Proprioceptive training programs were effective in reducing the incidence rates of ankle sprains in the athletic population, including those with and those without a history of ankle sprains.

Reference/Citation: Hamstra-Wright KL, Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6):362-369.Clinical Question: What factors put physically active individuals at risk to develop medial tibial stress syndrome (MTSS)?Data Sources: The authors performed a literature search of CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from each database's inception to July 2013. The following key words were used together or in combination: armed forces, athlete, conditioning, disorder predictor, exercise, medial tibial stress syndrome, militaries, MTSS, military, military personnel, physically active, predictor, recruit, risk, risk characteristic, risk factor, run, shin pain, shin splints, and vulnerability factor.Study Selection: Studies were included in this systematic review based on the following criteria: original research that (1) investigated risk factors associated with MTSS, (2) compared physically active individuals with and without MTSS, (3) was printed in English, and (4) was accessible in full text in peerreviewed journals.Data Extraction: Two authors independently screened titles or abstracts (or both) of studies to identify inclusion criteria and quality. If the article met the inclusion criteria, the authors extracted demographic information, study design and duration, participant selection, MTSS diagnosis, investigated risk factors, mean difference, clinical importance, effect size, odds ratio, and any other data deemed relevant. After the data extraction was complete, the authors compared findings for accuracy and completeness. When the mean and standard deviation of a particular risk factor were reported 3 or more times, that risk factor was included in the meta-analysis. In addition, the methodologic quality was assessed with an adapted checklist developed by previous researchers. The checklist contained 5 categories: study objective, study population, outcome measurements, assessment of the outcome, and analysis and data presentation. Any disagreement between the authors was discussed and resolved by consensus.Main Results: A total of 165 papers were initially identified, and 21 original research studies were included in this systematic review. More than 100 risk factors were identified in the 21 studies. Continuous data were reported 3 or more times for risk factors of body mass index (BMI), navicular drop, ankle plantarflexion range of motion (ROM), ankle-dorsiflexion ROM, ankleeversion ROM, ankle-inversion ROM, quadriceps angle, hip internal-rotation ROM, and hip external-rotation ROM. As compared with the control group, significant risk factors for developing MTSS identified in the literature were (1) Conclusions: The primary factors that appeared to put a physically active individual at risk for MTSS were increased BMI, increased navicular drop, greater ankle plantar-flexion ROM, and greater hip external-rotation...

The coronavirus 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) incited a national emergency (1) that forced colleges and universities in the United States to close their doors in March 2020 (2). These sudden university closures left minimal time for sport coaches, strength and conditioning (S&C) coaches, and other support staff to create and disseminate feasible at-home training programs for student-athletes. Nationwide shutdowns further complicated athletes' training at home by limiting access to adequate exercise equipment and space required for training. As this is the first time all sports have come to a halt since the 1940s, no data exist regarding student-athlete sport training regimens, nutritional habits, and mental health status during times of limited or no access to adequate training equipment and/or resources (3). Therefore, research is warranted to investigate the effect extended time away from typical training routines has on collegiate student-athlete sport training habits and overall well-being.Collegiate student-athletes' sport training and competition seasons typically follow a set schedule with routine access to school-based support including sport coaches responsible for on-field sport-specific training, S&C coaches responsible for general performance development, athletic trainers in charge of injury and rehabilitation management, nutritional support for dietary needs, and access to adequate exercise training equipment. Brief periods away from these resources generally occur in 2to 6-wk blocks over semester breaks. Lack of training during these times can result in detraining evidenced by decreased aerobic capacity, speed, and muscular power (4). Large increases in acute workloads in general or after periods of detraining increase the risk of both overuse and traumatic injuries (5,6). For example, higher injury rates are often seen among collegiate athletes during preseason when training volume markedly increases (7). Return to sport after COVID-19 lockdowns may exaggerate this effect, similar to the increased tendon injury occurrence seen in 2011 after the National Football League's 19-week lockout (8). More recently, a case study following a professional soccer team through the fall

Context Transgender student-athletes are increasingly participating in sport, requiring athletic trainer (AT) preparedness to care for their needs. Objective To measure ATs' (1) perceived definition of transgender, (2) comfort and competence working with transgender student-athletes, (3) sources of education, (4) perceived legal concerns, and (5) perception of competitive advantage. Design Cross-sectional study. Setting Mixed-methods survey. Patients or Other Participants Collegiate or university ATs (n = 5537) received an email invitation to participate; the data of 667 ATs were included in the analysis. Main Outcome Measure(s) A multipart 43-item questionnaire addressing the primary objectives of the study, with other factors that were explored in relation to these objectives to uncover potential influences on their responses. We calculated descriptive statistics, and for open-ended responses, we used the consensual qualitative research tradition. Results About half (48.1%, n = 321) of the participants agreed they were competent in treating transgender patients, but only 36.0% (n = 240) believed they were competent in practicing collaboratively with an endocrinologist in the drug-screening processes. Fewer than half (45.6%, n = 304) of participants felt they were competent in using appropriate terminology relating to transgender patients. The ATs disagreed when asked if they were competent regarding counseling transgender patients about the effects of hormone replacement therapy on sport participation (48.1%, n = 321) or on mental health concerns (40.3%, n = 269). Participants learned most frequently from media outlets (35.2%, n = 235) or personal experiences with family, friends, or themselves (33.7%, n = 225), yet 35.1% (n = 243) received no education in caring for transgender patients. Many ATs (41.2%, n = 278) believed that transgender female student-athletes had a competitive advantage. In contrast, 6.6% (n = 44) of participants indicated that transgender male student-athletes had a competitive advantage. Conclusions Although collegiate ATs generally felt competent in treating transgender patients, they did not feel capable of addressing specific aspects of transgender patients' health care needs. Regardless of the resulting perceived unfair advantage, ATs must be aware of the regulations and therapeutic effects associated with hormone-related therapy for transgender student-athletes.

Context: The core competencies of health care indicate that all medical professionals should provide patient-centered care (PCC), or care that is respectful and responsive to one's values and preferences, during each encounter. Objective: To identify collegiate student-athletes' definition of PCC and measure their perceived level of PCC from an athletic trainer (AT). Design: Cross-sectional study. Setting: Mixed-method survey. Patients or Participants: A total of 610 (age = 19 ± 1 year) NCAA student-athletes completed the survey. Main Outcome Measure(s): The survey consisted of one open-ended question prompting the participant to define PCC in their own words. The quantitative data was gathered through the Global Perceptions of Athletic Trainer PCC tool which explored the overall agreement about the ATs use of PCC constructs. Finally, those participants who had received care from an AT completed the validated Patient Perception of Patient-Centeredness (PPPC) instrument. Qualitative analysis was completed through Text IQ™ technology from Qualtrics® with a mean sentiment score (MSS) attributed to each of the coded statements. We performed descriptive statistics for all quantitative data. Results: The qualitative analysis revealed 13 topics in which the most used were individualized, priority, and best. Other topics were inconsistent with how the medical community has defined PCC. On the global agreement scale of PCC tool, the participants expressed a strong agreement (mode = 4) with 12 of the 15 statements. On the patient perception instrument, participants expressed that the AT was completely (mode = 4) patient-centered for all dimensions during their most recent encounter. However, the behaviors of PCC, defined by the medical community, may not be directly expressed from the viewpoint of a collegiate student-athlete. Conclusions: Student-athletes defined PCC as individualized and prioritized health care. Additionally, student-athletes perceived that ATs provided care that kept their best interest in mind and practiced PCC during their encounters.