Proceedings from the Ice Hockey Summit III: Action on Concussion

The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: 1) describe sport-related concussion (SRC) epidemiology, 2) classify prevention strategies, 3) define objective, diagnostic tests, 4) identify treatment, and 5) integrate science and clinical care into prioritized action plans and policy. Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches, and officials) voted to prioritize these action items in the final Summit session. 1) Establish a national and international hockey data base for SRC at all levels, 2) eliminate body checking in Bantam youth hockey games, 3) expand a behavior modification program (Fair Play) to all youth hockey levels, 4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues, 5) establish objective tests to diagnose concussion at point of care (POC), and 6) mandate baseline testing to improve concussion diagnosis for all age groups. Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity, and consequences of concussion in the sport of ice hockey.

The Effects of Caffeine on Vertical Jump Height and Execution in Collegiate Athletes

Bloms, LP, Fitzgerald, JS, Short, MW, and Whitehead, JR. The effects of caffeine on vertical jump height and execution in collegiate athletes. J Strength Cond Res 30(7): 1855-1861, 2016-Caffeine ingestion elicits a variety of physiological effects that may be beneficial to maximal-intensity exercise performance, although its effectiveness and physical mechanism of action enhancing ballistic task performance are unclear. The purpose of this study was to examine the effects of caffeine ingestion on vertical jump height and jump execution in Division I collegiate athletes. The study used a single-blind, randomized, crossover design. Athletes (n = 25) consumed either caffeine (5 mg·kg) or placebo. After a 60-minute waiting period, athletes performed 3 squat jumps (SJ) and 3 countermovement jumps (CMJ) while standing on a force platform. Jump height and execution variables were calculated from mechanography data. In comparison with placebo, caffeine increased SJ height (32.8 ± 6.2 vs. 34.5 ± 6.7 cm; p = 0.001) and CMJ height (36.4 ± 6.9 vs. 37.9 ± 7.4 cm; p = 0.001). Peak force (p = 0.032) and average rate of force development (p = 0.037) were increased during the CMJ in the caffeine trail compared with the control. Time to half peak force was the only execution variable improved with caffeine (p = 0.019) during the SJ. It seems that caffeine affects both height and execution of jumping. Our data indicate that the physical mechanism of jump enhancement is increased peak force production or rate of force development during jumping depending on technique. The physical mechanism of jump enhancement suggests that the ergogenic effects of caffeine may transfer to other ballistic tasks involving the lower-body musculature in collegiate athletes.

Comparative Effectiveness Research: A Roadmap for Physical Activity and Lifestyle

PURPOSE

Comparative effectiveness research (CER) is designed to support informed decision making at both the individual, population, and policy levels. The American College of Sports Medicine and partners convened a conference with the focus of building an agenda for CER within the context of physical activity and nonpharmacological lifestyle approaches in the prevention and treatment of chronic disease. This report summarizes the conference content and consensus recommendations that culminated in a CER roadmap for physical activity and lifestyle approaches to reducing the risk of chronic disease.

METHODS

This conference focused on presentations and discussion around the following topic areas: 1) defining CER, 2) identifying the current funding climate to support CER, 3) summarizing methods for conducting CER, and 4) identifying CER opportunities for physical activity.

RESULTS

This conference resulted in consensus recommendations to adopt a CER roadmap for physical activity and lifestyle approaches to reducing the risk of chronic disease. In general, this roadmap provides a systematic framework by which CER for physical activity can move from a planning phase to a phase of engagement in CER related to lifestyle factors with particular emphasis on physical activity to a societal change phase that results in changes in policy, practice, and health.

CONCLUSIONS

It is recommended that physical activity researchers and health care providers use the roadmap developed from this conference as a method to systematically engage in and apply CER to the promotion of physical activity as a key lifestyle behavior that can be effective at making an impact on a variety of health-related outcomes.

The Effects of Proprioceptive Neuromuscular Facilitation Stretching on Post-Exercise Delayed Onset Muscle Soreness in Young Adults

Until recently, the scientific community believed that post-exercise stretching could reduce delayed onset muscle soreness (DOMS), but recent reviews of studies on the topic have concluded that pre- or post-exercise static stretching has no effect on mitigating DOMS. However, the effect of proprioceptive neuromuscular facilitation (PNF) post-exercise stretching on preventing DOMS has not been adequately studied. The purpose of this study was to determine the effect of post-exercise PNF stretching on DOMS. Young adult participants (N=57) were randomly assigned to a PNF stretching group (n=19), a static stretching group (n=20), and to a no-stretching control group (n=18). All participants completed exercise designed to induce DOMS prior to post-exercise experimental stretching protocols. Participants rated their soreness level on a pain scale 24 and 48 hours post-exercise. A 3 × 2 mixed ANOVA showed there was an effect for time (p<.01). Post hoc testing revealed that DOMS pain significantly decreased (p<.05) from 24 to 48 hours post-exercise for the PNF and control groups, but not for the static stretching group. Other analyses revealed a significant correlation (r=.61, p<.01) between the pre- and post-exercise stretch scores and the 48 hour post-exercise pain score for the PNF group. Consistent with the results of previous research on post-exercise static stretching, these results indicate that post-exercise PNF stretching also does not prevent DOMS. However, the correlation analysis suggests it is possible the pre-stretch muscle contractions of the post-exercise PNF protocol may have placed a load on an already damaged muscle causing more DOMS for some participants.

Pre-Workout Carbohydrate Supplementation does not Affect Measures of Selfassessed Vitality and Affect in College Swimmers

Beneficial effects of dietary carbohydrate (CHO) on physical and psychological parameters have been demonstrated in athletes. Because affect, or mood, can predict athletic performace, the main objective of this study was to determine the effect of pre-workout CHO on affect in swimmers. College swimmers (n = 37) participated in a randomized crossover experiment of the effects of a pre-workout CHO supplement on vitality and affect. Subjects consumed a CHO supplement or placebo for two days before morning practice. After each morning practice, swimmers completed measures of affect and feelings of vitality. Pearson correlations were performed to describe relationships among variables. Differences in means between the CHO and placebo conditions were determined by paired t-tests. Independent t-tests were used to determine differences in variables between the highest and lowest tertiles of breakfast consumption frequency. All statistical analyses were performed using SAS 9.1.3 (Cary, NC) and statistical signficance was set at α = 0.05. There were no significant differences in affect or feelings of vitality between the CHO supplement and placebo conditions (all p ≥ 0.15). Our results do not support a beneficial effect of CHO supplementation before morning swim practice on affect or feelings of vitality in swimmers. Key pointsPre-workout carbohydrate did not affect post-workout measures of vitality or affect in collegiate swimmers.Avoidance of feeling nauseous/ill' and 'lack of time' were the most frequent reasons reported by swimmers for forgoing breakfast before morning swim practice.A longer trial of carbohydrate supplementation is needed to verify if there is indeed no effect of pre-workout carbohydrate on post-workout measures of vitality or affect in swimmers.

Using skinfold calipers while teaching body fatnessrelated concepts: Cognitive and affective outcomes

Body composition testing has been advocated as part of fitness test batteries in an educational effort to promote health-related fitness, and to prevent public health problems like obesity. However, the measurement of the body composition of children and youth, especially involving the use of skinfold calipers, has raised concerns. In two experiments the cognitive and affective consequences of skinfold caliper use in a 7th grade (155 boys, 177 girls, total N = 332) health/physical education context were examined. Experiment 1 demonstrated that the students could be taught to accurately measure a partner and/or significantly learn body fatness-related concepts compared to controls. It was also shown that inexpensive plastic Fat Control calipers produced accurate measurements. Experiment 2 was designed to replicate the significant cognitive outcome effects, and also to test the hypothesis that psychological damage is a likely consequence of skinfold caliper use-and that hypothesis was refuted. Specifically, knowledge scores, and outcome scores on adapted affect scales (e.g., PANAS, MAACL), physical self-esteem scales (CY-PSPP) and on the Social Physique Anxiety Scale supported the premise that skinfold calipers can be used in an educational context to facilitate cognitive learning without causing adverse affective consequences.

Breast cancer prediction and the Wolfe classification of mammograms

Mammographic parenchymal patterns have been proposed as a method of determining women at high risk of developing breast cancer. Wolfe's original report of relative risks as high as 37:1 for "dysplastic" breasts (DY) as compared with adipose breasts (N1), with intermediate values of P1 and P2, were not uniformly confirmed by others. (Relative risks are used here as the equivalent of odds ratios.) A case-control study of 706 breast cancers, each with two matching controls, drawn from 40,000 participants in four Breast Cancer Detection Demonstration Project clinics, was conducted to assess the role of the Wolfe classification of breast parenchymal patterns as a breast-cancer risk factor together with a set of well-established risk factors for breast cancer. Relative risks of 3.1 for DY to N1, 3.5 for P2 to N1, and 2.0 for P1 to N1 were determined. These are comparable to or greater than other known risk factors found in the same population. The Wolfe classification of parenchymal patterns strengthens the basis for clinical judgment, but should not be used exclusively to determine intervention in an individual patient's care.

Quantitative electrophysiological study of alcoholic neuropathy

Thirty-one chronic alcoholic patients were investigated using quantitative electrophysiological techniques. Estimates of the numbers of functioning motor units in the extensor digitorum brevis muscles and measurements of the parameters of the potentials of these units are presented along with the values for motor nerve conduction velocities in the innervating lateral popliteal nerves. Motor conduction velocities and sensory nerve action potential amplitudes were also measured in the ulnar nerves. The results and their inter-relationships lead us to conclude that the slowing of motor nerve conduction and reduction in sensory nerve action potential amplitudes in alcoholic neuropathy are a consequence of axon loss. We found no evidence of pathological slowing of conduction in surviving axons. Reinnervation by functioning motor axons is poor compared to a number of other neuropathic conditions. In our patients there was no evidence of preferential involvement of sensory axons. The results support a predominant axonal dysfunction in alcoholic neuropathy.