Athletic preinjury function is typically determined via subjective recall; however, obtaining preinjury function before injury occurs should be attempted in order to establish an individual baseline for postinjury comparison. The purpose of this study was to obtain preinjury baseline values for the Foot and Ankle Disability Index (FADI) and Foot and Ankle Disability Index sport version (FADISP), single-leg hop for distance, and Star Excursion Balance Test anterior reach and determine if athletes returned to those values following ankle injury. Out of 41 qualifying injuries, FADI/FADISP scores were significantly reduced at initial injury compared with baseline and all other time points (p < .001) but recovered by discharge. Single-leg hop and Star Excursion Balance Test recovered to baseline values by the discharge time point (p ≥ .98). Subjective and objective preinjury function can be reestablished by discharge from supervised treatment following low-grade ankle injury and maintained for at least 6 months following the cessation of treatment. However, testing metrics should be reviewed on an individual athlete basis, because group data may mask individual patient needs.
Aaron D. Sciascia, Arthur J. Nitz, Patrick O. McKeon, Jennifer Havens, and Timothy L. Uhl
Leah M. Balsamo, Kenneth P. Clark, Katherine E. Morrison, and Nicole M. Cattano
Context: Medial tibial stress syndrome (MTSS) is an overuse injury studied in endurance (ED) runners with minimal data on sprint (SP) athletes. Incorporating patient-reported outcome measures (PROMs) into clinical practice with running athletes may provide an objective way to track and treat MTSS. Purpose: To investigate PROMs as a means to monitor MTSS and general wellness in all running (i.e., ED and SP) track athletes during a competitive season. Results: The PROMs overall showed few MTSS symptoms and good global health (mean MTSS score: 0.35 ± 0.85, mean Global Health score: 33.6 ± 3.5). Sprinters reported significantly poorer MTSS scores and Global Health scores (0.544, 95% confidence interval, CI, [0.370, 1.050], p = .04]; 32.50, 95% CI [30.84, 34.16], p = .028) than ED runners (0.04, 95% CI [0.000, 0.041]; 35.5, 95% CI [33.29, 37.65]). There was a main deteriorating effect over time for the MTSS score (p = .047). Conclusions: Sprinters reported more symptoms than ED runners and need to be further researched as an independent population. The PROMs may be useful in tracking symptoms and modifying practices for individual track athletes.
Robert C. Lynall, Rachel S. Johnson, Landon B. Lempke, and Julianne D. Schmidt
Context: Reaction time is commonly assessed postconcussion through a computerized neurocognitive battery. Although this measure is sensitive to postconcussion deficits, it is not clear if computerized reaction time reflects the dynamic reaction time necessary to compete effectively and safely during sporting activities. Functional reaction time assessments may be useful postconcussion, but reliability must be determined before clinical implementation. Objective: To determine the test–retest reliability of a functional reaction time assessment battery and to determine if reaction time improved between sessions. Design: Cohort. Setting: Laboratory. Participants: Forty-one participants (21 men and 20 women) completed 2 time points. Participants, on average, were 22.5 (2.1) years old, 72.5 (11.9) cm tall, had a mass of 71.0 (13.7) kg, and were mostly right leg and hand dominant (92.7%). Interventions: Participants completed 2 clinical reaction time tests (computerized Stroop and drop stick) and 5 functional reaction time tests (gait, jump landing, single-leg hop, anticipated cut, and unanticipated cut) across 2 sessions. Drop stick and functional reaction time assessments were performed in single (motor task only) and dual task (motor task with cognitive task). Main Outcome Measures: Reaction time (in seconds) was calculated during all assessments. Test–retest reliability was determined using 2-way mixed-effects intraclass correlation coefficients (3, k). Paired samples t tests compared mean reaction time between sessions. Results: Test–retest reliability was moderate to excellent for all reaction time outcomes (intraclass correlation coefficients [3, k] range = .766–.925). Several statistically significant between-session mean differences were observed, but effect sizes were negligible to small (d range = 0.05–0.44). Conclusions: The functional reaction time assessment battery displayed similar reliability to the standard computerized reaction time assessment battery and may provide important postinjury information, but more research is needed to determine clinical utility.
Emma F. Zuk, Gyujin Kim, Jacqueline Rodriguez, Brandon Hallaway, Amanda Kuczo, Shayna Deluca, Kirsten Allen, Neal R. Glaviano, and Lindsay J. DiStefano
Clinical Scenario: Patellofemoral pain (PFP) is characterized by general anterior knee pain around the patella and is one of the most prevalent knee conditions. PFP is challenging to treat due to a wide range of contributing factors and often has chronic, reoccurring symptoms. Traditional treatment focuses on quadriceps and gluteal strengthening with minimal emphasis on deep trunk musculature. Recently, there has been a growing body of literature supporting the beneficial effects of core stability exercises as a treatment option for PFP. Clinical Question: Are core stability exercises coupled with traditional rehabilitation more effective than only traditional rehabilitation techniques for decreasing pain in patients with PFP? Summary of Key Findings: Three articles met the inclusion criteria and investigated core strengthening exercises as a treatment for PFP. Two studies investigated a 4-week exercise protocol and demonstrated a greater decrease in pain when compared to the control group. The third study examined the effects of a 6-week program where both the intervention and control groups resulted in similar reduction of pain. All articles included received a minimum of 6 on the PEDro scale. Clinical Bottom Line: There is evidence that supports core stability exercise protocols coupled with traditional rehabilitation as being more effective in reducing pain in patients with PFP when compared to traditional rehabilitation alone. Strength of Recommendation:The grade of A is recommended based on the Strength of Recommendation Taxonomy.
Stephanie Mazerolle Singe and James Mensch
Informal support systems, such as spouses, friends, and family members, have been identified as possible facilitators to achieving a work–life balance (WLB) for athletic trainers. Little, however, is known about the spouse and their experiences facilitating a WLB. A total of 17 spouses (11 females and six males) of full-time athletic trainers completed our study. The participants journaled their responses to 14 open-ended questions that pertained to WLB. A general inductive approach revealed three major themes: (a) living in time blocks, (b) frequent work schedule changes, and (c) the duty of multiple roles within the family construct. Three more themes emerged as strategies that spouses utilize: (a) intentional planning, (b) adaptation, and (c) workplace integration. Although spouses face many challenges in their own lives, they acknowledge their support toward their spouse’s WLB. Spouses reported overall satisfaction with their current WLB but identified many ways it could be improved.
Hillary H. Holmes, Randall T. Fawcett, and Jaimie A. Roper
Walking is an integral indicator of human health commonly investigated while walking overground and with the use of a treadmill. Unlike fixed-speed treadmills, overground walking is dependent on the preferred walking speed under the individuals’ control. Thus, user-driven treadmills may have the ability to better simulate the characteristics of overground walking. This pilot study is the first investigation to compare a user-driven treadmill, a fixed-speed treadmill, and overground walking to understand differences in variability and mean spatiotemporal measures across walking environments. Participants walked fastest overground compared to both fixed and user-driven treadmill conditions. However, gait cycle speed variability in the fixed-speed treadmill condition was significantly lower than the user-driven and overground conditions, with no significant differences present between overground and user-driven treadmill walking. The lack of differences in variability between the user-driven treadmill and overground walking may indicate that the user-driven treadmill can better simulate the variability of overground walking, potentially leading to more natural adaptation and motor control patterns of walking.
Lauren E. Schroeder, Rachel L. Tatarski, and Joshua T. Weinhandl
Decreased dorsiflexion range of motion (DROM) can be modified using static stretching and joint mobilizations and may attenuate known knee anterior cruciate ligament injury risk factors. It is not known how these interventions compare to each other and how they improve knee landing mechanics. This study’s purpose was to determine the immediate effects of static stretching and joint mobilization interventions on DROM measurement changes and right-leg drop jump knee landing mechanics. Eighteen females and 7 males, all recreationally active, completed 2 study sessions. Active and passive DROM, the weight-bearing lunge test, the anterior reach portion of the Star Excursion Balance Test, and a right-leg drop jump landing task were completed before and after the intervention. Change in DROM (ΔDROM) was calculated for DROM assessments between preintervention and postintervention. Pairwise dependent t tests determined no differences in ΔDROM between interventions, and statistical parametric mapping determined increased knee flexion (P = .004) and decreased anterior shear force (P = .015) during landing after both interventions. Increased DROM improves sagittal plane displacement and loading at the knee. Stretching may be a more feasible option in a healthy population for those wanting to maintain range of motion and decrease knee injury risk without physical therapist involvement.
Ahalee C. Farrow and Ty B. Palmer
This study aimed to examine the effects of age on hip flexion maximal and rapid strength and rectus femoris (RF) muscle size and composition in men. Fifteen young (25  y) and 15 older (73  y) men performed isometric hip flexion contractions to examine peak torque and absolute and normalized rate of torque development (RTD) at time intervals of 0 to 100 and 100 to 200 milliseconds. Ultrasonography was used to examine RF muscle cross-sectional area and echo intensity. Peak torque, absolute RTD at 0 to 100 milliseconds, and absolute and normalized RTD at 100 to 200 milliseconds were significantly lower (P = .004–.045) in the old compared with the young men. The older men exhibited lower cross-sectional area (P = .015) and higher echo intensity (P = .007) than the young men. Moreover, there were positive relationships between cross-sectional area and absolute RTD at 0 to 100 milliseconds (r = .400) and absolute RTD at 100 to 200 milliseconds (r = .450) and negative relationships between echo intensity and absolute RTD at 100 to 200 milliseconds (r = −.457) and normalized RTD at 100 to 200 milliseconds (r = −.373). These findings indicate that hip flexion maximal and rapid strength and RF muscle size and composition decrease in old age. The relationships observed between ultrasound-derived RF parameters and measurements of RTD suggest that these age-related declines in muscle size and composition may be relevant to hip flexion rapid torque production.