Showing papers in "Journal of Athletic Training in 2014"
TL;DR: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.
Abstract: Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background: An estimated 3.8 ...
1,026 citations
University of Toledo1, University College Dublin2, Ulster University3, Indiana University4, Loughborough University5, Qatar Airways6, University of Virginia7, University of Sydney8, University of Delaware9, University of Kentucky10, Radboud University Nijmegen11, University of Queensland12, University of North Carolina at Charlotte13
TL;DR: The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs that will enhance the validity of research conducted in this clinical population.
Abstract: While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant or patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalize this evidence to the target patient population. Therefore, there is a need to provide standards for patient or participant selection criteria in research focused on CAI with justifications using the best available evidence. The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs. These recommendations will enhance the validity of research conducted in this clinical population with the end goal of bringing the research evidence to the clinician and patient.
281 citations
TL;DR: The current literature does not provide substantial evidence to suggest that ACL-R is an adequate intervention to prevent knee osteoarthritis.
Abstract: Objective: To determine the prophylactic capability of anterior cruciate ligament (ACL) reconstruction in decreasing the risk of knee osteoarthritis (OA) when compared with ACL-deficient patients, ...
256 citations
TL;DR: The methods of the Web-based National Collegiate Athletic Association ISS for data collection as implemented from the 2004-2005 to 2013-2014 academic years are described.
Abstract: Background: Since 1982, the National Collegiate Athletic Association has used the Injury Surveillance System (ISS) to collect injury and athlete-exposure data from a representative sample of colleg...
231 citations
TL;DR: The findings suggest that health-related quality of life should be examined during the rehabilitation process of individuals with CAI, and there was a strong relationship between FAAM and FAAM-Sport scores but not between any other instruments.
Abstract: Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is...
141 citations
TL;DR: No current reliability or validity information supports the use of the CTSIB, SOT, Romberg test, or Wii Fit for balance assessment in athletes with a concussion, and the BESS can evaluate balance problems after a concussion.
Abstract: Context: An estimated 300 000 sport-related concussion injuries occur in the United States annually. Approximately 30% of individuals with concussions experience balance disturbances. Common method...
125 citations
TL;DR: Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as great knee-varus displacement during the single-legged squat.
Abstract: Context: Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury. Objective: To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM). Main Outcome Measure(s): Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-ext...
111 citations
TL;DR: Clinicians can use any of the 10 significant measures with their associated cutoff scores to identify those who could benefit from rehabilitation that reestablishes postural stability.
Abstract: Context: Chronic ankle instability (CAI) is characterized by repeated ankle sprains, which have been linked to postural instability. Therefore, it is important for clinicians to identify individuals with CAI who can benefit from rehabilitation. Objective: To assess the likelihood that CAI participants will exhibit impaired postural stability and that healthy control participants will exhibit better test performance values. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: People with CAI (n = 17, age = 23 ± 4 years, height = 168 ± 9 cm, weight = 68 ± 12 kg) who reported ankle “giving-way” sensations and healthy volunteers (n = 17, age = 23 ± 3 years, height = 168 ± 8 cm, weight = 66 ± 12 kg). Intervention(s): Participants performed 7 balance tests: Balance Error Scoring System (BESS), time in balance, foot lift, single-legged stance on a force plate, Star Excursion Balance Test, side hop, and figure-of-8 hop. Main Outcome Measure(s): Balance was quantified with errors (score...
103 citations
TL;DR: Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury and showed more significant predictor models ofsocial support on state anxiety at return to play.
Abstract: Context: When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury However, many injured athletes experience negative psychological r
92 citations
TL;DR: The high school football players surveyed did not have appropriate knowledge of the symptoms and consequences of concussions, and only a small proportion correctly identified brain hemorrhage, coma, and death as possible consequences of inappropriate care after a concussion.
Abstract: Context: Participating in sports while experiencing symptoms of a concussion can be dangerous. An athlete's lack of knowledge may be one factor influencing his or her decision to report symptoms. I...
90 citations
TL;DR: This hypothesis-driven paper integrates the concept of mechanotransduction with the application of massage to explore beneficial mechanisms and provides a framework that describes the current understanding of the mechanisms whereby massage therapy activates potentially beneficial immunomodulatory pathways.
Abstract: Massage has the potential to attenuate the inflammatory process, facilitate early recovery, and provide pain relief from muscular injuries. In this hypothesis-driven paper, we integrate the concept of mechanotransduction with the application of massage to explore beneficial mechanisms. By altering signaling pathways involved with the inflammatory process, massage may decrease secondary injury, nerve sensitization, and collateral sprouting, resulting in increased recovery from damage and reduction or prevention of pain. Our goal is to provide a framework that describes our current understanding of the mechanisms whereby massage therapy activates potentially beneficial immunomodulatory pathways.
TL;DR: Identifying the impact mechanisms in collegiate ice hockey that result in frequent and high-magnitude head impacts will provide data that may improve the understanding of the high rate of concussion in the sport and inform injury-prevention strategies.
Abstract: Context: Concussion injury rates in men's and women's ice hockey are reported to be among the highest of all collegiate sports. Quantification of the frequency of head impacts and the magnitude of ...
TL;DR: This dissertation presents a meta-analyses of the biomechanical properties of the anterior cruciate ligament of the knee, which has implications for both the application and rehabilitation of the medial collateral ligament.
Abstract: Ron Courson, ATC, PT, NREMT-I, CSCS (Chair)*; Michael Goldenberg, MS, ATC (Chair)*; Kevin G. Adams, CAA†; Scott A. Anderson, ATC‡; Bob Colgate§; Larry Cooper, MS, LAT, ATC*; Lori Dewald, EdD, ATC, MCHES, F-AAHE||; R.T. Floyd, EdD, ATC*; Douglas B. Gregory, MD, FAAP¶; Peter A. Indelicato, MD#; David Klossner, PhD, ATC**; Rick O’Leary, MS, ATC, AT/L*; Tracy Ray, MD††; Tim Selgo‡‡; Charlie Thompson, MS, ATC*; Gary Turbak, DHSc, ATC§§ *National Athletic Trainers’ Association; †National Interscholastic Athletic Administrators Association; ‡College Athletic Trainers’ Society; §National Federation of State High School Associations; ||American College Health Association; ¶American Academy of Pediatrics; #American Orthopaedic Society for Sports Medicine; **National Collegiate Athletic Association; ††American Medical Society for Sports Medicine; ‡‡National Association of Collegiate Directors of Athletics; §§National Association of Intercollegiate Athletics
TL;DR: Fluoroquinolone tendinopathy may not respond well to the current popular eccentric training regimes and may require an alternative, staged treatment approach.
Abstract: Context: Fluoroquinolone antibiotics have been used for several decades and are effective antimicrobials. Despite their usefulness as antibiotics, a growing body of evidence has accumulated in the peer-reviewed literature that shows fluoroquinolones can cause pathologic lesions in tendon tissue (tendinopathy). These adverse effects can occur within hours of commencing treatment and months after discontinuing the use of these drugs. In some cases, fluoroquinolone usage can lead to complete rupture of the tendon and substantial subsequent disability. Objective: To discuss the cause, pharmacology, symptoms, and epidemiology of fluoroquinolone-associated tendinopathy and to discuss the clinical implications with respect to athletes and their subsequent physiotherapy. Data Sources: We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Allied and Complementary Medicine Database (AMED), and SPORTDiscus databases for available reports of fluoroquinolone-related tendinopathy (tendinitis, ten...
TL;DR: Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.
Abstract: Context: A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of ath...
TL;DR: Age-related changes in shoulder and scapular strength and ROM were apparent in elite adolescent tennis players and future authors should examine the association of these adaptations with performance data and injury incidence.
Abstract: Context: Tennis requires repetitive overhead movements that can lead to upper extremity injury. The scapula and the shoulder play a vital role in injury-free playing. Scapular dysfunction and glen...
TL;DR: Recommendations are provided to equip the sports medicine community with the tools necessary to conduct the PPE as effectively and efficiently as possible using available scientific evidence and best practices.
Abstract: Objective: To present athletic trainers with recommendations for the content and administration of the preparticipation physical examination (PPE) as well as considerations for determining safe participation in sports and identifying disqualifying conditions. Background: Preparticipation physical examinations have been used routinely for nearly 40 years. However, considerable debate exists as to their efficacy due to the lack of standardization in the process and the lack of conformity in the information that is gathered. With the continuing rise in sports participation at all levels and the growing number of reported cases of sudden death in organized athletics, the sports medicine community should consider adopting a standardized process for conducting the PPE to protect all parties. Recommendations: Recommendations are provided to equip the sports medicine community with the tools necessary to conduct the PPE as effectively and efficiently as possible using available scientific evidence and best practi...
TL;DR: Because of the environmental conditions and race duration, the Falmouth Road Race provides a unique setting for a high incidence of EHS, and a clear relationship exists between environmental stress, especially as measured by Tamb and HI, and the occurrence of EHI or other EHI.
Abstract: Context: The Falmouth Road Race is unique because of the environmental conditions and relatively short distance, which allow runners to maintain a high intensity for the duration of the event. Therefore, the occurrence of exertional heat illnesses (EHIs), especially exertional heat stroke (EHS), is 10 times higher than in other races. Objective: To summarize the occurrence and relationship of EHI and environmental conditions at the Falmouth Road Race. Design: Descriptive epidemiologic study. Setting: An 11.3-km (7-mile) road race in Falmouth, Massachusetts. Patients or Other Participants: Runners who sustained an EHI while participating in the Falmouth Road Race. Main Outcome Measure(s): We obtained 18 years of medical records and environmental conditions from the Falmouth Road Race and documented the incidence of EHI, specifically EHS, as related to ambient temperature (Tamb), relative humidity, and heat index (HI). Results: Average Tamb, relative humidity, and HI were 23.3 ± 2.5°C, 70 ± 16%, and 24 ± 3....
TL;DR: The number of documented concussions more than doubled after the institution of the Lystedt law, which may be attributed to heightened awareness and closer monitoring.
Abstract: Context: The Lystedt law requires high school athletes who have sustained a concussion to be removed from practice and play and not to be allowed to return until cleared by a medical professional. Objective: To determine the effect of the Lystedt law on injury and concussion documentation in the Seattle public high schools. Design: Cross-sectional study. Setting: Seattle public high schools. Patients or Other Participants: The numbers of students, aged 13 to 19 years in the 2008–2009, 2009–2010, and 2010–2011 school years, were 4348, 4925, and 4806, respectively. Main Outcome Measure(s): All injuries documented in SportsWare by athletic trainers in Seattle public high schools. We evaluated all injuries, including concussions recorded during the 2008–2009 school year, before the Lystedt law, and during the 2 school years after the law took effect (2009–2010 and 2010–2011). Incidence rates before and after the law were estimated and compared. Results: The concussion rate was −1.09% in 2008–2009, 2.26% in 20...
TL;DR: People with a history of concussion may demonstrate persistent decrements in neurocognitive function, as evidenced by decreased response accuracy, deficits in the allocation of attentional resources, and increased stimulus-response conflict during tasks requiring variable amounts of cognitive control.
Abstract: Context: Increasing attention is being paid to the deleterious effects of sport-related concussion on cognitive and brain health. Objective: To evaluate the influence of concussion incurred during ...
TL;DR: Findings generally suggest that female volleyball players could have a lower risk of developing shoulder-related problems than male volleyball players, and isokinetic shoulder testing should be included in the functional screening of volleyball players.
Abstract: Context: Volleyball players are reported to have shoulder strength imbalances. Previous authors have primarily investigated small samples of male players at a single skill level, without considering playing position, and with inconsistent findings. Objective: To evaluate shoulder strength asymmetry and a history of shoulder injury in a large sample of professional volleyball players of both sexes across different playing positions and skill levels. Design: Descriptive laboratory study. Patients or Other Participants: A sample of 183 volleyball players (99 men, 84 women). Main Outcome Measure(s): We assessed shoulder internal-rotator and external-rotator concentric strength at 60°/s using an isokinetic dynamometer and dominant-nondominant differences in shoulder strength and strength ratios using repeated-measures analyses of variance. Peak torque was normalized for body mass and external-rotation/internal-rotation concentric strength. Results: Internal-rotation strength was asymmetric in favor of the domi...
TL;DR: S100B measurement seems to have the potential to be a diagnostic adjunct for concussion in sports settings, and it is recommended that the interpretation of S100B values be based on congruent study designs to ensure measurement reliability and validity.
Abstract: Objective: Elevated levels of the astroglial protein S100B have been shown to predict sport-related concussion. However, S100B levels within an athlete can vary depending on the type of physical activity (PA) engaged in and the methodologic approach used to measure them. Thus, appropriate reference values in the diagnosis of concussed athletes remain undefined. The purpose of our systematic literature review was to provide an overview of the current literature examining S100B measurement in the context of PA. The overall goal is to improve the use of the biomarker S100B in the context of sport-related concussion management. Data Sources: PubMed, SciVerse Scopus, SPORTDiscus, CINAHL, and Cochrane. Study Selection: We selected articles that contained (1) research studies focusing exclusively on humans in which (2) either PA was used as an intervention or the test participants or athletes were involved in PA and (3) S100B was measured as a dependent variable. Data Extraction: We identified 24 articles. Study...
TL;DR: Transcutaneous electrical nerve stimulation demonstrated the strongest and most consistent effects in increasing voluntary quadriceps activation and may be the best disinhibitory intervention for improving the same.
Abstract: Objective: To determine the effects of various therapeutic interventions on increasing voluntary quadriceps muscle activation. Background: Decreased voluntary quadriceps activation is commonly associated with knee injury. Recently, research has focused on developing specific disinhibitory interventions to improve voluntary quadriceps activation; yet, it remains unknown which interventions are most effective in promoting this improvement. Data Sources: We searched Web of Science from January 1, 1965 through September 27, 2012, using the key words quadriceps activation and transcutaneous electrical nerve stimulation, transcranial magnetic stimulation, cryotherapy, focal joint cooling, joint mobilization, joint mobilisation, joint manipulation, manual therapy, and neuromuscular electrical stimulation. Study Selection: Studies evaluating the effect of disinhibitory interventions on volitional quadriceps activation were used in our review. Standardized effect sizes (Cohen d) and 95% confidence intervals (CIs) ...
TL;DR: The SMPs working with injured athletes must understand the self-regulatory processes that may take place throughout injury rehabilitation and be able to apply psychological principles in natural and subtle ways to aid athletes' self-Regulatory abilities.
Abstract: Context: Research from the sport medicine professional's (SMP's) perspective indicates that SMPs are often required to address psychosocial aspects of injuries during treatment. However, only a few...
TL;DR: Fatigue index was positively correlated with fatigue/rest sway ratio for COP path length and COP velocity in the anteroposterior and mediolateral directions for nondominant single-legged stance and participants with better performance in the RSA test appeared less affected by balance impairment, especially in single-leg stance.
Abstract: Context: Although balance is generally recognized to be an important feature in ensuring good performance in soccer, its link with functional performance remains mostly unexplored, especially in yo...
TL;DR: Visual assessments were made reliably by experienced and novice testers and movement-pattern categories based on visual assessments were in excellent agreement with objective methods to measure FPPA change.
Abstract: Context: Abnormal movement patterns have been implicated in lower extremity injury. Reliable, valid, and easily implemented assessment methods are needed to examine existing musculoskeletal disorde...
TL;DR: The Landing Error Scoring System (LESS) is useful for evaluating landing errors in patients with ACLR and may help to identify areas of focus during rehabilitation and before return to sport.
Abstract: Context: The Landing Error Scoring System (LESS) is a clinical evaluation of jump-landing mechanics and may provide useful information in assisting with return-to-sport decisions in patients after ...
TL;DR: The data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle, and supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation.
Abstract: Context: Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable...
TL;DR: It is suggested that, although benefits to using PROMs exist, there are also barriers, and strategies to decrease barriers and facilitate the use of PRoms warrant investigation.
Abstract: Context: Patient-rated outcome measures (PROMs) are important for driving treatment decisions and determining treatment effectiveness. However, athletic trainers (ATs) rarely use them; understandin...
TL;DR: Intervention effects in the girls for enhanced INT-induced gains in performance relative to the control group on the curl-up, long jump, single-legged hop, and 0.8-km run indicate that INT is an effective and time-efficient addition to PE for enhancing motor skills and promoting physical activity in children.
Abstract: Context: Integrative neuromuscular training (INT) has successfully enhanced physical fitness and reduced abnormal biomechanics, which appear to decrease injury rates in adolescent female athletes. If not addressed at the proper time, low levels of physical fitness and abnormal mechanics may predispose female athletes to an increased risk of musculoskeletal injuries. Objectives: To evaluate sex-specific effects of INT on selected measures of health- and skill-related fitness in children during physical education (PE). Design: Cohort study. Setting: Public primary school. Patients or Other Participants: Forty children (16 boys, 24 girls; age = 7.6 ± 0.3 years, height = 124.5 ± 6.4 cm, mass = 29.5 ± 7.6 kg) from 2 second-grade PE classes. Intervention(s): The classes were randomized into the PE-plus-INT group (10 boys, 11 girls) or the control group (6 boys, 13 girls) that participated in traditional PE. The INT was performed 2 times per week during the first approximately 15 minutes of each PE class and con...