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Paterno M.V.,Cincinnati Childrens Hospital Medical Center | Paterno M.V.,Sports Medicine Biodynamics Center and Human Performance Laboratory | Paterno M.V.,University of Cincinnati | Paterno M.V.,Health Science University | And 13 more authors.
Gait and Posture | Year: 2013

Postural sway is defined as the movement of a body's center of mass within the base of support to maintain postural equilibrium. Deficits in postural sway are present after ACL injury; however, current evidence linking it to future injury risk is unclear. The purpose of this study was to determine if postural sway deficits persist after ACL reconstruction (ACLR). The hypothesis tested was that after ACLR, patients who return to sport (RTS) would demonstrate differences in postural sway compared to control (CTRL) subjects. Fifty-six subjects with unilateral ACLR released to RTS, and 42 uninjured CTRL subjects participated. Dynamic postural sway was assessed and 3-way (2. ×. 2. ×. 2) ANOVA was used to analyze the variables. A side. ×. group. ×. sex (. p=. 0.044) interaction in postural sway was observed. A side. ×. group analysis also revealed an interaction (. p=. 0.04) however, no effect of sex was observed (. p=. 0.23). Analysis within the ACLR cohort showed less (. p=. 0.001) postural sway on the involved side (1.82. ±. 0.84°) versus the uninvolved side (2.07. ±. 0.96°). No side-to-side differences (. p=. 0.73) were observed in the CTRL group. The involved limb of subjects after ACLR demonstrated the least postural sway. In conclusion, these findings indicate that dynamic postural sway may be significantly altered in a population of athletes after ACLR and RTS compared to CTRL subjects. Further investigation is needed to determine if deficits in postural sway can be used as an effective criterion to assist in the decision to safely RTS after ACLR. © 2012 Elsevier B.V.

Sugimoto D.,Cincinnati Childrens Hospital Medical Center | Sugimoto D.,Sports Medicine Biodynamics Center and Human Performance Laboratory | Sugimoto D.,Michele Center for Sports Injury Prevention | Sugimoto D.,Boston Childrens Hospital | And 10 more authors.
Journal of Strength and Conditioning Research | Year: 2014

Recent studies demonstrate the link between reduced hip abductor strength and increased risk for knee injury such as patellofemoral pain syndrome in women athletes. Meta-analytic reports indicate that the efficacy of integrative neuromuscular training (INT) is associated with compliance to the prescribed programming. Thus, the purpose was to investigate the compliance effects of a trunk and hip-focused INT exercises on hip abductor strength in young women athletes. In a controlled laboratory study design, 21 high school women volleyball players (mean age = 15.6 ± 1.4 years, weight = 64.0 ± 7.4 kg, height = 171.5 ±7.0 cm) completed isokinetic hip abductor strength testing in pre- and postintervention, which consisted of 5 phases of supervised progressive trunk and hip-focused INT exercises twice a week for 10 weeks. The compliance effects were analyzed based on the changed hip abductor strength values between pre- and postintervention and 3 different compliance groups using 1-way analysis of variance and Pearson's correlation coefficients. The participants in the high-compliance group demonstrated significant hip abductor peak torque increases compared with noncompliance group (p = 0.02), but not between moderate-compliance and noncompliance groups (p = 0.27). The moderate correlation coefficient value (r = 0.56) was recorded between the isokinetic hip abductor peak torque changes and the 3 compliance groups. Because of the observed significant effects and moderate linear association, the effectiveness of a trunk and hip-focused INT protocol to improve hip abduction strength seems dependent on compliance. Compliance of trunk and hip-focused INT is an important aspect of increasing hip abductor strength increase in young women athletes. © 2014 National Strength and Conditioning Association.

Sugimoto D.,Micheli Center for Sports Injury Prevention | Sugimoto D.,Boston Childrens Hospital | Sugimoto D.,Cincinnati Childrens Hospital Medical Center | Sugimoto D.,Sports Medicine Biodynamics Center and Human Performance Laboratory | And 13 more authors.
Sports Medicine | Year: 2014

Background: Although a series of meta-analyses demonstrated neuromuscular training (NMT) is an effective intervention to reduce anterior cruciate ligament (ACL) injury in female athletes, the potential existence of a dosage effect remains unknown. Objective: Our objective was to systematically review previously published clinical trials and evaluate potential dosage effects of NMT for ACL injury reduction in female athletes. Design: This study took the form of a meta- and sub-group analysis. Setting: The keywords 'knee', 'anterior cruciate ligament', 'ACL', 'prospective', 'neuromuscular', 'training', 'female', and 'prevention' were utilized in PubMed and EBSCO host for studies published between 1995 and May 2012. Participants: Inclusion criteria set for studies in the current analysis were (i) recruited female athletes as subjects, (ii) documented the number of ACL injuries, (iii) employed an NMT intervention aimed to reduce ACL injuries, (iv) had a control group, (v) used a prospective control trial design, and (vi) provided NMT session duration and frequency information. Main outcome measures: The number of ACL injuries and female athletes in each group (control and intervention) were compared based on duration, frequency, and volume of NMT via odds ratios (ORs). Results: A total of 14 studies were reviewed. Analyses that compared the number of ACL injuries with short versus long NMT duration showed greater ACL injury reduction in female athletes who were in the long NMT duration group (OR 0.35, 95 % CI 0.23-0.53, p = 0.001) than in those in the short NMT duration group (OR 0.61, 95 % CI 0.41-0.90, p = 0.013). Analyses that compared single versus multi NMT frequency indicated greater ACL injury reduction in multi NMT frequency (OR 0.35, 95 % CI 0.23-0.53, p = 0.001) compared with single NMT frequency (OR 0.62, 95 % CI 0.41-0.94, p = 0.024). Combining the duration and frequency of NMT programs, an inverse dose-response association emerged among low (OR 0.66, 95 % CI 0.43-0.99, p = 0.045), moderate (OR 0.46, 95 % CI 0.21-1.03, p = 0.059), and high (OR 0.32, 95 % CI 0.19-0.52, p = 0.001) NMT volume categories. Conclusions: The inverse dose-response association observed in the subgroup analysis suggests that the higher the NMT volume, the greater the prophylactic effectiveness of the NMT program and increased benefit in ACL injury reduction among female athletes. © 2013 Springer International Publishing Switzerland.

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