Context: Understanding implementation strategies of Approved Clinical Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice. Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.8 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview transcripts were analyzed and coded for common themes and subthemes regarding implementation strategies. Established themes were triangulated through peer review and member checking to verify the data. Results: The ACIs identified EBP implementation as important for validation of the profession, changing paradigm shift, improving patient care, and improving student educational experiences. They promoted 3 methods of implementing EBP concepts with their students: self-discovery, promoting critical thinking, and sharing information. They assisted students with the steps of EBP and often faced challenges in implementation of the first 3 steps of EBP: defining a clinical question, literature searching, and literature appraisal. Finally, ACIs indicated that modeling the behavior of making clinical decisions based on evidence was the best way to encourage students to continue using EBP. Conclusions: Athletic training education program directors should encourage and recommend specific techniques for EBP implementation in the clinical setting. The ACIs believed that role modeling is a strategy that can be used to promote the use of EBP with students. Training of ACIs should include methods by which to address the steps of the EBP process while still promoting critical thinking.
This study aimed to compare functional movement screen (FMS [TM]) scores and Beighton and Horan joint mobility index (BHJMI) scores among pubescence in adolescent athletes. Sixty-six adolescents between the ages of 8 and 14 voluntarily participated in this study. The participants performed the tests of the BHJMI, the tasks of the FMS (TM), and the clearing tests of the FMS (TM). The composite scores of the FMS (TM) and the BHJMI were scored objectively by the same researcher. The subjects were separated into prepubescent, early-pubescent, and postpubescent groups based on the results of the modified pubertal maturation observational scale. A 2 × 3 (gender × pubescence) factorial analysis of variance revealed a main effect for FMS (TM) scores across pubertal groups (p = 0.032) but not in BHJMI composite scores (pre = 2.69 ± 0.40, pub = 1.96 ± 0.40, post = 3.13 ± 0.43, p = 0.131). The postpubescent participants had significantly higher FMS (TM) scores compared with the prepubescent participants (post = 15.91 ± 0.47, pre = 14.28 ± 0.44, p = 0.008) and the early-pubescent participants (pub = 14.55 ± 0.44, p = 0.039). No differences were identified between gender for FMS (TM) scores (male participants = 15.16 ± 0.38, female participants = 14.67 ± 0.35, p = 0.351) or BHJMI scores (male participants = 2.36 ± 0.35, female participants = 2.83 ± 0.32, p = 0.321). No significant interactions were found between gender and pubescence regarding the BHJMI composite scores (p = 0.503) or the FMS (TM) scores (p = 0.216). There was no correlation between FMS (TM) composite scores and BHJMI composite scores (p = 0.89). Our results suggest that the FMS (TM) can discriminate between levels of pubescence and detect alterations during the pubertal growth cycle, whereas the BHJMI may not. A prospective extension of this study to include follow-up of injured participants appears worthwhile to determine if the FMS (TM) can suitably predict injury in the adolescent population.
Context: Many styles of foot pads are commonly applied to reduce immediate pain and pressure under the foot. Objective: To examine the effect of 3 different foot pads on peak plantar pressure (PPP) and mean plantar pressure (MPP) under the first metatarsophalangeal joint (MTPJ) during slow running. Design: A 4 (pad) × 4 (mask) repeated-measures design. Setting: University athletic training clinic and fitness facility. Participants: 20 physically active participants, 12 men (19.7 ± 1.3 y, 181.5 ± 6.3 cm, 83.6 ± 12.3 kg) and 8 women (20.8 ± 1.5 y, 172.7 ± 11.2 cm, 69.9 ± 14.2 kg) with navicular drop greater than or equal to 10 mm, no history of surgery to the lower extremity, and no history of pain or injury to the first MTPJ in the past 6 months. Interventions: PPP and MPP were evaluated under 4 areas of the foot: the rear foot, lateral forefoot, medial forefoot, and first MTPJ. Four pad conditions (no pad, metatarsal dome, U-shaped pad, and donut-shaped pad) were evaluated during slow running. All measurements were taken on a standardized treadmill using the Pedar in-shoe pressure-measurement system. Main Outcome Measures: PPP and MPP in 4 designated foot masks during slow running. Results: The metatarsal dome produced significant decreases in MPP (163.07 ± 49.46) and PPP (228.73 ± 63.41) when compared with no pad ( P < .001). The U-shaped pad significantly decreased MPP (168.68 ± 50.26) when compared with no pad ( P < .001). The donut-shaped pad increased PPP compared with no pad ( P < .001). Conclusions: The metatarsal dome was most effective in reducing both peak and mean plantar pressure. Other factors such as pad comfort, type of activity, and material availability must also be considered. Further research should be conducted on the applicability to other foot types and symptomatic subjects.
Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury. Examining the possible relationship between on-field or sideline signs and symptoms and recovery times would give clinicians the confident ability to properly treat and manage an athlete's recovery process in a more systematic manner. Furthermore, identifying factors after a head injury that may be predictive of protracted recovery times would be useful for athletes, parents, and coaches alike.Which on-field and sideline signs and symptoms affect length of recovery after concussion in high school and college athletes?
Context The emergence of the doctor of athletic training (DAT) degree creates opportunities to develop advanced practice leaders in athletic training. Preliminary data suggest academic employers are likely to hire and believe it would be beneficial to hire someone with a DAT degree; however, it remains unclear how academic employers perceive the DAT degree. Objectives To explore the impressions of academic employers regarding the qualifications of athletic trainers (ATs) with the DAT degree for employment in the academic setting. Design Qualitative study. Setting Individual video interviews. Participants A total of 11 employers who are ATs (8 women, 3 men; age = 42 ± 8.5 years; years as an educator = 10.3 ± 5.9 years). Data Collection and Analysis The primary investigator interviewed participants via individual video conferences using a semistructured interview guide to gather perceptions of the DAT degree and the role of ATs with the DAT in academic settings. Data were analyzed and coded into common themes and categories, followed by triangulation of data via the research team and member checking to ensure data accuracy. Results One predominant theme emerged relative to the employers' impressions regarding qualifications of ATs with the DAT degree. Participants characterized those with the DAT degree as being capable of conducting practice-based research and implementing innovative practices in and outside of the classroom. Participants also described DAT-credentialed ATs as individuals who embodied advanced practice characteristics demonstrated through leadership, soft skills, core competencies, and advanced application of knowledge and skills. Conclusions Although academic employers' impressions toward hiring DAT-credentialed ATs were positive, the focus and role of the DAT degree remains unclear. Further education is needed within the athletic training community to clarify the goal and focus of the DAT degree and its role in athletic training education.
