Lower Quarter Y-Balance Test Scores and Lower Extremity Injury in NCAA Division I Athletes.
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ABSTRACT:
SUBMITTER: Lai WC
PROVIDER: S-EPMC5555509 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:Injury rates in student athletes are high and often unpredictable. Injury risk factors are not agreed upon and often not validated. Here, we present a random-forest machine learning methodology for identifying the most significant injury risk factors and develop a model of lower extremity musculoskeletal injury risk in student athletes with physical performance metrics spanning joint strength measured with force transducers, postural stability measured using a force plate, and flexibility, measured with a goniometer, combined with previous injury metrics and athlete demographics. We tested our model in a population of 122 student athletes with performance metrics for the lower extremity musculoskeletal system and achieved an injury risk accuracy of 79% and identified significant injury risk factors, that could be used to increase accuracy of injury risk assessments, implement timely interventions, and decrease the number of career-ending or chronic injuries among student athletes.
| S-EPMC7739722 | biostudies-literature
Project description:BACKGROUND AND PURPOSE:There is limited evidence regarding risk factors for lower extremity overuse bone injury (LEOBI) in collegiate athletes. The purposes of the study were to: 1) determine incidence of LEOBI in selected sports and its impact on athletic participation and ADL, 2) assess risk relationships between LEOBI and selected risk factors, and 3) establish the viability of using calcaneal densitometry as a screening tool to identify risk for LEOBI. STUDY DESIGN:Prospective analytical cohort design. METHODS:Collegiate athletes in selected sports (swimming/diving, women's soccer, field hockey, cross-country/track) at one university were invited to participate. Consenting athletes completed an initial questionnaire including demographic information, history, and menstrual function. Measurements included height/weight, hip abductor strength, foot posture index, and calcaneal bone mineral density. Athletes were monitored for potential LEOBI for nine months and an algorithm was used to determine if physician referral was required. The primary outcome of interest was the occurrence of physician-diagnosed LEOBI. If LEOBI was diagnosed by the physician, the athlete completed a follow-up visit including a repeat bone mineral density scan. All athletes were invited for a repeat scan at the end of the year and completed a final questionnaire. Athlete demographics were summarized using descriptive statistics and differences in continuous risk factors were analyzed using t-tests and ANOVA. Finally, risk relationships for categorical variables were analyzed using chi-square and relative risk. RESULTS:84 athletes (64 female, 20 male) consented to participate. Over the study period, eight athletes (one male, seven females) were diagnosed with LEOBI (LEOBI group), five with stress fractures and three with medial tibial stress syndrome. The other 76 athletes who did not have a diagnosis of LEOBI were placed in the non-LEOBI group. Five of the eight were cross-country/track athletes; no swimming/diving athletes had bone injury. Sport (cross-country/track) had a significant relative risk value of 2.26 (95% CI = 1.18-4.32) for LEOBI. There was no association between LEOBI occurrence and sex, hip abductor strength, body mass index, foot type, and menstrual function. There was no difference in bone mineral density at initial or follow-up measures between LEOBI and non-LEOBI groups (p>.05) when analyzing all athletes. When analyzing ground-based athletes only at follow-up (n=44), athletes with LEOBI had lower bone mineral density of right (p = .05) and left (p =.07) calcaneus. The relative risk for developing LEOBI based on calcaneal bone mineral density below the mean of the study participants was 2.1 (95%CI = 1.09-3.35) on the left and 1.53 (95% CI=.80- 3.06) on the right. CONCLUSION:The incidence of LEOBI in this population of athletes was approximately 10%. Risk factors were sport (cross-country/track) and decreased left calcaneal bone mineral density. This study supports the use of calcaneal bone mineral density as a screening measurement for LEOBI risk and suggests the need for further investigation into additional LEOBI risk factors. LEVEL OF EVIDENCE:2.
| S-EPMC4387723 | biostudies-other
Project description:BackgroundConcussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated.HypothesisThe purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries.Study designCross-sectional study.Level of evidenceLevel 3.MethodsStudent-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries.ResultsThere were significant associations between concussion and lateral ankle sprain ( P = 0.012), knee injury ( P = 0.002), and lower extremity muscle strain ( P = 0.031). There were also significant associations between reported concussions and knee injury ( P = 0.003), unreported concussions and knee injury ( P = 0.002), and unrecognized concussions and lateral ankle sprain ( P = 0.001) and lower extremity muscle strains ( P = 0.006), with odds ratios ranging from 1.6 to 2.9.ConclusionThere was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers.Clinical relevanceClinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.
| S-EPMC5089357 | biostudies-literature
Project description:BACKGROUND:Yearly changes in active joint stiffness may help explain when neuromuscular sex differences emerge in adolescent athletes that may relate to increased anterior cruciate ligament injury risk in females. HYPOTHESIS:Pubertal males would demonstrate increases in knee stiffness while pubertal females would not. Second, postpubertal female athletes would have significantly lower knee joint stiffness than postpubertal male athletes. STUDY DESIGN:Cohort Study; Level of Evidence 2 and Cross-Sectional Study; Level of Evidence 3. METHODS:Two hundred sixty-five females and 50 males participated in 2 testing sessions approximately 1 year apart. The subjects were classified as either pubertal (n = 182, age 12.4 +/- 0.9 years) or postpubertal (n = 133, age 14.5 +/- 1.4 years) based on the modified Pubertal Maturational Observational Scale at each visit. Active joint stiffness of the ankle, knee, and hip was estimated during a drop vertical jump. Stiffness was calculated as the slope of the moment-angle curve from a least squares linear regression during the stance phase. RESULTS:All athletes showed increased active knee stiffness during the span of a year (P < 0.05). However, this increase was not different when stiffness was normalized to body mass. Only males demonstrated greater magnitudes of ankle and hip active stiffness (P < .05). Peak ankle and hip moments, but not knee moments, in postpubertal males were significantly greater than postpubertal females (P < .05). Females had a higher knee to hip moment ratio than males (P < .05). CONCLUSION:Both males and females showed increased active knee stiffness during the span of a year; males demonstrated increased ankle and hip active stiffness as well. Differences in hip joint posture at initial contact (greater flexion in males) and external hip flexion moment (greater flexion magnitude in males) may indicate that males use a different hip recruitment strategy during drop vertical jumps than females.
| S-EPMC3968426 | biostudies-literature
Project description:Context The Lower Quarter Y-Balance Test (LQ-YBT) was developed to provide an effective and efficient screen for injury risk in sports. Earlier protocol recommendations for the LQ-YBT involved the athlete placing the hands on the hips and the clinician normalizing scores to lower limb length measured from the anterior-superior iliac spine to the lateral malleolus. The updated LQ-YBT protocol recommends the athlete's hands be free moving and the clinician measure lower limb length to the medial malleolus.Objective To investigate the effect of hand position and lower limb length measurement method on LQ-YBT scores and their interpretation.Design Cross-sectional study.Setting National Sports Institute of Malaysia.Patients or other participants A total of 46 volunteers, consisting of 23 men (age = 25.7 ± 4.6 years, height = 1.70 ± 0.05 m, mass = 69.3 ± 9.2 kg) and 23 women (age = 23.5 ± 2.5 years, height = 1.59 ± 0.07 m, mass = 55.7 ± 10.6 kg).Intervention(s) Participants performed the LQ-YBT with hands on hips and hands free to move on both lower limbs.Main outcome measure(s) In a single-legged stance, participants reached with the contralateral limb in each of the anterior, posteromedial, and posterolateral directions 3 times. Maximal reach distances in each direction were normalized to lower limb length measured from the anterior-superior iliac spine to the lateral and medial malleoli. Composite scores (average of the 3 normalized reach distances) and anterior-reach differences (in raw units) were extracted and used to identify participants at risk for injury (ie, anterior-reach difference ≥4 cm or composite score ≤94%). Data were analyzed using paired t tests, Fisher exact tests, and magnitude-based inferences (effect size [ES], ±90% confidence limits [CLs]).Results Differences between hand positions in normalized anterior-reach distances were trivial (t91 = -2.075, P = .041; ES = 0.12, 90% CL = ±0.10). In contrast, reach distances were greater when the hands moved freely for the normalized posteromedial (t91 = -6.404, P < .001; ES = 0.42, 90% CL = ±0.11), posterolateral (t91 = -6.052, P < .001; ES = 0.58, 90% CL = ±0.16), and composite (t91 = -7.296, P < .001; ES = 0.47, 90% CL = ±0.11) scores. A similar proportion of the cohort was classified as at risk with the hands on the hips (35% [n = 16]) and the hands free to move (43% [n = 20]; P = .52). However, the participants classified as at risk with the hands on the hips were not all categorized as at risk with the hands free to move and vice versa. The lower limb length measurement method exerted trivial effects on LQ-YBT outcomes.Conclusions Hand position exerted nontrivial effects on LQ-YBT outcomes and interpretation, whereas the lower limb length measurement method had trivial effects.
| S-EPMC5687235 | biostudies-literature
Project description:During unimanual motor tasks, muscle activity may not be restricted to the contracting muscle, but rather occurs involuntarily in the contralateral resting limb, even in healthy individuals. This phenomenon has been referred to as mirror electromyographic activity (MEMG). To date, the physiological (non-pathological) form of MEMG has been observed predominately in upper extremities (UE), while remaining sparsely described in lower extremities (LE). Accordingly, evidence regarding the underlying mechanisms and modulation capability of MEMG, i.e., the extent of MEMG in dependency of exerted force during unilateral isometric contractions are insufficiently investigated in terms of LE. Furthermore, it still remains elusive if and how MEMG is affected by long-term exercise training. Here, we provide novel quantitative evidence for physiological MEMG in homologous muscles of LE (tibialis anterior (TA), rectus femoris (RF)) during submaximal unilateral dorsiflexion in healthy young adults. Furthermore, endurance athletes (EA, n = 11) show a higher extent of MEMG in LE compared to non-athletes (NA, n = 11) at high force demands (80% MVC, maximum voluntary contraction). While the underlying neurophysiological mechanisms of MEMG still remain elusive, our study indicates, at least indirectly, that sport-related long-term training might affect the amount of MEMG during strong isometric contractions specifically in trained limbs. To support this assumption of exercise-induced limb-specific MEMG modulation, future studies including different sports disciplines with contrasting movement patterns and parameters should additionally be performed.
| S-EPMC5649197 | biostudies-literature
Project description:Although motor features have been the defining element of essential tremor (ET), lower neurocognitive test scores are increasingly being recognized. However, the clinical correlates, if any, of these lower test scores remain largely unexplored. The aim of this study was to determine whether cognitive test scores in ET have any functional correlates. The Modified Mini Mental Status Examination (MMSE), Katz Activities of Daily Living (ADL) scale and Lawton Instrumental (I) ADL scale were administered to 95 cases. The Katz ADL score (rho = 0.26, P = 0.01) and Lawton IADL score (rho = 0.32, P = 0.001) were correlated with MMSE scores, such that poorer cognitive performance indicated greater dysfunction. Furthermore, cognitive test scores were a better predictor of functional disability than was tremor severity. Poorer cognitive performance in ET was associated with greater functional deficit. Cognition should enter the clinical dialog with ET patients as an issue of clinical significance.
| S-EPMC2847294 | biostudies-other
Project description:Background:Olympic handball is a sport mainly focused on executing throwing and passing techniques with the throwing arm. Functional specialization due to the unilateral characteristic and dominance of the throwing arm may lead to adapted control of shoulder stability and mobility. Thus, we examined side differences between the throwing and the non-throwing arm. Additionally, correlations between the Upper Quarter Y Balance Test (YBT-UQ) and handball-specific performance measures were investigated. Methods:All participants (F?=?13?yrs., n?=?14, training experience [te] 5.9?±?1.3?yrs.; M?=?14?yrs., n?=?24, te 6.5?±?2.5?yrs.; M?=?15?yrs., n?=?18, te 9.3?±?2.2?yrs) were Olympic handball players of a regional youth selection team. YBT-UQ was executed assessing performance in medial, inferolateral and superolateral reach direction normalized to the upper limb length together with a composite score of the mean of all reach directions. A radar gun and a target net were used for the assessment of throwing velocity and throwing accuracy. The paired t-test was used to detect side differences in YBT-UQ performance. Pearson's correlation analysis was calculated for associations between YBT-UQ and throwing velocity/accuracy. Results:Significant differences between the throwing and non-throwing arm were only detected for the superolateral reach direction in the 14-year-old males. Small correlations between YBT-UQ performance and throwing velocity/accuracy (13-year-old females: -?0.01???r???-?0.37 / 0.01???r???0.31; 14-year-old males: 0.10???r???0.45 / -0.01???r???.-0.51; 15-year-old males: 0.06???r???0.34 / 0.01???r???-?0.45) were observed, irrespective of age and sex category. Conclusions:There was only a minimal difference in performance of the YBT-UQ between the throwing and non-throwing arm and only weak if any relationships between throwing performance and stability/mobility of the upper extremities in adolescent Olympic handball players existed. Further research is needed to investigate whether the YBT-UQ is a useful tool to detect training-related improvements in measures of shoulder stability/mobility and functional performance.
| S-EPMC7457287 | biostudies-literature
Project description:BackgroundThe Upper Quarter Y Balance test (YBT-UQ) is a field test for measuring shoulder mobility/stability. However, there is a lack of information regarding age- and sex-specific reference values for classifying the YBT-UQ performance of children and adolescents.ObjectiveThe aim was to investigate YBT-UQ performance in youth and to provide age- and sex-specific normative values.MethodSix hundred and sixty-five persons (325 girls, 340 boys) aged between 10 and 17 years carried out the YBT-UQ test. Following this, maximum reach values, normalised in terms of arm length, were calculated for each arm (i.e., left and right) and reach direction (i.e., medial [MD], inferolateral [IL], superolateral [SL]), and the composite score (CS) per arm. Additionally, percentiles were displayed graphically and in tabular form, distinguished according to age and gender.ResultsIn boys, those aged 14-15 years showed a higher achievement (e.g., MD direction) compared with both younger (12-13-year-olds) and older (16-17-year-olds) persons. In girls, differences related to age could only be observed for the IL direction and the CS, where the youngest age group (10-11-year-olds) achieved better results than the older groups. Sex-specific differences to the girls' advantage could be observed in 12-13-year-olds (i.e., SL and CS), and to the boys' advantage in 14-15-year-olds (i.e., for all reach directions) and 16-17-year-olds (i.e., IL and SL direction and CS). Further, curvilinear developments were observed with regard to the 10th, 50th, and 90th percentiles, and were more strongly marked in boys than in girls.ConclusionsThe obtained age- and sex-specific normative values for the YBT-UQ can be used by teachers, coaches, and therapists to classify the level of shoulder mobility/stability among 10-17 year-old children and adolescents.
| S-EPMC8213051 | biostudies-literature
Project description:Collegiate American football has a high rate of injury. The Lower Quarter Y-Balance Test (YBT-LQ), a dynamic assessment of lower extremity strength, mobility, and balance, has been purported to identify athletes at risk for injury in different sports including football. Previous studies examining the association between YBT-LQ and injury have reported varied findings; therefore, the purpose of this study was to assess if preseason YBT-LQ performance predicted whether football players would sustain a non-contact lower extremity or low back (lower quarter (LQ)) injury during the season. Fifty-nine male collegiate American football players (age 20.8 ± 1.3 y, height 1.8 ± 0.1 m, body mass 94.6 ± 14.2 kg) completed a survey of training and injury history and had their YBT-LQ performance assessed at the start of the season. Athletic training staff tracked the occurrence of non-contact LQ injuries during the season. There were no significant relationships found between preseason YBT-LQ values and incidence of non-contact LQ injury in this population of collegiate American football players. This study is consistent with recent reports that have not found a significant association between preseason YBT-LQ values and LQ injury. These results suggest that, in isolation, the YBT-LQ may have limited utility as a screening test for non-contact injury in collegiate football players.
| S-EPMC7183065 | biostudies-literature