Sport-Specific Increased Risk of Anterior Cruciate Ligament Injury Following a Concussion in Collegiate Female Lacrosse.

ABSTRACT: Poor neurocognitive performance has been associated with a greater risk of musculoskeletal injury, and anterior cruciate ligament (ACL) injury prevention protocols include exercises to improve neuromuscular control. Research shows that a concussion elevates the risk for subsequent lower-extremity injury, because concussions lead to lower neurocognitive performance. Studies have been conducted using data within individual male sports, such as football and rugby, or across collegiate sports in aggregate; no study has focused on women's sports. Using 7 years of data collected by athletic training staff at Davidson College, this paper evaluates preconcussive versus postconcussive lower-extremity injury risk across five collegiate women's sports: field hockey, soccer, basketball, volleyball, and lacrosse. Using incidence rate ratios, lacrosse athletes had a five-fold increase in ACL injury risk within 365 d following a concussion. Recognizing that postconcussive ACL tear risk varies across different women's sports is important in informing sport-specific concussion return to play protocols.

Age-dependent diagnostic yield of echocardiography as a second-line diagnostic investigation in athletes with abnormalities at preparticipation screening.

AIMS: Systematic pre-participation screening of subjects practicing sports activity has the potential to identify athletes at risk of sudden cardiac death. However, limited evidence are present concerning the yield of echocardiography as a second-line exam in athletes with abnormal pre-participation screening. METHODS: Consecutive athletes were screened (2011-2017) in a community-based sports medicine center in Tuscany, with familial history, physical examination and ECG. Patients with abnormal/>1 borderline ECG findings, symptoms/signs of cardiovascular diseases, cardiovascular risk factors or family history of juvenile/genetic cardiac disease underwent echocardiography. RESULTS: A total of 30109 athletes (age 21 [15;31]) were evaluated. Of these, 6234 (21%) were aged 8-11 years, 18309 (61%) 12-18 years, 4442 (15%) 19-35 years, 1124 (4%) >35 years. A total of 2569 (9%) athletes were addressed to echocardiography. Referral rates increased significantly with age (5% in preadolescents to 38% in master athletes, P< 0.01). Subclinical heart diseases were found in 290/30109 (0.8%) and were common >35 years (135/1124, 11%), but rare at 19-35 years (91/4442, 2%), very rare <18 years (64/24 543, 0.2%; P< 0.01). Seventy-four (0.3%) athletes were disqualified because of the structural alterations identified, 29 (0.1%) with cardiac structural diseases at risk for sudden death. CONCLUSIONS: Italian community-based pre-participation screening showed an age-dependent yield, with a three-fold increase in referral in athletes >35 years. Subclinical structural abnormalities potentially predisposing to sudden death were rare (0.01%), mostly in post-pubertal and senior athletes. Age-specific pre-participation screening protocols may help optimize resources and improve specificity.

The construction of categories in sport: Unfair advantages, equality of opportunity and strict attainability.

On 8 September 2020, the Swiss Federal Supreme Sport dismissed the double appeal by Caster Semenya against the decision of the Court for Arbitration of Sport to uphold the World Athletics regulations restricting testosterone levels in female runners. On 24 February 2021, Semenya appealed to the European Court of Human Rights. This is the most recent episode of an international legal case which was ignited at the 2009 Berlin World Track Championship, when Semenya was 18 years old. Semenya's case has generated an intricate web of questions for classification in sport that are yet to be resolved. In this paper we aim to disentangle them. We proceed as follows: we describe the problem of binary classification related to Semenya's case and introduce the concept of property advantage, and the fair equality of opportunity principle. We compare Semenya's case with Eero Mantyranta's case and fail to identify a way according to which the two cases could justifiably be treated differently. We then discuss three possible ways to organize sport categories based on the combination of Loland's fair equality of opportunity principle and our strict attainability criterion, and outline the implications of each alternative for international sports law regulation. Finally, we summarize and outline the legacy of Semenya for the construction of categories in sport.

The logic of categorisation in sport.

The aim of this paper is to examine the basis of eligibility rules in sport by exhibiting the logic of categorisation, with its associated ethical problems. We shall be concerned mainly with pre-competition categories - age, sex, weight and dis/ability - because they are directly relevant to sports performance and are relatively stable inequalities. We shall prefer to use the term "categorisation", although we mean by it just what others might mean by classification, to refer to divisions, classes, groups, etc. The paper argues that we have categories only because we consider it desirable to offer some groups protected status in order to enable and promote inclusion and fairness. This desirability condition determines eligibility. Only then do issues arise of which sub-categories we should have, and how they are to be policed. There will always be categories in sport, as a minimum to protect athletes based on age groupings, from children to veterans. But since every categorisation brings its own problems, we need to ensure that we keep them balanced, so that sport can strive for maximum inclusion of different kinds of athletes, and maximum fairness. This requires us to step back from the many particular debates in order to rethink the logic of the whole categorisation process.

Classification in sport: A question of fairness.

Competitor classification schemes have been a part of sport since its origins. Eligibility criteria have developed towards inclusion and increasing diversity. The pool of competitors has expanded from the ancient Olympic Games, eligible only to free Greek men, via nineteenth-century English sport favouring primarily the upper class of so-called gentlemen amateurs, to the current global and diverse pool of men, women, children, and able-bodied as well as disabled persons. Hence, the challenge of sound classification schemes has increased. This article examines the principles of fair classification of athletes. With the help of normative theory as well as practical examples, a fair equality of opportunity principle for sport (FEOPs) is formulated. It is demonstrated how sound classification schemes combine the normative backing from FEOPs with relevant scientific insights. Current classification challenges and possibilities for change are discussed. It is suggested that in several sports, biological sex classes can be abandoned, and that in some sports, sex classes can be replaced by body size classes. It is argued, too, that sports in which body height exerts a significant and systematic impact on performance should classify accordingly. In the final part, classification is discussed in light of new techno-scientific possibilities, among them the possibility of innovative performance-enhancing prosthetics.

Impact of early sports specialisation on paediatric ECG.

Athletes of pediatric age are growing in number. They are subject to a number of risks, among them sudden cardiac death (SCD). This study aimed to characterize the pediatric athlete population in Switzerland, to evaluate electrocardiographic findings based on the International Criteria for electrocardiography (ECG) Interpretation in Athletes, and to analyze the association between demographic data, sport type, and ECG changes. Retrospective, observational study of pediatric athletes (less than 18 years old) including medical history, physical examination, and a 12-lead resting ECG. The primary focus was on identification of normal, borderline, and abnormal ECG findings. The secondary observation was the relation between ECG and demographic, anthropometric, sport-related, and clinical data. The 891 athletes (mean 14.8 years, 35% girls) practiced 45 different sports on three different levels, representing all types of static and dynamic composition of the Classification of Sports by Mitchell. There were 75.4% of normal ECG findings, among them most commonly early repolarization, sinus bradycardia, and left ventricular hypertrophy; 4.3% had a borderline finding; 2.1% were abnormal and required further investigations, without SCD-related diagnosis. While the normal ECG findings were related to sex, age, and endurance sports, no such observation was found for borderline or abnormal criteria. Our results in an entirely pediatric population of athletes demonstrate that sex, age, and type of sports correlate with normal ECG findings. Abnormal ECG findings in pediatric athletes are rare. The International Criteria for ECG Interpretation in Athletes are appropriate for this age group.

Influence of organised sports practice during adolescence on health of adult women with special emphasis on participation in aesthetic sports.

This study aimed to assess the differences in psychosocial health and cardiometabolic risk during adulthood in women based on previously organised sport (OS) participation during adolescence and current activity levels, with emphasis on participation in aesthetic sports. The study included 1947 women aged 18-55 years who were categorised into four groups: 355 aesthetic athletes during adolescence, 494 non- aesthetic athletes during adolescence, 791 non-athletes during adolescence with similar current levels of physical activity (PA) to OS groups and 307 currently inactive non-athletes during adolescence. Participants answered questionnaires regarding sport participation, psychosocial health and cardiometabolic risk. The results show that non-athletes during adolescence who are currently inactive reported significantly lower psychosocial health and higher cardiometabolic risk scores. Women with currently homogenous PA levels (χ² = 0.514) reported similar physical quality of life (QoL), exercise addiction, anxiety and depression symptoms regardless of participation in OS during adolescence (P > .05), except aesthetic athletes who reported the worst sleep and mental QoL. Very high training volumes in aesthetic athletes did not influence psychological outcomes and cardiometabolic risk in adulthood compared to lower training volumes. In conclusion, the effects of PA during adulthood appear to be powerful enough to induce beneficial adaptations in health outcomes that match those observed in women who participate in OS during adolescence, except for aesthetic sports participants, who show a high risk of lower quality of sleep in adulthood. PA should be promoted in adults and especially women who have not participated in OS during adolescence.

Preinjury and Postinjury Factors That Predict Sports-Related Concussion and Clinical Recovery Time.

OBJECTIVES: To evaluate the relationship between preinjury risk factors (RFs) and subsequent occurrence of concussion and examine whether preinjury RFs or postinjury assessments predict clinical recovery in collegiate athletes. METHODS: Risk factors (sex, sport, and self-report history of concussion, migraine, attention-deficit disorder, learning disability, depression, and anxiety) and Sport Concussion Assessment Tool (SCAT), depression/anxiety screenings, and neuropsychological testing were obtained before the season. For athletes who sustained concussion, RFs, postinjury SCAT, neuropsychological assessment, and clinical recovery were assessed. RESULTS: We assessed 1152 athletes (69% male) at baseline and 145 (75% male) after subsequent concussion diagnosis. Only sport type (Wald = 40.29, P = 0.007) and concussion history (Wald = 9.91, P = 0.007) accounted for unique variance in subsequent concussion. Of athletes followed until full recovery, mean days until symptom-free (DUSF) was 9.84 ± 11.11 days (n = 138, median = 5 days, range = 1-86) and mean days until full return to play (DUFRTP) was 20.21 ± 19.17 (n = 98, median = 20.21, range = 4-150). None of the RFs or baseline testing measures were associated with DUSF or DUFRTP (P's > 0.05). After injury, athletes who reported more total symptoms (rs = 0.31, P < 0.001) and higher symptom severity (rs = 0.33, P < 0.001) exhibited longer DUSF. Days until symptom-free correlated with DUFRTP (rs = 0.75, P < 0.001). Among athletes assessed within 2 days after injury, DUSF was associated with Immediate Postconcussion Assessment and Cognitive Test visual motor (rs = -0.31, P = 0.004), reaction time (rs = 0.40, P < 0.001), and symptom score (rs = 0.54, P < 0.001). CONCLUSIONS: Only sport type and concussion history predicted subsequent occurrence of concussion, and none of the RFs or baseline measures predicted clinical recovery. Immediate postinjury assessments, including symptom number and severity, and select clinical measures predicted longer clinical recovery.

Methods of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP), 2014-2015 Through 2018-2019.

BACKGROUND: The National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) was established in 2011 to provide a comprehensive appraisal of injuries sustained by high school student-athletes who received services from athletic trainers (ATs). The purpose of this article is to update the surveillance methods of the NATION-SP for data reported during the 2014-2015 through 2018-2019 academic years. SURVEILLANCE SYSTEM STRUCTURE: The NATION-SP used a rolling recruitment model to identify a convenience sample of US high schools with access to ATs. The ATs at participating institutions volunteered to contribute data via electronic medical records systems; common data elements were then pushed to and maintained by the Datalys Center for Sports Injury Research and Prevention. The ATs completed detailed reports on each injury, including the condition and circumstances. The treatments component was used to comprehensively assess the services provided to athletes by ATs. The outcomes companion component was developed to monitor patient-reported outcomes after athletic injury. SUMMARY: The NATION-SP continues to serve a critical purpose in informing injury-prevention and treatment efforts among high school athletes.

Detecção de esteroides anabólicos androgênicos e seus produtos de biotransformação em dried urine spots por ionização por paper spray acoplada à espectrometria de massas (PS-MS) / Detection of anabolic androgenic steroids and its biotransformation products in dried urine spots by paper spray-mass spectrometry ionization (PS-MS)

Os esteroides anabólicos androgênicos (EAA) são utilizados clinicamente para tratar diferentes doenças, porém propagou-se o uso não terapêutico por atletas de elite e fisiculturistas, com o intuito de aumentar a massa muscular e melhorar o desempenho físico. O uso de substâncias ergogênicas, como fármacos estimulantes e narcóticos analgésicos no esporte, foi proibido em 1967 pelo International Olympic Committee (COI), mas somente em 1976 os EAA entraram para a lista de substâncias proibidas. O uso de EAA está associado a diversos efeitos adversos, principalmente cardiovasculares, neuroendócrinos e distúrbios psiquiátricos, além de dislipidemia, elevação dos marcadores inflamatórios e disfunção endotelial. As análises toxicológicas constam como a maneira mais eficaz de minimizar o doping no esporte. O material é fornecido pelo atleta durante as competições ou treinamentos e previne que os competidores alcancem vantagem competitiva devido ao uso de EAA. A utilização de métodos para amostragem alternativos tem ganhado força, devido à necessidade de técnicas mais práticas que utilizam pouco volume de amostra e possuem facilidade de armazenamento. O dried urine spots é um método no qual pequenas amostras de urina são aplicadas em papéis de filtro para análises qualitativas ou quantitativas. Ele se caracteriza por ser uma técnica rápida, fácil, simples e barata para a coleta, armazenamento e distribuição, além de minimizar os riscos de infecção, podendo ser utilizado na rotina. A técnica de paper spray (PS-MS) foi desenvolvida a partir da relevância de métodos como o dried blood spots por proporcionar análises mais rápidas, apresenta alta especificidade, capacidade de analisar diferentes analitos simultaneamente, baixo limite de detecção e dispensa a necessidade de reagentes específicos. Sendo assim, neste trabalho foi desenvolvido e validado o método de screening de EAAs em dried urine spots por ionização por paper spray acoplada à espectrometria de massas. O método apresentou limites de detecção entre 2-15ng/mL e presença de três interferentes endógenos. Os dez analitos de interesse deste estudo são estáveis por 150 dias em temperatura ambiente. Dessa forma, a análise de EAAs em dried urine spots por PS-MS demonstra grande potencial para se tornar um método alternativo no monitoramento rápido de drogas de abuso

Anabolic androgenic steroids (AAS) are used clinically to treat different diseases, but non-therapeutic use has spread among elite athletes and bodybuilders, with the aim of increase muscle mass and improve physical performance. The International Olympic Committee (IOC) banned the use of ergogenic substances, such as stimulating drugs and analgesic narcotics in sports, in 1967, but only in 1976, AAS were included on the list of prohibited substances. The use of AAS is associated with several adverse effects, mainly cardiovascular, neuroendocrine and psychiatric disorders, in addition to dyslipidemia, elevated inflammatory markers and endothelial dysfunction. Toxicological analyzes are the most effective approach to minimize doping in sport. The material is provided by the athlete during competitions or training and prevents competitors from achieving a competitive advantage due to the use of AAs. The use of alternative sampling methods has gained strength, due to the need for more practical techniques that use low sample volume and can be easily storage. Dried urine spots are a method, which a small amount of urine samples is applied to filter papers for qualitative or quantitative analysis. It is characterized by being a fast, easy, simple and inexpensive technique for collection, storage and distribution, in addition to minimizing the risks of infection, and can be used in the routine. The paper spray technique (PS-MS) was developed based on the relevance of methods such as dried blood spots for providing faster analysis, high specificity, ability to analyze different analytes simultaneously, low detection limit and for eliminating the need for specific reagents. Therefore, this work developed and validated a screening method for AAS in dried urine spots by paper spray-mass spectrometry ionization. The method provided detection limits between 2-15ng/mL and the presence of three endogenous interferents. The ten analytes of interest in this study are stable for 150 days at room temperature. Thus, the analysis of AAS in dried urine spots by PS-MS demonstrates great potential to become an alternative method for the rapid monitoring of drugs of abuse

Promoção da saúde e redução de vulnerabilidades por meio da prática da atividade física / Promoting health and reducing vulnerability through physical activity

Resumo: Introdução: Diante da pandemia da Covid-19, os(as) estudantes de Medicina tornaram-se ainda mais fragilizados(as) e vulnerabilizados(as) pelo contexto de isolamento social, uma vez que tiveram suas rotinas alteradas. Assim, a Associação Atlética Acadêmica Marcel Resende Davi (AAAMRD), visando cumprir com a sua responsabilidade social de promoção da saúde, buscou incentivar a prática desportiva ao valorizar esse hábito em prol do bem-estar físico e mental dos(as) estudantes. Desse modo, este artigo objetiva relatar a experiência da atlética com a realização de um desafio esportivo virtual entre suas equipes. Relato de experiência: O desafio foi elaborado e executado remotamente para 112 atletas de 14 equipes esportivas. Nos grupos de WhatsApp®, particulares de cada time, os(as) atletas deveriam enviar mídias dos exercícios físicos realizados e contabilizá-los em uma lista. Ressalta-se que foram disponibilizados treinos nas redes sociais da atlética, em parceria com profissional capacitado, como forma de proporcionar treinos seguros. Ao final das 11 semanas de desafio, as três melhores equipes foram premiadas. Aplicou-se também um formulário de feedback para verificar a efetividade da ação. Discussão: A tecnologia, importante aliada na organização do desafio, permitiu que a promoção da saúde ocorresse remotamente, respeitando o distanciamento social. Ao estimular a constância de treinos, a atlética contribuiu para a manutenção de parte da rotina dos(as) graduandos(as), prejudicada pelo contexto pandêmico. Além disso, o espírito de coletividade e a interação entre os(as) atletas dentro dos grupos contribuíram para que esse distanciamento não fosse total, formando uma rede de apoio ao compartilharem também seus medos, inseguranças e saudades. Conclusão: Os resultados alcançados com o desafio e os feedbacks positivos confirmaram a efetividade da promoção da saúde proposta pela AAAMRD. Ademais, em conformidade com as Diretrizes Curriculares Nacionais e apesar do momento adverso, a instituição mostrou-se presente na formação pessoal e profissional dos(as) estudantes.

Abstract: Introduction: In the face of the COVID-19 pandemic, medical students have become even more fragile and vulnerable due to social isolation, since their routines have been altered. Thus, the Marcel Resende Davi Academic Athletic Association (AAAMRD), fulfilling its social responsibility to promote health, sought to encourage the practice of sports, highlighting the benefit of this habit for students' physical and mental well-being. This article aims to report the institution's experience of organising a virtual sports challenge among its teams. Experience report: The challenge was designed and executed remotely for 112 athletes from 14 sports teams. In Whatsapp® groups, private to each team, athletes were asked to send media of the physical exercises they performed and count them in a list. It is noteworthy that training was made available on the AAAMRD social networks, in partnership with a trained professional, as a way to provide safe training. At the end of the 11-week challenge, the top three teams were awarded. A feedback form was also applied to verify the effectiveness of the action. Discussion: Technology, an important ally in organizing the challenge, allowed health promotion to take place remotely, respecting social distance. By encouraging constant training, the AAAMRD helped maintain part of the undergraduate students' routine, hampered by the pandemic. Moreover, the collective spirit and interaction between athletes, within their respective groups, corroborated to reduce the distance between them, forming a support network in which they could also share their fears and insecurities. Conclusion: The results achieved through the challenge and the positive feedback confirmed the effectiveness of the health promotion proposed by AAAMRD. Furthermore, in accordance with the Brazilian National Guidelines for Undergraduate Medical Education and, despite the adverse moment, the institution remained present in the students' personal and professional development.

Analysis of the Athletic Career and Retirement Depending on the Type of Sport: A Comparison between Individual and Team Sports.

The type of sport practiced may shape the athletic career, considered as the period in which an athlete is dedicated to obtaining their maximum performance in one or more sports. The aim of this study was to compare athletic careers and retirement in individual and team sports. Four hundred and ten former elite athletes (38.5 ± 7.6 years) answered an ad hoc questionnaire; 61.5% were men and 38.5% women; 45.1% were from individual sports, while 54.9% were from team sports. It emerged that the age of maximum sports performance and the retirement age occurred significantly later in team sports than in individual sports (U = 15,042 and U = 12,624.5, respectively p < 0.001). Team sports athletes combined their athletic career with work to a greater extent than those from individual sports (χ2 (3, N = 408) = 14.2; p = 0.003; Cv = 0.187). Individual sports athletes trained more hours per week (30.0 ± 11.7 h) than those involved in team sports (19.2 ± 10.7 h; U = 9682; p < 0.001). These athletes (team sports) were in a better economic and working situation at retirement transition (χ2 (3, N = 406) = 23.9; p < 0.001; Cv = 0.242). Individual sports athletes perform physical activity more frequently than team sports athletes (U = 16,267.5; p = 0.045), while team sports athletes participate more actively in veteran competitions (χ2 (1, N = 390) = 3.9; p = 0.047; Cv = 0.104) and more frequently attend events as spectators (χ2 (1, N = 390) = 8.4; p = 0.004; Cv = 0.151). dual career support providers should be aware that team sports athletes enjoy a longer athletic career, and they are in a better position to face the retirement transition than individual sports athletes.

El ejercicio como estrategia terapéutica en la epilepsia: revisión bibliográfica / Exercise as a therapeutic strategy in epilepsy: a literature review

INTRODUCCIÓN: La epilepsia es una enfermedad neurológica común con consecuencias emocionales y físicas significativas. Hasta el 30% de los pacientes son refractarios a los fármacos antiepilépticos, por lo que se han planteado terapias no farmacológicas coadyuvantes, como la actividad física. OBJETIVO: Se realizó una búsqueda en la bibliografía sobre actividad física en personas con epilepsia, con el fin de evaluar los beneficios, potenciales efectos secundarios, el impacto en las comorbilidades, la clasificación de riesgo de cada deporte y las barreras existentes para su práctica. DESARROLLO: Múltiples modelos en animales y en humanos evalúan los beneficios del ejercicio en la epilepsia, explicados por efectos en neurotransmisores, hormonas y factores neurotróficos; además, demuestran efectos positivos en comorbilidades como la obesidad, las enfermedades cardiovasculares, la depresión y la osteoporosis. A pesar de ser una práctica que ha mostrado ser segura, las personas con epilepsia son menos activas físicamente debido a barreras que limitan su práctica. CONCLUSIONES: La actividad física es beneficiosa y segura para las personas con epilepsia. La bibliografía sugiere un mejor control de las crisis epilépticas, además de beneficios psicosociales y sobre las comorbilidades. Hay un bajo riesgo de lesiones asociadas con esta práctica. El ejercicio debería promoverse después de una evaluación clínica cuidadosa, considerando el control de crisis en el último año, posibles factores precipitantes y el tipo de deporte que se va a practicar

INTRODUCTION: Epilepsy is a common neurologic disease with emotional and physical consequences. Thirty percent of patients have drug-resistant epilepsy, therefore adjuvant non-pharmacological therapies, such as physical activity, have been proposed. AIM: This study reviews the literature about physical activity in people with epilepsy, to evaluate the benefits, potential side effects, impact on comorbidities, the risk classification of sports, and the barriers to their practice. DEVELOPMENT: Multiple animal and human models evaluate the benefits of exercise in epilepsy, explained by modulation on neurotransmitters, hormones, and neurotrophic factors. Furthermore, exercise demonstrates positive impact on comorbidities such as obesity, cardiovascular disease, depression, and osteoporosis. Despite being a practice that has been shown to be safe, people with epilepsy are less physically active due to barriers that limit their practice. CONCLUSIONS: Physical activity is beneficial and safe for people with epilepsy. Literature suggests better control of seizures, psychosocial benefits, and improvements on the comorbidities. There is a low risk of injury associated. Exercise should be promoted after a careful clinical evaluation, considering seizure control in the last year, potential triggering factors and the sport chosen

[Exercise as a therapeutic strategy in epilepsy: a literature review]. / El ejercicio como estrategia terapéutica en la epilepsia: revisión bibliográfica.

INTRODUCTION: Epilepsy is a common neurologic disease with emotional and physical consequences. Thirty percent of patients have drug-resistant epilepsy, therefore adjuvant non-pharmacological therapies, such as physical activity, have been proposed. AIM: This study reviews the literature about physical activity in people with epilepsy, to evaluate the benefits, potential side effects, impact on comorbidities, the risk classification of sports, and the barriers to their practice. DEVELOPMENT: Multiple animal and human models evaluate the benefits of exercise in epilepsy, explained by modulation on neurotransmitters, hormones, and neurotrophic factors. Furthermore, exercise demonstrates positive impact on comorbidities such as obesity, cardiovascular disease, depression, and osteoporosis. Despite being a practice that has been shown to be safe, people with epilepsy are less physically active due to barriers that limit their practice. CONCLUSIONS: Physical activity is beneficial and safe for people with epilepsy. Literature suggests better control of seizures, psychosocial benefits, and improvements on the comorbidities. There is a low risk of injury associated. Exercise should be promoted after a careful clinical evaluation, considering seizure control in the last year, potential triggering factors and the sport chosen.

TITLE: El ejercicio como estrategia terapéutica en la epilepsia: revisión bibliográfica.Introducción. La epilepsia es una enfermedad neurológica común con consecuencias emocionales y físicas significativas. Hasta el 30% de los pacientes son refractarios a los fármacos antiepilépticos, por lo que se han planteado terapias no farmacológicas coadyuvantes, como la actividad física. Objetivo. Se realizó una búsqueda en la bibliografía sobre actividad física en personas con epilepsia, con el fin de evaluar los beneficios, potenciales efectos secundarios, el impacto en las comorbilidades, la clasificación de riesgo de cada deporte y las barreras existentes para su práctica. Desarrollo. Múltiples modelos en animales y en humanos evalúan los beneficios del ejercicio en la epilepsia, explicados por efectos en neurotransmisores, hormonas y factores neurotróficos; además, demuestran efectos positivos en comorbilidades como la obesidad, las enfermedades cardiovasculares, la depresión y la osteoporosis. A pesar de ser una práctica que ha mostrado ser segura, las personas con epilepsia son menos activas físicamente debido a barreras que limitan su práctica. Conclusiones. La actividad física es beneficiosa y segura para las personas con epilepsia. La bibliografía sugiere un mejor control de las crisis epilépticas, además de beneficios psicosociales y sobre las comorbilidades. Hay un bajo riesgo de lesiones asociadas con esta práctica. El ejercicio debería promoverse después de una evaluación clínica cuidadosa, considerando el control de crisis en el último año, posibles factores precipitantes y el tipo de deporte que se va a practicar.

Sleep-wake cycle of elite athletes prior to the Rio 2016 Olympic Games / Ciclo de vigilia-sueño de atletas de élite antes de los Juegos Olímpicos de Río 2016 / Ciclo de vigília-sono de atletas de elite antes dos Jogos Olímpicos Rio 2016

OBJECTIVE: To analyze chronotype, duration and quality of sleep among elite athletes, to compare differences in sleep variables between sex, and to compare differences between athletes of individual and team sports. METHOD: The sample included 70 Brazilian elite athletes of both sex (male=37; female=33) with a mean age 23.0 ± 4.0 years old. To measure sleep-wake cycle, athletes wore an actigraph on the wrist for 10 days. Moreover, athletes answered the chronotype questionnaire of Horne and Östberg. RESULTS: The most athletes are intermediate-type (n=55, 78.6%), with a mean of 07h:18min of sleep per night. The athletes demonstrated higher sleep fragmentation (39.26 ± 23.66 minutes) and higher sleep latency (30.88 ± 16.19 minutes) during pre-competition training days. Additionally, the athletes of individual sports demonstrated more fragmentation (p < 0.001) and less sleep efficiency (p < 0.001) compared athletes of team sports. However, there was no significant difference in all sleep variables between the male and female sex. CONCLUSION: The overall elite athletes presented poor sleep quality during the training periods prior to the Rio 2016 Olympic Games, and individual athletes showed higher fragmentation and poorer sleep efficiency compared to team athletes

OBJETIVO: Analizar el cronotipo, la duración y la calidad del sueño entre los atletas de élite, comparar las diferencias en las variables de sueño entre los sexos y comparar las diferencias entre los atletas de los deportes individuales y de equipo. MÉTODO: La muestra incluyó a 70 atletas de élite brasileños de ambos sexos (hombre = 37; mujer = 33) con una edad media de 23.0 ± 4.0 años. Para medir lo ciclo de vigilia-sueño, los atletas usaron un actígrafo en la muñeca durante 10 días. Además, los atletas respondieron el cuestionario cronotipo de Horne y Östberg. RESULTADOS: La mayoría de los atletas son de tipo intermedio (n = 55, 78.6%), con una media de 07h: 18min de sueño por noche. Los atletas demostraron una mayor fragmentación del sueño (39.26 ± 23.66 minutos) y una mayor latencia del sueño (30.88 ± 16.19 minutos) durante los días de entrenamiento previo a la competencia. Además, los atletas de deportes individuales demostraron más fragmentación (p <0.001) y menos eficiencia del sueño (p <0.001) en comparación con los atletas de deportes de equipo. Sin embargo, no hubo diferencias significativas en todas las variables de sueño entre el sexo masculino y el femenino. CONCLUSIÓN: Los atletas de élite en general presentaron mala calidad del sueño durante los períodos de entrenamiento previos a los Juegos Olímpicos de Río 2016, y los atletas individuales mostraron una mayor fragmentación y una menor eficiencia del sueño en comparación con los atletas del equipo

OBJETIVO: Analisar o cronotipo, a duração e a qualidade do sono de atletas de elite, comparar as diferenças nas variáveis do sono entre os sexos e as diferenças entre atletas de esportes individuais e coletivos. MÉTODO: A amostra incluiu 70 atletas de elite brasileiros de ambos os sexos (masculino = 37; feminino = 33) com idade média de 23.0 ± 4.0 anos. Para mensurar o ciclo vigília-sono, os atletas usaram um actígrafo no punho por 10 dias. Além disso, os atletas responderam ao questionário de cronotipo de Horne e Östberg. RESULTADOS: A maioria dos atletas é do tipo intermediário (n = 55, 78.6%), com média de 07h:18min de sono por noite. Os atletas demonstraram maior fragmentação do sono (39.26 ± 23.66 minutos) e maior latência do sono (30.88 ± 16.19 minutos) durante os dias de treinamento pré-competição. Além disso, os atletas de esportes individuais demonstraram maior fragmentação (p <0.001) e menor eficiência do sono (p <0.001) em comparação aos atletas de esportes coletivos. No entanto, não houve diferença significativa em todas as variáveis de sono entre os sexos masculino e feminino. CONCLUSÃO: Os atletas de elite em geral apresentaram baixa qualidade do sono durante os períodos de treinamento antes dos Jogos Olímpicos Rio 2016, e os atletas de esportes individuais apresentaram maior fragmentação e menor eficiência do sono em comparação aos atletas de esportivos coletivos

Clinical Reaction-Time Performance Factors in Healthy Collegiate Athletes.

CONTEXT: In the absence of baseline testing, normative data may be used to interpret postconcussion scores on the clinical reaction-time test (RTclin). However, to provide normative data, we must understand the performance factors associated with baseline testing. OBJECTIVE: To explore performance factors associated with baseline RTclin from among candidate variables representing demographics, medical and concussion history, self-reported symptoms, sleep, and sport-related features. DESIGN: Cross-sectional study. SETTING: Clinical setting (eg, athletic training room). PATIENTS OR OTHER PARTICIPANTS: A total of 2584 National Collegiate Athletic Association student-athletes (n = 1206 females [47%], 1377 males [53%], and 1 unreported (<0.1%); mass = 76.7 ± 18.7 kg; height = 176.7 ± 11.3 cm; age = 19.0 ± 1.3 years) from 3 institutions participated in this study as part of the Concussion Assessment, Research and Education Consortium. MAIN OUTCOME MEASURE(S): Potential performance factors were sex; race; ethnicity; dominant hand; sport type; number of prior concussions; presence of anxiety, learning disability, attention-deficit disorder or attention-deficit/hyperactivity disorder, depression, or migraine headache; self-reported sleep the night before the test; mass; height; age; total number of symptoms; and total symptom burden at baseline. The primary study outcome measure was mean baseline RTclin. RESULTS: The overall RTclin was 202.0 ± 25.0 milliseconds. Female sex (parameter estimate [B] = 8.6 milliseconds, P < .001, Cohen d = 0.54 relative to male sex), black or African American race (B = 5.3 milliseconds, P = .001, Cohen d = 0.08 relative to white race), and limited-contact (B = 4.2 milliseconds, P < .001, Cohen d = 0.30 relative to contact) or noncontact (B = 5.9 milliseconds, P < .001, Cohen d = 0.38 relative to contact) sport participation were associated with slower RTclin. Being taller was associated with a faster RTclin, although this association was weak (B = -0.7 milliseconds, P < .001). No other predictors were significant. When adjustments are made for sex and sport type, the following normative data may be considered (mean ± standard deviation): female, noncontact (211.5 ± 25.8 milliseconds), limited contact (212.1 ± 24.3 milliseconds), contact (203.7 ± 21.5 milliseconds); male, noncontact (199.4 ± 26.7 milliseconds), limited contact (196.3 ± 23.9 milliseconds), contact (195.0 ± 23.8 milliseconds). CONCLUSIONS: Potentially clinically relevant differences existed in RTclin for sex and sport type. These results provide normative data adjusting for these performance factors.

A biomechanical comparison of conventional classifications of bowling action-types in junior fast bowlers.

Fast bowling is categorised into four action types: side-on, front-on, semi-open and mixed; however, little biomechanical comparison exists between action types in junior fast bowlers. This study investigated whether there are significant differences between action-type mechanics in junior fast bowlers. Three-dimensional kinematic and kinetic analyses were completed on 60 junior male fast bowlers bowling a five-over spell. Mixed-design factorial analyses of variance were used to test for differences between action-type groups across the phases of the bowling action. One kinetic difference was observed between groups, with a higher vertical ground reaction force loading rate during the front-foot contact phase in mixed and front-on compared to semi-open bowlers; no other significant group differences in joint loading occurred. Significant kinematic differences were observed between the front-on, semi-open and mixed action types during the front-foot contact phase for the elbow and trunk. Significant kinematic differences were also present for the ankle, T12-L1, elbow, trunk and pelvis during the back-foot phase. Overall, most differences in action types for junior fast bowlers occurred during the back-foot contact phase, particularly trunk rotation and T12-L1 joint angles/ranges of motion, where after similar movement patterns were utilized across groups during the front-foot contact phase.

High-performance athletes’ attitude towards doping: Validation of the Spanish version of the Performance Enhancement Attitude Scale for Colombia / Actitud frente al dopaje de deportistas de alto rendimiento: Validación de la versión española de la Performance Enhancement Attitude Scale para Colombia

BACKGROUND: Doping is the use of substances to achieve a better performance in sports. This practice is considered to be growing worldwide. Despite regulations by the World Anti-Doping Agency, 14-39% of high-performance athletes have consumed prohibited substances at least once in their sports career. The attitudes towards this type of consumption are used as predictors of the intent of usage of prohibited substances to improve physical performance. OBJECTIVE: This study aimed to validate the Spanish Version of the Performance Enhancement Attitude Scale of high-performance athletes in the Colombian context. METHODOLOGY: A cross-sectional study was performed with a convenience sampling of 112 athletes aged 15 and older, registered in a State Sports Institute in Medellín, Colombia in 2016. The participants self-completed Petróczi and Aidman instrument, Performance Enhancement Attitude Scale, adapted into Spanish by Morente-Sánchez, et al. in 2014. The reliability of the scale was assessed using Cronbach's Internal Consistency Coefficient and an exploratory and confirmatory factor analysis (CFA) was conducted to evaluate the scale's structure. RESULTS: The scale had a reliability of 0.87 and the factor analysis confirmed the unidimensionality. Of all the athletes participating in the research, the Performance Enhancement Attitude Scale average was 35.8 of 102 points, indicating a low tendency of attitudes towards doping. CONCLUSION: The psychometric properties of the 17 items of the Performance Enhancement Attitude Scale are adequate and could be used when assessing attitudes towards doping of high-performance athletes in similar contexts. This information could be used for the purposes of developing educational strategies for doping prevention in our athletes

INTRODUCCIÓN: El dopaje es el uso de sustancias para lograr un mejor desempeño en los deportes. Esta práctica parece estar creciendo en todo el mundo. A pesar de las regulaciones de la World Anti-Doping Agency, 14-39% de los deportistas de alto rendimiento han consumido sustancias prohibidas al menos una vez durante su carrera deportiva. las actitudes hacia este tipo de consumo se emplean como predictores de la intención de uso de sustancias prohibidas para mejorar el rendimiento físico. OBJETIVO: El objetivo del estudio fue validar en deportistas de alto rendimiento en el contexto colombiano la versión española de la escala de Actitudes frente al mejoramiento del rendimiento. DISEÑO: Se realizó un estudio de corte transversal en 2016 con una muestra por conveniencia de 112 deportistas de 15 y más años inscritos en un instituto deportivo estatal en Medellín (Colombia). METODOLOGÍA: Los participantes autodiligenciaron el instrumento de Petróczi y Aidman Performance Enhancement Attitude Scale (PEAS), adaptado al español por Morente-Sánchez et al. Se evaluó la confiabilidad de la escala con el coeficiente de consistencia internal de Cronbach y se hicieron análisis factorial exploratorio y confirmatorio para evaluar la estructura de la escala. RESULTADOS: Los resultados indicaron que la escala tenía una confiabilidad de 0,87 y el análisis factorial confirmó la unidimensionalidad. En los deportistas participantes en la investigación el promedio de la PEAS fue de 35,8 de 102 puntos posibles, indicando baja tendencia de actitudes hacia el dopaje. CONCLUSIÓN: Las propiedades psicométricas de los 17 ítems de la PEAS son adecuadas, y podría ser utilizada en la evaluación de actitudes hacia el dopaje en deportistas de alto rendimiento en contextos similares. Esta información podría ser utilizada para el desarrollo de estrategias educativas para la prevención del dopaje en nuestros deportistas

La metáfora de la pirámide deportiva: el efecto trickle down y up en España / Sport Pyramid Metaphor: Trickle Down and Up Effect in Spain

La metáfora de la pirámide deportiva (efecto trickle down y trickle up) es utilizada por la administración para justificar la inversión en el deporte de élite. Las evidencias de este efecto son difusas y estudios previos ponen en entredicho su veracidad. Este artículo examina el efecto de esta metáfora en España. Mediante coeficientes de correlaciones de Spearman (ρ), se estudia la relación entre el éxito deportivo y la evolución de las licencias federativas de 23 modalidades deportivas, desde 1992 hasta 2016. Los resultados muestran tres grupos distintos: 1) aquellos con indicios de la posible existencia de los efectos trickle down y up; 2) aquellos que muestran correlaciones negativas entre número de licencias y éxito deportivo; y 3) aquellos que no muestran ninguna relación entre variables. En conclusión, se corrobora que no existe una evidencia clara y generalizada que confirme la existencia de la metáfora de la pirámide deportiva en España

The sports pyramid metaphor (trickle down and trickle up effect) has been used by several governments to justify their public investments in elite sport. The scientific evidence of this effect is fragmented, previous studies question their veracity. This study examines the effect of the sports pyramid metaphor in Spain. Using Spearman's correlation coefficient (ρ), we tested for possible relationships between sporting success and the evolution of the federation membership history of 23 sports modalities during 1992-2016. According to results, three different groups of sports could be identified: 1) those that could be assumed to present both trickle down and up effects; 2) those with negative correlations between sporting success and membership figures; and 3) sports that do not show any relationships between those variables. As a conclusion, it is stated that there is no clear and generalized evidence to confirm the existence of the sport pyramid metaphor in Spain