Orthopedics Commons^™

From Confirmation To Guidance: Making The Case For Intraprocedural Pocus As The Next Developmental Step In Ultrasound-Supported Shoulder Reduction A Conceptual Practice Proposal And Research Agenda, James Espinosa

Rowan-Virtua Research Day

Point-of-care ultrasound (POCUS) is well established for the diagnosis of shoulder dislocation and for the confirmation of successful reduction. However, its role during the reduction maneuver itself remains under-described. This conceptual practice proposal argues that intraprocedural POCUS represents the logical next developmental step in ultrasound-supported shoulder reduction. By introducing real-time visualization of humeral head translation during reduction attempts, clinicians may identify ineffective vectors earlier, adjust technique midstream, and potentially reduce repeated attempts or escalation of procedural sedation. This work does not present outcome data but instead proposes a practical framework, workflow model, and research agenda for intraprocedural implementation. Future study …

Modeling Structural Support To Facilitate Novel Treatments Of Degenerative Disc Disease, Jose Luis Calderon

Poster Presentations

Over 600 million people worldwide suffered from low back pain in 2020, with projections for 2050 being over 800 million [1]. Annual costs associated with low back pain total over 450 billion dollars in the US alone [2]. This research serves as a proof-of-concept for the use of structural supports to facilitate intervertebral disc healing. This treatment would involve the implementation of these supports along with existing injection treatments to promote regeneration. In both models, along with the combined model, the ability for these supports to alleviate intervertebral disc height loss is shown. This indicates that these supports would serve …

A Systemic Review Of Functional Outcomes And Patient Satisfaction Across Lower-Limb Prosthetic Types In Military Personnel And Veterans, Emma Ho Harris, Amir Ghafarian, Sen Gao, Khaled Saleh, Jason Pasley

Medical Student Research Symposium

Background: Military personnel and veterans are at increased risk of lower-limb amputation, often due to combat-related trauma such as improvised explosive devices (IEDs), as well as secondary factors including tobacco use, peripheral artery disease, and diabetes. This study systematically reviews and compares lower-limb prosthetic technologies in military personnel and veterans, focusing on functional outcomes, mobility, and patient satisfaction.

Methods: A comprehensive literature search was conducted using PubMed MeSH terms to identify studies examining lower-limb prosthetic use and outcomes among military personnel and veterans. The final MeSH-based search yielded 27 results.

Results: The review included 27 studies on lower-limb prosthetic use …

Ibuprofen, Flurbiprofen Or Naproxen Sodium Minimally Influences Musculoskeletal Adaptations To Treadmill Exercise In Rats, Brandon Roberts, Alyssa Geddis, Alexandra Ciuciu, Marinaliz Reynoso, Nikhil Mehta, Alyssa Varanoske, Alyssa Kelley, Maximus Leiss, Alexander Kolb, Julie Hughes, Marshall Naimo, Ryan Tomlinson, Jeffery Staab

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may influence musculoskeletal health. The purpose of this study was to compare the effects of three different NSAIDS: naproxen sodium, ibuprofen, flurbiprofen or a placebo on musculoskeletal adaptations in rodents with or without 6 weeks of aerobic exercise.

METHODS: Nine-week-old male Wistar rats (n = 80) were randomized to either exercise (EX) or no-exercise control (CON) conditions and treated with naproxen, ibuprofen (IBU), flurbiprofen (FLU) or placebo (PLA). For exercise, rats ran 5 days per week for 6 weeks at a 5% incline on a motorized treadmill for 30 min. Three-point bending (3 PB) and …

A Systematic Review Of Recent Developments In Platelet-Rich Plasma Therapy In Hip Osteoarthritis: Variability In Protocols And Clinical Outcomes (2019–2024), Emily Awdish, Marlena Muszynska, Konrad Lautenschlager, Ali Hamade

Annual Research Symposium

No abstract provided.

Fabricating Silver-Ceria Polymer Nanocomposite Scaffolds For Biomedical Therapeutic Applications, Shreya S. Pawar

Honors Undergraduate Theses

Improper healing of bone fractures and limited regeneration of bone following bone tumor resection remain a prevalent complication worldwide. Long-term effects of this include joint instability, limited movement, and arthritis. Bone infections (osteomyelitis), reactive oxygen species (ROS) generation via excessive inflammation, and underlying conditions such as osteoporosis can contribute to suboptimal bone tissue regeneration. ROS accumulation stimulates osteoblast apoptosis, while promoting osteoclast differentiation. These processes inhibit mineralization and osteogenesis. Conventional therapeutics involve the utilization of drugs and bone grafts. However, these approaches pose limitations and can result in subsequent complications. Microbial infections, ROS accumulation, and excessive inflammations are factors that …

Anxiety And Depression Amongst Female Athletes, Dp Golden, Re Obmann, Em Moore

Clinical Practice in Athletic Training

Context: Anxiety (categorized by a feeling of fear, dread, and uneasiness) and depression (mood disorder causing feelings of persistent sadness and loss of interest in things an individual once loved) are two major mental health disorders effecting females considerably who participate in sport. Females are more likely to present with anxiety (55-60%)1 and depression (1.844 times)2 compared to males. The purpose of this study was to examine the prevalence between mental health comorbidities (anxiety and depression), across female athletes aged 18-40. Methods: An anonymous survey was distributed via snowball sampling using social media. Demographic data, Generalized Anxiety Disorder-7 (GAD-7), validated …

Effects Of Sex Hormones And The Menstrual Cycle On Knee Joint Laxity In Physically Active Females: A Critically Appraised Topic, Ae Eicher, Rj Gage, K Park-Braswell

Clinical Practice in Athletic Training

Clinical Scenario: In recent years, females have exhibited increased physical activity and sport participation than ever before. Recent studies have identified a rising incidence rate of ACL injuries and indicate that the risk of ACL tears is greater in females than males. Knee laxity and physiological variation in women during the menstrual cycle have demonstrated increased ligament laxity, therefore, varying hormone concentrations may contribute to changes in ligamentous mechanical properties. Despite these findings, it remains unclear whether fluctuating sex hormone concentrations directly correlate to measurable changes in knee laxity. Clinical Question: How do fluctuations in sex hormones throughout the menstruation …

Individual Goal And Velocity Based Throwing Program For Collegiate Baseball Pitchers With Medial Elbow Injuries, Le Trail, Jm Cline, Ap Jacobsen

Clinical Practice in Athletic Training

Background: A 22-year-old male collegiate baseball pitcher experienced sudden pain in the medial left elbow following feeling a pop when pitching. The pitcher was removed from the competition and was evaluated with a point-of-care ultrasound at the conclusion of the competition. Ultrasound revealed an intact ulnar collateral ligament (UCL) and no edema. Differential Diagnosis: UCL sprain, Wrist flexor strain Treatment: The patient was referred to a primary care sports medicine physician for further evaluation. The physician found no tenderness or laxity at the UCL and ordered an MRI arthrogram for further diagnostic information. MRI revealed a grade II flexor digitorum …

Presentation Of An Accessory Navicular Bone In A Collegiate Women’S Field Hockey Player: A Type 3 Clinical Case Study, N Sutker, J Franco, K Mallory, B Hansberger

Clinical Practice in Athletic Training

Background: The accessory navicular is an extra bone located posterior and medial to the navicular tuberosity. The prevalence of accessory navicular has been reported to be 4 - 21% in the general population though this anatomical variant may often be overlooked during differential diagnosis. This case presents a female collegiate field hockey patient that was initially diagnosed with a midfoot sprain but was later determined to have an accessory navicular bone which required surgical removal. Patient: A 19-year-old female Division I collegiate field hockey patient presented to the athletic training clinic with pain in her left medial foot. The patient …

Changes In Neural Excitability Following 6-Week Of Balance Training In Individuals With Chronic Ankle Instability, Sh Chung, J Freeman, Rs Mccann

Clinical Practice in Athletic Training

Context: Individuals with chronic ankle instability (CAI) often struggle with balance issues due to changes in the central nervous system (CNS). Specifically, difficulties in modulating spinal reflexive excitability and enhancing corticospinal excitability contribute to poor balance, indicating challenges in transferring control to supraspinal centers. A recent study found that a single session of balance training could positively impact the CNS, improving spinal reflexive excitability modulation and corticospinal excitability in CAI patients. However, there is limited research on the effects of long-term balance training on neural excitability in CAI individuals. Therefore, this study aimed to investigate the effects of a 6-week …

Chronic Neck Pain, Vasculopathy, And Pre-Syncope In A Young Adult: A Type 4 Case Study, Tn Crane, K Moore, A Field

Clinical Practice in Athletic Training

Background: The patient is a 23-year-old college female presenting with chronic cervicalgia, bilateral upper extremity neurovascular symptoms, and insidious pre-syncope episodes over the past 3.5 years. Upper extremity neurovascular symptoms include bilateral numbness and tingling into the hands and bilateral throbbing arm pain originating proximal to the elbow and traveling to the fingers, which worsens with cervical rotation bilaterally. The patient has experienced 10 episodes of pre-syncope lasting less than 30 seconds that occur with cervical flexion, extension, or bilateral rotation. Pre-syncope symptoms include lightheadedness, blurry vision, increased neck/arm pain, headache, and malaise. Upon clinical evaluation, no obvious deformity, discoloration, …

Cyclops Lesion In A Collegiate Men’S Lacrosse Player: A Type 4 Clinical Case Study, K Powers, R Moen, G Siarkas

Clinical Practice in Athletic Training

Background: In late July 2023, a 20-year-old male division I lacrosse player reported to the Athletic Training clinic with pain, swelling, and an inability to fully extend his left knee. Evaluation revealed an extension deficit of 5 – 10° during active range of motion (ROM). The patient had previously undergone a double-bundle procedure to repair a torn anterior cruciate ligament (ACL) in his left knee in November 2022. Following this surgery, the patient completed a standard but conservative ACL reconstruction (ACLR) rehabilitation program as prescribed by the sports medicine team but switched to a light strength training regimen on his …

How Comorbidity With Adhd Impacts On Neurocognitive Performance In Adolescents After Sport-Related Concussions: A Scoping Review, T Chiba, Dm Emerson

Clinical Practice in Athletic Training

Context: The number of sport-related concussions (SRCs) is higher in adolescents than in other age groups and accounts for 32% of concussions. Athletes with attention-deficit hyperactivity disorder (ADHD) have a higher risk of previous history of concussion and future concussion risk compared with those without ADHD. People with ADHD present lower baseline scores of neurocognitive performances compared with those without ADHD. Neurocognitive deficits after SRC lead to increase risk of musculoskeletal injuries or another concussion after return to play (RTP) and affect RTP process. There is no consensus regarding the management of SRCs for those with ADHD. This scoping review …

A Qualitative Study Evaluating Athletic Trainers’ Self-Perceived Knowledge And Knowledge Acquisition Of Concussion Biomarkers, Kgs Swindell, T Mccormick, Jm Allen

Clinical Practice in Athletic Training

Context: Rapid movement of the brain caused by a concussion can damage brain cells and create chemical changes within the brain, which may cause lasting neurological, cognitive, and behavioral symptoms. It is suggested that following a trauma, biomarkers can be released which may be useful in accurately diagnosing concussions. Potential biomarkers being studied include β-amyloid peptide 42 [Aβ42], S100 calcium-binding protein B [S100B], glial fibrillation acidic protein [GFAB], microtubule-associated protein 2 [MAP2], and 2’,3’-cyclic-nucleotide 3'- phosphodiesterase [CNPase]. This study focuses on evaluating AT knowledge and awareness of biomarkers, with sub-analyses evaluating ATs’ perception of current knowledge of biomarkers, and the …

An Investigation Of Lower Extremity Injuries In Soccer Athletes Related To Their Playing Environment, Ak Whitlock, K Francis, H Maloney

Clinical Practice in Athletic Training

Context: The goal of this study was to investigate a connection between cleat type, surface type, and increased lower extremity injury rates in soccer athletes. Our hypothesis was that the cleat model, surface type, and facility affected the lower extremity injury rate among soccer athletes. Methods: A review of survey results distributed to the male and female soccer from an NCAA D-I program was completed. The survey investigated athlete injury history related to the specific shoe worn and the field surface information where the injury occurred. Measures of central tendency were calculated. Data was analyzed using a correlation analysis with …

Anaerobic Capacity And Lower Body Strength Deficits Related To Thermal Protective Gear In Rural Volunteer Firefighters, J Diggins, R Shagena, T Patrick, A Catanese

Clinical Practice in Athletic Training

Context: Firefighting is a dangerous job with occupational hazards, strenuous shifts, and increased work- related fatigue that contributes to risk of injury. The weight of thermal protective gear (TPG) may increase neuromuscular challenges while on-duty. The purpose of this study was to investigate the influence of TPG on volunteer firefighters’ anaerobic and lower body strength performance. Methods: Nine healthy males (mean±SD: age= 41±9.3 years; ungeared body mass= 96.47 ± 14.51kg; ungeared height=181.67 ± 4.48cm; VFF experience 8 years) participated in a cross-sectional correlation study during three visits to a university research laboratory. Participants’ TPG included thermal pants, jacket, boots, and …

Athletic Trainers’ Attitudes Towards Concussion Biomarkers And Their Future Use In Concussion Diagnosis, Jm Allen, T Mccormick, Kgs Swindell, T Campbell

Clinical Practice in Athletic Training

Context: Currently, concussions are diagnosed using subjective criteria that typically require baseline measurements to be considered accurate. In some cases, symptoms may not be immediately evident following a brain injury. Recently, studies have begun analyzing the possibility of using biomarkers as a means of objectively diagnosing concussions. However, more research and information on biomarkers are required before implementation of diagnostic methods are possible; therefore, the purpose of our study was to explore and analyze current practicing athletic trainers’ attitudes toward the future implementation of concussion biomarkers in clinical practices. Methods: A phenomenological qualitative research design was used to gather information …

Caffeine Consumption On Sports Performance Measures In College Athletes: A Critically Appraised Topic, Ja Wills, Al Fraley

Clinical Practice in Athletic Training

Focused Clinical Question: How does caffeine (CAF) consumption affect sports performance measures in healthy college athletes? Data Sources: In December 2023, PubMed was utilized to search key terms, including collegiate athlete, caffeine, and performance measures. A publication time frame from 2013-2023 was established. Study Selections: Inclusion criteria consisted of studies investigating collegiate athletes ingesting CAF and its impact on anaerobic, agility, and speed performance measures. Exclusion criteria consisted of participants with current injuries and ingredients consumed in addition to CAF. Data Extraction: Outcomes included sports performance measures such as: vertical jump test, 60- and 100-meter time trials, reaction time, maximum …

Citation Accuracy Of Scholarly Journal Articles In Sports Medicine, Lk Warner, Le Trail, Bj Warner, Sa Cage

Clinical Practice in Athletic Training

Context: Previous research has expounded on the importance of accurate use of references in scholarly manuscripts. A thorough and appropriate use of references allows authors to validate and lend credence to the position they are attempting to take on their subject matter.Reference errors have been well documented in multiple scholarly journals covering healthcare topics. To date, there does not appear to be a description of the accuracy of reference lists in sports medicine scholarly journal articles. Therefore, the purpose of this study was to describe the rate of reference errors in sports medicine literature. Methods: We examined four peer-reviewed sports …

Conflict Management In Athletic Training: The Influence Of Organizational Culture, Cc Emerson

Clinical Practice in Athletic Training

Context: Athletic trainers (ATs) face conflict within the social ecosystem of the organizations in which they practice and arises due to incompatibility of goals and interests. Within athletic departments, the ATs’ role to advocate for health and safety often comes at odds with an organizational culture directed towards maximizing performance and winning. ATs are often evaluated by dominant and powerful members of organizations who may not understand or respect the AT’s role. The purpose of this study was to examine the experience of managing conflict as an AT within the culture of athletics. Methods: This qualitative study explored experiences of …

Consistency In Patient-Reported Outcomes Survey Response, Me Beck, J Johnson, Wz Garrett, C Lavender

Clinical Practice in Athletic Training

Context: Patients returning from ACL or other knee injuries must be physically ready to return to activity and mentally. Patient-reported outcome measures are important means to evaluate the level of patient readiness. Many healthcare providers utilize multiple surveys as part of their intake process to determine current status. The distribution of multiple surveys related to one joint may be problematic. A question of completeness and consistency among participants is a limitation of most measures. The purpose of this study was 1) to determine the level at which people will persist in multiple surveys and 2) to determine the consistency in …

Continuing Education Seminar’S Impact On Knowledge And Retention Among Athletic Trainers., Brandon Warner, D Gill, S Shultz, W Karper, Sa Cage

Clinical Practice in Athletic Training

Context: The athletic training profession requires continuing education (CE) to maintain their national practice credential. Recent research has shown healthcare professionals to have knowledge and skill declines post-continuing education courses. Even with the CE mandate and available research, there is little evidence on the effectiveness of continuing education in the profession of athletic training. There is also a lack of research on the impact of a CE seminar assessing behavior change post-seminar. Therefore, the purpose of this study is to determine the impact of an educational seminar on participant knowledge gain, knowledge retention, and reported use of ES for pain …

Effects Of Concussion History On Risk Taking Behaviors In Collegiate Athletes, K Formey, Tr Campbell

Clinical Practice in Athletic Training

VirginiaContext: According to the literature, in the United States there are an estimated 1.6 to 3.8 million sport-related concussions annually with over 10,000 concussions among National Collegiate Athletic Association (NCAA) student-athletes1. The annual incidence of medically diagnosed pediatric concussions increased from 34 per 10,000 persons in 2003 to 150 per 10,000 persons in 20132. There has been an increase in research studied on the physiological mechanisms and causes of concussions among people of all ages with sports participation being the etiology of about half of all pediatric concussions2. Concussions occur from excessive forces being applied to the skull resulting in …

Effects Of Passive Heat Interventions On A Person’S Active Heat Acclimatization: A Critically Appraised Topic, Sl Dickstein, Dm Emerson, Al Fraley

Clinical Practice in Athletic Training

Focused Clinical Question: Does implementing a month-long passive heat protocol in a sauna affect a person’s active heat acclimatization by decreasing average heart rate (HR), decreasing internal body temperature, and increasing skin temperature (Tsk)? Data Sources: A comprehensive search was conducted in September 2023 through PubMed. The search terms used were passive heat therapy, heat acclimatization, and hypoxia. Manuscripts were limited to those published within the last 5 years. Study Selection: Inclusion criteria consisted of physically active participants, measures of HR and body temperature, and randomized-controlled trials and crossover studies using saunas as a passive heat intervention. Exclusion criteria consisted …

Enhancing Cultural Competency In Sports Medicine Resident And Fellowship Physicians Through The Coming Out Star Exercise., Sa Cage, Ap Jacobsen

Clinical Practice in Athletic Training

Context: Previous studies have reported that lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) healthcare providers and student-athletes encounter difficulties in their work or competition settings. Numerous medical professional associations have published statements affirming their commitment to providing equitable healthcare for patients from the LGBTQIA community. However, there is a paucity of research related to building cultural competency among healthcare professionals with regards to LGBTQIA patients. The purpose of this study was to describe the effects of the Coming Out Star exercise on giving sports medicine track resident and fellowship physicians a better understanding of the challenges faced by …

Esophageal Candidiasis In A Baseball Athlete, A Fitzgerald, N Carvino

Clinical Practice in Athletic Training

Background: Candidiasis is a yeast-based fungal infection often found in immunocompromised individuals, that can produce white patches, redness or soreness in the mouth, xerostomia, loss of taste, pain with eating and swallowing, and angular cheilitis. The patient in this case is a 21-yearold male baseball player who presented to the athletic trainer (AT) with flu-like symptoms such as fever, cough, body aches, shortness of breath, and chills. The AT referred the patient to the team physician, who prescribed Zithromax five days after the onset of symptoms for bronchitis. There was no improvement after two days, so a Medrol pack was …

External Pressures On Injured Athletes’ And Their Effects On Mental Health And Return To Play, A Graham, J Johnson

Clinical Practice in Athletic Training

Context: Student athletes face many challenges in and out of their sport. Along with practicing and playing to their best ability, they have to worry about keeping up with schooling. Once a player is hurt and out of play, they add the pressure of getting back into play on their plate. Along with their own internal pressure, athletes may experience pressure from outside sources. These sources could include friends, family, coaches, and parental guardians. External pressures could play a role in how an athlete returns to play. This research can help us understand whether the external pressures end up causing …

Influence Of Thermal Protective Gear On Rural Volunteer Firefighter Postural Stability, E Shagen, J Patrick

Clinical Practice in Athletic Training

Context: Firefighting is a physically demanding job. The ability to maintain and appropriately adjust postural stability is vital for the safety of firefighters, as they navigate through unpredictable terrain in various rescue situations while wearing restrictive equipment. The weight and design of thermal protective gear (TPG) may alter weight distribution causing changes to the center of gravity or restrict movement. The need for firefighters to maintain postural stability is essential for preventing falls on- duty. The purpose of this study was to assess the influence of TPG on rural volunteer firefighter (VFF) postural stability. Methods: Nine healthy males (mean±SD: age= …

Injury Prevention Programs: Factors That Effect If A Coach Uses Injury Prevention Programs, A Deguzman, Jc Martinez

Clinical Practice in Athletic Training

Context: The purpose of this study was to determine how coaches view injury prevention programs (IPP) and how this affects their decision to implement an IPP with their team. The more information gained on a coach’s influence to implement an injury prevention program for their team, the more athletic trainers can understand and educate on the importance of injury prevention programs. Methods: Design: Cross-sectional Setting: Web-based survey Target Population: Youth Sport Coaches Dependent Variable: Coaches beliefs on IPPs Independent Variable: Willingness to implement an IPP. Youth sport coaches were surveyed on their attitudes and beliefs about injury prevention programs. All …