Orthopedics 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. …

Anterior Cruciate Ligament Hybrid Remnant Preservation Reconstruction Demonstrates Similar Outcomes As Traditional Reconstruction After 6 Months: A Randomized Control Trial, Joshua P. Castle, Eleftherios L. Halkias, Brittaney Pratt, Ashley Frei, Matthew A. Gasparro, Vasilios Moutzouros

Medical Student Research Symposium

Background

The anterior cruciate ligament (ACL) is often debrided during reconstruction (ACLR) to improve visualization. However, remnant ACL tissue contains nerve fibers and including remnant tissue in ACLR could provide benefit. Therefore, a technique was developed that preserves the tibial remnant and incorporates it into ACLR: Hybrid Remnant Preservation Reconstruction (HRPR) ACLR. This study compares HRPR-ACLR to traditional reconstruction by comparing patient reported outcomes and complications.

Methods

Patients presenting to one surgeon's clinic with an ACL injury are screened. Exclusion criteria are patient age<14 years, multi-ligament injury, chronic tears, and revision ACLR. Patients are consented and randomized to HRPR or traditional ACLR. Demographics, patient-reported outcomes, range of motion (ROM) and complications were collected.

Results

Thirty-three patients were included, 20 HRPR and 13 controls. No demographic differences were noted. PROMIS-PF, …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Herniated Nucleus Pulposus Radiculopathy In Athletes, Elizabeth G. Massel

Capstone Showcase

Herniated nucleus pulposus (HNP), commonly referred to as intervertebral disc (IVD) herniation, is the second most common cause of neck and back pain, and most common cause of radiculopathy. The purpose of this CME article is to provide guidance on the medical management and secondary prevention of HNP in athletic populations, and highlight the pathophysiological process of mechanical overload putting athletes at a proportionately higher risk of the disease. It will address the unique pathophysiology of overuse-related HNP, as opposed to underuse, with the mechanical overload on vertebral discs associated with many sports. It will also review, with more emphasis …

Bridging Biomedical Research With Aerospace Engineering In The Lab Of Tomorrow, Christine Walck

Publications

“My goal with this lab is to take biomedical research and tie it into a school that is grounded in aerospace and aeronautical engineering,” says Assistant Professor of Mechanical Engineering at Embry-Riddle Aeronautical University’s Daytona Beach Campus, Christine Walck. “How do I make that connection? That’s the question I’ve been working on for the past couple of years with Vicon.”

Femoral Neck Fracture Management In The Young Patient: A Case Review, Luis Berrios, Kevin J. Orellana, Michael Lago, Frank Gerold

Research Colloquium

Introduction:The optimal management of femoral neck fractures in the young patient remains controversial. Although there are universally accepted principles, there remains some variability in the optimal timing of surgery and method of fixation. In general, surgery should be performed on an urgent or emergent basis when feasible to decrease peri-operative complications, length of stay, and most importantly the ultimate likelihood of avascular necrosis. However, it is important to note that the preference toward a specific method of fixation remains heterogeneous among orthopedic surgeons.(1)

The purpose of this study is to present our preferred technique for treatment of displaced femoral …

Wrist Motion Is Distinct Between Touch Screen And Manual Or Digital Devices, Mandi J. Lopez, Catherine Takawira, Mary P. Fox, Pengju Wang, Evan Boatwright, Thomas Lucak, Chin Chi Liu, Bryce Fugarino

School of Medicine Faculty Publications

Background Restricted motion during touch screen device use may contribute to wrist overuse injuries. Wrist radioulnar deviation and extension while using touch screen devices and digital or manual counterparts in male and female medical professional dominant and non-dominant hands were quantified to test the hypothesis that mobile touch screen device use reduces wrist motion. Methods An active motion detection system was used to record wrist motion of 12 participants while: tablet swiping and turning book pages; raising a cell and traditional phone to the ear; texting and typing; and entering numbers on a cell phone and manual calculator. Medial and …

Worse Postoperative Outcomes And Higher Reoperation In Smokers Compared To Nonsmokers For Arthroscopic Rotator Cuff Repair, Susan G. Wager, Spencer Brown, Michael Gaudiani, Joshua P. Castle, Eric Jiang, Vasilios Moutzouros, Eric Makhni, Stephanie J. Muh

Medical Student Research Symposium

Introduction: Smoking impairs healing potential and is a significant risk factor for complications following orthopaedic surgeries. The purpose of this study was to determine if a cohort of former or current smokers at time of surgery met the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) scores in comparison to nonsmokers.

Methods: A retrospective review of patients who underwent rotator cuff repair was performed. Patients who completed preoperative and 6-month postoperative PROMIS scores were included. The MCID was calculated using a distribution technique with a threshold of 0.5 …

The Top 50 Most Cited Articles On The Medial Patellofemoral Ligament (Mpfl): A Bibliometric Analysis, Varag Abed, Alex Duvall, Jonathan D. Rexroth, Alyssa Goodwin, Joseph Liu, Austin Stone

Medical Student Research Symposium

Objectives: To determine which original articles on the topic of the medial patellofemoral ligament (MPFL) have been cited the most in the literature utilizing a bibliometric approach. Secondarily, to determine temporal trends between article types.

Methods: Articles on the topic of the MPFL were identified by utilizing the Web of Science Database. The search yielded 1,596 results and the top 50 cited original articles were collected for further analysis. The following information was gathered for all included articles: title, first author's name, journal name, year of publication, impact factor of the journal in 2021, total number of citations of the …

The Effect Of Chronic Alcohol Consumption On Exercise-Induced Muscle Damage In Young Men, Emma Hamilton, Grant Hilliard

Honors Theses

PURPOSE: To investigate the effects of chronic alcohol consumption on exercise-induced muscle damage of the knee extensors in young men. METHODS: Twenty-one males (age 21.9 ± 1.1 yr; weight 183.4 ± 27.6 lbs; height 174.0 ± 13.1 cm) performed 100 maximal eccentric contractions at 30°/sec of the knee extensors using their non-dominant leg. The isometric and isokinetic muscle strengths (60°/sec and 180°/sec) were measured pre-exercise and immediately, 24 h, 48 h, 72 h, 96 h, and 120 h post-exercise. Muscle soreness and plasma creatine kinase (CK) activity were measured pre-exercise and 24 h, 48 h, 72 h, 96 h, and …

Hospital-Acquired Venous Thromboembolism Or Bleeding Following Total Joint Arthroplasty: A Systematic Review And Meta-Analysis For The Association Of The Gene Polymorphism., Michael Debeau

Medical Student Research Symposium

This review seeks to understand the current existing literature on genetic polymorphisms to VTE following orthopedic surgery. Using PRISMA guidelines, 234 studies were retrieved from PubMed and Cochrane. The eligibility assessment yielded 16 studies including a systematic review. A STREGA and STROBE quality assessment found these studies to have high methodological quality. A significant association was found between the PAI-1 4G/4G genotype and resistance to anticoagulation therapy (OR = 2.692; 95% CI = 1.302 - 4.702). Moreover, the MTHFR C677T and A1298C polymorphisms significantly increased the incidence of VTE in patients that are compound heterozygotes (OR = 2.89; 95% CI …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

In-Home Delivery Of Constraint-Induced Movement Therapy Via Virtual Reality Gaming, Alexandra L. Borstad, Roger Crawfis, Kala Phillips, Linda Pax Lowes, David Maung, Ryan Mcpherson, Amelia Siles, Lise Worthen-Chaudhari, Lynne V. Gauthier

Journal of Patient-Centered Research and Reviews

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of …

The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter

Honors Undergraduate Theses

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.

Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.

Methods: …

The Effect Of Spinal Cord Injury On Vagal Afferents., April N. Herrity

Electronic Theses and Dissertations

Spinal cord injury (SCI) is a significant public health concern that leaves patients with a multitude of life-long disabilities. Major complications of SCI apart from paralysis, include deficits in bladder and bowel function. Lower urinary tract dysfunction continues to remain a top priority issue affecting quality of life for this population. The majority of visceral organs receive a dual sensory innervation from both spinal nerves as well as the vagus nerve. Following SCI, the vagus nerve is a potential pathway through which information from regions below the level of a spinal injury can travel directly to the brainstem, bypassing the …