Daniel J. Cipriani

Effect of stretch frequency and sex on the rate of gain and rate of loss in muscle flexibility during a hamstring-stretching program: a randomized single-blind longitudinal study.

Abstract Cipriani, DJ, Terry, ME, Haines, MA, Tabibnia, AP, and Lyssanova, O. Effect of stretch frequency and sex on the rate of gain and rate of loss in muscle flexibility during a hamstring-stretching program: A randomized single-blind longitudinal study. J Strength Cond Res 26(8): 2119–2129, 2012—This study evaluated the effects of 4 different weekly stretching protocols on the rate of gain and decline in hamstring flexibility over an 8-week period, across sex. Using a randomized single-blind design, 53 healthy subjects aged 18–46 years were assigned to 1 of 4 stretching protocols or a control group. The stretching protocols consisted of either daily or 3 times per week stretching and performed once or twice each day. These protocols differed in terms of frequency and total weekly stretching time. All the subjects stretched their hamstring muscles for 4 weeks and were measured weekly for their hip range of motion (ROM). Stretching ceased the final 4 weeks as the weekly measurements continued. The results revealed no significant differences in the rate of gain or the rate of loss between the different stretching protocols (2-way analysis of variance, F = 2.60, p > 0.05). All the stretching groups gained in hip ROM from pre to week 4 (F = 269.24, p < 0.001). After cessation, the rate of loss was similar for all the 4 stretching groups (F = 102.86, p < 0.001); all the groups retained significant gains at the end of the study (p < 0.001). The control group did not change over time. Those who stretched at least 6 times per week gained more than those who stretched 3 times per week (24 and 16.8%, respectively, F = 5.20, p < 0.05). Subject sex did not influence ROM changes (p > 0.05). Stretching appears to be equally effective, whether performed daily or 3 times per week, provided individuals stretch at least 2 times each day. Moreover, although women are more flexible than men are, there was no sex difference in terms of stretching response.

COMPARING PRESEASON FRONTAL AND SAGITTAL PLANE PLYOMETRIC PROGRAMS ON VERTICAL JUMP HEIGHT IN HIGH-SCHOOL BASKETBALL PLAYERS

King, JA and Cipriani, DJ. Comparing preseason frontal and sagittal plane plyometric programs on vertical jump height in high-school basketball players. J Strength Cond Res 24(8): 2109-2114, 2010-The primary purpose of this study was to evaluate whether frontal plane (FP) plyometrics, which are defined as plyometrics dominated with a lateral component, would produce similar increases in vertical jump height (VJH) compared to sagittal plane (SP) Plyometrics. Thirty-two junior varsity and varsity high-school basketball players participated in 6 weeks of plyometric training. Players participated in either FP or SP plyometrics for the entire study. Vertical jump height was measured on 3 occasions: preintervention (baseline), at week 3 of preparatory training, and at week 6 of training. Descriptive statistics were calculated for VJH. A 2-way analysis of variance (ANOVA) with repeated measures was used to test the difference in mean vertical jump scores using FP and SP training modalities. Results showed a significant effect over time for vertical jump (p < 0.001). Moreover, a significant time by protocol interaction was noted (p < 0.032). A 1-way ANOVA demonstrated that only the SP group demonstrated improvements over time, in VJH, p < 0.05. The FP group did not improve statistically. The data from this study suggest that FP plyometric training did not have a significant effect on VJH and significant improvement in VJH was seen in subjects participating in SP plyometrics thus reinforcing the specificity principle of training. However, coaches should implement both types of plyometrics because both training modalities can improve power and quickness among basketball players.

The Effects of Intermittent Stretching Following a 4-week Static Stretching Protocol: A Randomized Trial

Rancour, J, Holmes, CF, and Cipriani, DJ. The effects of intermittent stretching following a 4-week static stretching protocol: A randomized trial. J Strength Cond Res 23(8): 2217-2222, 2009-Stretching is performed in rehabilitation and sports conditioning programs. It is not known how often during a week stretching needs to be performed to maintain flexibility. Therefore, the purpose of this study was to determine the influence of intermittent stretching (i.e., 2-3 days/week) on hip range of motion (ROM) following a 4-week, daily stretching program. This study used a randomized, single-blind, test-retest design. Healthy adult subjects, age 18 to 50 years, were randomly assigned to 1 of 2 static stretching protocols: (a) standard protocol or (b) intermittent protocol. All subjects stretched their hamstrings daily for the first 4 weeks. The standard group discontinued all stretching after 4 weeks. The intermittent group continued to stretch 2 to 3 days per week for an additional 4 weeks. All subjects were measured for hip ROM weekly for the full 8 weeks. Thirty-two subjects completed the study (standard group = 14; intermittent group = 18, mean age 24.6 years). Mean hip ROM increased (p < 0.05) for both groups from before protocol (PRE) to Week 4 (standard group gain from 71.4 ± 18.5 degrees to 90.6 ± 20.5 degrees and intermittent group gain from 68.6 ± 15.7 degrees to 89.1 ± 16.8 degrees). During the final 4 weeks, mean hip ROM decreased (p < 0.05) for the standard group from 90.6 ± 20.5 degrees to 83.9 ± 20.3 degrees. Mean hip ROM for the intermittent group did not decrease during the final 4 weeks of the study (89.1 ± 16.8 degrees to 93.2 ± 14.9 degrees, p > 0.05). Intermittent stretching (i.e., 2 or 3 days/week) is sufficient to maintain ROM gains acquired from a prior static stretching program. Clinicians and trainers may educate their clients of the benefits of intermittent stretching to maintain flexibility.

Influence of infrapatellar and suprapatellar straps on quadriceps muscle activity and onset timing during the body-weight squat.

Abstract Straub, RK and Cipriani, DJ. Influence of infrapatellar and suprapatellar straps on quadriceps muscle activity and onset timing during the body-weight squat. J Strength Cond Res 26(7): 1827–1837, 2012—The use of knee braces for the treatment of patellofemoral pain syndrome (PFPS) is widely documented, yet the mechanism by which such braces alleviate knee pain remains unclear. This study attempted to clarify this issue by simplifying the brace to the level of only straps. The effectiveness of an infrapatellar strap for PFPS remains controversial, and the use of a suprapatellar strap has not yet been studied. Quadriceps muscle activity and onset timing parameters were measured with surface electromyography (EMG) during a body-weight squat in 19 healthy subjects during 4 different knee-strapping conditions (infra, supra, both, and none). No differences in normalized mean or peak EMG activity in any part of the quadriceps were found. The onset timing of the vastus lateralis (VL) was significantly delayed when using an infrapatellar strap (p < 0.05) or both straps (p < 0.05) and marginally delayed when using a suprapatellar strap (p < 0.10) in comparison with the no-strap (control) condition. No differences in the vastus medialis oblique (VMO) onset timing or VMO-VL onset timing difference were found among the strapping conditions, although an improvement in timing was noted with the suprapatellar condition. The results provide novel evidence that the application of an infrapatellar strap, suprapatellar strap, or both straps improves quadriceps muscle timing imbalances by delaying VL onset. Because the largest delay in VL onset occurred when wearing both straps, the combined application of an infrapatellar and suprapatellar strap may be the most beneficial in managing patellofemoral pain. Knee straps, unlike braces, are cost effective, nonrestrictive, and can be universally fitted to any knee and based on the results deserve further study in the patellofemoral pain population.

Self-Reported Smoking and Musculoskeletal Overuse Injury Among Male and Female U.S. Marine Corps Recruits

The association between self-reported smoking and overuse injury in a cohort of young men (n = 900) and women (n = 597) undergoing 12 weeks of standardized military instruction, after adjustment for physical activity, health history, and incoming fitness tests was examined. The outcome includes all International Classification of Diseases, 9th Revision codes related to injuries resulting from cumulative microtrauma (overuse injuries). The short survey asked about the subjects demographics, smoking habits, prior injuries sustained, physical activity level, self-perceived fitness, and (for women) menstrual history. From the survey, 4 questions established smoking behavior: smoked at least 100 cigarettes in lifetime, age smoked a whole cigarette for the first time, how many cigarettes smoked during the last 30 days, and how many cigarettes smoked per day during the last 30 days. None of the adjusted hazard ratios for the smoking questions were associated with an increased risk of overuse injury for either sex. Furthermore, this study did not find a significant association with respect to smoking and all injuries in either men or women. In conclusion, smoking does not appear to be an independent risk factor for overuse injury in either young men or women during 12 weeks of standardized military instruction.

The Association of Self-Reported Measures With Poor Training Outcomes Among Male and Female U.S. Navy Recruits

This prospective study evaluated the association of self-reported health habits and behaviors in 2,930 Navy recruits with poor training outcomes, defined as graduating late or separating from training. Although 17% of the men and 21% of the women had a poor training outcome, results suggest that some self-reported measures were associated with poor training outcomes. Men who did not run or jog at least 1 month before basic training or had a previous lower limb injury without complete recovery and women reporting the same or less physical activity compared with their same-age counterparts were more likely to have a poor training outcome. An important first step in decreasing poor training outcomes is encouraging incoming recruits to participate in physical activity and taking steps to identify and rehabilitate recruits who are not completely healed from a lower limb musculoskeletal injury before reporting to basic training.

Superficial Precooling on a 4-Week Static Stretching Regimen: A Randomized Trial

Background: The influence of superficial precooling on range of motion (ROM) as part of a stretching program has not been extensively studied. It is not clear if the analgesic effect can benefit a stretching program. Hypotheses: Superficial precooling will result in greater gains in ROM as part of a stretching program, compared with stretching without a precooling intervention. Superficial precooling will also result in greater retention in ROM gains following cessation of stretching, compared with stretching without a precooling intervention. Study Design: Prospective randomized single-blind test-retest design. Methods: Twenty-nine participants were randomly assigned to 1 of 2 static stretching protocols: a standard protocol (n, 14; age, 24.6 ± 5.4 years) or a precool protocol (n, 15; age, 25.1 ± 7.3 years). These samples allowed for 80% power for statistical significance testing. Both groups performed static hamstring stretching daily for 4 weeks. The precool group applied ice to the hamstring for 10 minutes before stretching. Both groups stretched for 4 weeks and then stopped stretching for the last 4 weeks. Hip ROM measures were obtained each week for 8 weeks. Results: For the standard group, mean hip ROM increased from 71.4° ± 18.5° to 90.6° ± 20.5° and for the precool group, 71.5° ± 22.3° to 91.8° ± 20.9°. For the standard group, mean hip ROM decreased from 90.6° ± 20.5° to 83.9° ± 20.3° and for the precool group, 91.8° ± 20.9 to 85.0° ± 19.4°. There were no differences between groups at any time in the study (P > .05). Conclusions: Precooling had no beneficial effects on ROM or on retention of ROM. Clinical Relevance: Cold application, before stretching, does not provide any benefit to a stretching program.

Segmental Limb Length And Vertical Jump Height

AbstractTo examine the role that lower extremity segmental length plays on vertical jump displacement. Previous research examining the relationship between segmental limb length and vertical jump ability revealed poor correlations. However, prior research did not use a reliable method to measure jum

Rating Scale Analysis and Psychometric Properties of the Caregiver Self-Efficacy Scale for Transfers

ABSTRACT Parents and caregivers faced with the challenges of transferring children with disability are at risk of musculoskeletal injuries and/or emotional stress. The Caregiver Self-Efficacy Scale for Transfers (CSEST) is a 14-item questionnaire that measures self-efficacy for transferring under common conditions. The CSEST yields reliable data and valid inferences; however, its rating scale structure has not been evaluated for utility. The aims of this study were to evaluate the category response structure of the CSEST, test the utility of a revised rating scale structure, and confirm its psychometric properties. The Rasch Measurement Model was used for all analyses. Subjects included 175 adult caregivers recruited from multiple communities. Results confirm that a revised five-category rating scale structure yields reliable data and valid inferences. Given the relationship between self-efficacy and risk of physical and/or emotional stress, measuring parental self-efficacy for transfers is a proactive process in rehabilitation.

Review of the PE Metrics cognitive assessment tool for fifth grade students

Summary Study aim: this study examined the item difficulty and item discrimination scores for the HRFK PE Metrics cognitive assessment tool for 5th-grade students. Materials and methods: ten elementary physical education teachers volunteered to participate. Based on convenience, participating teachers selected two 5th grade physical education classes. Teachers then gave students (N = 633) a 28-question paper and pencil HRFK exam using PE Metrics Standards 3 and 4. Item difficulty and discrimination analysis and Rasch Modeling were used data to determine underperforming items. Results: analysis suggests that at least three items are problematic. The Rasch Model confirmed this result and identified similar items with high outfit mean square values and low Point Biserial correlation values. Conclusions: teachers are in need of valid and reliable HRFK assessment tools. Without the removal of three items in the PE Metrics HRFK exam for 5th-grade students, complete use of the exam could offer incorrect conclusions.