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Jeffrey A. Woods, Russell R. Pate and Maria L. Burgess

Field tests of upper body muscular strength and endurance (UBMSE) are often administered to children, but little is known about the determinants of performance on these tests. Therefore the purpose of this investigation was to examine potential determinants of performance on several common field tests of UBMSE including pull-ups, flexed-arm hang, push-ups, and two types of modified pull-ups. Subjects were 56 girls and 38 boys, ages 9 to 11 years. Potential determinants assessed were age, height, weight, gender, % fat, physical activity, and laboratory measures of muscular strength and endurance. Multiple regression analysis revealed that the laboratory measures of UBMSE failed to account for significant fractions of variance in performance on four of the five tests. However, % fat was significantly associated with performance on four of five tests. These results indicate that factors other than muscular strength and endurance account for most of the variance in performance, and that % fat appears to be a particularly important determinant of performance.

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Shannon David, Kim Gray, Jeffrey A. Russell and Chad Starkey

The original and modified Ottawa Ankle Rules (OARs) were developed as clinical decision rules for use in emergency departments. However, the OARs have not been evaluated as an acute clinical evaluation tool.

Objective:

To evaluate the measures of diagnostic accuracy of the OARs in the acute setting.

Methods:

The OARs were applied to all appropriate ankle injuries at 2 colleges (athletics and club sports) and 21 high schools. The outcomes of OARs, diagnosis, and decision for referral were collected by the athletic trainers (ATs) at each of the locations. Contingency tables were created for evaluations completed within 1 h for which radiographs were obtained. From these data the sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values were calculated.

Results:

The OARs met the criteria for radiographs in 100 of the 124 cases, of which 38 were actually referred for imaging. Based on radiographic findings in an acute setting, the OARs (n = 38) had a high sensitivity (.88) and are good predictors to rule out the presence of a fracture. Low specificity (0.00) results led to a high number of false positives and low positive predictive values (.18).

Conclusion:

When applied during the first hour after injury the OARs significantly overestimate the need for radiographs. However, a negative finding rules out the need to obtain radiographs. It appears the AT’s decision making based on the totality of the examination findings is the best filter in determining referral for radiographs.