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Current comment from the American College of Sports Medicine. August 1993--"The prevention of sport injuries of children and adolescents".

Many children and adolescents choose to participate in organized sports for fun and fitness, and to develop sports skills. However, new injury patterns are developing as the number of children and adolescents in organized sports increases--injury patterns that were not apparent when youth spent most of their sport and fitness time in free play. Up to one half of all injuries that are sustained by children and adolescents while playing organized sports are likely preventable. Attention to physical deficits, training methods, safety equipment, and psychological health should decrease the incidence of these injuries. As the governing bodies of specific sports develop safety guidelines for young athletes, adults involved with youth sports must become aware of these guidelines and assist with their implementation. This pronouncement addresses methods for decreasing the number and severity of these injuries. It delineates injury prevention strategies that should be included in the pre-participation examination; stresses the importance of adherence to recommended training principles; and discusses appropriate modifications of game rules and sport and fitness activities as needed for individuals who would likely be at risk for injury should adult rules and training methods be followed. Children and adolescents should include fitness exercises in the training routine, rather than devoting all of each training session to the development of specific skills required for a certain sport. The fitness activities may be geared toward the strength, endurance, and flexibility requirements of the specific sport, but should not exclude other components of a well-rounded general fitness program.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Physical and sports activities in the history of patients treated for addictions. Report 1999 of the study sponsored by the Ministry of Youth and Sports (France)].

Early February 1999, the French Ministère de la Jeunesse et des Sports (Youth and Sports Ministry) sponsored three different studies, aiming to prevent harmful behavior in the area of sport practices among youth. Two years earlier, our health care team working with drug users published reports on the meaningfulness of intensive sports activities in the history of our patients. The present work was performed to highlight the midterm results of one of these studies, to better understand and quantify the importance of physical training in the history of a group of outpatients seen for addictive disorders and comorbid pathologies. For 20 consecutive weeks, 3,040 self-administered questionnaires were available for persons consulting 20 health centers, 2 self-help groups and a general practitioner network working in the field of alcohol or heroine abuse. One thousand one hundred and eleven questionnaires were filled out (36.1%) and returned by mail for complete analysis: 86% of the answering persons had practiced at least one sports activity or participated in physical training, 10.5% had participated in a national or international level competition, and 10.6% reported stress fractures. In the intensive sports group, 36% had used illicit drugs intravenously and 16.4% said they had already used doping substances. Only 28.4% said they experienced dependence during their period of intensive sports activities compared with 15.2% before this time, and a majority (56.4%) thereafter. Intensive sports or physical training should not be seen as a protective factor nor as a way of improving addictive behaviors. More studies are needed to evaluate individual vulnerability factors and specific harm of overtraining and to determine the exact periods when men and women participating in sports activities are likely to abuse drugs, especially at the end of their career.

Adult↗

Cognitive-affective sources of sport enjoyment in adolescent sport participants.

Cognitive-affective sources of sport enjoyment were examined among male high school freshmen (N = 231), all of whom had participated in organized youth sport. Subjects completed several sport-specific measures. Also, recorded was an indicator of number of years of participation in organized sport. Stepwise multiple regression analysis indicated that significant sources of sport enjoyment included task orientation, perceived competence, learned helpless affect, and years of participation in organized sport. Results also indicated, however, that ego orientation failed to enter the stepwise equation as a significant predictor of sport enjoyment. The findings are discussed in regard to the importance of the development of competence to enjoyment. Suggestions are offered for the need to advance task orientation and self-referenced perceived ability in sport achievement settings in order to foster positive affect and ongoing participation in organized youth sport.

Adolescent↗

Sports injury experiences from the Western Australian Sports Injury Cohort Study.

OBJECTIVE: The Western Australian Sports Injury Study is the first prospective cohort study of sports injuries sustained during community-level sports participation in Australia. METHODS: The players were nonprofessional/non-elite participants of hockey, Australian football, basketball and netball from metropolitan Perth. Players completed a baseline questionnaire relating to their sports injury history, training practices, protective equipment use, demographic profile, general health and lifestyle factors. Sports participation and injury experiences were monitored by monthly telephone surveys over two consecutive five-month winter sporting seasons during 1997 and 1998. RESULTS: Of the 1,512 players recruited into the initial cohort, 966 (i.e. 64%) responded to at least 700% of the callback surveys over the two-year follow-up. Across all sports, the injury incidence rate was 16.1 injuries/ 1,000 exposure hours (both games and training). Injury rates were highest in Australian football and lowest in netball. Lower limb injuries were twice as common as those to the upper limb (67% vs. 31%). Three-quarters of injured players sought treatment from a health care practitioner. CONCLUSIONS AND IMPLICATIONS: This is the first longitudinal study of injuries to community-based sports participants in Australia. Compared with elite sports participants, the risk of injury is relatively low. The results provide valuable direction for the design and conduct of further aetiological studies.

Adolescent↗

[Utilisation of a questionnaire of fatigue in sport children: effect of sport, age and gender].

In children, fatigue induced by regular sport activity with important training sessions and competitions is still difficult to objective. The purpose of this study was to evaluate the fatigue induced by intensive training, with an auto-questionnaire of fatigue specially elaborated for sport children aged in 8 to 16 year-old, and the incidence of age, sex and the type of sport practiced. A study was conducted on 780 auto-questionnaires (QFES) distributed to 581 children, during 24 months in France (Rhône-Alpes-Auvergne). Results to the QFES are equivalent between sedentary and sport children. For 84.1% of them, no significant sign of fatigue was detected. No age effect has be seen, but girls presented a greater score of fatigue (+5.5%) compared to boys. When considering the specificity of sport, sex difference disappeared. On the contrary, in children with elevated score of fatigue, three domains were principally affected: physical signs, symptoms and motivation. The results obtained in this study assess the relevance of this questionnaire in evaluating sport induced fatigue. Prevention should mainly focus in sport children, in order to reduce potential risks of a sport activity practiced in exhausting conditions.

Adolescent↗

The competing demands of sport and health: an essay on the history of ethics in sports medicine.

The history of ethics in sports medicine has been driven by the tension between the demands of sport and the demands of health.Historically, physicians have held that the demands of health place ethical limits upon the demands of sport. As external observers of the sports community, premodern sports physicians relentlessly criticized athletes and trainers who pursued victory even at the cost of the athlete's health. As integral members of the sports community,though, modern sports physicians have themselves sometimes placed the demands of sport ahead of the demands of health.

Competitive Behavior↗

[Epidemiology of sports injuries. A 15 year analysis of sports orthopedic ambulatory care].

Analysis of a special outpatient department of sports orthopaedics covers a 15-year period (1972-1986); the department studies by us was initially part of the Orthopaedic Hospital of the University of Heidelberg, whereas later on we continued our studies at the Sports Clinic in Stuttgart-Bad Cannstatt. A grand total of 13,296 sportsmen treated in these departments was assessed, having a total of 15,212 injuries or lesions/damage due to sports activities. All cases were systematically recorded right from the beginning. In 1986, 19.3 million Federal German sportsmen were members of the Federal German Sports Association (DSB), i.e. 31.4% of the populations. The number of sports-related accidents that occurred per year is estimated at 1.5 million, i.e. more than 15% of the total number of accidents. The absolutely highest incidence rate of accidents is seen in popular sports such as football (i.e. "soccer", the most widely practised sport in the Federal Republic), skiing, handball, volleyball, track-and-field athletics, and gymnastics and physical training. The major part of the accidents involves the lower extremities (66.6%), followed by the arms (22.8%) and the vertebral column (4.7%). In respect of diagnoses, lesions of capsular ligaments are by far the most frequent ones. "Distortions" are stated to occur in 32.9% of the cases, severe injuries such as fractures, luxations and ruptures of ligaments representing a total of 33.6%. The incidence rate of contusions is increasing (12.6%), and so is that of lesions of the muscles and tendons (10.4%). 76.5% of the injured persons are men, with an age bracket peak at 20-29 years, followed by the group of 10-19 years. Analysis of the lesions yields valuable pointers to possibilities of accident or injury prevention within the individual sports categories.

Adolescent↗

Nonsurgical sports medicine training in the United States: a survey of sports medicine fellowship graduates.

OBJECTIVE: To survey graduates of nonsurgical sports medicine fellowship training programs about the quality and content of their educational curriculum. DESIGN: Survey. PARTICIPANTS: Participants were year 2000 active members of the American Medical Society for Sports Medicine (AMSSM) and American Osteopathic Academy of Sports Medicine (AOASM) and all other attendees at the 2000 AOASM and AMSSM annual meetings. The survey also was sent to candidates sitting for the 1999 CAQ examination from the American Board of Family Practice, American Board of Internal Medicine, American College of Emergency Physicians, and American Academy of Pediatrics. RESULTS: A total of 1608 surveys were distributed; 612 were returned for a return rate of 43%. Of respondents, 294 were fellowship trained, and 318 considered themselves to be sports medicine physicians but were not fellowship trained. Sections of the survey completed only by fellowship-trained physicians and focusing on training curriculum are reported in this article. Categories of survey questions included clinical experience, curriculum, academic activities, research, teaching experiences, primary care skills, procedures, types of athletes seen during training, supervision, and benefits. General attitudes about fellowship training also were surveyed: 99% of graduates were satisfied with their training and would do a fellowship again, and 98% felt they their training prepared them for a career in sports medicine. Orthopaedic experiences and physical examination skills were rated the highest. Research experience, work with disabled athletes, and selected areas of nonorthopaedic medical training, such as sports ophthalmology and sports psychology, were rated the lowest. CONCLUSIONS: Overall, fellowship training in sports medicine seems to be satisfactory to fellowship graduates. Strengths and weaknesses in training programs were identified.

Attitude of Health Personnel↗

Classifying sports medicine diagnoses: a comparison of the International classification of diseases 10-Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8).

BACKGROUND: The International classification of diseases 10-Australian modification (ICD-10-AM) and the Orchard sports injury classification system (OSICS-8) are two classifications currently being used in sports injury research. OBJECTIVES: To compare these two systems to determine which was the more reliable and easier to apply in the classification of injury diagnoses of patients who presented to sports physicians in private sports medicine practice. METHODS: Ten sports physicians/sports physician registrars each coded one of 10 different lists of 30 sports medicine diagnoses according to both ICD-10-AM and OSICS-8 in random order. The coders noted the time taken to apply each classification system, and allocated an ease of fit score for individual diagnoses into the systems. The 300 diagnoses were each coded twice more by "expert" coders from each system, and these results compared with those of the 10 volunteers. RESULTS: Overall, there was a higher level of agreement between the different coders for OSICS-8 than for ICD-10-AM. On average, it was 23.5 minutes quicker to complete the task with OSICS-8 than with ICD-10-AM. Furthermore, there was also higher concordance between the three coders with OSICS-8. Subjective analysis of the codes assigned indicated reasons for disagreement and showed that, in some instances, even the "expert" coders had difficulties in assigning the most appropriate codes. CONCLUSIONS: Based on the results of this study, OSICS-8 appears to be the preferred system for use by inexperienced coders in sports medicine research. The agreement between coders was, however, lower than expected. It is recommended that changes be made to both OSICS-8 and ICD-10-AM to improve their reliability for use in sports medicine research.

Abbreviated Injury Scale↗

Moral development and form of participation, type of sport, and sport experience.

The present study investigated aspects of moral development in sport, according to the form of participation, type of sport, and sport experience. 510 participants, 14 to 49 years of age (M=24.9, SD=8.3) who came from organized competitive sports included athletes (n=327), referees (n=138), and coaches (n=45) in football (n = 161), handball (n = 198), and basketball (n = 150). Years of sport experience ranged from 1 to 6, 7 to 14, and 15 to 30 years of participation in sports. The Defining Issues Test was given; analysis showed no significant differences in development of moral reasoning among participants across different types of sports, forms of participation, and years of experience in sport.

Adolescent↗

Interest in sports and belief in sports superstitions.

51 nonathletes, students (45 women) at a medium-sized southern university, were administered a survey containing three scales: an Interest in Sports Scale, a Belief in Sports Superstitions Scale, and Tobacyk and Milford's Paranormal Belief Scale (1983). Scores on the Interest in Sports Scale were significantly correlated with scores on the Belief in Sports Superstitions Scale, which measured adherence specifically to sports superstitions, but not with scores on the Paranormal Belief Scale, which measured a wide variety of irrational beliefs. Thus, participants with high interest in sports showed a tendency to subscribe to the type of irrational belief associated specifically with sports. Scores on the Belief in Sports Superstitions Scale were positively correlated with scores on the Paranormal Belief Scale.

Adult↗