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Matthew Burwell, Justin DiSanti, and Tamara C. Valovich McLeod

Clinical Scenario: Youth athletes may specialize in a sport of their choosing, or based on external pressures, to pursue elite status in that sport. Current evidence shows an association between highly specialized athletes and an increase in injuries as well as a connection between injury and lower health-related quality of life (HRQOL). Clinical Question: In college athletes, do early sport specialization characteristics (ie, age at specialization and degree of specialization) impact current HRQOL? Summary of Key Findings: The literature was searched for studies that investigated the age of specialization (early vs late) or degree of specialization (high, moderate, and low) and the impact on HRQOL. (1) The search returned 6 possible studies related to the clinical question. Three of the studies met the inclusion criteria and were used for this appraisal. (2) Two of the 3 included studies reported that highly specialized athletes noted lower HRQOL. (3) One study found there to be no significant difference in HRQOL between athletes who specialized early versus late but did find those who specialized early to have a greater incidence of injuries that required surgery. Clinical Bottom Line: There is moderate evidence that early sport specialization is associated with lower HRQOL compared with late sport specialization. It is important to educate athletes, parents, and coaches on the potential detriments that are associated with early sport specialization to allow stakeholders to make informed decisions regarding participation. Strength of Recommendation : Grade B evidence exists to support the idea that early, intensive sport specialization may be associated with decreased HRQOL in current college athletes.

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Jennifer M. Medina McKeon and Patrick O. McKeon

more favorable than studies with more risk of bias. 2 Ultimately, from the SOR perspective, evidence that is generated from patient-oriented outcomes, and has little risk of bias, is ranked higher. Finally, there are elements of quantity and consistency that have to be incorporated into the SOR

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Patrick O. McKeon and Jennifer M. Medina McKeon

clinical practice is to make appropriate decisions regarding patient care, leading to improvement in patient outcomes. Patient-oriented outcomes include injury risk reduction, safe return to play, enhanced health-related quality-of-life, and the freedom to participate in meaningful life situations and

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Cameron J. Powden, Rachel M. Koldenhoven, Janet E. Simon, John J. Fraser, Adam B. Rosen, Abbis Jaffri, Andrew B. Mitchell, and Christopher J. Burcal

addition, this investigation only focused on patient-oriented outcomes. The inclusion of disease-oriented outcomes would enhance the understanding of patients with CAI response to intervention and the relationship between patient- and disease-oriented impairments. To enhance and build upon our responder

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Devin S. Kielur and Cameron J. Powden

similar outcomes to establish consistency as well as patient-oriented outcomes for short-term or long-term success. Conclusions This synthesis and meta-analysis suggest that CTF has no effect on DFROM when compared with control groups of ROM activities. Moderate DFROM improvements were identified with pre

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Matthew Booth, Jacob Powell, Patrick O. McKeon, and Jennifer M. Medina McKeon

VRT related to patient-oriented outcomes of self-reported dizziness and balance improvements as well as return-to-sport participation. The selected outcomes of interest extracted, when available, were: 1. Dizziness, as measured by the Dizziness Handicap Inventory (DHI) (25 items, 4 points each, 100

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Adam B. Rosen, Abbis Jaffri, Andrew Mitchell, Rachel M. Koldenhoven, Cameron J. Powden, John J. Fraser, Janet E. Simon, Matthew Hoch, and Christopher J. Burcal

-week multimodal intervention for individuals with chronic ankle instability: examination of disease-oriented and patient-oriented outcomes . J Athl Train . 2019 ; 54 ( 4 ): 384 – 396 . PubMed ID: 30589387 doi:10.4085/1062-6050-344-17 10.4085/1062-6050-344-17 28. Powden CJ , Hogan KK , Wikstrom