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Upper extremity injuries in baseball pitchers cause significant time loss from competing and decreased quality of life. Although shoulder range of motion (ROM) is reported as a key factor to prevent potential injury, it remains unclear how limited glenohumeral ROM affects pitching biomechanics which may contribute to upper extremity injuries. To investigate how pitchers with decreased total arc glenohumeral ROM of the throwing arm differed in upper extremity pitching kinematics and kinetics as well as ball velocity compared with pitchers with greater levels of glenohumeral ROM. Cross-sectional study. Laboratory. Fifty-seven baseball pitchers (ages 18–24) were divided into either control (≥160° total arc) or lower ROM (<160° total arc) groups. The mean glenohumeral ROM deficits, pitching kinematic and kinetic outcomes, and ball velocity were compared between groups. The control group demonstrated significantly less deficit in total arc ROM between arms than the lower ROM (control: −1.5° ± 10.0°; lower ROM: −12.4° ± 13.9°; P <.001). While the lower ROM group displayed less maximal shoulder external rotation (ER) while pitching, the control group had significantly less difference in ROM between maximal shoulder ER while pitching and clinically measured ER (lower ROM: 64.4° ± 12.1°; control: 55.8° ± 16.6°; P =.025). The control group had significantly faster ball velocity than the lower ROM group (control: 85.0 ± 4.3 mph; lower ROM: 82.4 ± 4.8 mph; P =.024). Pitchers with decreased total arc glenohumeral ROM (<160° total arc) may undergo overstretching toward ER in the shoulder during the late cocking phase. Pitchers with higher total arc ROM can pitch the same or faster ball without increasing loading in the upper extremity. Total arc glenohumeral ROM measurement can be a clinical screening tool to monitor shoulder condition over the time, and pitchers with limited total arc ROM might be at higher risk of shoulder injury. [ABSTRACT FROM AUTHOR]

Context: Study abroad programs are a key educational opportunity for athletic training students to grow in cultural competence. Yet, there are few faculty-led, study abroad programs specifically designed for athletic training community engagement in low-income nations. Objective: To describe the process of developing and implementing a short-term athletic training and public health service-learning study abroad program to Nicaragua. Background: Partnerships with a Nicaraguan partner institution aimed at creating sustainable study abroad programs for students from a variety of disciplines were initially explored. A short-term, study abroad program with athletic training and public health faculty was established based on the opportunities and benefits that it would provide to students, interests of host staff, and the accessibility to a local community. Synthesis: Nine athletic training and exercise science students, composed mostly of graduate students, participated in the program in Nicaragua. Students worked with local soccer coaches and their student-athletes. Curriculum for the coaches included basic athletic injury prevention and management techniques including the Federation Internationale de Football Association 11+ injury prevention protocol, concussions and head injury, heat illness and hydration management, nutrition and performance, and basic first aid. With the student-athletes, the group implemented injury prevention skills including the Federation Internationale de Football Association 11+, proper heading techniques, and teamwork drills. Results: Working with the Nicaraguan soccer players and coaches provided students important lessons in cultural competence, interprofessional education, communication, and patient care. Recommendation(s): As athletic training education shifts to a professional master's degree, it is important for educators to consider study abroad program length, structure, and student learning outcomes if they are interested in creating faculty-led programs. Conclusion(s): Athletic training study abroad programs, which provide students with opportunities for direct interaction with coaches and student-athletes, can provide students with beneficial learning opportunities. This program can offer a framework for those interested in offering short-term programs abroad.

Context: Intervention studies for chronic ankle instability (CAI) often focus on improving physical impairments of the ankle complex. However, using an impairments-focused approach may miss psychological factors that may mediate function and recovery. Patient-reported outcome (PRO) measures can be used to assess several dimensions of the health-related quality of life (HRQoL) and deliver enhanced patient-centered care. Therefore, the purpose of this investigation was to evaluate group-level improvements in HRQoL and treatment response rates following various interventions in patients with CAI. Design: Cross-sectional. Methods: Data from 7 previous studies were pooled by the chronic ankle instability outcomes network for participant-level analysis, resulting in 136 patients with CAI. Several interventions were assessed including balance training, gait biofeedback, joint mobilizations, stretching, and strengthening, with treatment volume ranging from 1 to 4 weeks. Outcome measures were PROs that assessed ankle-specific function (Foot and Ankle Ability Measure), injury-related fear (Tampa Scale of Kinesiophobia and Fear Avoidance Belief Questionnaire), and global well-being (Disablement in the Physically Active); the PROs assessed varied between studies. Preintervention to postintervention changes were evaluated using separate Wilcoxon signed-rank tests and effect sizes, and a responder analysis was conducted for each PRO. Results: Significant, moderate to large improvements were observed in PROs that assessed ankle-specific function, injury-related fear, and global well-being following intervention (P <.001). Responder rates ranged from 39.0% to 53.3%, 12.8% to 51.4%, and 37.8% for ankle specific function, injury-related fear, and global well-being, respectively. Conclusions: Various interventions can lead to positive improvements in HRQoL in patients with CAI. Treatment response rates at improving HRQoL are similar to response rates at improving impairments such as balance, further reinforcing the need for individualized treatment approaches when treating a patient with CAI. [ABSTRACT FROM AUTHOR]

Context: Ankle sprains result in pain and disability. While factors such as body mass and prior injury contribute to subsequent injury, the association of the number of ankle sprains on body anthropometrics and self-reported function are unclear in this population. Therefore, the purpose of this investigation was to assess differences in anthropometric measurements and self-reported function between the number of ankle sprains utilizing a large, pooled data set. Design: Cross-sectional. Methods: Data were pooled from 14 studies (total N = 412) collected by the Chronic Ankle Instability Outcomes Network. Participants were categorized by the number of self-reported sprains. Anthropometric data and self-reported function were compared between those who reported a single versus >1 ankle sprain as well as among groups of those who had 1, 2, 3, 4, and ≥5 ankle sprains, respectively. Results: Those who had >1 ankle sprain had higher mass (P = .001, d = 0.33) and body mass index (P = .002, d = 0.32) and lower Foot and Ankle Ability Measure-Activities of Daily Living (P < .001, r = .22), Foot and Ankle Ability Measure-Sport (P < .001, r = .33), and Cumberland Ankle Instability Tool (P < .001, r = .34) scores compared to the single ankle sprain group. Those who had a single ankle sprain weighed less than those who reported ≥5 sprains (P = .008, d = 0.42) and had a lower body mass index than those who reported 2 sprains (P = .031, d = 0.45). Conclusions: Some individuals with a history of multiple ankle sprains had higher body mass and self-reported disability compared to those with a single sprain, factors that are likely interrelated. Due to the potential for long-term health concerns associated with ankle sprains, clinicians should incorporate patient education and interventions that promote physical activity, healthy dietary intake, and optimize function as part of comprehensive patient-centered care. [ABSTRACT FROM AUTHOR]

Lower levels of physical activity (PA) are often observed among children with autism spectrum disorder (ASD) compared to children without ASD; however, some studies have demonstrated few to no PA differences between the two groups. The purpose of this systematic review with meta-analysis was to compare the differences in PA between children (2–18 years) with and without ASD. An exhaustive search of five online databases was completed, and 31 studies met the inclusion criteria. A pooled random-effects Hedges's g model was used to determine differences in PA between children with and without ASD. Children with ASD were found to be significantly less physically active than children without ASD (Δ = −0.62, p <.001). Subgroup analyses revealed significant moderate to large differences in PA by intensity level, age, setting, and measurement methods. Future studies are needed to further explore the underlying mechanisms associated with lower levels of PA among children with ASD. [ABSTRACT FROM AUTHOR]

Background: Region-specific patient-reported outcomes (PROs) are commonly used in rehabilitation medicine. Digital versions of PROs may be implemented into electronic medical records and are also commonly used in research, but the validity of this method of administration (MOA) must be established. Purpose: To determine the agreement between and compare the test–retest reliability of a paper version (FAAM-P) and digital version (FAAM-D) of the Foot and Ankle Ability Measure (FAAM). Study Design: Randomized, nonblinded, crossover observational study. Methods: A total of 90 adults were randomized to complete the FAAM-P or FAAM-D first, and then completed the second MOA (first day [D1]). The FAAM-D was a digital adaptation of both FAAM-P subscales on Qualtrics. Identical test procedures were completed 1 week later (D2). Data were removed if a participant scored 100% on both MOA, reported injury between D1 and D2, or did not complete both MOA. Agreement was assessed on 46 participants between the 2 MOA using intraclass correlation coefficients (ICC) at D1. There was good-to-excellent test–retest reliability for the FAAM activities of daily living. Results: The authors observed good agreement between the FAAM-P and FAAM-D for the activities of daily living (ICC = .88) and sport scales (ICC = .87). Test–retest reliability was good-to-excellent for the FAAM activities of daily living (FAAM-P: ICC = .87; FAAM-D: ICC = .89) and sport (FAAM-P: ICC = .71; FAAM-D: ICC = .91). Conclusions: The MOA does not appear to affect the responses on the FAAM; however, the authors observed slightly higher reliability on the FAAM-D. The FAAM-D is sufficient to be used for generating practice-based evidence in rehabilitation medicine. [ABSTRACT FROM AUTHOR]

Context: Patellar tendinopathy (PT) is prevalent in physically active populations, and it affects their quality of living, performance of activity, and may contribute to the early cessation of their athletic careers. A number of previous studies have identified contributing factors for PT; however, their contributions to self-reported dysfunction remain unclear. Objective: The purpose of this investigation was to determine if strength, flexibility, and various lower-extremity static alignments contributed to self-reported function and influence the severity of PT. Design: Cross-sectional research design. Setting: University laboratory. Participants: A total of 30 participants with PT volunteered for this study (age: 23.4 [3.6] y, height: 1.8 [0.1] m, mass: 80.0 [20.3] kg, body mass index: 25.7 [4.3]). Main Outcome Measures: Participants completed 7 different patient-reported outcomes. Isometric knee extension and flexion strength, hamstring flexibility and alignment measures of rearfoot angle, navicular drop, tibial torsion, q-angle, genu recurvatum, pelvic tilt, and leg length differences were assessed. Pearson's correlation coefficients were assessed to determine significantly correlated outcome variables with each of the patient-reported outcomes. The factors with the highest correlations were used to identify factors that contribute the most to pain and dysfunction using backward selection, linear regression models. Results: Correlation analysis found significant relationships between questionnaires and body mass index (r = −.35–.46), normalized knee extension (r =.38–.50) and flexion strength (r = −.34–.50), flexibility (r =.32–.38, q-angle (r =.38–.56), and pelvic tilt (r = −.40). Regression models (R2 =.22–.54) identified thigh musculature strength and supine q-angle to have greatest predictability for severity in patient-reported outcomes. Conclusions: These findings put an emphasis of bodyweight management, improving knee extensor and flexor strength, and posterior flexibility in PT patients. [ABSTRACT FROM AUTHOR]

Patellar tendinopathy is a common yet misunderstood condition that afflicts a variety of patient populations. This lack of understanding affects the ability of clinicians to provide effective treatment interventions. Patients with tendinopathy often report long-term and low to moderate levels of pain, diminished flexibility, and reduced strength, as well as decreased physical function. Load-management strategies combined with exercise regimens focused on progressive tendon loading are the most effective treatment options for patients with patellar tendinopathy. This review will provide an evidence-based approach to patellar tendinopathy, including its pathoetiology, evaluation, and treatment strategies. [ABSTRACT FROM AUTHOR]

The Cumberland Ankle Instability Tool is a common patient reported outcome used to assess those with Chronic Ankle Instability. However, paper versions of the Cumberland Ankle Instability Tool have only been assessed for reliability purposes. The purpose of this study was to assess the agreement and reliability of a digital version of the Cumberland Ankle Instability Tool-Digital. Sixty-eight participants with a history of ankle sprain(s) were recruited to participate in this study. Participants completed a paper version of the Cumberland Ankle Instability Tool and a digital version then returned one week later and completed them again. Intraclass correlation coefficients (ICC) and Kappa coefficients were used to determine the agreement between the paper and digital versions as well as test-retest reliability between the two time periods. The digital version showed excellent reliability (ICC = 0.93, 95% CI: 0.89–0.96) with the paper version. The test-retest reliability between testing sessions was considered good (ICC = 0.86, 95% CI: 0.77–0.92). A majority of individual items on the digital version demonstrated substantial agreement (κ = 0.60–0.81) with the paper version. A digital version of the Cumberland Ankle Instability Tool demonstrated good to excellent psychometric properties. Clinicians who utilize a digital version as part of an electronic medical record system can utilize them confidently to accurately assess patients with Chronic Ankle Instability. Future studies may want to consider assessing a digital version with expanded clinical and research populations. The digital version of the Cumberland Ankle Instability Tool demonstrated adequate psychometric properties. The digital version of the Cumberland Ankle Instability Tool can be considered a reliable instrument for the assessment of Chronic Ankle Instability. A digital version of the Cumberland Ankle Instability Tool can provide automated scoring and quick administration for clinicians in a rehabilitation setting. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if there were neurocognitive deficits among controls, copers and those with chronic ankle instability (CAI). Participants included those without history of ankle injury (n = 14), ankle sprain copers (n = 13) and patients with self-reported CAI (n = 14). They completed a battery of valid and reliable computer-based neurocognitive tests. The differences between neurocognitive domain scores were compared across the Control, Coper and CAI groups. Patients with CAI had lower composite memory, visual memory and simple attention compared to controls. In males with CAI, large differences in memory and attention were found relative to control participants. These differences may contribute to uncontrolled episodes of giving way through deficits in spatial awareness and/or an inability to identify environmental obstacles. Clinicians should explore ways to provide additional stimuli through innovative rehabilitation protocols aimed at maximizing neurocognitive abilities in patients with CAI. [ABSTRACT FROM AUTHOR]

The objective of this study was to perform a systematic review and meta-analysis comparing the effect of telehealth interventions to usual care for cancer survivors' quality of life. A comprehensive search of four different databases was conducted. Manuscripts were included if they assessed telehealth interventions and usual care for adult cancer survivors and reported a measure of quality of life. Pooled random effects models were used to calculate overall mean effects for quality of life pre- and post-intervention. Eleven articles fit all systematic review and meta-analysis criteria. Initial analyses indicated that telehealth interventions demonstrated large improvements compared with usual care in quality of life measures (Δ = 0.750, p = 0.007), albeit with substantial heterogeneity. Upon further analysis and outlier removal, telehealth interventions demonstrated significant improvements in quality of life compared with usual care (Δ = 0.141–0.144, p < 0.05). The results of the systematic review with meta-analysis indicate that supplementary interventions through telehealth may have a positive impact on quality of life compared with in-person usual care. [ABSTRACT FROM AUTHOR]