Clinical measures associated with dynamic balance and functional movement.

Decreased balance and impaired functional movement have been linked with increased injury risk. The purpose of our study was to determine the association between specific measures of power, strength, flexibility, balance, and endurance compared with more global measures of dynamic balance, using the Y-Balance Test (YBT), and functional movement, using the functional movement screen (FMS), in healthy soldiers. Our participants (n = 64; 53 men, 11 women) were healthy active duty service members (25.2 ± 3.8 years, 25.1 ± 3.1 kg·m(-2)). Seventeen tests with 38 associated measures of strength, power, flexibility, endurance, balance, and functional measures were assessed. A significant Pearson product moment correlation (r > 0.2 and p < 0.01) was used to narrow the number of variables of interest. Two hierarchical stepwise regression analyses were performed to determine the most parsimonious set of variables associated with the YBT and FMS performance scores. Our results included a 4 variable model (F = 13.4, p < 0.001) that was associated with YBT scores (R = 0.72, R2 = 0.51). Superior performance on the YBT was associated with better performance on the FMS lunge and upper trunk mobility tests, decreased number of hops during a 6-m hop test, and greater gastrocnemius flexibility. A second 4 variable model (F = 11.813, p < 0.001) was associated with FMS scores (R = 0.70, R2 = 0.50). Superior performance on the FMS was associated with greater anterior reach on the YBT, greater distance on the crossover hop test, increased hamstring flexibility, and higher levels of self-reported function through the lower-extremity functional scale. Physical fitness leaders and clinicians could use these models to inform decision making when developing and assessing the outcomes of a personalized intervention program for those with low FMS and YBT scores.

Implementation of filmarray respiratory viral panel in a core laboratory improves testing turnaround time and patient care.

The FilmArray respiratory virus panel detects 15 viral agents in respiratory specimens using polymerase chain reaction. We performed FilmArray respiratory viral testing in a core laboratory at a regional children's hospital that provides service 24 hours a day 7 days a week. The average and median turnaround time were 1.6 and 1.4 hours, respectively, in contrast to 7 and 6.5 hours documented 1 year previously at an on-site reference laboratory using a direct fluorescence assay (DFA) that detected 8 viral agents. During the study period, rhinovirus was detected in 20% and coronavirus in 6% of samples using FilmArray; these viruses would not have been detected with DFA. We followed 97 patients with influenza A or influenza B who received care at the emergency department (ED). Overall, 79 patients (81%) were given oseltamivir in a timely manner defined as receiving the drug in the ED, a prescription in the ED, or a prescription within 3 hours of ED discharge. Our results demonstrate that molecular technology can be successfully deployed in a nonspecialty, high-volume, multidisciplinary core laboratory.

Reliability of lower quarter physical performance measures in healthy service members.

INTRODUCTION: Measures of endurance, flexibility, strength, and power may be of value in predicting injury risk, but application to the military setting has been limited. The purpose of this study was to assess the reliability and precision of lower quarter physical performance measures among novice raters. METHODS: Sixty-four (53 male, 11 female) healthy active duty Soldiers (aged 25.2±3.8 years, 25.1±3.1 kg/m²) were recruited while in training at Fort Sam Houston, Texas. Subjects completed 13 lower quarter physical performance measures in a counterbalanced order. Measures included indicators of lumbopelvic endurance (trunk flexion, trunk extension, and trunk lateral flexion), lower extremity flexibility (gastrocnemius, soleus, iliotibial band, hamstring, and quadriceps), hip strength (hip external rotation, hip abduction), quality of movement (lateral step down), and lower extremity power (timed hop test and crossover hop test). Interrater test-retest reliability was assessed between baseline scores and those obtained 48 hours later using intraclass correlation coefficients (ICC) and standard errors of measurements (SEM). RESULTS: Measures of lumbopelvic endurance had ICC(2,1) values ranging from 0.77 to 0.79 with SEM ranging from 18.3 to 24.5 seconds. Measures of flexibility had ICC(2,2) values ranging from 0.27 to 0.59 with SEM ranging from 4.1° to 9.9°. Measures of hip strength had ICC(2,3) values ranging from 0.61 to 0.82 with SEM ranging from 1.3 kg to 3.0 kg. Measures of power had ICC(2,3) values ranging from 0.78 to 0.93 with SEM values of 0.2 seconds and 27.4 cm. CONCLUSIONS: The majority of measures assessed had adequate reliability in this sample of uniformed service members assessed by novice raters. The measures of strength and power had moderate to good reliability with small measurement error, indicating the possibility of these measures to detect change over time. Although the measures of lumbopelvic endurance had good reliability, they were associated with relatively large SEM values compared to the group mean, thus limiting the ability of these tests to detect change over time. The measures of flexibility had limited reliability which may be associated with a restriction in range of the underlying scores that could artificially underestimate reliability. These results can help inform which physical performance measures should be used in future research to assess injury prediction and human performance optimization among uniformed service members.