Physician and Sportsmedicine最新文献

Objectives: Screening instruments suitable for the early detection of mental health issues in athletes are limited. The aim of this study is to adapt the Mental Health Disorders Screening Instrument for Athletes (MHDSIA) into Turkish and evaluate its psychometric properties.

Methods: The adaptation process followed COSMIN guidelines. Language adaptation was performed using a forward-backward translation method, and content validity was evaluated with expert opinions. This cross-sectional methodological study included 251 volunteer athletes. Exploratory factor analysis and confirmatory factor analyses were employed for construct validity, and reliability was examined with the Cronbach's alpha coefficient. Criterion validity was tested against the Symptom Checklist 90-Revised (SCL-90-R), and sensitivity and specificity were evaluated via Receiver Operating Characteristic (ROC) curve analysis.

Results: The Turkish version of the MHDSIA demonstrated high internal consistency (Cronbach's Alpha = 0.864) and satisfactory content validity (I-CVI = 0.857-1.000; S-CVI = 0.969). EFA supported a single-factor structure, which was confirmed by CFA, with adequate goodness-of-fit indices (e.g. RMSEA = 0.074). The ROC analysis showed an AUC of 0.774 (p < 0.001), with an optimal cutoff point identified as 32, yielding sensitivity of 78.4% and specificity of 67.5%.

Conclusion: The Turkish version of the MHDSIA was determined to be a valid and reliable screening instrument, and it has been demonstrated that it can be used as an effective method for assessing the mental health of athletes.

Objectives: Traumatic anterior glenohumeral joint dislocations are associated with prolonged time loss and high rates of reinjury in rugby. This is particularly common during contact events. There is a lack of clear guidance to facilitate return to contact decisions following these injuries in rugby. The aim of the study was to identify and reach consensus (≥70% agreement) regarding return to contact criteria and assessment methods following traumatic anterior glenohumeral joint dislocations in rugby union players.

Methods: A three-round Delphi consensus study was conducted.

Results: Thirty-three health and sport practitioners participated in Round 1. Round 2 and 3 were completed by 28 and 26 practitioners respectively. Thirty criteria reached consensus for inclusion. These criteria included time frames, subjective ratings (including pain, apprehension, and player readiness) and clinical criteria (including clinical stability). Functional criteria such as range of motion, muscle function and proprioception of the glenohumeral joint, and fitness were also recommended for inclusion. In addition, assessment of rugby specific skills were recommended. Modalities reaching consensus to evaluate subjective criteria such as pain included Visual Analogue Scale ratings, specific questions, and palpation. The anterior apprehension and relocation test was recommended for clinical stability, whereas observation of functional movements was recommended to evaluate shoulder function.

Conclusion: A comprehensive range of clinical, functional, subjective, and sport specific criteria and assessment methods should be considered alongside time frames to guide return to contact decisions following traumatic anterior glenohumeral joint dislocations in rugby union players.

Background: The preseason period in rugby plays a key role in athlete preparation for the demands of the sport during the in-competition period. Epidemiological data pertaining to rugby have focused mainly on senior elite professional with little evidence available for junior elite professionals, and even less during the preseason period. This may limit the ability of stakeholders in the sport to understand the effects of injury on participants during the preseason period.

Objective: To determine the epidemiology, clinical characteristics, and associated risk factors for injury among elite male junior provincial rugby players in South Africa during a 14-week preseason period.

Design: A prospective cohort study.

Methods: Data collection procedures were in-line with consensus statements in sports and rugby. Prospective injury data related to 53 male participants were collected. Descriptive statistics was used to describe clinical characteristics of injury, cross-tabulations were created to investigate risk factor associations, and logistic regression was used to model the risk factors.

Results: The overall injury prevalence was 75.5%. The incidence of match play injuries (149.26/1000 h) were higher than training injuries (23.32/1000 h). Injuries to the lower limb (48.8%) and muscle/tendon injuries (48.2%) were most commonly reported injuries by anatomical region and tissue type during the preseason period. When controlling for age and playing position, baseline injury was associated with a higher risk of sustaining a subsequent injury during preseason. Age, baseline injury, and playing position showed no statistically significant association with injury risk.

Conclusion: A high number of training and match play injury incidence were recorded for elite male junior provincial rugby players. Baseline injury was associated with a higher risk of sustaining a subsequent injury during preseason when controlling for playing position and age.

Background: Due to a range of pressures associated with high-performance environments, elite athletes are at increased risk of eating disorders and disordered eating. Most prevalence studies focus on female athletes in lean or esthetic sports, with males, particularly those competing in power sports, seldom considered. This study addresses this gap by exploring disordered eating in elite male adolescent rugby union players.

Methods: We distributed an online survey to male rugby players aged 16-18 through RFU-affiliated academies. The survey contained three sections: general demographics; the Eating Disorder Examination Questionnaire (EDE-Q); and knowledge of eating disorders.

Results: From 107 responses, 14% had a global EDE-Q score that met the clinical cut off of 1.68 for males displaying symptoms of an eating disorder. An increased Body Mass Index (BMI) was statistically significantly associated with a positive increase in global EDE-Q score. Props demonstrated the highest global EDE-Q scores. The desire to change body size was also statistically associated with increased global EDE-Q scores. Most participants admitted poor knowledge of eating disorders and where to access help to manage them by giving a score of 2 on a 1-5 Likert scale ranging from no knowledge to very knowledgeable.

Conclusions: Overall, 14% of the elite adolescent male rugby participants in this study met the clinical cut off EDE-Q global score, suggesting that there may be a higher prevalence of disordered eating behaviors and attitudes compared to the general population. Increased BMI and certain positions are associated with more disordered eating behaviors and attitudes. There is also a lack of confidence in knowledge about EDs and where to access help, therefore greater education and awareness about this issue is warranted. More research is required to further explore the reasons for the increase in disordered eating behaviors and attitudes.

Objectives: The aims of this study were to describe the etiology of acute respiratory infections (ARinf) in athletic individuals, and to identify differences in the clinical presentation, evidence of possible multi-organ involvement, and illness classification between common pathogen groups.

Methods: One-hundred-and-sixteen cases of confirmed ARinf in athletic individuals were evaluated ≤ 5 days of the onset of an ARinf. Nasopharyngeal swab multiplex PCR testing was performed to identify a causative pathogen. Symptomatology, clinical examination findings, results of selected blood tests, and the clinical syndrome and illness severity classifications were compared between four common pathogen groups.

Results: The etiologies of ARinf in this cohort were: rhinovirus = 34(29%), influenza = 17(15%), SARS-CoV-2 = 15(13%), common coronavirus = 13(11%), 'unidentified' = 16(14%), 'dual pathogen' = 9(8%), and 'other' = 12(10%). Clinical presentation differed among the four common pathogen groups as follows: Influenza had more total symptoms, lower respiratory & regional symptoms, and systemic & non-respiratory symptoms than rhinovirus (p ≤ 0.002) and common coronavirus (p < 0.05). Influenza and SARS-CoV-2 had higher total symptoms and systemic & non-respiratory symptom severity scores than rhinovirus (p ≤ 0.0006 and p < 0.03 respectively) and common coronavirus (p ≤ 0.03 and p = 0.02 respectively). Evidence of other non-respiratory organ involvement on clinical examination was highest for influenza (53%). Illness classification for pathogen groups differed: common coronavirus had the highest percentage (%) of rhinitis-like ('common cold') illnesses (69%), and influenza had the highest % of 'flu-like' illnesses (82%). Influenza had the highest % of severe illnesses (88%) and common coronavirus the lowest (31%). 41% of rhinovirus presented with severe illness.

Conclusion: Influenza and SARS-CoV-2 had greater number and severity of symptoms than rhinovirus and common coronavirus. Among the four common pathogen groups, influenza had the highest percentage of abnormal clinical examination and serological findings and severe illnesses. Knowledge of the causative pathogen and the clinical presentation may add value to the risk assessment and guide clinical decision-making in return-to-sport following ARinf in athletic individuals.

Objectives: The objective of this study was to assess a clinically feasible DT protocol consisting of the Balance Error Scoring System (BESS) and Standard Assessment of Concussion (SAC) administered simultaneously during and beyond clinically determined concussion recovery.

Method: We recruited 28 collegiate student-athletes (14 post-concussion, 14 control) who performed a DT BESS and SAC assessment at three timepoints: 1) clinical recovery, 2) return to play (RTP) day, and 3) 30 days post-concussion. Scores on each component were assessed with a linear mixed model ANOVA with repeated measures and task prioritization was assessed with a Chi-Square.

Results: There was not a significant group by time interaction for the BESS (F: 0.48, p = 0.625, ή² = 0.018) or SAC (F: 1.927, p = 0.156, ή² = 0.069), but there was a significant difference in task prioritization at RTP (χ²: 13.4, p = 0.010).

Conclusion: While group performance did not differ over time, the concussion participants had a range of task prioritizations at RTP, including mutual interference, which could help identify athletes with incomplete neurological recovery.

Objective: To assess sex-based differences in the frequency and characteristics of pediatric lateral ankle avulsion fractures.

Methods: This prospective observational cohort study (Level II) was conducted at a tertiary sports medicine clinic between July 2022 and March 2025. This study included a total of 132 patients with 133 injuries aged 5-12 years presenting within 30 days of a first-time lateral ankle injury (67.4% female and 32.6% male). Injuries were categorized as avulsion or non-avulsion using ultrasound as the reference standard. Demographics, injury type and mechanism, sport type, and validated patient-reported measures were analyzed by sex using chi-squared and Mann-Whitney U tests.

Results: Males were found to be significantly more likely to sustain lateral ankle avulsion fractures than their female counterparts (50.0% vs. 24.1%, p < 0.01). There were no statistically significant differences between the avulsion and non-avulsion groups for age, race, ethnicity, BMI, or days to presentation. Sport during injury did vary by sex (p = 0.02), but the cause of injury did not. Pain, mobility, anxiety, and Pedi-FABS scores did not vary between sexes at presentation, regardless of their avulsion status.

Conclusions: Our study demonstrated that males with lateral ankle injuries were more likely to sustain avulsion fractures than females in this pediatric population. Despite these differences in injury type, both sexes reported similar levels of function, anxiety, pain, and activity at initial presentation. Understanding early sex-based differences in lateral ankle fracture patterns may inform diagnostic evaluation and management in pediatric patients.

Purpose: Concussion-induced pathophysiology creates an energetic imbalance within the brain. Though physical activity (PA) is recommended to facilitate recovery, individualized factors such as symptom severity and/or energy availability may be barriers to PA engagement and may need to be considered to promote concussion recovery. Our purpose was to compare PA over a one-week period between adolescents with and without a recent concussion.

Methods: Adolescent athletes within 3 weeks of concussion and uninjured athletes wore wrist-worn actigraphy devices for one week to quantify three outcomes: PA (steps/day), caloric expenditure, and resting heart rate (RHR). We used linear mixed models with random slopes and random intercepts for participants to examine between-group differences for each outcome over the monitoring period, adjusting for variables that differed between groups.

Results: We enrolled and followed 149 adolescents for one week: 85 with concussion (starting at 9.2 ± 3.5 days post-injury, age = 15.3 ± 1.8 years, 52% female) and 64 uninjured controls (age = 15.4 ± 1.5 years, 61% female). After adjusting for covariates, the concussion group took fewer steps/day (β = -4837 steps/day; 95%CI: -6266, -3409; p < 0.001) and expended fewer calories (β = -338 calories; 95%CI: -512, -164; p = 0.001) than controls during the monitoring period. RHR was similar between groups (β = 0.74 beats/min; 95%CI: -2.41, 3.88; p = 0.65).

Conclusion: Adolescents after recent concussion demonstrated lower PA and expended fewer calories than uninjured controls, indicating that it may take several weeks after concussion to resume PA levels similar to uninjured peers. Our results may reflect participants following concussion guidelines/physician guidance to gradually increase PA during concussion recovery as tolerated without symptom exacerbation, leading to less PA engagement compared to controls. Further research into energy needs after concussion may inform therapeutic targets to facilitate recovery.

Objectives: Although it has been well documented that judo athletes from different competitive levels often exhibit inadequate hydration status, studies investigating the hydration habits of Paralympic judo athletes with visual impairment are scarce. Thus, this study examined urine-based hydration indicators and hydration-related behaviors of para judo athletes.

Methods: Twelve judo athletes (6 women and 6 men) with visual impairment from the national Paralympic judo team voluntarily participated in the study. Athletes' hydration status was assessed through urine specific gravity (USG), urine color (UC), and body weight (BW) changes over 24 hours, monitored at six time points. Additionally, athletes' hydration knowledge, attitudes, and behaviors were evaluated using a hydration survey administered in an accessible format.

Results: At rest, USG remained stable across measurement points (F_3,33 = 1.11; p = 0.36), while urine color increased following both training sessions. The evening judo training session induced a significant increase in USG (p = 0.009), whereas morning training had no effect. Body weight decreased significantly after both training sessions (p < 0.001), but overall 24-hour body mass remained stable (p > 0.05). Athletes demonstrated high levels of hydration knowledge (68.5%) and attitudes (70.2%), but only moderate hydration behaviors (62.2%). No significant associations were observed between survey scores and urine-based hydration markers (p > 0.05).

Conclusions: These findings indicate that Para judo athletes with visual impairment experience persistent challenges in maintaining day-to-day fluid balance despite adequate theoretical knowledge. Therefore, accessible, behavior-oriented hydration strategies and structured monitoring approaches should be developed for this underrepresented group, with active involvement of coaches and nutrition professionals.

Background: Medial elbow injuries occur in approximately one-third of all young baseball players and are characterized by injuries to the bone and cartilaginous growth plates. Bone mineral mass, a representative of bone strength, may show individual differences during growth, and the bone strength can temporarily decrease depending on the stage of bone development. However, the relationship between bone mineral mass and medial elbow injuries in young baseball players has not yet been investigated.

Hypothesis: The bone mineral mass would be lower in players with medial elbow injuries, causing lower bone strength and increased susceptibility to injury.

Study design: Cross-sectional study.

Methods: We recruited 215 baseball players aged 9-12 years; the players completed a questionnaire regarding their age, height, weight, practice duration and frequency, baseball experience, and number of pitches per day. The injury and control groups were determined by ultrasonographic evaluation of the medial aspect of the elbow joint, and bone mineral mass was measured by bioelectric impedance analysis. The hip and shoulder ranges of motion were measured. Each variable was compared between the injury and control groups using the Student's t-test. Simultaneous multivariate logistic regression analysis was subsequently performed to identify the factors associated with medial elbow injuries.

Results: Bone mineral mass was significantly higher in the injury group than in the control group (2.02 ± 0.30 kg vs. 1.91 ± 0.26 kg, p = 0.003). However, it was not significantly associated with medial elbow injuries in multivariate logistic analysis. Baseball experience (OR, 1.03; 95% CI, 1.01-1.06; p = 0.009) were significantly associated with medial elbow injury.

Conclusion: Contrary to our hypothesis, bone mineral mass was higher in players with medial elbow injuries, but was not significantly associated with them. A one-time measurement of bone mineral mass is probably not specific enough to analyze the condition of the medial epicondyle. Baseball experience has been identified as a possible factor associated with medial elbow injuries in young players, and increases in experience should be used as an indicator to assess elbow joint health.