bluuebunny/crossref_metadata_2025 huggingface dataset:
VARIABLE STARS AND STELLAR POPULATIONS IN ANDROMEDA XXV. III. A CENTRAL CLUSTER OR THE GALAXY NUCLEUS?*
Authors: Cusano Felice , Garofalo Alessia , Clementini Gisella , Cignoni Michele , Federici Luciana , Marconi Marcella , Ripepi Vincenzo , Musella Ilaria , Testa Vincenzo , Carini Roberta , Faccini Marco
Published: September 2016

We present B and V time series photometry of Andromeda XXV, the third galaxy in our program on the Andromeda’s satellites, which we have imaged with the Large Binocular Cameras of the Large Binocular Telescope. The field of Andromeda XXV is found to contain 62 variable stars, for which we present light curves and characteristics of the light variation (period, amplitudes, variability type, mean magnitudes, etc.). The sample includes 57 RR Lyrae variables (46 fundamental-mode—RRab, and 11 first-overtone—RRc, pulsators), 3 anomalous Cepheids, 1 eclipsing binary system, and 1 unclassified variable. The average period of the RRab stars (

σ = 0.04 days) and the period–amplitude diagram place Andromeda XXV in the class of the Oosterhoff-Intermediate objects. From the average luminosity of the RR Lyrae stars we derive for the galaxy a distance modulus of (m–M)0 = 24.63 ± 0.17 mag. The color–magnitude diagram reveals the presence in Andromeda XXV of a single, metal-poor ([Fe/H] = −1.8 dex) stellar population as old as ∼10–12 Gyr, traced by a conspicuous red giant branch and the large population of RR Lyrae stars. We discovered a spherically shaped high density of stars near the galaxy center. This structure appears to be at a distance consistent with Andromeda XXV and we suggest it could either be a star cluster or the nucleus of Andromeda XXV. We provide a summary and compare the number and characteristics of the pulsating stars in the M31 satellites analyzed so far for variability.
Análisis constructivo y estructural de la catedral de Valencia
Authors: Llopis Pulido V. , Alonso Durá A. , Fenollosa E. , Martínez Boquera A.
Published: September 2016

Las características constructivas de la catedral de Valencia la convierten en un ejemplo representativo del gótico mediterráneo: reducida esbeltez, escasa diferencia de altura entre las naves y limitadas dimensiones de huecos.

Estas características se explican a partir del presente trabajo donde se muestra un estudio constructivo y un análisis del sistema estructural frente a cargas gravitatorias y efectos sísmicos. En el análisis se utiliza el método por empujes incrementales (pushover) y el método no-lineal de modelo de daño. La función de arbotantes y diafragmas quedará patente con la modificación del modelo MEF que eliminará progresivamente cada uno de estos elementos constructivos.

Los resultados muestran una suficiente capacidad resistente frente a un sismo con un período de retorno de 475 años que empeora si se considera de 950 años. Se evidenciará la necesidad de la continuidad muraria a través de los arbotantes que se convierten en auténticos muros diafragmáticos.
Reliability of Entry-Level Athletic Trainers' Palpation Skills of Bony Anatomical Landmarks in the Lumbopelvic Region
Authors: Schultz Sarah M. , Jacobs Michelle M. , Gorgos Kara S. , Wasylyk Nicole T. , Hanrahan Sean , Van Lunen Bonnie L.
Published: September 2016

Context

Accuracy of locating various lumbopelvic landmarks for novice athletic trainers has not been examined.

Objective

To examine reliability of novice athletic trainers for identification of the L4 spinous process and right and left posterior superior iliac spine (PSIS).

Design

Cross-sectional reliability.

Setting

Laboratory.

Patients or Other Participants

Sixteen physically active volunteers participated (age = 22.56 ± 2.67 years, height = 172.0 ± 9.38 cm, mass = 67.39 ± 9.73 kg, body mass index = 22.8 ± 1.97). Four novice athletic trainers (certified < 2 years) served as the testers of interest.

Intervention(s)

Subjects were placed prone and 2 expert athletic trainers (certified > 12 years) agreed upon each bony landmark and transferred the palpation markings to contact paper. Each novice athletic trainer palpated the landmarks twice within the same test session and used the same method as the experts for transfer and recording. Novice athletic trainers rotated between subjects after 1 marking trial. Expert marks were transposed over the tester marks to assess distance and agreement.

Main Outcome Measure(s)

Independent variables were novice athletic trainer (AT1, AT2, AT3, AT4) and time (Trial 1, Trial 2); dependent variables included distance from the expert marking in millimeters for L4 and PSIS palpations, and agreement within or outside of a designated area for the L4 spinous process. Intraclass correlation coefficients (ICC [2,1]), standard error of measurement, and percent agreement were calculated.

Results

Intratester reliability for L4 ranged from 0.370 to 0.833, right PSIS (RPSIS) ranged from 0.371 to 0.771, and left PSIS (LPSIS) ranged from −0.173 to 0.760. Intertester ICC (2,1) for Trial 1 and Trial 2 were, respectively, 0.319 and 0.466 (L4), 0.213 and 0.002 (RPSIS), and 0.96 and 0.073 (LPSIS). Percent agreement between expert and testers ranged from 18.75%–81.3% for L4 spinous process.

Conclusions

Our results indicate novice athletic trainers are generally poor at reliably locating lumbopelvic anatomical landmarks, and this should be addressed within educational programming.
Preceptors' Perceptions of the Preparation and Qualifications for the Preceptor Role
Authors: Nottingham Sara
Published: September 2016

Context

The 2012 Commission on Accreditation of Athletic Training Education (CAATE) standards include several changes that allow more institutional autonomy when determining the qualifications and preparation of preceptors. Clinical education coordinators (CECs) must make educated decisions in this area, yet minimal research exists to guide their decisions.

Objective

To investigate the preceptor's perceptions regarding the preparation and qualifications for their role.

Design

Qualitative.

Setting

Three undergraduate, CAATE-accredited athletic training programs.

Patients or Other Participants

Seventeen preceptors (8 males, 9 females; 9.88 ± 9.46 years of clinical experience; 5.06 ± 3.92 years of clinical teaching experience) working in the college/university, rehabilitation clinic, and high school settings. Participants were recruited through the CECs of 3 institutions and selected through purposeful sampling. Data were collected until a variety of participant experiences were obtained and data saturation occurred.

Main Outcome Measure(s)

The researcher interviewed participants using an individual, in-person, and semistructured format. Interviews were recorded, transcribed verbatim, and analyzed using inductive coding with ATLAS.ti software. Trustworthiness was established with the use of source and site triangulation, member checking, and peer debriefing.

Results

Four categories emerged from the data, including benefits, preparation, qualifications, and challenges of being a preceptor. While participants described it was beneficial to supervise students, they also faced several challenges, including balancing their responsibilities and keeping their knowledge current. Participants discussed that mentorship from other preceptors and past experiences as students were primary contributors to their roles as preceptors, whereas preceptor training and communication by the CEC could improve. Participants described that clinical experience, willingness to be a preceptor, and confidence were the main qualifications for becoming a preceptor.

Conclusions

Clinical education coordinators should recruit confident clinicians with sufficient clinical experience to become preceptors along with ensuring adequate preparation of and communication with preceptors. Educators and researchers should consider the challenges faced by preceptors and develop strategies for overcoming these challenges.
Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion
Authors: Iadevaia Cheree , Roiger Trevor , Zwart Mary Beth
Published: September 2016

Context

Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear.

Objective

To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion.

Design

Qualitative study.

Setting

Secondary school.

Patients or Other Participants

Seven adolescent student-athletes (age range, 12–16 years) who sustained a sport-related concussion at least 1 year (15.3 ± 2.8 months) before the study participated along with their primary care-giving parents (n = 7).

Data Collection and Analysis

Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results.

Results

Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships.

Conclusions

Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent student-athletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling behind while ensuring a healthy return to normal school routines. Furthermore, adolescent support systems must be considered throughout the recovery process.
Wireless Versus Wired Iontophoresis for Treating Patellar Tendinopathy: A Randomized Clinical Trial
Authors: Rigby Justin H. , Mortensen Brett B. , Draper David O.
Published: September 2016

Context

The efficacy of the relatively new wireless iontophoresis patch compared with the traditional wired dose controller is unknown.

Objective

To determine the differences among 2 iontophoresis drug-delivery systems (wireless patch versus wired dose controller) and a sham treatment in treating patellar tendinopathy.

Design

Randomized controlled clinical trial.

Setting

Physical therapy clinic.

Patients or Other Participants

Thirty-one participants diagnosed with patellar tendinopathy (men = 22, women = 9, age = 24.5 ± 5.9 years).

Intervention(s)

Participants were randomly assigned into 1 of 3 treatment groups: wireless patch, wired dose controller, or sham treatment. Participants in the active treatment groups received six 80 mA/min iontophoresis treatments using 2 mL of 4% dexamethasone sodium phosphate. During each visit, clinical outcome measures were assessed and then the assigned treatment was applied.

Main Outcome Measure(s)

Clinical outcome measures were Kujala Anterior Knee Pain Scale, pressure sensitivity, knee-extension force, and sit-to-stand pain assessment using a numeric rating scale. For each clinical outcome measure, we used a repeated-measures analysis of covariance to determine differences among the treatment groups over the treatment period.

Results

Participants reported a clinically important improvement on the Kujala Anterior Knee Pain Scale across all treatment groups, with no differences among groups (P = .571). A placebo effect was observed with pressure sensitivity (P = .0152); however, the active treatment decreased participants' pain during the sit-to-stand test (P = .042).

Conclusions

A placebo effect occurred with the sham treatment group. Generally, improvement was noted in all groups regardless of treatment type, but greater pain reduction during a functional task was evident within the active treatment groups during the sit-to-stand test. The wireless patch and wired dose controller treatments were equivalent across all variables.
Incidence of Patients With Knee Strain and Sprain Occurring at Sports or Recreation Venues and Presenting to United States Emergency Departments
Authors: Gray Aaron M. , Buford William L.
Published: September 2016

Context

Knee injuries account for a substantial percentage of all athletic injuries. The relative rates of knee injury for a variety of sports by sex and age need to be understood so we can better allocate resources, such as athletic trainers, to properly assess and treat injuries and reduce injury risk.

Objective

To describe the epidemiology of patients with sport-related knee strain and sprain presenting to US emergency departments from 2002 to 2011.

Design

Cross-sectional study.

Setting

Using the Consumer Products Safety Commission's National Electronic Injury Surveillance System and the US Census Bureau, we extracted raw data to estimate national rates of patients with knee strain and sprain presenting to emergency departments.

Patients or Other Participants

Participants were individuals sustaining a knee strain or sprain at sports or recreation venues and presenting to local emergency departments for treatment. We included 12 popular sports for males and 11 for females. Ages were categorized in six 5-year increments for ages 5 to 34 years and one 10-year increment for ages 35 to 44 years.

Main Outcome Measure(s)

Incidence rates were calculated using weights provided by the National Electronic Injury Surveillance System and reported with their 95% confidence intervals for sport, sex, and age.

Results

Strain and sprain injury rates varied greatly by sport, sex, and age group. The highest injury rates occurred in football and basketball for males and in soccer and basketball for females. The most at-risk population was 15 to 19 years for both sexes.

Conclusions

Athletes experience different rates of knee strain and sprain according to sport, sex, and age. Increased employment of athletic trainers to care for the highest-risk populations, aged 10 to 19 years, is recommended to reduce emergency department use and implement injury-prevention practices.
Multiplanar Knee Laxity and Perceived Function During Activities of Daily Living and Sport
Authors: Taylor Jeffrey B. , Wang Hsin-Min , Schmitz Randy J. , Rhea Christopher K. , Ross Scott E. , Shultz Sandra J.
Published: September 2016

Context

Greater knee-joint laxity may lead to a higher risk of knee injury, yet it is unknown whether results of self-reported outcome measures are associated with distinct knee-laxity profiles.

Objective

To identify the extent to which multiplanar knee laxity is associated with patient-reported outcomes of knee function in healthy individuals during activities of daily living and sport.

Design

Descriptive laboratory study.

Setting

University research laboratory.

Patients or Other Participants

Forty healthy individuals (20 men, 20 women; age = 18–31 years).

Main Outcome Measure(s)

All participants were given the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) and Sports Activities Scale (KOS-SAS) and subsequently measured for knee laxity in the sagittal, frontal, and transverse planes. Separate backward stepwise regression analyses were performed to determine the extent to which multiplanar knee-laxity values predicted KOS-ADL and KOS-SAS scores within each sex.

Results

Women had higher magnitudes of anterior, posterior (POSTLAX), varus (VARLAX), valgus (VALLAX), and internal-rotation laxity than men and trended toward greater external rotation (ERLAX) laxity. Greater POSTLAX, less VALLAX, and greater VARLAX was associated with lower KOS-ADL scores (KOS-ADL = −4.8 [POSTLAX], + 3.3 [VALLAX] − 2.2 [VARLAX] + 100.4, R2 = 0.74, P < .001) and greater POSTLAX and less VALLAX was associated with lower KOS-SAS scores (KOS-SAS = −8.2 [POSTLAX], + 3.6 [VALLAX] + 96.4, R2 = 0.67, P < .001) in women. In men, greater POSTLAX and less ERLAX was associated with lower KOS-SAS scores (KOS-ADL = −4.7 [POSTLAX], + 0.9 [ERLAX] + 96.4, R2 = 0.49, P < .001).

Conclusions

The combination of POSTLAX with less relative VALLAX (women) or less relative ERLAX (men) was a strong predictor of KOS scores, suggesting that a self-reported outcome measure may be beneficial as part of a preparticipation screening battery to identify those with perceived functional deficits associated with their knee laxity.
Concussion-Related Protocols and Preparticipation Assessments Used for Incoming Student-Athletes in National Collegiate Athletic Association Member Institutions
Authors: Kerr Zachary Y. , Snook Erin M. , Lynall Robert C. , Dompier Thomas P. , Sales Latrice , Parsons John T. , Hainline Brian
Published: September 2016

Context

 National Collegiate Athletic Association (NCAA) legislation requires that member institutions have policies to guide the recognition and management of sport-related concussions. Identifying the nature of these policies and the mechanisms of their implementation can help identify areas of needed improvement.

Objective

 To estimate the characteristics and prevalence of concussion-related protocols and preparticipation assessments used for incoming NCAA student-athletes.

Design

 Cross-sectional study.

Setting

 Web-based survey.

Patients or Other Participants

 Head athletic trainers from all 1113 NCAA member institutions were contacted; 327 (29.4%) completed the survey.

Intervention(s)

 Participants received an e-mail link to the Web-based survey. Weekly reminders were sent during the 4-week window.

Main Outcome Measure(s)

 Respondents described concussion-related protocols and preparticipation assessments (eg, concussion history, neurocognitive testing, balance testing, symptom checklists). Descriptive statistics were compared by division and football program status.

Results

 Most universities provided concussion education to student-athletes (95.4%), had return-to-play policies (96.6%), and obtained the number of previous concussions sustained by incoming student-athletes (97.9%). Fewer had return-to-learn policies (63.3%). Other concussion-history–related information (eg, symptoms, hospitalization) was more often collected by Division I universities. Common preparticipation neurocognitive and balance tests were the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; 77.1%) and Balance Error Scoring System (46.5%). In total, 43.7% complied with recommendations for preparticipation assessments that included concussion history, neurocognitive testing, balance testing, and symptom checklists. This was due to moderate use of balance testing (56.6%); larger proportions used concussion history (99.7%), neurocognitive testing (83.2%), and symptom checklists (91.7%). More Division I universities (55.2%) complied with baseline assessment recommendations than Division II (38.2%, χ2 = 5.49, P = .02) and Division III (36.1%, χ2 = 9.11, P = .002) universities.

Conclusions

 National Collegiate Athletic Association member institutions implement numerous strategies to monitor student-athletes. Division II and III universities may need additional assistance to collect in-depth concussion histories and conduct balance testing. Universities should continue developing or adapting (or both) return-to-learn policies.
Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions
Authors: MS Suzie Aparicio , Welch Bacon Cailee E. , Parsons John T. , Bay R. Curtis , Cohen Randy P. , DeZeeuw Terry , McLeod Tamara C. Valovich
Published: September 2016

Context

The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices.

Objective

To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions.

Design

Cross-sectional study.

Setting

Web-based survey.

Patients or Other Participants

Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff.

Main Outcome Measure(s)

The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use.

Results

The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14).

Conclusions

The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured assessment and allocation of staffing and workloads.
Exploring the Athletic Trainer's Role in Assisting Student-Athletes Presenting With Alcohol-Related Unintentional Injuries
Authors: Howell Steven M. , Barry Adam E. , Pitney William A.
Published: September 2016

Compared with their nonathlete peers, collegiate athletes consume higher quantities of alcohol, drink with greater frequency, and exhibit an increased propensity to engage in heavy episodic drinking (ie, binge drinking), which often may result in alcohol-related consequences. Moreover, collegiate athletes are also more likely to engage in other maladaptive lifestyle behaviors, such as participating in physical fights and riding with an intoxicated driver, and less likely to engage in protective behaviors, such as wearing a helmet while operating a motorcycle, moped, or bicycle. Taken together, these behaviors clearly pose a health risk for student-athletes and increase the likelihood that they will experience an alcohol-related unintentional injury (ARUI). An ARUI represents a risk not only to the health and well-being of collegiate athletes but also to their athletic performances, collegiate careers, and potential professional opportunities. Therefore, athletic trainers need to be equipped with the knowledge and skills to provide face-to-face brief interventions to student-athletes presenting with ARUIs and to evaluate the effect of their involvement. We address potential action items for implementation by athletic trainers.
Joint Kinetics and Kinematics During Common Lower Limb Rehabilitation Exercises
Authors: Comfort Paul , Jones Paul Anthony , Smith Laura Constance , Herrington Lee
Published: September 2016

Context

 Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited.

Objective

 To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises.

Design

 Descriptive laboratory study.

Setting

 Laboratory.

Patients or Other Participants

 A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated.

Intervention(s)

 Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system.

Main Outcome Measure(s)

 Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments.

Results

 We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001).

Conclusions

 Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat.
National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses
Authors: Casa Douglas J. , DeMartini Julie K. , Bergeron Michael F. , Csillan Dave , Eichner E. Randy , Lopez Rebecca M. , Ferrara Michael S. , Miller Kevin C. , O'Connor Francis , Sawka Michael N. , Yeargin Susan W.
Published: September 2016

Objective

 To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation.

Background

 Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes.

Recommendations

 Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.
Selective Activation of Shoulder, Trunk, and Arm Muscles: A Comparative Analysis of Different Push-Up Variants
Authors: Marcolin Giuseppe , Petrone Nicola , Moro Tatiana , Battaglia Giuseppe , Bianco Antonino , Paoli Antonio
Published: September 2016

Context

The push-up is a widely used exercise for upper limb strengthening that can be performed with many variants. A comprehensive analysis of muscle activation during the ascendant phase (AP) and descendant phase (DP) in different variants could be useful for trainers and rehabilitators.

Objective

To obtain information on the effect of different push-up variants on the electromyography (EMG) of a large sample of upper limb muscles and to investigate the role of the trunk and abdomen muscles during the AP and DP.

Design

Cross-sectional study.

Setting

University laboratory.

Patients or Other Participants

Eight healthy, young volunteers without a history of upper extremity or spine injury.

Intervention(s)

Participants performed a set of 10 repetitions for each push-up variant: standard, wide, narrow, forward (FP), and backward (BP). Surface EMG of 12 selected muscles and kinematics data were synchronously recorded to describe the AP and DP.

Main Outcome Measure(s)

Mean EMG activity of the following muscles was analyzed: serratus anterior, deltoideus anterior, erector spinae, latissimus dorsi, rectus abdominis, triceps brachii caput longus, triceps brachii caput lateralis, obliquus externus abdominis, pectoralis major sternal head, pectoralis major clavicular head, trapezius transversalis, and biceps brachii.

Results

The triceps brachii and pectoralis major exhibited greater activation during the narrow-base variant. The highest activation of abdomen and back muscles was recorded for the FP and BP variants. The DP demonstrated the least electrical activity across all muscles, with less marked differences for the abdominal and erector spinae muscles because of their role as stabilizers.

Conclusions

Based on these findings, we suggest the narrow-base variant to emphasize triceps and pectoralis activity and the BP variant for total upper body strength conditioning. The FP and BP variants should be implemented carefully in participants with low back pain because of the greater activation of abdominal and back muscles.
Whole-Body Vibration While Squatting and Delayed-Onset Muscle Soreness in Women
Authors: Dabbs Nicole C. , Black Christopher D. , Garner John
Published: September 2016

Context

 Research into alleviating muscle pain and symptoms in individuals after delayed-onset muscle soreness (DOMS) has been inconsistent and unsuccessful in demonstrating a useful recovery modality.

Objective

 To investigate the effects of short-term whole-body vibration (WBV) on DOMS over a 72-hour period after a high-intensity exercise protocol.

Design

 Randomized controlled clinical trial.

Setting

 University laboratory.

Patients or Other Participants

 Thirty women volunteered to participate in 4 testing sessions and were assigned randomly to a WBV group (n = 16; age = 21.0 ± 1.9 years, height = 164.86 ± 6.73 cm, mass = 58.58 ± 9.32 kg) or a control group (n = 14; age = 22.00 ± 1.97 years, height = 166.65 ± 8.04 cm, mass = 58.69 ± 12.92 kg).

Intervention(s)

 Participants performed 4 sets to failure of single-legged split squats with 40% of their body weight to induce muscle soreness in the quadriceps. The WBV or control treatment was administered each day after DOMS.

Main Outcome Measure(s)

 Unilateral pressure-pain threshold (PPT), range of motion (ROM), thigh circumference, and muscle-pain ratings of the quadriceps were collected before and for 3 days after high-intensity exercise. Each day, we collected 3 sets of measures, consisting of 1 measure before the WBV or control treatment protocol (pretreatment) and 2 sets of posttreatment measures.

Results

 We observed no interactions for PPT, thigh circumference, and muscle pain (P > .05). An interaction was found for active ROM (P = .01), with the baseline pretreatment measure greater than the measures at baseline posttreatment 1 through 48 hours posttreatment 2 in the WBV group. For PPT, a main effect for time was revealed (P < .05), with the measure at baseline pretreatment greater than at 24 hours pretreatment and all other time points for the vastus medialis, greater than 24 hours pretreatment through 48 hours posttreatment 2 for the vastus lateralis, and greater than 24 hours pretreatment and 48 hours pretreatment for the rectus femoris. For dynamic muscle pain, we observed a main effect for time (P < .001), with the baseline pretreatment measure less than the measures at all other time points. No main effect for time was noted for thigh circumference (P = .24). No main effect for group was found for any variable (P > .05).

Conclusions

 The WBV treatment approach studied did not aid in alleviating DOMS after high-intensity exercise. Further research is needed in various populations.
Necessity of Removing American Football Uniforms From Humans With Hyperthermia Before Cold-Water Immersion
Authors: Miller Kevin C. , Long Blaine C. , Edwards Jeffrey
Published: September 2016

Context

 The National Athletic Trainers' Association and the American College of Sports Medicine have recommended removing American football uniforms from athletes with exertional heat stroke before cold-water immersion (CWI) based on the assumption that the uniform impedes rectal temperature (Trec) cooling. Few experimental data exist to verify or disprove this assumption and the recommendations.

Objectives

 To compare CWI durations, Trec cooling rates, thermal sensation, intensity of environmental symptoms, and onset of shivering when hyperthermic participants wore football uniforms during CWI or removed the uniforms immediately before CWI.

Design

 Crossover study.

Setting

 Laboratory.

Patients or Other Participants

 Eighteen hydrated, physically active men (age = 22 ± 2 years, height = 182.5 ± 6.1 cm, mass = 85.4 ± 13.4 kg, body fat = 11% ± 5%, body surface area = 2.1 ± 0.2 m2) volunteered.

Intervention(s)

 On 2 days, participants exercised in the heat (approximately 40°C, approximately 40% relative humidity) while wearing a full American football uniform (shoes; crew socks; undergarments; shorts; game pants; undershirt; shoulder pads; jersey; helmet; and padding over the thighs, knees, hips, and tailbone [PADS]) until Trec reached 39.5°C. Next, participants immersed themselves in water that was approximately 10°C while wearing either undergarments, shorts, and crew socks (NOpads) or PADS without shoes until Trec reached 38°C.

Main Outcome Measure(s)

 The CWI duration (minutes) and Trec cooling rates (°C/min).

Results

 Participants had similar exercise times (NOpads = 40.8 ± 4.9 minutes, PADS = 43.2 ± 4.1 minutes; t17 = 2.0, P = .10), hypohydration levels (NOpads = 1.5% ± 0.3%, PADS = 1.6% ± 0.4%; t17 = 1.3, P = .22), and thermal-sensation ratings (NOpads = 7.2 ± 0.3, PADS = 7.1 ± 0.5; P > .05) before CWI. The CWI duration (median [interquartile range]; NOpads = 6.0 [5.4] minutes, PADS = 7.3 [9.8] minutes; z = 2.3, P = .01) and Trec cooling rates (NOpads = 0.28°C/min ± 0.14°C/min, PADS = 0.21°C/min ± 0.11°C/min; t17 = 2.2, P = .02) differed between uniform conditions.

Conclusions

 Whereas participants cooled faster in NOpads, we still considered the PADS cooling rate to be acceptable (ie, >0.16°C/min). Therefore, if clinicians experience difficulty removing PADS or CWI treatment is delayed, they may immerse fully equipped hyperthermic football players in CWI and maintain acceptable Trec cooling rates. Otherwise, PADS should be removed preimmersion to ensure faster body core temperature cooling.
Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players
Authors: Swartz Erik E. , Broglio Steven P. , Cook Summer B. , Cantu Robert C. , Ferrara Michael S. , Guskiewicz Kevin M. , Myers Jay L.
Published: September 2016

Objective

To test a helmetless-tackling behavioral intervention for reducing head impacts in National Collegiate Athletic Association Division I football players.

Design

Randomized controlled clinical trial.

Setting

Football field.

Patients or Other Participants

Fifty collegiate football players (intervention = 25, control = 25).

Intervention(s)

The intervention group participated in a 5-minute tackling drill without their helmets and shoulder pads twice per week in the preseason and once per week through the season. During this time, the control group performed noncontact football skills.

Main Outcome Measure(s)

Frequency of head impacts was recorded by an impact sensor for each athlete-exposure (AE). Data were tested with a 2 × 3 (group and time) repeated-measures analysis of variance. Significant interactions and main effects (P < .05) were followed with t tests.

Results

Head impacts/AE decreased for the intervention group compared with the control group by the end of the season (9.99 ± 6.10 versus 13.84 ± 7.27, respectively). The intervention group had 30% fewer impacts/AE than the control group by season's end (9.99 ± 6.10 versus 14.32 ± 8.45, respectively).

Conclusion

A helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season.
False-Positive Rates of Reliable Change Indices for Concussion Test Batteries: A Monte Carlo Simulation
Authors: Nelson Lindsay D.
Published: September 2016

Background

 Neurocognitive testing is widely performed for the assessment of concussion. Athletic trainers can use preseason baselines with reliable change indices (RCIs) to ascertain whether concussed athletes' cognitive abilities are below preinjury levels. Although the percentage of healthy individuals who show decline on any individual test is determined by its RCI's confidence level (eg, 10% false-positive rate using an RCI with an 80% confidence interval), the expected rate of 1 or more significant RCIs across multiple indices is unclear.

Objective

 To use a Monte Carlo simulation procedure to estimate the normal rate (ie, base rate) of significant decline on 1 or more RCIs in multitest batteries.

Results & Conclusion

 For batteries producing 7 or more uncorrelated RCIs (80% confidence intervals), the majority of normal individuals would show significant declines on at least 1 RCI. Expected rates are lower for tests with fewer indices, higher inter-RCI correlations, and more stringent impairment criteria. These reference points can help testers interpret RCI output for multitest batteries.
Epidemiology of National Collegiate Athletic Association Men's and Women's Cross-Country Injuries, 2009–2010 Through 2013–2014
Authors: Kerr Zachary Y. , Kroshus Emily , Grant Jon , Parsons John T. , Folger Dustin , Hayden Ross , Dompier Thomas P.
Published: September 2016

Context

 Recent injury-surveillance data for collegiate-level cross-country athletes are limited.

Objective

 To describe the epidemiology of National Collegiate Athletic Association (NCAA) men's and women's cross-country injuries during the 2009–2010 through 2013–2014 academic years.

Design

 Descriptive epidemiology study.

Setting

 Aggregate injury and exposure data collected from 25 men's and 22 women's cross-country programs, providing 47 and 43 seasons of data, respectively.

Patients or Other Participants

 Collegiate student-athletes participating in men's and women's cross-country during the 2009–2010 through 2013–2014 academic years.

Main Outcome Measure(s)

 Injury rates; injury rate ratios (RRs); injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs).

Results

 The Injury Surveillance Program captured 216 injuries from men's cross-country and 260 injuries from women's cross-country, leading to injury rates of 4.66/1000 athlete-exposures (AEs) for men (95% CI = 4.04, 5.28) and 5.85/1000 AEs for women (95% CI = 5.14, 6.56). The injury rate in women's cross-country was 1.25 times that of men's cross-country (95% CI = 1.05, 1.50). Most injuries affected the lower extremity (men = 90.3%, women = 81.9%). The hip/groin-injury rate in women (0.65/1000 AEs) was higher than that in men (0.15/1000 AEs; RR = 4.32; 95% CI = 1.89, 9.85). The ankle-injury rate in men (0.60/1000 AEs) was higher than that in women (0.29/1000 AEs; RR = 2.07; 95% CI = 1.07, 3.99). Common diagnoses were strains (men = 19.9%, women = 20.4%) and inflammation (men = 18.1%, women = 23.8%). The majority of injuries were classified as overuse (men = 57.6%, women = 53.3%).

Conclusions

 Consistent with prior research, injury distributions varied between male and female athletes, and the injury rate among females was higher. Understanding the epidemiology of these cross-country injuries may be important for developing appropriate preventive interventions.
Knee-Extension Torque Variability and Subjective Knee Function in Patients With a History of Anterior Cruciate Ligament Reconstruction
Authors: Goetschius John , Hart Joseph M.
Published: September 2016

Context

 When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R.

Objective

 To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R.

Design

 Descriptive laboratory study.

Setting

 Laboratory.

Patients or Other Participants

 A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg).

Main Outcome Measure(s)

 Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression.

Results

 Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P < .05). Torque variability and strength were correlated with IKDC scores (P < .05). Torque variability, strength, and CAR were correlated with each other (P < .05). Torque variability alone accounted for 14.3% of the variance in IKDC scores. The combination of torque variability and number of months after surgery accounted for 21% of the variance in IKDC scores. Strength and CAR were excluded from the regression model.

Conclusions

 Knee-extension torque variability was moderately associated with IKDC scores in patients with a history of ACL-R. Torque variability combined with months after surgery predicted 21% of the variance in IKDC scores in these patients.
Advanced Treatment Monitoring for Olympic-Level Athletes Using Unsupervised Modeling Techniques
Authors: Siedlik Jacob A. , Bergeron Charles , Cooper Michael , Emmons Russell , Moreau William , Nabhan Dustin , Gallagher Philip , Vardiman John P.
Published: September 2016

Context

Analysis of injury and illness data collected at large international competitions provides the US Olympic Committee and the national governing bodies for each sport with information to best prepare for future competitions. Research in which authors have evaluated medical contacts to provide the expected level of medical care and sports medicine services at international competitions is limited.

Objective

To analyze the medical-contact data for athletes, staff, and coaches who participated in the 2011 Pan American Games in Guadalajara, Mexico, using unsupervised modeling techniques to identify underlying treatment patterns.

Design

Descriptive epidemiology study.

Setting

Pan American Games.

Patients or Other Participants

A total of 618 US athletes (337 males, 281 females) participated in the 2011 Pan American Games.

Main Outcome Measure(s)

Medical data were recorded from the injury-evaluation and injury-treatment forms used by clinicians assigned to the central US Olympic Committee Sport Medicine Clinic and satellite locations during the operational 17-day period of the 2011 Pan American Games. We used principal components analysis and agglomerative clustering algorithms to identify and define grouped modalities. Lift statistics were calculated for within-cluster subgroups.

Results

Principal component analyses identified 3 components, accounting for 72.3% of the variability in datasets. Plots of the principal components showed that individual contacts focused on 4 treatment clusters: massage, paired manipulation and mobilization, soft tissue therapy, and general medical.

Conclusions

Unsupervised modeling techniques were useful for visualizing complex treatment data and provided insights for improved treatment modeling in athletes. Given its ability to detect clinically relevant treatment pairings in large datasets, unsupervised modeling should be considered a feasible option for future analyses of medical-contact data from international competitions.
Comparison of Upper Extremity Physical Characteristics Between Adolescent Competitive Swimmers and Nonoverhead Athletes
Authors: Hibberd Elizabeth E. , Laudner Kevin , Berkoff David J. , Kucera Kristen L. , Yu Bing , Myers Joseph B.
Published: September 2016

Context

Alterations to upper extremity physical characteristics of competitive swimmers (posture, range of motion [ROM], and subacromial-space distance) are commonly attributed to cumulative training load during a swimmer's competitive career. However, this accepted clinical belief has not been established in the literature. It is important to understand whether alterations in posture and associated physical characteristics occur as a result of sport training or factors other than swimming participation to better understand injury risk and possible interventions.

Objective

To compare posture, subacromial-space distance, and glenohumeral external-rotation, internal-rotation, and horizontal-adduction ROM between adolescent competitive swimmers and nonoverhead athletes.

Design

Cross-sectional study.

Setting

Local swimming pools and high school athletic training rooms.

Patients or Other Participants

Forty-four competitive adolescent swimmers and 31 nonoverhead athletes who were not currently experiencing any elbow, shoulder, neck, or back pain that limited their sport activity.

Intervention(s)

Posture, subacromial-space distance, and glenohumeral ROM were measured using photography, diagnostic ultrasound, and a digital inclinometer, respectively.

Main Outcome Measure(s)

Forward shoulder posture, forward head posture, normalized subacromial-space distance, internal-rotation ROM, and external-rotation ROM.

Results

No clinically significant differences existed between swimmers and nonoverhead athletes for posture, normalized subacromial-space distance, or external- or internal-rotation ROM. Swimmers presented with less horizontal-adduction ROM than nonoverhead athletes.

Conclusions

Factors other than swimming participation, such as school and technology use, play important roles in the adaptation of physical characteristics in adolescents. Adolescents, regardless of swimming participation, presented with postural deviations. It is important to consider factors other than swimming participation that contribute to alterations in physical characteristics to understand injury risk and injury-prevention strategies in competitive adolescent swimmers.