Sports participation volume and psychosocial outcomes among healthy high school athletes.

OBJECTIVES: We assessed the association between hours/week of sports participation and psychosocial outcomes among high school athletes. We hypothesized that more hours of participation would be associated with the lower levels of anxiety and depressive symptoms. METHODS: Participants completed the Patient-reported Outcomes Measurement Information System (PROMIS) Pediatric Profile 25 quality of life and other questionnaires to assess sports participation, socioeconomic status, and health history. We evaluated the multivariable relationship between hours/week in sport and PROMIS scores while adjusting for the independent effect of age and varsity team status. RESULTS: A total of 230 high school athletes participated in this study (mean=15.4±1.2 years of age). More hours/week playing sports were significantly associated with the lower levels of depressive symptoms (coefficient=-0.073, 95% CI=-0.137, -0.010; P=0.02). Sports participation was not significantly associated with any other psychosocial domain scores on the PROMIS questionnaire. CONCLUSION: More hours of sports participation were significantly associated with the lower depressive symptoms, but no other psychosocial domain. While our findings are cross-sectional, sport participation may play a role in attenuating symptoms of depression in high school athletes. RELEVANCE FOR PATIENTS: Sports participation may play a beneficial role in lessening depressive symptoms among healthy high school students.

Symptom profiles and postural control after concussion in female artistic athletes.

OBJECTIVES: The purpose of our investigation was to compare post-concussion symptom profiles and postural control measures among female youth artistic athletes (gymnasts and cheerleaders) relative to female ball sport athletes (volleyball or basketball). METHODS/FINDINGS: We compared 27 artistic athletes (median age = 15.0 years; evaluated median = 13 days post-injury) and 49 ball sport athletes (median age = 15.3 years; evaluated median = 10 days post-injury) within 21 days of sustaining a concussion on measures of symptom profiles and postural control (Balance Error Scoring System [BESS]), tandem gait, and Romberg tests. After adjusting for the independent effect of time from injury-evaluation, concussion history, and pre-morbid migraine history, we observed that artistic athletes performed the BESS tandem stance foam condition with fewer errors than ball sport athletes (ß = -2.4; 95% CI = -4.7, -0.2; p = .03). Artistic athletes demonstrated a higher, yet not statistically significant, headache severity than ball sport athletes (median = 4.5 vs 4.0, p = .07). CONCLUSIONS: Overall, artistic athletes had similar symptom profiles to ball sport athletes. Postural control measures, other than the BESS tandem stance foam condition, were not significantly different from ball sport athletes. This suggests that although their sports may require higher levels of balance, artistic athletes' performance on post-concussion balance tests may be similar to athletes of other disciplines.

Sleep Quality and Quality of Life Among Healthy High School Athletes.

We examined the association between sleep quality and quality of life (QOL) among uninjured high school athletes. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Profile 25 questionnaire. One hundred ten athletes reported poor sleep quality (mean PSQI: 6.6 ± 2.0; mean age: 15.3 ± 1.1; 62% female); 162 athletes reported good sleep quality (mean PSQI: 2.3 ± 1.3; mean age: 15.1 ± 1.7; 33% female). After adjusting for sex and age, worse sleep quality was associated with higher physical function/mobility (ß = 0.034; 95% confidence interval [CI] = 0.007-0.060; P = .01), anxiety (ß= 0.391; 95% CI = 0.263-0.520; P < .001), depressive symptom (ß = 0.456; 95% CI = 0.346-0.565; P < .001), fatigue (ß = 0.537; 95% CI = 0.438-0.636; P < .001), pain interference (ß = 0.247; 95% CI = 0.119-0.375; P < .001), and pain intensity (ß = 0.103; 95% CI = 0.029-0.177; P = .006) ratings. Poor self-reported sleep quality among adolescent athletes was associated with worse QOL ratings. Clinicians should consider assessing sleep hygiene to provide guidance on issues pertaining to reduced QOL.

Musculoskeletal Overuse Injuries in the Pediatric Population.

In pediatric patients, musculoskeletal overuse injuries are common clinical complaints. Recently, the number of youth who are engaged in formal competition has increased. A National Council of Youth Sports survey found that 60 million children aged 6 to 18 yr participate in some form of organized athletics. Surveillance reporting systems, such as the National High School Sports-Related Injury Surveillance System and the High School Reporting Information Online (high school RIO), an Internet-based sports injury surveillance tool, have suggested an increase in the rates of overuse injuries. This article will focus on potential risk factors for overuse injuries, including those that are intrinsic and extrinsic in youth athletes. We also make note of some of the more common overuse injuries seen in the outpatient clinical setting, their diagnoses, and treatment based on current evidence-based literature.

Is there an association between superolateral Hoffa fat pad edema on MRI and clinical evidence of fat pad impingement?

OBJECTIVE: Patients with symptomatic Hoffa fat pad impingement often exhibit fat pad edema on MRI. We studied two patient groups to determine the association between MRI fat pad edema and clinical symptoms of Hoffa fat pad impingement. MATERIALS AND METHODS: We studied 34 consecutive patients with an MRI diagnosis of fat pad edema and no injury in the prior year (group 1) and 47 consecutive patients with a knee MRI examination and no injury in the prior year (group 2). Two sports medicine physicians reviewed the clinical records to confirm or exclude symptomatic fat pad impingement. Two musculoskeletal radiologists independently scored 12 Hoffa fat pad locations for the presence of edema, noting the epicenter. RESULTS: Seventeen of the 34 patients in group 1 had clinical symptoms of fat pad impingement, with all 34 having fat pad edema. There was no association between clinical fat pad impingement and fat pad edema in any specific location (p > 0.183), but patients with fat pad impingement had a greater number of regions of edema (p = 0.005, 0.026 for two observers). In group 2, all four patients with clinical fat pad impingement had MRI fat pad edema, but 38 of the 43 patients without clinical impingement had MRI fat edema; 11 of the 38 had edema centered in the superolateral fat pad. CONCLUSION: Edema is present on MRI in the superolateral region of Hoffa fat pad in patients with clinical fat pad impingement. However, such edema can also be present in patients without symptoms of fat pad impingement.