Athletic Trainers' Psychosocial Experiences During the COVID-19 Pandemic: A Qualitative Research Study.

CONTEXT: Despite the many challenges posed by the COVID-19 pandemic, athletic programs have sought ways to persevere and deliver sport programming. This process has strained the psychosocial health of all sport stakeholders but especially those entrusted with promoting the health of participants and enforcing safety protocols. Athletic trainers (ATs) have been a major influence in striving to achieve these goals by expanding their typical roles to lead in promoting the safe delivery of sport programs. OBJECTIVE: To examine the psychosocial lived experiences of ATs as they practiced during the COVID-19 pandemic. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association Divisions I, II, and III. PATIENTS OR OTHER PARTICIPANTS: A total of 27 ATs practicing at the collegiate level (Divisions I, II, and III) who were actively involved in planning and implementing return-to-sport protocols during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS: Semi-structured interviews were conducted via Zoom. Inductive conventional content analysis identified emerging themes that characterized participants' narratives. Three members of the research team were involved in the analysis process and used field notes, continuous member checking, peer review, and multiple-researcher triangulation to establish data credibility and confirmability. RESULTS: Three higher-order themes related to ATs' psychosocial lived experiences emerged: (1) internalized experience, (2) interpersonal interactions, and (3) AT identity. Several subthemes were also identified to further organize elements that characterized or differentiated participants' lived experiences. CONCLUSIONS: Athletic trainers encountered significant challenges in maintaining their psychosocial health during the pandemic as they strived to assist others in this regard. Providing effective psychological and social support resources and strategies for ATs may not only allow them to better support themselves but may also enhance their ability to deliver professional services and promote psychosocial health among their athletes and other stakeholders in their respective sport systems in the future.

Collegiate Athletic Trainers' Experiences Implementing Return-to-Sport Policies and Procedures During COVID-19: A Qualitative Research Study.

CONTEXT: Athletic trainers (ATs) were critical personnel in the development of policies and procedures for the safe return to campus and resumption of sport during the 2020-2021 academic year. Policies focused on preventing the potential spread of COVID-19, as well as screening, testing, and management of cases; however, which aspects of implementation were successful or more challenging was unknown. OBJECTIVE: To identify successes and challenges in the implementation of return-to-sport policies and procedures during the 2020-2021 academic year amid the COVID-19 pandemic. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association Divisions I, II, and III. PATIENTS OR OTHER PARTICIPANTS: A total of 27 ATs (9 women [33.3%], mean age = 48.5 ± 9.8 years, years of experience = 25.0 ± 10.5) who were in positions of leadership or who were actively involved in developing and then implementing COVID-19 return-to-sport policies and procedures completed Zoom interviews. DATA COLLECTION AND ANALYSIS: Semistructured Zoom interviews were audio and video recorded and later transcribed. The data were analyzed by a team of 4 experienced researchers using the consensual qualitative research approach. Field notes, intercoder reliability, and multiple-analyst triangulation were used to establish data credibility. RESULTS: Emerging themes were implementation of public health interventions, interprofessional collaboration, and advancing the profession of athletic training. Participants described establishing and strengthening collaborations with other health care professionals as well as key stakeholders on campus as a positive outcome of the pandemic, but variations in policies among institutions and states made policy communication and enforcement more challenging. CONCLUSIONS: The ATs played a pivotal role in policy development, communication, and enforcement. Overall, participants took pride in serving as health care leaders for their universities and opening the eyes of colleagues to the breadth of their athletic training skill sets.

Kinesiology Tape: A Descriptive Survey of Healthcare Professionals in the United States.

BACKGROUND: The existing body of kinesiology tape (KT) research reveals inconsistent results which challenges the efficacy of the intervention. Understanding professional beliefs and KT clinical application might provide insight for future research and development of evidence-based guidelines. PURPOSE: The purpose of this study was to survey and document the beliefs and clinical application methods of KT among healthcare professionals in the United States. DESIGN: Cross-sectional survey study. METHODS: A 30-question online survey was emailed to members of the National Athletic Trainers Association, Academy of Orthopedic Physical Therapy, and American Academy of Sports Physical Therapy. Professionals were also informed through a recruitment post in different private healthcare Facebook groups. RESULTS: One thousand and eighty-three respondents completed the survey. Most respondents used KT for post-injury treatment (74%), pain modulation (67%), and neuro-sensory feedback (60%). Most believed that KT stimulates skin mechanoreceptors (77%), improve local circulation (69%), and modulates pain (60%). Some respondents believed KT only created a placebo effect (40%) and use it for such therapeutic purposes (58%). Most used a standard uncut roll (67%) in black (71%) or beige (66%). Most respondents did not use any specialty pre-cut tape (83%), infused tape (99.54%), or a topical analgesic with tape (65%). The most common tape tension lengths used by respondents were 50% tension (47%) and 25% (25%) tension. Patient reported outcomes (80%) were the most common clinical measures. Most respondents provided skin prep (64%) and tape removal (77%) instructions. Some did not provide any skin prep (36%) or tape removal (23%) instruction. The average recommended times to wear KT were two to three days (60%). The maximum times ranged from two to five days (81%). CONCLUSION: This survey provides insight into how professionals use KT and highlights the gap between research and practice. Future research should address these gaps to better determine evidence-based guidelines. LEVEL OF EVIDENCE: 3.

AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS.

BACKGROUND: As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy. PURPOSE: The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis. STUDY DESIGN: Cross-Sectional Study. METHODS: Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity). RESULTS: Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS. CONCLUSIONS: The BTrackS Balance Plate and Sport Balance software has the greatest concussion sensitivity of any balance testing instrument reported to date. LEVEL OF EVIDENCE: Level 2 (Individual cross sectional diagnostic study).

Understanding organization structures of the college, university, high school, clinical, and professional settings.

Athletes participate at many different levels of competition--from amateur to professional, from backyard sandlot to Yankee Stadium. There are as many different organized structures involved in providing medical care to athletes as there are types of athletes themselves. Although the organizational structures involved in providing medical care for a little league team in a small town are different from those involved in providing care for a professional baseball team, the mission is the same-caring for athletes. This is the central theme of this article. Though there are different organizational structures, there are more common threads than differences in the mission of those who provide medical care for athletes at any level.