Cohort Of Athletes Research Articles

Unveiling a hide side of the athlete's heart: a CMR focus on the left atrium.

Abstract Background cardiac magnetic resonance (CMR) is the gold standard to evaluate cardiac chambers’ dimensions and function, but data on left atrium (LA) dimensions and function among elite athletes are lacking. Objective to describe LA size and function among a cohort of elite athletes and evaluate eventual differences based on sports discipline and gender. Methods We enrolled 120 Olympic athletes with un-remarkable cardiovascular pre-participation screening tests (mean age 25±5 years, 50% males, 25% skill, 25% power, 25% mixed, 25% endurance). All the athletes underwent CMR without contrast administration. LA dimensions, in terms of absolute and indexed area and volume, were computed using 4- and 2-chamber steady state precession cine-sequences. LA ejection fraction (LAEF) and LA coupling index (LACI index, as the ratio between LA and LV end-diastolic volumes) were calculated. Cine-images were also used to analyse atrial deformation with a dedicated offline software to measure LA global longitudinal strain. LA dimensions and function were compared between males and females and athletes of different sports categories based on European classification. Results Among the entire cohort, endurance athletes showed the greatest remodelling in terms of LA and LV dimensions (Table). There were no significant differences in LAEF and LV-EF between athletes of different sport categories (p=0.121 and p=0.679). A trend in increasing LA volumes and decreasing LA strain consistent with a growing cardiovascular demand was observed, but the only statistically significant difference was between skill athletes and all the other groups for LA volumes (p<0.001), while there were no significant differences in LA strain (p=0.170). LACI did not differ between athletes of different sports categories (p=0.170). Female athletes showed higher LAEF and LA strain than males (respectively 55±5 vs 52±6% p=0.012 and 35±7 vs 32±7%, p=0.009) while LACI did not differ based on gender (19±5% for both females and males, p=0.385). Conclusion Among our cohort of Olympics, LA remodelling was observed in all athletes, being less evident in skill group, as for the LV. Thus, the ratio between LA and LV did not differ between sport categories. LAEF and LA strain were not significantly different between athletes of different sports categories although LA strain was slightly lower in endurance. Female athletes showed higher LAEF and LA strain than males, while LACI was not different based on gender.

Atrial and ventricular arrhythmias in young, lifelong and retired elite endurance athletes

Abstract Background Whilst endurance athletes are known to have an overall higher prevalence of atrial fibrillation (AF), the prevalence of other non-sustained and sustained atrial arrhythmias (AAs) and ventricular arrhythmias (VAs) remains poorly defined. Purpose We aimed to define the prevalence of non-sustained and sustained AAs (including AF) and VAs in a healthy cohort of young, lifelong and retired elite endurance athletes. We also sought to assess associations between arrhythmias, fitness and measures of cardiac structure. Methods Holter monitors in healthy endurance athletes (n=288) from an international cohort of elite endurance athletes (the Pro@Heart consortium) were analysed for the presence of sustained and non-sustained AAs and VAs. Athletes were sub-divided into young elite athletes (n=176) and former elite athletes (n=112) of which 60 were lifelong (≥2.5 hours/week) and 52 retired (<2.5 hours/week) athletes (determined by current high-intensity exercise activity). Each athlete underwent cardio-pulmonary exercise testing, echocardiography and contrast-enhanced cardiac MRI. Participants with known structural or electrical cardiac disease were excluded. Independent T-test / One-Way ANOVA (parametric data) or Mann-Whitney U / Kruskal-Wallis Tests (non-parametric data) assessed for differences between the groups. Results Young athletes (n=176, 70.5% male) were significantly fitter with a greater degree of cardiac remodelling as compared with lifelong (n=60, 63.3% male) and retired (n=52, 82.7% male) athletes (Figure 1). The prevalence of non-sustained AAs (young: 4.0% vs lifelong: 66.7% vs retired: 61.5%, p<0.001), sustained AAs (young: 0.6% vs lifelong: 8.3% vs retired: 15.4%, p<0.001) and non-sustained VAs (young: 1.7% vs lifelong: 18.3% vs retired: 23.1%, p<0.001) was higher in lifelong and retired athletes compared with young athletes (Figure 2). Non-sustained VAs were predominately monomorphic (85%), short and moderate rate (median duration 2.8 seconds and heart rate 154 beats per minute). No athletes developed sustained VAs and/or sudden cardiac arrest. Young athletes had less VAs that were multifocal in origin compared with lifelong and retired athletes (young: 29.5%, lifelong: 37.3%, retired: 53.5%, p=0.027). There was no difference in prevalence of any arrhythmia between lifelong and retired athletes. There were no significant correlations between arrhythmias and fitness or cardiac imaging parameters. Conclusion Healthy athletes have a significant prevalence of non-sustained atrial and ventricular arrhythmias and sustained atrial arrhythmias that is more prevalent in older athletes. In older athletes, the prevalence of arrhythmias is similar regardless of whether athletes are actively engaged in training or retired suggesting that pro-arrhythmic remodelling in athletes is sustained, not immediately reversible and may be minimally responsive to detraining.Arrhythmias and cardiac imagingArrhythmias amongst athlete groups

Clinical overlap between healthy athletes and athletes with arrhythmogenic right ventricular cardiomyopathy

Abstract Introduction The extensive physiological cardiac remodelling that results from the haemodynamic stress of endurance exercise shares many features with the pathological manifestations of arrhythmogenic right ventricular cardiomyopathy (ARVC), giving rise to a significant diagnostic challenge for clinicians. Contemporary discriminators of disease have been derived from comparisons between healthy athletes and non-athletic ARVC patients. Differentiation between healthy and diseased athletes may be more difficult. Purpose To assess published clinical differentiators of physiological remodelling from ARVC in a cohort of endurance athletes. Methods This project utilises data from the Pro@heart consortium comprising elite endurance athletes that have received comprehensive cardiac phenotyping using cardiac magnetic resonance imaging, echocardiography, resting and ambulatory electrocardiography and cardiopulmonary exercise testing. Measures of cardiac structure and function with potential to differentiate health and disease were assessed in healthy endurance athletes without symptoms or suspicion of ARVC, endurance athletes diagnosed with ARVC (meeting ARVC task force criteria) and athletes with suspected sub-clinical ARVC (complex ventricular arrhythmias and ≥1 task force criteria). One way ANOVA assessed differences in continuous variables, while Chi Square with pair wise Z test and Bonferroni p value correction were used to test for differences in nominal data. Results Athletes with ARVC and athletes with suspected ARVC displayed more clinical indicators of ARVC compared to healthy athletes (table 1). While a greater proportion of athletes with ARVC and suspected ARVC met ≥1 and ≥3 indicators of pathology compared to healthy athletes, it was relatively common for healthy athletes to meet ≥1 criteria (53%) and ≥3 criteria (14%) (table 2). Comparison of mean values showed right ventricular ejection fraction (RVEF) and right ventricular fractional area change (RV FAC) were lower in athletes with or suspected to have ARVC compared to healthy athletes, however no significant differences in burden of ventricular premature beats (VPB) were noted (table 1). A high burden of VPBs, evidence of ventricular arrhythmia, evidence of late gadolinium enhancement (LGE), a low RVEF, and a reduced RV FAC were more prevalent in athletes with ARVC compared to healthy athletes (table 2). However, there was clinically relevant overlap in all measures between healthy and diseased athletes (table 2). Right ventricular to left ventricular volume ratio was a particularly poor discriminator of pathology (table 1 & 2). Conclusion Electrophysiological, structural and functional abnormalities are not uncommon in healthy athletes resulting in significant overlap with athletic ARVC patients. Future research is required to identify better clinical discriminators of disease, and to assess the clinical significance of abnormal measures in ostensibly healthy athletes

Coronary atherosclerotic burden in master athletes: relationship with cardiovascular risk and volume of exercise

Abstract Background Although prior studies suggesting an association between coronary artery calcification (CAC) and lifelong exercise, the clinical relevance and mechanisms for this interaction remains unknown. Recent evidence suggests that a significant amount of exercise might not be linked to a more favourable composition of coronary plaques. We aimed to analyse the prevalence of high coronary atherosclerotic (CAS) burden assessed by coronary CT scan (CCTA) in master athletes, according to cardiovascular (CV) risk and volume of exercise. Methods A total of 105 master male athletes (48±5.6 years old), asymptomatic and without known CV disease, were prospectively studied. A high CAS burden was defined as the presence of at least one of the following characteristics in CCTA: CAC score >100; CAC score >75th percentile; obstructive plaques; plaques in the left main, three vessels or two vessels including the proximal anterior descending artery; segment Involvement Score (SIS) >5; CT-adapted Leaman score (CT-LeSc) ≥5T. his variable was evaluated according to the CV risk, stratified by SCORE2, and volume of exercise, determined by metabolic equivalent task score (MET/hour/week). Results Most athletes (n=88) were engaged in endurance sports, during 17.1±9.8 years, with a median exercise volume of 66 [IQR 44-103] METs/hour/week. The mean SCORE2 was 2.8±1.5%, with 76.9% of athletes classified as having a low to moderate CV risk, and none having very high-risk. A high CAS burden was present in 25.7% of the athletes, without significant differences according to the SCORE2 risk categories [Low- Moderate Vs. High Risk: 25.5% Vs. 37.5%, respectively ; p=0.142] nor volume of exercise [below Vs. above median: 30.6% Vs. 21.4%, respectively; p=0.283)] (Figure 1 A). Combining these variables, athletes with high CV risk and a high volume of exercise showed significantly higher occurrence of a high CAS burden compared to those with low-moderate risk and high volume of exercise (50% Vs. 15.6%; p=0.017). Among athletes with low-moderate risk, high volume of exercise trended to be protective (15.6% Vs. 31.4%; p=0,092), while there was a similar rate of high CAS burden in athletes with low volume of exercise, independently of risk class (Figure 1B). Conclusions In our cohort of master athletes, one fourth demonstrated a high burden of CAS burden evaluated by CCTA. While a higher volume of exercise combined with high cardiovascular risk showed an association with worse coronary composition it trended to be protective in athletes with lower risk. Integrating clinical and exercise-related data is crucial for evaluating athletes amidst the complex associations between exercise, cardiovascular risk, and CAS burden, necessitating longitudinal studies for comprehensive understanding.Figure 1Figure 2

Diagnostic effectiveness of the Sport Mental Health Assessment Tool 1 supplemented with a brief clinical intake interview in a cohort of Polish elite Olympic athletes

ObjectiveSeveral studies have used the Sport Mental Health Assessment Tool 1 (SMHAT-1) among athletes but none have combined SMHAT-1 with a subsequent clinical intake interview. The aim of this study...

Initial Symptom Severity and Recovery of Sport-Related Concussion in Team Versus Individual Sport Athletes.

Recovery after sport-related concussion is variable, and potential differences between team vs individual sport athletes are not fully understood. In a cohort of athletes with concussions, we sought to compare these groups across (1) symptom severity score, (2) individual symptom cluster scores, and (3) recovery metrics. A retrospective, cohort study of 13 to 23-year-old athletes treated at a regional sport concussion center between November 2017 and April 2022 was conducted. Athletes were categorized into team vs individual sport athletes, with additional classification of individual sports based on strong vs minimal team elements (ie, the degree of interdependence displayed by athletes). The primary outcomes were symptom severity score, measured by either the Sport Concussion Assessment Tool-5th Edition or the Immediate Post-Concussion Assessment and Cognitive Testing, and physical, cognitive, emotional, and sleep symptom cluster scores. Secondary outcomes were recovery metrics, including time to return-to-learn, symptom resolution, and return-to-play. Of the 1051 athletes, 954 (90.8%) were in team sports and 97 (9.2%) in individual sports. In multivariable linear regression, individual sport athletes had higher emotional symptom severity compared with team sport athletes (β = 0.09 [0.01, 0.17], P = .034) when adjusting for sex, attention-deficit/hyperactivity disorder, psychological disorders, time to clinic, on-field evaluation, and Immediate Post-Concussion Assessment and Cognitive Testing vs Sport Concussion Assessment Tool-5th Edition scale. There were no significant differences in return-to-learn (P = .104), symptom resolution (P = .941), or return-to-play (P = .279) on univariate regressions. In the current single-center, pilot study of athletes with a sport-related concussion, individual sport athletes exhibited more emotional symptoms than team sport athletes. These preliminary data lend early support that individual sport athletes may be more at risk of emotional symptoms than team sport athletes after a sport-related concussion. Clinicians may use these findings to identify athletes who may be particularly vulnerable to emotional symptoms.

Insight on Exercise-Induced Heart Remodeling in Different Track and Field Disciplines.

Background: The foot racing disciplines include sprints, middle distances, and long distances, which vary in terms of intensities, duration of training, and metabolic demands. The aim of our study was to evaluate the differences in morpho-functional parameters describing cardiac remodeling in a large cohort of Olympic athletes practicing the different track subspecialties. Methods: We evaluated 140 track and field (52.1% males, mean age 26.3 ± 4.3 years) Olympic athletes divided into four groups according to the distance performed: Group A (46, 32.9%): 100 and 200 mt; Group B (34, 24.3%): 400 mt; Group C (25, 17.9%): 800, 1500, and 3000 mt; Group D (35, 24.9%): 5000, 10,000 mt, and marathon distance. The athletes underwent a pre-participation screening, which included transthoracic echocardiography and exercise stress testing. Results: In Group A and in Group B, most athletes presented normal cardiac geometry (41/46, 89.1% in Group A and 31/34, 91.2% in Group B, p < 0.0001). Instead, in Groups C and D, more than half presented eccentric cardiac remodeling (13\25, 52% in Group C and 23\35, 65.7% in Group D). No significant differences were found between subspecialties in LVEF (p = 0.587), diastolic function (p = 0.431), and training hours/week (p = 0.078). Conclusions: In conclusion, the presence and extent of cardiac remodeling vary according to the distance of the discipline practiced, with the largest dimensional increase in both left and right ventricles and atria in mid- and long-distance runners and the lowest in sprinters.

Athlete Perspectives on Concussion Recognition and Management in Gaelic Games: A Qualitative Analysis.

Background: The focus of this qualitative research was to interview current and retired Gaelic games athletes to ascertain how athletes viewed concussion recognition and management. Methods: A grounded theory methodology design was utilised to investigate concussion recognition and management experiences of a cohort of Gaelic games athletes (n = 22). Data for the study were collected using a semi-structured interview format. Results: Two major themes were identified: (1) an inconsistent identification of concussion as an injury and the absence of standardised procedures for removal from play, and (2) the impact of athlete-driven decision making on concussion management. Concussions were experienced by all the participants on multiple occasions while playing Gaelic games. However, concussion recognition and removal rarely occurred, as many athletes chose not to disclose their injuries or self-managed their concussions. Conclusions: The recognition and management of concussions in Gaelic games are currently inadequate, and they may be posing significant risks to athletes' long-term health. This research highlights the need for more stringent protocols for concussion recognition and removal at pitch side. In addition, Gaelic games require a more objective injury management plan during acute and chronic concussion recovery.

Use Of Cpet In Routine Pre-participation Screening: Results From The Italian Experience On A Large Cohort Of Olympic Athletes

Use Of Cpet In Routine Pre-participation Screening: Results From The Italian Experience On A Large Cohort Of Olympic Athletes

CMR native T1 and T2 Mapping in Olympic athletes: the influence of sport discipline and sex

Abstract Background Cardiac Magnetic Resonance (CMR) has a growing role in evaluating athletes’ hearts. Mapping techniques provide added value for tissue characterisation, but data on athletes and sports disciplines are lacking. Aim To describe native mapping values in a cohort of Olympic Athletes and evaluate the influence of sports discipline and sex. Methods A group of 300 Olympic athletes (13% skill, 20% power, 25% mixed, 42% endurance, 58% male) with unremarkable cardiovascular screening and a control group of 42 sedentary subjects (52% male) underwent CMR without contrast administration. Athletes were divided based on sex and sports categories according to the ESC classification. Results Among athletes of different sports categories and controls, endurance presented the lowest value of T1 mapping (p&amp;lt;0.001). No differences in T2 mapping were observed (p=0.472). Female athletes had higher values of T1 native myocardial mapping compared to males (p=0.001), while there were no differences in T2 mapping (p=0.817). Male athletes with higher left ventricular mass indexed (LV-Massi) had lower values of T1 mapping (p=0.006) and slightly higher values of T2 mapping, even if not significant (p=0.150). Female athletes with higher LV-Massi did not show significant differences in T1 and T2 mapping (p=0.053 and p=0.438) Conclusions T1 native myocardial mapping showed significant differences related to sports disciplines and gender. Athletes with the largest LV remodelling, mostly endurance and mixed, showed the lowest values of T1 mapping. Male athletes showed lower values of T1 mapping than females. No significant differences were observed in T2 mapping related to sports disciplines and gender.

Effect of Sport Activity on Uncomplicated Bicuspid Aortic Valve: Long-Term Longitudinal Echocardiographic Study.

The bicuspid aortic valve (BAV) is a congenital heart defect that can lead to certain complications (aortic stenosis, regurgitation, dilatation and endocarditis), the diagnosis and clinical monitoring of which are effectively entrusted to transthoracic echocardiography (TTE). The impact of training on the natural history of the disease remains unclear. A retrospective cohort of athletes with uncomplicated BAV aged 18-50 years, who underwent at least 2 TTEs with a minimum follow-up of 5 years, subdivided according to the level of physical activity during follow-up into ''untrained'' and ''trained'', was collected. 47 athletes (87.3% male, median 21.0, (18.0; 33.0) years) were included. Median follow-up was 11.6 (8.4; 16.3) years. No statistically significant difference in the growing rate of aorta, left ventricle, nor a significant worsening of aortic stenosis and regurgitation was found. Moreover, there was no significant correlation between weekly training minutes during follow-up and the echocardiographic parameters related to heart size and function. In BAV without major complications, high training volumes do not correspond to a more rapid and significant deterioration in valve function nor to a more rapid increase in aortic or cardiac chamber size.

Mental Resilience in Crisis: Examining the Mental Health and Well‐Being of Iranian Athletes During the COVID‐19 Pandemic

ABSTRACTThe pervasive impact of COVID‐19 and economic sanctions has significantly influenced the well‐being of Iranian athletes, leaving lasting imprints on both their physical and mental health. During this challenging time, this comprehensive study delves into the nuanced disparities among various cohorts of Iranian athletes across multiple dimensions, including insomnia severity, psychological distress, anxiety, depression, intrusive thoughts, life satisfaction, and hope. Stratifying the participants based on their professionalism level, age, education, sports activity engagement, and COVID‐19 infection status, our survey‐based findings from a cohort of 280 athletes reveal compelling insights: Male athletes exhibit higher levels of distress, anxiety, and depression compared to their female counterparts. Professional athletes manifest elevated psychological distress, anxiety, and depression in contrast to semi‐professional and amateur athletes. Insomnia severity is more prevalent among professional athletes, concurrently accompanied by higher levels of hope within this group. Young athletes and those with higher educational attainment report increased intrusive thoughts. Local and national athletes demonstrate higher levels of life satisfaction and hope compared to their international counterparts. Athletes not infected with Coronavirus experience heightened psychological distress compared to their COVID‐19‐infected counterparts. This nuanced exploration underscores the intricate interplay between various factors and their profound implications for the mental well‐being of Iranian athletes in the face of global health challenges and economic constraints. By recognizing the vulnerabilities exposed during the pandemic and sanctions, policymakers can work toward a more resilient and robust sports sector, ensuring that the mental health and psychosocial well‐being of athletes remain at the forefront of policy considerations.

Can sleep hygiene interventions affect strength and power outcomes for female athletes?

AbstractImproved sleep can enhance sprint, endurance, and sports-specific skills; however, it is yet to be investigated whether improved sleep indices could enhance strength and power performance. Sleep hygiene (SH) is growing in popularity as a tool to enhance sleep indices amongst athletic cohorts, yet the optimal delivery strategy of sleep hygiene education is yet to be determined. Using a randomised, controlled design with repeated measures, this study recruited 34 female footballers playing in WSL or WSL academy league. Participants were split into 3 groups: one receiving both group-based and individualised sleep hygiene education, one receiving only group-based SH education and a control group receiving no education. Monitoring of sleep (actigraphy, diaries) and physical performance (countermovement jump, isometric mid-thigh pull) was carried out at week 1, week 4 and week 7. Split-plot ANOVAs were used to assess for differences between groups × weeks, and groups × time. Individualised sleep hygiene education resulted in significantly improved sleep duration (p = 0.005), latency (p = 0.006) and efficiency (p = 0.004) at week 7 compared to controls, whilst also resulting in significantly improved countermovement jump scores (p = 0.001) compared to control. Results of this study suggest that jump performance may be affected by sleep factors, and that individualised SH may be superior to group-based SH, providing information to coaches regarding training optimisation and the efficacy of SH education methods.

Altered neural recruitment despite dual task performance recovery in athletes with repeat concussion.

Sports-related concussions (SRCs) pose significant challenges to college-aged athletes, eliciting both immediate symptoms and subacute cognitive and motor function impairment. While most symptoms and impairments resolve within weeks, athletes with repeat SRCs may experience heightened risk for prolonged recovery trajectories, future musculoskeletal injuries, and long-term neurocognitive deficits. This includes impaired dual task performance and altered neurophysiology that could persist across the lifespan and elicit future pathophysiology and neurodegeneration. Thus, it is imperative to improve our understanding of neurophysiology after SRC. This study aimed to investigate the impact of repeat SRCs on dual task performance and associated neural recruitment using functional near-infrared spectroscopy (fNIRS). A total of 37 college-aged athletes (ages 18-24) participated in this cross-sectional observational study. Among these athletes, 20 had a history of two or more SRCs, while 17 had never sustained a SRC and served as controls. Participants completed the Neuroimaging-Compatible Dual Task Screen (NC-DTS) while fNIRS measured neural recruitment in the frontoparietal attention network and the primary motor and sensory cortices. Behavioral analysis revealed that athletes with repeat SRCs exhibited comparable single task and dual task performance to control athletes. Additionally, dual task effects (DTE), which capture performance declines in dual tasks versus single tasks, did not significantly differ between groups. Notably, the cohort of athletes with repeat SRC in this study had a longer time since their last SRC (mean = 1.75 years) than majority of previous SRC studies. Neuroimaging results indicated altered neural recruitment patterns in athletes with multiple repeat SRCs during both single and dual tasks. Specifically, athletes with repeat SRCs demonstrated increased prefrontal cortex (PFC) activation during single motor tasks compared to controls (P < 0.001, d = 0.47). Conversely, during dual tasks, these same athletes exhibited reduced PFC activation (P < 0.001, d = 0.29) and primary motor cortex (M1) activation (P = 0.038, d = 0.16) compared to their single task activation. These findings emphasize the complex relationship between SRC history, dual task performance, and changes in neurophysiology. While athletes with repeat SRCs demonstrate recovery in behavioral dual task performance, persistent alterations in neural recruitment patterns suggest ongoing neurophysiological changes, possibly indicating compensatory neural strategies and inefficient neural resource allocation, even beyond symptom resolution and medical clearance. Understanding the compensatory neural recruitment strategies that support behavioral performance following repeat SRCs can inform return-to-play decisions, future musculoskeletal injury risk, and the long-term impact of SRCs on neurocognitive function.

Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes.

This study was aimed at identifying the prevalence and experience of urinary incontinence (UI) among elite female Gaelic sports athletes in Ireland. A cross-sectional study comprising an anonymous online survey of elite Gaelic sports (Camogie and Ladies Gaelic Football) players. Players were asked about their background information, knowledge of the pelvic floor and practice of pelvic floor muscle training (PFMT), as well as their experiences of UI. The prevalence and severity of UI was assessed using the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI-SF) questionnaire. Logistic regression was used to evaluate risk factors. A total of 185 players responded (25 ± 5years) and 95.3% (n = 176) were nulliparous. Forty-one percent (n = 75) of players had learned about PFMT and 13% (n = 24) had performed PFMT within the last 4 weeks. The ICIQ-UI-SF was completed by 159 players, with UI reported by 61.6% (n = 98), 52% (n = 51) of whom experienced stress urinary incontinence (SUI). A significant association was found between UI and longer weekly sporting activity time (OR 1.05, 95% CI 1.002 to 1.008). Parous players were more likely to experience UI (p = 0.025). Jumping and sprinting activities were the most commonly reported triggers, with pre-voiding and wearing protection (liners, pads) the most commonly adopted UI management strategies. Only ten players reported receiving treatment for UI. Urinary incontinence is prevalent among this cohort of elite female Gaelic sports athletes. Many players used strategies to manage their UI whereas few sought help for what is a treatable condition. Findings suggest the need for education of players regarding pelvic floor health and treatment options available.

Baseline Symptoms and Neurocognitive Performance Across Collision, Contact, and Non-Contact Female High School Athletes.

Our purpose was to represent a rare cohort of female collision sport athletes and investigate the association between sport type (collision, contact, non-contact), symptoms, and performance on baseline neurocognitive assessments. We conducted a cross-sectional study using baseline computerized neurocognitive scores (ImPACT) of 75,128 female high school student-athletes (age: 15.27 ± 1.05 years) playing multiple sports. The dependent variables were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. The independent variable was sport type, categorized as collision, contact, non-contact, adjusted for the effect of the following co-variables: age, concussion history, and comorbidities (learning disability, ADHD, psychiatric condition, headaches, migraines, speech therapy, special education, and repeating one of more years of school) using multivariable regression models. Female collision sport athletes reported significantly higher symptoms (9.81 ± 12.63) at baseline compared to contact (5.78 ± 9.25) or non-contact (6.39 ± 9.74) sport athletes (p < 0.001). Using non-contact sports as a reference, there was no significant association between collision sport participation and cognitive composite scores (verbal memory: β = -0.57, 95% confidence interval: -1.80, 0.66, p = 0.38; visual memory: β = -0.83, 95% confidence interval: -2.46, 0.79, p = 0.31; visual motor speed: β = -0.21, 95% confidence interval: -1.01, 0.59, p = 0.61; reaction time: β = 0.01, 95% confidence interval: -0.01, 0.02, p = 0.29). Participation in collision sports appears to be associated with baseline symptoms but not neurocognitive functioning among female adolescent athletes.

Sport and longevity: an observational study of international athletes.

The human lifespan is influenced by various factors, with physical activity being a significant contributor. Despite the clear benefit of exercise on health and longevity, the association between different types of sports and lifespan is yet to be considered. Accordingly, we aimed to study this association in a large international cohort of former athletes using a robust linear regression model. We collected data on athletes from public sources, accumulating a total of 95,210 observations, 95.5% of which were accounted for by males. The dataset represented athletes born between 1862 and 2002 from 183 countries across 44 sports disciplines. We calculated the change in lifespan by measuring the difference in age between athletes and the corresponding reference populations, while accounting for variations caused by sex, year of death, and country. The results revealed that various sports impacted lifespan differently, with male athletes being more likely to experience benefits from sports than female athletes. Among male athletes, pole vaulting and gymnastics were linked to the highest extension in lifespan (8.4years, 95% CI [6.8, 9.9] and 8.2years, 95% CI [7.4, 9], respectively), while volleyball and sumo wrestling were the most negatively associated with lifespan (- 5.4years, 95% CI [- 7, - 3.8]; - 9.8years, 95% CI [- 11, - 8.6], respectively). The association between lifespan and popular team sports in males was positive for cricket, rowing, baseball, water polo, Australian rules, hurling, lacrosse, field hockey, minimal for rugby, canoeing and kayaking, basketball, gridiron football, and football (soccer), and negative for handball and volleyball. Racquet sports (i.e., tennis and badminton) exhibited a consistent and positive association in both male and female athletes, as shown by an extended lifespan of up to 5.7years in males (95% CI [5, 6.5]) and 2.8years in females (95% CI [1.8, 3.9]). Although lacking conclusive evidence, we theorize that the observed results may be attributed to the aerobic and anaerobic characteristics of each sport, with mixed sports yielding the maximum benefits for the lifespan. While results from female athletes should be cautiously interpreted, our study highlights the complex interplay between sports and lifespan and contributes to the growing body of knowledge on the multifaceted relationship between physical activity and human longevity.

Career Length After Surgically Treated ACL Plus Collateral Ligament Injury in Elite Athletes

Background: Limited data are available regarding career length and competition level after combined anterior cruciate ligament (ACL) and medial- or lateral-sided surgeries in elite athletes. Purpose: To evaluate career length after surgical treatment of combined ACL plus medial collateral ligament (MCL) and ACL plus posterolateral corner (PLC) injuries in elite athletes and, in a subgroup analysis of male professional soccer players, to compare career length and competition level after combined ACL+MCL or ACL+PLC surgeries with a cohort who underwent isolated ACL reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: A consecutive cohort of elite athletes undergoing combined ACL+MCL and ACL+PLC surgery was analyzed between February 2001 and October 2019. A subgroup of male elite soccer players from this population was compared with a previously identified cohort having had isolated primary ACLR without other ligament surgery. A minimum 2-year follow-up was required. Outcome measures were career length and competition level. Results: A total of 98 elite athletes met the inclusion criteria, comprising 50 ACL+PLC and 48 ACL+MCL surgeries. The mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Return-to-play (RTP) time was significantly longer for ACL+PLC injuries (12.8 months; P = .019) than for ACL+MCL injuries (10.9 months). In the subgroup analysis of soccer players, a significantly lower number of players with combined ACL+PLC surgery were able to RTP (88%; P = .003) compared with 100% for ACL+MCL surgery and 97% for isolated ACLR, as well as requiring an almost 3 months longer RTP timeline (12.9 months; P = .002) when compared with the isolated ACL (10.2 months) and combined ACL+MCL (10.0 months) groups. However, career length and competition level were not significantly different between groups. Conclusion: Among elite athletes, the mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Professional soccer players with combined ACL+PLC surgery returned at a lower rate and required a longer RTP time when compared with the players with isolated ACL or combined ACL+MCL injuries. However, those who did RTP had the same career longevity and competition level.

Associations of Sex and Sport Contact-Level with Recovery Timelines Among Collegiate Athletes with Sport-Related Concussion

BackgroundGrowing interest has motivated recent studies to examine differences in recovery after sport-related concussion (SRC) by sex. However, heterogeneity in study design, participants, and recovery outcomes has led to mixed findings. Further work is needed to evaluate potential differences by sex and to investigate the role of related characteristics, such as sport contact-level, in recovery timelines. This study aimed to investigate whether concussion recovery trajectories differ by sex, considering a priori clinical and demographic covariates, and accounting for the sequence of recovery outcomes. Our secondary question was whether sport contact-level modifies the relationship between sex and time to outcomes. Using data from the Ivy League–Big Ten Epidemiology of Concussion Study, we included SRCs reported across five academic years; 2015–2020 (February 2020). We used Cox proportional hazards regressions to estimate associations between sex and time from injury to three outcomes: (1) symptom resolution, (2) return to academics, (3) return to full play, accounting for measured confounders.ResultsAmong 1160 SRCs (male, n = 667; female, n = 493) with complete data, median age overall was 20 years (25th-75th percentiles:19–21), and most occurred among athletes playing high-contact sports (78.0%). Males were slightly more likely to complete symptom resolution over time compared to females (HR = 1.18, 95%CI = 1.05–1.33), but results were attenuated in fully adjusted models (HR 1.13, 95%CI = 0.99–1.29). Similarly, the HR of full academic return for males compared to females was 1.22 (95%CI = 1.07–1.38), but was attenuated in fully adjusted models (HR = 1.11, 95%CI = 0.97–1.28). The HR of full return to play for males compared to females was 1.14 (95%CI = 1.02–1.28), and was attenuated after adjustment (HR = 1.06, 95%CI = 0.93–1.20) as well. The interaction between sex and playing a high/low-contact sport was not statistically significant across models, though differences were apparent.ConclusionsAmong a cohort of collegiate athletes with SRC, recovery timelines appeared similar between male and female athletes, adjusting for measured confounders. Differences by sex, considering sport contact-level, were evident and may be important clinically and in future studies. This study used robust methods, accounting for nesting in the sequence of RTP outcomes. Results inform concussion management protocols and planned qualitative work to further elucidate how collegiate athletes experience concussion recovery.Key PointsHeterogeneity in study design, participants, and recovery outcomes has led to mixed findings in determining differences in recovery trajectories after concussion by sex.We found that having longer time to symptom resolution, and also the sequence of having academic return before symptoms resolve and longer time to academic return were confounders in the relationship between sex and RTP timelines. Time to sequential recovery outcomes appeared similar between male and female athletes, adjusting for observable confounders. Further differences by sex were evident when considering contact-level, and may be important to consider clinically and in future research.Results indicate that differences in concussion recovery trajectories by sex may be largely attributed to and driven by differences in sports with a men’s or women’s team only, such as football, and this should be explored further.

Determining factors of sports dropout of young scholars: a cross-sectional analysis in the 8-13 year age group.

This article investigates the phenomenon of sports abandonment among young scholars aged between 8 and 13 years. Regardless of the growing awareness of the importance of sport and physical activity during childhood and adolescence, this theme must be adequately explored in the scientific literature. Our study addresses this gap through a cross-sectional research design, tracking and analyzing data from a cohort of young athletes over one year. The main objective of our study is to identify the determinants leading to sports dropout in this specific age group. We looked at several possible causes through a multivariate analysis, including social pressures, parental expectations, time conflicts, physical and psychological stress, and lack of enjoyment. The results show a significant attrition rate, with psychosocial factors emerging as the most influential in determining whether a young person will continue or stop their participation in sport. Furthermore, our study highlights the importance of targeted interventions and preventive strategies that promote a positive, inclusive, and balanced sports environment for adolescents. These interventions can be particularly effective when implemented by coaches, parents and others involved in youth sports education. Finally, this paper discusses the implications of the findings for sports professionals, physical educators, and public policy makers. It highlights the need for more effective support policies and innovative pedagogical approaches to promote sporting persistence during adolescence. Our findings can serve as a starting point for further research in this field, helping to build a future where young people can enjoy the many benefits of sport and physical activity.