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Brenda Lindstrom, Karen Chad, Nigel Ashworth, Bobbi Dunphy, Elizabeth Harrison, Bruce Reeder, Sandi Schultz, Suzanne Sheppard and Kori Fisher

Background:

Engaging sedentary individuals in physical activity (PA) is challenging and problematic for research requiring large, representative samples. For research projects to be carried out in reasonable timeframes, optimum recruitment methods are needed. Effective recruitment strategies involving PA interventions for older adults have not been determined.

Purpose:

To compare the effectiveness of recruitment strategies for a PA intervention.

Methods:

Two recruitment strategies, print media and personal contact, targeted health-care professionals and the general public.

Results:

The strategies generated 581 inquiries; 163 were randomized into the study. Advertising to the general public via print materials and group presentations accounted for 78% of the total inquiries. Referrals from physicians and health-care professionals resulted in 22% of the inquiries.

Conclusion:

Mass distribution of print material to the general public, enhanced by in-person contact, was the most effective recruitment strategy. These findings suggest various recruitment strategies targeting the general population should be employed.

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Todd A. Evans and Kenneth C. Lam

Evidence-based practice is an established guiding principle in most medical and health care disciplines. Central to establishing evidence-based practice is the assessment of clinical outcomes. Clinical outcomes represent a form of evidence on which to base medical decisions, as well as providing the mechanism for assessing the effectiveness of evidence-based interventions. However, clinical outcomes are not routinely assessed in sport rehabilitation. If sport rehabilitation clinicians fail to incorporate clinical outcomes assessment and, as a result, evidence into daily practice, they may be missing an opportunity to improve patient care and putting their professional reputation at risk within the medical community. The purposes of the article are to highlight the emergence of clinical outcomes assessment in the medical community and the current health care system, illustrate the role of clinical outcomes assessment as it pertains to providing the best patient care, and identify challenges that could potentially impede the implementation of outcomes assessment in sport rehabilitation.

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James A. Levine

The know-how is available to reverse the obesity epidemic. Reversing obesity is a societal necessity because it is the predominant contributor to chronic ill health in developed countries and a growing precipitant of illness in middle and low-income countries. In the United States, for example, obesity is the chief driver of health care costs in a country that can no longer afford health care. Although some might advocate population-wide medication use to mitigate the effects of obesity on health, the more direct response is to end obesity. The goal of this paper is explain how mass-scalable obesity containment can be designed, built, and disseminated. Scalable Obesity Solutions (S.O.S.) are discussed from concept through deployment.

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Kimberly S. Peer

Sports medicine professionals are facing new dilemmas in light of the changing dynamics of sport as an enterprise. These changes have considerable ethical implications as sports medicine team members are placed in challenging ethical decision-making situations that often create values tensions. These values conflicts have the potential to threaten and degrade the trust established through the mutual expectations inherent in the social contract between the health care providers and society. According to Starr,1 the social contract is defined as the relationship between medicine and society that is renegotiated in response to the complexities of modern medicine and contemporary society. Anchored in expectations of both society and the medical professions, this tacit contract provides a strong compass for professional practice as it exemplifies the powerful role and examines the deep responsibilities held by health care providers in our society. Although governed by professional boards and organizational codes of ethics, sports medicine professionals are challenged by the conflicts of interest between paternalistic care for the athlete and autonomous decisions often influenced by stakeholders other than the athletes themselves. Understanding how the construct of sport has impacted sports health care will better prepare sports medicine professionals for the ethical challenges they will likely face and, more importantly, facilitate awareness and change of the critical importance of upholding the integrity of the professional social contract.

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Thomas H. Kelly and Carl G. Mattacola

Context:

The National Institutes of Health's Clinical and Translational Science Award initiative is designed to establish and promote academic centers of clinical and translational science (CTS) that are empowered to train and advance multi- and interdisciplinary investigators and research teams to apply new scientific knowledge and techniques to enhance patient care. Among the key components of a full-service center for CTS is an educational platform to support research training in CTS. Educational objectives and resources available to support the career development of the clinical and translational scientists, including clinical research education, mentored research training, and career development support, are described.

Objective:

The purpose of the article is to provide an overview of the CTS educational model so that rehabilitation specialists can become more aware of potential resources that are available and become more involved in the delivery and initiation of the CTS model in their own workplace. Rehabilitation clinicians and scientists are well positioned to play important leadership roles in advancing the academic mission of CTS. Rigorous academic training in rehabilitation science serves as an effective foundation for supporting the translation of basic scientific discovery into improved health care. Rehabilitation professionals are immersed in patient care, familiar with interdisciplinary health care delivery, and skilled at working with multiple health care professionals.

Conclusion:

The NIH Clinical and Translational Science Award initiative is an excellent opportunity to advance the academic development of rehabilitation scientists.

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Thomas Gotschi

Background:

Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland’s past and planned investments in bicycling relate to health and other benefits.

Methods:

Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model.

Results:

By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used.

Conclusions:

This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

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learn, celebrate, and connect with other ATs as well as see the newest sports medicine products and services. Visit https://convention.nata.org to see housing options and convention updates. NATA Launches Health Care in Action Campaign After the success of NATA’s 2019 Own Your Impact campaign, we

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Tamara C. Valovich McLeod, Megan N. Houston and Cailee E. Welch

Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.

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Cormac G. Ryan, Patricia Schofield and Denis J. Martin

Negative views of older adults can lead to suboptimal care. For older adults with persistent low back pain (LBP), promotion of physical activity by health care professionals is important. Health care professionals’ views of older adults are influenced by their training. This study aimed to compare recommendations for physical activity for managing persistent LBP offered by students in physiotherapy and occupational therapy to an older person vs. a younger person. In a cross-sectional online survey, participants (N = 77) randomly received a vignette of either a 40-yr-old or 70-yr-old patient with persistent LBP. Other than age, the vignettes were identical. There was no difference between the younger and older vignettes in the likelihood of participants making overall appropriate physical activity recommendations—63% vs. 59%, OR (95%CI) = 1.19 (0.48–2.99), p = .71—although there was a trend toward age bias on recommendations specific to daily activity. Postqualification education may be where ageist views need to be addressed.

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Roberta Bgeginski, Diogo A. DeSousa, Bruna M. Barroso, Janete Vettorazzi, Michelle F. Mottola, Felipe B. Schuch and José Geraldo L. Ramos

Background:

The Physical Activity Readiness Medical Examination (PARmed-X) for Pregnancy aims to facilitate the communication between the health care provider, the fitness professional and the pregnant woman. The purpose of the current study was to test the psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy.

Methods:

Reliability and validity of psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy were tested in 107 women recruited from the Hospital de Clínicas de Porto Alegre. Participants completed the first page of the instrument twice with a minimal interval of 1 week for test-retest reliability analysis. The absolute and relative contraindications to exercise on page 2 of the document were completed by the obstetrician.

Results:

Results indicated good evidence of construct validity. The isolated items in the PARmed-X document presented a large heterogeneity in kappa coefficients ranging from very low estimates to perfect estimates. The overall indication of prescription of physical activity, nonetheless, presented a good kappa coefficient of 0.749.

Conclusions:

The Brazilian Portuguese version of the PARmed-X for Pregnancy can be applied as a valid tool for medical screening by health care providers to help inform safe exercise prescription during pregnancy.