The purpose of this study was to examine the real-time intersession and interrater reliability of the functional movement screen (FMS). The overall study consisted of 19 volunteer civilians (12 male, 7 female). The intersession reliability consisted of 12 men and 7 women, whereas 10 men and 6 women participated in the interrater reliability test session. Two raters (A and B) were involved in the interrater reliability aspect of this study. The FMS includes 7 tests: deep squat (DS), hurdle step (HS), in-line lunge (IL), shoulder mobility (SM), active straight leg raise (ASLR), trunk stability push-up (TSPU), and rotary stability (RS). Researchers analyzed the data via intraclass correlation (ICC). To determine the reliability of the intersession scoring of the FMS and the intrasession interrater scoring of the FMS a 2-way mixed effects model intraclass correlation coefficient (ICC(3,1)) was used for the continuous data, whereas a weighted Cohen's kappa (κ) was used for the categorical data. The dependent variables were FMS total score (0-21 scale) and associated tests were DS, HS, IL, SM, ASLR, TSPU, and RS. Intersession reliability (ICC, SEM) and κ were as follows: FMS total score (0.92, 0.51), DS (κ = 0.69), HS (κ = 0.16), IL (κ = 0.69), SM (κ = 0.84), ASLR (κ = 0.69), TSPU (κ = 0.77), and RS (no covariance). Interrater reliability (ICC, SEM) and κ were as follows: FMS total score (0.98, 0.25), DS (κ = 1.0), HS (κ = 0.33), IL (κ = 0.88), SM (κ = 0.90), ASLR (κ = 0.88), TSPU (κ = 0.75), and RS (no covariance). The FMS total scores displayed high intersession and interrater reliabilities. Finally, with the exception of HS, all tasks displayed moderate to high intersession reliability and good to high interrater reliability.

Context: Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing.Objective: To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestepcutting task (SS).Design: Controlled laboratory study. Setting: Laboratory.Patients or Other Participants: Eighteen uninjured female collegiate soccer players (age ¼ 19.2 6 0.9 years, height ¼ 1.66 6 0.5 m, mass ¼ 61.6 6 5.1 kg) volunteered.Intervention(s): The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained.Main Outcome Measure(s): Dependent variables were hipand knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase.Results: Knee-flexion angle decreased from prefatigue (À178 6 58) to 50% fatigue (À168 6 68) and to 100% fatigue (À148 6 48) (F 2,34 ¼ 5.112, P ¼ .004). Knee flexion at peak stance increased from prefatigue (À52.98 6 5.68) to 50% fatigue (À56.18 6 7.28) but decreased from 50% to 100% fatigue (À50.58 6 7.18) (F 2,34 ¼ 8.282, P ¼ 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 6 0.23 Nm/kgm) to 50% fatigue (0.55 6 0.25 Nm/kgm) but decreased from 50% to 100% fatigue (0.37 6 0.24) (F 2,34 ¼ 3.755, P ¼ 03). Hip-flexion angle increased from prefatigue (45.48 6 10.98) to 50% fatigue (46.28 6 11.28) but decreased from 50% to 100% fatigue (40.98 6 11.38) (F 2,34 ¼ 6.542, P ¼ .004). Hip flexion at peak stance increased from prefatigue (49.88 6 9.98) to 50% fatigue (52.98 6 12.18) but decreased from 50% to 100% fatigue (46.38 6 12.98) (F 2,34 ¼ 8.639, P ¼ 001). Hip-abduction angle at initial contact decreased from prefatigue (À13.88 6 6.68) to 50% fatigue (À9.18 6 6.58) and to 100% fatigue (À7.88 6 6.58) (F 2,34 ¼ 11.228, P , .001). Hip-adduction moment decreased from prefatigue (0.14 6 0.13 Nm/kgm) to 50% fatigue (0.08 6 0.13 Nm/kgm) and to 100% fatigue (0.06 6 0.05 Nm/kg) (F 2,34 ¼ 5.767, P ¼ .007).Conclusions: The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants' maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice.Key Words: anterior cruciate ligament, knee, fatiguing, kinematics, kinetics Key PointsA progressive change in lower extremity mechanics occurred for knee-flexion angle, hip-abduction angle,...

Context: Insufficient lower extremity strength may be a risk factor for lower extremity injuries such as noncontact anterior cruciate ligament tears. Therefore, clinicians need reliable instruments to assess strength deficiencies.Objective: To assess the intrarater, interrater, intrasession, and intersession reliability of a portable fixed dynamometer in measuring the strength of the hip and knee musculature.Design: Crossover study. Setting: Sports medicine research laboratory.Patients or Other Participants: Three raters (A, B, C) participated in this 2-phase study. Raters A and B tested 11 healthy college graduate students (2 men, 9 women) in phase 1. Raters A and C tested 26 healthy college undergraduate students (7 men, 19 women) in phase 2.Main Outcome Measure(s): The dependent variables for the study were hip adductor, hip abductor, hip flexor, hip extensor, hip internal rotator, hip external rotator, knee flexor, and knee extensor peak force.Results: The phase 1 intrasession intraclass correlation coefficients for sessions 1, 2, and 3 ranged from 0.88 to 0. Conclusions: The portable fixed dynamometer showed good to high intrasession and intersession reliability values for hip and knee strength. Intrarater and interrater reliability were fair to high, except for hip internal rotation, which showed poor reliability.

Sanders, GJ, Boos, B, Rhodes, J, Kollock, RO, and Peacock, CA. Competition-based heart rate, training load, and time played above 85% peak heart rate in NCAA division I women's basketball. J Strength Cond Res 35(4): 1095–1102, 2021—Basketball athletes frequently engage in intensities ≥85% HRpeak throughout competition. Knowing the time spent competing at intensities ≥85% HRpeak can improve training protocols. The purpose of the study was to assess heart rate responses across 4-quarter games (N = 31) in an NCAA Division I women's basketball season. Ten female athletes were tested and monitored with heart rate–based wearable microsensor devices. Before the season, HRpeak was recorded through a peak metabolic test (V̇o 2peak). Average (HRavg) and HRpeak were recorded for each game, and time spent in 5 heart rate zones (HRZones) were recorded: HRZone1 = 50–60% HRpeak, HRZone2 = 60–70% HRpeak, HRZone3 = 70–76% HRpeak, HRZone4 = 77–84% HRpeak, and HRZone5 = 85–100% HRpeak. Training load was calculated with the summated-heart-rate-zone model (SHRZmod). There was a main effect of position (p ≤ 0.019) and quarter (p ≤ 0.005) on SHRZmod and on time spent in HRZone1–5. Athletes accumulated the most time in HRZone4 and HRZone5 and in the fourth quarter, and SHRZmod was the greatest in the fourth quarter. There was no main effect for HRavg and HRpeak (p ≥ 0.110). Athletes averaged 34.5 minutes per game competing in HRZone5 or ≥85% HRpeak with nearly one-third of those minutes accumulated in the fourth quarter. Although there were no differences in HRavg and HRpeak from quarter to quarter, SHRZmod increased from the first to fourth quarter. Utilizing time spent in heart rate zones and training load with SHRZmod can provide valuable information to practitioners regarding the intensity and physiological demands of competitive basketball games.

Hop tests alone did not provide clinicians with enough information to make evidence-based decisions about lower extremity strength in isolated muscle groups.

Context: Shoulder injury in baseball pitchers is a very common problem and has been linked to an imbalance in rotator cuff strength. Recently, the use of functional shoulder strength ratios has become more popular because they more closely resemble the actions of the shoulder during the throwing motion. Objective: To investigate the link between preseason shoulder rotator cuff functional strength ratios and the development of shoulder pain and injury. Design: Prospective research design. Setting: University human performance laboratory. Patients: Fifteen collegiate baseball pitchers participated in this study. At the end of the baseball season, six (19.5 + 1.8 years, 73.6 ± 2.8 inches, 198.7 + 19.1 lbs) developed shoulder injury and were placed in the injured group, and nine (21.0 ± 1.7 years, 73.1 ± 2.3 inches, 207.9 + 28.1 lbs) did not develop injury and were placed in the noninjured group. Interventions: Isokinetic peak torque was collected concentrically and eccentrically for both shoulder internal rotation (IR) and external rotation (ER) at 60° • s '1, 180° -s-', and 300° -s-1. Main Outcome Measure: The following functional ratios were calculated from the peak torque measures: concentric ER: concentric IR; eccentric ER: eccentric IR; concentric ER: eccentric IR (cocking phase); and eccentric ER: concentric IR (acceleration phase). Analysis was conducted using an analysis of variance comparing the injured and noninjured groups. A secondary analysis was conducted using an analyses of variance on the concentric and eccentric peak torque for shoulder IR and ER between groups. Results: The acceleration phase functional shoulder ratio was significantly higher (p = .019) in the injured group and a concentric IR peak torque (p = .003) was significantly lower in the injured group com pared with the noninjured group. Conclusion: Increased acceleration phase ratios and decreased concentric IR peak torque may be linked to the development of shoulder injury during a baseball season.

Our meta-analysis suggests that individuals with symptoms of a knee overuse injury have lower absolute and normalized hip muscle strength. Specifically, they had lower absolute hip external-rotator, knee-extensor, and knee-flexor strength, as well as lower normalized hip external-rotator, hip-extensor, and hip-abductor strength, compared with asymptomatic control participants. The findings suggest a possible link between lower hip and thigh strength and knee overuse injuries. Further research is needed to determine if weakness is a cause or a result of knee overuse injuries before screening and intervention can be developed for at-risk warfighters.

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