Kellie C. Huxel Bliven
Roberta Gaspar, Natalia Padula, Tatiana B. Freitas, João P.J. de Oliveira and Camila Torriani-Pasin
Introduction: Considering the reduction of physical activity performed daily in people with spinal cord injury, it is necessary to analyze the interventions based on physical exercises in order to provide recommendations based on evidence. Objectives: To review and evaluate the literature on physical exercise interventions for individuals with SCI, based on the International Classification of Functioning, Disability and Health, as well as physiological parameters for exercise prescription. Method: A systematic review of the literature produced from August 2016 to February 2017 within the PubMed, Embase, Cochrane Library, and MEDLINE databases. Results: Two independent examiners conducted a search in which 223 articles were initially found. A third evaluator verified possible divergences and generated a final list of 25 articles that strictly met the inclusion criteria, 5 of which investigated the effects of aerobic exercise, 2 of resistance training, 2 of balance training, 12 of gait training, and 4 evaluating the combined effect of 2 or more forms of training. Conclusion: Considering studies classified as of high and moderate quality of evidence, positive effects were observed in the domains of structures and functions, in aerobic, resistance training and combined exercises, and in some studies with gait training. In the domain of activities and participation, positive effects were observed in the studies with gait training, balance training, and combined interventions.
Daniel M. Corcos and Mark L. Latash
Mitch Abrams and Michelle L. Bartlett
The #MeToo movement has brought long needed attention to the epidemic of sexual assault and sexual violence. In the world of sports, the need to prevent and address such acts requires individuals with training in clinical, forensic and sport psychology. These professionals must have particular understanding of the dynamics of sexual violence within the athletic and sport culture. This paper serves to highlight context-specific approaches to pertinent identification and treatment issues. An overview of sexual abuse victim and perpetrator identification will be offered. In addition to the introduction of risk assessment and recommendation of comprehensive prevention programming, treatment needs in the athletic context will be explored. Group-level interventions currently being utilized will be reviewed, recommended topic areas to be covered in protocols will be enumerated and suggestions for systemic and cultural change in the sport domain will be offered.
Jeffrey B. Driban and R. Mark Laursen
Jennifer M. Medina McKeon and Patrick O. McKeon
Kai-Yu Ho, Brenda Benson Deaver, Tyrel Nelson and Catherine Turner
Context: Popularity of using handheld devices in clinical settings has increased, especially the use of motion analysis applications (MAAs). Video-based measurement tools have been found reliable in measuring knee valgus in subjects without anterior cruciate ligament (ACL) injury. However, there is a need for validation of using a MAA to measure knee valgus in an injured population, given that they may exhibit higher degrees of knee valgus. Objective: To examine the reliability and validity of using a MAA to measure knee valgus during functional activities used to assess return to sport after ACL reconstruction (ACLR). Design: Reliability and validity study. Setting: University laboratory. Participants: Twelve participants with ACLR and 20 healthy individuals. Interventions: Each subject performed single-leg drop landing, single-leg hop, and 90° cut with simultaneous 3-dimensional (3D) motion capture and video recording on an iPad. Main Outcome Measures: Peak knee valgus during the landing phase was measured using a MAA and 3D analysis. To obtain reliability, peak knee valgus was measured on 2 separate days. Reliability was determined using intraclass correlation coefficients and standard errors of measurement. Validity was assessed using Pearson correlation coefficients by comparing peak knee valgus between the MAA and 3D analysis. The t tests were used to compare knee valgus obtained between raters, within raters, and between the MAA and 3D analysis. Results: Our data revealed excellent intrarater and interrater reliability with low standard errors of measurement of using a MAA for both groups. Significant, moderate to large associations were found in comparing peak knee valgus between the MAA and 3D analysis. However, knee valgus was significantly different between the MAA and 3D analysis across all tasks in both groups. Conclusion: Although a MAA is reliable for measuring peak knee valgus in individuals with ACLR and healthy controls, the actual values obtained by a MAA should be viewed with caution.
Ian McGinnis, Justin Cobb, Ryan Tierney and Anne Russ
Clinical Question: What is the efficacy of vestibular rehabilitation for treating imbalance and self-reported dizziness in patients experiencing prolonged symptoms of concussion? Clinical Bottom Line: There is consistent, but low-level, evidence supporting that vestibular rehabilitation can have a positive effect on self-reported dizziness (dizziness severity, Dizziness Handicap Inventory [DHI], Activities-Specific Balance Confidence Scale [ABC]) and objective balance (Sensory Organization Test [SOT], Balance Error Scoring System [BESS]) in patients with prolonged symptoms following concussion. Vestibular rehabilitation is not for every concussed patient. Several, though few, patients did not improve or became worse with the implementation of vestibular rehabilitation. Many of the vestibular rehabilitation exercises utilized in these studies are easily accessible to athletic trainers and, with informed decision making and proper oversight, could be implemented in the athletic training room.
Matthew Booth, Jacob Powell, Patrick O. McKeon and Jennifer M. Medina McKeon
Focused Clinical Question: In patients who have sustained a concussion, does vestibular rehabilitation therapy improve clinical symptoms of dizziness and self-reported balance deficits and/or influence return-to-participation timelines beyond that of preintervention scores or standard care? Clinical Bottom Line: The evidence supported the use of VRT to attenuate clinical symptoms of dizziness and self-reported balance deficits.