bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knee and Ankle Position, Anterior Drawer Laxity, and Stiffness of the Ankle Complex
Authors: Kovaleski John E. , Norrell Phillip M. , Heitman Robert J. , Hollis J. Marcus , Pearsall Albert W. 
Published: December 2009

AbstractContext:Anterior drawer testing of the ankle is commonly used to diagnose lateral ligamentous instability. Our hypothesis was that changing knee and ankle positions would change the stability of the ankle complex during anterior drawer testing.Objectives:To assess the effects of knee and ankle position on anterior drawer laxity and stiffness of the ankle complex.Design:A repeated-measures design with knee and ankle position as independent variables.Setting:University research laboratory.Patients or Other Participants:Bilateral ankles of 10 female (age  =  19.8 ± 1.1 years) and 10 male (age  =  20.8 ± 1.2 years) collegiate athletes were tested.Intervention(s):Each ankle complex underwent loading using an ankle arthrometer under 4 test conditions consisting of 2 knee positions (90° and 0° of flexion) and 2 ankle positions (0° and 10° of plantar flexion [PF]).Main Outcome Measure(s):Recorded anterior laxity (mm) and stiffness (N/mm).Results:Anterior laxity of the ankle complex was maximal with the knee positioned at 90° of flexion and the ankle at 10° of PF when compared with the knee positioned at 0° of flexion and the ankle at 10° or 0° of PF (P &lt; .001), whereas ankle complex stiffness was greatest with the knee positioned at 0° of flexion and the ankle at 0° of PF (P &lt; .009).Conclusions:Anterior drawer testing of the ankle complex with the knee positioned at 90° of flexion and the ankle at 10° of PF produced the most laxity and the least stiffness. These findings indicate that anterior drawer testing with the knee at 90° of flexion and the ankle at 10° of PF may permit better isolation of the ankle capsuloligamentous structures.
Athletic Trainers' and Physical Therapists' Perceptions of the Effectiveness of Psychological Skills Within Sport Injury Rehabilitation Programs
Authors: Hamson-Utley J. Jordan , Martin Scott , Walters Jason 
Published: December 2009

Abstract

Context:
Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited.

Objective:
To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes.

Design:
The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation.

Setting:
Professional member databases of the National Athletic Trainers' Association and the American Physical Therapy Association.

Patients or Other Participants:
Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age  =  34.18 ± 8.32 years, years in profession  =  10.67 ± 7.34) and 356 PTs (age  =  38.58 ± 7.51 years, years in profession  =  13.18 ± 6.17) responded.

Main Outcome Measure(s):
The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach αs ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals' education, training experience, and interest.

Results:
Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P &lt; .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P &lt; .05).

Conclusions:
Overall, ATs and PTs held positive attitudes on the effectiveness of psychological skills to augment the rehabilitation process. Clinical implications regarding the use of mental skills are discussed.
Concussion in Sports: Postconcussive Activity Levels, Symptoms, and Neurocognitive Performance
Authors: Majerske Cynthia W. , Mihalik Jason P. , Ren Dianxu , Collins Michael W. , Reddy Cara Camiolo , Lovell Mark R. , Wagner Amy K. 
Published: December 2009

Abstract

Context:
Evidence suggests that athletes engaging in high-intensity activities after concussion have more difficulties with cognitive recovery.

Objective:
To examine the role postinjury activity level plays in postconcussive symptoms and performance on neurocognitive tests in a population of student-athletes.

Design:
Retrospective cohort study with repeated measures of neurocognitive performance and symptom reporting.

Setting:
University-based sports concussion clinic.

Patients or Other Participants:
Ninety-five student-athletes (80 males, 15 females: age  =  15.88 ± 1.35 years) were retrospectively assigned to 1 of 5 groups based on a postinjury activity intensity scale.

Main Outcome Measure(s):
We employed a regression analysis for repeated measures to evaluate the relationship of activity intensity to symptoms and neurocognitive outcome up to 33 days after concussion. Postconcussion symptom scores and neurocognitive (verbal memory, visual memory, visual motor speed, and reaction time) scores served as the primary outcome measures.

Results:
Level of exertion was significantly related to all outcome variables (P &lt; .02 for all comparisons). With multivariate analysis, activity intensity remained significant with respect to visual memory (P  =  .003) and reaction time (P &lt; .001).

Conclusions:
Activity level after concussion affected symptoms and neurocognitive recovery. Athletes engaging in high levels of activity after concussion demonstrated worse neurocognitive performance. For these tasks, those engaging in moderate levels of activity demonstrated the best performance.
Questioning Skills Demonstrated by Approved Clinical Instructors During Clinical Field Experiences
Authors: Barnum Mary G. 
Published: December 2009

AbstractContext:The current trend in athletic training clinical education places greater emphasis on the quality of interactions occurring between Approved Clinical Instructors (ACIs) and athletic training students (ATSs). Among other attributes, the ability of ACIs to facilitate and direct quality clinical learning experiences may be influenced by the skill with which the ACI is able to use selected teaching strategies.Objective:To gain insight into ACIs' use of questioning as a specific teaching strategy during the clinical education experiences of undergraduate ATSs.Design:Qualitative case study design involving initial and stimulated-recall interviews, prolonged field observations, and audio recording of ACI-ATS interactions.Setting:The primary athletic training facility at one athletic training education program accredited by the Commission on Accreditation of Athletic Training Education.Patients or Other Participants:The 8 ACI participants included 3 full-time athletic training education program faculty members and 5 graduate-level assistants. The 24 ATS participants included 1 senior, 17 juniors, and 6 sophomores.Data Collection and Analysis:Transcribed data collected from 8 initial interviews, 23 field observations, 23 audio-recorded ACI-ATS interactions and 54 stimulated-recall interviews were analyzed through microscopic, open, and axial coding, as well as coding for process. The cognition level of questions posed by ACIs was analyzed according to Sellappah and colleagues' Question Classification Framework.Results:The ACI participants posed 712 questions during the 23 observation periods. Of the total questions, 70.37% were classified as low-level cognitive questions and 17.00% as high-level cognitive questions. The remaining 12.64% were classified as other.Conclusions:Although all ACIs used questioning during clinical instruction, 2 distinct questioning patterns were identified: strategic questioning and nonstrategic questioning. The way ACIs sequenced questions (their questioning pattern) appeared to be more important than the number of specific cognitive-level questions posed. Nonstrategic questioning appears to support knowledge and comprehension, whereas strategic questioning appears to support critical thinking.
Systematic Review of Postural Control and Lateral Ankle Instability, Part II: Is Balance Training Clinically Effective?
Authors: McKeon Patrick O. , Hertel Jay 
Published: December 2009

Abstract

Objective:
To answer the following clinical questions: (1) Can prophylactic balance and coordination training reduce the risk of sustaining a lateral ankle sprain? (2) Can balance and coordination training improve treatment outcomes associated with acute ankle sprains? (3) Can balance and coordination training improve treatment outcomes in patients with chronic ankle instability?

Data Sources:
PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway.

Study Selection:
Only studies assessing the influence of balance training on the primary outcomes of risk of ankle sprain or instrumented postural control measures derived from testing on a stable force plate using the modified Romberg test were included. Studies had to provide results for calculation of relative risk reduction and numbers needed to treat for the injury prevention outcomes or effect sizes for the postural control measures.

Data Extraction:
We calculated the relative risk reduction and numbers needed to treat to assess the effect of balance training on the risk of incurring an ankle sprain. Effect sizes were estimated with the Cohen d for comparisons of postural control performance between trained and untrained groups.

Data Synthesis:
Prophylactic balance training substantially reduced the risk of sustaining ankle sprains, with a greater effect seen in those with a history of a previous sprain. Completing at least 6 weeks of balance training after an acute ankle sprain substantially reduced the risk of recurrent ankle sprains; however, consistent improvements in instrumented measures of postural control were not associated with training. Evidence is lacking to assess the reduction in the risk of recurrent sprains and inconclusive to demonstrate improved instrumented postural control measures in those with chronic ankle instability who complete balance training.

Conclusions:
Balance training can be used prophylactically or after an acute ankle sprain in an effort to reduce future ankle sprains, but current evidence is insufficient to assess this effect in patients with chronic ankle instability.
Managing Heteronormativity and Homonegativity in Athletic Training: In and Beyond the Classroom
Authors: Maurer-Starks Suanne S. , Clemons Heather L. , Whalen Shannon L. 
Published: December 2009

Abstract

Context:
As an allied health professional working in various settings, an athletic trainer (AT) is responsible for the health care of a highly diverse population. More often than not, this diversity is defined by the visible, such as race or sex. However, diversity encompasses many more variables than these observable factors and includes sexual orientation. Efforts have been made to educate ATs about issues related to sex and race; however, sexual orientation typically has not been addressed, although ATs have treated and will continue to treat lesbian, gay, and bisexual (LGB) patients.

Objective:
To introduce ATs (educators and practicing clinicians) to the concept of heteronormativity, its effect on society, and its influences on the manner in which they teach athletic training students and deliver health care to their patients.

Data Collection and Analysis:
We searched various databases, including MEDLINE, ERIC, SportDiscus, and CINAHL Information Systems using the terms bisexual, diversity, gay, heteronormativity, homophobia in sport, and lesbian. Pertinent articles were cross-referenced to gain additional information.
The literature revealed the historic implications of homonegativity for sport and its effects on those involved in sport culture, including ATs.

Conclusions:
Future dialogues should focus on innovative strategies for including LGB issues into athletic training curricula and for meeting the needs of students and professionals in addition to patients who identify as LGB.
Functional Performance Testing in Participants With Functional Ankle Instability and in a Healthy Control Group
Authors: Buchanan Amanda S. , Docherty Carrie L. , Schrader John 
Published: December 2009

AbstractContext:Functional ankle instability (FAI) affects a large part of the population. Inconsistent findings have been reported regarding the existence of functional performance deficits in individuals with FAI.Objective:To examine functional performance in participants with FAI compared with participants in a control group during 2 hopping tests.Design:Case-control study.Settings:Athletic training research laboratory.Patients or Other Participants:There were 40 college-aged individuals who participated in our study: 20 with FAI and 20 without FAI. We defined FAI as history of an ankle sprain and residual episodes of “giving way.”Intervention(s):Participants completed 2 functional performance tests (FPTs): the single-limb hopping and the single-limb hurdle tests.Main Outcome Measure(s):Time to complete each test was recorded. Following each FPT, participants were asked if their ankles felt unstable during the test.Results:We found no difference between participants in the FAI and control groups for the hopping or hurdle tests (P &gt; .05). When asked if their ankles felt unstable during the FPTs, approximately half of the participants in the FAI group and none of the participants in the control group reported a feeling of instability. Subsequently, a secondary analysis of variance was calculated with participants grouped into 3 categories: control participants, FAI participants reporting instability symptoms during FPT (FAI-S), and FAI participants not reporting instability symptoms during FPT (FAI-NS). Results revealed a difference among the 3 groups for the single-limb hopping test (P &lt; .01). Post hoc analysis revealed a difference between the FAI-S participants and both the control and the FAI-NS participants. No difference was identified for the single-limb hurdle test (P  =  .41).Conclusions:The FAI-S participants had performance deficits during the single-limb hopping test. Therefore, clinicians could use this simple hopping test as an additional method to determine the presence of FAI.
Prophylactic Ankle Braces and Star Excursion Balance Measures in Healthy Volunteers
Authors: Hardy Lisa , Huxel Kellie , Brucker Jody , Nesser Thomas 
Published: December 2009

AbstractContext:The effects of prophylactic ankle braces on lower extremity functional performance in healthy participants have not been studied extensively.Objective:To determine if prophylactic ankle braces affected multidirectional reach distances during a test of dynamic balance.Design:Crossover.Setting:Laboratory.Patients or Other Participants:Thirty-six healthy, physically active volunteers (18 men, 18 women; age  =  23.6 ± 2.7 years, height  =  173.8 ± 9.3 cm, mass  =  74.4 ± 12.7 kg, reach-leg length  =  91.9 ± 5.1 cm).Intervention(s):Volunteers performed balance testing in 3 conditions: unbraced, while wearing a semirigid ankle brace, and while wearing a lace-up ankle brace.Main Outcome Measure(s):We used the Star Excursion Balance Test, calculating the mean of 3 attempts in 8 directions (anterior, anterior-medial, medial, posterior-medial, posterior, posterior-lateral, lateral, and anterior-lateral), normalized by the participant's reach-leg length. Data were collected after 6 practice attempts for each of the conditions according to a balanced Latin square.Results:Bracing condition had no effect (P &gt; .05) on any of the Star Excursion Balance Test directional measures. The largest mean difference due to bracing was 2.5% between the lace-up brace condition and the control in the posterior reach direction. This indicates that the actual reach differences due to bracing were less than 5.08 cm (2 inches) in length.Conclusions:Clinicians can be confident that the prophylactic use of ankle braces does not disrupt lower extremity dynamic balance during a reaching task in healthy participants.
The Acute Effects of Sleeper Stretches on Shoulder Range of Motion
Authors: Laudner Kevin G. , Sipes Robert C. , Wilson James T. 
Published: December 2009

AbstractContext:The deceleration phase of the throwing motion creates large distraction forces at the shoulder, which may result in posterior shoulder tightness and ensuing alterations in shoulder range of motion (ROM) and may result in an increased risk of shoulder injury. Researchers have hypothesized that various stretching options increase this motion, but few data on the effectiveness of treating such tightness are available.Objective:To evaluate the acute effects of “sleeper stretches” on shoulder ROM.Design:Descriptive with repeated measures.Setting:Biomechanics laboratory and 2 separate collegiate athletic training facilities.Patients or Other Participants:Thirty-three National Collegiate Athletic Association Division I baseball players (15 pitchers, 18 position players; age  =  19.8 ± 1.3 years, height  =  184.7 ± 6.4 cm, mass  =  84.8 ± 7.7 kg) and 33 physically active male college students (age  =  20.1 ± 0.6 years, height  =  179.6 ± 6.6 cm, mass  =  83.4 ± 11.3 kg) who reported no recent participation (within 5 years) in overhead athletic activities.Intervention(s):Range-of-motion measurements of the dominant shoulder were assessed before and after completion of 3 sets of 30-second passive sleeper stretches among the baseball players. The ROM measurements in the nonthrower group were taken using identical methods as those in the baseball group, but this group did not perform any stretch or movement between measurements.Main Outcome Measure(s):Internal and external glenohumeral rotation ROM and posterior shoulder motion (glenohumeral horizontal adduction).Results:In the baseball group, posterior shoulder tightness, internal rotation ROM, and external rotation ROM were −3.5° ± 7.7°, 43.8° ± 9.5°, and 118.6° ± 10.9°, respectively, before the stretches and were −1.2° ± 8.8°, 46.9° ± 9.8°, and 119.2° ± 11.0°, respectively, after the stretches. These data revealed increases in posterior shoulder motion (P  =  .01, effect size  =  0.30) and in internal shoulder rotation (P  =  .003, effect size  =  0.32) after application of the stretches. No other differences were observed in the baseball group, and no differences were noted in the nonthrower group.Conclusions:Based on our results, the sleeper stretches produced a statistically significant acute increase in posterior shoulder flexibility. However, this change in motion may not be clinically significant.
The Interrelationships Among Sex Hormone Concentrations, Motoneuron Excitability, and Anterior Tibial Displacement in Women and Men
Authors: Hoffman Mark , Harter Rod A. , Hayes Bradley T. , Wojtys Edward M. , Murtaugh Paul 
Published: December 2009

Abstract

Context:
Sex hormone fluctuations have been implicated as a contributing factor to the high rates of noncontact injury to the anterior cruciate ligament in females.

Objective:
To determine the strength of the relationships among variables of sex hormone concentrations, motoneuron excitability, and anterior tibial displacement (ATD) in women and men and to determine if these relationships differ between the sexes.

Design:
Cohort study.

Setting:
Sports medicine laboratory.

Patients or Other Participants:
Twenty-eight regularly menstruating women (age  =  22.4 ± 3.4 years) and 15 men (age  =  22.3 ± 3.7 years) participated in the study.

Intervention(s):
Fluctuations in sex hormones were determined for the participants. Female participants were tested every other day of their menstrual cycles, whereas male participants were tested every fourth day during the 28-day period.

Main Outcome Measure(s):
We measured Hoffmann reflexes (maximum Hoffmann reflex [Hmax] to maximum M-wave [Mmax] ratio in the soleus), ATD under a 134-N load, and saliva concentrations of estrogen and progesterone. The independent variable was sex. Pearson product moment correlation coefficients were calculated for each participant by pairing measurements made on the same day. Two-tailed independent-samples t tests were used to determine the difference between the male and female correlations for each variable.

Results:
Over the course of the study, the relationships between Hmax∶Mmax and estrogen, Hmax∶Mmax and progesterone, ATD and estrogen, and ATD and progesterone were not different between the sexes. However, the relationship between ATD and progesterone was different between the sexes (P  =  .036).

Conclusions:
The observed correlations did not support our hypothesis that the relationships between sex hormone levels and reflex activity or between sex hormone levels and ATD would be different for women compared with men. If sex hormone concentrations significantly contribute to anterior cruciate ligament ruptures because of changes in laxity or in motoneuron excitability, their mechanism of action is likely multifactorial and complex.
Summary Statement: Appropriate Medical Care for the Secondary School-Aged Athlete
Authors: Almquist Jon , Valovich McLeod Tamara C. , Cavanna Angela , Jenkinson Dave , Lincoln Andrew E. , Loud Keith , Peterson Bart C. , Portwood Craig , Reynolds John , Woods Thomas S. 
Published: December 2009

Abstract

Objective:
To present the recommendations made by the Appropriate Medical Care for Secondary School-Aged Athletes Task Force and to summarize the subsequent monograph developed around 11 consensus points.

Data Sources:
The MEDLINE, CINAHL, and SportDiscus databases were searched for relevant literature regarding secondary school-aged athletes; health care administration; preparticipation physical examination; facilities; athletic equipment; emergency action planning; environmental conditions; recognition, evaluation, and treatment of injuries; rehabilitation and reconditioning; psychosocial consultation; nutrition; and prevention strategies.

Conclusions and Recommendations:
Organizations that sponsor athletic programs for secondary school-aged athletes should establish an athletic health care team to ensure that appropriate medical care is provided to all participants. The 11 consensus points provide a framework—one that is supported by the medical literature and case law—for the development of an athletic health care team and for assigning responsibilities to the team, administrators, and staff members of institutions sponsoring secondary school and club-level athletic programs.