Methods and Descriptive Epidemiology of Services Provided by Athletic Trainers in High Schools: The National Athletic Treatment, Injury and Outcomes Network Study

Abstract

Context:Research is limited on the extent and nature of the care provided by athletic trainers (ATs) to student-athletes in the high school setting.Objective: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) project and provide the descriptive epidemiology of AT services for injury care in 27 high school sports.Design: Descriptive epidemiology study. Setting: Athletic training room (ATR) visits and AT services data collected in 147 high schools from 26 states.Patients or Other Participants: High school studentathletes participating in 13 boys' sports and 14 girls' sports during the 2011À2012 through 2013À2014 academic years.Main Outcome Measure(s): The number of ATR visits and individual AT services, as well as the mean number of ATR visits (per injury) and AT services (per injury and ATR visit) were calculated by sport and for time-loss (TL) and non-time-loss (NTL) injuries.Results: Over the 3-year period, 210 773 ATR visits and 557 381 AT services were reported for 50 604 injuries. Most ATR visits (70%) were for NTL injuries. Common AT services were therapeutic activities or exercise (45.4%), modalities (18.6%), and AT evaluation and reevaluation (15.9%), with an average of 4.17 6 6.52 ATR visits and 11.01 6 22.86 AT services per injury. Compared with NTL injuries, patients with TL injuries accrued more ATR visits (7.76 versus 3.47; P , .001) and AT services (18.60 versus 9.56; P , .001) per injury. An average of 2.24 6 1.33 AT services were reported per ATR visit. Compared with TL injuries, NTL injuries had a larger average number of AT services per ATR visit (2.28 versus 2.05; P , .001).Conclusions: These findings highlight the broad spectrum of care provided by ATs to high school student-athletes and demonstrate that patients with NTL injuries require substantial amounts of AT services.Key Words: medical coverage, sports, injury surveillance, NATION Key PointsAmong 147 high schools from 26 states, 210 773 athletic training room visits and 557 381 athletic trainer services were reported during the 2011-2012 through 2013-2014 school years. Common athletic trainer services were therapeutic activities or exercise (45.4%), modalities (18.6%), and athletic trainer evaluation and re-evaluation (15.9%). Compared with non-time-loss injuries, patients with time-loss injuries accrued more athletic training room visits and athletic trainer services per injury. However, non-time-loss injuries required a larger average number of athletic trainer services per athletic training room visit. O ver the past 40 years, a variety of surveillance systems have documented the epidemiology of sport-related injuries.1À5 However, sports injurysurveillance systems have been hindered by 2 main limitations. First, most injuries included in such systems were limited to time-loss (TL) injuries, or those resulting in restriction from participation in sport-related activities for at least 24 hours.2 Second, although the athletic trainers (ATs) who contributed data to these injury-surveillance s...

Athletic Training Services During Daily Patient Encounters: A Report From the Athletic Training Practice-Based Research Network

“…21 Furthermore, the authors of a recent study from the National Athletic Treatment, Injury and Outcomes Network (NATION) reported that although time-loss injuries accounted for a larger number of visits and services per injury than nontime-loss injuries, the latter required more services per visit. 22 Our findings regarding services for current injuries provide additional insight, as one-third of all daily encounters were related to current injuries and required taping, ice-or hot-pack application, or treatment services. Together, these results indicate that ATs may spend a considerable amount of time managing nontimeloss injuries due to the greater volume and amount of care associated with nontime-loss injuries compared with timeloss injuries.…”

Spotlight on Athletic Training Practice-Based Research Networks: A Celebration and a Challenge

“…More importantly, how do we justify our value, improve our services, and advance our profession in the public health care arena without being able to confidently proclaim what we do? Recent research published in JAT [1][2][3] and derived from research networks focusing on practice-based athletic training is helping us to understand what we do by studying those who do it. In this issue, Lam et al 1 provide a summary from the Athletic Training Practice-Based Research Network (AT-PBRN) that describes the practice characteristics of ATs in the secondary school setting based on more than 36 000 patient encounters in nearly 5000 patients from 34 schools in 10 states.…”

“…Similarly, in 2015, the initial summaries from the National Athletic Treatment, Injury and Outcomes Network (NATION) were also published in JAT. 2,3 The NATION draws epidemiologic data from 147 high schools across 26 states, with the initial reports representing more than 50 000 injuries and 200 000 athletic training room visits. Establishing these large, practice-based research networks is not a trivial task.…”

“…Through the NATION, Dompier et al 2 found that most of the injuries in patients who presented to the athletic training facility (82.45%) did not result in time lost from participation. Furthermore, Kerr et al 3 reported that most athletic training room visits (70%) were provided to patients who were still able to participate. Although any AT would attest to these findings, they are now supported by data from the practice-based networks.…”

“…For new injuries, the most common services provided were evaluation and thermal modalities. 3 Kerr et al 3 noted that therapeutic exercises represented the most common service provided by ATs (45.4%), followed by modalities (18.6%) and evaluations (15.9%). Similar to the patient characteristics, these results offer insight into the services routinely provided by ATs and the potential value of these services.…”