The Dose-Response Relationship of an Exercise-Based Injury Prevention Program: A Secondary Analysis of a Randomized Controlled Trial on Athletics (Track-and-Field) Athletes Over a 39-Week Follow-Up.

Despite exercise-based injury prevention programs (EIPPs) being widely researched and used, several randomized controlled trials (RCTs) have failed to show their protective effect on injury risk. This is potentially due to underappreciating the EIPP dose-response relationship, by not controlling the analysis for the injuries sustained during the early EIPP implementation period, before the EIPP becomes efficacious. To determine the dose-response relationship of EIPP by controlling for the effects of injuries sustained before it became efficacious. We conducted a secondary analysis of an RCT analyzing the EIPP efficacy in athletics over a 39-week follow-up on 840 athletes, by including only those with 100% response rate. We controlled the statistical analyses for a range of lengths of early EIPP implementation period by either excluding the athletes with early injuries (i.e., exclusion approach) or adjusting for the early injuries' effects (i.e., inclusion approach). We estimated the EIPP's dose-response relationship by measuring the EIPP's effect at each length of the controlled period. When we considered no early controlled period, the EIPP showed no effect (OR = 0.85 [95% CI: 0.67-1.09]; p = 0.209). However, both exclusion and inclusion approaches showed that the EIPP effect increased significantly after 5-6 weeks of controlled period. This relationship plateaued at 7-12 weeks of controlled period, peaking at 10 weeks with the exclusion approach (OR = 0.28 [95% CI: 0.16-0.48]; p < 0.001), and 7 weeks with the inclusion approach (OR = 0.37 [95% CI: 0.25-0.55]; p < 0.001). Acknowledging the dose-response relationship of EIPPs could help researchers to design and analyze RCTs and practitioners to plan EIPP implementation timely. Trial Registration: ClinicalTrials.gov Identifier: NCT03307434.

Concussion acutely disrupts auditory processing in division I football student-athletes.

INTRODUCTION: Diagnosis, assessment, and management of sports-related concussion require a multi-modal approach. Yet, currently, an objective assessment of auditory processing is not included. The auditory system is uniquely complex, relying on exquisite temporal precision to integrate signals across many synapses, connected by long axons. Given this complexity and precision, together with the fact that axons are highly susceptible to damage from mechanical force, we hypothesize that auditory processing is susceptible to concussive injury. METHODS: We measured the frequency-following response (FFR), a scalp-recorded evoked potential that assesses processing of complex sound features, including pitch and phonetic identity. FFRs were obtained on male Division I Collegiate football players prior to contact practice to determine a pre-season baseline of auditory processing abilities, and again after sustaining a sports-related concussion. We predicted that concussion would decrease pitch and phonetic processing relative to the student-athlete's preseason baseline. RESULTS: We found that pitch and phonetic encoding was smaller post-concussion. Student-athletes who sustained a second concussion showed similar declines after each injury. CONCLUSIONS: Auditory processing should be included in the multimodal assessment of sports-related concussion. Future studies that extend this work to other sports, other injuries (e.g. blast exposure), and to female athletes are needed.

Female Orthopaedic Surgeons Are Less Represented as Head Team Physicians in Collegiate Athletic Programs.

PURPOSE: The purpose of this study was to evaluate National Collegiate Athletic Association (NCAA) head team physicians (HTP), focusing on gender as it relates to divisional variability, medical specialty, and research productivity. METHODS: In December 2022, the NCAA member directory was utilized to obtain HTP information from the top 5 conferences within Divisions I, II, and III (DI, DII, DIII, respectively). Division I schools were selected from the previously established "Power 5" conferences. Divisions II and III used NCAA rankings. HTP data was collected from publicly available verifiable data sources. Data for gender, Scopus H-index, residency programs, and fellowship programs were collected. Mean, median, skewness, p-values, and odds ratio were calculated for analysis. RESULTS: One hundred and eighty six NCAA institutions were evaluated: 69 DI (37%), 65 DII (35%), and 52 DIII (28%). DIII had the highest female representation (8; 16%). Out of the 67 orthopaedic surgery HTPs, 5 (7.5%) were female and 62 male (92.5%). There is a statistically significant difference in female orthopedic surgeon representation in the HTP field compared to males (p-value = 0.038, alpha = 0.05). Female orthopaedic surgeons have 38% lower odds of being represented as HTPs compared to males (p-value = 0.046, alpha = 0.05). Female HTPs in Divisions I and III had higher H-indexes than the overall average and median values for their respective divisons. CONCLUSION: Female HTPs are significantly less represented compared to males in the NCAA. Furthermore, female orthopaedic surgeons were found to have lower odds of being represented as HTPs compared to their male counterparts. For research productivity, female HTPs impacted the distribution as outliers in Divisions I and III.

Clustering technical approaches of elite and world-class pole vaulters based on 10 years of measurement during competitions.

Recently, a variety of technical approaches in world-class pole-vaulters' behaviour have been observed. The aim of this study was to investigate the presence of subgroups using different technical approaches and to compare biomechanical performance differences. Biomechanical analysis of performances over 5.00 metres from 99 athletes were clustered with K-means methodology based on the relative position of the top hand at take-off and the direction of the top of the pole from take-off to the maximal pole bending. Analysis revealed four subgroups that were distinguished by higher and lower direction angle and relative position values. Despite differences in technique, the analysis did not reveal significant differences between these four groups in performance, take-off speed, or athlete anthropometrics. Nevertheless, these clusters showcased variations in pole-athlete interactions and pole bending, suggesting different strategies and physical requirements associated with each approach. Cluster 2 characterised the classical technique with a high direction angle and a take-off position close to the vertical plane. Cluster 4 displayed a technique with a low take-off angle, suggesting the influence of athletes like Lavillenie, in deviating from the conventional model. Understanding and categorising athletes based on their preferred technique can aid coaches in providing tailored instructions, leading to performance improvements.

Differences in pacing behaviour between global championship medal performances and world records in men's and women's middle- and long-distance running track events.

The differences in pacing demands between track distance-running championship and meet (e.g., World Record [WR]) races have not been specified yet in the current literature. Therefore, the aim of this study was to determine pacing behaviour differences between WRs and global championship (i.e., World Championships and Olympic Games) medal performances (GCMs) in middle- and long-distance running events. Percentages of mean race section speeds were compared through analysis of variance between men's and women's 169 WRs and 189 GCMs over 800 m, 1500 m, 3000 m steeplechase, 5000 m and 10,000 m. U-shaped and negative pacing approaches are observed during men's and women's 1500 m WRs and GCMs, respectively. The first and third 400 m of men's and women's 1500 m GCMs were relatively slower and faster, respectively (p ≤ 0.05, 1.31 ≤ d ≤ 1.69). Even profiles are followed during women's 3000 m steeplechase WRs and GCMs, whereas positive approaches were adopted in men's GCMs. Finally, whereas 5000 m and 10,000 m GCMs were finished with a fast endspurt, WRs had a U-shaped profile in men, with differences between the initial and last race stages (p ≤ 0.01, 1.20 ≤ d ≤ 3.66), and an even profile in women. Coaches should consider the different pacing demands existing among meet and global championship races to specifically implement training characteristics targeting either goal type.

Athletes' Coping With the COVID-19 Pandemic: The Role of Self-Compassion and Cognitive Appraisal.

Coping with the COVID-19 pandemic had implications for athletes' mental well-being. This mixed-methods study examined the influence of self-compassion on athletes' coping during the pandemic through the mediator of cognitive appraisal. The prospective design involved 90 athletes completing two online surveys 1 week apart measuring self-compassion, cognitive appraisal, and coping strategies. The PROCESS macro was used for the mediation analysis. A qualitative thematic analysis was used to explore athletes' responses to the pandemic during the second survey. Self-compassion had an indirect negative effect on avoidance-focused coping by appraising the pandemic as less of a threat (95% confidence interval [-0.20, -0.001]) and had a total effect on emotion-focused coping (95% confidence interval [0.02, 0.40]). Based on the thematic analysis, athletes described many raw emotions and a variety of coping strategies during the pandemic. Self-compassion demonstrated promising benefits to athletes who dealt with the challenging situation of the pandemic.

The insufficiency of recreational exercises in improving cardiovascular fitness: an investigation of ventricular systolic and diastolic parameters and left atrial mechanical functions.

AIM: This study aimed to compare the left ventricular (LV) systolic and diastolic parameters and left atrial (LA) mechanical functions of individuals engaging in recreational sports and resistance exercises on a weekly basis. METHODS: A total of 43 male amateur athletes were included in this study, of which 24 performed resistance exercises (REs) (29.70 ± 8.74 year, weight: 81.70 ± 12.64 kg, height: 176.05 ± 7.73 cm, BMI: 27.64 ± 4.97 kg/m2), and 19 participated in recreational football training and were included in the recreational sports group (31.73 ± 6.82 year, weight: 86.00 ± 18.52 kg, height: 178.62 ± 4.95 cm, BMI: 25.55 ± 3.42 kg/m2). The exercises were standardized according to the weekly exercise frequency and volume. After recording the participants' demographic information, the LV systolic and diastolic parameters and LA mechanical functions were measured using echocardiography (ECHO) and Tissue Doppler Imaging. RESULTS: Significant differences were observed in various cardiac parameters between the recreational sports group (REG) and resistance exercise Group (RSG). Specifically, the left ventricular (LV) diastolic diameter, LV end diastolic volume index (LVEDVi), and stroke volume index were notably higher in the REG compared to the RSG (t = 2.804, p = .010, effect size (ES) = 2.10; t = 3.174, p = .003, ES = 0.98; t = 3.36, p = .002, ES = 1.02, respectively). Notably, the RSG exhibited higher values for LV mass index (LVMi) and isovolumic relaxation time (IVRT) than the REG (t = 2.843, p = .007, ES = 0.87; t = 2.517, p = .016, ES = 0.76) in terms of LV systolic and diastolic parameters. Regarding left atrial (LA) mechanics, the REG demonstrated increased LA total emptying volume index, LA maximum volume index, LA volume before systole measured at the onset of the p-wave index, and conduit volume index compared to RSG (t = 2.419, p = .020, ES = 0.75; t = 2.669, p = .011, ES = 0.81; t = 2.111, p = .041, ES = 0.64; t = 2.757, p = .009, ES = 0.84, respectively). CONCLUSION: Our study revealed significant variations in LV and LA functions between REG and RSG. Our data suggest that REs led to substantial cardiac remodeling, altering myocardial structure and function. In contrast, the effect of recreational exercise on cardiac adaptation was less pronounced than that of resistance exercise. Consequently, we propose that individuals engaging in recreational exercise should consider modalities that impose higher cardiovascular demand for more effective cardiac conditioning.

Effects of wearing fixed orthodontic appliance on dynamic balance, reaction time, and pain perception in adolescents and young adult elite athletes.

OBJECTIVE: To investigate the effects of using fixed orthodontic appliance on dynamic balance, auditory/visual reaction times, as well as pain perception in adolescent and young adult elite athletes. METHODS: A total of 34 elite athletes (n = 19 males) aged 16-21 years from different sports (track and field sprint, long jump and discus throw) were randomly allocated to treatment (n = 17) or control (n = 17) groups. The treatment group received self-ligating brackets with 0.04 cm super-elastic nickel-titanium arch wire, placed in the brackets to correct the teeth position. Perceived pain (i.e., visual analogue scale), dynamic balance (i.e., Y balance test), and auditory reaction time and visual reaction time using Direct RT software were assessed before (day-1), and on five occasions after fixed orthodontic appliance placement (day+1, +3, +7, +14, and +30). The two groups' quantitative data [expressed as mean (standard deviation)] for each occasion were compared using the Student's t-test. Comparisons of the Y-balance test, auditory reaction time, visual reaction time, and pain visual analogue scale data were each made between the 6 occasions via a factorial A × B analysis of variance in order to check for the possible interaction between the two groups and the (6) consecutive days (occasions). RESULTS: Compared to the control group, the treatment group showed significantly (i) lower values of anterior reach for both the dominant ([78(4) vs. 75(3)%, respectively]) and the non-dominant [76(3) vs. 74(4)%, respectively] legs at day+3, and (ii) higher values of pain visual analogue scale at day+1, day+3, and day+7 [0.00(0.00) vs. 4.94(1.25); 0.00(0.00) vs. 4.12(1.17), and 0.00(0.00) vs. 0.41(0.51), respectively). Factorial analysis of variance revealed that only pain visual analogue scale values were different between the two groups at day+1 and day+3. CONCLUSION: FOA induced a high pain level during the first week following its placement in elite athletes.

Does vitamin D affect strength and speed characteristics and testosterone concentration in elite young track and field athletes in the North European summer?

BACKGROUND: Currently there are no data examining the relationship between the serum concentration of vitamin D bio-chemical marker 25(OH)D and strength and speed characteristics in elite young track and field athletes. Moreover, there are currently no data examining the correlation of vitamin D status with testosterone concentration in elite young track and field athletes. In studies involving members of the general population and athletes from other sports, conflicting data have been reported. MATERIAL AND METHODS: Athletes (n = 68) from both genders took part in this study. Male athletes (n = 23) with mean ± SD age of 18.2 ± 1.9 years and female athletes (n = 45) with mean ± SD age of 17.3 ± 2.6 years participated. All athletes were ranked in the Top-3 in their respective age group and their corresponding results were listed in the Top-20 European records according to https://www.tilastopaja.eu/ in 2021. RESULTS: The average 25(OH)D concentration was 36.5 ± 10.8 ng/mL and 37.8 ± 14.5 ng/mL in male and female athletes respectively. The prevalence of 25(OH)D deficiency (below 20 ng/ml) in both genders was only 5.8%. In the whole group, only 27.9% of athletes had 25(OH)D concentrations between 20 and 30 ng/ml, while 66.2% of athletes had concentrations above 30 ng/ml. There was no difference in vitamin D status between male and female athletes. There was no statistically significant Kruskal-Wallace test correlation between 25(OH)D concentration and performance in the 20 m and 30 m sprint, counter-movement jump and broad jump. There was no correlation between serum concentrations of 25(OH)D and total testosterone in either male or female athletes. CONCLUSION: In elite young track and field athletes who permanently live and train in an area above 50° north latitude, the prevalence of vitamin D deficiency in the summer months was much lower than in previously published studies examining an athletic population, that may be related to the training process. In this specific group of athletes, no correlation was found between serum 25 (OH) D concentration and strength and speed characteristics or total testosterone concentration.

Beyond Suppressing Testosterone: A Categorical System to Achieve a "Level Playing Field" in Sport.

Regulations implemented by World Athletics (WA) require female athletes with differences of sexual development to suppress their blood testosterone levels in order to participate in certain women's sporting competitions. These regulations have been justified by reference to fairness. In this paper, we reconstruct WA's understanding of fairness, which requires a "level playing field" where no athlete should have a significant performance advantage based on factors other than talent, dedication, and hard work over an average athlete in their category. We demonstrate that by placing regulations only on testosterone levels, while ignoring physical as well as socioeconomic advantages, WA consistently fails to meet its own definition of fairness. We then discuss several ways in which this definition could be met. Our analysis shows that a categorical system, in which athletes are divided into categories based on properties leading to significant performance advantages, is best suited for meeting WA's definition of fairness.

Normative spatiotemporal and ground reaction force data for female and male sprinting.

This study aimed to demonstrate the differences in spatiotemporal and ground reaction force (GRF) variables during overground sprinting between performance levels for female and male sprinters with providing normative data during the entire acceleration phase. Forty-four female and 102 male sprinters performed 60-m sprints, during which the spatiotemporal and GRF variables were obtained using a long force platform system. Female and male sprinters were each allocated into four groups based on their maximal speed (7.5-9.5 m/s and 8.5-10.5 m/s, respectively) with 0.5 m/s intervals, and average values for 50-m distance were calculated. Using the GRF data, normative data for four groups of female and male sprinters were successfully obtained. For female sprinters using average values of all steps, there were differences between performance levels for step frequency (SF) and support time (ST), all impulses, and all mean forces. For male sprinters using average values of all steps, there were differences between performance levels for SF, ST and flight time, all impulses except for braking impulse, and all of the mean forces. The normative data indicate that most of the spatiotemporal and GRF variables may be changed, particularly increasing SF and propulsive force, when sprint performance is improved.

Does lateral banking and radius affect well-trained sprinters and team-sports players during bend sprinting?

This study investigated the short-term responses of step characteristics in sprinters and team-sports players under different bend conditions. Eight participants from each group completed 80 m sprints in four conditions: banked and flat, in lanes two and four (L2B, L4B, L2F, L4F). Groups showed similar changes in step velocity (SV) across conditions and limbs. However, sprinters produced significantly shorter ground contact times (GCT) than team sports players in L2B and L4B for both left (0.123 s vs 0.145 s and 0.123 s vs 0.140 s) and right steps (0.115 s vs 0.136 s and 0.120 s vs 0.141 s) (p > 0.001-0.029; ES = 1.15-1.37). Across both groups, SV was generally lower in flat conditions compared to banked (Left: 7.21 m/s vs 6.82 m/s and Right: 7.31 m/s vs 7.09 m/s in lane two), occurring due to reduced step length (SL) rather than step frequency (SF), suggesting that banking improves SV via increased SL. Sprinters produced significantly shorter GCT in banked conditions that led to non-significant increases in SF and SV, highlighting the importance of bend sprinting specific conditioning and training environments representative of indoor competition for sprint athletes.

Title IX's Unintended Consequences: The Female Athlete Triad and the Need for Special Treatment.

This Note examines the effects of Title IX's equal treatment framework on female collegiate athletes in the context of the female athlete triad. It describes the shortcomings of Title IX's equal treatment approach and its deleterious effects on the health of female student athletes. It argues for the adoption of the special treatment approach as a remedy.

Dynamical Analyses Show That Professional Archers Exhibit Tighter, Finer and More Fluid Dynamical Control Than Neophytes.

Quantifying the dynamical features of discrete tasks is essential to understanding athletic performance for many sports that are not repetitive or cyclical. We compared three dynamical features of the (i) bow hand, (ii) drawing hand, and (iii) center of mass during a single bow-draw movement between professional and neophyte archers: dispersion (convex hull volume of their phase portraits), persistence (tendency to continue a trend as per Hurst exponents), and regularity (sample entropy). Although differences in the two groups are expected due to their differences in skill, our results demonstrate we can quantify these differences. The center of mass of professional athletes exhibits tighter movements compared to neophyte archers (6.3 < 11.2 convex hull volume), which are nevertheless less persistent (0.82 < 0.86 Hurst exponent) and less regular (0.035 > 0.025 sample entropy). In particular, the movements of the bow hand and center of mass differed more between groups in Hurst exponent analysis, and the drawing hand and center of mass were more different in sample entropy analysis. This suggests tighter neuromuscular control over the more fluid dynamics of the movement that exhibits more active corrections that are more individualized. Our work, therefore, provides proof of principle of how well-established dynamical analysis techniques can be used to quantify the nature and features of neuromuscular expertise for discrete movements in elite athletes.

Eccentric hamstring strength in young athletes is best documented when normalised to body mass: A cross-sectional study with normative data of 590 athletes from different age categories.

Despite its widespread use in adults, the Nordic hamstring exercise remains underexplored in athletic youth populations. Further, given the dynamic nature of growth and maturation, comparisons with elite adult populations may be inaccurate. Here we describe absolute and body mass-normalised eccentric hamstring normative values for football, athletics and multi-sport youth populations. 676 routine standardised tests were conducted, including 244 U12-U18 student-athletes (football, athletics, multi-sport) and 346 Qatar Stars League (QSL) football players using the NordBord. The average maximum values for the left and right leg from 3 repetitions were recorded. Significant increases in absolute strength were seen across chronological (e.g., 150 N ± 15 for U12 to 330 N ± 40 for U18) and skeletal (142.9 N ± 13.9 for skeletal age of 12 compared to 336.2 N ± 71.2 for skeletal age of 18) age groups. The differences in values normalised to body mass were smaller at 3.6 N/kg ± 0.25 for the U-13 group, but similar for the U14 to U18 groups (4.5 N/kg ± 0.16, 4.6 N/kg ± 0.11, 4.6 N/kg ± 0.27, 4.7 N/kg ± 0.14, 4.5 N/kg ± 0.18). Students displayed lower absolute strength than the professional football players (272.1 N compared to 297.3 N, p < 0.0001) but higher relative strength (4.7 N/kg compared to 4.2 N/kg, p < 0.0001). Comparing Nordic hamstring strength values between athletes, and between skeletal and chronological age groups can be done when values are normalised to the athlete's body mass. For the U14s and onwards age categories, body mass normalised values are comparable to professional football players.

[Robotic mechanotherapy in a complex of procedures for the functional state recovery of the neuromuscular system and peripheral hemodynamics in track-and-field athletes]. / Robotizirovannaya mekhanoterapiya v komplekse protsedur dlya vosstanovleniya funktsional'nogo sostoyaniya nervno-myshechnogo apparata i perifericheskoi gemodinamiki legkoatletov.

The background of the study is caused by the need to develop methods of drug-free neuromuscular system and peripheral hemodynamics recovery of athletes to optimize their functioning after intense physical activity in current conditions of high sporting competition. OBJECTIVE: To develop a program of comprehensive recovery of neuromuscular apparatus and hemodynamics of the lower limbs of track-and-field athletes during intense physical activity, including mechanotherapy on the robotic biomechanical complex with biological feedback and to evaluate its efficacy, comparing with a standard recovery program. MATERIAL AND METHODS: The study involved 23 track-and-field athletes (the mean age 24.6±3.8 years) with qualification «master of sports¼ and «master of sports of international class¼. The athletes were randomly divided into two groups (study and control). In the study group athletes received hydro-, presso- and magnetotherapy procedures, as well as mechanotherapy procedures on a robotic biomechanical complex with biological feedback. The athletes from control group received only traditional rehabilitation with hydro-, press- and magnetotherapy. The examination of the functional state of the neuromuscular apparatus and peripheral hemodynamics was performed with the use of stimulation electroneuromyography, robotic dynamometry and rheovasography. RESULTS: When registering a motor response from a foot extensor digitorum brevis, innervated by the deep fibular nerve, after conduction of procedures set, a decrease in the residual latency parameters of study group's athletes was found. The dynamometric investigation showed a decrease in the fatigue coefficient of knee joint's flexors and extensors, as well as an increase in the strength of knee joint's extensors in the athletes from the study group. During the rheovasography the decrease of the rheographic index in the «foot¼ and «lower leg¼ segments in the study group was revealed. The decrease of the geographic index in the «lower leg¼ segment and normalization of the rheographic waves distribution time in the «foot¼ segment in control group were identified. CONCLUSION: The study results showed the efficacy of both the standard recovery program for athletes and the program, supplemented by mechanotherapy. It has been found that the use of hydro-, presso- and magnetotherapy is more conductive to the normalization of the blood flow, while the inclusion of mechanotherapy, in addition to the action on peripheral hemodynamics, improves the neuromuscular transmission, reduces fatigue of muscular system and increases its strength indicators.

Performance-enhancing drugs and the Olympics.

The rules of fair play in sport generally prohibit the use of performance-enhancing drugs (PEDs). The World Anti-Doping Agency (WADA) oversees global antidoping regulations and testing for elite athletes participating in Olympic sports. Efforts to enforce antidoping policies are complicated by the diverse and evolving compounds and strategies employed by athletes to gain a competitive edge. Now between the uniquely proximate 2021 Tokyo and 2022 Beijing Olympic Games, we discuss WADA's efforts to prevent PED use during the modern Olympic Games. Then, we review the major PED classes with a focus on pathophysiology, complexities of antidoping testing, and relevant toxicities. Providers from diverse practice environments are likely to care for patients using PEDs for a variety of reasons and levels of sport; these providers should be aware of common PED classes and their risks.

Relationship Between Self-Reported Concomitant Depressive and Anxiety Symptoms and the Post-Concussion Symptoms Scale (PCSS).

OBJECTIVES: The current study explored how affective disturbances, particularly concomitant anxiety and depressive symptoms, impact baseline symptom self-reporting on the Post-Concussion Symptoms Scale (PCSS) in college athletes. METHODS: Athletes were separated into four groups (Healthy Control (HC) (n = 581), Depression Only (n = 136), Anxiety Only (n = 54), Concomitant Depression/Anxiety (n = 62)) based on their anxiety and depression scores. Groups were compared on Total PCSS Score as well as 5 PCSS Symptom Cluster scores (Cognitive, Physical, Affective, Sleep, and Headache). RESULTS: The three affective groups reported significantly greater symptomatology than HCs, with the Concomitant group showing the highest symptomatology scores across all clusters. The depressive symptoms only group also reported significantly elevated symptomatology, compared to HCs, on every symptom cluster except headache. The anxiety symptoms only group differed from HCs on only the cognitive symptoms cluster. Additionally, the Concomitant group reported significantly increased PCSS symptomatology, in terms of total scores and all 5 symptom clusters, compared to the depressive symptoms only and anxiety symptoms only groups. CONCLUSIONS: Our findings suggest that athletes experiencing concomitant depressive/anxiety symptoms report significantly greater levels of symptomatology across all 5 PCSS symptom clusters compared to HCs. Further, results suggest that athletes experiencing concomitant affective disturbance tend to report greater symptomatology than those with only one affective disturbance. These findings are important because, despite the absence of concussion, the concomitant group demonstrated significantly elevated symptomatology at baseline. Thus, future comparisons with post-concussion data should account for this increased symptomatology, as test results may be skewed by affective disturbances at baseline.

Tracking sleep in the field: sleep quality and sleep behaviours of elite track and field athletes during preparation and competition.

Elite athletes are susceptible to inadequate sleep, which may peak during competition and be exacerbated by poor sleep behaviours. This study sought to characterise and compare the sleep quality and sleep behaviours of elite track and field athletes during preparation and major competitions. Forty elite international track and field athletes (50% female, aged 25.1 ± 3.9 years) completed the Athlete Sleep Screening Questionnaire and the Athlete Sleep Behaviour Questionnaire on three separate occasions: during habitual training, during a pre-meet training camp and during a major international competition. Overall, 62.5% of athletes reported at least mild sleep difficulty during competition. Athletes reported higher sleep difficulty and poorer sleep behaviour during major competitions and the pre-meet training camp compared to habitual training (P = .001-.025). No significant differences were observed between the training camp and major competition. Global sleep behaviour scores were underpinned by unique characteristics at each timepoint. Sleep behaviour (R2 = .330, P = .017), injury status (R2 = .253, P = .003) and major championship experience (R2 = .113, P = .034) were associated with sleep difficulty during competition. Sleep quality and behaviours vary according to stage of the track and field season, providing a foundation for targeted intervention.

Is the visual impairment origin a performance factor? Analysis of international-level para swimmers and para athletes.

The aim of this study was to investigate the effect of congenital and acquired visual impairments on the international performance of Para swimmers and Para track and field athletes. We collected results from visually impaired Para athletes competing in Para swimming or Para athletic events at all IPC-labelled competitions between 2009 and 2019. The dataset contained 20,689 events results. Impairment origin was collected from the International Paralympic Committee (IPC) website. We separated impairment origin into two groups to distinguish those with a congenital impairment from those with an acquired impairment. In visual impairment sport classes (11-12-13), the performance level and the age performance relationship were investigated according to the impairment origin. In classes 11 and 12, peak performance was achieved earlier by male and female swimmers with a congenital impairment compared with those who had an acquired impairment (p < 0.05). No differences were present in class 13 or in any class in Para athletics (p > 0.05). A similar performance level was observed among the two sport disciplines for each class (p > 0.05). This study demonstrated that impairment origin can influence the performance pathway among visually impaired swimmers.