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PubMed2002

Clinical Supervision of Athletic Training Students at Colleges and Universities Needs Improvement.

OBJECTIVES: To assess the type and amount of clinical supervision athletic training students received during clinical education. DESIGN AND SETTING: An online survey was conducted with a questionnaire developed specifically for this study. SUBJECTS: Head athletic trainers from National Collegiate Athletic Association Division I (28), Division II (34), and Division III institutions (30). Thirty-four represented Commission on the Accreditation of Allied Health Education Programs-accredited athletic training education programs, 20 represented athletic training programs in Joint Review Commission on Athletic Training candidacy, and 35 offered the internship route. MEASUREMENTS: Descriptive statistics were computed. Three sets of chi-square analyses were completed to assess associations among athletic training students with first-responder qualifications, program and institution characteristics, certified athletic trainer medical coverage of moderate- and increased-risk sports, and clinical supervision. A trend analysis of students' class standing and time spent in different types of clinical supervision was also completed. The alpha level was set at <.05. RESULTS: Most of the athletic training students (83.7%), particularly in accredited programs, had first-responder qualifications. More than half of the head athletic trainers (59.8%) indicated that athletic training students were authorized to provide medical care coverage without supervision. A minimal amount of medical care coverage of moderate- and increased-risk sports was unsupervised. No significant difference between the size of the education or athletic program and type and amount of clinical supervision was noted. Freshman athletic training students spent more time in direct clinical supervision and less time in unsupervised experience, but the opposite was true for senior students. CONCLUSIONS: Athletic training students are being utilized beyond appropriate clinical supervision and the scope of clinical education. Future research should employ methods using nonparticipant observation of clinical instructors' supervision of students as well as students' own perceptions of their clinical supervision.

Journal Article↗
PubMed2003

Adherence to Drug-Dispensation and Drug-Administration Laws and Guidelines in Collegiate Athletic Training Rooms.

OBJECTIVE: To assess adherence in collegiate athletic training rooms to federal drug laws and to describe current practices. DESIGN AND SETTING: We created a survey of drug-law adherence using federal drug laws and administration guidelines and mailed it to randomly selected certified athletic trainers (ATCs) in United States college and university athletic training rooms. Means, standard deviations, and cross-tabulations were calculated to assess demographic information. A nonparametric test (Kruskal-Wallis) was calculated to compare adherence-score means. RESULTS: Adherence scores were collected from 168 college and university ATCs. The data suggest that ATCs in most athletic training rooms are still not complying with federal drug laws. Drug-dispensation and -administration adherence scores ranged from 5 to 20 (20% to 80% adherence) of 25 points. On average, 49.3% of ATCs in athletic training rooms had marginal adherence to federal regulations (12.34 adherence score). The difference between adherence scores and National Collegiate Athletic Association athletic divisions (Division I, II, III, and III/National Association of Intercollegiate Athletics; P <.002) was significant. In most athletic training rooms, ATCs (55.9%) and students (13.3%) dispensed prescription drugs. In addition, ATCs in most athletic training rooms (53.8%) administered any amount of over-the-counter medication as necessary, and many did not record the transaction (46.2%). DISCUSSION: Nine years after the National Collegiate Athletic Association drug-distribution study in university athletic programs, similar problem areas persist, including unqualified personnel dispensing medications, inappropriately packaged and labeled medications, and a lack of record keeping. CONCLUSIONS: Athletic trainers should work in conjunction with members of the sports medicine team to review federal and state laws and revise institutional drug policies and procedures to comply with regulations in order to provide the best health care to student athletes in a legal and safe manner.

Journal Article↗
PubMed1979

Low exercise ventilation in endurance athletes.

Previous studies have shown that endurance athletes are endowed with low ventilatory responses to chemical stimuli. The implications of this association have never been clear. Although recent evidence shows that exercise ventilation (VE) correlates with ventilatory chemoresponsiveness in a group of athletes, the extent to which non-athletes may differ from athletes in this regard is unknown. We have examined the relationship between ventilatory chemoresponsiveness and exercise VE in a group of 7 non-athletes, and contrasted these findings with those obtained previously from 8 endurance and 8 non-endurance athletes. Correlation lines of exercise VE with chemical responses were similar in slope and intercept for both athletes and non-athletes. However, we found that non-athletes had greater exercise VE per unit metabolic rate (VO2 or VCO2), and greater ventilatory responses to O2 and CO2, when compared with endurance athletes at equal relative work loads (P less than 0.05). The lower exercise VE/VCO2 of endurance athletes as compared with non-athletes persisted in hyperoxia, indicating that factors other than differences in hypoxic sensitivity explain the lower exercise VE of endurance athletes. Low exercise VE may be the link between low ventilatory chemosensitivity and outstanding endurance athletic performance.

Adult↗
PubMed2006

Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program.

CONTEXT: A nationwide systematic preparticipation athletic screening was introduced in Italy in 1982. The impact of such a program on prevention of sudden cardiovascular death in the athlete remains to be determined. OBJECTIVE: To analyze trends in incidence rates and cardiovascular causes of sudden death in young competitive athletes in relation to preparticipation screening. DESIGN, SETTING, AND PARTICIPANTS: A population-based study of trends in sudden cardiovascular death in athletic and nonathletic populations aged 12 to 35 years in the Veneto region of Italy between 1979 and 2004. A parallel study examined trends in cardiovascular causes of disqualification from competitive sports in 42,386 athletes undergoing preparticipation screening at the Center for Sports Medicine in Padua (22,312 in the early screening period [1982-1992] and 20,074 in the late screening period [1993-2004]). MAIN OUTCOME MEASURES: Incidence trends of total cardiovascular and cause-specific sudden death in screened athletes and unscreened nonathletes of the same age range over a 26-year period. RESULTS: During the study period, 55 sudden cardiovascular deaths occurred in screened athletes (1.9 deaths/100,000 person-years) and 265 sudden deaths in unscreened nonathletes (0.79 deaths/100,000 person-years). The annual incidence of sudden cardiovascular death in athletes decreased by 89% (from 3.6/100,000 person-years in 1979-1980 to 0.4/100,000 person-years in 2003-2004; P for trend < .001), whereas the incidence of sudden death among the unscreened nonathletic population did not change significantly. The mortality decline started after mandatory screening was implemented and persisted to the late screening period. Compared with the prescreening period (1979-1981), the relative risk of sudden cardiovascular death in athletes was 0.56 in the early screening period (95% CI, 0.29-1.15; P = .04) and 0.21 in the late screening period (95% CI, 0.09-0.48; P = .001). Most of the reduced mortality was due to fewer cases of sudden death from cardiomyopathies (from 1.50/100,000 person-years in the prescreening period to 0.15/100,000 person-years in the late screening period; P for trend = .002). During the study period, 879 athletes (2.0%) were disqualified from competition due to cardiovascular causes at the Center for Sports Medicine: 455 (2.0%) in the early screening period and 424 (2.1%) in the late screening period. The proportion of athletes who were disqualified for cardiomyopathies increased from 20 (4.4%) of 455 in the early screening period to 40 (9.4%) of 424 in the late screening period (P = .005). CONCLUSIONS: The incidence of sudden cardiovascular death in young competitive athletes has substantially declined in the Veneto region of Italy since the introduction of a nationwide systematic screening. Mortality reduction was predominantly due to a lower incidence of sudden death from cardiomyopathies that paralleled the increasing identification of athletes with cardiomyopathies at preparticipation screening.

Adolescent↗
PubMed1998

Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors.

BACKGROUND: High prevalence of bronchial hyperresponsiveness and asthma has been found in cross-country skiers. There is limited evidence that asthma and bronchial responsiveness would be common also in athletes with summer events. OBJECTIVES: The objective of this study was to investigate occurrence of and risk factors for increased bronchial responsiveness and asthma in elite athletes with summer events and to compare their results with those of control subjects. METHODS: Forty-nine speed and power athletes (mean age 21.1 years, range 16 to 31), 71 long-distance runners (mean age 26.6 years, range 16 to 39), 42 swimmers (mean age 18.6 years, range 14 to 25), and 45 control subjects (mean age 26.7 years, range 21 to 37) were studied. The subjects answered questionnaires and were given a resting spirometric examination, a skin prick test, and a histamine challenge test. RESULTS: Current asthma (current asthmatic symptoms and increased bronchial responsiveness) was observed in 14% (22 of 162) of the athletes and in 2% (1 of 45) of the control subjects (p = 0.041). Total asthma (current asthmatic symptoms and increased bronchial responsiveness or physician-diagnosed asthma) occurred in 23% (37 of 162) of the athletes and in 4% (2 of 45) of the control subjects (p = 0.0048). Atopy according to skin prick test results was found in 48% (77 of 162) of the athletes and in 36% (16 of 45) of the control subjects (not significant). Clinical pollen allergy (positive skin test reaction to pollen and symptoms of rhinoconjunctivitis) was significantly (p = 0.037) more common in athletes than in control subjects. Atopic athletes showed significantly more often increased bronchial responsiveness, current asthma, and total asthma than nonatopic athletes (p = 0.011, p = 0.0049, and p < 0.0001, respectively), and the odds ratios of increased bronchial responsiveness and asthma increased with the number of positive skin test reactions. After adjustment for confounding factors, the odds ratio for the occurrence of current asthma was 5.49 (95% confidence interval 0.56 to 53.7) in speed and power athletes, 2.88 (0.30 to 27.7) in long-distance runners, and 10.8 (1.10 to 106.0) in swimmers compared with control subjects. The adjusted odds ratios for the occurrence of total asthma were 3.56 (0.62 to 20.5) in speed and power athletes, 6.01 (1.19 to 30.2) in long-distance runners, and 5.89 (1.00 to 34.5) in swimmers. CONCLUSIONS: Asthma is more common in highly trained athletes than in control subjects. Asthma is especially common in elite swimmers, but the risk of asthma is increased also in long-distance runners. Increased bronchial responsiveness and asthma are strongly associated with atopic disposition and its severity in elite athletes.

Adolescent↗
PubMed2001

Dietary intakes of elite female athletes in Greece.

BACKGROUND: Although there is a great interest in sports in Greece, there are very few data regarding dietary intakes and habits of Greek elite female athletes. The present study assesses the dietary intakes and the energy balance of elite female athletes of four different sports (volleyball, middle distance running, ballet dancing, and swimming) and a non-athletic control group. METHODS: Data were collected over two seasons, the training and the competitive, using 7-day weighed dietary records. Energy expenditure was calculated from 7-day activity records. Anthropometric measurements were also taken for all athletes. RESULTS: Athletes and controls had similar BMI values. Per cent body fat was lower for athletes compared with controls. Between sports, middle distance runners had the lowest per cent body fat. No significant differences were found between mean energy intake of athletes and controls. Mean energy intake was found lower than calculated energy expenditure, for all four teams. Macronutrient and micronutrient intakes of the athletes were not statistically different from those of the non-athletic control group. Mean micronutrient intakes were found above the recommended values with the exception of iron. Both athletes and controls had a high intake of vitamin C that is a characteristic of the population of the Mediterranean countries. CONCLUSIONS: Energy intakes varied between sports and between athletes of the same sport. Calculated energy expenditure was higher from the reported energy intake for most athletes. Athletes with the lowest energy intakes reported menstrual abnormalities.

Adipose Tissue↗
PubMed2006

Comparison of hematologic data in world elite junior speed skaters and in non-athletic juniors.

During the world junior speed skating championship 2002 all athletes (60 males, 56 females) were subjected to hematologic blood testing one day before the competition as requested by International Skating Union--ISU. This study aimed to obtain hematological reference values for junior athletes, whilst the influence of endurance training on hematologic variables of young athletes was studied. Hematologic results of athletes were compared to results of non-athletes matched by age and gender (14 males, 17 females). The blood analysis was done on an ADVIA 120. To compare measurement of ferritin, erythropoietin, and soluble transferrin receptor in serum as well as in EDTA-plasma, serum and EDTA-blood was obtained from the control group. In hemoglobin and hematocrit we found no significant difference between the two groups, whereas the number of erythrocytes was lower in athletes. The mean corpuscular volume was higher in athletes, whilst the corpuscular hemoglobin content was only marginally higher in athletes than in non-athletes. Consequently corpuscular hemoglobin concentration mean was lower in athletes than in non-athletes. There was no difference of erythropoietin and soluble transferrin receptor, whilst in ferritin we found a difference between the groups. Endurance training does not change the values of hemoglobin and hematocrit. Increased mean corpuscular volume and decreased corpuscular hemoglobin concentration mean could be a result of changed properties of red blood cell-membrane caused by acidosis and higher osmolality during the training. In junior athletes we did not find an iron overload as described in some adult athletes.

Adolescent↗
PubMed1998

Screening for hypertrophic cardiomyopathy in young athletes.

BACKGROUND: For more than 20 years in Italy, young athletes have been screened before participating in competitive sports. We assessed whether this strategy results in the prevention of sudden death from hypertrophic cardiomyopathy, a common cardiovascular cause of death in young athletes. METHODS: We prospectively studied sudden deaths among athletes and nonathletes (35 years of age or less) in the Veneto region of Italy from 1979 to 1996. The causes of sudden death in both populations were compared, and the pathological findings in the athletes were related to their clinical histories and electrocardiograms. Cardiovascular reasons for disqualification from participation in sports were investigated and follow-up was performed in a consecutive series of 33,735 young athletes who underwent preparticipation screening in Padua during the same period. RESULTS: Of 269 sudden deaths in young people, 49 occurred in competitive athletes (44 male and 5 female athletes; mean age, 23+/-7 years). The most common causes of sudden death in athletes were arrhythmogenic right ventricular cardiomyopathy (22.4 percent), coronary atherosclerosis (18.4 percent), and anomalous origin of a coronary artery (12.2 percent). Hypertrophic cardiomyopathy caused only 1 sudden death among the athletes (2.0 percent) but caused 16 sudden deaths in the nonathletes (7.3 percent). Hypertrophic cardiomyopathy was detected in 22 athletes (0.07 percent) at preparticipation screening and accounted for 3.5 percent of the cardiovascular reasons for disqualification. None of the disqualified athletes with hypertrophic cardiomyopathy died during a mean follow-up period of 8.2+/-5 years. CONCLUSIONS: The results show that hypertrophic cardiomyopathy was an uncommon cause of death in these young competitive athletes and suggest that the identification and disqualification of affected athletes at screening before participation in competitive sports may have prevented sudden death.

Adolescent↗
PubMed2001

Alcohol and college athletes.

PURPOSE: This study examines heavy episodic alcohol consumption and associated harms in collegiate athletes in the United States. The factors which may promote or deter such use are explored. METHODS: Randomly selected students in a nationally representative sample of 4-yr colleges in the United States completed self-report questionnaires in the spring of 1997. Athletes were defined as students who participated in one or more hours of intercollegiate athletics per day. Heavy episodic or "binge" drinking for men was defined as consuming five or more alcoholic drinks on at least one occasion in the past 2 wk and four or more for women. Athletes were compared with other students at their colleges. RESULTS: Athletes reported more binge drinking, heavier alcohol use, and a greater number of drinking-related harms. Athletes are more likely to exhibit the strong social ties found to be associated with binge drinking. Athletes, despite drinking more heavily than other students, report greater exposure to alcohol prevention efforts and possess unique motivations to limit their alcohol use. CONCLUSIONS: Athletes are a high-risk group for binge drinking and alcohol-related harms. Although special educational programs have targeted this group they have not sufficiently impacted the problem. Future prevention efforts targeted for athletes should address the unique social and environmental influences on athletes. Programs should also take advantage of motives of athletes for self-limiting alcohol intake. Colleges, athletic departments, coaches, and sports medicine professionals are urged to act to help reduce athletes risk of alcohol-related harms.

Adult↗
PubMed2004

Prevalence of eating disorders in elite athletes is higher than in the general population.

OBJECTIVE: The objectives of the study were to examine the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), anorexia athletica (AA), and eating disorders not otherwise specified (ED-NOS) in both male and female Norwegian elite athletes and a representative sample from the general Norwegian population. DESIGN: A 2-step study including self-reported questionnaire and clinical interview. SETTING/PARTICIPANTS: The entire population of Norwegian male and female elite athletes (n=1620) and controls (n=1696) was evaluated for the presence of eating disorders (EDs). MAIN OUTCOME MEASUREMENT: Based on the results of the questionnaire, all athletes and controls classified as at risk for EDs, and a representative sample of athletes and controls classified as healthy participated in the clinical part of the study to determine the number of subjects meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for EDs. RESULTS: More athletes (13.5%) than controls (4.6%; P<0.001) had subclinical or clinical EDs. The prevalence of EDs among male athletes was greater in antigravitation sports (22%) than in ball game (5%) and endurance sports (9%; P<0.05). The prevalence of EDs among female athletes competing in aesthetic sports (42%) was higher than that observed in endurance (24%), technical (17%), and ball game sports (16%). CONCLUSIONS: The prevalence of EDs is higher in athletes than in controls, higher in female athletes than in male athletes, and more common among those competing in leanness-dependent and weight-dependent sports than in other sports. A collaborative effort among coaches, athletic trainers, parents, physicians, and athletes is optimal for recognizing, preventing, and treating EDs in athletes.

Adolescent↗
PubMed1982

Ambulatory electrocardiographic recording in endurance athletes.

Data from ambulatory electrocardiographic recording in 35 highly trained endurance athletes and in 35 non-athletic controls of similar ages are given. The minimal, mean hourly, and maximal heart rates were significantly lower in the athletes. Thirteen athletes (37 . 1%) but only two controls (5 . 7%) had sinus pauses exceeding 2 . 0 seconds. First degree atrioventricular block was observed in 13 athletes (37 . 1%) and five controls (14 . 3%), second degree Wenckebach type block in eight athletes (22 . 9%) and two controls (5 . 7%), and second degree block with Mobitz II-like pattern in three athletes (8 . 6%) and no control. All athletes with Mobitz II-type pattern also had first degree and Wenckebach-type second degree atrioventricular block. The behavior of sinus rate on development of atrioventricular block varied, not only interindividually but also intraindividually, from absence of change to an increase or decrease in most subjects in both study groups. A decrease in sinus rate on appearance of atrioventricular block was found constantly in only two athletes and one control. Atrioventricular dissociation with junctional rhythm occurred in seven athletes (20%) and with ventricular rhythm in one athlete. Neither of these phenomena was seen in the group of controls. The athletes had slightly fewer ventricular extrasystoles than controls, and no athlete had ventricular tachycardia, whereas two controls had ventricular tachycardia.

Adolescent↗
PubMed1996

A cross-sectional study on body composition and energy expenditure in women athletes during aging.

The relationships between total and regional body composition, intra-abdominal adipose tissue (IAAT), resting metabolic rate (RMR), and substrate oxidation were examined in 43 highly trained women athletes and 14 sedentary women aged 18-69 yr. Athletes were divided into four groups (18-29, 30-39, 40-49, and 50-69 yr) and controls into two groups (18-29 and 40-50 yr). Maximal oxygen consumption declined with age (r = -0.52, P < 0.0005) in the athletes and was higher in all groups of athletes than in controls (P < 0.0001). No differences in percent fat and fat-free mass (FFM) were found between the youngest and oldest athletes. Although body mass index was < 25 kg/m2 in all subjects, percent body fat and total fat mass were higher in controls than in athletes for both young and older women (all P < 0.05). FFM was higher in young athletes than in young controls (P < 0.0001). Despite similar percent fat among athletes, IAAT increased with age (r = 0.75, P < 0.0001), but subcutaneous abdominal fat and sagittal diameter did not. IAAT and subcutaneous abdominal fat were also higher in young controls than in young athletes and in older controls than in older athletes (all P < 0.005). Age and FFM were independent predictors of the decline in RMR in the athletes. Fat oxidation (g/day) was highest in the youngest athletes and declined with age (r = -0.47, P < 0.005). We conclude that intense chronic exercise in women athletes prevented the decline in FFM with age. Endurance-trained women have low IAAT stores, which may potentially reduce subsequent risk associated with the metabolic syndrome.

Adipose Tissue↗
PubMed2000

The athlete's heart. A meta-analysis of cardiac structure and function.

BACKGROUND: It has been postulated that depending on the type of exercise performed, 2 different morphological forms of athlete's heart may be distinguished: a strength-trained heart and an endurance-trained heart. Individual studies have not tested this hypothesis satisfactorily. METHODS AND RESULTS: The hypothesis of divergent cardiac adaptations in endurance-trained and strength-trained athletes was tested by applying meta-analytical techniques with the assumption of a random study effects model incorporating all published echocardiographic data on structure and function of male athletes engaged in purely dynamic (running) or static (weight lifting, power lifting, bodybuilding, throwing, wrestling) sports and combined dynamic and static sports (cycling and rowing). The analysis encompassed 59 studies and 1451 athletes. The overall mean relative left ventricular wall thickness of control subjects (0.36 mm) was significantly smaller than that of endurance-trained athletes (0.39 mm, P=0.001), combined endurance- and strength-trained athletes (0.40 mm, P=0.001), or strength-trained athletes (0.44 mm, P<0.001). There was a significant difference between the 3 groups of athletes and control subjects with respect to left ventricular internal diameter (P<0. 001), posterior wall thickness (P<0.001), and interventricular septum thickness (P<0.001). In addition, endurance-trained athletes and strength-trained athletes differed significantly with respect to mean relative wall thickness (0.39 versus 0.44, P=0.006) and interventricular septum thickness (10.5 versus 11.8 mm, P=0.005) and showed a trend toward a difference with respect to posterior wall thickness (10.3 versus 11.0 mm, P=0.078) and left ventricular internal diameter (53.7 versus 52.1 mm, P=0.055). With respect to cardiac function, there were no significant differences between athletes and control subjects in left ventricular ejection fraction, fractional shortening, and E/A ratio. CONCLUSIONS: Results of this meta-analysis regarding athlete's heart confirm the hypothesis of divergent cardiac adaptations in dynamic and static sports. Overall, athlete's heart demonstrated normal systolic and diastolic cardiac functions.

Adult↗
PubMed1988

Menarche in athletes: the influence of genetics and prepubertal training.

It is unclear whether the later menarche observed in competitive athletes is due to genetic factors or environmental factors related to intense prepubertal training. In order to investigate the importance of these factors upon the age of menarche (AOM), 263 competitive swimmers and 71 women with no athletic experience were asked to complete questionnaires concerning general health and reproductive development. Based upon their responses, similar questionnaires were sent to the sisters of both groups. Complete data were obtained from 140 athlete/sister pairs and 43 control/sister pairs. Results indicate that the athletes were older at menarche than their sisters, the non-athletes, and the sisters of the non-athletes (14.3 yr, 13.7 yr, 12.9 yr, and 13.0 yr, respectively). The sisters of the athletes were significantly older at menarche than the controls and their sisters, while the AOM of the non-athletic controls and their sisters did not differ. The interpretation of the data is complicated by the fact that the sisters of the athletes were likely to be athletes (75%), while those of the control group tended to be non-athletic (74%). The athletes differed from their sisters who trained prior to menarche (13.9 years) and from those who did not engage in prepubertal training (13.1 years). Controls did not differ from any of their sister groups, nor did they differ from the untrained sisters of athletes. In terms of the similarity of the AOM within the sister pairs, the athletes/sisters and controls/sisters were equally similar. Significant correlations were observed between athletes and their sisters who trained prior to menarche and controls and their sisters who did not.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

Exercise-induced bronchospasm in high school athletes via a free running test: incidence and epidemiology.

BACKGROUND: Exercise-induced bronchospasm (EIB) affects up to 35% of athletes and up to 90% of asthmatics. Asthma morbidity and mortality have increased over the past several decades among residents of Philadelphia, PA. It is possible that a simple free running test for EIB may serve as a tool to study the factors contributing to recent trends in asthma, and to screen for asthma in athletes in the urban setting. OBJECTIVES: The purposes of this study were to (1) assess a free running test to screen for EIB, and (2) examine prevalence of and epidemiologic factors associated with EIB in high school athletes. DESIGN: Cross-sectional observational study on the incidence and risk factors for EIB. To validate our method and criteria for the diagnosis of EIB, a repeat test was performed on a portion of the athletes. In a randomized single-blinded fashion, 15 athletes who had demonstrated EIB initially received albuterol or placebo prior to a repeat exercise test. SETTING: Community high school athletic facilities. PARTICIPANTS: We studied 238 male high school varsity football players. INTERVENTION: All athletes underwent an acquaintance session with a questionnaire, followed by a 1-mile outdoor run (6 to 8 mins). MEASUREMENTS: Peak expiratory flow (PEF) measurements were determined prior to and 5, 15, and 30 min after exercise. Heart rates (HRs) and dyspnea scores were measured. EIB was defined as a decrease of 15% in PEF at any time point after exercise. Associations of EIB with demographic factors were assessed by univariate and multivariate analyses. RESULTS: Two hundred thirty-eight athletes participated: 92 European-Americans (EA), 140 African-Americans (AA), 5 Hispanics, and 1 Native American. Mean age was 16+/-1 years. Average HR postexercise was 156+/-24 beats/min. Twenty-four (10%) reported a history of treated asthma. The prevalence of EIB among the remaining 214 athletes was 19 of 214 (9%). The rate of EIB among AA athletes was higher than among EA athletes: (17/126 [13%] AA vs 2/82 [2%] EA, p = 0.01). During the validation portion of the study, the placebo-treated group (n = 7) demonstrated a consistent drop in PEF after exercise on repeat testing, with a 16+/-5% fall in PEF on initial testing and a 14+/-13 drop with placebo. In contrast, the fall in airflow in the albuterol-treated athletes (n = 8) following exercise reversed with albuterol treatment, from a 15+/-6% fall in PEF at initial testing to an increase in PEF of 6+/-9% from baseline following albuterol administration. A history of wheezing (p < 0.001), residence in a poverty area (p < 0.0001), race (p = 0.01), remote history of asthma (p < 0.001), and absolute water content of the air on the day tested (p = 0.04) were significantly associated with EIB. By stepwise regression, EIB was most closely associated with a history of wheezing (p = 0.001) and poverty area residence (p = 0.003). CONCLUSIONS: Our findings indicate a substantial rate of unrecognized EIB exists among urban varsity athletes, and suggest that active screening for EIB, especially for students residing in poverty areas, may be indicated to identify individuals at risk for EIB and asthma.

Albuterol↗
PubMed2007

Are drinking games sports? College athlete participation in drinking games and alcohol-related problems.

OBJECTIVE: Studies indicate greater heavy episodic drinking and related consequences for college student-athletes compared with nonathletes. Surprisingly, little research has examined college athletes' participation in drinking games, a context associated with excessive alcohol consumption and negative alcohol-related consequences in college students. METHOD: We examined how drinking game participation contributes to alcohol consumption and alcohol-related consequences among college-level intramural and intercollegiate athletes compared with nonathletes in two independent samples. Study 1 consisted of 1,395 randomly selected students (61% women) at a West Coast college campus, including 335 students who reported intramural athletic participation. Study 2 consisted of 6,055 randomly selected college students (63% women) from three college campuses, including 1,439 intramural athletes and 317 intercollegiate athletes. RESULTS: Results of Study 1 indicated that intramural athletes consumed significantly more drinks per week, had significantly higher typical and peak blood alcohol concentration levels, and reported more negative consequences than nonathletes. Drinking game participation mediated the relationship between intramural athlete status and measures of consumption and consequences. Results of Study 2, including both intramural and intercollegiate athletes, were consistent with those of Study 1, revealing drinking game participation as a mediator of the relationships between athlete status and alcohol consumption and consequences. CONCLUSIONS: Drinking games represent contexts for college athletes to engage in heavy episodic drinking, and participation in drinking games mediates the relationship between alcohol consumption and negative consequences in athletes. Interventions targeted at college athletes should consider the impact of drinking game participation.

Adolescent↗
PubMed2005

Comparison of the predictors for atrial rhythm disturbances between trained athletes and control subjects.

Atrial rhythm disturbances, particularly atrial fibrillation (AF), are frequently encountered in trained athletes. P wave dispersion (PWD) is a recent electrocardiographic (ECG) marker that reflects velocity of atrial impulse propagation. However, it remains unknown whether the P wave duration and PWD are different between athletes and sedentary controls. In this study we therefore determined the P wave duration and PWD, markers for conduction abnormalities, in trained athletes and controls. Fifty athletes and sex and age-matched 40 healthy sedentary controls were included in the study. All of the athletes were the members of a local athletic college and they were regularly maintaining their sportive activities; the duration of athletic competition was 7.7 +/- 3.3 years and the average athletic time was 10.1 +/- 1.6 hours/week. The 12-lead surface ECG was obtained from each subject in the supine position. The P wave duration was measured, and the difference between the maximum and minimum P wave duration was defined as the PWD. Distribution of sex, age, body mass index, blood pressure was similar in athletic groups and controls. Heart rate was significantly lower in the athletes than in the controls (66 +/- 7 vs 73 +/- 9 beats/min, p < 0.05). Maximum and minimum P wave durations were not statistically different in athletic group and controls (115 +/- 6 vs 114 +/- 4 ms and 74 +/- 8 vs 74 +/- 7 ms, respectively). In addition, PWD did not differ significantly in both groups (41 +/- 6 vs 40 +/- 7 ms, respectively). Thus, athlete's heart is not associated with prolonged P wave duration and increased PWD, indicating that P wave duration or PWD could not be used as a predictor for AF developed in trained athletes.

Adult↗
PubMed1991

The 'athletic heart syndrome'. A critical review.

Cardiological findings in athletes are often similar to those observed in clinical cases. Electrocardiographic and cardiac imaging abnormalities as well as physical findings may be the same in both of these groups. Bradycardia and rhythm disturbances are the most common abnormalities in athletes. Most athletes with abnormal electrocardiograms are asymptomatic and numerous investigators have failed to detect heart disease in association with such electrocardiograms. In contrast to cardiac dysfunction observed in clinical cases, enhanced or normal ventricular systolic and diastolic function have been reported in athletes. In endurance athletes, this is associated with very high values for maximal aerobic power (VO2max). Absolute and body size-normalised cardiac dimensions in most athletes do not approach values from chronic disease states, and may not exceed echocardiographic normal limits. In addition, pathological and physiological enlargement appear to be biochemically and functionally different. Myosin ATPase enzyme expression and calcium metabolism are different in rats with pathologically or physiologically induced enlargement. The reported biochemical differences underlie systolic and diastolic dysfunction in pathological enlargement. Conversely, trained rodents and humans have demonstrated enhanced systolic and diastolic function. It is important to note that cardiac enlargement observed in athletes is the result of normal adaptation to physical conditioning and/or hereditary influences. Conversely, pathological changes result from disease processes which can lead in turn to reduced function, morbidity and mortality. Since the mid 1970s echocardiography has been used to compare cardiac dimensions in male endurance- and resistance-trained athletes. A sport-specific profile of eccentric and concentric enlargement has been documented in endurance and resistance athletes, respectively. Subsequent studies of athletes have examined factors such as age, sex and degree of competitive success to determine their contribution to these sport-specific cardiac profiles. Unique athletic subgroups have also been analysed and have included ballet dancers, rowers, basketball players and triathletes. However, there is a paucity of data on cardiac dimensions in female athletes. Finally, physical conditioning studies have also examined echocardiographic dimensions before and after endurance and resistance training. Significant enlargement of internal dimensions, wall thickness or left ventricular mass have been reported but such increases are relatively small and by no means universal. Several conflicting explanations for enlarged cardiac dimensions appear in the literature. Chronic volume and pressure haemodynamic overloading during physical conditioning has been proposed to explain eccentric and concentric cardiac enlargement in endurance- and resistance-trained athletes respectively. However, twin studies suggest that hereditary factors may be important determinants of cardiac dimensions and/or the degree of cardiac adaptability to physical conditioning.(ABSTRACT TRUNCATED AT 400 WORDS)

Body Mass Index↗