Browse

Concussion history, trunk motion, and lower extremity biomechanics associate with musculoskeletal injury risk. We aimed to examine the interaction between concussion history and trunk motion as possible modifiable factors for injury risk biomechanics during jump landing and cutting. Division I female athletes (24 with, 20 without concussion history) performed jump landings and jump-to-cuts at 45° in the opposite direction of the landing limb. We used multiple linear regressions with interaction terms to examine ankle dorsiflexion angle, knee flexion and abduction angle, and external knee flexion and abduction moment. We observed a group by trunk flexion interaction for nondominant external knee flexion moment (P = .042) during jump landing. Concussion history associated with increased external knee flexion moment as trunk flexion increased. We observed a group by trunk flexion interaction for the dominant limb dorsiflexion angle (P = .044), and group by trunk lateral bending interactions for the dominant (P = .039) and nondominant limb (P = .016) external knee flexion moment during cutting. During cutting, concussion history associated with decreased dominant dorsiflexion angles as trunk flexion increased, and decreased dominant and nondominant external knee flexion moment as lateral bending toward the planted limb increased. Concussion history associated with atypical biomechanics as trunk flexion and lateral bending increased.

Context: The quadriceps femoris is consistently ranked among the muscles most prone to sustain strain injuries in sports involving kicking and sprinting actions. Given the documented preventive effect of Nordic hamstring curl programs against hamstring strain injuries, incorporating exercises that induce eccentric overload on the quadriceps could potentially help mitigate strain injuries within this muscle group. The Reverse Nordic Curl (RNC) has emerged as a viable field-based exercise for eccentrically working the quadriceps. This study aimed to compare quadriceps muscle eccentric activation during the RNC with 3 bodyweight squat-based exercises: single-leg squat (SLS), Bulgarian squat, and forward lunge. Design: Cross-sectional study. Methods: Twenty-three healthy volunteers (15 men) were monitored for rectus femoris, vastus lateralis, and vastus medialis electromyographic signal, as well as knee range of motion, while performing 10 repetitions of each exercise. Electromyography data acquired during eccentric phases were normalized by maximum voluntary isometric contraction of the knee extensors. The exercises were compared based on the electromyography and knee range of motion values. Results: RNC generated a similar rectus femoris and vastus medialis eccentric activation compared with the squat-based exercises (P > .05 for all), and a lower vastus lateralis activation than SLS (P < .001). Among the bodyweight squat-based exercises, SLS generated greater eccentric activation than forward lunge and Bulgarian squat for the 3 muscles (P < .05 for all). RNC was performed with lower knee-flexion range of motion than bodyweight squat-based exercises (P < .001). Conclusions: RNC did not produce superior eccentric quadriceps activation compared to bodyweight squat-based exercises, even proving to be less demanding for the vastus lateralis compared to the SLS. These findings may assist practitioners in selecting exercises to elicit quadriceps eccentric stimulus, with a focus on preventing strain injuries.

Context: Psychological concerns, such as athlete burnout and diminished well-being, have become a more recognized problem among collegiate student-athletes due to substantial demands. The purpose of this study was to determine if (1) an association exists between athlete burnout and well-being in female collegiate student-athletes and (2) social support has a main or buffering-effect on well-being and athlete burnout. Design: Cross-sectional. Methods: 174 National Collegiate Athletic Association Division I female collegiate student-athletes were recruited from a single institution to participate. A web-based survey was distributed via Qualtrics during the middle of an academic semester. The following scales were utilized to evaluate social support, athlete burnout, and well-being: Perceived Available Support in Sport Questionnaire, Athlete Burnout Questionnaire, and Warwick Edinburgh Metal Well-Being Scale. Results: Correlation analyses presented a significant negative, moderate correlation (r = −.58, P < .001) between athlete burnout and well-being as well as between social support and athlete burnout (r = −.526, P < .001). A moderate, positive correlation was identified between social support and well-being (r = .604, P < .001). Social support was a significant predictor for reduced sense of accomplishment (F _1,172 = 68.32, P < .001), physical and emotional exhaustion (F _1,172 = 22.00, P < .001), sport devaluation (F _1,172 = 56.51, P < .001), and well-being (F _1,172 = 115.3, P < .001). Conclusion: Findings provide new information on theory-based considerations for reducing athlete burnout and improving well-being in female collegiate student-athletes.

Clinical Scenario: Reaction time is integral in many tasks during work, sport, and life, thus, alterations in reaction time may impact performance and injury risk. There are various factors that can influence reaction time, such as the physical state of the individual, including their age or sex. When comparing males and females, there is a major physiological difference to their physical state as hormones fluctuate during menstrual cycle phases, which not only affects the reproductive system, but females may experience physiological, cardiovascular, respiratory, or metabolic changes throughout their menstrual cycle phases. Therefore, this goal of this critically appraised topic is to examine whether reaction time changes during menstrual cycle phases. Focused Clinical Question: In healthy, eumenorrheic females, does reaction time change from one menstrual cycle phase to other menstrual cycle phases? Summary of Key Findings: Among the five studies evaluated in this CAT, all found significant changes to reaction time during phases of the menstrual cycle. Most studies found that reaction time was inversely related to sex hormone levels, indicating that phases with low hormone levels had longer reaction time than those phases with higher hormone levels; however, one study found reaction time to be prolonged or slower during the luteal phase, when hormone levels are higher. Clinical Bottom Line: Both auditory and visual reaction times vary across the menstrual cycle in healthy females with regular menstrual cycles (frequency and length). Given these findings, it is important to incorporate reaction time training across all phases of the menstrual cycle in female athletes. Strength of Clinical Recommendation: Based on the Strength of Recommendation Taxonomy, a Grade C is the strength of recommendation.

Context: The Y-Balance Test Lower Quarter (YBT-LQ) is a widely utilized tool for evaluating dynamic postural control, requiring a combination of mobility and strength. This study aimed to investigate the combined relationship between isometric thigh muscle strength and joint kinematics on YBT-LQ performance. Design: Cross-sectional laboratory study. Methods: Isometric quadriceps and hamstrings strength were measured before the YBT-LQ in 39 healthy participants (27 females and 12 males). The test was performed under 3-dimensional markerless motion capture, where joint kinematics were extracted from the maximum reach position from each direction. Three multivariable linear regression models were then used to determine the strongest combination of predictors for YBT-LQ performance. Results: Greater hamstrings strength and increased knee flexion, ankle dorsiflexion, and trunk ipsilateral-flexion joint angles explained 56.8% (P < .001) of the variance in anterior reach. Hip flexion, knee flexion, and ankle dorsiflexion angles were the strongest predictors for posteromedial reach distance, explaining 73.0% of the variance (P < .001). Last, 43.3% (P < .001) of the variance in posterolateral reach distance was predicted by hamstring strength and knee-flexion angle. Conclusions: These results emphasize the importance of hamstring strength in YBT-LQ performance across different reach directions. Additionally, the kinematics illustrate a potential movement strategy for maximizing reach distance on the YBT-LQ in healthy individuals. Clinicians can utilize this information to guide interventions aimed at improving dynamic postural control, particularly by focusing on increasing hamstring strength and testing for impairments in specific movement patterns.

This study examined doctoral students’ occupational socialization experiences in U.S. adapted physical activity doctoral programs. Twenty-eight doctoral students were recruited and participated in semistructured, in-depth interviews. Interview transcripts were analyzed through a collaborative qualitative analysis, which resulted in the construction of four themes: (a) early socialization experiences foster a positive, but limited impression of physical education and physical activity; (b) doctoral education is pursued to have a greater impact on the disability community; (c) relationships with socializing agents provide support during doctoral education; and (d) coursework and learning in the community facilitate preparation for faculty roles. The findings indicate that there are several similarities between doctoral students and their peers in other doctoral degree programs. Some of these similarities point to issues that may concern prospective doctoral students and faculty members in adapted physical activity terminal degree programs.

Attentional focus strategies, especially external focus, are associated with improvements in mechanisms of postural control. This can be important in reducing sports injuries in practices such as running, which has seen an increase in adherence. However, the impacts of these strategies on postural control in runners are unclear. This study aimed to investigate the effects of internal and external focus strategies on postural control performance with different bases of support tasks in runners. A total of 19 young adults (18–38 years old) were divided into a running group (n = 9) and a control group (n = 10). Posturography tests were performed on stable and unstable surfaces, under control, and internal and external focus conditions. The distance, mean velocity, and total velocity of the center of pressure were analyzed (p ≤ .05). There was a reduction in oscillation under external focus compared to internal and control conditions, as well as under internal focus compared to the control condition. A Group × Surface × Focus interaction for the variables distance and mean velocity in the mediolateral direction was found only for the control group. However, no significant effects were found between groups for postural control performance. Attentional focus strategies were able to reduce postural sway, with external focus condition being the most effective. Practitioners can benefit from these strategies to increase postural control performance to help reduce the number of injuries and improve sports performance. It is speculated that the effects of attentional control strategies on postural control may differ depending on the specific adaptations of each sport.

Context: The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI. Design: Cross-cultural validation. Methods: A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test–retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18 years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires. Results: The ULFI-G showed good internal consistency (α = .88); excellent test–retest reliability (intraclass correlation coefficient_2:1 = .98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r = .84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r = .54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = −.62); and Short Form 12’s physical health domain (r = −.7). A single-factor structure was revealed. Conclusions: The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population.

Implicit biases are attitudes, emotions, or stereotypes that occur in an unconscious manner and have the potential to negatively affect behaviors, actions, and decisions. Recent studies have suggested that even when certain factors are controlled for, health care workers do not provide equitable care to patients from different demographics. When patients are not receiving equitable health care, there is a potential for disparities in patient-related outcomes. The purpose of this study was to determine attitudes toward implicit bias among athletic trainers. A secondary purpose of this study was to assess differences and correlations between attitudes toward implicit bias and demographic factors including age, years of experience, gender identity, sexual orientation, and race. Participants were recruited for this study by emailing athletic trainers from publicly available staff directories at institutions of higher education and high schools, and athletic training education program directors. The survey consisted of questions gathering demographic information and questions taken from the Attitudes Toward Implicit Bias Instrument. A total of 218 athletic trainers (age = 38 [11] y, years of certified experience = 14 [11] y) opened and completed the survey. On average, participants scored 71.0 [11.2] on the Attitudes Toward Implicit Bias Instrument. This mean score indicated that the average participant felt that implicit bias had the potential to negatively impact patient care and needed to be addressed through education. There was a significant, negligible negative correlation between age and attitudes toward implicit bias (r[216] = −.157, P = .02). Examining implicit bias among athletic trainers warrants further research to understand how implicit bias can negatively affect access to equitable health care opportunities. The development of high-quality interventions for identifying and addressing implicit bias is crucial to ensuring optimal patient outcomes in athletic training and all medical settings.