Bulletin Board

By Staff

Training & Conditioning, 14.9, December 2004, http://www.momentummedia.com/articles/tc/tc1409/bulletinboard.htm

Medicare Rule Threatens Clinic ATC work
Athletic trainers who work in clinical settings face a new threat thanks to a change in Medicare regulations. In August, the U.S. Centers for Medicare and Medicaid Services said it plans to no longer pay for therapy incident to a doctor’s care in physicians’ offices or clinics unless it is given by physical therapists, occupational therapists, speech and language therapists, or by doctors themselves. CMS says the move, part of its 2005 physician-payment rates, is designed to implement Congress’s wishes to make sure therapy is given only by the most qualified people and to hold down Medicare costs.

While the change directly affects only Medicare patients, many other insurers follow the government’s lead, and a major ripple effect could limit future payments for services provided by clinic-based athletic trainers.

The National Athletic Trainers’ Association says the change will only make it harder for patients to be adequately served while removing physicians’ ability to choose what other practitioners their patients see. Many physicians have weighed in, too, saying athletic trainers are qualified to provide the therapy-related services and that without them, there may not be enough practitioners available to help patients.

The American Medical Association, and at least three members of Congress, have asked CMS to stop the proposal or at least reconsider. Unless CMS withdraws its plan, the rule will take effect Jan. 1.

Monitoring Football Players’ Body Temps.
It isn’t news that athletes working out in hot weather may be at risk for heatstroke. What is news, however, is what one Colorado doctor did this summer to keep a high school football team safe.

During voluntary football workouts at Cherry Creek (Colo.) High School, Michael Davidson, MD, attached gauges to players’ foreheads to constantly monitor their body temperature. "[Heatstroke casualties] are needless, preventable deaths," Davidson told the Rocky Mountain News.

The experiment may have saved at least one athlete from harm. A player was pulled aside one day when his gauge revealed a body temperature of 108 degrees.

Along with monitoring the athletes for heat illness, Davidson also collected data during the three-week monitoring period. He found that if a player’s temperature rises early in a workout, that player is out of shape, while if it spikes late, that player is dehydrated. And a player whose temperature peaks after remaining steady for several days is suffering from long-term dehydration.

Study Evaluates College Athletes’ Diets
A recent study examining the eating habits and behaviors of NCAA Division I athletes revealed that this population could benefit from better education on nutrition and the effects of diet on performance. It also showed that many athletes’ diets failed to meet some of their basic nutritional needs.

The study, which involved 345 athletes at one D-I school, found that male athletes’ mean energy intake was generally below the level recommended for their age group and activity level. In addition, most male and female athletes consumed inadequate amounts of both carbohydrate and protein. Males were especially prone to insufficient carbohydrate consumption, while typically consuming more fat, saturated fat, cholesterol, and sodium than recommended by dietary guidelines. The study also found athletes’ diets often lacked adequate amounts of several key nutrients, including folate, vitamin E, magnesium, and zinc.

A majority of female athletes reported that they wanted to weigh less, regardless of their sport. And the attempt to lose weight was "significantly associated" with decreased energy and macronutrient intake, as well as fat and carbohydrate restriction.

The study, "Nutrient Intakes and Dietary Behaviors of Male and Female Collegiate Athletes," was conducted by researchers at the University of Missouri and published in the August 2004 issue (Volume 14, Issue 4) of the International Journal of Sport Nutrition and Exercise Metabolism. It is available for purchase at: www.humankinetics.com/IJSNEM/

No More Vioxx
Sports medicine professionals have recently lost one of their newest options in pain medications. In October, the non-steroidal anti-inflammatory drug Vioxx® was pulled from the market by its manufacturer, Merck.

The prescription-only drug (generic name rofecoxib) was recalled after a three-year study showed an increased risk of cardiovascular problems, including heart attack and stroke, after 18 months of use, according to Merck. The study was conducted to discover if Vioxx could prevent the recurrence of colon polyps that sometimes turn cancerous, but it was halted when the increased risk of heart problems was discovered.

Vioxx, which had worldwide sales of $3.5 billion in 2003, was best known for treating arthritis pain, but was also commonly used with athletes as an anti-inflammatory. Vioxx is one of several second-generation NSAIDs known as COX-2 inhibitors that were expected to produce fewer side effects than first-generation NSAIDs, which can cause gastrointestinal problems.