression, each with 4 levels of increasing difficulty. TrA activation ratio (TrA contracted thickness/TrA resting thickness) was measured during each exercise using ultrasound imaging. The dependent vari...
A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effe... more A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. Cohort study. One American collegiate soccer team followed for 2 seasons. Forty-one male collegiate athletes aged 18-25 years. The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Lower extremity injury risk and time lost to lower extremity injury. The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.
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