bluuebunny/crossref_metadata_2025_split huggingface dataset:
Whey Protein Addition to a Carbohydrate-Electrolyte Rehydration Solution Ingested After Exercise in the Heat
Authors: James Lewis J. , Gingell Rebecca , Evans Gethin H. 
Published: March 2017

Context:
Many active people finish exercise hypohydrated, so effective rehydration after exercise is an important consideration.

Objective:
To determine the effects of a rehydration solution containing whey protein isolate on fluid balance after exercise-induced dehydration.

Design:
Randomized controlled clinical trial.

Setting:
University research laboratory.

Patients or Other Participants:
Twelve healthy men (age = 21 ± 1 years, height = 1.82 ± 0.08m, mass = 82.71 ± 10.31 kg) participated.

Intervention(s):
Participants reduced body mass by 1.86% ± 0.07% after intermittent exercise in the heat and re-hydrated with a volume of drink in liters equivalent to 1.5 times their body mass loss in kilograms of a solution of either 65 g/L carbohydrate (trial C) or 50 g/L carbohydrate and 15 g/L whey protein isolate (trial CP). Solutions were matched for energy density and electrolyte content. Urine samples were collected before and after exercise and for 4 hours after rehydration.

Main Outcome Measure(s):
We measured urine volume, drink retention, net fluid balance, urine osmolality, and subjective responses. Drink retention was calculated as the difference between the volume of drink ingested and urine produced. Net fluid balance was calculated from fluid gained through drink ingestion and fluid lost through sweat and urine production.

Results:
Total cumulative urine output after rehydration was not different between trial C (1173 ± 481 mL) and trial CP (1180 ± 330 mL) (F1 = 0.002, P = .96), and drink retention during the study also was not different between trial C (50% ± 18%) and trial CP (49% ± 13%) (t11 = −0.159, P = .88). At the end of the study, net fluid balance was negative compared with base-line for trial C (−432 ± 436 mL) (t11 = 3.433, P = .03) and trial CP (−432 ± 302 mL) (t11 = 4.958, P = .003).

Conclusions:
When matched for energy density and electrolyte content, a solution of carbohydrate and whey protein isolate neither increased nor decreased rehydration compared with a solution of carbohydrate.
Menstrual Irregularity and Musculoskeletal Injury in Female High School Athletes
Authors: Thein-Nissenbaum Jill M. , Rauh Mitchell J. , Carr Kathleen E. , Loud Keith J. , McGuine Timothy A. 
Published: March 2017

Context:
The female athlete triad describes the interrelatedness of energy availability, menstrual function, and bone density. Although associations between triad components and musculoskeletal injury (INJ) have been reported in collegiate athletes, limited information exists about menstrual irregularity (MI) and INJ in the high school population.

Objective:
To determine the prevalence of and relationship between MI and INJ in high school athletes.

Design:
Cross-sectional study.

Setting:
High schools.

Patients or Other Participants:
The sample consisted of 249 female athletes from 3 high schools who competed in 33 interscholastic, school-sponsored sport teams, dance teams, and cheerleading or pom-pon squad during the 2006–2007 school year. Each athlete remained on the roster throughout the season.

Main Outcome Measure(s):
Participants completed a survey regarding injury type, number of days of sport participation missed, and menstrual history in the past year.

Results:
The prevalences of MI and INJ were 19.7% and 63.1%, respectively. Athletes who reported MI sustained a higher percentage of severe injuries (missing ≥22 days of practice or competition) than did athletes who reported normal menses. Although the trend was not significant, athletes with MI were almost 3 times more likely to sustain an injury resulting in 7 or more days of time lost from sport (odds ratio = 2.7, 95% confidence interval = 0.8, 8.8) than those who sustained an injury resulting in 7 or fewer days of time lost.

Conclusions:
The incidences of MI and INJ in this high school population during the study period were high. Athletes who reported MI sustained a higher percentage of severe injuries than did athletes who reported normal menses. Education programs to increase knowledge and improve management of MI and its potential effects on injury in female high school athletes are warranted.
Risk Factors Associated With Shoulder Pain and Disability Across the Lifespan of Competitive Swimmers
Authors: Tate Angela , Turner Gregory N. , Knab Sarah E. , Jorgensen Colbie , Strittmatter Andrew , Michener Lori A. 
Published: March 2017

Context:
The prevalence of shoulder pain among competitive swimmers is high, but no guidelines exist to reduce shoulder injuries. Elucidating differences between swimmers with and without shoulder pain can serve as a basis for the development of a program to prevent shoulder injury that might lead to pain and dysfunction.

Objective:
To determine whether physical characteristics, exposure, or training variables differ between swimmers with and without shoulder pain or disability.

Design:
Cross-sectional study.

Setting:
Multisite swimming centers.

Patients or Other Participants:
A total of 236 competitive female swimmers aged 8 to 77 years.

Data Collection and Analysis:
Participants completed the Penn Shoulder Score and underwent testing of core endurance, range of motion, muscle force production, and pectoralis minor muscle length and the Scapular Dyskinesis Test. Swimmers were grouped by age for analysis: ages 8 to 11 years (n = 42), 12 to 14 years (n = 43), 15 to 19 years (high school, n = 84), and 23 to 77 years (masters, n = 67). Comparisons were made between groups with and without pain and disability using independent t tests for continuous data and χ2 analyses and Fisher exact tests for categorical data.

Results:
Nine (21.4%) swimmers aged 8 to 11 years, 8 (18.6%) swimmers aged 12 to 14 years, 19 (22.6%) high school swimmers, and 13 (19.4%) masters swimmers had shoulder pain and disability. Differences that were found in 2 or more age groups between athletes with and without shoulder pain and disability included greater swimming exposure, a higher incidence of previous traumatic injury and patient-rated shoulder instability, and reduced participation in another sport in the symptomatic groups (P &lt; .05). Reduced shoulder flexion motion, weakness of the middle trapezius and internal rotation, shorter pectoralis minor and latissimus, participation in water polo, and decreased core endurance were found in symptomatic females in single varying age groups (P &lt; .05).

Conclusions:
Female competitive swimmers have shoulder pain and disability throughout their lives. Given that exposure and physical examination findings varied between athletes with and without substantial pain and disability, a program to prevent shoulder injury that might lead to pain and dysfunction appears warranted and might include exposure reduction, cross-training, pectoral and posterior shoulder stretching, strengthening, and core endurance training.
Sports Nutrition Knowledge Among Collegiate Athletes, Coaches, Athletic Trainers, and Strength and Conditioning Specialists
Authors: Torres-McGehee Toni M. , Pritchett Kelly L. , Zippel Deborah , Minton Dawn M. , Cellamare Adam , Sibilia Mike 
Published: March 2017

Context:Coaches, athletic trainers (ATs), strength and conditioning specialists (SCSs), and registered dietitians are common nutrition resources for athletes, but coaches, ATs, and SCSs might offer only limited nutrition information. Little research exists about sports nutrition knowledge and current available resources for nutrition information for athletes, coaches, ATs, and SCSs.Objective:To identify resources of nutrition information that athletes, coaches, ATs, and SCSs use; to examine nutrition knowledge among athletes, coaches, ATs, and SCSs; and to determine confidence levels in the correctness of nutrition knowledge questions within all groups.Design:Cross-sectional study.Setting:National Collegiate Athletic Association Division I, II, and III institutions across the United States.Patients and Other Participants:The 579 participants consisted of athletes (n = 185), coaches (n = 131), ATs (n = 192), and SCSs (n = 71).Main Outcome Measure(s):Participants answered questions about nutrition resources and domains regarding basic nutrition, supplements and performance, weight management, and hydration. Adequate sports nutrition knowledge was defined as an overall score of 75% in all domains (highest achievable score was 100%).Results:Participants averaged 68.5% in all domains. The ATs (77.8%) and SCSs (81.6%) had the highest average scores. Adequate knowledge was found in 35.9% of coaches, 71.4% of ATs, 83.1% of SCSs, and only 9% of athletes. The most used nutrition resources for coaches, ATs, and SCSs were registered dietitians.Conclusions:Overall, we demonstrated that ATs and SCSs have adequate sports nutrition knowledge, whereas most coaches and athletes have inadequate knowledge. Athletes have frequent contact with ATs and SCSs; therefore, proper nutrition education among these staff members is critical. We suggest that proper nutrition programming should be provided for athletes, coaches, ATs, and SCSs. However, a separate nutrition program should be integrated for ATs and SCSs. This integrative approach is beneficial for the continuity of care, as both categories of professionals might be developing and integrating preventive or rehabilitative programs for athletes.
Muscle Imbalance Among Elite Australian Rules Football Players: A Longitudinal Study of Changes in Trunk Muscle Size
Authors: Hides Julie , Stanton Warren 
Published: March 2017

Context:
Trunk muscles, such as the transversus abdominis (TrA) and multifidus, play a key role in lumbopelvic stability, which is important in athletic performance. Asymmetry or imbalance in these and other trunk muscles could result from the specific requirements of the game of Australian rules football.

Objective:
To determine whether seasonal variations in the sizes of key trunk muscles associated with lumbopelvic stability occur in Australian Football League players.

Design:
Cross-sectional study.

Setting:
Hospital.

Patients or Other Participants:
The number of players eligible to participate at each of the 4 time points was 36 at the start of preseason 1 (T1), 31 at end of season 1 (T2), 43 at the end of preseason 2 (T3), and 41 at the start of preseason 3 (T4). The group with data at all 4 time points (n  =  20) was used in the analyses and was shown to be representative of the total sample.

Intervention(s):
Magnetic resonance imaging was used to determine the cross-sectional areas (CSAs) of the multifidus (vertebral levels L2 to L5) and lumbar erector spinae (LES) muscles (L3), as well as the thickness of the TrA and internal oblique (IO) muscles at L3.

Main Outcome Measure(s):
Cross-sectional areas of the multifidus and LES muscles and thickness of the TrA and IO muscles.

Results:
By the end of the playing season, results showed 11.1% atrophy for multifidus CSA at L3 and 21% atrophy for TrA thickness at rest. In comparison, the CSA of the LES muscles increased by 3.6%, and the thickness of the IO muscle increased by 11.8% compared with the start of the preseason.

Conclusions:
The results indicated an imbalance of the key muscles associated with lumbopelvic stability.
Prediction of Core and Lower Extremity Strains and Sprains in Collegiate Football Players: A Preliminary Study
Authors: Wilkerson Gary B. , Giles Jessica L. , Seibel Dustin K. 
Published: March 2017

Context:Poor core stability is believed to increase vulnerability to uncontrolled joint displacements throughout the kinetic chain between the foot and the lumbar spine.Objective:To assess the value of preparticipation measurements as predictors of core or lower extremity strains or sprains in collegiate football players.Design:Cohort study.Setting:National Collegiate Athletic Association Division I Football Championship Subdivision football program.Patients or Other Participants:All team members who were present for a mandatory physical examination on the day before preseason practice sessions began (n  =  83).Main Outcome Measure(s):Preparticipation administration of surveys to assess low back, knee, and ankle function; documentation of knee and ankle injury history; determination of body mass index; 4 different assessments of core muscle endurance; and measurement of step-test recovery heart rate. All injuries were documented throughout the preseason practice period and 11-game season. Receiver operating characteristic analysis and logistic regression analysis were used to identify dichotomized predictive factors that best discriminated injured from uninjured status. The 75th and 50th percentiles were evaluated as alternative cutpoints for dichotomization of injury predictors.Results:Players with ≥2 of 3 potentially modifiable risk factors related to core function had 2 times greater risk for injury than those with &lt;2 factors (95% confidence interval  =  1.27, 4.22), and adding a high level of exposure to game conditions increased the injury risk to 3 times greater (95% confidence interval  =  1.95, 4.98). Prediction models that used the 75th and 50th percentile cutpoints yielded results that were very similar to those for the model that used receiver operating characteristic-derived cutpoints.Conclusions:Low back dysfunction and suboptimal endurance of the core musculature appear to be important modifiable football injury risk factors that can be identified on preparticipation screening. These predictors need to be assessed in a prospective manner with a larger sample of collegiate football players.
Frequency of Use of Clinical Shoulder Examination Tests by Experienced Shoulder Surgeons
Authors: Sciascia Aaron D. , Spigelman Tracy , Kibler W. Ben , Uhl Timothy L. 
Published: March 2017

ContextHealth care professionals have reported and used a multitude of special tests to evaluate patients with shoulder injuries. Because of the vast array of tests, educators of health care curriculums are challenged to decide which tests should be taught.ObjectiveTo survey experienced shoulder specialists to identify the common clinical tests used to diagnose 9 specific shoulder injuries to determine if a core battery of tests should be taught to allied health professionals.DesignCross-sectional study.SettingDescriptive survey administered via e-mail.Patients or Other ParticipantsOf 131 active members of the American Shoulder and Elbow Surgeons, 71 responded to the survey.Main Outcome Measure(s)Respondents were asked to complete a survey documenting their use of clinical tests during a shoulder examination. They answered yes or no to indicate their use of 122 different tests for diagnosing 9 shoulder conditions.ResultsThe average number of tests used for all pathologic conditions was 30 ± 9. The anterior apprehension and cross-body adduction tests were used by all respondents. At least 1 test was used for each of the 9 conditions listed (range = 1–7), and at least 50% of respondents used 25 tests. The tests were reviewed for valid diagnostic accuracy via the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. High diagnostic value and a large amount of QUADAS variability have been reported in the literature for 16 of the 25 tests.ConclusionsA small percentage (20%) of clinical tests is being used by most examiners. The 25 most common tests identified from this survey may serve as a foundation for the student's knowledge base, with the clear understanding that multiple clinical tests are used by some of the most experienced clinicians dealing with shoulder injuries.
Preferential Type II Muscle Fiber Damage From Plyometric Exercise
Authors: Macaluso Filippo , Isaacs Ashwin W. , Myburgh Kathryn H. 
Published: March 2017

Context:
Plyometric training has been successfully used in different sporting contexts. Studies that investigated the effect of plyometric training on muscle morphology are limited, and results are controversial with regard to which muscle fiber type is mainly affected.

Objective:
To analyze the skeletal muscle structural and ultrastructural change induced by an acute bout of plyometric exercise to determine which type of muscle fibers is predominantly damaged.

Design:
Descriptive laboratory study.

Setting:
Research laboratory.

Patients or Other Participants:
Eight healthy, untrained individuals (age = 22 ± 1 years, height = 179.2 ± 6.4 cm, weight = 78.9 ± 5.9 kg).

Intervention(s):
Participants completed an acute bout of plyometric exercise (10 sets of 10 squat-jumps with a 1-minute rest between sets).

Main Outcome Measure(s):
Blood samples were collected 9 days and immediately before and 6 hours and 1, 2, and 3 days after the acute intervention. Muscle samples were collected 9 days before and 3 days after the exercise intervention. Blood samples were analyzed for creatine kinase activity. Muscle biopsies were analyzed for damage using fluorescent and electron transmission microscopy.

Results:
Creatine kinase activity peaked 1 day after the exercise bout (529.0 ± 317.8 U/L). Immunofluorescence revealed sarcolemmal damage in 155 of 1616 fibers analyzed. Mainly fast-twitch fibers were damaged. Within subgroups, 7.6% of type I fibers, 10.3% of type IIa fibers, and 14.3% of type IIx fibers were damaged as assessed by losses in dystrophin staining. Similar damage was prevalent in IIx and IIa fibers. Electron microscopy revealed clearly distinguishable moderate and severe sarcomere damage, with damage quantifiably predominant in type II muscle fibers of both the glycolytic and oxidative subtypes (86% and 84%, respectively, versus only 27% of slow-twitch fibers).

Conclusions:
We provide direct evidence that a single bout of plyometric exercise affected mainly type II muscle fibers.
Eating Disorder Risk and the Role of Clothing in Collegiate Cheerleaders' Body Images
Authors: Torres-McGehee Toni M. , Monsma Eva V. , Dompier Thomas P. , Washburn Stefanie A. 
Published: March 2017

Context
With increased media coverage and competitive opportunities, cheerleaders may be facing an increase in eating disorder (ED) prevalence linked to clothing-related body image (BI).

Objective
To examine ED risk prevalence, pathogenic weight control behaviors, and variation in clothing-specific BI across position and academic status among collegiate cheerleaders.

Design
Cross-sectional study.

Setting
National Collegiate Athletic Association Division I and II institutions.

Patients or Other Participants
Female collegiate cheerleaders (n = 136, age = 20.4 ± 1.3 years, height = 160.2 ± 8.1 cm, weight = 57.2 ± 8.3 kg).

Main Outcome Measure(s)
Participants self-reported height, weight, and desired weight and completed the Eating Attitudes Test. Body image perceptions in 3 clothing types (daily clothing, midriff uniform, full uniform) were assessed using sex-based silhouettes (body mass index = 18.3 kg/m2 for silhouette 1, 23.1 kg/m2 for silhouette 4).

Results
The ED risk for cheerleaders was estimated at 33.1%. However, when body mass index was controlled using backward stepwise logistic regression, flyers had greater odds (odds ratio = 4.4, 95% confidence interval = 1.5, 13.2, P = .008) of being at risk compared with bases, but no difference was noted between the base and back-spot positions (odds ratio = 1.9, 95% confidence interval = 0.5, 6.6, P = .333). A main effect of BI perceptions was seen (P &lt; .001), with a significant interaction by clothing type (F2,133 = 22.5, P &lt; .001, η2 = 0.14). Cheerleaders desired to be smaller than their perceived BIs for each clothing type, with the largest difference for midriff uniform (2.6 ± 0.8 versus 3.7 ± 0.9), followed by full uniform (2.7 ± 0.8 versus 3.5 ± 0.9) and daily clothing (2.8 ± 0.8 versus 3.5 ± 0.9).

Conclusions
Cheerleaders, especially flyers, appear to be at risk for EDs, with greatest BI dissatisfaction when wearing their most revealing uniforms (ie, midriffs). Universities, colleges, and the national governing bodies of these squads need to focus on preventing eating disorders and BI dissatisfaction and promoting self-esteem.
Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting
Authors: McLeod Tamara C. Valovich , Lam Kenneth C. , Bay R. Curtis , Sauers Eric L. , Valier Alison R. Snyder 
Published: March 2017

Context
Analysis of health care service models requires the collection and evaluation of basic practice characterization data. Practice-based research networks (PBRNs) provide a framework for gathering data useful in characterizing clinical practice.

Objective
To describe preliminary secondary school setting practice data from the Athletic Training Practice-Based Research Network (AT-PBRN).

Design
Descriptive study.

Setting
Secondary school athletic training facilities within the AT-PBRN.

Patients or Other Participants
Clinicians (n = 22) and their patients (n = 2523) from the AT-PBRN.

Main Outcome Measure(s)
A Web-based survey was used to obtain data on clinical practice site and clinician characteristics. Patient and practice characteristics were obtained via deidentified electronic medical record data collected between September 1, 2009, and April 1, 2011.
Descriptive data regarding the clinician and CPS practice characteristics are reported as percentages and frequencies. Descriptive analysis of patient encounters and practice characteristic data was performed, with the percentages and frequencies of the type of injuries recorded at initial evaluation, type of treatment received at initial evaluation, daily treatment, and daily sign-in procedures.

Results
The AT-PBRN had secondary school sites in 7 states, and most athletic trainers at those sites (78.2%) had less than 5 years of experience. The secondary school sites within the AT-PBRN documented 2523 patients treated across 3140 encounters. Patients most frequently sought care for a current injury (61.3%), followed by preventive services (24.0%), and new injuries (14.7%). The most common diagnoses were ankle sprain/strain (17.9%), hip sprain/strain (12.5%), concussion (12.0%), and knee pain (2.5%). The most frequent procedures were athletic trainer evaluation (53.9%), hot- or cold-pack application (26.0%), strapping (10.3%), and therapeutic exercise (5.7%). The median number of treatments per injury was 3 (interquartile range = 2, 4; range = 2–19).

Conclusions
These preliminary data describe services provided by clinicians within the AT-PBRN and demonstrate the usefulness of the PBRN model for obtaining such data.