Accuracy of movement quality screening to document effects of neuromuscular control retraining exercises in a young ex-footballer with hip and groin symptoms: A proof of concept case study

Movement retraining programme in young soccer and rugby football players: A feasibility and proof of concept study

INTRODUCTION

Movement screening to identify abnormal movement patterns can inform development of effective interventions. The primary objective of this study was to evaluate the feasibility of using a movement screening tool in combination with a tailored movement control retraining programme in young soccer and rugby football players. A secondary objective was to investigate changes in movement control patterns post-intervention, to provide proof of concept (PoC) for movement retraining.

METHODS

52 male amateur players, including 34 soccer players (mean age 15 ± 2 years) and 18 rugby players (mean age 15 ± 1 years) participated. They were screened for movement control ability using a shortened version of the Hip and Lower Limb Movement Screening (Short-HLLMS) and completed an eight-week movement control retraining programme. Evaluation of feasibility included consent from players invited, adherence, attendance at the exercise sessions, drop-out and adverse events. Short-HLLMS total score and The Copenhagen Hip and Groin Outcome Score (HAGOS) were analysed to provide PoC for retraining movement control.

RESULTS

feasibility outcomes were favourable. Significant statistical changes occurred post-intervention in the Short-HLLMS total score (paired-samples t-test) and in three HAGOS subscales (symptoms, physical function in daily living and in sport and recreation) (Wilcoxon-Signed Rank Test) in both groups.

CONCLUSIONS

Feasibility of using the Short-HLLMS in combination with a movement control retraining programme in soccer and rugby players was promising. The data provided PoC for the potential application of a shortened version of the HLLMS to evaluate changes in movement control and to inform targeted motor control programmes.

Constructing a Talent Identification Index System and Evaluation Model for Cross-Country Skiers

A talent identification index system for male and female cross-country skiers in four age groups (11-12 years old, 13-14 years old, 15-16 years old, and 17-18 years old) was established. The system comprises five body shape indexes ( i =5): Leg-to-Body Ratio (LBR), body fat percentage, maturity status, spreaded brachia index, and upper extremity length. The physiological function indexes ( i =2) are VO_2max and haemoglobin mass (Hb). The psychological indexes ( i =5) cover reaction time, perception speed, a quality-of-will scale, an attention test, and operational thinking. The physical fitness indexes ( i =11) comprise upper limb explosiveness, vertical jump, 3000-metre run, orthostatic forward flexion, closed-eyes single-leg stand, standing long jump, 20-metre sprint, pull-ups (males), flexed arm hang (females), hexagon jump, and a Functional Movement Screen (FMS) test. The athletic performance indexes ( i =3) comprise on-snow time trials for 1.2 km, 5 km, and 10 km. The talent identification evaluation model was created using automated evaluation software. The talent identification index system and evaluation standard table for cross-country skiers passed the P₆₀ shortlist and P₉₀ elite boundaries established using the percentile method. Thus, the results of this test profile verify that the evaluative model is objectively effective.

Assessment of movement coordination strategies to inform health of movement and guide retraining interventions

INTRODUCTION

Exploring characteristics of human movement has long been the focus of clinicians and researchers. Changes in movement coordination strategies have been identified in the presence of pain highlighting the need for assessment in clinical practice. A major development in the understanding of movement related disorders is recognition of individual differences in presentation and consequently the need to tailor interventions based on assessment.

PURPOSE

The purpose of this masterclass is to build a rationale for the clinical assessment of movement coordination strategies, exploring loss of movement choices, coordination variability, and to present a clinical framework for individualised management, including the use of cognitive movement control tests and retraining interventions. An approach for the qualitative rating of movement coordination strategies is presented. A compromised movement system may be one characterised by a lack of ability to access motor abundance and display choice in the use of movement coordination strategies. The identification of lost movement choices revealed during the assessment of movement coordination strategies is proposed as a marker of movement health.

IMPLICATIONS FOR PRACTICE

The health of the movement system may be informed by the ability to display choice in movement coordination strategies. There is evidence that restoring these choices has clinical utility and an influence on pain and improved function. This approach seeks to provide individuals with more flexible problem solving, enabled through a movement system that is robust to each unique challenge of function. This assessment framework sits within a bigger clinical reasoning picture for sustained quality of life.

Retraining in a Female Elite Rower with Persistent Symptoms Post-Arthroscopy for Femoroacetabular Impingement Syndrome: A Proof-of-Concept Case Report

Athletes with femoroacetabular impingement syndrome (FAIS) managed arthroscopically do not always return to sport. Inability to control back/pelvis, hip and lower limb movements may contribute to the onset and recurrence of symptoms. Our hypothesis is that results from a battery of cognitive movement control tests can inform a cognitive movement control (neuromuscular) retraining programme for improving the clinical presentation and quality of life in an athlete with FAIS. This case report presents a female elite rower with persistent left-sided anterior hip pain, four years post-arthroscopic surgery for FAIS, whose symptoms failed to respond to conventional physical therapy. Hip and groin outcome score (HAGOS), passive and active hip flexion range of motion (ROM) workload (time training on water), hip and pelvic kinematics (3-D motion analysis) and electromyography during a seated hip flexion movement control test, and a movement control test battery to identify movement control impairments (The Foundation Matrix), were assessed pre-intervention (week 0) and immediately post-intervention (week 16). Impaired movement control was targeted in a tailored 16-week cognitive movement control retraining exercise program. All measures improved: HAGOS (all 6 sub-scales); symptoms (61/100 pre-training to 96/100 post-training); physical activities participation (13/100 to 75/100); and active hip flexion ROM increased (78 to 116 and 98 to 118 degrees, respectively); workload increased from 4 to 18 h/week; and movement control impairment reduced (25/50 to 9/50). Pelvic motion on kinematic analysis were altered, and delayed activation onset of tensor fascia latae and rectus femoris muscles reduced. This proof-of-concept case report supports the hypothesis that cognitive movement control tests can inform a targeted cognitive movement control retraining program to improve symptoms, function and quality of life, in an elite rower with persistent hip pain. This training offers an alternative approach to conventional physical therapy, which has failed to restore function in FAIS, and the present study illustrates how specific cognitive movement control assessment can direct individual training programmes.