Context: Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics.Objective: To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population.Design: Cohort study. Setting: Field-based functional movement screening performed at soccer practice facilities.Patients or Other Participants: A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age ¼ 13.9 6 1.8 years, age range ¼ 11 to 18 years), of whom 25% (n ¼ 207) were less than 13 years of age.Intervention(s): Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up).Main Outcome Measure(s): Landings were scored for ''errors'' in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed.Results: Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 6 1.71) than injured participants (6.24 6 1.75; t 1215 ¼ À2.784, P ¼ .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%.Conclusions: Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.Key Words: children, knee, biomechanics, movement patterns Key PointsThe Landing Error Scoring System (LESS) score may effectively identify elite-youth soccer athletes at higher risk of sustaining anterior cruciate ligament (ACL) injuries. Elite-youth soccer athletes with LESS scores of 5 or more were at higher risk of sustaining ACL injuries than athletes with LESS scores less than 5. Individuals with LESS scores of 5 or more may be targeted for ACL injury-prevention exercise programs.

Players with the greatest amount of movement errors experienced the most improvement. A program's effectiveness may be enhanced if this population is targeted.

Context:Few validation studies of sport injury-surveillance systems are available.Objective: To determine the validity of a Web-based system for surveillance of collegiate sport injuries, the Injury Surveillance System (ISS) of the National Collegiate Athletic Association's (NCAA).Design: Validation study comparing NCAA ISS data from 2 fall collegiate sports (men's and women's soccer) with other types of clinical records maintained by certified athletic trainers.Setting: A purposive sample of 15 NCAA colleges and universities that provided NCAA ISS data on both men's and women's soccer for at least 2 years during 2005-2007, stratified by playing division.Patients or Other Participants: A total of 737 men's and women's soccer athletes and 37 athletic trainers at these 15 institutions.Main Outcome Measure(s): The proportion of injuries captured by the NCAA ISS (capture rate) was estimated by comparing NCAA ISS data with the other clinical records on the same athletes maintained by the athletic trainers. We reviewed all athletic injury events resulting from participation in NCAA collegiate sports that resulted in 1 day or more of restricted activity in games or practices and necessitated medical care. A capture-recapture analysis estimated the proportion of injury events captured by the NCAA ISS. Agreement for key data fields was also measured.Results: We analyzed 664 injury events. The NCAA ISS captured 88.3% (95% confidence interval = 85.9%, 90.8%) of all time-lost medical-attention injury events. The proportion of injury events captured by the NCAA ISS was higher in Division I (93.8%) and Division II (89.6%) than in Division III (82.3%) schools. Agreement between the NCAA ISS data and the non-NCAA ISS data was good for the majority of data fields but low for date of full return and days lost from sport participation.Conclusions: The overall capture rate of the NCAA ISS was very good (88%) in men's and women's soccer for this period.Key Words: capture-recapture analysis, injury epidemiology, time loss, collegiate athletes Key Points• Overall, the capture rate of the National Collegiate Athletic Association Injury Surveillance System was 88% for men's and women's soccer injuries during the study period.• Thus, this injury-surveillance system is capable of providing reliable and valid injury statistics, at least for men's and women's soccer.

Results suggest that training duration may be an important factor to consider when designing injury prevention programs that facilitate long-term changes in movement control.

Promising mHealth approaches for TB treatment adherence include:Video observationPatient- or device-facilitated indirect monitoringDirect monitoring through embedded sensors or metabolite testingTo mitigate ethical concerns, our framework considers accuracy of monitoring technologies, stigmatization and intrusiveness of the technologies, use of incentives, and the balance of individual and public good.

Traditional weight training programs use an exercise prescription strategy that emphasizes improving muscle strength through resistance exercises. Other factors, such as stability, endurance, movement quality, power, flexibility, speed, and agility are also essential elements to improving overall functional performance. Therefore, exercises that incorporate these additional elements may be beneficial additions to traditional resistance training programs. The purpose of the study was to compare the effects of an isolated resistance training program (ISO) and an integrated training program (INT) on movement quality, vertical jump height, agility, muscle strength and endurance, and flexibility. The ISO program consisted of primarily upper and lower extremity progressive resistance exercises. The INT program involved progressive resistance exercises, and core stability, power, and agility exercises. Thirty subjects were cluster randomized to either the ISO (n = 15) or INT (n = 15) training program. Each training group performed their respective programs 2 times per week for 8 weeks. The subjects were assessed before (pretest) and after (posttest) the intervention period using the following assessments: a jump-landing task graded using the Landing Error Scoring System (LESS), vertical jump height, T-test time, push-up and sit-up performance, and the sit-and-reach test. The INT group performed better on the LESS test (pretest: 3.90 ± 1.02, posttest: 3.03 ± 1.02; p = 0.02), faster on the T-test (pretest: 10.35 ± 1.20 seconds, posttest: 9.58 ± 1.02 seconds; p = 0.01), and completed more sit-ups (pretest: 40.20 ± 15.01, posttest: 46.73 ± 14.03; p = 0.045) and push-ups (pretest: 40.67 ± 13.85, posttest: 48.93 ± 15.17; p = 0.05) at posttest compared with pretest, and compared with the ISO group at posttest. Both groups performed more push-ups (p = 0.002), jumped higher (p < 0.001), and reached further (p = 0.008) at posttest compared with that at pretest. Performance enhancement programs should use an integrated approach to exercise selection to optimize performance and movement technique benefits.

Objective:  To present recommendations for athletic trainers and other health care providers regarding the identification of risk factors for and management of individuals with patellofemoral pain (PFP). Background:  Patellofemoral pain is one of the most common knee diagnoses; however, this condition continues to be one of the most challenging to manage. Recent evidence has suggested that certain risk factors may contribute to the development of PFP. Early identification of risk factors may allow clinicians to develop and implement programs aimed at reducing the incidence of this condition. To date, clinicians have used various treatment strategies that have not necessarily benefitted all patients. Suboptimal outcomes may reflect the need to integrate clinical practice with scientific evidence to facilitate clinical decision making. Recommendations:  The recommendations are based on the best available evidence. They are intended to give athletic trainers and other health care professionals a framework for identifying risk factors for and managing patients with PFP.

No abstract