bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hip Kinematics During a Stop-Jump Task in Patients With Chronic Ankle Instability
Authors: Brown Cathleen N. , Padua Darin A. , Marshall Stephen W. , Guskiewicz Kevin M. 
Published: March 2017

Context: Chronic ankle instability (CAI) commonly develops after lateral ankle sprain. Movement pattern differences at proximal joints may play a role in instability.
Objective: To determine whether people with mechanical ankle instability (MAI) or functional ankle instability (FAI) exhibited different hip kinematics and kinetics during a stop-jump task compared with “copers.”
Design: Cross-sectional study.
Setting: Sports medicine research laboratory.
Patients or Other Participants: Sixty-three recreational athletes, 21 (11 men, 10 women) per group, matched for sex, age, height, mass, and limb dominance. All participants reported a history of a moderate to severe ankle sprain. The participants with MAI and FAI reported 2 or more episodes of giving way at the ankle in the last year and decreased functional ability; copers did not. The MAI group demonstrated clinically positive anterior drawer and talar tilt tests, whereas the FAI group and copers did not.
Intervention(s): Participants performed a maximum-speed approach run and a 2-legged stop jump followed by a maximum vertical jump.
Main Outcome Measure(s): An electromagnetic tracking device synchronized with a force plate collected data during the stance phase of a 2-legged stop jump. Hip motion was measured from initial contact to takeoff into the vertical jump. Group differences in hip kinematics and kinetics were assessed.
Results: The MAI group demonstrated greater hip flexion at initial contact and at maximum (P = .029 and P = .017, respectively) and greater hip external rotation at maximum (P = .035) than the coper group. The MAI group also demonstrated greater hip flexion displacement than both the FAI (P = .050) and coper groups (P = .006). No differences were noted between the FAI and coper groups in hip kinematic variables or among any of the groups in ground reaction force variables.
Conclusions: The MAI group demonstrated different hip kinematics than the FAI and coper groups. Proximal joint motion may be affected by ankle joint function and laxity, and clinicians may need to assess proximal joints after repeated ankle sprains.
Knee Separation Distance and Lower Extremity Kinematics During a Drop Land: Implications for Clinical Screening
Authors: Sigward Susan M. , Havens Kathryn L. , Powers Christopher M. 
Published: March 2017

Context: Excessive knee valgus during dynamic tasks is thought to contribute to lower extremity overuse and traumatic injuries. Clinically, assessments of frontal-plane knee motion typically include measures of the distance between the knees during landing. However, it is not clear how this clinical assessment relates to knee-abduction angle or how it is influenced by the position of the lower extremities in the transverse and frontal planes.
Objective: To determine whether normalized knee separation distance (NKSD) is a predictor of knee-abduction angles and to assess the influence of lower extremity transverse-plane and frontal-plane angles on NKSD during a drop land.
Design: Cross-sectional study.
Setting: Motion analysis laboratory.
Patients or Other Participants: Twenty-five healthy female athletes.
Intervention(s): The frontal-plane distance between the 2- dimensional coordinates of markers over the greater trochanters (intertrochanteric distance), lateral femoral epicondyles (knee separation distance), and lateral malleoli (stance width) bilaterally was calculated during a drop land. The knee separation distance was normalized by intertrochanteric distance (NKSD). Concurrently, 3-dimensional lower extremity transverse-plane and frontal-plane kinematics were obtained.
Main Outcome Measure(s): We assessed NKSD, stance width, and bilateral average knee and hip transverse plane and frontal-plane angles and ankle frontal-plane angles. Linear regression was used to determine the association between NKSD and bilateral average knee frontal-plane angles. Stepwise multiple regression was used to identify the best predictors of NKSD during the drop land.
Results: After we controlled for stance width, NKSD explained 52% of the variance in the knee frontal-plane angle. When we took lower extremity kinematics into account, after controlling for stance width, the average hip frontal-plane angle was the best predictor of NKSD, explaining 97% of the variance.
Conclusions: Although NKSD is a predictor of knee- abduction angle, frontal-plane hip angle and stance width are strongly related to NKSD. Caution must be taken when interpreting NKSD as knee abduction.
Self-Paced Exercise Performance in the Heat After Pre-Exercise Cold-Fluid Ingestion
Authors: Byrne Christopher , Owen Craig , Cosnefroy Aurélien , Lee Jason Kai Wei 
Published: March 2017

Context: Precooling is the pre-exercise reduction of body temperature and is an effective method of improving physiologic function and exercise performance in environmental heat. A practical and effective method of precooling suitable for application at athletic venues has not been demonstrated.
Objective: To confirm the effectiveness of pre-exercise ingestion of cold fluid without fluid ingestion during exercise on pre-exercise core temperature and to determine whether pre-exercise ingestion of cold fluid alone without continued provision of cold fluid during exercise can improve exercise performance in the heat.
Design: Randomized controlled clinical trial.
Setting: Environmental chamber at an exercise physiology laboratory that was maintained at 32°C, 60% relative humidity, and 3.2 m/s facing air velocity.
Patients or Other Participants: Seven male recreational cyclists (age = 21 ± 1.5 years, height = 1.81 ± 0.07 m, mass = 78.4 ± 9.2 kg) participated.
Intervention(s): Participants ingested 900 mL of cold (2°C) or control (37°C) flavored water in 3 300-mL aliquots over 35 minutes of pre-exercise rest.
Main Outcome Measure(s): Rectal temperature and thermal comfort before exercise and distance cycled, power output, pacing, rectal temperature, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss during exercise.
Results: During rest, a greater decrease in rectal temperature was observed with ingestion of the cold fluid (0.41 ± 0.16°C) than the control fluid (0.17 ± 0.17°C) over 35 to 5 minutes before exercise (t6 = −3.47, P = .01). During exercise, rectal temperature was lower after ingestion of the cold fluid at 5 to 25 minutes (t6 range, 2.53–3.38, P ≤ .05). Distance cycled was greater after ingestion of the cold fluid (19.26 ± 2.91 km) than after ingestion of the control fluid (18.72 ± 2.59 km; t6 = −2.80, P = .03). Mean power output also was greater after ingestion of the cold fluid (275 ± 27 W) than the control fluid (261 ± 22 W; t6 = −2.13, P = .05). No differences were observed for pacing, mean skin temperature, heart rate, blood lactate, thermal comfort, perceived exertion, and sweat loss (P &gt; .05).
Conclusions: We demonstrated that pre-exercise ingestion of cold fluid is a simple, effective precooling method suitable for field-based application.
Validity and Reliability of Limits-of-Stability Testing: A Comparison of 2 Postural Stability Evaluation Devices
Authors: Pickerill Marie L. , Harter Rod A. 
Published: March 2017

Context: A lack of published comparisons between measures from commercially available computerized posturography devices and the outcome measures used to define the limits of stability (LOS) makes meaningful interpretation of dynamic postural stability measures difficult.
Objectives: To compare postural stability measures between and within devices to establish concurrent and construct validity and to determine test-retest reliability for LOS measures generated by the NeuroCom Smart Balance Master and the Biodex Balance System.
Design: Cross-sectional study.
Setting: Controlled research laboratory.
Patients or Other Participants: A total of 23 healthy participants with no vestibular or visual disabilities or lower limb impairments.
Intervention(s): The LOS were assessed during 2 laboratory test sessions 1 week apart.
Main Outcome Measure(s): Three NeuroCom LOS variables (directional control, endpoint excursion, and movement velocity) and 2 Biodex LOS variables (directional control, test duration).
Results: Test-retest reliability ranged from high to low across the 5 LOS measures (intraclass correlation coefficient [2,k] = 0.82 to 0.48). Pearson correlations revealed 4 significant relationships (P &lt; .05) between and within the 2 computerized posturography devices (r = 0.42 to −0.65).
Conclusions: Based on the wide range of intraclass correlation values we observed for the NeuroCom measures, clinicians and researchers alike should establish the reliability of LOS testing for their own clinics and laboratories. The low to moderate reliability outcomes observed for the Biodex measures were not of sufficient magnitude for us to recommend using the LOS measures from this system as the gold standard. The moderate Pearson interclass correlations we observed suggest that the Biodex and NeuroCom postural stability systems provided unique information. In this study of healthy participants, the concurrent and construct validity of the Biodex and NeuroCom LOS tests were not definitively established. We recommend that this study be repeated with a clinical population to further explore the matter.
Functional Ankle Instability and Health-Related Quality of Life
Authors: Arnold Brent L. , Wright Cynthia J. , Ross Scott E. 
Published: March 2017

Context: To our knowledge, no authors have assessed health-related quality of life (HR-QOL) in participants with functional ankle instability (FAI). Furthermore, the relationships between measures of ankle functional limitation and HR-QOL are unknown.
Objective: To use the Short Form–36v2 Health Survey (SF-36) to compare HR-QOL in participants with or without FAI and to determine whether HR-QOL was related to functional limitation.
Design: Cross-sectional study.
Setting: Sports medicine research laboratory.
Patients or Other Participants: Sixty-eight participants with FAI (defined as at least 1 lateral ankle sprain and 1 episode of giveway per month) or without FAI were recruited (FAI group: n = 34, age = 25 ± 5 years, height = 1.71 ± 0.08 m, mass = 74.39 ± 12.78 kg, Cumberland Ankle Instability Tool score = 19.3 ± 4; uninjured [UI] group: n = 34, age = 23 ± 4 years, height = 1.69 ± 0.08 m, mass = 67.94 ± 11.27 kg, Cumberland Ankle Instability Tool score = 29.4 ± 1).
Main Outcome Measure(s): All participants completed the SF-36 as a measure of HR-QOL and the Foot and Ankle Ability Measure (FAAM) and the FAAM Sport version (FAAMS) as assessments of functional limitation. To compare the FAI and UI groups, we calculated multiple analyses of variance followed by univariate tests. Additionally, we correlated the SF-36 summary component scale and domain scales with the FAAM and FAAMS scores.
Results: Participants with FAI had lower scores on the SF-36 physical component summary (FAI = 54.4 ± 5.1, UI = 57.8 ± 3.7, P = .005), physical function domain scale (FAI = 54.5 ± 3.8, UI = 56.6 ± 1.2, P = .004), and bodily pain domain scale (FAI = 52.0 ± 6.7, UI = 58.5 ± 5.3, P &lt; .005). Similarly, participants with FAI had lower scores on the FAAM (FAI = 93.7 ± 8.4, UI = 99.5 ± 1.4, P &lt; .005) and FAAMS (FAI = 84.5 ± 8.4, UI = 99.8 ± 0.72, P &lt; .005) than did the UI group. The FAAM score was correlated with the physical component summary scale (r = 0.42, P = .001) and the physical function domain scale (r = 0.61, P &lt; .005). The FAAMS score was correlated with the physical function domain scale (r = 0.47, P &lt; .005) and the vitality domain scale (r = 0.36, P = .002).
Conclusions: Compared with UI participants, those with FAI had less HR-QOL and more functional limitations. Furthermore, positive correlations were found between HR-QOL and functional limitation measures. This suggests that ankle impairment may reduce overall HR-QOL.
Incidence of Injuries in High School Softball and Baseball Players
Authors: Shanley Ellen , Rauh Mitchell J. , Michener Lori A. , Ellenbecker Todd S. 
Published: March 2017

Context: Participation in high school sports has grown 16.1% over the last decade, but few studies have compared the overall injury risks in girls' softball and boys' baseball.Objective: To examine the incidence of injury in high school softball and baseball players.Design: Cohort study.Setting: Greenville, South Carolina, high schools.Patients or Other Participants: Softball and baseball players (n = 247) from 11 high schools.Main Outcome Measure(s): Injury rates, locations, types; initial or subsequent injury; practice or game setting; positions played; seasonal trends.Results: The overall incidence injury rate was 4.5/1000 athlete-exposures (AEs), with more injuries overall in softball players (5.6/1000 AEs) than in baseball players (4.0/1000 AEs). Baseball players had a higher initial injury rate (75.9/1000 AEs) than softball players (66.4/1000 AEs): rate ratio (RR) = 0.88, 95% confidence interval (CI) = 0.4, 1.7. The initial injury rate was higher than the subsequent injury rate for the overall sample (P &lt; .0001) and for softball (P &lt; .0001) and baseball (P &lt; .001) players. For both sports, the injury rate during games (4.6/1000 AEs) was similar to that during practices (4.1/1000 AEs), RR = 1.22, 95% CI = 0.7, 2.2. Softball players were more likely to be injured in a game than were baseball players (RR = 1.92, 95% CI = 0.8, 4.3). Most injuries (77%) were mild (3.5/1000 AEs). The upper extremity accounted for the highest proportion of injuries (63.3%). The incidence of injury for pitchers was 37.3% and for position players was 15.3%. The rate of injury was highest during the first month of the season (7.96/1000 AEs).Conclusions: The incidence of injury was low for both softball and baseball. Most injuries were minor and affected the upper extremity. The injury rates were highest in the first month of the season, so prevention strategies should be focused on minimizing injuries and monitoring players early in the season.
Approved Clinical Instructors' Perspectives on Implementation Strategies in Evidence-Based Practice for Athletic Training Students
Authors: Hankemeier Dorice A. , Van Lunen Bonnie L. 
Published: March 2017

Context: Understanding implementation strategies of Approved Clinical Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice.Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students.Design: Qualitative study.Setting: Telephone interviews.Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.8 ± 3.9 years) were interviewed.Data Collection and Analysis: We interviewed each participant by telephone. Interview transcripts were analyzed and coded for common themes and subthemes regarding implementation strategies. Established themes were triangulated through peer review and member checking to verify the data.Results: The ACIs identified EBP implementation as important for validation of the profession, changing paradigm shift, improving patient care, and improving student educational experiences. They promoted 3 methods of implementing EBP concepts with their students: self-discovery, promoting critical thinking, and sharing information. They assisted students with the steps of EBP and often faced challenges in implementation of the first 3 steps of EBP: defining a clinical question, literature searching, and literature appraisal. Finally, ACIs indicated that modeling the behavior of making clinical decisions based on evidence was the best way to encourage students to continue using EBP.Conclusions: Athletic training education program directors should encourage and recommend specific techniques for EBP implementation in the clinical setting. The ACIs believed that role modeling is a strategy that can be used to promote the use of EBP with students. Training of ACIs should include methods by which to address the steps of the EBP process while still promoting critical thinking.
Preferences for and Barriers to Formal and Informal Athletic Training Continuing Education Activities
Authors: Armstrong Kirk J. , Weidner Thomas G. 
Published: March 2017

Context: Our previous research determined the frequency of participation and perceived effect of formal and informal continuing education (CE) activities. However, actual preferences for and barriers to CE must be characterized.Objective: To determine the types of formal and informal CE activities preferred by athletic trainers (ATs) and barriers to their participation in these activities.Design: Cross-sectional study.Setting: Athletic training practice settings.Patients or Other Participants: Of a geographically stratified random sample of 1000 ATs, 427 ATs (42.7%) completed the survey.Main Outcome Measure(s): As part of a larger study, the Survey of Formal and Informal Athletic Training Continuing Education Activities (FIATCEA) was developed and administered electronically. The FIATCEA consists of demographic characteristics and Likert scale items (1 = strongly disagree, 5 = strongly agree) about preferred CE activities and barriers to these activities. Internal consistency of survey items, as determined by Cronbach α, was 0.638 for preferred CE activities and 0.860 for barriers to these activities. Descriptive statistics were computed for all items. Differences between respondent demographic characteristics and preferred CE activities and barriers to these activities were determined via analysis of variance and dependent t tests. The α level was set at .05.Results: Hands-on clinical workshops and professional networking were the preferred formal and informal CE activities, respectively. The most frequently reported barriers to formal CE were the cost of attending and travel distance, whereas the most frequently reported barriers to informal CE were personal and job-specific factors. Differences were noted between both the cost of CE and travel distance to CE and all other barriers to CE participation (F1,411 = 233.54, P &lt; .001).Conclusions: Overall, ATs preferred formal CE activities. The same barriers (eg, cost, travel distance) to formal CE appeared to be universal to all ATs. Informal CE was highly valued by ATs because it could be individualized.
Hip Muscle Activity During 3 Side-Lying Hip-Strengthening Exercises in Distance Runners
Authors: McBeth Joseph M. , Earl-Boehm Jennifer E. , Cobb Stephen C. , Huddleston Wendy E. 
Published: March 2017

Context:
Lower extremity overuse injuries are associated with gluteus medius (GMed) weakness. Understanding the activation of muscles about the hip during strengthening exercises is important for rehabilitation.

Objective:
To compare the electromyographic activity produced by the gluteus medius (GMed), tensor fascia latae (TFL), anterior hip flexors (AHF), and gluteus maximus (GMax) during 3 hip-strengthening exercises: hip abduction (ABD), hip abduction with external rotation (ABD-ER), and clamshell (CLAM) exercises.

Design:
Controlled laboratory study.

Setting:
Laboratory.

Patients or Other Participants:
Twenty healthy runners (9 men, 11 women; age = 25.45 ± 5.80 years, height = 1.71 ± 0.07 m, mass = 64.43 ± 7.75 kg) participated.

Intervention(s):
A weight equal to 5% body mass was affixed to the ankle for the ABD and ABD-ER exercises, and an equivalent load was affixed for the CLAM exercise. A pressure biofeedback unit was placed beneath the trunk to provide positional feedback.

Main Outcome Measure(s):
Surface electromyography (root mean square normalized to maximal voluntary isometric contraction) was recorded over the GMed, TFL, AHF, and GMax.

Results:
Three 1-way, repeated-measures analyses of variance indicated differences for muscle activity among the ABD (F3,57 = 25.903, P&lt;.001), ABD-ER (F3,57 = 10.458, P&lt;.001), and CLAM (F3,57 = 4.640, P=.006) exercises. For the ABD exercise, the GMed (70.1 ± 29.9%), TFL (54.3 ± 19.1%), and AHF (28.2 ± 21.5%) differed in muscle activity. The GMax (25.3 ± 24.6%) was less active than the GMed and TFL but was not different from the AHF. For the ABD-ER exercise, the TFL (70.9 ± 17.2%) was more active than the AHF (54.3 ± 24.8%), GMed (53.03 ± 28.4%), and GMax (31.7 ± 24.1 %). For the CLAM exercise, the AHF (54.2 ± 25.2%) was more active than the TFL (34.4 ± 20.1%) and GMed (32.6 ± 16.9%) but was not different from the GMax (34.2 ± 24.8%).

Conclusions:
The ABD exercise is preferred if targeted activation of the GMed is a goal. Activation of the other muscles in the ABD-ER and CLAM exercises exceeded that of GMed, which might indicate the exercises are less appropriate when the primary goal is the GMed activation and strengthening.
Discriminating Between Copers and People With Chronic Ankle Instability
Authors: Wikstrom Erik A. , Tillman Mark D. , Chmielewski Terese L. , Cauraugh James H. , Naugle Keith E. , Borsa Paul A. 
Published: March 2017

Context:
Differences in various outcome measures have been identified between people who have sprained their ankles but have no residual symptoms (copers) and people with chronic ankle instability (CAI). However, the diagnostic utility of the reported outcome measures has rarely been determined. Identifying outcome measures capable of predicting who is less likely to develop CAI could improve rehabilitation protocols and increase the efficiency of these measures.

Objective:
To determine the diagnostic utility and cutoff scores of perceptual, mechanical, and sensorimotor outcome measures between copers and people with CAI by using receiver operating characteristic curves.

Design:
Case-control study.

Setting:
Sports medicine research laboratory.

Patients or Other Participants:
Twenty-four copers (12 men, 12 women; age = 20.8 ± 1.5 years, height = 173 ± 11 cm, mass = 78 ± 27 kg) and 24 people with CAI (12 men, 12 women; age = 21.7 ± 2.8 years, height = 175 ± 13 cm, mass = 71 ± 13 kg) participated.

Intervention(s):
Self-reported disability questionnaires, radiographic images, and a single-legged hop stabilization test.

Main Outcome Measure(s):
Perceptual outcomes included scores on the Foot and Ankle Disability Index (FADI), FADI-Sport, and a self-report questionnaire of ankle function. Mechanically, talar position was quantified by measuring the distance from the anterior tibia to the anterior talus in the sagittal plane. Sensorimotor outcomes were the dynamic postural stability index and directional indices, which were calculated during a single-legged hop stabilization task.

Results:
Perceptual outcomes demonstrated diagnostic accuracy (range, 0.79–0.91), with 95% confidence intervals ranging from 0.65 to 1.00. Sensorimotor outcomes also were able to discriminate between copers and people with CAI but with less accuracy (range, 0.69–0.70), with 95% confidence intervals ranging from 0.37 to 0.86. The mechanical outcome demonstrated poor diagnostic accuracy (0.52).

Conclusions:
The greatest diagnostic utility scores were achieved by the self-assessed disability questionnaires, which indicated that perceptual outcomes had the greatest ability to accurately predict people who became copers after their initial injuries. However, the diversity of outcome measures that discriminated between copers and people with CAI indicated that the causal mechanism of CAI is probably multifactorial.