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Disagreement of Rehabilitation Adherence Perceptions Among Athletic Trainers and Injured Collegiate Athletes

Luis Torres, Shala E. Davis, Colleen A. Shotwell, and Fredrick A. Gardin

Collegiate athletic trainers continue to report adherence to physical rehabilitation programs to be a problem in collegiate athletics, as rehabilitation adherence among collegiate athletes can range between 40% and 90%. Inconsistent appropriate adherence to these programs may limit patients’ ability to successfully recover from their sports injuries. This study sought to understand if differences in perception of rehabilitation adherence existed between athletic trainers and collegiate athletes. A nonsignificant fair inverse correlation was found between the athletic trainer perceptions and patient self-perceptions of rehabilitation adherence after an examination of 19 separate physical rehabilitation programs led by 5 collegiate athletic trainers (R = −.48, p = .06). Given the found practitioner–patient disconnect, collegiate athletic trainers should consider further encouraging patient involvement within their rehabilitation programs through various tactics such as the use of patient-rated outcomes or conversations that minimize patient distress.

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Professional Identity in Irish Certified Athletic Therapists

Siobhán O’Connor, Oran Lavelle Hayes, and Kate Sheridan

Professional identity is an important construct that considers an individual’s own values, beliefs, attitudes, and motives surrounding their own role in their profession. No research has examined this concept in athletic training/therapy beyond the U.S. context. We examined professional identity in Irish certified athletic therapists (n = 81) using the Professional Identity and Values Scale. Participants presented with a total Professional Identity and Values Scale score of 92.0 ± 9.9. Age (r = .26, p = .02; r = .27, p = .02) and years of experience (r = .29, p = .01; r = .32, p = .0004) were positively correlated with total Professional Identity and Values Scale score and professional development subscale score, respectively. No gender differences were observed (p > .05). Despite being a new emerging profession, Irish athletic therapists presented with a strong professional identity.

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Optimizing Health-Related Outcomes Following Musculoskeletal Injury Through the Integration of Self-Efficacy Theory and the Fear Avoidance Model

Bridget M. Walsh, Ke’La H. Porter, and Matthew C. Hoch

A primary goal of rehabilitation is to produce optimal health-related quality of life outcomes, which includes returning patients to their desired level of activity. Injury-related fear, kinesiophobia, and fear-avoidance beliefs are psychological factors that negatively impact health-related quality of life and are associated with decreased levels of physical activity. Conversely, increased levels of self-efficacy have been linked to favorable rehabilitation outcomes. To promote full recovery and optimal health-related quality of life, the rehabilitation process should consider addressing self-efficacy and injury-related fear (e.g., kinesiophobia, fear-avoidance beliefs). Therefore, the purpose of this paper is to introduce a theoretical framework which integrates self-efficacy theory and the Fear-Avoidance Model to mitigate injury-related fear and optimize patient outcomes following musculoskeletal injury. The intention of this theoretical framework is to provide clinicians with psychosocial interventions to improve self-efficacy and prevent the progression of injury-related fear at varying times throughout the rehabilitation process.

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Epidemiology of Shoulder Dislocations Presenting to Emergency Departments in the United States, 2007–2020

Rebecca R. Rodriguez and Kenneth C. Lam

Context: Shoulder dislocations are the most commonly treated joint dislocation in the emergency department. Zacchilli and Owens previously reported on the epidemiology of shoulder dislocations presenting to the emergency department in the United States from 2002 to 2006. At the time of data collection and analysis, no epidemiological report had been published to update these findings. Purpose: The purpose of our study was to provide an updated epidemiological report from 2007 to 2020. Results : A total of 26,203 shoulder dislocations were recorded in the National Electronic Injury Surveillance System database from 2007 to 2020. The highest rates occurred in males (71.4%, n = 18,722) and patients aged 20–29 years old (28.2%, n = 7,292). The most common mechanism of injury was sports involvement (48.6%, n = 12,735). Interpretation: Our findings suggest that rates of shoulder dislocations have remained consistent with previous research on this topic, indicating no significant changes over the past 19 years. More effective prevention strategies are needed, especially for at-risk populations.

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Pain Mechanosensitivity in Individuals With and Without a History of Lateral Ankle Sprain: A Critically Appraised Topic

Ilana Patlan, Elisabeth Ohrnberger, and Kyle B. Kosik

Clinical Scenario: Pain is a common symptom experienced by individuals who sustain an acute lateral ankle sprain and can continue to persist among those who develop chronic ankle instability. Most rehabilitation protocols for individuals with acute ankle sprains or chronic ankle instability focus on restoring physical impairments and have largely omitted any pain-relieving therapies. This impairment-based focus has led pain to be an understudied symptom among individuals with an ankle sprain history. Overlooking the role of pain has also left clinicians with little insight into whether pain experienced after an ankle sprain is local (i.e., peripheral sensitization) or widespread (i.e., central sensitization). Understanding the pain profiles for those with an ankle sprain history may represent an unexploited area for clinicians and future research to improve health outcomes for this patient population. Clinical Question: Is there evidence to suggest that pain mechanosensitivity levels are different between those with and without a history of lateral ankle sprain? Summary of Key Findings: The literature was systematically searched for Level 4 evidence or higher. The search yielded two cross-sectional case-control studies and one cross-sectional study that met the inclusion and exclusion criteria. Based on the available evidence, pain mechanosensitivity levels are lower across ligamentous stabilizers immediately after an acute ankle sprain and over lower extremity neuromuscular structures among individuals with chronic ankle instability. Clinical Bottom Line: There is weak evidence to support an ankle sprain history can affect local pain mechanosensitivity levels of structures surrounding the ankle but not at distant locations. Strength of Recommendation: Level 4 evidence is available according to the Center for Evidence-Based Medicine.

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Continuing Education Assessment

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Volume 29 (2024): Issue 2 (Mar 2024)

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Are Irish Athletic Therapy Students Confident in Concussion Assessment and Management? A Cross-Sectional Study of Final Year Students’ Self-Efficacy

Anna P. Postawa, Enda F. Whyte, and Siobhán O’Connor

Concussion is one of the most challenging injuries for sports medicine clinicians. It is crucial that students develop high self-efficacy for concussion-relevant skills during professional education, as it impacts the quality of their patient care. This study aimed to explore Irish final year athletic therapy students’ self-efficacy in concussion assessment and management and the factors that impact its development. Participants’ level of self-efficacy varied, from low to high, depending on the skill assessed. Lack of practice and lecturer’s positive feedback impacted student self-efficacy the most. Educators should provide students with an opportunity to practice their skills in an environment that facilitates feedback.

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Economic Analysis of Secondary School Outreach Athletic Training Services

Brian A. Czajka

The health care benefit of athletic trainers in secondary schools is well established; however, the economic effects of athletic training outreach programs on the organization providing the services are not well researched. The purpose of this study was to determine the economic effects of outreach athletic training services on the organization the outreach athletic training services. The daily number of patient visits and procedure charges were compiled and compared between a time period when outreach athletic training services were provided to local secondary schools and a time period when these services were not provided. The findings of this study showed that an organization providing outreach athletic training services may experience significant increases in daily patient visits and daily procedure charges.

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Trunk Endurance and Low Back Pain Outcomes in College Golfers

Andrew Skibski, John Goetschius, and L. Colby Mangum

Low back pain (LBP) is a common injury in golf. There are several outcomes used to quantify LBP-related disability, such as core endurance tests and questionnaires. The primary purpose of this study was to compare clinical outcomes between college golfers with and without LBP. A secondary purpose was to determine relationships between these measures. We found no difference between groups for Biering-Sørensen endurance (p = .558). Episodes of LBP were significantly related to the Oswestry Disability Index (ρ = .491) and Golf-specific LBP questionnaire (ρ = −.576). Oswestry Disability Index and Golf-specific LBP questionnaire also demonstrated a moderate relationship (ρ = −.604).