Ankle DF ROM should be assessed when patients with PFP demonstrate a lower quality of movement during a lateral step-down test. Lower hip muscle strength may be associated with lower quality of movement among patients with relatively greater ankle DF ROM.

Injury prevention exercises for reduced incidence of injuries in combat soldiers. J Strength Cond Res 35(11): 3128-3138, 2021-The aim of this study was to determine the influence of an "all-cause injury" prevention program, focused on static-to-dynamic transitions, on injury prevalence in a military commanders course. Two cohorts of male infantry commanders were recruited (intervention [INT group], n 5 196 and controls [CO group], n 5 169) and tracked by a physiotherapist, who recorded any injuries that occurred during the 14week course. Soldiers were tested precourse, midcourse, and postcourse for anthropometrics, proprioception ability, and dynamic postural balance (DPB). The INT group performed injury prevention exercises for 5 minutes, 3 times a week, and the CO group continued with their routine physical fitness sessions. The prevalence of injuries reported to the physiotherapist during the course was significantly lower for the INT group compared with the CO group (14.8 and 34.3%, respectively, p , 0.001). Similarly, rates of injury in the INT group were significantly lower than in the CO group (p , 0.001; hazard 5 2.53, 95% confidence interval 5 1.62-3.95). Precourse proprioception ability was significantly lower in those that became injured during the commanders course, irrespective of the group. Likewise, for DPB parameters, the injured subjects in both groups had significantly lower precourse scores than the noninjured subjects. From pretesting to midtesting, the injured soldiers in the INT group improved their ability up to the level of the noninjured subjects. A reduced prevalence of injuries was found for soldiers who completed the injury prevention program. Because the subjects soldiers injured on the course had reduced somatosensory abilities at the outset, and as these abilities can be improved by static-to-dynamic exercises, identifying at-risk soldiers and providing them with appropriate strategies for improvement beforehand is indicated.

BackgroundChronic ankle instability (CAI) is attributed to functional instability driven by insufficient proprioception. However, it is not clear whether the deficits are related to global impaired performance or to specific decrease in ankle motor-control. The aim of this study was to assess the correlation between lower limb postural control and upper limb position sense among people with CAI, in order to further explore the function of the central neural control in people with CAI.MethodsFourteen participants (10 males, 4 females) with self-reported CAI and 14 age- and gender-matched, healthy controls participated in this study. Each participant completed single-limb stance postural control tests and shoulder position sense tests. The Overall Stability Index (OSI) was used as a measure of postural stability. The average of the absolute error score (AES) was calculated as a measure of shoulder position sense. Pearson correlations between the scores of the four body sites –lower limb postural stability (preferred/non-preferred), shoulder (preferred/non-preferred) were determined separately for each group.ResultsIn the control group, significant correlations were found between the OSI score of the right and left ankles (r = 0.887, p < 0.001), between the AES of the right and left shoulders (r = 0.656, p = 0.011), as well as between the OSI score and the AES of the non-preferred side (r = 0.649, p = 0.012). In the CAI group, significant correlation was found only between the OSI score at both ankles (r = 0.6, p = 0.002).ConclusionsIndividuals with CAI demonstrated lower limb postural control and upper limb position sense similar to those shown in healthy controls. However, correlations between the lower and upper limbs were observed only in the healthy controls. Clinicians can use this information and employ activities that focus on coordinating the upper and lower extremities when designing neuromuscular control training programs for people with CAI.

Background Inadequate quadriceps strength following anterior cruciate ligament reconstruction (ACLR) often results in alterations in gait pattern that are usually reported during loading response. Neuro-muscular electrical stimulation (NMES) is frequently used to overcome this quadriceps weakness. Despite the beneficial effects of NMES, persistent deficits in strength and gait are reported. The aim of this study was to investigate the feasibility of applying quadriceps functional electrical stimulation (FES) during walking in addition to standard rehabilitation, in the initial stage of ACLR rehabilitation. Methods Subjects were randomized to quadriceps FES synchronized with walking group ( n = 10) or quadriceps NMES (duty cycle of 10 s on/10 s off) group ( n = 13). Both interventions were performed for 10 min three days a week, in addition to a standard rehabilitation program. Assessments were performed up to 2 weeks before the ACLR (pre-ACLR), and 4 weeks postoperatively. Outcomes measured were gait speed, single limb stance gait symmetry, quadriceps isometric peak strength ratio (peak strength at 4 weeks/peak strength pre-ACLR) and peak strength inter-limb symmetry. Gait outcomes were also assessed 1-week post-surgery. Results Subjects in both groups regained pre-ACLR gait speed and symmetry after 4 weeks of rehabilitation, with no difference between groups. However, although pre-ACLR quadriceps peak strength was similar between groups (FES - 205 Nm, NMES − 225 Nm, p = 0.605), subjects in the FES group regained 82% of their pre-quadriceps strength compared to 47% in the NMES group ( p = 0.02). In addition, after 4 weeks, the FES group had significantly better inter-limb strength symmetry 0.63 ± 0.15 vs. 0.39 ± 0.18 in the NMES group ( p = 0.01). Conclusions Quadriceps FES combined with traditional rehabilitation is a feasible, early intervention treatment option, post-ACLR. Furthermore, at 4 weeks post-surgery, FES was more effective in recovering quadriceps muscle strength than was NMES. While spatiotemporal gait parameters did not differ between groups, kinetic and kinematic studies may be useful to further understand the effects of quadriceps FES post-ACLR. The promising results of this preliminary investigation suggest that such studies are warranted. Trial registration ISRCTN 02817399 . First posted June 29, 2016.

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