Browsing by Author "Hibberd, Elizabeth E."
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Item Comparison of Upper Extremity Physical Characteristics Between Adolescent Competitive Swimmers and Nonoverhead Athletes(National Athletic Trainers' Association, 2016) Hibberd, Elizabeth E.; Laudner, Kevin; Berkoff, David J.; Kucera, Kristen L.; Yu, Bing; Myers, Joseph B.; University of Alabama Tuscaloosa; Illinois State University; University of North Carolina; University of North Carolina Chapel HillContext: Alterations to upper extremity physical characteristics of competitive swimmers (posture, range of motion [ROM], and subacromial-space distance) are commonly attributed to cumulative training load during a swimmer's competitive career. However, this accepted clinical belief has not been established in the literature. It is important to understand whether alterations in posture and associated physical characteristics occur as a result of sport training or factors other than swimming participation to better understand injury risk and possible interventions. Objective: To compare posture, subacromial-space distance, and glenohumeral external-rotation, internal-rotation, and horizontal-adduction ROM between adolescent competitive swimmers and nonoverhead athletes. Design: Cross-sectional study. Setting: Local swimming pools and high school athletic training rooms. Patients or Other Participants: Forty-four competitive adolescent swimmers and 31 nonoverhead athletes who were not currently experiencing any elbow, shoulder, neck, or back pain that limited their sport activity. Intervention(s): Posture, subacromial-space distance, and glenohumeral ROM were measured using photography, diagnostic ultrasound, and a digital inclinometer, respectively. Main Outcome Measure(s): Forward shoulder posture, forward head posture, normalized subacromial-space distance, internal-rotation ROM, and external-rotation ROM. Results: No clinically significant differences existed between swimmers and nonoverhead athletes for posture, normalized subacromial-space distance, or external-or internal-rotation ROM. Swimmers presented with less horizontal-adduction ROM than nonoverhead athletes. Conclusions: Factors other than swimming participation, such as school and technology use, play important roles in the adaptation of physical characteristics in adolescents. Adolescents, regardless of swimming participation, presented with postural deviations. It is important to consider factors other than swimming participation that contribute to alterations in physical characteristics to understand injury risk and injury-prevention strategies in competitive adolescent swimmers.Item Determinants for the use of complementary and alternative medicine: results from a national study(University of Alabama Libraries, 2018) Allen, Kristen R.; Turner, Lori W.; University of Alabama TuscaloosaHealth disparities are differences that limit opportunities to attain optimal health. For many health conditions, minorities are living with or dying from the burden of disease, injury, and disability at early ages. Experts recommend physical activity, abstaining or quitting smoking, limiting alcohol consumption, and maintaining a healthy body weight to reduce the risk of chronic diseases and promote overall health. However, either instead of or in addition to engaging in some of the scientifically based recommendations, many individuals choose to use forms of Complementary and Alternative Medicine (CAM) to prevent or treat health related conditions. Some CAM modalities are safe and effective, some are potentially unsafe and effective, some are neutral, and others are potentially dangerous. Another issue is lack of patient disclosure to primary care providers regarding CAM use, which can result in complications from drug interactions, toxicities and/or other undesired effects. This study categorized CAM as safe and effective, unsafe and effective, neutral, and unsafe and ineffective; examined the use of safe and unsafe CAM therapies among a national sample of adults; identified the top three self-reported CAM modalities among a national sample of adults; and identified factors associated with patient disclosure for the top three self-reported CAM modalities. Additionally, this study ascertained the reported reasons for the use of the top three self-reported CAM modalities and determined which predisposing, enabling, need, and health behavior practices were related to CAM use among a national sample of adults. Data were extracted from the 2012 National Health Interview Survey (NHIS), and the Sociobehavioral Model of CAM Use (SBM of CAM Use) served as the theoretical framework. Hierarchical log-linear regression was used to identify factors that influence determinants for the use of safe and unsafe CAM among a national sample of adults. Out of the 34,525 adults included in analysis, 75% of participants identified as White, 15% identified as AA, and 17% identified as Hispanic, and the average age of participants was 49 years old (M=48.53, SD=18.165). Chi-square analysis revealed small meaningfully significant associations in the predisposing, enabling, need, and health behavior practices for the use of safe, potentially unsafe, and neutral CAM. Specifically, significant differences in the use of a practitioner for acupuncture, chiropractic or osteopathic manipulation, massage and the use yoga, tai chi, and qi gong were associated with age (p <.001); sex was associated with yoga, tai chi, and qi gong; marital status and age (when combined) were significant predictors for the use of multi-vitamin or mineral supplements (p <.001). Educational attainment emerged as a significant predictor for the use of relaxation techniques, yoga, tai chi, and qi gong (p <.001). Income and perceived need were meaningfully significant predictors for the use of a practitioner for massage (p <.001), and alcohol status and physical activity were predictors for the use of a practitioner for massage and the use of relaxation techniques, yoga, tai chi, and qi gong (p <.001). Findings from this study provide new information on factors in the predisposing, enabling, need, and health behavior practices that influence the use safe and unsafe CAM therapies among a national sample of adults. Health educators, healthcare providers, and other health professionals need to be educated on the types of CAM modalities, and the associated risks and benefits so accurate information can be disseminated to target populations. Furthermore, education and/or training on the use of CAM in schools of nursing, nutrition, medicine, pharmacy, public health, and other allied health professions are needed so improvement in the disclosure of CAM can occur between patient and healthcare professionals.Item Development and validation of a social cognitive theory-based instrument to predict physical activity among people with spinal cord injury(University of Alabama Libraries, 2016) Wilroy, Jereme David; Turner, Lori W.; University of Alabama TuscaloosaBackground: There are over 200,000 people with spinal cord injury in the U.S. alone and each year another 15,000 to 20,000 incidents occur. Massive trauma to the spine can result in a SCI leaving behind devastation to the body including paralyzed muscle and loss of sensation. People with SCI are more susceptible to sedentary lifestyles because of the displacement of physical functioning caused by the spinal cord injury and the overwhelming majority are physically inactive. Benefits of physical activity for people with SCI include physical fitness, functional capacity, social integration and psychological well-being. Theoretical constructs have been operationalized to measure social cognitions towards physical activity for this population; however a valid and reliable instrument is lacking. Purpose: Therefore, the purpose of this study was to develop and validate a social cognitive theory-based instrument to predict physical activity among people with SCI. Methods: An instrument was drafted utilizing previous items from the literature. To examine content validity of the instrument, an expert panel of six people reviewed it, and the instrument was modified based on feedback. Cognitive interviewing with five people with SCI was conducted to assess readability, comprehensibility, and time. The final 64-item version of the instrument was used to collect data from participants via an online survey in order to test the validity and reliability. Results: One-hundred twenty-six people with SCI completed the survey with the majority being male (64.3%), white (79.4%), married (39.7%), with a mean age of 42.8 (± 13.7). The most prevalent level of SCI was complete paraplegia (34.9%) and the mean years from time since injury was 14.0 (±11.6). The physical activity outcome variable was significantly and positively correlated with self-regulatory efficacy (r = 0.575), task self-efficacy (r = 0.491), self-regulation (r = 0.432), social support (r= 0.284), and outcome expectations (r = 0.247). A prediction model for the physical activity outcome consisted of self-regulatory efficacy (B = 4.883; p < .001) and social support (B = 1.389; p = .050). Discussion: Multivariate analysis revealed that self-regulatory efficacy and social support were the strongest predictors of physical activity among people with SCI. Based on findings from the study, physical activity interventions targeted at people with spinal cord injury should focus on improving self-regulatory behaviors and providing social support to increase physical activity. A strategy for increasing self-regulatory efficacy within an intervention may involve the development of an action plan by each participant. The action planning would include setting goals and objectives, scheduling times for physical activity, and identifying barriers and a plan for coping with each barrier. Social support is the perceived support from others concerning the behavior and may include family, friends, or online communities. Targeting social support in an intervention may include peer modeling, peer support, health messages from participant doctor, and family involvement.Item Dominant-Limb Range-of-Motion and Humeral-Retrotorsion Adaptation in Collegiate Baseball and Softball Position Players(National Athletic Trainers' Association, 2014) Hibberd, Elizabeth E.; Oyama, Sakiko; Tatman, Justin; Myers, Joseph B.; University of Alabama Tuscaloosa; University of Texas at San Antonio (UTSA); Otterbein University; University of North Carolina; University of North Carolina Chapel HillContext: Biomechanically, the motions used by baseball and softball pitchers differ greatly; however, the throwing motions of position players in both sports are strikingly similar. Although the adaptations to the dominant limb from overhead throwing have been well documented in baseball athletes, these adaptations have not been clearly identified in softball players. This information is important in order to develop and implement injury-prevention programs specific to decreasing the risk of upper extremity injury in softball athletes. Objective: To compare range-of-motion and humeral-retrotorsion characteristics of collegiate baseball and softball position players and of baseball and softball players to sex-matched controls. Design: Cross-sectional study. Setting: Research laboratories and athletic training rooms at the University of North Carolina at Chapel Hill. Patients or Other Participants: Fifty-three collegiate baseball players, 35 collegiate softball players, 25 male controls (nonoverhead athletes), and 19 female controls (nonoverhead athletes). Intervention(s): Range of motion and humeral retrotorsion were measured using a digital inclinometer and diagnostic ultrasound. Main Outcome Measure(s): Glenohumeral internal-rotation deficit, external-rotation gain, total glenohumeral range of motion, and humeral retrotorsion. Results: Baseball players had greater glenohumeral internal-rotation deficit, total-range-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, total-range-of-motion, and humeral-retrotorsion difference in softball players and female controls. Conclusions: Few differences were evident between softball players and female control participants, although range-of-motion and humeral-retrotorsion adaptations were significantly different than baseball players. The throwing motions are similar between softball and baseball, but the athletes adapt to the demands of the sport differently; thus, stretching/strengthening programs designed for baseball may not be the most effective programs for softball athletes.Item The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009-2010 Through 2014-2015 Academic Years(National Athletic Trainers' Association, 2017) Kopec, Thomas J.; Hibberd, Elizabeth E.; Roos, Karen G.; Djoko, Aristarque; Dompier, Thomas P.; Kerr, Zachary Y.; Samford University; University of Alabama Tuscaloosa; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of MedicineContext: Deltoid ligament sprains among collegiate studentathletes have not been extensively investigated. Research regarding the mechanisms, participation-restriction time, and recurrence of deltoid ligament sprains in collegiate studentathletes is lacking. Objective: To describe the epidemiology of deltoid ligament sprains in 25 National Collegiate Athletic Association championship sports. Design: Descriptive epidemiology study. Setting: National Collegiate Athletic Association Injury Surveillance Program. Main Outcome Measure(s): We analyzed deltoid ligament sprains recorded in the Injury Surveillance Program for the 2009-2010 through 2014-2015 academic years. Deltoid ligament sprain injury rates, rate ratios, and injury proportion ratios with 95% confidence intervals (CIs) were reported. Results: During the study period, 380 deltoid ligament sprains were reported, resulting in a combined injury rate of 0.79/10 000 athlete-exposures (AEs; 95% CI = 0.71, 0.87). Most deltoid ligament sprains occurred in practices (54.2%, n = 206). However, the competition injury rate was higher than the practice injury rate (rate ratio = 3.74; 95% CI = 3.06, 4.57). The highest deltoid ligament sprain rates were in women's gymnastics (2.30/10 000 AEs; 95% CI = 1.05, 3.55), men's soccer (1.73/10 000 AEs; 95% CI = 1.14, 2.32), women's soccer (1.61/10 000 AEs; 95% CI = 1.13, 2.09), and men's football (1.40/10 000 AEs; 95% CI = 1.18, 1.62). Nearly half of all deltoid ligament sprains (49.7%, n = 189) were due to player contact, and 39.5% (n = 150) were non-time-loss injuries (ie, participation restricted for less than 24 hours). Only 8.2% (n = 31) of deltoid ligament sprains were recurrent. Conclusions: The highest deltoid ligament sprain rates were in women's gymnastics, men's and women's soccer, and men's football. However, the rate for women's gymnastics was imprecise (ie, the CI was wide), highlighting the need for further surveillance of deltoid ligament sprains in the sport. Most deltoid ligament sprains were due to player contact. Future researchers should assess interventions that may prevent deltoid ligament sprains.Item Epidemiology of National Collegiate Athletic Association men's and women's swimming and diving injuries from 2009/2010 to 2013/2014(BMJ, 2015) Kerr, Zachary Y.; Baugh, Christine M.; Hibberd, Elizabeth E.; Snook, Erin M.; Hayden, Ross; Dompier, Thomas P.; Harvard University; Boston Children's Hospital; University of Alabama TuscaloosaBackground Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years. Methods Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs. Results The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR= 1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR= 0.70; 95% CI 0.52 to 0.95) and diving (IRR= 0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers. Conclusions Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research.Item Occupational sedentary behavior: application of the social ecological model(University of Alabama Libraries, 2017) Hutcheson, Amanda K.; Usdan, Stuart L.; University of Alabama TuscaloosaSedentary behavior is recognized as a significant public health problem. One of the primary domains to target sedentary behavior is in the workplace. Although research has called for the incorporation of an ecological perspective to investigate influences on occupational sedentary behavior, there are still numerous inconsistencies and gaps in the literature with regard to domain-specific ecological influences on sedentary behavior. The purpose of this study was to explore factors contributing to occupational sedentary behavior at multiple levels (intrapersonal, interpersonal, and institutional) using the social ecological model as a framework. The study utilized a quantitative, cross-sectional design through the administration of an online questionnaire. A convenience sample of 527 employed adults at a large Southeastern institution were recruited for this study. Occupational sedentary behavior among participants was 342.45 minutes (SD = 133.25). Significant differences in occupational sedentary behavior were observed by gender (p = .007), education level (p = .026), and employment classification (p = .006); where women, participants with a higher education, and professional staff reported significantly longer time spent in occupational sedentary behavior. Barrier self-efficacy ( = -.15, p = .001), local connectivity ( = -.10, p = .046), and overall connectivity ( = -.11, p = .018) emerged as significant predictors of occupational sedentary behavior (R2 = .058, F(3, 478) = 9.74, p < .001). Barrier self-efficacy (F[1, 457] = 8.51, p = .007, partial η2 = .016) and employment classification (F[2, 457] = 4.40, p = .013, partial η2 = .019) were significant predictors of occupational sedentary behavior. Findings from this study provide new information regarding the potential impact of psychosocial factors and workplace environmental configurations, such as barriers and connectivity, on employee sitting time during the workday and support the use of an ecological perspective to understand occupational sedentary behavior. Public health education researchers and practitioners should continue to explore ecological influences on occupational sedentary behavior and develop comprehensive interventions to address the negative health effects of occupational sedentary behavior.Item Pedestrian crossing behavior in college students: exploration using the theory of planned behavior(University of Alabama Libraries, 2017) Piazza, Andrew John; Knowlden, Adam P.; University of Alabama TuscaloosaBackground. In the United States, pedestrian fatalities make up a substantial proportion of total traffic fatalities. High use of mobile data and exposure to high-traffic environments place college students at increased risk. The present study aimed to utilize the theory of planned behavior (TPB) to examine college students’ behavioral intention to cross the street on campus while using a mobile device. A secondary aim was to estimate the incidence of distracted mobile device use among street-crossing pedestrians at a large public southeastern university. Methods. Questionnaire data were collected from undergraduate college students attending a Southeastern university. Questionnaire development involved a literature review, face and content validity by expert panel, readability and comprehensibility by pilot test, stability reliability by test-retest, and internal consistency using Cronbach’s alpha. Construct validity of the TPB for predicting behavioral intention to cross the street on campus while using a mobile device was assessed using linear regression analyses. The second aim involved performing observations to estimate the incidence of distracted mobile device use among street-crossing pedestrians. Results. The TPB constructs of attitude toward the behavior (B = .395, p < .001), subjective norm (B = .328, p < .001), and perceived behavioral control (B = .158, p < .001) were significant predictors of behavioral intention and explained 48.4% of the variance. Observations yielded 4,878 crossing instances (33.9% male and 66.1% female). Overall, 1,201 (24.6%) cases involved device use with 16.8% of male crossings and 28.6% of female crossings involving distraction. A significant difference in device use while crossing was found between some observation locations, X^2(3) = 8.866, p = .031. Discussion. A questionnaire was developed to measure TPB constructs predictive of college students’ behavioral intention to cross the street on campus while using a mobile device. Such a questionnaire can be used in the design and evaluation of TPB-based interventions to decrease distracted mobile device use while crossing the street among college students. Observation data provide an estimate of distracted mobile device use while crossing the street. Future research should focus on improving understanding of the problem and evaluation of interventions to influence behavioral intention.Item Performance recovery following exercise induced muscle damage (EIMD) through an exhaustive bout of exercise(University of Alabama Libraries, 2016) Kopec, Thomas John; Richardson, Mark T.; Esco, Michael R.; University of Alabama TuscaloosaThe purpose of the studies was to evaluate practical measures for testing recovery status in the field setting with non-invasive variables of knee flexion range of motion (ROM), landing error scoring system performance (LESS), Rectus femoris cross-sectional area (CSA), thigh circumference (circumference), and heart rate variability (lnRMSSD). All of the studies required participants to complete the respective dependent variables, and then all studies completed the same performance battery, consisting of vertical jump (VJheight), isometric quadriceps strength (ISO), and time-to-peak isometric quadriceps strength (ISOTTP). The same exhaustive exercise was utilized in all three studies and incorporated broad jumps and a timed running course. Participants were then measured again for the dependent variables and performance measures following the exercise protocol, and then returned at 24, 48, and 72-hours for follow-up testing. Study 1 analyzed the knee flexion ROM and LESS; Study 2 analyzed Rectus femoris CSA and thigh circumference at 15 cm proximal to the superior pole of the patella; and Study 3 analyzed the correlations between lnRMSSD and CSA. Study 1: The pre-exercise values for ROM were related to ∆VJheight 24, ∆ISO24, ∆VJheight 48, and ∆ISO48. Pre-exercise LESS were related to ∆ISO24 and ∆ISO48. Study II: There were no significant relationships between the changes in CSA, circumference, and the performance variables over 72-hours. Study III: Changes in lnRMSSD and CSA were largely related immediately following the exercise protocol from baseline, and between baseline and 24-hour follow-up. In conclusion, knee flexion ROM and LESS can be used to predict the return of performance measures towards baseline following an exhaustive bout of exercise, but that the changes in Rectus femoris CSA and thigh circumference were not good indicators of recovery. However, there were large correlations between changes in lnRMSSD and changes in CSA immediately following exercise and at 24-hour follow-up, illustrating that lnRMSSD can detect both global and localized physiological responses following an exhaustive exercise bout. ROM and LESS may be appropriate for predicting the responses in performance measures, and lnRMSSD is sensitive to both global and localized perturbations to homeostasis following exhaustive exercise.Item Preseason screening of shoulder range of motion and humeral retrotorsion does not predict injury in high school baseball players(Elsevier, 2017) Oyama, Sakiko; Hibberd, Elizabeth E.; Myers, Joseph B.; University of Texas at San Antonio (UTSA); University of Alabama TuscaloosaBackground: Shoulder and elbow injuries are commonplace in high school baseball. Although altered shoulder range of motion (ROM) and humeral retrotorsion angles have been associated with injuries, the efficacy of preseason screening of these characteristics remains controversial. Methods: We conducted preseason screenings for shoulder internal and external rotation ROM and humeral retrotorsion on 832 high school baseball players and tracked their exposure and incidence on throwing-related shoulder and elbow injuries during a subsequent season. Poisson regression with robust error variance was used to determine whether preseason screening could identify injury risk in baseball players and whether the injury risk was higher for pitchers compared with players who do not pitch. Results: Shoulder rotation ROM or humeral retrotorsion at preseason did not predict the risk of throwing-related upper extremity injury (P =.15-.89). Injury risk was 3.84 higher for baseball players who pitched compared with those who did not (95% confidence interval, 1.72-8.56; P =.001). Discussion: Preseason measures of shoulder ROM and humeral retrotorsion may not be effective in identifying players who are at increased injury risk. Because shoulder ROM is a measure that fluctuates under a variety of influences, future study should investigate whether taking multiple measurements during a season can identify at-risk players. The usefulness of preseason screening may also depend on rigor of participation in sports. Future studies should investigate how preseason shoulder characteristics and participation factors (ie, pitch count and frequency, competitive level, pitching in multiple leagues) interact to predict injury risk in baseball players. (C) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.Item Rate of Upper Extremity Injury in High School Baseball Pitchers Who Played Catcher as a Secondary Position(National Athletic Trainers' Association, 2018) Hibberd, Elizabeth E.; Oyama, Sakiko; Myers, Joseph B.; University of Alabama Tuscaloosa; University of Texas at San Antonio (UTSA)Context: Many high school pitchers play another position after they have finished pitching for the day or on their rest days from pitching. Because of the cumulative demands on the arm, pitchers who also play catcher may have a greater risk of developing a throwing-related shoulder or elbow injury. Objective: To compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also played catcher as a secondary position and those who did not play catcher. Design: Prospective cohort study. Setting: Field laboratory. Patients or Other Participants: A total of 384 male high school baseball pitchers were recruited from 51 high school teams. Pitchers who reported their secondary position as catcher were classified into the pitcher/catcher group and those who did not report playing catcher as a secondary position were classified into the other group. Main Outcome Measure(s): Participants completed a demographic questionnaire preseason and then athlete participation and injury status were tracked during the subsequent season. Athlete-exposures were monitored and the shoulder and elbow injury proportion rates were calculated. Results: Athlete-exposures did not differ between groups (P = .488). The pitcher/catcher group's risk of shoulder or elbow injury was 2.9 times greater than that of the other pitchers (15% versus 5%; injury proportion rate = 2.9; 95% confidence interval = 1.03, 8.12). Conclusions: Pitchers who reported also playing catcher were at a greater risk of sustaining a throwing-related shoulder or elbow injury than the other pitchers. These findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load. Serial physical examinations of pitchers/catchers during the season may be useful in determining if their physical characteristics are changing during the season because of the cumulative throwing load.