ABSTRACT
Background: Pelvic floor dysfunction (PFD) occurs when muscles of the pelvic floor become weakened, impaired, or experience tension leading to a variety of complications. Due to the reactive nature and high demands of many sports, athletes are at increased susceptibility and of particular interest concerning PFD. Hypothesis/Purpose: The purpose of this study was to explore the prevalence of PFD among college-aged athletes, assess how PFD impacted athletic performance, and identify contributing factors for increased likelihood of PFD in athletes. Study Design: Cross-Sectional Study. Methods: All fully active LVC NCAA Division 3 athletes were recruited for screening for PFD using the Cozean Pelvic Dysfunction Screening Protocol and were surveyed on their self-knowledge of PFD. Athletes who scored ≥ 3 on this tool completed an additional survey, created by the investigators, to identify the impact PFD had on their athletic performance and personal life and were then randomly assigned to one of three investigators to undergo a noninvasive coccygeal assessment to determine underactive, overactive, or normal pelvic floor muscle (PFM) activity. Results: Fifty-three Division III male and female athletes between the ages of 18-25 years old participated in the study. Statistically significant differences were found between Cozean scores and demographic factors of age (p \<0.001), gender (p \<0.05), self-knowledge of PFD (p \<0.001), and sport (p \<0.001) among all participants that contributed to the increased likelihood of PFD. Thirteen athletes scored ≥ 3 on the Cozean with the 92.3% experiencing under/over active PFM activity and the majority indicating that PFD significantly impacted their athletic performance and quality of life. Conclusion: The results indicate that older female NCAA Division III college athletes who participate in swimming and who possess self-knowledge of PFD are more likely to experience PFD. Additionally, these athletes are likely to encounter a significant impact on their athletic performance and quality of life. These results provide preliminary evidence on the need of PFD awareness and assessment among college athletes. Level of Evidence: Level 3b.
ABSTRACT
BACKGROUND: Conventional motion analysis studies define the ankle joint center as the midpoint between the most medial and lateral aspects of the malleoli, yet research points toward a more distal joint center location. The purpose of this study was to develop and evaluate an anatomically based correction that would move the conventional ankle joint center to a more accurate location. METHODS: Lower extremity radiographs from 30 pediatric patients were analyzed retrospectively. An offset between the conventional and more accurate ankle joint centers was measured and correlated to other common anatomical measures based on conventional skin mounted marker positions. The best correlated measure was used to define a simple correction factor, which was subsequently evaluated by its effect on six degree-of-freedom ankle joint translations during normal gait (n=8). FINDINGS: Shank length was found to have the highest bivariate linear correlation (r=0.89) with the offset. Adjusting the ankle joint center using a percentage of shank length (2.7%) was also as accurate as the regression equation in predicting offset (mean error 0.6mm, or 6% offset). Adjusting the ankle joint center using this simple percentage resulted in a 25% reduction in mean ankle joint translations during normal gait. INTERPRETATION: The accuracy of the ankle joint center can be increased through a simple, anatomically based correction. This correction may prove beneficial in some kinematic and kinetic applications requiring increased anatomical fidelity.