bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery
Authors: Cleary Michelle , Ruiz Daniel , Eberman Lindsey , Mitchell Israel , Binkley Helen 
Published: August 2016

Objective:We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.Background:A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.Differential Diagnosis:The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.Treatment:The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.Uniqueness:To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.
The Effects of Eversion Fatigue on Frontal Plane Joint Position Sense in the Ankle
Authors: Sandrey Michelle A. , Kent Timothy E. 
Published: August 2016

Context:There is limited information on fatigue of the evertors on frontal plane joint position sense (JPS).Objective:To examine the effects of isokinetic concentric-eccentric fatigue of the evertors on frontal plane JPS of the ankle.Design:A 2 × 4 factorial design.Setting:Research Laboratory.Patients or Other Participants:40 male and female healthy subjects.Interventions:JPS was tested at 10° and 20° of inversion and 5° and 10° of eversion in a nonfatigued/fatigued condition. After fatigue of evertors was determined on an isokinetic device, post fatigue testing of JPS occurred.Main Outcome Measures:JPS absolute error (AE) for inversion and eversion.Results:Main effect for condition and angle were significant with pre/post fatigue. There were overestimation of angles postfatigue with AE greater at 20° of inversion (P = .003), followed by 10° of inversion (P < .001), 10° of eversion (P = .005), and 5° of eversion (P = .005).Conclusion:When the ankle evertors were fatigued, the AE for JPS was significantly higher at all test angles.
Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down
Authors: Hollman John H. , Ginos Barbara E. , Kozuchowski Jakub , Vaughn Amanda S. , Krause David A. , Youdas James W. 
Published: August 2016

Context:Reduced strength and activation of hip muscles might correlate with increased weight-bearing knee valgus.Objective:To describe relationships among frontal-plane hip and knee angles, hip-muscle strength, and electromyographic (EMG) recruitment in women during a step-down.Design:Exploratory study.Setting:Laboratory.Participants:20 healthy women 20 to 30 years of age.Interventions:Frontal-plane hip and knee angles were measured. Gluteus maximus and medius recruitment were examined with surface EMG. Hip-abduction and -external-rotation strength were quantified with handheld dynamometry.Main Outcome Measurements:The authors analyzed correlation coefficients between knee and hip angles, gluteus maximus and medius EMG, and hip-abduction and -external-rotation strength.Results:Hip-adduction angles (r = .755, P = .001), gluteus maximus EMG (r = −.451, P = .026), and hip-abduction strength (r = .455, P = .022) correlated with frontal-plane projections of knee valgus.Conclusions:Gluteus maximus recruitment might have greater association with reduced knee valgus in women than does external-rotation strength during step-down tasks. Gluteus medius strength might be associated with increased knee valgus.
Psychological Benefits of Virtual Reality for Patients in Rehabilitation Therapy
Authors: Chen Chih-Hung , Jeng Ming-Chang , Fung Chin-Ping , Doong Ji-Liang , Chuang Tien-Yow 
Published: August 2016

Context:Whether virtual rehabilitation is beneficial has not been determined.Objective:To investigate the psychological benefits of virtual reality in rehabilitation.Design:An experimental group underwent therapy with a virtual-reality-based exercise bike, and a control group underwent the therapy without virtual-reality equipment.Setting:Hospital laboratory.Patients:30 patients suffering from spinal-cord injury.Intervention:A designed rehabilitation therapy.Main Outcome Measures:Endurance, Borg's rating-of-perceived-exertion scale, the Activation–Deactivation Adjective Check List (AD-ACL), and the Simulator Sickness Questionnaire.Results:The differences between the experimental and control groups were significant for AD-ACL calmness and tension.Conclusion:A virtual-reality-based rehabilitation program can ease patients' tension and induce calm.
Altered Ankle Kinematics and Shank-Rear-Foot Coupling in Those with Chronic Ankle Instability
Authors: Drewes Lindsay K. , McKeon Patrick O. , Paolini Gabriele , Riley Patrick , Kerrigan D. Casey , Ingersoll Christopher D. , Hertel Jay 
Published: August 2016

Context:Kinematic patterns during gait have not been extensively studied in relation to chronic ankle instability (CAI).Objective:To determine whether individuals with CAI demonstrate altered ankle kinematics and shank-rear-foot coupling compared with controls during walking and jogging.Design:Case control.Setting:Motion-analysis laboratory.Participants:7 participants (3 men, 4 women) suffering from CAI (age 24.6 ± 4.2 y, height 172.6 ± 9.4 cm, mass 70.9 ± 8.1 kg) and 7 (3 men, 4 women) healthy, matched controls (age 24.7 ± 4.5 y, height 168.2 ± 5.9 cm, mass 66.5 ± 9.8 kg).Interventions:Subjects walked and jogged on a treadmill while 3-dimensional kinematics of the lower extremities were captured.Main Outcome Measures:The positions of rear-foot inversion–eversion and shank rotation were calculated throughout the gait cycle. Continuous relative-phase angles between these segments were calculated to assess coupling.Results:The CAI group demonstrated more rear-foot inversion and shank external rotation during walking and jogging. There were differences between groups in shank-rear-foot coupling during terminal swing at both speeds.Conclusions:Altered ankle kinematics and joint coupling during the terminal-swing phase of gait may predispose a population with CAI to ankle-inversion injuries. Less coordinated movement during gait may be an indication of altered neuromuscular recruitment of the musculature surrounding the ankle as the foot is being positioned for initial contact.
Reliability of the Anterior Drawer and Talar Tilt Tests Using the Ligmaster Joint Arthrometer
Authors: Docherty Carrie L. , Rybak-Webb Katherine 
Published: August 2016

Context:Joint arthrometers have been developed to help determine the severity of ligament sprains.Objective:To establish intratester and intertester reliability of the talar inversion and anterior drawer tests using the LigMaster.Design:Intratester reliability was investigated using a repeated-measures design. Intertester reliability was investigated using 2 different clinicians testing subjects on the same day.Setting:Athletic training research laboratory. Participants: Thirty participants volunteered for this study.Main Outcome Measurements:Anterior displacement and talar inversion were measured using the LigMaster.Results:Intrarater reliability was .74 for the talar inversion test and .65 for the anterior drawer test. Interrater reliabilities for the talar inversion and anterior drawer tests were .76 and .81, respectively.Conclusions:The LigMaster joint arthrometer is a reliable tool for measuring talar inversion and anterior displacement at the ankle.
Intramuscular Pressure, Tissue Oxygenation, and Muscle Fatigue of the Multifidus during Isometric Extension in Elite Rowers with Low Back Pain
Authors: Dehner Christoph , Schmelz Andreas , Völker Hans-Ullrich , Pressmar Jochen , Elbel Martin , Kramer Michael 
Published: August 2016

Context:Chronic low back pain (LBP) has been reported with a high incidence in elite rowers. It results in less effective training, long interruptions in training, and a drop in performance.Objective:The authors hypothesized that exercise-induced LBP in rowers is caused by a chronic functional compartment syndrome (CFCS) of the multifidus muscle.Design:Controlled clinical trial.Setting:The rowers were tested in their training camp. The control group was tested at a university hospital.Participants:14 volunteer elite rowers complaining of LBP and 16 healthy volunteer amateur athletes.Main Outcome Measurements:Intramuscular pressure (IMP), tissue oxygenation pressure (pO2), and median frequency (MF) shift in the electromyographic power density spectrum during isometric fatiguing extension at 60% of maximum voluntary contraction.Results:At the beginning (controls 186.6 mm Hg vs rowers 60.2 mm Hg, P = .002) and the end (controls 224.1 mm HG vs rowers 77.1 mm Hg, P < .001) of the endurance exercise the median IMP was significantly higher in the healthy controls. Nearly identical resting pO2 was measured in both groups (controls 37.6 mm Hg vs rowers 37.3 mm Hg, P = .740). Rowers showed higher median MF shift (rowers −11.5 Hz vs controls −8.5 Hz, P = .079) during contraction.Conclusions:These observations cannot sufficiently be explained by the CFCS model and suggest that factors other than IMP have an additional effect on pain generation during exercise in elite rowers.
The Effect of 3 Foot Pads on Plantar Pressure of Pes Planus Foot Type
Authors: Nordsiden Lacey , Van Lunen Bonnie L. , Walker Martha L. , Cortes Nelson , Pasquale Maria , Onate James A. 
Published: August 2016

Context:Many styles of foot pads are commonly applied to reduce immediate pain and pressure under the foot.Objective:To examine the effect of 3 different foot pads on peak plantar pressure (PPP) and mean plantar pressure (MPP) under the first metatarsophalangeal joint (MTPJ) during slow running.Design:A 4 (pad) × 4 (mask) repeated-measures design.Setting:University athletic training clinic and fitness facility.Participants:20 physically active participants, 12 men (19.7 ± 1.3 y, 181.5 ± 6.3 cm, 83.6 ± 12.3 kg) and 8 women (20.8 ± 1.5 y, 172.7 ± 11.2 cm, 69.9 ± 14.2 kg) with navicular drop greater than or equal to 10 mm, no history of surgery to the lower extremity, and no history of pain or injury to the first MTPJ in the past 6 months.Interventions:PPP and MPP were evaluated under 4 areas of the foot: the rear foot, lateral forefoot, medial forefoot, and first MTPJ. Four pad conditions (no pad, metatarsal dome, U-shaped pad, and donut-shaped pad) were evaluated during slow running. All measurements were taken on a standardized treadmill using the Pedar in-shoe pressure-measurement system.Main Outcome Measures:PPP and MPP in 4 designated foot masks during slow running.Results:The metatarsal dome produced significant decreases in MPP (163.07 ± 49.46) and PPP (228.73 ± 63.41) when compared with no pad (P < .001). The U-shaped pad significantly decreased MPP (168.68 ± 50.26) when compared with no pad (P < .001). The donut-shaped pad increased PPP compared with no pad (P < .001).Conclusions:The metatarsal dome was most effective in reducing both peak and mean plantar pressure. Other factors such as pad comfort, type of activity, and material availability must also be considered. Further research should be conducted on the applicability to other foot types and symptomatic subjects.
Measurement Properties of Headache-Specific Outcomes Scales in Adolescent Athletes
Authors: Piebes Sarah K. , Snyder Alison R. , Bay R. Curtis , McLeod Tamara C. Valovich 
Published: August 2016

Context:Recurrent headaches significantly affect health-related quality of life (HRQOL) in adults; the impact of headache on HRQOL among adolescents is unknown, and the psychometric properties of headache-specific outcomes instruments have not been adequately studied in this population.Objective:To evaluate the psychometric properties of the Headache Impact Test (HIT-6) and Pediatric Migraine Disability Assessment (PedMIDAS) in healthy adolescent athletes.Design:Descriptive survey.Setting:High school athletic training facilities during the fall sports season.Participants:177 high school athletes (89 males and 88 females).Interventions:A survey consisting of a demographic and concussion-history questionnaire, a graded symptom scale, the HIT-6, and the PedMIDAS. Internal consistency (α), test–retest reliability (rs), Bland-Altman analyses, and the Mann-Whitney U test were used to evaluate psychometric properties and age and gender differences.Main Outcome Measures:The HIT-6 and PedMIDAS item and total scores.Results:Test–retest reliability for the HIT-6 total score was rs = .72, and reliability of individual items ranged from rs = .52 to .67. The test–retest reliability for the PedMIDAS total score was rs = .61, and reliability of individual items ranged from rs = .23 to .62. Both scales demonstrated acceptable internal consistency: HIT-6 α = .89−.90 and PedMIDAS α = .71−.75.Conclusions:The authors found moderate test–retest reliability for the HIT-6 and the PedMIDAS in a healthy adolescent athlete population. Research on the applicability and utility of the HIT-6 and PedMIDAS in concussed adolescents is warranted.
Diagnosis and Treatment of 2 Adolescent Female Athletes With Transient Abdominal Pain During Running
Authors: Spitznagle Theresa M. , Sahrmann Shirley 
Published: August 2016

Context:Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlight the differences in their treatment based on specific movement impairments.Study Design:Case series.Diagnosis:The movement diagnosis determined for both patients was thoracic flexion with rotation. The key signs and symptoms that supported this diagnosis included (1) alignment impairments of thoracic flexion and posterior sway and ribcage asymmetry; (2) movement impairments during testing and running of asymmetrical range of motion for trunk rotation, side bending, and flexion of the thoracic spine; and (3) reproduction of TAPR.Discussion:Musculoskeletal impairments related to the trunk muscles combined with the mechanical stresses of running could contribute to TAPR. Treatment in each of the patients was focused on patient education regarding correction of alignment, muscle, and movement impairments of the extremities, thoracic spine, and ribcage. A strategy was determined for correcting motion during running to reduce or abolish the TAPR. Outcomes were positive in both patients. Differences in specific impairments in each patient demonstrate the need for specificity of treatment. These 2 patients illustrate how developing a movement diagnosis and identifying the contributing factors based on a systematic examination can be used in individuals with TAPR.
Hip- and Thigh-Muscle Activation During the Star Excursion Balance Test
Authors: Norris Beth , Trudelle-Jackson Elaine 
Published: August 2016

Context:The Star Excursion Balance Test (SEBT) is often used to train and assess dynamic balance and neuromuscular control. Few studies have examined hip- and thigh-muscle activation during the SEBT.Objective:To quantify hip- and thigh-muscle activity during the SEBT.Design:Repeated measures.Setting:Laboratory.Participants:22 healthy individuals, 11 men and 11 women.Methods:EMG measurements were taken as participants completed 3 trials of the anterior (A), medial (M), and posteromedial (PM) reach directions of the SEBT.Main Outcome Measures:Mean EMG data (% maximal voluntary isometric contraction) from the gluteus medius (Gmed), gluteus maximus (Gmax), and vastus medialis (VM) were measured during the eccentric phase of each SEBT reach direction. Test–retest reliability of EMG data across the 3 trials in each direction was calculated. EMG data from each muscle were compared across the 3 reach directions.Results:Test–retest reliability ranged from ICC3,1 values of .91 to .99. A 2-way repeated-measure ANOVA revealed a significant interaction between muscle activation and reach direction. One-way ANOVAs showed no difference in GMed activity between the A and M directions. GMed activity in the A and M directions was greater than in the PM direction. There was no difference in GMax and VM activity across the 3 directions.Conclusion:GMed was recruited most effectively when reaching was performed in the A and M directions. The A, M, and PM directions elicited similar patterns of muscle recruitment for the GMax and VM. During all 3 SEBT directions, VM activation exceeded the 40–60% threshold suggested for strengthening effects. GMed activity also exceeded the threshold in the M direction. GMax activation, however, was below the 40% threshold for all 3 reach directions, suggesting that performing dynamic lower extremity reaching in the A, M, and PM directions may not elicit strengthening effects for the GMax.
A Neuromuscular Intervention for Exercise-Related Medial Leg Pain
Authors: Newsham Katherine R. , Beekley Matthew D. , Lauber Christine A. 
Published: August 2016

Context:Exercise-related medial leg pain (ERMLP) is a common complaint among athletes, and efforts toward rehabilitation are often unsuccessful.Objective:To evaluate the efficacy of a therapeutic intervention in ERMLP localized to soft tissue.Design:A quasi-experimental, nonequivalent control-group study.Setting:Athletic training facility.Patients:20 volunteer male and female athletes (18–22 y old) with ERMLP. Complete data were available for 13 participants.Intervention:Treatment group (TRE, n = 7) received therapeutic intervention focused on relieving muscle hypertonicity in the deep compartment of the lower leg and restoring balance of the toe flexors and extensors. Control group (CON, n = 6) received no intervention.Main Outcome Measures:Self-reported pain intensity, pain threshold, and extensor hallucis longus to extensor digitorum brevis (EHL:EDB) electromyography ratio.Results:There were no significant differences in age, duration of symptoms, or pain measures between the 2 groups at baseline. CON demonstrated no significant changes in any of the outcome measures in posttreatment testing, but significant between-groups differences were identified for pain during activity (CON mean = 6.5, 95% CI 5.05, 7.95; TRE mean = 3.5, 95% CI 1.67, 5.33; P = .01), change scores for pain during activity (CON mean = 0.33, 95% CI −1.25, 1.91; TRE mean = −3.43, 95% CI:−4.6, −2.25; P < .001), change scores in pressure threshold (CON mean = −0.25, 95% CI −0.74, 0.23; TRE mean = 0.72, 95% CI 0.22, 1.37; P = .006), and change in EHL:EDB ratios (CON mean = 0.05, 95% CI −0.22, 0.33; TRE mean = 1.07, 95% CI 0.75, 2.07; P < .046).Conclusion:Therapeutic interventions focused on restoring muscle balance appear to be effective in resolving ERMLP.
Intersession Reliability and Concurrent Validity of Isometric Endurance Tests for the Lateral Trunk Muscles
Authors: Greene Paul F. , Durall Christopher J. , Kernozek Thomas W. 
Published: August 2016

Context:A torso-elevated side support (TESS) has previously been described for measuring endurance of the lateral trunk muscles. In some individuals, however, TESS performance may be hindered by upper extremity pain or fatigue. For this reason a novel test, the feet-elevated side-support test (FESS), was examined.Objective:To determine intersession reliability of a FESS and a TESS on the left and right sides using a single examiner, to evaluate the relationship between tests, and to compare reasons for test termination.Design:Nonexperimental prospective repeated measures.Setting:University laboratory.Participants:A convenience sample of 60 healthy participants from a university community (17 men, 43 women; age 21.1 ± 2.2 y; height 169.9 ± 9.5 cm; weight 67.1 ± 11.9 kg).Results:Intraclass correlation coefficient between 3 testing sessions = .87 with right FESS, .86 with left FESS, .78 with right TESS, and .91 with left TESS. Pearson correlation coefficients ranged from .59 (between left FESS and left TESS in women) to .75 (between left FESS and left TESS in men). Upper extremity pain or fatigue was the reason given for test termination in 42.5% of participants during the TESS and 5.0% during the FESS (P = .000, Fisher exact test).Conclusions:FESS and TESS had comparable intersession reliability by the same evaluator. Moderate to high correlations were found between FESS and TESS scores, suggesting that the tests assess similar qualities. Far fewer participants terminated the FESS because of upper extremity pain or fatigue. Thus, the FESS may be a suitable alternative to the previously validated TESS, particularly for individuals with upper extremity pain or weakness.
A Gender Comparison of Central and Peripheral Neuromuscular Function After Exercise
Authors: Stern Ashley , Kuenze Chris , Herman Daniel , Sauer Lindsay D. , Hart Joseph M. 
Published: August 2016

Context:Central and peripheral muscle fatigue during exercise may exacerbate neuromuscular factors that increase risk for noncontact anterior cruciate ligament injury.Objective:To compare lower extremity motor-evoked potentials (MEPs), muscle strength, and electromyography (EMG) activation after an exercise protocol.Design:Pretest, posttest group comparison.Setting:University laboratory.Participants:34 healthy volunteers (17 female, age = 21.9 ± 2.3 years, weight = 77.8 ± 3.0 kg, height = 171.1 ± 6.6 cm, and 17 male, age = 23.4 ± 6.5 years, weight = 81.6 ± 3.3 kg, height = 179.6 ± 7.3 cm).Intervention:A standardized 30-min exercise protocol that involved 5 repeated cycles of uphill walking, body-weight squatting, and step-ups.Main Outcome Measures:Quadriceps and hamstring MEP amplitude (mV) and transmission velocity normalized to subject height (m/s) were elicited via transcranial magnetic stimulation and measured via surface EMG. Quadriceps and hamstring peak EMG activation (% MVIC) and peak torque (Nm/kg) were measured during MVICs. Separate ANCOVAs were used to compare groups after exercise while controlling for baseline measurement.Results:At baseline, males exhibited significantly greater knee-extension torques (males = 2.47 ± 0.68 Nm/kg, females = 1.95 ± 0.53 Nm/kg; P = .036) and significantly higher hamstring MEP amplitudes (males = 223.5 ± 134.0 mV, females = 89.3 ± 77.6 mV; P = .007). Males exhibited greater quadriceps MEP amplitude after exercise than females (males = 127.2 ± 112.7 mV, females = 32.3 ± 34.9 mV; P = .016).Conclusions:Males experienced greater peripheral neuromuscular changes manifested as more pronounced reductions in quadriceps torque after exercise. Females experienced greater central neuromuscular changes manifested as more pronounced reduction in quadriceps MEP amplitude. Reduced central neural drive of the quadriceps coupled with knee-extension torque preservation after exercise may increase risk of knee injury in females.