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Higgins K, Woods B, Haskell B, Bullock M, Rogers R, Izuegbunam N. Utility of the Counseling Center Assessment of Psychological Symptoms Screen in a Collegiate Athlete Population. J Athl Train 2023; 58:740-746. [PMID: 36913631 DOI: 10.4085/1062-6050-0579.22] [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] [Indexed: 03/15/2023]
Abstract
CONTEXT Mental health screening as a part of collegiate athletic preparticipation evaluations is becoming increasingly common, but effective and efficient screening depends on a screening tool that can accurately identify mental health symptoms and the need for mental health intervention. DESIGN Case-control study. SETTING Archival clinical records review. PATIENTS OR OTHER PARTICIPANTS Two cohorts of incoming National Collegiate Athletics Association Division I collegiate athletes (N = 353). MAIN OUTCOME MEASURE(S) Athletes completed the Counseling Center Assessment of Psychological Symptoms (CCAPS) Screen as a part of their preparticipation evaluation. These data were then matched with basic demographic data and mental health treatment history from clinical records, and the utility of the CCAPS Screen in determining a future or ongoing need for mental health services was analyzed. RESULTS Score differences for each of the 8 CCAPS Screen scales (Depression, Generalized Anxiety, Social Anxiety, Academic Distress, Eating Concerns, Frustration, Family Distress, and Alcohol Use) were found based on several demographic variables. Logistic regression analysis demonstrated that female sex, team sport participation, and the Generalized Anxiety scale score predicted future participation in mental health treatment. Decision tree testing of the CCAPS scales showed low utility in classifying those who received mental health treatment versus those who did not. CONCLUSIONS The CCAPS Screen did not appear to differentiate well between those who eventually received mental health services and those who did not. This should not be taken to mean that mental health screening is not useful but rather that a 1-time, state-based screening is not sufficient for athletes who experience intermittent but recurring stressors in a dynamic environment. A proposed model for improving the current standard of practice for mental health screening is provided as a focus of future research.
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Affiliation(s)
- Kate Higgins
- Sport Psychology, University of Nebraska-Lincoln Athletics
| | - Brett Woods
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City
| | - Brett Haskell
- Sport Psychology, University of Nebraska-Lincoln Athletics
| | - Mariah Bullock
- Sport Psychology, University of Nebraska-Lincoln Athletics
| | - Rachel Rogers
- Department of Statistics, University of Nebraska-Lincoln
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Baez S, Jochimsen K. Current Clinical Concepts: Integration of Psychologically Informed Practice for Management of Patients With Sport-Related Injuries. J Athl Train 2023; 58:687-696. [PMID: 37647239 DOI: 10.4085/1062-6050-0556.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Psychologically informed practice is an approach to patient management that encourages clinicians to treat patients from a biopsychosocial perspective and can be adopted by athletic trainers to manage sport-related injuries. As described in the domains of athletic training clinical practice, athletic trainers are expected to identify, address, and make appropriate referrals regarding psychosocial responses to injuries and mental health symptoms. Psychologically informed practice suggests addressing physical impairments in addition to screening and intervening for psychosocial responses with patients. In this Current Clinical Concepts paper, we discuss appropriate patient-reported outcome measures used to screen for mental health symptoms and psychosocial responses, provide recommendations on psychological interventions that can be integrated to enhance patient outcomes, and describe how to effectively refer a patient to an appropriate mental health professional.
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Affiliation(s)
- Shelby Baez
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Kate Jochimsen
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
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Michaels C, Holman A, Teramoto M, Bellendir T, Krautgasser-Tolman S, Willick SE. Descriptive Analysis of Mental and Physical Wellness in Collegiate Dancers. J Dance Med Sci 2023; 27:173-179. [PMID: 37264604 PMCID: PMC10456971 DOI: 10.1177/1089313x231178091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Understanding the physical and mental health of collegiate dancers is important for developing appropriate screening protocols and treatment interventions. This study aims to provide descriptive data on the overall health, injury burden, and well-being of a group of collegiate dancers, including the interactions between injury, nutrition, and mental health, to provide insight for wellness screening and interventions in collegiate dance programs. METHODS Members of the School of Dance at the University of Utah were sent an electronic general health survey. The survey included questions regarding medical history, family history, injuries, diet, sleep quality, symptoms of depression and anxiety, and history of eating disorders. RESULTS Of the 231 dancers who received the survey, 198 responded (response rate = 85.7%). Fifty 2% of respondents had an active injury. Symptoms of depression and anxiety were common (35.4%), and 37.4% of the dancers were interested in receiving mental health support. Symptoms of depression and anxiety had a significant association with both a history of injury and active injuries (P = .033 and .039, respectively). History of eating disorder was also significantly associated with active injuries (P = .005). The most commonly injured body area was ankle or foot (n = 144, 72.7%), followed by lower leg or shin (n = 76, 38.4%), and knee (n = 61, 30.8%). Over a quarter of the dancers (n = 54, 27.3%) reported having trouble sleeping, and 9.1% reported having a history of eating disorder. CONCLUSIONS This study highlights the important interplay between mental health, sleep, nutrition, and injury. These results show that in a group of collegiate dancers, active injuries and mental health concerns are common, and that there are statistically significant associations between injury, nutrition, and mental health. These data provide insight into factors that affect dancer wellness and help inform future screening and intervention protocols for dance programs.
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Affiliation(s)
- Chris Michaels
- University of Utah Orthopaedic Center
- University of Utah School of Dance
| | | | - Masaru Teramoto
- University of Utah Department of Physical Medicine & Rehabilitation, Salt Lake City, UT
| | - Trina Bellendir
- University of Utah Department of Physical Therapy and Athletic Training, Salt Lake City, UT
| | | | - Stuart E. Willick
- University of Utah Department of Physical Medicine & Rehabilitation, Salt Lake City, UT
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Donohue B, Scott J, Goodwin G, Barchard KA, Bohall G, Allen DN. Initial examination of the mental health disorders: screening instrument for athletes. Front Psychol 2023; 14:1029229. [PMID: 37599751 PMCID: PMC10436329 DOI: 10.3389/fpsyg.2023.1029229] [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: 08/26/2022] [Accepted: 06/06/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction There is a need to psychometrically develop assessment instruments capable of screening mental health disorders in athlete populations. The current study was conducted to determine reliability, validity and clinical utility of the Mental Health Disorders Screening Instrument for Athletes (MHDSIA). Methods and results 259 collegiate athletes completed the MHDSIA. Factor analysis determined a single factor with good internal consistency, and this factor was positively correlated with an established measure of psychiatric symptomology (Symptom Checklist 90-R), demonstrating its concurrent validity. An optimum clinical cutoff score (i.e., 32) was determined using Receiver Operating Characteristic (ROC) analyses to assist appropriate mental health referrals. Discussion Results suggest the MHSIA is a reliable, valid, and relatively quick and easy to interpret screen for the broad spectrum of mental health disorders in collegiate athletes. As expected, NCAA athletes reported lower MHDSIA scores than club and intramural athletes, while males reported similar severity scores as females.
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Affiliation(s)
- Brad Donohue
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Jesse Scott
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Grace Goodwin
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Kimberly A. Barchard
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Greg Bohall
- The Chicago School of Professional Psychology, Chicago, IL, United States
| | - Daniel N. Allen
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
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Woo CC. Recreational windsurfing-related acute injuries: a narrative review. Part 2: injury prevention and a proposal for a set of potential prevention strategies with a holistic approach. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2023; 67:159-174. [PMID: 37840584 PMCID: PMC10575326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Objective The purpose of this review was to identify existing prevention strategies for recreational windsurfing-related acute injuries and provide clinicians with a practical overview of current evidence supporting proposed potential prevention strategies. Methods A literature search was conducted through March 8, 2023, using relevant keywords with Boolean operators, such as "windsurfing" AND "injury prevention" and "windsurfing" AND "exercise interventions," from the PubMed and Google Scholar databases. Only peer-reviewed English-articles were included. Results Existing prevention strategies, right-of-way rules, a new proposed set of eight potential primary to tertiary prevention strategies for windsurfing-related acute injuries, and proposed definitions of injury prevention levels equivalent to Haddon's matrix were identified and tabled. Conclusions The proposed potential prevention strategies may facilitate clinicians in preventing recreational windsurfing-related acute injuries. Injury prevention for recreational windsurfing is under-researched. Future studies should focus on large prospective clinical trials evaluating the efficacy of prevention strategies for recreational windsurfing-related injuries.
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Ambegaonkar JP, Hansen-Honeycutt J, Wiese KR, Cavanagh CM, Caswell SV, Ambegaonkar SJ, Martin J. Female Collegiate Dancers' Physical Fitness across Their Four-Year Programs: A Prospective Analysis. J Funct Morphol Kinesiol 2023; 8:98. [PMID: 37489311 PMCID: PMC10366741 DOI: 10.3390/jfmk8030098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023] Open
Abstract
Dance is physically demanding, requiring physical fitness (PF) that includes upper body, lower body, core fitness, and balance for successful performance. Whether PF changes as dancers advance from when they enter (freshmen) to when they graduate from their collegiate program (seniors) is unclear. We prospectively compared collegiate dancers' freshman-to-senior PF. We recorded PF in regard to upper body strength endurance (push-ups), core strength endurance (front, left-side, right-side, and extensor plank hold times), lower body power (single leg hop-SLH-distances % height; Leg Symmetry Index: LSI = higher/lower × 100, %), and balance (anterior reach balance, % leg length, LL; LSI balance = higher/lower × 100, %) in 23 female collegiate dancers (freshman age = 18.2 ± 0.6 years). Repeated measures ANOVAs (p ≤ 0.05) were used to compare measures from freshman to senior years. Across their collegiate programs, dancers' PF remained unchanged. Specifically, their upper body strength endurance push-up numbers (p = 0.93), their core strength endurance plank times (left: p = 0.44, right: p = 0.67, front: p = 0.60, p = 0.22), their SLH distances (left: p = 0.44, right: p = 0.85), and their symmetry (p = 0.16) stayed similar. Also, dancers' right leg (p = 0.08) and left leg balance (p = 0.06) remained similar, with better balance symmetry (p < 0.001) in seniors. Overall, dancers' PF did not change across their collegiate programs. Thus, female dancers' freshman PF may be an adequate baseline reference measure when devising rehabilitation programs and determining readiness-to-return-to-activity post injury.
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Affiliation(s)
- Jatin P. Ambegaonkar
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (K.R.W.); (C.M.C.); (S.V.C.); (J.M.)
| | | | - Kelley R. Wiese
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (K.R.W.); (C.M.C.); (S.V.C.); (J.M.)
| | - Catherine M. Cavanagh
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (K.R.W.); (C.M.C.); (S.V.C.); (J.M.)
| | - Shane V. Caswell
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (K.R.W.); (C.M.C.); (S.V.C.); (J.M.)
| | | | - Joel Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (K.R.W.); (C.M.C.); (S.V.C.); (J.M.)
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Turska-Kmieć A, Neunhaeuserer D, Mazur A, Dembiński Ł, del Torso S, Grossman Z, Barak S, Hadjipanayis A, Peregud-Pogorzelski J, Kostka T, Bugajski A, Huss G, Kowalczyk-Domagała M, Wyszyńska J. Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes. Front Pediatr 2023; 11:1125958. [PMID: 37425260 PMCID: PMC10323832 DOI: 10.3389/fped.2023.1125958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.
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Affiliation(s)
- Anna Turska-Kmieć
- Department of Cardiology, Children’s Memorial Health Institute, Warsaw, Poland
- Polish PaediatricSociety, Warsaw, Poland
- Working Group on Sports Cardiology, Polish Cardiac Society, Warsaw, Poland
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, University of Padova Department of Medicine, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Artur Mazur
- Polish PaediatricSociety, Warsaw, Poland
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - Łukasz Dembiński
- Polish PaediatricSociety, Warsaw, Poland
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Stefano del Torso
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Childcare Worldwide, Padova, Italy
| | - Zachi Grossman
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Maccabi Health Services, Pediatric Clinic, Tel Aviv, Israel
| | - Shimon Barak
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adamos Hadjipanayis
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
| | - Jarosław Peregud-Pogorzelski
- Polish PaediatricSociety, Warsaw, Poland
- Department of Paediatrics, Paediatric Oncology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
- The Polish Society of Sports Medicine, Wroclaw, Poland
| | - Andrzej Bugajski
- The Polish Society of Sports Medicine, Wroclaw, Poland
- Department of Physiotherapy, College of Physiotherapy, Wroclaw, Poland
| | - Gottfried Huss
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Kinder-Permanence Hospital Zollikerberg, Zollikerberg, Switzerland
| | - Monika Kowalczyk-Domagała
- Department of Cardiology, Children’s Memorial Health Institute, Warsaw, Poland
- Working Group on Paediatric Cardiology, Polish Cardiac Society, Warsaw, Poland
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszów University, Rzeszów, Poland
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Riding NR, Dorobantu DM, Williams CA, Stuart G, Fritsch P, Wilson MG, Mossialos E, Pieles G. Protecting the stars of tomorrow: do international cardiovascular preparticipation screening policies account for the paediatric athlete? A systematic review and quality appraisal. Br J Sports Med 2023; 57:371-380. [PMID: 36332982 DOI: 10.1136/bjsports-2022-105659] [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: 10/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE (1) Identify and review current policies for the cardiovascular screening of athletes to assess their applicability to the paediatric population and (2) evaluate the quality of these policy documents using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. DESIGN Systematic review and quality appraisal of policy documents. DATA SOURCES A systematic search of PubMed, MEDLINE, Scopus, Web of Science, SportDiscus and CINAHL. ELIGIBILITY CRITERIA FOR SELECTING STUDIES An article was included if it was a policy/position statement/guideline/consensus or recommendation paper relating to athletes and cardiovascular preparticipation screening. RESULTS AND SUMMARY Of the 1630 articles screened, 13 met the inclusion criteria. Relevance to paediatric athletes was found to be high in 3 (23%), moderate in 6 (46%) and low in 4 (31%), and only 2 provide tailored guidance for the athlete aged 12-18 years. A median 5 related citations per policy investigated solely paediatric athletes, with study designs most commonly being retrospective (72%). AGREEII overall quality scores ranged from 25% to 92%, with a median of 75%. The lowest scoring domains were rigour of development; (median 32%) stakeholder involvement (median 47%) and Applicability (median 52%). CONCLUSION Cardiac screening policies for athletes predominantly focus on adults, with few providing specific recommendations for paediatric athletes. The overall quality of the policies was moderate, with more recent documents scoring higher. Future research is needed in paediatric athletes to inform and develop cardiac screening guidelines, to improve the cardiac care of youth athletes.
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Affiliation(s)
- Nathan R Riding
- Bristol Medical School, University of Bristol, Bristol, UK.,Institute of Sport and Exercise Health (ISEH), University College London, London, UK
| | - Dan-Mihai Dorobantu
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK.,Population Health Sciences, University of Bristol, Bristol, UK.,Congenital Heart Unit, Bristol Royal Hospital for Children and Heart Institute, Bristol, UK
| | - Craig A Williams
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Graham Stuart
- Congenital Heart Unit, Bristol Royal Hospital for Children and Heart Institute, Bristol, UK.,National Institute for Health Research Cardiovascular Biomedical Research Centre, Bristol Heart Institute, Bristol, UK
| | | | - Mathew G Wilson
- Institute of Sport and Exercise Health (ISEH), University College London, London, UK.,Athlete Health and Performance Research Centre and the Sports Medicine Department, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Elias Mossialos
- Department of Health Policy, London School of Economics, London, UK
| | - Guido Pieles
- Institute of Sport and Exercise Health (ISEH), University College London, London, UK .,Athlete Health and Performance Research Centre and the Sports Medicine Department, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Benoit-Piau J, Morin M, Guptill C, Fortin S, Gaudreault N. Movement Competency Screen: Rethinking the Rating. Int J Sports Phys Ther 2022; 17:1282-1289. [PMID: 36518829 PMCID: PMC9718700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/12/2022] [Indexed: 06/17/2023] Open
Abstract
Background Dancers are at high risk of musculoskeletal disorders. There has been a growing interest in the last few years in pre-season screening using tools to evaluate movement competency, among which is the Movement Competency Screen (MCS). It is currently scored using a categorical 3-level rating system, but this method does not seem to take into account the load level of movements. A 5-level scoring system could potentially alleviate this problem. Hypothesis/Purpose For each scoring system, to investigate (1) the internal consistency, and (2) the association with transversus abdominis activation (TrA), hip muscle strength and with Functional Movement screen (FMSTM) total score. Study design Secondary analyses of a prospective cohort study. Methods One hundred and eighteen professional and preprofessional dancers evolving in ballet or contemporary dance were recruited. The MCS was performed and was scored according to the 3- and 5-level scoring systems. The key variables for movement competency that were considered for convergent validity were the activation ratio of the TrA evaluated with ultrasound imaging and hip strength assessed with a handheld dynamometer. Movement competency was also measured with the FMSTM. Results Internal consistency was higher for the 5-level scoring of the MCS items ($*$\alpha$*$=0.548) compared to the 3-level scoring system ($*$\alpha$*$=0.494). Multiple linear regressions showed that TrA activation, hip adductor strength, and FMSTM could significantly explain 24.0% of the variance for the 5-level scoring system of the MCS whereas hip internal rotator strength and FMSTM could explain only 16.4% of the variance for the 3-level scoring system. Conclusion The 5-level scoring system showed better metrologic properties in terms of internal consistency and concurrent validity and therefore, should be preferred over the 3-level scoring system in future research. Level of Evidence Level III.
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Affiliation(s)
| | - Mélanie Morin
- Faculté de médecine et des sciences de la santé Université de Sherbrooke
| | | | | | - Nathaly Gaudreault
- Faculté de médecine et des sciences de la santé Université de Sherbrooke
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Characteristics of Second-Line Investigations of Middle-Aged Athletes Who Failed Preparticipation Examinations. Clin J Sport Med 2022; 32:396-400. [PMID: 34446648 DOI: 10.1097/jsm.0000000000000966] [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: 11/25/2020] [Accepted: 07/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The role of exercise testing during preparticipation examinations (PPEs) of middle-aged athletes is uncertain. This study examined the characteristics of disqualifications after an initial PPE that includes an exercise test in competitive athletes older than 30 years. We investigated disqualification rates and reasons, second-line investigations performed, and final decisions regarding competitive sports participation. DESIGN Chart review. SETTING Sports medicine clinic. PARTICIPANTS Athletes aged >30 years that performed an exercise test as part of their annual PPE at our sports medicine clinic (n = 866). INDEPENDENT VARIABLES Age, sex, height, weight, sport type, cardiovascular risk factors, and abnormal PPE findings. MAIN OUTCOME MEASURES Additional investigations performed, approval/disqualification regarding competitive sports participation. RESULTS The initial disqualification rate of athletes was 9.8%. Three (3.6%) athletes were disqualified following questionnaire and physical examination, 19 (22.4%) because of resting electrocardiogram findings, and 65 (76.5%) following the exercise test. After additional work-up, only 5 athletes (0.4%) were ultimately found ineligible for competitive sports. From those, only 2 athletes (0.2%) were disqualified because of exercise test findings, which were episodes of supraventricular tachycardia and not ischemia-related. CONCLUSIONS The addition of an exercise test to the PPE of middle-aged athletes is of limited value. If exercise testing of older athletes is performed, arrhythmias are probably of higher significance than ST-T changes.
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Matsel KA, Brown SN, Hoch MC, Butler RJ, Westgate PM, Malone TR, Uhl TL. The Intra- and Inter-rater Reliability of an Arm Care Screening Tool in High School Baseball Coaches. Int J Sports Phys Ther 2021; 16:1532-1540. [PMID: 34909258 PMCID: PMC8637259 DOI: 10.26603/001c.29680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players. PURPOSE To establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches. STUDY DESIGN Methodological intra- and inter-rater reliability study. METHODS Thirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care Screen (ACS) by three examiners (two coaches, one physical therapist) in real-time and again seven days later by reviewing video recordings of each players' initial screening performance. Results from each examiner were compared within and between raters using Cohen's kappa and percent absolute agreement. RESULTS Substantial to excellent intra-rater and inter-rater reliability were established among all raters for each component of the ACS. The mean Cohen's kappa coefficient for intra-rater reliability was 0.76 (95% confidence interval, 0.54-0.95) and percent absolute agreement ranged from 0.82-0.94 among all raters. Inter-rater reliability demonstrated a mean Cohen's kappa value of 0.89 (95% confidence interval, 0.77-0.99) while percent absolute agreement between raters ranged from 0.81-1.00. Intra- and inter-rater reliability did not differ between raters with various movement screening experience (p>0.05). CONCLUSIONS High school baseball coaches with limited experience screening movement can reliably score all three components of the ACS in less than three minutes with minimal training. LEVEL OF EVIDENCE Level 3, Reliability study.
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12
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Athlete Preparticipation Physical Evaluation. Sports Med Arthrosc Rev 2021; 29:200-206. [PMID: 34730121 DOI: 10.1097/jsa.0000000000000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Preparticipation evaluations (PPE) are both a traditional and legal requirement by many governing bodies for sport. The ideal goal of the PPE is safe participation in sport for athletes. This article provides an overview of common PPE elements and current best practice recommendations. Descriptions of every possible examination are published elsewhere and are beyond the intent of this article. Additional considerations for transgender, masters athletes, and Special Olympians are also outside the scope of this review, but are well covered in The Preparticipation Physical Evaluation, fifth edition monograph.
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Ionescu AM, Pitsiladis YP, Rozenstoka S, Bigard X, Löllgen H, Bachl N, Debruyne A, Pigozzi F, Casasco M, Jegier A, Smaranda AM, Caramoci A, Papadopoulou T. Preparticipation medical evaluation for elite athletes: EFSMA recommendations on standardised preparticipation evaluation form in European countries. BMJ Open Sport Exerc Med 2021; 7:e001178. [PMID: 34745648 PMCID: PMC8527121 DOI: 10.1136/bmjsem-2021-001178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2021] [Indexed: 01/12/2023] Open
Abstract
Sports medicine is a medical specialty that supports the performance of professional and amateur athletes while maintaining their health. Sports medicine professionals need to ensure the safe participation of athletes in sports activities achieved through a periodical preparticipation evaluation (PPE) and a regular medical monitoring of the athletes’ health in accordance with the latest recommendations regarding health condition and medical history, physical working capacity, training period and programme, recovery, nutrition, use of supplements, injuries prevention and safe return to play. In order to harmonise these national variations in the content and application of the PPE, the EFSMA Scientific and Educational Commission proposes a ‘gold standard’ for elite athletes across Europe. Important objectives of PPE are early detection and prevention of severe complications during sports activities both in leisure time and competitive sports. The PPE should entail the following diagnostic components: health status, anthropometry, functional and exercise capacity. It is of utmost importance to develop and implement preventive strategies such as the PPE. Besides monitoring the health status of athletes, the PPE plays an important role in the selection process, bringing valuable information for coaches and supporting a personalised treatment approach. Screening of athletes through a standardised digital PPE could be beneficial for a better understanding of the impact of long-term physical activity. Furthermore, PPE leads the scientific community to a way of working closer together in the interest of the athletes.
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Affiliation(s)
- Anca Mirela Ionescu
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Sports Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Yannis P Pitsiladis
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UK
| | - Sandra Rozenstoka
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Sports Medicine and Rehabilitation Centre, Riga Stradins University, Riga, Latvia
| | - Xavier Bigard
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Union Cycliste Internationale, Aigle, Switzerland
| | - Herbert Löllgen
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Practice for Cardiology, Sports Medicine, Remscheid, Germany
| | - Norbert Bachl
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Austrian Institute of Sports Medicine, Vienna, Austria
| | - Andre Debruyne
- European Federation of Sports Medicine Associations, Lausanne, Switzerland
| | - Fabio Pigozzi
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Sports Medicine Unit, University of Rome Foro Italico, Rome, Italy
| | - Maurizio Casasco
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Italian Sports Medicine Federation, Rome, Italy
| | - Anna Jegier
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Sports Medicine, Medical University of Lodz, Lodz, Poland
| | - Alina Maria Smaranda
- Sports Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Adela Caramoci
- Sports Medicine, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
| | - Theodora Papadopoulou
- European Federation of Sports Medicine Associations, Lausanne, Switzerland.,Lower Limbs- ADMR Hip & Groin, Defence Medical Rehabilitation Centre Headley Court, Loughborought, UK
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14
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Weise KK, Galt SJ, Hale MH, Springer DB, Swanson MW. Pre-participation Vision Screening and Comprehensive Eye Care in National Collegiate Athletic Association Athletes. Optom Vis Sci 2021; 98:764-770. [PMID: 34328455 DOI: 10.1097/opx.0000000000001738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Pre-participation physical evaluation and its vision screenings have been the mainstay of medical clearance for competitive play for decades. The ability of screening to address athlete's sports-specific vision needs is unknown. METHODS Fifty-eight intercollegiate football players consented to participate in a comprehensive, sports-specific eye examination in addition to the standard pre-participation vision screening. Sensitivity, specificity, and positive and negative predictive values were determined for screening's ability to detect athletes whose vision might improve with correction, athletes who had significant ocular findings that impact safety, and either of the two conditions together. The effect no recent eye examination added to pre-participation vision screening results was evaluated for change in screening yield. Descriptive statistics of the cohort and associations with no recent comprehensive eye examination were generated. RESULTS The pre-participation vision screening was able to identify three athletes not meeting visual acuity requirements for medical clearance to play without a comprehensive assessment. A failed screening was poorly able to identify athletes who might benefit from improved acuity (sensitivity, 9.1%; specificity, 100%), have sports-specific significant ocular findings (sensitivity, 10.5%; specificity, 97.3%), or have either together (sensitivity, 7.5%; specificity, 100%). Sixty percent (33/55) of athletes reported never having a comprehensive examination or one within the last 10 years. Fifty-eight percent (34/58) had improved best-corrected visual acuity after comprehensive examination, and 81% (47/58) had improved acuity or a sports-specific significant finding. CONCLUSIONS The pre-participation vision screening was largely able to identify athletes meeting the minimum visual acuity requirement for athlete clearance. It poorly identified those who might benefit from improved vision with refractive correction and those in whom sport-specific significant eye findings were noted. Comprehensive eye care had a clear benefit for the majority of athletes tested. This benefit needs to be balanced with the potential added costs and time constraints to players and athletic department staff.
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Affiliation(s)
| | - Sarah J Galt
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
| | - M Heath Hale
- Department of Athletics, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Daniel B Springer
- Department of Athletics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mark W Swanson
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
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15
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Functional Movement Screening as a Predictor of Injury in Highly Trained Female’s Martial Arts Athletes. POLISH HYPERBARIC RESEARCH 2021. [DOI: 10.2478/phr-2020-0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Abstract
Objective. This research examines the emerging role of FMS™ in the context of predicting lower extremity injury in females University athletes. The secondary purpose of this study is to investigate the differences between FMS performance comparisons between three martial arts sports to establish baseline comparisons.
Method. Forty-seven university female athletes were recruited for this study, The data collected was separated into three groups based on their sports discipline (judo N=17 age: 19±4, wrestling N=15 age: 18±5, karate N=15 age: 19±3), Independent t-tests were performed on each group with significance being set at P<0.05 to determine difference in FMS™ scores between injured and non injured athletes during the successive competitive seasons. One-way analyses of variances were used to determine if there was a significant difference between sports, ‘body parts injured’ groups, and ‘mechanisms of injury’ groups.
Results. One-way analysis of variance revealed no statistically significant difference between the two (ankle, knee) injury groups, and non-injury group (F2,54= 2.34; p=0.106). There was no statistical difference between the pre-season FMS™ scores of the injured and non-injured groups (t47 = -1.68; P=.100; d=0.52; 95%CI: -0.11, 1.15). Finally, strong evidence of FMS score was found when comparing the three sports with one-way ANOVAs (F=5.83, df= 2, 54, p=0.005).
Conclusion. One of the more significant findings to emerge from this study is that FMS™ has emerged as a powerful tool for identifying lower extremity injury in female athletes. Further investigation and experimentation into FMS™ are strongly recommended before implementing them into a pre-participation physical examination (PPE) for combat sports. What is now needed is a cross-national study involving other sports.
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16
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Coleman N, Beasley M, Briskin S, Chapman M, Cuff S, Demorest RA, Halstead M, Hornbeck K, Kinsella SB, Logan K, Liu R, Mooney C, Myers RA, Ruparell S, Santana J, Walter KD, Waterbrook AL, Wolf SF. Musculoskeletal and Sports Medicine Curriculum Guidelines for Pediatric Residents. Curr Sports Med Rep 2021; 20:218-228. [PMID: 33790194 DOI: 10.1249/jsr.0000000000000830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Musculoskeletal (MSK) and sports-related conditions are relatively common in the pediatric population. Pediatric residencies should provide residents with the knowledge and skills to assess and manage both acute and chronic MSK and sports injuries and complaints. Residents should develop the competencies and attitudes to safeguard and promote a healthy and active lifestyle for youth. Programs can use a variety of educational tools, both in the clinic and on the field, to provide a well-rounded MSK curriculum throughout the residency years. This article provides a review of general pediatric sports medicine curriculum guidelines and suggested implementation strategies.
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Affiliation(s)
- Nailah Coleman
- Children's National Hospital, The Goldberg Center for Community Pediatric Health, Washington, DC
| | - Michael Beasley
- Boston Children's Hospital, Sports Medicine Division, Boston, MA
| | - Susannah Briskin
- Rainbow Babies and Children's Hospital, Division of Sports Medicine, Solon, OH
| | | | - Steven Cuff
- Nationwide Children's Hospital, Sports Medicine, Westerville, OH
| | - Rebecca A Demorest
- Webster Orthopedics, Pediatric and Young Adult Sports Medicine, Dublin, CA
| | | | - Kimberly Hornbeck
- Medical College of Wisconsin, Children's Wisconsin Primary Care Sports Medicine, Milwaukee, WI
| | | | - Kelsey Logan
- Cincinnati Children's Hospital Medical Center, Division of Sports Medicine, Cincinnati, OH
| | - Ruikang Liu
- Penn State Health-Children's Hospital, Department of Pediatrics, Hershey, PA
| | | | - Rebecca A Myers
- University of Colorado, Department of Family Medicine, Longmont, CO
| | - Sonia Ruparell
- Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Chicago, IL
| | - Jonathan Santana
- Baylor College of Medicine, Department of Pediatrics, Section of Adolescent and Sports Medicine, Houston, TX
| | - Kevin D Walter
- Medical College of Wisconsin, Departments of Orthopaedic Surgery & Pediatrics, Children's Wisconsin Primary Care Sports Medicine, Delafield, WI
| | - Anna L Waterbrook
- The University of Arizona, Department of Emergency Medicine, Tucson, AZ
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17
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National Collegiate Athletic Association Athletic Departments’ Mental Health Screening Practices: Who, What, When, and How. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2021-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
College student athletes face unique, sport-related stressors that may lead to, or exacerbate, mental health (MH) concerns and symptoms. Although the National Collegiate Athletic Association has identified MH screening as a best practice, minimal data exist regarding contemporary screening practices. We explored National Collegiate Athletic Association Division I (DI), Division II (DII), and Division III (DIII) athletic departments’ current MH screening practices (N = 264). Compared with DII/DIII (53%), a greater percentage of Division I (89%) conducted formal MH screening. At DII/DIII institutions, athletic trainers were more likely to both administer and review screeners than any other sports medicine professional; sport psychologists primarily oversaw these tasks at DI schools. DI, compared with DII/DIII, institutions were more likely to have had a student athlete attempt suicide (62% vs. 40%) and participate in inpatient treatment (69% vs. 43%). There is a clear need for the National Collegiate Athletic Association to continue to promote policies that support MH screening and to create mechanisms in which it can monitor institutional involvement.
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18
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Hoover DL, Killian CB, Tinius RA, Bellar DM, Wilkinson SG, Esslinger FT, Judge LW. Predictive Validity of a Functional Movement Screen in Professional Basketball Players. ACTA ACUST UNITED AC 2020; 56:medicina56120724. [PMID: 33371366 PMCID: PMC7767371 DOI: 10.3390/medicina56120724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 11/25/2022]
Abstract
Background and objectives: Striking a balance between maximizing performance and preventing injury remains elusive in many professional sports. The purpose of this study was to assess the relative risk of non-contact injuries in professional basketball players based on predictive cut scores on the Functional Movement Screen™ (FMS). Materials and Methods: Thirty-two professional basketball players from the National Basketball Association (NBA) and Women’s National Basketball Association (WNBA) participated in this study. This observational pilot cohort study assessed and scored each participant using the FMS during training camp. Each athlete was then tracked throughout the season while recording the number, type, and time lost due to injuries. Possible exposures, actual exposures, and exposures missed due to non-contact injury (NCI) for each athlete were calculated and then used to determine the crude and specific incident rates for exposures missed due to NCI per 1000 exposures. Results: Linear regression models were used to evaluate the predictive ability of the FMS score for total missed exposures, NCI, and CI missed exposures. In all models, the FMS total score failed to attain significance as a predictor (p > 0.05). FMS scores ranged from 5 to 18. The recommended cut score of 14 showed a sensitivity of 0.474 and a specificity of 0.750. The cut score of 15 showed the best combination, exhibiting a sensitivity of 0.579 and specificity of 0.625. A total of 5784 exposures to NCI were possible for the men and women combined, and 681 possible exposures were missed. Of these, 23.5% were due to NCI, 16.5% were due to contact injuries (CI), and 60% were due to illnesses and personal reasons. Conclusions: The FMS proved to be a measure that was not associated with any injury measure in this sample of professional basketball players, suggesting the instrument lacks predictive validity in this population.
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Affiliation(s)
- Donald L. Hoover
- Doctor of Physical Therapy Department, Western Michigan University, Kalamazoo, MI 49008, USA
- Correspondence: ; Tel.: +1-269-387-7369
| | - Clyde B. Killian
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN 42667, USA;
| | - Rachel A. Tinius
- School of Kinesiology, Recreation, and Sport, Western Michigan University, Bowling Green, KY 42101, USA; (R.A.T.); (F.T.E.)
| | - David M. Bellar
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Steven G. Wilkinson
- Doctor of Physical Therapy Program, Rocky Mountain University of Health Professions, Provo, UT 84606, USA;
| | - Francis T. Esslinger
- School of Kinesiology, Recreation, and Sport, Western Michigan University, Bowling Green, KY 42101, USA; (R.A.T.); (F.T.E.)
| | - Lawrence W. Judge
- School of Kinesiology, Ball State University, Muncie, IN 47306, USA;
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19
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Increasing Primary Care Follow-up after Preparticipation Physical Evaluations. Pediatr Qual Saf 2020; 5:e358. [PMID: 33134760 PMCID: PMC7591121 DOI: 10.1097/pq9.0000000000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/04/2020] [Indexed: 11/26/2022] Open
Abstract
Preparticipation physical evaluations (PPEs) strive to prevent injuries and sudden death in athletes. Ideally, the medical home is the best setting for completion. However, many school systems request large PPE screenings for their student-athletes. This quality-improvement project aimed to increase primary care provider (PCP) follow-up for athletes “cleared with recommendation” (CR) or “disqualified” (DQ) during our mass PPEs.
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20
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Hirschhorn RM, Cadet D, Delus R, Phillips J, Murphy TE, Haggard C, Razayeski J, Yeargin S. The prevalence of sickle cell trait in Division I university athletics programs. PHYSICIAN SPORTSMED 2020; 48:430-436. [PMID: 32149552 DOI: 10.1080/00913847.2020.1740628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To determine the prevalence of student-athletes with sickle cell trait (SCT) and describe their demographics, prior knowledge of status, and hemoglobin (Hb) profile. Methods: A retrospective chart review was conducted at two National Collegiate Athletic Association Division I universities. Participants were student-athletes during the 2010/11-2018/19 academic years. The independent variable was SCT status. Main outcome measures included actual prevalence of SCT positive student-athletes, sex, race, sport, prior knowledge of personal and family history SCT status, and Hb profile (HbA, HbA2, HbS, HbF, HbC) proportions. Results: Fifty-three SCT positive student-athletes (13.2 ± 2.0 per academic year) were identified, accounting for ~1% of the student-athlete population annually. The majority were Black/African-American (n = 49, 100.0%; 4 missing) and males (n = 44, 83.0%). Football had the majority (n = 28, 52.8%) of SCT student-athletes. Most student-athletes were unaware of their SCT status (n = 33, 62.3%). There was no difference between actual and expected prevalence of SCT student-athletes overall and by race in any academic year (p > 0.05). Results of Hb electrophoresis testing were available for 44 (83.0%) student-athletes. Average values for HbA, HbA2, HbS, HbF and HbC were 58.54 ± 4.26%, 3.42 ± 0.53%, 37.99 ± 4.60%, 0.17 ± 0.68% and 0.00 ± 0.00%, respectively. Conclusions: Student-athletes with SCT were a small proportion of the student-athlete population. The majority of SCT student-athletes had no prior knowledge of personal or family history; therefore, it is insufficient to rely on self-reported history. No difference was found between actual and expected prevalence of SCT student-athletes. Due to high proportion of student-athletes who are unaware of their SCT status, institutions should facilitate SCT screening with confirmatory testing for all student-athletes to prevent missed identification of those with SCT.
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Affiliation(s)
- Rebecca M Hirschhorn
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
| | - Danielle Cadet
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
| | - Rodain Delus
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
| | - Jessica Phillips
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
| | | | - Clinton Haggard
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
| | | | - Susan Yeargin
- Department of Exercise Science, University of South Carolina , Columbia, SC, USA
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21
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Schmidt JD, Rawlins MLW, Lynall RC, D'Lauro C, Clugston JR, McAllister TW, McCrea M, Broglio SP. Medical Disqualification Following Concussion in Collegiate Student-Athletes: Findings from the CARE Consortium. Sports Med 2020; 50:1843-1855. [PMID: 32557231 DOI: 10.1007/s40279-020-01302-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The absence of evidence-based guidelines make medical disqualification (MDQ) following concussion one of the most challenging decision-making processes faced by sports medicine professionals. OBJECTIVE We aimed to compare premorbid and postmorbid factors between student-athletes that were and were not medically disqualified from sport following a concussion. METHODS Among 1832 student-athletes diagnosed with concussion within the CARE Consortium, 53 (2.9%) were medically disqualified (MDQ +) and 1779 (97.1%) were not medically disqualified (MDQ-). We used contingency tables and descriptive statistics for an initial evaluation of a broad list of premorbid and postmorbid factors. For those factors showing association with MDQ status, we calculated odds ratios and 95% confidence intervals for the odds of being MDQ + in the presence of the identified factor. RESULTS History of 2 (OR: 3.2, 95% CI 1.5, 6.9) or 3 + (OR: 7.4, 95% CI 3.4, 15.9) previous concussions; 1 + headaches in past 3 months (OR: 1.8, 95% CI 1.0, 3.2); immediate removal from play (OR: 2.4, 95% CI 1.2, 4.9); alcohol (OR: 2.6, 95% CI 1.2, 5.4), tobacco (OR: 3.3, 95% CI 1.1, 9.5), or marijuana use since injury (OR: 5.4, 95% CI 1.5, 19.0); as well as prolonged recovery due to mental health alterations (OR: 5.3, 95% CI 2.0, 14.1) or motivation/malingering (OR: 7.5, 95% CI 3.3, 17.0) increased odds of being MDQ + . The MDQ + group took longer to become asymptomatic relative to the MDQ- group (MDQ + : 23.5 days, 95% CI 15.8, 31.2; MDQ-: 10.6 days, 95% CI 9.5, 11.6; p < 0.001). CONCLUSIONS MDQ following concussion was relatively rare. We identified three patterns related to MDQ following concussion: (1) concussion and headache history were the only premorbid factors that differed (2) initial concussion presentation was more severe and more immediate in the MDQ + group, and (3) post-concussion recovery outcomes expressed the greatest differences between groups.
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Affiliation(s)
- Julianne D Schmidt
- UGA Concussion Research Laboratory, University of Georgia, 330 River Rd, Athens, GA, USA.
- Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA, USA.
| | | | - Robert C Lynall
- UGA Concussion Research Laboratory, University of Georgia, 330 River Rd, Athens, GA, USA
- Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA, USA
| | - Christopher D'Lauro
- Department of Behavioral Science and Leadership, United States Air Force Academy, USAF, Air Force Academy, CO, USA
| | - James R Clugston
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - Tom W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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22
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Empirical Development of a Screening Method to Assist Mental Health Referrals in Collegiate Athletes. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2019. [DOI: 10.1123/jcsp.2018-0070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The conspicuous absence of validated screening measures specific to mental health symptomology in collegiate athletes has negatively affected clinical practice in this population. Therefore, this study was performed to develop a sport specific measure to optimally identify collegiate athletes who are particularly likely to benefit from mental health programming. Participants were 289 collegiate-athletes who were assessed for mental health symptomology using the Global Severity Index of Symptom Checklist-90-Revised (GSI), factors that interfere with sport performance using the Problems in Sport Competition Scale (PSCS) and Problems in Sport Training Scale (PSTS), and motivation to pursue professional counseling using the Desire to Pursue Sport Psychology Scale (DSPS). As hypothesized, a hierarchical multiple regression analysis indicated that PSCS, PSTS and DSPS scores significantly predicted GSI scores, controlling gender and sport status (NCAA, club, intramural). Receiver operating characteristic (ROC) analysis indicated that high-risk athletes (GSI T-scores ≥ 60) could be correctly classified by PSTS and PSCS scores. Results suggest the PSCS and PSTS may assist identification of collegiate athletes who are especially appropriate for mental health programs. These scales additionally identify factors directly relevant to athletes’ sport performance.
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23
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Association of pre-season musculoskeletal screening and functional testing with sports injuries in elite female basketball players. Sci Rep 2019; 9:9286. [PMID: 31243317 PMCID: PMC6595006 DOI: 10.1038/s41598-019-45773-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 05/31/2019] [Indexed: 12/02/2022] Open
Abstract
Basketball is one of the most popular sports in Lithuania, and participation in women’s basketball is on the rise. Pre-participation examinations, including musculoskeletal screening and functional performance testing, is an essential part of a multidisciplinary approach to prevent future injuries. Because the lower extremities are the most commonly-injured body area in basketball players. Assessing fundamental movement qualities is of utmost importance. The aim of our study was to determine if functional tests can predict sports injuries in elite female basketball players. A total of 351 records for professional female basketball players were screened during 2013–2016 season. We analysed functional characteristics before the season and used functional performance tests for injury risk assessment: the Functional Movement Screen (FMS), the lower quarter Y Balance test (YBT-LQ) and the Landing Error Scoring System (LESS). Data from 169 players’ records were analysed: 77 of them made it to the end of season without injury, making up the non-injured group, while 92 of them suffered lower limb sport injuries during the sport season (injury group). Student’s t-test and the Mann-Whitney U-test were used to determine differences between groups. The most commonly encountered sports injuries in our population were those of knee 40.2% and ankle 38%. The injury group had a lower total FMS score (p = 0.0001) and higher total LESS score (p = 0.028) than non-injury group. The dynamic balance of lower limbs was similar in both groups. Imperfect functional movement patterns and poor jump-landing biomechanics during pre-season screening were associated with lower extremity injuries in elite female basketball players. Impairments of dynamic stability in the lower extremities were not associated with injury rates in our population. A combination of functional tests can be used for injury risk evaluation in female basketball players.
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24
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Cooper L, Harper R, Wham GS, Cates J, Chafin SJ, Cohen RP, Dompier TP, Huggins RA, Newman D, Peterson B, McLeod TCV. Appropriate Medical Care Standards for Organizations Sponsoring Athletic Activity for the Secondary School-Aged Athlete: A Summary Statement. J Athl Train 2019; 54:741-748. [PMID: 31135211 DOI: 10.4085/1062-6050-544-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To present the appropriate medical care standards for organizations that sponsor athletic activities for secondary school-aged athletes. DATA SOURCES To develop the current standards and identify current best-practices evidence, the task force used a multistep process that included reviewing the existing 2004 Appropriate Medical Care for Secondary School-Aged Athletes consensus points and cross-referencing of National Athletic Trainers' Association (NATA) statements and official documents from the strategic alliance (the NATA, NATA Foundation, Board of Certification, and Commission on Accreditation of Athletic Training Education). Gaps in the recommendations from the 2004 Appropriate Medical Care for Secondary School-Aged Athletes document were identified by the task force, and the new appropriate medical care standards were developed and refined. CONCLUSIONS AND RECOMMENDATIONS Twelve standards, with supporting substandards, were developed that encompassed readiness to participate in activity; facilities; equipment; protective materials; environmental policies; nutrition, hydration, and dietary supplementation; wellness and long-term health; comprehensive emergency action plans; on-site immediate care; on-site therapeutic interventions; psychological concerns; and athletic health care administration. Collectively, these standards describe a comprehensive approach to providing appropriate health care to secondary school-aged athletes and should serve as a framework with which organizations can evaluate and improve the medical care supplied to adolescent athletes.
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Affiliation(s)
| | | | | | | | - Scott J Chafin
- Gregorio, Chafin, Johnson, Poolson, & Tabor, LLC, Shreveport, LA
| | - Randy P Cohen
- Department of Intercollegiate Athletics, University of Arizona, Tucson
| | - Thomas P Dompier
- Department of Athletic Training, Lebanon Valley College, Annville, PA
| | - Robert A Huggins
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | - Dan Newman
- Department of Athletics, Union High School, Tulsa, OK
| | | | - Tamara C Valovich McLeod
- Athletic Training Programs and School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
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25
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Estock P, Simon JE. Prevalence and Outcomes of Exposure to Catastrophic Events Among Athletic Trainers. J Athl Train 2018; 53:1098-1102. [PMID: 30507308 DOI: 10.4085/1062-6050-533-17] [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: 11/09/2022]
Abstract
CONTEXT Little is known about the prevalence of exposure to catastrophic events or how caring for athletes exposed to catastrophic events can influence burnout in athletic trainers (ATs). OBJECTIVE To assess (1) the prevalence of exposure to catastrophic events, (2) the levels of burnout among ATs who have been exposed to catastrophic events, and (3) the coping strategies they used. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS We invited 9881 certified members of the National Athletic Trainers' Association to participate in this study; 1007 surveys were completed, for a response rate of 10.2% (433 men, 572 women, and 2 who preferred not to answer the question). MAIN OUTCOME MEASURE(S) Participants completed an online survey to assess demographic information, exposure to a catastrophic event, and scores on the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Coping Inventory for Stressful Situations (CISS). Scores on the MBI-HSS (personal accomplishment, depersonalization, and emotional exhaustion subscales) and CISS (avoidance, task, and emotion-oriented subscales) were determined. Two multivariate analyses of variance (one for MBI-HSS and one for CISS) were conducted using the independent variable of group (catastrophic event and no catastrophic event). The α level was set at P < .05 for all analyses. RESULTS A total of 518 ATs (51.4%) reported providing care to athletes exposed to a catastrophic event and 489 (48.6%) did not. The group that reported providing care for athletes exposed to a catastrophic event had a significantly worse personal accomplishment score (46.1 ± 6.7) than the group that had never provided such care (44.6 ± 7.7; P < .05). The emotion-oriented score for those who had provided care for athletes exposed to a catastrophic event was 14.3 ± 4.8 versus 14.9 ± 4.2 for those who had not ( P < .05), indicating less use of emotion-oriented coping strategies. CONCLUSIONS The ATs who provided care to athletes exposed to a catastrophic event could be more likely to suffer from a lack of personal accomplishment and exhibit task and emotion-oriented coping behaviors.
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Affiliation(s)
- Patricia Estock
- School of Applied Health Sciences and Wellness, Ohio University, Athens
| | - Janet E Simon
- School of Applied Health Sciences and Wellness, Ohio University, Athens
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Darche JP, Murray MJ, Bridges KM, Noland J, Greiner KA. Assessing the utility of yearly pre-season laboratory screening for athletes on a major professional sports team. J Sci Med Sport 2018; 22:484-487. [PMID: 30442547 DOI: 10.1016/j.jsams.2018.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/12/2018] [Accepted: 10/18/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Professional athletes undergo annual pre-season laboratory screening, although clinical evidence supporting the practice is limited and no uniform set of guidelines on pre-season laboratory screening exists. The aim of this study was to assess the clinical value of annual pre-season laboratory screening tests for a major professional sports team over multiple years. DESIGN Retrospective chart review. METHODS A retrospective analysis was performed of all laboratory results as well as screening ECGs for a single major professional sports team over a 9-year timeframe (2009-2017). RESULTS The data show that 10.01% of initial screening test results were abnormal and 40.32% of abnormal tests resulted in additional testing. Overall, only 0.35% of initial tests resulted in a clinically significant outcome. Non-US born players showed a significantly higher average rate of abnormal tests/year compared to US-born players (p-value 0.006), but there was no difference in clinically significant outcomes. There was no relationship between athlete age and laboratory screening outcomes. CONCLUSIONS In our study population, yearly pre-season laboratory screening of professional athletes did not yield substantial clinically significant outcomes and would not be warranted under normal clinical standards. Future best practice guidelines should combine research concerning effects of family medical history, race, gender, country of origin, and type of sport on athlete health when creating recommendations for which pre-season laboratory screenings may be pertinent even with evidence of little utility.
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Affiliation(s)
- J P Darche
- Department of Family Medicine, University of Kansas Medical Center, USA
| | - Megan J Murray
- Department of Family Medicine Research Division, University of Kansas Medical Center, USA.
| | - Kristina M Bridges
- Department of Family Medicine Research Division, University of Kansas Medical Center, USA
| | - Joe Noland
- Department of Family Medicine, University of Kansas Medical Center, USA
| | - K Allen Greiner
- Department of Family Medicine, University of Kansas Medical Center, USA; Department of Family Medicine Research Division, University of Kansas Medical Center, USA
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Abstract
The aim was to assess the utility and feasibility of a comprehensive cardiac screening protocol in young athletes before participation in sports. A total of 380 athletes referring before participation in sports, between April, 2014 and April, 2015, were included in this study. The mean age was 12.4 years. A screening protocol has been applied to all, including personal and family history, physical examination, 12-lead electrocardiography, transthoracic echocardiography, 24-hour rhythm Holter analysis, and treadmill exercise test. The most frequent complaints were chest pain in 19 (5%), dyspnoea in 13 (3.4%), and dizziness and fainting in five patients (1.3%) on exercise. There was sudden death and arrhythmia in 41 patients (10.7%) owing to family history. Heart murmur was present in 20 (5.2%) and hypertension in 10 patients (2.6%) on physical examination. The 12-lead electrocardiography was abnormal in 9 patients (2.4%). The findings of transthoracic echocardiography were insignificant in 47 patients (12.3%) and in five patients (1.3%) a haemodynamically important condition was detected. The 24-hour rhythm Holter analysis was abnormal in six patients (1.5%). There were significant ST changes in two patients (0.5%) on treadmill exercise test with normal findings on myocardial perfusion scans. No significant relation was present between findings of screening protocol and transthoracic echocardiography, 24-hour rhythm Holter analysis, or treadmill exercise test results. Pre-participation screening in young athletes should consist of a targeted personal history, family history, physical examination, and 12-lead electrocardiography. Other tests should be applied only if the screening indicates the presence of a cardiovascular disease.
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Albright JP. CORR Insights®: What Is the Diagnostic Accuracy of the Duck Walk Test in Detecting Meniscal Tears? Clin Orthop Relat Res 2018; 476:904-906. [PMID: 29419633 PMCID: PMC6260055 DOI: 10.1007/s11999.0000000000000153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- John P Albright
- J. P. Albright, Professor, The University of Iowa, Iowa City, IA, USA
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Rosenhagen A, Niederer D, Vogt L, Banzer W. Knee misalignment and exercise amount: Predictive value for chronic low back pain in young competitive athletes. Hum Mov Sci 2018; 57:178-183. [DOI: 10.1016/j.humov.2017.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/28/2017] [Accepted: 12/07/2017] [Indexed: 01/30/2023]
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Onate JA, Starkel C, Clifton DR, Best TM, Borchers J, Chaudhari A, Comstock RD, Cortes N, Grooms DR, Hertel J, Hewett TE, Miller MM, Pan X, Schussler E, Van Lunen BL. Normative Functional Performance Values in High School Athletes: The Functional Pre-Participation Evaluation Project. J Athl Train 2018; 53:35-42. [PMID: 29314871 DOI: 10.4085/1062-6050-458.16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs. OBJECTIVE To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States. DESIGN Cross-sectional study. SETTING Athletic training facilities and gymnasiums across the United States. PATIENTS OR OTHER PARTICIPANTS A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study. MAIN OUTCOME MEASURE(S) Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion-lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion-lunge, single-legged anterior-reach, and SLHOP test performance and symmetry. RESULTS The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P < .001). A Cohen d value of 0.97 indicated a large effect of sex on SLHOP performance. We observed differences for SLHOP and ankle-dorsiflexion-lunge performance among grade levels, but these differences were not clinically meaningful. CONCLUSIONS We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional performances and implement approaches for preventing musculoskeletal injuries in high school-aged athletes.
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Affiliation(s)
- James A Onate
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus.,Sports Medicine Research Institute, The Ohio State University, Columbus
| | - Cambrie Starkel
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Daniel R Clifton
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Coral Gables, FL
| | - James Borchers
- Sports Medicine Research Institute, The Ohio State University, Columbus.,Department of Family Medicine, The Ohio State University, Columbus
| | - Ajit Chaudhari
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus.,Sports Medicine Research Institute, The Ohio State University, Columbus
| | - R Dawn Comstock
- Colorado School of Public Health, University of Colorado Anschutz, Aurora
| | - Nelson Cortes
- Division of Health and Human Performance, George Mason University, Manassas, VA
| | - Dustin R Grooms
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens
| | - Jay Hertel
- Department of Kinesiology and Orthopedic Surgery, University of Virginia, Charlottesville
| | - Timothy E Hewett
- Mayo Clinic Biomechanics Laboratories and Sports Medicine Research Center, Departments of Orthopedic Surgery, Physical Medicine and Rehabilitation & Physiology and Biomedical Engineering, Rochester and Minneapolis, MN
| | - Meghan Maume Miller
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Xueliang Pan
- Department of Biomedical Informatics, The Ohio State University, Columbus
| | - Eric Schussler
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA
| | - Bonnie L Van Lunen
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA
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Winkelmann ZK, Crossway AK. Optimal Screening Methods to Detect Cardiac Disorders in Athletes: An Evidence-Based Review. J Athl Train 2017; 52:1168-1170. [PMID: 29154691 DOI: 10.4085/1062-6050-52.11.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Reference/Citation: Harmon KG, Zigman M, Drezner JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis. J Electrocardiol. 2015;48(3):329-338. CLINICAL QUESTION Which screening method should be considered best practice to detect potentially lethal cardiac disorders during the preparticipation physical examination (PE) of athletes? DATA SOURCES The authors completed a comprehensive literature search of MEDLINE, CINAHL, Cochrane Library, Embase, Physiotherapy Evidence Database (PEDro), and SPORTDiscus from January 1996 to November 2014. The following key words were used individually and in combination: ECG, athlete, screening, pre-participation, history, and physical. A manual review of reference lists and key journals was performed to identify additional studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. STUDY SELECTION Studies selected for this analysis involved (1) outcomes of cardiovascular screening in athletes using the history, PE, and electrocardiogram (ECG); (2) history questions and PE based on the American Heart Association recommendations and guidelines; and (3) ECGs interpreted following modern standards. The exclusion criteria were (1) articles not in English, (2) conference abstracts, and (3) clinical commentary articles. Study quality was assessed on a 7-point scale for risk of bias; a score of 7 indicated the highest quality. Articles with potential bias were excluded. DATA EXTRACTION Data included number and sex of participants, number of true- and false-positives and negatives, type of ECG criteria used, number of cardiac abnormalities, and specific cardiac conditions. The sensitivity, specificity, false-positive rate, and positive predictive value of each screening tool were calculated and summarized using a bivariate random-effects meta-analysis model. MAIN RESULTS Fifteen articles reporting on 47 137 athletes were fully reviewed. The overall quality of the 15 articles ranged from 5 to 7 on the 7-item assessment scale (ie, participant selection criteria, representative sample, prospective data with at least 1 positive finding, modern ECG criteria used for screening, cardiovascular screening history and PE per American Heart Association guidelines, individual test outcomes reported, and abnormal screening findings evaluated by appropriate diagnostic testing). The athletes (66% males and 34% females) were ethnically and racially diverse, were from several countries, and ranged in age from 5 to 39 years. The sensitivity and specificity of the screening methods were, respectively, ECG, 94% and 93%; history, 20% and 94%; and PE, 9% and 97%. The overall false-positive rate for ECG (6%) was less than that for history (8%) or PE (10%). The positive likelihood ratios of each screening method were 14.8 for ECG, 3.22 for history, and 2.93 for PE. The negative likelihood ratios were 0.055 for ECG, 0.85 for history, and 0.93 for PE. A total of 160 potentially lethal cardiovascular conditions were detected, for a rate of 0.3%, or 1 in 294 patients. The most common conditions were Wolff-Parkinson-White syndrome (n = 67, 42%), long QT syndrome (n = 18, 11%), hypertrophic cardiomyopathy (n = 18, 11%), dilated cardiomyopathy (n = 11, 7%), coronary artery disease or myocardial ischemia (n = 9, 6%), and arrhythmogenic right ventricular cardiomyopathy (n = 4, 3%). CONCLUSIONS The most effective strategy to screen athletes for cardiovascular disease was ECG. This test was 5 times more sensitive than history and 10 times more sensitive than PE, and it had a higher positive likelihood ratio, lower negative likelihood ratio, and lower false-positive rate than history or PE. The 12-lead ECG interpreted using modern criteria should be considered the best practice in screening athletes for cardiovascular disease, and the use of history and PE alone as screening tools should be reevaluated.
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Affiliation(s)
- Zachary K Winkelmann
- Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute. Dr Crossway is now at the Department of Athletics, Nazareth College, Rochester, NY
| | - Ashley K Crossway
- Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute. Dr Crossway is now at the Department of Athletics, Nazareth College, Rochester, NY
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Huggins RA, Scarneo SE, Casa DJ, Belval LN, Carr KS, Chiampas G, Clayton M, Curtis RM, Duffy AJ, Flury A, Gammons M, Hosokawa Y, Jardine JF, LaBella CR, Oats R, Ransone JW, Sailor SR, Scott K, Stearns RL, Vandermark LW, Weston T. The Inter-Association Task Force Document on Emergency Health and Safety: Best-Practice Recommendations for Youth Sports Leagues. J Athl Train 2017; 52:384-400. [PMID: 28430552 DOI: 10.4085/1062-6050-52.2.02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Robert A Huggins
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | - Samantha E Scarneo
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | - Douglas J Casa
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | - Luke N Belval
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | | | - George Chiampas
- Korey Stringer Institute, University of Connecticut.,US Soccer Federation.,Northwestern University
| | | | - Ryan M Curtis
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | - A J Duffy
- National Athletic Trainers' Association
| | | | | | - Yuri Hosokawa
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | | | | | | | | | | | | | - Rebecca L Stearns
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
| | - Lesley W Vandermark
- National Athletic Trainers' Association.,Korey Stringer Institute, University of Connecticut
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Pabian PS, Oliveira L, Tucker J, Beato M, Gual C. Interprofessional management of concussion in sport. Phys Ther Sport 2017; 23:123-132. [DOI: 10.1016/j.ptsp.2016.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/12/2016] [Accepted: 09/07/2016] [Indexed: 12/14/2022]
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Clifton DR, Grooms DR, Hertel J, Onate JA. Predicting Injury: Challenges in Prospective Injury Risk Factor Identification. J Athl Train 2016; 51:658-661. [PMID: 27808574 DOI: 10.4085/1062-6050-51.11.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Musculoskeletal injury-prediction methods vary and may have limitations that affect the accuracy of results and clinical meaningfulness. BACKGROUND Research examining injury risk factors is meaningful, but attempting to extrapolate injury risk from studies that do not prospectively assess injury occurrence may limit clinical applications. Injury incidence is a vital outcome measure, which allows for the appropriate interpretation of injury-prediction analyses; a lack of injury-incidence data may decrease the accuracy and increase the uncertainty of injury-risk estimates. Extrapolating results that predict an injury risk factor to predicting actual injuries may lead to inappropriate clinical decision-making models. CONCLUSIONS Improved understanding of the limitations of injury-prediction methods, specifically those that do not prospectively assess injuries, will allow clinicians to better assess the clinical meaningfulness of the results.
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Affiliation(s)
- Daniel R Clifton
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Dustin R Grooms
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, and.,Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
| | - James A Onate
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
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35
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Bird SP, Markwick WJ. MUSCULOSKELETAL SCREENING AND FUNCTIONAL TESTING: CONSIDERATIONS FOR BASKETBALL ATHLETES. Int J Sports Phys Ther 2016; 11:784-802. [PMID: 27757291 PMCID: PMC5046972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Youth participation in basketball is on the rise, with basketball one of the top five participation sports in Australia. With increased participation there is a need for greater awareness of the importance of the pre-participation examination, including musculoskeletal screening and functional performance testing as part of a multidisciplinary approach to reducing the risk for future injuries. As majority of all basketball injuries affect the lower extremities, pre-participation musculoskeletal screening and functional performance testing should assess fundamental movement qualities throughout the kinetic chain with an emphasis on lower extremity force characteristics, specifically eccentric loading tasks. Thus, the purpose of this clinical commentary is to review the existing literature elucidating pre-participation musculoskeletal screening and functional performance tests that can be used as a framework for rehabilitation professionals in assessing basketball athletes' readiness to safely perform the movement demands of their sport. METHODS Relevant articles published between 2000 and 2016 using the search terms 'musculoskeletal screening', 'functional testing', 'youth athletes', and 'basketball' were identified using MEDLINE. From a basketball-specific perspective, several relevant musculoskeletal assessments were identified, including: the Functional Hop Test Combination, the Landing Error Scoring System, the Tuck Jump Assessment, the Weight-Bearing Lunge Test, and the Star Excursion Balance Test. Each of these assessments creates movement demands that allow for easy identification of inefficient and/or compensatory movement tendencies. A basic understanding of musculoskeletal deficits including bilateral strength and flexibility imbalances, lower crossed syndrome, and dominance-related factors are key components in determination of injury risk. DISCUSSION Assessment of sport-specific movement demands through musculoskeletal screening and functional performance testing is essential for rehabilitation professionals to determine movement competency during performance of fundamental movements related to basketball performance. Youth athletes represent a unique population due to their developing musculoskeletal and neuromuscular systems and should undergo pre-participation musculoskeletal screening for identification of movement limitations. Such an approach to musculoskeletal screening and functional performance may assist in identifying injury risk and also be useful at the end of rehabilitation in determining readiness to return to sport models. LEVEL OF EVIDENCE Level 5.
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Pryor RR, Bennett BL, O'Connor FG, Young JMJ, Asplund CA. Medical Evaluation for Exposure Extremes: Heat. Wilderness Environ Med 2016; 26:S69-75. [PMID: 26617381 DOI: 10.1016/j.wem.2015.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.
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Affiliation(s)
- Riana R Pryor
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut (Dr Pryor).
| | - Brad L Bennett
- Military & Emergency Medicine Department, F. Hébert School of Medicine, Bethesda, Maryland (Dr Bennett); Uniformed Services University of the Health Sciences, Bethesda, Maryland (Drs Bennett and O'Connor)
| | - Francis G O'Connor
- Uniformed Services University of the Health Sciences, Bethesda, Maryland (Drs Bennett and O'Connor)
| | - Justin M J Young
- Department of Family Medicine and Community Health, Division of Sports Medicine, John A. Burns School of Medicine, University of Hawaii, Mililani, Hawaii (Dr Young)
| | - Chad A Asplund
- Department of Family Medicine, Georgia Regents University, Augusta, Georgia (Dr Asplund)
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Miller DJ, Blum AB, Levine WN, Ahmad CS, Popkin CA. Preparticipation Evaluation of the Young Athlete: What an Orthopaedic Surgeon Needs to Know. Am J Sports Med 2016; 44:1605-15. [PMID: 26330569 DOI: 10.1177/0363546515598994] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The preparticipation evaluation (PPE) is a widely used tool for detecting health conditions that may delay or disqualify athletic participation. The medical interview is the most valuable tool for identifying athletes who may be at increased risk for injury. Physical examination is tailored to identifying cardiac abnormalities or factors that may place an athlete at increased risk for injury. Although practiced in Europe, universal cardiac screening with electrocardiography is not currently recommended in the United States largely due to the high rate of false-positive results. Neuropsychological testing for management of concussion and laboratory testing for sickle cell trait may be indicated in select groups of athletes. Health care providers should view the PPE as a chance for anticipatory guidance and athlete-directed health counseling. Despite widespread acceptance of the PPE, the quality of such examinations varies significantly, which is an area for possible improvement and further research.
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Affiliation(s)
- Daniel J Miller
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | | | - William N Levine
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | - Christopher S Ahmad
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
| | - Charles A Popkin
- Center for Shoulder, Elbow and Sports Medicine, Department of Orthopedic Surgery, Columbia University, New York, New York, USA
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Myhre KE, Webber BJ, Cropper TL, Tchandja JN, Ahrendt DM, Dillon CA, Haas RW, Guy SL, Pawlak MT, Federinko SP. Prevalence and Impact of Anemia on Basic Trainees in the US Air Force. SPORTS MEDICINE-OPEN 2016; 2:23. [PMID: 27239430 PMCID: PMC4863912 DOI: 10.1186/s40798-016-0047-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 04/27/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Anemia has been implicated in adverse health outcomes of athletes and military trainees, ranging from overuse injuries to degraded physical and cognitive performance. The purpose of this study was to investigate prevalence of anemia among US Air Force (USAF) basic trainees, to compare physical performance and discharge rates between anemic and non-anemic trainees, and to determine the risks and relative risks of being discharged for anemic versus non-anemic women and men. METHODS All USAF basic trainees were screened for anemia between July 2013 and January 2014, during an 8-week basic training course at Joint Base San Antonio-Lackland, TX. Age, sex, screening hemoglobin, anthropometric measurements, initial/final physical fitness assessment scores, and discharge data were collected from trainees. Those identified as anemic (hemoglobin <13.5 g/dL for males and <12.0 g/dL for females) received additional labwork, nutritional counseling, and oral iron-replacement, if indicated. Mean percent improvement was calculated for all performance parameters from beginning to end of training. Anemic trainees were compared to non-anemic trainees by t test with Welch modification. Results were stratified by sex and anemia severity with post-hoc Bonferroni correction. RESULTS Prevalence of anemia was 12.6 % (N = 18,827). Respective prevalence of borderline, moderate, and severe anemia was 12.6, 10.9, and 1.9 % for females and 4.8, 3.8, and 0.3 % for males. Mean 1.5-mile run-time, push-up and sit-up counts improved from beginning to end of training for both anemic and non-anemic trainees (p < 0.001 both). Non-anemic trainees had slightly greater run-time improvements than borderline and moderate anemics (female: 17.7 vs. 15.2, and 15.1 % improvement, p < 0.05 both; male: 14.9 vs. 13.2, and 13.5 % improvement, p < 0.05 both). One-way ANOVA demonstrated statistically significant differences between initial and final fitness data for all measures and both genders (p < 0.001) with the exception of final sit-up counts for male trainees (p = 0.082). Discharge rate for anemic trainees was 9.0 % (20 % for severely anemic trainees) as compared to 5.7 % for non-anemics. CONCLUSIONS Anemia was prevalent among USAF basic trainees. Identification and treatment of anemia may optimize physical performance and decrease the rate of medical discharge.
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Affiliation(s)
- Kathryn E Myhre
- Joint Base San Antonio, Adolescent and Young Adult Medicine Service, Fort Sam Houston, San Antonio, TX USA ; University of Texas School of Public Health, San Antonio, USA
| | | | | | | | - Dale M Ahrendt
- Joint Base San Antonio, Adolescent and Young Adult Medicine Service, Fort Sam Houston, San Antonio, TX USA
| | - Christopher A Dillon
- Joint Base San Antonio, Adolescent and Young Adult Medicine Service, Fort Sam Houston, San Antonio, TX USA
| | - Roy W Haas
- Joint Base San Antonio, Lackland, San Antonio, TX USA
| | | | - Mary T Pawlak
- Joint Base San Antonio, Lackland, San Antonio, TX USA
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Kroshus E. Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health. J Athl Train 2016. [PMID: 27111587 DOI: 10.4085/1062-6050-5l5.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
Abstract
CONTEXT Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. OBJECTIVE To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. DESIGN Cross-sectional study. SETTING College sports medicine departments. PATIENTS OR OTHER PARTICIPANTS Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). MAIN OUTCOME MEASURE(S) Electronic survey of departmental mental health screening activities. RESULTS A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. CONCLUSIONS The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to be addressed to allow for implementation of screening-related activities.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington; Seattle Children's Research Institute, Center for Child Health, Behavior, and Development
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Kroshus E. Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health. J Athl Train 2016; 51:389-97. [PMID: 27111587 DOI: 10.4085/1062-6050-51.5.07] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. OBJECTIVE To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. DESIGN Cross-sectional study. SETTING College sports medicine departments. PATIENTS OR OTHER PARTICIPANTS Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). MAIN OUTCOME MEASURE(S) Electronic survey of departmental mental health screening activities. RESULTS A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. CONCLUSIONS The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to be addressed to allow for implementation of screening-related activities.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington; Seattle Children's Research Institute, Center for Child Health, Behavior, and Development
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Chisati EM, Nyasa C, Banda AM. Preparticipation physical evaluation: An opportunity for Malawian athletes. Malawi Med J 2016; 28:182-184. [PMID: 28321283 DOI: 10.4314/mmj.v28i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Enock M Chisati
- Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Charles Nyasa
- Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi
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Potteiger JA, McGowan-Stinski M. Protecting the Metabolic Health of Football Players With High Fat Mass. Strength Cond J 2015. [DOI: 10.1519/ssc.0000000000000158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lombardi N, Freedman K, Tucker B, Austin L, Eck B, Pepe M, Tjoumakaris F. Economic analysis of athletic team coverage by an orthopedic practice. PHYSICIAN SPORTSMED 2015; 43:355-9. [PMID: 26414156 DOI: 10.1080/00913847.2015.1092858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Coverage of high school football by orthopedic sports medicine specialists is considered standard of care in many localities. Determining the economic viability of this endeavor has never been investigated. The primary purpose of the present investigation was to perform an economic analysis of local high school sports coverage by an orthopedic sports medicine practice. METHODS From January 2010 to June 2012, a prospective injury report database was used to collect sports injuries from five high school athletic programs covered by a single, private orthopedic sports medicine practice. Patients referred for orthopedic care were then tracked to determine expected cost of care (potential revenue). Evaluation and management codes and current procedure terminology codes were obtained to determine the value of physician visits and surgical care rendered. Overhead costs were calculated based on historical rates within our practice and incorporated to determine estimated profit. RESULTS 19,165 athletic trainer contacts with athletes playing all sports, including both those 'on-field' and in the training room, resulted in 473 (2.5%) physician referrals. The covering orthopedic practice handled 89 (27.9%) of the orthopedic referrals. Of orthopedic physician referrals, 26 (5.4%) required orthopedic surgical treatment. The covering team practice handled 17/26 (65%) surgical cases. The total revenue collected by the covering team practice was $26,226.14. The overhead cost of treatment was $9441.41. Overall estimated profit of orthopedic visits and treatment during this period for the covering practice was $16,784.73. CONCLUSIONS The covering team practice handled 28% of the orthopedic referrals, 65% of the surgical cases and captured 59% of the potential profit. An increase in physician referrals could increase the benefit for orthopedic surgeons.
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Affiliation(s)
- Nicholas Lombardi
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Kevin Freedman
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Brad Tucker
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Luke Austin
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Brandon Eck
- b 2 Mercy Suburban Hospital , Norristown, PA, USA
| | - Matt Pepe
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Fotios Tjoumakaris
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
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Abstract
Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.
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Moreau WJ, Nabhan DC, Roecker C, Kimura MN, Klein A, Guimard B, Pierce K, Helma P, Nelson R, Bahr KS, Nelson L, Williams P. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus. J Chiropr Med 2015; 14:176-82. [PMID: 26778931 PMCID: PMC4685191 DOI: 10.1016/j.jcm.2015.08.004] [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: 08/05/2015] [Revised: 08/11/2015] [Accepted: 08/19/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. METHODS In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. RESULTS The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. CONCLUSION This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs.
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Affiliation(s)
- William J. Moreau
- Managing Director, United States Olympic Committee, Associate Professor, Southern California University of Health Sciences, Colorado Springs, CO
| | - Dustin C. Nabhan
- Associate Director, United States Olympic Committee, Visiting Scholar, Southern California University of Health Sciences, Colorado Springs, CO
| | | | - Melissa Nagare Kimura
- Chief Clinical Office and Associate Vice President, Southern California University of Health Sciences, Whittier, CA
| | - Andrew Klein
- Private Practice, Park Nicollet Clinic, St Louis Park, MN
| | - Brett Guimard
- Senior Health Care Service Provider, United State Olympic Committee, Chula Vista, CA
| | - Kevin Pierce
- Senior Health Care Service Provider, United State Olympic Committee, Chula Vista, CA
| | - Patrick Helma
- Private Practice, Cooper City Chiropractic, Cooper City, FL
| | | | | | - Laney Nelson
- Private Practice, Camp 4 Human Performance, Salt Lake City, UT
| | - Perry Williams
- Private Practice, Winchester Chiropractic, Winchester, KY
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Anderson BE, Neumann ML, Huxel Bliven KC. Functional movement screen differences between male and female secondary school athletes. J Strength Cond Res 2015; 29:1098-106. [PMID: 25330082 DOI: 10.1519/jsc.0000000000000733] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The functional movement screen (FMS) is commonly used to assess movement capacity and determine injury risk. Evidence suggests that athletes who score 14 points or less on the FMS are at increased risk for injury, but differences between males and females have been minimally studied. The purpose of this study was to investigate sex differences in FMS scores of secondary school athletes. Using a cross-sectional study design, 60 healthy secondary school athletes performed the FMS, which is composed of 7 functional movement tasks (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, trunk stability push-up, and rotary stability) and 3 clearance screens. Dependent variables were FMS total composite score and individual task scores; secondary analyses were performed using total research score and individual task research scores when indicated. Lower scores indicated functional movement deficits and increased injury risk. Healthy secondary school female athletes scored lower on the total composite (p = 0.004) than healthy secondary school male athletes. Females also scored lower on the following individual FMS tasks: inline lunge (p < 0.04) and trunk stability push-up (p = 0.001). Healthy secondary school female athletes scored 14 or less on the FMS total composite score and significantly lower in general compared with healthy secondary school male athletes, which suggests these female athletes may be at higher risk for injury. Factors that may contribute to increased injury risk include deficits in mobility, core stabilization, and coordinated movement patterns. Clinicians should be aware of possible sex differences when using the FMS and developing injury prevention programs.
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Affiliation(s)
- Barton E Anderson
- 1Athletic Training Program, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona; and 2Kinesiology Program, College of Graduate Health Studies, A.T. Still University, Mesa, Arizona
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Emery MS, Quandt EF. Legal and Ethical Issues in the Cardiovascular Care of Elite Athletes. Clin Sports Med 2015; 34:507-16. [DOI: 10.1016/j.csm.2015.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Caswell SV, Cortes N, Chabolla M, Ambegaonkar JP, Caswell AM, Brenner JS. State-specific differences in school sports preparticipation physical evaluation policies. Pediatrics 2015; 135:26-32. [PMID: 25535257 DOI: 10.1542/peds.2014-1451] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study evaluated the current preparticipation physical evaluation (PPE) administrative policies and cardiovascular screening content of all 50 states and Washington, DC. METHODS PPE policies, documents, and forms from all 50 states and Washington, DC, were compared with the preparticipation physical evaluation-fourth edition (PPE-4) consensus recommendations. All electronic documents were publicly available and obtained from state interscholastic athletic associations. RESULTS Fifty (98%) states required a PPE before participation. Most states (53%, n = 27) required a specific PPE form, whereas 24% (n = 12) of states recommended a specific form. Twenty-three states (45%) required or recommended use of the PPE-4 form or a modified version of it, and 27 states (53%) required or recommended use of outdated or unidentifiable forms. Ten states (20%) had not revised their PPE forms in >5 years. States permitted 9 different health care providers to administer PPEs. Only 22 states (43%) addressed all 12 of the PPE-4 personal and family history cardiovascular screening items, and 2 states (4%) addressed between 8 and 11 items. For the remaining 26 states, most (29%) addressed ≤3 screening items. CONCLUSIONS Our results show that inconsistencies in PPE policies exist nationwide. Most states have been slow to adopt PPE-4 recommendations and do not adequately address the personal and family cardiovascular history questions. Findings suggest a need for PPE standardization nationwide and adoption of an electronic PPE process. This approach would enable creation of a national database and benefit the public by facilitating a more evidenced PPE.
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Affiliation(s)
- Shane V Caswell
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, Virginia; and
| | - Nelson Cortes
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, Virginia; and
| | - Mary Chabolla
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, Virginia; and
| | - Jatin P Ambegaonkar
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, Virginia; and
| | - Amanda M Caswell
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, Virginia; and
| | - Joel S Brenner
- Children's Hospital of The King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia
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