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Efficacy of a Mulligan Concept Sustained Natural Apophyseal Glide Technique for Cervicogenic Headache: A Critically Appraised Topic

Kyle North, Koki Kawaguchi, Michelle Perri, Megan Mormile, Russell T. Baker, James May, and Alan Nasypany

Clinical Question : In adults with cervicogenic headache (CGH), what are the effects of a clinician-applied Mulligan Concept C1–C2 rotational sustained natural apophyseal glide on cervicogenic symptomology? Clinical Bottom Line: Both Level 2b and Level 4 evidence of Grade B quality exists to support using the C1–C2 rotational sustained natural apophyseal glide to decrease CGH severity and participant-reported neck disability immediately posttreatment, while also increasing cervical range of motion in adult patients with CGH headaches and a positive flexion–rotation test. Further research should examine the long-term effects of the C1–C2 rotational sustained natural apophyseal glide technique on cervical range of motion, flexion–rotation test results, and CGH frequency and severity. In addition, the flexion–rotation test should be explored as a standard diagnostic assessment in CGH cases.

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High-Load Squat Training Improves Sprinting Performance in Junior Elite-Level Soccer Players: A Critically Appraised Topic

Lars H. Lohmann, Konstantin Warneke, Stephan Schiemann, and Irene R. Faber

Practical Question: Is high-load squat training beneficial in improving sprinting performance in junior elite-level soccer players? Clinical Bottom Line: There is Level 3 evidence to support the validity of high-load squat training as a measure to improve sprinting performance in junior male elite-level soccer players. All three studies included showed significant increases in soccer-related sprinting performance.

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Unstable Osteochondral Fracture of the Talus, Osteochondritis Dissecans, and Chronic Lateral Ankle Instability in an Adolescent Athlete: A Case Report

Toby J. Brooks, Kevin Crawford, and Eugene E. Curry

A 15-year-old multisport athlete with chronic left ankle pain and instability 2 years following initial injury was diagnosed with an unstable osteochondral fracture of the lateral talar dome, osteochondritis dissecans, and lateral ligament instability. The patient underwent open surgical repair consisting of loose body excision, lateral ligament reconstruction, and talar dome debridement and microfracture followed by postoperative therapeutic exercise for 7 months. The patient successfully returned to competitive sports within a calendar year. Although not considered particularly rare among adult populations, osteochondral fracture of the talus is relatively rare in adolescents. This case demonstrates that a diagnosis of unstable osteochondral fracture and/or gross lateral ligament instability should be considered in cases involving adolescent athletes with significant ankle injury and prolonged pain and/or loss of function.

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Continuing Education Assessment

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Volume 27 (2022): Issue 5 (Sep 2022)

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Does Reactive Neuromuscular Training Increase Gluteal Musculature Activation During Squatting Movements? A Critically Appraised Topic

Ian Brewer, Josh Zimmerman, Marcie Fyock-Martin, Nelson Cortes, and Joel Martin

Clinical Question: Does reactive neuromuscular training (RNT) increase gluteal muscle activation during squatting movements? Clinical Bottom Line: The current best evidence suggests RNT may result in acute increases of gluteus maximus and gluteus medius muscle activation when performing the barbell back squat exercise; however, the findings were inconsistent and unclear for other types of squatting movements. Grades B and D evidence exists on the effects of RNT to increase gluteus maximus and medius muscle activation, respectively, during squatting movements. Given the methodological differences and mixed findings reported in this critically appraised topic, practitioners should carefully consider whether using RNT would be appropriate for a given clinical scenario.

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Clinical Decision Making in Athletic Training

Russell L. Muir

Athletic trainers frequently make decisions under uncertain conditions leading to the use of decisional shortcuts (heuristics). Heuristics can be useful decisional tools, but their use gives rise to predictable cognitive errors (cognitive bias), which can lead to diagnostic and injury management errors. This study assessed athletic trainers’ understanding of these topics and explored their presence in athletic training education. Few participants were taught about heuristics (11.6%) and cognitive bias (24.1%), although those taught about heuristics demonstrated greater understanding of both topics. To improve clinical efficacy and patient outcomes, athletic trainers should seek educational opportunities related to heuristics and cognitive bias.

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Kinesio Taping Versus Athletic Taping in Managing Chronic Golfer’s Elbow in Male Athletes

Asmaa F. Abdelmonem, Mariam A. Ameer, Karim Ghuiba, and Ammar M. Al Abbad

Medial epicondylalgia is a repetitive stress condition. The aim of this study was to assess whether Kinesio taping offers any superiority over athletic taping for chronic medial epicondylalgia management. The results show statistically significant differences in isokinetic and patient self-reported variables between each group: (a) Group A: Kinesio tape with rehabilitation; (b) Group B: athletic taping with rehabilitation; and (c) group C: only rehabilitation. Although no significant differences in preintervention group assessments (p > .05) were found, only Group (A) showed statistically significant posttreatment improvements. Kinesio taping over athletic taping appears effective for treating chronic medial epicondylalgia and facilitating pain reduction and isokinetic improvements.

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NATA News & Notes

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Survey of National Collegiate Athletic Association Athletic Trainers’ Administration of the National Wrestling Coaches Association Weight Certification Program

Samuel L. Konrath and Dale R. Wagner

Despite implementation in 1997, published research detailing the administration of the National Collegiate Athletic Association’s minimum weight certification program is lacking. This survey aimed to determine how athletic trainers administer this program. Thirty-five of 77 (45.5% response rate) athletic trainers for National Collegiate Athletic Association Division I wrestling programs responded. Most (74.3%) had ≥5 years of experience measuring body composition, and nearly all (97.1%) used skinfold calipers. Caliper type varied, but everyone used the same measurement sites and procedure to estimate minimal weight. There appears to be consistency in the administration of minimal wrestling weight standards across National Collegiate Athletic Association Division I programs.