Context: Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear.Objective: To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion.Design: Qualitative study. Setting: Secondary school.Patients or Other Participants: Seven adolescent studentathletes (age range, 12-16 years) who sustained a sport-related concussion at least 1 year (15.3 6 2.8 months) before the study participated along with their primary care-giving parents (n ¼ 7).Data Collection and Analysis: Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results.Results: Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships.Conclusions: Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent studentathletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling behind while ensuring a healthy return to normal school routines. Furthermore, adolescent support systems must be considered throughout the recovery process.

Adolescent exposure to concussions is of concern due to the risk imposed on the developing brain and the potential for adverse outcomes later in life. Although a graduated return to play is heavily emphasized in concussion management, researchers need to investigate barriers inhibiting the implementation of return-to-learn protocols. Concussion education should aim to modify indifferent attitudes toward concussive injuries. Additionally, investigators should continue to assess how a history of concussion affects quality of life in recently retired collegiate athletes.

In the United States, an excess of $1 billion is spent annually on anterior cruciate ligament (ACL) repair surgeries/rehabilitation programs in varsity female sports. Research has indicated that female athletes may be 2 to 10 times more likely to sustain an ACL tear than their male counterparts. Objective: The purpose of this study was to analyze the neuromuscular changes in females during different phases of the menstrual cycle. Design: Observational Cohort Setting: Laboratory Participants: Fifty (50) physically active college aged females (25 on oral contraception) were recruited to participate in three separate visits throughout one menstrual cycle. The groups were similar at baseline. Intervention: Visits coincided with follicular, ovulatory, and the luteal phase of the cycle. At each visit, participants had their blood drawn to assess for estradiol, progesterone, and relaxin levels. Along with blood measurements, isokinetic quadriceps strength at 60°/sec, 180°/sec, and 300°/sec, and knee joint laxity were measured at each visit. Main Outcome Measures: Isokinetic quadriceps strength, KT-1000 measurements, blood assays. Results: Isokinetic peak torque at 60°/sec was significantly lower during the follicular (151.6 ± 26.8 NM) than during the ovulatory phases (157.5 ± 27.1 NM, p<0.05). Isokinetic peak torque at 180°/sec was significantly lower during the follicular phase (98.7 ± 17.9 NM) than the ovulatory (107.1 ± 19.5 NM, p<0.05) and luteal phases (111.2 ± 19.5 NM, p<0.05). Results were similar for the x 300°/sec isokinetic testing with significantly lower peak torque during follicular (79.0 ± 16.0 NM) than the ovulatory (85.4 ± 16.8 NM, p<0.05) or luteal phases (85.7 ± 16.0 NM, p<0.05). No differences were observed for knee joint laxity among any of the visits. Conclusion: Results show that muscle strength is lowest during the follicular phase of the menstrual cycle and muscle strength and knee joint laxity are independent of hormone level fluctuations.

Context It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding EBP concepts across the curriculum, a modified critical appraisal assignment was developed to teach therapeutic modality concepts. Objective The purpose of this action research project was to demonstrate how a modified critical appraisal assignment can be used to introduce the process and aspects of critical appraisal and begin scaffolding the development of critical appraisal skills over time. The objectives of this study were to evaluate the students' ability to (1) successfully locate relevant research needed to answer clinical questions and (2) successfully appraise the literature according to basic EBP strategy. From a program perspective, the modified critical appraisal assignment was a starting point from which to include EBP principles into didactic coursework. Design Seventeen athletic training students completed 3 modified critical appraisal assignments pertaining to the use of therapeutic modalities. Each paper included 5 sections: (1) clinical question, (2) key clinical findings, (3) clinical applicability based on information from the appraisal and significance of results, (4) article comparison table, and (5) implications for clinical practice, patient education, and future research. The instructor evaluated the assignments blind. Conclusions Students were generally able to complete the critical appraisal assignment; however, students had difficulty locating research that answered the clinical question. Students struggled to relate the key clinical findings of the research articles and implications for clinical practice to the given clinical question. Findings from this study have informed faculty teaching, including introducing EBP skills earlier in the curriculum and inserting assignments that stress various aspects of the critical appraisal process.

An 18-year-old NCAA Division I women’s softball player presented with a sudden onset of pain in her left wrist during a strength and conditioning workout. Initial examination revealed pain, loss of AROM, decreased muscle strength, and paresthesia. The patient experienced symptomology for 12+ weeks. Corticosteroid injections were administered which finally confirmed diagnosis, reduced pain, and paresthesia. Intersection syndrome is generally an overuse condition which resolves within approximately 2 weeks. This case demonstrates that examination findings, imaging, immobilization, and a therapeutic exercise plan may not be sufficient to decrease patient symptomology.