Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Motivations Behind The Rise And Success Of Homeopathy In India, Kavya Patchipulusu

Senior Theses

Homeopathy is a form of medicine that is incredibly controversial and is often labeled as a fraudulent, placebo effect drug, that can have potentially dangerous side effects. This is the picture that is painted of homeopathy in the United States and many other countries in which these medicines are banned in distribution or highly unregulated. In contrast, India has popularized and well-integrated homeopathy into their medical systems with government backing and consistent funding towards accredited homeopathic institutions and funding hospital systems. This paper will explore the circumstances and health care dynamics of India that allowed homeopathy to gain the level …

A Comparison Of Health Outcomes In Bare-Metal Stenting Versus Drug-Eluting Stenting, Ryan Hill

Senior Theses

Coronary artery disease (CAD) is an epidemic in the United States and around the world, with millions falling victim to CAD and other forms of heart disease annually. There are both many causes and many treatments to these aforementioned heart diseases. Some of these causes and comorbidities include the usual suspects: obesity, diabetes and smoking. However, the component I am more interested in is the multitude of different procedures and technologies that can serve to treat cases of CAD.

The inspiration for choosing the topic of CAD treatment for my senior thesis derives from my interest in the field of …

Burnout In Athletic Training: Measured By Survey In Most Common Settings For Athletic Trainers, R Johnson Krug, N Sand, S Brooks, T Smith

Clinical Practice in Athletic Training

Introduction: Burnout is a common problem in athletic training, affecting both athletic trainers (ATs) and the athletes they serve. Athletic trainers are responsible for the prevention, diagnosis, and treatment of sports-related injuries. Long work hours, often including evenings and weekends, as well as frequently under pressure to meet the demands of athletes, coaches, and parents. Athletic trainers face numerous stressors that contribute to burnout. These stressors may include heavy workloads, lack of control over their schedules, time pressures, and pressure to produce positive outcomes. Athletic trainers may also experience emotional and physical exhaustion, depersonalization, and a reduced sense of personal …

Athletic Trainers’ Familiarity With Potential Concussion Biomarkers: A Descriptive Study, T R. Campbell, B J. Davis, J C. Martinez, J M. Cavallario

Clinical Practice in Athletic Training

Introduction: An estimated 3.8 million individuals sustain a concussion annually in the United States. Despite the high number of cases, this number may not accurately depict the true incidence rate due to underreporting of symptoms by patients. With current concussion tools relying heavily on subjective input from patients, it is imperative that a valid and reliable objective tool, such as a clinical biomarker, is identified to improve concussion diagnosis and management. If such a biomarker is identified, it will be essential that athletic trainers (ATs) be familiar with how biomarkers could be used. The purpose of this study was to …

Accuracy Of Therapeutic Drug Monitoring In Vancomycin And The Pharmacist Role: A Retrospective Case-Series, Kateryna Parkhomenko

Senior Theses

Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods …

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

A Case Study On Treatment Of Subcoracoid Impingement In An Overhead Athlete With Manual Therapy, M Mennell

Clinical Practice in Athletic Training

Introduction: Subcoracoid impingement of the shoulder is a condition that occurs when the tendons or soft tissues in the shoulder are compressed or pinched between the coracoid process and the humeral head. It is also suspected that subcoracoid impingement can occur when the humerus translates anteriorly, decreasing the subcoracoid space. This impingement can cause pain, inflammation, and limited mobility in the shoulder joint. All kinds of impingement are typically multifactorial, and have several areas that need to be addressed. The purpose of this case report is to examine the effects of therapeutic exercise as well as manual therapy on subcoracoid …

Slowing It Down: The Impact Of A Core Stabilization Program Of Hypermobile Sprinters, T Spears, J Gonzalez-Pons, J Debose

Clinical Practice in Athletic Training

Background: Low back pain (LBP) is a common complaint in sprinters, and it can present itself in many ways. One study published in 2019 surveyed 2539 runners; 22.6% of them reported LBP of some kind at least once within that year.5 LBP can occur in sprinters for many reasons. One study noted that muscle weakness, imbalance, and improper recruitment of hip and/or core musculature are a few sources of LBP in athletes.4 The aim of this study is to examine the effectiveness of a core stabilization program on athletes suffering from lumbar facet hypermobility. Differential Diagnosis: Conditions that are typically …

Low Ferritin Count In Female Collegiate Soccer Player Presents As Concussion, E N. Nelson, T D. Pitcock, M K. Knoblauch, L J. Harrison

Clinical Practice in Athletic Training

Background: Women’s soccer leads the National Collegiate Athletic Association for having the highest number of concussions in female sports. Common symptoms of concussion can include light headedness, headaches, and dizziness, but these symptoms are not exclusive to concussions. Female athletes may experience nutritional deficits that can lead to a wide range of symptoms mimicking those commonly experienced with a concussion such as headaches, dizziness, and fatigue. The patient in this case is a 21- year-old female soccer athlete who presented with sensitivity to light, light headedness, nausea, and fatigue after experiencing repeated ‘headers’ as well as a collision during a …

The Validity And Reliability Of Assessments Through Telemedicine: An Evidence-To-Practice Review, Connor L. Givens, Gabrielle A. Griffin, Matthew D. Johnson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The validity and reliability of telemedicine assessments has been explored through numerous studies. Telemedicine is a diagnostic tool that combines visual technology, audio technology, and tools for assessment. The assessment of musculoskeletal disorders is a key portion in the field of athletic training. The development of telemedicine assessment tools has improved over time but has not yet been perfected. Data was collected via four databases that included articles examining validity, inter- and intra- rater reliability, and telemedicine assessment for musculoskeletal tests. The reviews of the systematic review used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and quality appraisal tool for …

Return-To-Tennis Considerations And An Elusive Diagnosis For A Cuboid Avulsion Fracture: A Disablement Model Case Study, Grant G. Yee, Zachary K. Winkelmann, Zoe J. Foster

Clinical Practice in Athletic Training

This disablement-model case study is focused on a 23-year-old NCAA Division I men’s tennis player that sustained an injury in a competitive singles tennis match. Upon initial examination, the athletic trainer diagnosed the individual with an anterior talofibular ligament sprain and treated conservatively. The patient experienced significant disruptions to his activities of daily living due to his difficulties with ambulation during the early stages of his recovery. Interestingly, the patient was eventually diagnosed with a cuboid avulsion fracture. Midfoot fractures are uncommonly experienced in the general population, and are particularly uncommon in tennis athletes, making them difficult to recognize. Clinical …

Review Of Diagnostic Accuracy Of The Ottawa Knee Rules In Adult Acute Knee Injuries, Sean L. Glover, Amy M. Loveless, Sara A. Posson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Acute knee injuries are commonly found in athletic populations. The wide range of knee injuries can present a challenge deciding which injuries require imaging. Currently, radiography is considered the gold standard of imaging for knee fractures. However, imaging is often costly not only for the patient, but also for the healthcare system. Since imaging is expensive, it is critical that clinicians decipher which patients require such testing. The Ottawa Knee Rules (OKR) is a predictor tool created by Stiell et al in 1995 to help clinicians accurately distinguish potential knee fractures from non-fractures for imaging purposes. The OKR guidelines state …

Superficial Peroneal Nerve Entrapment In Female Collegiate Tennis Athlete: A Disablement Model Case Study, Sarah Branning, Neeru Jayanthi, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 19-year-old female, NCAA Division I collegiate tennis player presented with a burning and aching sensation halfway up the lateral portion of her right calf following an extensive period spent in a squatting position. This discomfort began distal to the fibular head, then ran along her lateral calf, reached into her ankle, and wrapped behind the lateral malleolus. Initially, the patient only noticed this discomfort during long durations of physical activity. However, she began to report symptoms with activities of daily living (ADLs) and following workouts. The patient first received a working diagnosis of a stress reaction along the mid …

Effects Of Social Determinants Of Health And Diabetes On A Lower Extremity Workplace Injury: A Disablement Model Case Study, Bridget L. Davidson, Richelle M. Williams, Sean M. Rogers

Clinical Practice in Athletic Training

This clinical case study involves a 36-year-old male patient who injured his right lower leg while working in the kitchen at a county correctional institution. The mechanism of injury involved the patient getting his foot caught under a wooden pallet, losing his balance, and then catching himself on his right leg in a twisting motion. The injury led to the patient seeking care in the emergency department and was diagnosed with a nonspecific strain of the right triceps surae muscle group. Upon discharge, the patient was referred to outpatient athletic training services within the hospital system. Follow-up care provided by …

University Football Player With Hoffa’S Fat Pad Syndrome: A Disablement Model Case Study, Kaitlyn Jones, Kristy Dao, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 23-year-old university football player presented with acute onset anterior knee pain with no distinct mechanism of injury. The pain began soon after the start of fall football camp and prevented the patient from participating in team activities, including weights and practices. Along with pain, the patient experienced edema, decreased knee flexion range of motion, and an antalgic gait. The findings of the evaluation of this patient were consistent with Hoffa’s fat pad syndrome, an inflammatory and impingement condition of the infrapatellar fat pad that is often a rare diagnosis of exclusion. Conservative treatment was used for this patient, which …

The Effects Of Dry Cupping Therapy On Touch Pressure Threshold In Collegiate Baseball Players., S A. Cage, R L. Peebles, J D. Volpi, L E. Trail, B J. Warner

Clinical Practice in Athletic Training

Introduction: Cupping therapy is a therapeutic modality that uses negative pressures to achieve therapeutic benefits. Various published studies report that cupping therapy decreases pain, increases range of motion, and improves blood flow. Previous studies also report an effect on tissue tenderness. However, there do not appear to be any studies assessing the effects of cupping therapy on touch pressure threshold, which measures skin sensitivity. Changes in touch pressure threshold may provide more information on the neurological effect cupping therapy has on treated tissues. The purpose of this study was to compare the effects of cupping therapy on touch pressure threshold …

Acute Management Of An Abdominal Cavity Perforation In A Collegiate Baseball Pitcher: A Case Report., D M. Gallegos, A P. Jacobsen, R M. Galbraith, R L. Peebles, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player was performing warm up exercises when he tripped backwards onto one of the team’s pitching machines that had been laid on its side. Upon falling backward, the patient sustained a puncture wound through the left buttock from one of the machine’s handles. Unaware of the injury, the patient’s teammates lifted him off of the machine and retrieved the athletic trainer. Evaluation revealed a deep wound with visible adipose tissue and musculature. At this time, the patient was immediately transported to the emergency department of the local hospital, and team physicians were informed to …

Twelfth Rib Avulsion Fracture In A Collegiate Baseball Pitcher: A Case Report., L K. Warner, A P. Jacobsen, R M. Galbraith, C Hodges, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player reported to the athletic training staff after experiencing acute pain in his left side following throwing a pitch. The patient experienced immediate difficulty with active lateral flexion and trunk rotation. Palpation revealed spasm and tenderness along the internal and external oblique muscle. The patient reported having subluxed a rib on a previous occasion. While the pain experienced was similar, the patient stated that there was more pain along the muscle bellies of the internal and external oblique muscles compared to the previous injury. No difficulties with breathing, bowel movements, or urination were reported. …

The Diagnosis, Rehabilitation, And Treatment Of Posterior Impingement In A High School Baseball Pitcher, K Tisdale

Clinical Practice in Athletic Training

Introduction: Posterior impingement, also known as internal impingement, is a type of secondary impingement that is caused by overuse and repetitive movements of the shoulder overhead during motions such as throwing, spiking, etc. A combination of shoulder abduction and external rotation produces impingement of the infraspinatus and/or of the supraspinatus against the posterior-superior glenoid. Posterior impingement is common in overhead athletes, and this mechanism is usually seen during the cocking phase of throwing. Someone suffering from posterior impingement may complain of posterior shoulder pain, posterior stiffness and decline in performance. Patient Information: In this case study, a 15- year-old male …

The Impact Of Bracing On Kinesiophobia And Recovery In Acl Reconstruction Patients: A Case Study, N Valdecanas, K Neelon, K Braunreiter

Clinical Practice in Athletic Training

Introduction: With 100,000 to 200,000 cases reported in the U.S. yearly, the anterior cruciate ligament (ACL) is a commonly torn structure in the knee among contact and non-contact sports. As medical research on ACL injuries grows, ACL reconstruction (ACLR) continues to be the preferred surgical intervention. Due to extensive rehabilitation timeline requirements, ACLR patients may face physical and psychosocial circumstances affecting their overall recovery. At any point in rehabilitation the patient may experience kinesiophobia, or an irrational fear relating to further injury from participation in physical movement, especially with return to running, jumping, and sports-specific programs. Functional bracing has been …

Use Of Blood Flow Restriction Training With A Collegiate Baseball Player Following Hook Of The Hamate Excision, J P. Goza, R M. Galbraith, A P. Jacobsen, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player underwent successful excision of the hook of hamate of the left hand. Following two weeks in a padded splint to allow for appropriate scar healing, the patient’s sutures were removed and rehabilitation was initiated. Initial rehabilitation consisted of passive range of motion exercises progressing to active range of motion exercises. After one week of range of motion exercises and improvement of range of motion, resistance training with blood flow restriction was initiated. Differential Diagnosis: Hook of the hamate excision. Treatment: Week 3: Prior to beginning resistance training with blood flow restriction, grip strength …

Hook Of The Hamate Fracture In A Collegiate Baseball Player Preceded By A Hamate Stress Fracture, H N. Parker, R M. Galbraith, A P. Jacobsen, C Hodges, B J. Warner, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old male collegiate baseball player reported to the athletic training staff complaining of pain along the hypothenar eminence of the left hand. The patient’s pain was intensified when swinging a bat but remained constant even at rest. The patient reported symptoms beginning approximately three weeks prior to being evaluated by the athletic training staff, but delaying reporting symptoms in order to continue playing. Physical exam revealed tenderness over the hook of the hamate and hypothenar eminence, decreased active wrist extension, decreased grip strength, and pain with resisted pronation and supination. At this time, the patient was removed from …

A Case Report Of The Evaluation And Management Of Low Back Pain In A High School Basketball Player, K Leveston, K Neelon, E Ephran

Clinical Practice in Athletic Training

Background: Low back pain can be a tough injury to endure, especially in the growing high school athlete.3 LBP in a high school athlete can be caused by various factors, such as structural deformities, mobility deficits, and so much more. The majority of LBP in adolescents is nonspecific LBP, which is defined as LBP that does not cause systemic or structural changes.5 Nonspecific LBP is often a result of other etiologies such as hypermobile or hypomobile segments of the spine, hip mobility deficits, gait, sleeping positions, or improper weightlifting form. Differential Diagnoses: Other possible diagnoses of LBP in adolescents could …

Figure-8-Reconstruction Of Posterior Sternoclavicular Joint Dislocation 18 Days Post Initial Injury, M Suri, S Bunemann

Clinical Practice in Athletic Training

Introduction: Traumatic sternoclavicular joint injuries account for less than 3% of all traumatic joint injuries1. Although rare, posterior dislocation of the sternoclavicular joint has the potential to be life-threatening due to the proximity of vital structures posterior to the manubrium. This injury typically requires a high-energy force applied through the joint2. SC dislocations become increasingly difficult to reduce after 24 hours, so timely diagnosis and treatment are important. Glass et al. found mediastinal compression occurred 30% of the time with posterior dislocations. If left untreated, prolonged pressure on the superior mediastinum can cause erosion of the great vessels, tracheoesophageal fistula, …

Comparison Of The Closed Shoulder Reduction Techniques: An Evidence-To-Practice Review, Kaitlin Sznajder, Dylan Arango, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The shoulder joint is one of the most dislocated joints in the body. It does not have substantial bony support which allows for a large range of motion. Shoulder joints most commonly dislocate anteriorly, and less often dislocate posteriorly and inferiorly. There is a myriad of ways to reduce a shoulder dislocation including closed and open techniques. The purpose of this evidence-to-practice review is to summarize which closed shoulder reduction techniques are most effective and apply those results to an athletic training setting. The authors of this guiding systematic review studied multiple articles that compared different closed shoulder reduction techniques …

Validity Of Selective Tissue Tests For Knee Pathologies: An Evidence-To-Practice Review, Stephanie P. Ulshafer, Samara D. Johnson, Kevin N. Schoell, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The knee is the most commonly injured joint in sport, inherently meaning the knee is also the joint most frequently evaluated by healthcare providers. Clinicians evaluate and treat the knee as efficiently as possible to prevent long-term disability of the patient. Clinicians rely on physical examination tests such as McMurray’s Test, Apley’s Test, Joint Line Tenderness, Lachman Test, Anterior Drawer, Pivot Shift Test, and the Ottawa Knee Rules for initial diagnosis and initiation of care. These physical examination tests have varying levels of diagnostic accuracy and validity. Clinicians should know how definite they can be about a diagnosis from physical …

Body Tempering And Its Effect On Ankle Dorsiflexion And Power, Neal Ori, Justin Goins, Jay Patel, Robbie Ingle

Clinical Practice in Athletic Training

Body Tempering (BT) is a newer myofascial release (MFR) technique that is used by athletes and healthcare professionals. The effects of BT are stated to be similar to foam rolling (FR) and other MFR techniques, but there is minimal research assessing the effects of BT on power and range of motion (ROM). The purpose of this study was to determine the effect of BT on ankle dorsiflexion ROM and power, as well as to compare the effects of BT to traditional FR. Twenty college-aged participants (10 males-10 females) were tested before and after intervention on three measurements of the broad …

Anisocoria As The Sole Initial Symptom Of Concussion In A Collegiate Volleyball Player: A Case Report, I Hopper, B J. Warner, M Mckenney, R M. Galbraith, C Cox, S A. Cage

Clinical Practice in Athletic Training

Background: A 21-year-old female collegiate volleyball player reported to the athletic training staff after a competition upon noticing that her pupils were unequal. The patient stated that she was not experiencing any other signs or symptoms that would indicate a concussion, but did recall striking her head on the court during pre-competition warmups. The patient reported no previous history of concussion or eye injury. Further evaluation did not reveal any issues with the patient’s reflexes, balance, or memory. At this time, the decision was made to preemptively withhold the patient from participating in athletic activities so she could be monitored …

Concussion Profiles: Moving Beyond The Graded Symptom Scale, Tamara Valovich Mcleod, Brian Vesci

Clinical Practice in Athletic Training

No abstract provided.

Conservative Care Of A Patient With Initial Anterior Shoulder Dislocation Participating In An Intercollegiate Basketball: A Disablement Model Case Study, Lucas Bianco

Clinical Practice in Athletic Training

A 23-year-old male patient participating in intercollegiate basketball, suffered an acute shoulder dislocation. The patient was diagnosed with an anterior glenohumeral labral tear and was treated with an indirect approach to increase range of motion (ROM) and function while decreasing pain. Patient-related outcome (PRO) measures were used along with clinician related outcome (CRO) measures to discharge the patient. The immediate changes in ROM and pain along with follow-up assessments of the Disabilities of the Arm, Shoulder, Hand (DASH) Scale achieved Minimal Clinically Importance Difference (MCID) levels. As rehabilitation specialists, athletic trainers have the opportunity to provide quality care to patients …