Objective:

Determine the reliability of two different modified (MOD1 and MOD2) testing methods compared to a standard method (ST) for testing trunk flexion and extension endurance.

Participants:

Twenty‐eight healthy individuals (age 26.4 ± 3.2 years, height 1.75 ± m, weight 71.8 ± 10.3 kg, body mass index 23.6 ± 3.4 m/kg2).

Method:

Trunk endurance time was measured in seconds for flexion and extension under the three different stabilization conditions. The MOD1 testing procedure utilized a female clinician (70.3 kg) and MOD2 utilized a male clinician (90.7 kg) to provide stabilization as opposed to the ST method of belt stabilization.

Results:

No significant differences occurred between flexion and extension times. Intraclass correlations (ICCs3,1) for the different testing conditions ranged from .79 to .95 (p <.000) and are found in Table 3. Concurrent validity using the ST flexion times as the gold standard coefficients were .95 for MOD1 and .90 for MOD2. For ST extension, coefficients were .91 and .80, for MOD1 and MOD2 respectively (p <.01).

Conclusions:

These methods proved to be a reliable substitute for previously accepted ST testing methods in normal college‐aged individuals. These modified testing procedures can be implemented in athletic training rooms and weight rooms lacking appropriate tables for the ST testing.

Level of Evidence:

3

Background and Purpose:

Rehabilitation and strength and conditioning are often seen as two separate entities in athletic injury recovery. Traditionally an athlete progresses from the rehabilitation environment under the care of a physical therapist and/or athletic trainer to the strength and conditioning coach for specific return to sport training. These two facets of return to sport are often considered to have separate goals. Initial goals of each are often different due to the timing of their implementation encompassing different stages of post-injury recovery. The initial focus of post injury rehabilitation includes alleviation of dysfunction, enhancement of tissue healing, and provision of a systematic progression of range-of-motion and strength. During the return to function phases, specific return to play goals are paramount. Understanding of specific principles and program parameters is necessary when designing and implementing an athlete's rehabilitation program. Communication and collaboration amongst all individuals caring for the athlete is a must. The purpose of this review is to outline the current evidence supporting utilization of training principles in athletic rehabilitation, as well as provide suggested implementation of such principles throughout different phases of a proposed rehabilitation program.

Evidence Acquisition:

The following electronic databases were used to identify research relevant to this clinical commentary: MEDLINE (from 1950–June 2011) and CINAHL (1982–June 2011), for all relevant journal articles written in English. Additional references were accrued by independent searching of references from relevant articles.

Results:

Currently evidence is lacking in the integration of strength and conditioning principles into the rehabilitation program for the injured athlete. Numerous methods are suggested for possible utilization by the clinician in practice to improve strength, power, speed, endurance, and metabolic capacity.

Conclusion:

Despite abundance of information on the implementation of training principles in the strength and conditioning field, investigation regarding the use of these principles in a properly designed rehabilitation program is lacking.

Purpose/Background:

Medial shin pain (MSP) is a common complaint that may stop an athlete from running. No previous study has identified deficits in pelvic, hip or knee motion as potential contributing factors to MSP. The purpose of this study was to investigate the differences in kinematics during running between uninjured athletes and those with MSP. Secondary analyses investigated differences in limbs between groups and differences between sexes.

Methods:

This case-control study investigated fourteen runners aged 18–40 years old with a history of unilateral MSP and fourteen runner controls. Three dimensional lower quarter kinematics were captured as runners ran on a treadmill. Specifically, peak hip internal rotation (IR), frontal plane pelvic tilt (PT) excursion, and knee flexion were examined.

Results:

Groups were similar in age, mass, height, and training mileage. Subjects with a history of MSP demonstrated significantly greater frontal plane PT (P = 0.002, Effect size = 0.55) and peak hip IR (P = 0.004, Effect size = 0.51); and less knee flexion (P = 0.02, Effect size = 0.46) than the control group. No significant difference was found in kinematics of the MSP group during their involved side stance phase as compared to their non-involved side.

Conclusions:

Runners with MSP displayed greater PT excursion, peak hip IR, and decreased knee flexion while running as compared to a control group. These results should help guide treatment for the running athlete that experiences MSP.

Level of Evidence:

3b

Testing for outcome or performance can take many forms; including multiple iterations of self-reported measures of function (an assessment of the individual’s perceived dysfunction) and/or clinical special tests (which are primarily assessments of impairments). Typically absent within these testing mechanisms is whether or not one can perform a specific task associated with function. The paper will operationally define function, discuss the construct of function within the disablement model, will overview the multi-dimensional nature of ‘function’ as a concept, will examine the current evidence for functional testing methods, and will propose a functional testing continuum. Limitations of functional performance testing will be discussed including recommendations for future research.

Context:

There is a dearth of literature on the performance enhancement in the recovering athlete in the terminal phases of rehabilitation. There are established training methods that target strength, power, speed, endurance, and metabolic capacity that all lead to performance enhancement.

Evidence Acquisition:

A PubMed search from 1980 to 2010 was undertaken for articles in English. Additional references were accrued from reference lists of research articles.

Results:

Multiple options are available to improve strength, power, speed, endurance, and metabolic capacity during rehabilitation.

Conclusion:

Sports clinicians have several components to address in the rehabilitation of a recovering athlete in addition to performance enhancement. Sports clinicians should focus their efforts on increasing power, a product of maximum force and speed of performance.

Establishing the cause of lumbo-pelvic-hip complex pain is a challenge for many clinicians. This case report describes the mechanism of injury, diagnostic process, surgical management, and rehabilitation of a female high school basketball athlete who sustained an injury when falling on her right side. Diagnostics included clinical examination, radiography of the spine and hip joint, magnetic resonance imaging arthrogram, 3-dimensional computed tomography scan, and computed tomography of the hip joint. A systematic multidisciplinary clinical approach resulted in the patient’s return to previous functional levels.

Background:

Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression—that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs.

Evidence Acquisition:

A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review.

Results:

Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs.

Conclusions:

Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs.