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Holtzman B, Kelly RK, Saville GH, McCall L, Adelzedah KA, Sarafin SR, Nikam P, Meneguzzi I, McIntyre A, Kraus EK, Ackerman KE. Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes. Br J Sports Med 2024:bjsports-2024-109165. [PMID: 39461735 DOI: 10.1136/bjsports-2024-109165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2024] [Indexed: 10/29/2024]
Abstract
OBJECTIVES To determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent and young adult male athletes. METHODS Male athletes ages 15-30 years presenting to a sports medicine clinic at two tertiary care centres were invited to complete a survey about athlete health and well-being. Participants were divided into low EA and adequate EA groups based on survey responses. The associations between low EA and REDs outcomes were evaluated using χ2 tests and ORs were calculated using binomial logistic regression (significance: p<0.05). RESULTS Low EA was associated with increased frequency of self-reported immunological, metabolic, psychological, cardiovascular and gastrointestinal dysfunction; reduced endurance performance, response to training, judgement, coordination and muscle strength; and increased irritability and depression. Low EA athletes were more likely to have self-reported cardiovascular dysfunction (OR 2.87, 95% CI 1.56 to 5.26) and psychological illness (OR 3.23, 95% CI 1.91 to 5.41), decreased training response (OR 2.64, 95% CI 1.38 to 5.03) and endurance performance (OR 2.26, 95% CI 1.13 to 4.52) and were less likely to have self-reported gonadal dysfunction (OR 0.49, 95% CI 0.30 to 0.81), than adequate EA athletes (p<0.05). CONCLUSIONS Low EA surrogates are associated with many adverse health outcomes and performance effects of REDs in male athletes. More prospective REDs research in males is needed to improve various aspects of REDs screening in young male athletes.
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Affiliation(s)
- Bryan Holtzman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Rose K Kelly
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Grace H Saville
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lauren McCall
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kaya A Adelzedah
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Samantha R Sarafin
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Prakruthi Nikam
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Isabella Meneguzzi
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Abby McIntyre
- Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USA
| | - Emily K Kraus
- Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USA
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
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Panosso I, Senger D, Delabary MDS, Angioi M, Haas AN. Validated Tools Used to Assess Musculoskeletal Injuries in Dancers: A Systematic Review. J Dance Med Sci 2024:1089313X241272137. [PMID: 39169513 DOI: 10.1177/1089313x241272137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Introduction: Dance is a physically demanding art form that often results in musculoskeletal injuries. To effectively treat these injuries, standardized and reliable assessment tools designed to the dancer's needs are required. Thus, the aim of this review is to identify studies that have employed validated tools to assess musculoskeletal injuries in ballet, modern, and contemporary dancers, focusing on describing the content and psychometric quality of the tools used. Methods: This systematic review is registered at PROSPERO (CRD42022306755). PubMed, Cochrane, LILACS, Web of Science and SPORTDiscus databases were searched by two independent reviewers. Articles assessing musculoskeletal injuries with validated tools in ballet, modern and/or contemporary dancers and written in English, Portuguese, or Spanish were included. Non-peer reviewed articles, books, conference abstracts, thesis/review articles, or case design studies were excluded. The original validation studies were compiled when necessary. Two independent reviewers conducted a standardized data extraction and evaluated the methodological quality using an adapted Downs and Black checklist. Results: From the 3933 studies screened, 172 were read to verify if they met the inclusion criteria, resulting in 37 studies included accounting for 16 unique validated tools. Two were imaging exams, one was an injury classification system, and 13 were self-reported injury questionnaires. Only four injury assessment tools were validated for dancers, emphasizing the need for further validation studies for the dance population. Most of the articles (57%) achieved high-quality methodological scores and the remaining (43%) reported medium-quality scores. Conclusions: Valid, reliable, and specific tools to assess dance injuries are lacking in general. For enhanced methodological rigor in future studies, the incorporation of validated tools is recommended to improve methodological quality and facilitate cross-study comparisons. Researchers may consider conducting validation studies, involving processes such as translation into another language, validation of modifications to the original tool, or reporting reliability within the article itself.
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Affiliation(s)
- Isabela Panosso
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Danrlei Senger
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Aline Nogueira Haas
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Singh Y, Pettit M, El-Hakeem O, Elwood R, Norrish A, Audenaert E, Khanduja V. Understanding hip pathology in ballet dancers. Knee Surg Sports Traumatol Arthrosc 2022; 30:3546-3562. [PMID: 35305112 PMCID: PMC9464154 DOI: 10.1007/s00167-022-06928-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The literature on hip injuries in ballet dancers was systematically evaluated to answer (1) whether the prevalence of morphological abnormalities and pathology of hip injuries in dancers differs from the general population (2) if there are any specific risk factors which contribute to a higher rate of hip injury and (3) what are the outcomes of primary and secondary intervention strategies. METHODS A systematic literature search of Medline, EMBASE and the Cochrane Library was undertaken for all literature relating to hip injuries in ballet dancers using the PRISMA guidelines. Reference lists were also searched for relevant literature. Clinical outcome studies, prospective/retrospective case series published between 1989 and October 2021 were included. Review articles (non-original data), case reports, studies on animals as well as book chapters were excluded. RESULTS The search yielded 445 studies, of which 35 were included for final analyses after screening. This included 1655 participants, of which 1131 were females. The analyses revealed that damage at the chondrolabral junction and degenerative disease of the hip may develop at a higher rate in ballet dancers than in the general population (odds ratio > 1 in 15/18 cohorts). The intra-articular lesions were more frequently found in postero-superior region of the hip suggesting an alternative impingement mechanism. Furthermore, numerous risk factors specific for hip injury in ballet were highlighted amidst a wide body of literature which consistently reports risk factors for a more generic 'dancer vulnerability'. CONCLUSION Ballet dancers may suffer from both higher rates of chondrolabral damage and degenerative disease in their hips. In contrast to other sports, the intra-articular lesions are more frequently found in postero-superior region of the hip. Future research clarifying the prevalence of osseous abnormalities and prevention strategies in dancers may be pivotal in delaying the development of hip disease in this cohort. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Yash Singh
- Addenbrooke's Hospital, University of Cambridge School of Clinical Medicine, Hills Road, Cambridge, CB2 0SP, UK
| | - Matthew Pettit
- Addenbrooke's Hospital, University of Cambridge School of Clinical Medicine, Hills Road, Cambridge, CB2 0SP, UK
| | - Osama El-Hakeem
- Addenbrooke's Hospital, University of Cambridge School of Clinical Medicine, Hills Road, Cambridge, CB2 0SP, UK
| | - Rachel Elwood
- Addenbrooke's Hospital, University of Cambridge School of Clinical Medicine, Hills Road, Cambridge, CB2 0SP, UK
| | - Alan Norrish
- Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Emmanuel Audenaert
- Ghent University Hospital, C. Heymanslaan 10, Ingang 46-Verdieping 4, 9000, Ghent, Belgium
| | - Vikas Khanduja
- Department of Trauma and Orthopaedics, Young Adult Hip Service, Addenbrooke's-Cambridge University Hospital, Box 37, Hills Road, Cambridge, CB2 0QQ, UK.
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Hattori S, Aikawa Y, Omi N. Female Athlete Triad and Male Athlete Triad Syndrome Induced by Low Energy Availability: An Animal Model. Calcif Tissue Int 2022; 111:116-123. [PMID: 35522259 DOI: 10.1007/s00223-022-00983-z] [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: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022]
Abstract
Energy availability (EA) is defined the difference in energy intake and exercise energy expenditure. Reduction of EA (i.e. Low energy availability, LEA) often causes abnormalities of reproduction system and drastic bone loss in some female athletes, the phenomenon is called as female athlete triad. More than ever before, it is considered a serious problem, the reason of these are (1) the syndrome occurred in female athletes but also male athletes, (2) LEA is leads to dysfunction of various organs other than reproductive system (Relative energy deficiency in sport, RED-S). On the other hand, we have focused on this syndrome and have proposed novel insights into the physiological effects of LEA on bone and solutions through nutritional treatment by recreating it in animal models. In this review, we will summarize the epidemiological and physiological perspectives of these diseases from historical background to recent findings, and introduce the usefulness of using animal models to explore mechanisms and treatments.
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Affiliation(s)
- Satoshi Hattori
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8572, Japan
| | - Yuki Aikawa
- Department of Science of Living, Tsu City College, 157 Isshinden-nakano, Tsu, Mie, 514-0112, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8572, Japan.
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