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.

Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.

This study aimed to compare functional movement screen (FMS [TM]) scores and Beighton and Horan joint mobility index (BHJMI) scores among pubescence in adolescent athletes. Sixty-six adolescents between the ages of 8 and 14 voluntarily participated in this study. The participants performed the tests of the BHJMI, the tasks of the FMS (TM), and the clearing tests of the FMS (TM). The composite scores of the FMS (TM) and the BHJMI were scored objectively by the same researcher. The subjects were separated into prepubescent, early-pubescent, and postpubescent groups based on the results of the modified pubertal maturation observational scale. A 2 × 3 (gender × pubescence) factorial analysis of variance revealed a main effect for FMS (TM) scores across pubertal groups (p = 0.032) but not in BHJMI composite scores (pre = 2.69 ± 0.40, pub = 1.96 ± 0.40, post = 3.13 ± 0.43, p = 0.131). The postpubescent participants had significantly higher FMS (TM) scores compared with the prepubescent participants (post = 15.91 ± 0.47, pre = 14.28 ± 0.44, p = 0.008) and the early-pubescent participants (pub = 14.55 ± 0.44, p = 0.039). No differences were identified between gender for FMS (TM) scores (male participants = 15.16 ± 0.38, female participants = 14.67 ± 0.35, p = 0.351) or BHJMI scores (male participants = 2.36 ± 0.35, female participants = 2.83 ± 0.32, p = 0.321). No significant interactions were found between gender and pubescence regarding the BHJMI composite scores (p = 0.503) or the FMS (TM) scores (p = 0.216). There was no correlation between FMS (TM) composite scores and BHJMI composite scores (p = 0.89). Our results suggest that the FMS (TM) can discriminate between levels of pubescence and detect alterations during the pubertal growth cycle, whereas the BHJMI may not. A prospective extension of this study to include follow-up of injured participants appears worthwhile to determine if the FMS (TM) can suitably predict injury in the adolescent population.

Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. 1 Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. 2,3 Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities 4 and quality of life 5,6 of patients with these conditions. Two of the primary goals in the treatment of these conditions is reducing pain and increasing shoulder range of motion (ROM). 3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. 7,8 In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). 2,3,7 Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. 3,9,10 However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear. Focused Clinical QuestionIs low-level laser therapy combined with an exercise program more effective than an exercise program alone in the treatment of adults with shoulder pain?Summary of Search, "Best Evidence" Appraised, and Key Findings• The literature was searched for studies of level 2 evidence or higher that investigated the effects of LLLT on pain and function in adults with shoulder pain.• The literature search returned 7 possible studies related to the clinical question; 4 randomized controlled trials met the inclusion criteria and were included. Aimee L. Thornton, Cailee W. McCarty, and Mollie-Jean BurgessClinical Scenario: Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM). 3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array ...

Clinical Scenario: There is a high incidence of anterior cruciate ligament (ACL) injury in adolescents participating in pivoting sports such as soccer, basketball, and handball. Most ACL injuries in athletes are noncontact injuries, with a mechanism of sudden deceleration, change in direction, or landing from a jump. These mechanisms coupled with an increase in contraction of the quadriceps have been shown as risk factors for ACL injuries. Injuries to the ACL may require surgery, a long rehabilitation, and the potential for reinjury. Studies have shown reductions in lower extremity injury rates using training protocols that focus on landing mechanics, balance training, strength training, and/or agility training. There has been some thought that starting preventive training programs with adolescent athletes may be the most effective approach to reducing adolescent ACL injuries. Focused Clinical Question: Can lower extremity injury-prevention programs effectively reduce ACL injury rates in adolescent athletes? Keywords: youth, preventive training program, knee injury Clinical ScenarioThere is a high incidence of anterior cruciate ligament (ACL) injury in adolescents participating in pivoting sports such as soccer, basketball, and handball. Most ACL injuries in athletes are noncontact injuries, with a mechanism of sudden deceleration, change in direction, or landing from a jump. These mechanisms coupled with an increase in contraction of the quadriceps have been shown as risk factors for ACL injuries. Injuries to the ACL may require surgery, a long rehabilitation, and the potential for reinjury. Studies have shown reductions in lower extremity injury rates using training protocols that focus on landing mechanics, balance training, strength training, and/or agility training. There has been some thought that starting preventive training programs with adolescent athletes may be the most effective approach to reducing adolescent ACL injuries. Focused Clinical QuestionCan lower extremity injury-prevention programs effectively reduce ACL injury rates in adolescent athletes?Summary of Search, "Best Evidence" Appraised, and Key Findings• The literature was searched for studies of level 2 evidence or higher that investigated the effect of injury-prevention training programs on knee-sprain incidence in adolescent athletes.• The literature search returned 10 possible studies related to the clinical question; 4 studies met the inclusion criteria and were included.• Two high-quality cluster randomized controlled trials and 2 prospective cohort studies were included.• Of the included studies, 2 demonstrated reductions of ACL injuries of the intervention group and 2 showed no statistical difference between the intervention group and control group. Clinical Bottom LineThere is moderate evidence to support the use of a supervised injury-prevention training program that focuses on developing neuromuscular control of the lower extremity through neuromuscular strengthening exercises, plyometrics, and proprioception exercises. The prog...