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PubMed2002

Combating drug use in competitive sports. An analysis from the athletes' perspective.

BACKGROUND: Doping has developed into a widespread problem in competitive and high-performance sports due to increasing professionalism in, and commercialization of sports. In contrast, governments and sports organizations have limited financial resources to support all competitive sports. Therefore, further improvement of anti-doping measures can only be achieved through the inclusion and active participation of the athletes themselves. METHODS: In this study, 101 German athletes who are subject to national and international anti-doping tests were asked if doping in sports should be combatted, and which anti-doping measures appeared effective from an athlete's perspective. RESULTS: Ninety-eight point zero two per cent of those questioned felt that measures should be taken against doping in sports. Improved methods of detection and more information on the health risks were favored, as opposed to more severe punishments. In addition, more than two thirds of the athletes supported the introduction of an anti-doping law. The desire for more frequent drug testing was also expressed, despite the distinct invasion of the athletes' privacy. CONCLUSIONS: An anti-doping law, as requested by the athletes, should include measures for educating the public about the health risks involved with doping. In addition, such a law would also make it possible to develop suitable methods of detection.

Adolescent↗
PubMed2002

Development of measurability and importance scales for the NATA athletic training educational competencies.

A recent mandate issued by the National Athletic Trainers' Association Board of Certification (NATABOC) stated that beginning in 2004 a student must graduate from an accredited Commission on Accreditation of Allied Health Education Programs (CAAHEP) in order to qualify for the NATABOC exam. The content of this exam is based on the National Athletic Trainers' Association (NATA) Athletic Training Educational Competencies. These 542 competencies in 12 different domains were developed through role delineation studies with the most recent edition published in 1999. Therefore, these competencies must be included in each athletic training curriculum program across the country in order to prepare their students for certification and to achieve program accreditation. Concern over the large number of competencies to be attained within the educational time frame created the need to develop an instrument to examine this issue. In response, instruments were developed to examine one domain of the NATA Educational Competencies. Specifically, the General Medical Conditions and Disabilities competencies were assessed for their perceived importance and measurability by certified athletic trainers and sports medicine physicians. This article reports the results of a validation study of an instrument designed to measure the perceived measurability and importance of the NATA Athletic Training Educational Competencies. Generally, the results are encouraging. The data supports six constructs, and each of these constructs exhibits high reliabilities. Relative competency calibrations within and between scales were consistent with theory. And, ratings assigned by different groups of trainers were comparable.

Certification↗
PubMed2002

Development of reference ranges in elite athletes for markers of altered erythropoiesis.

BACKGROUND AND OBJECTIVES: Our previous research developed two statistical models that are useful indicators of current (ON-model) or recently discontinued (OFF-model) recombinant human erythropoietin (rHuEPO) use by athletes. The component variables of the ON-model are hematocrit (Hct), reticulocyte hematocrit (RetHct), serum erythropoietin (EPO), percent macrocytes (%Macro), and soluble transferrin receptor (sTfr), whilst the OFF-model uses only the first three variables. Genetics and training modalities of elite athletes may conceivably produce unusual values for blood parameters related to erythropoiesis. The aims of this study were to develop reference ranges in elite athletes for key hematologic parameters as well as ON- and OFF-models scores, and to evaluate the effect of ethnicity, gender, residence at moderate altitude (approximately 2000 m) and within-individual variation on the variables and model scores. DESIGN AND METHODS: Over a period of three weeks, 413 female and 739 male elite athletes from 12 countries visited laboratories to provide three blood samples for analysis of blood parameters sensitive to erythropoiesis. For each parameter and for the ON- and OFF-model scores, we used mixed modeling to establish the range within which we could be 95% certain that the value for a randomly chosen athlete would fall, taking into account various random effects (variation within and between subjects and laboratories) and fixed effects (means for different levels of ethnicity, age, sport, altitude of residency). We performed similar analyses for changes in the ON- and OFF-model scores between the three visits. RESULTS: Most fixed effects were accompanied by clear-cut, small to moderate differences in several parameters. However, residency at moderate altitude was accompanied by a much higher hematocrit than residency nearer sea level, with the mean (and 95% confidence limits) for the difference being 2.3 (0.9 to 3.7) and 1.8 (0.1 to 3.5) units for males and females, respectively. Males at altitude also demonstrated a moderately higher ON-model score. Otherwise the influence of these effects was small for ON-, OFF- and changes in model scores. INTERPRETATION AND CONCLUSIONS: Assessment of an athlete's blood parameters and ON- and OFF-model scores may need adjustment for training modalities and other characteristics of the subject. Changes in model scores (together with monitoring of urine samples for the presence of rHuEPO) provide a promising approach to detection of rHuEPO abuse, because they are less sensitive to subject characteristics and less variable than raw model scores.

Adolescent↗
PubMed2002

Collaboration Between Athletic Training Clinical and Classroom Instructors.

OBJECTIVE: The education of an athletic training student involves a balance between theory and application, which can be stated as a balance between classroom and clinical education. The instructors in these settings should work together to promote the overall educational process. Our primary purpose was to measure the observations and perceptions of physical presence, cooperation, and communication between clinical and classroom instructors and secondarily to determine if these have a perceived effect on the education of the student. SUBJECTS: Clinical instructors, classroom instructors, and athletic training students in Commission on Accreditation of Allied Health Education Programs-accredited and National Athletic Trainers' Association-approved athletic training education programs. MEASUREMENTS: Data were analyzed using various correlation techniques, a general linear model, and a one-way analysis of variance. DESIGN AND SETTING: We designed a questionnaire to measure the observations and perceptions of physical presence, cooperation, and communication between the clinical and classroom instructors. RESULTS: Of the 30 athletic training educational programs solicited for involvement in this study, 19 responded (63%). A total of 737 questionnaires were distributed, and 547 were returned (74%). Classroom instructors rated observations of cooperation between clinical and classroom instructors at a significantly higher frequency than did clinical instructors. Students rated observations of communication at a significantly lower frequency than did the clinical and classroom instructors. All 3 groups agreed that the physical presence, cooperation, and communication between the clinical and classroom instructors has a large effect upon the education of the student. CONCLUSIONS: Clinical instructors must be educators as well as care providers. At the same time, classroom instructors must make efforts to include clinical instructors in all aspects of the educational process. Also, athletic training students should be exposed to the inner workings of their educational programs, so they may have a better understanding and appreciation of how theory and application tie together.

Journal Article↗
PubMed2002

Clinical-Education-Setting Standards Are Helpful in the Professional Preparation of Employed, Entry-Level Certified Athletic Trainers.

OBJECTIVE: To determine the helpfulness of clinical-education-setting standards in the professional preparation of entry-level certified athletic trainers. DESIGN AND SETTING: We developed a 22-item questionnaire based on the 12 standards presented by Weidner and Laurent. Subjects used a Likert scale (0 = no help, 5 = very helpful) to indicate their perceptions of the helpfulness of each standard in preparing them for their roles and responsibilities as certified athletic trainers. SUBJECTS: We surveyed employed, entry-level certified athletic trainers who recently completed Commission on Accreditation of Allied Health Education Programs-accredited athletic training education programs. MEASUREMENTS: Percentage means were computed for the helpfulness ratings of each standard. A percentage mean was computed for the overall contribution of clinical education to professional development. Chi-square analyses were used to assess the differences in helpfulness ratings among respondents. RESULTS: The overall mean score across all standards was 4.17. No significant differences in the helpfulness ratings of any of the respondents were noted regardless of sex, ethnicity, number of clinical-education hours, total semesters of clinical education, settings in which students gained clinical experience, or current employment (P </=.05). CONCLUSIONS: The standards for athletic training clinical-education settings are helpful and should be applied to all settings. Varying standards do not need to be imposed on our different athletic training clinical-education settings.

Journal Article↗
PubMed2002

Paradoxical Vocal-Cord Dysfunction: Management in Athletes.

OBJECTIVE: To describe a treatment strategy for paradoxical vocal-cord dysfunction (PVCD) as it applies to an athletic population. BACKGROUND: Paradoxical vocal-cord dysfunction has been identified as a cause of dyspnea and stridor in athletes. The basic element of PVCD is an inappropriate closure of the vocal cords during respiration, resulting in airway obstruction. This condition is familiar to speech-language pathologists and otolaryngologists yet remains poorly understood in the sports medicine community. Treatment strategies are even less understood. A therapeutic exercise program designed to promote diaphragmatic breathing may allow an athlete to gain control during episodes of dyspnea. Elimination of contributing or concomitant conditions is critical to resolution of the condition. DESCRIPTION: The treatment of PVCD requires an understanding of the pathoanatomy of the condition. The focus of the exercise program is on relaxation of the larynx and conscious activation of the diaphragm and abdominal muscles during respiration. The athlete must have a sense of laryngeal control while performing the exercises. In addition, the patient and practitioner must realize the amount of neuromuscular reeducation required to change breathing patterns. CLINICAL ADVANTAGES: This therapy may allow the athlete to gain control over episodic dyspnea, participate in athletic activities with fewer complications, and, perhaps, reduce or eliminate medications prescribed to treat suspected bronchospasm.

Journal Article↗
PubMed1992

Physiological assessment of Saudi athletes.

This study was aimed at assessing the physiological responses of Saudi male athletes to maximal exercise testing. Seventy five national athletes representing nine different sports and fourteen healthy controls were subjected to graded bicycle ergometer tests, during which cardiorespiratory and metabolic functions were monitored and recorded. The results of this study indicate that the maximal oxygen uptake (VO2max) values for the Saudi athletes were not significantly different from those of controls. The cyclists, however, attained the highest VO2max with a mean of 55.05 ml.kg-1.min-1 followed by the middle distance runners (X = 53.17) and the long distance runners (X = 51.19). Comparison of the Saudi athletes with some previously reported international standards revealed that the Saudi athletes had a VO2max that was lower than their respective French, Swedish, Belgian, Norwegian, Italian, Canadian or American athletes.

Adult↗
PubMed2002

Enduring effects of concussion in youth athletes.

The purpose of this study was to explore the mild, enduring effects of concussion in otherwise healthy youth athletes. Reported history of concussion and cognitive functioning was examined in an initial sample of 35 youth athletes, 21 of whom were considered healthy volunteers (No Recent Concussion within the past 6 months) with no identified medical or neuropsychological difficulties related to concussion. The remaining 14 volunteers had each sustained a concussion within 1 week of testing (Recent Concussion). Significant differences in performances on a general cognitive measure, and specifically in the area of attention, were found as a function of number of concussions reported by the No Recent Concussion athletes. Furthermore, on some of the measures, No Recent Concussion athletes with a history of two or more concussions appeared to resemble Recent Concussion athletes more so than No Recent Concussion athletes with a history of one or no concussion. The importance of assessment of youth concussion and the use of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for this purpose are discussed.

Journal Article↗
PubMed2004

Athletic Training Education Program Directors' Perceptions on Job Selection, Satisfaction, and Attrition.

OBJECTIVE: To determine the potential reasons for becoming a program director and reasons for leaving the program director position within athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP); in addition, to describe the most and least beneficial and satisfying aspects of the program director position. DESIGN AND SETTING: In 1999, we sent a validated survey to athletic training education program directors of CAAHEP-accredited athletic training education programs. SUBJECTS: Of 113 athletic training education program directors of accredited undergraduate programs, 83 participated, for a response rate of 73.4%. MEASUREMENTS: The survey consisted of open-ended questions regarding potential reasons for becoming a program director and possibly leaving the program direction position and most and least beneficial and satisfying aspects of the position. We used inductive content analysis to determine themes for the responses to the open-ended questions. Descriptive statistics, including percentages, were calculated to report the data. RESULTS: Academic environment was the primary theme for becoming an athletic training education program director and professional appointment was the primary theme for possibly leaving the position. Professional advancement and student growth and success were the primary themes for the most beneficial and satisfying aspects. Workload and student issues and discipline were the primary themes for the least beneficial and satisfying aspects. CONCLUSIONS: Factors that affect job selection, satisfaction, and attrition are related to academic environment, teaching, students, professional advancement, program development/advancement, workload, personal issues, and athletics.

Journal Article↗
PubMed2004

Vigorous exercise training is not associated with prevalence of ventricular arrhythmias in elderly athletes.

AIM: Physical activity, when vigorous, is not devoided of arrhythmic risk. Since the risk of developing arrhythmias increase as an otherwise healthy person ages, the question arises as to whether high intensity physical activity could be dangerous in the elderly person. The present study addressed the incidence of arrhythmias in elderly athletes in comparison to age-matched control subjects. METHODS: We studied 49 male athletes engaged in various sport disciplines, mean age 62.3+/-2.3 and 24 sedentary or moderately physically active healthy males, mean age 62.9+/-1.7 years (Controls). All subjects underwent 2-D, M-mode and Doppler echocardiographic examination, resting ECG and exercise stress test followed by 24-hour electrocardiographic monitoring. RESULTS: No pathological findings were detected in both experimental groups at echocardiographic examination. Exercise performance was greater in athletes than controls (206.9+/-5.2 vs 156.3+/-12 watt, p<0.01). During exercise test, no significant between-groups difference was detected in the incidence of ventricular arrhythmias, that is multiple premature ventricular contractions (MPVC), polymorphous premature ventricular contractions (PPVC) and repetitive premature ventricular contractions (RPVC). No subject featured horizontal or downsloping ST segment depression in both groups. At 24-hour electrocardiographic monitoring the incidence of the overall number of premature ventricular contractions was significantly greater in controls than athletes (87.0% vs 63.3%, p<0.05), whereas no significant difference were detected in the incidence of discrete ventricular arrhythmias between athletes (4.1% MPVC, 14.3% PPVC, 8.2% couplets) and controls (0.5% MPVC, 16.7% PPVC, 12.5% couplets). CONCLUSION: These finding indicate that in elderly, otherwise healthy, athletes vigorous training even to competition does not result in a greater incidence of ventricular arrhythmias, although caution should be made for a careful preparticipation evaluation.

Age Factors↗
PubMed1992

Subject characteristics and low back pain in young athletes and nonathletes.

Factors associated with low back pain (LBP) were sought by means of a questionnaire and physical measurements in 138 adolescents. One-hundred athletes and 38 nonathletes, 138 subjects total (58 boys and 80 girls; age range 10.3-13.3 yr), were studied. The questionnaire included questions on physical activity and LBP. Quantitative measurements on anthropometry, flexibility (joint hypermobility and muscular tightness), and strength were performed. There was no significant difference in the occurrence of LBP between athletes and nonathletes. Among the athletes, the duration of training during the past 12 months (min.wk-1) was higher in subjects with the experience of LBP during the past 12 months (N = 23) compared with nonsymptomatic subjects (N = 76) (mean 493 +/- 308 min.wk-1 vs 354 +/- 160 min.wk-1; P less than 0.0001). Similar differences were also seen between subjects with positive lifetime histories of LBP and nonsymptomatic subjects. Various differences were seen in the measurements of anthropometry, flexibility, and strength between boys and girls as well as between athletes and nonathletes. In a multivariate analysis, the cumulative incidence of lifetime history of LBP was associated with tightness of hip flexor muscles only (P = 0.014). LBP during the past 12 months was associated only with the amount of training during the past 12 months (min.wk-1) (P = 0.0066). Our study suggests that high training duration predisposes young athletes to LBP. However, e.g., the flexibility measurements cannot be used to determine athletes at high risk.

Adolescent↗
PubMed2004

Development of Standards and Criteria for the Selection, Training, and Evaluation of Athletic Training Approved Clinical Instructors.

OBJECTIVE: To develop standards and associated criteria for the selection, training, and evaluation of athletic training approved clinical instructors (ACIs). DESIGN AND SETTING: A previously developed set of 7 physical therapy clinical instructor standards/criteria and 2 additional standards/criteria developed through a review of the literature were systematically adapted, judged, and revised through a Delphi technique. SUBJECTS: Athletic training education experts currently employed as program directors for entry-level Commission on Accreditation of Allied Health Education Programs-accredited athletic training educational programs and who had the following: a doctoral degree, at least 5 years of supervising athletic training students, and familiarity/experience with clinical instruction in various athletic training clinical education settings. MEASUREMENTS: We used panelists' critiques and ratings to make sequential revisions in a series of 3 Delphi rounds. Standards were rated as to whether they were clear, necessary, and appropriate. We rated criteria for the associated standard as to whether they were useful, helpful, clear, specific, and consistent. RESULTS: We developed a final set of 7 standards and 50 associated criteria to measure these standards. The accepted standards include the following: legal and ethical behavior, communication skills, interpersonal relationships, instructional skills, supervisory and administrative skills, evaluation of performance, and clinical skills and knowledge. CONCLUSIONS: The 7 standards and associated criteria developed in this research project could be used not only for selecting, training, and evaluating an ACI but also for developing an understanding of the requirements of clinical education in general. Further research should include validating these standards/criteria among athletic training ACIs representing different types of clinical settings.

Journal Article↗
PubMed2005

Tobacco use among young North American aboriginal athletes.

Tobacco use remains a major cause of preventable illness and death in North America. Although reported smoking rates have decreased, they remain high among the young and among Aboriginal people. As part of an oral health promotion project, a convenience sample of 163 Aboriginal athletes participating in the 2002 North American Indigenous Games completed a self-administered questionnaire addressing tobacco use and knowledge of tobacco effects. Mean age of athletes was 19.6 years (SD 7.4); most were male and Canadian citizens. Only 22 participants reported current smoking; past use of tobacco was more common, with 58 reporting a history of smoking. Although age was not associated with current smoking, older athletes were significantly more likely (p <or=0.05) to have smoked. Twenty-three athletes reported ever using smokeless tobacco, with 9 reporting current daily use. Athletes were knowledgeable about tobacco effects on oral health. This study shows substantially lower tobacco use among this group of young Aboriginal athletes than the North American average. These findings suggest that participation in organized sports may be a protective factor against tobacco use in a population known to have high smoking rates.

Adolescent↗
PubMed2005

Fitness profile of elite Croatian female taekwondo athletes.

The aim of the study was to assess fitness profile of elite Croatian female taekwondo athletes and to determine which physical, physiological and motor characteristics differentiate mostly the successful from the less successful fighters. Thirteen national taekwondo champions were divided into two groups according to their senior international competitive achievements. Physiological characteristics, including maximal oxygen uptake (VO2max), were assessed during a continuous progressive treadmill test. The measured motor abilities included explosive and elastic leg strength, maximal strength, muscular endurance, anaerobic alactic power, agility and flexibility. Differences between the successful and less successful athletes were determined using independent t-test. Even though the differences were not statistically significant, the successful athletes had somewhat less fat (2.3%) and were taller by 5.8 cm. The successful athletes achieved significantly higher maximum running speed (15.8 +/- 0.5 versus 14.9 +/- 0. 7 km h(-1); p < 0.05), their ventilatory anaerobic threshold was significantly higher (41.4 +/- 4.1 versus 37.6 +/- 2.0 ml kg(-1) min(-1); p < 0.05) at a significantly lower heart rate (166.8 +/- 6.8 versus 171.0 +/- 8.2 beats min(-1); p < 0.05) than in the less successful athletes. Significant differences were also found in three tests of explosive power (p < 0.05), anaerobic alactic power (p < 0.01), and lateral agility (p < 0.05). The performance of taekwondo female athletes primarily depends on the anaerobic alactic power, explosive power expressed in the stretch-shortening cycle movements, agility and aerobic power.

Adolescent↗
PubMedDate not supplied

Medical and orthopaedic conditions in special olympics athletes.

OBJECTIVE: Many Special Olympics athletes experience hypokinetic diseases and comorbid conditions that may predispose them to serious injuries during physical activity. A clear understanding of these conditions and diseases may assist health care professionals in preventing further distress and managing the injuries sustained by these athletes. Such diseases and conditions include overweight and obesity, diabetes, vision problems, seizure disorders, and Down syndrome, which is often associated with atlantoaxial instability. DATA SOURCES: MEDLINE, SPORT Discus, and Special Olympics information sources for the years 1990-2000 using the key terms Special Olympics, mental retardation, comorbidity, Down syndrome, hypokinetic diseases, and physical activity were searched. DATA SYNTHESIS: A basic review of hypokinetic diseases and comorbid conditions prepares health care professionals for working with people with mental retardation. CONCLUSIONS AND RECOMMENDATIONS: Health care volunteers at Special Olympics events treat athletes with mental retardation who may also have some of the comorbid conditions and hypokinetic diseases observed commonly in this population. Moreover, many of these conditions and diseases are typical in athletes without mental retardation. Athletic trainers should be familiar with these conditions and diseases but should review the unique conditions and prescription medications commonly found in the Special Olympics population before providing medical services for these athletes.

Journal Article↗
PubMed2005

The changes in running performance and maximal oxygen uptake after long-term training in elite athletes.

AIM: The relationship between VO2max (mL x kg(-1) x min(-1)) and running performance has been assessed in cross-sectional studies. Follow-up studies of the long-term effects of running training on the changes in performance and VO2max have not been undertaken. METHODS: Twenty-five male endurance-trained (MET) and 8 female endurance-trained (FET) athletes were tracked over 4 years. In each event the athletes were divided into Class A, including half the number of athletes with the best performances, and Class B. VO2max, examined at the end of the competitive season, and the best performance was chosen each year. RESULTS: After 3 years of training, in MET and FET athletes the performance improved by 1.77% and 0.69% (P<0.01 and P=0.579), respectively. In Class A runners, training resulted in non-significant increase in performance (-0.04%) (P=0.982) and in Class B runners, performance increased by 3.16% (P=0.001). In all groups VO(2max) remained essentially unchanged. Longitudinal changes in the VO2max were not related with the changes in running performance in any group. CONCLUSIONS: This study show than in older runners with more years of training, heavy training does not produce improvements in running performance neither changes in the VO2max. It is possible that these elite athletes have reached the plateau in their performance; although unlikely, some improvement in training techniques may happen and break the present limit. In younger runners with less years of training, heavy training produce improvements in running performance without changes in the VO2max. These athletes that had not attained his biological limits at the beginning of study improved the performance in competition and it is quite probable that this improvement be due to training. The changes in performance were not related to changes in VO2max. Consequently, another physiological or psychological variables must be studied by longitudinal form to explain the variability of performance in competition.

Adaptation, Physiological↗
PubMed1992

An overview of selected state licensure athletic training laws.

With the growth of athletic training, many state governing bodies have created regulations concerning the role of athletic trainers in their respective states. Some of these states have included the licensure, certification, and/or registration of athletic trainers as a prerequisite for employment. Although many states have similar requirements, each state differs in its legislation that affects various athletic training domains. Athletic trainers should be aware of these variances in state licensure laws, especially when seeking employment in another state. In May 1991, a survey of the 20 states with licensure laws was conducted to examine application procedures, scope of practice, and other factors related to the licensing of athletic trainers.

Journal Article↗
PubMed1993

The Athletic Prevention Programming and Leadership Education (APPLE) Model: Developing Substance Abuse Prevention Programs.

Alcohol and other drug (AOD) abuse affects every sector of society, and student-athletes are no exception. Because many factors affecting athletes do not affect other students, athletic departments commonly approach prevention through AOD education. Different educational approaches are described in this article, particularly the Athletic Prevention Programming and Leadership Education (APPLE) model. Project APPLE is designed to enable an athletic department to systematically analyze its AOD prevention in seven areas: recruitment practices, expectations and attitudes, education and AOD programs, policies, drug testing, discipline, and referral and counseling. Because athletic trainers often are involved in this process, this article should help them to design more effective AOD programs.

Journal Article↗