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Starbuck C, Walters V, Herrington L, Barkatali B, Jones R. Knee Offloading by Patients During Walking and Running After Meniscectomy. Orthop J Sports Med 2024; 12:23259671231214766. [PMID: 38524891 PMCID: PMC10958822 DOI: 10.1177/23259671231214766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/19/2023] [Indexed: 03/26/2024] Open
Abstract
Background Changes in knee loading have been reported after meniscectomy. Knee loading has previously been assessed during jogging and treadmill running rather than overground running, which could give altered results. Purpose/Hypothesis The purpose of this study was to evaluate knee function during overground running and walking after meniscectomy. It was hypothesized that the affected limb would demonstrate higher external knee adduction moment, lower knee flexion moment (KFM), and lower knee rotation moment (KRM) compared with the contralateral limb and with healthy individuals. Study Design Controlled laboratory study. Methods Kinematic and kinetic data were collected during running and walking in individuals after a meniscectomy and healthy individuals. Total knee joint moments (TKJM) were calculated from the sagittal, frontal, and transverse knee moments. Isometric quadriceps strength, perceived knee function, and kinesiophobia were also assessed. A mixed linear model compared differences between the affected leg, the contralateral leg, and the healthy leg. Results Data were collected on 20 healthy individuals and 30 individuals after a meniscectomy (mean ± SD, 5.7 ± 2.9 months postsurgery), with 12, 16, and 2 individuals who had medial, lateral, and both medial and lateral meniscectomy, respectively. The affected limb demonstrated lower TKJM (P < .001), KFM (P = .004), and KRM (P < .001) during late stance of walking compared with the healthy group. Lower TKJM and KFM were observed during running in the affected limb compared with the contralateral limb and healthy group. No significant differences were observed between contralateral and healthy limbs except for KRM during late stance of walking. Lower quadriceps strength was observed in the affected (P < .001) and contralateral limbs (P = .001) compared with the healthy group. Individuals after a meniscectomy also reported greater kinesiophobia (P = .006) and lower perceived knee function (31.1%; P < .001) compared with the healthy group. Conclusion After meniscectomy, individuals who sustained a traumatic meniscal injury showed lower TKJM in the affected limb compared with the contralateral limb and healthy individuals. This decrease in TKJM can be attributed to altered knee-loading strategies in the sagittal and transverse planes. Clinical Relevance Improving movement strategies, quadriceps strength, and kinesiophobia through rehabilitation approaches will allow individuals to load their knee appropriately when returning to sport. Registration NCT03379415 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Chelsea Starbuck
- Applied Sports, Technology, Exercise and Medicine Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
- Manchester Institute of Health and Performance, Manchester, UK
| | - Vanessa Walters
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
- Manchester Institute of Health and Performance, Manchester, UK
| | - Lee Herrington
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
| | | | - Richard Jones
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
- Manchester Institute of Health and Performance, Manchester, UK
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Buckthorpe M, Gokeler A, Herrington L, Hughes M, Grassi A, Wadey R, Patterson S, Compagnin A, La Rosa G, Della Villa F. Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction. Sports Med 2024; 54:49-72. [PMID: 37787846 DOI: 10.1007/s40279-023-01934-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/04/2023]
Abstract
Outcomes following anterior cruciate ligament reconstruction (ACLR) need improving, with poor return-to-sport rates and a high risk of secondary re-injury. There is a need to improve rehabilitation strategies post-ACLR, if we can support enhanced patient outcomes. This paper discusses how to optimise the early-stage rehabilitation process post-ACLR. Early-stage rehabilitation is the vital foundation on which successful rehabilitation post-ACLR can occur. Without high-quality early-stage (and pre-operative) rehabilitation, patients often do not overcome major aspects of dysfunction, which limits knee function and the ability to transition through subsequent stages of rehabilitation optimally. We highlight six main dimensions during the early stage: (1) pain and swelling; (2) knee joint range of motion; (3) arthrogenic muscle inhibition and muscle strength; (4) movement quality/neuromuscular control during activities of daily living (5) psycho-social-cultural and environmental factors and (6) physical fitness preservation. The six do not share equal importance and the extent of time commitment devoted to each will depend on the individual patient. The paper provides recommendations on how to implement these into practice, discussing training planning and programming, and suggests specific screening to monitor work and when the athlete can progress to the next stage (e.g. mid-stage rehabilitation entry criteria).
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Affiliation(s)
- Matthew Buckthorpe
- Faculty of Sport, Technology and Health Sciences, St Mary's University, London, TW1 4SX, Twickenham, UK.
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.
| | - Alli Gokeler
- Exercise Science and Neuroscience, Department Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Lee Herrington
- Centre for Human Sciences Research, University of Salford, Salford, UK
| | - Mick Hughes
- North Queensland Physiotherapy Centre, Townsville, QLD, Australia
| | - Alberto Grassi
- II Clinica Ortopedica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Ross Wadey
- Faculty of Sport, Technology and Health Sciences, St Mary's University, London, TW1 4SX, Twickenham, UK
| | - Stephen Patterson
- Faculty of Sport, Technology and Health Sciences, St Mary's University, London, TW1 4SX, Twickenham, UK
| | - Alessandro Compagnin
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Giovanni La Rosa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
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Robles-Palazón FJ, Comfort P, Ripley NJ, Herrington L, Bramah C, McMahon JJ. Force plate methodologies applied to injury profiling and rehabilitation in sport: A scoping review protocol. PLoS One 2023; 18:e0292487. [PMID: 37812631 PMCID: PMC10561863 DOI: 10.1371/journal.pone.0292487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
Musculoskeletal injuries are a common health problem among sporting populations. Such injuries come with a high financial burden to the involved organisations and can have a detrimental impact on the career attainment of injured individuals. Force plates are now a common tool available to sport and exercise science and medicine professionals to enable them to profile injury risk predisposition and modulate the rehabilitation process within sporting environments. This is because contemporary force plate technology is portable and affordable and often comes with software that enables the automatic and immediate feedback of test variables to key stakeholders. However, to our knowledge, to date, there has been no comprehensive review of the scientific literature pertaining to clinical applications of force plate technology. Therefore, this article presents a protocol and a methodological framework to perform a scoping review to identify and map the available scientific literature in which force plates have been applied to the injury profiling and rehabilitation of athletes. The specific aims of the scoping review are 1) to identify and describe the force plate tests, methodologies, and metrics used to screen for injury risk and guide the return of injured athletes to full-time training and competition, 2) to identify potential trends and/or differences by participants' age, sex, and/or level of performance in tests, methodologies, and metrics selected, and 3) to identify key gaps in the existing evidence base and new questions that should be addressed in future research. The global aim of the scoping review is to improve practitioner decision-making around force plate test and variable selection when applied to the injury prevention and rehabilitation of sporting populations.
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Affiliation(s)
- Francisco Javier Robles-Palazón
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Faculty of Sport Sciences, Department of Physical Activity and Sport, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
| | - Paul Comfort
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Centre for Exercise and Sport Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Nicholas J. Ripley
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Lee Herrington
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Christopher Bramah
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - John J. McMahon
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
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Ranson C, Wootten M, Biswas A, Herrington L, Gallimore D, Jackson PD, Taylor A, Spencer S, Hull JH, McCaig S. Year-round longitudinal health surveillance in UK Olympic Summer Sport Athletes 2016-2019. Br J Sports Med 2023; 57:836-841. [PMID: 36693713 DOI: 10.1136/bjsports-2022-105992] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To identify the priority injury and illness types across UK summer Olympic World Class Programme sports to inform development, implementation and evaluation of associated injury risk mitigation and management initiatives. METHODS Four years (2016-2019) of electronic medical records of 1247 athletes from 22 sports were analysed and reported using methods based on the 2020 International Olympic Committee consensus statement for epidemiological recording and reporting. RESULTS 3562 injuries and 1218 illness were recorded, accounting for 146 156 and 27 442 time-loss days. Overall, 814 (65%) athletes reported at least one injury, while 517 (41%) reported at least one illness. There were 1.3 injuries per athlete year resulting in a mean burden of 54.1 days per athlete year. The lumbar/pelvis, knee, ankle and shoulder body regions had the highest incidence and burden. Athletes reported 0.5 illnesses per athlete year, resulting in a mean burden of 10.4 days per athlete year, with most composed of respiratory illness and gastroenteritis. Injuries within sport groups were representative of the injury risk profile for those sports (eg, knee, hand and head injuries had the highest incidence in combat sports), but respiratory illnesses were consistently the greatest problem for each sport group. CONCLUSIONS To optimise availability for training and performance, systematic risk mitigation and management initiatives should target priority injury problems occurring in the lumbar/pelvis, knee, ankle and shoulder, and respiratory illness. Follow-up analysis should include identification of sport-specific priority health problems and associated risk factors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - James H Hull
- English Institute of Sport, Manchester, UK
- UCL, London, UK
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Starbuck C, Walters V, Herrington L, Barkatali B, Jones R. No differences in knee joint loading between individuals who had a medial or lateral meniscectomy: An ancillary study. Knee 2023; 42:304-311. [PMID: 37141797 DOI: 10.1016/j.knee.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/08/2023] [Accepted: 04/11/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Arthroscopic partial meniscectomy is a frequently undertaken procedure for traumatic meniscal injuries. The location of knee joint degeneration and long-term prognosis differs between knees who have had a medial or lateral meniscectomy. However, there is no evidence comparing knee loading following a medial or lateral meniscectomy during sporting tasks. This study compared knee loading during walking and running between individuals who either had a medial or lateral meniscectomy. METHODS Knee kinematic and kinetic data were collected during walking and running in individuals three to twelve months post-surgery. Participants were grouped according to the location of surgery (medial, n = 12, and lateral, n = 16). An independent t-test compared knee biomechanics between the groups and Hedge's g effects sizes were also conducted. RESULTS External knee adduction and knee flexion moments were similar between groups for walking and running with negligible to small effect sizes (effect size, 0.08-0.30). Kinematic (effect size, 0.03-0.22) and spatiotemporal (effect size, 0.02-0.59) outcomes were also similar between the groups. CONCLUSIONS The lack of differences in surrogate knee loading variables between medial and lateral meniscectomy groups was unexpected. These findings suggest that combining groups in the short-term period following surgery is applicable. However, the data presented in this study cannot explain the differences in long-term prognosis between medial and lateral meniscectomies.
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Affiliation(s)
- Chelsea Starbuck
- Applied Sports, Technology, Exercise and Medicine Research Centre, Faculty of Science and Engineering, Swansea University, UK; Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK; The Manchester Institute of Health and Performance, Manchester, UK.
| | - Vanessa Walters
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK; The Manchester Institute of Health and Performance, Manchester, UK
| | - Lee Herrington
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
| | | | - Richard Jones
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK; The Manchester Institute of Health and Performance, Manchester, UK
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Yoma M, Herrington L, Mackenzie T. The Effects Of Differing Density Of Swim-Training Sessions On Shoulder Range Of Motion and Isometric Force Production In National and University Level Swimmers. Int J Sports Phys Ther 2023; 18:375-387. [PMID: 37020450 PMCID: PMC10069333 DOI: 10.26603/001c.72717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/28/2023] [Indexed: 04/03/2023] Open
Abstract
Background Well-developed physical qualities (i.e., greater load capacity) in athletes can provide protection against injuries. Although higher competitive level swimmers have more developed physical qualities, no studies have investigated how physical qualities of the shoulder respond to a swim-training session in different competitive levels. Purpose To compare baseline shoulder external rotation range of motion (ER ROM) and isometric peak torque of the shoulder internal rotators (IR) and external rotators (ER) between national and university level swimmers with differing training volumes. To compare the post-swim changes of these physical qualities between groups. Study design Cross-sectional. Methods Ten male swimmers (age= 18.7 ± 1.2 years) were divided into high-load (N= 5 national-level, weekly swim-volume= 37.0 ± 2.7 km) and low-load groups (N= 5 university-level, weekly swim-volume= 6.8 ± 1.8 km). For each group, shoulder active ER ROM and isometric peak torque of the shoulder IR and ER were measured before and immediately after a high-intensity swim-training session (for each group, the hardest swim-session of the week was analyzed). The results were evaluated by the level of significance (p-value), effect size, and whether changes exceeded the measurement error. Results University-level swimmers had lower baseline ER torque (p= 0.006; d= 2.55) and IR torque (p= 0.011; d= 2.42) than national-level swimmers. For post-swim analysis, ER ROM decreased more in university swimmers (change= -6.3° to -8.4°; d= 0.75-1.05) than national counterparts (change= -1.9° to -5.7°; d= 0.43-0.95). Greater drops in rotation torque were found in university swimmers (IR change= -15% to -21.0%; d= 0.83-1.66; ER change= -9.0% to -17.0%; d= 1.14-1.28) compared to national swimmers (IR change= -10.0% to -13.0%; d= 0.61-0.91; ER change= -3.7% to -9.1%; d= 0.50-0.96). The average change of all tests in university swimmers exceeded the minimal detectable change (MDC), whereas in national level swimmers some tests exceeded the MDC. Despite this, only post-swim ER torque in the dominant side (p= 0.003; d= 1.18) was significantly lower in university swimmers (possibly due to the small sample size). Conclusions University swimmers have less baseline shoulder external and internal rotator torque and had greater drops of all shoulder physical qualities after a swim-training session, which may have implications for injury risk. However, due to the sample size, the results have to be interpreted with caution. Level of evidence 3.
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Affiliation(s)
- Matias Yoma
- Centre for Health Sciences, School of Health and Society University of Salford
| | - Lee Herrington
- Centre for Health Sciences, School of Health and Society University of Salford
| | - Tanya Mackenzie
- Centre for Health Sciences, School of Health and Society University of Salford
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Alhammad A, Herrington L, Jones P, Althomali OW, Jones R. The reliability of lower limb 3D gait analysis variables during a change of direction to 90- and 135-degree manoeuvres in recreational soccer players. J Back Musculoskelet Rehabil 2023; 36:173-180. [PMID: 35964167 DOI: 10.3233/bmr-210351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Several biomechanical outcomes are being used to monitor the risk of injuries; therefore, their reliability and measurement errors need to be known. OBJECTIVE To measure the reliability and measurement error in lower limb 3D gait analysis outcomes during a 90∘ and 135∘ change of direction (COD) manoeuvre. METHODS A test re-test reliability study for ten healthy recreational players was conducted at seven-day intervals. Kinematics (Hip flexion, adduction, internal rotation angles and knee flexion abduction angles) and kinetics (Knee abduction moment and vertical ground reaction force) data during cutting 90∘ and 135∘ were collected using 3D gait analysis and force platform. Five trials for each task and leg were collected. Standard error of measurement (SEM) and the intraclass correlation coefficient (ICC) were calculated from the randomised leg. RESULT The ICC values of the kinematics, kinetics, and vertical ground reaction force (VGRF) outcomes (90∘ and 135∘) ranged from 0.85 to 0.95, showing good to excellent reliability. The SEM for joint angles was less than 1.69∘. The VGRV showed a higher ICC value than the other outcomes. CONCLUSION The current study results support the use of kinematics, kinetics, and VGRF outcomes for the assessment of knee ACL risk in clinic or research. However, the hip internal rotation angle should be treated with caution since the standard measurement error exceeded 10% compared to the mean value. The measurement errors provided in the current study are valuable for future studies.
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Affiliation(s)
- Ayman Alhammad
- Medical Rehabilitation Hospital, Ministry of Health, Madinah, Saudi Arabia
| | - Lee Herrington
- School of Health and Society, University of Salford, Salford, UK
| | - Paul Jones
- School of Health and Society, University of Salford, Salford, UK
| | - Omar W Althomali
- Department of Physiotherapy, College of Applied Medical Sciences, University of Ha'il, Ha'll, Saudi Arabia
| | - Richard Jones
- School of Health and Society, University of Salford, Salford, UK
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Needham C, Herrington L. Cutting Movement Assessment Scores during Anticipated and Unanticipated 90-Degree Sidestep Cutting Manoeuvres within Female Professional Footballers. Sports (Basel) 2022; 10:sports10090128. [PMID: 36136383 PMCID: PMC9502847 DOI: 10.3390/sports10090128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/04/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background: ACL injuries present a considerable burden in female football, with highest incidence being related to change of direction (COD) tasks. The aim was to identify if differences existed between an anticipated and unanticipated 90-degree cutting task using the CMAS. Methods: 11 female professional footballers completed twelve 90-degree COD tasks (6 anticipated, 6 unanticipated). Participants performed the unanticipated task in response to a moving football at the start of their acceleration. All COD tasks were filmed and assessed using the CMAS. Results: The CMAS score for the unanticipated COD task (5.53 ± 0.71) was significantly larger than for the anticipated COD task (3.55 ± 0.85, p < 0.012). Excellent intra-rater reliability was observed (ICC = 0.97) for analysis of CMAS scores. Conclusions: Female footballers in this sample demonstrated a greater CMAS score during an unanticipated COD task compared to an anticipated COD task. These athletes are therefore more likely to display ‘high-risk’ movement patterns, thus greater risk of injury. Reacting to a sporting implement, such as a moving ball, may be a contributing factor to these results. Further research into unanticipated COD tasks should be considered to determine why these differences occur and the impact of anticipation on performance.
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Affiliation(s)
- Chloe Needham
- Centre for Health Sciences Research, University of Salford, Salford M6 6PU, UK
- Birmingham City Football Club, Wast Hills Training Ground, Birmingham B38 9EL, UK
| | - Lee Herrington
- Centre for Health Sciences Research, University of Salford, Salford M6 6PU, UK
- Correspondence:
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Almalki H, Herrington L, Jones R. Arabic version of the International Knee Documentation Committee Subjective Knee Form (IKDC): Translation and validation. J Back Musculoskelet Rehabil 2022; 35:659-665. [PMID: 34657874 DOI: 10.3233/bmr-210136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In order to administer the International Knee Documentation Committee Subjective Knee Form (IKDC) questionnaire to Arabic speakers, a rigorous process of cross-cultural adaptation and validation is required in order to reach equivalence between the original publication and target version of the questionnaire. OBJECTIVES The main aim of this study is to translate and culturally adapt the IKDC into Arabic to suit the Arabic population. The secondary aim is to assess the Arabic version of the IKDC in order to test the psychometric characteristics (reliability, validity and dimensionality). METHODS The translation process has been carried out according to cross-cultural adaptation guidelines in accordance with the American Orthopaedic Society for Sports Medicine guidelines with forward/backward translations and pre-testing. The Arabic IKDC, Knee injury and Osteoarthritis Outcome Score (KOOS), RAND-36-Item Health Survey (RAND-36) questionnaire, and visual analogue scales (VAS) of pain were tested in 105 ACLR patients. Test-retest reliability, internal consistency, construct validity and content validity were evaluated. RESULTS The test-retest reliability proved excellent with a high value for the intraclass correlation coefficient (r= 0.95). The internal consistency was strong (Cronbach's α= 0.91). Good construct validity by the strong correlations between similar component of the KOOS subscales, Rand-36 subscales and VAS, and good content validity with absence of floor and ceiling effects. CONCLUSIONS The Arabic version of the IKDC is a valid and reliable instrument for Arabic patients with ACLR. However, further research is required with a more varied knee sample in order to enable generalisation to a wider population.
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Affiliation(s)
- Husam Almalki
- Rehabilitation Department, King Abdulaziz Specialist Hospital, Ministry of Health, Taif, Saudi Arabia
| | - Lee Herrington
- School of Health and Society, University of Salford, Salford, UK
| | - Richard Jones
- School of Health and Society, University of Salford, Salford, UK
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Lewis G, Towlson C, Roversi P, Domogalla C, Herrington L, Barrett S. Quantifying volume and high-speed technical actions of professional soccer players using foot-mounted inertial measurement units. PLoS One 2022; 17:e0263518. [PMID: 35113962 PMCID: PMC8812977 DOI: 10.1371/journal.pone.0263518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
AIMS The aims of the study were two-fold: i) examine the validity and reliability of high-speed kicking actions using foot-mounted inertial measurement unit's (IMU), ii) quantify soccer players within-microcycle and inter-positional differences in both the frequency and speed of technical actions. METHODS During the in-season phase (25 weeks) of the UK domestic season, 21 professional soccer player ball releases, high-speed ball releases and ball release index were analysed. Pearson product-moment correlation coefficient and confidence intervals were used to determine the validity between the systems, whilst a general linear mixed model analysis approach was used to establish estimated marginal mean values for total ball releases, high-speed ball releases and ball release index. RESULTS Good concurrent validity was observed for ball release velocity and high-speed kicks against a high-speed camera (r2- 0.96, CI 0.93-0.98). Ball releases, high-speed ball releases and ball release index all showed main effects for fixture proximity (p>0.001), playing positions (p>0.001) and across different training categories (p>0.001). The greatest high-speed ball releases were observed on a match-day (MD)+1 (17.6 ± 11.9; CI- 16.2 to 19) and MD-2 (16.8 ± 15; CI- 14.9 to 18.7), with MD+1 exhibiting the highest number of ball releases (161.1 ± 51.2; CI- 155.0 to 167.2) and ball release index (145.5 ± 45.2; CI- 140.1 to 150.9) across all fixture proximities. Possessions (0.3 ± 0.9; CI- 0.3 to 0.4) and small-sided games (1.4 ± 1.6; CI- 1.4 to 1.5), had the lowest values for high-speed ball releases with technical (6.1 ± 7.2; CI- 5.7 to 6.6) and tactical (10.0 ± 10.5; CI- 6.9 to 13.1) drills showing the largest high-speed ball releases. CONCLUSIONS The present study provides novel information regarding the quantification of technical actions of professional soccer players. Insights into absolute and relative frequency and intensity of releases in different drill types, provide practitioners with valuable information on technical outputs that can be manipulated during the process of planning training programmes to produce desired outcomes. Both volume and speed of ball release actions should be measured, when monitoring the technical actions in training according to fixture proximity, drill type and player position to permit enhanced training prescription.
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Affiliation(s)
- Glyn Lewis
- Performance and Medicine Department, Norwich City F.C., Norwich, United Kingdom
- Sport Science Department, University of Salford, Norwich, United Kingdom
| | - Christopher Towlson
- Department of Sport, Health and Exercise Science, University of Hull, Kingston upon Hull, United Kingdom
| | - Pietro Roversi
- Performance and Medicine Department, Norwich City F.C., Norwich, United Kingdom
| | - Chris Domogalla
- Performance and Medicine Department, Norwich City F.C., Norwich, United Kingdom
| | - Lee Herrington
- Sport Science Department, University of Salford, Norwich, United Kingdom
| | - Steve Barrett
- Sport Science, Performance Analysis, Research and Coaching (SPARC), PlayerMaker, London, United Kingdom
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11
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Glynn B, Laird J, Herrington L, Rushton A, Heneghan NR. Analysis of landing performance and ankle injury in elite British artistic gymnastics using a modified drop land task: A longitudinal observational study. Phys Ther Sport 2022; 55:61-69. [DOI: 10.1016/j.ptsp.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
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12
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Yoma M, Herrington L, Mackenzie TA. Cumulative Effects of a Week's Training Loads on Shoulder Physical Qualities and Wellness in Competitive Swimmers. Int J Sports Phys Ther 2021; 16:1470-1484. [PMID: 34956735 PMCID: PMC8637267 DOI: 10.26603/001c.29875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Competitive swimmers are exposed to high training loads, which can contribute to the development of shoulder pain. There is a lack of research investigating the interactions between the accumulation of training loads and factors associated to shoulder pain in swimmers. PURPOSE The primary objective was to analyze the changes in shoulder physical qualities and wellness factors over a week of training in competitive swimmers. A secondary objective was to compare the changes in these variables between different swim-training volumes performed during the week. DESIGN Cross-sectional. METHODS Thirty-one national and regional-level swimmers were included (18 females, 13 males; age= 15.5 ± 2.2 years). Active shoulder external rotation (ER) range of motion (ROM), shoulder-rotation isometric torque, and wellness factors using the Hooper questionnaire were measured twice over the week: a baseline measurement (before Monday´s training session) and a follow-up during the week. Participants were divided into a high-volume group (HVG) and low-volume group (LVG) based on the day follow-up was performed. HVL (n= 15) was tested at the end of the training week (after Saturday´s session) and LVG (n= 16) during the week (after Thursday or Friday´s session). Rating of perceived exertion (RPE) of the whole week was recorded after the follow-up session. RESULTS At follow-up, the LVG averaged a volume of 26.2 ± 2.2 km, whereas the HVG averaged a volume of 37.5 ± 3.7 km. LVG and HVG participants decreased active shoulder ER ROM on dominant (p= 0.002; p= 0.006) and nondominant sides (p= 0.001; p= 0.004), displayed increased muscular soreness (p= 0.001; p= 0.007) and worsened overall wellness (p< 0.001; p= 0.010). Fatigue (p= 0.008) and poor sleep quality were increased (p= 0.023) in HVG, but not in LVG. There were no changes in shoulder-rotation torque and stress in any group. Regarding between-groups differences, only weekly RPE was higher (p= 0.004) in HVG. CONCLUSIONS The accumulation of training loads over the week negatively affect physical and wellness factors. Greater swim-volumes were associated with an increase perception of training loads. The regular monitoring of multiple factors to assess swimmers' response to training might be necessary. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Matias Yoma
- Centre for Health Sciences, School of Health and Society, University of Salford
| | - Lee Herrington
- Centre for Health Sciences, School of Health and Society, University of Salford
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Yoma M, Herrington L, Mackenzie TA, Almond TA. Training Intensity and Shoulder Musculoskeletal Physical Quality Responses in Competitive Swimmers. J Athl Train 2021; 56:54-63. [PMID: 33176360 DOI: 10.4085/1062-6050-0357.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Shoulder pain is the main cause of missed or modified training in competitive swimmers. Shoulder musculoskeletal maladaptations occur to some extent as a consequence of training loads during swimming that may increase the risk of shoulder injury. Further evidence is needed to understand the training intensities at which these maladaptations occur. OBJECTIVE To determine the acute effect of training intensity on the shoulder musculoskeletal physical qualities associated with shoulder injury in competitive swimmers. DESIGN Cross-sectional study. SETTING Indoor swimming pool. PATIENTS OR OTHER PARTICIPANTS Sixteen asymptomatic national- and regional-level swimmers (7 females, 9 males; age = 14.6 ± 3.9 years, height = 160.5 ± 12.7 cm, mass = 55.3 ± 12.5 kg). MAIN OUTCOME MEASURE(S) Bilateral active shoulder-rotation range of motion (ROM), joint position sense, latissimus dorsi length, combined elevation test, and shoulder-rotation isometric peak torque and handgrip peak force normalized to body weight were measured before and immediately after low- and high-intensity swim-training sessions. The intensity of the sessions was determined by the distance swum over or at the pace threshold and confirmed by the swimmer's rating of perceived exertion. RESULTS After the high-intensity training session, shoulder external-rotation ROM (dominant side: P < .001, change = -7.8°; d = 1.10; nondominant side: P = .002, change = -6.5°, d = 1.02), internal-rotator isometric peak torque (dominant side: P < .001, change = -11.4%, d = 0.42; nondominant side: P = .03, change = -6.6%, d = 0.20), and external-rotator isometric peak torque (dominant side: P = .004, change = -8.7%, d = 0.27; nondominant side: P = .02, change = -7.6%, d = 0.25) were reduced. No changes were found in any of the outcome measures after the low-intensity session. CONCLUSIONS Shoulder active external-rotation ROM and rotation isometric peak torque were decreased immediately after a high-intensity training session, possibly increasing the risk of injury during subsequent training. Monitoring these variables may help practitioners adjust and manage training loads to decrease the risk of shoulder injury.
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Affiliation(s)
- Matias Yoma
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Lee Herrington
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Tanya Anne Mackenzie
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Timothy Alejandro Almond
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
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Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça LDM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med 2021; 55:1270-1276. [PMID: 34158354 DOI: 10.1136/bjsports-2021-104087] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. METHODS We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. RESULTS Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). CONCLUSION Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. TRIAL REGISTRATION NUMBER ACTRN12619000522112.
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Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy and Department of Clinical Research, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rosalyn Cooke
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.,Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - François Fourchet
- Physiotherapy Department, Hôpital de La Tour, Meyrin, Switzerland.,Laboratoire Interuniversitaire de Biologie de la Motricité, UJM-Saint-Etienne, University of Lyon, Lyon, France
| | - Philip Glasgow
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,School of Sport, Ulster University, Jordanstown, UK
| | - Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Lee Herrington
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK.,Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Claire E Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seoul, South Korea
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Roma, Italy.,Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, Roma, Italy
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Duncan Reid
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre University Hospital, Copenhagen, Denmark.,Physical Medicine Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre University Hospital, Copenhagen, Denmark
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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Bramah C, Preece SJ, Gill N, Herrington L. Kinematic Characteristics of Male Runners With a History of Recurrent Calf Muscle Strain Injury. Int J Sports Phys Ther 2021; 16:732-740. [PMID: 34123526 PMCID: PMC8169031 DOI: 10.26603/001c.22971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Calf muscle strain injuries are a common running injury affecting male runners and are known to have high reoccurrence rates. Currently, limited evidence exists investigating factors associated with this injury with no previous study investigating the running kinematics of male runners with a history of repeat calf muscle strain injuries. PURPOSE To investigate whether male runners with a history of repeat calf muscle strain injury demonstrate differences in stance phase running kinematics when compared to healthy controls. STUDY DESIGN Case-control investigation. LEVEL OF EVIDENCE 3b. METHODS Stance phase kinematics were compared between 15 male runners with a history of calf muscle strain injury and 15 male control participants during treadmill running at 3.2m/s. Independent t-tests were used to compare differences in stance phase kinematic parameters between groups and effect sizes were calculated using Cohen's d. RESULTS The group with a history of calf muscle strain injury demonstrated a significant 2.1⁰ and 3.1⁰ increase in contralateral pelvic drop and anterior pelvic tilt during mid stance. In addition, this group exhibited longer stance times and a more anterior tilted pelvis, flexed hip and a greater distance between the heel and centre of mass at initial contact. Large effect sizes, greater than 0.8, were observed for all differences. No significant differences were observed for ankle and knee joint kinematics between the groups. CONCLUSION This is the first study to identify kinematic characteristics associated with recurrent calf muscle strain injury. While it is not possible to determine causality, the observed kinematic differences may contribute to recurrent nature of this injury. Specifically, it is possible that neuromuscular deficits of the hip and calf muscle complex may lead to increased strain on the calf complex. Rehabilitation interventions which focus on addressing pelvis and hip kinematics may reduce the demands placed upon the calf complex and could prove clinically effective.
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Starbuck C, Bramah C, Herrington L, Jones R. The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high-performing endurance runners. Scand J Med Sci Sports 2021; 31:1657-1665. [PMID: 33864288 DOI: 10.1111/sms.13972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 11/30/2022]
Abstract
Achilles tendinopathy and patellofemoral pain are common running injuries associated with increased Achilles tendon (AT) forces and patellofemoral joint (PFJ) stresses. This study examined AT forces and PFJ stresses at different running speeds in high-performing endurance runners. Twenty runners ran overground at four running speeds (3.3, 3.9, 4.8, and 5.6 m/s). AT forces and PFJ stresses were estimated from kinematic and kinetic data. Repeated measures ANOVA with partial eta squared effect sizes was conducted to assess differences between running speeds. Increased peak AT forces (19.5%; p < 0.001) and loading rates (57.3%; p < 0.001) from 3.3 m/s to 5.6 m/s were observed. Cumulative AT loading was greater in the faster speeds compared to the slower speeds. Faster running speeds resulted in increased peak plantar flexor moments, increased peak plantar flexion angles, and a more flexed knee and an anterior center of pressure position at touchdown. Peak PFJ stress was lower in the slowest speed (3.3 m/s) compared to the faster running speeds (3.9-5.6 m/s; p = 0.005). PFJ stress loading rate significantly increased (43.6%; p < 0.001). Greater AT loading observed could be associated with strategies such as increased plantar flexor moments and altered lower body position at touchdown which are commonly employed to generate greater ground contact forces. Greater AT and PFJ loading rates were likely due to shorter ground contact times and therefore less time available to reach the peak. Running at faster speeds could increase the risk of developing Achilles tendinopathy and patellofemoral pain or limit recovery from these injuries without sufficient recovery.
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Affiliation(s)
- Chelsea Starbuck
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK.,The Manchester Institute of Health and Performance, Manchester, UK
| | - Christopher Bramah
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK.,The Manchester Institute of Health and Performance, Manchester, UK
| | - Lee Herrington
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK
| | - Richard Jones
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, UK.,The Manchester Institute of Health and Performance, Manchester, UK
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Herrington L, Ghulam H, Comfort P. Quadriceps Strength and Functional Performance After Anterior Cruciate Ligament Reconstruction in Professional Soccer players at Time of Return to Sport. J Strength Cond Res 2021; 35:769-775. [DOI: 10.1519/jsc.0000000000002749] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Bramah C, Preece SJ, Gill N, Herrington L. The between-day repeatability, standard error of measurement and minimal detectable change for discrete kinematic parameters during treadmill running. Gait Posture 2021; 85:211-216. [PMID: 33610824 DOI: 10.1016/j.gaitpost.2020.12.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/03/2020] [Accepted: 12/30/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Kinematic parameters of the trunk, pelvis and lower limbs are frequently associated with both running injuries and performance, and the target of clinical interventions. Currently there is limited evidence reporting the between-day repeatability of discrete kinematic parameters of the trunk, pelvis and lower limbs during treadmill running. RESEARCH QUESTION What is the between-day repeatability, standard error of measurement and minimal detectable change of discrete kinematic parameters of the trunk, pelvis and lower limbs during treadmill running? METHODS 16 healthy participants attended two kinematic data collection sessions two weeks apart. Three-dimensional kinematic data were collected while participants ran on a motorised treadmill at 3.2 m/s. The interclass correlation coefficient, standard error of measurement and minimal detectable change were calculated for discrete kinematic parameters at initial contact, toe off, peak angles and joint excursions during the stance phase of running. RESULTS Good to excellent repeatability with low standard error of measurement and minimal detectable change values were observed for sagittal and frontal plane kinematics at initial contact (Range: ICC, 0.829-0.941; SEM, 0.6°- 2.6°; MDC, 1.5°- 7.2) and peak angles during stance (Range: ICC, 0.799 - 0.946; SEM, 0.6°- 2.6°; MDC, 1.7°- 7.1°). Peak transverse plane kinematics of the hip (ICC, 0.783; SEM, 3.2°; MDC, 8.7°) and knee (ICC, 0.739; SEM, 3°; MDC, 8.4°) demonstrated moderate between-day repeatability with large SEM and MDC values. Kinematics at toe off demonstrated the lowest ICC values and largest measurement errors of all parameters (Range: ICC, 0.109 - 0.900; SEM, 0.8°- 5.7°; MDC, 2.5°- 15.7°). SIGNIFICANCE This is the first study detailing the measurement error and minimal detectable change for discrete kinematic parameters of the trunk and pelvis during treadmill running. The reported values may provide a useful reference point for future studies investigating between-day differences in running kinematics.
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Affiliation(s)
- Christopher Bramah
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom.
| | - Stephen J Preece
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
| | - Niamh Gill
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
| | - Lee Herrington
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
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Cooke R, Rushton A, Martin J, Herrington L, Heneghan NR. Practicability of lower extremity functional performance tests and their measurement properties in elite athletes: protocol for a systematic review. BMJ Open 2020; 10:e042975. [PMID: 33371047 PMCID: PMC7757441 DOI: 10.1136/bmjopen-2020-042975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Lower extremity injury (LEI) is highly prevalent and its occurrence increases the risk of future injury in athletic populations. Identifying athletes at risk of injury is the key to target injury-prevention programmes. Functional performance tests (FPT) assess an athlete's ability to produce and accept forces during movement tasks reflective of those experienced in sport, and are used to identify deficits in physical qualities or neuromuscular control. This review aims to identify FPT which have potential to predict LEI and assess their measurement properties associated with reliability, validity, responsiveness and practicability (interpretability and feasibility). METHODS/ANALYSIS This protocol will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol and the COnsensus-based Standards for the selection of health Measurement INstruments Methodology. The search strategy has two stages: stage 1 will identify lower limb FPT used in athletic populations; and stage 2 will assess the measurement properties of the identified FPT. A sensitive search strategy will use MEDLINE, EMBASE, CINHAL and SPORTdiscus databases; from inception to June 2020. Hand searching reference lists, key journals and grey literature will be completed. One reviewer will complete search 1 and data extraction. Two reviewers will complete the search, data extraction and risk-of-bias assessment for search 2. Evidence will be pooled or summarised by individual measurement property by each individual study and grouped by FPT. Meta-analysis using a random effects model with subgroup analysis will be performed where possible. Pooled or summarised results for each FPT in relation to each measurement property will be rated against the criteria for good measurement properties. Two reviewers will assess the overall body of evidence per measurement property per FPT using the modified Grading of Recommendations, Assessment, Development and Evaluation guidelines. This review will enable clinicians to make an informed choice when selecting FPT. ETHICS AND DISSEMINATION No ethical approval is required for this review and the results will be disseminated through peer-reviewed publications and submitted for conference presentation. PROSPERO REGISTRATION NUMBER CRD42020188932.
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Affiliation(s)
- Rosalyn Cooke
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - James Martin
- Institute of Applied Health Research, Public Health Building, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands, UK
| | - Lee Herrington
- School of Health and Society, University of Salford, Salford, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Elsais WM, Preece SJ, Jones RK, Herrington L. Could Relative Movement Between the Adductor Muscles and the Skin Invalidate Surface Electromyography Measurement? J Appl Biomech 2020; 36:319-325. [PMID: 32796135 DOI: 10.1123/jab.2019-0299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/20/2020] [Accepted: 05/13/2020] [Indexed: 10/27/2023]
Abstract
The superficial hip adductor muscles are situated in close proximity to each other. Therefore, relative movement between the overlying skin and the muscle belly could lead to a shift in the position of surface electromyography (EMG) electrodes and contamination of EMG signals with activity from neighboring muscles. The aim of this study was to explore whether hip movements or isometric contraction could lead to relative movement between the overlying skin and 3 adductor muscles: adductor magnus, adductor longus, and adductor gracilis. The authors also sought to investigate isometric torque-EMG relationships for the 3 adductor muscles. Ultrasound measurement showed that EMG electrodes maintained a position which was at least 5 mm within the muscle boundary across a range of hip flexion-extension angles and across different contraction levels. The authors also observed a linear relationship between torque and EMG amplitude. This is the first study to use ultrasound to track the relative motion between skin and muscle and provides new insight into electrode positioning. The findings provide confidence that ultrasound-based positioning of EMG electrodes can be used to derive meaningful information on output from the adductor muscles and constitute a step toward recognized guidelines for surface EMG measurement of the adductors.
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Neamatallah Z, Herrington L, Jones R. An investigation into the role of gluteal muscle strength and EMG activity in controlling HIP and knee motion during landing tasks. Phys Ther Sport 2020; 43:230-235. [DOI: 10.1016/j.ptsp.2019.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/18/2019] [Accepted: 12/21/2019] [Indexed: 01/14/2023]
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Bramah C, Preece SJ, Gill N, Herrington L. A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months. Am J Sports Med 2019; 47:3406-3413. [PMID: 31657964 PMCID: PMC6883353 DOI: 10.1177/0363546519879693] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aberrant frontal-plane hip and pelvis kinematics have been frequently observed in runners with patellofemoral pain (PFP). Gait retaining interventions have been shown to improve running kinematics and may therefore be beneficial in runners with PFP. PURPOSE To investigate whether a 10% increase in the running step rate influences frontal-plane kinematics of the hip and pelvis as well as clinical outcomes in runners with PFP. STUDY DESIGN Case series; Level of evidence, 4. METHODS Runners with PFP underwent a 3-dimensional gait analysis to confirm the presence of aberrant frontal-plane hip and/or pelvis kinematics at baseline. A total of 12 participants with frontal-plane hip and/or pelvis kinematics 1 standard deviation above a reference database were invited to undergo the gait retraining intervention. Running kinematics along with clinical outcomes of pain and functional outcomes were recorded at baseline, 4 weeks after retraining, and 3 months. Gait retraining consisted of a single session where step rate was increased by 10% using an audible metronome. Participants were asked to continue their normal running while self-monitoring their step rate using a global positioning system smartwatch and audible metronome. RESULTS After gait retraining, significant improvements in running kinematics and clinical outcomes were observed at 4-week and 3-month follow-up. Repeated-measures analysis of variance with post hoc Bonferroni correction (P < .016) showed significant reductions in peak contralateral pelvic drop (mean difference [MD], 3.12° [95% CI, 1.88°-4.37°]), hip adduction (MD, 3.99° [95% CI, 2.01°-5.96°]), and knee flexion (MD, 4.09° [95% CI, 0.04°-8.15°]) as well as significant increases in self-reported weekly running volume (MD, 13.78 km [95% CI, 4.62-22.93 km]) and longest run pain-free (MD, 6.84 km [95% CI, 3.05-10.62 km]). Friedman test with a post hoc Wilcoxon signed-rank test showed significant improvements on a numerical rating scale for worst pain in the past week and the Lower Extremity Functional Scale. CONCLUSION A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP. These improvements were maintained at 3-month follow-up. It is important to assess for aberrant running kinematics at baseline to ensure that gait interventions are targeted appropriately. REGISTRATION NCT03067545 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Christopher Bramah
- School of Health Sciences, University of
Salford, Salford, UK,Christopher Bramah, MSc,
MCSP, School of Health Sciences, University of Salford, Blatchford Building,
Salford, M6 6PU, UK () (Twitter:
@chrisbramah)
| | | | - Niamh Gill
- School of Health Sciences, University of
Salford, Salford, UK
| | - Lee Herrington
- School of Health Sciences, University of
Salford, Salford, UK
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Smith M, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça L, Fourchet F, Glasgow P, Gribble P, Herrington L, Hiller C, Lee S, Macalusco A, Meeusen R, Oweye O, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom E, Delahunt E. Establishing return to play criteria after acute lateral ankle sprain injuries: An international Delphi study. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Walters V, Starbuck C, Herrington L, Barkatali B, McGregor S, Jones R. The influence of running footwear on knee loading post-meniscectomy. Footwear Science 2019. [DOI: 10.1080/19424280.2019.1606311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Vanessa Walters
- Centre for Health Sciences Research, College of Health and Social Care, University of Salford, Salford, UK
| | - Chelsea Starbuck
- Centre for Health Sciences Research, College of Health and Social Care, University of Salford, Salford, UK
- The Manchester Institute of Health and Performance, Manchester, UK
| | - Lee Herrington
- Centre for Health Sciences Research, College of Health and Social Care, University of Salford, Salford, UK
| | | | - Stephen McGregor
- The Manchester Institute of Health and Performance, Manchester, UK
| | - Richard Jones
- Centre for Health Sciences Research, College of Health and Social Care, University of Salford, Salford, UK
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Warner MB, Wilson DA, Herrington L, Dixon S, Power C, Jones R, Heller MO, Carden P, Lewis CL. Corrigendum to 'A Systematic review of the discriminating biomechanical parameters during the single leg Squat' [Physical Therapy in Sport 36 (2019) 78-91]. Phys Ther Sport 2019; 37:62-63. [PMID: 30877845 DOI: 10.1016/j.ptsp.2019.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Martin B Warner
- School of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
| | - David A Wilson
- School of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| | - Lee Herrington
- Centre for Health Sciences Research, University of Salford, Salford, UK
| | - Sharon Dixon
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Conor Power
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Richard Jones
- Centre for Health Sciences Research, University of Salford, Salford, UK
| | - Markus O Heller
- School of Engineering and the Environment, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK
| | - Patrick Carden
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Cara L Lewis
- Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, USA
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Warner MB, Wilson DA, Herrington L, Dixon S, Power C, Jones R, Heller MO, Carden P, Lewis CL. A systematic review of the discriminating biomechanical parameters during the single leg squat. Phys Ther Sport 2019; 36:78-91. [DOI: 10.1016/j.ptsp.2019.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/11/2022]
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Abstract
BACKGROUND Previous research has demonstrated clear associations between specific running injuries and patterns of lower limb kinematics. However, there has been minimal research investigating whether the same kinematic patterns could underlie multiple different soft tissue running injuries. If they do, such kinematic patterns could be considered global contributors to running injuries. HYPOTHESIS Injured runners will demonstrate differences in running kinematics when compared with injury-free controls. These kinematic patterns will be consistent among injured subgroups. STUDY DESIGN Controlled laboratory study. METHODS The authors studied 72 injured runners and 36 healthy controls. The injured group contained 4 subgroups of runners with either patellofemoral pain, iliotibial band syndrome, medial tibial stress syndrome, or Achilles tendinopathy (n = 18 each). Three-dimensional running kinematics were compared between injured and healthy runners and then between the 4 injured subgroups. A logistic regression model was used to determine which parameters could be used to identify injured runners. RESULTS The injured runners demonstrated greater contralateral pelvic drop (CPD) and forward trunk lean at midstance and a more extended knee and dorsiflexed ankle at initial contact. The subgroup analysis of variance found that these kinematic patterns were consistent across each of the 4 injured subgroups. CPD was found to be the most important variable predicting the classification of participants as healthy or injured. Importantly, for every 1° increase in pelvic drop, there was an 80% increase in the odds of being classified as injured. CONCLUSION This study identified a number of global kinematic contributors to common running injuries. In particular, we found injured runners to run with greater peak CPD and trunk forward lean as well as an extended knee and dorsiflexed ankle at initial contact. CPD appears to be the variable most strongly associated with common running-related injuries. CLINICAL RELEVANCE The identified kinematic patterns may prove beneficial for clinicians when assessing for biomechanical contributors to running injuries.
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Affiliation(s)
| | | | - Niamh Gill
- School of Health Sciences, University of Salford, Salford, UK
| | - Lee Herrington
- School of Health Sciences, University of Salford, Salford, UK
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Higson E, Herrington L, Butler C, Horsley I. The short-term effect of swimming training load on shoulder rotational range of motion, shoulder joint position sense and pectoralis minor length. Shoulder Elbow 2018; 10:285-291. [PMID: 30214495 PMCID: PMC6134534 DOI: 10.1177/1758573218773539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Shoulder pain or injury is the most common issue facing elite competitive swimmers and the most frequent reason for missed or modified training. Literature suggests that highly repetitive upper limb loading leads to inappropriate adaptations within the shoulder complex. The most likely maladaptations to occur are variations in shoulder rotational range of motion, reduction in joint position sense and shortened pectoralis minor length. This has yet to have been confirmed in experimental studies. The aim of this study was to investigate the short-term effects of swimming training load upon internal and external rotation range of motion, joint position sense and pectoralis minor length. METHOD Sixteen elite swimmers training in the British Swimming World Class programme participated. Measures of internal and external range of motion, joint position sense error score and pectoralis minor length were taken before and after a typical 2 h swimming session. RESULTS Following swimming training shoulder external rotation range of motion and pectoralis minor length reduced significantly (-3.4°, p = <0.001 and -0.7 cm, p = <0.001, respectively), joint position sense error increased significantly (+2.0° error angle, p = <0.001). Internal rotation range of motion demonstrated no significant change (-0.6, p = 0.53). DISCUSSION This study determined that elite level swimming training results in short-term maladaptive changes in shoulder performance that could potentially predispose them to injury.
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Affiliation(s)
- Emma Higson
- English Institute of Sport, Loughborough, UK
| | - Lee Herrington
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK,Lee Herrington, Directorate of Sport, Exercise and Physiotherapy, Allerton Building, University of Salford, Salford, M6 6PU, UK.
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Abstract
Objective A previous study on shoulder pain mapping showed specific pain patterns for common shoulder disorders. This study aimed to test those patterns for accuracy, modify shoulder pain mapping as needed, and observe their reliability and validity. Methods This prospective study used a two-step process and was undertaken to determine its potential utility in daily practice. New shoulder pain patients marked their pain, its character and severity, on a custom-made mapping form. Then a researcher blinded to the diagnoses gave their estimations on the basis of previously established maps, and they were correlated with final diagnoses. Subsequently, a guide table was developed on how to read the maps, and intertester reliability was performed with three independent testers. Results The study included 194 patients, and the overall accuracy for estimations was between 45.4% and 49.5%. The sensitivity was high, especially for instability, followed by calcific tendinitis, acromio-calvicular joint pathology, and impingement. The intertester reliability showed clinically significant agreement between testers for both disease groups (κ = 0.70) and individual disorders (κ = 0.52). Conclusions This was a unique and extensive study on shoulder pain mapping. The study concluded that pain mapping could be a useful adjunct to the clinical assessment of patients with shoulder pain and can be used in the primary care setting as well as secondary care and for research.
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Affiliation(s)
- Levent Bayam
- Orthopaedic department, Central Manchester University Hospitals, Manchester, UK
| | - Rajendra Arumilli
- Orthopaedic department, Central Manchester University Hospitals, Manchester, UK
| | - Ian Horsley
- Physiotherapy Department in Sports City at English Institute of Sport, Manchester
| | - Fatma Bayam
- Consultant Radiologist, Aintree University Hospital, Liverpool, Senior Lecturer in Sports Rehabilitation, Salford University, Salford, UK
| | - Lee Herrington
- Senior Lecturer in Sports Rehabilitation, Salford University
| | - Lennard Funk
- Consultant Orthopaedics, Wrightington Hospital, Wigan, UK
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Abstract
BACKGROUND Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. PURPOSE To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. STUDY DESIGN Controlled laboratory study. METHODS Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. RESULTS A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). CONCLUSION Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. CLINICAL RELEVANCE Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.
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Affiliation(s)
- Lee Herrington
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Saud Alarifi
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Richard Jones
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
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Abstract
Previous research has reported a prevalence of running related injuries in 25.9% to 72% of all runners. A greater hip internal rotation and adduction during the stance phase in running has been associated with many running related injuries, such as patellofemoral pain. Researchers in the USA designed a treatment device 'the Powers™ strap' to facilitate an external rotation of the femur and to thereby control abnormal hip and knee motion during leisure and sport activities. However, to date no literature exists to demonstrate whether the Powers™ strap is able to reduce hip internal rotation during running. 22 healthy participants, 11 males and 11 females (age: 27.45±4.43 years, height: 1.73±0.06m, mass: 66.77±9.24kg) were asked to run on a 22m track under two conditions: without and with the Powers™ strap. Three-dimensional motion analysis was conducted using ten Qualisys OQUS 7 cameras (Qualisys AB, Sweden) and force data was captured with three AMTI force plates (BP600900, Advanced Mechanical Technology, Inc.USA). Paired sample t-tests were performed at the 95% confidence interval on all lower limb kinematic and kinetic data. The Powers™ strap significantly reduced hip and knee internal rotation throughout the stance phase of running. These results showed that the Powers™ strap has the potential to influence hip motion during running related activities, in doing so this might be beneficial for patients with lower limb injuries. Future research should investigate the influence of the Powers™ strap in subjects who suffer from running related injuries, such as patellofemoral pain.
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Affiliation(s)
- Henrike Greuel
- School of Health Science, University of Salford, Frederick Road Campus, Brian Blatchford building, PO30, Salford M66PU, Greater Manchester, UK, UK.
| | - Lee Herrington
- School of Health Science, University of Salford, Frederick Road Campus, Brian Blatchford building, PO30, Salford M66PU, Greater Manchester, UK, UK.
| | - Anmin Liu
- School of Health Science, University of Salford, Frederick Road Campus, Brian Blatchford building, PO30, Salford M66PU, Greater Manchester, UK, UK.
| | - Richard K Jones
- School of Health Science, University of Salford, Frederick Road Campus, Brian Blatchford building, PO30, Salford M66PU, Greater Manchester, UK, UK.
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Herrington L, Alenezi F, Alzhrani M, Alrayani H, Jones R. The reliability and criterion validity of 2D video assessment of single leg squat and hop landing. J Electromyogr Kinesiol 2017; 34:80-85. [DOI: 10.1016/j.jelekin.2017.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 11/15/2022] Open
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Alahmari A, Herrington L, Jones R, Liu A, Neamatallah Z. THE RELIABILITY OF TWO-DIMENSIONAL (2D) BIOMECHANICAL VARIABLES DURING MULTIDIRECTIOANAL SINGLE LEG LANDING. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alenezi F, Herrington L, Jones P, Jones R. KNEE VALGUS ANGLE AND LOADING ACROSS COMMON ATHLETIC TASKS; REFERENCE VALUES AND GENDER DIFFERENCES IN A HEALTHY POPULATION. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Greuel H, Jones RK, Herrington L, Anmin L. THE POWERS
TM
STRAP MODIFIES HIP AND KNEE MOVEMENT DURING THE SINGLE LEG SQUAT AND THE SINGLE LEG STEP DOWN TASK. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096952.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alkasem M, Herrington L, Porter S. Does patellofemoral pain syndrome consider the most common differential diagnosis for anterior knee pain: an experts opinion. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jones PA, Herrington L, Graham-Smith P. Braking characteristics during cutting and pivoting in female soccer players. J Electromyogr Kinesiol 2016; 30:46-54. [DOI: 10.1016/j.jelekin.2016.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 05/13/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022] Open
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Relph N, Herrington L. THE EFFECT OF CONSERVATIVELY TREATED ACL INJURY ON KNEE JOINT POSITION Sense. Int J Sports Phys Ther 2016; 11:536-543. [PMID: 27525178 PMCID: PMC4970844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Proprioception is critical for effective movement patterns. However, methods of proprioceptive measurement in previous research have been inconsistent and lacking in reliability statistics making it applications to clinical practice difficult. Researchers have suggested that damage to the anterior cruciate ligament (ACL) can alter proprioceptive ability due to a loss of functioning mechanoreceptors. The majority of patients opt for reconstructive surgery following this injury. However, some patients chose conservative rehabilitation options rather than surgical intervention. PURPOSE The purpose of this study was to determine the effect of ACL deficiency on knee joint position sense following conservative, non-operative treatment and return to physical activity. A secondary purpose was to report the reliability and measurement error of the technique used to measure joint position sense, (JPS) and comment on the clinical utility of this measurement. STUDY DESIGN Observational study design using a cross-section of ACL deficient patients and matched uninjured controls. METHODS Twenty active conservatively treated ACL deficient patients who had returned to physical activity and twenty active matched controls were included in the study. Knee joint position sense was measured using a seated passive-active reproductive angle technique. The average absolute angle of error score, between 10 °-30 ° of knee flexion was determined. This error score was derived from the difference between the target and repositioning angle. RESULTS The ACL deficient patients had a greater error score (7.9 °±3.6) and hence poorer static proprioception ability that both the contra-lateral leg (2.0 °±1.6; p = 0.0001) and the control group (2.6 °±0.9; p = 0.0001). The standard error of the mean (SEM) of this JPS technique was 0.5 ° and 0.2 ° and the minimum detectable change (MDC) was 1.3 ° and 0.4 ° on asymptomatic and symptomatic subjects respectively. CONCLUSION This study confirms a static proprioceptive deficiency exists in the knee joint following ACL injury and rehabilitation, potentially due to a reduction in functioning mechanoreceptors in the ligament over time. The differences between the ACL deficient knee and the control group were above the SEMs and MDCs of the measurement which suggests clinical relevance. Longitudinal studies are needed to evaluate if patients who return to activity with a joint position sense deficiency develop secondary injuries. LEVELS OF EVIDENCE Individual Cohort Study (2b).
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Affiliation(s)
- Nicola Relph
- Edge Hill University, Ormskirk, Lancashire,
England
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Relph N, Herrington L. The effects of knee direction, physical activity and age on knee joint position sense. Knee 2016; 23:393-8. [PMID: 27012638 DOI: 10.1016/j.knee.2016.02.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/12/2016] [Accepted: 02/23/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous research has suggested a decline in knee proprioception with age. Furthermore, regular participation in physical activity may improve proprioceptive ability. However, there is no large scale data on uninjured populations to confirm these theories. The aim of this study was to provide normative knee joint position data (JPS) from healthy participants aged 18-82years to evaluate the effects of age, physical activity and knee direction. METHODS A sample of 116 participants across five age groups was used. The main outcome measures were knee JPS absolute error scores into flexion and extension, Tegner activity levels and General Practitioner Physical Activity Questionnaire results. RESULTS Absolute error scores in to knee flexion were 3.6°, 3.9°, 3.5°, 3.7° and 3.1° and knee extension were 2.7°, 2.5°, 2.9°, 3.4° and 3.9° for ages 15-29, 30-44, 45-59, 60-74 and 75 years old respectively. Knee extension and flexion absolute error scores were significantly different when age group data were pooled. There was a significant effect of age and activity level on joint position sense into knee extension. Age and lower Tegner scores were also negatively correlated to joint position sense into knee extension. CONCLUSIONS The results provide some evidence for a decline in knee joint position sense with age. Further, active populations may have heightened static proprioception compared to inactive groups. Normative knee joint position sense data is provided and may be used by practitioners to identify patients with reduced proprioceptive ability.
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Affiliation(s)
- Nicola Relph
- Sport and Exercise Kinesiology, Sports Injury Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk L39 4QP, United Kingdom.
| | - Lee Herrington
- Sports Rehabilitation, School of Health Sciences, Frederick Road Campus, University of Salford, Salford M6 6PU, United Kingdom.
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Horsley I, Herrington L, Hoyle R, Prescott E, Bellamy N. Do changes in hand grip strength correlate with shoulder rotator cuff function? Shoulder Elbow 2016; 8:124-9. [PMID: 27583010 PMCID: PMC4950463 DOI: 10.1177/1758573215626103] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 12/11/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Shoulder pain as a result of rotator cuff pathology is one of the most common musculoskeletal complaints presenting within primary care. Assessment of hand grip strength has been proposed as an indicator of rotator cuff function. This experimental study assessed the relationship between grip strength and shoulder lateral rotator muscle strength in a number of different shoulder positions, aiming to investigate whether such a relationship existed and whether grip strength could be used as a functional assessment tool for the posterior cuff. METHODS Twenty-seven healthy, physically active, volunteers (19 males, eight females) with no history of shoulder, upper limb or neck injury comprised the study group. The mean (SD) age was 19.8 (5.7) years (range 18 years to 23 years). Grip strength (measured with hand grip dynamometer) and lateral rotator strength (measured with a hand held dynamometer) was measured at neutral, 90° abduction, and 90° abduction with 90° external rotation. RESULTS The correlation between grip strength and shoulder lateral rotation strength ranged between r = 0.91 (r (2 )= 0.84) and r = 0.72 (r (2 )= 0.52) across all positions. CONCLUSIONS A strong correlation between grip strength and lateral rotator strength was shown at all positions for both left and right hands, suggesting that assessment of grip strength could be used as a rotator cuff monitor of recruitment function.
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Affiliation(s)
- Ian Horsley
- Ian Horsley, Sports City, Manchester M11 3FF, UK. Tel: +44 (0)7774854019.
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Paz GA, Maia MDF, Farias D, Santana H, Miranda H, Lima V, Herrington L. KINEMATIC ANALYSIS OF KNEE VALGUS DURING DROP VERTICAL JUMP AND FORWARD STEP-UP IN YOUNG BASKETBALL PLAYERS. Int J Sports Phys Ther 2016; 11:212-219. [PMID: 27104054 PMCID: PMC4827364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
PURPOSE/BACKGROUND Lower limb asymmetry between dominant and nondominant limbs is often associated with injuries. However, there is a lack of evidence about frontal plane projection angle (FPPA) of the knee joint (knee valgus) during drop vertical jump (DVJ) and forward step-up tasks (FSUP) in young basketball players. Therefore, the purpose of this study was to assess the FPPA (i.e., dynamic knee valgus) via 2D video analysis during DVJ and FSUP tasks in the dominant and nondominant limbs of young male basketball players. METHODS Twenty seven young male basketball players (age 14.5 ± 1.3 y, height 161.1 ± 4.1 cm, weight 64.2 ± 10.2 kg) participated in this study. The participants were asked to perform a bilateral DVJ and unilateral FSUP tasks. Kinematic analysis of FPPA was completed via a two-dimensional (2D) examination in order to evaluate the knee valgus alignment during the beginning of the concentric phase of each task. Knee valgus alignment was computed considering the angle between the line formed between the markers at the anterior superior iliac spine and middle of the tibiofemoral joint and the line formed from the markers on the middle of the tibiofemoral joint to the middle of the ankle mortise. Paired t-tests were used to evaluate differences in tasks. Standard error of measurement (SEM) was calculated to establish random error scores. RESULTS There was no difference in knee valgus angle during the DVJ task between dominant (20.2 ± 4.4 º) and nondominant legs (20 ± 4.1 º; p = 0.067). However, a significant difference was noted during FSUP between the non-dominant limb (18.7 ± 3.4 º) when compared to the dominant (21.7 ± 3.5 º; p = 0.001) limb. CONCLUSION Two dimensional kinematic analysis of knee FPPA may help coaches and other professionals to detect asymmetries between dominant and nondominant limbs, and to develop training programs with the goal of reducing overall lower extremity injury risk. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
| | | | - Déborah Farias
- School of Physical Education and Sports – Federal University of Rio de Janeiro, RJ, Brazil
| | | | - Humberto Miranda
- School of Physical Education and Sports – Federal University of Rio de Janeiro, RJ, Brazil
| | - Vicente Lima
- Biodynamic Laboratory of Exercise, Health, and Performance – Castelo Branco University, Rio de Janeiro, RJ, Brazil
| | - Lee Herrington
- Directorate of Sport, University of Salford, Salford, Greater Manchester, United Kingdom
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Greuel H, Jones RK, Herrington L. 6 Underlying mechanisms of muscular dysfunction in patients with patellofemoral pain (PFP). Br J Sports Med 2015. [DOI: 10.1136/bjsports-2015-095576.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
CONTEXT Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited. OBJECTIVE To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises. DESIGN Descriptive laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated. INTERVENTION(S) Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system. MAIN OUTCOME MEASURE(S) Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments. RESULTS We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001). CONCLUSIONS Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat.
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Affiliation(s)
- Paul Comfort
- Directorate of Sport, Exercise and Physiotherapy, University of Salford, Manchester, United Kingdom
| | - Paul Anthony Jones
- Directorate of Sport, Exercise and Physiotherapy, University of Salford, Manchester, United Kingdom
| | - Laura Constance Smith
- Directorate of Sport, Exercise and Physiotherapy, University of Salford, Manchester, United Kingdom
| | - Lee Herrington
- Directorate of Sport, Exercise and Physiotherapy, University of Salford, Manchester, United Kingdom
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Dawson SJ, Herrington L. Improving Single-Legged-Squat Performance: Comparing 2 Training Methods With Potential Implications for Injury Prevention. J Athl Train 2015; 50:921-9. [PMID: 26308498 DOI: 10.4085/1062-6050-50.9.03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Poor dynamic limb alignment during loading tasks has links to the development of knee injuries, including patellofemoral pain and anterior cruciate ligament injury. Therefore, modalities to improve limb alignment during loading tasks are thought to reduce loading through these structures and potentially prevent injury. OBJECTIVE To compare hip-strengthening and skill-acquisition training to examine if they can improve lower limb biomechanics, potentially preventing injury, and to examine whether changes demonstrated can be maintained after 6 weeks of no practice. DESIGN Controlled laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 19 recreationally active individuals volunteered, and 17 (9 women: age = 27.9 ± 3.1 years, height = 165.4 ± 8.4 cm, mass = 60.5 ± 9.2 kg; 8 men: age = 30.4 ± 6.4 years, height = 181.4 ± 7.1 cm, mass = 69.8 ± 15.2 kg) completed the study. Nine participants were allocated to a hip-strengthening program; 8, to a skill-acquisition program. INTERVENTION(S) Participants performed a 6-week training program of either hip strengthening (n = 9) or skill acquisition (n = 8) 3 times per week. MAIN OUTCOME MEASURE(S) Measurements of clam-exercise strength, hip-abduction strength, frontal-plane projection angle, hip-adduction angle, and a qualitative score were taken at baseline, 6 weeks, and 12 weeks. RESULTS We observed improvements in frontal-plane projection angle (strength: t8 = 5.344, P = .001; skill: t7 = 4.393, P = .003), hip-adduction angle (strength: t8 = 3.597, P = .007; skill: t7 = 4.722, P = .002), and qualitative score (strength: t8 = 3.900, P = .005; skill: t7 = 8.283, P < .001) postintervention, which were retained at the 12-week retest in both groups. CONCLUSIONS A 6-week intervention of either hip-strengthening or skill-acquisition training improved lower limb biomechanics. The changes in biomechanics after skill training were retained at 12 weeks, suggesting a change in motor patterning that could be favorable to longer-term injury prevention.
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Affiliation(s)
- Samuel J Dawson
- Physiotherapy Department, Wrexham Maelor Hospital, United Kingdom
| | - Lee Herrington
- Directorate of Sport, University of Salford, Manchester, United Kingdom
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Mackenzie TA, Herrington L, Horlsey I, Cools A. An evidence-based review of current perceptions with regard to the subacromial space in shoulder impingement syndromes: Is it important and what influences it? Clin Biomech (Bristol, Avon) 2015; 30:641-8. [PMID: 26071974 DOI: 10.1016/j.clinbiomech.2015.06.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Reduction of the subacromial space as a mechanism in the etiology of shoulder impingement syndromes is debated. Although a reduction in this space is associated with shoulder impingement syndromes, it is unclear if this observation is cause or consequence. METHOD The purposes of this descriptive review are to provide a broad perspective on the current perceptions with regard to the pathology and pathomechanics of subacromial and internal impingement syndromes, consider the role of the subacromial space in impingement syndromes, describe the intrinsic and extrinsic mechanisms considered to influence the subacromial space, and critique the level of evidence supporting these concepts. FINDING Based on the current evidence, the hypothesis that a reduction in subacromial space is an extrinsic cause of impingement syndromes is not conclusively established and the evidence permits no conclusion. INTERPRETATION If maintenance of the subacromial space is important in impingement syndromes regardless of whether it is a cause or consequence, research exploring the correlation between biomechanical factors and the subacromial space, using the later as the outcome measure, would be beneficial.
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Affiliation(s)
- Tanya Anne Mackenzie
- Salford University, Health, Sports and Rehabilitation Sciences, Manchester, United Kingdom/M5 4WT.
| | - Lee Herrington
- Salford University, School of Sport, Exercise and Physiotherapy, Salford, Manchester, United Kingdom.
| | | | - Ann Cools
- Ghent University Dept of Rehabilitation Science and Physiotherapy, Ghent, Belgium.
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Bdaiwi AH, Mackenzie TA, Herrington L, Horsley I, Cools AM. Acromiohumeral Distance During Neuromuscular Electrical Stimulation of the Lower Trapezius and Serratus Anterior Muscles in Healthy Participants. J Athl Train 2015; 50:713-8. [PMID: 25933249 DOI: 10.4085/1062-6050-50.4.03] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Compromise to the acromiohumeral distance has been reported in participants with subacromial impingement syndrome compared with healthy participants. In clinical practice, patients with subacromial shoulder impingement are given strengthening programs targeting the lower trapezius (LT) and serratus anterior (SA) muscles to increase scapular posterior tilt and upward rotation. We are the first to use neuromuscular electrical stimulation to stimulate these muscle groups and evaluate how the muscle contraction affects the acromiohumeral distance. OBJECTIVE To investigate if electrical muscle stimulation of the LT and SA muscles, both separately and simultaneously, increases the acromiohumeral distance and to identify which muscle-group contraction or combination most influences the acromiohumeral distance. DESIGN Controlled laboratory study. SETTING Human performance laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty participants (10 men and 10 women, age = 26.9 ± 8.0 years, body mass index = 23.8) were screened. INTERVENTION(S) Neuromuscular electrical stimulation of the LT and SA. MAIN OUTCOME MEASURE(S) Ultrasound measurement of the acromiohumeral distance. RESULTS Acromiohumeral distance increased during contraction via neuromuscular electrical stimulation of the LT muscle (t(19) = -3.89, P = .004), SA muscle (t(19) = -7.67, P = .001), and combined LT and SA muscles (t(19) = -5.09, P = .001). We observed no differences in the increased acromiohumeral distance among the 3 procedures (F(2,57) = 3.109, P = .08). CONCLUSIONS Our results supported the hypothesis that the muscle force couple around the scapula is important in rehabilitation and scapular control and influences acromiohumeral distance.
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Affiliation(s)
- Alya H Bdaiwi
- Department of Health, Sports, and Rehabilitation Sciences, University of Salford, United Kingdom
| | - Tanya Anne Mackenzie
- Department of Health, Sports, and Rehabilitation Sciences, University of Salford, United Kingdom
| | - Lee Herrington
- Department of Health, Sports, and Rehabilitation Sciences, University of Salford, United Kingdom
| | - Ian Horsley
- English Institute of Sport, Manchester, United Kingdom
| | - Ann M Cools
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Belgium
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Herrington L, Munro A, Comfort P. A preliminary study into the effect of jumping-landing training and strength training on frontal plane projection angle. ACTA ACUST UNITED AC 2015; 20:680-5. [PMID: 25920339 DOI: 10.1016/j.math.2015.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 03/26/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
The presence of increased knee valgus angles during functional tasks has been associated with a range of knee pathologies. A number of different exercise interventions have been undertaken to improve knee alignment during functional tasks. The most successful of these interventions are multi-modal incorporating both strength and jump-landing training. Little research has been undertaken to compare these elements individually to assess if success is due to an individual element or the training as a whole. The study assessed the between group effects of strength training or jump-landing training alone on knee valgus alignment during a number of functional tasks, using a cohort specific treatment superiority design. Thirty asymptomatic female participants undertook a 6 week (minimum 15 sessions) strength or jump-landing programme, the effects of which were examined by assessing for any change in frontal plane projection angle (FPPA) during single leg squat and landing and bilateral drop jump landing. Both training methods had positive effects of FPPA during some but not all of the tasks. Strength training brought about significant changes in FPPA during single leg squat and landing, whilst jump-landing training significantly influenced single leg landing and drop jump landing performance. The changes reported, therefore appear to be related to the nature of the training and the tasks undertaken during that training. The findings indicating that a combined training protocol incorporating both strengthening and jump-landing training may bring about the greatest improvement across a spectrum of tasks for the patient, supporting the previous work on multimodal training.
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Affiliation(s)
| | - Allan Munro
- School of Health Sciences, University of Bradford, UK
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Herrington L, Waterman R, Smith L. Electromyographic analysis of shoulder muscles during press-up variations and progressions. J Electromyogr Kinesiol 2015; 25:100-6. [DOI: 10.1016/j.jelekin.2014.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 07/25/2014] [Accepted: 10/04/2014] [Indexed: 11/24/2022] Open
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Munro A, Herrington L. The effect of videotape augmented feedback on drop jump landing strategy: Implications for anterior cruciate ligament and patellofemoral joint injury prevention. Knee 2014; 21:891-5. [PMID: 24950995 DOI: 10.1016/j.knee.2014.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 05/07/2014] [Accepted: 05/22/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Modification of high-risk movement strategies such as dynamic knee valgus is key to the reduction of anterior cruciate ligament (ACL) and patellofemoral joint (PFJ) injuries. Augmented feedback, which includes video and verbal feedback, could offer a quick, simple and effective alternative to training programs for altering high-risk movement patterns. It is not clear whether feedback can reduce dynamic knee valgus measured using frontal plane projection angle (FPPA). METHODS Vertical ground reaction force (vGRF), two-dimensional FPPA of the knee, contact time and jump height of 20 recreationally active university students were measured during a drop jump task pre- and post- an augmented feedback intervention. A control group of eight recreationally active university students were also studied at baseline and repeat test. RESULTS There was a significant reduction in vGRF (p=0.033), FPPA (p<0.001) and jump height (p<0.001) and an increase in contact time (p<0.001) post feedback in the intervention group. No changes were evident in the control group. CONCLUSION Augmented feedback leads to significant decreases in vGRF, FPPA and contact time which may help to reduce ACL and PFJ injury risk. However, these changes may result in decreased performance. CLINICAL RELEVANCE Augmented feedback reduces dynamic knee valgus, as measured via FPPA, and forces experienced during the drop jump task and therefore could be used as a tool for helping decrease ACL and PFJ injury risk prior to, or as part of, the implementation of injury prevention training programs.
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Relph N, Herrington L, Tyson S. The effects of ACL injury on knee proprioception: a meta-analysis. Physiotherapy 2014; 100:187-95. [DOI: 10.1016/j.physio.2013.11.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 11/25/2013] [Indexed: 11/26/2022]
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