Context Motor planning, a prerequisite for goal-driven movement, is a complex process that occurs in the cortex. Evidence has suggested that motor planning is altered in patients with chronic ankle instability (CAI). We know balance training can improve balance, but we do not know if it also improves motor planning. Such changes in cortical activity can be assessed using electroencephalography. Objective To evaluate changes in cortical measures of motor planning after balance training in patients with CAI. Design Controlled laboratory study. Setting Research laboratory. Patients or Other Participants Fifteen patients with CAI (age = 20.80 ± 2.37 years, height = 169.47 ± 7.95 cm, mass = 70.45 ± 19.25 kg). Intervention(s) A 4-week progression-based balance-training program. Main Outcome Measure(s) Motor planning was assessed via electroencephalography before a lateral-stepping task. We calculated event-related spectral perturbations in the θ (4–8 Hz), α (8–12 Hz), β (14–25 Hz), and γ (30–50 Hz) bands. The change in power (in decibels) was calculated in each band for the 500 milliseconds before the onset of the lateral-stepping movement. Additional outcomes were the Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living and Sport subscales; the anterior-, posteromedial-, and posterolateral-reach directions of the Star Excursion Balance Test; and static balance. Patients completed 3 test sessions: baseline, 24- to 48-hour posttest, and 1-week posttest. Repeated-measures analyses of variance were used to assess changes over time. The α level was set at .05. Results The FAAM–Activities of Daily Living subscale score was improved at both posttests (P < .05), and the FAAM-Sport subscale score was improved at the 1-week posttest (P = .008). Balance was better in all 3 directions of the Star Excursion Balance Test at both posttest sessions (P < .001). After balance training, no differences were identified in cortical activity at either posttest session (P > .05). Conclusions No improvements were identified in electroencephalography measures of motor planning during lateral stepping in patients with CAI. Improved balance suggested that sensorimotor adaptations occurred, but they may not have transferred to the lateral-stepping task or they may have been mediated via other processes in patients with CAI.

These findings put an emphasis of bodyweight management, improving knee extensor and flexor strength, posterior flexibility in patellar tendinopathy patients.

Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.

Context: Rehabilitative exercises alleviate pain for patients with Patellofemoral pain (PFP); however, no research has analyzed cartilage response after a bout of those athletic activities in patients with PFP. Objective: To determine if a single session of rehabilitative exercises alters femoral cartilage morphology. Design: Crossover study Setting: Research laboratory Patients or Other Participants: Twelve participants with PFP (age=21.0±2.0years, height=1.72±0.1, mass=68.7±12.6) and 12 matched healthy participants (age=21.3±2.8, height=1.71±0.1, mass=65.9±12.2) were enrolled. Intervention(s): Participants completed treadmill running, lower extremity strengthening exercises and plyometric exercises each for 30 minutes. Main Outcome Measure(s): Patient-reported outcomes (PROs) of Visual Analog Scale (VAS), Anterior Knee Pain Scale (AKPS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Knee Injury and Osteoarthritis Outcome Score for Patellofemoral Pain and Osteoarthritis (KOOSPF) were collected. Femoral cartilage ultrasonographic images were obtained at 140° knee flexion. Ultrasound images were segmented into medial and lateral by the intercondylar notch. Medial and lateral cartilage cross sectional area (CSA; mm2) and echo intensity (EI), defined as the average grayscale from 0 to 255, were analyzed by ImageJ software. The difference between loading conditions were calculated using repeated-measures ANOVA. Spearman's correlation was calculated to find association between cartilage percent change (Δ%) and PROs. Results: Pain increased in the PFP group following all loading conditions (p<0.007). There were no statistically significant differences in cartilage CSA or EI alteration between or within groups (p>0.06). KOOS was negatively associated with Δ% of the lateral femoral cartilage EI following plyometric loading (ρ =−0.87, p=0.001), and AKPS was positively correlated to the Δ% of lateral femoral cartilage EI (ρ =0.57, p=0.05). Conclusions: Ultrasound imaging did not identify the cartilaginous deformation following all loading conditions. However, as lateral cartilaginous EI changes were associated with AKPS and KOOS, those questionnaires may be useful to monitor changes of femoral cartilage health.

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