Impact of Factors that Affect Reading Skill Level on King-Devick Baseline Performance Time.

The King-Devick (K-D) test is often used as part of a multimodal assessment to screen for sport-related concussion. However, the test involves reading numbers, and little is known about variation in baseline performance on the K-D by reading skill level. We conducted a cross-sectional study analyzing data from the Concussion Assessment, Research and Education (CARE) Consortium to assess differences in baseline performance on the K-D associated with factors that impact reading skill level (learning disorder [LD] and primary home language other than English [PHLOTE]), while controlling for covariates (gender, type of sport, attentional issues, history of concussion and modality of administration). We had a sample of 2311 student-athletes (47% female), and multivariate regression indicated an average K-D performance time of 40.4 s. Presence of LD was associated with a 3.3 s slower K-D time (95% CI 1.9-4.7, p < 0.001), and PHLOTE was associated with a 2.6 s slower K-D time (95% CI 1.2-4.0, p < 0.001), after controlling for other covariates. These results suggest caution in the use of normative data with the K-D. Future studies should explore the impact of factors associated with reading skill level on sensitivity of the K-D in detecting concussion.

Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation.

There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal.

Gender differences in noncontact anterior cruciate ligament injuries.

Female athletes have an increased incidence of ACL rupture. The cause of this increased injury rate is unclear, but it is most likely from a complex interplay between multiple variables. The relative risk of incurring an ACL injury is still low. The increased risk of ACL injury in women compared with men should not discourage female participation in sports. Instead, the focus should be on strategies to prevent injuries. Intrinsic factors are difficult or impossible to change; modifiable risk factors need to identified and prevention strategies should be employed.

Pulmonary embolism: sifting the risk factors.

A 20-year-old female college cross-country runner developed chest pain and dyspnea that increased with running. A chest radiograph revealed a right-side pleural effusion, and a ventilation-perfusion scan indicated a probable pulmonary embolism. The diagnosis was left-side pulmonary emboli. Testing for genetic risk factors was negative, leaving oral contraceptive use as the likely cause of the condition. The patient was treated with anticoagulant drugs and discontinuation of oral contraceptives, and was allowed to resume running gradually. Discussion covers genetic and other risk factors, anticoagulation therapy, and return to play.

Assessment and management of concussion in sports.

The most common head injury in sports is concussion. Athletes who sustain a prolonged loss of consciousness should be transported immediately to a hospital for further evaluation. Assessment of less severe injuries should include a thorough neurologic examination. The duration of symptoms and the presence or absence of post-traumatic amnesia and loss of consciousness should be noted. To avoid premature return to play, a good understanding of the possible hazards is important. Potential hazards of premature return to play include the possibility of death from second-impact syndrome, permanent neurologic impairment from cumulative trauma, and the postconcussion syndrome.

The relationship of skill level to anterior cruciate ligament injury.

OBJECTIVE: To examine the relationship of skill, as represented by NCAA division level, to anterior cruciate ligament rupture in collegiate men's and women's basketball and soccer players. DESIGN: Randomized, retrospective. PARTICIPANTS: Women's and men's basketball and soccer players at NCAA Division I, II, and III institutions. MAIN OUTCOME MEASURE: Athletes with or without ACL injury. RESULTS: There was no relationship of ACL injury rate to NCAA division level in men's or women's basketball or soccer. CONCLUSIONS: There are many different variables that contribute to a player's skill level. Although these variables may relate to ACL injury and may be responsible for the differential in injury rate between men and women, skill level as represented by collegiate division does not relate to ACL injury. When considering possible etiologies of the differential in ACL injury rates between men and women, the use of the term "skill" should be avoided, and more specific terms used.