Practice Patterns of Athletic Trainers Regarding the On-Site Management of Patients With Joint Dislocations.

CONTEXT: As part of clinical practice, athletic trainers (ATs) provide immediate management of patients with acute joint dislocations. Management techniques may include on-site closed joint reduction of the dislocated joint. Although joint reduction is part of the 2020 educational standards, currently practicing ATs may have various levels of exposure, knowledge, and skills. OBJECTIVE: To capture AT self-reported knowledge and practice patterns concerning closed joint reductions. DESIGN: Cohort study. SETTING: Online survey (Qualtrics). PATIENTS OR OTHER PARTICIPANTS: The survey link was emailed to 5000 certified ATs. A total of 772 responses were completed by certified ATs with clinical practice experience (15.4% response rate). MAIN OUTCOME MEASURE(S): Participants were asked to complete a survey about their practice patterns concerning patients with closed joint reductions, which included questions about the types of closed reductions ATs performed most commonly, the frequency of on-site reduction by ATs, and participants' demographic information. Additionally, the survey addressed the ATs' training and comfort level in performing closed reductions and knowledge of standing orders and the state practice act. RESULTS: Ninety percent (n = 694) of ATs reported ever performing a closed reduction (either with or without a physician present), with 10% (n = 78) stating they had never performed a joint reduction. The interphalangeal joint of the finger (73.2% of ATs), shoulder (63.3%), and patella (48.2%) were cited as the 3 most common reductions performed without a physician present. Only 46.5% (n = 359) of ATs indicated receiving training in joint-reduction techniques as part of their precertification athletic training curriculum or program; a greater percentage (64%) said they learned directly from a physician. Fewer than 60% of ATs reported having standing orders related to joint reductions. CONCLUSIONS: Considering the high percentage of ATs who reported performing closed joint reductions and the low percentage with formal training, further development of joint-reduction training and standing orders is warranted.

Heating capacity of rebound shortwave diathermy and moist hot packs at superficial depths.

CONTEXT: The effectiveness of a new continuous diathermy unit, ReBound, as a heating modality is unknown. OBJECTIVE: To compare the effects of ReBound diathermy with silicate-gel moist hot packs on tissue temperature in the human triceps surae muscle. DESIGN: Crossover study. SETTING: University research laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 12 healthy, college-aged volunteers (4 men, 8 women; age = 22.2 ± 2.25 years, calf subcutaneous fat thickness = 7.2 ± 1.9 mm). INTERVENTION(S): On 2 different days, 1 of 2 modalities (ReBound diathermy, silicate-gel moist hot pack) was applied to the triceps surae muscle of each participant for 30 minutes. After 30 minutes, the modality was removed, and temperature decay was recorded for 20 minutes. MAIN OUTCOME MEASURE(S): Medial triceps surae intramuscular tissue temperature at a depth of 1 cm was measured using an implantable thermocouple inserted horizontally into the muscle. Measurements were taken every 5 minutes during the 30-minute treatment and every minute during the 20-minute temperature decay, for a total of 50 minutes. Treatment was analyzed through a 2 × 7 mixed-model analysis of variance with repeated measures. Temperature decay was analyzed through a 2 × 21 mixed-model analysis of variance with repeated measures. RESULTS: During the 30-minute application, tissue temperatures at a depth of 1 cm increased more with the ReBound diathermy than with the moist hot pack (F6,66 = 7.14, P < .001). ReBound diathermy and moist hot packs increased tissue temperatures 3.69°C ± 1.50°C and 2.82°C ± 0.90°C, respectively, from baseline. Throughout the temperature decay, ReBound diathermy produced a greater rate of heat dissipation than the moist hot pack (F20,222 = 4.42, P < .001). CONCLUSIONS: During a 30-minute treatment at a superficial depth, the ReBound diathermy increased tissue temperature to moderate levels, which were greater than the levels reached with moist hot packs.

Muscle heating with Megapulse II shortwave diathermy and ReBound diathermy.

CONTEXT: A new continuous diathermy called ReBound recently has been introduced. Its effectiveness as a heating modality is unknown. OBJECTIVE: To compare the effects of the ReBound diathermy with an established deep-heating diathermy, the Megapulse II pulsed shortwave diathermy, on tissue temperature in the human triceps surae muscle. DESIGN: Crossover study. SETTING: University research laboratory. PATIENTS OR OTHER PARTICIPANTS: Participants included 12 healthy, college-aged volunteers (4 men, 8 women; age = 22.2 ± 2.25 years, calf subcutaneous fat thickness = 7.2 ± 1.9 mm). INTERVENTION(S): Each modality treatment was applied to the triceps surae muscle group of each participant for 30 minutes. After 30 minutes, we removed the modality and recorded temperature decay for 20 minutes. MAIN OUTCOME MEASURE(S): We horizontally inserted an implantable thermocouple into the medial triceps surae muscle to measure intramuscular tissue temperature at 3 cm deep. We measured temperature every 5 minutes during the 30-minute treatment and each minute during the 20-minute temperature decay. RESULTS: Tissue temperature at a depth of 3 cm increased more with Megapulse II than with ReBound diathermy over the course of the treatment (F6,66 = 10.78, P < .001). ReBound diathermy did not produce as much intramuscular heating, leading to a slower heat dissipation rate than the Megapulse II (F20,220 = 28.84, P < .001). CONCLUSIONS: During a 30-minute treatment, the Megapulse II was more effective than ReBound diathermy at increasing deep, intramuscular tissue temperature of the triceps surae muscle group.