Focused extracorporeal shockwave therapy for youth sports-related apophyseal injuries: case series.

BACKGROUND: Apophyseal overuse injuries are self-limited with skeletal maturity; however, they may be a source of significant pain and time lost from training. There is a lack of consensus for its management with the current available treatment, which might lag behind the ongoing development of regenerative medicine. The current retrospective case study aimed to assess the potential effectiveness and short-term safety of extracorporeal shockwave therapy (ESWT) in apophyseal injuries. METHODS: Data from 22 growing athletes [15 patients with Osgood-Schlatter disease and seven patients with Sever's disease] who received ESWT at a sports medicine unit in a university hospital were reviewed. All patients received low energy (= 0.1 mJ/mm2) level-focused ESWT using electrohydraulic generation technology. The clinical focusing technique was used upon applying ESWT. RESULTS: The number of sessions received to achieve full recovery ranged from 1 to 3 sessions. The time from treatment initiation to previous activity level was 2 weeks in 14 patients (63.3%), 4 weeks in seven patients (31.8%) and 11 weeks in one patient (4.5%). No adverse events were reported. No recurrence occurred up to 3 months after the last session. CONCLUSION: ESWT is a potentially safe and effective treatment for apophyseal injuries. It may facilitate an early return to sport activities.

Associations Between Adolescent Sport and Exercise Participation and Device-Assessed Physical Activity in Adulthood: Evidence From the 1970 British Cohort Study.

BACKGROUND: Adolescence is a critical period filled with life changes. Early implementation of effective health promotion strategies could help alleviate the morbidity and mortality associated with inactivity. This study investigated whether adolescent participation in exercise and sport is associated with device-assessed physical activity (PA) levels in midlife. METHODS: A total of 2984 participants (41.2% male) from the 1970 British Cohort Study were included. Participants were surveyed at age 16 years on 5 indicators of exercise and sport participation. Total daily PA and moderate to vigorous PA (MVPA) at age 46 years were measured using a thigh-worn accelerometer, worn for 7 days. Associations between each adolescent exercise or sport indicator and adulthood total daily PA and MVPA were examined using linear regressions, adjusting for sex, wear time, body mass index, smoking, disability, malaise, alcohol consumption, social class, education, and self-rated health. RESULTS: In fully adjusted models, adolescents who reported exercising "much more" than others (8.6 min/d; 95% confidence interval, -0.1 to 17.1), who played sports at the park/playground more than once a week (8.5 [3.0-14.0] min/d), and who exercised on the most recent Saturday (3.8 [0.7-6.9] min/d) had higher adult total PA levels than those who reported the lowest activity levels. There was no evidence of an association between greater sport and exercise participation at age 16 y and MVPA at age 46 y. There was no association between sports at school and either measure of adult PA. CONCLUSION: Active adolescents, particularly those who engaged in out-of-school exercise, had higher total daily PA levels, but not MVPA levels, in midlife. This highlights the potential of early PA interventions to improve PA levels in adulthood.

Lower calcium and iron intake in adolescent gymnasts: A case of concern for youth sports nutrition.

OBJECTIVES: Diet is important for the appropriate development and maturation of young amateur athletes. The aim of this study was to determine whether young gymnasts were consuming adequate amounts of nutrients, particularly calcium and iron. METHODS: This cross-sectional survey was conducted in Portugal's Almada and Lisbon regions in 2020. To determine if participants' diet was adequate, weight, height, and skinfold measurements were taken. Dietary consumption was examined using two 24-h recalls. We collected data from 66 participants (60% females, 12-18 y of age), of whom 82% had normal weight and 39% had ideal body fat. RESULTS: The daily total energy intake (TEI) was1605 ± 601 kcal. Of the TEI, 19%, 31%, and 50% were comprised of protein, fat, and carbohydrates, respectively. The most often consumed protein sources were poultry and ultra-processed meat products (52% and 45%, respectively). The average daily consumption of calcium and iron was 626 ± 293 and 9 ± 3 mg, respectively. Only 2 of the 66 participants had calcium intake within recommended levels, and 1of 5 had iron intake within recommended levels, the percentage of which was lower in girls than boys (7.5% versus 38.5%, P < 0.05). CONCLUSIONS: Despite having a sufficient macronutrient distribution, Portuguese gymnasts consume a high amount of ultra-processed items and a low amount of calcium and iron. The low proportion of female gymnasts with adequate iron consumption is cause for worry in sports nutrition.

Voleibol escolar: caracterização das escolas/municípios participantes dos jogos escolares de Santa Catarina / School volleyball: characterization of the schools/municipalities participating in the Santa Catarina school games

RESUMO O ambiente escolar tem contribuído no processo de desenvolvimento esportivo, especialmente pela oferta diversificada de atividades nas aulas de Educação Física e em projetos extracurriculares voltados às modalidades esportivas. O trabalho realizado com as equipes escolares de voleibol no estado de Santa Catarina tem sido altamente reconhecido ao longo dos anos, porém há poucas evidências sobre as escolas que têm contribuído na formação de jogadores de voleibol no cenário catarinense. Assim, o objetivo do estudo foi caracterizar as escolas participantes dos Jogos Escolares de Santa Catarina (JESC) de voleibol. Realizou-se a análise documental dos boletins dos JESC disponibilizados pela Fundação Catarinense de Esporte (FESPORTE). As evidências revelaram que os estabelecimentos de ensino com maiores participações e conquistas, em ambas as categorias investigadas, são escolas de educação básica da rede estadual, seguidas pelas instituições de ensino da rede privada e, em menor número, por escolas municipais. Enquanto na categoria feminina as escolas estão localizadas em sua grande maioria nas regiões Leste-Norte e Sul, na categoria masculina concentram-se na região Centro-oeste, especialmente em cidades de pequeno e médio porte, com elevado Índice de Desenvolvimento Humano (IDH).

ABSTRACT The school environment has contributed to the sports development process, especially due to the diversified offer of activities in Physical Education classes and extracurricular projects focused on sports. The work done with school volleyball teams in the state of Santa Catarina has been highly recognized over the years, but there is little evidence about schools that have contributed to the training of volleyball players in the Santa Catarina scenario. Thus, this study aimed to characterize the schools participating in the Jogos Escolares de Santa Catarina (JESC, Santa Catarina School Games) of volleyball. The documentary analysis of the JESC bulletins provided by the Fundação Catarinense de Esporte (FESPORTE, Santa Catarina Sports Foundation) was carried out. The evidence revealed that the educational establishments with the highest participation and achievements in both categories investigated were basic education schools of the state school system, followed by private educational institutions and, to a lesser extent, municipal schools. While in the women's group, the schools were mostly located in the East-North and South regions, in the men's group, they were concentrated in the Midwest region, especially in small and medium-sized cities with high Human Development Indices (HDIs).

Muscular strength training impacts in young athletes / Impactos do treinamento de força muscular em jovens atletas / Impactos del entrenamiento de la fuerza muscular en jóvenes atletas

ABSTRACT Introduction: Muscle strength is directly related to its cross-sectional area and the volume of its fibers, but there is no absolute linear relationship between hypertrophy and improvement in athletic performance. Under this complex perspective, muscle training strategies have been implemented to promote relevant muscle strength and improve overall athletic ability. Objective: Explore the impacts of muscle strength training on young athletes based on sport kinetic principles. Methods: we adopted the method of intragroup statistical comparison with body indexes of 10 volunteers undergoing muscle training focused on the core and lower limb set. Results: Muscle strength gain was effectively verified via electromyogram, and the test of athletic skills showed an evolution in jumping, balance, and reduction of wrong passes. Conclusion: Evidence-based muscle training can increase muscle strength and promote sports skill gain in young athletes. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A força muscular está ligada diretamente à área de sua seção transversal e ao volume de suas fibras, porém não há relação linear absoluta entre hipertrofia e melhora no desempenho atlético. Sob essa complexa perspectiva, estratégias de treinamento muscular vêm sendo implementadas para promover a força muscular relevante, no intuito de promover a melhora da capacidade atlética geral. Objetivo: Explorar os impactos do treinamento de força muscular nos jovens atletas baseado nos princípios cinéticos do esporte. Métodos: adotou-se o método de comparação estatística intragrupo com índices corporais de 10 voluntários submetidos ao treinamento muscular focado no conjunto do core e membros inferiores. Resultados: O ganho de força muscular foi efetivamente constatado via eletromiograma e o teste das habilidades atléticas demonstrou uma evolução no salto, equilíbrio e redução de passes errados. Conclusão: O treinamento muscular baseado em evidências consegue aumentar a força muscular e promover o ganho de habilidade esportiva nos jovens atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La fuerza muscular está directamente relacionada con su área transversal y con el volumen de sus fibras, pero no existe una relación lineal absoluta entre la hipertrofia y la mejora del rendimiento deportivo. Bajo esta compleja perspectiva, se han implementado estrategias de entrenamiento muscular para promover la fuerza muscular pertinente, con el fin de promover la mejora de la capacidad atlética general. Objetivo: Explorar los impactos del entrenamiento de la fuerza muscular en jóvenes atletas basándose en los principios de la cinética deportiva. Métodos: se adoptó el método de comparación estadística intragrupo con los índices corporales de 10 voluntarios sometidos a un entrenamiento muscular centrado en todo el núcleo y las extremidades inferiores. Resultados: La ganancia de fuerza muscular se verificó eficazmente a través del electromiograma y la prueba de habilidades atléticas mostró una evolución en los saltos, el equilibrio y la reducción de los pases erróneos. Conclusión: El entrenamiento muscular basado en la evidencia puede aumentar la fuerza muscular y promover la ganancia de habilidades deportivas en los atletas jóvenes. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Evidências adicionais de validade da versão brasileira do Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2) / Further validity evidence of the brazilian version of the Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2) / Evidencias adicionales de validez de la versión brasileña del Cuestionario de Percepción del Clima Motivacional en el Deporte PMCSQ-2

Esta pesquisa teve como objetivo adicionar novas evidências de validade à versão brasileira do Questionário de Percepção de Clima Motivacional no Esporte PMCSQ-2. A amostra foi composta por 1.125 crianças e adolescentes praticantes esporte em projetos sociais (média= 13,80±1,34 anos; 61,1% meninos). A Análise Fatorial Exploratória sugeriu estrutura com dois fatores coerentes: clima motivacional orientado ao ego e à tarefa, conforme hipótese teórica. A Análise Fatorial Confirmatória demonstrou adequação do PMCSQ-2 para avaliação das categorias específicas do clima motivacional: aprendizagem cooperativa, esforço, função importante na equipe, rivalidade entre membros da equipe, reconhecimento desigual e punição para erros. Também foram observados indicadores de invariância do modelo entre meninas e meninos. Os resultados sugerem adequação do instrumento ao contexto de projetos sociais. (AU)

This study sought new validity evidence for the Brazilian version of the Perceived Motivational Climate in Sports Questionnaire (PMCSQ-2). The sample consisted of 1125 children and adolescents (Mage = 13.80±1.34 years, 61.1% boys). All subjects practiced sports. Exploratory Factor Analysis suggested an internal structure composed of two general factors: performance-oriented and mastery-oriented motivational climate, as theoretically hypothesized. Confirmatory Factor Analysis demonstrated the adequacy of the PMCSQ-2 to assess specific categories of the motivational climate: cooperative learning, effort, important role in the team, rivalry among team members, unequal recognition and punishment for mistakes. The invariance of the measurement model between girls and boys was confirmed. These study results suggest the adequacy of the measure in the non-governmental organizations context. (AU)

Esta investigación tuvo como objetivo agregar nuevas evidencias de validez a la versión brasileña del Cuestionario de Percepción del Clima Motivacional en el Deporte PMCSQ-2. La muestra se compuso por 1125 niños y adolescentes deportistas en proyectos sociales en Porto Alegre (promedio = 13.80 ± 1.34 años; 61.1% chicos). El Análisis Factorial Exploratorio sugirió una estructura con dos factores: clima motivacional orientado al ego y la tarea, de acuerdo con la hipótesis teórica. El Análisis Factorial Confirmatorio demostró la idoneidad del PMCSQ-2 para evaluar categorías específicas del clima motivacional: aprendizaje cooperativo, esfuerzo, rol importante en el equipo, rivalidad entre los miembros del equipo, reconocimiento desigual y castigo por errores. Se observaron indicadores de invarianza del modelo de medición entre los sexos. Los resultados indican la adecuación del instrumento para medir la percepción del clima motivacional en el contexto de los proyectos sociales. (AU)

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review.

BACKGROUND: Overuse injuries are common in sporting children and adolescents. These injuries are a particular concern when they involve the epiphyseal-physeal-metaphyseal (EPM) complex given their potential to disturb skeletal growth. Specifically, the limits of mechanical tolerance of the EPM complex to repetitive stress may be exceeded by the intense and continuous training characteristic of many youth sports today. OBJECTIVE: This article describes the present status of knowledge on the occurrence and outcome of primary periphyseal stress injuries (PPSIs) affecting the EPM complex in the extremities of children and adolescents involved in youth sports. METHODS: A comprehensive review of the sports medicine literature was conducted to determine the nature and extent of PPSIs affecting the EPM complex of the extremities among youth sports participants and the potential for consequent skeletal growth disturbance and resultant limb deformity associated with these injuries. RESULTS: Our initial search uncovered 128 original published scientific articles reporting relevant data on PPSIs. There were 101 case reports/series, 19 cross-sectional, 1 case-control, and 7 cohort studies with relevant data. The case reports/series studies reported 448 patients with PPSIs involving the extremities. Children and adolescents representing a variety of high impact repetitive youth sports activities-including baseball, badminton, climbing, cricket, dance, gymnastics, rugby, soccer, swimming, tennis, and volleyball-may sustain PPSIs involving the shoulder, elbow, hand and wrist, knee, and ankle and foot. Although incidence data from prospective cohort studies are lacking, data arising from cross-sectional studies suggest that PPSIs may be common in select groups of youth athletes-including the shoulder in baseball players (0-36.6%), wrist in gymnasts (10-83%) and platform divers (52.6%), and fingers in rock climbers (5-58%). Notably, not all stress-related skeletal changes detected on imaging were symptomatic in these studies. When diagnosed and treated with an appropriate period of rest and rehabilitation, most patients studied were able to return to their sport activities. However, our data also show that 57/448 PPSIs (12.7%) produced growth disturbance, and that 28/448 patients (6.2%) underwent surgery for their injuries. Absence of treatment, delayed presentation and diagnosis, and non-compliance with a rest regimen were common in cases that produced growth disturbance. CONCLUSIONS: PPSIs may affect the extremities of children and adolescents engaged in a variety of youth sports, especially at advanced levels of training and competition. Most skeletally immature patients with PPSIs respond well to timely treatment; however, in extreme cases, PPSIs can progress to produce skeletal growth disruption which may necessitate surgical intervention. Clearly, establishing the early diagnosis of PPSIs and providing timely treatment of these injuries are needed to ensure the skeletal health of youth sports participants. Rigorous prospective longitudinal epidemiological and imaging studies designed to provide incidence rates of PPSIs and to determine the effect of PPSIs on long-term skeletal health are also necessary.

Stressed and Distressed: Potential Underpinnings of Exercise-Related Inspiratory Distress in Adolescent Sport Performers.

Many adolescent sport performers present with exercise-related respiratory symptoms consistent with exercise-induced laryngeal obstruction (EILO). The pathogenic underpinnings of EILO are not fully resolved, and existing behavioral management includes therapies targeting laryngeal physiology whereas surgical interventions target laryngeal anatomical anomalies. Recent findings from research and clinical practice indicate that psychological stress and thoracic breathing co-occur with laryngeal tightness in adolescent sport performers with EILO. This Perspective article theorizes on this potential coexistence. It discusses possible underpinnings of respiratory symptoms (including EILO) and thoracic breathing in adolescent sport performers by considering the effects of various stressors to which adolescent sport performers are exposed, and the impact these may have on the breathing, including in terms of laryngeal narrowing. The effect of stress on the breathing is examined in light of the reciprocal communication between the brain and the body and the relationship between psychological stress and stress responses in the respiratory system mediated by the autonomic nervous system. To inform decision-making and clinical awareness in this area, it may be worth expanding the focus from targeting mainly laryngeal structures to also include constrictions of the airways and the effects of thoracic breathing on the larynx during exercise. The importance of considering respiratory distress from a multidimensional perspective, and of incorporating the complexity of sport performers' psychological and physical experiences in the management of their health and well-being, is emphasized. IMPACT: This Perspective adds to the understanding of respiratory distress in populations other than adults, which is important and necessary. LAY SUMMARY: Adolescent sport performers are exposed to a number of stressors that may affect breathing and laryngeal narrowing, which in turn may have implications for the management of their overall health and well-being.

Operative Treatment of Cervical Spine Injuries Sustained in Youth Sports.

BACKGROUND: Little data exists on surgical outcomes of sports-related cervical spine injuries (CSI) sustained in children and adolescent athletes. This study reviewed demographics, injury characteristics, management, and operative outcomes of severe CSI encountered in youth sports. METHODS: Children below 18 years with operative sports-related CSI at a Level 1 pediatric trauma center were reviewed (2004 to 2019). All patients underwent morden cervical spine instrumentation and fusion. Clinical, radiographic, and surgical characteristics were analyzed. RESULTS: A total of 3231 patients (mean, 11.3±4.6 y) with neck pain were evaluated for CSI. Sports/recreational activities were the most common etiology in 1358 cases (42.0%). Twenty-nine patients (2.1%) with sports-related CSI (mean age, 14.5 y; range, 6.4 to 17.8 y) required surgical intervention. Twenty-five were males (86%). Operative CSI occurred in football (n=8), wrestling (n=7), gymnastics (n=5), diving (n=4), trampoline (n=2), hockey (n=1), snowboarding (n=1), and biking (n=1). Mechanisms were 27 hyperflexion/axial loading (93%) and 2 hyperextension injuries (7%). Most were cervical fractures (79%) and subaxial injuries (79%). Seven patients (24%) sustained spinal cord injury (SCI) and 3 patients (10%) cord contusion or myelomalacia without neurological deficits. The risk of SCI increased with age (P=0.03). Postoperatively, 2 SCI patients (29%) improved 1 American Spinal Injury Association Impairment Scale Grade and 1 (14%) improved 2 American Spinal Injury Association Impairment Scale Grades. Increased complications developed in SCI than non-SCI cases (mean, 2.0 vs. 0.1 complications; P=0.02). Bony fusion occurred in 26/28 patients (93%) after a median of 7.2 months (interquartile range, 6 to 15 mo). Ten patients (34%) returned to their baseline sport and 9 (31%) to lower-level activities. CONCLUSIONS: The incidence of sports-related CSI requiring surgery is low with differences in age/sex, sport, and injury patterns. Older males with hyperflexion/axial loading injuries in contact sports were at greatest risk of SCI, complications, and permanent disability. Prevention campaigns, education on proper tackling techniques, and neck strength training are required in sports at high risk of hyperflexion/axial loading injury. LEVEL OF EVIDENCE: Level III-retrospective cohort study.

Research on burnout level of juvenile trampolinists and relevant affecting factors / Pesquisa sobre o nível de burnout de trampolinistas juvenis e fatores afetivos relevantes / Investigación sobre el nivel de burnout de los trampolinistas juveniles y los factores afectivos relevantes

ABSTRACT Introduction The paper investigates burnout causes and relevant affecting factors of juvenile trampolinists. Objective With 93 participants aged U10-16 of 2019 National Juvenile Trampoline Championship as investigation objects, to improve the current situation of juvenile burnout, exploring the methodology to alleviate and eliminate it, enhancing the sense of achievement in training and competition and providing a theoretical basis for coaches to train and cultivate athletes. Methods Questionnaire survey, semi-structured interview, mathematical statistics. Results The burnout level of the trampolinists is below the moderate level, and the overall burnout level of athletes is not high; the sense of achievement decrease> negative evaluation of sports>emotional/physical exhaustion; the correlation between the overall level of burnout of athletes and different genders, training age, education stage and athlete level is not significant; in terms of burnout, there are very significant positive correlations(P<0.01) between overload factor, personal factor, and situational factor, and emotional/physical exhaustion, sense of achievement decrease and negative evaluation of sports respectively. Conclusions Strengthen the communication with trampolinists, improve their self-regulation ability in various ways, master the methods to alleviate burnout, and increase social support for them. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução O artigo investiga as causas do burnout e os fatores que afetam os jovens trampolinistas. Objetivo Ter como objeto de pesquisa 93 participantes de U10-16 do Campeonato Nacional Juvenil de Trampolim 2019, para melhorar a situação atual do burnout juvenil, explorando a metodologia para amenizá-lo e eliminá-lo, potencializando a sensação de realização em treinamentos e competições e proporcionando uma base para os treinadores trabalharem com os atletas. Métodos Questionário de levantamento, entrevista semiestruturada, estatística matemática. Resultados O nível de burnout dos trampolinistas está abaixo do nível moderado e o nível geral de burnout dos atletas não é alto; diminuição da sensação de realização> avaliação negativa de esportes> burnout emocional/físico; a correlação entre o nível geral de burnout dos atletas e os diferentes gêneros, a idade de treinamento, o estágio educacional e o nível do atleta não é significativa; Em termos de burnout, existem correlações positivas altamente significativas (P <0,01) entre o fator de sobrecarga, o fator pessoal e o fator situacional, e burnout emocional/físico, a diminuição do senso de realização e a avaliação negativa dos esportes, respectivamente. Conclusões Fortalecer a comunicação com os trampolinistas, melhorar sua capacidade de autorregulação de várias maneiras, dominar os métodos para aliviar o burnout e aumentar o apoio social para eles. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción El artículo investiga las causas del burnout y los factores que afectan a los trampolinistas juveniles. Objetivo Con 93 participantes de edades U10-16 del Campeonato Nacional Juvenil de Trampolín 2019 como objetos de investigación, mejorar la situación actual del burnout juvenil, explorando la metodología para aliviarlo y eliminarlo, potenciando el sentido de logro en entrenamientos y competencias y brindando un base para que los entrenadores trabajen con los atletas. Métodos Encuesta por cuestionario, entrevista semiestructurada, estadística matemática. Resultados El nivel de burnout de los trampolinistas está por debajo del nivel moderado y el nivel de burnout general de los atletas no es alto; disminución del sentido de logro> evaluación negativa de los deportes> burnout emocional / físico; la correlación entre el nivel general de burnout de los atletas y los diferentes géneros, la edad de entrenamiento, la etapa educativa y el nivel del atleta no es significativa; en términos de burnout, existen correlaciones positivas muy significativas (P <0,01) entre el factor de sobrecarga, el factor personal y el factor situacional, y el burnout emocional / físico, la disminución del sentido de logro y la evaluación negativa de los deportes, respectivamente. Conclusiones Fortalecer la comunicación con los trampolinistas, mejorar su capacidad de autorregulación de diversas formas, dominar los métodos para aliviar el burnout y aumentar el apoyo social a ellos. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Adolescents' healthy sports behavior model based on the theory of social-ecological system / Modelo de comportamento esportivo saudável de adolescentes baseado na teoria do sistema socioecológico / Modelo de comportamiento deportivo saludable de adolescentes basado en la teoría del sistema socioecológico

ABSTRACT Introduction: Education administrative departments and schools should regard sports as an integral part of school education and allow students to use sports every day. Guarantee the time for sports activities; schools should organize various forms of extracurricular sports activities". Objective: Based on the ecological system theory, the paper constructs a three-factor structural model that restricts youth sports participation and compiles a scale of factors restricting youth sports participation. Methods: The thesis selected 1,800 primary and secondary school students as the research object and used exploratory factor analysis to explore the questionnaire structure on the obstacles to sports participation. Results: 1) Exploratory factor analysis, the cumulative contribution rate of the first three factors extracted was 58.90%, and the load of each factor was more significant than 0.4. The three factors were school factors, family factors, and personal factors in order; 2) Reselected subjects, Exploring the three-factor structural model of obstacles to sports participation were verified. The final modified model RMSEA was 0.071, CFI was 0.98, and χ2/df was 8.55. The three factors were school factors, family factors, and personal factors. Conclusions: The fit of the three-factor structural indicators restricting youth sports participation is ideal, and the model is relatively stable. The "Questionnaire on Restricting Factors of Youth Sports Participation" can be used as a measurement tool to evaluate and understand youth sports participation constraints. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: Departamentos administrativos de educação e escolas devem considerar os esportes como parte integrante da educação escolar e permitir que os alunos pratiquem esportes todos os dias. Garantia de tempo para atividades esportivas; as escolas devem organizar várias formas de atividades esportivas extracurriculares. Objetivo: Com base na teoria do sistema ecológico, o artigo constrói um modelo estrutural de três fatores que restringe a participação em esportes de jovens e compila uma escala de fatores que restringem a participação em esportes de jovens. Métodos: a tese selecionou 1.800 alunos do ensino fundamental e médio como objeto de pesquisa e utilizou uma análise fatorial exploratória para explorar a estrutura do questionário sobre obstáculos à participação esportiva. Resultados: 1) Análise fatorial exploratória, a taxa de contribuição cumulativa dos três primeiros fatores extraídos foi de 58,90% e a carga de cada fator foi mais significativa do que 0,4. Os três fatores eram fatores escolares, fatores familiares e fatores pessoais em ordem; 2) Foram verificados os temas reelecionados, explorando o modelo estrutural de três fatores de obstáculos à participação esportiva. O modelo RMSEA modificado final foi 0,071, CFI foi 0,98 e χ2 / df foi 8,55. Os três fatores eram fatores escolares, fatores familiares e fatores pessoais. Conclusões: O ajuste dos indicadores estruturais de três fatores que restringem a participação dos jovens em esportes é ideal e o modelo é relativamente estável. O "Questionário sobre Fatores Restritivos da Participação em Esportes de Jovens" pode ser usado como uma ferramenta de medição para avaliar e compreender as limitações da participação em esportes de jovens. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción: Los departamentos administrativos de educación y las escuelas deben considerar los deportes como una parte integral de la educación escolar y permitir que los estudiantes utilicen los deportes todos los días. Garantizar el tiempo para actividades deportivas; las escuelas deberían organizar diversas formas de actividades deportivas extracurriculares. Objetivo: Basado en la teoría del sistema ecológico, el artículo construye un modelo estructural de tres factores que restringe la participación deportiva juvenil y compila una escala de factores que restringen la participación deportiva juvenil. Métodos: La tesis seleccionó a 1.800 estudiantes de primaria y secundaria como objeto de investigación y utilizó un análisis factorial exploratorio para explorar la estructura del cuestionario sobre los obstáculos a la participación deportiva. Resultados: 1) Análisis factorial exploratorio, la tasa de contribución acumulada de los tres primeros factores extraídos fue de 58,90% y la carga de cada factor fue más significativa que 0,4. Los tres factores fueron factores escolares, factores familiares y factores personales en orden; 2) Se verificaron sujetos reselegidos, Explorando el modelo estructural de tres factores de obstáculos a la participación deportiva. El modelo final modificado RMSEA fue 0.071, CFI fue 0.98 y χ2 / df fue 8.55. Los tres factores fueron factores escolares, factores familiares y factores personales. Conclusiones: El ajuste de los indicadores estructurales de tres factores que restringen la participación deportiva juvenil es ideal y el modelo es relativamente estable. El "Cuestionario sobre factores restrictivos de la participación deportiva juvenil" puede utilizarse como una herramienta de medición para evaluar y comprender las limitaciones de la participación deportiva juvenil. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

An Educational Intervention for Improving the Snacks and Beverages Brought to Youth Sports in the USA.

OBJECTIVES: The purpose of this study was to test a small-scale intervention and its ability to decrease total sugar intake and number of calories offered at youth sports games. METHODS: This study was a pre/post-test quasi-experimental design. A flier was developed and distributed to parents. The flier aimed to decrease the sugar-sweetened beverages and increase the nutritional quality of food brought to games. Baseline data were collected in 2018 (n = 61). The flier was distributed prior to the start of the league, once during the league, and posted online in 2019. Postintervention data were collected in the intervention group (n = 122) and a comparison group (n = 74). Nutritional information was collected through direct observation. RESULTS: The average amount of total sugar provided per game per child was 25.5 g at baseline when snacks/beverages were provided at games. After the intervention, the average amount of total sugar provided significantly decreased (16.7 g/game/child, p < 0.001). CONCLUSIONS: The intervention reduced total sugar offered and the number of sugar-sweetened beverages brought to games. It was low-cost and could be easily implemented by public health practitioners and/or parks and recreation administrators. Further, considerations could be made to implement policies relative to snacks and beverages at youth sports games.

Relação entre tempo de experiência e habilidades técnicas de crianças praticantes de futsal / Relationship between time of experience and technical skills of children futsal practitioners

O objetivo deste estudo foi comparar e correlacionar o tempo de experiência e as habilidades técnicas em crianças praticantes de futsal da categoria sub-11. 22 crianças praticantes de futsal (21 do sexo masculino e uma do sexo feminino), com idade entre nove e onze anos, participantes de uma escolinha de futsal foram divididas em dois grupos de praticantes: com menor tempo de experiência (G1); e, com maior tempo de experiência (G2), todos em fase de aprendizagem e de treinamento do futsal. Ambos grupos foram avaliados pelo teste Skills, adaptado ao futsal. Foram obtidas, comparadas e correlacionadas a idade, massa corporal, estatura, condução de bola, domínio de bola, precisão do chute e precisão de passe com o pé direito e esquerdo. A avaliação ocorreu individualmente com um período de adaptação da criança as tarefas do teste e teve duração aproximada de três minutos para cada criança. Dois avaliadores com experiência na modalidade participaram da realização do teste. Comparações das variáveis entre os grupos foram realizadas e correlações entre o tempo de experiência e as habilidades técnicas foram testadas com α de 5%. Os achados deste estudo indicam que todas as habilidades técnicas apresentaram valores similares (p > 0,05). Assim, na categoria sub-11, o tempo de experiência não foi um fator determinante no nível de aprendizado das habilidades técnicas e nas características antropométricas das crianças. Ainda, foram identificadas correlação entre o tempo de experiência com as variáveis da idade, domínio1,95m, domínio3,05m, passe com o pé esquerdo e condução de bola. Portanto, independente do tempo de experiência em jogadores da categoria sub-11, os mesmos podem apresentar desempenho similar nas habilidades técnicas do futsal....(AU)

The objective of this study was to compare and correlate the time of experience and technical skills in children practicing futsal in the sub-11 category. 22 children playing futsal (21 male and one female), aged between nine and eleven years old, participating in a futsal school were divided into two groups of practitioners: with less experience (G1); and, with a longer experience (G2), all of them in the futsal learning and training phase. Both groups were evaluated by the Skills test, adapted to futsal. Age, body mass, height, ball handling, ball control, kick accuracy and passing accuracy with the right and left foot were obtained, compared and correlated. The evaluation took place individually with a period of adaptation of the child to the test tasks and lasted approximately three minutes for each child. Two evaluators with experience in the modality participated in the test. Comparisons of variables between groups were made and correlations between time of experience and technical skills were tested with α of 5%. The findings of this study indicate that all technical skills showed similar values (p>0.05). Thus, in the sub-11 category, the length of experience was not a determining factor in the level of learning of technical skills and anthropometric characteristics of children. In addition, a correlation was identified between the time of experience with the variables of age, domain1.95m, domain3.05m, pass with the left foot and ball handling. Therefore, regardless of the time of experience in players of the sub-11 category, they can present similar performance in the technical skills of futsal. (AU)

Association between sleep quality and pain in young amateur athletes / Asociación entre calidad del sueño y dolor en jóvenes atletas amateurs / Associação entre qualidade do sono e dor em jovens atletas amadores

ABSTRACT Introduction: It has been shown that there is a close association between sleep quality and pain. In young athletes, sleep disorders and pain have a particularly high prevalence; however, the relationship between them has not been widely studied. Objective: To study the association between sleep quality and pain in young athletes. Methods: A cross-sectional study was conducted in which 71 young amateur athletes (39 males) were included. The mean age was 16.9 ± 1.2 years, with 6.5 ± 3.2 years of sports practice and 5.2 ± 1.2 hours of training per week. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The participants were classified according to sleep quality, as PSQI-I = without sleep disorders, PSQI-II = requiring medical assistance and PSQI-III = requiring medical assistance and treatment. Also, pain intensity was assessed on the Numerical Rating Scale, both at rest (NRSr) and during sports activity (NRSs), along with pain duration. Results: The individuals classified as PSQI-III presented higher NRSr (Mdn = 2.0; IQR = 4.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.04) and higher NRSs (Mdn = 4.0; IQR = 5.0 vs. Mdn = 0.0; IQR = 2.0; p = 0.03) than the individuals classified as PSQI-I. No differences were observed in relation to pain duration. The PSQI score was positively but weakly associated with NRSr (rs = 0.24, p=0.046) and NRSs (rs = 0.27, p = 0.03) but not with pain duration. Conclusion: Young athletes with lower levels of sleep quality show higher levels of pain at rest and during sports practice. Therefore, sleep quality and pain should be considered in the routine assessment of young athletes, by technical and health teams. Level of evidence III; type of study: Cross-sectional .

RESUMEN Introducción: Se demostró que existe estrecha relación entre calidad del sueño y dolor. En atletas jóvenes, los disturbios del sueño y dolor tienen prevalencia bastante alta, sin embargo, la relación entre ellos no fue ampliamente estudiada. Objetivo: Estudiar la asociación entre calidad del sueño y dolor en atletas jóvenes. Métodos: Fue realizado un estudio transversal, en el cual fueron incluidos 71 atletas jóvenes amateurs (39 hombres). El promedio de edad fue de 16,9 ± 1,2 años, con 6,5 ± 3,2 años de práctica deportiva y 5,2 ± 1,2 horas de entrenamiento por semana. La calidad del sueño fue evaluada por medio del Índice de Calidad del Sueño de Pittsburgh (PSQI). Los participantes fueron clasificados de acuerdo con la calidad del sueño, PSQI-I= sin disturbios del sueño, PSQI-II= requiere atención médica y PSQI-III= requiere atención médica y tratamiento. Además, la intensidad del dolor fue evaluada en la Escala de Evaluación Numérica en reposo (EANr) y durante la actividad deportiva (EANe), juntamente con la duración del dolor. Resultados: Los individuos clasificados como PSQI-III presentaron mayor valor en el EANr (Mdn = 2,0; IQR = 4,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,04) y EANe mayores (Mdn = 4,0; IQR = 5,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,03) que los individuos clasificados con PSQI-I. No fue observada ninguna diferencia con relación a la duración del dolor. El puntaje del PSQI fue positivo y con débil asociación a EANr (rs = 0,24, p=0.046) y EANe (rs = 0,27, p = 0,03), pero no con la duración del dolor. Conclusión: Los atletas jóvenes con niveles más bajos de calidad del sueño tienen niveles más elevados de dolor en reposo y durante la práctica deportiva. Por lo tanto, la calidad del sueño y el dolor deben ser considerados por los equipos técnicos y de salud en la evaluación rutinaria de atletas jóvenes. Nivel de evidencia III;Tipo de estudio: Transversal.

RESUMO Introdução: Demonstrou-se que existe estreita associação entre qualidade do sono e dor. Em atletas jovens, distúrbios do sono e dor têm prevalência bastante alta, no entanto, a relação entre eles não foi amplamente estudada. Objetivo: Estudar a associação entre qualidade do sono e dor em atletas jovens. Métodos: Foi realizado um estudo transversal, no qual foram incluídos 71 atletas jovens amadores (39 homens). A média de idade foi de 16,9 ± 1,2 anos, com 6,5 ± 3,2 anos de prática esportiva e 5,2 ± 1,2 horas de treinamento por semana. A qualidade do sono foi avaliada por meio do Índice de Qualidade do Sono de Pittsburgh (PSQI). Os participantes foram classificados de acordo com a qualidade do sono, PSQI-I = sem distúrbios do sono, PSQI-II = requer atendimento médico e PSQI-III = requer atendimento médico e tratamento. Além disso, intensidade da dor foi avaliada na Escala de Avaliação Numérica em repouso (EANr) e durante a atividade esportiva (EANe), juntamente com a duração da dor. Resultados: Os indivíduos classificados como PSQI-III apresentaram maior valor no EANr (Mdn = 2,0; IQR = 4,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,04) e EANe maiores (Mdn = 4,0; IQR = 5,0 vs. Mdn = 0,0; IQR = 2,0; p = 0,03) do que os indivíduos classificados com PSQI-I. Nenhuma diferença foi observada com relação à duração da dor. O escore do PSQI foi positivo e com fraca associação a EANr (rs= 0,24, p=0.046) e EANe (rs= 0,27, p = 0,03), mas não com a duração da dor. Conclusão: Atletas jovens com níveis mais baixos de qualidade do sono têm níveis mais elevados de dor em repouso e durante a prática esportiva. Portanto, a qualidade do sono e a dor devem ser consideradas pelas equipes técnicas e de saúde na avaliação rotineira de atletas jovens. Nível de evidência III; Tipo de estudo: Transversal.

Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes.

BACKGROUND: Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. PURPOSE: To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. STUDY DESIGN: Cross-sectional study with prospectively collected data. METHODS: Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. RESULTS: Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level (r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score (R2 = 0.242; B = 3.0; P < .001). CONCLUSION: This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. CLINICAL RELEVANCE: All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.

Characterizing Epidemiology and Associated-Factors of Adolescent Sports-Related Traumas Using Trauma Quality Improvement Program.

ABSTRACT: Sports-related injuries contribute to a considerable proportion of pediatric and adolescent craniofacial trauma, which can have severe and longstanding consequences on physical and mental health. The growing popularity of sports within this at-risk group warrants further characterization of such injuries in order to enhance management and prevention strategies. In this study, the authors summarized key trends in 1452 sports-related injuries among individuals aged 16 to 19 using the American College of Surgeon's Trauma Quality Improvement Program database from 2014 to 2016. The authors observed a preponderance of injuries associated with skateboarding, snowboarding, and skiing, with significantly higher percentages of traumatic brain injuries among skateboarding-related traumas. Notably, we observed that traumatic brain injurie rates were slightly higher among subjects who wore helmets. Intensive care unit durations and hospital stays appeared to vary by sport and craniofacial fracture. Altogether, this study contributes to the adolescent sports-related injuries and craniofacial trauma literature.

Parameters of cardiac symptoms in young athletes using the Heartbytes database.

Introduction: To determine clinical parameters that are related to abnormal cardiac symptoms in physically active youth. Methods: We used Simon's Heart Heartbytes National Youth Cardiac Registry to collect data from adolescent athletes in southeastern Pennsylvania. We collected age, race/ethnicity, abnormal cardiac symptoms, medical history, medication use, caffeine intake, and family history. We obtained height, weight, blood pressure, cardiac murmur findings, and ECGs. Echocardiogram was obtained if necessary. Binary logistic regression analysis was performed to identify independent associations between abnormal cardiac symptoms and collected variables. The odds ratio (OR), 95% confidence interval (95% CI), and p-values were used as statistical values. Results: Of the 887 athletes (543 males and 344 females, age = 16.9 ± 2.1 years, height = 166.9 ± 11.4 cm, weight = 62.0 ± 16.0 kg), 186 (21%) had abnormal cardiac symptoms including chest pain, passing out, difficulty breathing, extreme fatigue, and heart race. There was an independent association between abnormal symptoms and a past medical history (OR: 4.77, 95%CI: 3.18, 7.17, p = 0.001) and medication use (OR: 1.74, 95%CI: 1.08, 2.79, p = 0.022). In medical history, young athletes with asthma showed a greater propensity of abnormal cardiac symptoms (48.9%) compared to young athletes without (14.0%, p = 0.001). Additionally, young athletes with anxiety or depression demonstrated a higher proportion of abnormal cardiac symptoms (48.9%) than those without (19.5%, p = 0.001). Although the association between the presence of abnormal symptoms and African-American race (OR: 2.04, 95%CI: 0.96, 4.35, p = 0.065) and average daily consumption of at least 2 caffeine drinks (OR: 2.08, 95%CI: 0.86, 5.02, p = 0.103) were not significant, there was a trend to reach the a priori significance level. Conclusions: This study identified several clinical parameters that are associated with symptoms suggestive of abnormal cardiac conditions. Larger studies need to be done to better sort out the clinical history that may contribute to false positives to further reduce false positives at heart screenings.

Does Functional Bracing of the Unstable Shoulder Improve Return to Play in Scholastic Athletes? Returning the Unstable Shoulder to Play.

BACKGROUND: Functional bracing is often used as an adjunct to nonoperative treatment of anterior shoulder instability, but no study has evaluated the effectiveness of in-season bracing. The purpose of this study was to examine successful return to play in a nonoperative cohort of adolescent athletes with in-season shoulder instability and compare those athletes treated with bracing to those who were not. HYPOTHESIS: The use of functional bracing will improve success rates in a cohort of athletes treated nonoperatively for in-season shoulder instability. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 97 athletes with anterior shoulder instability were followed for a minimum of 1 year. The mean age was 15.8 ± 1.4 years (range, 12.0-18.0 years). All athletes were treated with initial nonoperative management. Twenty athletes (21%) were also treated with bracing while 77 (79%) were not. The athlete completing the current season and 1 subsequent season without surgery or time lost from shoulder injury was defined as a successful outcome. RESULTS: There was no statistical difference in nonoperative success rates between the braced and nonbraced athletes (P = 0.33). Braced athletes (n = 20) returned to play 80% of the time, while nonbraced athletes (n = 77) returned at a rate of 88%. Of the braced athletes, 85% were football players (n = 17). A football-only comparison demonstrated no difference between braced failures (26%) and nonbraced failures (16%) (P = 0.47). CONCLUSION: This is the first study to evaluate the utility of functional bracing in returning an athlete to sport and completing a full subsequent season without surgery or time loss due to injury of the shoulder. In adolescent athletes with shoulder instability treated nonoperatively, functional bracing did not result in increased success rates when compared with no bracing. CLINICAL RELEVANCE: The data from this study indicate that functional bracing may not improve success rates for athletes with shoulder instability.

Strategies adopted in the defensive return by handball coaches from teams U-12 to U-18

Abstract Aims: to analyze the choices of handball coaches for structuring the defensive return throughout the teaching-learning process (U-12 to U-18 teams). Methods: Nineteen coaches from teams U-12 to U-18 from two leagues in the state of São Paulo were interviewed. The speeches from the semi-structured interviews were analyzed through thematic analysis, which produced two themes and their respective subthemes. Results: Most coaches structure their defensive return and emphasize content to make it difficult for an opponent to counterattack. A higher percentage of directed play was observed in teams U-12 and U-14, which suggests a possible early specialization process. In the U-16 and U-18 teams, higher percentages of free play were observed when compared to the others. In older teams, a higher percentage of directed play would be expected, mainly because these are stages with an increase in player specialization. Conclusion: The findings suggest that the simultaneous training of different teams may be leading to sports specialization procedures in the younger teams and, simultaneously, underestimating the possibilities in the older teams.

Parkour, transpondo o obstáculo da competição / Parkour, overcoming the hurdle of competition / Parkour, transpondiendo el obstáculo delacompetición

Objetivo: O parkour é uma nova versão esportiva, criado nos subúrbios de França que se opõe ao agonismo próprio da modernidade e parece confrontar as certezas que o positivismo engendra. Este trabalho tem por objetivo conhecer os praticantes de parkour e entender como concebem o conceito de competição que começa a ser disseminado nele. Método: Uma pesquisa exploratória com oitenta e quatro sujeitos foi aplicada em praticantes de todo o Brasil. Resultados: Os resultados permitem dizer que os jovens são aqueles que mais procuram o parkour e que os grupos são heterogêneos, ainda se percebe que as mulheres precisam conquistar seu espaço, pois não são protagonistas na modalidade. Conclusão: Verificou-se que há interesses da Federação Internacional de Ginástica em agrupar o parkour como uma de suas disciplinas e que os praticantes brasileiros não têm um consenso sobre se aceitam a competição ou não.

Objective: Parkour is a new sport version, created in the suburbs of France that opposes to the agonism proper to modernity and seems to confront the certainties that the positivism engenders. This paper aims to know the parkour practitioners and understand how they conceive the concept of competition that begins to spread in it. Method: An exploratory survey with eighty-four subjects was applied to practitioners from all over Brazil. Results: The results allow us to say that young people are those who seek parkour the most and the groups are heterogeneous, it is still clear that women need to conquer their space, as they are not protagonists in the sport.Conclusion:It was found that there are interests of the International Gymnastics Federation in grouping parkour as one of its disciplines and that Brazilian practitioners do not have a consensus about to accept or not the competition.

Objetivo: Parkoures una nueva versión deportiva, creada em los suburbios de Francia que se opone al agonismo de la modernidad y enfrenta las certezas que engendra el positivismo. Este trabajo tiene como objetivo conocer a los profesionales del parkoury comprender cómo conciben el concepto de competición que está comenzando a difundirse en él. Método: Se aplicó una investigación exploratoria con ochenta y cuatro sujetos practicantes del parkourde todo Brasil. Resultados: Los resultados nos permiten decir que los jóvenes son los que más buscan el parkoury que los grupos son heterogéneos, todavía está claro que las mujeres necesitan conquistar su espacio, ya que no son protagonistas en el deporte. Conclusión: Se descubrió que hay intereses de la Federación Internacional de Gimnasia en agrupar el parkourcomo una de sus disciplinas y que los practicantes brasileños no tienen un consenso sobre si aceptar la competición o no.