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Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint are of both historic and modern interest for athletes and non-athletes alike. The thumb metacarpophalangeal joint requires stability in both flexion and extension utilizing a combination of static and dynamic stabilizers. This article reviews the magnetic resonance imaging categorization of thumb ulnar collateral ligament injuries and proposes two additional injury patterns seen in high-level and professional athletes who play American football. In addition to the direct magnetic resonance imaging findings in collateral ligament tears, secondary findings of rotation and subluxation can be seen at the thumb metacarpophalangeal joint due to the altered physiologic forces on the joint. Internal brace augmentation via suture tape of a traditional ulnar collateral ligament repair is a novel surgical technique that provides protection during initial healing and the ensuing remodeling phase following repair or reconstruction, resulting in a faster return to play. [ABSTRACT FROM AUTHOR]

Purpose: To report normative stiffness parameters obtained using shear wave elastography in dorsiflexion from the Achilles tendons in asymptomatic professional ballet dancers and compare them with college-level athletes. Methods: An Institutional Review Board (IRB)-approved study consists of 28 professional ballet dancers and 64 asymptomatic collegiate athletes. The athletes were further subdivided into runner and non-runner disciplines. Shear wave elastography (SWE) measurements were made in maximum ankle dorsiflexion position. Results and discussion: Forty-eight (52%) males and 44 (48%) females were examined with an overall mean age of 22.2 (± 3.8 years). There were no significant SWE differences between dominant and non-dominant legs in both groups and comparing spin vs. non-spin leg of ballet dancers (p > 0.05). Ballet dancers had significantly higher short-axis velocity values than runners and non-runners (2.34 m/s increase and 2.79 m/s increase, respectively, p < 0.001). Long-axis velocity was significantly higher in ballet dancers compared to non-runners (by 0.80 m/s, p < 0.001), but was not different between ballet dancers and runners (p > 0.05). Short-axis modulus was significantly higher in dancers compared to runners and non-runners (by 135.2 kPa and 159.2 kPa, respectively, p < 0.001). Long-axis modulus (LAM) was not significantly different in ballet dancers when compared to runners. Conclusion: Asymptomatic professional ballet dancers exhibit greater short-axis tendon stiffness compared to athletes and greater long-axis tendon stiffness compared to non-runners but similar to runners. The functional benefit from elevated short-axis stiffness in dancers is not clear but may be related to greater axial loading and adaptations of the tendon matrix. [ABSTRACT FROM AUTHOR]

The increasing demand placed on professional athletes to enhance their fitness and performance has prompted the search for new, more sensitive biomarkers of physiological ability. One such potential biomarker includes microRNA (miRNA) small regulatory RNA sequences. The study investigated the levels of the selected circulating miRNAs before and after a 10-week training cycle in 12 professional female volleyball players, as well as their association with cortisol, creatine kinase (CK), and interleukin 6 (IL-6), using the qPCR technique. Significant decreases in the miR-22 (0.40 ± 0.1 vs. 0.28 ± 0.12, p = 0.009), miR-17 (0.35 ± 0.13 vs. 0.23 ± 0.08; p = 0.039), miR-24 (0.09 ± 0.04 vs. 0.05 ± 0.02; p = 0.001), and miR-26a (0.11 ± 0.06 vs. 0.06 ± 0.04; p = 0.003) levels were observed after training, alongside reduced levels of cortisol and IL-6. The correlation analysis revealed associations between the miRNAs' relative quantity and the CK concentrations, highlighting their potential role in the muscle repair processes. The linear regression analysis indicated that miR-24 and miR-26a had the greatest impact on the CK levels. The study provides insights into the dynamic changes in the miRNA levels during training, suggesting their potential as biomarkers for monitoring the adaptive responses to exercise. Overall, the findings contribute to a better understanding of the physiological effects of exercise and the potential use of miRNAs, especially miR-24 and miR-26a, as biomarkers in sports science and medicine. [ABSTRACT FROM AUTHOR]

Objective: Mid‐life cardiovascular risk factors are associated with later cognitive decline. Whether repetitive head injury among professional athletes impacts cardiovascular risk is unknown. We investigated associations between concussion burden and postcareer hypertension, high cholesterol, and diabetes among former professional American‐style football (ASF) players. Methods: In a cross‐sectional study of 4080 professional ASF players conducted between January 2015 and March 2022, we used an mulitsymptom concussion symptom score (CSS) and the number of loss‐of‐consciousness (LOC) episodes as a single severe symptom to quantify football‐related concussion exposure. Primary outcomes were hypertension, dyslipidemia, and diabetes, defined by current or recommended prescription medication use. Results: The prevalence of hypertension, high cholesterol, and diabetes among former players (52 ± 14 years of age) was 37%, 34%, and 9%. Concussion burden was significantly associated with hypertension (lowest vs. highest CSS quartile, odds ratio (OR) = 1.99; 95%CI: 1.33–2.98; p < 0.01) and high cholesterol (lowest vs. moderate CSS, OR = 1.46, 95%CI, 1.11–1.91; p < 0.01), but not diabetes. In fully adjusted models, the prevalence of multiple CVD was associated with CSS. These results were driven by younger former players (≤ 40 year of age) in which the odds of hypertension were over three times higher in those in the highest CSS quartile (OR = 3.29, 95%CI: 1.39–7.61; p = 0.01). Results were similar for LOC analyses. Interpretation: Prior concussion burden is associated with postcareer atherogenic cardiovascular risk profiles among former professional American football players. [ABSTRACT FROM AUTHOR]

Our main aim in this study was to analyze any differences in Win Percentages at Home (HW) that might represent a Home-Court Advantage (HA) in women's professional basketball. A secondary objective was to analyze how team ability might modify the HA effect by comparing any interaction effect between HW and team ability in games played with and without fans. We collected data from first Spanish female basketball divisions, using a linear mixed model (LMM) for repeated measures to identify differences between time periods (games with fans vs. games without fans) for HA and HW. When comparing games with and without fans, we found no significant HA and HW differences (p =.283 and p =.872, respectively). In fact, interestingly, we observed higher win values when fans were absent. Additionally, during the COVID-19 shut down stage, HA increased; but it returned to pre-pandemic levels afterward, with no significant differences between these periods (p =.482). Similarly, while HW seemed to increase during the COVID-19 shut down period and continued improving in the post-pandemic phase, there were actually no statistically significant differences (p =.772). Higher HA and HW were evident without fans during the pandemic compared to the pre-pandemic period when fans were present in women's professional basketball. During the post-pandemic period, HA decreased upon fans' return, while HW continued increasing. We discuss possible bases for these unexpected findings. [ABSTRACT FROM AUTHOR]

Background: Professional ice hockey players may contract irritant and allergic contact dermatitis. Aims: To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden. Methods: Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients. Results: One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population. Conclusion: The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate whether a genetic-based algorithm derived from ACE (rs1799752) and ACTN3 (rs1815739) polymorphisms could be utilized to predict the magnitude of improvements in vertical jump performance following high-intensity resistance training. Methods: Twenty male professional footballers (age 18.7 ± 0.6 year; height 169.8 ± 2.7 cm, body mass 62.3 ± 6.0 kg) were recruited and allocated into "low" and "high" weighted total genotype score (TGS) groups based on the number of power/strength-associated ACE and ACTN3 polymorphisms. Explosive power of the lower limb was assessed by vertical jump test before and after an eight-week high-intensity resistance training. Results: The magnitude of improvement was found to be significantly different between the high and low TGS groups (p = 0.042; d = 0.98) with greater improvement being observed in the high TGS group (15.4%) as compared to the low TGS group (2.8%) following the resistance training intervention. Further stratification of the players into tertiles based on the percentage change score in vertical jump showed that a large proportion of footballers among the high responders belonged to the high TGS group (83.3%). Conclusions: In conclusion, this study showed the combined influence of ACE and ACTN3 polymorphisms on the magnitude of improvements in vertical jump performance following high-intensity resistance training. This finding may contribute towards the development of a more personalised resistance training regime that targets explosive power adaptations. [ABSTRACT FROM AUTHOR]

Purpose: Given the controversial use of the Acute:Chronic Workload Ratio (ACWR) in determining the availability of soccer players for training and matches, this study aimed at verifying how many professional soccer players had an ACWR above 1.5 (considered a 'danger zone') immediately before the exposure (training or match) in which they sustained a hamstring muscle injury. Methods: Forty-eight male soccer players of a professional team were monitored through global positioning system (GPS) in this 2-season retrospective study (10 participated in both seasons and 38 in a single season). The ACWR of total distance, high-speed running distance, very high-speed running distance, and the number of actions performed >19 km/h were calculated before all hamstring injuries and included in the analysis. Results: Twenty players sustained hamstring injuries. There was no time effect on the group's daily workload or the average workload over the 4 weeks before the injury (p > 0.05). Fifteen players (i.e., 75%) had ACWR below 1.5 for the four GPS metrics immediately before the training or match in which they sustained a hamstring injury. Five players (25%) were classified in the 'danger zone' (i.e., ACWR > 1.5) for the very high-speed running distance; 3 of these players were also in the 'danger zone' for high-speed running distance and the number of actions >19 km/h, and 2 players for the total distance. Conclusion: Since three-quarters of the hamstring injuries affecting professional soccer players were preceded by ACWR values below 1.5 in all GPS metrics, it is prudent for medical/coaching staff exercise caution when considering the ACWR 'danger zone' as the primary metric for determining player availability for training or matches. [ABSTRACT FROM AUTHOR]

Purpose: Lactate has recently been the focus of research for its hypertrophic effects. The aim of this study was to introduce lacto-resistance exercise, emphasizing lactate production during exercise, and compare its hypertrophic effects with traditional resistance training in professional bodybuilders. Methods: Twenty-four participants performed traditional and lacto-resistance exercises in two separate sessions. Blood lactate concentrations and metabolic stress, estimated by plasma ammonia levels (PAL) and muscle oxygen saturation (SmO2), were compared between two exercises. The participants were then matched based on their rectus femoris muscle cross-sectional area (RFCSA) and allocated to the control (C, n = 8), traditional resistance training (TRT, n = 8), and lacto-resistance training (La-RT, n = 8) groups. The TRT and La-RT groups completed their own four-week resistance training program and RFCSA and one-repetition maximum (1RM) changes were compared between the groups. Results: The average changes in blood lactate concentrations (1.38-fold), SmO2 (0.86-fold), and PAL (1.16-fold) from rest to post-exercise were significantly higher in the lacto-resistance exercise compared to those obtained following traditional resistance exercise (all P < 0.05). After four weeks of resistance training, the values of 1RM squat (TRT: 1.14-fold, P < 0.05; La-RT: 1.2-fold induction, P < 0.05) and 1RM leg press (TRT: 1.11-fold, P < 0.05; La-RT: 1.20-fold, P < 0.05) were significantly higher than in the C group. Post-training values of RFCSA in La-RT group were significantly higher than in the C group (1.22-fold, P < 0.01), but not in the TRT group. Conclusion: Lacto-resistance training, therefore, is a useful hypertrophy-oriented exercise, even for professional athletes who hardly experience muscle mass gains with traditional resistance training. [ABSTRACT FROM AUTHOR]

Background/Aim: Thermoplastic mouthguards have been a reliable means of protection against impacts and shocks for a century. Although orofacial injuries are prevalent among basketball players, many athletes still avoid using mouthguards due to concerns regarding impaired breathing, speech interference, and nausea. This study aims to compare basketball players' subjective assessments of two different thicknesses of custom‐made mouthguards (MGs) with boil‐and‐bite MGs (B&B MG). Material and Methods: A total of 60 systematically healthy male professional basketball players, without active orthodontic treatment, were enrolled and randomly assigned to three groups: Group 1 (received B&B MGs; n = 20), Group 2 (received custom‐made MGs with a 3 mm thickness [ethyl vinyl asetat]; n = 20), and Group 3 (received custom‐made MGs with a 5 mm thickness; n = 20). To evaluate MG comfort and usability, 12 key factors, including comfort, fit, stability, tiredness, thirsting, oral dryness, nausea, speaking, breathing, drinking, ease of wear and removal, and inclination to chew, were assessed. The athletes were made to rate these factors using a 10 cm‐long Visual Analog Scale, measured at three‐time intervals, and the values for both inter‐group and intra‐group were compared. Results: Data from 48 basketball players were retrieved, and data analysis revealed that B&B MGs had the least favorable parameter values. Among the B&B MG group, stability was reported to be poorer during the initial measurement (p <.05). In the second measurement, B&B MGs showed significantly lower values for comfort, stability, tiredness, speaking, and inclination to chew (p <.05). During the third measurement, the B&B MG group exhibited significantly reduced values for comfort, breathing, drinking, and speaking (p <.05). In contrast, no statistically significant difference was observed between 3 and 5 mm thickness MGs in these measurements. Conclusions: Custom‐made MGs with different thicknesses consistently outperformed B&B MGs in all measurements, indicating the potential to tailor MG thickness based on sport, age, professional level of athlete, and presence of other protective equipment. While custom‐made mouthguards are considered the gold standard, dentists who provide B&B MGs can lead to cost savings while maintaining protection and encouraging athletes to use higher‐quality custom‐made mouthguards. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited. HUDDLE (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms) aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events. HUDDLE was a multicity, cross-sectional study of NFL alumni and family members aged 50 years and older. Subjects reported their health history and participated in CVD education and screening (blood pressure, electrocardiogram, and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30 days postscreening to review results and recommendations. This analysis focuses on former NFL athletes. Of 498 participants screened, 57.2% (N = 285) were former NFL players, the majority of whom were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants, 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that hypertension was a significant predictor of clinically relevant structural abnormalities on TTE. HUDDLE identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by hypertension, affirming the role of TTE for CVD screening in this population aged older than 50 years. (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms [HUDDLE]; NCT05009589) [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Shoulder pain is a leading cause of disability. Occupations requiring high upper extremity demands may put workers at greater risk of shoulder injury and resulting pain. We examined associations of occupation with shoulder pain and upper extremity disability in the Johnston County Osteoarthritis Project. Methods: Work industry and occupational tasks for the longest job held were collected from participants. At follow-up ranging from 4–10 years later, participants were asked about shoulder symptoms (pain, aching, or stiffness occurring most days of 1 month in the last year) and given a 9-item, modified Disabilities Arm Shoulder and Hand (DASH) questionnaire to categorize disability from 0–4 (none-worst). Logistic regression and cumulative logit regression models were used to estimate associations with prevalent shoulder symptoms and with worse disability category, respectively. Models were adjusted for cohort, age, sex, race, education and time to follow-up. Sex- and race-stratified associations were evaluated. Results: Among 1560 included participants, mean age was 62 years (standard deviation ± 9 years); 32% were men, and 31% were Black. Compared to the managerial/professional industry, higher odds of both shoulder symptoms and worse upper extremity disability were seen for most industrial groups with physically demanding jobs, particularly the service industry. Work that often or always required lifting/moving > 10 lbs. was associated with higher odds of shoulder symptoms. Work that sometimes or always required heavy work while standing was associated with higher odds of shoulder symptoms, and this association was stronger among men and White workers. Conclusion: Physically demanding occupations were associated with increased occurrence of shoulder pain and disability. Mitigating specific physical work demands may reduce shoulder-related disability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to i) determine the prevalence of anxiety/depression symptoms in professional cricketers and ii) identify factors associated with symptoms of anxiety/depression. One-hundred and seventy-seven (n = 177, response rate of 76%) professional cricketers completed the General Health Questionnaire 12 (GHQ-12). Odd ratios (OR) for anxiety/depression symptoms were related to players' career, family and education. Prevalence of symptoms of anxiety/depression was 59% (n = 104/177). Anxiety/depression symptoms increased when players were contracted for more than 2 years (OR: 5.0; 95% CI: 1.2–21.3; p = 0.028) and if they played their last offseason overseas (OR: 3.5; 95% CI: 1.3–9.6; p = 0.013). Anxiety/depression symptoms decreased by 70% when players made "productive use" of their time in the offseason (OR: 0.3; 95% CI: 0.1–0.9; p = 0.036) and contracted for 2 years (OR: 0.3; 95% CI: 0.1–1.0; p = 0.049). These findings can be incorporated into cricket mental health literacy programmes to improve awareness and understanding, and to encourage early help-seeking. [ABSTRACT FROM AUTHOR]

Professional athletes competing in the NBA are frequently exposed to time-zone-shifting travels. These time zone changes may cause circadian rhythm (CR) phase shifts and these shifts affect sportive performance. The aim of this study was to investigate the effects of CR phase shifts on the performance of NBA teams. 25016 regular season games across 21 consecutive seasons were included in the CR phase shift calculations. To examine the CR phase shift effect on team performance, teams were divided into three groups regarding Coordinated Universal Time (UTC): the same internal UTC as the local UTC (LS); the internal UTC ahead of the local UTC (LA); and the internal UTC behind the local UTC (LB). With a different approach, teams were divided into another three categories: the same internal UTC as its opponent's internal UTC (OS); the internal UTC ahead of its opponent's internal UTC (OA); and the internal UTC behind its opponent's internal UTC (OB). 24985 game data were used to compare these groups in terms of 25 variables. Statistical analyses were conducted separately for home and away teams. For home games, it was found that LA and OA are the most and LB is the least successful group in winning and scoring performances. For away games, it was determined that LS is the most advantageous group with the best winning percentage. These results revealed that teams from more west may have a CR advantage in regular season home games. However, it is thought that the performance of away teams depends more on travel fatigue than CR phase shifts. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the influence of strength level between stronger and weaker handball players on handball specific fitness elements and to explore the correlations between strength and sport-specific fitness elements. Twenty-one professional male handball-players (age: 25.9 ± 6.9 years; mass: 87.9 ± 13.9 kg; height: 1.81 ± 0.08 m), participated in the study. Players were divided into the stronger (SG) and weaker group (WG) according to their relative to body mass 1 repetition maximum strength (1RM). Measurements included body composition, countermovement jump (CMJ), isometric leg extension peak torque (IPT) and rate of torque development (RTD), 5-step long-jump, 0-20 m linear sprint, T-half test, throwing velocity, and 1RM in bench press and squat. No significant difference was found for body composition between SG and WG (p > 0.05). However, SG had significantly higher CMJ height (21.5%, p = 0.002), IPT (22.4%, p = 0.008), RTD relative to body mass (p < 0.05), 5-step long jump (10.9%, p = 0.005), lower 0-20 linear sprint (-6.3%, p = 0.012), lower T-half test time trial (-7.3%, p = 0.001), and higher throwing velocity compared with WG (p < 0.05). When all players included in one group, large to very large correlations were found between 1RM strength and IPT with fat-free mass (r = 0.518-0.774) and throwing velocity (r = 0.472-0.819). Very large correlations were found between RTD with fat-free mass (r = 0.760) and throwing velocity (r = 0.780-0.835). Stronger players have greater performance in all handball-fitness attributes compared with their weaker counterparts. The significant correlations between handball-specific fitness elements with strength and RTD suggest that strength training is essential for handball players as it may link to higher on court performance. [ABSTRACT FROM AUTHOR]

Low back pain can affect musculoskeletal problems of the upper limb in adolescent overhead athletes. However, few epidemiological studies have examined this causal relationship. This prospective cohort study aimed to investigate the relationship between baseline low back pain experience and the occurrence of future shoulder and elbow pain among high school baseball players. Participants comprised 383 high school baseball players from 43 high school baseball teams who had undergone baseline medical evaluations (a self-completed questionnaire and physical examination). The occurrence of shoulder and elbow pain during a 1-year follow-up and associations with baseline low back pain (positive subjective symptom during the last year at baseline) adjusted for flexibility of the scapulo-thoracic region, shoulder, and lower extremities, such as straight-leg raise angle (hamstring tightness), Thomas test (iliopsoas tightness), heel-buttock-distance (quadriceps tightness) and passive range of motion of the hip were investigated using multivariable analysis. A total of 307 players (80.2%) participated in the 1-year follow-up survey, with shoulder and elbow pain reported in 75 players (24.4%) and 119 players (38.8%), respectively, during follow-up. After adjusting for factors associated with shoulder pain using logistic regression modeling, significant associations between LBP experienced during the last year at baseline (odds ratio, 2.18; 95% confidence interval, 1.23–3.87; P = 0.0078) and new-onset of shoulder pain were noted. Baseline low back pain impacted future shoulder pain in high school baseball players during the 1-year follow-up. Management of shoulder pain warrants careful attention to low back pain. [ABSTRACT FROM AUTHOR]

The isolated III grade lateral collateral ligament injuries are rare, and there is limited literature available on their management. We report 3 cases of professional soccer players with isolated distal lateral collateral ligament III grade injury, confirmed by MRI studies. After undergoing MRI examinations, all three players resumed competitive activity without resting and experienced no consequences regarding joint stability. We assessed the significance of the lateral collateral ligament in providing lateral stabilization to the knee joint in professional footballers with clinical tears of the lateral collateral ligament. The other structures of posterolateral area that remain intact contribute to joint stability, and the lateral collateral ligament's extra-articular position appears to expedite the ligament's healing process. Therefore, we propose a possible conservative treatment approach, mostly for professional athletes and adolescent patients, involving a rehabilitation plan without the need for surgery. [ABSTRACT FROM AUTHOR]

Context: Professional athletes showed excellent results after hip preserving procedures. However, there is still a lack of knowledge regarding the rate of return to activity and the rehabilitation time of recreational athletes. Thus, the aim of this study was to investigate factors that were associated with an extended return-to-activity time in nonprofessional athletes. Design: Retrospective, quantitative case-control study. Methods: This study included 47 cases (45 nonprofessional athletes), which were divided according to return-to-activity time (short term: 0.0-7.0 mo vs long term: >7.0 mo). The clinical outcome were evaluated with the modified Harris hip score, the nonarthritic hip score, the Western Ontario and McMaster Universities Osteoarthritis Index, and the University of California, Los Angeles activity score. For statistical analysis between both groups, an unpaired student t test and a paired Wilcoxon test were used. In addition, the sports behavior, intraoperative findings, and surgical procedures were also assessed. Results: After a mean follow-up of 4.3 years (±0.6; 3.4-5.6), the overall postoperative modified Harris hip score was 81.8 points, the nonarthritic hip score was 75.8 points, the Western Ontario and McMaster Universities Osteoarthritis Index was 36.7 points, and the University of California, Los Angeles activity score was 7.9. Compared with the preoperative results, all scores improved significantly (P < .001). Patients of the short-term return-to-activity group showed a higher preoperative activity diversity and, postoperatively, a higher rate in high-impact sports (P = .024). Conclusions: After mini-open arthrotomy for femoroacetabular impingement syndrome treatment, 92.5% of the recreational athletes returned to sports activity. The findings did not detect factors influencing the return-to-activity time. However, a higher preoperative diversity of activities and a shift to high-level impact sport activities might support a shorter rehabilitation. [ABSTRACT FROM AUTHOR]

Despite an increasing interest in studying creativity in sport, previous research has primarily focused on in-game creative performance and employed research designs neglecting sport participants' perspectives. Hence, this study explored professional athletes' developmental experiences involving creativity. Semistructured retrospective interviews were conducted with eight ice hockey players performing in or retired from the National Hockey League, Kontinental Hockey League, or Swedish Hockey League. Players described 15 modalities of creative actions emerging when playing, practicing, and performing. Based on the players' experiences, creativity led to augmented levels of enjoyment (i.e., elicited passion), development (i.e., enhanced potential), achievement (i.e., enriched in-game qualification), and fulfillment (i.e., extended career progression). Findings contribute to a more nuanced understanding of creativity in sport and provide novel insights on the role of creativity in the development and maintenance of expertise in sport and the nature and role of deliberate play and deliberate practice in developing creativity. [ABSTRACT FROM AUTHOR]

Professional team male-dominated sports have been built on masculine values; however, these values are challenged by the increasing number of women athletes entering this workplace. In this research, we explore the suitability and gender appropriateness of existing management processes and practices through three women's professional and semiprofessional leagues. Drawing on a feminist perspective of continuum of care, players (n = 36) and organizational representatives (n = 28) were interviewed to gain insights into how athletes and organizations contend with their rapidly evolving workplaces. Framed around the values of affirmation, empowerment, and belonging, the continuum of care contrasts players' everyday experiences of care with how organizations administer care. The research contributes through application of the feminist continuum of care. We present considerations for the management of female professional athletes in ways that are careful and an alternative value system that is affirmative, inclusive, and empowering. [ABSTRACT FROM AUTHOR]

Introduction: The potential consequences of repeated concussions in sport are well documented. However, it remains unclear whether the cumulative impact of sports‐related concussions differs between different contact sports. Therefore, the aim of the current study was to investigate the cumulative effects of sports‐related concussions on clinical and neurocognitive health in different contact sports. Materials and Methods: In a prospective multicenter study, we examined 507 (74 females) active professional athletes between 18 and 40 years of age from five different contact sports (soccer, handball, American football, basketball, and ice hockey). Data collection involved concussion history, clinical symptom evaluation, neurocognitive assessment, and the collection of other sports‐related information. Composite scores were built for clinical symptoms (such as neck pain and balance disturbances) and for neurocognitive symptoms (such as memory and attention impairments). Results: Athletes having suffered 3+ concussions in the past showed disproportionally higher clinical symptom severity than athletes with less than three concussions across all sports. The level of clinical symptom burden in athletes with 3+ concussions indicated mild impairment. The number of past concussions did not affect neurocognitive performance. Discussion: Repeated sports‐related concussions appear to have a cumulative impact on clinical—but not cognitive—symptom severity. Although clinical symptom burden in athletes with 3+ concussions in the past was not alarmingly high yet in our sample, increased caution should be advised at this point. Despite few exceptions, results are similar for different contact sports, suggesting a similar multidisciplinary concussion management across all types of sport. [ABSTRACT FROM AUTHOR]

Anterior Cruciate Ligament (ACL) injuries are serious and potentially career‐ending. Reconstruction surgery and extended rehabilitation typically follow, but some athletes never attain the same level of sport performance. The psychosocial experiences of athletes who sustain ACL injuries and their cognitive appraisal, emotional and behavioral responses to the injury, and reconstruction require further attention during the different recovery phases. The aim is to explore these psychosocial experiences, social support needs and sources thereof of competitive athletes who sustained unilateral ACL ruptures and underwent reconstruction surgery. Semi‐structured interviews with six competitive rugby players (M age: 22.3 ± 2.92 years), elicited information at seven time‐points. We analyzed the qualitative information through thematic analysis. Five common themes emerged: (1) cognitive appraisal, (2) emotional responses (negative and positive affective responses), (3) behavioral responses, (4) social support needs and sources thereof, and (5) adversity‐induced identity expansion (athletic and person‐centered identities). In‐vivo quotes gave a rich description of the athletes' experiences throughout the "long, long journey" to return‐to‐sport. These findings may sensitize and assist sports healthcare professionals, coaches, teammates, family, and friends to explore various psychosocial experiences throughout the injury and recovery period. Phase‐appropriate psychosocial support or referral to sport psychology services is recommended to enhance the recovery process, improve long‐term physical and mental health, and subsequent performance. [ABSTRACT FROM AUTHOR]

Background/Aim. Resuscitation and surgical medical aid are the most important medical procedures in disaster relief operations. The limited time frame available for lifesaving activities in such circumstances demands that resuscitation and surgical medical teams be established and trained for timely reaction and disaster medical support prior to disaster occurrence. The aim of the study was to analyze the awareness among the hospital medical staff in the Plovdiv Region of the hospital response plan in case of disaster, which concerns surgical and resuscitation team composition and tasks for disaster medical support. Methods. An anonymous survey, consisting of 55 questions about hospital staff awareness of the medical activities described in the hospital disaster medical support plan, was conducted between July and September 2019 among 295 hospital medical professionals in the Plovdiv Region, Bulgaria. Descriptive statistics and Pearson's χ2 test were used in the statistical analysis of results. Results. The survey showed that the majority of medical staff demonstrated complete ignorance regarding the presence, number, and tasks of the specialized medical teams planned for hospital disaster response. Employees of multidisciplinary hospitals for active treatment were more familiar with the aforementioned plans than their colleagues from the university multidisciplinary hospitals. Conclusion. Insufficient awareness about human resources foreseen for disaster medical support negatively impacts the hospital surge capacity, leading to inadequate medical assistance in such cases. Hospital tactical disaster preparedness must be ameliorated by conducting a more rigorous training program among medical staff related to the planned hospital activities in case of disastrous events, especially for those working in emergency departments, intensive care units, and surgical departments. [ABSTRACT FROM AUTHOR]

Increase in youth sports participation, longer duration of play, and earlier starting points have increased the prevalence of acute and repetitive overuse musculoskeletal injuries. This rise in injury rates has led to increased efforts to better understand the susceptible sites of injury that are unique to the growing immature skeleton. Upper extremity injuries are currently the best studied, particularly those that occur among pediatric baseball players and gymnasts. The weak link in skeletally immature athletes is the growth plate complex that includes those injuries located at the epiphyseal and apophyseal primary physes and the peripherally located secondary physes. This article reviews the anatomy and function of these growth plate complexes, followed by a discussion of the pathophysiologic mechanisms, spectrum of imaging findings, and existing evidence-based guidelines for injury prevention and return to play. [ABSTRACT FROM AUTHOR]

The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries. [ABSTRACT FROM AUTHOR]

Muscle injuries are the most common sports-related injuries, with hamstring involvement most common in professional athletes. These injuries can lead to significant time lost from play and have a high risk of reinjury. We review the anatomy, mechanisms of injury, diagnostic imaging modalities, and treatment techniques for hamstring injuries. We also present the latest evidence related to return to play (RTP) after hamstring injuries, including a review of articles targeted to RTP in European soccer (Union of European Football Associations), American football (National Football League), and other professional sports. Review of imaging findings in hamstring injury, grading systems for injuries, considerations for RTP, as well as advances in injury prevention, are discussed. [ABSTRACT FROM AUTHOR]

This study examined the impact of an intensive professional development series on early childhood educators' content knowledge of engineering and their self-efficacy towards teaching engineering. Seventeen early childhood teachers participated and responded to questionnaires, surveys, and focus-group interviews before and after the professional development. The results show that these early childhood educators significantly (1) increased their knowledge of engineering; (2) improved their engineering teaching self-efficacy; and (3) enhanced their confidence level towards teaching engineering for young children. This study is important because it provides an example of an effective approach to enhance early childhood teachers' preparation in teaching engineering activities for young children. It also sheds light on the urgency to improve overall teacher preparation and continuous education in science, technology, engineering, and mathematics for young children. [ABSTRACT FROM AUTHOR]

This monograph analyzes online coverage and social media posts from five professional athletes—Simone Biles, Serena Williama, Naomi Osaka, Chloe Kim, and Gracie Gold—to sheds light on the journalistic and individual narratives around athletes, performance, goals as these intersect with mental health. Online news and entertainment media's general representation of athletes frequently emphasizes victory with a focus on outcomes, often overshadowing the athletes' well-being. Using social identity and framing theories, the study identifies narratives in social and online media, emphasizing the storytelling components related to mental health, as well as what athletes express as potential causes of the mental health issues they are experiencing, especially intense competition, physical condition, media pressure, and a general lack of mental health awareness in sports. The study's examination of how athletes use their social media platforms to help journalists craft their stories offers a deeper understanding of their mental health stories beyond the basic win-or-lose narrative. We advocate for a paradigm shift, urging recognition of athletes as individuals with vulnerabilities who deserve supportive environments. [ABSTRACT FROM AUTHOR]

Many young athletes aspire to become professional athletes. They are programmed from an early age to believe that the only way to get there is to play collegiately. Those who do make it to the university level are often plagued by time constraints, injuries, or an overinflated sense of athletic identity, all of which can cause problems when it comes time to transition out of athletics. This paper will look at the aspects that can aid or impede an athlete's transition from collegiate sports to a career. While student-athletes are in a unique position and obtain amazing experiences, they are also put in a high-pressure, high-stakes situation. This paper will highlight the causes of unsuccessful transition and provide recommendations for student-athletes to receive the holistic support they need in order to be successful while in college and in the years beyond. [ABSTRACT FROM AUTHOR]

Incorporating plyometric exercises (PE) into soccer players' conditioning routines is vital for boosting their performance. Nevertheless, the effects of PE sessions with diverse volume loads on inflammation, oxidative stress, and muscle damage are not yet clearly understood. This study aimed to examine the effects of altering the volume-loads of PE on indicators of oxidative muscle damage and inflammation. The study involved forty young male soccer players who were randomly assigned to three different volume-loads of PE (Low volume-load [100 jumps]: LVL, n = 10; Moderate volume-load [150 jumps]: MVL, n = 10; and High volume-load [200 jumps]: HVL, n = 10) and a control group (CON = 10). The levels of various biomarkers including delayed onset muscle soreness (DOMS), serum lactate dehydrogenase (LDH), creatine kinase (CK), 8-hydroxy-2-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyl (PC), leukocytes, neutrophils, interleukin-6 (IL-6), and C-reactive protein (CRP) were measured at different time points. These measurements were taken at rest, immediately after completion of PE, and 24-, 48-, and 72-hours post-PE. The CK, LDH, DOMS, 8-OHdG, MDA, and PC levels were significantly increased (p < 0.05) after the PE protocol, reaching their peak values between 24 to 48 hours post-PE for all the volume-loaded groups. The levels of leukocytes, neutrophils, and IL-6 also increased after the PE session but returned to resting values within 24 hours post-PE. On the other hand, CRP levels increased at 24 hours post-PE for all the treatment groups (p < 0.05). The changes observed in the indicators of muscle damage and inflammation in response to different volume-loads of PE was not significant. However, the HVL and MVL indicated significant differences compared to LVL in the 8-OHdG (at 48-hour) and MDA (at 72-hour). Athletes engaging in higher volume-loads demonstrated more pronounced responses in terms of biochemical variables (specifically, LVL < MVL < HVL); however, these changes were not statistically significant (except 8-OHdG and MDA). [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship among subjective well-being and depression-anxiety-stress and dispositional mindfulness in professional athletes, and the role of cognitive fusion and experiential avoidance and age in the relationship. Methods: Totally 423 professional athletes were selected and assessed with the Satisfaction with Life Scale (SWLS), Positive Affect Scale (PAS), Depression-Anxiety-Stress Scale (DASS-21), Five Facet Mindfulness Questionnaire (FFMQ), Cognitive Fusion Questionnaire (CFQ), and Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ). Results: After controlling for gender, the FFMQ scores were positively correlated with SWB scores (β=0.35), and negatively correlated with DASS-21 scores (β=-0.40). The scores of CFQ and AAQ-Ⅱ played a sequential mediating role in the relationship between FFMQ scores and the scores of SWB and DASS-21 (β=0.04, -0.12). Age moderated the relationship between the scores of FFMQ and SWB (β=-0.01).Conclusion: The subjective well-being and depression-anxiety-stress may be related to dispositional mindfulness in professional athletes, and age could moderate the relationship between subjective well-being and dispositional mindfulness. [ABSTRACT FROM AUTHOR]

Our aim in this study was to examine the impact of fans (vs. no fans), geographical location of league, and team ability on home winning percentage (HW%) or home advantage (HA) in professional European basketball. Data were collected from five prestigious professional, national basketball leagues within Europe (Spain, Germany, Italy, Greece and Israel) across 16 regular seasons (2005-2006 to 2020-2021). We conducted comparisons between matches with and without fans, location of leagues, team ability (High, Medium, Low), and combinations of these factors via non-parametric tests (e.g., Mann-Whitney tests, Kruskal-Wallis). We found significantly greater HA during matches with fans for leagues in Germany (p =.001), Italy (p =.012) and Spain (p =.002). For matches with fans, HA and HW% were significantly different between several, but not all, leagues for high (p <.05), medium (p <.05) and low (p <.02) team abilities. In conclusion, HA and HW% were enhanced by spectator attendance, with this phenomenon varying by location/region and team ability. Consideration of these multiple contextual factors may assist coaches and sport organizations to develop key strategies for enhanced team success. [ABSTRACT FROM AUTHOR]

[Display omitted] [ABSTRACT FROM AUTHOR]

The English Football Association (FA from hereon in) 4 Corner Model is a multidisciplinary framework that aims to enhance player talent identification and development, and is characterised by physical, social, technical/tactical and psychological components. Despite the framework being prominent within English football development pathways, player insights into the effectiveness of the framework in supporting academy to first team transitions are lacking. Therefore, the aim of this study was to explore established first team professional footballer's perceptions of the FA 4 Corner Model, in relation to the attributes that they perceived to facilitate the successful transition to a professional first team environment. Twelve current (n = 8) and ex (n = 4) professional players who had successfully transitioned from a youth academy, and subsequently became an established first team player, were interviewed for the study. Interpretations across the qualitative data set highlighted the importance of players adapting to physical and tactical demands, while also dealing with different psychosocial factors when entering a first team setting. The study highlights that disparities can exist between players, coaches, practitioners, and sport scientists perceived development needs, a situation that could hinder players progression through the player pathway. [ABSTRACT FROM AUTHOR]

Background: Sinus bradycardia and first degree or second degree Mobitz type I atrioventricular (AV) block in an athlete are considered adaptive and reversible phenomena; however, some evidence suggests that they may persist after detraining and become pathological. The aim of the study was to investigate the characteristics of a group of former professional athletes who required pacemaker (PM) implantation for intrinsic (idiopathic) sinus node (SN) dysfunction or AV block in comparison to control groups of sedentary individuals. Methods: We included all patients who underwent PM implantation during 2022. Three groups were compared: group 1 including 18 former professional athletes who received a PM for SN dysfunction/AV block in the absence of heart disease; group 2 including the first 20 sedentary individuals without heart disease who underwent PM implantation; and group 3 including all other 323 patients who received PM, the majority with underlying heart diseases. Results: Compared to the non-athlete control group 2, the mean age at diagnosis and at the time of PM implantation of former professional athletes did not show statistically significant differences. However, subgroup analysis revealed significant differences depending on the type of sports discipline: the age at diagnosis and at PM implantation was significantly lower in former endurance athletes than former strength/mixed athletes, control non-athletes, and all other patients. Moreover, former endurance professional athletes exhibited a higher prevalence of second or third degree AV block (78%) as the reason for PM implantation compared to power/mixed athletes (44%). The other clinical characteristics, including echocardiographic parameters, did not differ between former athletes and non-athletes. Conclusions: Former professional endurance athletes with idiopathic SN dysfunction/AV block manifested the disease earlier in the life course compared to former power/mixed athletes and non-athletes. This suggests that bradycardia/AV block caused by intense and prolonged endurance sports may not always be benign and adaptive phenomena. [ABSTRACT FROM AUTHOR]

Using a person‐centered approach, the present study aimed to investigate the coping profiles of adolescent football players involved in elite football training centers. The purposes were to (1) identify coping profiles based on the reported use of multiple coping strategies in response to competitive stress, (2) explore whether emotional competencies and psychological need satisfaction would predict coping profile membership, and (3) examine the extent to which coping profiles were differently associated with individual and team perceived stress, interpersonal coping, and subjective team performance, as well as demographic characteristics. A sample of 416 young French football players (males = 282; females = 134; Mage = 16.2; SDage = 1.2) from 12 elite football training centers participated in this study. Latent profile analysis results yielded three coping profiles allowing players to be grouped according to their preferences for a combined use of certain strategies (i.e., low copers, high disengaged copers, and high task copers). Results provided further insight into each coping profile membership by indicating the role played by intrapersonal emotional competence and psychological need satisfaction. Finally, differences between coping profiles have been shown in terms of individual perceived stress intensity, interpersonal coping approach, and gender. These findings provide a deeper understanding of adaptive coping profiles within a population of adolescent football players involved in elite training centers. Implications for developing and tailoring psychoeducational interventions for adolescent football players exhibiting a maladaptive coping profile (i.e., disengagement‐oriented coping profile) are considered. [ABSTRACT FROM AUTHOR]

Muscle typology is heterogeneous among national level football (soccer) players, but positional differences remain unclear. Furthermore, fast typology (FT) individuals fatigue more than slow typology (ST) individuals in lab conditions. Therefore, we investigated if muscle typology is different between playing positions and if the decay in high‐intensity activities from the first to the second half is larger in FT football players than in ST players. We estimated muscle typology in 147 male professional football players by measuring soleus and gastrocnemius muscle carnosine via proton magnetic resonance spectroscopy. Players were classified as ST, intermediate typology (IT) or FT and categorized as goalkeeper, center back, full back, midfielder, winger or forward. Across four seasons in‐game distances covered in multiple running speed, acceleration and deceleration zones were collected during the first and second half. We found no differences in muscle typology between positions (p = 0.412). FT players covered 10.9% more high acceleration distance (>3 m.s−2) in the first half than ST players (p = 0.021) and high acceleration distance decay was larger for FT players (−12.4%) than ST (−7.7%; p = 0.006) and IT players (−7.3%; p = 0.010). Moreover, the decline in distance covered in several high‐intensity zones tended to be larger in FT players (−11.2% high‐intensity >15 km.h−1; −12.7% high deceleration <−3 m.s−2; −11.5% medium acceleration 2‐3 m.s−2) than in ST players (−7.1% high‐intensity; −8.1% high deceleration; −8.1% medium acceleration; 0.05 < p < 0.1). In conclusion, possessing a particular muscle typology is not required to play any football position at the national level. However, there are indications that FT players might fatigue more toward the end of the game compared to ST players. [ABSTRACT FROM AUTHOR]

We conducted a cross‐sectional study investigating whether sport identification predicts different forms of collective action intentions aimed to redress the unfavourable condition faced by disadvantaged individuals. In doing so, moral perceptions (moral convictions, moral violation and moral obligation) were tested as mediators. Participants were young football players from the grassroots of a professional Italian club (N = 111). Results revealed that sport identification was indirectly associated with greater willingness to engage in both normative and non‐normative solidarity‐based collective action via stronger moral obligation perceptions; moral convictions mediated the relationship between sport identification and normative collective action, while no mediation effects emerged for moral violation. We discuss findings in relation to collective action and sport research. [ABSTRACT FROM AUTHOR]

Background: Many adolescent athletes experience low back pain; the most common cause is lumbar spondylolysis. Although early identification of lumbar spondylolysis in adolescent athletes is critical, few studies have focused on identifying the early stages of spondylolysis in baseball players. This study aimed to investigate the clinical characteristics of early-stage spondylolysis in male adolescent baseball players.Methods: The participants comprised male junior and high school baseball players. Before magnetic resonance imaging, we recorded their demographic data, low back pain characteristics, and physical findings (lumbar flexion, extension, Kemp's test and the provocative tenderness of a spinous process). After the imaging evaluation, the association among low back pain characteristics, physical findings and the final diagnosis (early-stage spondylolysis or not) were investigated using univariate and multivariable analyses.Results: A total of 171 players were included in this study. Univariate analyses indicated that the characteristics associated with early-stage spondylolysis were longer duration of low back pain (P = 0.0085), low back pain-related interference while running (P = 0.0022), low back pain starting with laterality (P = 0.0001), lumbar extension (P = 0.022), positive Kemp's test (P = 0.020), and the tenderness of a spinous process (P = 0.0003). After adjusting for confounding factors (age and position), we found that early-stage spondylolysis was significantly associated with low back pain duration ≥4 weeks (odds ratio 3.13, 95% confidence interval 1.42-6.92; P = 0.0048), low back pain-related interference while running (odds ratio 2.89, 95% confidence interval 1.30-6.46; P = 0.0094), low back pain starting with laterality (odds ratio 2.78, 95% confidence interval 1.24-6.27; P = 0.0133), and the tenderness of a spinous process (odds ratio 3.00, 95% confidence interval 1.36-6.57; P = 0.0062).Conclusions: Male adolescent baseball players with early-stage spondylolysis might have low back pain duration of more than four weeks, low back pain-related interference while running, and a history of low back pain starting with laterality. The tenderness of a spinous process might be helpful in the diagnosis of early-stage spondylolysis in male adolescent baseball players. [ABSTRACT FROM AUTHOR]

Matrix metalloproteinases (MMPs) play an important role in matrix remodeling, as well as in ligament integrity. Anterior cruciate ligament (ACL) rupture is a severe and frequent knee injury in sports. The aim of this study was to investigate polymorphisms within the MMP3 gene with the predisposition for noncontact ACL rupture in the Croatian professional athletes. One hundred eighty‐seven (95 with ACL rupture occurring through a noncontact mechanism and 92 asymptomatic controls) unrelated Caucasians were recruited between 2016 and 2017. All participants were genotyped for three single‐nucleotide polymorphisms (SNP) within the MMP3 gene: rs591058 C/T, rs650108 A/G, and rs679620 G/A using the pyrosequencing method. For all three investigated SNPs, genotype frequencies have significantly differed between cases and controls. The MMP3 rs591058 TT (p = 0.0012, odds ratio [OR] = 38.541, 95% confidence interval [CI] = 1.7024–8.7254), rs650108 GG (p = 0.0051, OR = 23.338, 95% CI = 1.2899–4.2226) and rs679620 AA (p = 0.0030, OR = 34.750, 95% CI = 1.5266–7.9101) genotypes, as well as haplotype variant T‐G‐A (p = 0.0104, OR = 1.71, 95% CI = 1.13–2.59) were significantly overrepresented in cases compared to controls. These results support association between functional variants within the MMP3 gene and the risk of ACL rupture. Still, further research is needed to corroborate these results in a larger population. [ABSTRACT FROM AUTHOR]

Objective: To grasp the meaning of perinatal palliative care for the multidisciplinary team. Methods: This is a qualitative study guided by content analysis. The study included 56 health professionals working in maternal and child units of a public university hospital. A semi-structured interview was conducted, which was recorded and subsequently fully transcribed. The collection took place from June 2018 to May 2019. Data were entered and exported to Atlas ti: The Qualitative Date Analysis & Research Software, version 23.1.1.0. Results: Four thematic categories emerged from the data analysis: palliative care and eligible public in the view of professionals; communication between family and team in decision-making; assistance in palliative care; humanized care. Conclusions: The professionals think of palliative care in Perinatology in a similar way and perceive the difficulties of communication with the family and decision-making. They agree that it is necessary to provide greater support to the family, and to provide comfort measures, either for the non-viable fetus or for the baby eligible for palliative care. [ABSTRACT FROM AUTHOR]

The COVID-19 crisis also affected elite sport severely, as elite athletes either stopped or drastically reduced their training regimen due to the lack of competitions and the mandatory lockdown. The aim of this study was to test whether heart rate variability was a reliable index of training load, which was dramatically altered due to the mandatory lockdown that occurred as a consequence of the COVID-19. Training (volume and intensity) and heart rate variability of sixteen professional male (n = 8; body mass index = 22.2 ± 2.0) and female cyclists (n = 8; body mass index = 20.3 ± 1.1) before (4 weeks), during (7 weeks), and after (4 weeks) the mandatory lockdown in Spain were monitored. Individual analyses showed that the mandatory lockdown caused reliable reductions in training volume in 13 subjects (–96 to –7% reductions in minutes), that were followed by an increase after the lockdown in all subjects (5 to 270%). In contrast, changes in training load were not homogenous across individuals. Moreover, such changes were not matched by comparable variations in heart rate variability. A mixed model of the heart rate variability as a function of training volume and intensity revealed no significant modulation by these two variables, and subject specific effects on the slope. In this study, we did not find evidence of association between heart rate variability and training load and/or intensity as many previous reports have suggested, even if training conditions changed dramatically overnight. [ABSTRACT FROM AUTHOR]

Background: The Major League Baseball (MLB) draft is a common route for players to enter professional baseball in the United States. Players taken in earlier rounds are typically higher-performing players. When looking at pitchers specifically, higher performance at the amateur level may be associated with an increased frequency of adaptive change in the throwing elbow. Purpose: To determine whether pitchers taken in earlier rounds of the MLB draft have a greater frequency or extent of pathological change in the elbow, as measured by dynamic stress ultrasound. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Dynamic stress ultrasounds (SUSs) were performed over 18 years on the dominant and nondominant arms of 651 professional pitchers. The 383 drafted players were grouped according to the round in which they were drafted (rounds 1-5, 6-10, 11-20, 21+). Groups were compared with respect to "relative" ulnar collateral ligament (UCL) thickness (dominant-nondominant), relative ulnohumeral joint laxity (joint space distance under stress minus joint space at rest), and the presence of pathology (calcifications, tears, hypoechoic foci, osteophytes). In addition, a subgroup analysis was done to compare the progression of SUS findings over 3 years in players for which data were available. Results: Draft round groups did not differ by age, number of previous spring training, or handedness. Comparing baseline measurements, there was no significant relationship between draft round and relative UCL thickness (P =.932), relative laxity (P =.996), or presence of pathology detectable on SUS (P =.642). However, increased relative UCL thickness was significantly associated with the presence of pathology on SUS (odds ratio, 1.45; 95% CI, 1.26-1.69; P <.001). Longitudinally, there was no significant relationship between draft round and 3-year progression of relative laxity, relative UCL thickness, or clinical progression of pathology. Conclusion: Higher-performing pitchers are drafted earlier in the MLB draft. This may be attributable to peak pitch velocity, in-game performance, visibility gained during player showcases, or any number of other sport-specific variables. However, despite this, there was no significant relationship between draft round and adaptive changes to the elbow or specific properties of the UCL on stress ultrasound. [ABSTRACT FROM AUTHOR]

The Interpersonal Behaviors Questionnaire (IBQ) in Sport assesses athlete perceptions of coach interpersonal behaviors that support or thwart athletes' basic psychological needs. While different sources of validity evidence for responses to the IBQ have been provided for adults, only validity evidence for relations to other variables has been provided with youth. Moreover, potential problems with internal structure for youths' responses to the IBQ have recently been noted and motivated the current study. Specifically, a three-phase mixed-methods design was employed to provide validity evidence for modification of the IBQ for youth. Phase I empirically examined the internal structure for youth athletes' responses to the IBQ. Phase II used cognitive think-aloud interviews to identify and then modify problematic IBQ items to create the Youth Interpersonal Behaviors Questionnaire in Sport (Y-IBQ). Phase III examined the psychometric properties of the Y-IBQ to provide initial validity evidence for this instrument in a youth athlete sample. [ABSTRACT FROM AUTHOR]

The European Centre of Excellence (CoE) for Research in Continuing Professional Development (UPGRADE) is a pan-European network of researchers, clinicians, regulators, educators, and professional bodies, established in 2020 through a consensus group of experts, who defined its mission, vision, values, aims and objectives. The Centre's aim is to advance the science of Continuing Professional Development (CPD) for healthcare professionals through research and dissemination of best practices for CPD. Debate among UPGRADE partners and interchange of research data will yield best practices across countries to optimise quality CPD programmes. Collaboration, information exchange and communication among CPD experts will be facilitated through UPGRADE via an online Community of Inquiry (CoI). UPGRADE aims to evolve as a driving force network of academics and health professional leaders in research, education, professional regulation, and clinical practice whose collaborative work ensures quality and safe person-centred care. UPGRADE members are from 22 European countries, represented by strategic leaders in diverse sectors of health, policy, academia, and professional organisations. Three research-working groups constitute the pillars of UPGRADE, which addresses gaps in research, collect and create critical databases, and solidify the effectiveness of CPD. [ABSTRACT FROM AUTHOR]

The purpose of this study was twofold: (1) to examine the influence of the mental toughness (MT) trait on resilience, cognitive appraisals and perceived performance states and (2) to explore dynamic relationships between these states among soccer goalkeepers during a competitive season. Thirty-six soccer goalkeepers from regional to professional levels first voluntarily completed a questionnaire measuring their mental toughness. Subsequently, a single-item approach was used to assess resilience, cognitive appraisals (threat, loss, challenge and benefit) and subjective performance every 2 weeks for 4 months. Results of multilevel analyses showed that mental toughness significantly and positively predicted resilience, which significantly and positively predicted benefit appraisal and negatively predicted threat appraisal. Moreover, subjective performance was significantly and positively predicted by benefit appraisal. Our results also revealed the mediating role of resilience in the relationship between mental toughness and appraisals (threat and benefit) as well as the mediating role of benefit appraisal in the relationship between resilience and subjective performance. Practical applications are proposed to optimize the daily experiences of goalkeepers, such as creating a supportive climate. [ABSTRACT FROM AUTHOR]

Auditory experience-dependent plasticity is often studied in the domain of musical expertise. Available evidence suggests that years of musical practice are associated with structural and functional changes in auditory cortex and related brain regions. Resting-state functional magnetic resonance imaging (MRI) can be used to investigate neural correlates of musical training and expertise beyond specific task influences. Here, we compared two groups of musicians with varying expertise: 24 aspiring professional musicians preparing for their entrance exam at Universities of Arts versus 17 amateur musicians without any such aspirations but who also performed music on a regular basis. We used an interval recognition task to define task-relevant brain regions and computed functional connectivity and graph-theoretical measures in this network on separately acquired resting-state data. Aspiring professionals performed significantly better on all behavioral indicators including interval recognition and also showed significantly greater network strength and global efficiency than amateur musicians. Critically, both average network strength and global efficiency were correlated with interval recognition task performance assessed in the scanner, and with an additional measure of interval identification ability. These findings demonstrate that task-informed resting-state fMRI can capture connectivity differences that correspond to expertise-related differences in behavior. [ABSTRACT FROM AUTHOR]

Background Soccer is a high-speed contact sport with risk of injury. Despite long-standing concern, evidence to date remains inconsistent as to the association between playing professional-level soccer and lifelong musculoskeletal consequences. Aims The objectives were to assess risk of osteoarthritis in former professional soccer players compared to matched general population controls, and subsequently assess associated musculoskeletal disorders which may contribute to, or result from, osteoarthritis—specifically meniscal injury and joint replacement. Methods We conducted a retrospective cohort study using national electronic health records (EHRs) on a cohort of 7676 former professional soccer players aged 40 or over at recruitment, matched on year of birth, sex (all male) and socio-economic status with 23 028 general population controls. Outcomes of interest were obtained by utilizing individual-level record linkage to EHRs from general hospital inpatient and day-case admissions. Results Compared to controls, former soccer players showed a greater risk of hospital admission for osteoarthritis (hazard ratio [HR] 3.01; 95% confidence interval [CI] 2.80–3.25; P  < 0.001). This increased risk appeared age dependant, normalizing over age 80 years and reflective of increased risk of lower limb osteoarthritis. Further, risk of hospital admissions for meniscal injury (HR 2.73; 95% CI 2.42–3.08; P  < 0.001) and joint replacement (HR 2.82; 95% CI 2.23–3.57; P  < 0.001) were greater among former soccer players. Conclusions We report an increased risk of lower limb osteoarthritis in former soccer players when compared with matched population controls. The results of this research add data in support of lower limb osteoarthritis among former soccer players representing a potential industrial injury. [ABSTRACT FROM AUTHOR]

Purpose: Investigate the association between self-reported subjective and performance-based cognition among older (50--70 years) former professional American football players, as well as the relationship of cognitive measures with concussion history and years of football participation, as a proxy for repetitive head impact exposure. Methods: Among older former National Football League (NFL) players (N = 172; mean age = 60.69 ± 5.64), associations of subjective (Patient ReportedOutcomeMeasurement Information SystemCognitive Function-Short Form) and performance-based cognitive measures (Brief Test of Adult Cognition by Telephone [BTACT] Executive Function and Episodic Memory indices) were assessed via univariable and multivariable regression models, with a priori covariates of depression and race. A similar univariate and multivariable regression approach assessed associations between concussion history and years of football participation with subjective and performance-based cognitive measures. In a sample subset (n = 114), stability of subjective cognitive rating was assessed via partial correlation. Results: Subjective ratings of cognition were significantly associated with performance-based assessment, with moderate effect sizes (episodic memory ηp 2 = 0.12; executive function ηp 2 = 0.178). These associations were weakened, but remained significant (Ps < 0.05), with the inclusion of covariates. Greater concussion history was associated with lower subjective cognitive function (ηp 2 = 0.114, P < 0.001), but not performance-based cognition. The strength of association between concussion history and subjective cognition was substantially weakened with inclusion of covariates (ηp 2 = 0.057). Years of participation were not associated with measures of subjective or objective cognition (Ps > 0.05). Conclusions: These findings reinforce the importance of comprehensive evaluation reflecting both subjective and objective measures of cognition, as well as the consideration of patient-specific factors, as part of a comprehensive neurobehavioral and health assessment of older former contact sport athletes. [ABSTRACT FROM AUTHOR]

Rotator cuff tears are potentially a career-ending injury for athletes. The surgeon must identify which patients will benefit from surgical repair. The factors to consider are age, type of sport, time since injury, athlete's level, and the patient's expectations. An essential and independent fact determining the surgical treatment is whether the damage is due to overuse or from a traumatic/collision injury. Some sports are more demanding than others resulting in different return-toparticipation (RTP) rates. This RTP return rate can present a real challenge and more so by a desire to reach the pre-injury level of play. The incidence of rotator cuff tearing varies from one sport to another. In football players this can be 12% whereas for tennis players this incidence is 4%to 17%. The RTP ratemust be considered when making treatment decisions and is influenced by the level of the athlete: for professional athletes, the rate is 61%, and for recreational 73%. When the surgeon and the patient decide on the surgical treatment, the surgeon must consider whether to perform a double-row or a single-row rotator cuff tendon repair. The decision-making and the surgical technique will be addressed. [ABSTRACT FROM AUTHOR]