ATHLETIC TRAINING EDUCATION PROGRAMS NEED TO BETTER ADDRESS THE SPECIAL NEEDS ATHLETE  

  Moore, M; Smith-Goodwin E, Wilmington College, Wilmington, Ohio

The NCAA encourages participation by athletes with physical or mental disabilities in athletics and physical activities to the full extent of their interest and abilities.  One could question whether athletic trainers are adequately educated and trained to work with special needs athletes.  The purpose of this study was to investigate Certified Athletic Trainers attitudes about assessing and evaluating special needs athletes, and determines their overall preparedness to work with these athletes.  This study also addressed whether ATC’s felt confident in assessing injuries to special needs athletes. The study utilized descriptive survey research. The focus of the survey was the attitudes of athletic trainers when assessing special needs athletes.   The survey was divided into three sections: demographics (questions # 1-7), ATC’s views on participation by special needs athletes (questions # 8 – 12) and experience working with special needs athletes (questions #13 – 24).Questionnaires were sent out in November, 2004 to the thirty-five certified athletic trainers that are members of the Greater Dayton (Ohio)Athletic Trainers’ Association (GDATA).  GDATA members represent various employment settings.  A total of 42%  (N = 15) of questionnaires were completed and returned in self addressed stamped envelopes. The instrument was developed in consultation with and reviewed by a panel of experts in the field of sports medicine for their relevancy to the profession of athletic training. The Wilmington College Institutional Review Board approved the instrument for exempted review.  The data for this research project was analyzed descriptively using an IBM computer using SPSS.  The responses were analyzed by using frequencies (percentages and frequency counts.  Results showed that 66% (N=  10) of ATC’s reported that they did not feel that their educational background prepared them to work with special needs athletes.  Although, interestingly, 73%  (N=11) of the ATC’s reported that they were confident assessing special needs athletes during an injury. 93% (N=14) of the surveyed ATC’s felt that undergraduate athletic training education programs should have a class designed to specifically address working with special needs athletes.  87% (N=13) of the respondents felt that a clinical rotation working with special needs athletes would be beneficial.   Although this study is limited by the number of respondents, it doe shed light on perhaps future competencies that need to be addressed for athletic training education programs.

Key words:  special needs athletes, NCAA, athletic training education

PERCEPTIONS OF ATC’S ADMINISTERING OROTRACHEAL INTUBATION AS AN EMERGENCY AIRWAY TECHNIQUE

   Hilgenberg, K,  Smith-Goodwin, E; Wilmington College, Wilmington Ohio

Orotracheal intubation is considered an advanced airway management procedure that allows direct ventilation of the lungs through the use of an endotracheal tube. It is indicated for use on patients who are experiencing a difficult airway, providing a means to control and manage the airway.  It is a technique routinely used by paramedics and, in some states, like Ohio, also legal for EMT-Basics to perform.   If an athlete were to incur airway difficulties on the field it is the responsibility of the athletic trainer to provide care until EMS personnel arrives.  However, waiting for EMS to arrive when the athlete is in need of advanced airway management puts the athlete at greater risk. The primary purpose of this study was to investigate the attitudes of Certified Athletic Trainers in the value of learning and performing emergency orotracheal intubation. A secondary purpose was to investigate the perceived need for advanced airway management in the athletic training profession. 

The instrumentation used in this study was a twenty part questionnaire utilizing the Likert scale. The focus was on the need of orotracheal intubation to be added as a competency for athletic trainers to expand their emergency airway management skills. The survey was divided into three sections: demographics (questions # 1-8), level of emergency training/certification  (questions # 9 ) and questions dealing with perceptions of orotracheal intubation training (questions #10-20). The questionnaire, with cover letter, was mailed or hand delivered in person.  The 24 subjects were chosen randomly based on a convenience sample of ATC’s in southwest Ohio. The instrument was developed in consultation with and reviewed by a panel of experts in the field of sports medicine for their relevancy to the profession of athletic training. The Wilmington College Institutional Review Board approved the instrument for exempted review.  There were a total of 16 surveys returned yielding a response rate of 66.7%.  The subjects that returned the survey consisted of 8 females and 8 males. 

The non-parametric data was analyzed descriptively on an IBM computer using the SPSS system of statistical computer software.  The ordinal and nominal data received from the survey was analyzed using frequencies (percentages and frequency counts). The results revealed that athletic trainers feel uncomfortable not having training in orotracheal intubation with a total of 63% (n = 10) confirming these feelings.  A total of 75% (n=12) feel uncomfortable with having to wait for EMS to arrive to administer orotracheal intubation to an athlete in need.  There was a 75% (n= 12) agreement that if athletic trainers were properly educated and trained in orotracheal intubation, they would feel comfortable in administering it.  Finally, the results showed a 63% (n=10) agreement that orotracheal intubation should be added as a competency to the athletic training undergraduate curriculum.

Key words: orotracheal intubation, advanced airway management, ventilation, endotracheal tube.

THE EQUALITY GIVEN TO FEMALE ATHLETIC TRAINERS BY THEIR MALE ATHLETES
   Iwanski, M,  Smith-Goodwin, E; Wilmington College, Wilmington Ohio

Several studies have addressed the equality of women in athletic training. Currently there is only one full-time female athletic trainer in the entire National Football League.  There are only two in the National Basketball Association, and none in the National Hockey League or in Major League Baseball. The purpose of this study was to investigate if male athletes at one Midwest division III private college had a gender bias toward the athletic training staff. One hundred and five male athletes were surveyed in October, 2004, from the football, basketball, and soccer teams at Wilmington College of Ohio. The study utilized descriptive survey research. There were sixty-three surveys completed by the football players (100%), twenty-two by the basketball players (100%), and twenty by the soccer players (63%). Of the one hundred and five surveys completed, 74 athletes were Caucasian, 20 were African American, and 11 were of another ethnicity. The ages of the athletes ranged from 18-28 years old. The subjects completed a twenty-five question survey consisting of three parts. The first part of the survey consisted of demographics. Another area consisted of the amount of physical presence (in the training room and around athletic trainers) by the athlete. On the third part of the survey athletes were given twelve scenarios dealing with athletic trainers and were asked to choose their preference for a male athletic trainer, female athletic trainer or no preference. The scenarios involved four different areas including communication styles, knowledge, basic skills, and advanced skills. The surveys were statistically analyzed using frequencies (percentages and frequency counts) with SPSS for Windows, Version 10.01. This study found that the majority (ranging from 55.2-84.8% in 11/12 scenarios) of male athletes have no preference of male versus female athletic trainers. However, the athletes that did choose one of the two genders for the specific scenarios, preferred female athletic trainers as opposed to male athletic trainers in all four areas studied. It was also found that certain factors such as age, ethnicity, and sport played did not have a significant relation with the responses of the athletes. These results would suggest that, at least at this one institution, male athletes view female and male trainers as equals in both knowledge and skills. Women have come a long way in athletic training, but not far enough.  Further research needs to address perceptions of other professionals, both male and female, in the athletic industry concerning this topic and the advancement of women in the field.

Keys words: equality, gender bias, communication styles, advancement of women.

SUBJECTIVE ANALYSIS OF HUGHSTON’S EXTRAARTICULAR PROCEDURE VERSUS PATELLAR TENDON INTRAARTICULAR SURGERY FOR ACL INJURIES  

Payne R, Smith-Goodwin E: Wilmington College, Wilmington, Ohio 

The Hughston procedure was a popular technique for ACL injuries in the past, but is not commonly used today due to the advancement and ease of performing intraarticular procedures. Wilmington College has had the benefit of the availability of both surgical techniques. This study was conducted to analyze patient satisfaction with different aspects of both intraarticular and extraarticular procedures. This survey may aide sports medicine professionals in making decisions about what surgery may be best for their athletes. The purpose of this study was to compare rehabilitation, perceived strength recovery, incidence of re-injury, future complications, and overall satisfaction of athletes who have undergone the Hughston extraarticular procedure versus the intraarticular patellar tendon graft for ACL injuries. An 18-question survey was developed and submitted to the Wilmington College IRB for exempted review. The survey was tested for validity by a panel of Sports Medicine Professionals at Wilmington College.  The survey consisted of two sections which included four demographic questions, and 14 survey questions. The survey questions consisted of six questions pertaining to recovery, five questions about future complications, and three questions pertaining to overall satisfaction. Questionnaires were sent out in November 2004 to 49 athletes, coaches, and alumni of NCAA Division III Wilmington College, who have had either a patellar tendon graft (n=25) or the Hughston procedure (n=24) performed for ACL injuries. Sixteen surveys (33%) were returned. Eight athletes underwent patellar tendon grafts and eight underwent the Hughston procedure. Descriptive research was used using, non-parametric statistics with nominal and ordinal data. Data was analyzed using SPSS to obtain percentages and frequency counts. 100% (n=8) of extraarticular patients rated their rehabilitation as being either difficult or very difficult, while only 50% (n=4) of intraarticular patients felt this way. The remaining 50% (n=4) of intraarticular patients rated their rehabilitation as being either average or easy. 62.5% (n=5) of extraarticular patients rated their perceived quadriceps strength compared to their unaffected leg as being either 100% or greater than 100%, while 37.5% (n=3) rated their perceived quadriceps strength as being either 80-99% or less than 80%. 12.5% (n=1) of intraarticular patients rated their perceived quadriceps strength as either 100% or greater than 100%, while 87.5% (n=7) rated their perceived quadriceps strength as either 80-99% or less than 80%. 37.5% (n=3) of intraarticular patients reported that they had suffered some type of knee injury since their procedure. Injuries included: re-torn ACL, MCL sprain/tear, and medial meniscus tears. No extraarticular patients reported any such injuries. When asked if they have ever had anterior knee pain, 75% (n=6) of intraarticular patients responded yes, compared to 37.5% (n=3) of extraarticular patients. When asked if they ever experience knee pain anywhere else in their knee, 62.5% (n=5) of extraarticular patients responded yes, compared to 50% (n=4) of intraarticular patients. When asked about knee range of motion, 100% (n=8) of intraarticular patients said they were able to fully extend their knee compared to 87.5% (n=7) of extraarticular patients. 75% (n=6) of intraarticular patients said they were able to fully flex their knee compared to 50% (n=4) of extraarticular patients. Patients were then asked to rate their overall satisfaction with their surgical procedure regarding all previous questions they had answered. 62.5% (n=5) of extraarticular patients responded that they were very satisfied with their surgery and 37.5% (n=3) responded that they were satisfied. 50% (n=4) of intraarticular patients responded that they were very satisfied, 37.5% (n=3) responded as satisfied, and 12.5% (n=1) responded that they were dissatisfied. Although the sample size of this study was limited, the results concluded that there is not a significant difference in patient satisfaction between the Hughston extraarticular procedure and the patellar tendon graft for ACL injuries. Athletic Trainers as well as any other members of the Sports Medicine Team should be knowledgeable of the various procedures available for ACL surgeries, as well as the positives and negatives of each, in order to make the best decision for their athlete.  One particular surgery is not necessarily the best for every athlete and many factors need to be considered before making any decisions.