Browsing by Author "Emery, Carolyn"
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- ItemOpen AccessA Comparison of Biomechanical Outcomes in Single Leg Squat and Vertical Drop Jump in Youth and Young Adults with and without a Previous Youth Sport-Related Knee Joint Injury(2018-04-30) Lorenzen, Kristin Nicole; Emery, Carolyn; Ronsky, Janet L.; Whittaker, Jackie L.; Edwards, William Brent; Bertram, John E.Objective: To examine the kinematic and kinetic differences during functional movements between youth and young adults with a history of intra-articular knee injury and age, sex, and sport matched controls. Methods: In total, 186 youth/young adults (age 15-26; 100 female, 86 male; 93 matched pairs) attended a testing session in which kinematic and kinetic data were collected using a motion capture camera system and two force platforms. Joint angles and moments for the ankle, knee, hip, and trunk were calculated and between-group differences were analyzed. Results: No group differences were observed for either males or females in the primary outcomes (knee abduction/adduction angle, knee abduction/adduction moment) in either the vertical drop jump or single leg squat. Group differences were observed for the females during the vertical drop jump in the hip abduction moment on the index limb and the knee valgus angle, knee abduction moment, and hip external rotation angle on the non-index limb; during the single leg squat in the hip adduction angle on the index limb and the knee flexion angle on the non-index limb. Conclusions: Previously injured female participants demonstrate some kinematic and kinetic differences in functional movements 3-10 years following an intra-articular knee joint injury.
- ItemOpen AccessAdapted Physical Activity Camps: Family Experiences and Implications for Family Relationships(2021-07-12) Youngblood, Jessica; McDonough, Meghan; Emery, Carolyn; Condliffe, Elizabeth; Legg, DavidChildren with disabilities tend to be less active than typically developing children and barriers to participate in activities may cause strain on family relationships. Families caring for a child with a disability face higher levels of stress, burnout, and feelings of isolation. The purpose of this thesis was to better understand family members’ perspectives regarding family relationships as they relate to participation in an adapted summer camp for children and adolescents living with a disability. This thesis was informed by the Social Relational Model of Disability and Bowen’s Family Systems Theory. A constructivist epistemology and relativist ontology provided the foundation for two collective case studies examining interactions and relationships among families participating in adapted physical activity (PA) camps. The first study examined a camp where children and adolescents with disabilities have the opportunity to participate in a variety of adapted sports. The second study focused on a camp where children and adolescents with disabilities have the opportunity to participate in physical activities with their parents and siblings. In both studies, focus groups were conducted with each family at one time point with questions regarding their perceptions of their family relationships as they related to participation in the camps and their perspectives regarding the suspension of these recreation programs as a result of the COVID-19 pandemic. Thematic analysis was conducted to identify themes and examine similarities and differences in the families’ reported experiences. While experiences in the two contexts varied, themes included family members’ perspectives regarding what the child living with a disability is able to achieve, conversations surrounding disability, support for managing daily stressors, an understanding of one another, shared experiences and memories, sibling bonding, and pride in the child with a disability. Families also noticed that the confidence and independence experienced by the child living with a disability was meaningful for interactions within their families. The loss of the camps due to COVID-19 was associated with families experiencing isolation, worry, and frustration. The findings from these studies can be used to better understand family members’ experiences regarding adapted PA as it relates to family relationships.
- ItemOpen AccessAdapted Sport and Recreation Camps: Examining Physical Activity, Self-Perceptions, and Motivations for Participation in Youth with Physical Disabilities(2022-01-27) Tremblay, Catherine; Emery, Carolyn; Condliffe, Elizabeth; Smirl, Jonathan; McDonough, Meghan; Legg, DavidPurpose: The purpose of this study is to examine whether time spent in moderate-to-vigorous physical activity (MVPA), self-perceptions, and motivation for participation in physical activity (PA) change following participation in a 5-day adapted sport and recreation (S&R) camp in youth aged 7-18 years with physical disabilities. Objectives: The first objective is to examine changes in weekly levels of MVPA in minutes in youth (ages 7-18 years) with a physical disability during, and at 6- and 12-months following participation in a 5-day adapted S&R camp compared to pre-camp MVPA. The second objective is to examine changes in self-perception and motivation for participation in PA in youth with a physical disability following a 5-day adapted S&R camp compared to pre-camp. Methods: This is a one-year longitudinal pre-experimental study that used Actigraphy to measure time spent in MVPA and used The Children’s Attraction to PA and the Self-Perception Profiles in Children measures to examine changes in self-perceptions and motivations for participating in PA. Data was collected pre-camp, during camp, and at 6- and 12-months post-camp. Results: Time spent in MVPA was higher during camp compared to pre-camp for children (z=-2.10; p=0.04) and adolescents (z=-2.31; p=0.03). This increase was not sustained at 6 months post-camp for both groups or at 12-months post-camp for the adolescent group (p>0.05). The children’s camp-group saw an increase in time spent in MVPA at 12-months post-camp relative to pre-camp (z=-2.02; p=0.04). Self-perceptions and attraction to physical activity did not meaningfully change on day 3, and 6-months and 12-months following participation in an adapted S&R camp. No apparent trends or patterns were seen based on individual level data. Conclusion: Time spent in MVPA, self-perceptions and attraction to PA in children did not change following participation in the adapted S&R camp. Future studies should consider a larger sample, a study design including a control group for comparison, and ways to improve psychosocial aspects when planning adapted S&R camps for youth with physical disabilities.
- ItemOpen AccessAdapted sport and recreation summer camp: youth with physical disabilities, their parents and staff perspectives on psychosocial outcomes and physical activity participation(2019-06-25) Sandron, Elysa; Emery, Carolyn; Condliffe, Elizabeth; Legg, David; McDonough, Meghan; Brunton, LauraObjectives: 1. To examine how an adapted sport and recreation (S&R) camp may facilitate a pathway to regular participation in physical activity (PA). 2. To assess the psychosocial benefits of an adapted S&R program from the perspective of youth with physical disabilities, their parents, and staff. Methods: Youth with physical disabilities participated in an adapted S&R camp designed to introduce adapted S&R programs offered in the community. Photography to stimulate conversation (youth), semi-structured interviews (17 youth, 4 staff) and focus groups were conducted (12 parents/guardians). Inductive thematic analysis was conducted. Results: Youth perspectives resulted in five themes; 1) comfort around others with disabilities, 2) improved social skills, 3) reframing of therapeutic exercises as sports and devices as sports equipment, 4) discovery of abilities, and 5) overcoming stigma. Parent and staff perspectives resulted in three themes pertaining to perceptions of benefits experienced by youth; 1) normalizing participation in sport and PA, 2) motivation to participate in PA and be independent in daily activities, and 3) empowerment and confidence. Three themes related to perceptions on guiding youth through a pathway to PA; 4) recognizing youth’s ability, 5) raising awareness of PA opportunities, and 6) relief from barriers. Conclusions: Findings suggest adapted S&R camps are a possible pathway supporting PA participation for youth with physical disabilities.
- ItemOpen AccessAdvancing Concussion Assessment in Pediatrics (A-CAP): a prospective, concurrent cohort, longitudinal study of mild traumatic brain injury in children: protocol study(BMJ, 2017-07-01) Yeates, Keith O.; Beauchamp, Miriam; Craig, William; Doan, Quynh; Zemek, Roger; Bjornson, Bruce H.; Gravel, Jocelyn; Mikrogianakis, Angelo; Goodyear, Bradley; Abdeen, Nishard; Beaulieu, Christian; Dehaes, Mathieu; Deschenes, Sylvain; Harris, Ashley D.; Lebel, Catherine; Lamont, Ryan; Williamson, Tyler; Barlow, Karen M.; Bernier, Francois; Brooks, Brian L.; Emery, Carolyn; Freedman, Stephen B.; Kowalski, Kristina; Mrklas, Kelly; Tomfohr-Madsen, Lianne; Schneider, Kathryn J.Introduction Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI. Methods and analysis A-CAP is a prospective, longitudinal cohort study of children aged 8.00-16.99 years with either mTBI or OI, recruited during acute emergency department (ED) visits at five sites from the Pediatric Emergency Research Canada network. Injury information is collected in the ED; follow-up assessments at 10 days and 3 and 6 months postinjury measure a variety of neurobiological and psychosocial markers, covariates/confounders and outcomes. Weekly postconcussive symptom ratings are obtained electronically. Recruitment began in September 2016 and will occur for approximately 24 months. Analyses will test the major hypotheses that neurobiological and psychosocial markers can: (1) differentiate mTBI from OI and (2) predict outcomes of mTBI. Models initially will focus within domains (eg, genes, imaging biomarkers, psychosocial markers), followed by multivariable modelling across domains. The planned sample size (700 mTBI, 300 OI) provides adequate statistical power and allows for internal cross-validation of some analyses. Ethics and dissemination The ethics boards at all participating institutions have approved the study and all participants and their parents will provide informed consent or assent. Dissemination will follow an integrated knowledge translation plan, with study findings presented at scientific conferences and in multiple manuscripts in peer-reviewed journals.
- ItemOpen AccessBiomechanical differences between young adults with and without a history of youth sport-related ankle injury(2022-10) Russell, Monica; Edwards, William Brent; Emery, Carolyn; Manocha, Ranita; Kuntze, Gregor; Kobsar, Dylan; Sparks, HollyAnkle sprain injuries are common in youth sport and often have residual symptoms that linger years after the initial injury. These symptoms could include impaired balance and altered lower extremity joint kinematics and kinetics. Ankle sprain injury is strongly associated with the development of post-traumatic ankle osteoarthritis, with potential pathomechanisms linked to altered ankle joint loading. Thus, the primary objective of this research was to quantify differences in balance and lower extremity joint kinematics and kinetics between individuals who have sustained an ankle injury during youth sport 3 to 15 years prior to study participation compared to those with no history of lower extremity injury. The secondary objective of this study was to assess the impact of limb asymmetry and age on balance and lower extremity joint kinematics in individuals with and without ankle injury history during their youth. Balance did not differ between females with and without ankle sprain history. During walking, females with ankle sprain history demonstrated larger peak knee external rotation angle, larger peak knee extension angle, and larger peak hip flexion than uninjured controls. During a single-leg squat task, previously injured females displayed smaller peak ankle plantarflexion angle, peak knee extension angle, and peak hip external rotation angle than uninjured controls. Differences in ground reaction forces were observed during the walking and single-leg squat task between injured and uninjured females. During walking, older females displayed smaller peak ankle inversion, plantarflexion, hip abduction, and hip extension angles than younger females. During the SLS task, older females demonstrated a larger peak eversion angle and peak plantarflexion angle, and smaller peak knee external rotation and extension angles. . Small numbers of male participants limited analytic possibilities, however descriptively they may have a longer centre of pressure (COP) pathlength during the single-leg balance task compared to females. Male participants also seem to demonstrate different peaks in lower extremity joint kinematics compared to female participants. These results indicate long-term biomechanical effects of ankle sprain injuries, or pre-existing differences in biomechanics that may predispose certain individuals to ankle sprain injuries.
- ItemOpen AccessDizziness, Neck Pain and Headaches Following Sport-Related Concussion: Symptoms, Risk Factors and Physiotherapy Management(2013-01-29) Schneider, Kathryn; Meeuwisse, Willem; Emery, CarolynSport-related concussion is a commonly occurring injury in sport today. Little is currently known about baseline symptoms and Sport Concussion Assessment Tool (SCAT) scores in youth athletes. Additionally, symptoms of dizziness, neck pain and headaches are commonly reported in the youth population and there is currently no literature evaluating these symptoms as risk factors for incident concussion. There is a paucity of literature currently available evaluating treatment for individuals with persistent symptoms following a sport-related concussion. Thus, while there has been an explosion of research in the area of sport-related concussion, there remain gaps in the current literature specifically relating to symptoms as risk factors for concussion and physiotherapy treatment for individuals with persistent symptoms. In this document, baseline symptoms and scores on the SCAT were evaluated and presented. Reports of dizziness, neck pain and headaches at the start of the season were found to be risk factors for concussion. A systematic review evaluating rest and treatment for individuals with persistent symptoms following a sport-related concussion found that there is minimal evidence currently available. In a randomized controlled trial, individuals who were treated with multimodal physiotherapy treatment, including vestibular rehabilitation, were 10 times more likely to be medically cleared to return to sport within eight weeks of initiation of treatment. Multimodal physiotherapy treatment should be considered for individuals with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.
- ItemOpen AccessDoes Injury Definition Matter? The Influence of Different Definitions on Interpretations of Injury Risk among Pre-Professional Ballet and Contemporary Dancers(2017) Kenny, Sarah; Emery, Carolyn; Whittaker, Jackie; Palacios-Derflingher, LuzBackground: Dance is a physical discipline that requires artistic expression combined with athletic capacity. The blend of artist and athlete can only be achieved through rigorous training, which increases a dancer’s susceptibility to musculoskeletal (MSK) injury. Research aimed at preventing dance injuries is warranted in order to ensure long-term dance participation and associated health benefits. Although there has been an extensive amount of study in the field of dance-related injury prevention, knowledge gaps remain due to a paucity of rigorous research. Foundational to dance-related injury prevention research is the definition of injury. Objectives: The primary objective of this doctoral research is to assess the influence of injury definition on interpretations of injury risk among pre-professional ballet and contemporary dancers. Methods: Full-time pre-professional ballet and contemporary dancers underwent an evidence-informed, psychometrically sound, pre-participation evaluation. Prospective injury surveillance was implemented during one academic year to identify three definitions of dance-related injury (i.e., time-loss, medical attention, all MSK complaints) utilizing two injury registration methodologies (i.e., therapist-report, self-report). Potential injury risk factors were identified using classification and regression tree analysis followed by multivariable linear regression. Results: Injury prevalence, incidence and severity of injuries impacting pre-professional dancers varies depending on the definition of injury, injury reporting methodology, and style of dance. Injuries resulting in time-loss and medical attention underestimate the burden of injury, while the prevalence of MSK complaints amongst pre-professional ballet and contemporary dancers is high. Self-reported one-year injury history is a significant risk factor for dance-related MSK complaints, and age, psychological coping skills, ankle range of motion, and dynamic balance may influence the injury risk profile of this population. Conclusions: To understand the full impact of injury in dance, it is imperative that injury surveillance systems employ injury definitions that are sensitive enough to capture all injuries. It is recommended that future epidemiological studies examining risk factors for dance injury look beyond the linear interaction of isolated potential risk factors and employ methodological strategies that incorporate analyses examining risk patterns (i.e., interactions among multiple risk factors) to better understand the complex nature of dance injury etiology.
- ItemOpen AccessThe effect of a ski-snowboard injury prevention video on safety knowledge and behaviours in school programs(2018-01-11) Mitra, Tatum; Hagel, Brent; Emery, Carolyn; Nettel-Aguirre, Alberto; Caird, Jeff; Russell, KellyPurpose: To implement and evaluate the effects of a skiing and snowboarding injury prevention video on child and adolescent safety knowledge and behaviours. Study Design: Cluster-randomized controlled trial. Background: Skiing and snowboarding are two popular winter activities; however, these sports can lead to injury. Previous studies have found that injuries in snow sports can be prevented and may be associated with poor decisions, actions and human error. Currently, there is no comprehensive injury prevention program found in skiing and snowboarding. Methods: The participants were students in grades 2 through 9 who were a part of the ski and snowboard school programs at a ski area in Southern Alberta. The participants were randomized into either the control or intervention group, based on the school they attended. The control group followed the current standard protocol for the ski and snowboard school programs, including an orientation video, while the intervention group received a video that focuses on safety knowledge and injury prevention. The outcomes were measured through the use of pre- and post-tests (safety knowledge uptake) and the observations of risky behaviours on the ski hill. Results: There was a significant increase in safety knowledge scores for those in the intervention group immediately following exposure to the video intervention (mean change: +1.91 points/15 points) compared with the control group after exposure to the control video (mean change: +0.10 points/15 points). There were 23.31 risky behaviours/100 runs (95% CI: 16.75-29.87) for those in the control group, and 22.95 risky behaviours/100 runs (95% CI: 17.63-28.26) for those in the intervention group. Conclusion: This project demonstrates that a skiing and snowboarding injury prevention video can improve knowledge scores within a school-aged population. The video intervention, however, was not associated with the overall incidence of risky behaviours in this population. Future injury prevention research should investigate how to better translate knowledge to induce behavioural changes and limit risky behaviours in child and adolescent skiers and snowboarders.
- ItemOpen AccessEffect of Previous Concussion on Sport-Specific Skills in Youth Ice Hockey Players(2016-01-18) Eliason, Paul; Emery, Carolyn; Meeuwisse, Willem; Hagel, Brent; Nadeau, Luc; Yeates, KeithObjective: To investigate the effect of previous concussion on sport-specific skill performance in youth ice hockey players. Methods: In total, 596 participants [525 males and 71 females, ages 11-17, representing elite (upper 30% by division of play) and non-elite (lower 70% by division of play)] were recruited from minor ice hockey teams in Calgary, Alberta over three seasons of play (2012-2015). Primary Outcome Measure: On-ice skill performance was based on the Hockey Canada Skills Test (HCST) battery which included forward agility weave, forward and backward speed skate, forward to backward transition agility, and a 6-repeat endurance skate. Results: There were no significant differences in the adjusted odds ratios or the mean scores between those with and without a history of concussion for all HCST components. Conclusions: Youth ice hockey players with a history of concussion have similar HCST performance scores to those that do not.
- ItemOpen AccessEffects of Interval Exercise on Commonly Studied Fluid Biomarkers for Sport-related Concussion in Serum and Plasma(2022-06) Penner, Linden; Smirl, Jonathan; Emery, Carolyn; Debert, Chantel; Wellington, Cheryl; Fraser, DouglasHigh intensity interval exercise has been shown to increase blood levels of commonly studied fluid biomarkers for SRC. If true, the potential diagnostic or prognostic applications of these markers for SRC may be limited due to exercise being implicit in sport. This thesis examines the effects of interval exercise on serially collected plasma levels of t-tau, GFAP, NFL, and UCH-L1 in healthy young adults (7 females; 3 males), and differences in biomarker levels between plasma and serum matrices. The first study showed small and short-lived decreases in plasma NFL and GFAP immediately following interval exercise. The second study demonstrated differences between plasma and serum concentrations of t-tau, NFL, and GFAP. Together, these results suggest exercise should be considered prior to the clinical validation of these biomarkers for diagnosis or prognosis of SRC and highlights the need to harmonize analytical methodologies across research investigations aiming to develop objective measures of SRC.
- ItemOpen AccessEquipment and Concussion in Youth Ice Hockey and Ringette(2021-06-28) Kolstad, Ashley; Emery, Carolyn; Hagel, Brent; Black, Amanda; Palacios-Derflingher, Luz; Mihalik, JasonThis thesis examined equipment related to concussion prevention in youth ice hockey and ringette players. The first study examined potential equipment-related risk factors for concussion in youth ice hockey players. We considered both a prospective cohort (rate of concussion) and nested case (concussion) control (musculoskeletal injury) design (odds of concussion) for each equipment characteristic. Main results showed significant lower rates and odds of concussion for mouthguard wearers (when compared to non-wearers) and no differences in concussion likelihood for newer and older helmet ages. The second study examined the feasibility and reliability for conducting virtual helmet fit assessments in youth ice hockey and ringette players for future concussion prevention examination. The results indicated high percent agreement (≥80%) for reliability on almost all criteria for virtual assessments and barriers for assessments related to technology (e.g., camera quality) and environment (e.g., lighting). Overall, equipment may be important for concussion prevention and player safety.
- ItemOpen AccessEvaluating different methodological approaches to inform physiologically-based exercise strategies to improve recovery following sport-related concussion(2022-06) Miutz, Lauren Nicole; Emery, Carolyn; Smirl, Jonathan; Brassard, Patrice; Phillips, AaronAfter sustaining a sport-related concussion (SRC), following a brief initial rest period (24-48 hours), a gradual return to physical exertion with exercise performed below symptom threshold is recommended.1,2 However, there is currently a paucity of literature examining how physical activity (PA) should be performed during the recovery phase following a concussion; including recommendations on intensity, duration, and modality. Research has shown that physical exertion can exacerbate symptoms (e.g., headache, balance, vision impairments, dizziness) and cerebral blood flow (CBF) regulatory mechanisms can be altered,3,4 which may impact one’s quality of life and ability to return to sport.2,5 Combined, these findings provide a potential physiological explanation for the mechanisms of clinical symptom exacerbation commonly reported during exertion following a concussion.6 Evaluating the methodologies using a physiologically-informed approach informed a further the understanding of the underlying mechanisms of clinical symptom exacerbation at rest and during PA, which is vital in creating evidence-based recovery management processes following SRC. In this dissertation, the evidence related to how PA affects recovery following an SRC in adolescents was systematically reviewed. Second, appropriate attachment site for objectively measured sleep and PA metrics was examined in adolescents. Next, a newly developed cycle protocol was compared physiologically to the Buffalo Concussion Treadmill Test in uninjured adults. Finally, CBF responses to progressively increasing lower body negative pressure during moderate intensity aerobic exercise in healthy young adults was investigated. The overall findings from this research enhanced the understanding of physiological measures associated with exertion (including modality and postural considerations) in an uninjured population.
- ItemOpen AccessEvaluation of the Effect of Policy Change on Physical Contacts in Youth Ice Hockey Using Video Analysis(2016) Krolikowski, Maciej; Emery, Carolyn; Palacios-Derflingher, Luz; Hagel, Brent; Nadeau, LucObjective: To determine the association between body checking policy change and the frequency and intensity of physical contacts in Bantam ice hockey players (ages 13-14). Methods: This is a cohort study design. Video-analysis data includes 13 non-elite (lowest 70% by division of play) Bantam (ages 13-14) ice hockey games videotaped in Calgary, Alberta, Canada (2014-15 where body checking was permitted) and Vancouver, British Columbia, Canada (2014-15 where body checking was not permitted). Primary outcome measures include high intensity physical contact (body checking), as well as hooking and slashing behaviours. Results: Lower incidence rates of high intensity physical contact were observed in Bantam ice hockey players in a league where body checking was not permitted [IRR= 0.09 (95% CI; 0.05-0.15)]. Players in a league where body checking was not permitted had significantly higher incidence rates of hooking and slashing behaviours [IRR= 1.81 (95% CI; 1.33-2.47)]. Conclusions: There was a lower incidence of higher intensity physical contacts in Bantam ice hockey players in a league where body checking is not permitted, whereas the incidence of hooking and slashing behaviours were higher. This research will inform the mechanisms explaining injury and will have important national public health implications (reduction of injury) for policy decisions related to rule enforcement in youth ice hockey.
- ItemOpen AccessExamining Physical Activity, Adiposity, and Function in Youth with and without Spastic Cerebral Palsy(2018-06-27) Janzen, Leticia Mae; Emery, Carolyn; Condliffe, Elizabeth; Kuntze, Gregor; Brunton, Laura; Toomey, Clodagh M.Objectives: To examine physical activity (PA), body composition, balance, and strength in youth (ages 10-18) with cerebral palsy (CP), compared to age- and sex-matched typically developing (TD) peers. Methods: Thirty youth with CP [gross motor function classification system (GMFCS) levels I-III; 20 males], were matched to TD youth. PA (minutes in sedentary, light, and moderate-vigorous) was measured using ActiGraph accelerometers. Body composition (fat and lean mass indices) was assessed by dual-energy x-ray absorptiometry. Center of pressure (total path length and 95% ellipse area) on two force plates represented balance. Lower-extremity strength was measured using hand-held dynamometry. Results: Youth with CP, GMFCS levels II or III, achieved less moderate-vigorous PA, were more sedentary, weaker with all lower-extremity muscle groups, had lower lean mass indices, and had larger 95% ellipse areas than TD youth. Conclusions: GMFCS level appeared to impact the severity of activity limitations and of body structure and functional impairments.
- ItemOpen AccessExploring Psychological Resilience, Plasma Cortisol, and Sport-Related Concussion Outcomes Among Canadian Adolescent Sport Participants(2024-06-26) Josafatow, Nikolas; Debert, Chantel; Emery, Carolyn; Yeates, Keith; Esser, MichaelSport-related concussion (SRC) is a common injury among Canadian adolescent sport participants (ASP). Numerous factors potentially impact recovery from SRC, including psychological resilience and cortisol. Researchers have found low psychological resilience and low cortisol may be independently linked to increased post-SRC symptom burden and a longer duration of recovery. However, the relationship between resilience and cortisol has not yet been investigated following adolescent SRC, which was the overarching goal of this thesis. The first aim of this study was to explore the trajectory of resilience, as measured by the Connor-Davidson Resilience Scale 10 (CDRISC-10), before and after SRC, controlling for age and sex. Following, we described the relationships between resilience and SRC outcomes, including symptom burden and length of recovery based on physician clearance to return to play. We also aimed to examine group differences in plasma cortisol (stratified by morning [before 11:00am] and basal [11:00am–6:00pm] collection times) between uninjured and post-SRC ASP, controlling for age and sex/menstrual cycle phase (male, female follicular, female luteal), and time of blood draw. We then compared post-SRC cortisol to SRC outcomes controlling for age, and sex/menstrual cycle phase. Finally, we aimed to investigate the associations between resilience and plasma cortisol before and after adolescent SRC. The analyses were stratified by time of cortisol collection as outlined above. Uninjured analyses controlled for age and sex, while post-SRC analyses controlled for age, sex, and symptom severity. We found sex-specific trajectories of resilience following SRC, and that acute post-SRC measures of resilience may better predict SRC outcomes compared to pre-injury measures. Morning and basal cortisol were significantly lower post-SRC for males and females regardless of menstrual cycle phase. Post-SRC morning and basal cortisol demonstrated non-linear relationships with symptom burden, potentially reflecting impairment of the HPA axis and HPA axis activation in response to stress. Finally, morning cortisol decreased with increased resilience in our uninjured participants, but not in our post-SRC participants, suggesting HPA axis impairment following SRC. Overall, the results of this thesis revealed novel aspects of SRC pathophysiology and provide groundwork for future investigations into the complex relationship between resilience, cortisol, and SRC outcomes.
- ItemOpen AccessIdentifying the Impact of Injury Definition and Training Load on the Study of Jumper’s Knee(2016) MacDonald, Kerry; Meeuwisse, Willem; MacKenzie, Don; Emery, Carolyn; Palacios-Derflingher, Luz Maria; Ronsky, JanetWith a growing body of research into volleyball injuries we are beginning to understand potential risk factors for the most prevalent injuries. Volleyball has been found to have more overuse than acute injuries, yet the majority of research to date has failed to utilize an injury definition sensitive enough to capture the true frequency and burden of overuse problems. Furthermore, the mechanism of overuse injuries is believed to be a chronic overloading of tissue, in combination with an incomplete healing process. With advancements in technology, it is now possible to accurately and efficiently measure these loads which, in turn, could have significant impact on injury prevention. Previously identified risk factors were assessed with the purpose of developing a sport-specific screening program. The impact of injury definition on the data collection for overuse injuries was also examined. This analysis evaluation confirmed the need to use specific overuse injury definitions, with an improved sensitivity for the capture of overuse injury frequency and burden compared to more conventional time-loss definitions. An assessment of known risk factors, including a measure of jumping load, was completed with the more sensitive overuse injury capture. Although no risk factor was found to significantly predict injury outcome, several methodological challenges were identified. This research demonstrates that traditional assessment techniques that have been used for time-loss injuries are not sufficient for overuse injury capture and analyses. The contribution of this dissertation to the literature is the demonstration that the methods presented can more accurately capture the injury burden and record the specific load metrics for that injury. However, further advancements in statistical analysis for prevalence measures of injury are required to assess dynamic risk factors, including measures of load, for overuse injuries.
- ItemOpen AccessThe Influence of Peer-to-Peer Learning via Technology on Youth Soccer Coaches’ Neuromuscular Training Warm-up Exercise Error Detection(2020-06-25) Taddei, Larissa Mikayla; Pasanen, Kati; Emery, Carolyn; Katz, Larry; Culos-Reed, Susan NicoleObjective: To evaluate whether a peer-to-peer (P2P) learning technology integrated instruction (intervention) workshop, compared to a standard in person instruction (control) workshop improves coaches’ self-efficacy and ability to identify neuromuscular training warm-up exercise errors. Methods: Calgary Minor Soccer Association clubs (n= 6) agreed to participate in a randomized controlled trial. In each club, one of each type of workshop were randomly allocated to the scheduled dates. Coaches (n=85) randomly attended a control or intervention workshop. At the end of the workshop, the soccer NMT warm-up exercise test, a video-based test where coaches identify common NMT exercise errors, was completed. At the beginning and end of the workshop, the soccer NMT warm-up self-efficacy scale was completed to assess coaches’ self-efficacy in their ability to identify NMT exercises errors on a 7-point Likert scale. Results: Eighty-five youth soccer coaches attended the control (n=41) or the intervention workshop (n= 44). Mean NMT warm-up exercise test scores were 72% (95% CI: 68.38 - 76.44) for the control and 71% (95% CI: 67.50 - 79.38) for the intervention workshop. Mean change in NMT warm-up self-efficacy scores were 0.98 (95% CI: 0.56 – 1.40) for the control and 1.77 (95% CI: 1.41 – 2.14) for the intervention workshop. Multivariable linear regression analyses indicated that workshop delivery method was not associated with the exercise test score (beta= -3.45, 95%CI: -10.80 - 3.91, R2=0.13) but was associated with a greater difference in change of self-efficacy scores for the intervention workshop (beta= 0.97, 95%CI: 0.26 – 1.89, R2=0.13). Conclusions: A P2P learning technology integrated instructional workshop did not alter coaches tested ability to identify exercise mistakes but did increase coaches’ self-efficacy in identifying exercise mistakes compared to a standard in person workshop.
- ItemOpen AccessInjury Rates, Mechanisms, and Risk Factors For Injury in Youth Rock Climbers(2013-07-17) Woollings, Kaikanani; Emery, CarolynObjective: To examine the incidence, mechanisms, and risk factors for injury in 11- to 19-year-old recreational and elite sport climbers and boulderers. Methods: Cross-sectional study design. Participants were recruited from climbing facilities across Alberta, Canada, and 116 youths completed an anonymous questionnaire. Primary Outcome Measure: Climbing injury Results: The incidence rate of climbing injury was 4.44 injuries/1000 climbing hours (95% CI; 3.74, 5.23). Sprains and strains were the predominant injury type, and the primary mechanism of injury was repetitive overuse. Hands and fingers were the most commonly injured locations. Older age (15–19-year-olds), injury in a sport other than climbing, and preventive taping were shown to be risk factors for injury. Conclusions: Climbing injury incidence rates are high in youth climbers. Findings are consistent with reported rates and details surrounding injury in adults. Modifiable potential risk factors warrant further investigation in order to inform development of future injury prevention strategies.
- ItemOpen AccessLong-term cardiorespiratory, exercise intolerance and autonomic nervous system outcomes following adolescent sport-related concussion(2023-09-15) Carere, Joseph; Smirl, Jonathan; Emery, Carolyn; Brassard, Patrice; Doyle-Baker, PatriciaAdolescents experience high rates of sport related concussion (SRC) and are neurologically vulnerable. There is a paucity of research examining long-term physiological outcomes following adolescent SRC. This thesis compared cardiorespiratory, exercise intolerance, and autonomic nervous system (ANS) outcomes 5-15-years prior to study enrolment for individuals who sustained an adolescent SRC (SRC), a sport-related musculoskeletal injury (MSK), or played adolescent sport and went uninjured (CON). Data was collected for 156 participants (50 CON; 52 MSK; 54 SRC). Study findings suggest cardiorespiratory fitness and ANS function were generally robust to SRC, though prolonged concussion-related symptoms led to heightened discomfort during physical activity in a small subset of participants. Overall, these findings are encouraging when considering adolescent sport participation. They demonstrate that ANS and cardiorespiratory fitness are generally robust in the long-term to SRC sustained during this important neurodevelopment period. Future research should investigate physiological outcomes in those with persistent symptoms.