Preventive Training Program Feedback Complexity, Movement Control, and Performance in Youth Athletes

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes. Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches\u27 choosing. Design: Cluster-randomized controlled trial. Setting: Soccer fields. Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years). Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, or control group. Simplified and traditional PTPs lasted 10 to 12 minutes and used the same exercises. The simplified PTP provided only sagittal-plane feedback (eg, “get low”), and the traditional PTP provided feedback targeting all motion planes (eg, “don\u27t let your knees cave inward”). Research assistants administered the PTP warmups 2 to 3 times/week for the season. Control team coaches chose and ran their own warmup strategies. Main Outcome Measure(s): Participants completed 4 sessions (preseason [PRE], postseason [POST] at approximately 8 weeks after PRE, retention 1 [R1] at 6 weeks postseason, and retention 2 [R2] at 12 weeks postseason). They performed 3 trials of a jump-landing task, which was evaluated using the Landing Error Scoring System (LESS) and 2 recorded standing LJ trials at each test session. A time series panel was used to evaluate group differences across time points for the LESS and LJ. Results: Change score analyses revealed improvements in the LESS score from PRE to POST for all groups. Improvements from PRE were retained at R1 and R2 for the intervention groups (simplified and traditional). The traditional group demonstrated better LJ performance at POST (P \u3c .001) and R1 (P = .049) than the simplified or control group. Conclusions; Simplified cues were as effective as traditional cues in improving LESS scores from PRE to POST season. Participating in PTPs, regardless of their complexity, likely provides movement benefits

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics

Athletic Administrators Report of Emergency Action Plan Adoption in Secondary School Athletics: The Influence of Athletic Training Services

This study describes the emergency action plan (EAP) adoption in secondary school athletics reported by athletic administrators in the United States. Utilizing best-practice criteria, a questionnaire assessed athletic administrators’ knowledge and adoption of an EAP in their athletics program. A majority of athletic administrators reported having an EAP; however, the EAP often lacked the necessary components to be compliant with best-practice guidelines. Further, access to an athletic trainer was associated with increased EAP adoption and adopting a venue specific EAP. Athletic administrators should utilize these data to facilitate improved policy adoption and management of athletics programs

Carbon Fiber Insoles Enhance Perception of Performance Despite Variable Objective Outcomes: Specific to the Moderately Active Individual

International Journal of Exercise Science 16(4): 885-897, 2023. Carbon fiber insoles (CFIs) may benefit performance in elite athletes, however, their use in moderately active individuals has been adopted without evidence supporting such enhancements in this population. Fifteen male subjects performed vertical jump (VJ) and repeat treadmill sprint tests before and after a VO2peak while wearing 1) CFIs and 2) control insoles (CON). Subjects completed a subjective survey regarding their perceived performance abilities for both conditions. There were no significant differences between CFIs and CON in VJ height, sprint distance, heart rate following sprints; and rate of oxygen consumption, perceived fatigue, and perceived exertion at 85% of maximal speed (p \u3e 0.05) during the VO2peak. At maximal speed, although there was no difference between conditions in peak rate of oxygen consumption (95%CI [-4.85, 0.21]) and respiratory exchange ratio (95%CI [-0.01, 0.03]), CFIs resulted in a reduced level of perceived fatigue (95%CI [-1, 0]) and perceived exertion (95%CI [-2, 0]) compared to CON. Subjects subjectively reported increased feelings of “propulsion or explosiveness” (p = 0.026) and being able to “perform better while jumping” (p = 0.029) while wearing CFIs. Heightened perceptions of performance enhancements when wearing CFIs indicate, in the moderately active, perceptual benefits could be more influential for determining CFI use

Quadriceps and Hamstrings Coactivation During Common Therapeutic Exercises

Anterior tibial shear force and knee valgus moment increase anterior cruciate ligament (ACL) loading. Muscle coactivation of the quadriceps and hamstrings influences anterior tibial shear force and knee valgus moment, thus potentially influencing ACL loading and injury risk. Therefore, identifying exercises that facilitate balanced activation of the quadriceps and hamstrings might be beneficial in ACL injury rehabilitation and prevention

The Precaution Adoption Process Model in Describing Emergency Action Plan Adoption

Purpose: The purpose of this study was to identify the ability of the Precaution Adoption Process Model (PAPM) to classify athletic trainers (ATs) and athletic directors (ADs) readiness to act with regards to adopting an emergency action plan (EAP), and describe factors influencing PAPM stages. Method: We used a cross-sectional questionnaire design to evaluate readiness to act for developing an EAP among ATs and ADs working in United States high schools. The PAPM is a participant-driven model to identify someone’s readiness to act or change and has seven stages: Unaware, Unengaged, Undecided, Decided not to Act, Decided to Act, Acting and Maintaining. Prevalence ratios (PRs) with 95% confidence intervals (95% CI) were calculated. Results: A majority of ATs and ADs reported maintaining an EAP in their secondary school (AT “Maintaining” = 84.4%, AD “Maintaining” = 68.7%). ADs were more likely to be staged as “Decided not to Act” (PR=0.14, 95% CI= 0.05, 0.41) for the development of an EAP compared to ATs. ATs were more likely to be staged as “Maintaining” (PR=1.23, 95% CI = 1.16, 1.30) for the development of an EAP compared to ADs. Conclusions: The PAPM appears to be able to classify AT and AD readiness to act with adoption of an EAP. However, statistical modeling struggles to identify predictors for the various stages. Future research should aim to use the PAPM stages in the development of tailored interventions

Lower Extremity Kinematics and Ground Reaction Forces After Prophylactic Lace-Up Ankle Bracing

Long-term effects of ankle bracing on lower extremity kinematics and kinetics are unknown. Ankle motion restriction may negatively affect the body's ability to attenuate ground reaction forces (GRFs)

Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program

Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk

Adoption of Lightning Safety Best-Practices Policies in the Secondary School Setting

CONTEXT: Lightning-related injuries are among the top 10 causes of sport-related death at all levels of sport, including the nearly 8 million athletes participating in US secondary school sports. OBJECTIVE: To investigate the adoption of lightning safety policies and the factors that influence the development of comprehensive lightning safety policies in United States secondary schools. DESIGN: Cross-sectional study. SETTING: Secondary school. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers (ATs). MAIN OUTCOME MEASURE(S): An online questionnaire was developed based on the “National Athletic Trainers' Association Position Statement: Lightning Safety for Athletics and Recreation” using a health behavior model, the precaution adoption process model, along with facilitators of and barriers to the current adoption of lightning-related policies and factors that influence the adoption of lightning policies. Precaution adoption process model stage (unaware for need, unaware if have, unengaged, undecided, decided not to act, decided to act, acting, maintaining) responses are presented as frequencies. Chi-square tests of associations and prevalence ratios with 95% CIs were calculated to compare respondents in higher and lower vulnerability states, based on data regarding lightning-related deaths. RESULTS: The response rate for this questionnaire was 13.43% (n = 365), with additional questionnaires completed via social media (n = 56). A majority of ATs reported maintaining (69%, n = 287) and acting (6.5%, n = 27) a comprehensive lightning safety policy. Approximately 1 in 4 ATs (25.1%, n = 106) described using flash to bang as an evacuation criterion. Athletic trainers practicing in more vulnerable states were more likely to adopt a lightning policy than those in less vulnerable states (57.4% versus 42.6%, prevalence ratio [95% CI] = 1.16 [1.03, 1.30]; P = .009). The most commonly cited facilitator and barrier were a requirement from a state high school athletics association and financial limitations, respectively. CONCLUSIONS: A majority of ATs related adopting (eg, maintaining and acting) the best practices for lightning safety. However, many ATs also indicated continued use of outdated methods (eg, flash to bang)

Seven Steps for Developing and Implementing a Preventive Training Program: Lessons Learned from JUMP-ACL and Beyond

Musculoskeletal injuries during military and sport-related training are common, costly and potentially debilitating. Thus, there is a great need to develop and implement evidence-based injury prevention strategies to reduce the burden of musculoskeletal injury. The lack of attention to implementation issues is a major factor limiting the ability to successfully reduce musculoskeletal injury rates using evidence-based injury prevention programs. We propose 7 steps that can be used to facilitate successful design and implementation of evidence-based injury prevention programs within the logical constraints of a real-world setting by identifying implementation barriers and associated solutions. Incorporating these 7 steps along with other models for behavioral health interventions may improve the overall efficacy of military and sport-related injury prevention programs