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Principles of Athletic Training 14 th Edition. William E. Prentice. Principles of Athletic Training 14 th Edition PowerPoint Presentations. Damian Goderich, MA, Physical Education, USF. Chapter 1: The Athletic Trainer as a Health Care Provider. What is an ATHLETIC TRAINER?.

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Principles of athletic training 14 th edition
Principles of Athletic Training 14th Edition

William E. Prentice


Principles of athletic training 14 th edition powerpoint presentations

Principles of Athletic Training 14th EditionPowerPoint Presentations

Damian Goderich, MA, Physical Education, USF



What is an ATHLETIC TRAINER?

  • Are they a doctor?

  • Can they prescribe medicine?

  • Are they a coach?

  • Where can they work?

  • Do you have to go to school to be an athletic trainer?


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


Historical perspective
Historical Perspective managing and rehabilitating injuries

  • 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 19th century in intercollegiate & interscholastic sports

    • Early treatments involved rubs, counter-irritants, home remedies and poultices


Evolution of contemporary athletic trainer
Evolution of Contemporary Athletic Trainer managing and rehabilitating injuries

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


  • Rapid evolution of the profession following WW I managing and rehabilitating injuries

    • 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


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


Changing face of athletic training profession
Changing Face of Athletic Training Profession have been achieved

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 clinic or facility vs. athletic training room

Athletic trainers – NOT TRAINERS!!


Sports medicine and athletic training
Sports Medicine and Athletic Training athletes or those just injured during physical activity

Broad field of medical practices related to physical activity and sport

Involves a number of specialties involving active populations

Typically classified as relating to performance enhancement or injury care and management


Sports Medicine athletes or those just injured during physical activity

Human

Performance

Injury

Management

Exercise Physiology

Practice of Medicine

Athletic Training

Biomechanics

Sport Psychology

Sports Physical Therapy

Strength Conditioning

Sports Massage

Personal Fitness Trainers

Sports Podiatry/Orthotists

Sports Dentistry


Growth of professional sports medicine organizations
Growth of Professional Sports Medicine Organizations athletes or those just injured during physical activity

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)


International federation of sports medicine
International Federation of Sports Medicine athletes or those just injured during physical activity

Federation Internationale de Medecine Sportive (FIMS)

Principal purpose to promote the study and development of sports medicine throughout the world

Made up of national sports medicine associations of over 100 countries

Organization includes many disciplines that are concerned with physically active individuals


American academy of family physicians
American Academy of Family Physicians athletes or those just injured during physical activity

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


National athletic trainers association
National Athletic Trainers’ Association athletes or those just injured during physical activity

To enhance the quality of health care for athletes and those engaged in physical activity, and to advance the profession of athletic training through education and research in the prevention, evaluation, management and rehabilitation of injuries

The NATA now has 32,000 members


Figure 1-1 athletes or those just injured during physical activity


American college of sports medicine
American College of Sports Medicine athletes or those just injured during physical activity

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


American orthopaedic society for sports medicine
American Orthopaedic Society for Sports Medicine athletes or those just injured during physical activity

To encourage and support scientific research in orthopaedic sports medicine and to develop methods for safer, more productive and enjoyable fitness programs and sports participation

Members receive specialized training in sports medicine, surgical procedures, injury prevention and rehabilitation

1,200 members are orthopaedic surgeons and allied health professionals


National strength and conditioning association
National Strength and Conditioning Association athletes or those just injured during physical activity

To facilitate a professional exchange of ideas in strength development as it relates to the improvement of athletic performance and fitness and to enhance, enlighten, and advance the field of strength and conditioning

30,000 strength and conditioning coaches, personal trainers, exercise physiologists, athletic trainers, researchers, educators, sport coaches, physical therapists, business owners, exercise instructors and fitness directors

Accredited certification programs

Certified Strength and Conditioning Specialist, (CSCS)

NSCA Certified Personal Trainer (NSCA-CPT)


American academy of pediatrics sports committee
American Academy of Pediatrics, Sports Committee athletes or those just injured during physical activity

Dedicated to providing the general pediatrician and pediatric sub-specialist with an understanding of the basic principles of sports medicine and fitness and providing a forum for the discussion of related issues

To educate all physicians, especially pediatricians, about the special needs of children who participate in sports


American physical therapy association sports physical therapy section
American Physical Therapy Association, Sports Physical Therapy Section

To provide a forum to establish collegial relations between physical therapists, physical therapist assistants, and physical therapy students interested in sports physical therapy

Promotes prevention, recognition, treatment and rehabilitation of injuries in an athletic and physically active population

Provides educational opportunities through sponsorship of continuing education programs and publications


Ncaa committee on competitive safeguards and medical aspects of sports
NCAA Committee on Competitive Safeguards and Medical Aspects of Sports

Collects and develops pertinent information regarding desirable training 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


National academy of sports medicine
National Academy of Sports Medicine of Sports

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)


Other health related organizations
Other Health Related Organizations of Sports

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


Sports medicine journals
Sports Medicine Journals of Sports

A variety of publications exist, providing excellent resources to the sports medicine community

Journal of Athletic Training

Journal of Sports Rehabilitation

International Journal of Sports Medicine

Physician and Sports Medicine

Clinics in Sports Medicine

American Journal of Sports Medicine

Sports Health

Athletic Therapy Today

Training & Conditioning

Athletic Training & Sports Health Care


Employment settings for the athletic trainer
Employment Settings for the Athletic Trainer of Sports

Employment opportunities are becoming increasingly diverse

Dramatic transformation since 1950

Due largely to the efforts of the NATA

Started out primarily in the collegiate setting, progressed to high schools and are now 30% are found primarily in hospital and clinic settings


Settings include: of Sports

Clinics and hospitals

Physician extenders

Industrial/Occupational settings

Corporate settings

Colleges or Universities

Secondary schools

School districts

Professional sports

Amateur/Recreational/Youth sports

Performing arts

Military & Law enforcement

Health & fitness clubs


Figure 1-3 of Sports


Treating physically active populations
Treating Physically Active Populations of Sports

Consists of athletic, recreational or competitive activities

Requires physical skills and utilizes strength, power, endurance, speed, flexibility, range of motion and agility


The Adolescent Athlete of Sports

Focuses on organized competition

A number of sociological issues are involved

How old or when should a child begin training?

Skeletal maturity presents some challenges with respect to healthcare

Physically and emotional adolescents can not be managed the same way as adults


The Aging Athlete of Sports

Physiological and performance capability changes overtime

Function will increase and decrease depending on point in lifecycle

May be the result of both biological and sociological effects

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


Exercise program should be gradual and progressive as long as no unusual signs or symptoms develop

Individuals over age 40 should have a physical and exercise testing before engaging in an exercise program


Occupational Athlete as no unusual signs or symptoms develop

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 responsibilities

Intervention when injuries arise

Correcting mechanics, faulty postures, strength deficits, lack of flexibility

Injury prevention is still critical


Roles responsibilities of the athletic trainer
Roles & Responsibilities of the Athletic Trainer as no unusual signs or symptoms develop

Charged with injury prevention and health care provision for an injured patient

Athletic trainer deals with the patient and injury from its inception until the athlete returns to full competition


Roles and responsibilities board of certification domains
Roles and Responsibilities: Board of Certification Domains as no unusual signs or symptoms develop

Prevention

Clinical evaluation and diagnosis

Immediate care

Treatment, rehabilitation and reconditioning

Health care administration

Professional responsibilities


Prevention as no unusual signs or symptoms develop

Ensure safe environment

Conduct pre-participation physicals

Develop training and conditioning programs

Select and fit protective equipment properly

Explaining important diet and lifestyle choices

Ensure appropriate medication use while discouraging substance abuse


Clinical Evaluation & Diagnosis as no unusual signs or symptoms develop

Recognize nature and extent of injury

Involves both on and off-field evaluation skills and techniques

Understand pathology of injuries and illnesses

Referring to medical care

Referring to supportive services

Immediate Care

Administration of appropriate first aid and emergency medical care (CPR, AED)

Activation of emergency action plans (EAP)


Treatment, Rehabilitation Reconditioning as no unusual signs or symptoms develop

Design preventative training systems

Rehabilitation program design

Supervising rehabilitation programs

Incorporation of therapeutic modalities and exercise

Offering psychosocial intervention

Organization & Administration

Record keeping

Ordering supplies and equipment

Establishing policies and procedures

Supervising personnel


Professional Responsibilities as no unusual signs or symptoms develop

Athletic trainer as educator

Athletic trainer and continuing education

Athletic trainers as counselor

Athletic trainers as researcher

Incorporation of evidence medicine and participating and acquisition of evidence for efficacy of patient care


Personal qualities of the athletic trainer
Personal Qualities of the Athletic Trainer as no unusual signs or symptoms develop

Stamina and the ability to adapt

Empathy

Sense of humor

Communication

Intellectual curiosity

Ethical practice

Professional memberships


Athletic trainer and the athlete
Athletic Trainer and as no unusual signs or symptoms developthe 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 made aware of the how, when and why that dictates the course of injury rehabilitation


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


Athletic trainer and parents
Athletic Trainer and Parents management

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


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


The athletic trainer and the team physician
The Athletic Trainer and the Team Physician and inform parents of Health Insurance Portability and Accountability Act (HIPAA)

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


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


Potentially serve as the academic program medical director and conducting physical exams

Coordinates and guides medical aspects of program

Provides input into educational content and provides programmatic instruction


The athletic trainer and the coach
The Athletic Trainer and and conducting physical examsthe 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


Coach must be aware of risks associated with sport and conducting physical exams

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

Develop good working relationships with staff, including athletic trainers

Must be a cooperative relationship


Referring the patient to other personnel
Referring the Patient to and conducting physical examsOther Personnel

The athletic trainer must be aware of available medical and non-medical personnel

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


Support Health Services & Personnel and conducting physical exams

  • Physicians

  • Dentist

  • Podiatrist

  • Nurse

  • Physicians Assistant

  • Physical Therapist

  • Occupational Therapist

  • Massage Therapist

  • Ophthalmologist

  • Dermatologist

  • Gynecologist

  • Exercise Physiologist

  • Biomechanist

  • Nutritionist

  • Sport Psychologist

  • Coaches

  • Strength & Conditioning Specialist

  • Social Worker

  • Neurologist

  • Emergency Medical Technician


Recognition and accreditation of the athletic trainer as an allied health professional
Recognition and Accreditation of the Athletic Trainer as an Allied Health Professional

June 1990- AMA officially recognized athletic training as an allied health profession

Committee on Allied Health Education and Accreditation (CAHEA) was charged with responsibility of developing essentials and guidelines for academic programs to use in preparation of individuals for entry into profession through the Joint Review Committee on Athletic Training (JRC-AT)


June 1994-CAHEA dissolved and replaced immediately by Commission on Accreditation of Allied Health Education Programs (CAAHEP)

Recognized 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


In 2003, JRC-AT became an independent accrediting agency Commission on Accreditation of Allied Health Education Programs (CAAHEP)

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

CAATE was officially recognized by CHEA in 2007

CHEA 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


Effects of CHEA 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

Recognition will continue to be a positive step in the development of the athletic training profession


Accredited athletic training education programs
Accredited Athletic Training Education Programs aspects

Entry-level athletic training education programs

In 2009, 357 undergraduate programs, 19 entry-level master’s programs

Advanced graduate athletic training education programs

Designed for individuals that are already certified ATs


Education council
Education Council aspects

In 1997 the Education Council was established to dictate the course of the educational preparation for the athletic training student

Focus has shifted to competency based education at the entry level

Education Council has significantly expanded and reorganized the clinical competencies and proficiencies


Athletic training education competencies
Athletic Training Education Competencies aspects

Twelve Content Areas

Risk management

Pathology of injuries and illnesses

Orthopedic clinical examination & diagnosis

Acute care

Pharmacological aspects of injury and illness

Therapeutic modalities


Athletic training education competencies1
Athletic Training Education Competencies aspects

Conditioning & rehabilitative exercise

General medical conditions and disabilities

Nutritional aspects of injury and illnesses

Psychosocial intervention and referral

Health care administration

Professional development & responsibilities


Foundational Behaviors of Professional Practice aspects

“People” components of the profession

Recognizing the primary focus of practice should be the patient

Understanding that competent health care requires a team approach

Being aware of legal elements of practice

Practicing ethically

Advancing the knowledge base in athletic training

Appreciate cultural diversity

Being an advocate and model for the AT profession


Post professional athletic training education programs
Post-Professional Athletic Training Education Programs aspects

15 programs are certified by the NATA Graduate Education Committee

Designed to enhance academic and clinical preparation of already certified athletic trainers


Specialty certifications
Specialty Certifications aspects

NATA is in the process of developing specialty certifications

Further enhance professional development

Aid in expanding scope of practice

Specialty certifications build on entry level knowledge


Purpose aspects

To provide the athletic trainer with advanced clinical practice credential that demonstrates attainment of knowledge and skills that will enhance patient care, enhance health-related patient quality of life, and optimize clinical outcomes in specialized areas of athletic training practice


Requirements for certification as an athletic trainer
Requirements for Certification as an Athletic Trainer aspects

Must have extensive background in formal academic preparation and supervised practical experience

Guidelines are set by the Board of Certification (BOC)


Upon meeting the educational guidelines applicants are eligible to sit for the examination

Examination is computer based

Exam assesses the 6 domains

Prevention

Evaluation and diagnosis

Immediate care

Treatment, rehabilitation & reconditioning

Organization and administration

Professional responsibility


Upon passing the certification examination = BOC certified as an athletic trainer

Credential of ATC

BOC certification is a prerequisite for licensure in most states


Continuing education requirements
Continuing Education Requirements as an athletic trainer

Ensure ongoing professional growth and involvement

Requirements that must be met to remain certified

75 CEUs over the course of three years


Purpose: as an athletic trainer

To encourage athletic trainers to obtain current professional development information

To explore new knowledge in specific areas

To master new athletic training related skills and techniques

To expand approaches to effective athletic training

To further develop professional judgment

To conduct professional practice in an ethical and appropriate manner


CEUs are awarded for: as an athletic trainer

Attending symposiums, workshops, seminars

Serving as a speaker or panelist

Certification exam model

Participating in the USOC program

Authoring a research article; authoring/editing a textbook

Completing post-graduate work

All certified athletic trainers must demonstrate proof of current CPR/AED certification


State regulation of the athletic trainer
State Regulation of the Athletic Trainer as an 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


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 47 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


Regulation may be in the form of: efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies

Licensure

Limits practice of athletic training to those who have met minimal requirements established by a state licensing board

Limits the number of individuals who can perform functions related to athletic training as dictated by the practice act

Most restrictive of all forms of regulation


Certification efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies

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


Exemption efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies

State recognizes that an athletic trainer performs similar functions to other licensed professions (e.g. physical therapy), yet still allows them to practice athletic training despite the fact that they do not comply with the practice acts of other regulated professions

Legislation regulating the practice of athletic training has been positive and to some extent protects the athletic trainer from litigation


Future directions for the athletic trainer
Future Directions for the Athletic Trainer efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies

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 athletic training services

Standardization of state practice acts


Athletic trainers will seek specialty certifications efforts to secure recognition by seeking some type of regulation of the athletic trainer by state licensing agencies

Expanding breadth and scope of practice

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


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


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