Collegiate Athletic Population Research Articles

Are NCAA Division I Athletes Prepared for End-of-Athletic-Career Transition? A Literature Review

ABSTRACTObjective: This review focuses on research that specifically highlights the constructs, paradigms, and factors that impact the end-of-athletic-career transition. However, the majority of the research conducted around this topic is established outside of the United States and regarding professional athletes. The National Collegiate Athletic Association (NCAA) is one of the most dominant athletic institutions in the world, and arguably transitions the most end-of-athletic-career athletes per year, and minimal research exists on this specific collegiate athletic population. The purpose of this review is to review the existent literature on this topic and highlight the leading research and components impacting athletes during the end-of-athletic-career transition in order to inform future research and practices with the college athletics population. Method: This review utilizes a Client Oriented Practical Evidence Search question as an Evidence Based Practice approach to guide the literature search and literature review process while identifying the leading research contributing to end-of-athletic-career transition. Results: Following rigorous search criteria, a total of 14 articles were included in the literature review. The selected articles identified central constructs impacting the athletic career transition process, including retirement planning, identity loss, coping skills, and support systems. Conclusion: Additional research is warranted in the United States, particularly with the NCAA collegiate athletes in order to better understand the end-of-athletic-career transition process, as well as instituting interventions to increase resilience in college senior NCAA athletes transitioning out of sport.

Elbow Dislocation and Subluxation Injuries in the National Collegiate Athletic Association, 2009-2010 Through 2013-2014.

Background:Examination of the incidence of elbow dislocation and subluxation injuries in the collegiate athlete population is limited.Purpose:To determine the incidence of elbow dislocation and subluxation injuries in the National Collegiate Athletic Association (NCAA) and investigate the risk factors involved.Study Design:Descriptive epidemiology study.Methods:All elbow subluxation and dislocation injuries from the 2009-2010 through 2013-2014 academic years in the NCAA Injury Surveillance Program database were extracted. The incidence was calculated for different injuries, sports, activity, time in game, competition status, and injury characteristics. Such differences were compared by use of risk ratios to determine risk factors for injury.Results:The overall incidence of elbow instability injuries was 0.04 per 10,000 athlete-exposures (AEs). Elbow dislocations were more common, with 553 injuries (82.2%, 0.03/10,000 AEs), while elbow subluxations were the minority, with 119 injuries (17.8%, 0.01/10,000 AEs). Men’s wrestling had the highest incidence of elbow instability (1.08/10,000 AEs), more than women’s gymnastics (0.74), men’s football (0.11), and women’s volleyball (0.06). All injuries occurred via a contact mechanism, and 99.2% were new injuries. Sixty-nine percent of injuries kept athletes sidelined for more than 2 weeks. Injuries were 3 times more likely to occur in competition (0.08/10,000 AEs) than practice (0.03/10,000 AEs). Injuries sustained during competition were 1.4 times more likely to occur early in the match than late.Conclusion:Elbow instability injuries are an infrequent but serious source of disability for select NCAA athletes, with a number of associated risk factors. Athletes sustaining these injuries, along with their coaches and medical providers, may benefit from these return-to-play data to best manage expectations and outcomes.

Lower Quarter Y-Balance Test Scores and Lower Extremity Injury in NCAA Division I Athletes.

Background:Functional movement tests that are predictive of injury risk in National Collegiate Athletic Association (NCAA) athletes are useful tools for sports medicine professionals. The Lower Quarter Y-Balance Test (YBT-LQ) measures single-leg balance and reach distances in 3 directions.Purpose:To assess whether the YBT-LQ predicts the laterality and risk of sports-related lower extremity (LE) injury in NCAA athletes.Study Design:Case-control study; Level of evidence, 3.Methods:The YBT-LQ was administered to 294 NCAA Division I athletes from 21 sports during preparticipation physical examinations at a single institution. Athletes were followed prospectively over the course of the corresponding season. Correlation analysis was performed between the laterality of reach asymmetry and composite scores (CS) versus the laterality of injury. Receiver operating characteristic (ROC) analysis was used to determine the optimal asymmetry cutoff score for YBT-LQ. A multivariate regression analysis adjusting for sex, sport type, body mass index, and history of prior LE surgery was performed to assess predictors of earlier and higher rates of injury.Results:Neither the laterality of reach asymmetry nor the CS correlated with the laterality of injury. ROC analysis found optimal cutoff scores of 2, 9, and 3 cm for anterior, posteromedial, and posterolateral reach, respectively. All of these potential cutoff scores, along with a cutoff score of 4 cm used in the majority of prior studies, were associated with poor sensitivity and specificity. Furthermore, none of the asymmetric cutoff scores were associated with earlier or increased rate of injury in the multivariate analyses.Conclusion:YBT-LQ scores alone do not predict LE injury in this collegiate athlete population. Sports medicine professionals should be cautioned against using the YBT-LQ alone to screen for injury risk in collegiate athletes.

Neuropsychological Testing in Mild Traumatic Brain Injury: What to Do When Baseline Testing Is Not Available.

Barth and colleagues' seminal study using baseline neuropsychological testing as a model for sports concussion management serves as the template for many collegiate sports medicine programs. However, there remains a significant need for an evidence-based strategy in cases where no baseline testing has been conducted. In this article, we further articulate such a model based on work with athletes at our Division I university. The foundation of the model involves base rates of impairment in a typical neurocognitive sports concussion battery, with decision rules that differ slightly for males and females. There is flexibility in the model such that its application can start during an acute period postconcussion when athletes are still potentially symptomatic, as well as after athletes self-report being symptom free. We use our population of collegiate athletes and the tests we administer as a framework to provide concrete values to the proposed algorithm based on specific tests, but the logic of our evidence-based model could easily be applied to other sports concussion populations and neurocognitive test batteries. Our proposed neuropsychological concussion management guidelines are evidence based, but also allow for accommodating trends in the literature which suggest that increasingly individualistic clinical concussion management approaches are most prudent.

Association of Lower Quarter Y-Balance Test with lower extremity injury in NCAA Division 1 athletes: an independent validation study

ObjectivesTo determine if the Lower Quarter Y-Balance Test (LQYBT) is predictive of lower extremity injury in NCAA Division 1 athletes. DesignProspective cohort, therapy. ParticipantsOne hundred eighty-nine NCAA Division 1 athletes participated in the study and underwent a preparticipation screen that included the LQYBT. Maximal reach distances were recorded in each direction and normalized to leg length. A composite score was calculated by summing the three normalized reach distances and dividing by three times leg length. Side to side asymmetry was calculated as the lesser of the two composite scores, divided by the greater of the two composite scores, multiplied by 100. Injuries for the following season were tracked and recorded; LQYBT scores were compared between injured and non-injured athletes. ResultsIn our sample, 90 [59 female, 31 male] of the 189 athletes participating suffered a lower extremity injury. No significant differences were found between injured and non-injured athletes for reach distance, normalized reach distance, normalized composite reach distance, or normalized composite percent score (P>0.05). ConclusionsThe LQYBT does not appear to predict general lower extremity injury in a diverse population of NCAA D1 athletes. These results are in direct conflict with previous findings suggesting the LQYBT is predictive of injury suggesting its utility as an injury risk screening tool in a general collegiate athletic population should continue to be questioned.

Assessment of Dietary Vitamin D Intake and Compliance With Recommended Vitamin D Supplementation in Division I Collegiate Athletes

The primary aim of this study was to assess dietary vitamin D intake and compliance with a recommended vitamin D supplementation program in a collegiate athlete population. Subsequently, associations between dietary intake, compliance with supplementation, and 25-hydroxyvitamin D [25(OH)D] levels were investigated. This study retrospectively reviewed vitamin D data for 256 athletes across 13 sports at one NCAA Division I University. Independent variables were gender, skin tone, sport, season of year, dietary intake of vitamin D, and supplementation compliance. The main outcome measure was serum 25(OH)D. Low vitamin D status was defined as 25(OH)D level less than 30 ng/mL. Supplementation was recommended for athletes with low status. In fall, 35.5% of athletes had levels less than 30 ng/mL. Mean 25(OH)D level declined (P < .001) between fall (40.7 ± 7.5 ng/mL) and winter (32.5 ± 7.3 ng/mL) in non-supplemented athletes. Supplementation increased 25(OH)D levels by 8.5 ± 9.5 ng/mL (95% confidence interval: 6.6 to 10.4) in 12 weeks. On average athletes reported moderate compliance, taking approximately half of their prescribed supplements. There was a weak correlation between percent supplement compliance and 25(OH) D levels (r = 0.257, P = .011). Athletes with better vitamin D status had higher intake of milk (among freshmen only, P = .042) and yogurt (among all athletes, P = .025). Increasing dietary intake of vitamin D-rich foods and moderate to good compliance with recommended supplementation may help collegiate athletes improve or maximize their vitamin D status.

Star Excursion Balance Test Performance Varies by Sport in Healthy Division I Collegiate Athletes.

Cross-sectional. To describe performance and asymmetry on the Star Excursion Balance Test (SEBT) by sex and sport, and to determine if differences exist within a collegiate athlete population. Performance on the SEBT may differ between sexes and levels of competition, though the results of previous studies have been inconsistent. Investigation of performance and asymmetry differences between sports is limited. Sex- and sport-specific reference values likely need to be determined to best assess SEBT performance. Performance on the SEBT was retrospectively reviewed in 393 healthy National Collegiate Athletic Association Division I collegiate athletes from 8 sports. Means, standard deviations, and 95% confidence intervals were calculated for all variables. Normalized reach distance (percent limb length) and asymmetry between limbs were compared for the anterior (ANT), posterolateral (PL), and posteromedial (PM) directions and for the composite (COMP) score using a 2-way analysis of variance (ANOVA) of sex by sport, and a 1-way ANOVA to separately compare sports within each sex. Average normalized reach distance ranged from 62% to 69%, 84% to 97%, and 99% to 113% in the ANT, PL, and PM directions, respectively, and from 82% to 92% in the COMP score. Normalized asymmetry ranged from 3% to 4%, 5% to 8%, and 5% to 6% in the ANT, PL, and PM directions, respectively. A significant sex-by-sport interaction (P = .039) was observed in the ANT direction, with a sex effect for soccer players (P<.001; men less than women). Significant differences were observed in the PL and PM directions and in the COMP score among women's teams, with women's ice hockey players reaching the farthest (COMP, 90.0%). Among men's teams, significant differences were observed in all directions and in the COMP score. Men's ice hockey players (COMP, 91.9%) and wrestlers achieved the farthest distances (COMP, 88.8%). Performance on the SEBT varies by team, with a difference between sexes also present for soccer. Performance on the SEBT and potential injury risk should be interpreted within the context of the athlete's sport.

Abstract 15345: Prevalence of Abnormal Preparticipation Screening H&amp;Ps in Collegiate Athletes as Compared to Focused Screening Echocardiography

Introduction: For all competitive athletes, the American Heart Association preparticipation screening (AHA PPS) guidelines recommend a 12 element focused history and physical. Evaluation of an abnormal PPS finding is left to the clinician’s discretion. The correlation between an abnormal PPS finding and structural heart disease is not well documented. A murmur on physical exam is classically used as a tool to identify a multitude of structural heart abnormalities. We propose that the current AHA PPS and specifically, a murmur detected on exam, correlate poorly with true echocardiographic abnormalities in the collegiate athlete population. Methods: A PPS modeled after the AHA guidelines was conducted on all incoming athletes at a single university from 2007 to 2013. All athletes independently underwent a focused screening echo the same day of the exam. PPS examiners were blinded to results of the screening echoes. Data from both screening exams were compared. We report the prevalence of abnormal H&amp;P findings and its relation to structural abnormalities found on focused echo screening. Results: There were 2472 athletes screened. At least one positive PPS element was noted in 655 (26.5%) athletes. Of this group, 24 (3.7%) had an abnormal focused echo. The PPS was normal in 1817 (73.5%) athletes but an abnormal echo was found in 19 of these athletes, indicating 44.2% of all abnormal echoes (N=43) had a negative PPS. Of the athletes with abnormal echo findings, 23 had structural abnormalities classically associated with a murmur. Only four of these athletes had an actual murmur on exam. In total, a murmur was detected in 36 athletes. By echocardiography, 25 (69.4%) had no structural abnormalities, thereby rendering the murmur benign. A murmur consistent with a minor structural abnormality was found in 7 (19.4%) athletes, and a murmur consistent with a significant structural abnormality was found in 4 (11.1%) athletes. Conclusions: The AHA PPS and specifically, a murmur on exam, do not reliably detect the presence of structural heart disease. An abnormal PPS is rarely associated with structural heart disease and an immediate focused echo can rapidly determine this and eliminate the need for further cardiac evaluation.

Experiences and Attitudes of Collegiate Athletic Trainers Regarding Alcohol-Related Unintentional Injury in Athletes

Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population. To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care. Cross-sectional study. Web-based survey. A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9. We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010-2011 academic year. The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010-2011 academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student-athletes with alcohol-related problems. Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it.

Sunscreen use and availability among female collegiate athletes

Each year more than 250,000 athletes participate on National Collegiate Athletic Association (NCAA) teams. The majority of outdoor NCAA athletes, however, do not use sunscreen on a daily basis. Previous research notes that sunscreen availability represents the main barrier to use among collegiate athletes. We sought to explore the effect of sunscreen availability on its application among outdoor collegiate athletes. Participants (n = 83) on NCAA Division IA female golf teams were randomized to form treatment and control groups. Treatment group players placed study-supplemented sunscreen in their golf bags and locker rooms during the study period. Both groups completed self-administered surveys at the beginning and end of the 4-week investigation. The athletes for whom sunscreen was placed in the locker room and bags exhibited a statistically greater use of sunscreen at the end of the study compared with the control group (P = .01). Provision of readily available sunscreen in the locker room resulted in an average of 1.13 more days per week of sunscreen use, after adjustment for baseline use (P = .008). In addition, players with ready access to sunscreen during competitions increased their reapplication, although not significantly, by nearly 20% (P = .10). Sunscreen reapplication during practice did not change for either group. Future investigations should target a larger population of both male and female outdoor collegiate athletes. The application of sunscreen increased significantly when athletes had easy access to sunscreen during practice and competition. These findings highlight a major opportunity to improve sun-protective behaviors among this vulnerable population.

Exploring the Relationship Between Goal Achievement Orientation and Mindfulness in Collegiate Athletics

Nicholls’ achievement goal theory suggests that a task-oriented individual sets goals based on a desire to master particular skills or tasks (Nicholls, 1984, 1989), thus promoting intrinsic motivation (Duda, Chi, Newton, &amp; Walling, 1995). An ego-oriented individual evaluates one’s own performance against the performance of others with comparable skill sets, basing success on outperforming the opponent (Nicholls, 1984, 1989), resulting in low intrinsic motivation. Cognitive evaluation theory, embraced within self-determination theory (Deci &amp; Ryan, 1985, 1991), suggests that an event that satisfies an inherent need for competence and autonomy leads to increased intrinsic motivation (Standage, Duda, &amp; Pensgaard, 2005). Similarly, Brown and Ryan (2003) found that trait-mindfulness predicted more autonomous activity in day-to-day life and lower intensity and frequency of negative affect. It was therefore hypothesized that in a population of collegiate athletes, a relationship between mindfulness and goal orientation would exist; athletes higher in task-orientation would be more mindful than athletes higher in ego-orientation. Results indicate that a relationship does in fact exist between the Acting with Awareness subscale of the Kentucky Inventory of Mindfulness Skills (KIMS; Baer, Smith, &amp; Allen, 2004) and task-orientation, in that as level of awareness increases, the level of task-orientation also increases. Level of awareness also predicted level of task orientation in athletes. Implications for practice and future research are discussed.

Relationship Of Total Energy Intake To Body Mass Index In Collegiate Female Athletes

PURPOSE: To determine the relationship between total energy intake of female collegiate lacrosse players, soccer players, cross-country runners and controls to body mass index (BMI) within the respective athletes competitive season. METHODS: Participants were 27 lacrosse players, 28 soccer players, 14 crosscountry runners and 104 non-athlete controls. Participants completed a five day dietary record for 3 weekdays and 2 weekend days during the competitive season. All participants' self-reported height and weight or data was gathered from their respective coaches. Group mean correlations between total energy intake and BMI were performed using the Pearson Product Moment Correlation procedure. RESULTS: Significant positive relationships were found between total energy intake and BMI in cross country runners (p = 0.0043) and controls (p = 0.025). However, no significant relationships were established between total energy intake and BMI in the lacrosse (p = 0.065) and soccer (p = 0.074) populations. CONCLUSIONS: These results indicate that BMI may not be related to total energy intake in sports requiring a higher degree of motor skill development and the inclusion of higher intensity training regimens including heavy resistance training. These athletes may be of a different general body type (mesomorphic) and hence may have greater muscle mass leading to higher BMI scores irrespective of total energy intake. These differences may be important to understand when working with a female collegiate athletic population on energy intake recommendations.

Prevalence of Eating Disorders

PURPOSE: Auxiliary units (color guard, dance line, majorettes) are not commonly considered part of an athletic population; and therefore may have been overlooked in disordered eating research. This study estimated eating disorder prevalence by associated risk characteristics in auxiliary unit members and compared eating disorder characteristics, actual and preferred body image, and anthropometric measurements between females classified as “at risk” and “not at risk” according to Eating Attitudes Test scores (EAT-26). METHODS: A volunteer, cross-sectional study of collegiate auxiliary unit female members during 2005–2006 at 3 National Collegiate Athletic Association Division I institutions in the Southeastern United States participated (n=101). A descriptive survey was used to collect personal information regarding menstrual history, self-reported height and weight. Eating disorder symptoms and characteristics were assessed using the EAT-26, and subjective and preferred body image was assessed by a gender-specific BMI based silhouette matching test (Figural Stimuli). RESULTS: Prevalence in eating disorders was estimated at 29.7% (95% CI: 29.7 ± 0.09). Questionnaire revealed 21% used laxatives, diet pills, or diuretics; 14% reported vomiting to control weight or shape; and 15% reported having a history of amenorrhea. T-test indicated significantly higher scores or measurements for “at risk” group (n= 30) compared to “not at risk” group (n=71) for the EAT-26 total score (18.3±13.6 vs. 5.1±4.1; p<0.01), dieting (16.5±20.4 vs. 3.0±3.5; p<0.01), bulimia (2.4±2.9 vs. 0.86±1.0; p=0.01), hip circumference (100.7±9.5cm vs. 95.7 ±8.7 cm; p=0.01), self-reported weight (64.8±12.2lb vs. 59.8±9. 9lb; p=0.03), measured weight (65.3±12.9lb vs. 59.9±1 0.1lb; p=0.04), difference between measured and preferred weight (6.9±7. 5lb vs. 3.9±4.8 lb; p=0.02), and calculated target or ideal healthy weight (63.9± 0.2lb vs. 58.9±7.8lb;p=0.02). CONCLUSIONS: Prevalence of eating disordered behavior in auxiliary unit members appears similar to the collegiate athletic population validating concerns that auxiliary units are associated with unacceptable prevalence of eating disorders. Results highlight the need to examine and address unhealthy weight management behaviors independent of eating disorder risk.

Ultrasound assessment of spleen size in collegiate athletes

Objectives: To determine normal spleen dimensions in a healthy collegiate athletic population. Methods: 631 Division I collegiate athletes from one university participated in the study. During pre-participation examinations, demographic data...

Alcohol misuse among college athletes: self-medication for psychiatric symptoms?

A collegiate athlete population was surveyed for alcohol abuse as well as self-reported depression, anxiety, and other psychiatric symptoms. This study revealed that in a group of 262 athletes there were 21 percent who reported high alcohol use and problems associated with its use. Significant correlations were found between reported alcohol abuse and self-reported symptoms of depression and general psychiatric symptoms. Subjects with positive depression and psychiatric symptom ratings in the "severe" range had a significantly higher rate of alcohol abuse than subjects who had low depression and low or mild symptom ratings. Conversely, subjects reporting higher rates of alcohol misuse had more psychiatric symptoms. These findings suggest a possible causal link between psychopathology and serious alcohol abuse among college athletes. They also point to the need for routine depression and anxiety screening in college students who are typically beginning a significant exposure to alcohol.

Creatine supplement use in an NCAA Division I athletic program.

To determine the prevalence and pattern of creatine use among varsity athletes at a National Collegiate Athletic Association (NCAA) Division I athletic program. Anonymous descriptive survey. Institutional. Collegiate varsity and junior varsity athletes. Self-reports of creatine use, including pattern of use and dose, source of information on creatine, and expected and perceived effects from creatine use. Surveys were obtained from 93% of 806 eligible athletes. Overall, 68% of athletes had heard of creatine and 28% reported using it. Forty-eight percent of men reported having used creatine as compared with 4% of women. With two exceptions, all men's teams had at least 30% of athletes who reported a history of creatine use. Of athletes that had used creatine, about one-third had first used it in high school. Friends and teammates were the most common sources of creatine information. Increased strength and muscle size were the most common effects the athletes expected and perceived from creatine use. In this population of collegiate athletes, creatine use was widespread among men but was minimal among women. Athletes learned about creatine supplementation primarily from their peers, and substantial numbers began to take creatine while still in high school. Most athletes could not report their dosing of creatine. This study reported findings at one location for one academic year. Studies are needed at multiple locations and over time to further delineate creatine use patterns.

Preparticipation echocardiographic screening for cardiovascular disease in a large, predominantly black population of collegiate athletes

Sudden death in young competitive athletes is most commonly due to underlying cardiovascular disease. Echocardiography has the potential to identify structural cardiovascular abnormalities, such as hypertrophic cardiovascular (HC), that have been incriminated in such events. In this study, echocardiography (2-dimensional and M-mode) was used as a primary screening test to assess 265 Howard University collegiate athletes for cardiovascular disease; 262 (99%) were black. Most athletes (234, 88%) had no definitive echocardiographic evidence off HC or other major cardiovascular diseases, but 30 (11%) had mitral valve prolapse, and 1 other athlete had a small atrial septal defect. In addition, 4 athletes were identified as having mild systemic hypertension. Most athletes (236 of 265) showed normal left ventricular wall thickness of ≤12 mm, but an important minority (29, 11%) had maximal ventricular septal thicknesses off ≥13 mm that could not always be distinguished (by morphology alone) from mild anatomic expressions of nonobstructive HC. Based on this experience, preparticipation athletic screening using echocardiography as the primary test does not appear to be justified on a cost-effective basis. In addition, the substantial minority of subjects with increased wall thickness made clinical interpretation of the echocardtographic findings difficult in individual athletes.