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Context: A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccerspecific program described as the F-MARC 11þ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11þ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population.Objective: To investigate the effects of a soccer-specific warm-up program (F-MARC 11þ) on lower extremity injury incidence in male collegiate soccer players.Design: Cohort study. Setting: One American collegiate soccer team followed for 2 seasons.Patients or Other Participants: Forty-one male collegiate athletes aged 18-25 years. Intervention(s):The F-MARC 11þ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer.Main Outcome Measure(s): Lower extremity injury risk and time lost to lower extremity injury.Results: The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR ¼ 0.28, 95% confidence interval ¼ 0.09, 0.85) and time lost to lower extremity injury (P , .01).Conclusions: This F-MARC 11þ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.

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Context:The reliability of clinical techniques to quantify thoracic spine rotation range of motion (ROM) has not been evaluated.Objective: To determine the intratester and intertester reliability of 5 thoracic rotation measurement techniques.Design: Descriptive laboratory study. Setting: University research laboratory.Patients or Other Participants: Forty-six healthy volunteers (age=23.6±4.3 years, height=171.0±9.6 cm, mass= 71.4 ± 16.7 kg).Main Outcome Measure(s): We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. On day 1, 2 examiners obtained 2 sets of measurements (sessions 1, 2) to determine the within-session intertester reliability and within-day intratester reliability. A single examiner obtained measurements on day 2 (session 3) to determine the intratester reliability between days. Each technique was performed 3 times per side, and averages were used for data analysis. Reliability was determined using intraclass correlation coefficients, standard error of measurement (SEM), and minimal detectable change (MDC). Differences between raters during session 1 were determined using paired t tests.Results: Within-session intertester reliability estimates ranged from 0.85 to 0.94. Ranges for the SEM were 1.0°to 2.3°a nd for the MDC were 2.8°to 6.3°. No differences were seen between examiners during session 1 for seated rotation (bar in front, both sides), half-kneeling rotation (bar in front, left side), or the lumbar locked position (both sides) (all values of P> .05). Within-day intratester reliability estimates ranged from 0.86 to 0.95. Ranges for the SEM were 0.8°to 2.1°and for the MDC were 2.1°to 5.9°. Between-days intratester reliability estimates ranged from 0.84 to 0.91. Ranges for the SEM were 1.4°to 2.0°a nd for the MDC were 3.9°to 5.6°.Conclusions: All techniques had good reliability and low levels of measurement error. The seated rotation, bar in front, and lumbar-locked rotation tests may be used reliably when more than 1 examiner is obtaining measurements.Key Words: biomechanics, bubble inclinometer, goniometer, scapulothoracic joint Key Points• Within-session and between-sessions reliability values for the 2 examiners for each of the 5 thoracic rotation range-ofmotion measurement techniques were good. • All measurement techniques showed low SEM « 3°) and minimal detectable change « 6°) values for all techniques.• The seated rotation, bar in front, and lumbar-locked rotation tests did not display differences between examiners during session 1. These techniques may be used with confidence by clinicians and researchers.

Study Design Randomized clinical trial. Objectives To determine whether manipulation of the proximal or distal tibiofibular joint would change ankle dorsiflexion range of motion and functional outcomes over a 3-week period in individuals with chronic ankle instability. Background Altered joint arthrokinematics may play a role in chronic ankle instability dysfunction. Joint mobilization or manipulation may offer the ability to restore normal joint arthrokinematics and improve function. Methods Forty-three participants (mean ± SD age, 25.6 ± 7.6 years; height, 174.3 ± 10.2 cm; mass, 74.6 ± 16.7 kg) with chronic ankle instability were randomized to proximal tibiofibular joint manipulation, distal tibiofibular joint manipulation, or a control group. Outcome measures included ankle dorsiflexion range of motion, the single-limb stance on foam component of the Balance Error Scoring System, the step-down test, and the Foot and Ankle Ability Measure sports subscale. Measurements were obtained prior to the intervention (before day 1) and following the intervention (on days 1, 7, 14, and 21). Results There was no significant change in dorsiflexion between groups across time. When groups were pooled, there was a significant increase (P<.001) in dorsiflexion at each postintervention time interval. No differences were found among the Balance Error Scoring System foam, step-down test, and Foot and Ankle Ability Measure sports subscale scores. Conclusions The use of a proximal or distal tibiofibular joint manipulation in isolation did not enhance outcome effects beyond those of the control group. Collectively, all groups demonstrated increases in ankle dorsiflexion range of motion over the 3-week intervention period. These increases might have been due to practice effects associated with repeated testing. Level of Evidence Therapy, level 2b-. J Orthop Sports Phys Ther 2012;42(2):125–134. doi:10.2519/jospt.2012.3729