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1.
Rev. bras. ortop ; 56(6): 813-818, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1357147

ABSTRACT

Abstract Recurrent stress fractures rarely affect the same athlete. We present the case of a female triathlete who suffered multiple stress fractures in both tibias, the right fibula, and the left femoral neck. Conservative treatment was instituted in all episodes, with rest, reduced training load, and physical therapy rehabilitation. The relative energy deficiency in sport syndrome, along with an eating disorder, training overload, and osteopenia, was identified as a risk factor. Although rare, multiple stress fractures can occur in female triathletes. These patients must be screened for risk factors associated with biomechanics, nutrition, and training to develop an effective prevention and treatment program.


Resumo Fraturas por estresse recorrentes num mesmo atleta são raras. Apresentamos o caso de uma triatleta que sofreu múltiplas fraturas por estresse na tíbia bilateral, na fíbula direita e no colo femoral esquerdo. O tratamento conservador foi instituído em todos os episódios, com repouso, redução da carga de treino e reabilitação fisioterápica. Foi identificada como fator de risco a síndrome da deficiência energética relativa no esporte, com distúrbio alimentar, sobrecarga de treino e osteopenia. Mesmo que seja raro, múltiplas fraturas por estresse podem ocorrer em mulheres triatletas, nas quais é importante avaliar os fatores de risco associados à biomecânica, nutrição e ao treinamento para arquitetar um programa de prevenção e tratamento efetivos.


Subject(s)
Humans , Female , Adult , Tibia/injuries , Fractures, Stress , Risk Factors , Physical Therapy Modalities , Lower Extremity , Female Athlete Triad Syndrome , Athletes
2.
Rev. bras. med. esporte ; 27(2): 184-188, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1280071

ABSTRACT

ABSTRACT Introduction: Low energy availability, amenorrhea and osteoporosis make up the Female Athlete Triad observed in physically active females and athletes. The Low Energy Availability in Females Questionnaire (LEAF-Q) was created with the purpose of identifying female athletes at risk for the Female Athlete Triad. Objective: To translate and culturally adapt the LEAF-Q for Brazilian Portuguese and validate it in a group of Brazilian athletes. Methods: The first stage of the study consisted of translation, cultural adaptation and content validation of the questionnaire in 20 athletes. In the second stage, for the test-retest reliability analysis and the construct validation, the final adapted version was applied in a sample of 127 athletes from various sports disciplines, 54 of whom responded to the questionnaire on a second occasion. For the test-retest reliability analysis, the intraclass correlation coefficient (ICC) was calculated and the paired t-test, McNemar's test and Bland-Altman plot were carried out. The construct validation modeled by known or contrasted groups was carried out by comparing the mean LEAF-Q scores of group 1 (athletes who practiced weight-sensitive sports) with those of group 2 (athletes who practiced team sports) using the Student's t test. Results: The Brazilian version of the LEAF-Q showed excellent test-retest reliability, with an ICC of 0.92. The construct validity by known or contrasted groups was confirmed after demonstrating that athletes who practiced weight-sensitive sports had a higher LEAF-Q mean score than athletes who practiced team sports (p≤0.05). Conclusion: The Brazilian version of the LEAF-Q is an important tool, which presented textual and cultural adequacy, proved to be reliable in terms of test-retest reliability, and presents evidence of validity to investigate the risk of the triad. Level of evidence II; Diagnostic Studies - Investigating a diagnostic instrument .


RESUMEN Introducción: La baja energía disponible, amenorrea y osteoporosis conforman la Tríada de la mujer deportista, y afecta a mujeres físicamente activas y atletas. El cuestionario Low Energy Availability in Females Questionnaire (LEAF-Q) fue creado con la finalidad de identificar a atletas del sexo femenino en riesgo de Tríada de la mujer deportista. Objetivo: Traducir y adaptar culturalmente al portugués de Brasil y validar el LEAF-Q en un grupo de atletas brasileñas. Métodos: La primera etapa del estudio consistió en traducción, adaptación cultural y validación de contenido del instrumento en 20 atletas. En la segunda etapa, para el análisis de la confiabilidad test-retest y validación de constructo, la versión final adaptada del cuestionario fue aplicada a una muestra de 127 atletas de diversas modalidades y, entre ellas, 54 respondieron el cuestionario en una segunda ocasión. Para el análisis de la confiabilidad test-retest fue calculado el coeficiente de correlación intraclase (ICC), así como la realización de los tests t pareado, de McNemar y del gráfico de Bland-Altman. La validación de constructo modelada por grupos conocidos o contrastados fue realizada a partir de la comparación de las puntuaciones promedio del LEAF-Q del grupo 1 (atletas de modalidades sensibles al peso) y del grupo 2 (atletas de deportes colectivos), empleando el test t de Student. Resultados: La versión brasileña de LEAF-Q presentó excelente confiabilidad de test-retest, con ICC de 0,92. La validez de constructo por grupos conocidos o contrastados fue confirmada al demostrar que atletas de modalidades sensibles al peso tienen puntuación promedio mayor en el LEAF-Q que atletas de deportes colectivos (p ≤ 0,05). Conclusión: La versión brasileña del LEAF-Q es una herramienta importante, que presentó adecuación textual y cultural, probó ser confiable, en términos de confiabilidad de test-retest, y presenta evidencias de validación para investigar el riesgo de tríada. Nivel de evidencia II; Estudios diagnósticos - Investigación de un instrumento diagnóstico .


RESUMO Introdução: A baixa energia disponível, amenorreia e osteoporose compõe a tríade da mulher atleta, e afeta mulheres fisicamente ativas e atletas. O questionário Low Energy Availability in Females Questionnaire (LEAF-Q) foi criado com a finalidade de identificar atletas do sexo feminino em risco de tríade da mulher atleta. Objetivo: Traduzir e adaptar culturalmente para o português do Brasil e validar o LEAF-Q em um grupo de atletas brasileiras. Métodos: A primeira etapa do estudo consistiu em tradução, adaptação cultural e validação de conteúdo do instrumento em 20 atletas. Na segunda etapa, para a análise da confiabilidade teste-reteste e validação de construto, a versão final adaptada do questionário foi aplicada em uma amostra de 127 atletas de diversas modalidades e, dentre elas, 54 responderam o questionário em uma segunda ocasião. Para a análise da confiabilidade teste-reteste, foi calculado o coeficiente de correlação intraclasse (ICC), assim como a realização dos testes t pareado, de McNemar e do gráfico de Bland-Altman. A validação de construto modelada por grupos conhecidos ou contrastados foi realizada a partir da comparação das pontuações médias do LEAF-Q do grupo 1 (atletas de modalidades sensíveis ao peso) e do grupo 2 (atletas de esportes coletivos), empregando o teste t de Student. Resultados: A versão brasileira do LEAF-Q apresentou excelente confiabilidade teste-reteste, com ICC de 0,92. A validade de construto por grupos conhecidos ou contrastados foi confirmada ao demonstrar que atletas de modalidades sensíveis ao peso têm pontuação média maior no LEAF-Q do que atletas de esportes coletivos (p ≤ 0,05). Conclusão: A versão brasileira do LEAF-Q é uma ferramenta importante, que apresentou adequação textual e cultural, provou ser confiável, em termos de confiabilidade teste-reteste e apresenta evidências de validação para investigar o risco de tríade. Nível de evidência II; Estudos diagnósticos - Investigação de um instrumento diagnóstico .


Subject(s)
Humans , Female , Cross-Cultural Comparison , Surveys and Questionnaires , Female Athlete Triad Syndrome/diagnosis , Translating , Brazil
3.
Rev. bras. ginecol. obstet ; 43(5): 395-402, May 2021. graf
Article in English | LILACS | ID: biblio-1288555

ABSTRACT

Abstract In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.


Resumo Emumaatleta saudável, oaporte calórico é suficientepara anecessidade energética esportiva e para as funções fisiológicas corporais, permitindo um equilíbrio entre disponibilidade energética (DE), metabolismo ósseo e função menstrual. Por outro lado, um desequilíbrio devido à baixa disponibilidade energética (BDE) por dieta restritiva, perturbações alimentares ou grandes períodos de gasto energético conduz a uma desregulação multissistêmica priorizando as funções essenciais do corpo. Este fenômeno, descrito inicialmente como tríade da mulher atleta e, atualmente, comodéfice energético relativo no esporte (RED-S, nasigla eminglês) tem como pilares a BDE, disfunção menstrual e alterações na densidade mineral óssea (DMO), estando presente em uma percentagem considerável de atletas de alta competição, com consequências nefastas para o seu futuro a curto, médio e longo prazo. A presente revisão foi realizada a partir da análise crítica das publicações mais recentes disponíveis e pretende proporcionar uma percepção global do tema RED-S. O objetivo é promover a aquisição de um conhecimento mais consolidado sobre uma temática subvalorizada, possibilitando a aquisição de estratégias preventivas, diagnóstico precoce e/ou tratamento adequado.


Subject(s)
Humans , Female , Energy Intake/physiology , Female Athlete Triad Syndrome/diagnosis , Female Athlete Triad Syndrome/prevention & control , Athletic Performance , Relative Energy Deficiency in Sport , Feeding and Eating Disorders/complications , Energy Metabolism/physiology , Athletes , Amenorrhea , Menstruation Disturbances/complications
4.
Femina ; 49(1): 39-43, 20210131. ilus
Article in Portuguese | LILACS | ID: biblio-1146939

ABSTRACT

"Tríade da mulher atleta" e "deficiência relativa de energia no esporte" são afecções comuns encontradas em esportistas. Tendo como fisiopatologia a disponibilidade energética negativa, essas síndromes têm impacto negativo na saúde das atletas. Apesar de serem frequentemente discutidas entre especialistas vinculados ao mundo desportivo, ainda são pouco conhecidas entre outras especialidades. Essa revisão da literatura foi proposta com o intuito de expor o problema ao ginecologista e obstetra, considerando esses profissionais importantes aliados na prevenção e diagnóstico precoce. Da mesma maneira, a intervenção terapêutica correta minimiza os diversos prejuízos à saúde e melhora o desempenho esportivo.(AU)


"Female athlete triad" and "relative energy deficiency in sport" are conditions relatively common among women participating in sports. Its pathophysiology based on negative energy availability, these syndromes have a negative impact on the athlete's health. Although they are frequently discussed among specialists linked to the sports all over the world, a little has been known among other physicians. This literature review was proposed in order to expose the problem to the gynecologist and obstetrician, considering these professionals as important allies in prevention and early diagnosis. In the same way, the correct therapeutic intervention allows to minimizes the numerous damages to athlete's health and to improve their sports performance.(AU)


Subject(s)
Humans , Female , Female Athlete Triad Syndrome/complications , Female Athlete Triad Syndrome/physiopathology , Female Athlete Triad Syndrome/prevention & control , Osteoporosis , Bone Diseases, Metabolic , Risk Factors , Sports Nutritional Sciences , Menstruation Disturbances
5.
Einstein (Säo Paulo) ; 12(4): 459-466, Oct-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732465

ABSTRACT

Objective To propose the inclusion of a gynecological investigation during the evaluation of athletes before competitions, using a specific instrument called the Pre-participation Gynecological Examination (PPGE). Methods The study assessed 148 athletes, mean age of 15.4±2.0 years, who engaged in eight different sports modalities, and who responded to a questionnaire named Pre-Participation Gynecological Examination (PPGE), to the International Consultation on Incontinence Questionnaire - Short Form (for urinary loss), and to the Eating Attitudes Test (for eating disorders). Results Fifty percent of the participants reported irregular menstrual intervals, 23.0% did not know about sexually transmitted diseases, and 72.4% denied having, at least, an annual gynecological appointment. The study identified 18.2% who had urinary loss, and 15% presented with an increased risk of eating disorders. Moreover, 89.9% were not familiar with the occurrence of urinary incontinence in athletes and did not know that they were susceptible to the female athlete triad. A total of 87.1% of them stated that would not mention these issues to their coaches even if this would improve their health or performance. Conclusion The Pre-Participation Gynecological Examination can be considered an easy-to-apply instrument that allowed the diagnosis of alterations often underestimated by the athletes themselves. After its application, the alterations were identified, and determined the athletes’ referral to appropriate evaluation and treatment. .


Objetivo Propor a inclusão da investigação ginecológica durante a avaliação pré-participação de mulheres praticantes de exercício físico, por meio de um instrumento específico, denominado Pre-Participation Gynecological Examination (PPGE). Métodos Foram avaliadas 148 atletas com média de idade de 15,4±2,0 anos, participantes de oito diferentes modalidades esportivas, que responderam ao Pre-Participation Gynecological Examination, ao International Consultation on Incontinence Questionnaire - Short Form (para avaliar perda urinária) e ao Eating Attitudes Test (para avaliar alterações alimentares). Resultados Cinquenta por cento das atletas referiram irregularidade menstrual, 23% desconheciam as doenças sexualmente transmissíveis e 72,4% negaram acompanhamento ginecológico, no mínimo, anual. Foram identificados 18,2% de mulheres com perda urinária e 15% de maior risco de alterações alimentares. Além disso, 89,9% desconheciam a existência de incontinência urinária em atletas ou o fato de estarem suscetíveis à tríade da mulher atleta. Entre elas, ainda, 87,1% afirmaram não se referirem a seus técnicos sobre as questões ginecológicas, mesmo que isso pudesse melhorar sua saúde e seu desempenho. Conclusão O questionário Pre-Participation Gynecological Examination mostrou-se um instrumento de fácil aplicabilidade e permitiu o diagnóstico de alterações por vezes não valorizadas pelas próprias atletas. Após a aplicação do questionário, as alterações puderam ser identificadas, determinando o encaminhamento ...


Subject(s)
Adolescent , Female , Humans , Athletes , Exercise/physiology , Gynecological Examination/methods , Health Knowledge, Attitudes, Practice , Sports/physiology , Athletic Performance , Female Athlete Triad Syndrome/diagnosis , Female Athlete Triad Syndrome/physiopathology , Menstrual Cycle/physiology , Surveys and Questionnaires/standards , Reproducibility of Results , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/psychology , Urinary Incontinence/diagnosis , Urinary Incontinence/physiopathology
6.
Kosin Medical Journal ; : 1-10, 2014.
Article in English | WPRIM | ID: wpr-124660

ABSTRACT

As female athletic participation has increased, the positive effects of exercise on health have become evident. However, with this growth in sports activity, a set of health problems unique to the female athlete has emerged. The female athlete triad and its components can occur in females of all ages in every sport. The Female Athlete Triad poses serious health risks, both short and long term, to the overall well-being of affected individuals. Sustained low energy availability can impair health, causing many medical complications within the skeletal, endocrine, cardiovascular, reproductive, and central nervous systems. With the surge of females participating in athletics within the past 10 to 15 years, it is both conceivable and likely that the prevalence of this syndrome will continue to grow. Therefore, it is imperative that appropriate screening and diagnostic measures are enacted by a multidisciplinary team of health care providers, counselors, teachers, and dieticians in order to provide the proper care to affected athletes. Initial awareness should take place within the educational confines of elementary and high schools. Screening for female athletes exhibiting risk factors for the triad should also take place at the time of sports physicals. If one component of the triad is identified, the clinician should take the time to effectively workup the other. Treatment for each component of the triad includes both pharmacological and nonpharmacological measures, with emphasis placed upon increased energy availability and overall improved nutritional health. Using this all-encompassing type of approach, sports medicine practitioners should feel empowered to continue to promote the lifelong well-being of female athletes in the years to come.


Subject(s)
Athletes , Central Nervous System , Counseling , Female , Female Athlete Triad Syndrome , Health Personnel , Humans , Mass Screening , Nutritionists , Prevalence , Risk Factors , Sports , Sports Medicine
8.
Hanyang Medical Reviews ; : 28-32, 2009.
Article in Korean | WPRIM | ID: wpr-144444

ABSTRACT

The past three decades have seen a dramatic increase in female participation in athletics. The presentation of female athlete in 2008 Beijing Olympic Game increased up to 42.4% of total competitors. Despite the increased participation in female athletics, sports medicine research focusing on female athletics is still in its early stages. The unique anatomic, physiologic, and biomechanical characteristics of female need special attention. In general, females are shorter in stature, shorter femur, wider pelvis, larger knee valgus, narrower shoulder, and more lax in soft tissue. Females tend to have more fat, less muscle mass, and lower bone mineral density than equally trained males. Female athletes also have a concern about the pregnancy and cyclic hormonal changes with menstruation. The important musculoskeletal conditions for female athlete are scoliosis, shoulder instability and frequent knee problems including anterior cruciate ligament injury. Medically, female athlete triad composed with disordered eating, athletic amenorrhea, and premature osteoporosis is a major problems to evaluate and needs the early management.


Subject(s)
Amenorrhea , Anterior Cruciate Ligament , Athletes , Athletic Injuries , Bone Density , Eating , Female , Female Athlete Triad Syndrome , Femur , Humans , Knee , Male , Menstruation , Muscles , Osteoporosis , Pelvis , Pregnancy , Scoliosis , Shoulder , Sports , Sports Medicine
9.
Hanyang Medical Reviews ; : 28-32, 2009.
Article in Korean | WPRIM | ID: wpr-144437

ABSTRACT

The past three decades have seen a dramatic increase in female participation in athletics. The presentation of female athlete in 2008 Beijing Olympic Game increased up to 42.4% of total competitors. Despite the increased participation in female athletics, sports medicine research focusing on female athletics is still in its early stages. The unique anatomic, physiologic, and biomechanical characteristics of female need special attention. In general, females are shorter in stature, shorter femur, wider pelvis, larger knee valgus, narrower shoulder, and more lax in soft tissue. Females tend to have more fat, less muscle mass, and lower bone mineral density than equally trained males. Female athletes also have a concern about the pregnancy and cyclic hormonal changes with menstruation. The important musculoskeletal conditions for female athlete are scoliosis, shoulder instability and frequent knee problems including anterior cruciate ligament injury. Medically, female athlete triad composed with disordered eating, athletic amenorrhea, and premature osteoporosis is a major problems to evaluate and needs the early management.


Subject(s)
Amenorrhea , Anterior Cruciate Ligament , Athletes , Athletic Injuries , Bone Density , Eating , Female , Female Athlete Triad Syndrome , Femur , Humans , Knee , Male , Menstruation , Muscles , Osteoporosis , Pelvis , Pregnancy , Scoliosis , Shoulder , Sports , Sports Medicine
10.
Nutrire Rev. Soc. Bras. Aliment. Nutr ; 32(3): 79-94, 2007. ilus
Article in Portuguese | LILACS | ID: biblio-882116

ABSTRACT

The proved relationship between nutrition and sports performance is specially important during adolescence. This is due to the higher nutritional intakes required for the growth and development of adolescents together with the characteristic energy expenditure in sports. This phase of life is very propitious to developing unhealthy nutrition habits, associated to a lack of knowledge about food consumption and nutrition. That is the reason why the role of nutritional orientation is so important for adolescent athletes. Their ideal nutrition should be adjusted to the competition periods, besides providing specially the adequate supply of liquids, proteins and energy. Insufficient energy consumption might have serious implications for these individuals, such as low height, delayed pubertal development, micronutrients deficiency, dehydration, menstrual irregularities, bone alterations, higher incidence of lesions and higher risk of developing eating disorders. Female athletes are more vulnerable to a simultaneous manifestation of eating disorders, amenorrhea and osteoporosis, the so-called female athlete triad. This syndrome is more frequent among those who practice sports that require a slim body and among those under tough influence and demand from their parents, coaches or even themselves. For this reason, the role of nutritional education is extremely important for health during adolescence, aiming at guaranteeing an adequate growth and development. It is also essential for a good sports performance through a balanced dietary intake and the acquisition of healthy nutrition habits that should remain in adult life


La relación comprobada entre alimentación y desempeño deportivo requiere una atención especial durante la adolescencia. Esto por que alas exigencias nutricionales aumentadas de esa fase del crecimiento y desarrollo intensos, se suman las necesidades energéticas de la actividad deportiva. Además, esta fase de la vida es muy vulnerable a la adopción de prácticas alimentares poco saludables, asociadas a grandes conocimiento sobre alimentación y nutrición. Por tanto, el papel de la orientación nutricional para atletas adolescentes es fundamental. La alimentación ideal debe ajustarse a las fases de la competición para garantizar especialmente el aporte adecuado de líquidos, proteínas y energía. Consumo energético insuficiente puede promover serias consecuencias en esta población, tales como: baja estatura, retardo puberal, deficiencia de micronutrientes, deshidratación, irregularidade menstrual, alteraciones óseas, mayor incidência de lesiones y mayor riesgo de surgimiento de disturbios alimentares. Atletas adolescentes de sexo femenino son más susceptibles a la manifestación simultánea de distúrbios alimentares, amenorrea y osteoporosis, llamada triade del atleta. Este síndrome es más frecuente en la practica de deportes que exigen un biótipo delgado y entre niñas sometidas a influencias y exigencias de los padres, entrenadores, o,incluso, por autoexigencia. Luego, el papel de la ducación nutricional es de suma importância para la salud durante la adolescencia como garantía para un crecimiento y desarrollo adecuado y un buen desempeño deportivo através no solamente de una alimentación equilibrada sino también del estímulo para aquisición de hábitos alimentares saludables que se conservarán en la vida adulta


A relação comprovada entre a alimentação e o desempenho esportivo merece destaque especial, na fase da adolescência. Tal fato, justifica-se pelas maiores necessidades nutricionais exigidas para o crescimento e desenvolvimento do adolescente que são somadas ao gasto energético próprio do esporte. Esse estágio de vida é muito vulnerável ao desenvolvimento de práticas alimentares pouco saudáveis, as quais se associam a um grande desconhecimento sobre alimentação e nutrição. Dessa forma, deve ser ressaltado o papel da orientação nutricional adequada para atletas adolescentes. A alimentação ideal destes deve ser adaptada às fases de competição, além de garantir em especial o suprimento adequado de líquidos, proteína e energia. O consumo energético insuficiente pode ter sérias implicações nesses indivíduos, como desenvolvimento de baixa estatura, atraso puberal, deficiência de micronutrientes, desidratação, irregularidade menstrual, alterações ósseas, maior incidência de lesões e maior risco de aparecimento de distúrbios alimentares. Atletas adolescentes do sexo feminino são mais suscetíveis à manifestação simultânea de distúrbios alimentares, amenorreia e osteoporose, a chamada tríade da atleta. Esta síndrome é mais comum entre as praticantes de esportes que exigem um biótipo caracterizado pela magreza e entre aquelas submetidas a fortes influências e exigências de pais, treinadores ou mesmo das próprias atletas. Logo, o papel da educação nutricional é de suma importância para a saúde durante a adolescência, no intuito de garantir um crescimento e desenvolvimento adequados, bem como um bom desempenho esportivo por meio de uma alimentação equilibrada e do estímulo à adoção de hábitos alimentares saudáveis e a manutenção destes na vida adulta


Subject(s)
Humans , Male , Female , Adolescent , Female Athlete Triad Syndrome/diet therapy , Female Athlete Triad Syndrome/metabolism , Female Athlete Triad Syndrome/prevention & control , Feeding Behavior
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