Semester

Spring

Date of Graduation

2008

Document Type

Thesis

Degree Type

MS

College

College of Physical Activity and Sport Sciences

Department

Athletic Training

Abstract

Context. Sudden cardiac death among young competitive collegiate athletes has heightened interest in cardiovascular pre-participation screening in colleges and universities. Objective. The purpose of the study was to identify the cardiovascular screening protocols among National Collegiate Athletic Association (NCAA) Division I, II, and III institutions in accordance with the recommended American Heart Association (AHA) guidelines. Design. The design of this study was a prospective descriptive analysis, which identified the cardiovascular screening and use of the recommended American Heart Association guidelines by surveying Division I, II, and III National Collegiate Athletic Association institutions. Setting. National Collegiate Athletic Association Division I, II, and III institutions. Participants. This study included the head athletic trainers or director of athletic training services at 330 Division I, 293 Division II, and 445 Division III institutions for a total of 1068. This was a sample of convenience by including every NCAA institution in each Division. The subjects that are included were used because of their primary role with pre-participation physical examinations. The subjects that were excluded are certified athletic trainers that are not employed by NCAA Division I, II, and III institutions. Intervention. The subjects completed an electronic survey via email. The email directed the subjects to the website providing the consent by submission of the survey. Each section included demographics, pre-participation examination, medical history, physical examination, and referral. After a two week period a second email was sent encouraging participants to complete the survey. Main Outcome Measures. Based on the responses the majority of NCAA Division I, II, and III institutions performed a cardiac screening within their preparticipation physical examination. NCAA Division I include the majority of medical history and physical examination questions within their cardiovascular screening. Based on the responses NCAA Division III improved the most on implementation of the recommended American Heart Association guidelines within their cardiac screening from the previous study performed in 2000. Results. A total of 327 head certified athletic trainers and director of athletic training services completed the survey responding to cardiovascular screening for a return rate of 33.5 percent. Of those, 103 (31.5%) NCAA Division I, 91 (27.8%) NCAA Division II, and 133 (40.7%) NCAA Division III institutions. The mean score of undergraduate student enrollment was 7562.70 +/- 9146.915, student athletes 372.08 +/- 173.942, and number of varsity sports was 17.12 +/- 14.263. Of the responses a total of 172(52.6%) were aware of the NCAA recommendations with 74(71.8%) Division I, 44(48.4%) Division II, and 54(40.6%) Division III. A total of 322(98.5%) of NCAA institutions perform a cardiovascular screening within their pre-participation physical examination. NCAA institutions that performed yearly pre-participation physical examinations were 186(56.9%). One hundred eighty seven (27.2%) team physicians administered the tests, with 206(63%) specializing in general medicine. Other professionals that assist in pre-participation physical examinations are certified athletic trainers (n=257,78.6%), athletic training students (n=135,41.3%), team physicians (n=147,45%), and physical therapists (n=34,10.4%). Results from the 3 x 3 Chi-Square contingency table indicted that there was a significant difference (chi2=11.429, P=.022) between NCAA Division and the inclusion of the recommended AHA guidelines assessing from inadequate, moderate, and adequate. A total of 327(45%) NCAA institutions were found to be adequate including 9 of the 12 AHA recommendations with Division I (n=103,55.3%), Division II (n=91,48.4%), and Division III (n=133,34.6%). NCAA institutions judged to be inadequate with 4 or less of the AHA recommendations were (n=327,7%) with Division I (n=103,4.9%), Division II (n=91,5.5%) and Division III (n=133,9.8%). Conclusion. This study was designed for the purpose of describing and comparing cardiovascular screening procedures with the recommended 1996 American Heart Association guidelines within NCAA Division I, II, and III institutions. The responses represent the practices of head certified athletic trainers at NCAA Division I, II, and III institutions. Based on the hypotheses in regards to the responses and the results of the Chi-Square all were accepted with implementation of the recommended American Heart Association guidelines. This study indicated that NCAA institutions have increased the number of recommendations of American Heart Association guidelines used for cardiovascular screening of collegiate athletes. When the recommended AHA guidelines were used for comparison, only 7 percent of the NCAA institutions were considered to have inadequate screening forms. This is encouraging, indicating that these NCAA institutions recognize the importance of cardiovascular screenings within pre-participation physical examinations. The continual improvement of screening with implementation of the recommended AHA guidelines and recognition of cardiovascular conditions by the certified athletic trainers and sports medicine professionals has the potential to reduce the rate of sudden cardiac death among collegiate athletes.

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