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Eric L. Sauers

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Eric L. Sauers

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Paul A. Borsa, Eric L. Sauers and Derald E. Herling

Arthrometric assessment for glenohumeral (GH) laxity is currently unprecedented in orthopedic practice. Clinical evaluation of GH laxity is based on manual tests that lack objectivity and reliability. We have developed an arthrometer that quantifies AP laxity relative to applied load. Forty healthy shoulders were assessed for AP laxity at 67-, 89-, 111-, and 134-N load levels. A factorial ANOVA revealed significant mean (± SD) differences between directions (p < .0001) and between loads (p < .001). Our results demonstrate the quantified relationship between applied directional loads and GH translation in vivo. We determined bilateral symmetry within subjects and demonstrated excellent reproducibility of the device. Frequency distributions for AP laxity revealed a bell-shaped curve, indicating a normal distribution. Anterior laxity was significantly greater then posterior laxity, and it demonstrated better compliance between the selected load levels.

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Eric L. Sauers and Rod A. Harter

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Paul A. Borsa, Eric L. Sauers and Scott M. Lephart

Functional training for the purpose of restoring dynamic joint stability has received considerable interest in recent years. Contemporary functional training programs are being designed to complement, rather than replace, traditional rehabilitation protocols. The purpose of this clinical commentary is to present a management strategy for restoring dynamic stability in the posterior cruciate ligament (PCL)-injured knee. The strategy presented integrates five key concepts: (a) planned variation of exercise, (b) outcomes-based assessment, (c) kinetic chain exercise, (d) proprioception and neuromuscular control, and (e) specificity of activity. Pertinent research findings and a clinical rationale are provided for using functional training in the restoration of dynamic stability in the PCL-injured knee.

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Eric L. Sauers, Danelle L. Dykstra, R. Curtis Bay, Kellie Huxel Bliven and Alison R. Snyder

Context:

Throwing-related arm injuries are common in softball pitchers and may lead to diminished health-related quality of life (HRQOL). Arm symptoms such as pain have been reported to be more common in healthy overhead athletes than nonoverhead athletes. Furthermore, more frequent shoulder symptoms and lower shoulder function have been demonstrated in athletes with self-reported history of shoulder injury.

Objective:

To evaluate the relationship between arm injury history, current pain rating, and HRQOL assessed via 2 region-specific patient self-report scales in high school and college softball pitchers.

Design:

Cross-sectional.

Setting:

High school and college athletic training facilities.

Participants:

25 female softball pitchers (10 high school, 15 college; 18 ± 2 y, 169 ± 7.6 cm, 67.5 ± 10.3 kg).

Intervention:

Self-reported arm injury history and rating of current pain and HRQOL were collected during the late season.

Main Outcome Measures:

A self-report questionnaire of arm injury history and current pain rating was used, and HRQOL was assessed via 2 region-specific scales: the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Functional Arm Scale for Throwers© (FAST©). Correlational analysis was used to evaluate the relationships between arm injury history, current pain rating, and the DASH total score and sport module and the FAST total score, pitching module, and subscales.

Results:

A history of arm injury from throwing was reported by 64% of participants, 31% of whom had to cease activity for more than 10 d. The most common site of arm time-loss injury was the shoulder (81%). Mild to severe shoulder pain during the competitive season was reported by 60% of respondents. The DASH and the FAST total scores were significantly correlated (r = .79, P < .001). Respondent rating of shoulder pain correlated significantly with the DASH total (r = .69) and sports module (r = .69) and the FAST total (r = .71), pitching module (r = .65), and pain (r = .73), impairment (r = .76), functional-limitation (r = .79), disability (r = .52), and societal-limitations (r = .46) subscales.

Conclusion:

History of arm injury is common in female high school and college softball pitchers. Severe injury and elevated pain are associated with lower HRQOL that extends beyond the playing field.

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Alison R. Snyder, Jessica C. Martinez, R. Curtis Bay, John T. Parsons, Eric L. Sauers and Tamara C. Valovich McLeod

Context:

Patient-oriented outcome measures such as the Medical Outcomes Short Form (SF-36) and the Pediatric Outcomes Data Collection Instrument (PODCI) are important tools for determining the impact of events like sport-related injury on health-related quality of life (HRQoL). Unfortunately, there are no published studies using these instruments that compare adolescent athletes with their nonathlete peers, making interpretations of these measures in this population difficult.

Objective:

To compare HRQoL in adolescent athletes and nonathletes using 2 common instruments.

Design:

Cross-sectional.

Setting:

7 high schools.

Participants:

219 athletes and 106 nonathletes.

Intervention:

None.

Main Outcome Measures:

The SF-36 and the PODCI were completed in a counterbalanced manner during 1 session. Dependent variables included the 8 subscale and 2 composite scores of the SF-36 and the 5 subscale scores and 1 global score of the PODCI.

Results:

On the SF-36, athletes reported higher scores on the physical function, general health, social functioning, and mental health subscales and the mental composite score and lower scores on the bodily pain subscale than nonathletes. On the PODCI, athletes reported higher scores on the sport and physical function and happiness subscales and lower scores on the pain/comfort subscale.

Conclusions:

Athletes reported higher scores on a number of SF-36 and PODCI subscales related to mental, emotional, and physical well-being than nonathletes. Our findings suggest that athletic involvement may be a benefit to the overall health status of adolescents and imply that athletes may be a distinct adolescent group requiring their own normative values when using the SF-36 and PODCI.