Knowledge and attitudes about sports-related dental injuries and mouthguard use in young athletes in four different contact sports-water polo, karate, taekwondo and handball.

BACKGROUND/AIMS: The increasing popularity of participating in sports activities among children and adolescents has increased the risk of sports-related orofacial and dental injuries. Therefore, it is important to establish efficient preventive strategies regarding sports-related dental trauma. The aim of this study was to evaluate the occurrence of sports-related dental injuries in young athletes and to compare the frequency of such injuries between high-risk and medium-risk sports, along with assessing athletes' attitudes and habits regarding mouthguard use. METHODS: A total of 229 young athletes from four different sports (water polo (n = 59), karate (n = 58), taekwondo (n = 57) and handball (n = 55)) participated in this study. A standardized questionnaire about the frequency of orofacial and dental injuries was used. Questions were also asked about athletes' habits related to mouthguard use. RESULTS: Mean age of the participants was 12.9 ± 3.2 years, and the average time of playing experience was 4.8 ± 3.1 years. Orofacial injury had been experienced by 58 athletes (25.3%), while 31 athletes (13.5%) suffered dental injury. Higher rate of dental injuries was observed in water polo (18.6%), karate (17.2%) and handball (21.8%) than in taekwondo (3.5%) (P = .035). Most participants were aware of mouthguards for dental trauma prevention and considered them efficient for preventing dental injuries during sports activities, but only 94 (41%) used them. There was a statistically significant difference in the use of mouthguards between taekwondo (73.7%) and karate (70.7%) players compared to handball (14.5%) and water polo players (5.1%) (P < .001). CONCLUSIONS: Handball and water polo had similarly high occurrence of dental trauma as karate, a high-risk martial art sport. Therefore, the classification of sports according to the risk of dental trauma should be reconsidered. It would be beneficial to make wearing a mouthguard mandatory in all high-risk sports, as well as in those with medium-risk for dental injuries.

The Neuromuscular Qualities of Higher- and Lower-Level Mixed-Martial-Arts Competitors.

PURPOSE: To determine whether the maximal strength, impulse, and power characteristics of competitive mixed-martial-arts (MMA) athletes differ according to competition level. METHODS: Twenty-nine male semiprofessional and amateur MMA competitors were stratified into either higher-level (HL) or lower-level (LL) performers on the basis of competition grade and success. The 1-repetition-maximum (1RM) squat was used to assess lower-body dynamic strength, and a spectrum of impulse, power, force, and velocity variables were evaluated during an incremental-load jump squat. In addition, participants performed an isometric midthigh pull (IMTP) and 1RM bench press to determine whole-body isometric force and upper-body dynamic strength capabilities, respectively. All force and power variables were expressed relative to body mass (BM). RESULTS: The HL competitors produced significantly superior values across a multitude of measures. These included 1RM squat strength (1.84 ± 0.23 vs 1.56 ± 0.24 kg BM; P = .003), in addition to performance in the incremental-load jump squat that revealed greater peak power (P = .005-.002), force (P = .002-.004), and velocity (P = .002-.03) at each load. Higher measures of impulse (P = .01-.04) were noted in a number of conditions. Average power (P = .002-.02) and velocity (P = .01-.04) at all loads in addition to a series of rate-dependent measures were also superior in the HL group (P = .005-.02). The HL competitors' 1RM bench-press values approached significantly greater levels (P = .056) than the LL group's, but IMTP performance did not differ between groups. CONCLUSIONS: Maximal lower-body neuromuscular capabilities are key attributes distinguishing HL from LL MMA competitors. This information can be used to inform evidenced-based training and performance-monitoring practices.

Low risk of concussions in top-level karate competition.

BACKGROUND: Although it is well known that injuries occur in combat sports, the true incidence of concussions is not clearly defined in the literature for karate competition. AIM: To determine the incidence of concussions in top-level (World Karate Federation World Championships) karate competition. METHODS: Injuries that took place in 4 consecutive World Karate Championships (from 2008 to 2014) were prospectively registered. A total of 4625 fights (2916 in the male category and 1709 in the female category) were scrutinised, and concussions were identified and analysed separately for frequency (rate per fight) and injury risk. RESULTS: A total of 4 concussions were diagnosed by the attending physicians after carrying out athlete examinations. Globally, there was 1 concussion in every 1156 fights, or 0.43/1000 athlete-exposures (AE). In male athletes, the rate of concussion was 1/5832 min of fighting, and in female athletes, it was 1/6836 min. OR for concussion in women is 0.57 (95% CI 0.06 to 5.47; z=0.489; p=0.6249) and risk ratio for concussions in men is RR 1.478 (95% CI 0.271 to 8.072), p=0.528, representing a higher risk of definite concussions in men than in women, but not statistically significant. There is not a significantly higher risk of concussions in team competition (no weight limit) when compared with individual competition (held with strict weight limits for each category). CONCLUSION: The risk of concussions in top-level karate competition is low, with a tendency for an increased risk for men and for competition without weight limits, but not statistically significant with respect to women or individual competition.

Repeated head trauma is associated with smaller thalamic volumes and slower processing speed: the Professional Fighters' Brain Health Study.

OBJECTIVES: Cumulative head trauma may alter brain structure and function. We explored the relationship between exposure variables, cognition and MRI brain structural measures in a cohort of professional combatants. METHODS: 224 fighters (131 mixed martial arts fighters and 93 boxers) participating in the Professional Fighters Brain Health Study, a longitudinal cohort study of licensed professional combatants, were recruited, as were 22 controls. Each participant underwent computerised cognitive testing and volumetric brain MRI. Fighting history including years of fighting and fights per year was obtained from self-report and published records. Statistical analyses of the baseline evaluations were applied cross-sectionally to determine the relationship between fight exposure variables and volumes of the hippocampus, amygdala, thalamus, caudate, putamen. Moreover, the relationship between exposure and brain volumes with cognitive function was assessed. RESULTS: Increasing exposure to repetitive head trauma measured by number of professional fights, years of fighting, or a Fight Exposure Score (FES) was associated with lower brain volumes, particularly the thalamus and caudate. In addition, speed of processing decreased with decreased thalamic volumes and with increasing fight exposure. Higher scores on a FES used to reflect exposure to repetitive head trauma were associated with greater likelihood of having cognitive impairment. CONCLUSIONS: Greater exposure to repetitive head trauma is associated with lower brain volumes and lower processing speed in active professional fighters.