Childhood Sports Participation and Adolescent Sport Profile

Is There Just One Type of Multisport Pathway? A Scoping Review of Multisport Engagement in Early Athlete Development

Multisport engagement is positioned as the antithesis to specialization within youth development pathways. However, different terms are used to describe the multisport pathway, which may create confusion regarding what the pathway should look like. This review investigated all published research examining the multisport pathway, with a focus on terminology, and how different terms have led to varying interpretations of this research. Four databases were searched for all peer reviewed studies published up until December 2021. All included papers were full text, in English, and focusing on multisport athlete engagement. In total, 1974 abstracts were screened for inclusion eligibility, resulting in 82 articles included within this review. General results showed most studies are empirical (71%, n = 58) and looked at athlete development pathways using retrospective questionnaires aimed at investigating the specific pathway to sporting excellence. However, despite the consensus that multisport athletes play many sports in their lifetime, there is little investigation into when and the level of intensity (play versus practice) at which these sports are being played. Further, inconsistencies in the terminology used to describe this pathway have made it difficult to understand potential mechanisms that lead to any positive or negative effects. It is recommended that differences between the key terms of diversification and sampling are clarified and should not be regarded as synonymous as they may represent different paths within multisport development based on varying levels of intensity of play and practice.

Higher Family Affluence is Associated With Multi-Sport Participation Among Irish Youth

The impact of early single sport participation among young people has received much attention, with both sport leaders and pediatricians advocating multi-sport participation at least until early adolescence. In this study we explored the association between family socioeconomic status and level of Irish youth specialization in sport. We relied on data from the Children's Sport Participation and Physical Activity (CSPPA) study, involving a representative sample of 3499 Irish children and adolescents aged 10-15 years. We analyzed data from questions related to the number of sports played, the number of days per week the youth were engaged in sport, and family affluence (as a proxy measure for socioeconomic status). Youth sport specialization before 12 years of age (males 5.7%; females 4.2%) and even between 13-15 years of age (males, 7.8%; females, 5.8%) was uncommon. However, lower levels of specialization were associated with higher socioeconomic status in that more children with high family affluence participated in multiple sports. Careful consideration should be given to whether low socioeconomic status may act as a barrier to participation in multiple sports.

Visual representations of single- and multi-sport participation in a youth swimming sample: Implications for definitions and discussions of early specialization

Academic literature and sport policy documents have cited concerns about an increasing prevalence of early sport specialization, with associated burnout, dropout, and injury. However, evidence to support such statements is limited. Definitions of early specialization vary, but a common criterion is continued participation in a single sport, prior to adolescence. We explored the prevalence of single-sport participation and other patterns of sport involvement from ages 6-12 in a Canadian swimming sample using retrospective longitudinal methods. Parents of 236 competitive swimmers (ages 12-17) completed surveys on their children's sport backgrounds, including the number of sports participated in annually from age 6-12. A cluster heat map elucidated single- and multi-sport patterns over time. Mixed analyses of variance tested for differences by gender and club type. Fourteen percent of our sample showed stable participation in either one sport or multiple sports per year over time, 25% decreased their annual number of sports, and 60% increased. This trend of increasing, rather than decreasing the number of sports in their annual activity roster when approaching age 12 was particularly pronounced for girls. Only 10 participants (4% of the sample) consistently engaged in a single sport each year from age 6-12. Summer (seasonal) swimmers consistently did more sports than year-round swimmers. Overall, our findings showed highly idiosyncratic longitudinal patterns of sport participation that did not easily conform to current sport activity guidelines. We also found similar idiosyncrasy in an ad-hoc analysis of participants who had dropped out of swimming a year later. If single-sport participation is considered a key criterion for defining early specialization, our findings suggest the prevailing narrative around early specialization may be overstated in relation to the number of single-sport athletes. Alternatively, other components of early specialization may be more prevalent and deserving of attention due to possible associations with harmful outcomes.

Puberty timing and relative age as predictors of physical activity discontinuation during adolescence

Among same-age adolescents, those who enter puberty relatively later and those who are relatively younger (e.g., born later in the year) might be at greater risk of physical activity discontinuation. This study aimed to (1) describe gender-specific discontinuation, re-engagement, and uptake rates in various types of physical activities from the age of 11 to 17 years, and (2) assess puberty timing and relative age as predictors of discontinuation from organized, unorganized, individual, and group-based physical activities. Longitudinal data from 781 (56% girls, age 10-13 years at study baseline) Canadian participants who self-reported puberty status, birthdate, and involvement in 36 physical activities every four months from 2011 to 2018 was analyzed. The incidence of discontinuation, re-engagement, and uptake in organized/unorganized and individual/group activities from grade 6 until grade 12 was described and Cox proportional hazard models were used to estimate associations of puberty timing and relative age with organized/unorganized and individual/group activity discontinuation. Results demonstrate that individual and unorganized activities are maintained longer than group-based and organized activities. Girls who started puberty earlier were more likely to discontinue organized activities than girls with average-puberty timing [Hazard ratio (HR) (95% confidence interval (CI)) 1.68 (1.05-2.69)]. Compared to boys born in the 4th quarter of the year, boys born in the 2nd quarter of the year were less likely to discontinue organized [HR (95% CI) 0.41 (0.23-0.74)], unorganized [HR (95% CI) 0.33 (0.16-0.70)], group [HR (95% CI) 0.58 (0.34-0.98)], and individual activities[HR (95% CI) 0.46 (0.23-0.91)], and boys born in the 3rd quarter were less likely to discontinue unorganized activities[HR (95% CI) 0.41 (0.19-0.88)]. This study illustrates the patterns of physical activity participation throughout adolescence. However, the generalizability of findings may be limited due to participant representation.

Sport4Me: A people focused approach to engaging Australians in sport

The traditional model of community club-based sport is fine for those, particularly children and youth, who enjoy the competitive focus and have the skills and commitment to play. But societal preferences during leisure time have changed dramatically over recent decades. However, sport organisations have made limited progress in response to these changes in providing ways in which children and youth can participate outside the traditional competitive structures and environments. In this paper the context of community club-based structures is reviewed leading into an assessment of the associated impact of these structures on sport participation. Children and youth's current motivations to play sport including what makes sport fun to play, are considered. It is then demonstrated that the associations between motivations to play sport and the factors that contribute to fun and enjoyment, are often misaligned for many individuals, with a primary focus on competition-based structures to deliver community club sport. In the final part of the paper a model for community sport organisations where people are put first is proposed - Sport4Me. Sport4Me is about flexible, inclusive, equitable sporting opportunities that focus on friends, fun, physical literacy and play. The model would complement the traditional competitive club-based model and afford participants more choice whilst fostering an environment that promotes lifelong involvement in sport. This model will require structural and cultural changes to the sporting environment and include coaching practices. Sport4Me is an evidence-based model, but it is not radical in its conceptualisation but rather, builds on previously proposed approaches, considers the needs and wants of potential sport participants and widens the scope of sport delivery.

Does earlier acquisition of motor competence promote pubertal physical activity in Japanese elementary school children: A 4-year follow-up study

This 4-year follow-up study investigated which profile of motor competence (MC) in early childhood more strongly correlated with moderate-to-vigorous physical activity (MVPA) in early pubescence. A total of 247 first-grade children (152 boys) aged 6 to 7 years old participated in the baseline measurement. MVPA was measured using an accelerometer annually until the fifth grade. Body fat percentage was assessed using dual-energy X-ray absorptiometry at baseline. MC included fundamental movement skills (FMS) and motor performance, which were assessed in terms of locomotor and object control. FMS was assessed by the Test of Gross Motor Development-2, while motor performance (locomotor: run, hop, jump, and side-step, object control: throw, kick, and hand dribble) was assessed by Japanese Physical Fitness and Motor Abilities Test at baseline. Multiple regression analysis showed that locomotor and object control performance were significant predictors of MVPA in later grades in boys but not in girls. These associations between locomotor performance and MVPA mainly remained significant after controlling for body fat and MVPA at baseline. FMS in both genders was not a significant predictor of MVPA in early pubescence. This study suggests that appropriate strategies for increasing MVPA from prepubescence to early pubescence may differ between boys and girls.

Risk Factors of Sports-Related Injury in School-Aged Children and Adolescents: A Retrospective Questionnaire Survey

Studies conducting quantitative surveys in school-aged children and adolescents help identify sports-related risk factors for acute and overuse injuries are scarce. This study aimed to quantify the risk factors for sports-related injury in school-aged children and adolescents by school categories. University students (n = 484) retrospectively recalled their sports experiences and related injuries in a questionnaire according to the following school categories: lower elementary school (LE), upper elementary school (UE), junior high school (JH), and high school (H). Both sports-related acute and overuse injuries were recorded. After adjusting various covariates, weekly hours in sports were identified as a significant risk factor in LE and UE. The interaction of weekly hours in sports and sports specialization was significant in LE and UE, suggesting that early specialization would be a risk factor in lower school categories. In JH and H, female sex, high-level competition, and injury experienced in a previous school category were significantly related to sports-related injuries. In conclusion, weekly hours in sports, high-level competitions, previous injury experience, and sex were confirmed as risk factors in specific school categories. Most identified risk factors are modifiable, suggesting that sports-related injuries can be prevented in school-aged children and adolescents.

Running-related injuries in middle school cross-country runners: Prevalence and characteristics of common injuries

BACKGROUND

Understanding the prevalence and factors associated with running-related injuries in middle school runners may guide injury prevention.

OBJECTIVE

To determine the prevalence of running-related injuries and describe factors related to a history of injury.

DESIGN

Retrospective cross-sectional study.

SETTING

Survey distributed online to middle school runners.

METHODS

Participants completed a web-based survey regarding prior running-related injuries, training, sleep, diet, and sport participation.

MAIN OUTCOME MEASUREMENTS

Prevalence and characteristics differentiating girls and boys with and without running-related injury history adjusted for age.

PARTICIPANTS

Youth runners (total: 2113, average age,  13.2 years; boys: n = 1255, girls: n = 858).

RESULTS

Running-related injuries were more prevalent in girls (56% vs. 50%, p = .01). Ankle sprain was the most common injury (girls: 22.5%, boys: 21.6%), followed by patellofemoral pain (20.4% vs. 7.8%) and shin splints (13.6% vs. 5.9%); both were more prevalent in girls (p < .001). Boys more frequently reported plantar fasciitis (5.6% vs. 3.3%, p = .01), iliotibial band syndrome (4.1% vs. 1.4%, p = .001) and Osgood-Schlatter disease (3.8% vs. 1.2%, p = .001). Runners with history of running-related injuries were older, ran greater average weekly mileage, ran faster, had fewer average hours of sleep on weekends, skipped more meals, missed breakfast, and consumed less milk (all p < .05). Girls with history of running-related injuries reported higher dietary restraint scores, later age of menarche, more menstrual cycle disturbances, and higher likelihood of following vegetarian diets and an eating disorder diagnosis (all p < .05). Runners with no history of running-related injuries were more likely to have participated in ≥2 years of soccer or basketball (p < .001).

CONCLUSIONS

Most middle school runners reported a history of running-related injuries and certain injuries differing by gender. Modifiable factors with the greatest association with running-related injuries included training volume, dietary restraint, skipping meals, and less sleep. Sport sampling, including participation in ball sports, may reduce running-related injury risk in this population.

The Prevalence and Consequences of Within-Sport Specialization in Track and Field Athletics

Purpose: The aim of this study was to provide an in-depth analysis of the prevalence and consequences of within-sport specialization in track and field in the United Kingdom. Method: The competition histories of top 100 ranked athletes from four representative events (100 m, 800 m, long jump, and shot put) were recorded from a publically-accessible database. Athletes were drawn from Under 20 (U20), U15, and U13 populations from the 2014/15 season, U15 populations from the 2009/10 season, and U13 populations from the 2007/08 season. Athletes' specialization status was defined based upon the number of event groups (sprint, endurance, jump, throw) in which they had recorded at least one performance. Chi-squared tests were used to examine the association between level of specialization at U13 and U15 and both performance and retention at subsequent age grades. Results: Within-sport specialization was rare among U13 and U15 track and field athletes, with approximately 10% of top 100 ranked U13s and 25% of top 100 ranked U15s competing in a single event group only. However, less than 35% of participants competed in sprinting, endurance running, jumping, and throwing events (i.e., diversification). There were no sex differences in the extent of specialization. Top ranked U20 female athletes were more likely to have diversified at U13 than their peers. There was no association between specialization at U13/U15 and subsequent retention. Conclusion: Administrators and coach educators should provide more sophisticated guidance for coaches and parents in relation to within-sport specialization.

Empirical Support for the Tenets of Sport Participation and Physical Activity-Based Models: A Scoping Review

Notwithstanding their wide-spread use, it is unclear what level of empirical evidence exists to support sport participation and physical activity-based models. Sport participation and physical activity-based models characterize different stages of sport involvement based on sport activities (organized and unorganized) individuals take part in throughout their lifespan. The objectives of this scoping review was to explore the nature of empirical support for tenets of sport participation and physical activity-based models describing the evolution of an individuals' sport participation. Seventeen different sport participation models were identified through an iterative literature review, using a snowball search strategy and expert (n = 8) consultation. Of the identified models, three described the evolution of an individual's sport participation based on their participation in different activities at various stages of sport involvement and were retained for the review. A second literature review identified peer-reviewed publications supporting at least one tenet of these three models. Many tenets of retained models received some empirical support from some of the 38 publications identified, but some tenets were not tested. Most of the evidence supporting tenets originated from studies among elite-level athletes. Whereas some evidence exists to support current sport participation and physical activity models, more research is warranted, particularly among the general population of non-elite athletes, for the models to be used in full confidence to guide sport policies, programs, and practices.

Early Sport Specialization

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Early sport specialization has been recognized as a potential factor in the relationship between physical activity and health since the early 1970s.

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There is no universally agreed-upon terminology or definition for early sport specialization, but early sport specialization typically encompasses preteen athletes who play 1 sport competitively throughout the year or play on several teams within 1 season, leading to intensive participation without variation in physical activity.

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There is a limited number of comprehensive long-term outcome studies that have identified a potential link between early sport specialization and musculoskeletal injury or burnout.

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Methodologically sound prospective research looking at chronologic age and years of participation by sports played will help to answer whether there is an impact from early sport specialization on the relationship with successful participation and injury occurrence.

Early Sport Specialization Among Former National Collegiate Athletic Association Athletes: Trends, Scholarship Attainment, Injury, and Attrition

BACKGROUND

Many youth athletes focus on 1 sport to gain a competitive advantage, but early sport specialization may increase risk of overuse injuries and burnout. College athletes have successfully achieved advanced status; therefore, the study of their specialization patterns is a method to assess how specialization affects an athletic career.

PURPOSE

To determine trends in sport specialization by sex, sport, and decade of participation in National Collegiate Athletic Association (NCAA) athletes and assess the effect of specialization on scholarship attainment, injury, and attrition.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

An electronic survey was distributed to NCAA athletes who participated from 1960 to 2018. Survey topics included sex, sport, decade of participation, scholarship status, ≥30-day time-loss injuries sustained in college, orthopaedic surgery in college, career length, and age of single-sport specialization. Early specialization was defined as specialization in a single sport before age 15 years. Rates of early specialization were calculated for each sport, sex, individual and team sports, and decade of participation. Rates of scholarship attainment, injury, and attrition were compared between groups. Univariate associations were queried with logistic regression analysis to determine predictors of specialization, scholarship attainment, injury, and early attrition.

RESULTS

Of 1550 athletes who participated (17% response rate), 544 (35.1%) were women. Overall, 18.1% of athletes specialized before age 15 years (n = 281). Athletes in gymnastics, tennis, swimming and diving, and soccer were significantly more likely to specialize early, whereas football and baseball athletes were more likely to specialize late (P < .05 for all groups). Early specialization was more common among women (23.4% vs 15.2%; odds ratio, 1.72; P < .01). There was a trend toward earlier specialization for recent college graduates, with graduates from the last decade more likely to be classified as early specialization than those from previous decades (P = .036). Scholarship attainment was overall equivalent between groups. Time-loss injuries, lower extremity injuries, and orthopaedic surgery in college were not statistically different between groups. Career lengths were similar, but burnout was more common among early specialization athletes (10.5% vs 7.0%; odds ratio, 3.76; P < .01).

CONCLUSION

Less than one-fifth of NCAA athletes surveyed specialized before age 15 years, and neither scholarship attainment nor time-loss injury rate was affected by early specialization. Early specialization is on the rise but is associated with increased burnout.

Sustainability-Sport-Physical Activity

The present study is a synthesizing analysis of international literature on correlations between sustainability, sport, and physical activity. The study of sustainability is considered essential in modern research; its multidisciplinary approach relies on sports science and sports economics as well. There are several aspects of sustainability that are closely associated with health and health preservation; the beneficial effect of exercise on health is also widely known. For the analysis of this complex matter, our current study relied on secondary sources, and besides exploring specialist literature, it also illustrates and analyzes related statistical data. Our results highlight the correlations between living environment and physical activity, the importance of increasing individual commitment towards sustainability and using green spaces for exercising, as well as questions on social and environmental development in relation to physical activity. The study revealed the existence of highly complex links between physical environment, physical activities, and sustainability. The results section of our study provides a brief summary on the possible ways of making people physically active. Increasing physical activity is of paramount importance for achieving the objectives formulated in relation to sustainability.

Community Participation of School-Age Children: Who is at Risk of Restricted Participation?

AIMS

This study aimed to identify children with restricted community participation and examine the extent to which the child, family, and environmental factors were associated with restricted participation.

METHODS

A school-based sample of 92 children with disabilities and 391 children without disabilities aged 5-12 years was recruited in Hong Kong. Parents completed the Participation and Environment Measure for Children and Youth and a demographic questionnaire. Moreover, children completed the Children's Depression Inventory. Rasch analysis was used to determine the criteria that differentiated between children with and without participation restriction, based on frequency of activities. Logistic regression was used to identify the factors associated with participation restriction.

RESULTS

One hundred seventy-three children (35.8% of the sample), including 42 with disabilities, were identified as having restricted participation. Participation restriction was associated with higher depressive symptoms in children (odds ratio (OR) = 1.05, 95% confidence interval (CI) [1.01, 1.08]), lower environmental resources (OR = 0.97, 95% CI [0.96, 0.99]), and coming from families with three or more children (OR = 2.80, 95% CI [1.44, 5.46]).

CONCLUSIONS

The results suggest that a sizable number of children are at risk for restricted participation in the community. Healthcare services and strategies that address the associated factors are needed to promote children's community participation.

What Defines Early Specialization: A Systematic Review of Literature

Introduction: While practitioners and organizations advise against early specialization, the lack of a consistent and clear definition of early specialization reduces the impact of recommendations and policies in youth sport. An important first step in understanding the consequences of early specialization is establishing what early specialization is. Objectives: This PRISMA-guided systematic review aimed to determine the types, characteristics, and general content of early specialization papers within the literature, and examine how early specialization has been defined and measured in order to advance knowledge toward a clear and consistent definition of early specialization. Data sources: Four different electronic databases were searched (SPORTDiscus, Web of Science, Sports Medicine and Education Index, and Scopus). Both non data-driven and data-driven studies were included to ensure a comprehensive understanding of the literature. Eligibility Criteria: In order to be included in the review, the paper must: (a) Focus on specialization and explicitly use the term "specialization" (b) Focus on sport and athletes (c) Be papers from a peer-reviewed (d) Be in English. And finally, (e) be available in full text. Results: One thousand three hundred and seventy one articles were screened resulting in 129 articles included in the review after applying inclusion/exclusion criteria. Results indicated a clear discrepancy between key components of early specialization and the approaches used to classify early specializers. Conclusion: Future research should work toward developing a valid and reliable approach to classifying early specializers and establishing a consistent definition across studies.

Trends in Neuromotor Fitness in 10-to-12-Year-Old Dutch Children: A Comparison Between 2006 and 2015/2017

Children with a low level of neuromotor fitness are less skilled to participate in sports activities. Moreover, lower levels of neuromotor fitness are related to adiposity, lower cardiovascular health, and poor self-esteem in children. The aim of this paper was to determine neuromotor fitness in 10-12-year-old Dutch children over a 10-year period. Test scores measured in 2015/2017 (N = 533 in 2015, N = 941 in 2017) were compared with scores of same-aged children measured in 2006 (N = 1986). Neuromotor fitness was assessed using the MOPER fitness test battery, including speed and agility, strength, flexibility, and coordination and upper-limb speed. Data were analyzed using multilevel linear regression models and tobit regression analyses in case of skewed distributions with an excess of zeros. Analyses were stratified by age and gender, and adjusted for level of urbanization. Children in 2015/2017 performed significantly worse on speed and agility (β = 0.8 to 1.1 s), significantly better on coordination/upper-limb speed (β = -1.0 to -0.6 s), and-except for 12-year-old girls-significantly worse on flexibility vs. children in 2006 (β = -3.4 to -1.8 cm). Additionally, upper-body strength was significantly worse among 10-year olds (β = -3.2 to -2.5 s) while leg strength was significantly worse among 11-year-olds in 2015/2017 vs. 2006 (β = -1.8 to -1.7 cm). Trunk strength was worse among 11- and 12-year old boys (β = 1.1 to 1.2 s). In line with a previously observed downward trend in neuromotor fitness among children (1980-2006), we found worse scores on speed and agility, and flexibility in 2015/2017 vs. 2006, stressing the need for interventions aimed at improving neuromotor fitness in order to promote physical activity and future health.

Ten Research Priorities Related to Youth Sport, Physical Activity, and Health

Background: Sport has been identified as one of the 7 best investments for increasing physical activity levels across the life span. Several questions remain on how to effectively utilize youth sport as a strategy for increasing physical activity and improving health in youth. The purpose of this paper is to identify the main research priorities in the areas of youth sport and physical activity for health.Methods: An international expert panel was convened, selected to cover a wide spectrum of topics related to youth sport. The group developed a draft set of potential research priorities, and relevant research was scoped. Through an iterative process, the group reached consensus on the top 10 research priorities.Results: The 10 research priorities were identified related to sport participation rates, physical activity from sport, the contribution of sport to health, and the overall return on investment from youth sport. For each research priority, the current evidence is summarized, key research gaps are noted, and immediate research needs are suggested.Conclusion: The identified research priorities are intended to guide researchers, policymakers, and practitioners to increase the evidence base on which to base the design, delivery, and policies of youth sport programs to deliver health benefits.

Effectiveness of a family intervention on health-related quality of life-a healthy generation, a controlled pilot trial

BACKGROUND

Physical activity is associated with better health, but knowledge about health promoting interventions, including physical activity for families in disadvantaged areas and the impact on health-related quality of life (HRQOL) is sparse. The aim of this study was to assess HRQOL in children and their parents after participation in the programme "A Healthy Generation".

METHODS

The programme is delivered in socioeconomically disadvantaged areas in Sweden and offers physical activity and a healthy meal or fruit twice a week from August to May to families with children in grade 2. Children (n = 67), aged 8-9 years, and their parents (n = 90) participated in this controlled study conducted in four schools, two control and two intervention schools. HRQOL of children and adults was assessed at baseline and follow-up after the intervention with the Pediatric Quality of Life Inventory (PedsQL) 4.0 and the Gothenburg Quality of Life scale, respectively. Analyses of covariance (ANCOVAs), linear regression and Pearson's correlation were conducted.

RESULTS

There were no significant differences between intervention and control in HRQOL among children or adults after the intervention. However, in a subgroup of children (n = 20) and adults (n = 29) with initial low HRQOL scores at baseline, there was a significant difference between the intervention group and control group after the intervention (children (total score): p = 0.02; adults (social domain) p = 0.04). Furthermore, within the intervention group, there was a significant relationship between level of participation in "A Healthy Generation" and the physical domain of HRQOL among girls (r = 0.44, p = 0.01), but not boys (r = - 0.07, p = 0.58).

CONCLUSION

Participation in the programme "A Healthy Generation" did not show a significant intervention effect on HRQOL in general. However, the findings suggest that HRQOL may be increased for children and adults with low HRQOL in disadvantaged areas. This knowledge can contribute to the development of health promoting interventions in such areas, and to more equitable health.

TRIAL REGISTRATION

ISRCTN ISRCTN11660938. Retrospectively registered 23 September 2019.

Longitudinal Trends in Sport Participation and Retention of Women and Girls

Measurement and analysis of sport participation data is vital to understand trends, and therefore to make informed decisions relating to sport policy and strategies to get more people active through sport. This study identified patterns of club sport participation, retention and drop-out of women and girls over a 7 year period in a popular team sport in Australia. The study included registered women and girls of all ages (4–96 years at baseline) in an almost exclusively female sport, with a particular focus on the ages 4–14 years where most participation occurs. All commencing participants in the base year (2010) were tracked over the 7 year period. Participants were classified in two ways: the total number of years they played and their overall pattern of participation. Differences between age groups were analyzed using Kruskall Wallis and Mann Whitney tests. Registration records of 29,225 participants were analyzed in the study. Overall, there were considerable differences in the years participating in the sport. Almost one third (30%) of commencing 4–9 year olds played continuously for the 7 years. This proportion diminished through ages at commencement from 10 to 19, reaching a low point of 4% for ages 15–19, then rebounded slightly, reaching 7% for ages 30+. The proportion who dropped out during the 7 year period and did not return varied with age in the converse manner, as did the proportion of single-year players. The optimal age of entry to sport for retention in participation was 6–9 years. Consideration needs to be given to the age appropriateness of sports programs for very young participants. Strategies specifically relating to retention of girls and young women during adolescence should be developed.

Movement Competency Training Delivery: At School or Online? A Pilot Study of High-School Athletes

Movement competency (MC) development of high-school athletes can prepare them for the requirements of physical preparation training and the demands of sport. The aim of this study was to explore the physical effects of and athlete compliance to coach-led versus self-directed training approaches in this population. Thirty-nine high-school athletes (19 male, 14.5 ± 0.3 years old; 20 female, 14.6 ± 0.3 years) were allocated into two groups for a physical preparation program to improve MC. Groups were prescribed either (i) one face-to-face and one online (F2F, n = 18), or (ii) two online (OL, n = 21) sessions per week for 16-weeks. Before and after the intervention, the Athlete Introductory Movement Screen (AIMS) was used to assess MC alongside common physical capacity measures (triple-hop, star-excursion balance, medicine ball throw, 40m sprint and countermovement jump). Dropout left 22 participants with pre-post physical scores. Compliance with online training was low and F2F session attendance moderate. Semi-structured interviews were conducted to assess participant perceptions following the intervention. Assessing individual responses, the F2F group had a higher proportion of positive responders to AIMS scores, yet capacity measures were inconclusive across groups. Face-to-face coaching when acquiring MCs as part of physical preparation, may provide greater positive perceptions towards training compared to self-directed online prescriptions, and thereby greater compliance.

Mechanisms underpinning the association between physical activity and mental health in adolescence: a 6-year study

BACKGROUND

Physical activity (PA) can promote mental health, but the mechanisms underpinning this association are not well-established. This study examined if perceptions of three basic psychological needs (autonomy, competence, relatedness) and moderate-to-vigorous physical activity (MVPA) mediate the association between number of years participating in PA and mental health in adolescence.

METHODS

Participants included 937 children (55% female) age 10-11 at inception of the longitudinal MATCH study, who provided data every 4 months over 6 years. Mediation analyses were used to assess the natural direct effect of number of years of PA participation (cycles 1-15) during late childhood and adolescence on later mental health (cycle 16), measured with the Mental Health Continuum-Short Form (MHC-SF), and the natural indirect effect through each of self-perceived autonomy, competence and relatedness, and self-report MVPA (cycle 15).

RESULTS

In single mediator models, indirect effects of autonomy, competence, relatedness and self-report MVPA were statistically significant. In joint mediation models (each of three models including one basic psychological need and MVPA), autonomy, competence and relatedness mediated 71, 27, and 51% of the association respectively; MVPA mediated 27-31% of the association. In the mediation model including all four mediators, relatedness mediated the largest proportion of the association, followed by autonomy and MVPA.

CONCLUSION

Results support developing strategies to encourage adolescents to engage and remain involved in PA. This could foster perceptions of autonomy, competence, and relatedness as well as MVPA, which in turn may enhance mental health.

Health Consequences of Youth Sport Specialization

Sport specialization is a training method now commonly used by young athletes who hope to achieve elite-level success. This may be defined as (1) choosing a main sport, (2) quitting all other sports to focus on 1 sport, and (3) year-round training (greater than 8 months per year). A number of sports medicine organizations have published recommendations based on the limited evidence available on this topic. The objective of this article was to perform a narrative review of the currently available evidence and sports medicine organizational recommendations regarding sport specialization and its effects on health to guide athletic trainers and sports medicine providers. To accomplish this goal, we conducted a narrative review of articles and position statements on sport specialization published from 1990 through 2018. Injury, overuse injury, serious overuse injury, and lower extremity injury were likely associated with higher degrees of sport specialization in various populations. Sports medicine organizations in general recommended against sport specialization in young athletes and instead promoted multisport participation for physical and psychological benefits. Few long-term data suggest that sport specialization has negative health-related quality-of-life consequences. Higher degrees of sport specialization likely pose risks of overuse injury; however, the age of specialization at which this risk occurs is not known. Because different populations and sports activities may put children at risk for certain injuries, future researchers should monitor large populations with sport-specific prospective active surveillance.

Characteristics of youth who leave the emergency department without being seen following sports-related concussion

Aim:

Despite the rising incidence of emergency department (ED) visits for sports-related concussion, the frequency and characteristics of youth leaving before being seen are unknown.

Methodology:

National estimates of ED visits for sports-related head injuries among youth (10–18 years) were generated for 2006–2017 using the National Electronic Injury Surveillance System. Logistic regression models estimated the odds of leaving without being seen across patient characteristics and time.

Results:

From 2006 to 2017, 985,966 (95% CI: 787,296–1,184,637) ED visits were identified for sports-related concussions, of which 5015 (95% CI: 3024–7006) left without being seen.

Conclusion:

Youth with sports-related concussion must receive timely care and ED improvements may reduce rates of leaving without being seen.

Over the last decade, more and more youth have visited the emergency department (ED) for sports-related concussion. At the same time, EDs are becoming more crowded, with long wait times and many patients leaving before being evaluated. An increase in the proportion of youth with concussion who left without being seen (LWBS) is possible. We used national data of ED visits to examine the rate of youth (aged 10–18 years) who LWBS for sports-related concussion from 2006 to 2017. While the rate of LWBS has not changed over time, more nonwhite youth and youth who were not injured at school left before being evaluated.

Sports Specialization Is Not Associated With Greater Odds of Previous Injury in Elite Male Youth Soccer Players

OBJECTIVE

To determine the relationship between sport specialization and previous injury in elite male youth soccer players.

DESIGN

Retrospective survey.

SETTING

U.S. Soccer Development Academy.

PARTICIPANTS

Male youth soccer players (N = 2123).

ASSESSMENT OF RISK FACTORS

Sport specialization, weekly training volume, training ratio, and age.

MAIN OUTCOME MEASURES

Previous sports-related injury, injury type (traumatic vs overuse), injury severity, and injury location.

RESULTS

Of 2099 participants (average age 13.2 ± 1.8 years), 61.7% were specialized in soccer (played soccer >8 mo/yr and no other sports) and 38.3% were nonspecialized (played soccer >8 mo/yr and also played other organized sports). Specialized athletes were older than nonspecialized athletes (13.7 ± 1.9 vs 12.5 ± 1.4, P < 0.0001). Thirty-three percent (690/2099) of athletes reported at least one previous sports-related injury for a total of 765 traumatic injuries and 25 overuse injuries. Distribution of injury type was similar for specialized and nonspecialized athletes. Among athletes with overuse injuries, nonspecialized athletes were more likely to report upper-extremity and trunk overuse injuries than specialized athletes. After accounting for age and weekly training volume, specialized athletes had decreased odds of reporting any previous injury compared with nonspecialized athletes [odds ratio (OR), 0.78; 95% confidence interval (CI), 0.64-0.95], and similar odds of reporting a previous lower-extremity (LE) overuse injury as nonspecialized athletes (OR, 0.70; 95% CI, 0.56-1.1). However, specialized athletes missed more practices due to injury than nonspecialized players [median = 3, interquartile range (IQR) 2-4 vs median = 2, IQR 2-4, P = 0.0003].

CONCLUSIONS

In this national sample of elite, male youth soccer players, after accounting for age and weekly training volume, specialized athletes had decreased odds of reporting any previous injury and similar odds of reporting a previous LE overuse injury as nonspecialized athletes. These data suggest the need for further research to determine whether injury risk related to sports specialization depends on sex, chosen sport, and skill/competitive level.

Years Participating in Sports During Childhood Predicts Mental Health in Adolescence: A 5-Year Longitudinal Study

PURPOSE

Sport participation promotes mental health and prevents mental illness. However, the association between specific sport profiles and mental health has not been examined. We investigate the longitudinal association between number of years with a recreational or performance sport profile and mental health during adolescence and whether these associations differ by sex.

METHODS

Participants (n = 318, 58.2% female) reported participation in sport every 4 months over 5 years, from ages 10-11 to 14-15 years. Each year, they were categorized as recreational or performance sport participants or as nonparticipants. Mental health was assessed at age 15-16 years. Multivariate linear regression was used to model the association between number of years (0-5) with a recreational and performance sport profile and mental health, controlling for sex, age, income, and age at puberty.

RESULTS

A recreational sport profile for ≥2 years was associated with better mental health compared with 0 years of recreational sport participation; the strongest association was observed for a recreational sport profile of 4-5 years (βˆ [95% confidence interval]: 10.29 [2.60, 17.98]). A performance sport profile for ≥1 year was associated with better mental health in late adolescence compared with 0 years of performance sport participation; the strongest association was observed for a performance sport profile of 4-5 years (βˆ [95% confidence interval]: 19.48 [9.50, 29.46]). No differences by sex were observed.

CONCLUSION

Both recreational and performance sport profiles in childhood and early adolescence are positively associated with mental health in late adolescence. To promote mental health, strategies to encourage youth to engage and remain involved in sport are warranted.