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Trisha Patel and Neeru Jayanthi

Single sport specialization has been associated with injury risk and burnout. However, there is no known previous qualitative research regarding health-related quality of life (HRQoL) of single sport and multi-sport young athletes and their parents. In order to better understand the perceptions of these potential risks of youth sports specialization, a qualitative parent-child study of specialized young athletes was performed. Thirty-six families (50 young athletes and 42 parents) participated in this study by completing an interview about their sports participation. Twenty-seven of these families completed the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire, assessing quality of life. Health-Related Quality of Life (HRQoL) scores were high in all young athlete and parent categories with no significant differences (p = .96) in quality of life between single (specialized) and multi-sport young athletes and their respective parents (p = .17). Qualitative analysis of interviews highlighted the positive perception of sports and parents’ concern regarding sports specialization. Thus, although no quality of life differences were found based on sport specialization, the highly positive quality of life scores suggest a benefit of sports despite specialization.

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Kim D. Barber Foss, Alexis B. Slutsky-Ganesh, Jed A. Diekfuss, Dustin R. Grooms, Janet E. Simon, Daniel K. Schneider, Neeru Jayanthi, Joseph D. Lamplot, Destin Hill, Mathew Pombo, Philip Wong, David A. Reiter, and Gregory D. Myer

Context: The etiology of patellofemoral pain has remained elusive, potentially due to an incomplete understanding of how pain, motor control, and kinesiophobia disrupt central nervous system functioning. Objective: To directly evaluate brain activity during experimental knee pain and its relationship to kinesiophobia in patients with patellofemoral pain. Design: Cross-sectional. Methods: Young females clinically diagnosed with patellofemoral pain (n = 14; 14.4 [3.3] y; body mass index = 22.4 [3.8]; height = 1.61 [0.1] m; body mass = 58.4 [12.7] kg). A modified Clarke test (experimental pain condition with noxious induction via patella pressure and quadriceps contraction) was administered to the nondominant knee (to minimize limb dominance confounds) of patients during brain functional magnetic resonance imaging (fMRI) acquisition. Patients also completed a quadriceps contraction without application of external pressure (control contraction). Kinesiophobia was measured using the Tampa Scale of Kinesiophobia. The fMRI analyses assessed brain activation during the modified Clarke test and control contraction and assessed relationships between task-induced brain activity and kinesiophobia. Standard processing for neuroimaging and appropriate cluster-wise statistical thresholds to determine significance were applied to the fMRI data (z > 3.1, P < .05). Results: The fMRI revealed widespread neural activation in the frontal, parietal, and occipital lobes, and cerebellum during the modified Clarke test (all zs > 4.4, all Ps < .04), whereas neural activation was localized primarily to frontal and cerebellar regions during the control contraction test (all zs > 4.4, all Ps < .01). Greater kinesiophobia was positively associated with greater activity in the cerebello-frontal network for the modified Clarke test (all zs > 5.0, all Ps < .01), but no relationships between kinesiophobia and brain activity were observed for the control contraction test (all zs < 3.1, all Ps > .05). Conclusions: Our novel experimental knee pain condition was associated with alterations in central nociceptive processing. These findings may provide novel complementary pathways for targeted restoration of patient function.

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Christopher D. Riehm, Scott Bonnette, Michael A. Riley, Jed A. Diekfuss, Christopher A. DiCesare, Andrew Schille, Adam W. Kiefer, Neeru A. Jayanthi, Stephanie Kliethermes, Rhodri S. Lloyd, Mathew W. Pombo, and Gregory D. Myer

Background: Young athletes who specialize early in a single sport may subsequently be at increased risk of injury. While heightened injury risk has been theorized to be related to volume or length of exposure to a single sport, the development of unhealthy, homogenous movement patterns, and rigid neuromuscular control strategies may also be indicted. Unfortunately, traditional laboratory assessments have limited capability to expose such deficits due to the simplistic and constrained nature of laboratory measurement techniques and analyses. Methods: To overcome limitations of prior studies, the authors proposed a soccer-specific virtual reality header assessment to characterize the generalized movement regularity of 44 young female athletes relative to their degree of sport specialization (high vs low). Participants also completed a traditional drop vertical jump assessment. Results: During the virtual reality header assessment, significant differences in center of gravity sample entropy (a measure of movement regularity) were present between specialized (center of gravity sample entropy: mean = 0.08, SD = 0.02) and nonspecialized center of gravity sample entropy: mean = 0.10, SD = 0.03) groups. Specifically, specialized athletes exhibited more regular movement patterns during the soccer header than the nonspecialized athletes. However, no significant between-group differences were observed when comparing participants’ center of gravity time series data from the drop vertical jump assessment. Conclusions: This pattern of altered movement strategy indicates that realistic, sport-specific virtual reality assessments may be uniquely beneficial in exposing overly rigid movement patterns of individuals who engage in repeated sport specialized practice.