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Kelly L. Holzberger, Kim Keeley and Martin Donahue

management of athletic patients suspected of having this condition. A clear example of the appropriate recognition, referral, diagnosis, treatment, and return to play of an athlete with SVT serves to provide athletic trainers with the knowledge they need to function as part of the interprofessional

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Stephanie Di Lemme, Jon Sanderson, Richard G. Celebrini and Geoffrey C. Dover

Key Points ▸ Talus fractures are rare and nonoperative treatment is uncommon. ▸ A clinically-accessible nonoperative rehabilitation plan for a talus fracture is presented. ▸ Blood flow restriction (BFR) may have contributed to quicker return-to-play for this elite hockey player. ▸ More evidence

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Vincenzo Ricci and Levent Özçakar

improvement in the thoracic spine range of motions, with a complete return to play 3 months after the injury. No setbacks or complications were encountered during the rehabilitation process. Discussion Interscapular pain is a common problem in clinical practice with multiple etiologies including discogenic

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Sergio Jiménez-Rubio, Archit Navandar, Jesús Rivilla-García and Victor Paredes-Hernández

forcing an early return to play. 25 This implies that although the previously mentioned protocols, programs, and exercises have shown to be effective with the general athletic population, there appears to be a need for a soccer-specific rehabilitation program. Such a program must have loads and movement

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Rachel S. Johnson, Mia K. Provenzano, Larynn M. Shumaker, Tamara C. Valovich McLeod and Cailee E. Welch Bacon

Clinical Scenario:

It is hypothesized that cognitive activity following a concussion may potentially hinder patient recovery. While the recommendation of cognitive rest is often maintained and rationalized, a causal relationship between cognitive activity and symptom duration has yet to be established.

Clinical Question:

Does the implementation of cognitive rest as part of the postconcussion management plan reduce the number of days until the concussed adolescent patient is symptom free compared to a postconcussion management plan that does not incorporate cognitive rest?

Summary of Key Findings:

A thorough literature search returned 7 possible studies; 5 studies met the inclusion criteria and were included. Three studies indicated that increased cognitive activity is associated with longer recovery from a concussion, and, therefore, supported the use of cognitive rest. One study indicated that the recommendation for cognitive rest was not significantly associated with time to concussion symptom resolution. One study indicated that strict rest, defined as 5 days of no school, work, or physical activity; might prolong symptom duration.

Clinical Bottom Line:

There is moderate evidence to support the prescription of moderate cognitive rest for concussed patients. Clinicians who intend on implementing cognitive rest in their concussion protocols should be aware of inconsistencies and be open-minded to alternative treatment progressions while taking into consideration each individual patient and maintaining adequate patient-centered care principles.

Strength of Recommendation:

Grade B evidence exists that prescription of moderate cognitive rest for concussed patients may be beneficial as a supplement to physical rest as treatment for symptom reduction in adolescents.

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Caroline Westwood, Carolyn Killelea, Mallory Faherty and Timothy Sell

Context: Concussions are consequence of sports participation. Recent reports indicate there is an increased risk of lower-extremity musculoskeletal injury when returning to sport after concussion suggesting that achieving “normal” balance may not fully indicate the athlete is ready for competition. The increased risk of injury may indicate the need to refine a screening tool for clearance. Objective: Assess the between-session reliability and the effects of adding a cognitive task to static and dynamic postural stability testing in a healthy population. Setting: Clinical laboratory. Participants: Twelve healthy subjects (6 women; age 22.3 [2.9] y, height 174.4 [7.5] cm, weight 70.1 [12.7] kg) participated in this study. Design: Subjects underwent static and dynamic postural stability testing with and without the addition of a cognitive task (Stroop test). Test battery was repeated 10 days later. Dynamic postural stability testing consisted of a forward jump over a hurdle with a 1-legged landing. A stability index was calculated. Static postural stability was also assessed with and without the cognitive task during single-leg balance. Variability of each ground reaction force component was averaged. Main Outcome Measures: Interclass correlation coefficients (ICC2,1) were computed to determine the reliability. Standard error of measure, mean standard error, mean detectable change, and 95% confidence interval were all calculated. Results: Mean differences between sessions were low, with the majority of variables having moderate to excellent reliability (static .583–.877, dynamic .581–.939). The addition of the dual task did not have any significant effect on reliability of the task; however, generally, the ICC values improved (eyes open .583–.770, dual task .741–.808). Conclusions: The addition of a cognitive load to postural stability assessments had moderate to excellent reliability in a healthy population. These results provide initial evidence on the feasibility of dual-task postural stability testing when examining risk of lower-extremity musculoskeletal injury following return to sport in a concussed population.

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Taylor K. Wise

). Return-to-play should be determined by the medical factors associated with the athlete’s condition and the acceptable level of risk (individual to each athlete) that would accompany participating in their specific sport ( Creighton, Shrier, Shultz, Meeuwisse, & Matheson, 2010 ). Eating disorder policies

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Sergio Jiménez-Rubio, Archit Navandar, Jesús Rivilla-García, Víctor Paredes-Hernández and Miguel-Ángel Gómez-Ruano

high-velocity profiles mentioned previously, along with the peak and average velocities of the soccer players, could indicate the load on the hamstring muscle complex. A comparison of these parameters before and after an injury could be used to determine the success of the return-to-play (RTP) process

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Sinéad O’Keeffe, Niamh Ní Chéilleachair and Siobhán O’Connor

injury assessment, the injured participant completed the AFAQ, 19 which will be termed the AFAQ1 for the purpose of clarity in this study. Those who sustained a time-loss injury completed the AFAQ a second time immediately before their first training or match when returning to play, termed the AFAQ2

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Jessica E. Digiacomo, Riann M. Palmieri-Smith, John A. Redman III and Lindsey K. Lepley

Review Board. Table 1 Participant Demographics (Mean ± SD) Group N Age (y) Weight (kg) Height (m) Graft type Preinjury IKDC Preinjury Tegner Return to play IKDC Return to play Tegner Primary ACL surgery to return to play (mo) Return to play to reinjury (mo) Return to play without reinjury (mo, as of