Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues.

BACKGROUND: While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players. AIMS: To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population. METHODS: Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). RESULTS: One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy. CONCLUSION: It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.

The Interval Between Matches Significantly Influences Injury Risk in Field Hockey.

Fixture congestion increases injury risk in football, but how it impacts other sports is unclear. The aim of this study was to identify associations between match density and injury incidence in field hockey players. Injury data from a prospective cohort study of professional and youth players was analysed in two ways. Inter-match intervals were clustered into<2424-hours, 3-7-days, and 13 + days, and injury rate ratios (IRR) were calculated to identify differences between clusters in match injuries. Separately, a Lasso-penalised Poisson regression model was used to determine the association between match load across the previous 24-hours, 3-days, 7-days and 14-days, and match and training injuries. Injury rates in matches within 24-hours of the previous match were mostly significantly higher when compared to matches after 3-7-days (IRRs: 3.78; 6.77, P = 0.003; 0.005). While a higher match exposure in the preceding 24-hour and 3-day periods was associated with higher combined match and training injury rates (ß̂ = 0.0001; 0.0018), a higher match exposure in the previous 7-and 14-day periods was associated with a reduced injury rate (ß̂ = -0.0001; -0.0005). Due to the increased injury risk in matches 3-days and especially 24-hours following the previous fixture, match distribution should be cautiously planned.

Tracking sleep in the field: sleep quality and sleep behaviours of elite track and field athletes during preparation and competition.

Elite athletes are susceptible to inadequate sleep, which may peak during competition and be exacerbated by poor sleep behaviours. This study sought to characterise and compare the sleep quality and sleep behaviours of elite track and field athletes during preparation and major competitions. Forty elite international track and field athletes (50% female, aged 25.1 ± 3.9 years) completed the Athlete Sleep Screening Questionnaire and the Athlete Sleep Behaviour Questionnaire on three separate occasions: during habitual training, during a pre-meet training camp and during a major international competition. Overall, 62.5% of athletes reported at least mild sleep difficulty during competition. Athletes reported higher sleep difficulty and poorer sleep behaviour during major competitions and the pre-meet training camp compared to habitual training (P = .001-.025). No significant differences were observed between the training camp and major competition. Global sleep behaviour scores were underpinned by unique characteristics at each timepoint. Sleep behaviour (R2 = .330, P = .017), injury status (R2 = .253, P = .003) and major championship experience (R2 = .113, P = .034) were associated with sleep difficulty during competition. Sleep quality and behaviours vary according to stage of the track and field season, providing a foundation for targeted intervention.

Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents.

Self-motion perception used for locomotion and navigation requires the integration of visual, vestibular, and proprioceptive input. In the absence of vision, postural stability and locomotor tasks become more difficult. Previous research has suggested that in visually deprived children, postural stability and levels of physical activity are overall lower than in sighted controls. Here we hypothesized that visually impaired and blind children and adolescents differ from sighted controls in postural stability and gait parameters, and that physically active individuals outperform sedentary peers in postural stability and gait parameters as well as in navigation performance. Fourteen blind and visually impaired children and adolescents (8-18 years of age) and 14 matched sighted individuals took part. Assessments included postural sway, single-leg stance time, parameters of gait variability and stability, self-reported physical activity, and navigation performance. Postural sway was larger and single-leg stance time was lower in blind and visually impaired participants than in blindfolded sighted individuals. Physical activity was higher in the sighted group. No differences between the group of blind and visually impaired and blindfolded sighted participants were observed for gait parameters and navigation performance. Higher levels of physical activity were related to lower postural sway, longer single-leg stance time, higher gait stability, and superior navigation performance in blind and visually impaired participants. The present data suggest that physical activity may enhance postural stability and gait parameters, and thereby promote navigation performance in blind and visually impaired children and adolescents.

Epidemiology of injuries during the Wheelchair Basketball World Championships 2018: A prospective cohort study.

Several international sports federations have implemented a standardized injury reporting system during their championships. However, very few studies have investigated athletes with disabilities during major championships apart from the Paralympic Games. Therefore, the aim of this study was to assess the rate and characteristics of injuries during the Wheelchair Basketball World Championships 2018 (WBWC). This prospective cohort study was conducted during the WBWC held in Hamburg, Germany, from August 16 to August 26, 2018. Physicians or physiotherapists of all 28 participating teams (total 336 players) were asked to report all newly incurred injuries (with location, diagnosis, cause, and estimated duration of absence) daily on a standardized injury report form. Prevalence and incidence rates were calculated. Medical staff of 11 teams (132 players) reported 100 injuries, equivalent to 75.8 per 100 players (95% CI: 60.9-90.7) or 68.9 per 1000 player-days (55.4-82.4). Eight time-loss injuries were reported (6.1 injuries per 100 players [95% CI: 1.9-10.3] or 5.5 injuries per 1000 player-days [1.7-9.3]). More injuries were incurred during matches (n = 68) than during training. Most injuries affected the neck/cervical spine (16%), thoracic spine/upper back (15%), and shoulder (14%). The most frequent diagnosis was muscle spasms (25%), the most frequent cause was overuse (52%). A high rate of non-time-loss injuries compared to Paralympic Games was reported. Future studies should focus on the etiology of muscle spasms and further identify injury mechanisms of traumatic and overuse injuries in wheelchair basketball players to develop adequate preventive measures.

Walking barefoot vs. with minimalist footwear - influence on gait in younger and older adults.

BACKGROUND: In recent years, minimalist footwear has been increasingly promoted for its use in sportive and recreational activities. These shoes are considered to function naturally like barefoot walking while providing a protective surface. Despite a growing popularity of these shoes in the older population, little is known about the influence of minimalist footwear on gait patterns. This study investigated whether overground walking with minimalist shoes is comparable to barefoot walking regarding gait stability and variability parameters. METHODS: In a randomized within-subject study design, 31 healthy younger (29 ± 4 years) and 33 healthy community-dwelling older adults (71 ± 4 years) volunteered. Participants walked on flat ground, once barefoot and once with minimalist shoes. Gait variability of minimum toe clearance (MTC), stride length, stride time, and local dynamic gait stability were analysed. RESULTS: The results for both age groups showed significant condition effects (minimalist shoes vs. barefoot walking) for the outcomes of local dynamic stability (p = .013), MTC variability (p = .018), and stride length variability (p < .001) indicating increased local dynamic stability and decreased gait variability during the minimalist shoe condition. Group effects (young vs. older adults) were detected in all gait outcomes. CONCLUSION: Walking with minimalist shoes appeared to be associated with better gait performance than walking barefoot in both age groups. Thus, walking with minimalist shoes is not similar to barefoot walking. With respect to reducing the risk of falling, we suggest that minimalist shoes could be an alternative to barefoot walking or a transition option between shoes to barefoot for older adults.

Comparison of 10 vs. 20 min neuromuscular training for the prevention of lower extremity injuries in male youth football: A cluster randomised controlled trial.

The aim of this study was to compare the effects of 20 min neuromuscular training with a programme of 10 min in youth football players. 342 (15.4 ± 1.7 years) male football players from 18 teams were included, and cluster-randomized by team into two intervention groups. Both groups performed an injury prevention programme twice a week over five months using the same exercises but a different duration. The first intervention group (INT10, n = 175) performed the programme for 10 min, the second intervention group (INT20, n = 167) for 20 min. Primary outcomes were lower extremity (LE) injuries. Secondary outcomes were injury type, severity, mechanism and compliance to the intervention. 13 teams with 185 players were included for final analysis. No significant group difference was found between INT10 (6.37 per 1000 h) and INT20 (7.20 per 1000 h) for the incidence rate ratio of the lower extremities (IRR = 1.03, 95% confidence interval 0.59, 1.79), nor for the distribution of injury location, type, severity or mechanism. The results show that performing preventive exercises for 10 min is no less effective than 20 min in youth football players. Shorter training sessions can, therefore, be effectively used for injury prevention. TRIAL REGISTRATION: DRKS00015282.

Is an Elastic Ankle Support Effective in Improving Jump Landing Performance, and Static and Dynamic Balance in Young Adults With and Without Chronic Ankle Instability?

CONTEXT: In some patients, ankle sprains lead to chronic symptoms like pain or muscular weakness called chronic ankle instability (CAI). External ankle supports have shown to be effective in preventing sprains and reducing recurrence, but the underlying mechanisms are unclear. As sensorimotor variables are associated with injury incidence, an influence of external ankle support on landing performance and balance seems plausible. OBJECTIVE: To analyze the effects of an elastic ankle support on jump landing performance and static and dynamic balance in patients with CAI and healthy controls. DESIGN: Crossover study. SETTING: Functional tests in a laboratory setting. PATIENTS OR OTHER PARTICIPANTS: Twenty healthy students and 20 patients with CAI were included for study participation based on their scores in ankle stability and function questionnaires. INTERVENTION: Healthy and CAI participants performed each test with and without an elastic ankle support. MAIN OUTCOME MEASURES: (1) Jump landing performance was measured with the Landing Error Scoring System, (2) static balance was assessed with the Balance Error Scoring System, and (3) dynamic balance was assessed using the Y Balance Test. Linear mixed models were used to analyze the effects of the elastic ankle support on sensorimotor parameters. RESULTS: Healthy controls performed significantly better in the Landing Error Scoring System (P = .01) and Y Balance Test anterior direction (P = .01). No significant effects of elastic ankle support on Landing Error Scoring System, Balance Error Scoring System, or Y Balance Test performance were observed in the CAI or control group. There were no significant group-by-ankle support interactions. CONCLUSIONS: In the current study, the acute use of elastic ankle support was ineffective for enhancing jump landing performance, and static and dynamic balance. Further research is needed to identify the underlying mechanisms of the preventive effects of elastic ankle support.

Less noise during dual-task walking in healthy young adults: an analysis of different gait variability components.

Dual-task costs of gait (variability) parameters are frequently used to probe the grade of automaticity of walking. However, recent studies reported contradicting dual-task costs for different gait variability measures within the same cohorts. The effects of a dual-task on the gait pattern are, thus, not fully understood. The aim of the current study was to analyze the different gait variability components ('Tolerance', 'Noise', and 'Covariation') during dual-task walking compared to single-task walking. In an experimental study, 21 young and healthy adults (11 males, 10 females, age: 24 ± 3 years) were included. The participants completed three experimental conditions: (a) single-task walking, (b) dual-task walking (serial-seven subtractions), and (c) cognitive single task in sitting position. To analyze different gait variability components, we applied a method which distinguishes the three components: 'Tolerance', 'Noise', and 'Covariation' (TNC). To test for differences, we used the statistical parametric mapping method. Compared to single-task walking, the results depict lower gait variability of the result parameters during the dual-task condition at 0-15% (p = 0.010) and 94-100% (p = 0.040) of the stance phase and 0-63% (p < 0.001) during the swing phase. The decreased result parameter variability was due to less (sensorimotor) 'Noise' (stance: 2-100%, p < 0.001; swing: 2-59%, p < 0.001) during the dual-task walking condition. In further studies, the sources of the reduced unstructured (sensorimotor) noise in the dual-task condition should be analyzed to better understand the effect of a cognitive dual task on the gait pattern.

Kinesio Taping Improves Perceptions of Pain and Function of Patients With Knee Osteoarthritis: A Randomized, Controlled Trial.

Context: Although increasingly used for therapeutic treatment, only limited evidence exists regarding the effects of kinesio taping on patients with knee osteoarthritis (OA). Objective: To determine the effects of kinesio taping on pain, function, gait, and neuromuscular control concerning patients with knee OA. Design: Randomized sham-controlled trial. Setting: University laboratory. Participants: A total of 141 patients (65.1 [7.0] y) with a clinical and radiographic diagnosis of knee OA. Intervention: Kinesio tape, sham tape, or no tape for 3 consecutive days. Main Outcome Measures: Self-reported pain, stiffness, and function were measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Further tests included the Balance Error Scoring System, 10-m walk test, the maximum voluntary isometric contraction force of the quadriceps femoris, and knee active range of motion. Results: At baseline, there were no differences in all outcomes between groups except for knee flexion. Significant effects were found for WOMAC pain (tape vs sham, P = .05; tape vs control, P = .047), stiffness (tape vs sham, P = .01; tape vs control, P ≤ .001), and physical function (tape vs sham, P = .03; tape vs control P = .004). No interactions were found for balance, muscle strength, walking speed, or active range of motion. Conclusion: Wearing kinesio tape for 3 consecutive days had beneficial effects regarding self-reported clinical outcomes of pain, joint stiffness, and function. This emphasizes that kinesio taping might be an adequate conservative treatment for the symptoms of knee OA.

Exercise-induced neuroplasticity: Balance training increases cortical thickness in visual and vestibular cortical regions.

Physical exercise has been shown to induce structural plasticity in the human brain and to enhance cognitive functions. While previous studies focused on aerobic exercise, suggesting a link between increased cardiorespiratory fitness and exercise-induced neuroplasticity, recent findings have suggested that whole-body exercise with minor metabolic demands elicits beneficial effects on brain structure as well. In the present study, we tested if balance training, challenging the sensory-motor system and vestibular self-motion perception, induces structural plasticity. Thirty-seven healthy adults aged 19-65 years were randomly assigned to either a balance training or a relaxation training group. All participants exercised twice a week for 12 weeks. Assessments before and after the training included a balance test and the acquisition of high-resolution T1-weighted images to analyze morphological brain changes. Only the balance group significantly improved balance performance after training. Cortical thickness was increased in the superior temporal cortex, in visual association cortices, in the posterior cingulate cortex, in the superior frontal sulcus, and in the precentral gyri in the balance group, compared to the relaxation group. Moreover, there was evidence that the balance training resulted in decreased putamen volume. Improved balance performance correlated with the increase of precentral cortical thickness and the decrease in putamen volume. The results suggest that balance training elicits neuroplasticity in brain regions associated with visual and vestibular self-motion perception. As these regions are known for their role in spatial orienting and memory, stimulating visual-vestibular pathways during self-motion might mediate beneficial effects of physical exercise on cognition.

Spinal posture changes using dynamic rasterstereography during the modified Matthiass test discriminate between postural weak and strong healthy children (10-14 years): a pilot study.

The aim of this pilot study was to investigate whether the clinical Matthiass test can be objectified by means of dynamic rasterstereography in children. We aimed at discriminating between postural weak and strong children. Dynamic rasterstereography was used to capture sagittal spinal posture changes during the modified Matthiass test (mMT). Primary outcomes were spinal posture changes (trunk inclination, kyphotic and lordotic angles) during the test. Two-step cluster analysis was run jointly on the three primary outcomes. Data of 101 healthy children (10-14 years, 46% girls) were assessed. Cluster analysis identified two groups of participants with significantly different postural performance levels during the mMT (low vs. high performers). Low performers showed a higher increase in backward lean, as well as kyphosis and lordosis (4°-5°, respectively) when compared to high performers. The two performance groups were age-, BMI-, and activity-matched.Conclusion: This pilot study established preliminary normative data on spinal posture changes during the Matthiass test (high performers) and provided corresponding cutoff values for postural weakness (low performers). These results could provide a basis for future longitudinal and interventional studies targeting long-term consequences of childhood postural weakness and the prevention of back pain. What is Known: • The prevalence of postural insufficiencies in children is high. • No consensus exists about the postural assessment in children. • A common clinical test to identify postural insufficiency is the Matthiass test yet criticized for its subjective assessment. What is New: • This pilot study objectified the modified Matthiass test by rasterstereography and statistically identified two groups of healthy children with different postural performance levels. • It established preliminary normative data on spinal posture changes and provided corresponding cutoff values for postural weakness.

Effects of barefoot and footwear conditions on learning of a dynamic balance task: a randomized controlled study.

PURPOSE: Although barefoot balancing has shown to be more challenging compared to shod balancing, it is still unclear whether this may also influence the balance learning effects. The purpose of this study was to explore the impact of barefoot and shod exercising on learning of a dynamic balance task. METHODS: Sixty healthy and physically active adults (mean age 25.3 ± 3.4 years) were randomly allocated into one of three groups (barefoot, shod and controls). The barefoot and shod intervention groups exercised once weekly over 7 weeks on a stability platform with an unstable surface. Each training session included 15 trials over 30 s. Before and after the intervention period, all participants completed two balance tests (stability platform and Balance Error Scoring System = BESS) under barefoot and shod conditions. Group effects in stability gains (pre to post-test differences) were analysed using ANOVA. Development of balance learning curves during the intervention period was analysed using a mixed effects model. RESULTS: Balance times improved in both intervention groups (p < 0.001, 95% CI barefoot 5.82-9.22 s, shod 7.51-10.92 s) compared to controls. The barefoot intervention group showed a significantly less sloped balance learning curve compared to the shod intervention group (p = 0.033). No changes over time or differences between groups were found for the BESS test. CONCLUSIONS: Improvements in the dynamic balance task did not differ between individuals exercising barefoot or with footwear although the progression was slower in the barefoot group. The lack of changes in the BESS supports the task-specificity of balance learning effects.

Epidemiology of injuries in outdoor and indoor hockey players over one season: a prospective cohort study.

OBJECTIVES: To determine the incidence and characteristics of hockey ('field hockey') injuries over the course of one outdoor and indoor season. Comparisons of female versus male players, outdoor versus indoor season and match versus practice were performed. METHODS: Female and male teams of the first, second, third, regional and youth divisions were recruited among a local hockey association in Northern Germany, and followed over an indoor and an outdoor season. Exposure times and location, type, severity and cause of injuries during practice and matches were documented by the coaches or medical staff and collected weekly. Prevalence and incidence rates were calculated. RESULTS: Of the 232 players (mean±SD age 20.7±4.7 years, 68.1% male, 31.9% first division), 84 players (36.2%) suffered 108 new injuries during the season. The overall incidence rate was 3.7 injuries per 1000 player hours (95% CI 3.0 to 4.4). The injury incidence was lower in practice (2.7 per 1000 player practice hours, 95% CI 2.0 to 3.3) than in matches (9.7 per 1000 player match hours, 95% CI 6.8 to 12.7), and was similar for female and male players as well as during the outdoor and the indoor season. Most injuries affected the lower limb (thigh, knee and ankle) and occurred without contact (58.3%). Severe injuries (n=34; 31.5%) were predominantly located at the knee and hand/finger. CONCLUSION: Hockey players have a high prevalence and incidence of injuries, especially at the lower limb.

Foot Strike Patterns Differ Between Children and Adolescents Growing up Barefoot vs. Shod.

Effects of early and permanent footwear use are not well understood. The aim of this study was to investigate the effects of habituation to footwear on foot strike patterns of children and adolescents. Healthy habitually barefoot and shod participants (aged 6-18 years) from South Africa (n=288) and Germany (n=390) performed multiple 20-m jogging and running trials with and without shoes. Each foot strike was captured using a high-speed camera to determine a rearfoot or non-rearfoot strike. The probability of a rearfoot strike in both cohorts and each age was analyzed by using a mixed-effects logistic regression adjusted for possible confounders. Habitually barefoot children showed a higher probability of using rearfoot strikes than habitually shod children (p<0.001). The probability was age-dependent and decreased in habitually barefoot children with age (ORbarefoot-jogging=0.82, 95% CI, 0.71 to 0.96, p=0.014; ORbarefoot-running=0.58, 95% CI, 0.50 to 0.67, p<0.001 and ORshod-running=0.68, 95% CI, 0.59 to 0.79, p<0.001). In habitually shod children, the probability increased significantly for shod jogging (OR=1.19, 95% CI, 1.05 to 1.35, p=0.006). To conclude, foot strike patterns of children are influenced by habituation to footwear. Younger habitually barefoot children show higher rates of rearfoot strikes for shod and barefoot running, and it converges in later adolescence.

Spinal postural changes during the modified Matthiass test in healthy children : Interday and interrater reliability of dynamic rasterstereographic measurements.

OBJECTIVE: The Matthiass test serves to identify postural insufficiencies by evaluating the sagittal posture but this subjective assessment may be responsible for different reports on the prevalence of postural insufficiencies in children. Previously, rasterstereography was used to objectify this clinical test. Until now, the coupling of the Matthiass test with rasterstereography has not yet been applied to children and the reliability is unknown; therefore, the objective of our study was to provide interday and interrater reliability of rasterstereographic measurements during dynamic (modified Matthiass test) and static trials (only interday) in healthy children. METHODS: Trunk inclination, kyphotic, and lordotic angles were measured using rasterstereography during static and dynamic trials (modified Matthiass test: 90° shoulder flexion, hand-held load, 5% of body weight). Intraclass correlation coefficients (ICC) were calculated using a two-way mixed model (absolute agreement, average measure). RESULTS: In this study 21 healthy children were assessed (age range 10-12 years). Dynamic rasterstereographic measurements showed fair to good interday and interrater reliability (ICC 0.46-0.70) and static measurements good to excellent interday reliability (ICC 0.63-0.91). CONCLUSION: Dynamic rasterstereography during the modified Matthiass test furnishes reliable data serving to objectify spinal changes of healthy children and detect postural insufficiencies. Additional efforts are needed to investigate how the early detection of postural insufficiencies can help to prevent back pain in children, adolescents and adults.

Feasibility study of dual-task-managing training to improve gait performance of older adults.

INTRODUCTION: Dual task (DT) training is becoming prominent in fall prevention. However, DT training should include task-managing strategies like task switching or task prioritization to be beneficial to improve gait performance under DT conditions. The aim of this pilot study was to evaluate the effect of a task managing training on gait stability. METHODS: A DT training (12 sessions; 60 min each; 12 weeks) was compared to a non-training control group within a RCT (38 independent living participants; 72.7 ± 4.7 years). Single Task (ST) and DT walking (visual verbal Stroop task) were measured on a treadmill (FDM-T, 3.5 km/h, 100 HZ). Gait parameters like step length, step width, gait line, maximum forces and gait variability were compared. RESULTS: The training group improved their gait performance under ST and DT conditions as revealed by significant group × time interaction effects. DISCUSSION AND CONCLUSIONS: The training successfully improved gait performance and therefore might be a promising approach to prevent falls. Additional fall prevention studies should focus on motor-cognitive performance and reinforce outcomes of task managing strategies.

Agreements and disagreements in exercise therapy prescriptions after hip replacement among rehabilitation professionals: a multicenter survey.

BACKGROUND: Exercise therapy following total hip replacement (THR) is considered to be important during the initial postoperative care, but till date only a few evidence-based recommendations exist. The aim of this survey was to identify prescription standards among different rehabilitation professionals, for the exercise therapy management after THR in Germany. METHODS: The study was a cross-sectional survey. Standardized questionnaires were sent to 38 eligible rehabilitation facilities in Germany. Participating surgeons, orthopaedic physicians, physiotherapists and exercise therapists rated the optimal early weight-bearing, resistance training, key components and dose of exercise therapy, and the hip loading during exercising. The returned questionnaires were then analyzed for level of agreement (≥80%) among respondents. RESULTS: 313 rehabilitation professionals from 28 clinics returned completed questionnaires and were considered eligible for analysis. Out of total respondents, 53.9% (cemented THR) and 18.2% (uncemented THR) recommended full weight-bearing within five days after surgery. Commencement of resistance training later than three weeks after surgery is recommended by 20.6% (36%) for cemented (uncemented) prosthesis. Feedback varied significantly amongst the professions. Regarding the overall objectives of rehabilitation after hip replacement, respondents agree in six out of eight requested items. Agreement concerning priorities of specific exercises was achieved in three out of twelve items. The recommended exercise therapy dose varied significantly with working experience (p = 0.02). CONCLUSION: Rehabilitation professionals mainly disagreed with the exercise therapy prescriptions following the total hip replacement during the initial postoperative care in Germany.

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

PURPOSE: Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. METHODS: Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. RESULTS: No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. CONCLUSIONS: Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

Can the recent sex-specific evolutions in elite running performances be attributed to advanced footwear technology?

Recent improvements in elite running performances across all distances have been largely attributed to the introduction of advanced footwear technology (AFT), which features a curved and stiff plate working synergistically with a new generation of midsole foams demonstrating enhanced resilience and compliance. These recent improvements appear to be considerably more pronounced in women's events, highlighted by improvements in road racing world records by an average of 3.7% (range: 2.6%-5.2%) compared to mean progressions of 1.5% (range: 1.3%-1.9%) in the same men's events. Although there is a growing body of research investigating the mechanisms underpinning running performance enhancements derived from AFT, there remains no explanation for potential sex-based differences in their benefits. We overview the currently available evidence and highlight why the recent direction of AFT research provides a barrier to progress by focusing primarily on male athletes. We subsequently provide our perspective on why women may be benefiting from the new generation of shoes more than men, suggest potential mechanisms leading to hypotheses that need to be further investigated in upcoming studies, and finally propose that factors outside of footwear innovation may have concurrently driven the recently observed performance evolutions.