Rehabilitation and Therapy Commons^™

Perceived Outcomes Of Web-Based Modules Designed To Enhance Athletic Trainers' Knowledge Of Evidence-Based Practice, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier, Aimee L. Wyant, Jessica M. Mutchler, William A. Pitney, Danica G. Hays

Rehabilitation Sciences Faculty Publications

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial.

Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians.

Design: Qualitative study.

Setting: Individual telephone interviews.

Patients or Other Participants: A …

Injury Prevention With Physical Therapy, Karen Kott, Margaret F. Lemaster

Rehabilitation Sciences Faculty Publications

(First paragraph) Ergonomics is the study of human performance (positioning and movement) and workplace design, such as equipment, ambience, and placement. The purpose of ergonomics is to maximize productivity by increasing safety, improving work quality, reducing operator fatigue and discomfort, and decreasing the risk of work -related musculoskeletal disorders (MSDs).^1-3

An Evidence-Based Practice Educational Intervention For Athletic Trainers: A Randomized Controlled Trial, Cailee E. Welch, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes a necessity in athletic training, Web-based modules have been developed and made available to the National Athletic Trainers' Association membership as a mechanism to educate athletic trainers (ATs) on concepts of EBP.

Objective: To assess the effect of an educational intervention on enhancing knowledge of EBP among ATs.

Design: Randomized controlled trial.

Setting: Web-based modules and knowledge assessment.

Patients or Other Participants: A total of 164 of 473 ATs (34.7% response rate), including professional athletic training students, graduate students, clinical preceptors, educators, and clinicians, were randomized into a control group (40 men, 42 women) …

Health-Related Quality Of Life In Individuals With Chronic Ankle Instability, Megan N. Houston, Bonnie L. Van Lunen, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Individuals with chronic ankle instability (CAI) have reported decreased global and regional function. Despite the identification of functional deficits in those with CAI, more research is required to determine the extent to which CAI influences the multidimensional profile of health-related quality of life.

Objective: To determine whether global, regional, and psychological health-related outcomes differ between individuals with and without CAI.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Twenty-five participants with CAI (age = 21.9 ± 2.5 years, height = 170.8 ± 8.6 cm, mass = 69.8.0 ± 11.7 kg) were sex- and limb-matched to 25 healthy participants …

Perceptions Of Approved Clinical Instructors: Barriers In The Implementation Of Evidence-Based Practice, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood.

Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed.

Data Collection and …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 2: Attitudes, Beliefs, Accessibility, And Barriers, Cailee W. Mccarthy, Dorice A. Hankemeier, Jessica M. Walter, Eric J. Newton, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students.

Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students.

Design: Cross-sectional study.

Setting: Online survey instrument.

Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training …

Use Of Evidence-Based Practice Among Athletic Training Educators, Clinicians, And Students, Part 1: Perceived Importance, Knowledge, And Confidence, Dorice A. Hankemeier, Jessica M. Walter, Cailee W. Mccarty, Eric J. Newton, Stacy E. Walker, Shana L. Pribesh, Beth E. Jamali, Sarah A. Manspeaker, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context:

Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.

Objective:

To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.

Design:

Cross-sectional study.

Setting:

Online survey instrument.

Patients or Other Participants:

The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.

Main Outcome Measure(s):

Demographic information and perceived importance and knowledge of and …

Commentary On "The Motor Learning Strategy Instrument: Interrater Reliability Within Usual And Virtual Reality Physical Therapy Interventions", Karen M. Kott, Sharon Held

Rehabilitation Sciences Faculty Publications

No abstract provided.

Effectiveness Of Low-Level Laser Therapy Combined With An Exercise Program To Reduce Pain And Increase Function In Adults With Shoulder Pain: A Critically Appraised Topic, Aimee L. Thornton, Cailee W. Mccarty, Mollie-Jean Burgess

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM).(3) Conservative treatment has traditionally included a therapeutic exercise program targeted …

Instruction And Jump-Landing Kinematics In College-Aged Female Athletes Over Time, Jena Etnoyer, Nelson Cortes, Stacie I. Ringleb, Bonnie L. Van Lunen, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries.

Objective: To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box–drop-jump task, running–stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes.

Design: Randomized controlled clinical trial.

Setting: Laboratory.

Patients or Other Participants: Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months …

Test-Retest Reliability And Construct Validity Of The Tinetti Performance-Oriented Mobility Assessment In People With Stroke, Jennifer Canbek, George Fulk, John Echternach

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Tinetti Performance-Oriented Mobility Assessment (POMA) is commonly used to measure balance ability in older adults. The purpose of this study was to determine the test-retest reliability and minimal detectable change (MDC) of the POMA and explore its cross-sectional and longitudinal construct validity for use in people early after stroke.

Methods: Participants were recruited if they had a first documented stroke and were receiving physical therapy during inpatient rehabilitation. The POMA, gait speed, and motor Functional Independence Measure (FIM) scores were collected at admission and at discharge from inpatient rehabilitation. A second trial of the POMA was …

Upper Extremity Strength Characteristics In Female Recreational Tennis Players With And Without Lateral Epicondylalgia, Ann M. Lucado, Morey J. Kolber, M. Samuel Cheng, John L. Echternach Sr.

Rehabilitation Sciences Faculty Publications

STUDY DESIGN: Descriptive, cross-sectional.

OBJECTIVES: To compare static strength characteristics of the upper extremity musculature in female recreational tennis players with lateral epicondylalgia to those of nonsymptomatic tennis players and a control group of women who did not play tennis.

BACKGROUND: There is a paucity of research describing the relationship between lateral epicondylalgia and strength characteristics of the upper extremity musculature, despite the functional relationship between the shoulder, elbow, and wrist.

METHODS: Sixty-three women were recruited into 3 groups (n = 21 per group): symptomatic tennis players (SIP) with lateral epicondylalgia, nonsymptomatic tennis players, and controls. Data collection was performed …

Two Different Fatigue Protocols And Lower Extremity Motion Patterns During A Stop-Jump Task, David Quammen, Nelson Cortes, Bonnie L. Van Lunen, Shawn Lucci, Stacie I. Ringleb, James Onate

Rehabilitation Sciences Faculty Publications

Context: Altered neuromuscular control strategies during fatigue probably contribute to the increased incidence of non-contact anterior cruciate ligament injuries in female athletes.

Objective: To determine biomechanical differences between 2 fatigue protocols (slow linear oxidative fatigue protocol [SLO-FP] and functional agility short-term fatigue protocol [FAST-FP]) when performing a running-stop-jump task.

Design: Controlled laboratory study.

Setting: Laboratory.

Patients or Other Participants: A convenience sample of 15 female soccer players (age = 19.2 ± 0.8 years, height = 1.67± 0.05m, mass = 61.7 + 8.1 kg) without injury participated.

Intervention(s): Five successful trials of a running–stop-jump task were obtained prefatigue and postfatigue during …

Aging, Neuromuscular Decline, And The Change In Physiological And Behavioral Complexity Of Upper-Limb Movement Dynamics, S. Morrison, K. M. Newell

Rehabilitation Sciences Faculty Publications

Aging is characterized by a general decline in physiological and behavioral function that has been widely interpreted within the context of the loss of complexity hypothesis. In this paper, we examine the relation between aging, neuromuscular function and physiological-behavioral complexity in the arm-hand effector system, specifically with reference to physiological tremor and isometric force production. Experimental findings reveal that the adaptive behavioral consequences of the aging-related functional decline in neurophysiological processes are less pronounced in simple motor tasks which provides support for the proposition that the motor output is influenced by both extrinsic (e.g., task related) and intrinsic (e.g., coordination, …

Falls And Physical Activity In Persons With Multiple Sclerosis, J. J. Sosnoff, B. M. Sandroff, J. H. Pula, S. M. Morrison, R. W. Motl

Rehabilitation Sciences Faculty Publications

Objectives. To examine the association between fall history and physical activity using an objective measure of physical activity (i.e., accelerometry) in persons with multiple sclerosis.

Design. A community-based sample of 75 ambulatory persons with multiple sclerosis volunteered for the investigation. Participants self-reported fall history in the last year, underwent a neurological exam to determine Expanded Disability Status Scale (EDSS) score, and wore an accelerometer around the waist for 7 consecutive days to determine physical activity.

Results. Overall, 37 persons (49.3% of the sample) reported falling in the last year with 28 of the 37 falling more than once. Persons who …

Clinical Preceptors' Perspectives On Clinical Education In Post-Professional Athletic Training Education Programs, Kelvin Phan, Cailee W. Mccarty, Jessica M. Mutchler, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Clinical education is the interaction between a clinical preceptor and student within the clinical setting to help the student progress as a clinician. Post-professional athletic training clinical education is especially important to improve these students' clinical knowledge and skills. However, little research has been conducted to assess the pedagogical principles for clinical education at this level or what factors are necessary to enhance the clinical skills and decision-making abilities of post-professional students. Therefore, exploring the perspectives of clinical preceptors involved in post-professional education will help educators understand what strategies are necessary to improve post-professional athletic training education programs (PPATEPs). …

Overcoming Barriers To Implementation Of Evidence-Based Practice Concepts In Athletic Training Education: Perceptions Of Select Educators, Sarah Manspeaker, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making.

Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers.

Design: Qualitative interviews of emergent design with grounded theory.

Setting: Undergraduate CAATE-accredited athletic training education programs.

Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± …

Mobility, Balance, And Falls In Persons With Multiple Sclerosis, Jacob J. Sosnoff, Michael J. Socie, Morgan K. Boes, Brian M. Sandroff, John H. Pula, Yoojin Suh, Madeline Weikert, Steven Morrison, Robert W. Motl

Rehabilitation Sciences Faculty Publications

Background: There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS).

Methods: 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery.

Results: Over 51% of the participants …

Approved Clinical Instructors' Perspectives On Implementation Strategies In Evidence-Based Practices For Athletic Training Students, Dorice A. Hankemeier, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Understanding implementation strategies of Approved Clinibal Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice.

Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students.

Design: Qualitative study.

Setting: Telephone interviews.

Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 …

The Reliability Of Portable Fixed Dynamometry During Hip And Knee Strength Assessments, Roger O. Kollock Jr., James A. Onate, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Insufficient lower extremity strength may be a risk factor for lower extremity injuries such as noncontact anterior cruciate ligament tears. Therefore, clinicians need reliable instruments to assess strength deficiencies.

Objective: To assess the intrarater, interrater, intrasession, and intersession reliability of a portable fixed dynamometer in measuring the strength of the hip and knee musculature.

Design: Crossover study.

Setting: Sports medicine research laboratory.

Patients or Other Participants: Three raters (A, B, C) participated in this 2-phase study. Raters A and B tested 11 healthy college graduate students (2 men, 9 women) in phase 1. Raters A and C tested 26 …

Curricular Satisfaction Levels Of National Athletic Trainers' Association- Accredited Postprofessional Athletic Training Graduates, Kevin J. Henry, Bonnie Van Lunen, Brian Udermann, James A. Onate

Rehabilitation Sciences Faculty Publications

Context: Academic programs rely on outcomes assessments to determine if changes in the curriculum are necessary.

Objective: To examine the overall satisfaction levels of graduates (2005-2006) of National Athletic Trainers' Association-accredited postprofessional athletic training education programs as related to the 2002 Standards and Guidelines for Development and Implementation of NATA-Accredited PostProfessional Graduate Athletic Training Education Programs.

Design: Original survey instrument and demographic questionnaire.

Setting: Online survey instrument.

Patients or Other Participants: Of 211 survey recipients, 123 returned surveys (58.29% response rate).

Main Outcome Measure(s): Demographic information and satisfaction levels in 10 standard areas (depth of learning, breadth of learning, critical …

Test-Retest Reliability And Minimal Detectable Change Scores For The Timed "Up & Go" Test, The Six-Minute Walk Test, And Gait Speed In People With Alzheimer Disease, Julie D. Ries, John L. Echternach, Leah Nof, Michelle Gagnon Blodgett

Rehabilitation Sciences Faculty Publications

Background. With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability Of Outcome measures for people with this disease is necessary.

Objective. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups With mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were Studied.

Design. This was a prospective, nonexperimental, descriptive methodological study. …

An Assessment Of Burnout In Undergraduate Athletic Training Education Program Directors, Jessica M. Walter, Bonnie L. Van Lunen, Stacy E. Walker, Zahra C. Ismaeli

Rehabilitation Sciences Faculty Publications

Context: Athletic training education program directors (ATEPDs) often manage their time among students, program administration, and patient care.

Objective: To assess the level of burnout in ATEPDs and to determine the relationship between burnout and various demographics of ATEPDs.

Design: Cross-sectional study.

Setting: Public and private colleges and universities nationwide.

Patients or Other Participants: Two hundred forty-nine ATEPDs of undergraduate athletic training education programs accredited by the Commission on Accreditation of Athletic Training Education.

Intervention(s): We administered the Maslach Burnout Inventory (MBI) to all participants.

Main Outcome Measure(s): The MBI consisted of 21 items assessing 3 characteristics of burnout: emotional …

Dependence In Prestroke Mobility Predicts Adverse Outcomes Among Patients With Acute Ischemic Stroke, Mary I. Dallas, Shari Rone-Adams, John L. Echternach, Lawrence M. Bass, Dawn M. Bravata

Rehabilitation Sciences Faculty Publications

Background and Purpose - Stroke survivors are commonly dependent in activities of daily living; however, the relation between prestroke mobility impairment and poststroke outcomes is poorly understood. The primary objective of this study was to evaluate the association between prestroke mobility impairment and 4 poststroke outcomes. The secondary objective was to evaluate the association between prestroke mobility impairment and a plan for physical therapy.

Methods - This was a secondary analysis of the National Stroke Project data, a retrospective cohort of Medicare beneficiaries who were hospitalized with an acute ischemic stroke (1998 to 2001). Logistic-regression modeling was used to examine …

Reference Group Data For The Functional Gait Assessment, Martha L. Walker, Alvis G. Austin, Gina M. Banke, Suzanne R. Foxx, Lynn Gaetano, Laurie A. Gardner, Jill Mcelhiney, Kisiah Morris, Liz Penn

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Functional Gait Assessment (FGA) is a clinical tool for evaluating performance in walking. The purpose of this study was to determine age-referenced norms for performance on the FGA in community-living older adults.

Subjects: Subjects were 200 adults, ages 40 to 89 years, living independently.

Methods: Each subject completed the FGA one time and was scored simultaneously by 2 testers.

Results: The intraclass correlation coefficient for interrater reliability was .93. Mean scores for the FGA ranged from 29/30 for adults in their 40s to 21/30 for adults in their 80s.

Discussion and Conclusion: Patient performance on the …

Patellofemoral Pain In Female Ballet Dancers: Correlation With Iliotibial Band Tightness And Tibial External Rotation, John Winslow, Evangeline Yoder

Rehabilitation Sciences Faculty Publications

Review of the literature reveals that ballet dancers have a high incidence of idiopathic patellofemoral pain. Twenty-four female ballet dancers were subjects in a study of the relationship between: 1) iliotibial band (ITB) tightness and patellofemoral pain, and 2) ITB tightness and degrees of tibial external rotation used in the dance demi-plie. Dancers were initially assessed by questionnaire to determine if any had knee pain. Twelve subjects mel the study criteria for patellofemoral pain, and 12 dancers without knee pain served as controls for the study. Iliotibial band tightness was measured (Ober test), and degrees of tibial external rotation used …