An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.
Lorin A. Cartwright and Timothy Neal
Andreas Kuettel, Natalie Durand-Bush, and Carsten H. Larsen
The purpose of this study was (a) to investigate gender differences in mental health among Danish youth soccer players, (b) to discover the mental health profiles of the players, and (c) to explore how career progression and mental health are related. A total of 239 Danish youth elite soccer players (M = 16.85, SD = 1.09) completed an online questionnaire assessing mental well-being, depression, anxiety, along with other background variables. Female players scored significantly lower on mental well-being and had four times higher odds of expressing symptoms of anxiety and depression than males. Athletes’ mental health profiles showed that most athletes experience low depression while having moderate mental well-being. Depression, anxiety, and stress scores generally increased when progressing in age, indicating that the junior–senior transition poses distinct challenges to players’ mental health, especially for female players. Different strategies to foster players’ mental health depending on their mental health profiles are proposed.
Eleftherios Paraskevopoulos, Georgios Gioftsos, Georgios Georgoudis, and Maria Papandreou
Adherence to exercise rehabilitation has been shown to be an important factor that may influence successful treatment. In professional athletes, a significant reduction in exercise adherence delays recovery. The aim of this study was to explore barriers to and facilitators of exercise rehabilitation adherence in injured volleyball athletes. Eight professional volleyball athletes were recruited, and qualitative data were collected using semistructured interviews. All athletes had completed their rehabilitation program after they had suffered a musculoskeletal injury. All data were analyzed using thematic analysis after the investigators ensured that saturation had been reached. Pain was identified as a significant barrier to exercise adherence by all athletes. The provision of social support, including mental, practical, and task related, also had a significant positive impact. The athletes’ ability to develop the necessary coping strategies and confidence on performing exercises at home was also mentioned as a factor that affected exercise adherence, although less often.
Sara Oliveira, Marina Cunha, António Rosado, and Cláudia Ferreira
This study aimed to test a model that hypothesized that the compassionate coach, as perceived by the athletes, has an impact on athlete-related social safeness and psychological health, through shame and self-criticism. The sample comprised 270 Portuguese adult athletes, who practiced different competitive sports. The path analysis results confirmed the adequacy of the proposed model, which explained 45% of the psychological health’s variance. Results demonstrated that athletes who perceive their coaches as more compassionate tend to present higher levels of social safeness (feelings of belonging to the team) and of psychological health, through lower levels of shame and self-criticism. These novel findings suggest the importance of the adoption of supportive, warm, safe, and compassionate attitudes from coaches in athletes’ mental health. This study also offers important insights by suggesting that feelings of acceptance and connectedness in team relationships may be at the root of athletes’ emotional processes and well-being.
Sandra K. Hnat, Musa L. Audu, Ronald J. Triolo, and Roger D. Quinn
Estimating center of mass (COM) through sensor measurements is done to maintain walking and standing stability with exoskeletons. The authors present a method for estimating COM kinematics through an artificial neural network, which was trained by minimizing the mean squared error between COM displacements measured by a gold-standard motion capture system and recorded acceleration signals from body-mounted accelerometers. A total of 5 able-bodied participants were destabilized during standing through: (1) unexpected perturbations caused by 4 linear actuators pulling on the waist and (2) volitionally moving weighted jars on a shelf. Each movement type was averaged across all participants. The algorithm’s performance was quantified by the root mean square error and coefficient of determination (R 2) calculated from both the entire trial and during each perturbation type. Throughout the trials and movement types, the average coefficient of determination was 0.83, with 89% of the movements with R 2 > .70, while the average root mean square error ranged between 7.3% and 22.0%, corresponding to 0.5- and 0.94-cm error in both the coronal and sagittal planes. COM can be estimated in real time for balance control of exoskeletons for individuals with a spinal cord injury, and the procedure can be generalized for other gait studies.
Matthew Zaremba, Joel Martin, and Marcie Fyock-Martin
Clinical Scenario: Knee pathologies often require rehabilitation to address the loss of knee-extensor (KE) strength, function, and heightened pain. However, in the early stages of rehabilitation, higher loads may be contraindicated. Blood flow restriction (BFR) resistance training does not require high loads and has been used clinically to promote strength improvements in a variety of injured populations. BFR resistance training may be an effective alternative to high-intensity resistance training during early rehabilitation of knee pathologies. Clinical Question: Following a knee injury, does BFR resistance training improve KE strength and function, and reduce patient-reported pain? Summary of Key Findings: Four randomized controlled trial studies met the inclusion criteria. Each included study evaluated the use of BFR resistance training on knee pathologies and the effects on KE strength, functional outcomes, and pain compared with high- or low-load resistance training. All 4 studies reported significant improvements in KE strength, function, and pain through a variety of outcome measures, following BFR resistance training use as the treatment. Clinical Bottom Line: There is consistent evidence to support the use of BFR resistance training as a treatment intervention following knee injury and as a means to improve KE strength and function and to reduce pain. Strength of Recommendation: Grade A evidence supporting the use of BFR resistance training for improvement in KE strength and function, and the reduction of patient-reported pain following an acute or chronic knee pathology.
Michal Vágner, Zdeněk Bílek, Karel Sýkora, Vladimír Michalička, Lubomír Přívětivý, Miloš Fiala, Adam Maszczyk, and Petr Stastny
The aim of this study was to find the effect of holographic sight (HS) on short-distance shooting accuracy and precision during static and high-intensity dynamic actions. Twenty policemen (31 ± 2.2 years, 85.6 ± 6.1 kg, and 181.9 ± 4.4 cm) performed five shots in the 10-s limit under the static condition for 20 m and dynamic condition 15–5 m, and after 4 × 10 m sprint action, both with fixed sight (FS) and HS. The analysis of variance post hoc test revealed that HSstatic had higher shouting accuracy than FSstatic, FSdynamic, and HSdynamic (p = .03, p = .0001, and p = .0001, respectively) and FSdynamic had lower precision than FSstatic, HSstatic, and HSdynamic (p = .0003, p = .0001, and p = .01, respectively) in vertical sway. The HS for rifles has improved the accuracy of static shooting and vertical sway precision of dynamic shooting.
Julie R. Steele
Lisa Chaba, Stéphanie Scoffier-Mériaux, Fabienne d’Arripe-Longueville, and Vanessa Lentillon-Kaestner
This article focuses on two popular sports that can put male athletes at risk of developing an eating disorder: bodybuilding and running. Bodybuilders concentrate on gaining muscle mass and runners on leaning body mass. Based on the trans-contextual model of motivation, this study aimed to better understand the psychological mechanisms underlying eating disorders in these athletes. In all, 272 male bodybuilders and 217 male runners completed measures of sport motivation, theory of planned behavior variables (i.e., attitude, subjective norm, perceived behavioral control, and intention to gain muscle mass/lean body mass), and eating disorders (dieting, control, and bulimia behaviors). The results revealed satisfactory fit indices for both samples. Autonomous and controlled motivations for sport were positively directly and indirectly related to eating disorders in these athletes. This motivational mechanism needs more in-depth investigation, and motivational profiles might help distinguish athletes with and without eating disorders.
Melanie A. Mason, Anne C. Russ, Ryan T. Tierney, and Jamie L. Mansell
Context: Exercise can cause fluctuations in blood glucose control in type 1 diabetics. For athletes with type 1 diabetes, maintenance of blood glucose within an ideal range may be difficult.Objective: To determine, in individuals with type 1 diabetes, the effectiveness of the closed loop control system versus the open loop control system in keeping blood glucose levels in the ideal range with exercise. Data Sources: A search of PubMed was conducted in June of 2020 using the Boolean phrases: (closed loop control system OR artificial pancreas) AND type 1 diabetes AND exercise AND ideal range AND adolescents, artificial pancreas AND glucose prediction AND exercise. Study Selection : Titles were reviewed for relevance, the abstract was then assessed for applicability, and finally the full text was examined. Articles were included that examined the percent of time in the ideal blood glucose range when exercise occurred during that day. Articles were excluded that didn’t compare the closed loop and open loop control systems and articles that did not involve exercise. Data Extraction : The PEDro scale was used to determine the methodological quality of the included studies. The measure addressed was the percent of time in the ideal blood glucose range of 70-180 mg/dL. 95% Confidence Intervals and Cohen’s D were calculated for each article. Data Synthesis : The search yielded 268 articles and 3 were selected for inclusion. The two randomized controlled trials scored 9/10 on the PEDro scale and the randomized two-arm crossover clinical trial scored 9/10 on the PEDro scale. Percent time spent in the ideal blood glucose range when exercise was performed was significantly higher in the closed loop group versus the open loop group in each of the three studies. In one randomized control trial, mean time in the ideal range was 71.3% (SD = 17.6, 95% CI = 62.5, 80.10) in the closed loop group versus 64.7% (SD = 13.3, 95% CI = 58.1–71.4) in the open loop group. Cohen’s D was 0.4. In the second randomized control trial, mean time in the ideal range was 73.5% (SD = 8.4, 95% CI = 70.1, 76.9) for the closed loop group versus 50% (SD = 26.8, 95% CI = 39.1, 60.9). Cohen’s D was 1.2. The two-arm crossover clinical trial resulted in a mean time in target range of 84.1% (SD = 11.5, 95% CI = 79.0, 89.2) in the closed loop group versus 68.7% (SD = 13.9, 95% CI = 62.5, 74.9) in the open loop group. Cohen’s D was 1.2. Conclusions : For adolescents with type 1 diabetes who exercise, the closed loop control system maintains blood glucose levels in the ideal range for a longer percent of time versus an open loop system. Each patient should be evaluated on a case-by-case basis with his/her healthcare team. Future research should examine the closed loop control system on specific energy systems.