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Volume 18 (2024): Issue 1 (Mar 2024)

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Are Irish Athletic Therapy Students Confident in Concussion Assessment and Management? A Cross-Sectional Study of Final Year Students’ Self-Efficacy

Anna P. Postawa, Enda F. Whyte, and Siobhán O’Connor

Concussion is one of the most challenging injuries for sports medicine clinicians. It is crucial that students develop high self-efficacy for concussion-relevant skills during professional education, as it impacts the quality of their patient care. This study aimed to explore Irish final year athletic therapy students’ self-efficacy in concussion assessment and management and the factors that impact its development. Participants’ level of self-efficacy varied, from low to high, depending on the skill assessed. Lack of practice and lecturer’s positive feedback impacted student self-efficacy the most. Educators should provide students with an opportunity to practice their skills in an environment that facilitates feedback.

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Economic Analysis of Secondary School Outreach Athletic Training Services

Brian A. Czajka

The health care benefit of athletic trainers in secondary schools is well established; however, the economic effects of athletic training outreach programs on the organization providing the services are not well researched. The purpose of this study was to determine the economic effects of outreach athletic training services on the organization the outreach athletic training services. The daily number of patient visits and procedure charges were compiled and compared between a time period when outreach athletic training services were provided to local secondary schools and a time period when these services were not provided. The findings of this study showed that an organization providing outreach athletic training services may experience significant increases in daily patient visits and daily procedure charges.

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Quantifying Human Gait Symmetry During Blindfolded Treadmill Walking

Otella Shoja, Masoumeh Shojaei, Hamidollah Hassanlouei, Farzad Towhidkhah, and Lei Zhang

Bilateral gait symmetry is an essential requirement for normal walking since asymmetric gait patterns increase the risk of falls and injuries. While human gait control heavily relies on the contribution of sensory inputs, the role of sensory systems in producing symmetric gait has remained unclear. This study evaluated the influence of vision as a dominant sensory system on symmetric gait production. Ten healthy adults performed treadmill walking with and without vision. Twenty-two gait parameters including ground reaction forces, joint range of motion, and other spatial–temporal gait variables were evaluated to quantify gait symmetry and compared between both visual conditions. Visual block caused increased asymmetry in most parameters of ground reaction force, however mainly in the vertical direction. When vision was blocked, symmetry of the ankle and knee joint range of motion decreased, but this change did not occur in the hip joint. Stance and swing time symmetry decreased during no-vision walking while no significant difference was found for step length symmetry between the two conditions. This study provides a comprehensive analysis to reveal how the visual system influences bilateral gait symmetry and highlights the important role of vision in gait control. This approach could be applied to investigate how vision alters gait symmetry in patients with disorders to help better understand the role of vision in pathological gaits.

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Trunk Endurance and Low Back Pain Outcomes in College Golfers

Andrew Skibski, John Goetschius, and L. Colby Mangum

Low back pain (LBP) is a common injury in golf. There are several outcomes used to quantify LBP-related disability, such as core endurance tests and questionnaires. The primary purpose of this study was to compare clinical outcomes between college golfers with and without LBP. A secondary purpose was to determine relationships between these measures. We found no difference between groups for Biering-Sørensen endurance (p = .558). Episodes of LBP were significantly related to the Oswestry Disability Index (ρ = .491) and Golf-specific LBP questionnaire (ρ = −.576). Oswestry Disability Index and Golf-specific LBP questionnaire also demonstrated a moderate relationship (ρ = −.604).

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Common Wrist-Extensor Tendon and Pectoralis Muscle Stiffness in Healthy Recreational Tennis Players

Joseph M. Day and Harold Merriman

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Design: Cross-sectional study. Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC > .78 for the pectoralis musculature) and excellent (ICC > .94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, −22.8 to 252.5 kPa for the dominant arm [P = .039]). Mean pectoralis major and minor stiffness differences were not significant (P > .214). Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected.

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The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis

Haiting Zhai, Liqing Zhang, JiXiang Xia, and Cheng Li

Background: Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. Methods: The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network,, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I 2 statistic. Results: A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60–80 years. Respiratory exercise was effective in relieving LBP (standardized mean difference = −0.87, P < .00001) and improving physical disability (standardized mean difference = −0.79, P < .00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4 weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500 minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. Conclusions: Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4 weeks of breathing resistance exercise program as the most effective for treating LBP.

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In Remembrance: The Life and Legacy of Michael T. Turvey (1942–2023)

Michael A. Riley and Dagmar Sternad

Michael T. Turvey passed away on August 12, 2023 at the age of 81. This obituary aims to honor his life and career by highlighting some key events in his personal and professional life, noting some of his many remarkable accomplishments, and emphasizing his exceptional mentorship, friendship, and generosity.

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The Role of Imitation, Primitives, and Spatial Referent Coordinates in Motor Control: Implications for Writing and Reading

Shelia Guberman and Mark L. Latash

We review a body of literature related to the drawing and recognition of geometrical two-dimensional linear drawings including letters. Handwritten letters are viewed not as two-dimensional geometrical objects but as one-dimensional trajectories of the tip of the implement. Handwritten letters are viewed as composed of a small set of kinematic primitives. Recognition of objects is mediated by processes of their creation (actual or imagined)—the imitation principle, a particular example of action–perception coupling. The concept of spatial directional field guiding the trajectories is introduced and linked to neuronal population vectors. Further, we link the kinematic description to the theory of control with spatial referent coordinates. This framework allows interpreting a number of experimental observations and clinical cases of agnosia. It also allows formulating predictions for new experimental studies of writing.

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Overuse Injury Definitions and Rates of Overuse Injury in Epidemiology Studies Concerning High School-Aged Athletes: A Critically Appraised Topic

Tricia Cich and Kevin M. Biese

Context: The definition of an “overuse injury” had some ambiguity until recent publications. It is unknown whether the improved definition of “overuse injury” has been applied to epidemiology studies that examine high school-aged athletes. This population may be predisposed to overuse injuries due to several factors. Clinical Question: Is there more consistency in how the term “overuse injury” is being used, and has the rate of overuse injuries in high school-aged athletes’ epidemiology studies changed since Roos and Marshall’s 2014 systematic review on overuse injury definitions? Clinical Bottom Line: Since Roos and Marshall’s systematic review, more studies are recognizing “overuse injuries” as needing a specific mechanism of injury; however, several studies failed to differentiate “overuse injuries” from “noncontact injuries.” The rate of overuse injuries does not appear to have changed significantly.