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Background: Exercise-based rehabilitation targeting intersegmental control has high success rates and fast recovery times in the management of athletic groin pain (AGP). The influence of this approach on hip strength and lower limb reactive strength and how these measures compare with uninjured athletes (CON) remain unknown. Additionally, the efficacy of this program after return to play (RTP) has not been examined. Purpose: First, to examine differences in isometric hip strength, reactive strength, and the Hip and Groin Outcome Score (HAGOS) between the AGP and CON cohorts and after rehabilitation; second, to examine the relationship between the change in HAGOS and the change in strength variables after rehabilitation; last, to track HAGOS for 6 months after RTP. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 42 athletes diagnosed with AGP and 36 matched controls completed baseline testing: isometric hip strength, lower limb reactive strength, and HAGOS. After rehabilitation, athletes with AGP were retested, and HAGOS was collected at 3 and 6 months after RTP. Results: In total, 36 athletes with AGP completed the program with an RTP time of 9.8 ± 3.0 weeks (mean ± SD). At baseline, these athletes had significantly lower isometric hip strength (abduction, adduction, flexion, extension, external rotation: d = –0.67 to −1.20), single-leg reactive strength ( d = −0.73), and HAGOS ( r = −0.74 to −0.89) as compared with the CON cohort. Hip strength ( d = −0.83 to −1.15) and reactive strength ( d = −0.30) improved with rehabilitation and were no longer significantly different between groups at RTP. HAGOS improvements were maintained or improved in athletes with AGP up to 6 months after RTP, although some subscales remained significantly lower than the CON group ( r = −0.35 to −0.51). Two linear regression features (hip abduction and external rotation) explained 11% of the variance in the HAGOS Sports and Recreation subscale. Conclusion: Athletes with AGP demonstrated isometric hip strength and reactive strength deficits that resolved after an intersegmental control rehabilitation program; however, improved hip strength explained only 11% of improvement in the Sports and Recreation subscale. HAGOS improvements after pain-free RTP were maintained at 6 months.

Sport scientists could benefit from knowing about the processes underpinning machine learning (ML) and its practical applications, as it has substantial implications for our field. ML has already h...

Background: Performance measures such as strength, jump height/length, and change of direction (CoD) time during anterior cruciate ligament (ACL) rehabilitation have been used to determine readiness to return to play and identify those who may be at risk of rerupture. However, athletes may reach these criteria despite ongoing biomechanical deficits when performing these tests. Combining return-to-play criteria with an assessment of movement through 3-dimensional (3D) biomechanics in male field sports athletes to identify risk factors for ACL rerupture has not been explored previously. Purpose: To prospectively examine differences in strength, jump, and CoD performance and movement using 3D biomechanics in a cohort of male athletes playing level 1 sports (ie, multidirectional field sports that involve landing, pivoting, or CoD) between those who reinjured the reconstructed ACL (RI group) and those with no reinjury (NRI group) after 2 years of follow-up and to examine the ability of these differences to predict reinjury. Study Design: Cohort study; Level of evidence, 2. Methods: After primary ACL reconstruction (ACLR), 1045 male athletes were recruited and underwent testing 9 months after surgery including isokinetic strength, jump, and CoD performance measures as well as patient-reported outcomes and 3D biomechanical analyses. Participants were followed up after 2 years regarding ACL reinjury status. Differences were determined between the RI and NRI groups in patient-reported outcomes, performance measures, and 3D biomechanics on the ACLR side and symmetry between limbs. The ability of these measures to predict ACL reinjury was determined through logistic regression. Results: No differences were identified in strength and performance measures on the ACLR side or in symmetry. Biomechanical analysis indicated differences on the ACLR side primarily in the sagittal plane for the double-leg drop jump (effect size, 0.59-0.64) and greater asymmetry primarily in the frontal plane during unplanned CoD (effect size, 0.61-0.69) in the RI group. While these biomechanical test results were different between groups, multivariate regression modeling demonstrated limited ability (area under the curve, 0.67 and 0.75, respectively) to prospectively predict ACL reinjury. Conclusion: Commonly reported return-to-play strength, jump, and timed CoD performance measures did not differ between the RI and NRI groups. Differences in movement based on biomechanical measures during double-leg drop jump and unplanned CoD were identified, although they had limited ability to predict reinjury. Targeting these variables during rehabilitation may reduce reinjury risk in male athletes returning to level 1 sports after ACLR. Registration: NCT02771548 (ClinicalTrials.gov identifier).

Background:Psychological factors including self-reported readiness to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) measured with the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scale have been shown to correlate with RTS. Physical deficits have been shown to exist in the later stages after ACLR rehabilitation. No previous studies have investigated the relationship between self-reported readiness to RTS and objective physical measures of power and strength.Purpose:To investigate the relationship between ACL-RSI scores and measures of strength and power scores after ACLR.Study Design:Case control study; Level of evidence, 3.Methods:This study recruited 452 male athletes who had undergone primary ACLR. Each athlete completed the ACL-RSI questionnaire, isokinetic strength testing, and jump testing approximately 9 months after surgery.Results:ACL-RSI scores showed a trivial or weak correlation with strength and power measures at 9 months after surgery ( r = 0.06-0.16). Similar results were found for the relationship between ACL-RSI scores and limb symmetry index for strength and power measures ( r = 0.04-0.15). Comparing the strength and power measures of athletes with higher (≥90) ACL-RSI scores (n = 93) versus athletes with lower (≤75) ACL-RSI scores (n = 92) showed no significant differences except for isokinetic hamstring strength, but with a trivial effect size ( P = .040; effect size = 0.15).Conclusion:Self-reported readiness to RTS as measured by the ACL-RSI had little or no relationship with athletes’ strength and power measures, and there was no meaningful difference in strength and power between athletes with higher and lower ACL-RSI scores at 9 months after ACLR. The findings suggest that psychological recovery and physical recovery after ACLR are different constructs, and strategies to measure and address each construct separately may be necessary to ensure successful RTS after ACLR.

Classification algorithms determine the similarity of an observation to defined classes, e.g., injured or healthy athletes, and can highlight treatment targets or assess progress of a treatment. The primary aim was to cross-validate a previously developed classification algorithm using a different sample, while a secondary aim was to examine its ability to predict future ACL injuries. The examined outcome measure was 'healthy-limb' class membership probability, which was compared between a cohort of athletes without previous or future (No Injury) previous (PACL) and future ACL injury (FACL). The No Injury group had significantly higher probabilities than the PACL (p < 0.001; medium effect) and FACL group (p ≤ 0.045; small effect). The ability to predict group membership was poor for the PACL (area under curve [AUC]; 0.61

Objectives To report ACL-RSI scores in healthy athletes with no history of ACL injury. To measure ACL-RSI scores at nine-months post-ACL reconstruction and to assess the difference between healthy athlete and patient responses. Design Cross-sectional study. Setting Private sports clinic. Participants 499 ACL reconstruction athletes completed the scale as they returned for their nine-month post-operative review appointment. A matched control group of 103 healthy athletes were selected for comparison. Main outcome measures ACL-RSI for participants with controls completing a study-specific modified scale. Results The median response to the ACL-RSI for the control group was higher (80.0) (Interquartile Range (IRQ) 66.7–88.3) than that of the ACL reconstruction group (74.17) (IRQ 59.2–86.0), however the effect size was small (0.1). Conclusion This study reports normative values for uninjured athletes using the ACL-RSI questionnaire giving a benchmark for recovery after ACLR but also reflecting awareness of injury risk in uninjured athletes. ACL-RSI scores nine-months post-operatively had not yet returned to levels seen in matched uninjured controls.

Background: Athletes are twice as likely to rupture the anterior cruciate ligament (ACL) on their healthy contralateral knee than the reconstructed graft after ACL reconstruction (ACLR). Although physical testing is commonly used after ACLR to assess injury risk to the operated knee, strength, jump, and change-of-direction performance and biomechanical measures have not been examined in those who go on to experience a contralateral ACL injury, to identify factors that may be associated with injury risk. Purpose: To prospectively examine differences in biomechanical and clinical performance measures in male athletes 9 months after ACLR between those who ruptured their previously uninjured contralateral ACL and those who did not at 2-year follow-up and to examine the ability of these differences to predict contralateral ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: A cohort of male athletes returning to level 1 sports after ACLR (N = 1045) underwent isokinetic strength testing and 3-dimensional biomechanical analysis of jump and change-of-direction tests 9 months after surgery. Participants were followed up at 2 years regarding return to play or at second ACL injury. Between-group differences were analyzed in patient-reported outcomes, performance measures, and 3-dimensional biomechanics for the contralateral limb and asymmetry. Logistic regression was applied to determine the ability of identified differences to predict contralateral ACL injury. Results: Of the cohort, 993 had follow-up at 2 years (95%), with 67 experiencing a contralateral ACL injury and 38 an ipsilateral injury. Male athletes who had a contralateral ACL injury had lower quadriceps strength and biomechanical differences on the contralateral limb during double- and single-leg drop jump tests as compared with those who did not experience an injury. Differences were related primarily to deficits in sagittal plane mechanics and plyometric ability on the contralateral side. These variables could explain group membership with fair to good ability (area under the curve, 0.74-0.80). Patient-reported outcomes, limb symmetry of clinical performance measures, and biomechanical measures in change-of-direction tasks did not differentiate those at risk for contralateral injury. Conclusion: This study highlights the importance of sagittal plane control during drop jump tasks and the limited utility of limb symmetry in performance and biomechanical measures when assessing future contralateral ACL injury risk in male athletes. Targeting the identified differences in quadriceps strength and plyometric ability during late-stage rehabilitation and testing may reduce ACL injury risk in healthy limbs in male athletes playing level 1 sports. Clinical Relevance: This study highlights the importance of assessing the contralateral limb after ACLR and identifies biomechanical differences, particularly in the sagittal plane in drop jump tasks, that may be associated with injury to this limb. These factors could be targeted during assessment and rehabilitation with additional quadriceps strengthening and plyometric exercises after ACLR to potentially reduce the high risk of injury to the previously healthy knee. Registration: NCT02771548 ( ClinicalTrials.gov identifier).

Athletic groin pain (AGP) is a chronic, painful condition which is prevalent in players of field sports that require rapid changes of direction. Following successful rehabilitation, systematic changes have been observed in the kinetics and kinematics of pre-planned change of direction manoeuvres, providing insight into potential foci for rehabilitation monitoring and for the assessment of interventions. However, changing direction in field sports is often reactive rather than pre-planned, and it is not known whether such post-rehabilitation changes are seen in reactive manoeuvres. We analysed the stance phase kinetics and kinematics of a 90° reactive cutting manoeuvre in 35 AGP patients before and after a successful exercise intervention programme. Following the intervention, transverse plane rotation of the pelvis towards the intended direction of travel increased, and the body centre of mass was positioned more anteriorly relative to the centre of pressure. Ankle dorsiflexion also increased, and participants demonstrated greater ankle plantar flexor internal moment and power during the second half of stance. These findings provide insight into mechanical variables of potential importance in AGP, as identified during a manoeuvre based on a common sporting task.

Objectives To report the consistency in movement strategy selection in athletic groin pain patients and to assess whether there are differences in consistency between athletic groin pain patients and healthy athletes. Design Cross sectional exploratory study. Methods Twenty athletic groin pain patients and 21 healthy athletes performed 15 repetitions of 110° change of direction task. Lower limb and trunk kinematics alongside ground reaction forces were collected. A correlation-to-mean algorithm was used to allocate each trial to a movement strategy using kinematic and kinetic features. Mann–Whitney U tests were used to compare the frequency of the most selected strategy (i.e. consistency) and fuzziness between athletic groin pain patients and healthy athletes. Chi-squared tests were used to compare the strategy selection between athletic groin pain patients and healthy athletes. Results There were no differences between groups in consistency in movement strategy selection (>80%). Athletic groin pain patients tended to select a knee dominant movement strategy whereas healthy athletes preferred an ankle dominant movement strategy. Conclusions The consistency observed in athletic groin pain patients supports the implementation of movement strategy assessments to inform AGP rehabilitation programmes tailored to athletes’ deficiencies. Such assessments could help enhance the success of athletic groin pain rehabilitation. Differences in movement strategy selection might not be associated with injury state since there were no differences between athletic groin pain patients and healthy athletes.

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Introduction: Previous studies examining jump tasks after anterior cruciate ligament reconstruction (ACLR) have focused on performance measures without examining joint kinematic and kinetic variables. The aim of this study was to identify differences in biomechanical and performance measures between limbs across tests 9 months after surgery. Methods: Four jump tests (double-leg drop jump (DLDJ), single-leg drop jump (SLDJ), single-leg hop for distance (SLHD) and hurdle hop (HH)) were carried out on 156 male subjects in a 3D motion capture laboratory 9 months after surgery. Statistical parametric mapping was used to identify differences in jump performance and biomechanical variables between limbs. Results: Biomechanical measures were lower on the ACLR side across all four tests for internal knee valgus moment (effect size (ES) 0.77-0.92), knee internal rotation angle (ES 0.59-0.8), and ankle external rotation moment (ES 0.59-0.73), with the center of mass less posterior to the knee during the single-leg tests (ES 0.61-0.82). The timing of the largest difference between limbs was not at the same % stance between variables within a test or for any variable across tests. Large ES differences were observed in performance in the SLDJ (ES 0.73-0.81; LSI 78%) and small differences in the SLHD (ES 0.36; LSI 94%) between the limbs. Conclusion: Findings highlighted biomechanical differences between limbs which are consistent across jump tasks suggesting insufficient rehabilitation at 9 months post surgery. Results indicate that the SLDJ may identify greater performance deficits between limbs than SLHD, which may over-estimate rehabilitation status.

Whyte, EF, Richter, C, O'Connor, S, and Moran, KA. Investigation of the effects of high-intensity, intermittent exercise and unanticipation on trunk and lower limb biomechanics during a side-cutting maneuver using statistical parametric mapping. J Strength Cond Res 32(6): 1583-1593, 2018-Anterior cruciate ligament (ACL) injuries frequently occur during side-cutting maneuvers when fatigued or reacting to the sporting environment. Trunk and hip biomechanics are proposed to influence ACL loading during these activities. However, the effects of fatigue and unanticipation on the biomechanics of the kinetic chain may be limited by traditional discrete point analysis. We recruited 28 male, varsity, Gaelic footballers (21.7 ± 2.2 years; 178.7 ± 14.6 m; 81.8 ± 11.4 kg) to perform anticipated and unanticipated side-cutting maneuvers before and after a high-intensity, intermittent exercise protocol (HIIP). Statistical parametric mapping (repeated-measures analysis of varience) identified differences in phases of trunk and stance leg biomechanics during weight acceptance. Unanticipation resulted in less trunk flexion (p < 0.001) and greater side flexion away from the direction of cut (p < 0.001). This led to smaller (internal) knee flexor and greater (internal) knee extensor (p = 0.002-0.007), hip adductor (p = 0.005), and hip external rotator (p = 0.007) moments. The HIIP resulted in increased trunk flexion (p < 0.001) and side flexion away from the direction of cut (p = 0.038), resulting in smaller (internal) knee extensor moments (p = 0.006). One interaction effect was noted demonstrating greater hip extensor moments in the unanticipated condition post-HIIP (p = 0.025). Results demonstrate that unanticipation resulted in trunk kinematics considered an ACL injury risk factor. A subsequent increase in frontal and transverse plane hip loading and sagittal plane knee loading was observed, which may increase ACL strain. Conversely, HIIP-induced trunk kinematic alterations resulted in reduced sagittal plane knee and subsequent ACL loading. Therefore, adequate hip and knee control is important during unanticipated side-cutting maneuvers.

BackgroundClinical assessments and rehabilitation in athletic groin pain (AGP) have focused on specific anatomical structures and uniplanar impairments rather than whole body movement.ObjectiveTo examine the effectiveness of rehabilitation that targeted intersegmental control in patients with AGP and to investigate post rehabilitation changes in cutting biomechanics.MethodsTwo hundred and five patients with AGP were rehabilitated focusing on clinical assessment of intersegmental control, linear running and change of direction mechanics in this prospective case series. Hip and Groin Outcome Score (HAGOS) was the primary outcome measure. Secondary measures included pain-free return to play rates and times, pain provocation on squeeze tests and three-dimensional (3D) biomechanical analysis during a 110° cutting manoeuvre.ResultsFollowing rehabilitation, patients demonstrated clinically relevant improvements in HAGOS scores (effect size (ES): 0.6–1.7). 73% of patients returned to play pain-free at a mean of 9.9 weeks (±3.5). Squeeze test values also improved (ES: 0.49–0.68). Repeat 3D analysis of the cutting movement demonstrated reductions in ipsilateral trunk side flexion (ES: 0.79) and increased pelvic rotation in the direction of travel (ES: 0.76). Changes to variables associated with improved cutting performance: greater centre of mass translation in the direction of travel relative to centre of pressure (ES: 0.4), reduced knee flexion angle (ES: 0.3) and increased ankle plantar flexor moment (ES: 0.48) were also noted.ConclusionsRehabilitation focused on intersegmental control was associated with improved HAGOS scores, high rates of pain-free return to sporting participation and biomechanical changes associated with improved cutting performance across a range of anatomical diagnoses seen in AGP.

This study examines the ability of commonly used supervised learning techniques to classify the execution of a maximum effort change of direction task into predefined movement pattern as well as the influence of fuzzy executions and the impact of selected features (e.g. peak knee flexion) towards classification accuracy. The experiment utilized kinematic and kinetic data from 323 male subjects with chronic athletic groin pain. All subjects undertook a biomechanical assessment and had been divided previously into 3 different movement strategies in an earlier paper. Examined supervised learning techniques were: a decision tree, an ensemble of decision trees, a discriminant analysis model, a naive Bayes classifier, a k-nearest-neighbour model, a multi-class model for support vector machines, a stepwise forward regression model, a neural network and a correlation approach. Performance (measured by comparing the predefined and classified movement pattern) was highest for the correlation approach (82% - CI 81-83%) and support vector machine (80% - CI 79-80%). The percentage of fuzzy observations within the data was between 16 and 25%. The most informative features for classification were: hip flexion and ankle rotation as well as ankle flexion moment, thorax [flexion and frontal sway], abduction angle in [hip and pelvis] and hip rotation. Findings of this study support the assumption that multiple patterns are used to execute a movement task and demonstrate that classification models can predict movement patterns with a high accuracy (~84%).

We investigated the effects of high intensity, intermittent exercise (HIIP) and anticipation on trunk, pelvic and lower limb biomechanics during a crossover cutting manoeuvre. Twenty-eight male, varsity athletes performed crossover cutting manoeuvres in anticipated and unanticipated conditions pre- and post-HIIP. Kinematic and kinetic variables were captured using a motion analysis system. Statistical parametric mapping (repeated-measures ANOVA) was used to identify differences in biomechanical patterns. Results demonstrated that both unanticipation and fatigue (HIIP) altered the biomechanics of the crossover cutting manoeuvre, whereas no interactions effects were observed. Unanticipation resulted in less trunk and pelvic side flexion in the direction of cut (d = 0.70 - 0.79). This led to increased hip abductor and external rotator moments and increased knee extensor and valgus moments with small effects (d = 0.24-0.42), potentially increasing ACL strain. The HIIP resulted in trivial to small effects only with a decrease in internal knee rotator and extensor moment and decreased knee power absorption (d = 0.35), reducing potential ACL strain. The effect of trunk and hip control exercises in unanticipated conditions on the crossover cutting manoeuvre should be investigated with a view to refining ACL injury prevention programmes.

Digital, Purpose: The purpose of this study was to assess the interchangeability of position tracking metrics obtained using global positioning systems (GPS) versus those obtained by a semi-automatic high definition (HD) optical camera system. Methods: Data was collected from a cohort of 29 elite football players (age: 23.1 ± 5.1 years, height: 180.4 ± 5.8 cm, mass: 74.6 ± 6.7 kg) in four matches played in four different stadiums. In two matches 10 Hz GPS (GPS-1, StatSports, Belfast, UK) were used, while in the other two matches augmented 10 Hz GPS (GPS-2, StatSports, Belfast, UK) were used. All four matches were analysed concomitantly using six semi-automated HD motion cameras sampling at 25 Hz (TRACAB, Chyronhego, New York, USA). Results: Mean bias was between 6% and 10% for GPS-1 and 1–4% for GPS-2, respectively. No proportional bias was found (p > 0.184). The SEE within calibration functions (expressed in % to mean) was between 5% and 22% for GPS-1 and 4–14% for GPS-2. While some significant differences existed between GPS-1 and TRACAB (total distance and high-speed), positional tracking variables were highly correlated between GPS-1, GPS-2 and TRACAB (r2 > 0.92) with GPS-2 displaying stronger correlations (> r2 = 0.96). Conclusion: In the present study augmented GPS technology (GPS-2) and the TRACAB camera system provided interchangeable measures of positional tracking metrics to allow concurrent assessment and monitoring of training and competition in football players. However, we recommend practitioners evaluate their own systems to identify where errors exist, calculate and apply the regression equations to confidently interchange data.

This study sought to investigate the kinematic and kinetic variables that change in patients with athletic groin pain (AGP) after a successful exercise intervention. The kinematic and kinetic measures of subjects with AGP (n = 65) that completed a lateral hurdle hop, pre and post an exercise rehabilitation program were compared to a control group of matched uninjured individuals (n = 50). Analysis of Characterising Phases was used to identify differences in kinematic and kinetic measures between the groups. AGP subjects returned to pain-free participation in sport in a median time of 9.14 weeks (5.14‐29.0). In total 18 different biomechanical variables were significantly different between the AGP group and the uninjured group pre-rehabilitation. Of these, seven variables were no longer significantly different between the AGP group post-rehabilitation and the uninjured group. These seven variables may represent the factors most related to return to play in this cohort and are potential targets for rehabilitation.

Welch, N, Richter, C, Moran, K, and Franklyn-Miller, A. Principal component analysis of the associations between kinetic variables in cutting and jumping, and cutting performance outcome. J Strength Cond Res 35(7): 1848-1855, 2021-The primary aim of this study was to determine which features within the ground reaction force (GRF) trace during cutting are related to performance outcome in different angled cuts. The secondary aim was to understand the relationship between GRF features in a series of maximum strength, explosive strength, and reactive strength tests, and cutting performance outcome. Twenty-five male intercounty Gaelic football players (23.5 ± 4.2 years, 183 ± 6 cm, and 83 ± 6.9 kg) participated in the study. Subjects completed 110 and 45° cutting tasks, single leg squat jumps, drop landings, drop jumps, and isometric midthigh pulls. A principal component (PC) analysis and simulation approach were applied to the data and correlations between PCs and cutting performance outcome measured. Lower vertical to horizontal impulse ratios (r = -0.70 to -0.46) in both cuts and greater forces over the first 50 ms of ground contact (r = -0.44) in the 110° cut correlated with enhanced cutting performance outcomes. Greater reactive strength index and height in the drop jump (r = -0.51 and -0.54) and greater impulses over the first 25 ms of ground contact in the drop landing (r = 0.49 and 0.70) correlated with enhanced cutting performance outcomes. These results highlight the importance of greater horizontal and rapid force production in cutting and greater reactive strength qualities to enhance cutting performance.

Background: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy. Methods: 322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering. Results: Three subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain. Conclusions: We identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task. These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms. Trial registration number NCT02437942, pre results.

Crowdfunding represents an alternative way of funding entrepreneurial ventures – and is attracting a high amount of interest in research as well as practice. Against this background, this paper analyzes reward-based crowdfunding campaign strategies and their communication tools. To do this, 446 crowdfunding projects were gathered and empirically analyzed. Three different paths of successful crowdfunding projects could be identified and are described in detail. Practical implications of crowdfunding strategies are derived, and are dependent on the required sales effort and the project added value. The terms communicator, networker and self-runner are created for this crowdfunding strategy and filled with practical examples. This paper contributes to the literature in different ways: first, it sheds more light on the developing concept of crowdfunding, with an overview of current academic discussions on crowdfunding. Furthermore, the analysis of success factors for crowdfunding initiatives adds to an emerging area of research and allows entrepreneurs to extract best practice examples for increasing the probability of successful crowdfunding projects under consideration of the key influencing factors of communication.

Background: Patient-reported outcomes and return-to-play (RTP) rates are inferior after revision anterior cruciate ligament reconstruction (ACLR) compared with primary ACLR. Physical properties such as maximal, explosive, and reactive strength influence reinjury and RTP rates after ACLR. No study has compared these outcomes between revision and primary ACLR. Purpose: To compare maximal, explosive, and reactive strength of the ACLR limb, as well as patient-reported outcomes and RTP rates between primary and revision ACLR at 9 months after surgery. Study Design: Cohort study; Level of evidence, 2. Methods: A comparative study was performed at 9 months after surgery for 344 male athletes who had undergone ACLR (298 primary, 46 revision). Maximal strength of the ACLR limb was measured by means of isokinetic dynamometry. Explosive strength was measured by use of single-leg countermovement jump height, and reactive strength was measured by single-leg drop jump. Patient-reported outcomes and responses to RTP questionnaires were recorded for both groups. Results: The primary ACLR group had higher scores than the revision ACLR group for single-leg countermovement jump height ( P = .02) and single-leg drop jump reactive strength index ( P = .01) on the ACLR limb. No significant difference was observed between groups on maximal strength of the quadriceps or hamstring, and no significant difference in limb symmetry index was observed between groups on any strength or jump test. The primary ACLR group demonstrated higher scores on the Marx Activity Rating Scale ( P = .03) and the Anterior Cruciate Ligament–Return to Sport after Injury scale ( P < .001). Athletes in the primary ACLR group were more likely to have returned to sport ( P < .001). Conclusion: At 9 months after surgery, athletes who had undergone revision ACLR achieved maximal strength similar to that of athletes who had undergone primary ACLR. However, athletes who had revision ACLR demonstrated lower scores on explosive and reactive strength tests. Athletes who underwent revision ACLR had lower RTP rates at 9 months after surgery, potentially due to explosive and reactive strength deficits and lower perceived readiness for RTP.

This study discusses possible sources of discrepancy between findings of previous human motion studies and presents a framework that seeks to address these issues. Motion analysis systems are widely employed to identify movement deficiencies - e.g. patterns that potentially increase the risk of injury or inhibit performance. However, findings across studies are often conflicting in respect to what a movement deficiency is or the magnitude of the relationship to a specific injury. To test the information content of movement data, a framework was build to differentiate between movements performed by a control (NORM) and abnormal (IMP-L and IMP-C) cohort using solely movement data. Movement data was recorded during jumping, hopping and change of direction exercises and was mathematically decomposed into subject scores. Subjects scores were then used to identify the most appropriate machine learning technique, which was subsequently utilized to create a prediction model that classified if a movement was performed by: IMP-L, IMP-C or NORM. The Monte Carlo method was used to obtain a measure of expected accuracy for each step within the analysis. Findings demonstrate that even the worst classification model outperformed the best guess observed and that not all members of the NORM group represent a NORM pattern as they were repeatedly classified as IMP-L or IMP-C. This highlights that some NORM limbs share movement characteristics with the abnormal group and consequently should not be considered when describing NORM.

The purpose of this study was to investigate the benefit of landmark registration when applied to waveform data. We compared the ability of data reduced from time-normalised and landmark registered vertical ground reaction force (vGRF) waveforms captured during maximal countermovement jumps (CMJ) of 53 active male subjects to predict jump height. vGRF waveforms were landmark registered using different landmarks resulting in four registration conditions: (i) end of the eccentric phase, (ii) adding maximum centre of mass (CoM) power, (iii) adding minimum CoM power, (iv) adding minimum vGRF. In addition to the four registration conditions, the non-registered vGRF and concentric phase only were time-normalised and used in subsequent analysis. Analysis of characterising phases was performed to reduce the vGRF data to features that captured the behaviour of each waveform. These features were extracted from each condition’s vGRF waveform, time-domain (time taken to complete the movement), and warping functions (generated from landmark registration). The identified features were used as predictor features to fit a step-wise multilinear regression to jump height. Features generated from the best performing registration condition were able to predict jump height to a similar extent as the concentric phase (86–87%), while all registration conditions could explain jump height to a greater extent than time-normalisation alone (65%). This suggests waveform variability was reduced as phases of the CMJ were aligned. However, findings suggest that over-registration can occur when applying landmark registration. Overall, landmark registration can improve prediction power to performance measures as waveform data can be reduced to more appropriate performance related features.

Athletic groin pain (AGP) is a common injury prevalent in field sports. One biomechanical measure that may be of importance for injury risk is stiffness. To date, [corrected] however, stiffness has not been examined in AGP. The primary aim was to determine whether AGP affects vertical and joint stiffness and if so, whether successful rehabilitation is associated with a change in stiffness. Sixty-five male patients with AGP and fifty male controls were recruited to this study. Assessment included a biomechanical examination of stiffness during a lateral hurdle hop test. Subjects with AGP were tested pre- and post-rehabilitation, while controls were tested once. AGP subjects were cleared for return to play in a median time of 9.14 weeks (5.14-29.0). Stiffness was significantly different at pre-rehabilitation in comparison with controls for three [corrected] of the ten stiffness values examined: ankle plantar flexor, knee extensor, hip abductor, and vertical stiffness (P < .05, D = 0.38-0.81). [corrected]. Despite clearance for return to play, of these four variables, only hip abductor stiffness changed significantly from pre- to post-rehabilitation (P = .05, D = 0.36) [corrected] to become non-significantly different to the uninjured group (P = .23, D = 0.23). [corrected]. These findings suggest that hip abductor stiffness may represent a target for AGP rehabilitation. Conversely, given the clearance for return to play, the lower sagittal plane and vertical stiffness in the AGP group in comparison with the uninjured controls likely represents either a compensatory mechanism to reduce the risk of further injury or a consequence of neuromuscular detraining.

Motion analysis technologies have been widely used to monitor the potential for injury and enhance athlete performance. However, most of these technologies are expensive, can only be used in laboratory environments, and examine only a few trials of each movement action. In this paper, we present a novel ambulatory motion analysis framework using wearable inertial sensors to accurately assess all of an athlete's activities in real training environment. We first present a system that automatically classifies a large range of training activities using the discrete wavelet transform (DWT) in conjunction with a random forest classifier. The classifier is capable of successfully classifying various activities with up to 98% accuracy. Second, a computationally efficient gradient descent algorithm is used to estimate the relative orientations of the wearable inertial sensors mounted on the shank, thigh, and pelvis of a subject, from which the flexion-extension knee and hip angles are calculated. These angles, along with sacrum impact accelerations, are automatically extracted for each stride during jogging. Finally, normative data are generated and used to determine if a subject's movement technique differed to the normative data in order to identify potential injury-related factors. For the joint angle data, this is achieved using a curve-shift registration technique. It is envisaged that the proposed framework could be utilized for accurate and automatic sports activity classification and reliable movement technique evaluation in various unconstrained environments for both injury management and performance enhancement.

We demonstrate a wearable ambulatory analysis framework that could be used to evaluate running asymmetry, day-to-day during unconstrained training. The system can automatically differentiate running from other training movement tasks, and extract all of the runner's associated step-cycles (heel-strike to heel-strike). We evaluate the system's ability in 21 participants who have artificially induced asymmetry. Impact accelerations differentiate asymmetry more effectively than angular velocities (gyroscope), and tibial inertial sensors differentiate more effectively than sensors attached to the thigh.

The effectiveness of vertical drop jumps (VDJs) to screen for non-contact ACL injuries is unclear. This may be contributed to by discrete point analysis, which does not evaluate patterns of movement. Also, limited research exists on the second landing of VDJs, potential lower limb performance asymmetries and the effect of fatigue. Statistical parametric mapping investigated the main effects of landing, limb dominance and a high intensity, intermittent exercise protocol (HIIP) on VDJ biomechanics. Twenty-two male athletes (21.9 ± 1.1 years, 180.5 ± 5.5 cm, 79.4 ± 7.8 kg) performed VDJs pre- and post-HIIP. Repeated measures ANOVA identified pattern differences during the eccentric phases of the first and second landings bilaterally. The first landing displayed greater (internal) knee flexor (η2 = 0.165), external rotator (η2 = 0.113) and valgus (η2 = 0.126) moments and greater hip (η2 = 0.062) and knee (η2 = 0.080) flexion. The dominant limb generated greater knee flexor (η2 = 0.062), external rotator (η2 = 0.110) and valgus (η2 = 0.065) moments. The HIIP only had one effect, increased thoracic flexion relative to the pelvis (η2 = 0.088). Finally, the dominant limb demonstrated greater knee extensor moments during the second landing (η2 = 0.100). ACL injury risk factors were present in both landings of VDJs with the dominant limb at potentially greater injury risk. Therefore, VDJ screenings should analyse both landings bilaterally.

Deficits in trunk control predict ACL injuries which frequently occur during high risk activities such as cutting. However, no existing trunk control/core stability programme has been found to positively affect trunk kinematics during cutting activities. This study investigated the effectiveness of a 6-week dynamic core stability programme (DCS) on the biomechanics of anticipated and unanticipated side and crossover cutting manoeuvres. Thirty-one male, varsity footballers participated in this randomised controlled trial. Three-dimensional trunk and lower limb biomechanics were captured in a motion analysis laboratory during the weight acceptance phase of anticipated and unanticipated side and crossover cutting manoeuvres at baseline and 6-week follow-up. The DCS group performed a DCS programme three times weekly for 6 weeks in a university rehabilitation room. Both the DCS and control groups concurrently completed their regular practice and match play. Statistical parametric mapping and repeated measures analysis of variance were used to determine any group (DCS vs control) by time (pre vs post) interactions. The DCS resulted in greater internal hip extensor (p=0.017, η2=0.079), smaller internal knee valgus (p=0.026, η2=0.076) and smaller internal knee external rotator moments (p=0.041, η2=0.066) during anticipated side cutting compared with the control group. It also led to reduced posterior ground reaction forces for all cutting activities (p=0.015-0.030, η2=0.074 - 0.105). A 6-week DCS programme did not affect trunk kinematics but it did reduce a small number of biomechanical risk factors for ACL injury, predominantly during anticipated side cutting. A DCS programme could play a role in multimodal ACL injury prevention programmes. This article is protected by copyright. All rights reserved.

The aim of this study was to assess and compare the ability of discrete point analysis (DPA), functional principal component analysis (fPCA) and analysis of characterizing phases (ACP) to describe a dependent variable (jump height) using vertical ground reaction force curves captured during the propulsion phase of a countermovement jump. FPCA and ACP are continuous data analysis techniques that reduce the dimensionality of a data set by identifying phases of variation (key phases), which are used to generate subject scores that describe a subject's behavior. A stepwise multiple regression analysis was used to measure the ability to describe jump height of each data analysis technique. Findings indicated that the order of effectiveness (high to low) across the examined techniques was: ACP (99%), fPCA (78%) and DPA (21%). DPA was outperformed by fPCA and ACP because it can inadvertently compare unrelated features, does not analyze the whole data set and cannot examine important features that occur solely as a phase. ACP outperformed fPCA because it utilizes information within the combined magnitude-time domain, and identifies and examines key phases separately without the deleterious interaction of other key phases.

Internet traffic classification has been the subject of intensive study since the birth of the Internet itself. Indeed, the evolution of approaches for traffic classification can be associated with the evolution of the Internet itself and with the adoption of new services and the emergence of novel applications and communication paradigms. Throughout the years many approaches have been proposed for addressing technical issues imposed by such novel services. Deep-Packet Inspection (DPI) has been a very important research topic within the traffic classification field and its concept consists of the analysis of the contents of the captured packets in order to accurately and timely discriminate the traffic generated by different Internet protocols. DPI was devised as a means to address several issues associated with port-based and statistical-based classification approaches in order to achieve an accurate and timely traffic classification. Many research works proposed different DPI schemes while many open-source modules have also become available for deployment. Surveys become then valuable tools for performing an overall analysis, study and comparison between the several proposed methods. In this paper we present a survey in which a complete and thorough analysis of the most important open-source DPI modules is performed. Such analysis comprises an evaluation of the classification accuracy, through a common set of traffic traces with ground truth, and of the computational requirements. In this manner, this survey presents a technical assessment of DPI modules and the analysis of the obtained evaluation results enable the proposal of general guidelines for the design and implementation of more adequate DPI modules.

Motion analysis systems are widely employed to identify movement deficiencies-e.g. patterns that potentially increase the risk of injury or inhibit performance. However, findings across studies are often conflicting in respect to what a movement deficiency is or the magnitude of association to a specific injury. This study tests the information content within movement data using a data driven framework that was taught to classify movement data into the classes: NORM, ACLOP and ACLNO OP, without the input of expert knowledge. The NORM class was presented by 62 subjects (124 NORM limbs), while 156 subjects with ACL reconstruction represented the ACLOP and ACLNO OP class (156 limbs each class). Movement data from jumping, hopping and change of direction exercises were examined, using a variety of machine learning techniques. A stratified shuffle split cross-validation was used to obtain a measure of expected accuracy for each step within the analysis. Classification accuracies (from best performing classifiers) ranged from 52 to 81%, using up to 5 features. The exercise with the highest classification accuracy was the double leg drop jump (DLDJ; 81%), the highest classification accuracy when considering only the NORM class was observed in the single leg hop (81%), while the DLDJ demonstrated the highest classification accuracy when considering only for the ACLOP and ACLNO OP class (84%). These classification accuracies demonstrate that biomechanical data contains valuable information and that it is possible to differentiate normal from rehabilitating movement patterns. Further, findings highlight that a few features contain most of the information, that it is important to seek to understand what a classification model has learned, that symmetry measures are important, that exercises capture different qualities and that not all subjects within a normative cohort utilise 'true' normative movement patterns (only 27 to 71%).

An evaluation of a six-week Combined minimal footwear transition and gait-retraining combination vs. gait retraining only on impact characteristics and leg stiffness. Twenty-four trained male runners were randomly assigned to either (1) Minimalist footwear transition Combined with gait-retraining over a six-week period ("Combined" group; n = 12) examined in both footwear, or (2) a gait-retraining group only with no minimalist footwear exposure ("Control"; n = 12). Participants were assessed for loading rate, impact peak, vertical, knee and ankle stiffness, and foot-strike using 3D and kinetic analysis. Loading rate was significantly higher in the Combined group in minimal shoes in pre-tests compared to a Control (P ≤ 0.001), reduced significantly in the Combined group over time (P ≤ 0.001), and was not different to the Control group in post-tests (P = 0.16). The impact peak (P = 0.056) and ankle stiffness reduced in both groups (P = 0.006). Loading rate and vertical stiffness was higher in minimalist footwear than conventional running shoes both pre (P ≤ 0.001) and post (P = 0.046) the intervention. There has a higher tendency to non-rearfoot strike in both interventions, but more acute changes in the minimalist footwear. A Combined intervention can potentially reduce impact variables. However, higher loading rate initially in minimalist footwear may increase the risk of injury in this condition.

Background Low back pain is one of the most prevalent musculoskeletal conditions in the world. Many exercise treatment options exist but few interventions have utilised free-weight resistance training. To investigate the effects of a free-weight-based resistance training intervention on pain and lumbar fat infiltration in those with chronic low back pain. Methods Thirty participants entered the study, 11 females (age=39.6±12.4 years, height=164 cm±5.3 cm, body mass=70.9±8.2 kg,) and 19 males (age=39.7±9.7 years, height=179±5.9 cm, body mass=86.6±15.9 kg). A 16-week, progressive, free-weight-based resistance training intervention was used. Participants completed three training sessions per week. Participants completed a Visual Analogue Pain Scale, Oswestry Disability Index and Euro-Qol V2 quality of life measure at baseline and every 4 weeks throughout the study. Three-dimensional kinematic and kinetic measures were used for biomechanical analysis of a bodyweight squat movement. Maximum strength was measured using an isometric mid-thigh pull, and lumbar paraspinal endurance was measured using a Biering-Sorensen test. Lumbar paraspinal fat infiltration was measured preintervention and postintervention using MRIs. Results Postintervention pain, disability and quality of life were all significantly improved. In addition, there was a significant reduction in fat infiltration at the L3L4 and L4L5 levels and increase in lumbar extension time to exhaustion of 18%. Conclusions A free-weight-based resistance training intervention can be successfully utilised to improve pain, disability and quality of life in those with low back pain.

Within this paper we demonstrate the effectiveness of a novel body-worn gait monitoring and analysis framework to both accurately and automatically assess gait during `free-living' conditions. Key features of the system include the ability to automatically identify individual steps within specific gait conditions, and the implementation of continuous waveform analysis within an automated system for the generation of temporally normalized data and their statistical comparison across subjects.

Background While measures of asymmetry may provide a means of identifying individuals predisposed to injury, normative asymmetry values for challenging sport specific movements in elite athletes are currently lacking in the literature. In addition, previous studies have typically investigated symmetry using discrete point analyses alone. This study examined biomechanical symmetry in elite rugby union players using both discrete point and continuous data analysis techniques. Methods Twenty elite injury free international rugby union players (mean ± SD: age 20.4 ± 1.0 years; height 1.86 ± 0.08 m; mass 98.4 ± 9.9 kg) underwent biomechanical assessment. A single leg drop landing, a single leg hurdle hop, and a running cut were analysed. Peak joint angles and moments were examined in the discrete point analysis while analysis of characterising phases (ACP) techniques were used to examine the continuous data. Dominant side was compared to non-dominant side using dependent t-tests for normally distributed data or Wilcoxon signed-rank test for non-normally distributed data. The significance level was set at α = 0.05. Results The majority of variables were found to be symmetrical with a total of 57/60 variables displaying symmetry in the discrete point analysis and 55/60 in the ACP. The five variables that were found to be asymmetrical were hip abductor moment in the drop landing (p = 0.02), pelvis lift/drop in the drop landing (p = 0.04) and hurdle hop (p = 0.02), ankle internal rotation moment in the cut (p = 0.04) and ankle dorsiflexion angle also in the cut (p = 0.01). The ACP identified two additional asymmetries not identified in the discrete point analysis. Conclusions Elite injury free rugby union players tended to exhibit bi-lateral symmetry across a range of biomechanical variables in a drop landing, hurdle hop and cut. This study provides useful normative values for inter-limb symmetry in these movement tests. When examining symmetry it is recommended to incorporate continuous data analysis techniques rather than a discrete point analysis alone; a discrete point analysis was unable to detect two of the five asymmetries identified. Electronic supplementary material The online version of this article (doi:10.1186/s13102-015-0006-9) contains supplementary material, which is available to authorized users.

We present a novel framework to monitor the three- dimensional trajectory (orientation and position) of a golf swing using miniaturized inertial sensors. Firstly we employed a highly accurate and computationally efficient revised gradient descent algorithm to obtain the orientation of a golf club. Secondly, we designed a series of digital filters to determine the backward and forward segments of the swing, enabling us to calculate drift-free linear velocity along with the relative 3D position of the golf club during the entire swing. Finally, the calculated motion trajectory was verified against a ground truth VICON system using Iterative Closest Point (ICP) in conjunction with Principal Component Analysis (PCA). The computationally efficient framework present here achieves a high level of accuracy (r = 0.9885, p < 0.0001) for such a low-cost system. This framework can be utilized for reliable movement technique evaluation and can provide near real-time feedback for athletes in various unconstrained environments. It is envisaged that the proposed framework is applicable to other racket based sports (e.g. tennis, cricket and hurling).

Motion analysis technologies have been widely used to monitor the potential for injury and enhance athlete performance. However, most of these technologies are expensive, can only be used in laboratory environments and examine only a few trials of each movement action. In this paper, we present a novel ambulatory motion analysis framework using wearable inertial sensors to accurately assess all of an athlete's activities in an outdoor training environment. We firstly present a system that automatically classifies a large range of training activities using the Discrete Wavelet Transform (DWT) in conjunction with a Random forest classifier. The classifier is capable of successfully classifying various activities with up to 98% accuracy. Secondly, a computationally efficient gradient descent algorithm is used to estimate the relative orientations of the wearable inertial sensors mounted on the thigh and shank of a subject, from which the flexion-extension knee angle is calculated. Finally, a curve shift registration technique is applied to both generate normative data and determine if a subject's movement technique differed to the normative data in order to identify potential injury related factors. It is envisaged that the proposed framework could be utilized for accurate and automatic sports activity classification and reliable movement technique evaluation in various unconstrained environments.

Although an authoritative panel recommended the use of ergometer rowing as a non-weight-bearing form of exercise for obese adults, the biomechanical characterization of ergometer rowing is strikingly absent. We examined the interaction between body mass index (BMI) relative to the lower extremity biomechanics during rowing in 10 normal weight (BMI 18–25), 10 overweight (BMI 25–30 kg·m−2), and 10 obese (BMI > 30 kg·m−2) participants. The results showed that BMI affects joint kinematics and primarily knee joint kinetics. The data revealed that high BMI leads to unfavorable knee joint torques, implying increased loads of the medial compartment in the knee joint that could be avoided by allowing more variable foot positioning on future designs of rowing ergometers.

Based on defined User-to-Network Interconnection (UNI) as well as Network-to-Network Interconnection (NNI) types various interconnection modes are practicable. These modes allow a further description of interconnection models as well as architecture models including interconnection functions and related interfaces. Topics covered in this article comprise functional entities and related interfaces interconnecting Internet Protocol (IP) network domains as well as interfaces between these border functions. Mainly focussed functionalities are Session Border Controllers (SBC) from various vendors handling Voice over IP (VoIP) session control traffic, SIP traffic specifically. Furthermore, partial and not standardised topics belonging to sub-functions and reference points are disclosed. Prerequisites in view of the continuous work are treated of beyond analyses and classifications of standardisation even if not all open-end questions can be answered completely in subsequent studies

Researchers in the geosciences are increasingly working with large files and datasets, which they often need to share with collaborators external to their institution. Examples include maps of rock types, computer models and simulations. These files may contain unpublished, confidential or commercially sensitive data. AARNet’s CloudStor, which has received input from the Australian geoscience research community during its development, is a new online file sharing service combining several transport, storage and security methods, to allow Australian researchers to quickly and easily share files of any size for a limited period of time in a trusted environment. Researchers at supported institutions can logon to CloudStor using their institutional credentials and upload a file to share with any collaborator, or issue a voucher for any collaborator to share a file with them. This paper discusses observations on the relevance of CloudStor to the Australian geoscience research community.

The economic importance of small and medium sized enterprises (SMEs) and entrepreneurship has increased during last decades significantly. Therefore, it is valuable to investigate the underlying mechanisms of the antecedents of entrepreneurial activity in SMEs. Our study investigates the drivers of entrepreneurially oriented behaviour (EO) as a main contributor to entrepreneurship in Finnish small owner-managed firms. We focus on entrepreneur’s work values and experience as entrepreneur and firm’s financial slack and financial conservatism. The empirical data were drawn from a mail survey of 194 Finnish owner-managed small companies. Our results reveal that owner-manager’s intrinsic and status work values and experience are the strongest drivers of EO. This study contributes to the EO literature by focusing on the personal characteristics of the entrepreneur or top manager as owner’s personality, values and identities are recognised as important factors fostering entrepreneurial behaviour, especially in the small firm context.