Athletic Training

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Research

Research Equipment and Facilities : Athletic Training Research Agenda : Faculty Research Interests : Current Student and Faculty Research Projects : Research Links

Research Equipment and Facilities

The Athletic Training Program seeks to foster the value of scholarly activity and to develop students' leadership skills in the research aspects of Athletic Training. The multidisciplinary setting at Arizona School of Health Sciences, which includes physical therapy, occupational therapy, physician assistant studies, medical informatics, and audiology, promotes cross-disciplinary scholarship and provides students with exposure to a variety of different research programs.

The Mesa Campus of A.T. Still University houses two Interdisciplinary Research Laboratories, the Interdisciplinary Neuromuscular Research Laboratory and the Interdisciplinary Metabolic Research Laboratory, both with an expanded offering of research equipment and opportunities.

The Neuromuscular Research Laboratory is located in a 3000 square-foot facility and includes an in-floor Kistler 9286 AA Slimline Force Plate, a portable multi-component force plate for measuring ground reaction forces and moments acting in any direction, a Vicon Motion Analysis System with Motion Monitor Software to capture kinematic data, two surface EMG units, the Noraxon Myosystem 1200 8-channel and Myosystem 1400 8-channel surface EMG, for assessment of neuromuscular performance characteristics, a NeuroCom Smart Balance Master with a long forceplate and the Dynavision system, for measuring postural stability and vestibular function, and a Cybex 330 Isokinetic Dynamometer with the HUMAC/Windows/CYBEX 300 upgrade, for the measurement of muscle strength and power. The lab also houses portable equipment including a LigMaster computerized stress device, available for assessment of ankle, knee, elbow, and glenohumeral joint force-displacement characteristics, DataPac 2K2 data acquisition software, electrogoniometers, accelerometers, a custom made shoulder stiffness device, and a GaitRite gait analysis system.

The Metabolic Research Laboratory is housed in a 1600 square foot facility and includes a Parvo metabolic system with ECG, CosMed portable metabolic system, treadmill, Lode electronically braked adult and pediatric cycle ergometers, Monark cycle ergometer, blood draw chair, and YSI Glucose/Lactate analyzer system.

ATSU's Mesa Campus Learning Resource Center (LRC) supports the teaching and eventual practice of students and the teaching and research of its faculty. The LRC takes advantage of electronically based information resources that have developed since the emergence of the Internet a decade ago to facilitate and support access and use evidence in support of all instruction, research, and services at the University. The LRC’s collections are a blending of print and electronic resources to bring information access into the curriculum and clinical rotations of the students.

Access to and use of the LRC’s electronic resources is facilitated through its website (on the ATSU Intranet) and its online portal (http://atsu.azhin.org). The we site provides access to the LRC’s print holding, information on services provided and copies of LRC service request forms. The portal provides access to, and facilitates use of, more than 1,000 clinically oriented electronic, full text journals, more than120 full text medical textbooks, and an array of web-based, health information-based vendors. Via the LRC’s membership in the National Network of Medical Libraries’ Docline interlibrary loan system and OCLC’s interlibrary loan system, it can rapidly borrow books and articles from more than 20,000 libraries worldwide. More than 75 percent of the articles obtained from other libraries are received digitally within three days.


Figure 1: Force Platform Walkway System.

Figure 2: Measurement of neuromuscular responses during landing.

Figure 3: Cybex Isokinetic Dynamometer	Figure 4: Balance assessment on the Teton Tremor Box.

Figure 5: Lower Extremity Perturbation Device	Figure 7: LigMaster computerized stress device for assessment of glenohumeral joint laxity and stiffness.

Figure 8: LigMaster computerized stress device for assessment of valgus elbow laxity and stiffness.	Figure 9: Use of a modified digital inclinometer to objectively assess scapular upward rotation.

ASHS Athletic Training Research Agenda

The Athletic Training Program has adopted a research agenda focused on outcomes research to enable evidence-based athletic training practice. As a framework for conducting patient-oriented outcomes research, the Athletic Training Program has adopted the National Center for Medical Rehabilitation Research (NCMRR) disablement model. The NCMRR has proposed the use of a disablement model as an organizing framework for supporting its research efforts. The core disablement concepts of “impairments, functional limitations, and disabilities” have become generally accepted. The NCMRR Model includes the elements of “pathophysiology, impairment, functional limitation, disability, and social limitation.” This framework is also intended to encourage and promote interdisciplinary research efforts.

Usage of this model as a philosophical guide for research also opens the door to alternate funding sources, especially at the federal level. Multiple agencies, including the National Center for Medical Rehabilitation Research, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Aging, Department of Rehabilitation Medicine, National Institute on Disability and Rehabilitation Research, and the National Council on Disability support this line of investigation.

Additionally, because this model looks at all aspects of "disablement," which could range from simple disease to long-term disability, it therefore also considers the interaction of the individual and their environment when placed within a disabled state. Thus, it is very much in keeping with ATSU's theme of "Defining Whole Person Healthcare." In fact, this model very much reflects the results of any pathophysiological condition upon the "whole person" as well as their interactions with society. From this point of view, it is a very public health oriented model as well.

NCMRR Disablement Model
Patho- physiology	Impairment	Functional Limitation	Disability	Societal Limitation
Interruption of or interference with normal physiological and develop- mental processes or structures.	Loss and/or abnormality of cognitive, emotional, physiological, or anatomical structure or function, including all losses or abnorm- alities, not just those attributable to the initial patho-physiology.	Restriction or lack of ability to perform an action in the manner or within a range consistent with the purpose of an organ or organ system.	Inability or limitation in performing tasks, activities, and roles to levels expected within physical and social contexts.	Restriction, attributable to social policy of barriers (structural or attitudinal), which limits fulfillment of roles or denies access to services and opportunities that are associated with full participation in society.

ATSU Athletic Training Program Research
Patho- physiology	Impairment	Functional Limitation	Disability	Societal Limitation
Shoulder injury Mild head injury	Mild head injury Shoulder injury Neuro- muscular control	Mild head injury Shoulder injury Neuro- muscular control	Health-related quality of life Mild head injury Shoulder injury Pediatric sports medicine	Health-related quality of life Mild head injury Pediatric sports medicine
Figure 10. Athletic training faculty research interests fit the NCMRR disablement model.

Faculty Research Interests

Dr. Parsons' research includes two distinct lines. The first, and primary, line of research focuses on the organizational, administrative, and professional responsibility domains of athletic training practice. Research in this line includes questions about athletic training education, health policy and regulatory issues, information technology, and medicolegal considerations on the athletic training profession and clinical practice. Dr. Parsons’ preferred methodological approach to these questions includes a mixture of both quantitative and qualitative methods, with a preference toward narrative, and content and text analytic methods. The second area pursues the topics of disablement, outcomes assessment, and health-related quality of life (HRQOL) in athletic training practice. This research explores how concepts of disability and HRQOL apply to patients with sports related injuries and illnesses, and seeks to establish the subjective experience of patients suffering from those conditions.

Dr. Valovich McLeod’s ongoing line of research revolves around sports medicine concerns of the pediatric athlete, with special emphasis on sport-related concussion. Dr. McLeod completed her dissertation on the use of clinical assessment tools for concussion in youth sports athletes. She has also looked at factors affecting the use of clinical concussion assessments such as practice effects and exertion and sat on the NATA Pronouncements Committee on the Management of Sports Related Concussions. Her current work is investigating the short- and long-term effects of pediatric sports concussion as well as recovery following concussion on traditional concussion measures and health-related quality of life. Dr. McLeod also has research interests regarding gender differences in lower extremity function, specifically neuromuscular control and postural stability. She also has interest in an injury prevention approach with younger athletes through neuromuscular and balance training.

Dr. Snyder Valier’s research focuses on clinical outcomes assessment, with an emphasis on the evaluation of health-related quality of life. (HRQOL). Her primary area of interest is in measuring the outcomes of various athletic training interventions as well as evaluating HRQOL of high school and college athletes who suffer sport-related injury. She has investigated HRQOL in adolescent athletes in both the secondary school setting as well as in outpatient orthopaedic clinics. Dr. Valier is also interested in the use and development of patient-based outcomes instruments for the purpose of outcomes assessment and measuring the end result of healthcare services. Her interests also include the measurement properties and interpretation of patient-rated outcome measures, with special attention towards meaningful change values (eg, minimal clinically important difference and minimal detectible change) In addition to her emphasis in clinical outcomes assessment, Dr. Valier has an interest in muscle physiology, specifically as it relates to stretching. She has examined the biomechanics and muscle activity of static and ballistic stretching techniques as well as compared the impact of static stretching and massage on hip flexion range of motion.

Mr. Anderson’s primary research interests are focused on assessment of fundamental movement patterns and application of corrective exercise in orthopaedic rehabilitation. He has expertise in use of the Functional Movement Screen (FMS) and Selective Functional Movement Assessment (SFMA) and is currently involved in research looking at various measurement properties of the FMS. In addition, he also has interests in clinically oriented topics including manual therapy techniques, post-surgical rehabilitation, and ACL reconstruction rehabilitation outcomes. Mr. Anderson is also actively engaged in the continued development and maintenance of the CORE-AT Electronic Medical Record and has interests in its application in clinical education.

Dr. Kellie Huxel Bliven’s research focuses on upper extremity function as it relates to injury prevention and rehabilitation. Dr. Bliven completed her dissertation on dynamic joint stability, specifically stiffness regulation and muscle activation strategies of the shoulder. She has also looked at joint stability factors of gender, joint position, and pathology. Her other areas of upper extremity research focus on adaptations and injury prevention in the overhead athlete, muscle activation patterns during rehabilitation exercises, and clinical outcomes in overhead athletes.

Dr. Bay teaches courses in research methodology and statistical analysis. His current areas of interest concern the relationship between patients’ illness epistemology and their subjective and objective responses to therapeutic interventions, as well as the application of structural equation modeling to medical research.

Dr. Lam’s line of research revolves around the prevention and rehabilitation of lower extremity injuries, with a special emphasis on sport-related knee injuries in the adolescent population. He is specifically interested in assessing the clinical outcomes of anterior cruciate ligament (ACL) injuries as it relates to the health-related quality of life of the patient and the comparative effectiveness of rehabilitation techniques. Through his research, Dr. Lam hopes to gain a better understanding of the immediate and long-term impact of ACL injuries and help improve patient care following injury. Furthermore, Dr. Lam is interested in identifying potential risk factors related to knee injuries, including jump-landing mechanics and postural stability, and investigating the effectiveness of prevention programs.

Dr. Sauers' primary research interests are related to examination and rehabilitation of the athletic shoulder with specific interests in shoulder outcomes assessment, the effectiveness of interventions for treating shoulder impairment, and shoulder mobility assessment. Dr. Sauers is also interested in the study of shoulder kinematics with research aimed at quantifying normal and pathologic laxity and stiffness of the glenohumeral joint and evaluating the relationship between micro-instability, scapular dyskinesis, and posterior capsular tightness in the overhead-throwing athlete. Dr. Sauers is also interested in studying issues related to athletic training education in the context of health professions education and issues related to post-professional education, including specialty certification and residency education in healthcare.

Current Student and Faculty Research Projects

Neuromuscular Control

An evaluation of balance and landing characteristics in college and high school athletes
The relationship between balance and landing screening and health-related quality of life in college athletes
The impact of sport-related injury of the ankle and knee on health-related quality of life

Shoulder Injury

Quantification of glenohumeral joint laxity and stiffness in patients with documented shoulder instability
Acute and chronic adaptations in the throwing shoulder of professional baseball pitchers
Chronic adaptations in the throwing shoulder of professional baseball players
Clinical Measures of Shoulder Motion in Professional Baseball Players: A Comparison of the Dominant and Non-Dominant Shoulders in Pitchers and Position Players
The effects of a seven-month season on selected clinical measures of shoulder mobility in the professional baseball player
Reliability of a Classification Protocol for the Assessment of Scapular Motion in Patients with Shoulder Pathology
The value of selected clinical measures of shoulder mobility for predicting shoulder pathology in the professional baseball player: A prospective study
Range of motion effects of a three week PNF hold-relax facilitory protocol on glenohumeral internal rotation
A comparison of glenohumeral joint laxity and stiffness in the throwing and non-throwing shoulders of high school baseball pitchers
A comparison of ulnar collateral ligament laxity and stiffness in the throwing and non-throwing shoulders of high school baseball pitchers
Qualitative assessment and comparison of scapular kinematics between aquatic athletes with moderate and severe shoulder impingement
A comparison of three-dimensional scapular kinematics in the throwing and non-throwing shoulders of professional baseball pitchers
Impairment, functional loss, and disability in professional baseball players with shoulder and elbow pathology
The relationship between pitch count and pitch frequency and shoulder and elbow injuries in female youth softball players

Sport-Related Concussion

A survey of health professions management practices regarding sport-related concussion.
Attitudes, beliefs and knowledge regarding academic accommodations following sport-related concussion.
The effect of concussion on measures of symptoms, cognition, balance, and health-related quality of life.
A systematic review of health-related quality of life following pediatric traumatic brain injury.
The effect of co-morbid factors on symptom reports at baseline and following sport-related concussion.

Pediatric Sports Medicine

Injury surveillance in youth football

Other Areas

Assessment of valgus laxity and stiffness at the elbow using computerized stress arthrometry in collegiate athletes
A survey of the current educational environments of athletic training education programs: Academic vs. health professions models
The reliability of the FMS research scoring criteria
A content analysis of athletic training state practice acts

Research Links

American Academy of Orthopaedic Surgeons - http://www.aaos.org/
American College of Sports Medicine - http://www.acsm.org/
American Journal of Sports Medicine - http://ajs.sagepub.com/
American Orthoapaedic Society for Sports Medicine - http://www.sportsmed.org/
American Shoulder and Elbow Surgeons - http://www.ases-assn.org/
American Sports Medicine Institute - http://www.asmi.org/
Brain Injury Association - www.biausa.org/
Cincinnati Sportsmedicine Research and Education Foundation - http://www.cincinnatisportsmed.com/
Journal of Athletic Training - http://www.journalofathletictraining.org/
NATA-Research and Education Foundation - http://www.natafoundation.org/
National Institutes of Health - http://www.nih.gov/
National Library of Medicine - http://www.nlm.nih.gov/
National Science Foundation - http://www.nsf.gov/
Orthopaedic Research and Education Foundation - http://www.oref.org/
PUB-MED - http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed
The Aircast Foundation - http://www.aircastfoundation.org/
The Shoulder Source - http://www.orthop.washington.edu/uw/tabID__3351/Default.aspx