Amanda M. Caswell

State-Specific Differences in School Sports Preparticipation Physical Evaluation Policies

OBJECTIVE: This study evaluated the current preparticipation physical evaluation (PPE) administrative policies and cardiovascular screening content of all 50 states and Washington, DC. METHODS: PPE policies, documents, and forms from all 50 states and Washington, DC, were compared with the preparticipation physical evaluation–fourth edition (PPE-4) consensus recommendations. All electronic documents were publicly available and obtained from state interscholastic athletic associations. RESULTS: Fifty (98%) states required a PPE before participation. Most states (53%, n = 27) required a specific PPE form, whereas 24% (n = 12) of states recommended a specific form. Twenty-three states (45%) required or recommended use of the PPE-4 form or a modified version of it, and 27 states (53%) required or recommended use of outdated or unidentifiable forms. Ten states (20%) had not revised their PPE forms in >5 years. States permitted 9 different health care providers to administer PPEs. Only 22 states (43%) addressed all 12 of the PPE-4 personal and family history cardiovascular screening items, and 2 states (4%) addressed between 8 and 11 items. For the remaining 26 states, most (29%) addressed ≤3 screening items. CONCLUSIONS: Our results show that inconsistencies in PPE policies exist nationwide. Most states have been slow to adopt PPE-4 recommendations and do not adequately address the personal and family cardiovascular history questions. Findings suggest a need for PPE standardization nationwide and adoption of an electronic PPE process. This approach would enable creation of a national database and benefit the public by facilitating a more evidenced PPE.

Balance comparisons between female dancers and active nondancers.

Purpose: Female dancers have lower anterior cruciate ligament (ACL) injury rates compared with physically active women. Enhanced balance can decrease musculoskeletal injury risk. Dancers are proposed to have superior balance compared with physically active nondancers, and this may reduce their risk for ACL injury. However, whether female dancers actually have better balance than active nondancers is unclear. Method: Thirty-three women (15 dancers, 18 nondancers) performed the Balance Error Scoring System (BESS; error scores), the Star Excursion Balance Test (SEBT; percent leg length), and the Modified Bass Test of Dynamic Balance (BASS; maximum score = 100). Results: Dancers had fewer errors on the BESS than did nondancers (p < .001, 12.0 ± 6.9 vs. 25.3 ± 9.1). Dancers also had greater SEBT reach distances in the medial (right, p = .03, 90.4 ± 4.2% vs. 86.5 ± 5.5%; left, p = .04, 90.7 ± 4.5% vs. 86.7 ± 5.9%) and posteromedial directions (right, p = .01, 92.6 ± 5.6% vs. 87.0 ± 6.4%; left, p = .01, 93.9 ± 6.3% vs. 87.9 ± 6.3%), but not in the anteromedial direction (right, p = .23, 84.5 ± 4.4% vs. 86.2 ± 3.5%; left, p = .51, 86.4 ± 3.5% vs. 85.5 ± 4.0%). BASS scores were similar between groups (p = .58, 90.6 ± 5.5 vs. 91.7 ± 56). Conclusions: The novel findings of the study are that dancers had greater balance than did nondancers in some but not all tests. Although dancing may improve balance as compared with not dancing, it is not better than physical activity in improving balance. Thus, balance comparisons between dancers and nondancers may not fully explain why female dancers exhibit low ACL injury rates compared with physically active women. Other factors (e.g., anticipated/unanticipated movement demands) should be examined to understand the ACL injury disparity between dancers and physically active women.

IMPLICIT AND EXPLICIT VIDEO FEEDBACK ON LANDING MECHANICS: A RANDOMIZED CONTROLLED TRIAL

Background Lower extremity(LE) patterns have been altered using implicit(IF) and explicit(EF) feedback motor learning strategies, however, it remains unclear which strategy may be more effective for injury prevention. Objective To examine the effects of reduced relative IF and EF video-feedback on LE biomechanics. Design Randomized Controlled Trial. Setting Recreational. Participants 30 participants were randomly assigned to 3-groups: control (CG) (n=10, 24±2 years, 1.68±0.1 m, 68±14 kg), IF (n=10, 25±3 years, 1.72±0.1 m, 69±12 kg), and EF (n=10, 23±2 years, 1.74±0.1 m, 74±8 kg). Exclusion criteria: no LE injury 6-months prior to testing, no ACL reconstruction, and no history of participation in supervised LE injury prevention programs. Interventions Twelve drop-jumps were performed 3-times a week for 5 weeks. IF group focused attention on overall jump performance, whereas EF group focused attention on knee mechanics. 3D LE biomechanics were tested after 1-week (PST1), 2-weeks (PST2), and 5-weeks (PST3), and 1-month retention (RTN). Participants viewed 2-videos for sagittal and frontal planes, in normal speed and slow motion. Video-feedback was provided along a reduced feedback continuum partitioned into 100%, 33% and 16.6% feedback frequency phases. Main Outcome Measurements Linear mixed-effects models were conducted to assess group and time differences for peaks of hip abduction(HA°), knee abduction(KA°), and vertical ground reaction force(vGRF,N), p<0.05. Results No group-time interaction was found(p>0.05). Group effects were attained(p<0.05) for HA: IF was lower than EF and CG, and for KA, where PST3 was closer to neutral when compared to PST1. Time effect for vGRF(p<0.05) was observed: PST3 and RTN were lower than PST1. Conclusions Retention and retrieval of learned movement patterns seemed to follow identical attrition patterns. It is feasible to suggest that both motor learning strategies produced similar outcomes. Future research should expand the retention period and retrieval of learned skill movements to enhance the effectiveness of injury prevention programs.