Medicine and Health Sciences Commons^™

Health-Related Quality Of Life In Individuals With Chronic Ankle Instability, Megan N. Houston, Bonnie L. Van Lunen, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.

Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Twenty-five participants with CAI (age = 21.9 ± 2.5 years, height = 170.8 ± 8.6 cm, mass = 69.8.0 ± 11.7 kg) were sex- and limb-matched to 25 healthy participants …

An Evidence-Based Practice Educational Intervention For Athletic Trainers: A Randomized Controlled Trial, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes a necessity in athletic training, Web-based modules have been developed and made available to the National Athletic Trainers' Association membership as a mechanism to educate athletic trainers (ATs) on concepts of EBP.

Objective: To assess the effect of an educational intervention on enhancing knowledge of EBP among ATs.

Design: Randomized controlled trial.

Setting: Web-based modules and knowledge assessment.

Patients or Other Participants: A total of 164 of 473 ATs (34.7% response rate), including professional athletic training students, graduate students, clinical preceptors, educators, and clinicians, were randomized into a control group (40 men, 42 women) …

Perceived Outcomes Of Web-Based Modules Designed To Enhance Athletic Trainers' Knowledge Of Evidence-Based Practice, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier, Aimee L. Wyant, Jessica M. Mutchler, William A. Pitney, Danica G. Hays

Rehabilitation Sciences Faculty Publications

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial.

Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians.

Design: Qualitative study.

Setting: Individual telephone interviews.

Patients or Other Participants: A …

Future Directions Of Evidence-Based Practice In Athletic Training: Perceived Strategies To Enhance The Use Of Evidence-Based Practice, Cailee E. Welch, Dorice A. Hankemeier, Aimee L. Wyant, Danica G. Hays, William A. Pitney, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care.

Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training …

Concurrent Validity Of Accelerations Measured Using A Tri-Axial Inertial Measurement Unit While Walking On Firm, Compliant, And Uneven Surfaces, Michael H. Cole, Wolbert Van Den Hoorn, Justin K. Kavanagh, Steven Morrison, Paul W. Hodges, James E. Smeathers, Graham K. Kerr

Rehabilitation Sciences Faculty Publications

Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations; i) subtraction of the best linear fit from the data (detrending); and ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred …

Changes In The Dynamics Of Postural And Locomotor Control As A Result Of Varying Task Demands, Kathleen Sherry Thomas

Human Movement Sciences & Special Education Theses & Dissertations

The aim of this study was to examine changes in postural and locomotor control under varying task demands. Three experiments were designed to address the impact that fast walking had on standing posture over time, slow walking had on gait dynamics over time, and the extent to which gait speed interacts with the ability to walk randomly.

For experiment I, the aim was to identify the time course in which postural adaptation occurred while walking at faster than preferred speeds. Postural motion was assessed at specific intervals over a 35-min walking trial. Findings revealed that walking at a faster speed …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 2: Attitudes, Beliefs, Accessibility, And Barriers, Cailee W. Mccarthy, Dorice A. Hankemeier, Jessica M. Walter, Eric J. Newton, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students.

Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students.

Design: Cross-sectional study.

Setting: Online survey instrument.

Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training …

Commentary On "The Motor Learning Strategy Instrument: Interrater Reliability Within Usual And Virtual Reality Physical Therapy Interventions", Karen M. Kott, Sharon Held

Rehabilitation Sciences Faculty Publications

No abstract provided.

Instruction And Jump-Landing Kinematics In College-Aged Female Athletes Over Time, Jena Etnoyer, Nelson Cortes, Stacie I. Ringleb, Bonnie L. Van Lunen, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries.

Objective: To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box–drop-jump task, running–stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes.

Design: Randomized controlled clinical trial.

Setting: Laboratory.

Patients or Other Participants: Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 1: Perceived Importance, Knowledge, And Confidence, Dorice A. Hankemeier, Jessica M. Walter, Cailee W. Mccarty, Eric J. Newton, Stacy E. Walker, Shana L. Pribesh, Beth E. Jamali, Sarah A. Manspeaker, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context:

Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.

Objective:

To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.

Design:

Cross-sectional study.

Setting:

Online survey instrument.

Patients or Other Participants:

The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.

Main Outcome Measure(s):

Demographic information and perceived importance and knowledge of and …

Perceptions Of Approved Clinical Instructors: Barriers In The Implementation Of Evidence-Based Practice, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood.

Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed.

Data Collection and …

The Influence Of Interlimb Differences On Anterior Cruciate Ligament Injury Risk Factors In Female Collegiate Soccer Athletes, Eric Kevin Greska

Human Movement Sciences & Special Education Theses & Dissertations

Female collegiate soccer athletes suffer anterior cruciate ligament (ACL) injuries at a rate of 0.31 per 1000 athlete-exposures, with 67% of injuries expected to be from a non-contact mechanism. As well, previous studies have demonstrated dissimilarity in non-contact ACL injuries relative to dominant and non-dominant legs; with the non-dominant leg being the involved side in 48-67% of reported incidents. The aim of this study was to examine lower extremity neuromechanics relative to leg dominance during an unanticipated sidestep cutting task, with differing states of fatigue and training.

Twenty female collegiate soccer players performed three valid trials for both the dominant …

Two Different Fatigue Protocols And Lower Extremity Motion Patterns During A Stop-Jump Task, David Quammen, Nelson Cortes, Bonnie L. Van Lunen, Shawn Lucci, Stacie I. Ringleb, James Onate

Rehabilitation Sciences Faculty Publications

Context: Altered neuromuscular control strategies during fatigue probably contribute to the increased incidence of non-contact anterior cruciate ligament injuries in female athletes.

Objective: To determine biomechanical differences between 2 fatigue protocols (slow linear oxidative fatigue protocol [SLO-FP] and functional agility short-term fatigue protocol [FAST-FP]) when performing a running-stop-jump task.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: A convenience sample of 15 female soccer players (age = 19.2 ± 0.8 years, height = 1.67± 0.05m, mass = 61.7 + 8.1 kg) without injury participated.

Intervention(s): Five successful trials of a running–stop-jump task were obtained prefatigue and postfatigue during …

Falls And Physical Activity In Persons With Multiple Sclerosis, J. J. Sosnoff, B. M. Sandroff, J. H. Pula, S. M. Morrison, R. W. Motl

Rehabilitation Sciences Faculty Publications

Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry) in persons with multiple sclerosis.

Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS) score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity.

Results. Overall, 37 persons (49.3% of the sample) reported falling in the last year with 28 of the 37 falling more than once. Persons who …

Clinical Preceptors' Perspectives On Clinical Education In Post-Professional Athletic Training Education Programs, Kelvin Phan, Cailee W. Mccarty, Jessica M. Mutchler, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Clinical education is the interaction between a clinical preceptor and student within the clinical setting to help the student progress as a clinician. Post-professional athletic training clinical education is especially important to improve these students' clinical knowledge and skills. However, little research has been conducted to assess the pedagogical principles for clinical education at this level or what factors are necessary to enhance the clinical skills and decision-making abilities of post-professional students. Therefore, exploring the perspectives of clinical preceptors involved in post-professional education will help educators understand what strategies are necessary to improve post-professional athletic training education programs (PPATEPs). …

Aging, Neuromuscular Decline, And The Change In Physiological And Behavioral Complexity Of Upper-Limb Movement Dynamics, S. Morrison, K. M. Newell

Rehabilitation Sciences Faculty Publications

Aging is characterized by a general decline in physiological and behavioral function that has been widely interpreted within the context of the loss of complexity hypothesis. In this paper, we examine the relation between aging, neuromuscular function and physiological-behavioral complexity in the arm-hand effector system, specifically with reference to physiological tremor and isometric force production. Experimental findings reveal that the adaptive behavioral consequences of the aging-related functional decline in neurophysiological processes are less pronounced in simple motor tasks which provides support for the proposition that the motor output is influenced by both extrinsic (e.g., task related) and intrinsic (e.g., coordination, …

Overcoming Barriers To Implementation Of Evidence-Based Practice Concepts In Athletic Training Education: Perceptions Of Select Educators, Sarah Manspeaker, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making.

Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers.

Design: Qualitative interviews of emergent design with grounded theory.

Setting: Undergraduate CAATE-accredited athletic training education programs.

Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± …

Mobility, Balance, And Falls In Persons With Multiple Sclerosis, Jacob J. Sosnoff, Michael J. Socie, Morgan K. Boes, Brian M. Sandroff, John H. Pula, Yoojin Suh, Madeline Weikert, Steven Morrison, Robert W. Motl

Rehabilitation Sciences Faculty Publications

Background: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS).

Methods: 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery.

Results: Over 51% of the participants …

Approved Clinical Instructors' Perspectives On Implementation Strategies In Evidence-Based Practices For Athletic Training Students, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Understanding implementation strategies of Approved Clinibal Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice.

Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 …

The Reliability Of Portable Fixed Dynamometry During Hip And Knee Strength Assessments, Roger O. Kollock Jr., James A. Onate, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Insufficient lower extremity strength may be a risk factor for lower extremity injuries such as noncontact anterior cruciate ligament tears. Therefore, clinicians need reliable instruments to assess strength deficiencies.

Objective: To assess the intrarater, interrater, intrasession, and intersession reliability of a portable fixed dynamometer in measuring the strength of the hip and knee musculature.

Design: Crossover study.

Setting: Sports medicine research laboratory.

Patients or Other Participants: Three raters (A, B, C) participated in this 2-phase study. Raters A and B tested 11 healthy college graduate students (2 men, 9 women) in phase 1. Raters A and C tested 26 …

An Assessment Of Burnout In Undergraduate Athletic Training Education Program Directors, Jessica M. Walter, Bonnie L. Van Lunen, Stacy E. Walker, Zahra C. Ismaeli

Rehabilitation Sciences Faculty Publications

Context: Athletic training education program directors (ATEPDs) often manage their time among students, program administration, and patient care.

Objective: To assess the level of burnout in ATEPDs and to determine the relationship between burnout and various demographics of ATEPDs.

Design: Cross-sectional study.

Setting: Public and private colleges and universities nationwide.

Patients or Other Participants: Two hundred forty-nine ATEPDs of undergraduate athletic training education programs accredited by the Commission on Accreditation of Athletic Training Education.

Intervention(s): We administered the Maslach Burnout Inventory (MBI) to all participants.

Main Outcome Measure(s): The MBI consisted of 21 items assessing 3 characteristics of burnout: emotional …

The Effect Of Three Foot Orthoses On Plantar Pressure Under The First Metatarsophalangeal Joint Of Pes Planus Foot Type During Standing And Slow Running, Lacey Ann Nordsiden

Human Movement Sciences & Special Education Theses & Dissertations

The purpose of this study was to examine the effect of three different foot orthoses on plantar pressure under the first metatarsophalangeal joint during standing and slow running. Twenty physically active participants, 12 males (19.7±1.3 years, 181.5±6.3cm, 83.6±12.3kg) and 8 females (20.8±1.5 years, 172.7±11.2cm, 69.9±14.2kg) with navicular drop greater than 10mm, no history of surgery to the lower extremity, and no history of pain or injury to the 1st metatarsophalangeal joint in the past six months volunteered for the study. Each subject performed standing and slow running tasks with four different orthosis conditions: no orthosis, metatarsal dome, U-shaped orthosis, and …

The Hand Center: Considerations Related To The Design, Planning, Staffing, And Marketing, Marcia L. Miller

Community & Environmental Health Theses & Dissertations

A therapist intent on planning a hand therapy center has no resources that are specific to this specialty area of practice. There are contributions utilized to plan occupational and physical therapy departments that can be synthesized to a degree in the planning of a hand therapy center. The practice of hand therapy incorporates a high degree of physical interaction, with close proximity to the patient and handling by the therapist. This paper explores the unique requirements of a hand therapy department. In order to determine hand therapists' preferences for equipment and space utilization a survey was developed and distributed to …

Abnormal Electrical Potentials In Lower Limb Muscles After Ankle Sprain Grades I, Ii And Iii, Talal A. Al-Shatti

Rehabilitation Sciences Theses & Dissertations

Fibrillation and positive sharp wave potentials have been found after ankle sprain in muscles around the injured joint. The purpose of this study was to better define and explain the reaction of the muscles around the ankle joint after grades I, II and m ankle sprains. Methods: Fifteen subjects (9 males and 6 females, mean age of 33.2 years) with ankle sprains voluntarily participated in this study. A stress x-ray was done to determine the grade of ankle sprain. Nerve conduction velocity and EMO studies were done three weeks after the injury. None of the patients in this study manifested …

The Effect Of Jogging On Anterior Knee Laxity After Anterior Cruciate Ligament Reconstruction, Fawzi F. Bouzubar

Rehabilitation Sciences Theses & Dissertations

Jogging is commonly performed in the latter stages of the rehabilitation program (2½-3 months) following ACL reconstruction. However, its cyclic loading effect on the ACL graft, 4-6 months after surgery has not been examined. Therefore, the purpose of this study was to examine changes in anterior knee laxity before and after 15 minutes of jogging on the treadmill. Subjects (N=l 1) were 8 males and 3 females (X age= 30.27 ± 4.76 years; heights= 175.7 ± 10.7 cm; weights= 81.1 ± 15.9 kg) with unilateral ACL reconstruction (central 1/3 patellar tendon graft, postoperation range = 4-6 months). Measurements were made …

Patellofemoral Joint Compressive Forces During Backward And Forward Running At The Same Speed, Hesham N. Alrowayeh

Rehabilitation Sciences Theses & Dissertations

A previous study found that the patellofemoral joint compressive force (PFJRF) during backward running was less than during forward running at free speed. Therefore, the purpose of this study was to compare the patellofemoral joint compressive forces during backward and forward running at the same speed. Ten runners (4 females, 6 males) between the age of 20-25 (X=22, SD=2) ran in backward and forward directions at the slow speed of 2.3 mph (1.0 m.sec^-1). Using the inverse dynamic technique the knee extensor moment and PFJRF during the slow backward and forward running were calculated. Results showed that the …

The Effect Of Floor Sitting Posture On Low-Back Pain, Knee Pain And Hip Pain Among Kuwaiti Men, Sameera H. Al-Jedi

Rehabilitation Sciences Theses & Dissertations

Background and Purpose. Ground resting posture is common in Kuwait and other Arab communities. Kuwaiti men gather daily, especially on weekend nights socializing in the Diwaniya. Diwaniya is a special room in every Kuwaiti house. The Diwaniya is traditionally furnished with seating cushions and pillows. Men are seated on the floor in a tailor-sitting posture for long periods of time. The tailor-sitting posture flexes the trunk. hips, and knees. The flexion position has been shown to decrease the lumbar lordosis and increase joint compression in hips and knees. However there are no studies about the effect of floor sitting …

Comparison Of The Emg Activity Of The Supraspinatus And Infraspinatus Muscles During Various Closed Chain Exercises, I-Chen Lin

Rehabilitation Sciences Theses & Dissertations

Advantages of closed chain exercises used in the lower extremity have been well documented. However, the effects of closed chain exercises on the upper extremities have not been studied very much. Thus, the purpose of this research is to analyze the EMG activity of the supraspinatus and infraspinatus muscles and compare the relative amounts of activities by performing different isotonic closed chain exercises and an open chain exercise in normal subjects. The supraspinatus and infraspinatus muscles in 1 o healthy subjects were studied with fine wire, intramuscular, electromyographic electrodes while performing 5 closed chain exercises and a D2. open chain …

Reliability Of The Dynamic Gait Index In Vestibular Disorders, Diane M. Wrisley

Rehabilitation Sciences Theses & Dissertations

The purpose of this study was to examine the inter-rater and intra-rater reliability of the Dynamic Gait Index (DGI) when used with patients with vestibular disorders. Subjects included 30 patients aged 27-88 years, with vestibular disorders, who were referred for vestibular rehabilitation. Subjects' performance on the DGI was concurrently rated by two physical therapists experienced in vestibular rehabilitation to determine inter-rater reliability. To determine intra-rater reliability each subject repeated the DGI one-hour later. Percent agreement and kappa statistics were calculated for individual DGI items. Kappa statistics for individual items were averaged to yield a composite kappa score of the DGI. …

Windlass Taping Technique For Symptomatic Relief Of Plantar Fasciitis, Beth Anne Ernst

Rehabilitation Sciences Theses & Dissertations

This study investigated the biomechanical and symptomatic effects of a newly described taping technique to support the longitudinal arch in symptomatic plantar fasciitis patients. The subjects were 20 individuals all diagnosed by a physician with unilateral plantar fasciitis, ambulating full weight-bearing without an assistive device.

Measurements were taken pre and post-taping for calcaneal position, tibial position and navicular height, with the subjects serving as their own control. The subjects also reported pain level pre and post tape using a visual analog scale. The statistical analysis performed on the biomechanical data was the t-test, and Wilcoxon matched-pairs signed ranks test was …