Inter-Rater Agreement of a Functional Dual-Task Test Developed for the Assessment of Sports Related Concussions

Please enjoy Volume 5, Issue 1 of the JSMAHS. In this issue you will find Professional and under graduate research abstracts, case reports, and critically appraised topics. This research was funded by an OATA Research Grant Thank you for viewing this 5th Annual OATA Special Edition

Anterior cruciate ligament reconstruction associated with brain activity differences during unilateral lower extremity motor imagery: A Pilot Study.

Recent research has indicated that anterior cruciate ligament reconstruction (ACL-R) is associated with neuroplastic adaptations. It is speculated that these adaptions could affect motor processes. However, it is unclear how these adaptions may influence the feedforward and feedback mechanisms of motor control. The purpose of this study was to determine if ACL-R is associated with an alteration in feedforward motor control. A group of healthy active participants (n=3, age=24.5±0.71 years, height=1.74±0.05m, weight=74.16±18.28kg) and a left ACL-R group (n=3, age=22.5±4.95 years, height=1.79±0.09m, weight=87.32±24.06kg, 52±31 months post-surgery) were locally recruited. Functional magnetic resonance imaging (fMRI) was performed for analysis of brain activation during a kinesthetic motor imagery (MI) task that served as a model indicator of feedforward motor control. The subjects MI task consisted of remaining completely motionless while mentally performing unilateral left (involved) 45° knee extension/flexion at a rate of 1.2 Hz for 4 blocks of 30 seconds interspersed with 30 second rest. The two groups were contrasted using a mixed-effects general linear model with a cluster-forming threshold of z>3.1. Results revealed that, in comparison to the control group, the ACL-R group had increased activity within the ipsilateral inferior temporal sulcus (voxels:88; p<0.001, z-max:4.32, MNI coordinate voxel: -52,-4,-18) and contralateral insula (voxels:77; p<0.001, z-max:5.86, MNI coordinate voxel:34,2,18), dorsolateral prefrontal cortex (voxels:43; p<0.03, z-max:5.02, MNI coordinate voxel:38,36,14), and visual cortex (voxels:42; p<0.03, z-max:4.45, MNI coordinate voxel:10,-94,16), relative to the side of injury, and decreased activation in the basal ganglia (voxels: 230; p<0.001, z-max:5.44, MNI coordinate voxel:12,-24,-8). These results indicate that ACL-R is associated with potential alterations in motor planning, specifically increasing executive function and visual-motor activity to engage in motor imagery. Future research should focus on understanding the neural networks associated with the observed neuroplastic adaptations within this population and develop therapeutic interventions to restore sensorimotor planning neural activity

A Functional Agility Short-Term Fatigue Protocol Changes Lower Extremity Mechanics

The purpose of this study was to evaluate the effects of a functional agility fatigue protocol on lower extremity biomechanics between two unanticipated tasks (stop-jump and sidestep). The subjects consisted of fifteen female collegiate soccer athletes (19 ± 0.7 years, 1.67 ± 0.1 m, 61.7± 8 kg) free of lower extremity injury. Participants performed five trials of stop-jump and sidestep tasks. A functional short-term agility protocol was performed, and immediately following participants repeated the unanticipated running tasks. Lower extremity kinematic and kinetic values were obtained pre and post fatigue. Repeated measures analyses of variance were conducted for each dependent variable with an alpha level set at 0.05. Knee position post-fatigue had increased knee internal rotation (11.4 ± 7.5 degrees vs. 7.9 ± 6.5 degrees p = 0.011) than pre-fatigue, and a decreased knee flexion angle (-36.6 ± 6.2 degrees vs. -40.0 ± 6.3 degrees, p = 0.003), as well as hip position post-fatigue had decreased hip flexion angle (35.5 ± 8.7 degrees vs. 43.2 ± 9.5 degrees, p = 0.002). A quick functional fatigue protocol altered lower extremity mechanics of Division I collegiate soccer athletes during landing tasks. Proper mechanics should be emphasized from the beginning of practice/game to aid in potentially minimizing the effects of fatigue in lower extremity mechanics

Landing Technique Affects Knee Loading and Position During Athletic Tasks

Anterior cruciate ligament (ACL) injuries have been reported to occur with the ankle in a dorsiflexed position at initial contact. Few studies have attempted to quantify the biomechanical parameters related with such landing patterns during athletic tasks. Objectives- The purpose of this study was to evaluate the effects that two landing techniques have in lower extremity biomechanics while performing two tasks. Design- Single-group repeated measures design. Methods- Twenty female soccer athletes from a Division 1 institution performed two landing techniques (forefoot and rearfoot) during two unanticipated tasks (sidestep cutting and pivot). Repeated measures analyses of variance were conducted to assess differences in the kinematic and kinetic parameters between landing techniques for each task. Results: The forefoot landing technique had significantly higher internal knee adductor moment than the rearfoot for both the pivot and sidestep cutting task (p \u3c 0.001 and p = 0.003, respectively). For the sidestep cutting task, participants had increased knee valgus angle with the rearfoot, whereas for the pivot they had increased knee valgus with the forefoot landing technique (p \u3c 0.05). Conclusions- The results of this study highlighted that there are inherent differences in biomechanical outcomes between foot-landing techniques. The forefoot landing technique increasingly affects knee adduction moment loading, which can potentially place a higher strain on the ACL. Essentially, the demands of the landing technique on lower extremity biomechanics (e.g., hip and knee) are task dependent

The Arabidopsis KH-Domain RNA-Binding Protein ESR1 Functions in Components of Jasmonate Signalling, Unlinking Growth Restraint and Resistance to Stress

Glutathione S-transferases (GSTs) play important roles in the protection of cells against toxins and oxidative damage where one Arabidopsis member, GSTF8, has become a commonly used marker gene for early stress and defense responses. A GSTF8 promoter fragment fused to the luciferase reporter gene was used in a forward genetic screen for Arabidopsis mutants with up-regulated GSTF8 promoter activity. This identified the esr1-1 (enhanced stress response 1) mutant which also conferred increased resistance to the fungal pathogen Fusarium oxysporum. Through positional cloning, the ESR1 gene was found to encode a KH-domain containing RNA-binding protein (At5g53060). Whole transcriptome sequencing of esr1-1 identified altered expression of genes involved in responses to biotic and abiotic stimuli, hormone signaling pathways and developmental processes. In particular was an overall significant enrichment for jasmonic acid (JA) mediated processes in the esr1-1 down-regulated dataset. A subset of these genes were tested for MeJA inducibility and we found the expression of some but not all were reduced in esr1-1. The esr1-1 mutant was not impaired in other aspects of JA-signalling such as JA- sensitivity or development, suggesting ESR1 functions in specific components of the JA-signaling pathway. Examination of salicylic acid (SA) regulated marker genes in esr1-1 showed no increase in basal or SA induced expression suggesting repression of JA-regulated genes is not due to antagonistic SA-JA crosstalk. These results define new roles for KH-domain containing proteins with ESR1 unlinking JA-mediated growth and defense responses.http://doi.org/10.1371/journal.pone.0126978</a

Curricular Satisfaction Levels of National Athletic Trainers\u27 Association- Accredited Postprofessional Athletic Training Graduates

Context: Academic programs rely on outcomes assessments to determine if changes in the curriculum are necessary. Objective: To examine the overall satisfaction levels of graduates (2005-2006) of National Athletic Trainers\u27 Association-accredited postprofessional athletic training education programs as related to the 2002 Standards and Guidelines for Development and Implementation of NATA-Accredited PostProfessional Graduate Athletic Training Education Programs. Design: Original survey instrument and demographic questionnaire. Setting: Online survey instrument. Patients or Other Participants: Of 211 survey recipients, 123 returned surveys (58.29% response rate). Main Outcome Measure(s): Demographic information and satisfaction levels in 10 standard areas (depth of learning, breadth of learning, critical thinking, instructor availability, theoretic basis, writing skills, scholarly growth, community return, leadership, and overall program satisfaction) were obtained. Satisfaction scores were categorized into 10 percentage brackets (eg, 80%-89%) for each standard area. Results: No differences were noted in relation to any of the standard satisfaction areas for evaluation of time off from school. However, graduates who required more than the allotted amount of time to complete their degree were less satisfied in the areas of depth of learning (P = .027), breadth of learning (P = .001), instructor availability (P = .005), writing (P = .022), and overall program satisfaction (P = .016). Conclusions: Graduates were generally satisfied across all areas of their didactic curriculum. However, satisfaction levels were affected if graduates required more than the allotted amount of time to complete their degrees

Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol

Context: Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing. Objective: To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestep-cutting task (SS). Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: Eighteen uninjured female collegiate soccer players (age 19.2 ± 0.9 years, height = 1.66 ± 0.5 m, mass 61.6 ± 5.1 kg) volunteered. Intervention(s): The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained. Main Outcome Measure(s): Dependent variables were hip- and knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase. Results: Knee-flexion angle decreased from prefatigue (-17 degrees ± 5 degrees) to 50% fatigue (-16 degrees ± 6 degrees) and to 100% fatigue (-14 degrees ± 4 degrees) (F2,34 = 5.112, P = .004). Knee flexion at peak stance increased from prefatigue (-52.9 degrees ± 5.6 degrees) to 50% fatigue (-56.1 degrees ± 7.2 degrees) but decreased from 50% to 100% fatigue (-50.5 degrees ± 7.1 degrees) (F2,34 = 8.282, P = 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 ± 0.23 Nm/kgm) to 50% fatigue (0.55 ± 0.25 Nm/kgm) but decreased from 50% to 100% fatigue (0.37 ± 0.24) (F 2,34 = 3.755, P = 03). Hip-flexion angle increased from prefatigue (45.4 degrees ± 10.9 degrees) to 50% fatigue (46.2 degrees ± 11.2 degrees) but decreased from 50% to 100% fatigue (40.9 degrees ± 11.3 degrees) (F2,34 = 6.542, P= .004). Hip flexion at peak stance increased from prefatigue (49.8 degrees ± 9.9 degrees) to 50% fatigue (52.9 degrees ± 12.1 degrees) but decreased from 50% to 100% fatigue (46.3 degrees ± 12.9 degrees) (F 2,34 = 8.639, P = 001). Hip-abduction angle at initial contact decreased from prefatigue (-13.8 degrees ± 6.6 degrees) to 50% fatigue (-9.1 degrees ± 6.5 degrees) and to 100% fatigue (-7.8 degrees ± 6.5 degrees) (F2,34 = 11.228, P = .001). Hip-adduction moment decreased from prefatigue (0.14 ± 0.13 Nm/kgm) to 50% fatigue (0.08 ± 0.13 Nm/kgm) and to 100% fatigue (0.06 ± 0.05 Nm/ kg) (F2,34 = 5.767, P = .007). Conclusions: The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants\u27 maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice

Differences in Static postural Control Performance Between Athletes who are Hearing and Athletes who are Deaf or Hard-of-Hearing

Please enjoy Volume 5, Issue 1 of the JSMAHS. In this issue you will find Professional and under graduate research abstracts, case reports, and critically appraised topics. This research was funded by an OATA Research Grant Thank you for viewing this 5th Annual OATA Special Edition

Comparison of a Head Mounted Impact Measurement Device to the Hybrid III Anthropomorphic Testing Device in a Controlled Laboratory Setting

Background: Reports estimate that 1.6 to 3.8 million cases of concussion occur in sports and recreation each year in the United States. Despite continued efforts to reduce the occurrence of concussion, the rate of diagnosis continues to increase. The mechanisms of concussion are thought to involve linear and rotational head accelerations and velocities. One method of quantifying the kinematics experienced during sport participation is to place measurement devices into the athlete’s helmet or directly on the athlete’s head. Purpose: The purpose of this research to determine the accuracy of a head mounted device for measuring the head accelerations experienced by the wearer. This will be accomplished by identifying the error in Peak Linear Acceleration (PLA), Peak Rotational Acceleration (PRA) and Peak Rotational Velocity (PRV) of the device. Study Design: Laboratory study. Methods: A helmeted Hybrid III 50th percentile male headform was impacted via a pneumatic ram from the front, side, rear, front oblique and rear oblique at speeds from 1.5 to 5 m/s. The X2 Biosystems xPatch® (Seattle, WA) sensor was placed on the headform’s right side at the approximate location of the mastoid process. Measures of PLA, PRA, PRV from the xPatch ® and Hybrid III were analyzed for Root Mean Square Error (RMSE), and Absolute and Relative Error (AE, RE). Result: Seventy-six impacts were analyzed. All measures of correlation, fixed through the origin, were found to be strong: PLA R2 =0.967 p \u3c 0.01, PRA R2 =0.933 p \u3c 0.01, PRV R2 =0.999 p \u3c 0.00. PLA RMSE was 34%, RE 31.0% ± 14.0, and AE 31.1% ± 13.7. PRA RMSE was 23.4%, RE -6.7 ± 22.4 and AE 18.9% ± 13.8. PRV RMSE was 2.2%, RE 0.1 ± 2.2, and AE 1.8 ± 1.3. Conclusion: Without including corrections for effect of skin artifact, the xPatch® produces measurements highly correlated with the gold standard yet above the average error of testing devices in both PLA and PRA, but a low error in PRV. PLA measures from the xPatch® system demonstrated a high level of correlation with the PLA data from the Hybrid III mounted data collection system. Level of Evidence: