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Hip Injury Profile and Time Missed From Participation in Male National Collegiate Athletic Association Division I Baseball Athletes

Ioanna K. Bolia, Jennifer A. Bell, Hyunwoo P. Kang, Aryan Haratian, Laith K. Hasan, Michael B. Eppler, Russ Romano, James E. Tibone, Seth C. Gamradt, and Alexander E. Weber

Context: It is important to examine hip injury characteristics in baseball athletes in order to develop injury-specific prevention protocols. There is currently a lack of literature regarding collegiate baseball athletes. Objective: To report the hip injury characteristics and time missed from sport participation in National Collegiate Athletic Association Division I baseball players over a period of 5 years. Results: Forty-seven hip–groin injuries were recorded in 30 National Collegiate Athletic Association Division I baseball players. Pitchers had the highest number of hip–groin injuries (24/47, 51%), and outfielders had the longest time missed from baseball participation (33 days on average). The two most common types of hip–groin injuries were femoroacetabular impingement syndrome (14/47, 30%) and hip adductor strain (14/47, 30%). Days missed from baseball participation was 4.5 days (range: 4–7) for short-term injuries and 90 days (range: 46–131) for long-term injuries. Interpretations: Femoroacetabular impingement syndrome and adductor muscle strain were the predominant diagnoses in National Collegiate Athletic Association Division I baseball players with hip–groin injury; short-term injuries resulted in ∼5 days missed but recovery from a long-term injury took ∼3 months. Pitchers had the highest number of injuries (including adductor strain and femoroacetabular impingement syndrome).

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The Impact of Concussion Education on Injury Disclosure in High School Athletes: A Critically Appraised Topic

Alyson Hansbarger, Ryan Thomson, Jamie L. Mansell, and Ryan T. Tierney

Clinical Scenario: Sport-related concussions are common injuries during sport-related activities. Evaluations of these injuries involve symptom reporting. Unfortunately, concussion symptoms are widely underreported by athletes, and can lead to longer recovery times. Concussion education programs were created to encourage reporting of symptoms by athletes. Clinical Question: Does concussion education impact injury disclosure in high school athletes? Summary of Key Findings: Three studies were included in this appraisal. Two studies utilized an educational lecture, and one study utilized an informational video providing the concussion education. All three studies found significant increases in injury history disclosure from pre-education to immediate post-education. Clinical Bottom Line: There is moderate evidence to support the idea that education has a positive impact on concussion reporting behaviors. These studies found positive results immediately following concussion education therefore it may be beneficial to provide concussion education several times a year. Strength of Recommendation: There is Level B evidence to support the idea that implementing concussion education will impact concussion reporting behaviors as it pertains to injury history disclosure.

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Plyometrics Did Not Improve Jump-Landing Biomechanics in Individuals With a History of Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Hyunjae Jeon, Sean Krysak, Steven J. Pfeiffer, and Abbey C. Thomas

Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.

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A Preliminary Examination of Concussion Knowledge and Attitudes by Collegiate Athletes Who Are Deaf or Hard of Hearing

Matthew P. Brancaleone and René R. Shingles

Athletes who are deaf or hard of hearing (D/HoH) participate at all levels of athletic competition, but no evidence exists regarding their knowledge of and attitudes toward concussion. The purpose of our study was to explore the knowledge of and attitudes toward concussion in athletes who are D/HoH using the Rosenbaum Concussion Knowledge and Attitudes Survey. The Rosenbaum Concussion Knowledge and Attitudes Survey consists of two subscales, the Concussion Knowledge Index (range 0–25) and the Concussion Attitudes Index (15–75). Athletes who are D/HoH had a Concussion Knowledge Index score of 16.25 ± 3.83 and Concussion Attitudes Index score of 58.04 ± 6.44. There were differences between races for Concussion Knowledge Index scores (p < .01). Findings may allow health care professionals to better target educational interventions for athletes who are D/HoH.

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Exercise and the Effects of Hydration on Blood Viscosity in Sickle Cell Trait Carriers: A Critically Appraised Topic

Leslie Tufano, Jon Hochstetler, Timothy Seminerio, and Rebecca M. Lopez

Clinical Question: During bouts of exercises in a hypohydrated state, do patients with sickle cell trait compared with patients without sickle cell trait demonstrate higher blood viscosity? Clinical Bottom Line: There is evidence that there is a difference in hematocrit levels in patients with sickle cell trait and patients without sickle cell trait both pre- and postexercise with suboptimal hydration status. Moreover, the effects on hematocrit levels increase over baseline levels in the recovery stages postexercise in patients with sickle cell trait.

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NATA News & Notes

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Antigravity Treadmill in Rehabilitation After Hip Labral Repair Arthroscopy

Brandon M. DeSantis, Victor R. Kalman, and Steven Browne

Antigravity treadmills are being used in rehabilitation programs but have not been used consistently with posthip labral repair arthroscopy surgeries. The purpose of this study was to review the posthip labral protocol used by eight National Collegiate Athletic Association Division I collegiate athletes (all ages 18–21) from multiple sports that used the antigravity treadmill as a bridge between “no running” and “on-ground running.” The authors found that athletes who did this returned to play between 4.5 and 7 months, had a better overall functional status, and had no re-injuries. This is the first known study of its kind available in the literature.

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Athletic Trainers’ Methods for Determining Return to Activity for Patients With an Ankle Sprain Part I: Types of Measures Used

Ryan S. McCann, Ashley M.B. Suttmiller, Phillip A. Gribble, and Julie M. Cavallario

Athletic trainers are commonly responsible for clearing patients with ankle sprains for return to activity. What criteria athletic trainers typically use to determine return to activity readiness in this population remains unclear. The purpose of this qualitative study was to examine criteria athletic trainers use to determine patients’ return to activity readiness following an ankle sprain. Participants varied in selected clinician-, patient-rated, and functional assessments for patients with ankle sprains. As many selected methods did not agree with expert consensus recommendations, more work is likely needed to instill best practices for evaluation of patients with ankle sprains.

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Athletic Trainers’ Methods for Determining Return to Activity for Patients With an Ankle Sprain Part II: Influences of Selected Outcomes

Ryan S. McCann, Ashley M.B. Suttmiller, Phillip A. Gribble, and Julie M. Cavallario

Athletic trainers’ reasons for selecting or avoiding certain evaluation techniques for patients with an ankle sprain are not fully understood. Such information is important to facilitating evidence-based practice and eliminating barriers. The purpose of this qualitative study was to determine what factors influence athletic trainers’ selection or avoidance of specific outcomes used to determine patients’ return to activity readiness following an ankle sprain. Participants cited many factors that facilitate and inhibit their use of best-practice recommendations and alternative methods for evaluating patients with ankle sprains. Athletic trainers’ should continue to promote facilitators and eliminate barriers to the use of best practices.

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Wetted Ice With Elastic Wrap Decreases Intramuscular Temperature More Quickly Than Game Ready®

Courtney R. Anderson, Kara N. Gange, Bryan Christensen, and Rachelle Vettern

Cryotherapy is a popular treatment chosen by health care providers to treat musculoskeletal injuries. The purpose of this study was to determine which cryotherapy method, Game Ready® or a wetted ice bag with elastic wrap, caused a greater and faster decline in tissue temperature during a 30-min treatment. At 2 cm below adipose, intramuscular tissue temperatures decreased more and faster with the wetted ice treatment compared with the Game Ready® treatment at all three time points: 10 min, 20 min, and 30 min. Furthermore, wetted ice significantly decreased temperature more than Game Ready® at 20 min (peak change [Ca]GR = 3.40 °C, [Ca]WI = 6.14 °C, p = .03) and 30 min ([Ca]GR = 5.62 °C, [Ca]WI = 8.67 °C, p = .02). One of the primary goals after injury is to lower tissue temperature to decrease cellular metabolism to reduce the risk of secondary ischemic injury. No evidence exists to support the optimal tissue temperature decrease for specific physiological results with cryotherapy. However, the literature is consistent with modalities producing colder temperatures are considered a better immediate care modality to decrease cell metabolism as much as possible. Therefore, these findings suggest wetted ice with an ACE wrap would be the more effective treatment in the immediate care phase.