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Feasibility of Mobile Application-Delivered Mindfulness Meditation for Individuals After Anterior Cruciate Ligament Reconstruction

Shelby Baez, Francesca Genoese, Elaine Reiche, Matthew Harkey, Christopher Kuenze, Jason Moser, and Brian Pietrosimone

Mindfulness meditation (MM) has decreased kinesiophobia in patients with knee pathologies. Mobile application-delivered MM (Mobile MM) may reduce kinesiophobia in individuals after anterior cruciate ligament reconstructions (ACLR). The purpose of this study was to examine the feasibility (i.e., retention, adherence, and acceptability) and preliminary efficacy of a 4-week Mobile MM intervention in individuals with a history of ACLR. Nine participants ≥1 year post unilateral ACLR completed 12 sessions of Mobile MM over 4 weeks via the Headspace mobile application that were facilitated remotely through a Health Insurance Portability and Accountability ACT of 1996 (HIPAA) compliant teleconference system. Participant retention of 100% and intervention adherence of 100% were observed. Participants reported moderate to high acceptability for the Mobile MM. A large between-group effect size of 1.6 [0.13, 2.98] in the Tampa Scale of Kinesiophobia-11 change score was observed. Mobile MM is a feasible intervention to address kinesiophobia in individuals with a history of ACLR.

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Neurocognitive Hop Performance in Patients With Chronic Ankle Instability

Ji Yeon Choi, Colleen Vogel, Christopher J. Burcal, Lindsey E. Remski, Brian A. Knarr, and Adam B. Rosen

The purpose of this study was to determine differences in neurocognitive hop function among individuals with chronic ankle instability, ankle sprain copers, and control participants and identify the relationship between the self-reported function and neurocognitive hop performance; 61 participants across control, ankle sprain coper, and chronic ankle instability groups completed the Cumberland Ankle Instability Tool and the Choice-Reaction Hop Test. There was no significant difference in neurocognitive hop performance among groups. However, there was a large correlation between the Cumberland Ankle Instability Tool and the Choice-Reaction Hop Test. Those with chronic ankle instability with worse self-reported disability concurrently demonstrated decreased performance during the Choice-Reaction Hop Test, reflecting poorer neurocognitive hop performance.

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In Patients With Chronic Pain Conditions, Does Dry Needling Reduce Pain?

Paden Kleinhesselink, Ryan Tierney, Jamie Mansell, and Anne Russ

Dry needling’s primary goal is to alleviate pain by inserting solid filament needles into muscles, tendons, and ligaments to provide a stimulus that inhibits nerve endings to decrease pain. This critically appraised topic investigates the effects dry needling has on patients with various chronic pain conditions and its ability to relieve pain. Articles were selected if patients had a chronic pain condition lasting at least 3 months, pain was reported using the Visual Analog Scale, and were randomized control trials or prospective studies. All selected studies for this critically appraised topic showed significant improvement in chronic pain. With these improvements, dry needling has been shown to be an effective treatment in chronic pain conditions.

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NATA News & Notes

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Continuing Education Assessment

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Volume 28 (2023): Issue 6 (Nov 2023)

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The Efficacy of Cryotherapy on Decreasing Swelling: A Critically Appraised Topic

Rachel A. Ziner, Jamie L. Mansell, Anne C. Russ, and Ryan T. Tierney

Context: Swelling is a major consequence of musculoskeletal conditions and can be a barrier to healing. Cryotherapy has been reported to decrease swelling. How effective is cryotherapy in reducing swelling during rehabilitation? Methods: PubMed was searched in June 2022 using the Boolean phrases: Swelling OR edema AND cryotherapy OR ice, Swelling AND injury AND cryotherapy. Included articles were published during or after 2017, consisted of one or more cryotherapy interventions, and listed swelling as an outcome measure. The PEDro scale was used to assess study validity. Swelling was measured by the figure-of-eight method (in centimeters). Means, SDs, and 95% confidence interval (CI) were calculated. Results: Three articles were screened. Stasinopoulos et al. received a score of 9/10; Sari et al. and Tittley et al. received a score of 10/10. Tittley et al. reported a decrease in swelling from 52.7 (SD = 0.8; 95% CI [52.35, 53.05]) to 52.0 (SD = 0.8; 95% CI [51.65, 52.35]). Stasinopoulos et al. reported decreases from 62.62 (SD = 0.34; 95% CI [62.51, 62.80]) to 61.10 (SD = 0.30; 95% CI [60.98, 61.24]). Sari et al. also found minimal change in swelling from pre- to posttreatment, 38.7 (SD = 2.6; 95% CI [37.83, 39.57]) to 38.2 (SD = 2.4; 95% CI [37.40, 39.00]). Conclusion: There is consistent evidence indicating that cryotherapy applied during rehabilitation does not decrease swelling in a patient with a musculoskeletal condition.

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Evaluation and Management of Exertional Rhabdomyolysis Following a Spin Class

Haley A. Turner, Lily C. Goodman, Christian J. Chang, Guillermo Moris, and Jose M. Moris

Exertional rhabdomyolysis (ER) has become prevalent over the last decade after performing spin classes. ER is characterized by the plasma elevation of creatine kinase as a marker of severe muscle damage. This case study highlights a 26-year-old healthy male that suffered from ER after performing their first ever spin class. The acute and chronic management of the ER is described, along with follow-up assessments that tracked the recovery following discharge from the hospital. Symptoms, such as localized swelling with complete loss of mobility and pain disproportionate to soreness, were characteristic in this individual with ER. Examining the concentration of plasma creatine kinase and monitoring urine output and color provided a good measure to determine when to discharge the patient. Management wise, ambulation should be minimized, and complete bed rest is ideal in conjunction with fluid replacement therapy. Although the individual in this case study did not develop compartment syndrome, its occurrence is always a possibility that should be routinely screened for. Lastly, further research is warranted to determine if there are any dietary interventions to promote a steadfast recovery from ER.

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Professional Conflict in Athletic Training and Nursing Environments: A Commentary on Comparisons and Solutions

Alicia M. Pike Lacy, Thomas G. Bowman, Craig R. Denegar, and Stephanie M. Singe

The athletic training and nursing professions have similar characteristics regarding workplace environment and challenges with interdependence. Professionals in both fields often face conflict with stakeholders while fulfilling their job responsibilities. Although sources and antecedents of conflict differ somewhat between the professions, the consequences of conflict are nearly identical. Job-related stress, depression and burnout, and interpersonal conflict can take a toll on clinicians’ mental and physical health. Greater efforts must be made to better prepare clinicians to diffuse and resolve conflict. Compared with athletic training, nursing has placed a greater emphasis on developing students’ conflict resolution skills in the professional curriculum. Therefore, athletic training educators and preceptors can learn from nursing education and adopt similar educational experiences for athletic training students. Providing students with tools early on can give them confidence to address conflict promptly and constructively, which may mitigate negative impacts of the conflict on patient care.

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NATA News & Notes