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Wallis WEG, Al-Alem Q, Lorimer H, Smail OJ, Williams GKR, Bond B. The acute influence of amateur boxing on dynamic cerebral autoregulation and cerebrovascular reactivity to carbon dioxide. Eur J Appl Physiol 2024; 124:993-1003. [PMID: 37768343 PMCID: PMC10879355 DOI: 10.1007/s00421-023-05324-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE The purpose of this study was to investigate the acute effect of head impacts, sustained over the course of three rounds of amateur boxing, on indices of cerebrovascular function. METHODS Eighteen university amateur boxers (six female) completed three experimental trials in a randomised order; (1) three rounds of boxing (BOX), (2) an equivalent bout of pad boxing (where no blows to the head were sustained; PAD), and (3) a time-matched seated control trial (CON). Indices of cerebrovascular function were determined immediately before and 45 min after each trial. Specifically, dynamic cerebral autoregulation (dCA) was determined by considering the relationship between changes in cerebral blood velocity and mean arterial pressure during 5 min of squat-stand manoeuvres at 0.05 and 0.10 Hz. Cerebrovascular reactivity was determined using serial breath holding and hyperventilation attempts. RESULTS Participants received an average of 40 ± 16 punches to the head during the BOX trial. Diastolic, mean and systolic dCA phase during squat stand manoeuvres at 0.05 Hz was lower after BOX compared to pre BOX (P ≤ 0.02, effect size (d) ≥ 0.74). No other alterations in dCA outcomes were observed at 0.05 or 0.10 Hz. The number of head impacts received during the BOX trial was associated with the change in systolic phase (r = 0.50, P = 0.03). No differences in cerebrovascular reactivity to breath holding or hyperventilation were observed. CONCLUSIONS A typical bout of amateur boxing (i.e., three rounds) can subtly alter cerebral pressure-flow dynamics, and the magnitude of this change may be related to head impact exposure.
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Affiliation(s)
- W E G Wallis
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - Q Al-Alem
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - H Lorimer
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - O J Smail
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - G K R Williams
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK
| | - B Bond
- Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, Sport and Health Sciences, Baring Court, St Luke's Campus, University of Exeter, Exeter, EX1 2LU, UK.
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Eginyan G, Williams AM, Joseph KS, Lam T. Trunk muscle activity and kinematics during boxing and battle rope exercise in people with motor-complete spinal cord injury. J Spinal Cord Med 2024; 47:135-142. [PMID: 34874241 PMCID: PMC10795558 DOI: 10.1080/10790268.2021.2005993] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Recovery of seated balance is a rehabilitation priority for people with motor-complete spinal cord injury (mcSCI). Previous research has demonstrated that people with mcSCI can voluntarily engage their trunk muscles during different exercise programs that have the potential to improve seated balance control. Boxing and battle rope exercises could offer another opportunity to improve seated balance for people with mcSCI, but it is unknown if this type of exercise engages trunk musculature and challenges seated balance. OBJECTIVE To describe the movement patterns of people with mcSCI compared to controls by characterizing the muscle activation patterns and kinematics of the trunk and upper-body during boxing and battle rope exercise. DESIGN Cross-sectional study. PARTICIPANTS 4 males with mcSCI between C7-T9, and 4 able-bodied controls. METHODS Participants performed different boxing and battle rope exercises while kinematics and electromyography (EMG) from the trunk and arms were recorded. OUTCOME MEASURES Trunk EMG amplitude, trunk and arm joint angles, and trunk curvature. RESULTS Boxing and battle ropes elicited higher relative EMG activity in people with mcSCI compared to controls (P < 0.001). Participants with mcSCI had similar upper-limb kinematics during the exercises to controls, but demonstrated reduced trunk rotation and increased trunk curvature. CONCLUSIONS These findings suggest that boxing and battle rope can elicit trunk activity in people with mcSCI, though they may adopt increased trunk curvatures. Future research should explore if such exercise programs may improve seated balance in people with mcSCI.
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Affiliation(s)
- Gevorg Eginyan
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Physical Activity Research Centre (PARC), International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Alison M.M. Williams
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Physical Activity Research Centre (PARC), International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Konrad S. Joseph
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Physical Activity Research Centre (PARC), International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Tania Lam
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Physical Activity Research Centre (PARC), International Collaboration On Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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Da Broi M, Al Awadhi A, Voruz P, Nouri A, Schaller K. The spectrum of acute and chronic consequences of neurotrauma in professional and amateur boxing - A call to action is advocated to better understand and prevent this phenomenon. Brain Spine 2023; 4:102743. [PMID: 38510617 PMCID: PMC10951782 DOI: 10.1016/j.bas.2023.102743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 03/22/2024]
Abstract
Introduction Despite changes in regulations, boxing-related injuries and fatalities are still occurring. The numbers available in the literature regarding mortality and long-term consequences may not accurately represent the actual situation. Indeed, the real extent of this phenomenon remains poorly known. Research question Delineating the spectrum of acute and chronic consequences of boxing-related traumatic brain injuries (TBI). Material and methods Narrative review of the literature concerning acute and chronic boxing-related TBI. Keywords such as mortality, boxing, subdural hematoma were used to search in PubMed and Google scholar. An updated analysis of the Velazquez fatalities collection in boxing was undertaken. Results The Velazquez collection includes 2076 fatalities from 1720 to the present with a death rate of 10 athletes per year. More than half of the deaths (N = 1354, 65.2%) occurred after a knock-out, and nearly 75% happened during professional bouts. In Australia, from 1832 to 2020, 163 fatalities were recorded (75% professional). In Japan, from 1952 to 2016, 38 deaths were recorded with a mean age of 23.9 years. Up to 40% of retired professional boxers in the United States were diagnosed with symptoms of chronic brain injury. Clinical dementia is far more prevalent among professional boxers than in amateurs with an incidence of 20%. Discussion and conclusions A concerted effort to raise awareness and shed light on boxing-related neuro-trauma is required. Similar considerations can be made for other combat sports or contact sports. A call to action to address this knowledge gap, decrease and prevent this phenomenon is advocated.
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Affiliation(s)
- Michele Da Broi
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Abdullah Al Awadhi
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Voruz
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland
| | - Aria Nouri
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Karl Schaller
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
- Department of Neuroscience, University of Geneva, Geneva, Switzerland
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deWeber K, Parlee L, Nguyen A, Lenihan MW, Goedecke L. Headguard use in combat sports: position statement of the Association of Ringside Physicians. PHYSICIAN SPORTSMED 2023:1-10. [PMID: 37559553 DOI: 10.1080/00913847.2023.2242415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023]
Abstract
Headguard use is appropriate during some combat sports activities where the risks of injury to the face and ears are elevated. Headguards are highly effective in reducing the incidence of facial lacerations in studies of amateur boxers and are just as effective in other striking sports. They should be used in scenarios - especially sparring prior to competitions - where avoidance of laceration and subsequent exposure to potential blood-borne pathogens is important. Headguards are appropriate where avoidance of auricular injury is deemed important; limited data show a marked reduction in incidence of auricular injury in wrestlers wearing headguards.Headguards should not be relied upon to reduce the risk of concussion or other traumatic brain injury. They have not been shown to prevent these types of injuries in combat sports or other sports, and human studies on the effect of headguards on concussive injury are lacking. While biomechanical studies suggest they reduce linear and rotational acceleration of the cranium, changes in athlete behavior to more risk-taking when wearing headguards may offset any risk reduction. In the absence of high-quality studies on headguard use, the Association of Ringside Physicians recommends that further research be conducted to clarify the role of headguards in all combat sports, at all ages of participation. Furthermore, in the absence of data on gender differences, policies should be standardized for men and women.
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Affiliation(s)
- Kevin deWeber
- Sports Medicine, SW Washington Sports Medicine Fellowship, Vancouver, Wa, USA
| | - Lindsay Parlee
- Family Medicine, SW Washington Family Medicine Residency, Vancouver, Wa, USA
| | - Alexander Nguyen
- Family Medicine, Memorial Healthcare System, Fort Lauderdale, Fl, USA
| | | | - Leah Goedecke
- Neuromuscular Medicine, Michigan State University, East Lansing, Mi, USA
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Pfister D, Jackson RC, Güldenpenning I, Williams AM. Timing a fake punch: Inhibitory effects in a boxing-specific spatial attention task. Hum Mov Sci 2023; 89:103092. [PMID: 37075655 DOI: 10.1016/j.humov.2023.103092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
The ability to respond quickly and accurately to spatial cues is of great importance to performance on any task where quick decision-making is required. The two main effects of spatial attention are priming, when a response to a target is facilitated after being cued at the same location, and inhibition of return (IOR), when the response to the target is slower to the cued area. Whether priming or IOR occurs is largely dependent on the length of the interval between the cue and the target. To determine whether these effects are relevant to dueling sports with deceptive actions we created a boxing-specific task that mimicked combinations of feints and punches. Altogether, we recruited 20 boxers and 20 non-boxers and found significantly longer reaction times to a punch thrown on the same side as a fake punch after a 600 ms interval, consistent with the IOR effect. We also found a moderate positive correlation between years of training and the magnitude of the IOR effect. This latter finding indicates that even athletes trained to avoid deception can be as susceptible as novices if the timing of the feint is right. Finally, our approach highlights the benefits of studying IOR using more sport specific settings, broadening the scope of the field.
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Affiliation(s)
- Daniel Pfister
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA; Institute for Human and Machine Cognition, Pensacola, FL, USA.
| | - Robin C Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Iris Güldenpenning
- Department of Sport & Health, Paderborn University, Warburger Str. 100, 33098 Paderborn, Germany
| | - A Mark Williams
- Institute for Human and Machine Cognition, Pensacola, FL, USA
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Naskar A, Jayanty D, Head K, Khanna GL, Vatsalya V, Banerjee A. Diagnostic Prospectives with Tau Protein and Imaging Techniques to Detect Development of Chronic Traumatic Encephalopathy. J Behav Brain Sci 2023; 13:55-65. [PMID: 37275219 PMCID: PMC10239269 DOI: 10.4236/jbbs.2023.134005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Brain damage sustained from repeated blows in boxing, wrestling, and other combat sports has serious physical and mental health consequences. The degenerative brain disease, chronic traumatic encephalopathy (CTE), presents clinically with memory loss, aggression, difficulty in rational thinking and other cognitive problems. This spectrum, which mimics Alzheimer's disease, is diagnosed post-mortem through a brain biopsy in many professional athletes. However, little is known about the process of development and how to identify vulnerable individuals who may be on course for developing CTE. Boxing is a sport that has a severe toll on athletes' health, primarily on their brain health and function. This review addresses the concerns of brain injury, describes the pathologies that manifest in multiple scales, e.g., molecular and cognitive, and also proposes possible diagnostic and prognostic markers to characterize the early onset of CTE along with the aim to identify a starting point for future precautions and interventions.
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Affiliation(s)
- Amit Naskar
- Cognitive Brain Dynamics Lab, National Brain Research Centre, Manesar, India
| | - Danielle Jayanty
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Kimberly Head
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Gulshan L. Khanna
- Professor and Pro Vice Chancellor, Manav Rachna International Institute of Research and Studies, Faridabad, India
| | - Vatsalya Vatsalya
- Department of Medicine, University of Louisville, Louisville, KY, USA
- Robley Rex VA Medical Center, Louisville, KY, USA
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA
| | - Arpan Banerjee
- Cognitive Brain Dynamics Lab, National Brain Research Centre, Manesar, India
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7
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Cioffi R, Lubetzky AV. BOXVR Versus Guided YouTube Boxing for Stress, Anxiety, and Cognitive Performance in Adolescents: A Pilot Randomized Controlled Trial. Games Health J 2023; 12:259-268. [PMID: 36745402 DOI: 10.1089/g4h.2022.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Adolescents frequently experience high levels of anxiety and stress, which can impede quality of life and academic performance. Boxing as a form of exercise has been shown to have mental health benefits in adults. Methods: This study investigated the impact of boxing exercise with a virtual reality (VR) game vs. with a guided video on anxiety, stress, and executive function in adolescents. Participants were randomly assigned to 1 of 3 cohorts: Oculus Rift BOXVR game (n = 14), boxing with a guided workout video (n = 14), or a non-intervention control (n = 14). The BOXVR and guided video groups participated in 10-minute exercise sessions, 5 times a week for 3 weeks. Results: The groups were comparable at baseline on all outcomes. Only BOXVR participants exhibited a significant (p < 0.001) reduction in stress and significant improvements on the Trail Making Test (TMT) B at weekly checkpoints and follow up. All cohorts showed improvements in executive function on the TMT A. At the end of the study, the BOXVR group reported significantly lower stress levels than the guided video group, and significantly better TMT A & B scores than the control group. Only the control group showed a significant reduction in anxiety but the groups were not significantly different in anxiety at the end of the study. The BOXVR group reported significantly greater enjoyment after each exercise session than the guided video group. Conclusion: BOXVR was shown to be effective in reducing adolescent stress and improving executive function over a three-week period. While larger studies with real-life functional outcomes are necessary, boxing with an immersive VR game represents a potential non-pharmaceutical mode to reduce stress in adolescents that is easy to implement in school settings.
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Affiliation(s)
- Rose Cioffi
- Ossining High School, Ossining, New York, USA
| | - Anat V Lubetzky
- Physical Therapy Department, Steinhardt School of Culture Education and Human Development, New York University, New York City, New York, USA
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Kerdsawatmongkon J, Nualnetr N, Isariyapan O, Kitreerawutiwong N, Srisoparb W. Effects of Home-Based Boxing Training on Trunk Performance, Balance, and Enjoyment of Patients With Chronic Stroke. Ann Rehabil Med 2023; 47:36-44. [PMID: 36635885 PMCID: PMC10020051 DOI: 10.5535/arm.22127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To investigate the effect of 6 weeks of home-based boxing training on trunk performance, balance, fear of falling, and level of therapy enjoyment in individuals with chronic stroke. METHODS Eighteen participants with chronic stroke were randomly divided into boxing and control groups (9 patients per group). The boxing group received home-based boxing training for 25 minutes plus balance and trunk exercise training for 15 minutes, while the control group received only home-based balance and trunk exercise training for 40 minutes, three days a week for 6 weeks. The Trunk Impairment Scale (TIS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, and Physical Activity Enjoyment Scale (PACES) were assessed at baseline, and at 2, 4, and 6 weeks post-training. The Wilcoxon signed rank test and Mann-Whitney U-test were used to determine differences between pre- and post-training within and between groups. Statistical significance was set at p<0.05. RESULTS The TIS scores significantly increased from 13 to 17 points in the boxing group (p<0.05) compared to an increase from 15 to 17 points in the control group (p<0.05). The Mini-BESTest scores significantly increased from 14 to 22 points in the boxing group (p<0.05) compared to an increase from 17 to 20 points in the control group (p<0.05). There were no differences in the TIS, Mini-BESTest, ABC, and PACES scores between the two groups. CONCLUSION Home-based boxing training with balance and trunk exercise training had a similar training effect compared to home-based balance and trunk exercise training.
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Affiliation(s)
- Jeerawan Kerdsawatmongkon
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Nomjit Nualnetr
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Northeastern Stroke Research Group, Khon Kaen University, Khon Kaen, Thailand.,Research and Training Center for Enhancing Quality of Life of Working-Age People, Khon Kaen University, Khon Kaen, Thailand
| | - Olan Isariyapan
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | | | - Waroonnapa Srisoparb
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
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Manninen IK, Mäkinen LK, Laukka P, Klockars T, Blomgren K. Effect of head impacts and chemical irritation on elite athletes' olfaction. Eur J Sport Sci 2023; 23:278-283. [PMID: 34839784 DOI: 10.1080/17461391.2021.2008014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Limited research exists on athletes' olfaction. As diet is an elementary part of an athlete's lifestyle and training, it is important to know whether the sport discipline itself carries a risk for olfactory impairment. The aim of this study was to evaluate whether elite swimmers (chemical irritation), boxers (head impact) or soccer players (head impact) are at risk for impaired olfaction. Elite-level male swimmers (n = 30), boxers (n = 35) and soccer players (n = 30) aged 18-40 years were recruited from Finnish sport clubs. Floorball players (n = 30) were recruited as a control group. All participants filled in a questionnaire about their training history, nasal and sinonasal diseases, asthma, nasal operations and traumas, smoking and self-evaluation of olfaction and taste function. Sniffin' Sticks odour identification test with 12 different odorants and anterior rhinoscopy were performed on all participants. The mean score from the smelling test did not differ between the sport groups. Sinonasal diseases and bronchial asthma were more common among swimmers than among the other athletes. Rhinitis symptoms were common among all athletes. Boxing, soccer or swimming does not seem to affect sense of smell. The majority of our participating elite athletes had normal olfaction, even if they had had a long history of active sports.Highlights Boxing, soccer or swimming does not seem to affect sense of smell.Rhinitis symptoms were prevalent among all elite athlete groups in our study.Athletes with hyposmia can perceive their own decreased olfaction.Swimmers have more bronchial asthma and sinus diseases than other athlete groups.
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Affiliation(s)
- Iida-Kaisa Manninen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Tuomas Klockars
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karin Blomgren
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Patel RA, Blasucci L, Mahajan A. A pilot study of a 12-week community-based boxing program for Parkinson's disease. J Clin Neurosci 2023; 107:64-67. [PMID: 36512938 DOI: 10.1016/j.jocn.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Community-based exercise programs for Parkinson's disease (PD) have gained popularity. Our understanding of such programs on non-motor features is limited. We characterized the effect of a 12-week community-based boxing exercise program on motor and non-motor symptoms in people with Parkinson's disease (PwPD). METHODS In this prospective observational study, PwPD underwent a 12-week community-based boxing program (2 sessions per week, for a total of 24 sessions). The following assessments were performed by a movement disorders neurologist at baseline and after completion of the program: MDS-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) in a modified version since assessments were performed virtually due to COVID-19 pandemic, MDS Non-Motor Rating Scale (MDS-NMS), Hamilton Depression Rating Scale (HDRS), Lilli Apathy Rating Scale (LARS), Parkinson's Disease Questionaire-39 (PDQ-39), and Schwab and England Activities of Daily Living scale (SE-ADL). Pre- and post-assessments were compared using Wilcoxon signed rank test; only participants who completed the program and both assessments were analyzed. RESULTS A total of 14 PwPD agreed to be a part of the study and completed assessments. All participants were ambulatory and functionally independent at baseline. Total non-motor feature severity (MDS-NMS, p = 0.0031), depression (HDRS, p = 0.015), and motor features (MDS-UPDRS PART 3 modified, p = 0.023) all improved significantly after the intervention. Scales on apathy (LARS, p = 0.29), Parkinson's disease-specific health related quality (PDQ-39, p = 0.093), and activities of daily living (SE-ADL, p = 0.32) did not demonstrate significant change. CONCLUSION PwPD who participated in a community-based, pilot boxing program showed improvements in motor exam and non-motor symptoms.
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Affiliation(s)
- Roshni Abee Patel
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA; Jesse Brown VA Medical Center, Neurology Service, 820 S Damen Ave, Chicago, IL 60612, USA
| | - Lucia Blasucci
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA
| | - Abhimanyu Mahajan
- Rush University Medical Center, Dept of Neurological Sciences, 1725 W Harrison Ave Ste 755, Chicago, IL 60612, USA.
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Sethi NK. To be or not to be ringside? Ethical issues pertaining to combat sports medicine. PHYSICIAN SPORTSMED 2022; 50:461-462. [PMID: 35166625 DOI: 10.1080/00913847.2022.2043129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Nitin K Sethi
- Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
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12
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Matharu GS, Bodansky DMS, Gatt IT, Delaney R, Loosemore M, Hayton MJ. Hand Carpometacarpal Joint Instability in Elite Boxers: Injury Characteristics, Surgical Technique, and Outcomes. J Hand Surg Am 2022:S0363-5023(22)00468-3. [PMID: 36307285 DOI: 10.1016/j.jhsa.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/14/2022] [Accepted: 07/27/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE We describe a single-surgeon's experience of managing hand carpometacarpal joint (CMCJ) instability in elite boxers, focusing on injury characteristics, surgical technique, and outcomes. METHODS This retrospective cohort included consecutive elite boxers undergoing surgery for hand CMCJ instability from 2009 to 2021. CMC joint instability is usually clear on clinical examination using a 'seesaw' test. All cases had a plain radiograph and in equivocal cases for instability advanced imaging such as MRI or ultrasound scan. CMCJs were accessed via longitudinal incisions between index/middle rays, and additionally ring/little. Often marked deficiency in the CMCJ ligamentous capsule was seen. The articular surfaces were decorticated to cancellous bone and autogenous bone graft impacted. The CMCJs were fixed in extension using various methods, latterly memory staples. Outcomes included radiographic fusion, return to boxing, and complications. RESULTS Forty hands had surgery in 38 boxers. In total, 101 CMCJs were fused, with an average of 2.5 joints per patient. Patients were mainly young (mean age 24.1 years), male (37/38) with the trailing hand more commonly affected (trailing hand 87.5%, leading hand 12.5%). The most frequently fused CMCJ was the index (97.5%, n = 39), then middle (95%, n = 38), ring (45%, n = 18), and little (15%, n = 6). There were 82% (31/38) of patients who returned to the same level of boxing at a median of 8 months from surgery (range 3-27 months). Three patients had revision surgery for non-union, a median of 10.3 months after initial surgery (range 9.4-133.1 months): 2 for index/middle and one for the little CMCJ. All 3 revisions fused and the patients returned to boxing at the same level, although the little CMCJ required a second bone graft and fixation. CONCLUSIONS Patients can achieve full recovery after treatment of CMCJ instability, and most can return to boxing at the same level with little risk of complications. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Gulraj S Matharu
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Westbury-on-Trym, Bristol, UK
| | | | - Ian T Gatt
- Physiotherapy Department, English Institute of Sport, Sheffield, UK
| | - Rachel Delaney
- Hand Therapy Department, The OrthTeam Centre, Manchester, UK
| | - Michael Loosemore
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
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Giannatos V, Panagopoulos A, Antzoulas P, I Giakoumakis S, Lakoumentas J, Kouzelis A. Functional performance of the upper limb and the most common boxing-related injuries in male boxers: a retrospective, observational, comparative study with non-boxing population. BMC Sports Sci Med Rehabil 2022; 14:162. [PMID: 36050792 PMCID: PMC9434859 DOI: 10.1186/s13102-022-00558-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/26/2022] [Indexed: 12/04/2022]
Abstract
Background To investigate the functional status and recording the most common injuries of the upper limb in male Greek boxing squad in comparison to the general population. Methods A retrospective injury surveillance study using an electronic questionnaire was performed in 2021. The questionnaire was sent to male members of the Greek Boxing Federation and consisted of three parts. Demographic data, functional status scales, training conditions, hours of training, the location and description of upper limb injuries and whether the injury occurred during competition or training and also whether it was a new or a recurrent one were gathered. The same questionnaire was sent to non-boxer males (military recruits), but without asking them to report any training parameters. Inclusion criteria were age < 35 years-old for all participants and no involvement in martial arts for the control group. Also, all participants (boxers and non-boxers) completed the Patient Rated Wrist Evaluation (PRWE) scale and the Quick Disabilities of Arm, Shoulder and Hand (quick-DASH) score. Results The final study cohort was consisted of 62 elite or amateur boxers and 75 non-boxer males, less than 35 years old. The quick-DASH score was found to be significantly lower (better) in boxers in comparison to the general population (15.65 ± 10.25 vs. 12.55 ± 8.62; p = 0.020) whereas the PRWE score was similar in both groups (9.25 ± 14.96 vs. 8.61 ± 13.05; p = 0.843). Physical therapy sessions, thumb injuries and boxer’s knuckle were also found to be significantly higher in the boxers group. On the other hand, upper limb surgeries were significantly less in the boxers group. Finally, the size of boxing gloves was associated to the number of finger fractures, thumb injuries and ulnar sided wrist pain in boxers. Conclusions Although a controversial sport, boxing appears to have no long-term consequences to the upper limb function, especially regarding hand performance. The size of gloves during heavy bag training was found to be an aggravating factor for hand injuries. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00558-3.
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Affiliation(s)
- Vasileios Giannatos
- Department of Shoulder and Elbow, Orthopaedic Clinic, Patras University Hospital, Papanikolaou 1, 26504, Rio-Patra, Greece
| | - Andreas Panagopoulos
- Department of Shoulder and Elbow, Orthopaedic Clinic, Patras University Hospital, Papanikolaou 1, 26504, Rio-Patra, Greece.
| | - Panagiotis Antzoulas
- Department of Shoulder and Elbow, Orthopaedic Clinic, Patras University Hospital, Papanikolaou 1, 26504, Rio-Patra, Greece
| | - Savvas I Giakoumakis
- Special Clinic of Orthopaedic Rehabilitation, Koenig Ludwig, Schwangau, Bavaria, Germany
| | - John Lakoumentas
- Department of Medical Physics, School of Medicine, Patras University, Patras, Greece
| | - Antonis Kouzelis
- Department of Shoulder and Elbow, Orthopaedic Clinic, Patras University Hospital, Papanikolaou 1, 26504, Rio-Patra, Greece
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14
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du Preez J, Jhala P, Lystad RP. Availability and content of concussion guidelines in Australian combat sports. J Sci Med Sport 2022; 25:800-804. [PMID: 35871904 DOI: 10.1016/j.jsams.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the availability and content of publicly available concussion information published by peak amateur and professional combat sport governing bodies in Australia. DESIGN Cross-sectional study; document analysis. METHODS Publicly available concussion information was retrieved from the websites of eleven peak Australian amateur and professional combat sport governing bodies. Data on type of source material, concussion definition, provision of medical services, concussion evaluation, and return-to-sport information were extracted. The quality of the information was assessed using a modified version of the Global Rating Scale. RESULTS Eight out of eleven combat sport governing bodies provided concussion information in source documents ranging from competition rules to position statements to specific policies. Five governing bodies provided information on post-contest concussion evaluation or testing, four of which mentioned the Sport Concussion Assessment Tool. Eight governing bodies provided information on return-to-sport, of which six stipulated mandatory minimum rest periods and four indicated that athletes should complete a graduated return-to-sport protocol. The provided concussion information was generally of low quality, with a median score of 3 out of 9 (range: 1-4). CONCLUSIONS There is substantial scope and an urgent need for improving concussion guidelines across peak combat sport governing bodies in Australia to improve the health and safety of their athletes.
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Affiliation(s)
- James du Preez
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Prashant Jhala
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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15
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Sethi NK, Neidecker J. Neuroimaging in professional combat sports: consensus statement from the association of ringside physicians. PHYSICIAN SPORTSMED 2022:1-8. [PMID: 35678314 DOI: 10.1080/00913847.2022.2083922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Professional boxing, kickboxing, and mixed martial arts (MMA) are popular sports with substantial risk for both acute and chronic traumatic brain injury (TBI). Although rare, combat sports athletes have died in the ring or soon after the completion of a bout. Deaths in these instances are usually the result of an acute catastrophic neurological event such as an acute subdural hematoma (SDH). Other causes may include acute epidural hematoma (EDH), subarachnoid hemorrhage (SAH), intraparenchymal hemorrhage (IPH), or a controversial, rare, and still disputed clinical entity called second-impact syndrome (SIS). Neuroimaging or brain imaging is currently included in the process of registering for a license to compete in combat sports in some jurisdictions of the United States of America and around the world. However, the required imaging specifics and frequency vary with no consensus guidelines. The Association of Ringside Physicians (an international, nonprofit organization dedicated to the health and safety of the combat sports athlete) sets forth this consensus statement to establish neuroimaging guidelines in combat sports. Commissions, ringside physicians, combat sports athletes, trainers, promoters, sanctioning bodies, and other healthcare professionals can use this statement for risk stratification of a professional combat sports athlete prior to licensure, identifying high-risk athletes and for prognostication of the brain health of these athletes over the course of their career. Guidelines are also put forth regarding neuroimaging requirements in the immediate aftermath of a bout.
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Affiliation(s)
- Nitin K Sethi
- Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - John Neidecker
- Department of Sports Medicine, Orthopedic Specialists of North Carolina, Raleigh NC, USA
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16
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Gatt I, Allen T, Wheat J. Quantifying wrist angular excursion on impact for Jab and Hook lead arm shots in boxing. Sports Biomech 2021:1-13. [PMID: 34872457 DOI: 10.1080/14763141.2021.2006296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
The hand region is reported as the most common injury site in boxing, with more observed time loss than any other area in this sport. The amount of wrist motion, specifically flexion, has been described as contributing to these injuries, yet no literature is available to quantify wrist kinematics in boxing. This is the first paper describing wrist motion on impact in boxing. Utilising an electromagnetic tracking system, two types of shots were assessed, Jab (straight arm) and Hook (bent arm), during in-vivo testing procedures with 29 elite boxers. For both shots, flexion and ulnar deviation occurred concurrent on impact, with an M and SD of 9.3 ± 1.9° and 4.7 ± 1.2° respectively for Jab shots, and 5.5 ± 1.1° and 3.3 ± 1.1° respectively for Hook shots, supporting dart throwing motion at the wrist. For both Jab & Hook, wrist motion on impact occurred within >30% and >20% respectively of total available active range of motion, with wrist angles greater in both flexion (t = 9.0, p < 0.001, d = 1.7) and ulnar deviation (t = 8.4, p < 0.001, d = 1.6) for Jab compared to Hook shots. The study provides novel and quantifiable information regarding wrist kinematics during the impact phase of punching and potentially an improved understanding of injury mechanisms in boxing.
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Affiliation(s)
- Ian Gatt
- Physiotherapy Department, English Institute of Sport, Manchester, United Kingdom of Great Britain and Northern Ireland
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Allen
- School of Engineering, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Jonathan Wheat
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, United Kingdom of Great Britain and Northern Ireland
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17
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Alevras AJ, Fuller JT, Mitchell R, Lystad RP. Boxing-related fatalities in Australia: A retrospective analysis of news media reports. J Sci Med Sport 2021; 25:25-30. [PMID: 34602333 DOI: 10.1016/j.jsams.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To quantify and describe boxing-related deaths in Australia. DESIGN Retrospective analysis of news media reports of all boxing-related fatalities in Australia during 1832 to 2020. METHODS Australia and New Zealand Newsstream, Factiva, Informit, Google News, Fairfax Media Archive, and Trove were searched from inception to December 31, 2020. News media articles reporting all-cause boxing-related mortality were included for analysis. RESULTS There were 163 boxing-related fatalities in Australia during 1832 to 2020, including 122 (74.8%) professional and 40 (24.5%) amateur athletes. The most common causes of death were traumatic brain injury (n = 121; 74.2%) and cardiac arrest (n = 11; 6.7%). Boxing-related deaths occurred most frequently during the decades from 1910 to 1930. The fatality rate remained relatively steady from the 1870s through the 1930s, and then declined precipitously until the 1980s. Since legislation to regulate boxing started being introduced in the mid-1970s, there were a total of eleven deaths, of which all but one were caused by traumatic brain injury. CONCLUSIONS Participation in boxing is associated with risk of death, in particular death caused by traumatic brain injury. The boxing-related fatality rate declined precipitously prior to government legislation to regulate boxing started being introduced, with no discernible further reduction in fatalities since. Given that a main purpose of government regulation of boxing is to protect the health and safety of athletes, the findings herein suggest that current regulations are either inadequate or not effectively implemented.
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Affiliation(s)
- Alexander J Alevras
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Joel T Fuller
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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18
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Nakamura K, Uchida M, Sato T. Basic research on the primary prevention of boxing-related sports injuries with the development of a quantitative motion analysis software. J Phys Ther Sci 2021; 33:495-498. [PMID: 34177114 PMCID: PMC8219606 DOI: 10.1589/jpts.33.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/26/2021] [Indexed: 12/05/2022] Open
Abstract
[Purpose] To develop a quantitative motion analysis software specific to boxing (Fist
Tactics Support) and to verify its effectiveness based on the percentage of hits that land
on the participants. [Participants and Methods] A total of 24 male professional boxers
were divided into two groups: those who used Fist Tactics Support to analyze fight videos
and instituted training changes based on the results (Fist Tactics Support group, 12
participants) and those who did not (control group, 12 participants). The overall
percentage of hits that landed on the participants in the fights was compared between the
two groups and between pre- and post-intervention. [Results] There were no significant
differences between the two groups; however, the percentage of hits that landed on the
boxers of the Fist Tactics Support group was significantly lower at post-intervention than
at pre-intervention. [Conclusion] The use of scientific analysis results in boxing may
facilitate the primary prevention of sports injuries.
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Affiliation(s)
- Kouichi Nakamura
- Department of Physical Therapy, Faculty of Health Science, Tokoha University: 1-30 Mizuochi-cho, Aoi-ku, Shizuoka-shi, Shizuoka 420-0831, Japan
| | - Masaki Uchida
- Department of Physical Therapy, Faculty of Health Science, Tokoha University: 1-30 Mizuochi-cho, Aoi-ku, Shizuoka-shi, Shizuoka 420-0831, Japan
| | - Tomonori Sato
- Department of Physical Therapy, Faculty of Health Science, Tokoha University: 1-30 Mizuochi-cho, Aoi-ku, Shizuoka-shi, Shizuoka 420-0831, Japan
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19
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Ware AL, Wilde EA, Newsome MR, Moretti P, Abildskov T, Vogt GS, McCauley SR, Hanten G, Hunter JV, Chu ZD, Levin HS. A preliminary investigation of corpus callosum subregion white matter vulnerability and relation to chronic outcome in boxers. Brain Imaging Behav 2020; 14:772-86. [PMID: 30565025 DOI: 10.1007/s11682-018-0018-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Microstructural neuropathology occurs in the corpus callosum (CC) after repetitive sports concussion in boxers and can be dose-dependent. However, the specificity and relation of CC changes to boxing exposure extent and post-career psychiatric and neuropsychological outcomes are largely unknown. Using deterministic diffusion tensor imaging (DTI) techniques, boxers and demographically-matched, noncontact sport athletes were compared to address literature gaps. Ten boxers and 9 comparison athletes between 26 and 59 years old (M = 44.63, SD = 9.24) completed neuropsychological testing and MRI. Quantitative DTI metrics were estimated for CC subregions. Group×Region interaction effects were observed on fractional anisotropy (FA; η2p ≥ .21). Follow-up indicated large effects of group (η2p ≥ .26) on splenium FA (boxers<comparisons) and genu mean diffusivity (MD; boxers>comparisons), but not radial diffusivity (RD). The group of boxers had moderately elevated number of psychiatric symptoms and reduced neuropsychological scores relative to the comparison group. In boxers, years sparring, professional bouts, and knockout history correlated strongly (r > |.40|) with DTI metrics and fine motor dexterity. In the comparison group, splenium FA correlated positively with psychiatric symptoms. In the boxer group, neuropsychological scores correlated with DTI metrics in all CC subregions. Results suggested relative vulnerability of the splenium and, to a lesser extent, the genu to chronic, repetitive head injury from boxing. Dose-dependent associations of professional boxing history extent with DTI white matter structure indices as well as fine motor dexterity were supported. Results indicated that symptoms of depression and executive dysfunction may provide the strongest indicators of global CC disruption from boxing.
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20
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Abstract
Identifying performance indicators in professional boxing trough T-pattern analysis (TPA) was a priority objective of the present study. We accessed data through the boxrec.com portal, where 15 boxing fights were selected. All these fights concluded in the first or second round and belonged to champions (lb. for lb.) of international organizations recognized in professional boxing. The boxers' interactive decisions were approached through an observational methodology. For the conformation and behavioral record, a mixed registration system was agreed upon by two former exprofessional boxers. The data were analyzed through Theme (TPA) to reveal differences relating to the outcome (Winner vs Loser), in terms of temporal regularities and number of occurrences through Chi-square (χ2). More percentages of individual T-Patterns were found in winners than in losers, and winning boxers showed greater decisional complexity than the losers. However, these differences between both groups of boxers were not supported by Chi-square (χ2).
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Affiliation(s)
- Miguel Pic
- Institute of Sport, Tourism, and Service, South Ural State University, Chelyabinsk, Russia; Motor Action Research Group (GIAM).
| | - Gudberg K Jonsson
- Human Behavior Laboratory, University of Iceland, Reykjavik, Iceland
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21
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Brown DA, Grant G, Evans K, Leung FT, Hides JA. The association of concussion history and symptom presentation in combat sport athletes. Phys Ther Sport 2021; 48:101-108. [PMID: 33406456 DOI: 10.1016/j.ptsp.2020.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the concussion-related symptoms reported among combat sport athletes with and without a history of concussion, and a history of neck injury. DESIGN Cross-sectional survey. SETTING Data were collected using an online survey instrument. PARTICIPANTS Three hundred and nine adult combat sport athletes. MAIN OUTCOME MEASURES Self-reported 12-month concussion history and neck injury history and a 22-item symptom checklist. RESULTS A history of concussion was reported by 19.1% of athletes, a history of neck injury was reported by 23.0%, and 13.6% reported both injuries. Neck pain was the most frequently reported symptom. Athletes with a history of injury had significantly greater proportions of 'high' total symptoms and symptom severity scores compared with athletes with no history of injury. Athletes with a history of concussion had 2.35 times higher odds of reporting 'high' total symptoms and symptoms severity scores. CONCLUSION Athletes with a history of concussion or neck injury have greater odds of presenting with higher symptom scores. The presence of high total symptom scores and high symptom severity scores may indicate a need for further investigation into domains commonly associated with concussion.
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Affiliation(s)
- Daniel A Brown
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Gary Grant
- School of Pharmacy and Pharmacology, 1 Parklands Dr, Southport, Griffith University, Gold Coast, QLD, 4215, Australia.
| | - Kerrie Evans
- Faculty of Medicine and Health, 75 East Street, Lidcombe, The University of Sydney, NSW, 2141, Australia; Healthia Limited, Australia, 25 Montpelier Road, Bowen Hills, QLD, 4006, Australia.
| | - Felix T Leung
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
| | - Julie A Hides
- School of Allied Health Science, 170 Kessels Rd, Nathan, Griffith University, Brisbane, QLD, 4111, Australia.
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22
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Kelestimur F. Antibodies against the pituitary and hypothalamus in boxers. Handb Clin Neurol 2021; 181:187-191. [PMID: 34238457 DOI: 10.1016/b978-0-12-820683-6.00014-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Traumatic brain injury (TBI), a growing public health problem worldwide, has recently been recognized as one of the leading causes of hypopituitarism. The main causes of TBI-induced pituitary dysfunction are car accidents, falls, violence, sports-related brain injury, and war accidents, including blast-related brain injuries. Car accidents and falls are the most common causes of TBI and pituitary dysfunction among the younger generation and elderly population, respectively. The prevalence of hypopituitarism after TBI is about 30%. GH is the most common hormone lost. The mechanisms underlying hypopituitarism are still unclear; however, recent studies have demonstrated that hypoxic insult, increased intracranial pressure, axonal injury, genetic predisposition, neuroinflammation, and autoimmunity may be responsible for the development of pituitary dysfunction. Neuroendocrine abnormalities are recently described in athletes dealing with contact sports, including boxing and kickboxing, which are characterized by chronic repetitive head trauma. Mild TBI and concussion are accepted in boxing and kickboxing. The positivity of antipituitary and antihypothalamic antibodies is also a significant risk factor in the development of neuroendocrine abnormalities. Autoimmune reaction may also be responsible for the reduction in pituitary volume in boxers with hypopituitarism. In this chapter, the role of autoimmunity in the occurrence of pituitary dysfunction among boxers is discussed.
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Abstract
A 56-year-old man with end-stage heart failure performed a 4-week, symptom-limited, progressive inpatient cardiac prehabilitation program while confined to the cardiovascular intensive care unit awaiting heart transplantation. Mobility was limited by an acute gout flare and multiple central venous access lines. He received a tailored prescription of intermittent boxing, supervised hallway ambulation, stair training, and golfing on a putting green on four consecutive weekdays and was encouraged to mobilize with nursing on the remaining days. The patient progressed and by the last week demonstrated increased activity tolerance. He had a successful transplant after 40 days in the intensive care unit and was discharged with stamina sufficient to participate in outpatient cardiac rehabilitation, demonstrating the value, safety, and feasibility of an individualized inpatient cardiac prehabilitation program for patients with advanced cardiac disease medically confined to the intensive care unit.
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Affiliation(s)
- Katelyn D Brown
- Department of Cardiac Rehabilitation, Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas
| | - Jenny Adams
- Department of Cardiac Rehabilitation, Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas
| | - Dan M Meyer
- Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Texas
| | - Robert L Gottlieb
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas.,Department of Internal Medicine, Texas A&M University College of Medicine, Dallas, Texas.,Division of Precision Medicine, Baylor University Medical Center, Dallas, Texas
| | - Shelley A Hall
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas.,Department of Internal Medicine, Texas A&M University College of Medicine, Dallas, Texas
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Abstract
The long-term effects of repetitive head trauma on the brain have often been studied in boxers and American football players. The medical literature on this topic was reviewed in order to compare the findings related to boxing with those related to football. The evidence gathered from this review indicates that there are significant differences between the clinical and neuropathological descriptions of the chronic brain damage reported in retired boxers compared to those reported in retired football players. Differing biomechanics of head impacts in the two sports may help explain the different clinical and neuropathological consequences of participation in boxing versus football.
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Affiliation(s)
- Ira R Casson
- Department of Neurology, Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
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25
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Khatri D, D'Amico R, Tucker A, Abel M, Langer D, Boockvar J. Surgical Management of Symptomatic Boxing-Induced Spinal Cerebrospinal Fluid Leak After Failed Epidural Blood Patch. World Neurosurg 2020; 139:478-482. [PMID: 32376374 DOI: 10.1016/j.wneu.2020.04.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spontaneous spinal cerebrospinal fluid (CSF) leak is an increasingly recognized condition responsible for spontaneous intracranial hypotension. A host of connective tissue disorders and mechanical factors may precipitate the condition. Conservative treatment has limited efficacy, and many patients with persistent symptoms ultimately require epidural blood patch (EBP). However, about 23%-44% of patients experience recurrence of symptoms after EBP. Unidentified or multiple sites of CSF leaks are thought to be responsible for the failure of EBP. Using our previously published technique, we treated a patient who developed a large spontaneous CSF leak in her cervicothoracic spine after a boxing class, offering further evidence of the utility of the technique for select patients. CASE DESCRIPTION A 28-year-old woman was referred to our center with recurrent, severe headaches and associated nausea and vomiting. She underwent EBP 3 times with no resolution of her symptoms. A right-side partial C7-T1 hemilaminotomy was performed to identify a large meningocele filled with CSF. After dissection, dural sealant was applied using an angled needle with a syringe to buttress the meningocele to allow for normalization of the hydrostatic pressure. At 5-month follow-up, her symptoms have resolved with no headaches and paresthesias in upper limbs. CONCLUSIONS Commonplace events, such as a boxing/sparring class, may precipitate a spontaneous spinal CSF leak. Our minimally invasive surgical approach can be safely used in patients with spontaneous intracranial hypotension with recurrent symptoms, no identified leak site, and prior failed attempts of EBP.
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Affiliation(s)
- Deepak Khatri
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA.
| | - Randy D'Amico
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - Amy Tucker
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - Mariya Abel
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - David Langer
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
| | - John Boockvar
- Department of Neurosurgery, Lenox Hill Hospital, New York, New York, USA
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Lambert C, Beck BR, Harding AT, Watson SL, Weeks BK. Regional changes in indices of bone strength of upper and lower limbs in response to high-intensity impact loading or high-intensity resistance training. Bone 2020; 132:115192. [PMID: 31846824 DOI: 10.1016/j.bone.2019.115192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/22/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Abstract
It is well known that the bone response to physical activity is highly dependent on the nature of the loads imposed. Despite this, few direct comparisons of the effect of impact-style loading and resistance training on bone have been made. We therefore aimed to compare the effects of 10-month, twice-weekly, high-impact loading and 10-month, twice-weekly, high-intensity resistance training on indices of bone strength of both the upper and lower limbs of young adult women. Physically inactive, otherwise healthy, young adult women (18-30 years) with below average bone mass (T-score ≤ 0) were recruited as part of the OPTIMA-Ex trial. Testing included DXA- and pQCT-derived measures of bone mass and indices of bone strength and QUS-derived measures of bone quality of the dominant (D) and non-dominant (ND) upper (radius) and lower limbs (femoral neck, tibia, calcaneus). The present study examined those participants who completed the impact training (IT; n = 10) and resistance training (RT; n = 12) arms of the trial. Age differed between groups at baseline (IT = 23.2 ± 3.8 years, RT = 20.5 ± 1.8 years; p = 0.042). Compliance with the training programs did not differ (IT = 61.4 ± 15.1%, RT = 66.4 ± 11.2%, p = 0.381). Age and baseline differences in bone outcomes served as covariates for repeated measures and univariate ANCOVA conducted for dependent variables and percent change respectively. IT improved distal pQCT-derived bone mineral density (BMD) of the upper limb (ND radius: total BMD = 8.55 ± 2.26% versus 1.50 ± 2.04%, p = 0.040 and trabecular BMD = 1.86 ± 0.90% versus -1.30 ± 0.81%, p = 0.029) and lower limb (ND tibia trabecular BMD = 1.22 ± 0.55% versus -0.82 ± 0.50%, p = 0.017), more than RT. IT also improved upper limb bone strength index (BSI) (ND radius total BSI = 15.35 ± 2.83% versus 2.67 ± 2.55, p = 0.005) and lower limb BSI (D tibia total BSI = 5.16 ± 1.13% versus 0.37 ± 1.02%, p = 0.008; D tibia trabecular BSI = 3.93 ± 1.76% versus -2.84 ± 1.59, p = 0.014, ND tibia trabecular BSI = 3.57 ± 1.63% versus -3.15 ± 1.48%, p = 0.009) more than RT. Conversely, RT improved DXA-derived cortical volumetric BMD at the femoral neck more than IT (3.68 ± 1.99% versus -4.14 ± 2.20%, p = 0.021). Results suggest that IT and RT provide differing site-specific effects in both the upper and lower limbs, with superior bone responses observed at the distal segment from IT, while RT appeared to have greater effect on the shaft of the bone, on indices of bone-strength in young adult women.
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Affiliation(s)
- Conor Lambert
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; The Bone Clinic, Brisbane, Queensland, Australia
| | - Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
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Jodra P, Lago-Rodríguez A, Sánchez-Oliver AJ, López-Samanes A, Pérez-López A, Veiga-Herreros P, San Juan AF, Domínguez R. Effects of caffeine supplementation on physical performance and mood dimensions in elite and trained-recreational athletes. J Int Soc Sports Nutr 2020; 17:2. [PMID: 31900166 PMCID: PMC6942320 DOI: 10.1186/s12970-019-0332-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/13/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Caffeine supplementation (CAFF) has an established ergogenic effect on physical performance and the psychological response to exercise. However, few studies have compared the response to CAFF intake among athletes of different competition level. This study compares the acute effects of CAFF on anaerobic performance, mood and perceived effort in elite and moderately-trained recreational athletes. METHODS Participants for this randomized, controlled, crossover study were 8 elite athletes (in the senior boxing national team) and 10 trained-recreational athletes. Under two experimental conditions, CAFF supplementation (6 mg/kg) or placebo (PLAC), the athletes completed a Wingate test. Subjective exertion during the test was recorded as the rating of perceived exertion (RPE) both at the general level (RPEgeneral) and at the levels muscular (RPEmuscular) and cardiorespiratory (RPEcardio). Before the Wingate test, participants completed the questionnaires Profiles of Moods States (POMS) and Subjective Vitality Scale (SVS). RESULTS In response to CAFF intake, improvements were noted in Wpeak (11.22 ± 0.65 vs 10.70 ± 0.84; p = 0.003; [Formula: see text] =0.44), Wavg (8.75 ± 0.55 vs 8.41 0.46; p = 0.001; [Formula: see text] =0.53) and time taken to reach Wpeak (7.56 ± 1.58 vs 9.11 ± 1.53; p < 0.001; [Formula: see text] =0.57) both in the elite and trained-recreational athletes. However, only the elite athletes showed significant increases in tension (+ 325%), vigor (+ 31%) and SVS (+ 28%) scores after the intake of CAFF compared to levels recorded under the condition PLAC (p < 0.05). Similarly, levels of vigor after consuming CAFF were significantly higher in the elite than the trained-recreational athletes (+ 5.8%). CONCLUSIONS CAFF supplementation improved anaerobic performance in both the elite and recreational athletes. However, the ergogenic effect of CAFF on several mood dimensions and subjective vitality was greater in the elite athletes.
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Affiliation(s)
- P. Jodra
- Faculty of Health Sciences, Universidad Alfonso X El Sabio, Madrid, Spain
- University of Alcalá, Madrid, Spain
| | | | - A. J. Sánchez-Oliver
- Department of Human Motricity and Sports Performance, Faculty of Education Sciences, Seville University, Seville, Spain
| | - A. López-Samanes
- School of Physiotherapy, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - A. Pérez-López
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - P. Veiga-Herreros
- Faculty of Health Sciences, Universidad Alfonso X El Sabio, Madrid, Spain
| | - A. F. San Juan
- Sports Biomechanics Laboratory, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences – INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - R. Domínguez
- Faculty of Health Sciences, Universidad Isabel I, Burgos, Spain
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Casper ST, O'Donnell K. The punch-drunk boxer and the battered wife: Gender and brain injury research. Soc Sci Med 2019; 245:112688. [PMID: 31830739 DOI: 10.1016/j.socscimed.2019.112688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022]
Abstract
This essay uses gender as a category of historical and sociological analysis to situate two populations-boxers and victims of domestic violence-in context and explain the temporal and ontological discrepancies between them as potential brain injury patients. In boxing, the question of brain injury and its sequelae were analyzed from 1928 on, often on profoundly somatic grounds. With domestic violence, in contrast, the question of brain injury and its sequelae appear to have been first examined only after 1990. Symptoms prior to that period were often cast as functional in specific psychiatric and psychological nomenclatures. We examine this chronological and epistemological disconnection between forms of violence that appear otherwise highly similar even if existing in profoundly different spaces.
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Affiliation(s)
| | - Kelly O'Donnell
- College of Humanities and Sciences, Thomas Jefferson University, USA
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Channon A, Matthews CR, Hillier M. Medical care in unlicensed combat sports: A need for standardised regulatory frameworks. J Sci Med Sport 2019; 23:237-240. [PMID: 31706826 DOI: 10.1016/j.jsams.2019.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To explore the provision of medical care at 'unlicensed', full-contact amateur and lower-level professional combat sports competitions in England. DESIGN Qualitative, mixed methods. METHODS Observations totalling 200h of fieldwork shadowing medical professionals at 27 individual combat sports events, alongside formal, semi-structured interviews with 25 medical professionals, 7 referees and 9 promoters/event staff. RESULTS Practices and standards vary widely. Event organisers and promoters often have very little understanding of how different types of medical practitioners operate. They rarely, if ever, check that the staff they are hiring are qualified, sometimes resulting in unqualified staff being used to provide medical cover at events. Venues are often poorly equipped to accommodate basic medical procedures. Patient confidentiality is very often compromised. Medical professionals often have limited autonomy within the combat sports milieu and may find themselves marginalised, with their judgements overruled by non-medical staff during competitive events. Some practitioners are cognisant of the dangers such working environments pose to their professional reputations and livelihoods, but remain working within combat sports regardless. CONCLUSIONS Despite pockets of good practice, the lack of standardised rules for medical care provision creates substantial risks to athletes, to practitioners and the standing of the profession. The development and implementation of standardised, enforceable regulatory frameworks for full-contact combat sports in England is urgently needed.
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Affiliation(s)
- Alex Channon
- University of Brighton, School of Sport and Service Management, UK.
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Combs-Miller SA, Dugan EL, Beachy A, Derby BB, Hosinski AL, Robbins K. Physiological complexity of gait between regular and non-exercisers with Parkinson's disease. Clin Biomech (Bristol, Avon) 2019; 68:23-28. [PMID: 31146080 DOI: 10.1016/j.clinbiomech.2019.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physiological complexity represents overall health of a system and its underlying capacity to adapt to stresses. The primary purpose of this study was to determine if physiological complexity of gait both ON and OFF anti-Parkinson medication differed between regular and non-exercisers with Parkinson's disease. METHODS Twenty participants with idiopathic Parkinson's disease were enrolled in this cross-sectional study (regular exercisers n = 10, non-exercisers n = 10). Two data collection sessions were completed during a single visit, first after a 12-hour overnight withdrawal from anti-Parkinson medications (OFF), and again one-hour after taking anti-Parkinson medications (ON). During each session participants completed a 2-minute walking task at their preferred pace while wearing wireless inertial measurement units on each lower extremity segment (thigh, shank, foot). Multivariate multiscale entropy was calculated from the tri-axial accelerometer signals and converted to a complexity index for analysis. FINDINGS Regular exercisers demonstrated significantly higher complexity indices ON and OFF anti-Parkinson medications compared to non-exercisers (ON F = 3.84 P = 0.02; OFF F = 3.61, P < 0.03). Regular exercisers did not significantly differ in complexity between OFF and ON states (most affected leg F = 0.15 P = 0.71; least affected leg F = 0.30 P = 0.60), but non-exercisers demonstrated significantly decreased complexity in the least affected leg OFF anti-Parkinson medications (F = 5.17 P < 0.04). INTERPRETATION Enhanced gait complexity in the regular exercisers may indicate that ongoing exercise is a key ingredient contributing to health in persons with Parkinson's disease. Exercising on a regular basis with Parkinson's disease may augment one's ability to adapt to barriers encountered during gait regardless of medication state.
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Affiliation(s)
- Stephanie A Combs-Miller
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA.
| | - Eric L Dugan
- Texas Children's Hospital, Motion Analysis and Human Performance Program, 17580 Interstate 45 South, The Woodlands, TX 77384, USA; Baylor College of Medicine, Department of Orthopaedic Surgery, 17580 Interstate 45 South, The Woodlands, TX 77384, USA
| | - Ann Beachy
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Brook B Derby
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Alicia L Hosinski
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Kristen Robbins
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
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Cournoyer J, Hoshizaki TB. Head dynamic response and brain tissue deformation for boxing punches with and without loss of consciousness. Clin Biomech (Bristol, Avon) 2019; 67:96-101. [PMID: 31082637 DOI: 10.1016/j.clinbiomech.2019.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Loss of consciousness is a poorly understood indicator of concussion severity. Conflicting results have been published supporting loss of consciousness as a severe concussion as well as having no relationship with severity. Understanding how loss of consciousness relates to brain trauma severity will provide useful insights to guide rule changes and return to sport protocols. The purpose of this study was to compare magnitudes of head acceleration and brain tissue deformation for punches resulting in a loss of consciousness and punches that do not. METHODS Physical representations of boxing punches presenting with and without loss of consciousness were performed using an anthropometric headform and finite element model. The variables measured were peak linear and rotational acceleration, maximum principal strain, cumulative strain damage 10%, and strain rate in five regions of the brain. FINDINGS Loss of consciousness in boxing resulted from hooks to the side of the mandible creating high levels of rotational acceleration and increased magnitudes of brain trauma in all regions of the brain. Differences between punches resulting in loss of consciousness and no loss of consciousness were distinguished by maximum principal strain for each of the brain region analyzed. INTERPRETATION This research supports the notion that loss of consciousness in boxing is caused by higher levels of brain trauma and may require a longer recovery time.
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Abstract
OBJECTIVE The incidence of boxing-related upper-extremity (UE) injuries in the United States has not been well characterized. Recent rule changes have been made to make participation safer for athletes, although the consequences of such rule changes on injury rates is unclear. Therefore, we sought to determine the incidence, characteristics, and trends of boxing-related UE injuries. METHODS The National Electronic Injury Surveillance System (NEISS) was queried for the years 2012-2016. All UE injuries related to boxing from 2012 to 2016 that occurred during organized boxing participation were selected. Examined variables included injured body party, injury diagnosis, patient age, and sex. Annual injury incidence rates by body part and diagnosis were calculated. RESULTS The mean incidence of boxing-related UE injuries from 2012 to 2016 was 673 injuries (95% CI 537-809) per 100,000 person-years, with hand fractures being the most common injury (132 (95% CI 130-135) per 100,000 person-years). The incidence of UE injury significantly declined from 865 (95% CI 846-884) per 100,000 person-years in 2012 to 656 (95% CI 642-671) per 100,000 person-years in 2016 (p < 0.01). Injuries to the hand exhibited the largest decrease, declining by 33%. The majority of boxers sustaining UE injuries were male (84.4%) and between the ages of 20-39 (59.9%). CONCLUSIONS Injuries to the UE due to participation in boxing accounted for thousands of emergency department visits in the United States annually, with males younger than 20 years of age, most susceptible to injury. Injuries to the hand, wrist and shoulder occurred at the highest rate. Finally, following rule changes made by sanctioning organizations in 2013, a significant decline in boxing-related UE injuries were observed.
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Affiliation(s)
- Nicholas J Lemme
- a Department of Orthopaedics , Alpert Medical School of Brown University , Providence , RI , USA
| | - Lauren Ready
- a Department of Orthopaedics , Alpert Medical School of Brown University , Providence , RI , USA
| | - Meghan Faria
- b Department of Exercise Science , University of Rhode Island , Kingston , RI , USA
| | - Steven F DeFroda
- a Department of Orthopaedics , Alpert Medical School of Brown University , Providence , RI , USA
| | - Joseph A Gil
- a Department of Orthopaedics , Alpert Medical School of Brown University , Providence , RI , USA
| | - Brett D Owens
- a Department of Orthopaedics , Alpert Medical School of Brown University , Providence , RI , USA
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Abstract
OBJECTIVES To examine whether changing weigh-in from the same day of the match to the day before the match and prohibiting 6-oz gloves are associated with fatalities in boxing matches sanctioned by the Japan Boxing Commission (JBC). METHODS We analyzed the rates of boxing fatalities before and after the two rule changes above via secondary analysis of data. Demographics and boxing records of deceased boxers were examined using descriptive statistics, exact binomial test the Mann-Whitney-Wilcoxon test and Fisher's exact tests. RESULTS As of this study, a total of 38 boxers (23.9 ± 3.3 years of age) reportedly died due to injuries sustained in JBC-sanctioned boxing matches since 1952. Changing weigh-in to the day before the match or prohibiting 6-oz gloves was not significantly associated with the rates of boxing fatalities 5 years and 10 years before and after the rule changes (p > 0.05). Deceased boxers after these rule changes were significantly older, completed significantly more rounds in the final match, and were significantly less likely to lose the previous match (prior to the final match) and to do so by knockouts (p < 0.05). CONCLUSION Changing weigh-in to the day before the match and prohibiting 6-oz gloves may not result in reducing boxing fatalities.
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Affiliation(s)
- Masaru Teramoto
- a Division of Physical Medicine & Rehabilitation , University of Utah , Salt Lake City , UT , USA
| | - Chad L Cross
- b Department of Radiation Oncology, School of Medicine and Department of Environmental & Occupational Health, School of Community Health Sciences , University of Nevada , Las Vegas , NV , USA
| | - Daniel M Cushman
- a Division of Physical Medicine & Rehabilitation , University of Utah , Salt Lake City , UT , USA
| | - Stuart E Willick
- a Division of Physical Medicine & Rehabilitation , University of Utah , Salt Lake City , UT , USA
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Abstract
Extensive exposure of boxers to neurotrauma in the early 20th century led to the so-called punch drunk syndrome, which was formally recognized in the medical literature in 1928. "Punch drunk" terminology was replaced by the less derisive 'dementia pugilistica' in 1937. In the early case material, the diagnosis of dementia pugilistica required neurological deficits, including slurring dysarthria, ataxia, pyramidal signs, extrapyramidal signs, memory impairment, and personality changes, although the specific clinical substrate has assumed lesser importance in recent years with a shift in focus on molecular pathogenesis. The postmortem neuropathology of dementia pugilistica has also evolved substantially over the past 90 years, from suspected concussion-related hemorrhages to diverse structural and neurofibrillary changes to geographic tauopathy. Progressive neurodegenerative tauopathy is among the prevailing theories for disease pathogenesis currently, although this may be overly simplistic. Careful examination of historical cases reveals both misdiagnoses and a likelihood that dementia pugilistica at that time was caused by cumulative structural brain injury. More recent neuropathological studies indicate subclinical and possibly static tauopathy in some athletes and non-athletes. Indeed, it is unclear from the literature whether retired boxers reach the inflection point that tends toward progressive neurodegeneration in the manner of Alzheimer's disease due to boxing. Even among historical cases with extreme levels of exposure, progressive disease was exceptional.
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Affiliation(s)
- Rudy J Castellani
- Center for Neuropathology, Western Michigan University School of Medicine, Kalamazoo, MI, USA
| | - George Perry
- College of Sciences, University of Texas, San Antonio, San Antonio, TX, USA
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Hart MG, Housden CR, Suckling J, Tait R, Young A, Müller U, Newcombe VFJ, Jalloh I, Pearson B, Cross J, Trivedi RA, Pickard JD, Sahakian BJ, Hutchinson PJ. Advanced magnetic resonance imaging and neuropsychological assessment for detecting brain injury in a prospective cohort of university amateur boxers. Neuroimage Clin 2017; 15:194-199. [PMID: 28529875 PMCID: PMC5429235 DOI: 10.1016/j.nicl.2017.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 04/22/2017] [Accepted: 04/25/2017] [Indexed: 10/25/2022]
Abstract
BACKGROUND/AIM The safety of amateur and professional boxing is a contentious issue. We hypothesised that advanced magnetic resonance imaging and neuropsychological testing could provide evidence of acute and early brain injury in amateur boxers. METHODS We recruited 30 participants from a university amateur boxing club in a prospective cohort study. Magnetic resonance imaging (MRI) and neuropsychological testing was performed at three time points: prior to starting training; within 48 h following a first major competition to detect acute brain injury; and one year follow-up. A single MRI acquisition was made from control participants. Imaging analysis included cortical thickness measurements with Advanced Normalization Tools (ANTS) and FreeSurfer, voxel based morphometry (VBM), and Tract Based Spatial Statistics (TBSS). A computerized battery of neuropsychological tests was performed assessing attention, learning, memory and impulsivity. RESULTS During the study period, one boxer developed seizures controlled with medication while another developed a chronic subdural hematoma requiring neurosurgical drainage. A total of 10 boxers contributed data at to the longitudinal assessment protocol. Reasons for withdrawal were: logistics (10), stopping boxing (7), withdrawal of consent (2), and development of a chronic subdural hematoma (1). No significant changes were detected using VBM, TBSS, cortical thickness measured with FreeSurfer or ANTS, either cross-sectionally at baseline, or longitudinally. Neuropsychological assessment of boxers found attention/concentration improved over time while planning and problem solving ability latency decreased after a bout but recovered after one year. CONCLUSION While this neuroimaging and neuropsychological assessment protocol could not detect any evidence of brain injury, one boxer developed seizures and another developed a chronic sub-dural haematoma.
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Affiliation(s)
- M G Hart
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom.
| | - C R Housden
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - J Suckling
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - R Tait
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - A Young
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - U Müller
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom; Adult ADHD Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge Road, Fulbourn, Cambridge CB21 5HH, United Kingdom
| | - V F J Newcombe
- Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; University Division of Anaesthesia, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - I Jalloh
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - B Pearson
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - J Cross
- Department of Radiology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - R A Trivedi
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - J D Pickard
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - B J Sahakian
- Department of Psychiatry, University of Cambridge and the MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ, United Kingdom
| | - P J Hutchinson
- Academic Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Box 167, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom; Wolfson Brain Imaging Centre, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
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Abstract
Hand and wrist injuries in martial arts are typically a reflection of the combat nature of this discipline. In striking sports, the axial load mechanism of injury is common and causes fractures and dislocations; in grappling sports, sprain injuries and degenerative changes predominate. There is clear evidence to support that hand protection reduces the risk of hand injury. Traditional training in martial arts on proper technique and target selection in striking sports reduces the risk of hand injury, and is an important component of hand and wrist injury prevention.
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Affiliation(s)
| | - Thomas P Lehman
- OUHSC Department of Orthopedic Surgery, College of Medicine Building, 800 Stanton L. Young Boulevard Suite 3400, Oklahoma City, OK 73104, USA
| | - Ghazi Rayan
- University of Oklahoma Health Sciences Center, 3366 Northwest Expressway # 700, Oklahoma City, OK 73112, USA.
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Abstract
This study aimed to (1) profile a professional boxer (23 years and 80 kg) with boxing-specific, muscle function, aerobic capacity and body composition tests, and (2) quantify how these measures varied during an 8-week preparation phase leading to, and post a state-Title Bout fought in the 76.2-kg class. A series of boxing-specific and muscle function tests were completed on 11 occasions: 9 prior and twice after the bout, each separated by approximately 2 weeks. The boxing test included 36 maximal punches (9 of each: lead and rear straights, lead and rear hooks) to a punching integrator measuring forces and velocity. Muscle function tests included countermovement jump, drop-jumps, isometric mid-thigh pull and isometric bench-press. Body composition was assessed using skin-fold measurements on three occasions and one dual energy X-ray absorptiometry scan. Aerobic capacity was assessed using 2 VO2 max tests. Leading up to the bout, performance decreased in isometric mid-thigh pull (8%), isometric bench-press (5%), countermovement jump (15%) and impact forces in 3 of 4 punches (4%-7%). Whereas measures of dynamic and isometric muscle function remained depressed or unchanged post competition, punching forces (6%-15%) and aerobic power (6%) increased. Data suggest the athlete may have super-compensated following rest as fatigue dissipated and further adaptation occurred.
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Affiliation(s)
- Israel Halperin
- a Physiology Discipline , Australian Institute of Sport , Bruce , ACT , Australia.,b Centre for Exercise and Sport Science Research, School of Exercise & Health Science , Edith Cowan University , Joondalup , WA , Australia
| | - Steven Hughes
- a Physiology Discipline , Australian Institute of Sport , Bruce , ACT , Australia
| | - Dale W Chapman
- a Physiology Discipline , Australian Institute of Sport , Bruce , ACT , Australia.,b Centre for Exercise and Sport Science Research, School of Exercise & Health Science , Edith Cowan University , Joondalup , WA , Australia
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Lenetsky S, Brughelli M, Harris NK. Shoulder function and scapular position in boxers. Phys Ther Sport 2015; 16:355-60. [PMID: 26239217 DOI: 10.1016/j.ptsp.2015.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/18/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate differences in strength, shoulder range of motion and scapula position in a cohort of boxers in comparison with a control group of non-boxers. DESIGN Cross-sectional study. PARTICIPANTS 18 boxers with 3 or more years of experience (years = 5.5 ± 3.1, sessions per week = 4.3 ± 0.7, age = 27.0 ± 6.8) and 20 control participants (age = 28.3 ± 4.6). EXPERIMENTAL PROTOCOL The participants were tested for isometric internal and external rotation strength measured with a hand held dynamometer, passive internal and external rotation measured via 2D video using a digital camera, and scapular function measured with a scoliometer and visual inspection by a trained researcher. Both arms (dominant and non-dominant) were tested to allow for comparison. Magnitude based inferences were used to find meaningful differences intra and inter group. RESULTS Boxers had greater scapular dyskinesis (hazard ratio (HR) = 2.73 ×/÷ 3.37) and increased external rotation in the dominant arm (effect size (ES) = 0.70 ± 0.68) when compared to the non-boxer group. CONCLUSION Boxers with 3 or more years of experience displayed symptoms that increase their risk of upper limb injury when compared to a control group.
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Affiliation(s)
- Seth Lenetsky
- Sports Performance Research Institute New Zealand, Auckland University of Technology, AUT University, Private Bag 92006, Auckland 0627, New Zealand.
| | - Matt Brughelli
- Sports Performance Research Institute New Zealand, Auckland University of Technology, AUT University, Private Bag 92006, Auckland 0627, New Zealand
| | - Nigel K Harris
- Sports Performance Research Institute New Zealand, Auckland University of Technology, AUT University, Private Bag 92006, Auckland 0627, New Zealand
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Martínez-Pérez R, Paredes I, Munarriz PM, Paredes B, Alén JF. Chronic traumatic encephalopathy: The unknown disease. Neurologia 2014; 32:185-191. [PMID: 25534950 DOI: 10.1016/j.nrl.2014.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/06/2014] [Accepted: 08/08/2014] [Indexed: 11/18/2022] Open
Abstract
Chronic traumatic encephalopathy is a neurodegenerative disease produced by accumulated minor traumatic brain injuries; no definitive premortem diagnosis and no treatments are available for chronic traumatic encephalopathy. Risk factors associated with chronic traumatic encephalopathy include playing contact sports, presence of the apolipoprotein E4, and old age. Although it shares certain histopathological findings with Alzheimer disease, chronic traumatic encephalopathy has a more specific presentation (hyperphosphorylated tau protein deposited as neurofibrillary tangles, associated with neuropil threads and sometimes with beta-amyloid plaques). Its clinical presentation is insidious; patients show mild cognitive and emotional symptoms before progressing to parkinsonian motor signs and finally dementia. Results from new experimental diagnostic tools are promising, but these tools are not yet available. The mainstay of managing this disease is prevention and early detection of its first symptoms.
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Affiliation(s)
- R Martínez-Pérez
- Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España.
| | - I Paredes
- Servicio de Neurocirugía, Hospital Virgen de la Salud, Toledo, España
| | - P M Munarriz
- Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España
| | - B Paredes
- Departamento de Psicología, Universidad Nacional de Educación a Distancia (UNED), España
| | - J F Alén
- Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España
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Mendoza-Puente M, Oliva-Pascual-Vaca Á, Rodriguez-Blanco C, Heredia-Rizo AM, Torres-Lagares D, Ordoñez FJ. Risk of headache, temporomandibular dysfunction, and local sensitization in male professional boxers: a case-control study. Arch Phys Med Rehabil 2014; 95:1977-83. [PMID: 24996064 DOI: 10.1016/j.apmr.2014.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 06/04/2014] [Accepted: 06/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality in professional male boxers (exposed to repetitive craniofacial trauma) who were actively training and without severe previous injuries compared with handball players. DESIGN Case-control study. SETTING University-based physical therapy research clinic. PARTICIPANTS Eighteen boxers (mean age, 23±4.61y) as the cases group, and 20 handball players as the comparison group (mean age, ±2y, and sex matched), were included. All participants (N=38) completed the assessment protocol. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold over the trigeminal nerve sensory branches, the masseter muscle, and the tibialis anterior muscle. The secondary outcome measure included the temporomandibular function (Helkimo Clinic Index). RESULTS The boxers showed slight mandibular function impairment, local muscular and neural sensitization, and a higher impact from headaches than did the handball players. The between-group comparison found significant differences in all outcome measures (P<.05), except in the tibialis anterior muscle pressure pain threshold on the dominant (P=.958) and the nondominant (P=.453) sides. CONCLUSIONS Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region than do professional handball players. It cannot be determined whether these findings are short-lasting, as a result of the training activity, or long-lasting.
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Purcell LK, Leblanc CM. Boxing participation by children and adolescents: A joint statement with the American Academy of Pediatrics. Paediatr Child Health 2013; 17:39-40. [PMID: 23277756 DOI: 10.1093/pch/17.1.39] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Thousands of boys and girls younger than 19 years of age participate in boxing in North America. Although boxing provides benefits for participants, including exercise, self-discipline and self-confidence, the sport of boxing encourages and rewards deliberate blows to the head and face. Participants in boxing are at risk of head, face and neck injuries, including chronic and even fatal neurological injuries. Concussions are one of the most common injuries occurring in boxing. Because of the risk of head and facial injuries, the Canadian Paediatric Society and the American Academy of Pediatrics vigorously oppose boxing as a sport for children and adolescents. These organizations recommend that physicians oppose boxing in youth and encourage patients to participate in alternative sports in which intentional head blows are not central to the sport.
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Schinke RJ, Ramsay M. World title boxing: from early beginnings to the first bell. J Sports Sci Med 2009; 8:1-4. [PMID: 24474878 PMCID: PMC3879639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2008] [Accepted: 07/30/2009] [Indexed: 06/03/2023]
Abstract
There is scant literature where applied sport scientists have considered first hand experiences preparing professional boxers for world title bouts. The present submission reflects more than 10 years of applied experience working with professional boxers, residing in Canada. What follows is a composite of sequential steps that ownership and coaching staff of one Canadian management group have tried leading up to more than 20 world title bout experiences. The strategies proposed have been built progressively over time, and what follows is a general overview of a more detailed pre-bout structure from shortly in advance of a world title bout offer to the moment when the athlete enters the ring to perform. We propose that an effective structure is founded upon detailed a priori preparation, tactical decisions throughout bout preparation, and a thorough understanding by the athlete of what he will encounter during the title bout. Key PointsWorld championship boxing.Competition preparation.Professional sport.Athlete performance.
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Schinke RJ. A four-year chronology with national team boxing in Canada. J Sports Sci Med 2007; 6:1-5. [PMID: 24198695 PMCID: PMC3809046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 06/18/2007] [Indexed: 06/02/2023]
Abstract
Applied sport psychologists tend to begin their consulting relationships with national teams having formalized skills, and often, limited contextual and sport- specific understanding. The present report overviews the first four years of a long-term consulting relationship one practitioner developed with the Canadian National Boxing Team. From the vantage of an applied sport psychology consultant, I overview how a limited consulting role expanded into increased responsibilities and opportunities. Suggestions are provided for the aspiring sport psychology consultant interested in working with athletes and coaches within the combative sport of elite amateur boxing. Key pointsA case study with elite amateur boxers.A strategy to develop rapport.Four years of major games experiences on site.
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Affiliation(s)
- Robert J Schinke
- Ben Avery Physical Education Center, School of Human Kinetics, Laurentian University , Sudbury, Ontario, Canada
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