Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Re... more Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint-, adductor-, pubic bone stress injury-, iliopsoas-, or abdominal wall-related pathology. However, their prevalence patterns and coexistence in an active population are unclear. This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region. The objectives were to examine the prevalence of key clinical entities, document coexisting pathologies, and present prevalence patterns based on key demographics. Cross-sectional study; Level of evidence, 3. A retrospective review was conducted of clinical records of all hip and groin injuries seen between January 2006 and December 2011 under the care of a single experienced sports medicine consultant. In all cases, imaging was undertaken by a team of specialist musculoskeletal rad...
This is the protocol for a review and there is no abstract. The objectives are as follows: To ass... more This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects (benefits and harms) of whole-body cryotherapy (cold air exposure) for preventing and treating muscle soreness after exercise in adults.
The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT) on re... more The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT) on recovery following exercise induced muscle damage. Controlled trials were identified from computerized literature searching and citation tracking performed up to February 2013. Eighteen trials met the inclusion criteria; all had a high risk of bias. Pooled data from 13 studies showed that CWT resulted in significantly greater improvements in muscle soreness at the five follow-up time points (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Pooled data also showed that CWT significantly reduced muscle strength loss at each follow-up time (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Despite comparing CWT to a large number of other recovery interventions, including cold water immersion, warm water immersion, compression, active recovery and stretching, there was little evidence for a superior treatment intervention. The current evidence base shows that...
Abstract The aim of this study is to estimate the ratio of male and female participants in Sports... more Abstract The aim of this study is to estimate the ratio of male and female participants in Sports and Exercise Medicine research. Original research articles published in three major Sports and Exercise Medicine journals (Medicine and Science in Sports and Exercise, British Journal of Sports Medicine and American Journal of Sports Medicine) over a three-year period were examined. Each article was screened to determine the following: total number of participants, the number of female participants and the number of male participants. The percentage of females and males per article in each of the journals was also calculated. Cross tabulations and Chi-square analysis were used to compare the gender representation of participants within each of the journals. Data were extracted from 1382 articles involving a total of 6,076,580 participants. A total of 2,366,968 (39%) participants were female and 3,709,612 (61%) were male. The average percentage of female participants per article across t...
Bleakley CM, Costello JT. Do thermal agents affect range of movement and mechanical properties in... more Bleakley CM, Costello JT. Do thermal agents affect range of movement and mechanical properties in soft tissues? A systematic review. OBJECTIVES: To examine the effect of thermal agents on the range of movement (ROM) and mechanical properties in soft tissue and to discuss their clinical relevance. DATA SOURCES: Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE) were searched from their earliest available record up to May 2011 using Medical Subjects Headings and key words. We also undertook related articles searches and read reference lists of all incoming articles. STUDY SELECTION: Studies involving human participants describing the effects of thermal interventions on ROM and/or mechanical properties in soft tissue. Two reviewers independently screened studies against eligibility criteria. DATA EXTRACTION: Data were extracted independently by 2 review authors using a customized form. Methodologic quality was also assessed by 2 authors independe...
Laboratory analyses of chronic ankle instability populations during gait have elucidated a number... more Laboratory analyses of chronic ankle instability populations during gait have elucidated a number of anomalous movement patterns. No current research exists analysing these movement patterns in a group in the acute phase of lateral ankle sprain (LAS) injury. It is possible that participants with an acute LAS display movement patterns continuous with their chronically impaired counterparts.Sixty eight participants with acute LAS and nineteen non-injured participants completed five gait trials. 3D lower extremity temporal kinematic and kinetic data were collected from 200ms pre- to 200ms post-heel strike (period 1) and from 200ms pre- to 200ms post-toe off (period 2). During period 1, the LAS group displayed increased knee flexion with increased net extensor pattern at the knee joint, increased ankle inversion and reduced ankle plantar flexion, with a greater inversion moment, compared to the non-injured control group. During period 2, the LAS group displayed decreased hip extension w...
Dynamic stability is ubiquitous to fulfilling daily living activities. Instrumented postural cont... more Dynamic stability is ubiquitous to fulfilling daily living activities. Instrumented postural control analysis plays an important role in evaluating the effects of injury on dynamic stability during balance tasks, and is often characterized with measures based on the displacement of the centre of pressure (COP) assessed with a force platform. However, the desired outcome of the task is frequently characterized by a loss of dynamic stability, secondary to injury. Typically, failed trials of balance tasks are discarded during research investigations. To compare the COP characteristics of failed trials in participants with acute lateral ankle sprain (LAS) to successful trial data in another group with the same injury, and a non-injured control group during a single limb stance (SLS) task. Cross-sectional. University biomechanics laboratory. 29 participants with acute LAS attempted and succeeded a task of eyes closed SLS on their non-injured limb (successful injured group). A separate gr...
Evaluate the potentially adaptive movement patterns associated with acute lateral ankle sprain (L... more Evaluate the potentially adaptive movement patterns associated with acute lateral ankle sprain (LAS) using biomechanical analyzes.
Scandinavian Journal of Medicine and Science in Sports
No research exists predicating a link between acute ankle sprain injury-affiliated movement patte... more No research exists predicating a link between acute ankle sprain injury-affiliated movement patterns and those of chronic ankle instability (CAI) populations. The aim of the current study was to perform a biomechanical analysis of participants, 6 months after they sustained a first-time acute lateral ankle sprain (LAS) injury to establish this link. Fifty-seven participants with a 6-month history of first-time LAS and 20 noninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment of force) data were acquired for the joints of the lower extremity, from 200 ms pre-initial contact (IC) to 200 ms post-IC. Individual joint stiffnesses and the peak magnitude of the vertical component of the ground reaction force (GRF) were also computed. LAS participants displayed increases in hip flexion and ankle inversion on their injured limb (P < 0.05); this coincided with a reduction in the n...
Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and me... more Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined dat...
Single-limb stance is maintained via the integration of visual, vestibular and somatosensory affe... more Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury.
Upright single-limb stance (SLS) is maintained via integration of visual, vestibular and somatose... more Upright single-limb stance (SLS) is maintained via integration of visual, vestibular and somatosensory afferents. The presence of redundancies between these afferents allows the sensorimotor system to simplify a specific task within a number of strategies. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. No current investigation has supplemented kinetic analysis of eyes-open and eyes-closed SLS tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain (LAS) group to assess the adaptive capacity of the sensorimotor system to injury. To compare centre of pressure (COP) and lower limb postural orientation characteristics of participants with acute LAS to non-injured participants during a SLS task. Cross-sectional. University biomechanics laboratory. 66 participants with acute LAS completed a task of eyes-open SLS on their injured and non-injured limbs (task 1). 23 of these participants successfu...
Postural control assessments are frequently used in clinical and research settings to evaluate mo... more Postural control assessments are frequently used in clinical and research settings to evaluate movement deficits following acute lateral ankle sprain (LAS). The Star Excursion Balance Test (SEBT) is one such postural control assessment tool. To date, no research has investigated the immediate post-injury movement strategies associated with LAS, as quantified by center of pressure (COP) and kinematic analyses during performance of selected reach directions of the SEBT. To compare the kinematic and COP patterns of a group with acute LAS and a non-injured control group during performance of selected reach directions of the SEBT. Cross-sectional. University biomechanics laboratory. 81 participants with acute LAS and 19 non-injured controls. 3D kinematics of the hip, knee and ankle joints as well as associated fractal dimension (FD) of the COP path during the performance of the anterior (ANT), posterior-lateral (PL) and posterior-medial (PM) reach directions of the SEBT. The LAS group ha...
Scandinavian Journal of Medicine and Science in Sports
No research currently exists investigating the effect of acute injury on single-limb landing stra... more No research currently exists investigating the effect of acute injury on single-limb landing strategies. The aim of the current study was to analyze the coordination strategies of participants in the acute phase of lateral ankle sprain (LAS) injury. Thirty-seven participants with acute, first-time LAS and 19 uninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment-of-force) data were acquired for the joints of the lower extremity from 200 ms pre-initial contact (IC) to 200 ms post-IC. The peak magnitude of the vertical component of the ground reaction force (GRF) was also computed. Injured participants displayed a bilateral increase in hip flexion, with altered transverse plane kinematic profiles at the knee and ankle for both limbs (P < 0.05). This coincided with a reduction in the net-supporting flexor moment of the lower extremity (P < 0.05) and magnitude of the peak ...
Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This in... more Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. Sixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. Between-group analyses revealed significant differences in stance limb inter-joint coordination strat...
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, Jan 4, 2015
To evaluate the adaptive movement and motor control patterns of a group with a 6-month history of... more To evaluate the adaptive movement and motor control patterns of a group with a 6-month history of first-time lateral ankle sprain (LAS) injury during a drop vertical jump (DVJ) task. Fifty-one participants with a 6-month history of first-time acute LAS injury and twenty controls performed a DVJ task. 3D kinematic and sagittal plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump (phase 1) and drop landing (phase 2) phases of the DVJ. Inter-limb symmetry and the rate of impact modulation (RIM) relative to bodyweight (BW) during both phases of the DVJ were also determined. LAS participants displayed bilateral increases in knee flexion and an increase in ankle inversion during phases 1 and 2, respectively. They also displayed reduced ankle plantar flexion on their injured limb during both phases of the DVJ (p < 0.05); increased inter-limb asymmetry of RIM was noted for both phases of the DVJ, while the moment-of-force profile exhibited bi...
No researchers, to our knowledge, have investigated the immediate postinjury-movement strategie... more No researchers, to our knowledge, have investigated the immediate postinjury-movement strategies associated with acute first-time lateral ankle sprain (LAS) as quantified by center of pressure (COP) and kinematic analyses during performance of the Star Excursion Balance Test (SEBT). To analyze the kinematic and COP patterns of a group with acute first-time LAS and an noninjured control group during performance of the SEBT. Case-control study. University biomechanics laboratory. A total of 81 participants had acute first-time LAS (53 men, 28 women; age = 23.22 ± 4.93 years, height = 1.73 ± 0.09 m, mass = 75.72 ± 13.86 kg) and 19 noninjured participants (15 men, 4 women; age = 22.53 ± 1.68 years, height = 1.74 ± 0.08 m, mass = 71.55 ± 11.31 kg) served as controls. Participants performed the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the SEBT. We assessed 3-dimensional kinematics of the lower extremity joints and associated fractal dimension (FD) of the COP path during performance of the SEBT. The LAS group had decreased normalized reach distances in the ANT, PL, and PM directions when compared with the control group on their injured (ANT: 58.16% ± 6.86% versus 64.86% ± 5.99%; PL: 85.64% ± 10.62% versus 101.14% ± 8.39%; PM: 94.89% ± 9.26% versus 107.29 ± 6.02%) and noninjured (ANT: 60.98% ± 6.74% versus 64.76% ± 5.02%; PL: 88.95% ± 11.45% versus 102.36% ± 8.53%; PM: 97.13% ± 8.76% versus 106.62% ± 5.78%) limbs (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .01). This observation was associated with altered temporal sagittal-plane kinematic profiles throughout each reach attempt and at the point of maximum reach (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). This result was associated with a reduced FD of the COP path for each reach direction only on the injured limb (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Acute first-time LAS was associated with bilateral deficits in postural control, as evidenced by the bilateral reduction in angular displacement of the lower extremity joints and reduced reach distances and FD of the COP path on the injured limb during performance of the SEBT.
This case report describes the occurrence of bilateral myositis ossificans in the rectus femoris ... more This case report describes the occurrence of bilateral myositis ossificans in the rectus femoris muscles of a young Gaelic football player with a long history of recurrent bilateral thigh strain. In each case, clinical diagnosis was followed up with biochemical profiling and sonographic investigations. Management consisted of rest from elite level competition and intense rehabilitation to address any potential risk factors for rectus femoris strain. A 4-week course of acetic acid iontophoresis was administered to the first myositis ossificans lesion on the left thigh; however, as this did not result in any significant changes to the lesion's dimensions, it was not used on the contralateral lesion. The athlete returned to full sporting capacity 4 months after the first lesion was diagnosed. A 13-month follow-up showed that the athlete continued to play to full capacity with no recurrence of injury.
To review the quality of literature and measurement properties of physical performance tests (PPT... more To review the quality of literature and measurement properties of physical performance tests (PPTs) of the lower extremity in athletes. Using the PICOS method we established our research question as to whether individual PPTs of the lower extremity have any relationship to injury in competitive athletes ages 12 years to adult (no limit). A search strategy was constructed by combining the terms 'lower extremity' and synonyms for 'performance test' and names of performance tests with variants of the term 'athlete'. After examining the knee in part 1 of this 2 part series, the current report focuses on findings in the rest of the lower extremity. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to critique the methodological quality of each paper. A second measure was used to analyse the quality...
ABSTRACT We read Carter’s editorial with much interest.1In the past year, few subjects in sport h... more ABSTRACT We read Carter’s editorial with much interest.1In the past year, few subjects in sport have generated as much interest as injuries and concussions in school rugby. This is particularly true for Northern Ireland, where two catastrophic injuries recently occurred.The current lack of comprehensive, clear, and coherent data from a surveillance study is striking and makes its development a priority. To help close this data gap, a group of allied healthcare professionals established a regional research group, Rugby Injury Surveillance in Ulster Schools (RISUS). This has been funded by the MITRE charity and supported by Ulster University.The group’s aim was to establish a surveillance system to determine the incidence of all rugby related injuries and concussion in senior schools’ rugby in Ulster. This online Injury Surveillance System (www.risus.info) went live at the start of the current season, with 800 schoolboys recruited over the 2014-15 season.In addition, pre-season data on all players were collected on factors relating to their demographics, concussion history, use of protective equipment, conditioning, and nutritional supplement use.We agree that the key to such a project is engagement with the sports regulating body1—otherwise it would be impossible to implement strategies to reduce risk. We have found such support from the Irish Rugby Football Union and Ulster branch, who fully endorse our project.Our ultimate aim is that the data will allow our national rugby bodies to develop regional policy, if necessary enforce rule changes, and increase recognition of injuries to minimise the risk to youth rugby players. We hope to publish our study findings at the end of this playing season.NotesCite this as: BMJ 2015;350:h435
Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Re... more Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint-, adductor-, pubic bone stress injury-, iliopsoas-, or abdominal wall-related pathology. However, their prevalence patterns and coexistence in an active population are unclear. This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region. The objectives were to examine the prevalence of key clinical entities, document coexisting pathologies, and present prevalence patterns based on key demographics. Cross-sectional study; Level of evidence, 3. A retrospective review was conducted of clinical records of all hip and groin injuries seen between January 2006 and December 2011 under the care of a single experienced sports medicine consultant. In all cases, imaging was undertaken by a team of specialist musculoskeletal rad...
This is the protocol for a review and there is no abstract. The objectives are as follows: To ass... more This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects (benefits and harms) of whole-body cryotherapy (cold air exposure) for preventing and treating muscle soreness after exercise in adults.
The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT) on re... more The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT) on recovery following exercise induced muscle damage. Controlled trials were identified from computerized literature searching and citation tracking performed up to February 2013. Eighteen trials met the inclusion criteria; all had a high risk of bias. Pooled data from 13 studies showed that CWT resulted in significantly greater improvements in muscle soreness at the five follow-up time points (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Pooled data also showed that CWT significantly reduced muscle strength loss at each follow-up time (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Despite comparing CWT to a large number of other recovery interventions, including cold water immersion, warm water immersion, compression, active recovery and stretching, there was little evidence for a superior treatment intervention. The current evidence base shows that...
Abstract The aim of this study is to estimate the ratio of male and female participants in Sports... more Abstract The aim of this study is to estimate the ratio of male and female participants in Sports and Exercise Medicine research. Original research articles published in three major Sports and Exercise Medicine journals (Medicine and Science in Sports and Exercise, British Journal of Sports Medicine and American Journal of Sports Medicine) over a three-year period were examined. Each article was screened to determine the following: total number of participants, the number of female participants and the number of male participants. The percentage of females and males per article in each of the journals was also calculated. Cross tabulations and Chi-square analysis were used to compare the gender representation of participants within each of the journals. Data were extracted from 1382 articles involving a total of 6,076,580 participants. A total of 2,366,968 (39%) participants were female and 3,709,612 (61%) were male. The average percentage of female participants per article across t...
Bleakley CM, Costello JT. Do thermal agents affect range of movement and mechanical properties in... more Bleakley CM, Costello JT. Do thermal agents affect range of movement and mechanical properties in soft tissues? A systematic review. OBJECTIVES: To examine the effect of thermal agents on the range of movement (ROM) and mechanical properties in soft tissue and to discuss their clinical relevance. DATA SOURCES: Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE) were searched from their earliest available record up to May 2011 using Medical Subjects Headings and key words. We also undertook related articles searches and read reference lists of all incoming articles. STUDY SELECTION: Studies involving human participants describing the effects of thermal interventions on ROM and/or mechanical properties in soft tissue. Two reviewers independently screened studies against eligibility criteria. DATA EXTRACTION: Data were extracted independently by 2 review authors using a customized form. Methodologic quality was also assessed by 2 authors independe...
Laboratory analyses of chronic ankle instability populations during gait have elucidated a number... more Laboratory analyses of chronic ankle instability populations during gait have elucidated a number of anomalous movement patterns. No current research exists analysing these movement patterns in a group in the acute phase of lateral ankle sprain (LAS) injury. It is possible that participants with an acute LAS display movement patterns continuous with their chronically impaired counterparts.Sixty eight participants with acute LAS and nineteen non-injured participants completed five gait trials. 3D lower extremity temporal kinematic and kinetic data were collected from 200ms pre- to 200ms post-heel strike (period 1) and from 200ms pre- to 200ms post-toe off (period 2). During period 1, the LAS group displayed increased knee flexion with increased net extensor pattern at the knee joint, increased ankle inversion and reduced ankle plantar flexion, with a greater inversion moment, compared to the non-injured control group. During period 2, the LAS group displayed decreased hip extension w...
Dynamic stability is ubiquitous to fulfilling daily living activities. Instrumented postural cont... more Dynamic stability is ubiquitous to fulfilling daily living activities. Instrumented postural control analysis plays an important role in evaluating the effects of injury on dynamic stability during balance tasks, and is often characterized with measures based on the displacement of the centre of pressure (COP) assessed with a force platform. However, the desired outcome of the task is frequently characterized by a loss of dynamic stability, secondary to injury. Typically, failed trials of balance tasks are discarded during research investigations. To compare the COP characteristics of failed trials in participants with acute lateral ankle sprain (LAS) to successful trial data in another group with the same injury, and a non-injured control group during a single limb stance (SLS) task. Cross-sectional. University biomechanics laboratory. 29 participants with acute LAS attempted and succeeded a task of eyes closed SLS on their non-injured limb (successful injured group). A separate gr...
Evaluate the potentially adaptive movement patterns associated with acute lateral ankle sprain (L... more Evaluate the potentially adaptive movement patterns associated with acute lateral ankle sprain (LAS) using biomechanical analyzes.
Scandinavian Journal of Medicine and Science in Sports
No research exists predicating a link between acute ankle sprain injury-affiliated movement patte... more No research exists predicating a link between acute ankle sprain injury-affiliated movement patterns and those of chronic ankle instability (CAI) populations. The aim of the current study was to perform a biomechanical analysis of participants, 6 months after they sustained a first-time acute lateral ankle sprain (LAS) injury to establish this link. Fifty-seven participants with a 6-month history of first-time LAS and 20 noninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment of force) data were acquired for the joints of the lower extremity, from 200 ms pre-initial contact (IC) to 200 ms post-IC. Individual joint stiffnesses and the peak magnitude of the vertical component of the ground reaction force (GRF) were also computed. LAS participants displayed increases in hip flexion and ankle inversion on their injured limb (P < 0.05); this coincided with a reduction in the n...
Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and me... more Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined dat...
Single-limb stance is maintained via the integration of visual, vestibular and somatosensory affe... more Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury.
Upright single-limb stance (SLS) is maintained via integration of visual, vestibular and somatose... more Upright single-limb stance (SLS) is maintained via integration of visual, vestibular and somatosensory afferents. The presence of redundancies between these afferents allows the sensorimotor system to simplify a specific task within a number of strategies. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. No current investigation has supplemented kinetic analysis of eyes-open and eyes-closed SLS tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain (LAS) group to assess the adaptive capacity of the sensorimotor system to injury. To compare centre of pressure (COP) and lower limb postural orientation characteristics of participants with acute LAS to non-injured participants during a SLS task. Cross-sectional. University biomechanics laboratory. 66 participants with acute LAS completed a task of eyes-open SLS on their injured and non-injured limbs (task 1). 23 of these participants successfu...
Postural control assessments are frequently used in clinical and research settings to evaluate mo... more Postural control assessments are frequently used in clinical and research settings to evaluate movement deficits following acute lateral ankle sprain (LAS). The Star Excursion Balance Test (SEBT) is one such postural control assessment tool. To date, no research has investigated the immediate post-injury movement strategies associated with LAS, as quantified by center of pressure (COP) and kinematic analyses during performance of selected reach directions of the SEBT. To compare the kinematic and COP patterns of a group with acute LAS and a non-injured control group during performance of selected reach directions of the SEBT. Cross-sectional. University biomechanics laboratory. 81 participants with acute LAS and 19 non-injured controls. 3D kinematics of the hip, knee and ankle joints as well as associated fractal dimension (FD) of the COP path during the performance of the anterior (ANT), posterior-lateral (PL) and posterior-medial (PM) reach directions of the SEBT. The LAS group ha...
Scandinavian Journal of Medicine and Science in Sports
No research currently exists investigating the effect of acute injury on single-limb landing stra... more No research currently exists investigating the effect of acute injury on single-limb landing strategies. The aim of the current study was to analyze the coordination strategies of participants in the acute phase of lateral ankle sprain (LAS) injury. Thirty-seven participants with acute, first-time LAS and 19 uninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment-of-force) data were acquired for the joints of the lower extremity from 200 ms pre-initial contact (IC) to 200 ms post-IC. The peak magnitude of the vertical component of the ground reaction force (GRF) was also computed. Injured participants displayed a bilateral increase in hip flexion, with altered transverse plane kinematic profiles at the knee and ankle for both limbs (P < 0.05). This coincided with a reduction in the net-supporting flexor moment of the lower extremity (P < 0.05) and magnitude of the peak ...
Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This in... more Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. Sixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. Between-group analyses revealed significant differences in stance limb inter-joint coordination strat...
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, Jan 4, 2015
To evaluate the adaptive movement and motor control patterns of a group with a 6-month history of... more To evaluate the adaptive movement and motor control patterns of a group with a 6-month history of first-time lateral ankle sprain (LAS) injury during a drop vertical jump (DVJ) task. Fifty-one participants with a 6-month history of first-time acute LAS injury and twenty controls performed a DVJ task. 3D kinematic and sagittal plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump (phase 1) and drop landing (phase 2) phases of the DVJ. Inter-limb symmetry and the rate of impact modulation (RIM) relative to bodyweight (BW) during both phases of the DVJ were also determined. LAS participants displayed bilateral increases in knee flexion and an increase in ankle inversion during phases 1 and 2, respectively. They also displayed reduced ankle plantar flexion on their injured limb during both phases of the DVJ (p < 0.05); increased inter-limb asymmetry of RIM was noted for both phases of the DVJ, while the moment-of-force profile exhibited bi...
No researchers, to our knowledge, have investigated the immediate postinjury-movement strategie... more No researchers, to our knowledge, have investigated the immediate postinjury-movement strategies associated with acute first-time lateral ankle sprain (LAS) as quantified by center of pressure (COP) and kinematic analyses during performance of the Star Excursion Balance Test (SEBT). To analyze the kinematic and COP patterns of a group with acute first-time LAS and an noninjured control group during performance of the SEBT. Case-control study. University biomechanics laboratory. A total of 81 participants had acute first-time LAS (53 men, 28 women; age = 23.22 ± 4.93 years, height = 1.73 ± 0.09 m, mass = 75.72 ± 13.86 kg) and 19 noninjured participants (15 men, 4 women; age = 22.53 ± 1.68 years, height = 1.74 ± 0.08 m, mass = 71.55 ± 11.31 kg) served as controls. Participants performed the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the SEBT. We assessed 3-dimensional kinematics of the lower extremity joints and associated fractal dimension (FD) of the COP path during performance of the SEBT. The LAS group had decreased normalized reach distances in the ANT, PL, and PM directions when compared with the control group on their injured (ANT: 58.16% ± 6.86% versus 64.86% ± 5.99%; PL: 85.64% ± 10.62% versus 101.14% ± 8.39%; PM: 94.89% ± 9.26% versus 107.29 ± 6.02%) and noninjured (ANT: 60.98% ± 6.74% versus 64.76% ± 5.02%; PL: 88.95% ± 11.45% versus 102.36% ± 8.53%; PM: 97.13% ± 8.76% versus 106.62% ± 5.78%) limbs (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .01). This observation was associated with altered temporal sagittal-plane kinematic profiles throughout each reach attempt and at the point of maximum reach (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). This result was associated with a reduced FD of the COP path for each reach direction only on the injured limb (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Acute first-time LAS was associated with bilateral deficits in postural control, as evidenced by the bilateral reduction in angular displacement of the lower extremity joints and reduced reach distances and FD of the COP path on the injured limb during performance of the SEBT.
This case report describes the occurrence of bilateral myositis ossificans in the rectus femoris ... more This case report describes the occurrence of bilateral myositis ossificans in the rectus femoris muscles of a young Gaelic football player with a long history of recurrent bilateral thigh strain. In each case, clinical diagnosis was followed up with biochemical profiling and sonographic investigations. Management consisted of rest from elite level competition and intense rehabilitation to address any potential risk factors for rectus femoris strain. A 4-week course of acetic acid iontophoresis was administered to the first myositis ossificans lesion on the left thigh; however, as this did not result in any significant changes to the lesion's dimensions, it was not used on the contralateral lesion. The athlete returned to full sporting capacity 4 months after the first lesion was diagnosed. A 13-month follow-up showed that the athlete continued to play to full capacity with no recurrence of injury.
To review the quality of literature and measurement properties of physical performance tests (PPT... more To review the quality of literature and measurement properties of physical performance tests (PPTs) of the lower extremity in athletes. Using the PICOS method we established our research question as to whether individual PPTs of the lower extremity have any relationship to injury in competitive athletes ages 12 years to adult (no limit). A search strategy was constructed by combining the terms 'lower extremity' and synonyms for 'performance test' and names of performance tests with variants of the term 'athlete'. After examining the knee in part 1 of this 2 part series, the current report focuses on findings in the rest of the lower extremity. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to critique the methodological quality of each paper. A second measure was used to analyse the quality...
ABSTRACT We read Carter’s editorial with much interest.1In the past year, few subjects in sport h... more ABSTRACT We read Carter’s editorial with much interest.1In the past year, few subjects in sport have generated as much interest as injuries and concussions in school rugby. This is particularly true for Northern Ireland, where two catastrophic injuries recently occurred.The current lack of comprehensive, clear, and coherent data from a surveillance study is striking and makes its development a priority. To help close this data gap, a group of allied healthcare professionals established a regional research group, Rugby Injury Surveillance in Ulster Schools (RISUS). This has been funded by the MITRE charity and supported by Ulster University.The group’s aim was to establish a surveillance system to determine the incidence of all rugby related injuries and concussion in senior schools’ rugby in Ulster. This online Injury Surveillance System (www.risus.info) went live at the start of the current season, with 800 schoolboys recruited over the 2014-15 season.In addition, pre-season data on all players were collected on factors relating to their demographics, concussion history, use of protective equipment, conditioning, and nutritional supplement use.We agree that the key to such a project is engagement with the sports regulating body1—otherwise it would be impossible to implement strategies to reduce risk. We have found such support from the Irish Rugby Football Union and Ulster branch, who fully endorse our project.Our ultimate aim is that the data will allow our national rugby bodies to develop regional policy, if necessary enforce rule changes, and increase recognition of injuries to minimise the risk to youth rugby players. We hope to publish our study findings at the end of this playing season.NotesCite this as: BMJ 2015;350:h435
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