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Ralph A. Vernacchia, James R. Reardon and David R. Templin

This study presents the case of a male university basketball player who died of a heart attack caused by an abnormal heart rhythm (Wolff-Parkinson-White syndrome) and describes the various emotional stages his teammates and coaches experienced during the days and months following this tragic incident. The team’s emotional responses to their teammates’ sudden death were categorized into several stages: shock, confusion, and denial; performance resolve; realization of loss; glorification and memorialization; closure and relief; avoidance and debriefing; reentry and acceptance. A modified critical incident stress debriefing process was used by educational and clinical sport psychologists who collaborated to manage and provide care-giving services to team members and coaches.

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Clemens von Schacky, Maximilian Kemper, Robert Haslbauer and Martin Halle

The Omega-3 Index is defined as erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and represents an individual’s status in these two marine omega-3 fatty acids. A target range of 8 to 11% has been suggested, because values below predispose to cardiovascular events, especially sudden cardiac death, as well as to suboptimal brain function, like prolonged reaction times or even depression. Compared with the general population, elite athletes have an increased incidence of sudden death. The Omega-3 Index has not yet been investigated in elite athletes. In an exploratory approach, we determined the Omega-3 Index in 106 consecutive German national elite winter endurance athletes presenting for preparticipation screening, using a well-established analytical procedure (HS-Omega-3 Index). Surprisingly, only one athlete had a value within the target range, but all others had values <8%. We conclude that we have identified a deficiency of EPA and DHA in these elite athletes. This deficiency presents a potential option for prevention of cardiovascular events such as sudden cardiac death, and improving aspects of brain function. It will be important to scrutinize our finding by more thorough epidemiologic studies and appropriate intervention trials.

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Vinicius Coneglian Santos, Adriana Cristina Levada-Pires, Sâmia Rocha Alves, Tânia Cristina Pithon-Curi, Rui Curi and Maria Fernanda Cury-Boaventura

Purpose:

To investigate the effects of docosahexaenoic-(DHA)-rich fish oil (FO) supplementation on lymphocyte function before and after a marathon race.

Methods:

Twenty-one athletes participated in this study. Eight marathon runners were supplemented with 3 g of FO daily for 60 d (FO group), and 13 athletes were not supplemented (C group). The following measures of lymphocytes were taken before and after the marathon: cell proliferation, cytokine production (IL-2, IL-10, TNF-α, and IL-4), and signs of cell death.

Results:

In the C group, the marathon had no effect on lymphocyte proliferation, DNA fragmentation, or mitochondrial membrane polarization; however, the marathon increased phosphatidylserine externalization (by 2.5-fold), induced a loss of plasma membrane integrity (by 20%), and decreased IL-2, TNF-α, and IL-10 production (by 55%, 95%, and 50%, respectively). FO supplementation did not prevent lymphocyte death induced by the marathon, as indicated by cell viability, DNA fragmentation, and phosphatidylserine externalization. However, FO supplementation increased lymphocyte proliferation before and after the marathon, and before the race, FO supplementation decreased IL-2, TNF-α, and IL-10 production in concanavalin-A-stimulated lymphocytes (by 55%, 95%, and 58%, respectively) compared with cells from the C group. The production of cytokines was not altered before or after the race in the FO group.

Conclusions:

DHA-rich FO supplementation increased lymphocyte proliferation and prevented a decrease in cytokine production, but it did not prevent lymphocyte death induced by participation in the marathon. Overall, DHA rich-FO supplementation has beneficial effects in preventing some of the changes in lymphocyte function induced by marathon participation.

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Jonatan R. Ruiz, Carmen Fiuza-Luces, Nuria Garatachea and Alejandro Lucia

For centuries, the general consensus has been that vigorous, competitive exercise was harmful and shortened life expectancy. Recent data from prospective cohort studies conducted on marathon runners, professional cyclists, and Olympic athletes indicate, however, that regular intense endurance-exercise training has protective benefits against cardiovascular disease and premature death. There are still important questions to be answered, such as what is the optimal dose, in terms of both duration and intensity of training or competition, beyond which the health benefits of regular exercise stabilize or might even potentially disappear.

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Bradford Strand, Shannon David, Katie J. Lyman and Jay M. Albrecht

The purpose of this original research was to survey high school coaches in four states in the Midwest region of the United States regarding their knowledge of first aid, cardiopulmonary resuscitation (CPR), and use of an Automated External Defibrillator (AED) as well as confidence in managing/treating emergency situations. Responses to general knowledge inquiries revealed that coaches were able to accurately answer questions related to return to play, level of consciousness, external bleeding, and cardiac arrest. However, coaches were unable to correctly answer questions specific to rest, ice, compression, and elevation (RICE) and also misidentified information related to pediatric AED use. Because sudden cardiac death is the leading cause of death and has been linked to lack of bystander intervention, the results of this project should be considered by coaches and administrators to implement certification and continuing education for high school coaches. Finally, coaches who were certified in first aid, CPR, and AED were more confident in treating an individual who required care compared with coaches not certified. Therefore, individuals who coach at all levels of sport and recreational activities should consider formal training and certification.

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Nicholas L. Holt, Homan Lee, Youngoh Kim and Kyra Klein

The overall purpose of this study was to examine individuals’ experiences of running an ultramarathon. Following pilot work data were collected with six people who entered the 2012 Canadian Death Race. Participants were interviewed before the race, took photographs and made video recordings during the race, wrote a summary of their experience, and attended a focus group after the race. The research team also interviewed participants during the race. Before the race participants had mixed emotions. During the race they experienced numerous stressors (i.e., cramping and injuries, gastrointestinal problems, and thoughts about quitting). They used coping strategies such as making small goals, engaging in a mental/physical battle, monitoring pace, nutrition, and hydration, and social support. After the race, nonfinishers experienced dejection or acceptance whereas finishers commented on the race as a major life experience. These findings provide some insights into factors involved in attempting to complete ultramarathons and offer some implications for applied sport psychology.

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Lenny D. Wiersma

Extreme sport athletes perform in environments that are characterized by danger, unpredictability, and fear, and the consequences of a mistake include severe injury or death. Maverick’s is a big-wave surfing location in northern California that is known for its cold water temperatures, dangerous ocean wildlife, deep reef, and other navigational hazards. The purpose of this study was to use a phenomenological framework to understand the psychology of big-wave surfing at Maverick’s. Seven elite big-wave surfers completed in-depth phenomenological interviews and discussed the psychology related to various stages of big-wave surfing, including presurf, in the lineup, catching the wave, riding the wave, wiping out, and postsurf. Big-wave surfers described a variety of experiences associated with surfing at Maverick’s and discussed several ways that they coped with its challenges. The results provide a greater understanding of the psychology of participating in an extreme environment.

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Ray Tricker, David L. Cook and Rick McGuire

In recent years drug abuse by college athletes has received greater attention. Because of the recognition of the growing problem of drug use in athletics, the new NCAA drug testing policy, and recent deaths of elite athletes, the sport psychologist should be prepared to deal with this issue. In many college settings the sport psychologist may be expected to provide support with counseling or participate in the development of a drug abuse prevention program for student athletes. Therefore sport psychologists need to closely examine the factors that may predispose athletes toward using drugs, understand the role of prevention, and develop a thorough knowledge of positive, viable alternatives to drugs. This article addresses five important issues that relate to drug abuse in college athletics: (a) why athletes are at risk, (b) athletic leadership and its relationship to substance abuse, (c) the role of the sport psychologist, (d) issues related to the effectiveness of drug education for athletes, and (e) recommendations for athlete drug education programs.

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Shane Bilsborough and Neil Mann

Considerable debate has taken place over the safety and validity of increased protein intakes for both weight control and muscle synthesis. The advice to consume diets high in protein by some health professionals, media and popular diet books is given despite a lack of scientific data on the safety of increasing protein consumption. The key issues are the rate at which the gastrointestinal tract can absorb amino acids from dietary proteins (1.3 to 10 g/h) and the liver’s capacity to deaminate proteins and produce urea for excretion of excess nitrogen. The accepted level of protein requirement of 0.8g · kg−1 · d−1 is based on structural requirements and ignores the use of protein for energy metabolism. High protein diets on the other hand advocate excessive levels of protein intake on the order of 200 to 400 g/d, which can equate to levels of approximately 5 g · kg−1 · d−1, which may exceed the liver’s capacity to convert excess nitrogen to urea. Dangers of excessive protein, defined as when protein constitutes > 35% of total energy intake, include hyperaminoacidemia, hyperammonemia, hyperinsulinemia nausea, diarrhea, and even death (the “rabbit starvation syndrome”). The three different measures of defining protein intake, which should be viewed together are: absolute intake (g/d), intake related to body weight (g · kg−1 · d−1) and intake as a fraction of total energy (percent energy). A suggested maximum protein intake based on bodily needs, weight control evidence, and avoiding protein toxicity would be approximately of 25% of energy requirements at approximately 2 to 2.5 g · kg−1 · d−1, corresponding to 176 g protein per day for an 80 kg individual on a 12,000kJ/d diet. This is well below the theoretical maximum safe intake range for an 80 kg person (285 to 365 g/d).

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Kadhiresan R. Murugappan, Michael N. Cocchi, Somnath Bose, Sara E. Neves, Charles H. Cook, Todd Sarge, Shahzad Shaefi and Akiva Leibowitz

affected National Collegiate Athletic Association (NCAA) Division I football players, the risk of exertional death was 37 times higher than in athletes without sickle cell trait ( Harmon et al., 2012 ). The pathophysiologic mechanism remains unclear; however, increased sickling of erythrocytes occurring