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1.  Efficacy of Rugby Headgear in Attenuating Repetitive Linear Impact Forces 
Journal of Athletic Training  2003;38(4):330-335.
Objective:
To determine the effectiveness of rugby headgear and the effect of impact site and headgear type on attenuating repetitive linear impact forces.
Design and Setting:
We obtained 10 headgear of 2 different types (n = 20) from 2 popular manufacturers: type I was Honeycomb headgear and type II was Vanguard headgear. Both headgear types were approved by the International Rugby Board. Headgear were tested according to National Operating Committee on Standards for Athletic Equipment protocols with one modification. The headgear were dropped from a height of 30 cm according to the International Rugby Board standards. Headgear were tested at a National Athletic Equipment Reconditioners Association facility.
Measurements:
We recorded peak acceleration of gravity (g) and Gadd Severity Index readings for each impact. The design of the study was 4 one-way, within-subjects, repeated-measures analyses of variance with alpha = .05. Descriptive statistics were calculated for all categoric variables.
Results:
Peak g and Gadd Severity Index increased with repetitive impacts, resulting in a headgear's decreased ability to attenuate linear impact forces. Attenuation differed significantly between headgear type I and type II at both impact sites and between the parietal-lateral and occipital impact sites for both headgear types.
Conclusions:
The headgear initially attenuated impact forces from a drop height of 30 cm. However, over 10 drops, both headgear decreased in their ability to attenuate repetitive linear impact forces. Decreased attenuation in the occipital region as well as significant differences in attenuation abilities between headgear types support the need for further investigation to examine the efficacy of rugby headgear.
PMCID: PMC314393  PMID: 14737216
concussion; protective equipment; Gadd Severity Index; peak g
2.  Lacrosse Helmet Designs and the Effects of Impact Forces 
Journal of Athletic Training  2002;37(2):164-171.
Objective: To examine the effects of repetitive impact forces on lacrosse helmets and increase awareness of helmet safety standards about reconditioning and recertification practices.
Design and Setting: The independent variables for this study consisted of 4 lacrosse helmets of various design: 2 contemporary helmets (Sport Helmets Cascade and Cascade Air) and 2 traditional helmets (Sport Helmets Ultralite and Bacharach Ultralite). The dependent variable was attenuation of impact forces as measured by the Gadd Severity Index (GSI). Helmets were tested at an independent testing facility certified by the National Athletic Equipment Reconditioners Association.
Measurements: Helmets were raised to 152 cm and released onto an anvil padded with a 1.27-cm rubber modular elastomer programmer. Ten treatments to a front (FD) and right rear boss drop site (RD) were performed. A triaxial accelerometer within the head form measured impact force. Peak acceleration data were integrated into the GSI. We performed a 1-way analysis of variance and calculated descriptive statistics and the Tukey post hoc test.
Results: A statistically significant difference was seen in FD GSI score (F3,36 = 9.680, P < .05) and in the RD GSI score (F3,36 = 28.140, P < .05) between helmet types. Mean GSI scores were 1166.1, 1117.6, 857, and 1222.8 for the FD and 974.5, 1022.1, 1376.3, and 1496.5 for the RD for Sport Helmets Cascade, Cascade Air, Ultralite, and Bacharach Ultralite, respectively. With repetitive drops, GSI scores increased, indicating a greater chance for cerebral injury. Percentage increases in GSI scores from drops 1 to 10 were 48.8, 54.3, 45.6, and 18.8 on the FD and 22.6, 35.9, 71.7, and 57.4 on the RD for the Sport Helmets Cascade, Cascade Air, Ultralite, and Bacharach Ultralite, respectively.
Conclusions: Our findings indicate differences between helmets at the 2 drop sites and decreasing capacity of the helmets to dissipate forces with repetitive impacts.
PMCID: PMC164340  PMID: 12937430
Gadd Severity Index; National Operating Committee on Standards for Athletic Equipment; head injury
3.  The Effects of Low-Dose Creatine Supplementation Versus Creatine Loading in Collegiate Football Players 
Journal of Athletic Training  2001;36(2):124-129.
Objective:
To compare the effects of low doses of creatine and creatine loading on strength, urinary creatinine concentration, and percentage of body fat.
Design and Setting:
Division IA collegiate football players took creatine monohydrate for 10 weeks during a sport-specific, periodized, off-season strength and conditioning program. One-repetition maximum (1-RM) squat, urinary creatinine concentrations, and percentage of body fat were analyzed.
Subjects:
Twenty-five highly trained, Division IA collegiate football players with at least 1 year of college playing experience.
Measurements:
We tested strength with a 1-RM squat exercise before, during, and after creatine supplementation. Percentage of body fat was measured by hydrostatic weighing before and after supplementation. Urinary creatinine concentration was measured via light spectrophotometer at 0, 1, 3, 7, 14, 21, 28, 35, 42, 48, 56, and 63 days. An analysis of variance with repeated measures was computed to compare means for all variables.
Results:
Creatine supplementation had no significant group, time, or interaction effects on strength, urinary creatinine concentration, or percentage of body fat. However, significant time effects were found for 1-RM squat and fat-free mass in all groups.
Conclusions:
Our data suggest that creatine monohydrate in any amount does not have any beneficial ergogenic effects in highly trained collegiate football players. However, a proper resistance training stimulus for 10 weeks can increase strength and fat-free mass in highly trained athletes.
PMCID: PMC155521  PMID: 12937451
creatine phosphate; ergogenic aids; resistance training
4.  Functional Thumb Taping Procedure 
Journal of Athletic Training  1994;29(4):357-359.
Images
PMCID: PMC1317813  PMID: 16558301
5.  Aneurysmal Bone Cyst in a Female Collegiate Field Hockey Player: A Case Report 
Journal of Athletic Training  2000;35(1):86-90.
Objective:
To present the case of an intercollegiate field hockey player with an aneurysmal bone cyst of the femur and the clinical decision making necessary in the evaluation, management, surgical intervention, and positive outcome of this athlete.
Background:
A 21-year-old field hockey player presented with signs and symptoms typical of a deep thigh contusion. She had no history of direct or indirect trauma, infection, or previous injury.
Differential Diagnosis:
Aneurysm, bone cyst, chondroma, giant cell tumor, osteochondroma, osteosarcoma, osteoid osteoma.
Treatment:
When her symptoms persisted beyond 6 months despite conservative care, she underwent radiographs, magnetic resonance imaging, and bone scan, which revealed a lesion in the right femur. At surgery, the lesion was diagnosed as an aneurysmal bone cyst, and it was excised by an incisional x-ray-guided biopsy followed by curettage and bone grafting.
Uniqueness:
The aneurysmal bone cyst presented as a typical thigh strain or deep contusion during the athlete's training and conditioning season. After all forms of conservative management proved ineffective, the athlete was referred to her physician. A detailed history and physical examination demonstrated no underlying musculoskeletal pathology coinciding with the athlete's symptoms.
Conclusions:
Increased clinical awareness is necessary when conservative management fails to resolve an athletic injury in an appropriate length of time. Proper diagnostic tools are essential in determining the pathology of the injury and whether surgical intervention is needed.
Images
PMCID: PMC1323445  PMID: 16558615
bone graft; curettage; giant cell tumor; lytic lesion
6.  Atraumatic Osteochondral Fracture and Osteoarthritis in a Collegiate Volleyball Player: A Case Report 
Journal of Athletic Training  2000;35(1):80-85.
Objective:
To present the case of a collegiate athlete with an atraumatic osteochondral fracture influenced by the presence of osteoarthritis.
Background:
Osteochondral fractures are fairly common occurrences in athletes, although it can be difficult to recognize such an injury in the absence of a traumatic event. Osteoarthritis is 1 condition that can increase an athlete's susceptibility to an atraumatic osteochondral fracture. However, because of the atraumatic nature of the injury, the possibility of an osteochondral fracture may be overlooked.
Differential Diagnosis:
Meniscal damage, osteochondritis dissecans, patellofemoral disorders.
Treatment:
The osteochondral fragment was surgically removed, and fibrous growth was encouraged by drilling and laser smoothing.
Uniqueness:
Osteochondral fractures are usually associated with some type of traumatic mechanism, such as a rotational and compressive force. Also, osteoarthritis is not common in young collegiate athletes. However, this 20-year-old volleyball player had no apparent injury and lacked the usual signs and symptoms (eg, locking, giving way, crepitus, loss of range of motion) associated with an osteochondral fracture. The athlete's susceptibility to an osteochondral fracture was increased by the presence of osteoarthritis.
Conclusions:
The athletic trainer should consider the possibility of an osteochondral fracture in an athlete with persistent effusion and pain in the absence of a traumatic mechanism of injury.
Images
PMCID: PMC1323444  PMID: 16558614
osteochondritis dissecans; knee injury

Results 1-6 (6)