Kinesiology Commons^™

Nonlinear Differences In Postural Sway Across Attentional Focus Conditions In Individuals With And Without Anterior Cruciate Ligament Reconstruction, Natalie L. Ferguson, Brian L. Cone, Christopher K. Rhea, Anne Beethe, Breanna Studenka

Rehabilitation Sciences Faculty Publications

BACKGROUND: The structure of variability in postural sway reflects the adaptability and health of the postural control system. Entropy quantifies this structure by measuring the regularity of repeated fluctuations over time. Although entropy has been used to examine sway in neurological populations, little is known about how sway complexity changes following anterior cruciate ligament reconstruction (ACLR). Attentional focus may also influence postural control, with external focus typically promoting more efficient and automatic regulation than internal focus.

AIM: To examine how attentional focus (internal vs. external) influences the structure of postural sway in individuals with and without ACLR.

METHODS: Forty-three participants …

Multisystem Predictors Of Dynamic Gait Stability Across Fall Risk In Older Adults, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea, Brittany Samulski

Rehabilitation Sciences Faculty Publications

Gait stability arises from interactions between physiological, cognitive, and psychological systems, yet these domains are often assessed in isolation. This study examined multisystem predictors of anteroposterior margin of stability during walking (MoSAP) in community-dwelling older adults. Of 340 participants, 143 were retained after data quality screening (105 females; age: 70.8 ± 7.8 years). Participants completed the Physiological Profile Assessment (PPA), cognitive testing using Montreal Cognitive Assessment (MoCA), fear-of-falling evaluations using Modified Falls Efficacy Scale (MFES) and a biomechanical gait assessment during preferred and fast speeds. Participants were stratified into four PPA-based fall-risk groups: low, mild, moderate, and high risk. MoSAP …

Hierarchical Clustering Reveals Multilevel Structure For Multifactorial Assessment In Community-Dwelling Older Adults, Brittany S. Samulski, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Multifactorial falls assessment is recommended for older adults at elevated risk but can generate numerous potentially overlapping measurements, increasing testing burden despite potentially diminishing informational returns as correlated measures are added. Characterizing how measures covary may inform subsequent efforts to evaluate more efficient assessment procedures. Community-dwelling older adults (n = 298) completed a single-visit assessment including the Physiological Profile Assessment (PPA), preferred- and maximal-speed walking, Montreal Cognitive Assessment (MoCA), and Modified Falls Efficacy Scale (MFES). Hierarchical agglomerative clustering was applied to 51 variables. Dendrogram fidelity, cluster separation, and resampling stability were evaluated using the cophenetic correlation coefficient (CCC), silhouette width, …

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Acute Lower Leg Transcutaneous Electrical Nerve Stimulation Increases Leg Blood Flow And Exercise Capacity In Patients With Peripheral Arterial Disease, Thomas K. Pellinger, Catherine B. Neighbors, Joshua C. Hefta, Patrick H. Luo, Carl B. Suarez, Erotokritos T. Varlas, Grant H. Simmons, Brett J. Wong

EVMS School of Health Professions Faculty Publications

We tested the hypothesis that two different durations of lower leg transcutaneous electrical nerve stimulation (TENS) increase post-TENS popliteal artery blood flow (PABF), popliteal vascular conductance (PVC), and 6-min walk distance (6MWD) in patients with peripheral artery disease (PAD). Seven subjects (5 male, 2 female) with PAD (67.9 ± 7.4 years; claudication: ankle-brachial index (ABI) < 0.90) participated in three randomized treatment sessions: control or bilateral TENS (3.0 Hz burst mode, 250 µs) for either 15 or 45 min. PABF (Doppler ultrasound) was measured before and after treatment. 6MWD and time/distance to claudication onset were measured 25 min post-treatment during each session. PABF, PVC and 6MWD increased after both 15 and 45 min of TENS (P < 0.05, post-TENS vs. pre-TENS baseline/control). Our preliminary results suggest that as little as 15 min of lower leg TENS increases leg blood flow and exercise capacity in individuals with PAD.

Healthcare Provider Perspectives On A Clinical Decision Tool To Support Individualized Exercise Prescriptions And Discussions For Breast Cancer Survivors, Jinani Jayasekera, Oliver W. A. Wilson, Kaitlyn M. Wojcik, Eleanor M. Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K. Parson, Padma Sheila Rajagopal, Richard L. Street Jr.

Department of Medicine Faculty Publications

Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.

Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged >= 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.

Results: The sample consisted of …

Differences In Dieting Behavior In Athletic Trainers, Emily Madrak, Ki L. Cole, Bridget M. Miller, Jennifer L. Volberding

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Athletic trainers (ATs) have a foundational knowledge in many facets of health, including optimization of wellness. Though ATs may be actively trying to improve their own health, societal pressure can have a large impact on behavior. The purpose of this study was to identify differences between gender and years-certified in diet patterns in ATs. Methods: A cross-sectional survey was distributed to 2500 National Athletic Training Association members, It included a demographics section and five-item researcher-created questions regarding diet. Chi-square tests of independence were used to determine the relationship. Results: Significance was determined for gender and question 2, “Have …

Comparing Lower Extremity Kinematics Using Trazer And Inertial Motion Capture Systems, Gabriella Juoza-Clark Spt, Joellen Carter Spt, Nikki Stam Spt, Kevin Robinson Pt, Dsc, Ocs

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: This study assessed the validity of a non-immersive body motion tracking system (TRAZER) as an alternative to using Inertial Measurement Units (IMU)-based motion capture (MyoMotion) for lower extremity kinematic analysis. Methods: Twenty healthy participants (10 females, 10 males) with a mean age of 24.03 years (range: 20-33 years) and a mean BMI of 25.15 kg/m² (range: 18.45-32.23 kg/m²) performed double and single-leg squats. Data Analysis: Kinematic data from TRAZER and MyoMotion IMUs were compared using a mixed two-way ANOVA. Results: No significant differences were observed in knee flexion data across all movements (p > 0.05) and knee abduction during the …

Parameters Of Suspension Training On Core Performance: A Critically Appraised Topic, Sara Stiltner, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Clinical Scenario: The core is a functional unit connecting the upper and lower extremities consisting of abdominal, back, and hip musculature. A highly functional core is essential within the kinetic chain and aids in injury prevention and rehabilitation. Traditional means of core stability training are performed on a stable surface. An emerging mode of core training is suspension training (ST), which utilizes a movement paired with instability to challenge the core stabilizers and increase motor unit recruitment.The purpose of suspension training is to increase muscle activation in core stabilizer’s, while mimicking functional movements.It was the purpose of this research to …

Using External Visual Feedback Techniques To Improve Chronic Ankle Instability: A Critically Appraised Topic, Paxtyn Watkins, Bradlee Wells, Aric J. Warren

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Lateral ankle sprains (LAS) are among the most common musculoskeletal injury in physically active populations posing a substantial health burden. Individuals who sustain ankle sprains often have a diminished quality of life with prolonged symptoms, decreased levels of physical activity, and the propensity to develop chronic ankle instability (CAI). It is estimated that up to 40% of people who sustain an initial lateral ankle sprain will develop CAI. Many therapeutic interventions exist to help alleviate symptoms and the feeling of “giving out.” This critically appraised topic will examine multiple interventions that involve using external visual feedback methods to improve …

The Impact Of Athletic Retirement On Anxiety In Elite Athletes, A Critically Appraised Topic, Jordan Gorham, Emily Madrak

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Though there is growing interest in athletic mental health, this interest appears to diminish significantly once an athlete enters athletic retirement. The abrupt transition can precipitate mental health struggles, exacerbated by the lack of adequate preparation for lifestyle after retirement and the attachment of athletic identity to their sport. Consequently, these circumstances may increase symptoms associated with poor mental health, with a specific focus on anxiety. As the athlete retires and moves into different stages of life, research notes that athletes with stronger athletic identities have poorer mental health than those who had weaker athletic identity^. While the scrutiny …

Comparing Position Specific Gps Normative Data In Professional Female Club Soccer, Andy Seraphin, Christi Edson, Cory Price, Barrett Jones, Amanda Jagielo, Justin Mullner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Objective: To establish normative ranges in common performance tests for professional women’s club soccer. Setting:1^st division professional women’s soccer club in the United States

Participants: Twenty-eight healthy professional women’s soccer players (Age: 27.8 ± 5.1 years; Body Mass: 66.2 ± 6.7 kg). Main Outcome Measures: Season GPS data was analyzed and metrics included minutes, total distance, high speed running, total accelerations, total decelerations, and maximum speed. Statistical analysis was performed to determine differences between positions. Results: Statistically significant differences were found across all metrics in comparison to overall mean. Differences in each metric may be due to a …

Effects Of Neurocognitive Multitask Activities On A Novel Lower Extremity Functional Performance Test, Sidney M. Stoddard, Logan Hill, Bryan L. Riemann, George J. Davies

Physical Therapy Faculty Publications

Objective: To examine the effects of incorporating (1) a neurocognitive reactive component and (2) a neurocognitive multitask component on performance degradation of a single-limb hop functional performance test.

Design: Randomized within-subject design of 32 healthy young adults.

Methods: Participants performed 3 randomly assigned variations of the single-limb T-Drill Hop Test (TDHT). The time to complete each test was recorded. The reactive TDHT (R-TDHT) consisted of the TDHT with a flashing light, indicating the "T" intersection hop direction. The neurocognitive reactive-recall TDHT (RR-TDHT) incorporated the R-TDHT and required participants to observe 5 flashing light colors. Participants then recalled the colors in …

Implementation Evaluation Of Blood Flow Restriction In The Rehabilitative Setting, Corbit Franks, Madison Wellborn, Matthew A. Chatlaong, Daphney M. Carter, William M. Miller, Matthew B. Jessee, Robert E. Davis

Internet Journal of Allied Health Sciences and Practice

Purpose: Blood flow restriction refers to a training/rehabilitation method consisting of an external pressure system applied to a limb to partially inhibit blood flow to the tissues. Though much research has been conducted concerning the use of blood flow restriction, there is limited research concerning why clinicians may or may not utilize it. Objective: The current qualitative study utilized the Consolidated Framework for Implementation Research to investigate why clinicians may or may not implement blood flow restriction in the clinical setting. Methods: A semi-structured interview addressing twelve implementation constructs within four domains (Intervention Characteristics, Outer Setting, Inner Setting, and Characteristics …

A Case Series: Effectiveness Of Nintendo Ring Fit In Improving Balance And Stability Deficits After Recovery From Acl Reconstruction, Emma C. Lord, Melissa A. Tolbert, Whitley J. Stone

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 10, 2025. This study aimed to assess the effectiveness of a gaming system in improving balance, strength, and power after recovery from an anterior cruciate ligament reconstruction (ACLR). Existing bilateral deficits were also assessed among patients.

Four participants between the ages of 18-24 years were recruited for this case-control study. Participants must have had an ACLR in the last 2 years, been discharged from formal physical therapy, and have a continued history of participating in physical activity at least three times a week. Participants were assigned to either the …

Curbing Fatal And Non-Fatal Drowning Deaths: An Effort To Reach Under-Resourced Children In Baltimore, Maryland, Ashton P. Christo, William D. Ramos

International Journal of Aquatic Research and Education

Drowning remains a significant public health problem in the United States, with The Centers for Disease Control and Prevention (CDC) reporting approximately 4,000 drowning deaths annually. Children aged 1-4 face the highest risk, and African American children are disproportionately affected–7.6 times more likely to drown than white children (CDC, 2024). In a city on the East Coast that is predominantly African American, limited access to swimming lessons heightens the risk. To reduce drowning rates, a collaborative swimming program was established between a city high school and a public school enrichment program. The initiative provided essential water safety and swimming skills …

Teaching Swimming To Children With Disabilities: A Qualitative Analysis Of Swim Instructorstea, Stephanie S. Garcia-Hidalgo, Martin E. Block

International Journal of Aquatic Research and Education

When teaching children with disabilities, swim instructors need to be able to assess the unique strengths and needs of each child to determine modifications needed to instruction, equipment, and the setting and then be flexible enough to make changes in real-time to ensure success for the child. Unfortunately, many swim instructors only work seasonally and have the occasional child with a disability, and as a result are likely to have limited training and experiences with children with disabilities. The purpose of this pilot qualitative study is to examine backgrounds, training, and experiences of six swim instructors who work with children …

Examining Burnout Among Athletic Trainers Employed In The College And Secondary School Settings, Stephanie M. Singe, Dayna Liu, Alexandrya Cairns

Clinical Practice in Athletic Training

Burnout continues to be an important concern for athletic trainers working traditional employment settings. The purpose of this study was to compare the secondary school and collegiate settings in relation to burnout. Both secondary school and collegiate athletic trainers participated in a self-reported, online cross-sectional design (Qualtrics) to collect data on their experiences with burnout. Data collection occurred during the second week of October 2023 and ceased during the early weeks of November. Collegiate athletic trainers reported moderate burnout overall (54.56 ±15.89) on the CBI whereas secondary school athletic trainers reported low burnout overall (46.67 ±16.57). On the personal-related burnout …

Psychological And Psychosocial Effects Of Contemplative Practices In The Athletic Population: A Systematic Review, Victoria Baker, Emily Duckett, Alison Gardiner-Shires, Lindsey Keenan

Clinical Practice in Athletic Training

Mental health concerns in athletes are becoming a primary focus for institutions, companies, coaches, and more. An athlete carries an abundant load of stressors due to their lifestyle. The stressors can negatively impact an athlete by producing anxiety, depression, insomnia, and other mental health concerns. Previous studies have found a connection between the use of contemplative practices on psychological and psychosocial effects in athletes, creating an opportunity to evaluate the research of contemplative practices in the athletic population. 5, 7, 8, 13-16 A systematic review was conducted using nine electronic databases. Seven studies were included in this review, each assessing …

Concurrent Acl And Medial/Lateral Meniscal Repair In A Collegiate Soccer Player: Disablement Model Case Study, Rebecca L. Perry, Angelica Alicea, Jeanette Welch, Carl White, Emily E. Hildebrand, Peter Lisman

Clinical Practice in Athletic Training

This case examines a 19-year-old female Division I collegiate soccer player who underwent anterior cruciate ligament (ACL) reconstruction with medial and lateral meniscal repairs. Though meniscal tears often occur in conjunction with ACL injury, incidence of concurrent medial and lateral tears with presence of a displaced bucket-handle lesion is rare. This patient attempted to tackle an oncoming opponent in which contact caused forceful trunk rotation away from her planted right foot. Sideline evaluation revealed medial and posterior knee pain with active knee range of motion deficits. Further evaluation revealed apprehension and muscle guarding during Lachman’s, anterior drawer, and valgus stress …

Conservative Management Of Athletic Pubalgia In A Collegiate Beach Volleyball Athlete: A Case Study, Sydney F. Hendrick, Amy L. Fraley, Madison V. Kefferstan, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 24-year-old female collegiate beach volleyball athlete experienced sharp pain in the pubis symphysis region after turning and running to reach a ball hit over her right shoulder. The patient was unable to move her lower extremities without extreme pain and required help off the court. She was referred to the student health center, where no initial imaging was performed. Differential diagnoses included osteitis pubis, abdominal strain, and athletic pubalgia. Magnetic resonance imaging (MRI) showed a small partial sports hernia with the shearing of the aponeurotic plate. The team physician recommended conservative management. The patient requested a consultation with a …

Introducing Patient-Centered Outcomes To Preceptors In Caate-Approved Athletic Training Programs, K. Judge

Clinical Practice in Athletic Training

The 2020 standards set by the Commission on Accreditation of Athletic Training Education (CAATE) now require the incorporation of the International Classification of Function and Patient-Centered Outcomes into professional practice. These standards can be introduced initially through simulation, but to develop a competent and culturally aware professional, outcome measures should be completed during clinical experiences under the guidance of approved preceptors. As this is a relatively new standard, many preceptors did not receive this as part of their education and may be uncomfortable integrating outcomes into their practice. This lack of integration can negatively affect the learning opportunities of athletic …

Incorporating Balance Training Into Ankle Sprain Injury Prevention Programs: An Evidence-To-Practice Review, David Tomchuk, Jacob Meyer, Kyle Schneider, Ben Fox

Clinical Practice in Athletic Training

Ankle sprains are among the most common injuries in sports and non-sporting activities. For patients, ankle sprains can result in multiple short and long-term hardships, such as financial burdens of evaluation and treatment, absenteeism from sport and physical activity, and diminished ankle and lower extremity function. However, athletic trainers and other stakeholders are also impacted by administrative and time burdens in caring for ankle sprains and how ankle sprains affect team dynamics and performance. The 2022 guiding systematic review evaluated the effectiveness of incorporating preventive balance training exercises on the incidence of ankle sprains in soccer athletes. The search performed …

Use Of An Electronic Dynamometer Following Pitching To Identify Fatigue In Softball Pitchers, Bethany L. Hansberger, Peter Lisman

Clinical Practice in Athletic Training

This study used a case-series design to collect in-game fatigue measures for collegiate softball pitchers immediately after pitching during the competitive season. Five softball pitchers (age = 19.8 ± 1.5 years; height = 169.9±6.1 cm; body mass = 79.1±22.6 kg) from one Division I program were recruited. Isometric internal and external rotation, scaption, and grip strength measures were collected using an electronic dynamometer at the beginning and conclusion of the fall non-traditional season, and at the beginning of preseason in January. Strength measures were also obtained during the competitive season at the conclusion of pitching in a game and compared …

Suturing Education For Athletic Trainers: An Evidence-To-Practice Review, Morgan K. Webb, Brett T. Heim, Allyson E. Ritchey, Kenya Moore, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Teaching suturing skills to medical students is a critical component of their education. Implementing suturing into a comprehensive framework is developed from how professors teach the skill. Suturing is a required skill by the General Medical Council that all medical students must have, and how it is being introduced to new students is changing. This review aimed to summarize different educational interventions and determine the most efficient and cost-effective way to teach future suturing skills. The original systematic review included 25 articles in the final data synthesis. Fourteen studies were randomized control trials, six were quasi-experimental, and five were observational. …

Impact Of A Focused Best Practice Workshop On Athletic Trainer Confidence, Jaclyn B. Arduini, Jennifer L. Volberding, Zachary A. Murray

Clinical Practice in Athletic Training

Athletic trainers are required to be proficient in emergency management skills, without review these skills may decay creating a potentially dangerous knowledge gap. Confidence measures of emergency management skills were taken before and after a workshop to determine if they changed due to the review of material. All 11 confidence measures increased post workshop, seven significantly, including rectal temperature, hemostatic agents, external hemostatic modalities, in-line stabilization, measurement and application of a cervical collar, football and other equipment removal. ATs should aim to incorporate emergency management review into continuing education choices.

Neuromuscular Deficits Following An Isolated Pcl Tear In A Collegiate Lacrosse Player: A Case Study, Mckenna G. Witlin, Erin R. Mcmullan, Courtney M. Meyer, Amy L. Fraley

Clinical Practice in Athletic Training

This disablement model case study outlines a 21-year-old female collegiate lacrosse player attending a United States service academy who presented with a unique neuromuscular deficit following a conservative grade II PCL tear rehabilitation. Nearing the end of her rehabilitation protocol, she noticed difficulty with toe-off while running; however, she did not report to the athletic trainer due to the institution’s holiday break proximity. An unexpected transfer of care occurred when the patient returned after the holidays, and she was cleared for full participation upon return. Several days after the patient was cleared, she reported her ankle feeling “stuck.” Upon evaluation, …

Improving The Discussion Of Suicide Prevention: A Quality Improvement Project, Chelsea Reynolds, Alyssa Zeitouni, Kathryn Stephenson

Clinical Practice in Athletic Training

Suicide is currently the second leading cause of death among adolescents in the United States and the third leading cause of death in this age group worldwide.1,2 Suicide prevention is understandably a growing focus in pediatrics. Currently, at the Children’s Hospital Outpatient Clinic, that is staffed by pediatric resident physicians, suicidal ideation is screened for using a PHQ-9 screen. However, at the time this study was initiated and completed, the TEEN screen was utilized. After the screening is performed, regardless of type, it is up to the provider to address these findings in a safe and effective manner. The goal …

Gamified Gait Rehabilitation Via Real-Time Biofeedback And Adaptive Hip-Exoskeleton Control, Mariya Huzaifa Tohfafarosh

Theses

Gait impairments arise from systemic diseases, age-related degeneration, musculoskeletal dysfunctions, or neurological conditions. While traditional rehabilitation can be effective, they often face challenges such as high costs, inaccessibility, and low patient engagement. To address these challenges, my work introduces a virtual reality-based rehabilitation (VRBR) system, integrating real-time motion and electromyographic (EMG) muscle activation feedback with a gamified virtual environment for enhanced adaptability and engagement. The system includes a custom-designed hip-exoskeleton that provides adaptive spring-like assistance or resistance, supporting both mobility-impaired users and strength training. Assistance levels can be tuned to match the user's progress. Additionally, a custom pressure insole was …

A Description Of Mental Health Policies In Ohio Secondary Schools, Laura L. Harris, Molly Rowe

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To compare secondary school mental health policies implemented for the student body with those implemented for student athletes.