bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ankle Ligament Healing After an Acute Ankle Sprain: An Evidence-Based Approach
Authors: Hubbard Tricia J. , Hicks-Little Charlie A. 
Published: December 2009

Abstract

Objective:
To perform a systematic review to determine the healing time of the lateral ankle ligaments after an acute ankle sprain.

Data Sources:
We identified English-language research studies from 1964 to 2007 by searching MEDLINE, Physiotherapy Evidence Database (PEDro), SportDiscus, and CINAHL using the terms ankle sprain, ankle rehabilitation, ankle injury, ligament healing, and immobilization.

Study Selection:
We selected studies that described randomized, controlled clinical trials measuring ligament laxity either objectively or subjectively immediately after injury and at least 1 more time after injury.

Data Extraction:
Two reviewers independently scored the 7 studies that met the inclusion criteria. Because of differences in study designs, a meta-analysis could not be performed. Effect sizes and confidence intervals could be calculated only for 1 study. The percentages of subjective and objective instability were calculated for the remaining studies.

Data Synthesis:
Ankle laxity improved over a period of 6 weeks to 1 year. One author showed stress talar tilt values of 16.10 ± 8.8° immediately after injury and 3.4 ± 3.6° at 3 months after injury. In 2 articles, the authors reported that positive anterior drawer tests were still present in 3% to 31% of participants at 6 months after injury. Additionally, feelings of instability affected 7% to 42% of participants up to 1 year after injury.

Conclusions/Recommendations:
In the studies that we examined, it took at least 6 weeks to 3 months before ligament healing occurred. However, at 6 weeks to 1 year after injury, a large percentage of participants still had objective mechanical laxity and subjective ankle instability. Direct comparison among articles is difficult because of differences in methods. More research focusing on more reliable methods of measuring ankle laxity is needed so that clinicians can know how long ligament healing takes after injury. This knowledge will help clinicians to make better decisions during rehabilitation and for return to play.
Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report
Authors: Myer Gregory D. , Ford Kevin R. , Divine Jon G. , Wall Eric J. , Kahanov Leamor , Hewett Timothy E. 
Published: December 2009

AbstractObjective:To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury.Background:In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured.Differential Diagnosis:Partial or complete tear of the ACL.Measurements:The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort.Findings:The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth.Conclusions:During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.
Thigh Muscle Activity, Knee Motion, and Impact Force During Side-Step Pivoting in Agility-Trained Female Basketball Players
Authors: Wilderman Danielle R. , Ross Scott E. , Padua Darin A. 
Published: December 2009

Abstract

Context:
Improving neuromuscular control of hamstrings muscles might have implications for decreasing anterior cruciate ligament injuries in females.

Objective:
To examine the effects of a 6-week agility training program on quadriceps and hamstrings muscle activation, knee flexion angles, and peak vertical ground reaction force.

Design:
Prospective, randomized clinical research trial.

Setting:
Sports medicine research laboratory.

Patients or Other Participants:
Thirty female intramural basketball players with no history of knee injury (age  =  21.07 ± 2.82 years, height  =  171.27 ± 4.66 cm, mass  =  66.36 ± 7.41 kg).

Intervention(s):
Participants were assigned to an agility training group or a control group that did not participate in agility training. Participants in the agility training group trained 4 times per week for 6 weeks.

Main Outcome Measure(s):
We used surface electromyography to assess muscle activation for the rectus femoris, vastus medialis oblique, medial hamstrings, and lateral hamstrings for 50 milliseconds before initial ground contact and while the foot was in contact with the ground during a side-step pivot maneuver. Knee flexion angles (at initial ground contact, maximum knee flexion, knee flexion displacement) and peak vertical ground reaction force also were assessed during this maneuver.

Results:
Participants in the training group increased medial hamstrings activation during ground contact after the 6-week agility training program. Both groups decreased their vastus medialis oblique muscle activation during ground contact. Knee flexion angles and peak vertical ground reaction force did not change for either group.

Conclusions:
Agility training improved medial hamstrings activity in female intramural basketball players during a side-step pivot maneuver. Agility training that improves hamstrings activity might have implications for reducing anterior cruciate ligament sprain injury associated with side-step pivots.
Dynamic Valgus Alignment and Functional Strength in Males and Females During Maturation
Authors: Schmitz Randy J. , Shultz Sandra J. , Nguyen Anh-Dung 
Published: December 2009

Abstract

Context:
Sex differences in dynamic measures have been established in physically mature populations. Gaining information on maturation's effect on dynamic performance measures implicated in injury risk may enable us to better design injury prevention programs.

Objective:
To examine sex differences in dynamic valgus alignment and triple-hop distance measures across maturational stages in males and females. A secondary purpose was to determine if a field test of strength and power predicts dynamic valgus alignment.

Design:
Cross-sectional study.

Setting:
Laboratory.

Patients or Other Participants:
157 young athletes (78 females, 79 males) aged 9 to 18 years.

Intervention(s):
Subjects performed drop-jump landings and single-leg triple-hop tests as part of a broader injury screening.

Main Outcome Measure(s):
Maturational status was ascertained from self-report questionnaires and grouped according to Tanner stages 1 and 2 (MatGrp1), 3 and 4 (MatGrp2), and 5 (MatGrp3). Frontal-plane knee valgus displacement, which served as a measure of dynamic valgus alignment, and single-leg triple-hop distance were assessed.

Results:
Males demonstrated less dynamic valgus alignment during drop jumps in the latter maturational stages (MatGrp1  =  13.1° ± 8.7°, MatGrp2  =  9.0° ± 6.2°, MatGrp3  =  9.2° ± 9.4°), whereas females increased dynamic valgus alignment throughout maturation (MatGrp1  =  11.5° ± 6.9°, MatGrp2  =  12.8° ± 8.8°, MatGrp3  =  15.5° ± 8.7°). Thus, in the more mature groups, males had less dynamic valgus alignment than females. Both males (MatGrp1  =  393.5 ± 63.7 cm, MatGrp2  =  491.8 ± 95.1 cm, MatGrp3  =  559.3 ± 76.3 cm) and females (MatGrp1  =  360.3 ± 37.1 cm, MatGrp2  =  380.1 ± 44.3 cm, MatGrp3  =  440.0 ± 66.2 cm) increased triple-hop distance, but males increased more. Within each subgroup of MatGrp and sex, triple-hop distance had no predictive ability for dynamic malalignment.

Conclusions:
When dynamic valgus alignment and strength were assessed, sex and maturational status displayed an interaction. However, functional strength did not predict degree of dynamic valgus alignment.
The Relationships Among Sagittal-Plane Lower Extremity Moments: Implications for Landing Strategy in Anterior Cruciate Ligament Injury Prevention
Authors: Shimokochi Yohei , Yong Lee Sae , Shultz Sandra J. , Schmitz Randy J. 
Published: December 2009

Abstract

Context:
Excessive quadriceps contraction with insufficient hamstrings muscle cocontraction has been shown to be a possible contributing factor for noncontact anterior cruciate ligament (ACL) injuries. Assessing the relationships among lower extremity internal moments may provide some insight into avoiding muscle contraction patterns that increase ACL injury risk.

Objective:
To examine the relationships of knee-extensor moment with ankle plantar-flexor and hip-extensor moments and to examine the relationship between knee moment and center of pressure as a measure of neuromuscular response to center-of-mass position.

Design:
Cross-sectional study.

Setting:
Applied Neuromechanics Research Laboratory.

Patients or Other Participants:
Eighteen healthy, recreationally active women (age  =  22.3 ± 2.8 years, height  =  162.5 ± 8.1 cm, mass  =  57.8 ± 9.3 kg).

Intervention(s):
Participants performed a single-leg landing from a 45-cm box onto a force plate. Kinetic and kinematic data were collected.

Main Outcome Measure(s):
Pearson product moment correlation coefficients were calculated among the net peak knee-extensor moment (KEMpk), sagittal-plane ankle (AM) and hip (HM) net internal moments, and anterior-posterior center of pressure relative to foot center of mass at KEMpk (COP).

Results:
Lower KEMpk related to both greater AM (r  =  −0.942, P &lt; .001) and HM (r  =  −0.657, P  =  .003). We also found that more anterior displacement of COP was related to greater AM (r  =  −0.750, P &lt; .001) and lower KEMpk (r  =  0.618, P  =  .006).

Conclusions:
Our results suggest that participants who lean the whole body forward during landing may produce more plantar-flexor moment and less knee-extensor moment, possibly increasing hip-extensor moment and decreasing knee-extensor moment production. These results suggest that leaning forward may be a technique to decrease quadriceps contraction demand while increasing hamstrings cocontraction demand during a single-leg landing.
Pregame Urine Specific Gravity and Fluid Intake by National Basketball Association Players During Competition
Authors: Osterberg Kristin L. , Horswill Craig A. , Baker Lindsay B. 
Published: December 2009

Abstract

Context:
Urine specific gravity (USG) has been used to estimate hydration status in athletes on the field, with increasing levels of hypohydration indicated by higher USG measurements (eg, greater than 1.020). Whether initial hydration status based on a urine measure is related to subsequent drinking response during exercise or athletic competition is unclear.

Objective:
To determine the relationship between pregame USG and the volume of fluid consumed by players in a professional basketball game.

Design:
Cross-sectional study.

Setting:
Basketball players were monitored during Summer League competition.

Patients or Other Participants:
Players (n  =  29) from 5 teams of the National Basketball Association agreed to participate.

Main Outcome Measure(s):
Pregame USG was measured for each player on 2 occasions. Athletes were given ad libitum access to fluid during each game and were unaware of the purpose of the study. Volume of fluid intake was measured for each player. To assess sweat loss, athletes were weighed in shorts before and after each game.

Results:
Sweat loss ranged from 1.0 to 4.6 L, with a mean sweat loss of 2.2 ± 0.8 L. Fluid intake ranged from 0.1 to 2.9 L, with a mean fluid intake of 1.0 ± 0.6 L. Pregame USG was greater than 1.020 in 52% of the urine samples collected and was not correlated with fluid volume consumed during either of the games (r  =  0.15, P  =  .48, and r  =  0.15, P  =  .52, respectively).

Conclusions:
Approximately half of the players began the games in a hypohydrated state, as indicated by USG. Fluid intake during the game did not compensate for poor hydration status before competition. Furthermore, sweat losses in these players during games were substantial (greater than 2 L in approximately 20 minutes of playing time). Therefore, both pregame and during-game hydration strategies, such as beverage availability and player education, should be emphasized.
Personal and Environmental Characteristics Predicting Burnout Among Certified Athletic Trainers at National Collegiate Athletic Association Institutions
Authors: Kania Michelle L. , Meyer Barbara B. , Ebersole Kyle T. 
Published: December 2009

AbstractContext:Recent research in the health care professions has shown that specific personal and environmental characteristics can predict burnout, which is a negative coping strategy related to stressful situations. Burnout has been shown to result in physiologic (eg, headaches, difficulty sleeping, poor appetite), psychological (eg, increased negative self-talk, depression, difficulty in interpersonal relationships), and behavioral (eg, diminished care, increased absenteeism, attrition) symptoms.Objective:To examine the relationship between selected personal and environmental characteristics and burnout among certified athletic trainers (ATs).Design:Cross-sectional survey.Setting:A demographic survey that was designed for this study and the Maslach Burnout Inventory–Human Services Survey.Patients or Other Participants:A total of 206 ATs employed at National Collegiate Athletic Association (NCAA) institutions as clinical ATs volunteered.Main Outcome Measure(s):We assessed personal and environmental characteristics of ATs with the demographic survey and measured burnout using the Maslach Burnout Inventory–Human Services Survey. Multiple regression analyses were performed to examine relationships between specific personal and environmental characteristics and each of the 3 subscales of burnout (emotional exhaustion, depersonalization, personal accomplishment).Results:Most ATs we surveyed experienced low to average levels of burnout. Personal characteristics predicted 45.5% of the variance in emotional exhaustion (P &lt; .001), 21.5% of the variance in depersonalization (P &lt; .001), and 24.8% of the variance in personal accomplishment (P &lt; .001). Environmental characteristics predicted 16.7% of the variance in emotional exhaustion (P  =  .005), 14.4% of the variance in depersonalization (P  =  .024), and 10.4% of the variance in personal accomplishment (P  =  .209). Stress level and coaches' pressure to medically clear athletes predicted ratings on all 3 subscales of burnout.Conclusions:Our findings were similar to those of other studies of burnout among NCAA Division I ATs, coaches, and coach-teachers. The results also support the Cognitive-Affective Model of Athletic Burnout proposed by Smith. Finally, these results indicate new areas of concentration for burnout research and professional practice.
Recently Certified Athletic Trainers' Undergraduate Educational Preparation in Psychosocial Intervention and Referral
Authors: Stiller-Ostrowski Jennifer Lynn , Ostrowski John A. 
Published: December 2009

Abstract

Context:
“Psychosocial Intervention and Referral” is one of the 12 content areas established by the National Athletic Trainers' Association Education Council and is required to be taught in athletic training education programs (ATEPs). The perceived preparation of athletic trainers (ATs) in this content area has not been evaluated.

Objective:
To explore the preparation level of recently certified ATs within the content area of “Psychosocial Intervention and Referral.”

Design:
Qualitative design involving semistructured, in-depth, focus group interviews.

Setting:
Interviews were conducted at 2 National Collegiate Athletic Association Division I institutions in 2 regions of the United States.

Patients or Other Participants:
A total of 11 recently certified ATs who met predetermined criteria were recruited. The ATs represented a range of undergraduate ATEPs and current employment settings.

Data Collection and Analysis:
Focus group interviews were transcribed verbatim and analyzed deductively. Peer debriefing and member checks were used to ensure trustworthiness.

Results:
The ATEPs are doing an adequate job of preparing ATs for many common communication and interpersonal issues, but ATs report being underprepared to deal with athlete-related issues in the areas of motivation and adherence, counseling and social support, mental skills training, and psychosocial referral.

Conclusions:
Limitations of undergraduate ATEPs regarding preparation of athletic training students within the “Psychosocial Intervention and Referral” content area were identified, with the goal of improving athletic training education. The more we know about the issues that entry-level ATs face, the more effectively we can structure athletic training education.
Shoulder Injuries Among United States High School Athletes During the 2005–2006 and 2006–2007 School Years
Authors: Bonza John E. , Fields Sarah K. , Yard Ellen E. , Dawn Comstock R. 
Published: December 2009

Abstract

Context:
The shoulder is one of the most commonly injured body sites among athletes. Little previous research describes shoulder injury patterns in high school athletes.

Objective:
To describe and compare shoulder injury rates and patterns among high school athletes in 9 sports (football, soccer, basketball, baseball, and wrestling for boys and soccer, volleyball, basketball, and softball for girls).

Design:
Prospective injury surveillance study.

Setting:
Injury data were collected from 100 nationally representative US high schools via High School Reporting Information Online.

Patients or Other Participants:
Athletes from participating high schools injured while involved in a school-sanctioned practice or competition in 1 of the above sports during the 2005–2006 and 2006–2007 school years.

Main Outcome Measure(s):
Shoulder injury rates, diagnoses, severity, and mechanisms.

Results:
During the 2005–2006 and 2006–2007 school years, athletes in this study sustained 805 shoulder injuries during 3 550 141 athlete-exposures (AEs), for an injury rate of 2.27 shoulder injuries per 10 000 AEs. This corresponds to an estimated 232 258 shoulder injuries occurring nationwide during this time. Shoulder injuries were more likely to occur during competition than practice (rate ratio  =  3.01, 95% confidence interval  =  2.62, 3.46). Shoulder injury rates per 10 000 AEs were highest in football (5.09), wrestling (4.34), and baseball (1.90). Common shoulder injury diagnoses included sprains/strains (39.6%), dislocations/separations (23.7%), contusions (11.5%), and fractures (6.6%). Although 44.8% of athletes sustaining a shoulder injury returned to play in less than 1 week, 22.9% were out of play for more than 3 weeks, and 6.2% of shoulder injuries required surgery. Common mechanisms of shoulder injury included player-to-player contact (57.6%) and contact with the playing surface (22.8%).

Conclusions:
High school shoulder injury rates and patterns varied by sport. Continued surveillance is warranted to understand trends and patterns over time and to develop and evaluate evidence-based preventive interventions.
Acute Whole-Body Cooling for Exercise-Induced Hyperthermia: A Systematic Review
Authors: McDermott Brendon P. , Casa Douglas J. , Ganio Matthew S. , Lopez Rebecca M. , Yeargin Susan W. , Armstrong Lawrence E. , Maresh Carl M. 
Published: December 2009

Abstract

Objective:
To assess existing original research addressing the efficiency of whole-body cooling modalities in the treatment of exertional hyperthermia.

Data Sources:
During April 2007, we searched MEDLINE, EMBASE, Scopus, SportDiscus, CINAHL, and Cochrane Reviews databases as well as ProQuest for theses and dissertations to identify research studies evaluating whole-body cooling treatments without limits. Key words were cooling, cryotherapy, water immersion, cold-water immersion, ice-water immersion, icing, fanning, bath, baths, cooling modality, heat illness, heat illnesses, exertional heatstroke, exertional heat stroke, heat exhaustion, hyperthermia, hyperthermic, hyperpyrexia, exercise, exertion, running, football, military, runners, marathoner, physical activity, marathoning, soccer, and tennis.

Data Synthesis:
Two independent reviewers graded each study on the Physiotherapy Evidence Database (PEDro) scale. Seven of 89 research articles met all inclusion criteria and a minimum score of 4 out of 10 on the PEDro scale.

Conclusions:
After an extensive and critical review of the available research on whole-body cooling for the treatment of exertional hyperthermia, we concluded that ice-water immersion provides the most efficient cooling. Further research comparing whole-body cooling modalities is needed to identify other acceptable means. When ice-water immersion is not possible, continual dousing with water combined with fanning the patient is an alternative method until more advanced cooling means can be used. Until future investigators identify other acceptable whole-body cooling modalities for exercise-induced hyperthermia, ice-water immersion and cold-water immersion are the methods proven to have the fastest cooling rates.