Musculoskeletal System Commons^™

Rebound Bursting Selectively Enables Fast Dynamics In Dopamine Midbrain Neurons Projecting To The Dorsolateral Striatum, Strahinja Stojanovic, Christopher J. Knowlton, Richard Egger-Mackrodt, Johanna Mankel, Josef Shin, Stephan Lammel, Carmen C. Canavier, Jochen Roeper

School of Graduate Studies Faculty Publications

Dopamine (DA) midbrain neurons are involved in a wide array of key brain functions including movement control and reward-based learning. They are also critical for major brain disorders such as Parkinson's disease or schizophrenia. DA neurons projecting to distinct striatal territories are diverse with regard to their molecular makeup and cellular physiology, which are likely to contribute to the observed differences in temporal DA dynamics. Among these regions, the dorsolateral striatum (DLS) displays the fastest DA dynamics, which might control the moment-to-moment vigor and variability of voluntary movements. However, the underlying mechanisms for these DLS-specific fast DA fluctuations are unresolved. …

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 …

Corticobasal Syndrome With Mixed Pathology In The Absence Of Grn Mutation: A Clinico-Pathological Case Of Ftld-Tdp With Coexisting Alzheimer’S And Lewy Body Pathology, Hugo Zamarron, David Irwin, Jeffery Phillips, Edward Lee, Matthew Tisdall, Corey Mcmillan

Research Colloquium

Background: Corticobasal syndrome (CBS) is a neurodegenerative disorder characterized by often asymmetric fronto-pariteal and extra-pyramidal features that is traditionally associated with tauopathy, but pathological findings are heterogenous, including other forms of frontotemporal lobar degeneration (FTLD) and mixed pathologies of aging. We present clinical, radiographic, and histopathologic features of asymmetry in a unique patient with CBS and underlying FTLD with TDP-43 pathology (FTLD-TDP), co-occurring with other age-related pathologies.

Case Presentation: A 76-year-old man presented with progressive cognitive and motor dysfunction including asymmetric parkinsonism, left-sided dystonia and rigidity, apraxia, visuospatial impairment, and a subtle social disorder including apathy and social withdrawal. The …

Systematic Review And Meta-Analysis Examining If Hyperplasia Occurs In Humans In Response To Resistance Exercise, Hitesh Gowda, Scott Dankel, Harshal Parmar, Nicholas Barton

Rowan-Virtua Research Day

Background: It is commonly believed that resistance exercise in humans induces muscle growth primarily via muscle hypertrophy, but there is some debate as to whether muscle hyperplasia occurs. The purpose of this meta-analysis was to quantitively assess whether the presence of muscle hyperplasia occurs in humans performing resistance training.

Methods: Medline, Scopus, and Web of Science were searched on May 17, 2024. Studies that assessed muscle fiber number pre and post resistance training were included in a three-level random effects model to assess changes in muscle fiber number.

Results: A total of 11 studies met the search criteria, with all …

Assessing Sleep Quality In A Preclinical Model Of Low Back Pain Through Novel Noninvasive Methods, Lydia C. Saltz

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Chronic low back pain (LBP) has widespread negative impacts on quality of life. Current treatments for chronic LBP fail to provide long-term efficacy and motivate the need to understand key drivers of poor patient outcomes. Mounting evidence indicates that sleep disturbances and chronic LBP have a strong reciprocal relationship. Women may be particularly vulnerable to the negative impacts of the sleep-pain axis, exhibiting greater prevalence in both conditions. However, the relationship between sleep, pain, and sex remains understudied. Preclinical models can be used to parse out characteristic sleep features that degrade with pain, which can be further broken out by …

Forearm Muscle Alterations During Maximal Voluntary Isometric Contraction, Jacob Hutchison, Mark Timmons, Brandon Jones

Appalachian Student Healthcare Research Review

Background: This study evaluated the relationship between grip strength and forearm skeletal muscle architecture during maximal grip contractions. Grip strength is a gauge for many different health related attributes, yet research on muscle architecture has been primarily completed in lower limb studies. This study aims to develop a better understanding of how biomechanical architecture of muscle operates to produce force during maximal isometric contractions of the forearms.

Methods: Sixteen individuals participated in this investigation (12 males, 4 females, mean age: 20.6 ± 2.5 years, mean height: 177.8 ± 8.3cm, mean weight: 79.2 ± 17.6Kg). Participants tested grip strength by performing …

A Hypoxia Research-Driven Path Led To Identifying Neuroprotection Mediators: An Interview With Dr. Nicolas G. Bazan, Nicolas G. Bazan

School of Medicine Faculty Publications

No abstract provided.

Triangular Fibrocartilage Complex: An Anatomical And Medical Illustration Study., Hallie Tiburzi, Carlos A G Machado, Massimo S D'Antoni, R Shane Tubbs

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Recent advances in small-joint arthroscopy and cutting-edge magnetic resonance imaging systems have enabled orthopedic surgeons to perform more complex repairs of the wrist. Such repairs can include those of the triangular fibrocartilage complex (TFCC) of the wrist that necessitates a reappraisal of its morphometry with special emphasis on the relationship between its articular disc (AD) and surrounding tissues. The TFCC AD is a fibrocartilaginous, biconcave structure located between the ulnar styloid process and the carpal bones of the wrist. We carefully dissected and measured the ADs of 58 wrists from 34 embalmed cadavers (20 females, 14 males) and fabricated three-dimensional …

Using Ai-Generated Scenarios To Enhance Learning Of The Emergency Assessment Process, D Cobble, L Schroeder, J Vaughn, S Ford

Clinical Practice in Athletic Training

Introduction: Rigorous accreditation standards require students to demonstrate competency in various clinical proficiencies through clinical practice or simulation-based educational activities. Therefore, simulation has become an integral component of athletic training education, as scenarios can provide realistic and reproducible experiences for all students. To that end, our study had two primary objectives: investigate the ability of artificial intelligence (AI) to generate accurate and realistic athletic training simulation scenarios and evaluate AI's effectiveness in teaching and reinforcing the emergency assessment process through student-created scenarios. Methods: Phase one, AI developed three different scenarios for patients experiencing (1) an ovarian cyst, (2) a hypoglycemic …

Prevalence, Perceptions, And Attitudes Of Accommodation For Students With Disabilities In Athletic Training Education Programs, T J. Babcock, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Disability accommodation has been widely researched in healthcare education programs, including medical doctor (MD), doctor of osteopathy (DO), and physical therapy (PT). However, little research has been conducted on classroom and clinical education accommodation in athletic training education. The purpose of this study was to explore these settings and gain an understanding of student experiences with accommodation in athletic training education programs. This project was deemed exempt by Indiana State University’s Institutional Review Board. Methods: A cross-sectional 24-question survey was developed and adapted from prior qualitative research on accommodation in physical therapy education. Emails containing a link to the …

Clinat: In Service To Athletic Training Scholarship, Lindsey Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

To be of service to others means to help others without expecting anything in return. The ClinAT, or Clinical Practice in Athletic Training journal, is an online, open-access outlet for the dissemination of practice-based research in health care, and a donation of time, effort, and energy to the profession of athletic training. In 2018, when Indiana State University created its first issue of ClinAT, we were a faculty of 3 with 5 PhD students supporting the journal, one of whom was wholly dedicated to the effort. As the higher education landscape has changed, and the roles and responsibilities of our …

Barriers To The Implementation Of The Amsterdam 2022 Statement In The Secondary School Setting, L Torres, J L. Baldari, F A. Gardin, A M. Price

Clinical Practice in Athletic Training

Introduction: The Amsterdam 2022 International Consensus Statement on Concussion in Sport provides a summary of contemporary best practice recommendations for healthcare providers who are involved in the care of athletes at risk of sport-related concussion (SRC). Given that athletic trainers (ATs) have a professional responsibility to continually educate themselves on topics of great importance to the population that they care for, such as SRC management, it is reasonable to expect them to evolve their concussion management protocols to better align themselves with the recommendations found this statement. The purpose of this study was to identify the barriers associated with the …

Exploring The Vitality Of Athletic Training: Insights Into Professional Identity, Commitment, And Retention, L E. Eberman, M J. Rivera, K E. Games, M J. Drescher, J P. Young, J Clifton-Gaw, K Condrey, H Mccarn, N Mondelli, X Yuan

Clinical Practice in Athletic Training

Introduction: The confluence of fluctuating retention, fewer students entering professional programs, and the profession’s identity crisis (conflict between being a sports profession or a health profession) has created a serious question about the vitality of the athletic profession. However, research on the vitality of the profession has often focused on singular variables influencing professional identity, burnout, and commitment. The purpose of this project was to explore multiple factors influencing the vitality of the profession across professional identity and commitment in athletic training. Methods: We used a convergent parallel mixed-methods design, including surveys and interviews with athletic training students and athletic …

Escape From Diabetes, J E. Jochum, J Carmack, J Toon

Clinical Practice in Athletic Training

Introduction: In the past decade, interprofessional education (IPE) to promote interprofessional collaborative practice has become an integral component of pre-licensure education in the health professions. Research shows that IPE activities involving problem-solving in patient care that requires cooperation and communication among the professions is most effective. An effective activity to meet interprofessional competencies is the use of escape rooms. Escape rooms are team-based games where groups of individuals solve puzzles to accomplish a specific goal, typically in a limited amount of time. There are many benefits to using escape rooms in education, including promoting problem-solving, teamwork, and creativity, improving focus …

Athletic Trainer Compensation Characteristics, J P. Young, K Ef Mair, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Athletic trainers (ATs) are integral to healthcare yet face ongoing challenges that affect job satisfaction and retention. Factors such as long work hours, low pay, and work-family conflict contribute to dissatisfaction and a desire to leave the profession. Salary disparities and lack of administrative support are key factors impacting professional fulfillment and career longevity. Identifying how compensation influences job satisfaction is essential for improving retention and advancing the profession. Our study aimed to examine the compensation characteristics of ATs and determine the key factors that predict gross income. Methods: A cross-sectional, web-based survey was conducted. The survey was validated …

Preceptor Development: Identifying The Best Modality For Building Clinical Educators, G W. Cohen, R M. Lopez, A J. Tritsch

Clinical Practice in Athletic Training

Introduction: Preceptor training and development are not standardized within the athletic training profession. The Commission on Accreditation of Athletic Training Education (CAATE) requires that Athletic Training Programs provide an ongoing education plan for preceptors to promote a constructive learning environment for students. However, with the rapid expansion of clinical education opportunities outside of institutions' immediate area, programs must identify how to reach all their preceptors and uphold their programmatic expectations for clinical educators. Methods: The investigators conducted a cohort pre-test-post-test design study. A preceptor development program (PDP) was created and grounded in the theory of gamified learning and adult learning …

The Financial Stresses That Affect Athletic Training Students: A Qualitative Investigation, C Kuehner-Boyer, E León Zaragoza

Clinical Practice in Athletic Training

Introduction: A recent survey examining barriers that affect athletic training students found that financial-related barriers created significant stress for students in professional athletic training programs. The need to work while attending a professional athletic training program was the highest reported barrier with 54.82% of respondents indicating that this was a barrier for them during their program. Beyond the overall reporting rate, the need to work while completing a professional athletic training program was indicated by athletic training students to be the barrier that they encountered the most frequently with respondents reporting that this was a stress for them between monthly …

Musculoskeletal Tumors Disguised As Orthopedic Injuries: A Case Report, A Summers

Clinical Practice in Athletic Training

Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: …

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

Adolescent Femoral Neck Fractures: A Case Study On Initial Surgical Intervention, Avascular Necrosis Development, And Subsequent Total Hip Arthroplasty, K A. Fisher

Clinical Practice in Athletic Training

Background: The patient sustained a femoral neck fracture at the age of 13 after slipping and falling in his home. He was seen in the Emergency Department the same day and underwent a closed reduction and percutaneous pinning procedure the following morning. Ten weeks after returning to full weightbearing, and 13.5 weeks after his initial fracture, he developed stress fractures of the medial distal femoral and proximal tibial metaphyses. He experienced gradual worsening of hip pain and difficulty with ambulation between 11 to 13 months post-closed reduction and percutaneous pinning (CRPP). Avascular necrosis and collapse of the femoral head was …