It was not too long ago that many people referred to concussion as a “hidden injury” and a “complex injury for which we still had much to learn.” We still have a lot to learn about these injuries, but because of the advancement of concussion research we are better informed today than we were just a decade ago. Much of this work began in the early to mid-1990s with studies aimed at equipping clinicians with better concussion-assessment tools. We needed to remove the guesswork, so more systematic and objective concussion-assessment batteries (sideline and clinic) that included symptom checklists, cognitive tests, and balance assessments were developed and validated. As a result, it became easier to detect and/or rule out concussions and to track recovery for several days postinjury. From 2009 through 2014, all 50 states and the District of Columbia passed concussion legislation requiring concussion education for high school and youth athletes, among other things. This was a critical period in which more emphasis was placed on concussion prevention, ultimately leading to increased reporting of these injuries and a reduction in the number of unreported and undiagnosed concussions. More recently, the corpus of science has evolved to identify potential blood and neuroimaging biomarkers to complement the traditional-clinical assessment tools, and newer studies are focused on treatment after concussion—challenging the notions that “rest is best” and that the effects of concussion are permanent and immutable. The research is ongoing, and several large multisite studies will yield important findings to help guide clinical decision making in the next few years.
Kevin M. Guskiewicz and Samuel R. Walton
Margaret C. Morrissey, Michael R. Szymanski, Andrew J. Grundstein, and Douglas J. Casa
Intense exercise in extreme heat can increase the risk of developing exertional heat stroke (EHS). EHS is 100% survivable with appropriate care, and it is imperative that health care professionals recognize predisposing factors that may increase susceptibility to EHS. Understanding risk factors for EHS will enable clinicians to create effective prevention strategies to improve exercise heat tolerance and mitigate EHS risk. This review addresses new perspectives on risk factors for EHS that focus on hydration, heat acclimatization, medical conditions, climate change and policies, medications, and strength and conditioning sessions.
Bradley D. Hatfield, Calvin M. Lu, and Jo B. Zimmerman
Mark S. Dyreson
Since the origins of Homo sapiens 300,000 years ago, the quest to optimize human performance has shaped historical development. A macrohistorical perspective reveals that for 290,000 years the necessities of survival pushed hunter-forager cultures toward mass improvement of endurance capabilities and weapons skills. The agricultural revolution that began about 10,000 years ago changed those dynamics, focusing on enhancement for elite warriors while simultaneously diminishing the necessity of mass optimization. The multiple revolutions of modernity that began 500 years ago reanimated mass optimization while paradoxically removing physical enhancement from the realm of necessity through the increasing power of human-made motors rather than human locomotion. Microhistorical perspectives reveal that beyond the general patterns that shaped human cultures across time and place, the historical particularities vastly complicated optimization strategies. Employing macro- and microhistorical perspectives can enhance scientific understandings of optimal performance.
Sandra J. Shultz and Randy J. Schmitz
Despite considerable advances in anterior cruciate ligament (ACL) injury-risk identification and prevention over the past 20 years, the annual incidence of ACL injury has continued to rise, and females remain at greater risk of both primary and secondary ACL injury. Important questions remain regarding ancillary risk factors we should target, the most effective training and rehabilitation approaches to ensure retention and transfer of learned skills from the rehabilitation setting to real-world sporting environment, and the development of more evidence-based criteria for return to sport that consider the whole athlete. As we look to the future, the optimization of primary and secondary ACL-injury prevention represents a complex, multidisciplinary problem with many unique and exciting opportunities to engage the various subdisciplines of kinesiology to address these emerging questions.
This paper identifies several factors that lie within and external to the teaching act that have an impact on the quality of instruction that students can potentially receive, which in turn has implications for the extent to which students can engage in appropriate practice. These factors all exist on a continuum from limiting to enhancing, and we could hypothesize that they regulate the possibilities for practice that are afforded to students and that this practice time is considered in the development of competent movers in physical education. These factors are contextual, such as time, class size, and teaching resources; curricular, relating to the content and pedagogy of physical education; and instructional, such as teacher effectiveness and content knowledge.
Sport analytics promises to use Big Data and sophisticated statistical methods to identify effective strategies in sports—“the Moneyball moment.” However, much like alchemy, sport analytics is characterized by opacity and secrecy, and outside of baseball, evidence of success that would meet the usual scientific criteria is limited. An example is used to demonstrate that quite simple models can match more complex ones in terms of prediction. Like alchemy, sport analytics can deliver important advances in our understanding, but some problems need to be addressed. These include the need to incorporate theory, reconciling the pursuit of profit with scientific principles, and focusing on prediction as a measure of progress.
Richard B. Kreider
Strength, conditioning, and nutrition play an important role in preparing athletes to perform to the best of their ability. For this reason, nearly all competitive teams employ strength and conditioning specialists to prepare their athletes for competition, and most teams have sport dietitians and/or nutrition consultants as part of their performance-enhancement team. Academic and professional preparation of strength and conditioning and sport-nutrition specialists in kinesiology programs has opened up a number of career opportunities for students and scholars. In addition, advances in technology have enhanced the ability of strength and conditioning specialists and sport nutritionists to monitor athletes during training and competition. This paper provides an overview of the history, professional preparation, program components, and general principals of strength and conditioning and sport nutrition and the impact they have had on high-level performance, as well as future trends in these fields.