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CONTEXT: The cervical spine can be divided into upper and lower units, each making a different contribution to the magnitude of rotation and proprioception. However, few studies have examined the effect of the cervical-rotation positions on proprioception. OBJECTIVE: To compare cervical-spine rotation active joint-position sense (AJPS) near midrange of motion (mid-ROM; 30°) and near end-ROM (60°). DESIGN: Cross-sectional study. SETTING: Human performance research laboratory. PARTICIPANTS: 53 military helicopter pilots (age 28.4 ± 6.2 y, height 175.3 ± 9.3 cm, weight 80.1 ± 11.8 kg). MAIN OUTCOME MEASURES: A motion-analysis system was used to record cervical-rotation kinematics. Subjects sat in a chair wearing a headband and blindfold. First, they actively rotated the head right or left to a target position (30°/60°), with real-time verbal cues provided by the tester. Subjects held the target position for 5 s and then returned to the start position. After this, they replicated the target position as closely as possible. Five trials were performed in both directions to both target positions (R30/R60/L30/L60). Order of direction/position was randomized. The difference between target and replicated positions was calculated and defined as absolute error (AE), and the mean of 5 trials was used for analyses. Wilcoxon signed-ranks tests were used to compare AJPS at the different target positions (P < .0125 with Bonferroni adjustments). RESULTS: End-ROM AEs were significantly more accurate than mid-ROM AEs (P = .001). CONCLUSION: Cervical-spine-rotation AJPS is more accurate near end-ROM than mid-ROM. Both target positions should be used to examine cervical-spine-rotation AJPS of both the upper and lower units.

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CONTEXT: Knee injuries commonly occur in later stages of competition, indicating that fatigue may influence dynamic knee stability. Force sense (FS) is a submodality of proprioception influenced by muscle mechanoreceptors, which, if negatively affected by fatigue, may result in less-effective neuromuscular control. OBJECTIVES: To determine the effects of peripheral fatigue on FS of the quadriceps and hamstrings. DESIGN: Quasi-experimental study design. PARTICIPANTS: 20 healthy and physically active women and men (age 23.4 ± 2.7 y, mass 69.5 ± 10.9 kg, height 169.7 ± 9.4 cm). INTERVENTIONS: Fatigue was induced during a protocol with 2 sets of 40 repetitions, and the last set was truncated at 90 repetitions or stopped if torque production dropped below 25% of peak torque. MAIN OUTCOME MEASURES: FS of the hamstrings and quadriceps was tested on separate days before and after 3 sets of isokinetic knee flexion and extension to fatigue by examining the ability to produce a target isometric torque (15% MVIC) with and without visual feedback (FS error). Electromyographic data of the tested musculature were collected to calculate and determine median frequency shift. T tests and Wilcoxon signed-rank tests were conducted to examine prefatigue and postfatigue FS error for flexion and extension. RESULTS: Despite verification of fatigue via torque-production decrement and shift in median frequency, no significant differences were observed in FS error for either knee flexion (pre 0.54 ± 2.28 N·m, post 0.47 ± 1.62 N·m) or extension (pre -0.28 ± 2.69 N·m, post -0.21 ± 1.78 N·m) prefatigue compared with the postfatigue condition. CONCLUSIONS: Although previous research has demonstrated that peripheral fatigue negatively affects threshold to detect passive motion (TTDPM), it did not affect FS as measured in this study. The peripheral-fatigue protocol may have a greater effect on the mechanoreceptors responsible for TTDPM than those responsible for FS. Further investigation into the effects of fatigue across various modes of proprioception is warranted.

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CONTEXT: Dynamic postural stability is important for injury prevention, but little is known about how lower-extremity musculoskeletal characteristics (range of motion [ROM] and strength) contribute to dynamic postural stability. Knowing which modifiable physical characteristics predict dynamic postural stability can help direct rehabilitation and injury-prevention programs. OBJECTIVE: To determine if trunk, hip, knee, and ankle flexibility and strength variables are significant predictors of dynamic postural stability during single-leg jump landings. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: 94 male soldiers (age 28.2 ± 6.2 y, height 176.5 ± 2.6 cm, weight 83.7 ± 26.0 kg). INTERVENTION: None. MAIN OUTCOME MEASURES: Ankle-dorsiflexion and plantar-flexion ROM were assessed with a goniometer. Trunk, hip, knee, and ankle strength were assessed with an isokinetic dynamometer or handheld dynamometer. The Dynamic Postural Stability Index (DPSI) was used to quantify postural stability. Simple linear and backward stepwise-regression analyses were used to identify which physical characteristic variables were significant predictors of DPSI. RESULTS: Simple linear-regression analysis revealed that individually, no variables were significant predictors of the DPSI. Stepwise backward-regression analysis revealed that ankle-dorsiflexion flexibility, ankle-inversion and -eversion strength, and knee-flexion and -extension strength were significant predictors of the DPSI (R2 = .19, P = .0016, adjusted R2 = .15). CONCLUSION: Ankle-dorsiflexion ROM, ankle-inversion and -eversion strength, and knee-flexion and -extension strength were identified as significant predictors of dynamic postural stability, explaining a small amount of the variance in the DPSI.

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UNLABELLED: The repeal of the Direct Ground Combat Assignment Rule has renewed focus on examining performance capabilities of female military personnel and their ability to occupy previously restricted military occupational specialties. Previous research has revealed female Soldiers suffer a greater proportion of musculoskeletal injuries compared to males, including a significantly higher proportion of lower extremity, knee, and overuse injuries. Potential differences may also exist in musculoskeletal, biomechanical, and physiological characteristics between male and female Soldiers requiring implementation of gender-specific training in order to mitigate injury risk and enhance performance. PURPOSE: To examine differences in musculoskeletal, biomechanical, and physiological characteristics in male and female Soldiers. METHODS: A total of 406 101st Airborne Division (Air Assault) Soldiers (348 male; 58 female) participated. Subjects underwent testing for flexibility, isokinetic and isometric strength (percent body weight), single-leg balance, lower body biomechanics during a stop jump and drop landing, body composition, anaerobic power/capacity, and aerobic capacity. Independent t tests assessed between-group comparisons. RESULTS: Women demonstrated significantly greater flexibility (P<.01-P<.001) and better balance (P≤.001) than men. Men demonstrated significantly greater strength (P≤.001), aerobic capacity (47.5±7.6 vs 40.3±5.4 ml/kg/min, P<.001), anaerobic power (13.3±2.1 vs 9.5±1.7 W/kg, P<.001), and anaerobic capacity (7.8±1.0 vs 6.1±0.8 W/kg, P<.001) and lower body fat (20.1±7.5 vs 26.7±5.7 (%BF), P<.001). Women demonstrated significantly greater hip flexion and knee valgus at initial contact during both the stop jump and drop landing tasks and greater knee flexion at initial contact during the drop landing task (P<.05-P<.001). CONCLUSIONS: Gender differences exist in biomechanical, musculoskeletal, and physiological characteristics. Sex-specific interventions may aid in improving such characteristics to optimize physical readiness and decrease the injury risk during gender-neutral training, and decreasing between-sex variability in performance characteristics may result in enhanced overall unit readiness. Identification of sex-specific differences in injury patterns and characteristics should facilitate adjustments in training in order for both sexes to meet the gender-neutral occupational demands for physically demanding military occupational specialties.

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Proximal anterior tibia shear force is a direct loading mechanism of the anterior cruciate ligament (ACL) and is a contributor to ACL strain during injury. Measurement of this force during competition may provide insight into risk factors for ACL injury. Accelerometers may be capable of measuring tibial acceleration during competition. The purpose of this study was to examine the relationship between acceleration measured by a tibia-mounted accelerometer and proximal anterior tibia shear force as measured through inverse dynamics and peak posterior ground reaction forces during two leg stop-jump tasks. Nineteen healthy male subjects performed stop-jump tasks across increasing jump distances. Correlation coefficients were calculated to determine if a relationship exists between accelerometer data and proximal anterior tibia shear force and peak posterior ground reaction force. An analysis of variance was performed to compare these variables across jump distance. Significant correlations were observed between accelerometer data and peak posterior ground reaction force, but none between accelerometer data and proximal anterior tibia shear force. All variables except peak proximal anterior tibia shear force increased significantly as jump distance increased. Overall, results of this study provide initial, positive support for the use of accelerometers as a useful tool for future injury prevention research.

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Context: Athletes who throw commonly use rubber-tubing resistance exercises in the field setting to assist with warm-up before throwing. Yet no researchers have described which muscles are being activated or which exercises are most effective during rubber-tubing exercises used by throwers for warm-up.Objective: To describe the effectiveness of 12 rubber-tubing resistance exercises commonly used by throwers in activating the shoulder muscles important for throwing.Design: Descriptive research design.Setting: An applied biomechanics research laboratory.Patients or Other Participants: Fifteen physically active male subjects with no history of shoulder injury.Main Outcome Measure(s): Subjects randomly performed 12 rubber-tubing resistance exercises while we assessed muscle activation of the subscapularis, supraspinatus, teres minor, and rhomboid major by indwelling electromyography. Activation of the sternal portion of the pectoralis major, anterior deltoid, middle deltoid, latissimus dorsi, serratus anterior, biceps brachii, triceps brachii, lower trapezius, and infraspinatus muscles was assessed by surface electromyography.Results: Performance of 7 exercises (external rotation at 90 degrees of abduction, throwing deceleration, humeral flexion, humeral extension, low scapular rows, throwing acceleration, and scapular punch) resulted in the highest level of muscle activation of all muscles tested.Conclusions: These 7 exercises exhibited moderate activation (>20% maximal voluntary isometric contraction) in each muscle of the rotator cuff, the primary humeral movers, and the scapular stabilizer muscles. The results suggest that these exercises are most effective in activating the muscles important to the throwing motion and may be beneficial for throwers during their prethrowing warm-up routine.

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OBJECTIVE: To define the nomenclature and physiologic mechanisms responsible for functional joint stability. DATA SOURCES: Information was drawn from an extensive MEDLINE search of the scientific literature conducted in the areas of proprioception, neuromuscular control, and mechanisms of functional joint stability for the years 1970 through 1999. An emphasis was placed on defining pertinent nomenclature based on the original references. DATA SYNTHESIS: Afferent proprioceptive input is conveyed to all levels of the central nervous system. They serve fundamental roles in optimal motor control and sensorimotor control over functional joint stability. CONCLUSIONS/APPLICATIONS: Sensorimotor control over the dynamic restraints is a complex process that involves components traditionally associated with motor control. Recognizing and understanding the complexities involved will facilitate the continued development and institution of management strategies based on scientific rationales.

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OBJECTIVE: To discuss the role of proprioception in motor control and in activation of the dynamic restraints for functional joint stability. DATA SOURCES: Information was drawn from an extensive MEDLINE search of the scientific literature conducted in the areas of proprioception, motor control, neuromuscular control, and mechanisms of functional joint stability for the years 1970-1999. DATA SYNTHESIS: Proprioception is conveyed to all levels of the central nervous system. It serves fundamental roles for optimal motor control and sensorimotor control over the dynamic restraints. CONCLUSIONS/APPLICATIONS: Although controversy remains over the precise contributions of specific mechanoreceptors, proprioception as a whole is an essential component to controlling activation of the dynamic restraints and motor control. Enhanced muscle stiffness, of which muscle spindles are a crucial element, is argued to be an important characteristic for dynamic joint stability. Articular mechanoreceptors are attributed instrumental influence over gamma motor neuron activation, and therefore, serve to indirectly influence muscle stiffness. In addition, articular mechanoreceptors appear to influence higher motor center control over the dynamic restraints. Further research conducted in these areas will continue to assist in providing a scientific basis to the selection and development of clinical procedures.

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OBJECTIVE: To provide an overview of currently available sensorimotor assessment techniques. DATA SOURCES: We drew information from an extensive review of the scientific literature conducted in the areas of proprioception, neuromuscular control, and motor control measurement. Literature searches were conducted using MEDLINE for the years 1965 to 1999 with the key words proprioception, somatosensory evoked potentials, nerve conduction testing, electromyography, muscle dynamometry, isometric, isokinetic, kinetic, kinematic, posture, equilibrium, balance, stiffness, neuromuscular, sensorimotor, and measurement. Additional sources were collected using the reference lists of identified articles. DATA SYNTHESIS: Sensorimotor measurement techniques are discussed with reference to the underlying physiologic mechanisms, influential factors and locations of the variable within the system, clinical research questions, limitations of the measurement technique, and directions for future research. CONCLUSIONS/RECOMMENDATIONS: The complex interactions and relationships among the individual components of the sensorimotor system make measuring and analyzing specific characteristics and functions difficult. Additionally, the specific assessment techniques used to measure a variable can influence attained results. Optimizing the application of sensorimotor research to clinical settings can, therefore, be best accomplished through the use of common nomenclature to describe underlying physiologic mechanisms and specific measurement techniques.

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OBJECTIVE: To assess the effects of sex, joint angle, and the gastrocnemius muscle on passive ankle joint complex stiffness (JCS). DESIGN AND SETTING: A repeated-measures design was employed using sex as a between-subjects factor and joint angle and inclusion of the gastrocnemius muscle as within-subject factors. All testing was conducted in a neuromuscular research laboratory. SUBJECTS: Twelve female and 12 male healthy, physically active subjects between the ages of 18 and 30 years volunteered for participation in this study. The dominant leg was used for testing. No subjects had a history of lower extremity musculoskeletal injury or circulatory or neurologic disorders. MEASUREMENTS: We determined passive ankle JCS by measuring resistance to passive dorsiflexion (5 degrees.s(-1)) from 23 degrees plantar flexion (PF) to 13 degrees dorsiflexion (DF). Angular position and torque data were collected from a dynamometer under 2 conditions designed to include or reduce the contribution of the gastrocnemius muscle. Separate fourth-order polynomial equations relating angular position and torque were constructed for each trial. Stiffness values (Nm.degree(-1)) were calculated at 10 degrees PF, neutral (NE), and 10 degrees DF using the slope of the line at each respective position. RESULTS: Significant condition-by-position and sex-by-position interactions and significant main effects for sex, position, and condition were revealed by a 3-way (sex-by-position, condition-by-position) analysis of variance. Post hoc analyses of the condition-by-position interaction revealed significantly higher stiffness values under the knee-straight condition compared with the knee-bent condition at both ankle NE and 10 degrees DF. Within each condition, stiffness values at each position were significantly higher as the ankle moved into DF. Post hoc analysis of the sex-by-position interaction revealed significantly higher stiffness values at 10 degrees DF in the male subjects. Post hoc analysis of the position main effect revealed that as the ankle moved into dorsiflexion, the stiffness at each position became significantly higher than at the previous position. CONCLUSIONS: The gastrocnemius contributes significantly to passive ankle JCS, thereby providing a scientific basis for clinicians incorporating stretching regimens into rehabilitation programs. Further research is warranted considering the cause and application of the sex-by-position interaction.