Achilles tendinopathy (AT) is a common and often persistent musculoskeletal disorder affecting both athletic and non-athletic populations. Despite the relatively high incidence there is little insight into the impact and perceptions of tendinopathy from the individual’s perspective. Increased awareness of the impact and perceptions around individuals’ experiences with Achilles tendinopathy may provide crucial insights for the management of what is often a complex, persistent, and disabling MSK disorder. To qualitatively explore the lived experiences of individuals with AT. A qualitative, interpretive description design was performed using semi-structured telephone interviews. Semi-structured interviews were conducted on 15 participants (8 male and 7 female) with AT. Thematic analysis was performed using the guidelines laid out by Braun and Clarke. The study has been reported in accordance with the consolidated criteria for reporting qualitative research (COREQ) checklist. Four main themes were identified from the data: 1) beliefs and perceptions surrounding AT: “If I'm over training or something, I don't really know”, 2) the biopsychosocial impact of AT: “I think it restricts me in a lot of things that I would be able to do”, 3) individuals’ experiences with the management process: “You want it to happen now. You're doing all this stuff and it's just very slow progress”, and 4) future prognosis and outlook in individuals with AT: “I see myself better”. This study offers a unique insight into the profound impact and consequences of Achilles tendinopathy in a mixed sample of both athletic and non-athletic individuals. The findings of this study have important clinical implications. Specifically, it highlights the need for clinicians to recognize and adopt treatment approaches to embrace a more biopsychosocial approach for the management of tendinopathy.

Study Design: Repeated-measures clinical measurement reliability study.Background: While there are some shoulder functional tests for athletes, no widely used performance test of arm and shoulder function currently exists to assess lower-level upper extremity functional demands in, for example, a nonathlete population or elderly individuals. In these individuals, functional measures rely on patient self-report.Objectives: Describe the development of the Timed Functional Arm and Shoulder Test (TFAST), age-related scores, and between-session reliability in a group of asymptomatic high school athletes, young adults, middle-aged adults, older adults, and a preliminary group of symptomatic patients.Methods: One hundred forty asymptomatic individuals participated in the study: 36 high school athletes (14–18 years of age), 34 young adults (19–35 years of age), 37 middle-aged adults (36–65 years of age), 33 older adults (over 65 years of age), and 16 symptomatic patients (22–66 years of age). The TFAST is a functional test that includes 3 tasks: hand to head and back, wall wash, and gallon lift. Total repetitions were noted for each task, and the total TFAST score was calculated.Results: Mean total TFAST scores were higher for young adults (107.9; 95% confidence interval [CI]: 102.5, 113.4) and middle-aged adults (105.2; 95% CI: 99.1, 111.3) as compared to the high school athletes (89.9; 95% CI: 81.2, 98.5) and older adults (74.5; 95% CI: 65.6, 83.5). All groups were significantly different (P<.05) from each other, except the young and middle-aged adults. For patients, the mean score for the symptomatic side was 100.1 (95% CI: 89.6, 110.5). The between-session reliability values for the total TFAST scores in the asymptomatic individuals were as follows: intraclass correlation coefficient (ICC) = 0.93; 95% CI: 0.60, 0.98; standard error of measurement, 6.7; and minimal detectable change based on a 95% CI, 18.5 repetitions. The ICC values for individual tasks ranged from 0.80 to 0.94 (95% CI range, 0.44–0.98). The reliability for the patient group was 0.83 (95% CI: 0.51, 0.94).Conclusion: The TFAST was sensitive to detect differences in functional performance between age groups, demonstrated adequate between-session reliability, and demonstrated feasibility in a symptomatic patient group. Further assessment is needed to refine the TFAST. Development of a feasible and valid test of arm function would enhance clinical evaluation and outcome measurement. J Orthop Sports Phys Ther 2017;47(6):420–431. Epub 3 Mar 2017. doi:10.2519/jospt.2017.7136

Context: The Y-Balance Test Lower Quarter (YBT-LQ) is a widely utilized tool for evaluating dynamic postural control, requiring a combination of mobility and strength. This study aimed to investigate the combined relationship between isometric thigh muscle strength and joint kinematics on YBT-LQ performance. Design: Cross-sectional laboratory study. Methods: Isometric quadriceps and hamstrings strength were measured before the YBT-LQ in 39 healthy participants (27 females and 12 males). The test was performed under 3-dimensional markerless motion capture, where joint kinematics were extracted from the maximum reach position from each direction. Three multivariable linear regression models were then used to determine the strongest combination of predictors for YBT-LQ performance. Results: Greater hamstrings strength and increased knee flexion, ankle dorsiflexion, and trunk ipsilateral-flexion joint angles explained 56.8% (P < .001) of the variance in anterior reach. Hip flexion, knee flexion, and ankle dorsiflexion angles were the strongest predictors for posteromedial reach distance, explaining 73.0% of the variance (P < .001). Last, 43.3% (P < .001) of the variance in posterolateral reach distance was predicted by hamstring strength and knee-flexion angle. Conclusions: These results emphasize the importance of hamstring strength in YBT-LQ performance across different reach directions. Additionally, the kinematics illustrate a potential movement strategy for maximizing reach distance on the YBT-LQ in healthy individuals. Clinicians can utilize this information to guide interventions aimed at improving dynamic postural control, particularly by focusing on increasing hamstring strength and testing for impairments in specific movement patterns.

Physical fitness is a pillar of U.S. Air Force (USAF) readiness and ensures that Airmen can fulfill their assigned mission and be fit to deploy in any environment. The USAF assesses the fitness of service members on a periodic basis, and discharge can result from failed assessments. In this study, a 21-feature dataset was analyzed related to 223 active-duty Airmen who participated in a comprehensive mental and social health survey, body composition assessment, and physical performance battery. Graphical analysis revealed pass/fail trends related to body composition and obesity. Logistic regression and limited-capacity neural network algorithms were then applied to predict fitness test performance using these biomechanical and psychological variables. The logistic regression model achieved a high level of significance (p < 0.01) with an accuracy of 0.84 and AUC of 0.89 on the holdout dataset. This model yielded important inferences that Airmen with poor sleep quality, recent history of an injury, higher BMI, and low fitness satisfaction tend to be at greater risk for fitness test failure. The neural network model demonstrated the best performance with 0.93 accuracy and 0.97 AUC on the holdout dataset. This study is the first application of psychological features and neural networks to predict fitness test performance and obtained higher predictive accuracy than prior work. Accurate prediction of Airmen at risk of failing the USAF fitness test can enable early intervention and prevent workplace injury, absenteeism, inability to deploy, and attrition.