Background: Region-specific patient-reported outcomes (PROs) are commonly used in rehabilitation medicine. Digital versions of PROs may be implemented into electronic medical records and are also commonly used in research, but the validity of this method of administration (MOA) must be established. Purpose: To determine the agreement between and compare the test–retest reliability of a paper version (FAAM-P) and digital version (FAAM-D) of the Foot and Ankle Ability Measure (FAAM). Study Design: Randomized, nonblinded, crossover observational study. Methods: A total of 90 adults were randomized to complete the FAAM-P or FAAM-D first, and then completed the second MOA (first day [D1]). The FAAM-D was a digital adaptation of both FAAM-P subscales on Qualtrics. Identical test procedures were completed 1 week later (D2). Data were removed if a participant scored 100% on both MOA, reported injury between D1 and D2, or did not complete both MOA. Agreement was assessed on 46 participants between the 2 MOA using intraclass correlation coefficients (ICC) at D1. There was good-to-excellent test–retest reliability for the FAAM activities of daily living. Results: The authors observed good agreement between the FAAM-P and FAAM-D for the activities of daily living (ICC = .88) and sport scales (ICC = .87). Test–retest reliability was good-to-excellent for the FAAM activities of daily living (FAAM-P: ICC = .87; FAAM-D: ICC = .89) and sport (FAAM-P: ICC = .71; FAAM-D: ICC = .91). Conclusions: The MOA does not appear to affect the responses on the FAAM; however, the authors observed slightly higher reliability on the FAAM-D. The FAAM-D is sufficient to be used for generating practice-based evidence in rehabilitation medicine.

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Objective To conduct a systematic review of existing literature of cross-education balance effects after unilateral training in the CAI population. Data Sources PubMed, SPORTDiscus, CINAHL Plus Study Selection To be included in the systematic review, studies were required to be published in English, include participants with chronic ankle instability, have participants undergo a unilateral therapeutic exercise for the lower extremity, and measure balance performance on the untrained lower extremity before and after the intervention. Data Extraction The certainty of evidence within each included study was assessed via the Downs and Black checklist. A score of 24–28 is “excellent” or “very low risk of bias,” 19–23 is “good” or “low risk of bias”, 14–18 is “fair” or “moderate risk of bias”, and less than 14 is “poor” or “high risk of bias.” We extracted information from each included study regarding their design, participant characteristics, inclusion criteria, independent and dependent variables, intervention, and results. Baseline and post-intervention balance performance data for participants' untrained limbs were used to calculate Hedge's g effect size and 95% confidence intervals. Data Synthesis Our search returned six studies that met the inclusion criteria. The articles' risk of bias ranged from high to low (11–19). Four of five studies that examined unilateral balance training reported a cross-education effect occurred. The lone study that examined resistance training at the ankle joint also reported a cross-education effect occurred. Several cross-education effects were associated with large effect sizes. This study was limited by a small number of studies that varied in methodology and quality. Conclusions The results of this systematic review suggest that unilateral therapeutic exercise can improve balance performance on the untrained limb of individuals with CAI. More work is needed to determine which training parameters are most effective for generating a cross-education effect.

Background: Ulnar collateral ligament (UCL) reconstruction (UCLR) and repair (UCLr) are the gold standards in the treatment of UCL injuries. Although return-to-play timelines after UCLR have been established, pitching biomechanical variables are speculated to change after surgical intervention. Purpose/Hypothesis: To synthesize the literature and investigate changes in pitching biomechanics in baseball pitchers after UCLR or UCLr. We hypothesized that differences in pitching biomechanics would be observed for both intra- and interpatient comparisons. Study Design: Systematic review; Level of evidence, 3. Methods: We searched 4 electronic databases (PubMed, Web of Science, SCOPUS, and Sports Medicine & Education Index) from inception to February 2020. Data extracted included author and year of publication, study design, sample size, study population, and primary outcome variables. Meta-analysis was performed to produce random pooled effect sizes (▵). Results: We identified 1010 original articles for inclusion. A total of 5 studies were included in the systematic review; of these, 3 studies were included in the meta-analysis. No differences were found in shoulder range of motion (ROM) between post-UCLR and control pitchers (dominant arm external rotation ▵, 0.13°; 95% CI, –0.15° to 4.02°; P = .36); dominant arm internal rotation ▵, –0.20°; 95% CI, –0.74° to 0.35°; P = .48). Mean fastball velocity as well as pitches thrown decreased after UCLR in professional pitchers. Significant differences in elbow extension, elbow extension velocity, and shoulder internal rotation velocity were found among amateur pitchers. Conclusion: The results of this systematic review and meta-analysis show that limited differences exist in pitchers before and after UCLR as well as in post-UCLR pitchers and healthy, age-matched controls. UCLR may influence throwing velocity, but it had no effect on either the throwing biomechanics or theROM of baseball pitchers. Although trends appear to be forming, further evidence is needed to understand the effect of UCLR on throwing biomechanics.

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