Medicine and Health Sciences Commons^™

Turf Toe And Sesamoid Fracture Case Study, Mason Cannon

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

OBJECTIVE This case presents the evaluation and management of a 15-year-old male multi-sport high school athlete. The athlete initially sustained a turf toe injury that progressed into a sesamoid fracture. This report showcases the clinical findings, treatment progression, and outcomes within a disablement model framework.

Prevalence Of Low Energy Availability (Lea) Risk In Division Iii Female Distance Athletes, Ciara Murphy

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

OBJECTIVE The objective of this study was to explore the prevalence of LEA among division III female distance athletes.

The Effectiveness Of An Educational Program On Young Swimmers Water Consumption And Dry Land Exercises, Maria Thibodeaux, Shelby Bay, Maddie Hoyt, Elizabeth Starns, Elizabeth Nix

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

OBJECTIVE/CONTEXT Although shown to improve performance, many young swimmers are reluctant to participate in dry land exercises.¹ They are also more likely to become dehydrated than their non-swimming counterparts, suggesting they are not adequately hydrating during activity and throughout their day.² Therefore, this study aimed to evaluate the impact of a four-week educational program on dry land exercises and water consumption.

From Focal Chondral Defect To Matrix-Induced Autologous Chondrocyte Implantation In An Active Adult: A Case Study, Zoey Scott

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

OBJECTIVE Present a clinical case detailing the undetermined consequential factors associated with FCD progression  in athletic populations, and the subsequent challenges.

Post-Surgical Dislocations: A Latarjet Procedure, Brianagh Dean, Kimberly S. Peer

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

BACKGROUND The glenohumeral joint is the most frequently dislocated joint in the body, with an incidence rate of 40.4 per 100,000 in men and 15.5 per 100,000 women. Recurrence rates following a first-time anterior shoulder dislocation range from 33-40%, particularly among adolescent collision-sport athletes. Arthroscopic Bankart repair is performed to address anterior instability, however recurrent instability may occur in the presence of glenoid bone loss. The Latarjet surgery is indicated in cases of recurrent anterior instability with significant bony deficiency, functioning through a triple-blocking mechanism increasing glenoid surface area via coracoid transfer, creating a dynamic sling effect from the conjoined …

Oral Contraceptives Rate Of Reduction On Anterior Cruciate Ligament Injuries In Females: A Critically Appraised Topic, Paige Trent, Sara Stiltner

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

CLINICAL SCENARIO Anterior cruciate ligament (ACL) injuries occur more frequently in females than males, with estimates suggesting a 2-10 greater likelihood of females to sustain this trauma.3 FIFA issued a recent call to action encouraging further investigation into why females are still predisposed to this trauma.2 ACL incident rate is highest amongst females between 14–18-years-old with approximately 227.6 exposures per 100,000 persons per year.1 Multifactorial influences are suggested as predisposing risk factors including anatomical or hormonal components.1 Growing interest in hormonal contributions has led researchers to examine how fluctuations in estrogen, progesterone, and testosterone impact ligamentous integrity.8

Estrogen receptors are …

Case Report: Chronic Peroneal Subluxation, Natalie Weissman, Morgan Cooper Bagley, Colin Reidy

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

OBJECTIVE The case study presented explores the sign, symptoms, and unique treatment of a patient with a chronic peroneal subluxation of the right ankle. The clinical evaluation showed full range of motion with visible peroneal tendon movement over the right lateral malleolus. Surgery was not done or recommended; a four-phase rehabilitation with a return to play protocol was used. This case showed how rehabilitation through a non-surgical approach is still achievable.

The Effect Of Taper On Scapular Positioning In Division Iii Collegiate Swimmers, Maddie Hoyt, Elizabeth Starns, Andrew Busch

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

OBJECTIVE Scapular asymmetry and lateral translation are prevalent in competitive swimmers due to the repetitive overhead nature of the sport.^1,2 Additionally, ambiguity exists in the reliability of non-invasive scapular assessments. First, this study aimed to compare differences in scapular positioning during the competitive swimming season to the tapered season. The tapered season is marked by a significant decrease in intensity.^3,4,5 Second, this study aimed to determine the reliability of three commonly used scapular assessments.

Anterior Cruciate Ligament Autograft Reconstruction Outcomes In Adolescents And Young Adults: A Critically Appraised Topic, Klevione D. Brown, River A. Hamilton, Elizabeth A. Starns

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

CLINICAL SCENARIO Anterior cruciate ligament (ACL) tears are one of the most common serious knee injuries seen in high school and college-aged athletes.¹ Many athletes opt for surgical reconstruction because ACL injuries often result in knee instability and impair their ability to return to play in their sport.² There are three primary types of autografts used in reconstruction: bone-patellar tendon-bone (BTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts.³ It is important to determine if a graft type has better return-to-play outcomes for adolescent and young adult athletes.

Sport-Related Concussion Incidents Across Sports, Surfaces, And Injury Mechanisms: A Retrospective Analysis Of A Digital Concussion Database, Justin Belle, Jay Alberts, Jason Cruickshank, Richard Figler, Kelsey Owen, Sami Rifat

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

OBJECTIVE/CONTEXT Sport-related concussion (SRC) represents a significant injury burden in youth athletics. Advances in digital injury surveillance platforms allow for large-scale clinical databases that may provide insight into injury mechanisms, sport distribution, and management patterns. The purpose of this study was to describe the distribution of concussion-related incidents across sports, playing surfaces, and mechanisms of injury using data from a prospectively maintained clinical concussion database.

Dysautonomia In Adolescent Athletes With Persistent Post‑Concussion Complaints, Jason A. Cruickshank

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

OBJECTIVE/BACKGROUND Dysautonomia is dysfunction in autonomic nervous system manifesting following concussion, contributing to Persistent Post‑Concussion Complaints (PPCC).^1,5 Patients with dysautonomia may present with dizziness, tachycardia, postural intolerance, headaches, cognitive fog, and activity/exercise intolerance.^1,5 Recognition of autonomic involvement is essential to recovery and preventing prolonged symptoms^.1,5

The Effectiveness Of A Mental Health Literacy Webpage For Parents, Coaches, And Athletic Trainers, Mackenzie Warner, Kimberly Peer, Hannah Harnar, David Dees

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

INTRODUCTION Mental health illnesses continue to emerge as a major public health concern, particularly among adolescents and young adults. Secondary school student-athletes face unique pressures related to academics, athletic performance, time management, injuries, and social expectations, all of which may contribute to anxiety, depression, stress, or other mental health conditions. However, there is limited research that explores secondary school student-athletes and how mental health affects their everyday lives. This could be due to the lack of mental health literacy in the individuals who surround secondary school student-athletes, including parents, coaches, and athletic trainers. Increasing their understanding of mental health literacy …

Understanding Athletic Trainer's Knowledge And Perceptions Of Mental Health Best Practices: A Mixed-Methods Study, Chelsea Pasukinis, Yvette Ingram, Malissa Martin, Robert B. Krueger

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

OBJECTIVE Mental health disorders are increasing in our society. Research on athletic trainers' (AT) knowledge and perception of mental health disorders, and whether policies are developed and used, is limited. The purpose of this study is to investigate AT’s knowledge of mental health illness, current policies and procedures, and the perceptions ATs have of mental health.

A Case Report Of Blunt Renal Trauma In A High School Football Athlete, Mariah Reeder

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

OBJECTIVE/BACKGROUND Blunt abdominal trauma in football athletes is uncommon but carries significant risk for internal organ injury and hemorrhage. Although sport-related renal injuries are rare, a significant portion of them are high-grade (IV-V) and may require advanced medical intervention if not recognized promptly.¹ Symptoms may initially appear benign, such as “having the wind knocked out,” increasing the risk of delayed diagnosis. Athletic trainers often serve as first responders and play a critical role in early recognition, on-field management, and prompt referral for advanced medical care. This case highlights athletic trainer led clinical decision making and interdisciplinary coordination following blunt …

Assessment Of A Middle School Return To Learn Concussion Protocol, Aaron Yaksich, Laura L. Harris

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

OBJECTIVE To evaluate the effectiveness of a newly implemented return to learn (RTL) concussion protocol in an adolescent athletic population.

Challenging The Standard: A Case Report Of Postpartum Rehabilitation Prior To Return To High-Intensity Functional Training, Aly Matejka

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

OBJECTIVE Postpartum athletes frequently attempt to return to high-intensity training without graded rehabilitation of the deep core and pelvic floor complex, contributing to urinary incontinence, impaired load transfer, unresolved diastasis recti, and decreased performance capacity. Despite increasing participation of postpartum individuals in high-load functional training, there is limited applied literature outlining structured, criterion-based return-to-exercise progressions that address breathing mechanics, pelvic floor function, and force development prior to reintroduction of impact and resistance training. This case report describes the implementation of a 15-week postpartum rehabilitation and return-to-training protocol designed to restore neuromuscular control, muscular endurance and strength, and impact tolerance prior …

A Post-Professional Athletic Training Education Module For Detecting Skin Conditions In Diverse Skin Tones, Lauren Oskam, Laura L. Harris

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

OBJECTIVE To develop and evaluate a learning module designed to improve athletic trainers’ proficiency in identifying skin conditions commonly acquired in the sport of wrestling across diverse skin tones.

Leveraging Multimodal Large Language Models For Fall Risk Reduction In Older Adults In The Home: Proposed Model Design, Justin Do, Vivaswat Suresh, Lily Zhang, Bharvi M. Chavre, Jeremy Cha, Robert S. Pugliese

SKMC Student Presentations and Publications

This research letter proposes a novel model design leveraging natively multimodal large language models to identify fall risks and generate visualizations of recommended home environmental modifications, aiming to improve the accessibility and impact of personalized fall prevention advice for older adults. Through a pilot rating study, this work demonstrates that multimodal large language models can generate safe and actionable advice to reduce fall risk in lived spaces of older adults, and also generate realistic edits based on original images. While this concept needs further testing and clinical comparison, it highlights a promising avenue for further innovation of fall prevention tactics.

Anatomy Of The Orbit: Radiologic And Surgical Anatomy Of Anterior And Medial Approaches, Emily Garvey, Benjamin Bitner, Mindy R. Rabinowitz

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose of Review: To review relevant medial orbital anatomy as well as the most commonly used approaches to this space. Recent Findings: The use of the endoscopic endonasal approach for access to the medial orbit, including the intraconal space, has expanded allowing for removal of previously “inoperable” pathology. Summary: Each approach has their strength when considering access to the medial orbit, the transcaruncular incision allows for fast access with limited dissection while the transpalebral approach allows for visualization of the medial orbit but also extended access to the superior and lateral orbit. Conversely, the conjunctival approach allows for wider access …

A Tactile Trans-Flexor Carpi Radialis Surface Landmark Technique For Median Nerve Local Injection: A Cadaveric Study, Clark Chen, Keenan Sobol, Connor Hickey, Duncan Vannest, John Ibrahim, James Raphael

Einstein Health Papers

PURPOSE: Median nerve (MN) block under local anesthesia at the wrist is commonly performed but can be limited by anatomic variation, particularly absence of the palmaris longus tendon. This study investigates a novel trans-flexor carpi radialis (trans-FCR) technique for MN anesthesia that uses the flexor carpi radialis (FCR) tendon as a consistent surface landmark.

METHODS: Fourteen fresh frozen upper extremity cadaver specimens were used. A 25-gauge needle was inserted through the FCR sheath approximately 4 cm proximal to the wrist crease in a transverse fashion, angled approximately 0° to the vertical and parallel to the wrist crease. The trans-FCR technique …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Frailty Is A Predictor Of Inpatient Mortality And Unplanned Icu Admission Following Early Fixation Of Intertrochanteric Fractures., Victor Koltenyuk, Jared Sasaki, Nithin Gupta, Zachary Chanmin, Ruby G Patel, Taylor Manes, Jack W Weick

Surgery Articles

Purpose: This study sought to examine the role of frailty in predicting inpatient mortality following early surgical fixation of intertrochanteric (IT) fractures.

Methods: The ACS-TQIP (2017-21) database was queried for patients with intertrochanteric fractures undergoing surgical fixation within 48 h. Frailty status was determined using the 5-item modified frailty index (mFI-5) (0 = nonfrail, 1 = prefrail, and, 2 = frail, and > 2 = severely frail). The primary end point was inpatient mortality. Secondary end points were unplanned ICU admission and thromboembolic events (DVT or PE). Significance was considered a p-value < 0.05.

Results: Frailty, as determined by the mFI-5, was …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

Postapproval Study For Brain-Responsive Neurostimulation For Drug-Resistant Focal Epilepsy: Three-Year Efficacy And Interim Safety Results, Dawn Eliashiv, Vikram R. Rao, Barbara C. Jobst, Jerzy P. Szaflarski, John D. Rolston, Lesley C. Kaye, Taneeta Mindy Ganguly, Katie Bullinger, Patricia C. Dugan, David E. Burdette, Angela Y. Peters, Atif Sheikh, Kevin F. Haas, Dileep R. Nair, Lilit Mnatsakanyan, Imran H. Quraishi, Meriem K. Bensalem-Owen, Michael J. Doherty, Babak Razavi, Tiffany L. Fisher, Christopher T. Skidmore, Pradeep N. Modur, Tawnya M. Constantino, Vicenta Salanova, Andrew J. Cole, Olga Taraschenko, Angelica Rivera-Cruz, James W. Wheless, Nitin Tandon, Antoaneta Balabanov, Sami Aboumatar, Itzhak Fried, Cornelia Drees, Hae Won Shin, Zeenat Jaisani, Stephanie E. Maciver, Sanjay E. Patra, Edward F. Chang, Jon T. Willie, Ryder Gwinn, Travis Stoub, John M. Stern, Tami Crabtree, Cairn G. Seale, Sharon C. Mcfadden, Jacob F. Norman, Lise Johnson, Martha J. Morrell

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Neuromodulation therapies are approved for the treatment of focal epilepsy based on data from randomized controlled trials (RCTs). After approval of a responsive direct brain stimulation device (The RNS System for focal epilepsy), the Food and Drug Administration required a prospective study to evaluate whether real-world safety and effectiveness differed from outcomes in the RCT.

METHODS: This open-labeled study enrolled adult participants who met the RNS System-approved indication for use. The primary effectiveness end point was median percent change in seizure frequency at 3 years of treatment. Interim safety is presented; the primary safety endpoint analysis will …

Optimal Timing Of Ventriculoperitoneal Shunt Insertion Relative To Cranioplasty Post-Decompressive Craniectomy: A Frequentist Network Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Pious D. Patel, James S. Harrop, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

OBJECTIVE: Optimal timing of ventriculoperitoneal shunting (VPS) relative to cranioplasty (CP) after decompressive craniectomy remains controversial. VPS may be performed before, during, or after CP, but no consensus exists on which sequence minimizes complications. We performed a systematic review and network meta-analysis to compare the safety profiles of pre-, simultaneous, and post-CP shunting.

METHODS: We searched PubMed/MEDLINE, Embase, and CENTRAL from inception to October 2025. Eligible studies directly compared at least two timing strategies in patients undergoing both CP and VPS. Primary outcomes included overall complications, reoperation, infection, and intradural bleeding. Secondary outcomes included shunt-related and other procedure-specific adverse events. …

Comparing The Use Of Measured And Smoothed Data In Forecasting Visual Field Tests Using Deep Learning, Ashkan Abbasi, Sowjanya Gowrisankaran, Wei-Chun Lin, Xubo Song, Bhavna Josephine Antony, Gadi Wollstein, Joel Schuman, Hiroshi Ishikawa

Wills Eye Hospital Papers

OBJECTIVE: To evaluate the impact of training and testing deep learning (DL) models for visual field (VF) forecasting using input-target pairs in which the target is either the measured VF test result, or its smoothed counterpart constructed via linear regression.

DESIGN: A retrospective data analysis study evaluating DL models for VF forecasting under multiple training and testing configurations.

SUBJECTS AND CONTROLS: A total of 1400 subjects (healthy and glaucoma patients) with 19 437 reliable Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal cohorts at the University of Pittsburgh and New York University.

METHODS: Three DL-based pointwise VF …

Multi-Grader Validation Of The Telemedicine Retinopathy Of Prematurity Severity Score, Harrison W. Pratt, Sarthak V. Shah, Cindy S. Zhao, Arthur R. Brant, Caroline R. Baumal, Cagri G. Besirli, Audina M. Berrocal, Kimberley A. Drenser, Anna L. Ells, Clio Armitage Harper, G. Baker Hubbard, Eric D. Nudleman, Polly Quiram, Irena Tsui, Edward Wood, Yoshihiro Yonekawa, Tatiana Rosenblatt, Jochen Kumm, Darius M. Moshfeghi

Wills Eye Hospital Papers

We aimed to statefully validate Retinopathy of Prematurity (ROP) grading by evaluating intergrader variability over age-matched simulated exams. In a prospective retinal photographic grading cohort study, both eyes of twenty patients with five images per eye per visit were graded by twelve expert graders across six weekly visits. For each eye visit, ROP experts graded the Zone, Stage, and Plus, from which the Telemedicine ROP Severity Score (tROP-SS) was calculated. Graders retained knowledge of prior assessments for a given eye and followed International Classification of ROP rules. Intergrader coefficient of variation (CoV) for Zone, Stage, Plus, and tROP-SS remained below …

Volume Electron Microscopy Reveals Heterogeneity Of The Hemostatic Response In Veins And Arteries, Maurizio Tomaiuolo, Meghan E. Roberts, Jenna R. Severa, Christopher D. Mansi, Brenna B. Y. Mathers, Anna Mannix, Trace A Christensen, Lawrence F Brass, Talid Sinno, Timothy J. Stalker

Cardeza Foundation for Hematologic Research

Intravital imaging studies have provided insights into the spatial and temporal variations of platelet activation and thrombin generation that occur during hemostasis; however, these studies are generally limited to small vessels due to the practical limitations of imaging in thicker tissues. Recent advances in cleared tissue fluorescence imaging as well as volume electron microscopy (vEM) coupled with machine learning-based image segmentation provide an opportunity for analysis of the 3-dimensional structure of complex tissues. We utilized these technologies to examine hemostatic plugs from murine jugular veins and carotid arteries to investigate the spatial distribution of platelet activation and biochemical responses in …