Comparing The Effects Of Mat Pilates On Lower Limb Strength And Agility In Young Adults With Sedentary To Active Lifestyles, Morgan E. Mccammon

Honors Program Projects

Background: Meeting physical activity guidelines is essential for maintaining physical health, decreasing the risk of chronic disease, and improving fitness. Pilates is a form of low to moderate exercise that can be implemented to improve multiple components of fitness and be considered active. Today, Pilates is available to the general population through online instruction.

Objectives: The purpose of this study was to compare the effects of a four-week, self-led online Pilates program or a walking routine on inactive and active young adults. This study analyzed changes in lower limb strength and agility.

Methods: This experiment involved eighteen …

The Impact Of Physique On Strategy And Performance In The 400 M Hurdles Race Among Elite Male Athletes, Janusz Iskra, Subir Gupta, Krzysztof Przednowek, René V. Best, Arkadiusz Stanula

Baltic Journal of Health and Physical Activity

Introduction: the objective of this study was to assess the impact of physique on the stride pattern and performance of elite male 400-m hurdles runners. Materials and Methods: this study is based on the analysis of the performance of 297 male 400-m hurdlers in 13 Olympic games, 16 world championships, and 15 European championships. The hurdlers were divided into 4 groups, based on their height and body mass index (BMI) – taller and heavier (TH), taller and lighter (TL), shorter and heavier (SH), and shorter and lighter (SL). Times taken to complete various phases of the 400-m hurdles race – …

Acute Simultaneous Medial And Lateral Ankle Sprain In A Collegiate Football Player: A Case Report, Ian Matlack

UNO Student Research and Creative Activity Fair

The purpose of this case report is to present a twenty-year-old African American male with a complex ankle injury. During a collegiate football game, the athlete injured his left ankle, damaging his deltoid ligament complex, and lateral ankle complex, causing several bone bruises and tearing his peroneal retinaculum. With surgery being declined, standard rehabilitation protocols of POLICE for initial management of inflammation, strengthening, and ROM exercises were conducted. Manual therapies consisting of milking massage, scraping, and joint mobilizations were added to aid in pain and edema control. Comparative case studies suggest that the athlete may have experienced a subluxation of …

Effects Of Core Stabilization Exercises In Patients With Non-Specific Low Back Pain: Huber Motion Lab Versus Conventional, Ebru Koyuncu, Nur Tunali, Seda Saka, Ertuğrul Ural, Melek Güneş Yavuzer

Baltic Journal of Health and Physical Activity

Introduction: This study aimed to determine the effects of core stabilization exercises with Huber® Motion Lab on pain, depression, and activity levels in patients with non-specific low back pain (LBP).

Materials and methods: In this study, 30 patients with non-specific LBP were allocated either to an experimental or to a control group. Both groups received a conventional physiotherapy program for 15 sessions. In addition, the control group performed 30 minutes of core stabilization exercises on the floor, whereas the experimental group used the Huber® Motion Lab device. The main outcome measures were pain severity (Visual Analogue Scale VAS), depression (Beck …

Regaining Strength And Range Of Motion In A Young Adult Male With Spastic Quadriplegic Cerebral Palsy Through Locomotor Training, Vanessa Mikan Phd, Jay Hannath, Landry Gilpin

International Journal of Exercise Science: Conference Proceedings

Cerebral palsy (CP) is a condition that is attributed to some degree of brain damage that interferes with the ability of muscles to function normally. There is minimal understanding about the effects of physiotherapy on individuals with CP because there has been a lack of research on CP focused therapeutic designs due to the hands-on, single-subject nature of this research. However, improvements in the ability to independently walk short distances using an assistive walker have been documented as a result of locomotor training in children with CP. PURPOSE: To design and trial a harness-assisted treadmill apparatus (HATA) to enhance flexibility, …

Dropout From Exercise Trials Among Cancer Survivors—An Individual Patient Data Meta-Analysis From The Polaris Study, Benedikte Western, Andreas Ivarsson, Ingvild Vistad, Ingrid Demmelmaier, Neil K. Aaronson, Gillian Radcliffe, Marc Van Beurden, Martin Bohus, Kerry S. Courneya, Amanda J. Daley, Daniel A. Galvão, Rachel Garrod, Martine M. Goedendorp, Kathleen A. Griffith, Wim H. Van Harten, Sandi C. Hayes, Fernando Herrero-Roman, Anouk E. Hiensch, Melinda L. Irwin, Erica James, Marlou-Floor Kenkhuis, Marie J. Kersten, Hans Knoop, Alejandro Lucia, Anne M. May, Alex Mcconnachie, Willem Van Mechelen, Nanette Mutrie, Robert U. Newton, Frans Nollet, Hester S. Oldenburg, Ron Plotnikoff, Martina E. Schmidt, Katie H. Schmitz, Karl-Heinz Schulz, Camille E. Short, Gabe S. Sonke, Karen Steindorf, Martijn M. Stuiver, Dennis R. Taaffe, Lene Thorsen, Miranda J. Velthuis, Jennifer Wenzel, Kerri M. Winters-Stone, Joachim Wiskemann, Sveinung Berntsen, Laurien M. Buffart

Research outputs 2022 to 2026

Introduction: The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. Methods: This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients …

Assessments Used By Athletic Trainers To Decide Return-To-Activity Readiness In Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) often care for patients with ankle sprains. Expert consensus has been established for rehabilitation-oriented assessments (ROASTs) that should be included in ankle-sprain evaluations. However, the methods ATs use to determine return-to-activity readiness after an ankle sprain are unknown.

Objectives: To identify ATs' methods for determining patients' return-to-activity readiness after an ankle sprain and demographic characteristics of the ATs and their methods.

Setting: Online survey.

Design: Cross-sectional study.

Patients or Other Participants: We recruited 10 000 clinically practicing ATs. A total of 676 accessed the survey, 574 submitted responses (85% completion rate), and 541 respondents met the …

Chronic Training Load And Dorsiflexion Range Of Motion Throughout A Season In Professional American Soccer, Tristan L. Young

Electronic Theses and Dissertations

Soccer has an incredibly complex movement profile. Players experience various types of strains on their body from the requirement to land in awkward positions while maintaining the ability to quickly accelerate and decelerate. Dorsiflexion range of motion (DFROM) is of concern due to the movement profile and ball control that requires constant eccentric and concentric actions at the talocrural joint. With an American soccer season spanning across nine months these demands can contribute to overuse, which has been linked to restricted range of motion. Restricted DFROM and asymmetries have been identified as injury predictors, but their relationship to performance has …

The Effectiveness Of Resistance Exercises Performed On Stable And Unstable Surfaces In Relation To Torso Activation, Radim Jebavy, Dusan Blazek, Helena Vomackova, Jan Vavra, Jan Busta, Anna Pisz, Petr Stastny

Baltic Journal of Health and Physical Activity

Introduction: Deep stabilization system (DSS) strength and endurance are crucial for injury prevention and athletic performance. Training surfaces can influence training outcomes; therefore, this study aimed to compare the impact of performing strength trunk exercises on unstable and stable surfaces with conventional trunk exercises. Materials and Methods: DSS and trunk stability were assessed before and after 10 weeks of three different training interventions among twenty elite futsal players. Each intervention included 25 strength training sessions. Pre- and post-tests encompassed various measurements, including diaphragm, trunk flexion, trunk back extension, hip flexion, intraabdominal pressure, side plank, pronation, and supination tests. Results: Conventional …

Evaluation Of Conservative And Operative Treatments In Active Patients With Acromioclavicular (Ac) And Rotator Cuff (Rc) Injuries, Jesse Singh

Electronic Thesis and Dissertation Repository

Abstract

Introduction: Shoulder pain and disability, particularly acromioclavicular joint (ACJ) and rotator cuff (RC) injuries, are common in a physically active population. Determining operative or rehabilitative treatment plans involve multiple treatment choices influenced by the injury grade and treatment goals, such as return to sport. This thesis investigates the management of treatment for AC and RC injuries

Method: The first study is a scoping review that uses the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) to synthesize 32 studies involving athletes who have undergone conservative or operative treatment for their Rockwood grade III …

Reaction Time Under Limited Vision With Cognitive Challenge In Individuals With Anterior Cruciate Ligament Reconstruction, Hsuan Bonny Lu

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

The anterior cruciate ligament (ACL) rupture is a common sports injury. ACL reconstruction (ACLR) is a necessary treatment for individuals to return to competitive sports. However, a high rate of secondary injury occurs when individuals return to sport. Past research has shown that ACLR impairs physical performance, including reduction of force generate against the floor under the injured leg, changes in the gait pattern, and a loss of knee stability. While structural changes following ACL injury can leave the knee joint less stable, neurophysiological changes following ACL injury represent one potentially important mechanism underlying the performance deficits. Healthy individuals rely …

Pilot Testing Of A Non-Gaming Cognitive Battery In Expert Esports Athletes, Allison J. Brager, Patrick Belling, Jason Sada, Jeffrey Osgood, Bradley Fawver, Michael Dretsch

Journal for Sports Neuroscience

Introduction: The esports industry is rapidly expanding, making it imperative to identify common data elements of expert gamers for the purposes of performance optimization and enhancement. We aimed to measure cognitive performance in a convenient sample of expert esports athletes, as well as to determine if cognitive performance of these individuals could be further enhanced through a novel non-gaming neurocognitive test battery.

Methods: Elite esports athletes (n = 5) participated in a four-day cognitive and strength & conditioning program at the Sports Academy (Thousand Oaks, CA). Cognitive performance was assessed through five tasks of increasing cognitive load. Baseline …

Effectiveness Of Using Exercise App In Improving Exercise Adherence And Aerobic Endurance Of Football Players, Cheryll D.N.N. Obra, Agatha C.S. Quidilla, Rome J. Cajigal, Jannah K.A. Jerez, Shiela M.A. Ramos, Reyma J.C. Malabed

Philippine Journal of Physical Therapy

Introduction. The use of mobile apps known as mHealth is starting to shape the delivery of physical therapy care not only in patients but also to the healthy population. Using an exercise app is a potential strategy to promote physical activity among individuals. Thus, this pilot study examined the utility of the Nike® Training Club app in increasing exercise adherence and enhancing aerobic endurance.

Methods. The study utilized one-way repeated measures over time quasi-experimental design. It used purposive sampling to select 10 college football players aged 18-25 years old. After downloading the app, the participants were required to perform a …

Aerobic Exercise Terhadap Peningkatan Endurance Pada Pasien Penyakit Jantung Koroner Dengan Pemeriksaan 6mwt : Studi Kasus, Dela Fariha Fuadi, Andrew Wijaya Saputra, Nabilla Nur Awaliah Dzatikhulwani

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Background: Coronary heart disease (CHD) is a condition in which the heart's blood vessels (coronary arteries) are blocked by fat deposits. Based on data from Riskesdas (2018) it is revealed that cases of heart and blood vessel disease in Indonesia are increasing every year, increasing the mortality rate. This is due to the presence of risk factors that support the emergence of coronary heart disease. Objective: The aim of this paper is to evaluate the evaluation of aerobic exercise to increase endurance in patients with coronary heart disease by examining 6MWT. Method: This research is in the form of a …

Efektivitas Manual Therapy Dan Ultrasound Terhadap Peningkatan Fungsi Gerak Bahu Pada Kasus Nyeri Bahu Et Causa Bursitis Subacromialis Dengan Parameter Spadi Di Rsud Muhammad Natsir, Fadhilah Az-Zahra, Ronal Lufitos, Faizah Abdullah Djawas

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

ABSTRACT: Adhesive Capsulitis is a disorder that occurs in the shoulder area in the form of inflammation of the joint capsule which causes a feeling of stiffness and pain. Glenohumeral joint mobilization with the Maitland mobilization technique is using passive mobilization with physiological oscillatory movements which can produce a stretching effect and release of adhesive on the ligament capsule in the shoulder so that the range of motion of the shoulder joint can be increased. Hold relax is an exercise therapy with the principle of reciprocal inhibition which aims to improve antagonistic pattern relaxation, and mobilization, and to reduce pain. …

Neurodynamic Technique Terhadap Penurunan Nyeri, Peningkatan Grip Strength, Dan Peningkatan Kemampuan Fungsional Pada Carpal Tunnel Syndrome, Safrin Arifin, Fathia Dheanisa

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Carpal tunnel syndrome is a syndrome that occurs in 1-4% of the total population worldwide. This condition causes disruption of function and motion in the wrist that spreads to the fingers. Physiotherapy intervention is necessary to reduce the severity of symptoms in patients with CTS. Neurodynamic Techniques are nerve mobilization techniques that aim to restore homeostasis in the nerves so as to reduce pain and improve functional ability. Materials and methods. This research was conducted through searching several databases, found 31 articles which were then filtered and selected as many as 10 articles. However, of the 11 articles, further screening …

Acute Effects Of Three Different Stretching Techniques On Hamstring Flexibility In Professional Football Players, Erkan Erol, Ramazan Yıldız, Ayşe Yıldız, Fatih Emre Doğan, Bülent Elbasan

Baltic Journal of Health and Physical Activity

Introduction: Hamstring injuries are common in physically active people and athletes. Lack of hamstring flexibility is the one of the most important characteristics of hamstring injuries in athletes. The aim of this study was to investigate effects of three different stretching techniques on hamstring flexibility in professional football players. Materials and Methods: Fifty-five male football players between the ages of 18–20 years old were involved in the study. The participants were divided into 3 groups: static stretching, neuromobilization and Mulligan traction straight leg raise (TSLR), respectively. Each participant’s dominant lower extremity was assessed with a straight leg raise test (SLR) …

Efficacy Of Externally Paced Training On Pain In Tendinopathy: A Systematic Review And Meta Analysis, Dylan Carmody, Alyssa Conanan, Daniel Moeller, Sarah Khoblall, Christopher Keating

Department of Physical Therapy Faculty Papers

Tendinopathy is a common condition with treatments focused on local tissue adaptations. Externally paced loading programs are designed to cue (visually, auditorily, or temporally) a person as to when to perform an exercise repetition during a set of repetitions. Externally paced loading programs propose central and peripheral changes with tendinopathy but conclusions regarding their efficacy on pain outcomes remain limited. Our review seeks to explore the efficacy of externally paced loading as a method to reduce self-reported pain in tendinopathic conditions. An electronic database search was conducted of PubMed, SPORTDiscus, Scopus, and CINAHL databases. A total of 2,104 studies were …

Comparison Of Vascular Dopplers In Measuring Limb Occlusion Pressure For Blood Flow Restriction Therapy, Kiara Barrett, Logan Page, Marcin Szczyglowski, Tyler Martin, J. Grant Mouser

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 7, 2023. The use of blood flow restriction is becoming more common and requires the use of individualized pressures in order to remain a safe and effective rehabilitation modality. Measuring limb occlusion pressure (LOP) allows the practitioner to set the restriction pressure so that full occlusion does not occur. Objective: Compare a research-grade clinical vascular doppler and a consumer-grade vascular doppler in the measurement of LOP. Design: A randomized crossover design measuring LOP in the upper and lower body. Methods: 20 participants (men=10) visited the laboratory on one occasion. …

Efficacy Of Corrective Exercise On Improving Functional Movement Within The Tactical Population: A Critically Appraised Topic, Sara Stiltner, Adam J. Thompson, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Police, fire, emergency medical services, and military personnel encompass a tactical population that is considered an emerging setting in athletic training.Due to the occupational demands within this demographic, these patients are experiencing musculoskeletal injuries and injuries that withhold them from career duties at an alarming rate. One of the main contributors to the incidence of musculoskeletal injury is a lack of functional movement.^1-3 Incorporating corrective functional movement programs should be a primary goal in treating tactical populations.

Obstacle Crossing In Healthy Young And Older Individuals, Hope M. Hanson, Ashlyn M. Jendro, Abigail C. Schmitt

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: In the United States, the average population age is rising and will continue to increase in the coming years.With an older population comes increased risk of injury associated with falls. Falls are considered a leading cause of injury and death in older individuals, and many falls are caused by body imbalance or obstacle collision due to a clearly visible stationary object (e.g., rug, chair, branch). Older adults tend to cross obstacles with increased toe clearance in order to prevent tripping, but much of what is known about obstacle crossing in older adults is limited to artificial obstacles that are …

Differences In Trapezius Muscle H-Reflex Between Asymptomatic Subjects And Symptomatic Shoulder Pain Subjects, Ana S.C. Melo, Janet L. Taylor, Ricardo Ferreira, Bruno Cunha, Manuel Ascenção, Mathieu Fernandes, Vítor Sousa, Eduardo B. Cruz, J. Paulo Vilas-Boas, Andreia S.P. Sousa

Research outputs 2022 to 2026

In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of …

The Effect Of Fatigue On Lower Extremity Joint Kinematics And Performance, Sarah Alloto

Undergraduate Distinction Papers

Within recent years there has been an increase in the number of anterior cruciate ligament (ACL) injuries within female athletes (Learning how ACL, 2022). The ACL is a ligamentous structure within the knee that connects the femur and the tibia (Mayo, 2022). Its primary function is to provide stability, prevent the tibia from excessive anterior translation, and provide proprioceptive input for the lower limb (Mayo, 2022). ACL injuries are multifactorial in nature, meaning they can be the result of faulty biomechanics, individual genetic predisposition, or environmental factors (Alentorn- Geli et al., 2009). ACL injuries can be classified into two categories: …

Effect Of Kinesiophobia On Return To Play Of Athletes At Bridgewater College, Jenna Mccaffrey

Honors Projects

Kinesiophobia is known as the fear of movement, injury, or re-injury. It is the primary psychological construct of the Fear Avoidance Model of Chronic Pain under the biopsychosocial model's umbrella. This study tested the effects of kinesiophobia on return to play of athletes at Bridgewater College. Results found that kinesiophobia had no impact on return to play of female athletes at Bridgewater College. Male athletes have a positive correlation between Return Concerns and kinesiophobia.

Low Pre-Season Hamstring-To-Quadriceps Strength Ratio Identified In Players Who Further Sustained In-Season Hamstring Strain Injuries: A Retrospective Study From A Brazilian Serie A Team, Filipe Veeck, Cassio V. Ruas, Matheus Daros Pinto, Rafael Grazioli, Gustavo Pacheco Cardoso, Thiago Albuquerque, Lucas Schipper, Henrique Gonçalves Valente, Victor H. Santos, Márcio Dornelles, Paulo Rabaldo, Clarice S. Rocha, Bruno Manfredini Baroni, Eduardo Lusa Cadore, Ronei Silveira Pinto

Research outputs 2022 to 2026

A common pre-season injury prevention assessment conducted by professional football clubs is the hamstring-to-quadriceps (H:Q) strength ratio calculated by peak torque (PT). However, it is debatable whether players that present low pre-season H:Q ratios are more susceptible to further sustaining in-season hamstring strain injuries (HSI). Based upon retrospective data from a Brazilian Serie A football squad, a particular season came to our attention as ten out of seventeen (~59%) professional male football players sustained HSI. Therefore, we examined the pre-season H:Q ratios of these players. H:Q conventional (CR) and functional (FR) ratios, and the respective knee extensor/flexor PT from the …

Physiotherapists’ Work In Public Perception, Andrzej Lewandowski, Jadwiga Sarwinska, Zuzanna Piekorz

Baltic Journal of Health and Physical Activity

Introduction: The aim of the study is to determine basic physical traits of physiotherapists and indicators of their occupation according to social expectations. Material and Methods: 2121 people of different sex, age and education participated in the study. The preferences were categorized by sex and the education level. The test for equality of two percentage structures based on statistics ‘Z’ and the test for equality of proportions based on Fisher-Snedecor’s test were implemented. Results: The preferences for the physical traits are consistent with those commonly expected, and the high level of fitness is expected in the context of significant psychological …

Conservative Treatment Of A Symptomatic Os Vesalianum Pedis In A Professional Soccer Player: A Case Report, Mario F. Cruz, Lori A. Bolgla, Ryan Alexander, Peter J. Symbas, Jeremy Royal, Jordan Serrano-Dennis

Internet Journal of Allied Health Sciences and Practice

Objectives: Symptomatic os vesalianum pedis (OVP), a small accessory bone located adjacent to the base of the 5^th metatarsal of the foot, rarely affects individuals who participate in sports. The condition typically is treated with surgical intervention. This case report documents the examination, evaluation, and treatment approach for a professional soccer player treated conservatively with a symptomatic OVP. Methods: A nineteen-year-old professional soccer player presented with pain to the base of the left 5^th metatarsal. Physical examination and imaging resulted in a diagnosis of a symptomatic OVP. The player underwent a 5-stage criterion-based rehabilitation program. Results: The player …

Running Marathons In High School: A 5-Year Review Of Injury In A Structured Training Program, Mary A. Kennedy, Lauren V. Fortington, Matt Penney, Nicolas H. Hart, Pierre A. D’Hemecourt, Dai Sugimoto

Research outputs 2022 to 2026

Objective: The aim in this study was to quantify the number, nature, and severity of injuries sustained by male and female high school students who took part in a running training program that culminated in the completion of a half or full marathon. Design: This study is a retrospective clinical audit. Methods: Injury reports from high school students (grades 9 – 12) who participated in a half or full marathon 30-week progressive training program comprising four training days per week (three running days and one cross-training day) were reviewed. The number of runners completing a marathon, together with the number, …

The Effects Of Dynamic® Taping On Vertical Jumps In Adolescent Volleyball Players With Low Medial Longitudinal Arch, Dilek Hande Esen, Nihan Kafa, Nevin Atalay Guzel, Cengiz Akarcesme

Baltic Journal of Health and Physical Activity

Introduction: Taping has long been used by health professionals to provide mechanical support for the musculoskeletal system. However, there is insufficient evidence to demonstrate the effect of Dynamic® taping. The aim of this study was to investigate the effect of Dynamic® taping on vertical jump and medial longitudinal arch height in adolescent volleyball players with navicular drop. Material and Methods: 23 female athletes participated in the study (mean age of 15.22 ± 1.54 years). The medial longitudinal arch height was evaluated with the navicular drop test. Vertical jumping was measured with the VERT® device (Mayfonk Athletic, USA). On the first …

Identifying The Characteristics, Constraints, And Enablers To Creating Value In Applied Performance Analysis, Denise Martin, Peter G. O'Donoghue, Jonathan Bradley, Sam Robertson, Denise Mcgrath

Articles

While applied performance analysts (PAs) are a well-established applied sports science practitioner group, there is no clear definition of the purpose of an analyst, their key relationships, or the expertise required to execute the role successfully. This research sought to understand how PA practitioners and educators perceive their role as applied PA practitioners. Twenty-seven applied PAs and educators with applied PA experience participated in six online focus groups, completing an online survey in advance. Reflexive thematic analysis of transcripts and survey data generated an overarching theme: embedded applied PA practitioners have a value co-creation role within performance ecosystems which is …