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Athletic Training Students’ Use of Evidence-Based Practice Professional Behaviors During Clinical Experiences: A Report From the Association for Athletic Training Education Research Network

Cailee E. Welch Bacon, Julie M. Cavallario, Stacy E. Walker, R. Curtis Bay, and Bonnie L. Van Lunen

With the incorporation of evidence-based practice (EBP) during patient care as a curricular content standard, professional programs must prepare athletic training students (ATSs) for the application of EBP during the delivery of patient care. We aimed to examine ATSs’ implementation of professional behaviors associated with EBP during patient encounters (PEs). Through a multisite panel design, we tracked numerous factors associated with PEs experienced by 363 ATSs of 12 professional athletic training programs. Generalized estimating equation models were used to analyze the likelihood that students included EBP behaviors during 30,522 PEs. Clinical site type (p < .001), student role (p < .001), and encounter length (p < .001) were associated with all three EBP professional behaviors while clinical site type (p < .001) was also associated with whether the ATS asked a question of a clinician, including their preceptor. Program administrators seeking to promote the greatest opportunities for ATSs to implement EBP during patient care should seek clinic-based or other nonacademic site types that promote longer PEs in which students can perform or assist their preceptor.

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Personal and Social Correlates of Self-Reported Physical Activity in Individuals With a History of Anterior Cruciate Ligament Reconstruction

Rachel R. Kleis, Deirdre Dlugonski, Matthew C. Hoch, Rachel Hogg-Graham, Stacey Slone, and Johanna M. Hoch

Physical activity is negatively impacted after anterior cruciate ligament (ACL) injury and subsequent reconstruction. Previous evidence suggests that individuals with a history of ACL reconstruction (ACLR) may experience additional barriers to sport and physical activity participation. The purpose of this study was to identify personal and social factors (physical literacy, social support, and knee function) that are predictive of self-reported physical activity in individuals with a history of ACLR. Bivariate analyses determined that elements of physical literacy and knee function were positively correlated with self-reported physical activity. The final stepwise linear regression model demonstrated that the PLAYself Physical Literacy Self-description subsection accounted for 12.2% of the variance of self-reported physical activity (p = .003). The significant effect of the PLAYself Physical Literacy Self-description remained (p = .002) even when additional demographic covariates (age, time since ACLR, and sex) were added to the model. Findings suggest that physical literacy may be a salient factor to consider for promoting physical activity after ACLR.

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Continuing Education Assessment

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Volume 29 (2024): Issue 4 (Jul 2024)

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Recommendations for Implementation of Dog Therapy Intervention in the Athletic Training Facility

Rebecca Covach, Lindsey Keenan, and Emily Duckett

Dog therapy is implemented in various healthcare fields because of its unique ability to reduce perceived anxiety and hormonal stress, increase positive patient relationships with practitioners, and assist with demonstrating procedures. However, implementation of dog therapy in a clinical athletic training setting is not frequently discussed in relevant literature. This article outlines recommendations for the use and efficacy of therapy dogs in an athletic training facility, based on data from several studies across various healthcare fields. We provide information regarding best practice recommendations to incorporate therapy dogs into athletic training services, as well as the necessary administrative aspects and safeguards. Athletic trainers can use these recommendations and framework to explore the implementation of dog therapy into clinical practice.

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Leveraging the Momentum

Luke Donovan

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NATA News & Notes

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Erratum. Effect of Mindful Sports Performance Enhancement in College Athletes for Reducing Sports-Caused Anxiety and Improving Self-Awareness: A Critically Appraised Topic

International Journal of Athletic Therapy and Training

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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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Blood Flow Restriction Training Improves Muscular Outcomes in Patients With Chronic Ankle Instability: A Critically Appraised Topic

Jared Spencer, Cheyann Sales, and Aric J. Warren

Clinical Scenario: The high recurrence of lateral ankle sprains progresses to chronic ankle instability (CAI) and can affect many athletes in all sports. CAI is often associated with a decrease in muscle strength, an increase in pain, a decrease in the range of motion, and a decrease in balance or neuromuscular control. The use of blood flow restriction (BFR) with CAI can increase muscular outcomes and be used as a rehabilitation tool. Clinical Question: Is there evidence to suggest that BFR improves strength, muscle activation, and/or cross-sectional area of the lower leg musculature in those with CAI? Clinical Bottom Line: There is moderate evidence to support therapeutic exercise with low-intensity BFR in patients with CAI. The evidence concluded a significant improvement in BFR to increase muscle activation of the fibularis longus, anterior tibialis, vastus lateralis, and soleus. There is moderate evidence suggesting BFR can induce strength gains in the muscles of the lower extremity in patients with CAI. Strength of Recommendation: The comprehensive evidence is a Strength of Recommendation Taxonomy (SORT) Grade B, with a level of evidence of 2, according to the Centre for Evidence-Based Medicine (CEBM) for the studies included.