Introduction. The Functional Movement Screen (FMS) can be used by clinicians to assess movement and asymmetries in their clients. Understanding FMS composite and subtest scores can be a useful way for clinicians to monitor risk of injury. The purpose of this study was to identify if eccentric hamstring stretching and Nordic hamstring curls could improve movement, FMS scores, and active straight leg raise range of motion. Methods. Participants consisted of a convenience sample of high-school athletes. All subjects participated in the intervention, performing the FMS screen pre- and post-Nordic curls and stretching. Results. This pilot study suggests that the intervention may impact both FMS scores and active straight leg raise range of motion. Discussion. Clinicians can use this information to identify and fix these asymmetries in their athletes, minimizing risk of injury, but more research still needs to be done with larger sample sizes.

Objective/Context: It is crucial for athletic coaches to be proficient in cardiopulmonary resuscitation (CPR) knowledge and skill performance for the health and safety of their athletes. This research aimed to assess CPR knowledge and CPR skill retention five months post-training among athletic coaches. In addition, the study assessed whether the number of years certified in CPR had an association with CPR skill performance scores five months post-training. Design and Setting: As a part of a master’s thesis, this prospective cohort study was performed over a five-month period to align with the research timeline. Participants: The study was conducted among 19 NCAA Division III athletic coaches. Intervention: All participants attended an American Red Cross CPR training immediately followed by an initial knowledge and skills assessment. Five months later, participants completed the same knowledge and skills assessment again. Participants completed a survey to submit the number of years they had been certified in CPR. Main Outcome Measure(s): Paired samples t-test assessed the change in CPR knowledge and skill performance scores (dependent variables) over a five-month period (independent variable). A multiple linear regression analysis assessed whether the number of years certified in CPR (independent variable) had an association with CPR skill performance scores (dependent variable) five months post-training, after controlling for the initial scores. Results: Paired samples t-tests revealed a significant decrease in CPR knowledge performance (t(18)=4.42, pt(18)=0.62, p>0.05) from the initial to five-month follow-up assessments. A multiple linear regression analysis assessed whether the number of years certified in CPR had an association with CPR skill performance scores five months post-training (F(2,16)=3.64, p=0.05) with an R2 of 0.23. After controlling for the initial scores, the multiple linear regression analysis did not reveal a significant association between the number of years certified in CPR and CPR skill retention (t =-1.75, p>0.05). Conclusion: This study does not reflect a decrease in skill performance, but a decrease in knowledge performance thus suggesting that refresher trainings may be beneficial among athletic coaches to improve CPR knowledge and skill retention.

Introduction: Mental health concerns among collegiate students-athletes are exacerbated by poor sleep, and this population experiences elevated risk for irregular sleep patterns and associated sleep disorders. Interventions aimed at early identification of student-athletes experiencing sleep disorders and guiding them to treatment can contribute to improved mental health in this group. The present study’s objective was to clarify risk-factors associated with increased likelihood of sleep disorders and treatment avoidance in student-athletes. Methods: Data were self-reported survey responses related to sleep disorders, from US college/university varsity athletes (n=51,882) completing the 2011-2019 National College Health Assessments (NCHA). Outcomes: The primary outcomes that we examined were feeling exhausted, sleep disorder diagnoses, and the secondary outcome we examined was related treatment. Risk factors: The primary risk factors that we examined were year in school, gender, sexual orientation, race/ethnicity, school type, international student status, history of mental health treatment, receiving information on sleep disorders, and poor sleep impeding academic performance. Results: Over 75% of student-athletes reported feeling exhausted in the past year, whereas 3.8% reported a sleep disorder diagnosis, and only 2.2% received treatment. Gender, sexual orientation, race/ethnicity, school type, and history of mental health treatment were significant predictors of the symptom and of sleep disorder diagnoses, but only history of mental health treatment was a predictor of receiving concurrent sleep disorder treatment. Discussion: While the majority of student-athletes reported feeling exhausted, few were diagnosed with sleep disorders and even fewer received treatment. Several factors affected risk for poor sleep or probability of receiving treatment. Healthcare professionals working with student-athletes can apply this information to screen for, and help treat, individuals at elevated risk for disordered sleep.

Introduction: Collegiate marching artists face severe and prevalent stressors that may contribute to poor mental health and unhealthy habits. The purpose of this study was to determine the effect of sex and years of participation in collegiate marching band on the relationship between eating disorder risk and perceived stress levels. Methods: Marching artists from an NCAA Division I university completed the Eating Disorder Questionnaire-6 (EDEQ-6) and Perceived Stress Scale (PSS-10) to obtain disordered eating behaviors and perceived stress levels, respectively. Spearman rank correlations were used to determine the relationship between PSS-10 scores and global and subscale EDEQ-6 scores, and the relationship between years of participation in collegiate marching band and PSS-10 and EDEQ-6 scores. Mann-Whitney U tests were used to determine effect of sex on PSS-10 and EDEQ-6 scores. Results: Seventy-one marching artists participated. Positive correlations existed between PSS-10 scores and Global EDEQ-6 scores (r=0.31, p=0.01), EDEQ-6 Eating Concern (r=0.32, p=0.01), EDEQ-6 Shape Concern (r=0.31, p=0.01), and EDEQ-6 Weight Concern (r=0.31, p=0.01). There was a significant effect of sex on Global PSS-10 score (p=0.01), EDEQ-6 Shape Concern (p=0.01), and Global EDEQ-6 score (p=0.02). Discussion: Greater perceived stress may be correlated with eating disorder concerns and risk due to changes in coping mechanisms and body dissatisfaction. Females may report higher perceived stress and eating disorder concerns due to emotional-based coping and avoidance strategies. Collegiate marching artists may have a high chance of developing eating or other psychological disorders and future research should use more screening methods to fully understand the risk.

Background: Adolescent sports participation carries an inherent risk of musculoskeletal injury, with an estimated 2 million injuries occurring annually among high school athletes. Navigating the healthcare system to receive appropriate care can be challenging, potentially leading to delayed treatment and poorer outcomes. Athletic trainers (ATs) may play a crucial role in facilitating timely access to specialized care. The objective of this study was to assess the relationship between referral pathways (outreach athletic trainers (OATs), non-outreach athletic trainers (ATs), urgent care (UC), and emergency department (ED)) and appointment adherence while controlling for predisposing, enabling, and need factors. Methods: Using electronic medical record data of 14- to 17-year-old patients seen in a Midwest ambulatory orthopedic surgery department, adjusted logistic regressions were used to assess differences in appointment adherence between referral pathway groups. Results: Patients referred by OATs had significantly lower odds of no-show appointments compared to those referred through UC (aOR 2.90, 95% CI 1.05-8.02), ED (aOR 4.63, 95% CI 1.43-14.94), and non-affiliated ATs (aOR 3.09, 95% CI 1.20-7.95). Race, insurance type, and injury severity were also significant predictors of appointment adherence. Referral pathway was not significantly associated with appointment cancellation rates. Conclusions: Direct access to athletic trainers, especially those integrated within the healthcare system, significantly improves appointment adherence for adolescent patients seeking orthopedic care. Expanding athletic training services and strengthening care coordination efforts may improve access to timely and appropriate orthopedic care for adolescent athletes.

Introduction: Athletic trainers are reasonably expected to evolve their concussion management protocols to better align themselves with the recommendations found in the Amsterdam 2022 Statement. Secondary school athletic trainers may lack the time, training, or resources to actualize these recommendations within their protocols. The purpose of this study was to identify the barriers associated with the implementation of the Amsterdam 2022 Statement recommendations in the secondary school setting. Methods: 89 secondary school ATs (44 males, 45 females) in the NATA District 1 and District 2 regions were provided with an electronic survey using Qualtrics (Qualtrics, Provo, UT), consisting of 6 demographic items (i.e., sex, race/ethnicity, initial entry-level AT education, highest level of education, years of AT experience, and state of current practice) and 11 items related to details on their currently existing concussion management protocols, their familiarity with the new recommendations in the Amsterdam 2022 Statement, and their ability and willingness to update their concussion management protocols as needed. Results: Only about half of the athletic trainers (52.11%) in this study agreed that their current protocols aligned themselves with the latest recommendations despite these recommendations being publicly available to the sports medicine community for over a year at the time of this study. Reported barriers to implementation ranged from a lack of support from relevant stakeholders to a lack of awareness or resources pertaining to the use of the SCAT6 or the new RTS progressions. Conclusion: Organizational administrators can further facilitate the implementation process by providing practical support, especially as it relates to environmental, policy, and financial resources. In addition to the provision of support, continuing education on the topic of SRC needs to remain a focal point in the athletic training profession to reduce the delay that exists between the discovery of well-researched best practice recommendations to the utilization of these recommendations in active practice.

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: Countermovement Jump, Isometric Mid-Thigh Pull, and Nordic Hamstring Curl tests were performed to obtain lower body compound strength, power, and eccentric hamstring strength. Paired-samples t tests were used to determine between-limbs differences for each outcome measure. Results: Jump height had a mean of 28.9 ± 4.2 cm. Peak vertical force (IMTP) had a mean of 1869 ± 262N, with relative peak vertical force (21.6 ± 2.04 N/kg). Nordic hamstring results included L max force (310.0 ± 66.4 N) and R max force (298.9 ± 50.2 N). Conclusion: These metrics help professionals (athletic trainers, physical therapists, sports scientists, and physicians) identify female soccer players whose performance is either inside or outside normative data.

Context: Cannabis has become more prevalent in society and requires greater knowledge on the part of the athletic trainer. Objective. The purpose of this paper is to provide a framework for recognizing how cannabis education can be integrated into the athletic training curriculum utilizing the existing accreditation standards. Background. For decades the use of cannabis has been illegal. Athletes who were caught with cannabis in their system were penalized by their respective e sport organization body. During the past decade in the United States the federal government has moved toward decriminalization and expungement for those found with and arrested for cannabis possession and/or use. Furthermore, many states have maneuvered toward the legalization of marijuana for both medicinal and adult-use (recreational). The United States is not alone in this movement as other countries such as Canada, Israel, United Kingdom, and Australia have made changes toward their cannabis laws. Professional leagues such as Major League Baseball (MLB), the National Football League (NFL), and the NBA have shifted away from a punitive approach toward cannabis use and toward a health and wellness understanding. Additionally, the National Collegiate Athletic Association's (NCAA) Competitive Safeguards and Medical Aspects of Sports Committee has recently announced its intentions to support removing cannabis from the banned drug list. While both acceptance and accessibility of cannabis products has increased, there remains a need to formally educate stakeholders. The cannabis plant is complex and has been associated with numerous proposed therapeutic benefits. There are also known risks and side effects that have been reported with cannabis use that range from cannabinoid hyperemesis syndrome to psychosis. Description. Example plans of action for cannabis curricular integration are provided and associated with respective CAATE standards. Educational Advantage. Athletic trainers must be at the forefront of cannabis knowledge to provide comprehensive and holistic patient care.

The purpose of this study was to determine the effectiveness of a low volume anaerobic training session, electrical stimulation, cupping therapy, and sequential compression for decreasing blood lactate in collegiate pitchers after pitching. Methods: 20 healthy collegiate baseball pitchers consented to participate in this study as a convenience sample (age 21.6 ± 1.90 years; height 175.61 ± 21.41 cm; mass 80.33 ± 8.07 kg). A total of 17 participants completed the study. Subjects were randomly assigned to one of the four interventions and rotated between interventions in one-week increments. The interventions used were a low volume anaerobic training session, electrical stimulation, cupping therapy, and sequential compression. The a low volume anaerobic training session, electrical stimulation, cupping therapy, and sequential compression for decreasing blood lactate in collegiate pitchers after pitching was assessed using a factorial repeated measures ANOVA (with two within-subject factors: treatment and time of measurement). The assumption for sphericity was examined based on Mauchly's test, and where the assumption was violated ANOVA output was assessed based on Greenhouse-Geisse's correction (For epsilon <=0.75) or Huynh-Feldt's correction (for epsilon>0.75). Post-hoc pairwise analyses with Bonferroni corrections were performed for statistically significant findings, with all assessments based on the 5% significance level. Results: While blood lactate levels increased with a low volume anaerobic training session (mean difference = 0.7120 p=0.57), there were statistically significant decreases immediately after the intervention for sequential (mean difference =-2.64, p=0.03) and cupping therapy (mean difference =--2.94, p<0.001). While there was a decrease in blood lactate levels following electrical stimulation, this decrease was not statistically significant (mean difference =-0.712, p=0.26). Conclusion: Blood lactate levels decreased in the period immediately following pitching with the use of cupping and sequential compression. These benefits were not seen with a low volume anaerobic training session and electrical stimulation.