Lightweight rowers’ perspectives of living with Relative Energy Deficiency in Sport (RED-S)

Objective

To compete in lightweight rowing, strict limits are placed on the maximum body weight of each individual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers.

Design

Semi-structured individual qualitative interviews.

Participants

Adults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S.

Method

Audio-recorded semi-structured individual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software.

Results

Twelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems.

Conclusions

This study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S.

Understanding a population: A methodology for a population-based coastal safety survey

Drowning is a global public health problem, but accurately estimating drowning risk remains a challenge. Coastal drowning comprises a significant proportion of the drowning burden in Australia and is influenced by a range of behavioural factors (e.g. risk perception, knowledge, attitudes and behaviours) that are poorly understood. These factors, along with those that impact exposure (e.g. coastal visitation and activity participation) all impact on drowning risk. While excellent mortality and morbidity data exists in Australia, a lack of coastal participation data presents challenges to identifying high-risk groups or activities and prioritising prevention efforts. This methods paper describes the development and evolution of an ongoing, annual, nationally representative online survey as an effective tool used to capture valuable data about the Australian population’s relationship with the coast. This paper explores how the survey is structured (12–14 sections spanning multiple topics and themes), the different question types used (including open text, 4-digit responses and categorical questions), the sample size (1400–1600 respondents), sampling strategy (using demographic quota sampling which can then be post-weighted to the population if required) and how topics and themes have changed over time to enhance the quality of data collected (i.e., wording changes to enhance participant comprehension or data usability and changing issue-specific ‘feature’ topics of interest such as campaign evaluation). How the survey is implemented online is described, both practically through to third-party recruitment processes and ethically to maximise anonymity of respondents and ensure data quality. Interim analyses indicate the impact of considering exposure when calculating fatal drowning rates, especially by activity (e.g., crude boating drowning rate 0.12 per 100,000 population vs 0.95 per 100,000 exposed population [relative risk = 8.01; 95% confidence interval: 4.55–14.10]). This study highlights lessons learned in the process of conducting a nationally representative coastal participation survey as well as the strengths and limitations of adopting this approach. Data collected will provide more detailed information on the skills, behaviours, knowledge and attitudes of coastal activity participants. Analyses of this unique dataset will inform research that will underpin development and evaluation of coastal drowning prevention initiatives prioritising those most at risk. It is hoped that the methods detailed within this study may be useful for other countries to develop similar approaches to understanding their own population.

A brief literature review of the psychological benefits of volunteerism in watersports inclusion

The 2009 National Guidelines on Physical Activity for Ireland assert that 'all people with disabilities should be active'. Events such as the Watersports Inclusion Games invite individuals across the full spectrum of abilities to take part in physical activity in the form of adaptive watersports. This literature review aims to assess the value of inclusive watersport events such as this in the context of what is currently published on the motivation and benefits for volunteers in watersports inclusion. This is the first review that we are aware of on this subject. A literature review was performed using the Population, Exposures and Outcomes framework. Medical and psychological databases, journals and grey literature were searched using keywords, and articles were selected according to their relevance to the question. References from these articles were then hand-searched. The outcomes of this review suggest that, while there are many papers published on the benefits for volunteers in general and in sport, there is a relative paucity of literature on volunteers in inclusive sport, and even less relating to inclusive watersports. This review identifies a powerful opportunity to provide evidence to support the benefits of inclusive watersport for both participants and volunteers. Further research is required on why volunteers become involved in inclusive watersports and the benefits they derive from their involvement.

Improvement of quality of life in adolescents with epilepsy after an empowerment and sailing experience

PURPOSE

Epilepsy in adolescents affects their psychological health, independence, and emotional adjustment. Psychological and self-management interventions might give benefits to adolescent with epilepsy in terms of quality of life, emotional well-being, and reduced fatigue. "Fondazione Tender To Nave Italia" promotes a project using sailing activities as an empowerment opportunity. The main aim of our study was to examine the empowerment effects on quality of life of adolescents with epilepsy attending sailing activities, and to compare the results perceived by adolescents and their parents.

METHODS

Fifty-eight patients with a diagnosis of epilepsy were included in an empowerment project titled "Waves rather than spikes" from June 2013 to July 2018. Intellectual level was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria. Patients were administered Pediatric Quality of Life Inventory (PedsQL), adolescent and parent version. Behavioral data were collected by parent-report Child Behavior Checklist (CBCL).

RESULTS

Thirty female and 28 male patients with a mean age of 15 years, referred to "Bambino Gesù Children's Hospital" in Italy, were included. Thirty-three (56.9%) patients had a history of refractory epilepsy; 34 (56.2%) received polytherapy, 19 (32.7%) monotherapy, and 5 (8.6%) were not taking antiepileptic drugs. Intellectual functioning was normal in 43 (74.1%), borderline in 9 (15.5%), and mildly impaired in 6 (10.3%). Results from PedsQL adolescent report revealed significant postintervention improvement for total score (p = 0.023) and in two domains: physical health (p = 0.0066) and emotional functioning (p = 0.015). Results from PedsQL parent report showed significant postintervention improvement for the domain of school functioning (p = 0.023). In the multivariate model, a low CBCL value was predicting a higher score in the health subscore difference between pre- and postempowerment activity (p = 000.8).

CONCLUSION

Empowerments activities are crucial in order to reduce the burden of epilepsy in adolescents, and to improve quality of life. These are critical factors for a well-managed transition phase to adulthood.

Effects of aquatic exercise on mental health, functional autonomy and oxidative stress in depressed elderly individuals: A randomized clinical trial

OBJECTIVES

The aim of this study was to investigate the effects of aquatic exercise on mental health, functional autonomy and oxidative stress parameters in depressed elderly individuals.

METHODS

Initially, ninety-two elderly individuals were included in the study and were allocated into the depression group (n=16) and nondepression group (n=14). Both groups engaged in the aquatic exercise program for 12 weeks, including two weekly sessions (45 min/session) at a low intensity (between 50% and 60% of maximal heart rate or Borg scale scores of 13 to 14) throughout the intervention. All outcomes were evaluated at baseline and 12 weeks later.

RESULTS

The patients were 63.5±8.8 years old. The following scores were decreased after training in the depressed group: depression (53%), anxiety (48%), and Timed Up & Go (33%). The following scores increased: Berg Balance Scale (9%) and flexibility (44%). Regarding the blood-based parameters, there were decreases in protein carbonylation (46%) and nitric oxide (60%) and increases in glutathione (170%) and superoxide dismutase (160%) in the depression group (p<0.005).

CONCLUSIONS

The aquatic exercise program reduces depression and anxiety, improves functional autonomy and decreases oxidative stress in depressed elderly individuals.

Factors associated with life jacket use among cabin sailboat and day sailor boaters in the United States

INTRODUCTION

In 2015, drowning accounted for 68% of the 626 recreational boating related deaths in the United States. Although life jackets are estimated to prevent between 50% to 80% of boating deaths, approximately 83% of sailboat-related drowning victims were reported to not be wearing life jackets. Life jacket use among adult boaters has remained consistently low across most boat types and may vary by boater, boating, and environmental conditions. Although many risky environmental and boating factors may be associated with a higher risk of boating death, drowning occurs in all situations and it is useful to understand adult life jacket wearing behaviors in differing boating situations.

METHODS

This study uses observational survey data from 61318 adult sailors collected during the summer months of 1999 - 2017 from 124 selected study sites across 30 states in the US. Life jacket use was compared for day sailors and cabin sailboats by multiple boating, boater, and environmental conditions using Chi-square tests for equality of proportions. Results of these tests led to a choice of 3 informative and scientifically compelling variables to summarize variation in life jacket use for each sailboat type. Odds ratios were calculated comparing life jacket use from each boating situation to the lowest risk situation as determined by the 3 selected variables. These variables were represented in a tree diagram, detailing the additive impact of each factor. Following these analyses, all boating conditions were categorized to be risky or non-risky and a count variable was created for each observation based on the number of risks present. Cochran-Armitage trend tests were conducted to test for linearity in life jacket use for both boat types.

RESULTS

The overall life jacket wear rate was higher among adults in day sailor sailboats (51.6%) compared to cabin sailboats (13.8%) and in all measured demographic, boating, and environmental circumstances. Comparing high-risk cabin sailboat conditions of low water temperatures, small boat size, and high wind speed to the lowest-risk situation accounted for a 23.3% range in life jacket wear rate (OR=4.7). Comparing high-risk day sailor sailboat conditions of small boat size, one boater on board, and choppy/rough wave height to the lowest-risk situation accounted for a 39.3% range in life jacket wear rate (OR=5.9). For both boat types, the number of risks present and life jacket wear rate exhibited a statistically significant positive linear relationship at p<0.0001.

CONCLUSION

Study results suggest that boaters are aware of the connection between life jacket use and drowning prevention and are more likely to wear life jackets when boating in conditions perceived to be risky.

PRACTICAL APPLICATIONS

Boating safety promotion efforts should recommend adult life jacket use in all boating situations, as seemingly non-risky conditions may still result in drownings.

Girls in the boat: Sex differences in rowing performance and participation

Men outperform women in many athletic endeavors due to physiological and anatomical differences (e.g. larger and faster muscle); however, the observed sex differences in elite athletic performance are typically larger than expected, and may reflect sex-related differences in opportunity or incentives. As collegiate rowing in the United States has been largely incentivized for women over the last 20 years, but not men, the purpose of this study was to examine sex differences in elite rowing performance over that timeframe. Finishing times from grand finale races for collegiate championship on-water performances (n = 480) and junior indoor performances (n = 1,280) were compared between men and women across 20 years (1997–2016), weight classes (heavy vs. lightweight) and finishing place. Participation of the numbers of men and women rowers were also quantified across years. Men were faster than women across all finishing places, weight classes and years of competition and performance declined across finishing place for both men and women (P<0.001). Interestingly, the reduction in performance time across finishing place was greater (P<0.001) for collegiate men compared to women in the heavyweight division. This result is opposite to other sports (e.g. running and swimming), and to lightweight rowing in this study, which provides women fewer incentives than in heavyweight rowing. Correspondingly, participation in collegiate rowing has increased by ~113 women per year (P<0.001), with no change (P = 0.899) for collegiate men. These results indicate that increased participation and incentives within collegiate rowing for women vs. men contribute to sex differences in athletic performance.

Effect of Teaching Races for Understanding in Youth Sailing on Performance, Knowledge, and Adherence

PURPOSE

The purpose of this study was to know whether an intervention using an adaptation of the teaching games for understanding approach (named teaching races for understanding [TRfU]) led participants to improve skill execution, decision making, race performance, race involvement, race knowledge, enjoyment, intention to continue practicing sailing, and perceived competence.

METHOD

Participants were 67 children from a randomly selected sailing school (M_age = 9.32 years, SD = 2.60 years) and 2 coaches. We designed and validated the TRfU lessons, and 1 coach was trained in the approach. The TRfU group participated in 11 lessons. This study followed a mixed-methods data approach. Quantitative data were evaluated using a quasiexperimental pretest-posttest design with a control group. The intervention consisted of teaching sailing using the TRfU approach. Children and coaches' perceptions were evaluated through an interview on completion of the study. Data were collected using an adaptation of the Game Performance Assessment Instrument, a knowledge questionnaire, 2 psychological scales, and interviews with children and coaches.

RESULTS

The TRfU group showed statistically significant improvements in skill execution, decision making, and race performance compared with the control group, as well as significant improvements in race involvement, race knowledge, and enjoyment (ES = 0.64-2.63).

CONCLUSION

Teaching races for understanding can be used in sailing to improve students' capacity to reflect and connect theoretical knowledge with their motor performance in the race.