PRISM :: Browsing by Author "Emery, Carolyn A."

Browsing by Author "Emery, Carolyn A."

Now showing 1 - 20 of 29

Open Access
An Intervention Program Designed to Improve Balance and Power in U14 Alpine Ski-Racers
(2018-09-20) Kashluba, Kayla Amanda; Doyle-Baker, Patricia Katherine; Clark, Marcia L.; Emery, Carolyn A.; Jordan, Matthew J.; Westin, Maria
Purpose: To investigate if a neuromuscular training (NMT) warm-up program during preseason improved lower limb balance and maximal muscular power compared to a standard preseason program in alpine ski-racers 10-13-years-old (U14) after 8-weeks. Methods: Quasi-experimental study design. Participants included n=73 skiers from five Alberta Alpine Ski Association (AASA) ski-clubs. Ski-clubs in the intervention group (n=3) completed 2 15-min coach-delivered NMT warm-ups a week, while the standard of care (SOC) (n=2) ski-clubs completed their standard training; NMT warm-up program included balance, strength, and agility exercises. Performance outcome measures completed at baseline and post –testing included: vertical jump (VJ), star excursion balance test (SEBT) reach distances, and predicted VO2max. Results: Participants in the intervention group demonstrated significant improvements on the VJ and SEBT. Conclusions: Dynamic balance and peak leg power improved post implementation of the NMT warm-up program in U14 alpine ski-racers.
Open Access
Changes in exertion-related symptoms in adults and youth who have sustained a sport-related concussion.
(2018-12-20) Rutschmann, Trevor Dean; Schneider, Kathryn J.; Toomey, Clodagh M.; Emery, Carolyn A.; Yeates, Keith Owen
Design: Prospective Case-Series Background: Exertional testing is an important component of a multifaceted assessment following concussion, however, the literature evaluating symptom responses to exertion is limited. Objectives: To identify the primary symptoms responsible for the cessation of exertional testing and evaluate changes in post-concussion symptom scores (PCSS) from pre-exertion scores using the Sport-Concussion Assessment tool (SCAT5) at the following timepoints: immediate post- exertion, 1-4 hours post-exertion, 6-12 hours post-exertion and 20-26 hours post-exertion in both youth and adults who have sustained a sport-related concussion. Methods: Forty-five individuals consisting of both youth and adults (range 13-57 years) that were diagnosed with a sport-related concussion and self-reported difficulties with exertion were recruited from a university sports medicine clinic and performed the BCTT. Results: The most commonly reported symptoms reported for the cessation of exertional testing were headache (48.9%), dizziness (44.4%) and pressure in the head (26.7%). The majority (60%) of participants experienced an increase in symptoms from pre-exertion to immediate post exertion, however, collectively 75.8% of the respondents either improved or returned to pre- exertion symptom scores at the 6-12 hour time period. Conclusion: This study found that there were similar responses to exertion between males and females. The results of this study suggest that individuals who experience an exacerbation of concussion symptoms are likely to regress to pre-exertion scores within the same day. Future research with larger sample sizes would allow researchers to evaluate several covariates and their modifying behavior on symptom responses to exertion.
Open Access
Do components of a pre-participation examination in female adolescent soccer players predict acute lower extremity injuries in soccer?
(2011) Allen, Shawn P. W.; Emery, Carolyn A.
Open Access
Economic evaluation of an injury prevention strategy in high school basketball
(2006) McAllister, Jenelle Robyn; Emery, Carolyn A.
Objective: To examine the resource use and cost impact of high school basketball injuries in Calgary and area high school basketball players and to determine the cost of a balance training program in preventing injury in this population. Design: Economic Evaluation in conjunction with a Cluster-Randomized Controlled Trial. Main Outcome Measures: Mean cost per player by treatment arm; mean cost of injury in individuals suffering an injury, by treatment arm; cost to prevent one injury in a Calgary and area high school basketball player. Results: The mean cost per player and mean cost of injury were significantly greater for the intervention group than the control group. The cost of preventing one injury is $2000.40. Conclusions: The current practice for injury prevention in high school basketball (i.e. the status quo) was less expensive and marginally as effective as the balance training program. Further investigation to address poor compliance to the program is required.
Open Access
An Economic Evaluation of Body Checking Policies in Bantam Ice Hockey
(2019-01-25) Lee, Raymond; Currie, Gillian R.; Marshall, Deborah A.; Emery, Carolyn A.; Palacios-Derflingher, Luz Maria
Sport-related injury is the leading cause of injury in youth and are costly to the healthcare system. Disallowing body checking in Pee Wee (ages 11-12) ice hockey has been found to be effective in reducing the risk of injuries and associated healthcare costs, however the impact on injury risk and costs in Bantam (ages 13-14) remains unknown. The objectives of this study are to compare injury rates and costs between non-elite (lower 70% divisions of play) Bantam players in leagues allowing body checking to where body checking is disallowed, and to project the overall change on the number of injuries and costs to the Alberta healthcare system if body checking were disallowed for all Bantam players over one season. The study found that disallowing body checking reduced injuries by 4.32/1000 player-hours and saved cost by $1,737/1000 player-hours in the public healthcare system. This policy change could potentially prevent 1,102 injuries that occur during games and save $331,522 in the public healthcare system over one season in Alberta. However, this study used injury rates adjusted only for exposure hours and team clustering, but not other covariates or repeated observations. Thus further analysis is required before policy recommendations can be made.
Open Access
Evaluation of Community-Based Physical Activity Programming for Childhood Cancer Survivors
(2018-09-21) Shank, Jena Ann; Culos-Reed, Susan Nicole; Schulte, Fiona S. M.; Guilcher, Gregory M. T.; Emery, Carolyn A.; Laing, Catherine M.
Background: Childhood cancer treatments include numerous negative physical and psychosocial outcomes. Preliminary evidence suggests cancer-related side effects may be reduced by physical activity (PA). Fortunately, early research supports the physical and psychosocial benefits of PA in childhood cancer survivors. However, only a handful of research studies have been translated into community-based PA programs. One of these community- based programs is the Pediatric Cancer Patients and Survivors Engaging in Exercise for Recovery (PEER) program. The next step in translation is to evaluate patient outcomes regarding PEER participation. Thus, the purpose of the current proposal was to determine applicable evidence-based evaluation tools for the PEER program. Methods: The knowledge- to-action framework was used to compile feasible and sustainable evaluation tools, along with an algorithm to determine which tools are appropriate in the assessment of each PEER participant. Specifically, (a) a scoping review determined evaluation tools used to date in childhood cancer PA/exercise programs and studies. Based on the results of this review, (b) interviews were conducted with key stakeholders to understand what they find valuable to evaluate in PEER. This work, along with the goals of the PEER program, (c) guided the development of the evaluation tools along with an algorithm for tool implementation based on participant age, cognitive and physical ability. Finally, (d) the evaluation tools were tested for feasibility in PEER. Conclusions: The present work was the first to establish evidence-based evaluation tools that are feasible for the community-based PEER program. Ongoing PEER evaluation may enhance program translation and support the sustainability.
Open Access
Examining Measures of Weight as Risk Factors for Sport-Related Injury in Adolescents
(2016-07-20) Richmond, Sarah A.; Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.
Objectives. To examine body mass index (BMI) and waist circumference (WC) as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents () at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2) and WC (cm) were measured from direct measures at baseline assessment. Categories (overweight/obese) were created using validated international (BMI) and national (WC) cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level) estimated the risk of sport injury [incidence rate ratios (IRR) with 95% confidence intervals (CI)]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04) and knee injury (IRR = 2.07, 95% CI: 1.00–6.94) in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47)] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury.
Open Access
Exploring Health Locus of Control and Patient Preferences for the Non-Surgical Management of Osteoarthritis
(2021-08-09) Kennedy, Bryanne L; Currie, Gillian R.; Marshall, Deborah A.; Emery, Carolyn A.; Kania-Richmond, Anna A.; Gagliardi, Anna R.
Background:There is no cure for osteoarthritis, and management aims to reduce pain and improve function. Despite guidelines, 61% of people are referred for surgery before trying non-surgical options, and this needs to be further understood. Many factors affect uptake of options, including the osteoarthritis information available to patients. Individual beliefs around who and whatinfluences health, or locus of control, is related to patient preferences for disease management. There is a paucity of literature on locus of control and preferences for osteoarthritis management.Objectives:To identify the factors that patients with hip and knee osteoarthritis consider when choosing management strategies, and to explore their beliefs about who and what influences osteoarthritis symptoms and progression.Methods:Semi-structured interviews with patients who self-reported a diagnosis by a medical professional with hip and/or knee osteoarthritis and had at least one osteoarthritic joint that had not undergone replacement. A multifaceted recruitment approach was used. Interviews were transcribed verbatim and the Braun and Clarke method for thematic analysis was employed.Results:Interviews were conducted with 13 patients from Alberta, Canada. Sixteen factors were identified that participants considered when choosing management strategies. Majority were extrinsic (11), relating to features of programs and services, while five were intrinsic relating to how individual perspectives influence decision making. Three novel factors emerged: 1) whether further management was desired, 2) the prospect of surgery, and 3) participants’ choice inmanagement. Three descriptive themes captured participants’ beliefs about who and what influences their osteoarthritis symptoms and progression: etiology, progression, and symptoms. Most participants believed that others and themselves had some influence over their osteoarthritis symptoms.Conclusions:The findings reinforced that patient’s management decisions for their osteoarthritis were based on the options available to them. This was the first study to explore locus of control in the context of non-surgical osteoarthritis management and provides a point of departure for future work. Factors that patients consider when choosing management strategies were also identifiedthat could be considered for subsequent quantitative research on patient preferences.Keywords: osteoarthritis, internal-external control, patient preference, conservative treatment,disease management, qualitative research
Embargo
The Feasibility and Impact of a Painted Designs Intervention on School Children’s Physical Activity
(Taylor and Francis Group, 2022-06-16) Wong, Janet B.; McCallum, Kyle S.; Frehlich, Levi; Bridel, William; McDonough, Meghan H.; McCormack, Gavin R.; Fox, Kris; Brunton, Laura; Yardley, Leah; Emery, Carolyn A.; Hagel, Brent
Interventions such as painted designs on school tarmacs may increase children’s physical activity during school hours. This mixed-methods study examined the influence of a painted designs (e.g., traditional games, random circles) intervention on the physical activity experiences of elementary school children. Systematic observations and accelerometer data were collected to evaluate the type and quantity of student physical activity. Interviews were used to explore teacher and student experiences. Observed physical activity was not significantly different between intervention and control schools (t(43) = 0.22, p = 0.83), and children at the intervention schools undertook less physical activity (steps, moderate, vigorous, and combined moderate-to-vigorous activity) as compared with the control school (t = 2.71- 4.35, p < 0.05). Teachers and students commented that the painted designs were confusing but held potential for inclusiveness, physical activity, and learning. Additional resources and instruction may assist in better use of painted designs for physical activity and academic learning.
Open Access
Feasibility, reliability and concurrent validity of a field test of exertion in high school students
(2019-07-02) Miutz, Lauren Nicole; Schneider, Kathryn J.; Emery, Carolyn A.; Jordan, Matthew J.; Black, Amanda M.
Study Design: Test-retest reliability and concurrent validation study. Background: Exertional testing is an important component of a multifaceted assessment following concussion, however the literature evaluating a non-laboratory field test of exertion is limited. Objectives: 1) To evaluate the feasibility of a field test of aerobic capacity (modified shuttle run test - mSRT), 2) to examine the test-retest reliability of the mSRT, and 3) to evaluate the concurrent validity of a mSRT compared to the Buffalo Concussion Treadmill Test (BCTT) in uninjured high school students. Methods: Sixty uninjured adolescent males enrolled in high school sports performance courses (age 15-16 years) completed the mSRT twice (one week apart) and the BCTT once. Heart rate (HR) utilizing a Polar HR monitor, self-reported rating of perceived exertion (RPE), and overall symptoms were assessed. Results: The mSRT was feasible in high school students, with 95% of participants (n=57) completing all three testing sessions and no adverse events reported. The mSRT had a moderate level (ICC=0.68) of test-retest reliability. The mean difference between peak heart rates on the mSRT1 and BCTT was -2.62 (95% CI -7.14, 1.91). Median HRpeak (187 bpm), RPEpeak (18), and stage achieved (23) was highest following the BCTT. Fatigue or low energy was the most commonly reported symptom following all three testing sessions. Conclusions: This study found that there were similar responses to BCTT and mSRT in uninjured adolescent male participants. Further research to better understand the reliability and concurrent validity in a more heterogeneous sample, including female participants and participants following concussion, is warranted.
Open Access
Heads Above the Rest: Examining Head impacts in Canadian High School Football
(2021-04-16) Pankow, Mark Patrick; Emery, Carolyn A.; Dennison, Christopher R.; Hagel, Brent E.; Mrazik, Martin
This thesis contains three projects focused on concussion and head impacts in tackle football. First, is a systematic review and meta-analysis. Objective: To examine youth football concussion and head impact rates, modifiable risk factors, and football-specific prevention strategies. Methods: Nine databases were searched. Two authors (with a third to resolve disagreements) completed study screening and assessment of bias. Results: Concussion rates for high school (ages 13-19) and minor football (ages 5-15) were 0.78/1000 athlete exposures and 1.15/1000 athlete exposures. Of prevention strategies, contact training and contact restrictions had the strongest evidence supporting their effectiveness. Conclusions: The high rates of concussion and head impacts affirm the need for prevention strategies in youth football. The second manuscript investigated head impact rates in Canadian high school football. Objective: To describe head impact rates in Canadian high school football. Methods: Games (n=14) involving two teams were recorded during the 2019 season and analyzed to identify head impacts. Results: The offense experienced head impacts at a higher rate than the kicking and receiving units, but not the defense. Conclusion: To help reduce the head impact rates in this cohort, contact training emphasizing the removal of the head from contact may be beneficial. The third manuscript evaluated a score-based running time rule. Objective: To describe the effect of the score-based running time rule on the rates of head impacts in Canadian high school football. Methods: Video analysis was used to identify head impacts in games (n=14) involving two teams that were followed during the 2019 football season. Results: The rates of head impacts in games where running time came into effect were lower for the offense and defense, but not special team units (kicking team and receiving team). Conclusions: The score-based running time rule was associated with lower head impact rates for two of four team units.
Open Access
Helmet Use Among Skiers and Snowboarders in Southern Alberta
(2019-11) Pfister, Ken; Hagel, Brent Edward; Nettel-Aguirre, Alberto; Emery, Carolyn A.
Skiing and snowboarding are among the most popular winter activities in Canada. Unfortunately, many injuries occur in these activities, including severe injuries often involving the head, which can result in death. These injuries, particularly severe head or brain injuries, are an important burden on the health care system, and may be prevented by encouraging helmet use. Helmet effectiveness is well established, but there are little recent data on ski and snowboard helmet prevalence at ski areas in southern Alberta, with no published reports on correct helmet fit. This study determined the prevalence of helmet use and correct helmet use at a single ski area in Southern Alberta and examined the factors associated with helmet use and correct fit. Information on helmet use and correct use, as well as environmental and behavioural characteristics was collected at the base of the ski hill by both interviewing and observing participants. Age (<18 years old), skiing/snowboarding with companions, and skiing/snowboarding with companions also wearing helmets increased the likelihood of each wearing a helmet and wearing a helmet correctly. The protective effect of helmets in skiers and snowboarders has been demonstrated convincingly. The education and promotion of helmet use and correct helmet use is paramount in reducing the risk of head injuries among skiers and snowboarders. Our findings will inform participants, parents, members of the ski-snowboard industry, and the stakeholders that seek to influence them to improve the safety of skiers and snowboarders of all ages.
Open Access
Human risk factors in avalanche incidents
(2008) Sole, Albert Edgar; Emery, Carolyn A.
Objective: To describe the population of skiers, climbers, snowshoers and snowboarders at risk of avalanche morbidity or mortality in Western Canada, and to determine the risk factors for experiencing an avalanche incident that might lead to morbidity or mortality. Design: A retrospective, cross-sectional intercept survey. Participants: The participants were people shopping at the Mountain Equipment Coop. Main Outcome Measures: A description of the population at risk by age, sex, exposure, training, sport type, motivation, sensation seeking, attitude and socio-economic status. Mortality and incident rates were calculated by age and sport type. Odds ratios for risk of experiencing an avalanche are estimated using logistic regression for the following covariates: 1. Age. 2. Gender. 3. Sport type. 4. Training. 5. Motivation. 6. Sensations seeking. 7. Attitude. 8. Exposure. A theoretical model for the psychology of risk taking in avalanche terrain was developed. Results: The population at risk has an above average socio-economic status and age distribution similar to the general population. Seventy five percent are male, but the female population appears to be well integrated with the male portion. Age, gender, sport type, some motivations, sensation seeking, and attitude were found to be associated with the risk of experiencing an avalanche incident. Level of training, and socio-economic status, were not found to be a risk factors for avalanche incidents. Conclusions: The risk of experiencing an avalanche incident was found to be independent of the physical risk factors associated with the phenomenon itself. Attitude was found to have the strongest association with risk of experiencing an avalanche incident.
Open Access
Incidence, Risk Factors, and Mechanisms of Concussion and Musculoskeletal Injury in Youth Soccer Players
(2019-01-18) Codd, Chevonne; Schneider, Kathryn J.; Emery, Carolyn A.; Yeates, Keith Owen; Palacios-Derflingher, Luz Maria; Reed, Nickolas
Objective: Assessment of incidence, risk factors, and mechanisms of concussion and musculoskeletal (MSK) injuries in youth soccer players over one outdoor season of play. Methods: Prospective cohort study conducted. Participants completed a pre-season baseline questionnaire (demographic and injury history questions). A team safety advocate collected exposure and injury data. Results: A sample of 361 players (10-18 years) participated. Most injuries were reported in games (37 MSK, 24 concussions). MSK and concussions occurred at a rate (/1000player hours) of 5.47 (95%CI:2.99-9.18) and 3.12 (95%CI:0.13-6.16), respectively in males and 5.26 (95%CI: 3.33-7.89) and 3.66 (95%CI: 2.09-5.94), respectively in females. In a univariate model, female sex [IRRmsk=1.18(95% CI:1.02-1.36), IRRconc=1.18(95%CI:1.02-1.36)], previous concussion [IRRconc=1.07(95%CI:1.01-1.15)], higher level of play [IRR: 1.02(Tier II) to 0.63(Tier IV), reference Tier I] and older age group [IRR:1.48(U13) to 1.72(U14), reference U12] were risk factors for MSK injury and/or concussion. Conclusions: Injuries and concussions are common in youth soccer players.
Open Access
Inflammatory Profiling in Early Osteoarthritis
(2018-09-20) Ren, Guomin; Krawetz, Roman J.; Emery, Carolyn A.; De Koning, A. P. Jason
Osteoarthritis (OA) is one of the most common chronic diseases worldwide which can lead to disability. There is a desperate need for the efficient and reliable detection of OA at the early stage when patients are likely to benefit most from disease interventions. It has been shown in previous studies that inflammation plays important roles in cartilage degeneration, synovitis, remodeling of the subchondral bone and pain. The purpose of this thesis was to determine if a panel of inflammatory cytokines were distinct within individuals with pre-radiographic OA and/or an increased risk of developing OA. Serum inflammatory profiles were analyzed within a number of patient cohorts [i.e., radiographic OA patients (hip and knee), youth with a history of intra-articular knee injury, corresponding controls]; and it was found that inflammatory profiles were distinct between knee vs. hip OA patients. Additionally, a computation method was developed which identified a coordinated change in cytokine profiles in the youth knee injury cohort. This computational methodology highlighted a number of candidate biomarkers that contributed to this observed difference, including C-C motif chemokine 22 (CCL22)/macrophage derived chemokine (MDC) which was selected for further study. In a pre-clinical rat OA model, it was found that CCL22 plays a functional role in chondrocyte apoptosis and cartilage degeneration. Further, it was found that CCL22 treated synovial fibroblasts demonstrated altered expression of inflammatory factors. These results suggested that CCL22 may be a biomarker and potential drug target in early OA. These results also suggested that CCL22 may be associated with OA pain, yet this was not examined directly and an in vivo model where CCL22 expression could be regulated would be required to test this hypothesis. While it was observed that CCL22 is expressed in damaged cartilage and acts on human chondrocytes and synovial fibroblasts, additional studies are required to determine how CCL22 triggered these changes in synovial fibroblasts as these results suggest this is CCR4 independent. Furthermore, it would be essential to validate these findings in an independent cohort to examine the sensitivity and/or specificity of CCL22 as an early OA biomarker.
Open Access
Inflammatory Profiling in Early Osteoarthritis
(2018-09-20) Ren, Guomin; Krawetz, Roman J.; Emery, Carolyn A.; De Koning, A. P. Jason
Osteoarthritis (OA) is one of the most common chronic diseases worldwide which can lead to disability. There is a desperate need for the efficient and reliable detection of OA at the early stage when patients are likely to benefit most from disease interventions. It has been shown in previous studies that inflammation plays important roles in cartilage degeneration, synovitis, remodeling of the subchondral bone and pain. The purpose of this thesis was to determine if a panel of inflammatory cytokines were distinct within individuals with pre-radiographic OA and/or an increased risk of developing OA. Serum inflammatory profiles were analyzed within a number of patient cohorts [i.e., radiographic OA patients (hip and knee), youth with a history of intra-articular knee injury, corresponding controls]; and it was found that inflammatory profiles were distinct between knee vs. hip OA patients. Additionally, a computation method was developed which identified a coordinated change in cytokine profiles in the youth knee injury cohort. This computational methodology highlighted a number of candidate biomarkers that contributed to this observed difference, including C-C motif chemokine 22 (CCL22)/macrophage derived chemokine (MDC) which was selected for further study. In a pre-clinical rat OA model, it was found that CCL22 plays a functional role in chondrocyte apoptosis and cartilage degeneration. Further, it was found that CCL22 treated synovial fibroblasts demonstrated altered expression of inflammatory factors. These results suggested that CCL22 may be a biomarker and potential drug target in early OA. These results also suggested that CCL22 may be associated with OA pain, yet this was not examined directly and an in vivo model where CCL22 expression could be regulated would be required to test this hypothesis. While it was observed that CCL22 is expressed in damaged cartilage and acts on human chondrocytes and synovial fibroblasts, additional studies are required to determine how CCL22 triggered these changes in synovial fibroblasts as these results suggest this is CCR4 independent. Furthermore, it would be essential to validate these findings in an independent cohort to examine the sensitivity and/or specificity of CCL22 as an early OA biomarker.
Open Access
Injuries in Canadian female high school rugby and coach perceptions of injury prevention: Informing an injury prevention implementation strategy
(2021-01-06) Shill, Isla Jordan; Emery, Carolyn A.; Hagel, Brent Edward; Black, Amanda M.; Pasanen, Kati
This MSc thesis contains two projects focused on Canadian high school rugby. The first project is an evaluation of the epidemiology of female high school rugby in a Canadian context. Objective: To describe injury rates in female high school rugby and evaluate the association between baseline risk factors and injury outcomes. Methods: Injury surveillance was completed during a two-year prospective cohort study in the Calgary female high school rugby league. Results: Injury and concussion incidence rates were 93.7 injuries/ 1000 match-hours and 37.5 concussions/ 1000 match-hours, respectively. Injury within the past twelve months was associated with higher match injury rates. Higher team playing division was associated with higher training injury rates. The second project is an evaluation of the Canadian high school rugby coaching context. Objective: To describe the Canadian high school rugby coach context and evaluate intention to use a rugby-specific neuromuscular training warm-up. Methods: High school rugby coaches participated in a 2-hour “Train-the-Coach” neuromuscular training warm-up workshop. Pre- and post-workshop questionnaires were administered. Results: Pre-workshop, 92% of coaches agreed or strongly agreed they would ‘complete a rugby-specific warm-up program prior to every game and training session this season’. Post-workshop, 85% of coaches partly or strongly agreed that they “would conduct the SHRed Injuries program in every session with their students/athletes/client”. Conclusions: Injury and concussion rates in Canadian female high school rugby are high and intention to use a rugby-specific neuromuscular training warm-up was high before and after the workshop.
Embargo
Injury Setting and Social Support as Moderators of the Effects of Pediatric Concussion on Post-Concussive Symptoms
(2020-09-16) Chadwick, Leah; Yeates, Keith Owen; Emery, Carolyn A.; Brooks, Brian L.; Madigan, Sheri L.
Concussions are a pressing public health concern. Concussions often result in physical, cognitive, and emotional problems, known as post-concussive symptoms (PCS). Although most children recover from concussions without complication, a subset are hindered by persistent PCS that reduce their quality of life. Previous research tends to differentiate between sport-and-recreation-related and non-sport-related concussions because there may be differences between these settings that affect concussion outcomes. Social support, the perceived or actual support a person receives from their community and social networks, is known to protect against detrimental consequences of health problems. However, little research has examined the effect of social support on PCS after concussion. Social support may foster recovery, particularly for children with sport-related concussions, who are often isolated from their teams during recovery, resulting in feelings of loneliness and isolation. This study aimed to identify the effects of social support on PCS in children after sport-related versus non-sport-related concussion. Participants were children/adolescents aged 8-16 years with either concussion or orthopedic injury who were recruited during Emergency Department visits at five sites across Canada. Injury information was collected in the Emergency Department, social support was measured at 10 days, and PCS were measured at 10 days, 3 months, and 6 months post-injury. Linear multi-level modelling analysis was used to examine injury group (concussion versus orthopedic injury), injury setting (sport-related versus non-sport-related), and social support as predictors of PCS over time. The analyses found that social support predicted lower ratings of cognitive PCS, but regardless of the type of injury. However, injury setting did have a specific moderating effect on recovery from concussion, such that concussions in non-sport-related settings were associated with higher cognitive PCS relative to orthopedic injuries and concussions occurring in sport-related settings. We did not find any significant effects of social support or injury setting on somatic PCS, which suggests that trajectories of somatic and cognitive PCS after concussion may be associated with different risk factors.
Open Access
Lower Extremity Muscle Activation Following a Previous Knee Injury: Implications for Post-Traumatic Knee Osteoarthritis
(2018-12-05) Mohr, Maurice; Nigg, Benno Maurus; Emery, Carolyn A.; Von Tscharner, Vinzenz; Herzog, Walter
Individuals who sustain an intra-articular knee injury are at a high risk of developing post-traumatic knee osteoarthritis (PTOA) 10-20 years later. Compensatory activation patterns of knee muscles in response to the trauma may persist past the acute injury phase and result in abnormal mechanical loading and subsequent osteoarthritis of the knee. This dissertation aimed to use surface electromyography (sEMG) to explore abnormal leg muscle activation patterns and their possible involvement in PTOA development in individuals who suffered a previous knee injury 3-12 years ago. The first part of this thesis presents methodological investigations related to two sEMG-based assessments of knee muscle activation strategies. It was shown that 1) sEMG amplitude-based co-contraction indices during gait exhibit poor between-day reliability and 2) the magnitude of intermuscular coherence strongly depends on the configuration and alignment of the sEMG electrodes. Building on the methodological findings, the second part of this thesis investigated the association between a previous knee injury and leg muscle activation during walking and squatting while considering the influence of sex. Sex-specific abnormalities in quadricep and hamstring muscle activation patterns were present for the affected leg in individuals more than three years after a previous knee injury. Altered quadricep and hamstring muscle activation may result in abnormal movement and loading of the knee joint and thus be linked to mechanical risk factors for PTOA development. This dissertation could not provide evidence, however, that altered thigh muscle activation was associated with more self-reported knee pain or symptoms indicative of PTOA development. From a methodological perspective, the poor reliability of current sEMG-based markers for abnormal muscle activation may lower the sensitivity to detect associations with risk factors for PTOA. From a conceptual perspective, the development of PTOA is not solely based on joint mechanics but depends on the interplay between mechanical, biological, and structural abnormalities of the joint following a knee injury. Therefore, the pathway to PTOA is likely unique to each individual such that a consistent association between abnormal muscle activation following a knee injury and PTOA risk may not exist.
Open Access
Motivation and Social Factors Associated with Exercise Fidelity in a Basketball Neuromuscular Training Prevention Warm-up in Youth
(2019-09-18) Befus, Kimberley Darlene; Emery, Carolyn A.; McDonough, Meghan H.; Pasanen, Kati; Kenny, Sarah J.; McCormack, Gavin R.
Objective: To establish the reliability of an observational tool for the evaluation of exercise fidelity and to understand the influence of motivational and social factors, in the basketball context, on exercise fidelity to the SHRed Injuries Basketball Neuromuscular warm-up program in youth. Methods: First, an inter-rater reliability study for the evaluation of exercise fidelity by an expert and non-expert rater which consisting of two rounds of training, practice and exercise fidelity evaluation using video clips. Percent agreement and Bland Altman agreement were used to evaluate the reliability of ratings between an expert and non-expert rater. Second, a prospective cohort study in which 66 high school basketball players, participating in the 2018-2019 school basketball season, completed questionnaires which addressed the constructs of perceived autonomy support, quality of change-oriented feedback, motivation and perceived competence, in the basketball context. Approximately one-week later players were filmed completing the warm-up as part of their normal routine. Exercise fidelity was evaluated by the non-expert rater using the video clips. Conditional process analysis was used to analyse the purposed models. Results: An acceptable level of reliability was reached for the evaluation of exercise fidelity. Autonomy support was a direct negative predictor and an indirect positive predictor, via autonomous motivation, of exercise fidelity. Autonomous motivation was a positive predictor of exercise fidelity. Self-determined motivation and quality of change-oriented feedback were not found to be significant predictors of exercise fidelity. Conclusions: Autonomy support and autonomous motivation may play a role in player adherence to an injury prevention warm-up program.