Evidence-Based Practice in Athletic Training
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Questions and Answers

What is Evidence-Based Practice primarily concerned with?

  • Emphasizing medication over any other treatment options
  • Solely relying on patient values for treatment decisions
  • Utilizing traditional practices without regard for evidence
  • Combining clinical experience with patient preferences and research evidence (correct)

    • Evidence-Based Practice is a new concept in the field of athletic training.

    False

    What are the top three treatment options commonly considered for low back pain (LBP)?

    Medication, Soft tissue techniques, Exercises

    The integration of the best research evidence with clinical experience and patient values is known as __________.

    <p>Evidence-Based Practice</p> Signup and view all the answers

    Match the treatment option with its characteristic:

    <p>Rest = Often recommended for short-term pain relief Medication = Includes NSAIDs and prescription drugs Surgery = Last resort option for chronic conditions Exercises = Involves mobility and strengthening activities</p> Signup and view all the answers

    Which of the following is NOT typically a treatment option for chronic low back pain?

    <p>Sleeping more than 12 hours a day</p> Signup and view all the answers

    Patient values are not considered important when making clinical decisions in Evidence-Based Practice.

    <p>False</p> Signup and view all the answers

    Identify one modality used in the treatment of low back pain.

    <p>TENS, heat/ice, or ultrasound</p> Signup and view all the answers

    What is a major advantage of conducting a systematic review?

    <p>Inexpensive to conduct studies</p> Signup and view all the answers

    Randomized controlled trials are less reliable than anecdotal evidence.

    <p>False</p> Signup and view all the answers

    What type of evidence does a systematic review primarily utilize?

    <p>Scientific studies</p> Signup and view all the answers

    A case report often delivers knowledge about __________ diseases.

    <p>rare</p> Signup and view all the answers

    Which of the following is NOT considered a disadvantage of a systematic review?

    <p>Exhaustive review of literature</p> Signup and view all the answers

    Match the type of evidence with its key characteristic:

    <p>Systematic Review = Exhaustive literature review Randomized Controlled Trial = Random assignment of participants Case Report = Detailed interpretation of a single case Anecdotal Evidence = Personal stories or accounts</p> Signup and view all the answers

    The use of a semi-rigid brace leads to higher patient satisfaction than taping for acute lateral ankle sprains.

    <p>True</p> Signup and view all the answers

    What is a primary benefit of randomization in a randomized controlled trial?

    <p>Control bias</p> Signup and view all the answers

    What is the probability of a good outcome after manipulation for patients with non-radicular low back pain meeting the inclusion criteria?

    <p>97%</p> Signup and view all the answers

    The stabilization group for non-radicular low back pain benefits equally from core stability training regardless of age.

    <p>False</p> Signup and view all the answers

    What symptom characteristics are associated with the specific-exercise group for radicular low back pain?

    <p>Symptoms distal to the buttock that centralize with lumbar extension and peripheralize with lumbar flexion.</p> Signup and view all the answers

    In the traction group, patients show signs and symptoms of __________ compression.

    <p>nerve root</p> Signup and view all the answers

    Match the treatment group with its inclusion criteria.

    <p>Manipulation = No symptoms distal to the knee Stabilization = Younger age Specific-Exercise = Symptoms centralize with lumbar extension Traction = Signs of nerve root compression</p> Signup and view all the answers

    Which of the following is a characteristic of the specific-exercise group for flexion?

    <p>Symptoms peripheralize with lumbar flexion</p> Signup and view all the answers

    Limited evidence exists to support the use of traction in treating low back pain.

    <p>True</p> Signup and view all the answers

    Identify one inclusion criterion for the stabilization group.

    <p>Greater general flexibility or 'instability catch' during lumbar flexion/extension.</p> Signup and view all the answers

    <h1>=</h1> <h1>=</h1> Signup and view all the answers

    Study Notes

    Evidence-Based Practice (EBP)

    • EBP integrates the best research evidence, clinical experience, and patient values to make clinical decisions.
    • Sackett et al. described it.
    • EBP is not new, Simon (JNATA, 1969) recognized the need for scientific evidence.
    • The true value of athletic trainers' services necessitates the use of scientific evidence.
    • Traditional procedures may need to be reevaluated.

    Patient Case (Example)

    • 22-year-old soccer player with chronic low back pain.
    • Pain at 7/10 during physical activity and 3/10 at rest.
    • Low back stiffness.
    • No symptoms distal to the knee.
    • Self-reported functional limitations.

    Treatment Options for LBP

    • Rest
    • Medication (NSAIDs, prescription, epidural steroid injection)
    • Surgery
    • Modalities (TENS, ultrasound, heat/ice, laser, traction)
    • Soft tissue techniques/manual therapy (stretching, muscle energy technique, myofascial releases, massage, spinal manipulation)
    • Exercises (pain reliving positions, exercises for mobility/flexibility, strengthening, stability/stabilization, neuromuscular training)
    • Alternative medicine (acupuncture, herbs, yoga with meditation)

    How Successful?

    • How confident are practitioners about treatment outcomes?
    • Measurement of confidence levels (very, pretty, somewhat confident).
    • What kinds of evidence support treatment options?

    Subgrouping of Patients with LBP

    • Different groups of patients with low back pain (LBP) benefit from different approaches.
    • Categories are based on specific criteria, interventions and outcomes.
    • Examples of groups include:
      • Manipulation group (non-radicular LBP): criteria include no symptoms distal to the knee, recent onset, low fear avoidance beliefs questionnaire-work (FABQW <19), hip internal rotation range of motion (ROM) >35°.
      • Stabilization group (non-radicular LBP): criteria include younger age (<40 years), greater general flexibility, “instability catch” movements during lumbar flexion/extension, and positive findings for the prone instability test.
      • Specific-exercise group (radicular LBP): subcategorized by flexion or extension and lateral shift. Each category has specific inclusion criteria that need to be met for a specific intervention to be used.

    Levels of Evidence

    • Vary in quality relative to other studies.
      • Systematic reviews and meta-analyses are at the top, followed by randomized controlled trials, cohort studies, case- controlled studies, and case series and reports. Then, background information and expert opinion.

    Systematic Review and Meta-Analysis

    • A comprehensive review of all relevant scientific studies.
    • This approach is helpful due to its reliability in literature review and low cost for conducting studies. This also means less human involvement and no Institutional Review Board (IRB) required.
    • But, it has limitations due to its time-consuming nature and difficulties in synthesizing various studies.

    Randomized Controlled Trial

    • Randomly assigns participants to an experimental or control group.
    • Reliable evidence for controlling bias through random assignments.
    • However, it has time and money limitations along with participant and study management.

    Case Report

    • Describes and interprets an individual case, often rare diseases or trends.
    • Provides quick delivery of knowledge on new diseases or trends and can trigger awareness and initiation of appropriate action.
    • Limitations include lack of generalization and difficulty determining the effect of an intervention.

    Ottawa Ankle Rules

    • Clinically useful for reducing the number of false-negative x-rays in diagnosing ankle fracture.
    • This helps in cost savings and reducing wait times in emergency department.
    • This has improved practice as prevalence of negative x-rays has reduced significantly and less unnecessary radiation exposure is provided to patients.

    Evidence-Based Practice (EBP) as Standard of Care

    • Practitioners utilize EBP to enhance patient care by utilizing different sources of evidence.
    • EBP is a necessary component of meeting required third party reimbursement requirements in the health care field.

    5 Steps in Practicing EBP

    • Defines a clinically relevant question.
    • Searches for the best available evidence.
    • Critically appraises the evidence.
    • Applies the best available evidence.
    • Evaluates the outcomes of the application.

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    Description

    This quiz explores the concepts of Evidence-Based Practice (EBP) in athletic training, including its origins and applications in clinical decision-making. It also examines a patient case of a soccer player with chronic low back pain and various treatment options available. Test your understanding of how EBP integrates research, clinical experience, and patient values.

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