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Bergeron MF, Côté J, Cumming SP, Purcell R, Armstrong N, Basilico L, Burrows K, Charrin JB, Felix A, Groesswang H, Iwasaki Y, Kocher MS, Martowicz M, McConnell K, Moran J, Holm Moseid C, Mountjoy M, Soligard T, Tetelbaum E, Thiel A, Vertommen T, Viseras G, Budgett R, Engebretsen L, Erdener U. IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm. Br J Sports Med 2024; 58:946-965. [PMID: 39197945 DOI: 10.1136/bjsports-2024-108186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.
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Affiliation(s)
- Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
- Health Sciences, University of Hartford, West Hartford, Connecticut, USA
| | - Jean Côté
- School of Kinesiology and Health Studies, Queen's University, Kingston, Jamaica, Canada
| | | | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil Armstrong
- Childrens Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Luca Basilico
- World Skate, Maison du Sport International, Lausanne, Switzerland
| | - Kirsty Burrows
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Jean-Benoit Charrin
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Allyson Felix
- Athletes' Commission, International Olympic Committee, Lausanne, Switzerland
| | - Heike Groesswang
- International Bobsleigh & Skeleton Federation (IBSF), Salzburg, Austria
| | - Yasunobu Iwasaki
- Anti-Doping, Medical and Scientific Commission, Fédération Internationale de Gymnastique, Lausanne, Switzerland
- Anshinkai Anshin Hospital, Kobe, Hyogo, Japan
| | - Mininder S Kocher
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Magali Martowicz
- Corporate and Sustainable Development Department, International Olympic Committee, Lausanne, Switzerland
| | - Kit McConnell
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Jane Moran
- Medical Commission, International Skating Union, Lausanne, Switzerland
- Faculty of Medicine, The University of British Columbia - Vancouver Campus, Vancouver, British Columbia, Canada
| | - Christine Holm Moseid
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Evgenia Tetelbaum
- Sports Department, International Olympic Committee, Lausanne, Switzerland
| | - Ansgar Thiel
- President, German Sport University, Cologne, Germany
| | - Tine Vertommen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Expertise Center People and Well-being, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Gloria Viseras
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Commission, International Olympic Committee, Lausanne, Switzerland
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Chmielewski TL, Meierbachtol A, Aberman R, Gunderson T, Sikorski J, Cummer K. Go to the back before going forward: Addressing psychological responses in anterior cruciate ligament reconstruction rehabilitation. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:666-669. [PMID: 38554792 PMCID: PMC11282327 DOI: 10.1016/j.jshs.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/17/2023] [Indexed: 04/02/2024]
Affiliation(s)
- Terese L Chmielewski
- TRIA Orthopedic Center, Bloomington, MN 55431, USA; Rehabilitation Science Graduate Program, Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Adam Meierbachtol
- Optum Inc., Clinical Operations - Physical Health Division, Eden Prairie, MN 55344, USA
| | - Rick Aberman
- Dr. Rick Aberman Consulting, Minnetonka, MN 55305, USA
| | | | | | - Kathleen Cummer
- Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, Seattle, WA 98195, USA
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Gamble AR, McKay MJ, Anderson DB, Pappas E, Alvarez Cooper I, Macpherson S, Harris IA, Filbay SR, McCaffery K, Thompson R, Hoffmann TC, Maher CG, Zadro JR. Development of a patient decision aid for children and adolescents following anterior cruciate ligament rupture: an international mixed-methods study. BMJ Open 2024; 14:e081421. [PMID: 38684251 PMCID: PMC11086191 DOI: 10.1136/bmjopen-2023-081421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
AIM To develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction. DESIGN Mixed-methods study describing the development of a patient decision aid. SETTING A draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids. PARTICIPANTS People who ruptured their ACL when they were under 18 years old (ie, adolescents), their parents, and health professionals who manage these patients. Participants were recruited through social media and the network outreach of the steering group. PRIMARY AND SECONDARY OUTCOMES Semistructured interviews and questionnaires were used to gather feedback on the decision aid. The feedback was used to refine the decision aid and assess acceptability. An iterative cycle of interviews, refining the aid according to feedback and further interviews, was used. Interviews were analysed using reflexive thematic analysis. RESULTS We conducted 32 interviews; 16 health professionals (12 physiotherapists, 4 orthopaedic surgeons) and 16 people who ruptured their ACL when they were under 18 years old (7 were adolescents and 9 were adults at the time of the interview). Parents participated in 8 interviews. Most health professionals, patients and parents rated the aid's acceptability as good-to-excellent. Health professionals and patients agreed on most aspects of the decision aid, but some health professionals had differing views on non-surgical management, risk of harms, treatment protocols and evidence on benefits and harms. CONCLUSION Our patient decision aid is an acceptable tool to help children and adolescents choose an appropriate management option following ACL rupture with their parents and health professionals. A clinical trial evaluating the potential benefit of this tool for children and adolescents considering ACL reconstruction is warranted.
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Affiliation(s)
- Andrew R Gamble
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Marnee J McKay
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David B Anderson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Sophie Macpherson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian A Harris
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia
| | - Stephanie R Filbay
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kirsten McCaffery
- Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachel Thompson
- Discipline of Behavioural and Social Sciences in Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Christopher G Maher
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joshua R Zadro
- Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
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Roubea I, Korakakis V. Rehabilitation following ulnar collateral ligament injury of the elbow in a female acrobatic athlete: A case report. J Bodyw Mov Ther 2024; 38:329-338. [PMID: 38763577 DOI: 10.1016/j.jbmt.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The mechanism of injury and the conservative rehabilitation of the ulnar collateral ligament of the elbow (UCL) are well studied and reported in overhead athletes, while research on gymnastic athletes is sparse. Evidence suggests exercise as the mainstay in UCL injury rehabilitation. With this report, we aimed to provide a complete rehabilitation protocol following a partial UCL tear of an acrobatic athlete, where exercise and adjunct treatments, such as manual therapy, were used in a progressive staged rehabilitation. CASE DESCRIPTION A 16-year-old female acrobatic athlete was diagnosed with partial tear of the anterior band of UCL. The rehabilitation included progressive exercise loading in conjunction with manual therapy for 10 sessions in 8 weeks. Pain, UCL special tests, the Disabilities of Arm, Shoulder and Hand Score Questionnaire (DASH), and the Upper Limb Functional Index (ULFI) were assessed and administered at baseline and at 3, 6, 10 weeks, and 3 months. RESULTS Improvement in all outcome measures was noted at the 3-month follow-up indicating a substantial reduction in pain and disability, and an increase in stability of the elbow joint. Return to training was achieved at 8 weeks from the initial visit, while return to sport at the pre-injury level was achieved at 3 months. CONCLUSION Progressive exercise loading along with the addition of manual therapy is an effective intervention for the rehabilitation and return to sport following a partial UCL tear. A progressive staged rehabilitation guideline for acrobatic athletes with UCL injuries has been provided to be used and guide clinical practice. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Iliana Roubea
- Physiotherapy Department, University of West Attica, Egaleo, Athens, Greece; Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece.
| | - Vasileios Korakakis
- Hellenic Orthopaedic Manipulative Therapy Education (HOMT Edu), Athens, Greece; Department of Health Sciences, School of Life Sciences and Health Sciences, PhD in Physiotherapy Program, University of Nicosia, Cyprus
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Nyland J, Tomberlin C, Brey J, Carter S. Global knee function rating more strongly influences adolescent athletes that sustain a sports-related surgical ACL re-injury or contralateral ACL injury. Knee Surg Sports Traumatol Arthrosc 2024; 32:599-607. [PMID: 38419433 DOI: 10.1002/ksa.12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE This study evaluated differences between adolescent athletes who sustained a surgical anterior cruciate ligament (ACL) re-injury, or contralateral ACL injury following return to sports bridge programme participation (Group 1) compared to those that did not (Group 2). METHODS At 19.9 ± 7 years of age, 198 athletes participated in this study. Groups were compared for time postsurgery, preprogramme and postprogramme Knee Outcome Survey Sports Activity Scale (KOS-SAS) and global rating of knee function (GRKF) during sports activities, postprogramme lower extremity physical function test performance and perceived sports performance compared to preinjury level. RESULTS By 6.0 ± 3.2 years postsurgery, 11 (5.6%) sustained another ACL injury. Group 1 was younger (17.3 ± 1.7 years vs. 20.1 ± 6.8 years, p < 0.001). Postprogramme re-evaluation revealed that Group 1 had a greater GRKF compared to their programme initiation GRKF than Group 2 (32.6 ± 38 vs. 20.0 ± 23, p = 0.04). Group 1 also had a greater mean preprogramme to postprogramme GRKF change than Group 2 (51.3 ± 31 vs. 35.5 ± 21, p = 0.02) (effect size = 0.73). More Group 1 subjects also had a GRKF difference that exceeded the overall mean than Group 2 (p = 0.04). Group 1 had moderately strong relationships between preprogramme and postprogramme GRKF score change and the postprogramme GRKF score (r = 0.65, p = 0.04) and between preprogramme and postprogramme KOS-SAS score change and postprogramme GRKF score (r = 0.60, p = 0.04). CONCLUSION Global rating scores had a stronger influence among adolescent athletes that sustained either surgical ACL re-injury or contralateral ACL injury. Since group physical function and neuromuscular control factors were similar, clinicians need to increase their awareness and understanding of other factors that may influence surgical ACL re-injury or contralateral ACL injury risk. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- John Nyland
- Norton Orthopaedic Institute, Norton Healthcare, Louisville, Kentucky, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky, USA
| | - Colson Tomberlin
- Norton Orthopaedic Institute, Norton Healthcare, Louisville, Kentucky, USA
| | - Jennifer Brey
- Norton Orthopaedic Institute, Norton Healthcare, Louisville, Kentucky, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky, USA
| | - Sam Carter
- Norton Orthopaedic Institute, Norton Healthcare, Louisville, Kentucky, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky, USA
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McGinley J, Stapleton E, Gale E, Worrall H, Podvin C, Ellis HB, Wilson PL, Ulman S. Differences in athletic identity, sport participation, and psychosocial factors following anterior cruciate ligament rehabilitation in youth athletes. Front Psychol 2024; 14:1303887. [PMID: 38259536 PMCID: PMC10800524 DOI: 10.3389/fpsyg.2023.1303887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction While youth sports benefits the developing athlete, athletes may also be subject to injury and subsequent return-to-sport protocols. The current return-to-sport criteria emphasize physical measures; however, psychological measures may also be valuable to inform providers of an athlete's readiness. One such measure is athletic identity defined as the degree to which an individual identifies with the athlete role. To better understand athletic identity in return-to-sport, this study aimed to identify relationships and trends between the Athletic Identity Measurement Scale (AIMS), demographic variables, sport participation measures, and the Athletic Coping Skills Inventory-28 (ACSI-28) in youth athletes during rehabilitation following anterior cruciate ligament reconstruction (ACLR). Methods A retrospective review was completed of patients who underwent ACLR at a sports medicine clinic between October 2019 and May 2021. Patients responded to a series of patient reported outcomes (PROs) regarding physical and psychological function at a pre-surgical baseline and after 1 year of rehabilitation. Patients were then divided into groups of high/low AIMS and an increased/decreased AIMS between 1 year and baseline for comparison. Independent samples t-tests and ANOVAs were performed as appropriate with a 95% confidence interval. Results In the final sample, 87 patients (15.3 ± 1.8 years) were included, with 51.7% being females. Total AIMS scores decreased from 50.3 to 47.5 over rehabilitation (p = 0.019). Furthermore, results indicated that nearly all AIMS scores decreased during rehabilitation, with none showing an increase; however, not all domains were significant. Conversely, all sport participation and coping ability PROs increased over time points except for ACSI-Confidence and Achievement Motivation. Generally, those in the groups with high AIMS and an increase in AIMS also had higher scores in physical function and coping ability PROs, with the groups separated by high/low AIMS exhibiting more frequent statistical significance. Discussion Given these results, it appears that athletes may lose identification with the athlete role after ACLR and struggle even 1 year for rehabilitation, but those who recover athletic identity the best may also be those able to cope most effectively with the stressors induced by injury.
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Affiliation(s)
- James McGinley
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
| | - Emily Stapleton
- Department of Psychology, Scottish Rite for Children, Frisco, TX, United States
| | - Emily Gale
- Department of Psychology, Scottish Rite for Children, Frisco, TX, United States
| | - Hannah Worrall
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
| | - Caroline Podvin
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
| | - Henry B. Ellis
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Philip L. Wilson
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sophia Ulman
- Center for Excellence in Sports Medicine, Scottish Rite for Children Orthopedic and Sports Medicine Center, Frisco, TX, United States
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Lubowitz JH, Brand JC, Rossi MJ. Return-to-Sport Outcomes After Anterior Cruciate Ligament Surgical Treatment May Be Improved by Attention to Modifiable Factors and Consideration of Nonmodifiable Factors. Arthroscopy 2023; 39:571-574. [PMID: 36740280 DOI: 10.1016/j.arthro.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 02/07/2023]
Abstract
Today, we who treat athletes are able to effect immediate, significant improvement in anterior cruciate ligament (ACL) patient outcomes, regardless of surgical technique, by careful determination of when an athlete is ready to return to sport. "Prehabiliation," bracing, time after surgery to various rehabilitation activities, time after surgery until return to sport, functional testing, strength testing including limb symmetry indices, psychological readiness, age, gender, and type of sport are all factors influencing successful return to sport after ACL injury and treatment. Age and gender are not modifiable, and for some athletes, type of sport may be nonnegotiable. However, each of these factors could be thoughtfully considered before returning an athlete to sport after ACL treatment. All the other factors listed above, from prehab to bracing to strength to psychological readiness, may be modifiable.
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Nyland J, Pyle B, Krupp R, Kittle G, Richards J, Brey J. ACL microtrauma: healing through nutrition, modified sports training, and increased recovery time. J Exp Orthop 2022; 9:121. [PMID: 36515744 PMCID: PMC9751252 DOI: 10.1186/s40634-022-00561-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Sports injuries among youth and adolescent athletes are a growing concern, particularly at the knee. Based on our current understanding of microtrauma and anterior cruciate ligament (ACL) healing characteristics, this clinical commentary describes a comprehensive plan to better manage ACL microtrauma and mitigate the likelihood of progression to a non-contact macrotraumatic ACL rupture. METHODS Medical literature related to non-contact ACL injuries among youth and adolescent athletes, collagen and ACL extracellular matrix metabolism, ACL microtrauma and sudden failure, and concerns related to current sports training were reviewed and synthesized into a comprehensive intervention plan. RESULTS With consideration for biopsychosocial model health factors, proper nutrition and modified sports training with increased recovery time, a comprehensive primary ACL injury prevention plan is described for the purpose of better managing ACL microtrauma, thereby reducing the incidence of non-contact macrotraumatic ACL rupture among youth and adolescent athletes. CONCLUSION Preventing non-contact ACL injuries may require greater consideration for reducing accumulated ACL microtrauma. Proper nutrition including glycine-rich collagen peptides, or gelatin-vitamin C supplementation in combination with healthy sleep, and adjusted sports training periodization with increased recovery time may improve ACL extracellular matrix collagen deposition homeostasis, decreasing sudden non-contact ACL rupture incidence likelihood in youth and adolescent athletes. Successful implementation will require compliance from athletes, parents, coaches, the sports medicine healthcare team, and event organizers. Studies are needed to confirm the efficacy of these concepts. LEVEL OF EVIDENCE V.
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Affiliation(s)
- J Nyland
- Norton Orthopedic Institute, 9880 Angies Way, Louisville, KY, 40241, USA.
- MSAT Program, Spalding University, 901 South Third St, Louisville, KY, USA.
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.
| | - B Pyle
- MSAT Program, Spalding University, 901 South Third St, Louisville, KY, USA
| | - R Krupp
- Norton Orthopedic Institute, 9880 Angies Way, Louisville, KY, 40241, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - G Kittle
- MSAT Program, Spalding University, 901 South Third St, Louisville, KY, USA
| | - J Richards
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - J Brey
- Norton Orthopedic Institute, 9880 Angies Way, Louisville, KY, 40241, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
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Determinants of Team Sport Participation Decision in the Wake of the Pandemic Among University Youth. PHYSICAL ACTIVITY AND HEALTH 2022. [DOI: 10.5334/paah.203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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