Chapter 1 Principles of Athletic Training

clinical bottom line

Definition: Minimum amount of change required for your patient to feel a difference in the variable being measured

1. Members shall respect the rights, welfare, and dignity of all 2. Members shall comply with the laws and regulations governing the practice of athletic training 3. Members shall maintain and promote high standards in their provision of services 4. Members shall not engage in conduct that could be construed as a conflict of interest or that reflects negatively on the profession

4 basic ethics principles determined by NATA for athletic trainers are what?

1. Develop a clinical question 2. Search the literature 3. Appraise/evaluate the strength of the evidence. 4. Apply the best-available evidence 5. Assess the outcomes and effectiveness

5-steps in Evidence-Based Practice are...?

centrally-placed certified athletic trainer, who may be full- or part-time as a nonteacher who serves a number of schools.

A way for school districts to save money for athletic training services is by hiring a .....

coordination and guidance of the medical aspects of the program. The medical director--who may be the team physician--should provide input to the program's educational content and provide classroom, laboratory and or clinical instruction

Accredited athletic training education programs must have a physician medical director who is responsible for what?

1. Regular hours 2. Few weekend or evening responsibilities 3. Opportunity for growth 4. Better pay

An athletic trainer in physician practice can expect...

The athletic trainer is responsible for designing, implementing, and supervising the rehabilitation program from the time of initial injury until return to full activity

An athletic trainer is responsible for which phases of a rehabilitation program?

Biomechanist

An individual who possesses some expertise in the analysis of human motion. Uses sophisticated video and computer-enhanced digital analysis equipment to study movement

intercollegiate and interscholastic athletes in the U.S.

Athletic Training as we know it came into existence during the late nineteenth century with the firm establishment of what?

A policy calling for certified athletic trainers to be employed in all secondary-school athletic programs; Though only a recommendation and not a requirement (Hawaii is the only state that requires Athletic Trainers in each school)

Based on a proposal from the American Academy of Pediatrics, in 1998, what policy did the American Medical Association adopt?

Philosophical opinions regarding injury management and rehabilitation programs; this will help minimize any discrepancies or inconsistencies that may exist

Because an athletic trainer must be given the flexibility to function independently in the decision-making process and must often act without the advice or direction of the physician, the physician and the athletic trainer should share the same what?

No, Adolescents cannot be approached either physically or emotionally in the same manner as adults. Athletic Trainers must be aware of patterns of growth and development and all the special considerations that this process brings with it.

Can adolescents be approached in the same manner as adults in terms of Athletic Training?

External clinical evidence

Definition: Clinically relevant research either from the basic sciences or medicine, or from patient-centered clinical research into the accuracy and precision of preventive, therapeutic, and rehabilitative techniques

evidence-based practice

Definition: Making decisions about the clinical care of individual patients based on the current best available evidence in the professional literature

Minimal Clinically Important Difference (MCID)

Definition: Patient-derived scores that reflect changes in a clinical intervention that are meaningful for the patient

pedagogy

Definition: The methods and practice of teaching

Individual clinical expertise

Definition: The proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice

At the college/professional level, full-time strength coaches are hired to design and oversee the total program while the athletic training advises on safe practices and alternatives. Whereas, at the secondary school level, an athletic training may be in charge of designing, implementing and overseeing the fitness and conditioning program

Describe the difference in strength coaching in a college/professional team versus at the secondary school level in terms of athletic trainers responsibility

Yes, they can be found working with dance companies, theater performance groups, TV and Movie sets, casinos and even touring bands

Do athletic trainers work in performance arts? If so where?

Summary-item instruments include single items and may be specific to either a region or disease

Explain Summary-Item Patient-reported outcome instruments

clinical techniques such as specific evaluative tests, certain rehabilitation techniques or the effictiveness of using therapeutic modalities

For athletic trainers, the evidence-based approach raises questions about what...

Usually secondary school level health services are organized so that one or two nurses conduct the program under the direction of the school physician, who may serve a number of schools in a given area or district

How are the health services usually organized at the secondary school level?

By maintaining an active lifestyle

How can individuals maintain a relatively high level of physiological functioning?

Ensure the patient is always informed and made aware of the why, how, and when that collectively dictate the course of an injury rehabilitation program

How can you prevent confusion in athletes that stem from conflicted guidance between coach and medical personal?

Much like a player, the athletic trainer is involved with only one sport and is paid according to contract. Playoff and championship money may be added to the yearly income

How does an athletic trainer working with a professional team compare to a player?

A through D with A being the highest

How does the scale: Grading of Recommendations Assessment, Development and Evaluation (GRADE) rate quality of Evidence?

1 to 5 with 1 being the highest. Levels 1,2, and 3 of evidence are further subdivided into subcategories a, b, and c again based on the type of study.

How does the scale: Oxford Centre for Evidence Based Medicine (CEBM) rate research-evidence strength?

faculty-athletic trainer capacity

If a secondary school or middle school hires an athletic trainer, it is very often in what type of capacity?

The Trainer's Bible

In 1917, S. E. Bilik wrote what text on athletic training and the care of athletic injuries?

National Athletic Trainers' Association (NATA)

In 1950, some 101 athletic trainers from various conferences met in Kansas City, Missouri to officially form what?

general patient care

In an outpatient ambulatory rehabilitation clinic an Athletic Trainer may employed to work in which type of care?

1. A brief medical history of exactly what happened, according to the athlete 2. Observation 3. Palpation 4. Special tests, which might include tests for range of motion, muscle strength, or joint stability or a brief neurological examination

In evaluating an immediate injury, the subsequent off the field examination should include what?

1. Is full-time 2. Does not teach 3. Works in the department of athletics 4. Is paid by the institution

In most colleges and universities, the athletic trainer...

1. Half-time teacher and half-time athletic trainer 2. If a physical therapist, then part of time in school health center and part of time athletic Training

In smaller colleges or universities, athletic trainers may have dual responsibilities; give some examples....

"A" is the highest "B" entails inconsistent or limited-quality, but patient oriented "C" is consensus, disease-oriented evidence, usual practice, expert opinion, or case series

In the Strength of Recommendation Taxonomy (SORT) scale, how is the strength of recommendation valued?

1930s

In what decade was the athletic profession officially formed

twentieth century

In which century did many professional organizations that are dedicated to achieving health and safety in sports develop?

Greek and Roman

In which early civilizations were there coaches, trainers, and physicians who assisted the athlete in reaching optimum performance?

general student body who participate in intramural and club sports

Increasingly at the college level, athletic training services are being offered to who other than NCAA athletes?

Physically active individuals

Individuals who engage in athletic, recreational, or occupational activities that require physical skills and utilize strength, power, endurance, speed, flexibility, range of motion, and agility are called?

1. Practice of medicine 2. Athletic Training 3. Sports Physical Therapy 4. Sports Massage Therapy 5. Sports Dentistry 6. Osteopathic Medicine 7. Orthotics/Prosthetics 8. Sports Chiropractic 9. Sports Podiatry 10. Emergency Medical Technician 11. Paramedics

Injury Care & Management includes which specializations in Sports Medicine?

fitness and injury rehabilitation programs for their employees

It is common for industries to employ athletic trainers to oversee....

proper care from an athletic trainer had been provided

Many of the physical problems that occur later from improperly managed sports injuries could be avoided initially if...

40%

More than what percent of certified athletic trainers are employed in clinics and hospitals

1. Influence patient Care 2. Provide meaningful information regarding the effectiveness of interventions 3. Contribute to the process of clinical reasoning 4. Enhances communication 5. Motivates patients

Name some benefits of using Patient-Centered/Rated Outcome MEasures?

1. Trash/removing objects 2. Workplace ergonomics 3. Equipment considerations/maintenance 4. Sanitation 5. Hot/Cold 6. Weather

Name some factors to consider to "ensure a safe playing environment by minimizing safety hazards"

1. universities, colleges and secondary schools 2. hospitals 3. Professional sports 4. performing arts and entertainment industry 5. medical equipment sales and support 6. military 7. law enforcement departments 8. government agencies

Nowadays, athletic trainers can be found in which programs and industries?

business, sales, or marketing of products that other athletic trainers may use

Opportunities are expanding for athletic trainers to use their educational background as preparation for working in.....

The most extensive prehospital care by administering drugs orally and intravenously, interpreting ECGs, performing endotracheal intubations and using more complex equipment

Paramedics provide what?

structured questionnaires that have been demonstrated to provide meaningful, quantitative assessments of how the patient feels and how they are able to function with their disorders as a result of a treatment or intervention

Patient-centered/Rated Outcome Measures is used to gather information directly from the patient using what?

1. Exercise Physiology 2. Biomechanics 3. Sports Psychology 4. Sports Nutrition 5. Strength & Conditioning 6. Coaching 7. Personal Fitness Training

Performance Enhancement includes which specializations in Sports Medicine?

Physician Assistant is licensed to triage, conduct patient evaluations, diagnose and treat patients, arrange for various hospital-based diagnostic tests, and prescribe meds without conferring with a physician

Person trained to assume many of the responsibilities for patient care traditionally done by a physician.

Nurse Practitioner. NPs can diagnose and treat common acute and chronic problems, and prescribe and manage medications

Person who is a registered nurse with advanced education and clinical training.

Sports Chiropractor make use of spine and extremity manipulations

Physician that emphasizes diagnosis and treatment of mechanical disorders of the musculoskeletal system, believing that these disorders affect general health by way of the nervous system

Osteopath (DO)

Physician that emphasizes the role of the musculoskeletal system in health and disease, using a holistic approach to the patient

Physiatrist

Physician that provides integrated care in the prevention, diagnosis, and treatment of disorders to the brain, muscles, and bones

Internist

Physician who specializes in the practice of internal medicine.

Occupational Therapist

Physician who works with patients who have conditions that are mentally, physically, developmentally, or emotionally disabling to improve their ability to perform tasks in their daily living and working environments

1. To upgrade the field by devising and maintaining a set of professional standards, including a code of ethics 2. To bring together professionally competent individuals to exchange ideas, stimulate research and promote critical thinking 3. To give individuals an opportunity to work as a group with a singleness of purpose, thereby making it possible for them to achieve objectives that, separately, they could not accomplish

Professional organizations that are dedicated to athletic training and sports medicine have many goals including....

Fluid, The athletic trainer must establish both short-term and long-term goals for the process and then be able to modify the program to meet those goals.

Should a rehabilitation program be strict and rigid or fluid?

yes, athletes should be taught techniques of training that may reduce likelihood of injury and be well informed about their injuries.

Should an athletic trainer make it a priority to educate the athlete about injury prevention and management?

1. Excessive anger 2. Blaming others 3. Guilt 4. Being tired all day 5. Sleep problems 6. High absenteeism 7. Family problems 8. Selfpreoccupation

Signs of burnout include....?

1. Establishment of a certification exam 2. Recognition of athletic trainers as health care providers 3. Increased diversity of practice settings 4. The passage of practice acts that regulate athletic trainers in most states 5. Third-party reimbursement for athletic training services 6. Ongoing reevaluation, revision, and reform of athletic training educational programs

Since 1950, many positive milestones have occurred that have collectively shaped the future direction of Athletic Training including...?

Certified Athletic Trainer

Someone who is a specialist in athletic training that provides healthcare to physically active individuals is called a ...?

Trainer

Someone who trains dogs or horses or functions in coaching or teaching areas is called a...?

More advanced techniques than EMT, the AEMT is trained to administer IV fluids, use manual defibrillators, and apply advanced airway techniques

The AEMT is trained to do what?

First Aider

The Cramer family, in Kansas, published WHAT newsletter in 1932?

1. The origin of the existing pathology 2. The organ level, which describes specific impairments associated with that body system 3. The person level, which looks at specific functional limitations 4. Social implications created by the patient's disability and its effect on quality of life

The Disablement Model is a Clinician centered model that provides patient-oriented evidence, what is stressed across all applications of this model?

To care for patients at the scene of an accident and while transporting patients by ambulance

The EMT is trained to do what?

Generic Instruments look at a broad range of aspects of health status and consequences of illness or conditions that may be found in a wide range of healthy populations

The GENERIC Type of Patient reported Outcome do what?

1. Educate students 2. Understand basic principles of learning and pedagogy 3. Stay informed 4. Evaluate student knowledge 5. assist in helping students secure a professional position 6. Help students learn how to use online databases to access the most recent evidence 7. Expose students to leadership qualities and positions

The athletic trainer as an educator should:

1. Conducting preparticipation exams 2. Ensuring appropriate training and conditioning of the athlete 3. Monitoring environmental conditions to ensure safe participation 4. selecting, properly fitting, and maintaining protective equipment 5. Making certain that the athlete is eating properly 6. Making sure the athlete is using medications appropriately, while discouraging substance abuse

The athletic trainer can minimize the risk of injury by doing what?

6-8 months; the other 4-6 months are spent in off-season conditioning and individual rehabilitation

The athletic trainer for professional sports teams usually performs specific team athletic training duties for how many months of the year?

1. The principles and concepts of workplace, including inspecting, measuring and observing dimensions of the work space as well as specific tasks performed at the workstation. 2. Wellness programs and provide education and individual counseling

The athletic trainer working in an industrial or occupational setting must have a sound understanding of .....

Patient's specific clinical circumstances and wishes

The best available research evidence should be integrated with WHAT to come up with a correct and meaningful decision about management?

1. Injury Prevention 2. Evaluation 3. Diagnosis 4. Management and rehabilitation 5. Health education 6. Nutrition 7. Training and conditioning 8. Preparticipation physicals 9. Maintenance of essential documentation

The educational preparation for athletic trainers allows them to function in a variety of domains, including what...

1. Performance enhancement 2. Injury care and management

The field of sports medicine encompasses a number of more specialized aspects of dealing with the physically active or athletic populations that may be classified as either...?

Exercise, medicine, physical therapy, physical education, and sports

The history of athletic training draws on the 5 disciplines of...

in clinics and hospitals

The largest percentage of certified athletic trainers are employed where?

To improve and maintain an individual's functional capacities for physical labor, exercise, and sports

The purpose of all disciplines of sports medicine is to do what?

Clinical expertise and external clinical evidence

The two subdivisions of an Evidence Based Practice are what...?

1. A taping and treatment table 2. An ice machine 3. A few free weights

Treatment equipment should at least include which three things?

1. Generic 2. Dimension-specific 3. Disease-specific 4. Site or region specific 5. Summary-item

Types of Patient-Reported Outcome Scales include...

1. Ergonomic assessment 2. Work hardening/occupational 3. CPR training 4. Overseeing drug-testing programs

What additional responsibilities could an athletic trainer have in a hospital clinic other than general patient care and emergency room responsibilities?

Between the ages of 18 and 40

What ages to people tend to peak in reference to performance capabilities?

Disease-specific instruments are specific to a particular patient group that share a common disease

What are Disease-specific Type of Patient Reported Outcome instruments used for?

1. Injury/Illness prevention and wellness promotion 2. Examination, assessment, and diagnosis 3. Immediate and emergency care 4. Therapeutic intervention 5. Healthcare administration and professional responsibilities

What are the 5 Domains of Athletic Training?

1. Emergency Medical Responder (EMR) 2. Emergency MEdical Technician (EMT) 3. Advanced EMT (AEMT) 4. Paramedic

What are the four levels of emergency medical service (EMS) providers?

1. Stamina and ability to adapt 2. Empathy 3. Sense of humor 4. Ability to communicate 5. Intellectual curiosity 6. Ethics

What are the personal qualities of the athletic trainer?

Appropriate Medical Coverage for Intercollegiate Athletics (AMCIA)

What did the NATA Task Force establish that made recommendations for the number of athletic trainers who should be employed at a college or university based on a mathematical model?

Dimension-specific instruments focus on one specific aspect of health status concentrating primarily on psychological well-being

What does the Dimension-specific type of Patient Reported Outcome instruments focus on?

National Athletic Trainers' Association

What does the acronym NATA stand for?

Patient condition or problems Interventions that are possible treatment options Comparison of the alternatives that might be used in the intervention Outcome that you want the patient to achieve

What does the acronym PICO stand for?

Range from a department operating with one or two nurses and a physician available on a part-time basis to an elaborate setup comprised of a full complement of nursing services with a staff of full-time medical specialists and hospital facilities

What is the range of capabilities among college and university health services?

patient or client

What is the term for ill or injured athlete

Athletic Training clinic or facility

What is the term that refers to a health care facility for treating individuals who have an illness or injury?

Making sure the athlete is fit and thus able to handle the physiological and psychological demands of competition

What may be the most important aspect of injury prevention?

athletic training

What phrase has traditionally been known as the field that is concerned with the Athlete's health and safety

1. Health 2. Wellness 3. Performance enhancement 4. Clinic administrators

What responsibilities may an athletic trainer have that is employed in a hospital emergency room?

The inured patient

What should always be the major concern of an athletic trainer?

The occupational, industrial, or worker "athlete"

What term describes someone who often engages in strenuous demanding, or repetitive physical activities while performing his or her job?

Physical activity

What term is defined by consisting of athletic, recreational, or occupational activities that require physical skills and utilize strength, power, endurance, speed, flexibility, range of motion, and agility?

training

What word implies the act of coaching or teaching?

the individual cannot provide the level of service usually required by a typical school

Whats a problem associated with a centrally-placed certified athletic trainer servicing a district of schools?

Research data that clearly document effectiveness in reducing or preventing injury

When "Selecting, Fitting and Maintaining protective Equipment", Athletic trainers should make purchasing specific pieces or brands based on what?

coaches

When an athletic trainer is not present on a sport's program, who takes over and assumes that role?

Individuals under age 40, who have no apparent injury can begin an exercise program without further medical evaluation. Individuals 40 and over or who are at high risk, should have a complete medical examination and undergo an exercise test before beginning a program.

When beginning an exercise program, what are the medical recommendations for healthy individuals based on age?

1. Are the results valid, and did the study measure what it was supposed to measure. 2. If the study is valid, what is the clinical significance of the study 3. If the results are valid and clinically important, are the results applicable to the patient

When critically assessing the results of a study, the evidence-based medicine approach requires you to answer what three primary questions?

PICO or PIO

When developing a clinical question, which format should be used"

1. Community-based services available 2. Insurance or managed care plan coverage available for athlete

When referring an athlete for evaluation, the athletic trainer must be aware of what?

Generic instruments should be used in initial examinations and then follow-ups and reevaluations

When should Generic type of patient reported outcome instruments be used?

Cramer

Which family in Kansas started a chemical company that produced liniment to treat ankle sprains in the 1920s?

All phases including preventing injuries from occurring, providing initial first aid and injury management, evaluating injuries, and designing and supervising a timely and effective program of rehabilitation that can facilitate the safe and expeditious return to activity

Which phases of health care are athletic trainers responsible for?

Strength of Recommendation Taxonomy (SORT)

Which scale to assess the level or quality of the evidence in a specific research study does NATA use?

Global Rating of Change (GRC)

Which scales are commonly used in clinical research particularly with musculoskeletal injuries

An athletic trainer often has an advantage in that he knows the inured athlete well, including how the athlete responds to injury, how the athlete moves, and how hard to push to return the athlete safely to activity.

Who does the physician rely on for recommendations on an athletes health status?

The team physician

Who is in charge of compiling medical histories and conducting physical examinations for each athlete?

Team physicians determine when a recommendation should be made that an athlete be disqualified from competition on medical grounds and must have the final say as to when an injured athlete may return to activity.

Who must have absolute authority in determining the health status of an athlete who wishes to participate in the sports program?

physician

Who should be an advisor to the athletic trainer when able?

S. E. Bilik

Who was the physician who wrote the first major text on athletic training and the care of athletic inuries in 1917?

empathy

definition: the capacity to enter into the feeling or spirit of another person

burnout

definition: used to describe feelings of exhaustion and disinterest toward work

traditional setting

employment at colleges, universities and in secondary schools that provides services almost exclusively to an athletic population is refferred to as WHAT for athletic trainers?

liniment

is a medicated topical preparation for application to the skin

1. Availability at every scheduled practice or contest of qualified persons 2. Planned access to a physician by phone or nearby presence for prompt medical evaluation of the health care problems that warrant this attention 3. Planned access to a medical facility, including plans for communication and transportation

the effectiveness of athletic health care service can be evaluated only to the extent to which it meets what criteria?

Site or region specific instruments assess health problems in a specific part of the body

what do Site or Region specific Patient-Reported Outcome instruments do?

Therapeutic exercise that forces the inured anatomical structure to perform its normal function

what is the key to successful rehabilitation in terms of therapeutic exercises?

athlete

what term refers to a physically active individual who participates in recreational or organized sport activities who is not injured?