MRSA as a health concern in athletic facilities.

Methicillin-resistant Staphylococcus aureus (MRSA) is a group of bacteria resistant to antibiotic treatment. Open abrasions, therapeutic whirlpools, treatment tables, locker rooms (LR), and athletic equipment are identified as potential areas of transmission in athletic training rooms (ATR) and LR facilities. To determine the prevalence of MRSA and to identify control measures in ATR and LR, the authors collected samples from nine surfaces at seven high schools over a four-month period. Initial analyses considered both suspected colonies and confirmed MRSA colonies with analyses of variance revealing significant differences of suspected colonies based on regular cleaning product and facility surface. Further results, however, focused on MRSA colonies as the primary variable, rather than suspected colonies. Results indicate a need for more effective cleaning products and schedules in LRs.

Development and factor analysis of the Coaching and Athletic Training Questionnaire.

To explore athletes' perceptions related to coaching and athletic training care, the Coaching and Athletic Training Questionnaire was developed. A 10-item version was administered to 708 varsity athletes from three Division I universities in the National Collegiate Athletic Association. 341 women and 344 men completed questionnaires. Data from half of the sample of 685 were used for an exploratory factor analysis using principal components analysis with oblique rotation and the second half for a confirmatory factor analysis. Analyses yielded three interpretable factors, accounting for 68% of the variance, which were labeled Comfort with Athletic Trainer or Coach, Sex Influence on Quality of Care, and Athletic Trainer Preference. Multivariate analysis of variance indicated that factor scores of women and men differed significantly, and at followup women and men differed significantly on Comfort with Athletic Trainer or Coach, but the small effect size minimizes its meaningfulness. No significant difference was noted for the other two factors. It appears coaches should be sensitive and available in case of injury or other need. Athletes' perceived quality of care by athletic trainers does not appear related to sex of athlete or trainer.

Leg and calf press training modes and their impact on jump performance adaptations.

To examine the effects of resistance exercise (REX) mode on jump performance, subjects were assigned to one of three groups over a 6-week period with no cross-over. Subjects were assigned to leg and calf press REX on either a standard (n = 10) or ergometer (n = 9) device while a third group (n = 9) served as controls (CTRL). REX subjects worked out twice per week, which consisted of a three-set, 10-repetition paradigm for leg and calf press exercises. Immediately before and after the 6-week period, subjects performed tests that assessed jump (standing vertical jump, four-jump test protocol, depth jump) ability, while a fourth estimated knee extensor fast-twitch percentage (FT%) from fatigue incurred through a 50-repetition isokinetic protocol. Data analyses utilized 3 x 2 (group x time) repeated-measures ANCOVAs. Several dependent variables showed effects by group (standard REX, ergometer REX > CTRL) and time (post > pre). An interaction occurred for explosive leg power factor, a four-jump test variable, with standard REX post-test values as the interaction source. A trend for an interaction occurred for depth jump hang time, as ergometer REX values improved over time. Results suggest that mode-specific adaptations occur with REX training. Thus, athletes are best served with the selection of a REX device that is most specific to the demands of their jump performance task.

Self-reported comfort of collegiate athletes with injury and condition care by same-sex and opposite-sex athletic trainers.

CONTEXT: Athletes may experience similar comfort concerns as patients in other allied health care fields. OBJECTIVE: To address athlete comfort with injury and condition care provided by same-sex and opposite-sex athletic trainers. DESIGN: Cross-sectional survey design. SETTING: Three National Collegiate Athletic Association Division I university athletic programs were invited and agreed to participate. Universities were selected by geographic location and affiliation with 3 National Athletic Trainers' Association districts. PATIENTS OR OTHER PARTICIPANTS: A total of 685 athletes (341 women, 344 men) completed questionnaires (277 in the Mid-America District, 282 in the Far West District, and 126 in the Southeast District). MAIN OUTCOME MEASURE(S): Questionnaires consisted of 17 injuries and conditions common to both female and male athletic trainer scenarios. Three sex-specific items were added to each scenario. Responses were scored on a 5-point scale anchored by 1 (very uncomfortable) and 5 (very comfortable). Participants were asked to indicate the reason for any degree of discomfort. Internal consistency, determined by Cronbach alpha, was .93 for the female athletic trainer scenario and .95 for the male athletic trainer scenario. RESULTS: We found significant injury and condition category-by-sex interactions for general medical conditions (F(1,683) = 578.9, P < .001), psychological conditions (F(1,683) = 136.2, P < .001), injuries to the upper body (F(1,683) = 175.7, P < .001), injuries to the mid-body (F(1,683) = 199.1, P < .001), and injuries to the lower body (F(1,683) = 4.9, P < .001). For gender-specific injuries and conditions, we found a difference between the mean ratings in both female athlete comfort (t(340) = -26.350, P < .001) and male athlete comfort (t(340) = -26.350, P < .001) when athletes were provided care by a female athletic trainer and a male athletic trainer. Overall, athletes appeared to be more comfortable when provided care by a same-sex athletic trainer. The most common reason reported for discomfort was gender related. CONCLUSIONS: Both athletes and athletic trainers should be aware that athletes do experience discomfort, especially if the injury or condition is intimate in nature. It may be necessary to have athletic trainers of both sexes accessible to athletes to optimize the treatment received.

Blood lactate responses to leg presses performed against inertial resistance.

INTRODUCTION: A flywheel ergometer has been devised which employs gravity-independent inertial resistance. Concentric and eccentric actions, which are integral to weight-bearing and ambulation activities, may be done on this ergometer. However, blood lactate responses to exercise on the ergometer by contractile mode and training volume are unknown. METHODS: Workout order was balanced so that subjects performed each type of ergometer leg press workout twice in a nonsequential manner. Per workout, 10 repetitions were performed per set. Workouts were as follows: three sets with concentric and eccentric (CE3) actions, three sets with concentric-only (CO3) actions, and six sets with concentric-only (CO6) actions. Pre- and 5-min post-exercise lactate was measured from a fingertip blood drop. Lactate means were compared with a 2 x 3 (time X workout) ANOVA with repeated measures applied to both independent variables and Scheffe's post hoc test. With body mass and performance measures as predictor variables, multivariate regression attempted to explain post-exercise and delta (post-pre) lactate variance. RESULTS: Post-exercise blood lactate values (mmol x L(-1), mean +/- SEM) were as follows: CE3, 8.08 +/- 0.44; CO3, 7.57 +/- 0.49; and CO6, 6.96 +/- 0.43. CE3 and CO6 workouts produced comparable volumes of work. Though several CE3 performance measures were significantly correlated to post-exercise and delta lactate values, power indices had the strongest relationship. DISCUSSION: Factors related to lactate production and clearance caused CE3 values to be highest. Power indices were most correlated to lactate as they denote a higher work rate and reliance on glycolysis.

Self-reported comfort in athletic training of gender-specific and non-gender-specific injuries and issues.

CONTEXT: To assist athletes in maintaining optimal health, athletic trainers must work with athletes of both sexes. OBJECTIVE: To examine athletic trainers' comfort levels in providing care for gender-specific and non-gender-specific injuries and issues. DESIGN: We mailed 235 Gender Comfort in Athletic Training Questionnaires to program directors, who were asked to distribute and collect them. SETTING: We randomly selected 21 athletic training education program directors and invited them by e-mail to participate in the study. Fourteen program directors representing the 10 National Athletic Trainers' Association districts agreed to participate. PATIENTS OR OTHER PARTICIPANTS: A total of 192 participants returned completed questionnaires, for a response rate of 82% (103 women, 89 men; 101 senior athletic training students, 91 certified athletic trainers). MAIN OUTCOME MEASURE(S): The questionnaire consisted of 17 injuries and issues common to both female and male athlete scenarios. Three gender-specific items were added to each scenario. Responses were scored on a 5-point scale anchored by 1 (very uncomfortable) and 5 (very comfortable). Participants were asked to indicate the reason for any degree of discomfort. Internal consistency, determined by the Cronbach alpha, was .92 for the female athlete scenario and .93 for the male athlete scenario. RESULTS: We found significant differences between women and men certified athletic trainers for the female and male athlete scenarios. Overall, women were more comfortable caring for female injuries and issues, whereas men were more comfortable caring for male injuries and issues. Certified athletic trainers reported more comfort overall than athletic training students. The most common underlying reason reported for discomfort in caring for female and male injuries and issues was experience level. CONCLUSIONS: Athletic training education programs should provide early and more deliberate experiences with injuries and issues of a more intimate nature, including those that are gender specific and non-gender specific. These experiences may increase athletic trainers' level of comfort in providing care to athletes of the opposite sex.

Self-reported comfort in athletic training to same- and opposite-sex athletes.

To assess the comfort of athletic trainers in providing care to athletes of the same- and opposite-sex, the Gender Comfort in Athletic Training Questionnaire was developed. Cronbach alpha was .72. The 8-item questionnaire was mailed to 235 participants, who were senior athletic training students and clinical instructors affiliated with 14 university athletic training programs. 192 questionnaires were returned (82%). Only one t test showed a significant mean difference in reported comfort between women (n= 103, M=2.8, SD= 0.8; disagree) and men (n= 89, M=3.1, SD=0.8; neutral) on the statement: I feel more comfortable providing athletic training services to male athletes than female athletes. The women and men in this sample were similar in their self-ratings of comfort in providing athletic training services to male and female athletes.

Collaboration Between Athletic Training Clinical and Classroom Instructors.

OBJECTIVE: The education of an athletic training student involves a balance between theory and application, which can be stated as a balance between classroom and clinical education. The instructors in these settings should work together to promote the overall educational process. Our primary purpose was to measure the observations and perceptions of physical presence, cooperation, and communication between clinical and classroom instructors and secondarily to determine if these have a perceived effect on the education of the student. SUBJECTS: Clinical instructors, classroom instructors, and athletic training students in Commission on Accreditation of Allied Health Education Programs-accredited and National Athletic Trainers' Association-approved athletic training education programs. MEASUREMENTS: Data were analyzed using various correlation techniques, a general linear model, and a one-way analysis of variance. DESIGN AND SETTING: We designed a questionnaire to measure the observations and perceptions of physical presence, cooperation, and communication between the clinical and classroom instructors. RESULTS: Of the 30 athletic training educational programs solicited for involvement in this study, 19 responded (63%). A total of 737 questionnaires were distributed, and 547 were returned (74%). Classroom instructors rated observations of cooperation between clinical and classroom instructors at a significantly higher frequency than did clinical instructors. Students rated observations of communication at a significantly lower frequency than did the clinical and classroom instructors. All 3 groups agreed that the physical presence, cooperation, and communication between the clinical and classroom instructors has a large effect upon the education of the student. CONCLUSIONS: Clinical instructors must be educators as well as care providers. At the same time, classroom instructors must make efforts to include clinical instructors in all aspects of the educational process. Also, athletic training students should be exposed to the inner workings of their educational programs, so they may have a better understanding and appreciation of how theory and application tie together.