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Sinéad O’Keeffe, Niamh Ní Chéilleachair and Siobhán O’Connor

Context: Participating in Gaelic football provides a wealth of benefits, but a risk of musculoskeletal injury also exists. Injury is associated with physical consequences, including pain, discomfort, loss of function, time absent from school/sport, and considerable medical expenses, along with placing undue pressure on emergency services and hospital staff. Concurrent psychological consequences, such as fear avoidance, can also occur, causing psychological distress. There is a current dearth of available research examining the psychology of injury in male adolescent Gaelic footballers. Objective : To examine fear avoidance postinjury in male adolescent Gaelic footballers, the effect of pain, time loss, injury severity, and previous injury on the extent of fear avoidance, and the usefulness of a modified Athlete Fear Avoidance Questionnaire (AFAQ) as a screening tool for predicting injury. Design: Prospective cohort study. Setting: Recreational clubs. Participants: A total of 97 male adolescent club Gaelic footballers (13.4 [1.1] y). Interventions: Musculoskeletal injuries sustained during participation in Gaelic football, defined as any injury sustained during training or competition causing restricted performance or time lost from play, were assessed and recorded weekly by a certified athletic and rehabilitation therapist. Injuries requiring time loss from participation were classed as time-loss injuries. Injury characteristics that included type, nature, location, severity, and pain were recorded. Main Outcome Measures: Injured players completed the AFAQ, a measure of injury-related fear avoidance following injury assessment (AFAQ1). With time-loss injuries, the AFAQ was completed again (AFAQ2) prior to return to play. Modified AFAQ was completed at baseline. Results: Twenty-two injuries were recorded during the season with fear avoidance evident postinjury that significantly decreased before returning to play. Fear avoidance postinjury was higher in those with greater pain but time loss, injury severity, and previous injury did not significantly affect the extent of fear avoidance. Baseline fear avoidance did not predict injury. Conclusions: Psychological rehabilitation is recommended for managing postinjury psychological distress in male adolescent Gaelic footballers.

Open access

Hayley M. Ericksen, Caitlin Lefevre, Brittney A. Luc-Harkey, Abbey C. Thomas, Phillip A. Gribble and Brian Pietrosimone

Context: High vertical ground reaction force (vGRF) when initiating ground contact during jump landing is one biomechanical factor that may increase risk of anterior cruciate ligament injury. Intervention programs have been developed to decrease vGRF to reduce injury risk, yet generating high forces is still critical for performing dynamic activities such as a vertical jump task. Objective: To evaluate if a jump-landing feedback intervention, cueing a decrease in vGRF, would impair vertical jump performance in a separate task (Vertmax). Design: Randomized controlled trial. Patients (or Other Participants): Forty-eight recreationally active females (feedback: n = 31; 19.63 [1.54] y, 1.6 [0.08] cm, 58.13 [7.84] kg and control: n = 15; 19.6 [1.68] y, 1.64 [0.05] cm, 60.11 [8.36] kg) participated in this study. Intervention: Peak vGRF during a jump landing and Vertmax were recorded at baseline and 4 weeks post. The feedback group participated in 12 sessions over the 4-week period consisting of feedback provided for 6 sets of 6 jumps off a 30-cm box. The control group was instructed to return to the lab 28 days following the baseline measurements. Main Outcome Measures: Change scores (postbaseline) were calculated for peak vGRF and Vertmax. Group differences were evaluated for peak vGRF and Vertmax using a Mann–Whitney U test (P < .05). Results: There were no significant differences between groups at baseline (P > .05). The feedback group (−0.5 [0.3] N/kg) demonstrated a greater decrease in vGRF compared with the control group (0.01 [0.3] N/kg) (t(46) = −5.52, P < .001). There were no significant differences in change in Vertmax between groups (feedback = 0.9 [2.2] cm, control = 0.06 [2.1] cm; t(46) = 0.46, P = .64). Conclusions: While the feedback intervention was effective in decreasing vGRF when landing from a jump, these participants did not demonstrate changes in vertical jump performance when assessed during a different task. Practitioners should consider implementing feedback intervention programs to reduce peak vGRF, without worry of diminished vertical jump performance.

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Mahsa Jafari, Vahid Zolaktaf and Gholamali Ghasemi

Purpose: Firefighters require a high level of functional fitness to operate safely, effectively, and efficiently. The authors studied the distribution of functional movement screen (FMS) scores in firefighters and examined whether an 8-week corrective exercise program based on National Academy of Sport Medicine guidelines could improve them. Methods: All 524 active firefighters of a city completed the baseline FMS testing. Those who obtained a score of 14 or less, a sign of movement dysfunction, and volunteered to continue their participation were randomly assigned to either an experimental (n = 51) or a control (n = 45) group. Both groups participated in an 8-week training program. The control group used their own usual training routine, but the experimental group used the specific protocol designed for the study. Results: The FMS scores of 43% of the population were less than 14. Repeated-measures analysis of variance revealed a significant interaction between FMS scores of the groups (F 1,94 = 165, P < .001). The experimental group showed a 69% improvement from pretest (10.6) to posttest (17.8), whereas the control group showed only a 3% improvement from pretest (11.8) to posttest (12.1). Conclusions: Preceding studies have shown that FMS scores less than 14 increase the injury risk. The findings showed that using our proposed training protocol, low FMS scores could be improved to 14 and higher. Considering the high injury rate of firefighters, the authors suggest administering FMS periodically and to use a training protocol such as ours, to increase functional fitness and reduce injury risk.

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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

Context: The use of active video games (AVG) as a treatment modality in the rehabilitation context is increasing. However, little is known about the functional outcomes and psychological benefits of such rehabilitation in college athletes with lateral ankle sprains (LASs). Objective: To examine functional outcomes and psychological benefits of AVG-aided rehabilitation program for LAS. Design: A mixed-methods, single-subject case series design. Setting: College athletic training clinic. Patients: Two female college soccer players who sustained LAS (grades I and II) during sport participation. Intervention: A 4-week balance training program. One patient completed balance exercises using AVG, whereas the other patient completed traditional balance exercises. Main Outcome Measures: Several validated instruments were used to evaluate different functional outcomes and psychological factors: balance (Balance Error Scoring System, Star Excursion Balance Test), rehabilitation adherence (Rehabilitation Adherence Measure for Athletic Training), foot and ankle function (Foot and Ankle Ability Measure), perceptions of pain (Visual Analog Scale for pain), perceived readiness to return to sport (Injury-Psychological Readiness to Return to Sport Scale), and mood (Brunel Mood Scale). Results: It appears that the balance training protocols (AVG and traditional balance exercises) were equally effective in restoring patient’s balance to functional levels. Despite very individualistic processes of rehabilitation, the participants’ perceived pain, perceived readiness to return to sport, and mood states were closely linked with objective and subjective functional measures of progress. Conclusions: Based on the results, AVG has the potential to provide more versatility into the static and dynamic postural control exercises typically used following acute LAS. Moreover, the current results support the existing psychological and biopsychosocial theoretical conceptualizations of athletes’ responses to injuries and rehabilitation process.

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Kimmery Migel and Erik Wikstrom

Clinical Scenario: Approximately 30% of all first-time patients with LAS develop chronic ankle instability (CAI). CAI-associated impairments are thought to contribute to aberrant gait biomechanics, which increase the risk of subsequent ankle sprains and the development of posttraumatic osteoarthritis. Alternative modalities should be considered to improve gait biomechanics as impairment-based rehabilitation does not impact gait. Taping and bracing have been shown to reduce the risk of recurrent ankle sprains; however, their effects on CAI-associated gait biomechanics remain unknown. Clinical Question: Do ankle taping and bracing modify gait biomechanics in those with CAI? Summary of Key Findings: Three case-control studies assessed taping and bracing applications including kinesiotape, athletic tape, a flexible brace, and a semirigid brace. Kinesiotape decreased excessive inversion in early stance, whereas athletic taping decreased excessive inversion and plantar flexion in the swing phase and limited tibial external rotation in terminal stance. The flexible and semirigid brace increased dorsiflexion range of motion, and the semirigid brace limited plantar flexion range of motion at toe-off. Clinical Bottom Line: Taping and bracing acutely alter gait biomechanics in those with CAI. Strength of Recommendation: There is limited quality evidence (grade B) that taping and bracing can immediately alter gait biomechanics in patients with CAI.

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Jeroen Koekoek and Annelies Knoppers

Purpose: To explore how the use of gender categorizations inform children’s preferences of working with others in physical education. Method: Draw, write, and tell procedures were used to elicit the thoughts and feelings of 42 children, across four schools, about their peers and working together in groups. The children, aged between 11 and 13 years, were distributed across 14 focus groups to talk about conditions in group work that they thought facilitated and inhibited their learning. Results: Two meta-themes—(a) classmates and friendships and (b) work intention and trust—emerged from the interview data about their preferences for the ways groups were constituted. The results indicated that these children created or constructed categories of their peers based on gender but using gender-neutral words. Conclusion: Their constructions of working with others in PE contributed to an implicit curriculum consisting of different expectations for the same gender and for other gender groups.

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Ross D. Neville, Fergal Lyons, Brendan Doyle and Kimberley D. Lakes

This study compared fundamental movement skills (FMS) in children from schools on the lower and upper levels of socioeconomic status. Data were collected from 228 schoolchildren across five schools in Ireland. There were 147 children from schools of social disadvantage (Mage = 7.67 [SD = 0.62] years; 55% boys) and 81 children from schools considered in the normal range for socioeconomic development (Mage = 7.34 [SD = 0.26] years; 56% boys). FMS were assessed using the Test of Gross Motor Development–2. Mixed models were used to estimate differences in FMS, while controlling for the nested structure of the data and for sex, age, body mass index, and class size. There was a substantial sex×school interaction, with girls from schools of social disadvantage exhibiting greater object-control skills proficiency than their counterparts in schools on the upper tertiles of socioeconomic development (standardized effect size = 0.66 [±95% confidence limits, ±0.50]; p = .02). The suggestion that children from social disadvantage are delayed in FMS is unsupported in this cohort. Differences in the structure of physical education and types of sports undertaken by children in schools of social disadvantage in Ireland are considered as explanations for this departure from previous studies.

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Gakuto Kitamura, Hiroshige Tateuchi and Noriaki Ichihashi

Context: In competitive swimming, many swimmers experience low back pain (LBP). Lumbar hyperextension may cause LBP, and tight hip-flexor muscle may cause lumbar extension during swimming. Objective: The purpose of this study was to clarify the features of the elastic moduli of the muscles and the lumbar extension when swimmers with LBP perform a dolphin kick (DK). Design: Cross-sectional study. Setting: Single center. Other Participants: Eleven male college swimmers were enrolled as the LBP group (who have LBP when swimming and during a lumbar extension), and 21 male college swimmers were recruited as the control group (no LBP). Interventions: The elastic moduli of the psoas major, iliacus, teres major, latissimus dorsi, pectoralis major, and pectoralis minor were measured through ultrasonic shear wave elastography. The lumbar and hip extension angles during a DK were measured using a video camera. The passive hip extension and shoulder-flexion range of motion (ROM) were measured using a goniometer. Main Outcome Measures: Muscle elastic moduli and lumbar extension angles during DK. Results: The characteristics, muscle elastic moduli, DK motion, and ROM were compared between the 2 groups. LBP group demonstrated significantly higher elastic modulus of the psoas major and lower modulus of pectoralis minor compared with the control group. Also, LBP group showed greater lumbar extension during a DK and less hip extension ROM than the control group. Conclusions: The higher elastic modulus of the psoas major and greater lumbar extension during a DK may be related to the LBP in swimmers.

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Brendan T. O’ Keeffe, Ciaran MacDonncha, Kwok Ng and Alan E. Donnelly

Purpose: To examine the prevalence of and approaches to monitoring health-related physical fitness (HRPF) in secondary school-based physical education programs. Methods: Physical education teachers (N = 327; 56.6% females) from 235 secondary schools (33.1% of national total) in the Republic of Ireland completed a survey designed specifically for the purposes of this study. Results: HRPF tests were used by 95.3% of teachers. A significant decline in the testing frequency was observed from the junior grades (age 13–15 years) to the senior grades (age 16–18 years) (p < .001). Just over half (51.7%) of the teachers discarded the test results after a single use. Less than one third of the teachers indicated that they shared the test results with the students’ parents. The vast majority (87.0%) of the teachers agreed that the development of a digital platform would facilitate monitoring test results over time. Conclusions: HRPF testing is highly prevalent in secondary schools. More actions are needed to ensure that teachers use pedagogically sound student-centered approaches toward monitoring HRPF, with a focus on learning that may lead to more positive testing experiences for students. Consideration should be given to the development of digital platforms to facilitate monitoring and reporting HRPF.

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Shelby J. Martin and Timothy Anderson

Despite elevated risk of eating pathology (EP) among athletes, utilization of EP-treatment among athletes is low. Factors that may inhibit EP-help-seeking among athletes include perceived social stigma, self-stigma, and perfectionism. Heightened stigma associated with EP and sport climates may be exacerbated by negative perfectionism characteristic of athletes and decrease intentions to seek help for EP. We tested the following moderated-mediation model among a sample of collegiate athletes (N = 201) via online questionnaires: EP indirectly relates to EP help-seeking intentions through perceived and self-stigma and these relations are conditional on negative perfectionism. EP help-seeking intentions were negatively associated with EP severity, stigma, and negative perfectionism. EP was related to eating-specific help-seeking intentions through perceived social stigma, influencing self-stigma, but this was not moderated by negative perfectionism. Targeting mental-health treatment stigma among athletes may reduce risk of untreated EP among collegiate athletes.