Study Design: Case control study. Objectives: The objectives of this study are: (1) to perform factor analyses on data from the 8 components of the star excursion balance test (SEBT) in subjects with and without chronic ankle instability (CAI) in an effort to reduce the number of components of the SEBT, (2) to assess the relationships between performance of the different reach directions using correlation analyses, and (3) to determine which components of the SEBT are most affected by CAI. Background: The SEBT is a series of 8 lower-extremity-reaching tasks purported to be useful in identifying lower extremity functional deficits. Methods and Measures: Forty-eight young adults with unilateral CAI (22 males, 26 females; mean ± SD age, 20.9 ± 3.2 years; mean ± SD height, 173.6 ± 11.1 cm; mean ± SD mass, 80.1 ± 22.1 kg) and 39 controls (23 males, 16 females; mean ± SD age, 20.7 ± 2.4 years; mean ± SD height, 174.1 ± 12.9 cm; mean ± SD mass, 75.1 ± 18.6 kg) performed 3 trials of the 8 tasks with each of their limbs. Separate exploratory factor analyses were performed on data for involved limbs of the CAI group, uninvolved limbs of the CAI and control groups, and both limbs of the CAI and control groups. Pearson product moment correlations were calculated to identify the relationships between the different reach directions. A series of eight 2 × 2 analyses of variance were calculated to determine the influence of group (CAI, control) and side (involved, uninvolved) on performance of the 8 tasks. Results: For all 3 factor analyses, only 1 factor in each analysis produced an eigenvalue greater than 1 and the posteromedial reach score was the most strongly correlated task with the computed factor (␣ Ͼ .90), although all 8 tasks produced alpha scores greater than .67. Bivariate correlations between specific reach directions ranged from .40 to .91. Subjects with CAI reached significantly less on the anteromedial, medial, and posteromedial directions when balancing on their involved limbs compared to their uninvolved limbs and the side-matched limbs of controls. Conclusions:The posteromedial component of the SEBT is highly representative of the performance of all 8 components of the test in limbs with and without CAI. There is considerable redundancy in the 8 tasks. The anteromedial, medial, and posteromedial reach tasks may be used clinically to test for functional deficits related to CAI in lieu of testing all 8 tasks. There is a need for a hypothesis-driven study to confirm the results of this exploratory study.

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Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation.

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Two studies were performed to estimate the reliability of the Cybex Reactor in assessing agility tasks. In Study 1, participants (n=13) underwent identical testing sessions twice in 1 week. In Study 2, participants (n= 13) underwent identical testing sessions twice in 1 week, once 3 weeks later, and once 6 weeks later. Testing sessions consisted of four identical agility tasks requiring participants to react to cues shown on a video monitor. In Study 1, intraclass correlation coefficients (ICC) were .47 for Day 1 and .75 for Day 2 for time to complete each task. Participants performed faster on Day 2 (p <.05). In Study 2, ICC ranged from .58 to .83. ICC between sessions ranged from .59 to .73. Participants performed significantly faster each successive session except between Weeks 3 and 6 (p <.05). The Reactor appears to be reliable in assessing agility tasks with test–retest intervals of up to 6 weeks.

The purpose of this study was to determine the effect of varying prosthetic shank mass, while maintaining the mass centre location and moment of inertia, on the swing phase kinematics, kinetics and hip muscular effort of free speed above-knee (AK) amputee gait. Six AK amputees, wearing similar prosthetic designs, had three load conditions applied to their prosthetic shank: 1) Load 0-unloaded (X − 39.1% sound shank mass), 2) Load 1–75%, and 3) Load 2–100% sound leg mass. Despite increases in shank mass from 1.33 to 3.37 kg the AK amputee was able to maintain a consistent swing time and walking speed. As load increased, there were significant changes in the maximum knee and hip displacements, as well as phasic shifting. The prosthetic knee Resultant Joint Moment (RJM) was negligible while the shank was accelerating (periods 1 and 2), but was a major contributor during shank deceleration (periods 3 and 4). During periods 1 and 2 the principle contributors to the shank acceleration (forces resisting excessive knee flexion) were the gravitational moment (S-G) and the moment due to thigh angular acceleration (S-AT). During the periods of shank acceleration (sections 1 and 2), there was not a significant increase in the hip muscular effort. However, during sections 3 and4, the periods associated with shank deceleration, there were siginficant increases in the hip muscular effort. The hip muscular effort for the complete swing phase increased as load increased by 36.7% and 71.3% for loads 1 and 2. Despite the significant increases in hip muscular effort, four of the six subjects preferred load 1 condition.

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Objective: To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes. Data Sources: Information was gathered from a MEDLINE search of literature in English using the key words patellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy, and jumper's knee. Study Selection: All relevant peer-reviewed literature in English was reviewed. Data Synthesis: The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle fl exibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear. Conclusions: The pathoetiology of patellar tendinopathy is a complex process that results from both an infl ammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.