bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue and the Electromechanical Efficiency of the Vastus Medialis and Vastus Lateralis Muscles
Authors: Ebersole Kyle T. , Malek David M. 
Published: December 2009

AbstractContext:The relationship between the amplitudes of the mechanomyographic (MMG) and electromyographic (EMG) signals has been used to examine the “electromechanical efficiency” (EME) of normal and diseased muscle. The EME may help us to better understand the neuromuscular relationship between the vastus medialis and vastus lateralis muscles.Objective:To examine the EME of the vastus medialis and vastus lateralis muscles during a fatiguing task.Design:Repeated-measures design.Setting:Research laboratory.Patients or Other Participants:Ten healthy males (age  =  23.2 ± 1.2 years) with no history of knee injury.Intervention(s):Seventy-five consecutive, maximal concentric isokinetic leg extensions at a velocity of 180°/s.Main Outcomes Measure(s):Bipolar surface EMG electrodes were placed over the vastus medialis and vastus lateralis muscles, with an MMG contact sensor placed adjacent to the superior EMG electrode on each muscle. The MMG and EMG amplitude values (root mean squares) were calculated for each of the 75 repetitions and normalized to the highest value from the 75 repetitions. The EME was expressed as the ratio of the log-transformed normalized MMG amplitude to the normalized EMG amplitude. For each muscle, the linear relationship for the normalized-group mean EME was determined across the 75 repetitions.Results:Linear regression indicated decreases in torque (R2  =  .96), vastus medialis EME (R2  =  .73), and vastus lateralis EME (R2  = .73). The slopes for the vastus medialis and vastus lateralis EME were not different (P &gt; .10).Conclusions:The similarities in the fatigue-induced decreases in EME for the vastus medialis and vastus lateralis muscles suggested that symmetry was present between the muscles in the electric and mechanical responses to repeated, maximal muscle actions. The EME measurements may provide a unique insight into the influence of fatigue on the contractile properties of skeletal muscle, including alterations that occur to the intrinsic electric and mechanical components. The EME may be useful in assessing and quantifying clinically relevant asymmetries in vastus medialis and vastus lateralis muscle function in those with knee injuries.
Validity of the Foot and Ankle Ability Measure in Athletes With Chronic Ankle Instability
Authors: Carcia Christopher R. , Martin RobRoy L. , Drouin Joshua M. 
Published: December 2009

Abstract

Context:
The Foot and Ankle Ability Measure (FAAM) is a region-specific, non–disease-specific outcome instrument that possesses many of the clinimetric qualities recommended for an outcome instrument. Evidence of validity to support the use of the FAAM is available in individuals with a wide array of ankle and foot disorders. However, additional evidence to support the use of the FAAM for those with chronic ankle instability (CAI) is needed.

Objective:
To provide evidence of construct validity for the FAAM based on hypothesis testing in athletes with CAI.

Design:
Between-groups comparison.

Setting:
Athletic training room.

Patients or Other Participants:
Thirty National Collegiate Athletic Association Division II athletes (16 men, 14 women) from one university.

Main Outcome Measure(s):
The FAAM including activities of daily living (ADL) and sports subscales and the global and categorical ratings of function.

Results:
For both the ADL and sports subscales, FAAM scores were greater in healthy participants (100 ± 0.0 and 99 ± 3.5, respectively) than in subjects with CAI (88 ± 7.7 and 76 ± 12.7, respectively; P &lt; .001). Similarly, for both ADL and sports subscales, FAAM scores were greater in athletes who indicated that their ankles were normal (98 ± 6.3 and 96 ± 6.9, respectively) than in those who classified their ankles as either nearly normal or abnormal (87 ± 6.6 and 71 ± 11.1, respectively; P &lt; .001). We found relationships between FAAM scores and self-reported global ratings of function for both ADL and sports subscales. Relationships were stronger when all athletes, rather than just those with CAI, were included in the analyses.

Conclusions:
The FAAM may be used to detect self-reported functional deficits related to CAI.
An Epidemiologic Comparison of High School Sports Injuries Sustained in Practice and Competition
Authors: Rechel Julie A. , Yard Ellen E. , Comstock R. Dawn 
Published: December 2009

Abstract

Context:
More than 7 million US high school students play sports.

Objective:
To compare practice and competition injury rates and patterns in 5 boys' sports (football, soccer, basketball, wrestling, and baseball) and 4 girls' sports (soccer, volleyball, basketball, and softball) during the 2005–2006 school year.

Design:
Prospective injury surveillance study.

Setting:
Injury data were collected from 100 nationally representative United States high schools via High School RIO (Reporting Information Online).

Patients or Other Participants:
Athletes from participating high schools injured while participating in a school-sanctioned practice or competition in one of the above sports.

Main Outcome Measure(s):
Practice and competition injury rates, body site, diagnosis, and severity.

Results:
High school athletes participating in these 9 sports at participating schools sustained 4350 injuries during the 2005–2006 school year, which corresponds to an estimated 1 442 533 injuries nationally. The rate of injury per 1000 athlete-exposures was higher in competition (4.63) than in practice (1.69) (rate ratio [RR]  =  2.73, 95% confidence interval [CI]  =  2.58, 2.90). Of all sports, football had the highest competition (12.09) and practice (2.54) injury rates per 1000 athlete-exposures. Compared with injuries sustained during practice, higher proportions of competition injuries were head/face/neck injuries (proportion ratio [PR]  =  1.61, 95% CI  =  1.34, 1.94), particularly in boys' soccer (PR  =  7.74, 95% CI  =  2.53, 23.65) and girls' basketball (PR  =  6.03, 95% CI  =  2.39, 15.22). Competition injuries were more likely to be concussions (PR  =  2.02, 95% CI  =  1.56, 2.62), especially in boys' soccer (PR  =  6.94, 95% CI  =  2.01, 23.95) and girls' basketball (PR  =  5.83, 95% CI  =  2.06, 16.49). Higher proportions of competition injuries caused the athlete to miss more than 3 weeks of play (PR  =  1.28, 95% CI  =  1.08, 1.52), particularly in baseball (PR  =  3.47, 95% CI  =  1.48, 8.11) and volleyball (PR  =  2.88, 95% CI  =  1.01, 8.24).

Conclusions:
Rates and patterns of high school sport injuries differed between practice and competition. Providing athletic trainers with this information is a crucial step in developing the targeted, evidence-based interventions required to effectively reduce injury rates among the millions of high school student-athletes.
Issues in Outcomes Research: An Overview of Randomization Techniques for Clinical Trials
Authors: Kang Minsoo , Ragan Brian G. , Park Jae-Hyeon 
Published: December 2009

Abstract

Objective:
To review and describe randomization techniques used in clinical trials, including simple, block, stratified, and covariate adaptive techniques.

Background:
Clinical trials are required to establish treatment efficacy of many athletic training procedures. In the past, we have relied on evidence of questionable scientific merit to aid the determination of treatment choices. Interest in evidence-based practice is growing rapidly within the athletic training profession, placing greater emphasis on the importance of well-conducted clinical trials. One critical component of clinical trials that strengthens results is random assignment of participants to control and treatment groups. Although randomization appears to be a simple concept, issues of balancing sample sizes and controlling the influence of covariates a priori are important. Various techniques have been developed to account for these issues, including block, stratified randomization, and covariate adaptive techniques.

Advantages:
Athletic training researchers and scholarly clinicians can use the information presented in this article to better conduct and interpret the results of clinical trials. Implementing these techniques will increase the power and validity of findings of athletic medicine clinical trials, which will ultimately improve the quality of care provided.
Force Production and Reactive Strength Capabilities After Anterior Cruciate Ligament Reconstruction
Authors: Flanagan Eamonn P. , Galvin Lorcan , Harrison Andrew J. 
Published: December 2009

AbstractContext:Ambiguity exists in the literature regarding whether individuals can restore function to 100% after anterior cruciate ligament (ACL) reconstruction. The response of force production and reactive strength in stretch-shortening cycle activities after surgery has not been established.Objective:To compare reactive strength and force production capabilities between the involved and uninvolved legs of participants who had undergone ACL reconstruction and rehabilitation with the reactive strength and force production capabilities of a control group.Design:Repeated measures, cross-sectional.Setting:Research laboratory.Patients or Other Participants:Ten participants with ACL reconstructions who had returned to their chosen sports and 10 age-matched and activity-matched control subjects.Intervention(s):We screened the ACL group with the International Knee Documentation Committee Subjective Knee Evaluation Form and functional performance tests to measure a basic level of function. We assessed force production capabilities and reactive strength using squat, countermovement, drop, and rebound jump protocols on a force sledge apparatus.Main Outcome Measure(s):The dependent variables were flight time, peak vertical ground reaction force, leg spring stiffness, and reactive strength index.Results:No participant in the ACL group exhibited functional deficits in comparison with normative values or the control group. Using the force sledge apparatus, we found no notable differences in force production capabilities and reactive strength in the ACL group when comparing the involved with uninvolved legs or the degree of difference between legs with the control group.Conclusions:After ACL reconstruction, rehabilitated participants did not exhibit deficits in force production or reactive strength capabilities. Our results suggest that force production and reactive strength capabilities can be restored to levels comparable with the uninjured control limb and may not be limiting factors in ACL recovery.
Role Strain in Collegiate Athletic Training Approved Clinical Instructors
Authors: Henning Jolene M. , Weidner Thomas G. 
Published: December 2009

AbstractContext:Certified athletic trainers who serve as Approved Clinical Instructors (ACIs) in the collegiate setting are balancing various roles (eg, patient care and related administrative tasks, clinical education). Whether this balancing act is associated with role strain in athletic trainers has not been examined.Objective:To examine the degree of, and contributing factors (eg, socialization experiences, professional and employment demographics, job congruency) to, role strain in collegiate ACIs.Design:Cross-sectional survey design.Setting:Geographically stratified random sample of ACIs affiliated with accredited athletic training education programs at National Collegiate Athletic Association (NCAA) Division I, II, and III institutions.Patients or Other Participants:118 collegiate ACIs (47 head athletic trainers, 45 assistant athletic trainers, 26 graduate assistant athletic trainers).Main Outcome Measure(s):The Athletic Training ACI Role Strain Inventory, which measures total degree of role strain, 7 subscales of role strain, socialization experiences, professional and employment characteristics, and congruency in job responsibilities.Results:A total of 49% (n  =  58) of the participants experienced a moderate to high degree of role strain. Role Overload was the highest contributing subscale to total role strain. No differences were noted between total role strain and role occupant groups, NCAA division, or sex. Graduate assistant athletic trainers experienced a greater degree of role incompetence than head athletic trainers did (P  =  .001). Division II ACIs reported a greater degree of inter-role conflict than those in Division I (P  =  .02). Female ACIs reported a greater degree of role incompetence than male ACIs (P  =  .01). Those ACIs who stated that the ACI training provided by their institution did not adequately prepare them for the role as an ACI experienced greater role strain (P &lt; .001).Conclusions:The ACIs in the collegiate setting are experiencing role strain in balancing their roles as health care providers, clinical educators, and administrators. Methods to reduce role strain need to be considered.
Systematic Review of Postural Control and Lateral Ankle Instability, Part I: Can Deficits Be Detected With Instrumented Testing?
Authors: McKeon Patrick O. , Hertel Jay 
Published: December 2009

Abstract

Objective:
To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those 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 postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable.

Data Extraction:
We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively.

Data Synthesis:
Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures.

Conclusions:
Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability.
Medial Tibial Stress Syndrome: Evidence-Based Prevention
Authors: Craig Debbie I. 
Published: December 2009

AbstractReference:Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. The prevention of shin splints in sports: a systematic review of literature. Med Sci Sports Exerc. 2002;34(1):32–40.Clinical Question:Among physically active individuals, which medial tibial stress syndrome (MTSS) prevention methods are most effective to decrease injury rates?Data Sources:Studies were identified by searching MEDLINE (1966–2000), Current Contents (1996–2000), Biomedical Collection (1993–1999), and Dissertation Abstracts. Reference lists of identified studies were searched manually until no further studies were identified. Experts in the field were contacted, including first authors of randomized controlled trials addressing prevention of MTSS. The Cochrane Collaboration (early stage of Cochrane Database of Systematic Reviews) was contacted.Study Selection:Inclusion criteria included randomized controlled trials or clinical trials comparing different MTSS prevention methods with control groups. Excluded were studies that did not provide primary research data or that addressed treatment and rehabilitation rather than prevention of incident MTSS.Data Extraction:A total of 199 citations were identified. Of these, 4 studies compared prevention methods for MTSS. Three reviewers independently scored the 4 studies. Reviewers were blinded to the authors' names and affiliations but not the results. Each study was evaluated independently for methodologic quality using a 100-point checklist. Final scores were averages of the 3 reviewers' scores.Main Results:Prevention methods studied were shock-absorbent insoles, foam heel pads, Achilles tendon stretching, footwear, and graduated running programs. No statistically significant results were noted for any of the prevention methods. Median quality scores ranged from 29 to 47, revealing flaws in design, control for bias, and statistical methods.Conclusions:No current evidence supports any single prevention method for MTSS. The most promising outcomes support the use of shock-absorbing insoles. Well-designed and controlled trials are critically needed to decrease the incidence of this common injury.
Talocrural Dislocation With Associated Weber Type C Fibular Fracture in a Collegiate Football Player: A Case Report
Authors: Ricci R. Daniel , Cerullo James , Blanc Robert O. , McMahon Patrick J. , Buoncritiani Anthony M. , Stone David A. , Fu Freddie H. 
Published: December 2009

Abstract

Objective:
To present the case of a talocrural dislocation with a Weber type C fibular fracture in a National Collegiate Athletic Association Division I football athlete.

Background:
The athlete, while attempting to make a tackle during a game, collided with an opponent, who in turn stepped on the lateral aspect of the athlete's ankle, resulting in forced ankle eversion and external rotation. On-field evaluation showed a laterally displaced talocrural dislocation. Immediate reduction was performed in the athletic training room to maintain skin integrity. Post-reduction radiographs revealed a Weber type C fibular fracture and increased medial joint clear space. A below-knee, fiberglass splint was applied to stabilize the ankle joint complex.

Differential Diagnosis:
Subtalar dislocation, Maisonneuve fracture, malleolar fracture, deltoid ligament rupture, syndesmosis disruption.

Treatment:
The sports medicine staff immediately splinted and transported the athlete to the athletic training room to reduce the dislocation. The athlete then underwent an open reduction and internal fixation procedure to stabilize the injury: 2 syndesmosis screws and a fibular plate were placed to keep the ankle joint in an anatomically reduced position. With the guidance of the athletic training staff, the athlete underwent an accelerated physical rehabilitation protocol in an effort to return to sport as quickly and safely as possible.

Uniqueness:
Most talocrural dislocations and associated Weber type C fibular fractures are due to motor vehicle accidents or falls. We are the first to describe this injury in a Division I football player and to present a general rehabilitation protocol for a high-level athlete.

Conclusions:
Sports medicine practitioners must recognize that this injury can occur in the athletic environment. Prompt reduction, early surgical intervention, sufficient resources, and an accelerated rehabilitation protocol all contributed to a successful outcome in the patient.
Rotator Cuff Fatigue and Glenohumeral Kinematics in Participants Without Shoulder Dysfunction
Authors: Teyhen Deydre S. , Miller Joseph M. , Middag Tansy R. , Kane Edward J. 
Published: December 2009

AbstractContext:Researchers have established that superior migration of the humeral head increases after fatigue of the rotator cuff muscles. In these studies, the investigators used imaging techniques to assess migration of the humeral head during statically held shoulder positions. Their results may not represent the amount of superior humeral head migration that occurs during dynamic arm elevation.Objective:To investigate the effect of rotator cuff fatigue on humeral head migration during dynamic concentric arm elevation (arm at the side [approximately 0°] to 135°) in healthy individuals and to determine the test-retest reliability of digital fluoroscopic video for assessing glenohumeral migration.Design:Test-retest cohort study.Setting:Research laboratory.Patients or Other Participants:Twenty men (age  =  27.7 ± 3.6 years, mass  =  81.5 ± 11.8 kg) without shoulder disorders participated in this study.Intervention(s):Three digital fluoroscopic videos (2 prefatigue and 1 postfatigue) of arm elevation were collected at 30 Hz. The 2 prefatigue arm elevation trials were used to assess test-retest reliability with the arm at the side and at 45°, 90°, and 135° of elevation. The prefatigue and postfatigue digital fluoroscopic videos were used to assess the effects of rotator cuff fatigue on glenohumeral migration. All measurements were taken in the right shoulder.Main Outcome Measure(s):The dependent measure was glenohumeral migration (in millimeters). We calculated the intraclass correlation coefficient and standard error of the measurement to assess the test-retest reliability. A 2 × 4 repeated-measures analysis of variance was used to assess the effects of fatigue on arm elevation at the 4 shoulder positions.Results:The test-retest reliability ranged from good to excellent (.77 to .92). Superior migration of the humeral head increased postfatigue (P &lt; .001), regardless of angle.Conclusions:Digital fluoroscopic video assessment of shoulder kinematics provides a reliable tool for studying kinematics during arm elevation. Furthermore, superior migration of the humeral head during arm elevation increases with rotator cuff fatigue in individuals without shoulder dysfunction.
Professional Role Complexity and Job Satisfaction of Collegiate Certified Athletic Trainers
Authors: Brumels Kirk , Beach Andrea 
Published: December 2009

AbstractContext:Whenever professionals have multiple role obligations in the workplace, they face potential professional role complexities.Objective:To examine whether certified athletic trainers (ATs) employed at the collegiate level experienced professional role complexities, and if so, what effect those complexities had upon their job satisfaction and intent to leave a current position or the profession.Design:Survey.Setting:We used Internet survey methods to gather information from 1000 randomly selected collegiate ATs regarding the amount of stress they felt due to role complexities.Patients or Other Participants:We obtained a random sample of e-mail addresses for 1000 collegiate ATs in the United States and contacted these individuals with an invitation to participate. A total of 348 usable responses were received, for a 36% response rate.Main Outcome Measure(s):The role complexity aspect of the survey consisted of 45 questions addressing role ambiguity, role overload, role incongruity, role incompetence, and role conflict. The job satisfaction portion consisted of global questions regarding overall job satisfaction and intent to leave the job or profession.Results:A total of 38% of respondents experienced moderate to high stress levels from role overload, whereas 23% and 22% had moderate to high levels of stress from role ambiguity and role conflict, respectively. Clinicians and joint appointees who reported moderate to high levels of stress from role complexity issues had lower job satisfaction and more frequent thoughts of leaving than did their faculty counterparts.Conclusions:The majority of collegiate ATs experienced low levels of professional role complexities and were relatively satisfied with their jobs. However, collegiate ATs began to experience less job satisfaction and more thoughts of leaving when moderate to high stress levels occurred due to role ambiguity, overload, incongruity, incompetence, and conflict. Lessening the stress due to role complexities is critical to positive employment experiences for ATs employed in higher education.