Journal of Athletic Training最新文献

The performing arts industry places unique pressures on individuals, often leading to higher rates of mental health issues. Minimal information exists about how to create on-site intervention strategies for undergraduate performing art students. Athletic trainers at a dedicated university performing arts campus searched their electronic medical record (EMR) for reports of mental health-related issues in the dance, musical theater, and theater undergraduate students. The data analysis revealed anxiety and overstress conditions were primarily reported among dance and musical theater students. After communicating with stakeholders, the athletic trainers implemented a multi-faceted mental health intervention strategy for academic majors across the performing arts campus. The athletic trainers worked with the stakeholders and university counseling offices to destigmatize mental health conditions, reduce barriers, and implement mental health referrals and counseling across the campus. Reviewing internal data and listening to patient concerns enhanced mental health services in this undergraduate performing arts student population.

Context: Numerous studies report deficits in hip muscle performance in individuals with patellofemoral pain (PFP). However, the exact stage at which these deficits emerge and the impact of symptom duration remain unclear.

Objective: To compare hip abductor strength and endurance based on the presence or absence of PFP and its duration.

Design: Cross-sectional study.

Patients or other participants: 68 with PFP and 29 pain-free controls.

Main outcome measure(s): We evaluated isometric maximal strength, isometric endurance, and dynamic endurance of hip abductors. Comparisons were made between participants with PFP and pain-free controls and among different PFP duration subgroups (< 12 months, ≥ 12 months, ≤ 6 months, > 24 months) and pain-free controls.

Results: Hip abductor isometric strength (% body mass [BM]) was significantly lower in the PFP group (203.8 ± 46.8) and all PFP subgroups (< 12 months: 203.9 ± 57.0; > 12 months: 203.7 ± 42.2) (≤ 6 months: 205.1 ± 59.6; > 24 months: 207.7 ± 41.9), compared to pain-free controls (254.6 ± 60.3). However, no significant differences were found between PFP subgroups. There were also no significant differences in hip abductor isometric or dynamic endurance between PFP group and pain-free controls, or between PFP subgroups and pain free controls.

Conclusions: Hip abductors strength deficits emerge early in the course of PFP. However, further studies are needed to understand the observed lack of difference in endurance.

Position statements are utilized by healthcare organizations to summarize evidence and clearly articulate consensus on best practices. The procedures for developing position statements by the National Athletic Trainers' Association and the NATA Research and Education Foundation have been updated to enhance transparency, reduce bias, and better incorporate the available research to support clinical care recommendations. The paper details the processes of topic selection, author group formation, evidence gathering, and recommendation building, emphasizing the systematic approach and the inclusion of diverse expertise. These changes ensure that future position statements, starting from June 2024, will be more rigorously developed and serve as a reliable resource for athletic trainers, other healthcare providers, and important stakeholders in various settings.

CONTEXT: Chronic ankle instability (CAI) is the most serious long-term complication following an ankle sprain. Taping and bracing are frequently employed in the return to sport (RTS) continuum to avoid injury recurrence and to maximize post-injury performance. The Ankle-GO score is a valid and reliable objective RTS criteria, but the influence of ankle supports on this score in CAI patients remains unknown.OBJECTIVES: We aimed to evaluate the induce effects of taping or bracing on the Ankle-GO score among patients suffering from CAI.DESIGN: Crossover StudySETTING: Sports medicine research laboratoryPATIENTS: Thirty CAI patients (13 males and 17 females, 33.4 ±11.7 years) performed the Ankle-GO score in three conditions (taping, bracing and no ankle support).MAIN OUTCOME MEASURES: The Ankle-GO is a 25-point score clustering 2 self-reported questionnaires (Foot and Ankle Ability Measure and Ankle Ligament Reconstruction-Return to Sport after Injury) and 4 functional tests (Single Leg Stance, Star Excursion Balance Test, Side Hop Test and Figure-of-eight test). Performances on each component as well as the total score were compared between conditions using repeated measures of ANOVA.RESULTS: Taping and bracing significantly and equally improved the Ankle-GO score compared with no support (12.8 ±5.3 and 11.2 ±4.2 vs. 8 ±4.5 points respectively, P<.001). However, significant improvements were found solely in self-reported questionnaires with ankle support (P<.001). No differences were found in functional tests, although both taping and bracing significantly lowered instability perception during the tests (+1.9 and +1.8 points, respectively).CONCLUSION: Ankle-GO scores were significantly enhanced with taping or bracing. However, only self-reported function and psychological readiness were improved. Functional performance was not altered, although external supports enhanced perceived stability. Both taping and bracing supports appear equally important in improving self-confidence and perceived ankle stability among individuals with CAI returning to sport.

Context: Recent studies exploring chronic ankle instability (CAI) have found alterations in cutaneous reflexes of musculature surrounding the ankle which may contribute to perceived instability and recurrent LAS seen in this population. CAI is considered a multifaceted condition, making it difficult to determine the underlying cause of these altered reflexes. Objective: To observe how mechanical laxity of the ankle affects lower limb cutaneous reflexes and perceived instability during gait and how surgical intervention to correct laxity affects these measures. Design: Clinical Case Report Setting: Research Laboratory Patient: A physically active 25-year-old female (64in;130lbs) with 7 previous lateral ankle sprains (LAS) and met CAI diagnostic criteria based on CAI questionnaire scores. The patient underwent a Broström reconstruction of the CFL via allograft and partial synovectomy. Main Outcome Measures: CAI questionnaire scores, middle latency lower limb cutaneous reflexes, and perceived instability following sural nerve stimulation during gait. Results: Post-surgery, the patient's CAIT and FAAM questionnaire scores aligned with those of a healthy individual. PL reflexes were diminished or inhibitory during the stance phases of gait. Pronounced variability of PL reflexes may have contributed to this lack of facilitation. BF facilitation at midstance was absent during both testing sessions while BF and RF facilitation was generally reduced post-surgical intervention. The patient's average perceived instability following sural stimulation was markedly reduced from the pre-surgical (6.5±0.48) to post-surgical (1.9±0.24) session. Conclusions: Mechanical instability likely contributed to the reflex variations seen in this patient pre- surgically, while the enhanced static stability provided by the surgical procedure may have reduced the need for dynamic stability via lower limb cutaneous reflexes observed in the follow-up session. Identifying the specific limitations experienced by an individual with CAI will allow for a more effective monitoring and treatment and provide improved long-term health-related quality of life outcomes.

Context: Menstrual dysfunction among adolescent female athletes is associated with both an increased musculoskeletal injury risk and poor psychological health. Objective: To examine if adolescent flag football athletes with menstrual dysfunction report different levels of energy, mood, sleep, and stress during the season compared to those without menstrual dysfunction. Design: Prospective cohort study Setting: A series of questionnaires pre-season, in-season weekly, and post-season to athletes in Denver Metro Area Patients or Other Participants: Female athletes with and without self-reported menstrual dysfunction who participated in a high school flag football season. Main Outcome Measure(s): Quality of life measures (energy, mood, sleep, and stress) rated weekly from 0 (low energy, poor mood, poor sleep, low stress) to 10 (high energy, best mood, great sleep, and high stress). Results: Of the 60 adolescent female flag football athletes enrolled, 15 (25%) reported menstrual dysfunction. The groups were not significantly different in mean ratings for energy (5.3±1.1 vs.5.1±1.4; p=0.70) or mood (5.6±1.1 vs. 6.0±1.5; p=0.32). However, the menstrual dysfunction group reported significantly worse sleep (4.2±1.3 vs. 5.2±1.4; p=0.02) and more stress (7.0±1.0 vs. 5.9±1.3; p=0.005) than those without menstrual dysfunction. When adjusting for school year, BMI, and injuries sustained during the season, menstrual dysfunction was significantly associated with worse sleep (β= -0.98; 95% CI= -1.82, -0.13; p=0.03) and more stress (β=1.11; 95% CI=0.35, 1.87; p=0.005). Conclusion: Flag football athletes with menstrual dysfunction reported worse sleep and more stress compared to those without menstrual dysfunction. These findings contribute to the importance of monitoring and addressing menstrual dysfunction and its association with quality of life factors in female adolescent athletes.

Context: Football is the most popular sport among high school boys in the United States. Concussion risk is elevated in the sport due to the high degree of physical contact. Healthcare providers are more likely to be present at the time of concussion during games and for varsity-level athletes, but how time to an immediate athletic trainer (AT) evaluation varies between sport levels and injury settings has yet to be investigated.Objective: Investigate associations between athlete sport level, injury setting, and same day AT evaluation among high school football players following a concussion. Design: Cross-sectional study.Setting: Retrospective analysis of de-identified patient records created within the Athletic Training Practice-Based Research Network.Patients: Patients evaluated and diagnosed with a concussion during in-season high school football participation from 2010-2023. Main outcome measure: Sport level (freshman, junior varsity [JV], varsity), injury setting (game, practice), and same-day evaluation following concussion (yes, no). Results: 1,260 patient cases were included in analysis. A significant association was found between sport level and same-day evaluation (p=0.02), and between injury setting and same-day evaluation (p<.001). A higher percentage of patients playing at the varsity level were evaluated the same day as their injury compared to those playing at the JV and freshman levels. Additionally, a higher percentage of football athletes were evaluated the same day if they sustained an injury during an in-season practice compared to a game. These associations remained significant after stratifying by sport level for freshman (p=0.01) and JV (p<.001) athletes, but not for varsity athletes (p=0.61).Conclusions: Freshman and JV football athletes, as well as those injured during games, are less likely to receive a same-day evaluation by an AT after concussion. Timely care improves recovery following concussion, emphasizing the need for equitable access to immediate care across sport levels and settings.

Context: Slower habitual walking speed and aberrant gait biomechanics are linked to clinically significant knee-related symptoms and articular cartilage composition changes linked to posttraumatic osteoarthritis after anterior cruciate ligament reconstruction (ACLR).

Objectives: To (1) determine whether specific gait biomechanical variables can accurately identify individuals with clinically significant knee-related symptoms post-ACLR and (2) determine the corresponding threshold values, sensitivity, specificity, and odds ratios for each biomechanical variable.

Design: Cross-sectional study.

Setting: Laboratory.

Patients or other participants: A total of 71 individuals (38 female, 33 male; age = 21 ± 4 years, height = 1.76 ± 0.11 m, mass = 75.38 ± 13.79 kg, time after primary unilateral ACLR = 6.2 ± 0.4 months).

Main outcome measure(s): Three-dimensional motion capture of 5 overground walking trials was used to calculate discrete gait biomechanical variables of interest during stance phase (first and second peak vertical ground reaction force [vGRF], midstance minimum vGRF, peak internal knee-abduction and -extension moments, and peak knee-flexion angle), along with habitual walking speed. Previously established Knee Injury and Osteoarthritis Outcome Score cutoff scores were used to define patients with (ie, symptomatic; n = 51) and those without (ie, asymptomatic; n = 20) clinically significant knee-related symptoms. Separate receiver operating characteristic curves and respective areas under the curve (AUCs) were used to evaluate the capability of each biomechanical variable of interest to identify individuals with clinically significant knee-related symptoms.

Results: Habitual walking speed (AUC = 0.66), vGRF at midstance (AUC = 0.69), and second peak vGRF (AUC = 0.76) demonstrated low to moderate accuracy for identifying individuals with clinically significant knee-related symptoms. Individuals who exhibited habitual walking speeds ≤ 1.27 m/s, midstance minimum vGRF ≥ 0.82 body weights, and second peak vGRF ≤ 1.11 body weights demonstrated 3.13, 6.36, and 9.57 times higher odds of experiencing clinically significant knee-related symptoms, respectively.

Conclusions: Critical thresholds for gait variables may be used to identify individuals with increased odds of clinically significant knee-related symptoms and potential targets for future interventions.

Athletes with autism spectrum disorder (ASD) experience lesser care for injuries, and athletic trainers (ATs) report feeling unprepared to provide care competently for this population. Provision of sports-related care can be impacted by sensory differences associated with ASD, such as hyperreactivity to sensation or poor integration of sensory information. An in-depth review of the literature using the Strength of Recommendation Taxonomy guidelines was used to identify articles that address the sensory features of autism for ATs with the purpose of informing ATs about the sensory features of ASD and to present the most current evidence-based recommendations for providing care to athletes with ASD and other neurodivergent individuals who present with sensory differences. Relevant articles were reviewed by 4 independent researchers and organized by theme. Key themes included use of sensory-friendly or sensory-adapted environments, sensory kits, and informed communication strategies that acknowledge sensory differences. Providing individualized care for athletes with ASD and sensory features can improve the quality of and participation in sports for persons with autism.

Context: Nontraumatic shoulder pain (NSP) is common in volleyball, affecting performance and well-being. It is more prevalent in female players. Previous studies lack comprehensive assessments of shoulder pain that consider multiple factors, including range of motion, muscle strength, joint position sense, dynamic stability, and volleyball-specific mechanics.

Objective: To investigate NSP prevalence in female high school volleyball players, considering shoulder joint functional parameters and volleyball-specific factors.

Design: Cross-sectional study.

Setting: High school gymnasiums.

Patients or other participants: Fifty-nine female high school volleyball players (15-17 years).

Main outcome measure(s): Demographic data, environmental factors (years of experience, spiking technique, and serve type), shoulder joint function (passive glenohumeral joint's range of motion, muscle strength, joint position sense, and dynamic stability), and NSP prevalence during spiking and serving. Logistic regression analysis was conducted to identify significant factors associated with NSP.

Results: Nontraumatic shoulder pain prevalence was 54.2%, with 68.8% not informing coaches. Significant associations were found between NSP and factors such as Upper Quarter Y-Balance Test-Medial (P = .008; odds = 0.892; 95% confidence interval = 0.82, 0.97) and joint position sense of internal rotation (P = .031; odds = 1.411; 95% confidence interval = 1.03, 1.93).

Conclusion: Shoulder pain leads to impaired proprioception and dynamic stability. Effective communication between players and coaches is crucial for managing and preventing pain. Targeted training programs to enhance proprioception and dynamic stability may reduce shoulder pain and injuries. Educating players on the importance of reporting pain and encouraging early intervention is essential.