Sports Medicine Professionals Research Articles

Can Lateral Weight Shift Be Reliably Observed During The Functional Movement Screen Deep Squat?

Bilateral asymmetries of lower extremity strength have been reported in the literature and their existence may influence performance and increase injury risk. Although functional movement screen (FMS) deep squat (DS) scoring criteria does not include lateral weight shift, previous reports have demonstrated weight distribution asymmetry in both adolescent soccer players and active, adult participants. Lateral weight shifts are often observed in FMS DS, however, no previous report has determined the ability to validly and reliably observe this characteristic. PURPOSE: To determine if lateral weight shift could be reliably rated when compared to bilateral vertical ground reaction forces (vGRF) during FMS DS. METHODS: Thirty-seven active subjects (19 F, 18 M, 20.8 ± 1.4 yrs) granted informed consent and performed three FMS DS trials on two force plates (1200 Hz) while video (30 Hz) captured frontal, sagittal plane views. A Matlab script processed vGRF data with a lowpass filter and computed limb symmetry index (LSI) during the descent phase and full squat position. Two sports medicine professionals independently viewed videos and rated asymmetry using a novel, web-based sliding scale scoring rubric. Raters scored trials from 0-100 in interval increments of 1 with 50 representing a symmetric DS. Scores were averaged across trials and intraclass correlations (ICCs) were performed to determine inter-rater reliability. Receiver operator characteristics (ROC) curves determined cut-off scores that maximized sensitivity and specificity of determining substantial weight shifts (>10%, >15%). RESULTS: Subjects demonstrated average LSI of 9.8 ± 6.9% with eighteen subjects demonstrating LSI > 10%. Raters were able to determine correct shift direction (L, R) in 57.7% of all subjects and 68.1% for those with average LSI > 10%. Inter-rater reliability was poor (ICC=0.41, 95% CI=-0.07, 0.69). All ROC curve areas were < 0.61 indicating the scoring rubric failed to accurately diagnose LSI > 10% or >15%. CONCLUSIONS: Although active, adult subjects demonstrated lateral weight shift during FMS DS, raters weren’t able to reliably observe this shift even in severe cases. Clinicians should demonstrate caution when prescribing interventions based on visual observance of lateral weight shift during the FMS DS.

Mapping ethical positions with regard to a coach’s decision to select (or not) an injured athlete

The study’s objective was to map ethical positions with regard to the way in which 219 participants (45 non-athletes, 91 amateur athletes, 28 professional athletes, 17 amateur coaches, 8 professional coaches, and 30 physiotherapists) used various informational cues (an athlete’s indispensability for the team, the importance of the competition, the opinion given by sports medicine professionals, and the injured athlete’s attitude) to judge the acceptability of a coach’s decision to select (or not) an injured athlete just before a competition. The participants specified their judgment of acceptability in 16 scenarios created by combining these information cues under two conditions (selection and non-selection). The data were analyzed using cluster analyses, analyses of variance, and chi-squared tests. We found four clusters. Not selecting an injured athlete was always judged to be acceptable. The four clusters differed in terms of the type of role in sport and the level of acceptability of selecting an injured athlete. A coach’s decision with regard to an athlete’s health may be judged differently, according to the rater’s profile. Enabling athletes to compete while injured might violate ethical principles. Coaches and medical staff should also be aware of and understand their legal responsibilities.

Progressive Exercise Strategies to Mitigate Shoulder Injuries Among Weight-Training Participants

ABSTRACT Nontraumatic shoulder disorders are prevalent among weight-training participants as a result of training patterns as well as adaptive shoulder joint and muscle characteristics. This article presents a progressive approach to exercises designed to mitigate well-known joint and muscle characteristics that have been associated with shoulder disorders. Using a progressive evidence-based model, practical applications are presented that will guide sports medicine and strength training professionals in their ability to provide an evidence-informed upper extremity weight-training program for both patients and clients.

Collegiate Athletic Trainers' Experiences With External Pressures Faced During Decision Making.

Conflict is prevalent between sports medicine professionals and coaching staffs regarding return-to-play decisions for athletes after injury in the National Collegiate Athletic Association (NCAA) Division I setting. The firsthand experiences of athletic trainers (ATs) regarding such conflict have not been fully investigated. To better understand the outside pressures ATs face when making medical decisions regarding patient care and return to play after injury in the NCAA Division I Football Bowl Subdivision (FBS) setting. Qualitative study. Semistructured one-on-one telephone interviews. Nine ATs (4 men, 5 women; age = 31 ± 8 years [range = 24-48 years]; years certified = 9 ± 8). Interviews were audio recorded and later transcribed. Thematic analysis was completed phenomenologically. Researcher triangulation, peer review, and member checks were used to establish trustworthiness. Two major themes emerged from the qualitative analysis: (1) pressure is an expected component of the Division I FBS AT role, and (2) strategies can be implemented to mitigate the negative effects of pressure. Three subthemes supported the second major theme: (1) ensuring ongoing and frequent communication with stakeholders about an injured athlete's status and anticipated timeline for return to play, (2) providing a rationale to coaches or administrations to foster an understanding of why specific medical decisions are being made, and (3) establishing positive relationships with coaches, athletes, and administrations. External pressure regarding medical decisions was an anticipated occurrence for our sample. Such pressure was described as a natural part of the position, not negative but rather a product of the culture and environment of the Division I FBS setting. Athletic trainers who frequently face pressure from coaches and administration should use the aforementioned strategies to improve the workplace dynamic and foster an environment that focuses on patient-centered care.

Rates and Correlates of Mental Health Symptoms in Currently Competing Elite Athletes from the Australian National High-Performance Sports System

Elite athletes are at risk of mental ill-health via exposure to sports-related stressors and the overlap in competitive playing years with the peak age of onset of mental ill-health. Despite this risk, there is a paucity of robust empirical data on mental health symptoms in currently competing athletes. The purpose of this study was to assess the prevalence and correlates of mental health symptoms in a representative, national sample of elite athletes and to compare rates against published community norms. A cross-sectional, anonymous, online survey was administered to all categorised (e.g. highest level) athletes, aged 17years and older, registered with the Australian Institute of Sport (n = 1566). Main outcomes were self-reported scores on validated measures of psychological distress, probable 'caseness' (i.e. the experience of mental health symptoms that would usually warrant a need for care by a health professional), risky alcohol consumption, body weight and shape dissatisfaction, self-esteem, life satisfaction and problem gambling. Correlates of outcomes included demographic, individual vulnerability (e.g. social support, coping style) and sport-related variables. The participation rate was 51.7% (n = 810), of whom 749 athletes completed most or all outcomes measures. Compared to published community norms, athletes were significantly more likely to report 'high to very high' psychological distress (9.5% vs 17.7%, respectively) and to meet the threshold for 'probable caseness' (19% vs 35%). In contrast, athletes reported significantly lower rates of risky alcohol consumption, problem gambling and body dissatisfaction compared to community norms, and conversely higher self-esteem and life satisfaction. The adjusted odds of psychological distress and caseness were increased in athletes who reported prior treatment for a mental health problem (OR = 1.28-2.84), inadequate social support (OR = - 2.59 to 0.37) and more recent adverse life events (OR = 0.61-1.32); while, the odds of risky alcohol consumption were lower in female athletes (OR = - 1.36) and para-athletes (OR = - 1.20). In a representative and national sample of currently competing elite athletes, inclusive of gender and para-status, psychological distress and probable caseness were elevated relative to community norms, although other aspects of functioning were as good as, if not better than, community peers. Sports medicine and mental health professionals working with elite athletes should screen for psychological distress in athletes who may otherwise appear to be well-functioning, to provide timely, optimal treatment.

Coach, sports medicine, and parent influence on concussion care seeking intentions and behaviors in collegiate student-athletes

Sport is a socio-ecological framework where student-athletes are part of a larger community of stakeholders, including coaches, sports medicine professionals (SMPs), and parents. This framework may hold influence over whether student-athletes seek care for a concussion. We aimed to describe, compare, and determine the influence of stakeholder concussion knowledge, attitudes, and concussion scenario responses. We recruited a sample of 477 student-athletes and their 27 coaches (response rate=46.6%), 24 SMPs (48.7%), and 31 parents/guardians (4.8%). Stakeholder surveys assessed their concussion knowledge, attitudes toward care seeking, and concussion scenario responses. Surveys administered to student-athletes assessed their concussion care seeking intentions and behaviors. Kruskal-Wallis tests were used to compare responses between stakeholder groups and to determine the differences in student-athlete intentions and behaviors (alpha=0.05). SMPs had significantly better knowledge (p<0.001) and concussion scenario responses (p<0.001) compared to both coaches and parents. SMPs also had significantly better attitudes compared to parents, but not coaches (p=0.038). Coach concussion scenario responses (p=0.044) and SMP knowledge positively influenced student-athletes' concussion care seeking intentions (p=0.049). Parent responses were not associated with their child's concussion care seeking intentions and behaviors. The gap in coach and parent concussion knowledge and concussion scenario response relative to SMPs is a preliminary target for stakeholder concussion education and supports the current sports medicine model where SMPs primarily disseminate concussion education. Stakeholders, specifically coaches and SMPs, do hold influence over collegiate athlete concussion care seeking intentions and behaviors. Stakeholders should be addressed within educational efforts aimed at student-athletes and should also complete stakeholder-specific concussion education.

THE ASSOCIATION BETWEEN THE FUNCTIONAL MOVEMENT SCREENTM, Y-BALANCE TEST, AND PHYSICAL PERFORMANCE TESTS IN MALE AND FEMALE HIGH SCHOOL ATHLETES

Poor balance, lack of neuromuscular control, and movement ability are predictors of performance and injury risk in sports and physical activity participation. The Functional Movement Screen™ (FMS™) and lower quarter Y-Balance Test (YBT) have been used by clinicians to evaluate balance, functional symmetry, and static and dynamic movement patterns, yet little information exists regarding the relationship between the FMS™, YBT, and physical performance tests (e.g. vertical jump) within the high school population. The purpose of this study was to investigate the relationship between the FMSTM, dynamic balance as measured by the YBT and physical performance tests (standing long jump, vertical jump, Pro Agility Test) in male and female high school athletes. Cohort study. Fifty-six high school athletes (28 females, 28 males; mean age 16.4 ± 0.1) who participated in organized team sports were tested. Participants performed the FMS™, YBT, and three physical performance tests (standing long jump, vertical jump, Pro Agility Test). Females outperformed males on the FMS™ and YBT, while males outperformed females on the performance tests. In both sexes, the composite FMSTM score was positively correlated with the left and composite YBT scores. Agility was negatively correlated with composite FMSTM in males (p < 0.05) and the left and composite YBT in females (p < 0.05). The FMSTM and YBT may evaluate similar underlying constructs in high school athletes, such as dynamic balance and lower extremity power. The results of this study demonstrate the utility of the FMS and YBT to relate multiple constructs of muscular power to an individual's ability to balance. Furthermore, establishing the need for the utilization and application of multiple field-based tests by sports medicine professionals and strength and conditioning coaches when evaluating an athlete's movement and physical performance capabilities. Utilization of multiple field-based tests may provide the first step for the development of injury prevention strategies and long-term athlete development programs. 2b.

Stem Cell Injections for Musculoskeletal Pathology: An Overview for the Sports Medicine Professional

ABSTRACT Stem cell injections are a promising nonsurgical biological intervention that seek to augment the body's self-healing capacity. Owing to a growing range of clinical indications and excellent safety profile, sports medicine professionals are likely to encounter individuals who received or are considering stem cell injections. This column provides an overview of stem cell injection procedures, biological mechanisms, and evidence underpinning the potential utility of these interventions for musculoskeletal disorders.

Vitamin D Practice Patterns in National Collegiate Athletic Association Division I Collegiate Athletics Programs.

Vitamin D status has been associated with performance, health, and well-being in athletic populations. The measurement of vitamin D status via 25-hydroxyvitamin D [25(OH)D] testing has increased in the general population, as has vitamin D supplement use. It is unclear if similar patterns exist in collegiate athletics programs. To describe the clinical care related to the prevention, evaluation, and treatment of vitamin D deficiency and insufficiency used by sports medicine providers with National Collegiate Athletic Association (NCAA) Division I programs. Cross-sectional study. Population-based online survey. All NCAA Division I head athletic trainers. Information related to 25(OH)D testing, vitamin D supplementation, vitamin D-related protocols and procedures, and characteristics of athletic programs and participants. We received 249 responses (72% response rate). Use of 25(OH)D testing was described by 68% of participants, with the most common indicators being health status/history (78%) and injury status/history (74%). One-fifth of participants stated that vitamin D testing was conducted as screening (without a specific cause or indication). Target blood vitamin D concentrations were highly variable. A range of 8 to 1660 annual vitamin D blood tests was reported at a cost of <$50 (8%), $51 to $100 (51%), $101 to $150 (20%), and >$150 (10%). Forty-two percent of programs covered the cost of vitamin D supplements. More than half of the participants indicated that vitamin D blood testing and supplements were not a good use of program funds. In comparison with Football Championship Subdivision programs, Football Bowl Subdivision programs were more likely to conduct vitamin D testing and pay for vitamin D supplements, and their providers were more likely to believe that testing and supplements were a good use of program funds. A great deal of variability was present in vitamin D-related clinical practices among NCAA Division I athletics programs, which reflects existing contradictions and uncertainty in research, recommendations, and guidelines. Knowledge of current practice patterns is important in evaluating and establishing best practices, policies, and procedures for sports medicine and sports nutrition professionals in the collegiate setting.

Relationship between cricket participation, health and well-being: scoping review protocol

IntroductionCricket is a popular sport played by 2.5 billion people of all ages and abilities. However, cricket participation is decreasing in the UK, despite an increased focus of governments on...

I spy with my little eye … a knee about to go ‘pop’? Can coaches and sports medicine professionals predict who is at greater risk of ACL rupture?

BackgroundThe vertical drop jump (VDJ) test is widely used for clinical assessment of ACL injury risk, but it is not clear whether such assessments are valid.AimTo examine if sports medicine...

Prevalence of Patellar Tendinopathy and Patellar Tendon Abnormality in Male Collegiate Basketball Players: A Cross-Sectional Study.

Patellar tendinopathy (PT) is a degenerative condition known to affect athletes who participate in sports such as basketball and volleyball. Patellar tendinopathy is a challenging condition to treat and may cause an athlete to prematurely retire from sport. The prevalence of PT in male collegiate basketball players is unknown. To determine the prevalence of PT and patellar tendon abnormality (PTA) in a population of male collegiate basketball players. Cross-sectional study. National Collegiate Athletic Association Divisions II and III, National Association of Intercollegiate Athletics, and Northwest Athletic Conference male collegiate basketball teams were assessed in a university laboratory setting. Ninety-five male collegiate basketball players (age = 20.0 ± 1.7 years). A diagnostic ultrasound image of an athlete's patellar tendon was obtained from each knee. Patellar tendinopathy was identified based on a player's symptoms (pain with palpation) and the presence of a hypoechoic region on an ultrasonographic image. A majority of participants, 53 of 95 (55.8%), did not present with pain during palpation or ultrasonographic evidence of PTA. Thirty-two basketball players (33.7%) displayed ultrasonographic evidence of PTA in at least 1 knee; 20 of those athletes (21.1%) had PT (pain and tendon abnormality). Nonstarters were 3.5 times more likely to present with PTA (odds ratio = 3.5, 95% confidence interval = 1.3, 9.6; P = .017) and 4 times more likely to present with PT (odds ratio = 4.0, 95% confidence interval = 1.1, 14.8; P = .038) at the start of the season. One in 3 male collegiate basketball players presented with either PT or PTA. Sports medicine professionals should evaluate basketball athletes for PT and PTA as part of a preseason screening protocol.

Exploring the Use of Mobile Athlete Self-report Measures in Elite Gaelic Games: A Qualitative Approach.

Duignan, CM, Slevin, PJ, Caulfield, BM, and Blake, C. Exploring the use of mobile athlete self-report measures in elite Gaelic games: A qualitative approach. J Strength Cond Res 35(12): 3491-3499, 2021-Athlete self-report measures (ASRMs) are used in research and practice as an accurate, practical, and accessible method of athlete monitoring. Mobile adaptations of constructs from validated ASRM have increasingly been used for athlete monitoring in various sports settings; however, insights on the user experience and perceived value of these systems in the applied team sport setting have been limited. This study aimed to portray the experiences of stakeholders using a pre-existing mobile ASRM (M-ASRM) in elite Gaelic games. Twenty-one stakeholders in elite Gaelic games were recruited for this study (players n = 10, coaches and support staff n = 11). Subjects completed a semistructured interview with the lead researcher regarding their experience of using an M-ASRM in practice. Thematic analysis of the transcripts was conducted using NVivo 12 software. Results were defined under the themes of positive and negative user experience. Positive user experience was portrayed through M-ASRM uses and perceived value: communication and information disclosure, remote player monitoring, decision making and advanced planning, and player education and self-management. Negative user experience was portrayed through M-ASRM challenges: player adherence, player dishonesty, coach time and expertise requirements, and sociotechnical and system factors. Results outline the major uses of M-ASRM in elite Gaelic games and, importantly, highlight the key challenges experienced by stakeholders. These results can be applied by coaches, sports medicine professionals, and sports scientists using or intending to use an M-ASRM, providing key considerations to employ for effective use in team sport.

INSTRUMENT ASSISTED SOFT-TISSUE MOBILIZATION: A COMMENTARY ON CLINICAL PRACTICE GUIDELINES FOR REHABILITATION PROFESSIONALS

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FUNDAMENTAL MOVEMENT AND DYNAMIC BALANCE DISPARITIES AMONG VARYING SKILL LEVELS IN GOLFERS

Sports medicine professionals have instituted easy to use on field screening tests to determine physical readiness and identify athletes who may have increased injury risk. Currently there is little research on fundamental movement and dynamic balance abilities in golfers. To examine differences in fundamental movement patterns and dynamic balance in varying competition levels in golfers. Cross-sectional Cohort. The Functional Movement ScreenTM (FMS), and Y-Balance Test Upper Quarter and Lower Quarter (YBT-LQ/UQ) were performed on middle school (MS), high school (HS), college (COL), and professional (PRO) golfers. The FMSTM was assessed for individual tests and composite score. The YBT-LQ/UQ reaches were averaged normalized to limb length. Statistical analysis was completed with a series of Kruskall-Wallis tests with Dunn's post hoc for the FMS™ and YBT-LQ/UQ asymmetries, and a series of ANOVAs, with Tukey's post hoc for the YBT-LQ/UQ reaches (p<0.05). Effect Size Indices (ESI) were also calculated to determine clinical relevance. A total of 53 MS, 129 HS, 207 COL, and 29 PRO golfers were included in this study. Significant differences were observed between COL and HS in two FMS™ tests (push up; p=0.001), active straight leg raise; p=0.0019). PRO golfers YBT-LQ posteromedial reaches were greater than MS (p=0.0127, ESI = 4.3552). PRO YBT-UQ medial reaches were greater than COL (p<0.0001, ESI = 0.8915), HS (p<0.0001, ESI = 1.2640) and MS (p<0.001, ESI = 1.4218). PRO inferolateral (IL) and superoloateral (SL) reaches were greater [IL: COL (p=0.0427, ESI = 0.4413), HS (p=0.0002, ESI = 0.5851)], [SL: COL (p=0.0005, ESI = 0.5990), HS (p=0.0004, ESI = 0.6068)]. YBT-UQ composite scores were greater for PRO compared to COL (p<0.0001, ESI = 0.7657), HS (p<0.0001, ESI = 0.8161) and MS (p<0.0001, ESI = 1.085). Differences were observed in golfer's fundamental movement patterns in relationship to competition level. These data can be utilized to design personalized training programs that focus to improve movement quality. 2b.

Concussion in Sports.

Concussion, a peculiar type of mild traumatic brain injury (mTBI), is an injury frequently encountered in various contact and noncontact sports, such as boxing, martial arts, American football, rugby, soccer, ice hockey, horse riding, and alpine skiing. Concussion occurs anytime external forces of specific intensities provoke acceleration–deceleration of the brain, and it is characterized by the rapid onset of short-lived impairment of neurologic functions, spontaneously resolving within weeks, persisting for longer times only in a small percentage of cases. A wide range of molecular alterations, including mitochondrial dysfunction, energy deficit, and gene and protein expression changes, is triggered by concussion and lasts longer than clinical symptoms. In recent years, concussion has become a primary issue of discussion among sports medicine professionals, athletes, media, and sports sponsors in relation to athletes’ return to play, after a concussion. Continued improvement in prevention and management of concussed athletes requires extensive research from different disciplines. Research work needs to focus on both prevention and management. Researchers and clinicians’ efforts should be dedicated to a better understanding of the molecular changes occurring in the post-concussed brain and to clearly define healing after concussion for a safe return of athletes to play. It is essential for sports medicine professionals to stay informed about the advances in understanding concussions and how to rehabilitate each single player who sustained a concussion.

Adaptation of Running Biomechanics to Repeated Barefoot Running: A Randomized Controlled Study

Background: Previous studies have shown that changing acutely from shod to barefoot running induces several changes to running biomechanics, such as altered ankle kinematics, reduced ground-reaction forces, and reduced loading rates. However, uncertainty exists whether these effects still exist after a short period of barefoot running habituation. Purpose/Hypothesis: The purpose was to investigate the effects of a habituation to barefoot versus shod running on running biomechanics. It was hypothesized that a habituation to barefoot running would induce different adaptations of running kinetics and kinematics as compared with a habituation to cushioned footwear running or no habituation. Study Design: Controlled laboratory study. Methods: Young, physically active adults without experience in barefoot running were randomly allocated to a barefoot habituation group, a cushioned footwear group, or a passive control group. The 8-week intervention in the barefoot and footwear groups consisted of 15 minutes of treadmill running at 70% of VO2 max (maximal oxygen consumption) velocity per weekly session in the allocated footwear. Before and after the intervention period, a 3-dimensional biomechanical analysis for barefoot and shod running was conducted on an instrumented treadmill. The passive control group did not receive any intervention but was also tested prior to and after 8 weeks. Pre- to posttest changes in kinematics, kinetics, and spatiotemporal parameters were then analyzed with a mixed effects model. Results: Of the 60 included participants (51.7% female; mean ± SD age, 25.4 ± 3.3 years; body mass index, 22.6 ± 2.1 kg·m-2), 53 completed the study (19 in the barefoot habituation group, 18 in the shod habituation group, and 16 in the passive control group). Acutely, running barefoot versus shod influenced foot strike index and ankle, foot, and knee angles at ground contact (P < .001), as well as vertical average loading rate (P = .003), peak force (P < .001), contact time (P < .001), flight time (P < .001), step length (P < .001), and cadence (P < .001). No differences were found for average force (P = .391). After the barefoot habituation period, participants exhibited more anterior foot placement (P = .006) when running barefoot, while no changes were observed in the footwear condition. Furthermore, barefoot habituation increased the vertical average loading rates in both conditions (barefoot, P = .01; shod, P = .003) and average vertical ground-reaction forces for shod running (P = .039). All other outcomes (ankle, foot, and knee angles at ground contact and flight time, contact time, cadence, and peak forces) did not change significantly after the 8-week habituation. Conclusion: Changing acutely from shod to barefoot running in a habitually shod population increased the foot strike index and reduced ground-reaction force and loading rates. After the habituation to barefoot running, the foot strike index was further increased, while the force and average loading rates also increased as compared with the acute barefoot running situation. The increased average loading rate is contradictory to other studies on acute adaptations of barefoot running. Clinical Relevance: A habituation to barefoot running led to increased vertical average loading rates. This finding was unexpected and questions the generalizability of acute adaptations to long-term barefoot running. Sports medicine professionals should consider these adaptations in their recommendations regarding barefoot running as a possible measure for running injury prevention. Registration: DRKS00011073 (German Clinical Trial Register).

Administering Computerized Neurocognitive Testing Does Not Increase Symptoms Following Sport-Related Concussion

Computerized neurocognitive testing (CNT) is an important component for the management of sport-related concussion (SRC). The cognitive demands required to complete CNT may exacerbate SRC symptoms. PURPOSE: To prospectively examine changes in post-concussion symptom reporting after completing CNT. METHODS: One hundred forty-five athletes (15.72 ± 1.78 years) with a medically diagnosed SRC completed the Post-Concussion Symptom Scale (PCSS) before and after completing a CNT (e.g., The Immediate Post-Concussion Assessment and Cognitive Testing: ImPACT). Changes in total PCSS symptoms and symptom clusters (somatic, affective, and cognitive-migraine-fatigue) were examined with a series of paired samples t-tests. Participants were also assigned to groups based on the time elapsed from injury until their first clinical visit: 0-7, 8-14, and 15-21 days. A series of 3 (time since injury group) X 2 time (pre, post) analysis of variance were performed on symptom totals and clusters. Statistical significance was set at a Bonferroni-corrected p < .01. RESULTS: There were no significant differences in total (t (145) = -.69, p = .49), somatic, (t (145) = -1.02, p = .31), or cognitive-migraine-fatigue symptoms (t (145) = -1.75, p = .08) before and after CNT. There was a significant difference for affective symptoms (t (145) = 2.51, p = .01). Affective symptoms were significantly higher before CNT (M = 2.19, SD = 3.15) compared to after CNT (M = 1.80, SD = 2.89). There were no between-subjects or within-subjects main effects for total, somatic, affective, or cognitive-migraine-fatigue symptom clusters (p > .05). There were also no significant group x time interactions for total symptoms (Wilks λ =.99, F [1, 142] = 0.20, p = .40, η2 = .01), somatic, (Wilks λ =1.00, F [2, 142] = .30, p =.74, η2 = .004), affective (Wilks λ =.99, F [2, 142] = 0.89, p =.43, η2 = .01), or cognitive-migraine-fatigue symptom clusters (Wilks λ =.99, F [2, 141] = 0.41, p =.67, η2 = .01). CONCLUSIONS: The administration of CNT during recovery from SRC does not increase concussion symptoms. Sports medicine professionals should administer CNT to concussed athletes even when symptomatic, to more accurately identify neurocognitive impairment, which will help determine targeted treatment options.

COMPARISON of LOWER QUARTER Y-BALANCE TEST SCORES for FEMALE COLLEGIATE VOLLEYBALL PLAYERS BASED on COMPETITION LEVEL, POSITION, and STARTER STATUS.

The Lower Quarter Y-Balance Test (YBT-LQ) is used by sports medicine professionals to measure an athlete's dynamic balance. The YBT-LQ is used by clinicians to track recovery during clinical rehabilitation, assess an athlete's readiness to return to sport after injury, and to identify athletes potentially at-risk for a time-loss injury. Normative data for the YBT-LQ are lacking for female collegiate volleyball (VB) players. The purpose of this study was to examine preseason YBT-LQ scores and their relationships to level of competition, starter status, player position, and prior lower quadrant (i.e., low back and lower extremities) injury history. One-hundred thirty-four female collegiate VB players (mean age = 19.3 ± 1.1 years) representing athletes from three levels of competition (D II = 32, D III = 77, NAIA = 25) participated in this study. Athletes reported their prior injury history and performed the YBT-LQ testing protocol. NAIA and D III athletes demonstrated significantly greater reach measures on the YBT-LQ than D II athletes in several directions. Starters demonstrated significantly greater reach measures in five out of eight reach directions. Liberos/defensive specialists/setters demonstrated significantly greater posterolateral and composite reach measures bilaterally. There was no difference in reach measures based on prior history of lower quadrant (low back and lower extremities) injury. This study provides normative data for YBT-LQ in female collegiate volleyball players. The data presented in this report may be used by coaches and rehabilitation professionals when evaluating dynamic balance in healthy volleyball players and by clinicians to compare an injured athlete's recovery to norms. 3b.

Quantification of the Rockfloss® Floss Band Stretch Force at Different Elongation Lengths.

Floss bands are a popular intervention used by sports medicine professionals to enhance myofascial function and mobility. The bands are often wrapped around a region of the body in an overlapping fashion (eg,50%) and then tensioned by stretching the band to a desired length (eg,50%). To date, no research has investigated the stretch force of the bands at different elongation lengths. The purpose of this clinical study was to quantify the Rockfloss® band stretch force at 6 different elongation lengths (ie,25%-150%) for the 5.08- and 10.16-cm width bands. Controlled laboratory study. University kinesiology laboratory. One trained researcher conducted all measurements. The stretch force of a floss band was measured at 6 different elongation lengths with a force gauge. Band tension force at different band elongation lengths. The stretch force values for the 5.08-cm width (2 in) were as follows: 25% = 13.53 (0.25)N, 50% = 24.57 (0.28)N, 75% = 36.18 (0.39)N, 100% = 45.89 (0.62)N, 125% = 54.68 (0.26)N, and 150% = 62.54 (0.40)N. The stretch force values for the 10.16-cm width (4 in) were as follows: 25% = 16.70 (0.35)N, 50% = 31.90 (0.52)N, 75% = 47.45 (0.44)N, 100% = 57.75 (0.24)N, 125% = 69.02 (0.28)N, and 150% = 81.10 (0.67)N. Both bandwidths demonstrated a linear increase in stretch force as the bands became longer. These values may help professionals to understand and document the tension force being applied at different lengths to produce a more beneficial application during treatment. Future research should determine how the different length/tensions effect the local myofascia, arterial, and vascular systems.