The effects of carbohydrate (CHO) supplementation on muscle glycogen and resistance exercise performance were examined with eight highly resistance trained males (mean +/- SEM, age: 24.3 +/- 1.1 years, height: 171.9 +/- 2.0 cm, body mass: 85.7 +/- 3.5 kg; experience 9.9 +/- 2.0 years). Subjects participated in a randomized, double blind protocol with testing sessions separated by 7 days. Testing consisted of an initial isokinetic leg exercise before and after an isotonic resistance exercise (IRT) session consisting of 3 leg exercises lasting approximately 39 min. Subjects consumed a CHO (1.0 g CHO.kg body mass(-1)) or placebo treatment (PLC), prior to and every 10-min (0.5 g CHO.kg body mass(-1)) during the IRT. Muscle tissue was obtained from the m vastus lateralis after a supine rest (REST) immediately after the initial isokinetic test (POST-ISO) and immediately after the IRT (POST-IRT). The CHO treatment elicited significantly less muscle glycogen degradation from the POST-ISO to POST-IRT (126.9 +/- 6.5 to 109.7 +/- 7.1 mmol.kg wet weight(-1)) compared to PLC (121.4 +/- 8.1 to 88.3 +/- 6. 0 mmol.kg wet weight(-1)). There were no differences in isokinetic performance between the treatments. The results of this investigation indicate that the consumption of a CHO beverage can attenuate the decrease in muscle glycogen associated with isotonic resistance exercise but does not enhance the performance of isokinetic leg exercise.

No abstract

These preliminary data suggest that Division 1 white male endurance running athletes are at risk of LBI with higher relative TUB and lower BMI in combination with a lower leg BMD.

Background Initial protocols for return to play cardiac testing in young competitive athletes following SARS‐CoV‐2 infection recommended cardiac troponin (cTn) to screen for cardiac involvement. This study aimed to define the diagnostic yield of cTn in athletes undergoing cardiovascular testing following SARS‐CoV‐2 infection. Methods and Results This prospective, observational cohort study from ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) included collegiate athletes who underwent cTn testing as a component of return to play protocols following SARS‐CoV‐2 infection. The cTn values were stratified as undetectable, detectable but within normal limits, and abnormal (>99% percentile). The presence of probable or definite SARS‐CoV‐2 myocardial involvement was compared between those with normal versus abnormal cTn levels. A total of 3184/3685 (86%) athletes in the ORCCA database met the inclusion criteria for this study (age 20±1 years, 32% female athletes, 28% Black race). The median time from SARS‐CoV‐2 diagnosis to cTn testing was 13 days (interquartile range, 11, 18 days). The cTn levels were undetectable in 2942 athletes (92%), detectable but within normal limits in 210 athletes (7%), and abnormal in 32 athletes (1%). Of the 32 athletes with abnormal cTn testing, 19/32 (59%) underwent cardiac magnetic resonance imaging, 30/32 (94%) underwent transthoracic echocardiography, and 1/32 (3%) did not have cardiac imaging. One athlete with abnormal troponin met the criteria for definite or probable SARS‐CoV‐2 myocardial involvement. In the total cohort, 21/3184 (0.7%) had SARS‐CoV‐2 myocardial involvement, among whom 20/21 (95%) had normal troponin testing. Conclusions Abnormal cTn during routine return to play cardiac screening among competitive athletes following SARS‐CoV‐2 infection appears to have limited diagnostic utility.

Background: Lower limb bone stress injury (BSI) of the pelvis, femur, and tibia is prevalent in collegiate track and field distance runners. Bone mineral density (BMD), body composition (BComp), and anthropometric parameters before initial collegiate injury have not been compared between runners with BSI and their noninjured counterparts. Purpose: To characterize bone health in relation to BComp and anthropometric measurements from total-body dual x-ray absorptiometry (DXA) scans in collegiate male and female distance runners before BSI and develop BMD prediction models. Study Design: Case-control study; Level of evidence, 3. Methods: Distance runners (N = 79) from a single university track and field team were retrospectively enrolled into this study. The runners completed a DXA scan during the fall season (August-November) and participated in sport activities before the scan. Three months after scanning, electronic medical records were reviewed for the occurrence of BSI. An independent-sample t test was used to compare BMD (total and regional [spine, pelvis, and legs]), BComp (% body fat, fat mass, and lean mass), and anthropometric measurements (shoulder width and leg, arm, and trunk length) between runners with versus without BSI (included subgroup analysis by sex). Multiple linear regression with stepwise removal was used to determine variables most predictive of BMD. Results: Of the 79 enrolled participants (42 male, 37 female), 18 runners (22.8%; 11 female, 7 male) sustained a lower limb BSI. Compared with the noninjured group, injured runners had lower total and regional BMD ( P < .001 for all) and shorter leg and arm lengths ( P < .05 for both), whereas injured male runners had lower fat mass and injured female runners had lower lean mass in the legs ( P < .05 for both). Injured runners’ age-matched total BMD Z score (-0.1 ± 0.6) was considered clinically normal. BComp and anthropometric measures were predictive of total and regional BMD ( P < .05; R 2 = 0.64-0.80; percentage error = 3.8%-4.8%). Conclusion: The DXA scans of injured runners prior to incidence indicated lower BMD compared with noninjured runners. Shorter limb lengths, lower fat mass (male), and lower leg lean mass (female) may also be indicative of risk. Certain BComp and anthropometric measures were predictive of BMD.

No abstract

Cryptogenic stroke is a form of cerebral vascular accident that has an unknown origin and is rarely associated with patent foramen ovale (PFO) and migraine headaches. This is an uncommon occurrence in young, healthy, active adults, and it is increasingly rare for the episode to occur during an athletic competition. Stroke is easily recognizable with its distinct signs and symptoms, but it is also easily confused with many of its differential diagnoses, such as seizures or head trauma, if the episode occurs during an athletic competition. This case report describes the stroke episode, incidence of migraine headaches, diagnostic testing, and surgical management of a college female volleyball athlete who suffered a cryptogenic stroke associated with PFO during an athletic competition. Diagnostic testing included magnetic resonance imaging with contrast, electroencephalograph, lower extremity Doppler testing, and a transesophageal echocardiograph with agitated saline study. Surgical correction of the PFO included a cardiac catheterization percutaneous procedure based on fluoroscopic and echocardiograph imaging. After release from physicians, the athlete returned to full participation in the sport of volleyball, where she competed for the next 2 years without complications. The patient has reported no symptoms from stroke or PFO closure procedure in 3 years, and migraine headaches have decreased in severity, frequency, and duration.

Objectives: Lower limb bone stress injuries (BSI) of the pelvis, femur, and tibia are prevalent in collegiate track & field distance runners. However, it is not known the population’s bone, body composition (BComp), and anthropometric parameters prior to first respective collegiate injury compared to non-injured counterpart. This respective injury has been reported to require an extended timeframe for recovery as well as increases the risk, prospectively, for sustaining another similar injury. Extrinsic factors such as greater running frequency, mileage, pace, and change in terrain is known to influence risk which, during a competitive season, commonly occurs in collegiate runners. Intrinsic risk factors related to bone health and body composition of the runner have also been identified as important factors that further influence risk indicating proper screening of these respective intrinsic factors are necessary and recommended in order to better identify risk and prompt further evaluation. In light of previous observations and a clinical need in this unique population, the purpose of this study was to characterize bone mineral density, body composition, and skeletal dimensions assessed vai dual energy x-ray absorpitometry (DXA) in collegiate male and female distance runners prior to lower limb BSI status (i.e. injured or non-injured) during a competitive season as well as provide indices of risk specific DXA assessment. We hypothesized that 1) collegiate distance runners with a lower limb BSI will exhibit lower BMD relative to runners without injury; 2) total and regional body composition (i.e. fat and lean) as well as skeletal dimension differences will be observed between respective BSI status groups thus, allowing for identification of potential threshold cutoffs for this population; 3) measures of body composition and skeletal dimensions could be used to develop prediction models for regional and total BMD that may be utilized in the abscence of DXA for those with out readily available access. Methods: This was a retrospective case-control study design that was conducted at a University athletic training facility during the fall (August-November) 2013-2019 cross country seasons. Study measurements included a total body (TB) DXA scan, weight (kg), height (cm), and body mass index (BMI; kg/m2). The inclusion scan for the study participants with a lower limb BSI was the scan before first respective injury of collegiate career while study participants with no injury during collegiate career had their last scan of eligible fall season included. This study included male and female distance running athletes who were members of a NCAA D1A collegiate track and field team at a single University. Inclusion criteria included participation in sport-related activity prior to and after DXA scan for three months as well as only scans prior to first collegiate lower limb BSI. Exclusion criteria included any bone-related injury or recovery from such injury at time of DXA scan that prohibited prospective sport-related activities as well as scans prior to reoccurring lower limb BSI. Enrolled runners completed a DXA scan (August-November) and participated in sport activities before scan. Three months following scan, electronic medical records were reviewed to determine whether or not a BSI occurred. Independent samples t-test was used to compare BMD, BComp, and anthropometric measures between BSI vs non-injured (included subgroup analysis by sex). Multiple linear regression with stepwise removal was used to determine measures most predictive of BMD. Significance was set at p<0.05. Results: Demographics are shown in Table 1. Figure 1 shows athlete BMD characteristics among athletes (i.e. all, males, and females) with or without lower limb BSI. Overall, those in the NoBSI group had significantly higher BMD values for total, spine, pelvis, and legs (p<0.001). In males, the NoBSI group had significantly higher total, pelvis, and leg BMD (p<0.05) while no difference was observed in spine BMD compared to BSI group. Within females, the NoBSI group had significantly higher BMD in all respective measures compared to BSI group (p<0.001). Regression analysis revealed BComp and anthropometric measures were predictive of total bone mass [BM = (0.046 x age, yrs) + (0.024 x weight, kg) + (0.014 x %Fat) + (-0.017 x ARML) + (0.017 x SHWIDTH) + (-0.009 x TRNKL) + (0.037 x LL)]; P<0.05, R2 = 0.61 g/cm2, percent error = 11.01). In addition to predicted BM, as shown in Figure 2, other BComp and anthropometric measures [age, height, weight, BMI, FM, %Fat, BM, LL, SHWIDTH, TRNKL, and ARML) were predictive of total and regional BMD (P<0.05, R2 = 0.64-0.80 g/cm2, %error = 3.8-4.8). A physiologic comparison of those with and without long bone BSIs is shown in Table 2. No differences were found between BSI and NoBSI group demographics (i.e. height, weight, age, and BMI) in all athletes including males and females. BComp values in males found FM to be significantly lower in BSI compared to NoBSI while women leg LM in BSI group was significantly lower than NoBSI. Among all athletes, the BSI group had significantly shorter arm and leg limb lengths as well as a lower leg/trunk ratio compared to NoBSI group. Conclusions: Lower limb bone stress injuries are common in collegiate distance runners wherby total and regional BMD measures tend to be lower compared to runners who were not injured. Shorter limb lengths, lower fat mass (male), and lower leg lean mass (female) may also be indicative of BSI risk in this population. Interestingly, BComp and anthropometric measures are highly predictive of BMD in this sport population. These metrics may serve as sport-specific benchmarks for lower limb BSI risk and the equations developed here may be suitable for BMD screening in collegiate distance runners without readily availalbe access to DXA. [Figure: see text][Figure: see text][Table: see text][Table: see text]