Though there is growing interest in athletic mental health, this interest appears to diminish significantly once an athlete enters athletic retirement. The abrupt transition can precipitate mental health struggles, exacerbated by the lack of adequate preparation for lifestyle after retirement and the attachment of athletic identity to their sport. Consequently, these circumstances may increase symptoms associated with poor mental health, with a specific focus on anxiety. As the athlete retires and moves into different stages of life, research notes that athletes with stronger athletic identities have poorer mental health than those who had weaker athletic identity. While the scrutiny surrounding mental health intensifies as athletes approach the conclusion of their sporting careers, there exists a conspicuous void in research regarding the trajectory of anxiety levels in the years that follow. This critically appraised topic will investigate the interaction between athletic retirement and level of anxiety in elite athletes. Our search yielded four articles that suggest there is moderate consistency and moderate-level evidence supporting the increased level of anxiety levels in elite-level athletes upon athletic retirement. Overall, implementing strategies to ease the transition, pre-retirement, would exponentially aid in this process.

Clinical Scenario: The core is a functional unit connecting the upper and lower extremities consisting of abdominal, back, and hip musculature. A highly functional core is essential within the kinetic chain and aids in injury prevention and rehabilitation. Traditional means of core stability training are performed on a stable surface. An emerging mode of core training is suspension training (ST), which utilizes a movement paired with instability to challenge the core stabilizers and increase motor unit recruitment.The purpose of suspension training is to increase muscle activation in core stabilizer’s, while mimicking functional movements.It was the purpose of this research to determine the impact of ST on core performance. Focused Clinical Question: What parameters of suspension training improve core performance in healthy participants? Summary of Key Findings: Seven studies met inclusion criteria. Search Strategy: Two researchers explored evidence using key search terms: core stability AND suspension training. Evidence at a level 2B on the CEBM or higher published in 2015 or after were included in the analysis of results. Databases searched: EBSCO and PubMed Central. Summary of Key Findings: Suspension training programs should include at a minimum 5 full body exercises for overall improvement in core performance.2,11,12,14,16 Programs lasting three weeks or more showed improvement in overall core performance. 12,14,16 Programs taking place 3 days for a minimum of 45 minutes showed significant improvement 12,14,16 Clinical Bottom Line: The evidence reviewed suggests improvement in core performance can be achieved with the inclusion of ST.1-4,6-8 Core performance may show improvement with little as 9 training sessions but most programming lasted up to 6 months.4, 6-8 Exercises that demonstrated improvements in core performance are chest-press, glute bridges, regular and side plank exercises, pike and tuck exercises, squat and push-up variations, and bicycle crunches.2,11-12,14-16 The duration of a ST session should last a minimum of 30 minutes.6-8 No consensus as to the sets and reps of exercises were concluded. Strength of Recommendation: A grade of B evidence exists that suspension training is an effective intervention to improve core performance while following the minimum identified parameters.

Introduction: Lateral ankle sprains (LAS) are among the most common musculoskeletal injury in physically active populations posing a substantial health burden. Individuals who sustain ankle sprains often have a diminished quality of life with prolonged symptoms, decreased levels of physical activity, and the propensity to develop chronic ankle instability (CAI). It is estimated that up to 40% of people who sustain an initial lateral ankle sprain will develop CAI. Many therapeutic interventions exist to help alleviate symptoms and the feeling of “giving out.” This critically appraised topic will examine multiple interventions that involve using external visual feedback methods to improve the quality of the ankle stability. Methods: The following studies were found doing an online search using PubMed, EBSCOHost, and SPORTDiscus. The articles were selected by being at least a level 2 on the Oxford Centre for Evidence-Based Medicine 2011 levels of evidence. The outcomes must have included postural control, balance or increased ankle stability reported by patient reported outcomes. Results: The 4 articles chosen to be part of the appraisal supported using external visual feedback techniques to improve chronic ankle instability conditions. Four studies found that their method of external visual feedback improved ankle stability in patients with chronic ankle instability. The interventions included stroboscopic glasses, laser visual feedback, and a Biodex balance platform with visual feedback. Conclusions: There is a moderate amount of evidence available to support incorporating external visual feedback techniques in rehabilitation plans. Though these studies proved improvement in ankle stability, there is no defined technique that is suggested over the other. More high quality randomized controlled trial studies should be done to make this recommendation stronger.

Purpose: This study aimed to evaluate the effectiveness of different injection therapies for temporomandibular joint disorders (TMD) and answer the research question: how do botulinum toxin (onabotulinumtoxinA, Botox) and hyaluronic acid (HA) injections affect symptoms of temporomandibular joint disorder (TMD)? Methods: An electronic search of three databases was performed using the search terms “Treatment of TMD or TMJ” and one of the following: 1) “Hyaluronic Acid Injection” or 2) “Intramuscular Botox Injection”. Based on studies done with human patients, the effects of both hyaluronic acid and Botox injections as treatments for TMD were observed and analyzed. Inclusion criteria were: full articles in English, studies conducted in North America or Europe, and articles published from 2015 to the present. Review articles and abstract-only articles were excluded. Results: A total of 20 sources were found and analyzed; eight related to Botox and 12 related to HA. Of the eight Botox articles, six showed a reduction of pain based on the visual analogue scale (VAS) score, and two showed an increased range of motion. Out of the 12 articles related to HA, 12 showed a reduction in pain based on the VAS scores, and 11 showed an increased range of motion. Conclusions: About half of the studies indicate that Botox can reduce pain and increase joint range of motion. Compared to HA, almost all studies showed decreased pain and increased range of motion. This indicates that both treatment methods were associated with successful treatment of TMD symptoms. However, HA was most effective in treating symptoms of TMD.

Introduction: Simulation is commonly used in various formats in healthcare education to teach and evaluate knowledge and skills of students. However, there is limited to no literature in the application or perceptions of online simulations among athletic training programs. The purpose of this study was to explore athletic training students’ perceptions of an online simulation activity to determine if this type of simulation could be appropriately recommended as a means to effectively and efficiently expose students to patient types and circumstances that may not always be experienced by all students in real life. Methods: Individual in-person and video conference interviews were conducted with 15 professional Bachelor’s and professional Master’s degree athletic training students after they completed a semester of an online non-orthopedic patient simulation experience. Results: A thorough analysis of the interviews yielded the major themes of reflections (positive, negative, focus on grades), realism (history taking, improving SOAP notes, problem solving), facilitators (ability to practice, variety of patient scenarios), and barriers (wording of questions, technology issues, limited to specific settings, feedback, time to complete, and feedback). Conclusion: Athletic training students can benefit from completing online simulation activities concurrent with their clinical sequencing. These activities should be highly structured and targeted towards specific clinical learning outcomes. Strong scenario designs within online simulation activities may also give students the ability to practice skills and tasks that are limited in traditional clinical experiences.

Introduction: Concussions are a form of traumatic brain injury (TBI) that cause problems such as headaches, dizziness, dazed or confusion, difficulty remembering or concentrating, but one of the most common complications that can occur from concussions are sleep disturbances/disorders. About 90% of those affected by TBI reported some type of sleep disturbance that include insomnia, frequent wakefulness after onset sleep, poor sleep quality, increased need for sleep, and/or daytime sleepiness that may possibly interfere with daily living activities. Previous evidence suggests that daily blue wavelength light therapy (BLT) may be effective at reducing fatigue and improving sleep in patients recovering from mild TBI. Therefore, the clinical question of this critical appraisal is: Does BLT help improve overall sleep quality and or sleep disturbances in those with concussions? Methods: A literature search was conducted from October to November of 2023 through PubMed, Medline, Google Scholar, and ScienceDirect to identify studies of level 2 evidence or higher investigating the impact of BLT on sleep in concussed patients. Those studies included must have assessed the effectiveness of BLT versus a control to improve sleep quality and or sleep disturbances . The main outcomes were fatigue, daytime sleepiness, sleep quality, and depression. Results: Four relevant studies were included and met the inclusion and exclusion criteria. All of the studies supported the clinical question and identified that BLT intervention helps improve sleep quality and or disturbances in concussed patients. The BLT group feel asleep 57.5 minutes earlier compared to baseline (P =.004) and there was a significant reduction in fatigue in those that were in the BLT group (P < .001). Additionally, a significant reduction of daytime sleepiness in the BLT group was noted (P < .01). Discussion: There is significant evidence that shows that BLT improves sleep quality and or sleep disturbances in those who have sustained a concussion. BLT can alter the circadian rhythm at the time of melatonin release, with just a short amount of 30 or more minutes with the therapy through a six-week period. More healthcare providers should be educated on the effects BLT has on patients with a concussion.

Introduction: Athletic trainers (ATs) have a foundational knowledge in many facets of health, including optimization of wellness. Though ATs may be actively trying to improve their own health, societal pressure can have a large impact on behavior. The purpose of this study was to identify differences between gender and years-certified in diet patterns in ATs. Methods: A cross-sectional survey was distributed to 2500 National Athletic Training Association members, It included a demographics section and five-item researcher-created questions regarding diet. Chi-square tests of independence were used to determine the relationship. Results: Significance was determined for gender and question 2, “Have you ever followed a diet?” x2(1) = 4.96, p < 0.00. Men were more likely to have never followed a weight-loss diet, while women were more likely to have followed one at some point. Additionally, years-certified and question 5, “How long were you able to keep the weight off?” were significant, x2(6) = 22.10, p < 0.00. Those ATs certified 6-10 years were less likely to retain weight loss for greater than 1 year compared to ATs certified 20 years. Conclusions: Results demonstrate that there is a relationship present with dieting with ATs. This may be a result of societal stereotypes related to gender and age. However, improvements at the institutional level to integrate employee wellness programs may assist in promoting healthier behaviors. Additionally, departmental-level supervisors should have greater consideration for work-life balance in ATs. Finally, practicing intuitive eating may assist in creating a better relationship with food.

Introduction: This study assessed the validity of a non-immersive body motion tracking system (TRAZER) as an alternative to using Inertial Measurement Units (IMU)-based motion capture (MyoMotion) for lower extremity kinematic analysis. Methods: Twenty healthy participants (10 females, 10 males) with a mean age of 24.03 years (range: 20-33 years) and a mean BMI of 25.15 kg/m² (range: 18.45-32.23 kg/m²) performed double and single-leg squats. Data Analysis: Kinematic data from TRAZER and MyoMotion IMUs were compared using a mixed two-way ANOVA. Results: No significant differences were observed in knee flexion data across all movements (p > 0.05) and knee abduction during the left single-leg squat (p = 0.855). However, significant differences were noted for knee abduction in the double-leg squats (p < 0.001) and in the right single leg squat (p = 0.03) and ankle dorsiflexion across all movements (p < 0.001). Discussion: These results suggest that while TRAZER is suitable for gross movement assessment, it may not yet serve as a substitute for more precise clinical measurements.

Objective: To establish normative ranges in common performance tests for professional women’s club soccer. Setting:1st division professional women’s soccer club in the United States Participants: Twenty-eight healthy professional women’s soccer players (Age: 27.8 ± 5.1 years; Body Mass: 66.2 ± 6.7 kg). Main Outcome Measures: Season GPS data was analyzed and metrics included minutes, total distance, high speed running, total accelerations, total decelerations, and maximum speed. Statistical analysis was performed to determine differences between positions. Results: Statistically significant differences were found across all metrics in comparison to overall mean. Differences in each metric may be due to a variety of factors including general positional role, team formation and tactics, available space on the pitch, individual player instructions, and quality of opposition. Conclusion:These metrics help professionals (athletic trainers, physical therapists, sports scientists, and physicians) contextualize in season external loads, which may be helpful for general player health and performance, or when a player is new to the league or recovering from long term injury.