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?