Volume 49: Issue 4

Context:

The Landing Error Scoring System (LESS) is a clinical evaluation of jump-landing mechanics and may provide useful information in assisting with return-to-sport decisions in patients after anterior cruciate ligament reconstruction (ACLR). However, it is currently unknown how patients with ACLR perform on the LESS compared with healthy controls.

Objective:

To determine if the total LESS score differed between individuals with ACLR and healthy controls and to determine the types of errors that differ between groups.

Design:

Cross-sectional study.

Setting:

Research laboratory.

Patients or Other Participants:

A total of 27 individuals with unilateral ACLR (age = 19.8 ± 1.8 years, height = 170 ± 5.5 cm, mass = 68.8 ± 11.9 kg) and 27 controls (age = 20.5 ± 1.7 years, height = 169 ± 8.4 cm, mass = 66.6 ± 9.0 kg) with no history of ACLR.

Intervention(s):

Each participant completed 3 trials of a standardized jump-landing task.

Main Outcome Measure(s):

Each jump landing was assessed for specific postures using standardized LESS criteria by a blinded evaluator. Individual LESS items were summed to create a total LESS score. The dominant limb was assessed in the control group, and the reconstructed limb was assessed in the ACLR group.

Results:

The ACLR group had higher LESS scores compared with controls (ACLR: 6.7 ± 2.1 errors, control: 5.6 ± 1.5 errors, P = .04). Additionally, the ACLR group was more likely to err when landing with lateral trunk flexion (Fisher exact test, P = .002).

Conclusions:

Individuals with ACLR had worse landing mechanics as measured by the LESS. Lateral trunk deviation may be related to quadriceps avoidance in the reconstructed limb or poor trunk neuromuscular control. The LESS is useful for evaluating landing errors in patients with ACLR and may help to identify areas of focus during rehabilitation and before return to sport.

Context:

Upper quarter injuries have a higher incidence in female swimmers; however, to date, there are few ways to assess the basic functional ability of this region. The upper quarter Y balance test (YBT-UQ) may assist in this process because it was developed to provide a fundamental assessment of dynamic upper quarter ability at the limit of stability.

Objective:

To examine how sex affects performance on the YBT-UQ in swimmers.

Design:

Cohort study.

Patients or Other Participants:

Forty-three male and 54 female National Collegiate Athletic Association Division I college swimmers were recruited preseason.

Main Outcome Measure(s):

We measured YBT-UQ performance for the left and right limbs in the medial, inferolateral, and superolateral directions. The maximum score for each direction was normalized to upper extremity length. The average of the greatest normalized reach scores in each reach direction was used to develop a composite score (average distance in 3 directions/limb length [LL] × 100). To examine reach symmetry between sexes, the difference in centimeters between the left and right sides was calculated for each reach direction prior to normalization. Statistical analysis was conducted using an independent-samples t test (P < .05).

Results:

Average scores in the medial (women: 92.5 ± 7.4%LL, men: 100.0 ± 8.7%LL; P < .01) and inferolateral (women: 85.6 ± 10.3%LL, men: 89.8 ± 10.8%LL; P = .05) directions and composite score (women: 83.4 ± 8.3%LL, men: 88.3 ± 8.9%LL; P < .01) were higher in men than in women. No differences were observed for reach symmetry in any direction.

Conclusions:

Performance on several YBT-UQ indices was worse for female than male collegiate swimmers. These results may have implications for the use of preseason and return-to-sport testing in swimmers as a measurement of upper quarter function and symmetry.

Context:

The ingestion of carbohydrate (CHO) before and during exercise and at halftime is commonly recommended to soccer players for maintaining blood glucose concentrations throughout match play. However, an exercise-induced rebound glycemic response has been observed in the early stages of the second half of simulated soccer-specific exercise when CHO-electrolyte beverages were consumed regularly. Therefore, the metabolic effects of CHO beverage consumption throughout soccer match play remain unclear.

Objective:

To investigate the blood glucose and blood lactate responses to CHOs ingested before and during soccer match play.

Design:

Crossover study.

Setting:

Applied research study.

Patients or Other Participants:

Ten male outfield academy soccer players (age = 15.6 ± 0.2 years, height = 1.74 ± 0.02 m, mass = 65.3 ± 1.9 kg, estimated maximal oxygen consumption = 58.4 ± 0.8 mL·kg⁻¹·min⁻¹).

Intervention(s):

Players received a 6% CHO-electrolyte solution or an electrolyte (placebo) solution 2 hours before kickoff, before each half (within 10 minutes), and every 15 minutes throughout exercise. Blood samples were obtained at rest, every 15 minutes during the match (first half: 0–15, 15–30, and 30–45 minutes; second half: 45–60, 60–75, and 75–90 minutes) and 10 minutes into the halftime break.

Main Outcome Measure(s):

Metabolic responses (blood glucose and blood lactate concentrations) and markers of exercise intensity (heart rate) were recorded.

Results:

Supplementation influenced the blood glucose response to exercise (time × treatment interaction effect: P ≤ .05), such that glucose concentrations were higher at 30 to 45 minutes in the CHO than in the placebo condition. However, in the second half, blood glucose concentrations were similar between conditions because of transient reductions from peak values occurring in both trials at halftime. Blood lactate concentrations were elevated above those at rest in the first 15 minutes of exercise (time-of-sample effect: P < .001) and remained elevated throughout exercise. Supplementation did not influence the pattern of response (time × treatment interaction effect: P = .49).

Conclusions:

Ingestion of a 6% CHO-electrolyte beverage before and during soccer match play did not benefit blood glucose concentrations throughout the second half of exercise.

The University of Tennessee at Chattanooga was the site of a national conference April 15 and 16, 2014, held to discuss administrative practices that ensure the effectiveness of sports medicine programs at all levels of competition. The conference was sponsored by the National Athletic Trainers' Association and Erlanger Health System. Panel members consisted of 2 physicians, 9 athletic trainers, and a nonclinician advocate for young athletes; each was selected on the basis of established expertise relating to administrative standards for protecting student–athletes' health and welfare (Table).

Table. Members of the Select Panel on Safeguarding Student–Athlete Health and Welfare

Reliability and Validity of the Functional Assessment of Neurocognition in Sport (FANS): A Paradigm Shift in Post-Concussion Return-to-Sport Decision-Making

Landon B. LempkePhD, ATC,

Benjamin L. BrettPhD, and

Douglas P. TerryPhD,ABPP