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    The Effects of Sex, Limb Dominance, and Soccer Participation on Knee Proprioception and Dynamic Postural Control
    (HUMAN KINETICS PUBL INC, 2016) Cug, Mutlu; Wikstrom, Erik A.; Golshaei, Bahman; Kirazci, Sadettin
    Context: Both female athletes' participation in soccer and associated injuries have greatly increased in recent years. One issue is the 2-9 times greater incidence of noncontact anterior cruciate ligament (ACL) injuries in female athletes relative to male athletes in comparable sports. Several factors such as limb dominance and sporting history have been proposed to play a role in ACL incidence rates between male and female athletes. However, evidence about the effects of these factors and how they interact with sex is mixed, and thus no consensus exists. Objective: To quantify the effects of sports participation, limb dominance, and sex on dynamic postural control and knee-joint proprioception. Design: Cross-sectional study. Setting: University research laboratory. Participants: 19 male soccer players, 17 female soccer players, 19 sedentary men, and 18 sedentary women. Intervention: Joint-position sense was tested using reproduction of passive positioning on a Biodex isokinetic dynamometer (30 degrees, 45 degrees, and 60 degrees from 90 degrees of knee flexion). Three Star Excursion Balance Test directions were used to assess dynamic postural control. Main Outcome Measure: Normalized reach distance (% of leg length) in the anterior, posteromedial, and posterolateral directions on each leg quantified dynamic postural control. Average absolute error and constant error for both limbs quantified joint-position sense. Results: Posteromedial reach distance was significantly better in soccer players than sedentary individuals (P=.006). Anterior reach distance was significantly better (P=.04) in sedentary individuals than soccer players. No limb-dominance or sex differences were identified for dynamic postural control, and no differences in absolute-or constant-error scores were identified. Conclusion: Sporting history has a direction-specific impact on dynamic postural control. Sporting history, sex, and limb dominance do not influence knee-joint proprioception when tested in an open kinetic chain using passive repositioning.
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    Learning Effects Associated With the Least Stable Level of the Biodex (R) Stability System During Dual and Single Limb Stance
    (JOURNAL SPORTS SCIENCE & MEDICINE, 2014) Cug, Mutlu; Wikstrom, Erik A.
    The Biodex (R) Stability System (BSS) has high test-retest reliability when stable (high) resistance levels are used. However, reliability data for lower stability levels, associated with more pronounced learning curves, are rare in the existing literature. Thus, it is likely that BSS scores obtained from lower stability levels require greater familiarization (i. e. practice) to achieve a stable score both within and between test sessions. Therefore, the purpose of this investigation was to determine if a commonly reported 6 trial sequence (3 practice trials, 3 test trials) used with the BSS can achieve a stable within session score on the lowest stability level (i. e. level 1). The secondary purpose was to evaluate the test-retest reliability of the lowest BSS resistance level over a 10-week period. Twenty sedentary university students (11 male, 9 female; age: 21.5 +/- 1.9 years, height: 1.7 +/- 0.1 m, weight: 66.3 +/- 12.1 kg, BMI: 22.4 +/- 2.3) voluntarily participated. Participants completed two test sessions separated by 10-weeks. Twelve, 20-second trials (six dual limb stance, six single limb stance on the dominant limb) on the lowest stability level were completed during both test sessions by all participants. A stable within session dual and single limb stance score was achieved with a maximum of 3 familiarization trials. Reliability ranged between poor and good across all outcomes but all outcomes had large minimal detectable change scores. At least 3 stance specific familiarization trials are needed to achieve a stable BSS score within a single test session on the lowest resistance level. However, the inconsistent reliability and high minimal detectable changes scores suggest that the lowest resistance level should not be used as an objective marker of rehabilitation progress over extended periods of time (e. g. 10weeks).
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    Learning effects associated with the least stable level of the Biodex® stability system during dual and single limb stance
    (Journal of Sport Science and Medicine, 2014) Cug, Mutlu; Wikstrom, Erik A.
    The Biodex® Stability System (BSS) has high test-retest reliability when stable (high) resistance levels are used. However, reliability data for lower stability levels, associated with more pronounced learning curves, are rare in the existing literature. Thus, it is likely that BSS scores obtained from lower stability levels require greater familiarization (i.e. practice) to achieve a stable score both within and between test sessions. Therefore, the purpose of this investigation was to determine if a commonly reported 6 trial sequence (3 practice trials, 3 test trials) used with the BSS can achieve a stable within session score on the lowest stability level (i.e. level 1). The secondary purpose was to evaluate the test-retest reliability of the lowest BSS resistance level over a 10-week period. Twenty sedentary university students (11 male, 9 female; age: 21.5 ± 1.9 years, height: 1.7 ± 0.1 m, weight: 66.3 ± 12.1 kg, BMI: 22.4 ± 2.3) voluntarily participated. Participants completed two test sessions separated by 10-weeks. Twelve, 20-second trials (six dual limb stance, six single limb stance on the dominant limb) on the lowest stability level were completed during both test sessions by all participants. A stable within session dual and single limb stance score was achieved with a maximum of 3 familiarization trials. Reliability ranged between poor and good across all outcomes but all outcomes had large minimal detectable change scores. At least 3 stance specific familiarization trials are needed to achieve a stable BSS score within a single test session on the lowest resistance level. However, the inconsistent reliability and high minimal detectable changes scores suggest that the lowest resistance level should not be used as an objective marker of rehabilitation progress over extended periods of time (e.g. 10- weeks). © Journal of Sports Science and Medicine.