Context: An estimated 300 000 sport-related concussion injuries occur in the United States annually. Approximately 30% of individuals with concussions experience balance disturbances. Common methods of balance assessment include the Clinical Test of Sensory Organization and Balance (CTSIB), the Sensory Organization Test (SOT), the Balance Error Scoring System (BESS), and the Romberg test; however, the National Collegiate Athletic Association recommended the Wii Fit as an alternative measure of balance in athletes with a concussion. A central concern regarding the implementation of the Wii Fit is whether it is reliable and valid for measuring balance disturbance in athletes with concussion. Objective: To examine the reliability and validity evidence for the CTSIB, SOT, BESS, Romberg test, and Wii Fit for detecting balance disturbance in athletes with a concussion. Data Sources: Literature considered for review included publications with reliability and validity data for the assessments of balance (CTSIB, SOT, BESS, Romberg test, and Wii Fit) from PubMed, PsycINFO, and CINAHL. Data Extraction: We identified 63 relevant articles for consideration in the review. Of the 63 articles, 28 were considered appropriate for inclusion and 35 were excluded. Data Synthesis: No current reliability or validity information supports the use of the CTSIB, SOT, Romberg test, or Wii Fit for balance assessment in athletes with a concussion. The BESS demonstrated moderate to high reliability (interclass correlation coefficient = 0.87) and low to moderate validity (sensitivity = 34%, specificity = 87%). However, the Romberg test and Wii Fit have been shown to be reliable tools in the assessment of balance in Parkinson patients. Conclusions: The BESS can evaluate balance problems after a concussion. However, it lacks the ability to detect balance problems after the third day of recovery. Further investigation is needed to establish the use of the CTSIB, SOT, Romberg test, and Wii Fit for assessing balance in athletes with concussions.

The biomechanical management of bioenergetics of runners when running uphill was investigated. Several metabolic and mechanical variables have been studied simultaneously to spread light on the locomotory strategy operated by humans for effective locomotion. The studied variables were: heart rate, heart rate variability, oxygen intake and blood lactate, metabolic cost, kinematics, ground reaction force and muscular activity. 18 high-level competitive male runners ran at 70% VO2max on different uphill slope conditions: 0%, 2% and 7%. Modifications were significant in almost all variables studied, and were more pronounced with increasing incline. Step frequency/length and ground reaction force are adjusted to cope with both the task of uphill progression and the available (limited) metabolic power. From 0% to 7% slope, step frequency and ground reaction force and metabolic cost increased concurrently by 4%, 12% and 53%, respectively (with a 4% step length decrease as well). It is hypothesised that this biomechanical management is allowed by an environment-body communication performed by means of specific muscular activity.

Hamstrings injury is a common occurrence in athletic performance. These injuries tend to occur during a deceleration or landing task suggesting the negative work may be a key component in hamstrings injury. The purpose of this study was to investigate the muscular activity (EMG) of the biceps femoris (BF) in different phases (concentric vs. eccentric) of a Counter Movement Jump (CMJ), Squat Jump (SJ) and the Braking Phase (BP) of a landing task. Twelve female volleyball players performed 5 CMJs, SJs and BPs while surface EMG was recorded using a MuscleLab (BoscoSystemTM, Norway). EMG values were normalized to an maximal voluntary contraction. A repeated measures analysis of variance (ANOVA) was used to compare mean normalized EMG values of the concentric and eccentric portions of the CMJ with the BP and SJ. The ANOVA revealed significantly lower BF activation in the concentric and eccentric portions of the CMJ compared to the BP (64%, p < 0.001) and SJ (7%, p = 0.02), respectively. These findings suggest that the CMJ relies on a greater contribution of elastic tissues during the concentric and eccentric portions of the movement and thus requires less muscle activation of the BF.

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