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Background and Purpose:
The potential adverse effects of static stretching on athletic performance are well documented, but still appears to be controversial, especially as they relates to sprinting. The prevalence of this practice is demonstrated by the number of competitive and recreational athletes who regularly engage in stretching immediately prior to sprinting with the mindset of optimizing their performance. The purpose of this study was to examine the effects of acute static, dynamic, and ballistic stretching, and no stretching of the iliopsoas muscle on 40‐yard sprint times in 18‐37 year‐old non‐competitive, recreational runners.
Twenty‐five healthy recreational runners (16 male and 9 female) between the ages of 24 and 35 (Mean = 26.76 yrs., SD = 2.42 yrs.) completed this study. A repeated measures design was used, which consisted of running a 40‐yard sprint trial immediately following each of 4 different stretching conditions aimed at the iliopsoas muscle and lasting 1 minute each. The 4 conditions were completed in a randomized order within a 2‐week time period, allowing 48‐72 hours between each condition. Prior to each 40‐yard sprint trial, a 5‐minute walking warm‐up was performed at 3.5 mph on a treadmill. The subject then ran a baseline 40‐yard sprint. After a 10‐minute self‐paced walk, each subject performed one of the 4 stretching conditions (ballistic, dynamic, static, and no stretch) and then immediately ran a timed 40‐yard sprint.
There was a significant interaction between stretching conditions and their effects on sprint times, F(3,72) = 9.422, p<.0005. To break down this interaction, simple main effects were performed with 2 repeated measures ANOVAs and 4 paired t‐tests using a Bonferroni corrected alpha (α = .0083). There were no significant differences between the 4 pre‐condition times, p = 0.103 (Greenhouse‐Geisser) or the post‐condition times, p = 0.029. In the no stretch condition, subjects improved significantly from pre‐ to post‐ sprint times (p<0.0005). There were no statistically significant differences in pre‐ and post‐stretch condition sprint times among the static (p = 0.804), ballistic (p = 0.217), and dynamic (p = 0.022) stretching conditions.
Sprint performance may show greatest improvement without stretching and through the use of a walking generalized warmup on a treadmill. These findings have clinically meaningful implications for runners who include iliopsoas muscle stretching as a component of the warm‐up.
Level of Evidence:
Level 2
PMCID: PMC3474300  PMID: 23091787
Recreational runners; sprinting; stretching; warm‐up
2.  Safety of cervical spine manipulation: are adverse events preventable and are manipulations being performed appropriately? A review of 134 case reports 
Cervical spine manipulation (CSM) is a commonly utilized intervention, but its use remains controversial.
To retrospectively analyze all available documented case reports in the literature describing patients who had experienced severe adverse events (AEs) after receiving CSM to determine if the CSM was used appropriately, and if these types of AEs could have been prevented using sound clinical reasoning on the part of the clinician.
Data sources
PubMed and the Cumulative Index to Nursing and Allied Health were systematically searched for case reports between 1950 and 2010 of AEs following CSM.
Study selection
Case reports were included if they were peer-reviewed; published between 1950 and 2010; case reports or case series; and had CSM as an intervention. Articles were excluded if the AE occurred without CSM (e.g. spontaneous); they were systematic or literature reviews. Data extracted from each case report included: gender; age; who performed the CSM and why; presence of contraindications; the number of manipulation interventions performed; initial symptoms experienced after the CSM; and type of resultant AE.
Data synthesis
Based on the information gathered, CSMs were categorized as appropriate or inappropriate, and AEs were categorized as preventable, unpreventable, or unknown. Chi-square analysis with an alpha level of 0.05 was used to determine if there was a difference in proportion between six categories: appropriate/preventable, appropriate/unpreventable, appropriate/unknown, inappropriate/preventable, inappropriate/unpreventable, and inappropriate/unknown.
One hundred thirty four cases, reported in 93 case reports, were reviewed. There was no significant difference in proportions between appropriateness and preventability, P = .46. Of the 134 cases, 60 (44.8%) were categorized as preventable, 14 (10.4%) were unpreventable and 60 (44.8%) were categorized as ‘unknown’. CSM was performed appropriately in 80.6% of cases. Death resulted in 5.2% (n = 7) of the cases, mostly caused by arterial dissection.
There may have been discrepancies between what was reported in the cases and what actually occurred, since physicians dealing with the effects of the AE, rather than the clinician performing the CSM, published many of the cases.
This review showed that, if all contraindications and red flags were ruled out, there was potential for a clinician to prevent 44.8% of AEs associated with CSM. Additionally, 10.4% of the events were unpreventable, suggesting some inherent risk associated with CSM even after a thorough exam and proper clinical reasoning.
PMCID: PMC3360486  PMID: 23633885
Adverse events; Case reports; Cervical spine; Manipulation; Risk of harm; Safety
3.  Competency Revalidation Study of Specialty Practice in Sports Physical Therapy 
The primary purpose of this study was to revalidate the competencies that define the practice of sports physical therapy. Additionally, the study allowed for the comparison of responses of board certified specialists in sports physical therapy to respondents who were not specialists.
A survey instrument based the on American Board of Physical Therapy Specialties practice analysis template and The Guide to Physical Therapist Practice was developed by the Sports Specialty Council and a panel of subject matter experts in sports physical therapy. The instrument was sent to 630 physical therapists, 315 of whom were board certified specialists in sports physical therapy and 315 of whom were randomly selected members of the Sports Physical Therapy Section who were not board certified specialists in sports physical therapy. Two hundred and thirty seven subjects returned completed surveys for a 41% response rate. One hundred and fifty eight respondents were sports specialists
The survey results were reviewed by the Sports Specialty Council and another panel of subject matter experts. Using a defined decision making process, the results were used to determine the competencies that define the specialty practice of sports physical therapy. Survey results were also used to develop the sports physical therapy specialty board examination blue print. A number of significant comparisons between the specialists and non-specialists were identified.
The competency revalidation process culminated in the publication of the Sports Physical Therapy Description of Specialty Practice. This document serves to guide the process related to the attainment and maintenance of the board certified clinical specialist in sports physical therapy.
PMCID: PMC2953335  PMID: 21509106

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