What are our patients asking google about posterior cruciate ligament injuries? - frequently asked online questions and quality of online resources

OBJECTIVES

This study investigates the most common online patient questions pertaining to posterior cruciate ligament (PCL) injuries and the quality of the websites providing information.

METHODS

Four PCL search queries were entered into the Google Web Search. Questions under the 'People also ask' tab were expanded in order and 100 results for each query were included (400 total). Questions were categorized based on Rothwell's Classification of Questions (Fact, Policy, Value). Websites were categorized by source (Academic, Commercial, Government, Medical Practice, Single Surgeon Personal, Social Media). Website quality was evaluated based on the Journal of the American Medical Association (JAMA) Benchmark Criteria. Pearson's chi-squared was used to assess categorical data. Cohen's kappa was used to assess inter-rater reliability.

RESULTS

Most questions fell into the Rothwell Fact category (54.3%). The most common question topics were Diagnosis/Evaluation (18.0%), Indications/Management (15.5%), and Timeline of Recovery (15.3%). The least common question topics were Technical Details of Procedure (1.5%), Cost (0.5%), and Longevity (0.5%). The most common websites were Medical Practice (31.8%) and Commercial (24.3%), while the least common were Government (8.5%) and Social Media (1.5%). The average JAMA score for websites was 1.49 ± 1.36. Government websites had the highest JAMA score (3.00 ± 1.26) and constituted 42.5% of all websites with a score of 4/4. Comparatively, Single Surgeon Personal websites had the lowest JAMA score (0.76 ± 0.87, range [0-2]). PubMed articles constituted 70.6% (24/34) of Government websites, 70.8% (17/24) had a JAMA score of 4 and 20.8% (5/24) had a score of 3.

CONCLUSION

Patients search the internet for information regarding diagnosis, treatment, and recovery of PCL injuries and are less interested in the details of the procedure, cost, and longevity of treatment. The low JAMA score reflects the heterogenous quality and transparency of online information. Physicians can use this information to help guide patient expectations pre- and post-operatively.

Hormonal Basis of Biological Sex Differences in Human Athletic Performance

Biological sex is a primary determinant of athletic human performance involving strength, power, speed, and aerobic endurance and is more predictive of athletic performance than gender. This perspective article highlights 3 key medical and physiological insights related to recent evolving research into the sex differences in human physical performance: (1) sex and gender are not the same; (2) males and females exhibit profound differences in physical performance with males outperforming females in events and sports involving strength, power, speed, and aerobic endurance; (3) endogenous testosterone underpins sex differences in human physical performance with questions remaining on the roles of minipuberty in the sex differences in performance in prepubescent youth and the presence of the Y chromosome (SRY gene expression) in males, on athletic performance across all ages. Last, females are underrepresented as participants in biomedical research, which has led to a historical dearth of information on the mechanisms for sex differences in human physical performance and the capabilities of the female body. Collectively, greater effort and resources are needed to address the hormonal mechanisms for biological sex differences in human athletic performance before and after puberty.

Modelling the optimization of world-class 400 m and 1,500 m running performances using high-resolution data

The 400 m and 1,500 m are track events that rely on different but important contributions from both the aerobic and anaerobic energy systems. The purpose of this study is to model men's and women's 400 m and 1,500 m championship performances to gain a deeper understanding of the key mechanical and physiological factors affecting running speed and bend running using high-resolution data from live competition (10 Hz). To investigate World-class athletes' instantaneous speeds, propulsive forces and aerobic and anaerobic energy, we model and simulate the performances of the men's and women's European Athletics 400 m champions, Matthew Hudson-Smith and Femke Bol, as well as the men's European Athletics 1,500 m champion, Jakob Ingebrigtsen, and the women's European Athletics U23 1,500 m champion, Gaia Sabbatini. The simulations show that a fast start is essential in both the 400 m and 1,500 m because of the need for fast oxygen kinetics, with peak running speeds occurring within the first ∼50 m in both events. Subsequently, 400 m athletes slow continually from this maximum speed to the finish, and a total anaerobic contribution of ∼77% is found for both male and female champions. The key to faster 400 m racing is to reduce the decrease in velocity: this comes from both a high VO2 and a high anaerobic contribution. Ingebrigtsen's winning tactic in the European 1,500 m final is to adopt a very fast cruising pace from 300 m onwards that is possible because he is able to maintain a high VO2 value until the end of the race and has a large anaerobic contribution. He has fast VO2 kinetics that does not require as fast a start as his opponents, but then he speeds up in the last two laps, without a fast sprint finish. The comparison between Sabbatini's slower and quicker races (∼8 s difference) shows that it is the improvement of aerobic metabolism that has the greatest effect on 1,500 m performance. Coaches should note in particular that the all-out pacing nature of the 400 m requires the prioritization of anaerobic energy system development, and those who coach the 1,500 m should note the differing energy contributions between even-paced races and championship racing.

Fatherhood and Elite Athletics: Sacrifice, Selfishness, and Gaining "Dad Strength"

This study contributes to a growing body of scholarly discussions around the many aspects and challenges of combining parenthood with elite-level sport, with a particular focus on the experiences of male elite athletes who are fathers. We used a caring masculinities theoretical framework, community-based participatory research, and semi-structured interviews to explore the experiences of 10 elite/international and world-class athletes (n = 9 fathers, n = 1 expectant father). Through reflexive thematic analysis, we identified three main themes: fatherhood can (1) improve and (2) impede elite athlete-fathers' athletic performance; and (3) athlete-fathers experience a trade-off between athletic performance and fatherhood responsibilities. Our findings underscore the ways in which male athletes' experiences with parenthood reflect the new era of involved fatherhood and are analogous to some of the identity tensions that have been reported with regard to the experiences of elite female athletes who are pregnant and/or mothers. Recognizing the impact of children on male athletes' athletic careers and the parallels between fatherhood, motherhood, and elite sport may lead to better support for athlete-fathers while also contributing to diminishing the expectation that women are primary caregivers to children.

A 16-week school-based intervention improves physical fitness in Slovenian children: a randomized controlled trial

Introduction: The aim of this study was to evaluate the effects of a 16-week school-based physical activity (PA) intervention on physical fitness (PF) (speed, hand-eye coordination, flexibility) of 8- to 9-year-olds. Methods: A total of seventy-eight boys and girls (boys: n = 45, aged 8.4 ± 4.9 years; girls: n = 42, aged 8.6 ± 0.5 years) from a school in Slovenia were randomly assigned to either a group with an after-school PA program (EXP) or a control group (CON) that participated exclusively in mandatory physical education (PE). The EXP group engaged in the extracurricular PA program for 60 min twice a week for 16 weeks, concurrent with regular PE classes. The program primarily involved elementary PE games that included elements of athletics (e.g., skipping, push- off running, hopping, crossstepping, and jumping) and gymnastics (e.g., handstand, forward roll, backward roll, hand support jumps, squat jump on a vault box, climbing on horizontal bars, incline benches and ropes, crawling, and jumping rope). Standardized tests appropriate for this age group were used to assess PF, including the sit and reach test (SAR), the 30-meter sprint, and the alternate hand wall toss test at distances of 1.0 and 2.0 m (AHWT 1.0 and 2.0). Results: There was a significant group-time interaction for SAR test (EXP group increase: +1.6 cm, +6.3%; CON group decrease: -0.1 cm, -0.4%; p < 0.001, ηp2 = 0.361), and the 30 m sprint (EXP group improvement: -0.4 s, -6.3%; CON group decrease: +0.1 s, +1.6%; p < 0.001, ηp2 = 0.193). Similarly, the EXP group improved by +2.1 points (+25.6%) in the 1.0 m wall throw with the alternating hand, while the CON group showed only minimal changes (-0.2 points, -2.4%; p < 0.001, ηp2 = 0.545). No significant interaction was found for the 2.0 m toss (EXP and CON group both -0.1 points, -2.6%; p = 0.888, ηp2 = 0.001). Post-hoc analyses with paired t-tests revealed that the EXP group showed significant improvements in SAR test (p < 0.001), 30 m sprint (p < 0.001) and AHWT 1.0 test (p < 0.001), while the CON group showed no significant changes in SAR test (p = 0.533), 30 m sprint (p = 0.150), AHWT 1.0 test (p = 0.186) and AHWT 2.0 test (p = 0.430). Discussion: The results of the study showed that the extracurricular program with only two additional weekly sessions significantly improved the components of PF in 8- to 9-year olds. Significant improvements were observed in the areas of flexibility, speed and coordination, as shown in the SAR test, 30-meter sprint and 1.0-meter handwall toss tests. However, no similar improvements were observed in the 2.0-meter handwall toss, which illustrates the specific areas of impact of the program.

Associations of physical activity and history of sports participation with subjective and objective measures of executive functioning in university students

This study examined how physical activity and history of sports participation affect subjective and objective executive functioning in university students. A total of 215 university students aged 18-25 (81% female) completed a virtual assessment of executive function. The correlates were age, sex, physical activity, and history of sports participation. Structural equation modeling was used to examine objective executive function using a three-factor model (shifting, updating, inhibition). The Executive Function Index (EFI) was used to measure subjective executive functioning, and linear regression was used to examine total EFI scores. Physical activity (b = 0.12, p < .01) was a significant correlate of subjective but not objective executive functioning. Male sex and history of sports participation were significantly positively related to the objective measure of inhibition (b = 0.64, p < .01; b = 0.18, p < .05). These findings suggest that subjective and objective measures of executive functioning should be differentiated when investigating their relationship with physical activity and history of sports participation.

Effects of Static Hamstring Stretching on Maximal Sprint Speed and Relationship With Nordic Hamstring Strength

This study aimed to determine the acute effects of static stretching of the hamstrings on maximal sprint speed and its spatiotemporal variables and lower-limb kinematics during the late swing phase, as well as the relationship with Nordic hamstring strength. The study had a within-participant experimental design. Sixteen healthy male college sprinters were asked to sprint 80 m without static stretching and with static stretching of the hamstrings for 4 × 30 s per leg before the sprint; both conditions were counterbalanced. The knee flexion peak torque was measured using the Nordic hamstring. The differences between no static stretching and static stretching as well as their relationship with Nordic hamstring strength were investigated. The results showed that the touchdown distance (p = .036) significantly increased following static stretching. Although not significant, maximal sprint speed decreased (p = .086), and the theoretical hamstring length (difference between knee angle and hip angle) at ipsilateral touchdown was greater (p = .069) following static stretching. In addition, a lower peak torque of the Nordic hamstring resulted in a more significant decrease in maximal sprint speed following static stretching. Therefore, static stretching of the hamstring just before sprinting may increase the theoretical hamstring length during the late swing phase at maximal sprint speed and induce kinematics that increases the hamstring strain injury risk. Moreover, it is suggested that improving the Nordic hamstring strength may help minimize the negative effects of static stretching on the hamstrings.

The Force-Velocity Profiling Concept for Sprint Running Is a Dead End

PURPOSE

In this commentary, I present arguments against the use of the force-velocity profiling concept in design and adaptations of training programs targeting sprinting. The purpose of this commentary is to make sports practitioners more aware of the rationale behind the concept and explain why it does not work.

RATIONALE

Force-velocity profiling is a mathematical way to present the velocity development during sprint behavior. Some details of this behavior may be accentuated by transforming it to other variables, but it does not add any new information about sprint performance. Thus, contrary to what is often claimed, the force-velocity profile does not represent maximal capacities (ability of force and velocity generation) of the athlete. It is claimed that through force-velocity profiling one may identify the optimal ratio of force and velocity capacities. Furthermore, proponents of the force-velocity profiling concept suggest that through directed training force and velocity capacities can be altered (inversely dependent) to obtain this optimal ratio, without changing the capacity to express power. Fundamentally, this idea is unfounded and implausible.

CONCLUSION

At best, force-velocity profiling may be able to identify between-athletes differences. However, these can be more easily deduced directly from performance time traces.

Evolution of 1500-m Olympic Running Performance

PURPOSE

This study determined the evolution of performance and pacing for each winner of the men's Olympic 1500-m running track final from 1924 to 2020.

METHODS

Data were obtained from publicly available sources. When official splits were unavailable, times from sources such as YouTube were included and interpolated from video records. Final times, lap splits, and position in the peloton were included. The data are presented relative to 0 to 400 m, 400 to 800 m, 800 to 1200 m, and 1200 to 1500 m. Critical speed and D' were calculated using athletes' season's best times.

RESULTS

Performance improved ∼25 seconds from 1924 to 2020, with most improvement (∼19 s) occurring in the first 10 finals. However, only 2 performances were world records, and only one runner won the event twice. Pacing evolved from a fast start-slow middle-fast finish pattern (reverse J-shaped) to a slower start with steady acceleration in the second half (J-shaped). The coefficient of variation for lap speeds ranged from 1.4% to 15.3%, consistent with a highly tactical pacing pattern. With few exceptions, the eventual winners were near the front throughout, although rarely in the leading position. There is evidence of a general increase in both critical speed and D' that parallels performance.

CONCLUSIONS

An evolution in the pacing pattern occurred across several "eras" in the history of Olympic 1500-m racing, consistent with better trained athletes and improved technology. There has been a consistent tactical approach of following opponents until the latter stages, and athletes should develop tactical flexibility, related to their critical speed and D', in planning prerace strategy.

Effects of Vitamin D Supplementation in Elite Athletes: A Systematic Review

Background

Deficiency in vitamin D has been shown to increase the risk of injury.

Purpose

To synthesize current placebo-controlled randomized trials investigating the effect of vitamin D supplementation in elite athletes on (1) aerobic capacity; (2) anaerobic measures, such as strength, speed, and anaerobic power; (3) serum biomarkers of inflammation; and (4) bone health.

Study Design

Systematic review; Level of evidence, 1.

Methods

A literature search was conducted on November 30, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were randomized, placebo-controlled studies of longer than 2 weeks on subjects with active participation in organized sport. Excluded were nonrandomized controlled trial study designs, vitamin D administration routes other than oral, studies that did not use vitamin D supplementation as the sole intervention, and studies with nonathletic or military populations.

Results

Out of 2331 initial studies, 14 studies (482 athletes) were included. Of the 3 studies that assessed aerobic capacity, 2 demonstrated significantly greater improvements in maximal oxygen uptake and physical working capacity-170 (P < .05) in supplemented versus nonsupplemented athletes. Measurements of anaerobic power and strength were consistently increased in supplemented groups compared with nonsupplemented groups in 5 out of the 7 studies that assessed this. Of the 6 studies that assessed sprint speed, 4 found no significant difference between supplemented and nonsupplemented groups. Aside from 1 study that found significantly lower interleukin-6 levels in supplemented athletes, measures of other inflammatory cytokines were not affected consistently by supplementation. The 4 studies that assessed markers of bone health were conflicting regarding benefits of supplementation. One study found demonstrated improvements in bone mineral density in response to supplementation (P = .02) compared with control whereas another found no significant difference between supplemented and nonsupplemented groups. However, in 3 other studies, serum biomarkers of bone turnover such as bone-specific alkaline phosphatase, parathyroid hormone, and N-terminal telopeptide appeared to be higher in subjects with lower serum vitamin D levels (P < .05).

Conclusion

Results of this systematic review indicated that the greatest benefit of vitamin D supplementation in elite athletes may be improving aerobic endurance, anaerobic power, and strength. More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in this population.

Prospective and Retrospective Analysis of the Sporting Success of Elite Spanish High and Long Jumpers

The aim of the present study was to analyze the sporting progression from U14 to senior categories of elite Spanish high and long jumpers. For prospective analysis, 300 athletes ranked top 20 at U14 were analyzed (153 female and 147 male). For retrospective analysis, 64 athletes ranked in the top 20 in the senior category were included (21 female and 43 male). Ranking positions were registered in each of the seasons where they presented records. Only 6.3% (19) of athletes who reached the top 20 at U14 became successful senior athletes [4.7% (14) of athletes maintained top 20 status throughout their sporting careers from U14 to senior]. The transition rate from U14 to U16 (35.7%) was the most severe drop down in consecutive categories (after this, it ranged from 47.8 to 66.7%). Of the senior top 20 athletes (64), most of them were already ranked top 20 at U16 (59.4%, 38), at U18 (62.5%, 40), at U20 (70.3%, 45) and at U23 (78.1%, 50). Nevertheless, only 34.4% (22) were top 20 when they were U14 athletes. Transition rates in the top 20 senior athletes ranged from 86.7 to 95.5%. Around one out of four (26.6%, 17) of the top 20 senior athletes maintained top 20 status throughout their sporting careers from U14 to the senior category. Although early success is not a good predictor of senior success, successful senior athletes excelled early on and were able to remain in top rankings throughout their sporting careers of national elite jumpers.

Effects of sports experience on children's gross motor coordination level

Background

Gross motor coordination (GMC) development could be influenced by age, gender, weight status, geographical area, living setting, home environment, socio-economic status, sports practice.

Purpose

To verify whether practicing sports and practicing different sports could influence children's GMC level.

Methods

A total of 295 children aged 8-11 years were involved in the study and divided into 5 groups in relation to the sport they practiced: gymnastics group (n = 67; 51F, 16M), cycling group (n = 64; 15F, 49M), athletics group (n = 47; 22F, 25M), swimming group (n = 35; 20F, 15M), control group (n = 82; 42F, 40M). The four subtests of the Körperkoordinations Test für Kinder (KTK) assessed children's GMC level. The scores from each of the four subtests were summed into the KTK total raw score (RS) and then converted into a gender- and age-specific motor quotient (MQ).

Results

Children practicing sports showed significantly higher RS and MQ score than children of control group (203.14 ± 38.55 vs. 163.63 ± 43.50 and 98.56 ± 15.79 vs. 83.01 ± 16.71, respectively; p < 0.001). Children practicing gymnastics had a significantly higher RS and MQ than children of cycling, swimming, and control groups (p < 0.05), children of control group had a significantly lower RS and MQ than children of all other groups (p < 0.05). Children practicing gymnastics performed better walking backwards subtest than all other children's groups (p < 0.001). Children of control group performed worse jumping sideways subtest than children of gymnastics, athletics and swimming groups (p < 0.01). Children practicing gymnastics performed better moving sideways subtest than children of athletics, cycling and control groups (p < 0.01); children of control group performed worse than children of all other groups (p < 0.01). Children of control group performed worse hopping for height subtest than children of gymnastics, athletics and cycling groups (p < 0.05); children practicing gymnastics performed better than children of swimming and control groups (p < 0.05).

Conclusions

The performance model and therefore the specialized training that each sport discipline required, could justified the differences in children's GMC level among sports groups. Thus, coaches should plan individualized interventions and choose activity contents to support children's GMC development.

To Sleep Dreaming Medals: Sleep Characteristics, Napping Behavior, and Sleep-Hygiene Strategies in Elite Track-and-Field Athletes Facing the Olympic Games of Tokyo 2021

PURPOSE

Few data are available on sleep characteristics of elite track-and-field athletes. Our study aimed to assess (1) differences in sleep between sexes and among different track-and-field disciplines, (2) the effect of individualized sleep-hygiene strategies on athletes' sleep parameters, and (3) daytime nap characteristics in track-and-field athletes.

METHODS

Sleep characteristics of 16 elite Olympic-level track-and-field athletes (male: n = 8; female: n = 8) were assessed during the preseason period, at baseline (T0), and during the in-season period, after the adoption of individualized sleep-hygiene strategies (T1). Sleep parameters were objectively monitored by actigraphy for a minimum of 10 days, for each athlete, at both T0 and T1. A total of 702 nights were analyzed (T0 = 425; T1 = 277).

RESULTS

Female athletes displayed better sleep efficiency (88.69 [87.69-89.68] vs 91.72 [90.99-92.45]; P = .003, effect size [ES]: 0.44), lower sleep latency (18.99 [15.97-22.00] vs 6.99 [5.65-8.32]; P < .001, ES: 0.65), higher total sleep time (07:03 [06:56-07:11] vs 07:18 [07:10-07:26]; P = .030, ES: 0.26), earlier bedtime (00:24 [00:16-00:32] vs 00:13 [00:04-00:22]; P = .027, ES: 0.18), and lower nap frequency (P < .001) than male athletes. Long-distance runners had earlier bedtime (00:10 [00:03-00:38] vs 00:36 [00:26-00:46]; P < .001, ES: 0.41) and wake-up time (07:41 [07:36-07:46] vs 08:18 [08:07-08:30]; P < .001, ES: 0.61), higher nap frequency, but lower sleep efficiency (88.79 [87.80-89.77] vs 91.67 [90.95-92.38]; P = .013, ES: 0.44), and longer sleep latency (18.89 [15.94-21.84] vs 6.69 [5.33-8.06]; P < .001, ES: 0.67) than athletes of short-term disciplines. Furthermore, sleep-hygiene strategies had a positive impact on athletes' total sleep time (429.2 [423.5-434.8] vs 451.4 [444.2-458.6]; P < .001, ES: 0.37) and sleep latency (14.33 [12.34-16.32] vs 10.67 [8.66-12.68]; P = .017, ES: 0.19).

CONCLUSIONS

Sleep quality and quantity were suboptimal at baseline in Olympic-level track-and-field athletes. Large differences were observed in sleep characteristics between sexes and among different track-and-field disciplines. Given the positive effect of individualized sleep-hygiene strategies on athlete's sleep, coaches should implement sleep education sessions in the daily routine of top-level athletes.

Common Skin Infections in High School Athletes and the Role of the School Nurse

Skin infections in high school athletes pose a risk of transmission to other student athletes. Therefore, it is important to promptly identify possible skin infections and refer them to the healthcare provider for treatment so athletes can return to play quickly and with little interruption to the team. Common skin infections include bacterial infections such as Streptococcus and Staphylococcus, viral infections such as herpes simplex and molluscum contagiosum, and fungal infections such as tinea corporis and capitis. The National Federation of State High School Associations provides guidance for the prevention of skin infections as well as return to play guidelines. The school nurse and high school athletic trainer are both healthcare professionals who play a role in preventing, identifying, monitoring, and caring for student athletes who contract skin infections.

Dynamical Analyses Show That Professional Archers Exhibit Tighter, Finer and More Fluid Dynamical Control Than Neophytes

Quantifying the dynamical features of discrete tasks is essential to understanding athletic performance for many sports that are not repetitive or cyclical. We compared three dynamical features of the (i) bow hand, (ii) drawing hand, and (iii) center of mass during a single bow-draw movement between professional and neophyte archers: dispersion (convex hull volume of their phase portraits), persistence (tendency to continue a trend as per Hurst exponents), and regularity (sample entropy). Although differences in the two groups are expected due to their differences in skill, our results demonstrate we can quantify these differences. The center of mass of professional athletes exhibits tighter movements compared to neophyte archers (6.3 < 11.2 convex hull volume), which are nevertheless less persistent (0.82 < 0.86 Hurst exponent) and less regular (0.035 > 0.025 sample entropy). In particular, the movements of the bow hand and center of mass differed more between groups in Hurst exponent analysis, and the drawing hand and center of mass were more different in sample entropy analysis. This suggests tighter neuromuscular control over the more fluid dynamics of the movement that exhibits more active corrections that are more individualized. Our work, therefore, provides proof of principle of how well-established dynamical analysis techniques can be used to quantify the nature and features of neuromuscular expertise for discrete movements in elite athletes.

Early Success is not a Prerequisite for Success at the Adult Age in Spanish Sprinters

The aim of the study was to describe the relationship between success in junior and senior categories in sprint events. An observational and longitudinal analysis was carried out using rankings of the Royal Spanish Athletics Federation database. We analysed 547 sprinters (238 women and 309 men) from their U14 to senior stage who ranked in top-20 on at least one occasion during the period 2004 to 2021. The first entry in top-20 occurred mostly in U14 (44.4%, 243), and the frequency was progressively lower: 26.7% (146) in U16; 20.8% (114) in U18; 5.1% (28) in U20; 2% (11) in U23; and 0.9% (5) in the senior category. A similar tendency was observed in male and female athletes. Only 3.8% (9) of top-20 U14 athletes reached the senior elite stage, increasing this percentage in subsequent categories: 7.4% (15) in U16; 10.6% (24) in U18; 20.9% (32) in U20, and 31.4% (32) from U23 to the senior category. Data from female athletes showed higher maintenance of top-20 status from early categories to senior age. We conclude that even though the first entry into the national top-20 in sprint events occurs early in most cases, success in these initial stages is not a prerequisite for reaching top-20 positions in the senior category.

A mixed method approach to evaluating eating-related psychopathologies in collegiate student-athletes

OBJECTIVE

To examine the presence of body image concerns, drive for muscularity, and disordered eating behaviors in collegiate student-athletes.

PARTICIPANTS

One hundred and one NCAA Division I student-athletes participated in Phase I; 15 of these also participated in Phase II.

METHODS

This study employed a mixed method, sequential explanatory design. Participants first completed survey measures assessing body image concern, drive for muscularity, and eating behaviors. These results influenced open-ended, semi-structured interviews, which were thematically analyzed.

RESULTS

Body image and disordered eating behaviors were of greater concern than drive for muscularity. Student-athletes reported engaging in eating behaviors as opposed to not eating, yet these eating behaviors trended toward disordered behaviors such as obsessive "healthy eating" or orthorexia.

CONCLUSIONS

This study took a novel methodological approach to examining student-athlete body image and eating behaviors. Results emphasize the need for further support and education for student-athletes around body image and eating behaviors.

Athletic performance, sports experience, and exercise addiction: an association study on ANKK1 gene polymorphism rs1800497

Introduction

Exercise addiction is a phenomenon being able to affecting the athletic performance. The gene, ANKK1 and the polymorphism NM_178510.2:c.2137G > A (rs1800497) has been linked to the exercise addiction. However, further studies on diverse populations and sport branches are needed to totally explore the possible association of this polymorphism with the athletic performance. Thus, the present study aims to decipher any possible relations of the rs1800497 polymorphism with the athletic performance/personal best (PB) and sport experience of elite athletes.

Methods

Sixty volunteer elite athletes (31 sprint/power and 29 endurance) and 20 control/sedentary participated in the study. The polymorphism was genotyped using whole exome sequencing approach and PB were determined according to the International Association of Athletics Federations (IAAF) score.

Results

Our results underlined that there were not any significance differences for both allele and genotype frequencies between the groups in terms of athletic performance, although the frequency of allele G was higher (p > 0.05). Nevertheless, sport experience significantly associated with the rs1800496 polymorphism (p < 0.05).

Discussion

In conclusion, genotype G/G could be inferred to be linked to the higher sport experience and athletic performance. Still, further studies with higher number of participants are needed to conclude the association of this polymorphism with athletic parameters.

Short-Term Speed Variability as an Index of Pacing Stochasticity in Athletic Running Events

We aimed to compare differences in performance and pacing variability indices between 5000 m heats and finals during major championships in men and women. Data with 100 m time resolution were used to compare overall pacing variability (standard deviation of 100 m section times, SD; and coefficient of variation, CV%) and short-term pacing variability (root mean square of successive differences between 100 m section times, RMSSD). The changes in performance and pacing indices differed between races and competitions. For instance, the men's final in Beijing 2008 was quicker than the heat (p < 0.01) while the CV% was reduced (p = 0.03) and RMSSD increased (p < 0.01). For women, the heats and the final exhibited a similar mean time in London 2017 (p = 0.33) but with CV% (p < 0.001) and RMSSD (p < 0.001) showing opposite trends. Individual analyses of men's and women's champions revealed highly individual variability metrics. The use of RMSSD can complement overall variability indices for better characterization of pacing stochasticity.

"Biofeedback-based return to sport": individualization through objective assessments

Elite athletes are regularly exposed to high and repetitive mechanical stresses and impacts, resulting in high injury rates. The consequences of injury can range from time lost from training and competition to chronic physical and psychological burden, with no guarantee that the athlete will return to preinjury levels of sport activity and performance. Prominent predictors include load management and previous injury, highlighting the importance of the postinjury period for effective return to sport (RTS). Currently, there is conflicting information on how to choose and assess the best reentry strategy. Treating RTS as a continuum, with controlled progression of training load and complexity, seems to provide benefits in this process. Furthermore, objectivity has been identified as a critical factor in improving the effectiveness of RTS. We propose that assessments derived from biomechanical measurements in functional settings can provide the objectivity needed for regular biofeedback cycles. These cycles should aim to identify weaknesses, customize the load, and inform on the status of RTS progress. This approach emphasizes individualization as the primary determinant of RTS and provides a solid foundation for achieving it.

Normative spatiotemporal and ground reaction force data for female and male sprinting

This study aimed to demonstrate the differences in spatiotemporal and ground reaction force (GRF) variables during overground sprinting between performance levels for female and male sprinters with providing normative data during the entire acceleration phase. Forty-four female and 102 male sprinters performed 60-m sprints, during which the spatiotemporal and GRF variables were obtained using a long force platform system. Female and male sprinters were each allocated into four groups based on their maximal speed (7.5-9.5 m/s and 8.5-10.5 m/s, respectively) with 0.5 m/s intervals, and average values for 50-m distance were calculated. Using the GRF data, normative data for four groups of female and male sprinters were successfully obtained. For female sprinters using average values of all steps, there were differences between performance levels for step frequency (SF) and support time (ST), all impulses, and all mean forces. For male sprinters using average values of all steps, there were differences between performance levels for SF, ST and flight time, all impulses except for braking impulse, and all of the mean forces. The normative data indicate that most of the spatiotemporal and GRF variables may be changed, particularly increasing SF and propulsive force, when sprint performance is improved.

Body Image, Social Physique Anxiety Levels and Self-Esteem among Adults Participating in Physical Activity Programs

(1) Background: individuals may benefit from being involved in physical and athletic activities in order to improve their body appearance and promote their physical and mental health. This study aimed to investigate body image, body mass index (BMI) characteristics, social physique anxiety, self-esteem and possible correlations between the above factors. (2) Methods: 245 adults engaged in training programs in gyms, as well as in track and field, football and basketball athletic activities completed (a) a sociodemographic questionnaire which recorded their BMI values and utilized the (b) Body-Esteem Scale for Adolescents and Adults, (c) the Social Physique Anxiety Scale and (d) the Rosenberg Self-Esteem Scale. (3) Results: Females and individuals with higher BMI reported statistically significant lower body-esteem and greater social physique anxiety levels compared to males and individuals with lower BMI, respectively (p < 0.05). A total of 25.3% of our participants were labeled as "overweight", while 20.4% had been overweight in the past. Significant differences were reported between body-esteem and social physique anxiety levels (p < 0.001); age (p = 0.001); BMI value (p < 0.001) and never having a problem with body weight (p = 0.008). Additionally, individuals with lower body-esteem and greater social physique anxiety levels presented lower global self-esteem (p < 0.001). (4) Conclusions: individuals' engagement in physical activity promotes physical as well as mental well-being, contributing to an improved quality of life, which may be the most important issue for health care professionals.

Exploring Individual Mental Health Issues: A Qualitative Study among Fellowship-Trained Sports Medicine Physicians

The mental health of fellowship-trained sports medicine physicians (FTSMPs) around the United States is a subject that needs additional exploration. Currently, there is little research exploring how FTSMPs address their mental health on a routine basis. Using the theory of secondary trauma stress to help navigate this study, the purpose of this expressive, all-purpose qualitative study is to improve the understanding of FTSMPs' perceptions of their mental health and the kinds of strategies used to manage these issues. This is a general qualitative study. All interviews were conducted via video communication platforms such as Zoom. The final sample included 35 FTSMPs: 25 men and 10 women. Data collection used a semi-structured interview approach. Data analysis was carried out using NVivo 12 qualitative data analysis software. Four themes emerged: mental health matters affect individual daily lives of FTSMPs; FTSMPs correlate mental health struggles with stress and anxiety; FTSMPs experience barricades when seeking support for mental health issues; and FTSMPs have poor mental health support-seeking behaviors. Results highlight openings for hospitals and private practice institutions, including producing a maintainable work-life equilibrium for FTSMPs and offering these FTSMPs access to mental health services. These recommendations may diminish exhaustion amongst several FTSMPs, a product detrimental to patients, providers, and hospitals.

Acute Effect of Caffeine Supplementation on 100-m Sprint Running Performance: A Field Test

PURPOSE

No study has assessed the acute effect of caffeine supplementation on 100-m sprint running in athletics and caffeine's net ergogenicity on 100-m sprint running remains unclear. We investigated the acute effects of caffeine supplementation on 100-m sprint running performance in a field test.

METHODS

Thirteen male collegiate sprinters were subjected to 100-m sprint running time trials (TT) after the ingestion of 6 mg·kg -1 body weight caffeine or placebo supplementation in a double-blind, counterbalanced, randomized, and crossover design. Sprint velocity was measured with a laser system, and sprint time was calculated from the data in which the effects of environmental factors that would act as confounding factors on sprint time during TT were eliminated.

RESULTS

The corrected 100-m sprint time was significantly shortened by 0.14 s with caffeine supplementation compared with placebo (placebo: 11.40 ± 0.39 s, caffeine: 11.26 ± 0.33 s; P = 0.007, g = -0.33). The corrected sprint time up to 60 m during TT was also significantly shorter with caffeine supplementation than with placebo ( P = 0.002). Furthermore, the mean sprint velocity for splits of 0-10 and 10-20 m was significantly increased by caffeine supplementation (all P < 0.05).

CONCLUSIONS

Acute caffeine supplementation enhanced the corrected 100-m sprint time by improving the sprint performance in the first 60 m after more explosive acceleration in the early stage of the acceleration phase. Thus, for the first time, we directly demonstrated caffeine's ergogenicity on 100-m sprint performance in athletics.

Title IX's Unintended Consequences: The Female Athlete Triad and the Need for Special Treatment

This Note examines the effects of Title IX's equal treatment framework on female collegiate athletes in the context of the female athlete triad. It describes the shortcomings of Title IX's equal treatment approach and its deleterious effects on the health of female student athletes. It argues for the adoption of the special treatment approach as a remedy.

Evaluation of the Association of VDR rs2228570 Polymorphism with Elite Track and Field Athletes' Competitive Performance

The present study aimed to examine the vitamin D receptor (VDR), rs2228570 polymorphism, and its effect on elite athletes' performance. A total of 60 elite athletes (31 sprint/power and 29 endurance) and 20 control/ physically inactive, aged 18-35, voluntarily participated in the study. The International Association of Athletics Federations (IAAF) score scale was used to determine the performance levels of the athletes' personal best (PB). Whole exome sequencing (WES) was performed by the genomic DNA isolated from the peripheral blood of the participants. Sports type, sex, and competitive performance were chosen as the parameters to compare within and between the groups by linear regression models. The results showed no statistically significant difference between the CC, TC, and TT genotypes within and between the groups (p > 0.05). Additionally, our results underlined that there were no statistically significant differences for the association of rs2228570 polymorphism with PBs within the groups of the (p > 0.05) athletes. The genetic profile in the selected gene was similar in elite endurance, sprint athletes, and in controls, suggesting that rs2228570 polymorphism does not determine competitive performance in the analyzed athlete cohort.

Professor and Peer Perceptions of Requests for Academic Accommodations in College: An Examination of ADHD and Specific Learning Disorder

University students with attention-deficit/hyperactivity disorder (ADHD) and specific learning disorder (SLD) have higher rates of academic difficulty than their unaffected peers. Thus, some academic accommodations may be useful to them. However, research suggests that college students are hesitant to use their approved academic accommodations for fear of negative perceptions. The aim of the current study was to examine the perceptions of professors and fellow college students (i.e., peers) who were presented with a vignette depicting a fictitious student requesting an academic accommodation. It was hypothesized that professors and peers would have more negative impressions of students needing accommodations because of ADHD and SLD diagnoses, as compared to three other reasons (i.e., depression, a visual impairment, or collegiate athletics [specifically basketball]). In a sequence of two similar experiments, professors and then peers were presented with one of the five vignettes, and were asked to rate the student on various measures of academic ability and work ethic, among other things. Overall, our data suggested relatively positive perceptions of college students who request academic accommodations. However, contrary to the hypothesis, the fictitious basketball player received the most negative ratings. Implications and future directions are discussed.

Differences in Coordination Motor Abilities between Orienteers and Athletics Runners

This study aimed to examine the differences in coordination motor abilities between track and field (T&F) runners and foot orienteers (Foot-O). Another purpose of this study was to analyse gender differences in terms of coordination motor abilities. Coordination skills tests were undertaken by 11 Foot-O and 11 T&F runners. Each group consisted of five women and six men who lived in the Lower Silesia region of Poland. The Foot-O group consisted of 11 orienteers aged 24.09 (±4.78) years, with a minimum 10 years of experience, while the T&F group consisted of 11 long-distance runners aged 24.91 (±4.04) years and with a performance level at distances of 5 km and 10 km equivalent to that for orienteering. Some of the participants represented world-class level (e.g., world junior medallists), and most of them were of national elite level. Coordination tests of motor abilities were chosen for their reliability and repeatability and included tests of spatial orientation, rhythmisation of movements, balance and kinaesthetic differentiation. The Foot-O group performed significantly better than the T&F group in terms of some coordination abilities. Differences were observed between the Foot-O and T&F runners in balance ability measured during the "Walk on the bench" test. Further research should be carried out in this area in order to confirm these differences.

Exploring the stress of olympic postponement due to COVID-19 on elite/international and world-class parenting and pregnant runners

The primary objective of this community-based participatory research is to explore the impacts of COVID-19 and the delayed Tokyo 2020 Olympic Games on world-class and elite/international-class parenting and pregnant athletes. Participants in this study include 11 female and 10 male parenting and/or pregnant middle and distance runners. Combined, the participants have competed at 26 Olympic Games and 31 World Championships. Drawing on the general concepts of stressors and psychological resilience, we use thematic analysis to develop four themes to understand the stressors for world-class and elite/international-class parenting and pregnant athletes due to COVID-19 and the delayed Tokyo 2020 Olympic Games: (1) lack of childcare support, (2) family planning, and (3) needing to stay away from sources of COVID-including their children. Despite the stressors identified in the aforementioned themes, we identified a fourth theme: (4) participants demonstrated adaptability to stress in spite of-or due to-their athlete-parent identities.

The Prevalence of Inguinal Hernia Among Athletes in Saudi Arabia: A Cross-Sectional Study

Introduction An inguinal hernia is the most common type of hernia. It might manifest as a groin bulge, lump, or enlarged scrotum. Swelling may be uncomfortable and painful and even cause intestinal obstruction. This study aimed to measure the prevalence of inguinal hernia among athletes in Saudi Arabia. Subject and methods This is a cross-sectional study conducted among Saudi Arabian athletes. A self-administered questionnaire was distributed among athletes using an online survey through different Saudi Olympic Training and Fitness Centers throughout the kingdom. The questionnaire includes sociodemographic characteristics (i.e. age, gender, etc.), risk factors, and complications of inguinal hernia. Results Of the 594 athletes, 55.6% were females and 57.6% were aged between 18 and 24 years. The most common type of sport was running (31%). The most common risk factor for inguinal hernia was previous abdominal surgery (57.5%). The prevalence of inguinal hernia among Saudi athletes was 12.3%. Being older in age and being male were the independent significant predictors associated with increased risk for inguinal hernia, whereas weightlifting was the independent significant factor of decreased risk for inguinal hernia. Conclusion The prevalence of inguinal hernia among athletes was 12.3%. Older male athletes were most likely at a greater risk to suffer from inguinal hernia as compared to the rest of the athletes. Further research is needed to extract more data about the prevalence of inguinal hernia among Saudi Arabian athletes and determine its risk factors.

Relationship Between Self-Reported Concomitant Depressive and Anxiety Symptoms and the Post-Concussion Symptoms Scale (PCSS)

OBJECTIVES

The current study explored how affective disturbances, particularly concomitant anxiety and depressive symptoms, impact baseline symptom self-reporting on the Post-Concussion Symptoms Scale (PCSS) in college athletes.

METHODS

Athletes were separated into four groups (Healthy Control (HC) (n = 581), Depression Only (n = 136), Anxiety Only (n = 54), Concomitant Depression/Anxiety (n = 62)) based on their anxiety and depression scores. Groups were compared on Total PCSS Score as well as 5 PCSS Symptom Cluster scores (Cognitive, Physical, Affective, Sleep, and Headache).

RESULTS

The three affective groups reported significantly greater symptomatology than HCs, with the Concomitant group showing the highest symptomatology scores across all clusters. The depressive symptoms only group also reported significantly elevated symptomatology, compared to HCs, on every symptom cluster except headache. The anxiety symptoms only group differed from HCs on only the cognitive symptoms cluster. Additionally, the Concomitant group reported significantly increased PCSS symptomatology, in terms of total scores and all 5 symptom clusters, compared to the depressive symptoms only and anxiety symptoms only groups.

CONCLUSIONS

Our findings suggest that athletes experiencing concomitant depressive/anxiety symptoms report significantly greater levels of symptomatology across all 5 PCSS symptom clusters compared to HCs. Further, results suggest that athletes experiencing concomitant affective disturbance tend to report greater symptomatology than those with only one affective disturbance. These findings are important because, despite the absence of concussion, the concomitant group demonstrated significantly elevated symptomatology at baseline. Thus, future comparisons with post-concussion data should account for this increased symptomatology, as test results may be skewed by affective disturbances at baseline.

Epidemiology of Sports-Related Clavicle Fractures in the United States: Injuries From 2015 to 2019

Background

Clavicle fractures are common orthopaedic injuries that frequently occur during sports and recreational activity.

Purpose

To (1) determine the incidence rate of sports-related clavicle fractures among patients evaluated in emergency departments in the United States over a 5-year period, (2) determine the most common sports and risks associated with clavicle fractures, and (3) update the literature by comparing past and present injury trends.

Study Design

Descriptive epidemiology study.

Methods

The National Electronic Injury Surveillance System (NEISS) database was queried for patients evaluated with clavicle fractures in US emergency departments from 2015 to 2019. The authors evaluated the data by age, sex, race, and sport/recreational activity. Injuries were characterized based on sports-specific mechanism of injury. Using the NEISS weighted multiplier, the authors estimated annual incidence rates based on US Census data. Contingency table comparisons of categorical variables (ie, age groups vs sex distributions) were analyzed using either chi-square or Fisher exact tests as appropriate for the population size, while continuous variable comparisons were performed using 1-way analysis of variance statistical testing.

Results

A total of 2386 athletic-related clavicle fractures were evaluated at participating emergency departments, translating to 304,211 clavicle fractures, with an annual per-year injury rate of 18.72 clavicle fractures per 100,000 persons at risk (95% CI, 15.28-23.67). Male athletes had disproportionately higher injury rates than female athletes (P < .001) for every year of the study and demonstrated a higher incidence of fractures compared with female athletes (injury proportion ratio, 5.54). Patients aged 10 to 19 years accounted for the highest overall incidence of injury (64.5%). The annual incidence rate of athletic-related clavicle fractures was not significantly different during the study period (P = .24). The most common mechanisms of injury were participation in football (26.87%), soccer (15.76%), snowboarding (5.03%), bicycling (3.77%), wrestling (3.65%), and snow skiing (3.52%).

Conclusion

Study findings indicated that clavicle fractures sustained during sports and recreational activity disproportionately affect male athletes. Adolescent populations (10-19 years of age) had the highest overall incidence of injury, and the most common activities associated with clavicle fractures were football and soccer.

Ergogenic Effects of Caffeine on Ballistic (Throwing) Performance: A Meta-Analytical Review

Ballistic exercise is characterized by high velocity, force, and muscle activation. Typical examples of ballistic exercise are jumping and throwing activities. While several studies explored caffeine’s effects on throwing performance, the between study findings varied. Therefore, we performed a meta-analysis exploring caffeine’s effects on throwing performance (e.g., shot put, medicine ball throw, bench press throw). Seven databases were searched for eligible research. Ten studies (n = 151) were included. In the main meta-analysis, there was a significant ergogenic effect of caffeine on throwing performance (standardized mean difference [SMD]: 0.19; 95% confidence interval [CI]: 0.05, 0.33; p = 0.007). There was a significant ergogenic effect of caffeine in the subgroup analysis for studies that evaluated throwing velocity (SMD: 0.24; 95% CI: 0.10, 0.37; p = 0.0006) and used caffeine doses ≤3 mg/kg (SMD: 0.18; 95% CI: 0.05, 0.31; p = 0.006). There was no significant difference between caffeine and placebo in the subgroup analysis for studies that evaluated throwing distance (SMD: 0.15; 95% CI: −0.09, 0.40; p = 0.22) and used caffeine doses >3 mg/kg, (SMD: 0.17; 95% CI: −0.08, 0.41; p = 0.19). However, after one outlier study was excluded as part of a sensitivity analysis, an ergogenic effect was also observed for throwing distance and caffeine doses >3 mg/kg. Based on the results of this review, we conclude that individuals interested in the acute enhancement of throwing performance may consider caffeine supplementation.

The Athletic Identity Measurement Scale: A Systematic Review with Meta-Analysis from 1993 to 2021

Sport psychology embraced the study of athletic identity in the 1990s. The Athletic Identity Measurement Scale (AIMS) is at the forefront of athletic identity measurement. This quantitative review examined two hypotheses: individual who are most engaged in sports identify most as athletes and thus score higher on the AIMS, and athletic identity relates to positive (e.g., intrinsic motivation) and negative (negative emotions) factors. In addition to our two hypotheses, we explored whether the AIMS subscales influenced our two hypotheses. After completing a systematic search of SPORTDiscus, APA PsycINFO, ERIC, and Psychology and Behavioral Sciences Collection APA within the EBSCOhost platform along with some hand searching, 101 articles published between 1993 and our end date of August 2021 met the inclusion criteria. The included studies investigated 20,498 athletes competing in a variety of sports from the following continents: Australia, Asia, Europe, and North America. We based all analyses on random- and mixed-effects statistics. Higher-achieving athletes, as expected, self-reported a higher degree of athletic identity. The differences between athlete groups were significant (p < 0.001) and meaningful (g values ranged from 1.55 to 1.93). The AIMS total score correlations with positive and negative factors (correlates) were small in magnitude (r = 0.22 and 0.17). However, the relationships differed across correlate subcategories (e.g., intrinsic motivation/commitment, r = 0.51, and body issues, r = 0.14). Minimal AIMS subscale reporting occurred across the 101 studies; thus, we could not assess their importance with certainty. In conclusion, a higher degree of athletic identity related to valued sport correlates such as intrinsic motivation/commitment and the mastery goal orientation. These correlations were small in relation to negative or less desirable factors in sport such as body disorder issues and negative emotions. We recommend future research of greater complexity and the reporting of athletes’ competitive backgrounds to understand athletic identity. In addition, researchers should report AIMS subscale data.

Targeting rule implementation decreases neck injuries in high school football: a national injury surveillance study

OBJECTIVES

Neck injuries in football are attributed to helmet-to-helmet contact with youth players being at greatest risk. In 2014, the National Federation of State High School Associations (NFHS) implemented rules defining illegal contact against a defenseless player above the shoulders to reduce head and neck injuries in football players. This study evaluates whether rule implementation decreased rates of high school football neck injuries presenting to the emergency department (ED) pre-rule implementation (2009-2013) to post-rule implementation (2015-2019).

METHODS

Data were queried from the National Electronic Injury Surveillance System for high school football players 14 to 18 years old diagnosed with a neck injury from 1 January 2009 to 31 December 2019. Narratives in the data were reviewed for mechanism of injury, setting, loss of consciousness (LOC), and type of injury.

RESULTS

Between 2009 and 2019, an estimated 47,577 high school football neck injuries were diagnosed in EDs across the United States. 52.0% of neck injuries were sustained during competition compared to 48.0% during practice. A statistically significant (P = 0.004) decrease in neck injuries was realized from pre-rule implementation to post-rule implementation with averages of 5,278 and 3,481 injuries per year, respectively. Helmet-to-helmet neck injuries significantly (P = 0.04) decreased from pre- to post-rule implementation with averages of 851 and 508 injuries per year, respectively. Neck injuries sustained via other mechanisms were not affected by the 2014 rule implementation.

CONCLUSION

This study is the first to identify a decrease in overall and helmet-to-helmet related neck injuries diagnosed in the ED following the 2014 NFHS targeting rule implementation. These findings add to the growing literature regarding the importance and efficacy of rule implementation in reducing sports-related neck injuries.

Kinematic Factors Associated with Hitting Hurdles During the Initial Phase of a 110-m Hurdle Race

This study aimed to clarify the kinematic factors for the cause and effect of hitting hurdles during the initial phase of a 110-m hurdle run. Nine experienced male hurdlers participated in this study (body height: 1.74 ± 0.04 m, body mass: 67.4 ± 5.9 kg, age: 20.2 ± 1.4 years, personal best: 15.21 ± 0.47 s, seasonal best: 15.33 ± 0.55 s). Hurdlers undertook 12 trials of the initial phase of hurdling from the start to the second hurdle landing. Dual-sided sagittal plane motion was obtained from images from two high-speed cameras operating at 120 Hz. One ‘hit’ trial which had the largest horizontal displacement of markers fixed on the hurdle and one ‘non-hit’ trial which had the fastest time of hurdle clearance were extracted for each participant. Kinematic variables were compared between the two trials. Significantly lower height of the whole-body centre of mass at the take-off was found as a possible cause of hitting hurdles, caused by insufficient swing-up of the lead leg thigh. In contrast to conventional understanding, take-off velocity, take-off distance and the take-off angle were comparable between the ‘hit’ trial and ‘non-hit’ trial. Regarding the effect of hitting hurdles, it was observed that running velocity during hurdling was not substantially reduced. However, several characteristic movements were identified that might induce inefficient motion to re-accelerate running velocity during the following landing steps.

Food insecurity among female collegiate athletes exists despite university assistance

OBJECTIVE

To determine the prevalence and characteristics of food insecurity among female collegiate athletes.

PARTICIPANTS

NCAA Division I female athletes attending a public university located in East Texas in 2018.

METHODS

A prospective cross-sectional online survey was employed to gather quantitative and qualitative data regarding food security status. Participants were instructed to complete the 26-item questionnaire, including the six-item USFSSM.

RESULTS

Participants (N = 78) were 18-22 years of age, largely white (75%). Despite most (89.74%) receiving some form of scholarship and 80% reporting provision of some meals, 32.10% were classified as food insecure. Barriers to food intake were two-fold higher among the food insecure (88% vs 43%, p < .001); limited time (43.6%) and finances (23.1%) were the most frequently reported barriers.

CONCLUSIONS

Despite university support, food insecurity exists in female collegiate athletes. Outcomes warrant screening for food insecurity, referral to support resources throughout matriculation, and tailored intervention programs.

Acute caffeine supplementation enhances several aspects of shot put performance in trained athletes

The aim of this investigation was to determine the effect of a moderate dose of caffeine (3 mg/kg/b.m.) on muscular power and strength and shot put performance in trained athletes. Methods. Thirteen shot putters (eight men and five women) participated in a double-blind, placebo-controlled, randomized experiment. In two different trials, participants ingested either 3 mg/kg/b.m. of caffeine or a placebo. Forty-five min after substance ingestion, athletes performed a handgrip dynamometry test, a countermovement jump (CMJ), a squat jump (SJ), and a maximum-velocity push-up. The athletes also performed three types of throws: a backwards throw, a standing shot put and a complete shot put. Results. In comparison with the placebo, caffeine ingestion increased CMJ height (32.25 ± 7.26 vs. 33.83 ± 7.72 cm, respectively; effect size (ES) = 0.82, p = 0.012; +5.0%;) and SJ height (29.93 ± 7.88 vs. 31.40 ± 7.16 cm; ES = 0.63, p = 0.042; +6.4%) and distance in the standing shot put (10.27 ± 1.77 m vs. 10.55 ± 1.94 m; ES = 0.87, p = 0.009; +2.6%). However, caffeine ingestion did not increase strength in the handgrip test, power in the ballistic push-up, or distance in the backwards throw (all p > 0.05). Shot put performance changed from 11.24 ± 2.54 to 11.35 ± . 2.57 m (ES = 0.33, p = 0.26; +1.0%), although the difference did not reach statistically significant differences. Caffeine ingestion did not increase the prevalence of side effects (nervousness, gastrointestinal problems, activeness, irritability, muscular pain, headache, and diuresis) in comparison with the placebo (p > 0.05). Conclusion. In summary, caffeine ingestion with a dose equivalent to 3 mg/kg/b.m. elicited moderate improvements in several aspects of physical performance in trained shot putters but with a small effect on distance in a complete shot put.

The Role of Reported Affective Symptoms and Anxiety in Recovery Trajectories After Sport-Related Concussion

BACKGROUND

There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

PURPOSE/HYPOTHESIS

To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Using SRC data from the Ivy League-Big Ten Epidemiology of Concussion Study among varsity athletes through February 2020, we identified the 4 affective symptoms from the Sport Concussion Assessment Tool symptom inventory. We modeled the relationship between a 4-category affective symptom variable and time to symptom resolution, RTP, and RTP progression, adjusting for nonaffective symptom prevalence and concussion history. Cox regressions were used to estimate hazard ratios for time to event outcomes, and linear regressions were used to evaluate mean differences for continuous outcomes.

RESULTS

Among 2077 student-athletes (men, 63.5%) with SRC symptoms, affective symptom prevalence was 47.6% and 44.3% in women and men, respectively, and nervous-anxious prevalence was 24.2% and 22.5%, respectively. When comparing women with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with affective symptoms, and women with nervous-anxious symptoms spent significantly longer in RTP progression. When comparing men with and without co-occurring affective symptoms, rates of symptom resolution and RTP were significantly lower in those with co-occurring affective symptoms, and affective symptoms were not associated with time in RTP progression.

CONCLUSION

Student-athletes with affective symptoms and nervous-anxious symptoms exhibited delayed clinical recovery and RTP timelines, particularly for time in RTP. Symptom prevalence and concussion history contributed to this; however, unmeasured confounding remains, as indicated by the poor model fit. This study motivates future work to explore affective symptoms and RTP timelines, considering anxiety and risk/protective factors over time.

A Coach-Delivered Dating Violence Prevention Program: Coach Perspectives on Implementation

Coaching Boys into Men (CBIM), an evidence-based violence prevention program, utilizes the coach-athlete relationship to deliver information about healthy, respectful relationships to adolescent boys involved in athletics. Although CBIM has demonstrated effectiveness in clinical research trials, its implementation outside of an effectiveness study has not been explored. The purpose of this current study was to explore facilitators and barriers of effective implementation in community settings using experiences from one regional implementation in Southwestern Pennsylvania. Head coaches who implemented CBIM from 2017-2018 seasons (n = 35) were contacted and 22 (63%) agreed to participate. Coaches were asked how they delivered CBIM to their team, what aided the process, barriers to facilitation, and their overall thoughts on CBIM implementation. Interviews were structured to uncover specific information regarding implementation while also providing time and space for coaches to voice their suggestions and opinions. Interviews were coded using descriptive content analysis. Key facilitators to implementation were involvement of violence prevention advocates, athletic directors, assistant coaches, and players and having flexibility to integrate current events to emphasize topics covered in CBIM. Observed improvements in bystander intervention behaviors and better attitudes towards women and girls among athletes were key motivators for coaches to continue the program. Main barriers were inconsistencies in time available to discuss topics with players and need to refresh curriculum content over multiple seasons. Coaches identified components necessary for broader and sustained implementation of this evidence-based violence prevention intervention in community settings. Coaches' confidence in delivering program content can be bolstered with appropriate strategies in place to address barriers. As coaches witness positive impacts among their athletes, these successes contribute to coaches recognizing their role in transforming sports into a platform for community-wide violence prevention.

SARS-CoV-2 Infections and Incidence at a North Carolina Pre-Kindergarten-12 School During In-Person Education: August 2020 to January 2021

BACKGROUND

School closures were initially believed to mitigate SARS-CoV-2, but instead may have had a limited role in reducing community SARS-CoV-2 transmission. We describe a single school's experience with in-person education during the COVID-19 pandemic.

METHODS

From August 17, 2020 through January 23, 2021, we conducted a prospective study at a private pre-kindergarten through 12th grade (PreK-12) school in North Carolina. The school employed numerous SARS-CoV-2 mitigation measures, including mandatory masking and physical distancing without mandated laboratory screening tests. We analyzed de-identified contact tracing data collected by the school.

RESULTS

Seventy-five primary cases were reported among the 2110 students, faculty, and staff during the study period. Twenty-one (28%) of the primary cases were on-campus during their infectious periods; however, no classroom close-contacts subsequently reported a positive SARS-CoV-2 test result. Two secondary cases likely resulted from unmasked exposure at a school athletic event. There was no correlation between community incidence and secondary transmission in the school.

CONCLUSIONS

Despite high rates of SARS-CoV-2 community incidence during the study period, routine mitigation practices including daily health screenings, mandatory face coverings, and efficient contact tracing contributed to minimal secondary SARS-CoV-2 transmission within an urban PreK-12 school. The limited school-associated transmission occurred when masks were not used during athletic events.

Kinematic and Temporal Differences Between World-Class Men's and Women's Hurdling Techniques

This study aimed to compare joint kinematics and center of mass parameters throughout hurdle clearance between world-class men and women sprint hurdlers, who were competing in a World Championships final. This was the first study to present time-series kinematic data around hurdle clearance, and given the technical ability of the athletes analyzed, it can be used as a template when analyzing the technique of other athletes in similar competitions and training. Video data were collected of the 16 finalists at the 2017 IAAF World Championships using four high-speed cameras (150 Hz). Video files were continuously digitized manually from touchdown before hurdle clearance to toe-off after landing around the sixth hurdle for men and the fifth hurdle for women, and sex-based comparisons were made at key discrete time points using independent t-tests, and throughout the entire hurdle phase using statistical parametric mapping. When calculated relative to hurdle height, the women's center of mass height was significantly greater than the men's throughout the full analyzed sequence (p < 0.001). Men also displayed more hip flexion in the lead leg at take-off before hurdle clearance (p = 0.029) as well as a more extended knee joint at intervals during flight and upon landing (p ≤ 0.037). Women completed the hurdle phase in a significantly shorter time than men (~11% difference, p < 0.001). Finally, women seemed to be more efficient by maintaining and even exceeding their entry velocity for the first 40% of the hurdle phase. These results show a lower technical demand for the women to successfully negotiate hurdle clearance, thus providing further evidence to support the argument that the women's hurdle height is too low for their performance capabilities and should be raised in senior competition.

Effects of Functional Phenolics Dietary Supplementation on Athletes' Performance and Recovery: A Review

In recent years, many efforts have been made to identify micronutrients or nutritional strategies capable of preventing, or at least, attenuating, exercise-induced muscle damage and oxidative stress, and improving athlete performance. The reason is that most exercises induce various changes in mitochondria and cellular cytosol that lead to the generation of reactive species and free radicals whose accumulation can be harmful to human health. Among them, supplementation with phenolic compounds seems to be a promising approach since their chemical structure, composed of catechol, pyrogallol, and methoxy groups, gives them remarkable health-promoting properties, such as the ability to suppress inflammatory processes, counteract oxidative damage, boost the immune system, and thus, reduce muscle soreness and accelerate recovery. Phenolic compounds have also already been shown to be effective in improving temporal performance and reducing psychological stress and fatigue. Therefore, the aim of this review is to summarize and discuss the current knowledge on the effects of dietary phenolics on physical performance and recovery in athletes and sports practitioners. Overall, the reports show that phenolics exert important benefits on exercise-induced muscle damage as well as play a biological/physiological role in improving physical performance.

Training Periodization, Methods, Intensity Distribution, and Volume in Highly Trained and Elite Distance Runners: A Systematic Review

PURPOSE

This review aimed to determine (1) performance and training characteristics such as training intensity distribution (TID), volume, periodization, and methods in highly trained/elite distance runners and (2) differences in training volume and TID between event distances in highly trained/elite distance runners.

METHODS

A systematic review of the literature was carried out using the PubMed/MEDLINE, Scopus, and Web of Science databases.

RESULTS

Ten articles met the inclusion criteria. Highly trained/elite distance runners typically follow a pyramidal TID approach, characterized by a decreasing training volume from zone 1 (at or below speed at first ventilatory/lactate threshold [LT]) to zone 2 (between speeds associated with either both ventilatory thresholds or 2 and 4 mmol·L-1 LTs [vLT1 and vLT2, respectively]) and zone 3 (speed above vVT2/vLT2). Continuous-tempo runs or interval training sessions at vLT2 in zone 2 (ie, medium and long aerobic intervals) and those in zone 3 (ie, anaerobic or short-interval training) were both used at least once per week each in elite runners, and they were used to increase the number of either vLT2 or z3 sessions to adopt either a pyramidal or a polarized approach, respectively. More pyramidal- and polarized-oriented approaches were used by marathoners and 1500-m runners, respectively.

CONCLUSIONS

Highly trained and elite middle- and long-distance runners are encouraged to adopt a traditional periodization pattern with a hard day-easy day basis, consisting in a shift from a pyramidal TID used during the preparatory and precompetitive periods toward a polarized TID during the competitive period.

Gender-equitable Attitudes, Rape Myth Acceptance, and Perceived Peer Acceptance of Violence among High School Students: An Examination of Gender and Athletic Involvement

Adolescent relationship abuse (ARA) impacts approximately one-third of teens and is associated with myriad negative health outcomes. Studies on college men indicate that athletes hold less gender-equitable attitudes (GEA), greater rape myth acceptance (RMA), and higher perceived peer support for violence (PSV), and that these attitudes are associated with perpetration risk. However, research has yet to compare the prevalence of these attitudes across gender and athletic status among high school students. The present study addressed this gap by examining the direct and interactive effects of gender and athletic status on GEA, RMA, and PSV in a large sample of high school students living in the United States. Results showed that boys involved in athletics reported lower GEA, higher RMA, and higher PSV than girls involved in athletics and non-athletes. Findings demonstrate the importance of addressing attitudes associated with violent behavior among high school boys involved in athletics, in order to reduce risk of ARA.

Injury and Illness in Elite Athletics: A Prospective Cohort Study Over Three Seasons

Background

Athletics (also known as track and field) is one of the most popular sports in the world and is the centrepiece of the Summer Olympic Games. Participation in athletics training and competition involves a risk of illness and injury.

Purpose

To describe injury and illness in British Olympic track and field athletes over three full training and competition seasons.

Study Design

Descriptive Epidemiology Study.

Methods

A total of 111 athletes on the British national program were followed prospectively for three consecutive seasons between 2015-2018. Team medical personnel recorded all injuries and illnesses during this time, following current consensus-based methods. All data pertaining to these records were reviewed and analyzed for sports injury and illness epidemiological descriptive statistics.

Results

The average age of the athletes was 24 years for both males and females (24 years, +/- 4). Total exposure for the three seasons was 79 205 athlete days (217 athlete years). Overuse injuries (56.4%) were more frequent than acute injuries (43.6%). The thigh was the most common injury location (0.6 per athlete year), followed by the lower leg (0.4 per athlete year) and foot (0.3 per athlete year). Muscle and tendon were the most commonly injured tissues, while strains and tears were the most common pathology type. Hamstring muscle strain was the most common diagnosis causing time loss, followed by Achilles tendinopathy and soleus muscle strain. Respiratory illness was the most common illness type (0.3 per athlete year).

Conclusion

Hamstring strains, Achilles tendinopathy, and soleus strains are the most common injuries in athletics and have highest burden. Respiratory illness is the most common illness and has the highest burden. Knowledge of this injury and illness profile within athletics could be utilised for the development of targeted prevention measures within the sport at the elite level.

Level of Evidence

3.

Multimodal imaging of soccer ball-related ocular posterior segment injuries

PURPOSE

To investigate the clinical and anatomic characteristics of soccer ball-induced posterior segment injuries in the era of modern multi-modal imaging.

METHODS

Retrospective case series of patients with soccer ball injury and diagnostic imaging from 2007 to 2020 at a single vitreoretinal practice.

RESULTS

Eight patients met inclusion criteria. Fundus photographs (FP) and optical coherence tomography (OCT) were obtained in eight patients, fundus autofluorescence (FAF) in five patients, fluorescein angiography (FA) in three patients, and en-face OCT and OCT-Angiography (OCT-A) were obtained in two patients each. FA and FAF identified traumatic pigment epitheliopathy secondary to commotio. Increased hypo-autofluorescence was associated with shallow, peripheral retinal detachment on FAF. OCT of the macula displayed outer retinal changes associated with commotio, and offered insight into the acute and subacute changes of traumatic macular hole formation. A patient displayed foveal hyper-reflectivity in the shape of an hourglass with retinal cyst at the level of the external limiting membrane (ELM) as seen on OCT and En-face OCT. A patient with commotio involving the macula lacked microvascular changes on OCT-A.

CONCLUSION

OCT, FA, and FAF imaging may aid in the work-up and management of the soccer ball-related posterior segment injuries.

Performance-enhancing drugs and the Olympics

The rules of fair play in sport generally prohibit the use of performance-enhancing drugs (PEDs). The World Anti-Doping Agency (WADA) oversees global antidoping regulations and testing for elite athletes participating in Olympic sports. Efforts to enforce antidoping policies are complicated by the diverse and evolving compounds and strategies employed by athletes to gain a competitive edge. Now between the uniquely proximate 2021 Tokyo and 2022 Beijing Olympic Games, we discuss WADA's efforts to prevent PED use during the modern Olympic Games. Then, we review the major PED classes with a focus on pathophysiology, complexities of antidoping testing, and relevant toxicities. Providers from diverse practice environments are likely to care for patients using PEDs for a variety of reasons and levels of sport; these providers should be aware of common PED classes and their risks.

Wearables for Biomechanical Performance Optimization and Risk Assessment in Industrial and Sports Applications

Wearable technologies are emerging as a useful tool with many different applications. While these devices are worn on the human body and can capture numerous data types, this literature review focuses specifically on wearable use for performance enhancement and risk assessment in industrial- and sports-related biomechanical applications. Wearable devices such as exoskeletons, inertial measurement units (IMUs), force sensors, and surface electromyography (EMG) were identified as key technologies that can be used to aid health and safety professionals, ergonomists, and human factors practitioners improve user performance and monitor risk. IMU-based solutions were the most used wearable types in both sectors. Industry largely used biomechanical wearables to assess tasks and risks wholistically, which sports often considered the individual components of movement and performance. Availability, cost, and adoption remain common limitation issues across both sports and industrial applications.