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Does a Single Session of Cupping Therapy Increase Range of Motion in Individuals With Limited Hamstring Flexibility? A Critically Appraised Topic

Dwight Arganbright, Anne Russ, Jamie Mansell, and Ryan Tierney

Context: Improving hamstring tightness is a common therapeutic goal to maintain performance and reduce injury risk. How effective is a single session of therapeutic cupping on improving hamstring flexibility? Methods: PubMed was searched in the Summer of 2023 using the search terms: cupping and range of motion (ROM). Included studies were intervention studies that evaluated cupping and flexibility within the lower extremity during a single treatment session. Hip flexion ROM was measured with the passive or active straight leg test. Means, SDs, 95% CI, and effect sizes were calculated. Results: Three articles were screened. Warren et al. reported a statistically significant increase in ROM from pre- to posttest of 4.42° using a digital inclinometer during the passive straight leg test. However, this is below a reported minimal detectable difference for the passive straight leg test (10°). Schafer et al. and Williams et al. reported no significant cupping effect over time between groups. Conclusions: There is consistent evidence that a single session of cupping therapy does not increase lower-extremity ROM in patients with limited hamstring flexibility.

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Pain Reduction in Medial Tibial Stress Syndrome With Extracorporeal Shockwave Therapy: A Critically Appraised Topic

Elizabeth Perrero, Nancy A. Uriegas, Morgan Adams, and Amy L. Fraley

In active populations with medial tibial stress syndrome (MTSS), is extracorporeal shockwave therapy an effective treatment to reduce pain? A computerized search was conducted in October 2021. Inclusion criteria consisted of participants 18+ years old with diagnosed MTSS for 21+ days, where pain was in the posterior medial aspect of the tibia. Exclusion criteria involved patients with tibial fractures, compartment syndrome, and prior treatment of MTSS with extracorporeal shockwave therapy. Results were measured by the number of days athletes could complete the running protocol pain-free according to the Likert scale (p = .008), visual analog scale (p = .001), and Roles and Maudsley scale (RMS; p = .002). The third study showed no statistical significance in pain reduction or self-perception of change in symptoms on the Numerical Rating Scale (NRS; p = .05). Using the Strengthening the Reporting of Observational studies in Epidemiology scale, one study received a 17/22 since no biases were addressed, lack of participant status in each stage of the study, no numbers or analysis reported in each group, and no explanation of external validity or funding. The single-blind randomized controlled trial received a 10/11 using the Physiotherapy Evidence Database scale and one level of evidence. The double-blind sham randomized controlled trial received an 11/11 and one level of evidence (LOE). The research appraised would mostly agree the use of extracorporeal shockwave therapy could reduce pain in MTSS in active populations. The strength of recommendation is B.

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Assessing the Use of Recommended Practices in Adapted Physical Activity/Education Experiential-Learning Programs

Layne Case, Joonkoo Yun, Megan MacDonald, Bridget E. Hatfield, and Samuel W. Logan

This study investigated the use of recommended practices in university-based experiential learning associated with adapted physical activity and education (APA/E) undergraduate courses. Participants (N = 165) were instructors of APA/E courses with an experiential-learning component and/or professionals involved in APA/E experiential-learning programs at their university. Participants completed an online questionnaire designed to describe program characteristics and evaluate the use of two sets of practices, including those recommended for involving students and people with disabilities. Findings highlight low proportions of the use of practices recommended for people with disabilities and indicate that significantly more practices recommended for students were implemented (Z = −10.45, p < .001). Findings from this study have several implications for evaluation and intervention in APA/E experiential learning, such as including the disability community in planning and designing programming to benefit both students and people with disabilities. Instructors should aim to increase their implementation of practices recommended for involving people with disabilities.

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NATA News and Notes

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Epidemiological Study of Track-and-Field Meets On-Field Medical Care

Yosuke Hiroshige, Hodaka Watanabe, Shinji Tomiyama, and Hajime Kato

Background: Most epidemiological studies on track-and-field meets have been limited to the Olympics and world championships. These are meets in which only high-performance athletes participate at a certain time of the year. In contrast, epidemiological studies on athletes of various ages and across different seasons may provide health care providers with valuable insights into injury prevention and on-field medical care. The study aims to determine the trends and locations of injuries during track-and-field meets in athletes of various ages and seasons based on on-field medical care records. Methods: The number and incidence of injuries requiring on-field medical care during or after the event were obtained from 39 track-and-field meets. Injuries were defined as cases that required on-field medical care. The incidence was defined as the number of injuries per 1000 athlete exposures wherein 1 athlete exposure is the athlete’s participation in one event. We also recorded the number of injuries at each location and whether transportation to a medical station was required. Results: A total of 191 injuries were reported. This study identified a population with a high incidence of injury (middle- and long-distance events, combined events, and athletes over the age of 19), areas within the stadium where injuries were more likely to occur (finish line and first turn), and a high rate of transport to the medical station (approximately 70%); most of them were transported to wheelchairs. Conclusion: The results provide insights into the trends, locations, and transport of injured athletes during track-and-field meets. Professionals will better understand the injuries occurring during track-and-field meets and can improve the efficiency of on-field medical care activities. They will also assist organizers in track-and-field meets to improve the safety of their meet operations.

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Can Manual Lymph Drainage Be Considered as a Passive Recovery Strategy?

Humeyra Kiloatar, Aylin Aydogdu Delibay, Nisa Turutgen, and Mihri Baris Karavelioglu

Context: The aim of this study was to investigate the acute effects of Swedish massage and manual lymph drainage (MLD) on performance parameters related to jumping, walking, and blood lactic acid levels after Nordic hamstring exercises. Design: This study was designed as a controlled crossover study. Methods: The study included 16 young trained men. Participants’ lactic acid levels, gait-related parameters, and jumping performance were assessed. Assessments were performed at baseline, after Nordic hamstring exercises, and after 3 different passive recovery strategies: resting, Swedish massage, and MLD for 3 weeks. Results: As a result of the study, it was observed that lactic acid levels after the MLD and massage intervention were significantly lower in both MLD and massage conditions compared with the control condition (P < .05). There was no within- and between-conditions difference in jumping parameters after the MLD and massage interventions (P > .05). Walking speed in the MLD condition was statistically higher following the intervention compared with both before and after exercise (P < .05). Step time in the massage condition was statistically lower after the intervention compared with after Nordic hamstring exercise (P < .05). Conclusions: Although MLD and massage interventions have positive effects on lactic acid levels and walking and jumping parameters, they are not superior to each other. MLD can be used as a passive recovery technique after exercise.

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Can We Talk? Exploring the Effects of Mental Health Stigma, Support, and Openness on National Collegiate Athletic Association Student-Athlete Mental Health

Braden J. Brown, Ty B. Aller, Logan K. Lyons, Autumn Jenson, Audrey C. Juhasz, Jakob F. Jensen, and Jennifer L. Hodgson

National Collegiate Athletic Association (NCAA) student athletes may have more stigmatic views toward mental health (MH) and be less open to talking about or seeking support for MH struggles than their peers. This may contribute to and/or exacerbate existing MH challenges. This cross-sectional study explored the impact of MH stigma, support, and openness on student athletes’ levels of depression, anxiety, and stress among 478 NCAA student athletes representing 20 different sports from 56 universities. Results indicated that male, Black, Indigenous, People of Color (BIPOC), and Division I athletes reported higher levels of MH stigma. Compared with their White peers, BIPOC athletes exhibited less openness to talk about MH challenges. Division I and BIPOC athletes felt less supported to seek help for MH concerns. Structural equation modeling showed that MH stigma was positively associated with depression, anxiety, and stress, whereas MH openness was negatively associated with depression, anxiety, and stress. Research/practical implications, limitations, and future research and athletic department programming needs are discussed.

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Psychological Profile of Hungarian International-Level Distance Runners

Bence Kelemen, Renátó Tóth, Ottó Benczenleitner, and László Tóth

The aim of the present study was to investigate the psychological profile of the 2023 Hungarian National Distance Running Team in terms of personality traits, motivational styles, and competitive anxiety and to explore specific psychosocial factors that characterize the athletes’ mental preparation. The 16 international-level competitors were assessed using validated questionnaires in Hungarian (Big Five Inventory, the revised Sport Motivation Scale, and Competitive State Anxiety Inventory-2), and university students competing at professional and semiprofessional levels served as the control group. Results indicated that elite distance runners were primarily intrinsically motivated. Their psychological profile appeared similar to profiles found among athletes in the control group. Significant differences were found in traits, such as openness, conscientiousness, and motivation. Neuroticism was positively associated with athletes’ cognitive and somatic anxiety, with self-confidence providing a protective role. Working with a sports psychologist appeared to have no significant measurable effect on athletes precompetition anxiety. Specific personality traits and motivational structures are essential for elite sporting performance. Further research is needed to better understand and determine the specific components of mental preparation.

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Virtual Neuromuscular Training Among Physically Active Young Adults: A Feasibility Study

Samantha N. Magliato, Mathew J. Wingerson, Katherine L. Smulligan, Casey C. Little, Vipul Lugade, Julie C. Wilson, and David R. Howell

Context: Evidence indicates a 2 to 3 times increased risk of musculoskeletal injury after return to play from concussion. Undetected neuromuscular control deficits at return to play may relate to increased musculoskeletal injury risk. Rehabilitation to improve neuromuscular control may benefit patients with concussion, but access to rehabilitation professionals and/or poor adherence may limit efficacy. Our purpose was to determine the feasibility of an 8-week virtual neuromuscular training (NMT) program administered through a novel smartphone application among physically active, uninjured adults. Design: Feasibility trial. Methods: Participants were instructed to complete an NMT program administered via a smartphone application and returned for follow-up questionnaires 8 weeks later. They were instructed to complete 3 asynchronous self-guided workouts per week during the 8-week intervention period. Workouts included balance, plyometrics, strengthening, and dual-task exercises. The application provided instructions for each exercise using video, text, and audio descriptions. Our primary feasibility measure was participant adherence, calculated as the percentage of workouts completed out of the total possible 24 workouts. We recorded the average duration of each workout using start/stop/advance features within the application. Results: Twenty participants were enrolled, of which 15 (age = 26.3 [2.7] y, 67% female) returned for follow-up (75% retention). Participant adherence was 57.2% (25.0%; range: 16.7%–91.7%). Participants spent 17.3 (8.0) minutes per workout (range: 7.4–37.9 min). There were no adverse reactions or injuries. Most participants (60%) reported time availability as a primary barrier to intervention completion. Conclusions: Participants were moderately (>50%) adherent to a virtual NMT program, without any reported injuries. We identified several barriers to participation and pathways for improved adherence in the future. The virtual NMT program completed by uninjured adults provides evidence of its feasibility and future scalability to those with a recent concussion to address neuromuscular control deficits and reduce future injury risk.

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Volume 41 (2024): Issue 4 (Oct 2024)