Exercise Science Commons^™

Trust, Culture, And Conversation: How Athletic Training Leaders Navigate High-Stakes Interactions, Nicole A. Wilkins, Ashley B. Thrasher, Ericka P. Zimmerman

Clinical Practice in Athletic Training

Introduction: Engaging in difficult conversations is central to leadership growth and requires sustained effort to refine and strengthen these skills. Leaders not only need to navigate the complexities of their role within an organization, but also the intersectionality of interpersonal dynamics, emotional intelligence, structural hierarchies, and the nuanced environments that influence how communication occurs. Furthermore, leaders must adapt to role expectations that shift across clinical, academic, and administrative contexts, adjusting their approach to engaging in conversations based on these complexities. As part of a larger research project examining difficult conversations, this portion of the study explored how leaders in athletic …

Integrating Wearable Technologies Into Athletic Training: Bridging Innovation And Clinical Practice, Michael Douglas

Clinical Practice in Athletic Training

Athletic training is entering a transformative period driven by the convergence of wearable technologies, artificial intelligence (AI), and advanced biomechanical modeling. Historically, wearable technology in sport was primarily used for performance tracking, including workload monitoring, heart rate assessment, and movement quantification. However, advances in sensor accuracy and data analytics have expanded the clinical relevance of wearable systems, allowing athletic trainers to monitor fatigue markers, movement asymmetry, and neuromuscular control patterns that inform injury risk and rehabilitation progression. Wearable sensor technologies provide objective data that can support clinical decision-making when integrated with traditional evaluation methods.¹Despite these advancements, wearable technologies present persistent …

Recurrent Lateral Patellar Dislocation After Mpfl Repair With Subsequent Tibial Tubercle Anteromedialization And Concomiant Mpfl Reconstruction, Jacob Hardy, Anthony Thomas Drazick, Joshua Pratt, Jeremy M. Burnham

Clinical Practice in Athletic Training

Introduction: Patellar instability is a common knee pathology, particularly among adolescents and young adults, with reported incidence rates ranging from 7 to 77 per 100,000 person-years. Following an initial patellar dislocation, recurrence rates have been reported as high as 86%, particularly in patients with underlying anatomic risk factors. Identification of the multifactorial contributors to patellar instability is critical to guide appropriate management and prevent recurrent episodes. Common pathoanatomic factors associated with recurrent instability include trochlear dysplasia, patella alta, lateralized tibial tubercle, coronal or torsional malalignment, and abnormal patellar shift. This case report describes a patient who presented with a chronic …

Improving Entry-Level Athletic Training Student Confidence In Emergency Care: A Pilot Study, Michele Pye, Cade Watts, John Hunt, Kimberly Pritchard

Clinical Practice in Athletic Training

Introduction: Immediate and emergency care is essential to athletic training education and clinical practice. Athletic training students (ATS) may have limited exposure to emergencies during their clinical experiences, which can undermine their confidence. AT educators can improve ATS confidence and clinical reasoning using a simulation-based, learner-centered SNAPPS approach. SNAPPS consists of Summarizing the history and findings, Narrowing and Analyzing the differential diagnoses, Probing peers about uncertainties or confusion, Planning management, and Selecting case-related knowledge gaps for self-directed learning. This empowers students to control the learning environment while adding realism to encounters. The purpose of this pilot study was to determine …

Performance On The Timed Single-Leg Step-Down Test Is Correlated With Hip And Knee Biomechanics As Measured By 3d Markerless Motion Capture, Ghislain Aminake, Anthony Drazick, Christ Focht, Chloe Roy, Emily Clark, Savannah Knighton, Edward Austin, Jeremy Burnham

Clinical Practice in Athletic Training

Introduction: The timed single-leg step-down (SLSD) test is widely used in clinical and sports settings to assess lower extremity function and injury risk, yet the specific biomechanical determinants of performance on this test remain poorly understood. The purpose of this study is to investigate the relationship between performance on the timed SLSD test and hip and knee biomechanics captured by a markerless 3-D motion-analysis system. Methods: Twenty (20) healthy high school athletes with no recent history of lower extremity injury completed a 60-second timed single leg step down test. The number of quality SLSD repetitions (REPS) constituted their SLSD score. …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Eeg And Imu Gait Signal Processing: A Comparative Assessment Of The "Reza" Exponential Filter And Classic Filters, Reza Pousti, Daniel M. Russell, Derek C. Monroe, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Noise degrades both EEG and gait signals, and classical IIR filters (Butterworth, Chebyshev, elliptic) involve trade-offs between passband flatness, ripple, and roll-off. This study compared a novel exponential "Reza" filter with these designs for neural and locomotor data. We analyzed an open-source mobile brain-body imaging dataset with EEG and gait data from 49 healthy adults (EEG: 256-channel, 512 Hz; IMUs: six APDM Opals, 128 Hz). EEG channels were grand-averaged and band-pass filtered at 0.5-50 Hz, while IMU axes were averaged and band-pass filtered at 0.5-5 Hz. The outcomes were signal-to-noise ratio SNR (dB) and band-integrated Welch PSD (EEG:0.5-50 Hz; IMU:0.5-5 …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

An Exploratory Analysis Of The Role Of Sex In Load Carriage, Rachel E. Perez, Dustin R. Slivka, Brent C. Ruby

Graduate Student Theses, Dissertations, & Professional Papers

Axially loaded weight may impose a metabolic demand equivalent to that of fat mass (FM) during load carriage. Males (M) typically have a lower body fat percentage than females (F), resulting in metabolic demand differences during load carriage that may be mitigated by accounting for FM in pack loads. PURPOSE: To determine whether normalizing pack load to FM equalizes metabolic cost across sexes during load carriage. METHODS: Twenty-eight participants (14M, 23 ± 5 y, 1.81 ± 0.07 m, 78.7 ± 10.0 kg, 12.7 ± 5.4% body fat, VO₂peak 4.18 ± 0.54 L·min^-1; 14F, 22 ± 4 …

Predicting Tilt In Esports: A Psychophysiological Approach To Understanding Player Emotional Regulation, Nathan Rhea

University of the Pacific Theses and Dissertations

Emotional regulation and stress management are important to both casual and competitive esports players. When players become dysregulated, they experience a phenomenon known as “tilt” within the gaming community, where they often lose control of their emotions and their performance declines. This study aimed to investigate whether a psychophysiological variable in heart rate variability could predict tilt in college-age esports players. Additionally, the relationship between heart rate variability and emotions predicted by the Tiltometer system with gameplay performance and winning or losing was tested.

This study used a quantitative correlational research design. Participants for this study were college-age players (N=23) …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Demographic Characteristics And Selected Personality Traits Of Women In Competitive Bodybuilding, Chloe A. Zeeuw

Master's Theses

This study investigated demographic characteristics and measures of personality (dimensions of performance perfectionism and five-factor model characteristics) in women in competitive bodybuilding between 18-25 years old. A total of 24 women completed an online survey which included a demographic questionnaire, the Five Factor Model Rating Form (FFMRF), and the Performance Perfectionism Scale for Sport (PPSS) inventories. Descriptive results for the FFMRF were Openness (18.17±3.12), Conscientiousness (25.58±3.33), Extraversion (19.96±3.46), Agreeableness (19.88±4.58), and Neuroticism (15.67±4.94), and for the PPS-S were Self-oriented performance perfectionism (20.96±3.53), Socially prescribed performance perfectionism (13.96±4.26), and Other-oriented performance perfectionism (10.54±4.23). Pearson’s correlation coefficients and Shapiro-Wilk tests revealed that …

Evaluation Of Physical, Mental, And Mechanical Aspects Of An Extreme Military Training Event: A Continuous Monitoring Approach, Tirthankar Chatterjee, Debojyoti Bhattacharyya, Roshani Meena

Journal of Human Performance in Extreme Environments

Soldiers receive extensive training at extremes of environments and simulated terrains to improve their battle efficiency. A study was designed to evaluate the actual cost of a military physical efficiency test consisting of several physically engaging activities to quantify physiological, mechanical, and subjective demands. Sixteen Indian soldiers participated in a military training session consisting of events such as a 5-km run, 4-m vertical rope climbing, a 2.75-m jump, a 60-m dash, and a 9-m horizontal rope climbing with 6.5 kg of equipment in a hot dry environment. Their physiological status was monitored continuously. National Aeronautics and Space Administration Task Load …

Does Limb Specialization In Track And Field Introduce Asymmetry In Dynamic Stability?, Aaron X. Jones

Master's Theses

Time to stabilization (TTS) represents the time it takes for a person to become still after a hop landing. Lower times suggest greater dynamic stability. Whereas leg dominance (preference) does not seem to have a significant impact on TTS performance in the general healthy populations, limb specialization in sport may introduce asymmetry. This study compares TTS following forward hops in healthy male controls (N = 19) to varsity DIII Track & Field athletes (N = 20). Groups were equal for height, but the athlete group’s average limb length (106.7 ± 5.5 cm) was greater than the control group (101.5 ± …

The Impacts Of Physical (In)Activity On Endothelial Function, Joel Ernest Harden

Rehabilitation Sciences Theses & Dissertations

Exercise and physical activity are known to have beneficial effects on endothelial function and vascular health. Sedentary behavior and physical inactivity, however, have been shown to be related to poor endothelial function and vascular health. The overall purpose of this dissertation was to further elucidate the physiological links between physical (in)activity and vascular health. In the first study, 12 active, young (18-40 yr) individuals and 12 active, old (55+ yr) individuals were recruited. Participants underwent 5 days of removal of exercise, and had their endothelial function assessed via flow-mediated dilation (FMD) during their normal, habitual exercise state (EX) and during …

Construct Validity, Test-Retest Reliability, And Inter-Rater Objectivity Of The Swimming Competence Assessment Scale (Scas), Jon Sundan, Håvard Lorås, Monika Haga

International Journal of Aquatic Research and Education

This study aimed to investigate the construct validity, test-retest reliability, and inter-rater reliability of a newly developed and comprehensive instrument for assessment of children’s swimming competence. The Swimming Competence Assessment Scale (SCAS) consists of six consecutive test items (entry, swim on front, surface dive, float, swim on back and exit) that aligns with the Norwegian curricular standard of swimming competence. The exploratory factor analysis retained a unidimensional model, supporting one underlaying statistical dimension with acceptable internal consistency (α = 0.79). Intraclass correlation coefficients (ICCs) between test and retest ranged from .84 to .98, and .97 for the total score. Strong …

"Feel For The Water": What Is It, Really?, Robert Keig Stallman, Kristine De Martelaer

International Journal of Aquatic Research and Education

The phrase, 'feel for the water,' is commonly used. But what does it really mean? The traditional idea of this 'feel' focuses on the sensation of touch and use of the hands to produce propulsion. But what about water resistance? Mastering a feel for how to reduce resistance is equally important as the unique relationship between aquatic propulsion and resistance is of great importance. While being in the water, the effects of gravity and buoyancy also need to be perceived by the learner and taught by the instructor. Reflection on the effects on propulsion-resistance and gravity-buoyancy requires relevant exercises to …

Fighting Instinct: The Brain, Emotions And Decision-Making In The Water, Jill Nash, Sam Hills

International Journal of Aquatic Research and Education

This conceptual paper explores the complex interplay among the human brain, emotions, and decision-making processes, particularly in aquatic environments. Integrating insights from neuroscience, psychology, and behavioural economics, we investigate how instinctual responses and emotional states influence our decisions during water-related activities. By analysing both biological and psychological factors, the paper aims to illuminate the intricacies of human behaviour in various aquatic settings and highlights significant gaps in the research on emotional decision-making that warrant further investigation. Additionally, the paper suggests interventions, including plausible communication strategies, to mitigate the impact of instinctual responses and improve safety and decision-making efficiency.

Goggles And Water Competence: An Addendum, Marek Rejman, Robert Keig Stallman Ph.D.

International Journal of Aquatic Research and Education

We offer this short addendum to the 2017 article that appeared in IJARE, ‘’From swimming skill to water competence: Towards a more inclusive drowning prevention future’’ (Stallman et al., 2017), as an editorial to argue that the essential water competencies ought to be mastered “without goggles.” The focus is on the potential negative effect of goggle use during beginning swimming instruction along with their likely absence during unintended and unexpected immersions in natural bodies of water that often lead to drowning. Rejman and Stallman (2024) demonstrated the development of dependence on goggles among young adults and described its negative effect …

The Perceived Benefits Of And Barriers To Open-Water Swimming: A Mixed-Methods Examination, David Elliott Ph.D, Mark A. Christie Ph.D

International Journal of Aquatic Research and Education

This study set out to determine the perceived benefits of, and barriers to, open-water swimming (OWS). Adopting a mixed-methods approach, six hundred and sixty-five open-water swimmers responded to an online survey consisting of the Exercise Benefits and Barriers Scale (EBBS) and a series of open-ended questions. Data from the EBBS revealed the strongest perceived benefits to be ‘Psychological Outlook’ and ‘Life Enhancement.’ In terms of barriers, those presented in the EBBS received low ratings with only ‘Physical Exertion’ considered as being somewhat problematic. Content analysis performed on the open-ended responses showed social aspects, mental well-being, and connection to nature as …