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Common Peroneal Neuropathy Secondary to Repetitive Direct Blow Contusion Injuries in a Cheerleader: A Case Report

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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The Clinical Relevance of the Accessory Peroneus Quartus in a Male Division I Collegiate Track Athlete

Nina Robinson, Shannon L. David, Nicole A. German, and Jennifer Swenson

A healthy 20-year-old Division I track athlete participated in out-of-season practice and experienced inflammation on mid-lateral aspect of his right calcaneus. The patient modified his weekly training program, and a magnetic resonance imaging revealed the presence of an accessory peroneus quartus. This muscle is present in around 5.2% of the population. The pathological symptoms cause pain, snapping, and synovitis. Literature shows a higher prevalence of the accessory peroneus quartus muscle in males of European/American descent and in the right lower leg. Symptoms include peroneal tears, decrease in range of motion, and pain of the ankle and foot.

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Rib Stress Injuries Among Female National Collegiate Athletic Association Rowers: A Prospective Epidemiological Study

Caitlin A. Madison, Rod A. Harter, Marie L. Pickerill, and Jeff M. Housman

Rib stress injuries (RSIs) are debilitating injuries that competitive rowers often sustain during their careers, losing up to 10 weeks of training per year. Minimal research exists on RSIs and associated risk factors among National Collegiate Athletic Association women’s open-weight rowers. The purpose of this study was to determine the prevalence of RSIs and assess injury risk factors in intercollegiate female rowers. A prospective 14-week in-season injury surveillance was conducted via online surveys to collect demographic information, identify intrinsic and extrinsic risk factors, and document RSIs and other rowing-related injuries. During one National Collegiate Athletic Association season, 26% of our participants reported a rib cage injury, with six of these injuries identified as potential RSIs. Estimated prevalence for rib cage injuries is 6–33% in National Collegiate Athletic Association women’s rowing teams. RSI reporting and recognition was followed by aggressive clinical management in the population sampled, suggesting the need for larger scale epidemiological studies to determine the true prevalence, severity, and typical clinical course of these injuries.

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Do Cognitive Behavioral Therapy Techniques Reduce Symptom Duration in Children and Adolescents Who Have Sustained a Mild Traumatic Brain Injury?

Carlie K. Elmer and Tamara C. Valovich McLeod

Focused Clinical Question: Does cognitive behavioral therapy (CBT) reduce concussion symptoms among children and adolescents following mild traumatic brain injury? Clinical Bottom Line: Based on the results of this critically appraised topic, there is moderate evidence to support the use of CBT as a treatment intervention to reduce complaints of persistent concussion symptoms in children and adolescents.

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The Utilization of the Theory of Planned Behavior and Self-Determination Theory to Improve Physical Activity Following Anterior Cruciate Ligament Reconstruction

Rachel R. Kleis, Matthew C. Hoch, Deirdre Dlugonski, and Johanna M. Hoch

Patients with a history of anterior cruciate ligament reconstruction (ACLR) report decreased levels of physical activity participation, which can result in a significant public health burden. Psychosocial factors, such as fear of reinjury and decreased self-efficacy, negatively impact physical activity levels in this population. However, factors such as attitudes and beliefs toward exercise, motivation, self-efficacy, and social support are known to positively influence physical activity participation. The Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) incorporate such constructs and have been utilized to predict and improve physical activity behaviors in a variety of populations. Emerging evidence has applied the TPB and SDT to rehabilitation adherence in populations with musculoskeletal injury and post-ACLR. However, we believe a combination of the TPB and SDT will provide a framework for increasing physical activity engagement for people with a history of ACLR. The purpose of this review is to present an integrated theoretical model that combines the TPB and SDT with the aim of increasing physical activity after ACLR. Recommendations for future research and clinical practice based on the proposed model are also discussed.

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Continuing Education Assessment

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Volume 26 (2021): Issue 5 (Sep 2021)

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NATA News and Notes

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Prescription Medication for Posttraumatic Headache Following Concussion: A Critically Appraised Topic

Karlee Burns, Ryan Tierney, and Jane McDevitt

Clinical Question: In individuals with posttraumatic headache following concussion, what impact does medication have? Clinical Bottom Line: Prescription medications may be beneficial for those suffering posttraumatic headache following concussion by decreasing headache symptoms and improving cognitive function, though long-term outcomes were similar between those taking and not taking medications.

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Therapy Dog Intervention Decreases Stress and Increases Arousal in College Students

Paul A. Cacolice and Corinne M. Ebbs

Clinical Question: What is the effect of CT intervention on the stress and arousal levels of undergraduate students? Clinical Bottom Line: There is Level A–B evidence showing that the use of therapy dogs decreases stress and elevates arousal in female undergraduate students, with little evidence available for other populations.