Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

Barriers and Motivators of Young Dutch Elite Athletes for Optimizing Their Nutritional Intake

Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and motivators of young Dutch elite athletes to optimize their nutritional intake. Quantitative and qualitative research was conducted among 8 handball and 4 volleyball players at the Dutch National Sports Center (17.2 ± 0.8 years). First, the nutritional intake was tracked through food diaries and analyzed in Nutritics. Thereupon, five semi-structured interviews based on the COM-B model were carried out. The interviews were transcribed and coded. The athletes had a reduced intake of energy, carbohydrates, vitamins A, C, E, D, calcium, potassium, zinc, and iron compared to their requirements. Seven themes for optimizing their nutritional intake emerged in the interviews: needs assessment, practical translation, portion size, lack of time, involvement, individuality, and food distribution. Barriers that the athletes experienced were that they did not know what their total daily nutritional needs were and how this translates into practice. In addition, the portion size at dinner was too small. They also had little time to eat a full meal due to time pressure from training and school. On the other hand, motivators were receiving meal options to translate their needs into practice with a distribution of moments when they need to eat. Covering these topics in nutritional workshops where athletes actively participate with more individual focus, could contribute to the optimization of their nutritional intake.

The Influence of Swimming Athletes’ Burnout on Their Sports Participation Motivation in Hunan, China

Objective:This study aims to explore the effect of swimming athletes’burnout on their sports motivation in Hunan University,China.It seeks to understand how burnout influences various motivational factors,providing insights for optimizing swimming sports courses and enhancing student participation.Method:Employing random sampling,the study surveyed 260 swimming athletes from Hunan University.The research utilized a questionnaire divided into three parts:demographic information,the Athlete Burnout Questionnaire(ABQ),and the Intrinsic Motivation Inventory(IMI).Pearson’s r correlation analysis was conducted using SPSS to examine the relationships between burnout dimensions and motivational factors.Results:The study found significant correlations between a reduced sense of accomplishment and various motivational dimensions,including“interest/enjoyment,”“perceived competence,”“perceived choice,”and particularly“perceived tension.”Physical exhaustion showed a significant correlation only with“perceived tension,”indicating a strong link between psychological stress and physical fatigue.Sports devaluation was significantly correlated with“perceived tension,”suggesting that psychological stress impacts athletes’valuation of their sport.Conclusion:The findings highlight the complex interplay between burnout and motivation in swimming athletes.Psychological stress,as indicated by“perceived tension,”emerges as a key factor influencing both the physical and emotional aspects of burnout.The study underscores the need for holistic training approaches that balance physical training with psychological well-being,personalized coaching,and supportive environments to enhance intrinsic motivation and manage stress effectively.

Injury and illness in short-course triathletes:A systematic review

Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

How University Athletics Can Impact Mental Health among Student Athletes at the University of Evansville

In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.

The good,the bad,and the ugly of consumer sleep technologies use among athletes:A call for action

1.Introduction For athletes,the quality and quantity of sleep are essential elements for optimizing recovery and subsequent performance.1 Unfortunately,athletes frequently face challenges getting sufficient,high-quality sleep.2 A recent systematic review and meta-analysis of 81 studies involving 1830 athletes concluded that compared to healthy non-athletes,athletes'sleep duration was shorter with poorer sleep efficiency.

Lower serum magnesium concentration and higher 24-h urinary magnesium excretion despite higher dietary magnesium intake in athletes:a systematic review and meta-analysis

Magnesium plays a critical role in the human's life activities and energy metabolism. This study aimed to evaluate the magnesium status of athletes via a systematic review of cross-sectional studies. A comprehensive systematic search was conducted in PubMed, Web of Science, SPORTDiscus, Cochrane Library electronic databases, and other sources before April 5, 2021. Fourteen studies were included in the systematic review, involving 855 athletes and 521 control subjects. Serum magnesium concentration was significantly lower in athletes(mean difference(MD):-0.04 mmol/L;95% confidence interval(CI):-0.06 to-0.01;P = 0.02)in spite of significantly higher dietary magnesium intake(MD: 51.72 mg/day;95% CI: 14.62 to 88.83;P = 0.006). Meta-analysis showed that 24-h urinary magnesium excretion in athletes was significantly higher than that in the untrained population(MD: 0.76 mmol/day;95% CI: 0.11 to 1.41;P = 0.02). Despite higher total dietary magnesium intake, athletes generally have lower serum magnesium concentration and higher 24-h urinary magnesium excretion, demonstrating that the magnesium requirement of athletes is higher than the untrained population. It is necessary to carry out a dietary assessment and nutrition counseling to help athletes adopt proper diets to meet their nutritional needs in exercise.

Assessment of functional prognosis of anterior cruciate ligament reconstruction in athletes based on a body shape index

BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.AIM To verify the relationship between a body shape index(ABSI)and the functional prognosis of the knee after ACLR in athletes with ACL injuries.METHODS We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020,with a follow-up period of more than 24 mo.First,all populations were divided into a High-ABSI group(ABSI>0.835,n=38)and a Low-ABSI group(ABSI<0.835,n=38)based on the arithmetic median(0.835)of ABSI values.The primary exposure factor was ABSI,and the outcome indicators were knee function scores as well as postoperative complications.The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.RESULTS The preoperative knee function scores of the two groups were similar.The surgery and postoperative rehabilitation exercises,range of motion(ROM)compliance rate,Lysholm score,and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased,whereas the quadriceps atrophy index gradually decreased.The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up(P<0.05).In multifactorial logistic regression,ABSI was a risk factor of low knee joint function score after surgery,specifically low ROM scores(odds ratio[OR]=1.31,95%confidence interval[CI][1.10-1.44];P<0.001),low quadriceps atrophy index(OR=1.11,95%CI[0.97-1.29];P<0.05),low Lysholm scores(OR=2.34,95%CI[1.78-2.94];P<0.001),low symptoms(OR=1.14,95%CI[1.02-1.34];P<0.05),low activity of daily living(OR=1.34,95%CI[1.18-1.65];P<0.05),low sports(OR=2.47,95%CI[1.78-2.84];P<0.001),and low quality of life(OR=3.34,95%CI[2.88-3.94];P<0.001).ABSI was also a risk factor for deep vein thrombosis of the lower limb(OR=2.14,95%CI[1.88-2.36],P<0.05]and ACL recurrent rupture(OR=1.24,95%CI[0.98-1.44],P<0.05)after ACLR.CONCLUSION ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR,and the risk of poor knee function after ACLR,deep vein thrombosis of lower limb,and ACL recurrent rupture gradually increases with the rise of ABSI.

Heart Rate Variability as an Indicator of Stress in Students’ Athletes

Introduction: The wellbeing of student’s athletes has a paramount importance, a prolonged period of cognitive and physical performance that characterizes the life of student’s athletes often leads to fatigue, and a psychobiological state that increases the risk of injury and accidents. The use of Heart rate variability (HRV) has become increasingly popular as a non-invasive methodology that provides an indirect insight into the autonomic nervous system. HRV can be utilized as a diagnostic tool in detection of autonomic nervous system impairment and sympatho-vagal imbalance. HRV technology is employed to monitor the internal response of athletes to workload and identify athletes’s psychophysical stress to predict and therefore prevent injuries. Objective: The objective of the investigation is to establish whether the use of Polar H10 sensor heart rate monitors worn by athletes in a sitting position (inclination 60 degrees) during periods characterized by stress can provide a valid and non-invasive method to assess the psychophysiological state during sports competition and school exams. Method and Statistics: In the study, the HRV of 12 basketball students athletes and 4 students non-athletes was analyzed as a control group. The autonomic nervous system activity was assessed based on heart variability parameters (HRV): SDNN, rMSSD, LF, HF, and LF/HF. The measurements were made after establishing the baseline at rest, during the training phase (CT), competition phase (CC) and during the acute phase of stressors due to school exams coinciding with the competitive season (CC + E). Results: Compared to the respective values prior to the stress of the competitions and exams, a significant decrease in HRV indices was found: SDNN (P Conclusions: The analysis and examination of the data on the sample of the student population also showed a statistically significant correlation between decreased cardiac variability and injuries or indisposition to physical exertion.

Association between ACTN3 R577X genotype and risk of non-contact injury in trained athletes:A systematic review

Purpose:The aim of this study was to review,systematically,evidence concerning the link between the ACTN3 R577X polymorphism and the rates and severity of non-contact injuries and exercise-induced muscle damage in athletes and individuals enrolled in exercise training programs.Methods:A computerized literature search was performed in the electronic databases PubMed,Web of Science,and SPORTDiscus,from inception until November 2020.All included studies compared the epidemiological characteristics of non-contact injury between the different genotypes of the ACTN3 R577X polymorphism.Results:Our search identified 492 records.After the screening of titles,abstracts,and full texts,13 studies examining the association between the ACTN3 genotypes and the rate and severity of non-contact injury were included in the analysis.These studies were performed in 6 different countries(Spain,Japan,Brazil,China,the Republic of Korea,and Italy)and involved a total participant pool of 1093 participants.Of the studies,2 studies involved only women,5 studies involved only men,and 6 studies involved both men and women.All the studies included were classified as highquality studies(≥6 points in the Physiotherapy Evidence Database(PEDro)scale score).Overall,evidence suggests there is an association between the ACTN3 R577X genotype and non-contact injury in 12 investigations.Six studies observed a significant association between A CTN3 R577X polymorphism and exercise induced muscle damage:2 with non-contact ankle injury,3 with non-contact muscle injury,and 1 with overall non-contact injury.Conclusion:The present findings support the premise that possessing the ACTN3 XX genotype may predispose athletes to a higher probability of some non-contact injuries,such as muscle injury,ankle sprains,and higher levels of exercise-induced muscle damage.

Investigating the Effect of COVID-19 Infection on Professional Athletes’ Post-Infection with a Focus on Fatigue and Chronic Fatigue Syndrome

Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar effects are observed in an athlete population. The aetiology and pathophysiology are poorly understood but is thought to be multi-factorial. Patient reported outcome measures are commonly used to improve patient-centred outcomes (PROMs). They are essential to assess patient quality of life post-COVID infection. This paper aims to assess the effect of COVID-19 on athletes’ long-term fatigue and CFS and identify the PROMs used to characterise this. Methodology: Articles were selected for extraction based on the eligibility criteria and PRISMA guidelines. The inclusion criteria required papers to assess competitive athletes over eighteen years of age who were clinically diagnosed with COVID-19. Articles were extracted to assess different variables including type of sport, type of athlete and ethnicity. Key terms were obtained using MeSH trees and utilised with Web of Science and NCBI Pubmed. Papers were graded by quality using the Hawker quality assessment tool. Results and Discussion: Forty articles (N = 40) were identified for full-text screening (N = 8). Eight were selected for extraction based on the eligibility criteria. Data was obtained on athlete characteristics, sport characteristics, properties of PROM measurement techniques and fatigue presentation. Male athletes were found to be 10% - 50% more likely than female athletes to suffer from persistent fatigue symptoms (N = 2). Persistent fatigue was present in 9% - 10% Athletes from mixed backgrounds and genders (N = 2). Initial fatigue was documented to be between 47% - 56% (N = 2). A heterogenous range of PROMs were utilised to assess symptoms including fatigue and excluded emotional or mental fatigue. Conclusion: COVID-19 is associated with signs of persisting fatigue and potentially CFS in athlete populations. More work needs to be done to develop standardised and validated PROMs specific to CFS.

Visual efficiency among teenaged athletes and non-athletes

AIM：To compare visual efficiency,specifically accommodation,vergence,and oculomotor functions among athletes and non-athletes.METHODS：A cross-sectional study on sports vision screening was used to evaluate the visual skills of 214elementary students（107 athletes,107 non-athletes）,aged between 13 and 16y.The visual screening assessed visual parameters such as ocular motor alignment,accommodation,and vergence functions.RESULTS：Mean visual parameters were compared between age-group matched athletes（mean age14.82±0.98y）and non-athletes（mean age 15.00±1.04y）.The refractive errors of all participants were corrected to maximal attainable best corrected visual acuity of log MAR0.0.Accommodation function assessment evaluated amplitude of accommodation and accommodation facility.Vergence functions measured the near point of convergence,vergence facility,and distance fusional vergence at break and recovery point.Ocular motor alignment was not statistically significant between both groups.Athletes had a statistically significant amplitude of accommodation for both the right eye（t=2.30,P=0.02）and the left eye（t=1.99,P=0.05）.Conversely,non-athletes had better accommodation facility（t=-2.54,P=0.01）and nearpoint of convergence（t=4.39,P〈0.001）when compared to athletes.Vergence facility was found to be better among athletes（t=2.47,P=0.01）.Nevertheless,non-athletes were significantly better for both distance negative and positive fusional vergence.CONCLUSION：Although the findings are still inconclusive as to whether athletes had superior visual skills as compared to non-athletes,it remains important to identify and elucidate the key visual skills needed by athletes in order for them to achieve higher performance in their sports.

Application of Serum CK and BUN Determination in Monitoring Pre-Competition Training of Badminton Athletes

In order to investigate the feasibility of serum creatine kinase （CK） and blood urea nitrogen （BUN） in monitoring pre-competition training of badminton athletes, the pre-competition training load of 20 badminton athletes was studied, and serum CK and BUN were determined before, immediate and next morning after training. The results showed that after intensive training for one week, serum CK levels were significantly increased by 57.53 mmol/L （P〈0.05）. After regulation of the training intensity, average serum CK levels were increased by 21.79 mmol/L （P〈0.05）. BUN contents were increased by 0.83 mmol/L on average with the difference being not significant （P〉0.05）. After intermittent training, there was significant difference in the average increased levels of serum CK in athletes （P〈0.05）. There was significant difference before and after regulation of training （P〈0.05）. The increased levels of BUN were 0.78 mmol/L without significant difference （P〉0.05）. It was concluded that serum CK was one of the biochemical indicators monitoring the training load sensitivity of badminton athletes, but BUN was of little value in monitoring the training load. Both serum CK and BUN recovered slowly after one-week intensive training and intermittent training, suggesting the metabolic mechanism of human body in training needs further study.

Analysis of stress fractures in athletes based on our clinical experience

AIM:To analyze stress fractures in athletes based on experience from our sports medicine clinic.METHODS:We investigated the association between stress fractures and age,sex,sports level,sports activity,and skeletal site in athletes seen at our sports medicine clinic between September 1991 and April 2009.Stress fractures of the pars interarticularis were excluded from this analysis.RESULTS:During this period(18 years and 8 mo),14276 patients(9215 males and 5061 females)consulted our clinic because of sports-related injuries,and 263 patients(1.8%)[171 males(1.9%)and 92 females(1.8%)]sustained stress fractures.The average age of the patients with stress fractures was 20.2 years(range 10-46 years);112 patients(42.6%)were 15-19 years of age and 90(34.2%)were 20-24 years of age.Altogether,90 patients(34.2%)were active at a high recreational level and 173(65.8%)at a competitive level.The highest proportion of stress fractures was seen in basketball athletes(21.3%),followed by baseball(13.7%),track and field(11.4%),rowing(9.5%),soccer(8.4%),aerobics(5.3%),and classical ballet(4.9%).The most common sites of stress fractures in these patients were the tibia(44.1%),followed by the rib(14.1%),metatarsal bone(12.9%),ulnar olecranon(8.7%)and pelvis(8.4%).The sites of the stress fractures varied from sport to sport.The ulnar olecranon was the most common stress fracture site in baseball players,and the rib was the most common in rowers.Basketball and classical ballet athletes predominantly sustained stress fractures of the tibia and metatarsal bone.Track and field and soccer athletes predominantly sustained stress fractures of the tibia and pubic bone.Aerobics athletes predominantly sustained stress fractures of the tibia.Middle and long distance female runners who sustained multiple stress fractures had the female athlete triad.CONCLUSION:The results of this analysis showed that stress fractures were seen in high-level young athletes,with similar proportions for males and females,and that particular sports were associated with specific sites for stress fractures.Middle and long distance female runners who suffered from multiple stress fractures had the female athlete triad.

Enhanced inhibitory control during re-engagement processing in badminton athletes:An event-related potential study

Purpose:The purpose of present study was to investigate the impact of sport experience on response inhibition and response re-engagement in expert badminton athletes during the stop-signal task and change-signal task.Methods:A total of 19 badminton athletes and 20 nonathletes performed both the stop-signal task and change-signal task.Reaction times(RTs)and event-related potentials were recorded and analyzed.Results:Behavioral results indicated that badminton athletes responded faster than nonathletes to go stimuli and to change signals,with faster change RTs and change-signal RTs,which take into consideration the variable stimulus onset time mean.During successful change trials in the change-signal task,the amplitudes of the event-related potential components N2 and P3 were smaller for badminton athletes than for nonathletes.Moreover,change-signal RTs and N2 amplitudes as well as change RTs and P3 amplitudes were significantly correlated in badminton athletes.A significant correlation was also found between the amplitude of the event-related potential component N1 and response accuracy to change signals in badminton athletes.Conclusion:Moderation of brain cortical activity in badminton athletes was more associated with their ability to rapidly inhibit a planned movement and re-engage with a new movement compared with nonathletes.The superior inhibitory control and more efficient neural mechanisms in badminton athletes compared with nonathletes might be a result of badminton athletes’ professional training experience.

Effect of different stretching strategies on the kinetics of vertical jumping in female volleyball athletes

Purpose： The present study aimed to examine the effect of static stretching （SS） and a sport-specific dynamic stretching （DS） session at two specific post-stretch time intervals in highly trained female athletes （age 19.90 ± 1.60 years; height 1.80 ±0.06 m; mass 76.87 ± 9.95 kg） on kinetic parameters of peak force, time-to-takeoff, and rate of force development. Methods： The data were collected over 3 days （randomized within subject design with control session）. Following each stretch session （SS vs. DS vs. control） of equal duration （7 min total： 30 s per targeted muscle group） participants performed countermovement jumping on a force platform at 1 and 15 rain after stretching. Results： The DS session significantly improved upon kinetic variables of rate of force development, peak force, and time-to-takeoffrelative to SS at 1 min after stretching. No significant effect was found at 15 min. Conclusion： Together these findings suggest that when training and competing to jump quickly and maximally the female athlete should incorporate DS instead of SS as part of their pre-competition warm-up, but conduct performance within 15 min of their warm-up to elicit maximal gains

Sex differences in injury rates in team-sport athletes:A systematic review and meta-regression analysis

Background:Team-sport players have a particularly high injury risk.Although female sex is considered a risk factor,it is still unknown whether female and male team-sport players,in fact,differ in their injury rates.We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries.Methods:Studies that prospectively collected injury data for high-level female and male players(age≥16 years)in basketball,field hockey,football(soccer),handball,rugby(union and sevens),and volleyball were included.Two reviewers(AZ and ALR)independently assessed study quality and extracted data for overall,match,training,and severe injuries(>28 days’time loss)as well as data regarding injury locations and types.Incidence rate ratios(IRRs)were pooled in a meta-analysis,and meta-regression analysis was performed when 10 or more studies were available.Results:Of 20 studies,9 studies reported injury data from football,3 studies from rugby,3 studies from handball,1 study from basketball,1 study from field hockey,2 studies from volleyball,and 1 study from basketball and field hockey.For overall injuries,the pooled IRR=0.86(95%confidence interval(95%CI):0.76-0.98)indicated significantly more injuries in male than in female players.For injury location,the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity,hip/groin,thigh,ande foot injuries.Female players had a significantly higher rate of anterior cruciate ligament injuries(IRR=2.15,95%CI:1.27-3.62)than male players.No significant sex-specific differences in IRR were found for match,training,severe injuries,concussions,or ankle sprains.Conclusion:Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports.Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.

Jones type fifth metatarsal fracture fixation in athletes:A review and current concept

Jones type fifth metatarsal fracture is a common occurrence among athletes at all levels.These fractures may occur due to several mechanisms,but inversions and twisting injuries are considered some of the leading causes in sports.However,while Jones fracture incidences are frequent in the sporting world,there is still a lack of consensus on how such fractures should be effectively managed.There are numerous treatment options for patients with fifth metatarsal Jones fractures.The role of nonoperative treatment remains controversial,with concerns about delayed union and nonunion.Surgical stabilization of metatarsal Jones fractures is therefore often recommended for athletes,as it is often associated with a low number of complications and a higher rate of union than nonoperative management.This review will focus on literature regarding the prevalence of Jones type fifth metatarsal fracture,alongside the efficacy of both conservative and surgical treatment within this population.

Pre-participation screening for the prevention of sudden cardiac death in athletes

Pre-partecipation screening is the systematic practice of medically evaluating large populations of athletes before participation in sport activities for the purpose of identifying abnormalities that could cause disease progression or sudden death.In order to prevent sudden cardiac death(SCD),cardiovascular screening should include a strategy for excluding high-risk subjects from athletic and vigorous exercise.There are two major screening programmes in the world.In the United States competitive athletes are screened by means of family and personal history and physical examination.In Italy there is a mandatory screening for competitive athletes,which includes a resting electrocardiogram(ECG)for the detection of cardiac abnormalities.The most important issue to be addressed is whether a screened subject is really guaranteed that she/he is not suffering from any cardiac disease or at risk for SCD.Conceivably,the introduction of echocardiogram during the pre-participation screening,could be reasonable,despite the discrete sensitivity of ECG,in raising clinical suspicions of severe cardiac alterations predisposing to SCD.It is clear that the costbenefit ratio per saved lives of the ECG screening is abenchmark of the Public Health policy.On the contrary,the additional introduction of echocardiography in a large population screening programme seems to be too much expansive for the Public Health and for this reason not easily practicable,even if useful and not invasive.Even if we strongly believe that a saved life is more important than any cost-efficacy evaluation,the issue of the economical impact of this approach should be further assessed.