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Official Journal of the American College of Sports Medicine when compared to the smaller (1A-2A) schools. CONCLusIONs: These results suggest the larger schools (3A-4A) have greater access to an increased level of Sports Medicine coverage and as such appear to have an increased level of care for their high school student-athletes. Based on these results, there is a clear trend towards the smaller schools being at a disadvantage when it come is having an acceptable standard of “Sports Medicine coverage” at their schools. 1501 Board #93 May 30, 2:00 PM - 3:30 PM assessing the Impact of youth Climate differences in Elite Major League Baseball Pitchers Gregory Paul Kolovich, Lorena Floccari, Mark Schickedantz, David C. Flanigan, Grant L. Jones, Michael Griesser. Wexner Medical Center at The Ohio State University, Columbus, OH. (No relationships reported) PurPOsE: Recent studies demonstrate the detrimental effects on the glenohumeral joint by repetitive throwing at an early age in organized youth baseball. Pitchers born in warmer climates are more likely to throw year round, as opposed to pitchers born in colder climates, where young pitchers are likely to take a break from throwing during the winter. The purpose of this study was to investigate whether youth climate differences affect longevity of elite MLB pitchers. METhOds: Data were collected from all 710 Major League Baseball (MLB) pitchers who compiled a minimum of 1500 career innings. Forty pitchers were excluded from the study as they were currently active on a MLB roster in 2011 bringing the total to 670 MLB pitchers. Six outcome variables were investigated: career innings, career wins, career losses, career complete games, career games started, and career years pitched. rEsuLTs: We found that MLB pitchers born in regions with colder average temperatures (Canada, Europe, Midwest US, and Northeast US) compiled an average of 187 more career innings (2497 v. 2310 p < 0.0049), had 13 more career wins (153 v. 140 p < 0.005), and had 49 more career complete games (153 v 104 p < 0.000) than pitchers born in regions with warmer average temperatures (Southeast US, Southwest US, West US, Latin America, and Asia). CONCLusIONs: MLB pitchers born in regions with colder average temperatures are more likely to break from throwing during the winter season. These colder weather youth pitchers compiled greater career innings, career wins and career complete games suggesting that pitching year round at an early age may be detrimental to the longevity of Major League pitchers. These findings support the need for continued pitch count regulation in youth baseball as well suggest a need for monitored rest from throwing during the offseason. 1502 Board #94 May 30, 2:00 PM - 3:30 PM Preparticipation Physical Evaluation Forms and Implementation Policies differ across united states high school athletic associations Mary C. Chabolla, Amanda M. Caswell, Jatin P. Ambegaonkar, Nelson Cortes, Shane V. Caswell. George Mason University, Manassas, VA. (No relationships reported) The American Academy of Pediatrics’ (AAP) Preparticipation Physical Evaluation 4 th edition (PPE) monograph contains guidelines for screening and determining eligibility for United States (US) high school athletes. However, evidence of how PPEs are being implemented and AAP whether guidelines are being followed is lacking. PurPOsE: To investigate current PPE policies and practices in US high school athletic associations (HSAA). METhOds: We accessed publicly available PPE forms, policies, and procedures documents from all 50 states’ and the District of Columbia’s HSAA. We analyzed the content of PPE documents from each state using an electronic coding form for: A) policy existence, B) update frequency and C) format of PPE and examined requirements of the frequency of administration, and D) providers approved to perform PPEs. The PPE content was analyzed to determine whether a heart health history (HHR) component was included. Analyses were calculated for all PPE content items. rEsuLTs: Forty-nine states (96%) require that PPEs be completed for HS sport participation eligibility, while in 2 states (4%) it is recommended. Seventeen (33%) states either recommended (13.7%) or required (19.6%) use of the AAP 4th edition PPE form. Fifteen (30%) states revised PPE forms in 2012, while 5 (
<strong>Thursday</strong>, May 30, 2013 S292 Vol. 45 No. 5 Supplement CONCLusION: A positive significant correlation between the Single hop and Triple hop tests suggests that assessment of patients’ physical function by either test might provide relatively comparable data. There was also a significant correlation between knee passive laxity (anterior tibial translation) measured by application of 150N force and maximal manual force using an arthrometer, suggesting that these measures can be used interchangeably. Questionnaire results were not correlated with any of the objective measures. Further investigation on a larger population is underway. Investigation of correlations between the results of functional tests and KT arthrometer measurements may help inform clinical decision-making. 1505 Board #97 May 30, 2:00 PM - 3:30 PM Quadriceps strength, Not activation, Improves in the unexercised Limb Following a single-Legged Eccentric Exercise Program Lindsey Lepley, Riann Palmieri-Smith. University of Michigan, Ann Arbor, MI. (No relationships reported) Following injury, eccentric exercise of the injured limb is often contraindicated. Crosseducation training, whereby the uninvolved limb is exercised, is an alternative that may improve quadriceps strength and activation in the unexercised limb. Understanding the benefits of eccentric cross-education training can help determine if this exercise regimen can be used in individuals post-injury. PurPOsE: Determine if eccentric exercise is capable of producing quadriceps strength and activation gains in the unexercised limbs of healthy participants. METhOds: Eccentric exercise group (EX; 4f/5m; age 23.3±2.4 yrs; height 1.7±0.1 m; mass 70.6±14.3 kg) and control group (CNTRL; 6f/3m; age 22.6±3.6 yrs; height 1.7±0.1 m; mass 66.7±10.1 kg) had quadriceps strength and activation measures collected at pre-, mid- and post-intervention time points. EX participants exercised their dominant limb with an isokinetic dynamometer in eccentric mode at 60°/sec, three times per week for eight weeks. Quadriceps strength was quantified at 30 and 60°/sec in concentric and eccentric modes. Quadriceps activation was assessed using the burst superimposition technique and quantified via the central activation ratio. 2x3 Repeated Measures ANOVA was used to detect the effects of group and testing session on quadriceps strength and activation. Where appropriate, post hoc Bonferroni multiple comparison procedures were used. rEsuLTs: Greater eccentric quadriceps strength was found in the unexercised limbs of EX participants between the pre-to-mid and pre-to-post intervention time points (30°/sec (Nm/kg): Pre=2.2±0.2, Mid=3.4±0.4, Post=3.5±0.4, Pre-to-Mid P=0.05, Pre-to-Post P=0.02; 60°/sec: Pre=2.1±0.2, Post=3.9±0.5, P=0.02). No differences were noted between the mid-to-post time point (30°/sec P=0.06; 60°/sec P=0.18) or in concentric strength (P>0.05). No gains in quadriceps activation were detected (P=0.06). CNTRL participants strength did not change (P>0.05). CONCLusION: Exercising with eccentric contractions resulted in mode specific gains in quadriceps strength in the unexercised limbs of healthy participants at four weeks. No gains in quadriceps muscle activation were detected. Rehabilitation programs can utilize this type of eccentric exercise to safely improve quadriceps strength in the injured knee. 1506 Board #98 May 30, 2:00 PM - 3:30 PM Platelet rich Plasma: Improvement in Pain by anatomical site and Number of Injections Bronson Elizabeth Delasobera1 , Neal Shelley1 , Scott Robinson2 , Garry Ho, FACSM3 , Thomas Howard, FACSM3 . 1Georgetown University, Washington, DC. 2United States Army, Lacey, WA. 3Virginia Commonwealth University, Fairfax, VA. (No relationships reported) INTrOduCTION: Platelet rich plasma (PRP) treatment has been used for years in the sports medicine community, but there are very few studies evaluating its efficacy. We measured pain scores following PRP injections in a variety of anatomic sites, receiving either single or multiple injections. Our null hypotheses were that, among patients treated with PRP: 1) there are no significant differences in mean pain by anatomic region and 2) there is no significant difference in mean pain scores between patients receiving either single or multiple injections. METhOds: Study type: a retrospective, survey-based, cohort study. Setting: an academic sports medicine clinic where PRP injections are frequently performed. Subjects who received PRP injections completed surveys to quantify their pain and percent improvement. Each subject filled out the survey approximately one month post-injection and reported three pain scores: within 72 hours post-injection (PS1), one week following injection (PS2), and approximately one month following injection (PS3). Descriptive statistics and hypothesis testing (using a one way analysis of variance or Student’s t test where appropriate) were performed. Alpha was set at 0.05 for all comparisons. rEsuLTs: One hundred thirty five patients, who received two hundred PRP injections, were included for study. Overall, patients reported a 49.2% (95% CI: 45.2- 54%) mean improvement in pain scores (for combined single and multiple injection subjects). The mean percent improvements in pain scores by anatomic sites were not significantly different (p=0.58; see Table and Figure below). The mean percent MEDICINE & SCIENCE IN SPORTS & EXERCISE ® improvement (regardless of anatomical site) for patients who received multiple injections (mean 58.9%; 95% CI: 50.9-66.9%), compared to those who received a single injection (mean 54.3% (95% CI: 47.8-60.8%) was not significantly different (p=0.4). CONCLusIONs: PRP injections (combined single and multiple) are associated with a significant improvement in reported pain one-month post injection. PRP injections are most effective for thigh injuries, and least effective for hip injuries. We identified no significant difference in pain scores for patients receiving single vs. multiple injections. 1507 Board #99 May 30, 2:00 PM - 3:30 PM Gold Medal sports Medicine: Integrative Model of Medical Care during International Competition John P. Vardiman1 , Jake Siedlik1 , Michael Cooper1 , Russell Emmons1 , William Moreau2 , Dustin Nabhan3 , Jenna Street3 , Philip M. Gallagher1 . 1University of Kansas, Lawrence, KS. 2United States Olympic Committee, Colorado Spring, CO. 3United States Olympic Committee, Colorado Springs, CO. (Sponsor: Joseph Weir, FACSM) (No relationships reported) Many manual therapy techniques and therapeutic modalities are utilized to return patients to functional activities or activities of daily living. Assessing the change in a patients perception of their functional ability after receiving Instrument Assisted Soft Tissue Mobilization (IASTM) treatment has yet to be determined. PurPOsE: The purpose of this project was to assess the efficacy of the Instrument Assisted Soft Tissue Mobilization (IASTM) technique at changing a patient’s functional ability as well as their perception of functional ability of the functional squat test. METhOds: Twenty-four college-aged students (20.96±1.27 years, 62.11±13.11 kg, 168.52±9.08cm) participated in this study. Eleven subjects (8 female, 2 male) were randomly selected to receive the IASTM treatment (TG) and 13 subjects (11 female, 3 male) were randomly selected for the control group (CG). All subjects completed the Perception of Functional Ability Questionnaire (PFAQ) and then performed a baseline functional squat test using a 3-D Marker-less Motion Capture System (Dynamic Athletics, Overland Park, KS). The TG received a bilateral IASTM treatment to the posterior lower leg and the CG rested in a prone position for 10 minutes and did not receive the treatment. After the IASTM or 10 minute rest period all subjects performed a follow-up functional squat test in the motion capture system and completed a followup PFAQ. All pre-test post-test data was analyzed using a 2x2 repeated measures ANOVA (p
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