Journal of Athletic Training最新文献

{"title":"More Than Skin Deep: Patient-Provider Racial and Ethnic Concordance and Discordance in Collegiate Athletics and Concussion Management.","authors":"Erica Beidler, Thomas G Bowman, Samuel R Walton, Monica R Lininger, Meredith N Decker, Jessica Wallace, Luzita Vela, Tamaria Hibbler, Katherine Morigaki Breedlove, Michael J Larson, Thayne A Munce, Monique R Pappadis, John Sunchild, Sean Ahonen, Nyaz Didehbani, David X Cifu, Jacob E Resch, Patricia M Kelshaw","doi":"10.4085/1062-6050-0320.23","DOIUrl":"10.4085/1062-6050-0320.23","url":null,"abstract":"<p><strong>Context: </strong>There is strong evidence that racial and ethnic disparities exist in multiple arenas of health and wellness. The causes of racial and ethnic differences in health care are multidimensional; one factor that may affect injury/illness communication, interactions, and outcomes is patient-provider racial and ethnic concordance. At present, it is unclear what role patient-provider racial and ethnic concordance and discordance plays in facilitating concussion care for collegiate athletes.</p><p><strong>Objective: </strong>To investigate the presence of athlete-athletic trainer (AT) racial and ethnic concordance and discordance among diagnosed concussion cases and examine if racial and ethnic concordance and discordance influences time (in days) until diagnosis, symptom resolution, or return-to-sport clinical milestones in collegiate athletes.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Collegiate athletics.</p><p><strong>Patients or other participants: </strong>A total of 694 concussion cases (38.6% [n = 268] sustained by women, 61.4% [n = 426] sustained by men) that occurred within the 2015-2016 through 2019-2020 sport seasons at 9 institutions.</p><p><strong>Main outcome measure(s): </strong>The number of days from the date of injury to diagnosis, symptom resolution, and return to sport and from the date of diagnosis to symptom resolution and return to sport.</p><p><strong>Results: </strong>Overall, 68.4% (n = 475) of concussion cases had patient-provider racial and ethnic concordance, and 31.6% (n = 219) were discordant. All concordant pairs included a White athlete and White AT. Time to diagnosis differed between the concordant and discordant groups (median [interquartile range] = 1 [0-2] versus 0 [0-1], respectively) only in the model adjusted for sex, sport type, and availability of an AT (odds ratio [95% CI] = 1.46 [1.07-1.85]). There were no other group differences.</p><p><strong>Conclusions: </strong>One-third of concussion cases had athlete-AT racial and ethnic discordance. Although this group was diagnosed with a concussion 1 day sooner than the concordant group, no differences were observed for any concussion recovery milestones. These findings suggest that patient-provider racial and ethnic concordance may play a minor role in concussion recognition or reporting but not necessarily in the management and recovery thereafter.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"762-771"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Fatigue on Lower Limb Biomechanics and Kinetic Stabilization During the Tuck-Jump Assessment.","authors":"Lucy S Kember, Gregory D Myer, Isabel S Moore, Rhodri S Lloyd","doi":"10.4085/1062-6050-0252.23","DOIUrl":"10.4085/1062-6050-0252.23","url":null,"abstract":"<p><strong>Context: </strong>General and local muscular fatigue is postulated to negatively alter lower limb biomechanics; however, few prospective studies have been done to examine the effect of fatigue on tuck-jump performance. The tuck-jump assessment (TJA) is a criteria-based visual screening tool designed to identify neuromuscular deficits associated with anterior cruciate ligament (ACL) injury. Use of kinetics during the TJA after an intense sport-specific fatigue protocol may identify fatigue-induced neuromuscular deficits associated with ACL injury risk.</p><p><strong>Objective: </strong>To examine the effects of a sport-specific fatigue protocol on visually evidenced (2-dimensional) technical performance of repeated tuck jumps and lower limb kinetic stabilization.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Laboratory.</p><p><strong>Patients or other participants: </strong>Twelve female netball athletes (age = 20.8 ± 2.6 years, height = 170.0 ± 0.04 cm, mass = 67.5 ± 7.4 kg).</p><p><strong>Main outcome measure(s): </strong>Participants performed 1 set of a TJA before and after a sport-specific fatigue protocol. Paired t tests and effect sizes were used to evaluate differences and the magnitude of differences in TJA scoring criterion, kinetics, and kinetic stabilization prefatigue to postfatigue.</p><p><strong>Results: </strong>A small increase was observed for vertical relative lower extremity stiffness postfatigue (P = .005; Hedges g = 0.45). Peak center-of-mass displacement, time of jump cycle, ground contact time, flight time, jump height, and vertical net impulse decreased with small to moderate effect sizes (P < .01; Hedges g range, 0.41-0.74). No differences were observed for TJA composite scores, peak vertical ground reaction force, and stabilization indices of kinetic variables after the fatigue protocol (P > .05).</p><p><strong>Conclusions: </strong>Kinetic analysis of repeated tuck jumps after a fatigue protocol identified an altered jumping strategy, which was not identifiable via visual 2-dimensional assessment. However, based on kinetic measures, fatigue induces a stiffer jumping strategy, and practitioners should consider assessing load attenuation strategies that may not be visually evident when evaluating ACL-injury risk factors in athletes who are fatigued.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"705-712"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Clinical Concepts: Rehabilitation of Thoracic Outlet Syndrome.","authors":"Greg Hock, Andrew Johnson, Patrick Barber, Cassidy Papa","doi":"10.4085/1062-6050-0138.22","DOIUrl":"10.4085/1062-6050-0138.22","url":null,"abstract":"<p><p>Thoracic outlet syndrome (TOS) involves inconsistent symptoms, presenting a challenge for medical providers to diagnose and treat. Thoracic outlet syndrome is defined as a compression injury to the brachial plexus, subclavian artery or vein, or axillary artery or vein occurring between the cervical spine and upper extremity. Three common subcategories are now used for clinical diagnosis: neurogenic, arterial, and venous. Postural position and repetitive motions such as throwing, weightlifting, and manual labor can lead to symptoms. Generally, TOS is considered a diagnosis of exclusion for athletes due to the poor accuracy of clinical testing, including sensitivity and specificity. Thus, determining a definitive diagnosis and reporting injury is difficult. Current literature suggests there is not a gold standard diagnostic test. Rehabilitation has been shown to be a vital component in the recovery process for neurogenic TOS and for arterial TOS and venous TOS in postoperative situations.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":"59 7","pages":"683-695"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Journal of Athletic Training: An Ongoing Value Proposition.","authors":"J Ty Hopkins","doi":"10.4085/1062-6050-1005.24","DOIUrl":"10.4085/1062-6050-1005.24","url":null,"abstract":"","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":"59 7","pages":"682"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Recalcitrant Skin Lesion and Subsequent Infection in a Recreational Intramural Male Athlete: A Case Report.","authors":"James E Leone, Kimberly A Gray","doi":"10.4085/1062-6050-0467.22","DOIUrl":"10.4085/1062-6050-0467.22","url":null,"abstract":"<p><p>A 35-year-old intramural male athlete presented to the athletic training staff with a 4.5- × 2.2-cm itchy, painful, swollen, and infected insidious skin lesion on his right lateral malleolus due to an underlying dermatologic deficiency. Suspecting infection, the patient was referred to his nurse practitioner and was diagnosed with atopic dermatitis caused by a ceramide deficiency. He was placed on cefalexin and mupirocin 2% ointment but returned due to the lesion increasing to 8.5 × 6 cm, although the infection seemed controlled. He was instructed to use Ceravé topical cream, clobetasol propionate 5%, and to consume foods rich in healthy oils (omega-3 fatty acids, olive oil). Unmitigated, this lesion could have resulted in severe infection and tissue damage. Atopic dermatitis is relatively common in the general population, but its appearance in healthy athletes highlights that athletic trainers need to be well versed in not just apparent causes of skin ailments (ie, infection) but also root causes.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"779-784"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trunk and Lower Extremity Biomechanics in Female Athletes With and Without a Concussion History.","authors":"Eric J Shumski, Jeonghoon Oh, Julianne D Schmidt, Robert C Lynall","doi":"10.4085/1062-6050-0259.23","DOIUrl":"10.4085/1062-6050-0259.23","url":null,"abstract":"<p><strong>Context: </strong>Athletes with a history of concussion are at a greater risk for lower extremity musculoskeletal injury. Female athletes may be at an even greater risk than male athletes. Previous researchers on postconcussion landing biomechanics have focused on the lower extremities, but the trunk plays a crucial role as an injury risk factor.</p><p><strong>Objective: </strong>To compare lower extremity and trunk biomechanics during jump-landing and cutting maneuvers between female athletes with and those without a concussion history.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Biomechanics laboratory.</p><p><strong>Patients or other participants: </strong>A total of 26 athletes (mean ± SD age = 19.0 ± 1.3 years, height = 1.68 ± 0.07 m, mass = 64.02 ± 6.76 kg, body mass index = 22.58 ± 1.97 kg/m2; median [interquartile range] time since most recent concussion = 37.5 months [25.0 months, 65.8 months]) with a concussion history and 38 athletes (age = 19.0 ± 1.1 years, height = 1.71 ± 0.08 m, mass = 64.72 ± 9.45 kg, body mass index = 22.14 ± 1.80 kg/m2) without a concussion history.</p><p><strong>Main outcome measure(s): </strong>Peak kinetics (vertical ground reaction force, vertical loading rate, external knee-abduction moment, and external knee-flexion moment) and kinematics (trunk-flexion angle, trunk lateral-bending angle, ankle-dorsiflexion angle, knee-flexion angle, knee-abduction angle, and hip-flexion angle) were obtained during the eccentric portion of jump-landing and cutting tasks. Separate 2 (group) × 2 (limb) between- and within-factors analyses of covariance were used to compare outcomes between groups. We covaried for time since the most recent concussion and the limb that had a history of musculoskeletal injury.</p><p><strong>Results: </strong>Athletes with a concussion history displayed a greater peak knee-abduction angle in their nondominant limb than their dominant limb (P = .01, ηp2 = 0.107) and the nondominant limb of athletes without a concussion history (P = .02, ηp2 = 0.083) during jump landing. They also had less trunk lateral bending during cutting compared with athletes without a concussion history (P = .005, ηp2 = 0.126).</p><p><strong>Conclusions: </strong>Our results indicated landing biomechanics are different between female athletes with and those without a concussion history. This finding may be due to impairments in neuromuscular control postconcussion that may ultimately increase the risk of subsequent lower extremity injury, although further research is warranted given the cross-sectional nature of our study.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"751-761"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Reweighting System Differences on Vestibular Feedback With Increased Task Constraints in Individuals With and Without Chronic Ankle Instability.","authors":"Yuki A Sugimoto, Patrick O McKeon, Christopher K Rhea, Randy J Schmitz, Robert Henson, Carl G Mattacola, Scott E Ross","doi":"10.4085/1062-6050-0246.22","DOIUrl":"10.4085/1062-6050-0246.22","url":null,"abstract":"<p><strong>Context: </strong>Chronic ankle instability (CAI) is associated with a less flexible and adaptable sensorimotor system. Thus, individuals with CAI may present an inadequate sensory reweighting system, inhibiting their ability to place more emphasis (upweight) on reliable sensory feedback to control posture. However, how individuals with CAI reweight sensory feedback to maintain postural control in bilateral and unilateral stances has not been established.</p><p><strong>Objectives: </strong>To examine (1) group differences in how the sensory reweighting system changes to control posture in a simple double-limb stance and a more complex single-limb stance (uninjured limb and injured limb) under increased environmental constraints manipulating somatosensory and visual information for individuals with and without CAI and (2) the effect of environmental and task constraints on postural control.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Setting: </strong>Laboratory.</p><p><strong>Patients or other participants: </strong>A total of 21 individuals with CAI (age = 26.4 ± 5.7 years, height = 171.2 ± 9.8 cm, mass = 76.6 ± 15.17 kg) and 21 individuals without CAI (control group; age = 25.8 ± 5.7 years, height = 169.5 ± 9.5 cm, mass = 72.4 ± 15.0 kg) participated.</p><p><strong>Main outcome measure(s): </strong>We examined the equilibrium scores based on the first 10 seconds of trials in which participants completed 6 environmental conditions of the Sensory Organization Test during 3 tasks (double-limb and single-limb [uninjured and injured] stances). Sensory reweighting ratios for sensory systems (somatosensory, vision, and vestibular) were computed from paired equilibrium scores based on the first 10 seconds of the trials.</p><p><strong>Results: </strong>We observed 3-factor interactions between groups, sensory systems, and tasks (F4,160 = 3.754, P = .006) and for group, task, and environment (F10,400 = 2.455, P = .007). The CAI group did not downweight vestibular feedback compared with the control group while maintaining posture on the injured limb (P = .03). The CAI group demonstrated better postural stability than the control group while standing with absent vision (ie, eyes closed), fixed surroundings, and a moving platform on the injured limb (P = .03).</p><p><strong>Conclusions: </strong>The CAI group relied on vestibular feedback while maintaining better postural stability than the control group in injured-limb stance. Group differences in postural control depended on both environmental (absent vision and moving platform) and task (injured limb) constraints.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"713-723"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11277278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9830041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scapula-Focused Exercises With or Without Biofeedback and Corticospinal Excitability in Recreational Overhead Athletes With Shoulder Impingement.","authors":"Shi-Lun Luo, Yi-Fen Shih, Jiu-Jenq Lin, Yin-Liang Lin","doi":"10.4085/1062-6050-0066.23","DOIUrl":"10.4085/1062-6050-0066.23","url":null,"abstract":"<p><strong>Context: </strong>Individuals with shoulder impingement syndrome (SIS) exhibit changes in corticospinal excitability, scapular kinematics, and scapular muscle-activation patterns. To restore the scapular kinematics and muscle-activation patterns in individuals with SIS, treatment protocols usually include scapula-focused exercises, such as scapular-orientation and strength training.</p><p><strong>Objective: </strong>To investigate whether scapular-orientation and strength training can reverse the altered corticospinal excitability of recreational overhead athletes with SIS.</p><p><strong>Design: </strong>Randomized controlled clinical trial.</p><p><strong>Setting: </strong>University laboratory.</p><p><strong>Patients or other participants: </strong>Forty-one recreational overhead athletes with SIS: 20 in the scapular-orientation group (age = 26.45 ± 4.13 years, height = 171.85 ± 7.88 cm, mass = 66.70 ± 10.68 kg) and 21 in the strengthening group (age = 26.43 ± 5.55 years, height = 171.62 ± 5.87 cm, mass = 68.67 ± 10.18 kg).</p><p><strong>Intervention(s): </strong>Both groups performed a 30-minute training protocol consisting of 3 exercises to strengthen the lower trapezius (LT) and serratus anterior muscles without overactivating the upper trapezius muscles. Participants in the scapular-orientation group were instructed to consciously activate their scapular muscles with electromyographic biofeedback and cues, whereas the strengthening group did not receive biofeedback or cues for scapular motion.</p><p><strong>Main outcome measure(s): </strong>Corticospinal excitability was assessed using transcranial magnetic stimulation. Scapular kinematics and muscle activation during arm elevation were also measured.</p><p><strong>Results: </strong>After training, both groups demonstrated an increase in motor-evoked potentials in the LT (P = .004) and increases in scapular upward rotation (P = .03), LT activation (P < .001), and serratus anterior activation (P < .001) during arm elevation. Moreover, the scapular-orientation group showed higher LT activation levels during arm elevation after training than the strengthening group (P = .03).</p><p><strong>Conclusions: </strong>With or without biofeedback and cues, scapula-focused exercises improved scapular control and increased corticospinal excitability. Adding biofeedback and cues for scapular control during exercise helped facilitate greater LT activation, so feedback and cues are recommended during scapula-focused training.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"617-626"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False-Positive Rates, Risk Factors, and Interpretations of the Vestibular/Ocular Motor Screening in Collegiate Athletes.","authors":"Daniel Rosenblum, Catherine Donahue, Haven Higgins, Madison Brna, Jacob Resch","doi":"10.4085/1062-6050-0317.23","DOIUrl":"10.4085/1062-6050-0317.23","url":null,"abstract":"<p><strong>Context: </strong>Biological sex and history of motion sickness are known modifiers associated with a false-positive baseline Vestibular/Ocular Motor Screening (VOMS). However, other factors may be associated with a false-positive VOMS in collegiate athletes.</p><p><strong>Objective: </strong>To identify contributing factors to false-positive VOMS assessments using population-specific criteria. We also critically appraised previously reported interpretation criteria.</p><p><strong>Design: </strong>Descriptive laboratory study.</p><p><strong>Setting: </strong>Single-site collegiate athletic training clinic.</p><p><strong>Patients or other participants: </strong>National Collegiate Athletic Association Division I athletes (n = 462 [41% female]) aged 18.8 ± 1.4 years.</p><p><strong>Main outcome measure(s): </strong>Participants completed the Athlete Sleep Behavior Questionnaire, the 7-Item Generalized Anxiety Index, the Immediate Postconcussion Assessment and Cognitive Testing battery, the Patient Health Questionnaire-9, the Revised Head Injury Scale, the Sensory Organization Test, and the VOMS as part of a multidimensional baseline concussion assessment. Participants were classified into 2 groups based on whether they had a total symptom score of greater than or equal to 8 after VOMS administration, excluding the baseline checklist. We used χ2 and independent t tests to compare group demographics. A binary logistic regression with adjusted odds ratios (ORs) was used to evaluate the influence of sex, corrected vision, attention-deficit/hyperactivity disorder, Immediate Postconcussion Assessment and Cognitive Testing composite scores, concussion history, history of treatment for headache and/or migraine, Generalized Anxiety Index scores, Patient Health Questionnaire-9 scores, Athlete Sleep Behavior Questionnaire scores, and Sensory Organization Test equilibrium scores and somatosensory, visual, and vestibular sensory ratios on false-positive rates.</p><p><strong>Results: </strong>Approximately 9.1% (42 of 462 [30 females]) met criteria for a false-positive VOMS. A significantly greater proportion of females had false positives (χ21 = 18.37, P < .001). Female sex (OR = 2.79; 95% CI = 1.17, 6.65; P = .02) and history of treatment for headache (OR = 4.99; 95% CI = 1.21, 20.59; P = .026) were the only significant predictors of false-positive VOMS. Depending on cutoff interpretation, false-positive rates using our data ranged from 9.1% to 22.5%.</p><p><strong>Conclusions: </strong>Our results support the most recent interpretation guidelines for the VOMS in collegiate athletes due to a low false-positive rate and ease of interpretation. Biological sex and history of headaches should be considered when administering the VOMS in the absence of a baseline.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"600-607"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head Kinematics and Injury Analysis in Elite Bobsleigh Athletes Throughout a World Cup Tour.","authors":"April L McPherson, Travis Anderson, Jonathan T Finnoff, William M Adams","doi":"10.4085/1062-6050-0014.23","DOIUrl":"10.4085/1062-6050-0014.23","url":null,"abstract":"<p><strong>Context: </strong>The neurocognitive health effects of repetitive head impacts have been examined in many sports. However, characterizations of head impacts for sliding-sport athletes are lacking.</p><p><strong>Objective: </strong>To describe head impact kinematics and injury epidemiology in elite athletes during the 2021-2022 Bobsleigh World Cup season.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>On-track training and competitions during the Bobsleigh World Cup season.</p><p><strong>Patients or other participants: </strong>Twelve elite bobsleigh athletes (3 pilots [1 female], 9 push athletes [5 females]; age = 30 ± 5 years; female height and weight = 173 ± 8 cm and 75 ± 5 kg, respectively; male height and weight = 183 ± 5 cm and 101 ± 5 kg, respectively).</p><p><strong>Main outcome measure(s): </strong>Athletes wore an accelerometer-enabled mouthguard to quantify 6-degrees-of-freedom head impact kinematics. Isometric absolute and relative neck strength, number of head acceleration events (HAEs), workload (J), peak linear velocity (m·s-1), peak angular velocity (rad·s-1), peak linear acceleration (g), and peak angular acceleration (rad·s-2) were derived from mouthguard manufacturer algorithms. Linear mixed-effect models tested the effects of sex (male versus female), setting (training versus competition), and position (pilot versus push athlete) on the kinematic variables.</p><p><strong>Results: </strong>A total of 1900 HAEs were recorded over 48 training and 53 competition days. No differences were found between the number of HAEs per run per athlete by sex (incidence rate ratio [IRR] = 0.82, P = .741), setting (IRR = 0.94, P = .325), or position (IRR = 1.64, P = .463). No sex differences were observed for workload (mean ± SD: males = 3.3 ± 2.2 J, females = 3.1 ± 1.9 J; P = .646), peak linear velocity (males = 1.1 ± 0.3 m·s-1, females = 1.1 ± 0.3 m·s-1; P = .706), peak angular velocity (males = 4.2 ± 2.1 rad·s-1, females = 4.7 ± 2.5 rad·s-1; P = .220), peak linear acceleration (male = 12.4 ± 3.9g, females = 11.9 ± 3.5g; P = .772), or peak angular acceleration (males = 610 ± 353 rad·s-2, females = 680 ± 423 rad·s-2; P = .547). Also, no effects of setting or position on any kinematic variables were seen. Male athletes had greater peak neck strength than female athletes for all neck movements, aside from right-side flexion (P = .085), but no sex differences were noted in relative neck strength.</p><p><strong>Conclusions: </strong>We provide a foundational understanding of the repetitive HAEs that occur in bobsleigh athletes. Future authors should determine the effects of repetitive head impacts on neurocognitive function and mental health.</p>","PeriodicalId":54875,"journal":{"name":"Journal of Athletic Training","volume":" ","pages":"584-593"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}