scholarly journals Development of a Simulation Surgical Cricothyroidotomy Curriculum for Novice Providers: A Learning Curve Study

2021 ◽  
Author(s):  
Haana McMurray ◽  
Laura S Kraemer ◽  
Edward Jaffe ◽  
Sorana Raiciulescu ◽  
Julia M Switzer ◽  
...  
Keyword(s):  
Medical Students ◽  
Learning Curve ◽  
Completion Time ◽  
Mastery Learning ◽  
Final Test ◽  
Cohen’S D ◽  
Time To Completion ◽  
Cohen's D ◽  
Level Performance ◽  
Completion Times

ABSTRACT Introduction Airway obstruction is the third most common cause of preventable death on the battlefield, accounting for 1%–2% of total combat fatalities. No previous surgical cricothyroidotomy (SC) studies have analyzed the learning curve required to obtain proficiency despite being studied in numerous other surgical technique training experiments. The aims of this study were to establish expert SC performance criteria, develop a novel standardized SC curriculum, and determine the necessary number of practice iterations required by a novice to reach this pre-determined performance goal. Materials and Methods A standardized checklist and SC performance standards were established based on the performance of 12 board certified Military Health System surgeons with prior experience on performing a SC using a simulated trauma mannequin. Expert-level criteria were defined as a SC time to completion of 40 s or less and checklist score of at least 9/10, including all critical steps. Study subjects included 89 novice providers (54 active-duty first- and second-year medical students and 35 Navy corpsmen). Subjects received instruction on performing a SC using the principles of mastery learning and performed a final test of SC proficiency on a trauma mannequin within a realistic simulated MEDEVAC helicopter. The total number of subject practice attempts, checklist scores, and time to completion were measured and/or blindly scored. Learning curve and exponential plateau equations were used to characterize their improvement in mean time to SC completion and checklist scores. Results Mean pre-test knowledge scores for the entire group were 11.8 ± 3.1 out of 24 points. Total mean practice learning plateaued at checklist scores of 9.9/10 after 7 iterations and at a mean completion time of 30.4 s after 10 iterations. During the final test performance in the helicopter, 67.4% of subjects achieved expert-level performance on the first attempt. All subjects achieved expert-level performance by the end of two additional attempts. While a significantly larger proportion of medical students (79.9%) successfully completed the helicopter test on the first attempt compared to corpsmen (54.3%), there were no statistically significant differences in mean SC completion times and checklist scores between both groups (P > 0.05). Medical students performed a SC only 1.3 s faster and scored only 0.16 points higher than corpsmen. The effect size for differences were small to negligible (Cohen’s d range 0.18–0.33 for SC completion time; Cohen’s d range 0.45–0.46 for checklist scores). Conclusion This study successfully defined SC checklist scores and completion times based on the performance of experienced surgeons on a simulator. Using these criteria and the principles of mastery learning, novices with little knowledge and experience in SC were successfully trained to the level of experienced providers. All subjects met performance targets after training and overall performance plateaued after approximately seven iterations. Over two-thirds of subjects achieved the performance target on the first testing attempt in a simulated helicopter environment. Performance was comparable between medical student and corpsmen subgroups. Further research will assess the durability of maintaining SC skills and the timing for introducing refresher courses after initial skill acquisition.

scholarly journals Effectiveness of Blended Learning versus Lectures alone on ECG Analysis and Interpretation by Medical Students

2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch
Keyword(s):  
Medical Students ◽  
Blended Learning ◽  
Web Application ◽  
Deliberate Practice ◽  
Clinical Clerkship ◽  
Post Intervention ◽  
Ecg Analysis ◽  
Cohen’S D ◽  
Conventional Teaching ◽  
Cohen's D

Abstract Background Most medical students lack confidence and are unable to accurately interpret ECGs. Better methods of ECG instruction are therefore being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, than with conventional teaching (lectures alone). Methods Two cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of ECG analysis and interpretation, with structured feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediately post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test. Results The pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d =1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d =1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation. Conclusion Blended learning was superior in teaching ECG analysis and interpretation skills to medical students and achieved better levels of ECG competence and confidence than conventional lectures. Although medical students undergo a significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications enabling deliberate practice with structured feedback may therefore be a useful adjunct to lectures for teaching Electrocardiography.

scholarly journals Pre-medical students’ perceptions of educational environment and their subjective happiness: a comparative study before and after the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanyan Lin ◽  
Ye Ji Kang ◽  
Hyo jeong Lee ◽  
Do-Hwan Kim
Keyword(s):  
Medical Students ◽  
Effect Size ◽  
Educational Environment ◽  
Medium Effect ◽  
Subjective Happiness ◽  
Social Self ◽  
Self Perceptions ◽  
Cohen’S D ◽  
Before And After ◽  
Cohen's D

Abstract Background The COVID-19 pandemic necessarily changed pre-medical students’ educational environment into an online format—and students’ subjective happiness (SH) is highly impacted by their educational environment. This study investigates changes in pre-medical students’ perceptions of their educational environment and their SH before and after the pandemic, as well as explores the predictors related to their SH. Methods The Korean version of the Dundee Ready Educational Environment Measure (DREEM) questionnaire and single-item measures of SH and professional identity (PI) were used. The t-test was employed to analyze the differences of the SH, PI, and DREEM subscales scores before and after the onset of COVID-19. Cohen’s d was used as effect size and correlations between SH and different subscales of DREEM were analyzed using Pearson’s correlation. The multiple regression analysis was performed to reveal associations between predictors and SH. Results A total of 399 pre-medical students completed the survey both before and after the COVID-19 pandemic. The DREEM scores and all subscales scores significantly increased but each presents a different effect size. Students’ Perceptions of Learning (SPL: Cohen’s d = 0.97), Students’ Perceptions of Teaching (SPT: Cohen’s d = 1.13), and Students’ Perceptions of Atmosphere (SPA: Cohen’s d = 0.89) have large effect sizes. Students’ Academic Self-Perceptions (SASP: Cohen’s d = 0.66) have a medium effect size and Students’ Social Self-Perceptions (SSSP: Cohen’s d = 0.40) have a small effect size. In contrast, no significant change was noted in the SH and PI. Both PI and SSSP impacted SH before COVID-19, but after the pandemic, SH was impacted by SPL, SPA, and SSSP. Conclusions Students’ overall perception of their educational environment was more positive after the onset of COVID-19, but their social self-perceptions improved the least. Additionally, SSSP is the only predictor of SH both before and after the pandemic. The findings of this study suggest that educational institutions must pay attention to students’ social relationships when trying to improve their educational environment. Furthermore, so as to increase students’ SH, development of both educational environment and PI is essential.

scholarly journals A brief intervention to reduce burnout and improve sleep quality in medical students

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jennifer R. Brubaker ◽  
Aili Swan ◽  
Elizabeth A. Beverly
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Perceived Stress ◽  
Emotional Exhaustion ◽  
Smartphone Addiction ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Alarm Clock ◽  
Cohen’S D ◽  
Cohen's D

Abstract Background Perceived stress, burnout, and poor sleep quality are high among medical students. Interventions designed to target these issues are necessary to promote the health and well-being of medical students. The purpose of this study was twofold: 1) to assess the feasibility of implementing a sunrise alarm clock intervention with medical students and 2) to evaluate the impact of the intervention on perceived stress, burnout scores, and sleep quality. Methods We conducted a feasibility study to evaluate the efficacy of a two-week, sunrise alarm clock intervention in combination with electronic device removal at bedtime. We assessed first- and second-year medical students’ perceived stress, burnout scores, including Emotional Exhaustion, Depersonalization, and Low Sense of Personal Achievement, and sleep quality before and after the intervention. In addition, we measured smartphone addiction prior to the intervention. Results A total of 57 students consented to participate, of which 55 completed both the pre- and post-assessments (3.5% attrition). The mean age of the participants was 24.8 ± 1.9 years, 50.9% (n = 29) identified as women, and 68.4% (n = 39) identified as white. Pre-intervention, 42.1% (n = 24) of students met criteria for smartphone addiction and 77.2% (n = 44) met criteria for poor sleep quality. In addition, 22.8% (n = 13) of participants had high emotional exhaustion, 64.9% (n = 31) high depersonalization, and 42.1% (n = 24) low sense of personal accomplishment prior to the intervention. Following the two-week intervention, participants showed improvements in emotional exhaustion (p = 0.001, Cohen’s d = 0.353), depersonalization (p = 0.001, Cohen’s d = 0.411) low sense of personal accomplishment (p = 0.023, Cohen’s d = 0.275), perceived stress (p < .001, Cohen’s d = .334), and sleep quality (p < 0.001, Cohen’s d = 0.925). The number of participants who reported poor sleep quality decreased to 41.8% (n = 23), demonstrating a significant decline (p = 0.026). Participants also improved subjective sleep quality (p < 0.001, Cohen’s d = 1.033), sleep duration (p = 0.001, Cohen’s d = 0.431), sleep latency (p < 0.001, Cohen’s d = 0.433), and sleep efficiency (p = 0.021, Cohen’s d = 0.673). Conclusions These findings suggest that the two-week sunrise alarm clock protocol with electronic device removal was effective in improving sleep quality and reducing burnout scores, and perceived stress. However, additional research comparing this intervention to a proper control group is needed to draw meaningful conclusions about the effectiveness of this intervention.

Phonologische Verarbeitung bei Grundschulkindern mit schwacher Lesefähigkeit

2013 ◽  
Vol 2 (4) ◽  
pp. 199-215 ◽  
Author(s):  
Maria Klatte ◽  
Claudia Steinbrink ◽  
Kirstin Bergström ◽  
Thomas Lachmann
Keyword(s):  
Cohen’S D ◽  
Phonologische Verarbeitung ◽  
Cohen's D

Defizite in der phonologischen Informationsverarbeitung werden heute als Kernsymptom der Lese-Rechtschreibstörung betrachtet. In Trainingsstudien mit betroffenen Kindern erwiesen sich Phonemwahrnehmungsfähigkeiten als trainierbar, und Programme, in denen Aufgaben zur phonologischen Bewusstheit mit der systematischen Vermittlung von Phonem-Graphem-Zuordnungen kombiniert wurden, zeigten Transfereffekte auf Lese- und Rechtschreibleistungen. Ausgehend von diesen Erkenntnissen wurde ein computerbasiertes Trainingsprogramm zur Förderung der Phonemwahrnehmung, der phonologischen Bewusstheit und der Graphem-Phonem-Zuordnungen für deutschsprachige Grundschulkinder mit Lese-Rechtschreibstörung entwickelt. Aufgrund der besonderen Relevanz der Vokallänge für die deutsche Orthographie enthält das Programm neben Aufgaben, die auf Konsonanten fokussieren, auch Vokallängenaufgaben. Bei der Konzipierung des Programms wurden etablierte, ursprünglich für andere Sprachen entwickelte Aufgaben an die deutsche Phonologie angepasst und in ein computerbasiertes Format übersetzt. Im Rahmen der vorliegenden Studie sollte überprüft werden, ob die konstruierten Trainingsaufgaben die spezifischen Defizite von Kindern mit Lese-Rechtschreibstörung wie intendiert abbilden. Hierzu wurden leseschwache Dritt- und Viertklässler (n = 35) mit mindestens durchschnittlichen Lesern derselben Klassenstufen (n = 75; Kontrollgruppe) hinsichtlich ihrer Leistungen in den Aufgaben verglichen. Die leseschwachen Kinder zeigten in allen Aufgaben schlechtere Leistungen als die Kontrollgruppe. Die Effektstärken der Gruppenunterschiede (Cohen's d) lagen im mittleren bis hohen Bereich (0.50 – 2.19). Die Ergebnisse bestätigen, dass die Aufgaben des Trainingsprogramms die spezifischen Defizite leseschwacher Kinder abbilden. Ein Training mit diesen Aufgaben erscheint daher grundsätzlich sinnvoll. Die Wirkungen eines solchen Trainings auf die schriftsprachlichen Leistungen von Kindern mit Lese-Rechtschreibstörung werden in zukünftigen Studien überprüft.

Political Inclusion Reduces Political Prejudice

2019 ◽  
Author(s):  
Jan G. Voelkel ◽  
Dongning Ren ◽  
Mark John Brandt
Keyword(s):  
The Political ◽  
Political Discussion ◽  
Total N ◽  
Cohen’S D ◽  
Promising Strategy ◽  
Political Inclusion ◽  
Cohen's D ◽  
Political Divide ◽  
Scenario Study ◽  
Fair Chance

The political divide is characterized by liberals and conservatives who hold strong prejudice against each other. Here we introduce one possible strategy for reducing political prejudice: political inclusion. We define political inclusion as receiving a fair chance to voice one’s opinions in a discussion of political topics with political outgroup members. This strategy may reduce political prejudice by inducing perceptions of the political outgroup as fair and respectful; however, such a strategy may also highlight conflicting attitudes and worldviews, thereby further exacerbating prejudice. In three preregistered studies (total N = 799), we test if political inclusion reduces or increases prejudice toward the political outgroup. Specifically, political inclusion was manipulated with either an imagined scenario (Study 1) or a concurrent experience in an ostensible online political discussion (Studies 2 &amp; 3). Across all studies, participants who were politically included by political outgroup members reported reduced prejudice toward their outgroup compared to participants in a neutral control condition (Cohen’s d [-0.27, -0.50]). This effect was mediated by perceptions of the political outgroup as fairer and less dissimilar in their worldviews. Our results indicate that political discussions that are politically inclusive do not cause additional prejudice via worldview conflict, but instead give others a feeling of being heard. It is a promising strategy to reduce political prejudice.

scholarly journals Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

2021 ◽  
Vol 18 (5) ◽  
pp. 2654
Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian
Keyword(s):  
Virtual Reality ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Control Group ◽  
Mirror Therapy ◽  
Cohen’S D ◽  
Cohen's D ◽  
Experimental Group ◽  
Post Therapy

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

Development of a multimedia intervention to improve pneumoconiosis prevention in construction workers using RE-AIM framework

2021 ◽  
Author(s):  
Jieling Chen ◽  
Cho Lee Wong ◽  
Bernard Man Hin Law ◽  
Winnie Kwok Wei So ◽  
Doris Yin Ping Leung ◽  
...  
Keyword(s):  
South Asian ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Intervention Mapping ◽  
Intervention Development ◽  
Educational Interventions ◽  
Construction Workers ◽  
Post Intervention ◽  
Cohen’S D ◽  
Cohen's D

Summary Pneumoconiosis is a common occupational lung disease among construction workers. Educational interventions targeting specific ethnic groups of construction workers are of benefit for pneumoconiosis prevention. The aim of this study was to develop a multimedia educational intervention for pneumoconiosis prevention for South Asian construction workers, and to evaluate its feasibility, acceptability and effectiveness in increasing knowledge of pneumoconiosis, modifying beliefs about pneumoconiosis, and enhancing intention to implement measures for its prevention among the workers. This evaluation was performed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. A one-group design was adopted and intervention mapping was used to guide the process of intervention development, while the Health Belief Model guided the development of intervention content. The intervention was delivered at construction sites, ethnic minority associations and South Asian community centres. Data were collected via surveys completed at pre-intervention, post-intervention and 3 months after the intervention. A total of 1002 South Asian construction workers participated in the intervention. The participants reported a moderate-to-large increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, cues to action and self-efficacy (Cohen’s d: 0.37–0.89), a small reduction in perceived barriers (Cohen’s d = 0.12) and a moderate improvement in attitudes and intention to practice (Cohen’s d: 0.45, 0.51) at post-intervention. A follow-up survey of 121 participants found that the implementation of preventive measures appeared to increase. Overall, the findings demonstrate that the implementation of a culturally adapted multimedia educational intervention could be an effective approach to improving knowledge, self-efficacy and intention regarding pneumoconiosis prevention among South Asian construction workers.

scholarly journals Explainable AI enables clinical trial patient selection to retrospectively improve treatment effects in schizophrenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monika S. Mellem ◽  
Matt Kollada ◽  
Jane Tiller ◽  
Thomas Lauritzen
Keyword(s):  
Clinical Trial ◽  
Patient Selection ◽  
Treatment Effect ◽  
Controlled Clinical Trial ◽  
Learning Approaches ◽  
Full Sample ◽  
Cohen’S D ◽  
Explainable Ai ◽  
Cohen's D ◽  
Analytical Approaches

Abstract Background Heterogeneity among patients’ responses to treatment is prevalent in psychiatric disorders. Personalized medicine approaches—which involve parsing patients into subgroups better indicated for a particular treatment—could therefore improve patient outcomes and serve as a powerful tool in patient selection within clinical trials. Machine learning approaches can identify patient subgroups but are often not “explainable” due to the use of complex algorithms that do not mirror clinicians’ natural decision-making processes. Methods Here we combine two analytical approaches—Personalized Advantage Index and Bayesian Rule Lists—to identify paliperidone-indicated schizophrenia patients in a way that emphasizes model explainability. We apply these approaches retrospectively to randomized, placebo-controlled clinical trial data to identify a paliperidone-indicated subgroup of schizophrenia patients who demonstrate a larger treatment effect (outcome on treatment superior than on placebo) than that of the full randomized sample as assessed with Cohen’s d. For this study, the outcome corresponded to a reduction in the Positive and Negative Syndrome Scale (PANSS) total score which measures positive (e.g., hallucinations, delusions), negative (e.g., blunted affect, emotional withdrawal), and general psychopathological (e.g., disturbance of volition, uncooperativeness) symptoms in schizophrenia. Results Using our combined explainable AI approach to identify a subgroup more responsive to paliperidone than placebo, the treatment effect increased significantly over that of the full sample (p < 0.0001 for a one-sample t-test comparing the full sample Cohen’s d = 0.82 and a generated distribution of subgroup Cohen’s d’s with mean d = 1.22, std d = 0.09). In addition, our modeling approach produces simple logical statements (if–then-else), termed a “rule list”, to ease interpretability for clinicians. A majority of the rule lists generated from cross-validation found two general psychopathology symptoms, disturbance of volition and uncooperativeness, to predict membership in the paliperidone-indicated subgroup. Conclusions These results help to technically validate our explainable AI approach to patient selection for a clinical trial by identifying a subgroup with an improved treatment effect. With these data, the explainable rule lists also suggest that paliperidone may provide an improved therapeutic benefit for the treatment of schizophrenia patients with either of the symptoms of high disturbance of volition or high uncooperativeness. Trial Registration: clincialtrials.gov identifier: NCT 00,083,668; prospectively registered May 28, 2004

scholarly journals Louisiana Geriatric Workforce Enhancement Program: Analysis of Learning Outcomes From Dementia Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Katherine Kirsch ◽  
Catherine Lemieux ◽  
Laura Ainsworth ◽  
Sarah Choate ◽  
Ashleigh Borgmeyer ◽  
...  
Keyword(s):  
Primary Care ◽  
Program Analysis ◽  
Training Session ◽  
Cohen’S D ◽  
Response Formats ◽  
Cohen's D ◽  
Item Knowledge ◽  
South Louisiana ◽  
Severe Shortage ◽  
Primary Care Professionals

Abstract A recent Alzheimer’s Association report noted that by year 2050, the number of Americans diagnosed with Alzheimer’s disease and related dementias (ADRD) will triple to over 15 million. The report referred to primary care as the front line for meeting this demand, yet the nation faces a severe shortage of ADRD trained, primary care professionals (PCPs). Louisiana Geriatric Workforce Enhancement Program (LA-GWEP) addresses this demand. The purpose of this study was to examine preliminary data respective to LA-GWEP effectiveness with interdisciplinary education and training seminars, primarily aimed at medical, nursing, and social work PCPs. Three seminars were conducted in south Louisiana: Seminars 1 and 2 addressed effective communication, verbal and nonverbal, among persons with ADRD and caregivers; Seminar 3 offered basic overview of dementia symptomology, stages, and behaviors. Pre- and post-training session data were collected on-site. Participants completed questionnaires that included a 10-item knowledge assessment and 20-item Dementia Attitudes Scale (DAS). These measures contained Likert response formats; higher scores indicating greater levels of ADRD knowledge, in patient and caregiver contexts. Paired sample t-tests were conducted to observe any significant pre-to-post improvement, Cohen’s d for effect size. Seminar 1 revealed no significant pre-to-post difference: t = -1.019, p = 0.320. Adjusting content from audience feedback, Seminar 2 revealed significant pre-to-post difference: t = -7.516, p &lt; .001, Cohen’s d = 1.2. Seminar 3 yielded significant improvement on DAS scores: t = -2.96, p &lt; .01, Cohen’s d = 0.34. Implications for seminars in future years of LA-GWEP are discussed.

Muscle Strength Deficit though Intact Proprioception after Lateral Ankle Sprain without Persistent Instability

2021 ◽  
Author(s):  
Adel M. Madkhali ◽  
Shibili Nuhmani
Keyword(s):  
Ankle Sprain ◽  
Peak Torque ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Cohen’S D ◽  
History Of ◽  
Cohen's D

Abstract Background Lateral ankle sprain is one of the most common injuries in competitive sports. Previous studies which investigated muscle strength and proprioception (joint position sense) focused on subjects who sustained ankle sprain with instability. It is also important to investigate strength deficits and proprioception in subjects with a history of ankle sprain without instability. Therefore the aim of the study is to investigate proprioception and muscle strength deficits in athletes with lateral ankle sprain. Methods Twenty-four male athletes with a history of lateral ankle sprain and 24 age-matched controls (mean age of 22.42±4.13 years, mean height of 173±5.73 cm, and mean weight of 71.20±7.55 Kg) participated in this cross-sectional study. Peak torque and peak torque ratio at speeds of 30 and 120°/s for concentric and eccentric ankle inversion/eversion were evaluated using an isokinetic dynamometer. The joint position sense of the ankle joint was evaluated using an active angle reproduction test. Result Peak torque produced was significantly less in subjects with history of ankle sprain in concentric inversion 30°/s(t(47)=4.11; p=0.000, Cohen’s d=1.29), concentric inversion 120°/s (t(47)=3.01; p=0.006, Cohen’s d=1.13), concentric eversion 30°/s (t(47)=3.85; p=0.001, Cohen’s d=1.24) and concentric eversion 120°/s (t(47)=3.15; p=0.005, Cohen’s d=1.09). At the same time there was no significant difference observed in eccentric eversion peak torque in both speed (eccentric eversion 30°/s p=0.079; eccentric eversion 120°/s p=0.867) between experimental and control group. No significant difference was found in the joint position sense in the maximal active inversion −5° position (p=0.312) and the 15° inversion position (P=0.386) between both group. Conclusion The study’s results reported a significantly less peak torque of invertors and evertors during concentric movements in athletes with history of ankle sprain. At the same time, no significant difference reported in the evertor/invertor peak torque ratio, and active joint position sense between the 2 groups.

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