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This study provides preliminary evidence that youth/young adults following sport-related knee injury report more symptoms and poorer function, and are at greater risk of being overweight/obese 3-10 years post-injury compared to matched uninjured controls.

Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice.

We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury.

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From an historical perspective, ultrasound imaging (USI) has been used for medical purposes since the 1950s. The primary use of USI continues to be for traditional radiological goals, which consider the morphological characteristics and structural integrity of various organs and tissues. However, as the technology has been embraced as a safe, portable, objective, and relatively inexpensive means of examination, the ingenuity and diversity of applications has extended beyond these realms.Ultrasound imaging related to musculoskeletal rehabilitation has been developing rapidly since the 1980s. The first report of muscle imaging linked to rehabilitation was in 1968, when Ikai and Fukunaga 63 related the size of the upper arm muscles to strength. However, it was the work of Dr Archie Young and colleagues at the University of Oxford in the 1980s that sowed the seeds for the use of USI by physical therapists. A striking finding of their work was how dramatic limb muscle wasting is underestimated with a tape measure.144 Several studies of the quadriceps muscle followed, including investigation of the effect of knee joint injury, t SynopSiS: The use of ultrasound imaging by physical therapists is growing in popularity. This commentary has 2 aims. The first is to introduce the concept of rehabilitative ultrasound imaging (RUSI), provide a definition of the scope of this emerging tool in regard to the physical therapy profession, and describe how this relates to the larger field of medical ultrasound imaging. The second aim is to provide an overview of basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation and in relation to other common imaging modalities. J Orthop Sports Phys Ther 2007;37(8):434-449. doi:10.2519/jospt.2007 for a review). This early research used compound B-scanning, which enabled whole cross sections of large muscles to be captured, because the image could be built up as the transducer was moved over the skin. The compound technique, which was expensive, was phased out as a routine tool and replaced by real-time USI (definitions are provided in the appenDix) both in general medical and musculoskeletal settings.A recent (1990s) resurgence in the interest of rehabilitative applications of USI has been seen amongst clinical therapists. This stems from a series of studies in which USI was used to detect atrophy of the lumbar multifidus (isolated to the side and spinal level of symptoms) in individuals with acute low back pain (LBP), 51 as well as to determine that recovery of this muscle was not automatic when pain subsided, 49 thus required specific training to reduce risk of future episodes. 47 In addition, these studies

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