• Senior Athletic Training Students’ Perceptions and Self-Reported Behaviors of Evidence-Based Practice

      Schneider, Gregory P. (2011-03-17)
      Title: Senior Athletic Training Student‟s Perceptions and Self-Reported Behaviors of Evidence-Based Practice Context: Entry-level athletic training education is currently transitioning to include evidence-based practice (EBP) into their curriculums to continue to establish athletic training as a prestigious allied health profession. Objective: To determine senior athletic training student (SATS) perceptions of EBP and examine the self-reported behaviors of EBP to gain insight into the instructional methods currently used to educate athletic training students in EBP as the method of delivering care to patients. Design: Grounded theory study Setting: Commission on Accreditation of Athletic Training Education accredited undergraduate athletic training programs. Participants: Thirteen senior athletic training students [11=female, 2=male, currently completing their last semester/quarter of their athletic training education program (ATEP)] were interviewed to discover their perceptions, self-reported behaviors of EBP. Data Collection and Analysis: SATS perceptions and self-reported behaviors of EBP were discovered and explored qualitatively using grounded theory methodology. Constant comparison and coding allowed theories to be developed. Peer debriefing and multiple analyst triangulation evaluated the emerging theories to establish trustworthiness. Results: The analysis revealed that SATS have a positive perception of utilizing research to guide or supplement their clinical practices. The emerging theories demonstrated that the SATS have knowledge of how to use EBP when providing care to their patients. The perceived instructional methods focused on acquiring medical literature, with slight emphasis on appraising and applying it into clinical practice. Some ATEP assignments required SATS to acquire and appraise medical literature, which in turn some of the SATS were able to use in their clinical practices. SATS also expressed acquiring medical literature on their own to address a problem in their clinical practices, but the SATS did not appraise the found medical literature nor discuss it with their patients. The SATS did express confidence in their ability to communicate to their patients and establish trust by educating their patients. Conclusions: The SATS interviewed attained a scholastic knowledge of EBP. Other medical professions re-structured their curricula to have students use EBP. The changes in athletic training curriculum have allowed athletic training students to continue the incorporation of EBP. The instructional methods, described by the SATS, used to teach EBP do not appear to be as structured as other medical professions. Through the continued integration of EBP education into all levels of athletic training education, the profession can continue to enhance itself as a prestigious allied health profession.
    • The Effect of External Ankle Support on Football Specific Performance Tests and the Perception of the Athletes that Wear Them

      Cutts, Matthew (2013-09-04)
      Context: Researchers and manufacturers have been looking for the optimal method to safely and adequately support the ankle joint without hindering performance. A plethora of information on sport specific performance utilizing taping and/or bracing methods exists. However, no study has compared actual performance to the athletes’ perception of their performance wearing various ankle support. Objective: The purpose of this study was to examine the effect of ankle braces and taping on football performance tests and the participants’ perception of the affect the ankle support had on their performance. Design: Mixed methods crossover design with 3 conditions unsupported (U), a taped (T) using a modified basket weave, and two separate braced conditions; a traditional figure eight lace up with Velcro stirrups manufactured by McDavid (B1) and a hinged ankle brace manufactured by UltraAnkle Zoom (B2). Setting: Outdoor artificial turf surface Participants: Three collegiate football players (age = 21+/- 2 yrs, with 3.5 +/-1.5 yrs of college experience) voluntarily participated in this study. Main Outcome Measures: Vertical jump, broad jump, 5-10-5 agility test, 3-cone test, and the 40- yard dash. Because we were unable to achieve a large sample size, interviews were performed to gather descriptive data regarding the three conditions. Results: No trends were seen in data relative to the condition. Qualitative results indicated that participants felt most comfortable in condition they had used previously, but preferred the unsupported condition. Results: Vertical jump (U=24.01±4.31, T=22.91±4.87, B1=23.88±4.17, B2=23.73±4.11), broad jump (U=93.68±10.91, T=96.42±11.52, B1=94.55±12.96, B2=95.84±10.95), the 5-10-5 agility test (U=4.71±0.23, T=4.69±0.22, B1=4.76±0.29, B2=4.79±0.22), the 3-cone test (U=7.67±0.40, T=7.74±0.48, B1=7.75±0.54, B2=7.83±0.55), and the 40-yard dash (U=5.27±0.24, T=5.35±0.27, B1=5.41±0.28, B2=5.46±0.26). Conclusions: Due to the small sample size, we were unable to draw objective conclusions regarding the effect of the conditions on performance, however participants in this investigation preferred the unsupported condition for the testing.
    • The Effect of Instrument Type on the Measure of Hydration Status

      Niemann, Andrew (2012-10-18)
      Context: Although some instruments have been validated for clinical measure of hydration status, new and currently invalid instruments are available for purchase and clinical use. Athletic trainers commonly use these instruments to assess hydration status for weight checks and body mass loss charts due to their ease of use. However, the validity of these popular instruments has not yet been established. Objective: To determine the validity of urine specific gravity (USG) for the assessment of hydration status via the following instruments: handheld clinical refractometer, pen style digital refractometer, and midget urinometer as compared to the gold standard urine osmometer (OSMO). Design: Descriptive diagnostic validity study. Setting: Biochemical research laboratory. Patients or Other Participants: Healthy active men and women (n=108; mean age=22±4yrs; self reported height=174±20cm and mass=75±17kg) were recruited among faculty and students on a university campus. Interventions: The independent variable was instrument type with four levels: osmometer, handheld clinical refractometer, pen style digital refractometer, and midget urinometer. After recruitment, participants completed an informed consent and a short health history questionnaire to rule out any exclusionary criteria such as kidney disease or chronic urinary tract infection. Participants were then given a clean standard urine cup and asked to provide as much sample as possible, providing more than one cup when possible. Main Outcome Measures: Hydration status was measured by USG and OSM. USG was evaluated by a handheld clinical refractometer, pen style digital refractometer, and midget urinometer. The gold standard OSM was calculated by a freezing point depression osmometer. Z scores were calculated for each instrument and Pearson product-moment correlation coefficients were evaluated to examine the relationship between each instrument of USG and OSM. Results: Strong significant correlations were identified for the digital refractometer (r=0.814, p< 0.001) and handheld clinical refractometer (r=0.943, p< 0.001) with OSM. A weak statistically insignificant correlation was established between the midget urinometer (r=0.133, p< 0.142) and OSM. Average hydration status indicated variability among some of the instruments: digital refractometer USG=1.0194±0.0075, clinical refractometer USG=1.020±0.007, urinometer USG=1.028±0.091, osmometer OSM=743±271) Conclusions: Handheld clinical refractometry can be used confidently for assessing hydration status as it shows a strong significant correlation with the gold standard osmometer, which is consistent with previous literature. Additionally, the use of the pen style digital refractometer showed a strong, significant correlation with the gold standard osmometer and provides clinicians with another option for the clinical assessment of USG and hydration status. The findings of this also study suggest that the use of a midget urinometer should be performed with extreme caution, as it showed a weak correlation with the gold standard osmometer, indicating it might not provide accurate results when used to determine hydration status.
    • The Effects of A Gluteus Medius Training Protocol on Muscle Activation and Postural Control

      Dorpinghaus, Nathan (2012-10-22)
      Context: Researchers have suggested a weak or dysfunctional gluteus medius (GM) has been linked to a number of lower extremity injuries. Identifying an appropriate intervention to prevent or correct GM deficits and determine associated outcomes has become a subject of increased interest. Objective: To determine if GM training changes lower extremity muscle activation during a dynamic task. Design: Controlled laboratory study. Setting: Biomechanics research laboratory. Participants: Eighteen healthy, physically active participants (7 men, 11 women; age=21.2±2.01yrs; height=168.39±8.92cm; mass=77.76±16.39kg) volunteered for the study. Each participant served as their own control. Intervention(s): Muscle activation of 5 trunk muscles were measured bilaterally before and after the protocol during a single-leg drop landing (45cm). All of the participants completed a six week GM training protocol. Main Outcome Measure(s): Peak and mean muscle activation was measured 400ms pre-and post-landing (pre-mean, pre-peak, post-mean, post-peak). Muscle activation data was normalized using maximal voluntary contractions. Results: No significant differences were observed during the control period. Decreased muscle activation was observed in the non-dominant GM [pre-mean (F1,17=14.301, P=.001), pre-peak (F1,17=9.490, P=.007), post-mean (F1,17=5.373, P=.033), and post-peak (F1,17=4.678, P=.045)]. Increased biceps femoris (BF) mean muscle activation was observed on the dominant leg pre-landing (F1,17=4.752, P=.044). Conclusions: Six weeks of GM training was enough time to observe improved neuromuscular efficiency of the GM. Increased BF muscle activation prior to landing suggests participants had an increased feedforward response in preparation for landing following training. Therefore, the combination of improved neuromuscular efficiency and a greater feedforward response suggest pelvic stabilization may be improved during a single-leg drop landing as a result of six weeks of GM training. This study suggests clinicians should incorporate bilateral GM exercises to improve lower extremity neuromuscular efficiency and feedforward responses which may improve pelvic stabilization. Key words: Electromyography, lower extremity injury, rehabilitation, neuromuscular efficiency, single-leg drop landing.
    • The Effects of Playing<br /> Surfaces on Landing<br /> Mechanics During A<br /> Jump Rebound-Landing<br /> Task

      Stankowski, Kayla (2012-10-22)
      CONTEXT: Anterior cruciate ligament (ACL) injuries are common among physically active people. Most ACL injuries occur from a noncontact mechanism such as landing from a jump. It is well known that neuromuscular risk factors, such as poor landing mechanics can increase the risk for ACL injury. However, it is unknown how playing surfaces affect landing mechanics. OBJECTIVE: Determine if landing on different athletic surfaces effects landing mechanics. DESIGN: Repeated measures design SETTING: Research Laboratory and Gymnasium PARTICIPANTS: Thirty-two healthy, physically active individuals (14 males, 18 females; age=20±2years; height= 172.1±9.7 cm and mass=71±14kg) were recruited to participate in this study. INTERVENTION: Independent variable was surface type, a wood basketball court and a volleyball sport court. MAIN OUTCOME MEASURES: Landing mechanics, assessed by the LESS. A paired samples t-test was performed to compare the mean LESS scores on each surface within participants. RESULTS: No significant differences (P=0.22) were identified between the LESS scores on the wood basketball court (6±1) and the volleyball sport court surfaces (6±2) within each participant. CONCLUSIONS: The findings of this study demonstrated no differences in landing mechanics between a wood basketball court and a volleyball sport court surface as assessed by LESS scores. Clinicians and researchers should also take into consideration that shoes were not standardized between participants, which could alter results due to differences in shoe-surface interaction. Therefore future research should examine other athletic playing surfaces, including outdoor surfaces such as grass and artificial turf as well as standardize shoes worn by participants.
    • Validity of Instrument Assisted Soft Tissue Mobilization for Detecting Myofascial Adhesions through Secondary Diagnostic Ultrasound Analysis

      Silbaugh, Kaitlyn (2013-09-06)
      Context: many patients have pain and restricted motion due to myofascial adhesions. Clinicians use both manual and instrument assisted soft tissue mobilization (IASTM) techniques to treat myofascial adhesions. The main difference between manual therapies and IASTM is that IASTM claims that their instruments can accurately qualitatively detect myofascial adhesions through their resonance capability. However, the validity of this capability has yet to be researched. Objective: To determine the validity of using IASTM to detect myofascial adhesions through secondary diagnostic ultrasound analysis. Design: Correlational validity study. Setting: Athletic Training Laboratory. Patients or other participants: nineteen men (age = 22.4 ± 2.5) and eleven women (age = 21.2 ± 1.9). Data collection and analysis: From the thirty participants, one hundred adhesions were found and imaged. We calculated the percent level of agreement between the two rates, and then considered chance by using a κ coefficient to understand the relationship between the two rates of diagnostic us. Results: We identified an 83% level of agreement between raters. However, when chance was considered, we found a poor inter-rater reliability (κ= 0.344, p<0.001). Conclusions: There is moderate evidence that IASTM is successful in quantitatively detecting myofascial adhesions. Sources creating instrument resonance other than myofascial adhesions may include blood vessels or adipose nodules. Future investigation should further examine what specifically IASTM is detecting through its resonance, if not myofascial adhesions. Key words: instrument assisted soft tissue mobilization, Graston technique, diagnostic ultrasound, myofascia, fascial adhesions
    • Weight Loss Methods and Eating Disorder Risk Factors in Collegiate Wrestlers

      Rea, Jessica (2014-03-18)
      Purpose: The purpose of the study is to investigate the weight loss of collegiate wrestlers and assess their risk for eating disorders (ED). Methods: Wrestlers were recruited by contacting the athletic trainer (AT) at the institution they wrestled. ATs who agreed to participate were sent an electronic link containing a survey, 143 wrestlers provided usable data. The survey was created from two surveys one allows the athlete to describe his eating behaviors and the ATHLETE questionnaire which measures risk for ED. We analyzed the data using descriptive statistics and frequencies. Results: 76.6% of wrestlers indicated binge eating; eating behaviors are similar to those in previous literature including gradual dieting, restricting food/fluids, fasting, and exercise. Wrestlers in this study do not appear to be at risk for ED. Clinical applicability: Wrestlers display dangerous eating behaviors but are not at risk for ED. Key Words: Disordered eating, anorexia, bulimia, body image