Exercise Physiology Commons^™

A Case Study On Treatment Of Subcoracoid Impingement In An Overhead Athlete With Manual Therapy, M Mennell

Clinical Practice in Athletic Training

Introduction: Subcoracoid impingement of the shoulder is a condition that occurs when the tendons or soft tissues in the shoulder are compressed or pinched between the coracoid process and the humeral head. It is also suspected that subcoracoid impingement can occur when the humerus translates anteriorly, decreasing the subcoracoid space. This impingement can cause pain, inflammation, and limited mobility in the shoulder joint. All kinds of impingement are typically multifactorial, and have several areas that need to be addressed. The purpose of this case report is to examine the effects of therapeutic exercise as well as manual therapy on subcoracoid …

Superficial Peroneal Nerve Entrapment In Female Collegiate Tennis Athlete: A Disablement Model Case Study, Sarah Branning, Neeru Jayanthi, Zachary K. Winkelmann

Clinical Practice in Athletic Training

A 19-year-old female, NCAA Division I collegiate tennis player presented with a burning and aching sensation halfway up the lateral portion of her right calf following an extensive period spent in a squatting position. This discomfort began distal to the fibular head, then ran along her lateral calf, reached into her ankle, and wrapped behind the lateral malleolus. Initially, the patient only noticed this discomfort during long durations of physical activity. However, she began to report symptoms with activities of daily living (ADLs) and following workouts. The patient first received a working diagnosis of a stress reaction along the mid …

Return-To-Tennis Considerations And An Elusive Diagnosis For A Cuboid Avulsion Fracture: A Disablement Model Case Study, Grant G. Yee, Zachary K. Winkelmann, Zoe J. Foster

Clinical Practice in Athletic Training

This disablement-model case study is focused on a 23-year-old NCAA Division I men’s tennis player that sustained an injury in a competitive singles tennis match. Upon initial examination, the athletic trainer diagnosed the individual with an anterior talofibular ligament sprain and treated conservatively. The patient experienced significant disruptions to his activities of daily living due to his difficulties with ambulation during the early stages of his recovery. Interestingly, the patient was eventually diagnosed with a cuboid avulsion fracture. Midfoot fractures are uncommonly experienced in the general population, and are particularly uncommon in tennis athletes, making them difficult to recognize. Clinical …

The Validity And Reliability Of Assessments Through Telemedicine: An Evidence-To-Practice Review, Connor L. Givens, Gabrielle A. Griffin, Matthew D. Johnson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

The validity and reliability of telemedicine assessments has been explored through numerous studies. Telemedicine is a diagnostic tool that combines visual technology, audio technology, and tools for assessment. The assessment of musculoskeletal disorders is a key portion in the field of athletic training. The development of telemedicine assessment tools has improved over time but has not yet been perfected. Data was collected via four databases that included articles examining validity, inter- and intra- rater reliability, and telemedicine assessment for musculoskeletal tests. The reviews of the systematic review used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and quality appraisal tool for …

Childhood Mental Health Outcomes Following Mild Traumatic Brain Injury: An Evidence-To-Practice Review Leona J. Keller, Ms, Atc*; Sooji M. Berthiaume, Ms, Atc†; Karis J. L, Leona J. Keller, Sooji M. Berthiaume, Karis J. Landry, Alyssa L. Bolno, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Concussions can have lasting symptoms in children such as depression, anxiety, hyperactivity, or failure to control anger. If diminished mental health outcomes are not monitored and do not improve after concussion, children may need additional treatment as a result of sequela. The purpose of the guiding systematic review was to determine if there are increased mental health symptoms in pediatric patients who sustained a concussion as compared to pediatric patients who have not sustained a concussion. The guiding systematic review and meta-analysis authors used seven different databases for articles published from 1980 to 2020. Selected articles had mental health outcomes …

Concussion Clinical Pathway: Headache And Cervical Assessment Framework, Nicholas Hattrup, Nicholas Pfeifer, Tamara Valovich Mcleod

Clinical Practice in Athletic Training

The prevalence of sport specialization is a common concern in contemporary youth sports and has been linked to potential negative physical and psychological effects for developing athletes. While the evidence regarding negative physical effects, such as overuse injury, are consistent in the literature, the psychosocial outcomes are unclear due to the lack of published studies on the topic. Specialization is thought to lead to added stress, which may affect an athlete’s mental health, whereas athletes who sample multiple sports are believed to have a healthier psychosocial experience. Burnout is characterized as physical and emotional exhaustion, sport devaluation and a reduced …

Strategies To Improve Healthcare Communication With Non-Native English Speakers: An Evidence To Practice Review, Skylar B. Hudgens-Wallace, Kaitlyn M. Pierce, Madison P. Whitesell, Nancy A. Uriegas, Zachary K. Winkelmann

Clinical Practice in Athletic Training

As the number of non-native English speakers in the United States rises, the degree to which some patients understand their healthcare communication is decreasing. It is essential to recognize the areas of limited health literacy to ensure proper patient communication and education are achieved. The guiding systematic review aimed to examine different communication interventions and the reported patient experiences from those interactions. The main forms of healthcare communication interventions used in the study included in-person, telephone, and video call interpreters. Patients have been shown to respond best to in-person interpreters, but using interpreters via telephone or video call was also …

Effects Of Social Determinants Of Health And Diabetes On A Lower Extremity Workplace Injury: A Disablement Model Case Study, Bridget L. Davidson, Richelle M. Williams, Sean M. Rogers

Clinical Practice in Athletic Training

This clinical case study involves a 36-year-old male patient who injured his right lower leg while working in the kitchen at a county correctional institution. The mechanism of injury involved the patient getting his foot caught under a wooden pallet, losing his balance, and then catching himself on his right leg in a twisting motion. The injury led to the patient seeking care in the emergency department and was diagnosed with a nonspecific strain of the right triceps surae muscle group. Upon discharge, the patient was referred to outpatient athletic training services within the hospital system. Follow-up care provided by …

Prioritizing Patient-Centered Care When Integrating Athletic Training Students Into Clinical Practice, Amber Kingsley, Amy L. Fraley, Krista M. Richards, Matthew J. Drescher, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Athletic trainers are responsible for the patient care of student-athletes but also can be responsible for the education and mentorship of athletic training (AT) students through the role of preceptor. ATSs require extensive first-hand clinical experiences to prepare them for autonomous practice but must first feel comfortable with the skills they have learned to apply them in clinical practice. The unique clinical experience these ATSs experienced was the combined experience of a graduate assistant athletic trainer preceptor who also assisted as a teaching assistant in the classroom. This allowed the preceptor to help the ATSs expand on the information provided …

Attitudes Toward Implicit Bias Among Ncaa Medical Support Staff, B J. Warner, A P. Jacobsen, M Decker, S A. Cage

Clinical Practice in Athletic Training

Introduction: Implicit biases are unconscious attitudes, emotions, or stereotypes that have the potential to negatively affect behaviors, actions, and decisions. Recent research has shown that healthcare workers do not provide equitable care to patients from different demographics. When patients are receiving different levels of care, there is a potential for different patient-related outcomes. One of their first steps in many implicit bias interventions for healthcare professionals is identifying one’s implicit bias. The purpose of this study was to describe the attitudes toward implicit bias among non-athletic training healthcare professionals who provide care to collegiate student-athletes. Methods: An electronic survey was …

Knowledge Of And Attitudes Toward Native American And First Nations People Among Ncaa Division I Athletic Trainers, L E. Trail, L K. Warner, B J. Warner, M Decker, S A. Cage

Clinical Practice in Athletic Training

Introduction: Current literature shows that Native Americans people experience more health care disparities relative to other ethnic and racial groups. Previous research has also shown that these healthcare disparities are present in pediatric and young adult Native American populations. As healthcare professionals who will potentially treat these populations, it is important to understand the knowledge of and attitudes toward Native Americans people among athletic trainers. The purpose of this pilot study was to describe the knowledge of, and attitudes and opinions of National Collegiate Athletics Association (NCAA) Division I athletic trainers toward Native Americans. Methods: An electronic survey (Table 1) …

The Effects Of Dry Cupping Therapy On Touch Pressure Threshold In Collegiate Baseball Players., S A. Cage, R L. Peebles, J D. Volpi, L E. Trail, B J. Warner

Clinical Practice in Athletic Training

Introduction: Cupping therapy is a therapeutic modality that uses negative pressures to achieve therapeutic benefits. Various published studies report that cupping therapy decreases pain, increases range of motion, and improves blood flow. Previous studies also report an effect on tissue tenderness. However, there do not appear to be any studies assessing the effects of cupping therapy on touch pressure threshold, which measures skin sensitivity. Changes in touch pressure threshold may provide more information on the neurological effect cupping therapy has on treated tissues. The purpose of this study was to compare the effects of cupping therapy on touch pressure threshold …

The Diagnosis, Rehabilitation, And Treatment Of Posterior Impingement In A High School Baseball Pitcher, K Tisdale

Clinical Practice in Athletic Training

Introduction: Posterior impingement, also known as internal impingement, is a type of secondary impingement that is caused by overuse and repetitive movements of the shoulder overhead during motions such as throwing, spiking, etc. A combination of shoulder abduction and external rotation produces impingement of the infraspinatus and/or of the supraspinatus against the posterior-superior glenoid. Posterior impingement is common in overhead athletes, and this mechanism is usually seen during the cocking phase of throwing. Someone suffering from posterior impingement may complain of posterior shoulder pain, posterior stiffness and decline in performance. Patient Information: In this case study, a 15- year-old male …

Figure-8-Reconstruction Of Posterior Sternoclavicular Joint Dislocation 18 Days Post Initial Injury, M Suri, S Bunemann

Clinical Practice in Athletic Training

Introduction: Traumatic sternoclavicular joint injuries account for less than 3% of all traumatic joint injuries1. Although rare, posterior dislocation of the sternoclavicular joint has the potential to be life-threatening due to the proximity of vital structures posterior to the manubrium. This injury typically requires a high-energy force applied through the joint2. SC dislocations become increasingly difficult to reduce after 24 hours, so timely diagnosis and treatment are important. Glass et al. found mediastinal compression occurred 30% of the time with posterior dislocations. If left untreated, prolonged pressure on the superior mediastinum can cause erosion of the great vessels, tracheoesophageal fistula, …

Second Victim Syndrome And Organizational Support For Healthcare Providers: A Scoping Review, K R. Petryszyn, J P. Young, E R. Neil, J E. Benedict, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Healthcare providers may experience critical incident, medical error, or other adverse patient events in their clinical practice. Those that do encounter such events, may experience second victim syndrome (SVS), a condition in which providers feel psychological, cognitive, or physical reactions rendering care in these instances. Those with SVS may experience symptoms such as anxiety, depression, or burnout. Organizational support may mediate the impacts of SVS after an adverse patient event. We conducted a scoping review to explore and synthesize the literature on the support strategies implemented by healthcare organizations in the United States, for healthcare providers, after adverse patient …

Association Between Baseline Field Test Performance And Match Physical Performance In D1 Female Soccer Players, Benito Joel Cecenas

Graduate Student Theses, Dissertations, & Professional Papers

Background: Fitness testing is utilized by numerous soccer programs as a means for evaluation of player physical capacity. Previous literature has shown Yo-Yo Intermittent Recovery Test Level 1 (YYIR1) performance is associated with match physical performance in elite adult and youth soccer players. Until now, these relationships have not been investigated in the collegiate soccer setting, despite the YYIR1 being regularly utilized at the collegiate level to determine eligibility for competition, influence playing time, and to assess adaptation to training programs. For these reasons the association between the YYIR1 and match physical performance was investigated in women’s collegiate soccer.

Aims: …

Review Of Diagnostic Accuracy Of The Ottawa Knee Rules In Adult Acute Knee Injuries, Sean L. Glover, Amy M. Loveless, Sara A. Posson, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Acute knee injuries are commonly found in athletic populations. The wide range of knee injuries can present a challenge deciding which injuries require imaging. Currently, radiography is considered the gold standard of imaging for knee fractures. However, imaging is often costly not only for the patient, but also for the healthcare system. Since imaging is expensive, it is critical that clinicians decipher which patients require such testing. The Ottawa Knee Rules (OKR) is a predictor tool created by Stiell et al in 1995 to help clinicians accurately distinguish potential knee fractures from non-fractures for imaging purposes. The OKR guidelines state …

The Impact Of Bracing On Kinesiophobia And Recovery In Acl Reconstruction Patients: A Case Study, N Valdecanas, K Neelon, K Braunreiter

Clinical Practice in Athletic Training

Introduction: With 100,000 to 200,000 cases reported in the U.S. yearly, the anterior cruciate ligament (ACL) is a commonly torn structure in the knee among contact and non-contact sports. As medical research on ACL injuries grows, ACL reconstruction (ACLR) continues to be the preferred surgical intervention. Due to extensive rehabilitation timeline requirements, ACLR patients may face physical and psychosocial circumstances affecting their overall recovery. At any point in rehabilitation the patient may experience kinesiophobia, or an irrational fear relating to further injury from participation in physical movement, especially with return to running, jumping, and sports-specific programs. Functional bracing has been …

Clinical Athletic Trainers Decrease Orthopedic Physician Clinical Burden, A Barloon, K Meadows, A Pennuto, K Petrachaianan, N Glass, M Hogue

Clinical Practice in Athletic Training

Introduction/Context: More than half of physicians in the United States are reporting symptoms of burnout. These symptoms lead to increased risk to patient safety and overall physician health. The use of Certified Athletic Trainers (ATCs) is increasing in popularity, especially in Orthopedic clinics. ATCs in the clinical setting have been shown to allow physicians to focus on patient care and less on clerical and documentation tasks. The goal of this study is to assess if ATCs in the physician practice setting influence physician work-life integration, burnout, and work engagement. Methods/Intervention: Approval obtained by IRB at University of Iowa. An observational, …

Longitudinal Sport Science Implementation In American Collegiate Men’S Basketball, Jason Stone

Graduate Theses, Dissertations, and Problem Reports (ETD)

The expanding opportunities to implement sport science frameworks in elite-level basketball environments coincide with the sport’s increasing global prominence. Concomitant to these opportunities is the continual growth of the sport technology market (e.g., wearables, force plates) and computational power (e.g., data management tools, coding capabilities), which yields solutions and challenges for both athletes and practitioners. Due to the rapid influx of new sport technologies in high performance environments, particularly American Collegiate Men’s Basketball, more formal and ecologically valid research on how to effectively utilize data derived from them, particularly over long periods of time (i.e., multiple seasons) is needed. To …