Introduction to Athletic Training
Introduction to Athletic Training AT 2356
Popular in Prevention and Care of Athletic Injuries
Popular in Physical Education
Elisa Swaniawski I
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Elisa Swaniawski I
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This 74 page Class Notes was uploaded by Chris Taylor on Sunday January 31, 2016. The Class Notes belongs to AT 2356 at Texas State University taught by Gabriel Paul Fife in Fall 2016. Since its upload, it has received 30 views. For similar materials see Prevention and Care of Athletic Injuries in Physical Education at Texas State University.
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Date Created: 01/31/16
Chapter 1: The Athletic Trainer as a Health Care Provider Health Care Provider • Athletic trainers specialize in preventing, recognizing, managing and rehabilitating injuries • Function as a member of a health care team which also incorporates and involves a number of medical specialties • Provide a critical link between the medical community and physically active individuals 2 Historical Perspective • Early History • Evidence suggests that coaches, physicians & therapists existed in Greek and Roman civilizations • Assisted athletes in reaching top performance • Athletic trainers came into existence in the late 19 century in intercollegiate & interscholastic sports • Early treatments involved rubs, counter-irritants, home remedies and poultices 3 Evolution of Contemporary Athletic Trainer • Traditional setting of practice included colleges and secondary schools Dealing exclusively with an athletic population • Today certified athletic trainers (ATC) work in a variety of settings and with a variety of patient populations Professional sports, hospitals, clinics, industrial settings, the military, equipment sales, physician extenders 4 Rapid evolution of the profession following WW I Athletic trainers became specialists in preventing and managing injuries Dr. S.E. Bilik wrote, The Trainer’s Bible (1917) The Cramer brothers developed a line of liniments to treat ankle sprains (1920’s) and followed the publication The First Aider (1932) In the 1930’s the NATA started to come into existence but then disappeared during WW II In 1950 the NATA was reorganized and it has continued to flourish and expand 5 • With the evolution of the profession a number of milestones have been achieved Recognition of Acts as healthcare providers Increased diversity of practice settings Passage of practice acts Third party reimbursement for athletic trainers Constant revision and reform of athletic training education 6 Changing Face of Athletic Training Profession • Role of the athletic trainer is more in line, today, as a health care provider 40% of athletic trainers are employed in clinics, hospitals, industrial and occupational settings Also involved in NASCAR, performing arts, military, NASA, medical equipment & sales, law enforcement, and the US government • Has resulted in changes in athletic training education • Athletic trainers do not just provide medical care to athletes or those just injured during physical activity • Becoming more aligned as a clinical health care profession Requires terminology changes Patients and clients vs. athletes Athletic trainers – NOT TRAINERS!!hletic training room 8 Growth of Professional Sports Medicine Organizations • International Federation of Sports Medicine (1928) • American Academy of Family Physicians (1947) • National Athletic Trainers Association (1950) • American College of Sports Medicine (1954) • American Orthopaedic Society for Sports Medicine (1972) • National Strength and Conditioning Association (1978) • American Academy of Pediatrics, Sports Committee (1979) • Sports Physical Therapy Section of APTA (1981) • NCAA Committee on Competitive Safeguards and Medical Aspects of Sports (1985) • National Academy of Sports Medicine (1987) 9 International Federation of Sports Medicine 1. Federation Internationale de Medecine Sportive (FIMS) 2. Principal purpose to promote the study and development of sports medicine throughout the world 3. Made up of national sports medicine associations of over 100 countries 4. Organization includes many disciplines that are concerned with physically active individuals 10 American Academy of Family Physicians • To promote and maintain high quality standards for family doctors who are providing continuing comprehensive health care to the public • It is a medical association of more than 93,000 members • Many team physicians are members of this organization 11 National Athletic Trainers’ Association • To enhance the quality of health care for athletes and those engaged in physical activity, and to advance the profession of prevention, evaluation, management and rehabilitation of injuries • The NATA now has 32,000 members 12 American College of Sports Medicine • Patterned after FIMS (Umbrella Organization) • Interested in the study of all aspects of sports • Membership composed of medical doctors, doctors of philosophy, physical educators, athletic trainers, coaches, exercise physiologists, biomechanists, and others interested in sports • >20,000 members 13 American Orthopaedic Society for Sports Medicine • To encourage and support scientific research in orthopaedic sports enjoyable fitness programs and sports participationductive and • Members receive specialized training in sports medicine, surgical procedures, injury prevention and rehabilitation • 1,200 members are orthopaedic surgeons and allied health professionals 14 National Strength and Conditioning Association • improvement of athletic performance and fitness and to enhance, enlighten, and advance thee field of strength and conditioning • 30,000 strength and conditioning coaches, personal trainers, exercise physiologists, athletic exercise instructors and fitness directorsaches, physical therapists, business owners, • Accredited certification programs Certified Strength and Conditioning Specialist, (CSCS) NSCA Certified Personal Trainer (NSCA-CPT) 15 American Academy of Pediatrics, Sports Committee • Dedicated to providing the general pediatrician and pediatric sub-specialist with providing a forum for the discussion of related issuesicine and fitness and • To educate all physicians, especially pediatricians, about the special needs of children who participate in sports 16 American Physical Therapy Association, Sports Physical Therapy Section • assistants, and physical therapy students interested in sports physical therapy, physical therapist • active populationon, recognition, treatment and rehabilitation of injuries in an athletic and physically • Provides educational opportunities through sponsorship of continuing education programs and publications 17 NCAA Committee on Competitive Safeguards and Medical Aspects of Sports • methods, prevention and treatment of sports injuries, and utilization of sound safety measures • Disseminates information and adopts recommended policies and guidelines designed to further the above objectives • Supervises drug-education and drug-testing programs 18 National Academy of Sports Medicine • Founded by physicians, physical therapists and fitness professionals • Focuses on the development, refinement and implementation of educational programs for fitness, performance and sports medicine professionals • Offer a variety of certifications (fitness and performance) 19 Other Health Related Organizations • Various aspects of health related professions have also become involved Dentistry, podiatry, chiropractic medicine • National, state and local organizations have also emerged Focus on athletic health and safety • All bodies have worked towards the reduction of injury and illness in sport 20 Sports Medicine Journals • AJournal of Athletic Trainingst, providing excellent resources to the sports medicine community Journal of Sports Rehabilitation Physician and Sports Medicinets Medicine Clinics in Sports Medicine Sports Healthnal of Sports Medicine Athletic Therapy & Training Training & Conditioning Athletic Training & Sports Health Care 21 Employment Settings for the Athletic Trainer • EmDramatic transformation since 1950g increasingly diverse Due largely to the efforts of the NATA • Started out primarily in the collegiate setting, progressed to high schools and now 40% are found primarily in hospital and clinic settings 22 • Settings include: Clinics and hospitals Physician extenders Industrial/Occupational settings Corporate settings Colleges or Universities Secondary schools Professional sports Amateur/Recreational/Youth sports Performing arts Military & Law enforcement Health & fitness clubs 23 Treating Physically Active Populations • Consists of athletic, recreational or competitive activities • Requires physical skills and utilizes strength, power, endurance, speed, flexibility, range of motion and agility 24 • The Adolescent Athlete Focuses on organized competition A number of sociological issues are involved How old or when should a child begin training? Physically and emotional adolescents can not be managed the same waye as adults 25 • The Aging Athlete Physiological and performance capability changes overtime May be the result of both biological and sociological effectsecycle High levels of physiological function can be maintained through an active lifestyle The impact on long-term health benefits have been documented Beginning an exercise program 26 Exercise program should be gradual and progressive as long as no unusual signs or symptoms develop Indexercise testing before engaging in an exercise program 27 • Occupational Athlete Occupational, industrial or worker “athlete” are involved in strenuous, demanding or repetitive physical activity May result in accidents and injury Involves Instruction on ergonomic techniques to avoid injury associated with physical demand of job Intervention when injuries arise Correcting mechanics, faulty postures, strength deficits, lack of flexibility Injury prevention is still critical 28 Roles & Responsibilities of the Athletic Trainer • Charged with injury prevention and health care provision for an Often requires a cadre of sports medicine professionals • Athletic trainer deals with the patient and injury from its inception until the athlete returns to full competition 29 Roles and Responsibilities: Board of Certification Domains • Injury/illness prevention & wellness protection • Clinical evaluation and diagnosis • Immediate & emergency care • Treatment & rehabilitation • Organizational and professional health and well-being 30 • Prevention Ensure safe environment Conduct pre-participation physicals Develop training and conditioning programs Select and fit protective equipment properly Ensure appropriate medication use while discouraging substance abuse 31 • Clinical Evaluation & Diagnosis Recognize nature and extent of injury Understand pathology of injuries and illnessesls and techniques Referring to medical care Referring to supportive services • Immediate & Emergency Care Administration of appropriate first aid and emergency medical care (CPR, AED) Activation of emergency action plans (EAP) 32 • Treatment and Rehabilitation Design preventative training systems Rehabilitation program design Incorporation of therapeutic modalities and exercise Offering psychosocial intervention • OrRecord keeping Professional Health and Well-being Ordering supplies and equipment Establishing policies and procedures Supervising personnel 33 • Professional Responsibilities Athletic trainer as educator Athletic trainer and continuing education Athletic trainers as counselor Athletic trainers as researcher Incorporation of evidence based medicine Participating and acquiring evidence for efficacious patient care 34 Importance of Engaging Evidence Based Practice • Evidence driving patient care Failure to engage in evidenced based care could jeopardize patient care • EVB Steps Develop clinical question Search literature Appraise evidence Apply evidence Assess outcomes 35 • DeUtilizes the PICO format (Patient, Intervention, Comparison, Outcome) • SeUsing key words to assemble a comprehensive assessment of available literature • EvType of study vs. quality of evidence Must critically evaluate and rate the evidence • ApIntegrating evidence with patient needs and values Bridging barriers between research evidence and clinical decisions to ensure optimal care 36 • Assessing Treatment Outcomes Determining effectiveness Outcomes assessment measures Condition-oriented evidence Patient-oriented evidence Patient perceptions, experience, patient-centered goals Disablement model Evaluates functional loss due to impairment and impact on quality of life Comprehensive assessment Patient reported outcomes Global ratings of change 37 Personal Qualities of the Athletic Trainer • Stamina and the ability to adapt • Empathy • Sense of humor • Communication • Intellectual curiosity • Ethical practice • Professional memberships 38 Athletic Trainer and the Athlete • Major concern on the part of the ATC should be the injured patient • All decisions impact the patient • The injured patient must always be informed Be rehabilitationthe how, when and why that dictates the course of injury 39 • The patient must be educated about injury prevention and management • Instructions should be provided regarding training and conditioning • Inform the patient to listen to his/her body in order to prevent injuries 40 Athletic Trainer and Parents • Athletic trainers must keep parents informed, particularly in the secondary school setting Injury management and prevention • The parents decision regarding healthcare must be a primary consideration • Insurance plans may dictate care Selection of physician 41 • The athletic trainer, physician and coaches must be aware and inform parents of Health Insurance Portability and Accountability Act (HIPAA) Regulates dissemination of health information Protects patient’s privacy and limits the people who could gain access to medical records 42 The Athletic Trainer and the Team Physician • Athletic trainer works under direct supervision of physician • Physician assumes a number of roles Serves to advise and supervise ATC • Physician and the athletic trainer must be able to work together Have similar philosophical opinions regarding injury management Helps to minimize discrepancies and inconsistencies 43 • The physician is responsible for compiling medical histories and conducting physical exams Pre-participation screening • Diagnosing injury • Deciding on disqualifications Decisions regarding athlete’s ability to participate based on medical knowledge and psychophysiological demands of sport • Attending practice and games • Commitment to sports and athlete 44 • Potentially serve as the academic program medical director Coordinates and guides medical aspects of program Provides input into educational content and provides programmatic instruction 45 The Athletic Trainer and the Coach • Must understand specific role of all individuals involved with the team • Coach must clearly understand the limits of their ability to function as a health care provider in their respective state • Directly responsible for injury prevention Athlete must go through appropriate conditioning program 46 • Coach must be aware of risks associated with sport • Provide appropriate training and equipment • Should be certified in CPR and first aid • Must have thorough knowledge of skills, techniques and environmental factors associated with sport • DMust be a cooperative relationshipwith staff, including athletic trainers 47 Referring the Patient to Other Personnel • personneltic trainer must be aware of available medical and non-medical Patient may require special treatment outside of the “traditional” sports medicine team • Must be aware of community based services and various insurance plans Typically the athletic trainer and team physician will consult on the particular matter and refer accordingly 48 Support Health Services & Personnel • Exercise • Physicians Physiologist • Dentist • Biomechanist • Podiatrist • Nutritionist • Nurse • Sport Psychologist • Physicians Assistant • Coaches • Physical Therapist • Strength & • Occupational Conditioning Therapist Specialist • Massage Therapist • Social Worker • Ophthalmologist • Neurologist • Dermatologist • Emergency Medical • Gynecologist Technician • Osteopath 49 Recognition and Accreditation of the Athletic Trainer as an Allied Healthcare Professional • June 1990- AMA officially recognized athletic training as an allied health profession • Committee on Allied Health Education and Accreditation (CAHEA) was academic programs to use in preparation of individuals for entry intoor profession through the Joint Review Committee on Athletic Training (JRC- AT) 50 • June 1994-CAHEA dissolved and replaced immediately by Commission on ARecognized as an accreditation agency for allied health education programs by the U.S. Department of Education • Entry level college and university athletic training education programs at both undergraduate and graduate levels were accredited by CAAHEP through 2005 51 • In 2003, JRC-AT became an independent accrediting agency JRC-AT would accredit athletic training education programs without involvement of CAAHEP JRC-AT officially became the Committee for Accreditation of Athletic Training Education (CAATE) in 2006 CAATCHEA is a private nonprofit national organization that coordinates accreditation activity in the United States Recognition by CHEA puts CAATE on the same level as other national accreditors, such as CAAHEP 52 • Effects of CAATE accreditation are not limited to educational aspects • In the future, this recognition may potentially affect regulatory legislation, the practice of athletic training in nontraditional settings, and insurance considerations • professionn will continue to be a positive step in the development of the athletic training 53 Accredited Athletic Training Education Programs • EIn 2012, 333 undergraduate programs, 19 entry-level master’s programs • Advanced graduate athletic training education programs Designed for individuals that are already certified ATs 54 Education Council • preparation for the athletic training student to dictate the course of the educational • Focus has shifted to competency based education at the entry level • Education Council has significantly expanded and reorganized the clinical competencies and proficiencies 55 Athletic Training Education Competencies • EEvidence based practice Prevention & health promotion Clinical examination & diagnosis Therapeutic interventionslness Psychosocial strategies & referrals Healthcare administration Professional development & responsibilities 56 • Foundational Behaviors of Professional Practice “People” components of the profession Recognizing the primary focus of practice should be the patient Understanding that competent health care requires a team approach Practicing ethically elements of practice Advancing the knowledge base in athletic training Appreciate cultural diversity Being an advocate and model for the AT profession 57 Post-Professional Athletic Training Education Programs • 15 programs are certified by the NATA Graduate Education Committee • Designed to enhance academic and clinical preparation of already certified athletic trainers 58 Specialty Certifications • NATA is in the process of developing specialty certifications Aid in expanding scope of practiceopment • Specialty certifications build on entry level knowledge 59 • Purpose To credential that demonstrates attainment of knowledge andtice skills that will enhance patient care, enhance health-related patient quality of life, and optimize clinical outcomes in specialized areas of athletic training practice 60 Requirements for Certification as an Athletic Trainer • Must have extensive background in formal academic preparation and supervised practical experience • Guidelines are set by the Board of Certification (BOC) 61 • Upon meeting the educational guidelines applicants are eligible to sit for the examination • Examination is computer based • Exam assesses 5 domains Injury/illness prevention and wellness protection Immediate & emergency careagnosis Treatment and rehabilitation Organizational and professional health and well-being 62 • Upon passing the certification examination = BOC certified as an athletic trainer Credential of ATC • BOC certification is a prerequisite for licensure in most states 63 Continuing Education Requirements • Ensure ongoing professional growth and involvement • Requirements that must be met to remain certified 75 CEUs over the course of three years 64 • Purpose: To encourage athletic trainers to obtain current professional development information To explore new knowledge in specific areas To expand approaches to effective athletic trainingtechniques To further develop professional judgment To conduct professional practice in an ethical and appropriate manner 65 • CEUs are awarded for: Attending symposiums, workshops, seminars Serving as a speaker or panelist Certification exam writer Authoring a research article; authoring/editing a textbook Completing post-graduate work • All certified athletic trainers must demonstrate proof of current CPR/AED certification 66 State Regulation of the Athletic Trainer • During the early-1970s NATA realized the necessity of obtaining some type of official recognition by other medical allied health organizations of the athletic trainer as a health care professional • Laws and statutes specifically governing the practice of athletic training were nonexistent in virtually every state 67 • Athletic trainers in many individual states organized efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies • To date 48 of the 50 states have enacted some type of regulatory statute governing the practice of athletic training • Rules and regulations governing the practice of athletic training vary tremendously from state to state 68 • RLicensure may be in the form of: Limits practice of athletic training to those who have met minimal requirements established by a state licensing board Limthe practice actf individuals who can perform functions related to athletic training as dictated by Most restrictive of all forms of regulation 69 Certification Does not restrict using the title of athletic trainer to those certified by the state Can restrict performance of athletic training functions to only those individuals who are certified Registration Before an individual can practice athletic training he or she must register in that state Individual has paid a fee for being placed on an existing list of practitioners but says nothing about competency 70 Exemption State recognizes that an athletic trainer performs similar functions to other licensed professions they do not comply with the practice acts of other regulated professionsning despite the fact that • Legislation regulating the practice of athletic training has been positive and to some extent protects the athletic trainer from litigation 71 Future Directions for the Athletic Trainer • Will be determined by the efforts of the NATA and its membership Ongoing re-evaluation, revision and reform of athletic training education Further recognition of CAATE by CHEA will further enhance credibility Athletic trainers must continue to actively seek third party reimbursement for Standardization of state practice acts 72 Athletic trainers will seek specialty certifications Increase in secondary school employment of athletic trainers Increase in recognition of athletic trainers as physician extender Potential for expansion in the military, industry, and fitness/wellness settings With general population aging = increased opportunity to work with aging physically active individuals Continue to enhance visibility through research and scholarly publication 73 Continue to be available for local and community meetings to discuss health care of the athlete Increase recognition and presence internationally Most importantly, continue to focus efforts on injury prevention and to provide high quality health care to physically active individuals regardless of the setting in which the injury occurs 74
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