Challenges in applying minimal clinically important difference: a critical review.

Healthcare clinicians strive to make meaningful changes in patient function and participation. A minimal clinically important difference (MCID) is an estimate of the magnitude of change needed to be meaningful to a patient. Clinicians and investigators may assume that a cited MCID is a valid and generalizable estimate of effect.

Secondary School Athletic Trainers' Experiences With Organizational Conflict: A Comparison Across Employment Models.

Context: Athletic training is a multifaceted profession characterized by interpersonal relationships and a team approach to care. Collaborative relationships, by nature, open the door to conflict, which has been reported frequently in the collegiate athletic setting. However, secondary school athletic trainers' (ATs') experiences with conflict and pressure in their role are not readily understood.

Preseason Neck Mobility Is Associated With Throwing-Related Shoulder and Elbow Injuries, Pain, and Disability in College Baseball Pitchers.

Background: Shoulder and elbow injuries in baseball pitchers, which can lead to significant pain and disability, have been on the rise at all levels of play for 3 decades. Despite anatomic and neurophysiological relationships, neck mobility has not been explored as a contributor to shoulder and elbow injuries in baseball pitchers.

Hypothesis: Impaired neck mobility will increase the risk of shoulder and elbow injuries in college baseball pitchers.

Quadriceps Inhibition After Naturally Occurring Patellar Tendon Damage and Pain.

Context: After knee-joint injury, pain, effusion, and mechanoreceptor damage alter afferent signaling, which can result in quadriceps inhibition and subsequent weakness. The individual contributions of each factor to inhibition remain unclear due to confounding knee-joint injuries and indirect experimental models.

Objective: To characterize the influence of naturally occurring knee damage and pain on quadriceps neuromuscular function in individuals with patellar tendinopathy.

Application of a Preventive Training Program Implementation Framework to Youth Soccer and Basketball Organizations.

Context: Preventive training programs (PTPs) can reduce injury rates and improve neuromuscular control and sport performance. However, PTPs must be implemented correctly and consistently over time for athletes to benefit. Coaches represent the best long-term option for implementing PTPs.

Emergency Action Planning in Secondary School Athletics: A Comprehensive Evaluation of Current Adoption of Best Practice Standards.

Context: Emergency action plans (EAPs) are policies that improve response times and ensure access to emergency equipment for the management of patients with acute injuries and medical conditions, yet the extent to which EAP standards are adopted and implemented is unknown.

Objective: To describe the extent of EAP adoption and implementation in secondary school (SS) athletics with athletic trainer (AT) services in the United States.

Design: Cross-sectional study.

Dynamic Leap and Balance Test: Ability to Discriminate Balance Deficits in Individuals With Chronic Ankle Instability.

Context: The Dynamic Leap Balance Test (DLBT) is a new dynamic balance task that requires serial changes in base of support with alternating limb support and recovery of dynamic stability, as compared with the Y modification of the Star Excursion Balance Test (Y-SEBT), which assesses dynamic stability over an unchanging base of support.

Objectives: To assess the dynamic balance performance in 2 different types of dynamic balance tasks, the DLBT and the SEBT, in subjects with unilateral chronic ankle instability (CAI) when compared with matched controls. The authors hypothesized that the DLBT score would significantly differ between the CAI involved and uninvolved limbs (contralateral and healthy matched) and demonstrate a modest (r = .

A Growing Consensus for Change in Interpretation of Clinical Research Evidence.

Context:   The paradigm of evidence-based practice (EBP) is well established among the health care professions, but perspectives on the best methods for acquiring, analyzing, appraising, and using research evidence are evolving.

Background:   The EBP paradigm has shifted away from a hierarchy of research-evidence quality to recognize that multiple research methods can yield evidence to guide clinicians and patients through a decision-making process. Whereas the "frequentist" approach to data interpretation through hypothesis testing has been the dominant analytical method used by and taught to athletic training students and scholars, this approach is not optimal for integrating evidence into routine clinical practice.

Validation of the Professional Identity and Values Scale Among an Athletic Trainer Population.

Context:   Forming a professional identity is a process by which an individual achieves an awareness of his or her own self-concept in the context of the profession. Identity in relation to an individual's profession includes the ability to articulate one's role as a professional and professional philosophy. Professional identity has been studied extensively in other fields, but currently no professional identity scales have been validated within the athletic training profession.

Multilevel Examination of Job Satisfaction and Career Intentions of Collegiate Athletic Trainers: A Quantitative Approach.

Context:   Recent employment data from collegiate athletic training settings have demonstrated departure trends among men and women. These trends have been hypothesized to be related to work-life balance. However, work-life balance is only 1 aspect of a myriad of factors.

Performance of wells score to predict deep vein thrombosis and pulmonary embolism in endurance athletes.

Introduction: There are an increasing number of reports describing deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in otherwise healthy endurance athletes. The Wells score is the most commonly used clinical prediction rule to diagnose DVT/PE in clinical populations. However, the Wells score may have limited utility for recognition of DVT/PE in athletes, contributing to missed or delayed diagnosis.

Implications of Thoracic Epidural Analgesia on Hospital Charges in Rib Fracture Patients.

Objective: Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity.

Coach-led preventive training program in youth soccer players improves movement technique.

Unlabelled: Long-term implementation of preventive training programs (PTP) in youth sport requires coach involvement. However, the optimal training of coaches to effectively implement a PTP remains unknown. It is also unknown if the benefits of PTP can be enhanced with multiple sport seasons of exposure.

Achilles Tendon Adaptation During Transition to a Minimalist Running Style.

Context: Achilles tendons (ATs) adapt to increased loading generated by long-term adoption of a minimalist shoe running style. There may be difference in the chronology and extent of adaptation between the sexes.

Objective: To learn the chronology of AT adaptations in female and male runners who transitioned to a minimalist running style through a planned, progressive 12-wk transition program.

Landing Technique Improvements After an Aquatic-Based Neuromuscular Training Program in Physically Active Women.

Context: Neuromuscular training programs (NTPs) improve landing technique and decrease vertical ground-reaction forces (VGRFs), resulting in injury-risk reduction. NTPs in an aquatic environment may elicit the same improvements as land-based programs with reduced joint stress.

Objective: To examine the effects of an aquatic NTP on landing technique as measured by the Landing Error Scoring System (LESS) and VGRFs, immediately and 4 mo after the intervention.

Achilles Tendon Properties of Minimalist and Traditionally Shod Runners.

Context: Tendon adapts to load through alterations in its composition and mechanical properties. Mechanical adaptation to increased load often involves increases in cross-sectional area (CSA), stiffness, and modulus. Runners exhibit these adaptations.

Improved Outcomes Associated with the Liberal Use of Thoracic Epidural Analgesia in Patients with Rib Fractures.

Objective: Each year, more than 150,000 patients with rib fractures are admitted to US trauma centers; as many as 10% die. Effective pain control is critical to survival. One way to manage pain is thoracic epidural analgesia.

Female adolescent athletes' attitudes and perspectives on injury prevention programs.

Objectives: To examine what factors influence a high school female athlete's stated willingness to perform a lower extremity injury prevention program (IPP). A secondary aim was to examine if a participant's stated willingness affected her compliance with an IPP.

Design: Repeated measures.

Effects of heat acclimation on hand cooling efficacy following exercise in the heat.

This study examined the separate and combined effects of heat acclimation and hand cooling on post-exercise cooling rates following bouts of exercise in the heat. Seventeen non-heat acclimated (NHA) males (mean ± SE; age, 23 ± 1 y; mass, 75.30 ± 2.

Electromyographic and kinetic analysis of two abdominal muscle performance tests.

Background: In order to accurately assess the abdominal muscles, clinicians need valid clinical measures. The double leg lowering test (DLLT) and lower abdominal muscle progression (LAMP) are two common tests of abdominal muscle performance. The purposes of this study were to determine the relation between surface electromyographic (EMG) activity during the DLLT and LAMP levels; hip joint resultant moments and DLLT and LAMP levels; and the two measures of DLLT and LAMP.

Electromyographical and Perceptual Responses to Different Resistance Intensities in a Squat Protocol: Does Performing Sets to Failure With Light Loads Produce the Same Activity?

This investigation examined peak motor unit activity during sets that differed in resistance (50, 70, or 90% 1 repetition maximum [1RM]). Ten resistance-trained men (age, 23 ± 3 years; height, 187 ± 7 cm; body mass, 91.5 ± 6.