One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear. To determine (1) the effectiveness of a self-administered plantar-massage treatment in those with CAI and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors. Crossover study. University setting. A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI. All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage. Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test. Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a clinician-delivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome. In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the postural-control improvements is the stimulation of the plantar cutaneous receptors.Context:
Objectives:
Design:
Setting:
Patients or Other Participants:
Intervention(s):
Main Outcome Measure(s):
Results:
Conclusions:
Deficits in balance have been identified as a possible risk factor for knee injuries in athletes. Despite a lack of evidence for its effectiveness, kinesiology tape (KT) is widely used to prevent knee injuries. To investigate the influence of KT at the knee joint on balance ability in healthy men after eccentric exercise. Crossover study. University laboratory. Twelve young men with no history of lower limb injury volunteered for the study (age = 23.3 ± 2.6 years). All participants were students enrolled in a sports science program. Participants performed the balance test with and without KT at the knee joint on 2 separate days. The ability to maintain balance was assessed during a single-legged–stance test using a computerized balance-stability test system. The test was performed before and after 30 minutes of downhill walking on a treadmill. Eccentric exercise resulted in a deterioration of balance ability, which was attenuated by the use of KT. Further analyses revealed that the effectiveness of KT depended on the participant's balance status, with the preventive effect being greater in participants presenting with poorer baseline balance ability. Applied to the knee joint, KT counteracted the exercise-related deterioration of balance ability observed when no tape was used. Participants presenting with below-average balance ability received more benefit from KT. By preventing exercise-related impairment of balance ability, KT might help to reduce the risk of sport-associated knee injuries.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Intervention(s):
Main Outcome Measure(s):
Results:
Conclusions:
Because of the increasing popularity of participation in Irish dance, the incidence of lower limb injuries is high among this competitive population. To investigate the effects of fatigue on the peak lower limb and trunk angles as well as the peak lower limb joint forces and moments of competitive female Irish dancers during the performance of a dance-specific single-limb landing. Cross-sectional study. Laboratory. Fourteen healthy, female, competitive Irish dancers (age = 19.4 ± 3.7 years, height = 165.3 ± 5.9 cm, mass = 57.9 ± 8.2 kg). Participants performed an Irish dance–specific leap before and after a dance-specific fatigue protocol. During each landing movement, 3-dimensional lower limb kinematics (250 Hz) and ground reaction forces (1000 Hz) were collected. Paired t tests were performed to determine the differences (P ≤ .05) in lower limb and trunk biomechanics prefatigue and postfatigue. Peak lower limb and trunk angles as well as peak lower limb joint reaction forces and external moments. Compared with the prefatigue trials, dancers landed with reduced ankle plantar flexion (P = .003) and hip external rotation (P = .007) and increased hip-adduction alignment (P = .034) postfatigue. Dancers displayed greater anterior shear (P = .003) and compressive (P = .024) forces at the ankle and greater external knee-flexion moments (P = .024) during the postfatigue compared with the prefatigue landing trials. When fatigued, dancers displayed a decline in landing performance in terms of aesthetics as well as increased ankle- and knee-joint loading, potentially exposing them to a greater risk of injuries.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Intervention(s):
Main Outcome Measure(s):
Results:
Conclusions:
Low back pain (LBP) and lower limb injuries are common among Australian Football League (AFL) players. Smaller size of 1 key trunk muscle, the lumbar multifidus (MF), has been associated with LBP and injuries in footballers. The size of the MF muscle has been shown to be modifiable with supervised motor-control training programs. Among AFL players, supervised motor-control training has also been shown to reduce the incidence of lower limb injuries and was associated with increased player availability for games. However, the effectiveness of a self-managed MF exercise program is unknown. To investigate the effect of self-managed exercises and fitness and strength training on MF muscle size in AFL players with or without current LBP. Cross-sectional study. Professional AFL context. Complete data were available for 242 players from 6 elite AFL clubs. Information related to the presence of LBP and history of injury was collected at the start of the preseason. At the end of the preseason, data were collected regarding performance of MF exercises as well as fitness and strength training. Ultrasound imaging of the MF muscle was conducted at the start and end of the preseason. Size of the MF muscles. An interaction effect was found between performance of MF exercises and time (F = 13.89, P ≤ .001). Retention of MF muscle size was greatest in players who practiced the MF exercises during the preseason (F = 4.77, P = .03). Increased adherence to fitness and strength training was associated with retained MF muscle size over the preseason (F = 5.35, P = .02). Increased adherence to a self-administered MF exercise program and to fitness and strength training was effective in maintaining the size of the MF muscle in the preseason.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Intervention(s):
Main Outcome Measure(s):
Results:
Conclusions:
Documenting patient care is an important responsibility of athletic trainers (ATs). However, little is known about ATs' reasons for documenting patient care and the mechanics of completing documentation tasks. To understand ATs' perceptions about reasons for and the mechanics of patient care documentation. Qualitative study. Individual telephone interviews with Athletic Training Practice-Based Research Network members. Ten ATs employed in the secondary school setting (age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) were recruited using a criterion-based sampling technique. Participants were Athletic Training Practice-Based Research Network members who used the Clinical Outcomes Research Education for Athletic Trainers electronic medical record system and practiced in 6 states. We used the consensual qualitative research tradition. One investigator conducted individual telephone interviews with each participant. Data collection was considered complete after the research team determined that data saturation was reached. Interviews were transcribed verbatim and independently analyzed by 4 research team members following the process of open, axial, and selective coding. After independently categorizing interview responses into categories and themes, the members of the research team developed a consensus codebook, reanalyzed all interviews, and came to a final agreement on the findings. Trustworthiness was established through multiple-analyst triangulation and member checking. Participants identified 3 reasons for documenting patient care: communication, monitoring patient care, and legal implications. Four subcategories emerged from the mechanics-of-documentation theme: location, time of day, length of time, and criteria for documenting. The ATs described different criteria for documenting patient care, ranging from documenting every injury in the same manner to documenting time-loss and follow-up injuries differently. Whereas ATs recognized individual mechanisms that enabled them to document patient care, they may need more guidance on the appropriate criteria for documenting various patient care encounters and strategies to help them document more effectively.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Data Collection and Analysis:
Results:
Conclusions:
For the practice characteristics of the services athletic trainers (ATs) provide to be identified, all ATs must complete high-quality patient care documentation. However, little is known about ATs' perceptions of patient care documentation or the potential barriers they may encounter while trying to ensure high-quality documentation. To explore ATs' perceptions of and barriers to patient care documentation via the Clinical Outcomes Research Education for Athletic Trainers (CORE-AT) electronic medical record system in the secondary school setting. Qualitative study. Individual telephone interviews. We interviewed 10 ATs (4 men, 6 women; age = 32.6 ± 11.4 years, athletic training experience = 7.1 ± 7.8 years) who were members of the Athletic Training Practice-Based Research Network (AT-PBRN) and employed in the secondary school setting. We conducted an individual interview with each participant. After transcription of the interviews, the data were analyzed into common themes and categories following the consensual qualitative research tradition. Data triangulation occurred through member checking and multiple researchers to ensure accuracy during data analysis. Participants revealed several perceptions of patient care documentation, consisting of quality, expectations and accountability, priority, incentive, and culture of the secondary school setting. In addition, we identified barriers to quality patient care documentation: lack of time, lack of accountability for documenting patient care, inadequate facility resources, and lack of personnel. Participants discussed the volume of patients as a unique challenge in the secondary school setting. Whereas ATs perceived patient care documentation as important, several practical barriers may inhibit their ability to complete high-quality documentation of the services they provide. Effective strategies to improve the quality of patient care documentation among ATs are needed to ensure that their value, particularly in the secondary school setting, is accurately characterized.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Data Collection and Analysis:
Results:
Conclusions:
Comprehensive, multidomain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury. Case-control study. High school and collegiate athletics. A total of 125 high school and college-aged athletes (85 males, 40 females) 14 to 23 (16.8 ± 2.21) years old. Participants were administered sideline concussion-assessment measures (ie, Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], Standardized Assessment of Concussion [SAC], and Balance Error Scoring System [BESS]) 24 to 48 hours postinjury and completed ImPACT and the Post-Concussion Symptom Scale 5 to 7 and 10 to 14 days postinjury. Outcome measures were the ImPACT composite (verbal memory, visual memory, reaction time, visual-motor speed), SAC, and BESS scores and total symptom score on the Post-Concussion Symptom Scale. Participants demonstrated heterogeneous patterns of impairment on measures 24 to 48 hours postinjury, with the most common pattern being impairment on ImPACT and the SAC. Performance on the SAC and BESS at 24 to 48 hours after injury did not distinguish between those with and those without impairment on ImPACT at 5 to 7 days postinjury (χ2 = 5.076, P = .079) or 10 to 14 days postinjury (χ2 = 2.04, P = .361). More than 90% of athletes were impaired on at least 1 sideline or neurocognitive measure 24 to 48 hours after sport-related concussion. Although sideline measures are useful for concussion diagnosis, they are not suitable for prognostication of impairment or the presence of symptoms 1 to 2 weeks postinjury.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusions:
Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes. To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes. Cross-sectional study. Survey. A total of 288 athletes across 7 sports (198 males [68.8%] and 90 females [31.2%]). A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure. A sex difference in total SRC symptom knowledge was found (F286 = 4.97, P = .03, d = 0.26). Female high school athletes had more total SRC symptom knowledge (mean ± standard deviation = 15.06 ± 2.63; 95% confidence interval = 14.54, 15.57) than males (14.36 ± 2.76; 95% confidence interval = 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC. High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusions:
Concussions in student-athletes are a serious problem. Most states have enacted legislation mandating concussion education for student-athletes, under the assumption that education leads to better self-reporting of concussions and improved knowledge of symptoms. (1) To determine the effect of state-based concussion legislation on the proportion of student-athletes receiving concussion education and to assess the moderation of this effect by gender and sport and (2) to assess the effect of concussion education on student-athletes' knowledge of concussion symptoms and likelihood of seeking treatment after a concussion. Cross-sectional study. Private university. A total of 249 National Association of Intercollegiate Athletics collegiate athletes attending St Xavier University; 160 were surveyed prelegislation and 89 were surveyed postlegislation. Participants completed an anonymous survey that assessed previous involvement in concussion-education programs, degree of self-reporting after a concussion, and ability to enumerate symptoms. The number of athletes who reported having received education increased after the implementation of concussion legislation; however, almost 25% still reported not having received education. Athletes who played football were more likely to report having received education than those who played volleyball. The student-athletes' ability to name a diversity of concussion symptoms or to report seeking medical attention after a concussion did not improve in the postlegislation period relative to the prelegislation period. Legislation has been passed in all 50 states to address concussions in student-athletes; however, improvements are still needed. Concussion education must be delivered in a uniform, effective manner to all student-athletes across sports and genders. Concussion education should emphasize the diversity of symptoms, especially cognitive and behavioral symptoms. We must develop and disseminate evidence-based educational programs that are clinically proven to be effective in improving athletes' knowledge and behaviors.Context:
Objectives:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusions:
Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries. To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009–2010 through 2014–2015 academic years. Descriptive epidemiology study. Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009–2010 through 2014–2015 academic years. Collegiate student-athletes participating in 11 sports. Ball-contact–injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009–2010 through 2014–2015 academic years. During the 2009–2010 through 2014–2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time <24 hours), and 6.6% were severe (ie, participation-restriction time ≥21 days). The most common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10). Ball-contact–injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although more than half were non–time-loss injuries, severe injuries such as concussions and fractures were reported.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusion:
Athletic trainers have the opportunity to treat unique populations. Determining athletes' satisfaction with the athletic training services supplied can offer insights into how to improve the health care provided to athletes. To explore Deaflympians' satisfaction with athletic training services at the 2013 Deaflympic Summer Games. Cross-sectional survey. The 2013 Deaflympic Summer Games in Sofia, Bulgaria. Of the 115 Deaflympians contacted, 55 completed the questionnaire, for a 48% response rate (women = 33, men = 22). The Medical Interview Satisfaction Survey–Athletic Training was used. The questionnaire gathered demographic data and included 25 Likert-scale items that assessed 6 components of athletic training. Descriptive statistics were calculated as normalized scores to adjust for the different numbers of questions for each item. On a 5-point scale, the scores ranged from 3.82 (management) to 4.24 (environment), with an overall satisfaction score of 3.89. We conducted comparison tests to assess possible differences in overall satisfaction and satisfaction components. Satisfaction with frequency of use of the athletic training room and knowledge were the only areas that showed statistically significant differences. Other differences were in perceptions of medical coverage among age groups and management between sexes. Satisfaction with the athletic training services provided was lower among these Deaflympians than among collegiate athletes in other studies. However, we observed no differences in overall satisfaction scores by age, sex, race, previous Deaflympic experience, or individual or team sport. Deaflympians who used and visited the athletic training facility more often had higher overall satisfaction scores than individuals who used and visited the facility less. Deaflympians were satisfied with the athletic training services provided at the 2013 Deaflympic Summer Games.Context:
Objective:
Design:
Setting:
Patients or Other Participants:
Main Outcome Measure(s):
Results:
Conclusions:
Reliability and Validity of the Functional Assessment of Neurocognition in Sport (FANS): A Paradigm Shift in Post-Concussion Return-to-Sport Decision-Making
Driving After Concussion: Clinical Measures Associated with Post-concussion
The role of shoulder posture in pitching mechanics and injury risk in high school baseball pitchers
Corticospinal Excitability during Standing and Its Association with Postural Control Following Acute Lateral Ankle Sprain.
The socio-economic cost of anterior cruciate ligament injuries and lateral ankle sprains in amateur football and basketball.
JAT eISSN: 1938-162X
JAT ISSN: 1062-6050
ATEJ ISSN: 1947-380X