The literary development of every age has its peculiarities, the circumstance most characteristic of the present time, is the superior distinction, relatively, which women have acquired in some of the most brilliant departments of authorship. . . . The causes of this honourable peculiarity of our own days, like most other changes in society, would probably be found to lie among influences which are so subtle as to elude inquiry. It is obvious, however, that there has been, through two centuries, a progressive advance in the relation which the female sex has held to the intellectual condition of the race,
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EDITORIALS
PhD, ATC,
PhD, ATC,
PhD, LAT, ATC, and
PhD, ATC
PhD, ATC and
PhD, ATC
The Journal of Athletic Training welcomes this opportunity to highlight the research of women scholars in athletic training. Women entered the profession and became certified as early as 1971, yet it was not until 15 years later that women scholars in athletic training began to emerge. Although it was difficult for us to do an exhaustive search of available records, from what we could find, the earliest research by female athletic training scholars was published in 1986. This was shortly before an article entitled “Research in Athletic Training: The Missing Ingredient” appeared in the fall 1988 issue of
PROFESSIONAL CONCERNS
PhD, ATC,
PhD, ATC,
MSAT, ATC,
PhD, LAT, ATC,
PhD, ATC, and
PhD, ATC
The doctor of athletic training (DAT) degree has recently been introduced into academe. Limited literature exists regarding how individuals with this degree can become part of an athletic training faculty. To identify department chairs' perceptions of the DAT degree and determine whether they viewed the degree as viable when hiring new faculty within a postbaccalaureate professional athletic training program. Cross-sectional study. Online survey instrument. A total of 376 department chairs who had oversight of Commission on Accreditation of Athletic Training Education athletic training programs were invited to participate. Of these, 190 individuals (50.5%) accessed the survey, and 151 of the 190 department chairs (79.5%) completed all parts of the survey. A web-based survey instrument consisted of several demographic questions and 4-point Likert-scale items related to perceptions of the DAT degree. Independent variables were degree qualifications, advanced degree requirements, institutional control, student enrollment, current faculty with a clinical doctorate, and institutional degree-granting classification. The dependent variables were the department chairs' responses to the survey items. More than 80% of department chairs were moderately or extremely familiar with the concept of an advanced practice doctoral degree, and 64% believed it would be extremely to moderately beneficial to hire someone with this degree in the athletic training program. Furthermore, 67% of department chairs were very likely or likely to hire someone with a DAT degree and expected they would do so in the next 5 years. Characteristics associated with higher perception scores were lower institutional student enrollment, having more current faculty with an advanced practice doctoral degree, and a lower institutional degree-granting classification. Department chairs recognized the DAT degree as a viable degree qualification for teaching in professional athletic training programs. Future researchers should examine the need for athletic trainers with the DAT degree in clinical practice settings.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
PhD, ATC,
PhD, ATC, and
PhD, ATC
Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition. To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs. Qualitative study. Individual phone interviews. A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, and obtained employment from July through August 2016 participated in this study (6 women, 7 men; age = 26 ± 3 years; work settings included professional sports, college, secondary and middle school, and clinic). Data saturation guided the number of participants. Phone interviews using a semistructured interview guide were conducted at 3, 8, and 12 months of work experience. Data were analyzed using a constant comparative approach. Credibility was established via investigator triangulation, peer debriefing, and member checks. Participants recognized the mentoring relationship as a foundational aspect of the transition to practice. Mentors should be available by phone, email, or text to answer questions, provide feedback, or discuss ideas. Respondents wanted honest feedback, even when that feedback was constructively critical. Feedback was sought regarding topics such as patient care, communication, and networking. Participants needed reassurance and support from their mentors to help validate and improve their self-confidence. Newly credentialed ATs should seek mentors who will be available to communicate in various ways and will provide regular and constructive feedback. Future researchers should investigate how mentoring relationships influence other aspects of the transition to practice, such as patient care, overall job performance, turnover, and satisfaction.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
PhD, ATC,
MS, MSHA, ATC, NREMT, and
PhD, ATC
DOI: 10.4085/152-20
The literature in athletic training has consistently demonstrated evidence of work-family-life conflict and the potential consequences of that conflict among athletic trainers (ATs) employed in the clinical setting. Parental responsibilities have been suggested to increase the conflict among work, family, and life. The emotions that occur because of this conflict have received little attention and warrant further study. To investigate perceptions and antecedents of work-family guilt (WFG) among secondary school ATs with children. Phenomenological qualitative study. Secondary schools. Twenty (13 women, 7 men) ATs with children (range = 1–3) employed in the secondary school setting. All but 3 were married (n = 17) at the time of the study. Their average age was 37 ± 11 years, and they were certified as ATs for 14 ± 11 years. Participants completed one-on-one semistructured phone interviews. Multiple-analyst triangulation and peer review were used to establish data credibility. General inductive analysis revealed that men and women participants experienced feelings of WFG despite having supportive work environments. The guilt for both sexes stemmed from work interfering with family and an altruistic mindset. Women indicated they felt pressure from their husbands that contributed to feelings of guilt. Secondary school ATs experienced WFG. Trying to balance parental and athletic training duties can cause an emotional response, and ATs' giving and caring nature may be a precursor to guilt.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
EdD, ATC,
PhD, ATC, and
PhD, ATC
The documentation practices of athletic trainers (ATs) employed in the secondary school setting, including their strategies for, barriers to, and perceptions of documentation, have been characterized in previous research. The documentation practices of ATs employed in other settings have yet to be studied in depth. To examine the documentation practices of ATs employed in the clinic, physician practice, and emerging clinical settings. Qualitative study. Web-based interviews. A total of 22 ATs: 11 employed in the clinic or physician practice setting and 11 employed in an emerging clinical setting. The ATs employed in the settings of interest were recruited with purposeful, convenience, and snowball sampling. Participants were interviewed using a Web-based platform so that we could learn about their behaviors and perceptions of documentation. Data were analyzed using the consensual qualitative research approach, followed by a thematic analysis. Trustworthiness was addressed using data source triangulation, multiple-analyst triangulation, and an established interview guide and codebook. Participants described following clear guidelines for documentation established by regulatory agencies, employers, and electronic medical record templates. They were motivated to document for patient safety and to demonstrate value. Participants typically documented in real time and continuously, which was facilitated by employer requirements. The ATs described experiencing a learning curve for documentation due to the unique requirements of their settings, but learning was facilitated by employer guidance and mentorship. Employer guidelines, training, and ongoing support facilitated effective and thorough documentation in these clinical settings. Athletic trainers and employers in a variety of settings should consider establishing clear guidelines to promote thorough and effective documentation.Context
Objective
Design
Setting
Patients or Other Participants
Data Collection and Analysis
Results
Conclusions
PhD, LAT, ATC,
PhD, SCAT, ATC,
DAT, LAT, ATC,
DAT, AT, ATC,
MS, LAT, ATC, and
PhD, ATC
Previous researchers have indicated that athletic trainers (ATs) had a favorable view of treating transgender patients, yet the ATs did not perceive themselves as competent in their patient care knowledge or abilities. To gain more in-depth information about ATs' knowledge and experiences regarding the health care needs of transgender student-athletes. Mixed-methods study. Individual, semistructured follow-up interviews. Fifteen ATs (4 men, 10 women, 1 transgender female; age = 34 ± 9 years, experience = 11 ± 8 years) who took part in a cross-sectional survey in April 2018. The interviews were audio recorded and transcribed verbatim. Member checking was completed to ensure trustworthiness of the data. Next, the data were analyzed via a multiphase process and 3-member coding team who followed the consensual qualitative research tradition. The coding team analyzed the transcripts for domains and categories. The final consensus codebook and coded transcripts were audited by a member of the research team for credibility. Four main domains were identified: (1) perceived deficiencies, (2) misconceptions, (3) concerns, and (4) creating safety. Participants described knowledge deficiencies in themselves, health care providers within their units, and providers able to provide safe transition care. The ATs demonstrated misconceptions when defining transgender and transitioning and when describing how the body responds to hormone replacement therapy. They expressed concern for the mental health and wellness, self-image, and potential cost of transgender health care for transgender student-athletes. However, participants also described efforts to create safety within their units by validating transgender patients, instilling trust, adjusting the physical environment, and engaging in professional development to improve their knowledge. Athletic trainers wanted to create a safe space for transgender student-athletes but lacked the necessary knowledge to treat transgender patients. Professional resources to improve their knowledge, skills, and abilities in caring for transgender patients are a continuing need.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
LOWER EXTREMITY
MS, ATC,
PhD, ATC,
PhD, ATC, and
PhD, ATC
DOI: 10.4085/197-20
Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a possible cause of recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics, leading to research efforts to determine if real-time external biofeedback can result in changes. To determine the real-time effects of visual and auditory biofeedback on functional-task biomechanics in individuals with CAI. Crossover study. Laboratory. Nineteen physically active adults with CAI (7 men, 12 women; age = 23.95 ± 5.52 years, height = 168.87 ± 6.94 cm, mass = 74.74 ± 15.41 kg). Participants randomly performed single-limb static balance, step downs, lateral hops, and forward lunges during a baseline and 2 biofeedback conditions. Visual biofeedback was given through a crossline laser secured to the dorsum of the foot. Auditory biofeedback was given through a pressure sensor placed under the lateral foot and connected to a buzzer that elicited a noise when pressure exceeded the set threshold. Cues provided during the biofeedback conditions were used to promote proper biomechanics during each task. We measured the location of center-of-pressure (COP) data points during balance with eyes open and eyes closed for each condition. Plantar pressure in the lateral column of the foot during functional tasks was extracted. Secondary outcomes of interest were COP area and velocity, time to boundary during static balance, and additional plantar-pressure measures. Both biofeedback conditions reduced COP in the anterolateral quadrant while increasing COP in the posteromedial quadrant of the foot during eyes-open balance. Visual biofeedback increased lateral heel pressure and the lateral heel and midfoot pressure-time integral during hops. The auditory condition produced similar changes during the eyes-closed trials. Auditory biofeedback increased heel pressure during step downs and decreased the lateral forefoot pressure-time integral during lunges. Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appeared to effectively moderate different functional-task biomechanics.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
MS,
MS,
PhD, ATC,
PhD, ATC, and
PhD, ATC
Researchers have traditionally used motion capture to quantify discrete data points (peak values) during hop testing. However, these analyses restrict the evaluation to a single time point (ie, certain percentage of stance) and provide only a narrow view of movement. Applying more comprehensive analyses may help investigators identify important characteristics that are masked by discrete analyses often used to screen patients for activity. To examine the utility of functional data analyses to reveal asymmetries that are undetectable using discrete (ie, single time point) evaluations in participants with a history of anterior cruciate ligament reconstruction (ACLR) who achieved clinical hop symmetry. Cross-sectional study. Laboratory. Fifteen participants with unilateral ACLR (age = 21 ± 3 years, time from surgery = 4 ± 3 years) and 15 control participants without ACLR (age = 23 ± 2 years). Lower extremity biomechanics during the triple–hop-for-distance task for the ACLR and contralateral limbs of patients and a representative limb of control participants were measured. Peak sagittal-plane joint power, joint work, and power profiles were determined. Using discrete analyses, we identified lower peak knee power and work in the ACLR limb compared with the contralateral and control limbs (P < .05) but were unable to demonstrate differences at the ankle or hip. Using functional data analyses, we observed asymmetries at the ankle, knee, and hip between the ACLR and contralateral or control limbs throughout stance (P < .05), and it was revealed that these asymmetries stemmed from knee power deficits that were prominent during early loading. Despite achieving hop-distance symmetry, the ACLR knees absorbed less power. Although this information was revealed using discrete analyses, underlying asymmetries at the ankle and hip were masked. Using functional data analyses, we found interlimb asymmetries at the ankle, knee, and hip. Importantly, we found that functional data analyses more fully elucidated the extent and source of asymmetries, which can be used by clinicians and researchers alike to aid in clinical decision making.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
PhD, LAT, ATC, CES,
MS, CSCS,
BSc,
PhD, CSCS, EP-C,
MS, and
MS, CSCS
Inadequate hip range of motion (ROM) and isometric strength (ISO) may interfere with energy flow through the kinetic chain and result in increased injury susceptibility. To examine the relationship of hip ROM and ISO with energy flow through the trunk and pitching-arm segments during the windmill softball pitch in youth athletes. A subsequent purpose was to examine the relationship between energy flow and pitch speed. Descriptive laboratory study. University research laboratory. A sample of 29 youth softball pitchers (age = 11.2 ± 1.3 years, height = 155.0 ± 10.4 cm, mass = 53.2 ± 12.6 kg). Bilateral hip internal-rotation and external-rotation (ER) ROM and ISO were measured. Net energy outflow and peak rates of energy outflow from the distal ends of the trunk, humerus, and forearm were calculated for the acceleration phase of the windmill softball pitch, and pitch speed was measured. Regression analysis revealed an effect of drive-hip ER ISO on the net energy flow out of the distal ends of the trunk (P = .045) and humerus (P = .002). Specifically, increased drive-hip ER ISO was associated with increased net energy outflow from the trunk to the humerus and from the humerus to the forearm. No significant effects of hip ROM or other hip ISO measures were observed. Additionally, pitchers who achieved higher peak rates of distal outflow tended to achieve higher pitch speeds. An association was present between drive-hip ER ISO and the net energy flow out of the distal ends of the trunk and humerus during the acceleration phase of the windmill softball pitch, emphasizing the importance of hip and lower body strength in executing the whole-body windmill pitch. Overall, energy-flow analysis is an interesting new way to analyze pitching mechanics and will aid in furthering our understanding of performance and injury risk in windmill softball pitching.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
CONCUSSION
PhD, ATC,
PhD, ATC,
PhD, LAT, ATC, and
PhD, MPH, LAT, ATC
Understanding time loss resulting from sport-related concussion (SRC) within individual sports allows high school athletic trainers to provide accurate and evidence-based clinical information. Currently, research regarding patterns of clinical recovery outcomes in high school student-athletes across sports is lacking. To describe the time to authorized unrestricted return to participation (RTP) after SRC in a large cohort of high school student-athletes in a variety of sports using a time-to-event analysis. Descriptive epidemiology study. Aggregate injury and player exposure data from the Michigan High School Athletic Association Head Injury Reporting System. High school student-athletes. Dates for SRC injury events and authorized unrestricted RTP were entered into the Head Injury Reporting System for each case and were used to calculate time to unrestricted RTP. Survival analysis indicated the time to authorized RTP for males and females in weekly increments across sports and academic years. Separate Kaplan-Meier analyses adjusted for SRC cases with a history of concussion also identified the proportions of student-athletes who obtained authorized medical clearance in weekly increments. A total of 15 821 SRCs, 10 375 (65.6%) in males and 5446 (34.4%) in females, were reported during the 2015–2016 through 2018–2019 academic years. The median time to authorized unrestricted RTP was 11 days for all patients. Approximately 30% of concussed student-athletes were not cleared for unrestricted RTP by 14 days after their SRC diagnosis, with 13% taking longer than 21 days to return to unrestricted RTP after SRC. The results from this multisite, state-based injury surveillance system indicated that it is not abnormal for high school student-athletes to take longer than 14 days to fully recover from an SRC. This information may be useful for educating high school student-athletes and sport stakeholders, normalizing SRC recovery trajectory perceptions, and establishing realistic RTP timeline expectations.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
MS,
PhD, LAT, ATC,
PhD, MPH,
BA,
ScD,
PhD,
MPH,
PhD,
PhD, ATC,
PhD, MPH, ATC, and
PhD, LAT, ATC
Limited data exist concerning differences in concussion-education exposure and how education exposures relate to care seeking and symptom disclosure, specifically by National Collegiate Athletic Association Division I student-athletes. To investigate demographic characteristics associated with concussion-education exposure and examine whether overall education exposure (yes versus no) and education-source exposure number (multiple sources versus a single source) affect concussion care-seeking and disclosure factors in Division I student-athletes. Cross-sectional study. Classroom or online survey. Division I student-athletes (n = 341). Frequencies and proportions were computed for sex, race, school year, sport, and concussion history across concussion-education groups. Prevalence ratios (PRs) and 95% CIs were calculated to quantify the associations between student-athlete characteristics and (1) overall concussion-education exposure and (2) source-exposure number. Separate multivariable linear regression models estimated adjusted mean differences (MDs) and 95% CIs, which allowed us to assess differences in concussion knowledge, attitudes, and perceived social norms relative to concussion-education exposure and exposure to multiple sources. Separate multivariable binomial regression models were performed to estimate adjusted PRs and 95% CIs in order to evaluate associations of intention, perceived control, and care-seeking or disclosure behaviors and overall concussion-education exposure and exposure to multiple sources. All models controlled for sex, sport, and concussion history. Overall, 276 (80.9%) participants reported previous concussion education, with 179 (64.9%) being exposed to multiple sources. Student-athletes who participated in a contact sport (adjusted PR = 1.24; 95% CI = 1.06, 1.44) and those who had a concussion history (adjusted PR = 1.19; 95% CI = 1.09, 1.31) had higher prevalences of concussion-education exposure. Females had a lower prevalence of reporting multiple sources (adjusted PR = 0.82; 95% CI = 0.68, 0.99). Overall concussion-education exposure was significantly associated with more favorable perceived social norms surrounding concussion care seeking (adjusted MD = 1.37; 95% CI = 0.13, 2.61). These findings highlighted the potential differences in overall concussion-education exposure and provide clinicians with information on groups who may benefit from additional targeted education.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
THERMOREGULATION & ENERGY EXPENDITURE
PhD, ATC,
PhD, ATC,
PhD, ATC,
MS, ATC,
MS, ATC,
MS, ATC,
MS, ATC,
MS, ATC, NREMT, and
DMA
To our knowledge, no researchers have investigated thermoregulatory responses and exertional heat illness (EHI) risk factors in marching band (MB) artists performing physical activity in high environmental temperatures. To examine core temperature (Tc) and EHI risk factors in MB artists. Descriptive epidemiology study. Three rehearsals and 2 football games for 2 National Collegiate Athletic Association Division I institution's MBs. Nineteen volunteers (females = 13, males = 6; age = 20.5 ± 0.9 years, height = 165.1 ± 7.1 cm, mass = 75.0 ± 19.1 kg) completed the study. We measured Tc, wet bulb globe temperature, and relative humidity preactivity, during activity, and postactivity. Other variables were activity time and intensity, body surface area, hydration characteristics (fluid volume, sweat rate, urine specific gravity, percentage of body mass loss), and medical history (eg, previous EHI, medications). The statistical analysis consisted of descriptive information (mean ± standard deviation), comparative analyses that determined differences within days, and correlations that identified variables significantly associated with Tc. The mean time for rehearsals was 102.8 ± 19.8 minutes and for games was 260.5 ± 47.7 minutes. Mean maximum Tc was 39.1 ± 1.1°C for games and 38.4 ± 0.7°C for rehearsals; the highest Tc (41.2°C) occurred during a game. Fluid consumption did not match sweat rates (P < .001). Participants reported to games in a hypohydrated state 63.6% of the time. The maximum Tc correlated with the maximum wet bulb globe temperature (r = 0.618, P < .001) and was higher in individuals using mental health medications (rpb = −0.254, P = .022) and females (rpb = 0.330, P = .002). Body surface area (r = −0.449, P < .001) and instrument mass (r = −0.479, P < .001) were negatively correlated with Tc. Marching band artists experienced high Tc during activity and should have access to athletic trainers who can implement EHI-prevention and -management strategies.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
PhD, ATC,
PhD, ATC,
PhD, ATC,
PhD, ATC,
PhD, RD, CSSD,
MS, ATC,
MS, LAT, ATC,
MS, ATC, and
MS, ATC
Research exists on energy balances (EBs) and eating disorder (ED) risks in physically active populations and occupations by settings, but the EB and ED risk in athletic trainers (ATs) have not been investigated. To assess ATs' energy needs, including the macronutrient profile, and examine ED risk and pathogenic behavioral differences between sexes (men, women) and job statuses (part time or full time) and among settings (college or university, high school, nontraditional). Cross-sectional study. Free living in job settings. Athletic trainers (n = 46; male part-time graduate assistant ATs = 12, male full-time ATs = 11, female part-time graduate assistant ATs = 11, female full-time ATs = 12) in the southeastern United States. Anthropometric measures (sex, age, height, weight, body composition), demographic characteristics (job status [full- or part-time AT], job setting [college/university, high school, nontraditional], years of AT experience, exercise background, alcohol use), resting metabolic rate, energy intake (EI), total daily energy expenditure (TDEE), EB, exercise energy expenditure, macronutrients (carbohydrates, protein, fats), the Eating Disorder Inventory-3, and the Eating Disorder Inventory-3 Symptom Checklist. The majority of participants (84.8%, n = 39) had an ED risk, with 26.1% (n = 12) engaging in at least 1 pathogenic behavior, 50% (n = 23) in 2 pathogenic behaviors, and 10.8% (n = 5) in >2 pathogenic behaviors. Also, 82.6% of ATs (n = 38) presented in negative EB (EI < TDEE). Differences were found in resting metabolic rate for sex and job status (F1,45 = 16.48, P = .001), EI (F1,45 = 12.01, P = .001), TDEE (F1,45 = 40.36, P < .001), and exercise energy expenditure (F1,38 = 5.353, P = .026). No differences were present in EB for sex and job status (F1,45 = 1.751, P = .193); χ2 analysis revealed no significant relationship between ATs' sex and EB (\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\({\rm{\chi }}_{1,46}^2\)= 0.0, P = 1.00) and job status and EB (\({\rm{\chi }}_{1,46}^2\) = 2.42, P = .120). No significant relationship existed between Daily Reference Intakes recommendations for all macronutrients and sex or job status. These athletic trainers experienced negative EB, similar to other professionals in high-demand occupations. Regardless of sex or job status, ATs had a high ED risk and participated in unhealthy pathogenic behaviors. The physical and mental concerns associated with these findings indicate a need for interventions targeted at ATs' health behaviors.Context
Objective
Design
Setting
Patients or Other Participants
Main Outcome Measure(s)
Results
Conclusions
ATHLETE MONITORING
MEd, ATC,
MEd, ATC,
MEd, CSCS,
PhD, ATC, and
PhD, PT, ATC
DOI: 10.4085/205-20
Athlete monitoring via wearable technology is often used in soccer athletes. Although researchers have tracked global outcomes across soccer seasons, little information exists on athlete loads during individual practice drills. Understanding these demands is important for athletic trainers in making decisions about return to play. To provide descriptive information on total distance, total player load (PL), total distance per minute, and PL per minute for practice drill structures and game play by player position among female soccer athletes across a competitive season. Retrospective observational study. National Collegiate Athletic Association Division I university. A total of 32 female collegiate soccer players (age = 20 ± 1 years, height = 168.75 ± 4.28 cm). Athletes wore a single global positioning system and triaxial accelerometer unit during all practices and games in a single soccer season. Individual practice drills were labeled by the team's strength and conditioning coach and binned into physical, technical and tactical skills and large- and small-sided competition drill structures. Descriptive analyses were used to assess the median total distance, total PL, total distance per minute, and PL per minute by drill structure and player position (defender, forward or striker, and midfielder) during practices and games. Large- and small-sided competition drills imposed the greatest percentage of workload across all measures for each position (approximately 20% of total practice), followed by physical drills. When comparing technical and tactical skills drills, we found that technical skills drills required athletes to cover a greater distance (approximately 17% for technical skills and 15% for tactical skills), and tactical skills drills required higher play intensity during practices across all positions (approximately 18% for technical skills and 13% for tactical skills). Defenders had the highest median PL outcomes of all positions during practices. Different practice drill types imposed various levels of demands, which simulated game play, on female soccer athletes. Athletic trainers and other clinicians may use this information in formulating objective return-to-play guidelines for injured collegiate women's soccer players.Context
Objective
Design
Setting
Patients or Other Participants
Intervention(s)
Main Outcome Measure(s)
Results
Conclusions
PhD, ATC,
MS, AT, and
PhD, ATC
DOI: 10.4085/107-20
The effect of athletic participation on lifelong health among elite athletes has received increasing attention, as sport-related injuries can have a substantial influence on long-term health. To determine the current health-related quality of life (HRQoL) of former National Collegiate Athletic Association Division I athletes compared with noncollegiate athletes 5 years after an initial assessment. Cohort study. Online survey. From the former Division I athletes, 193 responses were received (response rate = 83.2%; 128 men, 65 women; age = 58.47 ± 6.17 years), and from the noncollegiate athletes, 169 surveys were returned (response rate = 75.1%; 80 men, 89 women; age = 58.44 ± 7.28 years). The independent variables were time (baseline, 5 years later) and group (former Division I athlete, noncollegiate athlete). Participants completed 7 Patient-Reported Outcomes Measurement Information System scales: sleep disturbance, anxiety, depression, fatigue, pain interference, physical function, and satisfaction with participation in social roles. Sleep disturbance, depression, fatigue, pain, and physical function were significant for time × group interactions (P values < .05), with the largest differences seen in pain and physical function between groups at time point 2 (22.19 and 13.99 points, respectively). Former Division I athletes had worse scores for depression, fatigue, pain, and physical function at follow-up (P values < .05), with the largest differences seen on the depression, fatigue, and physical function scales (8.33, 6.23, and 6.61 points, respectively). Because of the competitive nature of sport, the long-term risks of diminished HRQoL need to become a priority for health care providers and athletes during their athletic careers. Additionally, physical activity transition programs need to be explored to help senior student-athletes transition from highly structured and competitive collegiate athletics to lifestyle physical activity, as it appears that individuals in the noncollegiate athlete cohort engaged in more physical activity, weighed less, and had increased HRQoL.Context
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THANK YOU TO 2020 REVIEWERS
To the many reviewers whose conscientious efforts were instrumental in the preparation of this issue's articles, the Guest Editors express their thanks. Kelly Barnes, MS, CPT Jessica Barrett, PhD, ATC Amy Barrette, MSc, CAT(C) Debbie A. Bradney, DPE, ATC Ciara Burgi, PT, DPT, CSC, OCS Lisa Custer, PhD, ATC Lindsay J. DiStefano, PhD, ATC Abbey Dondanville, EdD, ATC Kristine A. Ensign, PhD, ATC Nicole M. Glasgow, MS, ATC Elizabeth E. Hibberd, PhD, ATC Barbara Hottle Long, EdD, ATC Tamerah N. Hunt, PhD, ATC Kellie C. Huxel Bliven, PhD, ATC Rachel Johnson, MS, ATC Patricia M. Kelshaw, PhD, ATC Rachel M.
We thank our 2020 manuscript reviewers for their hard work and dedication. We also thank retiring Clinical Applications Editor Marjorie A. King, PhD, PT, ATC, for her many years of service. Malin Åman, PhD Thomas E. Abdenour, DHSc, ATC Jorge A. Aburto-Corona, MS Julie Agel, MA, ATC Kazuma Akehi, PhD, LAT, ATC Gordon Alderink, PhD, PT Randy L. Aldret, PhD Andrea A. Almeida, MD Jon Almquist, ATC Thurman V. Alvey III, DO J.C. Andersen, PhD, PT, AT Barton E. Anderson, DHSc, AT, ATC B.J. Anderson, MD Kristy Arbogast, PhD Kirk J. Armstrong, EdD, ATC Tara Armstrong, BS, ATC William J.
Electrotherapy as a Rehabilitation Modality for Chronic Ankle Instability: A
Systematic Review
Mrs Laura Obeng FrimpongMSc, BASRaT,
Dr Samantha L WinterPhD, and
Dr Daniel T P FongPhD
Pain reduction following massage after induced fatigue is not mediated by changes in muscle stiffness or intramuscular fluid content: a randomized controlled trial with mediation analysis
Guilherme S. NunesPT, PhD,
Brenda Dutra GuterresPT,
Ane Priscila DielPT,
Anna Carolina O. Machado,
Nathália Kolling da RosaPT,
Victória dos Santos TurchettoPT, and
Fábio Juner LanferdiniPE, PhD
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
JAT eISSN: 1938-162X
JAT ISSN: 1062-6050
ATEJ ISSN: 1947-380X
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