Football is the most popular sport among US high school students and among the highest for sport-related concussion (SRC) incidence. Limited data detail how SRCs affect high school football players' psychosocial and health status beyond short-term injury recovery. To longitudinally assess how SRCs affected symptoms, depression, and health-related quality of life (HRQoL) in high school football players up to 12 months after SRC. Prospective cohort study. Thirty-one Wisconsin high schools. A total of 1176 interscholastic football players (age = 16.0 ± 1.2 years). Participants completed the Post-concussion Symptom Scale (PCSS) from the Sport Concussion Assessment Tool 3 (SCAT3), Patient Health Questionnaire-9 (PHQ-9) for depression, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for HRQoL at enrollment. Participants who sustained an SRC repeated each measure within 72 hours of their injury (onset) and at 7 days (D7), return to play (RTP), and 3 months (M3), 6 months (M6), and 12 months (M12) after SRC. Scores at each time point were compared with each participant's baseline using linear mixed models for repeated measures while controlling for age and previous SRC with participant as a random effect. Sixty-two participants sustained an SRC. Participants reported a higher number of PCSS symptoms, greater symptom severity, and lower PedsQL physical summary scores at onset and D7. From RTP through M12, PCSS symptoms, PCSS severity scores, PedsQL total scores, physical summary, and psychosocial summary were unchanged or improved relative to baseline. The PHQ-9 scores were not higher than baseline at any post-SRC interval. High school football players in this study who sustained an SRC described no sustained adverse health outcomes (increased PCSS symptoms or symptom severity, increased depression symptoms, or lower HRQoL) after their RTP through M12 after injury.Context
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Understanding how parents and their children perceive concussion symptoms may provide insights into optimal concussion-management strategies. To examine patient-parent correlations and agreement on concussion-symptom ratings, to identify differences in patient-parent symptom reporting between children (8–12 years of age) and adolescents (13–18 years of age), and to evaluate the correlation between patient and parent initial symptom-severity ratings with symptom duration and return-to-play time. Cross-sectional study. Primary care sports medicine clinic. A total of 267 patients aged 8 to 18 years seen for care within 21 days of sustaining a concussion. Patients were classified as children (n = 65; age = 11.3 ± 1.4 years; age range, 8–12 years) or adolescents (n = 202; age = 15.5 ± 1.4 years; age range, 13–18 years). Each patient and his or her parent (or legal guardian) completed a concussion-symptom–frequency inventory, the Health and Behavior Inventory (HBI), at the initial postinjury examination. Patients were followed until they no longer reported concussion symptoms (symptom-resolution time) and were allowed to return to unrestricted sport participation (return-to-play time). At the initial examination (8.9 ± 5.2 days postinjury), the symptom-frequency correlation between children and their parents was high (rs = 0.88; 95% confidence interval [CI] = 0.80, 0.95). Adolescents' symptom-frequency reports were also highly correlated with those of their parents (rs = 0.78; 95% CI = 0.71, 0.85). However, the child-parent correlation was higher than the adolescent-parent agreement (z = 2.21, P = .03). Greater patient (consolidated child and adolescent) HBI ratings were associated with longer symptom-resolution times (coefficient = 0.019; 95% CI = 0.007, 0.031; P = .002) and longer return-to-play times (coefficient = 0.012; 95% CI = 0.002, 0.022; P = .02), whereas parent HBI ratings were not. Our findings may help to set expectations regarding concussion-symptom durations and return-to-play timing for pediatric patients and their families. Given the patient-parent correlations in our sample, substantial reporting discrepancies between patients and their parents may be a relevant factor for clinicians to investigate further during concussion evaluations.Context
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Although it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited. To examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes. Cross-sectional study. Middle School students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys. Overall, 541 athletes representing 18 sports returned fully completed surveys. Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant. Odds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75). Developmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.Context
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Concussion-symptom education remains the primary approach used by athletic trainers to address underreporting of possible sport-related concussions. Social marketing represents an untapped approach to promote concussion reporting by communicating the benefits or consequences of reporting or not reporting, respectively. To apply expectancy value theory and identify how marketing the possible consequences of concealing concussion symptoms influenced young adults' concussion-reporting beliefs to increase the likelihood of reporting. Randomized controlled clinical trial. Laboratory. A total of 468 competitive collegiate club sport athletes at a large US university who engaged in 1 of 46 sports with various levels of concussion risk. Participants were randomly assigned by team to 1 of 3 conditions. The treatment condition was a social-marketing program focused on the possible consequences of the reporting decision. The control condition was traditional concussion-symptom education based on the National Collegiate Athletic Association's publication, “Concussion: A Fact Sheet for Student-Athletes.” An additional condition mirrored the traditional symptom education but included a less clinical delivery. Positive and negative beliefs regarding concussion reporting were assessed. We applied expectancy value theory, which posits that changing beliefs in the short term will produce greater reporting intentions in the long term. Club sport athletes exposed to consequence-based social marketing showed higher levels of positive reporting beliefs and lower levels of negative reporting beliefs than athletes exposed to traditional or revised symptom education. We observed no differences between the traditional and revised symptom-education programs. Exposure to consequence-based marketing decreased negative beliefs about reporting (B = −0.165, P = .01) and increased positive beliefs about reporting (B = 0.165, P = .01). Social marketing offers athletic trainers another strategic tool for motivating athletes to report concussion symptoms by translating scientific findings into marketable statements and then communicating the benefits of reporting or the negative consequences of concealing concussion symptoms.Context
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Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and subacute (3 days–3 months) periods after concussion. The Sport Concussion Assessment Tool (SCAT) is an acute assessment that, when compared with other concussion symptom inventories, includes or excludes symptoms that may result in different symptom factors. The primary purpose was to investigate the symptom factor structure of the 22-item SCAT symptom inventory in healthy, uninjured and acutely concussed high school and collegiate athletes. The secondary purpose was to document the frequency of the unique SCAT symptom inventory items. Case series. High school and college. A total of 1334 healthy, uninjured and 200 acutely concussed high school and collegiate athletes. Healthy, uninjured participants completed the SCAT symptom inventory at a single assessment. Participants in the acutely concussed sample completed the SCAT symptom inventory within 72 hours after concussion. Two separate exploratory factor analyses (EFAs) using a principal component analysis and varimax extraction method were conducted. A 3-factor solution accounted for 48.1% of the total variance for the healthy, uninjured sample: cognitive-fatigue (eg, feeling “in a fog” and “don't feel right”), migraine (eg, neck pain and headache), and affective (eg, more emotional and sadness) symptom factors. A 3-factor solution accounted for 55.0% of the variance for the acutely concussed sample: migraine-fatigue (eg, headache and “pressure in the head”), affective (eg, sadness and more emotional), and cognitive-ocular (eg, difficulty remembering and balance problems) symptom factors. The inclusion of unique SCAT symptom inventory items did not alter the symptom factor structure for the healthy, uninjured sample. For the acutely concussed sample, all but 1 unique SCAT symptom inventory item (neck pain) loaded onto a factor.Context
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A growing number of high-school–aged athletes participate on club sport teams. Some, but not all, state concussion laws apply to both interscholastic and private sport organizations. However, concussion education, management plans, and knowledge have not been examined in club coaches who coach high school-aged athletes. To determine if differences in concussion education, management plans, and knowledge exist between high school coaches and coaches of club sport teams. Cross-sectional study. Online survey. A total of 769 coaches (497 high school coaches, 272 club coaches coaching high school-aged athletes; 266 women [34.6%], 503 men [65.4%]) completed an anonymous online questionnaire. The questionnaire consisted of demographic and team information, requirements for concussion-education and -management plans, and concussion knowledge. High school coaches were more likely than club coaches to report that their organizing bodies or leagues required them to receive concussion-education information (97.4% versus 80.4%; P < .001) and that their organizing bodies or leagues had a concussion-management plan (94.0% versus 70.2%; P < .001). High school coaches were more likely than club coaches to correctly agree that most concussions resolve in 7 to 10 days (48.6% versus 40.1%; P = .02) and disagree that loss of consciousness is required to diagnose a concussion (87.1% versus 80.9%; P = .02). Club coaches were less likely to be aware of requirements for concussion-education and -management plans from their parent organizations and scored lower on specific concussion-knowledge questions than high school coaches despite the same education requirements across groups under their state concussion laws. These results raise concerns regarding the proper management of concussions in club sports and suggest a need for greater oversight and enforcement of state laws in the club sport setting.Context
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Emergency action plans (EAPs) are a critical component in the management of catastrophic sport-related injury. Some state high school athletics associations and state legislation have required that schools develop EAPs, but little research exists on the influence of a statewide policy requirement on local adoption of these policies. To examine the efficacy of a statewide policy requirement on local adoption of an EAP. Cross-sectional study. Online questionnaire. Secondary school athletic trainers were invited to complete a survey (n = 9642); 1136 completed the survey, yielding an 11.7% response rate. Survey responses on the adoption of EAPs along with cardiopulmonary resuscitation and automated external defibrillator (CPR/AED) requirements were cross-referenced with published statewide policies to determine the prevalence of EAP adoption. We evaluated the adoption of emergency action plan components based on the National Athletic Trainers' Association's emergency planning position statement along with CPR/AED requirements to determine component-specific prevalence. We compared the prevalence of EAP and component adoption between states that required EAPs and specific components of EAPs and states without such requirements. Athletic trainers in states that required adoption of an EAP reported including more components of the emergency planning position statement (mean = 8 ± 4, median = 9) than in states without a requirement (mean = 7 ± 4, median = 8). The adoption of EAP components did not differ between states that required specific components of the EAP versus development of the EAP only. However, schools in states with both EAP and CPR/AED training requirements reported higher rates of CPR/AED training implementation (95.5%) than states that only required CPR/AED training (81.6%, prevalence ratio = 1.10, 95% confidence interval = 1.01, 1.20). Based on these data, statewide policy requirements for the development of an EAP may be associated with increasing adoption of EAPs.Context
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Health care providers, including athletic trainers (ATs), may not be using the best practices for diagnosing exertional heat stroke (EHS), including rectal thermometry. Therefore, patients continue to be susceptible to death from EHS. To examine the health belief model and its association with using rectal thermometry as the best practice for diagnosing EHS. Cross-sectional study. Web-based survey. A total of 208 secondary school ATs completed an online survey, and the data of 159 were included in the analysis. The survey contained 2 primary sections: AT characteristics and health belief model structured questions assessing perceptions and techniques used to diagnose EHS. Answers to the latter questions were rated on a 5-point Likert scale. We performed a binary logistic regression to ascertain the effects of the health belief model constants (eg, perceived susceptibility, barriers), age, sex, and the type of school at which the AT worked on the likelihood that participants would use best practice for diagnosing patients with EHS. Only 33.3% (n = 53) of the participating ATs reported they used best practice, including rectal thermometers to obtain core body temperature. The binary logistic regression was different for the 5 constructs: perceived susceptibility (\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\(\chi _6^2\) = 22.30, P = .001), perceived benefits (\(\chi _6^2\) = 71.79, P < .001), perceived barriers (\(\chi _6^2\) = 111.22, P < .001), perceived severity (\(\chi _6^2\) = 56.27, P < .001), and self-efficacy (\(\chi _6^2\) = 64.84, P < .001). Analysis of these data showed that older ATs were at greater odds (P ≤ .02) of performing best practice. These data suggested that the health belief model constructs were associated with the performance of best practice, including using rectal thermometry to diagnose EHS. Researchers should aim to create tailored interventions based on health behavior to improve the adoption of best practice.Context
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Athletic trainers (ATs) are educated and trained in appropriate exertional heat-stroke (EHS) management strategies, yet disparities may exist between intended and actual uses in clinical practice. To examine the intended and actual uses of EHS management strategies among those who did and those who did not treat patients with suspected cases of EHS during the 2017 high school (HS) American football preseason. Cross-sectional study. Online questionnaire. A total of 1016 ATs who oversaw patient care during the 2017 HS American football preseason. Responding HS ATs recorded whether they had or had not managed patients with suspected EHS events during the 2017 HS American football preseason. Those who had managed patients with suspected cases of EHS reported the management strategies used; those who had not managed such patients described their intended management strategies. For each management strategy, z tests compared the proportions of actual use among ATs who managed patients with suspected EHS with the proportions of intended use among ATs who did not manage such patients. Overall, 124 (12.2%) ATs treated patients with suspected EHS cases during the 2017 HS American football preseason. Generally, the proportions of intended use of management strategies among ATs who did not treat patients with suspected EHS were higher than the actual use of those strategies among ATs who did. For example, ATs who did treat patients with suspected EHS were more likely than those who did not treat such patients to intend to take rectal temperature (19.6% versus 3.2%, P < .001) and immerse the athlete in ice water (90.1% versus 51.6%, P < .001). Inconsistencies occurred between intended and actual use of EHS management strategies. The standard of care for managing patients with suspected cases of EHS was not consistently used in clinical practice, although ATs who did not treat EHS stated they intended to use these management strategies more frequently. Future researchers should identify factors that preclude ATs from using the standard of care when treating patients with suspected cases of EHS.Context
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Athletic trainers (ATs) recognize patient care documentation as an important part of clinical practice. However, ATs using 1 electronic medical record (EMR) platform reported low accountability and lack of time as barriers to documentation. Whether ATs using paper, other EMRs, or a combined paper-electronic system exhibit similar behaviors or experience similar challenges is unclear. To explore ATs' documentation behaviors and perceived challenges while using various systems to document patient care in the secondary school setting. Qualitative study. Individual telephone interviews. Twenty ATs (12 women, 8 men; age = 38 ± 14 years; clinical experience = 15 ± 13 years; from National Athletic Trainers' Association Districts 2, 3, 6, 7, 8, 9, and 10) were recruited via purposeful and snowball-sampling techniques. Two investigators conducted semistructured interviews, which were audio recorded and transcribed verbatim. Following the consensual qualitative research tradition, 3 researchers independently coded transcripts in 4 rounds using a codebook to confirm codes, themes, and data saturation. Multiple researchers, member checking, and peer reviewing were the methods used to triangulate data and enhance trustworthiness. The secondary school setting was central to 3 themes. The ATs identified challenges to documentation, including lack of time due to high patient volume and multiple providers or locations where care was provided. Oftentimes, these challenges affected their documentation behaviors, including the process of and criteria for whether to document or not, content documented, and location and timing of documentation. To enhance patient care documentation, ATs described the need for more professional development, including resources or specific guidelines and viewing how documentation has been used to improve clinical practice. Challenges particular to the secondary school setting affected ATs' documentation behaviors, regardless of the system used to document care. Targeted professional development is needed to promote best practices in patient care documentation.Context
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Female patients with anterior cruciate ligament reconstruction (ACLR) are less likely to return to sport than males. Psychological readiness predicts successful return to sport, but it is unclear if psychological experiences differ between males and females during recovery. To explore gender differences in psychological readiness factors of return to sport after ACLR. Qualitative study. Laboratory. A total of 12 male (months since surgery = 6.2 ± 1.2) and 13 female (months since surgery = 6.4 ± 1.3) high school athletes with a history of ACLR. Participants were interviewed before physician clearance to return to activity. Transcribed interviews were analyzed using deductive thematic coding of 5 themes identified from previous research (psychological distress, self-efficacy, locus of control, athletic identity, and fear of reinjury) and inductive secondary subthematic coding. Gender comparisons were generated within primary themes and secondary subthemes. All deductive themes were consistently reinforced. Male and female participants reported fear of movement, loss of athletic identity, and motivational mindsets for return to sport and self-improvement. Males reported a stronger sense of internal locus of control using positive internal reinforcement, whereas females described balancing internal and external control and valuing external support systems. Male participants described mood changes influenced by physical and social limitations. Female participants closely monitored their emotions throughout recovery and were influenced by rehabilitation fluctuations. Male and female high school athletes described different psychological factors related to return to sport and locus of control as well as psychological distress. Gender-specific psychological interventions may be warranted to overcome psychological barriers after ACLR.Context
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Gait biomechanics are linked to biochemical changes that contribute to the development of posttraumatic knee osteoarthritis in individuals with anterior cruciate ligament reconstruction (ACLR). It remains unknown if modifying peak loading during gait using real-time biofeedback will result in acute biochemical changes related to cartilage metabolism. To determine if acutely manipulating peak vertical ground reaction force (vGRF) during gait influences acute changes in serum cartilage oligomeric matrix protein concentration (sCOMP) among individuals with ACLR. Crossover study. Thirty individuals with unilateral ACLR participated (70% female, age = 20.43 ± 2.91 years old, body mass index = 24.42 ± 4.25, months post-ACLR = 47.83 ± 26.97). Additionally, we identified a subgroup of participants who demonstrated an increase in sCOMP after the control or natural loading condition (sCOMPCHANGE > 0 ng/mL, n = 22, 70% female, age = 20.32 ± 3.00 years old, body mass index = 24.73 ± 4.33, months post-ACLR = 47.27 ± 29.32). Serum was collected both prior to and immediately after each condition to determine sCOMPchange. All participants attended 4 sessions that involved 20 minutes of walking on a force-measuring treadmill consisting of a control condition (natural loading) followed by random ordering of 3 loading conditions with real-time biofeedback: (1) symmetric vGRF between limbs, (2) a 5% increase in vGRF (high loading) and (3) a 5% decrease in vGRF (low loading). A general linear mixed model was used to determine differences in sCOMPCHANGE between altered loading conditions and the control group in the entire cohort and the subgroup. The sCOMPCHANGE was not different across loading conditions for the entire cohort (F3,29 = 1.34, P = .282). Within the subgroup, sCOMPCHANGE was less during high loading (1.95 ± 24.22 ng/mL, t21 = −3.53, P = .005) and symmetric loading (9.93 ± 21.45 ng/mL, t21 = −2.86, P = .025) compared with the control condition (25.79 ± 21.40 ng/mL). Increasing peak vGRF during gait decreased sCOMP in individuals with ACLR who naturally demonstrated an increase in sCOMP after 20 minutes of walking. ClinicalTrials.gov (NCT03035994)Context
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Trial Registry
A smaller lumbar multifidus (LM) muscle was reported to be a strong predictor of lower limb injury in professional Australian Football League players. However, despite the high prevalence of low back pain (LBP) and lower limb injury in rugby players, their LM characteristics have yet to be explored. To (1) examine LM characteristics in male and female university rugby players and their possible associations with LBP and lower limb injury and (2) investigate the relationship between LM characteristics and body composition in this group of athletes. Cross-sectional study. University research center. Thirty-four university rugby players (20 women, 14 men). Ultrasound measurements of LM cross-sectional area (CSA), thickness, and percentage change in thickness during contraction were obtained bilaterally, at the L5-S1 level, in prone and standing positions. Body composition measures were obtained using dual-energy x-ray absorptiometry. Self-reported questionnaires were used to obtain LBP and lower limb injury history. Players who reported LBP in the previous 3 months showed a smaller percentage change in thickness during contraction in the standing position (F = 5.21, P = .03). The LM CSA side-to-side asymmetry (right versus left) was greater in players who reported having a lower limb injury in the previous 12 months (F = 4.98, P = .03). The LM CSA was significantly associated with body composition measurements. A greater percentage change in thickness during contraction was significantly associated with a lower percentage of body fat. The LM echo intensity was strongly associated with the total percentage of body fat and was significantly greater in women. The influence of body composition on LM morphology in athletes cannot be ignored and warrants further investigation. Our findings also provide preliminary evidence of an association among LM morphology, LBP, and lower limb injury in university rugby players.Context
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In the past 10 years, participation in boys' youth and high school lacrosse has increased by 33%. Among many club teams and tournaments, athletes may not have access to medical coverage. Additionally, these athletes face a higher volume of play than in traditional scholastic sport settings. To describe the injury characteristics of boys' nonscholastic youth and high school club lacrosse athletes over the course of a summer season. Descriptive epidemiology study. Boys' nonscholastic youth and high school lacrosse athletes, aged 8 to 18 years, who competed in tournaments. Athletic trainers at tournaments were given standardized injury report forms to document patient encounters. These reports were then entered into the Datalys Injury Surveillance Tool. Over the summer tournament season, 233 injuries were reported in 109 342 athlete-exposures (AEs) for an injury rate of 2.13 per 1000 AEs (95% confidence interval = 1.87, 2.42). The most frequently injured body parts were the head and/or face (n = 51, 22%), arm and/or elbow (n = 34, 15%), and hand and/or wrist (n = 29, 12%). The most common diagnoses were contusions (n = 63, 27%), concussions (n = 44, 19%), fractures (n = 39, 17%), and sprains (n = 35, 15%). The most often injured position was midfielder (n = 65, 41%), followed by defense (n = 48, 30%), attack (n = 36, 23%), and goalkeeper (n = 9, 6%). The concussion rate was 0.4 per 1000 AEs (95% confidence interval = 0.28, 0.52). The injury rate experienced by boys' nonscholastic club lacrosse athletes was similar to the rates of their high school counterparts as well as school-sponsored football and wrestling athletes. Because of the risk of injury, athletic training services should be available for youth and high school club lacrosse tournaments.Context
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Reliability and Validity of the Functional Assessment of Neurocognition in Sport (FANS): A Paradigm Shift in Post-Concussion Return-to-Sport Decision-Making
Driving After Concussion: Clinical Measures Associated with Post-concussion
The role of shoulder posture in pitching mechanics and injury risk in high school baseball pitchers
Corticospinal Excitability during Standing and Its Association with Postural Control Following Acute Lateral Ankle Sprain.
The socio-economic cost of anterior cruciate ligament injuries and lateral ankle sprains in amateur football and basketball.
JAT eISSN: 1938-162X
JAT ISSN: 1062-6050
ATEJ ISSN: 1947-380X