St. Luke’s Virtual Concussion Clinic: A Unique Structure to Provide Comprehensive Care for Patients

Authors:
Kurt J. Nilsson, MD, MS
St. Luke’s Health System
St. Luke’s Concussion Clinic

Hilary Flint, PhD, MPH
St. Luke’s Health System
St. Luke’s Research

Janet Reis, PhD
Boise State University
College of Health Sciences
Office of Research

Krisi Pardue, CCC-SLP, CBIS
St. Luke’s Health System
St. Luke’s Concussion Clinic

Corresponding Author:
Kurt J. Nilsson, MD, MS
St. Luke’s Health System
St. Luke’s Concussion Clinic
600 N. Robbins Rd, Boise, ID 83702
208-383-2665
knilsson@slhs.org

St. Luke’s Virtual Concussion Clinic: A Unique Structure to Provide Comprehensive Care for Patients

ABSTRACT
Purpose: Failure to provide timely assessment and management of patients with concussions creates prolonged challenges for patients and primary care providers by disrupting work and school, interpersonal and family relationships, and placing patients at risk of injury. Thus, it is essential to provide timely and appropriate care to minimize post-concussion symptoms. The development of a virtual concussion clinic with a central referral and care coordination system is described. Additionally, key identifiers of virtual clinic patients are presented.

Methods: Intake and referral processes were implemented within 18 specialty clinics and 3 emergency departments. All patients (n= 623) completed a modified version of the Centers for Disease Control (CDC) Acute Concussion Evaluation (ACE) Form prior to their referred appointment with a clinician. Data was collected over a year and a half period.

General linear models compared the ACE domains and overall ACE scores with fixed variables of gender and cause of concussion.

Results: For our sample, most referrals came from emergency departments and primary care physicians. The sample was majority male (57%), with mean age 21.8 years. Females playing soccer, basketball, and cheerleading were most likely to have a concussion, whereas football represented 65% of concussions in male patients.

Significant effects for gender (p <0.02) were observed for all ACE domains except for Cognitive, and cause of concussion (p < .001) was significant for all ACE domains. The interaction between gender and cause of concussion (p=0.02) on the Physical ACE domain was significant. Conclusions: A virtual concussion clinic can successfully match the patient and his/her individual health care needs to an appropriate provider. Results demonstrate gender and cause of concussion impact evaluation, and warrants further research to discern optimal care for patients with concussion.
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The Value of Athletic Training Employment in Secondary School Athletics

Authors: Rachele E. Vogelpohl, PhD, ATC

Corresponding Author:
Rachele E. Vogelpohl
109 HC Nunn Drive
Highland Heights, KY 41099
vogelpohlra@nku.edu
859-572-5623

Rachele Vogelpohl is an assistant professor and Athletic Training Program director at Northern Kentucky University, and is a certified athletic trainer. She graduated from Northern Kentucky University with a bachelor’s degree and from the University of Hawaii, Manoa with both a master’s and doctoral degree.

The Value of Athletic Training Employment in Secondary School Athletics

ABSTRACT
Millions of secondary school students participate in interscholastic athletics each year, and unfortunately, injuries occur. Athletic trainers are health care providers specifically trained in injury prevention, diagnosis, and rehabilitation. Employment of an athletic trainer in the secondary school setting ensures that the student athletes are participating in a safe environment, that they are being cared for free of charge, and that emergency situations are handled in the proper way.
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Cardiopulmonary Resuscitation and Automated External Defibrillator Certification of Club Coaches in Alaska, Idaho, Oregon, Montana, and Washington

Authors: Jessica M. Kerns, MSAT, LAT, ATC; Dani M. Moffit, PhD, LAT, ATC

Corresponding Author:
Jessica M. Kerns
Sport Science and Physical Education Department
219 S. 8th Avenue, Stop 8105
Pocatello, ID 83209-8105
208-996-6737
harrjes3@isu.edu

Cardiopulmonary Resuscitation and Automated External Defibrillator Certification of Club Coaches in Alaska, Idaho, Oregon, Montana, and Washington

ABSTRACT
Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) qualifications for coaches within club sport systems appear largely unregulated. This is a concern because CPR/AED qualifications should be a safety consideration. This study attempted to identify the prevalence of CPR and AED certification for club sport coaches in five states, as well as assess the availability of AEDs at practices and games. Not all coaches surveyed identified having CPR (n=84, 72.6%) and/or AED (n=83, 75%) training. A majority of coaches reported having an AED at practice (n=43, 54.4%). For games, there were fewer coaches identifying the availability of an AED (n=36, 43.4%). While the majority of coaches report having CPR/AED certification several coaches did not select having both CPR and AED certification although AED is a part of all CPR training courses. There was no consistency as to the availability of an AED at practices or games. Through investigating this topic, it was learned that there is no overarching governing body in club sports and therefore, few agreed upon regulations.

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Taking Concussion Vital Signs Neurocognitive Test Under Varied Conditions

Authors: Scott L. Bruce, EdD, AT, ATC
Sarah Stauffer, AT, ATC
Andrew Chaney, AT, ATC
Kelsey Garrison, AT, ATC
Wright State University

Corresponding Author:
Scott L. Bruce, EdD, AT, ATC
Assistant Professor/Director of Research
Wright State University
3680 Colonel Glenn Hwy
Dayton, OH 45435
937-245-7622
scott.bruce@wright.edu

Scott Bruce is an Assistant Professor and the Director of Research for the Athletic Training Program at Wright State University.

Taking Concussion Vital Signs Neurocognitive Test Under Varied Conditions

ABSTRACT
Neurocognitive test batteries are commonly used tools for concussion assessments in the medical professions. Administered at baseline and post-injury these tests provide information on a patient’s neurocognitive ability during the recovery and return-to-activity phases. In athletics, student-athletes usually take the baseline exam as a group in a computer lab prior to the season beginning. If a medical professional believes an individual has sustained a possible concussion, they will retest them and compare their post-injury and baseline results. A deficit in one of more areas of the neurocognitive test may be indicative of a possible concussion. The purpose of this study was to examine whether or not there was a difference in neurocognitive test scores from Concussion Vital Signs when tested under two different conditions: “lights out” and with distractions. Our study was a randomized control trial performed at a Midwestern NCAA, “mid-major” Division I Institution. The subjects were 15 college-aged students with an overall mean age of 19 years (1.2). There were seven females (mean age was 19 ± 0.77) and eight males (mean age was 20 ± 1.2). A paired t-test was used to determine if a difference in the neurocognitive test section scores between the conditions existed. On three of the ten test sections, there was a statistically significant difference between the baseline and distraction condition. On four of the ten test sections between baseline and the lights out condition for males, but not for females. Testing should be done in a quiet room, with distractions minimized, as distraction hinders focus and performance. The results of this study indicate males may have a more difficult time concentrating while taking neurocognitive tests than females. Administering neurocognitive testing in a quiet, well-lit room is the best condition for the patient to take these concussion-related tests.

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The Reliability and Predictive Ability of the Movement Competency Screen in a Military Population

Authors:
Milbank, E.J.1, Peterson, D.D.2, Henry, S.M.1,3
1Department of Rehabilitation Sciences, University of Vermont, Burlington, VT;
2U.S. Naval Academy, Annapolis, MD
3Department of Rehabilitation Therapy, University of Vermont Medical Center

Corresponding Author:
Emily Milbank
Department of Rehabilitation and Movement Science
C/o Sharon Henry
305 Rowell Building
106 Carrigan Drive
University of Vermont
Burlington, VT 05401-0068
802-324-5619
emilbank@uvm.edu

The Reliability and Predictive Ability of the Movement Competency Screen in a Military Population

ABSTRACT:
Purpose: Musculoskeletal injuries in the United States Armed Forces impacts operational readiness. Therefore, a reliable, valid screening tool that identifies injury risk and predicts performance is needed. The purpose of this study was to: (1) establish the intra- and inter-rater reliability of the Movement Competency Screen (MCS) using a cohort of United States Naval Academy fourth class Midshipmen, (2) identify if a correlation exists between average total MCS scores and injury rates during training, and (3) identify if a correlation exists between average total MCS score and performance on the Physical Readiness Test (PRT).

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