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Intra- and Interrater Reliability of the Directional Balance and Reach Tests With and Without Rotation

Larry R. Munger, Jean-Michel Brismée, Phillip S. Sizer, and C. Roger James

This study investigated whether the directional balance and reach with and without rotation is a reliable screening tool to measure dynamic balance and ability to control motion in three planes. Twenty healthy, collegiate athletes participated. The directional balance and reach exhibited good to excellent levels of intra- and interrater reliability (intraclass correlation coefficient = .77–.99). The directional balance and reach provides clinicians with a reliable method that requires minimum financial, spatial, and temporal costs to administer in small and large screening, training, and evaluation programs to recognize asymmetries and deficits in assessing dynamic balance in all three planes of motion.

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Continuing Education Assessment

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Volume 27 (2022): Issue 6 (Nov 2022)

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Concussion Management Among National Collegiate Athletic Association Swim Programs

Katie Ritter, Ashley N. Marshall, Keenan Robinson, Dilaawar J. Mistry, Meeryo C. Choe, and Tamara Valovich McLeod

The nuances of swimming make the application of traditional return-to-play progressions following concussion challenging. Our purpose was to describe athletic training services and concussion management protocols among National Collegiate Athletic Association swim programs and compare them between the National Collegiate Athletic Association divisions. We surveyed 228 athletic trainers assigned to or with knowledge of their institution’s swim programs from a convenience sample of 539 (response rate = 42.3%) athletic trainers. Athletic training services were provided to 98.6% (214/217) of the programs. Nearly 80% (164/207) of the programs administered baseline concussion testing to swimmers, with differences observed between divisions (p < .001). No differences (p = .108) in the number of concussions sustained by swimmers in the past academic year were noted between divisions. Specific return-to-swim protocols were reported by 51.8% (115/222) of respondents with no differences in the presence of a specific return-to-swim protocol between divisions (p = .790). While concussions are reported less frequently in swimming than other sports, appropriate medical care, including a specific return-to-swim protocol, is warranted and provided for future use.

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Health-Related Quality of Life Among Patients With Painful Chronic Ankle Instability

Kyle B. Kosik, Matthew C. Hoch, Stacey Slone, Katherine A. Bain, and Phillip A. Gribble

More than half of individuals with chronic ankle instability (CAI) experience lingering pain from a previous injury. However, there is little empirical evidence investigating the role pain has on health-related quality of life (HRQL). The purpose of this cross-sectional study was to compare physical and psychological HRQL between CAI individuals with and without pain. Group comparisons demonstrated that CAI individuals with pain displayed a lower physical and mental HRQL than those without pain. In addition, CAI individuals with pain reported greater injury-related fear. These findings suggest that persistent pain compounds the negative effect that ankle joint instability has on physical and mental HRQL outcomes. Therefore, conservative therapies should consider multimodal approaches rather than focusing on joint stability alone.

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The Need for Contextual Intelligence in Athletic Training

Matthew R. Kutz

Athletic training and the environment in which it is practiced is constantly changing. The emergent environment is volatile, uncertain, complex, and ambiguous. This new environment necessitates an adjustment to athletic training education particularly as it pertains to the instruction and development of the nonclinical skills (meta-skills) needed for clinical settings. One such meta-skill is contextual intelligence. Contextual intelligence is the capacity to recognize the convergence of different variables and respond to the emerging context as it is developing. Practicing contextual intelligence includes integrating 12 specific behaviors and the 3D thinking framework of hindsight, insight, and foresight into clinical decision making.

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NATA News & Notes

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Athletic Trainers’ Perceptions of Patient-Reported Outcomes After Completing a Clinic-Wide Implementation Program

Lauren M. Gardner, Tricia M. Kasamatsu, and Melissa M. Montgomery

Patient-reported outcomes (PROs) are important for capturing patients’ perspectives on quality of life and aiding in provision of whole-person patient care; yet, PROs are not routinely used in athletic training practice. We investigated the athletic trainers’ perceptions of using PROs after they had completed a required PRO implementation program. Athletic trainers had positive perceptions after integrating PROs into clinical practice. Barriers associated with PRO use may be improved with a support structure that requires accountability and provides resources such as reminders and professional development to recognize ways that PROs can be used to improve patient care.

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The Neuromatrix Theory of Pain and Transactional Theory of Stress and Coping: Improving Understanding of Pain Catastrophizing in Individuals With ACL Reconstruction and Knee Osteoarthritis

Francesca M. Genoese, Matthew S. Harkey, and Shelby E. Baez

Individuals with anterior cruciate ligament reconstruction and early knee osteoarthritis symptoms commonly exhibit psychological impairments, such as pain catastrophizing. Pain catastrophizing is a negative cognitive–affective response to anticipated or actual pain and has been linked to greater pain intensity and decreased function in this population. However, an examination of the neuromatrix theory of pain and the transactional theory of stress and coping may help to explain the development and consequences of pain catastrophizing in individuals with anterior cruciate ligament reconstruction and early knee osteoarthritis symptoms. Exploration of these theoretical models will help clinicians better understand the impact of pain catastrophizing on post-injury outcomes, as well as help to identify intervention strategies to address maladaptive psychological responses and improve outcomes for individuals with anterior cruciate ligament reconstruction and early knee osteoarthritis symptoms.

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Clinician Impact on Athlete Recovery and Readiness in a 24-Hour Training Cycle

Dana P. Golden and Jay N. Hertel

This paper explores a 24-hr training cycle and how clinicians contribute to an athlete’s transition from recovery to readiness. The cycle is divided into three phases: immediate, intermediate, and extended. Phase break down is meant to provide wellness prioritization for the athlete and how the clinician can facilitate sustainable performance during a competitive season.