Validation of the athletic mental energy scale for Chinese school-age adolescents.

Mental energy is an important factor in many domains, including athletic performance. The athletic mental energy scale (AMES) is one of the established tools available to measure athletes' perceived mental energy state. To date, there is no validated questionnaire to assess athletic mental energy for Chinese adolescents. Therefore, purpose of this study was to validate a Chinese version of AMES (C-AMES) among the Chinese adolescents in Lanzhou, Gansu Province, China. We sampled 729 adolescents aged 14 to 18 in five middle schools in Lanzhou City, Gansu Province, China to complete the revised C-AMES. Data were analyzed for factor structure validity by performing CFA. The results showed that the fit index was acceptable (RMSEA = 0.050, CFI = 0.962, TLI = 0.951), and a six-factor model containing 18 C-AMES items had good measurement properties for athletic mental energy. We suggest future study may use C-AMES to examine the relationship between athletes' mental energy and athletic performance and sporting behavior.

Do SOD2 and SOD3 gene polymorphisms impact the oral health-related quality of life in Para athletes?

The aim of this study was to evaluate whether polymorphisms in SOD2 and SOD3 genes modulate the oral health-related quality of life (OHRQoL) of Para athletes with dental caries experience. The cross-sectional study included 264 Para athletes (143 in athletics, 61 in weightlifting and 60 in swimming). A trained and calibrated team recorded the decayed, missing and filled teeth index (DMFT). The Brazilian version of the Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Genomic DNA was extracted from the athletes' saliva, and genetic polymorphisms in the SOD2 (rs5746136 and rs10370) and SOD3 (rs2855262 and rs13306703) genes were analyzed by real-time polymerase chain reaction. Univariate and multivariate analyses were performed. A multivariate General Linear Model analysis, adjusted for sex, revealed that the SOD3 gene polymorphism (rs2855262) had a significant effect on the psychological disability domain [codominant (p = 0.045) and recessive (p=0.038) models]. The SOD2 gene polymorphism (rs5746136) had a significant effect on the total OHIP-14 score [dominant model (p = 0.038)] and the psychological discomfort [dominant model (p = 0.034)] and physical disability [codominant model (p=0.037)] domains. Presence of the SOD2 rs10370 polymorphism led to statistical differences in the total score [codominant (p = 0.026) and dominant (p = 0.023) models] and the handicap domain scores [codominant (p = 0.027) and dominant (p = 0.032) models]. Polymorphisms of the SOD2 and SOD3 genes may be important biomarkers of OHRQoL in Para athletes with dental caries experience.

Effects of strength training on repeated sprint ability in team sports players: a systematic review.

Objective: This systematic review was conducted to analyze the existing evidence on the effects of strength training (ST) and complex/contrast training (CCT) on repeated sprint ability (RSA) in team sports players. Methods: A systematic review of the literature was performed following the PRISMA statement. PubMed, Web of Science, and Scopus databases were used. Original full-text articles were analyzed, without date restriction until May 26, 2024, written in English, peer-reviewed, and for eligibility must have included (1) male or female team sports players, amateur or professional category, without age restriction (2) lower extremity ST and/or CCT program (3) active control group (4) running RSA test (e.g., repeated shuttle sprint ability test or straight-line repeated sprint ability test) before and after the intervention period (5) controlled trial. Results: A total of 3,376 studies were identified and screened. Finally, 10 articles were included based on the inclusion and exclusion criteria, all with moderate methodological quality according to the PEDro scale. The best time, mean time, and total time presented significant pre and post-test changes, using ST in 3, 2, and 1 experimental groups, respectively, and using CCT in 1, 1, and 1 experimental groups, respectively, with almost no differences in the percentage decrement most commonly reported in RSA tests. There were no changes in the control groups. Conclusion: Together, ST performed in a range of maximal power provides benefits in the best time and mean time and performed between 80 to 95% of 1 repetition maximum (RM) provides benefits in the best time, mean time, and total time in RSA tests. CCT performed between 75 to 90% of 1 RM combined with jumps and sprints provides benefits in the best time, mean time, and total time in RSA test, but no unaltered percentage decrement in ST and CCT in elite and semi-professional team sport players.

An examination of the relationship between sport performers' organizational stressor dimensions, physical health, and well-being.

Whilst research has assessed the multidimensionality of organizational stressors, severity has been overlooked. This study aimed to develop and validate a severity response scale, before examining the relationship between organizational stressor severity, physical health, and well-being, and if severity mediated the relationship between stressor occurrence and outcomes. 403 sport performers (186 male; Mage = 21.43) completed a questionnaire assessing study variables and data were analysed using structural equation modelling. Organizational stressor severity had a significant, negative relationship with physical health (r = -.374, p < .001), but notwith hedonic or eudaimonic well-being (p = .624 and .203). Direct effects were found for neuroticism (ß = -0.632, p < .001) and stressor frequency (ß = -0.226, p = .016) on physical health; however, when adding severity as a mediator, stressor frequency positively predicted stressor severity (ß = 1.025, p < .001); however, the indirect effect of stressor frequency on physical health via stressor severity (ß = -0.018, p = .885) and the direct effect between stressor frequency and physical health (ß = -0.191, p = .204) were non-significant. These novel findings highlight that higher stressor severity is associated with higher physical health complaints, and that repeated exposure to stressors may heighten an vulnerability to future stressors.

Hitting boundaries: Contract type, playing experience, non-cognitive skills, and sport anxiety in elite women cricketers.

This paper examined the psychological impact of contextual influences (i.e., contract type and playing experience) on sport anxiety in elite women cricketers participating in The Hundred. A sample of 71 elite female cricketers playing during the 2021-2022 season took part. Forty-nine of the sample (69%) held professional contracts, and 22 (31%) had yet to sign a professional contract. Participants provided details about their contract type and playing experience and completed self-report measures assessing sport anxiety, mental toughness, and general self-efficacy. Since mental toughness and self-efficacy are non-cognitive constructs, which buffer competitive trait anxiety, analysis controlled for these variables. Multivariate analyses of covariance examined sport anxiety scores among participants in relation to Hundred matches played (either 0, 1-10, or more than 10) and contract type (whether participants had a professional contract in place or not). Subfactors of Worry, Somatic, and Confusion assessed sports anxiety. No significant main effects existed. However, alongside a significant interaction, a covariate mental toughness effect occurred. Examination of the interaction revealed Worry scores were lower in cricketers who were yet to play a Hundred match who had not received a professional contract. Furthermore, Worry and Somatic scores were higher in cricketers that had played more than 10 Hundred matches and had not received a professional contract. These findings have important implications for the development of elite women cricketers. Particularly, they highlight the need to differentially support players through their career progression.

Body Composition and Dietary Intake Profiles of Elite Iranian Swimmers and Water Polo Athletes.

BACKGROUND: This study aimed to conduct a detailed and comparative analysis of body composition and dietary habits in elite swimming and water polo athletes. Through the examination of these key parameters, this study seeks to compare the dietary intake of these two distinct aquatic sports disciplines. METHODS: A total of 10 top-level swimmers and 13 water polo athletes participated in anthropometric and body composition assessments, as well as a detailed analysis of nutritional intake. To compare the two groups, an independent samples t-test was used, and variance homogeneity was checked using Levene's test. The effect size of the group differences was evaluated using Hedges' g. RESULTS: Water polo athletes showed significantly greater height (189.4 ± 2.9 vs. 186.5 ± 2.0 cm, p = 0.013), body mass index (24.3 ± 1.4 vs. 22.1 ± 0.5 kg/m2, p < 0.001), fat-free mass (62.9 ± 1.4 vs. 61.1 ± 1.38 kg, p < 0.001), skeletal muscle mass (47.1 ± 1.3 vs. 43.9 ± 1.6 kg, p < 0.001), and overall weight (86.9 ± 6.9 vs. 76.7 ± 2.2 kg, p < 0.001) in comparison to swimmers. Swimmers consumed greater amounts of mean daily energy (60.0 ± 1.0 vs. 39.0 ± 1.0 kcal/kg, p < 0.001), carbohydrate (7.8 ± 0.3 vs. 4.4 ± 0.5 g/kg, p < 0.001), protein (1.7 ± 0.5 vs. 1.4 ± 0.5 g/kg, p < 0.001), and fat (2.4 ± 0.5 vs. 1.7 ± 0.5 g/kg, p < 0.001) compared to water polo athletes. CONCLUSION: Our findings highlight the need for differentiated targeted nutritional interventions to enhance athletic performance in different types of water sports. Compared to water polo athletes, swimmers consumed significantly higher amounts of calories, matching their increased calorie demand from their specific training regime. However, this is an observational study and the differential needs of energy and macronutrients in water sports should be confirmed by studies with energy expenditure measurements.

Effects of a Dietary Microalgae (Arthrospira platensis) Supplement on Stress, Well-Being, and Performance in Water Polo Players: A Clinical Case Series.

BACKGROUND: A common tactic used by athletes to improve performance, lessen tiredness, and hasten recovery is dietary supplementation. We aimed to assess the role of a microalgae dietary liquid supplement additivated with Copper 22.5% NRV in water polo players' performance. METHODS: Twenty male water polo players were split into two groups: ten (spirulina group) took a twice-daily nutritional supplement containing 15 mL of spirulina liquid extract (titrated in Phycocyanin 1 mg/mL) and additivated with Copper 22.5% NRV for eight weeks, and ten (the placebo group) did not take the supplement. Subjective evaluations were finished using the Athlete's Subjective Performance Scale (ASPS). Levels of the biomarker creatine phosphokinase (CPK) were also assessed. RESULTS: The spirulina group's mean total ASPS score increased significantly from baseline to follow-up and was significantly better than that of the placebo group (p < 0.001). Conversely, ASPS ratings in the placebo group slightly decreased. A positive correlation between spirulina supplementation and less severe ASPS was found using correlation matrix analysis. However, there was a slight difference in CPK levels from the baseline to the follow-up in the spirulina group. CONCLUSIONS: A dietary supplement comprising spirulina and copper may help water polo players' subjective performance measurements by lowering muscular tension. Larger, randomized controlled trials are yet required.

Combined Impact of Creatine, Caffeine, and Variable Resistance on Repeated Sprint Ability in Young Soccer Players.

There is evidence that both intra-serial variable resistance (I-sVR), as pre-activation within the post-activation performance enhancement cycle (PAPE), and creatine and caffeine supplementation increase athletic performance in isolation. However, the effect of the three conditioning factors on 30 m repeated sprint ability (RSA) performance in young soccer players is unknown. This study determined the summative and isolation effect of ergogenic aids and pre-activation in half-back squats (HBSs) with I-sVR on performance in an RSA test in young soccer players. Twenty-eight young soccer players were randomly assigned to either EG1 (n = 7, creatine + caffeine + I-sVR), EG2 (n = 7, creatine + placebo2 + I-sVR), EG3 (n = 7, placebo1 + caffeine + I-sVR), or EG4 (n = 7, placebo1 + placebo2 + I-sVR), using a factorial, four-group-matched, double-blind, placebo-controlled design. Creatine supplementation included 0.3 g/kg/day for 14 days, caffeine supplementation included 0.3 mg/kg per day, and pre-activation in HBS with I-sVR (1 × 5 at 30% 1RM [1.0-1.1 m/s] + 1 × 4 at 60% 1RM [0.6-0.7 m/s]). The RSA test and HBS outcomes were evaluated. Three-way ANOVA showed non-significant differences for the RSA test and HBS outcomes (p > 0.05). At the end of this study, it was found that the three ergogenic aids, together, do not generate a summative effect on the physical performance of young soccer players. However, it is important to analyze individual responses to these specific protocols.

Analysis of Sports Supplement Consumption of Elite Referees of the Spanish Professional Fotball League.

BACKGROUND: Sports supplements (SSs) are widely used among team sport athletes; however, evidence supporting the use of SSs among football referees at the elite level is scarce. The aim of the present study was to analyze the consumption of SSs among referees with respect to their level of competition and referee type (main referees (MRs) vs. assistant referees (ARs)). METHODS: A total of 106 football referees participated in this study, with 46.2% from the First Spanish Division and 53.8% from the Second Spanish Division, representing 84.13% of the total number of referees. Each participant completed a validated questionnaire about SS consumption, with the SSs classified according to the Australian Institute of Sport (AIS) ABCD system: Group A has strong evidence for enhancing athlete health and performance, Group B shows potential benefits but needs more evidence, Group C has inconclusive evidence against use, and Group D includes prohibited substances. RESULTS: A total of 84.0% of the MRs and ARs reported the consumption of at least one SS. Differences were found only in the consumption of medical supplements between division (p = 0.016) and type of referee (p = 0.041), though no significant differences were found among the remaining AIS SS categories (p > 0.05). Sport performance (49.6%), Internet (41.0%), and dietitian-nutritionists (31.7%) were the primary reason for SS consumption, purchase location, and source of information, respectively. The most frequently consumed SS were whey protein (45.3%), followed by creatine (33.0%), sport bars and sports drinks (28.3%), and caffeine (19.8%). CONCLUSIONS: MRs and ARs reported a high prevalence of dietary supplement (SS) consumption, with significant differences between division and referee type observed only in medical supplement consumption.

Association of Genetic Profile with Muscle Mass Gain and Muscle Injury Prevention in Professional Football Players after Creatine Supplementation.

BACKGROUND: In recent years, the study of creatine supplementation in professional athletes has been of great interest. However, the genetics involved in response to supplementation is unknown. The aim of this study was to analyse, for the first time, the relationship between muscle performance-related genes and the risk of an increased body mass index (BMI) and muscle mass and a decrease in fat mass in professional football players after creatine supplementation. METHODS: For this longitudinal study, one hundred and sixty-one men's professional football players were recruited. The polymorphisms ACE I/D, ACTN3 c.1729C>T, AMPD1 c.34C>T, CKM c.*800A>G, and MLCK (c.49C>T and c.37885C>A) were genotyped using Single-Nucleotide Primer Extension (SNPE). To assess the combined impact of these six polymorphisms, a total genotype score (TGS) was calculated. The creatine supplementation protocol consisted of 20 g/day of creatine monohydrate for 5 days (loading dose) and 3-5 g/day for 7 weeks (maintenance dose). Anthropometric characteristics (body mass index (BMI), fat, and muscle mass) were recorded before and after the creatine supplementation protocol. Characteristics of non-contact muscle injuries during the 2022/2023 season were classified according to a consensus statement for injury recording. The results showed that the allelic frequencies of ACE and AMPD1 differed between responders and non-responders in muscle mass increase (all p < 0.05). Players with a TGS exceeding 54.16 a.u. had an odds ratio (OR) of 2.985 (95%CI: 1.560-5.711; p = 0.001) for muscle mass increase. By contrast, those with a TGS below 54.16 a.u. had an OR of 9.385 (95%CI: 4.535-19.425; p < 0.001) for suffering non-contact muscle injuries during the season. CONCLUSIONS: The increase in BMI and muscle mass in response to creatine supplementation in professional football players was influenced by a TGS derived from the combination of favourable genotypes linked to muscle performance. The CC genotype and C allele of AMPD1 were particularly associated with a higher likelihood of muscle mass increase under creatine supplementation in this group of professional football players.

Sports Supplement Consumption in 316 Federated Female Road Cyclists.

Although the extensive use of sports supplements (SSs) is prevalent among cyclists, this area has been poorly explored; in fact, no studies have been conducted on this topic regarding women cyclists to date. This descriptive, cross-sectional study, which included 316 federated female road cyclists, aimed to analyze SS consumption patterns in relation to scientific evidence and various categories. SSs were categorized according to the groups and subgroups established by the Australian Sport Institute (AIS, 2023) based on the level of evidence supporting their use. The analysis found that 85.1% of the female road cyclists surveyed used SSs, with an average consumption of 7 ± 6 supplements per individual. Pharmacies (60.8%), dietitian-nutritionists (58.9%), and health status (60.1%) were the primary purchase location, source of information, and reason for use, respectively. The most frequently consumed supplements were sports bars (77.5%), sports gels (61.4%), and caffeine (49.1%). Significantly, 80% of the ten most commonly used supplements were from the group with the highest evidence level, as classified by the AIS, with an average intake of 5 ± 3 supplements per cyclist. In summary, the use of SSs is prevalent among female road cyclists, with reliable sources for both purchasing and obtaining advice on supplements.

A pilot study on bio-banding in male youth ice hockey: Players' perceptions and coaches' selection preferences.

Classifying athletes based on estimates of biological maturation (i.e., bio-banding) as a supplement to traditional age grouping has been shown to be a potential tool for enriching player development in team sports; however, bio-banding has not yet been evaluated in ice hockey. The primary aim was to investigate player experiences and coaches' selection preferences in bio-banding versus age-banding in a group of 12-13-year-old (early growth spurt) male elite players (n = 69). We also examined the relationship between somatic maturity, expressed as a % predicted adult height (%PAH), and fitness performance. Bio-banding was assessed using a questionnaire and 29 coaches selected their top players in each game based on age or bio-bands. %PAH correlated with grip strength (r = .57, p>0.001) and jumping power (r = .63, p<0.001), but not with vertical jump height, sprint time or endurance. Players who played against more mature players in bio-bands than in age groups experienced higher demands, while players who played against less mature players were able to utilize their skills to a greater extent. Coaches generally favored later-than-average maturing players who performed better on performance tests and chronologically older players in bio-banding. We conclude that bio-banding in youth ice hockey has some promising effects and warrants further evaluation.

Effects of ankle Kinesio taping on knee and ankle joint biomechanics during unanticipated jumps in collegiate athletes.

OBJECTIVE: Most biomechanical research on the application of Kinesio taping (KT) to the ankle joint focused on testing anticipated movements. However, ankle sprains frequently occur in real life in unanticipated situations, where individuals are unprepared and face sudden external stimuli. This situation is completely different from the anticipated situation. The aim of the present study was to investigate the effects of ankle KT application on the kinematic and kinetic characteristics of the knee and ankle joints during unanticipated jump tasks in collegiate athletes. METHODS: Eighteen healthy collegiate athletes experienced three taping conditions in a randomized order: no taping (NT), placebo taping (PT), and KT, and performed unanticipated jump tasks. A 9-camera infrared high-speed motion capture system was employed to collect knee and ankle kinematic data, and a 3-dimensional force plate was utilized to collect knee and ankle kinetic data during the tasks. RESULTS: During the right jumps, KT significantly increased peak knee flexion angle (P = 0.031) compared to NT and significantly decreased peak vertical ground reaction force (P < 0.001, P = 0.001) compared to NT and PT. During the left jumps, KT significantly reduced peak ankle inversion angle (P = 0.022, P < 0.001) and peak ankle inversion moment (P = 0.002, P = 0.001) compared to NT and PT. CONCLUSION: During unanticipated jump maneuvers, KT reduced peak ankle inversion angle, peak vertical ground reaction force, and peak ankle inversion moment and increased peak knee flexion angle in collegiate athletes.

Immune Response to COVID-19 Vaccination in Elite Athletes.

Purpose: This study analyses the immune response of elite athletes after COVID-19 vaccination with double-dose mRNA and a single-dose vector vaccine. Methods: Immunoglobulin G (IgG) antibody titers, neutralizing activity, CD4 and CD8 T-cells were examined in blood samples from 72 athletes before and after vaccination against COVID-19 (56 mRNA (BNT162b2 / mRNA-1273), 16 vector (Ad26.COV.2) vaccines). Side effects and training time loss was also recorded. Results: Induction of IgG antibodies (mRNA : 5702 BAU/ml ; 4343 BAU/ml (hereafter: median), vector: 61 BAU/ml ; 52 BAU/ml, p<0.01), their neutralizing activity (99.7% ; 10.6%, p<0.01), and SARS-CoV-2 spike-specific CD4 T-cells (0.13% ; 0.05% ; p<0.01) after mRNA double-dose vaccines was significantly more pronounced than after a single-dose vector vaccine. SARS-CoV-2 spike-specific CD8 T-cell levels after a vector vaccine (0.15%) were significantly higher than after mRNA vaccines (0.02%; p<0.01). When athletes who had initially received the vector vaccine were boostered with an mRNA vaccine, IgG antibodies (to 3456 BAU/ml; p<0.01), neutralizing activity (to 100%; p<0.01), CD4 (to 0.13%; p<0.01) and CD8 T-cells (to 0.43%; p<0.01) significantly increased. When compared with dual-dose mRNA regimen, IgG antibody response was lower (p<0.01), the neutralizing activity (p<0.01) and CD8 T-cell (p<0.01) response higher and no significant difference in CD4 T-cell response (p=0.54) between the two regimens. Cumulative training loss (3 days) did not significantly differ between vaccination regimens (p=0.46). Conclusion: mRNA and vector vaccines against SARSCoV-2 appear to induce different patterns of immune response in athletes. Lower immune induction after a single-shot vector vaccine was clearly optimized by a heterologous booster. Vaccine reactions were mild and short-lived.

Transgender Athlete Participation in Sport: Misplaced Fear and the Harms of Exclusion.

ABSTRACT: As physical therapists and exercise professionals, we have an obligation to promote health and well-being through participation in sport and recreational/physical activity. We play an active role in facilitating and encouraging movement for a large percentage of the population, including our transgender patients/clients. It is integral that we include transgender individuals in supportive and inclusive atmospheres of play, and it is critical for us to lead the conversation around the inclusion of the transgender community in recreational activities and sport. This commentary provides evidence for the physical therapy community to support, advocate for, and include all populations as we promote healthy habits through sport.

Analysis of food supplements and sports foods consumption patterns among a sample of gym-goers in Portugal.

BACKGROUND: Gym-goers usually seek methods to improve performance, muscle gain, and overall health. One of the main strategies is including food supplements (FS) into their routine as aids to enhance their athletic capabilities and satisfy their nutritional needs. Thus, this study aimed to investigate and characterize the main FS and Sports Foods (SF) currently consumed, as well as the main reasons for their use and the source of advice in a group of gym-goers in the Lisbon Metropolitan Area (Portugal). METHODS: A cross-sectional study was conducted, including 303 gym-goers from Lisbon, Portugal, who were 133 women and 170 males (30.8 ± 12.9 years old). Face-to-face interviews were used by qualified researchers to gather data. RESULTS: Most of the interviewed athletes (71.95 %) took FS/SF, being men the main consumers. On average, 1.59 supplements were consumed per athlete. Logistic regression models indicated significant associations between age, gender, and motivations for gym attendance. While men and younger groups attended mainly for hypertrophy, women and older groups were focused on well-being. Protein (59.17 %) was the most used FS/SF, followed by creatine (41.28 %) and multivitamins (27.06 %). Men and younger individuals preferred protein and creatine, while older individuals focused more on specific vitamins and minerals. Women seemed to prefer L-carnitine and protein yogurts. Main sources of information included the internet, friends, and dietitians with notable gender and age-based preferences. Online stores were the main place of purchase. Monthly expenditures on FS/SF were not significantly affected by age or gender, but motivations for use had an influence. CONCLUSION: Most of the athletes interviewed took FS/SF, being men the major consumers. Protein was the principal FS/SF used, with online stores being the main place of purchase and the internet the primary source of information. Age and gender were key factors in adopted training, in the FS/SF chosen, and in the source of information selected. It is crucial that health professionals take primary responsibility for providing this guidance.

Yoga and Mindfulness Training for Professional Baseball Players: A Narrative Study on Perspectives and Practices.

Mindfulness-related practices (e.g., yoga) appear aligned with the field of athletic performance in developing sport-related capacities such as attention regulation, volition, perception, and coping. The purpose of the present narrative study was to explore the experiences of professional baseball players who interacted with the ideas and practices of mindfulness presented in classes featuring yoga and Mindfulness-Acceptance-Commitment (MAC). Participants were seven Minor League Baseball players who learned mindfulness practices in off-season instructional classes and then completed semi-structured episodic interviews on how their mindfulness practices were perceived and utilized in training and competition during the baseball season. Data were analyzed using the three-dimensional space approach to examine participants' subjective accounts of experience, behavior, environmental conditions, and external events. Individual narratives were re-storied and themed. Results indicated various themes across settings, from players' experiences in the yoga/MAC classes (effect of breath regulation on coping strategies; self-awareness and the mind-body connection), on the baseball field (confidence and self-efficacy; self-regulation; resilience and positive coping strategies), and off the baseball field (everyday life and activities; stigma of mental training). Overall, participants appeared to be accepting of mindfulness integrated into their training and provided perspectives supporting the benefits of yoga/MAC classes. This study has research and practice implications in incorporating yoga and mindfulness-based practices in athletic performance among young professional athletes.

Correlation of Posterior Tibial Tendon Ultrasound with Calcaneal Inclination Angle in Indonesian Professional Athletes with Medial Ankle Pain.

Background: Adult-acquired flatfoot deformity (AAFD) is characterized by partial or complete flattening of the longitudinal medial arch, which develops after maturity. AAFD secondary to posterior tibialis tendon dysfunction (PTTD) is one of professional athletes' most common foot and ankle pathologies. Different modalities and procedures can be used to establish the diagnosis of AAFD and PTTD. However, imaging measurements such as the calcaneal inclination index and ultrasonography (US) of the posterior tibialis tendon (PTT) in professional athletes with medial ankle and focal pain along the PTT have yet to be widely studied. This study investigates the correlation of PTT ultrasound for evaluating PTTD with calcaneal inclination angle (CIA) for evaluating AAFD in professional athletes with medial ankle and focal pain along the PTT. Through this study, clinicians and radiologists may benefit from considering AAFD in athletes with PTTD. Methods: 112 Indonesian professional athletes with medial ankle or foot pain and focal pain along the direction of the PTT underwent foot radiography using the CIA and ankle ultrasound to observe PTT abnormalities. Results: A negative correlation between fluid thickness surrounding the PTT and the CIA (p<0.001; 95% CI - 0.945, - 0.885), as well as a negative correlation between PTT thickness and CIA (p<0.001, 95% CI - 0.926, - 0.845), with a correlation coefficient (r) of - 0.921 and - 0.892, respectively. No significant correlation was found between PTT tear and CIA (p = 0.728; 95% CI -0.223, - 0.159; r - 0.033). Conclusion: This study showed a negative correlation between PTTD and AAFD via ultrasound and CIA in professional athletes with medial ankle and focal pain along the PTT. A better understanding of PTTD and AAFD imaging will lead to more effective management and prompt treatment.

Optimizing Concussion Care Seeking: Using Machine Learning to Predict Delayed Concussion Reporting.

BACKGROUND: Early medical attention after concussion may minimize symptom duration and burden; however, many concussions are undiagnosed or have a delay in diagnosis after injury. Many concussion symptoms (eg, headache, dizziness) are not visible, meaning that early identification is often contingent on individuals reporting their injury to medical staff. A fundamental understanding of the types and levels of factors that explain when concussions are reported can help identify promising directions for intervention. PURPOSE: To identify individual and institutional factors that predict immediate (vs delayed) injury reporting. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study was a secondary analysis of data from the Concussion Assessment, Research and Education (CARE) Consortium study. The sample included 3213 collegiate athletes and military service academy cadets who were diagnosed with a concussion during the study period. Participants were from 27 civilian institutions and 3 military institutions in the United States. Machine learning techniques were used to build models predicting who would report an injury immediately after a concussive event (measured by an athletic trainer denoting the injury as being reported "immediately" or "at a delay"), including both individual athlete/cadet and institutional characteristics. RESULTS: In the sample as a whole, combining individual factors enabled prediction of reporting immediacy, with mean accuracies between 55.8% and 62.6%, depending on classifier type and sample subset; adding institutional factors improved reporting prediction accuracies by 1 to 6 percentage points. At the individual level, injury-related altered mental status and loss of consciousness were most predictive of immediate reporting, which may be the result of observable signs leading to the injury report being externally mediated. At the institutional level, important attributes included athletic department annual revenue and ratio of athletes to athletic trainers. CONCLUSION: Further study is needed on the pathways through which institutional decisions about resource allocation, including decisions about sports medicine staffing, may contribute to reporting immediacy. More broadly, the relatively low accuracy of the machine learning models tested suggests the importance of continued expansion in how reporting is understood and facilitated.

Blood, Sweat, and Tears: Implications for Hydration Testing in Combat Sports-Investigating Body Mass Loss and Biomarker Changes.

Combat sports athletes often undergo rapid body mass loss (BML), which presents health risks. Hydration testing has been proposed as a possible solution to reduce or eliminate rapid BML. However, combat sports athletes may exhibit distinct physiological characteristics due to repeated exposure to BML. Thus, traditional and emerging hydration biomarkers should be investigated to determine their potential suitability for field use in this cohort. This study examined whether BML can explain changes in serum and urine osmolality (SosmΔ, UosmΔ), tear osmolarity (TosmΔ), hematocrit (HctΔ), and urine-specific gravity (USGΔ) after mild-moderate passive dehydration. Biomarker reliability was also assessed across two trials. Fifteen male and female combat sports athletes (age: 26.3 ± 5.3 years, body mass: 67.7 ± 9.9 kg) underwent a sauna protocol twice (5-28 days apart) aiming for 4% BML. The average BML in Trials 1 and 2 was 3.0 ± 0.7%. Regression analysis revealed that BML explained HctΔ (R2 = 0.22, p = 0.009) but not SosmΔ (R2 = 0.11, p = 0.079) or other biomarkers. Intraclass correlation coefficients (ICCs) were significant for all biomarkers except TosmΔ (ICC = 0.06, p = 0.37) and post-Tosm (ICC = 0.04, p = 0.42); post-Hct performed best (ICC = 0.82, p < 0.001). Contingency tables with post-Sosm (295 mOsm/kg) and post-USG (1.020) cutoffs revealed an 80% true negative rate (TNR) and a 62% true positive rate (TPR). Increasing the Sosm cutoff to 301 mOsm/kg decreased the TNR to 52% but increased the TPR to 83%. Although blood parameters were most sensitive to BML, they could only explain 11%-22% of biomarker variation. The typical USG cutoff misclassified 42% of athletes postdehydration, and reliability was generally poor-moderate. Alternative strategies should be pursued to manage rapid BML in combat sports.