Medicine and Health Sciences Commons^™

Assessments Used By Athletic Trainers To Decide Return-To-Activity Readiness In Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) often care for patients with ankle sprains. Expert consensus has been established for rehabilitation-oriented assessments (ROASTs) that should be included in ankle-sprain evaluations. However, the methods ATs use to determine return-to-activity readiness after an ankle sprain are unknown.

Objectives: To identify ATs' methods for determining patients' return-to-activity readiness after an ankle sprain and demographic characteristics of the ATs and their methods.

Setting: Online survey.

Design: Cross-sectional study.

Patients or Other Participants: We recruited 10 000 clinically practicing ATs. A total of 676 accessed the survey, 574 submitted responses (85% completion rate), and 541 respondents met the …

The 50 Most Cited Papers On Rugby Since 2000 Reveal A Focus Primarily On Strength And Conditioning In Elite Male Players, Katherine J. Hunzinger, Eric Schussler

Rehabilitation Sciences Faculty Publications

We sought to conduct a bibliometric analysis and review of the most cited publications relating to rugby since 2000 in order to identify topics of interest and those that warrant further investigations. Clarivate Web of Science database was used to perform a literature search using the search term "rugby." The top 200 papers by citation count were extracted and reviewed for the inclusion criteria: all subjects were rugby players. The top 50 manuscripts were included for analysis of author, publication year, country of lead authors, institution, journal name and impact factor, topic, participant sex, and level of rugby. The total …

Muslim Collegiate Student-Athletes' Experience With Fasting During Ramadan While Participating In Sport, Mishaal Amjad, Julie M. Cavallario, Nicolette A. Harris, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context: As colleges and universities continue to focus on creating diverse, equitable, and inclusive environments, it is important to gain more knowledge on the experiences that Muslim student-athletes have while fasting during the month of Ramadan. While previous researchers have investigated the physical effects of fasting on the body, little is known about the challenges or support Muslim student athletes experience while fasting and participating in sport during Ramadan.

Objective: To explore the experiences of Muslim collegiate student-athletes regarding fasting during Ramadan while participating in sports.

Design: Consensual qualitative research.

Setting: Individual video interviews.

Participants: 12 Muslim collegiate student-athletes (4 …

Implementation Of Patient-Centered Care By Athletic Training Students During Clinical Experiences: A Report From The Association Of Athletic Training Education Research Network, Julie M. Cavallario, Bonnie L. Van Lunen, Stacy E. Walker, R. Curtis Bay, Cailee E. Welch-Bacon

Rehabilitation Sciences Faculty Publications

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors …

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability, Masafumi Terada, Kyle B. Kosik, Ryan S. Mccann, Colin Drinkard, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

Results: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to …

Characteristics Of Patient Encounters For Athletic Training Students During Clinical Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R.Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients that have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences.

Objective: To describe the characteristics of patient encounters (PEs) ATSs engage in during clinical experiences. Design: Multi-site, panel design.

Setting: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's).

Patients or Other Participants: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical …

Preventive Training Program Feedback Complexity, Movement Control, And Performance In Youth Athletes, Hayley J. Root, Eleanor M. Beltz, Julie P. Burland, Jessica C. Martinez, R. Curt Bay, Lindsay J. Distefano

Rehabilitation Sciences Faculty Publications

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes.

Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches' choosing.

Design: Cluster-randomized controlled trial.

Setting: Soccer fields.

Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years).

Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, …

Content Validation Of The Athletic Training Milestones: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie Van Lunen, Lindsey E. Eberman

Rehabilitation Sciences Faculty Publications

The Athletic Training Milestones were developed as a comprehensive framework to assess athletic trainers' knowledge, skill, and behavior acquisition across the continuum of athletic training practice. However, without established content validity, it is unclear whether the Athletic Training Milestones can be used effectively as a clinical evaluation and research tool to evaluate competence and performance across multiple users and sites. We conducted a highly conservative content validity index (CVI) with data from 12 content experts. Our findings revealed an extremely high overall scale CVI of 0.99, and CVI scores of the 28 individual subcompetency items assessed ranged from 0.83 to …

Core Competency-Related Professional Behaviors During Patient Encounters: A Report From The Association For Athletic Training Education Research Network, Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. In what ways, if any, athletic training students (ATSs) are currently integrating CCs into patient encounters (PEs) during clinical experiences is unclear.

Objective: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences.

Design: Multisite panel design.

Setting: A total of …

A Systematic Review Of Center Of Mass As A Measure Of Dynamic Postural Control Following Concussion, Sarah Patejak, Joshua Forrest, Emily Harting, Mable Sisk, Eric Schussler

Rehabilitation Sciences Faculty Publications

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review.

METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study …

Employability In Academe For Athletic Trainers With The Doctor Of Athletic Training Degree, Bonnie L. Van Lunen, Stephanie H. Clines, Tyler Reems, Lindsey E. Eberman, Dorice A. Hankemeier, Cailee E. Welch

Rehabilitation Sciences Faculty Publications

The doctor of athletic training (DAT) degree has recently been introduced into academe. Limited literature exists regarding how individuals with this degree can become part of an athletic training faculty. To identify department chairs' perceptions of the DAT degree and determine whether they viewed the degree as viable when hiring new faculty within a postbaccalaureate professional athletic training program. Cross-sectional study. Online survey instrument. A total of 376 department chairs who had oversight of Commission on Accreditation of Athletic Training Education athletic training programs were invited to participate. Of these, 190 individuals (50.5%) accessed the survey, and 151 of the …

The Role Mentoring Plays In The Transition To Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Mentoring has been identified as an important method of supporting newly credentialed athletic trainers (ATs) during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs in developing a plan to better facilitate the transition.

Objective: To examine which aspects of the mentoring relationship provided the most benefit during the transition to practice of newly certified ATs.

Design: Qualitative study.

Setting: Individual phone interviews.

Patients or Other Participants: A total of 13 ATs who graduated from a professional master's program, were certified from February through July 2016, …

Celebrating Women Scholars In Athletic Training, Julie M. Cavallario, Cailee E. Welch Bacon, Lindsey E. Eberman, Stacy E. Walker

Rehabilitation Sciences Faculty Publications

No abstract provided.

Diagnosing Mild Traumatic Brain Injury Using Saliva Rna Compared To Cognitive And Balance Testing, Steven D. Hicks, Cayce Onks, Raymond Y. Kim, Kevin J. Zhen, Jayson Loeffert, Andrea C. Loeffert, Robert P. Olympia, Gregory Fedochak, Samantha Devita, Aakanksha Rangnekar, John Leddy, Mohammad N. Haider, Zofia Gagnon, Callan D. Mcloughlin, Matthew Badia, Jason Randall, Miguel Madeira, Aaron M. Yengo-Kahn, Justin Wenzel, Matthew Heller, Hallie Zwibel, Aaron Roberts, Samantha Johnson, Chuck Monteith, Michael N. Dretsch, Thomas R. Campbell, Rebekah Mannix, Christopher Neville, Frank Middleton

Rehabilitation Sciences Faculty Publications

BACKGROUND: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to diagnose because of reliance on subjective symptom reports. An objective biomarker could increase diagnostic accuracy and improve clinical outcomes. The aim of this study was to assess the ability of salivary noncoding RNA (ncRNA) to serve as a diagnostic adjunct to current clinical tools. We hypothesized that saliva ncRNA levels would demonstrate comparable accuracy for identifying mTBI as measures of symptom burden, neurocognition, and balance.

METHODS: This case‐control study involved 538 individuals. Participants included 251 individuals with mTBI, enrolled …

The Effect Of Fibular Reposition Taping On Postural Control In Individuals With Chronic Ankle Instability: A Critically Appraised Topic, Bradley C. Jackson, Robert T. Medina, Stephanie H. Clines, Julie M. Cavallario, Mathew H. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no …

A 4-Week Multimodal Intervention For Individuals With Chronic Ankle Instability: Examination Of Disease-Oriented And Patient-Oriented Outcomes, Cameron J. Powden, Johanna M. Hoch, Beth E. Jamali, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention have not been evaluated for their effects on a multidimensional profile of health.

Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, …

Isometric Hip Strength And Dynamic Stability Of Individuals With Chronic Ankle Instability, Ryan S. Mccann, Brenn A. Bolding, Masafumi Terada, Kyle B. Kosik, Ian D. Crossett, Phillip A. Grobble

Rehabilitation Sciences Faculty Publications

Context: Compared with individuals who have a history of lateral ankle sprain (LAS) without markers of chronic ankle instability (CAI; LAS copers) and healthy people, those with CAI often exhibit neuromuscular impairments and dynamic-stability deficits at the hip. However, the influence of hip-strength deficits on dynamic stability remains unknown.

Objective: To compare isometric hip strength and dynamic stability in individuals with or without CAI and examine the degree of dynamic-stability variance explained by isometric hip strength.

Design: Case-control study.

Setting: Research laboratory.

Patients or Other Participants: Sixty individuals (47 women, 13 men; age = 23.7 +/- 4.6 years, height = …

Inter-Rater Agreement And Validity Of A Tackling Performance Assessment Scale In Youth American Football, Eric Schussler, Richard J. Jagacinski, Susan E. White, Ajit M. Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Long term neurologic injury and concussion have been identified as risks from participation in American football. Altering tackling form has been recommended to reduce the risk of neurologic injury caused by head accelerations when tackling. The purpose of this research is to determine the inter-rater agreement and validity of the Qualitative Youth Tackling System (QYTS), a six-item feedback scale to correct tackling form, when utilized by novice and expert raters.

Hypothesis: Experienced raters will have higher levels of agreement with each other and with motion capture when compared to novice raters. Methods: Both novice and experienced raters viewed video …

Normative Functional Performance Values In High School Athletes: The Functional Pre-Participation Evaluation Project, James A. Onate, Cambrie Starkel, Daniel R. Clifton, Thomas M. Best, James Borchers, Ajit Chaudhari, Eric Schussler, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs.

Objective: To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States.

Design: Cross-sectional study.

Setting: Athletic training facilities and gymnasiums across the United States.

Patients or Other Participants: A total of 3951 male and female athletes …

Athletic Training Student Core Competency Implementation During Patient Encounters, Julie M. Cavallario, Bonnie L. Van Lunen, Johanna M. Hoch, Matthew Hoch, Sarah A. Manspeaker, Shana L. Pribesh

Rehabilitation Sciences Faculty Publications

Context: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience.

Objective: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters.

Design: Cross-sectional study.

Setting: Professional athletic training program, …

Postprofessional Athletic Training Students' Perceptions Concerning The Health Care Competencies, Cailee E. Welch Bacon, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: Over a decade ago, the Institute of Medicine indicated that all health care professionals should be educated in several health care competency areas (quality improvement, health care informatics, interprofessional education and collaborative practice, evidence-based practice, and patient-centered care). Despite this initiative, athletic training has only recently incorporated these competencies throughout education.

Objective: To assess postprofessional athletic training students' perceived abilities and importance regarding 6 core competencies.

Design: Cross-sectional. Setting: Self-reported paper survey. Patients or Other

Participants: A total of 221 from a convenience sample of 258 postprofessional athletic training students (85.7%) completed the survey (82 males, 138 females; age …

The Effect Of Tackling Training On Head Accelerations In Youth American Football, Eric Schussler, Richard J. Jagacinski, Susan E. White, Ajit M. Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Many organizations have introduced frameworks to reduce the incidence of football related concussions through proper equipment fitting, coach education, and alteration of tackling technique.

Purpose: The purpose of this study was to examine the effects of training in a vertical, head up tackling style on the number of head accelerations experienced while tackling in a controlled laboratory situation. The authors hypothesized that training in a head up tackling technique would reduce the severity of head acceleration experienced by participants.

Design: Controlled Laboratory Study.

Methods: Twenty-four participants (11.5 ± 0.6 years old, 60.5 ± 2.2 in, 110 ± 18.4 lbs.) …

Comparison Of A Head Mounted Impact Measurement Device To The Hybrid Iii Anthropomorphic Testing Device In A Controlled Laboratory Setting, Eric Schussler, David Stark, John H. Bolte, Yun Seok Kang, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete’s helmet or directly on the athlete’s head.

Purpose: The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by …

Epidemiology Of Knee Sprains In Youth, High School, And Collegiate American Football Players, Daniel R. Clifton, James A. Onate, Eric Schussler, Aristarque Djoko, Thomas P. Dompier, Zachary Y. Kerr

Rehabilitation Sciences Faculty Publications

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. Study Selection: …

Autologous Blood And Platelet-Rich Plasma Injections In The Treatment Of Achilles Tendinopathy: A Critically Appraised Topic, Cori Sinnott, Hayley M. White, Jennifer W. Cuchna, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Achilles tendinopathy is a painful condition commonly affecting the general and athletic population. It presents with localized pain, stiffness, and swelling in the midportion of the Achilles tendon. The physical stress placed on the tendon results in microtrauma, which leads to subsequent inflammation and degeneration. While it is not surprising that this condition affects the physically active, nearly one-third of Achilles tendinopathy cases occur in sedentary individuals. Etiology for this condition stems from a change in loading patterns and/or overuse of the tendon, resulting in microscopic tearing and degenerative changes. There are numerous causes contributing to the …

The Ability Of The Landing Error Scoring System To Detect Changes In Landing Mechanics: A Critically Appraised Topic, Claire E. Pointer, Tyler D. Reems, Emily M. Hartley, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Question: Is there evidence to suggest that the Landing Error Scoring System (LESS) is able to detect functional changes in landing mechanics in healthy individuals after participation in an injury prevention program (IPP)? Clinical Bottom Line: In a healthy, physically active population, there is strong evidence to support the use of the LESS as an outcome measure for changes in landing mechanics after the implementation of IPPs. Clinicians should consider the LESS as an evaluative tool for measuring the efficacy of IPPs in clinical practice.

Sagittal Plane Gait Kinematics In Individuals With Chronic Ankle Instability, Matthew C. Hoch, David R. Mullineaux, Kyoungkyu Jeon, Patrick O. Mckeon

Rehabilitation Sciences Faculty Publications

Single joint kinematic alterations have been identified during gait in those with chronic ankle instability (CAI). The purpose of this study was to compare sagittal plane hip, knee, and ankle kinematics during walking in participants with and without CAI. Twelve individuals with CAI and 12 healthy individuals walked on a treadmill at 1.5 m/s. Three-dimensional kinematics were analyzed using mean ensemble curves and independent t tests. Participants with CAI demonstrated less lower extremity flexion during the absorption phase of stance and the limb placement phase of swing, which may have implications for limb placement at initial contact.

Health-Related Quality Of Life In Athletes: A Systematic Review With Meta-Analysis, Megan N. Houston, Matthew C. Hoch, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted.

Study Selection: …

Patient-Reported Outcomes In Male And Female Collegiate Soccer Players During An Athletic Season, Johanna M. Hoch, Beth Druvenga, Brittany A. Ferguson, Megan N. Houston, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Clinicians are urged to document patient-based outcomes during rehabilitation to measure health-related quality of life (HRQOL) from the patient's perspective. It is unclear how scores on patient-reported outcome instruments (PROs) vary over the course of an athletic season because of normal athletic participation.

Objective: Our primary purpose was to evaluate the effect of administration time point on HRQOL during an athletic season. Secondary purposes were to determine test-retest reliability and minimal detectable change scores of 3 PROs commonly used in clinical practice and if a relationship exists between generic and region-specific outcome instruments.

Design: Cross-sectional study.

Setting: Athletic facility. …

Patient-Reported Outcome Measures In Individuals With Chronic Ankle Instability: A Systematic Review, Megan N. Houston, Johanna M. Hoch, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: A comprehensive systematic literature review of the health-related quality-of-life (HRQOL) differences among individuals with chronic ankle instability (CAI), ankle-sprain copers, and healthy control participants has not been conducted. It could provide a better indication of the self-reported deficits that may be present in individuals with CAI.

Objective: To systematically summarize the extent to which HRQOL deficits are present in individuals with CAI.

Data Sources: We searched for articles in the electronic databases of EBSCO Host and PubMed Central using key words chronic, functional, mechanical, coper, instability, sprains, and patient-assessed. We also performed a hand search of reference lists, authors, …