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Cardiac structure and function in women basketball athletes: seasonal variation and comparisons with nonathletic controls.

To characterize hypertrophy and quantify seasonal changes in cardiac structure and function of women collegiate basketball (BB) athletes (n = 15), echocardiographic (echo) measurements were made in the fall (FALL1), winter (WIN), and spring (SPR), then again during the subsequent fall (FALL2; n = 10). Comparisons were made to age-matched nonathletes (NA) measured during FALL1 (n = 22) and SPR (n = 5). Left ventricular (LV) internal dimension-diastole (LVIDd), LV end-diastolic volume (LVEDV), stroke volume (SV), LV mass (LVM), septal thickness (IVS), LV posterior wall thickness (LVPW), right ventricular (RV) internal dimension-diastole (RVIDd), and aortic root diameter (AOD) were significantly larger (12-70%) in the athletes; RVIDd-, LVEDV-, SV-, and LVM-index were also significantly greater (8-46%). From FALL1 to SPR measurement periods, LVIDd, RVIDd, LVEDV, SV, IVS, and LVM-index increased significantly (7-18%) in the athletes. Over the same period of time, LVIDd, LAD, AOD, LVEDV, and SV measured in the five NA subjects increased significantly. In the athletes, LVIDs, RVIDd, IVS, LVPW, and LVM decreased significantly (5-30%) from the SPR to FALL2 measurement period. These data characterize the general nature of the cardiac hypertrophy noted in women BB athletes compared to NA controls and show that distinct changes in heart structure corresponding to different periods of the competitive season can occur in these athletes.

Adult↗

Toward a conceptual understanding of the flow experience in elite athletes.

An in-depth investigation into flow state was conducted in order to understand how this optimal state is experienced by elite athletes. Twenty-eight elite-level athletes, representing 7 sports, were interviewed on their perceptions of flow state during performance of their sport. Csikszentmihalyi's (1990) model of the flow state was examined for its applicability to elite athletes. Correspondence was found between the dimensions of flow, as described by Csikszentmihalyi (1990), and the athletes' descriptions of their experience of flow; some dimensions received greater support through the qualitative analysis of the athletes' descriptions than did other dimensions. Those dimensions of flow most represented across the group's data were the autotelic experience of flow, total concentration on the task at hand, merging of action and awareness, and the paradox of control. The analyses provided a detailed, sport-specific picture of flow state in elite athletes.

Adolescent↗

A test of the perceived norms model to explain drinking patterns among university student athletes.

The author tested the ability of perceived drinking norms to discriminate among drinking patterns in a sample of National Collegiate Athletic Association (NCAA) Division I student athletes. He used an anonymous questionnaire to assess 297 athletes, representing 18 teams, at a public university in the Midwest. Alcohol use patterns showed considerable variation, with many athletes (37.1%) abstaining during their season of competition. A discriminant function analysis revealed that higher levels of alcohol involvement are disproportionately found among athletes who began drinking regularly at an early age. Perceived drinking norms were less important in the discrimination of student athlete drinker groups. Women and those with higher grade point averages were somewhat more likely to refrain from in-season drinking than other survey respondents.

Adult↗

Snuffing it out: a smokeless tobacco intervention with athletes at a small private college.

This study assessed attitude, knowledge, and use of smokeless tobacco (moist snuff, dry snuff, or chewing tobacco) among male varsity athletes at a small private college. Forty-three athletes were surveyed and 17 (40%) were found to be current users. Of these users, 27% reported dipping more than once a day, everyday; 25% of all users had noticed physical changes, such as white spots, inside their mouths. The wide acceptance of using smokeless tobacco was clear from the finding that 49% of those surveyed believed that athletes should be allowed to use "chew" during practice. These athletes also showed limited knowledge of the nicotine content and physiological effects of smokeless tobacco. As a result of the study, the authors developed a two-part intervention that included an educational presentation and oral screening by a local dentist and an administrative directive enforcing the National Collegiate Athletic Association's policy on smokeless tobacco use. A follow-up survey indicated the intervention had had some positive effects on the athletes' attitudes toward and knowledge about using smokeless tobacco. The survey also showed an increase from 4 to 7 in the number of former users who said they had stopped using smokeless tobacco.

Adolescent↗

Diastolic function and modifications of left ventricular architecture in ultraendurance athletes.

Although diastolic function is altered in left ventricular hypertrophy due to aortic stenosis or systemic hypertension, it has been shown to be normal in athletes. To analyze the reason for this discrepancy, we have studied left ventricular masses and volumes and diastolic flow velocities in 13 ultraendurance athletes and in 8 sedentary subjects as a control group by M-mode (TM), two-dimensional (2D) and Doppler echocardiography. Significant differences in the measurements of mass and volume have been found depending upon the method used. Considering that two-dimensional echocardiography is more appropriate for estimations of LV mass and LV volume, especially when the shape of the left ventricle is modified, overestimation of LV mass and underestimation of LV volume in ultraendurance athletes by TM could be explained by an elongation of LV cavity in athletes. Doppler velocimetry showed similar results in athletes and control subjects. We suggest that those LV configurational changes partly explain the preservation of diastolic function in athletes by restoring in diastole the energy stored in systole.

Adult↗

Stress from exercise in the below sea level environment causes an increase in serum testosterone levels in trained athletes.

A comparative study (n = 20) of serum levels of leutinizing hormone (LH) and testosterone (T) between male trained athletes (high-school students, 16-18 years old) living in North and South Shouna in the Jordan Valley (JV), 320-360 meters below sea level, and those living in Ramtha and Irbid, 550-650 meters above sea level, was conducted in November, 1999. Serum levels of LH and T were also measured in these athletes following a 20 Km noncompetitive run. The air temperatures on the day of the experiment was comparable (25 degrees C in North and South Shouna versus 23 degrees C in Ramtha and Irbid). Before exercise, serum levels of LH and T in athletes of the below sea level environment (North and South Shouna) were similar to those levels in athletes of the above sea level environment (Ramtha and Irbid). Exercise caused a significant increase in serum levels of both LH and T only in athletes of North and South Shouna. It seems likely that the higher secretion of LH contributes, at least in part, for the higher serum levels of T following exercise. Taken together, these data suggest that exercise has an effect on LH and T secretion that is similar to that of fasting. And finally, the below sea level environmental factors, such as the high barometric pressure, as well as the genetic background of the athletes affect the pituitary and adrenal cortex as well as testicular tissue, resulting in the secretion of more LH and T.

Adolescent↗

Airways hyperresponsiveness in high school athletes.

UNLABELLED: Adult athletes have a higher prevalence (11%-50%) of exercise-induced bronchoconstriction (EIB) and airways hyperresponsiveness (AHR) than the population at large (7%-11%): reports describing EIB/AHR in adolescent athletes are scant. HYPOTHESES: 1) a minimum AHR prevalence of 20% would be revealed in a group of high school athletes; 2) demographic data would predict AHR; 3) AHR-positive athletes would preferentially choose low ventilation sports. Eucapnic voluntary hyperpnea (EVH) was used to test for AHR in 23% of all athletes (79 of 343) of a midwestern high school. The AHR was defined by at least a 10%, 20%, or 25% decline in FEV1, FEF25-75, or PEFR at 1, 5, 10, or 15-min post-EVH, respectively. RESULTS: 30 of 79 (38%) tested positive for AHR; demographic data tended to predict AHR, as correlations between the total number of years exercised with the greatest decline in FEV1 and the total number of days exercised with the greatest decline in FEV1 following the EVH challenge tended to be significant (r = 0.354; p = 0.055 and r=0.314; p = 0.091, respectively); and 69% of AHR-positive students played only low ventilation sports. CONCLUSION: AHR prevalence was 38% in athletes of a midwestern high school; demographic data tended to predict AHR; those with AHR preferentially play low ventilation sports.

Adolescent↗

Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology.

The 1996 American Heart Association consensus panel recommendations stated that pre-participation cardiovascular screening for young competitive athletes is justifiable and compelling on ethical, legal, and medical grounds. The present article represents the consensus statement of the Study Group on Sports Cardiology of the Working Group on Cardiac Rehabilitation and Exercise Physiology and the Working Group on Myocardial and Pericardial diseases of the European Society of Cardiology, which comprises cardiovascular specialists and other physicians from different European countries with extensive clinical experience with young competitive athletes, as well as with pathological substrates of sudden death. The document takes note of the 25-year Italian experience on systematic pre-participation screening of competitive athletes and focuses on relevant issues, mostly regarding the relative risk, causes, and prevalence of sudden death in athletes; the efficacy, feasibility, and cost-effectiveness of population-based pre-participation cardiovascular screening; the key role of 12-lead ECG for identification of cardiovascular diseases such as cardiomyopathies and channelopathies at risk of sudden death during sports; and the potential of preventing fatal events. The main purpose of the consensus document is to reinforce the principle of the need for pre-participation medical clearance of all young athletes involved in organized sports programmes, on the basis of (i) the proven efficacy of systematic screening by 12-lead ECG (in addition to history and physical examination) to identify hypertrophic cardiomyopathy-the leading cause of sports-related sudden death-and to prevent athletic field fatalities; (ii) the potential screening ability in detecting other lethal cardiovascular diseases presenting with ECG abnormalities. The consensus document recommends the implementation of a common European screening protocol essentially based on 12-lead ECG.

Adolescent↗

Diets of elite athletes: has the discipline of sports nutrition made an impact?

Although numerous descriptions exist of special diets and particular foods used by Greek athletes as early as 580 B.C., survey data on diets of Olympians of the modern era are virtually nonexistent. A survey in Helsinki in 1952 reported the diets of Olympic athletes to be high energy, high fat, and high protein. The 1952 Olympians reportedly consumed an average daily energy intake of 18,841 kJ, with 40% of energy coming from carbohydrate, 20% from protein, and 40% from fat. More recent data on elite level athletes reveal wide variation in dietary intake. For example, energy intakes of athletes from four countries ranged from 7699 to 24,845 kJ. Group percentages of energy from carbohydrate, protein, and fat ranged from 33 to 57%, 12 to 26%, and 29 to 49%, respectively. Comparing dietary intake data of athletes on an absolute basis, however, is primarily a comparison of body size. When the protein and carbohydrate intakes of elite athletes are calculated as grams per kilogram body weight, the range for protein is 1.0-4.3 g/kg body wt for protein and 3.5-6.9 g/kg body wt for carbohydrate. Interestingly, variations in carbohydrate intake diminished while protein intake varied by country. Although some data on diets of Olympians exist, the most remarkable finding when reviewing the literature is the paucity of data. The discipline of sports nutrition has arguably had a positive effect on sports performance. However, many unanswered questions remain and great strides remain to be made.

Diet↗

Propulsion technique and anaerobic work capacity in elite wheelchair athletes: cross-sectional analysis.

Wheelchair sports and daily manual wheelchair propulsion are dominated by frequent short-term power demands. The purpose of the current cross-sectional study was to determine the variation in propulsion technique in association with sprint power production among elite wheelchair athletes. Therefore, 67 wheelchair athletes (different impairments; 17 female and 50 male athletes; age, 29.1+/-7 yr; body weight, 60.7+/-11.8 kg; training hours, 12.9+/-6.4 h x wk(-1); VO2 peak, 1.7+/-0.7 liter x min(-1); aerobic power output, 72.2+/-36.7 W) were studied during the World Championships and Games for the Disabled in Assen (1990) on propulsion technique and anaerobic work capacity in a 30-s sprint test on a computer controlled wheelchair ergometer. Mean power output (P30) (97+/-45.8 W; range, 8.3-195.3 W) and heart rate (158.6+/-23.6 b x min(-1)) were highly variable and seemed associated with impairment level: track athletes, classified in four different functional classes, showed a class-related P30 of 23, 68, 100, and 138 W for the male athletes (n=38). Sprint power relative to body weight varied between 0.36 W X kg BW(-1)+/-0.04 and 1.85 W X kg BW(-1)+/-0.43 for the different subject groups. Propulsion technique in terms of forces applied to the rim and timing showed significant differences between subject groups for the majority of parameters studied. Apart from the mediolateral force and the negative dip at the start of the push phase, the technique parameters were significantly related to power production. Fraction effective force, the ratio between the total force vector and the effective force applied to the hand rim, appeared low on average (especially for subjects with cerebral palsy and those with a high spinal lesion) but showed a significant correlation with power output (r=0.5). In general, propulsion technique parameters were related to both performance and functionality. The number of training hours showed a small but significant relation with peak power (r=0.31), peak torque (r=0.4), the amount of work per push (r=0.41) and the total force vector (r=0.31), stressing the role of training status, next to disability, as important mediating factor in both propulsion technique as well as performance capacity. No association between training hours and fraction effective force was seen. It can be concluded that propulsion technique and performance parameters are highly variable among wheelchair athletes. Also, propulsion technique is strongly associated with functionality and training hours and does clearly relate to performance. The current results on technique and performance and their possible causal relationship, but also with impairment and sports discipline, must be further substantiated in a longitudinal study design.

Adult↗

What can we learn about diet and physical activity from master athletes?

Only 13% of those 65 years and older engage in vigorous physical activity 3 or more days a week and obesity rates are increasing by 45% in adults over the age of 60. Physical activity helps prevent chronic disease and improves quality of life, yet few adults of any age are active. One exception is master athletes who participate in competitive sports during the middle and later years. The aerobic fitness of master athletes, as measured by maximal oxygen consumption, shows some decline, but not nearly as much as in sedentary controls. Master athletes have lipid profiles similar to those of young adults, which decreases their risk of heart disease. Master athletes also have better glucose tolerance and lower waist-to-hip ratios than sedentary adults, decreasing their risk for metabolic syndrome and type 2 diabetes. In the few dietary studies that have been conducted, master athletes consume more food energy while maintaining lower body weights than sedentary adults. Learning what motivates master athletes to stay highly active may help health professionals develop strategies to encourage exercise in the sedentary population of older adults.

Aged↗

Cervical and lumbar MRI in asymptomatic older male lifelong athletes: frequency of degenerative findings.

OBJECTIVE: The athletic activity of the adult U.S. population has increased markedly in the last 20 years. To evaluate the possible long-term effects of such activity on the cervical and lumbar spine, we studied a group of asymptomatic currently very active lifelong male athletes over age 40 (41-69 years old, av. age 53). MATERIALS AND METHODS: Nineteen active, lifelong male athletes were studied with MRI and the results compared with previous imaging studies of other populations. An athletic history and a spine history were also taken. RESULTS: Evidence of asymptomatic degenerative spine disease was similar to that seen in published series of other populations. Degenerative changes including disk protrusion and herniation, spondylosis, and spinal stenosis were present and increased in incidence with increasing patient age. In this group, all MRI findings proved to be asymptomatic and did not limit athletic activity. CONCLUSION: The incidence of lumbar degenerative changes in our study population of older male athletes was similar to those seen in other populations.

Adult↗

A treatment for vocal cord dysfunction in female athletes: an outcome study.

OBJECTIVES: This article reports the outcome of a speech pathology treatment program for vocal cord dysfunction (VCD) in 20 adolescent female athletes. STUDY DESIGN: A retrospective, nonrandomized group design was used to collect the outcome data. METHODS: Twenty consecutive referrals of female athletes diagnosed as having symptoms of VCD during exercise were assessed, treated, and followed for at least 6 months after treatment. RESULTS: Ninety-five percent of the participants reported the ability to control symptoms of VCD during exercise up to 6 months after treatment. Asthma medications were no longer used by 80% of the athletes. All of the females continued to participate in athletics. CONCLUSION: Speech pathology intervention focusing on respiratory control of VCD in adolescent female athletes is an effective treatment resulting in the athletes' ability to control the symptoms of VCD in exercise for at least 6 months after treatment.

Adolescent↗

Intensive training and cardiac autonomic control in high level athletes.

PURPOSE: We aimed to evaluate in a longitudinal study the effect of intensive training on cardiac autonomic control in athletes using 24-h heart rate variability analysis. METHODS: Time and frequency domain measures of heart rate variability were calculated from 24-h Holter monitoring in 15 high level bicyclists (mean age 21 +/- 4 yr) after 1 month of detraining and after 5 months of vigorous training. At the same times echocardiographic left ventricular mass and dimensions and maximal oxygen consumption (VO2max) were assessed. RESULTS: In detrained athletes, VO2max values, left ventricular mass and dimensions, and time and frequency domain measures of vagal modulation of heart rate were higher than in a group of untrained subjects of similar age while heart rate and the low-to-high frequency ratio were lower, indicating an enhanced vagal modulation of heart rate in athletes as compared with that in control subjects. After 5 months of vigorous training, left ventricular mass and dimensions and VO2max increased in athletes, while heart rate decreased further. In contrast, no changes were detectable in time and frequency domain measures of heart rate variability over the entire 24-h and in both waking and sleeping hours. CONCLUSIONS: This study demonstrates that an increased cardiac vagal control is detectable in detrained athletes; however, after intensive training, despite a significant decrease in heart rate, time and frequency domain measures of heart rate variability reflecting cardiac vagal control remain unchanged. Thus, other mechanisms than changes in cardiac autonomic control could be involved in determining the profound bradycardia of athletes.

Adolescent↗

Lack of correlation between ventricular late potentials and left ventricular mass in top-level male athletes.

PURPOSE: The aim of this study was to establish: 1) the prevalence of abnormal signal-averaged electrocardiogram (SAECG) in a large population of top-level athletes and 2) the relationship between SAECG parameters and left ventricular mass. One-hundred and fifty-three elite male athletes without apparent heart disease, symptoms, or arrhythmias were studied. METHODS: Fifty-six athletes (37%) had increased left ventricular mass (> 134 g.m(-2)). All athletes underwent time-domain SAECG on 300-400 heart beats recorded at rest from three bipolar orthogonal tests with a filter setting of 40-250 Hz. Criteria for abnormality were 1) filtered QRS duration > 114 ms, 2) duration of low-amplitude signals > 38 ms, or 3) root mean square voltage of the last 40 ms of the filtered QRS < 20 microV. RESULTS: The prevalence of abnormal SAECG was 7.2% (abnormality of one parameter), 6.5% (abnormality of two parameters), and 5.8%(abnormality of three parameters). The prevalence of abnormal SAECG was similar in athletes with or without increased left ventricular mass. CONCLUSIONS: In conclusion, this study showed: 1) the low rate of positive results of SAECG parameters in top-level male athletes, similar to that found in healthy sedentary subjects; and 2) the lack of correlation between left ventricular mass and overall SAECG parameters.

Action Potentials↗

Specific inspiratory muscle training in well-trained endurance athletes.

PURPOSE: It has been reported that arterial O2 desaturation occurs during maximal aerobic exercise in elite endurance athletes and that it might be associated with respiratory muscle fatigue and relative hypoventilation. We hypothesized that specific inspiratory muscle training (SIMT) will result in improvement in respiratory muscle function and thereupon in aerobic capacity in well-trained endurance athletes. METHODS: Twenty well-trained endurance athletes volunteered to the study and were randomized into two groups: 10 athletes comprised the training group and received SIMT, and 10 athletes were assigned to a control group and received sham training. Inspiratory training was performed using a threshold inspiratory muscle trainer, for 0.5 h x d(-1) six times a week for 10 wk. Subjects in the control group received sham training with the same device, but with no resistance. RESULTS: Inspiratory muscle strength (PImax) increased significantly from 142.2 +/- 24.8 to 177.2 +/- 32.9 cm H2O (P < 0.005) in the training but remained unchanged in the control group. Inspiratory muscle endurance (PmPeak) also increased significantly, from 121.6 +/- 13.7 to 154.4 +/- 22.1 cm H2O (P < 0.005), in the training group, but not in the control group. The improvement in the inspiratory muscle performance in the training group was not associated with improvement in peak VEmax, VO2max breathing reserve (BR). or arterial O2 saturation (%SaO2), measured during or at the peak of the exercise test. CONCLUSIONS: It may be concluded that 10 wk of SIMT can increase the inspiratory muscle performance in well-trained athletes. However, this increase was not associated with improvement in aerobic capacity, as determined by VO2max, or in arterial O2 desaturation during maximal graded exercise challenge. The significance of such results is uncertain and further studies are needed to elucidate the role of respiratory muscle training in the improvement of aerobic-type exercise capacity.

Adolescent↗

An effective, economic way of monitoring menstrual cycle hormones in at risk female athletes.

PURPOSE: Female athletes, in response to intensive training, competition stress and a lean, athletic physique, are at increased risk of altered hypothalamic-pituitary ovarian (HPO) axis function associated with menstrual cycle disturbance and reduced secretion of the ovarian hormones estrogen and progesterone. Because there is evidence suggesting possible detrimental effects on skeletal health associated with deficiencies in these hormones, a suitable means to asses ovarian hormone concentrations in at risk athletes is needed. The aim of this study was to evaluate a simple, economical means to monitor the ovarian hormone production in athletes, in the setting of intensive training. METHODS: Subjects comprised 14 adolescent rowers, 12 lightweight rowers, and two groups of 10 matched control subjects. Ovarian function was monitored during the competition season by estimation of urinary excretion of estrone glucuronide (E1G) and pregnanediol glucuronide (PdG), enabling the menstrual cycles to be classified as ovulatory or anovulatory. RESULTS: Results indicated 35% and 75% of schoolgirl and lightweight rowers had anovulatory menstrual cycles, respectively. These findings were highlighted by significantly lower excretion of E1G and PdG during phases of intensive training in both the lightweight and schoolgirl rowers, compared with the control subjects. CONCLUSION: It was concluded that the urinary E1G and PdG assays were an effective means to assess the influence of intense training on ovarian hormone concentrations in at risk athletes. It is recommended that this technique be applied more widely as a means of early detection of athletes with low estrogen and progesterone levels, in an attempt to avoid detrimental influences on skeletal health.

Adolescent↗

Factors influencing sport participation among athletes with spinal cord injury.

OBJECTIVE: This exploratory study examined the relationships between pre- and post-injury sport participation among active individuals with spinal cord injury (SCI) in the United Kingdom. In particular, factors that influence individuals with SCI into sport were identified. METHODS: A total of 143 British individuals with SCI currently participating in wheelchair basketball, wheelchair rugby, wheelchair tennis, and wheelchair athletics were recruited. A total of 112 subjects were active prelesion, and 31 subjects were inactive preinjury. A Disability Sport Participation questionnaire developed by the authors was used for data collection. The questionnaire was distributed through the British Wheelchair Sport Associations. Personal, impairment, health and fitness, socialization, and participation data of athletes with SCI were collected. Groups of active preinjury and inactive preinjury were compared. RESULTS: For athletes who had been active pre-SCI, the in-hospital rehabilitation program and specialized sport club for people with disabilities were more important contexts for introducing the sport after injury to individuals. Friends and peers with disabilities were much more influential as initial and continuing socialization agents than rehabilitation therapists. The main reasons for athletes with SCI who participated in sports after injury were for fitness, fun, health, and competition, although many athletes noted that social aspects and rehabilitation also influenced their sport participation. CONCLUSION: This study identified social contexts, social agents, difficulties, sources of information, and reasons for sport participation of athletes with SCI. The results may offer some directions for the improvement of rehabilitation programs for people with SCI and also help the development of appropriate strategies to encourage people with SCI to participate in sports and leisure activities.

Adult↗