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Effects of Sex Hormones and the Menstrual Cycle on Knee Joint Laxity in Physically Active Females: A Critically Appraised Topic
No full textClinical Scenario: In recent years, females have exhibited increased physical activity and sport participation than ever before. Recent studies have identified a rising incidence rate of ACL injuries and indicate that the risk of ACL tears is greater in females than males. Knee laxity and physiological variation in women during the menstrual cycle have demonstrated increased ligament laxity, therefore, varying hormone concentrations may contribute to changes in ligamentous mechanical properties. Despite these findings, it remains unclear whether fluctuating sex hormone concentrations directly correlate to measurable changes in knee laxity. Clinical Question: How do fluctuations in sex hormones throughout the menstruation cycle impact knee joint laxity among physically active females? Data Sources: A computerized search of electronic databases was completed. Search terms used to guide the search include sex hormones, knee joint laxity, and physically active females. Study Selection: The literature search yielded 51 total studies of which four adequately met inclusion and exclusion criteria. Selected studies explored the influence of sex hormones on knee laxity in physically active females with regular menstrual cycles and no use of contraceptives. Data Extraction: Observed outcome measures include analyzing hormone and measuring knee laxity throughout the menstrual cycle. Summary Measures: Across the four studies, anterior knee laxity was observed during ovulation (4.71mm ± 0.86). Two of the four studies revealed estradiol peaks during ovulation (187.27 pg/mL ± 27.26), while the remaining 2 studies found highest estradiol concentrations during the luteal phase (176.24 pg/mL ± 79.91). Evidence Appraisal: The Critical Appraisal Skills Program (CASP) and Oxford Center for Evidence Based Medicine (OCEBM) were utilized to appraise the quality of evidence included. Search Results: Databases including PubMed, EBSCO host, Medline, and CINAHL, were systematically searched for relevant studies. Initially, 51 studies were identified, with 12 duplicates removed. Following screening, 14 remained for further eligibility assessment. After thorough evaluation, four studies were selected for this Critically Appraised Topic. Data Synthesis: Two studies utilized a 95% confidence interval to examine changes in knee laxity concerning fluctuations in hormone levels within subjects. Evidence Quality: Reviewed manuscripts exhibit inconsistency in outcome measures and limited significance to enhance patient-centered evidence. Summary of Key Findings: Each study analyzed hormone concentration levels through blood draws and measured knee laxity using the KT-2000 arthrometer. Increased anterior knee laxity was observed during ovulation in two studies. Two of the four studies revealed peak estrogen levels during ovulation, while the remaining two studies found peak estrogen concentrations during the luteal phase. Clinical Bottom Line: Based upon the included studies, there is compelling evidence to suggest that sex hormone fluctuations across the menstruation cycle can impact the magnitude of knee laxity in physically active females
College Student-Athlete Perceptions of Characterizations and Interpersonal Trust in Their Athletic Trainer: A Point-of-Care Research Study
No full textPatient-centered care is essential in athletic training with limited research examining the relationship between patient and clinician. Previous theory has identified constructs of quality athletic trainers (ATs); however, it remains unknown how current athletes perceive these theorized constructs in the ATs providing them medical care. The purpose of this study was to determine the perceptions of characterizations of a quality athletic trainer and interpersonal trust between the student-athlete and AT in the collegiate setting and establish reliability of these surveys. A second aim was to explore differences between sex, previous exposure to an AT, and having had access to an AT in high school. Prior to the academic year, 393 Division-I student-athletes completed a survey consisting of a Likert-rating of characterization constructs (care, communication, commitment, integrity, knowledge) of a quality AT and the Trust in Athletic Trainer Scale, a modified version of the 11-item Trust in Physician Scale. High internal consistency was established for the construct survey (Cronbach a = 0.97) and the Trust in AT Scale (Cronbach a = 0.91). Student-athletes strongly perceived their ATs possess each of the 5 constructs, as well as strongly trusting their AT (48.06 ± 6.2/55). Those who had an AT in high school rated their current AT as having more commitment, integrity, and knowledge than those who did not (P = .03-.49). Individual trust items revealed the lowest trust in not needing a second opinion (3.94 ±0.9) and highest trust involved following ATs advice (4.62 ±0.6). Males had more trust in ATs telling the truth (P = .02), but less trust in ATs doing everything for their medical care (P = .01) and keeping information private (P = .03) than females. Those with an AT in high school had less doubt about their AT caring about them (P = .002) and greater trust about medical care judgments (P = .02). Student-athletes strongly perceive constructs and highly trust their ATs. However, student-athletes that had an AT in high school reflect greater levels of ATs’ commitment, integrity and knowledge, and items of trust. ATs should consider and reflect these constructs and trust as early as possible with their student-athletes to better enhance the patient-clinician relationship and perceived care
The Indiana Statesman, November 7, 2024
No full textDonald Trump elected as 47 president; Football stuns No. 15 North Dakota; President Mike Godard officially installedhttps://scholars.indianastate.edu/statesman/1073/thumbnail.jp
The Indiana Statesman, April 2, 2024
No full textCigarettes: Menthol ban slips again; Korean culture events; Trump begins selling new Bibles to publichttps://scholars.indianastate.edu/statesman/1196/thumbnail.jp
The Indiana Statesman, April 16, 2024
No full textISU professor passes away at 54; Armed robbery at TH bank; New ISU President: Dr. Godard; Trump jury faces selection issues due to potential biashttps://scholars.indianastate.edu/statesman/1200/thumbnail.jp
The Indiana Statesman, August 15, 2024
No full textMove-In Guide 2024; Letter from President Godard to new Sycamores; What you should pack and what to leave at homehttps://scholars.indianastate.edu/statesman/1061/thumbnail.jp
