scholarly journals Patient Throughput in a Sports Medicine Clinic With the Implementation of an Athletic Trainer

2016 ◽  
Vol 9 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Timothy S. Nicolello ◽  
Forrest Q. Pecha ◽  
Reed L. Omdal ◽  
Kurt J. Nilsson ◽  
Alejandro A. Homaechevarria
Keyword(s):  
Sports Medicine ◽  
Financial Stability ◽  
Patient Throughput ◽  
Level Of Evidence ◽  
Subsequent Increase ◽  
Clinical Model ◽  
Medicine Clinic ◽  
Clinical Efficiency ◽  
Relative Value ◽  
Clinic Efficiency

Background: Orthopaedic clinics have acquired a multitude of health professionals to improve clinic efficiency. More recently, athletic trainers (ATs) have been utilized to improve clinical efficiency and patient care because of their extensive background in musculoskeletal injuries and anatomy. Improved clinical efficiency allows for increased patient visits, potentially enhancing patient access and downstream revenue via relative value units (RVUs). Hypothesis: The addition of an AT into a sports medicine physician’s clinic will increase total patient throughput and overall RVU production. Study Design: Retrospective analysis. Level of Evidence: Level 4. Methods: Patients seen by each of the 2 primary care sports medicine physicians at St Luke’s Sports Medicine for a 2-year period were retrospectively evaluated. The initial clinic model included the physician and a medical assistant; during the second year of analysis an AT was added to the clinic staffing model. Two-tailed t tests were used to determine significant differences in patient volume between the 2 periods of data collection. Results: Through the implementation of an AT, patient throughput increased by 0.7 patients per hour over 2 half-day clinics, a 25% increase ( P < 0.01). Physician B patient visits increased by 21%, or 3.8 patients per 6.5-hour clinic day ( P < 0.01). Additionally, RVU production increased by 3.23 per half-day and 4.3 per full day for physicians A and B, respectively. Conclusion: Clinical efficiency was improved with the addition of an AT. Total physician RVUs improved, thereby raising the potential revenue of both the physician and health care institution. Employing ATs in a sports medicine clinic may improve clinical productivity and financial stability, thereby validating the incorporation of ATs into the established clinical model. Clinical Relevance: Limited research exists measuring patient throughput with an AT in a sports medicine clinic. This study investigates patient throughput and the subsequent increase in work-based RVUs.

scholarly journals Using Telemedicine to Pre-Screen Sports Medicine Patients in the Ambulatory Setting Reduces Wait Times and Maximizes Provider-Patient Interaction

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0041
Author(s):  
Alfred Atanda ◽  
Kathryn Leyden ◽  
Medical Student
Keyword(s):  
Patient Satisfaction ◽  
Knee Pain ◽  
Sports Medicine ◽  
Clinic Visit ◽  
Background Information ◽  
Full Time ◽  
Visit Time ◽  
Medicine Clinic ◽  
Exam Room ◽  
Room Time

Objectives: Gathering of background information during a clinic visit can be time-consuming. Some medical specialties have workflows that pre-screen patients ahead of time to minimize delays. Having background information ahead of time may decrease delays and ensure that the visit is focused on physical examination, diagnosis, and treatment. We have used telemedicine to treat established patients to reduce cost and resource utilization, while maintaining high levels of patient satisfaction. It is conceivable that telemedicine could also be used to pre-screen new patients prior to their in-person clinic visit. The goal of the current study was to evaluate whether utilizing telemedicine to pre-screen new patients to our sports medicine clinic would reduce time in the exam room waiting and being seen, and overall clinic times. Methods: From June 2018 through August 2018, we utilized videoconferencing telemedicine to pre-screen all new patients to a pediatric sports medicine clinic with a chief diagnosis of knee pain. Visits were performed by full-time telemedicine pediatricians who were provided appropriate training and an intake form describing which questions should be asked. All visits utilized the American Well software platform (Boston, USA) and were performed on the patient’s personal device. During the subsequent in-person visit, the overall timing of the visit was recorded including: time checked in, time waiting in waiting room, time waiting in exam room, time spent with provider, and time-checked out, were all recorded. Similar time points were recorded for matched control patients that did not undergo telemedicine pre-screening and were seen in the traditional manner. Inclusion criteria included: being brand new to the practice and unilateral knee pain. Results: There were eight pre-screened patients and ten control patients in this cohort. Compared to controls, pre-screened patients spent less time in the exam room (19 min vs. 31 min), higher percentage of the exam room time with the provider (58% vs. 34%), higher percentage of the overall visit time with the provider (29% vs. 19.5%), and less time for the overall visit (39 min vs. 52 min). Conclusion: Pre-screening patients to obtain background information can decrease exam room waiting time and overall visit time and maximize time during the visit spent with the provider. In addition, it could potentially be used to increase throughput through the clinic and improve patient satisfaction scores.

scholarly journals Systematic Review of Orthopaedic and Sports Medicine Injuries and Treatment Outcomes in Women's National Basketball Association and National Basketball Association Players

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098207
Author(s):  
Sachin Allahabadi ◽  
Favian Su ◽  
Drew A. Lansdown
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Achilles Tendon ◽  
Sports Medicine ◽  
Direct Consequence ◽  
National Basketball Association ◽  
Return To Play ◽  
Level Of Evidence ◽  
Cartilage Injuries ◽  
Women's National Basketball Association

Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.

scholarly journals Confirming Proper Button Deployment of Suspensory Fixation During ACL Reconstruction

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097434
Author(s):  
Daniel F. O’Brien ◽  
Lilah Fones ◽  
Victoria Stoj ◽  
Cory Edgar ◽  
Katherine Coyner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Case Series ◽  
Graft Fixation ◽  
Level Of Evidence ◽  
Lateral Cortex ◽  
Suture Button ◽  
Suspensory Fixation

Background: Suspensory fixation of anterior cruciate ligament (ACL) reconstruction (ACLR) grafts has emerged as a popular device for femoral graft fixation. However, improper deployment of the suspensory fixation can compromise proper graft tensioning, leading to failure and revision. Also, soft tissue interposition between the button and bone has been associated with graft migration and pain, occasionally requiring revision surgery. Many surgeons rely on manual testing and application of distal tension to the graft to confirm proper button deployment on the lateral cortex of the femur for ACL graft fixation. Purpose: To determine the reliability of the manual resistance maneuver when applying distal tension to deploy the suspensory device along the lateral cortex of the femur. Study Design: Case series; Level of evidence, 4. Methods: All patients undergoing ACLR with a suture button suspensory device for femoral fixation were eligible for enrollment in the study. The surgeries were performed by 3 board-certified, sports medicine fellowship–trained orthopaedic surgeons at a single outpatient surgical center between May 2018 and June 2019. All grafts were passed in a retrograde manner into the femoral tunnel, and a vigorous manual tensioning maneuver in a distal direction was placed on the graft to deploy and secure along the lateral cortex of the femur. Intraoperative mini c-arm fluoroscopy was obtained to demonstrate proper suture button positioning. If interposing tissue or an improperly flipped button was identified, rectifying steps were undertaken and recorded. Results: A total of 51 patients with a mean age of 33.3 years were included in the study. Of these patients, 74.5% had normal suture button positioning identified via intraoperative fluoroscopic imaging, while 15.7% had interposed soft tissue and 9.8% had an improperly flipped button. In all cases, the surgeon was able to rectify the malpositioning intraoperatively. Conclusion: Despite the manual sensation of proper suspensory button positioning, intraoperative fluoroscopy identified suture button deployment errors in ACLR 25% of the time. Correcting the malpositioning is not technically demanding. These findings advocate for routine intraoperative surveillance to confirm appropriate suture button seating during ACLR.

scholarly journals Contributions of PCSS, CISS, and VOMS for Identifying Vestibular/Ocular Motor Deficits in Pediatric Concussions

2021 ◽  
pp. 194173812199411
Author(s):  
Rishi D. Patel ◽  
Cynthia R. LaBella
Keyword(s):  
Sports Medicine ◽  
Tertiary Care ◽  
Motor Dysfunction ◽  
Motor Deficits ◽  
Ocular Motor ◽  
Symptom Scale ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Visual Problems ◽  
Clinical Tools

Background: Vestibular/ocular motor dysfunction can occur in pediatric concussions, which can impair reading, learning, and participation in athletics. This study evaluated 3 clinical tools for identifying postconcussion vestibular/ocular motor dysfunction: (1) Post-Concussion Symptom Scale (PCSS), (2) Convergence Insufficiency Symptom Survey (CISS), and (3) Vestibular/Ocular Motor Screening (VOMS). Hypothesis: Evaluating vestibular/ocular motor dysfunction with multiple clinical tools will capture more symptomatic patients than any 1 tool alone. Study Design: Cross-sectional data from a prospective cohort study. Level of Evidence: Level 4. Methods: Patients were between 8 and 17 years old and seen in a tertiary care pediatric sports medicine clinic between August 2014 and February 2018. Data were collected from initial visit and included VOMS, PCSS, and CISS. Descriptive statistics, Pearson’s correlations, and logistic regressions were used to describe relationships between clinical tools. Results: Of the 156 patients (55.1% female; 14.35 ± 2.26 years old) included, this study identified 129 (82.7%) with vestibular/ocular motor dysfunction. Of these 129, 65 (50.4%) reported “visual problems” on PCSS, 93 (72.1%) had abnormal CISS, and 99 (76.7%) had abnormal VOMS. Together, VOMS and CISS identified 64 (49.6%) patients without reported “visual problems” on PCSS. Higher total PCSS scores predicted abnormal CISS (odds ratio [OR], = 1.11; 95% CI, 1.07-1.17) and abnormal VOMS (OR, 1.03; 95% CI, 1.01-1.06). “Visual problems” on PCSS did not predict abnormal CISS or VOMS. Conclusions: Vestibular/ocular motor dysfunction were identified in nearly 83% of study subjects when PCSS, CISS, and VOMS are used together. Clinical Relevance: These results suggest adding CISS and VOMS to the clinical evaluation of concussions can help clinicians identify post-concussion vestibular/ocular motor dysfunction.

scholarly journals THE PREVENTION METHOD OF SPORTS MEDICINE IMAGING MODELING

2021 ◽  
Vol 27 (8) ◽  
pp. 833-836
Author(s):  
Fei Wu ◽  
Xuejun Ma ◽  
Wenjiang Zhao ◽  
Shuhua Qu
Keyword(s):  
Sports Medicine ◽  
Main Type ◽  
Sports Injury ◽  
Acute Injury ◽  
Chronic Injury ◽  
Level Of Evidence ◽  
Prevention Method ◽  
High Level ◽  
And Control ◽  
Type Of Injury

ABSTRACT Introduction: Sports injury is an important reason to interfere with sports training and physical exercise since it will not only bring unnecessary pain to the injured body, but also bring out negative emotions in athletes. Objective: To study the sports injury characteristics of high level competitive aerobics athletes in China. Methods: Literature data, questionnaire survey, expert interviews, field observation, mathematical statistics and physiotherapy tracking were used. Results: Wrists, ankles, waist and knees were the most frequently injured parts in high level competitive aerobics athletes in China. The main type of injury was acute injury, but chronic injury (48.18%) could not be ignored. Ninety percent of active high-level competitive aerobics athletes train with injuries, and 10 percent of them completely stop training because of injuries. Conclusions: Athletes should pay attention to their physical reserve and strengthen physical training. They must also be attentive to self-supervision, their own subjective feelings, and control the amount of exercise done. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals Diagnosing Overtraining Syndrome: A Scoping Review

2021 ◽  
pp. 194173812110447
Author(s):  
Justin Carrard ◽  
Anne-Catherine Rigort ◽  
Christian Appenzeller-Herzog ◽  
Flora Colledge ◽  
Karsten Königstein ◽  
...  
Keyword(s):  
Scoping Review ◽  
Sports Medicine ◽  
Female Athletes ◽  
Data Extraction ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Exercise Tests ◽  
Overtraining Syndrome ◽  
Scoping Reviews ◽  
Study Characteristics

Context: Overtraining syndrome (OTS) is a condition characterized by a long-term performance decrement, which occurs after a persisting imbalance between training-related and nontraining-related load and recovery. Because of the lack of a gold standard diagnostic test, OTS remains a diagnosis of exclusion. Objective: To systematically review and map biomarkers and tools reported in the literature as potentially diagnostic for OTS. Data Sources: PubMed, Web of Science, and SPORTDiscus were searched from database inception to February 4, 2021, and results screened for eligibility. Backward and forward citation tracking on eligible records were used to complement results of database searching. Study Selection: Studies including athletes with a likely OTS diagnosis, as defined by the European College of Sport Science and the American College of Sports Medicine, and reporting at least 1 biomarker or tool potentially diagnostic for OTS were deemed eligible. Study Design: Scoping review following the guidelines of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR). Level of Evidence: Level 4. Data Extraction: Athletes’ population, criteria used to diagnose OTS, potentially diagnostic biomarkers and tools, as well as miscellaneous study characteristics were extracted. Results: The search yielded 5561 results, of which 39 met the eligibility criteria. Three diagnostic scores, namely the EROS-CLINICAL, EROS-SIMPLIFIED, and EROS-COMPLETE scores (EROS = Endocrine and Metabolic Responses on Overtraining Syndrome study), were identified. Additionally, basal hormone, neurotransmitter and other metabolite levels, hormonal responses to stimuli, psychological questionnaires, exercise tests, heart rate variability, electroencephalography, immunological and redox parameters, muscle structure, and body composition were reported as potentially diagnostic for OTS. Conclusion: Specific hormones, neurotransmitters, and metabolites, as well as psychological, electrocardiographic, electroencephalographic, and immunological patterns were identified as potentially diagnostic for OTS, reflecting its multisystemic nature. As exemplified by the EROS scores, combinations of these variables may be required to diagnose OTS. These scores must now be validated in larger samples and within female athletes.

How to Set Up a Sports Medicine Clinic

1985 ◽  
Vol 13 (6) ◽  
pp. 168-176
Author(s):  
Heyward L. Nash
Keyword(s):  
Sports Medicine ◽  
Medicine Clinic ◽  
Set Up

BIOMECHANICAL ENERGY METABOLISM MODEL OF SPORTS MEDICINE

2021 ◽  
Vol 27 (7) ◽  
pp. 674-677
Author(s):  
Lu Jin
Keyword(s):  
Energy Metabolism ◽  
Knee Joint ◽  
Human Health ◽  
Contact Surface ◽  
Sports Medicine ◽  
Level Of Evidence ◽  
Joint Stress ◽  
Tibiofemoral Joint ◽  
Whole Process ◽  
Peak Value

ABSTRACT Introduction: This is a study on the reasonable organization and collocation of sports health elements in different sports forms, and how this is reflected through scientific exercise instructors. Objective: To improve the effect of sports medicine on the biomechanical energy metabolism of human health. Methods: The biomechanical model of knee joint stress was used to analyze the mechanical behavior of knee joint flexion, such as movement and contact; the variation law and peak value of stress on the contact surface of the tibiofemoral joint were obtained. Results: Based on the changes of stress on tibiofemoral joint contact surface and the peak value of the data obtained in this paper, the model and data basis were provided for guiding scientific sports training and sports medicine treatment, preventing knee joint sports injury, knee joint inflammation, and reasonably improving sports performance. Conclusions: Sports medicine is effective in improving human health. The objects of clinical exercise guidance include all people, from infancy to the old age. The function of exercise is recognized in the effect of the whole process of prevention, treatment and rehabilitation of a variety of clinical diseases. The effectiveness of exercise in the whole process of disease is also recognized. Level of evidence II; Therapeutic studies - investigation of treatment results.

EFFECT OF SPORTS MEDICINE ON REDUCING BODY FAT PERCENTAGE AND LEAN BODY MASS

2021 ◽  
Vol 27 (7) ◽  
pp. 714-717
Author(s):  
Chunyan Fan
Keyword(s):  
Aerobic Exercise ◽  
Body Fat ◽  
Exercise Performance ◽  
Performance Indicators ◽  
Sports Medicine ◽  
The Body ◽  
Anaerobic Exercise ◽  
Body Fat Percentage ◽  
Fat Percentage ◽  
Level Of Evidence

ABSTRACT Introduction: Aerobic exercise has begun to be widely recognized as a reasonable means of preventing fat and losing weight. Scholars have confirmed that sports can help the human body lose weight and lose fat. Objective: This article measures the exercise performance indicators of subjects in different body fat percentage groups and studies the relationship between body fat percentage and exercise performance indicators. Methods: The study uses experimental methods to determine the percentage of body fat of the subjects. After physical exercise and aerobic exercise, the volunteers were tested for aerobic capacity indicators. Results: The body fat percentage of physically inactive persons was negatively correlated with aerobic and anaerobic exercise capacity indexes. Conclusion: The mechanism of aerobic exercise in weight loss treatment has the effect of promoting lipolysis and regulating blood lipid metabolism. At the same time, it has a significant influence on the number and activity of fat cells. Level of evidence II; Therapeutic studies - investigation of treatment results.

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