Sports Sciences Commons^™

Current Concepts In Hip And Core Assessment To Reduce The Risk Of Acl Injury, Jeremy M. Burnham, Anthony T. Drazick, Ghislain Aminake, Darren L. Johnson, Mary Lloyd Ireland, Brian W. Noehren

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Hip and trunk (“core”) muscle dysfunction has emerged as a modifiable contributor to lower-limb biomechanics linked with non-contact anterior cruciate ligament (ACL) injuries. Clinicians increasingly target core stability and control during injury-prevention screening and post-operative rehabilitation programs; however, the literature lacks a focused synthesis of core-directed strategies for ACL injury mitigation. The purpose of this current concepts review is to synthesize current evidence on hip- and core-focused assessment and rehabilitation strategies that may mitigate ACL injury risk.

Design: Current Concepts Review.

Methods: A narrative search of PubMed and Google Scholar (January 2000 – April 2025) identified biomechanical, prospective, interventional, …

Test-Retest Reliability And Validity Of The Gas Exchange Threshold, Erik Ryan Snell Mr.

Theses and Dissertations--Kinesiology and Health Promotion

Theoretically, the gas exchange threshold (GET) demarcates the moderate and heavy intensity domains, whereby exercise performed at and below the GET results in a change in oxygen consumption ([ΔVO₂] ≤ 200 mL), and exercise above the GET results in a slow component (ΔVO₂ > 200 mL). This study examined the reliability and validity of the GET. 14 subjects performed two maximal graded exercise tests (GXTs) to determine the GET and its reliability. The minimal difference (MD = 21W) was applied to determine the GET above (GET_+MD) and below (GET_-MD) power outputs for 30 min …

Investigating Non-Functional Overreaching In Special Operations Tactical Training, Jeremy Alan Ross

Theses and Dissertations--Rehabilitation Sciences

Special Operations Forces (SOF) tactical training requires high levels of physical performance and psychological resilience. This training is often characterized by extreme temperatures and environments, extremely high levels of physical activity and large caloric deficits. As such, SOF personnel follow intense strength and conditioning (S&C) programs to enhance a wide range of athletic abilities. Such programs rely on a balance between training stress and recovery to allow for gradual improvement in physical ability over time, however it is unknown how to quantify tactical training stress in the context of a training program. This dissertation explores evidence related to how this …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

You’Re Too Slow! Self-Selected Volitional Efforts Reveal Unexploited Neuromuscular Reserve Capacity Compared To Maximal Efforts During Fatiguing, Load Equated Resistance Exercise, Brian Benitez

Theses and Dissertations--Kinesiology and Health Promotion

This investigation examined how movement intent influences neuromuscular excitation strategies during fatiguing resistance exercise, comparing maximal intended concentric efforts versus self-selected volitional efforts during load-equated Smith machine back squat exercise to quantify reserve capacity and characterize underlying neuromuscular mechanisms. Twenty-three resistance-trained participants (12 males, 11 females) completed a repeated-measures design, with replication, across six visits, performing smith machine back squat repetitions-to-failure at 70% 1RM under maximal intent (accelerate rapidly) and volitional intent (self-selected effort) conditions. Maximal voluntary isometric contractions used rapid (instantaneous 10-second effort) and ramp (5-second build-up, 5-second maximal) protocols. Surface electromyography (sEMG) was recorded from vastus lateralis and …

The Effects Habitual Training Shoe Use Has On Running Economy When Transitioning To High Performance Running Shoes, Dalton C. Harris

Theses and Dissertations--Kinesiology and Health Promotion

Background: The recent increase in popularity of minimal shoes in endurance running is linked to potential improvements in running economy and reduced injury risk. However, high performance running shoes, specifically designed to improve running economy remain the fastest shoe to wear when racing. Purpose: Knowing this, the aim of this paper is to examine whether or not the habitual use of minimal shoes increases the benefits of the high performance shoes. This will guide practitioners and athletes when establishing shoe rotations and training plans during race preparation. Methods: The study consisted of 4 sessions: Sessions 1 and 2 were maximal …

Equestrian Activities And Health Outcomes: A Multidimensional Analysis Of Physical Activity, Injury Patterns, And Occupational Concerns, Michaela Keener

Theses and Dissertations--Rehabilitation Sciences

Over 6 million participate in equestrian activities each year. However, research focusing on the benefits and risks around equestrian activities is limited to epidemiological research and small sample sizes. Equestrian participation ranges from recreational to occupational, and little research has evaluated how the risks of participation change based on the level of participation. Special consideration needs to be given to the occupational equestrians as equestrian participation is their livelihood. The first two aims of this study were to evaluate the physical activity engagement, perceptions of equestrian as a sport, acute injury history, and chronic pain frequency of equestrians across all …

The Effect Of Adding Perceptual-Cognitive Load To Assessments And Intervention Strategies In Healthy Adults, Ke'la H. Porter

Theses and Dissertations--Rehabilitation Sciences

In collegiate athletes, approximately one in four injuries require more than seven days before the athlete can return to full participation. Additionally, there are significant long-term consequences associated with these injuries, such as pain and osteoarthritis. Despite the role that the sensorimotor system and cognitive function play in athletic competition, the interaction between these systems in relation to sport-related injury is commonly overlooked. The sensorimotor system integrates and processes sensory, motor, and central mechanisms to produce a motor response. Further, cognition constructs, such as visual attention or processing speed, allow athletes to navigate the chaotic sporting environment. When there are …

Physical And Psychosocial Factors Related To Firefighter Musculoskeletal Disorders, Jennifer Ellen Tinsley Kubala

Theses and Dissertations--Rehabilitation Sciences

Career firefighters must perform physically and psychologically challenging duties in unpredictable and dangerous conditions. Previous investigations have found that firefighters suffer nearly 4 times the recorded musculoskeletal disorders (MSD) and workplace injuries compared to private and public sector workers, and take approximately 1.5 days longer to return to normal work. Thus, the burden of firefighter MSD experiences has been a growing area of exploration. The few investigations that have concurrently examined physical and psychosocial consequences experienced by firefighters have found a positive relationship between increased occupational stress reports and MSD experiences. However, these investigations, as well as those that individually …

The Relationship Between Sleep, Physical Activity, And Musculoskeletal Injury, In Us And Saudi College Students, Abdulaziz Hasan Alameer

Theses and Dissertations--Rehabilitation Sciences

According to the National Sleep Foundation, individuals should sleep 7-9 hours every night. Recently, insufficient or poor sleep has been linked to diabetes, cardiovascular illness, stroke, obesity, and Alzheimer's disease. Insufficient sleep for college students can negatively impact academic performance and mental health. In addition, especially for collegiate athletes, there is evidence that insufficient sleep is associated with an increased risk of musculoskeletal injury. However, it is uncertain if the link between sleep and injury varies between populations, types of individuals (athletes vs non-athletes), sports or types of exercise, or training volume. Despite the health risks of inadequate sleep, up …

Using Inertial Measurement Units (Imus) To Assess Fatigue-Related Changes In Running: Applications In Training Load Management, Reiley Thomas Bergin

Theses and Dissertations--Rehabilitation Sciences

The inertial measurement unit (IMU) is the most researched wearable technology in running. Yet, few studies have validated IMU-derived measures against accepted laboratory standards, such as three-dimensional (3D) motion capture and force plates. IMUs have the potential to provide information that can guide training load management decisions; however, no study has explored their capability to assess fatigue-related changes in running across consecutive days of training. Therefore, the purpose of this project was to evaluate the validity and reliability of IMU-derived measures and assess their capability for detecting fatigue-related changes in running in the days following an intensified training bout. The …

Blood Flow Restrictive Training Following Medial Patellofemoral Ligament And Anterior Cruciate Ligament Reconstruction Rehabilitation, Richard Watson

Theses and Dissertations--Rehabilitation Sciences

Both patellofemoral dislocation and anterior cruciate ligament (ACL) ruptures have a significant impact on an athlete’s ability to regain function and return to play. Surgical repair of the medial patellofemoral ligament (MPFL) and ACL ligament reconstructions result in a sequala of quadriceps weakness. Persistent quadriceps weakness following reconstruction can create a cascade effect of muscular atrophy and weakness resulting in significant knee and leg impairments. An abundance of research has shown that blood flow restrictive training (BFRT) has demonstrated significant results in post-surgical rehabilitation by increasing muscular strength and improving function. What is unclear is the effect of deflating or …

Consequences Of Shift Work And Job-Related Exposure On Sleep And Musculoskeletal Outcomes In Structural Firefighters, Jacob Dennis Jelmini

Theses and Dissertations--Rehabilitation Sciences

Firefighting is considered one of the most dangerous occupations in the workforce. Musculoskeletal injuries are consistently the most frequent, and most costly, documented non-fatal injuries in the firefighting setting. An increase in job stress, job exposure, and deprived sleep secondary to job-related duties are plausible explanations for the frequency in musculoskeletal injury. The aims of this dissertation were to ascertain not only how occupational exposure via firefighter emergency call volume may influence outcomes contributing to job stress and objective and subjective sleep metrics, but also its influence on the incidences of musculoskeletal pain.

The results showed that emergency call volume …

Examination Of Physiological And Perceptual Responses During Sustained, Isometric, Fatiguing, Handgrip Exercise Anchored To Ratings Of Perceived Exertion, Minyoung Kwak

Theses and Dissertations--Kinesiology and Health Promotion

The purposes of this study were to: 1) Examine the patterns of force responses relative to critical force (CF) during submaximal, fatiguing, isometric handgrip exercise anchored to different rating of perceived exertion (RPE) levels (RPE=3, 5, and 7); 2) assess the loss of force during the task and the level of performance fatigability after each RPE hold; 3) examine the time course of changes and patterns of neuromuscular [electromyography (EMG) amplitude (AMP), mean power frequency (MPF), mechanomyography (MMG) AMP and MPF, and neuromuscular efficiency (NME) (i.e. force/EMG AMP)] and muscle oxygen saturation (% SmO₂) responses during each RPE …

The Sport Concussion Assessment Tool: A Multidimensional Symptom Model For Detecting Elevated Post-Concussion Symptoms, Eric Ingram

Theses and Dissertations--Psychology

Following sport-related concussions, a multidimensional symptom interpretation may identify athletes with domain-specific problems when beginning to return-to-play (RTP). This study investigated whether a four-factor model of post-concussion symptoms (i.e., cognitive, physical, affective, and sleep-arousal) would identify student-athletes with persistent concerns not reflected by their total symptom score. Collegiate student-athletes (N=24,696) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool – 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e., beginning RTP and 6-month). Confirmatory factor analysis was used to compare one- and four-factor models of post-concussions symptoms. Normative reference data were …

Reliability And Validity Of A Commercial Running Power Meter To Indicate Metabolic Workload During Endurance Running, James Harris Hudgins Iii

Theses and Dissertations--Kinesiology and Health Promotion

Commercial running power (RP) meters may provide endurance runners and coaches with improved precision for monitoring running intensity. Cyclists rely upon the relationship between cycling power and metabolic demand to regulate physiological intensity during training and racing, independent of changes in the physical environment (e.g., terrain, wind). Research demonstrates strong reliability and validity for a specific RP meter to indicate metabolic demand within controlled running conditions. However, several potential influences on this relationship have not been investigated. Therefore, four studies were conducted with the following aims:

- Study 1: Determine the inter-limb reliability and validity of a single-limb-based RP meter …

Effect Of Pitching Restrictions And Mound Distance On Youth Baseball Pitch Counts., Hailey Mair, Nicholas A Kenney, Timothy L Uhl, L Robert Ullery, Robert G Hosey

Physical Therapy Faculty Publications

BACKGROUND: Studies have shown that higher pitch counts are directly related to a greater incidence of elbow and shoulder pain among youth baseball pitchers.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the effect of different pitching restriction rules on the number of pitches thrown in youth baseball leagues. We hypothesized that more pitches would be thrown in leagues with inning restrictions versus leagues with pitch count restrictions as well as in leagues with a longer mound distance (from pitching mound to home plate).

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Pitch count data were collected for …

Central Vs. Peripheral Vision During A Singe-Leg Drop Jump: Implications Of Dynamics And Patellofemoral Joint Stress, Junyoung Ko, Kyeongtak Song, Hoon Kim, Sae Yong Lee, Jihong Park

Athletic Training and Clinical Nutrition Faculty Publications

Landing on a single-leg without receiving direct visual information (e.g., not looking at the ground) may increase the risk of injury. We examined whether visual focus contributed to the changing lower-extremity dynamics and patellofemoral joint stress during a single-leg drop jump task. Twenty healthy volunteers visited the laboratory for three separate sessions. During each session, participants randomly performed either of two types of a single-leg drop jump task from a 30 cm high wooden box. Subsequently, participants looked at the landing spot (central vision condition) or kept their heads up (peripheral vision condition) when performing the task. Sagittal and frontal …

What Have We Learnt From Quantitative Case Reports Of Acute Lateral Ankle Sprains Injuries And Episodes Of 'Giving-Way' Of The Ankle Joint, And What Shall We Further Investigate?, Filip Gertz Lysdal, Yuehang Wang, Eamonn Delahunt, Dominic Gehring, Kyle B. Kosik, Tron Krosshaug, Yumeng Li, Kam-Ming Mok, Kati Pasanen, Alexandria Remus, Masafumi Terada, Daniel T. P. Fong

Athletic Training and Clinical Nutrition Faculty Publications

Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of ‘giving-way’ of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE®. Additional strategies included manual search of specific journals, as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative …

More Elevated Fastballs Associated With Placement On The Injured List Due To Shoulder Injury, Austin V. Stone, Brooks N. Platt, Brandon S. Collofello, Aaron D. Sciascia, Timothy L. Uhl, William B. Kibler

Orthopaedic Surgery and Sports Medicine Faculty Publications

Purpose

To evaluate whether impending shoulder injury was associated with changes in pitch location or velocity immediately preceding injury.

Methods

Pitchers placed on the injured list (IL) due to a shoulder injury between 2015 and 2020 were identified in the Major League Baseball transactions database. Four-seam fastball velocity and frequency of pitch location for each pitch type was collected for each player in the season before placement on the IL and within 1 month of placement on the IL with a minimum of 55 pitches thrown of 1 type. Pitch locations were collected as identified by Baseball Savant’s Game-Day Zones. …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

A Muscle Cell-Macrophage Axis Involving Matrix Metalloproteinase 14 Facilitates Extracellular Matrix Remodeling With Mechanical Loading, Bailey D. Peck, Kevin A. Murach, R. Grace Walton, Alexander J. Simmons, Douglas E. Long, Kate Kosmac, Cory M. Dungan, Philip A. Kern, Marcas M. Bamman, Charlotte A. Peterson

Center for Muscle Biology Faculty Publications

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single-cell RNA-seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor ( …

Reactive Oxygen Species (Ros) And Antioxidants As Immunomodulators In Exercise: Implications For Heme Oxygenase And Bilirubin, David Travis Thomas, Nicholas R. Delcimmuto, Kyle D. Flack, David E. Stec, Terry D. Hinds Jr.

Athletic Training and Clinical Nutrition Faculty Publications

Exercise is commonly prescribed as a lifestyle treatment for chronic metabolic diseases as it functions as an insulin sensitizer, cardio-protectant, and essential lifestyle tool for effective weight maintenance. Exercise boosts the production of reactive oxygen species (ROS) and subsequent transient oxidative damage, which also upregulates counterbalancing endogenous antioxidants to protect from ROS-induced damage and inflammation. Exercise elevates heme oxygenase-1 (HO-1) and biliverdin reductase A (BVRA) expression as built-in protective mechanisms, which produce the most potent antioxidant, bilirubin. Together, these mitigate inflammation and adiposity. Moderately raising plasma bilirubin protects in two ways: (1) via its antioxidant capacity to reduce ROS and …

Combined Driving: Task-Specific Position Impacts Grip Strength Of Equestrian Athletes, Michaela M. Keener, Kimberly I. Tumlin, Nicholas R. Heebner

Athletic Training and Clinical Nutrition Faculty Publications

BACKGROUND: Loss of hand strength is a predictor of mortality in aging populations. Despite reliance on the hands to participate in equestrian driving activity, no existing studies focus on associations of hand strength to athletic performance. Therefore, this study 1) established baseline handgrip of equestrian combined drivers in standing and task-specific positions, 2) determined endurance of task-specific handgrip, 3) compared handgrip strength to normative data, and 4) evaluated associations of handgrip and equestrian-specific variables.

METHODS: There were 51 combined drivers (9 males, 42 females) ages 21-78 who completed a survey, standing handgrip, and grip strength and endurance in a task-specific …

Neurophysiological And Psychological Characteristics Of Individuals With History Of Lateral Ankle Sprain, Katherine Bain

Theses and Dissertations--Rehabilitation Sciences

Lateral ankle sprain (LAS) is among the most common lower limb musculoskeletal injuries impacting both the general and sport populations. Even more problematic is that approximately 70% of individuals who sustain an LAS develop residual deficits. Of that subgroup, roughly 40% develop chronic ankle instability (CAI). Chronic ankle instability is a clinical diagnosis defined by the presence of ongoing impairments following the initial LAS which may include perceived instability, pain, mechanical instability, and episodes of giving way during physical activity. Not all who sustain multiple ankle sprains or experience residual deficits fit the clinical diagnosis criteria for CAI; yet may …

The Utilization Of Physical Literacy To Understand Physical Activity In Individuals With A History Of Anterior Cruciate Ligament Reconstruction, Rachel Renee Kleis

Theses and Dissertations--Rehabilitation Sciences

Injury to the anterior cruciate ligament (ACL) is common in physically active populations. Anterior cruciate ligament reconstruction (ACLR) is commonly performed after injury in order to restore joint stability and knee function and return patients to desired levels of physical activity. However, not everyone will return to their pre-injury levels of sport after surgery and recent evidence reveals that individuals with a history of ACLR are less likely to meet the recommended physical activity guidelines. Specifically, previous literature has reported that individuals with a history of ACLR take fewer daily steps and participate in less moderate-to-vigorous physical activity compared to …

A Plague Of Their Own: Injury Incidence Remains Elevated In The 2021 Major League Baseball Season Compared To Pre-Covid-19 Seasons, Brooks N. Platt, Breanna Sullivan, Shawn Dripchak, Timothy L. Uhl, Aaron Sciascia, William B. Kibler, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background Significant increases in injuries were observed in the 2020 Major League Baseball (MLB) season; these were attributed to an increased acute to chronic workload due to the interrupted preseason and compressed season during the coronavirus disease of 2019 (COVID-19) pandemic. In 2021, the MLB resumed its regular schedule.

Hypothesis/Purpose The purpose of this study was to determine the injury incidence and epidemiology of the 2021 MLB season compared to the injury incidence in the 2020 season and pre-COVID-19 seasons. The hypothesis was that, with the return to normal preseason training, injury incidence in 2021 would return to pre-COVID-19 rates. …

Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer

Physical Therapy Faculty Publications

Muscle power training with emphasis on high-velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail …

Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol

Physical Therapy Faculty Publications

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in …

The Correlation Between Acl Injury & Concussion, Brandon Michael Phillips

Theses and Dissertations--Kinesiology and Health Promotion

Concussion (also known as mild traumatic brain injury) is a neurological injury that occurs after a blow to the head or neck area and can have affects to movement based on the severity of the injury. Mild traumatic brain injury has possible linkage to an increased risk of anterior cruciate ligament (ACL) injury. The purpose of this thesis was to assess the impact of prior concussion on lower extremity mechanics that are associated with risk of ACL injury. A total of 11 individuals with prior history of concussion and 11 healthy individuals without prior history of concussion (56.5 months since …