bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-Case Research Design: An Alternative Strategy for Evidence-Based Practice
Authors: Stapleton Drue , Hawkins Andrew 
Published: September 2016

Objective
The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and pedagogical practices. The purpose of this paper is to review the literature related to SCD and its potential contributions to EBP in athletic training.

Data Source(s)
We searched PubMed, CINAHL, Proquest Dissertation and Theses, and Google Scholar using terms “single case design”, “single subject design”, “within subjects”, and combined search terms of “single case design AND athletic training, AND allied health, AND medicine, AND nursing”.

Data Synthesis
Textual support for the use of SCD in athletic training and a brief review of literature pertaining to: general features, strengths, limitations, and design options commonly associated with the use of SCD.

Conclusions
Use of SCD in allied health professions is limited, with fewer studies in athletic training settings. Low awareness and misinterpretation of SCD may be contributing to the low use of SCD in athletic training research. The key characteristics of SCD make it appropriate for use in clinical and educational settings and may provide clinicians, educators, and researchers an alternative tool for the development of evidence necessary to engage in evidence-based practice.
Effectiveness of Mobile Learning on Athletic Training Psychomotor Skill Acquisition
Authors: Davie Emily , Martin Malissa , Cuppett Micki , Lebsack Denise 
Published: September 2016

ContextInstruction of psychomotor skills is an important component of athletic training education. Accommodating the varied learning abilities and preferences of athletic training students can be challenging for an instructor initiating skill acquisition in a traditional face-to-face (F2F) environment. Video instruction available on mobile devices may offer an alternative teaching tool, allowing for student-initiated learning.ObjectiveTo compare outcomes of Quick Clips (QC) instruction with F2F instruction as measured by skill-examination scores.DesignQuasi-experimental.SettingFive higher learning institutions with Commission on Accreditation of Athletic Training Education (CAATE) accredited athletic training education programs.Patients or Other ParticipantsSeventy-four pre-athletic training students, average age 18.86 ± 1.0 years (49 women, 25 men), volunteered for this study. Participants were randomly assigned to 1 of 2 instructional groups (F2F or QC).Intervention(s)The principal investigator provided F2F instruction to 38 participants in 3 skills (knee valgus stress test, middle trapezius manual muscle test, and goniometric measurement of active ankle dorsiflexion). The remaining 36 participants watched 3 QC videos demonstrating the same skills.Main Outcome Measure(s)Three individual skill exam scores and the total score.ResultsA 1-way multivariate analysis of variance indicated a significant effect (P &lt; .0001) of instructional method on exam scores. Follow-up univariate analysis of variance indicated knee valgus stress test exam scores were significantly higher after F2F instruction (P &lt; .0001). Neither manual muscle test nor goniometric measurement exam scores were affected by instructional method.ConclusionsThe findings support the use of QC as an alternative to F2F instruction for 2 of the 3 skills. This finding is similar to studies reported in the nursing literature on computer-assisted learning, which found inconclusive evidence to support the superiority of one method over another. Mobile video instruction is an effective teaching strategy. It may be best utilized to supplement traditional F2F instruction.
Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training
Authors: Mazerolle Stephanie M. , Eason Christianne M. , Pitney William A. , Mueller Megan N. 
Published: September 2016

Context
Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner's sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits.

Objective
To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits.

Design
Cross-sectional study.

Setting
Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales.

Patients or Other Participants
A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old.

Main Outcome Measures(s)
Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession.

Results
The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t244 = 0.492, P = .95) or their willingness to leave the profession (t244 = −1.27, P = .21). We noted differences among ATs in different practice settings (F8,245 = 5.015, P &lt;.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = −0.533, P &lt; .001). Comfort with using work-leave benefits was different among practice settings (F8,245 = 3.01, P = .003).

Conclusions
The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.
Intramuscular Heating Characteristics of Multihour Low-Intensity Therapeutic Ultrasound
Authors: Rigby Justin H. , Taggart Rebecca M. , Stratton Kelly L. , Lewis George K. , Draper David O. 
Published: September 2016

Context
The heating characteristics of a stationary device delivering sustained acoustic medicine with low-intensity therapeutic ultrasound (LITUS) are unknown.

Objective
To measure intramuscular (IM) heating produced by a LITUS device developed for long-duration treatment of musculoskeletal injuries.

Design
Controlled laboratory study.

Setting
University research laboratory.

Patients or Other Participants
A total of 26 healthy volunteers (16 men, 10 women; age = 23.0 ± 2.1 years, height = 1.74 ± 0.09 m, mass = 73.48 ± 14.65 kg).

Intervention(s)
Participants were assigned randomly to receive active (n = 20) or placebo (n = 6) LITUS at a frequency of 3 MHz and an energy intensity of 0.132 W/cm2 continuously for 3 hours with a single transducer or dual transducers on the triceps surae muscle. We measured IM temperature using thermocouples inserted at 1.5- and 3-cm depths into muscle. Temperatures were recorded throughout treatment and 30 minutes posttreatment.

Main Outcome Measure(s)
We used 2-sample t tests to determine the heating curve of the LITUS treatment and differences in final temperatures between depth and number of transducers.

Results
A mild IM temperature increase of 1°C was reached 10 ± 5 minutes into the treatment, and a more vigorous temperature increase of 4°C was reached 80 ± 10 minutes into the treatment. The maximal steady-state IM temperatures produced during the final 60 minutes of treatment at the 1.5-cm depth were 4.42°C ± 0.08°C and 3.92°C ± 0.06°C using 1 and 2 transducers, respectively. At the 3.0-cm depth, the maximal steady-state IM temperatures during the final 60 minutes of treatment were 3.05°C ± 0.09°C and 3.17°C ± 0.05°C using 1 and 2 transducers, respectively. We observed a difference between the temperatures measured at each depth (t78 = −2.45, P = .02), but the number of transducers used to generate heating was not different (t78 = 1.79, P = .08).

Conclusions
The LITUS device elicited tissue heating equivalent to traditional ultrasound but could be sustained for multiple hours. It is a safe and effective alternative tool for delivering therapeutic ultrasound and exploring dosimetry for desired physiologic responses.
Assessment of Muscle Pain Induced by Elbow-Flexor Eccentric Exercise
Authors: Lau Wing Yin , Blazevich Anthony J. , Newton Michael J. , Wu Sam Shi Xuan , Nosaka Kazunori 
Published: September 2016

Context:
Delayed-onset muscle soreness (DOMS) is a common muscle pain that many people experience and is often used as a model of acute muscle pain. Researchers have reported the effects of various interventions on DOMS, but different DOMS assessment protocols used in these studies make it difficult to compare the effects.

Objective:
To investigate DOMS characteristics after elbow-flexor eccentric exercise to establish a standardized DOMS assessment protocol.

Design:
Descriptive laboratory study.

Setting:
Research laboratory.

Patients or Other Participants:
Ten healthy, untrained men (21–39 years).

Intervention(s):
Participants performed 10 sets of 6 maximal isokinetic eccentric contractions of the elbow flexors.

Main Outcome Measure(s):
Indirect muscle-damage markers were maximal voluntary isometric contraction torque, range of motion, and serum creatine kinase activity. Muscle pain was assessed before exercise, immediately postexercise, and 1 to 5 days postexercise using (1) a visual analog scale (VAS), (2) a category ratio-10 scale (CR-10) when applying static pressure and palpation at different sites (3, 9, and 15 cm above the elbow crease), and (3) pressure-pain thresholds (PPTs) at 50 sites (pain mapping).

Results:
Maximal voluntary isometric contraction and range of motion decreased and creatine kinase activity increased postexercise, indicating muscle damage. Palpation induced greater pain than static pressure, and longitudinal and transverse palpations induced greater pain than circular palpation (P &lt; .05). The PPT was lower in the medial region before exercise, but the pain-sensitive regions shifted to the central and distal regions of the biceps brachii at 1 to 3 days postexercise (P &lt; .05). The VAS was correlated with the CR-10 scale (r = 0.91, P &lt; .05) but not with the PPT (r = −0.28, P = .45).

Conclusions:
The way in which muscles are assessed affects the pain level score. This finding suggests that pain level and pain threshold cannot be used interchangeably and that the central and distal regions of the biceps brachii should be included in DOMS assessment using the VAS, CR-10 scale, and PPT after elbow-flexor eccentric exercise.
The Role of Personality in Job Satisfaction Among Collegiate Athletic Trainers
Authors: Eason Christianne M. , Mazerolle Stephanie M. , Monsma Eva V. , Mensch James M. 
Published: September 2016

Context The degree to which an individual likes his or her job is known as job satisfaction. A person with higher job satisfaction is less likely to depart from a profession than a person with lower job satisfaction. Researchers studying job satisfaction among other allied health professionals suggest a personality component could explain why the reasons for departure can be so individual.Setting Collegiate institutions.Objective To determine the relationship between job satisfaction and personality among collegiate athletic trainers (ATs).Patients or Other Participants A total of 202 ATs (68 [33.7%] men and 134 [66.3%] women), were recruited using the National Athletic Trainers' Association e-mail database. We excluded any AT from this study who worked outside of the collegiate setting. The response rate was 20.2%.Intervention(s) Data were collected using a Web-based survey instrument consisting of 3 sections: (1) demographics, (2) job satisfaction survey, and (3) Big Five Personality Inventory.Main Outcome Measure(s) Independent t tests were run to determine sex differences, and correlations were run to evaluate relationships between demographics and job satisfaction and between job satisfaction and personality.Results Women reported higher levels of neuroticism than men. Extroversion and conscientiousness showed a weak positive relationship with job satisfaction. A moderate positive relationship was found between agreeableness and job satisfaction. A moderate negative relationship was noted between neuroticism and job satisfaction.Conclusions Based on our findings, head ATs or other organizational leaders may consider using personality assessments during interview processes, or athletic training program directors may be able to better guide students interested in athletic training based on knowledge of their personalities.
Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience
Authors: Mazerolle Stephanie M. , Clines Stephanie , Eason Christianne M. , Pitney William A. 
Published: September 2016

Context The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously.Objective To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships.Design Semistructured phone interviews.Setting Graduate-assistant ATs in various clinical settings.Patients or Other Participants Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non–athletic training-based curriculum = 6). Median age was 24 years.Data Collection and Analysis Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability.Results Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support.Conclusions Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience.
Exertional Heat Stroke and Susceptibility to Malignant Hyperthermia in an Athlete: Evidence for a Link?
Authors: Poussel Mathias , Guerci Philippe , Kaminsky Pierre , Heymonet Marie , Roux-Buisson Nathalie , Faure Julien , Fronzaroli Emilien , Chenuel Bruno 
Published: September 2016

Objective
To describe the possible association (pathophysiologic and clinical features) between exertional heat stroke (EHS) and malignant hyperthermia (MH).

Background
Both EHS and MH are acute and life-threatening disorders. It has repeatedly been shown that EHS can occur in well-trained patients with known MH-associated mutation in the RYR1 gene in the absence of any extreme environmental conditions or extreme physical activity, thereby supporting a possible link between EHS and MH. In this case, a highly trained 30-year-old male athlete suddenly collapsed while running. He had initial hyperthermia (40.2°C) and progressive multiple organ failure requiring medical management in an intensive care unit. After he recovered completely, a maximal exercise test was performed and showed an obvious abnormality of oxidative metabolism in muscle; genetic analysis of the RYR1 gene identified a heterozygous missense variation p.K1393R. Consequently, the athlete was given appropriate information and allowed to progressively return to sport competition.

Differential Diagnosis
Doping, use of drugs and toxic agents, exercise-associated hyponatremia, exertional heat illness.

Treatment
Initial management started with the basic resuscitative guidelines of airway, breathing, and circulation (intubation). Cooling, administration of fresh frozen plasma, and intensive rehydration resulted in improvement.

Uniqueness
To our knowledge, ours is the first description of this MH mutation (p.K1393R) in the RYR1 gene that was associated with exertional rhabdomyolysis involving a dramatic impairment of oxidative metabolism in muscle.

Conclusions
Common features are shared by EHS and MH. Careful attention must therefore be paid to athletes who experience EHS, especially in temperate climates or when there are no other predisposing factors.
Preseason Perceived Physical Capability and Previous Injury
Authors: Sciascia Aaron , Haegele Lauren E. , Lucas Jean , Uhl Timothy L. 
Published: September 2016

Context Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking.Objective To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury.Design Cross-sectional study.Setting Preparticipation physical examinations.Patients or Other Participants A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury.Main Outcome Measure(s) Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury.Results Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P &lt; .001).Conclusions Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the goal for these athletes to return to participation after injury. Athletes reporting previous injuries perceived less physical capability before the competitive season. Self-assessment of joint-specific capability may supplement preseason physical examinations, identifying particular athletes needing further monitoring or care during a season.
Multistakeholder Perspectives on the Transition to a Graduate-Level Athletic Training Educational Model
Authors: Mazerolle Stephanie M. , Bowman Thomas G. , Pitney William A. 
Published: September 2016

Context The decision has been made to move away from the traditional bachelor's degree professional program to a master's degree professional program. Little is known about the perceptions about this transition from those involved with education.Objective To examine multiple stakeholders' perspectives within athletic training education on the effect that a change to graduate-level education could have on the profession and the educational and professional development of the athletic trainer.Design Qualitative study.Setting Web-based survey.Patients or Other Participants A total of 18 athletic training students (6 men, 12 women; age = 24 ± 5 years), 17 athletic training faculty (6 men, 9 women, 2 unspecified; 7 program directors, 5 faculty members, 3 clinical coordinators, 2 unidentified; age = 45 ± 8 years), and 15 preceptors (7 men, 7 women, 1 unspecified; age = 34 ± 7 years) completed the study.Data Collection and Analysis Participants completed a structured Web-based questionnaire. Each cohort responded to questions matching their roles within an athletic training program. Data were analyzed following a general inductive process. Member checks, multiple-analyst triangulation, and peer review established credibility.Results Thirty-one (62%) participants supported the transition, 14 (28%) were opposed, and 5 (10%) were neutral or undecided. Advantages of and support for transitioning and disadvantages of and against transitioning emerged. The first higher-order theme, advantages, revealed 4 benefits: (1) alignment of athletic training with other health care professions, (2) advanced coursework and curriculum delivery, (3) improved student and professional retention, and (4) student maturity. The second higher-order theme, disadvantages, was defined by 3 factors: (1) limited time for autonomous practice, (2) financial concerns, and (3) lack of evidence for the transition.Conclusions Athletic training students, faculty, and preceptors demonstrated moderate support for a transition to the graduate-level model. Factors supporting the move were comparable with those detailed in a recent document on professional education in athletic training presented to the National Athletic Trainers' Association Board of Directors. The concerns about and reasons against a move have been discussed by those in the profession.