Acute physiological, biomechanical, and perceptual responses of runners wearing downward-curved carbon fiber insoles.

In a randomized controlled cross-over study ten male runners (26.7 ± 4.9 years; recent 5-km time: 18:37 ± 1:07 min:s) performed an incremental treadmill test (ITT) and a 3-km time trial (3-km TT) on a treadmill while wearing either carbon fiber insoles with downwards curvature or insoles made of butyl rubber (control condition) in light road racing shoes (Saucony Fastwitch 9). Oxygen uptake, respiratory exchange ratio, heart rate, blood lactate concentration, stride frequency, stride length and time to exhaustion were assessed during ITT. After ITT, all runners rated their perceived exertion, perceived shoe comfort and perceived shoe performance. Running time, heart rate, blood lactate levels, stride frequency and stride length were recorded during, and shoe comfort and shoe performance after, the 3-km TT. All parameters obtained during or after the ITT did not differ between the two conditions [range: p = 0.188 to 0.948 (alpha value: 0.05); Cohen's d = 0.021 to 0.479] despite the rating of shoe comfort showing better scores for the control insoles (p = 0.001; d = -1.646). All parameters during and after the 3-km TT showed no differences (p = 0.200 to 1.000; d = 0.000 to 0.501) between both conditions except for shoe comfort showing better scores for control insoles (p = 0.017; d = -0.919). Running with carbon fiber insoles with downwards curvature did not change running performance or any submaximal or maximal physiological or biomechanical parameter and perceived exertion compared to control condition. Shoe comfort is impaired while running with carbon fiber insoles. Wearing carbon fiber insoles with downwards curvature during treadmill running is not beneficial when compared to running with control insoles.

One-dimension statistical parametric mapping in lower limb biomechanical analysis: A systematic scoping review.

BACKGROUND: Biomechanics significantly impacts sports performance and injury prevention. Traditional methods like discrete point analysis simplify continuous kinetic and kinematic data, while one-dimensional Statistical Parametric Mapping (spm1d) evaluates entire movement curves. Nevertheless, spm1d's application in sports and injury research is limited. As no systematic review exists, we conducted a scoping systematic review, synthesizing the current applications of spm1d across various populations, activities, and injuries. This review concludes by identifying gaps in the literature and suggesting areas for future research. RESEARCH QUESTION: What research exists using spm1d in sports biomechanics, focusing on the lower limbs, in what populations, and what are the current research gaps? METHODS: We searched PubMed, Embase, Web of Science, and ProQuest databases for the following search string: "(((knee) OR (hip)) OR (ankle)) OR (foot) OR (feet) AND (statistical parametric mapping)". English peer-reviewed studies assessing lower limb kinetics or kinematics in different sports or sports-related injuries were included. Reviews, meta-analyses, conference abstracts, and grey literature were excluded. RESULTS: Our search yielded 165 papers published since 2012. Among these, 112 examined healthy individuals (67 %), and 53 focused on injured populations (33 %). Running (n = 45), cutting (n = 25), and jumping/landing (n = 18) were the most common activities. The predominant injuries were anterior cruciate ligament rupture (n = 21), chronic ankle instability (n = 18), and hip-related pain (n = 9). The main research gaps included the unbalanced populations, underrepresentation of common sports and sport-related injuries, gender inequality, a lack of studies in non-laboratory settings, a lack of studies on varied sports gear, and a lack of reporting standardization. SIGNIFICANCE: This review spotlights crucial gaps in spm1d research within sports biomechanics. Key issues include a lack of studies beyond laboratory settings, underrepresentation of various sports and injuries, and gender disparities in research populations. Addressing these gaps can significantly enhance the application of spm1d in sports performance, injury analysis, and rehabilitation.

Healthcare providers have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes.

BACKGROUND: Being up-to-date with evidence-based knowledge of lower limb sports injuries is essential for Healthcare professionals (HCPs). PURPOSE: To assess whether HCPs possess up-to-date knowledge of lower limb sports injuries by comparing their knowledge to that of athletes. METHODS: With an expert panel, we developed an online quiz of 10 multiple-choice questions on various topics related to lower-limb sports injuries. Maximal score was 100. We used social media to invite HCPs (5 groups: Physiotherapists, Chiropractors, Medical Doctors, Trainers, and Other therapists) and athletes of all levels (amateur, semi-pro, and pro) to participate. We drafted the questions according to conclusions from the latest systematic reviews and meta-analyses. RESULTS: 1526 participants completed the study. Final quiz scores ranged from zero (n = 28, 1.8%) to 100 (n = 2, 0.1%) and were distributed normally with a mean score of 45.4 ± 20.6. None of the 6 groups' means surpassed the set threshold of 60 points. Multiple linear regressions of covariates indicated that age, gender, engagement in physical activity, learning hours per week, reading scientific journals, reading popular magazines and blogs, trainers, and other therapists' groups explained 19% of the variances (-5.914<ß < 15.082, 0.000

Quality of life in adolescents with longstanding non-traumatic knee pain: An analysis of 316 adolescents with Patellofemoral Pain and Osgood-Schlatter Disease.

OBJECTIVES: To describe the Quality of Life (QoL) among adolescents with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) and investigate characteristics associated with QoL. STUDY DESIGN: Cross-sectional. PARTICIPANTS: 316 adolescents with PFP or OSD. MAIN OUTCOME MEASURES: QoL subscale of The Knee injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol 5-dimensions (EQ-5D). RESULTS: The KOOS-QoL was 51 ± 18, and the total index score for the EQ5D was 0.67 ± 0.21. KOOS-QoL subscale showed that 60% reported being aware of their knee problems daily or constantly, 38% reported severe to extreme lack of confidence in their knees, 28% reported severe to extreme difficulty with their knees, and 20% reported severely or totally modifying their lifestyle to avoid potentially damaging activities to their knee. EQ-5D showed that 79% experienced problems with everyday activities, 48% reported mobility problems, 17% felt worried, sad, or unhappy, and 7% reported problems looking after themselves. CONCLUSIONS: Many adolescents with longstanding non-traumatic knee pain experience low QoL. More than half were aware of their knee problems at least daily, one in three reported a severe lack of confidence in their knee, and one in six felt worried, sad, or unhappy.

The association between forward head posture and non-specific neck pain: A cross-sectional study.

BACKGROUND: Poor posture is traditionally associated with various musculoskeletal disorders. Consequently, educators in the musculoskeletal field have been teaching postural observation as part of the physical assessment. Forward head posture (FHP) is hypothesized to be associated with neck pain; however, evidence in this topic remains inconclusive. PURPOSE: To investigate the association between FHP and neck pain intensity, disability, and cervical kinematics in individuals with neck pain compared to asymptomatic individuals. A secondary aim of this study was to explore the possible effect of a head-mounted display (HMD) used in a virtual reality (VR) assessment on FHP. METHODS: The study was conducted with 43 volunteers (20 asymptomatic individuals, 23 individuals with neck pain) aged 19 to 62. FHP was assessed by measuring craniovertebral angle on profile photographs. Secondary outcome measures included pain intensity, the neck disability index (NDI) questionnaire, and neck kinematics using specialized VR software. RESULTS: There were no significant differences between individuals with neck pain and asymptomatic individuals in FHP (craniovertebral angle = 48.24°±7.29; 48.90°±5.89, respectively, p > .05). The neck pain group demonstrated a restricted range of motion and slower neck movements (p < .05). We found no significant correlation between FHP and visual analog scale, NDI, and most neck kinematic measures. CONCLUSIONS: Our findings cannot support a clinically applicable association between FHP and neck pain. Additionally, individuals with neck pain had a lower range of motion and slower neck movements.

Translation, cross-cultural adaptation and reliability of the International Knee Documentation Committee (IKDC) subjective knee form and the tampa scale for kinesiophobia (TSK) into Hebrew.

INTRODUCTION: The International Knee Documentation Committee-Subjective Form (IKDC-SF) is one of the most used measures for evaluating the quality of life among people experiencing knee pain but is not yet available in Hebrew. Similarly, the Tampa Scale for Kinesiophobia (TSK), used to evaluate fear of movement, is not available in Hebrew. This study aimed to determine the reliability and construct validity of the Hebrew IKDC-SF and TSK among people experiencing chronic knee pain. MATERIALS AND METHODS: Translation and cultural adaptation of the IKDC-SF and TSK questionnaires, followed by test-retest reliability within a two-week interval. We report on internal consistency, construct validity, and the psychometric properties of both questionnaires. RESULTS: Both questionnaires showed high internal consistency (Cronbach's α = 0.85 and 0.89, respectively) and test-retest reliability, expressed by the Intra-Class Correlation Coefficient (ICC = 0.89 and 0.80 respectively). The standard error of measurement, group smallest real difference and minimal detectable change for the IKDC-SF were 4.66, 9.13, and 12.91 points, and 3.64, 7.13, and 10.08 points for the TSK, respectively. CONCLUSION: We demonstrated that the Hebrew version of the IKDC-SF and TSK is reliable and valid for assessing QoL, function, and kinesiophobia among people experiencing chronic knee pain.

Reliability and Validity of Patient-Reported Outcome Measures for Ankle Instability in Hebrew.

BACKGROUND The International Ankle Consortium has recommended several instruments for assessing and diagnosing chronic ankle instability. These include the Ankle Instability Instrument (AII), Cumberland Ankle Instability Tool (CAIT), Identification of Functional Ankle Instability (IdFAI), and Foot and Ankle Ability Measure (FAAM). This study aimed to translate, culturally adapt, and assess the reliability, validity, discriminative power, and classification agreement of the Hebrew online versions of the AII, CAIT, IdFAI, and FAAM. MATERIAL AND METHODS After translation and cross-cultural adaptation of the questionnaires, we recruited 87 participants with self-reported ankle disorders to evaluate the psychometric properties of the questionnaires. To evaluate each questionnaire's discriminative power, we recruited 75 healthy participants. Reliability was assessed by calculating internal consistency (Cronbach's alphas) and test-retest intraclass correlation coefficients. Convergent and divergent validity were assessed by Spearman's correlation between each instrument and the Short-Form-12 (SF-12) score for physical and mental components, respectively. RESULTS All instruments had acceptable internal consistency (alpha>0.7) and good test-retest reliability (ICC2,1>0.8), except for the IdFAI (ICC2,1=0.73). All instruments had moderate convergent validity (ρ>0.4 with SF-12 physical component) except for AII (r=0.36). No instrument was correlated with the SF-12 mental component score (good divergent validity, ρ<0.3). All instruments had excellent discriminative power (area under the receiver operator characteristic curve >0.9). Strong correlations were found between all instruments. CONCLUSIONS The Hebrew online versions of the AII, CAIT, IdFAI, and FAAM are reliable and valid and can be used in research or clinical settings.

On the job training in the dissection room: from physical therapy graduates to junior anatomy instructors.

BACKGROUND:  The training of near-peer (NP) teachers and junior faculty instructors received major attention as a possible solution for the shortage of experienced anatomy instructors in faculties of medicine and health professions. Several studies described the training of NP teachers and junior instructors (≤ 2 years of teaching experience) using various methods. However, few publications include On the Job Training (OJT), which enables reflection and performance evaluation and encourages professionals to cope with their blind spots. Previous publications describing OJT did not include formal observation of the NP teacher or junior instructor. Therefore, this study aimed to present a novel approach to OJT inclusion during prosection laboratories based on the Lewinian experiential model. METHODS:  Eight physical therapy (PT) graduates were recruited as junior anatomy instructors into the prosection laboratories. All participated in a unique training program during two consecutive academic years (2017, 2018) and received OJT during the teaching sessions. Two questionnaires were filled out to evaluate the educational impact of the training program. Eighty-three first-year PT students participated in prosection laboratories in anatomy taught by junior instructors, and filled out a questionnaire evaluating the performance of both junior and senior instructors. In addition, we compared the final grades in anatomy obtained by students taught by senior instructors to the grades of those taught by junior instructors. RESULTS:  Each junior anatomy instructor participated in four OJT sessions. Based on self-reported measures, all professional and didactic aspects of the training program received a median score of 4.5 or higher on a five-point Likert scale. Students obtained similar grades in anatomy when taught by junior instructors compared with senior ones, and were similarly satisfied from the teaching performance of both senior and junior anatomy instructors. CONCLUSIONS:  OJT is applicable in a small-sized PT program facing a shortage of anatomy instructors. Including junior anatomy instructors in prosection laboratories for PT students is a viable solution to the shortage of experienced anatomy instructors. Further study, involving a larger cohort with a longer follow up will strengthen the preliminary results presented here.

Repeated Sprint Protocols With Standardized Versus Self-Selected Recovery Periods in Elite Youth Soccer Players: Can They Pace Themselves? A Replication Study.

PURPOSE: Replicating the studies of Gibson et al and Brownstein et al to assess performance, and physiological, and perceived variables during a repeated sprint protocol (RSP) with standardized versus self-selected recovery in youth soccer players. METHODS: Nineteen male soccer players (age 13.1 [1.3] y) completed 2 separate RSPs. RSP1: 10 × 30-m sprints with 30-second recovery and RSP2: 10 × 30-m sprints interspersed with self-selected recovery periods. Mean time of both 10 × 30-m RSPs and self-selected recovery periods of RSP2 were assessed. Heart rate, blood lactate concentration, and rates of perceived exertion were measured following RSPs. RESULTS: RSP2 revealed longer recovery periods (RSP1: 30.0 [0.0] s; RSP2: 39.0 [7.7] s; P < .001; effect size d = 1.648) with shorter repeated sprint time (mean 30-m sprint time: RSP1: 4.965 [0.256] s; RSP2: 4.865 [0.227] s; P = .014; d = 0.414). Blood lactate concentration (P = .002-.005; d = 0.730-0.958), heart rate (P < .001; d = 1.353), and rates of perceived exertion (RSP1: 14.9 [1.9]; RSP2: 12.9 [2.1]; P = .016; d = 1.046) were higher following RSP1. CONCLUSION: In contrast to the original studies, the present replication study demonstrated that self-selected recovery periods during a RSP leads to better repeated sprint performance compared with standardized recovery periods in youth soccer players. The better repeated sprint performance with individual recovery durations in RSP2 was achieved with less physiological and perceived effort.

Attitudinal responses to current concepts and opinions from pain neuroscience education on social media.

BACKGROUND: Pain neuroscience education (PNE) programs have become popular among clinicians and are widely promoted through social and mainstream media. PURPOSE: To test the hypothesis that people with persistent pain are likely to express negative attitudes to PNE statements and compare their responses to other social media user groups. METHODS: A total of 1319 respondents completed an online survey and were directed into four groups: persistent pain, healthcare professionals with persistent pain, pain-free healthcare professionals, and pain-free controls. The survey included ten statements of popular PNE concepts. Feedback was invited by offering seven attitudinal response categories (three positives, three negatives, and one neutral). A two-step hierarchical regression model was used to assess the likelihood of reporting negatively. RESULTS: Compared to controls, respondents from the persistent pain group were more likely to report negatively towards all statements (OR 1.6-2.16), except for two statements (#3 and #5). Healthcare professionals were less likely to report negative attitudes for 4 out of 10 statement (OR 0.35-0.58). Health care professionals living with persistent responded to most statements like the pain-free controls (besides statement #2, OR 0.59). CONCLUSION: People living with persistent pain are more likely to express negative attitudes to PNE statements on social media, unlike healthcare professionals who were less likely to express negativity. Healthcare professionals living with persistent pain responded to most PNE statements like the pain-free control group. The study's main weaknesses include the lack of psychometric information of the questionnaire used, selection bias, small samples of the healthcare professionals and the overrepresentation of young social media users.

High Levels of Self-Reported Depressive Symptoms Among Physical Therapists and Physical Therapist Students Are Associated With Musculoskeletal Pain: A Cross-Sectional Study.

OBJECTIVE: Depressive symptoms and musculoskeletal (MSK) pain are 2 of the most common health conditions. Their relationship, however, remains unclear. As depressive symptoms in physical therapists have not been well assessed, the purpose of this work was to assess self-reported depressive symptoms and MSK pain prevalence-and their possible association-in physical therapists and physical therapist students. METHODS: An online cross-sectional survey was used to gather data from 707 physical therapists and 116 physical therapist students from Israel. The Patient Health Questionnaire-9 was used to assess depressive symptoms, and the Extended Nordic Musculoskeletal Questionnaire was used to evaluate the prevalence and characteristics of MSK pain. RESULTS: Overall, 108 participants (13.1%) scored in the moderate to severe depressive symptoms category (Patient Health Questionnaire-9 score >10), and 261 participants (31.7%) scored in the mild depressive symptoms category. In total, 84 physical therapists (11.9%) and 24 physical therapist students (20.7%) reported moderate to severe depressive symptoms during the last 2 weeks. Neck and back pain had the highest point prevalence (26.7%-35.3%) and lifetime prevalence (75.9%-78.5%), respectively. Mild depressive symptoms were associated with current pain (adjusted odds ratio [OR] = 1.58) and smoking (adjusted OR = 1.79-1.84). Current pain was also associated with severe depressive symptoms (adjusted OR = 2.76-3.07). Physical therapists with higher salaries were less likely to report severe depressive symptoms (adjusted OR = 0.11-0.36). CONCLUSION: The prevalence estimates generated from this study sample imply that 11.9% of physical therapists and 20.7% of physical therapist students in Israel experienced moderate to severe depressive symptoms. Neck and back pain had the highest point and lifetime prevalence. IMPACT: The prevalence of self-reported depressive symptoms in this sample places physical therapists and physical therapist students alongside physicians, nurses, and medical profession students who have been previously reported to have elevated depressive symptoms. Future studies should further explore the nature of the association between pain and depressive symptoms in these populations.

The cross-cultural adaptation and reliability of the online Hebrew version of the extended Nordic Musculoskeletal Questionnaire.

BACKGROUND: The Nordic Musculoskeletal Questionnaire assesses musculoskeletal (NMQ) symptoms in occupational environments. Physiotherapists are known to work with their bodies, and hence prone to occupational musculoskeletal injuries. To date, there is no Hebrew version of the extended version of the NMQ (NMQ-E). PURPOSE: To cross-culturally adapt the NMQ-E into Hebrew and evaluate the intra-rater reliability of the online Hebrew version (HNMQ-E) in a population of physiotherapists. METHODS: After cross-cultural adaptation, test-retest reliability over a week was assessed with 65 participants who had no change in their health status over the past week. Statistical analysis included the calculation of Cohen's kappa coefficient (κ), observed proportions of agreement, and intraclass correlations. RESULTS: Intra-rater reliability for the prevalence of pain was moderate to substantial (κ = 0.51-0.80), and highly variable agreement for questions about pain consequences (κ = 0.20-0.94). Observed proportions of agreement were higher than 0.78 for all the items. The mean completion time of the survey was 6:30 ± 3:37. CONCLUSIONS: The online version of the HNMQ-E has been found to be reliable and practical. Future studies on the properties of the HNMQ-E should investigate more general working populations.

STarT back tool retained its predicting abilities in patients with acute and sub-acute low back pain after a transcultural adaptation and validation to Hebrew.

BACKGROUND: The STarT Back Screening Tool (SBT) distributes low back pain (LBP) patients into three prognostic groups for stratified care. This approach has demonstrated beneficial clinical and cost-effectiveness. OBJECTIVES: To translate and validate the SBT by investigating its psychometric properties among Israelis with acute and sub-acute LBP, and to evaluate its ability to predict disability after three months. DESIGN: Prospective study. METHOD: The SBT was transcultural adapted into Hebrew using published guidelines. A total of 150 patients receiving physical therapy for acute or subacute LBP were administered the SBT. Clinical outcomes included the Roland-Morris Disability Questionnaire (RMDQ), the Hospital Anxiety and Depression Scale (HADS), the Fear-Avoidance Beliefs Questionnaire (FABQ) and a numerical pain rating scale (NPRS), collected by an independent interviewer by phone at the start of the physical therapy treatment and after three months. RESULTS: The test-retest reliability of the SBT total score and psychosocial subscale were excellent (intraclass correlation coefficient 0.89 and 0.82). Spearman's correlation coefficient between SBT total score and RMDQ was 0.82, HADS (Anxiety 0.66, Depression 0.76), FABQ (exercise 0.53), NPRS (severe pain 0.48, average pain 0.53). The SBT baseline score showed excellent predictive abilities in discriminating poor disability after three months (ROC curve = 0.825, P < 0.001, 95% CI 0.756-0.894). CONCLUSION: The Israeli translation and cross-cultural adaptation of the SBT is a valid and reliable instrument. The SBT discriminated low, medium and high-risk groups, and predicts disability after three months.

Physiotherapists lack knowledge of the WHO physical activity guidelines. A local or a global problem?

BACKGROUND: Physical inactivity is a significant cause of premature deaths globally, yet many physiotherapists)PT's) have little knowledge of the World Health Organization's physical activity guidelines (PA). OBJECTIVES: To assess the knowledge of Israeli PT's regarding the World Health Organization's (WHO) recommendations for PA for adults and adolescents. Secondary aims were to determine how many Israeli PT's, are recommending PA for their patients and to evaluate the knowledge level of Israeli PT's in relation to PT's in other countries. DESIGN: Cross-sectional online survey. PARTICIPANTS: Of the 1413 Israeli PT's offered the survey, 1062 (75%) completed it, which represents 16.4% of the 6450 licensed PT's in Israel. RESULTS: A mere 6.8% physiotherapists were aware of the WHO-recommended level of adult PA, and only 4% were knowledgeable of the recommendations for adolescents. Novice PT's (5 > years of experience) knew significantly more about adult PA recommendations (P < 0.05) than did the more senior physiotherapists. Nine out of every ten (90%) PT's routinely initiate conversations about PA, 83.5% signpost to PA support elsewhere, and 70.5% deliver brief intervention themselves for PA. The main barriers to promoting PA were (1) the belief that promotion would not change patient behavior, (2) lack of time, and (3) perceived lack of skills at counseling for behavior change. CONCLUSIONS: Israeli PT's have poor knowledge of the WHO's adults and adolescent guidelines for PA. Lack of knowledge among PT's regarding the WHO's PA guidelines is a recurrent global problem that requires immediate attention.