The incidence of CA-MRSA infections among student-athletes remains high. Therefore, it is critical that sports medicine providers continually reassess management protocols and best practices.

Purpose: Many health care professionals, including athletic trainers, utilize continuing education to maintain their certification or licensure status. Little is known about the perceptions of athletic trainers toward this educational process. The purpose of this study was to explore the perceptions of athletic trainers toward the continuing education process.Method: Data were collected from 2 sources: field notes from 6 focus groups with 43 individuals, and 6 hours of transcribed audiotape recordings from focus groups. Trustworthiness was established through member checks and multiple analyst triangulations. Results: Continuing education is valued and it is believed to advance the profession of athletic training and maintain competence. Engagement in continuing education was generally based on individual learning interest and applicability of the content to their individual work setting. Lastly, athletic trainers feel they are ultimately accountable for honestly engaging in learning activities and reporting continuing education activity. Conclusion:Continuing education is valued by credential holders and is an integral part of what it means to be a professional. It can be effective as long as athletic trainers appropriately select continuing education programs and responsibly engage in learning. Knowledge that is applicable and pertains to individual work duties is perceived as more meaningful. The benefits of effective continuing education are the maintenance of competency, improved self-efficacy, and enhanced professional respect, all of which can have a positive impact on and advance the profession.

Clinical Scenario: Iontophoresis is a method of local transfer of ionized medicated and nonmedicated substances through the skin and into the target tissues using magnetic polarization. The anti-inflammatory properties exhibited by dexamethasone sodium phosphate (DEX) combined with iontophoresis make it a potentially desirable treatment for clinicians wishing to administer a noninvasive localized drug concentration without having a large systemic concentration of that drug. Since concurrent treatments are commonly used in clinical practice, many of the published studies that included the use of DEX also used concurrent treatments. However, this may make it difficult for clinicians to determine the individual effectiveness of DEX iontophoresis in treating musculoskeletal conditions. Focused Clinical Question: Does DEX iontophoresis, alone, decrease pain and improve function in patients with musculoskeletal conditions when compared with placebo or control? Keywords: corticosteroid, transdermal drug delivery, therapeutic modalities Clinical scenarioIontophoresis is a method of local transfer of ionized medicated and nonmedicated substances through the skin and into the target tissues using magnetic polarization. The anti-inflammatory properties exhibited by dexamethasone sodium phosphate (DEX) combined with iontophoresis make it a potentially desirable treatment for clinicians wishing to administer a noninvasive localized drug concentration without having a large systemic concentration of that drug. Since concurrent treatments are commonly used in clinical practice, many of the published studies that included the use of DEX also used concurrent treatments. However, this may make it difficult for clinicians to determine the individual effectiveness of DEX iontophoresis in treating musculoskeletal conditions. Focused Clinical QuestionDoes DEX iontophoresis, alone, decrease pain and improve function in patients with musculoskeletal conditions when compared with placebo or control? summary of search, "Best evidence" appraised, and Key Findings• The literature was searched for clinical trials that investigated the effect of dexamethasone iontophoresis on reducing pain and/or improving function in patients with musculoskeletal conditions. • Three high-quality randomized controlled trials were included.• Two of the 3 included studies did not note any difference in outcomes for DEX compared with a placebo or control.

Clinical Scenario: Tendinopathies plague many active individuals, causing pain and reducing sport activity by decreasing range of motion and strength. There are many modalities that have been used to treat pain associated with chronic inflammation, such as ultrasound, moist heat packs, and electrical stimulation. Low-level laser therapy (LLLT) is one such modality. Potential benefits of managing pain associated with tendinopathies have been investigated using LLLT. Cellular respiration and metabolism are thought to be increased by LLLT acting on the mitochondrial cytochromes. The effects LLLT may have on cellular activity could increase blood flow to progress the healing process by reducing the pain-spasm cycle. The purpose of this critically appraised topic is to identify the clinical effectiveness of LLLT on pain associated with tendinopathy and to identify the parameters used to achieve statistically and clinically relevant pain outcomes. Focused Clinical Question: What is the effect of LLLT on pain associated with tendinopathy? Clinical Bottom Line: Although LLLT significantly decreases pain from baseline, its use may be no better than placebo or traditional treatments such as ultrasound, moist heat packs, electrical stimulation, or therapeutic exercise to reduce pain associated with tendinopathy. Total accumulated joules across the treatment sessions may need to be taken into account as a parameter.

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To determine whether chronic static exercise would alter resting caudal artery systolic blood pressure (RSBP) in stroke-prone hypertensive rats (SP-SHR), a 20- to 21-wk experimental study was initiated with 24 male and 16 female rats. In addition, eight rats were cannulated for heart rate and blood pressure measurements and implemented with Doppler flow probes (mesenteric and iliac arteries) for determination of the acute responses. The rats were trained to perform static exercise by forelimb hanging over an electrical grid (3-5 mA) activated with a high-frequency sound (2.5-10kHz) of 60 dB. Acute forelimb hanging by nontrained rats caused a 70-mmHg elevation in mean blood pressure, 115-beat/min increase in heart rate, and 71% decrease in mesenteric blood flow. The procedure for chronic forelimb hanging included increasing the number of sets per session from one to three, maintaining the number of repetitions between 6 and 10 and the hang time within 7-10 s/hang, while increasing the amount of weight supported per set from 0 to 12% of body weights for males and 30% for females. Two performance tests, one for endurance (no weights) and one for "strength" (weights), demonstrated that the hanging animals increased their endurance ability by 103% and their strength by 115%. RSBP was not significantly increased in either the male or female trained populations when evaluated by analysis of variance or trend-analysis procedures. Food and water consumption, sodium and potassium excretion, and blood volume measurements exhibited no group differences that had statistical significance. Five animals had evidence for previous strokes, with four being associated with the nonhanging animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic interventions focused on restoring muscle balance appear to be effective in resolving ERMLP.

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