Search Results (129)

Context: Sport-related concussion (SRC) management has evolved substantially over the past 25 years. Early paradigms emphasized prolonged physical and cognitive rest; however, growing evidence has demonstrated that recovery following SRC is multidimensional and influenced by interacting neurological, vestibular, autonomic, cervical, cognitive, and psychological systems. Consequently, contemporary clinical practice has shifted toward active, multifaceted rehabilitation approaches. Objective: We aimed to synthesize and contextualize the evidence supporting a multifaceted approach to sport-related concussion management from 2000 through 2025, with emphasis on implications for athletic training practice. Data Sources: A structured literature search was conducted using PubMed, SPORTDiscus, CINAHL, and Web of Science to identify peer-reviewed publications related to SRC evaluation, management, and rehabilitation. Study Selection: Studies published between 1 January 2000, and 31 December 2025 involving human participants with sport-related concussion or sport-like mechanisms of mild traumatic brain injury were included. Evidence from randomized controlled trials, cohort studies, systematic and narrative reviews, and major consensus or position statements was considered. Data Extraction: Relevant studies were reviewed and synthesized across key domains of SRC management, including aerobic exercise, vestibular and oculomotor rehabilitation, cervical spine management, multimodal and profile-based rehabilitation, return-to-learn strategies, psychological and behavioral health considerations, and implementation patterns within athletic training settings. Results: A total of 182 publications contributed evidence to one or more components of multifaceted SRC management. Across domains, evidence supports early, symptom-limited aerobic exercise; targeted vestibular and cervical rehabilitation; structured return-to-learn planning; and the integration of psychological support. Multimodal rehabilitation and profile-based clinical categorization approaches were associated with shorter recovery timelines and improved functional outcomes compared with rest-only strategies. Despite strong evidence, implementation variability persists across athletic training settings. Conclusions: Evidence accumulated over the past 25 years supports a shift toward active, individualized, and multidisciplinary approaches to SRC management. Athletic trainers are uniquely positioned to coordinate multifaceted care addressing the diverse contributors to concussion recovery. Full article

Law enforcement is an emerging clinical setting for athletic trainers (ATs), yet little is known regarding law enforcement officers (LEOs) perceptions of the profession. This qualitative study following a general inductive approach explored LEOs’ experiences with musculoskeletal injury and their interactions with ATs. Seven officers (N = 7) participated in one-on-one semi-structured interviews. Three themes emerged: (1) roles and responsibilities of ATs, (2) education and training, and (3) impact of injury on LEOs. While participants viewed ATs positively, they demonstrated limited understanding of the profession’s scope and expertise. Participants commonly described managing musculoskeletal injuries on their own due to cultural expectations to “push through” pain, limited organizational support, and administrative barriers to care. These patterns reflect broader occupational health and safety concerns within law enforcement and highlight opportunities for ATs to enhance injury prevention and early intervention by promoting a more supportive safety climate and improving access to musculoskeletal care. Full article

Background: Instrument-assisted soft-tissue mobilization (IASTM) is a popular intervention used for myofascial treatment. Healthcare professionals using IASTM must consider precautions and contraindications prior to administering the intervention. A recent international Delphi survey of IASTM experts recommended a list of 39 conditions to be considered as precautions and contraindications. The clinical relevance of these recommendations among healthcare professionals is of interest. The purpose of the survey was to explore healthcare professionals’ agreement regarding the IASTM Delphi recommendations for precautions and contraindications. Methods: A 16-question electronic survey was emailed to members of the Academy of Orthopedic Physical Therapy, American Academy of Sports Physical Therapy, National Athletic Trainers Association, and members of private physical therapy and athletic training Facebook^® and LinkedIn™ groups. Survey inclusion criteria included being a healthcare professional who has clinical experience using IASTM with patients. The strength of agreement grade scale was used to explore professionals’ opinions and agreement with the expert recommendations. Results: Four hundred and forty-five professionals (men = 52%; women = 46%; other = 2%) (mean age = 49 ± 12.33 years old) completed the survey. Most respondents (mean = 62%) agreed with 12 of 39 recommended conditions across the strength of agreement grade categories. The conditions included five precautions, four contraindications, and three conditions that could be both. Respondents also listed 32 other conditions they felt were relevant. Discussion: These survey results illustrate diversity among professionals’ agreement with expert recommendations. This may be explained by variations in clinical practice patterns and gaps in the research on this topic. The IASTM Delphi study’s recommended list of precautions and contraindications provides valuable information but is not all-inclusive, as other conditions may exist for different patients. When exploring understudied topics, researchers may want to begin with a Delphi study to establish expert recommendations, followed by an assessment of their clinical relevance through related survey studies of healthcare professionals’ agreement on the topic. Conclusions: This exploratory survey introduced a novel method of assessing the clinical relevance of a Delphi study on IASTM precautions and contraindications among healthcare professionals. Full article

Soft tissue manipulation (STM) is widely used by physical therapists, massage therapists, athletic trainers, and osteopathic physicians to manage musculoskeletal pain, yet its biological mechanisms remain poorly understood. Preclinical studies indicate that STM can alter immune cell behavior in animal models, increasing anti-inflammatory cytokines (IL-4, IL-10) and reducing chemokines such as RANTES/CCL5. Single-cell transcriptomic analyses suggest mechanical treatment may reprogram stromal cells and shift immune cell recruitment in aged or inflamed tissues. However, many of these mechanistic findings have yet to be confirmed in human studies. Early clinical trials show massage therapy can modify circulating leukocytes and reduce cytokine responses, but direct tissue-level evidence in human subjects remains limited. This narrative review summarizes existing insights and emphasizes the need for future clinical investigations targeting populations with chronic inflammation, repetitive-use injuries, post-surgical fibrosis, or age-related muscle decline. We advocate for studies incorporating tissue or fluid sampling, cytokine profiling, and molecular assays such as flow cytometry or transcriptomics to characterize STM’s immunological effects in people. Rather than simply easing symptoms, STM may act as a precision mechanical stimulus that recalibrates immune tone and promotes tissue repair. Bridging basic science with clinical research will be essential to establish STM as a biologically informed, mechanobiology-based therapeutic strategy. Full article

Swimming research has determined that rounded shoulders, forward head, and scapular dyskinesis are common imbalances that may lead to injury without correction. This case study aimed to evaluate a preventative exercise program designed to reduce injuries, correct postural deviations, and improve shoulder function over one collegiate swimming season. Twenty female NCAA Division I swimmers (average age = 21.6 ± 1.3 years) participated over 25 weeks, completing pre-, mid-, and post-season assessments of injury rates, shoulder range of motion, and stability using standardized tests. Injuries were included as diagnosed and reported by an athletic trainer. Testing included internal rotation, external rotation, the Hawkins-Kennedy test, Neer’s sign, Sulcus sign, and the Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST). Compared to the season prior with no intervention, swimmers who completed the program were 44% less likely to sustain an upper-extremity injury, as assessed from the CKCUEST scores (p < 0.01 for all metrics), shoulder internal rotation (p < 0.01 for both shoulders), and total range of motion (p < 0.01 for both shoulders). These findings suggest that a targeted corrective exercise program can effectively reduce injury rates and improve shoulder mobility and function in collegiate athletes. The interpretation of these results is limited by the study’s non-randomized design and absence of a control group. Full article

Introduction: Paramedics are increasingly being recognized as essential contributors to sports medicine, where their role extends beyond emergency response to prevention, planning, and collaboration with other medical professionals. Yet their scope of practice and effectiveness across sporting levels and regions remain insufficiently synthesized. Methods: This scoping review mapped international evidence on paramedics in sports medicine. Literature published in English between 2013 and 2023 was systematically searched in PubMed, Scopus, and ScienceDirect, and eligible studies were analyzed thematically. Thirty studies were included, spanning professional and amateur sports in North America, Europe, Asia, Oceania, and Africa. Results: The findings demonstrate that paramedics provide critical value across six domains. First, rapid emergency response, supported by innovations such as motorcycle-based ambulances, significantly reduced access times and improved survival rates. Second, preparedness and ongoing training, including physical fitness and interprofessional education, were shown to enhance effectiveness in demanding sporting environments. Third, collaboration with athletic trainers and other professionals improved on-field care and reduced unnecessary hospital transfers. Fourth, paramedics contributed to injury prevention programmes that lowered injury incidence and healthcare costs. Fifth, their involvement at mass gatherings ensured safety, streamlined triage, and reduced pressure on hospitals. Finally, evidence indicates that paramedic-led initiatives are cost-effective, generating both clinical and economic benefits. Conclusions: Paramedics play a multifaceted role in athlete care, emergency response, and injury prevention. Strengthening their integration through targeted training, protocol standardization, and equitable resource allocation can improve both athlete safety and system efficiency. Future research should focus on grassroots contexts and the use of paramedic-generated data to inform prevention and policy. Full article

This study presents a comprehensive analysis of Speed Climbing athletes by examining motion parameters critical to elite performance. As such, several key values are extracted from about 900 competition recordings in order to generate a dataset for the identification of patterns in athletes’ technique and efficiency. A CNN-based framework is used to automate the detection of human keypoints and features, enabling a large-scale evaluation of climbing dynamics. The results revealed significant variations in performance for single sections of the wall, particularly in relation to start reaction times (with differences of up to 0.27 s) and increased split times the closer the athletes are to the end of the Speed Climbing wall (from 0.39 s to 0.45 s). In addition, a more detailed examination of the movement sequences was carried out by analyzing the velocity trajectories of hands and feet. The results showed that coordinated and harmonic movements, especially of the lower limbs, correlate strongly with the performance outcome. To ensure an individualized view of the data points, a comparison was made between multiple athletes, revealing insights into the influence of individual biomechanics on the efficiency of movements. The findings provide both trainers and athletes with interesting insights in relation to tailoring training methods by including split time benchmarks and limb coordination. Full article

The ongoing secular changes in human movement development means that an assessment of primitive reflexes is now required not only in disabled but also in neurotypical children. This study had three aims: (1) presenting the TASHUN test battery as suitable for the assessment of primitive reflex activity in normal children and child athletes; (2) analyzing reflex characteristics of neurotypical children; (3) verifying validity and reliability of tests. Spearman’s rank correlation and ROC analysis were used for validation. Intraclass Correlation Coefficient and RM ANOVA analyzed reliability. The test on 242 schoolgirls has demonstrated that retained primitive reflexes are present in almost every individual (84.7–95.7%). Correlations showed strong positive association, with all values exceeding 0.8, and ROC analysis demonstrated excellent predictive strength (AUC values over 0.9). Interobserver reliability showed excellent agreement (ICC values above 0.9). No significant offset was present among the scoring by evaluators. Therefore, testing for primitive reflexes is necessary in neurotypical children in order to obtain a realistic image about the physiology of reflexes and their role in motor development. Our screening could be useful for practicing sport professionals, researchers and academics, to identify deficiencies, to further explore reflexes and to train future PE teachers and trainers. Full article

Background/Objectives: Participation in sports activities is one of the risk factors for traumatic dental injuries. Nevertheless, little data are available in the literature on such problems in persons with disabilities. This study aims to evaluate the prevalence and severity of traumatic dental injuries in athletes with intellectual disabilities and other coexisting chronic diseases, as well as the use of mouthguards and the level of treatment of injuries in this population. Methods: The research was carried out in seven special needs schools. Two calibrated dentists performed dental examinations in 100 subjects practicing sports, aged 8–30 years (study group), and in 128 individuals, aged 8–25 years, who do not perform systematic physical activity (control group). Statistica Software v.10 was used for statistical analysis, with the level of statistical significance at p ≤ 0.05. Results: The majority of individuals had one tooth affected by traumatic injury in the study and control individuals, with the results amounting to 14% and 5%, respectively; the difference between both groups was statistically significant (p = 0.02). Only one athlete used a mouthguard during training and competitions. Restorative treatment of traumatically damaged teeth was performed in six athletes (37%) out of the total sixteen subjects affected by dental injuries from the study group and in two (15%) out of thirteen participants from the controls. Conclusions: This study reveals that dentists should be professionally prepared to meet the special needs of the population with disabilities and chronic disorders to minimize the burden of dental trauma. There is an urgent need for preventive programs for special needs athletes, their parents/caregivers, and trainers concerning the use of mouthguards. Full article

Collegiate student-athletes are particularly vulnerable to food insecurity (FI). Prevalence rates range from 9.9% to 65%, although research is limited among this population. Background/Objectives: The challenge of balancing academic and degree progression requirements with training and competition demands can increase the risk for FI among student-athletes. Furthermore, insufficient funds for food has been reported for student-athletes living both on campus and off campus. Methods: This qualitative study employed a phenomenological design and constructivist theoretical framework to explore the experiences of athletic trainers, sports dietitians/nutritionists, and other professionals working with student-athletes in identifying and addressing FI among student-athletes via a series of online focus groups. Results: Participants (n = 27, 12 public colleges) had ≥7 years of collegiate athletics work experience, and most had been in their current position for <3 years. Five approaches to FI screening emerged; specifically, no screening, screening varies by team/sport, informal screening, dietitian screening, and formal screening. Emerging social determinants of FI included financial challenges, competing priorities, cultural/societal impacts, limited life skills, and the food environment. All these factors precipitated on a systems level, including individual, team/athletic department, and university/societal tiers. Conclusions: Athletic department and university policies and budgetary decisions emerged as potential antagonists of food security among student-athletes. FI mitigation strategies for student-athletes must go beyond simply addressing individual factors. Obtainment of food security among collegiate student-athletes requires system changes at the team/athletic department and university tiers. Full article

Background/Objectives: Concussions, their physical presentation, and patients’ recovery have been researched and documented numerous times, but the experiences of surviving and recovering from a concussion need to be explored further. The purpose of this study was to examine the lived experiences of NCAA Division I, II, and III student athletes who had suffered from one or more concussions. Methods: The consensual qualitative research (CQR) methodology was employed, guiding the formation of the interview questions and the analysis of the responses. The participants completed a free-response questionnaire as well as a semi-structured virtual interview that utilized a blend of idiographic, inductive, hermeneutic, and interpretive phenomenological approaches. Through their questionnaire and interview responses, they discussed their experience being concussed at a collegiate level. Results: Ten NCAA student athletes described their various physical, cognitive, emotional, and sleep-related symptoms due to receiving their concussion(s). Many of these student athletes reported feelings of loneliness, being misunderstood, or even not feeling “normal or at baseline” during and after their concussion recovery. One primary finding was the key role the athletic trainers played in the student athletes’ recovery process from initially receiving the concussion to their return to play. Conclusions: These findings will help contribute to the knowledge of what it is like to experience one or multiple concussions, the recovery process, and how that process can be improved. Full article

Background: This sport involves the integration of various capabilities and mechanisms, including cognitive, physiological, and biomechanical components, that allow the athlete to perform in competition. However, to date, no systematic review has analyzed the indicators that are decisive for sports performance in Bicycle Motocross (BMX). The objective of this work was to carry out a systematic review of the performance variables in BMX and establish recommendations for researchers and trainers. Materials and Methods: The following databases were consulted: PubMed, Scopus, and Web of Science. This systematic review uses the guidelines of the PRISMA statement and the guidelines for performing systematic reviews in sports sciences. The search approach, along with the selection criteria and additional details, were previously noted in the prospective registry (INPLASY202480036). The quality of the evidence was evaluated via the PEDro scale. Results: The 21 studies that make up the sample of this systematic review have a total sample of 287 athletes. However, in the studies analyzed, there are five main categories for the study of performance in BMX: (i) physiological profile and BMX and bicarbonate; (ii) BMX and physical characteristics (power, speed, and sprint); (iii) translation and rotational acceleration and systems and implements; (iv) psychological variables; and (v) skills and techniques. Conclusions: This systematic review provides convincing evidence regarding the influence of several factors that can determine performance in BMX, including P_max, cadence, neuromuscular capacity, feedback and cognitive training, accelerometry and video analysis, anaerobic–aerobic relationships, physical conditioning, strength, and speed. Full article

Objective: The aim of this study was to investigate the immediate effects of deep core muscle training in the plank position, using the Icaros^® system, integrated with virtual reality (VR), on selected posturographic parameters. Methods: To meet the stated objective, we utilized the Icaros^® therapeutic system (Icaros GmbH, Martinsried, Germany) for VR-based exercise. The posturographic parameters were measured using the FootScan^® force platform (Materialise Motion, Paal, Belgium). A representative sample of 30 healthy participants, 13 females and 17 males (age: 22.5 ± 2.1 years; weight: 65 ± 2.9 kg; height: 1.68 ± 0.4 m; BMI: 23.04 ± 1.75) was included in the study. All participants had no prior experience with VR. The selected posturographic parameters were the ellipse area (mm²) and traveled distance (mm), assessed four times at five-minute intervals, following a 15 min VR-based training session on the Icaros^® system. Results: The results revealed that the participants experienced a sense of instability after completing the 15 min VR session, as objectively demonstrated by changes in the measured parameters. Both the ellipse area and traveled distance showed a worsening trend during the first three measurements: immediately post-exercise, at 5 min, and at 10 min post-exercise. A downward trend was observed in the fourth measurement, taken 15 min after exercise. Statistically significant differences were found between both parameters: ellipse area (p = 0.000) and traveled distance (p = 0.000). Post hoc analysis further confirmed significant differences between the time points. Conclusions: Based on the findings, it is recommended that trainers and physiotherapists supervising athletes or patients using the Icaros^® VR system allow for a minimum rest period of 15 min in a seated or lying position following exercise. This recovery period appears essential to mitigate the sensation of instability and to reduce the risk of complications or injury due to potential falls. Full article

Objectives: The aim of this study was to evaluate the effectiveness of respiratory muscle training in runners in relation to gender and trainers (PowerBreathe and Threshold). Methods: This study comprised 32 athletes training in middle-distance running at a high sports level. The subjects were divided into groups depending on the applied breathing training (IMT): group IMT on the PowerBreath, group IMT on the Threshold, and the control group labeled sham-IMT. The following tests were performed on each athlete: spirometry, maximal inspiratory pressure, expiratory pressure, and physical performance. Results: A significant increase in the levels of the parameters VO₂/kg, PEF, PI_max, and PE_max, as well as a decrease in lactic acid levels and an increase in lactate threshold in both sexes, were observed as a result of the training on the PowerBreathe device. There were no significant differences in the levels of the parameters VO₂/kg, PEF, PI_max, lactic acid, and lactate threshold in either sex after Threshold training. A significant increase in PE_max was found in the Threshold device training group. Conclusions: Most of the assessed parameters of physical fitness and lung ventilation function, along with the respiratory muscle strength of women and men running middle distances, increased significantly after the use of IMT on PowerBreathe, and these results were maintained in the third stud, in contrast to the use of IMT on Threshold, with which there was no significant improvement. Full article

This study presents a comprehensive bibliometric analysis of growth and maturation (GAM) research in youth basketball. A systematic search of Web of Science (up to August 2024) identified 1160 records; after screening per bibliometric review guidelines, 141 relevant studies were selected. Descriptive analysis indicates an 11.59% annual increase in GAM publications since 2003, underscoring significant expansion of this field. The 576 authors contributing to these studies show a high degree of collaboration, averaging 5.42 co-authors per paper, and 52.60% of publications involve international partnerships. Citation network analysis reveals that GAM research on basketball players predominantly addresses sports performance, strength, and injuries. Core themes (e.g., maturity/maturation) are well integrated, while foundational topics such as growth, strength, and age, although central to the field, remain underexplored. These gaps highlight the need for more targeted investigations. Practically, the findings guide coaches, trainers, and sports administrators in designing developmentally appropriate training programs, implementing targeted injury-prevention strategies, and refining talent identification initiatives. By identifying key areas for further inquiry, this study seeks to strengthen youth basketball programs through growth-stage-specific training methods, optimized injury-prevention protocols, and a holistic approach to athlete development. Full article