Fundamental movement competency is essential for participation in physical activity and for mitigating the risk of injury, which are both key elements of health throughout life. The squat movement pattern is arguably one of the most primal and critical fundamental movements necessary to improve sport performance, to reduce injury risk and to support lifelong physical activity. Based on current evidence, this first (1 of 2) report deconstructs the technical performance of the back squat as a foundation training exercise and presents a novel dynamic screening tool that incorporates identification techniques for functional deficits that limit squat performance and injury resilience. The follow-up report will outline targeted corrective methodology for each of the functional deficits presented in the assessment tool.

THE SECOND PART OF THIS REVIEW PROVIDES A FLEXIBLE APPROACH TO INTEGRATIVE NEUROMUSCULAR TRAINING (INT) WITH THE GOALS TO IMPROVE INJURY RESILIENCE AND TO ENHANCE SPORT AND MOTOR PERFORMANCE ABILITIES IN YOUTH POPULATIONS. THE PROPOSED MODEL OF INT IN THIS MANUSCRIPT PRESENTS 6 ESSENTIAL COMPONENTS: DYNAMIC STABILITY (LOWER LIMB AND CORE), STRENGTH, PLYOMETRICS, COORDINATION, SPEED AND AGILITY, AND FATIGUE RESISTANCE. THE DEVELOPMENT OF THESE 6 CAPACITIES ARE INTEGRAL IN ESTABLISHING AN IMPORTANT FOUNDATION BY INITIALLY DEVELOPING FUNDAMENTAL MOVEMENT SKILL COMPETENCY BEFORE BUILDING UPON THESE SKILLS TO ENRICH SPORTS-SPECIFIC AND ACTIVITY-SPECIFIC SKILL SETS. FOR A VIDEO ABSTRACT OF THIS ARTICLE, SEE SUPPLEMENTAL DIGITAL CONTENT 1 (SEE VIDEO, http://links.lww.com/SCJ/A190).

Study Design Retrospective epidemiologic investigation. Objective To investigate the relationship between altitude and concussion rate in the National Football League (NFL). Because of the physiologic responses that occur during acclimatization to altitude, it was hypothesized that games played on fields at a higher altitude would have reduced concussion rates compared to games played on fields at a lower altitude. Background Recent research indicates that the elevation above sea level at which football games are played may be associated with the likelihood of a concussion in high school football athletes. Methods Data on incident concussions and athlete exposures for the first 16 weeks of the NFL 2012 and 2013 regular seasons were obtained from publicly available web-based sources and used to calculate competition concussion rates for each NFL stadium. Concussion rates were analyzed in relation to game elevation. Results During the first 16 weeks of the 2012 and 2013 NFL regular seasons, 300 concussions, involving 284 players, were reported (64.3 primary cases per 10 000 game exposures). The odds of a concussion were 30% lower when playing at a higher elevation (equal to or greater than 644 ft [196.3 m] above sea level) compared to a lower elevation (odds ratio = 0.70; 95% confidence interval: 0.53, 0.94). A multivariable generalized linear model controlling for season, week, and clustering of team at home and away confirmed these results, showing that the odds of at least 1 concussion were reduced by 32% in games played at higher elevation. Conclusion The results of this epidemiological investigation indicate that increased altitude was associated with a reduction in the odds of a sport-related concussion in NFL athletes. The reported relationship of concussion incidence and field elevation should be further investigated, and, if verified, further work will be needed to understand why that relationship exists. Level of Evidence Prognosis, level 2c. J Orthop Sports Phys Ther 2014;44(3):164–172. Epub 28 January 2014. doi:10.2519/jospt.2014.5298

Based on the fundamental principles of pediatric exercise science and developmental physiology, childhood provides a critical window to develop the physical readiness of youth through age-related training programs that are designed purposely to teach and reinforce fundamental movement skills to enhance preparedness for physical activity and sport. Successful implementation of developmental programs requires age-related instruction by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents. An understanding of the interaction of physical and cognitive development is needed to design and implement training strategies that optimize training outcomes. Regular training with structured and integrative modalities throughout the developmental years as part of physical education, recreation, and sports practice can improve athletic performance while reducing common sports-related injuries and can facilitate the adoption of healthy lifestyles throughout adulthood. In this commentary, we outline cognitive developmental considerations in youth that may influence the design and implementation of training programs aimed at optimizing motor skill development in youth.