Participation In High-risk Sports Research Articles

Anterior Glenohumeral Instability

➢ Anterior glenohumeral instability is a complex orthopaedic problem that requires a detailed history, a thorough physical examination, and a meticulous review of advanced imaging in order to make individualized treatment decisions and optimize patient outcomes.➢ Nonoperative management of primary instability events can be considered in low-demand patients, including elderly individuals or younger, recreational athletes not participating in high-risk activities, and select in-season athletes. Recurrence can result in increased severity of soft-tissue and osseous damage, further increasing the complexity of subsequent surgical management.➢ Surgical stabilization following primary anterior instability is recommended in young athletes who have additional risk factors for failure, including participation in high-risk sports, hyperlaxity, and presence of bipolar bone loss, defined as the presence of both glenoid (anteroinferior glenoid) and humeral head (Hill-Sachs deformity) bone loss.➢ Several surgical treatment options exist, including arthroscopic Bankart repair with or without additional procedures such as remplissage, open Bankart repair, and osseous restoration procedures, including the Latarjet procedure.➢ Favorable results can be expected following arthroscopic Bankart repair with minimal (<13.5%) bone loss and on-track Hill-Sachs lesions following a primary instability event. However, adjunct procedures such as remplissage should be performed for off-track lesions and should be considered in the setting of subcritical glenoid bone loss, select high-risk patients, and near-track lesions.➢ Bone-grafting of anterior glenoid defects, including autograft and allograft options, should be considered in cases with >20% glenoid bone loss.

Psychological transformation of the ‘self’ towards eco-sensitivity through high-risk nature-based sports: a South African context

ABSTRACT Mindless actions in the form of environmentally degrading behaviour constantly threaten the sustainability of healthy ecosystems. In this paper, the intrinsic value of strengthening the bond between humanity and nature through high-risk nature-based sports participation is explored. This interpretative phenomenological analytical study considers lived experiences of 10 skilled South African high-risk nature-based sports participants who take calculated risks through precautionary measures. Participant’s activities are performed in the wilderness in isolation from civilisation with minimal availability of human and medical resources in case of an emergency, which give rise to the term ‘high-risk.’ Phenomenological traditions from Heidegger and Merleau-Ponty navigate a hermeneutical understanding of theirbodily-being-towards-death. Evidence of meaningful psychological transformation towards an eco-sensitivity by way of high-risk nature-based sports participation is analysed, through first-hand narratives via semi-structured interviews. The sensitizing process of the ‘self’ can be effectively articulated in the synchronous relationship between the Eigenwelt, Mitwelt and Umwelt.

Agentic emotion regulation in high-risk sport: An in-depth analysis across climbing disciplines

Research has now debunked the standpoint that high-risk sports participants are a homogenous group of sensation seekers (Barlow et al., 2013); the process of agentic emotion regulation is a primary motive for high-engagement high-risk sports (i.e., mountaineering). The evidence, however, remains cross-sectional, and there is currently no evidence to support the timeline of this process. We aimed to bridge that gap by investigating the process of agentic emotion regulation over three post-participation time points across different disciplines of climbing that vary in risk and objective danger. Emotion regulation is the process by which individuals alter the nature, intensity, and duration of their emotions (Gross, 2008). Agency refers to individuals' perceived control over their internal beliefs, desires, intentions, and actions (Bandura, 1997). The results from two retrospective (n = 161, n = 134) studies and one longitudinal (n = 45) study revealed that those who engage in high-risk forms of climbing (i.e., traditional climbing) experience a greater increase in agency and emotion regulation difficulty after participation than individuals who participate in lower-risk forms of climbing (i.e., sport climbers) and other relatively low-risk sports (i.e., swimming). This research supports the benefits of high-risk activities for regulating participants' agentic emotion regulation difficulties.

Graft Failure in Adolescent Patients Undergoing Adult-Type ACL Reconstruction with Bone Patellar Tendon Bone or Hamstring Autograft

Introduction:Anterior cruciate ligament (ACL) injuries represent a quarter of high school knee injuries. Adult-type ACL reconstruction (ACL-R) is the treatment of choice for skeletally mature adolescent patients with a complete ACL tear. Graft choice is individualized to the patient, taking into account the patient’s anatomy, activity level, and athletic participation. This subset of patients is at perhaps the highest risk of failure due to demands on the reconstruction after surgery.Hypothesis/Purpose:The purpose of this study was to evaluate outcomes including graft rupture between bone-patellar tendon-bone (BTB) versus hamstring autograft in adolescent patients undergoing adult-type ACL reconstruction.Methods:A retrospective review of patients under the age of 21 undergoing primary adult-type ACL-R by a single surgeon using BTB or hamstring autograft between 2011 and 2019 was performed. Patient demographics, athletic participation, concomitant injuries, graft utilized, graft size, femoral and tibial fixation devices, compliance with rehabilitation protocol, complications, and rates of revision surgery were evaluated. Factors associated with graft failure were compared using Fisher’s exact test with statistical significance < 0.05.Results:269 patients with an average age of 16.5 years (range 12.4-20.6) and an average follow-up of 2.1 years (range 0.4-6.6 years) were included. 52.5% of the patients were female. The overall graft rupture rate was 4.8%. There was no difference in average age, sex, compliance, and participation in high risk sports between graft type groups. Graft size was larger in patients with BTB autograft than patients with hamstring autograft (9.0 vs. 8.3; p<.001). There was no difference in the overall rate of re-operation between BTB and hamstring autografts (8.6% vs. 10.6%; p=0.81). There was no significant difference in rate of graft rupture with BTB and hamstring autograft (2.9% vs. 5.5%; p=0.26). Average time to revision surgery in those with ruptures was 1.7 years (range 0.7-4.7 years). 46% of patients had revision ACL-R with a different surgeon. There was no difference in age or participation in high risk sports between patients with and without graft tear. There was a higher percentage of documented compliance issues in patients with graft tear (46%) than without graft tear (29%), though not statistically significant (p=0.17).Conclusion:Rates of graft tear after ACL-R did not differ with BTB versus hamstring autograft. Rates of compliance and participation in high risk sports did not significantly differ in patients with and without graft tear. Many patients had a change in surgical provider for revision surgery.

Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports

Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports The age of adolescence represents an enhanced reward sensitivity which is often linked to increased risk-taking behaviour. Peers enhance risk-taking behaviour which is shown through delinquency and substance use. Whereas most research on adolescent risk-taking has been directed towards negative risk-taking, this narrative review tries to highlight adventure and high-risk sport participation as a prosocial form of risk-taking and its potential influence on adolescents' behaviour. Adventure/high-risk sports such as mountainbiking, freeride ski and snowboarding and climbing have grown exponentially in the last years with a high popularity among adolescents. Besides the inherent risk of severe injury in case of a mismanaged accident, which should be minimized by preventive steps such as educative risk-management and protective gear, those sports bear the potential for multiple psychological benefits such as enhanced mood, autonomy, resilience and self-efficacy. Adventure/high-risk sports seem to have the possibility to satisfy the need for rewards, prestige and risk-taking in a socially accepted way. Few research projects have already successfully integrated adventure sport interventions in clinical settings in mental health treatment. The idea of testing adventure/high-risk sport interventions as an addition to the treatment in child and adolescent psychiatry and psychotherapy could be promising and an impulse for future research projects.

ImPACT in UK motorsport; is this the right concussion assessment for our drivers?

ObjectiveTo investigate the proportion of learning difficulties in UK motorsport competitors and the effect on ImPACT scores at baseline.BackgroundMotorsport competitors have a higher risk of concussion compared to other high-risk sports participants (Deakin et al.). The current worldwide gold standard for management in motorsport is the completion of baseline and post-injury ImPACT, however there has been no formal validation for this population.Design/MethodsThis is a retrospective analysis of a prospectively-maintained database cohort, in which demographic and neurocognitive data are archived. The submission includes TOCA competitors aged 14 years and above who completed baseline ImPACT assessments between June 2016-October 2018.Results229 drivers completed baseline ImPACT across three racing seasons in six UK-based championships. Drivers had 0–25 yrs experience at their current level (1.69 +/− 3.0) and the majority were semi-professional (52.4%). 97% of drivers were male and 89% were right-handed. Drivers had completed 8–20+ years of education (12.17 +/− 2.35) at the time of assessment. Almost a fifth had a formal diagnosis of dyslexia (16.6%). When comparing non-diagnosed to dyslexic drivers there was significantly poorer performance on verbal, visual and visual motor composite scores (t3.2, p &lt; 0.05; t3.6, p &lt; 0.001; t4.3, p &lt; 0.001; respectively) and non-significant effect on reaction time (t1.4, p &gt; 0.05).ConclusionsThis motorsport cohort exhibits a higher prevalence of dyslexia than the general population (16.6% vs. 10%), with dyslexic drivers performing significantly worse at baseline on most composite scores. Future post-injury analyses will indicate whether ImPACT is sensitive to the diagnosis of concussion in this unique sporting group.

Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand.

Anterior cruciate ligament injuries cause significant morbidity, and may be increasing in incidence as participation in high-risk sports increases. The aim of this study is to investigate the incidence of anterior cruciate ligament reconstruction (ACLR) surgery in New Zealand, and to analyse changes over time in demographic subgroups. Data were sourced from the Accident Compensation Corporation. Data relating to primary ACLRs performed from 2009 to 2016 were evaluated (n = 20 751). Baseline population estimates were obtained from national census data to calculate the incidence, and results were compared to previous data from 2000 to 2005 (n = 7375). The annual incidence of ACLR for 2009-2016 was 58.2 per 100 000 person-years and was greater in males than in females (72.2 and 44.9, respectively). This represents a 58% increase when compared with the period 2000-2005 (36.9 per 100 000). The greatest increase was seen in females aged 15-19 years, with the incidence increasing by 120% in the last decade, compared with 53% in females aged 20-24 years. The percentage of injuries caused by sports changed from 65% over 2000-2005 to 76% over 2009-2016, with netball, rugby and football accounting for the highest number of injuries. The incidence of ACLR procedures has increased markedly in New Zealand, and this increase was most pronounced in females aged 15-19 years. A greater proportion of procedures are now due to sport-related injuries.

Risk can be good for self-esteem: beyond self-determination theory

Despite many decades of research that has highlighted all risk-taking sport activities as a means to satisfy sensation seeking needs (e.g., Zuckerman 1979), recent research has challenged that view and has revealed that some high-risk activities provide opportunities for agentic emotion regulation during participation, and are not driven by sensation-seeking needs (e.g., Barlow, Woodman, and Hardy 2013). Participation in high-risk sports is also associated with increased self-esteem (e.g., Aşçi, Demirhan, and Dinç 2007). The aim of the present study was to investigate the link between the agentic and emotion regulation benefits of specific high-risk activities and any associated self-esteem benefits. We hypothesized that the emotion regulation and agency experiences in high-risk physical activities would mirror the elevated self-esteem derived from these activities. We examined high-risk activity (n = 84), low-risk activity (n = 65), and control (n = 45) groups and found that the experience of agentic emotion regulation was greater during participation for high-risk sport participants. High-risk sport participants also had less post-activity difficulty with emotion regulation and higher self-esteem. This study provides the first support that activities that require greater agentic emotion regulation during participation also lead to elevated self-esteem. Basic psychological needs satisfaction did not account for the differences between groups, suggesting that people have other needs (e.g., the need to self-regulate) that are not incorporated into self-determination theory.

Personality traits of high-risk sport participants: A meta-analysis

The purpose of this meta-analysis was to examine the relationships between personality traits and participation in high-risk sport. A total of 149 effect sizes from 39 eligible articles were obtained wherein the personality traits of high-risk sport participants were compared with either low-risk sport participants or individuals not engaged in any sport. Results revealed significant effect sizes in favor of the high-risk participants for sensation seeking, extraversion, and impulsivity. Significant effect sizes in favor of the comparator groups were found for neuroticism, telic dominance, and sensitivity to punishment. No significant differences were observed in psychoticism, sensitivity to reward, socialization, agreeableness, conscientiousness, or openness. The implications of these results and potential avenues of future research are highlighted.

Structural validation of three German versions of behavioral and motivational scales in high-risk sports

The aim of the present research was to validate German language versions of three inventories in high-risk sports to facilitate future research in the significant population of German speaking high-risk sports participants. We translated the Sensation Seeking, Emotion Regulation and Agency Scale (SEAS), the Risk-Taking Inventory and the Accidents and Close Calls in Sport Inventory into German, then tested the hypothesized factor structures with 719 high-risk sport participants from the European Alps using Bayesian structural equation modelling (BSEM). The final models were all good fits to the data, had good internal consistency and displayed adequate discriminant validity. All inventories displayed the same factor structure as in the English inventories bar the G‑SEAS After inventory in which a three-factor model fitted better than a two-factor model. Possible reasons for this difference include differences in the sample population, translation bias, or cross-cultural differences; however it seems likely that the nuanced approach of BSEM allowed this study to disentangle emotion regulation transfer from agency transfer after participating in high-risk sport where previous attempts using other methods have failed to. This will allow future research in high-risk sport to be conducted beyond English speaking populations and more significantly, facilitate the investigation of differences between the transfer effects of agency and emotion regulation.

A history of sport-related concussion is associated with sustained deficits in conflict and error monitoring.

Previous research has demonstrated long-term deficits in neurocognitive function in individuals with a history of sport-related concussion. The purpose of this study was to examine the relationship between a history of concussion and behavioral and event-related potential (ERP) indices of pre- and post-response conflict and error monitoring. A secondary aim was to determine whether years of high risk sport participation were related to impairments in these cognitive control processes. Forty-seven former athletes (age = 20.8 ± 2.2 years) with (n = 25; 5 females) and without (n = 22; 9 females) a history of concussion completed a modified flanker task while behavioral performance, N2, error-related negativity (ERN), and error positivity (Pe) components were assessed. An increase in post-response error-related (ERN) brain activity and a nonsignificant trend of increased pre-response conflict (N2) was observed in individuals with a prior sport-related concussion relative to non-concussed controls; however, no behavioral performance differences were found between groups. No significant associations were found between ERP and behavioral measures and the number of years of high-risk sport participation; however, time since last head injury was associated with shorter N2 latency. Together, these findings suggest a persistent impairment in cognitive control and error-related processing in individuals with a history of concussion. These findings are interpreted within the framework of the compensatory error-monitoring hypothesis.

German Language Version and Validation of the Risk-Taking Behaviour Scale (RBS-K) for High-Risk Sports

High-risk sports, particularly climbing, kayaking and extreme skiing, have become increasingly popular. The most widely used psychological survey instrument with regard to risk behaviour in sports is the Sensation Seeking Model, mostly assessed by the Sensation Seeking Scale (SSS-V). Until recently, the literature discussed risk behaviour solely through this model. However, this scale does not measure risk-taking behaviours. In contrast, the Risk-Taking Behaviour Scale (RBS-K) is a three-item scale that measures risk behaviour in high-risk sports. This study aimed to validate a German language version of the RBS-K. The RBS-K was translated and back-translated between English and German. High-risk sports participants (n = 2399) completed the German version of the RBS-K. Of those participants, 820 completed the RBS-K in person as part of a field survey and 1579 participated in an online survey. To validate the questionnaire, the SSS-V, accident involvement, age and sex were evaluated. The RBS-K divides the sample into deliberate risk takers (mean + standard deviation) and risk-averse persons (mean - standard deviation). We tested for internal consistency and correlations with SSS-V, age, sex and accident involvement. Group differences were calculated between deliberate risk takers and risk-averse persons. For internal consistency, we obtained a Cronbach's alpha of 0.56 and a McDonald's omega of 0.63. Significant correlations were shown between RBS-K and SSS-V as well as age and sex. Compared to risk-averse persons (n = 643, 26.8 %), deliberate risk takers (n = 319, 13.3 %) scored significantly higher in sensation seeking, were significantly younger and primarily male and had a significantly higher accident involvement. The RBS-K discriminates well for age, sex and accident involvement. Also, correlations between the RBS-K and the well-established SSS-V are acceptable. With regard to the results and its compact design, the scale seems to be well suited for field surveys. We discuss the relatively modest internal consistency in the context of the small number of items and the different dimensions of risk-taking.

Comparison of four alternative national universal anterior cruciate ligament injury prevention programme implementation strategies to reduce secondary future medical costs

Background/aimAnterior cruciate ligament (ACL) injury is a common and devastating sporting injury. With or without ACL reconstruction, the risk of knee osteoarthritis (OA) and permanent disability later in life is...

Motivational orientation and risk taking in elite winter climbers: A qualitative study

Objectives: High-risk sports participants have typically been viewed as a homogeneous group despite variability in performance characteristics and the level of risk undertaken. Prolonged engagement high-risk sports such as winter climbing are relatively underserved within current literature. Elite winter climbers attempt climbs that are outside the scope of the current “known”, i.e. unclimbed routes. The majority of the current understanding of motivation in high-risk sports is based on quantitative research and the methodologies and instruments used. The purpose of this study was to explore the experiences of elite winter climbers and gain a richer understanding of their motivational orientation and risk-taking behaviour. Design: Qualitative–inductive. Method: Four elite male winter climbers (aged 42–49 years old) took part in semi-structured interviews and explore their motivational orientation and risk-taking behaviour. A thematic analysis was used. Results: Two superordinate themes of enactive mastery and engendered disinhibition emerged from the data. Enactive mastery was interpreted as a composite of two higher-order themes: Task mastery and self-mastery. Engendered disinhibition was interpreted as a composite of two higher-order themes: Social cognitive appraisal and self-perception. Conclusion: Enactive mastery and engendered disinhibition emerged as key behavioural and psychological determinants that influenced individuals to attempt more difficult and riskier forms of winter climbing. Goal achievement was their primary motive which was set within a confidence frame encapsulated within these superordinate themes.

Interventions preventing ankle sprains; previous injury and high-risk sport participation as predictors of compliance.

To describe the association between participants' person-related potential predictor variables and cumulative compliance with interventions for preventing ankle sprains: neuromuscular training, wearing an ankle brace, and a combined training and bracing. Secondary analysis of compliance data from a randomized controlled trial (RCT) comparing measures preventing ankle ligament injuries. Ordinal regression with a backward selection method was used to obtain a descriptive statistical model linking participants' person-related potential predictor variables with the monthly cumulative compliance measurements for three interventions preventing ankle ligament injuries. Having had a previous ankle injury was significantly associated with a higher compliance with all of the preventive measures trialed. Overall compliance with bracing and the combined intervention was significantly lower than the compliance with NM training. Per group analysis found that participating in a high-risk sport, like soccer, basketball, and volleyball, was significantly associated with a higher compliance with bracing, or a combined bracing and NM training. In contrast, participating in a high-risk sport was significantly associated with a lower per group compliance with NM training. Future studies should include at least registration of previous ankle sprains, sport participation (high- or low-risk), experience in NM training, and hours of sport exposure as possible predictors of compliance with interventions preventing ankle sprains. Practitioners should take into account these variables when prescribing preventive neuromuscular training or bracing.

A comparison of genetic variants between proficient low- and high-risk sport participants

Athletes participating in high-risk sports consistently report higher scores on sensation-seeking measures than do low-risk athletes or non-athletic controls. To determine whether genetic variants commonly associated with sensation seeking were over-represented in such athletes, proficient practitioners of high-risk (n = 141) and low-risk sports (n = 132) were compared for scores on sensation seeking and then genotyped at 33 polymorphic loci in 14 candidate genes. As expected, athletes participating in high-risk sports score higher on sensation seeking than did low-risk sport athletes (P < .01). Genotypes were associated with high-risk sport participation for two genes (stathmin, (P = .004) and brain-derived neurotrophic factor (P = .03)) as well as when demographically matched subsets of the sport cohorts were compared (P < .05); however, in all cases, associations did not survive correction for multiple testing.

Risk-taking and impulsive personality traits in proficient downhill sports enthusiasts

Although past studies have examined how personality traits may motivate participation in high-risk sports, few previous studies have examined impulsive personality correlates with risk-taking within a group of sports enthusiasts. We examined relationships between measures of personality and risk-taking on the slopes as measured by a sport-specific Sensation Seeking Scale in a sample of proficient-level skiers and snowboarders (N=123, 61% male). Significant correlations were found between risk-taking and multiple traits including Reward Sensitivity, Punishment Sensitivity, and Sensation Seeking, implying that some traits that motivate participation in high-risk sports also lead to more risky behavior while participating in said sports. Rash Impulsivity, though not found to distinguish participants from non-participants in previous studies, did correlate with risk-taking behavior on the slopes. The results of this study show that while some aspects of impulsive personality may motivate risky sport participation, other traits may be related to risky behavior once engaged in the sport.

Concussion History and Years of High-Risk Sport Participation on Cognitive Control

Concussion History and Years of High-Risk Sport Participation on Cognitive Control

Personality and risky downhill sports: Associations with impulsivity dimensions

Studies show high-risk sports participants report higher levels of Sensation Seeking compared to non-participants, but few have explored other aspects of impulsivity. Using principal component scores to summarize measures of Reward Sensitivity, Punishment Sensitivity, and Rash Impulsivity we compared downhill sport participants (both beginner and proficient) to non-participants in an undergraduate sample (N=279, 50% female). Downhill sport participants scored significantly higher on Reward Sensitivity, possibly driven by the anticipatory approach facets of the BAS, and proficient participants scored significantly lower on Punishment Sensitivity than beginners and non-participants, driven by traits related more closely to fear than anxiety. No differences were found in Rash Impulsivity. Popular high-risk sports may serve as an important example of an exception to the co-occurrence of common impulsive traits.

Not All Risks Are Equal: The Risk Taking Inventory for High-Risk Sports

Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.