Jan 29, 2015
Bulletin Board

NATA and APTA Settle

September’s settlement of the NATA’s fair practice lawsuit against the American Physical Therapy Association (APTA) marked the end of an almost two-year legal battle. NATA President Marjorie Albohm, MS, ATC, hopes it also marked the beginning of a newfound respect between the two groups.

In early 2008, the NATA sued the APTA for antitrust violations, alleging that athletic trainers were being unfairly restricted from practicing manual therapies and accessing manual therapy continuing education courses and materials. The NATA claimed the APTA was monopolizing the manual therapy market by excluding athletic trainers from the courses and manipulating the Coders’ Desk Reference for Procedures to discriminate against athletic trainers. The NATA also accused the APTA of misleading the public about the qualifications of certified athletic trainers and misrepresenting what services they may legally provide to patients.

The APTA requested that the case be thrown out, calling the lawsuit “wholly without merit” and “needlessly hostile.” But the federal district court in Dallas denied that request. It also denied the APTA’s request to have the case moved from Texas, where the NATA’s offices are located, to Virginia, the home of the APTA offices. On Sept. 21, the day before the case was scheduled for a hearing, the two groups settled.

Terms of the settlement included the signing of a joint statement of cooperation by both the NATA and APTA boards of directors. Some of the statement’s major points include:

• Physical therapists are not the exclusive providers of manual therapy.

• The APTA agrees that athletic trainers are qualified to perform manual therapy services.

• The APTA will not make false or misleading statements about athletic trainers, including saying that they are unqualified to practice manual therapy.

• Athletic trainers are qualified to pursue continuing education in manual therapy.

“In the big picture, this is really a statement of mutual respect and understanding between the two professions,” Albohm says. “There is recognition that athletic trainers are respected healthcare professionals. The two professions do overlap in some ways, and now we are hopefully going to work together for the best possible outcomes for our patients.”

At the same time, Albohm realizes there will still be competition between the two groups. “Healthcare is a competitive marketplace, and we will each lobby for our own best interests when we need to,” she says. “We’ve created some good bonds, but we will be as competitive as anyone else, and we expect the same from the APTA and other professions as well.”

Questioning Quercetin

After researchers demonstrated quercetin’s ability to boost physical performance in mice, the flavonoid was hailed as a substance with amazing potential. But a study published in the August issue of the Journal of Applied Physiology serves as a reminder that results seen in non-human test subjects don’t necessarily translate to humans.

At the University of Georgia, researchers followed two groups of healthy men: One consumed a sports drink containing 250 milligrams of quercetin four times a day for 16 days, and the other drank a placebo sports drink. They tested the subjects’ cycling performance, perceived exertion, post-workout strength loss, peak oxygen consumption, and other performance factors and found no significant improvements in the group that consumed the quercetin.

“To a certain extent that was disappointing because our hypothesis, based on previous studies in mice, was that we would see positive effects,” Kirk Cureton, PhD, Professor in the Department of Kinesiology at Georgia, told Medical News Today. “But our findings are important because they suggest that results from the animal studies shouldn’t be generalized to humans.”

Quercetin is found in leafy vegetables, berries, fruit skin, black tea, red wine, and some fruit juices. It’s a popular supplement in many products and has been touted as a performance booster because in trials involving mice, quercetin stimulated the production of mitochondria, increasing endurance.

The Georgia study is one of the first to look at the effects of quercetin on humans. Another study from University of South Carolina researchers published in June suggested that quercetin may help humans improve their endurance performance, showing the need for more research in this area.

To view the abstract of the Georgia study, “Dietary Quercetin Supplementation Is Not Ergogenic In Untrained Men,” go to: jap.physiology.org and enter “Quercetin Supplementation” into the keyword search window.

To view the abstract of the South Carolina study, “The Dietary Flavonoid Quercetin Increases VO2max and Endurance Capacity,” go to: hk.humankinetics.com/IJSNEM/journal About.cfm and click on “Online Preview Articles.”

The Danger of Chest Blows in Lacrosse

With the number of high school teams increasing almost 300 percent over the past decade, lacrosse is one of the fastest growing sports in the U.S. Thus it’s more important than ever for athletic trainers to understand the sport’s health risks, and a study published in the September issue of the journal Pediatrics sheds a grim light on one of them: It found deaths caused by a strong blow to the chest are more common in boys’ lacrosse than in almost any other sport.

Researchers from the Minneapolis Heart Institute Foundation’s Hypertrophic Cardiomyopathy Center (HCC) studied 28 years of data from the Sudden Death in Young Athletes Registry. They found 19 sudden deaths among high school and college lacrosse players–all of them male–10 of which resulted from blows to the chest, which can cause commotio cordis (a disturbance of the heart rhythm). The study abstract did not specify the source of the blows.

The overall mortality rate in lacrosse is similar to that of football, basketball, and other contact sports, but the rate of deaths attributed to commotio cordis is much greater than in most other sports. According to the researchers, only ice hockey surpassed lacrosse in its mortality rate due to commotio cordis. Lacrosse deaths attributed to commotio cordis occurred at double the rate of baseball and about 15 times more often than in football.

Four of the 10 chest-impact lacrosse deaths examined in the study involved goalkeepers who were wearing chest protectors. “There is a risk for commotio cordis events in lacrosse players which appears to be somewhat greater, and this raises the issue of an effective chest protector since commercially available barriers have not been proven to be absolutely protective,” Barry Maron, MD, Director of the HCC and lead author of the study, told HealthDay News.

For the abstract of the study, “Commotio Cordis and the Epidemiology of Sudden Death in Competitive Lacrosse,” go to:pediatrics.aappublications.org/content/vol124/issue3/index.dtl.

To read a past T&C article on reducing the risk of both traumatic and non-traumatic heart-related deaths, go to: www.training-conditioning.com and type “When a Heart Stops” into the article search window.

AED on Campus Saves a Life

No one ever wants to have to administer CPR or use an automated external defibrillator (AED), but when a crisis arises, having the right people trained in first aid and an AED readily available is essential. A jogger is thankful that was the case at Auburn (Wash.) Mountainview High School, after he collapsed near the football field there in October.

Two students saw the man collapse and called the athletic training room, where Assistant Athletic Trainer Aaron Pierce, LAT, ATC, and a senior athletic training student responded. Pierce administered CPR while the student prepared the defibrillator for use if necessary. When the man’s heart stopped, the student used the AED to revive him. The man was taken to the hospital by emergency personnel and was soon in stable condition. He is now at home and expected to make a full recovery.

Since Auburn Mountainview Head Athletic Trainer Steve Calhoun, MS, LAT, ATC, arrived on campus in 1991, he has been running the school’s sports medicine program, where students are trained in first aid and AED use. Pierce, who graduated from Auburn Mountainview in 2004, was one of Calhoun’s students and now assists with the program. He estimates that he trains approximately 120 students at the school in how to use an AED each year.

Calhoun is also responsible for the AED being available in the first place. Seven years ago, he organized a major fundraiser so that each school in the district could have an AED on campus.

“We formed the Heart of Auburn Schools Foundation, which was a community group of about 15 people,” Calhoun says. “We held an auction and asked people to donate AEDs. On a wall, we put up representations of all the school buildings with hearts in them signifying how many AEDs we needed at each facility, and asked people to hold up their paddle if they were willing to donate one. When it was over, we had all 62 AEDs that we needed.”

The group also invited people from the area who had been saved by an AED or had a loved one saved by an AED to give testimonies at the auction. “We fed off the emotion of those stories, and it worked,” Calhoun says. “Soon after the auction, when we got all the AEDs, we trained every staff member in the district in how to use them.

“We hoped they would be in the right place at the right time,” Calhoun continues. “When I first heard about the jogger and what Aaron and the student had done, I immediately called the head of our advisory committee who worked with me on the fundraiser. We both were in awe knowing that this made a difference for a family in the community. It was a very happy ending.

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