Sports Sciences Commons^™

A 4-Week Multimodal Intervention For Individuals With Chronic Ankle Instability: Examination Of Disease-Oriented And Patient-Oriented Outcomes, Cameron J. Powden, Johanna M. Hoch, Beth E. Jamali, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention have not been evaluated for their effects on a multidimensional profile of health.

Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, …

Isometric Hip Strength And Dynamic Stability Of Individuals With Chronic Ankle Instability, Ryan S. Mccann, Brenn A. Bolding, Masafumi Terada, Kyle B. Kosik, Ian D. Crossett, Phillip A. Grobble

Rehabilitation Sciences Faculty Publications

Context: Compared with individuals who have a history of lateral ankle sprain (LAS) without markers of chronic ankle instability (CAI; LAS copers) and healthy people, those with CAI often exhibit neuromuscular impairments and dynamic-stability deficits at the hip. However, the influence of hip-strength deficits on dynamic stability remains unknown.

Objective: To compare isometric hip strength and dynamic stability in individuals with or without CAI and examine the degree of dynamic-stability variance explained by isometric hip strength.

Design: Case-control study.

Setting: Research laboratory.

Patients or Other Participants: Sixty individuals (47 women, 13 men; age = 23.7 +/- 4.6 years, height = …

Postprofessional Athletic Training Students' Perceptions Concerning The Health Care Competencies, Cailee E. Welch Bacon, Bonnie L. Van Lunen, Dorice A. Hankemeier

Rehabilitation Sciences Faculty Publications

Context: Over a decade ago, the Institute of Medicine indicated that all health care professionals should be educated in several health care competency areas (quality improvement, health care informatics, interprofessional education and collaborative practice, evidence-based practice, and patient-centered care). Despite this initiative, athletic training has only recently incorporated these competencies throughout education.

Objective: To assess postprofessional athletic training students' perceived abilities and importance regarding 6 core competencies.

Design: Cross-sectional. Setting: Self-reported paper survey. Patients or Other

Participants: A total of 221 from a convenience sample of 258 postprofessional athletic training students (85.7%) completed the survey (82 males, 138 females; age …

Normative Functional Performance Values In High School Athletes: The Functional Pre-Participation Evaluation Project, James A. Onate, Cambrie Starkel, Daniel R. Clifton, Thomas M. Best, James Borchers, Ajit Chaudhari, Eric Schussler, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs.

Objective: To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States.

Design: Cross-sectional study.

Setting: Athletic training facilities and gymnasiums across the United States.

Patients or Other Participants: A total of 3951 male and female athletes …

8893: Athletic Training Student Application Of Health Information Technology During Clinical Education: A Report From The Athletic Training Clinical Education Network, C. E. Welch Bacon, S. E. Walker, J. M. Cavallario, R. C. Bay, B. L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: Health information technology (HIT) is becoming ubiquitous in health care, so it is essential to ensure professional athletic training students (ATSs) are gaining exposure to the concepts of HIT throughout their clinical experiences. Research has demonstrated that when ATSs observe patient encounters (PEs) they are less likely to implement HIT; however, it is still unclear how or to what extent ATSs are incorporating concepts of HIT during individual PEs. Objective: To assess whether ATSs are integrating concepts of HIT during PEs as part of their clinical experiences. Design: Multisite, panel design. Setting: Convenience sample of 3 Commission on Accreditation …

Athletic Training Student Core Competency Implementation During Patient Encounters, Julie M. Cavallario, Bonnie L. Van Lunen, Johanna M. Hoch, Matthew Hoch, Sarah A. Manspeaker, Shana L. Pribesh

Rehabilitation Sciences Faculty Publications

Context: Health care research evidence suggests that early patient encounters (PEs), as well as the purposeful implementation of professional core competencies (CCs), for athletic training students (ATSs) may be beneficial to their ability to provide care. However, no investigators have related facets of the clinical education experience with CC implementation as a form of summative assessment of the clinical experience.

Objective: To determine the relationship between the frequency and length of PEs, as well as the student's role and clinical site during PEs, and the students' perceived CC implementation during these encounters.

Design: Cross-sectional study.

Setting: Professional athletic training program, …

Inter-Rater Agreement And Validity Of A Tackling Performance Assessment Scale In Youth American Football, Eric Schussler, Richard J. Jagacinski, Susan E. White, Ajit M. Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Long term neurologic injury and concussion have been identified as risks from participation in American football. Altering tackling form has been recommended to reduce the risk of neurologic injury caused by head accelerations when tackling. The purpose of this research is to determine the inter-rater agreement and validity of the Qualitative Youth Tackling System (QYTS), a six-item feedback scale to correct tackling form, when utilized by novice and expert raters.

Hypothesis: Experienced raters will have higher levels of agreement with each other and with motion capture when compared to novice raters. Methods: Both novice and experienced raters viewed video …

The Effect Of Tackling Training On Head Accelerations In Youth American Football, Eric Schussler, Richard J. Jagacinski, Susan E. White, Ajit M. Chaudhari, John A. Buford, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Many organizations have introduced frameworks to reduce the incidence of football related concussions through proper equipment fitting, coach education, and alteration of tackling technique.

Purpose: The purpose of this study was to examine the effects of training in a vertical, head up tackling style on the number of head accelerations experienced while tackling in a controlled laboratory situation. The authors hypothesized that training in a head up tackling technique would reduce the severity of head acceleration experienced by participants.

Design: Controlled Laboratory Study.

Methods: Twenty-four participants (11.5 ± 0.6 years old, 60.5 ± 2.2 in, 110 ± 18.4 lbs.) …

Autologous Blood And Platelet-Rich Plasma Injections In The Treatment Of Achilles Tendinopathy: A Critically Appraised Topic, Cori Sinnott, Hayley M. White, Jennifer W. Cuchna, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Achilles tendinopathy is a painful condition commonly affecting the general and athletic population. It presents with localized pain, stiffness, and swelling in the midportion of the Achilles tendon. The physical stress placed on the tendon results in microtrauma, which leads to subsequent inflammation and degeneration. While it is not surprising that this condition affects the physically active, nearly one-third of Achilles tendinopathy cases occur in sedentary individuals. Etiology for this condition stems from a change in loading patterns and/or overuse of the tendon, resulting in microscopic tearing and degenerative changes. There are numerous causes contributing to the …

Comparison Of A Head Mounted Impact Measurement Device To The Hybrid Iii Anthropomorphic Testing Device In A Controlled Laboratory Setting, Eric Schussler, David Stark, John H. Bolte, Yun Seok Kang, James A. Onate

Rehabilitation Sciences Faculty Publications

Background: Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete’s helmet or directly on the athlete’s head.

Purpose: The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by …

The Ability Of The Landing Error Scoring System To Detect Changes In Landing Mechanics: A Critically Appraised Topic, Claire E. Pointer, Tyler D. Reems, Emily M. Hartley, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Question: Is there evidence to suggest that the Landing Error Scoring System (LESS) is able to detect functional changes in landing mechanics in healthy individuals after participation in an injury prevention program (IPP)? Clinical Bottom Line: In a healthy, physically active population, there is strong evidence to support the use of the LESS as an outcome measure for changes in landing mechanics after the implementation of IPPs. Clinicians should consider the LESS as an evaluative tool for measuring the efficacy of IPPs in clinical practice.

Epidemiology Of Knee Sprains In Youth, High School, And Collegiate American Football Players, Daniel R. Clifton, James A. Onate, Eric Schussler, Aristarque Djoko, Thomas P. Dompier, Zachary Y. Kerr

Rehabilitation Sciences Faculty Publications

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. Study Selection: …

Sagittal Plane Gait Kinematics In Individuals With Chronic Ankle Instability, Matthew C. Hoch, David R. Mullineaux, Kyoungkyu Jeon, Patrick O. Mckeon

Rehabilitation Sciences Faculty Publications

Single joint kinematic alterations have been identified during gait in those with chronic ankle instability (CAI). The purpose of this study was to compare sagittal plane hip, knee, and ankle kinematics during walking in participants with and without CAI. Twelve individuals with CAI and 12 healthy individuals walked on a treadmill at 1.5 m/s. Three-dimensional kinematics were analyzed using mean ensemble curves and independent t tests. Participants with CAI demonstrated less lower extremity flexion during the absorption phase of stance and the limb placement phase of swing, which may have implications for limb placement at initial contact.

Health-Related Quality Of Life In Athletes: A Systematic Review With Meta-Analysis, Megan N. Houston, Matthew C. Hoch, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted.

Study Selection: …

Patient-Reported Outcomes In Male And Female Collegiate Soccer Players During An Athletic Season, Johanna M. Hoch, Beth Druvenga, Brittany A. Ferguson, Megan N. Houston, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: Clinicians are urged to document patient-based outcomes during rehabilitation to measure health-related quality of life (HRQOL) from the patient's perspective. It is unclear how scores on patient-reported outcome instruments (PROs) vary over the course of an athletic season because of normal athletic participation.

Objective: Our primary purpose was to evaluate the effect of administration time point on HRQOL during an athletic season. Secondary purposes were to determine test-retest reliability and minimal detectable change scores of 3 PROs commonly used in clinical practice and if a relationship exists between generic and region-specific outcome instruments.

Design: Cross-sectional study.

Setting: Athletic facility. …

Weight-Bearing Dorsiflexion Range Of Motion And Landing Biomechanics In Individuals With Chronic Ankle Instablity, Matthew C. Hoch, Kelley E. Farwell, Stacey L. Gaven, Joshua T. Weinhandl

Rehabilitation Sciences Faculty Publications

Context: People with chronic ankle instability (CAI) exhibit less weight-bearing dorsiflexion range of motion (ROM) and less knee flexion during landing than people with stable ankles. Examining the relationship between dorsiflexion ROM and landing biomechanics may identify a modifiable factor associated with altered kinematics and kinetics during landing tasks.

Objective: To examine the relationship between weight-bearing dorsiflexion ROM and single-legged landing biomechanics in persons with CAI.

Design: Cross-sectional study.

Setting: Laboratory.

Patients or Other Participants: Fifteen physically active persons with CAI (5 men, 10 women; age = 21.9 ± 2.1 years, height = 168.7 ± 9.0 cm, mass = 69.4 …

Patient-Reported Outcome Measures In Individuals With Chronic Ankle Instability: A Systematic Review, Megan N. Houston, Johanna M. Hoch, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context: A comprehensive systematic literature review of the health-related quality-of-life (HRQOL) differences among individuals with chronic ankle instability (CAI), ankle-sprain copers, and healthy control participants has not been conducted. It could provide a better indication of the self-reported deficits that may be present in individuals with CAI.

Objective: To systematically summarize the extent to which HRQOL deficits are present in individuals with CAI.

Data Sources: We searched for articles in the electronic databases of EBSCO Host and PubMed Central using key words chronic, functional, mechanical, coper, instability, sprains, and patient-assessed. We also performed a hand search of reference lists, authors, …

Perceptions Of Support Networks During The Graduate Assistant Athletic Trainer Experience, Stephanie M. Mazerolle, Stephanie Clines, Christianne M. Eason, William A. Pitney

Rehabilitation Sciences Faculty Publications

Context: The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously.

Objective: To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships.

Design: Semistructured phone interviews. Setting: Graduate-assistant ATs in various clinical settings.

Patients or Other Participants: Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years.

Data Collection and Analysis: Phone interviews were digitally recorded and …

Preparation Of The Professional Athletic Trainer: A Descriptive Study Of Undergraduate And Graduate Degree Programs, Julie M. Cavallario, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The examination of the appropriate professional degree for preparation as an athletic trainer is of interest to the profession. Descriptive information concerning universal outcomes is needed to understand the effect of a degree change.

Objective: To obtain and compare descriptive information related to professional athletic training programs and a potential degree change and to determine if any of these factors contribute to success on existing universal outcome measures.

Design: Cross-sectional study.

Setting: Web-based survey.

Patients or Other Participants: We contacted 364 program directors; 178 (48.9%; 163 undergraduate, 15 postbaccalaureate) responded.

Intervention(s): The survey consisted of 46 questions: 45 questions …

On-Field Signs And Symptoms Associated With Recovery Duration After Concussion In High School And College Athletes: A Critically Appraised Topic, Jaebin Shim, Deanna H. Smith, Bonnie Van Lunen

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of …

Hip Strengthening Compared With Quadriceps Strengthening In Conservative Treatment Of Patients With Patellofemoral Pain: A Critically Appraised Topic, Chyrsten L. Regelski, Brittany L. Ford, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Scenario: Patellofemoral pain is a common injury that affects both athletic and sedentary populations. Clinicians may treat patellofemoral pain more effectively through a comprehensive understanding of the most effective exercise protocols. Clinical Question: In patients with patellofemoral pain, are hip abductor and external rotator muscle strengthening exercises more effective in reducing pain and improving patient-reported function compared with isolated quadriceps strengthening? Summary of Key Findings: A comprehensive and systematic database search was conducted for studies of level 2 evidence or higher. The search yielded 253 studies; of these studies, four randomized control trials and one comparative control trial fit …

Differential Effects Of Fatigue On Movement Variability, N. Cortes, J. Onate, S. Morrison

Rehabilitation Sciences Faculty Publications

When individuals perform purposeful actions to fatigue, there is typically a general decline in their movement performance. This study was designed to investigate the effects exercise-induced fatigue has on lower limb kinetics and kinematics during a side-step cutting task. In particular, it was of interest to determine what changes could be seen in mean amplitude and all metrics of signal variability with fatigue. The results of the study revealed that post-fatigue there was an overall decrease in absolute force production as reflected by a decline in mean amplitude and variability (SD) of the ground reaction forces (GRF_V and GRF …

A Feedback Inclusive Neuromuscular Training Program Alters Frontal Plane Kinematics, Eric K. Greska, Nelson Cortes, Bonnie L. Van Lunen, James A. Oñate

Rehabilitation Sciences Faculty Publications

-Anterior cruciate ligament (ACL) neuromuscular training programs have demonstrated beneficial effects in reducing ACL injuries, yet further evaluation of their effects on biomechanical measures across a sports team season is required to elucidate the specific factors that are modifiable. The purpose of this study was to evaluate the effects of a 10-week off-season neuromuscular training program on lower extremity kinematics. Twelve Division I female soccer players (age: 19.2 ± 0.8 years, height: 1.67 ± 0.1 m, weight: 60.2 ± 6.5 kg) performed unanticipated dynamic trials of a running stop-jump task pretraining and posttraining. Data collection was performed using an 8-camera …

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 …

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 …

Landing Technique Affects Knee Loading And Position During Athletic Tasks, Nelson Cortes, Steven Morrison, Bonnie L. Van Lunen, James A. Onate

Rehabilitation Sciences Faculty Publications

Anterior cruciate ligament (ACL) injuries have been reported to occur with the ankle in a dorsiflexed position at initial contact. Few studies have attempted to quantify the biomechanical parameters related with such landing patterns during athletic tasks.

Objectives- The purpose of this study was to evaluate the effects that two landing techniques have in lower extremity biomechanics while performing two tasks.

Design- Single-group repeated measures design.

Methods- Twenty female soccer athletes from a Division 1 institution performed two landing techniques (forefoot and rearfoot) during two unanticipated tasks (sidestep cutting and pivot). Repeated measures analyses of variance were conducted to assess …

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 ± …

Educator Perceptions Of The Evidence-Based Teaching Model In Undergraduate Athletic Training Education, Sarah A. Manspeaker, Bonnie Van Lunen, Paula S. Turocy, Shana Pribesh, Dorice Hankemeier

Rehabilitation Sciences Faculty Publications

Context: While research recommends that health professions expand the instruction and use of evidence-based practice (EBP) due to the individualized approach to patient health care, few examples of the incorporation of EBP into academic courses exist in athletic training.

Objective: To evaluate educators' perceptions of the Evidence-Based Teaching Model (EBTM) as a strategy to introduce EBP concepts to athletic training (AT) students.

Design: Qualitative program evaluation including semi-structured interviews. Setting: Institutions that sponsor CAATE-accredited professional undergraduate programs.

Participants: Stratified purposeful sampling of 9 experienced educators (2 males, 7 females average years teaching 8 plus or minus 5 years) teaching therapeutic …

Energy Balance During Backpacking, L. C. Hill, D. P. Swain, E. L. Hill

Rehabilitation Sciences Faculty Publications

Energy expenditure and energy intake were determined in three Subjects during a 160-kilometer backpacking trip. Prior to the trip, heart rate and oxygen consumption during treadmill walking while carrying a backpack were measured. Subjects recorded heart rate during hiking. Heart rate Was used to estimate energy expenditure based on the heart rate: oxygen consumption relationship (Heart Rate Method). Expenditure was also estimated from distance walked and elevation gained (Terrain Method). Subjects recorded food consumption, and were weighed upon finishing the hike. Mean heart rate during biking was 105 +/- 12 beats per Minute. According to the Heart Rate Method, net …

Fitness Levels Of Middle Aged Martial Art Practitioners, P. Douris, A. Chinan, M. Gomez, A. Aw, D. Steffens, S. Weiss, J. Echternach

Rehabilitation Sciences Faculty Publications

Objectives: To quantify and compare fitness levels of middle aged practitioners of soo bahk do (SBD; a Korean martial art similar to karate) with those of sedentary subjects.

Methods: Eighteen volunteers, 14 men and four women (aged 40-60 years), participated. Nine sedentary subjects (mean age 46.7 years) and nine SBD practitioners (mean age 46.8 years) were matched for sex and age. All subjects participated in a one day battery of fitness tests. The following dependent variables were tested: body composition, balance, flexibility, quadriceps strength, grip strength, muscle endurance, and aerobic capacity.

Results: All dependent variables were analysed using paired t …