bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Single-Legged–Squat Performance: Comparing 2 Training Methods With Potential Implications for Injury Prevention
Authors: Dawson Samuel J. , Herrington Lee 
Published: September 2016

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

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

Design
Controlled laboratory study.

Setting
Laboratory.

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

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

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

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

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

ContextSupraspinatus tear is a common rotator cuff injury. During rehabilitation, debate persists regarding the most appropriate exercises. Whereas shoulder coordination is part of normal arm function, it has been infrequently considered in the context of exercise selection.ObjectiveTo assess shoulder-motion coordination during 2 common supraspinatus rehabilitation exercises and to characterize load and motion-direction influences on shoulder coordination.DesignDescriptive laboratory study.SettingMotion-analysis laboratory.Patient or Other ParticipantsFifteen asymptomatic right-hand–dominant men (age = 26 ± 4 years, height = 1.77 ± 0.06 m, mass = 74.3 ± 7.7 kg).Intervention(s)Full-can and empty-can exercises with and without a 2.27-kg load.Main Outcome Measure(s)We recorded motion with an optoelectronic system. Scapulohumeral rhythm and complete shoulder joint kinematics were calculated to quantify shoulder coordination. The effects of exercise type, load, motion direction, and humerothoracic-elevation angle on the scapulohumeral rhythm and shoulder-joint angles were assessed.ResultsWe observed multivariate interactions between exercise type and humerothoracic elevation and between load and humerothoracic elevation. Scapulohumeral rhythm increased by a mean ratio of 0.44 ± 0.22 during the full-can exercise, whereas the addition of load increased mean glenohumeral elevation by 4° ± 1°.ConclusionsThe full-can exercise increased the glenohumeral contribution, as hypothesized, and showed normal shoulder coordination. During the empty-can exercise, the increased scapulothoracic contribution was associated with a compensatory pattern that limits the glenohumeral contribution. Using loads during shoulder rehabilitation seems justified because the scapulohumeral rhythm is similar to that of unloaded arm elevation. Finally, motion direction showed a limited effect during the exercises in healthy individuals.
Accuracy of Urine Color to Detect Equal to or Greater Than 2% Body Mass Loss in Men
Authors: McKenzie Amy L. , Muñoz Colleen X. , Armstrong Lawrence E. 
Published: September 2016

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

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

Design
Controlled laboratory study.

Setting
Environmental chamber in a laboratory.

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

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

Main Outcome Measure(s)
Diagnostic efficacy of urine color was assessed using receiver operating characteristic curve analysis, sensitivity, specificity, and likelihood ratios.

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

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

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

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

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

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

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

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

Design
Descriptive epidemiology study.

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

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

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

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

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

Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined.Context:
To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC.Objective:
Cohort study.Design:
High school and collegiate athletic programs.Setting:
A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score &gt; 18 [top 10% of sample], n = 68).Patients or Other Participants:
Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment.Main Outcome Measure(s):
The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group.Results:
Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their injury. Additional investigation of baseline symptoms is warranted to help delineate the type and severity of premorbid symptoms.Conclusions:
Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries
Authors: Di Trani Lobacz Andrea , Glutting Joseph , Kaminski Thomas W. 
Published: September 2016

Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%–34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown.Context: To examine the frequency of method use and opinions about current HSI management among ATs.Objective: Cross-sectional study.Design: Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo.Setting: A total of 1356 certified ATs (691 men, 665 women; age = 35.4 ± 10.5 years, time certified = 11.92 ± 9.75 years).Patients or Other Participants: A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and χ2 tests to assess practice patterns.Data Collection and Analysis: The response rate was 17% (n = 1356). A 2-factor solution was accepted for factor analysis (r = 0.76, r = 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P &lt; .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction ( = 22.5, P = .002) but not increased confidence levels in more experienced ATs.Results:Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.Conclusions:
Athletic Training and Public Health Summit
Authors: Hoffman Mark , Bovbjerg Viktor , Hannigan Kim , Hootman Jennifer M. , Johnson Sam T. , Kucera Kristen L. , Norcross Marc F. 
Published: September 2016

Objective: To introduce athletic trainers to the benefits of using a population-based approach to injury and illness prevention and to explore opportunities for partnering with public health professionals on these initiatives.
Background: Athletic trainers play leading roles in individual injury and illness prevention but are less familiar with policy development, evaluation, and implementation from a population-level standpoint. The Athletic Training and Public Health Summit was convened to understand, explore, and develop the intersection of athletic training and public health.
Conclusions: To further the integration of athletic training within the public health arena, athletic trainers must expand their professional focus beyond the individual to the population level.
Epidemiologic Measures for Quantifying the Incidence of Concussion in National Collegiate Athletic Association Sports
Authors: Kerr Zachary Y. , Roos Karen G. , Djoko Aristarque , Dalton Sara L. , Broglio Steven P. , Marshall Stephen W. , Dompier Thomas P. 
Published: September 2016

Context:
Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion.

Objective:
To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011–2012 through 2014–2015 academic years.

Design:
Descriptive epidemiology study.

Setting:
Aggregate injury and exposure data collected from the National Collegiate Athletic Association Injury Surveillance Program in 13 sports (men's baseball, basketball, football, ice hockey, lacrosse, soccer, and wrestling and women's basketball, ice hockey, lacrosse, soccer, softball, and volleyball).

Patients or Other Participants:
Collegiate student-athletes.

Main Outcome Measure(s):
Sport-related concussion data from the National Collegiate Athletic Association Injury Surveillance Program during the 2011–2012 through 2014–2015 academic years were analyzed. We calculated concussion rates per 1000 athlete-exposures (AEs), concussion risk, average number of concussions per team, and percentage of teams with at least 1 concussion.

Results:
During the 2011–2012 through 2014–2015 academic years, 1485 concussions were sustained by 1410 student-athletes across 13 sports. Concussion rates ranged from 0.09/1000 AEs in men's baseball to 0.89/1000 AEs in men's wrestling. Concussion risk ranged from 0.74% in men's baseball to 7.92% in men's wrestling. The average ± SD number of concussions per team ranged from 0.25 ± 0.43 in men's baseball to 5.63 ± 5.36 in men's football. The percentage of teams with a concussion ranged from 24.5% in men's baseball to 80.6% in men's football.

Conclusions
Although men's wrestling had a higher concussion rate and risk, men's football had the largest average number of concussions per team and the largest percentage of teams with at least 1 concussion. The risk of concussion, average number of concussions per team, and percentage of teams with concussions may be more intuitive measures of incidence for decision makers. Calculating these additional measures is feasible within existing injury surveillance programs, and this method can be applied to other injury types.
Glenohumeral and Hip Range-of-Motion and Strength Measures in Youth Baseball Athletes
Authors: Picha Kelsey J. , Harding Josie L. , Bliven Kellie C. Huxel 
Published: September 2016

Context: The repetitive demands of throwing affect glenohumeral (GH) range of motion (ROM) and strength. Less is known about hip alterations in skeletally immature athletes.
Objective: To compare GH and hip ROM and strength between age, position, and side of youth baseball athletes.
Design: Cross-sectional study.
Setting: Multicenter testing.
Patients or Other Participants: Seventy-two healthy baseball athletes. Participants' self-reported characteristics were age group (7−11 years [n = 28] or 12−18 years [n = 44]), position (pitcher [n = 22], position player [n = 47], unreported [n = 3]), and side (throwing or nonthrowing arm, lead or stance leg).
Main Outcome Measure(s): Bilateral GH and hip internal- and external-rotation ROM were measured passively and summed for total arc of motion (TAM). Glenohumeral and hip rotation and gluteus medius strength were measured. Analyses included linear mixed models.
Results: Glenohumeral internal rotation was less in throwing than in nonthrowing arms (P &lt; .05) except in younger pitchers (P = .86). Compared with older athletes, younger athletes had more GH external rotation (103.3° ± 7.7° versus 97.5° ± 9.4°; P = .002), TAM (156.4° ± 8.7° versus 147.9° ± 10.9°; P = .04), and external rotation in throwing compared with nonthrowing arms (101.9° ± 1.2° versus 97.9° ± 1.1°; P &lt; .001). Glenohumeral TAM was less in throwing than in nonthrowing arms (150.5° ± 2.1° versus 154.9° ± 1.3°; P = .01). Younger athletes had more hip internal rotation (38.9° ± 6.8° versus 31.2° ± 7.5°; P &lt; .001) and TAM (68.4° ± 10.0° versus 60.7° ± 9.8°; P = .001) than older athletes. Lead-leg hip internal-rotation ROM was greater than in the stance leg (34.8° ± 8.9° versus 32.8° ± 7.7°; P = .01). Overall, older players were stronger than younger players (P &lt; .05), and the throwing arm was stronger in internal rotation than the nonthrowing arm (10.12 ± 3.72 lb [4.59 ± 1.69 kg] versus 9.43 ± 3.18 lb [4.28 ± 1.44 kg]; P = .047).
Conclusions: Youth baseball athletes had typical GH ROM adaptations of less internal rotation and more external rotation in the throwing versus the nonthrowing arm. Greater ROM in younger athletes may be explained by prepubertal characteristics. We obtained hip-strength values in youth baseball athletes, and as expected, older athletes were stronger.
Positive Factors Influencing the Advancement of Women to the Role of Head Athletic Trainer in the National Collegiate Athletic Association Divisions II and III
Authors: Mazerolle Stephanie M. , Eason Christianne M. 
Published: September 2016

Context: Research suggests that women do not pursue leadership positions in athletic training due to a variety of reasons, including family challenges, organizational constraints, and reluctance to hold the position. The literature has been focused on the National Collegiate Athletic Association Division I setting, limiting our full understanding.Objective: To examine factors that help women as they worked toward the position of head athletic trainer.Design: Qualitative study.Setting: Divisions II and III.Patients or Other Participants: Seventy-seven women who were employed as head athletic trainers at the Division II or III level participated in our study. Participants were 38 ± 9 (range = 24−57) years old and had an average of 14 ± 8 (range = 1−33) years of athletic training experience.Data Collection and Analysis: We conducted online interviews. Participants journaled their reflections to a series of open-ended questions pertaining to their experiences as head athletic trainers. Data were analyzed using a general inductive approach. Credibility was secured by peer review and researcher triangulation.Results: Three organizational facilitators emerged from the data, workplace atmosphere, mentors, and past work experiences. These organizational factors were directly tied to aspects within the athletic trainer's employment setting that allowed her to enter the role. One individual-level facilitator was found: personal attributes that were described as helpful for women in transitioning to the role of the head athletic trainer. Participants discussed being leaders and persisting toward their career goals.Conclusions: Women working in Divisions II and III experience similar facilitators to assuming the role of head athletic trainer as those working in the Division I setting. Divisions II and III were viewed as more favorable for women seeking the role of head athletic trainer, but like those in the role in the Division I setting, women must have leadership skills.