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Context: Studies have illustrated that overuse injuries occur in adolescent athletes more often than previously reported. The general purpose of this study was to provide a thorough report of secondary school athletic trainers encounters, practices, and perceptions of overuse injury in adolescent athletes., Design: Cross-sectional., Methods: An anonymous online questionnaire was distributed via email to athletic trainers in the secondary school setting. The questionnaire was sent to participants during the summer of 2021 and 430 participants (highest educational degree earned: master's degree = 66%) completed the survey. Various survey methods were used to evaluate athletic trainers (1) demographics, (2) estimations about what percentage of injuries evaluated and treated were classified as overuse, (3) methods for treating overuse injuries, (4) confidence in treating overuse injuries and the complete implementation of their treatment plan, (5) perceptions of various barriers to treating overuse injuries, and (6) perception as to why patients did not want to reduce activity to treat their overuse injuries., Results: Participants reported that about half of all evaluations and treatments in a year were overuse injuries and they were "fairly" or "completely" confident (90%) in their ability to treat these injuries. The most common treatments cited were stretching (91%) and reducing activity (90%). Only 61% of participants were "fairly" or "completely" confident in the complete implementation of their treatment plan. Participants believed that patients' reluctance to reduce sport activities (82% "moderate" or "extreme" barrier) was the most significant barrier to treatment. Participants cited athletes' avoidance of missing games as the most common reason athletes were reluctant to reduce sporting activity., Conclusions: Participants felt confident in treating overuse injuries yet faced significant barriers in treating these injuries. Clinicians should be prepared to have conversations about the importance of reducing sporting activity to allow proper healing for overuse injuries in adolescent athletes.

Objectives: Studies that evaluate the effectiveness of concussion laws often use only a single variable (ie, presence of the law), failing to account for law complexity. We examined the association between multiple design elements of state concussion laws and rates of sports-related concussion reporting among US high school athletes., Methods: We derived 3 design elements of concussion laws from the 2009-2017 LawAtlas database: (1) strength of law, (2) number of law revisions, and (3) speed of law adoption. We examined the association between these design elements and rates of new and recurrent sports-related concussion reporting from the 2009-2010 through 2016-2017 academic years in a nationally representative sample of high school athletes participating in High School Report Information Online, an online data collection tool., Results: A total of 7064 sports-related concussions (6332 [89.6%] new and 732 [10.4%] recurrent concussions) were reported during the study period, with an overall rate of 39.7 sports-related concussions per 100 000 athletic exposures (eg, game or practice). Rates of new concussion reporting were higher among high schools in states with medium- or high-strength concussion laws than in states with low-strength concussion laws and in states with at least 1 concussion law revision than in states with no concussion law revisions. Rates of recurrent concussion reporting were lower among high schools in states with ≥2 concussion law revisions than in states with <2 concussion law revisions. Early law adoption was associated with higher rates of new and recurrent concussion reporting, and late law adoption was associated with lower rates of new and recurrent concussion reporting., Conclusion: Our findings may help inform legislators of the public health effect of concussion laws.

Objectives: To describe concussion rates in high school athletes and involvement of healthcare professionals in concussion diagnosis, management and compliance with return to play (RTP) guidelines., Methods: Data were analysed from injury reports in the National High School Sports-Related Injury Surveillance System between 2009/2010 and 2012/2013 to identify student athletes with concussion and determine compliance with RTP guidelines. Compliance with RTP guidelines was examined using logistic regression, adjusting for sport and injury-related variables., Results: There were 5611 concussions recorded during 15 712 475 athlete exposures (AEs), a rate of 3.6 concussions per 10 000 AEs. Rates were higher during competition and among girls compared to boys in gender equitable sports. Healthcare professionals were less likely to be present at the time of concussion for girls' sports, lower competition levels and practices. Compliance with RTP guidelines was higher for athletes with recurrent concussions, those sustained in collision sports, for athletes reporting more symptoms and when a physician made the RTP decision., Conclusions: Presence of healthcare professionals and compliance with RTP guidelines varied by sport, gender, level of play and exposure type. High school athletes with concussion are best served by assessment teams with athletic trainers and physicians working together to manage concussions and contribute to RTP decisions.

Purpose: School-based athletic programs remain an important context for violence prevention efforts although a better understanding of how gender attitudes and abuse perpetration differ among athletes is needed., Methods: We analyzed baseline survey data from the "Coaching Boys into Men" study-a school-based cluster-randomized trial in 16 high schools in Northern California. We describe relationships among gender-inequitable attitudes, sport type, and recent adolescent relationship abuse perpetration among a sample of male athletes (n = 1,648)., Results: Gender-inequitable attitudes (adjusted odds ratio (AOR), 3.26; 95% confidence interval (CI), 2.56, 4.15), participation in both high school football and basketball (AOR, 2.08; 95% CI, 1.37, 3.18), and participation in football only (AOR, 1.50; 95% CI, 1.02, 2.22) emerged as independently associated with recent ARA perpetration., Conclusions: Findings warrant targeted violence prevention efforts among male high school athletes that incorporate discussions of gender attitudes and healthy relationships, especially among sports teams at greater risk of adolescent relationship abuse perpetration., (Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Sport schools are popular environments for simultaneously delivering education and sport to young people. Previous research suggests sport school involvement to have impact (i.e. the positive/negative, intended/unintended and long/short-term outcomes, results and effects) on student athlete's holistic (i.e. academic, athletic, psychosocial and psychological) development. However, previous research is limited by (1) cross-sectional methods, (2) limited multidimensional assessments, (3) lack of consideration for athlete characteristics (e.g. sex) and (4) failure to evaluate how sport school features affect student-athlete impacts. Objectives: The study, using a mixed methods case study approach, aims to (1) longitudinally evaluate the impact of sport school involvement on the holistic development of student athletes, (2) evaluate the impact on holistic development by student-athlete characteristics and (3) explore the features and processes of the sport–school programme that drive/facilitate holistic impacts. Methods: A longitudinal mixed methods design was employed across one full academic school year (33 weeks). Six data-collection methods (i.e. online questionnaire, physical fitness testing battery, academic assessment grades, log diaries, field notes/observation and timeline diagram/illustration) were used to assess the academic, athletic, psychosocial and psychological impacts for 72 student athletes from one sport school in the United Kingdom (UK). Results: Student athletes developed positive long-term holistic overall impacts (i.e. academically, athletically and personally), including maintaining stable and relatively high levels of sport confidence, academic motivation, general recovery, life skills, resilience and friends, family and free time scores. Despite positive impacts, juggling academic and sport workload posed challenges for student athletes, having the potential to lead to negative holistic impacts (e.g. fatigue, stress and injury). Positive and negative impacts were linked to many potential features and processes of the sport school (e.g. academic and athletic support services versus insufficient training load build-up, communication, coordination, flexibility and planning). Furthermore, when considering student-athlete characteristics, females had lower sport confidence, higher general stress and body image concerns and less general recovery than males and student athletes who played sport outside the school had lower general recovery. Conclusions: This mixed method, longitudinal study demonstrated sport school involvement resulted in many positive academic (e.g. good grades), athletic (e.g. fitness development), psychosocial (e.g. enhanced confidence) and psychological (e.g. improved resilience) impacts attributed to the academic and athletic support services provided. However, juggling heavy academic and athletic workloads posed challenges leading to negative impacts including fatigue, pressure, stress and injury. Furthermore, holistic impacts may be sex dependent and further support may be required for female student athletes in sport school environments. Overall, these findings demonstrate the complex nature of combining education and sport commitments and how sport schools should manage, monitor and evaluate the features of their programme to maximise the holistic impacts of sport–school student athletes. [ABSTRACT FROM AUTHOR]

Objective The first objective was to establish the respective factor structures of a concussion perceptions inventory that was adapted for youth athletes (ages 8–14 years) and their parents from the Perceptions of Concussion Inventory for Athletes. The second objective was to understand the associations between the concussion perceptions of youth athlete–parent dyads. Method In this cross-sectional study, 329 parent–youth athlete dyads completed a respective concussion perception inventory. Mean age of youth respondents was 10.9 ± 1.8 years (70.1% male) and mean age of parent respondents was 40.5 ± 13.6 years (60.9% female). Results Exploratory factor analyses revealed unique 7-factor structures for both the youth athlete and parent inventories (youth athlete: anxiety, clarity, treatment, permanent injury, symptom variability, long-term outcomes, and personal control; parent: anxiety, clarity, treatment, permanent injury, symptom variability, and long-term outcomes, and affect others). Weak associations were found between dyads on the 5 factors that were composed of identical items (anxiety, clarity, treatment, permanent injury, and symptom variability). Conclusions Findings suggest that this adapted inventory has adequate psychometric properties to be used in the study of the concussion perceptions of youth athletes and their parents. Weak correlations across the concussion perceptions in the dyads suggest that parents and children hold different concussion perceptions and this should be considered in instrument selection of future studies. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence rates (IRs) of catastrophic injuries and exertional medical events in lacrosse athletes. Methods: Catastrophic injuries and exertional medical events in lacrosse in the US among youth or amateur, high school and college athletes were analysed from the National Center for Catastrophic Sport Injury Research (NCCSI R) database from 1982/83 to 2019/20. Frequencies, IRs per 100,000 athlete-seasons (AS) with 95% confidence intervals (CIs), and incidence rate ratios (IRRs) with 95% CIs were calculated. Participation data were gathered from the National Federation of State High School Associations (NFHS), National Collegiate Athletic Association (NCAA) and USA Lacrosse. Results: Sixty-nine catastrophic events (16 youth or amateur, 36 high school and 17 college; 84% male) occurred in US lacrosse from 7/1/1982 to 6/30/2020. Thirty-six percent of all incidents were fatal. The overall IR was 0.5 per 100,000 AS (95% CI: 0.4-0.7). There were 15 cases of non-traumatic sudden cardiac arrests (SCA s) and 15 incidents of commotio cordis. Fatality rates from SCA and commotio cordis decreased 95% (IRR = 0.05; 95% CI: 0, 0.2) from 1982/83-2006/07 to 2007/08-2019/20. Incidence rates were higher for collegiate versus high school 1982/83-2019/20 (IRR = 3.2; 95% CI: 1.8, 5.7) and collegiate versus youth 2005/06-2019/20 (IRR = 8.0; 95% CI: 3.0, 21.4) level. Contact with a stick or ball (41%) and contact with another player (20%) were the primary mechanisms of injury. Conclusions: The incidence of catastrophic events during lacrosse was higher among collegiate than high school or youth athletes. SCA from an underlying cardiac condition or from commotio cordis was the most common catastrophic event. Fatality rates from catastrophic injuries have declined significantly over the study period, perhaps driven by protective measures adopted by lacrosse governing bodies. [ABSTRACT FROM AUTHOR]

Background: Concussions in Rugby Union are common with an increased risk to adolescent players. Coaches are key to injury prevention and a greater understanding of their knowledge and sentiments may guide future initiatives. There is a lack of data on rugby coaches, especially in South Africa. This study aimed to investigate the knowledge and opinions of high school rugby coaches regarding concussion management. Methods: This cross-sectional study of 37 high school rugby coaches in South Africa, was conducted via a self-reported questionnaire. Concussion knowledge was scored for correct answers only with closed-question scaling methods to measure the importance of items of concussion management using a graphical rating scale. An attitude scale (Likert) was used to assess self-reported opinions and behaviours. Associations were calculated for participant characteristics and overall concussion injury knowledge. Results: More participants showed good overall knowledge of ≥ 75% (n = 22, 59% vs. n = 15, 40%), especially those with greater coaching experience (p = 0.021). Player welfare was perceived more important than player performance (185 vs. 164), with concussion prevention most important (184 of 185). Appealing characteristics of an injury prevention programme were the improvement of player skill (173, SD ± 0.75, mean 4.68), being adaptable (171, ± 0.86, 4.62), and being completed in the warm-up (167, ± 0.93, 4.51). The biggest perceived barriers were duration (138, ± 1.59, mean 3.73), effort (130, ± 1.56, 3.51), compliance and lack of knowledge (both 127, ± 1.68, 3.43). Conclusion: These results support the implementation of ongoing concussion education for rugby coaches and identify areas for promoting awareness and knowledge of concussion injury prevention, identification, and specific management of younger athletes. Appealing characteristics and barriers are highlighted and may allow for improved implementation and adherence to concussion prevention programmes. Key points: • The risk of concussion to female athletes and younger athletes was under-reported and should be addressed in future coach-focused education initiatives. • Successive educational approaches may be effective in coaches' knowledge retention, although the most appropriate delivery methods should be researched further. • The ideal injury prevention programme should improve player skill whilst reducing the risk of injury, be adaptable, completed during the warm-up and not take much time or effort to complete. [ABSTRACT FROM AUTHOR]

Background: Nearly 8 million high school students in the United States participate in sports each year. With the lack of recent population data, an update to previous studies on US high school athletes is needed. Purpose: To update the epidemiology of sports injuries in high school athletes in the United States. Study Design: Descriptive epidemiology study. Methods: The data from the National Health School Sports-Related Injury Surveillance Study, including 100 nationally representative high schools, were obtained for 9 high school sports (boys' football, soccer, basketball, wrestling, and baseball and girls' soccer, basketball, volleyball, and softball) between the 2015 and 2019 academic years. Injury rates were calculated as the ratio of injuries per 1000 athlete exposures (AEs), defined as 1 athlete participating in 1 practice or competition. Data on injured body area, injury type (sprains/strains, concussions, contusions, and fractures), time loss, and need for surgery were also obtained. Rate ratios (RRs) with 95% CIs and P values were calculated. Results: Athletic trainers reported 15,531 injuries during 6,778,209 AEs, with an overall rate of 2.29 injuries per 1000 AEs. Injury rates were highest in football (3.96), girls' soccer (2.65), and boys' wrestling (2.36). The overall injury rate was lower in girls' sports (1.86) compared with boys' sports (2.52) (RR, 0.74 [95% CI, 0.71-0.76]; P <.001) and was higher in competition compared with practice (RR, 3.39 [95% CI, 3.28-3.49]; P <.001). The most commonly injured body areas were the head/face (24.2%), ankle (17.6%), and knee (14.1%). Sprains/strains (36.8%) and concussions (21.6%) were the most common diagnoses. Overall, 39.2% and 34% of injuries resulted in a time loss of <1 week and 1 to 3 weeks, respectively. Surgery was required in 6.3% of injuries, with wrestling (9.6%), girls' basketball (7.6%), and boys' baseball (7.4%) being the sports with the highest proportion of injuries needing surgery. Conclusion: Study findings demonstrated that boys' football, girls' soccer, and boys' wrestling had the highest injury rates, with boys' sports overall having higher injury rates than girls' sports. Sprains/strains and concussions were the most common diagnoses. Few injuries required surgery. [ABSTRACT FROM AUTHOR]

Presently, the invasiveness of direct repair surgery for lumbar spondylolysis is relatively high. Thus, high school and junior high school students who play sports often cannot return to sports before graduation because of the invasiveness. The use of a robotic system enabled an accurate and minimally invasive procedure. Robotic-assisted minimally invasive direct pars repair surgery is useful for young patients with progressive spondylolysis. [ABSTRACT FROM AUTHOR]

Objective Research on the neurocognitive effects of comorbid mood/anxiety disturbance in college athletes is limited. Previous research found that athletes with comorbid depression/anxiety performed worse on measures of attention/processing speed (A/PS) at baseline compared to healthy controls. However, this work solely examined mean performance. The current study expands upon this work by examining intraindividual variability (IIV) in relation to affective disturbance. Method 835 (M = 624, F = 211) collegiate athletes completed baseline neuropsychological testing. Athletes were separated into four groups (Healthy Mood [ n  = 582], Depression Alone [ n  = 137], Anxiety Alone [ n  = 54], and Co-Occurring Depression/Anxiety [ n  = 62]) based on self-reported anxiety and depression. IIV was examined globally and within composites of A/PS and memory via intraindividual standard deviation, with higher scores indicating greater variability. Results Linear regression results revealed that the Co-Occurring Depression/Anxiety group exhibited greater variability within the memory composite compared to the Healthy Mood group, as well as the Depression Alone and Anxiety Alone groups. The Depression Alone and Anxiety Alone groups did not differ from the Healthy Mood group on memory IIV. None of the groups differed on A/PS or global IIV. Conclusions Athletes with co-occurring depression/anxiety demonstrated greater variability in performance on memory tasks. Greater dispersion is predictive of greater cognitive decline following concussion; therefore, it is important that neuropsychological performance is interpreted beyond measures of central tendency. These findings also highlight the importance of having baseline data available for athletes with affective disturbance, as these factors may influence performance, place athlete at risk for poorer outcomes, and skew future post-concussion comparisons. [ABSTRACT FROM AUTHOR]

Daily workloads of adolescent student-athletes can be extremely high because of their investment in both school and sport. Adolescents are especially vulnerable to mood disturbances and disorders and thus mental health problems, as they experience psychological, physiological, and social shifts at this key stage of human development. The present study aims to provide information on the mental health of Finnish high school athletes by investigating their mood state profiles and the potential associations of sex, type of sport, and level of performance in sports and school with those profiles. Data were gathered through an online survey of 444 male and female student-athletes (aged 16–17) during the spring term of their second grade of high school. The 37-item Profile of Mood States questionnaire was used to measure mood states, with four mood state profiles found: (1) the surface profile (39.8%), (2) the Everest profile (13.2%), (3) the inverse Everest profile (13.2%), and (4) the iceberg profile (33.8%). Of the background variables, only sex was found to be related with the mood state profiles, with the Everest profile much more common in males (74.2%) than in females (25.8%). In addition, the energy index and total mood disturbance of mood states were higher among males than among females. The findings indicate that it is important to pay special attention to the mood states of young student-athletes, particularly females, and to create support systems that foster their resilience in combining sport and studies. Lay summary: This study explores mood in adolescent student-athletes in terms of mood state profiles, total mood disturbance, and energy index. Profile of Mood State (POMS) metrics were used to determine mood state profiles; POMS has previously been found to be a valid indicator of the state of athletes' mental health. There is a need to pay special attention to adolescent female student-athletes' coping and resilience when combining school and sport. Fatigue may be a notable impairing factor concerning student-athletes' academic performance at school. POMS is a valid and recommended tool to monitor and measure the mood state of athletes. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Sports Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Assessment of post-concussion symptoms is implemented at secondary, post-secondary, and professional levels of athletics. Network theory suggests that disorders can be viewed as a set of interacting symptoms that amplify, reinforce, and maintain one another. Examining the network structure of post-concussion symptoms may provide new insights into symptom comorbidity and may inform targeted treatment. We used network analysis to examine the topology of post-concussion symptoms using the Post-Concussion Symptom Scale (PCSS) in high school athletes with recent suspected sport-related concussion. Method Using a cross-sectional design, the network was estimated from Post Concussion Symptom Scale scores from 3,292 high school athletes, where nodes represented symptoms and edges represented the association between symptoms. Node centrality was calculated to determine the relative importance of each symptom in the network. Results The network consisted of edges within and across symptom domains. "Difficulty concentrating" and "dizziness" were the most central symptoms in the network. Although not highly central in the network, headaches were the highest rated symptom. Conclusions The interconnectedness among symptoms supports the notion that post-concussion symptoms are interrelated and mutually reinforcing. Given their central role in the network, "difficulty concentrating" and "dizziness" are expected to affect the activation and persistence of other post-concussion symptoms. Interventions targeting difficulties with concentration and dizziness may help alleviate other symptoms. Our findings could inform the development of targeted treatment with the aim of reducing overall symptom burden. Future research should examine the trajectory of post-concussion symptom networks to advance the clinical understanding of post-concussive recovery. [ABSTRACT FROM AUTHOR]

Context: Sleep plays a vital role in cognitive and physical performance. Teenage athletes (ages 13-19 years) are considered especially at risk for disordered sleep and associated negative cognitive, physical, and psychosomatic effects. However, there is a paucity of evidence-based recommendations to promote sleep quality and quantity in athletes who fall within this age range. We performed a review of the literature to reveal evidence-based findings and recommendations to help sports instructors, athletic trainers, physical therapists, physicians, and other team members caring for young athletes provide guidance on sleep optimization for peak sports performance and injury risk reduction. Methods: PubMed, Scopus, and Cochrane CENTRAL were searched on May 11, 2016, and then again on September 1, 2020, for relevant articles published to date. Study Design: Narrative review. Level of Evidence: Level 4. Results: Few studies exist on the effects disordered sleep may have on teenage athletes. By optimizing sleep patterns in young athletes during training and competitions, physical and mental performance, and overall well-being, may be optimized. Adequate sleep has been shown to improve the performance of athletes, although further studies are needed. Conclusion: Twenty-five percent of total sleep time should be deep sleep, with a recommended sleep time of 8 to 9 hours for most young athletes. Screen and television use during athletes' bedtime should be minimized to improve sleep quality and quantity. For young athletes who travel, jet lag can be minimized by allowing 1 day per time zone crossed for adjustment, limiting caffeine intake, planning meals and onboard sleeping to coincide with destination schedules, timing arrivals in the morning whenever possible, and using noise-canceling headphones and eyeshades. Strength-of-Recommendation Taxonomy (SORT): B. [ABSTRACT FROM AUTHOR]

Background/Aim: Participation in sports activities is a source of dental injury. Despite recommendations for the use of mouthguards, athletes underutilize them. The aim of this study was to provide estimates of dental injuries, the mechanism of injuries and the utilization of mouthguards in high school sports. Materials and Methods: This study was a secondary analysis of an existing dataset of a convenience sample of the National High School Sports‐Related Injury Surveillance Study. Data of athletic exposures, dental injuries, mouthguard usage, and mechanism of injury from the 2005/2006 to the 2019/2020 academic years were analyzed. Results: During the study period, there were 459 dental injuries in 49,987,927 athletic exposures resulting in a dental injury rate of 0.9 per 100,000 athletic exposures (AE). Slightly more than half of the traumatic dental injuries were sustained during competition (n = 256; 55.8%) and the rest (n = 200; 43.6%) were sustained during practice. The rate of dental injury in competition was 3.6 times higher than the rate in practice (RR: 3.6, 95% CI: 3.0–4.4). Dental injuries comprised 0.4% of the total 108,574 injuries sustained by athletes. Among girls' sports, field hockey had the highest rate (3.5 per 100,000 AE) and among boys' sports, basketball (2.4 per 100,000 AE) had the highest rate of dental injury. The most common mechanism of injury was contact with another player (276; 60.4%) followed by contact with apparatus (146; 31.9%). In the majority of dental injuries (308; 75.1%), the athlete was not wearing a mouthguard when the dental injury was sustained. Conclusions: Dental injuries were a small proportion of all injuries sustained by high school athletes. The majority of dental injuries were sustained when the athlete was not wearing a mouthguard. [ABSTRACT FROM AUTHOR]

Objective: Athletes perceive sports fans as a source of concussion nondisclosure pressure. Sports fans are exposed to injury depictions from the media that could lead them to underestimate its seriousness. This study examined the concussion knowledge of non-sports fans, sports fans, and wagering sports fans, as knowledge is a modifiable factor that can influence injury disclosure. Setting and participants: A convenience sample of 443 Australian adults completed an online survey. Design: Cross-sectional. Main measures: Self-rated and actual concussion knowledge (the Rosenbaum Concussion Knowledge and Attitudes Survey; RoCKAS). Results: There was no significant difference in the concussion knowledge of self-identified sports (n = 157) and non-sports (n = 286) fans; but sports fans rated their knowledge as significantly higher than non-sports fans (p <.05). Wagering sports fans (n = 24) had significantly less concussion knowledge than non-wagering sports fans (η2 =.03, small effect). Discussion: Athletes who feel nondisclosure pressure from sports fans may be influenced by people with incomplete concussion knowledge, particularly wagering sports fans. Sports fans over-estimated their knowledge, and this could contribute to the nondisclosure pressure felt by athletes. Programmes to increase injury disclosure by athletes should take these factors into consideration. [ABSTRACT FROM AUTHOR]

Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports. The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3–18 years) related to gymnastics, dance, or cheerleading from 2015–2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI). A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68–74%) and occurred in a sports-related setting (65%, 95% CI: 57–72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43–68%) and resulted in an orthopedic diagnosis (63–71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29–51%) and non-orthopedic diagnoses (29–38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%). Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes. [ABSTRACT FROM AUTHOR]

Objective This study sought to 1) ascertain the severity of the stress experienced by high school athletes due to playing a sport, 2) understand how these athletes deal with their stress, and if these athletes desire help from someone and 3) determine whether athletes consider their stress a debilitating factor. Methods 200 high school athletes between the ages of 16 and 17 were surveyed using an anonymous online survey platform to discover the relationship between stress and sports. The survey examined both male and female athletes from a variety of sports, different locations, and different ethnicities. Results Approximately 91% of all the cohort experienced some level of stress due to sports. Interestingly, about a third claimed stress positively affected performance. Fear of failure and self-pressure were the most common causes of stress. About 27% who were experiencing moderate to extreme stress wanted, but did not receive, help from a medical professional. However, of all the participants who experienced some level of stress, only 18% believed that receiving help from a medical professional would not be beneficial for them. Conclusion While it is easy to overlook and minimize the stress of a high school athlete, doing so may cause future problems such as anxiety and depression, both of which have been steadily increasing among that same population. It is important that, if needed, these athletes have access to medical professionals to adequately manage their stress. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study Design: Observational study. Context: Altered frontal plane knee mechanics during dynamic tasks have been often associated with lower-extremity injuries. Strategies to decrease these risk factors and improve knee joint stability are often applied in rehabilitation and training environments. Objective: The purpose of this study was to compare knee joint frontal plane projection angles (FPPA) via 2-dimensional video analysis during drop vertical jump (DVJ) and step-down test (SDT) tasks in the preferred and nonpreferred limbs of young male and female volleyball players. Methods: A total of 60 young male (n = 29) and female (n = 31) volleyball players (13.6 [1.1] y, 62.2 [11.2] kg, and 170.8 [10] cm) participated in this study. Once the athletes were screened for inclusion and exclusion criteria, limb preference was operationally defined as the preferred kicking leg or the foot used for stair climbing. In a randomized study design, participants were asked to perform a bilateral DVJ and unilateral step-down landing tasks for both preferred and nonpreferred limb. Kinematic analysis was performed via a 2-dimensional video recording of knee joint FPPA alignment. Results: No difference was noted in FFPA during DVJ and SDT tasks between preferred and nonpreferred limbs in both male and female groups (P >.05). The FFPA was significantly higher for both limbs during DVJ versus SDT in both groups (P ≤.05), but it was not different between male and female athletes. Conclusions: Based on these findings, clinicians may expect young male and female volleyball athletes to demonstrate similar and symmetrical lower-extremity 2-dimensional knee joint FPPA values across screening tests intended to identify lower-extremity injury risk factors. However, greater FPPA values should be expected during the more dynamic DVJ task. [ABSTRACT FROM AUTHOR]

American football is one of the most popular sports in the United States (US) among youth and high school athletes; however, participation is decreasing due to concerns about safety. This has led to many new safety initiatives over the last decade, but few studies have sought to evaluate if these interventions have made football safer. The purpose of this study is to investigate national-level data on football-related injuries to compare the injury characteristics and specific injury risks of high school and youth athletes over the last decade. This cross-sectional, retrospective study queried the National Electronic Injury Surveillance System (NEISS) database from 2010–2019 to compare national weighted estimates and injury characteristics of youth (ages 6–12) and high school (ages 14–18) athletes presenting to US emergency departments (EDs) with football-associated injuries. The overall injury risk of football-related injuries presenting to US EDs for high school athletes was 16.17 (C.I. 13.85–18.38) per 1,000 participants/year compared to 11.97 (C.I. 10.34–13.41) per 1,000 participants/year in youth athletes. From 2010 to 2019, the overall injury risk for youth athletes participating in football significantly (p < 0.0001) decreased from 13.31 (C.I. 11.23–15.38) per 1,000 participants to 9.93 (C.I. 7.24–12.62) per 1,000 participants. Additionally, the overall injury risk for high school athletes participating in football significantly (p < 0.0001) decreased from 2010 (N = 18.63 [C.I. 16.05–21.21] per 1,000 participants) to 2018 (N = 13.19 [C.I. 9.94–16.44] per 1,000 participants). High school athletes were almost twice as likely and 2.37 times more likely to present with knee and shoulder injuries compared to youth athletes per 1,000 participants/year. Our study provides evidence that the overall injury risk for both youth and high school football players has significantly decreased since 2010. Furthermore, our study demonstrates that these athletes sustain unique injury characteristics. [ABSTRACT FROM AUTHOR]

Background: Use of injury prevention programs (IPPs) by high school athletes has increased but their success in reducing injury depends on program compliance and fidelity of exercise performance. Hypothesis: Compliance with the 11+ IPP and exercise performance fidelity by high school athletic teams depend on sex, sport, and level of play. Study Design: Secondary analyses of data from a randomized controlled trial (RCT). Level of Evidence: Level 2. Methods: The 11+ IPP was implemented by 100 male and female high school athletic teams (American football, soccer, basketball, and lacrosse). Team compliance and fidelity with the program were evaluated by direct observation of warm-up routines and a weekly online survey completed by coaches. Differences in compliance and fidelity due to sport, sex, and level of play were assessed by analysis of variance. Results: Coaches reported that their teams performed the full IPP an average of 1.45 times per week, and 28% of observed warm-ups included all exercises in the IPP. Compliance differed by sport but not by level of play or the athletes' sex. At the end of the season, cueing was observed 19% of the time and differed by sport. Good technique was observed 66% of the time and varied by level of play. Conclusion: Team compliance with the IPP varied by sport and was below the recommended number of sessions per week needed to reduce injury. Removal of implementation barriers and improved support from coaches are needed at all levels of play for IPPs to be effective. Clinical Relevance: Clinical and sports practitioners intending to implement an IPP at the high school level should anticipate and address barriers that affect program compliance and fidelity of exercise performance. Frequent follow-up and instruction may be necessary for successful adoption of the IPP. [ABSTRACT FROM AUTHOR]

While the physical, psychological, and social benefits of physical activity have been touted for decades, few children in the U.S. are sufficiently active physically. We created a cross-age mentoring program to encourage children to not only engage in sports, but to also gain valuable personal and interpersonal skills from program activities. We interviewed 73 individuals from two community recreation centers—53 elementary school participants, 10 high-school student-athlete mentors, and 11 professional staff members—using semi-structured interviews. We found that cross-age mentorship program in sports created positive one-to-one and one-to-many relationships between the high school athlete mentors and the elementary school participants. Our grounded theory research demonstrates the efficacy of high school student-athletes as mentors in sports programs. We also have described in detail a program that is readily scalable because it is easy to implement, is cost-effective, and has benefits for all involved. Organizations such as after-school programs and community centers can design programs that bring these groups together and provide opportunities for learning and fun. [ABSTRACT FROM AUTHOR]

Importance: Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality. Objective: To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables. Design: This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender. Setting: A national sampling of U.S. high school students. Participants: Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls. Exposure(s): Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality. Main Outcomes and Measures: The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis. Results: The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)]. Conclusions and Relevance: There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys. [ABSTRACT FROM AUTHOR]

BACKGROUND Sport‐related concussions are a major public health problem with only 50% of concussed teens reporting their symptoms. The purpose of this systematic review was to identify individual and institutional factors that contribute to concussion knowledge, attitude, and reporting behaviors among US high school athletes. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis protocol was used to direct the process of this systematic review. A search for English, peer‐reviewed, quantitative studies published between 2010 and 2020 was conducted in 5 scholarly databases. The Joanna Briggs Critical Appraisal Tools were used to assess study quality. RESULTS: Twenty‐two studies met criteria for inclusion in this systematic review. The study designs were mostly cross‐sectional (N = 18). Synthesis revealed individual factors including gender, age, race/ethnicity, grade level, and concussion history were associated with differences in concussion knowledge, attitude, and/or reporting behaviors. Institutional factors identified included school location, concussion education, access to an athletic trainer, sport played, and team climate. Six studies found concussion education had a positive impact on knowledge and reporting behaviors. CONCLUSION: This systematic review identified certain populations which may be more vulnerable to underreporting concussion symptoms; therefore, a targeted approach to education and management may be more effective. [ABSTRACT FROM AUTHOR]

Wrestling is a physically demanding sport with an inherently high risk of injury relative to other sports. Injury risk factors may change dramatically for athletes participating in off-season wrestling, given exposure to new opponents, training methods, and wrestling styles compared with in-season months; however, this has never been elucidated in the literature. This study seeks to characterize the injuries sustained while participating in off-season wrestling and compare them to injuries sustained during the in-season months for middle and high school age athletes. The National Electronic Injury Surveillance System (NEISS) database was queried (2000–2018) to directly compare national estimates and injury characteristics of middle and high school age patients (11–18 years of age) presenting to US emergency departments (EDs) with wrestling-associated injuries, stratified by in-season and off-season months. The average annual number of patients 11 to 18 years of age presenting to US EDs with wrestling-associated injuries was 20,157 (95% Confidence Interval [C.I.] 16,622–23,691) during in-season months and 5,321 (C.I. 3,954–6,688) during off-season months between 2000 and 2018. Those sustaining in-season injuries were significantly (p < 0.001) more and less likely to injure their upper trunk (8.0%; C.I. 7.1% – 8.8%) and wrists (3.7%; C.I. 3.2% – 4.2%), respectively, than those presenting with off-season injuries (upper trunk: 5.3%; C.I. 4.2% – 6.5%; wrists: 6.6%; C.I. 5.1% – 8.1%). There were no significant differences with respect to the overall prevalence of injury diagnoses between in-season and off-season patient cohorts, including for fractures and dislocations (p > 0.05). These findings may alleviate concerns that off-season wrestling is inherently more dangerous than in-season wrestling due to changes in wrestling styles or opponent skill levels as the prevalence of specific injury diagnoses between the two seasons is similar. [ABSTRACT FROM AUTHOR]

Objective: Minority student-athletes have a lower survival rate from sudden cardiac arrest (SCA) than non-minority student-athletes. This study examined the relationship between high school indicators of socioeconomic status (SES) and survival in student-athletes with exercise-related SCA.Methods: High school student-athletes in the USA with exercise-related SCA on school campuses were prospectively identified from 1 July 2014 to 30 June 2018 by the National Center for Catastrophic Sports Injury Research. High school indicators of SES included the following: median household and family income, proportion of students on free/reduced lunch and percent minority students. Resuscitation details included witnessed arrest, presence of an athletic trainer, bystander cardiopulmonary resuscitation and use of an on-site automated external defibrillator (AED). The primary outcome was survival to hospital discharge. Differences in survival were analysed using risk ratios (RR) and univariate general log-binomial regression models.Results: Of 111 cases identified (mean age 15.8 years, 88% male, 49% white non-Hispanic), 75 (68%) survived. Minority student-athletes had a lower survival rate compared with white non-Hispanic student-athletes (51.1% vs 75.9%; RR 0.67, 95% CI 0.49 to 0.92). A non-significant monotonic increase in survival was observed with increasing median household or family income and with decreasing percent minority students or proportion on free/reduced lunch. The survival rate was 83% if an athletic trainer was on-site at the time of SCA and 85% if an on-site AED was used.Conclusions: Minority student-athletes with exercise-related SCA on high school campuses have lower survival rates than white non-Hispanic athletes, but this difference is not fully explained by SES markers of the school. [ABSTRACT FROM AUTHOR]

Background: The use of sport supplements has increased for all types and levels of sport, with an estimated increase of 5.8% annually. Sport supplement usage and doping among high school athletes has increased over the years to meet the demands of the sports. Objective: This scoping review identifies the trends and gaps in current literature regarding sport supplement use among high school rugby players in South Africa. Methods: A search was conducted using six electronic databases, namely Oxford Academic, Emerald Publishing, ResearchGate, SABINET, PubMed and Google Scholar. The eligibility of the articles was determined by means of a PRISMA flow diagram with the following inclusion criteria: (1) research concerning supplement use among rugby players, (2) research concerning supplement use among high school rugby players. Five articles all comprising of cross-sectional study designs were included in this scoping review. Results: The prevalence of sport supplement use among adolescent rugby players ranged from 30% to 45%. Protein supplements (31% - 79%) were the most commonly identified supplement used among adolescent rugby players with the aim to improve sport performance as the most common reason for use. The internet (74%) and magazines (72%), followed by coaches comments (28% to 30%), were given as the most common sources of information. Conclusion: The use of sport supplements is increasing among high school athletes due to the belief that these substances will provide sporting performance benefits or enhance the competitive 'edge' of these athletes. Additional education regarding the safety of supplements is necessary to lower the incidences of doping among young athletes and avoid the adverse health effects that uncontrolled supplement use can cause. [ABSTRACT FROM AUTHOR]

Objective: This systematic review and meta-analysis sought to rigorously examine mental health outcomes following paediatric concussion. To date, heterogeneous findings and methodologies have limited clinicians' and researchers' ability to meaningfully synthesise existing literature. In this context, there is a need to clarify mental health outcomes in a homogeneous sample, controlling for key methodological differences and applying a consistent definition of concussion across studies.Design: Systematic review and meta-analysis.Data Sources: We searched Medline, Embase, PsycINFO, CINAHL, SportDiscus, Scopus and PubMed.Eligibility: Peer-reviewed studies published between 1980 and June 2020 that prospectively examined mental health outcomes after paediatric concussion, defined as per the Berlin Consensus Statement on Concussion in Sport.Results: Sixty-nine articles characterising 60 unique samples met inclusion criteria, representing 89 114 children with concussion. Forty articles (33 studies) contributed to a random effects meta-analysis of internalising (withdrawal, anxiety, depression, post-traumatic stress), externalising (conduct problems, aggression, attention, hyperactivity) and total mental health difficulties across three time points post-injury (acute, persisting and chronic). Overall, children with concussion (n=6819) experienced significantly higher levels of internalising (g=0.41-0.46), externalising (g=0.25-0.46) and overall mental health difficulties compared with controls (g=0.18-0.49; n=56 271), with effects decreasing over time.Summary/conclusions: Our review highlights that mental health is central to concussion recovery. Assessment, prevention and intervention of mental health status should be integrated into standard follow-up procedures. Further research is needed to clarify the mechanisms underlying observed relationships between mental health, post-concussion symptoms and other psychosocial factors. Results suggest that concussion may both precipitate and exacerbate mental health difficulties, thus impacting delayed recovery and psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury. Examining the possible relationship between on-field or sideline signs and symptoms and recovery times would give clinicians the confident ability to properly treat and manage an athlete’s recovery process in a more systematic manner. Furthermore, identifying factors after a head injury that may be predictive of protracted recovery times would be useful for athletes, parents, and coaches alike. Focused Clinical Question: Which on-field and sideline signs and symptoms affect length of recovery after concussion in high school and college athletes? [ABSTRACT FROM AUTHOR]

Objective Variability in recovery time following sport-related concussion (SRC) is poorly understood. We explored the utility of brief mood, anxiety, and sleep questionnaires as postinjury predictors of SRC symptom clearance in adolescents. Method At initial visit 0–2 weeks postinjury, concussed athletes aged 12–18 years self-reported injury/medical factors (prior concussion, loss of consciousness, amnesia, and concussion symptom severity) and were administered psychological symptom measures. At 3 months, medical record review determined return-to-play (RTP) date. Subjects were divided into two datasets, with the first utilized for developing cutoff scores and then validated with the second dataset. Results A total of 64% of the 141 participants had early RTP (within 21 days postinjury), and 23% had late RTP (postinjury day 30 or later). The Generalized Anxiety Disorder Screener (GAD-7, M  = 2.1, SD  = 3.1) was the only significant predictor (p  = .001), with a 1.4-fold [95% CI 1.2–1.8] increased risk for every point. No other factors in the full model discriminated recovery groups (p s > .05). Receiver operating characteristic curve analysis derived a GAD-7 cut score ≥3 (sensitivity= 56.7%, specificity = 74.2%, AUCs = 0.63–0.79, p s < .001). Conclusions Postconcussion anxiety symptoms may help identify individuals at increased risk for prolonged recovery. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the relationships between athletic identity and sport commitment and return to sports (RTS) status in athletes after anterior cruciate ligament reconstruction (ACLR). Methods: Thirty-nine participants post-ACLR (8–24 months) were included in this cross-sectional study. Measures included the athletic identity measurement scale and sport commitment scale. In addition, we measured kinesiophobia and psychological readiness using the Tampa Scale for Kinesiophobia and ACL-Return to sport after injury scale. The subjects were categorized into Yes-RTS or No-RTS based on two questions to determine whether they were returning to sport at the same level of competition as before the injury. A Chi-squared test, Fisher's exact test, unpaired t-test, and Mann-Whitney's U test were used to analyze the data. Results: The Yes-RTS group had significantly higher scores on the athletic identity measurement scale (P = 0.023, effect size [ES] = − 0.36), sport commitment scale (P = 0.027, ES = − 0.35), and ACL-Return to sport after injury scale (P = 0.002, ES = − 0.50) and significantly lower Tampa Scale for Kinesiophobia scores (P = 0.014, ES = − 0.39) compared to the No-RTS group. Conclusion: Athletes who returned to sports at the same level of competition as before the injury had higher athletic identity and sport commitment and lower kinesiophobia compared to those who did not return to sports at the same level of competition. These self-beliefs regarding sport may play an important role in post-ACLR athletes' RTS. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the somatosensory and corticomotor physiology of retired contact sport athletes with a history of repeated concussion/subconcussion head trauma. Methods: Retired male athletes with a history of playing contact sports and repeated head trauma (n = 122) were divided into two groups: those who expressed concerns regarding their mental and cognitive health ("symptomatic": n = 83), and those who did not express any ongoing concerns ("asymptomatic": n = 39). Both groups were compared to age-matched male controls (n = 50) with no history of concussions or participation in contact sports, an absence of self-reported cognitive, or mood impairments. Transcranial magnetic stimulation (TMS) and vibrotactile stimulation were used to assess corticomotor and somatosensory pathways respectively. TMS and vibrotactile stimulation were correlated to self-reported responses using the Fatigue and Related Symptom Survey. Linear regression was used to associate concussion history with TMS, somatosensory variables. Results: Significant differences were found in symptom survey scores between all groups (p < 0.001). TMS showed significant differences between the "symptomatic" and control groups for intracortical inhibition and paired pulse TMS measures. Somatosensory measures showed significant differences for reaction time (p < 0.01) and reaction time variability (p < 0.01) between the "symptomatic" group to the "asymptomatic" and control groups. For other somatosensory measures, the "symptomatic" measures showed differences to the "control" group. Correlations showed significant associations between severity of symptom reporting with TMS and somatosensory measure, and regression revealed the number of concussions reported was shown to have significant relationships to increased intracortical inhibition and poorer somatosensory performance. Conclusion: This study shows that retired contact sport athletes expressing chronic symptoms showed significant pathophysiology compared to those with no ongoing concerns and non-concussed controls. Further, there is a linear dose-response relationship between number of reported concussions and abnormal neurophysiology. Neurophysiological assessments such as TMS and somatosensory measures represent useful and objective biomarkers to assess cortical impairments and progression of neuropsychological impairment in individuals with a history of repeated head trauma. [ABSTRACT FROM AUTHOR]

Background: Disordered eating (DE) is a growing problem among all athletes, particularly adolescents. To help prevent the progression of DE to a clinical eating disorder (ED), a brief screening tool could offer an efficient method for early identification of DE in athletes and facilitate treatment. The aim of this study is to validate a screening tool for DE that will identify male and female adolescent athletes of all sports and levels of competition who are at risk for DE. The Disordered Eating Screen for Athletes (DESA-6) consists of only 6 items and was designed for use in both male and female athlete populations. Methods: Validation involved two phases: Phase I consisted of screening high school athletes using the Eating Attitudes Test (EAT-26) and the DESA-6; and Phase II included inviting all high school athletes categorized as "at risk" after screening, plus age- and self-reported gender- matched athletes categorized as not "at risk", to complete the same surveys a second time along with clinical interview. Validity and regression analyses were used to compare the DESA-6 to the EAT-26 and EDE 17.0D. Results: When comparing to clinical interview, the DESA-6 had a total sensitivity of 92% and specificity of 85.96%, respectively. Upon comparison of concurrent validity, Phase II DESA-6 had a strong significant positive correlation for both males and females when compared to Phase II EDE 17.0D. Conclusions: A brief, easy to administer screening tool for recognizing DE that can be used by physicians, psychologists, athletic trainers, registered dietitians, and other sport/healthcare staff is of utmost importance for early intervention, which can lead to improved treatment outcomes. The DESA-6 is a promising tool for risk assessment of DE in athletes. [ABSTRACT FROM AUTHOR]

Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth. [ABSTRACT FROM AUTHOR]

This study aims at describing and comparing the prevalence of bullying behaviours and the perspective of victims, bystanders, and aggressors in team, individual, and combat sports. The survey involved 664 athletes of both genders (13-18 years old) from sports school and federated of several sports (team n=451, individual n=173, combat n=40), who filled in the Prevention of Violence in Sport Questionnaire. The prevalence of bullying (victims, bullies, and bystanders) was 26.7% in team sports; 19.1% in individual sports, and 23.1% in combat. Through the Chi-square test, it was verified that there were no significant differences between different sports in what concerns the prevalence of bullying behaviours; neither was there a difference in the perspective of victims, bystanders, and aggressors. The percentage was bigger in victims (7.7%) and bystanders (17.4%) in combat sports, and aggressors (3.3%) in team sports. There are not aggressors in combat sports. Further studies are needed in order to achieve a deeper knowledge of the problem and plan strategies to prevent this sort of behaviour. [ABSTRACT FROM AUTHOR]

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This cross sectional descriptive survey study intended to assess the healthy lifestyle behaviours of high school students by investigating whether the development of healthy lifestyle behaviours on the part of the students, lead to an increase in their quality of life. Furthermore, understanding whether engagement in sports as a licensed athlete leads to any difference in terms of healthy lifestyle behaviours and quality of life was included. Data was collected from 824 high school students using "Personal Information Form", "Health Promoting Lifestyle Profile-II (HPLPII)", and the Pediatric Quality of Life Inventory (PedsQL-Adolescent Form)". The analysis included descriptive statistics, one-way analysis of variance (one-way ANOVA), MANOVA and Pearson correlation analyses. In terms of Healthy Lifestyle Behaviour Total Score those who do sports with a license (χ=126.28) were significantly higher than those who do not (χ=116.14). The average total quality of life score was regarded as a high score. A weak correlation was observed between the healthy lifestyles and levels of quality of life. The students who engaged in sports as licensed athletes were found to have significantly higher levels of healthy lifestyle behaviours and quality of life. [ABSTRACT FROM AUTHOR]

Objective Preexisting attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for worse outcome following sport-related concussion. We used a statistical and psychometric approach known as network analysis to examine the architecture of physical, cognitive, and emotional symptoms at preseason baseline among student athletes with ADHD. Method A cohort of 44,527 adolescent student athletes completed baseline preseason testing with ImPACT® between 2009 and 2015. A subsample of athletes reporting a diagnosis of ADHD and at least one symptom were included in this study (N  = 3,074; 14–18 years old, 32.7% girls). All participants completed the 22-item Post-Concussion Symptom Scale at preseason baseline. Results Student athletes reported high frequencies of difficulty concentrating (boys/girls = 50.7%/59.4%), emotional symptoms (nervousness: boys/girls = 30.2%/51.0%; irritability: boys/girls = 23.6%/34.8%; sadness: boys/girls = 21.4%/39.7%), sleep/arousal-related symptoms (trouble falling asleep: boys/girls = 39.5%/49.4%; sleeping less than usual: boys/girls = 36.2%/43.4%; and fatigue: boys/girls = 29.8%/36.4%), and headaches (boys/girls = 27.6%/39.0%) during preseason baseline testing. The most central symptoms included dizziness, which was related to multiple somatic symptoms, and increased emotionality, which was related to a cluster of emotional symptoms. Girls reported symptoms at a greater frequency than boys, and there was evidence for variance in the global strength of the symptom network across gender, but not specific intersymptom relationships. Conclusion In the absence of injury, symptoms that commonly occur after concussion interact and potentially reinforce each other among student athletes with ADHD at preseason. Symptoms common in ADHD (i.e. difficulty concentrating) are not necessarily the most central within the symptom network. These findings may inform more precise interventions for athletes with ADHD and prolonged recovery following concussion. [ABSTRACT FROM AUTHOR]

Several countries around the world have adopted the concept of Physical Literacy (PL), as a promising approach for lifelong physical ac-tivity (PA) participation. Since sports appear to be an optimal context for PL development, the aim of this study was to evaluate ele-ments of PL (PA, motor competence [MC], and physical fitness [PF]) in children 8-12 years old, who participate in different sports. A total of 89 children (45 boys and 44 girls), aged 8-12 years (10.91 + 1.14) from Athens, Greece, who systematically participated in Gym-nastics (n=32), Basketball (n=37), and Track & Field (n=20) volunteered to take part. PL elements were assessed with protocols includ-ed in the Canadian Assessment of Physical Literacy (CAPL), according to which MC and PF constitute the PL domain of physical compe-tence (PC), whereas PA (step counts plus selfreported PA) and sedentary behavior compose the daily behavior (DB) domain. To exam-ine potential differences among the three sport groups, ANCOVAs were computed on domain- and individual-protocol scores, using gender and age as covariates. Moreover, the percentage of children at each PL-level (beginning; progressing; achieving; excelling) was computed. Results revealed that there were no statistically significant differences among the three sports either in DB or PC, whereas more than half of children were at the achieving and excelling PL level. Nevertheless, although participants' PF elements were found to be at a high level, their ambulatory activity and MC were not satisfactory. These results suggest that sport participation contributes to the enhancement of children's PL. Nonetheless, more efforts are needed if their optimal MC and PA levels are to be achieved. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the impact of humanistic coach training on athletes' developmental outcomes. A sample of 148 high school student-athletes between 12 and 17 years old from low socio-economic communities completed questionnaires during their season. The student-athletes were divided into an experimental group composed of student-athletes of 11 head coaches who participated in a humanistic coach training session, and a comparison group composed of student-athletes of 8 untrained coaches. Four questionnaires were used to assess competence, confidence, connection to the coach, and character (prosocial and antisocial behaviours) of the participants. The effects of the humanistic coach training program were assessed using repeated measures analysis of variance models. Results showed that connection to the coach worsened for athletes of untrained coaches. Also, participants from both groups reported an increase in antisocial behaviours at the end of the season, but the athletes of trained coaches reported engaging less frequently in antisocial behaviours compared to athletes of untrained coaches. These findings suggest that teaching humanistic coaching may help practitioners foster positive developmental outcomes in youth sport participants and build positive coach-athlete relationships, while also raising awareness to the use of sport as a tool to promote personal growth and development. [ABSTRACT FROM AUTHOR]

A stronger emphasis has been placed on increasing strength, power, size, and speed for today’s football player. The key to obtaining these abilities and skills are accomplished in the weight room. There are various types of lifting methods when it comes to resistance training (RT) for football. Two types of lifting styles that are often used for high school football weight training programs are the traditional lifting or core training programs and Olympic style lifting. It is thought that Olympic lifts help to increase power, which is something that can be transferred onto the playing field and help improve overall performance. This study compared two different styles of RT (traditional vs. Olympic) in North American High School football athletes in order to determine if one RT protocol was superior at improving measures of speed, strength, and power. Forty male, high school football players ranging from 14 to 18 years old participated in an eight week, off-season, early morning football resistance training program. Each participant was randomly selected into either the traditional resistance protocol (TR: n = 20) or Four Quarters protocol (FQ: n = 20) experimental groups. The players each had the same weight lifting/conditioning routine, however, twice a week the FQ group performed an Olympic lift variation and the TR group performed a dead lift. Pre- and post-assessment scores were obtained and compared in the 1-RM squat, 1-RM power clean, vertical jump (VJ) and 9.14 meter sprint. Pre- post- scores were compared with in each group with a dependent t-test. A gain score was also calculated for each dependent variable (post-pre score) and compared between the experimental groups with an independent t-tests (p≤0.05). Both groups made improvements in pre to post assessments in the 1-RM squat, 1-RM power clean, and VJ (p0.05). The results of this study are consistent with those found in previous literature demonstrating that increases in both the 1-RM squat and 1-RM power clean are better achieved using an Olympic lift variations when compared to using a traditional lifting method. Resistance training programs for athletes are designed with the goal of improving physical performance on the field of play. The results of this study suggest that improvements in muscular strength and power as measured by the 1-RM squat and 1-RM power clean are best achieved with a RT protocol that includes the Olympic lift variation of the power clean.