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JoEllen M. Sefton and Kenneth A. Games

Colleges and universities increasingly face pressure to take the lead in solving complex problems. Developing and sustaining interdisciplinary research centers that collaborate with community partners can be an effective method of approaching complex challenges. We use the example of interdisciplinary research centers designed to specifically work with tactical athlete organizations (e.g., military, police, fire) as one example of how research centers can be developed and produce important outcomes. A 10-step process is outlined for finding partners, executing projects, and growing research centers which are mutually beneficial to the partner organization and the academic institution. With vision, commitment, and persistence, interdisciplinary research centers can solve complex problems and have meaningful impacts in the community.

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Matthew Rivera, Lindsey Eberman, Kenneth Games and Cameron J. Powden

Context: The pectoralis minor (PM) is an important postural muscle that may benefit from myofascial techniques, such as Graston Technique® (GT) and self-myofascial release (SMR). Objective: To examine the effects of GT and SMR on PM length, glenohumeral total arc of motion (TAM), and skin temperature. Design: Cohort. Setting: Laboratory. Participants: Twenty-six healthy participants (19 females and 7 males; age = 20.9 [2.24] y, height = 170.52 [8.66] cm, and weight = 72.45 [12.32] kg) with PM length restriction participated. Interventions: Participants were randomized to the intervention groups (GT = 12 and SMR = 14). GT and SMR interventions were both applied for a total of 5 minutes during each of the 3 treatment sessions. Main Outcome Measures: PM length, TAM, and skin temperature were collected before and after each intervention session (Pre1, Post1, Pre2, Post2, Pre3, and Post3) and at 1-week follow-up (follow-up). Separate intervention by time analyses of variance examined differences for each outcomes measure. Bonferroni post hoc analyses were completed when indicated. Significance was set a priori at P ≤ .05. Results: No significant intervention by time interactions were identified for PM length, TAM, or temperature (P > .05). No significant intervention main effects were identified for PM length (P > .05), TAM (P > .05), or temperature (P > .05) between the GT or SMR technique groups. Overall, time main effects were found for PM length (P = .02) and temperature (P < .001). Post hoc analysis showed a significant increase in PM length for both intervention groups at follow-up (P = .03) compared with Post2. Furthermore, there were significant increases in temperature at Post1 (P < .001), Post2 (P = .01), and Post3 (P < .001) compared with Pre1; Post2 was increased compared with Pre2 (P = .003), Pre3 (P < .001), and follow-up (P = .01); Post3 increased compared with Pre3 (P = .01) and follow-up (P = .01). Conclusion: Serial application of GT and SMR to the PM did not result in increases in PM length or TAM. Regardless of intervention, skin temperature increased following each intervention.

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Zachary K. Winkelmann, Ethan J. Roberts and Kenneth E. Games

Context: Hamstring inflexibility is typically treated using therapeutic massage, stretching, and soft tissue mobilization. An alternative intervention is deep oscillation therapy (DOT). Currently, there is a lack of evidence to support DOT’s effectiveness to improve flexibility. Objective: To explore the effectiveness of DOT to improve hamstring flexibility. Design: Randomized single-cohort design. Setting: Research laboratory. Participants: Twenty-nine healthy, physically active individuals (self-reported activity of a minimum 200 min/wk). Interventions: All participants received a single session of DOT with randomization of the participant’s leg for the intervention. The DOT intervention parameters included a 1∶1 mode and 70% to 80% dosage at various frequencies for 28 minutes. Hamstring flexibility was assessed using passive straight leg raise for hip flexion using a digital inclinometer. Patient-reported outcomes were evaluated using the Copenhagen Hip and Groin Outcome Score and the Global Rating of Change (GRoC). Main Outcome Measure: The independent variable was time (pre and post). The dependent variables included passive straight leg raise, the GRoC, and the participant’s perceptions of the intervention. Statistical analyses included a dependent t test and a Pearson correlation. Results: Participants reported no issues with sport, activities of daily living, or quality of life prior to beginning the intervention study on the Copenhagen Hip and Groin Outcome Score. Passive straight leg raise significantly improved post-DOT (95% confidence interval, 4.48°–7.85°, P < .001) with a mean difference of 6.17 ± 4.42° (pre-DOT = 75.43 ± 21.82° and post-DOT = 81.60 ± 23.17°). A significant moderate positive correlation was identified (r = .439, P = .02) among all participants between the GRoC and the mean change score of hamstring flexibility. Participants believed that the intervention improved their hamstring flexibility (5.41 ± 1.02 points) and was relaxing (6.21 ± 0.86). Conclusions: DOT is an effective intervention to increase hamstring flexibility.

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Zachary K. Winkelmann and Kenneth E. Games

An 18-year-old, male collegiate basketball athlete complained of right testicular pain following basketball activities. The patient’s imaging denoted edema within the pubis at the insertion of the adductor longus tendon and rectus sheath aponeurosis consistent with inguinal disruption. The patient underwent conservative rehabilitation and attempted to return to participation with increased pain. Subsequently, the patient underwent surgery. Following surgical intervention, the patient underwent 6 weeks of rehabilitation with basketball-specific considerations. On conclusion, the patient was pain free and returned to activity. This case is unique due to the insidious onset, sport in which the patient participated, and failed conservative management.

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Kelly A. Brock, Lindsey E. Eberman, Richard H. Laird IV, David J. Elmer and Kenneth E. Games

Context: Several interventions are available to reduce the intensity and duration of the unwanted effects (eg, muscle soreness) associated with physical activity, such as massage, compression garments, and sequential pulse compression (SPC). Such interventions aim to increase blood flow to alleviate symptoms. However, there is a lack of evidence to support the use of SPC to alter total hemoglobin concentration (THb) in active individuals. Objective: To examine the acute effects of a single session of SPC on hemoglobin concentration compared with a control condition. Design: Single cohort, crossover design. Participants: Thirty-four physically active and healthy participants (females = 12 and males = 22) completed the study. Interventions: The authors randomly assigned participants to first receive the experimental (SPC) or control condition. Measures were recorded precondition and postcondition. Participants returned to the laboratory to complete the second condition ≥24 hours after the first condition. Main Outcome Measures: Relative changes in THb, deoxygenated hemoglobin, and oxygenated hemoglobin measures were recorded using near-infrared spectroscopy placed on the muscle belly of the medial gastrocnemius of the dominant limb. Results: SPC significantly increased THb (P < .001, d = 0.505) and oxygenated hemoglobin (P < .001, d = 0.745) change scores compared with the control condition. No statistical difference in deoxygenated hemoglobin change scores was found between the SPC and control conditions, but a medium effect size suggests potential biological significance (P = .06, d = 0.339). Conclusions: Overall, SPC increases THb to the lower-extremity and may be a viable option in the management of muscle soreness related to physical activity.

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Jessica R. Edler, Kenneth E. Games, Lindsey E. Eberman and Leamor Kahanov

The tibial plateau is a critical load-bearing surface in humans. Although tibial plateau fractures represent only 1% of all fractures, proper management by all members of the health care team, including athletic trainers, physicians, and physical therapists, is required for successful patient outcomes. A 14-year-old national-level competitive female diver injured her right knee during the precompetition warm-up period. Upon evaluation by an athletic trainer, the patient was referred for imaging and examination by a physician. She was seen by an orthopedic surgeon for consultation. The patient elected for a surgical repair of the tibial plateau fracture. Following surgery she underwent an 11-week comprehensive therapeutic exercise program with athletic trainers and physical therapists. The patient’s return-to-play progression included dry land activities, platform diving, 1-m springboard diving, and 3-m springboard diving. The patient has successfully returned to competitive diving. Proper identification of tibial fractures can be difficult considering their low occurrence in youth and their similar clinical presentation to more common youth injuries such as anterior cruciate ligament ruptures. Clinicians providing immediate on-site medical care should be thorough in their clinical exam including palpation and axial loading of the joint.

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Robert Vallandingham, Zachary Winkelmann, Lindsey Eberman and Kenneth Games

The management of an acute lateral ankle sprain (LAS) affects long-term outcomes, which highlights the need for assessment of practice at the point of care. The purpose of this retrospective chart review was to examine the management strategies for acute LAS as documented in a secondary school’s electronic medical records (EMR) over 2 years. Patient charts noting a LAS diagnosis (n = 107) were identified from the EMR. Most charts indicated palpation and anterior drawer test performance. Cryotherapy (82%) and compression (55%) varied in use. Therapeutic rehabilitation and return-to-activity testing were underreported. Overall, clinical management of acute LAS may not align with best available evidence.

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Mikayla Grindle, Kenneth E. Games, Lindsey E. Eberman and Leamor Kahanov

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Kami N. Thews, Zachary K. Winkelmann, Lindsey E. Eberman, Kirsten A. Potts and Kenneth E. Games

Firefighters are exposed to psychological stress while on duty that could lead to mental and behavioral illnesses that may go unreported. We surveyed firefighters to identify their perceived barriers encountered when attempting to report a mental and behavioral illness with a follow-up question related to how difficult the selected barrier was in the reporting process. A total of 314 firefighters completed the instrument, with most indicating they experienced cultural barriers such as social norms from administration and peers. The findings demonstrate an overall demand for a cultural change within the fire service for a supportive environment that encourages reporting.