The Use of Serious Gaming to Improve Sensorimotor Function and Motivation in People with Cerebral Palsy: A Systematic Review.

The aim of this systematic review was to review the evidence for serious gaming interventions in improving sensorimotor function in children and adults with cerebral palsy (CP). Seven databases were searched with terms related to serious gaming and CP. Articles were evaluated according to the Downs and Black rating scale and important principles of serious gaming defined by Whyte et al. Extracted data included the population, intervention, serious gaming elements, outcomes, and authors' conclusions. Fifty-seven articles were identified for inclusion. Participants' ages ranged from 3 to 57 years. Interventions tested included commercial videogames as well as specially designed games. Most interventions had themed content, short-term goals, rewards, feedback, and multiple games. Outcome measures and study designs were inconsistent between studies. Sensorimotor function results of noncomparative studies were positive or neutral overall, but results of comparative studies were more mixed. We concluded that serious gaming interventions may be a useful adjunct to treatment as they are noninvasive, were not associated with deterioration in most cases, and may improve compliance. More comparative studies need to be completed to assess compliance and treatment outcomes. Future games should also aim to adhere more closely to the principles of serious gaming.

A qualitative exploration of motivations and barriers for community leisure organisations' engagement with the Jooay™ mobile app.

PURPOSE: Participation in leisure activities is key to the physical and mental health of children and adolescents with disabilities. The Jooay™ mobile app aims to link children and adolescents with disability to participation opportunities in their community. This study explored the perspectives of community leisure organisations and their motivations and perceived barriers to be listed as a leisure service on Jooay™. MATERIALS AND METHODS: Twenty representatives of community leisure organisations in metropolitan Perth, Western Australia were interviewed. Vroom's Expectancy Theory was used to shape the semi-structured interview guides. Data were analysed with thematic analysis using an inductive open coding approach. RESULTS: Four key themes pertaining to motivations and barriers to registration with Jooay™ were developed: Building reputation; Collaboration; Ability to deliver accessible leisure services; and Usability of Jooay™. Multiple motivating factors for registering on Jooay™ were identified including positive financial implications, meeting corporate social responsibilities, building collaborative stakeholder partnerships, and building organisational confidence and awareness of disability through supportive partnerships. Environmental and organisational barriers to inclusion were highlighted. CONCLUSION: Findings will inform future promotion of the features and benefits of Jooay™ to engage community leisure organisations. This may increase the number of accessible leisure services listed within the app, providing a greater selection of community leisure activities in which children and adolescents with disability can participate.IMPLICATIONS FOR REHABILITATIONCommunity leisure organisations would be motivated to engage with the JooayTM app, provided the right supports are in place for them.Additional benefits of registering on JooayTM may include positive financial implications, meeting corporate social responsibilities, building collaborative stakeholder partnerships, and building disability confidence and awareness through supportive partnerships.Ongoing education and support is needed for community leisure organisations regarding; disability awareness, competency, and capacity to deliver leisure services in inclusive and equitable ways. This will enable them to increase their accessibility for children with disabilities, particularly for non-disability-specific leisure organisations.Information about leisure services on the Jooay™ app builds capacity in the community to identify diverse access needs of children and young people with disabilities and the most effective strategies to address them.

The efficacy of resistance training in addition to usual care for adults with acute burn injury: A randomised controlled trial.

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. Data analysis was an available cases analysis with no data imputed. Regression analyses were used for all longitudinal outcome data and between-group comparisons were used for descriptive analyses. Forty-eight patients were randomised resistance training (RTG) (n=23) or control group (CG) (n=25). The RTG demonstrated improved outcomes for the functional domain of the Burn Specific Health Scale-Brief (p=0.017) and the Quick Disability of Arm Shoulder and Hand (p<0.001). Between group differences were seen for C-reactive protein and retinol binding protein (p=0.001). Total quality of life scores, lower limb disability, muscle strength and volume were not seen to be different between groups (p>0.05). Resistance training in addition to usual rehabilitation therapy showed evidence of improving functional outcomes, particularly in upper limb burn injuries. Additionally, resistance training commenced acutely after a burn injury was not seen to be harmful to patients.

Hip adduction and abduction strength and adduction-to-abduction ratio changes across an Australian Football League season.

OBJECTIVES: Pre-season hip strength testing only represents the athlete's level of conditioning at that time point, and may change over an Australian Football (AF) season. This study aimed to examine if there are changes in hip adduction, abduction and the adduction-to-abduction ratio between preferred and non-preferred kicking legs throughout an AF season. The influence of training load and player characteristics was also examined. DESIGN: Cross-sectional repeated measures. METHODS: 38 uninjured elite AF players were included. Maximal isometric hip adduction and abduction strength were measured at four time points: start of pre-season (T1), end of pre-season (T2), mid-season (T3) and post-season (T4) using a hand held dynamometer with external belt fixation. RESULTS: Hip adduction strength and hip-adduction-to-abduction ratio were greater in T3 compared to T1 (adduction by 22.71N, p<0.001, ratio by 0.15N, p<0.001) and hip adduction and abduction were weaker in T4 compared to T1 (adduction by 18.6N, p=0.004, abduction by 24.67N, p<0.001). No differences were found between the preferred and non-preferred leg in adduction (p=0.409) or abduction (p=0.602) strength. There was an interaction between leg and time point for the adduction-to-abduction ratio; at T3 and T4, the ratio of the preferred kicking leg was significantly lower than the non-preferred kicking leg (T3 by 0.14N, p=0.020, T4 by 0.15N, p=0.019). Training load was not significantly associated with strength changes. CONCLUSIONS: Hip strength does change over an AF season. Regular in-season hip strength testing should occur to more accurately reflect player condition compared to one pre-season measurement.

Measurement of Upper Limb Range of Motion Using Wearable Sensors: A Systematic Review.

BACKGROUND: Wearable sensors are portable measurement tools that are becoming increasingly popular for the measurement of joint angle in the upper limb. With many brands emerging on the market, each with variations in hardware and protocols, evidence to inform selection and application is needed. Therefore, the objectives of this review were related to the use of wearable sensors to calculate upper limb joint angle. We aimed to describe (i) the characteristics of commercial and custom wearable sensors, (ii) the populations for whom researchers have adopted wearable sensors, and (iii) their established psychometric properties. METHODS: A systematic review of literature was undertaken using the following data bases: MEDLINE, EMBASE, CINAHL, Web of Science, SPORTDiscus, IEEE, and Scopus. Studies were eligible if they met the following criteria: (i) involved humans and/or robotic devices, (ii) involved the application or simulation of wearable sensors on the upper limb, and (iii) calculated a joint angle. RESULTS: Of 2191 records identified, 66 met the inclusion criteria. Eight studies compared wearable sensors to a robotic device and 22 studies compared to a motion analysis system. Commercial (n = 13) and custom (n = 7) wearable sensors were identified, each with variations in placement, calibration methods, and fusion algorithms, which were demonstrated to influence accuracy. CONCLUSION: Wearable sensors have potential as viable instruments for measurement of joint angle in the upper limb during active movement. Currently, customised application (i.e. calibration and angle calculation methods) is required to achieve sufficient accuracy (error <  5°). Additional research and standardisation is required to guide clinical application. TRIAL REGISTRATION: This systematic review was registered with PROSPERO ( CRD42017059935 ).

An objective measure for the assessment and management of fluid shifts in acute major burns.

BACKGROUND: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat™ on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns. METHODS: An observational longitudinal cohort study was conducted from December 2014 to February 2016. Patients with over 15% total body surface area (TBSA) burns and injury less than 48 h were enrolled in the study. BIS triplicate measures were collected in an open wound and with an ActicoatTM dressing (at 5 half hour intervals). Standard and alternate electrode placements were utilised for the reliability analysis and standard placement only for determining the validity of BIS in moderate to major burns. The ImpediMde SFB7 was used to collect whole-body and segmental BIS measures. Stata statistical software, release 14 was utilised to analyse all results. Descriptive analyses were performed and were reported using the means and standard deviations (SD). RESULTS: BIS-repeated measures established BIS raw resistance (R), and predicted volume variables were reliable in any condition (intra-class correlation coefficient (ICC) 0.996-0.999, 95% confidence intervals (CI) 0.996-0.999) without a systematic difference. Acticoat™ dressings significantly influenced all BIS-predicted volumes (p ≤ 0.01) as determined by multilevel mixed effects (MLME) linear regression analysis. Validity of BIS was demonstrated by resistance variables significantly decreasing with increasing net ionic fluid shift and increased TBSA (severity of injury) and calculated fluid volumes increasing with increasing net fluid shift and TBSA. BIS resistance also decreased with time as oedema reduced. For clinical use, a calculator was developed to adjust BIS variables when an Acticoat™ dressing is in situ, thus facilitating BIS variable change estimates in real time, with dressings intact. CONCLUSION: BIS may be used clinically to monitor fluid volume change in major acute burns.

Predicting 1 Repetition Maximum Using Handheld Dynamometry.

BACKGROUND: Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments. OBJECTIVE: To establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM. DESIGN: Criterion standard comparison. SETTING: Tertiary institution gymnasium. PARTICIPANTS: Convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years). METHODS: Muscle strength of the biceps and quadriceps muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD. MAIN OUTCOME MEASURES: Statistical analysis of the relation between the measures of strength was established using Pearson correlation and a Bland-Altman plot. A linear regression analysis with included covariates (gender, age, resistance training history, and body mass index) was used to derive the prediction equations. RESULTS: A significant correlation was found between 1RM and HHD scores for the biceps (r = .83, P < .001) and quadriceps muscle groups (r = .82, P < .001). However, strength scores were not in agreement. Linear regression analysis found significance in predicting 1RM from all HHD scores (P < .001). Gender as a covariate significantly influenced the prediction of 1RM for the biceps (P = .005) and quadriceps (P = .003) muscle groups. CONCLUSIONS: There is a significant relationship between 1RM and HHD measures of strength, and measures taken using an HHD can be used to predict 1RM in the biceps and quadriceps muscle groups. The use of an HHD may therefore provide a more accessible alternative to 1RM for muscle strength assessments. Further research is warranted to determine if results are applicable in clinical populations. LEVEL OF EVIDENCE: NA.

Monitoring wound healing in minor burns-A novel approach.

Assessment of minor burn wound closure is predominately determined by visual inspection and clinical specialist assessment, which remains largely a subjective analysis and results may vary depending on the clinician's experience. Bioimpedance spectroscopy (BIS) is an instrument that has a demonstrated ability to objectively monitor the wound healing process in various patient populations but has not yet been used in acute burn wounds. The aim of the pilot study was to examine whether the BIS technique is a valid measure of wound healing. Localised BIS resistance and phase angle triplicate measures, of minor limb burns, were collected on two serial occasions. Circumference limb measures were taken at the localised burn site to determine a truncated limb volume. Proportional-odds ordered logistic regression analyses determined resistance at zero frequency (R0, indicative of edema) and resistance of total body fluid (Rinf) were significantly associated with healing after adjustment for the influence of surgery. A one unit increase in R0 and Rinf increased the odds of wound healing by 6% and 5% respectively (p<0.01). Phase angle at 50kHz and Ri were not significantly associated with the markers of the wound healing process. Spearman's correlation determined there was a significant association between a healing wound and limb segment volume (ml) (rho -0.30, p<0.01). BIS is a technique, which has the potential to monitor the progress of wound healing.

Multidimensional impact of low-Dye taping on low-load hopping in individuals with and without plantar fasciitis.

OBJECTIVES: Evaluate the acute effect of low-Dye, placebo and no tape on motor behaviour in individuals with plantar fasciitis (PF). DESIGN: Prospective, experimental. SETTING: Motion analysis laboratory. PARTICIPANTS: Ten participants with PF and ten matched controls. MAIN OUTCOME MEASURES: Hopping behaviour (lower-limb stiffness and ankle angle at peak loading) were evaluated during low-load sleigh hopping, during three taping conditions. Stiffness and ankle angle were determined using three-dimensional motion analysis. Pain during submaximal loading was assessed with a numeric pain rating scale. RESULTS: The lower-limb stiffness response to therapeutic taping was modulated by the presence of PF (interaction, F = 4.48, p = 0.018). Matched controls demonstrated a significant increase in stiffness post application of low-Dye taping (p = 0.001), stiffness was unchanged in the PF group. In the PF group, low-Dye taping decreased hopping pain in comparison to placebo (p = 0.037) and no-tape (p = 0.024). There was no difference in ankle angle at peak loading between the groups or across taping conditions. CONCLUSIONS: Low-Dye taping reduces nociceptive inputs more than placebo in the presence of PF pain. Low-Dye tape alters stiffness in the control group but not the PF group. The motor behavioural outputs such as stiffness, during low-load hopping is modulated by both pathology and therapeutic taping.

Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis.

BACKGROUND/AIM: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury. METHODS: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and rated using the GRADE framework. RESULTS: Eleven studies matched our inclusion criteria. Primary analysis did not demonstrate significant improvements for increasing muscle strength (SMD 0.74, 95% CI -0.02 to 1.50, p=0.06). Sensitivity analysis to correct an apparent anomaly in published data suggested a positive effect (SMD 0.37, 95% CI 0.08-0.65, p=0.01). Psychological quality of life demonstrated benefit from training (MD=25.3, 95% CI 3.94-49.7). All studies were rated as having high risk of bias. The quality of the evidence was rated as low or very low. CONCLUSION: Further research with robust methodology is recommended to assess the potential benefit suggested in this review.

Bioimpedance spectroscopy: A technique to monitor interventions for swelling in minor burns.

The control of edema in burn injured patients is a priority as it can impede the wound healing process. Bioimpedance spectroscopy (BIS) has been identified as a method of swelling assessment that has merit after burns. The aim of this study was to examine the reliability and validity of BIS in the measurement of localised burn wound edema across (1) different dressing conditions (no dressing, non silver and silver dressings) and (2) three electrode positions. BIS resistance (R) was hypothesised to be inversely proportional to fluid (edema) volume. BIS was collected in triplicate for all conditions of interest. BIS repeated measures demonstrated excellent concordance for all BIS resistance variables (R0, Ri, Rinf) (intraclass correlation coefficient=0.999-1.00, 95% confidence intervals 0.999-1.00) without a systematic difference. Multilevel mixed effects linear regression analysis examined the effect of electrode position and dressing condition on BIS resistance variables. R0, Ri and Rinf significantly increased with decreasing localised limb segment volume (p≤0.01). Resistance was significantly (1) reduced when a silver dressing was in situ (p<0.01) and (2) increased when a non-silver dressing was insitu (p<0.01). There was a significant interaction between each dressing condition and localised limb segment volume (p<0.01). An algorithm was developed to adjust resistance values when a silver dressing is in use. BIS may be used clinically to monitor localised changes in burn wound edema.

Addressing the Barriers to Bioimpedance Spectroscopy Use in Major Burns: Alternate Electrode Placement.

Bioimpedance spectroscopy (BIS) is a method used to assess body composition and fluid distribution. As a technology for measurement of fluid shifts during acute burn resuscitation, there are potential barriers to its use due to the location of wounds. This study aimed to determine whether alternate electrode positions were a suitable alternative compared to standardized (manufacturer) positions in moderate to large size burns for the measurement of BIS resistance and fluid changes. BIS measurements were collected in standard and alternate electrode placements and in an open wound and Acticoat™ dressing condition. A percentage difference greater than 5% between each standard and alternate placement BIS measurements was deemed clinically significant. Chi-square tests determined there were no significant differences (P = .097-.96) between the standard and alternate electrode placements for whole body and limb segment BIS in both dressing conditions. Only whole body BIS resistance variables and extracellular fluid volumes were interchangeable in both dressing conditions and upper limb segmental measures were interchangeable in an open wound only. The differences between measurements of other BIS variables across the conditions were not acceptable or deemed not clinically acceptable without adjustment. The results showed that for moderate to large burn injuries clinicians can use whole body and upper limb segmental BIS variables to monitor changes in fluid shifts with alternate electrode placements where wounds preclude standardized placement within specified dressing conditions.

The effectiveness of session rating of perceived exertion to monitor resistance training load in acute burns patients.

Session-rating of perceived exertion (RPE) is a method frequently utilised in exercise and sports science to quantify training load of an entire aerobic exercise session. It has also been demonstrated that session-RPE is a valid and reliable method to quantify training load during resistance exercise, in healthy and athletic populations. This study aimed to investigate the effectiveness of session-RPE as a method to quantify exercise intensity during resistance training in patients with acute burns. Twenty burns patients (mean age=31.65 (±10.09) years), with a mean TBSA of 16.4% (range=6-40%) were recruited for this study. Patients were randomly allocated to the resistance training (n=10) or control group (n=10). All patients completed a four week resistance training programme. Training load (session-RPE×session duration), resistance training session-volume and pre-exercise pain were recorded for each exercise session. The influence of; age, gender, %TBSA, exercise group (resistance training vs. control), pre-exercise pain, resistance training history and session-volume on training load were analysed using a multilevel mixed-effects linear regression. Session-volume did not influence training load in the final regression model, however training load was significantly greater in the resistance training group, compared with the control group (p<0.001). Pre-exercise pain significantly influenced training load, where increasing pain was associated with a higher session-RPE (p=0.004). Further research is indicated to determine the exact relationship between pain, resistance training history, exercise intensity and session-RPE and training load before it can be used as a method to monitor and prescribe resistance training load in acute burns patients.

Running quietly reduces ground reaction force and vertical loading rate and alters foot strike technique.

This study aimed to determine if a quantifiable relationship exists between the peak sound amplitude and peak vertical ground reaction force (vGRF) and vertical loading rate during running. It also investigated whether differences in peak sound amplitude, contact time, lower limb kinematics, kinetics and foot strike technique existed when participants were verbally instructed to run quietly compared to their normal running. A total of 26 males completed running trials for two sound conditions: normal running and quiet running. Simple linear regressions revealed no significant relationships between impact sound and peak vGRF in the normal and quiet conditions and vertical loading rate in the normal condition. t-Tests revealed significant within-subject decreases in peak sound, peak vGRF and vertical loading rate during the quiet compared to the normal running condition. During the normal running condition, 15.4% of participants utilised a non-rearfoot strike technique compared to 76.9% in the quiet condition, which was corroborated by an increased ankle plantarflexion angle at initial contact. This study demonstrated that quieter impact sound is not directly associated with a lower peak vGRF or vertical loading rate. However, given the instructions to run quietly, participants effectively reduced peak impact sound, peak vGRF and vertical loading rate.

Demonstration of the test-retest reliability and sensitivity of the Lower Limb Functional Index-10 as a measure of functional recovery post burn injury: a cross-sectional repeated measures study design.

BACKGROUND: Lower limb burns can significantly delay recovery of function. Measuring lower limb functional outcomes is challenging in the unique burn patient population and necessitates the use of reliable and valid tools. The aims of this study were to examine the test-retest reliability, sensitivity, and internal consistency of Sections 1 and 3 of the Lower Limb Functional Index-10 (LLFI-10) questionnaire for measuring functional ability in patients with lower limb burns over time. METHODS: Twenty-nine adult patients who had sustained a lower limb burn injury in the previous 12 months completed the test-retest procedure of the study. In addition, the minimal detectable change (MDC) was calculated for Section 1 and 3 of the LLFI-10. Section 1 is focused on the activity limitations experienced by patients with a lower limb disorder whereas Section 3 involves patients indicating their current percentage of pre-injury duties. RESULTS: Section 1 of the LLFI-10 demonstrated excellent test-retest reliability (intra-class correlation coefficient (ICC) 0.98, 95 % CI 0.96-0.99) whilst Section 3 demonstrated high test-retest reliability (ICC 0.88, 95 % CI 0.79-0.94). MDC scores for Sections 1 and 3 were 1.27 points and 30.22 %, respectively. Internal consistency was demonstrated with a significant negative association (r s = -0.83) between Sections 1 and 3 of the LLFI-10 (p < 0.001). CONCLUSIONS: This study demonstrates that Section 1 and 3 of the LLFI-10 are reliable for measuring functional ability in patients who have sustained lower limb burns in the previous 12 months, and furthermore, Section 1 is sensitive to changes in patient function over time.

Nanocrystalline silver dressings significantly influence bioimpedance spectroscopy measurements of fluid volumes in burns patients.

Bioimpedance spectroscopy (BIS) is a tool utilized in health care to investigate body composition and fluid distribution. Limited research has addressed the clinical use of BIS in burns. This study aimed to examine the effects of silver dressings on BIS measurements in burns patients. BIS measurements were collected during two dressing conditions: no dressing (ND), and; Acticoat™ dressing (AD). Wilcoxon sign-ranks tests determined if there were any significant differences in BIS measures between the dressing conditions. Multilevel mixed-effects linear regressions examined the effect of %TBSA and body mass on BIS variables across the dressing conditions. The mean age of the patients (n=31) was 34.90 years; with a median TBSA of 15%. There was a significant increase in extracellular fluid (ECF) (p<0.001), intracellular fluid (ICF) (p<0.001) and total body water (TBW) (p<0.001) when AD was in place. There were significant interactions between dressing condition, %TBSA and body mass, whereby the difference in ECF, ICF and TBW between the ND and AD conditions were increased as %TBSA and body mass increased. Algorithms were developed subsequently to adjust BIS outputs for use when AD is in place. Clinician's may continue to use BIS in real-time using the predictive algorithms established during this study.

The Relationship Between Landing Sound, Vertical Ground Reaction Force, and Kinematics of the Lower Limb During Drop Landings in Healthy Men.

STUDY DESIGN: Controlled laboratory study, cross-sectional. BACKGROUND: Soft-landing instruction, which is advocated in several injury prevention programs, is thought to have a qualitative relationship with decreased vertical ground reaction forces (vGRFs) and increased lower-limb joint excursions. OBJECTIVE: To quantify the relationships among landing sound, vGRFs, and lower-limb kinematics during a drop-landing task. METHODS: Twenty-six asymptomatic men aged 18 to 35 years were asked to perform 15 single-leg drop landings from a 30-cm height. Five trials were collected under 3 sound conditions: normal, quiet, and loud. The vGRF, lower-limb kinematics (sagittal plane), and impact sound were recorded during the deceleration phase. RESULTS: A simple linear regression revealed a significant relationship between landing sound and vGRF (R(2) = 0.42, P<.001). A repeated-measures analysis of variance showed that ankle and knee excursion significantly increased by 7.0° and 11.7°, respectively, during quiet landing (compared to normal landing; P<.001). During the loud landing condition, ankle joint excursion significantly decreased by 9.4° compared to the normal landing condition (P<.001), and hip joint excursion significantly increased by 4.0° compared to normal landing condition (P<.045). CONCLUSION: As landing sound decreases, so does vGRF during a drop-landing task. These reductions were achieved by increasing ankle and knee joint excursions. Conversely, as the landing sound increases, so does vGRF. This was the result of decreasing ankle joint excursion and increasing hip joint excursion.

Hip adduction and abduction strength profiles in elite, sub-elite and amateur Australian footballers.

OBJECTIVES: It has been reported that obtaining an adduction-to-abduction strength ratio of 90-100%, and an adduction strength equal to that of the uninjured side, are suitable clinical milestones for return to sport following groin injury. Little is known about hip adduction and abduction strength profiles in Australian footballers. This study aimed to compare isometric hip adduction and abduction strength profiles between preferred and non-preferred kicking legs in elite, sub-elite and amateur Australian footballers. DESIGN: Cross sectional study METHODS: 36 elite, 19 sub-elite and 18 amateur Australian footballers, with a mean age of 24, 19 and 23 years respectively, were included. Maximal hip isometric adduction and abduction strength were measured using a hand held dynamometer with external belt fixation. RESULTS: There were no significant differences in isometric hip adduction (p=0.262) or abduction (p=0.934) strength, or the adduction-to-abduction ratio (p=0.163), between preferred and non-preferred kicking legs, regardless of playing level. Elite players had significantly greater isometric hip adduction and abduction strength than both sub-elite (mean difference; adduction=46.01N, p<0.001, abduction=30.79N, p=0.003) and amateur players (mean difference; adduction=78.72N, p<0.001, abduction=59.11N, p<0.001). There was no significant difference in the adduction-to-abduction ratio between the playing levels (p=0.165). CONCLUSIONS: No significant differences were found between preferred and non-preferred kicking legs across the playing levels for isometric hip adduction, abduction or the adduction-to-abduction ratio. This may have implications for developing groin injury prediction and return to sport criteria in Australian footballers.

The effects of vestibular stimulation and fatigue on postural control in classical ballet dancers.

This study aimed to investigate the effects of ballet-specific vestibular stimulation and fatigue on static postural control in ballet dancers and to establish whether these effects differ across varying levels of ballet training. Dancers were divided into three groups: professional, pre-professional, and recreational. Static postural control of 23 dancers was measured on a force platform at baseline and then immediately, 30 seconds, and 60 seconds after vestibular stimulation (pirouettes) and induction of fatigue (repetitive jumps). The professional dancers' balance was unaffected by both the vestibular stimulation and the fatigue task. The pre-professional and recreational dancers' static sway increased following both perturbations. It is concluded that professional dancers are able to compensate for vestibular and fatiguing perturbations due to a higher level of skill-specific motor training.