Plyometric exercise has been suggested for knee injury prevention in sports participation, but studies on ankle plyometric training are limited. This study aims to investigate the change of joint position sense and neuromuscular activity of the unstable ankle after six-week integrated balance/plyometric training and six-week plyometric training. Thirty recreational athletes with functional ankle instability were allocated into three groups: plyometric group (P) vs. plyometric integrated with balance training group (BP) vs. control group (C). Ankle joint position sense, integrated electromyography (EMG), and balance adjusting time during medial single-leg drop-landing tasks were measured before and after the training period. Following the six-week period, both training groups exhibited a lower absolute error in plantar flexion (P group: pre: 3.79° ± 1.98°, post: 2.20° ± 1.31°, p = 0.016; BP group: pre: 4.10° ± 1.87°, post: 2.94° ± 1.01°, p = 0.045), and the integrated group showed a lower absolute error in inversion angles (pre 2.24° ± 1.44° and post 1.48° ± 0.93°, p = 0.022), and an increased integrated EMG of ankle plantar flexors before landing. The plyometric group exhibited a higher integrated EMG of the tibialis anterior before and after landing (pre: 102.88 ± 20.93, post: 119.29 ± 38.33, p = 0.009 in post-landing) and a shorter adjusting time of the plantar flexor following landing as compared to the pre-training condition (pre: 2.85 ± 1.15 s, post: 1.87 ± 0.97 s, p = 0.006). In conclusion, both programs improved ankle joint position sense and muscle activation of the ankle plantar flexors during single-leg drop landing. The plyometric group showed a reduced adjusting time of the ankle plantar flexor following the impact from drop landing.
Ballet dancers are thought to be at higher risk of lower extremity injury. This objective of this study was to describe the self-reported incidence, location, and factors associated with lower extremity injury in collegiate ballet dancers. Two hundred and forty-nine female ballet dancers responded to a questionnaire that addressed their injury event/location, dance behavior over the past 2 years, and overall dance history. Behaviors assessed included the following: types and number of shoes worn (pointé shoes/ballet slippers), wear time, training time (session frequency and duration), use of warm-up/cool-down, and use of a strengthening program and lower extremity accessory. Overall dance history included age of the onset of training, total years of experience, and number of dance styles. Backward multivariable logistic regression analysis was used to determine the extent to which variables measured were associated with injury. Ankle injury was the most prevalent injury. Years of wearing pointé shoes (adjusted odds ratio = 1.21, p = 0.01) and days/weeks in pointé shoes (adjusted odds ratio = 1.26, p = 0.04) were associated with an increased risk of injury; while additional strengthening (adjusted odds ratio = 0.39, p = 0.02) and use of lower extremity accessories during classes/rehearsals (adjusted odds ratio = 0.64, p = 0.01) were protective associations. These findings suggested that the use of pointé shoes, lower extremity accessories, and additional exercise should specifically be recorded during evaluation of injured ballet dancers; and must be considered potential factors to modify during rehabilitation.
Knee osteoarthritis is a condition that causes weak bone strength and poor bone formation. The main cause is musculoskeletal pain. Treatment of pain in knee osteoarthritis patients is usually through infrared and retrowalking. The mechanism of infrared in reducing pain is through mild heating which gives a sedative effect on sensory nerve endings, while retrowalking decreases pain through rehabilitation exercise techniques for the lower extremities. This research aimed to compare the effectiveness of infrared and retrowalking on pain reduction in knee osteoarthritis patients at Puskesmas Kendal Kerep. This was a quasi-experimental study with 30 participants from Puskesmas Kendalkerep, divided into 2 groups: Group I (with infrared, n = 15) and Group II (with retrowalking, n = 15). Participants in both groups were given their interventions for 5 weeks. The level of pain was measured using the VAS scale at baseline and after the intervention. The paired t-test analysis showed that there was an improvement in pain in both groups after being given the interventions, while the independent t-test showed that there was no significant difference between the groups in the level of pain reduction. Keywords: knee osteoarthritis, knee pain, infrared, retrowalking
The purpose of this study was to compare the therapeutic effects of low-level laser therapy (LLLT) with 808 and 660 nm wavelength on muscle strength and functional outcomes in individuals with knee osteoarthritis (OA). A total of 47 participants were randomly assigned to the 808 nm, 660 nm, and sham control groups. Two LLLT groups received continuous LLLT with a mean power of 300 mW in different wavelengths at the knee joint 15 min a session three days per week for eight weeks, while the control group received the sham LED treatment. The knee strength and functional performance involving 30-s sit-to-stand, 40 m fast-paced walk, stair climbing, and the TUG test were measured at the baseline and one week after the interventions were completed. The results showed that knee extensor strength was more improved in the 808 nm group as compared to the 660 nm group (p < 0.001, d = 0.57) and the sham control (p < 0.001, d = 0.40), while increased flexor strength was demonstrated in the 808 nm (p = 0.009, d = 0.67) and sham control groups (p < 0.001, d = 0.97). The number of 30-s sit-to-stand was increased only in the 660 nm group (p = 0.006, d = 0.49). All three groups exhibited improvements in the other three functional performance-based tests after the interventions with no statistically significant differences among the groups. In conclusion, both intervention groups improved muscle strength and functional performance as compared to the control group. The 808 nm wavelength group showed better results in knee extensor strength. Therefore, laser therapy is suggested to be integrated into rehabilitation programs to improve muscle strength and functional performance in the population with knee OA.
Context: Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related injury. Objective: To systematically review and summarize the effectiveness of exercise-based interventions combined with physical modalities currently used in athletes with acute hamstring injuries. Data Sources: Five databases (EMBASE, Medline, Cochrane Library, SPORTDiscus, and Web of Science) were searched from inception to July 2021. Study Selection: A total of 4569 studies were screened. Nine randomized controlled trials (RCTs) on the effect of therapeutic exercise programs with and without physical agents in athletes with acute hamstring injuries were identified for meta-analysis. Study Design: Systematic review and meta-analysis Level of Evidence: Level 1 Data Extraction: The studies were screened, and the evidence was rated using the PEDro scale. Nine RCTs with PEDro scores ranging between 3 and 9 were included and extracted pain intensity, time to return to play (TTRTP), and reinjury rate in the study. Results: Loading exercises during extensive lengthening were shown to facilitate TTRTP at P < 0.0001 but did not prevent recurrence ( P = 0.17), whereas strengthening with trunk stabilization and agility exercise did not reduce the duration of injury recurrence ( P = 0.16), but significantly reduced the reinjury rate ( P < 0.007) at a 12-month follow-up. The results of the stretching programs and solely physical modalities could not be pooled in the statistical analysis. Conclusion: The meta-analysis indicated that a loading program helps athletes to return to sports on a timely basis. Although strengthening with trunk stabilization and agility exercise cannot significantly reduce recovery time, the program can prevent reinjury. The clinical effects of stretching programs and pure physical modality interventions could not be concluded in this study due to limited evidence. PROSPERO Registration: CRD42020183035
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