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Full-Text Articles in Rehabilitation and Therapy

In Football Players With Scaphoid Fractures, How Does Surgical Intervention Compare To A Conservative Intervention For The Outcomes Of Repair? A Critically Appraised Topic, Kaitlin Brun, Meggan Bartok, Caitlin Craig, Ally Smith May 2024

In Football Players With Scaphoid Fractures, How Does Surgical Intervention Compare To A Conservative Intervention For The Outcomes Of Repair? A Critically Appraised Topic, Kaitlin Brun, Meggan Bartok, Caitlin Craig, Ally Smith

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Scaphoid injuries are common in high impact or high collision sports with 11% of all hand injuries and 60%-70% of all carpal injuries being attributed to the scaphoid bone. Athletes at the highest risk include males ages 20-24 years of age and those who participate in football, basketball, or ice hockey. Fracture of the scaphoid are often misdiagnosed which increase the chance of a nonunion fracture. Currently most scaphoid fractures are treated either conservatively or with surgical interventions. The increasing knowledge of this injury leads us to question the best treatment options for future football athletes.


Effectiveness Of Kinesio Tape In Treating Low Back Pain: A Critical Appraisal, Stacey Lansky, Sara Stiltner May 2024

Effectiveness Of Kinesio Tape In Treating Low Back Pain: A Critical Appraisal, Stacey Lansky, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO

Low back pain is a musculoskeletal disorder that is expected to affect 80% of the population. 2,7-8 There are several therapeutic interventions including modalities and rehabilitation exercises that have been used in standard treatment of low back pain to improve pain and disability. 2,3,5,6,8,9 However, few studies have been done on the effects of Kinesio Tape (KT) on pain and disability in patients with low back pain. It should be a primary goal of clinicians treating patients with low back pain to understand if KT is an appropriate alternative intervention in treating pain and disability associated with low …


Athletic Trainers’ Knowledge And Perceived Ability Of Recognizing And Treating Panic Attacks, Caitlin Hill, Chyrsten Gessel, Jaclyn Tate May 2024

Athletic Trainers’ Knowledge And Perceived Ability Of Recognizing And Treating Panic Attacks, Caitlin Hill, Chyrsten Gessel, Jaclyn Tate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Mental health is a condition of mental wellness that enables people to manage life's stressors, develop their potential, study and work effectively, and give back to their communities. One mental health condition is anxiety. Anxiety is the expectation of a threat in the future. There are multiple subtypes of anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, separation anxiety, and panic disorder. This study investigates the relationship between ATs' knowledge and their perceived ability to identify and treat panic attacks.


Scapular Fracture In An Ice Hockey Player, Rachel N. Kornbluth, Art Mccreary, Aaron Lear May 2024

Scapular Fracture In An Ice Hockey Player, Rachel N. Kornbluth, Art Mccreary, Aaron Lear

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Ice hockey is a fast and aggressive sport.1-2 Due to deliberate collisions and fighting, a hard playing surface, and sharp skates, ice hockey players are at high and distinctive risk to injury.2-5 The way in which ice hockey players collide with, or check, one another, makes the shoulder vulnerable. About 8.6-21.9% of injuries sustained in ice hockey involve the shoulder.4 Acromioclavicular joint sprains and anterior glenohumeral dislocations are most common.1,4-5 This case presents a 25-year-old male collegiate ice hockey player who sustained a recurrent right-sided glenohumeral dislocation after being checked from behind with his arm …


Cpr Knowledge And Skill Retention Among Ncaa Division Iii Athletic Coaches: A Prospective Cohort Study, Allison Hanstine, Jaclyn Tate, Chyrsten Gessel May 2024

Cpr Knowledge And Skill Retention Among Ncaa Division Iii Athletic Coaches: A Prospective Cohort Study, Allison Hanstine, Jaclyn Tate, Chyrsten Gessel

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

It is crucial for athletic coaches to be proficient in CPR knowledge and skill performance for the health and safety of their athletes. This research aimed to assess CPR knowledge and CPR skill retention five months post-training among athletic coaches. In addition, the study assessed whether the number of years certified in CPR had an association with CPR skill performance scores five months post-training.


The Effectiveness Of Patient Education In A High School Setting, Noah Silvers, Laura L. Harris May 2024

The Effectiveness Of Patient Education In A High School Setting, Noah Silvers, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To compare different types of patient education when recommending best practices for the care of ankle sprains and concussions in adolescents.


Barriers To Implementation Of Post-Concussion Grade Exercise Tests, Tyler Beauregard May 2024

Barriers To Implementation Of Post-Concussion Grade Exercise Tests, Tyler Beauregard

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

The purpose of this study was to assess the potential barriers to sports physical therapy and athletic training clinicians implementing graded exertional tests, specifically for their patients following concussion.


Accuracy Of Ottawa Ankle Rules In Adolescent Foot And Ankle Injuries, Kalie Siereveld, Olivia Teague, Laura L. Harris May 2024

Accuracy Of Ottawa Ankle Rules In Adolescent Foot And Ankle Injuries, Kalie Siereveld, Olivia Teague, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To determine the effectiveness of Ottawa Ankle Rules (OAR) for informing physician referrals secondary to ankle and foot injuries within adolescents.



Quality Improvement Of A Post-Concussion Recovery Protocol, Halle Strege, Kaitlyn Burnham, Laura L. Harris May 2024

Quality Improvement Of A Post-Concussion Recovery Protocol, Halle Strege, Kaitlyn Burnham, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To determine the effectiveness of a post-concussion recovery protocol in an adolescent athletic population.


An Investigation Of Aed Access In One Secondary School, Michelle Skaggs, Laura L. Harris May 2024

An Investigation Of Aed Access In One Secondary School, Michelle Skaggs, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To evaluate the accessibility and time required to retrieve and apply Automated External Defibrillators (AEDs) against established standards.


Athletic Trainer Confidence In The Management Of Abdominal Injuries And Gi Conditions, Emily C. Roberts, Janet E. Simon May 2024

Athletic Trainer Confidence In The Management Of Abdominal Injuries And Gi Conditions, Emily C. Roberts, Janet E. Simon

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Inadequate evidence, position statements, clinical practice and post-surgical guidelines challenge athletic trainers’ capabilities to provide care for abdominal injuries and GI conditions.1-4 The primary objective of this study is to assess athletic trainers’ confidence in the management and treatment of abdominal injuries and GI conditions compared to musculoskeletal injuries.


The Effect Of Task Demands On Decision Making In Dynamic, Sport-Like Virtual Environments, Jeromy Alt, Paula L. Silva, Tehran Davis, Adam W. Kiefer, Ryan Macpherson May 2024

The Effect Of Task Demands On Decision Making In Dynamic, Sport-Like Virtual Environments, Jeromy Alt, Paula L. Silva, Tehran Davis, Adam W. Kiefer, Ryan Macpherson

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

To determine if level of temporal pressure to arrive at a desired location explains decisions about passability of closing gaps between opponents encountered and how decisions change with task experience.


The Effect Of Ankle Foot Orthotics On Collegiate Athletes’ Sprint Biomechanics, Elizabeth A. Starns, Paige Tucker May 2024

The Effect Of Ankle Foot Orthotics On Collegiate Athletes’ Sprint Biomechanics, Elizabeth A. Starns, Paige Tucker

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Carbon composite dynamic response ankle foot orthotics (CCDRAFOs) are lightweight ankle braces originally made to help pathologically involved legs walk more efficiently1. Since CCDRAFOs are traditionally not used on able-bodied individuals, there is limited information on the effects of CCDRAFOs on sprint performance of able-bodied athletes. However, the technology behind CCDRAFOs effectiveness has been suggested to have ergogenic aid properties2-5. This study’s purpose was to evaluate the effects of CCDRAFOs on collegiate athletes’ lower extremity biomechanics, specifically ankle and knee joint angles.



Neurocognitive Performance Differences Between Athletes Who Are Deaf Or Hard-Of-Hearing And Athletes Who Are Hearing, Matthew P. Brancaleone, Jaclyn Caccese, James Onate May 2024

Neurocognitive Performance Differences Between Athletes Who Are Deaf Or Hard-Of-Hearing And Athletes Who Are Hearing, Matthew P. Brancaleone, Jaclyn Caccese, James Onate

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

There are over 71,000 college students in the United States who are deaf or hard-of-hearing (D/HoH), with many participating in athletics. Athletes who are D/HoH have similar concussion rates to athletes who are hearing at the collegiate level. Differences in neurocognitive baseline performance between athletes who are D/HoH and athletes who are hearing may exist due to misunderstanding of written English instructions or differences in sensory processing. Therefore, the purpose of this study was to compare neurocognitive performance between athletes who are hearing and athletes who are D/HoH.



Using Standardized Patients As A Tool To Explore Student Critical Thinking, Sara Stiltner, Andrea Cripps May 2024

Using Standardized Patients As A Tool To Explore Student Critical Thinking, Sara Stiltner, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE

Standardized patients (SP) are a tool utilized regularly in athletic training to promote student confidence and independent thinking. SP are widely used in nursing, physical therapy, and in over 80% of medical education programs.1 The use of SP to supplement student learning and career preparation, in the undergraduate setting has been a validated in increasing student confidence.3 SP’s are a tool that utilize an actor trained to portray a patient who has a specific medical condition or illness and the actor is trained to respond to the students in a consistent manner.1,2 SP’s allow students the …


Does Strength Training Decrease The Risk Of Sports Related Knee Injury?, Zachary J. Noll, Quin W. Buob May 2024

Does Strength Training Decrease The Risk Of Sports Related Knee Injury?, Zachary J. Noll, Quin W. Buob

Rowan-Virtua Research Day

The knee is the most common joint affected by sports-related injuries, with approximately 2.5 million cases treated annually in the US alone, alongside 2 million worldwide ACL repairs. Among athletes engaged in contact sports like football, soccer, basketball, and volleyball, ACL tears are the primary injury concern. In non-contact sports, particularly running, meniscus tears are commonly experienced. A notable 23% of college athletes encounter knee injuries to varying degrees. Many risk factors have been identified including patient sex, activity type, and body composition, justifying the need for individualized preventive measures.

Various strength training protocols have demonstrated efficacy in reducing the …


An Analysis Of Strength Training Implementation In Ballet, Claire Hoover May 2024

An Analysis Of Strength Training Implementation In Ballet, Claire Hoover

Senior Honors Theses

Ballet, a style of dance that is known for its 180-degree external rotation, extreme precision, discipline, and aesthetics, is an athletic activity that is undertaken by many young people, particularly females. Although ballet has many athletic components, recent studies have shown there are a variety of weaknesses that impact its participants, including the female athlete triad, lack of lower extremity muscular strength, risk of injury, and overtraining. According to recent research, strength training, although not historically paired with ballet, could minimize ballet dancers’ deficiencies by increasing muscular strength and reducing risk of injury and incidence of the female athlete triad. …


Acl Bracing: Is It Still Being Done Clinically And Does It Influence Confidence And/Or Biomechanical Performance During A Drop Vertical Jump?, Bailey Watson May 2024

Acl Bracing: Is It Still Being Done Clinically And Does It Influence Confidence And/Or Biomechanical Performance During A Drop Vertical Jump?, Bailey Watson

Masters Theses & Specialist Projects

Introduction: Anterior cruciate ligament (ACL) ruptures account for 60% of sports-related injuries and the gold standard for treatment is surgical intervention to replace the damaged ligament to restore function of the ACL. Braces are typically used to return to previous physical activity levels; however, there are no clear guidelines on their utilization. Beyond the physical consequences of undergoing ACL reconstruction surgery, the psychological component is often ignored.

Purpose: The aim of this study is to better understand the impact of knee bracing on both biomechanical factors and confidence following ACL reconstruction. Two aims comprise the overarching purpose; the first is …


Cannabidiol (Cbd) And Resistance Training: Does Cbd Attenuate Acute Pain?, Guillermo Pacheco May 2024

Cannabidiol (Cbd) And Resistance Training: Does Cbd Attenuate Acute Pain?, Guillermo Pacheco

Masters Theses & Specialist Projects

INTRODUCTION: Resistance training (RT) is an advantageous form of physical activity for health and performance benefits; these benefits are maximized when done strenuously. However, strenuous RT can induce acute inflammatory pain which can lead to delayed-onset muscle soreness (DOMS). Common analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) can block protein synthesis, so other alternatives are needed for exercise and athletic communities to maintain physiological adaptations. Cannabidiol (CBD) is a non-psychotropic cannabinoid with purported anti-inflammatory, anti-oxidative, and analgesic properties. One of the main reasons for the use of CBD in exercise is pain alleviation; however, research in humans is limited. Therefore, the …


Assessing Brain Processing Deficits Using Neuropsychological And Vision-Specific Tests For Concussion, Brent A. Harper, Rahul Soangra Apr 2024

Assessing Brain Processing Deficits Using Neuropsychological And Vision-Specific Tests For Concussion, Brent A. Harper, Rahul Soangra

Physical Therapy Faculty Articles and Research

Introduction: Since verbal memory and visual processing transpire within analogous cerebral regions, this study assessed (i) if a visual function can predict verbal memory performance. It also hypothesized whether neurocognitive (e.g., ImPACT) tests focusing on the Visual Memory and Cognitive Efficacy Index will predict Verbal Memory scores and (ii) if vision metrics and age can identify individuals with a history of concussion. Finally, it also hypothesized that King–Devick and near point of convergence scores alongside age considerations will identify candidates with a prior reported history of concussion. Materials and methods: This observational cohort assessed 25 collegiate ice hockey players prior …


Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall Apr 2024

Increasing Social Inclusion And Engagement Of Exercise For Individuals With Spinal Cord Injuries: A Universal Resource Development For Wellness Facilities, Alexa Hall

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with spinal cord injuries (SCIs) are 1.5 times more likely to disengage in exercise one-year post-injury despite 80% of these individuals agreeing that exercise is critical to their overall health and quality of life (Baehr. Et al., 2022). A needs assessment was conducted on why the lack of engagement in exercise exists for individuals with SCIs within fitness facilities to identify barriers preventing participation. A quality improvement program called the Spinal Cord Injury Wellness Toolkit was created based off these findings and implemented at the MUSC Wellness Center. 14 individuals with SCIs participated at wellness center; REDCap surveys were …


An Adapted Yoga Program For Adults With Neuromuscular Impairments Designed To Improve Balance, Mood, Quality Of Life, And Engagement In Daily Occupations, Hayes Miller, Mary Smith Otd, Otr/L, Christienne Parten Otd, Med, Otr Apr 2024

An Adapted Yoga Program For Adults With Neuromuscular Impairments Designed To Improve Balance, Mood, Quality Of Life, And Engagement In Daily Occupations, Hayes Miller, Mary Smith Otd, Otr/L, Christienne Parten Otd, Med, Otr

Spring 2024 Virtual OTD Capstone Symposium

Neuromuscular impairments such as Parkinson's disease (PD) and Multiple Sclerosis (MS) affect an individual's balance, mood, and ability to engage in daily occupations, ultimately impacting their quality of life. Yoga is a practice that is adaptable to any level of function and is holistic in its goal of mind-body unity. However, there has been minimal research regarding yoga's efficacy as a modality for populations with neuromuscular impairments. This study aimed to improve these factors as well as proprioception and interoceptive awareness through the delivery of a 6-week community-based yoga program. The program involved 5 participants, 4 with PD and 1 …


Comparing The Effects Of Mat Pilates On Lower Limb Strength And Agility In Young Adults With Sedentary To Active Lifestyles, Morgan Mccammon Apr 2024

Comparing The Effects Of Mat Pilates On Lower Limb Strength And Agility In Young Adults With Sedentary To Active Lifestyles, Morgan Mccammon

Scholar Week 2016 - present

Background: Meeting physical activity guidelines is essential for maintaining physical health, decreasing the risk of chronic disease, and improving fitness. Pilates is a form of low to moderate exercise that can be implemented to improve multiple components of fitness and be considered active. Today, Pilates is available to the general population through online instruction.

Objectives: The purpose of this study was to compare the effects of a 4-week, self-led online Pilates program or walking routine on inactive and active young adults. This study analyzed changes in lower limb strength and agility.

Methods: This experiment involved 18 young adults from Olivet …


A New Lease On Life: The Occupational Impact Of Adaptive Skiing, Caitlin Tetherow, Amy Lyons-Brown, Amy Griswold Apr 2024

A New Lease On Life: The Occupational Impact Of Adaptive Skiing, Caitlin Tetherow, Amy Lyons-Brown, Amy Griswold

Spring 2024 Virtual OTD Capstone Symposium

This research study focuses on understanding the occupational impact of adaptive skiing on well-being and identity to promote lifelong occupational engagement, representation, and inclusion within current ski culture. A mixed-method research study utilized a 25-question online survey and an optional one-time virtual interview. 50 adaptive skiers and/or snowboarders participating in a winter adaptive program between 18-65 years old completed this study. This study found positive evidence supporting outcomes related to physical, emotional, spiritual, and social well-being and positive identity formation from adaptive skiing.


Wellness Research & Programming For Bodybuilders, Victoria Castillo, Karen Park, Kersten Laughlin Apr 2024

Wellness Research & Programming For Bodybuilders, Victoria Castillo, Karen Park, Kersten Laughlin

Spring 2024 Virtual OTD Capstone Symposium

This project explores the occupational impact on bodybuilders and wellness & program development for competitive bodybuilders. Phase one focuses on research to understand the occupational impact on bodybuilders during competition. Phase two, which focuses on program development, highlights the alignment to the objectives as they allow for the development of an educational program intended for bodybuilder coaches to help with health prevention and wellness with their bodybuilder clients.


The Occupational Performance Of Student-Athletes Post-Concussion: A Guide For Coaches And Athletic Trainers, Baylee A. Felts, Mary Ann Smith, Danielle Cade Apr 2024

The Occupational Performance Of Student-Athletes Post-Concussion: A Guide For Coaches And Athletic Trainers, Baylee A. Felts, Mary Ann Smith, Danielle Cade

Spring 2024 Virtual OTD Capstone Symposium

Concussions are a rising concern amongst the sports community. Student-athletes with concussions can exhibit deficits in physical, psychosocial, cognitive, and visual-perceptual abilities (Centers for Disease Control, 2019). Occupational therapists are equipped to address the impacts of those deficits to improve occupational engagement and performance but are often overlooked in concussion management teams (Finn, 2019). A concussion management team typically consists of coaches, athletic trainers (ATs), physicians, and sometimes physical therapists, depending on the severity of the concussion. Due to growing concern and continued research, the concussion management team must be current with new information. Coaches and ATs may not keep …


The Role Of Occupational Therapy In Enhancing Adaptive Golf, Jessica A. Garday, Susan Macdermott Apr 2024

The Role Of Occupational Therapy In Enhancing Adaptive Golf, Jessica A. Garday, Susan Macdermott

Spring 2024 Virtual OTD Capstone Symposium

This project is focused on advocating on behalf of golfers with disabilities by providing an educational resource for golf administrators on enhancing adaptive golf at their facility. The project's deliverable was an in-service presentation highlighting the importance of adaptive golf and its positive impact on community, state, and national individuals. The in-service was delivered through the Southern California Professional Golf Association SCPGA Catalyst webinar series. The topics included grants for adaptive equipment, the financial impact of adaptive golf on the industry, community partnerships, and golf course design modifications utilizing the most cost-effective approaches. The student found that more education can …


Disabling Conditions Of Para-Alpine Athletes: An Education Series For Ski Instructors, Meghan Hawes, Steven M. Gerardi, Heather Rennerfeldt Apr 2024

Disabling Conditions Of Para-Alpine Athletes: An Education Series For Ski Instructors, Meghan Hawes, Steven M. Gerardi, Heather Rennerfeldt

Spring 2024 Virtual OTD Capstone Symposium

Para-alpine ski instructors in the United States need more training on disabling conditions and their definition, deficits, and adaptations for para-alpine skiing; This capstone closes the gap. Para-Alpine skiing is discussed in detail, highlighting instructor training, adaptive equipment, and para-athletes. The disabling conditions of para-athletes are identified along with details related to their para-alpine skiing experience. The methods of this capstone consisted of creating an educational series of videos highlighting five disabling conditions: Autism, spinal cord injuries and conditions, vision impairments, cerebral palsy, and progressive neurodegenerative disorders. The product was presented following a 14-week experience with the National Sports Center …


Attitudes And Self-Efficacy Of Swimming Coaches Towards The Inclusion Of Swimmers With Autism Spectrum Disorder, Eleftheria Kasagianni, Dimitrios Kokaridas, Panagiotis Varsamis, Vasilis Tsimaras Mar 2024

Attitudes And Self-Efficacy Of Swimming Coaches Towards The Inclusion Of Swimmers With Autism Spectrum Disorder, Eleftheria Kasagianni, Dimitrios Kokaridas, Panagiotis Varsamis, Vasilis Tsimaras

International Journal of Aquatic Research and Education

The purpose of this study was to investigate the attitudes and self-efficacy of swimming coaches regarding the inclusion of swimmers with autism spectrum disorder (ASD). The sample consisted of 150 Greek swimming coaches with an average age of 29.58 years. Each participant completed the Swimming Coaches Attitudes towards Inclusion Questionnaire for perceptions assessment and the Biddle and Goudas (1997) self-efficacy questionnaire. The statistical analysis used SPSS 27 to calculate Cronbach’s alpha, Pearson product-moment correlations, independent t-tests, and ANOVA. The findings of the study showed that the swimming coaches expressed positive attitudes and a high percentage of perceived self-efficacy towards the …


‘You Have To Respect The Water’: Participant Experiences Of Appreciating And Managing The Risks Associated With Open Water Swimming – A Rapid Ethnographic Study, Mark A. Christie, David Elliott Mar 2024

‘You Have To Respect The Water’: Participant Experiences Of Appreciating And Managing The Risks Associated With Open Water Swimming – A Rapid Ethnographic Study, Mark A. Christie, David Elliott

International Journal of Aquatic Research and Education

Open water swimming (OWS) has rapidly grown in popularity, driven by the purported health benefits of cold-water immersion. A paucity of research remains specifically considering the notable risks inherent in OWS participation, and a lack of qualitative research on freshwater swimming experiences, and safety-related issues therein. This rapid ethnographic study, based at a dedicated OWS lake in the UK, conducted semi-structured interviews with OWS participants (n=17; female=11, male=6). Two core themes emerged: environmental issues impacting OWS experiences and behaviours; and knowledge and education of OWS which highlighted safe/unsafe practices, levels of education for managing risks, personal preparedness, swimming solo/with others, …