Author: Mokhtar

Previous studies have shown that sprinters have inhomogeneous muscle development, with well-developed hip flexors, extensors and muscles in the proximal femur. Muscle strength in sprinters corresponds well with the demands of the musculoskeletal system when sprinting, which can be a positive aspect in terms of strength-related factors. At the same time, however, the morphological differences would imply differences in mass distribution and thus maneuverability. More muscular legs would lead to greater mass and, in turn, to general speculation about the trade-off between greater torque-exertion capacity and greater difficulty in moving the lower limb.

This raises an interesting question: how do sprinters balance muscle strength and brisk movements? Contextually, not much is known about the maneuverability of sprinter legs from an inertial perspective. This knowledge gap caught the attention of a research team led by Professor Yasuo Kawakami of Waseda University’s Faculty of Sports Sciences, who, together with his colleagues Hoshizora Ichinose of Nihon University and Dr. Natsuki Sado of the University of Tsukuba examined the leg morphology of athletes. from an inertial perspective.

“As former athletes, we have been interested in the relevance of the human body in sport. Athletes train hard, but in many cases they do not know how their body specifically responds to training. We wanted to address this and help develop effective training strategies ,” says Kawakami, explaining the motivation behind their research.

In their study, the researchers analyzed fat- and water-separated MRI scans from 11 male sprinters, all trained athletes with careers lasting more than 7 years, and 12 male non-sprinters, individuals who had not undergone resistance training or practiced sports within the past two years at the time of the survey. By comparing the MRI features, they found that the sprinters had higher relative lower limb mass than the non-sprinters. This increase in muscle strength in turn promoted energy production while running. These findings have been published in Medicine & Science in Sports & Exercise. To understand the interplay between joint torque and segment maneuverability, the researchers further calculated the moment of inertia of the lower limbs around the hip. This comparison showed that moment of inertia did not differ between sprinters and non-sprinters, suggesting that increased muscle mass does not compromise lower limb maneuverability in sprinters.

When comparing different parts of the lower limbs between sprinters and non-sprinters, the researchers found that while the relative mass of the thighs differed between sprinters and non-sprinters, the relative mass of the shank and foot did not vary. Thus, the researchers conclude that these top-heavy, underlight features of sprinters’ limbs help them perform athletic movements with ease, judging from an inertia perspective.

This new study sheds light on the unique characteristics of sprinters’ lower limbs. The findings will be useful for the development of new training strategies. Based on their findings, what do the researchers suggest athletes and trainers do to train more effectively? Kawakami notes: “Sprinters can focus on training the muscles of their lower extremities without having to worry about the increased mass associated with sprint-induced lower extremity muscle strength and the resulting difficulty in moving due to a larger moment of inertia. This strategy will help balance running power and limb movements.”

Factors influencing anxiety-related symptoms, diagnosis, and treatment among college student-athletes in the National College Health Assessment.

Edwards B and Froehle AW. J Athl training. 2023, [epub ahead of print]. doi: 10.4085/1062-6050-0334.22.
Full text freely available

Take home message

Eight in 10 student-athletes report feeling overwhelmed, and nearly half report overwhelming anxiety. Yet fewer than 1 in 4 of these students report having received a diagnosis or treatment.

Background

College athletes are under significant stress due to the demands placed on athletes and students. About half of student-athletes report feeling overwhelming anxiety within a year, but only 12% of athletes report receiving an anxiety diagnosis. This could indicate that many athletes experience anxiety but may not seek treatment. If we knew what factors are associated with anxiety symptoms and treatment avoidance, we could better identify and help high-risk student-athletes.

Study aim

Edwards and Froehle analyzed eight years of data to examine the factors associated with anxiety symptoms and treatment avoidance.

Methods

Researchers obtained data from the National College Health Assessment. The data, which spans eight academic years, was reported anonymously by students at participating institutions and includes extensive demographic information such as school year, self-identified gender, sexual orientation, race/ethnicity, international student status, and history of mental health treatment. . The researchers only included respondents who were classified as “varsity athletes” based on their responses to specific survey questions. The researchers excluded students who participated only in club or intramural sports. The survey included “yes” or “no” questions, allowing researchers to categorize respondents into three groups: 1) “not diagnosed/treated,” 2) “diagnosed but not treated,” and 3) “treated.” The researchers examined eight factors that may be associated with anxiety-related diagnosis and treatment: 1) year in school, 2) gender, 3) sexual orientation, 4) race/ethnicity, 5) school type, 6) international student, 7) history of treatment in mental health, and 8) history of anxiety interfering with academic performance.

Results

A total of 51,882 student-athletes completed the surveys and met inclusion criteria. At least 8 in 10 respondents (83%) reported feeling “overwhelmed by everything you had to do,” and 48% reported “overwhelming anxiety.” Within these responses, female and non-binary athletes consistently reported more symptoms than men. Additionally, white or biracial/multiracial students, students with a history of mental health treatment, and American students were more likely to report symptoms than black students, students with no history of mental health treatment, and international students, respectively.

Among athletes who reported overwhelming anxiety, only 23% of respondents reported receiving either a diagnosis or treatment (~72% received both; ~28% had an untreated diagnosis). An untreated diagnosis was more common in people with no history of mental health treatment than in those with a history.

Viewpoints

A large portion of student-athletes report anxiety, but many do not seek treatment or diagnosis. The data presented in this study also identified factors associated with feeling “overwhelmed by everything you had to do” or “overwhelming anxiety.” These include gender, sexual orientation, race/ethnicity, and history of mental health treatment. These analyzes are limited because they only provide a snapshot of each athlete. We don’t know how our student-athletes change over time and how issues relate to the onset or worsening of anxiety symptoms. Despite these limitations, these results paint an alarming picture: 8 in 10 student-athletes report feeling overwhelmed and nearly half report “overwhelming anxiety.” Additionally, fewer than 1 in 4 student-athletes report receiving a treatment diagnosis with overwhelming anxiety. Collectively, these results suggest that we are failing to meet the mental health needs of our student-athletes, and that we do not have a complete picture of younger athletes.

Clinical implications

Clinicians should be aware that the athlete in front of them is most likely feeling overwhelmed. Doctors must consider the signs and symptoms of mental health problems and have an appropriate and empathetic plan to help their athletes obtain appropriate treatment when warranted. Additionally, many student-athletes never seek mental health care, highlighting the need to reduce stigma and increase awareness among athletes about mental health treatments.

Questions for discussion

What changes have you observed regarding student-athlete mental health awareness, recognition, and treatment seeking? What strategies do you use to screen student-athletes to identify those at high risk of feeling overwhelmed?

Written by Kyle Harris
Reviewed by Jeffrey Driban

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Retired elite athletes who had suffered a sports injury were more likely to develop knee and hip osteoarthritis compared to the general population.

The athletes – who had competed at Olympic level in 57 sports, including athletics, rowing and skiing – were also at increased risk of general lower back pain and shoulder osteoarthritis after a shoulder injury.

Researchers hope the findings will help develop new approaches to injury prevention to benefit athletes now and after retirement.

The study, led by a researcher from the University of Edinburgh, is the largest international study of its kind, and the first to observe the effects of osteoarthritis and pain in different joints in retired elite athletes in various summer and winter Olympic sports.

Researchers surveyed 3,357 retired Olympians aged about 45 about injuries and the health of their bones, joints, muscles and spine. They were also asked if they currently had joint pain and if they had a diagnosis of osteoarthritis.

For comparison, 1,735 people aged around 41 from the general population completed the same survey.

Researchers used statistical models to compare the prevalence of osteoarthritis and pain in the spine, upper extremities and lower extremities in retired Olympians compared to the general population.

The team took into account factors that can influence the risk of pain and osteoarthritis, such as injury, recurrent injury, age, gender and obesity.

They found that the knee, lumbar spine and shoulder are the most injury-prone areas for Olympians. These were also among the most common locations for osteoarthritis and pain.

After a joint injury, the Olympians were more likely to develop osteoarthritis than someone in the general population who suffered a similar injury, the study found.

The athletes also had an increased risk of shoulder, knee, hip and ankle pain and upper and lower back pain after an injury, although this did not differ from the general population.

Dr. Debbie Palmer, from the University of Edinburgh’s Moray House School of Education and Sport, said: “High-performance sport is associated with an increased risk of sports-related injuries and there is increasing evidence that retired elite athletes have high rates of post-traumatic complaints. arthrosis.

“This study provides new evidence for specific factors associated with pain and osteoarthritis in retired elite athletes across the knee, hip, ankle, lumbar and cervical spine and shoulder, and identifies differences in their occurrence that are specific to Olympians.”

Researchers say the study may help people make decisions about recovery and rehabilitation from injuries to prevent recurrence, and inform prevention strategies to reduce the risk and progression of pain and osteoarthritis in retirement.

Effects of physical exercise on early changes in blood-based brain biomarkers: implications for the acute point-of-care diagnosis of concussion

Bazarian J, Abar B, Merchant-Borna K, Pham DL, Rozen E, Mannix R, Kawata K, Chou YY, Stephen SJ, Gill J. J Neurotrauma. October 6, 2022. doi: 10.1089/neu.2022.0267. E-publishing prior to printing. PMID: 36200628.

https://www.liebertpub.com/doi/10.1089/neu.2022.0267

Take home message

Physical exercise can change some blood-based brain measurements that researchers hope can help clinicians objectively diagnose a concussion.

Background

An objective tool such as a blood-based biomarker (measures) could help diagnose acute concussion. However, many blood biomarkers associated with brain inflammation can change as a result of physical exertion. Therefore, we need more information about whether and to what extent the change occurs during military and sporting events to make clinical decisions.

Study aim

The authors assessed four blood-based biomarkers before and after a single workout of aerobic and resistance exercise to determine how these biomarkers changed after physical activity.

Methods

The authors recruited 30 collegiate football players (~19 years old). Fifteen players underwent diffuse tensor imaging 24 hours before and 48 hours after strength training and aerobic exercise. Blood was collected immediately before imaging and then again immediately after exercise and 45 minutes later. The authors analyzed the blood for four biomarkers: 1) glial fibrillary acidic protein (GFAP), 2) ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and 3) neurofilament light (NFL), and 4) tau. Players wore body sensors during training to measure distance (km), energy expenditure (kcal), player load (the sum of all three acceleration planes) and work ratio (% of time moving >1.5 m/sec) . On average the training sessions lasted 90 minutes.

Results

Overall, two blood-based biomarkers changed after physical activity, and two did not. Specifically, GFAP decreased (median decrease 28%) immediately after physical activity compared to baseline and returned to baseline within 45 minutes. In contrast, UCH-L1 was not immediately different from before exercise, but increased within 45 minutes after exercise (median increased by 37%). The changes in these first two biomarkers related to the duration of exercise. Specifically, a person would experience more biomarker changes if they trained for longer. The authors observed no differences over time for NFL, tau, or imaging results.

Viewpoints

The results suggest that just one bout of physical exercise initiates changes in some blood-based brain proteins without altering white matter integrity. This finding suggests that changes in the levels of two blood-based biomarkers are not due to white matter changes. The authors suggested that when commercial kits become available for physicians to assess concussions, we may need to use a comparison to take into account the duration of training. This adjustment may not be necessary if the UCH-L1 is evaluated immediately after a concussion or if the GFAP test occurs after a sporting event (after the patient has rested for 45 minutes). Furthermore, tau and NFL remained fairly stable over time; However, the authors acknowledged that these two biomarkers are less diagnostic during the first few hours after a concussion.

Clinical implications

Medical professionals should continue to use multiple tests to make decisions about the diagnosis of an acute concussion. In addition, they should be aware that more reliable, objective diagnostic tests will soon come to the market, but we should consider optimizing their accuracy.

Questions for discussion

Are biomarkers something you would like to use to assess concussions? If not, what are your concerns?

related posts

1. Acute changes in biomarkers after concussion
2. Serum biomarkers may be a useful diagnostic/prognostic tool for concussion
3. Biomarker SNTF could be the next new tool for concussion
4. Can biochemical markers in the blood detect concussions?
5. Biomarkers in Olympic boxing: diagnosis and effects of repetitive head trauma
6. Blood tests can provide information about long-term recovery from concussion

Written by Jane McDevitt
Reviewed by Jeffrey Driban

If you’ve spent time with a baby, you’ve probably noticed that he can barely sit still. From birth – and even in the womb – babies begin kicking, wiggling and moving, seemingly without purpose or external stimulation. These are called ‘spontaneous movements’ and researchers believe they play an important role in the development of the sensorimotor system, that is, our ability to control our muscles, movement and coordination. If we can better understand these seemingly random movements and how they are involved in early human development, we may also be able to identify early indicators of certain developmental disorders, such as cerebral palsy.

Currently, there is limited knowledge about how newborns and infants learn to move their bodies. “Previous research on sensorimotor development has focused on kinematic properties, muscular activities that produce movement in a joint or part of the body,” said project assistant professor Hoshinori Kanazawa of the Graduate School of Information Science and Technology. “However, our study focused on muscle activity and sensory input signals for the whole body. By combining a musculoskeletal model and a neuroscientific method, we found that spontaneous movements, which appear to have no explicit task or purpose, contribute to coordinated sensorimotor development. “

First, the team recorded the joint movements of 12 healthy newborns (less than 10 days old) and 10 young infants (about 3 months old) using motion capture technology. They then estimated the babies’ muscle activity and sensory input signals using a baby-scale whole-body computer model they created. Finally, they used computer algorithms to analyze the spatiotemporal (both space and time) characteristics of the interaction between the input signals and muscle activity.

“We were surprised that infants’ movements ‘wandered’ during spontaneous movements and that they pursued different sensorimotor interactions. We called this phenomenon ‘sensorimotor wandering,’” says Kanazawa. “It is widely believed that the development of the sensorimotor system generally depends on the occurrence of repeated sensorimotor interactions, meaning that the more often you do the same action, the more likely you are to learn and remember it. Our results implied however, that infants develop their own sensorimotor interactions.” system based on exploratory behavior or curiosity, so they repeat not just the same action, but a variety of actions. In addition, our findings provide a conceptual link between early spontaneous movements and spontaneous neuronal activity.”

Previous studies in humans and animals have shown that motor behavior (movement) involves a small number of primitive muscle control patterns. These are patterns typically seen in task-specific or cyclical movements, such as walking or reaching. The results of this latest study support the theory that newborns and infants can acquire sensorimotor modules, that is, synchronized muscle activities and sensory inputs, through spontaneous whole-body movements without an explicit goal or task. Even during sensorimotor wandering, the infants showed an increase in coordinated whole-body movements and in anticipatory movements. The movements performed by the infant group showed more general patterns and sequential movements, compared to the random movements of the newborn group.

Next, Kanazawa wants to look at how sensorimotor wandering influences later development, such as walking and reaching, along with more complex behavior and higher cognitive functions. “My original background is in pediatric rehabilitation. My major goal with my research is to understand the underlying mechanisms of early motor development and to find knowledge that can help promote infant development.”

Frequency of concussion exposure modulates suicidal ideation, planning, and attempts among US high school students

Kay JJM, Coffman CA, Tavakoli AS, Torres-McGehee TM, Broglio SP, Moore RD. J Athl training. 2022 doi: 10.10.4085/1062-6050-0117.22. E-publishing prior to printing.

Full text freely available

Take home message

High school students who reported a sports and recreation-related concussion in the past 12 months were more likely to report depressive symptoms and suicidal ideation than those who did not. Students who reported multiple concussions in the past 12 months were about twice as likely to report suicide attempts than those who reported a single concussion.

Background

A history of repeated concussions can increase the risk of adverse mental health outcomes, including suicidal ideation, the second leading cause of death among adolescents in the United States. However, we lack evidence to inform clinical practice about this risk in adolescents and whether the risk differs between men and women.

Study aim

Kay and colleagues completed a retrospective cross-sectional study to examine the association between concussion and suicidal thoughts or behavior in biological males and females.

Methods

The researchers used data from the National system for monitoring young people’s risk behavior to investigate this question. The survey was conducted in 2017 and 2019 among students aged 9^e to 12^e degree in both private and public schools. The authors summarized self-reported responses to sports- or recreation-related concussions as 1) no history, 2) a single concussion, or 3) multiple concussions. The survey included five yes/no questions related to mental health: 1) feeling sad/hopeless, 2) suicidal ideation, 3) suicide plans, 4) suicide attempts, and 5) harmful suicide attempts. The time frame for all variables was “within the past twelve months.”

Results

Fifteen percent of respondents reported at least one concussion in the past twelve months. A higher proportion of female respondents answered yes to every mental health question. The authors observed an overall association between history of concussion and the likelihood of reporting feelings of depression, suicidal ideation, and behavior. Respondents who reported multiple concussions in the past twelve months were about twice as likely to report a suicide attempt than those who reported a single concussion. Although this finding occurred in men and women, this association was stronger in men.

Viewpoints

Interestingly, the authors found that a high school student who reports a history of a concussion in the previous year is more likely to report negative mental health outcomes. However, they also noted that when a person sustains multiple concussions, he/she may be at even greater risk of attempting suicide. However, these data come from a cross-sectional study. Therefore, it is impossible to know the timing of these adverse mental health effects. Could they precede concussion and cause someone to take more risks and have more concussions? Is this an acute or chronic outcome that occurs after a concussion, or a vicious cycle where a concussion causes adverse mental health consequences that increase the risk of another concussion and worse outcomes that manifest as a suicide attempt? This information will be essential to understand and help inform prevention strategies. Hopefully, this study will encourage future longitudinal research that can assess the timing of events and the impact of multiple concussions. Future research could also explore the role of concussion severity in relation to mental health outcomes.

Clinical implications

Clinicians must recognize that even a single concussion can be associated with negative mental health consequences within 12 months. Clinicians should monitor mental health outcomes after a concussion and educate family members on how to recognize changes in a patient’s mental health status.

Questions for discussion

How do you currently discuss or monitor a patient’s mental health after a concussion? Given the findings of this study, is there anything you would like to change in your clinical practice?

Written by Kyle Harris
Reviewed by Jeffrey Driban

related posts

More reasons to think about suicide risk among our high school students
Most military service members don’t have to worry about CTE
The suicide rate for high school students is already too high, but concussions make it worse
Mental health problems and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement-Executive Summary

“Although an athlete may experience a slow or delayed recovery, there is reason to believe that recovery is achievable with additional time and injury management,” says study author Thomas W. McAllister, MD, of the Indiana University School of Medicine in Indianapolis. “This is an encouraging message that can help remove some of the discouragement athletes may feel when trying to return to their sport. While some athletes took longer than 24 days to return to play, we found that three-quarters of them were able to return to the sport if you were given just a month to recover.”

The study examined 1,751 college athletes diagnosed with a concussion by a team physician. Of the athletes, 63% were male and 37% female. Male athletes mainly competed in football, soccer and basketball. Female athletes mainly competed in football, volleyball and basketball.

Participants were evaluated five times: within six hours of their injury, one to two days later, as soon as they were free of complaints, as soon as they were allowed to play again and after six months.

Participants reported symptoms to medical staff daily for up to 14 days post-injury and then weekly if they had not yet returned to play.

A total of 399 athletes, or 23%, experienced a slow recovery.

Researchers found that among athletes who took longer than 24 days to return to play, more than three-quarters, or 78%, were able to return to play within 60 days of injury, and four-fifths, or 83%, were able to resume. to return to play within 90 days of the injury. Only 11% had not returned to play six months after the injury.

For the slow-recovery group, the average time to return to play was 35 days post-injury, compared to 13 days in the overall group.

“The results of this study provide useful information for athletes and medical teams to consider when evaluating expectations and making difficult decisions about medical disqualification and the value of continuing with their sport,” McAllister said.

A limitation of the study is that the participants were all collegiate varsity athletes and may not be representative of other age groups or sport levels, and the results may not apply to other types of mild brain injuries.

The study was supported by the Grand Alliance Concussion Assessment, Research, and Education Consortium, National Collegiate Athletic Association, and the Department of Defense.

Association for Concussion History and Long-Term Recovery in Youth.

Chizuk HM, Cunningham A, Horn EC, Thapar RS, Willer BS, Leddy JJ, Haider MN. Clin J Sport Med. 2022;32(6):e573-e579. doi:10.1097/JSM.0000000000001044

https://journals.lww.com/cjsportsmed/Abstract/2022/11000/Association_of_Concussion_History_and_Prolonged.19.aspx

Take home message

Athletes with three or more previous concussions were more likely to develop persistent postconcussive symptoms and take longer to recover than peers with fewer previous concussions.

Background

Persistent symptoms after concussion are defined in adults as symptoms lasting more than 10 to 14 days; in children it is defined as taking longer than a month to recover. A history of three or more concussions is associated with a longer recovery in adults. However, it remains unclear whether this also applies to pediatric patients.

Study objectives

The authors examined whether a greater number of previous concussions increased the risk of persistent postconcussive symptoms in pediatric patients.

Methods

The authors prospectively collected patient records from three sports medicine clinics near Buffalo, New York. Patients were between 8 and 18 years of age, diagnosed with a concussion within 14 days of injury, had a documented number of previous concussions, and were treated until clinical recovery. The researchers defined recovery as symptoms returning to normal with rest, a normal physical examination, and the ability to exercise and return to school without worsening symptoms. The researchers calculated recovery time as the difference between the days after the injury and when the participants recovered. Physicians recorded the number of physician-diagnosed concussions or undiagnosed concussions they considered reliable based on a patient’s history.

Results

The authors recruited 284 children, of which 270 were used in the final analysis. Fifteen children had three or more previous concussions. While 32 to 38% of youth with a history of 0 to 2 previous concussions developed persistent symptoms, two-thirds of those with 3 or more concussions developed persistent symptoms. The researchers found that a cutpoint of ≥ 3 or ≥ 4 concussions had the best prediction of who would eventually develop persistent symptoms.

Viewpoints

These results demonstrate that pediatric patients with a history of three or more concussions are more likely to develop persistent symptoms. It will be interesting to see if these findings can be replicated in a study involving more people with three or more concussions. However, these findings may hold up well because they are consistent with previous research among adults who have suffered a concussion.

Clinical implications

Doctors should use this information to educate patients, especially those who have suffered multiple concussions, that their recovery will likely take longer than their previous concussions. It may be helpful to inform school physicians and administrators that a patient has a history of multiple concussions and may require a longer recovery time and additional academic accommodations.

Questions for discussion

1. Do other factors from a patient’s history influence the risk of a concussion?

Written by Mitchell Barnhart
Reviewed by Jeffrey Driban

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