Lower Extremity Functional Tests Research Articles

Evaluation of the lower extremity functional test to predict lower limb injuries in professional male footballers

The Lower Extremity Functional Test (LEFT) is a reliable and valid test for the measurement of athletic fitness, fatigue resistance, and speed performance. Contradictory results exist regarding the screening value of the LEFT in predicting lower limb injuries. The purpose of this study was to investigate the screening value of the LEFT in predicting lower limb injuries in professional male footballers. One hundred and twenty-one professional male football players participated in the study. LEFT was recorded pre-season and the lower-limb injuries were recorded during a 9-month season. Logistic regression analysis was used to determine the accuracy of the prognosis of LEFT. A total of twenty-five lower limb injuries were recorded. The model explained 53% of the variance in lower limb injury, showing that predictions by LEFT score is reliable, and correctly predicted 89.3% of cases, which is a large improvement. ROC analysis showed significant accuracy of the LEFT score (AUC 0.908, 95% CI 1.126–1.336, p = 0.001, OR = 1.227) in discriminating between injured and uninjured players. The optimum cut-off level of the LEFT score was 90.21 s; Our findings showed that the LEFT score was able to predict lower limb injuries in professional male footballers. The slower an athlete’s LEFT scores, the more susceptible they are to future injury risk. Sports medicine specialists, football coaches and managers are suggested to use LEFT as a pre-season screening test to identify and prevent the weakness and functional imbalance of the athletes before the injury occurs by conducting this test.

The impact of a multicomponent training program on physical fitness and joint injuries in Spanish male professional soccer players

ABSTRACT This study aimed to assess the effects of a multicomponent training program (ProSAS) on selected measures of physical fitness and joint injuries in Spanish male professional soccer players. Twenty-six professional soccer players (age: 25.2 ± 3.1 years) were randomly assigned to either the experimental (EG; n = 16) or control group (CG; n = 10). Y-balance test (YBT), Single leg countermovement jump (SLCMJ), Single leg hop for distance test (SLH), Side-hop test (SH), Speedy jump test (SpJ), Agility T-test (TT) and Lower extremity functional test (LEFT) were performed before and after an 8-weeks training period. Additionally, any joint injury occurring during the intervention period were recorded. Significant improvements in the EG in all tests (p = 0.001 to p = 0.014), except for SLCMJ (p = 0.632) with the dominant leg were observed. CG displayed decreases in SLCMJ with the non-dominant leg (p = 0.014), SH for both legs (p = 0.001 to p = 0.050), TT (p = 0.005), and LEFT (p = 0.001). Inter-groups differences revealed better results for the EG in all variables (p = 0.001 to p = 0.008) except from SLCMJd (p = 0.555). Moreover, the EG exhibited lower joint injury incidence and burden compared to the CG (p < 0.05). These findings suggest that the ProSAS is an effective multicomponent program to improve variables related to risk of joint injuries, and consequently, to reduce the incidence and burden of these injuries in professional soccer players.

The Interruption of Rehabilitation Following Anterior Cruciate Ligament Reconstruction due to COVID-19 Restrictions: Association With Return-to-Sport Testing.

Among many unanticipated changes, access to rehabilitation was disrupted during the onset of the COVID-19 pandemic. It is unclear how the timing of late-stage rehabilitation following anterior cruciate ligament with surgical reconstruction (ACLR) during the initial months of the pandemic affected outcomes. The purpose of this study was to compare physical performance outcome measures in patients following ACLR prior to and following COVID-19-related restrictions. Retrospective cohort study. Data from patients who underwent return-to-sport testing following ACLR were analyzed based on date. December 2018 through March of 2020 (n = 66) was defined as the baseline period, and June through October 2020 (n = 27) was defined as the surveillance period. Outcome measures included single leg hop, triple hop, single leg vertical jump, and the lower-extremity functional test(LEFT). Linear mixed models were used to compare outcome measures before and after the onset of pandemic-related restrictions, clustered by sex and sport. A 1-way analysis of variance was performed to analyze the association between the number of virtual rehabilitation visits and outcome measures for subjects in the surveillance period. Subjects in the surveillance period performed significantly worse in the LEFT (+7.88s; 95% confidence interval, 1.11 to 14.66; P = .02) and single leg vertical jump on the unaffected side (-4.32cm; 95% confidence interval, -7.44 to -1.19, P < .01), and performed better with single leg vertical jump symmetry (+6.3%; 95% confidence interval, 1.0% to 11.5%; P = .02). There were no other statistically significant differences. There was no significant association between having virtual rehabilitation visits and any of the performance outcomes. There was a decline in physical performance outcome measures in patients following ACLR who did not attend regular in-person physical therapy sessions in the late-stage rehabilitation due to COVID-19-related restrictions. Other factors during this unique time period, such as access to training facilities or psychosocial stressors, may have also influenced outcomes.

Investigation of the relationship between lower extremity functional performance of American football players and their anthropometric characteristics and jump test results

Objective: Hop tests have well-known benefits when evaluating the rehabilitation process after sports injuries. However, utilization of hop tests to evaluate functional athletic performance of healthy athletes is currently uncertain and is not common in clinical practice. This study aimed to investigate the relationships between hop performance, their symmetries and functional test performance in American Football (AmF) players. Materials and Methods: Twenty-six collegiate AmF players aged 20.9±2.5 years participated in this study. According to their playing positions, players categorized as Skill Players (SP), Big Skill Players (BSP) and Linemen (LM). Body Mass Index (BMI) and body fat ratio were measured. Then, subjects were performed hop tests and 10-yards Lower Extremity Functional Test (LEFT). Players were also analysed by dividing into low and high performers for LEFT, according to their LEFT test duration. Results: Hop test performance of the SP was superior to LM for SLH, TH, and CH. The performance of BSP was inferior to SP for CH, and was superior to LM for SLH. In LEFT, the SP group was significantly faster than LM. For LEFT, TH, CH and 6H test results were significantly different between low and high performer players. Conclusion: Hop tests may be utilized to evaluate the functional athletic performance of AmF players. Physical characteristics and playing positions should also be considered. Symmetry had no effect on LEFT.

Effect of high-intensity sports specific training and high-intensity interval training on sprained ankle male adolescent soccer athletes before return-to-play

Ankle sprain is a highly observed injury in soccer due to repeated strenuous movements. Rehabilitation after injury leads to decreased physical strength and muscle-joint function. The ankle sprained patients need improved soccer specific fitness and ankle function simultaneously. Therefore, current study aimed to compare high-intensity sports specific training (HISST) with high-intensity interval training (HIIT) to identify effective training for fitness and lower-extremity functions. A total of 56 high school male soccer players (HIIT: 28, HISST: 28) who survived the acute phase due to ankle sprain participated the study. In the intervention period of 4 weeks, the HISST and HIIT groups were randomly assigned. Physical fitness and lower-extremity function tests were performed before and after the intervention. Physical fitness measurements included Volume Oxygen peak (VO2peak), anaerobic power, isokinetic ankle eversion strength, while lower extremity function tests consisted of Y-balance and hop tests. In both groups, VO2peak, exercise time, peak power, and eversion strength improved after the intervention, with significant improvement in all Y-balance subtests and hop tests (p &lt; 0.05). Regarding the posteromedial and posterolateral directions of the Y-balance test, and the crossover of the hop tests, HISST was significantly higher (p &lt; 0.05) than HIIT in the post-intervention test. Concludingly, HIIT and HISST can simultaneously improve VO2peak, abductor strength, and lower extremity function in sprained ankle athletes before returning to competition. Additionally, HISST was slightly more effective than HIIT for mediolateral balance and crossover hopping.

Effects of both hip and traditional strengthening exercises on early outcomes post anterior cruciate ligament reconstruction

Background. Lower extremity muscles weakness occur after the reconstruction of the anterior cruciate ligament (ACLR), specifically the hip muscles. The literature suggests that decreased hip strength which results from ACLR can lead to biomechanical changes in lower extremity. Objective. The aim of the current study was to assess effects of adding hip strengthening exercises with traditional strengthening exercises on early outcomes after ACLR. Materials and methods. Randomized controlled study was conducted on 50 male participants with primary unilateral ACLR, they were tested pre-operative and after 12 weeks postoperative; for pain intensity by visual analog scale (VAS), side to side difference knee extension limitation range of motion (ROM) by goniometer, and lower extremity function tests by side-to-side single-leg hop test and 10-yards test. They were assigned into two groups; group A (hip strengthening exercises with traditional strengthening exercises) and group B (traditional strengthening exercises only). Both groups received the treatment 3 sessions/week for 12 weeks. Results. The results of independent t-test showed that there were significant improvements (p &lt; 0.05) in all variables (pain intensity, side to side difference knee extension limitation ROM, side-to-side single-leg hop test and 10-yards test) in both groups with superiority of group A. Conclusion. Adding of hip strengthening exercises to traditional strengthening exercises were effective on early outcomes post ACLR.

Influence of Graft Type on Lower Extremity Functional Test Performance and Failure Rate After Anterior Cruciate Ligament Reconstruction.

Both autografts and allografts are used to reconstruct the anterior cruciate ligament (ACL) after injury; however, it is unclear whether graft source affects lower extremity functional test performance or failure rate in an active military population. To compare lower extremity functional test performance and graft failure rates between ACL grafts [allograft, hamstring, bone-patellar tendon-bone (BTB)]. Cross-sectional. Level 2. Ninety-eight cadets entering a US Service Academy with a history of unilateral ACL reconstruction (ACLR) agreed to participate. Before basic training, participants completed 4 lower extremity functional tests. Active injury surveillance was conducted within the study cohort to identify all subsequent graft failures. Cadets with hamstring autografts outperformed the BTB and allograft groups on the Lower Quarter Y-Balance Test-Posteromedial direction and single-leg hop test, respectively. No differences were detected by graft type for the other functional tests. The incidence of subsequent ipsilateral graft failures in patients with autograft was 8.11%. No failures were observed in the allograft group during the follow-up period. After controlling for sex, joint hypermobility, and time since injury and surgery, the risk of graft failure was 9.8 times higher for patients with a hamstring autograft than with a BTB (P = 0.045). After ACLR, graft type appears to influence some single-limb measures of lower extremity function and the risk of subsequent failure. Hamstring autografts demonstrated better functional performance but increased risk of graft failure. Surgeons need to weigh the pros and cons of all graft options in relation to the patient's lifestyle. Regardless of graft type, individuals with an ACLR may require additional rehabilitation to regain neuromuscular control during dynamic single-limb tasks and mitigate graft failure.

Correlations Between Preseason Functional Test Scores and Game Performance in Female Collegiate Volleyball Players.

BackgroundFunctional tests (FT) are assessment tools that attempt to evaluate balance, flexibility, strength, power, speed, or agility through performance of gross motor skills. FT are frequently administered by coaches or sports medicine professionals to evaluate athletic ability, to predict performance, to identify athletes at risk for injury, or to evaluate an athlete’s ability to return to sport after injury. Functional tests which can provide accurate or predictive information regarding athletic ability would be advantageous to coaching staffs or medical professionals.PurposeThe primary purpose of this study was to identify correlations between preseason FT scores and in-season game statistics in a cohort of female collegiate level volleyball (VB) players. A secondary purpose was to present FT descriptive data for this cohort based on level of competition, player position, and starter status.Study Designprospective cohort; correlationalMethodsOne hundred and thirty-one female collegiate VB players representing three levels of competition completed four FT [standing long jump (SLJ), single-leg hop (SLH), lower extremity functional test (LEFT), and the Y-Balance Test - Lower Quarter (YBT-LQ)] at the start of the preseason. Player statistics were collected from team records at the completion of the season.ResultsStarters performed significantly better on all tests. There were moderate negative correlations between LEFT scores and game statistics for liberos, defensive specialists, and outside hitters. There were moderate positive correlations between YBT-LQ composite scores and game statistics for liberos, defensive specialists, hitters, and middle blockers. There were also low to moderate level positive correlations between SLJ and SLH scores and game performance for outside hitters. There were low to moderate level positive correlations between SLH scores and game performance for middle blockers and opposite side hitters.ConclusionsThe results of this study indicate that there are low to moderate correlations between some preseason functional test scores and some game statistics. The SLJ, SLH, LEFT, and YBT-LQ tests may help coaches with talent identification and/or may influence training strategies.Level of Evidence3

Occupational Therapy and Prevention of Common Sports Injuries for Special Physical Training.

This paper provides an in-depth study of occupational therapy and the prevention of common sports injuries in special physical training. The issue of sports injuries and rehabilitation has always been a hot topic in special training. With the continuous development of sports, the increasing intensity of competition, and more stringent requirements for special techniques, the increase in difficulty and intensity of training has led to the increasing frequency of sports injuries, so how to prevent injuries in special physical training and rehabilitation and recovery of athletes after the injury is particularly important. Since the most common musculoskeletal injuries occur in the lower quadrant, this paper proposes a lower extremity functional test (LEFT) model as a means of identifying injury risk and guiding the implementation of training programs to prevent sports injuries. In this paper, a knee injury is used as an example, and an occupational therapy program of TCM physical therapy + aquatic rehabilitation is adopted for the already occurred sports injuries. Through interviews and clinical examinations of athletes, coaches, and medical personnel, this paper summarizes the sites, types, characteristics, and probability of occurrence of common sports injuries in special physical training. Experiments were conducted through clinical rehabilitation of common sports injuries with the addition of TCM manual massage. A series of effects of this modality on the rehabilitation of sports injuries were examined by monitoring physiological and biochemical indexes and by comparative analysis before and after testing physical function indexes using the Omega Wave system. Sports injuries are diverse. Traditional Chinese medicine physical therapy + water rehabilitation therapy is an effective physical therapy method. According to the relevant theories of traditional Chinese medicine treatment, diagnosis and treatment through meridians and related acupuncture points have significant curative effects. Traditional Chinese medicine, massage, and acupuncture have irreplaceable roles in the rehabilitation and treatment of sports injuries and can effectively improve and cure sports injuries.

The Association between Multidirectional Speed Performance, Dynamic Balance and Chronological Age in Young Soccer Players.

The ability to maintain a stable single-leg balance stance during a fast change of direction movement is a fundamental aspect both for improving sport-specific skills and for prevention strategies. The aim of this cross-sectional study was to investigate the associations between multidirectional speed performance (MDS), dynamic balance performance (DBP), and chronological age in young and uninjured soccer players. In addition, it was examined whether chronological age and balance can predict variance in speed performance. One-hundred forty-six young male soccer players (age range 11–19) performed the y-balance test (YBT) and the lower extremity functional test (LEFT). Descriptive statistics, Pearson correlation, and multiple regression analysis were executed. The analyses were carried out on the further variables: for the DBP, the YBT composite score % (CS dominant leg/CS non-dominant leg) and limb symmetry index % (LSI) were used; for the MDS, the LEFT time in seconds (s) was used. Findings revealed LEFT scores to have a significant association with chronological age (p = 0.000), CS dominant (p = 0.019) and LSI (p = 0.044) of the YBT. In addition, CS dominant and chronological age explained the variance of the LEFT by 44%, regardless of LSI. To conclude, MDS revealed a strong association with DBP of the dominant side but a small association with LSI. In addition, a small association was found between quick LEFT times and older players. Finally, MDS variance can be predicted from DBP of the dominant side and chronological age in young soccer players. The tests used in this study could be useful screening tools for the detection of performance deficits, the implementation of prevention training programs, and the optimization of selection strategies in soccer academies.

The Reliability of Common Functional Performance Tests within an Experimental Test Battery for the Lower Extremities.

The main aim of this study was to determine the test–retest reliability of an experimental functional test battery: Y-balance test (YBT), single-leg countermovement jump (SLCMJ), single-leg hop for distance (SLH), side-hop (SH), speedy-jump (SJ), agility-T (AT), and lower extremity functional test (LEFT). Secondary aims were (1) to determine the mean range for the limb symmetry index (LSI) and (2) to detect significant differences in performance between test–retest sessions. Twenty-two healthy adults (14 males, 8 females; age 23.3 ± 3.9) were tested by the same rater during two different sessions (T1–T2), with a seven-day interval, under the same conditions. Reliability analysis showed good-to-excellent reliability (0.89 < ICC < 0.97; 0.80 < α < 0.98) for the test battery. LSI ranged from 95.9 ± 6.7% (SH-T1) to 104.4 ± 12.5% (SLCMJ-T2). Repeated measures ANOVA detected significant performance differences between sessions in the LEFT (p = 0.009) and for non-dominant sides in the SLH (p = 0.015), SH (p = 0.007), and SJ (p = 0.011). The high reliability of the test battery suggests a potential use in clinical sports practice. The LSI range of ≥95% was proposed as a benchmark for healthy adults. Learning effect seems to have played a crucial role in the T2 improvements of the non-dominant side for hop performances (SLH, SH, SJ) and speed performance (LEFT).

The Effect of Eight Weeks of Relaxation Massage on the Mental Fatigue Control, Balance, Lower Extremity Function and Landing Mechanic in Physical Education Students

Background and Aims: Mental fatigue usually occurs following prolonged cognitive activity. Mental fatigue is a psychological condition that occurs as a result of long-term cognitive activities. Mental fatigue can have significant effects on the daily life of healthy people. This study aimed to investigate the effect of eight weeks of relaxation massage on the mental fatigue control and balance, lower extremity function, and landing mechanic in physical education students. Methods: This research is a quasi-experimental study, and the statistical population of this study was physical education students. From the statistical population, 30 male students with Mean±SD age= 19.5±5.5 years, weight= 69.6±6.8 kg, height= 187.75±4.5 cm, and sports history= 2.66±1.3 years. They were selected by purposeful and were randomly divided based on Research and Criteria into two groups: control group (n=15) and relaxation massage group (n=15). Before and after relaxation massage, mental exhaustion with 45 minutes of stroke activity (Stroop test), Dynamic Balance with Y test, Semi-dynamic balance with Lafayette Stability Platform, lower extremity function by the Lower Extremity Functional Test (LEFT) test and landing mechanic by LESS, Jump-landing skill film assessment by Auto CAD and Kinovea software were measured. Data analysis was performed in SPSS v. 22 software by using Statistical method of ANOVA test with repeated measures and paired t-test at the significant level P=0.05. Results: The results showed that a significant difference was observed between the relaxation massage group and the control group on lower limb function, landing mechanics, dynamic balance, and semi-dynamic balance of physical education students (P=0.001). Conclusion: Significant changes in lower limb function factors, landing mechanics, dynamic balance, and semi-dynamic balance in physical education students after relaxation massage exercises indicate the importance of this issue. Injury prevention specialists should study and research in introducing strategies to deal with the occurrence of mental fatigue.

Effects of McConnell Taping on Function and Dynamic Postural Control in Athletes with Patellofemoral Pain Syndrome

Abstract&#x0D; &#x0D; Background: Patellofemoral pain syndrome represented by anterior knee pain is the most common condition experienced by individuals suffering from knee pathology. Pain behind the kneecap or around the kneecap is the main characteristic, can occur due to the stress on joint structures, commonly affecting athletes and females. It mostly occurs during ascending and descending stairs and remains in a sitting position for a prolonged duration. Objective: To determine the effects of McConnell taping on function and dynamic postural control in athletes with patellofemoral pain syndrome. Methods: This quasi-experimental study consisted of 38 participants with ages ranging from 18 to 40 years presenting with anterior knee pain. Data was collected from the Spine Physiotherapy clinic, Sahiwal. About 28 patients were treated with McConnell taping along with conventional physical therapy. Star excursion balance test and lower extremity functional test scale were used to assess functional and dynamic postural control before treatment and after 24 hours of treatment. Results: The outcomes revealed that there was a statistically significant difference within the group. The p-value was found significant (p&lt;0.001) for both variables. Conclusion: This study concluded that McConnell taping was effective for treating patients with patellofemoral pain syndrome for functional and dynamic postural control.&#x0D; *Corresponding Author: Naeem Aslam, King Edward Medical University, Lahore, Pakistan; Email: naeemaslam693@gmail.com&#x0D; Citation: Aslam N., A. Razzaq, S. Iftikhar. 2021. Effects of McConnell taping on function and dynamic postural control in athletes with patellofemoral pain syndrome. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 1(1):9-14. &#x0D; Keywords: anterior knee pain; McConnell taping; patellofemoral pain syndrome

Medial tibial stress syndrome: The relationship between gender and lower-extremity functional performance among collegiate track and field athletes

Medial tibial stress syndrome (MTSS) is a common lower extremity injury in track and field athletes. Many risk factors are associated with MTSS, and lower extremity performance may become altered in athletes suffering from prior symptoms, potentially increasing risk of future injury. The purpose of this study was to first examine the effect a prior history of MTSS has on lower-extremity measures, per gender, in collegiate level track and field athletes, and then determine if such measures predict future injury. Fifty-three healthy Division III collegiate track and field athletes (mean age = 19.40 ± 1.13 years) completed an injury history questionnaire along with five preseason lower-extremity functional tests including: ankle dorsiflexion (DF), single-leg anterior reach (SLAR), two timed single-leg balance (SLBAL) tests on a force plate, and single-leg hop for distance (SLH). Performance data were compared across gender and questionnaire data regarding injury history and occurrence of MTSS. Fifteen subjects (28%) reported previous MTSS symptoms within the last 2 years. Chi-square analyses revealed females experienced more diagnoses compared to males (p = .03). Independent t-tests revealed differences between gender on all SLBAL tests, as males performed better on all recorded measures (p &lt; .001 – p = .003). No significant differences were noted in lower-extremity performance tests between subjects with and without prior MTSS injuries. Regression analyses using postseason injury questionnaire data revealed prior MTSS injuries had 17.3 higher odds of experiencing MTSS during the season (adjusted odds ratio [AOR] = 17.33, 95% CI: 3.5 – 86.4; p = .001).

Use of the lower extremity functional test to predict injury risk in active athletes.

The purpose of the current study was to assess the reliability and validity of the lower extremity functional test (LEFT) for predicting low back and lower limb injury in active athletes. Seventy athletes (45M, 25F; mean age: 21±2 years) from seven different sports volunteered. The LEFT was a battery of five weight-bearing functional movements involving different movement planes, directions, modes, and at varying intensities. Both legs were assessed in a random order and each athlete was given both movement quality and associated symptom scores. Intratester, intrarater and inter-rater reliability were evaluated. Participants were followed up for 12 months, and their exposure to sport and subsequent injuries were recorded. Independent samples t-tests were performed to determine if a significant difference existed in LEFT scores between injured and non-injured athletes. Receiver operating characteristic (ROC) curve analysis was employed to assess the instrument's capacity to predict injury. The intratester reliability ICC2, 1 was 0.875. The ICC2, 3 of intrarater reliability was 0.953 and the inter-rater reliability was 0.949, respectively. Nineteen participants had an injury in the low back or lower limb within the following 12 months. Injured athletes had significant lower movement quality and symptom scores of the LEFT than non-injured (t=4.278, P=0.000, Cohen's d=1.2; t=3.654, P=0.001, Cohen's d=1.3, respectively). When movement quality or symptom score alone was included in the ROC analysis, the area under the ROC curve (AUC) scores were 0.772 (P=0.000, 95% CI: 0.653-0.891) and 0.771 (P=0.001, 95% CI: 0.638-0.905), respectively. When movement quality and symptom scores were combined to predict injury, the AUC discrimination score was 0.853 (P=0.000, 95% CI: 0.754-0.953), resulting in 85.3% of cases being correctly predicted as low back or lower limb injured/noninjured. The findings from the current study suggest that the LEFT appears to be a reliable and valid functional assessment tool for predicting low back or lower limb injury risk in these college athletes, especially when movement quality and symptom scores were used in combination.

The Association Between Previous Injury And Two Lower Extremity Functional Tests

Previous injury to the lower extremity may increase an athlete’s risk for future injury. Functional screening is one way to determine if an athlete is at a higher risk of future injury. By assessing athletes’ performance on these tests, there is potential for medical providers to implement intervention strategies to decrease risk of future injury. PURPOSE: To determine the association between previous history of injury and two lesser known lower extremity functional tests, the single-leg hip bridge (SLHB) and the single-leg wall-sit (SLWS). METHODS: Sixty-eight recreationally active (participation in exercise or sports for at least 3 days per week for 30 minutes) individuals completed this cross-sectional study. Each participant completed continuous repetitions of a SLHB until failure and repeated on the contralateral leg, as well as a SLWS test, bilaterally, where they were required to hold a single-leg wall sit position until failure. Simple linear regression models were conducted to assess the association between previous injury and the SLHB score and SLWS time. A Poisson regression model was used to assess the association with previous injury for the right and left leg scores on the SLHB. RESULTS: Seventy participants were screened for this study. Of the 70, 2 were excluded, leaving 68 total participants (21 men, 22.4 ± 5.7 years old, 181.96 ± 6.78 cm, and 78.66 ± 10.60 kg and 47 women, 23.3 ± 1.7 years old, 166.30 ± 9.06 cm, and 66.22 ± 9.99 kg). Twenty-five (37%) participants self-reported a previous injury. There was a statistically significant association between a previous injury and the SLHB for the right leg (Relative Risk (RR) = 0.93; 95% Confidence Interval (CI): 0.76-0.93), but not statistically significant association between previous injury and SLHB for the left leg (RR = 0.98; 95% CI: 0.86-1.05). There was no statistically significant association between the SLWS time on either the right (mean difference = 5.57 seconds; 95% CI: -14.17-3.04) or left (mean difference = 5.68 seconds; 95% CI: -13.37-2.02) with previous injury. CONCLUSION: These findings indicate that previous injury to the lower extremity may not affect SLWS time. The SLHB count could be affected depending on the side the injury was on, but additional research is warranted.

Association Between Lower Extremity Functional Tests and Injury in Division I Female Collegiate Athletes

Association Between Lower Extremity Functional Tests and Injury in Division I Female Collegiate Athletes

Functional Tests of Leg Muscle Strength and Power in Adults With Cystic Fibrosis.

Muscle weakness is an important systemic consequence in adults with cystic fibrosis, but it can be challenging to evaluate clinically. This study examined the validity of lower-extremity functional tests to assess quadriceps muscle strength and muscle power. The subjects underwent 4 functional tests: 30-s sit-to-stand test, stair-climb power test, vertical jump height, and triple hop distance. Quadriceps muscle strength and power were tested by using a dynamometer (the accepted standard). Quadriceps strength was measured from 5 maximum voluntary isometric contractions to obtain peak torque. Quadriceps power was evaluated from the peak power and peak velocity attained during isotonic contractions of the quadriceps at a preset load of 20% of the peak torque. Pearson correlations were used to determine associations between functional tests and accepted measures of quadriceps strength and power. Fifteen adults with cystic fibrosis (9 males; mean ± SD age, 32 ± 13 y; mean ± SD FEV1% predicted, 73 ± 19) completed the study. The stair-climb power test had the strongest correlations with peak torque (r = 0.84, P < .001) and power (r = 0.65, P = .009). Vertical jump height was moderately correlated with quadriceps strength (r = 0.62, P = .014) and quadriceps peak power (r = 0.51, P = .048). Similarly, triple hop distance had moderate correlations with quadriceps strength (r = 0.78, P = .001) and peak power (r = 0.57, P = .026). The sit-to-stand test was only associated with quadriceps strength (r = 0.55, P = .034). Functional tests can be applied clinically to measure leg muscle strength and power, with the stair-climb power test having the strongest associations with the standard measures. The utility of using functional tests to evaluate longitudinal changes in muscle function and its association with clinical outcomes should be examined in cystic fibrosis.

PRESEASON LOWER EXTREMITY FUNCTIONAL TEST SCORES ARE NOT ASSOCIATED WITH LOWER QUADRANT INJURY – A VALIDATION STUDY WITH NORMATIVE DATA ON 395 DIVISION III ATHLETES

Preseason performance on the lower extremity functional test (LEFT), a timed series of agility drills, has been previously reported to be associated with future risk of lower quadrant (LQ = low back and lower extremities) injury in Division III (D III) athletes. Validation studies are warranted to confirm or refute initial findings. The primary purpose of this study was to examine the ability of the LEFT to discriminate injury occurrence in D III athletes, in order to validate or refute prior findings. It was hypothesized that female and male D III athletes slower at completion of the LEFT would be at a greater risk for a non-contact time-loss injury during sport. Secondary purposes of this study are to report other potential risk factors based on athlete demographics and to present normative LEFT data based on sport participation. Two hundred and six (females = 104; males = 102) D III collegiate athletes formed a validation sample. Athletes in the validation sample completed a demographic questionnaire and performed the LEFT at the start of their sports preseason. Athletic trainers tracked non-contact time-loss LQ injuries during the season. A secondary analysis of risk based on preseason LEFT performance was conducted for a sample (n = 395) that consisted of subjects in the validation sample (n = 206) as well as athletes from a prior LEFT related study (n = 189). Prospective cohort. Male athletes in the validation sample completed the LEFT [98.6 ( ± 8.1) seconds] significantly faster than female athletes [113.1 ( ± 10.4) seconds]. Male athletes, by sport, also completed the LEFT significantly faster than their female counterparts who participated in the same sport. There was no association between preseason LEFT performance and subsequent injury, by sex, in either the validation sample or the combined sample. Females who reported starting primary sport participation by age 10 were two times (OR = 2.4, 95% CI: 1.2, 4.9; p = 0.01) more likely to experience a non-contact time-loss LQ injury than female athletes who started their primary sport at age 11 or older. Males who reported greater than three hours per week of plyometric training during the six-week period prior to the start of the preseason were four times more likely (OR = 4.0, 95% CI: 1.1, 14.0; p = 0.03) to experience a foot or ankle injury than male athletes who performed three or less hours per week. The LEFT could not be validated as a preseason performance measure to predict future sports injury risk. The data presented in this study may aid rehabilitation professionals when evaluating an injured athlete's ability to return to sport by comparing their LEFT score to population norms. 2.

Preseason Functional Test Scores Are Associated With Future Sports Injury in Female Collegiate Athletes.

Brumitt, J, Heiderscheit, B, Manske, R, Niemuth, PE, Mattocks, A, and Rauh, MJ. Preseason functional test scores are associated with future sports injury in female collegiate athletes. J Strength Cond Res 32(6): 1692-1701, 2018-Recent prospective cohort studies have reported preseason functional performance test (FPT) measures and associations with future risk of injury; however, the findings associated with these studies have been equivocal. The purpose of this study was to determine the ability of a battery of FPTs as a preseason screening tool to identify female Division III (D III) collegiate athletes who may be at risk for a noncontact time-loss injury to the lower quadrant (LQ = low back and lower extremities). One hundred six female D III athletes were recruited for this study. Athletes performed 3 FPTs: standing long jump (SLJ), single-leg hop (SLH) for distance, and the lower extremity functional test (LEFT). Time-loss sport-related injuries were tracked during the season. Thirty-two (24 initial and 8 subsequent) time-loss LQ injuries were sustained during the study. Ten of the 24 initial injuries occurred at the thigh and knee. At-risk athletes with suboptimal FPT measures (SLJ ≤79% ht; (B) SLH ≤64% ht; LEFT ≥118 seconds) had significantly greater rates of initial (7.2 per 1,000 athletic exposures [AEs]) and total (7.6 per 1,000 AEs) time-loss thigh or knee injuries than the referent group (0.9 per 1,000 AEs; 1.0 per 1,000 AEs, respectively). At-risk athletes were 9 times more likely to experience a thigh or knee injury (odds ratio [OR] = 9.7, confidence interval [CI]: 2.3-39.9; p = 0.002) than athletes in the referent group. At-risk athletes with a history of LQ sports injury and lower off-season training habits had an 18-fold increased risk of a time-loss thigh or knee injury during the season (adjusted OR = 18.7, CI: 3.0-118.1; p = 0.002). This battery of FPTs appears useful as a tool for identifying female D III athletes at risk of an LQ injury, especially to the thigh or knee region.