Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers

Purpose: The purpose of this study was to determine whether practicing athletic trainers(ATs) were using the stepwise progression to make return-to-play(RTP) decisions after concussion and to determine what factors influenced their decision to use the stepwise progression.Methods: A total of 166 ATs(response rate = 16.6%) completed a 21-item questionnaire that evaluated participant demographics, methods of concussion management, and RTP decision-making using the stepwise progression. Descriptive statistics and a logistic regression were completed to analyze data.Results: Factors such as education level(p = 0.05) and number of concussions treated(p = 0.05) predicted use of the stepwise progression,whereas sex(p = 0.17), employment setting(p = 0.17), state law(p = 0.86), and years practicing(p = 0.17) did not predict whether ATs were following the stepwise progression.Conclusion: The majority of the ATs from this study are employing the stepwise progression to safely return athletes to play after sustaining a concussion. This demonstrates that ATs are providing a standard of care for concussed athletes across various athletic training settings; however,having a graduate degree and treating more concussions per year are predictors of whether an AT follows all steps of the stepwise progression.

An Examination of Concussion Injury Rates in Various Models of Football Helmets in NCAA Football Athletes

While newer, advanced helmet models have been designed with the intentions of decreasing concussions, very little research exists on injury rates in various football helmets at the collegiate level. The aim of this study was to examine concussion injury rates in various models of football helmets in collegiate football athletes. In addition, to compare injury rates of newer, advanced football helmets to older, traditional helmets among collegiate football athletes, a total of 209 concussions and 563,701 AEs （athlete-exposures） among 2,107 collegiate football athletes in seven helmet models were included in the analyses. Concussion injury rates revealed that the Riddell Revolution~ had the highest rate of 0.41 concussions per 1,000 AEs. The Schutt ION 4DTM helmet had the lowest rate of 0.25 concussions per 1,000 AEs. These newer helmet models did not significantly differ from one another （P = 0.74）, however, all models significantly differed from the older, traditional helmet model （P 〈 0.001）. The findings of this study suggest that concussion rates do not differ between newer and more advanced helmet models. More importantly, there are currently no helmets available to prevent concussions from occurring in football athletes.

Look into my eyes:What can eye-based measures tell us about the relationship between physical activity and cognitive performance?

Background:There is a growing interest to understand the neurobiological mechanisms that drive the positive associations of physical activity and fitness with measures of cognitive performance.To better understand those mechanisms,several studies have employed eye-based measures(e.g., eye movement measures such as saccades,pupillary measures such as pupil dilation,and vascular measures such as retinal vessel diameter)deemed to be proxies for specific neurobiological mechanisms.However,there is currently no systematic review providing a comprehensive overview of these studies in the field of exercise-cognition science.Thus,this review aimed to address that gap in the literature.Methods:To identify eligible studies,we searched 5 electronic databases on October 23,2022.Two researchers independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale,for interventional studies) and the critical appraisal tool from the Joanna Briggs Institute(for cross-sectional studies).Results:Our systematic review(n=35 studies) offers the following main findings:(a) there is insufficient evidence available to draw solid conclusions concerning gaze-fixation-based measures;(b) the evidence that pupillometric measures,which are a proxy for the noradrenergic system,can explain the positive effect of acute exercise and cardiorespiratory fitness on cognitive performance is mixed;(c) physical training-or fitness-related changes of the cerebrovascular system(operationalized via changes in retinal vasculature) are,in general,positively associated with cognitive performance improvements;(d) acute and chronic physical exercises show a positive effect based on an oculomotor-based measure function(operationalized via antisaccade tasks);and(e) the positive association between cardiorespiratory fitness and cognitive performance is partly mediated by the dopaminergic system(operationalized via spontaneous eye-blink rate).Conclusion:This systematic review offers confirmation that eye-based measures can provide valuable insigt into the neurobiological mechanisms that may drive positive associations between physical activity and fitness and measures of cognitive performance.However,due to the limited number of studies utilizing specific methods for obtaining eye-based measures(e.g.,pupillometry,retinal vessel analysis,spontaneous eye blink rate) or investigating a possible dose-response relationship,further research is necessary before more nuanced conclusions can be drawn.Given that eye-based measures are economical and non-invasive,we hope this review will foster the future application of eye-based measures in the field of exercise-cognition science.

Group dynamics motivation to increase exercise intensity with a virtual partner

Background: The effect of the K?hler group dynamics paradigm(i.e., working together with a more capable partner where one's performance is indispensable to the team outcome) has been shown to increase motivation to exercise longer at a strength task in partnered exercise video games (exergames) using a software-generated partner(SGP). However, the effect on exercise intensity with an SGP has not been investigated. The purpose of this study was to examine the motivation to maintain or increase exercise intensity among healthy, physically active middle-aged adults using an SGP in an aerobic exergame.Methods: Participants(n = 85, mean age = 44.9 years) exercised with an SGP in a 6-day cycle ergometer protocol, randomly assigned to either(a)no partner control,(b) superior SGP who was not a teammate, or(c) superior SGP as a teammate(team score was dependent on the inferior member). The protocol alternated between 30-min continuous and 4-min interval lhigh-intensity session days, during which participants could change cycle power output(watts) from target intensity to alter distance and speed.Results: Mean change in watts from a targeted intensity(75% and 90% maximum heart rate) was the primary dependent variable reflecting motivational effort. Increases in performance over baseline were demonstrated without significant differences between conditions. Self-efficacy and enjoyment were significantly related to effort in the more intense interval sessions.Conclusion: Under these conditions, no K?hler effect was observed. Exercise performance during the higher-intensity interval format is more closely related to enloyment and self-efficacy beliefs compared to the continuous sessions.

Selectively breeding for high voluntary physical activity in female mice does not bestow inherent characteristics that resemble eccentric remodeling of the heart,but the mini-muscle phenotype does

Physical activity engagement results in a variety of positive health outcomes,including a reduction in cardiovascular disease risk partially due to eccentric remodeling of the heart.The purpose of this investigation was to determine if four replicate lines of High Runner mice that have been selectively bred for voluntary exercise on wheels have a cardiac phenotype that resembles the outcome of eccentric remodeling.Adult females(average age 55 days)from the 4 High Runner and 4 non-selected control lines were anaesthetized via vaporized isoflurane,then echocardiographic images were collected and analyzed for structural and functional differences.High Runner mice in general had lower ejection fractions compared to control mice lines(2-tailed p=0.0236)and tended to have thicker walls of the anterior portion of the left ventricle(p=0.065).However,a subset of the High Runner individuals,termed mini-muscle mice,had greater ejection fraction(p=0.0006),fractional shortening percentage(p<0.0001),and ventricular mass at dissection(p<0.0027 with body mass as a covariate)compared to non-mini muscle mice.Mice from replicate lines bred for high voluntary exercise did not all have inherent positive cardiac functional or structural characteristics,although a genetically unique subset of mini-muscle individuals did have greater functional cardiac characteristics,which in conjunction with their previously described peripheral aerobic enhancements(e.g.,increased capillarity)would partially account for their increased VO2max.

Joint association of physical activity/screen time and diet on CVD risk factors in 10-year-old children

The increasing prevalence of childhood overweight and obesity has been associated with an increased risk for cardiovascular disease(CVD).While several studies examined the effect of single behaviors such as physical activity(PA),sedentary behavior or diet on CVD risk,there is a lack of research on combined associations,specifically in children.Therefore,the purpose of this study was to examine the joint association of PA or screen time(ST)and diet on CVD risk factors in children.PA,STand diet were assessed via questionnaire in 210 fifth grade students(age:10.6±0.4 years).The healthy eating index(HEI)was subsequently calculated as indicator for diet quality.Height,weight,% body fat,and resting blood pressure were measured according to standard procedures and blood samples obtained via fingerprick were assayed for blood lipids.Total cholesterol HDL ratio(TC:HDL),mean arterial pressure(MAP),and % body fat were used as indicators of CVD risk.55% of children did not meet current PA recommendations on at least 5 days/week and 70% exceeded current recommendations for ST.Further,only 2.5% possessed a“good”diet(HEI>80).There was no significant association of PA or STand diet on CVD risk score.Neither TC:HDL,MAP,and % body fat nor the total CVD risk score was significantly correlated with diet,PA,or ST.Children in the high PA group,however,had significantly better diet scores.Despite the fact that self-reported PA,ST,or dietary intake were not directly related to CVD risk in this sample,higher activity levels were associated with a healthier diet and lower ST indicating an overall healthier lifestyle of this subgroup.

C-reactive protein and telomerase reverse transcriptase(TERT)associate with chronic disease markers in a sample from low-income neighborhoods in Detroit,Michigan

Racial and ethnic minorities in economically deprived inner cities experience high rates of chronic diseases compared to neighborhoods with higher socioeconomic status(SES).However,these economically deprived populations are understudied in terms of biomarkers associated with chronic disease risk which include C-reactive protein(CRP),telomerase reverse transcriptase(TERT),and glycosylated hemoglobin(A1C).We examined relationships between CRP and TERT and chronic disease indicators(body mass index[BMI]and A1C)in two lowincome,predominantly African American(AA)neighborhoods in Detroit,Michigan.Sixty-nine adults(43 females,26 males,mean age 46 years[y],standard deviation[SD]=15.9)completed a health survey,anthropometry,and finger stick blood tests.A1C was measured using A1CNow test strips,and CRP and TERT levels were measured using enzyme-linked immunosorbent assay(ELISA)with samples extracted from dried blood spots.We examined CRP(mean=4.9,SD=3.1),TERT(mean=32.5,SD=15.1),and A1C(mean=5.4,SD=1.0)by BMI category.We fitted restricted maximum likelihood regression models to evaluate associations between CRP,TERT,BMI,and A1C,after adjustment for demographics and inclusion of a random effect for the neighborhood.In this predominantly AA sample(91%,63/69),68%had levels of CRP(means=4.8 mg/L,SD=3.0 for AAs;6.4 mg/L,SD=3.9 for all others)indicative of chronic inflammation(CRP greater than 3 mg/L).BMI was significantly associated with CRP(p=0.004)and TERT(p=0.026).TERT levels indicate that being overweight is associated with markers of chromosome remodeling,suggestive of chronic disease.CRP followed a similar trend with overweight individuals having higher inflammation and risk of chronic disease.Our findings warrant further exploration of additional factors that may influence CRP and TERT.Furthermore,examining populations in a more ethnically and/or economically diverse,yet still high proportion minority,sample will fill a knowledge gap in this understudied field.