Chiropractors in Multidisciplinary Teams: Enablers of Colocation Integration in GP-Led Primary Healthcare.

The aim of this study was to explore and document the enablers and barriers of chiropractic care colocation in general practice at a large-scale private primary care centre in Australia. This study focused on the perceptions of healthcare professionals regarding this integration. The research setting was a large integrated primary care centre located in an outer metro, low-socioeconomic area in the City of Moreton Bay, Queensland, Australia. Participant inclusion criteria included general medical practitioners, practice nurses, and medical managers who self-reported interactions with the physically collocated and integrated chiropractic practice. Data was collected from 22 participants using face-to-face, qualitative, semi-structured interviews with an average duration of 32 min. The data collected included perceptions of chiropractic treatment, enablers to patient referral pathways, and views of the integrated chiropractic care model. A reflexive thematic analysis was conducted on the data set. All participants reported that this was their first exposure to the colocation of a chiropractor within a general medical practice. Four key enablers of chiropractic care integration were identified: (1) the practitioner [chiropractor], (2) the organisation [general practice], (3) consumer flow, and (4) the environment [shared spaces and tenant ecosystem]. The chiropractic integration enhanced knowledge sharing and interprofessional trust among healthcare providers. The formal reporting of patient outcomes and understanding of the chiropractor's scope of practice further enabled referrals to the service. Shared administrative and business processes, including patient records, booking systems, and clinical meetings, facilitated relationship development between the chiropractor and referring health providers. Colocation as part of a larger primary care centre created proximity and convenience for health providers in terms of interprofessional communication, and for patients, in terms of access to chiropractic services. Existing governance structures supported communication, professional education, and shared values related to the delivery of patient-centred care. Identified barriers included limited public funding for chiropractic services resulting in reduced access for patients of low-socioeconomic status. Additionally, scepticism or negativity towards the discipline of chiropractic care was identified as an initial barrier to refer patients. In most cases, this view towards the chiropractor was overcome by regular patient reporting of positive treatment outcomes to their GP, the delivery of education sessions by the chiropractor for the health providers, and the development of interprofessional trust between the chiropractor and referring health providers. This study provides preliminary evidence and a conceptual framework of factors influencing the successful integration of chiropractic care within an Australian large primary care centre. The data collected indicated that integration of chiropractic care into a primary care centre serving a low-socioeconomic region can be achieved with a high degree of health provider satisfaction.

Does lower extremity alignment during normal stance predict lower limb kinematics and kinetics during drop landings?

BACKGROUND: Static lower extremity alignment (LEA) during normal stance has been used clinically as a tool to determine the presence of known anterior cruciate ligament (ACL) risk factors during dynamic tasks. Previous work investigating the relationship between static LEA during normal stance and risk factors for ACL injury is limited by the use of imprecise methods or because it focuses on knee valgus only and no other potentially important variables. The aim of this investigation was to determine the relationships between static LEA and the corresponding LEA during drop landings. METHODS: Forty-one female athletes were recruited for the study (age: 19.8 ± 2.5 years, height: 1.73 ± 0.06 m, mass: 64.03 ± 6.66 kg). Lower limb kinematic data were collected using a 10 camera infrared motion capture system (500 Hz) with retro-reflective markers placed over key anatomical landmarks. This system was linked to two force platforms (1000 Hz) with subsequent three-dimensional kinematic and kinetic data developed using standard software (Visual3D). Following an appropriate warm-up, data collection involved participants standing with their arms partially abducted to record static LEA. This was following by a series of drop landings from a 0.4 m box onto the force platforms. Maximum LEA data during drop landings were then compared with static LEA. RESULTS: Analyses showed that in comparison to static stance, during landings the anterior tilt of the pelvis decreased while hip abduction and knee internal rotation increased. At best, static LEA variables were moderately correlated (r = -0.51 to 0.58) with peak values measured during drop landings. Additionally, regression analysis did not yield any significant predictors of any key peak hip or knee variables measured during drop landings (p = 0.15 to 0.89). CONCLUSION: When combined, the poor relationships observed between kinematics during static LEA and LEA during drop landings calls into question the practice of using static measures to predict LEA during even simple landing tasks. These findings suggest static assessments of LEA may have minimal value as an ACL injury screening tool.

A Cross-Sectional Study of Factors Influencing Pre-Operative Anxiety in Orthognathic Patients.

Orthognathic treatment is an important treatment modality to manage severe dentofacial discrepancies. Patients awaiting orthognathic surgery often experience increased anxiety, which may adversely affect post-operative recovery and treatment satisfaction. This study investigated the effects of a number of factors on pre-operative anxiety in orthognathic patients. Seventy patients prospectively recruited from three orthognathic centres in the UK completed a pre-operative questionnaire that included validated scales for measuring anxiety, social support, resilience, and coping styles. Sociodemographic data and satisfaction with the information provided by the clinical team were also elicited from the questionnaire. Univariable analysis showed that social support from a significant other (p = 0.026), resilience (p < 0.001), and satisfaction with the information provided by the clinical team (p = 0.002) were significantly associated with reduced anxiety, whilst avoidance coping (p < 0.001) and coping through seeking social support (p = 0.006) were significantly related to increased anxiety. With the exception of coping by seeking social support, these relationships retained significance in a multivariable regression analysis. Neither gender nor ethnicity moderated the effects of social support on pre-operative anxiety. These findings suggest potential avenues for clinicians to address with future interventions to reduce pre-operative anxiety. Further qualitative research may provide greater clarity on the relationship between these variables and anxiety.

Previous experiences can influence individual cricket spin bowlers' perceptions of affordances in the performance landscape.

The ecological dynamics framework emphasises that movement solutions are guided by the relationship that exists between the performer and their environment, scaled to an individual's own action capabilities. This suggests that representative practice tasks should be used in high performance settings to encourage individually optimised movement solutions for both team and individual sports. This study specifically focuses on individual cricket spin bowlers and aims to understand the influence of their prior learning experiences on their perceptual attunement strategies when tasked with performing on a familiar Australian cricket pitch and a less familiar bespoke international (Indian) pitch. Two right hand leg spin bowlers that were part of a group of eight emerging expert spin bowlers were chosen for individual analysis. Bowler A reported 80 prior experiences of bowling on subcontinental (i.e., India, Pakistan, or Bangladesh) pitches whereas Bowler B had only 20 prior experiences. Overall, both bowlers' outcome performances either met or exceeded their expectations. Bowler A chose to calibrate his bowling style on the less familiar pitch to improve the fit between his delivery characteristics and the environmental pitch conditions, whereas Bowler B maintained his bowling style, even though he recognised a difference in the pitch conditions. Therefore, Bowler A maintained stable performance outcomes by implementing flexible movement solutions. In contrast, while Bowler B achieved his expected performance outcomes, his lack of diverse learning experiences may limit his action capabilities, although more performance trials are needed to confirm this conclusion. Regardless, this study demonstrates that there is valuable information in knowing how a player achieves a successful result, which should be coupled with performance outcomes to help create individualised development strategies.

Alternatives to common approaches for training change of direction performance: a scoping review.

BACKGROUND: Research focuses heavily upon the effect of strength and power training on change of direction performance. The objective of this scoping review is to highlight alternative approaches to training change of direction. METHODS: Four databases (Scopus, PubMed, Web of Science and SPORTDiscus) were searched with no date restrictions. To be included studies must (i) investigate change of direction performance following an intervention or investigate the relationships between variables of interest and change of direction performance; (ii) recruit participants > 18 years old; (iii) recruit participants involved in competitive sport. The majority of included studies investigated the effect of strength and/or power training, or, relationships between strength and/or power variables with change of direction performance. RESULTS: Despite fewer studies, alternative training methods resulted in greater improvements (compared with strength and/or power) in change of direction performance, with smaller training durations. Few studies included reactive agility as an outcome measure. CONCLUSION: Despite much of the literature focusing on strength and/or power, there are alternative training modalities that demonstrate merit for improving change of direction performance. Future studies should investigate the effect of alternative training interventions on reactive agility performance, to provide a more valid indication of transfer to competition.

Long-term Return to Sports After Anterior Cruciate Ligament Injury: Reconstruction vs No Reconstruction-A Comparison of 2 Case Series.

BACKGROUND: Reconstruction is considered to provide the best opportunity for return to sports (RTS) after anterior cruciate ligament (ACL) rupture. However, recent studies report that <50% of athletes return to preinjury sporting levels and that RTS rates at 1 year after injury are the same for athletes undergoing reconstruction and nonoperative management. Long-term studies are essential to confirm these findings and guide decisions regarding surgery. PURPOSE: First, to compare long-term sports participation after ACL reconstruction and nonreconstruction and, second, to relate RTS level to strength and stability. STUDY DESIGN: Cohort study; Level of evidence, 3. METHOD: Patients with ACL deficiency (n = 101) who were referred for physical therapy at the time of diagnosis were followed long term: 56 were treated surgically 2.5 years (interquartile range [IQR], 1-4) after injury and 45 were treated nonoperatively. At long-term follow-up, the reconstructed group was at 9 years (IQR, 7-11) after injury and aged 33.3 ± 6.2 years (mean ± SD, 70% male; 61% meniscal injury), and the nonreconstructed group was at 11 years (IQR, 7-14) after injury and aged 38.7 ± 8.3 years (67% male; 58% meniscal injury). Measures of objective stability, subjective stability, and quadriceps/hamstring strength were compared between groups using independent-samples t tests. Current RTS level, scored on a 6-point scale, was compared between groups using chi-square tests. Spearman rho correlated RTS with outcome measures. RESULTS: Of the total group of patients, 96% with reconstruction and 93% without continued to play sports. In the reconstructed and nonreconstructed groups, 4% and 7% did not RTS, and 8% and 17% returned to safe sports, respectively: 13% and 12% to running, 20% and 26% to sports involving limited twisting, 12% and 24% to recreational pivoting sports, and 43% and 14% to competitive pivoting sports. The only significant difference was in return to competitive pivoting sports (P = .003). Five patients with reconstruction ruptured the contralateral ACL, and 1 ruptured his graft. Most patients treated nonoperatively modified their sports participation. Their RTS levels correlated significantly with quadriceps strength (r = 0.65; P < .001), hamstring strength (r = 0.721; P < .001), and subjective stability (r = 0.405; P = .01). CONCLUSION: Surgically treated patients returned to competitive pivoting sports at 3 times the rate of those managed nonoperatively, confirming that reconstruction provides the best opportunity for continued participation in competitive pivoting sports. Regardless of grouping, RTS correlated with modifiable factors, including strength and stability. Higher rates of subsequent injuries observed after reconstruction may result from increased participation in competitive pivoting sports.

Validation of a Smartwatch-Based Workout Analysis Application in Exercise Recognition, Repetition Count and Prediction of 1RM in the Strength Training-Specific Setting.

The goal of this study was to assess the validity, reliability and accuracy of a smartwatch-based workout analysis application in exercise recognition, repetition count and One Repetition Maximum (1RM) prediction in the strength training-specific setting. Thirty recreationally trained athletes performed four consecutive sets of barbell deadlift, barbell bench press and barbell back squat exercises with increasing loads from 60% to 80% of their estimated 1RM with maximum lift velocity. Data was measured using an Apple Watch Sport and instantaneously analyzed using an iOS workout analysis application called StrengthControl. The accuracies in exercise recognition and repetition count, as well as the reliability in predicting 1RM, were statistically analyzed and compared. The correct strength exercise was recognised in 88.4% of all the performed sets (N = 363) with accurate repetition count for the barbell back squat (p = 0.68) and the barbell deadlift (p = 0.09); however, repetition count for the barbell bench press was poor (p = 0.01). Only 8.9% of attempts to predict 1RM using the StrengthControl app were successful, with failed attempts being due to technical difficulties and time lag in data transfer. Using data from a linear position transducer instead, significantly different 1RM estimates were obtained when analysing repetition to failure versus load-velocity relationships. The present results provide new perspectives on the applicability of smartwatch-based strength training monitoring to improve athlete performance.

Patients' and parents' expectations of orthodontic treatment in university settings.

INTRODUCTION: The primary aim was to compare patients' and parents' orthodontic treatment expectations at the Eastman Institute for Oral Health, University of Rochester, Rochester, NY (UR) in the United States. Secondary aims were to assess the association between sociodemographic factors and UR participants' expectations; and compare participants' expectations between UR, Academic Centre for Dentistry Amsterdam (ACTA) and King's College Dental Hospital, London, United Kingdom (KC) (previously published data). METHODS: One hundred and forty participants [70 patients and one of their parents (n = 70)] completed a validated questionnaire (10 questions) to measure orthodontic treatment expectations before screening at the Orthodontic Department at UR. Various sociodemographic factors were assessed. The paired t test (for continuous responses) and the Fisher exact test (for categorical responses) were used to compare UR patients' and parents' responses. Two-sample t test and the Fisher exact test were used to compare participants' responses among sociodemographic groups. One-way analysis of variance followed by the Tukey test, and the Fisher exact test were used to compare participants' responses between UR, and ACTA and KC (data collected from previous publications). A multiplicity correction was performed to control the false discovery rate. RESULTS: Patients at UR expected less check-up and diagnosis, and less discussion about treatment at the initial visit, more dietary restrictions, and less improvement in smile esthetics and social confidence with orthodontic treatment than parents. Participants' responses differed by sociodemographic factors at UR and between UR, ACTA, and KC. CONCLUSIONS: Expectations of orthodontic treatment differ between patients and their parents, are associated with sociodemographic factors, and vary among United States and European University centers.

Psychometric validation of a pre-existing questionnaire used to measure patient satisfaction following orthodontic treatment in a UK population.

OBJECTIVE: To determine the psychometric properties of a pre-existing orthodontic satisfaction questionnaire and to assess patient satisfaction of their orthodontic treatment. DESIGN: Psychometric assessment of a pre-existing orthodontic satisfaction questionnaire. SETTING: Two sites at King's College Hospital NHS Foundation Trust. PARTICIPANTS: Individuals aged 12-15 years who had completed fixed orthodontic treatment. METHODS: An expert panel assessed a pre-existing orthodontic treatment satisfaction questionnaire for validity and readability. As a result, revisions were made to the questionnaire and it was distributed to 103 participants aged 12-15 years, on completion of their fixed orthodontic treatment (T1). Test-retest reliability of the questionnaire was assessed through completion of a second questionnaire by 17 participants, at a two-week interval (T2). The questionnaire was assessed for reliability using item-total correlations (I-TC) and Cronbach's alpha. Factor analysis allowed exploration of the underlying factor structure of the questionnaire. Test-retest reliability was assessed using Cohen's kappa coefficient. Multiple regression analysis was used to find out the significant demographic variables that predicts the satisfaction level of treatment. RESULTS: Following validity and readability assessment by the expert panel, the questionnaire was revised. Eleven items were removed following item analysis (with I-TC ⩽ 0.3). Factor analysis was deemed uninterpretable. The overall scale demonstrated greater reliability than the underlying sub-scales. Therefore, the sub-scales were removed, resulting in one scale which assessed overall orthodontic satisfaction, comprising 37 items, with a Cronbach alpha of 0.92. The test-retest reliability of the revised 37-item scale was deemed to be poor (kappa coefficient = 0.39). Multiple regression analysis identified ethnicity as a significant predictor of orthodontic treatment satisfaction (P = 0.01). CONCLUSION: This study provides a valid measure to assess orthodontic treatment satisfaction for use in a UK population aged 12-15 years on completion of fixed orthodontic treatment.

The effect of increasing heel height on lower limb symmetry during the back squat in trained and novice lifters.

BACKGROUND: Symmetry during lifting is considered critical for allowing balanced power production and avoidance of injury. This investigation assessed the influence of elevating the heels on bilateral lower limb symmetry during loaded (50% of body weight) high-bar back squats. METHODS: Ten novice (mass 67.6 ± 12.4 kg, height 1.73 ± 0.10 m) and ten regular weight trainers (mass 66.0 ± 10.7 kg, height 1.71 ± 0.09 m) were assessed while standing on both the flat level floor and on an inclined board. Data collection used infra-red motion capture procedures and two force platforms to record bilateral vertical ground reaction force (GRFvert) and ankle, knee and hip joint kinematic and kinetic data. Paired t-tests and statistical parametric mapping (SPM1D) procedures were used to assess differences in discrete and continuous bilateral symmetry data across conditions. RESULTS: Although discrete joint kinematic and joint moment symmetry data were largely unaffected by raising the heels, the regular weight trainers presented greater bilateral asymmetry in these data than the novices. The one significant finding in these discrete data showed that raising the heels significantly reduced maximum knee extension moment asymmetry (P = 0.02), but in the novice group only. Time-series analyses indicated significant bilateral asymmetries in both GRFvert and knee extension moments mid-way though the eccentric phase for the novice group, with the latter unaffected by heel lift condition. There were no significant bilateral asymmetries in time series data within the regular weight training group. CONCLUSIONS: This investigation highlights that although a degree of bilateral lower limb asymmetry is common in individuals performing back squats, the degree of this symmetry is largely unaffected by raising the heels. Differences in results for discrete and time-series symmetry analyses also highlight a key issue associated with relying solely on discrete data techniques to assess bilateral symmetry during tasks such as the back squat.

How do you identify the patient with 'high expectations' of orthodontic treatment: An empirical approach.

OBJECTIVES: To identify an empirical method for identifying patients with 'high expectations' of orthodontic treatment with fixed appliances using a questionnaire-based approach. DESIGN: Secondary analysis of data from four studies which collected data on patients' expectations of orthodontic treatment using the same questionnaire. SETTING: Secondary care orthodontic services. PARTICIPANTS: All four datasets comprised new patients aged 12-15 years, with no history of orthodontic treatment, who fulfilled the criteria for NHS treatment using the Index of Orthodontic Treatment Need (IOTN). Unpublished dataset 1 comprised 100 participants, while dataset 2 had 70 participants, dataset 3 had 67 participants and dataset 4 comprised 40 participants. METHODS: The questionnaire utilised in all studies had a question which asked respondents to rate seven different expectations of outcome relating to straight teeth, better smile, ease of eating, speaking, cleaning teeth, improved career prospects and social confidence. Dataset 1 was analysed to determine the proportion of patients who had rated all seven outcome expectation items at a maximum score. Similar analyses were performed for the other three datasets to explore the trend in the proportion of patients with high expectations over time. RESULTS: For dataset 1, 2.0% of participants had high expectations, as defined by their scores on the questionnaire. The proportions for the datasets 2, 3 and 4 were 4.0%, 4.5% and 2.5%, respectively. CONCLUSION: The method outlined provides an empirical basis for identifying patients with statistically infrequent high expectations. This can potentially help clinicians in the management of such patients.

The effect of elevating the heels on spinal kinematics and kinetics during the back squat in trained and novice weight trainers.

This research assessed the influence of various heel elevation conditions on spinal kinematic and kinetic data during loaded (25% and 50% of body weight) high-bar back squats. Ten novice (mass 67.6 ± 12.4 kg, height 1.73 ± 0.10 m) and ten regular weight trainers (mass 66.0 ± 10.7 kg, height 1.71 ± 0.09 m) completed eight repetitions at each load wearing conventional training shoes standing on the flat level floor (LF) and on an inclined board (EH). The regular weight training group performed an additional eight repetitions wearing weightlifting shoes (WS). Statistical parametric mapping (SPM1D) and repeated measures analysis of variance were used to assess differences in spinal curvature and kinetics across the shoe/floor conditions and loads. SPM1D analyses indicated that during the LF condition the novice weight trainers had greater moments around L4/L5 than the regular weight trainers during the last 20% of the lift (P < 0.05), with this difference becoming non-significant during the EH condition. This study indicates that from a perspective of spinal safety, it appears advantageous for novice weight trainers to perform back squats with their heels slightly elevated, while regular weight trainers appear to realize only limited benefits performing back squats with either EH or WS.

The effect of backpack load position on photographic measures of craniovertebral posture in 150 asymptomatic young adults.

BACKGROUND: Altering the horizontal position of the weight in a backpack will influence the magnitude of the external torque it creates but the effect on posture is unclear. OBJECTIVE: To use photogrammetry to determine if changes in the horizontal position of a fixed backpack weight affect external measures of craniovertebral posture in 150 asymptomatic young adults. METHODS: A backpack was attached to a steel frame with a bar protruding posteriorly. A fixed load (5% body mass) was placed at three distances along the bar -0 m, 0.20 m, and 0.40 m. Sagittal and frontal plane photogrammetry was used to measure the craniovertebral angle (CVA), upper cervical gaze angle (UCGA) and lateral head tilt angle (LHTA). A comparison was made across unloaded (no backpack) and loaded conditions. RESULTS: There was a significant decrease in the CVA between unloaded and loaded conditions. Changes in the UCGA were small and, while significant, may not have practical importance. There were no differences in the LHTA between the conditions. CONCLUSIONS: Changes in the horizontal position of a fixed load affect external measures of craniovertebral posture so consideration needs to be given to not only the weight of a backpack but how the weight is positioned within the backpack.

Do the landing mechanics of experienced netball players differ from those of trained athletes competing in sports that do not require frequent landings?

OBJECTIVES: This study examined whether young (15-19 years old) high-performance netball players exhibit different landing mechanics compared to female controls who do not participate in sports requiring frequent landings. DESIGN: Comparative, cross-sectional. METHODS: Lower limb kinematics and kinetics from 23 youth high performance female netball players (age: 17.5±1.7 years, height: 1.77±0.06m, mass: 66.5±6.33kg, netball experience: 8.5±2.3 years) were compared to data from 23 females (age: 22.0±3.2 years, height: 1.70±0.05m, mass: 64.4±6.7kg) who were involved in competitive sport, but had minimal experience playing a jump-landing sport. The jump landing task required participants to perform a countermovement jump and grab a netball suspended at 85% of the participant's maximum jump height. On random trials the ball was raised rapidly to 100% maximum jump height as the participant initiated her jump. RESULTS: The netball group landed with significantly less contribution from the knee extensors to total work for the non-preferred leg (P<0.001, ds=1.10) than the inexperienced group. Although no other significant differences were found between groups, there were several small to moderate differences in several of the key biomechanical variables identified as being risk factors for ACL injury or associated with ACL strain. CONCLUSIONS: Both groups had similar knee valgus and internal rotation angles and moments, with nearly all participants presenting with relatively poor frontal plane knee control. Overall, results suggest that experience playing a netball may not be enough to develop low-risk landing mechanics.

Wrist pain in gymnasts: Efficacy of a wrist brace to decrease wrist pain while performing gymnastics.

STUDY DESIGN: This was a clinical trial of prospective cohort. INTRODUCTION: Wrist pain in gymnasts is a global phenomenon. Compression forces acting on wrists while performing gymnastics is a predisposing factor in the development of wrist pain and consequential injury of the distal radial physis in skeletally immature gymnasts. One approach to mitigate these forces is wrist bracing; however, studies on the efficacy of wrist braces to reduce wrist pain experienced by gymnasts are limited. PURPOSE OF THE STUDY: The purpose of this study was to investigate the efficacy of an innovative design of a wrist brace to decrease gymnasts' wrist pain while performing gymnastics. METHODS: A wrist brace was designed and trialled over 3 weeks by 48 male gymnasts (aged 8-22 years, levels 4-7) with wrist pain. Wrist pain was recorded on a visual analog scale of 1 to 10 before and after trial. Data analysis was performed using SPSS-22 (IBM Inc). Paired t-tests were performed to compare variables before and after trial, with effect size analyses used to quantify the relative magnitude of any differences. RESULTS: Paired t-tests indicated the gymnasts reported significantly reduced pain (P = .002; 53.5%) while wearing the braces for training on the pommel, floor, and parallel bars. The overall large effect size value was practically significant (d = 0.902). DISCUSSION: For any wrist brace to be effective, it needs to be implemented when the gymnast experiences wrist pain before an injury occurs. This would minimize the development of pain-provoked adaptive movement patterns that perpetuate dysfunction. CONCLUSIONS: The brace with the volar gel pad is recommended to be worn as an adjunct to current strategies in management of gymnasts' wrist pain or as an injury prevention device in skeletally immature gymnasts.

Patients' expectations: is there a typical patient?

OBJECTIVES: To qualitatively explore, and analyse, patients' expectations before the start of fixed appliance orthodontic treatment and determine whether typologies exist. DESIGN: A prospective cross-sectional qualitative study, which involved 13 patients (aged 12-15 years). SETTING: NHS Hospital Orthodontic Department (UK). MATERIALS AND METHODS: In-depth interviews were conducted with patients who consented to participate before the start of fixed appliance orthodontic treatment. The in-depth interview data were transcribed and then managed using a framework approach, followed by associative analysis. RESULTS: The in-depth interviews revealed two major themes and associated subthemes which were: first, patients' expectations about the treatment process and outcome; and second, patients' expectations of themselves during and after treatment. Three typologies related to patients' expectations of the orthodontic treatment process were also identified. The first group of participants had minimal expectations of the treatment process, did not anticipate discomfort or pain and did not anticipate that treatment would cause disruption to their daily life. The second group of participants had expectations that treatment would involve arch wire changes, dental extractions and result in some discomfort/pain, which would cause some limited disruption to their daily life (moderate expectations). The third type of participant had expectations of the treatment process involving arch wire changes and dental extractions, and anticipated that the discomfort and pain experienced would significantly affect their daily life (marked expectations). CONCLUSIONS: These results provide the clinician with information about patient typologies and provide the clinician with some direction when communicating with their patients and managing their expectations before the start of treatment.

Influence of technique on upper body force and power production during medicine ball throws.

This project examined the interrelationships between power production and upper body kinematics during a series of medicine ball push-press (MBP-P) throws. Twenty-five regular weight trainers (body mass = 86 ± 10 kg) performed a series of ballistic vertical MBP-P throws at loads representing 5% and 10% of their assessed 5RM bench press. Throws were performed lying supine on a force platform (1 kHz) with upper body kinematics assessed using standard infra-red motion capture techniques (0.5 kHz). Gross measures of performance and power production such as peak vertical ball velocity (Velpeak), peak force (Fpeak) and power (Ppeak) were recorded during the propulsive phase of the movement. Comparative analyses indicated that despite significant reductions in Velpeak from the 5% to 10% loads (P < 0.001), Fpeak remained largely unchanged (P = 0.167). Analysis of inter-trial variability showed that the gross measures of performance and power were relatively stable (Coefficient of Variation [CV%] <13%), while most upper limb segmental kinematics varied considerably between trials (CV% up to 70%). This project highlights the complexity of the relationships between power production and upper body kinematics during light load ballistic MBP-P throwing. Additionally, it shows how trained athletes can achieve similar outcomes during ballistic movements using a variety of movement strategies.

Examining environmental constraints in sport: Spin characteristics of two cricket pitches with contrasting soil properties.

In the sport of cricket, the pitch is an organic surface that represents an important environmental constraint. While the soil properties of the pitch are known to influence the pace and bounce of medium and fast deliveries, it is unknown how the soil constructs or the seam of the cricket ball affect the pace, bounce, and deviation of a spinning delivery. A specialised spin bowling machine was used to deliver 276 (139 wrist spin, 137 finger spin) spinning deliveries onto two cricket pitches with contrasting soil properties. The pitches included a bespoke international pitch (BIP; higher sand content at 43.28%) and a common Australian pitch (CAP; lower sand content at 7.44%). Results indicated that the BIP showed significantly slower reflection pace and larger deviation, compared to the CAP. Irrespective of the pitch type, when the seam of the ball impacted the pitch, there was a significantly slower reflection pace and larger deviation. The reflection properties of the BIP resembled that of a "spinning pitch" which can be used as a form of representative practice for conditions similar to those that may be experienced in India. The impact of the seam on the pitch surface significantly altered the reflection of the ball and should be considered in future cricket research.

Author Correction: Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Internal and external sagittal craniovertebral alignment: A comparison between radiological and photogrammetric approaches in asymptomatic participants.

BACKGROUND: Photogrammetric measures are a commonly applied, highly reliable tool for appraising craniovertebral postures during clinical assessments, rehabilitation, and research interventions. OBJECTIVE: This study aimed to compare and contrast three external measures of postural alignment (EMPA) using photogrammetric and radiological approaches, and to discuss whether the craniovertebral angle (CVA) reflects the shape of the underlying cervical spine. DESIGN: Cross Sectional Correlation Study. METHOD: Young adults attended three assessment sessions (S1, S2 and S3). S1 involved a standardised photogrammetric protocol. S2 involved radiographic image acquisition. S3 followed the same protocol in S1 but excluded the self-balancing procedure. Each session's EMPA were compared through either paired or independent samples t-tests. The different radiographic cervical subtypes and their corresponding CVAs were assessed. RESULTS: There were no significant differences in any EMPA between the two photogrammetric sessions. The CVA was the only EMPA to show a significant difference between photogrammetric (S3) and radiographic approaches. Cervical subtype variability is present throughout the full CVA range. CONCLUSIONS: Despite the statistically significant difference in the CVA between approaches, the mean difference was small and unlikely to be clinically meaningful. Accordingly, the quantification of EMPA can be undertaken with high levels of precision and reliability using standardised photogrammetric procedures. The CVA, however, does not provide an indication of the shape of the underlying cervical spine. The distinct radiological differences in the inter-segmental orientation of each vertebral motion segment in conjunction with the differences in the overall global cervical alignment, both within and between participants, negate this possibility.