bluuebunny/crossref_metadata_2025_split huggingface dataset:
Athletic Trainers' Beliefs About and Implementation of Evidence-Based Practice
Authors: Keeley Kimberly , Walker Stacy E. , Hankemeier Dorice A. , Martin Malissa , Cappaert Thomas A. 
Published: September 2016

Context
Understanding the beliefs about and use of evidence-based practice (EBP) among athletic trainers (ATs) will help to determine appropriate strategies to improve implementation.

Objective
To examine the ATs' beliefs about and use of EBP.

Design
Cross-sectional study.

Setting
Online survey instrument.

Patients or Other Participants
A total of 467 ATs responded to the survey request, a response rate of 11.67%. A total of 385 (9.6%) completed the EBP Beliefs Scale and 342 (8.5%) completed the EBP Implementation Scale.

Main Outcome Measure(s)
The EBP Beliefs Scale and EBP Implementation Scale were administered. The surveys collected demographic information in addition to information about participants' beliefs regarding EBP and implementation of EBP in clinical practice.

Results
The ATs demonstrated a level of neither agree nor disagree (56.00 ± 7.86) on the EBP Beliefs Scale. Belief scores were higher among those ATs required to document for third-party reimbursement (P = .001), those with access to current research through professional journals other than the Journal of Athletic Training (P = .02), and those with a doctoral degree (P = .01). A low level of implementation (9.00 ± 11.38), representing the implementation of EBP approximately 0 times in the previous 8 weeks, was found on the EBP Implementation Scale. Implementation scores were higher among preceptors (P = .01), those required to document for third-party reimbursement (P &lt; .001), those with access to current research through professional journals (P = .002), and those with a doctoral degree (P = .01).

Conclusions
Participants had a positive attitude toward EBP; however, they were not implementing EBP concepts when providing patient care. This suggests that additional information and EBP resources are needed so ATs can better implement EBP in practice. To provide the best patient care and to promote EBP within the profession, clinicians should make EBP a priority and advocate for EBP implementation.
Certified Athletic Trainers' Knowledge and Perceptions of Posttraumatic Osteoarthritis After Knee Injury
Authors: Pietrosimone Brian , Blackburn J. Troy , Golightly Yvonne M. , Harkey Matthew S. , Luc Brittney A. , DeFreese J. D. , Padua Darin A. , Jordan Joanne M. , Bennell Kim L. 
Published: September 2016

Context:
Posttraumatic osteoarthritis (PTOA) is a specific phenotype of osteoarthritis (OA) that commonly develops after acute knee injury, such as anterior cruciate ligament (ACL) or meniscal injury (or both). Athletic trainers (ATs) are well positioned to educate patients and begin PTOA management during rehabilitation of the acute injury, yet it remains unknown if ATs currently prioritize long-term outcomes in patients with knee injury.

Objective:
To investigate ATs' knowledge and perceptions of OA and its treatment after ACL injury, ACL reconstruction, or meniscal injury or surgery.

Design:
Cross-sectional study.

Patients or Other Participants:
An online survey was administered to 2000 randomly sampled certified ATs. We assessed participants' perceptions of knee OA, the risk of PTOA after ACL or meniscal injury or surgery, and therapeutic management of knee OA.

Results:
Of the 437 ATs who responded (21.9%), the majority (84.7%) correctly identified the definition of OA, and 60.3% indicated that they were aware of PTOA. A high percentage of ATs selected full meniscectomy (98.9%), meniscal tear (95.4%), ACL injury (90.2%), and partial meniscectomy (90.1%) as injuries that would increase the risk of developing OA. Athletic trainers rated undertaking strategies to prevent OA development in patients after ACL injury or reconstruction (73.8%) or meniscal injury or surgery (74.7%) as extremely or somewhat important. Explaining the risk of OA to patients with an ACL or meniscal injury was considered appropriate by 98.8% and 96.8% of respondents, respectively; yet a lower percentage reported that they actually explained these risks to patients after an ACL (70.8%) or meniscal injury (80.6%).

Conclusions:
Although 84.7% of ATs correctly identified the definition of OA, a lower percentage (60.3%) indicated awareness of PTOA. These results may reflect the need to guide ATs on how to educate patients regarding the long-term risks of ACL and meniscal injuries and how to implement strategies that may prevent PTOA.
High School Football Injury Rates and Services by Athletic Trainer Employment Status
Authors: Kerr Zachary Y. , Lynall Robert C. , Mauntel Timothy C. , Dompier Thomas P. 
Published: September 2016

Context
Reported injury rates and services in sports injury surveillance may be influenced by the employment setting of the certified athletic trainers (ATs) reporting these data.

Objective
To determine whether injury rates and the average number of AT services per injury in high school football varied by AT employment status.

Design
Cross-sectional study.

Setting
We used data from the National Athletic Treatment, Injury and Outcomes Network and surveyed ATs about their employment setting.

Patients or Other Participants
Forty-four responding ATs (37.9% of all National Athletic Treatment, Injury and Outcomes Network participants) worked at high schools with football programs and were included in this study. Fourteen ATs were full-time employees of the high school, and 30 ATs were employed as outreach ATs (ie, full-time and part-time ATs from nearby clinics, hospitals, and graduate school programs).

Main Outcome Measure(s)
We calculated injury rates per 1000 athlete-exposures and average number of AT services per injury.

Results
Reported injury rates and services per injury were greater among full-time school employees compared with outreach ATs. However, injury rates did not differ when restricted to time-loss injuries only.

Conclusions
Our findings suggest that ATs who are full-time school employees may be able to identify and care for more patients with injuries.
Rehabilitation for Chronic Ankle Instability With or Without Destabilization Devices: A Randomized Controlled Trial
Authors: Donovan Luke , Hart Joseph M. , Saliba Susan A. , Park Joseph , Feger Mark Anthony , Herb Christopher C. , Hertel Jay 
Published: September 2016

Individuals with chronic ankle instability (CAI) have deficits in neuromuscular control and altered movement patterns. Ankle-destabilization devices have been shown to increase lower extremity muscle activity during functional tasks and may be useful tools for improving common deficits and self-reported function.Context:
To determine whether a 4-week rehabilitation program that includes destabilization devices has greater effects on self-reported function, range of motion (ROM), strength, and balance than rehabilitation without devices in patients with CAI.Objective:
Randomized controlled clinical trial.Design:
Laboratory.Setting:
A total of 26 patients with CAI (7 men, 19 women; age = 21.34 ± 3.06 years, height = 168.96 ± 8.77 cm, mass = 70.73 ± 13.86 kg).Patients or Other Participants:
Patients completed baseline measures and were randomized into no-device and device groups. Both groups completed 4 weeks of supervised, impairment-based progressive rehabilitation with or without devices and then repeated baseline measures.Intervention(s):
We assessed self-reported function using the Foot and Ankle Ability Measure. Ankle ROM was measured with an inclinometer. Ankle strength was assessed using a handheld dynamometer during maximal voluntary isometric contractions. Balance was measured using a composite score of 3 reach directions from the Star Excursion Balance Test and a force plate to calculate center of pressure during eyes-open and eyes-closed single-limb balance. We compared each dependent variable using a 2 × 2 (group × time) analysis of variance and post hoc tests as appropriate and set an a priori α level at .05. The Hedges g effect sizes and associated 95% confidence intervals were calculated.Main Outcome Measure(s):
We observed no differences between the no-device and device groups for any measure. However, both groups had large improvements in self-reported function and ankle strength.Results:
Incorporating destabilization devices into rehabilitation did not improve ankle function more effectively than traditional rehabilitation tools because both interventions resulted in similar improvements. Impairment-based progressive rehabilitation improved clinical outcomes associated with CAI.Conclusions:
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer
Authors: Kasamatsu Tricia , Cleary Michelle , Bennett Jason , Howard Keith , McLeod Tamara Valovich 
Published: September 2016

Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools.Context:
To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion.Objective:
Cross-sectional study.Design:
Web-based survey.Setting:
A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]).Patients or Other Participants:
School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables.Main Outcome Measure(s):
Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles.Results:
Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.Conclusions:
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes
Authors: Nelson Lindsay D. , Guskiewicz Kevin M. , Barr William B. , Hammeke Thomas A. , Randolph Christopher , Ahn Kwang Woo , Wang Yanzhi , McCrea Michael A. 
Published: September 2016

Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery.Context: To compare clinical recovery patterns for high school and collegiate athletes.Objective: Prospective cohort study.Design: Large, multicenter prospective sample collected from 1999–2003 in a sports medicine setting.Setting: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey).Subjects: Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points).Main Outcome Measure(s): Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics.Results: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.Conclusions:
The Ability of American Football Helmets to Manage Linear Acceleration With Repeated High-Energy Impacts
Authors: Cournoyer Janie , Post Andrew , Rousseau Philippe , Hoshizaki Blaine 
Published: September 2016

Football players can receive up to 1400 head impacts per season, averaging 6.3 impacts per practice and 14.3 impacts per game. A decrease in the capacity of a helmet to manage linear acceleration with multiple impacts could increase the risk of traumatic brain injury.Context:
To investigate the ability of football helmets to manage linear acceleration with multiple high-energy impacts.Objective:
Descriptive laboratory study.Design:
Laboratory.Setting:
We collected linear-acceleration data for 100 impacts at 6 locations on 4 helmets of different models currently used in football. Impacts 11 to 20 were compared with impacts 91 to 100 for each of the 6 locations.Main Outcome Measure(s):
Linear acceleration was greater after multiple impacts (91−100) than after the first few impacts (11−20) for the front, front-boss, rear, and top locations. However, these differences are not clinically relevant as they do not affect the risk for head injury.Results:
American football helmet performance deteriorated with multiple impacts, but this is unlikely to be a factor in head-injury causation during a game or over a season.Conclusions:
Injuries and Associated Risk Factors Among Adolescent Elite Orienteerers: A 26-Week Prospective Registration Study
Authors: von Rosen Philip , Heijne Annette I.-L. M. , Frohm Anna 
Published: September 2016

In orienteering, the number of injury-registration studies is limited. Most researchers have used a cross-sectional design during specific events and, therefore, have mainly identified acute injuries.Context:To determine the prevalence of injuries by registering acute and overuse injuries in adolescent elite orienteerers over 26 weeks and to study the variation of injury prevalence over the season and the potential risk factors.Objective:Cohort study.Design:Two high schools in Sweden with national orienteering teams.Setting:All athletes (33 adolescent girls, 31 adolescent boys; age = 17 ± 1 years) from 2 high schools with orienteering teams.Patients or Other Participants:We used a weekly Web-based questionnaire to identify the incidence and prevalence of injuries and training variables. Risk factors for injury were calculated using multiple linear regression techniques.Main Outcome Measure(s):The average weekly prevalence of overuse and acute injuries was 35.7% (95% confidence interval = 34.8%, 36.6%) and 1.7% (95% confidence interval = 1.3%, 2.1%), respectively; overuse injuries (78.0%, n = 85) accounted for the majority. The incidence of acute and overuse injuries was highest for the foot/lower leg (48.6%, n = 53), and 71.6% (n = 78) of all injuries affected the foot/lower leg and knee area. Time to the first reported injury was associated with training volume (β = 0.184, P = .001), competition time (β = −0.701, P = .009), running on asphalt roads (β = −0.348, P = .008), and running on forest surfaces and trails (β = −0.331, P = .007), with a model fit of r 2 = 0.50 (intercept = 2.196, P &lt; .001). During the study, we observed a weekly increase (0.3%) in the prevalence of overuse injuries in the foot/lower leg (r 2 = 0.33, P = .001); the highest prevalence (26.9%) was at the beginning of the competitive season.Results:Overuse injuries, predominately in the foot/lower leg area, were more common than acute injuries in adolescent elite orienteerers. These injuries had the highest prevalence at the beginning of the competitive season; therefore, this period can be seen as a possible risk factor for sustaining overuse injuries in the foot/lower leg.Conclusions:
Neural Excitability and Joint Laxity in Chronic Ankle Instability, Coper, and Control Groups
Authors: Bowker Samantha , Terada Masafumi , Thomas Abbey C. , Pietrosimone Brian G. , Hiller Claire E. , Gribble Phillip A. 
Published: September 2016

Neuromuscular and mechanical deficiencies are commonly studied in participants with chronic ankle instability (CAI). Few investigators have attempted to comprehensively consider sensorimotor and mechanical differences among people with CAI, copers who did not present with prolonged dysfunctions after an initial ankle sprain, and a healthy control group.Context:
To determine if differences exist in spinal reflex excitability and ankle laxity among participants with CAI, copers, and healthy controls.Objective:
Case-control study.Design:
Research laboratory.Setting:
Thirty-seven participants with CAI, 30 participants categorized as copers, and 26 healthy control participants.Patients or Other Participants:
We assessed spinal reflex excitability of the soleus using the Hoffmann reflex protocol. Participants' ankle laxity was measured with an instrumented ankle arthrometer. The maximum Hoffmann reflex : maximal muscle response ratio was calculated. Ankle laxity was measured as the total displacement in the anterior-posterior directions (mm) and total rotation in the inversion and eversion directions (°).Main Outcome Measure(s):
Spinal reflex excitability was diminished in participants with CAI compared with copers and control participants (P = .01). No differences were observed among any of the groups for ankle laxity.Results:
Changes in the spinal reflex excitability of the soleus that likely affect ankle stability were seen only in the CAI group, yet no mechanical differences were noted across the groups. These findings support the importance of finding effective ways to increase spinal reflex excitability for the purpose of treating neural excitability dysfunction in patients with CAI.Conclusion:
Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking
Authors: Hall Emily A. , Simon Janet E. , Docherty Carrie L. 
Published: September 2016

Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated.Context:
To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking.Objective:
Crossover study.Design:
Research laboratory.Setting:
A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered.Patients or Other Participants:
Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition.Intervention(s):
Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale.Main Outcome Measure(s)
Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape conditions provided more perceived stability (0.98 cm and 0.94 cm, respectively) than the control condition (2.38 cm; both P values = .001).Results:
Both prophylactic conditions affected inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability. However, bracing provided more restriction at a slower rate than taping.Conclusions:
Biochemical Response to a Moderate Running Bout in Participants With or Without a History of Acute Knee Injury
Authors: Cattano Nicole M. , Driban Jeffrey B. , Barbe Mary F. , Tierney Ryan T. , Amin Mamta , Sitler Michael R. 
Published: September 2016

Context:
Individuals with an acute knee-injury history are 4 times more likely to develop knee osteoarthritis than those without a prior knee injury, and it is unknown why. Individuals with an injury history may exhibit aberrant changes in tissue turnover after physical activity (eg, running), which could lead to osteoarthritis, but this has yet to be determined among young, physically active individuals.

Objective:
To determine collagen degradation and synthesis and inflammatory biomarker concentration levels before exercise and changes in response to an acute running bout in injured participants compared with healthy control participants.

Design:
Cohort study.

Setting:
Research laboratory.

Patients or Other Participants:
A total of 22 physically active individuals between 18 and 25 years of age were recruited for the study: 11 injured participants (knee injury within 4 years of the study) who were medically cleared for physical activity and 11 matched healthy control participants.

Main Outcome Measure(s):
The independent variable was group (injured or control). Dependent variables were serum biomarker concentrations for cartilage oligomeric matrix protein, matrix metalloproteinase-13, proinflammatory marker interleukin-1β, c-terminal cross-linking telopeptide of type II collagen, and type II collagen synthesis marker. Each participant provided prerun and postrun blood samples for biomarker-concentration analysis.

Results:
No group differences existed in serum biomarker concentrations before exercise or in serum biomarker changes from pre-exercise to postexercise.

Conclusions:
After an acute bout of moderate-intensity running, young, active individuals in a high-risk postinjury population had similar biochemical responses as matched healthy controls. However, the external generalizability of these findings to other exercises and populations has yet to be determined.