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.
Kati S. Karinharju, Sjaan R. Gomersall, Kelly M. Clanchy, Stewart G. Trost, Li T. Yeo, and Sean M. Tweedy
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.
Clinical Scenario: Traditional loading (TL) is a common technique to employ when engaging in countermovement jumps (CMJ). Accentuated eccentric loading (AEL) is a newer modality that is being explored for acute CMJ performance. Focused Clinical Question: In adult, resistance-trained males, will AEL have a superior impact on acute CMJ performance compared to TL? Summary of Key Findings: The literature was searched for studies that examined the influence of AEL on acute CMJ performance compared to a TL protocol. TL was defined as any loading condition that utilized an equivalent resistance during both the eccentric and concentric contractions. Three studies met the inclusion and exclusion criteria, and were identified and included in the critically appraised topic. Each of the 3 studies found that various AEL conditions were either equal to or better than TL when examining subsequent CMJ performance. In no specific CMJ outcome measure was TL deemed to have a greater impact than AEL. Clinical Bottom Line: AEL provides more favorable acute CMJ performance than TL in adult, resistance-trained males. Strength of Recommendation: Consistent findings from 2 randomized crossover studies and one repeated-measured design investigation suggest level 2b evidence to support AEL as an ideal protocol for acute CMJ performance.
Hamid Reza Bokaeian, Fateme Esfandiarpour, Shahla Zahednejad, Hossein Kouhzad Mohammadi, and Farzam Farahmand
In this study, the effects of an exercise therapy comprising yoga exercises and medial-thrust gait (YogaMT) on lower-extremity kinetics, pain, and function in patients with medial knee osteoarthritis were investigated. Fifty-nine patients were randomly allocated to three treatment groups: (a) the YogaMT group practiced yoga exercises and medial thrust gait, (b) the knee-strengthening group performed quadriceps- and hamstring-strengthening exercises, and (c) the treadmill walking group practiced normal treadmill walking in 12 supervised sessions. The adduction and flexion moments of the hip, knee, and ankle; pain intensity; and 2-min walking test were assessed before and after treatment and at 1-month follow-up. The YogaMT group experienced a significant reduction in knee adduction moment. All groups showed significant improvement in pain and function. The YogaMT may reduce medial knee load in patients with knee osteoarthritis in the short term. A larger clinical trial is required to investigate the long-term outcomes of this intervention.