National Collegiate Athletic Association Institutions Research Articles

Female Orthopaedic Surgeons Are Less Represented as Head Team Physicians in Collegiate Athletic Programs

PurposeThe purpose of this study was to evaluate National Collegiate Athletic Association (NCAA) head team physicians (HTP), focusing on gender as it relates to divisional variability, medical specialty, and research productivity. MethodsIn December 2022, the NCAA member directory was utilized to obtain HTP information from the top 5 conferences within Divisions I, II, and III (DI, DII, DIII, respectively). Division I schools were selected from the previously established “Power 5” conferences. Divisions II and III used NCAA rankings. HTP data was collected from publicly available verifiable data sources. Data for gender, Scopus H-index, residency programs, and fellowship programs were collected. Mean, median, skewness, p-values, and odds ratio were calculated for analysis. ResultsOne hundred and eighty six NCAA institutions were evaluated: 69 DI (37%), 65 DII (35%), and 52 DIII (28%). DIII had the highest female representation (8; 16%). Out of the 67 orthopaedic surgery HTPs, 5 (7.5%) were female and 62 male (92.5%). There is a statistically significant difference in female orthopedic surgeon representation in the HTP field compared to males (p-value = 0.038, alpha = 0.05). Female orthopaedic surgeons have 38% lower odds of being represented as HTPs compared to males (p-value = 0.046, alpha = 0.05). Female HTPs in Divisions I and III had higher H-indexes than the overall average and median values for their respective divisons. ConclusionFemale HTPs are significantly less represented compared to males in the NCAA. Furthermore, female orthopaedic surgeons were found to have lower odds of being represented as HTPs compared to their male counterparts. For research productivity, female HTPs impacted the distribution as outliers in Divisions I and III.

Characterization of Health and Safety Resources for Athletes With Sickle Cell Trait at NCAA Institutions.

Yeargin, SW, Meyer, CM, Hirschhorn, RM, Lane, AD, Arent, SM, and Haggard, CR. Characterization of health and safety resources for athletes with sickle cell trait at NCAA institutions. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this study was to report the prevalence of student-athletes with sickle cell trait (SCT), determine which screening practices are most commonly used, describe the health and human performance services provided to athletes, and ascertain if differences between National Collegiate Athletic Association (NCAA) designations or divisions exist. A cross-sectional survey design was used to query healthcare administrators regarding SCT resources at their institution. The independent variables were designation (historically Black colleges or universities [HBCUs] or non-HBCU) and Division (DI, DII, and DIII). The dependent variables were SCT prevalence, and the health and human performance services provided to athletes. Of the 60 respondents, HBCU ( n = 16) reported 4.9 ± 2.7% of athletes with SCT, which was higher than non-HBCU (1.1 ± 0.8%; p = 0.022). Historically Black colleges or university reported a higher percentage of student-athletes supplying their own screening results than non-HBCU (52.5 ± 39.2 vs. 12.9 ± 24.0%; p = 0.022). Division III reported higher proportions of waivers than DI (68.3 ± 38.4 vs. 16.9 ± 31.0%; p = 0.010). Most schools ( n = 42, 70.0%) reported having policy and procedures regarding exertional sickling, but none ( n = 60, 100.0%) involved strength and conditioning coaches (SCCs) during development. Practically, a greater proportion of DII and DIII institutions do not have supplemental oxygen available compared with DI but not statistically ( p = 0.058). Pragmatically, the prevalence should be considered when ordering and preparing resources annually. NCAA institutions need to create policy and procedure sections beyond screening. Athletic trainers and SCCs need to have a strong collaborative relationship to optimize health and human performance services.

Racial and Ethnic Diversity of Athletic Trainers in National Collegiate Athletic Association Institutions, 2008-2018: A Retrospective Study.

Athletic trainers (ATs) are the most visible members of the sports medicine team and are responsible for the health and well-being of student-athletes. However, the representation of Black, Indigenous, and people of color (BIPOC) ATs in National Collegiate Athletic Association (NCAA) member institutions has not been studied. To quantify the representation of BIPOC ATs in National Collegiate Athletic Association (NCAA) member institutions. Cross-sectional study. National Collegiate Athletic Association's Demographic Database. Team athletic personnel at NCAA member institutions. Chi-square tests were used to assess differences in racial and ethnic frequencies across division, calendar year, and gender. Linear regression models were calculated to examine changes in racial and ethnic distributions of head and assistant ATs over time. Most NCAA ATs were categorized as White (88%), which was reflected in both head (90.8%) and assistant (87.2%) AT positions. Black ATs made up the largest proportion of a specific racial or ethnicity group within BIPOC ATs (3.4% of head ATs, 4.6% of assistant ATs), with the next most prevalent being Hispanic (2.8% of head ATs, 3.9% of assistant ATs). Historically Black Colleges and Universities showed higher proportions of BIPOC ATs in both the head and assistant categories than non-historically Black institutions. Division I schools had the greatest AT racial or ethnicity diversity in comparison with Divisions II and III (P < .0001). In our linear regression models, we found increases in many of the racial or ethnic categories for both head and assistant ATs. We demonstrated that BIPOC ATs represented a small proportion of the ATs currently working at NCAA member institutions. Although BIPOC ATs have increased over the past 10 years, a large racial and ethnic discordance gap still exists between student-athletes and the ATs caring for them.

Depression, anxiety and stress among female student-athletes: a systematic review and meta-analysis

ObjectiveTo identify, quantify and analyse determinants of depression, anxiety and stress symptoms among female student-athletes.DesignSystematic review and meta-analysis.Data sourcesFive online databases (PubMed, CINAHL, PsychInfo, SportDiscus and Web of Science) searched...

College Student-athletes' COVID-19 Worry and Psychological Distress Differed by Gender, Race, and Exposure to COVID-19–related Events

PurposeThe purpose of this study was to determine the prevalence of National Collegiate Athletic Association (NCAA) student-athletes’ exposure to COVID-19–related events (e.g., canceled season, diagnosed with COVID) and their psychological distress in April/May 2020. MethodsThe link to the online survey was emailed to NCAA student-athletes by the NCAA Student Athlete Advisory Council and the athletic departments of 80 NCAA institutions. In April–May of 2020, student-athletes (N = 5915; women = 3924) completed the online survey once. The survey included measures of their psychological distress, COVID-19 worry, and their exposure to different COVID-19–related events. To examine differences in exposure to COVID-related events by racial, ethnicity, and gender identities, we conducted logistic regressions. A path analysis examined relationships between COVID-related events, COVID-19 worry, and psychological distress for men and women. ResultsStudent-athletes’ exposure to COVID-19 events differed significantly by gender, race, and ethnicity. In addition, 58.7% of women's and 54.5% of men's psychological distress variance was explained by the path model and mostly by their COVID-related worry. Student-athletes’ stress was directly related to the changes that occurred in class delivery (i.e., online format) and indirectly by being quarantined. Men's psychological distress was also related through worry by their sport season being canceled. DiscussionThe general uncertainty and worry about COVID individuals experienced at the beginning of this pandemic primarily explained the athletes' high levels of psychological distress. As COVID-19 continues to cause quarantines and changes educational experiences, the worry and psychological distress of college students are likely to continue.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Tennis: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association (NCAA) has sponsored men's tennis programs since 1982. The popularity of tennis has grown, as has sponsorship of men's tennis within NCAA institutions. Continued monitoring of athletic injuries is important for identifying emerging temporal patterns. Exposure and injury data collected in the NCAA Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 4.41 per 1000 athlete-exposures. Lateral ligament complex tears of the ankle (8.5%) were the most reported injury. Trunk (15.1%) and shoulder (13.2%) injuries accounted for the largest proportions of all injuries. Noncontact and overuse were the most common mechanisms of injury among all reported injuries, together accounting for 69.4% of all injuries. Findings of this study differed slightly from previous studies, most notably in specific injuries reported. Continued monitoring of specific injury incidence as well as greater participation in injury surveillance is needed to inform the development of nuanced injury prevention strategies for this population.

Stress and Burnout Experienced by Intercollegiate Swimming Head Coaches

The purpose of the present study was to investigate stress and burnout among intercollegiate head swimming coaches in the National Collegiate Athletic Association (NCAA). Participants were 223 coaches working at NCAA institutions who completed the Coaching Issues Survey, which measures potential stressors experienced by coaches using four subscales of Win-Loss, Time-Role, Program-Success, and Athlete-Concerns. Time-Role was the most significant stressor and Win-Loss the lowest. Females reported significantly higher stress levels than their male counterparts, t(197) = −2.87, p = .01, on all subscales. Overall, levels of stress were not significant by NCAA divisions I, II, and III F(2,201) = 1.25, p = .29, suggesting that coaches across all levels experience stress. Findings highlight the importance of monitoring work–life balance across all collegiate athletic divisions and the need to understand why females report higher levels of stress and how this can be improved. Future research should consider how burnout can be avoided through coaching education and training interventions that might aid coaches who perceive their work environment as stressful.

Preparedness, Confidence, and Best Practices in Preventing, Recognizing, Managing Mental Health Cases in NCAA Institutions.

Currently, the National Collegiate Athletic Association (NCAA) recommends written policies and procedures that outline steps to support student athletes facing a mental health challenge and the referral processes for emergency and non-emergency mental health situations. To assess the mental health policies and procedures implemented and athletic trainers' perceived confidence in preventing, recognizing and managing routine and crisis mental health cases across all three divisions of NCAA athletics. Cross-sectional survey design and chart review. Online survey Participants: Athletic trainers with clinical responsibility at NCAA member institutions (n=1091, 21.5% response rate). Confidence in screening, preventative patient education, recognizing and referring routine and emergency mental health conditions (5-point Likert scale: 1= not at all confident, 2= hardly confident, 3= somewhat confident, 4= fairly confident, 5=very confident) using a content-validated survey (Cronbach's α=0.904) and mental health policy and procedure chart review. Respondents indicated they felt "fairly confident" with screening (40.21%, n=76/189) for risk of any mental health condition and "fairly confident" in implementing preventative patient education (42.11%, n=80/190). Respondents were "fairly confident" they could recognize (48.95%, n=93/190) and refer (45.79%, n=87/190) routine mental health conditions. Respondents were "fairly confident" they could recognize (46.84%, n=89/190), but "very confident" (46.32%, n=88/190) they could refer mental health emergencies. Policies lacked separate procedures for specific emergency mental health situations such as suicidal/homicidal ideation (36.1%), sexual assault (33.3%), substance abuse (19.4%), and confusional state (13.9%). Policies lacked prevention measures such as student athlete involvement (16.7%) in annual mental health education (16.7%). While athletic trainers were generally confident in their ability to address emergency and routine mental health conditions, opportunities exist to improve policies for prevention, screening, and referral. Best practice guidelines should be used as a guide to develop policies that foster an environment of mental health wellness.

Epidemiological profile of pain and non-steroid anti-inflammatory drug use in collegiate athletes in the United States

BackgroundAlthough athletic endeavours are associated with a high amount of physical stress and injury, the prevalence of pain is underreported in the sports medicine literature with only a few studies reporting pain on collegiate athletes or exploring sex difference of pain. Impact of pain on athlete availability, training and performance can be mitigated when key epidemiological information is used to inform adequate pain management strategies. This study aims to 1) provide an epidemiological profile of self-reported pain experienced by the National Collegiate Athletic Association (NCAA) athletes by sex during the first half of the 2019 season, 2) describe their self-reported non-steroidal anti-inflammatory drug (NSAID) use.MethodsOnline survey was completed by athletes at three NCAA institutions from 1 August to 30 September 2019. Descriptive statistics were used to describe player demographic data, self-reported pain and self-reported NSAID use. Pain incidence proportion were calculated.ResultsTwo hundred thirty female athletes and 83 male athletes completed the survey. Self-reported pain incidence proportion for female athletes was 45.0 (95% CI 41.5–48.5) vs 34.9 (95% CI 29.4–40.4) for male athletes. Majority of the athletes did not report pain (55% female vs 62% male) during the first half of the 2019 season. Female athletes reported pain in their back (35%), knee (26%), and ankle/foot (23%) whilst male athletes reported pain in their knee (35%), back (28%), and shoulder (24%). Of all athletes, 28% female vs 20% male athletes reported currently taking NSAIDs. Of athletes that reported pain, 46% female vs 38% male athletes currently took NSAIDs. 70% female vs 61% male athletes self-purchased NSAIDs, and 40% female vs 55% male athletes consumed alcohol.ConclusionsHalf of female athletes and one in three male athletes reported pain. Most commonly back, knee and foot/ankle pain and knee, back and shoulder pain was reported in female and male athletes respectively. One in four female athletes and one in five male athletes use NSAIDs for pain or prophylactic purpose. Majority self-purchase these medications indicating need for health literacy interventions to mitigate potential adverse effects.

The Psychological And Academic Impact Of Athletic Injury

PURPOSE: Awareness and research on the mental health of student athletes has been rapidly increasing and recently become a primary focus of the National Collegiate Athletic Association (NCAA) and National Athletic Trainers’ Association. Although many see athletes as individuals who have grit and strength, the impact of injury and sport can have drastic effects on an athlete’s mental health, as well as academic performance and social participation. Without proper support, critical negative secondary effects could occur during and after the rehabilitation process. Therefore, the purpose of this study was to examine the psychological and academic impact of athletic injury, specifically NCAA Division III athletes. METHODS: A total of 34 collegiate student-athletes participated in the study (19 male, 15 female) from the Minnesota Intercollegiate Athletic Conference. Participants completed a mixed-methods questionnaire on the perceived mental impact of previous or current sport injuries. The questions required short answer and likert scale rating responses. A seven layer thematic analysis using three coders and triangulation to control for bias was used to analyze short answer responses and develop primary and subthemes. Quantitative data was analyzed using descriptive statistics. RESULTS: Thematic analysis revealed major changes occurred in: Mental Health, Physical Health, Daily Habits, and Perceived Social Support following sport injury. Critical findings included: 38% of participants perceived negative social interactions from coaches, 35% had symptoms of depression, 74% had some type of emotional disruption, and 29% had a reduction in academic motivation. CONCLUSIONS: High reports of depressive feelings, overall disruption to emotions and habits, and lack of social support alongside these mental health changes are a cause for great concern for collegiate athletes and their institutions. It is recommended that NCAA institutions utilize sports psychologists or mental health professionals to allow athletes to have a larger support system and work through mental health and academic issues they may face.

Relationship Between the King-Devick Test and Commonly Used Concussion Tests at Baseline

Comprehensive assessments are recommended to evaluate sport-related concussion (SRC). The degree to which the King-Devick (KD) test adds novel information to an SRC evaluation is unknown. To describe relationships at baseline among the KD and other SRC assessments and explore whether the KD provides unique information to a multimodal baseline concussion assessment. Cross-sectional study. Five National Collegiate Athletic Association institutions participating in the Concussion Assessment, Research and Education (CARE) Consortium. National Collegiate Athletic Association student-athletes (N = 2258, age = 20 ± 1.5 years, 53.0% male, 68.9% white) in 11 men's and 13 women's sports. Participants completed baseline assessments on the KD and (1) the Symptom Inventory of the Sport Concussion Assessment Tool-3rd edition, (2) the Brief Symptom Inventory-18, (3) the Balance Error Scoring System, (4) the Standardized Assessment of Concussion (SAC), (5) the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test battery, and (6) the Vestibular/Ocular Motor Screening tool during their first year in CARE. Correlation coefficients between the KD and the 6 other concussion assessments in isolation were determined. Assessments with ρ magnitude >0.1 were included in a multivariate linear regression analysis to evaluate their relative association with the KD. Scores for SAC concentration, ImPACT visual motor speed, and ImPACT reaction time were correlated with the KD (ρ = -0.216, -0.276, and 0.164, respectively) and were thus included in the regression model, which explained 16.8% of the variance in baseline KD time (P < .001, Cohen f2 = 0.20). Better SAC concentration score (β = -.174, P < .001), ImPACT visual motor speed (β = -.205, P < .001), and ImPACT reaction time (β = .056, P = .020) were associated with faster baseline KD performance, but the effect sizes were small. Better performance on cognitive measures involving concentration, visual motor speed, and reaction time was weakly associated with better baseline KD performance. Symptoms, psychological distress, balance, and vestibular-oculomotor provocation were unrelated to KD performance at baseline. The findings indicate limited overlap at baseline among the CARE SRC assessments and the KD.

Epidemiology of Exertional Heat Illnesses in National Collegiate Athletic Association Athletes During the 2009-2010 Through 2014-2015 Academic Years.

Exertional heat illnesses (EHIs) among football athletes have been widely researched, but data examining all collegiate sports are limited. To describe the epidemiology of EHI in 25 National Collegiate Athletic Association (NCAA) sports. Descriptive epidemiology study. The NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years. A voluntary sample of 166 NCAA institutions over 2048 team-seasons. Athletic trainers reported EHIs to the NCAA Injury Surveillance Program. Only EHIs sustained during a sanctioned practice or competition were included. The EHI rate, specific diagnoses, and number of emergency transports were measured. Overall, 232 EHI events were reported (0.47/10 000 athlete-exposures [AEs]; 95% confidence interval [CI] = 0.41, 0.53). Football comprised 75% of all EHI events and had the largest rate (1.55/10 000 AEs; 95% CI = 1.32, 1.78). The overall EHI rate was higher in preseason practices (1.16/10 000 AEs) than all other time periods (regular and postseason practices and all competitions; 0.23/10 000 AEs, injury rate ratio [IRR] = 4.96; 95% CI = 3.79, 6.50). This result was retained when examining the individual sports of football (3.65/10 000 versus 0.63/10 000 AEs, IRR = 5.82; 95% CI = 4.18, 8.10), men's soccer (1.11/10 000 versus 0.07/10 000 AEs, IRR = 16.819; 95% CI = 1.89, 138.55), and women's soccer (1.10/10 000 versus 0.05/10 000 AEs, IRR = 22.52; 95% CI = 2.77, 183.05). The EHI rates were highest in states with elevated annual temperatures (1.05/10 000 AEs). Heat cramps (39%), heat exhaustion (27%), and dehydration (29%) were the most common types of EHI. Nineteen athletes with EHI (8%) required emergency transport. Football players continue to experience the most EHIs; however, EHIs can potentially occur in all NCAA sports. Continued emphasis on preseason EHI policies and institution-specific environmental guidelines is needed to address EHI rates.

Medical Claims at National Collegiate Athletic Association Institutions: The Athletic Trainer's Role.

National Collegiate Athletic Association (NCAA) institutions are required to certify insurance coverage of medical expenses for injuries student-athletes sustain while participating in NCAA events. Institutions assign this role to a variety of employees, including athletic trainers (ATs), athletic administrators, business managers, secretaries, and others. In 1994, Street et al observed that ATs were responsible for administering medical claim payments at 68.1% of institutions. Anecdotally, ATs do not always feel well suited to perform these tasks. To investigate the ways athletic associations and departments coordinate athletic medical claims and the role of ATs in this process. Cross-sectional study. Online Web-based survey. All 484 National Athletic Trainers' Association members self-identified as a head AT within an NCAA collegiate or university setting were solicited to respond to the online Web-based survey. Responses from 184 (38%) head ATs employed in collegiate settings were analyzed. Institutional demographic characteristics, type of insurance coverage, person assigned to handle insurance claims, hours spent managing claims, and training for the task. In 62% of institutions, an AT was responsible for processing athletic medical claims. The head and assistant ATs spent means of 6.17 and 10.32 hours per week, respectively, managing claims. Most respondents (62.1%) reported no formal training in handling athletic medical insurance claims. When asked when and how it was most appropriate to learn these concepts, 35.3% cited within an accredited athletic training program curriculum, 32.9% preferred on-the-job training, and 31.1% selected via continuing education. At NCAA institutions, ATs were responsible for administering athletic medical claims, a task in which most had no formal training. An AT may not possess adequate skills or time to handle athletic medical claims. Even if ATs are not solely responsible for this task, they remain involved as the coordinators of care. Athletic training programs, professional organizations that offer continuing education, and hiring institutions should consider focusing on and training appropriate personnel to manage athletic medical claims.

Comparison of Body Composition Variables Across a Large Sample of National Collegiate Athletic Association Women Athletes From 6 Competitive Sports.

Fields, JB, Metoyer, CJ, Casey, JC, Esco, MR, Jagim, AR, and Jones, MT. Comparison of body composition variables across a large sample of National Collegiate Athletic Association women athletes from 6 competitive sports. J Strength Cond Res 32(9): 2452-2457, 2018-Body composition (BC) plays a critical role in sport performance and athlete health. Body size and BC have been widely studied in men's sports, with reported changes observed over time. However, a paucity of current data exists in women athletes. The purpose of this descriptive study was to measure and compare BC data for collegiate women athletes from 6 competitive sports. A total of 524 athletes from 2 National Collegiate Athletic Association institutions participated: basketball (BB; n = 95), gymnastics (GYM; n = 42), lacrosse (LAX; n = 81), rowing (ROW; n = 57), soccer (SOC; n = 188), and volleyball (VB; n = 61). Body height (BH) and body mass (BM) were measured using a stadiometer and calibrated digital scale, respectively. Body fat percentage (BF%), fat mass (FM), and fat-free mass (FFM) were assessed using air displacement plethysmography. One-way analysis of variance was used to assess differences across sports. Least squares difference post hoc analyses were performed when a significant finding (p ≤ 0.05) was identified. ROW had the highest BF% (29.9 ± 6.1%) and BB the greatest FFM (57.2 ± 6.1 kg). GYM had the lowest BM (58.9 ± 5.3 kg), FM (11.6 ± 2.6 kg), and BH (158.73 ± 2.13 cm). LAX, SOC, and VB had similar BF%. Body height was greatest for BB and VB (177.92 ± 7.55 cm, 176.79 ± 7.36 cm, respectively). These data may assist in the establishment of descriptive values for use in goal setting and exercise programming. The current data demonstrate a trend toward increased body size and BC from previous research.

The influence of coach turnover on student-athletes' affective states and team dynamics: An exploratory study in collegiate sports

Coach turnover is frequent, especially in collegiate sports in the United States. To date, however, there is limited research on how coach turnover might affect student-athletes. Accordingly, we aimed to qualitatively explore how coach turnover might influence student-athletes’ psychosocial states and team dynamics in collegiate sports. Eleven athletic teams at a Midwestern Division I National Collegiate Athletic Association institution having undergone coach turnover during the past four years participated in the study. Four coaches and 21 student-athletes representing both individual and team sports, as well as two administrative staff members, participated in semi-structured interviews (coaches and administrators) and focus groups (student-athletes). Inductive data analysis revealed four first level themes: coach style and background, athlete affective states, team dynamics, and program culture. Our analysis suggested that, depending on their gender and coaching style, coaches might have a positive or negative impact on athletes’ affective states (e.g. positive and negative affect), team dynamics (e.g. cohesion; athlete leadership), and the program culture. Thus, practitioners might facilitate the positive impact of coaching turnover by assessing whether the new coach is a ‘good fit’ at the individual (micro), team (meso), and environmental (macro) level of analysis.

Investigation of the Rosenbaum Concussion Knowledge and Attitudes Survey in Collegiate Athletes.

The purpose of this study is to determine whether the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) is an appropriate outcome measure to assess knowledge and attitudes toward concussion in collegiate student-athletes as determined through validity and reliability testing. Convenience study. The researcher recruited all athletic teams at a Division III National Collegiate Athletic Association institution. Four hundred thirty-three collegiate student-athletes, 18 years of age or older, from a variety of sports took part in this study. As the validity of RoCKAS has never been established for the target population, this study randomly split respondents into 2 studies. Participants in this study completed the RoCKAS during preseason meetings before concussion education. The primary researcher was not present during the completion of the survey to allow participants to answer honestly without concern of coercion. A paper-based Rosenbaum Concussion Knowledge and Attitudes Survey. The Concussion Knowledge Index (CKI) was distributed in 2 cluster constructs and identified variables of low and high difficulty. Multivariate statistical analysis of the Concussion Attitude Index (CAI) explains 68.79% of the total variance. The Confirmatory Factor Analysis did not confirm the hypothesis that similar constructs can be found between data sets ((Equation is included in full-text article.)= 207.902; consistent akaike information criterion = 391.550; root mean square error of approximation = 0.125, and goodness of fit index = 0.868). The CKI is a valid and reliable measure in collegiate student-athletes. However, the results of the Confirmatory Factor Analysis indicated a poor model fit and improper correlations between attitude items. Therefore, the CAI may not be a sound outcome measure of collegiate student-athlete's attitudes toward concussions.

The Epidemiology of Stress Fractures in Collegiate Student-Athletes, 2004-2005 Through 2013-2014 Academic Years.

Stress fractures are injuries caused by cumulative, repetitive stress that leads to abnormal bone remodeling. Specific populations, including female athletes and endurance athletes, are at higher risk than the general athletic population. Whereas more than 460 000 individuals participate in collegiate athletics in the United States, no large study has been conducted to determine the incidence of stress fractures in collegiate athletes. To assess the incidence of stress fractures in National Collegiate Athletic Association (NCAA) athletes and investigate rates and patterns overall and by sport. Descriptive epidemiology study. National Collegiate Athletic Association institutions. National Collegiate Athletic Association athletes. Data were analyzed from the NCAA Injury Surveillance Program for the academic years 2004-2005 through 2013-2014. We calculated rates and rate ratios (RRs) with 95% confidence intervals (CIs). A total of 671 stress fractures were reported over 11 778 145 athlete-exposures (AEs) for an overall injury rate of 5.70 per 100 000 AEs. The sports with the highest rates of stress fractures were women's cross-country ( 28.59/100 000 AEs), women's gymnastics ( 25.58/100 000 AEs), and women's outdoor track ( 22.26/100 000 AEs). Among sex-comparable sports (baseball/softball, basketball, cross-country, ice hockey, lacrosse, soccer, swimming and diving, tennis, indoor track, and outdoor track), stress fracture rates were higher in women (9.13/100 000 AEs) than in men (4.44/100 000 AEs; RR = 2.06; 95% CI = 1.71, 2.47). Overall, stress fracture rates for these NCAA athletes were higher in the preseason (7.30/100 000 AEs) than in the regular season (5.12/100 000 AEs; RR = 1.43; 95% CI = 1.22, 1.67). The metatarsals (n = 254, 37.9%), tibia (n = 147, 21.9%), and lower back/lumbar spine/pelvis (n = 81, 12.1%) were the most common locations of injury. Overall, 21.5% (n = 144) of stress fractures were recurrent injuries, and 20.7% (n = 139) were season-ending injuries. Women experienced stress fractures at higher rates than men, more often in the preseason, and predominantly in the foot and lower leg. Researchers should continue to investigate biological and biomechanical risk factors for these injuries as well as prevention interventions.

Psychological impact of electrocardiogram screening in National Collegiate Athletic Association athletes

PurposeDetermine the psychological impact of false-positive ECG screening in National Collegiate Athletic Association (NCAA) athletes.MethodsAthletes representing seven NCAA institutions received a standardised history, physical examination and ECG interpreted using the...

College Athletes With Ankle Sprain History Exhibit Greater Fear-Avoidance Beliefs.

Postinjury, college athletes have reported elevated levels of fear. However, it is unclear how a history of ankle sprain impacts injury-related fear. The aim of this study was to determine if Fear-Avoidance Beliefs Questionnaire (FABQ) scores differ between college athletes with a history of a single ankle sprain, those with recurrent ankle sprains, and healthy controls. Cross-sectional design. National Collegiate Athletic Association institutions. From a large database of college athletes, 75 participants with a history of a single ankle sprain, 44 with a history of recurrent ankle sprains (≥2), and 28 controls with no injury history were included. Participants completed an injury history questionnaire and the FABQ. On the injury history form, the participants were asked to indicate if they had ever sustained an ankle sprain and, if yes, to describe how many. FABQ scores ranged from 0 to 66 with higher scores representing greater fear. Athletes with a history of recurrent ankle sprains (median, 28.00; interquartile range, 18.25-38.00) reported higher levels of fear than those with a history of a single ankle sprain (21.00; 8.00-31.00; P = .03; effect size = 0.199) and healthy controls (5.50; 0.00-25.00; P < .001; effect size = 0.431). Athletes with a history of a single sprain reported greater fear than healthy controls (P = .01, effect size = 0.267). Athletes with a history of a single sprain reported greater fear than healthy controls (P = .02, effect size = 0.23). College athletes with a history of ankle sprain exhibited greater levels of fear on the FABQ than healthy controls. These findings suggest that ankle sprains in general may increase injury-related fear and that those with a history of recurrent sprains are more vulnerable.

Electrocardiographic Screening in National Collegiate Athletic Association Athletes

The most effective protocol for cardiovascular screening of competitive athletes remains highly controversial. This study was a prospective, multicenter trial of cardiovascular screening at 35 National Collegiate Athletic Association institutions. Screening included a standardized history and physical examination (PE) as recommended by the American Heart Association and a 12-lead electrocardiogram (ECG) at rest. Centralized electrocardiographic interpretation was provided using the Seattle criteria. Athletes with screening abnormalities underwent additional evaluation directed by the host institution medical team. Primary outcomes included the proportion of total and false-positive screens; the sensitivity, specificity, and positive predictive value of history, PE, and ECG; and the prevalence of serious cardiovascular disorders associated with severe morbidity or sudden cardiac death. From August 2012 to June 2014, 5,258 athletes from 17 intercollegiate sports were screened: 55% men (mean age 20.1years), 73% Caucasian, 16% African-American, and 11% other/mixed race. At least 1 positive cardiac symptom or family history response was reported by 1,750 athletes (33.3%). PE was abnormal in 108 athletes (2.1%), and electrocardiographic abnormalities were present in 192 athletes (3.7%). Thirteen athletes (0.25%) were identified with serious cardiac conditions including hypertrophic cardiomyopathy (1), large atrial septal defect with right ventricular dilation (1), and ventricular pre-excitation (11). The false-positive rate for history was 33.3%, PE 2.0%, andECG 3.4%. The sensitivity/specificity/positive predictive value for history was 15.4%/66.9%/0.1%, PE 7.7%/98.2%/0.9%, and ECG 100%/96.6%/6.8%. In conclusion, electrocardiographic screening in National Collegiate Athletic Association athletes has a low false-positive rate and provides superior accuracy compared with a standardized history and PE to detect athletes with potentially dangerous cardiovascular conditions.