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CONTEXT: Borrowers burdened by high student debt generally experience financial constraints that can impact them both personally and professionally. To date no published data exists that profiles the education-related debt accrued by entry-level certified athletic trainers. OBJECTIVE: To assess the scope and scale of student debt associated with the completion of an entry-level athletic training degree. DESIGN: Cross-sectional study. SETTING: Online web-based survey. PATIENTS OR OTHER PARTICIPANTS: Participants were recruited with assistance from the National Athletic Trainers' Association, who disseminated the survey to 18,689 certified athletic trainers who were members in good standing and who had earned their certification between 2004 and 2022. A total of 2,271 individuals accessed the survey. MAIN OUTCOME MEASURE(S): The overall amount of student debt incurred to complete an entry-level degree in athletic training and the initial monthly repayment amount were collected from survey respondents. Education-related debt-to-income ratio (DTIR) and monthly payment DTIR which are measures of financial health/stability were also calculated from the acquired survey data. RESULTS: Among athletic trainers who took out student loans, the average amount owed by entry-level athletic trainers for the period spanning 20042022 was $61,717, with an average initial monthly loan payment amount reported to be $453. The mean education related DTIR calculated from respondents was 169%, which exceeded the benchmark value of 100% recommended within the finance industry. Also, the average monthly payment DTIR calculated from study participants was .144, which approached the recommended acceptable upper-limit of .15. CONCLUSIONS: Education-related DTIR and monthly payment DTIR values reported by respondents suggests the potential for entry-level athletic trainers to experience financial challenges related to their student debt.

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OBJECTIVE: Protective athletic equipment may hamper the delivery of effective chest compressions. Unfortunately, an algorithm for managing cardiac arrest emergencies with equipment-laden athletes has yet to be established by national CPR certifying agencies. Further, athletes classified as being overweight or obese carry adipose in the thoracic region, which has been reported to inhibit the ability of rescuers to provide quality chest compressions. Thus, the purpose of this study was two-fold. The first purpose was to assess the ability of emergency responders to perform CPR chest compressions on an obese manikin. The second purpose was to analyze the effect of American football protective equipment on the performance of chest compressions by emergency responders. METHODS: Fifty emergency responders completed four 2-minute bouts of compression-only CPR. The scenarios included performing chest compressions on both traditional and obese CPR manikins, and performing chest compressions over a set of shoulder pads/chest protector that is used in the sport of American football on both traditional and obese manikins. RESULTS: The most notable outcomes in this study were related to chest compression depth, which fell well below the minimum recommended depth published by the American Heart Association in all conditions. Mean compression depth was significantly lower when performed on the obese manikin (avg over pads = 32.8, SD = 9.2 mm; avg no pads = 38.2, SD = 9.1 mm) compared to the traditional manikin (avg over pads = 40.0, SD = 10.9 mm; avg no pads = 40.8, SD = 14.8 mm), with statistical analyses revealing a significant effect due to both manikin size (p < 0.001) and the presence of equipment (p = 0.003), and a statistically significant interaction effect (p = 0.035). Chest recoil data revealed a statistically significant effect due to both manikin size (p = 0.017) and the presence of chest/shoulder safety pads (p = 0.003). CONCLUSION: Within this sample of emergency responders, chest compressions were adversely affected both by the equipment and obesity. Additionally, the traditional manikin received comparable chest compressions regardless of the presence or absence of football protective equipment, albeit both conditions resulted in poor depth performance.

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OBJECTIVE: To identify normative near point of convergence (NPC) data for healthy high-school-aged athletes (13-19 years old) and determine the percentage of individuals with NPC scores that fall outside the currently accepted clinical cutoff value of 5 cm. Another objective was to determine the relationship between sex, concussion history, and attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) with NPC scores, if any. DESIGN: Case series. SETTING: High-school sports medicine clinic. PATIENTS OR PARTICIPANTS: Near point of convergence was assessed in 718 high-school student athletes (141 females and 577 males) with an average age of 15.96 ± 1.16 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: An accommodation convergence ruler was used to measure NPC. Near point of convergence scores were repeated a total of 3 times and the mean used for all statistical analyses. RESULTS: The NPC scores for all participants averaged 3.58 cm, and the intraclass correlation coefficient for the 3 repeated measurements was 0.956. Approximately 20% of mean NPC scores were above the accepted upper limit of 5 cm. Although a statistically significant effect for sex was identified, the difference between them was considered clinically insignificant. No relationship between NPC and history of concussion or ADD/ADHD was identified. CONCLUSIONS: Results indicate that in high-school-aged subjects, approximately 20% of individuals may have NPC values that fall outside the current critical cutoff value and may lead to incorrect diagnosis of ocular dysfunction. In addition, NPC does not seem to be affected by the history of concussion or a diagnosis of ADD/ADHD.

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CONTEXT: There are 3.8 million mild traumatic brain injuries (mTBIs) that occur each year in the United States. Many are left with prolonged life-altering neurocognitive deficits, including difficulties in attention, concentration, mental fatigue, and distractibility. With extensive data on the safety and efficacy of stimulant medications in treating attention deficit, concentration difficulties and distractibility seen with attention deficit disorder, it is not surprising that interest continues regarding the application of stimulant medications for the persistent neurocognitive deficits in some mTBIs. EVIDENCE ACQUISITION: Studies were extracted from PubMed based on the topics of neurocognitive impairment, mTBI, stimulant use in mTBI, stimulants, and the association between attention deficit/hyperactivity disorder and mTBI. The search criteria included a date range of 1999 to 2020 in the English language. STUDY DESIGN: Literature review. LEVEL OF EVIDENCE: Level 4. RESULTS: Currently, there is very limited literature, and no guidelines for evaluating the use of stimulant medication for the treatment of prolonged neurocognitive impairments due to mTBI. However, a limited number of studies have demonstrated efficacy and safety of stimulants in the treatment of neurocognitive sequelae of mTBI in the adult, pediatric, military, and athletic populations. CONCLUSION: There is limited evidence to suggest stimulant medication may be beneficial in patients with mTBI with persistent neurocognitive symtpoms. The decision to utilize stimulant medication for mTBI patients remains physician and patient preference dependent. Given the limited encouraging data currently available, physicians may consider stimulant medication in appropriate patients to facilitate the recovery of prolonged neurocognitive deficits, while remaining cognizant of potential adverse effects.

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OBJECTIVE: To determine whether scores obtained from Patient Health Questionnaire-9 (PHQ-9) or the General Anxiety Disorder-7 (GAD-7) instruments administered following a concussion can be used to predict recovery time. METHOD: Retrospective cohort study in a university-based specialty concussion center of 502 concussed participants. Participants completed a PHQ-9 and GAD-7 during their initial visit and subsequent visits during the recovery period (ie, at 14, 28, 56, and 84 days). RESULTS: The median recovery time from a concussion was 21 days from the initial clinical evaluation; however, individuals with a PHQ-9 score ≤ 6 (n = 262) had a median recovery time of 17 (95% confidence interval [CI] 15-19) days, whereas those with PHQ-9 scores >6 (n = 240) had a median recovery time of 33 (95% CI 28-37) days and a hazard ratio of 0.525 (95% CI 0.438-0.629, P < 0.0001). For individuals with a GAD-7 score ≤ 4 (n = 259), the median recovery was 19 (95% CI 17-21), days whereas for those with a GAD-7 score > 4 (n = 243), the median recovery was 32 (95% CI 28-36) days with a hazard ratio of 0.554 (95% CI 0.462-0.664, P < 0.00). CONCLUSIONS: Scores obtained from PHQ-9 and GAD-7 screening tools appear to be predictive of an individual's recovery and may help identify those subjects who may benefit from early psychological interventions.

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Sport-related concussion is a common injury that has garnered the attention of the media and general public because of the potential for prolonged acute symptoms and increased risk for long-term impairment. Currently, a growing body of evidence supports the use of various therapies to improve recovery after a concussion. A contemporary approach to managing concussion symptoms is to use aerobic exercise as treatment. To date, several studies on both pediatric and adult patients have established that controlled aerobic exercise is a safe and effective way to rehabilitate patients experiencing delayed recovery after concussion. However, less is known about the utility of an early exercise protocol for optimizing recovery after acute concussion and reducing the risk for persistent postconcussive symptoms, particularly in pediatric populations. Thus, the purpose of our paper was to review and evaluate the available literature on the implementation of aerobic exercise for the treatment of acute pediatric concussion.

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CONTEXT: A change in reaction time is one of various clinical measures of neurocognitive function that can be monitored after concussion and has been reported to be among the most sensitive indicators of cognitive impairment. OBJECTIVE: To determine the timeline for clinically assessed simple reaction time to return to baseline after a concussion in high school athletes. DESIGN: Observational study. SETTING: Athletic training room. PATIENTS OR OTHER PARTICIPANTS: Twenty-one high school-aged volunteers. INTERVENTION(S): Participants completed 8 trials of the ruler-drop test during each session. Along with baseline measures, a total of 6 additional test sessions were completed over the course of 4 weeks after a concussion (days 3, 7, 10, 14, 21, and 28). MAIN OUTCOME MEASURE(S): The mean reaction times calculated for all participants from each of the 7 test sessions were analyzed to assess the change in reaction time over the 7 time intervals. RESULTS: After a concussion and compared with baseline, simple reaction time was, on average, 26 milliseconds slower at 48 to 72 hours postinjury (P < .001), almost 18 milliseconds slower on day 7 (P < .001), and about 9 milliseconds slower on day 10 (P < .001). Simple reaction time did not return to baseline levels until day 14 postinjury. CONCLUSIONS: Clinically assessed simple reaction time appeared to return to baseline levels within a timeframe that mirrors other measures of cognitive performance (approximately 14 days).

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BACKGROUND: Numerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board. PURPOSE: To test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model. STUDY DESIGN: Controlled laboratory study. METHODS: Five whole, lightly embalmed cadavers were fitted with shoulder pads and helmets and tested both before and after global instability was surgically created at C5-C6. An electromagnetic motion analysis device was used to assess the amount of angular and linear motion with sensors placed above and below the injured segment during transfer. Spine-boarding techniques evaluated were the log roll, the lift and slide, and the 8-person lift. RESULTS: The 8-person lift technique resulted in the least amount of angular and linear motion for all planes tested as compared with the lift-and-slide and log-roll techniques. This reached statistical significance for lateral bending (P = .031) and medial-lateral translation (P = .030) when compared with the log-roll maneuver. The lift-and-slide technique was significantly more effective at reducing motion than the log roll for axial rotation (P = .029) and lateral bending (P = .006). CONCLUSION: The log roll resulted in the most motion at an unstable cervical injury as compared with the other 2 spine-boarding techniques examined. The 8-person lift and lift-and-slide techniques may both be more effective than the log roll at reducing unwanted cervical spine motion when spine boarding an injured football player. Reduction of such motion is critical in the prevention of iatrogenic injury.

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Neurodegenerative disorders and diseases (NDDs) that are either chronically acquired or triggered by a singular detrimental event are a rapidly growing cause of disability and/or death. In recent times, there have been major advancements in our understanding of various neurodegenerative disease states that have revealed common pathologic features or mechanisms. The many mechanistic parallels discovered between various neurodegenerative diseases suggest that a single therapeutic approach may be used to treat multiple disease conditions. Of late, natural compounds and supplemental substances have become an increasingly attractive option to treat NDDs because there is growing evidence that these nutritional constituents have potential adjunctive therapeutic effects (be it protective or restorative) on various neurodegenerative diseases. Here we review relevant experimental and clinical data on supplemental substances (i.e., curcuminoids, rosmarinic acid, resveratrol, acetyl-L-carnitine, and ω-3 (n-3) polyunsaturated fatty acids) that have demonstrated encouraging therapeutic effects on chronic diseases, such as Alzheimer's disease and neurodegeneration resulting from acute adverse events, such as traumatic brain injury.

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STUDY OBJECTIVE: To compare the amount of segmental vertebral motion produced with the lateral recovery position and the HAINES technique when performed on cadavers with destabilized cervical spines. METHODS: The cervical spines of 10 cadavers were surgically destabilized at the C5-C6 vertebral segment. Sensors from an electromagnetic tracking device were affixed to the vertebrae in question to monitor the amount of anterior/posterior, medial/lateral, and distraction/compression linear motion produced during the application of the two study techniques. RESULTS: The statistical analysis of linear motion data did not reveal any significant differences between the two recovery positions. CONCLUSION: At this time, no single version of the recovery position can be endorsed for the spine-injured trauma patient. More research is needed to fully ascertain the safety of commonly used recovery positions.

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CONTEXT: Researchers have confirmed that the ruler-drop test could be included as part of a multifaceted concussion-assessment battery and potentially as a way to track recovery from head injury. However, it is unclear if this clinical test of reaction time would be characterized by inconsistent performance because of practice effects. OBJECTIVE: To determine if the ruler-drop test is susceptible to practice effects after serial administration. DESIGN: Descriptive laboratory study. SETTING: Sports medicine research laboratory. PATIENTS OR OTHER PARTICIPANTS: Forty-three persons (age = 21.8 ± 2.6 years). INTERVENTION(S): Ten sessions were completed over 5 weeks. Participants completed 10 trials of the ruler-drop test during each session. MAIN OUTCOME MEASURE(S): The mean reaction times calculated for all participants from each test session were analyzed to determine if there was any meaningful change (ie, improvement) in reaction time over the course of the investigation. RESULTS: Simple reaction time improved (ie, decreased) after repeated administration of the ruler-drop test, and the most pronounced improvement occurred between the first 2 test sessions. Between the first and second test sessions, reaction time decreased by almost 7 milliseconds, and there was an overall improvement of almost 13 milliseconds between the first and tenth sessions. Although the pairwise comparisons between the first and second and the first and third sessions were not significant, the change in mean reaction time between the first session and most of the other sessions was significant. We noted no differences when successive sessions were compared. CONCLUSIONS: To prevent practice-related improvements in reaction time, practitioners should allow at least 1 practice session before recording baseline results on the ruler-drop test.

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CONTEXT: Two methods have been proposed to transfer an individual in the prone position to a spine board. Researchers do not know which method provides the best immobilization. OBJECTIVE: To determine if motion produced in the unstable cervical spine differs between 2 prone logrolling techniques and to evaluate the effect of equipment on the motion produced during prone logrolling. DESIGN: Crossover study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Tests were performed on 5 fresh cadavers (3 men, 2 women; age = 83 ± 8 years, mass = 61.2 ± 14.1 kg). MAIN OUTCOME MEASURE(S): Three-dimensional motions were recorded during 2 prone logroll protocols (pull, push) in cadavers with an unstable cervical spine. Three equipment conditions were evaluated: football shoulder pads and helmet, rigid cervical collar, and no equipment. The mean range of motion was calculated for each test condition. RESULTS: The pull technique produced 16% more motion than the push technique in the lateral-bending angulation direction (F1,4 = 19.922, P = .01, η(2) = 0.833). Whereas the collar-only condition and, to a lesser extent, the football-shoulder-pads-and-helmet condition demonstrated trends toward providing more stability than the no-equipment condition, we found no differences among equipment conditions. We noted an interaction between technique and equipment, with the pull maneuver performed without equipment producing more anteroposterior motion than the push maneuver in any of the equipment conditions. CONCLUSIONS: We saw a slight difference in the motion measured during the 2 prone logrolling techniques tested, with less lateral-bending and anteroposterior motion produced with the logroll push than the pull technique. Therefore, we recommend adopting the push technique as the preferred spine-boarding maneuver when a patient is found in the prone position. Researchers should continue to seek improved methods for performing prone spine-board transfers to further decrease the motion produced in the unstable spine.

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BACKGROUND: As prehospital emergency rescuers prepare cervical spine-injured adult patients for immobilization and transport to hospital, it is essential that patients be placed in a favorable position. Previously, it was recommended that patients with cervical spine injuries be immobilized in a slightly flexed position using pads placed beneath the head. However, it is unknown how neck flexion created with pad placement affects the unstable spine. OBJECTIVE: To determine the effects of three different head positions on the alignment of unstable vertebral segments. METHODS: Five cadavers with a complete segmental instability at the C5 and C6 level were included in the study. The head was either placed directly on the ground (or spine board) or on foam pads. Three conditions were tested: no pad; pads 2.84 cm thick; and pads 4.26 cm thick. Pads were positioned beneath the head to determine their effect on spinal alignment. Anterior-posterior translation, flexion-extension motion, and axial displacement across the unstable segment were compared between conditions. RESULTS: Although statistical tests failed to identify any significant differences between pad conditions, some meaningful results were noted. In general, the "no pad" condition aligned the spine in a position that best replicated the intact spine. CONCLUSIONS: Because the goal of emergency rescuers is to conserve whatever physiologic or structural integrity of the spinal cord and spinal column that remains, the outcome of this study suggests that this goal may be best achieved using the "no pad" condition. However, it is recommended that more research be conducted to confirm these preliminary findings.

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CONTEXT: Excessive spinal motion generated during multiple bed transfers of patients with unstable spine injuries may contribute to neurological deterioration. OBJECTIVE: To evaluate spinal motion in a cadaveric model of global spinal instability during hospital bed transfers using several commonly used techniques. DESIGN/PARTICIPANTS: A motion analysis and evaluation of hospital bed transfer techniques in a cadaveric model of C5-C6 and T12-L2 global spinal instability. Setting/outcome measures: Global instability at C5-C6 and T12-L2 was created. The motion in three planes was measured in both the cervical and lumbar spine during each bed transfer via electromagnetic motion detection devices. Comparisons between transfers performed using an air-assisted lateral transfer device, manual transfer, a rolling board, and a sliding board were made based on the maximum range of motion observed. RESULTS: Significantly less lateral bending at C5-C6 was observed in air-assisted device transfers when compared with the two other boards. Air-assisted device transfers produced significantly less axial rotation at T12-L2 than the rolling board, and manual transfers produced significantly less thoracolumbar rotation than both the rolling and sliding boards. No other significant differences were observed in cervical or lumbar motion. Motion versus time plots indicated that the log roll maneuvers performed during rolling board and sliding board transfers contributed most of the observed motion. CONCLUSIONS: Each transfer technique produced substantial motion. Transfer techniques that do not include the logroll maneuver can significantly decrease some components of cervical and lumbar motion. Thus, some spinal motion can be reduced through selection of transfer technique.

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BACKGROUND: Many studies have compared the restriction of motion that immobilization collars provide to the injured victim. No previous investigation has assessed the amount of motion that is generated during the fitting and removal process. The purpose of this study was to compare the three-dimensional motion generated when one-piece and two-piece cervical collars are applied and removed from cadavers intact and with unstable cervical spine injuries. METHODS: Five fresh, lightly embalmed cadavers were tested three times each with either a one-piece or two-piece cervical collar in the supine position. Testing was performed in the intact state, following creation of a global ligamentous instability at C5-C6. The amount of angular motion resulting from the collar application and removal was measured using a Fastrak, three-dimensional, electromagnetic motion analysis device (Polhemus Inc., Colchester, VT). The measurements recorded in this investigation included maximum values for flexion/extension, axial rotation, medial/lateral flexion, anterior/posterior displacement, axial distraction, and medial/lateral displacement at the level of instability. RESULTS: There was statistically more motion observed with application or removal of either collar following the creation of a global instability. During application, there was a statistically significant difference in flexion/extension between the one-piece (1.8 degrees) and two-piece (2.6 degrees) collars, p = 0.009. There was also a statistically significant difference in anterior/posterior translation between the one-piece (3.6 mm) and two-piece (3.4 mm) collars, p = 0.015. The maximum angulation and displacement during the application of either collar was 3.4 degrees and 4.4 mm. Statistical analysis revealed no significant differences between the one-piece and two-piece collars during the removal process. The maximum angulation and displacement during removal of either collar type was 1.6 degrees and 2.9 mm. CONCLUSIONS: There were statistically significant differences in motion between the one-piece and two-piece collars during the application process, but it was only 1.2 degrees in flexion/extension and 0.2 mm in anterior/posterior translation. Overall, the greatest amount of angulation and displacement observed during collar application was 3.4 degrees and 4.4 mm. Although the exact amount of motion that could be deleterious to a cervical spine-injured patient is unknown, collars can be placed and removed with manual in-line stabilization without large displacements. Only trained practitioners should do so and with great care given that some motion in all planes does occur during the process.

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STUDY DESIGN: Biomechanical cadaveric study. OBJECTIVE: We sought to analyze the amount of motion generated in the unstable cervical spine during various maneuvers and transfers that a trauma patient would typically be subjected to prior to definitive fixation, using 2 different protocols. SUMMARY OF BACKGROUND DATA: From the time of injury until the spine is adequately stabilized in the operating room, every step in management of the spine-injured patient can result in secondary injury to the spinal cord. METHODS: The amount of angular motion between C5 and C6, after a surgically created unstable injury, was measured using an electromagnetic motion analysis device (Polhemus Inc., Colchester, VT). A total sequence of maneuvers and transfers was then performed that a patient would be expected to go through from the time of injury until surgical fixation. This included spine board placement and removal, bed transfers, lateral therapy, and turning the patient prone onto the operating table. During each of these, we performed what has been shown to be the best and commonly used (log-roll) techniques. RESULTS: During bed transfers and the turn prone for surgery, there was statistically more angular motion in each plane for traditional transfer with the spine board and manually turning the patient prone as commonly done (P < 0.01). During spine board placement, there was more motion in all 3 planes with log-rolling, and this reached statistical significance for axial rotation (P = 0.015) and lateral bending (P = 0.004). There was more motion during board removal with log-rolling in all 3 planes. This was statistically significant for lateral bending (P = 0.009) and approached significance in flexion-extension (P = 0.058) and axial rotation (P = 0.058). During lateral therapy, there was statistically more motion in flexion-extension and lateral bending with the manual log-roll technique (P < 0.001). The total motion was decreased by more than 50% in each plane when using an alternative to log-roll techniques during the total sequence (P < 0.006). CONCLUSION: We have demonstrated the total angular motion incurred to the unstable cervical spine as experienced by the typical trauma patient from the field to stabilization in the operating room using the best compared with the most commonly used techniques. As previously reported, using log-roll techniques consistently results in unwanted motion at the injured spinal segment.

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BACKGROUND: After spine board immobilization of the trauma victim and transport to the hospital, the patient is removed from the spine board as soon as practical. Current Advanced Trauma Life Support's recommendations are to log roll the patient 90 degrees, remove the spine board, inspect and palpate the back, and then log roll back to supine position. There are several publications showing unacceptable motion in an unstable spine when log rolling. METHODS: Cervical spine motion was evaluated during spine board removal. A C5 to C6 instability was surgically created in cadavers. A three-dimensional electromagnetic tracking system was used to assess motion between C5 and C6. The log roll was compared with a lift-and-slide technique. Throughout the log roll procedure, manual inline cervical stabilization was provided by a trained individual in a series of trials. In other trials, the lift-and-slide technique was used. In the final stage, the amount of motion generated was assessed when the spine board removal techniques were completed by experienced and novice persons in maintaining inline stabilization of the head and neck. RESULTS: Motion between C5 and C6 was reduced during the lift-and-slide technique in five of six parameters. The reduction was statistically significant in four parameters. When performing the log roll, motion was not reduced with increased head holder experience. CONCLUSIONS: Spine boards can be removed using a lift-and-slide maneuver with less motion and potentially less risk to the patient's long-term neurologic function than expected using the log roll.

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OBJECTIVE: Standard protective athletic equipment used in collision sports such as American football poses a unique challenge to rescuers because they block access to both the airway and chest. The main objective of this investigation was to determine the effect of athletic equipment on the initiation of CPR. The feasibility of performing compressions over the chest protector as a potential time-saving step was also evaluated. METHODS: Thirty-four certified athletic trainers performed CPR on a manikin wearing protective equipment during a simulated episode of cardiac arrest. For one trial the protective equipment was removed or unfastened prior to initiating CPR, and for another, chest compressions were initiated over the protective equipment. The following were recorded for comparison purposes: time until first breath and first compression; percentage of compressions delivered to the recommended depth; compression rate; accuracy of hand placement; percentage of compressions without full chest recoil. RESULTS: Although chest compressions began sooner when compressions were delivered over the chest protector, this improvement was not statistically significant. A more notable positive outcome resulting from keeping the chest protector on was an increase in the number of compressions that were delivered to the recommended depth. Unfortunately, one of the significant negative outcomes of performing chest compression over the chest pad was the increased percentage of compressions that did not obtain full chest recoil. CONCLUSIONS: Although removal of the chest protector delays the initiation of chest compressions, keeping the chest protector on during CPR does not appear to be a feasible option.

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INTRODUCTION: In the prehospital setting, spine-injured patients must be transferred to a spine board to immobilize the spine. This can be accomplished using both manual techniques and mechanical devices. OBJECTIVES: The study aimed to evaluate the effectiveness of the scoop stretcher to limit cervical spine motion as compared to 2 commonly used manual transfer techniques. METHODS: Three-dimensional angular motion generated across the C5-C6 spinal segment during execution of 2 manual transfer techniques and the application of a scoop stretcher was recorded first on cadavers with intact spines and then repeated after C5-C6 destabilization. A 3-dimensional electromagnetic tracking device was used to measure the maximum angular and linear motion produced during all test sessions. RESULTS: Although not statistically significant, the execution of the log roll maneuver created more motion in all directions than either the lift-and-slide technique or with scoop stretcher application. The scoop stretcher and lift-and-slide techniques were able to restrict motion to a comparable degree. CONCLUSION: The effectiveness of the scoop stretcher to limit spinal motion in the destabilized spine is comparable or better than manual techniques currently being used by primary responders.

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Although muscle power is an important factor affecting independence in older adults, there is no inexpensive or convenient test to quantify power in this population. Therefore, this pilot study examined whether regression equations for evaluating muscle power in older adults could be derived from a simple chair-rise test. We collected data from a 30-second chair-rise test performed by fourteen older adults (76 +/- 7.19 years). Average (AP) and peak (PP) power values were computed using data from force-platform and high-speed motion analyses. Using each participant's body mass and the number of chair rises performed during the first 20 seconds of the 30-second trial, we developed multivariate linear regression equations to predict AP and PP. The values computed using these equations showed a significant linear correlation with the values derived from our force-platform and high-speed motion analyses (AP: R = 0.89; PP: R = 0.90; P < 0.01). Our results indicate that lower-body muscle power in fit older adults can be accurately evaluated using the data from the initial 20 seconds of a simple 30-second chair-rise test, which requires no special equipment, preparation, or setting.

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