Proceedings from the Ice Hockey Summit III: Action on Concussion.

The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: 1) describe sport-related concussion (SRC) epidemiology, 2) classify prevention strategies, 3) define objective, diagnostic tests, 4) identify treatment, and 5) integrate science and clinical care into prioritized action plans and policy. Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches, and officials) voted to prioritize these action items in the final Summit session. 1) Establish a national and international hockey data base for SRC at all levels, 2) eliminate body checking in Bantam youth hockey games, 3) expand a behavior modification program (Fair Play) to all youth hockey levels, 4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues, 5) establish objective tests to diagnose concussion at point of care (POC), and 6) mandate baseline testing to improve concussion diagnosis for all age groups. Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity, and consequences of concussion in the sport of ice hockey.

The Effects of Caffeine on Vertical Jump Height and Execution in Collegiate Athletes.

Bloms, LP, Fitzgerald, JS, Short, MW, and Whitehead, JR. The effects of caffeine on vertical jump height and execution in collegiate athletes. J Strength Cond Res 30(7): 1855-1861, 2016-Caffeine ingestion elicits a variety of physiological effects that may be beneficial to maximal-intensity exercise performance, although its effectiveness and physical mechanism of action enhancing ballistic task performance are unclear. The purpose of this study was to examine the effects of caffeine ingestion on vertical jump height and jump execution in Division I collegiate athletes. The study used a single-blind, randomized, crossover design. Athletes (n = 25) consumed either caffeine (5 mg·kg) or placebo. After a 60-minute waiting period, athletes performed 3 squat jumps (SJ) and 3 countermovement jumps (CMJ) while standing on a force platform. Jump height and execution variables were calculated from mechanography data. In comparison with placebo, caffeine increased SJ height (32.8 ± 6.2 vs. 34.5 ± 6.7 cm; p = 0.001) and CMJ height (36.4 ± 6.9 vs. 37.9 ± 7.4 cm; p = 0.001). Peak force (p = 0.032) and average rate of force development (p = 0.037) were increased during the CMJ in the caffeine trail compared with the control. Time to half peak force was the only execution variable improved with caffeine (p = 0.019) during the SJ. It seems that caffeine affects both height and execution of jumping. Our data indicate that the physical mechanism of jump enhancement is increased peak force production or rate of force development during jumping depending on technique. The physical mechanism of jump enhancement suggests that the ergogenic effects of caffeine may transfer to other ballistic tasks involving the lower-body musculature in collegiate athletes.

Ice hockey summit II: zero tolerance for head hits and fighting.

OBJECTIVE: To present currently known basic science and on-ice influences of sport related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October, 2013). Summit II focused on Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include the knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit include: 1) eliminate head hits from all levels of ice hockey, 2) change body checking policies, and 3) eliminate fighting in all amateur and professional hockey.

Ice Hockey Summit II: zero tolerance for head hits and fighting.

This study aimed to present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC. The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure for the science and discussion held during Summit II (Mayo Clinic, Rochester, MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward, (2) Acute and Chronic Concussion Care: Making a Difference, (3) Preventing Concussions via Behavior, Rules, Education, and Measuring Effectiveness, (4) Updates in Equipment: Their Relationship to Industry Standards, and (5) Policies and Plans at State, National, and Federal Levels To Reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were voted on subsequently for purposes of prioritization. The following proceedings include the knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. The highest-priority action items identified from the Summit include the following: (1) eliminate head hits from all levels of ice hockey, (2) change body checking policies, and (3) eliminate fighting in all amateur and professional hockey.

Comparative Effectiveness Research: A Roadmap for Physical Activity and Lifestyle.

PURPOSE: Comparative effectiveness research (CER) is designed to support informed decision making at both the individual, population, and policy levels. The American College of Sports Medicine and partners convened a conference with the focus of building an agenda for CER within the context of physical activity and nonpharmacological lifestyle approaches in the prevention and treatment of chronic disease. This report summarizes the conference content and consensus recommendations that culminated in a CER roadmap for physical activity and lifestyle approaches to reducing the risk of chronic disease. METHODS: This conference focused on presentations and discussion around the following topic areas: 1) defining CER, 2) identifying the current funding climate to support CER, 3) summarizing methods for conducting CER, and 4) identifying CER opportunities for physical activity. RESULTS: This conference resulted in consensus recommendations to adopt a CER roadmap for physical activity and lifestyle approaches to reducing the risk of chronic disease. In general, this roadmap provides a systematic framework by which CER for physical activity can move from a planning phase to a phase of engagement in CER related to lifestyle factors with particular emphasis on physical activity to a societal change phase that results in changes in policy, practice, and health. CONCLUSIONS: It is recommended that physical activity researchers and health care providers use the roadmap developed from this conference as a method to systematically engage in and apply CER to the promotion of physical activity as a key lifestyle behavior that can be effective at making an impact on a variety of health-related outcomes.

The Effects of Proprioceptive Neuromuscular Facilitation Stretching on Post-Exercise Delayed Onset Muscle Soreness in Young Adults.

Until recently, the scientific community believed that post-exercise stretching could reduce delayed onset muscle soreness (DOMS), but recent reviews of studies on the topic have concluded that pre- or post-exercise static stretching has no effect on mitigating DOMS. However, the effect of proprioceptive neuromuscular facilitation (PNF) post-exercise stretching on preventing DOMS has not been adequately studied. The purpose of this study was to determine the effect of post-exercise PNF stretching on DOMS. Young adult participants (N=57) were randomly assigned to a PNF stretching group (n=19), a static stretching group (n=20), and to a no-stretching control group (n=18). All participants completed exercise designed to induce DOMS prior to post-exercise experimental stretching protocols. Participants rated their soreness level on a pain scale 24 and 48 hours post-exercise. A 3 × 2 mixed ANOVA showed there was an effect for time (p<.01). Post hoc testing revealed that DOMS pain significantly decreased (p<.05) from 24 to 48 hours post-exercise for the PNF and control groups, but not for the static stretching group. Other analyses revealed a significant correlation (r=.61, p<.01) between the pre- and post-exercise stretch scores and the 48 hour post-exercise pain score for the PNF group. Consistent with the results of previous research on post-exercise static stretching, these results indicate that post-exercise PNF stretching also does not prevent DOMS. However, the correlation analysis suggests it is possible the pre-stretch muscle contractions of the post-exercise PNF protocol may have placed a load on an already damaged muscle causing more DOMS for some participants.

A prospective study of injury affecting competitive collegiate swimmers.

The purposes of this study were to determine the incidence and distribution of injuries affecting collegiate competitive swimmers and to test possible injury risk factors. A prospective cohort design was used to follow 34 swimmers (16 M, 18 F) from an NCAA Division I Midwest University over one academic year. Exposure-based injury rates were determined for both practice and competition. Risk of injury was assessed relative to gender, years swimming, and history of injury. Twenty of 34 swimmers sustained 31 injuries with overall injury rates of 5.55 injuries per 1000 athlete exposures and 3.04 injuries per 1000 hours exposure. Practice injury rates for female swimmers were higher than for women's practice injury rates in other NCAA sports. The most common injury locations were the shoulder, back, and knee. Risk factors that remained significant in the multivariate analysis were history of injury to the same anatomical location and history of injury at other anatomical sites.

Resistance training vs. static stretching: effects on flexibility and strength.

Morton, SK, Whitehead, JR, Brinkert, RH, and Caine, DJ. Resistance training vs. static stretching: Effects on flexibility and strength. J Strength Cond Res 25(12): 3391-3398, 2011-The purpose of this study was to determine how full-range resistance training (RT) affected flexibility and strength compared to static stretching (SS) of the same muscle-joint complexes in untrained adults. Volunteers (n = 25) were randomized to an RT or SS training group. A group of inactive volunteers (n = 12) served as a convenience control group (CON). After pretesting hamstring extension, hip flexion and extension, shoulder extension flexibility, and peak torque of quadriceps and hamstring muscles, subjects completed 5-week SS or RT treatments in which the aim was to stretch or to strength train the same muscle-joint complexes over similar movements and ranges. Posttests of flexibility and strength were then conducted. There was no difference in hamstring flexibility, hip flexion, and hip extension improvement between RT and SS, but both were superior to CON values. There were no differences between groups on shoulder extension flexibility. The RT group was superior to the CON in knee extension peak torque, but there were no differences between groups on knee flexion peak torque. The results of this preliminary study suggest that carefully constructed full-range RT regimens can improve flexibility as well as the typical SS regimens employed in conditioning programs. Because of the potential practical significance of these results to strength and conditioning programs, further studies using true experimental designs, larger sample sizes, and longer training durations should be conducted with the aim of confirming or disproving these results.

Pre-Workout Carbohydrate Supplementation does not Affect Measures of Selfassessed Vitality and Affect in College Swimmers.

Beneficial effects of dietary carbohydrate (CHO) on physical and psychological parameters have been demonstrated in athletes. Because affect, or mood, can predict athletic performace, the main objective of this study was to determine the effect of pre-workout CHO on affect in swimmers. College swimmers (n = 37) participated in a randomized crossover experiment of the effects of a pre-workout CHO supplement on vitality and affect. Subjects consumed a CHO supplement or placebo for two days before morning practice. After each morning practice, swimmers completed measures of affect and feelings of vitality. Pearson correlations were performed to describe relationships among variables. Differences in means between the CHO and placebo conditions were determined by paired t-tests. Independent t-tests were used to determine differences in variables between the highest and lowest tertiles of breakfast consumption frequency. All statistical analyses were performed using SAS 9.1.3 (Cary, NC) and statistical signficance was set at α = 0.05. There were no significant differences in affect or feelings of vitality between the CHO supplement and placebo conditions (all p ≥ 0.15). Our results do not support a beneficial effect of CHO supplementation before morning swim practice on affect or feelings of vitality in swimmers. Key pointsPre-workout carbohydrate did not affect post-workout measures of vitality or affect in collegiate swimmers.Avoidance of feeling nauseous/ill' and 'lack of time' were the most frequent reasons reported by swimmers for forgoing breakfast before morning swim practice.A longer trial of carbohydrate supplementation is needed to verify if there is indeed no effect of pre-workout carbohydrate on post-workout measures of vitality or affect in swimmers.