A. Barry Joyner

Sideline Performance of the Balance Error Scoring System during a Live Sporting Event.

Objective:The purpose was to examine the influence of a live sporting sideline environment on balance error scoring system (BESS) performance. Design:Prospective longitudinal cohort study. Setting:The BESS was performed by all participants at 3 locations: (1) quiet laboratory, (2) football stadium sidelines, and (3) basketball arena sidelines. Participants:The experimental group had 38 participants (age: 20.1 ± 1.1 years; height: 170.0 ± 7.7 cm; mass: 66.7 ± 9.5 kg) who were female intercollegiate student-athletes (SA). The control group consisted of 38 recreationally active female college students (age: 20.8 ± 1.1 years; height: 162.6 ± 6.0 cm; mass: 63.7 ± 10.6 kg). Interventions:The 2 groups performed the tests at the same locations, the SA group during live sporting events and the control group when no event was occurring. Main Outcome Measures:The dependent variable was the total BESS score. Separate 2 × 3 mixed methods analyses of variance investigated the influence of the environment and practice effect. Results:There was a significant interaction for group by environment (P = 0.004), and the SA group committed more errors at both the football and the basketball settings than the control group. The SA group also committed more errors at football (P = 0.028) than baseline. The control group demonstrated a likely practice effect with fewer errors during each administration. Conclusions:The BESS score deteriorated when performed on the sidelines of a live sporting event potentially challenging the clinical utility of the BESS. Clinicians need to consider the role of the local environment when performing the BESS test and should perform postinjury tests in the same environment as the baseline test. Clinical Relevance:When performing balance testing of patients with suspected concussions, clinicians need to consider the environment in which the test is performed and attempt to match the preseason testing environment.

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes.

Background: Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. Hypothesis: The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. Results: There were significant associations between concussion and lateral ankle sprain (P = 0.012), knee injury (P = 0.002), and lower extremity muscle strain (P = 0.031). There were also significant associations between reported concussions and knee injury (P = 0.003), unreported concussions and knee injury (P = 0.002), and unrecognized concussions and lateral ankle sprain (P = 0.001) and lower extremity muscle strains (P = 0.006), with odds ratios ranging from 1.6 to 2.9. Conclusion: There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinical Relevance: Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.

Examining the Stability of the 7-Item Social Physique Anxiety Scale Using a Test-Retest Method.

This study examined the stability of the 7-item Social Physique Anxiety Scale (SPAS-7) using a test-retest method. Collegiate, undergraduate (N = 201) students completed two administrations of the SPAS-7, with a 14-day separation between the administrations. The scale was administered either at the beginning or end of the physical activity class. The intraclass correlation coefficient (one-way analysis of variance) for two administrations of the SPAS-7 was R = .94 (95% confidence interval [CI]= .93 to .96). For a single administration, the intraclass correlation coefficient was R = .89 (95% CI = .86 to .92). The results revealed the SPAS-7 to be a stable tool for measuring social physique anxiety among college students.

Scapular Upward-Rotation Deficits After Acute Fatigue in Tennis Players.

CONTEXT Fatigue in overhead athletes reduces shoulder muscular contraction and proprioception. These deficits may lead to alterations in scapular upward rotation, which is associated with multiple chronic shoulder conditions prevalent in tennis players. OBJECTIVE To identify the effect of a functional fatigue protocol on scapular upward rotation in collegiate male tennis players. DESIGN Randomized controlled clinical trial. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty healthy male tennis players with no history of shoulder injury completed this study. Participants were divided into 2 groups, experimental (age = 19.4 ± 1.1 years, height = 180.1 ± 8.9 cm, weight = 72.7 ± 11.6 kg) and control (age = 19.6 ± 1.2 years, height = 181.1 ± 6.6 cm, weight = 81.6 ± 13.5 kg). INTERVENTION(S) Participants in the experimental group performed a tennis-serving protocol until the onset of fatigue. Fatigue was defined as a participant reporting a rating of 15 on the Borg Scale of Perceived Exertion and reaching a heart rate of 70% of maximum. Instead of completing the fatigue protocol, control participants rested for an interval time matched to the experimental group. MAIN OUTCOME MEASURE(S) Scapular upward rotation of the dominant arm was measured at rest and at 60°, 90°, and 120° of glenohumeral elevation in the scapular plane. Upward-rotation measurements were taken prefatigue, postfatigue, and at 24, 48, and 72 hours postexercise. Scapular upward-rotation values were calculated as change scores from baseline and analyzed using a 2 × 4 mixed-model analysis of variance. RESULTS Significant group-by-time interaction effects were found in postfatigue change scores. The experimental group displayed scapular upward-rotation deficits at all testing positions postfatigue (rest: -2.1° ± 1.4°, 60°: -2.2° ± 2.2°, 90°: -3.2° ± 2.1°, 120°: -4.0° ± 1.3°). No differences were observed at 24, 48, or 72 hours after the fatigue protocol. CONCLUSIONS Fatigue impaired scapular upward rotation in male tennis players, but values returned to baseline within 24 hours. Clinicians should monitor scapular upward rotation in tennis players returning to competition within a day after heavy serving activity.

An Examination of Euro-American and African-American Differences in Social Physique Anxiety among College Women:

Many studies have examined sex differences in social physique anxiety; however, few researchers have examined possible perceptual differences in such anxiety based on ethnicity. The present purpose was to examine social physique anxiety among college-age women of Euro-American and African-American descent. Participants (N = 91) from physical activity classes at a university located in the southeastern United States completed the Social Physique Anxiety Scale. The participants were 67 Euro-Americans and 24 African Americans. An independent t test yielded a significant difference (p = .01) between groups on Eklunds scale, which supports the hypothesis.