Do people with spinal cord injury meet the WHO recommendations on physical activity?

OBJECTIVES

To describe physical activity (PA) levels in persons with spinal cord injury (SCI) and to investigate associated factors.

METHODS

PA behavior of people with SCI in Switzerland was assessed in a community survey with four items from the Physical Activity Scale for individuals with physical disabilities (PA of light, moderate, and strenuous intensity and muscle-strengthening exercises). In addition to descriptive analyses, the odds of performing PA according to the WHO recommendations (at least 2.5 h/week of at least moderate intensity) were analyzed by multivariable logistic regression.

RESULTS

Participants (n = 485; aged 52.9 ± 14.8; 73.6 % male) carried out PA a total of 6.0 h/week (median). 18.6 % were physically inactive, 50.3 % carried out muscle-strengthening exercises, and 48.9 % fulfilled the WHO recommendations. Regression analyses showed that women, people aged 71+, and people with complete tetraplegia had significantly lower odds of fulfilling the WHO recommendations than participants in the respective reference category (men, ages 17-30, incomplete paraplegia).

CONCLUSIONS

PA levels of people with SCI in Switzerland are rather high. However, some subgroups need special consideration when planning interventions to increase PA levels.

Exercise and the Regulation of Endocrine Hormones

The endocrine system has profound regulatory effects within the human body and thus the ability to control and maintain appropriate function within many physiological systems (i.e., homeostasis). The hormones associated with the endocrine system utilize autocrine, paracrine, or endocrine actions on the cells of their target tissues within these physiologic systems to adjust homeostasis. The introduction of exercise as a stressor to disrupt homeostasis can greatly amplify and impact the actions of these hormones. To that end, the endocrine response to an acute exercise session occurs in a progression of phases with the magnitude of the response being relative to the exercise work intensity or volume. Various physiologic mechanisms are considered responsible for these responses, although not all are completely understood or elucidated. Chronic exercise training does not eliminate the acute exercise response but may attenuate the overall effect of the responsiveness as the body adapts in a positive fashion to the training stimulus. Regrettably, an excessive intensity and/or volume of training may lead to maladaptation and is associated with inappropriate endocrine hormonal responses. The mechanisms leading to a deleterious maladaptive state are not well understood and require additional research for elucidation.

Formation of the diuretic chlorazanil from the antimalarial drug proguanil--implications for sports drug testing

Chlorazanil (Ordipan, N-(4-chlorophenyl)-1,3,5-triazine-2,4-diamine) is a diuretic agent and as such prohibited in sport according to the regulations of the World Anti-Doping Agency (WADA). Despite its introduction into clinical practice in the late 1950s, the worldwide very first two adverse analytical findings were registered only in 2014, being motive for an in-depth investigation of these cases. Both individuals denied the intake of the drug; however, the athletes did declare the use of the antimalarial prophylactic agent proguanil due to temporary residences in African countries. A structural similarity between chlorazanil and proguanil is given but no direct metabolic relation has been reported in the scientific literature. Moreover, chlorazanil has not been confirmed as a drug impurity of proguanil. Proguanil however is metabolized in humans to N-(4-chlorophenyl)-biguanide, which represents a chemical precursor in the synthesis of chlorazanil. In the presence of formic acid, formaldehyde, or formic acid esters, N-(4-chlorophenyl)-biguanide converts to chlorazanil. In order to probe for potential sources of the chlorazanil detected in the doping control samples, drug formulations containing proguanil and urine samples of individuals using proguanil as antimalarial drug were subjected to liquid chromatography-high resolution/high accuracy mass spectrometry. In addition, in vitro simulations with 4-chlorophenyl-biguanide and respective reactants were conducted in urine and resulting specimens analyzed for the presence of chlorazanil. While no chlorazanil was found in drug formulations, the urine samples of 2 out of 4 proguanil users returned findings for chlorazanil at low ng/mL levels, similar to the adverse analytical findings in the doping control samples. Further, in the presence of formaldehyde, formic acid and related esters, 4-chlorophenyl-biguanide was found to produce chlorazanil in human urine, suggesting that the detection of the obsolete diuretic agent was indeed the result of artefact formation and not of the illicit use of a prohibited substance.

[Urinary incontinence in non-professional female marathon runners]

OBJECTIVE

To determine the prevalence of urinary incontinence within a population of female recreational runners during a marathon.

METHODS

Observational study carried on a marathon from the analysis of questionnaire handed to the participants before the beginning of the marathon. The questionnaire was handed to 800 participants and among them, 517 (64.6%) agreed to fill it. Among the participants, 268 (52.4%) were marathon runners and 243 (47.5%) were relay runners.

RESULTS

Mean age of the runners was 41.1 (±9.7), 479 (93.7%) of them were caucasian, mean body mass index was 20,7 (±1.9) kg/m(2) and 173 (34%) were nulliparous. Among responders, 157 (30.7%) runners declared to have urinary incontinence symptoms (any circumstances). Among 157 runners who declared an urinary incontinence, 83 (52,9%) presented with urinary leaks during the running. In half of the cases, these urinary leaks usually arose at the end of race. Urinary incontinence during coughing, sneezing or laughing was reported by 96/517 (18,5%) women. The prevalence of urge urinary incontinence was 63/517 (12%). Concerning the frequency of urinary incontinence, 39/517 (7.5%) women reported at least once weekly. For urinary incontinence bother, scores on the Visual Analogue Scale (VAS 0 to 100) was 1.6 (±1.7).

CONCLUSION

In this series, the prevalence of urinary incontinence was 30.7% within a population of female recreational runners. This rate seems to be similar to the current prevalence in the general population.

Exercise-induced bronchoconstriction: new evidence in pathogenesis, diagnosis and treatment

The acute airway narrowing that occurs as a result of exercise is defined exercise-induced bronchoconstriction (EIB). Most recent guidelines recommend distinguishing EIB with underlying clinical asthma (EIB_A) from the occurrence of bronchial obstruction in subjects without other symptoms and signs of asthma (EIBw_A). EIB has been in fact reported in up to 90 % of asthmatic patients, reflecting the level of disease control, but it may develop even in subjects without clinical asthma, particularly in children, athletes, patients with atopy or rhinitis and following respiratory infections. Both EIB_A and EIBw_A have peculiar pathogenic mechanisms, diagnostic criteria and responses to treatment and prevention. The use of biomarkers, proteomic approaches and innovative technological procedures will hopefully contribute to better define peculiar phenotypes and to clarify the role of EIB as risk factor for the development of asthma, as well as an occupational disease.

Can you treat the cheat in sports?

This editorial examines the issue of "cheating" (broadly defined) in sports from youth through professional sports. We describe possible underlying causes focusing on the development of a "personality disorder" and psychiatric/psychodynamic needs (e.g. a pathological need to be the best). We detail treatment and management from a medical-psychiatric perspective as well as implications for coaches, teams, leagues and professional organizations (e.g. soccer, bicycling, etc). Cheating behavior exists in other fields, for example, politics, law among others and some of the management principles mentioned here may apply there.

After revision anterior cruciate ligament reconstruction, who returns to sport? A systematic review and meta-analysis

BACKGROUND

Return to sport and to pre-injury level represents an important outcome after both primary and revision anterior cruciate ligament (ACL) reconstructions.

PURPOSE

The aim of the present meta-analysis was to determine the return to sport rate after revision ACL reconstruction.

MATERIAL AND METHODS

A systematic search was performed of the MEDLINE, Embase and the Cochrane Central Register of Controlled Trials Databases. All the studies that reported return to sport, return to pre-injury sport level and return to high level/competitive sport was considered for the meta-analysis. The overall pooled mean of post-operative knee laxity and pooled rate of positive pivot-shift and objective International Knee Documentation Committee (IKDC) categories was calculated as well.

RESULTS

Overall, 472 abstracts were identified and screened for inclusion and only 16 studies reported the rate of return to any level of sport activity at the final follow-up of 4.7 years (range 1.0-13.2 years), showing a pooled rate of 85.3% (CI 79.7 to 90.2). The return to pre-injury sport level was achieved in 53.4% (CI 37.8 to 68.7) of cases. Normal or quasi-normal objective IKDC, less than 5 mm of side-to-side difference at arthrometric evaluations and grade I-II pivot-shift test were reported in 84%, 88% and 93% patients, respectively.

CONCLUSIONS

In spite of almost 8 patients out of 10 returning to sport after revision ACL reconstruction and showing good stability, only half of the patients returned to the same pre-injury sport level.

Concussion under-reporting and pressure from coaches, teammates, fans, and parents

Concussions from sport present a substantial public health burden given the number of youth, adolescent and emerging adult athletes that participate in contact or collision sports. Athletes who fail to report symptoms of a suspected concussion and continue play are at risk of worsened symptomatology and potentially catastrophic neurologic consequences if another impact is sustained during this vulnerable period. Understanding why athletes do or do not report their symptoms is critical for developing efficacious strategies for risk reduction. Psychosocial theories and frameworks that explicitly incorporate context, as a source of expectations about the outcomes of reporting and as a source of behavioral reinforcement, are useful in framing this problem. The present study quantifies the pressure that athletes experience to continue playing after a head impact--from coaches, teammates, parents, and fans--and assesses how this pressure, both independently and as a system, is related to future concussion reporting intention. Participants in the study were 328 male and female athletes from 19 teams competing in one of seven sports (soccer, lacrosse, basketball, softball, baseball, volleyball, field hockey) at four colleges in the northeast region of the United States. Results found that more than one-quarter of the sample had experienced pressure from at least one source to continue playing after a head impact during the previous year. Results of a latent profile mixture model indicated that athletes who experienced pressure from all four of the measured sources were significantly more likely to intend to continue playing in the future than were athletes who had not experienced pressure from all sources, or only pressure from coaches and teammates. These findings underscore the importance of designing interventions that address the system in which athletes make decisions about concussion reporting, including athletes' parents, rather than focusing solely on modifying the individual's reporting cognitions.

Coach development programmes to improve interpersonal coach behaviours: a systematic review using the re-aim framework

OBJECTIVE

Although evidence supports the effectiveness of interpersonal Coach Development Programmes (CDPs), which are designed to foster coach-athlete relationships, an intervention's impact is shaped by numerous factors over and above effectiveness. The purpose of this systematic review was to examine the extent that published articles describing interpersonal CDP trials reported on indicators of internal and external validity, as conceptualised in the RE-AIM framework (ie, Reach, Effectiveness, Adoption, Implementation and Maintenance).

METHODS

The search strategy was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, involving a database search and supplemental manual search of key articles and journals. After initial screening, the full-text search strategy involved identifying articles describing CDP trials and then selecting a specific subgroup of articles involving interpersonal CDP trials and excluding ineligible articles. Resulting trials were coded using a 47-item sport coaching adaptation of the RE-AIM coding sheet.

RESULTS

17 published articles met eligibility criteria, representing 10 distinct CDP trials. After attaining coder agreement, global ratings of RE-AIM indicators within interpersonal CDP trials ranged from the low to moderate quality. Whereas indicators of effectiveness and implementation were reported to some extent across all studies, maintenance within sport organisations and a number of specific indicators from across dimensions were rarely reported.

CONCLUSIONS

These findings inform the future design and evaluation of CDPs that have the potential to be adopted in numerous settings and reach athletes and coaches who can most benefit.

Association between participation in outdoor play and sport at 10 years old with physical activity in adulthood

OBJECTIVE

This study aimed to investigate whether active outdoor play and/or sports at age 10 is associated with sport/physical activity at 32 year follow-up using a birth cohort study.

METHODS

Data were from the 1970 British Cohort Study, a longitudinal observational study. The present paper included data from the age 10 years and age 42 years surveys. At age 10 the participant's mother provided information regarding how often their child played sports, and played outside on streets, parks or playgrounds. At age 42 participants reported frequency of participation in physical activities and sports. Associations between participation in sport/active outdoor play at age 10 years and adult sport/physical activity were investigated using adjusted (gender, fathers socio-occupational class, child's BMI, father's BMI, self-rated health at age 42, assessment of own weight at age 42, participant's education) Cox regression.

RESULTS

Final adjusted Cox regression models showed that participants (n=6458) who often participated in sports at age 10 were significantly more likely to participate in sport/physical activity at age 42 (RR 1.10; 95% CI 1.01 to 1.19). Active outdoor play at age 10 was not associated with participation in sport/physical activity at age 42 (RR 0.99; 95% CI 0.91 to 1.07).

CONCLUSION

Childhood activity interventions might best achieve lasting change by promoting engagement in sport rather than active outdoor play.

Association of competitive and recreational sport participation with cardiac events in patients with arrhythmogenic right ventricular cardiomyopathy: results from the North American multidisciplinary study of arrhythmogenic right ventricular cardiomyopathy

AIMS

It has been proposed that competitive sport increases the risk of ventricular tachyarrhythmias (VTA) and death in patients with arrhythmogenic right-ventricular cardiomyopathy (ARVC). However, it is unknown whether this only applies to competitive sport or if recreational sports activity also increases the risk of VTA/death.

METHODS AND RESULTS

Probands diagnosed with ARVC according to the 2010 task force criteria for ARVC (n = 108) were included in the current analysis. At the time of enrolment, study participants were questioned about exercise level prior to and after ARVC diagnosis, within three categories of sports participation: competitive (n = 41), recreational (n = 48), and inactive (n = 19). Competitive sport was associated with a significantly higher risk of VTA/death when compared with both recreational sport [HR = 1.99 (1.21-3.28), P = 0.007] and inactive patients [HR = 2.05 (1.07-3.91), P = 0.030]. No increased risk of VTA/death was associated with recreational sport when compared with patients who were inactive [HR = 1.03 (0.54-1.97), P = 0.930]. Symptoms developed at an earlier age in patients who participated in competitive sport (30 ± 12 years), when compared with patients who participated in recreational sport (38 ± 17 years) (P = 0.015) and inactive patients (41 ± 11 years) (P = 0.002). No difference in age at first symptom was seen between patients who participated in recreational sport and inactive patients (P = 0.651).

CONCLUSION

Competitive sport was associated with a two-fold increased risk of VTA/death, and earlier presentation of symptoms, when compared with inactive patients, and to patients who participated in recreational sport. When compared with inactive patients, recreational sport was not associated with earlier onset of symptoms or increased risk of VTA/death. ClinicalTrials.gov Identifier: NCT00024505.

Nutritional knowledge and eating habits of professional rugby league players: does knowledge translate into practice?

Background

Adequate nutrient intake is important to support training and to optimise performance of elite athletes. Nutritional knowledge has been shown to play an important role in adopting optimal nutrition practices. The aim of the present study was to investigate the relationship between the level of nutritional knowledge and dietary habits in elite English rugby league players using the eatwell plate food categories.

Method

General nutritional knowledge questionnaires were collected during the Super League competitive season in the first team squad of 21 professional Rugby league players (mean age 25 ± 5 yrs, BMI 27 ± 2.4 kg/m2, experience in game 6 ± 4 yrs). According to their nutritional knowledge scores, the players were assigned to either good or poor nutritional knowledge group (n = 11, n = 10, respectively). Their dietary habits were assessment using a food frequency questionnaire.

Results

The findings revealed that nutritional knowledge was adequate (mean 72.82%) in this group of athletes with the highest scores in dietary advice section (85.71%), followed by food groups (71.24%) and food choice (69.52%). The majority of athletes were not aware of current carbohydrate recommendations. This translated into their dietary habits as many starchy and fibrous foods were consumed only occasionally by poor nutritional knowledge group. In terms of their eating habits, the good nutritional knowledge group consumed significantly more fruit and vegetables, and starchy foods (p <.05). Nutritional knowledge was positively correlated to fruit and vegetables consumption (rs = .52, p <.05) but not to any other eatwell plate categories.

Conclusions

The study identified adequate general nutritional knowledge in professional rugby league players with the exception of recommendation for starchy and fibrous foods. Players who scored higher in nutritional knowledge test were more likely to consume more fruits, vegetables and carbohydrate-rich foods.

Head trauma in sport and neurodegenerative disease: an issue whose time has come?

A number of small studies and anecdotal reports have been suggested that sports involving repeated head trauma may have long-term risks of neurodegenerative disease. There are now plausible mechanisms for these effects, and a recognition that these problems do not just occur in former boxers, but in a variety of sports involving repeated concussions, and possibly also in sports in which low-level head trauma is common. These neurodegenerative effects potentially include increased risks of impaired cognitive function and dementia, Parkinson's disease, and amyotrophic lateral sclerosis. Many would argue for taking a precautionary approach and immediately banning or restricting sports such as boxing. However, there are important public health issues in terms of how wide the net should be cast in terms of other sports, and what remedial measures could be taken? This in turn requires a major research effort involving both clinical and basic research to understand the underlying mechanisms, leading from head trauma to neurodegenerative disease and epidemiologic studies to assess the long-term consequences.

[Prevalence of genital anomalies in young football players]

The purpose of genital examination (GE) during the Pre-participation Physical Examination (PPE) is to identify the state of maturity, and rule out any genital pathology. To describe genital anomalies (GA) and estimate the awareness of GE in young football players. A descriptive, cross-sectional study was conducted in 280 elite football players from the results of PPE over two seasons. There was a detection rate of 5.4% GA, with varicocele being 3.2%, and of which only 13% were aware of their condition. Although this study shows a low incidence of genital abnormality in the study population, only 13% were aware of the GE prior to assessment. These findings demonstrate a low incidence of GA in this population. While GE is recommended during PPE, it is not a routine practice performed by family doctors or sports medicine specialists. This article attempts to raise awareness of the importance of GE in PPE as a preventive health strategy.

Smokeless tobacco, sport and the heart

Smokeless tobacco (snuff) is a finely ground or shredded tobacco that is sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek. Smokeless tobacco is widely used by young athletes to enhance performance because nicotine improves some aspects of physiology. However, smokeless tobacco has harmful health effects, including cardiovascular disorders, linked to nicotine physiological effects, mainly through catecholamine release. Nicotine decreases heart rate variability and the ventricular fibrillation threshold, and promotes the occurrence of various arrhythmias; it also impairs endothelial-dependent vasodilation and could therefore promote premature atherogenesis. At rest, heart rate, blood pressure, inotropism, cardiac output and myocardial oxygen consumption are increased by nicotine, leading to an imbalance between myocardial oxygen demand and supply. The same occurs at submaximal levels of exercise. These increases are accompanied by a rise in systemic resistances. At maximal exercise, heart rate, cardiac output and maximal oxygen uptake (V˙O2max) are unaffected by nicotine. Because endothelial dysfunction is promoted by nicotine, paradoxical coronary vasoconstriction may occur during exercise and recovery. Nicotine induces a decrease in muscular strength and impairs anaerobic performance. However, nicotine is used in sports as it diminishes anxiety, enhances concentration and agility, improves aerobic performance and favours weight control. Importantly, smokeless tobacco, similar to cigarette smoking, leads to nicotine dependence through dopaminergic pathways. Smokeless tobacco has harmful cardiovascular effects and is addictive: it fulfils all the criteria for inclusion in the World Anti-Doping Agency prohibited list as a doping product. Smokeless tobacco use in sporting activities must be discouraged.

Longer reaction time of the fibularis longus muscle and reduced postural control in basketball players with functional ankle instability: A pilot study

BACKGROUND

Motor control evaluation in subjects with functional ankle instability is questionable when both ankles of the same subject are compared (affected vs non-affected).

OBJECTIVE

To compare the postural control and reaction time of ankle muscles among: basketball players with FAI (instability group), basketball players without FAI (non-instability group) and healthy non-basketball-playing participants (control group).

DESIGN

Case-control study.

SETTING

Laboratory.

PARTICIPANTS

Instability (n = 10), non-instability (n = 10), and control groups (n = 11).

MAIN OUTCOME MEASURES

Centre of pressure variables (area, velocity and sway) were measured with a force platform. Reaction time of ankle muscles was measured via electromyography.

RESULTS

A one-way ANOVA demonstrated that there were significant differences between the instability and non-instability groups in the fibularis longus (p < 0.001), fibularis brevis (p = 0.031) and tibialis anterior (p = 0.049) muscles. Repeated-measures ANOVA and post hoc analysis determined significant differences for the area between the instability and non-instability groups (p = 0.001).

CONCLUSION

Basketball players with FAI have reduced postural control and longer reaction time of the fibularis and tibialis anterior muscles.

Nutritional responses to acute training sessions in young elite rugby players

BACKGROUND

Acute exercise has been shown to induce nutritional adaptations in obese and lean inactive youth but it remains unclear whether youth with a high level of physical activity experience such exercise-induced energy intake and appetite modifications.

METHODS

14 (15- to 16-year-old) male elite rugby players completed sessions on three separate occasions: (1) a control session (CON); (2) an exercise session (EX) and; (3) a rugby session (RUGBY). The energy induced by the rugby and exercise sessions was matched (Polar Team2 pro technology), and participants' energy intake, food preferences (ad libitum buffet meals) and appetite feelings (Visual Analogue Scales) were assessed throughout the experimental days.

RESULTS

The energy intake during lunch and snack time was not different between conditions. Dinner time energy intake was significantly increased after RUBGY compared to CON with respectively 969 ± 145 kcal and 777 ± 183 kcal (p < 0.05). The energy intake at dinner time was significantly increased during EX (1185 ± 199 kcal) compared to both CON (p < 0.001) and RUGBY (p < 0.01). None of the appetite feelings investigated were modified between sessions.

CONCLUSION

Adolescent elite rugby players regulate their energy intake differently depending on the nature of their training; independently of the energy expended. This demonstrates the need for energetic and nutritional education to optimize their physical fitness and performance.

Sport participation among individuals with acquired physical disabilities: group differences on demographic, disability, and Health Action Process Approach constructs

BACKGROUND

Despite numerous physical, social, and mental health benefits of engaging in moderate and vigorous intensity physical activities (e.g., sport), few individuals with acquired physical disabilities currently participate in adapted sport. Theory-based sport promotion interventions are one possible way to increase the amount of individuals who engage in sport.

OBJECTIVES

The primary objective of this study was to examine the profiles of three different sport participation groups with respect to demographic, injury, and Health Action Process Approach (HAPA) constructs.

METHODS

ANOVAs and Chi-square tests were used to determine group differences on demographic and disability-related constructs. A MANCOVA was conducted to determine differences between three sport participation groups (non-intenders, intenders, and actors) with age, years post-injury, mode of mobility, and sex included as covariates.

RESULTS

A cohort of 201 individuals was recruited; 56 (27.9%) were non-intenders, 21 (10.4%) were intenders, and 124 (61.7%) were actors. The MANCOVA revealed significant differences between groups on the HAPA constructs, F(22,370) = 9.02, p < .0001, Pillai's trace = .70, demonstrating that individuals with acquired physical disabilities will rate important health behavior constructs differently based on their sport intentions.

CONCLUSION

These results provide an important framework that adapted sport organizations can use to tailor their sport promotion programs.

Analysis of tennis champions' career: how did top-ranked players perform the previous years?

Professional tennis is a highly competitive sport ranked through an objective, merit-based, mathematical system. The objective of this study was to determine and analyze how top 1°-ranked professional tennis players perform in the previous three years. Data of ranking position of all top 1°-ranked female and male players in the professional era and their performance in Grand Slams tournaments were collected from tennis stakeholders’ websites and analyzed.

Top 1° male players’ ranking position averaged 2.17 ± 1.92 (CI 95%:1.56/2.78), 7.02 ± 18.073, and 10.73 ± 29.31, at 1, 2, and 3 previous years, respectively. Top 1° female players’ ranking position averaged 2.21 ± 1.59 (CI 95%:1.61/2.71), 4.78 ± 4.09, and 14.97 ± 26.75, at 1, 2, and 3 previous years, respectively. All top 1° male and female players were ranked within the 1°-10° and 1°-6° positions the previous year, respectively; the majority of tennis champions won at least one Grand Slam tournament during the year before reaching the top 1° ranking position (females = 69%; males = 65%), and during the same season (females = 82%; males = 92%). Female and male top 1°-ranked player maintained that position in the following year in 48.7% and 52.5% of cases, respectively.

In conclusion, tennis players need to perform at high level during at least three years prior to reach the top 1° position in the professional tennis ranking. Both, male and female champions, showed similar patterns of performance in their professional career.

The athlete biological passport: ticket to a fair Commonwealth Games

In summer 2014, the world watched as Glasgow hosted the 2014 Commonwealth Games and athletes pushed the boundaries of human performance. Sport has developed into a multi-billion pound industry leading to the development of a 'win at any cost' mentality in some individuals. The abuse of performance-enhancing drugs has developed into a sophisticated arms race between those unfairly enhancing performance and those wishing to preserve the dignity of sport and the health of the competitors. The challenge for the Commonwealth games organising committee was to ensure that competition remained fair and that athletes were kept safe. The athlete biological passport is a system implemented by the World Anti-Doping Agency directed towards enhancing the identification of those athletes accountable for the misuse of performance-enhancing substances. This article exemplifies which drugs are currently being exploited and how the athlete biological passport has evolved to improve their detection.

Do changes in muscle architecture affect post-activation potentiation?

The purpose of this randomized, cross-over design study was to examine the effect of three different muscle potentiation protocols on acute changes in muscle architecture and vertical jump performance. Eleven experienced, resistance trained men (25.2±3.6y) completed three potentiation squat protocols using moderate intensity (MI; 75%, 3 sets x 10 repetitions), high intensity (HI; 90%, 3 sets x 3 repetitions) and 100% (1RM; 1 set x 1repetition) of their 1RM. In addition, all participants completed a control session (CTL) in which no protocol was performed. During each testing session, muscle architecture and vertical jump testing were assessed at baseline (BL), 8min post (8P) and 20min post (20P) workout. Ultrasound measures included cross sectional area (CSA) and pennation angle (PANG) of both the rectus femoris (RF) and vastus lateralis (VL). Following each ultrasound measure, peak vertical jump power (PVJP) and mean (MVJP) power was assessed using an accelerometer. Magnitude based inferences were used to make comparisons between trials. The MI trial resulted in a likely greater increase from BL to 8P and 20P in RF-CSA and VL-CSA, while the HI trial resulted in a likely greater change from BL to 20P in both RF-CSA and VL-CSA. Meanwhile, changes in PVJP and MVJP for the MI trial was likely decreased at BL-8P and BL-20P, while the HI trial was shown to result in a likely or possible decrease compared to CTL at BL-8P and BL-20P, respectively. A likely negative relationship was observed between changes in VL-PANG and MVJP (r = -0.35; p , 0.018) at BL-8P, and between changes in PVJP and RF-CSA (r = -0.37; p , 0.014) at BL-20P. Results of this study were unable to demonstrate any potentiation response from the trials employed, however these protocols did result in acute muscle architectural changes. Key pointsThree squat protocols using moderate intensity (75% 1-RM; 3 sets x 10 repetitions), high intensity (90% 1-RM, 3 sets x 3 repetitions) and maximal intensity (100% 1RM; 1 set x 1repetition) were unable to potentiate jump height or jump power in experienced, resistance trained men.Experienced, resistance trained athletes who are not competitive may be limited in regards to potentiation due to a poor level of conditioning.Both the moderate and high intensity potentiation protocols stimulated acute changes in muscle architecture. Greater increases in the CSA of both the RF and VL muscles were noted.A different potentiation protocol may have elicited greater changes in muscle architecture.

The complexities of anti-doping violations: a case study of sanctioned cases in all performance levels of USA cycling

The use of banned substances and techniques in sport is regulated by anti-doping rules co-ordinated by the World Anti-Doping Agency. The purposes of these rules are to protect the health of the athlete, the level playing field and what WADA refers to as the spirit of sport. In this article, we review the known cases of sanctions in USA cycling since 2001. We show that the diversity of cases expands upon the simplistic, one-dimensional understanding of doping as risky and cheating. Contrary to this paradigm, we establish a typology of cases that challenges the one size fits all approach and, more specifically, we argue that WADA should develop new policies with independent standards for amateur and masters athletes.

Second to fourth digit ratio is a predictor of sporting ability in elite Indian male kabaddi players

BACKGROUND

To determine the 2D:4D ratio in elite Indian male kabaddi players and compare them with non-athletes.

OBJECTIVES

Our study was undertaken to find out a possible relation between digit ratio and sporting ability of male kabaddi players. This study also gives an insight into the possible ethnic differences between Indian sports personnel and other populations.

PATIENTS AND METHODS

Both right and left hands of 33 male kabaddi players attending training camp at the Bangalore regional centre of Sports Authority of India were scanned. Lengths of second and fourth digits were measured and their ratio calculated. Age, weight, height and body mass index matched subjects (25 males) who did not participate in any sports formed the control group.

RESULTS

A highly significant difference was found in 2D:4D ratios of both the hands with Kabaddi players having a lower ratio compared to their controls. There was no statistically significant difference in 2D:4D (Δ r-l) between Kabaddi players and controls.

CONCLUSIONS

Kabaddi is an intermediate sport not requiring a high level of endurance but at the same time requires masculine traits because of combating nature of the game. 2D:4D ratios can be used as reliable additional criteria when screening for prospective players to be inducted into the team.

The influence of different modes of ventilation on standing balance of athletes

Background:

The respiratory movements are one of the factors influencing standing balance. Although well-trained athletes have better postural performance compared to untrained men, it's not quite clear, if the formers' upright posture would be more stable during different ventilation modes, maximal voluntary hyperventilation and inspiratory breath-holding. There are no studies on this subject in the available literature.

Objectives:

The aim of this study was to investigate an influence of maximal inspiratory breath-holding and maximal voluntary hyperventilation on the standing balance of athletes.

Patients and Methods:

We assessed the amplitude and the velocity of postural sway in the athletes (n = 38) and untrained subjects (n = 28) by the force platform. The frequency characteristics of the center of pressure (CP) oscillations' were also analyzed. The amplitude and the frequency of respiratory movements were estimated by the strain gauge.

Results:

It was found that during quiet breath velocity and frequency of CP oscillations were lower in the athletes. Breath holding led to an increase of velocity and frequency of CP displacement in both groups, increase of these indices was more pronounced in the athletes. Maximal voluntary hyperventilation caused a significant increase of all stabilographic indices in both groups. Increase of frequency and amplitude of respiratory movements were mainly observed during hyperventilation in athletes and it caused an increase of the velocity of CP displacement. Changes of sway amplitude were the same in both groups.

Conclusions:

Breath holding led to activation of the postural control, which was more pronounced in the athletes. Hyperventilation caused an impairment of the postural stability. The athletes' postural system compensated the impact of hyperventilation more efficiently versus controls, but it was achieved at the expense of greater effort.

Effects of acute bouts of physical activity on children's attention: a systematic review of the literature

The aim of this review was to describe the effects of acute bouts of physical activity on attention levels of children. A systematic review was performed of English studies from searches in PubMed, Sportdiscus and PsycINFO from 1990 to (May) 2014 according to the PRISMA statement. Only prospective studies of children aged 4-18 years old were included, detailing acute effects of physical activity bouts with the primary outcome attention. One reviewer extracted data on the study characteristics. Two reviewers conducted the methodological quality assessment independently using a criteria checklist, which was based on the Downs and Black checklist for non-randomised studies. Overall the evidence is thin and inconclusive. The methodological differences in study sample (size and age), study design and measurement of attention make it difficult to compare results. There is weak evidence for the effect of acute bouts of physical activity on attention. More experimental studies with a comparable methodology, especially in the school setting, are needed to strengthen this evidence.

Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting

Background

Previous research aimed at improving injury surveillance standards has focused mainly on issues of data quality rather than upon the implementation of surveillance systems. There are numerous settings where injury surveillance is not mandatory and having a better understanding of the barriers to conducting injury surveillance would lead to improved implementation strategies. One such setting is community sport, where a lack of available epidemiological data has impaired efforts to reduce injury. This study aimed to i) evaluate use of an injury surveillance system following delivery of an implementation strategy; and ii) investigate factors influencing the implementation of the system in community sports clubs.

Methods

A total of 78 clubs were targeted for implementation of an online injury surveillance system (approximately 4000 athletes) in five community Australian football leagues concurrently enrolled in a pragmatic trial of an injury prevention program called FootyFirst. System implementation was evaluated quantitatively, using the RE-AIM framework, and qualitatively, via semi-structured interviews with targeted-users.

Results

Across the 78 clubs, there was 69% reach, 44% adoption, 23% implementation and 9% maintenance. Reach and adoption were highest in those leagues receiving concurrent support for the delivery of FootyFirst. Targeted-users identified several barriers and facilitators to implementation including personal (e.g. belief in the importance of injury surveillance), socio-contextual (e.g. understaffing and athlete underreporting) and systems factors (e.g. the time taken to upload injury data into the online system).

Conclusions

The injury surveillance system was implemented and maintained by a small proportion of clubs. Outcomes were best in those leagues receiving concurrent support for the delivery of FootyFirst, suggesting that engagement with personnel at all levels can enhance uptake of surveillance systems. Interview findings suggest that increased uptake could also be achieved by educating club personnel on the importance of recording injuries, developing clearer injury surveillance guidelines, increasing club staffing and better remunerating those who conduct surveillance, as well as offering flexible surveillance systems in a range of accessible formats. By increasing the usage of surveillance systems, data will better represent the target population and increase our understanding of the injury problem, and how to prevent it, in specific settings.

Electronic supplementary material

The online version of this article (doi:10.1186/s40621-014-0019-y) contains supplementary material, which is available to authorized users.

The influence of joint hypermobility on functional movement control in an elite netball population: A preliminary cohort study

OBJECTIVES

To ascertain the prevalence of General Joint Hypermobility (GJH) and Joint Hypermobility Syndrome (JHS) in elite level netballers. To investigate whether GJH influences functional movement control and explore whether symptoms of dysautonomia are reported in this population.

DESIGN

Observational within-subject cross-sectional design.

SETTING

Field based study.

PARTICIPANTS

27 elite level netballers (14-26 years).

MAIN OUTCOME MEASURES

GJH and JHS were assessed using the Beighton scale, 5 point questionnaire and the Brighton Criteria. Functional movement control was measured using posturography on a force platform and the Star Excursion Balance Test (SEBT).

RESULTS

The prevalence of GJH was 63% (n = 17) (Beighton score ≥4/9) and JHS was 15% (n = 4). Symptoms of dysautonomia were minimally prevalent. A trend was observed in which participants with GJH demonstrated increased postural instability on the functional tests. Following Bonferroni adjustment, this was statistically significant only when comparing posturographic data between the distinctly hypermobile participants and the rest of the group for path area (p = 0.002) and velocity (p = 0.002) on the left side.

CONCLUSIONS

A high prevalence of GJH was observed. A trend towards impairment of functional movement control was observed in the netballers with GJH. This observation did not reach statistical significance except for posturographic path area and velocity.

[Sport and urinary incontinence in women]

Women are more attentive to their physical appearance and a quarter of French women use to practice a regular physical activity. Benefits of sport on general health are recognized. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. In literature, intensive exercise is a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hyperpressure, inherent with certain activities, and excess capacity of sphincters. Some sports are more risky than others, and high-level sportswomen are the most exposed. Health professionals must invest in information, screening, prevention, counseling and treatment track athletes So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic and monitoring of sportswomen. Better information is needed because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge and to improve the management of these patients.

What doesn't kill me…: Adversity-related experiences are vital in the development of superior Olympic performance

OBJECTIVES

Recent research suggests that experiencing some adversity can have beneficial outcomes for human growth and development. The purpose of this paper was to explore the adversities that the world's best athletes encounter and the perceived role that these experiences play in their psychological and performance development.

DESIGN

A qualitative design was employed because detailed information of rich quality was required to better understand adversity-related experiences in the world's best athletes.

METHODS

Semi-structured interviews were conducted with 10 Olympic gold medalists from a variety of sports. Inductive thematic analysis was used to analyze the data.

RESULTS

The findings indicate that the participants encountered a range of sport- and non-sport adversities that they considered were essential for winning their gold medals, including repeated non-selection, significant sporting failure, serious injury, political unrest, and the death of a family member. The participants described the role that these experiences played in their psychological and performance development, specifically focusing on their resultant trauma, motivation, and learning.

CONCLUSIONS

Adversity-related experiences were deemed to be vital in the psychological and performance development of Olympic champions. In the future, researchers should conduct more in-depth comparative studies of Olympic athletes' adversity- and growth-related experiences, and draw on existing and alternative theoretical explanations of the growth-performance relationship. For professional practitioners, adversity-related experiences offer potential developmental opportunities if they are carefully and purposely harnessed.

[High blood pressure and physical exercise]

High blood pressure is a frequent pathology with many cardiovascular complications. As highlighted in guidelines, the therapeutic management of hypertension relies on non-pharmacological measures, which are diet and regular physical activity, but both patients and physicians are reluctant to physical activity prescription. To acquire the conviction that physical activity is beneficial, necessary and possible, we can take into account some fundamental and clinical studies, as well as the feedback of our clinical practice. Physical inactivity is a major risk factor for cardiovascular morbidity and mortality, and hypertension contributes to increase this risk. Conversely, regular practice of physical activity decreases very significantly the risk by up to 60%. The acute blood pressure changes during exercise and post-exercise hypotension differs according to the dynamic component (endurance or aerobic and/or strength exercises), but the repetition of the sessions leads to the chronic hypotensive benefit of physical activity. Moreover, physical activity prescription must take into account the assessment of global cardiovascular risk, the control of the hypertension, and the opportunities and desires of the patient in order to promote good adherence and beneficial lifestyle change.

Evaluation of a cross-sector community initiative partnership: delivering a local sport program

Corporate community initiatives (CCI) are often established via cross-sector partnerships with nonprofit agencies to address critical social problems. While there is a growing body of literature exploring the effectiveness and social impact of these partnerships, there is a limited evaluative research on the implementation and execution processes of CCIs. In this paper, we examined the implementation and operational processes in the delivery of a professional sport organization's CCI initiative using program theory evaluation. The findings showed discrepancies between the associate organization and the implementers regarding understanding and fulfilling responsibilities with performing certain aspects (maintaining accurate records and program marketing) of the service delivery protocol. Despite program stakeholders being satisfied overall with the program delivery, contradictions between program stakeholders' satisfaction in the quality of program delivery was found in critical components (marketing and communications) of the service delivery. We conclude that ongoing evaluations are necessary to pinpoint the catalyst of the discrepancies along with all partners valuing process evaluation in addition to outcome evaluation.

When 'just doing it' is not enough: assessing the fidelity of player performance of an injury prevention exercise program

OBJECTIVES

To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF).

DESIGN

Observational.

METHODS

The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly.

RESULTS

The raters agreed on 61/70 observations (87%) (Kappa=0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed.

CONCLUSIONS

The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

It is now recognised that inactive lifestyles underpin much of the disease burden evident in the richer nations of the world. Indeed, the WHO has identified physical inactivity as a 'global public health problem' and has established minimum physical activity (PA) targets for people at different stages of the life-course. Yet, according to WHO, just under 1/3 of working age adults across the globe meet those targets and it is not at all clear how the disjunction between the recommendations of policy makers and the behaviour of ordinary people might be surmounted. Using an opportunity to examine the impact of an urban regeneration project on community residents in East Belfast (Northern Ireland) this paper examines the views of some 113 people on how to increase rates of PA in an area of multiple deprivation. The results of the analysis suggest that lay people rarely consider PA as a discrete issue, or one that centres on individuals and their motivation, but rather as one component in a complex web of concerns, processes and events that include such things as the actions of neighbours and relatives, material and political environments, vandalism, violence, and the weather. We explore and unravel the nature of those concerns using novel methods of content analysis that generate 'issue webs'. Particular attention is paid to the ways in which lay people conceptualize 'activity' and to the manner in which they point to ways of encouraging activity that are rooted in everyday life rather than in the corpocentric, agent-centred and often sport dominated strategies favoured by local policy makers. Our results support those who argue that interventions to increase rates of PA need to move beyond behavioural approaches that focus on individuals and consider the social, political and material contexts in which 'activity' occurs.

Usefulness of echocardiography in preparticipation screening of competitive athletes

INTRODUCTION AND OBJECTIVES

Despite the established diagnostic value of the electrocardiogram in preparticipation screening of athletes, some cardiac structural changes can be missed, particularly in early disease stages. The aim of this study was to evaluate the prevalence of cardiac structural changes via the systematic use of echocardiography in preparticipation screening of competitive athletes.

METHODS

Professional athletes or participants in a competitive athletic program underwent a screening that included family and personal medical history, physical examination, electrocardiography, exercise testing, and Doppler echocardiography.

RESULTS

A total of 2688 athletes (67% men; mean age [standard deviation], 21 [10] years) were included. Most of the echocardiographic evaluations (92.5%) were normal and only 203 (7.5%) showed changes; the most frequent change was left ventricular hypertrophy, seen in 50 athletes (1.8%). Cessation of athletic activity was indicated in 4 athletes (0.14%): 2 for hypertrophic cardiomyopathy (electrocardiography had shown changes that did not meet diagnostic criteria), 1 pectus excavatum with compression of the right ventricle, and 1 significant pulmonary valve stenosis; the rest of the changes did not entail cessation of athletic activity and only indicated periodic monitoring.

CONCLUSIONS

Although rare, some cardiac structural changes can be missed on physical examination and electrocardiography; in contrast, they are easily recognized with echocardiography. These findings suggest the use of echocardiography in at least the first preparticipation screening of competitive athletes to improve the effectiveness of programs aimed at preventing sudden death in athletes.

Sport-related concussion: Evaluation and management

Concussion is a common injury among children and adolescents participating in organized sports and recreational activities. Any child or youth who sustains a concussion should be removed from play immediately and medically evaluated as soon as possible. Cognitive and physical rest are recommended to allow symptoms to resolve. Cognitive rest may require temporary school absence and/or a modified class work or homework load. After symptoms have completely resolved at rest and a full return to school is achieved, the student can progress through a medically supervised, stepwise exertion protocol to return to play. Everyone involved in child and youth sports must recognize the signs and symptoms of concussion, and ensure that any child or adolescent suspected of sustaining a concussion is properly evaluated and managed by qualified medical personnel. The present statement replaces a previous Canadian Paediatric Society position statement published in 2006 and revised in 2012.

Epidemiology of concussion in sport: a literature review

OBJECTIVE

The purpose of this study was to summarize sport concussion incidence data, identify sports that present higher injury frequency, reveal the degree of risk in some lesser-known sports, and outline specific details within the sports literature that raise additional concerns, such as helmet-to-helmet contact and player positions that experience frequent impact.

METHODS

A systematic literature review of Pub Med using keyword search on injury, concussion, and sports was performed through May 2012. Abstracts were identified, selections were made based upon inclusion criteria, and full-length articles were obtained. Additional articles were considered following review of reference sections. Articles were reviewed and tabulated according to sport.

RESULTS

Two hundred eighty-nine articles were screened, and 62 articles were reviewed. The overall incidence of concussion in sport ranged from 0.1 to 21.5 per 1000 athletic exposures. The lowest incidence was reported in swimming and diving. Concussion incidence was highest in Canadian junior ice hockey, but elevated incidence in American football remains a concern because of the large number of participants.

CONCLUSIONS

The literature reviewed included incidence of concussion on the field of play under real-world conditions and influenced by the current culture of sport. The studies examined in this article show that there is risk of concussion in nearly every sport. Some sports have higher concussion frequency than others, which may depend upon the forces and roles of the positions played in these sports. Younger athletes have a higher incidence of concussion, and female incidence is greater than male in many comparable sports. Headgear may reduce concussion in some sports but may also give athletes a false sense of protection.

Incidence and risk factors of lower leg fractures in Belgian soccer players

INTRODUCTION

Soccer is the world's most popular sport and one that is physically demanding and highly competitive. Consequently, the rate of injuries resulting from this sport is only increasing. It is estimated that 2-20% of all such injuries are fractures, one-third of which are located in the lower extremities. The aim of this epidemiological study was to investigate the incidence of lower-leg fractures (LLFs) in Belgian soccer players and determine the possible risk factors that lead to them.

METHODS

All injuries of players associated with the Royal Belgium Football Association (RBFA) were reported and collected in a nationwide registry. We retrospectively compared the incidence rate of and risk factors for LLFs in Belgian soccer players during two seasons, 1999-2000 and 2009-2010.

RESULTS

In total, 1600 fractures (3%) were located in the lower leg. After a decade, the number of LLFs remained unchanged. Ankle fractures were the most common (37%), followed by foot and tibia fractures (33% and 22%, respectively). The least common were fibula fractures, which accounted for just 9%. A higher incidence of every type of LLF was observed in older and amateur-level soccer players, when compared with their younger and professional counterparts. Male players experienced more tibia and foot fractures, whereas the incidences of ankle and fibula fractures were comparable with those in female soccer players. The vast majority of fractures occurred during soccer games.

CONCLUSION

Ankle fractures and foot fractures represented two-thirds of all fractures noted in this analysis. Male gender, recreational level and adult age were important risk factors for LLFs. After 10 years, the incidence of LLFs did not decrease. Given the socioeconomic impact of these injuries, improved prevention techniques are required to reduce their incidence, particularly with regard to the frequently occurring ankle and foot fractures in this population.

Considering how athletic identity assists adjustment to spinal cord injury: a qualitative study

OBJECTIVES

To establish how sport, and access to an athletic identity, has been used when adjusting to a spinal cord injury.

DESIGN

Qualitative study using semi-structured interviews.

SETTING

Private athletic club.

PARTICIPANTS

Eight (six males and two females) athletes from a wheelchair badminton club participated in the study. The individuals had finished rehabilitation, and were aged between 20 and 50 years.

MAIN OUTCOME MEASURES

A single semi-structured interview was undertaken with each participant.

RESULTS

Following the thematic analysis, two final themes were presented: (1) adjustment and paradox of chronic illness; and (2) the role and value of an athletic identity.

CONCLUSIONS

Badminton provided participants with an opportunity to continue and develop a positive athletic identity. Identity may be used as a factor that can promote recovery, and is considered as a way to encourage and maintain positive long-term adjustment to disability.

Bodychecking in youth ice hockey

Hockey is one of the most popular sports for Canadian children and youth. While the health benefits of physical activity and sport participation are well recognized, there is increasing concern around the frequency and severity of hockey-related injuries, particularly concussion. Studies consistently identify bodychecking as the primary mechanism associated with youth hockey injuries, including concussion. Policy to delay bodychecking until bantam league play (when participants are 13 to 14 years of age) will reduce the risks of injury and concussion in young ice hockey players. Bodychecking should be eliminated from non-elite youth ice hockey. The age at which bodychecking is introduced in competitive hockey leagues must be reconsidered. Both initiatives require policy change in many provinces/territories, and must be re-evaluated prospectively in light of emerging research.

Mental health and social participation skills of wheelchair basketball players: a controlled study

The aim of this study was to assess differences in psychological well-being, symptomatic psychological disorders and social participation, between competitive wheelchair basketball participants and those non-participants. Forty-six wheelchair participants, 24 Basketball players (aged 35.60 ± 7.56) and 22 non-players (aged 36.20 ± 6.23), completed three validated self-report questionnaires: Participation Scale (PS), Psychological Well-Being Scale [PWBS] and Symptom Checklist 90 R [SCL-90-R]. ANOVA showed significant overall differences between the two groups. The social restriction score, evaluated by PS, was significantly higher in the non-basketball participants (p=0.00001) than the basketball participants. The PWB Scale showed significant differences in all 6 dimensions: positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance (p<0.01), and autonomy (p<0.05), with better scores in the basketball participants. The SCL-90-R scores were significantly lower for the basketball group in the following 6 symptomatic dimensions: depression, phobic anxiety, and sleep disorder (p<0.01), somatization, interpersonal sensitivity and psychoticism (with p<0.05). It was concluded that competitive wheelchair basketball participants showed better psychological well-being and social skills than those non-participants.

Acute clinical and coronary angiographic characteristics in 16 cases]

OBJECTIVE

Determination of clinical and angiographic characteristics of myocardial infarctions related to sport.

METHODS

Retrospective study of acute coronary syndromes with ST elevation related to sport treated with interventional cardiology from 2006 to 2013.

RESULTS

Sixteen patients were included. They are mostly men (15/16), aged 24-65 years (over 35 years old in 13 cases) with few cardiovascular risk factors, most frequently heredity or smoking. Myocardial infarctions usually occur during the practice of sports (13/16), with serious rhythmic complications in three of the cases. On angiography, most patients have single vessel disease (12/16).

CONCLUSION

Myocardial infarction related to sports affects a male population aged over 35 years old with few cardiovascular risk factors, most often single vessel disease, making the preventative screening uneasy. Other studies investigating larger populations, assessing previous clinical events (symptoms, results of stress tests), evaluating the impact of competition and integrating sudden deaths would improve the screening and the treatment of sport-related myocardial infarctions.

Validation of a protocol for the estimation of three-dimensional body center of mass kinematics in sport

Since strictly related to balance and stability control, body center of mass (CoM) kinematics is a relevant quantity in sport surveys. Many methods have been proposed to estimate CoM displacement. Among them, segmental method appears to be suitable to investigate CoM kinematics in sport: human body is assumed as a system of rigid bodies, hence the whole-body CoM is calculated as the weighted average of the CoM of each segment. The number of landmarks represents a crucial choice in the protocol design process: one have to find the proper compromise between accuracy and invasivity. In this study, using a motion analysis system, a protocol based upon the segmental method is validated, adopting an anatomical model comprising 14 landmarks. Two sets of experiments were conducted. Firstly, our protocol was compared to the ground reaction force method (GRF), accounted as a standard in CoM estimation. In the second experiment, we investigated the aerial phase typical of many disciplines, comparing our protocol with: (1) an absolute reference, the parabolic regression of the vertical CoM trajectory during the time of flight; (2) two common approaches to estimate CoM kinematics in gait, known as sacrum and reconstructed pelvis methods. Recognized accuracy indexes proved that the results obtained were comparable to the GRF; what is more, during the aerial phases our protocol showed to be significantly more accurate than the two other methods. The protocol assessed can therefore be adopted as a reliable tool for CoM kinematics estimation in further sport researches.

A systematic review of studies comparing body image concerns among female college athletes and non-athletes, 1997-2012

Research prior to 2001 indicated that athletes experienced better body image than non-athletes, with no differences among sport types. Since then, female athletes have become increasingly sexually objectified in the media, and the sociocultural beauty ideal has shifted to emphasize appearing both athletic and thin. Part I of this paper explores the literature describing these changes. Part II presents a systematic and comprehensive literature review of 10 recent studies comparing body image concerns (BIC) among collegiate female athletes and non-athletes to identify the current status of BIC in female athletes. Findings indicate that involvement in collegiate athletics provides some protection from BIC; however, this protection appears attenuated for athletes in more feminine sports (e.g., gymnastics), and higher level athletes (Division I). Researchers should examine how sociocultural pressures unrelated to competition predict female athletes' BIC using measures that focus on objectification, positive body image, body functionality, and thin- and athletic-ideal internalization.

Practice effects reveal visuomotor vulnerability in school and university rugby players

This article reports on three pre- versus post-season prospective studies in which male university and high school contact sport players predominantly of Rugby Union (hereafter rugby) were compared with age, education, and IQ equivalent non-contact sport controls on the ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) test. All analyses revealed a relative absence of practice effects on the Visual Motor Speed (VMS) composite for contact sport groups compared with controls. The VMS data for rugby players from each study were pooled and subjected to additional analysis (Rugby, n = 145; Controls, n = 106). Controls revealed significant improvement over the season (p < .001), whereas no learning effect was in evidence for rugby players whose performance remained the same (interaction effect, p = .028). It is apparent that practice effects have diagnostic potential in this context, implicating vulnerability on speeded visuomotor processing in association with participation in rugby. Pointers for further research and concussion management in the individual case are explored.

Sport-specific endurance plank test for evaluation of global core muscle function

OBJECTIVE

To examine the validity and reliability of a sports-specific endurance plank test for the evaluation of global core muscle function.

DESIGN

Repeated-measures study.

SETTING

Laboratory environment.

PARTICIPANTS

Twenty-eight male and eight female young athletes.

MAIN OUTCOME MEASURES

Surface electromyography (sEMG) of selected trunk flexors and extensors, and an intervention of pre-fatigue core workout were applied for test validation. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and the measurement bias ratio */÷ ratio limits of agreement (LOA) were calculated to assess reliability and measurement error.

RESULTS

Test validity was shown by the sEMG of selected core muscles, which indicated >50% increase in muscle activation during the test; and the definite discrimination of the ∼30% reduction in global core muscle endurance subsequent to a pre-fatigue core workout. For test-retest reliability, when the first attempt of three repeated trials was considered as familiarisation, the ICC was 0.99 (95% CI: 0.98-0.99), CV was 2.0 ± 1.56% and the measurement bias ratio */÷ ratio LOA was 0.99 */÷ 1.07.

CONCLUSION

The findings suggest that the sport-specific endurance plank test is a valid, reliable and practical method for assessing global core muscle endurance in athletes given that at least one familiarisation trial takes place prior to measurement.

Greater chance of high core temperatures with modified pacing strategy during team sport in the heat

OBJECTIVES

To measure the activity profile, hydration status and core temperature of elite team sport athletes during matches in hot and cool conditions.

DESIGN

Thirty-five professional Australian footballers (age 25.9 ± 3.5 yrs; height 188.4 ± 7.8 cm; body mass 90.6 ± 8.8 kg), gave informed consent to participate in this study. Core temperature (T(c)), hydration and running performance were compared in eight hot and eight cool matches classified via a rating of the risk of heat illness from the Wet Bulb Globe Temperature (WBGT).

METHODS

Core temperature was measured via an ingestible sensor before matches and after each quarter and player movement was recorded by 5 Hz GPS and expressed per period of the match (rotation), for distance; high-intensity running (HIR, 4.17-10.00 m s(-1)), sprinting (>4.17 m s(-1)) and maximal accelerations (2.78-10.00 m s(-2)). All data was compared for hot and cool matches and the magnitude of effects was analysed with the effect size (ES) statistic.

RESULTS

Core temperature was elevated from rest at all time-points during matches (37.3-39.4 °C), with small additional elevations after the first and third quarters in hot matches (ES: 0.39 ± 0.40 and 0.37 ± 0.42 respectively). In hot matches 12 players had T(c)>40 °C but only one in cool matches. Total distance was reduced in the latter parts of each half (-6.5%, -0.49 ± 0.58; and -6.7%, -0.57 ± 0.59), yet the high intensity tasks of sprinting and accelerating were preserved.

CONCLUSIONS

Players tolerated core temperatures up to 40.5 °C during hot matches but reduced the volume of running undertaken, thus preserving the ability to undertake high intensity activities.