运动训练杂志的使命是通过在预防、评估、管理和康复损伤方面的教育和研究，加强对体育活动者的医疗保健质量感兴趣的专业人士之间的交流。运动训练杂志提供您可以使用的研究在日常实践中。它让您了解最终定义专业护理标准的科学进步——如果您对患者的福祉负责，您就不能没有这一点。

The mission of the Journal of Athletic Training is to enhance communication among professionals interested in the quality of healthcare for athletes through education and research in the prevention, assessment, management, and rehabilitation of injuries. The journal provides research that you can apply in daily practice, keeping you informed about the scientific advancements that ultimately define the standards of professional care. If you are responsible for the well-being of your patients, you cannot do without this information.

《Journal of Athletic Training》的使命是通过在预防、评估、管理和康复损伤方面的教育和研究，增强对体育活动者医疗保健质量感兴趣的专业人士之间的交流。该杂志提供可在日常实践中使用的研究成果，让您了解定义专业护理标准的科学进展。如果您对患者的福祉负责，这些信息是必不可少的。

Journal of Athletic Training

Individualized patient care is ideal for treating and rehabilitating patients with athletic illnesses and injuries. Exertional heat stroke (EHS) treatment best-practice recommendations state that all patients should undergo identical cold-water immersion (CWI) treatment for ideal outcomes. It is unknown, however, whether CWI can be optimized with individualized treatment plans, encouraging personalized medicine. To accomplish this task, clinicians and researchers need to better understand the factors affecting CWI effectiveness. In this short report, we will provide an update to the American College of Sports Medicine Roundtable on Exertional Heat Stroke, review research regarding EHS treatment, and identify knowledge gaps in EHS treatment.

Riana R. Pryor

J. Luke Pryor

Brendon P. McDermott

Persistent Knowledge Gaps Regarding Exertional Heat Stroke Treatment

Context Impairments in dynamic postural control and gluteal muscle activation have been associated with the development of symptoms related to long-term injury, which are characteristic of chronic ankle instability (CAI). Ultrasound imaging (USI) provides a visual means to explore muscle thickness throughout movement; however, USI functional-activation ratios (FARs) of the gluteal muscles during dynamic balance exercises have not been investigated. Objective To determine differences in gluteus maximus and gluteus medius FARs using USI, Y-Balance Test (YBT) performance, and lower extremity kinematics in individuals with or without CAI. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Twenty adults with CAI (10 men, 10 women; age = 21.70 ± 2.32 years, height = 172.74 ± 11.28 cm, mass = 74.26 ± 15.24 kg) and 20 adults without CAI (10 men, 10 women; age = 21.20 ± 2.79 years, height = 173.18 ± 15.16 cm, mass = 70.89 ± 12.18 kg). Intervention(s) Unilateral static ultrasound images of the gluteal muscles during quiet stance and to the point of maximum YBT reach directions were obtained over 3 trials. Hip, knee, and ankle sagittal-plane kinematics were collected with motion-capture software. Main Outcome Measure(s) Gluteal thickness was normalized to quiet stance to yield FARs for each muscle in each YBT direction. We averaged normalized reach distances and obtained average peak kinematics. Independent t tests, mean differences, and Cohen d effect sizes were calculated to determine group differences for all outcome measures. Results The CAI group had anterior-reach deficits compared with the control group (mean difference = 4.37%, Cohen d = 0.77, P = .02). The CAI group demonstrated greater anterior gluteus maximus FARs than the control group (mean difference = 0.08, Cohen d = 0.57, P = .05). Conclusions The CAI group demonstrated YBT reach deficits and alterations in proximal muscle activation. Increased reliance on the gluteus maximus during dynamic conditions may contribute to distal joint dysfunction in this population.

Alexandra F. DeJong

L. Colby Mangum

Jay Hertel

Ultrasound Imaging of the Gluteal Muscles During the Y-Balance Test in Individuals With or Without Chronic Ankle Instability

慢性踝关节不稳患者与非患者在Y平衡测试期间臀肌的超声成像

Objective To identify the most precise and consistent variables using joint repositioning for identifying joint position recognition (JPR) deficits in individuals with chronic ankle instability (CAI). Data Sources We conducted a computerized search of the relevant scientific literature from January 1, 1965, to July 31, 2010, using PubMed Central, CINAHL, MEDLINE, SPORTDiscus, and Web of Science. We also conducted hand searches of all retrieved studies to identify relevant citations. Included studies were written in English, involved human participants, and were published in peer-reviewed journals. Study Selection Studies were included in the analysis if the authors (1) had examined JPR deficits in patients with CAI using active or passive repositioning techniques, (2) had made comparisons with a group or contralateral limb without CAI, and (3) had provided means and standard deviations for the calculation of effect sizes. Data Extraction Studies were selected and coded independently and assessed for quality by the investigators. We evaluated 6 JPR variables: (1) study comparisons, (2) starting foot position, (3) repositioning method, (4) testing range of motion, (5) testing velocity, and (6) data-reduction method. The independent variable was group (CAI, control group or side without CAI). The dependent variable was errors committed during joint repositioning. Means and standard deviations for errors committed were extracted from each included study. Data Synthesis Effect sizes and 95% confidence intervals were calculated to make comparisons across studies. Separate meta-analyses were calculated to determine the most precise and consistent method within each variable. Between-groups comparisons that involved active repositioning starting from a neutral position and moving into plantar flexion or inversion at a rate of less than 5°/s as measured by the mean absolute error committed appeared to be the most sensitive and precise variables for detecting JPR deficits in people with CAI.

Jennifer M. Medina McKeon

Patrick O. McKeon

Evaluation of Joint Position Recognition Measurement Variables Associated With Chronic Ankle Instability: A Meta-Analysis

慢性踝关节不稳相关关节位置识别测量变量的评估：一项Meta分析

Context: Chronic ankle instability (CAI) is a term used to identify a condition associated with recurrent ankle sprains and persistent symptoms. Balance deficits, evaluated using center-of-pressure (COP) force-plate measurements, have been shown to occur in people with CAI.
Objective: To determine the differential abilities of selected force-plate postural-control measures to assess CAI.
Design: Case-control study.
Setting: Laboratory.
Patients or Other Participants: A total of 63 individuals with CAI (30 men, 33 women: age = 22.3 ± 3.7 years, height = 169.8 ± 9.6 cm, mass = 70.7 ± 14.3 kg) and 46 healthy controls (22 men, 24 women: age = 21.2 ± 4.1 years, height = 173.3 ± 9.2 cm, mass = 69.2 ± 13.2 kg) volunteered.
Intervention(s): Participants performed 3 10-second trials of quiet, single-limb stance on a force plate under 2 conditions: eyes open and eyes closed.
Main Outcome Measure(s): Measures of COP area, COP velocity, COP SD, COP range of excursion, percentage of COP range used, time-to-boundary absolute minimum, time-to-boundary mean of the minima, and time-to-boundary SD of the minima were calculated. All measures with the exception of COP area were calculated in both the mediolateral (ML) and anteroposterior directions. For each measure, a receiver operator curve analysis was created, and the corresponding area under the curve was tested. The optimal diagnostic threshold value for each measure was determined, and the corresponding positive and negative likelihood ratios were calculated.
Results: Three eyes-closed, single-limb force-plate measures (COP ML SD, ML percentage of COP range used, and time-to-boundary absolute minimum) predicted CAI status. However, all 3 measures had positive likelihood ratios associated with only small shifts in the probability of a patient with a positive test having CAI and negative likelihood ratios associated with very small shifts in the probability of a patient with a negative test not having CAI.
Conclusions: No single force-plate measure was very effective in predicting if an individual had CAI or not.

Danielle Knapp

Sae Yong Lee

Lisa Chinn

Susan A. Saliba

Differential Ability of Selected Postural-Control Measures in the Prediction of Chronic Ankle Instability Status

选择性姿势控制测量在预测慢性踝关节不稳状态中的差异能力

Context The effect of ultrasound frequency on phonophoresis drug delivery in humans is unknown. Objective To determine if a low (45-kHz) or high (1-MHz) frequency delivered a higher dexamethasone (Dex) concentration through the skin. Design Controlled laboratory study. Setting Laboratory. Patients or Other Participants A total of 40 healthy men between the ages of 18 and 45 years (age = 23.1 ± 2.6 years, height = 176.1 ± 7.2 cm, mass = 88.5 ± 19.4 kg, posterior calf subcutaneous thickness measured using musculoskeletal ultrasound imaging = 0.6 ± 0.2 cm). Intervention(s) Participants were randomly assigned to 1 of 4 groups (ultrasound frequency at microdialysis probe depth): (1) 45-kHz frequency at 1 mm, (2) 45-kHz frequency at 4 mm, (3) 1-MHz frequency at 1 mm, or (4) 1-MHz frequency at 4 mm (n = 10 in each group). Three linear microdialysis probes were inserted at the desired tissue depth. We rubbed dexamethasone sodium phosphate (Dex-P) into the skin and then applied a 15-minute phonophoresis treatment. Main Outcome Measure(s) Dialysate was collected during the treatment and 60 minutes posttreatment and analyzed for Dex-P, Dex, and the metabolite form of Dex. The sum of the 3 analytes was calculated as total dexamethasone (Dex-total), and differences between the 45-kHz and 1-MHz treatment groups were determined by a repeated-measures analysis of variance. Results At 1 mm, 3 (30%) participants in the 45-kHz and 4 (40%) participants in the 1-MHz group had measurable levels of Dex-P. Total dexamethasone increased after the treatment ceased, independent of ultrasound frequency (P &amp;lt; .001), with a trend of the 45-kHz treatment to produce a greater increase in drug concentration (P = .006). At 4 mm, 5 (50%) participants in the 45-kHz and 1 (10%) participant in the 1-MHz group had measurable levels of Dex-P. We observed no difference in Dex-total concentration between treatment groups at 4 mm (P = .72). Conclusions Phonophoresis provided a mechanism for Dex-total delivery at the 1- and 4-mm tissue depths. However, the effectiveness of the ultrasound frequencies varied between the 2 measured tissue depths.

Justin H. Rigby

Austin M. Hagan

Austin R. Kelcher

Chang Ji

Dexamethasone Sodium Phosphate Penetration During Phonophoresis at 2 Ultrasound Frequencies

地塞米松磷酸钠在2种超声频率下经超声电导时的渗透情况

Abstract Context: Parents are key decisionmakers for 1 the health and wellness of their children. Despite the benefits of engaging in physical activity, parental concerns about concussion may create hesitancy towards sport participation. The magnitude of concussion-related anxiety perceptions and factors that influence these beliefs in parents of youth athletes are largely unknown. Objective: To determine the prevalence of concussion-related anxiety perceptions in parents of youth athletes and establish the associations among concussion-related anxiety and demographic variables (i.e., parent sex, parent concussion history, child concussion history, parent concussion education). Design: Cross-sectional paper survey. Setting: Youth sports. Patients or Other Participants: 452 parents (60% female; mean age = 40.4±13.0 years) of youth athletes (8-14 years old) who participated in soccer, ice hockey, lacrosse, and football (i.e., higher concussion risk sports) in Pennsylvania and Michigan. Main outcomes Measures: Survey items were adapted from the Perceptions of Concussion Inventory for Athletes (PCI-A) to pertain to perceptions about their child. Parents also completed a demographic survey regarding concussion-related topics. Results: Overall, 73.2% of parents found the possibility of their child sustaining a concussion to be upsetting, 61.5% were fearful of their child sustaining a concussion, and 45.1% reported that the thought of their child having a concussion makes them feel anxious. Only 4.6% of parents suggested that concussions do not worry them. The lack of a personal concussion history and being female were associated with greater concussion-related anxiety in parents. Conclusions: This study provides evidence that parents of youth athletes have anxiety about their child sustaining a concussion, while also contributing to the understanding of what factors are related to such anxiety (i.e., female parent; no parent history of concussion). Negative parental concussion beliefs may contribute to the reduction in contact sport participation and should be directly addressed in concussion education specific to youth sport participation.

Erica Beidler

Elizabeth Teel

Ara J. Schmitt

Grace Muccio

John H. Holmes

Abigail C. Bretzin

Anxiety-Related Concussion Perceptions of Parents of Youth Athletes

青年运动员家长对脑震荡相关焦虑的认知

Abstract Context: The importance of analyzing head impact exposure among football players is well established, yet few studies have explored the differences across position groups in high school athletes. Better understanding of these differences may provide optimized intervention strategies for coaches and healthcare providers. Objective: To quantify the difference of head impacts per exposure (Imp/E) and impact burden high school football player position groups. Design: Prospective observational. Setting: High school athletic fields during Fall sports seasons. Patients and Participants: 200 football players from three high school varsity teams including 69 offensive/defensive linemen, 51 linebackers/running backs/tight ends and 80 cornerbacks/safeties/wide receivers (16.1±0.9yrs, 177.9±7.8cm, 86.4±22.7) categorized as linemen, backers, and skills players respectively. Main Outcome Measures: Imp/E across positions, teams, session type, and seasons. Cumulative head impact burden per location (front, top, right, left, back) across position groups. Results: Significant differences in Imp/E were found between position groups (P&amp;lt;0.001), where the backers group, (3.77[95% CI: 3.146, 4.395]) experienced higher total Imp/E compared to linemen (1.47[ 95% CI: 0.983, 1.96]) and skill players (1.56[95% CI: 1.11, 2.01]). Total accumulated burden of head impacts was significant (F(2,194) = 4.938, P&amp;lt;0.008), with backers (4622.85g’s [95% CI: 3077.43, 6168.27]) significantly (P=0.011) higher than linemen (2657.70g’s [95% CI: 2045.61, 3269.19 ]) and skill players (2875.7g’s [95% CI: 2216.38, 3535.01]) (P=0.022). Front location impact burden (F(2, 194) = 7.784, P&amp;lt;0.001) revealed backers (1606.24g’s [95% CI: 977.89, 2234.58]) also significantly (P=0.008) higher than both linemen (768.24g’s [95% CI: 433.84, 1102.64]) and skill players (567.75g’s [95% CI: 360.71, 774.78]) (P&amp;lt;0.001). Conclusion: Linebackers, tight ends, and running backs experienced more Imp/E and higher cumulative burden than other positions, which highlights the potential influence of specific positional requirements during football participation. Coaches and healthcare providers should be aware that a position’s role during play may directly relate to changes in head impact risk.

Kiera D. Glodowski

Bret Freemyer

Jay L Myers

Jong Soo Lee

Steven P. Broglio

Troy Furutani

Nathan Murata

Cris Stickley

Erik E. Swartz

Hawaiian High School Football Player Positional Differences in Helmet Impact Characteristics

夏威夷高中橄榄球运动员位置差异对头盔冲击特征的影响

Abstract Context: The demographic landscape of the United States is changing daily and the demand for representation in today&amp;#x92;s workforce is both a moral and practical imperative for creating workplaces diverse in thought, expression, and people. Objective: The purpose of this study was to investigate workplace culture and the direct and indirect influence of supervisors on inclusion of minoritized communities, including those who have experienced marginalization for race, ethnicity, religion, national origin, age, marital status, ability, sexual orientation, sex, gender, gender identity and expression, socioeconomic status, spirituality, political affiliation, literacy, or the intersectionality of multiple identities. Design: Consensual qualitative research study Setting: Semi-structured interview Patients or Other Participants: Eighteen participants were recruited through direct contact via their public domain email addresses that are located on college/university websites. Data Collection and Analysis: Demographic data was collected through a web-based recruitment survey which was also used to schedule a semi-structured interview. We used the multi-phased CQR tradition to identify domains and categories representative of the data. Results: Three domains emerged. The environment domain spoke to the culture each supervisor created through relationship building and intention; intention was further characterized as active or passive behaviors whereby almost all pa rticipants described both. Only one-third of participants referenced DEIA policies and procedures within their organization. The resources domain represented the existence and awareness of organizational DEIA resources, or lack thereof. The perceptions domain characterized the beliefs of the supervisors relative to DEIA. Conclusion: Structural efforts must include the creation and implementation of policies and procedures for employee inclusion, not just patient inclusion. The awareness and use of organizational resources is an important component to support supervisor efforts and should be leveraged from within the unit.

Jean TO

Young JY

Edler Nye

Nye EA

Eberman LE

Supervisor Authority and its Impacts on Equity, Diversity, and Inclusion in Athletic Training

体育训练中主管权威及其对公平、多样性和包容性的影响

Abstract Context: Non-combat musculoskeletal conditions are endemic among service members and disproportionately affect females. Pregnancy and childbirth contribute to lower physical fitness assessment scores and higher body mass index, both risk factors for musculoskeletal conditions, for up to one-year post-pregnancy. However, there is a paucity of information regarding the impact of pregnancy on musculoskeletal conditions. Objective: To explore the association between the post-pregnancy period and incident musculoskeletal conditions (MSK). Design: Retrospective, longitudinal cohort study. Setting: Medical and administrative data from the Medical Assessment and Readiness System. Other Participants: Female military service members with and without a pregnancy. Main Outcome Measure(s): Months since pregnancy end, health history, and demographic and military service data were abstracted for each subject. Subsequent MSKs were identified with relevant ICD-10 codes. A multivariable logistic regression model assessed the association between the time since pregnancy end and MSK incidence. Results: A total of 298,607 female service members were identified, of which 19,980 had a pregnancy. A larger percentage of post-pregnancy service members (65.8%) had a MSK diagnosis as compared to the non-pregnant cohort (60.3%). Adjusting for covariates, the model suggests a temporal influence on post-pregnancy MSK incidence, such that service members 3- to 4-months and 5- to 6-months post-pregnancy were more likely to be diagnosed with a MSK as compared to the non-pregnant cohort. However, service members &amp;lt;2 months post-pregnancy were less likely to be diagnosed with an MSK, and the odds of an MSK beyond 6-months decreased out to 24-months post-pregnancy. Conclusions: Pregnancy may increase a service member’s odds of sustaining an MSK 3- to 6- months post-pregnancy. Understanding the relationships between pregnancy and MSK risks may lead to changes in postpartum return-to-duty/activity policies, better enabling service members to care for themselves and their families.

Megan H. Roach

D. Alan Nelson

Christina M. Koreerat

Lisa M. Foglia

Timothy C. Mauntel

Association between Pregnancy and Musculoskeletal Conditions in Active-Duty Military Service Members

现役军人妊娠与肌肉骨骼疾病之间的关联

Context Postoperative muscle weakness contributes to the development of aberrant gait biomechanics that persist following traditional anterior cruciate ligament reconstruction (ACLR). However, it is unknown if quadriceps weakness impedes the ability of ACLR patients to modify gait biomechanics using a real-time gait biofeedback (RTGBF) intervention. Objective The purpose was to determine if quadriceps strength associates with the ability to modify vertical ground reaction force (vGRF) during a RTGBF intervention. Design Cross-Sectional Study Setting Research Laboratory Participants 35 individuals with unliateral ACLR (Time since ACLR= 32 ± 16 months; 22 Females, 13 Males) Main Outcome Measures Peak vGRF was evaluated during a baseline walking trial, and three 250-step randomized RTGBF walking trials which cued an increased average peak vGRF of the baseline walking trial by 5%, 10%, or 15%. The ability to modify gait was reported as changes in pvGRF (ΔpvGRF; BW) and root mean square error (RMSE) of the peak vGRF relative to the feedback target (pvGRF RMSE; BW). We also calculated quadriceps strength. Results There were no significant associations between strength (Mean: 2.56 ± 0.75 Nm/kg, Range: 0.84-4.6 Nm/kg) and ΔpvGRF (5% ΔpvGRF: 0.04 ± 0.03 BW, 10% ΔpvGRF: 0.10 ± 0.03 BW, 15% ΔpvGRF: 0.15 ± 0.04 BW) nor strength and RMSE (5% RMSE: 0.04 ± 0.02 BW, 10% RMSE: 0.05 ± 0.02 BW, 15% RMSE: 0.08 ± 0.04 BW) for any of the 3 RTGBF trials (R2: 0.003-0.025; P: 0.37-0.77). Conclusions The magnitude of quadriceps strength did not influence the ability to modify gait using RTGBF. These data suggest that it may be unnecessary to wait for quadriceps full strength recovery to capitalize on the benefits of RTGBF following ACLR.

Dr. Alyssa Evans-Pickett

Dr. Jason R. Franz

Dr. Darin A. Padua

Dr. Adam Kiefer

Dr. Todd A. Schwartz

Dr. J. Troy Blackburn

Dr. Brian Pietrosimone

Quadriceps Strength Does Not Associate with Gait Adaptation Ability in Individuals with Anterior Cruciate Ligament Reconstruction

股四头肌力量与前交叉韧带重建患者步态适应能力无显著关联

Abbreviation	J. Athl. Train.
Journal Impact	2.44
Quartiles(Global)	SPORT SCIENCES(Q1)

ISSN	1062-6050, 1938-162X
h-index	131

Publication Information	Publisher: National Athletic Trainers' Association Inc.，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1996，Proportion of original research papers: 91.18%，Self Citation Rate:11.50%， Gold OA Rate: 97.61%
Average review cycle	网友分享经验：平均6月
Average recruitment ratio	网友分享经验：约25%

Journal of Athletic Training

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