Preseason Assessment Research Articles

Relationship Between Short Sleep Duration and Preseason Concussion Testing.

Baseline, preseason assessment of cognition, symptoms, and balance has been recommended as part of a comprehensive sport concussion management program. We examined the relationship between sleep and baseline test results. We hypothesized that adolescents who slept fewer hours the night before would report more symptoms and perform more poorly on cognitive testing than students who had a full night sleep. Cross-sectional observation study. Preseason concussion testing for high school athletes. A large sample (n = 2928) of student athletes from Maine, USA, between the ages of 13 and 18 years completed preseason testing. Participants with developmental problems, a history of treatment for neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded. Athletes were divided into 4 groups based on their sleep duration the night before testing. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) cognitive composite scores and the embedded Post-Concussion Symptom Scale. Sleep was not related to any ImPACT cognitive composite score, after covarying for age and controlling for multiple comparisons. In contrast, there were sleep duration, sex, and sleep duration by sex effects on the Post-Concussion Symptom Scale. The effect of sleep duration on symptom reporting was more pronounced in girls. Supplementary analyses suggested that sleep insufficiency was associated with a diverse array of postconcussion-like symptoms. Poor sleep the night before baseline or postinjury testing may be an important confound when assessing postconcussion symptoms. Girls may be more vulnerable to experiencing and reporting symptoms following insufficient sleep. Clinicians should routinely ask how the athlete slept the night before preseason baseline testing and consider deferring the symptom assessment or later retesting athletes who slept poorly.

Do Canadian collegiate hockey players accurately perceive body composition changes after unmonitored training and diet?

Collegiate athletes often use nutritional programs and supplements to elicit body composition changes in muscle or fat. It is unknown if athletes can accurately perceive their fluctuations in body composition, yet their understanding may help them make more accurate interpretations regarding the success of potential nutrition or exercise regimens. The purpose of this study was to investigate if collegiate hockey players could accurately perceive a change in body composition during a 3-month period within their regular season, in which no predetermined nutritional or exercise program was provided. Twenty-four male Canadian collegiate hockey players completed preseason and midseason body composition assessments using dual-energy X-ray absorptiometry. Immediately before the midseason scan, players attempted to accurately match their perceived fluctuation in composition, with predetermined categorical ranges of relative body composition and strength. Two-thirds of players and one-half of players accurately perceived changes in arm-lean and arm-fat tissue, respectively. Approximately two-thirds of players did not accurately perceive gains or losses of lean or fat tissue within their leg and overall body. Although some athletes partially detected changes in the lean and fat tissue of particular regions, the vast majority of players cannot detect the type, or amount of tissue gained and lost across the overall body. Body composition assessments, rather than an athlete's perceptions, should be used to help interpret the success of a sport nutrition or exercise program. Athletes should be aware that physiologic adaptations might take place unnoticed, which could affect the acceptance and adherence of nutrition or exercise interventions.

Allometric scaling of strength scores in NCAA division I-A football athletes.

This study examined population-specific allometric exponents to control for the effect of body mass (BM) on bench press, clean, and squat strength measures among Division I-A collegiate football athletes. One repetition maximum data were obtained from a university pre-season football strength assessment (bench press, n = 207; clean, n = 88; and squat n = 86) and categorized into 3 groups by positions (line, linebacker, and skill). Regression diagnostics and correlations of scaled strength data to BM were used to assess the efficacy of the allometric scaling model and contrasted with that of ratio scaling and theoretically based allometric exponents of 0.67 and 0.33. The log-linear regression models yielded the following exponents (b): b = 0.559, 0.287, and 0.496 for bench press, clean, and squat, respectively. Correlations between bench press, clean, and squat to BM were r = -0.024, -0.047, and -0.018, respectively, suggesting that the derived allometric exponents were effective in partialling out the effect of BM on these lifts and removing between-group differences. Conversely, unscaled, ratio-scaled, and allometrically scaled (b = 0.67 or 0.33) data resulted in significant differences between groups. It is suggested that the exponents derived in the present study be used for allometrically scaling strength measures in National Collegiate Athletic Association Division I-A football athletes. Use of the normative percentile rank scores provide coaches and trainers with a valid means of judging the effectiveness of their training programs by allowing comparisons between individuals without the confounding influence of BM.

Current concepts in the treatment of sports concussions.

The management of patients with sports-related concussion (SRC) is comprehensive and includes preseason planning, education, initial evaluation, postinjury assessment, disposition, return-to-play decisions, and consideration of long-term brain health. Several recent publications have addressed sports concussion management using the best available evidence, and we review them here. The diagnosis and management of sports concussion have evolved over the past several decades, and with a greater understanding of the importance of both short- and long-term sequelae, there has been a clear trend toward recognizing and treating these brain injuries more cautiously and developing a proactive approach to management and return-to-play decision making. Although each of these used different methodologies in their review of the literature, their conclusions are fairly consistent, providing basic guidelines for contemporary approaches to management of SRC. Although many questions remain unanswered, there are several areas of agreement including the importance of education, preseason assessment, the benefit and utility of a standardized multimodal assessment on the sidelines, individualized treatment and return-to-play protocols, and the benefit of a multidisciplinary team in managing complicated injuries. This paper reviews these current sports concussion guidelines and the best available evidence that guides current management of SRC.

B-44 Free Communication/Poster - Training Strategies and Performance

Athletes with stronger cervical musculature are thought to experience less severe head impacts. Strength is often quantified as the peak torque that a player can generate. A player is unlikely to activate the musculature maximally during the milliseconds over which a single head impact occurs. PURPOSE: To compare head impact severity between football players with stronger and weaker cervical musculature using both peak torque and torque-time variables. METHODS: Forty-nine high school and collegiate football players (height=183.12±7.31 cm, mass=94.02±21.35 kg, age=17.79±2.08 years) completed a pre-season isometric cervical strength assessment. Participants pushed their head against a padded strain gauge, reaching their maximum torque as quickly as possible, for three trials in flexion, extension, right and left lateral flexion. Players were separated into groups of stronger and weaker players using a median split for the following five composite (summed over all four directions) strength measures: peak torque (Nm*kg-1), rate of torque development (Nm*sec-1 – greatest slope within 50-ms sliding window), time to 50% of peak torque (ms), time to peak torque (ms), and torque impulse (Nm*sec). The Head Impact Telemetry (HIT) System was used to capture three measures of head impact severity during games and practices: peak linear acceleration (g), peak rotational acceleration (rad/sec2), and HIT severity profile (HITsp – unitless) (n=19,060 head impacts>10g). Fifteen random intercepts general linear models were used to compare head impact severity between stronger and weaker players (α = 0.05). RESULTS: We did not observe significant differences in head impact severity between stronger and weaker players for peak torque, rate of torque development, or time to half peak torque. Players who reached peak torque quickly sustained head impacts with higher HITsp values (15.02, 95% CI: 14.48, 15.58) than players who reached peak torque slowly (14.20, 95% CI: 13.75, 14.66) (F1,46=5.49,p=0.021). CONCLUSION: Overall, cervical muscle strength had little influence on head impact severity. In fact, players that reached peak strength quickly sustained head impacts of slightly higher severity. Cervical muscle strength may play a lesser role in mitigating head impact severity than originally thought.

FACTORS ASSOCIATED TO PATELLAR TENDINOSIS IN ATHLETES: PROVIDING A BASE FOR INJURY MECHANISM AND PREVENTION

BackgroundPatellar tendon abnormalities (PTA) are frequent in volleyball and basketball athletes. Tendon degeneration happens through chronic process, related to the amount of stress applied in musculoskeletal system. An appropriated mechanical...

Frequency of spondylolysis and chronic low back pain in young soccer players

Objective: To demonstrate the safety of soccer for adolescents in terms of chronic lesions of the lumbar spine, particularly spondylolysis. Methods: 54 young players underwent a pre-season assessment. The athletes were submitted to radiography of the lumbosacral spine. Players complaining of chronic low back pain were later submitted to more specific tests. Results: only 1 athlete (1.85 % of our sample) had complaints of chronic low back pain. In this case, the radiograph showed olisthesis grade I spondylolysis at the L5 level. Conclusion: Soccer proved to be a very safe sport in terms of the risk of developing chronic lesions of the lumbosacral spine. However, the actual incidence of spondylolysis in these athletes was not determined because only plain radiographs were used in this study.

Shoulder Strength Imbalances as Injury Risk in Handball

This study was conducted to analyze whether internal (IR) and external (ER) rotator shoulder muscles weakness and/or imbalance collected through a preseason assessment could be predictors of subsequent shoulder injury during a season in handball players. In preseason, 16 female elite handball players (HPG) and 14 healthy female nonathletes (CG) underwent isokinetic IR and ER strength test with use of a Con-Trex® dynamometer in a seated position with 45° shoulder abduction in scapular plane, at 60, 120 and 240°/s in concentric and at 60°/s in eccentric, for both sides. An imbalanced muscular strength profile was determined using -statistically selected cut-offs from CG values. For HPG, all newly incurred shoulder injuries were reported during the season. There were significant differences between HPG and CG only for dominant eccentric IR strength, ER/IR ratio at 240°/s and for IRecc/ERcon ratio. In HPG, IR and ER strength was higher, and ER/IR ratios lower for dominant than for nondominant side. The relative risk was 2.57 (95%CI: 1.60-3.54; P<0.05) if handball players had an imbalanced muscular strength profile. In youth female handball players IR and ER muscle strength increases on the dominant side without ER/IR imbalances; and higher injury risk was associated with imbalanced muscular strength profile.

Rate of Force Development as an Adjunctive Outcome Measure for Return-to-Sport Decisions After Anterior Cruciate Ligament Reconstruction

Descriptive, prospective, longitudinal single-cohort study. To investigate the rate of force development to 30% (RFD(30)), 50% (RFD(50)), and 90% (RFD(90)) of maximal voluntary isometric contraction (MVIC) as an adjunct outcome measure for determining readiness for return to sport following an anterior cruciate ligament (ACL) reconstruction. One criterion of full recovery following an ACL reconstruction is the ability to achieve 85% or 90% of the maximal strength of the contralateral limb. However, the time required to develop muscular strength in many types of daily and sports activities is considerably shorter than that required to achieve maximal strength. Therefore, in addition to maximal strength, neuromuscular functions such as RFD should also be considered in the definition of recovery. Forty-five male professional soccer players who underwent an ACL reconstruction were recruited. Assessment with the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, and KT1000 instrumented arthrometer was performed postinjury/prereconstruction and at 6 and 12 months after ACL reconstruction. MVIC, RFD(30), RFD(50), and RFD(90) testing was performed preinjury, as part of standard preseason assessment, and at 6 and 12 months post-ACL reconstruction. The average MVIC value 6 months postreconstruction was 97% of the preinjury average value. In contrast, at 6 months, the RFD(30), RFD(50), and RFD(90) values were 80% (P = .04), 77% (P = .03), and 63% (P = .007), respectively, of the preinjury values. The mean RFD values for the reconstructed knee attained or exceeded 90% of the preinjury mean values only at the 12-month post-ACL reconstruction assessment (RFD(30), P = .86; RFD(50), P = .51; RFD(90), P = .56). Despite the near recovery of MVIC strength to preinjury levels, there were still significant deficits in RFD at 6 months post-ACL reconstruction. An RFD similar to the preinjury RFD was achieved at 12 months post-ACL reconstruction, following a rehabilitation program focusing on muscle power. These results suggest that, following an ACL reconstruction, RFD criteria may be a useful adjunct outcome measure for the decision to return athletes to sports. J Orthop Sports Phys Ther 2012;42(9):772-780, Epub 19 July 2012. doi:10.2519/jospt.2012.3780.

Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes

To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes. This is a prospective cohort study at 3 Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I college varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 45 noncontact sport athletes. All athletes were assessed prior to and shortly after the season with a cognitive screening battery (ImPACT) and a subgroup of athletes also were assessed with 7 measures from a neuropsychological test battery. Few cognitive differences were found between the athlete groups at the preseason or postseason assessments. However, a higher percentage of the contact sport athletes performed more poorly than predicted postseason on a measure of new learning (California Verbal Learning Test) compared to the noncontact athletes (24% vs 3.6%; p < 0.006). On 2 postseason cognitive measures (ImPACT Reaction Time and Trails 4/B), poorer performance was significantly associated with higher scores on several head impact exposure metrics. Repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes. Further work is needed to assess whether such effects are short term or persistent.

Performance Measures of NCAA Baseball Tryouts Obtained From The New 60-yd Run-Shuttle

The ability to accelerate, decelerate, and change directions quickly is a well-known asset to athletic performance. Determination of basic movement skills may be accomplished by timing the athlete's ability to move through a prescribed course. The purpose of this investigation was (a) to describe and compare 4 distinct segments of a new agility test called "JJ Shuttle," and (b) to describe the agility and kinetic factors obtained from young men (age 18-22 years) who were competing for a limited number of positions on the National Collegiate Athletic Association Division II team. Speed calculations allowed for comparisons between and among shuttle segments and, when considered with body mass, permitted calculation of an energy of motion represented by the kinetic factor (K-factor). Sorting of shuttle times identified the fastest athletes and revealed that they do not necessarily have the highest K-factor. Similarly, highlighting performances by K-factors identified athletes who may be able to contribute more by a particular combination of speed and size. Furthermore, rare individuals who might have both attributes stand out to the coach by employing sorting and ranking, all within the capabilities of Microsoft Office Excel® 2007. These performance measures and calculations obtained from the agility test may provide the coach or trainer with valuable insight into movement skills and potential contribution of the individual athlete to the success of the team. This information is critical in preseason assessments to help decide who makes the team and to evaluate progress within and between competitive seasons.

Forefoot alignment prediction in athletes' knee valgus during landing

BackgroundKnee valgus during landing has been identified as a risk factor for anterior cruciate ligament injury. Component motions of knee malalignment are femoral internal rotation and adduction, tibial abduction and...

Analysis of predictor factors in knee valgus in female soccer athletes

BackgroundKnee injuries in soccer are common regardless of age, gender or playing level. The injury that draws most attention is the anterior cruciate ligament tear and adolescent females seem to...

Correlation of age, sex, body mass index and sports modality to patellar rotation in jumping athletes

BackgroundPatellar malalignment reveals a inappropriate tendon traction and could lead to overuse injuries as patellar tendinopathy. There is two angles that describe the frontal patellar rotation: Arno (A) and McConnell...

New measurements of rearfoot, forefoot and shank-forefoot alignment in athletes

BackgroundFoot misalignments may contribute to development of sports injuries. Some evaluation protocols of foot alignment are not practical, have poor reliability and doesn't reflect functional foot behaviour. We propose a...

Abscess After a Laparoscopic Appendectomy Presenting as Low Back Pain in a Professional Athlete

A professional baseball player presented to the orthopaedic clinic for a preseason assessment because of continued lumbar spine and flank pain. He had a laparoscopic appendectomy for a perforated appendix 8 months before his presentation. He was able to finish the previous season with only mild limitation. He presented with back pain that limited his activity. His examination was nonlocalizing, but subsequent computed tomography revealed a hepatic abscess. The abscess was drained; he was treated with intravenous antibiotics; and his symptoms resolved.

Indicators of iron status in elite soccer players during the sports season

The main aim of the study was to investigate the changes of hematologic status in elite soccer players throughout a competitive season. Study was conducted with 35 male professional soccer players and the measurements were collected at the start of the conditioning period, at the start of the season, in the mid-season and at the end of the season. Blood was drawn from an antecubital vein for a complete blood count, serum iron, and transferrin and ferritin levels. We found significantly higher hematocrit at preseason assessment as compared with other sampling periods (P < 0.05). No other differences were found between any of the hematologic variables during the study. The lowest hemoglobin level, mean corpuscular volume (MCV), serum iron, ferritin and transferrin encountered in the study were Hb of 11.2 g/dl, MCV of 77.9 fl, serum iron of 34 microg/dl, ferritin of 15.1 microg/l, transferrin of 224 microg/dl in a 20-year-old soccer player at the start of the season. The variability of the iron status indicators in elite soccer players seems to be stable and poorly related to training phase during sports season.

A prospective cohort study of hamstring injuries in competitive sprinters: preseason muscle imbalance as a possible risk factor

Background:Hamstring injuries are common in sprinters. Identifying preseason risk factors is essential to target injury-prone athletes and develop injury preventive measures.Objective:To investigate the incidence of hamstring muscle injury in sprinters...

Preseason to Postseason Changes in Body Composition of Professional Ballet Dancers

Assessment of body composition in dancers as part of a pre-participation evaluation is controversial — it is strongly supported as an important monitor test by some health professionals, but condemned by others as increasing the potential for the development of eating disorders. A number of studies have documented normative values of body composition for dancers at the student, pre-professional, and professional levels. To the best of our knowledge, no study has ever assessed body composition changes that occur during a professional performance season. The present investigation evaluated male (n = 29) and female (n = 39) professional dancers before and after a performance season. While no significant changes in body composition in the males was noted, a significant decrease in both body weight and percentage of body weight as fat was found in the female dancers [Fat %, Pre: 12.8 ± 2.7; Post: 11.5 ±2.1 (p &lt; 0.05)]. These data suggest that both preseason and postseason assessments of body composition are necessary in order to screen for dancers who require further medical assessment and nutritional counseling to maintain optimal health.

The New Zealand rugby injury and performance project. VI. A prospective cohort study of risk factors for injury in rugby union football

Objectives—Although the nature of rugby injury has been well documented, little is known about key risk factors. A prospective cohort study was undertaken to examine the association between potential risk...