The technical note of Lam et al1 on the pragmatic or point-of-care clinical trial (POC-CT) design offers valuable insights into a nascent area of research in athletic training. Although the authors did an excellent job detailing the role and advantages of and considerations for the POC-CT design in athletic training, the introduction of the POC-CT is a small component of a growing approach across health care using information from “real-world” encounters for evidence generation. This approach, known as Real-World Evidence (RWE), could lead to novel applications of health care delivery and evidence generation. This commentary is
Skip to main content
Issues
Issues
Select Issue
Clinical Research Methodology
ScD, ATC,
PhD, ATC,
PhD, ATC, FNATA, and
PhD
Recently, calls to conduct comparative effectiveness research (CER) in athletic training to better support patient care decisions have been circulated. Traditional research methods (eg, randomized controlled trials [RCTs], observational studies) may be ill suited for CER. Thus, innovative research methods are needed to support CER efforts. To discuss the limitations of traditional research designs in CER studies, describe a novel methodologic approach called the point-of-care clinical trial (POC-CT), and highlight components of the POC-CT (eg, incorporation of an electronic medical record [EMR], Bayesian adaptive feature) that allow investigators to conduct scientifically rigorous studies at the point of care. Practical concerns (eg, high costs and limited generalizability of RCTs, the inability to control for bias in observational studies) may stall CER efforts in athletic training. In short, the aim of the POC-CT is to embed a randomized pragmatic trial into routine care; thus, patients are randomized to minimize potential bias, but the study is conducted at the point of care to limit cost and improve the generalizability of the findings. Furthermore, the POC-CT uses an EMR to replace much of the infrastructure associated with a traditional RCT (eg, research team, patient and clinician reminders) and a Bayesian adaptive feature to help limit the number of patients needed for the study. Together, the EMR and Bayesian adaptive feature can improve the overall feasibility of the study and preserve the typical clinical experiences of the patient and clinician. The POC-CT includes the basic tenets of practice-based research because studies are conducted at the point of care, in real-life settings, and during routine clinical practice. If implemented effectively, the POC-CT can be seamlessly integrated into daily clinical practice, allowing investigators to establish patient-reported evidence that may be quickly applied to patient care decisions. This design appears to be a promising approach for CER investigations and may help establish a “learning health care system” in the sports medicine community.Context
Objectives
Description
Clinical Advantages
Hip
MS, ATC,
MS, AT, ATC, and
PhD, AT, ATC
Sport specialization is a popular trend among youth athletes that has been associated with an increased risk for developing lower extremity overuse injuries. Early ice hockey specialization may contribute to the high rates of noncontact and overuse hip and groin injuries in collegiate ice hockey athletes. To examine the effects of high, moderate, and low levels of sport specialization on subjective hip and groin dysfunction in collegiate ice hockey athletes. Retrospective cohort study. Data were collected during the midseason of the 2018–2019 hockey season at a local ice hockey arena. National Collegiate Athletic Association Division III and club ice hockey players from Midwestern college programs (n = 187; 81 women, 106 men). Participants were stratified into high-, moderate-, and low-specialization groups based on ice hockey participation before grade 9 of high school. The 6 subscales of the Hip and Groin Outcome Score questionnaire were used to assess current subjective hip and groin dysfunction. The high-specialization group had lower scores than the low-specialization group on the Symptoms (P = .001), Pain (P = .003), Activities of Daily Living (P = .001), Sport and Recreation (P = .014), and Quality of Life (P = .002) subscales. The moderate-specialization group had lower scores than the low-specialization group on the Symptoms (P = .015) and Activities of Daily Living (P = .006) subscales. Collegiate ice hockey athletes who were highly specialized before high school reported greater current hip and groin pain, symptoms, and dysfunction during activities of daily living and sport and recreation and lower current hip- and groin-related quality of life compared with low-specialization ice hockey athletes. Early ice hockey specialization may be detrimental to hip and groin function in collegiate ice hockey athletes.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
Knee
PhD, ATC,
PhD, ATC,
MD, and
PhD, PT
Persistent neuromuscular deficits in the surgical limb after anterior cruciate ligament reconstruction (ACLR) have been repeatedly described in the literature, yet little is known regarding their association with physical performance and patient-reported function. To describe (1) interlimb differences in neuromuscular and functional outcomes and (2) the associations of neuromuscular outcomes with measures of physical and knee-related patient-reported function. Cross-sectional study. Laboratory. Thirty individuals after primary, unilateral ACLR (19 males; age = 21.5 years [range, 14–41 years]; 8 months [range = 6–23 months] postsurgery). Knee-extensor isometric and isokinetic peak torque was measured with an isokinetic dynamometer. Cross-sectional area (CSA) was measured bilaterally for each of the quadriceps muscles via magnetic resonance imaging. We measured quadriceps central activation bilaterally via the superimposed-burst technique. Physical performance (single-legged hop tests, step length via spatiotemporal gait analysis) and patient-reported outcomes (International Knee Documentation Committee questionnaire and Knee Injury and Osteoarthritis Outcome Score Sport and Recreation subscale) were also recorded. We conducted Wilcoxon signed rank tests to identify interlimb differences. Spearman ρ correlation analyses revealed associations between limb symmetry and neuromuscular and functional outcomes, as well as with patient-reported function. Deficits in the surgical limb as compared with the nonsurgical limb were present for all outcomes (P values < .05). Greater single-legged hop-test symmetry (83%) was significantly correlated with greater symmetry in knee-extensor isometric (63%; rs = 0.567, P = .002) and isokinetic (68%; rs = 0.540, P = .003) strength, as well as greater cross-sectional area of the vastus medialis (78%; rs = 0.519, P = .006) and vastus lateralis (82%; rs = 0.752, P < .001). A higher International Knee Documentation Committee questionnaire score (82.2) was significantly correlated with greater symmetry in knee-extensor isokinetic strength (rs = 0.379, P = .039). Although deficits were observed in the surgical limb for all neuromuscular measures, greater symmetry in the size and strength of the quadriceps, rather than activation, was more strongly associated with physical performance after ACLR. Greater symmetry in strength was also more strongly associated with patient-reported function.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
MS,
MS,
MS,
BS,
PhD, ATC, and
PhD
Ultrasound imaging provides a cost-effective method of measuring quadriceps morphology, which may be related to self-reported function after anterior cruciate ligament reconstruction (ACLR). To compare quadriceps morphology and strength between limbs in individuals with ACLR and matched control limbs and determine their associations with self-reported function. Cross-sectional study. Research laboratory. Forty-two individuals with ACLR (females = 66%; age = 21.8 ± 2.6 years; time since ACLR = 50.5 ± 29.4 months) and 37 controls (females = 73%; age = 21.7 ± 1.2 years). Quadriceps peak torque (PT) and rate of torque development were assessed bilaterally. Ultrasonography was used to measure the cross-sectional area (CSA) and echo intensity (EI) of the rectus femoris, vastus lateralis (VL), and vastus medialis. Self-reported function was assessed via the International Knee Documentation Committee (IKDC) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales. Paired-samples t tests were calculated to compare involved and uninvolved limbs. Independent t tests were conducted to compare groups (α = .05). Linear regression was performed to analyze associations between quadriceps function and self-reported function after accounting for time since ACLR, activity level, and sex, and models for EI added subcutaneous fat as a covariate. Isometric PT did not differ between limbs or groups. Involved limbs had a lower rate of torque development compared with the control (P = .01) but not the uninvolved limbs (P = .08). Vastus lateralis CSA was smaller in the involved than in the uninvolved (P < .01) but not the control limbs (P = .10). Larger VL CSA (ΔR2 = 0.103) and lower VL EI (ΔR2 = 0.076) were associated with a higher IKDC score (P < .05). Larger VL CSA was associated with greater KOOS Symptoms (ΔR2 = 0.09, P = .043) and Sport and Recreation (ΔR2 = 0.125, P = .014) scores. Lower VL EI was associated with higher KOOS Symptoms (ΔR2 = 0.104, P = .03) and Quality of Life (ΔR2 = 0.113, P = .01) scores. Quadriceps PT and rate of torque development were not associated with IKDC or KOOS subscale scores. Quadriceps morphology was associated with self-reported function in individuals with ACLR and may provide unique assessments of quadriceps function.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
PhD, ATC,
PhD, ATC, FNATA,
PhD, ATC, FNATA, FACSM,
PhD, and
PhD, PT, ATC, FNATA
Increased frontal-plane knee motion during functional tasks, or medial knee displacement, is a predictor of noncontact anterior cruciate ligament injury and patellofemoral pain. Intervention studies that resulted in a reduced risk of knee injury included some form of feedback to address aberrant lower extremity movement patterns. Research on integrating feedback into single-legged tasks and the ability to train 1 task and test another is limited. To determine if adding real-time visual biofeedback to common lower extremity exercises would improve single-legged landing mechanics in females with medial knee displacement. Cohort study. University laboratory. Twenty-four recreationally active females with medial knee displacement were randomized to a visual-biofeedback group (n = 12; age = 19.75 ± 0.87 years, height = 165.32 ± 8.69 cm, mass = 62.41 ± 8.91 kg) or a control group (n = 12; age = 19.75 ± 0.97 years, height = 166.98 ± 6.89 cm, mass = 59.98 ± 6.24 kg). Individuals in the feedback group viewed a real-time digital model of their body segments generated by Microsoft Kinect. The skeletal model changed color according to the knee-abduction angle of the test limb during the exercise tasks. Participants completed 3 trials of the single-legged drop vertical jump (SL-DVJ) while triplanar kinematics at the trunk, hip, knee, and ankle were collected via 3-dimensional motion capture. The feedback and control groups completed lower extremity exercises with or without real-time visual biofeedback, respectively. After the intervention, participants completed 3 additional trials of the SL-DVJ. At baseline, the feedback group had 3.83° more ankle eversion than the control group after initial contact. After the intervention, the feedback group exhibited 13.03° more knee flexion during the flight phase of the SL-DVJ and 6.16° less knee abduction after initial contact than the control group. The feedback group also demonstrated a 3.02° decrease in peak knee-abduction excursion compared with the baseline values (P = .008). Real-time visual biofeedback immediately improved faulty lower extremity kinematics related to knee-injury risk. Individuals with medial knee displacement adjusted their movement patterns after a single training session and reduced their medial knee motion during a dynamic task.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
Shoulder
MS, PT,
PhD, PT,
BS, PT,
BS, PT,
MD,
PhD, PT,
MS, PT, and
PhD, PT
Subacromial impingement syndrome (SIS) is associated with scapular dyskinesis, or imbalanced scapular muscle activity. Evidence has shown that feedback can improve scapular control in patients with SIS. However, it is unknown whether real-time video feedback or electromyography (EMG) biofeedback is optimal for improving scapular kinematics and muscle activity during a functional task. To compare the effects of video and EMG feedback sessions on absolute muscle activity (upper trapezius [UT], lower trapezius [LT], serratus anterior), muscle balance ratios (UT/LT, UT/serratus anterior), and scapular kinematics (anterior-posterior tilt, external-internal rotation, upward rotation) in SIS participants during arm elevation and lowering. Randomized controlled clinical trial. Research laboratory. Overhead athletes who were diagnosed with SIS and who also exhibited scapular dyskinesis (N = 41). Three-dimensional kinematics and EMG were recorded before and after feedback training. Lower trapezius muscle activity increased (4.2%–18%, P < .011) and UT/LT decreased (0.56–1.17, P < .013) in the EMG biofeedback training group as compared with those in the video feedback training group. Scapular upward rotation during arm elevation was higher in the video group than in the EMG group after feedback training (2.3°, P = .024). The EMG biofeedback improved muscle control and video feedback improved the correction of scapular upward rotation in patients with SIS. ClinicalTrials.gov: NCT03252444.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
Trial Registration Number
PT,
PT,
PT,
PT, and
PhD, PT
The shoulder joint and girdle are highly loaded during field hockey play. To optimize performance and to better substantiate preventive programs, it is important to gain insight into shoulder-girdle muscle function and balance in this athlete population. To evaluate relative scapular muscle-activity ratios through surface electromyography during maximal isokinetic strength testing in elite male field hockey players compared with nonathletes. Cross-sectional study. Institutional laboratory. Twenty-five elite field hockey players from the Belgian National Team and 25 age- and sex-matched nonathletes. We measured bilateral activity in 4 scapular muscles (upper trapezius [UT], middle trapezius [MT], lower trapezius [LT], and serratus anterior [SA]) during an external-internal rotation and protraction-retraction isokinetic shoulder protocol. Relative scapular muscle-activity ratios, or balance ratios, of the UT : MT, UT : LT, UT : SA, SA : MT, and SA : LT. We noted lower ratios bilaterally in the athlete group compared with the control group for the UT : MT, UT : LT, and SA : MT ratios during protraction, retraction, and external rotation, respectively, and unilaterally (dominant side only) for the UT : LT ratio during protraction. No consistent trend was present for established side differences in the studied balance ratios. Compared with nonathletes, elite field hockey players had altered intramuscular (within the trapezius) and intermuscular (between the trapezius and SA) balance ratios during maximal shoulder-girdle contractions, with relatively more MT and LT activity. This may reflect a sport-specific adaptation to optimize coordinated activity of the scapulothoracic muscles, meeting the specific demands of field hockey movements and simultaneously better protecting the shoulder against injury. Our results can assist in optimizing high-performance training and in supporting injury-prevention programs, which are key to both successful and long-lasting athletic careers.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
Spine
PhD, ATC,
DC, PhD,
DSc, PT, OCS,
MS, ATC, and
PhD
Neck pain (NP), neck injuries, and concussions are more prevalent in female athletes than in their male counterparts. Females exhibit less neck girth, strength, and stiffness against a perturbation. As part of the clinical examination for individuals with NP, ultrasound (US)–based imaging of the cervical muscles has become common. Muscle size or thickness and stiffness can be measured with US-based B-mode and shear-wave elastography (SWE), respectively. Information on reliability, normative values, and sex differences based on US-based muscle size or thickness and stiffness in young and athletic individuals is limited. To evaluate sex differences in US-based muscle size or thickness and biomechanical properties of the cervical-flexor and -extensor muscles. Cross-sectional study. Laboratory. A total of 13 women (age = 23.7 ± 1.9 years, height = 167.1 ± 6.1 cm, mass = 63.8 ± 5.6 kg) and 11 men (age = 25.6 ± 4.9 years, height = 178.7 ± 8.3 cm, mass = 78.9 ± 12.0 kg). The same examiner collected all measures, using US B-mode to scan the cross-sectional area and thickness of the longus colli (LC), sternocleidomastoid (SCM), cervical-extensor muscles, and upper trapezius (UT) muscle. The US SWE-mode was used to measure the stiffness of the SCM and UT. Independent t tests or Mann-Whitney U tests were calculated to determine sex differences. The intraclass correlation coefficient (ICC) measured intrarater test-retest reliability. Men had thicker SCMs than women (P = .01). No sex differences were present for longus colli cross-sectional area, cervical-extensor muscle thickness, or UT thickness (P > .05). In addition, no sex differences were evident for SCM (P = .302) or UT (P = .703) SWE stiffness. Reliability was good to excellent (ICC = 0.715–0.890) except for SCM SWE stiffness (ICC = 0.554). The only sex difference was in SCM thickness. However, smaller SCMs in women did not result in less SCM SWE stiffness. We provided normative values for US-based imaging of the cervical-flexor and -extensor muscles in young and athletic men and women.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
Exertional Heat Illness
MD,
MD,
MD,
MD,
PhD,
PhD, and
PhD
Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants after either EHS or other EHI who were tested earlier (≤6-week group) versus those who were tested later (>6-week group) to verify the hypothesis. Cohort study. Data obtained from records of military athletes who experienced EHS or EHI. All participants who underwent HTT after EHI or EHS experienced between 2014 and 2018 and for whom complete data regarding the severity of the event (rectal temperature, neurologic symptoms, and laboratory results) and HTT results were available were included. Participants with suspected EHS and those with other EHIs were evaluated separately. The percentages of participants with HI and mean probability of heat tolerance were compared between those tested within 6 weeks of the event and those tested later. A total of 186 participants were included in this study (EHS: 12 in the <6-week group, 9 in the >6-week group; EHI: 94 in the <6-week group, 71 in the >6-week group). In the EHS group, the percentages with HI (33% versus 44%, P = .67) and mean probability of heat tolerance (0.82 versus 0.82, P = .98) did not differ. In the EHI group, participants who were tested after 6 weeks had a greater chance of being diagnosed with HI (38% versus 21.3%, P < .02) The HTT results were similar between participants with EHS who were tested early (<6 weeks) and those tested late (>6 weeks). Further investigation of heat-tolerance changes in larger cohorts of patients after EHS is required to verify the theory of transient HI.Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
Injury Epidemiology
MSc, PT,
MSc, PT, and
PhD, PT
Despite the popularity of soccer at the male first-division youth level, data on the incidence of injuries in Brazil are limited. To prospectively study the injury profile of male first-division youth soccer players during 1 season (January to December 2017). Descriptive epidemiology study. Data compiled at a youth soccer academy. The study involved 228 players between 10 and 20 years old from a first-division Brazilian soccer academy. Injury incidence rate was reported as the number of injuries divided by overall exposure (training and match hours) multiplied by 1000. The rate ratio (injury incidence rate during matches in relation to training) was also calculated. Time-loss injuries (ie, physical complaints sustained during soccer matches or training that resulted in a player being unable to take part in soccer training or match play) during the season were recorded. A total of 187 injuries were documented in 122 players (65.2%). During the season, 100 389 hours of exposure (5995 hours of match play and 94 394 of training) were registered. The overall injury incidence rate was 1.86 per 1000 hours. In total, 4792 days were lost from soccer activities. The majority of injuries were noncontact thigh muscle disorders and ankle sprains. Injury incidence was greater in matches than in training, and the oldest age group (under 20 years old) had the highest injury incidence rate in matches, while the under 17-year-old group had the highest injury incidence rate in training sessions (22.48 and 3.05 per 1000 hours, respectively). Muscle injury incidence rates observed among Brazilian soccer athletes under 20 years old were similar to those reported in professional players. Preventive measures are recommended to reduce injury rates. Additionally, the number of injuries incurred during training was high compared with match play, and training programs need to be assessed so that injury prevention can be improved.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
Professional Concerns
PhD, ATC,
PhD, ATC, and
PhD, ATC, FNATA
Organizational conflict, particularly between coaches and medical professionals, has been reported in collegiate athletics. Different values create room for conflict between coaches and athletic trainers (ATs); however, ATs' experiences when making medical decisions are not fully understood. To investigate the presence of organizational conflict regarding medical decision making and determine if differences exist across athletic affiliations. Cross-sectional study. Collegiate athletics (National Collegiate Athletic Association [NCAA], National Association of Intercollegiate Athletics [NAIA], National Junior College Athletic Association [NJCAA]). A total of 434 ATs responded (age = 27.7 ± 3.2 years, years certified = 5.2 ± 2.7), representing the NCAA Division I (DI; n = 199), Division II (DII; n = 67), Division III (DIII; n = 108); NAIA (n = 37); and NJCAA (n = 23) settings. The survey instrument contained quantitative measures and open-ended questions, with affiliation as our primary independent variable. Responses to Likert-scale questions (1 = strongly agree, 5 = strongly disagree) regarding organizational pressures within athletics served as the dependent variables. Kruskal-Wallis analysis-of-variance and Mann-Whitney U post hoc tests assessed differences in organizational conflict across affiliations. Open-ended questions were analyzed inductively. We obtained a 14.47% (434 of 3000) response rate. National Collegiate Athletic Association DI ATs disagreed less than NCAA DII and DIII and NJCAA ATs that they would worry about job security if turnover in the head coaching position occurred (P < .05). Regarding the influence of coaches on job performance, differences were found between NCAA DI and DIII and between DI and NJCAA ATs (P < .01). Visibility of the injury and situational factors influenced the level of perceived pressure. Athletic trainers perceived pressure from coaches regarding medical decision making. Division I ATs placed greater emphasis on the role that coaches played in their job performance and job security. Athletic departments should consider transitioning to patient-centered models of care to better align values and reduce the external pressures placed on ATs.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
PhD, ATC,
PhD, ATC, FNATA,
PhD, ATC, and
PhD, LAT, ATC
Conflict between athletic trainers (ATs) and other stakeholders can occur because of competing interests over medical decisions regarding concussion. However, we are unaware of any studies specifically exploring these situations across various collegiate athletic affiliations. To investigate the challenges faced by ATs when treating concussed student-athletes. Qualitative study. Online questionnaire. A total of 434 ATs (267 women, 166 men, 1 missing data; age = 27.73 ± 3.24 years, experience = 5.17 ± 2.67 years) completed the questionnaire (response rate = 14.47%). Our participants represented multiple employment settings within intercollegiate athletics. We sent an online questionnaire to 3000 ATs working in the collegiate and university setting across the United States. A survey expert verified face, content, and construct validity of the questionnaire in 2 rounds of review, and 3 ATs completed a content-validity tool before we finalized the survey. We analyzed the qualitative data using a general inductive approach and ensured trustworthiness through multiple-analyst triangulation and peer review. When we examined the responses from our participants regarding their work with student-athletes who had sustained concussions, we found 2 major themes, each with subthemes. First, educational efforts appeared to be only modestly effective because of a lack of honesty, noncompliant actions, and coach interference. Second, return to learn was challenging because of a lack of communication among stakeholders, athletes being anxious about needing accommodations, and difficulty convincing faculty to provide reasonable accommodations. Based on our findings, we recommend continued efforts to improve the culture surrounding concussion in collegiate athletes. Athletic trainers should include key stakeholders such as coaches, student-athletes, parents, faculty, and other educational administrators in their educational efforts to improve the policies and culture surrounding concussion treatment.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
Thank You to Reviewers
We thank our 2019 manuscript reviewers for their hard work and dedication. We also thank retiring Editorial Board members Christopher M. Bailey, PhD; Daniel A. Judelson, PhD; and David I. Swedler, PhD, MPH, for their many years of service. Thomas E. Abdenour, DHSc, ATC Anna Abramson, MD John P. Abt, PhD, ATC Shellie Acocello, PhD, ATC J. D. Adams, PhD Julie Agel, MA, ATC Arnel Aguinaldo, PhD, ATC Kazuma Akehi, PhD, LAT, ATC Bara Alsalaheen, PhD, PT Yong Woo An, PhD, ATC J. C. Andersen, PhD, PT, AT Cortney N. Armitano, MS William J. Armstrong, PhD Amanda J. Arnold,
Reliability and Validity of the Functional Assessment of Neurocognition in Sport (FANS): A Paradigm Shift in Post-Concussion Return-to-Sport Decision-Making
Landon B. LempkePhD, ATC,
Benjamin L. BrettPhD, and
Douglas P. TerryPhD,ABPP
Driving After Concussion: Clinical Measures Associated with Post-concussion
Kumiko Hashida,
Julia Drattell,
Kim Love,
Robert C. Lynall,
Russell K. Gore,
Hannes Devos, and
Julianne D. Schmidt
The role of shoulder posture in pitching mechanics and injury risk in high school baseball pitchers
Yi-Hsuan WengPT, MS,
Tsun-Shun HuangPT, PhD, and
Jiu-Jenq LinPT, PhD
Corticospinal Excitability during Standing and Its Association with Postural Control Following Acute Lateral Ankle Sprain.
Joosung Kim,
Arlette C. Perry,
Kevin A. Jacobs,
Brian Arwari,
Soyeon Ahn, and
Kyung-Min Kim
The socio-economic cost of anterior cruciate ligament injuries and lateral ankle sprains in amateur football and basketball.
Nikki RommersPT PhD,
Lieselot LongéPT MSc,
Winnie DebeckerPT MSc,
Nikie PeetersPT MSc,
Bruno TassignonPT PhD,
Eva HuysmansPT PhD,
Koen PutmanPT PhD,
Johan VanlauweMD PhD,
David BeckwéePT PhD,
Nicky Van MelickPT PhD, and
Christophe EechautePT PhD
JAT eISSN: 1938-162X
JAT ISSN: 1062-6050
ATEJ ISSN: 1947-380X
Powered by PubFactory