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Item Analgesic Management of Pain in Elite Athletes: A Systematic Review(Wolters Kluwer, 2018-09) Harle, Christopher A.; Danielson, Elizabeth C.; Derman, Wayne; Stuart, Mark; Dvorak, Jiri; Smith, Lisa; Hainline, Brian; Health Policy and Management, School of Public HealthObjective: To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes. Design: Systematic literature review. Data Sources: Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus. Eligibility Criteria for Selecting Studies: Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded. Main Results: Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared. Conclusions: Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.Item Effect of Low Dose of Amphetamine on Thermoregulation System and Performance of Rats Running on Treadmills(Office of the Vice Chancellor for Research, 2015-04-17) Behrouzvaziri, Abolhassan; Molkov, Yaroslav; Morozova, Ekaterina; Yoo, Yeonjoo; Zaretskaia, Maria; Zaretsky, DmitryAmphetamine has been used widely as a performance-enhancing drug among athletes. There are numerous reports showing that low dose of amphetamine increases one’s performance by suppressing sensations of fatigues. However, a little has been known about the mechanism by which such an effect of amphetamine is caused. The goal of this study was to investigate how a low dose of amphetamine changed the duration and the capacity of running in rats by studying thermoregulation system of rats running on treadmills with experimental results and a mathematical model. 12 rats were separated into two groups of 6 and rats in the experimental group were injected with 2mg/kg of amphetamine and ones in the control group were injected with saline. Then each rat in both groups ran on a treadmill at the room temperature (25°) while the speed and the incline of the treadmill were increased stepwise in every 3 minutes. The running time of individual rats were determined by their ability of keeping up with the intensity of running and the core body temperatures and the oxygen consumptions ()of rats were recorded during the experiments. Then a mathematical model was constructed to describe rates of temperature changes in the core and muscles by quantifying the heat dissipations and heat productions using . Modeling revealed that amphetamine increases the heat dissipation in the core body, which slowed down the core temperature increase. Therefore rats injected with amphetamine were kept their core temperatures below approximately 40 °C for longer time, at which both groups were unable to run anymore. Additionally, the fact that the core temperature at the end of run was not significantly different between two groups, while muscle temperature was significantly different, suggests that the indicator of running capacity was the core temperature, rather than the muscle temperature. Finally, the level of overheating in muscles for the amphetamine group was severe enough to cause damages in muscles.Item The Impact of an Adapted Dance Fitness Program on Sport Performance Outcomes(2021-04-16) Callahan, Renee; Albright, Megan; Department of Occupational Therapy, School of Health and Human Sciences; Graber, ItzelThe capstone project investigated the effects of a virtual adapted dance fitness program, called DanceFloor Fitness, of the Special Olympics Indiana athletes’ sports performance outcomes. This program was developed and implemented based on the need of having supplemental cardiovascular training that was inclusive, client-centered, and accessible for the Special Olympics Indiana athletes, in order to improve leisure participation and increase social participation. The participants consisted of athletes, or county coordinators, affiliated with Special Olympics Indiana and participated at their own leisure. Participants completed 12 weeks of DanceFloor Fitness classes, held two days a week for 60 minutes each, and reported their fitness progress and program satisfaction via midpoint and pre/post surveys that collected qualitative outcome measurements. Overall, the majority of the athletes reported that DanceFloor Fitness classes helped them become better at their sport(s) and improved their muscular strength, mood, dance skills, communication with teammates, and the ability to make friends. Given the program’s virtual platform, unique curriculum, and specialized population, more research is needed to better understand the impact of an adapted dance fitness program on individuals of all ages, genders, and abilities.Item International Criteria for Electrocardiographic Interpretation in Athletes(Elsevier, 2017-02) Sharma, Sanjay; Drezner, Jonathan A.; Baggish, Aaron; Papadakis, Michael; Wilson, Mathew G.; Prutkin, Jordan M.; La Gerche, Andre; Ackerman, Michael J.; Borjesson, Mats; Salerno, Jack C.; Asif, Irfan M.; Owens, David S.; Chung, Eugene H.; Emery, Michael S.; Froelicher, Victor F.; Heidbuchel, Hein; Adamuz, Carmen; Asplund, Chad A.; Cohen, Gordon; Harmon, Kimberly G.; Marek, Joseph C.; Molossi, Silvana; Niebauer, Josef; Pelto, Hank F.; Perez, Marco V.; Riding, Nathan R.; Saarel, Tess; Schmied, Christian M.; Shipon, David M.; Stein, Ricardo; Vetter, Victoria L.; Pelliccia, Antonio; Corrado, Domenico; Medicine, School of MedicineSudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly over the last decade; pushed by a growing body of scientific data that both tests proposed criteria sets and establishes new evidence to guide refinements. On February 26-27, 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington, to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.Item Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection: Results From the Big Ten COVID-19 Cardiac Registry(AMA, 2021-05-27) Daniels, Curt J.; Rajpal, Saurabh; Greenshields, Joel T.; Rosenthal, Geoffrey L.; Chung, Eugene H.; Terrin, Michael; Jeudy, Jean; Mattson, Scott E.; Law, Ian H.; Borchers, James; Kovacs, Richard; Kovan, Jeffrey; Rifat, Sami F.; Albrecht, Jennifer; Bento, Ana I.; Albers, Lonnie; Bernhardt, David; Day, Carly; Hecht, Suzanne; Hipskind, Andrew; Mjaanes, Jeffrey; Olson, David; Rooks, Yvette L.; Somers, Emily C.; Tong, Matthew S.; Wisinski, Jeffrey; Womack, Jason; Esopenko, Carrie; Kratochvil, Christopher J.; Rink, Lawrence D.; Medicine, School of MedicineImportance: Myocarditis is a leading cause of sudden death in competitive athletes. Myocardial inflammation is known to occur with SARS-CoV-2. Different screening approaches for detection of myocarditis have been reported. The Big Ten Conference requires comprehensive cardiac testing including cardiac magnetic resonance (CMR) imaging for all athletes with COVID-19, allowing comparison of screening approaches. Objective: To determine the prevalence of myocarditis in athletes with COVID-19 and compare screening strategies for safe return to play. Design, Setting, and Participants: Big Ten COVID-19 Cardiac Registry principal investigators were surveyed for aggregate observational data from March 1, 2020, through December 15, 2020, on athletes with COVID-19. For athletes with myocarditis, presence of cardiac symptoms and details of cardiac testing were recorded. Myocarditis was categorized as clinical or subclinical based on the presence of cardiac symptoms and CMR findings. Subclinical myocarditis classified as probable or possible myocarditis based on other testing abnormalities. Myocarditis prevalence across universities was determined. The utility of different screening strategies was evaluated. Exposures: SARS-CoV-2 by polymerase chain reaction testing. Main Outcome and Measure: Myocarditis via cardiovascular diagnostic testing. Results: Representing 13 universities, cardiovascular testing was performed in 1597 athletes (964 men [60.4%]). Thirty-seven (including 27 men) were diagnosed with COVID-19 myocarditis (overall 2.3%; range per program, 0%-7.6%); 9 had clinical myocarditis and 28 had subclinical myocarditis. If cardiac testing was based on cardiac symptoms alone, only 5 athletes would have been detected (detected prevalence, 0.31%). Cardiac magnetic resonance imaging for all athletes yielded a 7.4-fold increase in detection of myocarditis (clinical and subclinical). Follow-up CMR imaging performed in 27 (73.0%) demonstrated resolution of T2 elevation in all (100%) and late gadolinium enhancement in 11 (40.7%). Conclusions and Relevance: In this cohort study of 1597 US competitive athletes with CMR screening after COVID-19 infection, 37 athletes (2.3%) were diagnosed with clinical and subclinical myocarditis. Variability was observed in prevalence across universities, and testing protocols were closely tied to the detection of myocarditis. Variable ascertainment and unknown implications of CMR findings underscore the need for standardized timing and interpretation of cardiac testing. These unique CMR imaging data provide a more complete understanding of the prevalence of clinical and subclinical myocarditis in college athletes after COVID-19 infection. The role of CMR in routine screening for athletes safe return to play should be explored further.