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Carol Biddington, Mary Popovich, Noel Kupczyk and Joni Roh


Certified athletic trainers (ATCs) must be able to manage sport-related emergencies.


To report emergency medical services (EMS) directors’ perception of how ATCs manage emergencies and ATCs’ comfort level in managing them.


2 descriptive questionnaires.


EMS directors (n = 64) were asked about their perceptions of ATCs’ ability to handle emergencies. ATCs (n = 224) identified their comfort level with handling emergencies.


EMS directors who had preseason meetings with ATCs had a significantly better perception of the ATCs’ ability to handle emergencies than did those who did not have preseason meetings. ATCs with advanced certifications (emergency medical technician-basic, emergency medical technician-paramedic, and automated external defibrillator) were more comfortable handling emergencies than those without.


EMS directors and ATCs revealed that ATCs could manage most emergencies that might arise in athletic activities. ATCs had a higher perception of their own ability to manage emergency situations than did the EMS directors.

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Richard J. Boergers, Thomas G. Bowman, Nicole Sgherza, Marguerite Montjoy, Melanie Lu and Christopher W. O’Brien

Key Points ▸ Lack of personnel and training are barriers for prehospital equipment removal. ▸ Athletic trainers do not frequently practice equipment removal with emergency medical services (EMS). ▸ Athletic trainers do not have confidence in EMS equipment removal skills. One of the primary roles of

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Ui-Jae Hwang, Sung-Hoon Jung, Hyun-A Kim, Jun-Hee Kim and Oh-Yun Kwon

Electrical muscle stimulation (EMS) uses a variety of electrical wave forms to artificially stimulate or superimpose training innervated muscles. EMS has been applied for muscle strengthening, facilitation of muscle contraction and motor control, and maintenance of muscle size and strength during

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Tibor Hortobágyi, Kevin Scott, Jean Lambert, George Hamilton and James Tracy

Cross-education enhances the performance of muscles not directly involved in the chronic conditioning of the muscles in a remote limb. Substantial cross-education occurs after training with eccentric contractions or with contractions evoked by electromyostimulation (EMS). Since during EMS and eccentric contractions, skin and muscle afferents are activated that have excitatory effects on contralateral homologous muscles, it was hypothesized that exercise training with stimulated vs. voluntary eccentric contractions would lead to greater cross-education. Thirty-two women were randomly assigned to a voluntary (Vol), an EMS, or a remote EMS (rEMS) exercise group and performed 840 voluntary or stimulated eccentric contractions over 6 weeks. All subjects, including nonexercising controls (Con), were tested pre- and posttraining for maximal voluntary and stimulated isometric and eccentric quadriceps strength. Ipsilateral voluntary and stimulated forces increased in all groups. Changes in EMG activity paralleled those in voluntary force in each limb. No changes occurred in grip strength. The greater contra- and ipsilateral strength gains after EMS training were most likely related to an additive effect of EMS and muscle lengthening.

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Brian V. Gallagher and Frank L. Gardner

The present study examined the relationship between cognitive vulnerabilities, coping strategy, and emotional response to athletic injury among 40 NCAA Division I injured athletes. It was hypothesized that the presence of early maladaptive schemas (EMS) and avoidant coping strategies would predict greater emotional distress among injured athletes. Early maladaptive schemas were assessed by the Young Schema Questionnaire-Short Form, which injured athletes completed upon injury. Coping strategies were measured by the Coping Response Inventory Adult Form, which was completed upon the completion of recovery. The Profile of Mood States was used to assess mood, and was completed during three phases of injury: upon injury, middle of rehabilitation, and upon recovery. As predicted, hierarchical multiple regression analysis demonstrate that EMSs and avoidance-focused coping were associated with higher levels of negative mood among injured athletes. The results also indicate that the relationship between EMS and mood vary based on the phase of injury, suggesting that different EMSs are differentially related to subtle differences in stressors encountered during each phase of the injury process.

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Aimee L. Thornton, Cailee W. McCarty and Mollie-Jean Burgess

Clinical Scenario:

Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM).3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear.

Focused Clinical Question:

Is low-level laser therapy combined with an exercise program more effective than an exercise program alone in the treatment of adults with shoulder pain?

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Christos K. Argus, Matthew W. Driller, Tammie R. Ebert, David T. Martin and Shona L. Halson


To evaluate the effectiveness of different recovery strategies on repeat cycling performance where a short duration between exercise bouts is required.


Eleven highly trained cyclists (mean ± SD; age = 31 ± 6 y, mass = 74.6 ± 10.6 kg, height = 180.5 ± 8.1 cm) completed 4 trials each consisting of three 30-s maximal sprints (S1, S2, S3) on a cycle ergometer, separated by 20-min recovery periods. In a counterbalanced, crossover design, each trial involved subjects performing 1 of 4 recovery strategies: compression garments (COMP), electronic muscle stimulation (EMS), humidification therapy (HUM), and a passive control (CON). The sprint tests implemented a 60-s preload (at an intensity of 4.5 W/kg) before a 30-s maximal sprint. Mean power outputs (W) for the 3 sprints, in combination with perceived recovery and blood lactate concentration, were used to examine the effect of each recovery strategy.


In CON, S2 and S3 were (mean ± SD) –2.1% ± 3.9% and –3.1% ± 4.2% lower than S1, respectively. Compared with CON, COMP resulted in a higher mean power output from S1 to S2 (mean ± 90%CL: 0.8% ± 1.2%; possibly beneficial) and from S1 to S3 (1.2% ± 1.9%; possibly beneficial), while HUM showed a higher mean power output from S1 to S3 (2.2% ± 2.5%; likely beneficial) relative to CON.


The authors suggest that both COMP and HUM may be effective strategies to enhance recovery between repeated sprint-cycling bouts separated by ~30 min.

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Riana R. Pryor, Douglas J. Casa, Susan W. Yeargin and Zachary Y. Kerr

% Schools With More Than One Paid AT % p Value Emergency policy  Had an emergency action plan 85.5 (956/1,118) 83.9 (381/454) 86.6 (575/664) .212  Had policy with instructions to initiate EMS response 89.1 (1,000/1,122) 86.8 (396/456) 90.7 (604/666) .042 Equipment available  Filled immersion tub with ice

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Chung-Chao Liang, Qi-Xing Change, Yu-Chou Hung, Chizan-Chung Chen, Chun-Hsiang Lin, Yu-Chun Wei and Jia-Ching Chen

, height, weight, and education, were also recorded. The physical performance and balance measures were evaluated as follows. Elderly Mobility Scale The Elderly Mobility Scale (EMS), applied in the physical function test, comprises seven items: lying down to sitting, sitting to lying down, sitting to

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Kyoung-yim Kim and Heejoon Chung

experts and technology. Such overreliance excludes locally based ecological knowledge and inhibits widespread understanding and support for environmental policies. Wilson and Millington ( 2013 ) also question EM’s emphasis on science and engineering in solving ecological challenges, because it often