Sports Sciences Commons^™

Health Consequences Of Low Energy Availability In Females And Their Underlying Physiological Mechanisms, Grace Parry

Senior Honors Theses

Low energy availability (LEA) is a state in which energy intake is insufficient to support energy expenditure while maintaining energy balance, which has been shown to result in gastrointestinal distress, immunosuppression, reduced metabolic rate, menstrual dysfunction, diminished bone health, and impaired cardiovascular function in females. Alterations to the microbiome and mucosal lining may propagate gastrointestinal complaints and compromised immune function associated with LEA. The pathophysiology of LEA is otherwise largely driven by hormonal adaptations. Diminished production of thyroid hormones is known to contribute to reduced metabolic rate. Decreases in leptin and insulin and increases in ghrelin disrupt reproductive function through …

Do Lower Extremity Injuries Of Nfl Players Affect Their Yearly Income?, Abdullah Sahyouni, Robert De La Torre, Gautham Pavar, Kinan Sawar, Yasmeen Alcodray, Bohdan Matsko, Justin Bennie, Nicole Xu, Harika Bollineni

Medical Student Research Symposium

Introduction: Injuries are arguably the most daunting career setbacks professional sports players have to face. To better understand the drawbacks of sports injuries, we decided to examine players’ annual income before and after sports injuries. Income is arguably the most important metric of success for professional athletes. To make the study more relevant for the US, we collected data on one of the most viewed professional sports leagues in the country: the National Football League (NFL).

Methods: We examined the NFL’s weekly injury reports for seasons from 2016 to 2020, and recorded players with lower extremity injuries (LEI) (Hamstring, Calves, …

Emotionally Concussed: The Impact Of Pre-Existing Anxiety On Concussion Recovery, Grace Szucs

Honors Theses

Recent advances in concussion research have shed light on numerous mental and physiological factors that may complicate concussion recovery. Systematic reviews of the existing literature have found that premorbid mental health conditions such as depression and anxiety may be a predictor of complicated concussion recovery, but studies have not had an appropriate design to isolate anxiety or depression as a predictor of lengthened recovery. This study investigated if athletes with a history of premorbid anxiety and/or depression would have a longer time of recovery than athletes without this history. Male and female athletes from a Division-1 athletic department treated for …

The 50 Most Cited Papers On Rugby Since 2000 Reveal A Focus Primarily On Strength And Conditioning In Elite Male Players, Katherine J. Hunzinger, Eric Schussler

Rehabilitation Sciences Faculty Publications

We sought to conduct a bibliometric analysis and review of the most cited publications relating to rugby since 2000 in order to identify topics of interest and those that warrant further investigations. Clarivate Web of Science database was used to perform a literature search using the search term "rugby." The top 200 papers by citation count were extracted and reviewed for the inclusion criteria: all subjects were rugby players. The top 50 manuscripts were included for analysis of author, publication year, country of lead authors, institution, journal name and impact factor, topic, participant sex, and level of rugby. The total …

Implementation Of Patient-Centered Care By Athletic Training Students During Clinical Experiences: A Report From The Association Of Athletic Training Education Research Network, Julie M. Cavallario, Bonnie L. Van Lunen, Stacy E. Walker, R. Curtis Bay, Cailee E. Welch-Bacon

Rehabilitation Sciences Faculty Publications

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors …

Effects Of Ohio Opioid Prescribing Policy On Postsurgical Prescriptions Following Sports Procedures, Joseph D. Henningsen, Scott Huff, Andrew D. Schneider, Fady Y. Hijji, Andrew W. Froehle, Anil Krishnamurthy

Orthopaedic Surgery Faculty Publications

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR).

Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (<90 days), and chronic follow-up (>90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year …

A Smartwatch Step-Counting App For Older Adults: Development And Evaluation Study, George Boateng, Curtis L. Petersen, David Kotz, Karen L. Fortuna, Rebecca Masutani, John A. Batsis

Dartmouth Scholarship

Background: Older adults who engage in physical activity can reduce their risk of mobility impairment and disability. Short amounts of walking can improve quality of life, physical function, and cardiovascular health. Various programs have been implemented to encourage older adults to engage in physical activity, but sustaining their motivation continues to be a challenge. Ubiquitous devices, such as mobile phones and smartwatches, coupled with machine-learning algorithms, can potentially encourage older adults to be more physically active. Current algorithms that are deployed in consumer devices (eg, Fitbit) are proprietary, often are not tailored to the movements of older adults, and have …

Modulating Tumour Hypoxia In Prostate Cancer Through Exercise: The Impact Of Redox Signalling On Radiosensitivity, Malcolm Brown, Amélie Rébillard, Nicolas H. Hart, Dominic O’Connor, Gillian Prue, Joe M. O’Sullivan, Suneil Jain

Research outputs 2022 to 2026

Prostate cancer is a complex disease affecting millions of men globally. Radiotherapy (RT) is a common treatment modality although treatment efficacy is dependent upon several features within the tumour microenvironment (TME), especially hypoxia. A hypoxic TME heightens radioresistance and thus disease recurrence and treatment failure continues to pose important challenges. However, the TME evolves under the influence of factors in systemic circulation and cellular crosstalk, underscoring its potential to be acutely and therapeutically modified. Early preclinical evidence suggests exercise may affect tumour growth and some of the benefits drawn, could act to radiosensitise tumours to treatment. Intracellular perturbations in skeletal …

Oxygen Deprivation Masks For Training, Brittany M. Hanlon

Student Publications

Oxygen deprivation masks are being advertised towards athletes as a piece of fitness equipment that can simulate the effects of high altitude, as well as a respiratory muscle training device. Studies that investigated the claims as to whether ODMs increased VO2max and improved endurance were looked into. Experimental data did not find that the use of these masks increased VO2max, nor was there any supporting data to prove that it improved endurance. The function of ODMs as a training tool to increase respiratory muscle strength was also examined. There were contradicting results between the three different studies examined. One study …

Psychosocial Outcomes Of Orthopedic Injuries: An Analysis Of The Relationship Between The Athlete And The Athletic Trainer, Hannah Barnett

Honors Projects

An analysis on the impact of the level of social support from athletic trainers on the outcomes of orthopedic injuries in athletes. The foundational model for this research is Wiese-Bjornstal’s Integrated Model (1998). This model examines the effect of athletes’ emotional responses on their recovery. Social support from the athletic trainer can help mediate negative emotional responses and encourage positive emotional responses, which is why social support is crucial to recovery. Athletes with higher levels of perceived social support from their athletic trainers had more success with rehabilitation. This report consists of a review of the existing literature on psychosocial …

Attenuated Lower Limb Stretch-Shorten-Cycle Capacity In Acl Injured Vs. Non-Injured Female Alpine Ski Racers: Not Just A Matter Of Between-Limb Asymmetry, Matthew J. Jordan, Nathaniel Morris, Sophia Nimphius, Per Aagaard, Walter Herzog

Research outputs 2022 to 2026

A retrospective analysis of routine countermovement jump (CMJ) testing, a coupled eccentric-concentric (stretch-shorten-cycle: SSC) movement, was performed in female elite alpine skiers with anterior cruciate ligament (ACL) reconstruction (ACLR) and without ACLR. A total of 567 tests obtained from the daily training environment were analyzed in 41 elite female athletes (non-injured control: n = 30, ACLR: n = 17), including n = 6 athletes with pre-injury data, between 16 and 32 years of age from alpine ski racing (n = 32) and skier cross (n = 9). Bilateral CMJ testing was conducted on a dual force plate system, and the …

Identifying And Reporting Position-Specific Countermovement Jump Outcome And Phase Characteristics Within Rugby League, John J. Mcmahon, Jason P. Lake, Paul Comfort

Research outputs 2022 to 2026

The countermovement jump (CMJ) has been suggested to be an important test of neuromuscular performance for rugby league (RL) players. Identifying force platform-derived CMJ variables that may be more applicable to RL positions (e.g., forwards and backs) has yet to be fully explored in the scientific literature. The aim of this study was to identify RL position-specific CMJ force-time variables. Specifically, we aimed to compare select forcetime variables from the countermovement (i.e., the combination of unweighting and braking) and propulsion phases of the CMJ between the global forwards and backs positional groups. We also aimed to compare typical (i.e., jump …

Machine Learning To Predict Sports-Related Concussion Recovery Using Clinical Data, Yan Chu, Gregory Knell, Riley P. Brayton, Scott O. Burkhart, Xiaoqian Jiang, Shayan Shams

Faculty Research, Scholarly, and Creative Activity

Objectives
Sport-related concussions (SRCs) are a concern for high school athletes. Understanding factors contributing to SRC recovery time may improve clinical management. However, the complexity of the many clinical measures of concussion data precludes many traditional methods. This study aimed to answer the question, what is the utility of modeling clinical concussion data using machine-learning algorithms for predicting SRC recovery time and protracted recovery?
Methods
This was a retrospective case series of participants aged 8 to 18 years with a diagnosis of SRC. A 6-part measure was administered to assess pre-injury risk factors, initial injury severity, and post-concussion symptoms, including …

Blood Flow Restriction Training After Patellar Instability (Brains Trial), Benjamin D. Brightwell, Austin V. Stone, Xiaojuan Li, Peter A. Hardy, Katherine L. Thompson, Brian W. Noehren, Cale A. Jacobs

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background

Patellar instability is a common and understudied condition that disproportionally affects athletes and military personnel. The rate of post-traumatic osteoarthritis that develops following a patellar dislocation can be up to 50% of individuals 5–15 years after injury. Conservative treatment is the standard of care for patellar instability however, there are no evidence-informed rehabilitation guidelines in the scientific literature. The purpose of this study is to assess the effectiveness of blood-flow restriction training (BFRT) for patellar instability. Our hypotheses are that this strategy will improve patient-reported outcomes and accelerate restoration of symmetric strength and knee biomechanics necessary to safely return …

Epidemiology Of Ncaa Track And Field Injuries From 2010 To 2014, Chris Hopkins, Joel Williams, Mitchell J. Rauh, Lu Zhang

Open Access Fund Publications

Background:

Track and field (T&F) athletes compete in a variety of events that require different skills and training characteristics. Descriptive epidemiology studies often fail to describe event-specific injury patterns.

Purpose:

To describe the epidemiology of injuries in National Collegiate Athletic Association (NCAA) T&F by sex, setting (practice vs competition), and time of season (indoor vs outdoor) and to compare injury patterns by events within the sport.

Study Design:

Descriptive epidemiology study.

Methods:

Data were obtained from the NCAA Injury Surveillance Program for all indoor and outdoor T&F injuries during the academic years 2009-2010 to 2013-2014. Injury rates, injury rate ratios, …

A Muscle Cell-Macrophage Axis Involving Matrix Metalloproteinase 14 Facilitates Extracellular Matrix Remodeling With Mechanical Loading, Bailey D. Peck, Kevin A. Murach, R. Grace Walton, Alexander J. Simmons, Douglas E. Long, Kate Kosmac, Cory M. Dungan, Philip A. Kern, Marcas M. Bamman, Charlotte A. Peterson

Center for Muscle Biology Faculty Publications

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single-cell RNA-seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor ( …

Implementation Barriers To Integrating Exercise As Medicine In Oncology: An Ecological Scoping Review, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel Spry, Dennis Taaffe, Nicolas H. Hart, Daniel A. Galvao

Research outputs 2014 to 2021

Purpose

While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems.

Methods

A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system.

Results

A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology …

Starting The New Year And Getting Rid Of Type 2 Diabetes?, Sheri R. Colberg

Human Movement Sciences & Special Education Faculty Publications

No abstract provided.

Longitudinal Changes Of Cardiorespiratory Fitness Performance In High School: Association With Individual And School-Based Variables, Xihe Zhu, Justin A. Haegele, Jinting Shao, Summer Davis

Human Movement Sciences & Special Education Faculty Publications

This study aimed to model adolescents’ cardiorespiratory fitness performance change trajectories longitudinally across high school years and its relation to school- and individual/student-level factors. We employed hierarchical linear modeling to examine longitudinal cardiorespiratory fitness performance changes, as measured by the progressive aerobic capacity endurance run (PACER), over the years, between sexes, and in association with the school-level variables. Participants were 76,227 adolescents from 80 high schools in the mid-Atlantic region of the United States. School-level academic performance (SAP), the percent of students eligible for free and reduced-price meals (FARM), and physical education student-faculty ratio were obtained with permission from the …

Preventive Training Program Feedback Complexity, Movement Control, And Performance In Youth Athletes, Hayley J. Root, Eleanor M. Beltz, Julie P. Burland, Jessica C. Martinez, R. Curt Bay, Lindsay J. Distefano

Rehabilitation Sciences Faculty Publications

Context: Preventive training programs (PTPs) reduce injury risk by improving movement control. Corrective feedback is important; however, many cues at once may be too complicated for athletes.

Objective: To compare movement control and long-jump (LJ) changes in youth athletes participating in a season-long PTP, with simplified feedback, traditional feedback, or a warmup of the coaches' choosing.

Design: Cluster-randomized controlled trial.

Setting: Soccer fields.

Patients or Other Participants: A total of 420 athletes (simplified feedback = 173, traditional feedback = 118, and control = 129; age = 11 ± 3 years).

Intervention(s): Teams were randomized into the simplified PTP, traditional PTP, …

Examination Of Athlete Triad Symptoms Among Endurance-Trained Male Athletes: A Field Study, Erin M. Moore, Clemens Drenowatz, David F. Stodden, Kelly Pritchett, Thaddus C. Brodrick, Brittany T. Williams, Justin M. Goins, Toni M. Torres-Mcgehee

All Faculty Scholarship for the College of Education and Professional Studies

Background: Studies examining the physiological consequences associated with deficits in energy availability (EA) for male athletes are sparse.

Purpose: To examine male athlete triad components; low energy availability (LEA) with or without an eating disorder risk (ED), reproductive hormone [testosterone (T)], and bone mineral density (BMD) in endurance-trained male athletes during different training periods.

Methods: A cross-sectional design with 14 participants (age: 26.4 ± 4.2 years; weight: 70.6 ± 6.4 kg; height: 179.5 ± 4.3 cm; BMI: 21.9 ± 1.8 kg/m2) were recruited from the local community. Two separate training weeks [low (LV) and high (HV) training volumes] were used …

Examining Eating Attitudes And Behaviors In Collegiate Athletes, The Association Between Orthorexia Nervosa And Eating Disorders, Nancy A. Uriegas, Zachary K. Winkelmann, Kelly Pritchett, Toni M. Torres-Mcgehee

All Faculty Scholarship for the College of Education and Professional Studies

Purpose: Orthorexia nervosa (Orthorexia) is an eating attitude and behavior associated with a fixation on healthy eating, while eating disorders (EDs) are clinically diagnosed psychiatric disorders associated with marked disturbances in eating that may cause impairment to psychosocial and physical health. The purpose of this study was to examine risk for Orthorexia and EDs in student-athletes across sex and sport type and determine the association between the two.

Methods: Student-athletes (n = 1,090; age: 19.6 ± 1.4 years; females = 756; males = 334) completed a survey including demographics, the ORTO-15 test (values), the Eating Attitudes Test-26 (EAT-26; >20 …

Integration Of Consumer-Based Activity Monitors Into Clinical Practice For Children With Type 1 Diabetes: A Feasibility Study, Jason R. Jaggers, Timothy Mckay, Kristi M. King, Bradly J. Thrasher, Kupper A. Wintergerst

Faculty Scholarship

Current technology commonly utilized in diabetes care includes continuous glucose monitors (CGMs) and insulin pumps. One often overlooked critical component to the human glucose response is daily physical activity habits. Consumer-based activity monitors may be a valid way for clinics to collect physical activity data, but whether or not children with type 1 diabetes (T1D) would wear them or use the associated mobile application is unknown. Therefore, the purpose of this study was to test the feasibility of implementing a consumer-based accelerometer directly into ongoing care for adolescents managing T1D. Methods: Adolescents with T1D were invited to participate in this …

Association Between Pitch Break On The 4-Seam Fastball And Slider And Shoulder Injury In Major League Baseball Pitchers: A Case-Control Study, Brooks N. Platt, Anthony J. Zacharias, Caitlin Conley, Lindsay Hockensmith, Nicholas Stockwell, Aaron Sciascia, Austin V. Stone

Orthopaedic Surgery and Sports Medicine Faculty Publications

Background: Few specific risk factors are known for shoulder injury in professional pitchers. New pitch-tracking data allow for risk stratification based on advanced metrics.

Purpose/Hypothesis: The purpose of this study was to determine the association between shoulder injury, pitch frequency, and pitch metrics (velocity, total break, break angle, and spin rate) for the 4-seam fastball, curveball, and slider. We hypothesized that more frequent use of the 4-seam fastball would be associated with shoulder injury.

Study Design: Case-control study; Level of evidence, 3.

Methods: The Major League Baseball (MLB) database was queried for pitchers who had been placed on the injury …

Prevalence Of Soccer Heading In Middle School American Youth Club Soccer Players, Pedro Gonzalez-Cabrera, Mohan Ganesan, Julie Jameson, Deanna M. Hughes

Physical Therapy Collection

The purpose of this study was to evaluate the prevalence of soccer heading during a season in a youth soccer club competitive team

Heading events were recorded real time using a recording datasheet for a single team and their opponent teams during the 2014 season of a youth soccer league. Position on the field at the time of the heading event was also documented.

Mean heading events were 35.5 events/match. A paired sample t-test showed no statistically significant difference between observed team and opponent teams. Mean standardized assessment of concussion (SAC) score for the observed soccer team was 24.9±2.6 (out …

Comparison Of Constant Load Exercise Intensity For Verification Of Maximal Oxygen Uptake Following A Graded Exercise Test In Older Adults, Ian R. Villanueva, John C. Campbell, Serena M. Medina, Theresa M. Jorgensen, Shannon L. Wilson, Siddhartha S. Angadi, Glenn A. Gaesser, Jared M. Dickinson

All Faculty Scholarship for the College of Education and Professional Studies

Maximal oxygen uptake (VO₂max) declines with advancing age and is a predictor of morbidity and mortality risk. The purpose here was to assess the utility of constant load tests performed either above or below peak work rate obtained from a graded exercise test for verification of VO₂max in older adults. Twenty-two healthy older adults (9M, 13F, 67 ± 6 years, BMI: 26.3 ± 5.1 kg·m⁻²) participated in the study. Participants were asked to complete two experimental trials in a randomized, counterbalanced cross-over design. Both trials (cycle ergometer) consisted of (1) an identical graded exercise …

Association Between Physical Activity And Sport Participation On Hemoglobin A1c Among Children And Adolescents With Type 1 Diabetes, Kristi King, Jason R. Jaggers, Lindsay J. Della, Timothy Mckay, Sara Watson, Amy E. Kozerski, Kimberly Hartson, Kupper A. Wintergerst

Faculty Scholarship

Purpose: To determine associations between physical activity (PA) and sport participation on HbA1c levels in children with type 1 diabetes (T1D). Method: Pediatric patients with T1D were invited to complete a PA and sport participation survey. Data were linked to their medical records for demographic characteristics, diabetes treatment and monitoring plans, and HbA1c levels. Results: Participants consisted of 71 females and 81 males, were 13 +- 3 years old with an average HbA1c level of 8.75 +- 1.81. Children accumulating 60 min of activity 3 days or more a week had significantly lower HbA1c compared to those who accumulated less …

Developing A Practical Application Of The Isometric Squat And Surface Electromyography, David Phillips, Angelic Rose Del Vecchio, Kevin Carroll, Evan L. Matthews

Department of Exercise Science and Physical Education Scholarship and Creative Works

Electromyography (EMG) is a research tool used in gait analysis, muscle coordination evaluation, clinical evaluation and sports techniques. Electromyography can provide an insight into neural adaptations, cross education effects, bilateral contraction deficiencies, and antagonist activity in exercise-related movements. While there are clear benefits to using EMG in exercise-related professions, accessibility, cost, and difficulty interpreting the data limit its use in strength and clinical settings. We propose a practical EMG assessment using the isometric squat to identify compensatory activation patterns and report early observations. Ten healthy participants were recruited. Participants performed a 2-min isometric handgrip protocol and an isometric squat protocol. …

Risk Of Low Energy Availability In National And International Level Paralympic Athletes: An Exploratory Investigation, Kelly Pritchett, Alicia Difolco, Savannah Glasgow, Robert Pritchett, Katy Williams, Trent Stellingwerff, Patricia Roney, Susannah Scaroni, Elizabeth Broad

All Faculty Scholarship for the College of Education and Professional Studies

(1) Background: The purpose of this study was to examine the symptoms of low energy availability (LEA) and risk of relative energy deficiency in sport (RED-S) symptoms in para-athletes using a multi-parameter approach. (2) Methods: National level para-athletes (n = 9 males, n = 9 females) completed 7-day food and activity logs to quantify energy availability (EA), the LEA in Females Questionnaire (LEAF-Q), dual energy X-ray absorptiometry (DXA) scans to assess bone mineral density (BMD), and hormonal blood spot testing. (3) Results: Based on EA calculations, no athlete was at risk for LEA (females < 30 kcal·kg⁻¹ FFM·day⁻¹; and males …

Injury Rates In Major League Baseball During The 2020 Covid-19 Season, Brooks N. Platt, Timothy L. Uhl, Aaron D. Sciascia, Anthony J. Zacharias, Nicole G. Lemaster, Austin V. Stone

Physical Therapy Faculty Publications

Background: The 2020 Major League Baseball (MLB) season was drastically altered because of the COVID-19 pandemic. The changes included an extended layoff between March and July as well as a shortened preseason.

Purpose/Hypothesis: To determine the incidence and epidemiology of MLB injuries in the abbreviated 2020 season compared with prior seasons. We hypothesized that there was an increase in the overall injury rate in the 2020 season compared with the 2018-2019 seasons and that it equally affected all body regions.

Study Design: Descriptive epidemiology study.

Methods: The MLB transactions database was queried to find players who had been placed on …