Alicia M. Montalvo

Effect of Kinesiology Taping on Pain in Individuals With Musculoskeletal Injuries: Systematic Review and Meta-Analysis

Abstract Kinesiology tape, an elastic tape used by sports medicine clinicians to enhance sports performance in athletes, is purported to facilitate a reduction in pain during physical activity in individuals with orthopedic injuries, but high-quality literature on this topic remains scarce. The purpose of this meta-analysis is to critically examine and review the existing literature to evaluate the effect of kinesiology tape application on pain in individuals with musculoskeletal injury. English-language publications from 2003 to 2013 were surveyed by searching SPORTDiscus, Scopus, ScienceDirect, CINAHL, Cochrane Library, PubMed, and PEDro databases using the terms kinesio tap*, kinesiology tap*, kinesiotap*, and pain. Thirteen articles investigating the effects of kinesiology tape application on pain with at least level II evidence were selected. The combined results of this meta-analysis indicate that kinesiology tape may have limited potential to reduce pain in individuals with musculoskeletal injury; however, depending on the conditions, the reduction in pain may not be clinically meaningful. Kinesiology tape application did not reduce specific pain measures related to musculoskeletal injury above and beyond other modalities compared in the context of included articles. We suggest that kinesiology tape may be used in conjunction with or in place of more traditional therapies, and further research that employs controlled measures compared with kinesiology tape is needed to evaluate efficacy.

An Evidence-Based Practice Approach to the Efficacy of Kinesio Taping for Improving Pain and Quadriceps Performance in Physically-Active Patellofemoral Pain Syndrome Patient

Background: Patellofemoral Pain Syndrome (PFPS) is the most commonly diagnosed musculoskeletal condition in physically active patients. Sports medicine clinicians typically use physical rehabilitation and therapeutic taping techniques to control pain and improve muscular performance in patients with PFPS. Recently, Kinesio Tape (KT) has gained popularity among sports medicine clinicians and athletes for the treatment of various musculoskeletal disorders; however, its efficacy in the treatment of most orthopedic conditions, including PFPS, has not been widely investigated. Objective: The purpose of this review was to critique evidence for the efficacy of KT in improving clinical outcomes in PFPS patients. Methods: English-language publications from 2003 to 2013 were surveyed by searching PubMed, CINAHL, SPORTDiscus, and the Cochrane Library databases using the terms Kinesio tape, Kinesio taping, and knee. Studies focused on generally healthy, physically-active individuals with PFPS who had KT applied at the knee were selected. Pain during activity and/or knee extensor performance was the measures of interest. Results: Conflicting results found in studies of varying methodological quality show that KT application does not differ significantly from McConnell medial glide taping technique with regard to pain reduction or knee extensor performance, and that pain may decrease and knee extensor performance may increase with KT application. Conclusions: The best evidence suggests that KT may be used in place of or in conjunction with traditional therapies to resolve pain and improve performance of the knee extensors. Currently, there is limited high level, high quality evidence available.

Neuromuscular asymmetries in the lower limbs of elite female youth basketball players and the application of the skillful limb model of comparison

OBJECTIVES Compare the ability of commonly used comparison models to detect neuromuscular asymmetries. A secondary purpose was to determine which neuromuscular task(s) has the greatest sensitivity to identify asymmetries based on the ASI (asymmetry index) calculation. METHODS Elite female youth basketball players (N = 29, age = 15.7 ± 1.34 y) performed the single leg countermovement jump in vertical, horizontal, and lateral directions, the star excursion balance test in the anterior, posteromedial, and posterolateral directions, and the sprint test with change of direction. Paired t-tests compared right and left limbs, the dominant (DL) and non-dominant (NDL) limbs, and the more/less skillful limbs. RESULTS The coincident identification between the more skillful leg and the leg subjectively described as the DL was low for all of the tasks performed (35%-52%). There were significant differences between the more and less skillful legs for all tasks, while performances between the right and left limbs and DL and NDL differed significantly for only one task each. The largest ASI detected in this study was found in the vertical single leg countermovement jump (14.11%). CONCLUSIONS The skillful limb model of comparison may be more useful than other models to detect neuromuscular asymmetries.

Integrative Neuromuscular Training and Injury Prevention in Youth Athletes. Part I: Identifying Risk Factors

ABSTRACT PART I OF THIS REVIEW DESCRIBES THE MOST IMPORTANT NEUROMUSCULAR SPORTS INJURY RISK FACTORS IN YOUTH ATHLETES: MUSCLE FATIGUE, ALTERED TIMING AND MAGNITUDE OF MUSCLE ACTIVATION, STRENGTH DEFICITS, PREDOMINANCE OF FRONTAL PLANE CONTROL STRATEGIES, NEUROMUSCULAR IMBALANCES BETWEEN LIMBS, INADEQUATE MUSCLE STIFFNESS, DEFICITS IN POSTURAL STABILITY, ALTERED PROPRIOCEPTION, AND FEED-FORWARD CONTROL. THE SECOND PART OF THIS REVIEW PROVIDES A FLEXIBLE APPROACH TO INTEGRATIVE NEUROMUSCULAR TRAINING WITH THE GOAL TO IMPROVE INJURY RESILIENCE AND TO ENHANCE SPORT AND MOTOR SKILL PERFORMANCE.

Physical Characteristics of Elite Adolescent Female Basketball Players and Their Relationship to Match Performance

Abstract There were two aims of this study: first, to investigate physical fitness and match performance differences between under-16 (U16) and under-18 (U18) female basketball players, and second, to evaluate the relationship between physical fitness and game-related performances. Twenty-three young, female, elite Spanish basketball players (16.2 1.2 years) participated in the study. The sample was divided into two groups: U16 and U18 players. The average scores from pre- and post-season physical fitness measurements were used for subsequent analyses. Anthropometric variables were also measured. To evaluate game performance, game-related statistics, including the number of games and minutes played, points, rebounds, assists, steals and blocks per game, were recorded for every competitive match in one season. When anthropometric and physical performance variables were compared between groups, the U18 group demonstrated significantly (p<0.05) higher values in upper (+21.2%) and lower (+27.11%) limb strength compared to the U16 group. Furthermore, no significant differences between groups were observed in match performance outcomes. Only two performance variables, steals and assists per game, correlated significantly with jump capacity, speed, agility, anaerobic power, repeated sprint ability and aerobic power (p ≤ 0.005). These findings can help optimize training programs for young, elite female basketball players.

Age-Dependent Patellofemoral Pain: Hip and Knee Risk Landing Profiles in Prepubescent and Postpubescent Female Athletes:

Background: Female athletes are at an increased risk of developing patellofemoral pain (PFP) relative to male athletes. The unique effects of maturation may compound that risk. Hypothesis/Purpose: The purpose was to evaluate the neuromuscular control mechanisms that are adaptive to pubertal maturation and determine their relative contribution to PFP development. It was hypothesized that aberrant landing mechanics (reduced sagittal-plane and increased frontal- and transverse-plane kinematics and kinetics) would be associated with an increased risk for PFP. Study Design: Cohort study; Level of evidence, 2. Methods: There were 506 high school female athletes who completed a detailed medical history, the Anterior Knee Pain Scale, and a knee examination for the diagnosis of PFP and attended follow-up appointments. Athletes performed a drop vertical jump task instrumented with force plates, and biomechanical measures generated from standard 3-dimensional biomechanical analyses were used to classify participants into high- or low-risk knee and hip landing profiles for the development of PFP. The biomechanical measures used in the knee landing profile included sagittal-plane knee range of motion, peak knee abduction angle, peak knee abduction moment, and peak-to-peak transverse-plane knee moment. The biomechanical measures used in the hip landing profile included sagittal-plane hip range of motion, peak hip extensor moment, peak abductor moment, and peak hip rotator moment. Testing was conducted at sport-specific preseason appointments over the course of 2 years, and changes in pubertal status, landing profile, and PFP development were documented. Results: Female athletes with high-risk hip landing profiles experienced increased hip flexion and decreased abductor, rotator, and extensor moments. Participants with high-risk hip landing profiles who transitioned to postpubertal status at follow-up had higher odds (odds ratio, 2.1 [95% CI, 1.1-4.0]; P = .02) of moving to a low-risk hip landing profile compared with those who had not reached postpubertal status at follow-up. Participants with high-risk knee landing profiles experienced decreased knee flexion and increased knee abduction, external abductor, and external rotator moments. Pubertal maturation was not associated with a change in the high-risk knee landing profile at follow-up. Conclusion: The progression from prepubertal to postpubertal status may have a protective effect on high-risk hip mechanics but no similar adaptations in high-risk knee mechanics during maturation. These data indicate that before puberty, maladaptive hip mechanics may contribute to PFP, while aberrant knee mechanics associated with PFP are sustained throughout the maturational process in young female athletes.

Muscle activation in suspension training: a systematic review

Abstract Suspension training is an adjunct to traditional strength and conditioning. The effect of added instability on muscle activation during traditional exercises is unclear and depends on the exercise and type of instability. The purpose of this review was to compare the activations of different muscles in suspension training exercises and their traditional counterparts. A search of the current literature was performed without language restrictions using the electronic databases PubMed (1969—12 January 2017), SPORTDiscus (1969—12 January 2017) and Scopus (1969—12 January 2017). The inclusion criteria were: (1) descriptive studies; (2) physically active participants; and (3) studies that analysed muscle activation using normalised electromyographic signals during different suspension training exercises. Eighteen studies met the inclusion criteria. For the push-up, inverted row, prone bridge and hamstring curl in suspension, the activation of upper-body and core muscles ranged between moderate (21–40% maximum voluntary isometric contraction (MVIC)) and very high (>60% MVIC). Muscle activation in these same muscle groups was greater with suspension exercises relative to comparable traditional exercises, except for the inverted row. Muscle activation in the upper extremity and core muscles varied greatly amongst studies.

The effects of bracing and knee flexion angle on hamstring activity during crutch walking: A preliminary study for post-operative care

Abstract Objectives: To determine if immobilization of the knee at varying degrees of knee flexion will limit the surface electromygraphical (sEMG) activity of hamstring muscles during crutch-assisted ambulation. Methods: Ten healthy participants walked with crutches with the knee maintained at 0, 30, 60 and 90° of knee flexion, both with and without a brace. The leg was non-weight bearing for all trials except for those with the knee at 0° of flexion, when subjects performed a ‘toe-touch’ gait. sEMG was used to record activity of the biceps femoris and semitendinosus during trials. Results: For the semitendinosus, there were no differences between braced and unbraced conditions at 0° (22.5 vs. 23.2%), 30° (37.5 vs. 28.7%), 60° (47.2 vs. 44.6%), and 90° (32.7 vs. 51.8%) of knee flexion (all, p > 0.05). Similarly, for the biceps femoris, there were no differences between braced and unbraced conditions at 0° (22.5 vs. 23.2%), 30° (44.5 vs. 28.7%), 60° (47.2 vs. 44.6%), and 90° (32.7 vs. 51.8%) of knee flexion (all, p > 0.05). Finally, there were no differences between braced at 90° of knee flexion and unbraced at 0° of knee flexion with regard to semitendinosus (32.7 vs. 23.2%) and biceps femoris (32.6 vs. 23.2%) activity (p > 0.05). Conclusions: The use of a brace to limit knee extension did not decrease activation of the hamstrings during crutch-assisted ambulation in healthy participants. More research is needed to determine if the use of a knee brace is necessary following surgical repair of the hamstring tendon.

‘What’s my risk of sustaining an ACL injury while playing football (soccer)?’ A systematic review with meta-analysis

Objective To estimate the incidence proportion (IP) and incidence rate (IR) of ACL injury in football players. Design Systematic review with meta-analysis. Data sources PubMed, CINAHL and SPORTDiscus electronic databases were searched from inception to 20 January 2017. Eligibility criteria for selecting study Studies that reported the total number of participants/population by sex, total number of ACL injuries by sex and total person-time by sex were included. Results Twenty-eight studies were included. The IP and IR of ACL injury in female football players were 2.0% (95% CI 1.2% to 3.1%) and 2.0/10 000 athlete exposures (AEs) (95% CI 1.6 to 2.6; I2=91%) over a period of one season to 4 years. The IP and IR of ACL injury in male players were 3.5% (95% CI 0.7% to 8.2%) and 0.9/10 000 AEs (95% CI 0.7 to 1.1; I2=94%). Studies that evaluated matched cohorts of female and male players showed no difference in IP (relative risk=1.2; 95% CI 0.9 to 1.6; P=0.47) over a period of one season to 4 years. Women were at greater risk than men (incidence rate ratio (IRR)=2.2; 95% CI 1.6 to 3.1; I2=83%; P<0.001). When accounting for participation level, the difference in IR between women and men was greatest for intermediate players (IRR=2.9; 95% CI 2.4 to 3.6) compared with amateur (IRR=2.6; 95% CI 1.4 to 4.8) and elite (IRR=2.0; 95% CI 1.1 to 3.4) players. Summary/conclusion Overall, more men sustained ACL injury in football. There was no difference in the relative risk of ACL injury between female and male football players in a window that spanned one season to 4 years. The IR of ACL injury among women was 2.2 times higher than the IR of ACL injury among men. The reported sex disparity in ACL injury was independent of participation level.