Snooze it or Lose it: Understanding Sleep Disturbance and Injuries in Soccer and Basketball Student-Athletes.

OBJECTIVES: To assess the sleep characteristics of collegiate soccer and basketball student-athletes and explore the associations between sleep and injury risk. DESIGN: Cohort study. SETTING: NCAA D1 and NAIA Tier 1. PARTICIPANTS: One hundred eighty-one collegiate soccer and basketball student-athletes (42% female; mean age: 20.0 ± 1.7 years). INDEPENDENT VARIABLES: Questionnaires were administered during the 2020/2021 and 2021/2022 preseason, collecting demographic, injury history, medical history, and sleep information, including sleep difficulty category scores of 0 to 4 (none), 5 to 7 (mild), and ≥8 (moderate/severe) and other sleep disturbance measures derived from the Athlete Sleep Screening Questionnaire (ASSQ), including insufficient sleep duration (<7 hours of sleep) and poor subjective sleep quality. MAIN OUTCOME MEASURES: All-complaint knee and ankle injuries. RESULTS: According to the ASSQ, 25.4% (95% confidence interval [CI], 17.9-34.3) of the student-athletes had mild sleep difficulty and 12.7% (95% CI, 7.3-20.1) had moderate/severe sleep difficulty. 36.1% (95% CI, 29.1-43.6) had insufficient sleep duration. 17.1% (95% CI, 11.7-23.7) were not satisfied with the quality of their sleep (poor sleep quality), and 13.8% (95% CI, 9.1-19.7) had an "eveningness" chronotype. Based on multivariable logistic regression models, student-athletes with poor sleep quality had significantly higher odds for injury (OR: 2.2, 95% CI, 1.04-4.79, P = 0.039). CONCLUSIONS: Clinically relevant dysfunctional sleep patterns are prevalent among collegiate soccer and basketball student-athletes. Poor sleep quality was significantly associated with injury risk among student-athletes. Findings suggest a substantial sleep problem in collegiate soccer and basketball student-athletes and warrant that student-athletes are regularly screened and timely interventions applied.

Construction of an Administrative Osteoarthritis Severity Index.

OBJECTIVE: Electronic health record (EHR) databases are a powerful resource to investigate clinical trajectories of osteoarthritis (OA). There are no existing EHR tools to evaluate risk for knee arthroplasty (KA). We developed an OA severity index (OASI) using EHR data and demonstrate the index's association with time to KA. METHODS: This retrospective cohort study used 2010-2018 nationally distributed Optum EHR data. Eligible patients were 45 to 80 years old with a new diagnosis of knee OA in 2011-2012 and no prior KA. The OASI was a sum of first instance of x-ray imaging, advanced imaging, intra-articular injection, nonsteroidal anti-inflammatory drugs, and opioids. Principal components analysis index (PCI) score was also explored. Extended Cox proportional hazard models assessed time-dependent OASI and time to KA. RESULTS: Among 16,675 eligible patients, 12.7% underwent KA. Median follow-up time was 72 months. Adjusted OASI models showed each additional event almost doubled the risk for KA (adjusted hazard ratio = 1.80, 95% confidence interval: 1.75-1.86). Similar results were observed for PCI. CONCLUSION: The sum OASI performs well identifying patients who would undergo KA and offers simplicity versus the PCI. Although replication in other cohorts is recommended, the OASI appears to be a novel and valid means to measure clinical OA severity in research studies using large EHR-based cohorts.

Balancing Act: Muscle Imbalance Effects on Musculoskeletal Injuries.

Overuse injuries affect persons of all ages and physical participation levels. These injuries involve repetitive overload causing damage and pain to various joints, affecting performance and ability to continue participation. Even when an injury diagnosis is apparent, functional assessment is useful in discovering the underlying mechanism.

Absence of Injury Is Not Absence of Pain: Prevalence of Preseason Musculoskeletal Pain and Associated Factors in Collegiate Soccer and Basketball Student Athletes.

Unlike musculoskeletal (MSK) injuries, MSK pain is rarely studied in athletes. In this study, we examined the prevalence of preseason MSK pain in apparently healthy collegiate soccer and basketball players and its relationship with previous injuries (1-year history), among other factors. Ninety-seven eligible student athletes (mean age: 20.1 (SD: 1.6) years; 43% male; 53% soccer players) completed a baseline questionnaire comprising questions related to demographics, medical and 1-year injury history and any current MSK pain and the corresponding body location. The overall prevalence of preseason MSK pain was 26% (95% CI: 17-36%) and it did not differ by sex or sport. The back (6.2%) and knee (5.2%) regions were reported to be the most frequently affected body parts for preseason MSK pain. Athletes with a previous injury and with perception of incomplete healing had 3.5-fold higher odds (OR: 3.50; 95% CI: 1.28-9.36) of baseline MSK pain compared with those without a previous injury. One in four collegiate soccer and basketball players had preseason MSK pain. Collegiate sports medicine professionals should consider conducting routine preseason evaluations of MSK pain in their athletes and initiate appropriate interventions for the prevention of MSK pain and its potential consequences among athletes.

Sugar-Sweetened Beverage Intake Assessment in a Family Medicine Residency Clinic.

INTRODUCTION: Sugar-sweetened beverages (SSBs) are a major source of added calories in the American diet, with significant adverse health outcomes. However, intake of SSBs is not commonly assessed in the clinical setting. In some populations with health disparities there is a higher consumption of caloric beverages, contributing to increased cardiometabolic risk. Family medicine residency clinics often provide services for the underserved population, and may encounter additional barriers in nutritional assessment. METHODS: Our study, conducted at a residency clinic in Omaha, Nebraska, utilized the abbreviated Beverage Intake Questionnaire 15 (BEVQ-15). We surveyed 310 patients over a 3-month period. RESULTS: Consumption of SSBs in our sample was significantly higher than that of the nonclinic population of Nebraska (P<0.001). Fifty-six percent of resident clinic respondents reportedly consumed at least one SSB daily, resulting in an average intake of 244 kilocalories. Intake was significantly higher in males, younger patients, those with lower socioeconomic status, and Latinos. While the majority of the study population was obese, there was no direct correlation between weight and SSB intake. The survey required less than 3 minutes to complete. Future interventions may focus on reduction of SSB intake and promotion of water consumption. CONCLUSIONS: Assessment of SSB intake in a family medicine residency clinic can be easily conducted, providing opportunities for clinical providers to suggest patient-specific modifiable behaviors. As the obesity epidemic continues to progress, point-of-care intervention to reduce SSB consumption may help reduce cardiometabolic risk and improve health outcomes.

Patient demographics and cardiovascular risk factors differentially influence geometric remodeling of the aorta compared with the peripheral arteries.

BACKGROUND: Detailed knowledge of the dimensions and shape of the main arteries of the body and how they change with age and disease is important for understanding arterial pathophysiology and improving minimally invasive devices to treat arterial diseases. Our goal was to describe and compare geometric remodeling of the aorta and peripheral arteries in the context of patient demographics and cardiovascular risk factors. METHODS: Three-dimensional reconstructions of computed tomography angiography scans were performed in 122 subjects 5-93 years of age (mean 47 ± 24 years, 64 M/58 F). Best-fit arterial diameters, lengths, and tortuosity for the principle named arteries in the chest, abdomen, pelvis, and upper thigh were measured, and multiple linear regression analysis was performed to examine how these morphologic parameters associate with patient demographics and risk factors. RESULTS: Large elastic arteries increased their diameter, length, and tortuosity with age, whereas muscular arteries primarily became more tortuous. Demographics and risk factors explained >70% of the variation in diameters of the abdominal aorta, paravisceral aorta, and the aortic arch; and >75% of variation in tortuosity from the profunda femoris to the brachiocephalic artery. Male sex, larger body mass index, and hypertension contributed to larger diameters, whereas the presence of diabetes was associated with somewhat-straighter arteries. Overall, the effects of cardiovascular risk factors on geometric remodeling were small compared with those of demographics. CONCLUSION: The geometry of the vascular tree is greatly affected by aging, demographics, and some risk factors. Elastic and muscular arteries remodel differently, possibly as the result of differences in their microstructure.