Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (686 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (358 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (112 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

PHYSICAL FITNESS AND HYGIENE (117 journals)                     

Showing 1 - 118 of 118 Journals sorted alphabetically
ACSMs Health & Fitness Journal     Full-text available via subscription   (Followers: 14)
Acta Facultatis Educationis Physicae Universitatis Comenianae     Open Access   (Followers: 3)
Acta Kinesiologiae Universitatis Tartuensis     Open Access   (Followers: 1)
ACTIVE : Journal of Physical Education, Sport, Health and Recreation     Open Access   (Followers: 32)
Adapted Physical Activity Quarterly     Hybrid Journal   (Followers: 5)
Ágora para la Educación Física y el Deporte     Open Access  
Al.Qadisiya journal for the Sciences of Physical Education     Open Access  
American Journal of Sexuality Education     Hybrid Journal   (Followers: 4)
Annals of Applied Sport Science     Open Access   (Followers: 11)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 10)
Applied Physiology, Nutrition and Metabolism     Hybrid Journal   (Followers: 37)
Arab Journal of Nutrition and Exercise     Open Access   (Followers: 1)
Arquivos em Movimento     Open Access   (Followers: 1)
Arrancada     Open Access  
Asian Journal of Sport and Exercise Psychology     Open Access   (Followers: 8)
Baltic Journal of Sport and Health Sciences     Open Access   (Followers: 4)
BMC Obesity     Open Access   (Followers: 6)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 42)
Child and Adolescent Obesity     Open Access   (Followers: 8)
Childhood Obesity     Hybrid Journal   (Followers: 24)
Clinical Journal of Sport Medicine     Hybrid Journal   (Followers: 39)
Comparative Exercise Physiology     Hybrid Journal   (Followers: 23)
Cultura, Ciencia y Deporte     Open Access   (Followers: 1)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 23)
eJRIEPS : Ejournal de la recherche sur l'intervention en éducation physique et sport     Open Access  
Environmental Health and Preventive Medicine     Open Access   (Followers: 4)
Éthique & Santé     Full-text available via subscription  
Fat Studies : An Interdisciplinary Journal of Body Weight and Society     Partially Free   (Followers: 3)
Food Science and Human Wellness     Open Access   (Followers: 4)
Frontiers in Sports and Active Living     Open Access   (Followers: 4)
Gelanggang Pendidikan Jasmani Indonesia     Open Access  
German Journal of Exercise and Sport Research : Sportwissenschaft     Hybrid Journal   (Followers: 2)
Geron     Full-text available via subscription  
Health and Quality of Life Outcomes     Open Access   (Followers: 14)
Health Education     Hybrid Journal   (Followers: 1)
Health Education Journal     Hybrid Journal   (Followers: 16)
Health Marketing Quarterly     Hybrid Journal   (Followers: 2)
Health Physics     Hybrid Journal   (Followers: 6)
Health Promotion & Physical Activity     Open Access   (Followers: 9)
Home Healthcare Now     Hybrid Journal   (Followers: 4)
Human Movement Science     Hybrid Journal   (Followers: 15)
Hygiene     Open Access   (Followers: 21)
IISE Transactions on Occupational Ergonomics and Human Factors     Hybrid Journal  
Indonesia Performance Journal     Open Access  
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 11)
International Journal of Applied Exercise Physiology     Open Access   (Followers: 54)
International Journal of Athletic Therapy & Training     Hybrid Journal   (Followers: 15)
International Journal of Behavioral Nutrition and Physical Activity     Open Access   (Followers: 34)
International Journal of Obesity     Hybrid Journal   (Followers: 57)
International Journal of Obesity Supplements     Full-text available via subscription   (Followers: 5)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 21)
International Journal of Spa and Wellness     Hybrid Journal  
International Journal of Sport, Exercise & Training Sciences     Open Access   (Followers: 4)
International Journal of Yoga     Open Access   (Followers: 17)
Isokinetics and Exercise Science     Hybrid Journal   (Followers: 10)
Journal of Advanced Nutrition and Human Metabolism     Open Access   (Followers: 16)
Journal of American College Health     Hybrid Journal   (Followers: 3)
Journal of Athlete Development and Experience     Open Access   (Followers: 3)
Journal of Bioenergetics and Biomembranes     Hybrid Journal   (Followers: 1)
Journal of Exercise & Organ Cross Talk     Open Access   (Followers: 1)
Journal of Human Performance in Extreme Environments     Open Access   (Followers: 2)
Journal of Human Sport and Exercise     Open Access   (Followers: 17)
Journal of Motor Learning and Development     Hybrid Journal  
Journal of Physical Activity and Health     Hybrid Journal   (Followers: 13)
Journal of Physical Activity and Hormones     Open Access   (Followers: 3)
Journal of Physical Activity Research     Open Access   (Followers: 4)
Journal of Physical Education and Human Movement     Open Access  
Journal of Physical Education and Sport Sciences     Open Access   (Followers: 5)
Journal of Physical Education Health and Sport     Open Access   (Followers: 2)
Journal of Physical Education, Recreation & Dance     Full-text available via subscription   (Followers: 13)
Journal of Science in Sport and Exercise     Hybrid Journal   (Followers: 6)
Journal of Sport and Health Science     Open Access   (Followers: 22)
Journal of Sport Sciences and Fitness     Open Access   (Followers: 14)
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 76)
Kinesiology : International Journal of Fundamental and Applied Kinesiology     Open Access   (Followers: 1)
Kinesiology Review     Hybrid Journal   (Followers: 4)
Malaysian Journal of Movement, Health & Exercise     Open Access   (Followers: 1)
Measurement in Physical Education and Exercise Science     Hybrid Journal   (Followers: 7)
Médecine & Nutrition     Full-text available via subscription   (Followers: 1)
Mental Health and Physical Activity     Hybrid Journal   (Followers: 17)
MHSalud : Movimiento Humano y Salud     Open Access  
Obesity     Hybrid Journal   (Followers: 40)
Obesity Research & Clinical Practice     Full-text available via subscription   (Followers: 10)
Obesity Reviews     Hybrid Journal   (Followers: 17)
Obesity Science & Practice     Open Access  
Open Obesity Journal     Open Access   (Followers: 2)
Pain Management in General Practice     Full-text available via subscription   (Followers: 12)
PALAESTRA : Adapted Sport, Physical Education, and Recreational Therapy     Full-text available via subscription   (Followers: 3)
Physical Activity and Health     Open Access   (Followers: 4)
Physical Education & Sport Pedagogy     Hybrid Journal   (Followers: 14)
Preventing Chronic Disease     Free   (Followers: 3)
Psychology of Sport and Exercise     Hybrid Journal   (Followers: 19)
Quality in Sport     Open Access  
Race and Yoga     Open Access   (Followers: 1)
RBNE - Revista Brasileira de Nutrição Esportiva     Open Access   (Followers: 1)
RBONE - Revista Brasileira de Obesidade, Nutrição e Emagrecimento     Open Access   (Followers: 1)
RBPFEX - Revista Brasileira de Prescrição e Fisiologia do Exercício     Open Access  
Research Quarterly for Exercise and Sport     Hybrid Journal   (Followers: 2)
Retos : Nuevas Tendencias en Educación Física, Deportes y Recreación     Open Access  
Revista Andaluza de Medicina del Deporte     Open Access   (Followers: 2)
Revista Brasileira de Atividade Física & Saúde     Open Access   (Followers: 1)
Revista Brasileira de Cineantropometria & Desempenho Humano     Open Access   (Followers: 1)
Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte : International Journal of Medicine and Science of Physical Activity and Sport     Open Access   (Followers: 1)
Revue phénEPS / PHEnex Journal     Open Access  
Scandinavian Journal of Sport and Exercise Psychology     Open Access   (Followers: 5)
SIPATAHOENAN : South-East Asian Journal for Youth, Sports & Health Education     Open Access  
Spor Bilimleri Dergisi / Hacettepe Journal of Sport Sciences     Open Access   (Followers: 1)
Sport and Fitness Journal     Open Access   (Followers: 7)
Sport Science and Health     Open Access   (Followers: 7)
Sport Sciences for Health     Hybrid Journal   (Followers: 5)
SPORTIVE : Journal Of Physical Education, Sport and Recreation     Open Access   (Followers: 2)
Sports     Open Access   (Followers: 3)
Sports Biomechanics     Hybrid Journal   (Followers: 29)
Sports Health: A Multidisciplinary Approach     Hybrid Journal   (Followers: 5)
Strength & Conditioning Journal     Hybrid Journal   (Followers: 57)
Timisoara Physical Education and Rehabilitation Journal     Open Access   (Followers: 2)
Turkish Journal of Sport and Exercise     Open Access  
Yoga Mimamsa     Open Access   (Followers: 3)

           

Similar Journals
Journal Cover
Sports Health: A Multidisciplinary Approach
Journal Prestige (SJR): 1.107
Citation Impact (citeScore): 2
Number of Followers: 5  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1941-7381 - ISSN (Online) 1941-0921
Published by Sage Publications Homepage  [1176 journals]
  • Serial Ultrasonography for the Assessment of Healing of Lower Extremity
           Bone Stress Injury and Correlation With Return to Sport/Exercise

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      Authors: Brett G. Toresdahl, Justin Conway, Theodore T. Miller, Marci A. Goolsby, Christian S. Geannette, Brianna Quijano, Lisa R. Callahan
      Abstract: Sports Health, Ahead of Print.
      Background:Lower extremity bone stress injuries (BSIs) are common among athletes who participate in high-impact activities. Conventional imaging is limited in assessing healing of BSIs.Hypothesis:Serial ultrasonography (US) can identify changes in appearance of lower extremity BSIs over time that can be correlated with symptoms and return to exercise/sport.Study Design:Cohort observational study.Level of Evidence:Level 3.Methods:Adults 18 to 50 years old with a recent exercise-associated BSI of distal tibia/fibula or metatarsals diagnosed by magnetic resonance imaging (MRI) were enrolled. US was performed every 2 weeks for 12 weeks. The sonographic appearance (soft tissue edema, periosteal reaction, hyperemia on power Doppler, callus) was correlated with the numerical rating scale (NRS) for pain and ability to return to sport/exercise.Results:A total of 30 patients were enrolled (mean age, 35.3 ± 7.7 years; 21 [70.0%] female). The tibia was most frequently affected (n = 15, 50.0%), followed by metatarsals (n = 14, 46.7%) and fibula (n = 1, 3.3%). At week 4, 25 of 30 (83.3%) had at least 1 US finding associated with the BSI. The degree of hyperemia was correlated with NRS at weeks 4 and 6 (Spearman correlations [ρ] 0.45 [0.09, 0.69] and 0.42 [0.07, 0.67], respectively), as well as return to sport/exercise at week 6 (ρ -0.45 [-0.68, -0.09]). US soft tissue edema was also correlated with NRS at week 6 (ρ 0.38 [0.02, 0.65]).Conclusion:Serial US of lower extremity BSIs can provide objective measures of healing. US findings were correlated with clinical outcomes at multiple timepoints.Clinical Relevance:US may have advantages over conventional imaging for monitoring healing of lower extremity BSIs. Further research is needed to better understand the prognostic value of these sonographic indicators of BSI healing and role in assessing readiness for return to sport/exercise.
      Citation: Sports Health
      PubDate: 2024-02-27T08:51:58Z
      DOI: 10.1177/19417381241231590
       
  • Effects of Caffeine-Taurine Co-Ingestion on Endurance Cycling Performance
           in High Temperature and Humidity Environments

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      Authors: Peiqi Yu, Yongzhao Fan, Hao Wu
      Abstract: Sports Health, Ahead of Print.
      Background:Taurine (TAU) and caffeine (CAF), as common ergogenic aids, are known to affect exercise performance; however, the effects of their combined supplementation, particularly in high temperature and humidity environments, have not been studied.Hypothesis:The combination of TAU and CAF will have a greater effect on endurance cycle performance and improve changes in physiological indicators during exercise compared with TAU or CAF supplementation alone and placebo.Study Design:Single-blind crossover randomized controlled study.Level of Evidence:Level 1.Methods:Twelve university students majoring in physical education volunteered to receive 4 different supplement ingestions: (1) placebo (maltodextrin), (2) TAU, (3) CAF, (4) TAU + CAF. After a 7-day washout period, participants completed a time to exhaustion (TTE) test in the heat (35°C, 65% relative humidity).Results:All experimental groups improved TTE compared with the placebo group. Peak and mean power of countermovement jump were significantly higher in the CAF group compared with the placebo group before the exhaustion exercise (P = 0.02, d = 1.2 and P = 0.04, d = 1.1, respectively). Blood lactate was significantly lower after the exhaustion test in the TAU group compared with the CAF (P < 0.01, d = 0.8) and TAU + CAF (P < 0.01, d = 0.7) groups. Core temperature in the TAU group was significantly reduced in the placebo group later in the exhaustion test (P < 0.01, d = 1.9).Conclusion:In high temperature and humidity environments, acute TAU, CAF, and combined supplementation all improved TTE and did not affect recovery from lower limb neuromuscular fatigue compared with placebo, with TAU having the best effect. Combined supplementation failed to exhibit superimposed performance.Clinical Relevance:The results provide suggestions for the effects of TAU, CAF, and their combined intake on exercise performance in high temperature and humidity environments.
      Citation: Sports Health
      PubDate: 2024-02-26T09:53:55Z
      DOI: 10.1177/19417381241231627
       
  • Secondary School Athletic Trainers’ Perceptions of How Youth Sport
           Specialization Impacts Workload

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      Authors: David R. Bell, Madison N. Renner, Mayrena I. Hernandez, Kevin M. Biese, Stephanie Adler, Emily Srygler
      Abstract: Sports Health, Ahead of Print.
      Background:Youth sport specialization is a growing trend in youth sports and is associated with an increased risk of injuries and burnout. However, it is unknown how sport specialization is perceived to be affecting the working environment of secondary school athletic trainers (ATs). The purpose of this paper is to describe how ATs perceive youth sport specialization impacting their workload and whether they perceive it to impact patient safety.Hypothesis:ATs will perceive that youth sport specialization impacts their workload and could impact patient safety.Study Design:A sequential, explanatory mixed methods design with 2 phases: (1) cross-sectional surveys and (2) individual interviews.Level of Evidence:Level 3.Methods:A total of 487 secondary school ATs completed the online survey (access rate, 8.4%; completion rate, 85.4%). The survey consisted of Likert questions and included sections about aspects of workload impacted by specialization, impacts on patient safety, demographics. Ten participants were selected to complete a semi-structured interview via video conference.Results:Approximately two-thirds of ATs perceive that sport specialization impacts their workload. (Somewhat, 38.6%; Quite a bit, 25.5%; A great deal, 5.5%) Attempts to reduce or modify patient activity and a patient’s time for rehabilitation were the highest rated aspects of workload impacted by sport specialization. Approximately 30% ATs (29.9%) perceive that sport specialization impacts their workload to where it may influence patient safety (Somewhat, 21.6%; Quite a bit, 6.4%; A great deal, 1.9%). Three themes and subsequent subthemes were identified from the qualitative interviews: (1) current youth sport expectations, (2) conflict between school and club sports, and (3) AT job impacts.Conclusion:Secondary school ATs perceive their workload to be negatively impacted by youth sport specialization and some believe it may impact patient safety.Clinical Relevance:Youth sport specialization is impacting youth sport stakeholders, including ATs, in a variety of ways.
      Citation: Sports Health
      PubDate: 2024-02-26T09:46:12Z
      DOI: 10.1177/19417381241231589
       
  • Ankle Injury Prevention Programs for Youth Sports: A Systematic Review and
           Meta-analysis

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      Authors: Ryan Berkey, Afsar Sunesara, Lindsay Allen, Ryan Pontiff, Alison DeVries, Steve R. Fisher
      Abstract: Sports Health, Ahead of Print.
      Context:Previous research has demonstrated that using a multicomponent approach to ankle injury preventions can significantly reduce ankle injuries; however, these studies lack specific intervention recommendations.Objective:To evaluate the exercise components of prevention programs on ankle injuries specifically in high school athletes. Secondary objectives were to assess the overall effectiveness of prevention programs on ankle injuries in this population and how compliance and education may impact success.Data Sources:A total of 5 databases were searched through September 26, 2022.Study Selection:Study inclusion criteria included randomized control trials (RCTs) investigating exercise interventions in high school athletes aged 13 to 19 years, participation in sports competition, reporting of injury incidence, and specific exercise interventions used.Study Design:Systematic review and meta-analysis.Level of Evidence:Level 1.Data Extraction:Pooled overall ankle injury incidence rate ratio and 95% CIs were calculated using random-effects meta-analysis.Results:A total of 10 studies were included, of which 9 used multicomponent exercise interventions and 1 used only balance training. Of the 10 studies, 3 demonstrated statistically significant reduction in ankle injuries. When data from all 10 studies were pooled and analyzed, there was a statistically significant overall reduction (incidence rate ratio, 0.74; 95% CI 0.60-0.91) in ankle injuries when comparing intervention groups with controls.Conclusion:The most effective injury prevention programs included multiple components, emphasized strengthening and agility exercises, and promoted high adherence to the intervention. The importance of coach and player education on how and why to perform an injury prevention program as well as the frequency and duration of programs was also important. Exercise-based injury prevention programs may reduce ankle injury incidence in youth athletes by 26% when pooling data from a multitude of sport types/settings.
      Citation: Sports Health
      PubDate: 2024-02-26T09:41:15Z
      DOI: 10.1177/19417381241231588
       
  • Higher Eccentric Hamstring Muscle Fatigue After Participation in a Soccer
           Match in Young Female Athletes

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      Authors: Sebastiano Nutarelli, Jacopo Emanuele Rocchi, Manuela Salerno, Alessandro Sangiorgio, Luca Deabate, Giuseppe Filardo
      Abstract: Sports Health, Ahead of Print.
      Background:Hamstring (HS) strength deficits and imbalances have been identified as risk factors for sustaining anterior cruciate ligament (ACL) injuries and muscular strains, with HS injuries being the most prevalent muscle injuries in soccer athletes. The aim of this study was to investigate HS eccentric strength before and after a soccer match in both male and female soccer athletes.Hypothesis:Soccer athletes have changes in eccentric HS strength after a soccer game.Study Design:Cohort observational study.Level of Evidence:Level 3.Methods:HS eccentric strength (mean and absolute peak torque and total work) was measured in 64 healthy male and female competitive football athletes (14-25 years) with an automatic device during the execution of the Nordic hamstring exercise (NHE) test before and after a 90-minute soccer match. The anterior-knee laxity (AKL) was quantified with an arthrometer.Results:Mean and absolute eccentric HS peak torque decreased by 24.5 N.m (-12.34%; P < 0.01) and 21.9 N.m (-10.08%; P < 0.01) in female athletes, whereas their male peers improved by 19.9 N.m (+9.01%; P = 0.01) and by 20.9 N.m (+8.51%; P = 0.02), respectively. HS total work in female athletes decreased by 831.1 J (P < 0.01) compared with the male athlete reduction of 235.3 J. Both the pre- versus postmatch intersex mean and absolute eccentric HS peak torque changes were significant (P < 0.01), as were the changes in HS total work (P < 0.01). The pre- versus postmatch AKL difference and the dominant versus nondominant limb comparison of the strength parameters were not significantly different. Younger female athletes (14-19 years old) presented a greater decrease in mean and absolute peak HS eccentric strength compared with those in older female athletes and men.Conclusion:HS eccentric strength and work differ based on athlete sex, as measured by the NHE test. Mean peak, absolute peak, and total work showed greater reductions in female athletes than those in their male peers. The subgroup of 14- to 19-year-old female athletes experienced the highest reduction in strength parameters.
      Citation: Sports Health
      PubDate: 2024-02-26T09:33:30Z
      DOI: 10.1177/19417381241230613
       
  • The Psychology of ACL Injury, Treatment, and Recovery: Current Concepts
           and Future Directions

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      Authors: Andrew J. Sheean, Mikalyn T. DeFoor, Kurt P. Spindler, Justin W. Arner, Aravind Athiviraham, Asheesh Bedi, Steven DeFroda, Justin J. Ernat, Salvatore J. Frangiamore, Clayton W. Nuelle, Andrew J. Sheean, Kurt P. Spindler, Asheesh Bedi
      Abstract: Sports Health, Ahead of Print.
      Context:Interest in the relationship between psychology and the outcomes of anterior cruciate ligament (ACL) reconstruction (ACLR) continues to grow as variable rates of return to preinjury level of activity continue to be observed.Evidence Acquisition:Articles were collected from peer-reviewed sources available on PubMed using a combination of search terms, including psychology, resilience, mental health, recovery, and anterior cruciate ligament reconstruction. Further evaluation of the included bibliographies were used to expand the evidence.Study Design:Clinical review.Level of Evidence:Level 4.Results:General mental health and wellbeing, in addition to a host of unique psychological traits (self-efficacy, resilience, psychological readiness and distress, pain catastrophizing, locus of control, and kinesiophobia) have been demonstrated convincingly to affect treatment outcomes. Moreover, compelling evidence suggests that a number of these traits may be modifiable. Although the effect of resilience on outcomes of orthopaedic surgical procedures has been studied extensively, there is very limited information linking this unique psychological trait to the outcomes of ACLR. Similarly, the available information related to other parameters, such as pain catastrophizing, is limited with respect to the existence of adequately sized cohorts capable of accommodating more rigorous and compelling analyses. A better understanding of the specific mechanisms through which psychological traits influence outcomes can inform future interventions intended to improve rates of return to preinjury level of activity after ACLR.Conclusion:The impact of psychology on patients’ responses to ACL injury and treatment represents a promising avenue for improving low rates of return to preinjury activity levels among certain cohorts. Future research into these areas should focus on specific effects of targeted interventions on known, modifiable risk factors that commonly contribute to suboptimal clinical outcomes.Strength-of-Recommendation Taxonomy (SORT):B.
      Citation: Sports Health
      PubDate: 2024-02-20T06:36:03Z
      DOI: 10.1177/19417381241226896
       
  • Opioids and Youth Athletes

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      Authors: Holly J. Benjamin, Molly M. Perri, Jacqueline Leemputte, Laura Lewallen, Clarabelle DeVries
      Abstract: Sports Health, Ahead of Print.
      Context:The ongoing opioid epidemic and associated adverse effects impart a large burden on our current healthcare system. The annual economic and noneconomic cost of opioid use disorder and fatal opioid overdose is currently estimated at $1 trillion.Objective:This review presents the prevalence, frequency of use, need, and effectiveness of opioid analgesia in the youth and adolescent athlete population. It identifies current indications for opioid versus nonopioid analgesic use in the setting of acute orthopaedic injuries, postoperative management, concussion, and chronic pain. Current knowledge of youth athlete opioid use, risks related to use, misuse, diversion, and addiction are reviewed.Data Sources:A PubMed, Medline, and Cochrane Library search was conducted in February 2023 to review opioid pain management strategies in the pediatric athlete population from 2000 to present.Study Selection:Searches were restricted to English language articles and human subjects. Initial reviews of titles and abstracts were performed by all authors and relevant full-text articles were selected. Priority was given to systematic and narrative reviews, meta-analyses, and prospective studies.Study Design:Narrative review.Level of Evidence:Level 3.Data Extraction:First author name, publication year, study design, study country, subject demographics, and data on the frequency, type, and duration of analgesic treatments for musculoskeletal injuries, postsurgical care, chronic pain disorders, and concussion were extracted.Results:Pediatric athletes comprise a high-risk population seeking analgesic relief for injury-related pain. Participation in high school sports is associated with increased risk of opioid use. An average of 28% to 46% of high school athletes have used opioids in their lifetime. Participation in ≥1 high school sport puts adolescents at 30% greater odds of future opioid misuse.Conclusion:The use of opioids in the pediatric athlete population is common and associated with both short- and long-term risks of misuse and addiction.
      Citation: Sports Health
      PubDate: 2024-02-17T06:32:09Z
      DOI: 10.1177/19417381241228629
       
  • Upper Extremity Musculoskeletal Profiles in Tennis Players: A Systematic
           Review

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      Authors: Natalie L. Myers, James L. Farnsworth, Sean M. Kennedy, Duane V. Knudson
      Abstract: Sports Health, Ahead of Print.
      Context:Tennis-specific musculoskeletal (MSK) screening can assess range of motion (ROM) and muscular imbalances. Identifying normative values before implementing a MSK screen is essential in contributing to athlete performance and injury risk profiles.Objective:To review upper extremity MSK data in healthy tennis players across age, sex, and level of play.Data Source:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this review. A search was conducted in MEDLINE, SPORTDiscus, Embase, and CINAHL.Study Selection:This review included shoulder, elbow, and wrist ROM, isometric strength, or isokinetic strength in a tennis population. Each article was critically appraised to help identify the internal and external validity of each study.Study Design:Systematic review.Level of Evidence:Level 3.Data Extraction:A total of 41 studies met the search criteria. Each contributor organized the data elements of interest into data tables, with a second contributor assigned for review. Data elements of interest included player and study characteristics: ROM, isometric dynamometry, and isokinetic strength.Results:A total of 3174 players were included in the final studies. Most of the players included were competitive adolescents and young adults; 15 studies included ROM data. Male tennis players consistently had more external rotation (ER) gain (range, 1.8º to 8.8º) and internal rotation (IR) loss (range, -15.3º to -3.0º) when compared with their female counterparts (ER range, -2.5º to 5.8º; IR range, -10.4º to -3º). Shoulder IR and ER strength were measured in the majority of all the strength studies, with the external rotators generating at least two-thirds the strength of the internal rotators.Conclusion:Overall MSK data of tennis players indicate that shoulder strength values are often larger than nontennis players, but equal to or slightly lower than comparable athletes in other overhead sports. Adaptive changes of the glenohumeral joint and subsequent rotational motion are similar to those of other overhead athletes.
      Citation: Sports Health
      PubDate: 2024-02-16T07:42:38Z
      DOI: 10.1177/19417381231223540
       
  • Temperamental and Neuropsychological Predictors for Major League
           Pro-Baseball Success

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      Authors: Kun Jung Kim, Sung Ah Chung, Sun Jae Lee, Doug Hyun Han
      Abstract: Sports Health, Ahead of Print.
      Background:Securing a professional baseball career is a formidable task, and only a unique few can overcome the obstacles necessary to become a Major League player in the Korea Baseball Organization (KBO). When achieving a spot in a KBO Major League team, a player’s technical aspect may be influenced by their initial neuropsychological status.Hypothesis:Personality and neurocognitive functions influence long-term pro-baseball league success.Study Design:Cohort observational study.Level of Evidence:Level 3.Methods:From the start of each player’s career, we monitored the status and course of 153 baseball players in the KBO from 2009 to 2019 who agreed to participate in this study. The Korean versions of the Temperament and Character Inventory (TCI) and the State-Trait Anxiety Inventory-Y (STAI-KY) analyzed traits and estimated state and trait anxiety levels, respectively. The Trail Making Test (TMT) (parts A and B) assessed attention shifting, and, in the Wisconsin Card Sorting Test (WCST), perseverative errors determined cognitive flexibility. Hierarchical logistic regression models were used to predict player status variables, with TCI and neurocognitive function variables as covariates.Results:High novelty-seeking scores, low state anxiety, and short TMT A results reliably predict KBO Major League participation in a player’s third year. Similarly, low state anxiety scores and high harm avoidance, reward dependence, and self-transcendence scores accurately predict KBO Major League participation in a player’s fifth year. Lastly, short TMT A results, low perseverative error scores, and high novelty-seeking, harm avoidance, reward dependence, and self-transcendence efficiently predict KBO Major League participation in a player’s seventh year.Conclusion:Draft ranking, personality, and neurocognitive function are associated with pro-baseball league achievement. In particular, personality and neuropsychological functions are associated with long-term success.Clinical Relevance:Clinically, sound personality and neuropsychological functions determine KBO Major League success.
      Citation: Sports Health
      PubDate: 2024-02-13T12:16:52Z
      DOI: 10.1177/19417381241227642
       
  • Dose-Response Effect of Mental Health Diagnoses on Concussion Recovery in
           Children and Adolescents

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      Authors: Christina L. Master, Daniel J. Corwin, Daniele Fedonni, Steven B. Ampah, Kaitlyn C. Housel, Catherine McDonald, Kristy B. Arbogast, Matthew F. Grady
      Abstract: Sports Health, Ahead of Print.
      Background:Pre-existing mental health diagnoses may contribute to greater emotional symptom burden and prolonged recovery after concussion.Hypothesis:Youth with pre-existing mental health diagnoses will have greater emotional symptom burden, greater risk for delayed return to exercise, and more prolonged recovery from concussion than those without those diagnoses.Study Design:Prospective cohort.Level of Evidence:Level 3.Methods:A prospective registry of youth concussion was examined for differences in emotional symptom burden after injury to develop a predictive risk model for prolonged recovery. The impact of individual and total number of pre-existing mental health diagnoses (0, 1, 2, and 3+) was assessed, and multivariable logistic regression was performed to identify factors associated with prolonged recovery.Results:Among a cohort of 3105 youth with concussion, those with a history of mental health diagnoses, in a dose-response fashion, had greater postinjury emotional symptom burden (7 emotional symptoms vs 4; P < 0.01), visio-vestibular dysfunction (65% abnormal vs 56% abnormal; P < 0.01), later return to symptom-limited exercise (23 vs 21 days; P < 0.01), and overall longer concussion recovery (38 days, interquartile range [IQR] 18, 80) versus 25 days (IQR 13, 54; P < 0.01). Boys with prolonged recovery after concussion had greater emotional symptom burden than girls (5 emotional symptoms vs 3; P < 0.01).Conclusion:Pre-existing mental health diagnoses are associated with greater postinjury emotional symptom burden and longer concussion recovery in a dose-response fashion. Visiovestibular deficits and delayed return to exercise are also associated with pre-existing mental health diagnoses and prolonged recovery. Boys with prolonged recovery from concussion experience greater emotional symptom burden than girls.Clinical Relevance:Addressing pre-existing mental health diagnoses is essential to concussion management. Boys with prolonged recovery from concussion may particularly benefit from interventions to address their higher emotional symptom burden. Interventions, including a home visio-vestibular exercise program and symptom-limited exercise, may contribute to improving time to concussion recovery.
      Citation: Sports Health
      PubDate: 2024-02-13T12:07:40Z
      DOI: 10.1177/19417381241228870
       
  • Mindfulness Practice Is Associated With Improved Wellbeing and Reduced
           Injury Risk in Female NCAA Division I Athletes

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      Authors: Kristin Haraldsdottir, Jennifer Sanfilippo, Scott Anderson, Quinn Steiner, Chad McGehee, Kevin Schultz, Andrew Watson
      Abstract: Sports Health, Ahead of Print.
      Background:Injury in sport is an inherent risk to participation, and it can have devastating consequences for the athlete, both mentally and physically. Previous research has found that impairments in wellbeing can increase the risk of injury, and that various forms of mindfulness training and practice can improve wellbeing and mental health in various populations.Hypothesis:Mindfulness would be associated with greater wellbeing and lower risk of injury.Study Design:Cohort study.Level of Evidence:Level 3.Methods:A total of 21 female Division I athletes underwent a formal 6-week mindfulness training program and were encouraged to continue mindfulness exercises. The athletes completed daily surveys on their smartphones in relation to mood, muscle readiness (soreness), readiness to train, energy level, daily training load, and whether they had participated in mindfulness training that day. Linear mixed effects models were used to evaluate wellbeing variables and mindfulness state, and separate mixed effects logistics regression models were used to evaluate injury incidence and wellness variables.Results:On days with mindfulness practice, athletes reported higher mood (19.6 [18.8-20.3] vs 19.4 [18.6-20.1, P = 0.03), muscle readiness (18.9 [17.8-20.0] vs 18.6 [17.5-19.6], P = 0.03), readiness to train (78.7 [75.9-81.5] vs 77.4 [74.7-80.2], P < 0.01), and energy level (19.3 [18.6-20.1] vs 18.8 [18.1-19.5, P < 0.01) than on the days when they did not participate in mindfulness training. Mindfulness practice was associated with significantly reduced likelihood of suffering an acute injury the following day (odds ratio, 0.42; 95% CI, 0.42-0.43; P < 0.01).Conclusion:On an individual level, participation in mindfulness by female collegiate athletes was associated with a dramatic reduction in injury risk the following day. In addition, mindfulness was associated with significantly improved mood, muscle readiness, readiness to train, and energy level.Clinical Relevance:These findings suggest that mindfulness training in athletes may improve wellbeing and reduce the risk of injury among high-level athletes.
      Citation: Sports Health
      PubDate: 2024-02-13T04:34:52Z
      DOI: 10.1177/19417381241227447
       
  • A National Survey on the Relationship of Youth Sport Specialization
           Behaviors to Self-Reported Anxiety and Depression in Youth Softball
           Players

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      Authors: Anne Marie Zeller, Aaron Lear, Eric Post, Suzanne McNulty, Brett Bentley
      Abstract: Sports Health, Ahead of Print.
      Background:There are little to no data on whether any associations exist between sport specialization and mental health in youth softball athletes.Hypothesis:Highly specialized youth softball athletes will have worse self-reported depression and anxiety symptom scores compared with low and moderate specialized athletes.Study Design:Cross-sectional survey.Level of Evidence:Level 4.Methods:An online cross-sectional survey was distributed in the fall of 2021 to a national sample of female youth softball athletes between the ages of 12 and 18 years. Sport specialization status was determined using a 3-point specialization scale that classifies either low, moderate, or high. The patient health questionnaire-9 (PHQ-9) and the 7-item general anxiety disorder scale (GAD-7) were used to assess self-reported symptoms of depression and anxiety. Comparison also included sports participation and specialization behaviors between specialization groups.Results:A total of 1283 subjects (mean age, 15.1 ± 1.7 years) fully completed the survey. After adjusting for covariates, lower scores were reported on both the PHQ-9 and GAD-7 by highly specialized athletes compared with moderate or low specialization athletes (PHQ-9, high = 8.6 ± 0.4; moderate = 11.2 ± 0.3; low = 10.9 ± 0.5; P < 0.01; GAD-7, high = 6.5 ± 0.4; moderate = 8.6 ± 0.3; low = 8.4 ± 0.4, P < 0.01). Conversely, higher scores were reported on both scales for athletes who received private softball coaching compared with those who did not (PHQ-9, 11.5 ± 0.3 vs 9.0 ± 0.3; P < 0.01; GAD-7, 8.8 ± 0.3 vs 6.9 ± 0.3, P < 0.01). Finally, athletes who reported an arm overuse injury in the previous year reported higher PHQ-9 scores (10.8 ± 0.3 vs 9.8 ± 0.3; P < 0.01).Conclusion:While sport specialization, as measured by the validated 3-point scale, was not associated with increased anxiety and depression symptom scores, other aspects of specialization behavior such as private coaching or overuse injury history were associated with worse scores on these scales, indicating potential concern for anxiety and depression. However, although the differences we observed were statistically significant, they did not exceed the minimal clinically important difference values that have been established for the PHQ-9 (5 points) or GAD-7 (4 points).Clinical Relevance:This project is a first step toward understanding the sport specialization behaviors and their influence on the mental health of youth softball athletes. Focusing on investigating specialization behaviors further may reveal to be a better indicator of risk of developing anxiety and depression symptoms compared with utilizing the 3-point specialization scale.
      Citation: Sports Health
      PubDate: 2024-02-12T09:25:17Z
      DOI: 10.1177/19417381241228539
       
  • Society News

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      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2024-02-12T09:14:17Z
      DOI: 10.1177/19417381241230438
       
  • Predictors of Running-Related Injury Among Recreational Runners: A
           Prospective Cohort Study of the Role of Perfectionism, Mental Toughness,
           and Passion in Running

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      Authors: Aynollah Naderi, Nasrin Alizadeh, Luis Calmeiro, Hans Degens
      Abstract: Sports Health, Ahead of Print.
      Background:The health benefits associated with recreational running are challenged by the occurrence of running-related injuries (RRIs). Effective preventive measures require knowledge of sport injury etiology. Psychological factors such as perfectionism, mental toughness, and passion are believed to predispose to sports injury by influencing training behaviors, motivation to run, and suppression of feelings of fatigue and pain. Yet their association with RRIs are understudied.Hypothesis:Perfectionism, mental toughness, and passion predict an increased risk of RRIs in recreational runners.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:A total of 143 recreational runners (age 34.9 ± 13.9 years, 37% women) with a response rate of 76.5% answered an online questionnaire about their characteristics, running behaviors, and psychological variables (perfectionism, mental toughness, and running passion) as well as a sports injury survey. Then, as a primary outcome, RRIs were recorded biweekly for 6 months. The incidence of injuries was expressed as RRI per 1000 hours of running. The association between predictive factors and RRIs was estimated using logistic regression.Results:The incidence of RRIs during follow-up was 5.16 per 1000 hours of running. The knee was the location injured most often (26.4%), followed by the foot (18.9%) and lower leg (13.2%). Higher obsessive passion (OP) for running (odds ratio [OR], 1.11; 95% CI, 1.04-1.20) and perfectionistic concerns (OR, 1.22; CI,1.05-1.41) were associated with a greater risk of RRIs, as were previous injury (OR, 2.49; CI,1.10-5.70), weekly running distance (OR,1.10; CI, 1.03-1.16), and both supinated (OR, 4.51; CI, 1.11-18.30) and pronated (OR, 3.55; CI, 1.29-9.80) foot type. Following a running schedule (OR, 0.24; CI, 0.09-0.66) was associated with a lower risk of RRIs.Conclusion:History of previous RRI, pronated and supinated foot type, weekly running distance, perfectionistic concerns, and OP increased RRI risk in recreational runners. Following a running schedule was a protective factor.Clinical Relevance:Multiple factors, including runners’ psychological characteristics, predict RRIs. These findings can inform the development of injury risk management strategies.
      Citation: Sports Health
      PubDate: 2024-02-05T06:55:57Z
      DOI: 10.1177/19417381231223475
       
  • Hip Pain in the Young Athlete: Femoroacetabular Impingement Syndrome

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      Authors: Omair Kazi, Alexander B. Alvero, Joshua Wright-Chisem, Shane J. Nho
      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2024-02-02T09:09:49Z
      DOI: 10.1177/19417381231223515
       
  • The Influence of Psychosocial Factors on Patients Undergoing Anterior
           Cruciate Ligament Reconstruction

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      Authors: Amit M. Momaya, Audria S. Wood, Elizabeth M. Benson, Adam L. Kwapisz
      Abstract: Sports Health, Ahead of Print.
      Context:Anterior cruciate ligament (ACL) injuries greatly impact patients in terms of future performance, reduced physical activity and athletic participation, and overall economic burden. Decades of research have investigated how to improve ACL reconstruction (ACLR) outcomes. Recently, there has been growing interest to understand the effects of psychosocial factors on patient outcomes.Study Design:Clinical review.Evidence Acquisition:A search of the PubMed database was performed in March 2023. Articles were reviewed by at least 2 authors to determine relevance. We highlighted publications of the past 5 years while incorporating previous pertinent studies.Level of Evidence:Level 5.Results:There is no standardization of psychosocial factors regarding ACLR. As such, there is a lack of consensus regarding which psychosocial measures to use and when. There is a need for clarification of the complex relationship between psychosocial factors and physical function. Despite this, psychosocial factors have the potential to help predict patients who are more likely to return to sport: (1) desire/motivation to return; (2) lower levels of kinesiophobia; (3) higher levels of self-efficacy, confidence, and subjective knee function; (4) risk acceptance; and (5) social support. However, there are no standardized interventions to improve psychosocial factors after ACLR.Conclusion:Psychosocial factors affect outcomes after ACLR. However, the interplay between psychosocial factors and physical function is complex. There is emerging evidence that testing and interventions may improve ACLR outcomes. There is a lack of standardized interventions to determine or improve psychosocial factors after ACLR. Further research is needed to identify psychosocial factors and to develop standardized interventions for clinicians to implement to improve clinical outcomes.
      Citation: Sports Health
      PubDate: 2024-02-01T04:54:38Z
      DOI: 10.1177/19417381231223560
       
  • The Influence of Strength and Sport Exposure on Psychological Readiness
           After ACL Reconstruction

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      Authors: Griffin P. Zink, Christin M. Zwolski, Staci M. Thomas, Mark V. Paterno, Laura C. Schmitt
      Abstract: Sports Health, Ahead of Print.
      Background:Among young athletes returning to sport after anterior cruciate ligament reconstruction (ACLR), the extent to which psychological readiness is influenced by factors beyond the psychological domain is largely unknown.Hypothesis:Young athletes with recent sport exposure and higher quadriceps strength will demonstrate higher psychological readiness within 8 weeks of medical clearance to return to sport (RTS) after ACLR.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:A total of 38 young athletes after primary ACLR completed testing within 8 weeks of medical clearance to RTS. All participants completed isometric knee extension strength testing, in addition to the ACL Return to Sport after Injury (ACL-RSI) questionnaire. Athletes who participated in sport between time of medical clearance to RTS and date of study enrollment were categorized as SPORT-YES. Those who had not yet participated in sports were categorized as SPORT-NO. Multiple linear regression analyses were used to determine differences in ACL-RSI scores based on quadriceps strength and sport exposure status, while adjusting for age and sex.Results:Of the 38 participants, 20 (52.6%) were categorized as SPORT-YES. The regression model estimating overall ACL-RSI score (P < 0.01, adjusted R2 = 0.389) included significant independent contributions from age, sex, and sport exposure variables (age: P = 0.01, β [95% CI] = -2.01 [-3.54, -0.48]; sex (male): P = 0.02, β [95% CI] = 12.50 [2.36, 22.64]; strength: P = 0.51, β [95% CI] = -2.47 [-10.07,5.13]; sport exposure: P < 0.01, β [95% CI] = 12.89 [3.58, 22.19]).Conclusion:In partial accordance with our hypothesis, recent sport exposure was significantly associated with higher ACL-RSI scores among young athletes in the weeks after medical clearance to RTS after ACLR, while quadriceps strength was not.Clinical Relevance:Future prospective work is needed to determine the existence and direction of causal relationships between exposure to sport environment and psychological readiness among young athletes after ACLR.
      Citation: Sports Health
      PubDate: 2024-01-30T08:40:32Z
      DOI: 10.1177/19417381231223522
       
  • Changes in Sports Participation, Specialization, and Burnout From 7th to
           12th Grade: Final Results From a 6-Year Longitudinal Study

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      Authors: Jacquelyn Valenzuela-Moss, Milo Sini, Tishya A.L. Wren, Bianca R. Edison
      Abstract: Sports Health, Ahead of Print.
      Background:Previous studies show alarming rates of burnout and dropout from sports participation and physical activity in the youth population. Early sports specialization may increase the risk of injury, burnout, and eventual dropout from sports.Hypothesis:Sports participation will decrease, specialization will increase, and burnout will increase from junior high to high school.Study Design:Prospective longitudinal study.Level of Evidence:Level 2b.Methods:The graduating class of 2023 was surveyed longitudinally in the fall of each school year from 7th to 12th grade (n = 35-77 from middle to high school based on new enrollment participants and attrition). Survey questions asked about sports participation, specialization, and burnout. Responses were analyzed by grade level using mixed effects linear and logistic regression accounting for repeated measures.Results:The number of days per week in which students engaged in at least 60 minutes of strenuous exercise progressively decreased from 7th through 12th grade from 4.0 to 2.3 days per week (P < 0.01). The percentage of students participating in sports also decreased from 7th to 12th grade from 82% to 39% (P < 0.01). More students stopped participating in a sport (38% vs 22% to 29%, P = 0.04), quit a sport to focus on a single sport (60% vs 46% to 49%, P = 0.01), or reported that 1 sport was most important to them (71% vs 54% to 67%, P = 0.06) in 9th grade. Burnout in sports did not differ significantly by grade level (19% to 23%, P> 0.99). In contrast, burnout in school was significantly more common in high school (54% to 69%) compared with middle school (36%, P < 0.01). Burnout in school was higher in female students compared with male students (68% vs 38%, P < 0.01).Conclusion:Organized sports participation and general physical activity decreased from middle to high school, with the entry into high school at 9th grade being a time at which a significant number of students dropped other sports to specialize in a single sport or stopped participating. Burnout in sports did not appear to increase with age; however, there was an increase in school-related burnout as students transitioned from middle to high school.Clinical Relevance:Our results highlight the need for continued research into sports participation, specialization, and burnout in adolescents. In addition, health professionals and the community (parents, coaches, teachers) supporting youth athletes may consider positive interventions during the periods of transition from middle to high school to include facilitating different tracks of sports participation (including a developmental or recreational model of play) to reduce dropout from sport and supportive measures to lessen burnout from sports and from school.
      Citation: Sports Health
      PubDate: 2024-01-29T11:38:52Z
      DOI: 10.1177/19417381231224792
       
  • Epidemiology and Sex-Specific Analysis of Basketball-Related Lower
           Extremity Fractures: A 10-Year Analysis of National Injury Data

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      Authors: Avanish Yendluri, Joshua J. Chiang, Katrina S. Nietsch, Kyle K. Obana, David P. Trofa, John D. Kelly, Robert L. Parisien
      Abstract: Sports Health, Ahead of Print.
      Background:Basketball-related fractures involving the lower extremities frequently present to emergency departments (ED) in the United States (US). This study aimed to identify the primary mechanisms, distribution, and trends of these injuries.Hypothesis:We hypothesize that (1) lower extremity fracture frequency will decrease from 2013 to 2022, (2) the ankle will be the most common fracture site, and (3) noncontact twisting will be the most common injury mechanism.Study Design:Descriptive epidemiological.Level of Evidence:Level 3.Methods:The National Electronic Injury Surveillance System (NEISS) was queried for lower extremity fractures from basketball presenting to US EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was characterized using the provided narrative. National estimates (NEs) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression.Results:There were 6259 cases (NE: 185,836) of basketball-related lower extremity fractures. Linear regression analysis of annual trends demonstrated a significant decrease in lower extremity fractures over the study period (2013-2022: P = 0.01; R2 = 0.64). The most common injury mechanism was a noncontact twisting motion (NE: 49,897, 26.9%) followed by jumping (NE: 39,613, 21.3%). The ankle was the most common fracture site (NE: 69,936, 37.6%) followed by the foot (NE: 49,229, 26.49%). While ankle and foot fractures decreased significantly (P < 0.05), fractures of the lower leg, knee, toe, and upper leg showed no significant trends (P = 0.09, 0.75, 0.07, and 0.85, respectively).Conclusion:Basketball-related lower extremity fractures decreased from 2013 to 2022, with the ankle being the most common fracture site and most fractures arising from a noncontact twist. Increasing utilization of outpatient clinics may have contributed to the decline, particularly for ankle and foot fractures. The prevalence of ankle fractures and twisting-related injuries reinforces the importance of protective footwear and targeted strengthening protocols.
      Citation: Sports Health
      PubDate: 2024-01-29T11:27:01Z
      DOI: 10.1177/19417381231223479
       
  • Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A
           Narrative Review

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      Authors: Connie Hsu, Brian Krabak, Brian Cunningham, Joanne Borg-Stein
      Abstract: Sports Health, Ahead of Print.
      Context:Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers.Evidence Acquisition:From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms “swimming,” “low back” or “lumbar,” and “injury” or “injuries.”Study Design:Narrative review.Level of Evidence:Levels 4 and 5.Results:The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments.Conclusion:Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention.Strength of Recommendations:B. Recommendation based on limited quality or inconsistent patient-oriented evidence.
      Citation: Sports Health
      PubDate: 2024-01-24T03:09:45Z
      DOI: 10.1177/19417381231225213
       
  • Mental Health in Elite Coaches

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      Authors: Laura Baumann, Andres Ricardo Schneeberger, Alan Currie, Samuel Iff, Erich Seifritz, Malte Christian Claussen
      Abstract: Sports Health, Ahead of Print.
      Context:Coaches play an important role in promoting mental health in elite sports. However, they themselves are exposed to risks affecting their mental health, and their fears and worries are often overlooked. Moreover, it remains unclear how coaches’ mental health affects their athletes’ mental health.Objective:To create a compilation of the literature on (1) elite coaches’ mental health and (2) how coaches’ mental health influences elite athletes’ mental health. Building on this, recommendations for improving coaches’ psychological well-being should be elaborated upon and discussed.Data Sources:A literature search was conducted up to November 30, 2021, using the following databases: PubMed, PsycINFO, Scopus, Web of Science, and SportDiscus.Study Selection:Studies reporting elite coaches’ mental health symptoms and disorders and the influence of elite coaches’ mental health on elite athletes’ mental health were included.Study Design:Scoping review.Level of Evidence:Level 4.Data Extraction:Data regarding elite coaches’ mental health, as well as their influence on athletes’ mental health and performance, were included in a descriptive analysis. The PRISMA guidelines were used to guide this review.Results:Little research has been done on elite coaches’ mental health disorders, although studies confirm that they do experience, for example, symptoms of burnout, anxiety, and depression. The influence of coaches’ mental health on their athletes is underinvestigated, with research focused mainly on the influence of coaches’ stress.Conclusion:Knowledge about coaches’ mental health is still limited. Coaches’ poor mental health diminishes coaching performance and might impair athletes’ mental health. Coaches should receive more support, including sports psychiatric care and education on the importance of mental health. This could improve the mental health of both coaches and athletes, and positively affect athlete performance.
      Citation: Sports Health
      PubDate: 2024-01-22T03:59:06Z
      DOI: 10.1177/19417381231223472
       
  • The Influence of Race, Socioeconomic Status, and Physical Activity on the
           Mental Health Benefits of Sport Participation During COVID-19

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      Authors: Kevin M. Biese, Timothy A. McGuine, Kristin Haraldsdottir, Claudia Reardon, Andrew M. Watson
      Abstract: Sports Health, Ahead of Print.
      Background:The purpose of this study was to compare the benefits of sport participation with no sport participation during the COVID-19 pandemic and determine the moderating effects of race and ethnicity, socioeconomic status (SES), and physical activity (PA) on mental health in adolescent athletes.Hypothesis:Sport participation would be associated with greater improvements in mental health for athletes from racial and ethnic minority and lower SES groups compared with White and high SES groups. PA would mediate
      Citation: Sports Health
      PubDate: 2024-01-22T03:57:47Z
      DOI: 10.1177/19417381231223494
       
  • Epidemiology of Stingers in the National Football League, 2015-2019

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      Authors: Joseph D. Lamplot, Camryn Petit, Rebecca Lee, Christina D. Mack, Mackenzie M. Herzog, Gary S. Solomon, Jed A. Diekfuss, Greg D. Myer, Kyle Hammond
      Abstract: Sports Health, Ahead of Print.
      Background:Transient traumatic neuropraxia of either the brachial plexus or cervical nerve root(s) is commonly described as a “stinger” or “burner” by the athlete. Stingers in American Football commonly occur acutely as isolated injuries; however, concomitant injuries, including cervical spine pathologies, have also been reported.Hypothesis:Among National Football League (NFL) athletes, the incidence rate of stingers is higher during the regular season than during the preseason and among positions with high velocity impacts such as running backs, linebackers, defensive backs, and receivers.Study Design:Retrospective epidemiology study.Level of Evidence:Level 4.Methods:Aggregation of all in-game injuries with a clinical impression of “neck brachial plexus stretch” or “neck brachial plexus compression” entered into the NFL injury surveillance database through the centralized league-wide electronic medical record system over 5 years (2015-2019 seasons). Incidence rates per player-play were calculated and reported.Results:A total of 691 in-game stingers occurred during the study period, with a mean of 138.2 per year. Average single-season injury risk for incident stinger was 3.74% (95% CI, 3.46%-4.05%). The incidence rate was higher during regular season games than during preseason games (12.26 per 100,000 player-plays [11.30-13.31] vs 8.87 [7.31-10.76], P < 0.01, respectively). The highest reported stinger incidence rates were among running backs and linebackers (both>15 per 100,000 player-plays). Among stingers, 76.41% did not miss time. Of those that resulted in time lost from football activities, mean time missed due to injury was 4.79 days (range, 3.17-6.41 days). Concomitant injuries were relatively low (7.09%).Conclusion:In-game stinger incidence was stable across the study period and occurred most frequently in running backs and linebackers. Stingers were more common during the regular season, and most players did not miss time. Concomitant injuries were relatively rare.Clinical Relevance:An improved understanding of the expected time loss due to stinger and concomitant injuries may provide insight for medical personnel in managing these injuries.
      Citation: Sports Health
      PubDate: 2024-01-17T05:04:20Z
      DOI: 10.1177/19417381231223413
       
  • Reliability and Validity of the Star Excursion Balance Test for Evaluating
           Dynamic Balance of Upper Extremities

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      Authors: Qi-Hao Yang, Yong-Hui Zhang, Shu-Hao Du, Yu-Chen Wang, Hao-Ran Xu, Ji-Wei Chen, Yuan Mao, Xue-Qiang Wang
      Abstract: Sports Health, Ahead of Print.
      Background:Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity.Hypothesis:The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs.Study Design:Observational study.Level of Evidence:Level 4.Methods:This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured.Results:Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (r = 0.315-0.755, P < 0.01) and a strong correlation with CKCUEST (r = 0.4-0.67, P < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (r = 0.26-0.43, P < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees.Conclusion:UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests.Clinical Relevance:UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.
      Citation: Sports Health
      PubDate: 2024-01-17T04:53:40Z
      DOI: 10.1177/19417381231221716
       
  • Impact of Running Exercise on Intervertebral Disc: A Systematic Review

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      Authors: Dingbo Shu, Siyu Dai, Jianping Wang, Fanjing Meng, Chuan Zhang, Zhenhua Zhao
      Abstract: Sports Health, Ahead of Print.
      Context:Running is one of the most popular sports worldwide. However, controversies exist regarding how running affects runner’s intervertebral discs (IVD).Objective:The purpose of this study was to systematically review studies that evaluated IVD morphology or composition changes in response to running exercise, to determine the impact of running exercise on IVD.Data Sources:A systematic literature search was performed for 4 major databases: PubMed, Cochrane, Embase, and Web of Science.Study Selection:Inclusion criteria were as follows: (1) healthy people without known IVD disease or major complications such as tuberculosis (IVD degeneration or low back pain are considered as minor complications); (2) subjects performed 1-time or regular running exercises; (3) pre and post comparison of runners or comparison between runners and healthy control subjects; (4) direct or indirect IVD morphology or composition measured; (5) IVD assessed before and after either acute or chronic running exercise, or compared cross-sectionally between runners and controls. Exclusion criteria were as follows: (1) reviews, editorials, letters or abstracts only; (2) animal studies; (3) subjects performed exercise other than running.Study Design:Systematic review.Level of Evidence:Level 3.Data Extraction:The extracted data included study design and primary outcomes of the included studies. The Newcastle-Ottawa scale (NOS) was used to evaluate study quality and risk of bias.Results:A total of 13 studies with 632 participants were included in the final analysis; 4 studies measured IVD changes using stature or spinal height, and the other 9 measured IVD changes using magnetic resonance imaging; 6 studies found that running acutely and negatively impacts IVD; 3 out of 5 cross-sectional studies found that IVD parameters are better for runners than controls; 1 longitudinal study found no significant difference in IVD before and after training for marathon in runners; 1 longitudinal study found no significant difference in changes of IVD between runners and controls after 15 years of follow-up.Conclusion:Negative changes in IVD exist for a short period of time after running, which may be due to the temporary compression pushing water content out of the disc. Cross-sectional studies suggest that long-term running exerts a mild positive effect on IVD; however, this inference has not been confirmed by high-quality longitudinal studies.
      Citation: Sports Health
      PubDate: 2024-01-11T07:40:22Z
      DOI: 10.1177/19417381231221125
       
  • Weightlifting Induced Spinal Accessory Nerve Palsy and Winged Scapula: A
           Case Report

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      Authors: Adnine Anass, Taik Fatima Zahrae, Aharrane Fatima Zahra, Takhrifa Nihad, Fadel Hicham, Abourazzak Fatima Ezzahra
      Abstract: Sports Health, Ahead of Print.
      Winged scapula is a rare musculoskeletal condition with numerous etiologies including spinal accessory nerve (SAN) palsy. Sport activities are rarely implicated with few scattered case reports. We report a case of an 18-year-old bodybuilder who suffered SAN palsy secondary to weightlifting exercises. Physical examination revealed winged scapula with painful mobility of the shoulder. A scapular magnetic resonance imaging scan and electromyography of the trapezius muscle were performed and confirmed the diagnosis of SAN palsy. Through this case, we review the literature of common and rare causes of SAN palsy and outline accepted treatment options.
      Citation: Sports Health
      PubDate: 2024-01-11T07:27:05Z
      DOI: 10.1177/19417381231219218
       
  • Mental Health Among Elite Youth Athletes: A Narrative Overview to Advance
           Research and Practice

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      Authors: Courtney C. Walton, Rosemary Purcell, Jo L. Henderson, Jeemin Kim, Gretchen Kerr, Joshua Frost, Kate Gwyther, Vita Pilkington, Simon Rice, Katherine A. Tamminen
      Abstract: Sports Health, Ahead of Print.
      Context:Participation in sports during youth is typically beneficial for mental health. However, it is unclear whether elite sport contexts contribute to greater risk of psychological distress or disorder. The aims of this paper are to highlight conceptual issues that require resolution in future research and practice, and to examine the key factors that may contribute to the mental health of elite youth athletes (EYAs).Evidence Acquisition:A narrative overview of the literature combined with the clinical and research expertise of the authors.Study Design:Narrative overview.Level of Evidence:Level 5.Results:EYAs experience a range of biopsychosocial developmental changes that interact with mental health in a multitude of ways. In addition, there are various sport-specific factors that contribute to the mental health of EYAs that may become more prominent in elite contexts. These include - but are not limited to - patterns relating to athlete coping and self-relating styles, the nature of peer, parental, and coach relationships, organizational culture and performance pressures, and mental health service provision and accessibility.Conclusion:A range of critical factors across individual, interpersonal, organizational, and societal domains have been shown to contribute to mental health among EYAs. However, this evidence is limited by heterogeneous samples and varied or imprecise terminology regarding what constitutes “youth” and “elite” in sport. Nevertheless, it is clear that EYAs face a range of risks that warrant careful consideration to progress to best practice principles and recommendations for mental health promotion and intervention in elite youth sport.SORT:Level C.
      Citation: Sports Health
      PubDate: 2024-01-04T06:30:26Z
      DOI: 10.1177/19417381231219230
       
  • Approach Scientific Statements Like a Scouting Report'

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      Authors: Lynette L. Craft, Kurt P. Spindler
      Pages: 9 - 11
      Abstract: Sports Health, Volume 16, Issue 1, Page 9-11, January/February 2024.

      Citation: Sports Health
      PubDate: 2023-12-19T12:06:52Z
      DOI: 10.1177/19417381231213365
      Issue No: Vol. 16, No. 1 (2023)
       
  • Return-to-Sport Rates After Hip Arthroscopy for Femoroacetabular
           Impingement Syndrome in Flexibility Sports Athletes: A Systematic Review

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      Authors: Muyiwa Ifabiyi, Milin Patel, Dan Cohen, Nicole Simunovic, Olufemi R. Ayeni
      Abstract: Sports Health, Ahead of Print.
      Context:Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain in young adults. Flexibility athletes represent an interesting subset due to the extreme range of motion requirements of their sport.Objective:The objective of this review was to provide a summary of the outcomes of hip arthroscopy for FAIS in patients who participate in flexibility sports.Data Sources:Three online databases (Medline, Embase, and PubMed) were searched from database inception (1946, 1974, and 1966, respectively) to January 10, 2023.Study Selection:Studies were screened for literature addressing surgical outcomes for flexibility athletes undergoing hip arthroscopy for FAIS.Study Design:Systematic review.Level of Evidence:Level 4.Data Extraction:Various patient-reported outcomes that evaluated the efficacy of hip arthroscopy in this patient population were abstracted and presented in descriptive and analytical format. ion was performed by 2 reviewers.Results:Overall, a total of 8 Level 3 or 4 studies and 295 patients (312 hips) were included in this review. The pooled standardized mean differences for the Visual Analog Scale for pain score, Modified Harris Hip Score, Hip Outcome Score - Activity of Daily Living scale, and Hip Outcome Score - Sport-Specific Subscale all demonstrated significant improvement after undergoing arthroscopy for FAIS between 12 and 116 months (N = 175, -1.97, 95% CI -2.5 to -1.4, P < 0.01, I2 = 76%; N = 211, 1.82, 95% CI 1.49 to 2.16, P < 0.01, I2 = 52%; N = 164, 1.75, 95% CI 1.42 to 2.05, P < 0.01, I2 = 28%; N = 211, 1.71, 95% CI 1.38 to 2.04, P < 0.01, I2 = 52%, respectively). Across 289 patients, 75.6% to 98% returned to sport at a similar or higher level than presurgery.Conclusion:This review demonstrates a trend of improvement in patient-reported pain, function, quality of life, and return to sport at a minimum of 12 months among flexibility athletes after hip arthroscopy to treat FAIS.
      Citation: Sports Health
      PubDate: 2023-12-28T10:14:16Z
      DOI: 10.1177/19417381231217503
       
  • Adding Neurofeedback Training to Neuromuscular Training for Rehabilitation
           of Chronic Ankle Instability: A 3-Arm Randomized Controlled Trial

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      Authors: Ali Yalfani, Masoud Azizian, Behnam Gholami-Borujeni
      Abstract: Sports Health, Ahead of Print.
      Background:Neurofeedback training (NFT) can aid in the treatment of the abnormal patterns of the brain brought on by physical injury, enhancing cognitive and behavioral abilities. The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and NFT (NMT+NFT) with NMT alone in rehabilitating athletes with chronic ankle instability (CAI).Hypothesis:NMT+NFT will be more effective than NMT alone.Study Design:A 3-arm, single-blind randomized controlled trial.Level of Evidence:Level 2.Methods:A total number of 62 athletes, aged 18 to 25 years, with CAI, participated in this study. The study subjects were allocated randomly to 3 groups: 21 cases in the control group, 21 cases in the combination group (CG) receiving NMT+NFT, and 20 cases in the neuromuscular group (NG) practicing NMT alone, undergoing exercises related to their groups for 8 weeks. Data were recorded and analyzed before and after the 8-week training program. The primary outcome measures were postural sway indices; secondary outcomes included ankle proprioception and biopsychosocial indices.Results:NMT+NFT was more effective than NMT alone in terms of improving postural control during single- and 2-legged standing positions under the conditions of eyes closed and eyes open, proprioception at 20° of plantar flexion, as well as anxiety and depression in athletes with CAI. However, the findings revealed that NMT+NFT and NMT alone could both improve such indices.Conclusion:NMT+NFT as a treatment protocol improved postural control, ankle proprioception, anxiety, and depression greater than NMT alone.Clinical Relevance:A combined protocol of NFT and NMT led to greater improvement compared with NMT alone. NFT was recommended as an adjunct therapy in the rehabilitation of athletes suffering from CAI.
      Citation: Sports Health
      PubDate: 2023-12-27T09:02:13Z
      DOI: 10.1177/19417381231219198
       
  • Comparison of the Buffalo Concussion Treadmill Test With a Physiologically
           Informed Cycle Test: Calgary Concussion Cycle Test

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      Authors: Lauren N. Miutz, Joel S. Burma, Patrice Brassard, Aaron A. Phillips, Carolyn A. Emery, Jonathan D. Smirl
      Abstract: Sports Health, Ahead of Print.
      Background:Sport-related concussions are a complex injury requiring multifaceted assessment, including physical exertion. Currently, concussion testing relies primarily on a treadmill-based protocol for assessing exertion-related symptoms in persons after concussion. This study compared a modified cycle protocol (Calgary Concussion Cycle Test [CCCT]) with the clinically adopted standard, the Buffalo Concussion Treadmill Test (BCTT), across multiple physiological parameters.Hypothesis:Treadmill and cycle matched workload protocols would produce similar results for cerebral blood velocity, mean arterial pressure (MAP), and end-tidal carbon dioxide partial pressure (PETCO2), but heart rate (HR) and oxygen consumption (VO2) would be higher on the treadmill than the cycle modality.Study Design:Crossover study design.Level of Evidence:Level 3.Methods:A total of 17 healthy adults (8 men, 9 women; age, 26 ± 3 years; body mass index, 23.8 ± 2.7 kg/m2) completed the BCTT and CCCT protocols, 7 days apart in a randomized order. During both exertional protocols, the physiological parameters measured were middle cerebral artery mean blood velocity (MCAv), MAP, PETCO2, VO2, and HR. Analysis of variance with effect size computations, coefficient of variation, and Bland-Altman plots with 95% limits of agreement were used to compare exercise tests.Results:The BCTT and CCCT produced comparable results for both male and female participants with no significant differences for average MCAv, MAP, and PETCO2 (all P> 0.05; all generalized eta squared [η2G] < 0.02 [negligible]; P value range, 0.29-0.99) between stages. When accounting for exercise stage and modality, VO2 (P < 0.01) and HR (P < 0.01) were higher on the treadmill compared with the cycle. Aside from the final few stages, all physiology measures displayed good-to-excellent agreeability/variability.Conclusion:The CCCT was physiologically similar to the BCTT in terms of MCAv, PETCO2, and MAP; however, HR and VO2 differed between modalities.Clinical Relevance:Providing a cycle-based modality to exertional testing after injury mayincrease accessibility to determine symptom thresholds in the future.
      Citation: Sports Health
      PubDate: 2023-12-27T08:55:58Z
      DOI: 10.1177/19417381231217744
       
  • Effects of Increasing Pitch Count on Pitch Type Ball Metrics and Release
           Height in High School Softball Pitchers

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      Authors: Jessica Downs Talmage, Kenzie B. Friesen, Anthony Fava, Kate Everhart, Gretchen D. Oliver
      Abstract: Sports Health, Ahead of Print.
      Background:Softball research has investigated changes in physical characteristics, mechanics, and ball speed as elements of fatigue. However, the influence of pitch volume on ball metrics is unclear. The purpose of this study was to investigate the influence of pitch volume on ball performance and release metrics in softball pitchers across different pitch types.Hypothesis:As pitch volume increased, there would be a decrease in ball metrics of the fastball and changes in breaking pitches would be observed earlier than the fastball or changeup.Study Design:Descriptive laboratory study.Level of Evidence:Level 5.Methods:A total of 21 (15.4 ± 1.6 years; 1.6 ± 0.2 m; 76.0 ± 17.2 kg) softball pitchers participated. Procedures consisted of participants pitching a simulated game consisting of 100 pitches, taking a 30-minute break, and then throwing 12 pitches to simulate the first inning of a doubleheader. Participants randomly threw each pitch type (fastball, changeup, curveball, or dropball). Ball performance and release metrics were measured using a Rapsodo portable pitch tracker.Results:A 3 (time) by 4 (pitch type) multivariate analysis of variance revealed that pitch speed was significantly higher in the first inning compared with the last inning and the doubleheader inning. The fastball, curveball, and dropball revealed a significant difference in pitch speed between timepoints. Specifically, the curveball and dropball first-inning pitch speed was significantly greater than the last and doubleheader inning. Alternatively, the fastball had a significant increase in pitch speed from the last inning to the doubleheader inning.Conclusion:The typical 30-minute break given between games for doubleheaders may be sufficient recovery time for the fastball but not for the curveball and dropball.Clinical Relevance:The Rapsodo device is an accessible method of tracking ball performance and pitch release metrics and could be helpful in identifying when a pitcher may be experiencing performance detriments in response to increasing pitch count.
      Citation: Sports Health
      PubDate: 2023-12-27T08:45:32Z
      DOI: 10.1177/19417381231217668
       
  • Timing of Outcomes and Expectations After Knee Surgery in the US Military:
           A Systematic Review

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      Authors: Benjamin G. Adams, Daniel I. Rhon, Kenneth L. Cameron, Kristen L. Zosel, Brittany R. Hotaling, Richard B. Westrick
      Abstract: Sports Health, Ahead of Print.
      Context:Knee injury and subsequent surgery are widespread in the military setting. Associations between knee surgery and expected outcomes over time have not been consolidated and characterized systematically by procedure type across the body of literature, and the temporal expectations of these outcomes remain unclear.Objective:To summarize common postoperative follow-up times and associated outcomes that determine clinical or surgical failure in US service members after elective knee surgery.Data Sources:A systematic search was conducted with 3 bibliographic databases of published research reports from 2010 through 2021.Study Selection:Studies in US military service members undergoing elective knee surgery, with a minimum of 1-year follow-up, and reporting on a functional/occupational outcome were included. Three reviewers screened all abstracts and full-text articles to determine eligibility.Study Design:Systematic review of longitudinal cohort studies.Level of Evidence:Level 2a.Data Extraction:Extracted data included military demographics, surgical procedure variables, surveillance period, and outcome measures. The Newcastle-Ottawa Scale and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to determine study quality and risk of bias.Results:A total of 22 studies (mean follow-up time of 40.7 months) met the inclusion criteria. For cruciate ligament repair, approximately one-third of patients required a second surgery or were medically separated from military service by 2 years from surgery; 100% were reinjured by 4 years, and 85% sustained a new injury within 5 years of surgery. For meniscal repair, nearly one-third of patients were medically separated, and half were placed on activity restrictions within 3 years of surgery. For articular cartilage repair, within 5 years, 39% of patients required a second surgery, 30% were placed on activity restrictions, and 36% were medically separated. For patellar repair, 37% of patients were medically separated and over half were placed on activity restrictions within 5 years.Conclusion:Common knee surgeries can have long-term implications for military careers that may not become apparent with shorter follow-up periods (
      Citation: Sports Health
      PubDate: 2023-12-27T07:36:47Z
      DOI: 10.1177/19417381231217449
       
  • Changes in Sleep, Stress, and Fatigue Were Not Prospectively Associated
           With Running-Related Injuries Among High School Cross Country Runners

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      Authors: Mikel R. Joachim, Bryan C. Heiderscheit, Stephanie A. Kliethermes
      Abstract: Sports Health, Ahead of Print.
      Background:Running-related injuries (RRI) are common among adolescent runners; however, our understanding of RRI risk factors in this population is limited. Sleep, stress, and fatigue are risk factors in other youth sports but have not been studied in high school runners. This study prospectively assessed the effect of changes in sleep duration and quality, stress, and fatigue on RRI among high school cross country runners.Hypothesis:Less and poorer quality sleep and greater stress and fatigue, compared with the previous week, would be associated with RRI.Study Design:Prospective, observational study.Level of Evidence:Level 2b.Methods:Runners completed a preseason demographics and injury history survey and daily surveys regarding sleep duration and quality, stress, fatigue, and current RRI. Values were summed within each week, and change scores were calculated relative to the previous week. Runners completing ≥75% of daily surveys were analyzed; sensitivity analyses for those completing ≥50% and ≥90% were also conducted. Generalized estimating equations assessed the association between change in each predictor, including its interaction with sex, and RRI, controlling for year in school, previous RRI, and repeated observations.Results:A total of 434 runners enrolled in the study; 161 (37%) completed ≥75% of daily surveys. No associations between change in sleep duration, sleep quality, or fatigue and RRI were observed (P values ≥0.24). A significant change in stress × sex interaction with RRI was observed (P < 0.01). Associations among boys (P = 0.06) and girls (P = 0.07) were marginally significant. Sensitivity results were similar.Conclusion:Short-term changes in sleep duration, quality, and fatigue were not associated with RRI, but a significant interaction between change in stress and sex suggests that stress may influence RRI risk in high school cross country runners.Clinical Relevance:Large changes in stress levels should be monitored throughout the season, as these changes may precede RRI occurrence in this population.
      Citation: Sports Health
      PubDate: 2023-12-27T07:31:18Z
      DOI: 10.1177/19417381231217347
       
  • Ammonia Inhalants: Use, Misuse, and Role in Sports Performance

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      Authors: Joshua M. Bender, Charles A. Popkin
      Abstract: Sports Health, Ahead of Print.
      Context:Ammonia inhalants, also known as smelling salts, are preparations of ammonia designed to treat fainting but more commonly used by athletes to boost awareness and arousal during competition. Despite their widespread use, the physiological and performance-enhancing effects of ammonia inhalants remain poorly understood. The aim of the present study was to review the current literature surrounding the benefits, risks, and physiological effects of ammonia inhalants.Evidence Acquisition:An extensive literature review of articles pertaining to ammonia inhalants was performed through MEDLINE and Google Scholar. The search terms “smelling salts,” “ammonia inhalants,” “strength,” “performance,” “head injury,” and “concussion” were used.Study Design:Clinical review.Level of Evidence:Level 4.Results:The physiological response to acute ammonia inhalation includes cerebral vasodilation and heart rate elevation without change in blood pressure. The existing evidence demonstrates an ergogenic benefit to ammonia inhalant use only during repeated bouts of high-intensity exercise; in these subjects, ammonia inhalation was associated with increased power as measured by the Wingate anaerobic test. In contrast, there is no performance benefit to ammonia inhalants in a short burst of maximal effort despite elevated arousal and an associated perception of performance enhancement. Importantly, ammonia inhalants have no role in medical management of head injuries, as they have the potential to exacerbate an underlying brain injury due to the involuntary withdrawal reflex associated with ammonia inhalation. Furthermore, the signs and symptoms of a concussion or more threatening head injury may be masked by ammonia inhalation and lead to continued participation in competition, causing additional harm.Conclusion:Ammonia inhalants have no role in medical management of head injuries and have limited benefit with regards to sports performance.Strength of Recommendation:B
      Citation: Sports Health
      PubDate: 2023-12-27T07:25:38Z
      DOI: 10.1177/19417381231217341
       
  • Changes in Quality of Life Among Collegiate Athletes During COVID-19

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      Authors: Thomas Harris, Jennifer Sanfilippo, Kristin Haraldsdottir, Scott Anderson, Andrew Watson
      Abstract: Sports Health, Ahead of Print.
      Background:The COVID-19 pandemic has had a significant effect on the mental health of athletes. How this has affected quality of life (QoL), specifically in the college population, is poorly defined.Hypothesis:During the COVID-19 pandemic, the mental and physical QoL will have decreased in collegiate athletes as compared with before the pandemic.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:Division I athletes from a total of 23 varsity teams at a single institution completed surveys between 2018 and 2022. QoL was assessed using the Veterans RAND 12-Item Health Survey (VR-12). VR-12 scores were separated into mental component scores (MCS) and physical component scores (PCS). Separate linear mixed effects models evaluated changes in MCS and PCS from pre-COVID to during COVID overall, as well as differences in changes by sex and sport type (individual, team).Results:For all athletes, the PCS increased (54.6 [95% CI 54.4-54.7] vs 55.1 [54.9-55.3]; P < 0.01) and the MCS decreased (55.2 [54.9-55.5] vs 53.5 [53.1-53.8]; P < 0.01) from pre-COVID to during COVID. When evaluating for sex, women demonstrated a greater increase in PCS (0.57 ± 0.22; P = 0.01) and greater decrease in MCS (1.06 ± 0.38; P < 0.01). With respect to sport type, individual sports demonstrated a greater decrease in MCS (1.46 ± 0.39; P < 0.01), but no interaction was identified for PCS (0.42 ± 0.23; P = 0.07).Conclusion:Collegiate athletes demonstrated a decrease in their self-reported mental QoL during the COVID-19 pandemic, as compared with before the pandemic. This effect was most evident in women and in individual sports. Athletes also reported an increase in physical QoL during COVID that was also larger in women, but not related to sport.Clinical Relevance:This study demonstrates the impact of the COVID-19 pandemic on collegiate athletes’ QoL, including negative effects on mental health. It also identifies cohorts of athletes (women, individual) who may be more significantly affected.
      Citation: Sports Health
      PubDate: 2023-12-13T07:10:46Z
      DOI: 10.1177/19417381231216425
       
  • Effects of Delayed-Onset Muscle Pain on Respiratory Muscle Function

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      Authors: Sema Ozden, Ozge Ozalp, Rabia Tugba Kilic, Hayri Baran Yosmaoglu
      Abstract: Sports Health, Ahead of Print.
      Background:Delayed-onset muscle soreness (DOMS) has been widely examined in the peripheral muscles; however, studies showing the potential effects of DOMS on respiratory function are limited.Hypothesis:DOMS in trunk muscles has a negative effect on respiratory function parameters, respiratory muscle strength, respiratory muscle endurance, and exercise capacity.Study Design:Prospective cohort study.Level of Evidence:Level 2.Methods:In 24 healthy participants with a mean age of 21 ± 2 years, DOMS was induced for the trunk muscles with a load equal to 80% of the maximum repetitive voluntary contraction. Pulmonary function parameters, respiratory muscle strength and endurance, exercise capacity, pain, fatigue, and dyspnea perception severity were recorded before DOMS and at 24 and 48 hours after DOMS.Results:After DOMS, decreases were observed in respiratory function parameters, namely, forced vital capacity, forced expiratory volume in the first second, vital capacity, and 25% to 75% flow rate value of forced expiratory volume (25% to 75%) (P = 0.02, P = 0.02, P < 0.01, P = 0.01, respectively). Maximal inspiratory pressure and exercise capacity also decreased (P = 0.02, P < 0.01, respectively). No difference was observed between all 3 measurements of maximal expiratory pressure (MEP) and MEP% values (P1 = P2 = P3 ≥ 0.99). The results of the respiratory muscle endurance tests did not reveal a significant difference in terms of load and time in all 3 conditions (P> 0.05).Conclusion:After DOMS, there was a 4% to 7.5% decrease in respiratory function parameters, and a 6.6% decrease in respiratory muscle strength.Clinical Relevance:The occurrence of DOMS before a competition can have a detrimental impact on pulmonary performance. Hence, it is imperative to consider this factor when devising training and exercise programs. In addition, the development of treatment protocols becomes crucial if DOMS arises.
      Citation: Sports Health
      PubDate: 2023-12-13T07:04:06Z
      DOI: 10.1177/19417381231214776
       
  • Influence of Footwear Selection on Youth Running Biomechanics: A Pilot
           Study

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      Authors: Andrew G. Traut, J.J. Hannigan, Justin A. Ter Har, Christine D. Pollard
      Abstract: Sports Health, Ahead of Print.
      Background:The relationship of running biomechanics, footwear, and injury has been studied extensively in adults. There has been little research on the effects of footwear on running biomechanics in youth.Hypothesis:Running biomechanics of youth will be significantly affected by changes in footwear. Minimal shoe running will demonstrate similarities to barefoot.Study Design:Crossover study design: randomized trial.Level of Evidence:Level 2.Methods:A total of 14 active male youth (8-12 years old) participants with no previous exposure to minimalist shoes or barefoot running had running biomechanics (lower extremity sagittal plane kinematics and vertical ground reaction forces [vGRFs]) collected and analyzed in 3 footwear conditions (barefoot, traditional, and minimal shoe).Results:The average vertical loading rate (AVLR) was significantly greater running barefoot (173.86 bodyweights per second [BW/s]) and in the minimal shoe (138.71 BW/s) compared with the traditional shoe (78.06 BW/s), (P < 0.01). There were significant differences between shoe conditions for knee flexion at initial contact (P < 0.01), knee sagittal plane excursion (P < 0.01), peak dorsiflexion (P < 0.01), and dorsiflexion at initial contact (P = 0.03). No participants displayed a forefoot-strike during this study.Conclusion:The introduction of barefoot and minimalist running in habitually shod youth significantly affected the running biomechanics of youth and caused immediate alterations in both lower extremity kinematics and vGRFs. Running barefoot or in minimal shoes dramatically increased the AVLR, which has been associated with injury, compared with a traditional shoe.Clinical Relevance:This study evaluated the effects of footwear on overground running biomechanics, including AVLR, in pre- and early-adolescent youth males. Based on our findings, clinicians should exercise caution in barefoot or minimal shoe transition among young, habitually shod, runners due to the immediate and dramatic increases in AVLRs.
      Citation: Sports Health
      PubDate: 2023-12-11T06:38:29Z
      DOI: 10.1177/19417381231215070
       
  • Exercise Immunology Applied to Pediatric Sport and the Importance of
           Monitoring Stages of Puberty and Biological Maturation

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      Authors: Paulo Francisco de Almeida-Neto, Jason Azevedo de Medeiros, Jason R. Jaggers, Ayrton Bruno de Morais Ferreira, Gilmara Gomes de Assis, Breno Guilherme de Araújo Tinôco Cabral, Paulo Moreira Silva Dantas
      Abstract: Sports Health, Ahead of Print.
      Context:Exercise immunology is aimed at understanding how exercise sessions can affect the immune system in athletic subjects of different age groups. The objective of the current study was to discuss in which stage of biological maturation (BM) young athletes may be more vulnerable in relation to the immune system, and whether there is a BM range in which it is safer to perform sports training with strenuous exercise loads.Evidence Acquisition:Evidence from scientific research from several scientific disciplines (eg, immunology, sport immunology, pediatrics, sports medicine, human development) was gathered to holistically examine the main particularities of exercise immunology as applied to pediatric sport.Study Design:Narrative review.Level of Evidence:Level 5.Results:In pediatric patients, lymphoid tissue expands during puberty and involutes after puberty until it returns to pre-expansion values. This suggests that there is a specific period in which the immune system may be stronger, which may provide opportunities for strenuous exercise in pediatric athletes. However, the chronological period when puberty occurs will be determined by BM, which is the rate at which the biological systems of the human body improves. This may affect the period of lymphoid tissue expansion and, consequently, the behavior of the immune system in pediatric subjects of the same age category.Conclusion:During puberty, there is a significant increase in the proinflammatory profile; to compensate for this, there is an expansion of lymphoid tissue that may favor the efficiency of the immune system. The period in which puberty is reached may vary according to the stages of BM. Therefore, in exercise immunology applied to pediatric sports, in addition to external and internal training loads, it is necessary to consider BM and puberty, which have been shown to be safer biomarkers than chronological age for determining immune system behavior in pediatric athletes.Strength-of-Recommendation Taxonomy (SORT):Evidence B level 3.
      Citation: Sports Health
      PubDate: 2023-11-24T12:42:45Z
      DOI: 10.1177/19417381231212481
       
  • Society News

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      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2023-11-23T07:37:45Z
      DOI: 10.1177/19417381231214157
       
  • Analysis of the Effect of Different Physical Exercise Protocols on
           Depression in Adults: Systematic Review and Meta-analysis of Randomized
           Controlled Trials

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      Authors: Érica M. Correia, Diogo Monteiro, Teresa Bento, Filipe Rodrigues, Luís Cid, Anabela Vitorino, Nuno Figueiredo, Diogo S. Teixeira, Nuno Couto
      Abstract: Sports Health, Ahead of Print.
      Context:Physical exercise (PE) is an effective treatment for depression, alone or as an adjunct.Objective:There is a lack of indicators regarding the frequency, intensity, duration, and type of physical exercise (PE). This study aims to synthesize and analyze the dose-effect of different PE protocols in adult subjects in the treatment of depression, based on the analysis of randomized controlled trials (RCTs).Data Sources:The search was conducted using Web of Science, PubMed, and Cochrane Library electronic databases.Study Selection:Studies with an exercise-based intervention published by December 31, 2021 were identified. RCTs and meta-analyses involving adults with depression were also included; 10 studies were selected, including a total of 956 subjects.Study Design:Systematic review and meta-analysis.Level of Evidence:Level 1.Results:Effect sizes were summarized using standardized mean differences (95% confidence interval) by effected randomized models. The results reinforce that exercise appears to be beneficial in improving depression among adults aged 18 to 65 years. Interventions lasting above 150 minutes per week of moderate intensity and group interventions seem to have a more significant effect on reducing depression. Studies have revealed that aerobic exercise, compared with resistance or flexibility, has a more positive effect on depression.Conclusion:PE can be a way to reduce depression and can be used as a possible adjunctive tool for pharmacological and/or alternative treatments. Considering the findings of this study, it is important that health professionals (eg, exercise physiologists, physicians, nurses, psychologists) promote the practice of PE as a complementary alternative and act early to prevent the worsening of depression.PROSPERO Registration Number:CRD42020188909
      Citation: Sports Health
      PubDate: 2023-11-23T07:35:15Z
      DOI: 10.1177/19417381231210286
       
  • Name, Image, and Likeness and the Health of the Young Athlete: A Call to
           Action for Sports Medicine Providers and the Athletic Healthcare Network

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      Authors: William L. Hollabaugh, Aaron S. Jeckell, Alex B. Diamond
      Abstract: Sports Health, Ahead of Print.
      Context:In June 2021, the National Collegiate Athletic Association (NCAA) adopted a new policy allowing NCAA athletes the opportunity to benefit and profit from their name, image, and likeness (NIL). Several state high-school associations have established policies to guide their members and students through the new era of NIL. While the potential benefits cannot be ignored, NIL presents novel responsibilities and stressors to athletes. This paper will review the paucity of literature on the effect of NIL on youth athletes and bring attention to mental health, wellbeing, or academic performance impacted by NIL.Evidence Acquisition:Articles were identified through Google and PubMed search starting from NIL policy approval (June 30, 2021). Search terms included “name, image and likeness” and “NIL.”Study Design:Clinical commentary.Level of Evidence:Level 5.Results:Although 1 article was identified through PubMed search and numerous articles were identified through Google search, no articles directly evaluated the effects of NIL on the mental health, wellbeing, or academic performance of youth athletes.Conclusion:It is critical for sports medicine providers and other members of the athletic healthcare network to familiarize themselves with these emerging topics to best serve their patients and communities. The athletic healthcare network must be prepared to address possible NIL-related health ramifications for our patients and their families and help them navigate a confusing and predatory landscape. We must provide resources to youth athletes to minimize the risks associated with NIL involvement and related activities, and to ensure that athletes with NIL contracts are able to balance their academic and athletic responsibilities. Fostering strong relationships between stakeholders and sports medicine staff is paramount to creating an environment that permits honest discussions about NIL and the health of athletes from youth to adulthood.Strength-of-Recommendation Taxonomy:N/A.
      Citation: Sports Health
      PubDate: 2023-11-20T12:23:26Z
      DOI: 10.1177/19417381231212645
       
  • Differences in Abdominal Muscle Thickness, Strength, and Endurance in
           Persons Who Are Runners, Active, and Inactive

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      Authors: Beth H. Schaeffer, Wendy K. Anemaet, Allison L. Arnold, Autumn B. Brabham, Nancy K. Groom, Cassidee R. Moore
      Abstract: Sports Health, Ahead of Print.
      Background:Core musculature is important for efficiency during activities including running. Both abdominal muscle strength and endurance contribute to this efficiency. The purpose of this study is to determine what differences and relationships exist in abdominal muscle thickness, strength, and endurance among persons who are runners, active, and inactive.Hypothesis:Persons in the running group would show significantly greater abdominal muscle thickness, muscle strength, and muscle endurance compared with those in the nonrunning groups.Study Design:Quantitative cohort design.Level of Evidence:Level 2b.Methods:A total of 78 subjects aged 18 to 27 years were divided into 3 groups: runners, active, and inactive. Assessment included abdominal muscle thickness via diagnostic ultrasound (Mindray North America), strength using a static Isotrack dynamometer (JTech Medical), and abdominal muscle endurance using a side plank. Statistical analysis using analysis of variance, t tests, and Pearson’s correlation coefficients and partial correlations was performed using SPSS Version 26 with a significance level of P < 0.05.Results:Significantly greater muscle thickness of internal obliques (IOs) at rest and during contraction was found in the running group compared with the active group, the active group compared with the inactive group, and the running group compared with the inactive group. There were no statistically significant differences in overall strength measured by dynamometry among the 3 groups. Plank time was significantly greater for the running group compared with the other 2 groups. Male participants were greater in all areas: strength, plank time as a measure of muscle endurance, and muscle thickness. Body mass index was significantly correlated with resting thickness, muscle endurance, and muscle strength.Conclusion:Persons who run, are active, and are inactive use their abdominal muscles differently. Runners have thicker IOs and better abdominal muscle endurance than the other 2 groups. Focusing on endurance training of the obliques may be beneficial for persons who run.Clinical Relevance:This research could contribute to developing core training programs to ensure runners target the correct abdominal muscles with the best type of training.
      Citation: Sports Health
      PubDate: 2023-11-20T12:21:22Z
      DOI: 10.1177/19417381231212471
       
  • Image Timing After COVID-19 Infection in Athletes

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      Authors: Scott Meester, Brenden J. Balcik, Nicholas Chill, Justin Lockrem, Aaron J. Monseau
      Abstract: Sports Health, Ahead of Print.
      Background:Coronavirus disease 2019 (COVID-19) has significantly impacted National Collegiate Athletic Association (NCAA) athletics, with specific concerns for cardiac involvement after infection. Pericardial abnormalities have been seen in up to 39.5% of athletes after COVID-19 infection, while myocardial involvement has been reported at a lower rate of 2.7%. To date, myocardial injury has been seen in 0.6% to 0.7% of athletes when using symptom screening and imaging as clinically indicated, which increases to 2.3% to 3.0% when all athletes with COVID-19 undergo cardiac magnetic resonance (CMR) imaging.Purpose:This study will examine whether there exists an ideal time from positive COVID-19 results to obtaining imaging to increase the likelihood of finding abnormalities.Study Design:Prospective cohort studyLevel of Evidence:Level 3.Methods:NCAA athletes at West Virginia University who were found to be COVID-19 positive on routine screening were required to undergo echocardiography (ECG) and CMR. These data were reviewed by cardiology and determined to be normal or abnormal. Statistical analysis with logistic regression and descriptive statistics was performed to evaluate whether a time existed where abnormalities on imaging were most likely to be found.Results:A total of 41 athletes were included in this study. ECG was performed earlier on average than CMR imaging, at 18.2 days versus 27.5 days. No significant difference was found in timing from COVID-19 infection diagnosis and abnormalities seen on imaging for either ECG or CMR imaging.Conclusion:The risk of cardiac involvement in athletes in the setting of COVID-19 has already been documented. This study suggests that imaging timing is independent of cardiac involvement with no correlation to specific time periods where more abnormalities may be found. However, CMR imaging showing changes at day 54 after infection suggests cardiac findings can be seen months after imaging.Clinical Relevance:Cardiac imaging for athletes after contracting COVID-19 does not show a significant relationship to time of imaging. However, given the cardiac involvement seen months after diagnosis, further examination of prolonged cardiac effects must be carried out.
      Citation: Sports Health
      PubDate: 2023-11-20T07:18:21Z
      DOI: 10.1177/19417381231212470
       
  • Sex Differences in Knee Extensor Neuromuscular Function in Individuals
           With and Without Patellofemoral Pain

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      Authors: Sungwan Kim, Neal R. Glaviano, Jihong Park
      Abstract: Sports Health, Ahead of Print.
      Background:Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP.Hypothesis:Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP.Study Design:Cross-sectional, case-control study.Level of Evidence:Level 4.Methods:A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD0-100, RTD100-200, and RTD20-80%), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP).Results:Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP (P < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; P < 0.01; Cohen d = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; P < 0.01; Cohen d = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; P = 0.03; Cohen d = 0.51) RTD than men with PFP.Conclusion:Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men.Clinical Relevance:Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.
      Citation: Sports Health
      PubDate: 2023-11-18T04:56:18Z
      DOI: 10.1177/19417381231209318
       
  • Limb Symmetry Index of Single-Leg Vertical Jump vs. Single-Leg Hop for
           Distance After ACL Reconstruction: A Systematic Review and Meta-analysis

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      Authors: Li Wang, QingHong Xia, Tao Li, ZeYan Wang, Jian Li
      Abstract: Sports Health, Ahead of Print.
      Context:The limb symmetry index (LSI) is recommended as a milestone of return to play (RTP), and relying on the LSI value of a single-leg hop for distance (SLHD) test may overestimate rehabilitation status. Identifying a more reliable functional test can help to carefully make decisions for RTP.Objective:The aim was to compare the LSI value of the SLHD test with that of a single-leg vertical jump (SLVJ) test after anterior cruciate ligament reconstruction (ACLR) and determine which test provides lower LSI values.Data Sources:The PubMed, Web of Science, Embase, and Cochrane Library databases were searched from inception to July 2022.Study Selection:Observational studies with participants who had both SLHD and SLVJ tests after ACLR and LSI values of an SLHD and SLVJ were included. Disagreements were resolved after discussion between the 2 researchers.Study Design:Systematic review and meta-analysis.Level of Evidence:Level 4.Data Extraction:Data on the primary outcomes (LSI values of the SLVJ and SLHD tests) were collected. Means and standard deviations (SDs) for each variable of interest were used to calculate standardized mean differences (SMDs).Results:A total of 12 studies met the inclusion criteria for the meta-analysis. A total of 587 patients underwent SLHD and SLVJ tests at different time points after ACLR. Compared with the SLHD test, the SLVJ test provided lower LSI values (SMD -0.42; 95% confidence interval (CI) -0.67 to -0.17). Subgroup analysis found that the SLVJ test provided a lower LSI value than the SLHD test in a specific period (approximately 7-18 months after ACLR, SMD -0.53; 95% CI -0.91 to -0.14) and a similar LSI value at other times.Conclusion:The SLVJ test provided lower LSI values in a specific period (7-18 months after ACLR).
      Citation: Sports Health
      PubDate: 2023-11-16T05:37:15Z
      DOI: 10.1177/19417381231205267
       
  • Return to Sports, Return to Preinjury Sports, Return to Prior Performance
           at Sports: All Meaningful Parameters With Different Meanings and Scales

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      Authors: Frank R. Noyes
      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2023-11-14T06:18:05Z
      DOI: 10.1177/19417381231212119
       
  • A Brief Review of the Literature for Published Dual-Energy X-Ray
           Absorptiometry Protocols for Athletes

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      Authors: Johnathan Dallman, Ashley Herda, Christopher J. Cleary, Tucker Morey, Andrew Diederich, Bryan G. Vopat, Lisa M. Vopat
      Abstract: Sports Health, Ahead of Print.
      Context:Dual-energy x-ray absorptiometry (DXA) is widely known for its utility in diagnosing a patient with osteopenia or osteoporosis; however, its utility in evaluation of body composition and potential athletic performance was previously routinely overlooked. In recent years, athletic programs have begun employing this equipment during athlete screening. However, it is currently unknown how athletic programs are utilizing this information to guide an athlete’s training and health.Objective:To explore the literature to identify what is known regarding sports performance and athlete health based on body composition recordings.Data Sources:PubMed and Google Scholar databases were searched for this brief review.Study Selection:A focus was placed on articles within the past 10 years that discussed DXA protocols within athletic populations; 14 articles were included in this brief literature review.Study Design:Brief literature review.Level of Evidence:Level 5.Data Extraction:One member of the research team searched the literature and retrieved articles with the purpose of analyzing and/or explaining DXA imaging in body composition analysis of active persons (primarily athletes).Results:Quality assurance scans with a phantom calibration block as well as athlete prescreening condition and activity standardization was routinely recommended. However, only 1 study reported a specific DXA protocol for athletes, and only 1 study described guidelines for how to report DXA results in athletic populations, suggesting it is plausible yet difficult due to the small changes detectable.Conclusion:Due to the limited literature as well as a lack of reference values for specific athletic populations, the authors of this review recommend using the current Nana et al (Int J Sport Nutr Exerc Metab 2015;25:198-215) DXA protocol for performing DXA scans in the athletic population as well as current Hind et al (J Clin Densitom 2018;21:429-443) guidelines for distributing the information.
      Citation: Sports Health
      PubDate: 2023-11-13T08:23:46Z
      DOI: 10.1177/19417381231208204
       
  • Assessing the Maximal Mechanical Capacities Through the Load-Velocity
           Relationship in Elite Versus Junior Male Volleyball Players

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      Authors: Andrés Baena-Raya, David M. Díez-Fernández, Antonio García-de-Alcaraz, Alberto Soriano-Maldonado, Alejandro Pérez-Castilla, Manuel A. Rodríguez-Pérez
      Abstract: Sports Health, Ahead of Print.
      Background:Physical testing is crucial for athlete monitoring, talent identification, optimizing training, and tailoring programs to enhance game-performance in elite competitions.Hypothesis:Load-velocity (L-V) relationship variables discriminate between elite and junior volleyball players, correlate with volleyball-specific performance, and are generalizable across lower- and upper-body exercises.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:A total of 9 elite and 11 junior volleyball players were assessed for the L-V relationship (load-axis intercept [L0], velocity-axis intercept [v0], and area under the L-V relationship line [Aline]) during the countermovement jump (CMJ) and bench press throw (BPT) exercises. Block and spike jump height, as well as standing and jumping spike speed were assessed 24 hours later.Results:Elite players presented greater magnitude in the L-V variables (P ≤ 0.03; effect size [ES] ≥ 1.06) and higher volleyball-specific performance (P ≤ 0.03; ES ≥ 1.09) than juniors (except for CMJ v0 and Aline). The L-V relationship variables were significantly associated with the block and spike jump height and jumping spike speed only in elite players (r ≥ 0.703 and P ≤ 0.04 in 11 out of 18 correlations). No significant associations were observed between CMJ and BPT for any L-V relationship variable (r ≤ 581; P ≥ 0.08, except for Aline in junior players).Conclusion:The L-V relationship is a practical procedure to assess volleyball players’ maximal mechanical capacities, which are associated with volleyball-specific performance in elite players. However, these data should not be used interchangeably between playing standards or exercises.Clinical Relevance:This information might help strength and conditioning coaches to prescribe more effective training programs that focus on developing the specific physical capacities necessary for players to potentially advance to elite status.
      Citation: Sports Health
      PubDate: 2023-11-11T06:20:40Z
      DOI: 10.1177/19417381231208706
       
  • Cannabis Use in Adolescent and Young Adult Athletes: A Clinical Review

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      Authors: Ryan Benoy, Cesar Ramirez, Mary Hitchcock, Claudia Reardon
      Abstract: Sports Health, Ahead of Print.
      Context:Cannabis use among the general population has increased over time, in part due to decriminalization of use and greater social acceptance of cannabis use. These changes have contributed to increased availability of cannabis products, thus raising the likelihood that a subset of adolescent and young adult athletes will use cannabis. Therefore, it is imperative that clinicians and other providers working with young athletes have a thorough understanding of the impact cannabis can have on the athletic performance and overall health of a young athlete.Evidence Acquisition:PubMed (Medline), CINAHL, PsycINFO, and SportDiscus databases were used to perform a literature search of articles published between January 1, 2010 and December 31, 2022. Additional articles were reviewed based on references obtained from initial articles.Study Design:Clinical review.Level of Evidence:Level 4.Results:Survey studies suggest that up to 1 in 4 athletes have used cannabis at least once in the last year. Age, sex, race, sexual orientation, level of competition, and country of residence of an athlete all contribute to differing rates of cannabis use among athletes. The scientific literature does not support using cannabis for athletic performance, and multiple studies have demonstrated notable impairments in objective athletic performance measures. Cannabis use can also negatively impact an athlete’s overall health via cardiovascular, gastrointestinal, and mental health symptoms and disorders.Conclusion:Cannabis use among adolescent and young adult athletes is common, and rates of use are influenced by many different factors. Current evidence suggests that cannabis use can worsen sport performance, negatively impact an athlete’s general health, and contribute to negative mental health outcomes.
      Citation: Sports Health
      PubDate: 2023-11-11T06:13:59Z
      DOI: 10.1177/19417381231208661
       
  • Profound First-Degree Atrioventricular Block in a High-Level Basketball
           Athlete

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      Authors: Justin D. Stumph, William K. Cornwell, Michael A. Rosenberg, Morteza Khodaee
      Abstract: Sports Health, Ahead of Print.
      First-degree atrioventricular (AV) block (PR interval>200 ms) is commonly observed among screening electrocardiogram (ECG) in athletes. Profound first-degree AV block (PR interval>400 ms) and Mobitz type I (Wenckebach) second-degree AV block are generally uncommon and often require further workup on a case-by-case basis, particularly when there is concern for a structural cardiac abnormality. In this case, we present an example of an asymptomatic profound first-degree AV block with Mobitz type I (Wenckebach) second-degree AV block. Transthoracic echocardiogram and stress echocardiogram were unremarkable and the patient was cleared to participate in sports without any restriction. Physicians managing athletes should be aware of ECG features that require additional evaluation and cardiology consultation.
      Citation: Sports Health
      PubDate: 2023-11-10T06:55:21Z
      DOI: 10.1177/19417381231210297
       
  • Does an Increase in Supraspinatus Tendon Thickness After Swimming Increase
           the Likelihood of Future Shoulder Pain'

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      Authors: Kirsten Porter, Anthony Shield, Deborah Pascoe, Jack Harvey, Scott Talpey
      Abstract: Sports Health, Ahead of Print.
      BackgroundIncrease in supraspinatus tendon thickness (STT) resulting from swimming practice has been observed in those with a history of shoulder pain. The magnitude of change in STT after a swimming session and its rate of recovery may be an indicator of future shoulder pain incidence.HypothesisThe supraspinatus tendons that demonstrate a greater increase in thickness as a result of swimming practice will have an increased likelihood of future shoulder pain in a cohort of competitive swimmers over a period of 6 months.DesignDescriptive epidemiology study.Level of Evidence:Level 2b, individual cohort studies.Methods:A cohort of 50 nationally qualified swimmers aged between 14 and 22 years, from 3 open National Swimming Programs in Victoria, Australia, were recruited for this study. Ultrasonographic measurements of swimmers’ STT was obtained of both shoulders, before, immediately after, and 6 hours after a single swimming practice session. Data were recorded of any significant interfering shoulder pain at 3 and 6 months after the initial testing session.ResultsStepwise logistic regression models indicated that significant predictors of the likelihood of experiencing significant interfering pain were sex [significant at 6 months; odds ratio (OR) 4.2] and the extent of change in STT immediately (OR 2.3 and 1.3 per mm at 3 and 6 months, respectively) and 6 hours postpractice (OR 1.9 and 1.5 per mm at 3 and 6 months, respectively).ConclusionThe current data suggest larger increases in tendon thickness after training are associated with an increased likelihood of future shoulder pain.Clinical RelevanceThese data may be valuable for monitoring training load and identifying athletes who may have an increased likelihood of shoulder pain.
      Citation: Sports Health
      PubDate: 2023-11-10T06:48:02Z
      DOI: 10.1177/19417381231208715
       
  • Cardiovascular Safety of the COVID-19 Vaccine in Team USA Athletes

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      Authors: Ankit B. Shah, Samantha M. Rizzo, Jonathan T. Finnoff, Aaron L. Baggish, William M. Adams
      Abstract: Sports Health, Ahead of Print.
      Background:Despite reassuring scientific data, the lay press and social media continue to propagate largely unsubstantiated claims that a significant number of athletes have died from cardiovascular complications related to COVID-19 vaccines. The present study sought to determine the incidence of COVID-19 vaccine cardiovascular complications in Team USA athletes.Hypothesis:It was predicted that there would be a low incidence of cardiovascular complications from COVID-19 vaccination in Team USA athletes.Study Design:Descriptive epidemiology study.Level of Evidence:Level 4.Methods:A retrospective review was conducted on the United States Olympic and Paralympic Committee electronic medical record, inclusive of athletes who represented Team USA in the 2020 Tokyo and 2022 Beijing Olympic and Paralympic Games, for COVID-19 vaccine cardiac complications including sudden cardiac arrest/death, myocarditis, pericarditis, and myopericarditis. Vaccination status (ie, fully vaccinated, yes or no), date of vaccination and eligible boosters, and type of vaccination during the study period were abstracted from the electronic medical record.Results:A total of 1229 athletes represented Team USA during the 2020 Tokyo (Olympic, 697; Paralympic, 237) and 2022 Beijing Games (Olympic, 229; Paralympic, 66). For the 2020 Tokyo Games, 73.8% of Olympians and 80.6% of Paralympians with available vaccination status had completed a primary vaccine series. For the 2022 Beijing Games, 100% of Olympians and Paralympians with available vaccination status were fully vaccinated. No athletes suffered sudden cardiac arrest/death or were diagnosed with myocarditis, pericarditis, or myopericarditis after COVID-19 vaccination.Conclusion:The data demonstrate an overall willingness of elite athletes to receive recommended COVID-19 vaccination coupled with a complete absence of vaccine-related cardiac complications in>1 year of follow-up.Clinical Relevance:Supposedly, this is the first study to investigate the incidence of COVID-19 vaccine cardiovascular complications in elite athletes. These data are an important first step to better inform cardiologists and sports medicine physicians who care for elite athletes.
      Citation: Sports Health
      PubDate: 2023-11-10T06:39:42Z
      DOI: 10.1177/19417381231208677
       
  • Acute and Chronic Effects of Blood Flow Restriction Training in Physically
           Active Patients With Anterior Cruciate Ligament Reconstruction: A
           Systematic Review

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      Authors: Pere García-Rodríguez, Javier Pecci, Sergio Vázquez-González, Helios Pareja-Galeano
      Abstract: Sports Health, Ahead of Print.
      Context:Muscle atrophy and loss of knee function are common findings after anterior cruciate ligament (ACL) reconstruction. Rehabilitation through blood flow restriction (BFR) has gained clinical relevance when combined with low loads to improve these disorders in recent years.Objective:To evaluate the rehabilitation effectiveness of ACL reconstruction with the use of BFR on pain, functionality, strength, and muscle mass in physically active people.Data Sources:A search of PubMed, Web of Science, and MEDLINE was performed on March 31, 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.Study Selection:Randomized clinical trials with active adults who underwent ACL surgery were included. They had to compare conventional treatments with the use of BFR, reporting values of pain, functionality, strength, or cross-sectional area (CSA). Articles whose participants presented concomitant injuries and whose intervention combined the use of BFR with treatments other than resistance training were excluded.Study Design:Systematic review.Level of Evidence:Level 2.Data Extraction:Study design, population, cuff pressure, and main outcomes including strength, quadriceps CSA, pain, and functionality.Results:Six studies out of a total of 389 were included (152 participants; 90 men and 62 women). These included studies showed no differences on CSA or strength when comparing BFR training with high loads exercise. BFR has demonstrated improvements in knee functionality and pain compared with other interventions such as immobilization or high loads training.Conclusion:The use of low loads combined with BFR improves pain, strength, functionality, and CSA. In addition, knee pain reduction and functionality are greater with BFR compared with the use of high loads or immobilization.
      Citation: Sports Health
      PubDate: 2023-11-10T06:34:09Z
      DOI: 10.1177/19417381231208636
       
  • Mindfulness for Young Athletes

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      Authors: Joel S. Brenner
      Abstract: Sports Health, Ahead of Print.
      Mindfulness has been around for centuries and a significant amount of research has been published in the past 6 years. Mindfulness has been shown to be helpful to improve overall wellbeing and sports performance. There has been a large increase in anxiety, depression, and overall stress in the pediatric, adolescent, and young adult population. This clinical commentary highlights the importance of using mindfulness as one tool to help young athletes improve their overall wellbeing and athletic performance. It also describes how it can be utilized in the sports medicine world along with noting a novel program at a Children’s Hospital that is utilizing these tools to help young athletes.
      Citation: Sports Health
      PubDate: 2023-11-08T06:26:10Z
      DOI: 10.1177/19417381231209219
       
  • Chondral Injury Associated With ACL Injury: Assessing Progressive Chondral
           Degeneration With Morphologic and Quantitative MRI Techniques

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      Authors: Emily J. Davidson, Caroline Figgie, Joseph Nguyen, Valentina Pedoia, Sharmila Majumdar, Hollis G. Potter, Matthew F. Koff
      Abstract: Sports Health, Ahead of Print.
      Background:Anterior cruciate ligament (ACL) injuries are associated with a risk of post-traumatic osteoarthritis due to chondral damage. Magnetic resonance imaging (MRI) techniques provide excellent visualization and assessment of cartilage and can detect subtle and early chondral damage. This is often preceding clinical and radiographic post-traumatic osteoarthritis.Hypothesis:Morphologic and quantitative MRI techniques can assess early and progressive degenerative chondral changes after acute ACL injury.Study Design:Prospective longitudinal cohort.Level of Evidence:Level 3.Methods:Sixty-five participants with acute unilateral ACL injuries underwent bilateral knee MRI scans within 1 month of injury. Fifty-seven participants presented at 6 months, while 54 were evaluated at 12 months. MRI morphologic evaluation using a modified Noyes score assessed cartilage signal alteration, chondral damage, and subchondral bone status. Quantitative T1ρ and T2 mapping at standardized anatomic locations in both knees was assessed. Participant-reported outcomes at follow-up time points were recorded.Results:Baseline Noyes scores of MRI detectable cartilage damage were highest in the injured knee lateral tibial plateau (mean 2.5, standard error (SE) 0.20, P < 0.01), followed by lateral femoral condyle (mean 2.1, SE 0.18, P < 0.01), which progressed after 1 year. Longitudinal prolongation at 12 months in the injured knees was significant for T1ρ affecting the medial and lateral femoral condyles (P < 0.01) and trochlea (P < 0.01), whereas T2 values were prolonged for medial and lateral femoral condyles (P < 0.01) and trochlea (P < 0.01). The contralateral noninjured knees also demonstrated T1ρ and T2 prolongation in the medial and lateral compartment chondral subdivisions. Progressive chondral damage occurred despite improved patient-reported outcomes.Conclusion:After ACL injury, initial and sustained chondral damage predominantly affects the lateral tibiofemoral compartment, but longitudinal chondral degeneration also occurred in other compartments of the injured and contralateral knee.Clinical Relevance:Early identification of chondral degeneration post-ACL injury using morphological and quantitative MRI techniques could enable interventions to be implemented early to prevent or delay PTOA.
      Citation: Sports Health
      PubDate: 2023-10-25T07:26:58Z
      DOI: 10.1177/19417381231205276
       
  • Changes in Quadriceps Rate of Torque Development After Anterior Cruciate
           Ligament Reconstruction and Association to Single-Leg Hop Distance

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      Authors: Beyza Tayfur, Alexa Keneen Johnson, Riann Palmieri-Smith
      Abstract: Sports Health, Ahead of Print.
      Background:Quadriceps neuromuscular function is negatively affected after anterior cruciate ligament reconstruction (ACLR). The specific effect that the ACLR has on the quadriceps femoris rate of force production and its impact on functional recovery is unknown.Hypothesis:The anterior cruciate ligament (ACL) limb would present persistent deficits in the rate of torque development (RTD), when compared with the non-ACL limb before ACLR until 9 months (9M) post-ACLR.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:Twenty-eight participants performed quadriceps maximum voluntary isometric contractions (MVICs) before (PRE), at 5 months (5M) and at 9M after ACLR. Single-leg hop distance was also assessed at 9M. Quadriceps RTD was calculated at 50, 100, and 200 ms after the onset of torque production. Maximum RTD was also calculated. A 2 (limb) × 3 (time) repeated-measures analysis of variance was used for RTD50, RTD100, RTD200, and RTDmax. Linear regressions were used to evaluate the associations of MVIC and RTD values at 5M and 9M with single-leg hop distance at 9M.Results:The ACL limb had lower RTD values at all times compared with the non-ACL limb (P < 0.05). RTD of the ACL limb significantly decreased from PRE to 5M, and then recovered to PRE levels at 9M (P < 0.05). The non-ACL limb displayed no differences from baseline to either 5M or 9M. MVIC and RTD200 at 5M predicted (R2 = 0.313 and R2 = 0.262, respectively) single-leg hop distance at 9M, better than the strength and RTD at 9M (R2 = 0.235 and R2 = 0.128, respectively).Conclusion:Quadriceps RTD is negatively affected after ACLR, and deficits may persist at the time of return to activity. Strength and RTD during recovery at 5M may predict more than 25% of the variance in single-leg hop distance at 9M, independently; hence, both provide important information to monitor functional recovery post-ACLR.Clinical Relevance:RTD should be measured to understand the changes in neuromuscular capacity after ACLR, and rehabilitation strategies that target quick force production, ie, quick muscle activation and functional tasks, should be implemented.
      Citation: Sports Health
      PubDate: 2023-10-24T11:40:08Z
      DOI: 10.1177/19417381231205295
       
  • The Effect of Core Stabilization Exercises on Physical Fitness Parameters
           in Child Gymnasts: Randomized Controlled Assessor-blind Study

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      Authors: Özge İpek Dongaz, Yaprak Başer, Kılıçhan Bayar
      Abstract: Sports Health, Ahead of Print.
      Background:The improvement of physical fitness parameters is beneficial for child gymnasts to maximize functionality. Core stability exercises (CSEs) help maintain spinal stabilization during athletic performance. Thus, they contribute to enhancing gymnasts’ performance on various movements and planes. This study aimed to investigate the effect of 8-week CSEs training on the physical fitness parameters of child gymnasts.Hypothesis:An 8-week CSEs intervention could be beneficial for improving the various physical parameters in child gymnasts.Study Design:Randomized trial.Level of Evidence:Level 2.Methods:Thirty-six child gymnasts (aged 7-12 years) were allocated randomly into a training group (TG) and control group (CG). Participants in the TG received CSEs in addition to the traditional program for 8 weeks. The physical fitness parameters of all participants were assessed twice before and after training.Results:The results showed that all participants’ scores of balance, endurance, sprint, and jumping parameters improved after exercise programs (P < 0.05). The muscle strength and flexibility scores of the TG showed a statistically significant difference compared with the CG (P < 0.05). However, compared with other parameters, there were no significant changes seen in the scores between groups (P> 0.05).Conclusion:The CSEs training contributed to the improvement of all physical fitness parameters in child gymnasts.Clinical Relevance:The addition of CSEs to traditional training could help improve athletic performance in child gymnasts.
      Citation: Sports Health
      PubDate: 2023-10-20T12:01:23Z
      DOI: 10.1177/19417381231205301
       
  • Has Sustained Time Away From Sports Due to the COVID-19 Pandemic Led to
           Increased Sport-Related Soft Tissue Injuries'

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      Authors: Daniel Yang, Kevin Orellana, Julianna Lee, Alex Stevens, Divya Talwar, Theodore Ganley
      Abstract: Sports Health, Ahead of Print.
      Background:A decrease in sport-related injuries was observed in 2020, which has been attributed to COVID-19 and recommendations to suspend organized sports. In adult populations, increased injury rates have been noted in athletes returning to play after an extended period of reduced play, attributable to deconditioning. There is growing literature surrounding concern over increased injury risk after return to sport after the COVID-19 shutdowns.Hypothesis:Like adults, pediatric patients experience an increase in sport-related injuries after periods of “deconditioning,” such as during the COVID-19 shutdown.Study Design:Descriptive epidemiology study.Level of Evidence:Level 4.Methods:The Consumer Product Safety Commission’s National Electronic Injury Surveillance System database was queried to identify 13- to 18-year-old patients who sustained a sprain/strain type injury in 2019 or 2021 to an extremity, and involved sporting equipment for basketball, baseball/softball, soccer, and football. The control group was established as patients who sustained injury in 2019, and the post-COVID-19 group was established as those in 2021. Quantity of injuries sustained in these 2 groups were compared and analyzed by subgroup.Results:There was a significant difference in the total number of sport-related sprains/strains in 2019 versus 2021 (P = 0.01), with more injuries in 2019 (n = 151,067) than in 2021 (n = 104,041). There were more injuries in boys than in girls. Proportion of injuries by sports were similar in both time periods. There was a significant decrease in basketball-related injuries by 21% (P ≤ 0.01, relative risk ratio [rrr] = 0.7979) and a significant increase in football-related injuries by 14% (P = 0.01, rrr = 1.1404) and in soccer injuries by 14.2% (P = 0.03, rrr = 1.1422).Conclusion:There is significant heterogeneity in injury rates by sports, with no conclusive increase in injuries, contrary to expectations.Clinical Relevance:This study suggests that the relationship between deconditioning and injury may be less clear in the child-athlete, and gives recommendations for return to sport after extended breaks.Strength-of-Recommendation Taxonomy (SORT):Level 2c.
      Citation: Sports Health
      PubDate: 2023-09-28T12:52:33Z
      DOI: 10.1177/19417381231198541
       
  • Throwing Shoulder Adaptations Are Not Related to Shoulder Injury or Pain:
           A Preliminary Report

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      Authors: Emily Strama, Karen A. Keenan, Timothy Sell, Mallory Faherty, Deirdre Rafferty, Karl Salesi, Jennifer Csonka, Michelle Varnell
      Abstract: Sports Health, Ahead of Print.
      Background:Overhead throwing in baseball and softball athletes induces shoulder adaptations theorized to increase risk of shoulder musculoskeletal injury (MSI) and/or pain due to range of motion (ROM) deficits.Hypothesis:Shoulder ROM adaptations are associated with a higher risk for developing shoulder MSI and pain.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:A total of 60 National Collegiate Athletic Association Division I athletes cleared for full athletic participation and free from upper extremity MSI in the last 4 weeks (age, 19.0 ± 1.2 years; weight, 82.1 ± 13.7 kg; height, 178.6 ± 11.2 cm; softball, n = 23; baseball, n = 37). Passive glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HA) ROM were measured with the scapula stabilized and used to categorize participants with/without external rotation gain (ERG), external rotation insufficiency (ERI), glenohumeral internal rotation deficit (GIRD), pathological GIRD, and posterior shoulder tightness (PST) before the competitive season. Groups were then compared to assess the incidence of shoulder MSI prospectively and prevalence of shoulder pain at the initial evaluation.Results:Baseball and softball athletes demonstrated significantly less IR ROM in the dominant shoulder (50.6° ± 9.4°) compared with the nondominant shoulder (59.1° ± 8.6°; P < 0.01) and significantly more ER ROM (dominant, 104.6° ± 12.1°; nondominant, 97.7° ± 12.0°; P < 0.01). Incidence of shoulder MSI was 15% but was not significantly related to any shoulder adaptations. No significant relationship was found between prevalence of pain and any shoulder adaptations in the 27% of athletes with pain.Conclusion:Increased ER and decreased IR ROM adaptations in intercollegiate overhead throwing athletes do not appear to be correlated to risk of shoulder MSI or pain.Clinical Relevance:The findings of this level 3 prospective study provide clinicians working with overhead athletes information regarding shoulder MSI risk and pain. It is recommended that clinicians should not use ROM adaptations exclusively to determine increased risk of shoulder MSI.
      Citation: Sports Health
      PubDate: 2023-09-23T06:09:14Z
      DOI: 10.1177/19417381231197217
       
  • Anxiety and Depression Prevalence in Incoming Division I Collegiate
           Athletes From 2017 to 2021

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      Authors: Jennifer L. Sanfilippo, Kristin Haralsdottir, Andrew M. Watson
      Abstract: Sports Health, Ahead of Print.
      Background:Young adults report increased rates of anxiety and depression than other age groups. Furthermore, young adult athletes experience additional stressors that may negatively impact their mental health. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among Division I collegiate athletes and the influences of sex, sport type, and distance from home.Hypothesis:It was hypothesized that self-reported levels of anxiety and depression would increase among this population during this timeframe.Study Design:Cross-sectional.Level of Evidence:Level 3.Methods:Participants included 792 incoming Division I collegiate athletes. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores were completed by all incoming student athletes at a single institution as part of their preparticipation examination over 5 years. Both survey scores were categorized into different levels of severity and separately compared with chi-square tests. Continuous scores were modeled separately using negative binomial regression models including year, sex, sport type, and home location as covariates.Results:Results showed consistent levels of anxiety and depression over time. Female athletes reported higher levels of both anxiety and depression than male athletes, and individual sport athletes reported higher levels of depression than team sport athletes. Distance from home was not associated with anxiety or depression levels.Conclusion:Overall, levels of anxiety and depression did not change in this population over this time period. However, differences in anxiety and depression were seen between sexes and depression between sport types.Clinical Relevance:Understanding anxiety and depression risk factors among collegiate athletes can enhance early identification and intervention to improve mental health and allow for better allocation of resources to at-risk groups among Division I collegiate athletes.
      Citation: Sports Health
      PubDate: 2023-09-22T05:36:55Z
      DOI: 10.1177/19417381231198537
       
  • The Associations Between Wellbeing and Injury Differ by Time Loss in
           Collegiate Athletes

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      Authors: Jennifer L. Sanfilippo, Courtney N. Hoffmann, Kristin Haraldsdottir, Quinn Steiner, Andrew M. Watson
      Abstract: Sports Health, Ahead of Print.
      Background:Self-reported wellbeing measures such as mood and soreness have been identified as predictors of injury risk. However, most research has focused on investigating time-loss injuries even though nontime-loss injuries are more prevalent.Hypothesis:Impairments in sleep and subjective wellbeing would be associated with increased injury for both time-loss and nontime-loss injuries.Study Design:Prospective longitudinal study.Level of Evidence:Level 3.Methods:During 2022, 127 athletes completed a daily survey that inquired about training load and sleep from the previous day along with mood, stress, and soreness on the current day. Incidence of injury was also monitored using documentation provided by athletes’ respective athletic trainers. Mixed effect models were used to analyze the relationship between wellbeing and sleep measures with injury.Results:Self-reported wellbeing, based most closely on soreness the day of injury, by National Collegiate Athletic Association Division 1 collegiate athletes was predictive of time-loss injuries, whereas no significant relationship was identified for nontime-loss injuries. Specifically, 1 unit increase in soreness was associated with a 39% increase in odds of sustaining a time-loss injury.Conclusion:This study found that subjective wellbeing and sleep have a different relationship with injury dependent upon whether the resulting injury leads to time loss.Clinical Relevance:Self-reported wellbeing appears to be a relevant predictor of injury among collegiate athletes for time-loss injuries.
      Citation: Sports Health
      PubDate: 2023-09-21T06:02:31Z
      DOI: 10.1177/19417381231198543
       
  • Serum Cartilage Oligomeric Matrix Protein Concentration Increases More
           After Running Than Swimming for Older People

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      Authors: Alexandra M. Hay, Madison J. Rhoades, Stephanie Bangerter, Seth A. Ferguson, Hyunwook Lee, Martha T. Gill, Garritt L. Page, Andrew Pope, Gary J. Measom, Ronald L. Hager, Matthew K. Seeley
      Abstract: Sports Health, Ahead of Print.
      Background:Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people.Hypotheses:Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health.Study Design:Cross-sectional.Level of Evidence:Level 3.Methods:A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score.Results:sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P> 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04).Conclusion:Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level.Clinical Relevance:These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain.
      Citation: Sports Health
      PubDate: 2023-09-12T06:10:59Z
      DOI: 10.1177/19417381231195309
       
  • Rib Stress Fractures and a Novel Muscle-Sparing Rib Fixation Plating in an
           Elite Tennis Player: A Systematic Review of the Literature and Case Report
           

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      Authors: Marcus Fearing, Vafa Behzadpour, Richard D. House, Armin Tarakemeh, Tucker Morey, Jeffrey Randall, Bryan Vopat, Jean-Philippe Darche
      Abstract: Sports Health, Ahead of Print.
      A nationally ranked Division One female collegiate tennis player presented with pain in the chest and right posterior rib region after feeling a popping sensation during a routine overhead movement. The patient was eventually diagnosed with 2 lower rib stress fractures. After unsuccessful conservative management, the player underwent an open reduction and internal fixation and autologous bone grafting of the sixth and seventh ribs with a muscle-sparing approach and was able to return to full competition. We present this case along with a systematic review of the literature regarding rib stress fractures, which included 6 separate online data sources (PubMed, EMBASE, Cochrane, CINAHL, SportDiscus, and Medline). The successful surgical intervention demonstrates a significant option for elite athletes who wish to return to competition but have been unable to with standard of care conservative management of rib stress fractures.
      Citation: Sports Health
      PubDate: 2023-09-09T12:39:14Z
      DOI: 10.1177/19417381231195271
       
  • Performance-Enhancing Drugs in Healthy Athletes: An Umbrella Review of
           Systematic Reviews and Meta-analyses

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      Authors: Alec A. Warrier, Eric N. Azua, Luke B. Kasson, Sachin Allahabadi, Zeeshan A. Khan, Enzo S. Mameri, Hasani W. Swindell, John M. Tokish, Jorge Chahla
      Abstract: Sports Health, Ahead of Print.
      Context:Many clinicians, trainers, and athletes do not have a true understanding of the effects of commonly used performance-enhancing drugs (PEDs) on performance and health.Objective:To provide an evidence-based review of 7 commonly used pharmacological interventions for performance enhancement in athletes.Data Sources:PubMed and Scopus databases were searched on April 8, 2022.Study Selection:Systematic reviews (SRs) and meta-analyses (MAs) assessing the performance-enhancing effects of the following interventions were included: androgenic anabolic steroids (AAS), growth hormone (GH), selective androgen receptor modulators (SARMs), creatine, angiotensin-converting enzyme (ACE)-inhibitors, recombinant human erythropoietin (rHuEPO), and cannabis.Study Design:Umbrella review of SRs and MAs.Level of Evidence:Level 4.Data Extraction:Primary outcomes collected were (1) body mass, (2) muscle strength, (3) performance, and (4) recovery. Adverse effects were also noted.Results:A total of 27 papers evaluating 5 pharmacological interventions met inclusion criteria. No studies evaluating SARMs or ACE-inhibitors were included. AAS lead to a 5% to 52% increase in strength and a 0.62 standard mean difference in lean body mass with subsequent lipid derangements. GH alters body composition, without providing a strength or performance benefit, but potential risks include soft tissue edema, fatigue, arthralgias, and carpel tunnel syndrome. Creatine use during resistance training can safely increase total and lean body mass, strength, and performance in high-intensity, short-duration, repetitive tasks. Limited evidence supports rHuEPO benefit on performance despite increases in both VO2max and maximal power output, and severe cardiovascular risks are documented. Cannabis provides no performance benefit and may even impair athletic performance.Conclusion:In young healthy persons and athletes, creatine can safely provide a performance-enhancing benefit when taken in controlled doses. AAS, GH, and rHuEPO are associated with severe adverse events and do not support a performance benefit, despite showing the ability to change bodily composition, strength, and/or physiologic measures. Cannabis may have an ergolytic, instead of ergogenic, effect.
      Citation: Sports Health
      PubDate: 2023-09-09T07:25:54Z
      DOI: 10.1177/19417381231197389
       
  • Pelvic Floor Muscle Training Interventions in Female Athletes: A
           Systematic Review and Meta-analysis

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      Authors: Celia Rodríguez-Longobardo, Olga López-Torres, Amelia Guadalupe-Grau, Miguel Ángel Gómez-Ruano
      Abstract: Sports Health, Ahead of Print.
      Context:Athletes are almost 3 times more at risk of experiencing urinary incontinence (UI) than sedentary women, with prevalence rates varying from 10.9% in low-impact sports such as cycling to 80% when engaging in high-impact sports such as trampoline gymnastics. To treat UI, pelvic floor muscle (PFM) training (PFMT) is recommended as a first line of treatment.Objective:The aim of the present study was to perform a meta-analysis of the available literature on the efficacy of PFMT interventions in young, nulliparous female athletes.Data Sources:A literature research was conducted using PubMed, Sport Discus, and Web of Science.Study Selection:The inclusion criteria were studies with PFMT intervention in female athletes or recreationally active women. Interventions could be carried out for treatment or prevention of pelvic floor dysfunctions.Study Design:Systematic review with meta-analysis.Level of Evidence:Level 5.Data Extraction:A descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 6 of the included articles, evaluating the maximal voluntary contraction (MVC) of the PFMs, the amount of urinary leakage (AUL), and the vaginal resting pressure (VRP). Random-effects model and standardized mean differences (SMD) ± 95% CI were reported.Results:The meta-analysis showed that PFMT produced a significant increase in MVC (SMD, 0.60; 95% CI, 0.11 to 1.08; P = 0.02) and a significant reduction of AUL (SMD, -1.13; 95% CI, -1.84 to -0.41; P < 0.01) in female athletes. No effects were shown in VRP (SMD, -0.05; 95% CI, -1.27 to 1.17; P = 0.93).Conclusion:PFMT is shown to be effective in increasing PFM strength and reducing urine leakage in female athletes, being a powerful tool to prevent and treat pelvic floor dysfunction in this population.
      Citation: Sports Health
      PubDate: 2023-09-09T07:13:13Z
      DOI: 10.1177/19417381231195305
       
  • Outcomes of Activity-Related Lower Extremity Muscle Tears After
           Application of the British Athletics Muscle Injury Classification: A
           Systematic Review

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      Authors: William L. Hollabaugh, Alexander Sin, Rachel Lane Walden, Jennifer S. Weaver, Lauren P. Porras, Lance E. LeClere, Ashley R. Karpinos, Rogelio A. Coronado, Andrew J. Gregory, Jaron P. Sullivan
      Abstract: Sports Health, Ahead of Print.
      Context:Muscle injury classification and grading systems have been reported for>100 years; yet it offer limited evidence relating the clinical or radiological qualities of a muscle injury to the pathology or clinical outcome. The British Athletics Muscle Injury Classification (BAMIC) incorporates recent predictive features of muscle injuries and provides a precise radiographic framework for clinical prediction and management.Objective:To investigate clinical outcomes, particularly time to return to play (RTP), reinjury rate (RIR), and prognostic value of specific magnetic resonance imaging (MRI) findings, of activity-related muscle injuries (tears) in athletes after application of the BAMIC.Data Sources:A search of PubMed (NLM), EMBASE (Ovid), Web of Science (Clarivate), Cochrane Library (Wiley), and ClinicalTrials.gov from the inception date of each database through August 31, 2022, was conducted. Keywords included the BAMIC.Study Selection:All English language studies evaluating clinical outcomes of RTP and RIR after activity-related muscle injuries and where BAMIC was applied were included. A total of 136 articles were identified, and 11 studies met inclusion criteria.Study Design:Systematic review (PROSPERO: CRD42022353801).Level of Evidence:Level 2.Data Extraction:Two reviewers independently screened studies for eligibility and extracted data. Methodological quality of included study was assessed independently by 2 reviewers with the Newcastle-Ottawa Quality Scale (NOS); 11 good quality studies (4 prospective cohort studies, 7 retrospective cohort studies) with 468 athletes (57 female) and 574 muscle injuries were included.Results:All studies reported a statistically significant relationship between BAMIC grade, BAMIC injury site, and/or combined BAMIC grade and injury site with RTP. A statistically significant increased RIR was reported by BAMIC grade and BAMIC injury site in 2 of 4 and 3 of 4 studies, respectively. The prognostic value of individual MRI criteria was limited.Conclusion:Consistent evidence suggests that BAMIC offers prognostic and therapeutic guidance for clinical outcomes, particularly RTP and RIR, after activity-related muscle injuries in athletes that may be superior to previous muscle injury classification and grading systems.
      Citation: Sports Health
      PubDate: 2023-09-08T11:53:16Z
      DOI: 10.1177/19417381231195529
       
  • Ulnar Variance in Athletes: A Scoping Review

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      Authors: Noah M. Scigliano, Kareena F. McSweeny, Ignacio Garcia Fleury, Joseph A. Buckwalter
      Abstract: Sports Health, Ahead of Print.
      Context:Ulnar variance (UV) is a measurement of the relative locations of the radius and ulna that may become perturbed in athletic populations. Positive UV can be associated with wrist pathologies often treated conservatively or surgically and may result in interruption of sports participation.Objective:This scoping review aims to summarize diagnostic measures of UV in athletes, describe its relation to separate wrist conditions, and present treatment strategies for symptomatic UV.Data Sources:A systematic search was created and modified for PubMed, CINAHL, Embase, and SPORTDiscus including articles from inception until February 2, 2022.Study Selection:Articles including UV characterization, imaging modality style, and an athletic population were searched across multiple databases.Study Design:A scoping review was designed to identify the methods for imaging UV in athletic populations following the PRISMA Extension for Scoping Reviews (PRISMA-ScR).Level of Evidence:Level 4.Data Extraction:The specific athletic population, imaging modality, measurement style, wrist pathology association, and surgical management of UV were extracted.Results:A total of 4321 records were screened independently for eligibility: 22 met inclusion criteria. Eight sports comprised the analysis. All studies referenced conventional radiography to diagnose UV; 50% specified the posteroanterior, 18.2% anteroposterior, and 13.6% pronated, gripping radiographs. Hafner’s method (7×), Palmer’s technique (2×), and the method of perpendiculars (3×) were used to measure UV. Athletes displayed more positive UV than nonathletes and UV became more positive over time in longitudinal studies. Triangular fibrocartilage complex tears, focal lunate necrosis, and ulnar abutment were associated with positive UV. Ulnar shortening osteotomy was the most performed operation for positive UV.Conclusion:Conventional radiography is the gold standard for imaging UV in athletes. Hafner’s method is the most commonly used radiograph measurement technique. Wrist pathology in athletic populations may indicate positive UV in need for operative management.
      Citation: Sports Health
      PubDate: 2023-09-08T11:52:37Z
      DOI: 10.1177/19417381231195527
       
  • Cannabis Use Disorder Not Associated With Opioid Analgesic Use or
           Patient-Reported Outcomes After ACL Reconstruction: A Retrospective
           Matched-Cohort Analysis

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      Authors: Dhruv S. Shankar, Brittany DeClouette, Kinjal D. Vasavada, Amanda Avila, Eric J. Strauss, Michael J. Alaia, Guillem Gonzalez-Lomas
      Abstract: Sports Health, Ahead of Print.
      Background:The purpose of this study was to compare opioid analgesic use and patient-reported outcomes (PROs) after anterior cruciate ligament reconstruction (ACLR) between patients with and without cannabis use disorder (CUD).Hypothesis:We hypothesized that patients with CUD would have greater postoperative opioid usage with comparable improvement in PROs.Study Design:Retrospective matched-cohort study.Level of Evidence:Level 3.Methods:We identified patients with CUD who underwent primary ACLR at a single center and had minimum 3-month follow-up. Patients with CUD were propensity score matched 1:1 to non-CUD controls with respect to age, sex, and follow-up time. Total refills, days supply, and morphine milligram equivalents (MMEs) of opioid analgesics prescribed were calculated for up to 1 year postoperatively. Patient-Reported Outcome Information System (PROMIS) instruments were used to assess PROs. Opioid use and outcomes were compared between CUD and control groups using Mann-Whitney U test and Fisher’s exact test. P values
      Citation: Sports Health
      PubDate: 2023-08-26T11:09:03Z
      DOI: 10.1177/19417381231190391
       
  • Are Physical Activity Interventions Effective in Improving Health-Related
           Quality of Life in Children and Adolescents' A Systematic Review and
           Meta-Analysis

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      Authors: Alberto Bermejo-Cantarero, Mairena Sánchez-López, Celia Álvarez-Bueno, Andres Redondo-Tébar, Antonio García-Hermoso, Vicente Martínez-Vizcaino
      Abstract: Sports Health, Ahead of Print.
      Context:Physical activity (PA) interventions improve well-being and positive mental health in children and adolescents, but the results of previous systematic reviews included participants with chronic medical conditions and did not accurately assess the multidimensional nature of health-related quality of life (HRQoL).Objective:The aims of this meta-analysis were to (1) evaluate the effects of PA interventions on several domains of HRQoL in healthy
      Citation: Sports Health
      PubDate: 2023-08-23T06:32:40Z
      DOI: 10.1177/19417381231190885
       
  • Acute Effects of Ice Hockey on Hip Range of Motion, Strength, and Pelvic
           Tilt in Competitive Male Players

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      Authors: William H. Suits, Margaret M. O’Neil, Kieran J. Fogarty
      Abstract: Sports Health, Ahead of Print.
      Background:Ice hockey players are at high risk for hip and groin injury. Several risk factors have been identified or proposed, including lower hip rotation range of motion (ROM), lower hip adductor strength, lower ratio of hip adductor to abductor strength, and lower pelvic tilt angle. It is not known how these risk factors change acutely with ice hockey participation.Hypothesis:Acute exposure to ice hockey will result in a reduction in ROM, strength, and pelvic tilt angle in competitive male players.Study Design:Controlled cohort study.Level of Evidence:Level 3.Methods:Risk factors for hip and groin injury, including isometric hip adductor strength at 0° of flexion, the ratio of hip adductor to abductor strength, total hip rotation passive ROM in supine, and the resting pelvic tilt angle, were assessed immediately before, immediately after, and 24 hours after an ice hockey exposure in 42 competitive male ice hockey players. Rating of perceived exertion (RPE) was collected to identify the intensity of the exposure.Results:There was a significant decrease in total hip rotation ROM (-7.32°, P < 0.01 (-3.91, -10.70)) and hip adductor strength (-4.41 kg, P < 0.01 (-2.81, -6.00) immediately after the exposure, and a significant decrease in total hip rotation ROM (-18.54°, P < 0.01 (-14.35, -22.73)), hip adductor strength (-6.56 kg, P < 0.01 (-4.58, -8.61)), and the ratio of hip adductor to abductor strength (-0.12, P < 0.01 (-0.21, -0.45)) 24 hours after. There was no significant change in pelvic tilt found in this study immediately after or 24 hours after. There was a moderate relationship between changes in hip adductor strength and changes in the ratio of hip adductor to abductor strength (r = 0.433, P < 0.01). RPE was not significantly correlated to any of the changes observed.Conclusion:Risk factors for hip and groin injury in ice hockey players are modifiable after a single ice hockey exposure.Clinical Relevance:The identified fluctuation of injury risk factors for hip and groin injury in ice hockey players has implications for injury risk profiling, rehabilitation, and return-to-competition decision-making.
      Citation: Sports Health
      PubDate: 2023-08-11T10:30:14Z
      DOI: 10.1177/19417381231190649
       
  • Comparative Efficacy of Robotic and Manual Massage Interventions on
           Performance and Well-Being: A Randomized Crossover Trial

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      Authors: Yann Kerautret, Franck Di Rienzo, Carole Eyssautier, Aymeric Guillot
      Abstract: Sports Health, Ahead of Print.
      Background:Manual massage (MM) interventions can improve psychophysiological states of relaxation and well-being. In this context, robotic massage (RM) represents a promising, but currently understudied, solution.Hypothesis:Both MM and RM would improve flexibility of the hamstrings and lumbopelvic muscles and promote a psychophysiological state of relaxation through decreased sympathetic activity.Study Design:Single-blind randomized crossover trial.Level of Evidence:Level 2.Methods:A total of 21 participants experienced 2 massage interventions targeting back soft tissues. During a first condition, the intervention was performed by a physical therapist, whereas during a second condition the intervention was performed by a robot. We collected objective and subjective indexes of performances and well-being before and after each massage intervention. We also collected physical therapists’ self-reports of perceived fatigue, tension, and ability to maintain the massage routine.Results:Skin conductance decreased from the pretest to the posttest in both conditions (partial R2 = 0.44, 95% CI [0.30, 1.00], P < 0.01), although the decrease was more pronounced after MM. Whereas both interventions were associated with improved subjective sensations, eg, pain, warmth, well-being (partial R2 = 0.08, 95% CI [0.06, 1.00], P < 0.01), MM yielded additional benefits compared with RM. The physical therapist reported greater fatigue and tension and reduced perceived massage efficiency along with repeated massage interventions. MM outperformed RM to elicit a psychophysiological state of relaxation.Conclusion:RM exhibited a pattern of changes comparable with that of MM, for both objective and subjective indexes of relaxation and well-being.Clinical Relevance:RM could represent a prophylactic option to prevent the onset of counterproductive fatigability in physical therapists.
      Citation: Sports Health
      PubDate: 2023-08-11T10:27:10Z
      DOI: 10.1177/19417381231190869
       
  • Does Running Increase the Risk of Hip and Knee Arthritis' A Survey of
           3804 Marathon Runners

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      Authors: Matthew J. Hartwell, Joseph E. Tanenbaum, George Chiampas, Michael A. Terry, Vehniah K. Tjong
      Abstract: Sports Health, Ahead of Print.
      Background:Long-distance running is a popular form of cardiovascular exercise with many well-described health benefits, from improving heart health to the management of obesity, diabetes, and mental illness. The impact of long-distance running on joint health in recreational runners, however, remains inconclusive.Hypothesis:The prevalence of osteoarthritis in runners is not associated with an athlete’s running-related history, including the number of marathons completed, cumulative years of running, average weekly mileage, and average running pace.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:A survey was distributed to all participants registered for the 2019 or 2021 Chicago marathon (n = 37,917). Surveys collected runner demographics and assessed for hip/knee pain, osteoarthritis, family history, surgical history, and running-related history. Running history included the number of marathons run, number of years running, average running pace, and average weekly mileage. The overall prevalence of osteoarthritis was identified, and a multivariable logistic regression model was used to identify variables associated with the presence of hip and/or knee osteoarthritis.Results:Surveys were completed by 3804 participants (response rate of 10.0%). The mean age was 43.9 years (range, 18-83 years) and participants had completed on average 9.5 marathons (median, 5 marathons; range, 1-664 marathons). The prevalence of hip and/or knee arthritis was 7.3%. A history of hip/knee injuries or surgery, advancing age, family history, and body mass index (BMI) were risk factors for arthritis. Cumulative number of years running, number of marathons completed, weekly mileage, and mean running pace were not significant predictors for arthritis. The majority (94.2%) of runners planned to run another marathon, despite 24.2% of all participants being told by a physician to do otherwise.Conclusion:From this largest surveyed group of marathon runners, the most significant risk factors for developing hip or knee arthritis were age, BMI, previous injury or surgery, and family history. There was no identified association between cumulative running history and the risk for arthritis.
      Citation: Sports Health
      PubDate: 2023-08-09T09:14:27Z
      DOI: 10.1177/19417381231190876
       
  • Can Symmetry of Single-Leg Vertical Jump Height Represent Normal Lower
           Limb Biomechanics of Athletes After Anterior Cruciate Ligament
           Reconstruction'

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      Authors: Peng Chen, Ling Wang, Shiyu Dong, Yue Ding, Shaohui Jia, Cheng Zheng
      Abstract: Sports Health, Ahead of Print.
      Background:After anterior cruciate ligament reconstruction (ACLR), single-leg horizontal hop distance limb symmetry index (LSI)>90% is recommended as a cutoff point for safe return to sport (RTS). However, athletes after ACLR have abnormal lower limb biomechanics despite an adequate single-leg hop distance LSI, implying that athletes are at high risk of reinjury. Symmetry of single-leg vertical jump height appears to be more difficult to achieve and can be a better representation of knee function than single-leg horizontal hop distance.Hypothesis:Athletes after ACLR with single-leg jump height LSI>90% had similar biomechanical characteristics to healthy athletes.Study Design:Controlled laboratory study.Level of Evidence:Level 3.Methods:A total of 46 athletes after ACLR were divided into low jump height (LJH, jump height LSI 90%, n = 23) groups according to symmetry of single-leg vertical jump height, while 24 healthy athletes acted as a control (CONT) group. One-way analysis of variance was used to compare the kinematic and kinetic characteristics of the LJH, HJH, and CONT groups during single-leg vertical jump.Results:Both the LJH and HJH groups demonstrated greater limb asymmetry (lower LSI) during landing compared with the CONT group in knee extension moment (P < 0.05), peak knee flexion angle (P < 0.05), and knee power (P < 0.05).Conclusion:Symmetry in single-leg vertical jump height does not represent normal lower limb biomechanics in athletes after ACLR.Clinical Relevance:Symmetrical jump height may not signify ideal biomechanical or RTS readiness, but single-leg vertical jump test can be used as a supplement to horizontal hop test or other functional tests to reduce the likelihood of false-negative results in the absence of detailed biomechanical evaluation.
      Citation: Sports Health
      PubDate: 2023-08-09T07:38:54Z
      DOI: 10.1177/19417381231190119
       
  • Clinical Presentation and Outcomes of Sacral Stress Fractures in Athletes:
           A Case Series of 13 Patients

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      Authors: Dhruv S. Shankar, Lauren A. Gillinov, Michael Buldo-Licciardi, Luilly Vargas, Dennis A. Cardone
      Abstract: Sports Health, Ahead of Print.
      Background:Sacral stress fractures are a rare cause of low back pain in athletes. Given the low incidence of these fractures, there is a scarcity of data on symptomatology, risk factors, and clinical outcomes.Hypothesis:Patients diagnosed with sacral stress fractures would be athletes presenting with low back pain.Study Design:Case series of 13 patients with sacral stress fractures.Level of Evidence:Level 4.Methods:We conducted a retrospective review of medical records to identify patients diagnosed with sacral stress fractures at a single academic institution. Fractures were diagnosed on noncontrast T2-weighted magnetic resonance imaging scans and categorized using the Bakker classification system. Subjects were administered an electronic survey that asked about (1) the onset, time course, and location of pain and other symptoms; (2) time to treatment and treatment modalities pursued; (3) sports performance and time to return to sport; and (4) risk factors for stress fractures.Results:Of 18 eligible patients, 13 (72.2%) completed the survey with mean follow-up of 49.6 months (range, 1-144 months). Mean age was 28.0 years (range, 18-52 years); 9 patients (69.2%) were female, of whom 7 (77.8%) were premenopausal. The most common fracture type was Bakker type B (8 patients; 61.5%). Most patients presented with acute lumbosacral back pain in the setting of running/jogging activities. All patients underwent nonoperative treatment for an average of 3.8 months (range, 0-8 months) and three-quarters reported pain resolution at last follow-up. Rate of return to sport was 83.3%, but most patients reported ongoing deficits in running performance.Conclusion:Sacral stress fractures commonly present as acute lumbosacral back pain provoked by running sports. While the pain associated with these fractures prevents most athletes from participating in sports, nonoperative management appears to be an effective treatment modality with a high rate of return to sport.
      Citation: Sports Health
      PubDate: 2023-08-05T06:55:08Z
      DOI: 10.1177/19417381231190580
       
  • Influence of a Concurrent Exercise Training Program on Health-Related
           Quality of Life During Advanced Pregnancy: The GESTAFIT Project

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      Authors: Nuria Marín-Jiménez, Laura Baena-García, Irene Coll-Risco, Marta Flor-Alemany, José Castro-Piñero, Virginia A. Aparicio
      Abstract: Sports Health, Ahead of Print.
      Background:Health-related quality of life (HRQoL) may be altered during pregnancy due to pregnancy-related changes in all domains of women’s health.Hypothesis:A supervised concurrent exercise-training program from the 17th gestational week until birth positively influences HRQoL.Study Design:Randomized controlled trial.Level of Evidence:Level 1.Methods:Eighty-six pregnant women (age, 33.1 ± 4.6 years; prepregnancy body mass index, 23.5 kg/m2), divided into exercise (n = 41) and control (n = 45) groups, participated in this study (per-protocol basis). The exercise group followed a 60-min, 3 days/week, concurrent (aerobic + resistance) exercise training program. HRQoL was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores (0-100) indicate better HRQoL.Results:After adjusting for potential confounders, the exercise group decreased 16.1 points less than the control group in the SF-36 physical functioning domain [between-group differences (B): 95% confidence interval (CI), 9.02 to 23.22; P < 0.01], and 4.5 points less in the SF-36 physical component summary than the control group (between-group differences (B): 95% CI, 0.65 to 8.28; P = 0.02). Intention-to-treat basis analyses depicted similar results, where the exercise group decreased 10.03 points less than the control group the in the SF-36 social functioning domain (between-group differences (B): 95% CI, 0.39 to 19.68; P = 0.04).Conclusion:A supervised concurrent exercise training program ameliorates HRQoL decreases along gestation. Although HRQoL decreased throughout pregnancy in both groups, this impact was less in the exercise group, especially in the SF-36 physical functioning, the SF-36 social functioning, and the SF-36 physical component summary.Clinical Relevance:Healthcare providers may encourage pregnant women to exercise in this physiological stage for a better HRQoL throughout pregnancy.ClinicalTrials.gov Identifier:NCT02582567; Date of registration: 20/10/2015
      Citation: Sports Health
      PubDate: 2023-08-01T06:44:54Z
      DOI: 10.1177/19417381231189730
       
  • Development and Validation of the Ankle-GO Score for Discriminating and
           Predicting Return-to-Sport Outcomes After Lateral Ankle Sprain

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      Authors: Brice Picot, Ronny Lopes, Gauthier Rauline, François Fourchet, Alexandre Hardy
      Abstract: Sports Health, Ahead of Print.
      Background:Lateral ankle sprain (LAS) is the most common sports-related injury. However, there are currently no published evidence-based criteria to guide the patient’s return to sport (RTS) and this decision is generally time-based. The aim of this study was to assess the psychometric properties of a new score (Ankle-GO) and its predictive ability for RTS at the same level of play after LAS.Hypothesis:The Ankle-GO is robust for discriminating and predicting RTS outcomes.Study Design:Prospective diagnostic studyLevel of Evidence:Level 2.Methods:The Ankle-GO was administered to 30 healthy participants and 64 patients at 2 and 4 months after LAS. The score was calculated as the sum of 6 tests for a maximum of 25 points. Construct validity, internal consistency, discriminant validity, and test-retest reliability were used to validate the score. The predictive value for the RTS was also validated based on the receiver operating characteristic (ROC) curve.Results:The internal consistency of the score was good (Cronbach’s alpha coefficient of 0.79) with no ceiling or floor effect. Test-retest reliability was excellent (intraclass coefficient correlation = 0.99) with a minimum detectable change of 1.2 points. The 2-month scores were significantly lower than 4-month and control group scores (7.7 ± 4, 13.9 ± 4.6, and 19.6 ± 3.4 points, respectively, P < 0.01). Ankle-GO values were also significantly higher in patients who returned to their preinjury level at 4 months compared with those who did not (P < 0.01). The predictive value of the 2-month Ankle-GO score was fair for a RTS at the same or higher than preinjury level at 4 months (area under ROC curve, 0.77; 95% CI, 0.65-0.89; P < 0.01).Conclusion:The Ankle-GO appears to be a valid and robust score for clinicians to predict and discriminate RTS in patients after LAS.Clinical Relevance:Ankle-GO is the first objective score to help in the decision-making of the RTS after LAS. At 2 months, patients with an Ankle-GO score
      Citation: Sports Health
      PubDate: 2023-07-12T06:56:41Z
      DOI: 10.1177/19417381231183647
       
  • Early Detection of COVID-19 in Female Athletes Using Wearable Technology

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      Authors: Liliana I. Rentería, Casey E. Greenwalt, Sarah Johnson, Shiloah A. Kviatkovsky, Marine Dupuit, Elisa Angeles, Sachin Narayanan, Tucker Zeleny, Michael J. Ormsbee
      Abstract: Sports Health, Ahead of Print.
      Background:Heart rate variability (HRV), respiratory rate (RR), and resting heart rate (RHR) are common variables measured by wrist-worn activity trackers to monitor health, fitness, and recovery in athletes. Variations in RR are observed in lower-respiratory infections, and preliminary data suggest changes in HRV and RR are linked to early detection of COVID-19 infection in nonathletes.Hypothesis:Wearable technology measuring HRV, RR, RHR, and recovery will be successful for early detection of COVID-19 in NCAA Division I female athletes.Study Design:Cohort study.Level of Evidence:Level 2.Methods:Female athletes wore WHOOP, Inc. bands through the 2020 to 2021 competitive season. Of the athletes who tested positive for COVID (n = 33), 14 had enough data to be assessed (N = 14; 20.0 ± 1.3 years; 69.8 ± 7.2 kg; 172.0 ± 8.3 cm). Roughly 2 weeks of noninfected days were used to set baseline levels of HRV, RR, recovery, and RHR to compare with -3, -2, and -1 days before a positive COVID-19 result.Results:Increases in RR (P = 0.02) were detected on day -3. RHR (P < 0.01) and RR increased (P < 0.01), while HRV decreased (P < 0.05) on day -1, compared with baseline. Differences were noted in all variables on the day of the positive COVID-19 result: decreased HRV (P < 0.05) and recovery scores (P < 0.01), and increased RHR (P < 0.01) and RR (P < 0.01).Conclusion:In female athletes, wearable technology was successful in predicting COVID-19 infection through changes in RR 3 days before a positive test, and also HRV and RHR the day before a positive test.Clinical Relevance:Wearable technology may be used, as part of a multifaceted approach, for the early detection of COVID-19 in elite athletes through monitoring of HRV, RR, and RHR for overall team health.
      Citation: Sports Health
      PubDate: 2023-07-04T08:23:52Z
      DOI: 10.1177/19417381231183709
       
  • Factors Associated With Awareness, Adoption, and Implementation of
           Anterior Cruciate Ligament Injury Prevention in Youth Sports

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      Authors: Alexander J. MacFarlane, Timothy Whelan, Nomi S. Weiss-Laxer, Mohammad N. Haider, Scott A. Dinse, Leslie J. Bisson, John M. Marzo
      Abstract: Sports Health, Ahead of Print.
      Background:Anterior cruciate ligament (ACL) injuries are among the most common injuries in adolescent athletes and result in significant financial and physical morbidity. Evidence-based programs designed to prevent ACL injury are effective. However, their adoption remains low. We sought to evaluate the awareness, evidence-based implementation, and barriers to implementation of ACL injury prevention programs (ACL-IPP) among youth athletic coaches.Hypothesis:Higher education level of the coach, higher level of training, number of teams coached, and coaching female teams would be associated with ACL-IPP implementation.Study Design:Cross-sectional surveyLevel of Evidence:Level 4.Methods:We conducted an email survey sent to all 63 school districts within Section VI of the New York State Public High School Athletic Association. We employed descriptive statistics and tests of correlation to identify factors associated with ACL-IPP implementation.Results:A total of 73% of coaches said they were aware of ACL-IPP, and only 12% of coaches implemented ACL-IPP according to best evidence. Coaches of higher competitive levels were more likely to adopt ACL-IPP (P = 0.01), more likely to use them multiple times per week (P = 0.03), and for ≥1 seasons (P = 0.02). Coaches of multiple teams were more likely to adopt ACL-IPP (P = 0.01). There were no differences in evidence-based implementation of ACL-IPP with gender coached or level of education of the coach.Conclusion:Overall awareness, adoption, and evidence-based implementation of ACL-IPP remain low. These results suggest that coaches at higher levels of play and multiple teams tend to use ACL-IPP more often. Gender coached and level of education do not appear to be associated with awareness or implementation.Clinical Relevance:Evidence-based ACL-IPP implementation remains low. Targeting coaches of younger athletes and fewer teams with local outreach programs and ACL-IPP may increase the implementation of ACL-IPP.
      Citation: Sports Health
      PubDate: 2023-07-03T09:23:45Z
      DOI: 10.1177/19417381231184427
       
  • High-Level Competitive Athletes Who Undergo Hip Arthroscopy Demonstrate
           Durable 5-Year Outcomes and Lower Subjective Pain: A Propensity-Matched
           Analysis

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      Authors: Thomas W. Fenn, Nolan S. Horner, H. Sadiyya Ingawa, Mario Hevesi, Corey Beals, Shane J. Nho
      Abstract: Sports Health, Ahead of Print.
      Background:Hip arthroscopy (HA) has been proven to be an effective treatment for femoroacetabular impingement syndrome (FAIS) in both competitive athletes (CA) and non-CA at short-term follow-up. However, there is a paucity of literature investigating midterm outcomes comparing athletes with Controls.Hypothesis:Athletes would have significant improvements at 5 years, with favorable outcomes compared with their control counterparts, and high return-to-sport (RTS) rate.Study Design:Propensity-matched retrospective comparative cohort study.Level of Evidence:Level 3.Methods:CAs who underwent primary HA for FAIS from January 1, 2012 to April 30, 2017 were identified and propensity matched on a 1:4 basis to Controls by age, sex, and body mass index (BMI). Patient-reported outcomes (PROs) were collected preoperatively and at 5 years. Minimal clinically important differences (MCID) and patient acceptable symptom states (PASS) rates were calculated using previously published thresholds. Rate and duration of RTS were collected retrospectively.Results:A total of 57 high-level CA (33 female, 24 male; age, 21.7 ± 4.2 years; BMI, 23.1 ± 2.8 kg/m2) were propensity matched to 228 Controls (132 female, 96 male; P> 0.99; age, 23.3 ± 5.8 years; P = 0.02; BMI, 23.8 ± 4.3 kg/m2, P = 0.24). Significant differences were observed in preoperative Hip Outcome Score Sports Specific and Activities of Daily Living (HOS-ADL) subscales (CA, 74.9 ± 13.7 vs Controls, 66.4 ± 18.4; P = 0.01) and modified Harris Hip Score (mHHS) (CA, 64.7 ± 12.9 vs Controls, 59.7 ± 14.3; P = 0.04). Both groups demonstrated significant postoperative improvements in all outcome scores measured (P ≤ 0.01). At 5 years postoperatively, there were significant differences between groups in Visual Analog Scale (VAS) Pain (CA, 17.3 ± 17.6 vs Controls, 24.7 ± 25.9; P = 0.02). There were no significant differences in achieving MCID or PASS. Athletes RTS at a median of 25.2 weeks (Q1 22.4-Q3 30.7) with an overall RTS rate of 90%. Similar rates of revision were seen between CA patients (n = 3; 5.3%) and Control patients (n = 9; 3.9%) (P = 0.66).Conclusion:CAs demonstrated significant and durable improvements in PROs as well as high MCID and PASS achievement rates after primary HA, which were comparable with those of Controls. Clinicians should be aware that CA patients demonstrate higher preoperative mHHS and HOS-ADL scores than Controls and achieve lower average self-reported pain at 5 years postoperatively. In addition, CA patients demonstrate high rates of RTS at a median of 25 weeks postoperatively.Clinical Relevance:This study provides insight into CA versus Control PROs and rates of achieving MCID and PASS at a midterm follow-up of 5 years. Furthermore, this study offers perception into RTS rate, both in general as well as specified to individualized sports.
      Citation: Sports Health
      PubDate: 2023-06-28T11:26:18Z
      DOI: 10.1177/19417381231183658
       
  • Cognition Uniquely Influences Dual-Task Tandem Gait Performance Among
           Athletes With a Concussion History

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      Authors: Eric J. Shumski, Julianne D. Schmidt, Robert C. Lynall
      Abstract: Sports Health, Ahead of Print.
      Background:After a concussion, there are unique associations between static balance and landing with cognition. Previous research has explored these unique correlations, but the factor of time, dual-task, and different motor tasks leave gaps within the literature. The purpose of this study was to determine the associations between cognition and tandem gait performance.Hypothesis:We hypothesized that athletes with a concussion history would display stronger associations compared with athletes without a concussion history between cognition and tandem gait.Study Design:Cross-sectional.Level of Evidence:Level 3.Methods:A total of 126 athletes without (56.3% female; age, 18.8 ± 1.3 years; height, 176.7 ± 12.3 cm; mass, 74.8 ± 19.0 kg) and 42 athletes with (40.5% female; age, 18.8 ± 1.3 years; height, 179.3 ± 11.9 cm; mass, 81.0 ± 25.1 kg) concussion history participated. Cognitive performance was assessed with CNS Vital Signs. Tandem gait was performed on a 3-meter walkway. Dual-task tandem gait included a concurrent cognitive task of serial subtraction, reciting months backward, or spelling words backward.Results:Athletes with a concussion history exhibited a larger number of significant correlations compared with athletes without a concussion history for cognition and dual-task gait time (4 significant correlations: rho-range, -0.377 to 0.358 vs 2 significant correlations: rho, -0.233 to 0.179) and dual-task cost gait time (4 correlations: rho range, -0.344 to 0.392 vs 1 correlation: rho, -0.315). The time between concussion and testing did significantly moderate any associations (P = 0.11-0.63). Athletes with a concussion history displayed better dual-task cost response rate (P = 0.01). There were no other group differences for any cognitive (P = 0.13-0.97) or tandem gait (P = 0.20-0.92) outcomes.Conclusion:Athletes with a concussion history display unique correlations between tandem gait and cognition. These correlations are unaffected by the time since concussion.Clinical Relevance:These unique correlations may represent shared neural resources between cognition and movement that are only present for athletes with a concussion history. Time does not influence these outcomes, indicating the moderating effect of concussion on the correlations persists long-term after the initial injury.
      Citation: Sports Health
      PubDate: 2023-06-28T11:17:52Z
      DOI: 10.1177/19417381231183413
       
  • Novel Posterior Shoulder Stretching With Rapid Eccentric Contraction and
           Static Stretching in Patients With Subacromial Pain Syndrome: A Randomized
           Trial

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      Authors: Halime Ezgi Türksan, Sevgi Sevi Yeşilyaprak, Mehmet Erduran, Cem Özcan
      Abstract: Sports Health, Ahead of Print.
      Background:In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE.Hypothesis:PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS.Study Design:Randomized controlled trial.Level of Evidence:Level 1.Methods:Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, external rotation ROM (ERROM), pain, modified Constant-Murley score, short form of the disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), rotator cuff strength, acromiohumeral distance (AHD), supraspinatus tendon thickness, and supraspinatus tendon occupation ratio (STOR).Results:Shoulder mobility, pain, function and disability, strength, AHD, and STOR improved in all groups (P < 0.05).Conclusion:In patients with SPS, PSSE with rapid eccentric contraction and static PSSE were superior to no stretching in improving clinical and ultrasonographic outcomes. Stretching with rapid eccentric contraction was not superior to static stretching, but improved ERROM compared with no stretching.Clinical Relevance:In SPS, both PSSE with rapid eccentric contraction and static PSSE included in physical therapy program are beneficial to improve posterior shoulder mobility and other clinical and ultrasonographic outcomes. In the case of ERROM deficiency, rapid eccentric contraction might be preferred.
      Citation: Sports Health
      PubDate: 2023-06-28T11:11:32Z
      DOI: 10.1177/19417381231181127
       
  • Effects of Different Loading Types on the Validity and Magnitude of
           Force-Velocity Relationship Parameters

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      Authors: Goran Jankovic, Danica Janicijevic, Aleksandar Nedeljkovic, Milos R. Petrovic, Marko Cosic, Amador Garcia-Ramos
      Abstract: Sports Health, Ahead of Print.
      Background:Force-velocity (F-V) relationship models gained popularity as a tool for muscle mechanical assessment. However, it is not clear whether the validity of the F-V relationship parameters (maximal theoretical force [F0], velocity [V0] and power [Pmax]) is affected using different load types: gravitational (W, rubber bands pulling the barbell downward), inertial (I, rubber bands pulling the barbell, which is equalized to the weight of the added plates upward), and combined (W + I, weight of the plates).Hypothesis:Load type would affect both the magnitude and validity of F-V relationship parameters. The highest magnitude and validity was expected for F0 using a W, for V0 using an I, and for Pmax using a W + I load.Study Design:Cross-sectional.Level of Evidence:Level 3.Methods:A total of 13 resistance-trained men (body mass, 87.7 ± 11.2 kg and body height, 183.9 ± 6.4 cm) performed bench press (BP) throws (BPTs) using 3 types of loads against 30 to 80 kg. The validity of F-V relationship parameters was explored with respect to the tests used traditionally for force (maximal voluntary contraction and 1-repetition maximum [1RM]), velocity (maximal velocity achieved during almost unloaded tasks), and power (BPT against the 50%1RM and medicine ball throws) assessment.Results:The W + I loading promoted the highest values of F0 and Pmax, while the highest magnitude of V0 was promoted by the I loading. The validity was acceptable for F0 obtained using the 3 loading conditions with respect to the BP 1RM (r range, 0.30-0.83), and V0 obtained using the I loading with respect to the stick throw (r = 0.54).Conclusion:The magnitude of the F-V relationship parameters is affected by load type, but their validity with respect to standardized tests is comparable, with the exception of the higher validity of V0 when obtained using the I loading.Clinical relevance:Any load type can be used for assessing F0, while I load should be selected when assessing V0.
      Citation: Sports Health
      PubDate: 2023-06-22T06:14:35Z
      DOI: 10.1177/19417381231182131
       
  • Sports-Related Health Problems in Para-Sports: A Systematic Review With
           Quality Assessment

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      Authors: Sietske C.M. Luijten, Leonie M. te Loo, Joske Nauta, Thomas W.J. Janssen, Jasmijn F.M. Holla, René H.J. Otten, Ingrid Vriend, Evert Verhagen
      Abstract: Sports Health, Ahead of Print.
      Context:Participation in sports is associated with a risk of sports-related health problems. For athletes with an impairment, sports-related health problems further burden an already restricted lifestyle, underlining the importance of prevention strategies in para-sports.Objective:To provide a comprehensive overview with quality assessment of the literature on sports-related health problems, their etiology, and available preventive measures in para-sports following the steps of the Sequence of Prevention.Data Sources:A literature search (in PubMed, Embase, SPORTDiscus, CINAHL and the Cochrane Library) was performed up to December 8, 2021, in collaboration with a medical information specialist.Study Selection:The search yielded 3006 articles, of which 64 met all inclusion criteria.Study Design:Systematic review with quality assessment.Level of Evidence:Level 3.Data Extraction:Two independent researchers carried out the screening process and quality assessment. One researcher extracted data, and the Sequence of Prevention categorized evidence.Results:A total of 64 studies were included, of which 61 reported on the magnitude and risk factors of sports-related health problems, while only 3 reported on the effectiveness of preventive measures. Of these, 30 studies were of high quality. Most studies (84%) included elite-level athletes. The reported injury incidence varied widely between sports (0-91 per 1000 athlete days) and impairment categories (1-50 per 1000 athlete days). The same applies to illness incidence with regard to different sports (3-49 per 1000 athlete days) and impairment categories (6-14 per 1000 athlete days).Conclusion:This review shows the current vast range of reported sport-related health problems in para-sports. There is limited evidence concerning the severity of these sports-related health problems and inconclusive evidence on the risk factors. Lastly, the evidence regarding the development and effectiveness of preventive measures for para-athletes is sparse.
      Citation: Sports Health
      PubDate: 2023-06-20T06:25:47Z
      DOI: 10.1177/19417381231178534
       
  • Home-Based Indoor Physical Activity Programs for Community-Dwelling Older
           Adults: A Systematic Review

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      Authors: Isis Kelly dos Santos, Ricardo Ney Cobucci, Jason Azevedo de Medeiros, Gilmara Gomes de Assis, Rafaela Catherine da Silva Cunha de Medeiros, Maria Irany Knackfuss, Breno Guilherme de Araújo Tinoco Cabral, Ronaldo Vagner Thomatieli dos Santos, Paulo Moreira Silva Dantas
      Abstract: Sports Health, Ahead of Print.
      Context:Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside.Objective:To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults.Data Sources:A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases.Study Selection:A total of 11 studies (13 publications) were included involving a total of 1004 older adults.Study Design:A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.Level of Evidence:Level 2.Data Extraction:Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome.Results:There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home.Conclusion:The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling.Protocol Register Number:CRD42020182008.
      Citation: Sports Health
      PubDate: 2023-06-17T05:02:59Z
      DOI: 10.1177/19417381231175665
       
  • Highly Active Middle School Athletes Demonstrate Poor Motor Skill
           Proficiency

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      Authors: Lauren S. Butler, Dai Sugimoto, Ashley Erdman, Jason Yoder, Kayla Greiner, Cynthia Larroque, Kevin Latz, Alex Loewen, Charles W. Wyatt, Amie DeVerna, Sophia Ulman
      Abstract: Sports Health, Ahead of Print.
      Background:Fundamental movement skills (FMS) are critical components to lifelong participation in sports and physical activity. With the rise in early sports specialization, mastery of motor skills may be limited in youth athletes. The purpose of this study was to assess FMS proficiency in highly active middle school athletes and determine whether proficiency differed between specialization levels and sex.Hypothesis:(1) Most athletes would fail to achieve proficiency in all domains of the Test of Gross Motor Development (TGMD-2), (2) highly specialized athletes would demonstrate lower proficiency in all domains of the TGMD-2, and (3) male athletes would demonstrate higher proficiency than female athletes.Study Design:Cross-sectional.Level of Evidence:Level 4.Methods:A total of 91 athletes were recruited (44 male, 12.6 ± 0.9 years). Activity level was quantified using the Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (Pedi-FABS), specialization level was determined using the Jayanthi Specialization Scale, and the TGMD-2 was used to assess FMS proficiency. Descriptive statistics were used to describe gross motor, locomotor, and object control percentile rank. A 1-way analysis of variance (ANOVA) was used to assess differences in percentile rank between low, moderate, and high specialization groups and independent samples t tests were used to compare sexes (α < 0.05).Results:Mean Pedi-FABS score was 23.6 ± 4.9. In total, 24.2%, 38.5%, and 37.4% of athletes classified as low, moderate, and highly specialized, respectively. Mean percentile ranks were 56.2%, 64.7%, and 62.6% for locomotor, object control, and gross motor domains, respectively. No athlete achieved a percentile rank>99% in any domain of the TGMD-2, and there was no significant difference between specialization groups or sex.Conclusion:Despite high activity levels, no athlete demonstrated proficiency in any domain of the TGMD-2, and there was no difference in proficiency between specialization levels or by sex.Clinical Relevance:Sport participation, regardless of level, does not ensure adequate mastery of FMS.
      Citation: Sports Health
      PubDate: 2023-06-17T04:59:39Z
      DOI: 10.1177/19417381231178822
       
  • In-Game Workload Demands of Position Players in Major League Baseball

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      Authors: Jonathan Freeston, Lonnie Soloff, Mark Schickendantz, Jason Genin, Salvatore Frangiamore, Rod Whiteley
      Abstract: Sports Health, Ahead of Print.
      Background:Athletes who are well prepared for the physical demands of competition are less susceptible to injury. Defining and then preparing athletes for these in-game demands is critical to athlete health and performance. The injury burden within Major League Baseball (MLB) is significant and differs by position. Despite its importance, the workload demands have not been described for position players in MLB.Hypothesis:That running demands would be significantly higher for outfielders, followed by infielders, and catchers, respectively, while batting and baserunning metrics would be similar across positions.Study Design:Cohort study.Level of Evidence:Level 3.Methods:Total and high-speed running distance (>75% Vmax), high-speed running count, hard accelerations (>2.78 m/s/s), defensive and baserunning minutes, total and hard throws (>75% max), and bat swing counts were calculated from Statcast data. Players with 100 games or more in the 2018 season (n = 126) were included for analysis.Results:All offensive and baserunning metrics were similar across positions; however, significant positional differences were observed for defensive and overall workload metrics. High-speed running was highest among outfielders (F1,7 = 27.1, P < 0.01), followed by infielders, then catchers. Hard accelerations (F1,7 = 12.9, P < 0.01) were highest among first basemen, then outfielders, remaining infielders, and catchers. Total throws (F1,7 = 17.7, P < 0.01) were highest among middle infielders. Hard throws (P < 0.01) were highest among shortstops and third basemen.Conclusion:In-game workloads differ significantly by defensive position in MLB. These differences in running, throwing, and hitting volumes have significant implications for physical preparation and injury return-to-play progressions to optimize performance and minimize injury and reinjury risk for these athletes.Clinical Relevance:These data provide insight into how best to prepare athletes of different positions for the demands of the game both in terms of preseason preparation as well as return-to-play benchmarks following injury. These data should also serve as a platform for future research into the relationship between workload and injury among professional baseball players.
      Citation: Sports Health
      PubDate: 2023-06-16T10:42:10Z
      DOI: 10.1177/19417381231179970
       
  • How Mental Health Affects Injury Risk and Outcomes in Athletes

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      Authors: Davis L. Rogers, Miho J. Tanaka, Andrew J. Cosgarea, Richard D. Ginsburg, Geoffrey M. Dreher
      Abstract: Sports Health, Ahead of Print.
      Context:The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care.Evidence Acquisition:We searched PubMed for pertinent peer-reviewed studies.Study Design:Clinical review.Level of Evidence:Level 5.Results:There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes.Conclusion:Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
      Citation: Sports Health
      PubDate: 2023-06-16T10:39:38Z
      DOI: 10.1177/19417381231179678
       
  • Hamstring Strains: Classification and Management

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      Authors: Jordan H. Larson, Thomas W. Fenn, Sachin Allahabadi, Shane J. Nho
      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2023-06-06T10:13:42Z
      DOI: 10.1177/19417381231175880
       
  • Exercise Intensity and Activity Energy Expenditure of Professional Golf
           Players in Official Competitive Setting

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      Authors: Filippo Scalise, Ferruccio Cavanna, Chiara Godio, Egidio P. Beretta
      Abstract: Sports Health, Ahead of Print.
      Background:Research regarding the physical needs of professional golf players is lacking. With advances in wearable technology, it has become easier to analyze physiological responses such as heart rate (HR) to determine activity energy expenditure (AEE). The purpose of the study was to evaluate exercise intensity (EI) and AEE during 4 consecutive tournament’s golf rounds using a popular wrist-based HR monitoring.Hypothesis:Wearable systems for HR monitoring can be used to provide an accurate estimate of energy expenditure.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:A total of 20 male professional golfers participated in the study. Each player was monitored during an official tournament consisting of 4 rounds of 18 holes. EI and AEE were determined using HR wrist monitoring (Whoop Strap 2.0). We calculated the percentage of HRmax (%HRmax) and the percentage of HRres (%HRres) and the AEE in kcal/min using Keytel’s formula.Results:The calculated mean %HRmax and %HRres for the study population were 56.4% ± 1.8% and 40.5% ± 2.6%, respectively. Considering American College of Sports Medicine guidelines, these average percentages correspond to a moderate EI. The average caloric expenditure was 5.4 ± 0.4 kcal/min and 1555.8 ± 157.8 kcal per round considering an average golf round duration of 288.3 ± 19.5 minutes.Conclusion:A professional player’s golf round is moderate physical activity. The AEE of this activity was equal to 5.4 cal/min, which is moderate energy consumption.Clinical Relevance:These data could help golf coaches and conditioning coaches to have a better understanding of the load placed on golfers during tournaments.
      Citation: Sports Health
      PubDate: 2023-06-06T09:48:37Z
      DOI: 10.1177/19417381231175149
       
  • Effects of 8 Weeks of Balance Training, Virtual Training, and Combined
           Exercise on Lower Limb Muscle Strength Balance, and Functional Mobility
           Among Older Men: A Randomized Controlled Trial: Letter to the Editor

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      Authors: Nidhi Sharma, Parveen Kumar, Simranjeet Kaur, Nidhi Sharma
      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2023-05-29T09:01:14Z
      DOI: 10.1177/19417381231175478
       
  • Effects of 8 Weeks of Balance Training, Virtual Training, and Combined
           Exercise on Lower Limb Muscle Strength Balance, and Functional Mobility
           Among Older Men: A Randomized Controlled Trial: Response

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      Authors: Hassan Sadeghi, Deborah A. Jehu, Abdolhamid Daneshjoo
      Abstract: Sports Health, Ahead of Print.

      Citation: Sports Health
      PubDate: 2023-05-29T08:56:54Z
      DOI: 10.1177/19417381231175477
       
  • Rotator Cuff Injuries in the Pediatric Population: A Retrospective Review
           of Patient Characteristics and Treatment at a Single Center

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      Authors: Kathleen L. Harwood, Karina Oganezova, Kevin J. Orellana, Katherine Ashe, Brendan A. Williams, John G. Horneff
      Abstract: Sports Health, Ahead of Print.
      Background:As youth participation in contact and overhead sports has increased in recent decades, so has the occurrence of injuries of the shoulder. Rotator cuff injury (RCI) is an infrequent shoulder pathology in pediatric patients and its description in the literature has been scarce. A greater understanding of RCI characteristics and treatment outcomes in children and adolescents would improve our understanding of this pathology and help to better guide clinical decision-making.Hypothesis:To identify pediatric patients with magnetic resonance imaging-confirmed RCI treated at a single center to summarize injury characteristics, treatment, and outcomes. It was hypothesized that injuries would occur predominantly in overhead throwing athletes and would demonstrate good outcomes among both operatively and nonoperatively treated patients.Study Design:Cross-sectional study.Level of Evidence:Level 4.Methods:A retrospective review of pediatric patients (
      Citation: Sports Health
      PubDate: 2023-05-29T08:43:55Z
      DOI: 10.1177/19417381231174021
       
  • A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of
           Primary Patellar Instability and Need for Recurrent Surgical Stabilization
           

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      Authors: Kenny Chang, J. Alex Albright, Matthew Quinn, Surya Khatri, Leon Zhao, Rory A. Byrne, Alan H. Daniels, Brett D. Owens
      Abstract: Sports Health, Ahead of Print.
      Background:Vitamin D has been proven experimentally to affect musculoskeletal health. The purpose of this study was to identify the relationship between vitamin D deficiency and patellar instability.Hypothesis:Vitamin D deficiency is associated with an increased risk of experiencing primary patellar instability and recurrent patellar dislocation after primary surgical stabilization.Study Design:Retrospective comparative study.Level of Evidence:Level 3.Methods:A 1:1 matched retrospective study of 328,011 patients diagnosed with vitamin D deficiency was performed using the PearlDiver database. Incidence of primary patellar instability was calculated according to sex and age. Rates of primary patellar instability and surgical stabilization for recurrent dislocation were calculated with sex- and age-specific stratifications. Multivariable logistic regression was used to compare the rates of primary injury and recurrent stabilization while controlling for demographics and medical comorbidities.Results:A total of 656,022 patients were analyzed. The overall 1-year incidence rate of patellar instability in patients with vitamin D deficiency was 82.6 per 100,000 person-years (95% CI, 73.2-92.9), compared with 48.5 (95% CI, 41.4-56.5) in the matched control. Women were significantly more likely to experience primary patellar instability within 1 (adjusted odds ratio [aOR] = 1.45; 95% CI, 1.12-1.88) and 2 years (aOR, 1.31; 95% CI, 1.07-1.59) of hypovitaminosis D diagnosis. Patients aged 10 to 25 years with hypovitaminosis D were at greater risk of requiring recurrent patellar stabilization for both men (aOR, 2.48; 95% CI, 1.06-5.80) and women (aOR, 1.77; 95% CI, 1.04-3.02).Conclusion:Patients diagnosed with vitamin D deficiency experienced higher rates of primary patellar instability and have greater risk of requiring recurrent surgical stabilization for subsequent dislocations.Clinical Relevance:These results suggest that monitoring and proactively treating vitamin D deficiency in the physically active patient may lower the risk of suffering primary patellar instability or recurrence after surgical stabilization.
      Citation: Sports Health
      PubDate: 2023-05-20T06:39:01Z
      DOI: 10.1177/19417381231172726
       
  • Athletic Fear Avoidance in Athletes Receiving Rehabilitation for
           Sport-Related Concussion: A Preliminary Study

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      Authors: Shuhei Suzuki, Carly L. Mattson, Michael C. Obermeier, Ann D. Casanova, Ann K. Doda, Layla A. Sayles, Aimee M. Custer, Terese L. Chmielewski
      Abstract: Sports Health, Ahead of Print.
      Background:Fear avoidance after musculoskeletal injury is avoiding activity due to fear of pain and contributes to persistent symptoms, depression, and disability. Little is known about fear avoidance for sport (athletic fear avoidance) in athletes with sport-related concussion (SRC).Hypothesis:Athletic fear avoidance after SRC would be elevated at the start of rehabilitation, improve over time, and be associated with postconcussion recovery outcomes.Study Design:Observational study.Level of Evidence:Level 4.Methods:Athletes in rehabilitation after SRC participated. Testing at initial and discharge visits and 6-month follow-up included Athletic Fear Avoidance Questionnaire (AFAQ), Postconcussion Symptom Scale (PCSS), Profile of Mood States (POMS), and Dizziness Handicap Inventory (DHI). Differences were explored in AFAQ score at initial testing based on sex or age (
      Citation: Sports Health
      PubDate: 2023-05-20T06:33:51Z
      DOI: 10.1177/19417381231172513
       
  • Does Headgear Prevent Sport-Related Concussion' A Systematic Review and
           Meta-Analysis of Randomized Controlled Trials Including 6311 Players and
           173,383 Exposure Hours

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      Authors: Wesam Saleh A. Al Attar, Hayam Mahmoud, Abdulaziz Alfadel, Oliver Faude
      Abstract: Sports Health, Ahead of Print.
      Context:A sport-related concussion (SRC) is a traumatic brain injury that is caused by biomechanical stresses and results in a complex pathophysiological process in the brain. Some in the sporting community believe that headgear (HG) can prevent SRC, and several professional Australian sports organizations, including rugby, football, and soccer clubs, recommend its use.Objective:The purpose of this study is to determine whether HG is effective in lowering the prevalence of SRC in sports.Data Sources:A systematic search for related studies published between 1985 and 2023 was conducted using the following databases: Cochrane Library, AMED, PubMed, Web of Science, and Physiotherapy Evidence Database (PEDro).Study Selection:Only randomized controlled trials (RCTs) that investigated the effectiveness of HG in reducing SRC rate were included.Study Design:Systematic review and meta-analysis of RCTs.Level of Evidence:Level 1a.Data Extraction:Two researchers independently completed the title and abstract search and performed full-text reviews. A third reviewer was consulted to reach a consensus if any discrepancies were noted. The PEDro scale was used to evaluate the quality of the included RCTs. Data recorded from each study included authors, year of publication, type and number of players, study design, duration of the study, injury rate, compliance (%), sports/level, and exposure hours.Results:The pooled results of 6311 players and 173,383 exposure hours showed 0% SRC reduction per 1000 hours of exposure in the experimental group compared with the control group, with an injury risk ratio of 1.03 (95% CI, 0.82-1.30; P = 0.79).Conclusion:This systematic review and meta-analysis demonstrates that HG does not prevent SRC among soccer and rugby players, and therefore the findings from this meta-analysis do not currently support the use of HG to prevent SRC in soccer or rugby.
      Citation: Sports Health
      PubDate: 2023-05-19T11:19:45Z
      DOI: 10.1177/19417381231174461
       
  • Results of a National Survey on Sport Specialization Behavior and Throwing
           Arm Injury in Youth Softball Players

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      Authors: Aaron Lear, Anne Marie Zeller, Suzy McNulty, Brett Bentley, Eric Post
      Abstract: Sports Health, Ahead of Print.
      Background:There are few data on throwing arm and shoulder injury in youth softball athletes, and no data on the influence of sport specialization on injury in softball.Hypothesis:We hypothesized that highly specialized athletes, and pitchers in particular, demonstrating various sport specialization behaviors would be more likely to report an upper extremity overuse injury in the previous 12 months.Study Design:Cross-sectional survey.Level of Evidence:Level 4.Methods:An online, anonymous, cross-sectional survey was distributed to a national sample of female youth softball players between the ages of 12 and 18 years in fall 2021. Topics included were indicators of sport specialization and self-reported injuries to the throwing arm.Results:A total of 1309 participants (mean age, 15.1 ± 1.7 years) completed the survey; 19.4% (N = 254) scored as highly specialized, 69.7% (N = 912) as moderately specialized, and 10.9% (N = 143) with low specialization. Of all participants, 27.3% (N = 357) pitched in the previous year. A minority of all players (43.7%; N = 572) reported arm injury in the previous 12 months, with 45.9% of pitchers (N = 164) reporting the same. Multivariate regression showed increased adjusted odds ratio (aOR) of injury history for athletes playing>30 games per year (aOR, 1.74; 95% CI, 1.26-2.40), participating on a club team (aOR, 3.36; 95% CI,1.85-6.07), and in pitchers participating on club teams (aOR, 2.97; 95% CI, 1.18-7.45). Decreased aOR of injury was noted in those participating in>8 months of softball per year (aOR, 0.25; 95% CI, 0.12-0.51) and in pitchers who were moderately specialized (aOR, 0.39; 95% CI, 0.17-0.92) and playing>8 months per year (aOR, 0.33; 95% CI, 0.11-0.96).Conclusion:This sample provides a large proportion of athletes classified as high or moderately specialized in youth softball (89%). A large proportion (43.7%) of subjects reported arm injury in the past year, and insight into injury risk is provided. The results present conflicting data on the risk versus protective effect of specialization in youth softball athletes.Clinical Relevance:This project is a first step toward understanding sport specialization behavior and its influence on injury in youth softball
      Citation: Sports Health
      PubDate: 2023-05-03T11:35:12Z
      DOI: 10.1177/19417381231171356
       
  • Association of Symptomatic Venous Thromboembolism and BMI in Patients
           Undergoing Sports Medicine Knee Procedures: A Retrospective Case-Control
           Study

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      Authors: Austin M. Looney, Aman Chopra, Seleem H. Elkadi, Justin Chau, Daniel F. Childers, Joon Chung, William F. Postma
      Abstract: Sports Health, Ahead of Print.
      Background:The purpose of this study was to characterize the prevalence of venous thromboembolism (VTE; including deep vein thrombosis [DVT] and pulmonary embolism [PE]) after sports medicine knee procedures by a single surgeon at an academic institution, identify factors associated with increased risk of VTE, and determine risk factor thresholds for beyond which VTE risk is elevated.Hypothesis:We hypothesized that the prevalence of VTE after sports medicine knee procedures is low, but that increasing weight and body mass index (BMI) would be associated with elevated risk.Study Design:Retrospective case-control study.Level of Evidence:Level 3.Methods:A retrospective case-control study analyzing sports medicine knee surgeries from 2017 to 2020 was conducted using current procedural terminology codes to identify cases. Optimal cutoff points for specific continuous patient characteristics were calculated to determine elevated risk of postoperative VTE. Overall VTE-free survival was assessed using Kaplan-Meier analysis and Cox proportional hazard regression models.Results:Among the 724 eligible patients, there were 13 postoperative VTE events (1.79% prevalence; 12 DVTs, 1 DVT/PE). Increasing weight and BMI were significant risk factors for postoperative VTE (P = 0.03 and P = 0.04, respectively), with weight>94.7 kg and BMI>27.9 kg/m2 associated with elevated risk in male patients and weight>79.1 kg and BMI>28.1 kg/m2 associated with elevated risk for female patients. Cox regression demonstrated a significantly increased risk of postoperative VTE for male patients with BMI ≥27.9 kg/m2.Conclusion:Patients who undergo sports medicine knee surgery with increased weight and BMI are at an elevated risk of postoperative VTE. An individualized approach should be considered for chemoprophylaxis in patients with these risk factors.Clinical Relevance:Consider chemoprophylaxis in patients with increased weight and BMI who undergo sports medicine knee surgery since they are at an elevated risk of postoperative VTE.
      Citation: Sports Health
      PubDate: 2023-04-28T11:58:25Z
      DOI: 10.1177/19417381231168786
       
  • Neuromotor Treatment of Arthrogenic Muscle Inhibition After Knee Injury or
           Surgery

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      Authors: Typhanie Dos Anjos, François Gabriel, Thais Dutra Vieira, Graeme Philip Hopper, Bertrand Sonnery-Cottet
      Abstract: Sports Health, Ahead of Print.
      Background:Persistent weakness of the quadriceps muscles and extension deficit after knee injuries are due to specific alterations in neural excitability - a process known as arthrogenic muscle inhibition (AMI). The effects of a novel neuromotor reprogramming (NR) treatment based on the use of proprioceptive sensations associated with motor imagery and low frequency sounds have not been studied in AMI after knee injuries.Hypothesis:This study aimed to assess quadriceps electromyographic (EMG) activity and the effects on extension deficits in persons with AMI who completed 1 session of NR treatment. We hypothesized that the NR session would activate the quadriceps and improve extension deficits.Study Design:Case series.Level of Evidence:Level 4.Methods:Between May 1, 2021 and February 28, 2022, patients who underwent knee ligament surgery or sustained a knee sprain with a deficit of>30% of the vastus medialis oblique (VMO) on EMG testing in comparison with the contralateral limb after their initial rehabilitation were included in the study. The maximal voluntary isometric contraction of the VMO measured on EMG, the knee extension deficit (distance between the heel and the table during contraction), and the simple knee value (SKV) were assessed before and immediately after completion of 1 session of NR treatment.Results:A total of 30 patients with a mean age of 34.6 ± 10.1 years (range, 14-50 years) were included in the study. After the NR session, VMO activation increased significantly, with a mean increase of 45% (P < 0.01). Similarly, the knee extension deficit significantly improved from 4.03 ± 0.69 cm before the treatment to 1.93 ± 0.68 after the treatment (P < 0.01). The SKV was 50 ± 5.43% before the treatment, and this increased to 67.5 ± 4.09% after the treatment (P < 0.01).Conclusion:Our study indicates that this innovative NR method can improve VMO activation and extension deficits in patients with AMI. Therefore, this method could be considered a safe and reliable treatment modality in patients with AMI after knee injury or surgery.Clinical Relevance:This multidisciplinary treatment modality for AMI can enhance outcomes through the restoration of quadriceps neuromuscular function and subsequent reduction of extension deficits after knee trauma.
      Citation: Sports Health
      PubDate: 2023-04-27T12:51:12Z
      DOI: 10.1177/19417381231169285
       
  • Estimates of Golf-Related Upper Extremity Injuries in the United States: A
           10-Year Epidemiology Study (2011-2020)

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      Authors: John Twomey-Kozak, Prince Boadi, Kate Rodriguez, Keith Whitlock, Jeff O’Donnell, Jack Magill, Oke Anakwenze, Christopher Klifto
      Abstract: Sports Health, Ahead of Print.
      Background:Golf is one of the most popular sports in the United States (US) and is played by participants of all ages and skill level. Given the popularity and sport-specific demands on the upper torso, golf poses a considerable risk for upper extremity (UE) injuries. Therefore, the aim of the current study was to (1) determine the incidence rate of UE golf injuries presenting to emergency departments (EDs) in the US, (2) determine the most commonly injured body parts and mechanisms of injury, and (3) compare current injury epidemiology with previous trends in the literature.Hypothesis:Male sex, bimodal age extremes (young and elderly), and utilization of golf carts (vs walking) are associated with a higher incidence of golf-related UE injuries.Study Design:Descriptive epidemiology study.Level of Evidence:Level 3.Methods:The National Electronic Injury Surveillance System (NEISS) is a statistically validated injury surveillance system that collects data from ED visits as a representative probability sample of hospitals in the US. We queried the NEISS for the years 2011 to 2020 to examine the following variables for golf-related UE injuries: sociodemographic, diagnosis, body part, and mechanism of injury.Results:From 2011 to 2020, there were a total of 1862 golf-related UE injuries presenting to participating EDs, which correlates to an estimated 70,868 total injuries. Overall, male golf players were disproportionately affected (69.2%) versus female golf players (30.8%) and the most commonly injured age groups were those aged>60 and 10 to 19 years. The most common injuries included fractures (26.8%), strains/sprains (23.4%), and soft tissue injuries (15.9%). The joints injured most frequently were the shoulder (24.8%), wrist (15.6%), and joints in the hand (12.0%). The most common mechanisms of injury were cart accidents (44.63%), falling/tripping (29.22%), and golf club swinging/mechanics (10.37%).Conclusion:Golf-related UE injuries can be acute or due to chronic overuse. Male athletes>60 years of age were the population most commonly presenting to the ED with a golf-related injury. Further, the shoulder, forearm, and wrist were most commonly injured. These findings are consistent with previous epidemiological trends in the literature. Interventions to reduce the incidence of injury should be sport-specific and focus primarily on equipment and golf cart safety and swing modification to optimize the biomechanical function of the UEs.Clinical Relevance:Our findings indicate that golf-related injury prevention programs should target UE injuries, particularly among young (60 years) golfers with poor swing mechanics.
      Citation: Sports Health
      PubDate: 2023-04-25T01:31:48Z
      DOI: 10.1177/19417381231168832
       
  • Ultrasound-Guided Glenohumeral Corticosteroid Injection for the Treatment
           of Adhesive Capsulitis of the Shoulder: The Role of Clinical Stage in
           Response to Treatment

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      Authors: Brittany M. Ammerman, Elizabeth R. Dennis, Daphne Ling, Jo A. Hannafin
      Abstract: Sports Health, Ahead of Print.
      Background:Treatment for idiopathic adhesive capsulitis of the shoulder remains controversial. Stages 1 to 2 reflect an inflammatory process supporting a rationale for intra-articular glenohumeral joint corticosteroid injection to treat synovial inflammation and prevent progression to capsular fibrosis.Hypothesis:We hypothesize that an intra-articular ultrasound-guided glenohumeral injection (USGI) of corticosteroid in patients diagnosed with Stage 1 or 2 idiopathic adhesive capsulitis will result in timely functional recovery and resolution of pain and stiffness.Study Design:Case series.Level of Evidence:Level 4.Methods:Patients with Stage 1 or 2 idiopathic adhesive capsulitis treated with an intra-articular corticosteroid injection were included. Patients were seen by a single physician and diagnosed using history and physical examination with careful attention to measurement of glenohumeral range of motion (ROM). A total of 61 patients met inclusion criteria. ROM measurements documented in the patient charts were recorded in forward flexion, abduction, internal rotation, and external rotation in neutral abduction. All ROM measurements were performed pre- and postinjection. All patients were treated with an USGI of local anesthetic and depomedrol. Recovery criteria were defined as forward flexion, abduction, and external rotation within 15° of the contralateral side and internal rotation within 3 spinous process levels of the contralateral side.Results:A total of 11 patients with Stage 1 and 50 patients with Stage 2 adhesive capsulitis comprised the final study cohort. Within the Stage 1 cohort, all 11 patients met recovery criteria for forward flexion and internal rotation (100%), 10 met recovery criteria for abduction (91%), and 8 met recovery criteria for external rotation (73%). Within the Stage 2 cohort, 31 patients met recovery criteria for forward flexion (62%), 30 met recovery criteria for abduction (60%), 36 met recovery criteria for internal rotation (72%), and 25 met recovery criteria for external rotation (50%). The difference in time to recovery in days was statistically significant in all ROM planes and was within 2 to 6 weeks for patients in Stage 1 and 7 to 10 weeks for Stage 2.Conclusion:USGI for early adhesive capsulitis allows patients to recover ROM more rapidly if performed early after onset of pain and stiffness.Clinical Relevance:These results stress the importance of recognition of idiopathic adhesive capsulitis in its early stages and subsequent intervention with an intra-articular glenohumeral corticosteroid injection.
      Citation: Sports Health
      PubDate: 2023-04-25T01:26:28Z
      DOI: 10.1177/19417381231168799
       
  • Relationship Between Caffeine Consumption and Young Athletes’
           Comorbidities, Exercise-Related Symptoms, and Baseline Electrocardiogram

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      Authors: Jason Farber, Sean Dikdan, Max Ruge, Drew Johnson, David Shipon
      Abstract: Sports Health, Ahead of Print.
      Background:Caffeine consumption causes diverse physiologic effects that can affect athletes both positively and negatively. There is a lack of research investigating the long-term effects of caffeine intake on exercise and on overall cardiovascular health in young athletes.Hypothesis:Certain characteristics such as age, body mass index (BMI), race, and medical diagnoses are associated with increased caffeine use, and there is a relationship between caffeine consumption and symptoms during exercise and cardiovascular abnormalities in young athletes.Study Design:Cross-sectional study.Level of Evidence:Level 4.Methods:This study utilized the HeartBytes National Youth Cardiac Registry to collect data related to demographics, caffeine use, and physical examination and electrocardiogram (ECG) findings of 7425 12- to 20-year-olds (60.6% male, 39.4% female) who attended a Simon’s Heart cardiac screening event between 2014 and 2021. Univariable and multivariable logistic regression models were used for analysis.Results:Persons who consumed caffeine were more likely to have attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio [aOR], 1.43; CI, 1.15-1.76]; P < 0.01) and more likely to have a BMI ≥30 kg/m2 (aOR, 1.69; CI, 1.27-2.25]; P < 0.01) compared with nondrinkers. After controlling for age, gender, race, and BMI, there were no significant differences in symptoms during exercise (aOR, 1.27; CI, 0.97-1.66; P = 0.08) or abnormal ECG findings (OR, 0.93; CI, 0.66-1.31; P = 0.70) between those who consume caffeine and those who do not.Conclusion:Caffeine consumption was associated with increased BMI and increased likelihood of having ADHD; however, caffeine use overall was not associated with increased risk of symptoms during exercise or ECG abnormalities.Clinical Relevance:Whereas caffeine consumption overall did not increase risk of exercise-related symptoms, soda drinkers were at higher risk for symptoms during exercise, and coffee drinkers were at higher risk of syncope with exercise. Prospective studies with longitudinal follow-up and more specific outcomes data is the next step in qualifying the impact of caffeine on young athletes.
      Citation: Sports Health
      PubDate: 2023-04-22T05:18:34Z
      DOI: 10.1177/19417381231168828
       
  • Comparison of Muscle Coordination During Front Crawl and Backstroke With
           and Without Swimmer’s Shoulder Pain

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      Authors: Yuiko Matsuura, Naoto Matsunaga, Hiroshi Akuzawa, Tomoki Oshikawa, Koji Kaneoka
      Abstract: Sports Health, Ahead of Print.
      Background:Shoulder pain, known as swimmer’s shoulder, is the most common injury for swimmers. Studies that have analyzed muscle activity have focused on the shoulder joint. However, the whole-body muscle coordination of swimmers with swimmer’s shoulder is not clear, although swimming requires movements of the upper limbs, trunk, and lower limbs to obtain propulsive force. This study investigated differences in muscle coordination between swimmers with and without swimmer’s shoulder during the front crawl and backstroke using muscle synergy analysis.Hypothesis:Swimmers with swimmer’s shoulder have muscle synergies differing from those without it.Study Design:Case-control study.Level of Evidence:Level 4.Methods:A total of 20 elite swimmers who regularly swam front crawl and backstroke were included (swimmer’s shoulder, n = 8; control, n = 12). Muscle synergy data were analyzed using the nonnegative matrix factorization method and compared between groups.Results:For both front crawl and backstroke, there were 2 synergies in the control group and 3 synergies in the swimmer’s shoulder group. During recovery, the control group showed coordinated triceps brachii, serratus anterior, upper trapezius, lower trapezius, internal oblique, and external oblique muscles activities; however, in the swimmer’s shoulder group, the contribution of the upper limbs decreased and only that of the trunk muscles increased.Conclusion:A comparison of muscle coordination during the front crawl and backstroke performed by swimmers with and without swimmer’s shoulder revealed that coordination differed during the recovery phase. During both front crawl and backstroke, the swimmer’s shoulder group could not maintain coordination with the upper limb when the trunk rolled, and split synergy was formed between the upper limbs and trunk.Clinical Relevance:Because coordination of the upper limbs and trunk is important during the recovery phase of front crawl and backstroke, swimmer’s shoulder rehabilitation should introduce exercises to improve their coordination between the upper limbs and the trunk.
      Citation: Sports Health
      PubDate: 2023-04-12T06:10:32Z
      DOI: 10.1177/19417381231166957
       
  • Biomechanical Effects of Manipulating Preferred Cadence During Treadmill
           Walking in Patients With ACL Reconstruction

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      Authors: Steven A. Garcia, Alexa K. Johnson, Marissa Orzame, Riann M. Palmieri-Smith
      Abstract: Sports Health, Ahead of Print.
      Background:Abnormal gait is common after anterior cruciate ligament reconstruction (ACLR) which may influence osteoarthritis risk in this population. Yet few gait retraining options currently exist in ACLR rehabilitation. Cueing cadence changes is a simple, low-cost method that can alter walking mechanics in healthy adults, but few studies have tested its effectiveness in an ACLR population. Here, we evaluated the acute effects of altering cadence on knee mechanics in patients 9 to 12 months post ACLR.Hypothesis:Cueing larger steps will facilitate larger knee angles and moments, while cueing smaller steps would induce smaller knee angles and moments.Study Design:Randomized cross-sectional design.Level of Evidence:Level 3.Methods:Twenty-eight patients with unilateral ACLR underwent gait assessments on a treadmill at preferred pace. Preferred walking gait was assessed first to obtain preferred cadence. Participants then completed trials while matching an audible beat set to 90% and 110% of preferred cadence in a randomized order. Three-dimensional sagittal and frontal plane biomechanics were evaluated bilaterally.Results:Compared with preferred cadence, cueing larger steps induced larger peak knee flexion moments (KFMs) and knee extension excursions bilaterally (P < 0.01), whereas cueing smaller steps only reduced knee flexion excursions (P < 0.01). Knee adduction moments remain unchanged across conditions and were similar between limbs (P> 0.05). Peak KFMs and excursions were smaller in the injured compared with uninjured limb (P < 0.01).Conclusion:Frontal plane gait outcomes were unchanged across conditions suggesting acute cadence manipulations result in mainly sagittal plane adaptations. Follow-up studies using a longitudinal cadence biofeedback paradigm may be warranted to elucidate the utility of this gait retraining strategy after ACLR.Clinical Relevance:Cueing changes in walking cadence can target sagittal plane knee loading and joint range of motion in ACLR participants. This strategy may offer high clinical translatability given it requires relatively minimal equipment (ie, free metronome app) outside of a treadmill.
      Citation: Sports Health
      PubDate: 2023-04-06T12:19:31Z
      DOI: 10.1177/19417381231163181
       
  • Virtual Reality Application for Vestibular/Ocular Motor Screening: Current
           Clinical Protocol Versus a Novel Prototype

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      Authors: Philip Pavilionis, Isayas Berhe Adhanom, Ryan Moran, Madison R. Taylor, Nicholas G. Murray
      Abstract: Sports Health, Ahead of Print.
      Background:Virtual reality (VR) has been explored to improve baseline and postinjury assessments in sport-related concussion (SRC). Some experience symptoms related to VR, unrelated to concussion. This may deter use of vestibular/ocular motor screening (VOMS) using VR. Baseline VR VOMS symptomatology differentiates baseline from overall symptomatology.Hypothesis:There will be no difference between current clinical manual VOMS (MAN), a clinical prototype (PRO), and VR for symptom provocation change score (SPCS) and near point of convergence (NPC) average score in a healthy population and sex differences among the 3 modes of administration.Study Design:Cohort study.Level of Evidence:Level 3.Methods:A total of 688 National Collegiate Athletic Association Division I student-athletes completed VOMS using 3 methods (MAN, N = 111; female athletes, N = 47; male athletes, N = 64; average age, 21 years; PRO, N = 365; female athletes, N = 154; male athletes, N = 211; average age, 21 years; VR, N = 212; female athletes, N = 78; male athletes, N = 134; average age = 20 years) over a 3-year period (2019-2021) during annual baseline testing. Exclusion criteria were as follows: self-reported motion sickness in the past 6 months, existing or previous neurological insult, attention deficit hyperactivity disorder, learning disabilities, or noncorrected vision impairment. Administration of MAN followed the current clinical protocols, PRO used a novel prototype, and VR used an HTC Vive Pro Eye head mounted display. Symptom provocation was compared using Mann-Whitney U tests across each VOMS subtest with total SPCS and NPC average by each method.Results:MAN had significantly (P < 0.01) more baseline SPCS (MAN = 0.466 ± 1.165, PRO = 0.163 ± 0.644, VR = 0.161 ± 0.933) and significantly (P < 0.01) and more SPCS (MAN = 0.396 ± 1.081, PRO = 0.128 ± 0.427, VR = 0.48 ± 0.845) when compared with PRO and VR. NPC average measurements for VR (average, 2.99 ± 0.684 cm) were significantly greater than MAN (average, 2.91 ± 3.35 cm; P < 0.01; Cohen’s d = 0.03) and PRO (average, 2.21 ± 1.81 cm; P < 0.01; Cohen’s d = 0.57). For sex differences, female athletes reported greater SPCS with PRO (female athletes, 0.29 ± 0.87; male athletes, 0.06 ± 0.29; P < 0.01) but not in VR or MAN.Conclusion:Using a VR system to administer the VOMS may not elicit additional symptoms, resulting in fewer false positives and is somewhat stable between sexes.Clinical Relevance:VOMS may allow for standardization among administrators and reduce possible false positives.
      Citation: Sports Health
      PubDate: 2023-03-29T12:45:04Z
      DOI: 10.1177/19417381231163158
       
  • Paresthesia Is Predictive of Symptom Recurrence After Fasciotomy for
           Exertional Compartment Syndrome of the Leg

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      Authors: Dhruv S. Shankar, Anna M. Blaeser, Lauren A. Gillinov, Kinjal D. Vasavada, Babatunde B. Fariyike, Edward S. Mojica, Lauren E. Borowski, Laith M. Jazrawi, Dennis A. Cardone
      Abstract: Sports Health, Ahead of Print.
      Background:Exertional compartment syndrome (ECS) is an underdiagnosed cause of lower extremity pain among athletes. The condition can be managed operatively by fasciotomy to relieve excess compartment pressure. However, symptom recurrence rates after fasciotomy are considerable, ranging from 3% to 17%.Hypothesis:Leg paresthesia and its distribution during ECS episodes would be a significant predictor of outcomes after fasciotomy.Study Design:Retrospective cohort study.Level of Evidence:Level 4.Methods:We conducted a retrospective chart review of patients who underwent fasciotomy for ECS at our center from 2010 to 2020 (institutional review board no. 21-00107). We measured postoperative outcomes including pain frequency and severity, Tegner activity level, and return to sport. Significant predictors of outcomes were identified using multivariable linear and logistic regression. P values
      Citation: Sports Health
      PubDate: 2023-03-23T12:11:55Z
      DOI: 10.1177/19417381231160164
       
  • Multifactorial Exercise Intervention Decreases Falls Risk in High-risk and
           Low-risk Older Adults

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      Authors: Amanda Estep, Steven Morrison, Shane V. Caswell, Jatin P. Ambegaonkar, João R Vaz, Nelson Cortes
      Abstract: Sports Health, Ahead of Print.
      Background:Each year, 1 in 4 people over the age of 65 years of age will experience a fall. It is important to identify and address modifiable risk factors that are associated with falls in adults at high and low risk for falls.Hypothesis:Falls risk improves in both high-risk and low-risk participants with the implementation of Stay Active and Independent for Life (SAIL).Study Design:Cohort studyLevel of Evidence:Level 3.Methods:Seventy-eight older adults (age, 70.9 ± 5.1 years) were included in this study and categorized into high risk and low risk for falling based on the falls risk score from the Physiological Profile Assessment. High risk was defined as having a preintervention falls risk score>1, whereas low risk was defined as having a preintervention falls risk score
      Citation: Sports Health
      PubDate: 2023-03-22T05:27:04Z
      DOI: 10.1177/19417381231158658
       
  • Female Athletes With Better Psychological Readiness Are at Higher Risk for
           Second ACL Injury After Primary ACL Reconstruction

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      Authors: Ryan Zarzycki, Kathleen Cummer, Elanna Arhos, Mathew Failla, Jacob J. Capin, Angela H Smith, Lynn Snyder-Mackler
      Abstract: Sports Health, Ahead of Print.
      Background:Approximately 1 in 4 athletes returning to sports will sustain a second anterior cruciate ligament (ACL) injury. Psychological factors related to kinesiophobia, confidence, and psychological readiness are associated with second ACL injury; however, the evidence is conflicting.Hypothesis:Athletes who sustain a second ACL injury (ie, graft rupture or contralateral ACL rupture) within 2 years of ACL reconstruction (ACLR) would have greater kinesiophobia, less confidence, and lower psychological readiness prior to return to sport (RTS) compared with athletes who do not sustain a second ACL injury.Study Design:Secondary analysis of a prospective randomized trial.Level of Evidence:Level 3.Methods:A total of 39 female Level I/II athletes completed the following measures after postoperative rehabilitation and a 10-session RTS and second ACL injury prevention program: ACL Return to Sport after Injury (ACL-RSI) scale, the 11-item Tampa Scale of Kinesiophobia (TSK-11), and question 3 on the Knee injury and Osteoarthritis Outcome Score (KOOS) quality of life (QoL) subscale. Athletes were dichotomized based on whether they sustained a second ACL injury within 2 years of ACLR or not. Independent t tests determined group differences in TSK-11, KOOS-QoL, ACL-RSI, and the 3 individual components of the ACL-RSI (ie, emotions, confidence, risk appraisal).Results:Nine athletes sustained a second ACL injury (4 graft ruptures and 5 contralateral ACL ruptures). The group that sustained a second ACL injury had higher scores on the ACL-RSI (P = 0.03), higher on the risk appraisal questions of the ACL-RSI (P < 0.01), and met RTS criteria sooner than athletes who did not (P = 0.04). All second ACL injuries occurred in athletes who underwent primary ACLR with hamstring tendon autografts.Conclusion:Athletes who sustained a second ACL within 2 years of ACLR had a more positive psychological outlook, higher scores on the specific questions related to the risk appraisal construct of the ACL-RSI, and met RTS criteria sooner than athletes who did not sustain a second ACL injury.Clinical Relevance:Counseling athletes about delaying RTS to reduce the risk of second ACL injury may be especially important in athletes who display high psychological readiness and meet RTS criteria sooner.
      Citation: Sports Health
      PubDate: 2023-03-20T06:08:01Z
      DOI: 10.1177/19417381231155120
       
  • The Nature of Rehabilitation Programs to Improve Musculoskeletal,
           Biomechanical, Functional, and Patient-Reported Outcomes in Athletes With
           ACL Reconstruction: A Scoping Review

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      Authors: Kelly Poretti, Navid Ghoddosi, Joel Martin, Oladipo Eddo, Nelson Cortes, Nicholas C. Clark
      Abstract: Sports Health, Ahead of Print.
      Context:After anterior cruciate ligament (ACL) reconstruction (ACLR), athletes commonly undergo prolonged rehabilitation (eg, 9-12 months), but few actually return to preinjury sports activities. The nature (composition, configuration) of an ACL rehabilitation program (ACL-RP) is an important factor in determining rehabilitation outcomes; however, details about the nature of ACL-RPs are reported inconsistently in research studies. To guide future research reporting to support clinical translation and implementation of ACL-RPs, it is necessary to describe the nature, reporting, and outcomes of ACL-RPs in the current literature.Objective:The purpose of this scoping review was to understand the nature and reporting of various ACL-RPs that address musculoskeletal, biomechanical, functional, or patient-reported outcome measures in adult and pediatric athletes with ACLR.Data Sources:Articles were selected from searches in 5 electronic databases (PubMed, EbscoHost [MEDLINE, SportDiscus, CINAHL Plus], PROQuest, Cochrane, and Embase).Study Selection:Studies were included if they evaluated a post-ACL-RP that implemented strength, balance, plyometric, change of direction running, and/or agility running and included self-reported physical function, quality of life, or pain outcomes.Study Design:Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines.Level of Evidence:Level 4.Data Extraction:Data were extracted and synthesized to evaluate the reporting of acute program variables (APVs) and exercise descriptors (EDs); 17 studies were included in the final synthesis.Results:Studies reported between 0% and 67% of the APVs and EDs combined. Only 2 studies were considered to have adequate reporting of both APVs and EDs.Conclusion:Inadequate reporting of APVs and EDs in past studies restricts the translation and implementation of existing research-based ACL-RPs to present-day clinical contexts.
      Citation: Sports Health
      PubDate: 2023-03-17T01:25:12Z
      DOI: 10.1177/19417381231158327
       
  • Reduced Match Exposure in the Previous 2 Matches Accounts for Hamstring
           Muscle Injury Incidence in Professional Football Players

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      Authors: Víctor Moreno-Pérez, Juan Del Coso, Roberto López-Del Campo, Ricardo Resta, José Romero-Sangüesa, Javier Courel-Ibáñez, Alberto Méndez-Villanueva
      Abstract: Sports Health, Ahead of Print.
      Background:Hamstring strain injuries are one of the most prevalent injuries in football (soccer). We examined the influence of accumulated match-play exposure on the occurrence of hamstring strain injury in professional football from 2 teams (Spanish 1st Division, LaLiga) over 3 seasons, and determined specific cut-off points as indicators of injury risk.Hypothesis:Overloaded players would be more likely to sustain a hamstring injury.Study Design:Prospective, controlled, observational study.Level of Evidence:Level 2b.Methods:Playing time, total running distance, and high-speed running (>24 km/h) distance during official matches of players that sustained a hamstring injury were compared with uninjured, paired controls. Cumulative playing time and running performance of 4 matches before the injury was computed. Relative risk (RR) of injury occurrence was estimated by generalized estimating equations. Diagnostic accuracy was determined by receiver operating characteristics and the area under the curve.Results:Thirty-seven hamstring strain injuries occurred, representing 23 ± 18 absence days per injury. Thirty-seven controls (uninjured players) were used as comparators. Low match-play exposures during 1 and 2 matches before injury were likely to explain injury occurrence (RR: 14-53%; P < 0.01). Metrics from the match before the hamstring muscle strain demonstrated the best accuracy to predict injury occurrence: high-speed running distance ≤328 m (sensitivity, 64%; specificity, 84%), playing time ≤64 min (sensitivity, 36%; specificity, 97%), and running distance ≤5.8 km (sensitivity, 39%; specificity, 97%).Conclusion:Relatively reduced competitive exposure in the previous 2 matches was associated with higher hamstring injury risk in professional football players.Clinical Relevance:Screening simple metrics such as the accumulated match exposure during official matches and considering specific cut-off points for some running variables may be good indicators of injury risk and may assist in better individual injury management in professional soccer players.
      Citation: Sports Health
      PubDate: 2023-03-10T09:39:50Z
      DOI: 10.1177/19417381231158117
       
  • Only 10% of Patients With a Concomitant MCL Injury Return to Their
           Preinjury Level of Sport 1 Year After ACL Reconstruction: A Matched
           Comparison With Isolated ACL Reconstruction

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      Authors: Eleonor Svantesson, Ramana Piussi, Susanne Beischer, Christoffer Thomeé, Kristian Samuelsson, Jón Karlsson, Roland Thomeé, Eric Hamrin Senorski
      Abstract: Sports Health, Ahead of Print.
      Background:There is a need for an increased understanding of the way a concomitant medial collateral ligament (MCL) injury may influence outcome after anterior cruciate ligament (ACL) reconstruction.Hypothesis:Patients with a concomitant MCL injury would have inferior clinical outcomes compared with a matched cohort of patients undergoing ACL reconstruction without an MCL injury.Study Design:Matched registry-based cohort study; case-control.Level of Evidence:Level 3.Methods:Data from the Swedish National Knee Ligament Registry and a local rehabilitation outcome registry were utilized. Patients who had undergone a primary ACL reconstruction with a concomitant nonsurgically treated MCL injury (ACL + MCL group) were matched with patients who had undergone an ACL reconstruction without an MCL injury (ACL group), in a 1:3 ratio. The primary outcome was return to knee-strenuous sport, defined as a Tegner activity scale ≥6, at the 1-year follow-up. In addition, return to preinjury level of sport, muscle function tests, and patient-reported outcomes (PROs) were compared between the groups.Results:The ACL + MCL group comprised 30 patients, matched with 90 patients in the ACL group. At the 1-year follow-up, 14 patients (46.7%) in the ACL + MCL group had return to sport (RTS) compared with 44 patients (48.9%) in the ACL group (P = 0.37). A significantly lower proportion of patients in the ACL + MCL group had returned to their preinjury level of sport compared with the ACL group (10.0% compared with 25.6%, adjusted P = 0.01). No differences were found between the groups across a battery of strength and hop tests or in any of the assessed PROs. The ACL + MCL group reported a mean 1-year ACL-RSI after injury of 59.4 (SD 21.6), whereas the ACL group reported 57.9 (SD 19.4), P = 0.60.Conclusion:Patients with a concomitant nonsurgically treated MCL injury did not return to their preinjury level of sport to the same extent as patients without an MCL injury 1 year after ACL reconstruction. However, there was no difference between the groups in terms of return to knee strenuous activity, muscle function, or PROs.Clinical Relevance:Patients with a concomitant nonsurgically treated MCL injury may reach outcomes similar to those of patients without an MCL injury 1 year after an ACL reconstruction. However, few patients return to their preinjury level of sport at 1 year.
      Citation: Sports Health
      PubDate: 2023-03-10T09:37:56Z
      DOI: 10.1177/19417381231157746
       
  • Improved Outcome With Knee Arthroscopy Relative to Physiotherapy for
           Symptomatic Unstable Meniscal Tears: 2-Year Prospective Cohort Study

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      Authors: Mark D. Porter, Bruce Shadbolt
      Abstract: Sports Health, Ahead of Print.
      Background:Although preservation of meniscal tissue is paramount, there are occasions when repair of a torn meniscus is not possible. The surgical option may be a partial meniscectomy, the objective being to alleviate the patient’s symptoms with resection of only that portion of the meniscus that is no longer functioning but is the cause of symptoms. Previous studies have questioned the need to perform such surgery and have recommended nonoperative treatment instead. Our goal was to compare the outcome of partial meniscectomy with that of physiotherapy alone for irreparable meniscal tears.Hypothesis:Clinical outcome following arthroscopic partial meniscectomy may differ from that following physiotherapy alone, for patients with symptomatic irreparable meniscal tears.Study Design:Nonrandomized prospective cohort study.Level of Evidence:Level 2.Methods:Patients satisfying the inclusion criteria chose to undergo knee arthroscopy (group A) or physiotherapy (group B). The diagnosis of a meniscal tear was made on physical assessment and magnetic resonance imaging examination. The meniscal tear was preventing them from continuing with their regular weightbearing exercise. Outcomes of interest were the following patient-reported outcomes (PROs): the Knee Osteoarthritis Outcome Score (KOOS) and Tegner Activity Score (TAS), with minimal clinically important differences being 10 and 1, respectively. PROs were completed at baseline, and at 1-year and 2-year follow-up. Changes in scores within and between groups were compared using analysis of variance and Wilcoxon tests (P 0.05. At both 1-year and 2-year follow-up, Group A had higher scores in the mean total KOOS (88.8, SD 8.0 vs 72.4, SD 3.8), as well as in all subscales within the KOOS, and the TAS (median 7, range 5-9 vs median 5, range 3-6), with P
      Citation: Sports Health
      PubDate: 2023-03-10T09:31:09Z
      DOI: 10.1177/19417381231156378
       
  • The Variability of Recovery From Pediatric Concussion Using Multimodal
           Clinical Definitions

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      Authors: Daniel J. Corwin, Kristina B. Metzger, Catherine C. McDonald, Melissa R. Pfeiffer, Kristy B. Arbogast, Christina L. Master
      Abstract: Sports Health, Ahead of Print.
      Background:While concussions are common pediatric injuries, a lack of agreement on a standard definition of recovery creates multiple challenges for clinicians and researchers alike.Hypothesis:The percentage of concussed youth deemed recovered as part of a prospective cohort study will differ depending on the recovery definition.Study Design:Descriptive epidemiologic study of a prospectively enrolled observational cohortLevel of Evidence:Level 3.Methods:Participants aged 11 to 18 years were enrolled from the concussion program of a tertiary care academic center. Data were collected from initial and follow-up clinical visits ≤12 weeks from injury. A total of 10 recovery definitions were assessed: (1) cleared to full return to sports; (2) return to full school; (3) self-reported return to normal; (4) self-reported full return to school; (5) self-reported full return to exercise; (6) symptom return to preinjury state; (7) complete symptom resolution; (8) symptoms below standardized threshold; (9) no abnormal visio-vestibular examination (VVE) elements; and (10) ≤1 abnormal VVE assessments.Results:In total, 174 participants were enrolled. By week 4, 63.8% met at least 1 recovery definition versus 78.2% by week 8 versus 88.5% by week 12. For individual measures of recovery at week 4, percent recovered ranged from 5% by self-reported full return to exercise to 45% for ≤1 VVE abnormality (similar trends at 8 and 12 weeks).Conclusion:There is wide variability in the proportion of youth considered recovered at various points following concussion depending on the definition of recovery, with higher proportions using physiologic examination-based measures and lower proportions using patient-reported measures.Clinical Relevance:These results further emphasize the need for a multimodal assessment of recovery by clinicians as a single and standardized definition of recovery that captures the broad impact of concussion on a given patient continues to be elusive.
      Citation: Sports Health
      PubDate: 2023-03-10T09:29:30Z
      DOI: 10.1177/19417381231152448
       
  • Differences in Short-Term Sport-Specific Functional Recovery After Primary
           ACL Reconstruction in the Adolescent Athlete

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      Authors: W. Craig Kemper, Connor M. Carpenter, K. John Wagner, Chien-Cheng Chen, Laura Saleem, Philip L. Wilson, Henry B. Ellis
      Abstract: Sports Health, Ahead of Print.
      Background:Although anterior cruciate ligament (ACL) injury rates have been studied extensively, it is unclear whether levels of functional and psychological readiness for return-to-sport after primary ACL reconstruction (ACLR) differ based on an athlete’s primary sport.Hypothesis:Youth athletes in different primary sports will demonstrate differences in short-term functional recovery, as well as patient-reported psychological and functional recovery after primary ACLR.Study Design:Retrospective cohort study of consecutive patients treated for ACL injury in pediatric sports medicine clinics.Level of Evidence:Level 3.Methods:Patients included underwent primary ACLR between December 1, 2015 and December 31, 2019 and reported sports participation at the time of injury. Demographic data, sports participation, surgical data, functional testing scores (Y-Balance Test [YBT]), functional and psychological patient-reported outcome measures (PROMs), and timing of return-to-play clearance were reviewed. YBT scores were the primary metric for clearance. Four groups were studied: soccer, football, basketball, and other.Results:A total of 220 male and 223 female athletes were included; 65.28% of soccer players were female and 100% of football players were male (P < 0.01). At initial postoperative YBT testing (6-9 months), soccer players had higher operative (P < 0.01) and nonoperative (P < 0.01) leg composite scores when compared with basketball players. No significant differences were found between sports in functional or psychological PROMs at presurgical baseline or 6 months postoperatively. When compared with football, soccer players completed functional clearance in a shorter time from surgery (P = 0.02). Multivariate analysis showed level of competition as a significant independent variable for clearance in female athletes.Conclusion:After primary ACLR, athletes, especially female athletes, demonstrated short-term sport-specific differences in YBT scores. Soccer players attained clearance sooner than football players. Level of competition influenced YBT composite scores in all athletes and time to clearance in female athletes.Clinical Relevance:Sport-specific differences in reinjury should be investigated to determine whether changes in return-to-play evaluation should be implemented.
      Citation: Sports Health
      PubDate: 2023-03-06T06:25:40Z
      DOI: 10.1177/19417381231156395
       
  • Utilizing Scapula Retraction Exercises With or Without Glenohumeral
           Rotational Exercises With a Gradual Progression for Subacromial Pain
           Syndrome

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      Authors: Leyla Eraslan, Ozan Yar, Fatma Bilge Ergen, Gazi Huri, Irem Duzgun
      Abstract: Sports Health, Ahead of Print.
      Background:Although exercise interventions are recommended in the management of subacromial pain syndrome (SPS), there is a lack of data regarding the exercises focusing on the principal biomechanical deficiencies that cause symptoms.Hypothesis:Utilizing progressive scapula retraction exercises (SRE) and glenohumeral rotation exercises (GRE) in the scapula stabilization program may lead to more reduction in symptoms and greater acromiohumeral distance (AHD) values.Study Design:A double-blind, randomized controlled trial.Level of Evidence:Level 2.Methods:A total of 33 patients were assigned randomly to either SRE or SRE+GRE. Both groups received a 12-week supervised rehabilitation program, including manual therapy and exercises (stretching and progressive scapula stabilization exercises). In addition, the SRE+GRE group performed GRE exercises at gradual elevation angles. From 12 to 24 weeks, patients performed exercise programs less frequently (3 times per week). Disability (shoulder pain and disability index [SPADI]), AHD (at 5 active abduction angles), pain intensity (visual analogue scale [VAS]), and patient satisfaction were recorded at baseline, 12 weeks, and 24 weeks. A total of 16 healthy individuals were recruited as a control group to compare AHD values. Data were analyzed using mixed model analyses of variance.Results:A statistically significant group-by-time interaction was found for AHD values (F4,92 = 6.38; P = 0.001), a significant group-by-time interaction for SPADI-disability (F1,33 = 5.148; P = 0.01), SPADI-total (F1,32 = 4.172; P = 0.03), and for pain during activity (F2,62 = 3.204; P = 0.05). However, no significant group-by-time interaction for SPADI-pain (F1,33 = 0.533; P = 0.48), for pain at rest (F1,31 < 0.001; P = 0.99), and at night (F1,32 = 2.166; P = 0.15). Yet, a significant time effect was observed.Conclusion:Progressive SRE and GRE in the scapula stabilization program lessens symptoms and improves AHD values in patients with SPS. Moreover, this program could preserve outcomes and further increase AHD when applied less frequently.Clinical Relevance:Utilizing SRE and GRE in the scapula stabilization program at gradual shoulder abduction angles provides better rehabilitation outcomes.
      Citation: Sports Health
      PubDate: 2023-03-06T06:23:40Z
      DOI: 10.1177/19417381231155190
       
  • Influence of Acute Melatonin Administration on Human Physical Performance:
           A Systematic Review

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      Authors: Vinícius Silva Faria, Leonardo Henrique Dalcheco Messias, Taciane Maria Melges Pejon, Wladimir Rafael Beck
      Abstract: Sports Health, Ahead of Print.
      Context:Melatonin is an ancient molecule with a wide range of functions in mammals, such as antioxidant, anti-inflammatory, and hypothermic effects among others. However, the influence of acute melatonin administration on human physical performance is debatable.Objective:To summarize available data from controlled trials about the effects of acute melatonin administration on human physical performance, especially with respect to strength, power, speed, and short- and long-term continuous exercise.Data Sources:A systematic search of the PubMed, Web of Science, Scopus, Embase, and Cochrane databases up to December 10, 2021, was conducted using specified keywords and Boolean operators (“melatonin” AND “exercise OR circuit-based exercise OR plyometric exercise OR exercise tolerance OR exercise test”).Study Selection:Only controlled studies in the English language and with humans were accepted.Study Design:Systematic review.Level of Evidence:Level 1.Data Extraction:Participants’ characteristics (sex, age, body mass, height and fat percentage), melatonin dose and administration time, and outcomes from the performance trial were extracted.Results:A total of 10 studies were identified after the screening process. Overall, melatonin did not change speed or short-term continuous exercise performances. However, in relation to strength and power, the results are debatable since 5 articles showed no difference, while another 2 pointed to a decrease in performance. In terms of performance improvement, only 1 study reported an increase in balance and another in long-term continuous exercise performance in nonathletes, with no advantage found for athletes.Conclusion:Melatonin did not cause any significant change in strength, speed, power, and short-term continuous exercise performances. In fact, it led to reduced strength and power performances in specific tests. On the other hand, melatonin seems to have improved balance and long-term continuous exercise performance, at least in nonathletes. More investigations are required to corroborate these findings.
      Citation: Sports Health
      PubDate: 2023-03-06T06:21:20Z
      DOI: 10.1177/19417381231155142
       
  • Exertional Heat Illness: Adoption of Policies and Influencing Contextual
           Factors as Reported by Athletic Administrators

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      Authors: Samantha E. Scarneo-Miller, William M. Adams, Kelly A. Coleman, Rebecca M. Lopez
      Abstract: Sports Health, Ahead of Print.
      Background:Little is known about the adoption by athletic administrators (AAs) of exertional heat illness (EHI) policies, and the corresponding facilitators and barriers of such policies within high school athletics. This study describes the adoption of comprehensive EHI policies by high school AAs and explores factors influencing EHI policy adoption.Hypothesis:We hypothesized that
      Citation: Sports Health
      PubDate: 2023-03-06T06:18:40Z
      DOI: 10.1177/19417381231155107
       
  • Postural Control Deficits During Static Single-leg Stance in Chronic Ankle
           Instability: A Systematic Review and Meta-Analysis

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      Authors: Xiao’ao Xue, Yiran Wang, Xiaoyun Xu, Hong Li, Qianru Li, Yuyan Na, Weichu Tao, Le Yu, Zhengbiao Jin, Hongyun Li, Ru Wang, Yinghui Hua
      Abstract: Sports Health, Ahead of Print.
      Context:Postural control deficits arising from injured ankles are central to chronic ankle instability (CAI) and its persistent symptoms. This is usually measured by recording the center of pressure (CoP) trajectory during static single-leg stance using a stable force plate. However, existing studies have produced conflicting results on whether this mode of measurement adequately reveals the postural deficits in CAI.Objective:To determine whether postural control during static single-leg stance is impaired in CAI patients when compared with uninjured healthy controls.Data Sources:Literature databases, PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus, were searched from inception to April 1, 2022, using ankle-, injury-, and posture-related terms.Study Selection:Two authors independently performed the step-by-step screening of article titles, abstracts, and full texts to select peer-reviewed studies investigating CoP trajectory during static single-leg stance using a stable force plate in CAI patients and healthy controls. A total of 13,637 studies were reviewed, and 38 studies (0.003%) met the selection criteria.Study Design:Meta-analyses of descriptive epidemiological study.Level of Evidence:Level 4.Data Extraction:CoP parameters, sway directions, visual condition, and numerical data (means and standard deviations) were extracted.Results:The injured ankles of CAI patients had higher standard deviations of sway amplitude in both anterior-posterior and medial-lateral directions (standardized mean difference [SMD] = 0.36 and 0.31, respectively) under conditions of open eyes than controls. Higher mean sway velocity in anterior-posterior, medial-lateral, and total directions (SMD = 0.41, 0.37, and 0.45, respectively) with closed eyes was also found.Conclusion:CAI patients had deficits of postural control during static single-leg stance, and these deficits were identified by the CoP trajectory. Further methodological explorations of CoP parameters and corresponding test conditions are required to enhance the sensitivity and reliability of postural deficit assessments in CAI using force plates.
      Citation: Sports Health
      PubDate: 2023-03-06T06:17:00Z
      DOI: 10.1177/19417381231152490
       
  • In Vivo Characterization of Cerebellar Peduncles in Chronic Ankle
           Instability: A Single and Multishell Diffusion-Weighted Imaging Study

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      Authors: Xiao’ao Xue, Rong Lu, Hong Li, Ziyi Chen, Dandan Sheng, Zhengbiao Jin, Shiyin Liu, Ailin Liu, Xu Yan, Weijun Tang, Shuang Chen, Yinghui Hua
      Abstract: Sports Health, Ahead of Print.
      Background:Ankle sprain causes proprioceptor injuries and prolonged joint deafferentation, which might lead to maladaptive neuroplasticity in patients with chronic ankle instability (CAI), especially in the cerebellum. Previous studies have indicated the impairment of superior cerebellar peduncle (SCP), but the inferior cerebellar peduncle (ICP) and middle cerebellar peduncle (MCP) have not been fully analyzed.Hypothesis:The cerebellar peduncles of participants with CAI would have altered fractional anisotropy (FA) and orientation dispersion index (ODI) in comparison with healthy controls without ankle injury history. In addition, FA and ODI would be correlated with the duration or severity of the sensorimotor deficits in CAI.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:A group of 27 participants with CAI and 26 healthy controls underwent diffusion-weighted imaging scanning, with the cerebellar peduncles as the regions of interest. The measures obtained by single-shell diffusion tensor imaging and the multishell neurite orientation dispersion and density imaging were used. Correlation analyses were performed to examine the potential relationship between the FA/ODI and both the normalized Y-balance scores and the durations of ankle instability.Results:The ipsilateral ICP of the injured ankle in participants with CAI showed significantly lower FA (Cohen d 95% CI, –1.33 to -0.21; P = 0.04) and marginally significant higher ODI (Cohen d 95% CI, 0.10 to 1.20, P = 0.08) when compared with the same measures in the control group, with the ODI being positively correlated with the duration of ankle instability (r = 0.42, P = 0.03).Conclusion:The ICP in participants with CAI exhibited impaired integrity and a trend of abnormally organized neurites in comparison with a healthy control group.Clinical Relevance:The impairments of ICP might be an ongoing part of the pathological process of CAI, having the potential to become a target for the diagnostic evaluation of this clinical entity.
      Citation: Sports Health
      PubDate: 2023-03-02T12:32:19Z
      DOI: 10.1177/19417381231156544
       
  • Evaluation of Achilles Tendon Stiffness as Measured by Shear Wave
           Elastography in Female College Athletes Compared With Nonathletes

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      Authors: Alyssa D. Althoff, Kayleigh Vance, Megan Plain, Russell A. Reeves, Jennifer Pierce, Frank W. Gwathmey, Brian C. Werner
      Abstract: Sports Health, Ahead of Print.
      Background:We sought to utilize a noninvasive technology to assess the effects of activity on Achilles tendon stiffness and define baseline Achilles tendon stiffness in female college athletes compared with nonathletes using tendon shear wave velocity as a marker for tendon stiffness.Hypothesis:Training status and exercise may affect Achilles tendon stiffness.Study Design:Level of Evidence:Level 4.Methods:A total of 32 college-age female athletes were prospectively enrolled (n = 17 varsity athletes and n = 15 nonathletes). Demographic characteristics, activity level, and previous injuries were recorded. Sonographic shear wave elastography (SWE) was used to assess Achilles tendon shear wave velocity bilaterally for all subjects, both at baseline and after 2 minutes of exercise. Student t tests were used to compare the mean elastography measurements between participants stratified by athlete status and pre/postexercise stimulus. Analysis of variance (ANOVA) was used to compare the mean proximal, middle, and distal Achilles tendon elastography measurements.Results:As seen by a greater mean shear wave velocity (8.60 ± 1.58 m/s vs 8.25 ± 1.89 m/s; P = 0.02), athletes had stiffer tendons than nonathletes. Exercise stimulus decreased average tendon shear wave velocity (8.57 ± 1.74 m/s vs 8.28 ± 1.72 m/s; P = 0.05). Tendon shear wave velocity was greatest proximally and least distally with significant differences between each region (P < 0.001). In addition, there was a significant 2-way interaction between weekly training status and foot dominance (P = 0.01). Post hoc analysis showed that this result was due to differences in tendon shear wave velocity between the dominant and nondominant lower extremity in nonathletes (7.73 ± 2.00 m/s vs 8.76 ± 1.62 m/s; P < 0.001).Conclusion:Female varsity collegiate athletes have higher baseline Achilles tendon stiffness as measured by SWE compared with nonathletes. Mean tendon stiffness varies based on Achilles measurement location. SWE is a quick, cost-effective, and noninvasive imaging modality that can be used to evaluate tendon stiffness and elasticity.Clinical Relevance:SWE is an efficient and noninvasive imaging modality that can evaluate dynamic tendon stiffness and elasticity. SWE may be helpful to assess injuries in female college athletes and may play a role in risk stratification or clinical follow-up. In theory, SWE could be used to identify athletes with increased elasticity as a marker for potential risk for rupture in this population.
      Citation: Sports Health
      PubDate: 2023-03-01T12:04:37Z
      DOI: 10.1177/19417381231153657
       
  • Anterior Cruciate Ligament Reconstruction Return-to-Sport Decision-Making:
           A Scoping Review

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      Authors: Eric Golberg, Mark Sommerfeldt, Adam Pinkoski, Liz Dennett, Lauren Beaupre
      Abstract: Sports Health, Ahead of Print.
      Context:Clinical guidelines support the use of testing batteries to assess athlete readiness for return to sport (RTS) and risk of reinjury after anterior cruciate ligament (ACL) reconstruction (ACL-R). There is no consensus on the composition of the testing batteries. Test selection is based mainly on commonality in research, personal preference, and equipment availability. Including athletic performance assessments (APA) used in the athlete’s sport may assist RTS decision-making for stakeholders.Objective:To determine whether APA for speed, agility, strength, or cardiovascular endurance are (1) used in ACL-R RTS literature and (2) indicative of RTS or reinjury rates.Data Sources:A systematic search was performed in MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, Web of Science, and ProQuest Dissertations and Theses Global.Study Selection:Eligibility criteria were as follows: (1) athletes between 6 months and 2 years post-ACL-R, (2) commonly used APA, (3) peer-reviewed primary study with original published data.Study Design:Scoping Review.Level of Evidence:Level 4.Data Extraction:A total of 17 studies included 24 instances of APA with a high degree of heterogeneity for both tests and protocols.Results:Agility makes up 75% of the APA. Only 17.6% of studies reported RTS or reinjury rates, none of which reported a significant relationship between these rates and APA outcomes.Conclusion:Speed, strength, and cardiovascular endurance tests are underrepresented in ACL-R RTS literature. Compared with healthy controls, deficits in APA results for ACL-R athletes were common; however, many studies reported significant improvements in results for ACL-R athletes over time. There is some evidence that well-trained ACL-R athletes can match the performance of uninjured athletes in high-level sports.
      Citation: Sports Health
      PubDate: 2023-01-28T05:55:56Z
      DOI: 10.1177/19417381221147524
       
  • Using an Arthrometer to Quantify Ankle Laxity: An Infographic Summary

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      Authors: Dawn T. Gulick
      Abstract: Sports Health, Ahead of Print.
      Lateral ankle sprains are a common musculoskeletal injury. The anterior talofibular ligament (ATFL) is the primary ligament involved and is assessed via an anterior drawer test. Clinically assessing joint laxity has been a subjective task. Evaluating both magnitude of translation and quality of the endfeel has presented challenges. Until recently, a reliable and valid arthrometer to test joints other than the knee has not been available. The Mobil-Aider arthrometer has undergone bench testing for validity, reliability testing in healthy persons, and most recently the testing of participants for pathology. A summary of these studies is available in the Online Supplement. The goal of this study was to determine the ability of the arthrometer to objectively identify the anterior translation of the ankle and the relationship to the clinical diagnosis. The participant was evaluated by a physician and magnitude of ankle sprain was determined. An arthrometer was used to perform an anterior drawer test (uninjured before injured, 3 measures each) in the prone position. Both clinicians were blinded to the data of the other. There were 30 participants, 10 per group (uninjured, 1° sprain, 2° sprain). Mann-Whitney U testing found significant differences between the control and grade 1 ankle sprain groups (P < .001), the control and grade 2 ankle sprain groups (P < .001), and the grade 1 and grade 2 ankle sprain groups (P = .004). There was ± 0.31 mm difference in anterior translation between healthy ankles, whereas there was 1.11 mm and 2.16 mm difference between ankles in grade 1 and grade 2 sprains, respectively. The anterior drawer test is the gold standard for clinical ATFL testing, but the subjective nature of this test poses challenges. Technology is available to assess ankle joint laxity and enhance the objectivity of patient assessment and throughout the recovery process. An arthrometer is a valuable tool in quantifying orthopaedic examination.
      Citation: Sports Health
      PubDate: 2023-01-24T06:58:56Z
      DOI: 10.1177/19417381221147511
       
  • Association of Diaphragm Contractility and Postural Control in a Chronic
           Ankle Instability Population: A Preliminary Study

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      Authors: Masafumi Terada, Kyle B. Kosik, Phillip A. Gribble
      Abstract: Sports Health, Ahead of Print.
      Background:Altered reorganization of the sensorimotor system after an initial lateral ankle sprain may lead to a chronic neuromuscular maladaptation in multiple body locations. Specifically, decreased diaphragm contractility has been observed in patients with chronic ankle instability (CAI). The diaphragm has an essential role in postural control. Decreased diaphragm contractility could associate with diminished postural control commonly observed in patients with CAI. However, no study has determined if diaphragm contractility contributes to postural control in a CAI population.Hypothesis:Decreased diaphragm contractility would be negatively associated with static postural control in patients with CAI.Study Design:Cross-sectional study design.Level of Evidence:Level 4.Methods:A total of 15 participants with CAI participated voluntarily. An ultrasonography assessment was performed to quantify the right and left hemidiaphragm thickness at the end of resting inspiration and expiration in supine while breathing quietly. The degree of diaphragm contractility was calculated from the diaphragm thickness. Participants performed 3 eyes-open trials of a 20-second single-leg balance task on the involved limb. Static postural control measures included the center of pressure velocity (COPV) and mean of time-to-boundary (TTB) minima in the anteroposterior (AP) and mediolateral directions.Results:Moderate correlations of the right hemidiaphragm contractility were observed with COPV (ρ = -0.54) and TTB mean minima (ρ = 0.56) (P < 0.05) in the AP direction. The left hemidiaphragm contractility was moderately correlated with COPV (ρ = −0.56) and TTB mean minima (ρ = 0.60) (P < 0.05) in the AP direction.Conclusion:Lower diaphragm contractility may be associated with diminished static postural control in the AP direction in patients with CAI.Clinical Relevance:This study highlights diaphragm contractility could be a potential connection with diminished static postural control in patients with CAI. Our data raise new avenues for future exploration including potential beneficial effects of implementation of diaphragm breathing exercises and techniques for restoring static postural control in patients with CAI.
      Citation: Sports Health
      PubDate: 2023-01-24T06:52:56Z
      DOI: 10.1177/19417381221147304
       
 
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  Subjects -> HEALTH AND SAFETY (Total: 1464 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (686 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (358 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (112 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

PHYSICAL FITNESS AND HYGIENE (117 journals)                     

Showing 1 - 118 of 118 Journals sorted alphabetically
ACSMs Health & Fitness Journal     Full-text available via subscription   (Followers: 14)
Acta Facultatis Educationis Physicae Universitatis Comenianae     Open Access   (Followers: 3)
Acta Kinesiologiae Universitatis Tartuensis     Open Access   (Followers: 1)
ACTIVE : Journal of Physical Education, Sport, Health and Recreation     Open Access   (Followers: 32)
Adapted Physical Activity Quarterly     Hybrid Journal   (Followers: 5)
Ágora para la Educación Física y el Deporte     Open Access  
Al.Qadisiya journal for the Sciences of Physical Education     Open Access  
American Journal of Sexuality Education     Hybrid Journal   (Followers: 4)
Annals of Applied Sport Science     Open Access   (Followers: 11)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 10)
Applied Physiology, Nutrition and Metabolism     Hybrid Journal   (Followers: 37)
Arab Journal of Nutrition and Exercise     Open Access   (Followers: 1)
Arquivos em Movimento     Open Access   (Followers: 1)
Arrancada     Open Access  
Asian Journal of Sport and Exercise Psychology     Open Access   (Followers: 8)
Baltic Journal of Sport and Health Sciences     Open Access   (Followers: 4)
BMC Obesity     Open Access   (Followers: 6)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 42)
Child and Adolescent Obesity     Open Access   (Followers: 8)
Childhood Obesity     Hybrid Journal   (Followers: 24)
Clinical Journal of Sport Medicine     Hybrid Journal   (Followers: 39)
Comparative Exercise Physiology     Hybrid Journal   (Followers: 23)
Cultura, Ciencia y Deporte     Open Access   (Followers: 1)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 23)
eJRIEPS : Ejournal de la recherche sur l'intervention en éducation physique et sport     Open Access  
Environmental Health and Preventive Medicine     Open Access   (Followers: 4)
Éthique & Santé     Full-text available via subscription  
Fat Studies : An Interdisciplinary Journal of Body Weight and Society     Partially Free   (Followers: 3)
Food Science and Human Wellness     Open Access   (Followers: 4)
Frontiers in Sports and Active Living     Open Access   (Followers: 4)
Gelanggang Pendidikan Jasmani Indonesia     Open Access  
German Journal of Exercise and Sport Research : Sportwissenschaft     Hybrid Journal   (Followers: 2)
Geron     Full-text available via subscription  
Health and Quality of Life Outcomes     Open Access   (Followers: 14)
Health Education     Hybrid Journal   (Followers: 1)
Health Education Journal     Hybrid Journal   (Followers: 16)
Health Marketing Quarterly     Hybrid Journal   (Followers: 2)
Health Physics     Hybrid Journal   (Followers: 6)
Health Promotion & Physical Activity     Open Access   (Followers: 9)
Home Healthcare Now     Hybrid Journal   (Followers: 4)
Human Movement Science     Hybrid Journal   (Followers: 15)
Hygiene     Open Access   (Followers: 21)
IISE Transactions on Occupational Ergonomics and Human Factors     Hybrid Journal  
Indonesia Performance Journal     Open Access  
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 11)
International Journal of Applied Exercise Physiology     Open Access   (Followers: 54)
International Journal of Athletic Therapy & Training     Hybrid Journal   (Followers: 15)
International Journal of Behavioral Nutrition and Physical Activity     Open Access   (Followers: 34)
International Journal of Obesity     Hybrid Journal   (Followers: 57)
International Journal of Obesity Supplements     Full-text available via subscription   (Followers: 5)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 21)
International Journal of Spa and Wellness     Hybrid Journal  
International Journal of Sport, Exercise & Training Sciences     Open Access   (Followers: 4)
International Journal of Yoga     Open Access   (Followers: 17)
Isokinetics and Exercise Science     Hybrid Journal   (Followers: 10)
Journal of Advanced Nutrition and Human Metabolism     Open Access   (Followers: 16)
Journal of American College Health     Hybrid Journal   (Followers: 3)
Journal of Athlete Development and Experience     Open Access   (Followers: 3)
Journal of Bioenergetics and Biomembranes     Hybrid Journal   (Followers: 1)
Journal of Exercise & Organ Cross Talk     Open Access   (Followers: 1)
Journal of Human Performance in Extreme Environments     Open Access   (Followers: 2)
Journal of Human Sport and Exercise     Open Access   (Followers: 17)
Journal of Motor Learning and Development     Hybrid Journal  
Journal of Physical Activity and Health     Hybrid Journal   (Followers: 13)
Journal of Physical Activity and Hormones     Open Access   (Followers: 3)
Journal of Physical Activity Research     Open Access   (Followers: 4)
Journal of Physical Education and Human Movement     Open Access  
Journal of Physical Education and Sport Sciences     Open Access   (Followers: 5)
Journal of Physical Education Health and Sport     Open Access   (Followers: 2)
Journal of Physical Education, Recreation & Dance     Full-text available via subscription   (Followers: 13)
Journal of Science in Sport and Exercise     Hybrid Journal   (Followers: 6)
Journal of Sport and Health Science     Open Access   (Followers: 22)
Journal of Sport Sciences and Fitness     Open Access   (Followers: 14)
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 76)
Kinesiology : International Journal of Fundamental and Applied Kinesiology     Open Access   (Followers: 1)
Kinesiology Review     Hybrid Journal   (Followers: 4)
Malaysian Journal of Movement, Health & Exercise     Open Access   (Followers: 1)
Measurement in Physical Education and Exercise Science     Hybrid Journal   (Followers: 7)
Médecine & Nutrition     Full-text available via subscription   (Followers: 1)
Mental Health and Physical Activity     Hybrid Journal   (Followers: 17)
MHSalud : Movimiento Humano y Salud     Open Access  
Obesity     Hybrid Journal   (Followers: 40)
Obesity Research & Clinical Practice     Full-text available via subscription   (Followers: 10)
Obesity Reviews     Hybrid Journal   (Followers: 17)
Obesity Science & Practice     Open Access  
Open Obesity Journal     Open Access   (Followers: 2)
Pain Management in General Practice     Full-text available via subscription   (Followers: 12)
PALAESTRA : Adapted Sport, Physical Education, and Recreational Therapy     Full-text available via subscription   (Followers: 3)
Physical Activity and Health     Open Access   (Followers: 4)
Physical Education & Sport Pedagogy     Hybrid Journal   (Followers: 14)
Preventing Chronic Disease     Free   (Followers: 3)
Psychology of Sport and Exercise     Hybrid Journal   (Followers: 19)
Quality in Sport     Open Access  
Race and Yoga     Open Access   (Followers: 1)
RBNE - Revista Brasileira de Nutrição Esportiva     Open Access   (Followers: 1)
RBONE - Revista Brasileira de Obesidade, Nutrição e Emagrecimento     Open Access   (Followers: 1)
RBPFEX - Revista Brasileira de Prescrição e Fisiologia do Exercício     Open Access  
Research Quarterly for Exercise and Sport     Hybrid Journal   (Followers: 2)
Retos : Nuevas Tendencias en Educación Física, Deportes y Recreación     Open Access  
Revista Andaluza de Medicina del Deporte     Open Access   (Followers: 2)
Revista Brasileira de Atividade Física & Saúde     Open Access   (Followers: 1)
Revista Brasileira de Cineantropometria & Desempenho Humano     Open Access   (Followers: 1)
Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte : International Journal of Medicine and Science of Physical Activity and Sport     Open Access   (Followers: 1)
Revue phénEPS / PHEnex Journal     Open Access  
Scandinavian Journal of Sport and Exercise Psychology     Open Access   (Followers: 5)
SIPATAHOENAN : South-East Asian Journal for Youth, Sports & Health Education     Open Access  
Spor Bilimleri Dergisi / Hacettepe Journal of Sport Sciences     Open Access   (Followers: 1)
Sport and Fitness Journal     Open Access   (Followers: 7)
Sport Science and Health     Open Access   (Followers: 7)
Sport Sciences for Health     Hybrid Journal   (Followers: 5)
SPORTIVE : Journal Of Physical Education, Sport and Recreation     Open Access   (Followers: 2)
Sports     Open Access   (Followers: 3)
Sports Biomechanics     Hybrid Journal   (Followers: 29)
Sports Health: A Multidisciplinary Approach     Hybrid Journal   (Followers: 5)
Strength & Conditioning Journal     Hybrid Journal   (Followers: 57)
Timisoara Physical Education and Rehabilitation Journal     Open Access   (Followers: 2)
Turkish Journal of Sport and Exercise     Open Access  
Yoga Mimamsa     Open Access   (Followers: 3)

           

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