OBJECTIVE:No previously published repeatability and reliability data for The Sports Concussion Assessment Tool-6 (SCAT6) exists. We aimed to evaluate inter/intra-tester reliability of the off-field SCAT6 in a non-concussed adult population. DESIGN:Inter-rater and Intra-rater reliability study design. SETTING:Single university site. PARTICIPANTS:Twenty active adults (mean age: 27.55 ± 5.59 years) with no recent history of concussion (Concussive injury within past year). INTERVENTIONS:Participants completed 3 SCAT6 tests on the same day, with 3 testers (Inter-rater testing). The same participants returned at 2 further time points to complete the remaining 2 SCAT6 tests with 1 tester (Intra-rater testing). Participants complete a total of 5 SCAT6 assessments in total across testers and time. Rater Background: Those completing the SCAT6 testing, our study rater team, comprised of 1 senior physiotherapist and PhD candidate, and 2 MSc Physiotherapy students. All raters were from Scotland, and had significant training in completing SCAT6 assessments. MAIN OUTCOME MEASURES:Off-field SCAT6 Domain scores. ANALYSIS:ICCs were used to establish inter and intra-rater reliability for continuous, ration and ordinal data components of the SCAT6. For nominal data sets, Fleiss's kappa was calculated. Kendall's W was used for non-parametric data. Percentage error scores were calculated for SCAT6 domains. RESULTS:Inter-tester : Symptom number, severity, and dual-task scoring demonstrated excellent reliability (ICC = 0.981; 0.984; 0.913, respectively). Total concentration score was found to have good reliability (0.827). Dual-task errors (0.398), Total mBESS (0.199), and Month recall all returned poor scores (k = 0.191). Intra-tester : Dual tasking was the only domain to report excellent reliability (ICC = 0.943). Symptom number (0.868), severity (0.831), total concentration (0.787), total mBESS (0.813), and time tandem gait (0.834) yielded good reliability scores. Dual-task error testing returned poor reliability scores (Kendall's W = 0.001). All remaining domains yielded moderate reliability. Percentage error rates ranges from 3% to 100%, demonstrating the variability between scores yielded for non-concussed individuals completing the same SCAT6 domain tests. CONCLUSION:SCAT6 ICC results reported good-excellent reliability for 4 and 6 domains, out of 13 domains, for inter-tester and intra-tester reliability, respectively. Notably, the domains which relied on tester error scoring yielded poor reliability results. Percentage error highlighted the failure of the SCAT6 to provide consistent domain score results in this population.

During an unpredictable side-cut, this study examined how a sport-specific neuromuscular training program (NMTP) influenced electromyography responses in the lower limb posterior muscles, leg movement angles, maximum vertical ground reaction force (vGRF), and the rate of force development of vGRF. Thirty-eight adult female recreational hockey players were randomly allocated into an intervention group (INT) or a control group (CON). Before beginning training or matches, the INT carried out the NMTP three times per week for eight weeks, whereas the CON performed their routine warm-up. A 45° sidecut (dominant leg only) was performed at baseline and after eight-weeks and recorded with a motion capture system. The effect of group and time, and their interaction, was investigated using a mixed-design ANOVA. After landing, the participants in the INT had greater activation of their gastrocnemius lateralis, gastrocnemius medialis, and gluteus maximus muscles than those in the CON. INT participants showed significantly lower amounts of maximum knee abduction and knee excursion, while there was an increase in these variables for the CON. At week eight, the vGRF RFD decreased for the INT but increased for the CON. Although non-significant, the overall muscle activity showed an increasing trend for the INT when it came to supervised NMTP for eight weeks compared to the effect seen in the CON. This activity caused greater alterations in the motion and forces of the lower body for the INT than the CON.

The purpose of this study was to investigate players' experiences and perceptions of the menstrual cycle (MC) and the perceived impact on performance. Female elite adult (n = 31, age 24.6 ± 5.1 years) and adolescent (n = 65, age 15.0 ± 1.1 years) players completed an online questionnaire consisting of quantitative and qualitative questions. MC symptoms were experienced by 90.1% naturally menstruating participants (86.9% adolescents and 93.6% adults (x2 = 1.53, df = 2, p = 0.47, n = 92)), and 78.3% adolescents perceived their MC impacts performance, compared to 96.4% adults (x2 = 4.54, df = 1, p = 0.033, n = 74). Physical symptoms, psychological symptoms and energy levels were cited as key reasons for the MC negatively impacting performance. Challenges in communicating MC experiences were reported by 44.92% (n = 23) adolescents compared to 20.0% (n = 6) adults (x2 = 7.29, df = 2, p = 0.026, n = 82), with a perceived lack of knowledge, ability to relate and awkwardness cited as key reasons. Football players report wellbeing and performance impacts due to their MC, highlighting the need for individual understanding and support. Furthermore, understanding the experiences of adolescents enables the development of targeted support structures that equip them with tools to manage and communicate about their MC, and hopefully preventing issues as they become senior players.

Background:Concussion management in youth sport relies on the experience of adults pitch-side as to injury recognition, removal, and management decisions. Little consensus exists on the consistency of pitch-side and medical pathway management approaches. Objectives:A scoping review was completed to identify and synthesise primary research as to the management of the concussed youth athlete. Methods:A systematic search was completed in Medline, CINAHL, PubMed, SPORTDiscus, OVID emcare, Web of Science, ScienceDirect, and Cochrane Library databases and Google Scholar from inception to 1st March 2025 according to PRISMA-ScR guidelines. Primary research studies that provided outcome data on management approaches for concussed youth athletes at all stages post-injury were included. Articles were synthesised and reported in themes. Results:36 studies were included and four themes identified: Exercise, activity, and neuromuscular training interventions (n = 14), Pitch-side, sub-acute management and monitoring (n = 6), Novel treatment interventions (n = 5), and individual management in specific populations (n = 11). Conclusion:Published primary research for concussed youth athlete management approaches with outcome data supports early activity recommendations and sub-threshold exercise programmes. Few data exist for alternative management approaches. Case reports/ series saturated this review, with limited generalisable data reported on. Further transparency on concussion injury reporting and management, with outcome data, is warranted.

Evidence from "pet-friendly" workplaces highlights potential benefits associated with taking companion animals to work, including reduced stress among employees. Ornamental fishes carry a much lower risk than other companion animals and may be a suitable alternative in situations where other animals would introduce too great a risk (e.g., allergy, accidental injury). The aim of this study was to investigate whether watching an aquarium during the working day influenced employee wellbeing through the reduction of stress and improvements in stress-related outcomes. An embedded mixed-methods study was conducted, comprising two within-subjects trials (Trials A and B) and a qualitative follow-up. Participants were university employees and research students who participated during their working day. In Trial A (n = 30), the immediate effects of watching live fishes on mood, physiological stress, and cognitive performance were compared with the effects of watching a fish video or resting quietly. Although some outcomes improved from pre- to post-activity, there was no evidence that watching fishes (live or video) had greater effects than resting quietly. In Trial B (n = 27), the effects of repeatedly engaging in the same three activities over several weeks were examined. Watching fish videos was associated with improvements in "high pleasure-low arousal" and overall job-related affective wellbeing, but no further effects of condition were found. Qualitative follow-up data collected from a subset of participants from the experimental trials (n = 13) indicated that all three activities may be beneficial as leaving their desks provided detachment from work for a short period. Qualitative data suggested that live fishes were perceived as more engaging, but this did not translate to quantitative findings. Locating fish aquaria within offices (rather than a separate workplace location) may promote wellbeing by encouraging "microbreaks"; further research is needed to investigate this hypothesis.

Female soccer players report that the menstrual cycle (MC) can negatively impact sporting performance, with barriers identified in communicating their MC experiences to coaches and support staff. Whilst research is growing, there are few studies exploring the coaching staff perspective in soccer, and none from those at the youth level. The aim was to explore soccer coaches’ awareness, perceptions and experiences of the MC and the perceived impact on performance. Thirteen coaches (female n = 4; male n = 9, aged 33 ± 9 years) from Scottish elite adult and youth soccer participated in individual semi-structured interviews (average interview time 39 ± 11 min). Interviews were audio recorded and transcribed verbatim, with reflexive thematic analysis (RTA) performed. RTA generated three key themes from 232 meaning units: environment and culture, coach–athlete dynamic, and coach support and education. Coaches perceived a societal culture of the MC being hidden, or taboo, with similar barriers noted within the club environment. Coaches were often embarrassed to discuss the MC with players and believed players were embarrassed. Communication differed depending on the coach–athlete relationship, with trust and familiarity cited as improving comfort in communication. Coach awareness and understanding of the MC both generally and within a sporting context influenced their perceived ability to communicate and support players. Findings highlight the need to support coaches by providing MC education, and practical guidance on how to support players’ health and wellbeing. Improved confidence in communication should allow players to feel supported and normalise conversations about the MC.

The purpose of this study was to determine symptom severity and frequency in female exercisers and athletes from a diverse range of sports who have a menstrual cycle (MC) or use hormonal contraceptives (HCs). An additional aim was to explore the perceived impact of MC/HC use upon exercise and sport performance. In total, 604 self-identifying female athletes and exercisers (M = 29.4 years, SD = 9.0) from 85 sports/activities completed a survey which included: sport/exercise participation, bleeding characteristics, HC use, symptom severity/frequency, symptom management strategies, menstrual product use, and perceived impact of MC/HC use on exercise performance. The data were subject to mixed-methods analysis. Over one third (n = 225; 37.25%) of participants reported current HC use. Ninety-five percent (95.36%) of participants experienced symptoms related to MC or HC use. Physiological, psychological, and affective symptoms were all among the most prevalent. The most frequently noted severe and very severe symptoms for all participants, MC and HC users, were abdominal cramps (36.92%, 39.32%, and 32.89%, respectively), mood changes (26.16%, 25.07%, and 28.00%, respectively), and tiredness (25.33%, 25.59%, and 24.89%, respectively). Symptom impact was self-managed through medical and/or other (cognitive/behavioral) strategies. Qualitative content analysis of the data produced four overarching themes: (a) the impact of symptoms, (b) menstrual stigma and taboos, (c) protective factors, and (d) coping strategies. In conclusion, menstruation is a multifaceted, unique experience that impacts upon sport/exercise performance. Practitioners should consider athletes’ distinct needs, including the frequency of occurrence and severity of their symptomatic experiences, when facilitating menstruation-supportive training, avoiding a “one-size fits-all” approach.

We aimed to evaluate the influence of supervision, athlete age and sex and programme duration and adherence on exercise-based injury prevention programme effectiveness in sport. Databases were searched for randomized controlled trials evaluating exercise-based injury prevention programme effectiveness compared to "train-as-normal". A random effects meta-analysis for overall effect and pooled effects by sex and supervision and meta-regression for age, intervention duration and adherence were performed. Programmes were effective overall (risk ratio (RR) 0.71) and equally beneficial for female-only (0.73) and male-only (0.65) cohorts. Supervised programmes were effective (0.67), unlike unsupervised programmes (1.04). No significant association was identified between programme effectiveness and age or intervention duration. The inverse association between injury rate and adherence was significant (β=-0.014, p = 0.004). Supervised programmes reduce injury by 33%, but there is no evidence for the effectiveness of non-supervised programmes. Females and males benefit equally, and age (to early middle age) does not affect programme effectiveness.

Disorders affecting the neurological and musculoskeletal systems represent international health priorities. A significant impediment to progress in trials of new therapies is the absence of responsive, objective, and valid outcome measures sensitive to early disease changes. A key finding in individuals with neuromuscular and musculoskeletal disorders is the compositional changes to muscles, evinced by the expression of fatty infiltrates. Quantification of skeletal muscle composition by MRI has emerged as a sensitive marker for the severity of these disorders; however, little is known about the composition of healthy muscles across the lifespan. Knowledge of what is ‘typical’ age-related muscle composition is essential to accurately identify and evaluate what is ‘atypical’. This innovative project, known as the MuscleMap, will achieve the first important steps towards establishing a world-first, normative reference MRI dataset of skeletal muscle composition with the potential to provide valuable insights into various diseases and disorders, ultimately improving patient care and advancing research in the field.

It remains unclear whether paraspinal muscle fatty infiltration in low back pain (LBP) is i) solely intramuscular, ii) is lying outside the epimysium between the muscle and fascial plane (epimuscular) or iii) or combination of both, as imaging studies often use different segmentation protocols that are not thoroughly described. Epimuscular fat possibly disturbs force generation of paraspinal muscles, but is seldomly explored. This project aimed to 1) compare epimuscular fat in participants with and without chronic LBP, and 2) determine whether epimuscular fat is different across lumbar spinal levels and associated with BMI, age, sex and LBP status, duration or intensity. Fat and water lumbosacral MRIs of 50 chronic LBP participants and 41 healthy controls were used. The presence and extent of epimuscular fat for the paraspinal muscle group (erector spinae and multifidus) was assessed using a qualitative score (0-5 scale; 0=no epimuscular fat and 5=epimuscular fat present along the entire muscle) and quantitative manual segmentation method. Chi-squared tests evaluated associations between qualitative epimuscular fat ratings and LBP status at each lumbar level. Bivariate and partial spearman’s rho correlation assessed relationships between quantitative and qualitative epimuscular fat with participants’ characteristics. Epimuscular fat was more frequent at the L4-L5 (X2= 13.781, p=0.017) and L5-S1 level (X2= 27.825, p<0.001) in participants with LBP compared to controls, which was not found for the higher lumbar levels. The total qualitative score (combined from all levels) showed a significant positive correlation with BMI, age, sex (female) and LBP status (r=0.23-0.55; p<0.05). Similarly, the total area of epimuscular fat (quantitative measure) was significantly correlated with BMI, age and LBP status (r=0.26-0.57; p<0.05). No correlations were found between epimuscular fat and LBP duration or intensity. Paraspinal muscle epimuscular fat is more common in chronic LBP patients. The functional implications of epimuscular fat should be further explored.

IntroductionThe upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.ObjectivesThis systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.MethodsWeb of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.ResultsAge, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.ConclusionThis is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk.

Background Low back pain (LBP) is highly prevalent in athletes, with lumbar multifidus (LM) atrophy and increased LM cross-sectional area (CSA) reported in athletes with LBP. Decreased LM CSA and thickness have also been previously associated with lower limb injury (LLI) in athletes. Yet, previous research has only investigated connections between LM, LBP, and LLI in small samples of athletes in a single sport at a time. The current study aimed to (1) examine LM morphology and function across a general sample of male and female university level varsity athletes; (2) investigate whether LM characteristics were predictors of LBP and LLI. Methods Exclusion criteria included previous severe spinal trauma or spinal fracture, spinal surgery, observable spinal abnormalities, and pregnancy. Ultrasound images of LM at L5 were acquired in prone and standing. Body composition was assessed with DEXA and a self-reported questionnaire provided demographics and history of injury. Paired t-tests and independent t-tests compared LM measurements between the sides and sex, respectively. Univariate and multivariate logistic regression analyses were used to assess if LM characteristics were predictors of LBP and LLI. Results 134 university varsity athletes (mean age, 21.0 ± 1.5, 84 male) were evaluated. LM CSA was larger on the non-dominant side in both males (non-dominant, 10.54 ± 1.55, dominant, 10.34 ± 1.58, p < 0.05) and females (non-dominant, 8.26 ± 1.32, dominant, 8.11 ± 1.33, p < 0.05) in prone. Increased LM thickness was associated with decreased odds of LBP in the previous 4-week (OR = 0.49 [0.27, 0.88], p = 0.02) and 3-month (OR = 0.43 [0.21, 0.89], p = 0.02) in the multivariable model, while a greater number of years playing at the university level was associated with increased odds of LBP (OR = 1.29 [1.01, 1.65], p = 0.04). Greater LM CSA asymmetry (OR = 1.14 [1.01, 1.28], p = 0.03) and sport (OR = 1.44 [1.04, 1.96], p = 0.02) were significant predictors of LLI in the previous 12 months. Conclusion Leg dominance may play a role in unilateral differences. LM thickness and LM CSA asymmetry were predictors of injury. Preseason screening of LM morphology and function could help identify athletes at risk of LBP and LLI. This could allow coaches, medical staff, and strength and conditioning staff to target these individuals and provide specific injury prevention programs.

Objective Aquatic exercise therapy is used for the treatment and management of chronic low back pain (CLBP). However, to the authors' knowledge, no studies to date have compared muscle activity between different aquatic exercises performed by people with CLBP. As such, this study assessed and compared muscle activity, pain, perceived exertion and exercise intensity between different rehabilitative aquatic exercises. Design Cross-sectional. Setting A 25-m indoor swimming pool within a university building. Participants Twenty participants with non-specific CLBP. Assessment Twenty-six aquatic exercises in shallow water (1.25-m depth). Muscle activity was quantified bilaterally for the erector spinae, multifidus, gluteus maximus and medius, rectus abdominis, and external and internal obliques. Main outcomes Mean and peak muscle activity, pain (visual analogue scale), perceived exertion (Borg scale) and exercise intensity (heart rate). Results Hip abduction/adduction and extension/flexion exercises produced higher activity for gluteal muscles. Variations of squat exercises increased the activity of back extensors. Higher abdominal muscle activity was produced with exercises that made use of buoyancy equipment and included leg and trunk movements while floating on the back, and with some proprioceptive and dynamic lower limb exercises. Pain occurrence and intensity were very low, with 17 exercises being pain free. Conclusions This study provides evidence on trunk and gluteal muscle activity, pain, intensity and perceived exertion for people with CLBP performing aquatic exercises. The findings may be useful when prescribing exercises for rehabilitation, as physiotherapists seek to implement progression in effort and muscle activity, variation in exercise type, and may wish to target or avoid particular muscles. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy.

CONTEXT:Injury prevention programs are effective when implemented in team sports, but many recreational runners have less access to such focused interventions or peer support and often seek other sources to learn about injury reduction strategies.OBJECTIVE:This study aimed to explore runners' motivations in attending a prehabilitation (prehab) for runners workshop, establish their comprehension of prehab, and identify barriers to ongoing engagement with injury prevention.DESIGN:Qualitative study using focus groups.PARTICIPANTS AND SETTING:Twenty-two runners participating in prehab for runners workshops took part in one of 4 focus groups, each recorded, transcribed, and analyzed using Grounded Theory to create codes, subthemes, and themes.RESULTS:Four themes emerged: (1) Participation was influenced by experience of previous injury and worry of cessation of running. As the workshop ran weekly for 4 weeks, opportunity to see someone more than once who was also a physiotherapist influenced participation. (2) Runners welcomed clarification for online exercises and advice suggested for runners. They were surprised by the difficulty of single-leg neuromuscular facilitation exercises and reported benefit from most or all information especially non-exercise-based approaches such as load management, pain monitoring, and running cues. (3) Participants were empowered by a structured, holistic, and evidence-based approach that embraced autonomy for exercise self-selection and progression. Confidence to engage in open discussion was due to small group size. (4) Barriers to prehab were personal responsibility, equipment, time, lack of supervision, and peer influence.CONCLUSION:A composite approach to strategies for injury risk reduction during prehab, combining progressive exercises with educational resources, can address runners' individual needs. Early discussion of motivational tools on commencement of prehab with guidance from runners on how to incorporate prehab independently into running training is recommended. Providing these tools allows runners to self-identify the approach best suited to their personal running profile at that given time.

Objective: With rising mobility and greater recognition of the diversity of origins, cultures, and outlooks, there has been increasing interest in transnational perspectives in sport psychology scholarship and practice. Based on personal and professional experiences, however, we are concerned that there are diverse transnational-athlete perspectives that have not yet been explored in the literature which are also often restricted by traditional nation-based sporting policies, organisations, and events. As cultural awareness and understanding may enhance consultancy effectiveness and enable the construction of heretofore unrealised identities for athletes, in this paper we seek to expand upon the heterogeneity of athlete experiences relating to mobility by exploring realworld cases of transnational athletes and how their experiences fit into current sporting structures. Design: Narrative review and commentary. Results: Three identity orientations that showcase transnational diversity are identified: postnational, intranational, and non-national. Key characteristics and challenges relating to these for athletes, coaches, and practitioners are exemplified and discussed. Conclusion: To enhance rapport and inclusivity, researchers and practitioners should not only consider experiences, perceptions, and constructed identities of postnational, intranational, and non-national athletes, but also seek to understand how these interact with or are influenced by environmental and structural factors.

Female participation rates in ultra-running is considerably lower than that of males, but the reasons for this are not fully understood. In this study, online questionnaire responses were collected from ultra-runners taking part in the Scottish Jedburgh 3 Peaks ultra and Highland Fling race. One-to-one-semi-structured phone interviews were conducted with a subset of runners to further explore themes from questionnaire responses. Similar experiences among male and female ultra-runners were identified. Enablers were: wanting a challenge, nature/outdoors, and the friendliness of the ultra-community.The main barrier was training time. Qualitative responses suggested negotiation-efficacy was important for factoring in training around work and family commitments, and although a greater proportion of males had dependants compared to females, female participation was considerably lower than males.This may be due to the historical influences of traditional gender roles however this effect may be diminishing as female participation in Scottish ultra-races appears to be increasing.

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories.

PURPOSETo investigate the test-retest reliability and criterion validity of the isometric horizontal push test (IHPT), a newly designed test that selectively measures the horizontal component of maximal isometric force.METHODSTwenty-four active males with ≥3 years of resistance training experience performed 2 testing sessions of the IHPT, separated by 3 to 4 days of rest. In each session, subjects performed 3 maximal trials of the IHPT with 3 minutes of rest between them. The peak force outputs were collected simultaneously using a strain gauge and the criterion equipment consisting of a floor-embedded force plate.RESULTSThe test-retest reliability of peak force values was nearly perfect (intraclass correlation coefficient = ∼.99). Bland-Altman analysis showed excellent agreement between days with nearly no bias for strain gauge 1.2 N (95% confidence interval [CI], -3 to 6 N) and force plate 0.8 N (95% CI, -4 to 6 N). A nearly perfect correlation was observed between the strain gauge and force plate (r = .98, P < .001), with a small bias of 8 N (95% CI, 1.2 to 15 N) in favor of the force plate. The sensitivity of the IHPT was also good, with smallest worthwhile change greater than standard error of measurement for both the strain gauge (smallest worthwhile change: 29 N; standard error of measurement: 17 N; 95% CI, 14 to 20 N) and the force plate (smallest worthwhile change: 29 N; standard error of measurement: 18 N; 95% CI, 14 to 19 N) devices.CONCLUSIONSThe high degree of validity, reliability, and sensitivity of the IHPT, coupled with its affordability, portability, ease of use, and time efficacy, point to the potential of the test for assessment and monitoring purposes.

OBJECTIVES:To identify which pre-and post-run injury risk reduction activities and prehabilitation (prehab) strategies Coaches and Running Group Leaders (Coaches/RGLs) engage in with runners; to explore their beliefs on why runners get injured; to identify Coaches/RGLs confidence providing injury prevention activities, and what they believe are effective for reducing risk of injury; to identify their perceived barriers to including prehab during running coaching/training. DESIGN:Survey; Participants: UK Coaches/RGLs (N = 100) OUTCOME MEASURES: Online questionnaire with open, closed and Likert scale questions. RESULTS:Most Coaches/RGLs performed active warm-ups (97%), cool-downs (94%),gave injury prevention advice (91%), and advice on recovery strategies (84%) during training. Fewer coaches/RGLs incorporated prehab (67%). Although they collectively exhibited a wide range of knowledge, individually there was less consistency and confidence providing this. Prehab was rated as very important for injury risk reduction, with supervision recommended to facilitate runner engagement. Coaches/RGLs found conflicting advice, time, environment, and resistance from runners as barriers to incorporating prehab into training. CONCLUSION:Coaches/RGLs believe prehab is important for runners however lack of confidence and knowledge appeared to limit the wider inclusion of prehab with runners. Coaches/RGLs welcomed reputable information on prehab from evidence-based sources. This may assist in reducing injury.

Due to conflicting data from previous studies a new methodological approach to evaluate heel pad stiffness and soft tissue deformation has been developed. The purpose of this study was to compare heel pad (HP) stiffness in both limbs between males and females during a dynamic unloading and loading activity. Ten males and 10 females volunteered to perform three dynamic trials to unload and load the HP. The dynamic protocol consisted of three continuous phases: foot flat (baseline phase), bilateral heel raise (unloading phase) and foot flat (loading phase) with each phase lasting two seconds. Six retroreflective markers (3 mm) were attached to the skin of the left and right heels using a customised marker set. Three-dimensional motion analysis cameras synchronised with force plates collected the kinematic and kinetic data throughout the trials. Three-way repeated measures ANOVA together with a Bonferroni post hoc test were applied to the stiffness and marker displacement datasets. On average, HP stiffness was higher in males than females during the loading and unloading phases. ANOVA results revealed no significant differences for the stiffness and displacement outputs with respect to sex, sidedness or phase interactions (p > .05) in the X, Y and Z directions. Irrespective of direction, there were significant differences in stiffness between the baseline and unloading conditions (p < .001) but no significant differences between the baseline and loaded conditions (p = 1.000). Post hoc analyses for the marker displacement showed significant differences between phases for the X and Z directions (p < .032) but no significant differences in the Y direction (p > .116). Finally, females portrayed lower levels of mean HP stiffness whereas males had stiffer heels particularly in the vertical direction (Z) when the HP was both unloaded and loaded. High HP stiffness values and very small marker displacements could be valuable indicators for the risk of pathological foot conditions.