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Misia Gervis, Helen Pickford and Thomas Hau

The purpose of this study was to investigate counselors’ professional understanding of the long-term psychological consequences of injury in UK football players. Semi-structured interviews were conducted with 11 counselors who were registered to work for the Professional Footballers’ Association (PFA). The interviews examined the counselors’ perception of the relationship between long-term injury and presenting mental health issues, the antecedents to those mental health issues, and recommendations for psychological intervention following injury. The critical finding was the mental health problems regularly presented to PFA counselors were often the psychological and behavioral consequences of long-term injury. Counselors recommended that early and sustained psychological intervention with long-term injured players would act as a preventative measure against future mental health issues.

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Robert C. Hilliard, Lorenzo A. Redmond and Jack C. Watson II

Although factors involved with help-seeking have been widely studied in the general college population, college student-athletes have received less attention. The purpose of this study was to examine the moderating role of self-compassion on the relationship between public and self-stigma, and how self-stigma was associated with attitudes toward seeking counseling. A sample of 243 student-athletes from NCAA Divisions I and III participated in the study. Using structural equation modeling, self-compassion was not found to moderate the relationship between public and self-stigma. However, public stigma was positively associated with self-stigma, and self-stigma was negatively associated with attitudes toward counseling. A multigroup analysis did not find differences between males and females for the model. The results of this study have implications for professionals who work with college student-athletes and suggest that efforts should aim to reduce stigma and examine alternative factors that might improve attitudes toward mental health help-seeking.

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Susanna Kola-Palmer, Samantha Buckley, Gabrielle Kingston, Jonathan Stephen, Alison Rodriguez, Nicole Sherretts and Kiara Lewis

Player welfare is an important development in supporting elite athletes during their professional careers. Little is known about how player engagement with player welfare provision impact on mental health. Over two consecutive years, professional rugby football league (RFL) players were invited to complete an anonymous online survey assessing psychological stress, athletic identity, and attitudes to player welfare provision. Findings indicate that nearly half of respondents experienced symptoms of anxiety and depression. Multivariate analyses suggest that higher psychological stress and athletic identity and less knowledge and less positive attitudes to RFL mental health support is associated with worse mental health, whereas older age is associated with better mental health. The study has identified some key variables to focus on in developing player care and support management, and also suggest directions for future research guiding player welfare support, especially regarding increasing positive attitudes to mental health supports.

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Cui Zhang, Qipeng Song, Wei Sun and Yu Liu

Daily stair activities have become increasingly challenging for older adults with deterioration in physical and cognitive capabilities. However, the dynamic stability of older adults during stair descent under a concurrent dual-task condition remains undetermined. The gait and dynamic stability variables of 40 healthy older adults were measured under single- and dual-task conditions during stair descent. The step length, step width, and single support time did not significantly increase (p > .05) under the dual-task condition during stair descent. The medial–lateral center of mass velocity significantly increased (p < .003), whereas the medial–lateral margin of dynamic stability value significantly decreased (p < .006) at the landing and initial single support under the dual-task condition during stair descent. The self-regulatory ability of healthy older adults under the dual-task condition during stair descent was underestimated. Dual tasking displayed a positive impact on the anterior–posterior dynamic stability of healthy older adults.

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Chad Van Ramshorst and Woochol Joseph Choi

This study investigated the contact forces and muscle activation during 2 choreographed fall techniques in contemporary dancers and how these were affected by the fall technique. Ten collegiate-level dancers were instructed in 2 choreographed falls: (1) an anteriorly focused fall involving ankle plantar flexion, knee flexion, and hip flexion with dispersion of forces up the anterior surface of the shank (technique 1) and (2) a laterally focused fall involving inversion at the ankle with dispersion of forces up the lateral aspect of the shank (technique 2). The knee and hip contact forces were 26.3% smaller (technique 1: 1743 N vs technique 2: 1284 N) and 24.1% greater (technique 1: 1334 N vs technique 2: 1656 N), respectively, in technique 2 (P < .03). At the time of knee contact, percentage of maximal voluntary isometric contraction (%MVIC) was 45.8% greater for rectus femoris muscle (technique 1: 7.2% vs technique 2: 10.5%) and 96.9% greater for gluteus medius muscle (technique 1: 3.2% vs technique 2: 6.3%) (P < .01) in technique 2. The results provide insight into determining safer landing strategies to avoid knee injuries in individuals who experience a fall (ie, dancers, athletes, and older adults).

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Maria K. Talarico, Robert C. Lynall, Timothy C. Mauntel, Erin B. Wasserman, Darin A. Padua and Jason P. Mihalik

Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s−1 increase in squat speed, sway range (mediolateral: β = −0.03; anteroposterior: β = −0.05) and area (β = −0.25) decreased, whereas sway speed (mediolateral: β = 0.05; anteroposterior: β = 0.29; total: β = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: β = 0.05; anteroposterior: β = 0.20) and area (β = 0.72) increased, whereas sway speed (anteroposterior: β = −0.14; total: β = −0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.

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Patrick Ippersiel, Richard Preuss and Shawn M. Robbins

Continuous relative phase (CRP) analysis using the Hilbert transform is prone to end effects. The purpose was to investigate the impact of padding techniques (reflection, spline extrapolation, extraneous data, and unpadded) on end effects following Hilbert-transformed CRP calculations, using sinusoidal, nonsinusoidal, and kinematic data from a repeated sit-to-stand-to-sit task in adults with low back pain (n = 16, mean age = 30 y). CRP angles were determined using a Hilbert transform of sinusoidal and nonsinusoidal signals with set phase shifts, and for the left thigh/sacrum segments. Root mean square difference and true error compared test signals with a gold standard, for the start, end, and full periods, for all data. Mean difference and 95% bootstrapped confidence intervals were calculated to compare padding techniques using kinematic data. The unpadded approach showed near-negligible error using sinusoidal data across all periods. No approach was clearly superior for nonsinusoidal data. Spline extrapolation showed significantly less root mean square difference (all periods) when compared with double reflection (full period: mean difference = 2.11; 95% confidence interval, 1.41 to 2.79) and unpadded approaches (full period: mean difference = −15.8; 95% confidence interval, −18.9 to −12.8). Padding sinusoidal data when performing CRP analyses are unnecessary. When extraneous data have not been collected, our findings recommend padding using a spline to minimize data distortion following Hilbert-transformed CRP analyses.

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David R. Howell, Thomas A. Buckley, Brant Berkstresser, Francis Wang and William P. Meehan III

The purpose of this study was to identify the rate of abnormal single-task and dual-task gait performance following concussion compared to uninjured controls using previously established normative reference values. The authors examined athletes with a concussion (n = 54; mean age = 20.3 [1.1] y, 46% female, tested 2.9 [1.5] d postinjury), and healthy controls were tested during their preseason baseline examination (n = 60; mean age = 18.9 [0.7] y, 37% female). Participants completed an instrumented single-/dual-task gait evaluation. Outcome variables included average walking speed, cadence, and step length. A significantly greater number of those with concussion walked with abnormal dual-task gait speed compared with the control group (56% vs 30%, P = .01). After adjusting for potential confounding variables (age, concussion history, symptom severity, and sleep), concussion was associated with lower dual-task gait speed (β = −0.150; 95% confidence interval [CI] = −0.252 to −0.047), cadence (β = −8.179; 95% CI = −14.49 to −1.871), and stride length (β = −0.109; 95% CI = −0.204 to −0.014). Although group analyses indicated that those with a concussion performed worse on single-task and dual-task gait compared with controls, a higher rate of abnormal gait was detected for the concussion group compared with the control group for dual-task gait speed only. Dual-task gait speed, therefore, may be considered as a measure to compare against normative values to detect postconcussion impairments.

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Patricia M. Kelshaw, Trenton E. Gould, Mark Jesunathadas, Nelson Cortes, Amanda Caswell, Elizabeth D. Edwards and Shane V. Caswell

Girls’ lacrosse participation and head injury rates have increased within the past decade. In response, optional headgear was implemented following the recently developed ASTM International lacrosse headgear performance standards. It remains unknown how lacrosse headgear responds to blunt impacts after use. Our purpose was to compare the peak linear acceleration between girls’ lacrosse headgear conditions (pristine and used) during blunt impacts. Pristine headgear (n = 10) were tested in their original condition and used headgear (n = 10) were worn for an entire competitive season. A Cadex Monorail Impactor impacted all headgear following ASTM standards (F1446-15b, F2220-15, and F3137-15) in the required testing locations. A 2 × 7 repeated-measures analysis of variance compared peak linear acceleration among headgear conditions and impact locations with a simple effects analysis planned comparison. There was no difference between headgear conditions for peak linear acceleration (pristine: 47.12 [13.92] g; used: 46.62 [14.84] g; F = 2.11, P > .05). A main effect for impact location (F = 983.52, P < .01), and an interaction effect of condition and impact location (F = 12.79, P < .01) were observed. All headgear, regardless of condition, met the ASTM performance standard. This suggests that headgear performance may not degrade subsequent to a single season of high school girls’ lacrosse.

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Susana Meireles, Neil D. Reeves, Richard K. Jones, Colin R. Smith, Darryl G. Thelen and Ilse Jonkers

Medial knee loading during stair negotiation in individuals with medial knee osteoarthritis has only been reported in terms of joint moments, which may underestimate the knee loading. This study assessed knee contact forces (KCF) and contact pressures during different stair negotiation strategies. Motion analysis was performed in 5 individuals with medial knee osteoarthritis (52.8 [11.0] y) and 8 healthy subjects (51.0 [13.4] y) while ascending and descending a staircase. KCF and contact pressures were calculated using a multibody knee model while performing step-over-step at controlled and self-selected speed, and step-by-step strategies. At controlled speed, individuals with osteoarthritis showed decreased peak KCF during stair ascent but not during stair descent. Osteoarthritis patients showed higher trunk rotations in frontal and sagittal planes than controls. At lower self-selected speed, patients also presented reduced medial KCF during stair descent. While performing step-by-step, medial contact pressures decreased in osteoarthritis patients during stair descent. Osteoarthritis patients reduced their speed and increased trunk flexion and lean angles to reduce KCF during stair ascent. These trunk changes were less safe during stair descent where a reduced speed was more effective. Individuals should be recommended to use step-over-step during stair ascent and step-by-step during stair descent to reduce medial KCF.