The Influence of Strength and Sport Exposure on Psychological Readiness After ACL Reconstruction.

Background: Among young athletes returning to sport after anterior cruciate ligament reconstruction (ACLR), the extent to which psychological readiness is influenced by factors beyond the psychological domain is largely unknown.

Hypothesis: Young athletes with recent sport exposure and higher quadriceps strength will demonstrate higher psychological readiness within 8 weeks of medical clearance to return to sport (RTS) after ACLR.

Study Design: Cross-sectional study.

Allograft Anterior Cruciate Ligament Reconstruction Fails at a Greater Rate in Patients Younger Than 34 Years.

Purpose: To characterize the secondary anterior cruciate ligament (ACL) injury rates after primary allograft anterior cruciate ligament reconstruction (ACLR) and to identify the age cut-score at which the risk of allograft failure decreases.

Methods: All patients who underwent primary ACLR within a single orthopaedic department between January 2005 and April 2020 were contacted at a minimum of 2 years post-ACLR to complete a survey regarding complications experienced post-surgery, activity level, and perceptions of knee health. Patients were excluded for incidence of previous ACLR (ipsilateral or contralateral) and/or age younger than 14 years.

The Association of Physical Competence With Psychological Response Among Young Athletes at Time of Return to Sport After ACL Reconstruction.

Background: The traditional index of return-to-sport (RTS) readiness after anterior cruciate ligament reconstruction (ACLR) is the achievement of physical competence criteria. Emerging research indicates that psychological response and self-perceptions of physical competence may be critical mechanisms for successful RTS among young athletes.

Hypothesis: Young athletes with higher actual physical competence (APC) and perceived physical competence (PPC) will demonstrate a more positive psychological response at the time of RTS after ACLR.

Preliminary Report on the Train the Brain Project, Part I: Sensorimotor Neural Correlates of Anterior Cruciate Ligament Injury Risk Biomechanics.

Context: Anterior cruciate ligament injury commonly occurs via noncontact motor coordination errors that result in excessive multiplanar loading during athletic movements. Preventing motor coordination errors requires neural sensorimotor integration activity to support knee-joint neuromuscular control, but the underlying neural mechanisms driving injury-risk motor control are not well understood.

Objective: To evaluate brain activity differences for knee sensorimotor control between athletes with high or low injury-risk mechanics.

Preliminary Report on the Train the Brain Project, Part II: Neuroplasticity of Augmented Neuromuscular Training and Improved Injury-Risk Biomechanics.

Context: Neuromuscular training (NMT) facilitates the acquisition of new movement patterns that reduce the anterior cruciate ligament injury risk. However, the neural mechanisms underlying these changes are unknown.

Objective: To determine the relationship between brain activation and biomechanical changes after NMT with biofeedback.

Sport Specialization and Coordination Differences in Multisport Adolescent Female Basketball, Soccer, and Volleyball Athletes.

Context: Early sport specialization, or the participation in 1 sport year-round to the exclusion of all others, is a growing concern in youth athletics because of its possible association with musculoskeletal injury. The underlying injury risk may be the result of coordination differences that sport-specialized athletes have been speculated to exhibit relative to multisport athletes; however, little evidence exists to support or refute this notion.

Objective: To examine relative hip- and knee-joint angular-motion variability among adolescent sport-specialized and multisport female adolescent athletes to determine how sport specialization may affect coordination.

Lower Extremity Biomechanics Are Altered Across Maturation in Sport-Specialized Female Adolescent Athletes.

Sport specialization is a growing trend in youth athletes and may contribute to increased injury risk. The neuromuscular deficits that often manifest during maturation in young, female athletes may be exacerbated in athletes who specialize in a single sport. The purpose of this study was to investigate if sport specialization is associated with increased lower extremity biomechanical deficits pre- to post-puberty in adolescent female athletes.

Biomechanical and Functional Outcomes After Medial Patellofemoral Ligament Reconstruction: A Pilot Study.

Background: Previous studies have acknowledged the medial patellofemoral ligament (MPFL) as the primary stabilizer of the patella, preventing lateral displacement. MPFL reconstruction (MPFL-R) restores stability and functionality to the patellofemoral joint and has emerged as a preferred treatment option for recurrent lateral patellar instability.

Purpose: To objectively measure biomechanical characteristics of athletes cleared for return to sport after MPFL-R compared with healthy controls.

The Effects of Knee Joint Angle and Contractor Intensity on Perceived Exertion.

This study examined knee joint angle and knee muscle contraction intensity effects on perceived exertion during isometric contractions. Fourteen healthy young adults participated in five experimental exercise sessions in which knee angles varied randomly (10°, 30°, 50°, 70°, and 90°), each separated by one week. During each session, subjects performed five isometric maximal voluntary contractions (MVCs) of knee extension, followed by nine, randomly ordered submaximal contractions (10%-90% MVC, 10% increments).

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates.

Context:  Fewer athletic injuries and lower anterior cruciate ligament injury incidence rates were noted in studies of neuromuscular-training (NMT) interventions that had high compliance rates. However, several groups have demonstrated that preventive NMT interventions were limited by low compliance rates.

Objective:  To descriptively analyze coach and athlete compliance with preventive NMT and compare the compliance between study arms as well as among school levels and sports.

Preliminary Outcomes of a Cross-Site Cognitive-Behavioral and Neuromuscular Integrative Training Intervention for Juvenile Fibromyalgia.

Objective: Cognitive-behavioral therapy (CBT) is effective in reducing disability among youth with juvenile fibromyalgia (FM); however, engagement in moderate to vigorous physical activity remains poor, even after CBT. The purpose of this study was to evaluate the feasibility and preliminary outcomes of an innovative program combining CBT with specialized neuromuscular exercise: the Fibromyalgia Integrative Training for Teens (FIT Teens) program.

Methods: Adolescents with juvenile FM (n = 22, all female, ages 12-18 years) from 2 urban children's hospitals participated in the 8-week FIT Teens intervention.

Reliability of 3-Dimensional Measures of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications for Multicenter Biomechanical and Epidemiological Research on ACL Injury Prevention.

Background: Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach.

Purpose: To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions.

A Qualitative Examination of a New Combined Cognitive-Behavioral and Neuromuscular Training Intervention for Juvenile Fibromyalgia.

Objectives: Adolescents with juvenile fibromyalgia (JFM) are typically sedentary despite recommendations for physical exercise, a key component of pain management. Interventions such as cognitive-behavior therapy (CBT) are beneficial but do not improve exercise participation. The objective of this study was to obtain preliminary information about the feasibility, safety, and acceptability of a new intervention--Fibromyalgia Integrative Training for Teens (FIT Teens), which combines CBT with specialized neuromuscular exercise training modified from evidence-based injury prevention protocols.

Reliability of 3-Dimensional Measures of Single-Leg Drop Landing Across 3 Institutions: Implications for Multicenter Research for Secondary ACL-Injury Prevention.

Context: Due to the limitations of single-center studies in achieving appropriate sampling with relatively rare disorders, multicenter collaborations have been proposed to achieve desired sampling levels. However, documented reliability of biomechanical data is necessary for multicenter injury-prevention studies and is currently unavailable.

Objective: To measure the reliability of 3-dimensional (3D) biomechanical waveforms from kinetic and kinematic variables during a single-leg landing (SLL) performed at 3 separate testing facilities.

Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research.

Purpose/background: Multi-center collaborations provide a powerful alternative to overcome the inherent limitations to single-center investigations. Specifically, multi-center projects can support large-scale prospective, longitudinal studies that investigate relatively uncommon outcomes, such as anterior cruciate ligament injury. This project was conceived to assess within- and between-center reliability of an affordable, clinical nomogram utilizing two-dimensional video methods to screen for risk of knee injury.

Rates of concussion are lower in National Football League games played at higher altitudes.

Study Design: Retrospective epidemiologic investigation.

Objective: To investigate the relationship between altitude and concussion rate in the National Football League (NFL). Because of the physiologic responses that occur during acclimatization to altitude, it was hypothesized that games played on fields at a higher altitude would have reduced concussion rates compared to games played on fields at a lower altitude.