The FMS has excellent interrater and intrarater reliability. Participants with composite scores of ≤14 had a significantly higher likelihood of an injury compared with those with higher scores, demonstrating the injury predictive value of the test. Significant concerns remain regarding the validity of the FMS.
Background: Early, accurate diagnosis of mild traumatic brain injury (mTBI) can improve clinical outcomes for patients, but mTBI remains difficult to This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Background:
Pediatric sports specialization, defined as intense year-round training in a single sport as a result of excluding other sports for more than 8 months per year, is common in the United States. There are demonstrated physical and social risks to early pediatric sports specialization (defined as before age 12 years). While thought to be needed to acquire appropriate experience and excel in a given sport, there remains little information on when athletes at the highest levels of their sport specialized. This study aimed to define when professional and collegiate ice hockey players specialized.
Hypothesis:
Early sports specialization before age 12 years will not be common among elite-level (professional and collegiate) ice hockey players.
Study Design:
Retrospective cross-sectional survey study.
Level of Evidence:
Level 3.
Methods:
Male professional and collegiate ice hockey players within 1 National Hockey League organization and 2 National Collegiate Athletic Association (NCAA) organizations who were 18 years of age or older completed a survey at training camp detailing their history of sports participation and specialization.
Results:
A total of 91 athletes participated in the study (mean age, 22.8 years; range, 18-39 years). The mean age at the start of any sports participation was 4.5 years, and the mean age of sports specialization was 14.3 years. The mean age of specialization in the professional group, the NCAA Division I group, and the NCAA Division III group was 14.1, 14.5, and 14.6 years, respectively.
Conclusion:
Early pediatric sports specialization is not common in elite-level (professional and collegiate) ice hockey players.
Clinical Relevance:
Early pediatric sports specialization before age 12 years is not necessary for athletic success in professional and collegiate ice hockey. This study provides further evidence supporting the recommendations of the American Medical Society for Sports Medicine, American Academy of Pediatrics, and American Orthopaedic Society for Sports Medicine against early sports specialization.
Objective
The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance.
Methods
RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively.
Results
An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89).
Conclusions
ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.
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