bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual Perspectives on Stigma: Reports of Experienced and Enacted Stigma by those Affected and Unaffected by Podoconiosis
Authors: Ayode Desta , Tora Abebayehu , Farrell David , Tadele Getnet , Davey Gail , McBride Colleen M.
Published: September 2016

Background

Disease-related stigma is a public health concern steadily gaining global attention. Evidence consistently shows that an individual's attribution of disease cause can prompt or justify interpersonal stigma. However, few studies have explored causal beliefs about inherited disease and their influence on stigmatising behaviours in low and middle income countries.

Design and methods

The study was conducted in 2013, in six communities in Wolaita zone, Southern Ethiopia. A total of 1800 respondents took part in the study, 600 were affected by an inherited disease and 1200 were unaffected neighbours. Two versions of the interviewer-administered survey were created, with measures assessed in parallel on experienced stigma for the affected and enacted stigma for unaffected respondents.

Results

Mean levels of enacted stigma reported by unaffected respondents were slightly lower (2.0, SD=0.7) than experienced stigma reported by affected respondents [2.2 (standard deviation=1.1)]. Beliefs that podoconiosis was hereditary were significantly and positively associated with levels of enacted stigma reported by unaffected respondents and experienced stigma reported by affected respondents (P<0.001). There was no association of reported levels of stigma experienced by affected respondents with levels of enacted stigma reported by the neighbouring unaffected respondents. Males consistently reported significantly lower levels of experienced and enacted stigma than females, P<0.0001.

Conclusions

If stigma reduction interventions are to be successful, culturally tailored, gender inclusive and innovative health education programs are required, directed at the general community as well as individuals affected by inherited diseases.
Retention Initiatives Used by Professional Master's Athletic Training Program Directors
Authors: Bowman Thomas G. , Dodge Thomas M. , Mazerolle Stephanie M.
Published: September 2016

Context

Many professional master's athletic training program directors believe retention is a problem facing athletic training education. However, it remains unknown what steps, if any, are taken to improve retention.

Objective

To inquire with program directors about their respective methods and interventions aimed at increasing retention rates.

Design

Qualitative study.

Setting

Professional master's athletic training programs.

Patients or Other Participants

Fifteen program directors out of 25 responded to an online survey invitation for a response rate of 60%. We also completed follow-up telephone interviews with 8 randomly selected program directors to gather greater insight into the ways they improve retention.

Main Outcome Measure(s)

We asked directors of all 25 professional master's athletic training programs in the United States to complete an online survey. We also asked 8 program directors from those who responded to complete telephone interviews. Grounded theory guided data analysis and we secured credibility through the use of multiple-analyst triangulation, member checks, and peer review.

Results

We identified 3 themes of ways program directors help improve student retention rates. Our participants described adequately screening admissions packets, providing financial support to defray the cost of pursuing a degree in athletic training at the professional master's level, and various student initiatives.

Conclusions

Based on our findings, we recommend a thorough application process that screens prospective students and identifies those who can complete the program. Program directors should also find ways to help defray the costs of earning a master's degree to allow students to become integrated into the program intellectually, socially, and clinically without increasing stress levels. Finally, providing students with opportunities for early socialization and mentoring should be aimed at explaining program expectations while preparing the students for professional practice.
The Effects of an Electronic Audience Response System on Athletic Training Student Knowledge and Interactivity
Authors: Tivener Kristin Ann , Hetzler Tona
Published: September 2016

Context

Electronic audience response systems (ARSs) are a technological teaching tool currently being used with widespread success within various disciplines of higher education. Researcher support for its application in athletic training education remains sparse, however.

Objective

The aim of this study was to examine whether use of an ARS in a basic athletic training course improved student knowledge acquisition and interactivity.

Design

Preintervention and postintervention surveys.

Setting

Commission on Accreditation of Athletic Training Education–accredited athletic training program.

Patients or Other Participants

Sixty-nine undergraduate students enrolled in one of 2 sections of an introductory athletic training course.

Main Outcome Measure(s)

A mixed-measures analysis of variance (ANOVA) was conducted to look for differences in knowledge acquisition based upon group membership (control versus experimental) and the effect of instruction.

Results

An interaction was discovered for the effect of instruction and use of the ARS (F1,59 = 5.89, P = .018, η2p = .091), indicating that the acquisition of knowledge in the experimental group (7.97 ± 1.49) was greater than for the control group (7.24 ± 1.75). A mixed-measure ANOVA found differences in classroom interactivity based upon group membership. There was a main effect for interactivity (F1,59 = 5.40, P = .024, η2p = .084), indicating that interactive participation increased among students from 7.16 ± 1.23 on the pretest to 7.56 ± 1.08 on the posttest; however, there was no interaction between interactivity and group membership, indicating that both the control and experimental groups increased interactivity at the same rate.

Conclusions

Audience response system technology improved student knowledge when used in an introductory athletic training course. Additional research should investigate active learning tools to determine what most strongly affects students' interactivity.
An Analysis of Doctoral Students' Perceptions of Mentorship During Their Doctoral Studies
Authors: Mazerolle Stephanie M. , Bowman Thomas G. , Klossner Joanne C.
Published: September 2016

Context

Mentorship has been established as a key facilitator of professional socialization for athletic trainers into various professional roles. Understanding how current doctoral students are trained to serve in future faculty roles is critical, as there is an increased demand for athletic trainers to serve in this capacity.

Objective

Gain an understanding of the relationship that develops between a doctoral student and the athletic training faculty mentor.

Design

Qualitative study.

Setting

Universities with athletic training doctoral students.

Patients or Other Participants

Twenty-eight doctoral students (19 females, 9 males; average age = 28 ± 3 years) participated in our study. The doctoral students were certified for 6 ± 3 years and represented 5 different National Athletic Trainers' Association districts and 9 different universities.

Main Outcome Measures

One-on-one telephone interviews following a semistructured script were recorded with all participants. Upon completion, each interview was transcribed and analyzed using a thematic approach. Peer review, multiple analyst triangulation, and stakeholder checks ensured trustworthiness.

Results

Three themes emerged from our thematic analysis procedure: (1) The relationship between the student and the faculty mentor needs to be one that is supportive, yet viewed as yielding autonomy and collaboration; (2) the relationship between the student and the faculty mentor needs to include opportunities for professional development specifically related to skill acquisition and development related to a future academic role; and (3) the relationship between the student and the faculty mentor must demonstrate a mutual investment in the educational experience.

Conclusions

Mentoring is necessary to help ensure a quality experience for doctoral students preparing for future positions in higher education or research. Like previous research in socialization, doctoral students want autonomy in their roles, but value their mentor's feedback and support. Therefore, doctoral faculty mentors should demonstrate strong communication skills and provide doctoral students opportunities for diverse learning experiences.
Designing Simulations for Athletic Training Students Through Interprofessional Teaching Collaboration
Authors: Tivener Kristin Ann , Gloe Donna Sue
Published: September 2016

Context

While multidisciplinary team approaches to education and practice have been promoted for decades, literature on collaborative efforts in athletic training and nursing remains sparse.

Objective

The goal of this article is to provide an example of an interprofessional teaching collaboration in which a simulation scenario was developed between athletic training and nursing education faculty members and to outline the observed benefits and barriers arising from this approach.

Background

Interprofessional education and interdepartmental faculty collaboration are increasingly becoming more established and practiced elements of health professionals' education. Bringing together professionals from diverse but interrelated disciplines in a collaborative teaching activity can enhance students' understanding of the health care system and the technical expertise each professional provides in emergent situations.

Description

In many health care education programs simulation has been increasingly used as a teaching tool to provide students with opportunities to practice and learn in an environment that mirrors reality as closely as possible. An example of a simulation scenario developed through an interprofessional teaching collaborative is provided as a foundational design for reproduction.

Clinical Advantage(s)

Interprofessional teaching collaboration of athletic training and nursing faculty can greatly enhance the content and realism of cardiopulmonary simulation for athletic training students when it involves the combined knowledge and experience of these 2 disciplines.

Conclusion(s)

Interprofessional teaching collaboration in simulation scenarios can greatly enhance learning insights and clinical relevance for athletic training students.
Single-Case Research Design: An Alternative Strategy for Evidence-Based Practice
Authors: Stapleton Drue , Hawkins Andrew
Published: September 2016

Objective

The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and pedagogical practices. The purpose of this paper is to review the literature related to SCD and its potential contributions to EBP in athletic training.

Data Source(s)

We searched PubMed, CINAHL, Proquest Dissertation and Theses, and Google Scholar using terms “single case design”, “single subject design”, “within subjects”, and combined search terms of “single case design AND athletic training, AND allied health, AND medicine, AND nursing”.

Data Synthesis

Textual support for the use of SCD in athletic training and a brief review of literature pertaining to: general features, strengths, limitations, and design options commonly associated with the use of SCD.

Conclusions

Use of SCD in allied health professions is limited, with fewer studies in athletic training settings. Low awareness and misinterpretation of SCD may be contributing to the low use of SCD in athletic training research. The key characteristics of SCD make it appropriate for use in clinical and educational settings and may provide clinicians, educators, and researchers an alternative tool for the development of evidence necessary to engage in evidence-based practice.
Effectiveness of Mobile Learning on Athletic Training Psychomotor Skill Acquisition
Authors: Davie Emily , Martin Malissa , Cuppett Micki , Lebsack Denise
Published: September 2016

Context

Instruction of psychomotor skills is an important component of athletic training education. Accommodating the varied learning abilities and preferences of athletic training students can be challenging for an instructor initiating skill acquisition in a traditional face-to-face (F2F) environment. Video instruction available on mobile devices may offer an alternative teaching tool, allowing for student-initiated learning.

Objective

To compare outcomes of Quick Clips (QC) instruction with F2F instruction as measured by skill-examination scores.

Design

Quasi-experimental.

Setting

Five higher learning institutions with Commission on Accreditation of Athletic Training Education (CAATE) accredited athletic training education programs.

Patients or Other Participants

Seventy-four pre-athletic training students, average age 18.86 ± 1.0 years (49 women, 25 men), volunteered for this study. Participants were randomly assigned to 1 of 2 instructional groups (F2F or QC).

Intervention(s)

The principal investigator provided F2F instruction to 38 participants in 3 skills (knee valgus stress test, middle trapezius manual muscle test, and goniometric measurement of active ankle dorsiflexion). The remaining 36 participants watched 3 QC videos demonstrating the same skills.

Main Outcome Measure(s)

Three individual skill exam scores and the total score.

Results

A 1-way multivariate analysis of variance indicated a significant effect (P < .0001) of instructional method on exam scores. Follow-up univariate analysis of variance indicated knee valgus stress test exam scores were significantly higher after F2F instruction (P < .0001). Neither manual muscle test nor goniometric measurement exam scores were affected by instructional method.

Conclusions

The findings support the use of QC as an alternative to F2F instruction for 2 of the 3 skills. This finding is similar to studies reported in the nursing literature on computer-assisted learning, which found inconclusive evidence to support the superiority of one method over another. Mobile video instruction is an effective teaching strategy. It may be best utilized to supplement traditional F2F instruction.
Seeking Greater Relevance for Athletic Training Education Within American Higher Education and the Health Care Professions
Authors: Perrin David H.
Published: September 2016

This paper addresses several of the challenges facing today's system of higher education, and discusses the implications of these challenges for the athletic training profession. Among the major challenges are cost, accountability, access, and value of a higher education. The paper next focuses on several issues about which athletic training educators should be thinking. They include the importance of a liberal arts education at the undergraduate level, athletic training's role in interprofessional education and practice, and the importance of diversity and inclusive excellence in helping to diversify the health care workforce and reduce health disparities. The paper concludes with a discussion of the evolution of athletic training from physical education to the health care professions and the transition to the professional master's degree as the entry-level degree in athletic training. The contents of this paper are based largely on the keynote address at the 2015 National Athletic Trainers' Association Athletic Training Educators' Conference in Dallas, Texas, February 27–March 1.
Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training
Authors: Mazerolle Stephanie M. , Eason Christianne M. , Pitney William A. , Mueller Megan N.
Published: September 2016

Context

 Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner's sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits.

Objective

 To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits.

Design

 Cross-sectional study.

Setting

 Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales.

Patients or Other Participants

 A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old.

Main Outcome Measures(s)

 Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession.

Results

 The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t244 = 0.492, P = .95) or their willingness to leave the profession (t244 = −1.27, P = .21). We noted differences among ATs in different practice settings (F8,245 = 5.015, P <.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = −0.533, P < .001). Comfort with using work-leave benefits was different among practice settings (F8,245 = 3.01, P = .003).

Conclusions

 The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.
Intramuscular Heating Characteristics of Multihour Low-Intensity Therapeutic Ultrasound
Authors: Rigby Justin H. , Taggart Rebecca M. , Stratton Kelly L. , Lewis George K. , Draper David O.
Published: September 2016

Context

The heating characteristics of a stationary device delivering sustained acoustic medicine with low-intensity therapeutic ultrasound (LITUS) are unknown.

Objective

To measure intramuscular (IM) heating produced by a LITUS device developed for long-duration treatment of musculoskeletal injuries.

Design

Controlled laboratory study.

Setting

University research laboratory.

Patients or Other Participants

A total of 26 healthy volunteers (16 men, 10 women; age = 23.0 ± 2.1 years, height = 1.74 ± 0.09 m, mass = 73.48 ± 14.65 kg).

Intervention(s)

Participants were assigned randomly to receive active (n = 20) or placebo (n = 6) LITUS at a frequency of 3 MHz and an energy intensity of 0.132 W/cm2 continuously for 3 hours with a single transducer or dual transducers on the triceps surae muscle. We measured IM temperature using thermocouples inserted at 1.5- and 3-cm depths into muscle. Temperatures were recorded throughout treatment and 30 minutes posttreatment.

Main Outcome Measure(s)

We used 2-sample t tests to determine the heating curve of the LITUS treatment and differences in final temperatures between depth and number of transducers.

Results

A mild IM temperature increase of 1°C was reached 10 ± 5 minutes into the treatment, and a more vigorous temperature increase of 4°C was reached 80 ± 10 minutes into the treatment. The maximal steady-state IM temperatures produced during the final 60 minutes of treatment at the 1.5-cm depth were 4.42°C ± 0.08°C and 3.92°C ± 0.06°C using 1 and 2 transducers, respectively. At the 3.0-cm depth, the maximal steady-state IM temperatures during the final 60 minutes of treatment were 3.05°C ± 0.09°C and 3.17°C ± 0.05°C using 1 and 2 transducers, respectively. We observed a difference between the temperatures measured at each depth (t78 = −2.45, P = .02), but the number of transducers used to generate heating was not different (t78 = 1.79, P = .08).

Conclusions

The LITUS device elicited tissue heating equivalent to traditional ultrasound but could be sustained for multiple hours. It is a safe and effective alternative tool for delivering therapeutic ultrasound and exploring dosimetry for desired physiologic responses.
Assessment of Muscle Pain Induced by Elbow-Flexor Eccentric Exercise
Authors: Lau Wing Yin , Blazevich Anthony J. , Newton Michael J. , Wu Sam Shi Xuan , Nosaka Kazunori
Published: September 2016

Context:

Delayed-onset muscle soreness (DOMS) is a common muscle pain that many people experience and is often used as a model of acute muscle pain. Researchers have reported the effects of various interventions on DOMS, but different DOMS assessment protocols used in these studies make it difficult to compare the effects.

Objective:

To investigate DOMS characteristics after elbow-flexor eccentric exercise to establish a standardized DOMS assessment protocol.

Design:

Descriptive laboratory study.

Setting:

Research laboratory.

Patients or Other Participants:

Ten healthy, untrained men (21–39 years).

Intervention(s):

Participants performed 10 sets of 6 maximal isokinetic eccentric contractions of the elbow flexors.

Main Outcome Measure(s):

Indirect muscle-damage markers were maximal voluntary isometric contraction torque, range of motion, and serum creatine kinase activity. Muscle pain was assessed before exercise, immediately postexercise, and 1 to 5 days postexercise using (1) a visual analog scale (VAS), (2) a category ratio-10 scale (CR-10) when applying static pressure and palpation at different sites (3, 9, and 15 cm above the elbow crease), and (3) pressure-pain thresholds (PPTs) at 50 sites (pain mapping).

Results:

Maximal voluntary isometric contraction and range of motion decreased and creatine kinase activity increased postexercise, indicating muscle damage. Palpation induced greater pain than static pressure, and longitudinal and transverse palpations induced greater pain than circular palpation (P < .05). The PPT was lower in the medial region before exercise, but the pain-sensitive regions shifted to the central and distal regions of the biceps brachii at 1 to 3 days postexercise (P < .05). The VAS was correlated with the CR-10 scale (r = 0.91, P < .05) but not with the PPT (r = −0.28, P = .45).

Conclusions:

The way in which muscles are assessed affects the pain level score. This finding suggests that pain level and pain threshold cannot be used interchangeably and that the central and distal regions of the biceps brachii should be included in DOMS assessment using the VAS, CR-10 scale, and PPT after elbow-flexor eccentric exercise.
The Role of Personality in Job Satisfaction Among Collegiate Athletic Trainers
Authors: Eason Christianne M. , Mazerolle Stephanie M. , Monsma Eva V. , Mensch James M.
Published: September 2016

Context

 The degree to which an individual likes his or her job is known as job satisfaction. A person with higher job satisfaction is less likely to depart from a profession than a person with lower job satisfaction. Researchers studying job satisfaction among other allied health professionals suggest a personality component could explain why the reasons for departure can be so individual.

Setting

 Collegiate institutions.

Objective

 To determine the relationship between job satisfaction and personality among collegiate athletic trainers (ATs).

Patients or Other Participants

 A total of 202 ATs (68 [33.7%] men and 134 [66.3%] women), were recruited using the National Athletic Trainers' Association e-mail database. We excluded any AT from this study who worked outside of the collegiate setting. The response rate was 20.2%.

Intervention(s)

 Data were collected using a Web-based survey instrument consisting of 3 sections: (1) demographics, (2) job satisfaction survey, and (3) Big Five Personality Inventory.

Main Outcome Measure(s)

 Independent t tests were run to determine sex differences, and correlations were run to evaluate relationships between demographics and job satisfaction and between job satisfaction and personality.

Results

 Women reported higher levels of neuroticism than men. Extroversion and conscientiousness showed a weak positive relationship with job satisfaction. A moderate positive relationship was found between agreeableness and job satisfaction. A moderate negative relationship was noted between neuroticism and job satisfaction.

Conclusions

 Based on our findings, head ATs or other organizational leaders may consider using personality assessments during interview processes, or athletic training program directors may be able to better guide students interested in athletic training based on knowledge of their personalities.
Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience
Authors: Mazerolle Stephanie M. , Clines Stephanie , Eason Christianne M. , Pitney William A.
Published: September 2016

Context

 The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously.

Objective

 To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships.

Design

 Semistructured phone interviews.

Setting

 Graduate-assistant ATs in various clinical settings.

Patients or Other Participants

 Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non–athletic training-based curriculum = 6). Median age was 24 years.

Data Collection and Analysis

 Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability.

Results

 Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support.

Conclusions

 Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience.
Exertional Heat Stroke and Susceptibility to Malignant Hyperthermia in an Athlete: Evidence for a Link?
Authors: Poussel Mathias , Guerci Philippe , Kaminsky Pierre , Heymonet Marie , Roux-Buisson Nathalie , Faure Julien , Fronzaroli Emilien , Chenuel Bruno
Published: September 2016

Objective

 To describe the possible association (pathophysiologic and clinical features) between exertional heat stroke (EHS) and malignant hyperthermia (MH).

Background

 Both EHS and MH are acute and life-threatening disorders. It has repeatedly been shown that EHS can occur in well-trained patients with known MH-associated mutation in the RYR1 gene in the absence of any extreme environmental conditions or extreme physical activity, thereby supporting a possible link between EHS and MH. In this case, a highly trained 30-year-old male athlete suddenly collapsed while running. He had initial hyperthermia (40.2°C) and progressive multiple organ failure requiring medical management in an intensive care unit. After he recovered completely, a maximal exercise test was performed and showed an obvious abnormality of oxidative metabolism in muscle; genetic analysis of the RYR1 gene identified a heterozygous missense variation p.K1393R. Consequently, the athlete was given appropriate information and allowed to progressively return to sport competition.

Differential Diagnosis

 Doping, use of drugs and toxic agents, exercise-associated hyponatremia, exertional heat illness.

Treatment

 Initial management started with the basic resuscitative guidelines of airway, breathing, and circulation (intubation). Cooling, administration of fresh frozen plasma, and intensive rehydration resulted in improvement.

Uniqueness

 To our knowledge, ours is the first description of this MH mutation (p.K1393R) in the RYR1 gene that was associated with exertional rhabdomyolysis involving a dramatic impairment of oxidative metabolism in muscle.

Conclusions

 Common features are shared by EHS and MH. Careful attention must therefore be paid to athletes who experience EHS, especially in temperate climates or when there are no other predisposing factors.
Preseason Perceived Physical Capability and Previous Injury
Authors: Sciascia Aaron , Haegele Lauren E. , Lucas Jean , Uhl Timothy L.
Published: September 2016

Context

 Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking.

Objective

 To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury.

Design

 Cross-sectional study.

Setting

 Preparticipation physical examinations.

Patients or Other Participants

 A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury.

Main Outcome Measure(s)

 Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury.

Results

 Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001).

Conclusions

 Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the goal for these athletes to return to participation after injury. Athletes reporting previous injuries perceived less physical capability before the competitive season. Self-assessment of joint-specific capability may supplement preseason physical examinations, identifying particular athletes needing further monitoring or care during a season.
Multistakeholder Perspectives on the Transition to a Graduate-Level Athletic Training Educational Model
Authors: Mazerolle Stephanie M. , Bowman Thomas G. , Pitney William A.
Published: September 2016

Context

 The decision has been made to move away from the traditional bachelor's degree professional program to a master's degree professional program. Little is known about the perceptions about this transition from those involved with education.

Objective

 To examine multiple stakeholders' perspectives within athletic training education on the effect that a change to graduate-level education could have on the profession and the educational and professional development of the athletic trainer.

Design

 Qualitative study.

Setting

 Web-based survey.

Patients or Other Participants

 A total of 18 athletic training students (6 men, 12 women; age = 24 ± 5 years), 17 athletic training faculty (6 men, 9 women, 2 unspecified; 7 program directors, 5 faculty members, 3 clinical coordinators, 2 unidentified; age = 45 ± 8 years), and 15 preceptors (7 men, 7 women, 1 unspecified; age = 34 ± 7 years) completed the study.

Data Collection and Analysis

 Participants completed a structured Web-based questionnaire. Each cohort responded to questions matching their roles within an athletic training program. Data were analyzed following a general inductive process. Member checks, multiple-analyst triangulation, and peer review established credibility.

Results

 Thirty-one (62%) participants supported the transition, 14 (28%) were opposed, and 5 (10%) were neutral or undecided. Advantages of and support for transitioning and disadvantages of and against transitioning emerged. The first higher-order theme, advantages, revealed 4 benefits: (1) alignment of athletic training with other health care professions, (2) advanced coursework and curriculum delivery, (3) improved student and professional retention, and (4) student maturity. The second higher-order theme, disadvantages, was defined by 3 factors: (1) limited time for autonomous practice, (2) financial concerns, and (3) lack of evidence for the transition.

Conclusions

 Athletic training students, faculty, and preceptors demonstrated moderate support for a transition to the graduate-level model. Factors supporting the move were comparable with those detailed in a recent document on professional education in athletic training presented to the National Athletic Trainers' Association Board of Directors. The concerns about and reasons against a move have been discussed by those in the profession.
Improving Single-Legged–Squat Performance: Comparing 2 Training Methods With Potential Implications for Injury Prevention
Authors: Dawson Samuel J. , Herrington Lee
Published: September 2016

Context

 Poor dynamic limb alignment during loading tasks has links to the development of knee injuries, including patellofemoral pain and anterior cruciate ligament injury. Therefore, modalities to improve limb alignment during loading tasks are thought to reduce loading through these structures and potentially prevent injury.

Objective

 To compare hip-strengthening and skill-acquisition training to examine if they can improve lower limb biomechanics, potentially preventing injury, and to examine whether changes demonstrated can be maintained after 6 weeks of no practice.

Design

 Controlled laboratory study.

Setting

 Laboratory.

Patients or Other Participants

 A total of 19 recreationally active individuals volunteered, and 17 (9 women: age = 27.9 ± 3.1 years, height = 165.4 ± 8.4 cm, mass = 60.5 ± 9.2 kg; 8 men: age = 30.4 ± 6.4 years, height = 181.4 ± 7.1 cm, mass = 69.8 ± 15.2 kg) completed the study. Nine participants were allocated to a hip-strengthening program; 8, to a skill-acquisition program.

Intervention(s)

 Participants performed a 6-week training program of either hip strengthening (n = 9) or skill acquisition (n = 8) 3 times per week.

Main Outcome Measure(s)

 Measurements of clam-exercise strength, hip-abduction strength, frontal-plane projection angle, hip-adduction angle, and a qualitative score were taken at baseline, 6 weeks, and 12 weeks.

Results

 We observed improvements in frontal-plane projection angle (strength: t8 = 5.344, P = .001; skill: t7 = 4.393, P = .003), hip-adduction angle (strength: t8 = 3.597, P = .007; skill: t7 = 4.722, P = .002), and qualitative score (strength: t8 = 3.900, P = .005; skill: t7 = 8.283, P < .001) postintervention, which were retained at the 12-week retest in both groups.

Conclusions

 A 6-week intervention of either hip-strengthening or skill-acquisition training improved lower limb biomechanics. The changes in biomechanics after skill training were retained at 12 weeks, suggesting a change in motor patterning that could be favorable to longer-term injury prevention.
Shoulder Coordination During Full-Can and Empty-Can Rehabilitation Exercises
Authors: Robert-Lachaine Xavier , Allard Paul , Gobout Veronique , Begon Mickael
Published: September 2016

Context

Supraspinatus tear is a common rotator cuff injury. During rehabilitation, debate persists regarding the most appropriate exercises. Whereas shoulder coordination is part of normal arm function, it has been infrequently considered in the context of exercise selection.

Objective

To assess shoulder-motion coordination during 2 common supraspinatus rehabilitation exercises and to characterize load and motion-direction influences on shoulder coordination.

Design

Descriptive laboratory study.

Setting

Motion-analysis laboratory.

Patient or Other Participants

Fifteen asymptomatic right-hand–dominant men (age = 26 ± 4 years, height = 1.77 ± 0.06 m, mass = 74.3 ± 7.7 kg).

Intervention(s)

Full-can and empty-can exercises with and without a 2.27-kg load.

Main Outcome Measure(s)

We recorded motion with an optoelectronic system. Scapulohumeral rhythm and complete shoulder joint kinematics were calculated to quantify shoulder coordination. The effects of exercise type, load, motion direction, and humerothoracic-elevation angle on the scapulohumeral rhythm and shoulder-joint angles were assessed.

Results

We observed multivariate interactions between exercise type and humerothoracic elevation and between load and humerothoracic elevation. Scapulohumeral rhythm increased by a mean ratio of 0.44 ± 0.22 during the full-can exercise, whereas the addition of load increased mean glenohumeral elevation by 4° ± 1°.

Conclusions

The full-can exercise increased the glenohumeral contribution, as hypothesized, and showed normal shoulder coordination. During the empty-can exercise, the increased scapulothoracic contribution was associated with a compensatory pattern that limits the glenohumeral contribution. Using loads during shoulder rehabilitation seems justified because the scapulohumeral rhythm is similar to that of unloaded arm elevation. Finally, motion direction showed a limited effect during the exercises in healthy individuals.
Accuracy of Urine Color to Detect Equal to or Greater Than 2% Body Mass Loss in Men
Authors: McKenzie Amy L. , Muñoz Colleen X. , Armstrong Lawrence E.
Published: September 2016

Context

 Clinicians and athletes can benefit from field-expedient measurement tools, such as urine color, to assess hydration state; however, the diagnostic efficacy of this tool has not been established.

Objective

 To determine the diagnostic accuracy of urine color assessment to distinguish a hypohydrated state (≥2% body mass loss [BML]) from a euhydrated state (<2% BML) after exercise in a hot environment.

Design

 Controlled laboratory study.

Setting

 Environmental chamber in a laboratory.

Patients or Other Participants

 Twenty-two healthy men (age = 22 ± 3 years, height = 180.4 ± 8.7 cm, mass = 77.9 ± 12.8 kg, body fat = 10.6% ± 4.6%).

Intervention(s)

 Participants cycled at 68% ± 6% of their maximal heart rates in a hot environment (36°C ± 1°C) for 5 hours or until 5% BML was achieved. At the point of each 1% BML, we assessed urine color.

Main Outcome Measure(s)

 Diagnostic efficacy of urine color was assessed using receiver operating characteristic curve analysis, sensitivity, specificity, and likelihood ratios.

Results

 Urine color was useful as a diagnostic tool to identify hypohydration after exercise in the heat (area under the curve = 0.951, standard error = 0.022; P < .001). A urine color of 5 or greater identified BML ≥2% with 88.9% sensitivity and 84.8% specificity (positive likelihood ratio = 5.87, negative likelihood ratio = 0.13).

Conclusions

 Under the conditions of acute dehydration due to exercise in a hot environment, urine color assessment can be a valid, practical, inexpensive tool for assessing hydration status. Researchers should examine the utility of urine color to identify a hypohydrated state under different BML conditions.
Statistical Primer for Athletic Trainers: The Difference Between Statistical and Clinical Meaningfulness
Authors: Riemann Bryan L. , Lininger Monica
Published: September 2016

Objective

To explain statistical significance and clinical meaningfulness and to provide guidance in evaluating the clinical meaningfulness of a study.

Background

Understanding the results and statistics reported in original research remains a large challenge for many certified athletic trainers, which in turn, may be among the biggest barriers to integrating research into athletic training practice.

Description

Statistical significance reflects the influence of chance on the outcome, whereas clinical meaningfulness reflects the degree to which the differences and relationships reported in a study are relevant to athletic training practice. As consumers of original research, athletic trainers must understand the core factors, most notably sample size, that influence statistical significance.

Recommendations

To assist clinicians in evaluating the clinical meaningfulness of a research study, authors should provide the core elements necessary for interpreting statistical significance and discuss the clinical meaningfulness of statistically significant findings.
Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study
Authors: Kerr Zachary Y. , Dompier Thomas P. , Dalton Sara L. , Miller Sayers John , Hayden Ross , Marshall Stephen W.
Published: September 2016

Context

Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting.

Objective

To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports.

Design

Descriptive epidemiology study.

Setting

Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states.

Patients or Other Participants

High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011−2012 through 2013−2014 academic years.

Main Outcome Measure(s)

The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non–time-loss (NTL) injuries.

Results

Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 ± 6.52 ATR visits and 11.01 ± 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P < .001) and AT services (18.60 versus 9.56; P < .001) per injury. An average of 2.24 ± 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P < .001).

Conclusions

These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.
High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes
Authors: Custer Aimee , Sufrinko Alicia , Elbin R. J. , Covassin Tracey , Collins Micky , Kontos Anthony
Published: September 2016

Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined.Context:

 To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC.Objective:

 Cohort study.Design:

 High school and collegiate athletic programs.Setting:

 A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score > 18 [top 10% of sample], n = 68).Patients or Other Participants:

 Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment.Main Outcome Measure(s):

 The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group.Results:

 Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their injury. Additional investigation of baseline symptoms is warranted to help delineate the type and severity of premorbid symptoms.Conclusions: