An 18-year-old female, Division I soccer player was diagnosed with complex regional pain syndrome approximately 2 weeks after tarsal tunnel release surgery. Postsurgically, the patient reported a significant increase in neuropathic pain, swelling, paresthesia, skin temperature asymmetry, and allodynia of the plantar and dorsal aspects of the foot, which were initially attributed to other causes. The intense pain and delayed diagnosis led to a decline in mental health and suicide ideation. Once diagnosed with complex regional pain syndrome, an epidural was placed at L5/S1 with a continuous flow of lidocaine, resulting in functional restoration. The patient’s diagnosis and recovery were based on the collaborative efforts of the surgeon, sports medicine physician, pain management specialist, and athletic trainer. She returned to soccer participation with minimal symptoms. This case is unique because the symptoms of complex regional pain syndrome were attributed to other causes, resulting in a delayed diagnosis and appropriate treatment. This delay resulted in the patient threatening self-harm.
Gina E. McAlear and Jennifer K. Popp
The goal of this study was to determine if emotional expressions at the end of swimmers’ 2016 Paralympic races varied according to medal won and if their race wins and losses were close or not close. Using FaceReader software, videos of 46 races of medal-winning Paralympic (M age = 24.6; SD = 5.4) swimmers’ faces (78 males and 60 females) from 22 countries were analyzed. Silver medalists were angrier and sadder than gold medalists and angrier and more disgusted than bronze medalists. Swimmers who swam slower than their 2015 best time were angrier than Paralympians who swam faster. Paralympians who finished lower than their 2015 world ranking had more neutral emotions and were less happy than Paralympians who finished higher. Gold medalists who narrowly defeated silver medalists were less happy and more fearful than gold medalists who won easily. Bronze medalists with close wins had fewer neutral emotions and were happier, less angry, and more surprised than bronze medalists with not-close wins. All medalists with close wins were more surprised than medalists with easier wins. Bronze medalists with close losses to silver medalists were happier and less angry than bronze medalists who lost more easily. Effect sizes ranged from d = 0.27 to 1.01. These results provide theoretical support to basic emotion theory and confirm the anecdotal observations that Paralympic competition generates wide-ranging and diverse emotions.
Kati S. Karinharju, Sjaan R. Gomersall, Kelly M. Clanchy, Stewart G. Trost, Li T. Yeo, and Sean M. Tweedy
This study evaluated the validity of two wheelchair-mounted devices—the Cateye® and Wheeler—for monitoring wheelchair speed and distance traveled. Speed estimates were validated against a calibrated treadmill at speeds from 1.5 to 10 km/hr. Twenty-five wheelchair users completed a course of known distance comprising a sequence of everyday wheelchair activities. Speed estimate validity was very good (mean absolute percentage error ≤ 5%) for the Wheeleri at all speeds and for the Cateye at speeds >3 km/hr but not speeds <3 km/hr (mean absolute percentage error > 20%). Wheeleri distance estimates were good (mean absolute percentage error < 10%) for linear pushing activities and general maneuvering but poor for confined-space maneuvering. Cateye estimates were good for continuous linear propulsion but poor for discontinuous pushing and maneuvering (both general and confined space). Both devices provided valid estimates of speed and distance for typical wheelchair-based exercise activities. However, the Wheeleri provided more accurate estimates of speed and distance during typical everyday wheelchair activities.
Alison R. Snyder Valier, Kelsey J. Picha, and Deanne R. Fay
This study describes the experiences of over 500 school-based athletic trainers (ATs) and their familiarity, knowledge, comfort, and confidence working with athletes with a disability. ATs’ experiences in managing the health care of school-based athletes with a physical disability are unknown. Half of the respondents indicated experience providing services to these athletes, while 70% indicated little to no specific training/education. About half of the ATs reported being comfortable and confident in managing the care of athletes with a physical disability, while a quarter reported being knowledgeable. Findings suggest that experience helps provide ATs with comfort and confidence in caring for these athletes, but educational opportunities are still needed.
Grace Katt and Kevin C. Miller
Clinical Scenario: Many American football players have died from exertional heatstroke, one of the leading causes of sudden death in athletes. These athletes are predisposed to exertional heatstroke, in part, because of their protective equipment. Few authors have systematically appraised the research to determine how much faster rectal temperature (Trec) increases when full American football uniforms generally consisting of a helmet, shoulder pads, jersey, pants with padding, socks, shoes, and underwear/compressions (PADS) are worn compared with no uniform so that clinicians can better plan and modify exercise sessions to prevent dangerous Trec (i.e., ≥40.5 °C). Clinical Question: How much faster does Trec increase when men wear a full American football uniform compared with workout clothing during exercise in the heat? Summary of Key Findings: The authors searched the literature for randomized controlled studies with PEDro scores >6 that compared Trec of males wearing PADS to a control uniform during exercise under controlled laboratory conditions. In all four studies, Trec increased faster when PADS were worn during exercise (PADS = 0.052 ± 0.007 °C/min and control = 0.039 ± 0.009 °C/min). The average effect size across studies was 1.4 ± 0.5. Clinical Bottom Line: PADS increase Trec significantly faster than lesser uniform ensembles. Clinicians should factor in equipment and alterations in exercise duration and rest break frequency to help prevent dangerous Trec in American football players. Strength of Recommendation: Given the large effect size and controlled experimental study designs, there is strong evidence that wearing PADS during exercise results in faster increases in body core temperature.
James W. Roberts, Nicholas Gerber, Caroline J. Wakefield, and Philip J. Simmonds
The failure of perceptual illusions to elicit corresponding biases within movement supports the view of two visual pathways separately contributing to perception and action. However, several alternative findings may contest this overarching framework. The present study aimed to examine the influence of perceptual illusions within the planning and control of aiming. To achieve this, we manipulated and measured the planning/control phases by respectively perturbing the target illusion (relative size-contrast illusion; Ebbinghaus/Titchener circles) following movement onset and detecting the spatiotemporal characteristics of the movement trajectory. The perceptual bias that was indicated by the perceived target size estimates failed to correspondingly manifest within the effective target size. While movement time (specifically, time after peak velocity) was affected by the target configuration, this outcome was not consistent with the direction of the perceptual illusions. These findings advocate an influence of the surrounding contextual information (e.g., annuli) on movement control that is independent of the direction predicted by the illusion.
Lucas C. Bianco
A 58-year-old female had a total knee arthroplasty due to arthritic changes in her right knee, along with pain and loss of function. Mind and body intervention techniques were utilized to improve patient-centered outcomes. Protocols are in place for the rehabilitation of patients following a total knee arthroplasty. However, sometimes the mind–body connection can be disrupted, and plateaus in the rehabilitative process may benefit from innovative techniques. As patient-centered care, biopsychosocial models, and collaborative practice continue to push the athletic training profession, these types of cases that provide holistic approaches to expand health care will lead to future research.