Search

Context: The latissimus dorsi plays a major role in generating the propulsive force during swimming. In addition, stiffness of this muscle may result in altered stroke biomechanics and predispose swimmers to shoulder pain. Measuring the flexibility of the latissimus dorsi can be of interest to reduce injury. However, the reliability of such measurement has not yet been investigated in competitive swimmers. Objective: To assess the within-session intrarater and interrater reliability of a passive shoulder flexion range of motion measurement for latissimus dorsi flexibility in competitive swimmers. Design: Within-session intrarater and interrater reliability. Setting: Competitive swimming clubs in Flanders, Belgium. Participants: Twenty-six competitive swimmers (15.46 [2.98] y; 16 men and 10 women). Intervention: Each rater performed 2 alternating (eg, left-right-left-right) measurements of passive shoulder flexion range of motion twice, with a 30-second rest period in between. Main Outcome Measures: The intraclass correlation coefficients were calculated to assess intrarater and interrater reliability. Results: Interrater intraclass correlation coefficient ranged from.54 (95% confidence interval [CI], −.16 to.81) to.57 (95% CI, −.24 to.85). Results for the intrarater reliability ranged from.91 (95% CI,.81 to.96) to.94 (95% CI,.87 to.97). Conclusion: Results of this study suggest that shoulder flexion range of motion in young competitive swimmers can be measured reliably by a single rater within the same session. [ABSTRACT FROM AUTHOR]

Introduction: Chronic ankle instability (CAI) develops after 30-40% of ankle sprains.1 Etiological models suggest CAI is underpinned by pathomechanical and sensorimotor deficits, but this is largely informed by cross sectional data.2 Objectives: To prospectively record key clinical outcomes and evaluate their individual recovery at 6 and 12 weeks post ankle sprain Study design: Prospective cohort study Methods: Athletes (>18y) presenting with an acute lateral ankle sprain (LAS) (<14 days) were recruited from hospital ED's, social media and physiotherapy clinics. The following outcomes were recorded at 6 and 12 weeks post injury: perceived instability (CAIT), self-reported ankle function (Q-FAAM), range of motion (ROM), strength, joint positional sense (JPS), balance and jump performance. For each outcome, recovery was considered as the point at which scores for the affected ankle were ≥ to the contralateral side (± minimal detectable change - MDC). We also recorded re-injury (%), and time to return to sport. Results: We have recruited N=33 patients (61% male; mean age 29y (range 18-60)), with 28 completing 6 and 12 week follow ups. At weeks 6 and 12, many participants had comparable side to side scores for ROM (61%; 89%) and balance (82%; 86%). Fewer participants reported normal scores for CAIT (23%) and Q-FAAM (13%) at week 6, with some increases at week 12 (50% and 46%). Muscle strength, JPS and jump performance were inconclusive. At 6 weeks, 50% had return to sport, increasing to 95% at 12 weeks. By week 12, 12 participants (36%) had incurred a re-sprain. Conclusions: Recurrence rates are high and align with previous reports. Our initial results suggest that sensorimotor outcomes seem to recover up to 12 weeks post LAS, but time to recovery varies considerably across these outcomes. Recruitment is ongoing; future analysis will examine key predictors of CAI.3 [ABSTRACT FROM AUTHOR]

Background: Knowledge of predictors for shoulder pain in swimmers can assist professionals working with the athlete in developing optimal prevention strategies. However, study methodology and limited available data have constrained a comprehensive understanding of which factors cause shoulder pain. Purpose: To investigate risk factors and develop and internally validate a multivariable prognostic model for the prediction of shoulder pain in swimmers. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 201 pain-free club- to international-level competitive swimmers were followed for 2 consecutive seasons. The cohort consisted of 96 male (mean ± SD age, 13.9 ± 2.2 years) and 105 female (13.9 ± 2.2 years) swimmers. Demographic, sport-specific, and musculoskeletal characteristics were assessed every 6 months. Swim-training exposure was observed prospectively. Shoulder pain interfering with training was the primary outcome. Multiple imputation was used to cope with missing data. The final model was estimated using multivariable logistic regression. We applied bootstrapping to internally validate the model and correct for overoptimism. Results: A total of 42 new cases of shoulder pain were recorded during the study. Average duration of follow-up was 1.1 years. Predictors included in the final model were acute:chronic workload ratio (odds ratio [OR], 4.31; 95% CI, 1.00-18.54), competitive level (OR, 0.19; 95% CI, 0.06-0.63), shoulder flexion range of motion, posterior shoulder muscle endurance (OR, 0.96; 95% CI, 0.92-0.99), and hand entry position error (OR, 0.37; 95% CI, 0.16-0.91). After internal validation, this model maintained good calibration and discriminative power (area under the receiver operating characteristic curve, 0.71; 95% CI, 0.60-0.94). Conclusion: Our model consists of parameters that are readily measurable in a swimming setting, allowing the identification of swimmers at risk for shoulder pain. Multivariable logistic regression showed the strongest predictors for shoulder pain were regional competitive swimming level, acute:chronic workload ratio, posterior shoulder muscle endurance, and hand entry error. [ABSTRACT FROM AUTHOR]

Purpose: Despite the increasing evidence that illness perceptions should be addressed in patients, there is a lack of studies evaluating whether physiotherapists question illness perceptions. This study, using a mixed-methods design, investigates the integration of illness perceptions during the first consultation of physiotherapists treating patients with low back pain (LBP).Methods: Thirty-four physiotherapists performed usual history taking in a patient with non-specific LBP. The interview was audiotaped and illness perceptions were indexed using an observational instrument, based on the domains of Leventhal’s Common Sense Model. Patients were also asked to fill in the Illness Perception Questionnaire-Revised for LBP.Results: Physiotherapists assessed the illness identity, also perceptions regarding the (physical) cause and controllability of LBP were evaluated. Illness perceptions, such as timeline, consequences, coherence and emotional representation, were poorly assessed. Results of the questionnaire reveal that LBP-patients report overuse, workload and bad posture as primary cause. Patients held positive beliefs about the controllability and have high illness coherence.Conclusion: Belgian physiotherapists mainly question bio-medically oriented illness perceptions, e.g. physical symptoms and causes, but do not sufficiently address psychosocially oriented illness perceptions as recommended in LBP guidelines.Implications for RehabilitationBelgian physiotherapists mainly question biomedical oriented illness perceptions (illness identity, provoking factors and treatment control) in patients with low back pain (LBP) during the history taking (i.e. the first consultation).From a bio-psycho-social view psychosocially oriented illness perceptions should be incorporated in the daily routine of physiotherapist’s to comply with the bio-psycho-social treatment guidelines for LBP.Continuing education is mandatory in order to improve physiotherapists’ knowledge regarding the use of all dimensions of illness perceptions in the assessment of patients with LBP. [ABSTRACT FROM AUTHOR]