Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.Design: Cross-sectional study. Setting: Online survey instrument.Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables.Results: Athletic trainers demonstrated low knowledge scores (64.2% 6 1.29%) and mild to moderate confidence (2.71 6 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 6 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P ¼ .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P , .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 6 0.91), whereas clinicians demonstrated the lowest scores (3.62 6 1.35). Individuals with terminal degrees had higher (P , .001) total knowledge scores (4.31 6 1.24) than those with bachelor's (3.78 6 1.2) or master's degrees (3.76 6 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 6 0.40 out of 4.0) than did those in all other athletic training roles (P , .001).Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.Key Words: athletic training setting, educational preparation, clinical practice Key PointsAthletic trainers valued the concept of evidence-based practice and recognized its importance to the profession. However, their level of knowledge about evidence-based practice and their level of confidence in that knowledge were both low. Evidence-based practice should be taught not only in the educational curricula for athletic training students but also to practicing clinicians.

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention on a multidimensional profile of health have not been evaluated. Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI. Design Controlled laboratory study. Setting Laboratory. Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of “giving way” in the 3 months before the study, and a Cumberland Ankle Instability Tool score ≤24. Intervention(s) Individuals participated in 12 sessions over 4 weeks that consisted of ankle stretching and strengthening, balance training, and joint mobilizations. They also completed home ankle-strengthening and -stretching exercises daily. Main Outcome Measure(s) Dorsiflexion range of motion (weight-bearing–lunge test), isometric ankle strength (inversion, eversion, dorsiflexion, plantar flexion), isometric hip strength (abduction, adduction, flexion, extension), dynamic postural control (Y-Balance test), static postural control (eyes-open and -closed time to boundary in the anterior-posterior and medial-lateral directions), and patient-reported outcomes (Foot and Ankle Ability Measure–Activities of Daily Living and Foot and Ankle Ability Measure–Sport, modified Disablement in the Physically Active scale physical and mental summary components, and Fear-Avoidance Beliefs Questionnaire–Physical Activity and Fear-Avoidance Beliefs Questionnaire–Work) were assessed at 4 times (baseline, preintervention, postintervention, 2-week follow-up). Results Dorsiflexion range of motion, each direction of the Y-Balance test, 4-way ankle strength, hip-adduction and -extension strength, the Foot and Ankle Ability Measure–Activities of Daily Living score, the modified Disablement in the Physically Active scale–physical summary component score, and the Fear-Avoidance Beliefs Questionnaire–Physical Activity score were improved at postintervention (P < .001; effect-size range = 0.72–1.73) and at the 2-week follow-up (P < .001; effect-size range = 0.73–1.72) compared with preintervention. Hip-flexion strength was improved at postintervention compared with preintervention (P = .03; effect size = 0.61). Hip-abduction strength was improved at the 2-week follow-up compared with preintervention (P = .001; effect size = 0.96). Time to boundary in the anterior-posterior direction was increased at the 2-week follow-up compared with preintervention (P < .04; effect-size range = 0.61–0.78) and postintervention (P < .04) during the eyes-open condition. Conclusion A 4-week rehabilitation program improved a multidimensional profile of health in participants with CAI.

Context:Windlass taping is used to reduce pain in plantar fasciitis and thought to take stress off the plantar fascia.Objective:To investigate the effects of windlass taping.Design:Single group, repeated measures.Setting:Outpatient physical therapy clinics.Patients:20 subjects with plantar fasciitis.Intervention:Windlass taping technique.Main Outcome Measures:Pretaping and posttaping measures included pain levels using a visual analog scale (VAS), resting-stance calcaneal position, tibial position, and navicular height. Fifteen also reported a VAS after wearing the tape for 24 h.Results:Median VAS score 37 mm pretape and 6 mm immediately posttape and 24 h later. Wilcoxon matched-pairs signed ranks test significant (P= .001) for reduction in pain scores. Pairedttests significant (P= .01) for a difference between means of pretaping and posttaping measurements for resting-stance positions.Conclusions:Windlass taping decreased pain in patients with plantar fasciitis and caused small changes in resting-stance positions.

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown. Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program. Design Controlled laboratory study. Setting Laboratory. Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of the ankle “giving way” in the 3 months before the study, and a score ≤24 on the Cumberland Ankle Instability Tool. Intervention(s) Individuals participated in 12 intervention sessions over 4 weeks and daily home ankle strengthening and stretching. Main Outcome Measure(s) Patient-reported outcomes (PROs) were assessed at 4 times (baseline, preintervention, postintervention, and 2-week follow-up). At the postintervention and 2-week follow-up, participants completed then-test assessments to measure RS. Then-test assessments are retrospective evaluations of perceived baseline function completed after an intervention. The PROs consisted of the Foot and Ankle Ability Measure-Activities of Daily Living and Sport subscales, the modified Disablement in the Physically Active scale physical and mental summary components, and the Fear-Avoidance Beliefs Questionnaire Physical Activity and Work subscales. We used repeated-measures analyses of variance to compare preintervention with then-test measurements. Individual-level RSs were examined by determining the number of participants who experienced preintervention to then-test differences that exceeded the calculated minimal detectable change. Results We did not identify an RS for any PRO (F > 2.338, P > .12), indicating no group-level differences between the preintervention and retrospective then-test assessments. Individual-level RS was most prominent in the Foot and Ankle Ability Measure-Sport subscale (n = 6, 30%) and the Fear-Avoidance Beliefs Questionnaire Physical Activity subscale (n = 9, 45%). Conclusions No group-level RS was identified for any PRO after a 4-week multimodal rehabilitation program in individuals with CAI. This finding indicates that traditional assessment of self-reported function was accurate for evaluating the short-term effects of rehabilitation in those with CAI. Low levels of individual-level RS were identified.

Context:A strength-endurance diagram predicts that a person should be able to perform 30 repetitions of an exercise if the resistance level is 60% of 1-repetition maximum (1RM). Objective: To compare the number of repetitions predicted by the diagram with recorded repetitions of a shoulder exercise. Design: Single-group comparison with a standard. Setting: University. Participants: 34 healthy adults (20 women, 14 men) with a mean age of 29 years (range 20-49). Main Outcome Measures: The number of repetitions that subjects could perform in good form of a shoulder exercise with resistance of 60% 1RM. Results: The mean number of repetitions was 21 (± 3, range 15-28), which was significantly different than the 30 repetitions that the diagram predicted. Conclusions: The strength-endurance diagram did not accurately predict the number of repetitions of a shoulder exercise that subjects could perform.