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.

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.

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.

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.

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.

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.

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.

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.

Sports hernia and femoroacetabular impingement in athletes: A systematic review

AIM: To investigate the association between sports hernias and femoroacetabular impingement(FAI) in athletes.METHODS: Pub Med, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism.RESULTS: FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone(89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries.CONCLUSION: The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.

Acute ankle sprain in athletes:Clinical aspects and algorithmic approach

Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.

Evaluation and treatment of internal impingement of the shoulder in overhead athletes

One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulderpain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial,involving physiologic shoulder remodeling,posterior capsular contracture,and scapular dyskinesis. Throwers with internal impingement may complain of shoulder stiffness or the need for a prolonged warm-up,decline in performance,or posterior shoulder pain. On physical examination,patients will demonstrate limited internal rotation and posterior shoulder pain with a posterior impingement test. Common imaging findings include the classic "Bennett lesion" on radiographs,as well as articular-sided partial rotator cuff tears and concomitant SLAP lesions. Mainstays of treatment include intense non-operative management focusing on rest and stretching protocols focusing on the posterior capsule. Operative management is variable depending on the exact pathology,but largely consists of rotator cuff debridement. Outcomes of operative treatment have been mixed,therefore intense non-operative treatment should remain the focus of treatment.

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.

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.

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.

Balance Performance in Female Collegiate Athletes

Proper balance is essential for athletes during competition and training as sport places different balance requirements on the human body. The purpose of the study was to analyze balance performance among female athletes using COP （center of pressure） sway parameters. Twenty one NCAA （National Collegiate Athletic Association） division I female athletes （soccer, volleyball and dance） completed the study. Static balance was assessed using UST （unilateral stance test） and dynamic balance was assessed using MCT （motor control test） on the NeuroCom Equitest. Sway velocities, root mean square sway and reaction time latencies were used to quantify balance. A one-way between subjects ANOVA （analysis of variance） was performed to analyze these balance parameters. Significant （p 〈 0.05） differences between groups were found and post hoc comparisons revealed that the volleyball and dance groups had better static balance compared to soccer players, while both soccer and volleyball groups had better dynamic balance compared to the dance group. The results from the study indicate two points： first, differences in balance performance among female athletes in different sporting discipline; second, there is no relationship between static and dynamic balance. This indicates that it may be more beneficial to assess and train for static and dynamic balance individually.

Athletes who train on unstable compared to stable surfaces exhibit unique postural control strategies in response to balance perturbations

Background:Athletes have been shown to exhibit better balance compared to non-athletes(NON).However,few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain balance.Two distinct athlete groups who experience different types of sport-specific balance training are stable surface athletes(SSA) such as basketball players and those who train on unstable surfaces(USA) such as surfers.The purpose of this study was to investigate the effects of training surface on dynamic balance in athletes compared to NON.Methods:Eight NON,eight SSA,and eight USA performed five 20-s trials in each of five experimental conditions including a static condition and four dynamic conditions in which the support surface translated in the anteroposterior(AP) or mediolateral(ML) planes using positive or negative feedback paradigms.Approximate entropy(Ap En) and root mean square distance(RMS) of the center of pressure(Co P) were calculated for the AP and ML directions.Four 3 × 5(group × condition) repeated measures ANOVAs were used to determine significant effects of group and condition on variables of interest.Results:USA exhibited smaller Ap En values than SSA in the AP signals while no significant differences were observed in the ML Co P signals.Generally,the negative feedback conditions were associated with significantly greater RMS values than the positive feedback conditions.Conclusion:USA exhibit unique postural strategies compared to SSA.These unique strategies seemingly exhibit a direction-specific attribute and may be associated with divergent motor control strategies.

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.

Validation of the functional rating index for the assessment of athletes with neck pain

AIM: To validate the culturally-adapted Persian Functional Rating Index(PFRI) for assessing neck pain(NP) in athletes. METHODS: In this cross-sectional study, 100 athletes with NP and 50 healthy athletes participated and responded to the PFRI. Fifty athletes with NP completed the PFRI for at least 7 d later to establish test-retest reliability. RESULTS: The athletes with NP responded to all items, indicating excellent clinical utility. No floor and ceiling effects were found, indicating content validity and responsiveness. The PFRI revealed capability to discriminate between the athletes with NP and healthy athletes. The PFRI demonstrated strong correlation with the Numerical Rating Scale(Spearman's rho = 0.94), and the Persian Neck Disability Index(Pearson r = 0.995), supporting criterion and construct validity. Internal consistency reliability was high(Cronbach's α coefficient: 0.97). The test-retest reliability was excellent(ICCagreement = 0.96). The absolute reliability values of standard error of measurement and smallest detectable change were 3.2 and 8.84, respectively. An exploratory factor analysis yielded one factor explaining 78.03% of the total variance. CONCLUSION: The PFRI is a valid and reliable measure of functional status in athletes with NP.