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Zeller AM, Lear A, Post E, McNulty S, Bentley B. A National Survey on the Relationship of Youth Sport Specialization Behaviors to Self-Reported Anxiety and Depression in Youth Softball Players. Sports Health 2024; 16:184-194. [PMID: 38344769 PMCID: PMC10916774 DOI: 10.1177/19417381241228539] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND There are little to no data on whether any associations exist between sport specialization and mental health in youth softball athletes. HYPOTHESIS Highly specialized youth softball athletes will have worse self-reported depression and anxiety symptom scores compared with low and moderate specialized athletes. STUDY DESIGN Cross-sectional survey. LEVEL OF EVIDENCE Level 4. METHODS An online cross-sectional survey was distributed in the fall of 2021 to a national sample of female youth softball athletes between the ages of 12 and 18 years. Sport specialization status was determined using a 3-point specialization scale that classifies either low, moderate, or high. The patient health questionnaire-9 (PHQ-9) and the 7-item general anxiety disorder scale (GAD-7) were used to assess self-reported symptoms of depression and anxiety. Comparison also included sports participation and specialization behaviors between specialization groups. RESULTS A total of 1283 subjects (mean age, 15.1 ± 1.7 years) fully completed the survey. After adjusting for covariates, lower scores were reported on both the PHQ-9 and GAD-7 by highly specialized athletes compared with moderate or low specialization athletes (PHQ-9, high = 8.6 ± 0.4; moderate = 11.2 ± 0.3; low = 10.9 ± 0.5; P < 0.01; GAD-7, high = 6.5 ± 0.4; moderate = 8.6 ± 0.3; low = 8.4 ± 0.4, P < 0.01). Conversely, higher scores were reported on both scales for athletes who received private softball coaching compared with those who did not (PHQ-9, 11.5 ± 0.3 vs 9.0 ± 0.3; P < 0.01; GAD-7, 8.8 ± 0.3 vs 6.9 ± 0.3, P < 0.01). Finally, athletes who reported an arm overuse injury in the previous year reported higher PHQ-9 scores (10.8 ± 0.3 vs 9.8 ± 0.3; P < 0.01). CONCLUSION While sport specialization, as measured by the validated 3-point scale, was not associated with increased anxiety and depression symptom scores, other aspects of specialization behavior such as private coaching or overuse injury history were associated with worse scores on these scales, indicating potential concern for anxiety and depression. However, although the differences we observed were statistically significant, they did not exceed the minimal clinically important difference values that have been established for the PHQ-9 (5 points) or GAD-7 (4 points). CLINICAL RELEVANCE This project is a first step toward understanding the sport specialization behaviors and their influence on the mental health of youth softball athletes. Focusing on investigating specialization behaviors further may reveal to be a better indicator of risk of developing anxiety and depression symptoms compared with utilizing the 3-point specialization scale.
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Affiliation(s)
- Anne Marie Zeller
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Knoxville, Tennessee
| | - Aaron Lear
- Cleveland Clinic Akron General, Akron, Ohio
| | - Eric Post
- United States Olympic and Paralympic Committee, Colorado Springs, Colorado
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Guilfoyle L, Kenny IC, O'Sullivan K, Campbell MJ, Warrington GD, Glynn LG, Comyns T. Coaches of youth field sports as delivery agents of injury prevention programmes: how are we training the trainers? A scoping review. Br J Sports Med 2024; 58:144-153. [PMID: 38216323 PMCID: PMC10894822 DOI: 10.1136/bjsports-2023-106934] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. DESIGN Scoping review. DATA SOURCES PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus and Google Scholar electronic databases were searched using keywords related to IPPs and youth field sports. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies of IPPs in youth field sports, that provided 'train-the-trainer' education to coaches as designated delivery agents. RESULTS 20 studies from two field sports (soccer/football; n=17, Rugby Union; n=3) fulfilled the eligibility criteria. Eleven CE interventions occurred in the preseason and 18 occurred at one time-point (single day). Five studies cited use of a behavioural change theory or model in the design of their CE, most frequently the Health Action Process Approach model (n=5); and use of behavioural change techniques varied. Twelve of twenty studies (60%) reported some form of ongoing support to coaches following the CE primary intervention concurrent with IPP implementation. CONCLUSION CE that occurs on 1 day (one time-point) is most popular for preparing coaches as delivery agents of IPPs in youth field sports. While recognising pragmatic barriers, more expansive in-service training, support and feedback may enhance the effective implementation of IPPs. TRIAL REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/FMHGD.
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Affiliation(s)
- Lauren Guilfoyle
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ian C Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kieran O'Sullivan
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Mark J Campbell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Lero, The Science Foundation Ireland Centre for Software Research, University of Limerick, Limerick, Ireland
| | - Giles D Warrington
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam G Glynn
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Tom Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Strosser S. Youth Sport Specialization and Risk of Injury: A General Review. Clin J Sport Med 2023; 33:652-657. [PMID: 37104869 DOI: 10.1097/jsm.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/02/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE The purpose of this literature review was to analyze, understand, and disclose prior empirical findings about the injury risks associated with youth sport specialization. DATA SOURCES Articles were included in this review if they examined the association between youth sport specialization status and injury. Nine articles from 5 journals met these criteria. All articles summarized the findings of cross-sectional (N = 5) or cohort studies (N = 4). MAIN RESULTS Each article included in this review indicated that specialized youth athletes are more susceptible to injury. Only 5 studies assessed the injury risks linked to specialization independent of sport training volume. These studies produced contradictory results. CONCLUSIONS Although specialized youth athletes are more prone to injury, future research is needed to determine the independent and inherent injury risk associated with specialization. Nevertheless, youth athletes should refrain from specialization until at least adolescence.
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Little CC, Howell DR, Armento AM, Sweeney EA, Walker GA. Training volume recommendations and psychosocial outcomes in adolescent athletes. PHYSICIAN SPORTSMED 2023; 51:420-426. [PMID: 36000411 DOI: 10.1080/00913847.2022.2113987] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES Researchers have recommended that youth athletes limit their practice volume to the number of hours/week that they are old in years. We examined sport perceptions, burnout, anxiety, and depressive symptoms among youth athletes who did and did not report playing more hours/week of organized sports than their age. METHODS Uninjured athletes aged 13-18 years old completed questionnaires documenting demographics, sport participation volume, health and injury history, depressive symptoms, anxiety, burnout, and sport perceptions during a pre-participation physical examination. We grouped participants as those who reported more hours/week in organized sports than their age (exceeds age/volume recommendation) vs. those who reported equal/less hours/week in organized sports than their age (meets age/volume recommendation). RESULTS Of 161 participants, 21% (n = 33) were in the 'exceeds age/volume recommendation' group (age = 15.2 ± 1.3 years; 55% female; 18.7 ± 4.0 hours/week) and 79% (n = 128) were in the 'meets age/volume recommendation' group (age = 15.6 ± 1.2 years; 50% female; 10.2 ± 3.4 hours/week). A higher proportion of the 'exceeds age/volume recommendation' group agreed with the statement 'youth in my sport play too many games before college' than the 'meets age/volume recommendation' group (33% vs. 16%; p = 0.03). After adjusting for the effect of age, sport specialization level, and weight, exceeding age/volume recommendations was associated with the perception that youth in sports play too many games before college (aOR = 3.24; 95% CI = 1.26, 8.29; p = 0.01), while burnout (aOR = 0.99; 95% CI = 0.94, 1.06; p = 0.93), anxiety (aOR = 0.97; 95% CI = 0.84, 1.11; p = 0.65), and depressive symptoms (aOR = 0.90; 95% CI = 0.74, 1.10; p = 0.30) were not significantly related. CONCLUSION Athletes who spend more hours in sport than their age appear to perceive their competition load during youth sports to be excessive. Coaches and providers should monitor athlete's training hours and perceptions of competition load to offer support and potentially prevent burnout development.
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Affiliation(s)
- Casey C Little
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
| | - David R Howell
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Aubrey M Armento
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Emily A Sweeney
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Gregory A Walker
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
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Wik EH, Lolli L, Chamari K, Materne O, Di Salvo V, Gregson W, Bahr R. Injury patterns differ with age in male youth football: a four-season prospective study of 1111 time-loss injuries in an elite national academy. Br J Sports Med 2021; 55:794-800. [PMID: 33361134 DOI: 10.1136/bjsports-2020-103430] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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] [Accepted: 12/03/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To describe age group patterns for injury incidence, severity and burden in elite male youth football. METHODS Prospective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13-U18; age range: 11-18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours. RESULTS We included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures. CONCLUSION Injury patterns differed with age; tailoring prevention programmes may be possible.
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Affiliation(s)
- Eirik Halvorsen Wik
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Department of Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Oslo Sports Trauma Research Center (OSTRC), Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Lorenzo Lolli
- Football Performance and Science Department, Aspire Academy, Doha, Qatar
- Football Exchange, Research Institute of Sport Sciences, Liverpool John Moores University, Liverpool, UK
| | - Karim Chamari
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Department of Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Olivier Materne
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Department of Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Valter Di Salvo
- Football Performance and Science Department, Aspire Academy, Doha, Qatar
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Warren Gregson
- Football Performance and Science Department, Aspire Academy, Doha, Qatar
- Football Exchange, Research Institute of Sport Sciences, Liverpool John Moores University, Liverpool, UK
| | - Roald Bahr
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Department of Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Oslo Sports Trauma Research Center (OSTRC), Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Kliethermes SA, Marshall SW, LaBella CR, Watson AM, Brenner JS, Nagle KB, Jayanthi N, Brooks MA, Tenforde AS, Herman DC, DiFiori JP, Beutler AI. Defining a Research Agenda for Youth Sport Specialization in the United States: The AMSSM Youth Early Sport Specialization Summit. Clin J Sport Med 2021; 31:103-112. [PMID: 33587486 DOI: 10.1097/jsm.0000000000000900] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 02/02/2023]
Abstract
ABSTRACT Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.
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Affiliation(s)
- Stephanie A Kliethermes
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Stephen W Marshall
- Department of Epidemiology, Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia R LaBella
- Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, Illinois
- Institute for Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Joel S Brenner
- Sports Medicine Division, Children's Specialty Group, PLLC, Sports Medicine Program, Children's Hospital of The King's Daughters, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia
| | - Kyle B Nagle
- Department of Pediatrics and Orthopedics and Rehabilitation, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Neeru Jayanthi
- Department of Orthopedics, Department of Family Medicine, Emory Sports Medicine Center, Emory University School of Medicine, Atlanta, Georgia
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel C Herman
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida
| | - John P DiFiori
- Primary Sports Medicine Service, Hospital for Special Surgery, New York, New York
| | - Anthony I Beutler
- Musculoskeletal Clinical Program, Intermountain Healthcare, Salt Lake City, Utah; and
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Rob T, Flannery P. Protecting children and young people from developing sport associated dementia. BMJ 2021; 372:n546. [PMID: 33632850 DOI: 10.1136/bmj.n546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schneider KJ, Nettel-Aguirre A, Palacios-Derflingher L, Mrazik M, Brooks BL, Woollings K, Blake T, McKay C, Lebrun C, Barlow K, Taylor K, Lemke N, Meeuwisse WH, Emery CA. Concussion Burden, Recovery, and Risk Factors in Elite Youth Ice Hockey Players. Clin J Sport Med 2021; 31:70-77. [PMID: 30300143 DOI: 10.1097/jsm.0000000000000673] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine rates of concussion and more severe concussion (time loss of greater than 10 days) in elite 13- to 17-year-old ice hockey players. METHODS This is a prospective cohort study (Alberta, Canada). Bantam (13-14 years) and Midget (15-17 years) male and female elite (top 20% by division of play) youth ice hockey players participated in this study. Players completed a demographic and medical history questionnaire and clinical test battery at the beginning of the season. A previously validated injury surveillance system was used to document exposure hours and injury during one season of play (8 months). Players with a suspected ice hockey-related concussion were referred to the study sport medicine physicians for assessment. Time loss from hockey participation was documented on an injury report form. RESULTS Overall, 778 elite youth ice hockey players (659 males and 119 females; aged 13-17 years) participated in this study. In total, 143 concussions were reported. The concussion incidence rate (IR) was 17.60 concussions/100 players (95% CI, 15.09-20.44). The concussion IR was 1.31 concussions/1000 player-hours (95% CI, 1.09-1.57). Time loss of greater than 10 days was reported in 74% of cases (106/143), and 20% (n = 28) had time loss of greater than 30 days. CONCLUSIONS Concussion is a common injury in elite youth ice hockey players. In this study population, a large proportion of concussions (74%) resulted in a time loss of greater than 10 days, possibly reflecting more conservative management or longer recovery in youth athletes.
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Affiliation(s)
- Kathryn J Schneider
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Alberto Nettel-Aguirre
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Luz Palacios-Derflingher
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Brian L Brooks
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Neurosciences Program, Alberta Children's Hospital, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Kaikanani Woollings
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
| | - Tracy Blake
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Carly McKay
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department for Health, University of Bath, Bath, Somerset, United Kingdom
| | - Constance Lebrun
- Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, Canada
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada ; and
| | - Karen Barlow
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Medicine, Child Health Research Centre, University of Queensland, Queensland, Australia
| | - Kirsten Taylor
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
| | - Nicole Lemke
- Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, Canada
| | - Willem H Meeuwisse
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carolyn A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
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Abstract
Pediatric patients with concussions have different needs than adults throughout the recovery process. Adolescents, in particular, may take longer to recover from concussion than adults. Initially, relative rest from academic and physical activities is recommended for 24 to 48 hours to allow symptoms to abate. After this time period, physicians should guide the return to activity and return to school process in a staged fashion using published guidelines. Further concussion research in pediatric patients, particularly those younger than high-school age, is needed to advance the management of this special population.
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Affiliation(s)
- Stessie Dort Zimmerman
- Urgent Care, Seattle Children's Hospital, 4800 Sand Point Way Northeast, M/S MB.7.520, Seattle, WA 98105, USA
| | - Brian T Vernau
- Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - William P Meehan
- Division of Sports Medicine, The Micheli Center for Sports Injury Prevention, Boston Children's Hospital, Harvard Medical School, 9 Hope Avenue-Suite 100, Waltham, MA 02453, USA
| | - Christina L Master
- Minds Matter Concussion Program, Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA.
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Tokish JM, Thigpen CA, Kissenberth MJ, Tolan SJ, Lonergan KT, Tokish JM, Dickens JF, Hawkins RJ, Shanley E. The Nonoperative Instability Severity Index Score (NISIS): A Simple Tool to Guide Operative Versus Nonoperative Treatment of the Unstable Shoulder. Sports Health 2020; 12:598-602. [PMID: 32609577 DOI: 10.1177/1941738120925738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The management of the adolescent athlete after initial shoulder instability remains controversial. HYPOTHESIS Individual risk factors in athletes with shoulder instability who are managed nonoperatively can be integrated into a scoring system that can predict successful return to sport. STUDY DESIGN Retrospective cohort study. LEVEL OF EVIDENCE Level 4. METHODS A total of 57 scholastic athletes with primary anterior shoulder instability who were managed nonoperatively were reviewed. Success was defined as a return to index sport at the same level and playing at least 1 subsequent season without missed time as a result of the shoulder. Patient-specific risk factors were individually evaluated, and odds ratios were calculated. A 10-point Nonoperative Injury Severity Index Score (NISIS) incorporated the risk factors for failure. This score was then retrospectively applied with regression analysis and a chi-square analysis to determine the overall optimal score that predicted failure of nonoperative management. RESULTS In total, 6 risk factors for failure were included in the NISIS: age (>15 years), bone loss, type of instability, type of sport (contact vs noncontact), male sex, and arm dominance. Overall, 79% of patients treated nonoperatively were able to successfully return to sport. Nearly all (97%) low-risk patients (NISIS <7) successfully returned to sport, while only 59% of high-risk patients returned to sport, a relative risk of 12.2 (P = 0.001). High-risk patients with unipolar bone loss successfully returned (100%), but 67% of high-risk patients with bipolar bone loss failed. CONCLUSION The NISIS is a simple and effective clinical tool to determine successful nonoperative management following anterior shoulder instability and may be helpful in guiding decision making when presented with the unstable shoulder in the scholastic athlete.
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Jildeh TR, Okoroha KR, Denha E, Eyers C, Johnson A, Shehab R, Moutzouros V. Return to Sport Following Adolescent Concussion: Epidemiologic Findings From a High School Population. Orthopedics 2020; 43:e306-e310. [PMID: 32501519 DOI: 10.3928/01477447-20200521-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/29/2019] [Indexed: 02/03/2023]
Abstract
High school athletes sustaining a concussion require careful attention when determining return-to-sport (RTS) readiness. The purpose of this study was to determine epidemiological and RTS data of a large cohort of high school athletes who sustained 1 or more concussions. Records of 357 consecutive youth patients who sustained concussions and presented to a single health care system between September 2013 and December 2016 were reviewed. Demographic data, RTS, and concussion-related variables were obtained via chart review. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores at baseline and following concussions were performed by neuropsychologists. The average age at injury was 15.5 years (range, 14-18 years), 61.9% of patients were male, 6.7% reported a loss of consciousness, and 14.3% reported amnesia, requiring 30.4±23.3 days of recovery prior to RTS. The most common sport of injury was football (27.7%). There was a high incidence of previous concussion (33.1%), and 32 athletes sustained a recurrent concussion. A multivariate model demonstrated that females, players with a history of concussion, and those diagnosed in-clinic rather than in-game required increased time to RTS. Memory ImPACT scores were found to increase as players had recurrent concussions. Visual motor speed and reaction time scores decreased with recurrent concussions. [Orthopedics. 2020;43(4):e306-e310.].
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DePadilla PhD L, Miller PhD GF, Everett Jones PhD Mph Jd S. Characteristics of Schools with Youth Sports Concussion-Related Educational Policies and Practices. J Sch Health 2020; 90:520-526. [PMID: 32350884 DOI: 10.1111/josh.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 09/02/2019] [Accepted: 10/22/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND School policies and practices designed to educate athletes, parents, and coaches about youth sports concussions may be a way to reduce concussion risk and improve both the recognition and management of concussions. METHODS Nationally representative data from the 2014 School Health Policies and Practices Study (SHPPS) were used to assess associations between school demographic characteristics (eg, school level, metropolitan status, and school type) and school policies and practices addressing youth sports concussion-related education for athletes, parents, and coaches. RESULTS Overall, many schools had policies and practices that addressed youth sports concussion-related education for athletes, parents, and coaches. There was significant variability in the adoption of policies and practices by some school demographic characteristics. Middle schools, private schools, and urban schools were less likely to adopt many of the policies and practices than high schools, public schools, and rural schools, respectively. For other school characteristics, no consistent patterns of associations emerged. CONCLUSIONS These findings suggest that middle, private, and urban schools, in particular, are more likely to lack youth sports concussion-related educational policies and practices and may need information or resources about the importance of education related to preventing, recognizing, and responding to concussions.
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Affiliation(s)
- Lara DePadilla PhD
- Health Scientist, , Division of Overdose Prevention, National Center for Injury for Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA., USA
| | - Gabrielle F Miller PhD
- Economist, , Division of Injury Prevention, National Center for Injury for Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA., USA
| | - Sherry Everett Jones PhD Mph Jd
- Health Scientist, , Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA., USA
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13
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Abstract
Ulnar collateral ligament (UCL) injuries can significantly impair the overhead athlete. Reconstruction of the anterior bundle of the UCL (UCL-R) has allowed a high proportion of these individuals to return to their previous level of play. Several techniques for UCL-R are described that produce acceptable results with an overall low complication rate. Transient ulnar neuritis is the most common complication following UCL-R. The rate of UCL injury in young athletes is rising with increased youth involvement and year-round participation in overhead sports. The sports medicine community must broaden its focus to not only treat UCL injuries but also prevent them.
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Affiliation(s)
- Edward Lyle Cain
- Andrews Sports Medicine and Orthopaedic Center, American Sports Medicine Institute, 805 St. Vincent's Drive, Suite 100, Birmingham, AL 35205, USA.
| | - Mims G Ochsner
- Andrews Sports Medicine and Orthopaedic Center, American Sports Medicine Institute, 805 St. Vincent's Drive, Suite 100, Birmingham, AL 35205, USA
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Meyers RN, Hobbs SL, Howell DR, Provance AJ. Are Adolescent Climbers Aware of the Most Common Youth Climbing Injury and Safe Training Practices? Int J Environ Res Public Health 2020; 17:ijerph17030812. [PMID: 32012970 PMCID: PMC7037851 DOI: 10.3390/ijerph17030812] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 01/03/2023]
Abstract
Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the 2017 USA Climbing Sport and Speed Youth National Championships. A total of 267 climbers completed the survey (mean age = 14 ± 2.7 years; 52% male). The A2 pulley injury was reported as the most common youth climbing injury by the largest portion of participants, 36%. The second most commonly identified injury was at the growth plate of the finger, 15% of participants, which was reported as significantly less than the A2 pulley injury, p < 0.001. Six percent of climbers reported the correct safe age to start double dyno campus board training. Roughly 18% of athletes identified growth plate injuries exclusively as a stress fracture, whereas 29.2% of those climbers self-reported as informed about finger growth plate injuries, but only 7.4% of climbers who self-reported as uninformed answered this question correctly. Misperceptions about skeletally-immature climbing injuries are prevalent amongst youth climbers. Education on the prevalence of finger growth plate injuries and the scarcity of A2 pulley injuries in youth climbers can increase diagnostic accuracy, improve care, and reduce long-term complications.
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Affiliation(s)
- Rachel N. Meyers
- Physical Therapy Division, Duke University School of Medicine, Durham, NC 27710, USA
- Correspondence:
| | - Steven L. Hobbs
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - David R. Howell
- Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO 80045, USA; (D.R.H.); (A.J.P.)
- School of Medicine, University of Colorado Hospital, Aurora, CO 80045, USA
| | - Aaron J. Provance
- Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO 80045, USA; (D.R.H.); (A.J.P.)
- School of Medicine, University of Colorado Hospital, Aurora, CO 80045, USA
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15
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Yang J, Yeates K, Sullivan L, Singichetti B, Newton A, Xun P, Taylor HG, MacDonald J, Pommering T, Tiso M, Cohen D, Huang Y, Patterson J, Lu ZL. Rest Evaluation for Active Concussion Treatment (ReAct) Protocol: a prospective cohort study of levels of physical and cognitive rest after youth sports-related concussion. BMJ Open 2019; 9:e028386. [PMID: 31015276 PMCID: PMC6501995 DOI: 10.1136/bmjopen-2018-028386] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Although current guidelines for the early clinical management of sports-related concussion (SRC) call for a gradual return-to-activity, the optimal level of rest needed to promote recovery remains unknown. This paper describes the protocol of the Rest Evaluation for Active Concussion Treatment (ReAct) study which objectively measures physical and cognitive rest following SRC and its relation to recovery among youth athletes. METHODS AND ANALYSIS Youth athletes aged 11-17 years are recruited preinjury and enrolled within 72 hours following a physician-diagnosed concussion. Injury information and acute clinical presentation are assessed at the time of injury. Youth participants are prospectively followed to objectively monitor daily physical and cognitive rest using two electronic devices: ActiGraph (to measure physical rest and sleep) and Narrative Clip (to measure cognitive rest), along with self-reported postconcussive symptoms using daily surveys. Other concussion outcomes, including functional outcomes, are assessed by surveying youth and their parents at three time points: (1) within 72 hours of injury, (2) at day 7 postenrolment and (3) at symptom resolution (or a maximum of 45 days postconcussion). ETHICS AND DISSEMINATION This study has received ethical approval from the Institutional Review Board (IRB) at the participating institution (IRB at Nationwide Children's Hospital, IRB16-00613). The results of the study will be presented at national and international scientific conferences and published in peer-reviewed journals.
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Affiliation(s)
- Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Keith Yeates
- Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lindsay Sullivan
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Bhavna Singichetti
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Alison Newton
- Center for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
| | - H Gerry Taylor
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - James MacDonald
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Sports Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Thomas Pommering
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Sports Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Michael Tiso
- Sport and Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Daniel Cohen
- Pediatrics, The Ohio State University, Columbus, Ohio, USA
- Emergency Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Yungui Huang
- Research Information Solution and Innovation, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Jeremy Patterson
- Research Information Solution and Innovation, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Zhong-lin Lu
- Psychology, The Ohio State University, Columbus, Ohio, USA
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16
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Abstract
In the United States, there has been a steady increase in sports participation across all age groups. An estimated 27 million youths between the ages of 6 and 18 years participate in team sports, and 60 million participate in some form of organized athletics. While there are great benefits from sports participation, early single sport specialization carries an increased risk of overuse injuries and burnout. Specialization has become increasingly popular among parents and coaches due to the common belief that it is the best way to develop an elite athlete. However, for most sports, there is no evidence that specialization before puberty is necessary to achieve elite status and in fact, there is evidence to the contrary. A recent American Orthopaedic Society for Sports Medicine (AOSSM) consensus statement has highlighted the negative side effects of early sports specialization; these include increased risk for overuse injury and burnout. School nurses are well-positioned to affect this issue through providing education and raising awareness of the potential detrimental consequences associated with youth sport specialization.
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Affiliation(s)
- Elizabeth Matzkin
- Chief of Women's Sports Medicine, Brigham and Women's Hospital, Boston, MA
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17
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Williams CE, Puro JS, Armstrong PW. Perspectives On The Changing Treatment Protocols of concussions in Youth Sports. MD Advis 2018; 11:5-9. [PMID: 30570902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Catherine E Williams
- Senior Vice President, Business Development and Corporate Secretary, MDAdvantage Insurance Company
| | - Janet S Puro
- MPH, MBA, Vice President, Business Development and Corproate Communications, MDAdvantage Insurance Company
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18
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Adubato S. Youth Sport Injuries: An Interview with Vincent K. McInerney, MD. MD Advis 2018; 11:E40-E41. [PMID: 30570909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Steve Adubato
- PhD, four-time Emmy Award-winning anchor, Thirteen/WNET (PBS) and NJTV (PBS)
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Abstract
Adequate sleep can easily become compromised as student-athletes try to balance the multiple demands on their time. People with sleep deficiency are at increased risk for acute illnesses, traumatic sports injuries, and development of chronic diseases. Training sessions or competitions during extremely early or late hours can interfere with circadian and homeostatic rhythms. Adjusting the training schedule to improve sleep duration has a significantly positive impact on several aspects of athletic performance. Pediatricians should increase the time dedicated in well-child visits for sleep hygiene and evaluate for sleep disorders at all ages. Parents, coaching staff, teachers, and pediatricians should advocate for improved education on the importance of sleep during adolescence. Future sleep research specific to adolescent athletes can further delineate requirements specific to sport, gender, training times, and surrounding competitions. [Pediatr Ann. 2017;46(3):e106-e111.].
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