Objectives: To examine the effect of six weeks of strength and proprioception training on eversion to inversion isokinetic strength ratios (E/I ratios) in subjects with unilateral functional ankle instability. Methods: Thirty eight subjects were randomly assigned to one of four treatment groups: strength training (S); proprioception training (P); strength + proprioception training (B); control (C). Isokinetic strength was tested before and after training using a Kin Com 125 automatic positioning isokinetic dynamometer. Subtalar joint eversion and inversion motions were tested both concentrically and eccentrically through a range of motion involving 40°. All peak torque and average torque values were normalised for body mass. E/I ratios were calculated from average torque and peak torque measures by taking the concentric eversion value and combining it with the eccentric inversion value. Data were analysed using a mixed model analysis of variance with repeated measures on the test factor. Average torque and peak torque E/I ratios at 30 and 120°/s were analysed separately. Results: There were no significant differences in average torque and peak torque E/I ratios of the functionally unstable ankle for any of the groups after training compared with before. Conclusions: Six weeks of strength and proprioception training (either alone or combined) had no effect on isokinetic measures of strength in subjects with self reported unilateral functional instability. Further studies examining this agonist (concentric) to antagonist (eccentric) muscle group strength ratio are needed.
Context:The combined effects of strength and proprioception training, especially in individuals with ankle instability, have not been studied extensively.Objective:To examine the influence of 6 weeks of strength and proprioception training on measures of muscle fatigue and static balance in those with unilateral functional ankle instability (FAI).Design:Pretest–posttest, randomized groups.Setting:A climate-controlled sports-medicine research laboratory.Subjects:38 subjects with self-reported unilateral FAI.Measurements:Muscle fatigue was determined using the median power frequency (fmed) from an electromyographic signal, and static balance was assessed using center-of-pressure values obtained from a triaxial force plate.Results:There were no significant effects of the strength or proprioception training on our measures of muscle fatigue and static balance.Conclusions:Strength training, proprioception training, and the combination of the 2 failed to improve postural-stability characteristics in a group of subjects with FAI.
Objective: To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients.Background: Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications.Recommendations: These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma.Key Words: abrasions, avulsions, blisters, incisions, lacerations, punctures, cleansing, debridement, nonocclusive dressings, occlusive dressings, infection, adverse reactions T raumatic injury to the skin is common among athletes participating in all sports.1 The exact frequencies of abrasions, avulsions, blisters, incisions, lacerations, and punctures are difficult to calculate because many patients do not seek medical attention after injury; for others, their activity level is initially unaffected, and the injury is not recorded on surveillance reports. Unreported skin trauma and inappropriate wound management can result in delayed healing, cross-contamination, bacterial colonization, and infection, adversely affecting the overall health and playing status of the patient. Managing acute skin trauma through appropriate cleansing, debridement, and dressing techniques can create an environment conducive to healing and lessen the risk of complications. 2,3Wound-management techniques have undergone drastic changes over the last 50 years, and other allied health care professions, organizations, and facilities have developed guidelines that serve as standards of care. [4][5][6] However, guidelines for the management of acute skin trauma by athletic trainers (ATs) are limited in the literature.1,7 The development and implementation of cleansing, debridement, and dressing techniques for acute skin trauma are critical for ATs to successfully deliver health care services to patients. The following review and recommendations provide information on the management of acute skin trauma and guidelines for ATs and other allied health and medical professionals who care for patients. RECOMMENDATIONSThis position statement is based on current research and literature with regard to the cleansing, debridement, dressing, and monitoring of acute skin trauma. We independently categorized the studies and literature using the Strength of Recommendation Taxonomy (SORT) developed by the American Academy of Family Physicians. 8 The taxonomy grades the quality of the data from the literature (level of evidence) and p...
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