{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:45:32Z","timestamp":1792716332211,"version":"4.5.0"},"reference-count":43,"publisher":"National Athletic Trainers' Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Early sport specialization, or the participation in 1 sport year-round to the exclusion of all others, is a growing concern in youth athletics because of its possible association with musculoskeletal injury. The underlying injury risk may be the result of coordination differences that sport-specialized athletes have been speculated to exhibit relative to multisport athletes; however, little evidence exists to support or refute this notion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine relative hip- and knee-joint angular-motion variability among adolescent sport-specialized and multisport female adolescent athletes to determine how sport specialization may affect coordination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Research laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>A total of 366 sport-specialized and 366 multisport adolescent female basketball, soccer, and volleyball players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s)<\/jats:title>\n                    <jats:p>Drop\u2013vertical-jump (DVJ) assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Average coupling-angle variability (CAV) for hip flexion and knee flexion, knee flexion and ankle flexion, hip flexion and knee abduction, knee flexion and knee abduction, knee flexion and knee internal rotation, and knee abduction and knee internal rotation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sport-specialized group exhibited increased coupling variability in dominant-limb hip flexion and knee flexion (P = .015), knee flexion and knee abduction (P = .014), and knee flexion and knee internal rotation (P = .048) while landing during the DVJ, although they had small effect sizes (\u03b72 = 0.010, 0.010, and 0.007, respectively). No differences were present between groups for any of the other CAV measures of the dominant limb, and no differences were found for any CAV measures of the nondominant limb (all P values &amp;gt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sport specialization was associated with increased variability of critical hip- and knee-joint couplings responsible for effective landing during the DVJ. Altered coordination strategies that involve the hip and knee joints may underlie unstable landings, inefficient force-absorption strategies, or greater contact forces that can place the lower extremities at risk for injury (or a combination of these).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-407-18","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T09:05:02Z","timestamp":1571648702000},"page":"1105-1114","source":"Crossref","is-referenced-by-count":75,"title":["Sport Specialization and Coordination Differences in Multisport Adolescent Female Basketball, Soccer, and Volleyball Athletes"],"prefix":"10.4085","volume":"54","author":[{"given":"Christopher A.","family":"DiCesare","sequence":"first","affiliation":[{"name":"The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Montalvo","sequence":"first","affiliation":[{"name":"College of Health Solutions, Arizona State University, Phoenix"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim D. 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Sportsmed"},{"issue":"1","key":"2020060411551778500_i1062-6050-54-10-1105-b37","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/1941738115614811","article-title":"Sports specialization, part II: alternative solutions to early sport specialization in youth athletes","volume":"8","author":"Myer","year":"2016","journal-title":"Sports Health"},{"issue":"1","key":"2020060411551778500_i1062-6050-54-10-1105-b38","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/13598130902860507","article-title":"What do we know about early sport specialization?","volume":"20","author":"Baker","year":"2009","journal-title":"Not much! High Abil Stud"},{"issue":"1","key":"2020060411551778500_i1062-6050-54-10-1105-b39","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/1612197X.2009.9671889","article-title":"ISSP position stand: to sample or to specialize? Seven postulates about youth sport activities that lead to continued participation and elite performance","volume":"7","author":"C\u00f4t\u00e9","year":"2009","journal-title":"Int J Sport Exerc Psychol"},{"key":"2020060411551778500_i1062-6050-54-10-1105-b40","unstructured":"Hill\n              G.\n            \n          \n          A Study of Sport Specialization in Midwest High School Athletes [dissertation]. Iowa City: University of Iowa;1987."},{"key":"2020060411551778500_i1062-6050-54-10-1105-b41","unstructured":"Cohen\n              J.\n            \n          \n          Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates;1988."},{"issue":"10","key":"2020060411551778500_i1062-6050-54-10-1105-b42","doi-asserted-by":"crossref","first-page":"847","DOI":"10.2165\/00007256-200636100-00004","article-title":"The effects of the menstrual cycle on anterior knee laxity: a systematic review","volume":"36","author":"Zazulak","year":"2006","journal-title":"Sports Med"},{"issue":"2","key":"2020060411551778500_i1062-6050-54-10-1105-b43","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1600-0838.2012.01523.x","article-title":"The impact of sport and active recreation injuries on physical activity levels at 12 months post-injury","volume":"24","author":"Andrew","year":"2014","journal-title":"Scand J Med Sci Sports"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/54\/10\/1105\/2369262\/1062-6050-407-18.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/54\/10\/1105\/2369262\/1062-6050-407-18.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T14:53:50Z","timestamp":1749653630000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/54\/10\/article-p1105.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,1]]},"references-count":43,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-407-18","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2019,10,1]]}}}