National Athletic Trainers' Association Bridge Statement: Management of Sport-Related Concussion.

OBJECTIVE: To provide athletic trainers and team physicians with updated recommendations to the 2014 National Athletic Trainers' Association (NATA) concussion position statement regarding concussion management, specifically in the areas of education, assessment, prognostic factors, mental health, return to academics, physical activity, rest, treatment, and return to sport. BACKGROUND: Athletic trainers have benefited from the 2 previous NATA position statements on concussion management, and although the most recent NATA position statement is a decade old, knowledge gains in the medical literature warrant updating several (but not all) recommendations. Furthermore, in various areas of the body of literature, current evidence now exists to address items not adequately addressed in the 2014 statement, necessitating the new recommendations. This document therefore serves as a bridge from the 2014 position statement to the current state of concussion evidence, recommendations from other organizations, and discrepancies between policy and practice. RECOMMENDATIONS: These recommendations are intended to update the state of the evidence concerning the management of patients with sport-related concussion, specifically in the areas of education; assessment advances; prognostic recovery indicators; mental health considerations; academic considerations; and exercise, activity, and rehabilitation management strategies.

The International Olympic Committee framework on fairness, inclusion and nondiscrimination on the basis of gender identity and sex variations does not protect fairness for female athletes.

The International Olympic Committee (IOC) recently published a framework on fairness, inclusion, and nondiscrimination on the basis of gender identity and sex variations. Although we appreciate the IOC's recognition of the role of sports science and medicine in policy development, we disagree with the assertion that the IOC framework is consistent with existing scientific and medical evidence and question its recommendations for implementation. Testosterone exposure during male development results in physical differences between male and female bodies; this process underpins male athletic advantage in muscle mass, strength and power, and endurance and aerobic capacity. The IOC's "no presumption of advantage" principle disregards this reality. Studies show that transgender women (male-born individuals who identify as women) with suppressed testosterone retain muscle mass, strength, and other physical advantages compared to females; male performance advantage cannot be eliminated with testosterone suppression. The IOC's concept of "meaningful competition" is flawed because fairness of category does not hinge on closely matched performances. The female category ensures fair competition for female athletes by excluding male advantages. Case-by-case testing for transgender women may lead to stigmatization and cannot be robustly managed in practice. We argue that eligibility criteria for female competition must consider male development rather than relying on current testosterone levels. Female athletes should be recognized as the key stakeholders in the consultation and decision-making processes. We urge the IOC to reevaluate the recommendations of their Framework to include a comprehensive understanding of the biological advantages of male development to ensure fairness and safety in female sports.

The Future of Artificial Intelligence in Sports Medicine and Return to Play.

Artificial intelligence (AI) has shown tremendous growth over the last decade, with the more recent development of clinical applications in health care. The ability of AI to synthesize large amounts of complex data automatically allows health care providers to access previously unavailable metrics and thus enhance and personalize patient care. These innovations include AI-assisted diagnostic tools, prediction models for each treatment pathway, and various tools for workflow optimization. The extension of AI into sports medicine is still early, but numerous AI-driven algorithms, devices, and research initiatives have delved into predicting and preventing athlete injury, aiding in injury assessment, optimizing recovery plans, monitoring rehabilitation progress, and predicting return to play.

The initial visibility of updated recommendations on preseason heat safety in high school athletics among United States athletic trainers.

Updated recommendations on preseason heat safety in high school (HS) athletics ("2021 Consensus Statements") were published in April 2021. This cross-sectional survey study explored the initial roll-out of the 2021 Consensus Statements, including their visibility among United States HS athletic trainers (ATs) and perceived levels of confidence in implementing them. Recruitment occurred first, from a random selection of ATs from the Board of Certification, Inc., and second, an open invitation via social media. An online cross-sectional questionnaire had participating ATs note whether they had seen the 2021 Consensus Statements. If yes, ATs reported their perceived level of confidence in implementing them (5-point-ordinal scale from "not at all confident" to "very confident); if no, ATs disclosed (open-ended) why they had not yet seen them. Descriptive statistics were calculated for quantitative variables; template analysis identified codes related to visibility of and confidence in implementing 2021 Consensus Statements. Nearly half (45.7%) of 116 responding HS ATs reported having seen at least one 2021 Consensus Statements; 23.3% had reviewed all three. Common reasons among the 63 that had not seen them included: not aware they were published (n = 22), have yet to read them (n = 19), and believed they could not access the journal (n = 10). Of the 53 ATs having seen at least one of the 2021 Consensus Statements, 67.9% (n = 36) were very/fairly confident in implementing them at their HS. Reasons for confidence included their schools ensuring up-to-date EHI prevention and management practices (n = 18) and athletics constituent support (n = 8). This exploratory study observed proportions of surveyed HS ATs that had not seen the 2021 Consensus Statements and were not confident in implementing them. Findings highlight the need to continue improving messaging about access to best-practice recommendations. Further, continued efforts inclusive of active and passive dissemination strategies across all athletics constituents are needed to aid proper implementation.

[Research progress of magnesium and magnesium alloy implants in sports medicine].

Objective: To review the research progress of magnesium and magnesium alloy implants in the repair and reconstruction of sports injury. Methods: Relevant literature of magnesium and magnesium alloys for sports injury repair and reconstruction was extensively reviewed. The characteristics of magnesium and its alloys and their applications in the repair and reconstruction of sports injuries across various anatomical sites were thoroughly discussed and summarized. Results: Magnesium and magnesium alloys have advantages in mechanical properties, biosafety, and promoting tendon-bone interface healing. Many preclinical studies on magnesium and magnesium alloy implants for repairing and reconstructing sports injuries have yielded promising results. However, successful clinical translation still requires addressing issues related to mechanical strength and degradation behavior, where alloying and surface treatments offer feasible solutions. Conclusion: The clinical translation of magnesium and magnesium alloy implants for repairing and reconstructing sports injuries holds promise. Subsequent efforts should focus on optimizing the mechanical strength and degradation behavior of magnesium and magnesium alloy implants. Conducting larger-scale biocompatibility testing and developing novel magnesium-containing implants represent new directions for future research.

A strategy to implement the American College of Sports Medicine's Exercise is Medicine® (EIM) initiative in a community oncology clinic.

PURPOSE: Despite proven benefits, few cancer patients exercise during chemotherapy. The American College of Sports Medicine's Exercise is Medicine® (EIM) initiative describes a model to integrate exercise into oncology care, based upon assessing patients' ability to exercise safely, advising on exercise benefits, and referring patients to exercise. We developed and tested a strategy to implement EIM in a community-based oncology clinic, to assess-advise-refer 20 patients undergoing chemotherapy to a 3-month online exercise class, and measured implementation outcomes. METHODS: Using a community-based provider participation in research (CBPPR) model, researchers and staff co-designed and tested a 4-level implementation strategy, with a goal of assessing-advising-referring 20 cancer patients to exercise. Surveys and interviews were conducted with 12 (100%) staff at baseline and post-implementation on acceptability/appropriateness/feasibility, perceptions of individual implementation roles, and organizational strengths/conditions. Data were analyzed using correlations, t-tests, and content analysis. RESULTS: The proposed strategy was revised in collaboration with staff who requested assistance for recruitment and data collection. EIM was successfully implemented with 41 (92%) patients assessed, 37 (90%) advised, and 22 (60%) referred to exercise classes. Barriers to implementation were staff shortages and time constraints; facilitators included research team supports. Staff's perceived organizational strengths were positively correlated with exercise promotion acceptability, appropriateness, and feasibility. There were no statistically significant changes in implementation outcomes (acceptability/appropriateness/feasibility) post-implementation. CONCLUSIONS: Using a collaborative model, EIM was successfully implemented in a community oncology clinic; however, the clinic required significant support from the research team. Adaptations to the EIM process may be required to improve implementation outcomes.

Racial and Ethnic Disparities in Sports Medicine and the Importance of Diversity.

Within orthopedics surgery as a specialty, sports medicine is one of the least diverse surgical subspecialties. Differences in minority representation between patient and provider populations are thought to contribute to disparities in care, access, and outcomes.

Efforts to Improve Diversity, Equality, and Inclusion in Sports Medicine via Community Engagement Initiatives Within American Cities Divided by Racial, Social, and Economic Factors.

Although the twenty-first century has seen major advances in evidence-based medicine to improve health, athletic performance, and injury prevention, our inability to implement these best practices across underserved American communities has limited the impact of these breakthroughs in sports medicine. Rochester, NY is stereotypical of American communities in which an economically challenged racially diverse urban center with grossly underperforming public schools is surrounded by adequately resourced predominantly Caucasian state-of-the-art education systems. As these great disparities perpetuate and further degrade our society in the absence of interventions, the need for community engagement initiatives is self-evident.

Trends for Diversity in Orthopedic Sports Medicine.

Despite the increasingly diverse population of the United States, orthopedic surgery continues to lag other medical specialties in terms of diversity. It remains the specialty with the lowest percentage of women, and White physicians dominate the field, especially in leadership positions. Although the trends are slowly moving in the right direction, additional efforts must be taken to further diversify the field. A targeted, multifaceted approach is required to enhance awareness, educate, mentor, and develop future leaders. Such an approach has recently been established by the American Orthopaedic Society for Sports Medicine, which will hopefully improve future minority and female representation.

Gender Equity Efforts in Sports Medicine.

Great progress has been made toward gender equality in athletics, whereas true equality has not yet been realized. Concurrently, women orthopedists along with advocate men have paved the way toward gender equity in orthopedics as a whole and more specifically in sports medicine. The barriers that contribute to gender disparities include lack of exposure, lack of mentorship, stunted career development, childbearing considerations and implicit gender bias and overt gender discrimination.

Trends and challenges in implementing sports medicine practices in chilean athletic training

The aim of the research is to determine the trends and challenges related to sports medicine practices in Chilean athletic training. This research examines the state of sports medicine practices in the field of athletic training in Chile, taking a close expression at both international trends and regionally-specific issues. To determine the research, smart PLS software was used and generated informative results, including descriptive statistics and correlation coefficient analysis, which also explains the smart PLS Algorithm model between them. Global trends include the integration of cutting-edge technologies, customized training programs, and an all-encompassing, interdisciplinary approach; however, for successful implementation in Chile, issues including scarce resources, educational disparities, cultural influences, infrastructure needs, and legal considerations must be resolved. The overall research found that direct and significant implementation of sports medicine practices in Chilean athletic training. The study highlights how crucial it is to comprehend and overcome these obstacles to maximize athlete performance and well-being. Sports medicine practices in Chile can progress by practitioners and stakeholders recognizing and adjusting tothe distinct features of the nation's sports ecosystem (AU)

Insatisfacción corporal, ortorexia y dependencia al ejercicio en corredores amateur de resistencia / Insatisfação corporal, ortorexia e dependência do treino em corredores amadores de resistência / Body image dissatisfaction, orthorexia and training addiction in amateur endurance runners

El objetivo del estudio fue conocer si existe relación entre la insatisfacción corporal, la ortorexia y la dependencia al ejercicio en una muestra de corredores de resistencia aficionados, así como examinar las variables psicológicas como la identidad, el perfeccionismo y el enfoque a través de la comparación entre grupos y la obtención de perfiles. Para ello, 129 corredores participantes en la edición XIII del Trail 7 Colinas de Tartessos en 2023 (96 hombres y 33 mujeres; media de edad M=45.5; DT=8.4), completaron el cuestionario de imagen corporal (Body Shape Qustionnaire, BSQ 14), la ortorexia 11 (ORTO-11), el Inventario de perfeccionismo multidimensional en el Deporte en competición (MIPS), la Escala de medición de identidad deportiva (AIMS), el cuestionario ad hoc de Satisfacción Manifiesta (CS), el cuestionario de Percepción de Éxito (POSQ). También se registraron los datos y parámetros como corredor. Los resultados mostraron que el 15% de los corredores presentaron insatisfacción corporal y el 16 % ortorexia. Además, el 13 % de los corredores presentaron ambas manifestaciones. Se encontró una correlación significativa positiva entre la insatisfacción corporal y la ortorexia. Ambas variables también presentaron correlaciones negativas con la satisfacción manifiesta sobre la imagen corporal. Sin embargo, no se encontró relación con la dependencia del ejercicio, aunque los componentes de esta última se relacionaron con variables psicológicas; el componente positivo mostró una correlación negativa con el perfeccionismo, y el componente negativo se relacionó positivamente con la identidad deportiva. Ambas variables resultaron relevantes en la comparación de los grupos en relación a la ortorexia, y de manera separadas en la discriminación; el perfeccionismo sobre la insatisfacción manifiesta y la escala de identidad sobre la ortorexia.(AU)

The aim of the present study was to find out whether there is a relationship between body dissatisfaction, orthorexia, and exercise dependence in a sample of amateur endurance runners, as well as to examine psychological variables such as identity, perfectionism, and focus by comparing groups and obtaining profiles. To this end, 129 runners participating in the XIII edition of the Trail 7 Colinas de Tartessos in 2023 (96 men and 33 women; mean age M=45.5; SD=8.4), completed the Body Shape Questionnaire (BSQ14),the Orthorexia 11 (ORTO-11), the Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), the Athletic Identity Measurement Scale (AIMS), the ad hoc Satisfaction Questionnaire (CS), the Perception of Success Questionnaire (POSQ). Data and parameters as a runner were also recorded. The results showed that 15% of the runners presented body dissatisfaction and 16% orthorexia. In addition, 13 % of the runners had both manifestations. A significant positive correlation was found between body dissatisfaction and orthorexia. Both variables were also negatively correlated with expressed satisfaction with body image. However, no relationshipwas found with exercise dependence, although components of exercise dependence were related to psychological variables; the positive component showed a negative correlation with perfectionism, and the negative component was positively related to sports identity. Both variables were relevant in the comparison of the groups in relation to orthorexia, and separately in discrimination,perfectionism on manifest dissatisfaction and the identity scale on orthorexia.(AU)

O objectivo do estudo foi analisar se existe uma relação entre insatisfação corporal, ortorexia e dependência do exercício numa amostra de corredores amadores de endurance, bem como analisar variáveis psicológicas como a identidade, o perfeccionismo e o foco, através da comparação entre grupos e da obtenção de perfis. Para o efeito, 129 corredores participantes na XIII edição do Trail 7 Colinas de Tartessos em 2023 (96 homens e 33mulheres; idade média M=45.5; DP=8.4), preencheram o Body ShapeQuestionnaire(BSQ 14), o Orthorexia 11 (ORTO-11), o Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), a Athletic Identity Measurement Scale (AIMS), o ad hoc Satisfaction Questionnaire (CS), e o Perception of Success Questionnaire (POSQ). Foram igualmente registados os dados e os parâmetros enquanto corredores. Os resultados mostraram que 15% dos corredores apresentavam insatisfação corporal e 16% ortorexia. Para alémdisso, 13% dos corredores apresentavam ambas as manifestações. Foi encontrada uma correlação positiva significativa entre a insatisfação corporal e a ortorexia. Ambas as variáveis estavam também negativamente correlacionadas com a satisfação expressa com a imagem corporal. No entanto, não foi encontrada qualquer relação com a dependência do exercício, embora os componentes da dependência do exercício estivessem relacionados com variáveis psicológicas; a componente positiva evidenciou uma correlação negativa com o perfeccionismo, e a componente negativa estava positivamente relacionado coma identidade desportiva. Ambas as variáveis foram relevantes na comparação dos grupos em relação à ortorexia, e separadamente na discriminação; o perfeccionismo na insatisfação manifesta e a escala de identidade na ortorexia.(AU)

Motivational orientation and intention to be physically active in physical education students: The role of motor self-efficacy / Orientação motivacional e intenção de ser fisicamente ativo em estudantes de educação física: O papel da auto-eficácia motora / Orientación motivacional e intención de ser físicamente activo en estudiantes de educación física: El papel de la autoeficacia motriz

La motivación orientada a la tarea se vincula con la tendencia de los estudiantes de Educación Física a asociarse con una mayor probabilidad de ser físicamente activos en el futuro y fuera de las clases de Educación Física, mientras que la motivación orientada al ego estaría vinculada a una menor probabilidad de desarrollar estilos de vida activos. Además, la literatura existente ha mostrado que la percepción de autoeficacia también sería una variable que determina la intención de ser activo. Así, el objetivo de esta investigación fue analizar las relaciones entre la orientación motivacional y la intención de ser activo, analizando el papel de la autoeficacia motriz en estas relaciones. Para ello, se desarrolló un modelo de ecuaciones estructurales en el que se evaluaron los efectos directos e indirectos entre las variables. Participaron en esta investigación 478 adolescentes con edades comprendidas entre los 13 y los 18 años (M=14.57; DT=1.15). Para la recogida de información se utilizaron elCuestionario Orientación al Ego y a la Tarea en el Deporte (TEOSQ), la Escala de Autoeficacia Motriz (MSES) y la Escala de Intención de Ser Físicamente Activo (MIFA). Los datos mostraron una relación positiva y directa entre la orientación a la tarea con la autoeficacia motriz y la intención de ser activo. Asimismo, los datos mostraron una relación positiva y directa entre la orientaciónal ego con la autoeficacia motora, pero no con la intención de ser activo. Asimismo, se observaron efectos indirectos y positivos entre la orientación a la tarea y al ego con la intención de ser activo. Por lo tanto, los resultados de este estudio muestran que podría ser necesario tener en cuenta la autoeficacia para comprender mejor las relaciones entre las orientaciones motivacionales y la intención de ser activo.(AU)

Task-oriented is linked to the tendency of Physical Education students to be associated with a higher likelihoodof being physically active in the future and outside of Physical Education classes, while ego-oriented motivation is linked to a lower likelihood of developing active lifestyles. However, existing literature has shown that self-efficacy perception is also a variable that determines the intention to be active. Thus, this research aimed to analyze the relationships between motivational orientationand the intention to be active, examining the role of motor self-efficacy in these relationships. To this end, astructural equation model was developed in which direct and indirect effects between the variables were evaluated. A total of 478 adolescents aged between 13 and 18 years old (M=14.57; SD=1.15) participated in this research. The Task and Ego Orientation in Sport Questionnaire (TEOSQ), the Motor Self-Efficacy Scale (MSES), and the Intention of Being Physically Active Scale (MIFA) were used to collect information. The data showed a positive and direct relationship between task orientation with motor self-efficacy and intention to be active. Likewise, the data showed a positive and direct relationship between ego orientation and motor self-efficacy, but not to be active. Additionally, indirect and positive effects were observed between task and ego orientation to be active. Therefore, the results of this study suggest that it might be necessary to consider self-efficacy to better understand the relationships between motivational orientations and intention to be active.(AU)

A orientação para a tarefa está ligada à tendência dos estudantes de Educação Física para serem fisicamente activos no futuro bem como fora das aulas de Educação Física. Por outro lado, a orientação para o ego está mais relacionada com uma menor probabilidade de desenvolverem estilos de vida activos. No entanto, a literatura existente tem demonstrado que a perceção de auto-eficácia seria também uma variável que determina a intenção de ser ativo. Assim, o objetivodo presente estudo foi analisar as relações entre a orientação motivacional e a intenção de ser ativo, analisando o papel da auto-eficácia motora nestas relações. Para isso, foi desenvolvido um modelo de equações estruturais no qual foram avaliados os efeitos diretos e indiretos. Participaram nesta investigação 478 adolescentes com idades compreendidas entre os 13 e os 18 anos (M=14,57; DP=1,15). Para a recolha de informação foram utilizados o Task and Ego Orientation in Sport Questionnaire (TEOSQ), aMotor Self-Efficacy Scale (MSES) e a Intention ofBeing Physically Active Scale (MIFA). Os dados revelaram uma relação positiva e direta entre a orientação para a tarefa, a auto-eficácia motora e a intenção de ser ativo. Além disso, os dados revelaram uma relação positiva e direta entre a orientação para o ego e a auto-eficácia motora, mas não com a intenção de ser ativo. Da mesma forma, foram observados efeitos indirectos positivos entre a orientação para a tarefa e a orientação para o ego com a intenção de ser ativo. Portanto, os resultados deste estudo sugerem que pode ser necessário considerar a autoeficácia para entender as relações entre as orientações motivacionais e a intenção de ser ativo.(AU)