Recreational Therapy Commons^™

Effects Of Concussion History On Risk Taking Behaviors In Collegiate Athletes, K Formey, Tr Campbell

Clinical Practice in Athletic Training

VirginiaContext: According to the literature, in the United States there are an estimated 1.6 to 3.8 million sport-related concussions annually with over 10,000 concussions among National Collegiate Athletic Association (NCAA) student-athletes1. The annual incidence of medically diagnosed pediatric concussions increased from 34 per 10,000 persons in 2003 to 150 per 10,000 persons in 20132. There has been an increase in research studied on the physiological mechanisms and causes of concussions among people of all ages with sports participation being the etiology of about half of all pediatric concussions2. Concussions occur from excessive forces being applied to the skull resulting in …

Effects Of Passive Heat Interventions On A Person’S Active Heat Acclimatization: A Critically Appraised Topic, Sl Dickstein, Dm Emerson, Al Fraley

Clinical Practice in Athletic Training

Focused Clinical Question: Does implementing a month-long passive heat protocol in a sauna affect a person’s active heat acclimatization by decreasing average heart rate (HR), decreasing internal body temperature, and increasing skin temperature (Tsk)? Data Sources: A comprehensive search was conducted in September 2023 through PubMed. The search terms used were passive heat therapy, heat acclimatization, and hypoxia. Manuscripts were limited to those published within the last 5 years. Study Selection: Inclusion criteria consisted of physically active participants, measures of HR and body temperature, and randomized-controlled trials and crossover studies using saunas as a passive heat intervention. Exclusion criteria consisted …

Enhancing Cultural Competency In Sports Medicine Resident And Fellowship Physicians Through The Coming Out Star Exercise., Sa Cage, Ap Jacobsen

Clinical Practice in Athletic Training

Context: Previous studies have reported that lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) healthcare providers and student-athletes encounter difficulties in their work or competition settings. Numerous medical professional associations have published statements affirming their commitment to providing equitable healthcare for patients from the LGBTQIA community. However, there is a paucity of research related to building cultural competency among healthcare professionals with regards to LGBTQIA patients. The purpose of this study was to describe the effects of the Coming Out Star exercise on giving sports medicine track resident and fellowship physicians a better understanding of the challenges faced by …

Esophageal Candidiasis In A Baseball Athlete, A Fitzgerald, N Carvino

Clinical Practice in Athletic Training

Background: Candidiasis is a yeast-based fungal infection often found in immunocompromised individuals, that can produce white patches, redness or soreness in the mouth, xerostomia, loss of taste, pain with eating and swallowing, and angular cheilitis. The patient in this case is a 21-yearold male baseball player who presented to the athletic trainer (AT) with flu-like symptoms such as fever, cough, body aches, shortness of breath, and chills. The AT referred the patient to the team physician, who prescribed Zithromax five days after the onset of symptoms for bronchitis. There was no improvement after two days, so a Medrol pack was …

External Pressures On Injured Athletes’ And Their Effects On Mental Health And Return To Play, A Graham, J Johnson

Clinical Practice in Athletic Training

Context: Student athletes face many challenges in and out of their sport. Along with practicing and playing to their best ability, they have to worry about keeping up with schooling. Once a player is hurt and out of play, they add the pressure of getting back into play on their plate. Along with their own internal pressure, athletes may experience pressure from outside sources. These sources could include friends, family, coaches, and parental guardians. External pressures could play a role in how an athlete returns to play. This research can help us understand whether the external pressures end up causing …

Influence Of Thermal Protective Gear On Rural Volunteer Firefighter Postural Stability, E Shagen, J Patrick

Clinical Practice in Athletic Training

Context: Firefighting is a physically demanding job. The ability to maintain and appropriately adjust postural stability is vital for the safety of firefighters, as they navigate through unpredictable terrain in various rescue situations while wearing restrictive equipment. The weight and design of thermal protective gear (TPG) may alter weight distribution causing changes to the center of gravity or restrict movement. The need for firefighters to maintain postural stability is essential for preventing falls on- duty. The purpose of this study was to assess the influence of TPG on rural volunteer firefighter (VFF) postural stability. Methods: Nine healthy males (mean±SD: age= …

Injury Prevention Programs: Factors That Effect If A Coach Uses Injury Prevention Programs, A Deguzman, Jc Martinez

Clinical Practice in Athletic Training

Context: The purpose of this study was to determine how coaches view injury prevention programs (IPP) and how this affects their decision to implement an IPP with their team. The more information gained on a coach’s influence to implement an injury prevention program for their team, the more athletic trainers can understand and educate on the importance of injury prevention programs. Methods: Design: Cross-sectional Setting: Web-based survey Target Population: Youth Sport Coaches Dependent Variable: Coaches beliefs on IPPs Independent Variable: Willingness to implement an IPP. Youth sport coaches were surveyed on their attitudes and beliefs about injury prevention programs. All …

Interdisciplinary Approach To Management Of An L4/L5 Disc Herniation In A Collegiate Football Player: A Type 3 Case Study, Cc Janush, A Meriwether, M Tillman

Clinical Practice in Athletic Training

Background: The rate for low back injuries in collegiate football players has been reported as 2.70 per 10,000 athlete exposures with lumbar disc herniations (LDH) accounting for roughly 8% of these injuries. In athletic populations, the decision of surgical versus conservative management for LDH can present a unique challenge to the clinician and patient given an patient’s concern for return to play with minimal time loss. This type 3 CASE study will discuss the non-operative management of an L4/L5 disc herniation in a collegiate football player and highlight the interdisciplinary team approach that allowed the athlete to play an entire …

Measuring Psychological Readiness With The Shoulder Instability-Return To Sport After Injury Scale In Athletes With Traumatic Shoulder Dislocations: A Critically Appraised Topic, Ha Arnett, K Moore, Zk Winkelmann, H Miller

Clinical Practice in Athletic Training

Focused Clinical Question: How can using the Shoulder Return to Sport after Injury (SI-RSI) scale to measure mental readiness in athletes after a shoulder injury improve return-to-play protocol? Data Sources: In September 2023, a computerized search of PubMed for evidence was completed. The search terms were fear of reinjury or psychological readiness, kinesiophobia, confidence, and return to play or return to sport, or RTP. The search was limited to studies published between 2018 and 2023. Study Selection: The inclusion criteria consisted of studies that used the SI-RSI to measure fear during return to play and shoulder injuries that required surgery. …

Mole Or Melanoma: Knowing Your Abcde’S May Save Your Life!, Jh Knaul

Clinical Practice in Athletic Training

Background: Skin cancer is the most common type of cancer in the United States. One in five Americans will be diagnosed with skin cancer in their lifetime, or about 9500/day. Research indicates that nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), affects more than 3 million Americans a year. More than 1 million Americans are living with Melanoma, nearly 200,000 cases of melanoma were diagnosed in 2022 with about 98,000 being invasive and 100,000 being non-invasive (in situ). The average age of diagnosis is 65. Melanoma rates in the US have been rising rapidly …

Myositis Ossificans In A Female Sprinter With The Sickle Cell Trait, Rl Quintana, M Menjivar

Clinical Practice in Athletic Training

Background: Sickle cell trait (SCT) is associated with an increase in muscle breakdown after strenuous exercise due to improper blood flow to active muscles. Evidence suggests that individuals with SCT can increase muscle breakdown during exercise by as much as 54%. This case outlines a 21-year-old African collegiate sprinter with SCT who reported feeling a “pop” in her right hamstring that caused her to stop running mid-race. She reported that no pain was associated with the “pop” but was scared by the sensation. Evaluations of strength and range of motion were all unremarkable and there were no palpable deformities. She …

Non-Operative Management Of Distal And Proximal Interphalangeal Fractures Without Excessive Sport Removal, Og Newhouse, J Johnson

Clinical Practice in Athletic Training

Background: Intra-articular fracturs of the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints occur primarily from impacted shear force. With continued participation, fractures have a high possibility of nonunion or malunion. While accounting for patients’ requests may not always be possible, extreme modification of activity may permit their requests. Patient: The patient is a college-aged female volleyball athlete who plays in the front row. The initial report showed a fracture of the right fifth phalange from incomplete range of motion (ROM), swelling, and bruising after an impacted shear force was placed on her finger from a block. She was referred …

Orientation Using Standardized Patients Increases Athletic Training Student Communication Effectiveness When Transitioning To Clinical Education Experiences, Jl Frye, Ma Belbey, Kj Armstrong

Clinical Practice in Athletic Training

Context: Transitioning from didactic to clinical education is overwhelming for novice athletic training students. The change in the learning environment often causes anxiousness as students get acquainted with the clinical site, preceptor expectations, and demonstrating clinical skills during patient care. Learning to communicate provides additional challenges as students must convey information to their patients, practice active listening, relay patient information to their preceptor, and possibly navigate conflict management. Simulation-based orientations have been effective in other healthcare professions to ease this transition; however, it has not been examined in professional athletic training students. Methods: The study used a convenience sample of …

Platelet-Rich-Plasma Injections Vs. Corticosteroid Injections In The Reduction Of Pain For Patients With Frozen Shoulder: A Critically Appraised Topic, Al Pendleton, Mr Dombrowski, Rj Bonser, Jg Coots

Clinical Practice in Athletic Training

Focused Clinical Question: Is a platelet-rich plasma or a corticosteroid injection better for relieving pain for patients with frozen shoulder pathologies? Data Sources: To identify relevant research papers, Boolean searches were conducted on Google Scholar, CINAHL Ultimate, MEDLINE Ultimate, and SPORTDiscus databases from September 14th through September 25th, 2023. Key terms used were corticosteroid (CS) injection, platelet-rich-plasma (PRP) injection, frozen shoulder, and adhesive capsulitis. Study Selection: The inclusion criteria were: articles published from 2018-2023, Randomized Control Trials comparing PRP and CS injections, and studies that used visual analog scale (VAS). Additionally, each article selected summarized outcome measures in a table. …

Presentation Of Bilateral Acetabular Labral Tears In A Collegiate Women’S Lacrosse Player: A Level 3 Clinical Case Study, W Giannelli, K Herraiz, A Mercer

Clinical Practice in Athletic Training

Background: The hip and groin injury rate in female collegiate lacrosse players has been reported to be 35.06 per 100,000 athlete exposures yet the frequency of acetabular labral tears (ATL) remains unclear. Sports which involve repeated bouts of running in combination with frequent twisting and pivoting motions, have been suggested to have a higher prevalence rate of ALT. This level 3 case study will discuss the unique presentation of bilateral ALTs in a female collegiate lacrosse player. Patient: Patient is a 19-year-old Division I collegiate women’s lacrosse player who first presented with pain in her left hip while at home …

Reliability And Validity Of The Iphone To Measure Hip Internal And External Rotation, Jl Blatz, Nm Cattano

Clinical Practice in Athletic Training

Context: Clinicians use a traditional goniometer or a quick visual estimate to measure range of motion (ROM) in patients, these methods can be time consuming or inaccurate. The purpose of this study is to assess the reliability and validity of the iPhone Measure app to measure hip internal rotation (IR) and external rotation (ER). Methods: 20 participants were recruited; they were physically active and aged 18-28 years old. Hip IR and ER was measured prone with the subject on a table. The measures were taken three times and bilaterally for each, then recorded. The ROM was measured by 2 student …

Single Limb Postural Control Throughout A Collegiate Football Season, L Custer, S Tomasi, J Lima, A Rieland

Clinical Practice in Athletic Training

Context: It is estimated that college football players sustain an average of 3 subconcussive blows to the head per game. Limited research has demonstrated that collegiate football players present with decreased static postural control, as measured using the Balance Error Scoring System, at the end of season compared to baseline. Interestingly, neurocognitive test scores in collegiate football players were not found to differ preseason, midseason and postseason. Authors hypothesized that using neurocognitive tests may not have been sensitive enough to detect the effects of the subconcussive impacts. Force plate data provides valid information of postural control. The purpose of this …

Specific Barriers To Athletic Trainers’ Familiarity With And Attitudes Toward Concussion Biomarkers: A Phenomenological Qualitative Study, Te Mccormick, Jm Allen, Kgs Swindell, Tr Campbell

Clinical Practice in Athletic Training

Context: The diagnosis of concussions is largely reliant on subjective information in conjunction with objective measures that might not be the most valid and/or reliable. There is now new research being performed evaluating the use of biological indicators, or biomarkers in the diagnosis and management of concussion. However, the amount of knowledge about biomarkers among athletic trainers is unknown. Additionally, the barriers preventing ATs from using such biomarkers has yet to be studied. Therefore, the purpose of this study is to examine athletic trainers’ familiarity with and their attitude towards concussion biomarkers, while evaluating specific barriers preventing their use in …

The Analysis Of Ground Kinematics In Tie-Down Ropers, M Watts, A Chelette, J Sandford, K Mata

Clinical Practice in Athletic Training

Context: Tie-down roping, an event in rodeo, occurs when the athlete ropes a calf while on horseback, quickly dismounts from the horse and ties three legs of the calf together. Injuries to the knee and lower body have occurred with athletes in the tie-down roping event. Previous research with college rodeo athletes has shown the knee to be the most frequently injured area of the body. The athlete’s lower body movements during the dismount from the horse may increase the risk of injury to the knee. However, these movements have not been previously studied in the tie-down roping event. The …

The Food Environment Of Female Athletes Attending Historically Black Colleges And Universities: A Qualitative Study On The Dimensions Of Food Access And Nutrition, Na Uriegas, Zk Winkelmann, Dm Emerson

Clinical Practice in Athletic Training

Context: Student-athletes are a subset of college students who face additional stressors related to the demands of their sport and academic workload. The food choices of student-athletes may be influenced by the unique food environment they are in. Further challenges may present for Historically Black Colleges and Universities (HBCUs) student-athletes as their institutions tend to be in low food access areas. We aimed to assess food security and explore the lived experiences of HBCU female student-athletes surrounding their food environment and ability to access food based on the five dimensions of food access: availability, accessibility, affordability, accommodation, and acceptability. Methods: …

Use Of An External Dynamic Arm Stabilizer In A Collegiate Baseball Player With Valgus Extension Overload: A Case Report., Jp Goza, Ap Jacobsen

Clinical Practice in Athletic Training

Background: A 21-year-old, male, collegiate baseball player reported to the athletic training staff complaining of pain along the posteromedial aspect of the right elbow. The patient reported a previous history of a grade I ulnar collateral ligament sprain that had been rehabilitated until he was able to return to full pain free activities. The patient could not recall a specific mechanism of injury. Physical examination revealed a loss of terminal elbow extension, and pain along the posteromedial aspect of the elbow. The patient reported no neurological symptoms during or after throwing. Valgus Stress, Milking, and Posterolateral Rotary Drawer tests were …

Weighted Ball Programs And Medial Elbow Injury In Youth Baseball Pitchers, M Sobolewski, K Pritchard

Clinical Practice in Athletic Training

Introduction: Weighted ball programs have been proven to increase pitching velocity, however a combination of poor musculature and body mechanics with increased elbow valgus can heighten the incidence of medial elbow overuse injuries in the youth population. Clinical Question: Can youth baseball pitchers who use weighted ball programs increase their pitching velocity without causing an increased risk of medial elbow injury? Methods: The literature was explored to discover studies that investigated medial elbow injuries using weighted ball programs in youth baseball pitchers. Articles included weighted ball programs as an intervention, kinetics/injury mechanics, youth elbow injuries, and prevention of overuse injuries. …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Improvement On The Slopes: The Impact Of An Adaptive Snow Sports Program On Children And Young Adults With Disabilities, Stephanie Green, Mark T. Fisher, J Eichner, Matthew J. Mclaughlin

Research Days

Background: Adaptive downhill skiing has been described as a fun, safe, engaging recreational activity for those with disabilities (Sterba, 2006). There are numerous ways the alpine skiing can be modified to meet these athletes’ needs. For instance, athletes can use tethered skis, horizontal poles held by their instructors, or modified walkers. For those that have poor standing balance, or are non-ambulatory, sit-skis are an option, with or without outriggers to add additional support and balance for athletes with poor trunk stability or core strength. These options provide equal and accessible alternatives for those with disabilities to get out and enjoy …

Dancing Through Parkinson’S: Investigating The Impact Of Argentine Tango On Motor, Cognitive And Psychosocial Function, Suraj Pothineni, Fazal Choudhary

Rowan-Virtua Research Day

Background: People with Parkinson’s Disease (PD) undergo progressive motor, cognitive, and psychosocial symptoms, which decrease their quality of life (QOL). Adapted tango (AT) has recently emerged as a promising approach to ameliorating functional mobility, balance, and gait seen in people with PD.

Methods: A comprehensive literature review is conducted using databases such as PubMed, SCOPUS, and Embase. A wide variety of search terms are used, including but not limited to Parkinson’s disease, exercise, dance, tango, motor, cognitive, psychosocial effects, freezing of gait, and balance.

Results: People with PD who have undergone AT have improved in certain motor, cognitive and psychosocial …

Play's Continuum Of Needs: Building Blocks For Deepening Play Opportunities In Medical Environments, Deborah Brewster Vilas

Graduate School of Education

Optimal healing for children in hospitals occurs when their developmental needs are considered as part of their overall treatment plan. One of the most pressing developmental needs for all children is the need to play, and this remains so even when they are confined to a hospital bed or face developmental delays or disabilities. This chapter examines the most basic components of implementing play programs in hospitals, such as the intentional creation of space for play, determining the best times for children to play, and exploring what types of play are therapeutic and possible in a hospital environment. The author …

Positively Waiting: Technology As The Preferred Distractor In A Pediatric Outpatient Setting, Timothy Ernest, Victoria Maddex, Arnaldo Mejias, Lindy Davidson, Donna Ettel-Gambino

Patient Experience Journal

Visiting any pediatric outpatient clinic as a child may be considered a stressful and anxiety-inducing experience. The literature suggests that positive distractions, such as pet therapy and single-user electronic devices, may aid in reducing anxiety and maximizing patient satisfaction throughout the patient’s experience at a pediatric outpatient clinic. The aim of this pilot quality improvement project was to determine which positive distractions patients experienced and whether single-user electronic loaner devices should be provided to patients at pediatric outpatient facilities. A quantitative causal comparative approach was utilized in identifying patient exposure to key positive distraction techniques that may significantly decrease anxiety. …

Myocardial Work Index: A Novel Method For Assessment Of Myocardial Function In South Asian Recreational Athletes, Shantanu Sengupta, Renuka Jain, Nitin Burkule, Susan Olet, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: We used a novel noninvasive method based on speckle-tracking echocardiography to evaluate myocardial performance in South Asian recreational athletes who completed a half marathon.

Methods: Transthoracic echocardiography was performed on 24 recreational athletes 48 hours before they took part in a half marathon (premarathon), within 2 hours of half marathon completion (postmarathon), and 72 hours after completion. Clinical, laboratory, and echocardiographic variables were collected. Speckle-tracking echocardiography was performed in all subjects to characterize myocardial mechanics.

Results: Mean age of participants was 41.8 ± 7.4 years, and 23 (95.8%) were male. No subject had a prior history of coronary artery …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …