Patient-Reported Outcomes and Perceived Confidence Measures in Athletes With a History of Ankle Sprain.

CONTEXT: Patient-reported outcome measures (PROs) and functional performance tests are recommended in the National Athletic Trainers' Association's position statement on the prevention and management of ankle sprains during the return-to-play process. Evaluating perceived confidence may be another valuable method to evaluate an athlete's readiness to return-to-play following an ankle sprain. OBJECTIVE: To evaluate the relationship between PROs and perceived confidence when performing functional performance tasks in high school athletes with a history of ankle sprain. DESIGN: Descriptive study. SETTING: Public high school. PATIENTS OR OTHER PARTICIPANTS: A total of 25 high school student-athletes (6 males and 19 females, age 16.2 [1.1] y, height 169.3 [7.7] cm, mass 63.2 [9.8] kg). INTERVENTION(S): None. MAIN OUTCOME MEASURES: The Cumberland Ankle Instability Tool, visual analog scale (VAS) for pain, Identification of Functional Ankle Instability, and Tampa Scale of Kinesiophobia-11 were completed by all participants. Participants then completed the weight-bearing lunge test; star excursion balance test; lateral, up-down, and triple hop tests; the single-leg vertical jump; and Southeast Missouri agility test and were asked to report their confidence in completing each task using a VAS with anchors of "no confidence" and "complete confidence." Pearson r correlations were calculated between the PROs and the confidence VAS scores of the functional tests. RESULTS: Moderate to strong negative correlations were identified between pain VAS measures and confidence VAS measures for all functional tests except the star excursion balance test and vertical jump. Moderate negative correlations were found between Tampa Scale of Kinesiophobia-11 scores and perceived confidence during the star excursion balance test and vertical jump. Finally, a moderate positive correlation was identified between Cumberland Ankle Instability Tool scores and perceived confidence measures during the Southeast Missouri agility test. CONCLUSIONS: High school athletes with a history of ankle sprain demonstrated significant correlations between several PROs and perceived confidence during various functional performance tests. The value of perceived confidence measures when making return-to-play decisions after ankle sprains warrants further investigation.

Results From the Imaging and Radiation Oncology Core Houston's Anthropomorphic Phantoms Used for Proton Therapy Clinical Trial Credentialing.

PURPOSE: The purpose of this study was to summarize the findings of anthropomorphic proton phantom irradiations analyzed by the Imaging and Radiation Oncology Core Houston QA Center (IROC Houston). METHODS AND MATERIALS: A total of 103 phantoms were irradiated by proton therapy centers participating in clinical trials. The anthropomorphic phantoms simulated heterogeneous anatomy of a head, liver, lung, prostate, and spine. Treatment plans included those for scattered, uniform scanning, and pencil beam scanning beam delivery modalities using 5 different treatment planning systems. For every phantom irradiation, point doses and planar doses were measured using thermoluminescent dosimeters (TLD) and film, respectively. Differences between measured and planned doses were studied as a function of phantom, beam delivery modality, motion, repeat attempt, treatment planning system, and date of irradiation. RESULTS: The phantom pass rate (overall, 79%) was high for simple phantoms and lower for phantoms that introduced higher levels of difficulty, such as motion, multiple targets, or increased heterogeneity. All treatment planning systems overestimated dose to the target, compared to TLD measurements. Errors in range calculation resulted in several failed phantoms. There was no correlation between treatment planning system and pass rate. The pass rates for each individual phantom are not improving over time, but when individual institutions received feedback about failed phantom irradiations, pass rates did improve. CONCLUSIONS: The proton phantom pass rates are not as high as desired and emphasize potential deficiencies in proton therapy planning and/or delivery. There are many areas for improvement with the proton phantom irradiations, such as treatment planning system dose agreement, range calculations, accounting for motion, and irradiation of multiple targets.