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Preview: pubmed: "Journal of Athletic...

pubmed: "Journal of Athletic...



NCBI: db=pubmed; Term="Journal of Athletic Training"[JOUR]



 



Statistical Primer for Athletic Trainers: The Essentials of Understanding Measures of Reliability and Minimal Important Change.
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Statistical Primer for Athletic Trainers: The Essentials of Understanding Measures of Reliability and Minimal Important Change.

J Athl Train. 2018 Jan 13;:

Authors: Riemann BL, Lininger M

Abstract
OBJECTIVE:   To describe the concepts of measurement reliability and minimal important change.
BACKGROUND:   All measurements have some magnitude of error. Because clinical practice involves measurement, clinicians need to understand measurement reliability. The reliability of an instrument is integral in determining if a change in patient status is meaningful.
DESCRIPTION:   Measurement reliability is the extent to which a test result is consistent and free of error. Three perspectives of reliability-relative reliability, systematic bias, and absolute reliability-are often reported. However, absolute reliability statistics, such as the minimal detectable difference, are most relevant to clinicians because they provide an expected error estimate. The minimal important difference is the smallest change in a treatment outcome that the patient would identify as important.
RECOMMENDATIONS:   Clinicians should use absolute reliability characteristics, preferably the minimal detectable difference, to determine the extent of error around a patient's measurement. The minimal detectable difference, coupled with an appropriately estimated minimal important difference, can assist the practitioner in identifying clinically meaningful changes in patients.

PMID: 29332472 [PubMed - as supplied by publisher]




Fatal Exertional Heat Stroke and American Football Players: The Need for Regional Heat-Safety Guidelines.
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Fatal Exertional Heat Stroke and American Football Players: The Need for Regional Heat-Safety Guidelines.

J Athl Train. 2018 Jan 13;:

Authors: Grundstein AJ, Hosokawa Y, Casa DJ

Abstract
CONTEXT:   Weather-based activity modification in athletics is an important way to minimize heat illnesses. However, many commonly used heat-safety guidelines include a uniform set of heat-stress thresholds that do not account for geographic differences in acclimatization.
OBJECTIVE:   To determine if heat-related fatalities among American football players occurred on days with unusually stressful weather conditions based on the local climate and to assess the need for regional heat-safety guidelines.
DESIGN:   Cross-sectional study.
SETTING:   Incidents of fatal exertional heat stroke (EHS) in American football players were obtained from the National Center for Catastrophic Sport Injury Research 5 and the Korey Stringer Institute.
PATIENTS OR OTHER PARTICIPANTS:   Sixty-one American football players at all levels of competition with fatal EHSs from 1980 to 2014.
MAIN OUTCOME MEASURE(S):   We used the wet-bulb globe temperature (WBGT) and a z-score WBGT standardized to local climate conditions from 1991 to 2010 to assess the absolute and relative magnitudes of heat stress, respectively.
RESULTS:   We observed a poleward decrease in exposure WBGTs during fatal EHSs. In milder climates, 80% of cases occurred at above-average WBGTs, and 50% occurred at WBGTs greater than 1 standard deviation from the long-term mean; however, in hotter climates, half of the cases occurred at near-average or below-average WBGTs.
CONCLUSIONS:   The combination of lower exposure WBGTs and frequent extreme climatic values in milder climates during fatal EHSs indicates the need for regional activity-modification guidelines with lower, climatically appropriate weather-based thresholds. Established activity-modification guidelines, such as those from the American College of Sports Medicine, work well in the hotter climates, such as the southern United States, where hot and humid weather conditions are common.

PMID: 29332471 [PubMed - as supplied by publisher]




A School-Based Neuromuscular Training Program and Sport-Related Injury Incidence: A Prospective Randomized Controlled Clinical Trial.
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A School-Based Neuromuscular Training Program and Sport-Related Injury Incidence: A Prospective Randomized Controlled Clinical Trial.

J Athl Train. 2018 Jan 13;:

Authors: Foss KDB, Thomas S, Khoury JC, Myer GD, Hewett TE

Abstract
CONTEXT:   An estimated 40 million school-aged children (age range = 5-18 years) participate annually in sports in the United States, generating approximately 4 million sport-related injuries and requiring 2.6 million emergency department visits at a cost of nearly $2 billion.
OBJECTIVE:   To determine the effects of a school-based neuromuscular training (NMT) program on sport-related injury incidence across 3 sports at the high school and middle school levels, focusing particularly on knee and ankle injuries.
DESIGN:   Randomized controlled clinical trial.
SETTING:   A total of 5 middle schools and 4 high schools in a single-county public school district.
PATIENTS OR OTHER PARTICIPANTS:   A total of 474 girls (222 middle school, 252 high school; age = 14.0 ± 1.7 years, height = 161.0 ± 8.1 cm, mass = 55.4 ± 12.2 kg) were cluster randomized to an NMT (CORE; n = 259 athletes) or sham (SHAM; n = 215 athletes) intervention group by team within each sport (basketball, soccer, and volleyball).
INTERVENTION(S):   The CORE intervention consisted of exercises focused on the trunk and lower extremity, whereas the SHAM protocol consisted of resisted running using elastic bands. Each intervention was implemented at the start of the season and continued until the last competition. An athletic trainer evaluated athletes weekly for sport-related injuries. The coach recorded each athlete-exposure (AE), which was defined as 1 athlete participating in 1 coach-directed session (game or practice).
MAIN OUTCOME MEASURE(S):   Injury rates were calculated overall, by sport, and by competition level. We also calculated rates of specific knee and ankle injuries. A mixed-model approach was used to account for multiple injuries per athlete.
RESULTS:   Overall, the CORE group reported 107 injuries (rate = 5.34 injuries/1000 AEs), and the SHAM group reported 134 injuries (rate = 8.54 injuries/1000 AEs; F1,578 = 18.65, P < .001). Basketball (rate = 4.99 injuries/1000 AEs) and volleyball (rate = 5.74 injuries/1000 AEs) athletes in the CORE group demonstrated lower injury incidences than basketball (rate = 7.72 injuries/1000 AEs) and volleyball (rate = 11.63 injuries/1000 AEs; F1,275 = 9.46, P = .002 and F1,149 = 11.36, P = .001, respectively) athletes in the SHAM group. The CORE intervention appeared to have a greater protective effect on knee injuries at the middle school level (knee-injury incidence rate = 4.16 injuries/1000 AEs) than the SHAM intervention (knee-injury incidence rate = 7.04 injuries/1000 AEs; F1,261 = 5.36, P = .02). We did not observe differences between groups for ankle injuries ( F1,578 = 1.02, P = .31).
CONCLUSIONS:   Participation in an NMT intervention program resulted in a reduced injury incidence relative to participation in a SHAM intervention. This protective benefit of NMT was demonstrated at both the high school and middle school levels.

PMID: 29332470 [PubMed - as supplied by publisher]




Balance Regularity Among Former High School Football Players With or Without a History of Concussion.
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Balance Regularity Among Former High School Football Players With or Without a History of Concussion.

J Athl Train. 2018 Jan 13;:

Authors: Schmidt JD, Terry DP, Ko J, Newell KM, Miller LS

Abstract
CONTEXT:   Subclinical postural-control changes may persist beyond the point when athletes are considered clinically recovered postconcussion.
OBJECTIVE:   To compare postural-control performance between former high school football players with or without a history of concussion using linear and nonlinear metrics.
DESIGN:   Case-control study.
SETTING:   Clinical research laboratory.
PATIENTS OR OTHER PARTICIPANTS:   A total of 11 former high school football players (age range, 45-60 years) with 2 or more concussions and 11 age- and height-matched former high school football players without a history of concussion. No participant had college or professional football experience.
MAIN OUTCOME MEASURE(S):   Participants completed the Sensory Organization Test. We compared postural control (linear: equilibrium scores; nonlinear: sample and multiscale entropy) between groups using a 2 × 3 analysis of variance across conditions 4 to 6 (4: eyes open, sway-referenced platform; 5: eyes closed, sway-referenced platform; 6: eyes open, sway-referenced surround and platform).
RESULTS:   We observed a group-by-condition interaction effect for medial-lateral sample entropy ( F2,40 = 3.26, P = .049, ηp2 = 0.140). Participants with a history of concussion presented with lower medial-lateral sample entropy values (0.90 ± 0.41) for condition 5 than participants without a history of concussion (1.30 ± 0.35; mean difference = -0.40; 95% confidence interval [CI] = -0.74, -0.06; t20 = -2.48, P = .02), but conditions 4 (mean difference = -0.11; 95% CI: -0.37, 0.15; t20 = -0.86, P = .40) and 6 (mean difference = -0.25; 95% CI: -0.55, 0.06; t20 = -1.66, P = .11) did not differ between groups.
CONCLUSIONS:   Postconcussion deficits, detected using nonlinear metrics, may persist long after injury resolution. Subclinical concussion deficits may persist for years beyond clinical concussion recovery.

PMID: 29332469 [PubMed - as supplied by publisher]