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PubMed1997

The 'worn-out athlete': a clinical approach to chronic fatigue in athletes.

Chronic fatigue in the athletic population is a common but difficult diagnostic challenge for the sports physician. While a degree of fatigue may be normal for any athlete during periods of high-volume training, the clinician must be able to differentiate between this physiological fatigue and more prolonged, severe fatigue which may be due to a pathological condition. As chronic fatigue can be the presenting symptom of many curable and harmful diseases, medical conditions which cause chronic fatigue have to be excluded. The clinician must then be able to differentiate between chronic fatigue associated with training or chronic fatigue from other medical causes, and also between the chronic fatigue syndrome and the overtraining syndrome. Once the clinician has excluded all of the above medical conditions which cause chronic fatigue in athletes, a significant proportion of fatigued athletes remain without a diagnosis. Novel data indicate that skeletal muscle disorders may play a role in the development of symptoms experienced by the athlete with chronic fatigue. The histological findings from muscle biopsies of athletes suffering from the 'fatigued athlete myopathic syndrome' are presented. We have designed a clinical approach to the diagnosis and work-up of the athlete presenting with chronic fatigue. The strength of this approach is that it hinges on the participation of a multidisciplinary team in the diagnosis and management of the athlete with chronic fatigue. The athlete, coach, dietician, exercise physiologist and sport psychologist all play an important role in enabling the physician to make the correct diagnosis.

Chronic Disease↗
PubMed2000

Components and variations in daily energy expenditure of athletic and non-athletic adolescents in free-living conditions.

The objectives of the study were to determine: (1) daily energy expenditure (EE) of athletic and non-athletic adolescents of both sexes in free-living conditions; (2) day-to-day variations in daily EE during 1 week; (3) energy costs of the main activities; and (4) the effect of usual activity on EE during sleep, seated and miscellaneous activities. Fifty adolescents (four groups of eleven to fifteen boys or girls aged 16-19 years) participated in the study. Body composition was measured by the skinfold-thickness method, and VO2max and external mechanical power (EMP) by a direct method (respiratory gas exchanges) on a cycloergometer. Daily EE and partial EE in free-living conditions were computed from heart-rate (HR) recordings during seven consecutive days using individual prediction equations established from the data obtained during a 24 h period spent in whole-body calorimeters with similar activities. Fat-free mass (FFM), VO2max, EMP, daily EE and EE during sleep were significantly higher in athletic than in non-athletic subjects. After adjustment for FFM, VO2max, EMP, daily EE and EE during exercise were still higher in athletic than in non-athletic adolescents (P < 0.001). However, adjusted sleeping EE was not significantly different between athletic and non-athletic adolescents. Increases in exercise EE were partly compensated for by significant reductions in EE during schoolwork and miscellaneous activities. Thus, the differences in daily EE between athletic and non-athletic subjects resulted mainly from increases in FFM and EE during exercise (duration and energy cost).

Adolescent↗
PubMed1999

Athletes and eating disorders: the National Collegiate Athletic Association study.

OBJECTIVE: To present findings from a collaborative study with the National College Athletic Association regarding the prevalence of disordered eating among student athletes. METHOD: 1,445 student athletes from 11 Division 1 schools were surveyed using a 133-item questionnaire. RESULTS: Results indicated that 1.1% of the females met DSM-IV criteria for bulimia nervosa versus 0% for males. None of the student athletes met DSM-IV criteria for anorexia nervosa. 9.2% of the females were identified as having clinically significant problems with bulimia versus .01% of the males. 2.85% of the females were identified as having a clinically significant problem with anorexia nervosa versus 0% for males. 10.85% of the females reported binge eating on a weekly or greater basis versus 13.02% of the males 5.52% of the females reported purging behavior (vomiting, laxatives, diuretics) on a weekly or greater basis versus 2.04% for the males. DISCUSSION: Results from the current investigation are more conservative than previous studies of student athletes, but comparable to another large study of elite Norwegian athletes. Reasons for these differences are discussed. Clearly female athletes report more difficulty with disordered eating than male athletes. Some specific risk factors for female athletes are discussed.

Adipose Tissue↗
PubMed1999

Eating disorder behaviors of ethnically diverse urban female adolescent athletes and non-athletes.

This study compared Caucasian, Hispanic, and African-American urban adolescent athlete and non-athlete females for relative frequency of behavioral and psychological indices of eating disorders, while controlling for physical size. High school female athletes (n=571) and non-athletes (n=463) completed the Eating Disorder Inventory (EDI) composed of eight subscales that measure behavioral and psychological indices common in anorexia nervosa and bulimia nervosa. The MANCOVA for the main effect of ethnicity showed Caucasians and Hispanics scored significantly higher than African-Americans on six of the eight behavioral and psychological subscales of the EDI (p<0. 05). A MANCOVA for the main effect of athletic status showed no significant differences between athletes and non-athletes on the behavioral subscales of the EDI (p>0.05). This study suggests that Hispanic and Caucasian urban adolescent females are comparably more at-risk for eating disorders than African-American urban adolescent females. In addition, athletes were no more at-risk than non-athletes for eating disordered behaviors.

Adolescent↗
PubMed2000

Aortic root dilatation among young competitive athletes: echocardiographic screening of 1929 athletes between 15 and 34 years of age.

BACKGROUND: Aortic dilatation can be lethal for young competitive athletes. The prevalence among athletes is not known, however, and thus a reasonable approach to early recognition remains uncertain. METHODS AND RESULTS: Echocardiograms of 1929 normotensive athletes 15 to 34 years of age were analyzed. Five (0.26%) athletes had aortic dilatation; 4 of the 5 played basketball. This made the prevalence of aortic dilatation 0.96% (4 of 415) among basketball and volleyball players, who represented a population of especially tall athletes. Tallness aside, only 2 of the 5 athletes had features of Marfan syndrome. Among the athletes without aortic dilatation, the relation between body surface area and aortic root dimension was nonlinear and best described with a quadratic regression model. Athletes with aortic dilatation fell well outside the 95% confidence interval. CONCLUSION: Because a higher incidence of aortic dilatation is to be anticipated among very tall athletes, inclusion of echocardiography in screening before participation in certain sports should be considered.

Adolescent↗
PubMed1985

Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes.

The prevalence (lifetime occurrence) rate of cancers of the reproductive system (uterus, ovary, cervix and vagina) and breast cancer was determined for 5,398 living alumnae, 2,622 of whom were former college athletes and 2,776 non-athletes, from data on medical and reproductive history, athletic training and diet. The former athletes had a significantly lower risk of cancer of the breast and reproductive system than did the non-athletes. The relative risk (RR), non-athletes/athletes, for cancers of the reproductive system was 2.53. 95% confidence limits (CL) (1.17, 5.47). The RR for breast cancer was 1.86, 95% CL (1.00, 3.47). The analysis controlled for potential confounding factors including age, family history of cancer, age of menarche, number of pregnancies, use of oral contraceptives, use of oestrogen in the menopausal period, smoking, and leanness. Of the college athletes, 82.4% had been on pre-college teams compared to 24.9% of the college non-athletes. We conclude that long term athletic training may lower the risk of breast cancer and cancers of the reproductive system.

Adult↗
PubMed2000

Breast cancer among former college athletes compared to non-athletes: a 15-year follow-up.

A growing body of evidence indicates that physical activity is protective against breast cancer. In 1996-97, we conducted a 15-year follow-up of 5398 college alumnae comprised of former college athletes with their non-athletic classmates. Participants completed a detailed mailed questionnaire on their health history from 1981-82 to the present. Excluding women who had died and non-deliverable questionnaires, 84.7% (n = 3940) of the participants in our earlier study responded to the questionnaire; the response rate for former athletes was 86.6% (n = 1945), for non-athletes, 83.0% (n = 1995). Results confirmed our earlier findings. Based on self-reports, former college athletes had a significantly lower risk of breast cancer than the non-athletes. The OR for the 15-year incidence of breast cancer is 0.605 with 95% confidence interval (CI) (0.438-0.835); the 15-year incident breast cancers were 64 among the athletes and 111 among the non-athletes. Among women under 45 the protective effect of physical activity on the risk of breast cancer is considerably greater; odds ratio (OR) = 0.164, 95% CI (0.042-0.636). Athletic activity during the college and pre-college years is protective against breast cancer throughout the life span, and more markedly among women under 45. These results confirm our earlier findings and the findings of other investigators.

Aged↗
PubMed1979

[Echocardiographic studies on athletes of various sport-types and non-athletic persons (author's transl)].

The results of echocardiographic studies on 90 athletes representing various sport-types and 18 non-athletic persons are presented. The intracardiac diameter measured by echocardiography was proportional to the heart volume determined radiologically. The thickness of the septum and posterior heart wall compared to the internal heart diameter was greater in athletes with static exercise than in endurance athletes. This must be interpreted as a tendency to concentric hypertrophy. In endurance athletes this relationship tended to be less than in non-athletic persons. In addition stroke volume and cardiac output at rest was higher in endurance athletes than in athletes with static exercise and non-athletic persons. At rest no variations in parameters of heart muscle contractility related to heart size or sport-type could be detected.

Adult↗
PubMedDate not supplied

Pulmonary function of Indian athletes and sportsmen: comparison with American athletes.

Studies were conducted to evaluate pulmonary functions in Indian athletes and sportsmen associated with different athletic events and games. It was found that swimmers were having significantly higher vital capacity (VC) and forced expiratory volume (FEV1) values than all other athletic groups studied. Results have been discussed keeping in view the physiological, functional and structural demands in various events. Pulmonary function values of Indian athletes have also been compared with American athletes of standardized height for a better appraisal of athletic potentiality in our athletes. The importance of athletic training from childhood have been ascribed to be the reason for superior lung volumes and capacities in US athletes.

Adult↗
PubMed1990

Perceptions of athletic injuries by athletes, coaches, and medical professionals.

35 athletes, their coaches, and medical professionals independently assessed the disruption, seriousness, and short-term effects of the athletes' athletic injuries. Athletes underestimated the disruption and short-term effects of the injury when compared to medical professionals. 25 lower level athletes and those with no previous serious athletic injury overestimated the short-term effects of their injuries. Coaches overestimated the disrupting effects of the injury for 10 higher level athletes and 25 athletes with no previous injury.

Activities of Daily Living↗
PubMed2003

Drug testing athletes to prevent substance abuse: background and pilot study results of the SATURN (Student Athlete Testing Using Random Notification) study.

PURPOSE: To assess the deterrent effect of mandatory, random drug testing among high school (HS) athletes in a controlled setting. METHODS: Two high schools, one with mandatory drug testing (DT) consent before sports participation, and a control school (C), without DT, were assessed during the 1999-2000 school year. Athletes (A) and nonathletes (NA) in each school completed confidential (A) or anonymous (NA) questionnaires developed for this study, respectively, at the beginning and end of the school year. Positive alcohol or drug tests required parent notification and mandatory counseling without team or school suspension. Thirty percent of the DT athletes were tested. Data were analyzed using the end of the school year measure, adjusted for the initial questionnaire results. Demographics of the athlete sample revealed that mean age was 15.5 years with 81.5% white, 9.6% Hispanic, 4.5% Asian, 2.6% American Indian/Native Alaskan, 1.3% African-American, and 1.3% Native Hawaiian/Pacific Islander. RESULTS: A (n = 276) and NA (n = 507) were assessed at the beginning (baseline) and at the end of the school year (A, n = 159; NA, n = 338). The past 30-day index of illicit drugs (4-fold difference) and athletic enhancing substances (3-fold difference) were lower (p < .05) among DT athletes at follow-up without difference in alcohol use. However, most drug use risk factors, including norms of use, belief in lower risk of drugs, and poorer attitudes toward the school, increased among DT athletes (p < .05). Although a reduction in the illicit drug use index was present among nonathletes at the DT school, at the end of the school year, it did not achieve statistical significance (p < .10). CONCLUSIONS: Random DT may have reduced substance use among athletes. However, worsening of risk factors and small sample size suggests caution to this drug prevention approach. A larger long-term study to confirm these findings is necessary.

Adolescent↗
PubMed2000

Food habits and sport activity during adolescence: differences between athletic and non-athletic teenagers in Switzerland.

OBJECTIVE: To describe food habits and dietary intakes of athletic and non-athletic adolescents in Switzerland. SETTING: College, high schools and professional centers in the Swiss canton of Vaud. METHOD: A total of 3,540 subjects aged 9-19 y answered a self-reported anonymous questionnaire to assess lifestyles, physical plus sports activity and food habits. Within this sample, a subgroup of 246 subjects aged 11-15 also participated in an in-depth ancillary study including a 3 day dietary record completed by an interview with a dietician. RESULTS: More boys than girls reported engaging in regular sports activities (P<0.001). Adolescent food habits are quite traditional: up to 15 y, most of the respondents have a breakfast and eat at least two hot meals a day, the percentages decreasing thereafter. Snacking is widespread among adolescents (60-80% in the morning, 80-90% in the afternoon). Food habits among athletic adolescents are healthier and also are perceived as such in a higher proportion. Among athletic adolescents, consumption frequency is higher for dairy products and ready to eat (RTE) cereals, for fruit, fruit juices and salad (P<0.05 at least). Thus the athletic adolescent's food brings more micronutrients than the diet of their non-athletic counterparts. Within the subgroup (ancillary study), mean energy intake corresponds to requirements for age/gender group. CONCLUSIONS: Athletic adolescents display healthier food habits than non-athletic adolescents: this result supports the idea that healthy behavior tends to cluster and suggests that prevention programs among this age group should target simultaneously both sports activity and food habits.

Adolescent↗
PubMed1982

Resting ECG in athletic and non-athletic adolescent boys: correlations with heart volume and cardiorespiratory fitness.

Resting ECG was recorded in 59 endurance trained athletic and 81 non-athletic boys aged 10-17 years and the findings were correlated with heart volume and cardiorespiratory fitness. The two groups were physically similar, but the athletes had significantly higher maximal oxygen uptake and the 15-17-year-old athletes had larger heart volumes. ECG findings were rather similar in both groups, the major differences being a lower heart rate in the athletes than in the controls (71 vs 82 beats/min) and a longer PQ interval (0.151 vs. 0.140 s) and a greater sum of SV2 and RV4 (59 vs. 50 mm) in the 15-17-year-old athletes. In the controls no correlation existed between precordial voltage criteria for ventricular hypertrophy and heart volume or between heart volume and cardiorespiratory fitness. Contrary to this, in the athletes both SV2 + RV5 and SV2 + RV4 correlated significantly (r about 0.40) with relative heart volume, and relative heart volume with both maximal oxygen uptake per kg (r = 0.41) and calculated work at heart rate 170 beats/min expressed per kg (r = 0.61). Our findings seem to indicate that as a consequence of endurance training the high level of cardiorespiratory fitness becomes related to a large heart volume. It is obvious that ECG changes due to relative vagal dominance develop earlier in the adolescent athletes than those attributable to anatomical changes.

Adolescent↗
PubMed2000

Painkilling drugs in collegiate athletics: knowledge, attitudes, and use of student athletes.

This study was designed to examine the attitudes of student athletes toward the use of painkilling drugs. A total of 563 student athletes at two Division One NCAA universities were surveyed in this study. Twenty-nine percent of the student athletes (n = 165) reported that they felt there is nothing wrong with using painkilling drugs on the day of competition (when injured) to cope with pain. These student athletes reported that they would use painkilling drugs to mask injury in order to continue to participate in their sport. Student athletes' perceptions of societal norms and expectations related to competition, and the degree of control student athletes perceive that they have when deciding to use painkillers, may be important determinants governing the extent to which they may be at risk for abusing these substances. Research on planned behavior and reasoned action against suggests that salient beliefs affect intentions and subsequent behaviors, either through attitudes or subjective norms, or the degree of (perceived) control that an individual feels he/she has over the behavior [1, 2]. This theoretical model was used as a guiding framework for analyzing the attitudes of college athletes toward painkilling drugs. Recommendations are included in this article for coaches, educators, team physicians, team trainers, and administrators who are concerned about controlling the use and abuse of painkilling drugs by student athletes.

Adaptation, Psychological↗
PubMed2002

The Development of Expert Male National Collegiate Athletic Association Division I Certified Athletic Trainers.

OBJECTIVE: To identify the major influences in the development of expert male National Collegiate Athletic Association (NCAA) Division I certified athletic trainers. DESIGN AND SETTING: The participants were individually interviewed, and the data were transcribed and coded. SUBJECTS: Seven male NCAA Division I certified athletic trainers, who averaged 29 years of experience in the profession and 20 years at the Division I level. RESULTS: We found 3 higher-order categories that explained the development of the certified athletic trainers and labeled these meaningful experiences, personal attributes, and mentoring. The growth and development of the athletic trainers were influenced by a variety of meaningful experiences that began during their time as students and continued throughout their careers. These experiences involved dealing with challenging job conditions, educational conditions, and attempts to promote and improve the profession. The personal attributes category encompassed the importance of a caring and service-oriented attitude, building relationships with athletes, and maintaining strong bonds within their own families. Mentoring of these individuals occurred both inside and outside the athletic training profession. CONCLUSION: We provide a unique view of the development of athletic trainers that should be of interest to those in the field, regardless of years of experience.

Journal Article↗
PubMed1992

Eating disorders among adolescent female athletes: influence of athletic participation and sport team membership.

Female athletes have been identified as a potential risk group for the development of eating disorders. Although adolescents in general are particularly vulnerable to the onset of eating disorders, little research has examined the problem among high school female athletes. The present study explored this population by comparing female athletes and nonathletes in terms of (a) behavioral and psychological traits associated with eating disorders and (b) use of pathogenic weight control techniques (laxatives, vomiting, fasting, and diet aids). Sport-by-sport comparisons were also investigated to determine if athletes in specific sports were more at risk. Moreover, in an attempt to link athletic participation and eating disordered behavior, the gender-role orientation of athletes was examined. Results indicated that (a) athletes were more likely than nonathletes to possess certain behavioral and psychological correlates of eating disorders, (b) there were few differences among the various sport teams, and (c) gender-role orientation was generally not a critical variable. Although group comparisons yielded limited significant differences, athletes nevertheless reported traits associated with eating disorders as well as use of pathogenic weight control techniques. The unique contributions of the sport context and coaching practices exacerbating disordered eating are discussed.

Adolescent↗