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Hamid Norasi, Jordyn Koenig, and Gary A. Mirka

The electromyographic (EMG) normalization (often to maximum voluntary isometric contraction [MVIC]) is used to control for interparticipant and day-to-day variations. Repeated MVIC exertions may be inadvisable from participants’ safety perspective. This study developed a technique to predict the MVIC EMG from submaximal isometric voluntary contraction EMG. On day 1, 10 participants executed moment exertions of 100%, 60%, 40%, and 20% of the maximum (biceps brachii, rectus femoris, neck flexors, and neck extensors) as the EMG data were collected. On day 2, the participants replicated the joint moment values from day 1 (60%, 40%, and 20%) and also performed MVIC exertions. Using the ratios between the MVIC EMGs and submaximal isometric voluntary contraction EMG data values established on day 1, and the day 2 submaximal isometric voluntary contraction EMG data values, the day 2 MVIC EMGs were predicted. The average absolute percentage error between the predicted and actual MVIC EMG values for day 2 were calculated: biceps brachii, 45%; rectus femoris, 27%; right and left neck flexors, 27% and 33%, respectively; and right and left neck extensors, both 29%. There will be a trade-off between the required accuracy of the MVIC EMG and the risk of injury due to exerting actual MVIC. Thus, using the developed predictive technique may depend on the study circumstances.

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Matthew Burwell, Justin DiSanti, and Tamara C. Valovich McLeod

Clinical Scenario: Youth athletes may specialize in a sport of their choosing, or based on external pressures, to pursue elite status in that sport. Current evidence shows an association between highly specialized athletes and an increase in injuries as well as a connection between injury and lower health-related quality of life (HRQOL). Clinical Question: In college athletes, do early sport specialization characteristics (ie, age at specialization and degree of specialization) impact current HRQOL? Summary of Key Findings: The literature was searched for studies that investigated the age of specialization (early vs late) or degree of specialization (high, moderate, and low) and the impact on HRQOL. (1) The search returned 6 possible studies related to the clinical question. Three of the studies met the inclusion criteria and were used for this appraisal. (2) Two of the 3 included studies reported that highly specialized athletes noted lower HRQOL. (3) One study found there to be no significant difference in HRQOL between athletes who specialized early versus late but did find those who specialized early to have a greater incidence of injuries that required surgery. Clinical Bottom Line: There is moderate evidence that early sport specialization is associated with lower HRQOL compared with late sport specialization. It is important to educate athletes, parents, and coaches on the potential detriments that are associated with early sport specialization to allow stakeholders to make informed decisions regarding participation. Strength of Recommendation : Grade B evidence exists to support the idea that early, intensive sport specialization may be associated with decreased HRQOL in current college athletes.

Open access

Ashley N. Marshall and Kenneth C. Lam

The Disablement in the Physically Active scale (DPA) is a patient-reported outcome measure that is used to evaluate health-related quality of life in athletic and highly functional patient populations. However, its appropriateness for pediatric athletes is unknown. The purpose of this study was to examine the readability of the DPA in pediatric athletes. On average, athletes reported that they had difficulty reading 20.2% of each domain and 81.8% of the scale domains exceeded the fifth-grade reading-level threshold. These findings suggest that the DPA may not be appropriate for pediatric athletes. Future research is warranted to develop a pediatric version of the DPA, utilizing the results of this study for guidance.

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Lorin A. Cartwright and Timothy Neal

An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.

Open access

Shaun Duffy, Nickolai Martonick, Ashley Reeves, Scott W. Cheatham, Craig McGowan, and Russell T. Baker

Clinicians utilize instrument-assisted soft tissue mobilization (IASTM) to identify and treat myofascial dysfunction or pathology. Currently, little is known regarding the ability of clinicians to provide similar IASTM forces across treatment sessions. The authors’ purpose was to quantify clinician reliability of force application during a simulated IASTM treatment scenario. Five licensed athletic trainers with previous IASTM training (mean credential experience = 5.2 [4.3] y; median = 5 y) performed 15 one-handed unidirectional sweeping strokes with each of the 3 instruments on 2 consecutive days for a total of 90 data points each. The IASTM stroke application was analyzed for peak normal forces (F peak) and mean normal forces (F mean) by stroke across 2 sessions. The authors’ findings indicate IASTM trained clinicians demonstrated sufficient F peak and F mean reliability across a treatment range during a one-handed IASTM treatment. Future research should examine if IASTM applied at different force ranges influences patient outcomes.

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Lewis King, SarahJane Cullen, Jean McArdle, Adrian McGoldrick, Jennifer Pugh, Giles Warrington, and Ciara Losty

A large proportion of jockeys report symptoms associated with mental health difficulties (MHDs), yet most do not seek help from professional mental health support services. Due to the paucity of literature in this field, this study sought to explore jockeys’ barriers to, and facilitators of, help-seeking for MHDs. Twelve jockeys participated in semistructured interviews, subsequently analyzed via reflexive thematic analysis. Barriers to help-seeking included the negative perceptions of others (stigma and career implications), cultural norms (masculinity and self-reliance), and low mental health literacy (not knowing where to seek help, minimization of MHDs, negative perceptions of treatment, and recognizing symptoms). Facilitators to help-seeking included education (exposure to psychological support at a younger age), social support (from professionals, jockeys, family, and friends), and media campaigns (high-profile disclosures from jockeys). Findings are consistent with barrier and facilitator studies among general and athletic populations. Applied recommendations and future research considerations are presented throughout the manuscript.

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Yeshayahu Hutzler, Riki Tesler, Avinoam Gilad, Kwok Ng, and Sharon Barak

Children and adolescents with disabilities (CAWD) represent 11% of Israeli children and adolescents. The 10 core indicators of the Global Matrix on Para Report Cards of physical activity (PA) of CAWD were used to create the 2022 Israeli Para Report Card. A panel of four experts reviewed resources and synthesized evidence of PA behaviors and policies for CAWD in Israel, converted the data to grades, and charted subcategories of language, sex, and disability across population. Data sources were surveys, reports, and memberships in sport federations and clubs. Among CAWD, levels of participation in daily PA were poor (<20%; Grade F), and participation of CAWD in sports was even lower (<10%; Grade F). A lack of environmental infrastructure may explain the low levels of participation. Females, Arabic speakers, and physiological CAWD need particular attention. Establishing governmental policies and interventions is required to increase overall PA and participation in sports among CAWD.