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Compared to force-plates, pressure-detecting insoles have the advantage that vertical ground reaction force (vGRF) can be estimated under field rather than laboratory conditions. However, the question arises whether insoles also provide valid and reliable results compared to a force-plate (i.e., the gold standard). The study aimed to investigate the concurrent validity and test–retest reliability of pressure-detecting insoles during static and dynamic movements. Twenty-two healthy young adults (12 females) performed standing, walking, running, and jumping movements while simultaneously collecting pressure (GP MobilData WiFi, GeBioM mbH, Münster, Germany) and force (Kistler®) data twice, 10 days apart. Concerning validity, ICC values showed excellent agreement (ICC > 0.75), irrespective of the test condition. Further, the insoles underestimated (mean bias: −4.41 to −37.15%) most of the vGRF variables. Concerning reliability, ICC values for nearly all test conditions also showed excellent agreement, and the SEM was rather low. Lastly, most of the MDC95% values were low (≤5%). The predominantly excellent ICC values for between-devices (i.e., concurrent validity) and between-visits (i.e., test–retest reliability) comparisons suggest that the tested pressure-detecting insoles can be used under field-based conditions for a valid and reliable estimation of relevant vGRF variables during standing, walking, running, and jumping.

The aim of the present study was to investigate the concurrent validity and the test–retest reliability of an electronic contact mat for drop jump assessment in physically active adults. Seventy-nine young, physically active adults participated in the validity study, and 49 subjects were recruited for the reliability study. The motor task required subjects to perform two-legged drop jumps using drop heights of 24, 43, and 62 cm as well as one-legged drop jumps with the left and right leg using a drop height of 24 cm. Ground contact times were simultaneously quantified with an electronic contact mat, a force plate (i.e., gold standard), and a light-barrier system (another criterion device). Concurrent validity was assessed using intraclass correlation coefficient (ICC), systematic bias, limits of agreement, and linear regression analysis. Test–retest reliability (one week apart) was determined by calculating the ICC, the standard error of measurement (SEM), the coefficient of variation (CV), and Lin´s concordance correlation coefficient (рc). Further, we determined the minimal detectable change (MDC95%). Irrespective of drop height and jump condition, good agreements between testing devices (ICC ≥ 0.95) were shown. Compared to the force plate (−0.6 to 3.1 ms) but not to the light-barrier system (31.4 to 41.7 ms), the contact mat showed low systematic bias values. In terms of test–retest reliability, our analyses showed that the measuring devices are in agreement (ICC: 0.70–0.92; SEM: 8.5–18.4 ms; CV: 3.6–6.4%). Depending on the measurement device, drop height, and jump condition, a MDC95% value ranging from 23.6 to 50.9 ms represents the minimum amount of change needed to identify practical relevant effects in repeated measurements of drop jump performance. Our findings indicate that the electronic contact mat is a valid and reliable testing device for drop jump assessment from different drop heights in young physically active adults.

A manual shoulder-training device may represent an alternative training device to improve symptoms and function in patients with subacromial shoulder pain by strengthening the external rotators. Thus, we examined the effects of a traditional versus an alternative strengthening exercise program on shoulder pain/function and physical performance in individuals with subacromial shoulder pain. Fifty-six adults with subacromial shoulder pain were randomly assigned to a passive control group (CON; n = 20), a traditional training group (TRA; n = 19), or an alternative training group (ALT; n = 17). Both training groups conducted a progressive home-based strengthening exercise program for the external rotators for eight weeks using elastic bands only (TRA group) or in combination with the shoulder-training device (Schulterhilfe®) (ALT group). Pre- and post-training assessment included measures of shoulder pain/function (i.e., shoulder pain and disability index (SPADI)) and physical performance (i.e., shoulder flexibility, maximal isometric strength, and strength endurance). We found significant test × group interactions in most of the investigated variables. Post hoc analyses showed significant training-related improvements for proxies of shoulder pain/function, shoulder flexibility, maximal isometric strength, and strength endurance in favor of the ALT and TRA group in comparison to the CON group. Further, larger and more frequent effects were found for the ALT compared to the TRA group. Measures of shoulder pain/function and physical performance can be significantly improved by both training regimens in individuals with subacromial shoulder pain. However, strength training using elastic bands with the manual shoulder device (ALT group) as compared to elastic bands (TRA group) only was more effective and may thus be a recommendable alternative in order to mitigate subacromial shoulder pain.

Background The sequence of blocked balance training (BT) followed by blocked plyometric training (PT) showed greater improvements in physical performance than vice versa and is explained by a preconditioning effect of BT-related adaptations on subsequent adaptations induced by PT. However, it remains unclear whether beneficial effects can also be induced using alternating instead of blocked BT and PT exercise sequences. Thus, we examined the effects of a blocked versus an alternated sequence of BT and PT on physical performance in trained individuals. Methods Twenty young soccer players (13 years) were randomly assigned to a blocked ( n  = 10) or an alternated ( n  = 10) intervention group. Both groups trained balance and plyometric exercises for six weeks (two sessions/week). The exercises were conducted in a blocked (three weeks of BT followed by three weeks of PT) or an alternated sequence (weekly change of BT and PT). Assessment of pre- and post-training performance included measures of balance, muscle power, speed, and agility. Results Mainly significant main effects of Test (i.e., pre- to post-test improvements) were observed for the Y-balance test ( p  ≤ 0.014, 1.3 ≤ Cohen’s d  ≤ 1.81), the squat jump ( p  = 0.029, d  = 1.36), the countermovement jump ( p  = 0.002, d  = 2.21), the drop jump ( p  = 0.004, d  = 1.96), the split times/total time over 15-m sprinting ( p  ≤ 0.001, 2.02 ≤  d  ≤ 3.08), and the figure-T agility run ( p  < 0.001, d  = 3.80). Further, tendencies toward significant Test x Group interactions were found for several items of the Y-balance test and for SJ height in favor of the blocked BTPT group. Conclusions Our results indicate that the combined training of balance and plyometric exercises is effective to improve proxies of physical performance in youth soccer players. In addition, there is a limited advantage in some parameters of balance and muscle power for the blocked as compared to the alternated sequence of BT and PT.

Excessive pronation and increased pronation velocity of the foot due to excessive Subtalar Joint (STJ) motion have been discussed as major intrinsic factors for the pathophysiology of overuse running injuries. A possible strategy to reduce these risk factors is the use of the supinator muscles acting eccentrically during the support phase of running. We hypothesised that STJ-specific strength training of the supinator and pronator muscles would be more effective in reducing rearfoot motion compared to traditional plantarflexor and dorsiflexor exercises. Twenty healthy male (20–35 years) recreational runners performed machine-based Subtalar Training (ST) with the right foot and machine-based plantar-/ dorsiflexor taining around the Talocrural joint (TT) with the left over a period of ten weeks. STJ muscle strength and shank muscle volume were measured in pre- and posttest. Furthermore, rearfoot motion during overground running (3.3 m/s) was analysed. The multifactorial analyses showed significant increases in muscle strength and volume (p < 0.001). Interaction effects (time x group) revealed higher strength increases for ST (p < 0.001) and higher muscle volume increase in the deep supinator muscles (p < 0.05) for ST. The analyses of rearfoot motion showed significant changes after the treatment indicated by a higher inversion angle at touchdown (p < 0.01) and reduced eversion velocity in mid-stance (p < 0.01). Both effects were higher after ST (p < 0.01; time x group interaction). Machine-based subtalar-specific strength training represents a potential prevention strategy for male runners to enhance the function of the supinator muscles, to stabilise rearfoot motion during running and, therefore, to reduce lower limb injury risk.

The peroneal muscles are the most effective lateral stabilisers whose tension braces the ankle joint complex against excessive supination. The purpose of this study was to identify the morphological and biomechanical effects of two machine-based shank muscle training methods. Twenty-two healthy male recreationally active sports students performed ten weeks of single-set high resistance strength training with 3 training sessions per week. The subjects conducted subtalar pronator/supinator muscle training (ST) with the right leg by using a custom-made apparatus; the left foot muscles were exercised with machine-based talocrural plantar and dorsiflexor training (TT). Muscle strength (MVIC), muscle volume and foot biomechanics (rearfoot motion, ground reaction forces, muscle reaction times) during a sudden ankle supination were recorded before and after the intervention. Compared to TT, ST resulted in significantly higher pronator (14% vs. 8%, P<0.01) and supinator MVIC (25% vs. 12%, P<0.01). During sudden foot inversions, both ST and TT resulted in reduced supination velocity (-12%; P<0.01). The muscle reaction onset time was faster after the training in peroneus longus (PL) (P<0.01). Muscle volume of PL (P<0.01) and TA (P<0.01) increased significantly after both ST and TT. After both ST and TT, the ankle joint complex is mechanically more stabilised against sudden supinations due to the muscle volume increase of PL and TA. As the reduced supination velocities indicate, the strength training effects are already present during free-fall. According to a sudden ankle supination in standing position, both machine-based dorsiflexor and pronator strength training is recommended for enhancing the mechanical stability of the ankle.

Background Due to the specific anatomy of the subtalar joint with its oblique axis, isometric pronator and supinator strength is not well documented. The purpose of this study was to determine intra- and between-session reliability of pronator and supinator strength and lower leg muscle activity measurements during maximum voluntary isometric contractions (MVIC). Methods Pronator and supinator peak torques (PT), with and without supplementary visual muscle strength biofeedback (FB), and muscular activities of peroneus longus (PL) and tibialis anterior (TA) were assessed twice 3 days apart by the same examiner in 21 healthy young male adults (mean age: 27.6 years; SD = 3.9). Limits of agreement (LoA) and minimum detectable change (MDC) were evaluated. Results By applying FB, reliability of both pronator and supinator PT was improved: LoA were reduced from 32% to 26% and from 20% to 18% and MDC from 20% to 15% and from 16% to 12% in supinator and pronator PT, respectively. Learning effects in pronator and supinator PT (p < 0.05), which were present without FB, were eliminated using FB. Except for TA during pronation, muscle activities showed low reliability indicated by LoA of 51% to 79%. Conclusions Using supplementary biofeedback, isometric subtalar pronator and supinator strength testing is reliable in healthy subjects. LoA of 18% and 26% have to be exceeded for pronator and supinator PT, respectively, to detect relevant effects in repeated measures.

Background The angle-dependent torque capacity of the subtalar pronators and supinators is important to maintain dynamic ankle stabilisation. Based on the peak torques during maximum voluntary isometric pronation and supination across the subtalar range of motion, the strength curves of younger and elderly males and females were investigated. Methods Maximum voluntary isometric subtalar pronator and supinator strength tests were administered to 30 younger and 30 elderly volunteers (each 15 male and 15 female subjects). Total active subtalar range of motion and peak pronator and supinator torques were measured in five anatomical subtalar joint angles using a custom-built apparatus with two force transducers. Furthermore, relative torques (normalised to the individual peak torque) and pronator-to-supinator strength-ratios were also calculated. Results Pronator-to-supinator strength ratio, and peak pronator and supinator torques are affected by age and by joint angle x age interactions. All supinator strength curves show a steadily descending characteristic from the pronated to the supinated positions. The pronator strength curve had an inverted U-shaped characteristic, except for younger women of whom 47 % exert highest peak values in the end-range pronation angle. Both relative pronator and supinator strength are dependent on sex ( P  < 0.05). Relative pronator strength is also affected by joint angle x sex ( P  < 0.0001) and joint angle x sex x age ( P  < 0.05) interactions. Beside age effects on all range of motion parameters, pronation range of motion is influenced by a sex x age interaction ( P  < 0.05). Conclusions Age- and sex-related differences in both subtalar strength profile and range of motion have to be considered when testing strength across subtalar range of motion. Younger females have higher pronator strength capacity in the most pronated joint angle, which may be due in part to their greater subtalar joint range of motion compared to the other groups. In the most supinated position both pronator and supinator strength capacity is reduced in younger females compared to younger males.

Modern orthopaedic surgery provides a variety of techniques for cartilage repair. The Autologous Matrix-Induced Chondrogenesis (AMIC) procedure is a single-step technique with a collagen I/III scaffold for the treatment of full-thickness cartilage lesions. The aim of the study was to analyze the outcome of the AMIC procedure in overweight patients with knee cartilage defects. Overweight patients treated with AMIC surgery were followed up by clinical and MRI examination. 9 patients with a cartilage defect of the knee with a mean lesion size of 2.1±1.2 cm2 and an average body mass index (BMI) of 29.3 were available for the follow-up. The Lysholm Score was significantly improved by the AMIC procedure (38 to 67, p≤0.008). The VAS Score was significantly lower after the procedure (9 to 3, p≤0.018). In the postoperative MOCART Scale, the scaffold reached defect covering of 80%. However, 2 patients had to be revised due to persisting knee pain. The AMIC procedure enhances pain reduction and gain of knee function for cartilage defects of overweight patients. However, in cases of an increased BMI, the patient had to be informed that success rate is reduced despite good defect covering.

Introduction Femoroacetabular impingement (FAI) represents a novel approach to the mechanical etiology of hip osteoarthritis. The cam-type femoroacetabular impingement deformity occurs frequently in young male athletes. The aim of our study was to evaluate the prevalence of FAI in male semiprofessional soccer players using clinical examination and magnetic resonance imaging (MRI), compared to amateur soccer players. In MRI, the α angle of Nötzli is determined for quantifying FAI. Materials and methods According to power analysis, a total of 22 asymptomatic semiprofessional soccer players with a median of 23.3 years of age (range 18–30 years) and 22 male amateur soccer players with a median of 22.5 years of age (control group, range 18–29 years) underwent an MRI to measure the hip α angle of Nötzli. The α angle of the kicking legs of the semiprofessional group and the amateur group were analyzed. The study group was moreover evaluated by the Hip Outcome Score (HOS) and a clinical hip examination including range of motion (ROM) and impingement tests. Results In the semiprofessional group, 19 soccer players had a right kicking leg and 1 soccer player had a left kicking leg. 2 soccer players kicked with two feet. In the semi-professional group, the mean value of the α angle of the kicking leg (57.3 ± 8.2°) was significantly higher than in the amateur group (51.7 ± 4.8°, P  = 0.008). In the semi-professional group, 15 (62.5 %) of 24 kicking legs had an increased α angle >55°, while 5 (27.3 %) kicking legs of the amateur group had an α angle >55°. Five semi professional soccer players had findings in clinical examination, whereof 4 had an increased α angle >55°. No participant of the amateur group showed pathological results in the clinical examination ( P  = 0.0484). Overall, semiprofessional soccer players had a higher proportion of an increased α angle than the amateur group. Conclusions Semiprofessional players have a higher prevalence of an increased α angle in the kicking leg than the amateur group at the same age. The kicking leg is predisposed for FAI.