CSM 2019 American Academy of Sports Physical Therapy Poster Presentations (Abstracts SPO1–SPO132)

Abstract

Previous article Full AccessAPTA Combined Sections MeetingCSM 2019 American Academy of Sports Physical Therapy Poster Presentations (Abstracts SPO1–SPO132)AuthorsJournal of Orthopaedic & Sports Physical TherapyPublished Online:December 31, 2018Volume49Issue1PagesCSM154-CSM208https://www.jospt.org/doi/10.2519/jospt.2019.49.1.CSM154SectionsPDFPDF PLUSAbstract ToolsAdd to FavoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinkedInRedditEmail AboutAbstractThese abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, SPO designates an American Academy of Sports Physical Therapy poster presentation.J Orthop Sports Phys Ther 2019;49(1):CSM154–CSM208. doi:10.2519/jospt.2019.49.1.CSM154SPO1The Use of Patient-Reported Outcome Measures in the Pediatric Sports PopulationJamila Aberdeen, Rebecca Frank Burnett, Heather Stewart, Elliot GreenbergCenter for Rehabilitation, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Sports Medicine Physical Therapy, Children's Hospital of Philadelphia, Chalfont, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, PennsylvaniaPURPOSE/HYPOTHESIS: Patient reported outcome measures (PROs) allow physical therapists (PTs) to assess functional limitations, track progress and evaluate outcomes. Although professional organizations have issued recommendations for PRO use, these recommendations are primarily based on adult patients and it is currently unknown which measures are being used within the pediatric population. The purposes of this study are to summarize the current use of PROs among pediatric sports PTs and determine how PRO information is used within clinical care.NUMBER OF SUBJECTS: Seventy-three PTs.MATERIALS/METHODS: An online survey, developed in REDCap, was administered via email to members of the Sports Section Youth Athlete Special Interest Group and the Pediatric Research in Sports Medicine Society, over the course of 8 weeks. The survey consisted of 24 possible questions, taking 3 to 5 minutes to complete. Descriptive statistics and frequency tallies were utilized to analyze the data.RESULTS: There was a wide range of clinical experience with 31% reporting 0 to 5 years (31%), 23% years, 16% 11 to 15 years, and 30% greater than 16 years. The majority (54%) reported working in a hospital based outpatient setting or private practice (24%). Ninety percent (n = 66) reported using PROs with 100% (n = 66) issuing them at the initial visit, 94% (n = 62) at discharge, and 91% (n = 60) monthly. Information obtained from PROs was used to demonstrate effectiveness of treatment (80%, n = 53/66), inform treatment decisions (77%, n = 51/66), satisfy insurance requirements (59%, n = 39/66), goal writing (60%, n = 40/66), and research (36%, n = 24/66). Inadequate time (42%, n = 28/66), difficultly remembering to administer (38%, n = 25/66) and uncertainty which PRO to use (21%, n = 14/66) were frequently reported reasons for not using PROs. The NDI (76%, n = 50/66), Oswestry (76%, n = 50/66), and QuickDASH (68%, n = 45/66) were most frequently used for neck, back and shoulder disorders, respectively. The Lower Extremity Functional Scale (LEFS) was utilized by 74% (n = 49/66) for hip or knee dysfunction, and 26% (n = 16/66) for ankle. Although the LEFS was most common, knee disorders demonstrated more variability in responses with 34/66 (52%) using the IKDC, 23/66 (35%) using the Pedi-IKDC and 13/66 (20%) using the KOOS.CONCLUSIONS: The majority of pediatric sports PTs are using PROs to establish efficacy of treatment, inform clinical decision making and set goals. Inadequate time and indecision with regards to which scale to use, were identified as barriers to use. Knee disorders demonstrated the largest variability in scale use. The majority of region specific scales utilized have not been evaluated within the pediatric population.CLINICAL RELEVANCE: Within today's value-based health care system, there is an increased emphasis on using PROs to demonstrate efficacy and functional improvement. Although many PTs are using PROs, variability in scale choice makes comparative outcomes research difficult. In addition, many of the PROs used are not validated within the pediatric population, which emphasizes the need for psychometric testing and/or scale development specifically for pediatric sports population.SPO2Is Kinesio Taping Effective in Rehabilitation of Athletes with Ankle Injury? A Systematic ReviewMohammed K. Alanazi, Mohammed Alshehri, Shaji J. Kachanathu, Muhammad Alrwaily, Mohammad A. Yabroudi, Aqeel M. AlenaziRehabilitation Science and Physical Therapy, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia; Physical Therapy, Jazan University, Jazan, Saudi Arabia; Department of Physical Therapy, Comprehensive Rehabilitation Center, Arar, Saudi Arabia; Rehabilitation Health Sciences, King Saud University, Riyadh, Saudi Arabia; Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; Division of Physical Therapy, West Virginia University, Morgantown, West VirginiaPURPOSE/HYPOTHESIS: There are many proposed benefits of Kinesio Tape (KT) suggesting that it could enhance ankle rehabilitation, however, its effectiveness is still unclear. Previous research showed conflicting results about KT effectiveness, and most studies lacked high quality. Therefore, there is a need to conduct a systematic review that investigated the effect of KT on athletes with ankle injuries. The purpose of this systematic review is to determine whether using KT improves the clinical outcomes in athletes with ankle injuries.NUMBER OF SUBJECTS: Not applicable.MATERIALS/METHODS: Electronic databases (MEDLINE, CINAHL, and Embase) were searched up to April 26, 2018 using a list of key words related to ankle and Kinesio Tape. Eligible studies were included if they were randomized control trials, examined the effect of KT on ankle sprain rehabilitation in athletes with ankle sprain or ankle instability, and written in English. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the included studies. Two independent reviewers performed data extraction and synthesis with tabulation for each study including purpose, participants' characteristics, intervention, comparison, outcome measures, and findings/conclusion. Disagreements were resolved by a third reviewer. The protocol was registered in the PROSPERO database with the registration number CRD42017078644.RESULTS: Only 4 studies met the eligibility criteria and were included in this systematic review. The quality of the studies ranged between low (3/10) to good (8/10) quality. Three of the included studies found that KT group showed no significant differences in balance, functional performance or swelling when compared to control. Only 1 study found that KT was effective for balance using Balance Error Scoring System when compared to baseline and control.CONCLUSIONS: There is lack of high-quality RCTs investigating the effect of KT in athletes with ankle injuries. Based on the currently available RCTs, it appears that KT does not improve functional performance or swelling in athletes with ankle injuries. However, KT appears to improve balance in the immediate or 48-hour term. Due to the small number of high quality RCTs, further rigorous research is required.CLINICAL RELEVANCE: Clinicians can use KT in athletes with ankle injuries to improve balance. However, using KT to improve functional performance or reduce swelling remains optional as it is not supported by current evidence.SPO3Identifying Differences among Patients with Achilles Tendinopathy Who Present with and without KinesiophobiaNabeel H. Alghamdi, Jennifer A. Zellers, Karin G. SilbernagelPhysical Therapy, University of Delaware, Newark, Delaware; University of Delaware, Newark, DelawarePURPOSE/HYPOTHESIS: Kinesiophobia has been reported to negatively affect outcome in patients with musculoskeletal pain. A recent study reported that 38% of patients with Achilles tendinopathy have a high degree of kinesiophobia. The purpose of this study was to evaluate if there are differences in age, body mass index (BMI), symptom severity and duration, quality of life, and function in patients with Achilles tendinopathy (AT) patients who present with and without kinesiophobia.NUMBER OF SUBJECTS: One hundred five patients (48 female; mean ± SD age, 52 ± 16.07 years) with a verified diagnosis of Achilles tendinopathy.MATERIALS/METHODS: Based on the Tampa Scale of Kinesiophobia (TSK), patients were subgrouped into having kinesiophobia if TSK greater than 37 (n = 61, 29 female) and without kinesiophobia if 37 or less (n = 44, 19 female). Symptom severity, injury location (midportion and insertional), pain catastrophizing, quality of life, and physical activity level were assessed using Victorian Institute of Sport Assessment-Achilles (VISA-A), Pain Catastrophizing Scale (PCS), Foot and Ankle Outcome Score-Quality of Life (FAOS-QOL), and Physical Activity Scale (PAS) questionnaires. Total work and limb symmetrical index (LSI = [injured/uninjured] × 100) of heel-rise test were used to evaluate calf muscle function. The comparisons between the groups were analyzed using independent t test or Mann-Whitney U test, and Fisher exact test.RESULTS: Fifty-eight percent (61/105) of patients with Achilles tendinopathy were considered to have kinesiophobia. No significant differences in injury location, was observed between groups (P = .578). Patients with kinesiophobia were significantly (P<.05) older (median, 58 years; range, 18–79 years versus 53 years; range, 20–79 years), had higher BMI (29.48 ± 7.45 kg/m2 versus 24.79 ± 5.92 kg/m2), longer duration of symptoms (28.9 ± 56.9 versus 13.79 ± 19.99), higher PCS score (10.4 ± 7.5 versus 6.5 ± 5.1). In addition patients with kinesiophobia reported a significantly (P<.05) greater degree of symptoms (VISA-A, 45.4 ± 20.5 versus 64.47 ± 18.8; FAOS-QOL, 43.75 [0–87.5] versus 56.3 [31.3–87.5]) and lower calf muscle function (LSI, 79% versus 87%).CONCLUSIONS: The kinesiophobia group demonstrated greater duration of symptoms, higher degree of symptom severity, poorer quality of life and lower physical activity level than group without kinesiophobia.CLINICAL RELEVANCE: Kinesiophobia may be a factor that affects outcomes in patients with Achilles tendinopathy, and might need to be addressed during treatment.SPO4The Effect of Load Carriage and Recovery on Shoulder Neuromuscular FunctionMuataz R. Almaddah, Arthur J. Nitz, John Abt, Babak Bazrgari, Timothy L. UhlRehabilitation Sciences, University of Kentucky, Lexington, Kentucky; Biomedical Engineering, University of Kentucky, Lexington, KentuckyPURPOSE/HYPOTHESIS: Heavy backpack walking stresses the shoulder complex which may lead to neuromuscular impairments arising from nerve compression of the brachial plexus. This study examined the effect of a 2-hour 20.5-kg load carriage task on shoulder strength, endurance, and nerve amplitude as well as the needed recovery time. We hypothesized: that all studied shoulder neuromuscular functions would deteriorate after 2 hours of loaded walking and recover to baseline values within 30 minutes after the task.NUMBER OF SUBJECTS: Thirteen.MATERIALS/METHODS: Thirteen healthy participants, 3 females and 10 males (mean ± SD age, 27 ± 5.3 years; weight, 82.5 ± 11.8 kg; height, 180 ± 5.6 cm). Subjects were excluded who had recent shoulder injuries, as were those with previous medical and neurological problems. Data were collected from the right shoulder at baseline, immediately post walking task and at subsequent intervals over the next 30 minutes during recovery. The load carriage task was administered in clinical lab settings, in which subjects walked for 2 hours on a treadmill with no inclination carrying a 20.5-kg backpack at a velocity of (5.5–7 km/h). Outcome measures were (1) Axillary nerve amplitudes recorded from Erb's point stimulation every 5 minutes during the 30-minute recovery. Maximal isometric strength and endurance were measured simultaneous during a maximal 30-second effort with shoulder abducted at 90° and arm externally rotated. Procedure was repeated every 10 minutes during recovery. (2) Strength, measured as average torque (Nm) generated between 2 and 5 seconds. (3) Endurance, measured as angular impulse (Nm·s) generated over the entire 30-second effort. All dependent measures demonstrated good reliability during pilot testing. Data were analyzed with Friedman's nonparametric repeated measures with 8 and 5 time points for nerve amplitudes and strength assessments respectively. Subsequent Wilcoxon signed-rank test was used if differences were found, to determine when baseline values were recovered. Due to multiple comparison adjusted P values for 7 comparisons (P≤.007) and 4 comparisons (P≤.0125) are considered significant.RESULTS: Nerve amplitude was reduced immediately post load carriage task to 6.7 (IQR, 5.2–7.8 mV) compared to baseline (7.5; IQR, 7.15–9.6 mV; P = .001) but recovered to baseline value at the 15-minute time point. Strength was reduced immediately post load carriage task to 45 (IQR, 34.7–49.9 Nm) compared to baseline (52.5; IQR, 45.5–64 Nm; P = .002) but recovered at the 30-minute time point. Endurance was reduced immediately posttask to 1262 (IQR, 1014–1411 Nm) compared to baseline (1428; IQR, 1224–1802 Nm; P = .011) but did not recover in the next 30 minutes.CONCLUSIONS: Walking with a heavy backpack reduced shoulder strength, endurance and motor nerve amplitude immediately post walking and requires a minimum of 15 minutes for shoulder neuromuscular function to start recovery.CLINICAL RELEVANCE: Reduction in muscle function may increase the risk of shoulder injury and lead to deteriorating performance during overhead tasks following load carriage if adequate recovery is not allowed.SPO5Monitoring Gait Smoothness Following Anterior Cruciate Ligament Reconstruction Using Accelerometry: A Prospective Longitudinal StudyYasir Alshehri, Scott Mullen, Wen Liu, Neena K. Sharma, Milind Phadnis, Marcio SantosPhysical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas; Biostatistics, University of Kansas Medical Center, Kansas City, Kansas; Sports Medicine and Performance Center, University of Kansas Medical Center, Kansas City, KansasPURPOSE/HYPOTHESIS: Persistent gait deficits following anterior cruciate ligament reconstruction (ACLR) are associated with the development of knee osteoarthritis. However, standard biomechanical gait analysis systems are expensive and time consuming. Therefore, developing an inexpensive, easily administered objective gait assessment tool may help clinicians to better monitor gait abnormality on a regular basis. Measurement of lower trunk accelerations during gait have been shown to provide useful information about gait smoothness, which helped to differentiate normal from abnormal gait patterns. This study aimed to monitor and compare changes in gait smoothness over time between individuals with ACLR and uninjured healthy subjects using a single accelerometer on the lower trunk.NUMBER OF SUBJECTS: Fifteen ACLR participants (mean ± SD age, 26.23 ± 7.83 years) and 15 healthy controls (age, 27.20 ± 4.89 years).MATERIALS/METHODS: Evaluation of participants took place in clinical settings at 2, 4, and 6 months postsurgery. A wireless tri-axial accelerometer was attached to subjects' lumbar spine (L4-L3). Participants were instructed to walk, walk fast (at 2, 4, and 6 months), and run (at 4 and 6 months) at self-selected speeds along a 12-m straight walkway. Gait smoothness was quantified using jerk (ie, the time derivative of acceleration) normalized by step distance and step duration. The lower is the normalized jerk (NJ) value, the higher is the gait smoothness. Paired t tests were used to compare 2 to 4 months postsurgery NJ in ACLR participants and independent t tests were used to assess differences in NJ between groups. At 6 months, the data of only 4 subjects were collected and processed. The results are reported below but they were not included in the current statistical analysis.RESULTS: When compared to 4 months visit and controls, ACLR participants at 2 months visit showed significant higher NJ values in the vertical, mediolateral, and anteroposterior directions during walking (P<.01 for all directions) and walking fast (P<.01 for all directions). At 4 months visit, ACLR individuals still had significant higher NJ for all directions during walking (P<.01), walking fast (P<.01), and running (P<.001) compared to controls. At 6 months visit, the 4 ACLR individuals showed improvement in gait smoothness over time for all gait tasks, but they still had higher NJ values when compared to controls.CONCLUSIONS: Gait smoothness of ACLR individuals improved across time, but did not reach the normal smoothness level of healthy controls 4 months postsurgery. There is a tendency for ACLR individuals not to reach the normal gait smoothness level even at 6 months after surgery, especially during running. Future studies should examine gait smoothness in a longer period and its association with functional measures.CLINICAL RELEVANCE: Movement smoothness measured by a single accelerometer is an inexpensive and practical approach to detect and monitor gait deficits in individuals post ACLR in clinical settings during rehabilitation.SPO6Utilizing the Classification and Regression Tree Analysis to Determine the Relationship Between the Landing Error Scoring System, Functional Tests, and Clinical Measures in the Professional Basketball PlayerPhilip Anloague, Donald Strack, Carl Eaton, Joshua Corbeil, Steven Short, Bailey Cruse, Alex Fogt, Matt Amicone, Michael HornakPhysical Therapy, University of Dayton, Dayton, Ohio; Oklahoma City Thunder, Oklahoma City, Oklahoma; Indiana Pacers, Indianapolis, Indiana; Sports Medicine, Indiana Pacers, Indianapolis, Indiana; Physical Therapy, Denver Nuggets, Denver, ColoradoPURPOSE/HYPOTHESIS: Background: lower extremity injuries occur at a relatively high rate in professional basketball. Evidence suggests that the Landing Error Scoring System (LESS) may be predictive of injury. The investigation of interactions among nonlinear factors may help further the understanding of the interdependence of various measures and poor performance on the LESS in professional basketball players. Purpose: to investigate predictors of poor performance on the LESS. We hypothesize that high LESS scores will be predicted by select clinical measures and components of common functional tests.NUMBER OF SUBJECTS: Forty-seven professional basketball players.MATERIALS/METHODS: Measurements were completed as part of preseason mobility screening prior to the 2015–16 and 2016–17 NBA seasons. Classification and Regression Tree analysis (CART) were used to investigate nonlinear interactions among predictors and their influence on players who scored greater than 7 on the LESS test.RESULTS: Of the 47 total number of players included in this study, 11 players scored 7 or greater on the LESS test and 36 scored between lower than 7. Pruning resulted in 3 splits (R2 = 0.430) demonstrating that LESS score was predicted by asymmetry in the YBT anterior reach (greater than 4 cm), 90°/90° hamstring score greater than 45.11°, and 90°/90° hamstring score less than 30.03°. The predictive model, after pruning, classified 5 of the 11 players with high LESS scores and 17 of the 36 players with moderate to low LESS scores. The area under the ROC curve was 0.8687 which suggests that classification of players using this model was not random.CONCLUSIONS: Performance on the LESS has been linked with injury. CART analysis captured nonlinear and complex interactions between clinical and functional measures suggesting that lower extremity biomechanical factors may be associated with performance on the LESS.CLINICAL RELEVANCE: The LESS test has been shown to be predictive of injury. Identifying which functional tests and specific clinical measures may be linked with poor performance on this test may aide clinicians in determining the appropriate interventions that may be associated with improved scores and minimize risk of injury.SPO7The Association Between Arch Type and Performance on the Y Balance Test in Professional Basketball PlayersPhilip Anloague, Donald Strack, Carl Eaton, Joshua Corbeil, Steven Short, Kyle Walker, Ayami Sato, Jonathan BurtoftPhysical Therapy, University of Dayton, Dayton, Ohio; Oklahoma City Thunder, Oklahoma City, Oklahoma; Indiana Pacers, Indianapolis, Indiana; Sports Medicine, Indiana Pacers, Indianapolis, Indiana; Physical Therapy, Denver Nuggets, Denver, ColoradoPURPOSE/HYPOTHESIS: Background lower extremity injury is common in professional basketball. The Y Balance Test (YBT) is a widely used screening tool for injury predisposition. Arch mechanics are often cited as a related factor for balance and injury and the Arch Height Index Measurement System (AHIMS) is a reliable and valid system for classifying arch type. Purpose: to investigate the association between arch type and YBT performance in professional basketball players. We hypothesize that performance on the YBT is associated with a cavus and/or planus arch type.NUMBER OF SUBJECTS: Sixty professional basketball players (120 arches).MATERIALS/METHODS: YBT and AHI Measurements were completed as part of preseason mobility screening prior to the 2015–16 and 2016–17 NBA seasons. AHI measures were calculated and descriptive statistics were run to determine arch type based 1.0 SD above (cavus) and below (planus) the mean. YBT composite scores were documented and individuals who scored greater than 4 cm between sides for the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions were identified. Frequency tables were compiled to determine the association between foot type and YBT performance.RESULTS: The mean ± SD AHI was 0.3041 ± 0.0319. Of the 120 arches, 18 (15%) were planus, 84 (70%) were normal, and 18 (15%) were cavus, relatively speaking. On the YBT, asymmetry (greater than 4 cm difference between left and right) was found in the ANT (48), PM (68), and PL (72). It was noted that 72% of the planus arches performed poorly on the YBT PM and 83% of the planus arches presented with a YBT composite score less than 94.CONCLUSIONS: These findings suggest that foot type may influence performance on the YBT in specific directions and in composite score.CLINICAL RELEVANCE: Balance is influenced by many factors. Understanding the arch type in athletes may help inform clinicians on how best to intervene with individuals who present with poor balance performance.SPO8Changes in Upper Extremity Musculoskeletal Characteristics Associated with 1 Competitive Season of Collegiate SwimmingMeghan P. Babcock, Melissa C. Minniti, Aleah Kirsch, Carolyn Killelea, Robert Zarzour, Timothy C. Sell, Mallory S. FahertyPhysical Therapy, Duke University, Durham, North Carolina; Athletic Medicine, Duke University, Durham, North Carolina; Department of Orthopaedic Surgery, Duke University, Durham, North CarolinaPURPOSE/HYPOTHESIS: Upper extremity (UE) injuries are common in swimmers throughout the course of a competitive collegiate season. The measurement of UE musculoskeletal characteristics preseason and postseason may help identify these effects on an athlete's risk for injury. Therefore, the purpose of this study was to determine if a season of competition affects UE posture, range of motion, flexibility, and strength.NUMBER OF SUBJECTS: Twenty-four NCAA Division I collegiate swimmers participated (mean ± SD age, 19.3 ± 0.9 years; height, 179.2 ± 8.8 cm; weight, 75.8 ± 7.5 kg).MATERIALS/METHODS: All testing occurred within 4 weeks before and after a 24-week competitive collegiate swim season. Forward head posture (FHP) and forward shoulder posture (FSP) were assessed bilaterally with a lateral photograph and ImageJ software. Glenohumeral internal/external rotation, posterior shoulder tightness (PST), and pectoralis minor length (PML) were assessed bilaterally. Isometric strength of the upper/middle/lower trapezius (UTS/MTS/LTS), rhomboids, internal rotation (IRS) external rotation (ERS), pectoralis major, serratus anterior, and supraspinatus (SSS) were assessed bilaterally with a handheld dynamometer. A paired samples t test or Wilcoxon Signed-Rank test was used after the data were assessed for normality. Significance was set at P<.05.RESULTS: Nondominant (NDom) FSP (difference, 6.7; P<.001) improved. Bilateral PST improved (Dom difference, 4.1; P = .003 and NDom difference, 4.3; P = .001). PML decreased bilaterally (Dom difference, 6.8; P = .001 and NDom difference, 7.7; P<.001). Dom and NDom LTS decreased (Dom difference, 1.7; P = .003 and NDom difference, 2.1; P = .001). NDom IRS decreased (difference, 2.3; P = .007). Dom and NDom ERS decreased (Dom difference, 1.7; P = .038 and NDom difference, 1.5; P = .020). Dom and NDom SSS decreased (Dom difference, 0.9; P = .037 and NDom difference, 1.4; P = .002).CONCLUSIONS: After completion of a competitive collegiate swimming season, UE strength decreased while posture, range of motion, and flexibility improved. Athletes experience a gradual increase in intensity and volume of training during the training. Typically, the last 3 to 5 weeks of the season, training will decrease in volume and increase intensity to maximize performance going into the Championship Season. Furthermore, the high volume of competition in the final portion of the season could contribute to increased range of motion and flexibility. The changes in PST could also contribute to the observed changes in posture in which less FSP was observed.CLINICAL RELEVANCE: Changes in posture and decreased rotator cuff isometric strength are known risk factors for injury in swimmers; these musculoskeletal characteristics are seen to be affected by a competitive season of swimming. Changes in FHP and FSP may lead to changes in biomechanics and a higher risk of injury towards the end of the competitive collegiate swimming season. In order to address these risk factors, injury prevention programs should be implemented that target increasing and maintaining rotator cuff strength while incorporating posterior shoulder flexibility and postural correction exercises.SPO9What Effect Does Spatiotemporal Parameter Manipulation Have on Running Economy?Mark Balzotti, Teresa Drew, Danielle Kreda, Morgan Mowers, Evan Torkel, Anthony R. Tripodi, Dennis Waite, Allison BrownPhysical Therapy, Rutgers, The State University of New Jersey, Newark, New JerseyPURPOSE/HYPOTHESIS: Manipulation of spatiotemporal parameters has been proposed to positively influence repetitive kinematic and kinetic behaviors known to associate with running injury yet may have a negative effect on running economy (RE). The purpose of this of this review is to examine the effect that spatiotemporal parameter manipulation has on RE.NUMBER OF SUBJECTS: Five articles were selected for this literature review.MATERIALS/METHODS: PubMed and Ovid-MEDLINE databases were searched using the search terms: “Stride Rate” AND “Running Economy,” “Step Rate” OR “Cadence” OR “Stride Frequency” and “Running Economy,” “Step Rate” and “VO2,” ( (Running) AND (Efficiency OR Economy)) AND ( (Step OR Stride) AND (Frequency OR Rate)), (Self-optimization) AND (running), (Stride* OR Cadence OR Step L* OR Step R*) AND (Oxygen Up* OR Oxygen Con* OR VO2* OR Running Eco* OR Running Eff*). Studies investigating the effect of stride length (SL) and stride frequency (SF) manipulation on RE were included if subjects ran 15 miles or more per week and were 18 to 50 years of age. Studies were excluded if subjects had a history of musculoskeletal injury in the past 3 months, history of lower extremity surgery within the past 6 months, or if published prior to 2005. Twelve articles were initially extracted, from which 7 were excluded due to failing to directly compare SF or SL manipulation to RE.RESULTS: The following 5 articles met the inclusion criteria: Connick et al (2014), de Ruiter et al (2014), Hunter et al (2017), Hunter et al (2007), and Lieberman et al (2015). The included studies manipulated subjects' SF by increasing or decreasing their SF relative to their preferred stride frequency (PSF) in order to evaluate the impact of manipulation on RE. The studies collectively found that PSF and preferred stride length (PSL) are the most economical, suggesting that runners tend to naturally self-optimize with a high level of accuracy. Additionally, multiple studies found a curvilinear relationship between SF and RE, with an SF of approximately 85 strides per minute being optimal.CONCLUSIONS: While clinicians often use spatiotemporal manipulation as a method of treating injured runners, current evidence suggests that any manipulation may lead to a decrease in RE. Given that multiple studies demonstrated runners' self-selected SF's being at or close to optimal SF, changes to these self-selected frequencies should be recognized for their potential to cause detrimental changes to a runner's RE.CLINICAL RELEVANCE: Current trends in research suggest that spatiotemporal parameter manipulation can decrease the lower body forces associated with running, which may be protective against lower extremity injury. However, because spatiotemporal parameter manipulation can negatively impact VO2max and consequently RE, clinicians should take caution when considering the use of spatiotemporal parameter manipulation as an intervention.SPO10A Complicated Case of Compartment Syndrome and Interprofessional CollaborationReid E. Becker, Gabriella Camacho, Nathaniel Head, Courtney Magoto, Rose L. Smith, Kari DunningRehabilitation Sciences, E