Clinical Scenario: Fluctuations in hydration can threaten health and performance in otherwise healthy individuals. Identifying a practical and efficient hydration assessment is essential to monitoring hydration status and avoiding severe fluctuation. A proposed, field expedient method suggests simultaneous analysis of body weight, urine color, and perceived thirst (WUT) through a Venn diagram. Focused Clinical Question : Is the WUT system a valid indicator of hydration status in healthy individuals? Summary of Key Findings : Four laboratory cohort studies were included in this critically appraised topic. One evaluated the efficacy of first-morning WUT samples, finding strong findings for WUT0 (none of the categories are met) and WUT3 (all categories are met), but inconsistent findings for WUT1 and WUT2. One evaluated the application of WUT across different time points and at differing hydration levels, finding positive results for WUT3 and WUT2. One evaluated the efficacy of WUT in participants experiencing body water manipulation, finding that WUT can assess hypohydration in individuals. The last study evaluated the efficacy of self-reported WUT samples, finding overall low diagnostic accuracy. Clinical Bottom Line : The WUT Venn diagram is inconsistently supported across the literature. Investigators reported WUT0 and WUT3 appear to provide a valid indication of hypohydration and euhydration, respectively. Strength of Recommendation: There is Grade B evidence that the WUT Venn diagram is a valid indicator of hydration status in healthy individuals at extreme scores.
This study investigated the effects of three different 6-week interventions—Sensory Targeted Ankle Rehabilitation Strategy (STARS) alone, balance training alone, and a sequentially integrated STARS and balance training on postural control, dorsiflexion range of motion, self-reported function, and kinesiophobia in athletes with chronic ankle instability. Thirty-five athletes were assigned to one of the three intervention groups. A 2 × 3 mixed repeated-measures analysis of variance revealed no significant Time × Group interactions and no significant group main effects for any outcome (all p > .05). However, significant time main effects were observed for all outcomes (all p < .001), indicating comparable improvements across all three intervention groups, with large effect sizes observed within each group for the majority of outcomes. STARS alone produced improvements comparable to balance training alone, and a sequentially integrated STARS and balance training across all measured outcomes associated with chronic ankle instability.
Delayed visuomotor reaction time has been linked to slower motor responses and increased injury risk, emphasizing the need for accurate and repeatable assessment tools. Portable light-based systems offer an accessible method for evaluating visuomotor reaction time, but their reliability for upper-extremity tasks has not been established. This study examined the test–retest reliability of an upper-extremity visuomotor reaction time task using a novel portable light-based device. Forty healthy participants completed two sessions 7–10 days apart, performing a 60-s task in which nine light-emitting diode targets illuminated in a randomized sequence and were deactivated as quickly as possible. Reaction time, total hits, and total misses were recorded, and reliability was assessed using intraclass correlation coefficients (ICCs). Reaction time (ICC = .80; 95% confidence interval [.62, .89]), misses (ICC = .83; 95% confidence interval [.67, .91]), and hits (ICC = .76; 95% confidence interval [.54, .87]) demonstrated good test–retest reliability. These findings indicate that this portable system provides consistent measures of upper-extremity reaction time and task accuracy in healthy individuals. The tool may offer a practical option for clinicians and researchers assessing visuomotor performance, with future work needed to determine its utility in injury risk screening and clinical populations.
Exertional heat stroke is a leading cause of death in youth athletes, yet adoption of heat safety policies varies across U.S. regions. We examined whether high schools in warmer heat regions demonstrated greater adoption and comprehensiveness of heat safety policies than those in cooler regions. Athletic trainers from 636 high schools reported adoption of heat safety prevention and recognition components, with schools classified into three wet-bulb globe temperature–based regions. Schools in warmer regions had higher overall adoption and more comprehensive prevention policies than those in cooler regions. Within regions, policy adoption generally did not differ by frequency of days exceeding region-specific “green flag” wet-bulb globe temperature thresholds. These findings suggest regional disparities in heat safety preparedness and highlight opportunities to reduce exertional heat stroke risk as heat exposure increases nationwide.
Heat safety policies and athletic training (AT) services are key components for preventing and managing exertional heat illness in high schools, but their association with best practice adoption remains unclear. We examined associations among AT services, state- and school-level heat safety policies, and best practice adoption in 293 high schools across 10 states. Higher state policy scores and school-based policy presence were associated with greater best practice implementation and higher odds of full-time AT service. Schools with an AT, especially full-time AT service, were more likely to implement best practice items, with full-time AT service associated with 24% more environmental monitoring best practice items than no AT service.
