Predictive Validity of a Functional Movement Screen in Professional Basketball Players.

Background and objectives: Striking a balance between maximizing performance and preventing injury remains elusive in many professional sports. The purpose of this study was to assess the relative risk of non-contact injuries in professional basketball players based on predictive cut scores on the Functional Movement Screen™ (FMS). Materials and Methods: Thirty-two professional basketball players from the National Basketball Association (NBA) and Women's National Basketball Association (WNBA) participated in this study. This observational pilot cohort study assessed and scored each participant using the FMS during training camp. Each athlete was then tracked throughout the season while recording the number, type, and time lost due to injuries. Possible exposures, actual exposures, and exposures missed due to non-contact injury (NCI) for each athlete were calculated and then used to determine the crude and specific incident rates for exposures missed due to NCI per 1000 exposures. Results: Linear regression models were used to evaluate the predictive ability of the FMS score for total missed exposures, NCI, and CI missed exposures. In all models, the FMS total score failed to attain significance as a predictor (p > 0.05). FMS scores ranged from 5 to 18. The recommended cut score of 14 showed a sensitivity of 0.474 and a specificity of 0.750. The cut score of 15 showed the best combination, exhibiting a sensitivity of 0.579 and specificity of 0.625. A total of 5784 exposures to NCI were possible for the men and women combined, and 681 possible exposures were missed. Of these, 23.5% were due to NCI, 16.5% were due to contact injuries (CI), and 60% were due to illnesses and personal reasons. Conclusions: The FMS proved to be a measure that was not associated with any injury measure in this sample of professional basketball players, suggesting the instrument lacks predictive validity in this population.

Development of an instrument to measure attitudes of physical therapy providers working with people with dementia.

BACKGROUND AND PURPOSE: This study investigated the factor structure of an instrument to measure attitudes and beliefs of how physical therapist (PT) practitioners perceive working with people with a dementia disorder. METHODS: A survey was mailed to every skilled nursing facility in Indiana (n = 495) for completion by a PT or physical therapist assistant. The survey was developed and included whether the severity of Alzheimer's disease (AD) impacts the attitudes of physical therapy practitioners. RESULTS: Of the 12 attitudinal questions, 11 were significant (P < .001) concerning how the severity of a diagnosis of AD (early, middle, and late) impacts attitudes of people in physical therapy practice. Principal component analysis identified 3 factors with Eigen values of 3.3 or higher accounting for 43% of the cumulative variance. These factors include professional competence, resources, and conscientiousness. CONCLUSION: This brief instrument could serve as an assessment tool to determine whether PT practitioners exhibit therapeutic nihilism when working with people with a dementia disorder.

Hippotherapy--an intervention to habilitate balance deficits in children with movement disorders: a clinical trial.

BACKGROUND: Clinical observations have suggested that hippotherapy may be an effective strategy for habilitating balance deficits in children with movement disorders. However, there is limited research to support this notion. OBJECTIVE: The purposes of this study were to assess the effectiveness of hippotherapy for the management of postural instability in children with mild to moderate balance problems and to determine whether there is a correlation between balance and function. DESIGN: A repeated-measures design for a cohort of children with documented balance deficits was used. METHODS: Sixteen children (9 boys and 7 girls) who were 5 to 16 years of age and had documented balance problems participated in this study. Intervention consisted of 45-minute hippotherapy sessions twice per week for 6 weeks. Two baseline assessments and 1 postintervention assessment of balance, as measured with the Pediatric Balance Scale (PBS), and of function, as measured with the Activities Scale for Kids-Performance (ASKp), were performed. RESULTS: With the Friedman analysis of variance, the PBS and the ASKp were found to be statistically significant across all measurements (P<.0001 for both measures). Post hoc analysis revealed a statistical difference between baseline and postintervention measures (P≤.017). This degree of difference resulted in large effect sizes for PBS (d=1.59) and ASKp (d=1.51) scores after hippotherapy. A Spearman rho correlation of .700 indicated a statistical association between PBS and ASKp postintervention scores (P=.003). There was no correlation between the change in PBS scores and the change in ASKp scores (r(s)=.13, P>.05). LIMITATIONS: Lack of a control group and the short duration between baseline assessments are study limitations. CONCLUSIONS: The findings suggest that hippotherapy may be a viable strategy for reducing balance deficits and improving the performance of daily life skills in children with mild to moderate balance problems.

Anterior cruciate ligament injury in female and male athletes: the relationship between foot structure and injury.

BACKGROUND: It has been shown that anterior cruciate ligament (ACL) injuries are more prevalent in female athletes than in male athletes. Soccer and basketball are considered high-risk sports for ACL injury in female athletes. Several studies have reported a relationship between ACL injury and measures of foot structure. This study was conducted to investigate the relationship between foot structure and ACL injury rates in female and male soccer and basketball players. METHODS: One hundred five soccer and basketball players (53 women and 52 men) were recruited and divided into an ACL-normal group (n=89) and an ACL-injured group (n=16). Two measures of foot structure (subtalar joint neutral position and navicular drop test values) were recorded for each subject. An independent t test and a paired t test were used to analyze differences in ACL status, foot structure, and sex. A chi2 analysis determined whether the prevalence of ACL injury was independent of sport. RESULTS: No statistically significant differences were found in the foot structure measures between women and men. Female soccer and basketball players had an ACL injury rate seven times that of male players. CONCLUSIONS: Values derived from subtalar joint neutral position measurement and the navicular drop test were not associated with ACL injury in collegiate female and male soccer and basketball players.

Prediction of functional outcomes in patients with chronic pain.

UNLABELLED: This prospective study determined the extent to which demographic factors, pain levels, psychological factors, and readiness to change predicted functional outcomes in patients with chronic pain. METHOD: Participants were 26 patients referred for evaluation to a multidisciplinary pain management program. The Pain Disability Index (PDI), Pain Patient Profile (P-3), and Pain Stages of Change Questionnaire (PSOCQ) measured function, psychological factors and readiness to change respectively. Patients completed the battery of tests upon initial evaluation and 3 months into treatment. RESULTS: A regression analysis using only initial assessment measures as predictors of functional outcome indicated a 2-variable prediction model (work status and contemplation) that accounted for 49% of the variance in 3-month functional outcome. Regression analysis using data at initial and follow-up assessment found that work status, contemplation, and best and worst pain at follow-up predicted 84.4% of the variance in 3-month functional outcome. CONCLUSION: These findings provide good models for prediction of 3-month functional outcome based on demographic, psychological, and readiness to change indicators.

Program Directors' and Clinical Instructors' Perceptions of Important Clinical-Instructor Behavior Categories in the Delivery of Athletic Training Clinical Instruction.

OBJECTIVE: To investigate the perceived importance of clinical instructors' behaviors and behavior categories in the roles of program director (PD) and clinical instructor (CI) and to ascertain the relative importance of these items within each role. DESIGN AND SETTING: From the literature, we developed a questionnaire, validated by a panel of experts, to collect data regarding the perceived importance of 30 specific CI behavior statements within 5 categories (instructional, interpersonal, evaluative, professional, and personal). The instrument used in the study had a Cronbach alpha of.92. SUBJECTS: Independent groups of 75 PDs and 242 CIs from Commission on Accreditation of Allied Health Education Programs-accredited entry-level undergraduate athletic training programs returned usable surveys. MEASUREMENTS: We computed mean and variation measures for each behavior and category and analyzed these items for between-role and within-role category differences. RESULTS: Program directors and CIs differed significantly in the perceived importance of the evaluative category of CI behaviors as well as in 3 specific evaluative behaviors. Program directors and CIs did not differ in the other 4 categories. For within-role groupings, we noted significant differences of perceived importance among the behavioral categories. CONCLUSIONS: Program directors and CIs perceived all 5 categories to be very important, and they should work to demonstrate these behaviors in clinical-education settings. Collaboration between the groups enhances the understanding of role responsibility in the delivery of athletic training clinical instruction.