Background: A majority of youth club sport organization coaches have well-established concussion knowledge gaps. Potential negative outcomes associated with sport-related concussion drive the need for resources to educate parents about prevention, recognition, and management of concussion in the youth athlete. Parents play a critical role in management of concussion for their child. Purpose: This study aims to (1) investigate current knowledge of concussion among parents whose children age 5-18 years play a club sport and (2) identify effects of an online video versus online print educational intervention on concussion knowledge change and learning. Methods: 140 parents whose children played a club sport answered questions regarding their knowledge of sport-related concussion pre and post random assignment to an educational intervention: CDC Concussion Awareness video or CDC Concussion Fact Sheet for Parents. Results: Participating parents demonstrated a moderate level of pre-intervention knowledge (mean= 3.73), but critical gaps in knowledge were identified. Knowledge of concussion improved slightly following intervention regardless of intervention type (mean= 3.87). Conclusions: This study confirms the presence of gaps in knowledge of concussion in parents whose children play club sports. Without the protection of concussion legislation, those athletes who participate in club sports are at particular risk due to lack of concussion knowledge and education. This study confirms that education can have a positive impact on parental knowledge of concussion. Clinical Relevance: Pre-knowledge of concussion is the greatest predictor of post-knowledge of concussion, therefore pre-assessment of target audience knowledge followed by a custom educational intervention taking into account principles of adult learning, would be the most beneficial to increasing concussion knowledge.
BACKGROUND: Idiopathic toe walking is characterized by persistent toe walking in the absence of clinically diagnosed neuromuscular disease. Treatment options in children diagnosed with idiopathic toe walking include: observation, physical therapy, serial casting, or Achilles tendon (heel cord) lengthening surgery. OBJECTIVE: In this case report, we present a non-invasive serial casting protocol to treat severe and persistent toe walking in an 18-month old child, diagnosed as an idiopathic toe walker following neurological examination. METHODS: A series of below knee casts was used to provide a consistent stretch to the plantar flexor muscles. Upon removal of each set of casts, passive range of motion at the ankles was measured with a goniometer. RESULTS: Four sets of casts, each lasting approximately one week, increased passive ankle dorsiflexion to 10 • of neutral and established a heel-toe walking gait. Improvements in ankle range of motion and gait were maintained upon repeated examinations at 3, 7, and 12 months post-casting. CONCLUSIONS: These results demonstrate that non-invasive procedures, such as serial casting, can be successful in very young children diagnosed as idiopathic toe walkers. Early identification and intervention for this diagnosis may eliminate the need for invasive surgeries and associated risks in this population.
Pain sensitivity and tolerance were studied using the cold-pressor technique. A 3 independent groups design was employed using rumination as the independent variable. Group 1 was given a situation in which anger-related self-rumination was introduced. Group 2 was given a self-related rumination task in which anger was not induced. Group 3 received a rumination task not related to the self. In addition, the State-Trait Anger Expression Inventory was given prior to the experiment to test the hypothesis that ratings on the Anger-In subtest would correlate with pain sensitivity. In each group were 6 men and 6 women. Each participant took the anger and another inventory not relevant to the present study before the experiment. An anger measure was taken before and after the experiment for each group to see if the anger induction in Group 1 actually increased anger. There were no differences among the 3 groups on the second anger measure, so differences between Groups 1 and 2 could not be attributed to anger. A 1-way analysis of variance for 3 groups showed a strong main effect on pain tolerance but not pain sensitivity. Groups 1 and 2 were significantly more tolerant of pain than Group 3. The correlation of ratings on the Anger-In (internalized anger) subtest fell short of statistical significance with pain sensitivity and also was not significant for pain tolerance. Results were discussed in terms of the possibility that self-rumination may increase pain tolerance by requiring a greater cognitive load than nonself rumination.
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