Physiological Processes Commons^™

Interdisciplinary Approach To Management Of An L4/L5 Disc Herniation In A Collegiate Football Player: A Type 3 Case Study, Cc Janush, A Meriwether, M Tillman

Clinical Practice in Athletic Training

Background: The rate for low back injuries in collegiate football players has been reported as 2.70 per 10,000 athlete exposures with lumbar disc herniations (LDH) accounting for roughly 8% of these injuries. In athletic populations, the decision of surgical versus conservative management for LDH can present a unique challenge to the clinician and patient given an patient’s concern for return to play with minimal time loss. This type 3 CASE study will discuss the non-operative management of an L4/L5 disc herniation in a collegiate football player and highlight the interdisciplinary team approach that allowed the athlete to play an entire …

Measuring Psychological Readiness With The Shoulder Instability-Return To Sport After Injury Scale In Athletes With Traumatic Shoulder Dislocations: A Critically Appraised Topic, Ha Arnett, K Moore, Zk Winkelmann, H Miller

Clinical Practice in Athletic Training

Focused Clinical Question: How can using the Shoulder Return to Sport after Injury (SI-RSI) scale to measure mental readiness in athletes after a shoulder injury improve return-to-play protocol? Data Sources: In September 2023, a computerized search of PubMed for evidence was completed. The search terms were fear of reinjury or psychological readiness, kinesiophobia, confidence, and return to play or return to sport, or RTP. The search was limited to studies published between 2018 and 2023. Study Selection: The inclusion criteria consisted of studies that used the SI-RSI to measure fear during return to play and shoulder injuries that required surgery. …

Mole Or Melanoma: Knowing Your Abcde’S May Save Your Life!, Jh Knaul

Clinical Practice in Athletic Training

Background: Skin cancer is the most common type of cancer in the United States. One in five Americans will be diagnosed with skin cancer in their lifetime, or about 9500/day. Research indicates that nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), affects more than 3 million Americans a year. More than 1 million Americans are living with Melanoma, nearly 200,000 cases of melanoma were diagnosed in 2022 with about 98,000 being invasive and 100,000 being non-invasive (in situ). The average age of diagnosis is 65. Melanoma rates in the US have been rising rapidly …

Myositis Ossificans In A Female Sprinter With The Sickle Cell Trait, Rl Quintana, M Menjivar

Clinical Practice in Athletic Training

Background: Sickle cell trait (SCT) is associated with an increase in muscle breakdown after strenuous exercise due to improper blood flow to active muscles. Evidence suggests that individuals with SCT can increase muscle breakdown during exercise by as much as 54%. This case outlines a 21-year-old African collegiate sprinter with SCT who reported feeling a “pop” in her right hamstring that caused her to stop running mid-race. She reported that no pain was associated with the “pop” but was scared by the sensation. Evaluations of strength and range of motion were all unremarkable and there were no palpable deformities. She …

Non-Operative Management Of Distal And Proximal Interphalangeal Fractures Without Excessive Sport Removal, Og Newhouse, J Johnson

Clinical Practice in Athletic Training

Background: Intra-articular fracturs of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints occur primarily from impacted shear force. With continued participation, fractures have a high possibility of nonunion or malunion. While accounting for patients’ requests may not always be possible, extreme modification of activity may permit their requests. Patient: The patient is a college-aged female volleyball athlete who plays in the front row. The initial report showed a fracture of the right fifth phalange from incomplete range of motion (ROM), swelling, and bruising after an impacted shear force was placed on her finger from a block. She was referred …

Orientation Using Standardized Patients Increases Athletic Training Student Communication Effectiveness When Transitioning To Clinical Education Experiences, Jl Frye, Ma Belbey, Kj Armstrong

Clinical Practice in Athletic Training

Context: Transitioning from didactic to clinical education is overwhelming for novice athletic training students. The change in the learning environment often causes anxiousness as students get acquainted with the clinical site, preceptor expectations, and demonstrating clinical skills during patient care. Learning to communicate provides additional challenges as students must convey information to their patients, practice active listening, relay patient information to their preceptor, and possibly navigate conflict management. Simulation-based orientations have been effective in other healthcare professions to ease this transition; however, it has not been examined in professional athletic training students. Methods: The study used a convenience sample of …

Platelet-Rich-Plasma Injections Vs. Corticosteroid Injections In The Reduction Of Pain For Patients With Frozen Shoulder: A Critically Appraised Topic, Al Pendleton, Mr Dombrowski, Rj Bonser, Jg Coots

Clinical Practice in Athletic Training

Focused Clinical Question: Is a platelet-rich plasma or a corticosteroid injection better for relieving pain for patients with frozen shoulder pathologies? Data Sources: To identify relevant research papers, Boolean searches were conducted on Google Scholar, CINAHL Ultimate, MEDLINE Ultimate, and SPORTDiscus databases from September 14th through September 25th, 2023. Key terms used were corticosteroid (CS) injection, platelet-rich-plasma (PRP) injection, frozen shoulder, and adhesive capsulitis. Study Selection: The inclusion criteria were: articles published from 2018-2023, Randomized Control Trials comparing PRP and CS injections, and studies that used visual analog scale (VAS). Additionally, each article selected summarized outcome measures in a table. …

Presentation Of Bilateral Acetabular Labral Tears In A Collegiate Women’S Lacrosse Player: A Level 3 Clinical Case Study, W Giannelli, K Herraiz, A Mercer

Clinical Practice in Athletic Training

Background: The hip and groin injury rate in female collegiate lacrosse players has been reported to be 35.06 per 100,000 athlete exposures yet the frequency of acetabular labral tears (ATL) remains unclear. Sports which involve repeated bouts of running in combination with frequent twisting and pivoting motions, have been suggested to have a higher prevalence rate of ALT. This level 3 case study will discuss the unique presentation of bilateral ALTs in a female collegiate lacrosse player. Patient: Patient is a 19-year-old Division I collegiate women’s lacrosse player who first presented with pain in her left hip while at home …

Reliability And Validity Of The Iphone To Measure Hip Internal And External Rotation, Jl Blatz, Nm Cattano

Clinical Practice in Athletic Training

Context: Clinicians use a traditional goniometer or a quick visual estimate to measure range of motion (ROM) in patients, these methods can be time consuming or inaccurate. The purpose of this study is to assess the reliability and validity of the iPhone Measure app to measure hip internal rotation (IR) and external rotation (ER). Methods: 20 participants were recruited; they were physically active and aged 18-28 years old. Hip IR and ER was measured prone with the subject on a table. The measures were taken three times and bilaterally for each, then recorded. The ROM was measured by 2 student …

Single Limb Postural Control Throughout A Collegiate Football Season, L Custer, S Tomasi, J Lima, A Rieland

Clinical Practice in Athletic Training

Context: It is estimated that college football players sustain an average of 3 subconcussive blows to the head per game. Limited research has demonstrated that collegiate football players present with decreased static postural control, as measured using the Balance Error Scoring System, at the end of season compared to baseline. Interestingly, neurocognitive test scores in collegiate football players were not found to differ preseason, midseason and postseason. Authors hypothesized that using neurocognitive tests may not have been sensitive enough to detect the effects of the subconcussive impacts. Force plate data provides valid information of postural control. The purpose of this …

Specific Barriers To Athletic Trainers’ Familiarity With And Attitudes Toward Concussion Biomarkers: A Phenomenological Qualitative Study, Te Mccormick, Jm Allen, Kgs Swindell, Tr Campbell

Clinical Practice in Athletic Training

Context: The diagnosis of concussions is largely reliant on subjective information in conjunction with objective measures that might not be the most valid and/or reliable. There is now new research being performed evaluating the use of biological indicators, or biomarkers in the diagnosis and management of concussion. However, the amount of knowledge about biomarkers among athletic trainers is unknown. Additionally, the barriers preventing ATs from using such biomarkers has yet to be studied. Therefore, the purpose of this study is to examine athletic trainers’ familiarity with and their attitude towards concussion biomarkers, while evaluating specific barriers preventing their use in …

The Analysis Of Ground Kinematics In Tie-Down Ropers, M Watts, A Chelette, J Sandford, K Mata

Clinical Practice in Athletic Training

Context: Tie-down roping, an event in rodeo, occurs when the athlete ropes a calf while on horseback, quickly dismounts from the horse and ties three legs of the calf together. Injuries to the knee and lower body have occurred with athletes in the tie-down roping event. Previous research with college rodeo athletes has shown the knee to be the most frequently injured area of the body. The athlete’s lower body movements during the dismount from the horse may increase the risk of injury to the knee. However, these movements have not been previously studied in the tie-down roping event. The …

The Food Environment Of Female Athletes Attending Historically Black Colleges And Universities: A Qualitative Study On The Dimensions Of Food Access And Nutrition, Na Uriegas, Zk Winkelmann, Dm Emerson

Clinical Practice in Athletic Training

Context: Student-athletes are a subset of college students who face additional stressors related to the demands of their sport and academic workload. The food choices of student-athletes may be influenced by the unique food environment they are in. Further challenges may present for Historically Black Colleges and Universities (HBCUs) student-athletes as their institutions tend to be in low food access areas. We aimed to assess food security and explore the lived experiences of HBCU female student-athletes surrounding their food environment and ability to access food based on the five dimensions of food access: availability, accessibility, affordability, accommodation, and acceptability. Methods: …

Use Of An External Dynamic Arm Stabilizer In A Collegiate Baseball Player With Valgus Extension Overload: A Case Report., Jp Goza, Ap Jacobsen

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 posteromedial aspect of the right elbow. The patient reported a previous history of a grade I ulnar collateral ligament sprain that had been rehabilitated until he was able to return to full pain free activities. The patient could not recall a specific mechanism of injury. Physical examination revealed a loss of terminal elbow extension, and pain along the posteromedial aspect of the elbow. The patient reported no neurological symptoms during or after throwing. Valgus Stress, Milking, and Posterolateral Rotary Drawer tests were …

Weighted Ball Programs And Medial Elbow Injury In Youth Baseball Pitchers, M Sobolewski, K Pritchard

Clinical Practice in Athletic Training

Introduction: Weighted ball programs have been proven to increase pitching velocity, however a combination of poor musculature and body mechanics with increased elbow valgus can heighten the incidence of medial elbow overuse injuries in the youth population. Clinical Question: Can youth baseball pitchers who use weighted ball programs increase their pitching velocity without causing an increased risk of medial elbow injury? Methods: The literature was explored to discover studies that investigated medial elbow injuries using weighted ball programs in youth baseball pitchers. Articles included weighted ball programs as an intervention, kinetics/injury mechanics, youth elbow injuries, and prevention of overuse injuries. …

Different Sensory Information Is Used For State Estimation When Stationary Or Moving., Aaron Wong, Alyssa Eyssalenne, Luke Carter, Amanda S Therrien

Moss-Magee Rehabilitation Papers

The accurate estimation of limb state is necessary for movement planning and execution. While state estimation requires both feedforward and feedback information, we focus here on the latter. Prior literature has shown that integrating visual and proprioceptive feedback improves estimates of static limb position. However, differences in visual and proprioceptive feedback delays suggest that multisensory integration could be disadvantageous when the limb is moving. We formalized this hypothesis by modeling feedback-based state estimation using the long-standing maximum likelihood estimation model of multisensory integration, which we updated to account for sensory delays. Our model predicted that the benefit of multisensory integration …

Effects Of Limosilactobacillus Reuteri Strains Pta-126787 And Pta-126788 On Intestinal Barrier Integrity And Immune Homeostasis In An Alcohol-Induced Leaky Gut Model, Dharanesh Gangaiah, Min Gu, Aline Zaparte, Olaf Will, Laurie C. Dolan, Anthony Goering, Jason Pillai, Shrinivasrao P. Mane, German Plata, Emily B. Helmes, David A. Welsh, Arvind Kumar Mahajan

School of Graduate Studies Faculty Publications

Intestinal barrier is a first line of defense that prevents entry of various harmful substances from the lumen into the systemic environment. Impaired barrier function with consequent translocation of harmful substances into systemic circulation (“leaky gut”) is a central theme in many gastrointestinal, autoimmune, mental, and metabolic diseases. Probiotics have emerged as a promising strategy to maintain intestinal integrity and address “leaky gut”. Using in silico, in vitro and avian in vivo analyses, we previously showed that two novel L. reuteri strains, PTA-126787 (L. reuteri 3630) and PTA-126788 (L. reuteri 3632), isolated from broiler chickens possess favorable safety profiles. Consistent …

Novel Mechanisms For The Neural Control Of Breathing In Acute Lung Injury, Kajal Kamra

Theses & Dissertations

Acute lung injury (ALI) triggers inflammation that disrupts the normal alveolar-capillary endothelial barrier, impairing gas exchange and causing hypoxemia, which reflexively increases respiration. An elevated respiratory rate (fR) usually develops within hours to days following ALI. This acute respiratory failure disorder affects approximately 200,000 new cases annually in the US and accounts for 10% of ICU admissions, with high morbidity and mortality. The neural mechanisms underlying respiratory dysfunction post-ALI are not fully understood. My doctoral dissertation aimed to investigate the mediators of abnormal ventilation during ALI. Systemic hypoxia stimulates the carotid body (CB) chemoreflex, a crucial protective reflex that maintains …

Potential Targeting Mechanisms For Bone-Directed Therapies, Betul Celik, Andrés Leal, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Bone development is characterized by complex regulation mechanisms, including signal transduction and transcription factor-related pathways, glycobiological processes, cellular interactions, transportation mechanisms, and, importantly, chemical formation resulting from hydroxyapatite. Any abnormal regulation in the bone development processes causes skeletal system-related problems. To some extent, the avascularity of cartilage and bone makes drug delivery more challenging than that of soft tissues. Recent studies have implemented many novel bone-targeting approaches to overcome drawbacks. However, none of these strategies fully corrects skeletal dysfunction, particularly in growth plate-related ones. Although direct recombinant enzymes (e.g., Vimizim for Morquio, Cerezyme for Gaucher, Elaprase for Hunter, Mepsevii for …

Standardized Patient Evaluation Tool: A Valid Measure Of The Core Competencies, Lindsey E. Eberman, Jessica Edler Nye

Clinical Practice in Athletic Training

No abstract provided.

The Value Of Using Validated Competency-Based Assessments Across The Career Span Of An Athletic Trainer, Matthew Drescher, Lindsey Eberman

Clinical Practice in Athletic Training

No abstract provided.

The Development, Implementation, And Value Of The Athletic Training Milestones For Assessing Progressive Clinical Behaviors, Hollie Walusz, Eric Sauers, Mark Laursen, Forrest Pecha

Clinical Practice in Athletic Training

No abstract provided.

Perceptions And Use Of The Athletic Training Milestones In Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie L. Van Lunen, Lindsey E. Eberman

Clinical Practice in Athletic Training

The Athletic Training Milestones (AT Milestones) were developed as an evaluation tool to capture the breadth and depth of athletic training knowledge, skills, and behavior. However, it is unclear whether athletic training programs are implementing this tool or how they are implementing it to gauge the clinical progression of students or residents in athletic training. We aimed to explore the perceptions and use of the AT Milestones among educators in athletic training programs. We used a cross-sectional, web- based survey with open-ended questions to collect data from athletic training programs on if and how they implement the AT Milestones at …

An Investigation Into Aetiology, Detection And Treatment Of Neonatal Alloimmune Thrombocytopenia, Mairead Horan

International Undergraduate Journal of Health Sciences

NAIT is a rare disorder with a similar aetiology to HDN, however unlike its erythrocyte counterpart, thrombocyte immunisation can occur within the first pregnancy. (Giouleka et al., 2023). The most common antibodies implicated are HLA-1a. (Winkelhorst et al., 2017). 2.5% of the Caucasian population are HPA-1a negative, of this population 33% are HLA-DR-B3*0101 positive increasing the risk of producing an alloantibody upon encountering the HPA-1a antigen. The maternal system becomes alloimmunised to the foreign paternal antigens of the foetus/neonate, which cross the placenta causing low platelets of the foetus. (Giouleka et al., 2023).

A third of antigen-positive neonates born to …

Effect Of Transcranial Direct Current Stimulation And Narrow-Band Auditory Stimulation On The Intraoperative Electroencephalogram: An Exploratoratory Feasibility Study, Oliver G. Isik, Tuan Z. Cassim, Meah T. Ahmed, Matthias Kreuzer, Alice M. Daramola, Paul S. Garcia

SKMC Student Presentations and Publications

INTRODUCTION: During general anesthesia, frontal electroencephalogram (EEG) activity in the alpha frequency band (8-12 Hz) correlates with the adequacy of analgesia. Transcranial direct current stimulation (tDCS) and auditory stimulation, two noninvasive neuromodulation techniques, can entrain alpha activity in awake or sleeping patients. This study evaluates their effects on alpha oscillations in patients under general anesthesia.

METHODS: 30 patients receiving general anesthesia for surgery were enrolled in this two-by-two randomized clinical trial. Each participant received active or sham tDCS followed by auditory stimulation or silence according to assigned group (TDCS/AUD, TDCS/SIL, SHAM/AUD, SHAM/SIL). Frontal EEG was recorded before and after neuromodulation. …

The Effect Of A Dynamic Lighting Schedule On Neurobehavioral Performance During A 45-Day Simulated Space Mission, Leilah Grant, Brianne Kent, Shadab Rahman, Melissa St Hilaire, Crystal Kirkley, Kevin Gregory, Toni Clark, John Hanifin, Laura Barger, Charles Czeisler, George Brainard, Steven Lockley, Erin Flynn-Evans

Department of Neurology Faculty Papers

Study Objective: We previously reported that during a 45-day simulated space mission, a dynamic lighting schedule (DLS) improved circadian phase alignment and performance assessed once on selected days. This study aimed to evaluate how DLS affected performance on a 5-minute psychomotor vigilance task (PVT) administered multiple times per day on selected days.

Methods: Sixteen crewmembers (37.4 ± 6.7 years; 5F) underwent six cycles of 2 × 8-hour/night followed by 5 × 5-hour/night sleep opportunities. During the DLS (n = 8), daytime white light exposure was blue-enriched (∼6000 K; Level 1: 1079, Level 2: 76 melanopic equivalent daytime illuminance (melEDI) lux) …

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Interactions Between Repetitive Mild Traumatic Brain Injury And Methylphenidate Administration On Catecholamine Transporter Protein Levels Within The Rodent Prefrontal Cortex, Anna Abrimian, Eleni Papadopoulos, Christopher P. Knapp, J. Loweth, Barry Waterhouse, Rachel Navarra

Rowan-Virtua Research Day

It is theorized that low concentrations of dopamine (DA) and norepinephrine (NE) within in the prefrontal cortex (PFC) following traumatic brain injury (TBI) leads to increased risky behavior. Our lab has shown that repeated mild TBI (rmTBI) sex-differentially increases risky behavior in a rodent model. Methylphenidate (MPH) is a psychostimulant drug used to treat symptoms of Attention-Deficit Hyperactivity Disorder (ADHD), also driven by a hypo-catecholaminergic PFC. MPH elevates catecholamine levels by blocking DA and NE transporters, DAT and NET. While the potential of psychostimulants to treat post-TBI symptoms have been explored, the effects of sub-chronic MPH on transporter levels following …

Does Esketamine In Cesarean Delivery Increase Postoperative Adversities And Related Diseases?, Cheryce Daniel, Kylon Coombs

Rowan-Virtua Research Day

Esketamine has emerged as a promising treatment option, particularly noted for its effectiveness in reducing postpartum depression, alleviating pain, and promoting faster recovery. Despite its therapeutic benefits, recent research has raised concerns regarding potential adverse effects associated with high doses of esketamine in patients. Specifically, there is growing interest in understanding the potential risks linked to the administration of esketamine during cesarean delivery, given its increasing use in obstetric anesthesia.

This comprehensive review aims to investigate the potential associations between the use of esketamine during cesarean delivery and the subsequent risk of related diseases or physiological disorders. The goal is …

The Impact Of Traumatic Brain Injury On Noradrenergic Innervation Of The Prefrontal Cortex, Jil P. Modi, Christopher P. Knapp, Rachel L. Navarra

Rowan-Virtua Research Day

Traumatic Brain Injury (TBI) is a common cause of death and disability in the United States, and it can occur due to varied reasons including motor vehicle accidents, gunshot wounds, and falls. Following TBIs, patients are often left with lifelong disabilities and cognitive problems that can lead to increased risk-taking behaviors. The main goal of my research was to understand the neural mechanisms that drive increased risk-taking behaviors due to TBIs. The specific areas of the brain I was interested in looking at were the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), and/or anterior cingulate cortex (ACC) of the prefrontal …