bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizations of a Quality Certified Athletic Trainer
Authors: Raab Scot , Wolfe Brent D. , Gould Trenton E. , Piland Scott G. 
Published: March 2017

Context: Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits.
Objective: To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT).
Design: Delphi study.
Setting: Interviews in conference rooms or business offices and by telephone.
Patients or Other Participants: Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers' Association (2, 3, 4, 9).
Data Collection and Analysis: Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives.
Results: We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits).
Conclusions: According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.
Acute Lower Extremity Running Kinematics After a Hamstring Stretch
Authors: Davis Hammonds Autumn L. , Laudner Kevin G. , McCaw Steve , McLoda Todd A. 
Published: March 2017

Context:
Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Pre-activity static straight-leg raise stretching often is used to gain passive hamstring flexibility.

Objective:
To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running.

Design:
Randomized controlled clinical trial.

Setting:
Biomechanics research laboratory.

Patients or Other Participants:
Thirty-four male (age = 21.2 ± 1.4 years) and female (age = 21.3±2.0 years) recreational athletes.

Intervention(s):
Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions.

Main Outcome Measure(s):
Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an α level of .008.

Results:
Flexibility increased between pretest and post-test in all participants (F1,30 = 80.61, P&lt;.001). Anterior pelvic tilt (F1,30 = 0.73, P=.40), hip flexion (F1,30 = 2.44, P=.13), and knee extension (F1,30 = 0.06, P=.80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F1,30 = 0.69, P=.41), hip flexion (F1,30 = 0.23, P=.64), and knee extension (F1,30 = 3.38, P=.62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F1,30 = 13.62, P=.001).

Conclusions:
A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics.
Reliability of Thoracic Spine Rotation Range-of-Motion Measurements in Healthy Adults
Authors: Johnson Katherine D. , Kim Kyung-Min , Yu Byung-Kyu , Saliba Susan A. , Grindstaff Terry L. 
Published: March 2017

Context:The reliability of clinical techniques to quantify thoracic spine rotation range of motion (ROM) has not been evaluated.Objective:To determine the intratester and intertester reliability of 5 thoracic rotation measurement techniques.Design:Descriptive laboratory study.Setting:University research laboratory.Patients or Other Participants:Forty-six healthy volunteers (age = 23.6±4.3 years, height = 171.0±9.6 cm, mass = 71.4 ±16.7 kg).Main Outcome Measure(s):We tested 5 thoracic rotation ROM techniques over 2 days: seated rotation (bar in back and front), half-kneeling rotation (bar in back and front), and lumbar-locked rotation. On day 1, 2 examiners obtained 2 sets of measurements (sessions 1, 2) to determine the within-session intertester reliability and within-day intratester reliability. A single examiner obtained measurements on day 2 (session 3) to determine the intratester reliability between days. Each technique was performed 3 times per side, and averages were used for data analysis. Reliability was determined using intraclass correlation coefficients, standard error of measurement (SEM), and minimal detectable change (MDC). Differences between raters during session 1 were determined using paired t tests.Results:Within-session intertester reliability estimates ranged from 0.85 to 0.94. Ranges for the SEM were 1.0° to 2.3° and for the MDC were 2.8° to 6.3°. No differences were seen between examiners during session 1 for seated rotation (bar in front, both sides), half-kneeling rotation (bar in front, left side), or the lumbar locked position (both sides) (all values of P &gt; .05). Within-day intratester reliability estimates ranged from 0.86 to 0.95. Ranges for the SEM were 0.8° to 2.1° and for the MDC were 2.1 ° to 5. 9°. Between-days intratester reliability estimates ranged from 0.84 to 0.91. Ranges for the SEM were 1.4° to 2.0° and for the MDC were 3.9° to 5.6°.Conclusions:All techniques had good reliability and low levels of measurement error. The seated rotation, bar in front, and lumbar-locked rotation tests may be used reliably when more than 1 examiner is obtaining measurements.
Perceived Frequency of Peer-Assisted Learning in the Laboratory and Collegiate Clinical Settings
Authors: Henning Jolene M. , Weidner Thomas G. , Snyder Melissa , Dudley William N. 
Published: March 2017

Context:Peer-assisted learning (PAL) has been recommended as an educational strategy to improve students' skill acquisition and supplement the role of the clinical instructor (CI). How frequently students actually engage in PAL in different settings is unknown.Objective:To determine the perceived frequency of planned and unplanned PAL (peer modeling, peer feedback and assessment, peer mentoring) in different settings.Design:Cross-sectional study.Setting:Laboratory and collegiate clinical settings.Patients or Other Participants:A total of 933 students, 84 administrators, and 208 CIs representing 52 (15%) accredited athletic training education programs.Intervention(s):Three versions (student, CI, administrator) of the Athletic Training Peer Assisted Learning Survey (AT-PALS) were administered. Cronbach α values ranged from .80 to .90.Main Outcome Measure(s):Administrators' and CIs' perceived frequency of 3 PAL categories under 2 conditions (planned, unplanned) and in 2 settings (instructional laboratory, collegiate clinical). Self-reported frequency of students' engagement in 3 categories of PAL in 2 settings.Results:Administrators and CIs perceived that unplanned PAL (0.39 ± 0.22) occurred more frequently than planned PAL (0.29 ± 0.19) regardless of category or setting (F1,282 = 83.48, P &lt; .001). They perceived that PAL occurred more frequently in the collegiate clinical (0.46 ± 0.22) than laboratory (0.21 ± 0.24) setting regardless of condition or category (F1,282 = 217.17, P &lt; .001). Students reported engaging in PAL more frequently in the collegiate clinical (3.31 ± 0.56) than laboratory (3.26 ± 0.62) setting regardless of category (F1,860 = 13.40, P &lt; .001). We found a main effect for category (F2,859 = 1318.02, P &lt; .001), with students reporting they engaged in peer modeling (4.01 ± 0.60) more frequently than peer mentoring (2.99 ± 0.88) (P &lt; .001) and peer assessment and feedback (2.86 ± 0.64) (P &lt; .001).Conclusions:Participants perceived that students engage in unplanned PAL in the collegiate clinical setting with a stronger inclination toward engagement in peer modeling. Educators should develop planned PAL activities to capitalize on the inherent desire of the students to collaborate with their peers.
Exertional Rhabdomyolysis in a Collegiate American Football Player After Preventive Cold-Water Immersion: A Case Report
Authors: Kahanov Leamor , Eberman Lindsey E. , Wasik Mitchell , Alvey Thurman 
Published: March 2017

Objective:To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive cold-water immersion.Background:A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated post-practice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45–260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal &lt; 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%– 30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids.Differential Diagnosis:Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis.Treatment:The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L).Uniqueness:The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis.Conclusions:In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after exercise should be monitored by the athletic training staff and may not be appropriate to prevent muscle damage, given the lack of supporting evidence.
Using the Star Excursion Balance Test to Assess Dynamic Postural-Control Deficits and Outcomes in Lower Extremity Injury: A Literature and Systematic Review
Authors: Gribble Phillip A. , Hertel Jay , Plisky Phil 
Published: March 2017

Context:
A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications.

Objective:
To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment.

Data Sources:
Databases used to locate peer-reviewed articles published from 1980 and 2010 included Derwent Innovations Index, BIOSIS Previews, Journal Citation Reports, and MEDLINE.

Study Selection:
The criteria for article selection were (1) The study was original research. (2) The study was written in English. (3) The SEBT was used as a measurement tool.

Data Extraction:
Specific data extracted from the articles included the ability of the SEBT to differentiate pathologic conditions of the lower extremity, the effects of external influences and interventions, and outcomes from exercise intervention and to predict lower extremity injury.

Data Synthesis:
More than a decade of research findings has established a comprehensive portfolio of validity for the SEBT, and it should be considered a highly representative, noninstrumented dynamic balance test for physically active individuals. The SEBT has been shown to be a reliable measure and has validity as a dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with a variety of lower extremity conditions, and to be responsive to training programs in both healthy people and people with injuries to the lower extremity. Clinicians and researchers should be confident in employing the SEBT as a lower extremity functional test.
Age-Related Differences and Reliability on Computerized and Paper-and-Pencil Neurocognitive Assessment Batteries
Authors: Register-Mihalik Johna K. , Kontos Daniel L. , Guskiewicz Kevin M. , Mihalik Jason P. , Conder Robert , Shields Edgar W. 
Published: March 2017

Context:
Neurocognitive testing is a recommended component in a concussion assessment. Clinicians should be aware of age and practice effects on these measures to ensure appropriate understanding of results.

Objective:
To assess age and practice effects on computerized and paper-and-pencil neurocognitive testing batteries in collegiate and high school athletes.

Design:
Cohort study.

Setting:
Classroom and laboratory.

Patients or Other Participants:
Participants consisted of 20 collegiate student-athletes (age  =  20.00 ± 0.79 years) and 20 high school student-athletes (age  =  16.00 ± 0.86 years).

Main Outcome Measure(s):
Hopkins Verbal Learning Test scores, Brief Visual-Spatial Memory Test scores, Trail Making Test B total time, Symbol Digit Modalities Test score, Stroop Test total score, and 5 composite scores from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) served as outcome measures. Mixed-model analyses of variance were used to examine each measure.

Results:
Collegiate student-athletes performed better than high school student-athletes on ImPACT processing speed composite score (F1,38  =  5.03, P  =  .031) at all time points. No other age effects were observed. The Trail Making Test B total time (F2,66  =  73.432, P &lt; .001), Stroop Test total score (F2,76  =  96.85, P  =  &lt; .001) and ImPACT processing speed composite score (F2,76  =  5.81, P  =  .005) improved in test sessions 2 and 3 compared with test session 1. Intraclass correlation coefficient calculations demonstrated values ranging from 0.12 to 0.72.

Conclusions:
An athlete's neurocognitive performance may vary across sessions. It is important for clinicians to know the reliability and precision of these tests in order to properly interpret test scores.
Psychosocial Variables and Time to Injury Onset: A Hurdle Regression Analysis Model
Authors: Sibold Jeremy , Zizzi Samuel 
Published: March 2017

Context:
Psychological variables have been shown to be related to athletic injury and time missed from participation in sport. We are unaware of any empirical examination of the influence of psychological variables on time to onset of injury.

Objective:
To examine the influence of orthopaedic and psychosocial variables on time to injury in college athletes.

Patients or Other Participants:
One hundred seventy-seven (men  =  116, women  =  61; age  =  19.45 ± 1.39 years) National Collegiate Athletic Association Division II athletes.

Main Outcome Measure(s):
Hurdle regression analysis (HRA) was used to determine the influence of predictor variables on days to first injury.

Results:
Worry (z  =  2.98, P  =  .003), concentration disruption (z  =  −3.95, P &lt; .001), and negative life-event stress (z  =  5.02, P &lt; .001) were robust predictors of days to injury. Orthopaedic risk score was not a predictor (z  =  1.28, P  =  .20).

Conclusions:
These findings support previous research on the stress-injury relationship, and our group is the first to use HRA in athletic injury data. These data support the addition of psychological screening as part of preseason health examinations for collegiate athletes.
Quadriceps and Hamstrings Coactivation During Common Therapeutic Exercises
Authors: Begalle Rebecca L. , DiStefano Lindsay J. , Blackburn Troy , Padua Darin A. 
Published: March 2017

Context:
Anterior tibial shear force and knee valgus moment increase anterior cruciate ligament (ACL) loading. Muscle coactivation of the quadriceps and hamstrings influences anterior tibial shear force and knee valgus moment, thus potentially influencing ACL loading and injury risk. Therefore, identifying exercises that facilitate balanced activation of the quadriceps and hamstrings might be beneficial in ACL injury rehabilitation and prevention.

Objective:
To quantify and compare quadriceps with hamstrings coactivation electromyographic (EMG) ratios during commonly used closed kinetic chain exercises.

Design:
Cross-sectional study.

Setting:
Research laboratory.

Patients or Other Participants:
Twenty-seven healthy, physically active volunteers (12 men, 15 women; age = 22.1 ± 3.1 years, height = 171.4 ± 10 cm, mass = 72.4 ± 16.7 kg).

Intervention(s):
Participants completed 9 separate closed chain therapeutic exercises in a randomized order.

Main Outcome Measure(s):
Surface electromyography quantified the activity level of the vastus medialis (VM), vastus lateralis (VL), medial hamstrings (MH), and biceps femoris (BF) muscles. The quadriceps-to-hamstrings (Q:H) coactivation ratio was computed as the sum of average quadriceps (VM, VL) EMG amplitude divided by the sum of average hamstrings (MH, BF) EMG amplitude for each trial. We used repeated-measures analyses of variance to compare Q:H ratios and individual muscle contributions across exercises (α = .05), then used post hoc Tukey analyses.

Results:
We observed a main effect for exercise (F3,79 = 22.6, P &lt; .001). The post hoc Tukey analyses revealed smaller Q:H ratios during the single-limb dead lift (2.87 ± 1.77) than the single-limb squat (5.52 ± 2.89) exercise. The largest Q:H ratios were observed during the transverse-lunge (7.78 ± 5.51, P &lt; .001), lateral-lunge (9.30 ± 5.53, P &lt; .001), and forward-lunge (9.70 ± 5.90, P &lt; .001) exercises.

Conclusions:
The most balanced (smallest) coactivation ratios were observed during the single-limb dead-lift, lateral-hop, transverse-hop, and lateral band-walk exercises. These exercises potentially could facilitate balanced activation in ACL rehabilitation and injury-prevention programs. They also could be used in postinjury rehabilitation programs in a safe and progressive manner.
Influence of Hip-Flexion Angle on Hamstrings Isokinetic Activity in Sprinters
Authors: Guex Kenny , Gojanovic Boris , Millet Grégoire P. 
Published: March 2017

Context:
Hamstrings strains are common and debilitating injuries in many sports. Most hamstrings exercises are performed at an inadequately low hip-flexion angle because this angle surpasses 70° at the end of the sprinting leg's swing phase, when most injuries occur.

Objective:
To evaluate the influence of various hip-flexion angles on peak torques of knee flexors in isometric, concentric, and eccentric contractions and on the hamstrings-to-quadriceps ratio.

Design:
Descriptive laboratory study.

Setting:
Research laboratory.

Patients and Other Participants
Ten national-level sprinters (5 men, 5 women; age = 21.2 ± 3.6 years, height = 175 ± 6 cm, mass = 63.8 ± 9.9 kg).

Intervention(s):
For each hip position (0°, 30°, 60°, and 90° of flexion), participants used the right leg to perform (1) 5 seconds of maximal isometric hamstrings contraction at 45° of knee flexion, (2) 5 maximal concentric knee flexion-extensions at 60° per second, (3) 5 maximal eccentric knee flexion-extensions at 60° per second, and (4) 5 maximal eccentric knee flexion-extensions at 150° per second.

Main Outcome Measure(s):
Hamstrings and quadriceps peak torque, hamstrings-to-quadriceps ratio, lateral and medial hamstrings root mean square.

Results:
We found no difference in quadriceps peak torque for any condition across all hip-flexion angles, whereas hamstrings peak torque was lower at 0° of hip flexion than at any other angle (P &lt; .001) and greater at 90° of hip flexion than at 30° and 60° (P &lt; .05), especially in eccentric conditions. As hip flexion increased, the hamstrings-to-quadriceps ratio increased. No difference in lateral or medial hamstrings root mean square was found for any condition across all hip-flexion angles (P &gt; .05).

Conclusions:
Hip-flexion angle influenced hamstrings peak torque in all muscular contraction types; as hip flexion increased, hamstrings peak torque increased. Researchers should investigate further whether an eccentric resistance training program at sprint-specific hip-flexion angles (70° to 80°) could help prevent hamstrings injuries in sprinters. Moreover, hamstrings-to-quadriceps ratio assessment should be standardized at 80° of hip flexion.