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Graig M. Chow, Matthew D. Bird, Stinne Soendergaard and Yanyun Yang

This manuscript seeks to offer insight about how coaches can better address drinking among collegiate student-athletes. Using a mixed-methods design, 519 NCAA coaches reported their attitudes and behaviors toward student-athlete drinking, and responded to open-ended questions about their perceived role, strategies, and challenges to addressing problems in this population. Three dimensions of coaches’ attitudes and behaviors toward student-athlete drinking emerged that were consistent regardless of the players’ or coach’s gender or division: Concerned Communication, Conditional Leniency, and Enforcement. Effective strategies identified by coaches included enforcement of policy, education about consequences of drinking, establishment of quality coach-athlete relationships, and management of athletes’ schedules. Coaches indicated the need to play a role in managing, educating, influencing, and supporting the student-athletes to prevent alcohol misuse. Coaches reported challenges regarding the culture of drinking on college campuses, individual differences (e.g., age) among student-athletes, acceptance and enforcement of the alcohol policy, lack of awareness about student-athletes’ activities, and identification of alcohol misuse.

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Rob Duffield, Alistair Murphy, Aaron Kellett and Machar Reid

Purpose:

To investigate the effects of combining cold-water immersion (CWI), full-body compression garments (CG), and sleep-hygiene recommendations on physical, physiological, and perceptual recovery after 2-a-day on-court training and match-play sessions.

Methods:

In a crossover design, 8 highly trained tennis players completed 2 sessions of on-court tennis-drill training and match play, followed by a recovery or control condition. Recovery interventions included a mixture of 15 min CWI, 3 h of wearing full-body CG, and following sleep-hygiene recommendations that night, while the control condition involved postsession stretching and no regulation of sleeping patterns. Technical performance (stroke and error rates), physical performance (accelerometry, countermovement jump [CMJ]), physiological (heart rate, blood lactate), and perceptual (mood, exertion, and soreness) measures were recorded from each on-court session, along with sleep quantity each night.

Results:

While stroke and error rates did not differ in the drill session (P > .05, d < 0.20), large effects were evident for increased time in play and stroke rate in match play after the recovery interventions (P > .05, d > 0.90). Although accelerometry values did not differ between conditions (P > .05, d < 0.20), CMJ tended to be improved before match play with recovery (P > .05, d = 0.90). Furthermore, CWI and CG resulted in faster postsession reductions in heart rate and lactate and reduced perceived soreness (P > .05, d > 1.00). In addition, sleep-hygiene recommendations increased sleep quantity (P > .05, d > 2.00) and maintained lower perceived soreness and fatigue (P < .05, d > 2.00).

Conclusions:

Mixed-method recovery interventions (CWI and CG) used after tennis sessions increased ensuing time in play and lower-body power and reduced perceived soreness. Furthermore, sleep-hygiene recommendations helped reduce perceived soreness.

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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

Context: The use of active video games (AVG) as a treatment modality in the rehabilitation context is increasing. However, little is known about the functional outcomes and psychological benefits of such rehabilitation in college athletes with lateral ankle sprains (LASs). Objective: To examine functional outcomes and psychological benefits of AVG-aided rehabilitation program for LAS. Design: A mixed-methods, single-subject case series design. Setting: College athletic training clinic. Patients: Two female college soccer players who sustained LAS (grades I and II) during sport participation. Intervention: A 4-week balance training program. One patient completed balance exercises using AVG, whereas the other patient completed traditional balance exercises. Main Outcome Measures: Several validated instruments were used to evaluate different functional outcomes and psychological factors: balance (Balance Error Scoring System, Star Excursion Balance Test), rehabilitation adherence (Rehabilitation Adherence Measure for Athletic Training), foot and ankle function (Foot and Ankle Ability Measure), perceptions of pain (Visual Analog Scale for pain), perceived readiness to return to sport (Injury-Psychological Readiness to Return to Sport Scale), and mood (Brunel Mood Scale). Results: It appears that the balance training protocols (AVG and traditional balance exercises) were equally effective in restoring patient’s balance to functional levels. Despite very individualistic processes of rehabilitation, the participants’ perceived pain, perceived readiness to return to sport, and mood states were closely linked with objective and subjective functional measures of progress. Conclusions: Based on the results, AVG has the potential to provide more versatility into the static and dynamic postural control exercises typically used following acute LAS. Moreover, the current results support the existing psychological and biopsychosocial theoretical conceptualizations of athletes’ responses to injuries and rehabilitation process.

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Robert C. Hilliard, Lindsey Blom, Dorice Hankemeier and Jocelyn Bolin

Context:

Athletic identity has been associated with rehabilitation overadherence in college athletes.

Objectives:

To explore which constructs of athletic identity predict rehabilitation overadherence, gauge athletes’ views of the most salient aspect of their athletic participation, and understand their perceptions of the reasons they adhere to their rehabilitation program.

Design:

Cross-sectional, mixed methods.

Setting:

University athletic training clinics and online.

Participants:

Currently injured college athletes (N = 80; 51 male, 29 female).

Main Outcome Measures:

Athletic Identity Measurement Scale (AIMS), Rehabilitation Overadherence Questionnaire (ROAQ), and 2 open-ended questions about athletic participation and rehabilitation adherence.

Results:

Higher levels of athletic identity were associated with higher levels of rehabilitation overadherence (r = .29, P = .009). Hierarchical multiple regression used on AIMS subscales to predict ROAQ subscales did not reveal a significant model for the subscale “ignore practitioner recommendations.” However, a significant model was revealed for the subscale “attempt an expedited rehabilitation,” F 5,73 = 2.56, P = .04, R 2 = .15. Negative affectivity was the only significant contribution to the equation (β = 0.33, t = 2.64, P = .01). Content analysis revealed that bodily benefits, sport participation, personal achievement, social relationships, and athlete status were perceived to be the most important aspects of being an athlete. The themes of returning to competition, general health, and relationship beliefs were identified as the major factors for adhering to a rehabilitation program.

Conclusions:

Negative affectivity accounted for a significant but low amount of variance for rehabilitation overadherence, suggesting that athletic trainers should pay attention to personal variables such as athletic identity that might influence the rehabilitation process. Using the knowledge of why athletes adhere to their rehabilitation and what is most important to them about being an athlete, athletic trainers can use appropriate interventions to facilitate proper rehabilitation adherence.

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Megan D. Granquist, Leslie Podlog, Joanna R. Engel and Aubrey Newland

Context:

Adherence to sport-injury rehabilitation protocols may be pivotal in ensuring successful rehabilitation and return-to-play outcomes.

Objectives:

To investigate athletic trainers' perspectives related to the degree to which rehabilitation adherence is an issue in collegiate athletic training settings, gain insight from certified athletic trainers regarding the factors contributing to rehabilitation nonadherence (underadherence and overadherence), and ascertain views on the most effective means for promoting adherence.

Design:

Crosssectional, mixed methods.

Setting:

Collegiate athletic training in the United States.

Participants:

Certified athletic trainers (n = 479; 234 male, 245 female).

Main Outcome Measures:

Online survey consisting of 3 questions regarding rehabilitation adherence, each followed by an open-ended comments section. Descriptive statistics were calculated for quantitative items; hierarchical content analyses were conducted for qualitative items.

Results:

Most (98.3%) participants reported poor rehabilitation adherence to be a problem (1.7% = no problem, 29.2% = minor problem, 49.7% = problem, 19.4% = major problem), while most (98.96%) participants reported that they had athletes who exhibited poor rehabilitation adherence (1% = never, 71.4% = occasionally, 22.5% = often, 5% = always). In addition, the majority (97.91%) of participants reported that overadherence (eg, doing too much, failing to comply with activity restrictions, etc) was at least an occasional occurrence (2.1% = never, 69.3% = occasionally, 26.3% = often, 1.9% = always). Hierarchical content analyses regarding the constructs of poor adherence and overadherence revealed 4 major themes: the motivation to adhere, the development of good athletic trainer–athlete rapport and effective communication, athletic trainers' perception of the coaches' role in fostering adherence, and the influence of injury- or individual- (eg, injury severity, sport type, gender) specific characteristics on rehabilitation adherence.

Conclusions:

These results suggest that participants believe that underadherence (and to a lesser extent overadherence) is a frequent occurrence in collegiate athletic training settings. Strategies for enhancing rehabilitation adherence rates and preventing overadherence may therefore be important for optimizing rehabilitation outcomes.

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Josephine Blagrave and Taylor Guy

the research process. Part 3, “Practical Issues,” explains and contrasts methodological approaches including qualitative, quantitative, and mixed methods approaches. Chapter 9 discusses qualitative and quantitative research methods and helps the reader identify the most appropriate method for the

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Justine J. Reel

, methods, results, and discussion. All methodologies are welcomed (e.g., quantitative, qualitative, and mixed methods). To ensure ethical research protocol is followed, prior institutional review board approval is expected. Authors are strongly encouraged to include a clinical implications section in a

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Lori A. Gano-Overway

research, theoretical papers, reviews, practical articles, and commentaries from a diversity of disciplinary perspectives using varied methodologies. I would like to continue to encourage these submissions; however, I would certainly welcome work that is interdisciplinary or uses mixed method approaches

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Diane M. Ste-Marie

giving away the findings (we do want you to continue reading, of course!), the first article by Edward Hebert incorporates an experimental paradigm that combines the factors associated with when and why observation is effective. Hebert used a mixed-method approach to examine the influence of the temporal

Open access

Ricky Camplain, Julie A. Baldwin, Meghan Warren, Carolyn Camplain, Monica R. Lininger and Robert T. Trotter

in jail populations: protocol for a mixed-methods study . JMIR Res Protoc . 2018 ; 7 ( 10 ): 10337 . 10.2196/10337 5. Stephan J , Walsh G . Census of Jail Facilities, 2006 . Washington, DC : US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics ; 2011 . 6. Bai