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Andrea Lucena Reis, Thaís Lucena Reis, Lucas Soares de Aguiar, José de Jesus Soares Reis, Thiago Lucena Reis, Lysleine Alves Deus, Rodrigo Vanerson Passos Neves, Hugo de Luca Corrêa, Fernando Sousa Honorato, Thais Branquinho de Araújo, Victor Lopes Silva, Bernardo Neme Ide, and Thiago Santos Rosa

Context: The elastic tubes have been used for clinical rehabilitation programs in which exercises are performed with submaximal intensities due to the difficulty in the measure the applied force. The authors aimed to quantify the elastic constant of elastic tubes used in neuromuscular rehabilitation programs predicting the force related to elastic tube elongation. A force test was performed by stretching the elastic tubes to determine the relationship between force and elongation. Eight elastic tubes with progressive levels of resistance represented by colors (yellow, red, blue, gray, black, grape, purple, and gold—low to higher resistance) were used. Design: Experimental. Methods: The test and retest were compared using the paired t test. The agreement and reliability between the test versus retest of pooled means colors were analyzed by plotting the Bland–Altman graph and intraclass correlation coefficient and the coefficient of variation. Pearson correlation was used to verify the validity between measurements. Results: The force values generated from the elastic tube elongation increase according to the color and thickness of elastic tubes with a strong and significant association between them (P < .0001). The elastic constant measurements were similar and presented high intraclass correlation coefficient values, low coefficient of variation values, and were reproducible (P < .0001). Conclusions: The force could be quantified according to elastic tube length variation by the linear regression equation with reproducibility. It gives greater measurement precision and better training load control when using elastic tubes in strength training programs.

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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.

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Siobhan K. Fitzpatrick and Janine V. Olthuis

American student-athletes (SAs) are at heightened risk for hazardous alcohol consumption compared with their nonathlete peers. However, little is known about this risk or the influence of psychosocial predictors on drinking behavior among Canadian SAs. This study compared rates of alcohol use across Canadian SAs and nonathletes and investigated whether the use of athlete-specific psychosocial predictors can improve the prediction of alcohol use outcomes in SAs. Participants (179 varsity athletes and 366 nonathletes) completed anonymous self-report questionnaires. Results suggest that Canadian athletes are at a heightened risk for experiencing alcohol-related problems compared with nonathletes, with general psychosocial predictors explaining the majority of variance in SA alcohol use. However, and quite notably, athlete-specific positive reinforcement motives predicted SA binge drinking. This research provides some of the first evidence of drinking-related problems among Canadian SAs and supports the potential use of preventative efforts to help SAs develop safe strategies for alcohol use.

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Katie Stephenson, Melissa N. Womble, Shawn R. Eagle, Philip Schatz, Tatiana Gervase, Brett Gustman, Eric Castor, Anthony P. Kontos, and R.J. Elbin

Objective: (1) To compare patient- and clinician-administered measurements of near point of convergence (NPC) distance including the percentage of patients exceeding clinical cutoffs among concussed adolescents and (2) to assess the reliability of patient- and clinician-measured NPC distances. Methods: A total of 762 patients (mean = 15.51, SD = 3.09 y) within 30 days of concussion participated. The NPC distance was measured consecutively with the patient and clinician controlling the fixation target. The differences between patient (PT) and clinician (CLIN) measurements and cases exceeding cutoffs (ie, ≥5 cm) were examined with a series of t tests and chi-square tests, respectively. Intraclass correlation coefficients and unbiased estimate of reliability were performed. Results: The NPC measurements were similar, t(761) = −.26, P = .79, between the PT (mean = 3.52, SD = 3.77 cm) and CLIN (mean = 3.54, SD = 3.97 cm) conditions. The number of measurements that exceeded cutoffs was similar among the PT (2.5%; 19/762) and CLIN conditions (3%; 23/762) (P = .10), and the number of measurements classified as abnormal/invalid was also similar among the PT (2.5%; 19/762) and CLIN conditions (3%; 23/762) (P = .10). There was excellent reliability between the methods (intraclass correlation coefficients = .85, unbiased estimate of reliability = .92). Conclusion: The findings support the application of this assessment in clinical settings where the clinician may not have direct contact with their patient and rely on the patient (eg, telehealth).

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Carrie B. Scherzer, Jeremy Trenchuk, Meaghan Peters, and Robert Mazury

Athletes can be at elevated risk for developing eating disorders, the effects of which can be devastating. Few researchers have examined the influence of a predisposition toward an eating disorder on athletic injury. Exercise dependence might bridge the gap toward understanding this relationship. This study sought to examine the relationship between predisposition toward an eating disorder and exercise dependence and looked at both as predictors of athletic injury. College students (n = 132) completed the Eating Disorders Inventory and the Exercise Dependence Questionnaire, as well as provided demographic, activity, and injury information. Subscales of the Eating Disorders Inventory and Exercise Dependence Questionnaire were significant predictors of having at least one athletic injury in the preceding year. These findings suggest that both predisposition toward an eating disorder and exercise dependence may be contributing factors to injury.

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Darjan Spudić, Janez Vodičar, Miha Vodičar, and Vedran Hadžić

Context: The importance of isometric trunk strength (ITS) among sport science professionals is higher than its actual reported effect size on either performance or low back pain (LBP) occurrence. Objective: To provide normative values of ITS and strength ratios, and to evaluate the effect of sex, sports discipline, and LBP status. Design: Crossover study. Setting: University research laboratory. Participants: Five hundred and sixty-seven elite athletes (186 females) with and without a history of LBP from different sports. Main Outcome Measure: Participants underwent ITS testing for trunk flexors, extensors, and lateral flexors. Normalized maximal strength (in newton meter per kilogram) and strength ratios were calculated. Differences between sex, LBP, and sport disciplines were assessed with 3-way analysis of variance (sex × LBP status × 7 sport categories) and partial eta-squared (ηp2) effect size. The predictive validity of ITS for LBP was checked with receiver operating characteristics (area under the curve). Results: The authors found significant differences in extensor and flexor ITS in favor of male athletes (medium ηp2, P < .05), while sex differences in lateral flexion ITS had a low size effect (P < .05). A low size effect was also observed for the differences in strength ratios extensors/flexors (mean 1.47; 95% confidence interval, 1.45–1.50) and left flexors/right flexors (mean 0.99; 95% confidence interval, 0.98–1.01) among sexes. The sport discipline-related differences generally had a low size effect. No significant differences in ITS were found between LBP and LBP-free athletes. Only 50% to 58% of athletes (area under the curve, 0.501–0.582) were correctly classified as LBP or LBP-free using different ITS and strength ratio variables. Conclusions: ITS and strength ratios have low predictive validity for LBP history but may discriminate between sex and sport disciplines. Our data are a useful reference point for meaningful individual results interpretation when athletes are evaluated during training or rehabilitation.

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David G. Behm, Nehara Herat, Gerard M.J. Power, Joseph A. Brosky, Phil Page, and Shahab Alizadeh

Context: Both health professionals and consumers use menthol-based topical analgesics extensively for the temporary relief of pain from musculoskeletal ailments or injury. However, there are no reports of differences in the pain pressure threshold (PPT) or the relative effectiveness of topical analgesics to reduce pain in the upper and lower body muscles and tendons. The objective of this study was to investigate whether differences existed in PPT and relative pain attenuation associated with a menthol-based topical analgesic over a variety of upper and lower body muscles and tendons. Design: Randomized allocation, controlled, intervention study. Methods: Sixteen participants (10 females and 6 males) were tested on their dominant or nondominant side. The order of specific muscle/tendon testing was also randomized, which included upper body (middle deltoid, biceps brachii, and lateral epicondylar tendon) and lower body locations (quadriceps, hamstrings, gastrocnemius, lumbosacral erector spinae muscles, and patellar and Achilles tendons). The PPT was monitored before and 15 minutes following the application of a menthol-based topical analgesic. Results: A menthol-based topical analgesic increased PPT (decreased pain sensitivity) overall (P = .05; 11.6% [2.4%]; d = 1.05) and PPT was higher (P < .0001; 31.5%–44.2%; d = 1.03–1.8) for lower versus upper body locations. Conclusions: Health professionals and the public can be assured of similar reductions in pain sensitivity independent of the location of application of a menthol-based topical analgesic.

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Tsz Lun (Alan) Chu, Bailey Sommerfeld, and Tao Zhang

Building on recent research examining athlete burnout trajectories, this study implemented the developmental model of sport participation to compare emotional and physical exhaustion, reduced sense of accomplishment, and sport devaluation between age groups (specializing [aged 13–15 years] vs. investment [aged 16–18 years]) and gender (boys vs. girls) among U.S. high school athletes. Participants were 367 high school athletes (M = 15.53; 212 males; 186 specializing) across various individual and team sports who completed a survey assessing their demographic information, sport backgrounds, and burnout perceptions. A 2 × 2 multivariate analysis of covariance, controlling for training hours, showed greater emotional and physical exhaustion and sport devaluation in the investment than the specializing group, but no developmental differences in reduced sense of accomplishment. Contrary to our hypothesis, no gender or interaction effects were found. Findings inform interventions and future research that address the role of developmental stages and gender in athlete burnout.

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Aaron S. Fox, Reed Ferber, and Jason Bonacci

Altered gait variability occurs in those with patellofemoral pain and may be relevant to pain progression. We examined gait kinematic and coordination variability between individuals with acute and chronic patellofemoral pain and healthy controls. Eighty-three patellofemoral pain runners (37 men and 46 women) and 142 healthy controls (52 men and 90 women) ran on a treadmill while 3-dimensional lower limb kinematic data were collected. Patellofemoral pain runners were split into acute (n = 22) and chronic (n = 61) subgroups based on pain duration (< and ≥3 mo, respectively). Approximate entropy assessed continuous hip, knee, and ankle kinematic variability. Vector coding calculated coordination variability for select joint couplings. Variability measures were compared between groups using 1-way analysis of variance and post hoc comparisons with Cohen d effect sizes. The chronic patellofemoral pain subgroup displayed higher frontal plane knee kinematic variability compared with controls (P = .0004, d = 0.550). No statistically significant effects for any coordination variability couplings were identified. Minimal differences in gait variability were detected between those with acute and chronic patellofemoral pain and healthy controls.

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Dean R. Watson, Andrew P. Hill, and Daniel J. Madigan

Attitudes toward help-seeking will contribute to whether athletes ask for support for performance and mental health issues when needed. While research outside of sport has found perfectionism is related to negative attitudes toward help-seeking, no studies have examined the relationship in sport. The authors provided the first test of whether perfectionism predicted attitudes toward both sport psychology support and mental health support. One hundred and sixty-six collegiate athletes completed measures of perfectionism and attitudes toward sport psychology support and mental health support. Multiple regression analyses revealed that perfectionistic concerns positively predicted closedness and stigma toward sport psychology support and mental health support, and negatively predicted help-seeking toward mental health support. However, perfectionistic strivings negatively predicted stigma toward sport psychology support and mental health support, and positively predicted confidence in sport psychology support and help-seeking toward mental health support. Athletes higher in perfectionistic concerns are less likely to seek support when required.