Interventions For Athletes Research Articles

Effects of a Mental Health Intervention in Athletes: Applying Self-Determination Theory.

Introduction: Many sport associations have responded to mental health issues in sport through the inclusion of self-management programs, such as mindfulness training, which may improve well-being through increasing one’s competence in self-regulating stressors. Yet, the mechanisms accounting such changes lack a theoretical basis, particularly in athletes.Aim: To determine the effect of a mental health intervention comprising a mindfulness program for promoting well-being, reducing stress, and increasing competence in mental health self-management. This is the first study among athletes to test the mechanisms of change in a mindfulness program using Self-Determination Theory (SDT).Methods: A 2 (groups) × 2 (time-point) non-randomized controlled trial was conducted, and between-groups baseline differences were firstly assessed. Two competing regression models assessing singular and serial indirect mediating mechanisms were conducted, in which mindfulness (Model 1) and competence satisfaction (Model 2) were both tested as primary and secondary mediators predicting change scores in stress and well-being. Demographic variables (i.e., gender, age) were controlled for in the analyses.Results: Two hundred and thirty-eight student athletes (mean age = 20.47 years, SD = 3.30, 57.6% = males) participated, with 108 in the intervention group who received an instructional workshop, and a home-directed mindfulness program comprising daily meditation sessions. No baseline differences were found between intervention and control groups. In Model 1, mindfulness was not directly enhanced by the intervention, subsequently resulting in no indirect effects on competence, stress and well-being. In Model 2, the intervention was directly related to positive changes in competence (β = 0.39, p < 0.05), subsequently resulting in indirect effects on mindfulness awareness (β = 0.07, p < 0.05), stress (β = −0.06, p < 0.05), and well-being (β = 0.05, p < 0.05). In addition, serial indirect effects for the intervention on stress were present through competence and mindfulness awareness in sequence (β = −0.02, p < 0.05), and; on well-being through competence, mindfulness awareness, and stress in sequence (β = 0.01, p < 0.05; R2 = 0.54).Conclusion: Mindfulness-based mental health interventions may be effective at reducing stress and promoting well-being in athletes, with the caveat that attention is given to the inclusion of mental health competence promotion in program design. However, it remains unclear whether increasing mindfulness itself can exert additional salutary effects. Our findings have an important bearing on how mindfulness programs are developed within athlete mental health interventions.

Role of Musculoskeletal Radiology in Modern Sports Medicine.

Musculoskeletal radiology's role in the recent and continued evolution of sports medicine is an exciting and expanding one. In this article we explore a variety of the ways that musculoskeletal radiology contributes to current practices in modern sports medicine, discussing advances across a variety of imaging modalities in the care of both elite athletes and so-called weekend warriors. We describe the technical and ethical factors pertaining to image-guided therapeutic intervention in athletes and speculate on the potential for future developments in the role of imaging in deciding when an athlete may return to participation. We also explore the recent shift to the delivery of imaging facilities at sporting events and in stadiums.

Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses.

Ankle bracing has been verified as being effective for secondary prevention of ankle injuries. However, new studies have recently been published that are not included in previous meta-analyses. Furthermore, the effects of bracing for primary prevention of ankle injuries are still unclear. The objective of this article was to systematically review the literature about the effectiveness of ankle bracing on primary and secondary prevention of acute ankle injuries in athletes. We searched PubMed, EMBASE, SPORTDiscus, CINAHL, and PEDro databases for eligible articles until July 2018. Randomized controlled trials that studied ankle bracing vs. no intervention for athletes were included. Risk of bias was assessed with the Cochrane Risk of Bias tool. Meta-analyses were conducted to study the effect of ankle bracing for primary and secondary prevention of ankle injuries. The Grading of Recommendation Assessment, Development, and Evaluation method was used to determine the quality of evidence. We included six randomized controlled trials. Significant risk ratios of 0.53 (95% confidence interval 0.32-0.88) and 0.37 (95% confidence interval 0.24-0.58) were found in favor of ankle bracing vs. no ankle bracing for primary (low quality of evidence, I2 = 77%) and secondary prevention (moderate quality of evidence, I2 = 0%) of acute ankle injuries. Numbers needed to treat were 26 and 12 for the primary and secondary prevention of acute ankle injuries. Ankle bracing is effective for primary and secondary prevention of acute ankle injuries among athletes. However, conclusions in regard to primary prevention should be drawn cautiously because of the low quality of evidence and significant heterogeneity.

THE EFFECT of ONE-ON-ONE INTERVENTION in ATHLETES with MULTIPLE RISK FACTORS for INJURY.

Lower extremity injuries in soccer players are extremely common. Implementation of group injury prevention programs has gained popularity due to time and cost-effectiveness. Unfortunately, players with greater number of risk factors are most likely to sustain an injury, yet less likely to benefit from a group injury prevention program. The purpose of this study was to determine if targeting these high risk players with one-on-one treatment would result in a reduction in the number of risk factors they possess. The authors hypothesized that fifty percent or more of subjects receiving one-on-one intervention would have a reduction of ≥1 risk factor(s). Quasi-experimental pretest-posttest design. Division I men's and women's soccer players were screened for modifiable risk factors using a battery of tests which assessed mobility, fundamental movement pattern performance, motor control, and pain. Players with ≥ 3 risk factors ("high risk") received one-on-one treatment from a physical therapist via an algorithm twice per week for four weeks. Players with < 3 risk factors ("low risk") did not receive one-on-one intervention. The proportion of treatment successes in the intervention group was 0.923 (95% CI 0.640-0.998). A significant proportion of high risk subjects (0.846) became low risk at posttest (p = 0.003). A significant between group difference was noted in risk factor change from pretest to posttest (p = 0.002), with the median risk factor change in the intervention group being -3. Utilizing one-on-one interventions designed to target evidence-based risk factors is an effective strategy to eliminate LE musculoskeletal injury risk factors in high risk individuals. 2b.

Multiple-Transportable Carbohydrate Effect on Long-Distance Triathlon Performance.

This study aimed to determine the effect of multiple-transportable carbohydrate on triathlon competition performance when ingested within bars, gels, and drinks. A double-blind randomized controlled trial was conducted within two national-body sanctioned half-ironman triathlon races held 3 wk apart in 74 well-trained male triathletes (18-60 yr; >2 yr competition experience). Carbohydrate comprising glucose/maltodextrin-fructose (2:1 ratio) or standard isocaloric carbohydrate (glucose/maltodextrin only) was ingested before (94 g) and during the cycle (2.5 g·km) and run (7.8 g·km) sections, averaging 78.6 ± 6.6 g·h, partitioned to bars (25%), gels (35%), and drink (40%). Postrace, 0- to 10-unit Likert-type scales were completed to assess gut comfort and energy. The trial returned low dropout rate (9%), high compliance, and sensitivity (typical error 2.2%). The effect of multiple-transportable carbohydrate on performance time was -0.53% (95% confidence interval = -1.30% to 0.24%; small benefit threshold = -0.54%), with likelihood-based risk analysis supporting adoption (benefit-harm ratio = 48.9%:0.3%; odds ratio = 285:1). Covariate adjustments for preexercise body weight and heat stress had negligible impact performance. Multiple-transportable carbohydrate possibly lowered nausea during the swim and bike; otherwise, effects on gut comfort and perceived energy were negligible. Multiple-transportable (2:1 maltodextrin/glucose-fructose) compared with single-transportable carbohydrate ingested in differing format provided a small benefit to long-distance triathlon performance, inferred as adoption worthy. Large sample in-competition randomized trials offer ecological validity, high participant throughput, compliance, and sensitivity for evaluation of health and performance interventions in athletes.

Multiple-transportable Carbohydrate Has Minimal Impact On Long-distance Triathlon Race Performance

PURPOSE: In the laboratory, the ingestion of multiple-transportable carbohydrates (fructose, glucose) in beverages at high rates (>1.3 g·min-1) enhances exogenous carbohydrate oxidation, fluid absorption, gut comfort, and performance, relative to single carbohydrate equivalents. In competition, however, endurance athletes prefer to ingest carbohydrate in a solid-gel-drink format but whether multiple-transportable carbohydrates in the mixed format also enhance competition performance is unknown. The objective of the study was to determine the effect of multiple- vs. single-transportable carbohydrate on triathlon race performance when ingested in the common format of bars, gels and drinks. METHODS: A double-blind randomized controlled trial was conducted within two sanctioned half-ironman triathlon races held 3 weeks apart in 74 well-trained male triathletes (18-60 y; >2 y competition experience). Carbohydrate was ingested before (94 g) an during the race from bars (25%), gels (35%) and drink (40%) comprising a 2:1 glucose/maltodextrin:fructose ratio vs isocaloric placebo glucose/maltodextrin only. Ingestion was apportioned by unit-distance covered during the cycle (2.5 g·km-1) and run (7.8 g·km-1) averaging 78.6 g·h-1 (SD 6.6). Post-race 0-10 unit Likert-type scales were completed to assess gut comfort and energy. RESULTS: The trial returned low dropout rate (9%), high compliance and sensitivity (typical error 2.2%), but the effect of the multiple-transportable carbohydrate on overall performance time (-0.6%, 95%CI -1.8%, 0.7%), swim, bike, and run times, and on nausea, gut comfort and perceived energy was of trivial-small magnitude without statistical significance. Within-subject covariate adjustment for pre-exercise body weight, heat stress, and within-race change in body weight had negligible impact on outcomes. CONCLUSION: Multiple-transportable carbohydrate ingested in the common bar-gel-drink format provided negligible benefit to long-distance triathlon performance. The experience of the large sample intervention study showed that in-competition clinical trials offer ecological validity, and high throughput rate, compliance, and sensitivity for evaluation of health and performance interventions in athletes. Funding: Nestec Ltd, Switzerland.

Twelve-weeks Oral Spray Vitamin D3 Supplementation Does Not Alter Bone Turnover Markers In Collegiate Gaelic Footballers

Vitamin D deficiency is associated with increased bone remodelling activity. Quantification of reference-standard bone turnover markers total procollagen type 1 N-terminal propeptide (P1NP) (bone formation) and beta C-terminal telopeptide of type I collagen (β-CTx) (bone resorption) therefore enable detection of subtle perturbations in bone remodelling that may result from vitamin D inadequacy and indicate an increased risk of stress fracture in athletes. PURPOSE: To investigate the effect of wintertime vitamin D3 supplementation using an oral spray on bone turnover markers in Irish athletes compared to placebo. METHODS: Stored samples from a randomised, double-blind, placebo-controlled trial conducted in Gaelic footballers (3000IU (75μg) vitamin D3 daily versus placebo for 12-weeks, n=42) were analysed for P1NP and β-CTx. Dietary vitamin D and calcium intake as well as total 25-hydroxyvitamin D (25OHD) data were available from the previous study. RESULTS: Overall, 72% of athletes presented with a 25(OH)D concentration <50nmol/L, and 5 exhibited vitamin D deficiency (<30nmol/L) at baseline. Dietary vitamin D and calcium intakes averaged 5.9±4.3μg/day and 1037±651mg/day respectively. Daily supplementation with 3000IU (75μg) vitamin D3 significantly increased mean ± SD 25(OH)D compared to no significant change in the placebo group (vitamin D; 47.37±13.29 to 83.68±32.98nmol/L (+79%) vs. placebo; 43.10±22.00 to 49.22±25.40 (+14%) P=0.006). However, ANCOVA revealed no significant difference in mean ± SD change from baseline for P1NP (-8.72±18.83 vs. -5.04±21.13μg/L, P=0.413) or β-CTx concentrations (-0.09±0.18 vs. -0.10±0.21μg/L, P =0.627) when compared to placebo. CONCLUSION: In this study, 12-weeks vitamin D3 supplementation using an oral spray solution did not influence bone turnover when compared to placebo, despite increasing mean 25(OH)D concentration by 79%. Vitamin D inadequacy (<50nmol/L) is apparent in collegiate Gaelic footballers however future interventions, aiming to test change over time in bone turnover as a primary outcome, should consider a longer intervention in athletes with vitamin D deficiency (<30nmol/L).

Assessment and management of adductor strain

Although athletic injuries about the hip and groin occur less commonly than injuries in the extremities, adductor muscle strain is one of these most common injuries in athletes who are involved in sports requiring sudden change of direction. High forces occur in the adductor tendons when the athlete must shift direction suddenly in the opposite direction. As a result, the adductor muscles contract to generate opposing forces. An adductor strain that is treated improperly can become chronic and career threatening. Despite the identification of risk factors and strengthening intervention for athletes, adductor strains continue to occur throughout sport. The prevention and management of groin injury remains a substantial issue. The purpose of this article is to let the readers know regarding the conservative treatment options for adductor strain and provide recommendations for sports medicine clinicians for improved treatment and patient outcomes.

Effectiveness of a Mindfulness-Based Intervention for Athletes

Recently, several top athletes, as well as coaches, have revealed that mindfulness can be regarded as a type of psychological training to optimize performance. Indeed, results of studies in clinical psychology, as well as neuroscience, suggest that mindfulness might be an effective strategy to promote concentration, emotion regulation and state of flow. However, the empirical evidence in the context of sport is rather sparse. The aim of this study was to examine the effectiveness of a mindfulness-based intervention in athletes. In a randomized controlled trial with 22 participants in the experimental and 24 participants in the control group, the effectiveness of the Berlin Mindfulness-based Training for Athletes (BATL) was tested and compared to a classical sport psychological intervention. The results of an analysis of covariance with repeated measures indicate that the intervention group significantly improved mindfulness as a trait compared to the control group. It can be concluded that BATL is an effective strategy to increase mindfulness in athletes. However, further studies are needed to evaluate the effectiveness of this intervention in improving performance and to be able to examine its effect mechanisms.

The yips in sport: A systematic review

ABSTRACTThe yips are a psycho-neuromuscular movement disorder, which affects sports in which fine motor precision skills are required for success. This review aims to examine key components of the yips within sport literature using a systematic approach. Twenty-five published studies were used in the systematic review, the majority of which focused on the yips in golf (n = 18); case studies were the most popular methodological approach (n = 12). Four components of the yips were identified: psychological, physiological, neurological and performance. This review describes evidence associated with each component according to research design, sample characteristics and main findings. Key findings associated with each component are evaluated and gaps within the existent literature are highlighted. It is concluded that future research incorporates a multi-discipline theory-driven approach on a wider range of sports using a more precise definition of yips types in order to enhance our understanding of the predictors and mechanisms of the yips which, in turn, will allow practitioners to develop effective interventions for athletes.

Negative Psychological Experiences and Saliva Secretory Immunoglobulin A in Field Hockey Players

Understanding psychological factors that affect immunity in sport might help to reduce infection risk in athletes. The present study examined within-person changes and individual differences in perceived coach control, intentions to drop out, and saliva secretory immunoglobulin A (SIgA). Thirty-two field hockey players completed questionnaires and provided saliva samples over a 2-month period. Within-person increases in individuals’ perceptions of psychological control and intentions to drop out were positively associated with SIgA concentration. Individual differences in control or drop-out intentions were not associated with SIgA. Interventions in athletes to prevent immune disturbances and reduce infection should consider these psychological factors.

A REVIEW OF THE ROLE OF PROBIOTICS IN SPORT

Probiotics are defined as living microorganisms which when administered in adequate amounts confer a health benefit on the host. Health benefits can be attributed to an ability to assist the...

Protective Behavioral Strategies and Their Relationship With Negative Alcohol Consequences Among College Athletes

Heavy episodic drinking (HED) is related to an increase in negative consequences (Wechsler, Lee, Kuo, &amp; Lee, 2000) including approximately 599,000 unintentional injuries and 1,825 deaths annually among college students (Hingson, Edwards, Heeren, &amp; Rosenbloom, 2009). College athletes participate in greater alcohol consumption and experience more negative consequences than their nonathlete peers (Hildebrand, Johnson, &amp; Bogle, 2001). Protective behavioral strategies (PBS) have played a significant role in reducing alcohol-related negative consequences within the college population (Martens et al., 2004). However, little is known about PBS use within specific at-risk populations such as athletes. This study aimed to identify the relationship between alcohol consumption, the use of protective behavioral strategies, and negative consequences among intercollegiate athletes. Results indicated that PBS partially mediated the relationship between alcohol consumption and negative consequences. Implications for intercollegiate athlete intervention and prevention programs are discussed as well as limitations of the study and directions for future research.

A meta-analytic approach to quantify the dose–response relationship between melatonin and core temperature

A melatonin-mediated reduction in body temperature could be useful as a "pre-cooling" intervention for athletes, as long as the melatonin dose is optimised so that substantial soporific effects are not induced. However, the melatonin-temperature dose-response relationship is unclear in humans. Individual studies have involved small samples of different sexes and temperature measurement sites. Therefore, we meta-analysed the effects of exogenous melatonin on body core temperature to quantify the dose-response relationship and to explore the influence of moderating variables such as sex and measurement site. Following a literature search, we meta-analysed 30 data-sets involving 193 participants and 405 ingestions of melatonin. The outcome was the mean difference (95 % confidence limits) in core temperature between the melatonin and placebo-controlled conditions in each study, weighted by the reciprocal of each standard error of the difference. The mean (95 % confidence interval) pooled reduction in core temperature was found to be 0.21 °C (0.18-0.24 °C). The dose-response relationship was found to be logarithmic (P < 0.0001). Doses of 0-5 mg reduced temperature by ~0.00-0.22 °C. Any further reductions in temperature were negligible with doses >5 mg. The pooled mean reduction was 0.13 °C (0.05-0.20 °C) for oral temperature vs 0.26 °C (0.20-0.32 °C) for tympanic and 0.22 °C (0.19-0.25 °C) for rectal temperature. In conclusion, our meta-regression revealed a logarithmic dose-response relationship between melatonin and its temperature lowering effects. A 5-mg dose of melatonin lowered core temperature by ~0.2 °C. Higher doses do not substantially increase this hypothermic effect and may induce greater soporific effects.

A Literature Review on the Role of Totally Extraperitoneal Repairs for Groin Pain in Athletes

A literature review was made on the role of totally extraperitoneal (TEP) hernia repairs for groin pain in athletes. Electronic databases were searched for literature published from January 1993 to November 2011. There were 10 articles incorporating 196 patients included in this review. Thirty percent of patients were reported to have direct inguinal hernias, 22% had indirect inguinal hernias, and 41% had dilated internal rings. Of note, 30% of cases had no macroscopic abnormality. Four studies reported on an early follow-up ranging between 3 and 6 weeks. Only minimal or mild symptoms were reported. Up to 33% of patients had impaired ability to perform at peak levels. Up to 53% of patients had persistence of symptoms at the early follow-up. Total follow-up time ranged from 3 to 80 months, and most patients were active (90%-100%). At long-term follow-up, 3% to 10% were unable to play, and 5% were reported as being unable to train. Two studies from the same center reported on TEP surgery for osteitis pubis, and most patients returned to sporting activity after 4 to 8 weeks. TEP repair is a good operative intervention in athletes with chronic groin pain not relieved by conservative measures. Athletes recover quickly and return to sport early.

Is Substance Use a Team Sport? Attraction to Team, Perceived Norms, and Alcohol and Marijuana Use Among Male and Female Intercollegiate Athletes

This research examined the role of attraction to one's team in predicting alcohol and marijuana use among intercollegiate athletes. Attraction to team and alcohol-related information were collected via an online survey and marijuana use-related information was gathered in a live setting. We investigated the influence of attraction to one's team above and beyond the influence of gender and perceived norms, and attraction to team as a moderator of these relationships. Attraction to one's team accounted for significant variance in marijuana use, and alcohol-related consequences after controlling for alcohol consumption. Regression analyses revealed significant interactions between gender, attraction to team, and norms in predicting alcohol and marijuana use. Stronger attraction to one's team may increase alcohol use but decrease marijuana use among male athletes, suggesting the importance of attraction to team when developing interventions for athletes.

Effect of Fish Oil-Derived Omega-3 Polyunsaturated Fatty Acid Supplementation on Exercise-Induced Bronchoconstriction and Immune Function in Athletes

Exercise-induced bronchoconstriction (EIB) is a condition in which vigorous physical activity triggers acute airway obstruction in asthmatic and nonasthmatic individuals with hyperresponsive airways. Studies have shown that inflammatory mediators and contraction of airway smooth muscle are central components in the pathogenesis of EIB, and it has long been recognized that leukotrienes and prostaglandins play an important role in the EIB response. Clinical responses to current therapy, such as leukotriene modifiers and corticosteroids are heterogeneous, and even with optimal treatment there is a substantial burden of unaddressed disease. While daily medications such as leukotriene modifiers provide only modest protection against symptoms, prolonged use of several medications can result in reduced effectiveness or tachyphylaxis. Although the treatment of EIB almost exclusively involves pharmacotherapy, there is now convincing evidence that dietary modification has the potential to reduce the severity of this condition. Omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fish oils, compete with arachidonic acid as substrates for the formation of proinflammatory mediators, such as leukotrienes, prostaglandins, and cytokines. Studies have shown that 3 weeks of fish oil supplementation, rich in EPA and DHA, reduces exercise-induced airway narrowing, airway inflammation, and bronchodilator use in elite athletes and asthmatic individuals with EIB. Based on the evidence to date, fish oil supplementation may represent a potentially beneficial treatment intervention for athletes and asthmatic individuals with EIB. From this, it follows that physicians should pay more attention to what their asthma/EIB patients eat, and incorporate dietary assessment and nutritional counseling in their everyday practice.

School health interventions for adolescents at nutritional risk: A survey of health teachers, nurses, and coaches

To determine the status of school-based health and nutrition interventions for adolescents who are pregnant, overweight, or athletes and to solicit opinions relative to interventions, we mailed questionnaires to coaches, nurses, and health teachers in a randomly selected sample of secondary schools in Pennsylvania. We received over 1100 responses from 179 schools. Less than 25% of the schools had interventions for overweight or pregnant teens and less than 45% had interventions for athletes. Descriptions of interventions showed that coaches, nurses, and health teachers were likely to be involved with particular adolescent groups. Of existing interventions, 30% to 60% were not externally funded. Over 85% of the respondents felt that schools should have interventions, and over 40% of the respondents were interested in being involved. Perceived obstacles included lack of time, funding, administrative support, and qualified personnel. These results indicate that school personnel are interested and see the need for health interventions for specific adolescent groups, but provision of such programs by schools has been limited. Cooperation among administrators, health personnel, parents, and the community is needed. For nutrition educators, there are opportunities to become involved with high-risk adolescents in school nutrition and health interventions either by direct contact with the adolescents or through training and support of school personnel.