Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic.

Objective: This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

Design: Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

Setting: Sports medicine and orthopedics clinic.

Factors that Influence Recovery From Concussion in Young Children and Preadolescents.

Objective: To examine differences in the presentation and management of concussion in younger children (aged 4-8 years) versus preadolescents (9-12 years) and identify factors that influence recovery time.

Design: Retrospective analysis of prospectively collected data.

Setting: Pediatric sports medicine and orthopedics clinic.

Time to Rehabilitation in Pediatric Concussion Patients Influences Recovery Outcomes.

Context: Targeted and directed rehabilitation with a healthcare provider can be an effective approach in the treatment of concussion, particularly for patients with protracted recovery, high symptom reporting, cervicogenic dysfunction, musculoskeletal involvement, and/or vestibular/oculomotor dysfunction. While many environmental and intrinsic medical history factors may influence concussion recovery, little is known about whether an individual's recovery trajectory can be influenced by the amount of time taken to receive rehabilitation. The purpose of this study was to evaluate recovery trajectories of concussion patients requiring targeted multimodal rehabilitation after a specialty concussion clinic visit within ≤3 days, 4 to 7 days, and >7 days.

Challenges and Research Opportunities for Integrating Quantitative Electroencephalography Into Sports Concussion Rehabilitation.

Although concussion management and return to play/learn decision making focuses on reducing symptoms, there is growing interest in objective physiological approaches to treatment. Clinical and technological advancements have aided concussion management; however, the scientific study of the neurophysiology of concussion has not translated into its standard of care. This expert commentary is motivated by novel clinical applications of electroencephalographic-based neurofeedback approaches (eg, quantitative electroencephalography [QEEG]) for treating traumatic brain injury and emerging research interest in its translation for treating concussion.

Post-concussion changes in the N200 and P300 ERPs are associated with cognitive symptoms and performance.

Purpose: To examine how post-concussion changes to the N200 and P300 event-related potentials (ERPs) are associated with cognitive symptoms and neurocognitive performance.

Methods: High-density electroencephalography (EEG) was recorded during a Go/No-Go task from 16 young adults within one month after their concussion and 16 matched controls. Participants were also administered the Cognitive-Linguistic Quick Test (CLQT) and self-reported concussion-like symptoms.

Association between days for concussion recovery and initial specialty clinic evaluation within 48 hours.

Background: Researchers have highlighted the importance of early access to concussion care within one week of injury in reducing recovery times. However, a persisting question for concussion researchers is "just how early is important?" The purpose of this study was to examine differences in recovery time as predicted by the number of days elapsed since injury (DSI) to initial evaluation among patients who had access to a specialty concussion clinic within seven days. We hypothesized that DSI group membership, even within seven days, would significantly predict risk of protracted recovery (i.

Physically Active Adults with Low Back Pain do not Demonstrate Altered Deadlift Mechanics: A Novel Application of Myotonometry to Estimate Inter-Muscular Load Sharing.

Background: Rehabilitation clinicians that work with physically active populations are challenged with how to safely return patients back to performing deadlift movements following low back injury. Application of reliable and valid tests and measures to quantify impairments related to low back pain (LBP) enhances clinical decision making and may affect outcomes. Myotonometry is a non-invasive method to assess muscle stiffness which has demonstrated significant associations with physical performance and musculoskeletal injury.

The Utility of Myotonometry in Musculoskeletal Rehabilitation and Human Performance Programming.

Myotonometry is a relatively novel method used to quantify the biomechanical and viscoelastic properties (stiffness, compliance, tone, elasticity, creep, and mechanical relaxation) of palpable musculotendinous structures with portable mechanical devices called myotonometers. Myotonometers obtain these measures by recording the magnitude of radial tissue deformation that occurs in response to the amount of force that is perpendicularly applied to the tissue through a device's probe. Myotonometric parameters such as stiffness and compliance have repeatedly demonstrated strong correlations with force production and muscle activation.

Myotonometry is Capable of Reliably Obtaining Trunk and Thigh Muscle Stiffness Measures in Military Cadets During Standing and Squatting Postures.

Introduction: Low back and lower extremity injuries are responsible for the highest percentage of musculoskeletal injuries in U.S. Army soldiers.

Reliability and Validity of a Flume-Based Maximal Oxygen Uptake Swimming Test.

A mode-specific swimming protocol to assess maximal aerobic uptake (VOmax) is vital to accurately evaluate swimming performance. A need exists for reliable and valid swimming protocols that assess VOmax in a flume environment. The purpose was to assess: (a) reliability and (b) "performance" validity of a VOmax flume protocol using the 457-m freestyle pool performance swim (PS) test as the criterion.

The Acute Effect of High-Intensity Resistance Training on Subsequent Firefighter Performance.

Mason, MR, Heebner, NR, Abt, JP, Bergstrom, HC, Shapiro, R, Langford, EL, and Abel, MG. The acute effect of high-intensity resistance training on subsequent firefighter performance. J Strength Cond Res 37(7): 1507-1514, 2023-High-intensity resistance training (HIRT) is commonly performed by structural firefighters on duty to enhance occupational readiness.

Pain Early After Anterior Cruciate Ligament Reconstruction is Associated With 6-Month Loading Mechanics During Running.

Background: Anterior cruciate ligament reconstruction (ACLR) results in persistent altered knee biomechanics, but contributing factors such as pain or patient function, leading to the altered loading, are unknown.

Hypothesis: Individuals with worse self-reported pain after ACLR would have poorer biomechanics during running, and poor loading mechanics would be present in the ACLR limb compared with contralateral and control limbs.

Study Design: Cohort pilot study.

The Utility of Myotonometry in Musculoskeletal Rehabilitation and Human Performance Programming.

Myotonometry is a relatively novel method used to quantify the biomechanical and viscoelastic properties (stiffness, compliance, tone, elasticity, creep, mechanical relaxation) of palpable musculotendinous structures with portable mechanical devices called myotonometers. Myotonometers obtain these measures by recording the magnitude of radial tissue deformation that occurs in response to the amount of force that is perpendicularly applied to the tissue through a device's probe. Myotonometric parameters such as stiffness and compliance have repeatedly demonstrated strong correlations with force production and muscle activation.

Gender Differences and the Influence of Body Composition on Land and Pool-Based Assessments of Anaerobic Power and Capacity.

Consistent differences between males and females have been shown in land-based measurements of anaerobic power and capacity. However, these differences have not been investigated for a tethered 30-s maximal swimming test (TST). The purpose of this study is to explore gender differences in land and pool-based assessments of anaerobic power (Fpeak) and capacity (Fmean), as well as the influence of body composition.

Asymmetrical Loading Patterns in Military Personnel With a History of Self-Reported Low Back Pain.

Background: Servicemembers are required to operate at high levels despite experiencing common injuries such as chronic low back pain. Continuing high levels of activity while compensating for pain may increase the risk of musculoskeletal injuries. As such, the purpose of this project was to determine if servicemembers with chronic low back pain have reduced lower extremity performance, and if they use alternate strategies to complete a functional performance task as compared to healthy servicemembers.

Exploring Vestibular/Ocular and Cognitive Dysfunction as Prognostic Factors for Protracted Recovery in Sports-Related Concussion Patients Aged 8 to 12 Years.

Objective: To explore the prognostic ability of the vestibular/ocular motor screening (VOMS), King-Devick (K-D) Test, and C3 Logix Trails A and B to identify protracted recovery from sports-related concussion (SRC) in patients aged 8 to 12 years.

Design: Retrospective cohort analysis.

Setting: Specialty pediatric sports concussion clinic.

Training Strategies Maintain Performance Characteristics in Marines Selected for Marine Forces Special Operations Individualized Training Course.

Introduction: Marines must complete an intensive Assessment and Selection (A&S) course before becoming a U.S. Marine Forces Special Operations Command (MARSOC) Raider.

Physical Therapists' Assessment of Patient Self-Efficacy for Home Exercise Programs.

Background: Patient adherence to home exercise programs (HEPs) is low, and poor patient self-efficacy is a barrier clinicians can influence. However, little evidence suggests that clinicians assess level of patient self-efficacy before prescribing HEPs.

Purpose: To determine the importance of patient self-efficacy to physical therapists (PTs) when addressing patient barriers, determine how PTs assess and use patient self-efficacy for HEPs, and describe the barriers facing PTs when assessing patient self-efficacy for HEPs.

INFLUENCE OF LIMB DOMINANCE AND SHOULDER INJURY ON STRENGTH AND EXPLOSIVE FORCE IN US MARINES.

Background: The specialized roles of many military personnel require specific skills and high physical demands, placing unique stresses on the shoulders and increasing risk of injury. As normal dominant/nondominant shoulder asymmetries have been established in military personnel, bilateral strength comparisons must be understood in context of daily physical demands to monitor patients' progress or readiness to return to duty.

Purpose: This study aims to assess bilateral differences in strength and explosive force in United States Marines with a history of dominant or nondominant shoulder pathology.

Management and Treatment of Concussions via Tele-Concussion in a Pediatric Setting: Methodological Approach and Descriptive Analysis.

Background: Approximately 2 million children in the United States sustain a concussion annually, resulting in an economic impact as high as US $20 billion. Patients who receive treatment at concussion specialty clinics, versus primary care, experience faster recovery, thereby reducing patient burden and subsequent medical-related costs. Accessibility to specialty clinics is typically limited by the availability of in-office visits.

Military Protein Intake Related to Strength and Fat Mass Independent of Energy Intake.

Introduction: Kinetic military units operate in austere training environments and deprivation not commonly experienced by competitive athletes. Nutritional strategies to protect against decrements in performance and potential injury risk may differ for these two groups. A cross sectional analysis was conducted to determine energy and macronutrient characteristics associated with performance metrics.

The Self-Efficacy for Home Exercise Programs Scale: Development and Psychometric Properties.

Background: The Self-Efficacy for Home Exercise Programs Scale (SEHEPS) was developed to help clinicians evaluate patients' self-efficacy for performing prescribed home exercise programs. Prior to clinical adoption, the scale's psychometric properties need to be examined.

Objective: To determine the psychometric properties of the SEHEPS.

Development of a pain neuroscience education program for post-traumatic stress disorder and pain.

: Individuals with co-morbid post-traumatic stress disorder (PTSD) and pain have higher disability, pain, and pain catastrophizing beliefs than patients without PTSD. Pain neuroscience education (PNE) may be an effective tool to help those with PTSD and pain reduce maladaptive beliefs about pain. The purpose of this paper is to report the development and evaluation of a PNE curriculum for participants with PTSD and pain.

Reliability and Validity of a Pool-Based Maximal Oxygen Uptake Test to Examine High-Intensity Short-Duration Freestyle Swimming Performance.

Nagle, EF, Nagai, T, Beethe, AZ, Lovalekar, MT, Zera, JN, Connaboy, C, Abt, JP, Beals, K, Nindl, BC, Robertson, RJ, and Lephart, SM. Reliability and validity of a pool-based maximal oxygen uptake test to examine high-intensity short-duration freestyle swimming performance. J Strength Cond Res 33(5): 1208-1215, 2019-A modality-specific swimming protocol to assess maximal oxygen uptake (V[Combining Dot Above]O2maxsw) is essential to accurately prescribe and monitor swimming conditioning programs.

Altered Physical Performance Following Advanced Special Operations Tactical Training.

Winters, JD, Heebner, NR, Johnson, AK, Poploski, KM, Royer, SD, Nagai, T, Randall, CA, Abt, JP, and Lephart, SM. Altered physical performance following advanced special operations tactical training. J Strength Cond Res 35(7): 1809-1816, 2021-The purpose of this study was to determine how the unique challenges of specific military tactical training phases influence overall physical performance characteristics.