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Bryony Buck, Scott Beveridge, Gerard Breaden Madden, and Hans-Christian Jabusch

Background: High-speed drumming requires precise control over the timing, velocity, and magnitude of striking movements. Aim: To examine effects of tempo and expertise on unaccented repetitive drumming performance using 3D motion capture. Methods: Expert and amateur drummers performed unimanual, unaccented, repetitive drum strikes, using their dominant right hand, at five different tempi. Performance was examined with regard to timing variability, striking velocity variability, the ability to match the prescribed tempo, and additional variables. Results: Permutated multivariate analysis of variance (PERMANOVA) revealed significant main effects of tempo (p < .001) and expertise (p <.001) on timing variability and striking velocity variability; low timing variability and low striking velocity variability were associated with low/medium tempo as well as with increased expertise. Individually, improved precision appeared across an optimum tempo range. Precision was poorest at maximum tempo (400 hits per minute) for precision variables. Conclusions: Expert drummers demonstrated greater precision and consistency than amateurs. Findings indicate an optimum tempo range that extends with increased expertise.

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Kristen M. Stearns-Reider, Rachel K. Straub, and Christopher M. Powers

Peak knee valgus has been shown to predict anterior cruciate ligament injury. The purpose of the current study was to compare peak rate of torque development (RTD) to peak isometric torque as a predictor of peak knee valgus during landing. Twenty-three healthy females participated. Hip abductor muscle performance was quantified using 2 types of isometric contractions: sustained and rapid. Peak isometric torque was calculated from the sustained isometric contraction. Peak RTD was calculated from the rapid isometric contraction (0–50 and 0–200 ms after force initiation). Kinematic data were collected during the deceleration phase of a double-leg drop jump task. Linear regression was used to assess the ability of hip abductor muscle performance variables to predict peak knee valgus. Increased peak RTD during the 0 to 50 milliseconds window after force initiation was found to significantly predict lower peak knee valgus (P = .011, R 2 = .32). In contrast, neither peak RTD from 0 to 200 milliseconds after force initiation window (P = .45, R 2 = .03) nor peak isometric torque (P = .49, R 2 = .03) predicted peak knee valgus. The inability of the hip abductors to rapidly generate muscular force may be more indicative of “at-risk” movement behavior in females than measures of maximum strength.

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Takao Mise, Yosuke Mitomi, Saki Mouri, Hiroki Takayama, Yoshitomo Inoue, Mamoru Inoue, Hiroshi Akuzawa, and Koji Kaneoka

Context: The range of shoulder rotation is associated with shoulder pain in young male and female swimmers. However, the association between shoulder pain and shoulder complex mobility of the scapulothoracic and acromioclavicular joints has not yet been examined. Moreover, shoulder pain occurs more frequently in females than in males, but only a few studies have examined the relationship between shoulder pain and sex as a risk factor. This study aims to determine the association between shoulder complex mobility and shoulder pain in young male and female swimmers. Design: Prospective cohort design. Methods: The participants were competitive swimmers (n = 76; 37 males and 39 females) with a mean age of 14 years in Japan. The shoulder rotation width, which was the index of shoulder complex mobility, shoulder internal and external rotation range, and middle finger distance of the back-scratch test were measured. An examiner regularly visited the swimming clubs to evaluate the development of shoulder pain and swimming distance. Logistic regression analysis was used to determine the physical characteristics related to the overall development of shoulder pain in both female and male swimmers. The cutoff value was calculated using receiver operating characteristic curves. Results: Sixteen participants, composed of 8 males and 8 females, developed shoulder pain. The overall swimming distance of the male (odds ratio [OR]: 1.0007, P = .01) and female (OR: 1.0018, P = .02) swimmers and the shoulder rotation width of the male (OR: 1.0952, P = .04) and female (OR: 0.888, P = .03) swimmers were identified as risk factors for shoulder pain. The cutoff value for swimming distance was 6000 m. Shoulder rotation width was more than 88 cm in males and <54 cm in females. Conclusions: Hypomobility and hypermobility of the shoulder complex were identified as risk factors for shoulder pain in male and female swimmers, respectively.

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Ashley M.B. Suttmiller and Ryan S. McCann

Context: Injury-related fear has recently been recognized to exist in ankle sprain populations. It is unclear, however, if injury-related fear levels differ between those who develop chronic ankle instability (CAI) and those who do not and the best tools for assessing these differences. Objective: The purpose of this study was to conduct a comprehensive systematic review investigating differences in injury-related fear between individuals with and without CAI. Evidence Acquisition: Relevant studies from CINAHL Plus with full text, PubMed, and SPORTDiscus through November 2020 were included. All studies used the Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, or Athlete Fear Avoidance Questionnaire as either a descriptor or a main outcome and provided comparison data between a CAI group and ankle sprain copers (COP) or controls (CON). The authors independently assessed methodological quality using the modified Downs and Black Quality Index. Studies were then grouped by between-group comparisons including CAI and CON, CAI and COP, and COP and CON. The authors calculated Hedge g effect sizes and 95% confidence intervals to examine group differences. Evidence Synthesis: A total of 11 studies were included in this review. In total, 8 studies provided data for the CAI and CON comparison, 7 for CAI and COP comparisons, and 4 for COP and CON comparisons. Methodological quality scores ranged from 60.0% to 86.7%, with 2 high-, and 9 moderate-quality studies. Overall, the evidence suggests that physically active individuals with CAI report higher levels of injury-related fear when compared with both COP and CON. Although limited, ankle sprain COP do not seem to differ from CON. Conclusion: Available evidence emphasizes the importance of injury-related fear in individuals who develop chronicity after ankle sprain injury. The Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia are useful for the identification of injury-related fear in individuals after sustaining an ankle sprain and should be used to inform rehabilitation strategies and to monitor efficacy in fear reduction.

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Lauren M. Harte, James J. Czyrny, Sonja Pavlesen, and Michael R. Ferrick

A 13-year-old female cheerleader presented with common peroneal neuropathy secondary to repetitive direct blow contusion injuries to the lateral leg, sustained during her role as a flyer in cheerleading. Symptoms resolved when removed from cheerleading activities. Nerve conduction velocity and needle electromyography electrodiagnostic test studies performed at presentation and during treatment confirmed improvement of the neuropathy. The use of a protective knee brace that provided cushion near the fibular head prevented recurrence after returning to cheerleading. An association between common peroneal neuropathy and cheerleading has not been documented in previous literature. Awareness of this association will help with diagnosis and prevention of injuries.

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Lorin A. Cartwright and Timothy Neal

An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.

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ZáNean McClain, Erin Snapp, Daniel W. Tindall, and Jill Anderson

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Philip Sullivan and Laura Tennant

Intercollegiate student-athletes appear to be a high-risk population with respect to mental health. Student athletic therapists are one of the groups with whom these athletes may be comfortable disclosing concerns. The current study investigated the relationship between mental health literacy and mental health referral efficacy in a sample of intercollegiate student therapists. One hundred and eleven student athletic therapists (81 female, 29 male, 1 nondiscloure) competed a revised version of the multicomponent mental health literacy measure and a four-item measure of mental health referral efficacy. T tests revealed statistically significant differences in mental health literacy by gender and personal history, and a multiple linear regression revealed a significant model predicting referral efficacy from mental health literacy. There are several implications of these results, particularly when working with a high-risk population of student-athletes.

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Andreas Kuettel, Natalie Durand-Bush, and Carsten H. Larsen

The purpose of this study was (a) to investigate gender differences in mental health among Danish youth soccer players, (b) to discover the mental health profiles of the players, and (c) to explore how career progression and mental health are related. A total of 239 Danish youth elite soccer players (M = 16.85, SD = 1.09) completed an online questionnaire assessing mental well-being, depression, anxiety, along with other background variables. Female players scored significantly lower on mental well-being and had four times higher odds of expressing symptoms of anxiety and depression than males. Athletes’ mental health profiles showed that most athletes experience low depression while having moderate mental well-being. Depression, anxiety, and stress scores generally increased when progressing in age, indicating that the junior–senior transition poses distinct challenges to players’ mental health, especially for female players. Different strategies to foster players’ mental health depending on their mental health profiles are proposed.

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Eleftherios Paraskevopoulos, Georgios Gioftsos, Georgios Georgoudis, and Maria Papandreou

Adherence to exercise rehabilitation has been shown to be an important factor that may influence successful treatment. In professional athletes, a significant reduction in exercise adherence delays recovery. The aim of this study was to explore barriers to and facilitators of exercise rehabilitation adherence in injured volleyball athletes. Eight professional volleyball athletes were recruited, and qualitative data were collected using semistructured interviews. All athletes had completed their rehabilitation program after they had suffered a musculoskeletal injury. All data were analyzed using thematic analysis after the investigators ensured that saturation had been reached. Pain was identified as a significant barrier to exercise adherence by all athletes. The provision of social support, including mental, practical, and task related, also had a significant positive impact. The athletes’ ability to develop the necessary coping strategies and confidence on performing exercises at home was also mentioned as a factor that affected exercise adherence, although less often.