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Context: The Dynamic Leap Balance Test (DLBT) is a new dynamic balance task that requires serial changes in base of support with alternating limb support and recovery of dynamic stability, as compared with the Y modification of the Star Excursion Balance Test (Y-SEBT), which assesses dynamic stability over an unchanging base of support. Objectives: To assess the dynamic balance performance in 2 different types of dynamic balance tasks, the DLBT and the SEBT, in subjects with unilateral chronic ankle instability (CAI) when compared with matched controls. The authors hypothesized that the DLBT score would significantly differ between the CAI involved and uninvolved limbs (contralateral and healthy matched) and demonstrate a modest (r = .50) association with the SEBT scores. Design: Case-control. Setting: Controlled laboratory. Participants: A total of 36 physically active adults, 18 with history of unilateral CAI and 18 without history of ankle injury, were enrolled in the study. CAI subjects were identified using the Identification of Functional Ankle Instability questionnaire. Interventions: The DLBT and the SEBT were performed in a randomized order on a randomly selected limb in CAI and healthy subjects. Main Outcome Measures: Time taken to complete the DLBT and the reach distances performed on the SEBT were compared between the CAI and the healthy subjects. Results: There were no statistically significant differences (P < .05) in SEBT reach distances between groups. The DLBT time was greater (P < .01) for unstable ankles compared with the stable ankle. The authors found no correlation (P > .05) between DLBT time and any of the SEBT reach distances suggesting that the DLBT provides unique information in the assessment of patients with CAI. Conclusion: The DLBT challenges the ability to maintain postural control in CAI subjects differently than the SEBT. There is a need of more dynamic balance assessment tools that are functional and clinically relevant. [ABSTRACT FROM AUTHOR]

Context: After knee-joint injury, pain, effusion, and mechanoreceptor damage alter afferent signaling, which can result in quadriceps inhibition and subsequent weakness. The individual contributions of each factor to inhibition remain unclear due to confounding knee-joint injuries and indirect experimental models. Objective: To characterize the influence of naturally occurring knee damage and pain on quadriceps neuromuscular function in individuals with patellar tendinopathy. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: Twenty participants who self-reported patellar tendinopathy (PT) and 10 healthy control individuals underwent ultrasonic tendon assessment. Injured participants were dichotomized by an orthopaedic surgeon into groups with (1) pain and structural tendon abnormality and (2) regional pain alone. Main Outcome Measure(s): Quadriceps inhibition was assessed with the Hoffman reflex and the central activation ratio via the superimposed-burst technique. Normally distributed measures were analyzed using a 1-way analysis of variance and post hoc independent t tests. Kruskal-Wallis tests with post hoc Mann-Whitney U tests were used to analyze nonnormally distributed data. An a priori a level of P = .05 was set. Results: Control participants presented with more spinalreflex excitability (0.37 6 0.23) than the PT (0.10 6 0.06; P = .03) and regional-pain (0.18 6 0.05; P = .02) groups. Kneeextension strength was greater in the control (3.37 6 0.59 Nm/ kg) than in the PT (2.41 6 0.67 Nm/kg; P = .01) group but not the regional-pain group (3.05 6 0.66 Nm/kg; P = .24). Control individuals presented with more quadriceps activation (97.93% 6 3.12) than the PT (84.44% 6 16.98; P, .01) and regionalpain (91.17% 6 10.56; P = .01) groups. No differences were present for any measures between the PT and regional-pain groups (P values . .05). Conclusions: Deficits in spinal-reflex excitability, quadriceps activation, and strength were present in both the PT and regional-pain groups. A combination of pain and structural damage appeared to have the greatest negative effect on quadriceps function, as only the PT group presented with neuromuscular outcomes that failed to meet clinical thresholds. [ABSTRACT FROM AUTHOR]

The purpose of this study was to formulate a predictive equation to discriminate males from females using static and dynamic lower extremity (LE) alignments. Twenty-four healthy adults volunteered to participate. Three-dimensional motion analysis was used to assess the kinematics of the right hip and knee during two functional tasks. Six measures of static LE alignment were also performed. Statistical comparisons were made between males and females for all variables. Static and dynamic variables that were significantly different by sex were entered into separate discriminant analyses for each task. The resulting equations were each able to correctly predict 87% of the subjects by sex. Fifty-eight percent and 55% of the variance was explained by sex for the vertical jump and plant & jump, respectively. The frontal plane hip angle was the best predictor of sex for both tasks. While there were statistically significant differences between the sexes for static measures of LE alignment, kinematic measures were better at discriminating between sexes. [ABSTRACT FROM AUTHOR]

Context: Recent employment data from collegiate athletic training settings have demonstrated departure trends among men and women. These trends have been hypothesized to be related to work-life balance. However, work-life balance is only 1 aspect of a myriad of factors. Due to the complex nature of the work-life interface, a multilevel examination is needed to better understand the precipitators of departure. Objective: To quantitatively examine factors that may influence collegiate athletic trainers' (ATs') job satisfaction and career intentions via a multilevel examination of the work-life interface. Design: Cross-sectional study. Setting: Web-based questionnaire. Patients or Other Participants: Athletic trainers employed in National Collegiate Athletic Association Division I, II, or III or National Association of Intercollegiate Athletics colleges or universities (N =299: 56.5% female, 43.5% male). The average age of participants was 33.6±8.3 years, and their average experience was 10.3±7.6 years. Data Collection and Analysis: Participants responded to an online questionnaire consisting of demographic questions, 9 Likert-scale surveys, and open-ended questions. Job-satisfaction Scores (JSSs) and intention-to-leave scores (ITLSs) served as the dependent variables and factors from individual, organizational, and sociocultural levels were the independent variables. Hierarchical regression analysis was run to determine the predictability of factors. Results: No sex differences in ITLS or JSS were found in our sample. Independent variables explained 68.5% of the variance in JSS and 28.8% of the variance in ITLS. Additions of factor levels increased the percentage of explained variance in both scores. Conclusions: A combination of individual-, organizational-, and sociocultural-level factors was able to best predict JSS and ITLS among collegiate ATs. [ABSTRACT FROM AUTHOR]

This study examined the separate and combined effects of heat acclimation and hand cooling on post-exercise cooling rates following bouts of exercise in the heat. Seventeen non-heat acclimated (NHA) males (mean ± SE; age, 23 ± 1 y; mass, 75.30 ± 2.27 kg; maximal oxygen consumption [VO2max], 54.1 ± 1.3 ml·kg−1·min−1) completed 2 heat stress tests (HST) when NHA, then 10 days of heat acclimation, then 2 HST once heat acclimated (HA) in an environmental chamber (40°C; 40%RH). HSTs were 2 60-min bouts of treadmill exercise (45% VO2max; 2% grade) each followed by 10 min of hand cooling (C) or no cooling (NC). Heat acclimation sessions were 90–240 min of treadmill or stationary bike exercise (60–80% VO2max). Repeated measures ANOVA with Fishers LSDpost hoc(α < 0.05) identified differences. When NHA, C (0.020 ± 0.003°C·min−1) had a greater cooling rate than NC (0.013 ± 0.003°C·min−1) (mean difference [95%CI]; 0.007°C [0.001,0.013],P = 0.035). Once HA, C (0.021 ± 0.002°C·min−1) was similar to NC (0.025 ± 0.002°C·min−1) (0.004°C [−0.003,0.011],P = 0.216). Hand cooling when HA (0.021 ± 0.002°C·min−1) was similar to when NHA (0.020 ± 0.003°C·min−1) (P = 0.77). In conclusion, when NHA, C provided greater cooling rates than NC. Once HA, C and NC provided similar cooling rates. [ABSTRACT FROM PUBLISHER]

Background: In order to accurately assess the abdominal muscles, clinicians need valid clinical measures. The double leg lowering test (DLLT) and lower abdominal muscle progression (LAMP) are two common tests of abdominal muscle performance. The purposes of this study were to determine the relation between surface electromyographic (EMG) activity during the DLLT and LAMP levels; hip joint resultant moments and DLLT and LAMP levels; and the two measures of DLLT and LAMP.Methods: Ten healthy participants were tested under both conditions. Surface EMG activity of the abdominal muscles was obtained, while pelvic movement was detected simultaneously.Results: A moderate to strong association was found between rectus abdominus muscle activity and a moderate association with the external obliques with both test levels. For the internal oblique/transversus abdominus, a moderate and weak association was found with the DLLT and LAMP, respectively. A very strong association existed between the hip resultant joint moments (RJM) and the DLLT, while there was a weak correlation between hip RJM and the LAMP. No significant correlation was found between the DLLT and LAMP grades.Conclusions: This finding suggests that these tests may measure different qualities of muscle performance and provides preliminary support for their use. Further evaluation of these assessments with clinical populations is necessary. [ABSTRACT FROM AUTHOR]

The article discusses the benefits of a well-designed cohort study over a Randomized Clinical Trial (RCT), in generating research evidences and improving the quality of health care services being provided to athletes. It mentions that the cohort studies of the Patellofemoral Pain Syndrome (PFPS) treatment programs helps in understanding the prognostic factors which contribute towards restoring pain-free functions in athletes. It mentions anticipating confounding factors is Cohort's limitation.

The article presents a study on whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can be used to determine changes in abdominal muscle performance following the use of core stabilization exercise programs for lower back pain (LBP). Specific stabilization exercise (SSE) and general stabilization exercise (GSE) groups were used.

The article presents information on a study which evaluates the effects of acute resistance exercise on muscle damage and psychological stress in young, untrained, lean and obese men. The study included 19 young men, 5 obese men, and observed perceptual measures like rating of perceived exertion, pain and soreness, fatigue, and general soreness. The methods and results of the study are also discussed.

The article discusses research which was conducted to investigate changes in the athletic performance of low land young athletes during a week long high altitude alpine ski racing camp. Researchers evaluated 11 youth ski racers. They found that approximately 20% of low land athletes have signs and symptoms of acute mountain sickness and that any negative performance changes seen in the athletes during the week declined as athletes became acclimated to altitude changes.

The article discusses the effects of high-intensity, short rest (HI/SR) resistance exercise protocols on adrenal cortical function in trained male and female athletes. Subjects performed exercises such as back squat, bench press, and deadlift at descending repetitions. The study looked at possible sex differences in metabolic factors such as lactate and cortisol levels, heart rate, and rating of perceived exertion. Also noted is the risk of overtraining in HI/SR exercise.

This investigation assessed differences between the response of men and women with knee osteoarthritis to superficial heat, cold, or contrast therapy applied with a water-circulating system or a standard heating pad, and rest. We further analyzed data from a previous study to better understand the influence of gender on the response to treatment based on Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales and a visual analog pain scale (VAS). Using a within-subject, randomized order design, 34 patients received each treatment in 1-week blocks. A KOOS questionnaire and VAS were completed at baseline and twice each week. Women were more likely to report clinically meaningful improvement in pain and symptoms on the KOOS with the use of heat, cold, and a heating pad. There were no significant differences in response to treatment between men and women for the function-daily living and quality of life subscales or percent pain reduction on the VAS. Men and women reported improved quality of life with intervention. Women are more likely to report clinically meaningful improvement in pain and symptoms associated with knee OA following the use of superficial heat, cold, or a heating pad than men. [ABSTRACT FROM AUTHOR]

The examination and assessment of injured and ill patients leads to the establishment of a diagnosis. However, the tests and procedures used in health care, including procedures performed by certified athletic trainers, are individually and collectively imperfect in confirming or ruling out a condition of concern. Thus, research into the utility of diagnostic tests is needed to identify the procedures that are most helpful and to indicate the confidence one should place in the results of the test. The purpose of this report is to provide an overview of selected statistical procedures and the interpretation of data appropriate for assessing the utility of diagnostic tests with dichotomous (positive or negative) outcomes, with particular attention to the interpretation of sensitivity and specificity estimates and the reporting of confidence intervals around likelihood ratio estimates. [ABSTRACT FROM AUTHOR]

Background: Female athletes are at a greater risk for noncontact anterior cruciate ligament injuries than male athletes. Gender differences in frontal plane kinematics (hip adduction, knee valgus, and ankle eversion) and temporal relationships that make up the components of dynamic knee valgus may explain this discrepancy.Hypothesis: The authors hypothesized that women would reach peak frontal plane kinematic values earlier during landing compared with their male counterparts.Study Design: Controlled laboratory study.Methods: Hip, knee, and ankle 3-dimensional kinematics were measured using high-speed motion capture in 10 National Collegiate Athletic Association Division I female athletes and 10 male practice squad athletes during a drop-jump landing. Independent t tests were used to analyze each dependent variable to identify differences between genders.Results: Maximum hip adduction, knee valgus, and ankle eversion occurred earlier in women than in men (mean differences 33.7% of stance [95% CI, 20.2%-47.2%], 41.7% [95% CI, 31.5%-51.6%], 16.5% of stance [95% CI, 7.3%-25.6%], respectively). Maximum hip adduction and knee valgus occurred before maximum knee flexion in women and after in men (mean differences 0.11 seconds [95% CI, 0.05-0.18 seconds], 0.19 seconds [95% CI, 0.13-0.25 seconds], respectively). Maximum ankle eversion occurred earlier in women than in men (mean difference 0.06 seconds [95% CI, 0.01-0.11 seconds]). There was a significant difference between genders for angular velocity of knee valgus (mean difference = 25.53 deg/sec [95% CI, 8.30-42.77 deg/sec]).Conclusion: Frontal plane kinematic temporal relationships at the hip, knee, and ankle differ between genders. The components of dynamic knee valgus peak during the deceleration phase in women and during the acceleration phase in men during a drop-jump landing. These data suggest that men and women employ a completely different kinematic landing/jumping strategy and that women land and collapse very rapidly into valgus compared with their male counterparts.Clinical Relevance: The differences in timing of the components of dynamic knee valgus between women and men may contribute to the increased risk of noncontact anterior cruciate ligament injuries in female athletes. There may be implications for neuromuscular reeducation training in those at risk for anterior cruciate ligament injury so the components of dynamic valgus occur later in the landing phase of jumping. [ABSTRACT FROM AUTHOR]

Context: Outcomes assessment is an integral part of ensuring quality in athletic training, but few generic instruments have been specifically designed to measure disablement in the physically active. Objective: To assess the psychometric properties of the Disablement in the Physically Active Scale (DPA), a patient-report, generic outcomes instrument. Design: Observational study. Setting: We collected data in 5 settings with competitive and recreational athletes. Participants entered into the study at 3 distinct points: (1) when healthy and (2) after an acute injury, or (3) after a persistent injury. Patients or Other Participants: Measures were obtained from 368 baseline participants (202 females, 166 males; age = 20.1 ± 3.8 years), 54 persistent participants (32 females, 22 males; age = 22.0 ± 8.3 years), and 28 acutely injured participants (8 females, 20 males; age = 19.8 ± 1.90 years). Main Outcome Measure(s): We assessed internal consistency with a Cronbach α and test-retest reliability with intraclass correlation (2,1) values. The scale's factor structure was assessed with a hierarchical confirmatory factor analysis. Concurrent validity was assessed with a Pearson correlation. Responsiveness was calculated using a receiver operating characteristic curve and a minimal clinically important difference value. Results: The Cronbach α scores for the DPA were 0.908 and 0.890 in acute and persistent groups, respectively. The intraclass correlation (2,1) value of the DPA was 0.943 (95% confidence interval = 0.885, 0.972). The fit indices values were 1.89, 0.852, 0.924, 0.937, and 0.085 (90% confidence interval = 0.066, 0.103) for the minimum sample discrepancy divided by degrees of freedom, goodness-of-fit index, Tucker-Lewis Index, comparative fit index, and root mean square error of approximation, respectively. The DPA scores accounted for 51% to 56.4% of the variation in global functioning scores. The area under the curve was statistically significant, and the minimally clinically important difference values were established. Conclusions: The DPA is a reliable, valid, and responsive instrument. [ABSTRACT FROM AUTHOR]