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Context: Football is the most popular sport among high school boys in the United States. Concussion risk is elevated in the sport due to the high degree of physical contact. Healthcare providers are more likely to be present at the time of concussion during games and for varsity-level athletes, but how time to an immediate athletic trainer (AT) evaluation varies between sport levels and injury settings has yet to be investigated.Objective: Investigate associations between athlete sport level, injury setting, and same day AT evaluation among high school football players following a concussion. Design: Cross-sectional study.Setting: Retrospective analysis of de-identified patient records created within the Athletic Training Practice-Based Research Network.Patients: Patients evaluated and diagnosed with a concussion during in-season high school football participation from 2010-2023. Main outcome measure: Sport level (freshman, junior varsity [JV], varsity), injury setting (game, practice), and same-day evaluation following concussion (yes, no). Results: 1,260 patient cases were included in analysis. A significant association was found between sport level and same-day evaluation (p=0.02), and between injury setting and same-day evaluation (p<.001). A higher percentage of patients playing at the varsity level were evaluated the same day as their injury compared to those playing at the JV and freshman levels. Additionally, a higher percentage of football athletes were evaluated the same day if they sustained an injury during an in-season practice compared to a game. These associations remained significant after stratifying by sport level for freshman (p=0.01) and JV (p<.001) athletes, but not for varsity athletes (p=0.61).Conclusions: Freshman and JV football athletes, as well as those injured during games, are less likely to receive a same-day evaluation by an AT after concussion. Timely care improves recovery following concussion, emphasizing the need for equitable access to immediate care across sport levels and settings.

Context: Immediate athletic trainer (AT) availability for acute injuries is essential as worse long-term outcomes are associated with delays in receiving medical care. Several factors have been found to influence AT availability between secondary schools, but few studies have evaluated how medical coverage varies between athlete groups., Objective: The purpose of this project was to identify factors that impact the time to AT evaluation following acute sport-related injury in a secondary school setting., Design: Cross-sectional study., Setting: Retrospective analysis of deidentified patient records via the Athletic Training Practice-Based Research Network., Patients or Other Participants: High school athletes diagnosed with an acute sport-related injury during in-season play from 2010 to 2023., Main Outcome Measure(s): Time to AT evaluation was measured as the number of days between injury onset, reported by the patient, and AT evaluation., Results: This report consists of 17 354 patient cases representing 20 different sports. Overall, 46.9% (n = 8138) of patients who sustained an injury during in-season play were evaluated by an AT the same day (range, 0-14 days). Significant group differences were reported for sex (P < .001), setting (P < .001), and sport level (P < .01), with female athletes and in-game injuries associated with longer times to AT evaluation. Freshmen were evaluated sooner than junior varsity (P < .01) and varsity (P < .001) athletes. No difference was observed between junior varsity and varsity athletes (P = .34)., Conclusions: Almost half of patients received medical care within 24 hours following an acute injury during in-season play, highlighting how qualified health care is accessible for many student-athletes through ATs in the secondary school setting. Differences in time to AT evaluation may be attributable to sex discrepancies in immediate medical coverage between sports and injury reporting patterns among athletes., (© by the National Athletic Trainers’ Association, Inc.)

Context: The anterior cruciate ligament (ACL) is well researched since injuries typically result in lengthy recoveries and rehabilitation periods until athletes can return to full activity. Although a large body of literature on the early and late stages of rehabilitation following ACL reconstructive (ACLR) surgery exists, less is known regarding the mid-phase of ACL rehabilitation and healthy versus injured limb differences in functional testing during this stage., Objectives: The purpose of this study is to determine if Y-Balance Test (YBT) scores obtained during the mid-phase of ACLR rehabilitation change over months 4, 5, and 6., Design: Case Series., Setting: Research laboratory. Patients or Other Participants: A total of 27 participants (17 females; 18.96±3.02 years (range 15-24); 173.63±10.29cm; 72.55±17.83kg) who sustained a unilateral ACL injury, experienced no episodes of instability or knee giving away, had not suffered a previous ACL injury, and expressed a desire to return to sport at the end of rehabilitation came in once a month following ACLR to participate in a battery of tests., Main Outcome Measures: YBT scores in the anterior, posterolateral (PL), and posteromedial (PM) directions in the healthy and reconstructed limbs., Results: A main effect for limb was observed for the anterior (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4±5.8; Reconstructed: m4: 77.2±5.9, m5: 78.5±5.1, m6: 78.1±6.4, p=0.023) and PM (Healthy: m4: 80.0cm±8.7, m5: 81.0cm±9.1, m6: 82.9cm±8.9; Reconstructed: m4: 79.3cm±6.8, m5: 79.4cm±8.2, m6: 81.1cm±8.5, p=0.013). directions indicating that the reconstructed limb performed worse than the healthy limb. A main effect for time was observed for the PL direction (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4cm±5.8; Reconstructed: m4: 77.2cm±5.9, m5:78.5cm±5.1, m6: 78.1cm±6.4, p=0.023)., Conclusions: The YBT measured improvement in the PL direction across time in the reconstructed limb. In the PM and anterior directions, the YBT did not measure these same improvements across this period.