bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Knee-Joint Moments in Male and Female College Soccer Players during a Single-Leg Landing
Authors: Garrison J. Craig , Hart Joe M. , Palmieri Riann M. , Kerrigan D. Casey , Ingersoll Christopher D.
Published: August 2016

Context:

Although kinematic analyses are helpful in describing movement differences between genders, kinetic data might further explain the predisposing factors contributing to potential injury during athletic landing maneuvers.

Objective:

To determine whether there are differences in knee moments between male and female varsity college soccer players during a single-leg landing.

Design:

Preexperimental with static group comparison.

Setting:

Motion-analysis laboratory.

Participants:

16 varsity college soccer players (8 men, 8 women).

Intervention:

Subjects performed 5 single-leg landings from a height of 60 cm.

Main Outcome Measures:

Peak internal rotation, valgus, varus, and extension knee moments calculated from raw ground-reaction forces and kinematic data.

Results:

Significant gender differences were present (P = .020), with men exhibiting 31% greater mean peak knee-varus moments than women when landing on a single leg from 60 cm (P = .020).

Conclusions:

Male soccer players demonstrate greater knee-varus moments than female soccer players during single-leg landing. This might be valuable in designing clinical treatment and prevention programs for ACL injuries.
Pain Perception during Repeated Ice-Bath Immersion of the Ankle at Varied Temperatures
Authors: Galvan Haydee G. , Tritsch Amanda J. , Tandy Richard , Rubley Mack D.
Published: August 2016

Context:

Ice-bath temperatures range from 1 to 15ºC; the pain response during treatment might be temperature specific.

Objective:

To determine levels of perceived pain during ice-bath immersion at distinct temperatures.

Design:

2 (sex) × 3 (temperature) × 9 (treatment time).

Setting:

Athletic training research laboratory.

Participants:

32 healthy subjects.

Intervention:

Ankle immersion in 1, 10, and 15°C ice baths for 20 minutes.

Main Outcome Measures:

Discomfort measured by the Borg scale of perceived pain at immersion for 1, 2, 4, 6, 8, 10, 15, and 20 minutes.

Results:

The magnitude of pain felt depended on treatment temperature (F18,522 = 11.65, P < .0001). Pain ratings were 43% higher for 1ºC than 10ºC and 70% higher than 15ºC, and ratings at 10ºC were 46% higher than at 15ºC.

Conclusions:

Pain depends on treatment temperature. Patients might report inconsistent pain ratings with varying temperature.
Strength Values of Shoulder Internal and External Rotators in Elite Volleyball Players
Authors: van Cingel Robert , Kleinrensink Gertjan , Stoeckart Rob , Aufdemkampe Geert , de Bie Rob , Kuipers Harm
Published: August 2016

Objective:

To determine concentric shoulder external-internal rotator strength, dominant and non-dominant shoulder differences and agonist/antagonist ratios.

Design:

A transversal study of isokinetic dynamometry of healthy shoulders, 95% confidence intervals are presented.

Participants:

35 asymptomatic elite, male volleyball players.

Measurements:

Peak torque normalized for body weight was recorded at 60, 180, and 300°/sec. with a Cybex 6000 dynamometer.

Results:

(1) internal rotators were significantly stronger than external rotators of the same shoulder; (2) internal rotators of the dominant arm were significantly stronger than of the non-dominant arm; (3) no difference existed between external rotators of the dominant and the non-dominant arm; (4) external–internal rotator ratios of the dominant arm were significantly lower than of the non-dominant arm; and (5) no differences were found between the ratios of each arm separately.

Conclusions:

Data presented are important for interpreting isokinetic shoulder rotator strength tests in elite volleyball players and could be relevant in rehabilitation and prevention of shoulder injuries.
Quantifying Bilateral Joint Contributions during Three Variations of the Step Exercise
Authors: Flanagan Sean P. , Kessans Kara M. , Salem George J.
Published: August 2016

Context:

Information regarding how the mechanical demand differs with variants of the step exercise may be used by clinicians to more appropriately prescribe lower-extremity exercise.

Objective:

To quantify the joint torque contributions of the lower extremity during three different step exercises: forward step-up (FS), lateral step-up (LS), and step-down (SD).

Design:

An experiment with a repeated measures design.

Setting:

Biomechanics laboratory.

Participants:

18 healthy subjects (9 men, 9 women, age 25.67 ± 4.23 years, height 1.73 ± 0.10 meters, mass 72.73 ± 10.67 kilograms).

Intervention:

Participants performed three sets of three repetitions of each exercise while instrumented for biomechanical analysis.

Main Outcome Measure:

Mechanical effort of the hip, knee, and ankle of both limbs during each exercise.

Results:

The greatest contribution from the hip was required during the FS, while the contribution from the knee was required during the SD. The greatest contribution from the ankle was required during the LS and SD.

Conclusion:

Choice of step exercise results in different distributions of mechanical demand across the lower extremities.
Ultrasound Heating Is Curvilinear in Nature and Varies between Transducers from the Same Manufacturer
Authors: Demchak Timothy J. , Straub Stephen J. , Johns Lennart D.
Published: August 2016

Context:

Ultrasound heating rates are known to differ between various manufacturers; it is unknown whether this difference exists within a manufacturer.

Objective:

Determine if intramuscular heating differences exist between transducers from the same manufacturer.

Study Design:

3 × 10 repeated measures. Independent variables were Transducer (A, B, and C) and Time (10-min time points during the treatment).

Setting:

Controlled laboratory.

Participants:

Twelve volunteers (M = 4, F = 8; age: 23 ± 4 years; calf-girth: 37.94 ± 4.16 cm; calf-skinfold: 27 ± 17 mm).

Intervention:

Three 10-min 1MHz continuous ultrasound treatments performed at an intensity of 1.2 W/cm2, over an area 2x transducer.

Main Outcome Measures:

Calf temperature increase.

Results:

Heating curve generated for each transducer were significantly different (P = .034) but the overall temperature increases following 10 minutes of treatment were within 0.1°C (F = 1.023 P = .573).

Conclusion:

Heating curves differ between transducers from the same manufacturer but peak heating at 10 minutes was similar.
Acute Stretch Perception Alteration Contributes to the Success of the PNF “Contract-Relax” Stretch
Authors: Mitchell Ulrike H. , Myrer J. William , Hopkins J. Ty , Hunter Iain , Feland J. Brent , Hilton Sterling C.
Published: August 2016

Context:

Some researchers have suggested that an alteration of stretch perception could be responsible for the success of the contract-relax (CR) stretch, a stretch technique derived from proprioceptive neuromuscular facilitation (PNF).

Objective:

This study was conducted to determine if the alteration of the stretch perception is a possible explanation for the range of motion (ROM) gains of the CR stretch.

Participants:

Eighteen subjects performed two stretches in randomized order: the slow stretch and the CR stretch.

Main Outcome Measure:

The stretch intensity was controlled. The stretch force was measured and compared between the slow stretch and CR stretch.

Results:

There was a significant difference between the stretch force that could be applied in the PNF stretch (126.0 N) and the slow stretch (108.4 N); P = 0.00086. The average stretch tolerance progressively increased with successive trials from 120.6 N in the first trial to 132.4 N in the fourth trial.

Conclusion:

The alteration of stretch perception plays a role in the success of the CR form of PNF stretching. At least four repetitions of the CR stretch are recommended to get the greatest ROM gain.
Recovery and Return to Activity Following Exertional Heat Stroke: Considerations for the Sports Medicine Staff
Authors: McDermott Brendon P. , Casa Douglas J. , Yeargin Susan W. , Ganio Matthew S. , Armstrong Lawrence E. , Maresh Carl M.
Published: August 2016

Objective:

To describe the current scientific evidence of recovery and return to activity following exertional heat stroke (EHS).

Data Sources:

Information was collected using MEDLINE and SPORTDiscus databases in English using combinations of key words, exertional heat stroke, recovery, rehabilitation, residual symptoms, heat tolerance, return to activity, and heat illness.

Study Selection:

Relevant peer-reviewed, military, and published text materials were reviewed.

Data Extraction:

Inclusion criteria were based on the article’s coverage of return to activity, residual symptoms, or testing for long-term treatment. Fifty-two out of the original 554 sources met these criteria and were included in data synthesis.

Data Synthesis:

The recovery time following EHS is dependent on numerous factors, and recovery length is individually based and largely dependent on the initial care provided.

Conclusion:

Future research should focus on developing a structured return-to-activity strategy following EHS.
Return to Activity Considerations in a Football Player Predisposed to Exertional Heat Illness: A Case Study
Authors: Coris Eric Emmanuel , Walz Stephen , Konin Jeff , Pescasio Michele
Published: August 2016

Context:

Heat illness is the third leading cause of death in athletics and a leading cause of morbidity and mortality in exercising athletes. Once faced with a case of heat related illness, severe or mild, the health care professional is often faced with the question of when to reactivate the athlete for competitive sport. Resuming activity without modifying risk factors could lead to recurrence of heat related illness of similar or greater severity. Also, having had heat illness in and of itself may be a risk factor for future heat related illness. The decision to return the athlete and the process of risk reduction is complex and requires input from all of the components of the team. Involving the entire sports medicine team often allows for the safest, most successful return to play strategy. Care must be taken once the athlete does begin to return to activity to allow for re-acclimatization to exercise in the heat prior to resumption particularly following a long convalescent period after more severe heat related illness.
Return to Competition Following Ischemic Colitis Caused by Severe Dehydration
Authors: Murray Bob , Stofan John , Sallis Bob
Published: August 2016

Objective:

This article summarizes a case of ischemic colitis suffered by a triathlete during an Ironman competition.

Background:

Exercise results in a significant reduction in splanchnic blood flow to help maintain cardiovascular function. When dehydration and heat stress accompany exercise, blood flow to the splanchnic vasculature is further reduced, increasing the risk of local ischemia and tissue injury.

Differential Diagnosis:

Ischemic colitis caused by dehydration and heat stress.

Treatment:

Right hemicolectomy involving a 16-cm segment of ischemic large intestine and appendectomy the day following the race.

Uniqueness:

This case study highlights one of the risks associated with dehydration during prolonged exercise in the heat. Of particular interest are practical interventions to reduce health and performance issues.

Conclusions:

Poor hydration and nutrition practices during intense exercise can affect gut function, impair performance, and jeopardize health. Optimal intake of fluid, carbohydrate, and salt will enhance performance and reduce risk to health.
Healthy Youth Are Reliable in Reporting Symptoms on a Graded Symptom Scale
Authors: Mailer Brandy J. , McLeod Tamara C. Valovich , Bay R. Curtis
Published: August 2016

Context:

Clinicians often rely on the self-report symptoms of patients in making clinical decisions; hence it is important that these scales be reliable.

Objective:

To determine the test-retest reliability of healthy youth in completing a graded symptom scale (GSS), modified from the Head Injury Scale Self-Report Concussion Symptoms Scale (HIS).

Design:

Repeated-measures.

Setting:

Middle school classroom.

Patients or Other Participants:

126 middle school students.

Intervention:

A survey consisting of a demographic and life events questionnaire and a GSS asking about symptom severity and duration.

Main Outcomes Measures:

Score for each symptom on the severity and duration scale and a total symptom score (TSS) and the total number of symptoms endorsed (TSE) from the severity scale. Responses on a life events questionnaire were also recorded.

Results:

We found excellent reliability for TSS (ICC = .93) and TSE (ICC = .88) for the severity scale. We found moderate to excellent reliability on the individual symptoms of both the severity (ICC = .65-.89) and duration (ICC =.56-.96) scales.

Conclusions:

Healthy youth can reliably self-report symptoms using a GSS. This patient-oriented outcome measure should be incorporated into more investigations in this age group.
Do the Physical Characteristics of a Virtual Reality Device Contraindicate Its Use for Balance Assessment?
Authors: Mihalik Jason P. , Kohli Luv , Whitton Mary C.
Published: August 2016

Context:

Virtual reality environments may allow researchers to investigate functional balance performance without risks associated with testing in the real world.

Objective:

To investigate the effects of the mass of a head-mounted display (HMD) on balance performance.

Design:

Counterbalanced pretest-posttest.

Setting:

Virtual reality laboratory.

Participants:

20 healthy college students.

Intervention(s):

Balance Error Scoring System (BESS) with a tracker-only headband and again with tracker plus HMD was performed.

Main Outcome Measures:

BESS error scores, elliptical sway area, and center of pressure travel distance were recorded.

Results:

No effect of the HMD mass on balance performance was observed. A significant stance by surface interaction was present but was negated when the HMD conditions were included in the model.

Conclusions:

The mass of a HMD has not been proven to adversely affect balance performance. These data suggest the HMD mass is not a contraindication to the use of immersive virtual environments in future concussion research involving balance.
Reliability and Validity of Electrothermometers and Associated Thermocouples
Authors: Jutte Lisa S. , Knight Kenneth L. , Long Blaine C.
Published: August 2016

Objective:

Examine thermocouple model uncertainty (reliability + validity).

Design:

First, a 3 × 3 repeated measures design with independent variables electrothermometers and thermocouple model. Second, a 1 × 3 repeated measures design with independent variable subprobe.

Intervention:

Three electrothermometers, 3 thermocouple models, a multi-sensor probe and a mercury thermometer measured a stable water bath.

Main Outcome Measures:

Temperature and absolute temperature differences between thermocouples and a mercury thermometer.

Results:

Thermocouple uncertainty was greater than manufactures’ claims. For all thermocouple models, validity and reliability were better in the Iso-Themex than the Datalogger, but there were no practical differences between models within an electrothermometers. Validity of multi-sensor probes and thermocouples within a probe were not different but were greater than manufacturers’ claims. Reliability of multiprobes and thermocouples within a probe were within manufacturers claims.

Conclusion:

Thermocouple models vary in reliability and validity. Scientists should test and report the uncertainty of their equipment rather than depending on manufactures’ claims.
Effectiveness of Physical Therapy Treatments on Lateral Epicondylitis
Authors: Kohia Mohamed , Brackle John , Byrd Kenny , Jennings Amanda , Murray William , Wilfong Erin
Published: August 2016

Objective:

To analyze research literature that has examined the effectiveness of various physical therapy interventions on lateral epicondylitis.

Data Sources:

Evidence was compiled with data located using the PubMed, EBSCO, The Cochrane Library, and the Hooked on Evidence databases from 1994 to 2006 using the key words lateral epicondylitis, tennis elbow, modalities, intervention, management of, treatment for, radiohumeral bursitis, and experiment.

Study Selection:

The literature used included peer-reviewed studies that evaluated the effectiveness of physical therapy treatments on lateral epicondylitis. Future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.

Data Synthesis:

Shockwave therapy and Cyriax therapy protocol are effective physical therapy interventions.

Conclusions:

There are numerous treatments for lateral epicondylitis and no single intervention has been proven to be the most efficient. Therefore, future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.
Augmented Feedback Reduces Ground Reaction Forces in the Landing Phase of the Volleyball Spike Jump
Authors: Cronin John B. , Bressel Eadric , Finn Loren
Published: August 2016

Context:

Frequency and magnitude of ground reaction forces (GRF) have been implicated in causing injuries such as “jumpers knee.”

Objective:

To investigate whether a single session of augmented feedback concerning landing technique would decrease GRF.

Design:

Pretest posttest experimental design.

Setting:

University biomechanics laboratory.

Participants:

Fifteen female Division 1 intercollegiate volleyball players.

Intervention:

Participants were required to land on a force platform after spiking a volleyball from a four-step approach before and after an intervention involving visual and aural augmented feedback on correct jumping and landing technique.

Main Outcome Measures:

Mediolateral (ML), anterioposterior (AP), and vertical (V) GRF normalized to body weight (BW).

Results:

Augmented feedback was found to significantly (P = 0.01) decrease VGRF by 23.6% but not ML (25%, P = 0.16) and AP (4.9%, P = 0.40) peak GRF.

Conclusions:

A single session of augmented feedback may be effective in reducing VGRF in collegiate athletes.
Hand-Held Dynamometry: Reliability of Lower Extremity Muscle Testing in Healthy, Physically Active, Young Adults
Authors: Kelln Brent M. , McKeon Patrick O. , Gontkof Lauren M. , Hertel Jay
Published: August 2016

Context:

Hand-held dynamometry (HHD) has been shown to be a reliable, objective way to obtain strength measurements in elderly and physically impaired subjects.

Objective:

To estimate the intratester, intertester, and intersession reliability of HHD testing of lower extremity movements in young, healthy subjects.

Design:

Repeated measures.

Setting:

Sports medicine laboratory.

Participants:

Nine males and eleven females (Mean age = 26 years).

Measurements:

Strength measures of 11 right lower extremity movements were taken by 3 different testers on 2 separate days using a HHD.

Results:

Intratester ICC range was .77 to .97 with SEM range of .01 to .44 kg. Mean intertester ICC range was .65 to .87 with SEM range of .11 to 1.05 kg. Mean intersession ICC range was .62 to .92 with SEM range of .01 to .83 kg.

Conclusions:

HHD has the potential to be a reliable tool for strength measurements in healthy, strong subjects; however, there are noteworthy limitations with movements where subjects can overpower the testers.
Kinematics and Kinetics of 2 Styles of Partial Forward Lunge
Authors: Wilson Daniel J. , Gibson Kyle , Masterson Gerald L.
Published: August 2016

Objective:

To evaluate the anterior shift of the body’s center of gravity (CG) and the associated inertial forces produced by 2 styles of a partial forward lunge.

Setting:

Gait-analysis laboratory of a research institution.

Participants:

10 healthy volunteers.

Intervention:

3 trials of each lunge.

Main Outcome Measures:

Kinematic data were collected, and inertial reaction forces were resolved into net compressive and shear forces using an inverse dynamic model.

Results:

Significantly (P < .001) greater anterior translation of the CG was found with an arms-in-front v arms-across-chest lunge style. No significant differences were found between the average peak inertial compressive and shear forces of the 2 styles (427 ± 184 N v 426 ± 187 N, −536 ± 113 N v −538 ± 127 N).

Conclusion:

Anterior translation of the CG was larger with the arms-forward partial-lunge position, creating increased balance demands. Both styles produced clinically safe (posteriorly directed) inertial shear forces, with greater anterior CG shift with the arms-forward style.
Rehabilitation after Arthroscopic Repair of Intra-Articular Disorders of the Hip in a Professional Football Athlete
Authors: Philippon Marc J. , Christensen Jesse C. , Wahoff Michael S.
Published: August 2016

Objective:

To report the 4-phase rehabilitation progression of a professional athlete who underwent arthroscopic intra-articular repair of the hip after injury during the 2006–07 season.

Design:

Case study; level of evidence, 4.

Main Outcome Measures:

Objective values were obtained by standard goniometric measurements, handheld dynamometer, dynamic sports testing, and clinical testing for intra-articular pathology.

Results:

This case report illustrates improvements in hip mobility, muscle-force output, elimination of clinical signs of intra-articular involvement, and ability to perform high-level sport-specific training at 9 wk postsurgery. At 16 wk postsurgery, the patient was able to return to full preparation for sport for the following season.

Conclusion:

After the 4-phase rehabilitation program, the patient demonstrated improvement in all areas of high-level function after an arthroscopic intra-articular repair of the hip. The preoperative management to return to sport is outlined, with clinical outcomes and criteria for return to competition.
Hip-Muscle Activation during the Lunge, Single-Leg Squat, and Step-Up-and-Over Exercises
Authors: Boudreau Samantha N. , Dwyer Maureen K. , Mattacola Carl G. , Lattermann Christian , Uhl Tim L. , McKeon Jennifer Medina
Published: August 2016

Context:

Functional exercises are often used in strengthening programs after lower extremity injury. Activation levels of the stabilizing hip muscles have not been documented.

Objective:

To document the progression of hip-muscle activation levels during 3 lower extremity functional exercises.

Design:

Cross-sectional.

Setting:

Laboratory.

Participants:

44 healthy individuals, 22 women and 22 men.

Intervention:

Subjects, in 1 testing session, completed 3 trials each of the lunge (LUN), single-leg squat (SLSQ), and step-up-and-over (SUO) exercise.

Main Outcome Measures:

Root-mean-square muscle amplitude (% reference voluntary muscle contraction) was measured for 5 muscles during the 3 exercises: rectus femoris (RF), dominant and nondominant gluteus medius (GMed_D and GMed_ND), adductor longus (ADD), and gluteus maximus (GMX).

Results:

The RF, GMAX, and GMed_D were activated in a progression from least to greatest during the SUO, LUN, and SLSQ. The progression for the GMed_ND activation was from least to greatest during the SLSQ, SUO, and then LUN. Activation levels of the ADD showed no progression.

Conclusion:

Progressive activation levels were documented for muscles acting on the hip joint during 3 functional lower extremity exercises. The authors recommend using this exercise progression when targeting the hip muscles during lower extremity strengthening.
Establishing Normative Data on Scapulothoracic Musculature Using Handheld Dynamometry
Authors: Turner Nichole , Ferguson Kristen , Mobley Britney W. , Riemann Bryan , Davies George
Published: August 2016

Context:

Scapular strength deficits have been linked to shoulder dysfunction.

Objective:

To establish normative data on the scapulothoracic musculature in normal subjects using a handheld dynamometer.

Design:

Descriptive normative data study.

Setting:

Field research.

Subjects:

172 subjects with varying levels of overhead activity.

Methods:

A handheld dynamometer was used to test the upper, middle, and lower trapezius; rhomboids; and serratus anterior.

Main Outcome Measures:

A 2-factor ANOVA was performed for each of the muscles by activity level and unilateral ratio by activity-level analyses. Post hoc analysis included multiple pairwise comparisons, using the Dunn-Bonferroni correction method.

Results:

Activity level did not significantly affect the unilateral ratios: Elevation:depression was 2.5:1, upward:downward rotation was 1.5:1, and protraction:retraction was 1.25:1. A rank order from strongest to weakest was established through significant comparisons.

Conclusion:

The unilateral ratios along with the rank order should be considered when discussing scapular rehabilitation protocols.
The Effect of Menstrual-Cycle Phase on Hamstring Extensibility and Muscle Stiffness
Authors: Bell David R. , Myrick Megan P. , Blackburn J. Troy , Shultz Sandra J. , Guskiewicz Kevin M. , Padua Darin A.
Published: August 2016

Context:

Preventing noncontact ACL injuries has been a major focus of athletic trainers and researchers. One factor that may influence female noncontact ACL injury is the fluctuating concentrations of hormones in the body.

Objective:

To determine whether muscle properties change across the menstrual cycle.

Design:

Repeated measures. Testing was performed within 3 d after the onset of menses and ovulation. Repeated-measures ANOVAs were used to determine changes in variables across the menstrual cycle, and Pearson correlations were used to determine relationships between variables.

Participants:

8 women with normal menstrual cycles.

Main Outcome Measures:

Active hamstring stiffness and hamstring extensibility.

Results:

Hamstring extensibility (P = .003) increased at the ovulation testing session but hamstring muscle stiffness (P = .66) did not.

Conclusions:

The results indicate that hamstring muscle stiffness did not change across the menstrual cycle and hamstring extensibility increased at ovulation, when estrogen concentration increases.
Expert Versus Novice Interrater Reliability and Criterion Validity of the Landing Error Scoring System
Authors: Onate James , Cortes Nelson , Welch Cailee , Van Lunen Bonnie
Published: August 2016

Context:

A clinical assessment tool that would allow for efficient large-group screening is needed to identify individuals potentially at risk for anterior cruciate ligament (ACL) injury.

Objective:

To assess the criterion validity of a jumplanding assessment tool compared with 3-dimensional (3D) motion analysis and evaluate interrater reliability across an expert vs novice rater using the Landing Error Scoring System (LESS).

Design:

Validity protocol.

Setting:

Controlled, laboratory.

Participants:

Nineteen female (age 19.58 ± .84 y, height 1.67 ± .05 m, mass 63.66 ± 10.11 kg) college soccer athletes volunteered.

Main Outcome Measurement:

Interrater reliability between expert rater (5 y LESS experience) vs novice rater (no LESS experience). LESS scores across 13 items and total score. 3D lower extremity kinematics were reduced to dichotomous values to match LESS items.

Interventions:

Participants performed drop-box landings from a 30-cm height with standard video-camera and 3D kinematic assessment.

Results:

Intrarater item reliability, assessed by kappa correlation, between novice and experienced LESS raters ranged from moderate to excellent (κ = .459–.875). Overall LESS score, assessed by intraclass correlation coefficient, was excellent (ICC2,1 = .835, P < .001). Statistically significant phi correlation (P < .05) was found between rater and 3D scores for knee-valgus range of motion; however, percent agreement between expert rater and 3D scores revealed excellent agreement (range of 84–100%) for ankle flexion at initial contact, knee-flexion range of motion, trunk flexion at maximum knee flexion, and foot position at initial contact for both external and internal rotation of tibia. Moderate agreement was found between rater and 3D scores for trunk flexion at initial contact, stance width less than shoulder width, knee valgus at initial contact, and knee-valgus range of motion.

Conclusions:

Our findings support moderate to excellent validity and excellent expert vs novice interrater reliability of the LESS to accurately assess 3D kinematic motion patterns. Future research should evaluate the efficacy of the LESS to assess individuals at risk for ACL injury.
Development of a Measure of Rehabilitation Adherence for Athletic Training
Authors: Granquist Megan D. , Gill Diane L. , Appaneal Renee N.
Published: August 2016

Context:

Rehabilitation adherence is accepted as a critical component for attaining optimal outcomes. Poor adherence is recognized as a problem in the athletic training setting. Measurement has been inconsistent, and no measure has been developed for athletic training settings.

Objective:

To identify indicators of sportinjury rehabilitation adherence relevant to athletic training and develop a Rehabilitation Adherence Measure for Athletic Training (RAdMAT) based on these indicators.

Design:

Mixed methods, 3 steps.

Setting:

College athletic training facility.

Participants:

Practicing certified athletic trainers (ATCs; n = 7) generated items, experts (n = 12) reviewed them, and practicing ATCs (n = 164) completed the RAdMAT for their most, average, and least adherent athlete.

Main Outcome Measure:

RAdMAT.

Results:

The RAdMAT is 16 items with 3 subscales. Subscales and total have good internal consistency and clearly discriminate among adherence levels.

Conclusions:

The RAdMAT is based on scholarly literature and clinical practice, making it particularly appropriate for use in athletic training clinical practice or for research purposes.
Pain and Ethnicity in Athletes
Authors: Buxton Barton P. , Perrin David H. , Hetzler Ronald K. , Ho Kwok W. , Gieck Joe H.
Published: August 2016

The purpose of this investigation was to determine the relationship between ethnicity and acute pain response in male athletes. Subjects included 93 male athletes (age = 18.65 ± .58 years) of differing ethnicity. Each subject performed a Cold Pressor Test (CPT) and was evaluated for pain threshold and pain tolerance times. Two one-way analyses of variance were performed to analyze the data. The results indicated that significant differences existed in pain tolerance times between ethnic groups (p<.05). However, no differences were observed in pain threshold times. These findings support the existence of a difference in pain tolerance between ethnic groups in collegiate athletes.
Assessment of Scapular Position
Authors: Neiers Lynne , Worrell Teddy W.
Published: August 2016

Assessment of posture is an integral component of the evaluation of patients with neck and shoulder dysfunctions. Protraction of the scapulae has been postulated to produce weakness of the shoulder musculature. Therefore, an accurate method is needed to assess scapular position in order to determine the effect of therapeutic intervention and classify dysfunction. The purpose of this study was to determine if an experienced clinician would accurately determine scapular position. Fifty subjects (age = 26 ±5.7 years, weight = 69.2 ±14.09 kg; height = 173.9 ±13.91 cm) participated in this study. The results revealed the following reliability coefficients: scapular distance (SD) intraclass correlation coefficient (ICC) = .80, scapular size (SS) ICC = .96, and normalized scapular abduction (NSA) (SD/SS) ICC = .34. These data demonstrate that NSA was not reproducible in this study. The authors hypothesize that NSA contains more measurement error because NSA is a ratio value in which both the numerator and denominator contain measurement error. Further study is needed before NSA values are used to determine scapular position or correlated NSA is used to force development of shoulder musculature.
Role of Body and Joint Position on Isokinetic Exercise and Testing
Authors: Smith Donna D.
Published: August 2016

This paper reviews the role of body and joint position during isokinetic exercise and testing. Due to the frequent implementation of isokinetic devices, it is important to examine the methodology of their use. Positioning of the subject and the target joint is a critical component of the methodology. The literature reveals significant relationships between the position of the subject and outcome measures such as torque, agonist-antagonist ratios, peak torque to body weight ratios, and reliability. These relationships are evidenced at the larger joints of the lower extremity, such as the hip, knee, and ankle, in addition to the shoulder joint of the upper extremity. Therefore, it behooves clinicians to review research regarding the effect of varied body and joint positions on outcome measures and regarding the relevance of specific positions to the predetermined goals.
Assessment of Knee Laxity Following Anterior Cruciate Ligament Reconstruction
Authors: Holcomb Kelly R. , Skaggs Cheryl A. , Worrell Teddy W. , DeCarlo Mark , Shelbourne K. Donald
Published: August 2016

A paucity of information exists concerning reliability of the KT-1000 knee arthrometer (MEDmetric Corp., San Diego, CA) when used by different clinicians to assess the same anterior cruciate ligament-deficient patient. The purpose of this study was to determine the reliability and standard error of measurement of four clinicians who routinely report KT-1000 arthrometer values to referring orthopedic surgeons. Two physical therapists and two athletic trainers performed anterior laxity tests using the KT-1000 on 19 subjects. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to determine reliability. Intratester ICC ranged from .98 to 1.0 and intratesterSEMranged from 0.0 to .28 mm. Intertester ICC andSEMfor all four testers were .53 and 1.2 mm, respectively. A 95% confidence interval (M ± 1.96 ×SEM) of the intertester variability ranged from −0.18 to 4.52 mm. Therefore, large intertester variation existed in KT-1000 values. Each facility should standardize testing procedures and establish intratester and intertester reliability for all clinicians reporting KT-1000 values.
Reliability of Three Single-Leg Hop Tests
Authors: Booher Laurie D. , Hench Karla M. , Worrell Teddy W. , Stikeleather Jill
Published: August 2016

Traditionally, lower extremity strength assessment has been performed in an open kinetic chain. Several authors, however, recommend closed kinetic chain assessment of lower extremity performance. Reliability of closed kinetic chain tests is not available. Therefore, the purpose of this study was to determine the reliability of the following single-leg hop tests: hop for distance, 6-m hop for time, and 30-m agility hop. Eighteen subjects (4 males and 14 females) participated in this study. An ANOVA repeated measures analysis revealed significant differences between the test trials within and between sessions for all dependent variables. However, when the mean of two test trials was analyzed, the three single-leg hop tests values were stable, that is, intraclass correlation coefficient (ICC 2,1) ranged from 0.77 to 0.99. Results demonstrate that these three single-leg hop tests were reliable as used in this study. Future research is needed to determine the sensitivity of these tests in the assessment of lower extremity performance following injury and following rehabilitation procedures.
The Reliability of Four Different Methods of Calculating Quadriceps Peak Torque and Angle-Specific Torques at 30°, 60°, and 75°
Authors: Arnold Brent L. , Perrin Dawid H.
Published: August 2016

Twelve university females were studied to determine the reliability of four different methods of calculating concentric and eccentric peak torque (PT) and angle-specific torques (ASTs) for knee extension. Each subject was tested on the Kin-Corn isokinetic dynamometer on two separate occasions, performing five concentric and eccentric contractions at 60° • s−1. PT and AST at 30°, 60°, and 75° were calculated by averaging the first three contractions, averaging all five contractions, taking the single best value of the first three contractions, and taking the single best value of all five contractions. Intraclass correlation coefficients derived from these calculations showed high correlation among the four methods. Additionally, z tests performed on correlation coefficients transformed to Fisher's Z revealed no differences between pairs of correlation coefficients. These data appear to show there is no difference among the four methods of calculating PT and AST.
Validation of the 12-Minute Cycle Ergometer Test Using a Higher Resistance Setting
Authors: Vanderburgh Paul M. , DeMeersman Ronald E.
Published: August 2016

The 12-Minute Stationary Cycle Ergometer Test (12MCET) has been developed and validated as an accurate VO2peak prediction test particularly for the injured (7). Prediction is based on body weight and total work done in 12 min at a resistance setting of 2.5 kp (men) and 2.0 kp (women) on the Monark cycle ergometer. In the development of the 12MCET a small number of subjects stated a preference for a higher resistance setting than 2.5 kp. The purpose of this study was to validate the use of the 12MCET with a resistance setting of 3.0 kp for a sample of 30 college-age men. When applied to the 12MCET, use of the 3.0 kp resistance setting overpredicted actual VO2peak by a mean of 175 ml • min−1 (p = .02). We concluded that the use of a 3.0 kp resistance setting for the 12MCET is inappropriate and that any resistance setting other than that prescribed should not be used without proper validation.
Clinical Outcomes Assessment for the Management of Sport-Related Concussion
Authors: McLeod Tamara C. Valovich , Register-Mihalik Johna K.
Published: August 2016

Patient Scenario:

An adolescent female youth soccer athlete, with a previous concussion history, suffered a second concussion 4 wk ago. Her postconcussive symptoms are affecting her school performance and social and family life.

Clinical Outcomes Assessment:

Concussion is typically evaluated via symptoms, cognition, and balance. There is no specific patient-oriented outcomes measure for concussion. Clinicians can choose from a variety of generic and specific outcomes instruments aimed at assessing general health-related quality of life or various concussion symptoms and comorbidities such as headache, migraine, fatigue, mood disturbances, depression, anxiety, and concussion-related symptoms.

Clinical Decision Making:

The data obtained from patient self-report instruments may not actively help clinicians make return-to-play decisions; however, these scales may be useful in providing information that may help the athlete return to school, work, and social activities. The instruments may also serve to identify issues that may lead to problems down the road, including depression or anxiety, or serve to further explore the nature of an athlete’s symptoms.

Clinical Bottom Line:

Concussion results in numerous symptoms that have the potential to linger and has been associated with depression and anxiety. The use of outcomes scales to assess health-related quality of life and the effect of other symptoms that present with a concussion may allow clinicians to better evaluate the effects of concussion on physical, cognitive, emotional, social, school, and family issues, leading to better and more complete management.
Tracking Ability, Motor Coordination, and Functional Determinants After Anterior Cruciate Ligament Reconstruction
Authors: Yosmaoglu Hayri Baran , Baltaci Gül , Kaya Defne , Ozer Hamza
Published: August 2016

Context:

The development pattern of motor coordination, strength, and functional ability during recovery from anterior cruciate ligament (ACL) reconstruction.

Objective:

To investigate the relationship between motor coordination, functional ability, and strength after ACL reconstruction.

Design:

Prospective clinical follow-up study.

Setting:

Sports-injury research laboratory.

Participants:

20 subjects who underwent ACL reconstruction.

Interventions:

Real-time eccentric and concentric motor coordination were tested by a multijoint lower limb tracking-trajectory test, quadriceps and hamstring isokinetic strength were assessed by isokinetic dynamometer, and functional performance was tested with a single-leg-hop test 6 and 12 mo after ACL reconstruction.

Main Outcome Measures:

Percentage deficits of the involved lower extremity for target-tracking ability, peak torque, total work parameters of isokinetic strength, and single-leg-hop distance.

Results:

Deficits in hamstring–quadriceps isokinetic muscle strength and single-leg-hop distance significantly decreased from the 6th to the 12th mo after surgery (P < .05). There were no significant differences in muscle concentric and eccentric motor-coordination deficits of the involved side (P > .05).

Conclusions:

Although muscle strength and functional performance clearly increased from the 6th to the 12th mo after surgery, coordination characteristics of involved side remained low. This pattern demonstrated that motor-coordination progression was not affected by strength development. Patients continued to have significant motor-coordination deficits even 12 mo postsurgery. Therefore, the authors recommend that neuromuscular-coordination exercises be included in long-term rehabilitation programs to improve motor coordination.
Effects of a Single-Task Versus a Dual-Task Paradigm on Cognition and Balance in Healthy Subjects
Authors: Ross Luke M. , Register-Mihalik Johna K. , Mihalik Jason P. , McCulloch Karen L. , Prentice William E. , Shields Edgar W. , Guskiewicz Kevin M.
Published: August 2016

Context:

Recent evidence has revealed deficiencies in the ability to divide attention after concussion.

Objective:

To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.

Design:

Pretest–posttest experimental design.

Setting:

Sports medicine research laboratory.

Patients:

30 healthy, recreationally active college students.

Intervention:

Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.

Main Outcome Measures:

The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.

Results:

On the SOT, performance significantly improved between test sessions (F1,29 = 35.695, P < .001) and from the single to the dual task (F1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F1,29 = 57.252, P < .001) and from the single to the dual task (F1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.

Conclusions:

The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.
Reliability of Video Motion-Analysis Systems to Measure Amplitude and Velocity of Shoulder Elevation
Authors: Melton Christopher , Mullineaux David R. , Mattacola Carl G. , Mair Scott D. , Uhl Tim L.
Published: August 2016

Context:

Dynamic shoulder motion can be captured using video capture systems, but reliability has not yet been established.

Objective:

To compare the reliability of 2 systems in measuring dynamic shoulder kinematics during forward-elevation movements and to determine differences in these kinematics between healthy and injured subjects.

Design:

Reliability and cohort.

Setting:

Research laboratory.

Participants:

11 healthy subjects and 10 post–superior labrum anteroposterior lesion patients (SLAP).

Intervention:

Contrasting markers were placed at the hip, elbow, and shoulder to represent shoulder elevation and were videotaped in 2 dimensions. Subjects performed 6 repetitions of active elevation (AE) and active assisted elevation of the shoulder, and 3 trials were analyzed using Datapac (comprehensive system) and Dartfish (basic system).

Main Outcome Measures:

Amplitudes and velocities of the shoulder angle were calculated. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and levels of agreement (LOA) were used to determine intersystem and intertrial reliability.

Results:

For AE, the amplitude maximum (ICC = .98–.99, SEM = 2–3°, LOA = −9° to 5°) and average velocity (ICC = .94–.97, SEM = 1°/s, LOA = −4° to 1°/s) indicated excellent intersystem reliability between systems. Intratrial reliability for minimum velocity was moderate for Datapac (ICC = .64, SEM = 4°/s, LOA = 7°/s) and poor for Dartfish (ICC = .52, SEM = 20°/s, LOA = 37°/s). Cohort results demonstrated for AE a greater amplitude for healthy v SLAP (139° ± 11° v 113° ± 13°; P = .001) and interaction for an average velocity increase of 2°/s in healthy and decrease of 2°/s in SLAP patients over the 3 trials (P = .02).

Conclusions:

Reliability ranges provide the means to assess the clinical meaningfulness of results. The cohort differences are supported when the values exceed the ranges of the SEM; hence the amplitude results are meaningful. For dynamic shoulder elevation measured using video, the assessment of velocity was found to produce moderate to good reliability. The results suggest that with these measures subtle changes in both measures may be possible with further investigations.
Effect of Static Foot Alignment on Plantar-Pressure Measures During Running
Authors: Lee Sae Yong , Hertel Jay
Published: August 2016

Context:

Altered foot dynamics due to malalignment of the foot may change plantar-pressure properties, resulting in various kinds of overuse injuries.

Objective:

To assess the effect of foot characteristics on plantar-pressure-related measures such as maximum pressure, maximum pressure–time, and pressure–time integral underneath the medial aspect of the foot during running.

Design:

Cross-sectional.

Setting:

Laboratory. Participants: 8 men and 17 women.

Main Outcome Measures:

Static non-weight-bearing rear-foot and forefoot alignment and navicular drop were measured. Plantar-pressure data were collected while subjects jogged at 2.6 m/s on a treadmill. Maximum pressure, time to maximum pressure, and pressure–time integral of the medial side of the foot were extracted for data analysis. Multiple-regression analysis was used to examine the effect of arch height and rear-foot and forefoot alignment on maximum pressure and pressure–time integral in the medial side of the foot.

Results:

In the medial rear-foot and midfoot regions, only rear-foot alignment had a significant effect on the variance of maximum pressure and pressure–time integral. There were no significant difference effects in the medial forefoot region.

Conclusion:

Rear-foot alignment was found to be a significant predictor of maximum plantar pressure and pressure–time integral in the medial rear-foot and midfoot regions. This indicates that control of rear-foot alignment may help decrease plantar pressure on the medial region of the foot, which may potentially prevent injuries associated with excessive rear-foot eversion.