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Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries
Andrea Di Trani Lobacz1, Joseph Glutting2, Thomas W Kaminski1
1Department of Kinesiology and Applied Physiology and.
Insights
Athletic trainers (ATs) show varied practices for hamstring strain injuries (HSIs), with high satisfaction but lower confidence in athlete return-to-play. There is a clear need for evidence-based clinical practice guidelines for HSIs.
Area of Science:
- Sports Medicine
- Athletic Training
- Rehabilitation Science
Background:
- Hamstring strain injuries (HSIs) are prevalent in sports, leading to significant missed playing time.
- High reinjury rates and prolonged recovery complicate HSI management for athletic trainers (ATs).
- Current clinical practices and ATs' opinions on HSI management are not well-documented.
Purpose of the Study:
- To investigate the frequency of HSI management methods used by ATs.
- To understand ATs' opinions on current HSI treatment and rehabilitation strategies.
Main Methods:
- A cross-sectional study involving a survey administered to 1356 certified athletic trainers (ATs).
- Survey data collected at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo.
- Analysis included descriptive statistics, chi-square tests, and factor analysis to identify practice patterns.
Main Results:
- ATs utilize either contemporary or traditional HSI management styles, with varied practices across experience levels and settings.
- High satisfaction (73.6%) with current HSI management was reported, but confidence in returning athletes to play was lower (62.0%).
- Method use correlated with perceived effectiveness; increased satisfaction was linked to certain methods, but not necessarily increased confidence in experienced ATs.
Conclusions:
- A lack of consensus exists among ATs regarding optimal HSI treatment and rehabilitation protocols.
- ATs express a desire for improved clinical practice guidelines for managing hamstring strain injuries.
- Further research is needed to evaluate multimodal strategies combining traditional and contemporary methods for effective HSI management.
Context:
Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown.
Objective:
To examine the frequency of method use and opinions about current HSI management among ATs.
Design:
Cross-sectional study.
Setting:
Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo.
Patients Or Other Participants:
A total of 1356 certified ATs (691 men, 665 women; age = 35.4 ± 10.5 years, time certified = 11.92 ± 9.75 years).
Data Collection And Analysis:
A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and χ(2) tests to assess practice patterns.
Results:
The response rate was 17% (n = 1356). A 2-factor solution was accepted for factor analysis (r = 0.76, r = 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P < .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (χ(2)2 = 22.5, P = .002) but not increased confidence levels in more experienced ATs.
Conclusions:
Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.
