Performance in all forms of motor activity related to sport performance improves progressively during the course of the childhood years as a consequence of normal growth and development. Whether (a) sport training can accelerate and ultimately enhance this biological development and (b) the existence of certain ages when training might prove to be more effective in improving performance, particularly early in childhood, remains uncertain. Physiological adaptations to endurance training in prepubertal children (improvements in maximal oxygen uptake) are dampened compared with adults, but enhancements of strength following resistance training are equally effective at all ages. The extent that intensive training regimens characteristic of early sport specialization in children can trigger physiological and performance adaptations may therefore depend on the form of exercise involved. Clearly, additional research is needed to enhance the understanding of the physiological responses to intensive sport training in prepubertal individuals.
Physiological Aspects of Early Specialized Athletic Training in Children
Thomas W. Rowland
A Skill Acquisition Perspective on Early Specialization in Sport
David I. Anderson and Anthony M. Mayo
This paper examines the costs and benefits of early specialization in sport from a skill acquisition perspective. The focus is on whether early specialization in a single sport is the best way to facilitate the acquisition of skill in that sport. The paper is organized relative to the two major conceptual frameworks that have motivated much of the discussion about early specialization in sport: the theory of deliberate practice and the Developmental Model of Sport Participation. Our analysis reveals that while early specialization in sport is one way to reach elite status, it is not the only way. Considerable evidence shows that many elite athletes specialized in their sport late, following diversified experiences with other sports. These findings raise a number of exciting questions about the long-term development of skill in sport.
Social Psychological and Developmental Perspectives on Early Sport Specialization
Thelma S. Horn
One of the primary dilemmas surrounding the topic of early sport specialization is whether the practice develops talent or creates long-term psychological problems. The purpose of this paper is to discuss this issue using psychosocial and developmental frameworks. This review begins with an overview of several developmentallybased constructs (e.g., biological maturation, perceived competence, body image, self-identity, motivational orientation) that are relevant to the sport domain. These developmental progressions are then used to address some potential implications for children who begin intensive training and competition at an early age. Next, some socioenvironmental factors are explored, with specific links made to the early sport specialization process. Finally, the paper ends with four recommendations for future research on the topic.
Clinical Management of Sport-Related Concussion: Developing a Roadmap to a Successful Outcome
Kevin Guskiewicz and Elizabeth Teel
In order to promote the most successful outcomes following concussion, a multifaceted team of individuals is required for appropriate injury diagnosis and management. This review explores the primary roles of sports medicine personnel in the concussion diagnosis and management process. We will discuss the psychometric properties, including sensitivity, specificity, and clinical utility, of on-field/sideline, laboratory, and neurophysiological assessment tools. Additionally, we will discuss the roles of other kinesiology experts in concussion management and recovery, and their importance to concussion research. By developing a thorough and consistent roadmap for concussion management, clinicians and researchers will be capable of providing athletes with the most successful outcomes.
Concussion in Sport: Conceptual and Ethical Issues
Michael J. McNamee, Bradley Partridge, and Lynley Anderson
The issue of concussion in sport is a matter of global public interest that is currently under dispute by educational, legal, and medical professionals and scientists. In this article we discuss the problem from philosophical, bioethical, and sports ethical perspectives. We articulate conceptual differences in approaches to definition and therefore diagnosis of concussion. We critically review similarities and differences in the leading consensus statements that guide the treatment of concussion diagnosis and treatment in sports. We then present a series of ethical problems including issues that relate to paternalistic intervention in the lives of athletes in order to prevent harm to athletes, conflicting and competing interests, and confidentiality.
Determining the Appropriate Model for Concussion Health Care in the College or University Setting
Charles R. Thompson
The incidence of concussions and potential for long-term health effects has captured the attention of the media, general public, medical professionals, parents, and obviously the athletes themselves. Concussions have been blamed for a variety of mental and physical health issues. The athletic trainer is at the forefront of the concussion management team, as they are typically on the scene when the concussion occurs and are often the first medical personnel to evaluate and, hopefully, remove the athlete from activity. There has been controversy of late regarding the influence of coaches in the care of concussed athletes. Therefore, a move to the “medical model” of sports medicine management can go a long way in resolving conflict of interest issues regarding the care of concussed athletes. A comprehensive concussion team and protocol are also essential to providing the highest level of care. This article takes a closer look at concussion management in the collegiate arena, with a particular focus on Princeton University.
In the article by Whitall, J., “Physical Activity Alone May Enhance Health But it May Not Reduce Disability in Chronic Stroke Survivors,” in Kinesiology Review, 4(1), pp. 3–10, http://dx.doi.org/10.1123/kr.2014-0072, the affiliation listed for the author was incomplete. In addition to the Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, Jill Whitall is affiliated with the Faculty of Health Sciences, University of Southampton, Southampton, England. The online version of the article has been corrected.
Introduction to the Special Issue: Concussion Management in Sport
Maureen R. Weiss
A Pediatric Perspective on Sport-Related Concussion
Tamara C. Valovich McLeod, Megan N. Houston, and Cailee E. Welch
Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.
Psychology of Sport Concussions
Diane M. Wiese-Bjornstal, Andrew C. White, Hayley C. Russell, and Aynsley M. Smith
The psychology of sport concussions consists of psychological, psychiatric, and psychosocial factors that contribute to sport concussion risks, consequences, and outcomes. The purpose of this paper is to present a sport concussion-adapted version of the integrated model of psychological response to sport injury and rehabilitation (Wiese-Bjornstal, Smith, Shaffer, & Morrey, 1998) as a framework for understanding the roles of psychological, psychiatric, and psychosocial factors in sport concussions. Elements of this model include preinjury psychological risk factors, postinjury psychological response and rehabilitation processes, and postinjury psychological care components. Mapped onto each element of this model are findings from the research literature through a narrative review process. An important caveat is that the subjective nature of concussion diagnoses presents limitations in these findings. Future research should examine psychological contributors to concussion risk, influences of physical factors on psychological symptoms and responses, and efficacy of psychological treatments utilizing theory-driven approaches.