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PubMed1995

Fluid and electrolyte status in athletes receiving medical care at an ultradistance triathlon.

Thirty competitors in the Hawaii Ironman Triathlon were prospectively studied to determine whether fluid and electrolyte disturbances were causes for seeking race-day medical care. Athlete weights were significantly (p < 0.0001) decreased during the race, but decreases were not different in treated (n = 11; % delta wt -2.3 +/- 2.9) versus not treated (n = 19; % delta wt - 2.0 +/- 1.9) athletes. Hyponatremia occurred in nine athletes (30%), and hypomagnesemia in six (20%), but only half of athletes were either electrolyte imbalance sought care. Although athletes receiving medical care may have fluid and electrolyte problems, these abnormalities may also occur in healthy athletes.

Adult↗
PubMed2004

Preparticipation physical examination: selected issues for the female athlete.

OBJECTIVE: The purpose of this article was to examine the preparticipation examination (PPE) with regard to the female athlete. Ever-increasing participation of women in competitive sport has created a requirement for more gender-specific sport medicine knowledge. In particular, physicians and other health care professionals should be aware of the triad of disordered eating, amenorrhea (and other menstrual dysfunction), and osteoporosis (or altered bone mineral density) collectively described as the female athlete triad. Suggested additions to the standard PPE may help identify athletes at risk. DATA SOURCES/METHODS: A literature search was carried out using MEDLINE for years 1966 to 2003, with keywords female athlete triad, PPE, female athlete, eating disorders, amenorrhea, and osteoporosis. Further studies were identified through reference lists. RESULTS: Better recognition and prevention of these problems is essential. At present, there is little evidence-based information available to guide the practicing clinician in this area. It remains to be determined which methods are the most sensitive and specific for detecting the triad disorders, as well as the most economical and time-efficient. CONCLUSIONS: The PPE offers an excellent opportunity to screen for these entities, as well to initiate early treatment. It is recommended that a standardized form (or part of the form) be developed for the female athlete.

Amenorrhea↗
PubMed2006

Sun-protective behavior among high-school and collegiate athletes in Los Angeles, CA.

OBJECTIVES: To evaluate the use, knowledge, and perceptions of sun-protective behavior (SPB), among young athletes in Southern California. DESIGN: Cross-sectional survey, assessing various measures of SPB, sun exposure, attitudes, and knowledge. SETTING AND PARTICIPANTS: A total of 1006 students from 2 public high schools and 1 public university in the Los Angeles area volunteered. Athlete volunteers were recruited during sports preparticipation examinations. Nonathlete controls were recruited from physical education classes (high school) and from an introductory lecture class (university). MAIN OUTCOME MEASURES: Use of SPB during sports and nonsports activities, sun exposure, sun-protection knowledge, and attitudes. Results from athletes were compared with those from controls at each site. RESULTS: Overall rates of SPB were low. During nonsports activities, university athletes had higher rates of sunscreen (37.7% vs. 32.3%, P = 0.03) and hat use (34.7% vs. 17%, P < 0.001) than did controls. However, university athletes had lower rates of use of long shirts (27.9% vs. 39.8%, P < 0.001), long pants (38.8% vs. 63%, P < 0.002), and had higher total sun exposure (16.1 vs. 10.1 h/wk, P < 0.001). Similar results were seen among the high-school subjects. Despite having good knowledge of the potential dangers of ultraviolet radiation exposure, approximately 1 in 5 subjects overall had experienced a blistering sunburn within the past year. CONCLUSIONS: Young athletes in the Los Angeles area reported low rates of SPB, high levels of ultraviolet radiation exposure, and high rates of sunburns, despite knowing the risks of sun exposure. Specific educational and behavioral interventions should be directed toward improving SPB in this high-risk group.

Adult↗
PubMedDate not supplied

Gender verification of female athletes.

The International Olympic Committee (IOC) officially mandated gender verification for female athletes beginning in 1968 and continuing through 1998. The rationale was to prevent masquerading males and women with "unfair, male-like" physical advantage from competing in female-only events. Visual observation and gynecological examination had been tried on a trial basis for two years at some competitions leading up to the 1968 Olympic Games, but these invasive and demeaning processes were jettisoned in favor of laboratory-based genetic tests. Sex chromatin and more recently DNA analyses for Y-specific male material were then required of all female athletes immediately preceding IOC-sanctioned sporting events, and many other international and national competitions following the IOC model. On-site gender verification has since been found to be highly discriminatory, and the cause of emotional trauma and social stigmatization for many females with problems of intersex who have been screened out from competition. Despite compelling evidence for the lack of scientific merit for chromosome-based screening for gender, as well as its functional and ethical inconsistencies, the IOC persisted in its policy for 30 years. The coauthors of this manuscript have worked with some success to rescind this policy through educating athletes and sports governors regarding the psychological and physical nature of sexual differentiation, and the inequities of genetic sex testing. In 1990, the International Amateur Athletics Federation (IAAF) called for abandonment of required genetic screening of women athletes, and by 1992 had adopted a fairer, medically justifiable model for preventing only male "impostors" in international track and field. At the recent recommendation of the IOC Athletes Commission, the Executive Board of the IOC has finally recognized the medical and functional inconsistencies and undue costs of chromosome-based methods. In 1999, the IOC ratified the abandonment of on-site genetic screening of females at the next Olympic Games in Australia. This article reviews the history and rationales for fairness in female-only sports that have led to the rise and fall of on-site, chromosome-based gender verification at international sporting events.

Chromatin↗
PubMed2005

The female athlete and menstrual function.

PURPOSE OF REVIEW: In the past year, there have been remarkable advancements in the understanding of the female athlete's pathology and in recognizing the specific needs of women participating in both recreational and competitive sports. The purpose of this review is to highlight the recent developments in the field of female athletes and menstrual function. RECENT FINDINGS: Although the female athletic triad, consisting of disordered eating, amenorrhea and osteoporosis, has been clinically recognized, there have been few studies quantifying the long-term effects. This review summarizes recently explored topics, including: disordered eating as a main culprit of menstrual irregularities, long-term longitudinal studies following female athletes through to retirement, and current treatment options. SUMMARY: Understanding the causes, profiles and the prevention of menstrual irregularities in the female athlete should help decrease its prevalence among women involved in athletics. The literature reviewed in this article stresses the importance of early detection, as well as the consequences of eating disorders, menstrual disturbances and bone loss left untreated.

Amenorrhea↗
PubMed2006

Sudden cardiac death in athletes: the Lausanne Recommendations.

OBJECTIVES: This study reports on sudden cardiac death (SCD) in sport in the literature and aims at achieving a generally acceptable preparticipation screening protocol (PPSP) endorsed by the consensus meeting of the International Olympic Committee (IOC). BACKGROUND: The sudden death of athletes under 35 years engaged in competitive sports is a well-known occurrence; the incidence is higher in athletes (approximately 2/100,000 per year) than in non-athletes (2.5 : 1), and the cause is cardiovascular in over 90%. METHODS: A systematic review of the literature identified causes of SCD, sex, age, underlying cardiac disease and the type of sport and PPSP in use. Methods necessary to detect pre-existing cardiac abnormalities are discussed to formulate a PPSP for the Medical Commission of the IOC. RESULTS: SCD occurred in 1101 (1966-2004) reported cases in athletes under 35 years, 50% had congenital anatomical heart disease and cardiomyopathies and 10% had early-onset atherosclerotic heart disease. Forty percent occurred in athletes under 18 years, 33% under 16 years; the female/male ratio was 1/9. SCD was reported in almost all sports; most frequently involved were soccer (30%), basketball (25%) and running (15%). The PPSP were of varying quality and content. The IOC consensus meeting accepted the proposed Lausanne Recommendations based on this research and expert opinions (http://multimedia.olympic.org/pdf/en_report_886.pdf). CONCLUSION: SCD occurs more frequently in young athletes, even those under the age of 18 years, than expected and is predominantly caused by pre-existing congenital cardiac abnormalities. Premature atherosclerotic disease forms another important cause in these young adults. A generally acceptable PPSP has been achieved by the IOC's acceptance of the Lausanne Recommendations.

Adolescent↗
PubMed2004

The prevalence of fibromyalgia in collegiate athletes.

BACKGROUND: : The prevalence of fibromyalgia in the general population is reported in numbers that range between 0.5% and 10%, with considerable variability in the populations studied and criteria for diagnosis used. The prevalence in competitive young adult athletes is unknown, but we expect it to be less than the general population. OBJECTIVES: : The objective of this study was to determine the prevalence of fibromyalgia in college student athletes. METHODS: : We conducted a prospective, cross-section cohort evaluation of 641 athletes using the 1990 American College of Rheumatology (ACR) criteria. Volunteer college student athletes were evaluated with a questionnaire and physical examination at preparticipation physical examinations from 1993 to 1999. RESULTS: : Of the 641 athletes examined, we found only one who met the ACR criteria for a diagnosis of fibromyalgia. LIMITATIONS: : There were a limited number of athletes involved, there was no age- or activity-matched control group, and there were no other demographic information or associated symptoms collected. CONCLUSIONS: : The prevalence for fibromyalgia in this population was found to be 0.16%, which is lower than the prevalence found in studies describing other populations. The protective effects of this population are unclear but could be related to age, fitness level, self-selection, and/or other factors.

Journal Article↗
PubMed2006

Heat illness symptom index (HISI): a novel instrument for the assessment of heat illness in athletes.

BACKGROUND: Heatstroke is the third leading cause of death in athletics, and an important cause of morbidity and mortality in exercising athletes. There is no current method, however, for identifying milder forms of heat illness. In this pilot study, we sought to develop and provide initial validation for a Heat Illness Symptom Index scale (HISI) that would facilitate research in the assessment of milder forms of heat illness in athletes. METHODS: The study was designed as a multimodal prospective observational study of Division I football players during twice daily practices in southern Florida. We developed a 13-item scale that assessed symptoms that are suspected to occur during milder forms of heat illness. The resultant scale was assessed for reliability using Cronbach's alpha, and was assessed for construct validity by correlating scale scores with factors that are known to be related to heat illness. HISI scores, as well as data on perceived exertion, player position, and pre and post practice weights were collected from 95 athletes participating in late summer football practices. A total of 557 athlete sessions were analyzed. RESULTS: The mean score on the heat illness symptom scale was 12.1 (SD 13.8) and the median value was 8.0. Cronbach's alpha confirmed suitable internal consistency of the scale when assessed separately for each of the five morning practices (alpha = 0.91, 0.88, 0.82, 0.92, 0.85). There were statistically significant correlations of the scale score with weight loss during practice (P = 0.006), rating of perceived exertion (P = 0.005), player position (P < 0.0001), and ambient heat index (P = 0.02) as hypothesized. CONCLUSIONS: This pilot study provides initial validation for a novel symptom-based tool for use in assessing mild forms of heat illness in an athletic population. Further validation studies of the instrument, and correlating symptom scores with measures of core temperature, are needed and planned.

Body Weight↗
PubMed1980

Echocardiographic assessment of cardiac chamber size and left ventricular function in aerobically trained athletes.

We compared the echocardiographic assessment of left ventricular function in 20 aerobically trained male athletes (VO2 max 61 ml/kg/min) with 20 control subjects of similar age and size (VO2 max 37 ml/kg/min). On average, the left ventricle was larger in athletes and the extent of myocardial contraction (fractional shortening) was reduced. In nine athletes, fractional shortening was less than our laboratory lower limit of normal (26%) and in four athletes the left ventricle was enlarged and fractional shortening was reduced. However, the peak rate of circumferential shortening was not reduced in athletes. We concluded that athletes have normal myocardial contractility but some have a reduced extent of myocardial contraction which could be mistaken for the effects of myocardial disease.

Adolescent↗
PubMed1997

Optimal and predicted anxiety in 9-12-year-old track and field athletes.

In an effort to determine the applicability of individual zone of optimal functioning (IZOF) theory in young athletes, state anxiety was assessed in 40 track and field athletes (20 male and 20 female) from 9 to 12 years of age. Optimal anxiety was determined by having participants complete the state-trait anxiety scale for children (STAIC) with instructions to recall how anxious they felt prior to their best performance of the season. Twenty-four hours prior to three 'more important' and three 'less important' track meets, participants completed the STAIC under instructions to predict how anxious they would feel 1 h prior to the upcoming track meet. Actual precompetition anxiety was assessed 1 h prior to each meet. Self-ratings of performance were collected following each meet in which the athletes competed. Athletes were grouped by age (younger, 9-10 years old); (older, 11-12 years old) and by gender for analysis. Analysis by independent t-tests indicated that predicted and actual precompetition anxiety values did not differ for either age or gender for the more important meets. However, the 11-12-year-old girls had higher (P<0.05) predicted and actual anxiety values in the 'less important' meets than all other groups. Significant correlations (P<0.05) between predicted and actual precompetition anxiety occurred in all groups for both the less important and more important meets (r=0.66-0.97), with the exception of the 9-10-year-old girls for less important meets (r=0.38, P>0.05). Of all the participants, 26% reported performing best when anxiety values were in the high range. Self-ratings of performance were not lower (P>0.05) in cases in which the athlete experienced high levels of precompetition anxiety. In summary, the present findings indicate that several aspects of IZOF theory apply to preadolescent athletes.

Age Factors↗
PubMed2004

Perceived parental beliefs about the causes of success in sport: relationship to athletes' achievement goals and personal beliefs.

This study examined the relationship between perceived parental beliefs and young athletes' achievement goal orientations and personal beliefs about the causes of success in sport. Participants were 183 male and female athletes, 11-18 years old, involved in team sports. Athletes completed the Task and Ego Orientation in Sport Questionnaire, the Beliefs about the Causes of Sport Success Questionnaire, and two modified versions of the latter inventory to assess their perceptions of their parents' beliefs. Canonical correlation analysis revealed that perceived parental beliefs were related to goal orientations and personal beliefs in a conceptually coherent fashion. Thus, the perceived parental belief that effort leads to success in sport was related to athletes' task orientation and personal belief that effort causes sport success. In contrast, the perceived parental beliefs that superior ability, external factors, and using deceptive tactics are precursors to success in sport corresponded to athletes' ego orientation and the same personal beliefs. The findings are discussed in terms of their implications for understanding the socialization experiences of young athletes.

Achievement↗
PubMed2005

Sonographic evaluations in elite college baseball athletes.

This study compared the thickness of the biceps and supraspinatus tendons, the widths of the subacromial space in the frontal and scapular planes, and abnormal sonographic findings in the shoulders of injured, and uninjured elite college baseball athletes and healthy controls. This study recruited two groups of 42 and 12 athletes, with and without histories of shoulder injuries, respectively, as well as one control group of 16 college students who were matched for physical characteristics but not involved in sports. The results showed that the thickness of the biceps and supraspinatus tendons and the subacromial space widths at 0 degrees and 90 degrees shoulder abduction in the frontal plane were significantly greater in the athletes than in the controls (P-values <0.004). The occurrences of the acromioclavicular joint bulging, bicep tendon degeneration, infraspinatus tendon degeneration and infraspinatus cortical irregularity differ significantly between the injured athlete and the group of uninjured athletes and controls (P-values <0.05). However, only infraspinatus tendon degeneration corresponded to the injury histories. There was a high similarity of sonographic spectrum of abnormal findings among the groups. Longitudinal follow-ups are required to determine the clinical importance of the sonographic spectrums and the occurrences of abnormal finding in asymptomatic athletes' shoulders.

Adult↗
PubMed2005

Dental trauma incidence and mouthguard use in elite athletes in Turkey.

Contact sports may lead to dental trauma, which often can be reduced with appropriate preventive measures. While numerous studies exist on this topic for several countries throughout the world, there is a lack of comprehensive descriptive studies in Turkey. The purpose of this study was to investigate the incidence and type of dental injuries associated with three different sports among Turkish elite athletes, who do not contact (volleyball), contact directly (taekwondo) or indirectly (handball) with competition rivals. Additionally, awareness and use of mouthguards were also compared. Thus, during the 2003 and 2004 Turkish National Championships in three sports, 50 taekwondo, 62 handball and 50 volleyball male athletes were interviewed by questionnaire. Results showed that taekwondo and handball athletes experienced significantly more dental trauma than volleyball athletes (P < 0.05). Twelve of the taekwondo (24%), 16 of the handball (26%) and four of the volleyball athletes (8%) experienced at least one type of dental injury. Awareness of mouthguards as a preventive measure against dental trauma was significantly higher among taekwondo and handball athletes (P < 0.05), although a very small percentage in either of these sports actually wore a mouthguard (10 and 0%, respectively). Trauma incidence between direct contact with rival competitors and indirect contact with rival competitors was not significantly different. The incidence of dental trauma in contact sports shows that the awareness and use of mouthguards must be intensified. Mouthguard use should be made compulsory, especially in those sports with high risk for dental trauma.

Adult↗
PubMed2006

Elite tae kwon do athletes' satisfaction with custom-made mouthguards.

Mouthguards are considered by most authors to be an essential part of equipment for athletes participating in contact sports. However, there are few studies evaluating the satisfaction of the elite athlete with mouthguards. The purpose of this study was to evaluate the satisfaction of elite tae kwon do athletes with custom-made mouthguards in a period of 4 months. The subjects were 22 elite athletes (11 boys and 11 girls) aged between 15 and 17 years. Each athlete was provided with an individual mouthguard made of ethyl vinyl acetate (EVA) material. Using Visual Analog Scale (VAS) questionnaire, esthetic appearance, ability to talk and to breathe, kiyapping (yelling in tae kwon do), oral dryness, nausea, stability, ease in fitting into the mouth, inclination to chew and overall satisfaction were evaluated. Respective values of boys and girls were also compared. One-way anova and paired sampled t-tests were performed for statistical analyses using spss 11.0 windows program. There was no significant difference in the level of satisfaction between the first week and fourth month values. Results also showed that the level of satisfaction did not change statistically between male and female athletes.

Adolescent↗
PubMed1994

Trace mineral requirements for athletes.

This paper reviews information pertaining to zinc, copper, chromium, and selenium requirements of athletes. Exercise increases zinc loss from the body, and dietary intake for some athletes, especially females, may be inadequate. Blood copper levels are altered by exercise, but there is no information to suggest that copper ingestion or status is compromised in athletes. Studies have shown that urinary chromium excretion is increased by exercise, but whether this leads to an increased requirement is still unknown. There is concern that athletes may not ingest sufficient quantities of chromium; however, there are inadequate data to confirm this. The limited data that exist show that athletes do not have altered selenium status. There is no conclusive evidence that supplementation with any of these trace minerals will enhance performance. A diet containing foods rich in micronutrients is recommended. However, for those athletes concerned that their diets may not be sufficient, a multivitamin/mineral supplement containing no more than the RDA may be advised.

Exercise↗
PubMed2000

Behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders.

The purpose of this study was to delineate and further define the behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders. Subjects consisted of 24 athletes with subclinical eating disorders (SCED) and 24 control athletes. Group classification was determined by scores on the Eating Disorder Inventory (EDI), the Body Shape Questionnaire (BSQ), and a symptom checklist for eating disorders (EDI-SC). Characteristics representative of the female athletes with subclinical eating disorders were derived from an extensive health and dieting history questionnaire and an in-depth interview (the Eating Disorder Examination). Energy intake and expenditure (kcal/d) were estimated using 7-day weighed food records and activity logs. The characteristics most common in the female athletes with subclinical eating disorders included: (a) preoccupation with food, energy intake, and body weight; (b) distorted body image and body weight dissatisfaction; (c) undue influence of body weight on self-evaluation; (d) intense fear of gaining weight even though at or slightly below ( approximately 5%) normal weight; (e) attempts to lose weight using one or more pathogenic weight control methods; (g) food intake governed by self-hatred upon breaking a rule; (h) absence of medical disorder to explain energy restriction, weight loss, or maintenance of low body weight; and (i) menstrual dysfunction. Awareness of these characteristics may aid in more timely identification and treatment of female athletes with disordered eating patterns and, perhaps, prevent the development of more serious, clinical eating disorders.

Adult↗
PubMed2000

Sub-regional tissue morphometry in male athletes and controls using dual X-Ray absorptiometry (DXA).

Athletes have traditionally been evaluated for body composition by percent fat, percent muscle, and somatotype. Since the late 1980s, dual X-ray absorptiometry (DXA) has offered total and regional body composition of bone mineral content (BMC), lean tissue and fat, but studies involving athletes are rare (11) and have not included regional tissue distribution. In the present study, DXA was used to compare a total of 121 male subjects belonging to 9 different athletic groups and controls. ANOVA showed total tissue percent BMC, lean tissue, and fat were significantly different between the various athletic groups (p <.001). Regional differences in tissue distribution between different athletic groups affect BMC and lean tissue (p <.001), but not fat (p >.05). However, athletes of the leanest groups had different fat distribution to that of nonexercising controls (p <.01). It appears that fat distribution is nonspecific in its response to exercise, while lean and BMC distributions show highly specific adaptations to specific sports.

Absorptiometry, Photon↗
PubMed2001

Nutrition knowledge, opinions, and practices of coaches and athletic trainers at a division 1 university.

The purpose of this investigation was to assess nutrition knowledge, opinions, and practices of coaches and trainers at a Division I university. Participants (n = 53) completed questionnaires regarding nutrition knowledge, opinions, and practices. Descriptive statistics and analysis of variance were used to analyze data. Overall, participants responded correctly to 67% of nutrition knowledge questions. Participants who coached/trained female athletes tended to score better than respondents who coached/trained male athletes. Strength and conditioning coaches and participants with greater than 15 years of experience scored higher than other participants. Nutrition opinions/practices responses revealed that nutritional supplements were provided for all but 6% of participants' athletes. Participants rated body weight as more important than body composition to athletes' performances. Over 30% of participants perceived at least one case of disordered eating within the past year. Some participants (53%) felt that athletes may consume more nutritious meals on team-sponsored trips if given larger food allowances. Thirty percent of participants reported dietitians were available to them; the same percentage reported utilizing dietitians. Coaches and trainers are knowledgeable about some appropriate nutritional recommendations, but registered dietitians or qualified sports nutrition professionals may complement the nutrition-related education and counseling of athletes (23).

Body Composition↗