bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Whole-Body Cooling for Exercise-Induced Hyperthermia: A Systematic Review
Authors: McDermott Brendon P. , Casa Douglas J. , Ganio Matthew S. , Lopez Rebecca M. , Yeargin Susan W. , Armstrong Lawrence E. , Maresh Carl M.
Published: December 2009

Objective:

To assess existing original research addressing the efficiency of whole-body cooling modalities in the treatment of exertional hyperthermia.

Data Sources:

During April 2007, we searched MEDLINE, EMBASE, Scopus, SportDiscus, CINAHL, and Cochrane Reviews databases as well as ProQuest for theses and dissertations to identify research studies evaluating whole-body cooling treatments without limits. Key words were cooling, cryotherapy, water immersion, cold-water immersion, ice-water immersion, icing, fanning, bath, baths, cooling modality, heat illness, heat illnesses, exertional heatstroke, exertional heat stroke, heat exhaustion, hyperthermia, hyperthermic, hyperpyrexia, exercise, exertion, running, football, military, runners, marathoner, physical activity, marathoning, soccer, and tennis.

Data Synthesis:

Two independent reviewers graded each study on the Physiotherapy Evidence Database (PEDro) scale. Seven of 89 research articles met all inclusion criteria and a minimum score of 4 out of 10 on the PEDro scale.

Conclusions:

After an extensive and critical review of the available research on whole-body cooling for the treatment of exertional hyperthermia, we concluded that ice-water immersion provides the most efficient cooling. Further research comparing whole-body cooling modalities is needed to identify other acceptable means. When ice-water immersion is not possible, continual dousing with water combined with fanning the patient is an alternative method until more advanced cooling means can be used. Until future investigators identify other acceptable whole-body cooling modalities for exercise-induced hyperthermia, ice-water immersion and cold-water immersion are the methods proven to have the fastest cooling rates.
Rhabdomyolysis of the Deltoid Muscle in a Bodybuilder Using Anabolic-Androgenic Steroids: A Case Report
Authors: Farkash Uri , Shabshin Nogah , Pritsch (Perry) Moshe
Published: December 2009

Objective:

Rhabdomyolysis (breakdown of skeletal muscle tissue) may be caused by mechanical, physical, chemical, or biological factors. We present the unique case of a bodybuilder who developed localized rhabdomyolysis of the deltoid muscle after injection of steroids into the shoulder region.

Background:

A 39-year-old amateur bodybuilder presented to the emergency department with excruciating pain and inability to move his right shoulder after injecting stanozolol, an anabolic-androgenic steroid (AAS), into his right deltoid muscle on the same day. On physical examination, the right deltoid muscle was swollen and tense and the surrounding skin red, tender, and warm. He had no fluctuation or systemic fever and no sensory or motor deficit. His distal pulsations were distinct. Laboratory test results suggested massive rhabdomyolysis. The major magnetic resonance imaging finding was diffuse hyperintensity signals on T2-weighted images of the deltoid muscle, which was consistent with edema.

Differential Diagnosis:

Polymyositis and dermatomyositis, mild injury, infectious myositis without phlegmon or abscess formation, radiation therapy, subacute denervation, compartment syndrome, early myositis ossificans, rhabdomyolysis, and sickle cell crisis.

Treatment:

The patient was treated with intravenous fluid replacement and sodium bicarbonate to alkalinize the urine. Four days after admission, his pain had decreased, he had regained range of motion, and his renal function remained unaffected.

Uniqueness:

Anabolic-androgenic steroid use is associated with various side effects that are generally systemic and dose related. We could not find reports of localized side effects of AAS use, as this case presented, elsewhere in the English-language literature.

Conclusions:

“Doping” among amateur athletes occurs frequently. It can cause acute and chronic health problems, most of which are systemic. This is the first description of localized rhabdomyolysis in the area of an AAS injection.
Sodium Replacement and Plasma Sodium Drop During Exercise in the Heat When Fluid Intake Matches Fluid Loss
Authors: Anastasiou Costas A. , Kavouras Stavros A. , Arnaoutis Giannis , Gioxari Aristea , Kollia Maria , Botoula Efthimia , Sidossis Labros S.
Published: December 2009

Context:

Sodium replacement during prolonged exercise in the heat may be critically important to maintaining fluid and electrolyte balance and muscle contractility.

Objective:

To examine the effectiveness of sodium-containing sports drinks in preventing hyponatremia and muscle cramping during prolonged exercise in the heat.

Design:

Randomized crossover study.

Patients or Other Participants:

Thirteen active men.

Intervention(s):

Participants completed 4 trials of an exercise protocol in the heat (30°C) consisting of 3 hours of exercise (alternating 30 minutes of walking and cycling at a heart rate of 130 and 140 beats per minute, respectively); a set of standing calf raises (8 sets of 30 repetitions); and 45 minutes of steep, brisk walking (5.5 kmṡh−1 on a 12% grade). During exercise, participants consumed fluids to match body mass loss. A different drink was consumed for each trial: carbohydrate-electrolyte drink containing 36.2 mmol/L sodium (HNa), carbohydrate-electrolyte drink containing 19.9 mmol/L sodium (LNa), mineral water (W), and colored and flavored distilled water (PL).

Main Outcome Measure(s):

Serum sodium, plasma osmolality, plasma volume changes, and muscle cramping frequency.

Results:

During both HNa and LNa trials, serum sodium remained relatively constant (serum sodium concentration at the end of the protocol was 137.3 mmol/L and 136.7 mmol/L, respectively). However, a clear decrease was observed in W (134.5 ± 0.8 mmol/L) and PL (134.4 ± 0.8 mmol/L) trials compared with HNa and LNa trials (P < .05). The same trends were observed for plasma osmolality (P < .05). Albeit not significant, plasma volume was preserved during the HNa and LNa trials, but a reduction of 2.5% was observed in the W and PL trials. None of the volunteers experienced cramping.

Conclusions:

The data suggest that sodium intake during prolonged exercise in the heat plays a significant role in preventing sodium losses that may lead to hyponatremia when fluid intake matches sweat losses.
Ultrasound Techniques Applied to Body Fat Measurement in Male and Female Athletes
Authors: Pineau Jean-Claude , Filliard Jean Robert , Bocquet Michel
Published: December 2009

Context:

For athletes in disciplines with weight categories, it is important to assess body composition and weight fluctuations.

Objective:

To evaluate the accuracy of measuring body fat percentage with a portable ultrasound device possessing high accuracy and reliability versus fan-beam, dual-energy X-ray absorptiometry (DEXA).

Design:

Cross-validation study.

Setting:

Research laboratory.

Patients or Other Participants:

A total of 93 athletes (24 women, 69 men), aged 23.5 ± 3.7 years, with body mass index  =  24.0 ± 4.2 and body fat percentage via DEXA  =  9.41 ± 8.1 participated. All participants were elite athletes selected from the Institut National des Sports et de l'Education Physique. These participants practiced a variety of weight-category sports.

Main Outcome Measure(s):

We measured body fat and body fat percentage using an ultrasound technique associated with anthropometric values and the DEXA reference technique. Cross-validation between the ultrasound technique and DEXA was then performed.

Results:

Ultrasound estimates of body fat percentage were correlated closely with those of DEXA in both females (r  =  0.97, standard error of the estimate  =  1.79) and males (r  =  0.98, standard error of the estimate  =  0.96). The ultrasound technique in both sexes had a low total error (0.93). The 95% limit of agreement was −0.06 ± 1.2 for all athletes and did not show an overprediction or underprediction bias. We developed a new model to produce body fat estimates with ultrasound and anthropometric dimensions.

Conclusions:

The limits of agreement with the ultrasound technique compared with DEXA measurements were very good. Consequently, the use of a portable ultrasound device produced accurate body fat and body fat percentage estimates in relation to the fan-beam DEXA technique.
Rotator Cuff Tear Pain and Tear Size and Scapulohumeral Rhythm
Authors: Scibek Jason S. , Carpenter James E. , Hughes Richard E.
Published: December 2009

Context:

The body of knowledge concerning shoulder kinematics in patients with rotator cuff tears is increasing. However, the level of understanding regarding how pain and tear size affect these kinematic patterns is minimal.

Objective:

To identify relationships between pain associated with a full-thickness rotator cuff tear, tear size, and scapulohumeral rhythm (SHR) and to determine whether pain and tear size serve as predictors of SHR.

Design:

A test-retest design was used to quantify pain and SHR before and after a subacromial lidocaine injection. Correlation and multivariate analyses were used to identify relationships among pain, tear size, and SHR.

Setting:

Orthopaedic biomechanics research laboratory.

Patients or Other Participants:

Fifteen patients (age range, 40–75 years) with diagnosed full-thickness rotator cuff tears participated. They were experiencing pain at the time of testing.

Intervention(s):

Shoulder kinematic data were collected with an electromagnetic tracking system before and after the patient received a lidocaine injection.

Main Outcome Measure(s):

Pain was rated using a visual analog scale. Three-dimensional scapular kinematics and glenohumeral elevation were assessed. Scapular kinematics included anterior-posterior tilt, medial-lateral tilt, and upward-downward rotation. A regression model was used to calculate SHR (scapular kinematics to glenohumeral elevation) for phases of humeral elevation and lowering.

Results:

Linear relationships were identified between initial pain scores and SHR and between tear size and SHR, representing an increased reliance on scapular motion with increasing pain and tear size. Pain was identified as an independent predictor of SHR, whereas significant findings for the effect of tear size on SHR and the interaction between pain and tear size were limited.

Conclusions:

We noted an increased reliance on scapular contributions to overall humeral elevation with increasing levels of pain and rotator cuff tear size. Pain associated with a rotator cuff tear serves as a primary contributor to the kinematic patterns exhibited in patients with rotator cuff tears.
Sagittal-Plane Trunk Position, Landing Forces, and Quadriceps Electromyographic Activity
Authors: Blackburn J. Troy , Padua Darin A.
Published: December 2009

Context:

Researchers have suggested that large landing forces, excessive quadriceps activity, and an erect posture during landing are risk factors for anterior cruciate ligament (ACL) injury. The influence of knee kinematics on these risk factors has been investigated extensively, but trunk positioning has received little attention.

Objective:

To determine the effect of trunk flexion on landing forces and quadriceps activation during landing.

Design:

Two (sex) × 2 (task) repeated-measures design.

Setting:

Research laboratory.

Patients or Other Participants:

Forty healthy, physically active volunteers (20 men, 20 women).

Intervention(s):

Participants performed 2 drop-landing tasks. The first task represented the natural, or preferred, landing strategy. The second task was identical to the first except that participants flexed the trunk during landing.

Main Outcome Measure(s):

We measured peak vertical and posterior ground reaction forces and mean quadriceps electromyographic amplitude during the loading phase of landing (ie, the interval from initial ground contact to peak knee flexion).

Results:

Trunk flexion decreased the vertical ground reaction force (P < .001) and quadriceps electromyographic amplitude (P < .001). The effect of trunk flexion did not differ across sex for landing forces or quadriceps electromyographic activity.

Conclusions:

We found that trunk flexion during landing reduced landing forces and quadriceps activity, thus potentially reducing the force imparted to the ACL. Research has indicated that trunk flexion during landing also increases knee and hip flexion, resulting in a less erect landing posture. In combination, these findings support emphasis on trunk flexion during landing as part of ACL injury-prevention programs.
Soccer-Specific Fatigue and Eccentric Hamstrings Muscle Strength
Authors: Greig Matt , Siegler Jason C.
Published: December 2009

Context:

Epidemiologic findings of higher incidences of hamstrings muscle strains during the latter stages of soccer match play have been attributed to fatigue.

Objective:

To investigate the influence of soccer-specific fatigue on the peak eccentric torque of the knee flexor muscles.

Design:

Descriptive laboratory study.

Setting:

Controlled laboratory environment.

Patients or Other Participants:

Ten male professional soccer players (age  =  24.7 ± 4.4 years, mass  =  77.1 ± 8.3 kg, V˙o2max  =  63.0 ± 4.8 mL·kg−1·min−1).

Intervention(s):

Participants completed an intermittent treadmill protocol replicating the activity profile of soccer match play, with a passive halftime interval. Before exercise and at 15-minute intervals, each player completed isokinetic dynamometer trials.

Main Outcome Measure(s):

Peak eccentric knee flexor torque was quantified at isokinetic speeds of 180° · s−1, 300° · s−1, and 60° · s−1, with 5 repetitions at each speed.

Results:

Peak eccentric knee flexor torque at the end of the game (T300eccH105  =  127 ± 25 Nm) and at the end of the passive halftime interval (T300eccH60  =  133 ± 32 Nm) was reduced relative to T300eccH00 (167 ± 35 Nm, P < .01) and T300eccH15 (161 ± 35 Nm, P  =  .02).

Conclusions:

Eccentric hamstrings strength decreased as a function of time and after the halftime interval. This finding indicates a greater risk of injuries at these specific times, especially for explosive movements, in accordance with epidemiologic observations. Incorporating eccentric knee flexor exercises into resistance training sessions that follow soccer-specific conditioning is warranted to try to reduce the incidence or recurrence of hamstrings strains.
Development and Preliminary Validation of the Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale
Authors: Glazer Douglas D.
Published: December 2009

Context:

Only a few scales measure confidence within sport; however, these scales are insufficient to measure confidence after athletic injuries. Therefore, better measures are needed to determine the psychological readiness of injured athletes to return to sport participation.

Objective:

To develop a scale that measures the psychological readiness of injured athletes to return to sport participation and to provide preliminary evidence of reliability and validity for the scale.

Design:

The Delphi method was used to develop the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). Two 1-way analyses of variance with repeated measures and 6 Pearson product moment correlations were computed to help validate the scale.

Setting:

Athletic training clinics at 3 National Collegiate Athletic Association (NCAA) schools.

Patients or Other Participants:

Four certified athletic trainers (ATs) and professors of Commission on Accreditation of Athletic Training Education-accredited athletic training programs and 3 NCAA Division III coaches made up a panel of experts that participated in the Delphi portion of the study to develop the I-PRRS. In the second part of the study, 22 injured athletes, who missed a minimum of 1 week of practice, from 3 NCAA schools in Divisions II and III were surveyed along with their respective ATs. The injured athletes and ATs participated in the validation of the I-PRRS.

Main Outcome Measure(s):

The injured athlete completed the Profile of Mood States (POMS) short form and the I-PRRS shortly after injury, before returning to the first practice, before returning to competition, and immediately after competition. The respective AT completed the I-PRRS before and after competition. The I-PRRS is a 6-item scale that measures the psychological readiness of injured athletes to return to sport, and the POMS short form is a 30-item scale that measures mood states. I added the negative moods of the POMS and subtracted the positive moods of the POMS to calculate a Total Mood Disturbance (TMD) score.

Results:

The I-PRRS scores were negatively correlated with the TMD scores of the POMS short form at all 4 time intervals, showing concurrent validity. The I-PRRS scores were lowest after injury, increased before practice, increased again before competition, and had no change after competition. The I-PRRS as completed by the athlete and respective AT was positively correlated both before and after practice, demonstrating external validity.

Conclusions:

Preliminary evidence for reliability and validity of the I-PRRS was demonstrated. The I-PRRS can be a beneficial tool for ATs to assess an athlete's psychological readiness to return to sport participation after injury.
An Assessment of Burnout in Undergraduate Athletic Training Education Program Directors
Authors: Walter Jessica M. , Van Lunen Bonnie L. , Walker Stacy E. , Ismaeli Zahra C. , Oñate James A.
Published: December 2009

Context:

Athletic training education program directors (ATEPDs) often manage their time among students, program administration, and patient care.

Objective:

To assess the level of burnout in ATEPDs and to determine the relationship between burnout and various demographics of ATEPDs.

Design:

Cross-sectional study.

Setting:

Public and private colleges and universities nationwide.

Patients or Other Participants:

Two hundred forty-nine ATEPDs of undergraduate athletic training education programs accredited by the Commission on Accreditation of Athletic Training Education.

Intervention(s):

We administered the Maslach Burnout Inventory (MBI) to all participants.

Main Outcome Measure(s):

The MBI consisted of 21 items assessing 3 characteristics of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Another component of the survey requested demographic information about the ATEPDs. We used univariate, multivariate, and factorial analyses of variance with the α level set a priori at .05. We also calculated Pearson product moment correlation coefficients.

Results:

Women had greater emotional exhaustion than men (20.67 ± 9.43 and 16.47 ± 9.64, respectively) (P  =  .001). The difference between tenure-status groups for emotional exhaustion was significant (P  =  .014), with tenure-track ATEPDs scoring higher on emotional exhaustion than tenured ATEPDs. Pearson product moment correlation coefficients revealed a weak negative relationship among emotional exhaustion and age (r  =  −0.263, P < .001), years of program director experience (r  =  −0.157, P  =  .013), and years at current job (r  =  −0.162, P  =  .010), indicating that as ATEPDs aged, gained more experience, and stayed in their current jobs, their emotional exhaustion scores decreased. There was also a weak negative relationship between age and depersonalization (r  =  −0.171, P  =  .007). There was a weak positive relationship between years at current job and personal accomplishment (r  =  0.197, P  =  .002).

Conclusions:

We found that ATEPDs experienced a moderate form of emotional exhaustion burnout and low depersonalization and personal accomplishment burnout, with women experiencing greater emotional exhaustion than males. Additionally, ATEPDs in tenure-track positions experienced greater emotional exhaustion than tenured ATEPDs. The ATEPDs need to obtain healthy coping strategies early within their directorships to manage components related to burnout.
Ice Hockey Injuries in a Japanese Elite Team: A 3-Year Prospective Study
Authors: Kuzuhara Kenji , Shimamoto Hideki , Mase Yasuyoshi
Published: December 2009

Context:

As the Asian Ice Hockey League gradually expands and becomes more competitive, ice hockey-related injuries may increase. However, no reports have been published on ice hockey injuries in Japan, including the method of injury and the daily supervision of the players during the regular season.

Objective:

To prospectively study the incidence, types, and mechanisms of ice hockey injuries in an elite Japanese ice hockey team.

Design:

Prospective observational cohort study design.

Setting:

An elite ice hockey team, Tokyo, Japan.

Patients or Other Participants:

Ninety-four players during the 2002–2005 seasons.

Main Outcome Measure(s):

Data were collected for 3 consecutive seasons using an injury reporting form.

Results:

The overall game injury rate was 74.3 per 1000 player-game hours and 11.7 per 1000 player-game hours for injuries resulting in any time loss. The overall practice injury rates were 11.2 per 1000 player-practice hours and 1.1 per 1000 player-practice hours for injuries resulting in any time loss. Forwards had the highest rate of injury, followed by defensemen and then goalkeepers. Contusions were the most common injury, followed by strains, lacerations, and sprains.

Conclusions:

Most injuries among Japanese ice hockey players occurred during games. Game or play intensity may influence the injury rate during games.
Does Creatine Supplementation Hinder Exercise Heat Tolerance or Hydration Status? A Systematic Review With Meta-Analyses
Authors: Lopez Rebecca M. , Casa Douglas J. , McDermott Brendon P. , Ganio Matthew S. , Armstrong Lawrence E. , Maresh Carl M.
Published: December 2009

Objective:

To critically assess original research addressing the effect of creatine supplementation on exercise heat tolerance and hydration status.

Data Sources:

We searched the electronic databases PubMed, Scopus, Web of Science, SPORTDiscus, and Rehabilitation & Physical Medicine, without date limitations, for the following key words: creatine, exercise, thermoregulation, dehydration, hyperthermia, heat tolerance, exertional heat illnesses, and renal function. Our goal was to identify randomized clinical trials investigating the effect of creatine supplementation on hydration status and thermoregulation. Citations from related articles also were identified and retrieved.

Data Synthesis:

Original research was reviewed using the Physiotherapy Evidence Database (PEDro) Scale. One author initially screened all articles. Fifteen of 95 articles examined the effects of creatine on thermoregulation or hydration status (or both). Two independent reviewers then reviewed these articles. Ten studies were selected on the basis of inclusion and exclusion criteria. The PEDro scores for the 10 studies ranged from 7 to 10 points (maximum possible score  =  10 points).

Conclusions:

No evidence supports the concept that creatine supplementation either hinders the body's ability to dissipate heat or negatively affects the athlete's body fluid balance. Controlled experimental trials of athletes exercising in the heat resulted in no adverse effects from creatine supplementation at recommended dosages.
Glenohumeral Rotation and Scapular Position Adaptations After a Single High School Female Sports Season
Authors: Thomas Stephen John , Swanik Kathleen A. , Swanik Charles , Huxel Kellie C.
Published: December 2009

Context:

Anterior instability and impingement are common in overhead athletes and have been associated with decreases in internal rotation (IR) and increases in external rotation (ER) motion. However, the chronology and the effect of different female sports on these conditions have yet to be determined.

Objective:

To measure glenohumeral IR and ER rotation, total range of motion, and scapular position in female overhead athletes over a single competitive season.

Design:

Multiple group pretest-posttest study.

Setting:

High school.

Patients or Other Participants:

Thirty-six female overhead athletes (age  =  15.29 ± 1.18 years, height  =  164.16 ± 7.14 cm, mass  =  58.24 ± 9.54 kg) with no history of shoulder or elbow surgery participating in high school swimming, volleyball, or tennis.

Intervention(s):

Participants were measured for all dependent variables at preseason and postseason.

Main Outcome Measure(s):

Participants were measured for glenohumeral IR and ER with the scapula stabilized. Total glenohumeral range of motion was calculated as the sum of IR and ER. Scapular upward rotation was measured at 0°, 60°, 90°, and 120° of glenohumeral abduction in the scapular plane, and scapular protraction was measured at 0°, 45° (hands on hips), and 90° of glenohumeral abduction.

Results:

Internal rotation decreased from preseason to postseason (P  =  .012). Swimmers had less IR than both volleyball and tennis players (P  =  .001). External rotation also decreased in the swimmers (P  =  .001). Overall, preseason to postseason total motion decreased for athletes participating in swimming (P  =  .001) and tennis (P  =  .019). For all participants, preseason to postseason scapular protraction at 45° glenohumeral abduction decreased (P  =  .007).

Conclusions:

Female overhead athletes demonstrated decreases in IR after only one competitive season. Clinically, our results indicate that overhead athletes should be monitored for motion changes throughout their competitive seasons.
Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures
Authors: Medina McKeon Jennifer M. , Hertel Jay
Published: December 2009

Context:

A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited.

Objective:

To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes.

Design:

Descriptive cohort design.

Setting:

University research laboratory.

Patients or Other Participants:

A total of 118 healthy adults (57 men: age  =  21.1 ± 3.0 years, height  =  179.1 ± 7.3 cm, mass  =  79.8 ± 13.0 kg; 61 women: age  =  20.0 ± 1.6 years, height  =  167.7 ± 6.7 cm, mass  =  62.7 ± 5.5 kg) volunteered.

Main Outcome Measure(s):

Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only.

Results:

Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion.

Conclusions:

We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.
Two Modes of Weight Training Programs and Patellar Stabilization
Authors: Wong Yiu-ming , Chan Suk-tak , Tang Kwok-wing , Ng Gabriel Y. F.
Published: December 2009

Context:

Underconditioned patellar stabilizing muscles could be a predisposing factor for patellar instability.

Objective:

To examine the effect of 2 modes of weight training on the size of the vastus medialis obliquus (VMO), the resting position and passive mobility of the patella, and the strength of the knee extensor muscles.

Design:

Prospective intervention, repeated measures in 3 groups.

Setting:

Orthopaedic and sports sciences research laboratory.

Patients or Other Participants:

48 healthy adults free from back and lower extremity injuries.

Intervention(s):

Participants were randomly assigned to muscle hypertrophy training, muscle strength training, or the control group. Those in the training groups pursued training 3 times per week for 8 weeks.

Main Outcome Measure(s):

Magnetic resonance imaging and ultrasound cross-sectional area of the VMO, patellar tilt angle on magnetic resonance imaging, instrumented passive patellar mobility, and isometric knee extension torque of the dominant leg.

Results:

Participants in both training groups had comparable gains in VMO size, passive patellar stability, and knee extension force, all of which were greater than for the control group (P < .05).

Conclusions:

Both short-term muscle hypertrophy and strength training programs can reinforce the patellar stabilizers in previously untrained volunteers.
Attractors to an Athletic Training Career in the High School Setting
Authors: Gardiner-Shires Alison , Mensch James
Published: December 2009

Context:

Employment opportunities for athletic trainers (ATs) in the high school setting have increased greatly in the past few years and will most likely continue to increase. Understanding what attracts individuals to become ATs and work in the high school setting is a complex process.

Objective:

(1) To examine attractors to the athletic training profession and the high school setting, (2) to determine what, if any, differences exist between attractors to the profession and those to the high school setting, and (3) to identify whether differences in attractors can be attributed to sex, time of decision, or job status.

Design:

For this descriptive study, we designed the survey using the existing socialization literature. A pilot study was conducted and distributed by e-mail.

Setting:

Survey e-mailed to participants.

Patients or Other Participants:

High school ATs (n  =  124) in South Carolina.

Main Outcome Measure(s):

Overall mean scores for attractors to athletic training and to the high school setting were calculated. Overall mean scores were compared with individual attractor mean scores to determine the most influential attractors. Effect sizes were used to determine differences in sex, time of decision, and job status.

Results:

Of the total population of South Carolina high school ATs, 92 (74%) returned surveys. High school ATs in South Carolina had similar demographics with regard to age, sex, and race. Attractors to athletic training and to the high school setting were similar and included statements consistent with the continuation, service, and interpersonal themes identified in the existing socialization literature. We noted differences, however, between early and late deciders and between full-time and part-time ATs.

Conclusions:

The findings surrounding attractors to athletic training and the high school setting contribute to the existing socialization literature and help in our understanding of how and why individuals choose to become ATs and to work in the high school setting.
National Athletic Trainers' Association Position Statement: Acute Management of the Cervical Spine–Injured Athlete
Authors: Swartz Erik E. , Boden Barry P. , Courson Ronald W. , Decoster Laura C. , Horodyski Mary Beth , Norkus Susan A. , Rehberg Robb S. , Waninger Kevin N.
Published: December 2009

Objective:

To provide certified athletic trainers, team physicians, emergency responders, and other health care professionals with recommendations on how to best manage a catastrophic cervical spine injury in the athlete.

Background:

The relative incidence of catastrophic cervical spine injury in sports is low compared with other injuries. However, cervical spine injuries necessitate delicate and precise management, often involving the combined efforts of a variety of health care providers. The outcome of a catastrophic cervical spine injury depends on the efficiency of this management process and the timeliness of transfer to a controlled environment for diagnosis and treatment.

Recommendations:

Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport, such as football, hockey, or lacrosse; and considerations in the emergency department.
Alterations in Knee Kinematics and Dynamic Stability Associated With Chronic Ankle Instability
Authors: Gribble Phillip A. , Robinson Richard H.
Published: December 2009

Chronic ankle instability (CAI) has been previously and separately associated with deficits in dynamic stability and proximal joint neuromuscular alterations, but how the 2 factors relate is unclear.Context:

To examine the contributions of lower extremity kinematics during an assessment of dynamic stability in participants with CAI.Objective:

Repeated-measures case-control design.Design:

Research laboratory.Setting:

Thirty-eight volunteers were categorized into groups of those with unilateral CAI (10 men, 9 women; age  =  20.3 ± 2.9 years, height  =  1.77 ± 0.1 m, mass  =  76.19 ± 13.19 kg) and those without (10 men, 9 women; age  =  23.1 ± 3.9 years, height  =  1.72 ± 0.1 m, mass  =  72.67 ± 16.0 kg).Patients or Other Participants:

Participants performed 10 jump landings on each limb with a rest period between test limbs.Intervention(s):

Ankle plantar flexion, knee flexion, and hip flexion were captured with an electromagnetic tracking device at the point of ground impact. Ground reaction force data were used to calculate time to stabilization in the anteroposterior and mediolateral planes.Main Outcome Measure(s):

For the anteroposterior plane, we found a group-by-side interaction (P  =  .003), with the injured side of the CAI group demonstrating reduced dynamic stability. For knee flexion, a group main effect (P  =  .008) showed that the CAI group landed with less knee flexion than the control group.Results:

Diminished dynamic stability and decreased knee flexion angle at initial contact were apparent in the CAI group and may play a role in contributing to CAI. This altered kinematic pattern may influence preventive and therapeutic interventions for those with CAI.Conclusions:
Ankle Bracing and the Neuromuscular Factors Influencing Joint Stiffness
Authors: Zinder Steven M. , Granata Kevin P. , Shultz Sandra J. , Gansneder Bruce M.
Published: December 2009

Health care professionals commonly prescribe external stabilization to decrease the incidence and severity of ankle sprains. The mechanism for this decrease is not clearly understood. Examining the effects of ankle bracing on biomechanical stability and influencing factors may provide important information regarding the neuromuscular effects of bracing.Context:

To study the effects of 2 different ankle braces on the neuromuscular factors influencing ankle stiffness.Objective:

Mixed-model repeated-measures design.Design:

Research laboratory.Setting:

Twenty-eight physically active participants composing 2 groups: 14 with unilateral functional ankle instability (age  =  26.19 ± 6.46 years, height  =  166.07 ± 12.90 cm, mass  =  69.90 ± 13.46 kg) and 14 with bilaterally stable ankles (age  =  23.76 ± 5.82 years, height  =  174.00 ± 11.67 cm, mass  =  68.60 ± 13.12 kg).Patients or Other Participants:

Participants were fitted with surface electromyography electrodes over the peroneus longus, peroneus brevis, tibialis anterior, and soleus muscles. Each participant received transient motion oscillations to his or her ankle on a custom-built medial-lateral swaying cradle in each of 3 conditions: no ankle brace (NB), lace-up brace (LU), and semirigid brace (SR).Intervention(s):

Ankle stiffness as measured by the cradle and preactivation levels (percentage of maximal voluntary isometric contraction) of the 4 test muscles.Main Outcome Measure(s):

Stiffness levels increased across brace conditions (NB  =  24.79 ± 6.59 Nm/rad, LU  =  28.29 ± 7.05 Nm/rad, SR  =  33.22 ± 8.78 Nm/rad; F2,52  =  66.185, P < .001). No differences were found between groups for rotational stiffness (stable  =  27.36 ± 6.17 Nm/rad, unstable  =  30.18 ± 8.21 Nm/rad; F1,26  =  1.084, P  =  .307). Preactivation levels did not change for any of the tested muscles with the application of an ankle brace (F2,52  =  1.326, P  =  .275).Results:

The increase in ankle rotational stiffness with the addition of an ankle brace and the lack of any demonstrable neuromuscular changes suggested ankle braces passively contributed to the stability of the system.Conclusions:
Novice to Expert Practice via Postprofessional Athletic Training Education: A Grounded Theory
Authors: Neibert Peter J.
Published: December 2009

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)–accredited postprofessional athletic training education programs.Objective:

Interviews at the 2003 NATA Annual Meeting & Clinical Symposia.Design:

Qualitative study using grounded theory procedures.Setting:

Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability.Patients and Other Participants:

The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness.Data Collection and Analysis:

The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications.Results:

The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.Conclusions:
Age-Related Differences in Neuropsychological Testing Among High School Athletes
Authors: Hunt Tamerah N. , Ferrara Michael S.
Published: December 2009

Clinicians have questioned the need to obtain annual baseline neuropsychological tests in high school athletes. If no difference among academic grades exists, annual baseline testing may not be necessary.Context:

To examine differences at baseline testing on pencil-and-paper neuropsychological tests among grade levels in high school athletes.Objective:

Cross-sectional, between-groups design.Design:

Schools participating in a Georgia high school athletics association.Setting:

High school football players (n  =  198) in the 9th through 12th grades, with a mean age of 15.78 ± 1.16 years.Patients or Other Participants:

Participants were divided into 4 groups by grade and were administered a symptom checklist and brief neuropsychological test battery. Grade level served as the independent variable. Symptom and individual test scores within the neuropsychological test battery served as dependent variables.Main Outcome Measure(s):

Differences were noted among grades on the Trail Making Test A (F3,194  =  3.23, P  =  .024, η2  =  0.048), Trail Making Test B (F3,194  =  3.93, P  =  .009, η2  =  0.057), Symbol Digit Modalities Test (F3,194  =  4.38, P  =  .005, η2  =  0.064), dominant tap (F3,194  =  3.14, P  =  .026, η2  =  0.046), and nondominant tap (F3,194  =  4.902, P  =  .003, η2  =  0.070). Using the Bonferroni correction (P ≤ .00625), we found differences between the 9th grade and 11th and 12th grades.Results:

Baseline neuropsychological test scores in high school athletes improved as a function of age, with differences between the 9th grade and 11th and 12th grades. Because the differences were driven by 9th-grade test scores, baseline testing should be completed, at minimum, upon entrance into 9th and 10th grades; however, annual testing is still recommended until additional research is conducted.Conclusions:
Keeping Your Head in the Game: Sport-Specific Imagery and Anxiety Among Injured Athletes
Authors: Monsma Eva , Mensch James , Farroll Jennifer
Published: December 2009

The use of sport-specific imagery during rehabilitation is sparse. Athletes who used imagery (either facilitative or debilitative) during injury rehabilitation were compared with injured athletes who did not use imagery. Return-to-practice anxiety in the groups was investigated also.Context:

To (1) explore debilitative images used during rehabilitation, (2) examine athlete and injury characteristics in relation to variations in imagery content and return-to-practice anxiety, (3) compare the frequency of imagery use early in injury rehabilitation with that just before return to practice, and (4) examine the relationship between image use and return-to-practice anxiety.Objective:

Observational design.Design:

Athletic training facilities.Setting:

Thirty-six injured National Collegiate Athletic Association Division I collegiate athletes sustaining at least an 8-day practice suspension due to injury.Patients or Other Participants:

Sport Imagery Questionnaire, Sport Anxiety Scale.Main Outcome Measure(s):

Athletes used both facilitative and debilitative images during different phases of rehabilitation. Men used more sport skill, strategy, and excitement imagery content than did women, who reported higher scores for worry and concentration disruption than did men. Athletes used fewer images related to their sport skills and strategies early in rehabilitation than just before they returned to practice. Additionally, athletes who used more arousal and less strategic imagery experienced more somatic anxiety.Results:

Similar to research findings on healthy athletes, sport-specific image content in injured athletes is related to return-to-practice anxiety during rehabilitation, and some of the images were perceived as debilitative. Practitioners should advise injured athletes to use sport-specific imagery, especially that related to sport skills and strategies, but they should caution athletes against using arousal imagery, because it may elevate somatic anxiety before return to practice. Image content recommendations should encompass the cognitive and motivational functions of imagery, and the practitioner should assess if any image used by the athlete is debilitative.Conclusions:
Body Image, Anthropometric Measures, and Eating-Disorder Prevalence in Auxiliary Unit Members
Authors: Torres-McGehee Toni M. , Green James M. , Leeper James D. , Leaver-Dunn Deidre , Richardson Mark , Bishop Phillip A.
Published: December 2009

Medical professionals have recognized eating disorders and related problems in competitive athletes. Auxiliary members (color guard, dance, majorettes) experience the same appearance-related pressures observed in sports commonly associated with eating disorders.Context:

To estimate eating-disorder prevalence based on associated eating-disorder characteristics and behaviors in female auxiliary members and to compare perceived and ideal body images and anthropometric measurements between at-risk and not–at-risk participants for eating-disorder characteristics and behaviors.Objective:

Cross-sectional design.Design:

Three universities in the southeastern United States.Setting:

Participants (n  =  101, mean age  =  19.2 ± 1.2 years) represented 3 auxiliary units, including color guard (n  =  35), dance line (n  =  47), and majorettes (n  =  19).Patients or Other Participants:

Participants self-reported menstrual history, height, and weight. Anthropometric measurements included height, weight, body fat percentage, and waist and hip circumferences. We screened for eating-disorder risk behavior with the Eating Attitudes Test (EAT)-26 and for body dissatisfaction with the Figural Stimuli Survey.Main Outcome Measure(s):

Based on the EAT-26, we estimated eating-disorder prevalence among members to measure 29.7% (95% confidence interval  =  20.8%, 38.6%). The EAT-26 results revealed that 21% of participants used purgatives and 14% vomited to control weight or shape. The at-risk group had higher scores on the EAT-26 total (P ≤ .01) and on the dieting (P ≤ .01), oral control (P  =  .02), and bulimia (P  =  .01) subscales. Hip circumference (P  =  .01), self-reported weight (P  =  .03), measured weight (P  =  .04), difference between measured and preferred weights (P  =  .02), and calculated target weight (P  =  .02) were different between the at-risk and not–at-risk groups.Results:

Collegiate auxiliary unit members may have an unacceptable prevalence of eating disorders. Our results validate concerns that auxiliary members may exhibit an unacceptable eating-disorder risk, highlighting the need to examine and address unhealthy weight-management behaviors independent of eating-disorder status.Conclusions:
Symptomatic and Functional Responses to Concentric-Eccentric Isokinetic Versus Eccentric-Only Isotonic Exercise
Authors: Parr Jeffrey J. , Yarrow Joshua F. , Garbo Carolyn M. , Borsa Paul A.
Published: December 2009

Context:

Rehabilitation protocols involving eccentric resistance exercise performed with loading more than 100% concentric 1-repetition maximum are effective in increasing muscle function in both healthy and injured populations. The mode of eccentric exercise (isokinetic versus isotonic) may be an important factor in limiting symptoms of delayed-onset muscle soreness and in improving muscle function after training.

Objective:

To compare functional and symptomatic responses after an eccentric-only (ECC) isotonic exercise protocol and after a combined concentric-eccentric (CON-ECC) isokinetic exercise protocol matched for total exercise volume.

Design:

Observational study.

Setting:

Controlled research laboratory.

Patients or Other Participants:

Twenty-four healthy, untrained, college-aged men (n  =  12) and women (n  =  12).

Intervention(s):

Participants were randomly assigned to the ECC isotonic or CON-ECC isokinetic exercise group and performed a single bout of resistance exercise involving the elbow flexors.

Main Outcome Measure(s):

Measurements of elbow flexion and extension, isometric strength, and muscle point tenderness were obtained before exercise (baseline) and during follow-up sessions (days 2, 4, 7, and 14). Separate 1-way analyses of variance and repeated-measures analyses of variance were used to determine outcome differences. Tukey post hoc testing was performed when indicated.

Results:

At baseline, no differences were present between groups for any measure. The ECC isotonic exercise protocol resulted in a 30% to 36% deficit in muscle strength, a 5% to 7% reduction in elbow flexion, and a 6% to 8% reduction in elbow extension at follow-up days 2 and 4 (P < .01). The CON-ECC isokinetic exercise protocol did not alter muscle strength or range of motion at any time when compared with baseline. Muscle point tenderness increased from baseline on days 2 and 4 in both groups (P < .05) but was not different between groups throughout the recovery period.

Conclusions:

Our results indicated more pronounced functional deficits occurred after a single bout of ECC isotonic exercise than with a CON-ECC isokinetic exercise protocol matched for training volume.