ATI Evidence-based Guide Investigating Medical and Preventative Services

April 28, 2026 updated by: Natalie Myers, ATI Holdings, LLC

Utilization and Effectiveness of Sports Medicine Services

To use existing standard-of-care documentation in a sports medicine electronic medical record (EMR) to evaluate patient characteristics, interventions delivered, utilization management, and clinical outcomes in routine sports medicine care, in order to generate evidence to improve clinical effectiveness and quality of care.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Musculoskeletal (MSK) and sports related injuries are highly prevalent across active and athletic populations and represent a substantial source of healthcare utilization, time loss from participation and a limitation in performance. Often these injuries vary from mechanism, acuity, and severity, ranging from acute traumatic events to chronic overuse conditions. Effective management of these sports-related injuries requires a coordinated effort aimed at helping athletes restore function, minimize the risk of re-injury and facilitating a safe return to sport. Sports Medicine rehabilitation is a widely recognized as a key component of nonoperative care, with evidence that supports the role of athletic trainers to support athletes in improving patient related outcomes, functional performance and return to sport timelines. However, variability does exist in how care is delivered across the sports medicine setting, providers and injury types which may influence both outcomes and resource utilization, underscoring the need to understand how value is achieved within sports medicine rehabilitation.

To address these priorities, investigators from ATI and the University of South Carolina are interested in evaluating how standard-of-care within sports medicine is delivered and how variation in care delivery mechanisms relates to clinical outcomes, value and service utilization. In this retrospective study, The investigators will conduct secondary analyses of existing standard-of-care documentation within ATI's sports medicine EMR, without altering clinical care or interacting with patients. Key variables of interest include: (1) injury and patient characteristics (ie. body region, surgical v. non-surgical status, acuity); (2) functional and performance outcomes (ie. patient reported outcomes, return to sport status); (3) utilization metrics (ie. number of visits, duration of care and frequency); (4) care delivery characteristics (ie. interventions, neuromuscular training, manual therapy and modality use); and delivery care (ie. in clinic, hybrid). By examining how the above variables interact, this study aims to better characterize rehabilitation of athletes receiving sports medicine services and identifying opportunities to optimize outcomes and value.

Investigators have previously used ATI clinical outcomes resources to characterize care patterns, evaluate outcomes and measurement properties, and explore predictors of utilization behaviors such as canceled visits. The present protocol extends this work by leveraging existing standard-of-care EMR documentation to evaluate patient characteristics, interventions delivered, utilization management patterns, and clinical and objective/functional outcomes in routine outpatient care, producing evidence to inform clinical effectiveness, quality improvement, implementation efforts, and policy-relevant value questions.

Study Type

Observational

Enrollment (Estimated)

550000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Illinois
      • Downers Grove, Illinois, United States, 60515
        • ATI

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

12 years to 25 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Individuals receiving medical and/or preventative services when part of an organized sports team.

Description

Inclusion Criteria:

Care setting and timeframe: Received sports medicine services at ATI Physical Therapy, with documentation available in the ATI Sports Medicine EMR, on or after January 1, 2018, through the date of data extraction.

Age range: Sports participants including middle school, high school and collegiate aged including adolescents through young adults that have been documented in the EMR.

Record availability: Have an EMR record that includes the minimum data elements necessary to address the study objectives (e.g., episode identifiers/dates sufficient to define an episode of care, diagnosis/body region, utilization variables, and at least one routinely collected outcome measure when applicable to the specific analysis).

Standard-of-care data: Data were collected as part of routine clinical care/documentation prior to and independent of this research study.

Exclusion Criteria:

The record is outside the eligible timeframe or does not reflect sports medicine care at ATI.

The record is a duplicate or cannot be reliably linked within the data source to a single episode/patient for analysis.

The record lacks the minimum necessary variables required for the specific analysis (e.g., missing episode dates needed to define utilization metrics; missing baseline/discharge outcome for analyses requiring change scores).

The data are corrupted, internally inconsistent (e.g., impossible dates), or otherwise unsuitable for analysis after standard data cleaning.

The record cannot be adequately coded/de-identified for analysis and reporting under the study's privacy/confidentiality procedures.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numerical Rating Scale (NRS)
Time Frame: Baseline (Day 1 at Evaluation), throughout patient's episode of care asked each visit, on average up to 12 weeks
Subjective; Patients rate pain on a scale from 0 (no pain) to 10 (worst pain imaginable).
Baseline (Day 1 at Evaluation), throughout patient's episode of care asked each visit, on average up to 12 weeks
Single Assessment Numeric Evaluation (SANE)
Time Frame: Administered at initial evaluation, and every 4th visit for the patient's episode of care (on average 12 weeks).
Subjective, Patient-perceived overall function or pain related to a specific condition compared to pre-injury. 0% (least possible) to 100% (most possible/normal)
Administered at initial evaluation, and every 4th visit for the patient's episode of care (on average 12 weeks).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

ATI Holdings, LLC

Investigators

  • Study Chair: Chris Stout, PsyD, ATI

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Herring SA. The team physician and return-to-play issues: a consensus statement. Medicine & Science in Sports & Exercise. 2002;34(7):1212-1214.
  • Martin CL, Greene J, David RB, Kliethermes S, Naylor J, Kucera K. Athletic Trainers as Outpatient Rehabilitation Providers: An Analysis of Role, Value, and Insurance Reimbursement in a Large Academic Healthcare System. Journal of Athletic Training. 2025;1(aop)
  • Patel DR, Yamasaki A, Brown K. Epidemiology of sports-related musculoskeletal injuries in young athletes in United States. Translational pediatrics. 2017;6(3):160.
  • Brenner JS, Watson A. Overuse injuries, overtraining, and burnout in young athletes. Pediatrics. 2024;153(2):e2023065129.
  • Coronado VG, Haileyesus T, Cheng TA, et al. Trends in sports-and recreation-related traumatic brain injuries treated in US emergency departments: the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) 2001-2012. The Journal of head trauma rehabilitation. 2015;30(3):185-197.
  • Rui P, Ashman JJ, Akinseye A. Emergency department visits for injuries sustained during sports and recreational activities by patients aged 5-24 years, 2010-2016. 2019

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 23, 2026

Primary Completion (Estimated)

April 23, 2029

Study Completion (Estimated)

April 23, 2029

Study Registration Dates

First Submitted

August 5, 2019

First Submitted That Met QC Criteria

August 7, 2019

First Posted (Actual)

August 8, 2019

Study Record Updates

Last Update Posted (Actual)

May 4, 2026

Last Update Submitted That Met QC Criteria

April 28, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SOR08012019

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Aggregated non-Private Health Information and non-Health Insurance Portability and Accountability Act data may potentially be made available upon request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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