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At least 19 recordsLinked to original sources

Social support in the athletic training room: athletes' expectations of staff and student athletic trainers.

OBJECTIVE: Social support has been identified repeatedly in the literature as being beneficial to individuals suffering from injury or illness. Because of the frequent interaction between athletic trainers and student athletes, the athletic trainer is in a unique position to provide a variety of social support to the athlete. The purpose of the study was (1) to identify the degree to which athletes actually receive each of eight types of social support; (2) to identify the types of social support athletes need or expect to receive from staff and student athletic trainers; and (3) to compare the athletes' satisfaction with the quality of the support received from athletic training staff and students. DESIGN AND SETTING: A questionnaire was used to collect data for this study. It was administered at a Division I university. SUBJECTS: Eighty-five student-athletes at a Division I university. MEASUREMENTS: The survey consisted of 24 questions that used a five-point Likert rating scale. RESULTS: There was no significant difference in the amount of social support received by athletes from staff and student athletic trainers, in athletes' expectations of staff and student athletic trainers with regard to provision of social support, or in the athletes' level of satisfaction with staff and student athletic trainers' provision of social support. CONCLUSIONS: Examined collectively, the findings indicate that athletes do not differentiate between staff and student athletic trainers with regard to the provision of social support. However, finding that athletes do not differentiate between staff and student athletic trainers in this area is significant in itself and has implications for athletic training education programs.

Journal Article↗

Perceptions of athletic training services by collegiate student-athletes: a measurement of athlete satisfaction.

OBJECTIVE: I evaluated the perceptions student-athletes had of their athletic trainers and of the medical coverage provided them by the athletic departments at their institutions. My intent was to assess differences between male and female athletes, between athletes of high-profile and low-profile sports, and between athletes who competed at the NCAA Division I and Division II levels. The research design was also directed at identifying any subgroup of student-athletes who demonstrated a significantly different perception toward their athletic trainer(s). DESIGN AND SETTING: Questionnaires were sent to 32 athletic training programs at 28 NCAA Division I and II institutions. Eighteen of the 32 programs participated, yielding a 56% response. SUBJECTS: A total of 343 student-athletes from 18 selected athletic programs at both the NCAA Division I and II levels participated. One questionnaire contained response errors and was not included in the analysis. MEASUREMENTS: A questionnaire was developed and pilot tested at 3 collegiate settings apart from those participating in the study. Validity and reliability analyses were conducted and confirmed by additional professionals in the field of athletic training. Cumulative mean perception scores between groups were measured using independent t tests. Differences in scores between subgroups were measured using a 1-way analysis of variance. RESULTS: I observed significant differences in mean cumulative perception scores between sex and sport-profile groups. Male athletes and athletes in high-profile sports demonstrated a higher mean perception score than did females and athletes in low-profile sports. There was no difference in scores when compared across athletic divisions. Subgroups of all the athletes participating were identified. Several subgroups demonstrated significant differences in mean cumulative perception scores. CONCLUSIONS: Males and females in low-profile sports at Division II schools and females in high-profile sports at Division II schools had significantly lower mean perception scores than did other subgroups of athletes.

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Is ACL reconstruction only for athletes? A study of the incidence of meniscal and cartilage injuries in an ACL-deficient athlete and non-athlete population: an Indian experience.

While anterior cruciate ligament (ACL) reconstruction is readily offered to athletes, non-athletes are often treated conservatively. We carried out a retrospective, cross-sectional analysis study to compare the incidence of meniscal and cartilage injuries in an athlete and non-athlete population in relation to time of presentation since injury. The results were used to assess the need and relevance of ACL reconstruction in the non-athlete population. The study included 1375 patients who underwent ACL reconstruction between 1998 and 2004. These patients were initially broadly divided into two categories: athletes (575) and non-athletes (800). Each category was then sub-divided into four subgroups based on time elapsed between the injury and presentation at our clinic (Group A, 3 months; Group B, 3-12 months; Group C, 1-3 years; Group D, more than 3 years). Arthroscopic findings were documented for medial and lateral meniscus and cartilage injuries, and comparisons were made between the incidence of associated injuries in the corresponding groups. There was a statistically significant increase in the incidence of meniscal injuries and cartilage injuries after 1 year in both the groups. There was no difference in the incidence of meniscal and cartilage injuries in athletes and non-athletes among the corresponding groups. (chi-square test, p = 0.05). These results demonstrate that both athletes and non-athletes are equally susceptible for long-term meniscal and cartilage injuries if ACL reconstruction is not carried out early.

Anterior Cruciate Ligament↗

Sudden cardiac death in division I collegiate athletics: analysis of automated external defibrillator utilization in National Collegiate Athletic Association division I athletic programs.

OBJECTIVE: To determine current outcomes of automated external defibrillator (AED) interventions in sports medicine programs in National Collegiate Athletic Association (NCAA) division I athletics. DESIGN: Qualitative scripted telephone interview with all positive responders to prior NCAA division I-wide study on AED utilization and implementation. SETTING: NCAA division I sports medicine programs. Head athletic trainers were the main data source. PARTICIPANTS: All positive responders to a previously published study on AED implementation in the NCAA division I sports medicine community. Positive responders were those that indicated that they had used their departmental AEDs in a sudden cardiac death (SCD) scenario. MAIN OUTCOME MEASUREMENTS: Survival to hospital discharge was the main outcome sought. When available, additional outcomes were time to defibrillation, time to notification of athletic training staff, EMS response time, location of event, and sudden cardiac victim type (i.e., student, coach, fan). RESULTS: Sixteen departments that previously reported having had an SCD event at their institution responded to this follow-up telephone survey. Twenty percent of AED uses were attributed to student athletes, with 33% of utilizations for athletic department staff and 47% for fans. Defibrillation was actually administered in 53% of AED unit applications. Time to shock was an average of 3.4 minutes, with average EMS response time of 8.2 minutes for those events without EMS on site. Reported survival to hospital discharge in this university athletic department setting for SCD was 0% for students, 75% for staff, 57% for fans, and 61% overall. CONCLUSIONS: The results of this study demonstrate the need for NCAA division 1 athletic sports medicine programs to examine, and possibly expand, the traditional scope of practice of caring primarily for student athletes to include the larger community of sports participants comprised of athletes, departmental staff, and spectators. Athletic department AED programs were extremely successfully at increasing survival of SCD far above national prehospital standards, mainly in the nonathletic population. Further study is also necessary in the realm of AED placement, maintenance, and training of staff.

Chi-Square Distribution↗

A Survey of Team Physicians on the Participation Status of Hemophilic Athletes in National Collegiate Athletic Association Division I Athletics.

OBJECTIVE: To determine if team physicians would allow individuals with hemophilia A to participate in National Collegiate Athletic Association Division I athletics and what factors influence their decisions. An additional purpose was to determine if individuals with hemophilia A are presently participating in Division I athletics. DESIGN AND SETTING: The data were collected with a mail survey designed by the researchers. SUBJECTS: 66 Division I team physicians. MEASUREMENTS: The questions in the survey were considered important in understanding the history of team physicians with hemophilic athletes, the self-established standard that team physicians would follow in the future with regard to athletic participation by hemophilic players, and the team physicians' reasoning for their standards. RESULTS: Of the 231 surveys sent, 72 were returned and 66 were analyzed. Sixteen hemophilic players were reported to have participated in Division I athletics. Several team physicians allowed hemophilic athletes to participate under many circumstances. As the severity of hemophilia A and risk of injury due to sport type (noncontact, contact, or collision) increased, the number of team physicians allowing participation decreased. Also, it was reported that hemophilic athletes were currently participating in sports. CONCLUSIONS: Athletes with hemophilia are currently participating in Division I athletics, but they have special needs regarding their conditions. Prevention and management plans have been devised to expedite the care of these athletes.

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Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes.

UNLABELLED: Participation in intensive sports activities leads to muscular specializations that may generate alterations in involved articular forces and cause static (posture) and dynamic changes (alterations of articular stability, coordination, etc.). Prevention of injury requires specific functional muscular evaluation in all athletes and for any kind of sport. OBJECTIVE: To dynamically evaluate, through isokinetic tests, the peak torque, total work, and average power of the knee flexor and extensor muscles of jumper and runner athletes and compare them to those of a non-athletic population, evaluating dominance and balance between agonistic and antagonistic muscle groups. RESULTS: In the non-athlete group, we noted a higher asymmetry between the dominant and nondominant members. The jumpers had the highest values of the evaluated parameters of all groups, whereas parameters for the runners were intermediate between non-athletes and jumpers.

Adolescent↗

Echocardiographic findings in endurance athletes with hypertrophic non-obstructive cardiomyopathy (HNCM) compared to non-athletes with HNCM and to physiological hypertrophy (athlete's heart).

Hypertrophic non-obstructive cardiomyopathy (HNCM) is one of the most frequent causes of sudden cardiac death in young athletes. Since the clinical findings in HNCM patients may be inconspicuous and the ECG changes found in endurance athletes may be similar to those of HNCM patients, echocardiography, as a non-invasive procedure, seems to take on an important role in differential diagnostics. To prove this hypothesis, conventional echocardiographic parameters were compared in three groups with confirmed diagnosis: Group I: HNCM (n = 9) without sports activity; Group II: HNCM (n = 9) with regular, intensive endurance training (3-5 hours/week). The diagnosis was invasively confirmed in both groups. Group III: healthy subjects (n = 9) with physiological hypertrophy and regular endurance training (3-6 hours/week). In the presence of HNCM, endurance sports activity appears to offset the reduction in the left ventricle and enlargement of the left atrium. The wall thickness of the septum and posterior wall do not differ in the two HNCM groups, but show a significant difference to the healthy athletes. The enddiastolic diameter, the absolute septum and posterior wall thickness and the ratio of septum+posterior wall/enddiastolic diameter can be taken as the most important differential diagnostic criterium in physiological hypertrophy, but not the ratio between septum/posterior wall. It is concluded that conventional echocardiographic examination can be considered a valuable non-invasive method for differentiating HNCM from athlete's heart, even in patients with HNCM who participate in endurance sports. However, a reliable diagnosis may not be possible in individual cases.

Adolescent↗

Over-the-counter drug use amongst athletes and non-athletes.

AIM: Many over-the-counter (OTC) drugs used in the symptomatic relief of upper respiratory tract (URT) conditions are banned by sports governing bodies. It would appear therefore that athletes are being penalised for practising conventional pharmacological methods in the management of common ailments. The aim was to identify any differences between athletes and non-athletes and amongst athletic groups, with respect to the prevalence of URT conditions and the use of OTC drugs to treat such conditions. METHODS: Questionnaires were distributed at domestic and international athletics meetings and at university lectures and tutorials. Respondents (n=401) represented both track and field athletes (n=199) and non-athletes (n=202). RESULTS: No differences were found between athletes and non-athletes and between elite and non-elite athletes in terms of the frequency of episodes of URT conditions reported in the previous year. A higher proportion of elite, as opposed to non-elite athletes did not take OTC medicines (p=0.028) and of those that did take OTC medicines a higher proportion of elite athletes (68%) as opposed to non-elite (32%) took those not containing sympathomimetics, banned by the International Olympic Committee (IOC). Athletes were found to have greater knowledge of IOC banned OTC drugs (p=0.002) and within this group, elite athletes were most knowledgeable (p=0.0003). Although most respondents (81%) believed that OTC drugs should not be prohibited in sport, athletes made up the greatest proportion in support of prohibition (23.5% as opposed to 14.4% of non-athletes) with elite as opposed to non-elite most in favour (p=0.0181). CONCLUSION: These results suggest that URT conditions are no more prevalent between athletes and non-athletes or between endurance and power athletes. Athletes competing at the highest level tended to avoid OTC medicines or those containing IOC banned drugs and were most knowledgeable in terms of banned OTC drugs and most in favour of their prohibition suggesting that the control mechanisms in place are only reaching elite athletes.

Adult↗

Athlete's heart in women. Echocardiographic characterization of highly trained elite female athletes.

UNLABELLED: OBJECTIVES; To define the expression of "athlete's heart" in women by determining the alterations in cardiac dimensions associated with long-term intense conditioning in elite female athletes. DESIGN; Prospective cardiovascular assessment conducted from 1986 through 1993. Subjects were evaluated using 2-dimensional, M-mode, and Doppler echo-cardiographic studies. SETTING: Institute of Sports Science, Italian National Olympic Committee, Rome, Italy. PARTICIPANTS: A total of 600 elite female athletes (mean age, 21 years; range, 12-49 years) who had participated in vigorous training (mean duration, 9 years; range, 2-32 years) and had competed in 27 sports, including 211 athletes at the international level and 389 at the national level. A control group consisted of 65 sedentary volunteer women (mean age, 23.7 years; range, 14-41 years) who were free of cardiovascular disease and who did not participate in regular athletic training. MAIN OUTCOME MEASURES: Left ventricular end-diastolic cavity dimension and wall thickness. RESULTS: Athletes demonstrated larger left ventricular end-diastolic cavity dimension (mean +/- SD) (49 +/- 4 mm) and greater maximal wall thickness (8.2 +/- 0.9 mm) than controls (46 +/- 3 mm and 7.2 +/- 0.6 mm; P < .001). These dimensions were 6% and 14% larger in athletes. Among athletes, left ventricular cavity dimension was 40 mm to 66 mm, exceeded normal limits ( > 54 mm) in 47 women (8%), and was within the range consistent with primary dilated cardiomyopathy ( > or = 60 mm) in 4 athletes (1%). Training for endurance sports, such as cycling, cross-country skiing, and rowing had the greatest effect on cavity dimension. Left ventricular wall thickness was 6 mm to 12 mm in athletes and did not exceed normal limits or extend into the borderline gray zone with hypertrophic cardiomyopathy in any subject. Compared with data from 738 previously studied male athletes, female athletes showed significantly smaller left ventricular cavity dimension (11% less; P < .001) and wall thickness (23% less; P < .001). CONCLUSIONS: Highly trained women athletes frequently demonstrate cardiac dimensional changes as an adaptation to physical training, although absolute left ventricular cavity size exceeding normal limits was evident in a minority (8%) of women athletes and was rarely (1% of athletes) within the range of dilated cardiomyopathy. Athletic training was not a stimulus for substantial increases in absolute left ventricular wall thickness, which was within normal limits for all women athletes. These findings suggest that the clinical differentiation of athlete's heart and hypertrophic cardiomyopathy appears to be a diagnostic dilemma that is limited to male athletes.

Adolescent↗

Low bone mineral density is two to three times more prevalent in non-athletic premenopausal women than in elite athletes: a comprehensive controlled study.

OBJECTIVE: To compare bone mineral density (BMD), investigate factors associated with BMD, and examine the prevalence of low BMD in athletes and non-athletic controls. METHODS: The study included a questionnaire (part I), measurement of BMD (part II), and a clinical interview (part III). All Norwegian female athletes on national teams (n = 938) and an aged matched random sample of non-athletic controls (n = 900) were invited to participate. The questionnaire was completed by 88% of athletes and 70% of controls. A random sample of these athletes (n = 300) and controls (n = 300) was invited to participate in parts II and III. All parts were completed by 186 athletes (62%) and 145 controls (48%). RESULTS: Mean (standard deviation) total body (TB) BMD was higher (p<0.001) in athletes (1.21 (0.09) g/cm2) than in controls (1.18 (0.08) g/cm2), and higher (p<0.001) in high impact (HI) sports athletes than in medium impact (MI) and low impact (LI) sports athletes. In athletes, body weight and impact loading sports were positively associated, and percent body fat and eating disorders were negatively associated with TB BMD. Body weight and weight bearing activities were positively associated and menstrual dysfunction was negatively associated with TB BMD in controls. A higher percentage of controls (28.3%) than athletes (10.7%) had low BMD (p<0.001). CONCLUSION: Female elite athletes have 3-20% higher BMD than non-athletic controls and HI sports athletes have 3-22% higher BMD compared with MI and LI sports athletes. Low BMD is two to three times more common in non-athletic premenopausal women than in elite athletes.

Adolescent↗

Collegiate Student-Athletes' Satisfaction With Athletic Trainers.

Context: In today's sport settings, the athletic trainer is often the first member or the health care team with whom the athlete interacts. Delivery of patient care can be improved by increasing patient/athlete satisfaction.Objective: To evaluate the satisfaction collegiate student-athletes had with their athletic trainer(s) and the athletic training services provided at their institutions.Design: A survey format was solicited to 40 randomly selected National Collegiate Athletic Association Division I and II athletic training programs in 4 regions across the United States.Setting: Collegiate athletic training environment.Patients or Other Participants: A total of 325 student-athletes from 20 of the programs solicited agreed to participate.Main Outcome Measure(s): The questionnaire was a variation on a previously used instrument developed for assessing athletes' perceptions of care. Validity and reliability analyses supported use of the instrument. A linear regression model was calculated to determine predictors of satisfaction score.Results: Significant differences in satisfaction scores were observed between athletes in high- and low-profile sports and between male and female athletes. When sex and sport profile were combined, differences in scores were noted between female athletes in high-profile sports and males in low-profile sports. Both sex and sport profile were predictors of satisfaction among the student-athletes who participated in the study.Conclusions: Female athletes and athletes in high-profile sports demonstrated greater satisfaction with their athletic trainer(s). Competitive level did not have a significant influence on satisfaction.

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A survey of athletic trainers as health care advocates for testicular and breast self-examination in athletic populations.

There have been no previous studies of athletic trainers' educational practices regarding breast or testicular cancer, so we surveyed athletic trainers regarding: 1) the incidence of cancer among athletes, 2) educational practices concerning breast/testicular cancer, 3) educational practices regarding breast/testicular self-examination, 4) breast/testicular concerns of athletes, 5) breast self-examination and testicular self-examination among athletic trainers. A researcher-developed questionnaire was randomly distributed to athletic trainers at the 1994 NATA convention, and SPSS-X was used to analyze results, using Chi-square. One alarming finding was that 28% of athletic trainers surveyed had worked with an athlete who had cancer. Twenty-two percent of the athletic trainers surveyed reported that a female athlete had brought a breast concern to them, and 51% reported that a male athlete had brought a testicular concern to them. Most of the athletic trainers surveyed do not educate athletes about breast or testicular cancer and do not teach athletes about self-examination procedures, but do perform breast self-examination or testicular self-examination on themselves. Acting as a role model is an important step toward the education of athletes in our care, but more must be done. As health care professionals, athletic trainers must become more proactive, rather than reactive, when dealing with cancer prevention.

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Knowledge and Attitudes of Certified Athletic Trainers in Pennsylvania Toward HIV/AIDS and Treating HIV-Positive Athletes.

OBJECTIVE: As the number of people infected with the Human Immunodeficiency Virus (HIV) continues to increase so does the likelihood that athletic trainers will treat HIV-positive athletes. The purposes of this study were to determine how knowledgeable certified athletic trainers in Pennsylvania are about HIV/ AIDS and their attitudes toward treating the injuries of HIV- positive/AIDS athletes. Another purpose of this study was to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. DESIGN AND SETTING: A questionnaire was mailed to 807 NATA-certified athletic trainers who resided in the state of Pennsylvania. A total of 410 (50.8%) athletic trainers participated in the study: 241 (58.8%) males and 169 (41.2%) females. SUBJECTS: NATA-certified athletic trainers who resided in the state of Pennsylvania as of March 19, 1994. MEASUREMENTS: A questionnaire was developed by the investigators after reviewing the appropriate literature and in consultation with a panel of experts that consisted of athletic trainers, physicians, and a health educator who specialized in HIV/AIDS education. The questionnaire consisted of three sections: demographic information, HIV/AIDS knowledge, and HIV/AIDS attitude. Returned questionnaires were analyzed via descriptive (frequencies, percentages, and means) and inferential statistics. Univariate analysis consisted of independent t tests to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. RESULTS: NATA-certified athletic trainers in Pennsylvania are moderately knowledgeable about HIV/AIDS and have constructive attitudes in treating the athletic injuries of HIV-positive/ AIDS athletes. Their major concern, however, is fear of HIV transmission. It was further determined that differences in HIV/AIDS attitudes had no effect on HIV/ AIDS knowledge level. CONCLUSIONS: The likelihood that athletic trainers will treat HIV-positive athletes is ever increasing. HIV/AIDS education and appropriate clinical precautions are paramount in protecting the clinician and athlete alike.

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The female athlete triad: are elite athletes at increased risk?

PURPOSE: The aim of this study was to examine the percentage of elite athletes and controls at risk of the female athlete triad. METHODS: A detailed questionnaire, which included questions regarding training and/or physical activity patterns, menstrual history, oral contraceptive use, weight history, eating patterns, dietary history, and the Body Dissatisfaction (BD) and Drive for Thinness (DT) subscales of the Eating Disorder Inventory (EDI), was prepared. The questionnaire was administered to the total population of female elite athletes in Norway representing the national teams at the junior or senior level, 13-39 yr of age (N = 938) and non-athlete controls in the same age group (N = 900). After exclusion, a total of 669 athletes (88%) and 607 controls (70%) completed the questionnaire satisfactorily. RESULTS: A higher percentage of controls (69.2%) than athletes (60.4%) was classified as being at risk of the Triad (P < 0.01). A higher percentage of controls than athletes reported use of pathogenic weight-control methods and had high BD subscale scores (P < 0.001). However, more athletes reported menstrual dysfunction and stress fractures compared with controls (P < 0.05). A higher percentage of both athletes competing in leanness sports (70.1%) and the non-athlete control group (69.2%) was classified as being at risk of the Triad compared with athletes competing in non-leanness sports (55.3%) (P < 0.001). Furthermore, a higher percentage of athletes competing in aesthetic sports (66.4%) than ball game sports (52.6%) was classified as being at risk of the Triad (P < 0.001). CONCLUSIONS: More athletes competing in leanness sports and more non-athlete controls were classified as being at risk of the Triad compared with athletes competing in non-leanness sports.

Adolescent↗

Collegiate Athletic Trainers' Confidence in Helping Female Athletes With Eating Disorders.

OBJECTIVE: To examine college athletic trainers' confidence in helping female athletes who have eating disorders. DESIGN AND SETTING: We mailed a 4-page, 53-item survey to head certified athletic trainers at all National Collegiate Athletic Association Division IA and IAA institutions (N = 236). A 2- wave mailing design was used to increase response rate. SUBJECTS: A total of 171 athletic trainers returned completed surveys for a response rate of 77%. Eleven institutions either did not identify their head athletic trainer or did not have an identifiable mailing address. Two surveys were undeliverable because of incorrect mailing addresses. MEASUREMENTS: The survey consisted of 4 subscales: (1) efficacy expectation, (2) outcome expectation, (3) outcome value, and (4) experience in dealing with eating disorders. Content validity was established by review from a national panel of experts. Reliability ranged from.66 to.73 for the subscales. RESULTS: Although virtually all athletic trainers (91%) had dealt with a female athlete with an eating disorder, only 1 in 4 (27%) felt confident identifying a female athlete with an eating disorder, and only 1 in 3 (38%) felt confident asking an athlete if she had an eating disorder. One in 4 athletic trainers (25%) worked at an institution that did not have a policy on handling eating disorders. Almost all athletic trainers (93%) felt that increased attention needs to be paid to preventing eating disorders among collegiate female athletes. CONCLUSIONS: Collegiate athletic programs are encouraged to develop and implement eating-disorder policies. Continuing education on the prevention of eating disorders among athletes is also strongly recommended.

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The role of athletic trainers in counseling collegiate athletes.

OBJECTIVE: To assess athletic trainers' perceptions with regard to (a) their role in counseling athletes, (b) how qualified they felt to address counseling issues, and (c) current training room procedures for providing psychological services to athletes. DESIGN AND SETTING: A 47-item, open-ended survey was administered to Division I certified athletic trainers who volunteered to participate. SUBJECTS: Fourteen Division I certified athletic trainers (mean age, 33 yr; range, 24 to 47 yr) volunteered to participate in the survey. They included five head athletic trainers, five assistant athletic trainers, three graduate assistants, and one associate director of athletics and sports medicine. MEASUREMENTS: Survey results were tabulated and reported in percentages. RESULTS: Athletic trainers felt that their roles went beyond the care and prevention of athletic injuries, yet they did not necessarily feel qualified to counsel athletes. Most athletic trainers were familiar with on-campus student support services to which student athletes with personal issues could be referred for assistance, but none had access to a sport psychologist. CONCLUSIONS: It is recommended that the NATA include counseling preparation in curriculums and that continuing education be offered to provide certified athletic trainers with current information and skills for delivering psychological services to athletes.

Journal Article↗

Physiologic limits of left ventricular hypertrophy in elite junior athletes: relevance to differential diagnosis of athlete's heart and hypertrophic cardiomyopathy.

OBJECTIVES: The present study was undertaken to define physiologic limits of left ventricular hypertrophy in elite adolescent athletes. BACKGROUND: Systematic sports training may cause increased left ventricular wall thickness (LVWT), creating uncertainty regarding the differential diagnosis of athlete's heart from hypertrophic cardiomyopathy (HCM). This distinction is crucial because HCM is responsible for about one-third of all sudden deaths in young athletes. Echocardiographic data defining athlete's heart are limited largely to adults, with little information specifically in adolescent athletes (14 to 18 years old), for whom the risk of sudden death from HCM is highest. METHODS: Seven hundred and twenty elite adolescent athletes (75% male) aged 15.7 +/- 1.4 years participating in ball, racket, and endurance sports and 250 healthy sedentary controls of similar age, gender, and body surface area underwent echocardiography. RESULTS: Compared with controls, athletes had greater absolute LVWT (9.5 +/- 1.7 mm vs. 8.4 +/- 1.4 mm; p < 0.0001). Maximal LVWT exceeded predicted upper limits in 38 athletes (5%); however, no female athlete had a LVWT >11 mm and only three trained male athletes had absolute LVWT >12 mm (0.4%). Each of the 38 athletes with a LVWT exceeding predicted limits also showed enlarged left ventricular cavity dimension (54.4 +/- 2.1 mm; range 52 to 60 mm). CONCLUSIONS: Trained adolescent athletes demonstrated greater absolute LVWT compared with nonathletes. Only a small proportion of athletes exhibited a LVWT exceeding upper limits, very rarely >12 mm, and then always with chamber enlargement. Hypertrophic cardiomyopathy should be considered strongly in any trained adolescent male athlete with LVWT >12 mm (females >11 mm) and nondilated left ventricle.

Adolescent↗