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Continuing Education Assessment

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Volume 29 (2024): Issue 6 (Nov 2024)

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An Examination of the Knowledge of and Attitudes Toward Concussions in Texas High School and Junior High Coaches

Melissa L. Jack, Keilea Sumrall, Joshua C. Yonker, Arthur Soto, Sunil Mathur, and Kenneth Podell

Every state in the United States mandates concussion education annually or biennially for those involved in organized youth sports to improve awareness, knowledge, and attitudes toward concussions. The purpose of this study was to examine Texas high school and junior high school coaches’ knowledge of and attitudes toward concussions using the Rosenbaum Concussion Knowledge and Attitudes Survey—Coaches Version. Among all analyzed participants, the mean overall concussion knowledge index (Concussion Knowledge Index = 0–25) was 21 (SD = 1.79), while the overall concussion attitude index (Concussion Attitude Index  = 15–75) was 63 (SD = 5.69). No significant differences for knowledge or attitude were found between gender, coaching level, sport type, geographical location, or school size (all p > .10). Mandatory concussion education has resulted in high levels of knowledge about and favorable attitudes toward concussions in Texas junior high school and high school coaches, with similar findings to other research in this area.

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The Effects of Cupping Therapy and Stretching on Lumbar Spine Range of Motion Using Bubble Inclinometry

Heather L. Glovach, David A. Wilkenfeld, and Jennifer L. Ostrowski

Low back pain is a leading cause of disability. Cupping can be effective for improving motion in those with back pain; however, little is known about its efficacy compared with other interventions. This study evaluated differences among cupping, stretching, and cupping with stretching on lumbar flexion, extension, and lateral flexion. Although the interventions increased lumbar spine motion, there was no significant difference between groups. Cupping with stretching appears to result in greater motion changes; however, the overall increases were small. Cupping does not appear to increase lumbar spine motion more than stretching or cupping combined with stretching. While cupping may improve low back pain through other means, it does not appear to significantly impact lumbar spine motion in asymptomatic individuals.

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Patient-Reported Outcome Scores of Athletes With Time-Loss and Non-Time-Loss Ankle Sprains

Ryan S. McCann, Ricardo R. Squillantini, Ashley M.B. Suttmiller, and Sunghoon Chung

Non-time-loss ankle sprains often receive less care than time-loss (TL) ankle sprains, but the effect of TL on persistent impairments needs to be explored. Our purpose was to compare patient-reported outcomes between athletes with non-time-loss and TL ankle sprains at return to activity and 6-month postinjury. Participants with a non-time-loss ankle sprain had worse patient-reported outcome scores at return to activity and 6 months compared with TL ankle sprains despite having less severe injuries. Greater than 24 hr of activity restriction following an acute ankle sprain is likely beneficial to the recovery of perceived function and stability.

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Enchondroma in a Collegiate Division II Women’s Acrobatics and Tumbling Athlete: A Level 4 Case Report

Rebekah L. Minter, Rebecca M. Lopez, Jessica M. Myers, and Amanda J. Tritsch

A 19-year-old collegiate female acrobatics and tumbling athlete presented with deep shooting pain in her right thigh during impact activities. Diagnostic imaging revealed a 12-mm enchondroma in her right proximal femoral metadiaphysis. After 10 days of rest, the patient began gradually increasing the intensity of impact skills and completed the remainder of the acrobatics and tumbling season. This is the first reported case of an enchondroma in the proximal femoral metadiaphysis in a young athlete. Athletic trainers must use clinical reasoning skills and interprofessional collaboration when managing atypical presentations to improve patient care and promote a positive recovery after injury.

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Athletic Therapists’ Exposure and Response to Psychological Challenges Associated With Athlete Injury Recovery

Francesca M. Principe and Gretchen Kerr

This study sought to understand athletic therapists’ perspectives on the psychological challenges athletes experience during injury recovery and to assess their perceived level of preparedness in addressing these challenges. Using an online survey, 49 certified athletic therapists from across Canada reported they are aware of the psychological challenges facing injured athletes and believe they play a role in assisting injured athletes in their psychological recovery. However, the results indicated that athletic therapists do not feel adequately prepared to provide this support and recommended more exposure to content related to psychological aspects of injury in their education.

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Does a Single Session of Cupping Therapy Increase Range of Motion in Individuals With Limited Hamstring Flexibility? A Critically Appraised Topic

Dwight Arganbright, Anne Russ, Jamie Mansell, and Ryan Tierney

Context: Improving hamstring tightness is a common therapeutic goal to maintain performance and reduce injury risk. How effective is a single session of therapeutic cupping on improving hamstring flexibility? Methods: PubMed was searched in the Summer of 2023 using the search terms: cupping and range of motion (ROM). Included studies were intervention studies that evaluated cupping and flexibility within the lower extremity during a single treatment session. Hip flexion ROM was measured with the passive or active straight leg test. Means, SDs, 95% CI, and effect sizes were calculated. Results: Three articles were screened. Warren et al. reported a statistically significant increase in ROM from pre- to posttest of 4.42° using a digital inclinometer during the passive straight leg test. However, this is below a reported minimal detectable difference for the passive straight leg test (10°). Schafer et al. and Williams et al. reported no significant cupping effect over time between groups. Conclusions: There is consistent evidence that a single session of cupping therapy does not increase lower-extremity ROM in patients with limited hamstring flexibility.

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Pain Reduction in Medial Tibial Stress Syndrome With Extracorporeal Shockwave Therapy: A Critically Appraised Topic

Elizabeth Perrero, Nancy A. Uriegas, Morgan Adams, and Amy L. Fraley

In active populations with medial tibial stress syndrome (MTSS), is extracorporeal shockwave therapy an effective treatment to reduce pain? A computerized search was conducted in October 2021. Inclusion criteria consisted of participants 18+ years old with diagnosed MTSS for 21+ days, where pain was in the posterior medial aspect of the tibia. Exclusion criteria involved patients with tibial fractures, compartment syndrome, and prior treatment of MTSS with extracorporeal shockwave therapy. Results were measured by the number of days athletes could complete the running protocol pain-free according to the Likert scale (p = .008), visual analog scale (p = .001), and Roles and Maudsley scale (RMS; p = .002). The third study showed no statistical significance in pain reduction or self-perception of change in symptoms on the Numerical Rating Scale (NRS; p = .05). Using the Strengthening the Reporting of Observational studies in Epidemiology scale, one study received a 17/22 since no biases were addressed, lack of participant status in each stage of the study, no numbers or analysis reported in each group, and no explanation of external validity or funding. The single-blind randomized controlled trial received a 10/11 using the Physiotherapy Evidence Database scale and one level of evidence. The double-blind sham randomized controlled trial received an 11/11 and one level of evidence (LOE). The research appraised would mostly agree the use of extracorporeal shockwave therapy could reduce pain in MTSS in active populations. The strength of recommendation is B.

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