Adolescent Competitive Athletes Research Articles

Long-term effects of doping with anabolic steroids during adolescence on physical and mental health.

Systematic doping programs like in the GDR were applied in adolescent competitive athletes to induce supramaximal athletic performance. The substances had adverse somatic and psychological effects. The psychological development of the young athletes was impaired and they suffered in adulthood from long-term effects and secondary diseases even years after the doping period. The study compared three groups: competitive athletes with doping(I), competitive athletes without doping(II) and persons with no sports activities(III). Somatic and psychological diseases were analyzed to identify the adverse effects of doping in the most vulnerable phase of development in adolescence. Participants were asked to supply a patient history and completed a questionnaire with standardized psychological tests. The doping cohort had a higher rate of somatic diseases, psychological disorders and social and professional difficulties. The differences were gender-specific with males more often having impaired liver function, depression, tumors and difficulties associated with the workplace . The doping group reported more emotional and physical neglect during childhood. They proved to be less optimistic but more pessimistic, to perceive less social support and to be more depressive. The study identified less extraversion and more neuroticism. Posttraumatic stress disorder (PTSD) occurred in a small number of participants in the doping group. Doping is associated with psychiatric variables. Predictors were the subscale identifying feelings of the Toronto alexithymia scale 20 (TAS-20), the sense of coherence and the Beck depression inventory 2 (BDI-II) and the Beck depression inventory (BDI). Physical and psychosocial effects imply correlation with the application of doping substances but might not only be due to the side effects of these substances but also caused by the system, which exerts great psychological pressure and stress during adolescence, ahighly vulnerable phase.

Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes.

Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Cross-sectional study; Level of evidence, 3. Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (β = -0.228; P = .033) and DPSI (β = -0.240; P = .025) were significantly associated with the CAIT score . Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.

Comparison of performance and anthropometric parameters in paediatric competitive athletes during COVID-19 pandemic in the Czech Republic.

In 2020, measures against the spread of COVID-19 were adopted, including nationwide school closures, restrictions on the free movement of persons and leisure time sports activities. The aim was to assess the impact of COVID-19-associated restrictions on the performance of paediatric and adolescent competitive athletes by comparing basic anthropometric and performance parameters. The sample comprised 389 participants (115 girls, 274 boys). All participants were examined during regular preventive sports health checks from September to November 2019 and a year later. At the initial examination, the mean age of the entire sample was 12.2 ± 2.7 years (median 12.0, minimum 7.0; maximum 17.0). The examination consisted of a complete medical history and physical examination including maximal exercise testing on a leg cycle ergometer. In the entire sample, as well as in the boy and girl subgroups, body height, weight, body mass index (BMI), BMI percentile, and power output significantly increased according to a percentile graph for boys and girls in 2020. A reduction in power output (W/kg) was found. By 2020, W/kg dropped in 56.4% of the youngest participants (7-13 years), 75% of those aged 14-16 years and 64.9% of the oldest individuals (16-17 years). The percentage of the youngest children with power output reductions was statistically significantly lower than the percentages of the other age subgroups (p = 0.007). There were no significant differences in results between genders. Performance and anthropometric parameters worsened especially among older children. This should be reflected when planning epidemic measures in case of any similar situation in the future.

Tryptophan recovery index as a new biomarker for fitness.

The maximal oxygen uptake (VO2max) and maximal power output (Pmax) are commonly used parameters to evaluate the endurance fitness status. A connection between exercise and the kynurenine pathway (KP), which describes the metabolism of unused tryptophan, has already been reported. However, a potential association of the KP with endurance fitness levels remains unknown. In this study, adolescent competitive athletes performed an exhaustive incremental exercise test. Blood samples were taken before, directly after, and 30 minutes after the end of exercise. Tryptophan (Trp), kynurenine (Kyn) and kynurenic acid (KA) serum levels were determined by high-performance liquid chromatography (HPLC). Forty-four male and 27 female athletes (median age: 16 years) were recruited. During exhaustive exercise tests, Trp initially declined and then increased 30 minutes after discontinuing exercise. Similar findings were observed for Kyn, whereas KA levels behaved inversely. After incremental exhaustive exercise the relative increase of Trp concentrations, termed the tryptophan-recovery-index (TRI), showed a highly significant positive correlation with VO2max and Pmax (r=0.468 and 0.491, p-values <0.001). There was a significant gender-difference with higher levels of all metabolites at all measured time points in male participants. In the present study, a highly significant correlation was found between the TRI and the maximal oxygen uptake in well-trained athletes. The implementation of TRI can therefore be suggested as a biomarker for physical fitness.

The Impact of the Pandemic COVID 19 on Adolescent’s Sports Performance in Czech Republic

Background: During the COVID-19 pandemic, free movement, leisure activities and sports, both competitive and elite, were restricted by measures against the spread of the infection. The study aimed to evaluate the impact of the restricttions on the performance of Czech adolescent competitive athletes. Methods: The sample of the retrospective study comprised 125 participants (41 girls, 84 boys). The initial examination, the mean age of the entire sample was 15.5 ± 1.2 (median 16.0) years; 16.0 ± 1.2 in girls and 15.5 ± 1.2 in boys, respectively. All participants were examined during regular preventive sports health checks from September to November 2019 and a year later. The examination consisted of a complete medical history and physical examination, anthropometric measurements (height, weight and body mass index [BMI] calculations) and maximal exercise testing on a leg cycle ergometer, ECG and blood pressure recordings. The response variables in regression models were power output (W/kg) and MET. Results: In the entire sample, as well as in the boy and girl subgroups, body height, weight, BMI, BMI percentile and power output were significantly increased in 2020 compared to 2019, yet with a statistically significant reduction in both power output per kilogram of body weight and metabolic equivalent (MET). In 2020, the relative power output dropped by 0.13 W/kg and MET by 0.6. There was no statistically significant predictor of changes in relative power output and MET identified in regression models, including no significant impact of the sport type. There were no significant differences in results between genders. Conclusions: Performance and anthropometric parameters, specifically power output per kilogram of body weight and MET, worsened in the sample of adolescent male and female athletes.

Are they too perfect to eat healthy? Association between eating disorder symptoms and perfectionism in adolescent rhythmic gymnasts

ObjectiveEating disorders are associated with perfectionism in adults, but evidence is lacking in adolescent competitive athletes. This study examined eating disorder symptoms and perfectionism in a sample of 13–15 years old, adolescent rhythmic gymnasts. MethodsEighty-nine female rhythmic gymnasts (41 international and 48 recreational level gymnasts), completed the Eating Attitudes Tests 26 (EAT-26), the Sport Perfectionism Questionnaire (SPQ), the Social Desirability Scale (SDS) and provided information on their training. ResultsIt was found that 41.46% of the international and 14.58% of the recreational level gymnasts scored ≥20 in EAT-26. International level gymnasts also scored higher than recreational in EAT-26 (p = 0.002), and its subscales Dieting (p = 0.012) and Oral Control (p ˂ 0.001) and in the Sport Perfectionism Questionnaire (p = 0.005) and the subscales Striving for Perfectionism (p ˂ 0.001) and Personal Standards (p ˂ 0.001). No differences were found between groups in the subscales Concerns over Mistakes (p = 0.429), and Negative Reactions to Imperfection (p = 0.096). Multiple regression analysis in international level gymnasts, showed that Negative Reactions to Imperfection, body mass index and training experience accounted for 33.2% of the variance in EAT-26 (adjusted R2 = 0.332, F = 6.786, p ˂ 0.001). A negative association was observed between training experience and eating disorder symptoms in international level athletes. No association was found between the subscales of perfectionism and EAT-26 in recreational gymnasts (p ˃ 0.316). ConclusionsInternational level, adolescent rhythmic gymnasts show more eating pathology than recreational. Negative Reactions to Imperfection and BMI seem relevant for gymnasts' dieting behaviour while training experience may help adolescent athletes to cope with disturbed eating behaviours.

COVID-19: Analysis of cavitary air inspired through a mask, in competitive adolescent athletes

IntroductionDue to the mandatory use of a mask in the context of the COVID-19 pandemic, and the authorization to do outdoor sports in Catalonia, we set out to evaluate the physiological impact of the hypoxia and hypercapnia generated by the mask during aerobic exercise.Methods46 adolescent competitive athletes (35 women, 11 men) were evaluated. Measurements were taken of ambient air, at rest intra-mask, and during a stress test intra-mask. The concentration of O2 and CO2 intra-mask and the O2 Saturation were evaluated.ResultsThe O2 of ambient air in the laboratory: 20.9%; Basal intra-mask O2: 18.0 ± 0.7% and intra-mask O2 during exercise: 17.4 ± 0.6% (p < 0.0001). The CO2 was: 0.05 ± 0.01% environmental; baseline intra-mask: 1.31 ± 0.5%, and during exercise intra-mask: 1.76 ± 0.6% (p < 0.0001). Baseline O2 saturation with mask was 98.4 ± 0.6% and immediately after exercise was 97.1 ± 2.8% (p < 0.03). During the exercise intra-mask, 30% of the young athletes exceeded 2% of CO2 and 22% breathed oxygen with a concentration lower than 17%.ConclusionsThe use of masks generate hypercapnic hypoxia during exercise. One third of the subjects exceed the CO2 threshold of 2%.

Fatigue Increases ACL Injury Risk in Youth Athletes: Risk Assessment Study Using Drop-jump Test

Objectives:The impact of fatigue on injury risk to the anterior cruciate ligament (ACL) in adolescent athletes is unknown. Identifying athletes who demonstrate increased risk for injury may help determine who would benefit from early neuromuscular control intervention for injury prevention. The goal of this study was to determine if fatigue increases ACL injury risk in adolescent athletes using the drop-jump test to assess dynamic valgus.Methods:Youth and adolescent competitive athletes were recruited for this video analysis study. Participants were recorded performing the standard drop-jump test assessing dynamic valgus on landing three times. They then completed a standardized fatigue protocol consisting of a timed period of high-intensity aerobic tasks. A set amount of fatigue was quantified and achieved using a maximum vertical jump, which was compared to pre-fatigue values. The drop-jump test was then repeated three additional times post-fatigue. All drop-jump recordings (six in total) were randomized by order and scored for dynamic knee valgus by three independent reviewers. A multivariable analysis was performed to assess the correlation between demographic variables and injury risk.Results:Forty-seven female patients and thirty-eight male athletes were included in the study. The average age was 15.4 years (age 14-18). Athletes were found to have significantly higher ACL injury risk post-fatigue when compared to pre-fatigue (p = .001). Thirty-five athletes were found to change from low/medium injury risk pre-fatigue to medium/high risk post fatigue. No demographic variables were found to contribute to ACL injury risk.Conclusion:In adolescent athletes, fatigue appears to increase risk of ACL injury through drop-jump testing. Age, BMI, and hip width were not found to contribute to ACL injury risk. Implementation of neuromuscular or conditioning programs for at-risk athletes may reduce injury risk.

Return to Play Following Open Treatment of Femoroacetabular Impingement in Adolescent Athletes.

After treatment of femoroacetabular impingement (FAI) in adolescent competitive athletes, the rate, timing, and level of return to play have not been well reported. Adolescent athletes who underwent open FAI treatment were assessed at a minimum 1-year follow-up. Patients completed a self-reported questionnaire centered on the time and level of return to play. Pain and functional outcomes were assessed using the modified Harris Hip Score (mHHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS). Among the 24 athletes included, 21 (87.5%) (95% confidence interval [CI], 67.6% to 97.3%) successfully returned to play after open FAI treatment. The median time to return to play was 7 months (95% CI, 6 to 10 months). Of the 21 who returned to play, 19 (90%) returned at a level that was equivalent to or greater than their level of play before surgery. Three athletes (12.5%) did not return to play and indicated that failure to return to play was unrelated to their hip. There was significant improvement in the mHHS (P < 0.0001), HOOS (P < 0.0001), α angle (P < 0.0001), and offset (P < 0.0001). Most adolescent athletes can expect to return to the same or better level of sports participation during the first year after open treatment of FAI.

Beyond Tebowing and superstitions: religious practices of 15-year-old competitive athletes

Research of religious practices in sport typically limits investigation to Christian prayer and/or “superstitions” among professional or collegiate athletes. This study moves in a different direction by examining the religious spiritual practices reported by 13 adolescent competitive athletes in individual interviews and focus groups. With a mix of religious backgrounds among the 15-year-old participants, this sample of males and females reported religious practices such as talking with dead ancestors and different forms of prayer and meditation. The paper categorises these and other practices according to Nancy Tatom Ammerman’s 2014 study, enabling a conceptualisation of how adolescent athletes use religious practices in everyday ways to enable confidence in their play. The study overall points to a significant religious element within competitive youth sports that challenges cynical assumptions about elite athletes' use of religion found in other studies.

Tendon Adaptation to Sport-specific Loading in Adolescent Athletes

Tendon adaptation due to mechanical loading is controversially discussed. However, data concerning the development of tendon thickness in adolescent athletes is sparse. The purpose of this study was to examine possible differences in Achilles (AT) and patellar tendon (PT) thickness in adolescent athletes while considering age, gender and sport-specific loading. In 500 adolescent competitive athletes of 16 different sports and 40 recreational controls both ATs and PTs were sonographically measured. Subjects were divided into 2 age groups (< 13; ≥ 13 years) and 6 sport type categories (ball, combat, and water sports, combined disciplines, cycling, controls). In addition, 3 risk groups (low, moderate, high) were created according to the athlete's risk of developing tendinopathy. AT and PT thickness did not significantly differ between age groups (AT/PT:<13: 5.4±0.7 mm/3.6±0.5 mm;≥13: 5.3±0.7 mm/3.6±0.5 mm). In both age groups males presented higher tendon thickness than females (p<0.001). AT thickness was highest in ball sports/cyclists and lowest in controls (p≤0.002). PT thickness was greatest in water sports and lowest in controls (p=0.02). High risk athletes presented slightly higher AT thickness compared to the low risk group (p=0.03). Increased AT and PT thickness in certain sport types compared to controls supports the hypothesis of structural tendon adaptation due to sport-specific loading.

Attitudes and Dispositions toward Doping in Adolescent Elite Athletes

For effective prevention of doping, individual and situational factors that make an elite athlete more susceptible to doping than others should be investigated. The aim of this study was to quantitatively measure doping related attitudes and dispositions of adolescent competitive athletes at elite level. Data were collected by questionnaires among athletes (n=123) who were participating in the 2nd Asian Youth Games. Outcome measures included doping knowledge, behavior and attitude (performance enhancement attitude scale, PEAS). One athlete admitted the past use of doping and 2 athletes reported that they knew others who had doped. Athletes were mainly provided with anti-doping information from anti-doping agency (16.3%), coaches (11.4%) or medical staffs (10.6%). The average PEAS score was 38.39±11.36. High school (elder) athletes showed higher PEAS score (39.63±11.35) than middle school (younger) athletes (34.53±10.67) and team sport athletes showed lower PEAS score (35.11±9.80) than athletes in endurance (45.08±15.49) or motor skill sports (43.25±9.08). This study suggests that many factors play an important role in athlete’s decisions regarding the use of doping. Further research should incorporate these factors to understand the complexity of doping and to identify points for effective anti-doping program.

Analysis of problems using Data Mining techniques – findings from sports clubs in Germany

Sports clubs are often objects of investigation in European research on sport and society. Usually descriptive analyses are carried out and sport clubs are differentiated by structural factors such as size, age, and number of offered sports. However, these factors do not always have to be the distinctive ones as sports clubs are very heterogeneous and have many other features. Therefore, a more explorative analysis was applied using Data Mining for the analysis of the four main problems in German sports clubs. These problems are the adherence and acquisition of volunteers, adolescent competitive athletes, coaches, and members. The data base for the analysis of problems is the Sport Development Report 2007/2008 (n = 13,068). Decision trees were estimated for all four problems. The findings suggest that, beside the size of the club, the share of members participating in convivial gatherings and the offered sports are decisive for the severity of these problems. Some problems were higher in soccer, tennis, shooting, and equestrian clubs. With regard to further research, a comparison of Data Mining results in European sports club research would be interesting.

Simultaneous bilateral avulsion fracture of the anterior superior iliac spine in a young athlete

A 16-year-old boy was running a 100 m sprint. About 40 m from the starting line, he felt a sharp snap in his right groin with moderate sudden pain. As he decelerated, there was similar snap with sudden pain in the left groin. He collapsed to the ground with moderate pain over both the groins. On arrival in the emergency department by ambulance about an hour from the time of injury, the pain was still localised to both the groins and had somewhat subsided with analgesics. On examination, he was of moderate build with good muscular tone. A radiograph of the pelvis was performed which showed bilateral avulsion of the anterior superior iliac spine (ASIS). Avulsion fracture of the ASIS is an uncommon injury, accounting for only 1.4% of injuries to the hip and pelvis. It is mostly seen in adolescent competitive athletes, usually sprinters, distance runners and soccer players, more commonly in boys (13:1). In the skeletally immature adolescent athlete, the physis is the weakest component of the muscle.

Stress fractures in adolescent competitive athletes with open physis

There have been no studies devoted exclusively to stress fractures in competitive athletes with immature skeletal systems so far. The object of this case series was to describe special features of stress fractures in athletes with immature skeletal systems, with special reference to sport-specific strain, diagnosis and treatment results. The study population was made up of 19 children and adolescents with a total of 21 stress fractures. The average observation period was 4.83 years [standard deviation (SD) 2.69] and the average age at diagnosis, 14.04 years (SD 4.7). The lower extremity was affected in most of our cases. In adolescent athletes, endurance sports appear to lead preferentially to stress fractures in the region of the metatarsal bones, while sports requiring sudden stops at high speed appear to increase the risk of fractures in the region of the tibial diaphysis (P=0.0322). Most (20 of 21) of the fractures in this study were treated conservatively with refraining from athletic activity and reduction of stress/weight-bearing for an average of 6.73 weeks (SD 2.91). In five cases the extremity was in addition immobilized in a plaster cast for 5.32 weeks (SD 2.21). Complete healing was achieved in 14 cases. In seven cases, however, the treatment did not lead to a satisfactory outcome. Most of the patients whose symptoms persisted over a long period had fractures in the tibia and were engaged in sports requiring frequent sudden stops. Our data suggest that stress fractures in athletes, whose skeletal systems are still immature, lead to a clinical picture that does not always culminate in a good outcome of treatment. We therefore recommend a thorough and early diagnostic investigation (including MRI) and consistent treatment whenever a patient's history and clinical picture give any indication that a stress fracture might be present.

Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected.

To describe the prevalence, location and sports distribution of pelvic avulsion fractures in adolescent competitive athletes. One thousand two hundred and thirty-eight radiographs of the pelvis taken for focal traumatic symptoms in athletes with an age range of 11-35 years over a period of 22 years were reviewed. One hundred and ninety-eight adolescent athletes were affected by 203 avulsion fractures of the pelvic apophyses (five cases presented multiple locations). The localisation was the ischial tuberosity (IT) in 109 cases, anterior inferior iliac spine (AIIS) in 45 cases, anterior superior iliac spine (ASIS) in 39 cases, superior corner of pubic symphysis (SCPS) in 7 cases and iliac crest (IC) in 3 cases. Soccer (74 cases) and gymnastics (55 cases) were the sports with the highest number of avulsion fractures documented. Apophyseal avulsion fractures of the pelvis in adolescent competitive athletes are most common in soccer and gymnastics. The lesions are usually the consequence of sudden and forceful muscle-tendon contractions during sport activities. Plain radiographs, are determinant for the diagnosis.

Coping styles among adolescent competitive athletes.

The use of approach and avoidance coping styles and task-focused and emotion-focused coping strategies in competitive sport was explored. Four hundred twenty-one adolescent males from New South Wales, Australia, who were currently competing in team sports indicated their usual responses to each of 8 acute stressors commonly experienced in sport, using a 128-item inventory. The reliability coefficient (Cronbach's alpha) for each stressor ranged from .81 to .92. Twenty-six of the original 128 items on the inventory were retained, on the basis of factor analysis. Correlations between stressors indicated that coping styles were a function of type of stressor, providing support for the transactional model. Goodness of fit was high (.87). The present results partially support the construct of coping style among adolescent-aged sports competitors.