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PubMed1992

Athletic trainer availability in interscholastic athletics in michigan.

Between January and March 1989, I surveyed the athletic directors of the 711 high schools of the Michigan High School Athletic Association, in order to determine the level of medical care available for students who participate in various sports. The results were compared to previous studies done in Michigan and in other states, to determine if there had been any increase in the number of athletic trainers working in a high school setting or any improvement in their educational backgrounds. Certification by the National Athletic Trainers' Association (NATA) was the measurement used to determine improvement in educational background. With 57% of the 711 athletic directors responding, 41% reported that they had the services of an athletic trainer for at least one sport during the year. The percentage of athletic trainers varied directly with the size of the school. The more populous schools had the greatest percentage of athletic trainers. Seventy percent of the athletic trainers were reported to be certified by the NATA. These findings were compared to two earlier studies conducted in Michigan and to surveys in other states. It was determined that there was an increase in the availability of athletic trainers, particularly certified athletic trainers, at the post-secondary level.

Journal Article↗
PubMed1994

Athletic trainers' attitudes toward drug screening of intercollegiate athletes.

Since the inception of NCAA-mandated drug screening in 1986, college athletic trainers have found themselves involved at various levels in institutional drug-screening programs. Several legal, moral, and ethical questions have been raised regarding the drug screening of college athletes, and studies have been conducted to rate athletes' attitudes toward this practice. We examined the responses of certified athletic trainers employed in college settings to ascertain their attitudes toward the drug screening of athletes in general, and, specifically, how they view their role in this process. Surveys were distributed to 500 college athletic trainers randomly selected from the membership database maintained by the National Athletic Trainers' Association, Inc (Dallas, TX). The results of this survey indicate that the majority of athletic trainers feel that their association with the drug-screening process places them in the dual role of police and counselor, but that this relationship does not negatively affect their rapport with their athletes. Opinions regarding the drug-screening process and the importance of education in deterring drug use are somewhat dependent upon the athletic trainer's involvement in the drug-screening process. Athletic trainers possess a stronger desire to serve as resource persons who organize substance abuse education programs rather than serving as administrators of the sampling process.

Journal Article↗
PubMed1992

Findings from the preparticipation athletic examination and athletic injuries.

This study investigated the relationships between the findings from a standardized preparticipation athletic examination, the sport played, and athletic injuries requiring treatment by a physician and/or requiring the athlete to miss one or more games. Of public high school students receiving a preparticipation athletic examination during the 1989-1990 academic year, 674 (56%) either completed a telephone interview or returned a mailed questionnaire at the end of the academic year. The sample consisted of 408 (60.5%) blacks and 243 (36.1%) whites; 470 (69.7%) of the subjects were males. The subjects ranged in age from 13 to 20 years (mean +/- SD, 16.1 +/- 1.2 years), and participated in at least 10 school sports. Injuries were reported by 29.5% of the athletes. The highest proportion of athletes injured occurred among male football (36.3%), female basketball (33.3%), male baseball (19.4%), male soccer (17.2%), and female track and field (15.8%) participants. Responses by the athletes and their parents on the standardized health history were significantly associated with injuries in several specific areas. Knee injuries were associated with previous knee injuries, knee surgery, and history of injuries requiring medical treatment. Ankle injuries were associated with previous ankle injuries and previous injuries requiring medical treatment. Both arm and other leg injuries were associated with previous fractures. Male athletes with either abnormal knee or ankle findings from the physical examination were more likely to injure the knee or ankle, respectively. However, the sensitivities and positive predictive values of these relationships are weak. These data suggest that the preparticipation athletic examination may not predict certain athletic injuries and that additional prevention efforts for specific body areas of injury are needed in certain sports.

Adolescent↗
PubMed2006

Awareness and comfort in treating the Female Athlete Triad: are we failing our athletes?

BACKGROUND: Recognition of the Female Athlete Triad (disordered eating, amenorrhea, osteoporosis) has increased significantly since it was defined in 1992 by the American College of Sports Medicine. However, knowledge and treatment of the Female Athlete Triad is still lacking among physicians and medical personnel. PURPOSE: We surveyed physicians, physical therapists, athletic trainers, and coaches to determine their knowledge and comfort in treating the Female Athlete Triad. METHODS: A questionnaire was submitted to 240 health care professionals (physicians, medical students, athletic trainers, physical therapists, and coaches) in a metropolitan city. RESULTS: Forty-eight percent of physicians, 43% of physical therapists, 38% of athletic trainers, 32% of medical students, and 8% of coaches were able to identify all 3 components of the Female Athlete Triad. When physicians were subdivided into specialties, 69% of Physical Medicine and Rehabilitation (PM&R) physicians, 63% of orthopaedic surgeons, 53% of family physicians, 36% of pediatricians, and 17% of gynecologists were able to identify all 3 components of the Female Athlete Triad. Only 9% of physicians felt comfortable treating the Female Athlete Triad. When physicians were subdivided into specialties, 17% of orthopaedic surgeons, 13% of family practitioners, 12% of PM&R physicians, and 4% of pediatricians felt comfortable with treatment programs. CONCLUSION: Data suggest that a heightened level of awareness and education in the proper treatment of the Female Athlete Triad is needed.

Female↗
PubMed2006

A comparison of stimulus synchronous activity in the primary motor cortices of athletes and non-athletes.

In this study, we measured primary motor cortex (MI) activity during a reaction time task to examine the appearance of MI activity that synchronized with the stimulus presentation (stimulus synchronous MI activity, SSMA). Because brain activity was expected to be enhanced by the repetitive/extensive activation, we hypothesized that the SSMA would be more clearly observable in athletes who were trained to perform reactive movements than in non-athletes. MI activity was measured in ten athletes and ten non-athletes by magnetoencephalography. The tasks were a simple reaction task and a Go/Nogo reaction task in which the subjects were asked to abduct their right index fingers in response to a visual stimulus. The Go/Nogo reaction time task was adopted to confirm the presence of the SSMA, because the MI activity in response to a Nogo stimulus did not overlap with the MI activity that was synchronous with the execution of the movement. The results show that the SSMA was clearly apparent in the athlete group (9/10). In the non-athlete group, however, only three subjects showed the SSMA (3/10). Moreover, the MI activity of the athletes tended to be larger than that of the non-athletes, even though the athletes did not specifically practice these index finger movements during their daily training. We concluded that long-term physical training promotes MI activity and the effects of reactive task repetition were more clearly apparent in the MI activity of the athletes.

Adult↗
PubMed1994

Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports.

In the present study, we used echocardiography to investigate the morphologic adaptations of the heart to athletic training in 947 elite athletes representing 27 sports who achieved national or international levels of competition. Cardiac morphology was compared for these sports, using multivariate statistical models. Left ventricular (LV) diastolic cavity dimension above normal (> 54 mm, ranging up to 66 mm) was identified in 362 (38%) of the 947 athletes. LV wall thickness above normal (> 12 mm, ranging up to 16 mm) was identified in only 16 (1.7%) of the athletes. Athletes training in the sports examined showed considerable differences with regard to cardiac dimensions. Endurance cyclists, rowers, and swimmers had the largest LV diastolic cavity dimensions and wall thickness. Athletes training in sports such as track sprinting, field weight events, and diving were at the lower end of the spectrum of cardiac adaptations to athletic training. Athletes training in sports associated with larger LV diastolic cavity dimensions also had higher values for wall thickness. Athletes training in isometric sports, such as weightlifting and wrestling, had high values for wall thickness relative to cavity dimension, but their absolute wall thickness remained within normal limits. Analysis of gender-related differences in cardiac dimensions showed that female athletes had smaller LV diastolic cavity dimension (average 2 mm) and smaller wall thickness (average 0.9 mm) than males of the same age and body size who were training in the same sport.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Comparison of athletes with life-threatening ventricular arrhythmias with two groups of healthy athletes and a group of normal control subjects.

Sudden cardiac death in well-trained athletes is most often superimposed on the presence of structural heart disease. However, some athletes die suddenly in the absence of overt heart disease. To improve identification of athletes at high risk for ventricular tachycardia (VT), ventricular repolarization, the signal-averaged electrocardiogram (ECG), and the echocardiogram from 13 male athletes with symptomatic VT and without evidence of manifest cardiac disease were compared with data obtained in 3 matched control groups (15 apparently healthy professional road cyclists, 10 professional basketball players, and 15 normal control subjects without any sports activity). All patients had apparently normal QRS duration on the routine ECG, and none were taking antiarrhythmic drugs. Echocardiography and signal-averaged electrocardiography were useful in distinguishing the group of athletes with tachyarrhythmias from the group of normal nonsporting controls, but not from both groups of normal athletes. The QT interval (V4) and the QT interval corrected with the cubic root were shorter for the nonsporting controls. Three parameters for QT dispersion showed significant differences (p < 0.003) between athletes with disease and all other groups. It is concluded that although significant differences were detected between normal subjects and the 3 groups of athletes by routine ECG, the signal-averaged ECG, and echocardiography, only an increased QT dispersion from the 12-lead ECG was helpful in distinguishing athletes with VT from other athletes.

Adult↗
PubMed2004

Intercollegiate student athlete use of nutritional supplements and the role of athletic trainers and dietitians in nutrition counseling.

A survey of university student athletes was conducted to determine supplement use, perceived efficacy of supplements, availability and use of nutrition services, and perceived nutrition knowledge of athletic trainers. Results from 236 athletes showed that 88% used one or more nutritional supplements, yet perceived efficacy was moderate (2.9 or less; 5-point scale). Classes (69.4%), brochures (75%), and individual counseling (47%) were available and were used by 29.9%, 33.2%, and 17.9% of athletes, respectively. Primary sources of nutrition information were athletic trainers (39.8%), strength and conditioning coaches (23.7%), and dietitians (14.4%). Athletes perceived athletic trainers to have strong nutrition knowledge (mean=3.8+/-0.9; 5-point scale). Many (23.5%) did not know whether a dietitian was available. Dietitians must accelerate their marketing efforts to student athletes, work closely with athletic trainers to provide sound nutrition information, and provide services that meet the needs of a diverse population of student athletes.

Adolescent↗
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↗
PubMedDate not supplied

Automated external defibrillators in National Collegiate Athletic Association Division I Athletics.

BACKGROUND: Sudden cardiac death is the leading cause of death in athletes. Evidence on current sudden cardiac death prevention through preparticipation history, physicals, and noninvasive cardiovascular diagnostics has demonstrated a low sensitivity for detection of athletes at high risk of sudden cardiac death. Data are lacking on automated external defibrillator programs specifically initiated to respond to rare dysrhythmia in younger, relatively low-risk populations. METHODS: Surveys were mailed to the head athletic trainers of all National Collegiate Athletic Association Division I athletics programs listed in the National Athletic Trainers' Association directory. In all, 303 surveys were mailed; 186 departments (61%) responded. RESULTS: Seventy-two percent (133) of responding National Collegiate Athletic Association Division I athletics programs have access to automated external defibrillator units; 54% (101) own their units. Proven medical benefit (55%), concern for liability (51%), and affordability (29%) ranked highest in frequency of reasons for automated external defibrillator purchase. Unit cost (odds ratio = 1.01; 95% confidence interval, 1.01-1.0), donated units (odds ratio = 1.92; confidence interval, 3.66-1.01), institution size (odds ratio =.0001; confidence interval, 1.3 E-4 to 2.2E-05), and proven medical benefit of automated external defibrillators (odds ratio = 24; confidence interval, 72-8.1) were the most significant predictors of departmental defibrillator ownership. Emergency medical service response time and sudden cardiac death event history were not significantly predictive of departmental defibrillator ownership. The majority of automated external defibrillator interventions occurred on nonathletes. CONCLUSIONS: Many athletics medicine programs are obtaining automated external defibrillators without apparent criteria for determination of need. Usage and maintenance policies vary widely among departments with unit ownership or access. Programs need to approach the issue of unit acquisition and implementation with knowledge of the surrounding emergency medical service system, geography of their individual sports medicine facilities, numbers and relative risk of their athletes, and budgetary constraints.

Chi-Square Distribution↗
PubMed2005

The female athlete triad exists in both elite athletes and controls.

PURPOSE: To examine the prevalence of the female athlete triad (the Triad) in Norwegian elite athletes and controls. METHODS: This study was conducted in three phases: (part I) screening by means of a detailed questionnaire, (part II) measurement of bone mineral density (BMD), and (part III) clinical interview. In part I, all female elite athletes representing the national teams at junior or senior level, aged 13-39 yr (N = 938) and an age group-matched randomly selected population-based control group (N = 900) were invited to participate. The questionnaire was completed by 88% of the athletes and 70% of the controls. Based on data from part I, a stratified random sample of athletes (N = 300) and controls (N = 300) was selected and invited to participate in parts II and III of the study. 186 athletes (62%) and 145 controls (48%) participated in all parts of the study. RESULTS: Eight athletes (4.3%) and five controls (3.4%) met all the criteria for the Triad (disordered eating/eating disorder, menstrual dysfunction, and low BMD). Six of the athletes who met all the Triad criteria competed in leanness sports, and two in nonleanness sports. When evaluating the presence of two of the components of the Triad, prevalence ranged from 5.4 to 26.9% in the athletes and from 12.4 to 15.2% in the controls. CONCLUSION: Our results support the assumption that a significant proportion of female athletes suffer from the components of the Triad. In addition, we found that the Triad is also present in normal active females. Therefore, prevention of one or more of the Triad components should be geared towards all physically active girls and young women.

Absorptiometry, Photon↗
PubMed2004

Self-reported comfort in athletic training to same- and opposite-sex athletes.

To assess the comfort of athletic trainers in providing care to athletes of the same- and opposite-sex, the Gender Comfort in Athletic Training Questionnaire was developed. Cronbach alpha was .72. The 8-item questionnaire was mailed to 235 participants, who were senior athletic training students and clinical instructors affiliated with 14 university athletic training programs. 192 questionnaires were returned (82%). Only one t test showed a significant mean difference in reported comfort between women (n= 103, M=2.8, SD= 0.8; disagree) and men (n= 89, M=3.1, SD=0.8; neutral) on the statement: I feel more comfortable providing athletic training services to male athletes than female athletes. The women and men in this sample were similar in their self-ratings of comfort in providing athletic training services to male and female athletes.

Attitude↗
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↗