Symptom Exacerbation and Adverse Events during a Randomized Trial of Early-stage Concussion Rehabilitation.

CONTEXT: Few studies utilize randomized clinical trials (RCT) to quantify clinical intervention safety of rehabilitation after sport-related concussion across sport levels. OBJECTIVE: Describe symptom exacerbation and adverse events (AEs) associated with two concussion rehabilitation interventions. DESIGN: Cluster Randomized Controlled Trial (XXX). SETTING: Sports medicine clinic and field settings. PARTICIPANTS: The RCT enrolled 251 concussed athletes (median age=20 years; female n=48) across 28 sites from New Zealand professional rugby (n=31), Canadian professional football (n=52), United States (U.S.)/Canadian colleges (n=128) and U.S. high schools (n=40). INTERVENTIONS: Two medically supervised interventions: 1) Enhanced Graded Exertion (EGE): international return to sport strategy and sport specific activities only (EGE-only n=119) and 2) Multidimensional Rehabilitation (MDR) followed by EGE: early symptom-directed exercises once symptoms were stable, followed by EGE after symptoms resolved (MDR+EGE n=132). MAIN OUTCOME MEASURES: Primary outcomes were intrasession total symptom severity score exacerbation and significant intersession (increase 10+ severity points) sustained total symptom severity exacerbation, each measured with a Postconcussion Symptom Scale (132 total severity points on scale). Reported AEs were also described. Activity-based rehabilitation sessions (n=1437) were the primary analysis unit. Frequencies, proportions, medians, and Interquartile Ranges (IQRs) were calculated for outcomes by treatment group. RESULTS: The 251 post-injury participants completed 1437 (MDR+EGE=819, EGE-only=618) activity-based intervention sessions. A total of 110 and 105 participants contributed data (those missing had no documented session data) to at least 1 activity-based session in the MDR+EGE and EGE-only arms respectively. Intrasession symptom exacerbations were equivilantly low in MDR+EGE and EGE-only arms (MDR+EGE: 16.7%, 95% CI:14.1%,19.1%; EGE-only: 15.7%, 95% CI: 12.8%,18.6%). In total, 9/819 MDR+EGE sessions (0.9%) and 1/618 EGE-only sessions (0.2%) resulted in a pre- to post-session symptom exacerbation beyond a 10+ severity point increase; 8/9 resolved to <10 points by the next session. Two study-related AEs (1 in each arm) were reported. CONCLUSIONS: Participants in MDR+EGE and EGE-only activities reported equivalently low rates of symptom exacerbation.

The effects of affect-guided interval training on pleasure, enjoyment, and autonomy: A registered report.

This registered report tested the effects of a novel exercise protocol, namely affect-guided interval training, on motivationally relevant variables of remembered pleasure, forecasted pleasure, enjoyment, and autonomy. Affect-guided interval training (AIT) consisted of 60-s intervals that alternated between the highest pleasant intensity and lowest pleasant intensity for 20 min; this was intended to minimize the potential displeasure of traditional high-intensity interval training. The novel protocol was compared to self-selected exercise intensity (30 min) and high-intensity interval training (60-s intervals for 20 min). All sessions were, on average, vigorous in intensity (80-89% peak heart rate). Data indicate that the AIT session was experienced as the most pleasant, had the most pleasant slope of affect, was remembered as the most pleasant, resulted in the most positive affective forecasts, and was the most enjoyable. Both the affect-guided interval session and self-selected exercise session resulted in greater autonomy than high-intensity interval training. Several evaluative and motivationally relevant variables, including (a) remembered pleasure, (b) enjoyment, and (c) forecasted pleasure were predicted by (a) experienced pleasure, the (b) pleasure experienced at the end of exercise, and (c) the slope of pleasure experienced throughout the exercise session. Overall, this study suggests that affect-guided interval training is a feasible and positive alternative that can be included as a viable option for exercise programming.

Effects of workplace stress, perceived stress, and burnout on collegiate coach mental health outcomes.

Introduction: Given the continuously changing job demands of coaches, coach burnout continues to be an important area of study. Coaching literature highlights the role occupational stressors play in the development and management of burnout. However, research highlights the potential need for the field to differentiate feelings of burnout from those of other sub-clinical mental health indicators (e.g., anxiety, depression). This study sought to examine the relationship between workplace stress, perceived stress, coach burnout, coach well-being, and sub-clinical health issues (anxiety, stress, depression). Methods: One hundred forty-four NCAA collegiate coaches completed online questionnaires measuring the proposed variables. Structural equation modeling was used to test the proposed hypothesis that burnout would serve as a partial mediator between workplace and perceived stress and mental health indicators (e.g., depression, anxiety, stress, and well-being). Results: Workplace stress and perceived stress were positively associated with both burnout subscales. Additionally, perceived stress alone exhibited a positive association with depression, anxiety, and stress and a negative association with well-being. While there was a positive significant relationship between disengagement and depression in the model and a negative significant relationship between disengagement and well-being, most relationships between the two burnout subscales and mental health outcomes were negligible. Discussion: It can be concluded that while workplace and perceived life stressors may impact feelings of burnout and mental health indicators directly, burnout does not appear to exhibit a strong effect on perceptions of mental health and well-being. In line with other research studies, it may be worth considering whether burnout should be considered another type of clinical mental health issue instead of as a direct contributor to coach mental health.

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes.

BACKGROUND: An association has been identified between concussion and lower extremity musculoskeletal injury (LEMSKI) after return to sports participation. However, the collegiate student-athlete studies have relied on relatively small single-institution studies, which limits generalizability. PURPOSE: To assess odds of, and time to, LEMSKI after concussion in US collegiate athletes, using the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). STUDY DESIGN: Descriptive epidemiology study. METHODS: Data from the NCAA ISP during the 2010-2011 through 2019-2020 athletic seasons were considered for analysis. Frequency distributions were examined for details related to the initial and subsequent injuries (injuries to bone, bursa, joint, ligament, muscle, or tendon). Multivariable logistic regression models and random-effects Poisson regression models examined odds of time loss (TL) and non-time loss (NTL) LEMSKI after concussion, as well as the time interval between initial concussion and subsequent LEMSKI in a single athletic season, or initial musculoskeletal injury (MSKI) and subsequent LEMSKI in a single athletic season. Analyses were performed separately for football and other sports. RESULTS: A total of 31,556 initial injuries were recorded (football: 11,900; other sports: 19,656), which were followed by 0 or 1 injury in the same season. Overall, first injury type was not a significant predictor of subsequent LEMSKI, although certain contrasts yielded significant estimates. In football, the odds of NTL LEMSKI were higher after concussion than after upper extremity MSKI (UEMSKI; adjusted odds ratio [ORAdj], 1.56; 95% CI, 1.06-2.31). In football, the odds of TL LEMSKI were lower after concussion than after UEMSKI (ORAdj, 0.71; 95% CI, 0.51-0.99). No other significant effect estimates were observed for football or other sports. CONCLUSION: First injury type, either concussion or upper extremity, was not associated with an elevated risk of LEMSKI. Specifically, the results of this study did not identify an elevated odds of LEMSKI after a concussion. However, the authors observed greater odds of NTL LEMSKI and lower odds of TL LEMSKI in football.

Parent influence on concussion reporting in first-year collegiate athletes.

OBJECTIVE: To assess the relationship between sport-parenting practices and concussion reporting intentions of collegiate athletes across two levels of competition. PARTICIPANTS: Entering first-year student-athletes (varsity and club) at a mid-sized university in the Southeast region of the United States (n = 327). METHODS: Written surveys were completed prior to the start of the 2015 academic year. Structural equation modeling was used to test a model predicting concussion-reporting intentions. RESULTS: College athletes were more likely to intend to report a suspected concussion when they believed their parents wanted them to report (B=-0.88, SD = 0.94), and when they experienced less sport achievement pressure from their parents (B=-0.12, SD = 8.07). CONCLUSIONS: Parents influence the concussion safety of entering collegiate athletes at both the varsity and club level. Lower pressure sport parenting prior to college entry may help foster safer concussion reporting behaviors and may be an appropriate target for future intervention development work.

The Effects of Increasing Training Load on Affect and Perceived Exertion.

ABSTRACT: Cavarretta, DJ, Hall, EE, and Bixby, WR. The effects of increasing training load on affect and perceived exertion. J Strength Cond Res 36(1): 16-21, 2022-This study was designed to investigate how affect and ratings of perceived exertion based on repetitions in reserve (RPE/RIR) change as a function of increasing load during a 10 repetition maximum (RM) test. Twenty-nine novice lifters completed a 10RM test for 2 different conditions presented in a randomized, counterbalanced fashion. RPE/RIR and affect were assessed immediately after each successful 10RM attempt. RPE/RIR was significantly different at all loads from 50 to 100% 10RM (p < 0.001) with no differences between exercise and exercise load (p = 0.059). RPE/RIR was higher for all lower body exercises compared with upper-body exercises (p < 0.001) but was not different between machine and free-weight exercises (p > 0.344). Affect became less positive only at 100% 10RM compared with all other loads (p < 0.05). Finally, affect was more positive for upper-body exercises compared to lower-body exercises (p = 0.025) and more positive for machines compared to free-weights (p = 0.015). The results of this study suggest that among novice lifters, RPE/RIR increases as load increases during a 10RM and affective valence remains relatively constant but becomes less positive when exercising at maximal intensities (100% 10RM). Further research is needed to replicate these findings and elucidate the effects of different muscles used (e.g., upper vs. lower body) and modality of exercise (e.g., machine vs. free-weight) on RPE/RIR and affect among both novice and experienced lifters.

Using Personality and Temperament to Predict Exercise Behavior: A Pilot Study of the Braverman Nature Assessment.

The Braverman Nature Assessment (BNA) is intended to determine the dominant monoamine neurochemical that drives an individual's temperament and behavior. The measure has been colloquially praised for the ability to determine the most effective exercise protocols for an individual based on their "dominant nature." This study seeks to examine the proposed relationship between the Braverman Natures and exercise behavior. Seventy-three adults (57 females) between ages 18-65 (mean = 26 years) completed an online survey consisting of the BNA, Big Five Personality Inventory (BFI), and Aerobics Center Longitudinal Study Physical Activity Questionnaire (ACLSPAQ). All Natures showed significant correlations to unique sets of personality traits (BFI). Dopamine and Serotonin Nature scores (via BNA) showed positive correlations to total physical activity (PA)measures. Serotonin Nature had positive correlation with participation in resistance exercise (r = .36, p < .01) and showed the strongest correlations to PA participation. Dopamine was not associated with Extraversion as predicted; however, showed positive correlations to vigorous intensity exercise (r = .26, p < .05). The Natures demonstrate some low to moderate correlations between neurochemical scores and exercise behaviors such as preference for various exercise modalities. There is preliminary evidence to suggest that the BNA may be a useful tool for exercise prescription based on correlations between personality and exercise behavior found in this study. The results do not support colloquial literature on the use of BNA in exercise prescription.

Not Just for Dancing? A Content Analysis of Concussion and Head Injury Videos on TikTok.

Social media platforms are an accessible and increasingly used way for the public to gather healthcare-related information, including on sports injuries. "TikTok" is currently one of the fastest-growing social media platforms worldwide, and it is especially popular amongst adolescents and young adults. The widespread use and popularity of TikTok suggests that this platform has potential to be a source for healthcare information for younger individuals. The aim of this study was to gain a preliminary understanding of the concussion/head injury-related information on TikTok, and to gauge if TikTok could serve as a platform for concussion education. This exploratory study used a systematic search strategy to understand more about how concussion is being portrayed through TikTok videos. Using the keywords "concussion" and "head injury," 200 videos were downloaded from TikTok and 43 videos were excluded. Of the 92 videos retrieved using the keyword "concussion," 95% (n = 88) had more than 100,000 views and 6% (n = 10) had been viewed more than 10 million times. Over half, 54% (n = 50) of the "concussion" videos depicted individuals "playing around" and getting hit in the head, whilst only 1% (n = 1) of the TikTok videos were categorized as "explaining concussion facts." The large numbers of views of concussion-related TikTok videos demonstrates the popularity of this platform and indicates that healthcare organizations should consider TikTok as a potential means for concussion education amongst younger individuals.

Good Food, Good Mood: Perspectives on the Relationship Between Nutrition and Mental Health With Division I Collegiate Athletic Programs.

Research has shown a strong relationship between nutrition and mental health. Packed schedules and little rest time may make student-athletes more susceptible to mental health issues than the general population, but few athletes are fully aware of the effects that nutrition can have on their mental health. While collegiate athletic programs are beginning to recognize the individual contributions of nutrition and mental health to performance and are hiring sport dietitians and psychologists for their athletes, it is unclear whether these topics are ever discussed within the same context. The goal of this study was to understand the perspectives of different athletic personnel on the relationship between nutrition and mental health. 17 athletic personnel (11 Female, 6 Male) from 6 NCAA Division I universities were recruited for a 30-45-min semi-structured WebEx interview. Participants included athletic trainers, coaches, dietitians, sport psychologists, strength and conditioning coaches, and sports medicine physicians. Participants were asked questions about their educational backgrounds, resources, and perspectives on the integration of nutrition and mental health in their programs. Transcribed responses were sorted into four themes: (1) Resources, (2) Education, (3) Department Integration or Collaboration, and (4) Student and Coach Engagement. All participants reported a need for greater monetary resources and staffing. Around 59% of the participants felt they had little more than general or personal interest-level knowledge on topics pertaining to nutrition or mental health, with the exception of sports dietitians or psychologists. Each school varied in the degree to which their athletic staff regularly communicated about their work and athlete health statuses. Athletes were reportedly more or less likely to utilize the resources provided depending on coach attitudes toward nutrition or mental health. Regardless of size, reputation and annual spending, each university was reported to be in the early stages of integrating nutrition and mental health programs into their existing athletic departments. Implications of this work may be to help schools plan for ways to reallocate funding for nutrition or mental health programming.

Gait Assessment in College Athletes: Do Concussion History, Symptoms, Gender, and Type of Sport Matter?

CONTEXT: Though previous research has focused on examining the effects of concussion history using a dual-task paradigm, the influence of factors like symptoms (unrelated to concussion), gender, and type of sport on gait in college athletes is unknown. OBJECTIVE: To examine the effect of concussion history, symptoms, gender, and type of sport (noncontact/limited contact/contact) individually on gait among college athletes. DESIGN: Exploratory cross-sectional study. SETTING: Laboratory. PARTICIPANTS: In total, 98 varsity athletes (age, 18.3 [1.0] y; height, 1.79 [0.11] m; mass, 77.5 [19.2] kg; 27 with concussion history, 58 reported at least one symptom, 44 females; 8 played noncontact sports and 71 played contact sports) walked under single- and dual-task (walking while counting backward by 7) conditions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Dual-task cost (DTC; % difference between single task and dual task) of gait speed, cadence, step length and width, percentage of swing and double-support phases, symptom score, and total symptom severity score. Independent samples t tests and 1-way analysis of variance were conducted (α value = .05). RESULTS: Self-reported concussion history resulted in no significant differences (P > .05). Those who reported symptoms at testing time showed significantly greater DTC of step length (mean difference [MD], 2.7%; 95% confidence interval [CI], 0.3% to 5.1%; P = .012), % of swing phase (MD, 1.0%; 95% CI, -0.2 to 2.1%; P = .042), and % of double-support phase (MD, 3.9%; 95% CI, 0.2% to 7.8%; P = .019). Females demonstrated significantly higher DTC of gait speed (MD, 5.3%; 95% CI, 1.3% to 9.3%; P = .005), cadence (MD, 4.0%; 95% CI, 1.4% to 6.5%; P = .002), % of swing phase (MD, 1.2%; 95% CI, 0.1% to 2.3%; P = .019), and % of double-support phase (MD, 4.1%; 95% CI, 0.4% to 7.9%; P = .018). Noncontact sports athletes had significantly greater step width DTC than contact sports athletes (MD, 14.2%; 95% CI, 0.9% to 27.6%; P = .032). CONCLUSIONS: Reporting symptoms at testing time may influence gait under dual-task conditions. Additionally, female athletes showed more gait changes during a dual task. Sports medicine professionals should be aware that these variables, while unrelated to injury, may affect an athlete's gait upon analysis.

Turn Characteristics During Gait Differ With and Without a Cognitive Demand Among College Athletes.

CONTEXT: Sports often involve complex movement patterns, such as turning. Although cognitive load effects on gait patterns are well known, little is known on how it affects biomechanics of turning gait among athletes. Such information could help evaluate how concussion affects turning gait required for daily living and sports. OBJECTIVE: To determine the effect of a dual task on biomechanics of turning while walking among college athletes. DESIGN: Cross-sectional study. SETTING: University laboratory. PARTICIPANTS: Fifty-three participants performed 5 trials of a 20-m walk under single- and dual-task conditions at self-selected speed with a 180° turn at 10-m mark. The cognitive load included subtraction, spelling words backward, or reciting the months backward. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Turn duration, turning velocity, number of steps, SD of turn duration and velocity, and coefficient of variation of turn duration and velocity. RESULTS: Participants turned significantly slower (155.99 [3.71] cm/s vs 183.52 [4.17] cm/s; P < .001) and took longer time to complete the turn (2.63 [0.05] s vs 2.33 [0.04] s; P < .001) while dual tasking, albeit taking similar number of steps to complete the turn. Participants also showed more variability in turning time under the dual-task condition (SD of turn duration = 0.39 vs 0.31 s; P = .004). CONCLUSIONS: Overall, college athletes turned slower and showed more variability during turning gait while performing a concurrent cognitive dual-task turning compared with single-task turning. The slower velocity increased variability may be representative of specific strategy of turning gait while dual tasking, which may be a result of the split attention to perform the cognitive task. The current study provides descriptive values of absolute and variability turning gait parameters for sports medicine personnel to use while they perform their concussion assessments on their college athletes.

Baseline Neurocognitive Performance and Symptoms in Those With Attention Deficit Hyperactivity Disorders and History of Concussion With Previous Loss of Consciousness.

Previous consensus statements on sports concussion have highlighted the importance of Attention Deficit Hyperactivity Disorder (ADHD) and loss of consciousness (LOC) as risk factors related to concussion management. The present study investigated how self-reported history of either ADHD diagnosis or history of previous concussion resulting in LOC influence baseline neurocognitive performance and self-reported symptoms. This analysis was performed retrospectively on data collected primarily from student-athletes, both Division 1 and club sports athletes. The dataset (n = 1460) is comprised of college students (age = 19.1 ± 1.4 years). Significant differences were found for composite scores on the ImPACT for both history of concussion (p = 0.016) and ADHD (p = 0.014). For concussion history, those with a previous concussion, non-LOC, performed better on the visual motor speed (p = 0.004). Those with diagnosis of ADHD performed worse on verbal memory (p = 0.001) and visual motor speed (p = 0.033). For total symptoms, concussion history (p < 0.001) and ADHD (p = 0.001) had an influence on total symptoms. Those with ADHD reported more symptoms for concussion history; those with previous LOC concussion reported more symptoms than those with non-LOC concussion (p = 0.003) and no history (p < 0.001). These results highlight the importance of baseline measures of neurocognitive function and symptoms in concussion management in order to account for pre-existing conditions such as ADHD and LOC from previous concussion that could influence these measures.

Concussion history influences sleep disturbances, symptoms, and quality of life in collegiate student-athletes.

OBJECTIVES: Immediately after experiencing a concussion, many will report the presence of a variety of symptoms, which may include disturbances in sleep. It is possible that these symptoms and other resulting quality of life (QOL) disturbances may persist for some time following a concussion. The purpose of this study was to determine if a history of concussions was related to ongoing sleep disturbances, symptoms, and changes in QOL. METHODS: Eighty-two student-athletes (club and varsity) completed an online survey to determine concussion history, sleep disturbances, concussion symptoms, and QOL dysfunctions. Separate analyses of variance were performed to determine if sleep disturbances, symptoms, and QOL dysfunctions were related and if they differed based on concussion history (0, 1-2, 3+). RESULTS: Those with no concussion history reported fewer sleep disturbances (P = .028), symptoms (P = .029), symptom severity (P = .014), QOL dysfunctions (P = .003), and QOL severity (P = .011) than those who self-reported having had a previous concussion(s). Additionally, the number of sleep disturbances was found to positively correlate with symptoms (P < .001), symptom severity (P < .001), QOL dysfunctions (P = .001), and severity of QOL dysfunctions (P = .002). CONCLUSIONS: The results of the current study demonstrate that concussion history is related to persistent changes in sleep, ongoing symptoms, and QOL dysfunctions and should be considered in concussion management protocols even after return to play and academics has occurred.

The effects of power and stretch yoga on affect and salivary cortisol in women.

Yoga practice is known to improve well-being and decrease stress. However, acute yoga is understudied. This study investigated the effects of two different types of yoga on affect and salivary cortisol levels in college women. Thirty-three women aged 18-30 years each completed 1-hour sessions of power yoga and stretch yoga. Measures of affect and salivary cortisol were assessed before, during, and after each session. Participants perceived power yoga to be more pleasurable and energizing. Salivary cortisol significantly decreased after both yoga sessions. Thus, even one session of yoga may be effective in improving affect and decreasing stress in college women.

Affective Responses From Different Modalities of Resistance Exercise: Timing Matters!

Resistance exercise provides positive changes in affect that may increase adherence. Little is known about the temporal dynamics of affect or the relationship between training modality and affect. This experiment investigated the temporal dynamics of affect during resistance exercise and compared the affective responses from machine and free weight exercises. Twenty-eight novice lifters (21 females) completed 2 workouts consisting of 4 machine or 4 free weight exercises for 3 sets of 9-11 repetitions at 80% 10 repetition-maximum. Feeling Scale was administered at baseline, during, 5- and 30-min post. During the workout, Feeling Scale was administered during the seventh repetition of the second set and after completion of the third set to provide an intra- and inter-set affective measurement. A Repeated Measures General Linear Model revealed a significant effect for time (p < 0.001) with affect more positive for all time points, 5- and 30-min following exercise compared to baseline levels (p's < 0.001). Additionally, affect was more positive at 5- compared to 30-min post (p = 0.015) and higher for the inter-set measurement compared to the intra-set measurement (p = 0.001). The results suggest that affective valence becomes more positive during and following resistance exercise. This preliminary evidence suggests affective rebounding may occur after cessation of the set. Lastly, there appears to be no differences in the affective responses from machine and free weight exercises among novice lifters although this finding may be confounded by other factors such as differences in muscle group selection or total amount of volume performed.

Influence of Resistance Exercise on Appetite and Affect Following Pre-Sleep Feeding.

To determine changes in appetite, affect and cortisol in response to an acute bout of resistance exercise (RE) the morning after consuming whey (WP) and casein (CP) protein and a non-caloric placebo (PLA) consumed pre-sleep, 14 active men (n = 5) and women (n = 9) consumed a single dose of 24 g WP, 48 g WP, 24 g CP, 48 g CP, or PLA 30 min pre-sleep. Prior to and immediately after RE, appetite, affect and cortisol were assessed. Significant time effects were observed for Energetic Arousal and Tense Arousal (p = 0.017) and Feeling Scale and Felt Arousal Scale (p < 0.001). Appetite did not change over time or condition. Cortisol levels increased after RE (p = 0.007). Pre-RE, Tense Arousal was correlated with hunger (r = 0.25, p = 0.047) and desire to eat (r = 0.35, p = 0.005). Post-RE, cortisol was found to be significantly related to Feeling Scale (r = 0.32, p = 0.018), Felt Arousal Scale (r = 0.33, p = 0.015) and Energetic Arousal (r = 0.32, p = 0.018). Varying doses of WP and CP pre-sleep did not have an effect on morning appetite and cortisol, but cortisol was found to be related to affect and appetite.

No Performance or Affective Advantage of Drinking versus Rinsing with Water during a 15-km Running Session in Female Runners.

The advantage of ingesting fluids during endurance exercise lasting < 90 min has recently been challenged, but literature confirming or disputing this case is limited, particularly for female athletes. This study examined the effects of consuming water versus mouth rinsing with water during a running time trial. Recreationally active female runners (n = 19) completed two, 15-km time trials on an outdoor course in temperate environment (~20ºC; 87% RH) separated by at least one week in a randomized cross-over study design. Participants consumed 355 ml of water (DW) during their run or mouth rinsed (MR) with water from a handheld water bottle every 3 km for 5 s with physiological, perceptual, and affective variables assessed. DW or MR did not affect completion time (79.8 ± 8.1 min and 79.2 ± 8.2 min, p = 0.23), HR (p = 0.35), or RPE (p = 0.73), respectively. Sweat losses were greater (p = 0.03) for DW: 1.47 ± 0.34 L compared to MR: 1.28 ± 0.27 L; however, thirst sensation was not significantly different for MR: 6.7 ± 1.4 compared to DW: 6.2 ± 1.6. A significant effect was exhibited for time (p < 0.01) but not condition for Feeling Scale and Felt Arousal Scale or Energetic and Tense Arousal. Carrying only one smaller fluid container for MR versus a larger or multiple water bottles/backpack systems used for water consumption can reduce fluid load carried during extended duration runs without altering performance or affect for runs of 1.0-1.5 h. MR may also be beneficial to decrease thirst without ingesting fluid for runners that limit exercise fluid consumption because of gastrointestinal discomfort concerns.

Influence of Concussion History and Genetics on Event-Related Potentials in Athletes: Potential Use in Concussion Management.

Sports-related concussions are an increasing public health issue with much concern about the possible long-term decrements in cognitive function and quality of life that may occur in athletes. The measurement of cognitive function is a common component of concussion management protocols due to cognitive impairments that occur after sustaining a concussion; however, the tools that are often used may not be sensitive enough to expose long term problems with cognitive function. The current paper is a brief review, which suggests that measuring cognitive processing through the use of event related potentials (ERPs) may provide a more sensitive assessment of cognitive function, as shown through recent research showing concussion history to influence ERPs components. The potential influence of genetics on cognitive function and ERPs components will also be discussed in relation to future concussion management.