Outcomes In Athletes Research Articles

Long-Term Functional Outcomes and Athletic Ability in Shoulder Sports After Anatomic Coracoclavicular Ligament Reconstruction for Chronic Type 3 and 5 Acromioclavicular Joint Injuries.

Promising short- and midterm outcomes have been seen after anatomic coracoclavicular ligament reconstruction (ACCR) for chronic acromioclavicular joint (ACJ) injuries. To evaluate long-term outcomes and shoulder-related athletic ability in patients after ACCR for chronic type 3 and 5 ACJ injuries. It was hypothesized that these patients would maintain significant functional improvement and sufficient shoulder-sport ability at a long-term follow-up. Case series; Level of evidence, 4. Included were 19 patients (mean age, 45.9 ± 11.2 years) who underwent ACCR for type 3 or 5 ACJ injuries between January 2003 and August 2014. Functional outcome measures included the American Shoulder and Elbow Surgeons (ASES), Rowe, Constant-Murley, Simple Shoulder Test (SST), and Single Assessment Numeric Evaluation (SANE) scores as well as the visual analog scale (VAS) for pain, which were collected preoperatively and at the final follow-up. Postoperative shoulder-dependent athletic ability was assessed using the Athletic Shoulder Outcome Scoring System (ASOSS). Shoulder activity level was evaluated using the Shoulder Activity Scale (SAS), while the Subjective Patient Outcome for Return to Sports (SPORTS) score was collected to assess the patients' ability to return to their preinjury sporting activity. The mean follow-up time was 10.1 ± 3.8 years (range, 6.1-18.8 years). Patients achieved significant pre- to postoperative improvements on the ASES (from 54.2 ± 22.6 to 83.5 ± 23.1), Rowe (from 66.6 ± 18.1 to 85.3 ± 19), Constant-Murley (from 64.6 ± 20.9 to 80.2 ± 22.7), SST (from 7.2 ± 3.4 to 10.5 ± 2.7), SANE (from 30.1 ± 23.2 to 83.6 ± 26.3), and VAS pain scores (from 4.7 ± 2.7 to 1.8 ± 2.8) (P < .001 for all), with no significant differences between type 3 and 5 injuries. At the final follow-up, patients achieved an ASOSS of 80.6 ± 32, SAS level of 11.6 ± 5.1, and SPORTS score of 7.3 ± 4.1, with no significant differences between type 3 and 5 injuries. Four patients (21.1%) had postoperative complications. Patients undergoing ACCR using free tendon allografts for chronic type 3 and 5 ACJ injuries maintained significant improvements in functional outcomes at the long-term follow-up and achieved favorable postoperative shoulder-sport ability, activity, and return to preinjury sports participation.

Outcomes and Proportions of Subsequent Contralateral Sports Hernia Repair Following Primary Unilateral Repair.

In the event that nonoperative treatment for sports hernia fails, surgical repair may be warranted. Bilateral repair can occur in up to 45% of surgically treated patients. To investigate the clinical outcomes of athletes who underwent unilateral sports hernia repair and determine the proportion of patients who required contralateral sports hernia repair. Case series; Level of evidence, 4. We identified patients at our institution who underwent primary unilateral sports hernia repair (rectus abdominis-adductor longus aponeurotic plate repair and adductor lengthening) with a single surgeon between 2015 and 2020. We assessed patient-reported outcomes using the Hip Outcome Score-Sport (HOS-Sport), the Numeric Pain Rating Scale, and an internally developed return-to-play questionnaire. We further collected data regarding subsequent sports hernia procedures on the ipsilateral or contralateral side. We calculated summary statistics for outcomes and examined the association between preinjury patient characteristics and the HOS-Sport score at follow-up or successful return to preinjury sport using linear and logistic regression, respectively. A total of 104 of 128 (81.3%) eligible patients (mean age at surgery, 23.0 ± 6.2 years; 94.2% male; 51.9% American football athletes) completed follow-up at a mean time of 4.4 ± 1.5 years. Overall, 79.8% of athletes (n = 83) were able to return to their preinjury sport/activity, but 90.2% (83/92) who attempted to return were able to do so. When examining reasons for not returning to preinjury sport, only 9 patients reported not returning to preinjury sport because of limitations or persistent symptoms from their original injury. Only 4 patients underwent subsequent sports hernia procedures (3 contralateral, 1 ipsilateral revision) after their index unilateral sports hernia repair. At follow-up, the mean HOS-Sport score was high (94.0 ± 10.8), and the mean Numeric Pain Rating Scale score was low (0.31 ± 1.26). There were no preinjury patient characteristics associated with either the HOS-Sport score at follow-up or the successful return to preinjury sport. Patients with unilateral sports hernia symptoms can undergo repair and return to sport at the preinjury level with little concern for injuries to the contralateral groin. In our cohort, patient-reported hip function and pain outcomes at follow-up were excellent.

Perceptions of the importance of sports nutrition knowledge and barriers in implementing them: a qualitative study among track and field stakeholders in Sri Lanka

BackgroundIntegrating the core aspects of sports nutrition knowledge [SNK] into the multidisciplinary team is critical to improving an athlete’s performance and well-being. Conducting in-depth interviews with members of the sports-related team is a comprehensive method of gathering information on various aspects of SNK. This qualitative study aimed to examine the opinions and beliefs of stakeholders in athletics regarding the importance of SNK.MethodsFifteen professional track and field athletes and stakeholders were recruited into the study. Separate in-depth interviews were conducted to collect information within four key themes. Practical difficulties in getting an appropriate meal were included in an additional theme. Thematic analysis was performed using NVIVO v10.0.ResultsAll participants were mindful of the importance of proper food habits for overall athletic outcomes and reported different opinions on meal timing and composition. The opinions on supplements were heterogeneous and both positive and negative claims were reported. Beliefs regarding hydration demonstrated that the cohort was well aware of the significance of adequate hydration plus the signs and consequences of dehydration with many reporting experiences of the negative consequences of dehydration. All respondents reported that both alcohol and smoking may have an adverse impact on performance and health.ConclusionsAll respondents emphasized the importance of proper food habits for sports performance and well-being, but also identified barriers to optimizing nutrition.

Thoracic outlet syndrome in overhead athletes

BackgroundWe aimed to retrospectively compare the clinical outcomes of endoscopy-assisted first-rib resection for thoracic outlet syndrome (TOS) between overhead athletes and non-athletes and investigate the return to same-level sports rate in overhead athletes. MethodsWe retrospectively reviewed 181 cases with TOS (75 women, 106 men; mean age, 28.4 years; range, 12–57 years) who underwent endoscopy-assisted first-rib resection. We divided into two groups: 79 overhead athletes and 102 non-athletes groups. A transaxillary approach for first-rib resection and neurovascular decompression was performed under magnified visualization. Endoscopic findings related to the neurovascular bundle, interscalene distance, and scalene muscle were evaluated intraoperatively. We assessed the Roos and Disability of the Arm, Shoulder, and Hand (DASH) scores, return to same-level sports rate, and ball velocity. ResultsOverhead athletes were significantly more likely to be men, younger, used the dominant side more frequently, and have a larger physique, more shoulder and elbow pain, and shorter symptom duration. The outcomes of the Roos score revealed significant differences in excellent or good results between overhead athletes (91.1%) and non-athletes (62.8%). The two groups significantly differed in preoperative and postoperative DASH and recovery rate scores (P = 0.007, < .001, < .001). ConclusionsOverhead athletes with TOS were more likely to be men, younger, dominant side more frequently, and have more shoulder and elbow pain, and a shorter symptom duration. Endoscopy-assisted transaxillary first-rib resection and neurolysis provided superior clinical outcomes in overhead athletes with TOS compared with non-athletes and a high return-to-same-level-play rate in sports.

CHARACTERISTICS OF MODERN TECHNOLOGIES IN THE TRAINING AND COMPETITIVE PROCESS OF ELITE ATHLETES IN SPORTS GAMES

Introduction. The integration of modern technologies is crucial for enhancing elite athlete training, offering cutting-edge tools for performance optimization. The widespread use of technology in elite sports, including video assistant referees and wearable sensors, providing real-time biomechanical oversight, challenges related to ethics, data protection, and regulatory frameworks require resolution for widespread implementation. This study aims to conduct a thorough assessment of the integration of modern technologies, specifically examining their efficacy in optimizing the training performance and competitive outcomes of elite athletes in sports games. Material and Methods. Bibliometric techniques and expert evaluations were used to determine the modern trends in innovative technologies to improve the effectiveness of elite athletes` preparation. A thorough biomechanical analysis utilizing diverse methods was performed on 41 elite athletes in sports games. Results. The examination of sports science literature and expert assessments unveils predominant trends in the utilization of innovative technologies in elite sports, with a particular emphasis on the widespread adoption of wearable technology, biomechanics and motion analysis, and recovery and regeneration techniques. The outcomes from OpenCap biomechanical analysis show a high correlation (r=0.99, α = 0.05) between the symmetry of knee joint angles during barbell squats by elite athletes, confirming the efficacy of real-time monitoring exercise techniques. The Romberg coefficient of 194.5% ± 2.47 indicates a notable degree of stability among elite athletes. Conclusions. This study enhances the comprehension of innovative technologies, exemplified by OpenCap biomechanical analysis, and their effectiveness in optimizing the training performance and competitive outcomes of elite athletes in sports games. The findings provide valuable insights for coaches, sports scientists, and researchers aiming to optimize training methods and elevate athlete performance in sports games.

Examining the Relationship Between Perceived Coaching Approaches for Life Skills Development and Life Skills Outcomes for High School Athletes

Promoting life skills is a prominent focus of the mission of high school sports. The purpose of this study was to examine the relationship between perceived coaching approaches for life skills development and life skills outcomes for high school athletes. A total of 346 athletes participating in high school sports from the United States completed the athlete-reported version of the Coaching Life Skills in Sport Questionnaire (perceived implicit and explicit coaching approaches) and the Life Skills Scale for Sport. Findings from hierarchical and stepwise regression models revealed that perceived implicit and explicit levels of coaching were differentially associated with each of the eight life skills outcomes, with the most consistent and significant predictor of life skills outcomes being structuring and facilitating a positive climate. Findings are discussed in relation to the conceptual and practical utility of the implicit–explicit continuum of life skills development and transfer, the importance of coach and athlete awareness of coaching approaches for life skills development, and recognition of the strengths and limitations of a variety of ontological and epistemological approaches to studying life skills in sport.

Short-term Effects of Kinesio Taping Application on Outcomes of Athletes With Shin Splints

Purpose: Shin splints are a common injury in the world of sports, causing pain along the inner edge of the tibial and impacting an athlete’s performance and well-being. The study aims to examine how kinesio taping application affects pain, postural control, and plantar pressure parameters in athletes with shin splints. Methods: A placebo-controlled trial design was used, with 32 athletes with shin splints randomly assigned to either the kinesio taping group (KT=16) or the placebo group (PC=16). The KT group received kinesio tape with 75% tension applied to the affected shin, while the PC group received the same application without tension. Before and after the taping intervention, pain levels, postural control, and plantar pressure parameters were evaluated. Results: Results indicated that the KT group experienced a significant pain reduction and improved postural control and plantar pressure parameters compared to the PC group. Conclusion: These results suggest that kinesio tape can relieve pain in the short term and enhance postural control and plantar pressure distribution in athletes with shin splints. Further research is necessary to explore the long-term effects and underlying mechanisms.

Assessing the long term benefits of early specialization in youth sports on athletic and psychological outcomes

Assessing the long term benefits of early specialization in youth sports on athletic and psychological outcomes

Impact of lower limb alignment abnormality (physiologic knee valgus) on the functional recovery outcome of athletes with meniscal injuries.

This study aimed to investigate the impact of lower limb alignment abnormalities, specifically physiological knee valgus, on the functional recovery outcomes of athletes with meniscal injuries. It also examined the factors influencing these abnormalities to provide scientific evidence for treatment and rehabilitation of related sports injuries. We conducted a retrospective study of 118 athletes from Guizhou Normal University, who were divided into two groups based on the presence or absence of lower limb alignment abnormalities. The Simple group comprised athletes with isolated meniscal injuries, while the Combined group included athletes with meniscal injuries and concurrent lower limb alignment abnormalities. We assessed the functional status of both groups and analyzed factors influencing lower limb alignment abnormalities. Of the 118 athletes, 46 (38.98%) exhibited lower limb alignment abnormalities, and 72 (61.02%) did not. No significant differences in general characteristics were found between the groups (all P > 0.05). The Combined group displayed higher Visual Analog Scale (VAS) scores and Functional Performance Test (FPT) results (coordinated contraction, shuttle run, CarioCa) compared to the Simple group (P < 0.05). Conversely, joint range of motion (ROM), knee muscle strength (flexors), and International Knee Documentation Committee (IKDC) scores were lower in the Combined group (all P < 0.05). Multivariate logistic regression analysis identified active ROM < 105.32°, passive ROM < 101.66°, and knee muscle strength (flexors) < 84.41 N as risk factors for lower limb alignment abnormalities (P < 0.05), while FPT acted as a protective factor (P < 0.05). The combined testing model demonstrated higher predictive efficacy (AUC = 0.903, 95% CI: 0.852-0.955, P < 0.001). Lower limb alignment abnormalities significantly affect the functional recovery outcomes of athletes with meniscal injuries. Factors such as ROM, knee muscle strength, and IKDC score may pose risks for these abnormalities, whereas FPT can provide protective benefits. Timely detection and correction of lower limb alignment abnormalities during the rehabilitation process from meniscal injuries are crucial to enhance recovery and improve prognosis.

Return-to-Sport Rates After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Flexibility Sports Athletes: A Systematic Review.

Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain in young adults. Flexibility athletes represent an interesting subset due to the extreme range of motion requirements of their sport. The objective of this review was to provide a summary of the outcomes of hip arthroscopy for FAIS in patients who participate in flexibility sports. Three online databases (Medline, Embase, and PubMed) were searched from database inception (1946, 1974, and 1966, respectively) to January 10, 2023. Studies were screened for literature addressing surgical outcomes for flexibility athletes undergoing hip arthroscopy for FAIS. Systematic review. Level 4. Various patient-reported outcomes that evaluated the efficacy of hip arthroscopy in this patient population were abstracted and presented in descriptive and analytical format. Abstraction was performed by 2 reviewers. Overall, a total of 8 Level 3 or 4 studies and 295 patients (312 hips) were included in this review. The pooled standardized mean differences for the Visual Analog Scale for pain score, Modified Harris Hip Score, Hip Outcome Score - Activity of Daily Living scale, and Hip Outcome Score - Sport-Specific Subscale all demonstrated significant improvement after undergoing arthroscopy for FAIS between 12 and 116 months (N = 175, -1.97, 95% CI -2.5 to -1.4, P < 0.01, I2 = 76%; N = 211, 1.82, 95% CI 1.49 to 2.16, P < 0.01, I2 = 52%; N = 164, 1.75, 95% CI 1.42 to 2.05, P < 0.01, I2 = 28%; N = 211, 1.71, 95% CI 1.38 to 2.04, P < 0.01, I2 = 52%, respectively). Across 289 patients, 75.6% to 98% returned to sport at a similar or higher level than presurgery. This review demonstrates a trend of improvement in patient-reported pain, function, quality of life, and return to sport at a minimum of 12 months among flexibility athletes after hip arthroscopy to treat FAIS.

The Squat One Repetition Maximum May Not Be the Best Indicator for Speed-Related Sports Performance Improvement in Elite Male Rugby Athletes

In the strength and conditioning field, a variety of training exercises are being applied to improve speed-related performance, but there is a lack of traditional strength training guides that can be used for training effectiveness. The aim of this study was to assess the impact of a six-week traditional strength training program on elite rugby players and explore the relationships between the one repetition maximum (1RM) of traditional strength exercises and athletic performance. Twenty elite rugby players (age = 30.5 ± 1.5 years, mass = 96.7 ± 16.6 kg, height = 179.3 ± 6.0 cm) completed the strength training program, and 1RM values for bench press, squat, deadlift, and power clean, along with athletic performance metrics (20 m and 40 m sprints, vertical jump, broad jump, Bronco test, L-run), were measured before and after the training period. Medium effect sizes were observed in the deadlift (p = 0.04, d = 0.49) and bench press (p = 0.019, d = 0.57) 1RM, while the squat exhibited a very large effect size (p &lt; 0.001, d = 2.08). Both before and after training, greater power clean 1RM demonstrated a strong correlation with each athletic performance test. However, bench press 1RM, both pre-and post-training, did not significantly associate with functional performances (p &gt; 0.05). Notably, power clean 1RM showed the strongest correlation with athletic performance; despite being the most significant improvement in squat 1RM after the six-week training period, it was not associated with athletic performance outcomes in rugby players. This study underscores the varied impact of specific strength exercises on athletic performance, emphasizing the distinct role of power clean 1RM in predicting speed-related performance in male rugby players.

The level of anxiety as a facilitating or inhibiting factor in sports performance

The research part of the paper is based on four hypotheses that aim to verify the following correlations: correlations between sports anxiety and anxiety as a feature, then between cognitive anxiety and self-esteem, correlations between anxiety in team sports and individual sports. Sport anxiety and sport performance were also investigated, as well as exploring sport anxiety to reduce it and increase athletes' sport performance. Regarding this, three online questionnaires were administered to a group of 90 athletes (48 from individual sports and 42 from team sports) of both female and male gender, for a period of 6 months. The team sports were basketball and football and the individual sports were gymnastics, martial arts and wrestling. The respective questionnaires represented the research instruments and were as follows: ASQ, Rosemberg and CSAI 2. The research aimed to find out through the results obtained whether anxiety in its forms, as a characteristic, or cognitive influences positively or negatively the performance outcomes of athletes. At the same time, it was found that self-esteem represents an important factor in helping to reduce cognitive anxiety, and even more importantly, it helps athletes to use anxiety effectively. It has been found that sports performance is affected by anxiety, especially in elite athletes, who feel a major pressure on their way to competitive success. Correlations between the ASQ and subscales of the CSAI-2 test found that anxious individuals already have a background for developing greater sport anxiety, interpreting certain situations negatively, compared to individuals who are more positive.

Upper echelons in college sport: the impact of athletic directors on organizational performance and revenues

PurposeUsing the lens of upper echelons theory, this study examines the degree to which National Collegiate Athletic Association athletic department performance outcomes are associated with the personal characteristics and experiences of the athletic director leading the organization.Design/methodology/approachThe authors match organizational performance data with athletic director and institutional characteristics to form a robust data set spanning 16 years from the 2003–04 to 2018–19 seasons. The sample contains 811 observations representing 136 unique athletic directors. Fixed effects panel regressions are used to analyze organizational performance and quantile regression is used to analyze organizational revenues.FindingsThe authors fail to uncover statistically significant evidence that athletic director personal characteristics, functional experience and technical experience are associated with organizational performance. Rather, the empirical modeling indicates organizational performance is primarily driven by differentiation in the ability to acquire human capital (i.e. playing talent). The results also indicate that on average, women are more likely to lead lower revenue organizations, however, prior industry-specific technical experience offsets this relationship.Originality/valueIn opposition to upper echelons research in numerous settings, the modeling indicates the personal characteristics and experiences of the organization's lead executive are not an economically relevant determinant of organizational performance. This may indicate college athletics is a boundary condition in the applicability of upper echelons theory.

Glenoid Bone Loss - A Retrospective Evaluation of Functional Outcomes after Bone Block Surgery for Anterior Shoulder Instability in High-demand Athletes.

Objective This study assesses the relationship between the glenoid bone loss size and range of motion, functional outcomes, and complications in high-performance athletes undergoing bone block surgery for anterior shoulder instability. Methods This retrospective study evaluated postoperative outcomes in athletes submitted to bone block surgery for anterior shoulder instability. In 5 years, 41 shoulders underwent the procedure; 20 had bone losses up to 15%, and 21 shoulders presented bone losses ranging from 15% and 25%. Results There was no statistically significant difference regarding postoperative complications, new dislocations, and the rate of return to sports. In addition, the quantitative criteria evaluated, i.e., ranges of motion and functional scores, showed no statistically significant difference between groups. Conclusion The size of the bone loss per se does not seem to affect functional outcomes and complications from these procedures, which are safe techniques for small and large bone losses.

Links between environmental features and developmental outcomes of elite youth athletes: A cross-sectional study within the German talent pathway

From a holistic perspective, the talent development environment (TDE) influences not only the athletic development but also the development of personal skills as well as the wellbeing of elite youth athletes. Alongside research on the effects of broader environmental features on athlete-related talent development (TD) outcomes, the importance of the closer social climate (i.e., teammates, coaches, support staff) is also emphasized. Therefore, the purpose of this study was to examine the relationship between environmental features, the social climate and athlete-related TD outcomes (I). Additionally, an exploratory analysis was conducted to investigate the role of motivational climate and psychological safety in the relationship between environmental features and athlete-related TD outcomes (II). To this end, 345 German elite youth athletes completed an online survey assessing their perceptions of environmental features, coach-created motivational climate, and psychological safety as well as wellbeing, performance satisfaction, and life skills development. The results revealed that environmental features (especially long-term development focus, effective coach-athlete communication, and the social network), motivational climate and psychological safety were all significantly associated with the outcome variables. These findings underline the significance of environmental features for athlete-related TD outcomes of young talented athletes in German elite youth sports. However, the results indicated that motivational climate and psychological safety did not have significant indirect effects on the relationship between TDE features and athlete-related TD outcomes. Thus, it remains to be questioned if and what other processes influence this relationship.

Relationship between Body Composition Asymmetry and Specific Performance in Taekwondo Athletes: A Cross-Sectional Study

Currently, there is interest in investigating how interlimb asymmetries (IA) of body composition impact sport-specific performance outcomes. This study aimed to examine the relationship between body composition inter-limb asymmetry and specific performance outcomes in taekwondo athletes. Seventeen national and international athletes (males, n = 8, mean age = 23.3 ± 3.1 years, mean stature = 177.2 ± 8.5 cm, mean body mass = 80.0 ± 7.3 kg; females, n = 9, mean age = 25.0 ± 4.0 years, mean stature = 161.1 ± 4.4 cm, mean body mass = 59.8 ± 5.7 kg) participated in the study. During a non-consecutive 2-day period, body composition (BC) and IA were assessed using dual X-ray absorptiometry, and the magnitude (%) of IA was calculated. Specific-performance included taekwondo specific agility test (TSAT) and Frequency Speed of Kick Test Multiple (FSKTMULT). The relationship between BC asymmetry and performance outcomes was analyzed using a partial correlation approach (controlling for gender, age, and training time). The influence of the significant results was examined using forward stepwise linear regression models. The main results showed no significant differences between the lower limbs (p &lt; 0.05). The IA ranged from 1.37% to 2.96%. Moderate to large negative correlations (r = −0.56 to −0.76, p &lt; 0.05) were documented between IA of body mass, free fat mass (FFM), and lean soft tissue mass (LSTM) with most FSKTMULT outcomes. Bone mineral density (BMD) was correlated with set 5 (rho = −0.49, p = 0.04). The FFM and LSTM asymmetries influenced the KDI reduction by 21%. Meanwhile, IA BMD negatively influenced set 5 performance by 48%. The findings of our study indicate that asymmetries independent of the magnitude of muscle and bone mass-related outcomes may have detrimental effects on high-intensity performance in taekwondo athletes. This underscores the importance of implementing comprehensive training programs and paying attention to achieving body composition inter-limb symmetry to improve overall performance levels in this sport.

Optimised return to play: high treatment success rate in core muscle injury with surgical release of the anterior tendon of the rectus abdominis muscle and proximal tenotomy of the adductor longus muscle

ObjectivesCore muscle injury is a debilitating condition that causes chronic groin pain in athletes, particularly common in soccer players. The condition is characterised by pain in the inguinal region and can lead to a significant number of absences from high-intensity physical activity. It is caused by repetitive overload without proper counterbalance from the abdominal muscles, hip flexors, and adductors in susceptible athletes. Surgical indications for core muscle injury consider cases where non-surgical treatments have not provided sufficient relief. The aim of this study was to assess the results of surgical intervention for core muscle injury using the technique employed by the Sports Medicine Group of (Institute of Orthopedics and Traumatology of Hospital das Clínicas – Universidade de São Paulo). The procedure involves releasing the anterior portion of the tendon of the rectus abdominis muscle near the pubic symphysis, along with proximal tenotomy of the adductor longus muscle tendon. MethodsThis study utilised a consecutive historical cohort analysis of the medical records of 45 male athletes, of which, 75.6% were professional soccer players, who underwent surgical treatment between January 1, 2002, and December 31, 2021. The participants included active athletes aged between 18 and 40 years, with a mean age of 23.9 years, and were diagnosed with myotendinous core muscle injury. These athletes experienced pain in the pubic symphysis and adductor tendon region and had previously undergone medical treatment and physical therapy for a duration of three to six months without significant improvement. ResultsThe average time for athletes to return to sport after surgery was 135 days, with a majority of participants being soccer and futsal players. The surgical intervention yielded promising results, with a positive correlation between unilateral injuries and the time taken to return to sport. The complication rate was low, at 6.7%. Notably, the rate of symptom resolution was high, at 93.3%. Furthermore, the analysis indicated that the player's position on the field significantly influenced the discharge period, suggesting that the game position plays a role in the recovery process. ConclusionThe combined surgical procedure involving the release of the rectus abdominis tendon and adductor longus muscle tenotomy demonstrates favourable outcomes for athletes with core muscle injury. This study provides strong support for the effectiveness of this surgical approach in managing the condition and offers a potential path to recovery and return to sports activities. Level of evidence4. Study designCross-sectional study.

2 Contributions of Cardiovascular Disease Burden and Concussion History on Cognitive Function in Older Former National Football League Players.

Objective:Traumatic brain injury and cardiovascular disease (CVD) are modifiable risk factors for cognitive decline and dementia. Greater concussion history can potentially increase risk for cerebrovascular changes associated with cognitive decline and may compound effects of CVD. We investigated the independent and dynamic effects of CVD/risk factor burden and concussion history on cognitive function and odds of mild cognitive impairment (MCI) diagnoses in older former National Football League (NFL) players.Participants and Methods:Former NFL players, ages 50-70 (N=289; mean age=61.02±5.33 years), reported medical history and completed the Brief Test of Adult Cognition by Telephone (BTACT). CVD/risk factor burden was characterized as ordinal (0-3+) based on the sum of the following conditions: coronary artery disease/myocardial infarction, chronic obstructive pulmonary disease, hypertension, hyperlipidemia, sleep apnea, type-I and II diabetes. Cognitive outcomes included BTACT Executive Function and Episodic Memory Composite Z-scores (standardized on age- and education-based normative data), and the presence of physician diagnosed (self-reported) MCI. Concussion history was discretized into five groups: 0, 1-2, 3-5, 6-9, 10+. Linear and logistic regression models were fit to test independent and joint effects of concussion history and CVD burden on cognitive outcomes and odds of MCI. Race (dichotomized as White and Non-white due to sample distribution) was included in models as a covariate.Results:Greater CVD burden (unstandardized beta [standard error]; B=-0.10[0.42], p=.013, and race (B=0.622[0.09], p&lt;.001), were associated with lower executive functioning. Compared to those with 0 prior concussions, no significant differences were observed for those with 1-2, 3-5, 6-9, or 10+ prior concussions (ps &gt;.05). Race (B=0.61[.13], p&lt;.001), but not concussion history or CVD burden, was associated with episodic memory. There was a trend for lower episodic memory scores among those with 10+ prior concussion compared to those with no prior concussions (B=-0.49[.25], p=.052). There were no significant differences in episodic memory among those with 1-2, 3-5, or 6-9 prior concussions compared to those with 0 prior concussions (ps&gt;.05). CVD burden (B=0.35[.13], p=.008), race (greater odds in Non-white group; B=0.82[.29], p=.005), and greater concussion history (higher odds of diagnosis in 10+ group compared to those with 0 prior concussions; B=2.19[0.78], p&lt;.005) were associated with higher odds of MCI diagnosis. Significant interaction effects between concussion history and CVD burden were not observed for any outcome (ps &gt;.05).Conclusions:Lower executive functioning and higher odds of MCI diagnosis were associated with higher CVD burden and race. Very high concussion history (10+) was selectively associated with higher odds of MCI diagnosis. Reduction of these modifiable factors may mitigate adverse outcomes in older contact sport athletes. In former athletes, consideration of CVD burden is particularly pertinent when assessing executive dysfunction, considered to be a common cognitive feature of traumatic encephalopathy syndrome, as designated by the recent diagnostic criteria. Further research should investigate the social and structural determinants contributing to racial disparities in long-term health outcomes within former NFL players.

Arthroscopic Labral Reconstruction With a Modified Inferior Capsular Shift Allows Return to Sport and Excellent Outcomes in Contact and Noncontact Athletes With Anterior Shoulder Instability at Minimum 5-Year Follow-Up

PurposeTo compare return to sport, functional outcomes, recurrence of instability, and osteoarthritis(OA) between collision/contact and limited/non-contact athletes following arthroscopic labral reconstruction with a modified inferior capsular shift for anterior shoulder instability. MethodsAthletes underwent an arthroscopic labral reconstruction with a modified inferior capsular shift, by the senior author between 1999 and 2017. Inclusion criteria were labral stripping from 12(just beyond the biceps anchor) to 6 o’clock, less than 20% glenoid bone loss, active sports participation, and no prior surgery. Athletes were divided into collision/contact and limited/non-contact groups. Outcome measures, physical examination, and radiographic evaluation were collected at a minimum 5-year follow-up. Re-operations or any subjective laxity were considered failures. Radiographs were analyzed for OA utilizing Samilson-Prieto Radiological Classification. ResultsNinety-two patients underwent arthroscopic labral reconstruction with a modified inferior capsular shift. Sixty-four met the inclusion criteria. Thirty-eight(age=26.0±8.0 years) participated in at least one collision/contact sport, and 26(age=38.0±9.0 years) participated in limited/non-contact sports. Two(5%) collision/contact and 3(12%) limited/non-contact athletes had traumatic re-injury requiring revision surgery. Of the remaining athletes (59/64), minimum 5-year follow-up was obtained on 54(92%) with a mean follow-up of 12±4 years(range 5 to 23 years). All athletes returned to their original sport at the same level. There was no significant difference between collision/contact and limited/non-contact athletes in timing of return to sports (5.2±1.9 and 6.0±3.1 months, respectively; p=0.389). There were no significant differences between groups on any outcomes scores. ConclusionArthroscopic labral reconstruction with a modified inferior capsular shift addressed anterior instability with return to sport for both collision/contact and limited/non-contact athletes with excellent functional and clinical outcomes, full shoulder ROM, and a low prevalence of advanced OA at minimum 5-year follow-up. This modified technique resulted in a low failure rate in both limited/non-contact and collision/contact athletes.

Effects of Flavonoid Supplementation on Athletic Performance in Healthy Adults: A Systematic Review and Meta-Analysis.

Flavonoids, known for their antioxidant properties, can prevent reactive oxygen species (ROS) and influence athletic performance through various physiological and metabolic mechanisms. However, there are conflicting results after summarizing and analyzing the relevant literature. Hence, it is warranted to evaluate the overall impact of flavonoids on athletic performance in healthy adults based on a comprehensive and systematic review and meta-analysis. After searching four databases for literature published since their respective establishments until February 2023 and conducting publication bias and quality assessments, a total of 22 studies were ultimately included. The names and doses of flavonoids, various outcome measurements, as well as types of training, were extracted from included studies. The athletic performance outcomes from the included studies were categorized into 'performance tests' and 'exercise tolerance,' depending on the type of training undertaken. Several statistical results, such as pooled effect size (ES), among others, were implemented by meta-analysis using the random effects model. The results of meta-analysis suggest that there is currently sufficient evidence (ES = -0.28; 95% confidence interval (CI): [-0.50, -0.07]; p = 0.01 and ES = 0.23; 95% CI: [0.07, 0.39]; p = 0.005) to support the notion that flavonoid supplementation enhanced athletic performance in performance tests and exercise tolerance. In addition, among the subgroups, nonsignificant results were observed for athletes (p = 0.28) and acute supplementation (p = 0.41) in performance tests, as well as athletes (p = 0.57) and acute supplementation (p = 0.44) in exercise tolerance. Meanwhile, significant results were found for non-athletes (p = 0.04) and long-term supplementation (p = 0.02) in performance tests, as well as non-athletes (p = 0.005) in performance tests and long-term supplementation (p = 0.006) in exercise tolerance. The nonsignificant results were likely due to the limitation in the number of related papers, sample sizes, optimal dosage, duration, type of flavonoids, and other factors. Therefore, future research should focus on further investigating these relationships with larger sample sizes, optimal dosage, duration, and type of flavonoids to provide more robust conclusions.