BACKGROUND & AIMS: :Walker, EJ, Aughey, RJ, McLaughlin, P, and McAinch, AJ. Seasonal change in body composition and physique of team sport athletes. J Strength Cond Res XX(X): 000-000, 2020-Body composition of team sport athletes was measured at 3 points across the preseason and competitive season. This repeated-measures study was conducted in 46 professional Australian football (AF) (age 23.8 ± 3.8 years), 26 soccer (age 22.7 ± 4.7 years), and 33 rugby union players (age 28.1 ± 4.2 years). A mixed-design analysis of variance was used to determine change across the season, and Pearson's correlation was used to determine the relationship between different measures. Anthropometry, dual-energy x-ray absorptiometry (DXA), and 3-dimensional (3D) scan technology were used in AF and soccer, whereas only DXA was used in rugby. Body mass remained unchanged for both AF and soccer with gains in lean mass (p < 0.01), from preseason to early in the competitive season. Skinfold measures declined in AF (p < 0.001) and soccer (p < 0.05) across the season, whereas DXA-measured fat mass only declined in soccer (p < 0.01). Rugby backs (p < 0.01) and forwards (p < 0.001) reduced body fat and gained lean mass from preseason to in-season with forwards having greater relative and absolute changes as measured by DXA. 3D technology did not show change across the season. Dual-energy x-ray absorptiometry body fat percent and the sum of skinfold correlation were large (r = 0.74 [p < 0.001, CI 0.67-0.81]). The greatest change in body composition occurs from the beginning of preseason to the start of competition, with changes returning to baseline levels toward the end of season. Dual-energy x-ray absorptiometry and skinfold measures were moderately correlated, providing a good alternative to track change in subcutaneous fat in AF and soccer athletes.

背景与目标： : Walker，EJ，Aughey，RJ，McLaughlin，P和McAinch，AJ。团体运动运动员身体成分和体质的季节性变化。J Strength Cond Res XX(X): 000-000，在季前赛和竞技赛季中以3分测量团队运动运动员的2020组成。这项重复测量研究是在46名澳大利亚职业足球 (AF) (年龄23.8 ± 3.8岁)，26名足球 (年龄22.7 ± 4.7岁) 和33名橄榄球联盟球员 (年龄28.1 ± 4.2岁) 中进行的。使用方差的混合设计分析来确定整个季节的变化，并使用Pearson相关性来确定不同度量之间的关系。人体测量学，双能x射线吸收法 (DXA) 和3维 (3D) 扫描技术用于AF和足球，而仅DXA用于橄榄球。从季前赛到比赛赛季初，AF和足球的体重保持不变，瘦体重增加 (p <0.01)。整个赛季中，AF (p < 0.001) 和足球 (p < 0.05) 的皮褶量下降，而DXA测量的脂肪量仅在足球中下降 (p <0.01)。橄榄球后卫 (p < 0.01) 和前锋 (p < 0.001) 减少了体脂，并从季前赛到赛季中增加了瘦体重，而前锋的相对和绝对变化更大，如DXA所示。3D技术在整个季节都没有变化。双能x射线吸收法体脂百分比和皮褶相关性之和较大 (r = 0.74 [p <0.001，CI 0.67-0.81])。身体成分的最大变化发生在季前赛开始到比赛开始之间，变化在赛季结束时恢复到基线水平。双能x射线吸收法和皮褶测量呈中等相关性，为追踪AF和足球运动员皮下脂肪的变化提供了很好的替代方法。

BACKGROUND & AIMS: :According to Wikipedia, a medical director is typically a physician who provides healthcare guidance, leadership,oversight, and quality assurance. The medical director is responsible for creating treatment protocols and providing oversight for all constituents who deliver healthcare services to a particular target population. There are, however, significant variations from country to country regarding the role and responsibilities of the medical director. The author discusses his experience as a sports physiotherapist in the medical director position for the Israel Football Association.

背景与目标： : 根据维基百科，医疗总监通常是提供医疗保健指导、领导、监督和质量保证的医生。医疗总监负责制定治疗方案，并为向特定目标人群提供医疗服务的所有成员提供监督。但是，在医疗主任的作用和职责方面，各国之间存在很大差异。作者讨论了他在以色列足球协会医疗总监职位上担任体育物理治疗师的经验。

BACKGROUND & AIMS: :For adolescent athletes (14-18 years), data on sport nutrition knowledge, behaviors and beliefs are limited, especially based on sex, race/ethnicity and socioeconomic status. High school soccer players (n = 535; 55% female; 51% White, 41% Latino; 41% National School Lunch Program (NSLP) participants (80% Latino)) completed two questionnaires (demographic/health history and sport nutrition). The sport nutrition knowledge score was 45.6% with higher scores in NSLP-Whites vs. NSLP-Latinos (p < 0.01). Supplement knowledge differed by sex (16% lower in females; p = 0.047) and race/ethnicity (33% lower in Latinos; p < 0.001). Breakfast consumption was 57%; females ate breakfast less (50%) than males (60%; p < 0.001); NSLP-participants ate breakfast less (47%) than non-NSLP (62%; p < 0.001). Supplement use was 46%, with Latinos using more supplements than Whites do (p = 0.016). Overall, 30% used protein shakes, with females using less than males (p = 0.02), while use was twice as likely in Latino vs. White (p = 0.03). Overall, 45% reported their nutrient requirements were different from non-athlete peers. Latinos were less likely (p = 0.03) to report that their diet met nutritional requirements, but more than twice as likely to report that nutritional supplements were necessary for training (p < 0.001). Adolescent athletes, especially females and Latinos, would benefit from sport nutrition education that enhances food selection skills for health and sport performance.

背景与目标： : 对于青少年运动员 (14-18岁)，有关运动营养知识，行为和信念的数据有限，尤其是基于性别，种族/种族和社会经济地位。高中足球运动员 (n = 535; 55% 女性; 51% 白人，41% 拉丁裔; 41% 国家学校午餐计划 (NSLP) 参与者 (80% 拉丁裔)) 完成了两份问卷 (人口/健康史和运动营养)。运动营养知识得分45.6%，NSLP-白人与NSLP-拉丁美洲人得分较高 (p <0.01)。补充知识因性别 (女性16% 较低; p = 0.047) 和种族/民族 (拉丁美洲人33% 较低; p < 0.001) 而异。早餐消费57%; 女性比男性少 (50%) 吃早餐 (60%; p < 0.001); NSLP参与者比非NSLP少 (47%) 吃早餐 (62%; p <0.001)。补充剂的使用是46% 的，拉丁美洲人比白人使用更多的补充剂 (p = 0.016)。总体而言，30% 使用蛋白质奶昔，女性使用的蛋白质奶昔少于男性 (p = 0.02)，而拉丁美洲人与白人相比，使用的可能性是白人的两倍 (p = 0.03)。总体而言，45% 报告说他们的营养需求与非运动员同行不同。拉丁美洲人不太可能 (p = 0.03) 报告他们的饮食符合营养需求，但报告营养补充剂是培训所必需的可能性是其两倍以上 (p <0.001)。青少年运动员，特别是女性和拉丁美洲人，将受益于运动营养教育，这种教育可以提高健康和运动表现的食物选择技能。

BACKGROUND & AIMS: AIMS:Use pattern-centered methods to examine how adolescents' alcohol use and sports activities are related both to childhood sport and problem behavior and to heavy drinking in early adulthood. DESIGN:The data used in this study come from four waves of the Michigan Study of Adolescent Life Transitions (MSALT) that began in 1983, when participants were approximately age 12, and continued into early adulthood, when participants were approximately age 28. PARTICIPANTS:Sixty per cent of the approximately 1000 MSALT youth living in south-eastern Michigan were females and 97% were European American. Approximately 28% of one or both parents held at least a college degree, and 45% held a high school diploma or lower. FINDINGS:Pattern-centered analyses revealed that the relation between adolescent sport activity and age 28 heavy alcohol use obtained primarily for sport participants who were also using more than the average amount of alcohol and other drugs at age 18. Similarly, children who were characterized by relatively high levels of sport participation, aggression and other problem behavior at age 12 were more likely than expected by chance to become sport participants who used more than the average amount of alcohol and other drugs at age 18. CONCLUSIONS:The results indicate that childhood problem behavior and adolescent sport participation can, but do not necessarily, presage heavy drinking in adulthood and that pattern-centered analytical techniques are useful for revealing such theoretically generated predictions.

背景与目标：

BACKGROUND & AIMS: :Questionable research practices (QRPs) are intentional and unintentional practices that can occur when designing, conducting, analysing, and reporting research, producing biased study results. Sport and exercise medicine (SEM) research is vulnerable to the same QRPs that pervade the biomedical and psychological sciences, producing false-positive results and inflated effect sizes. Approximately 90% of biomedical research reports supported study hypotheses, provoking suspicion about the field-wide presence of systematic biases to facilitate study findings that confirm researchers' expectations. In this education review, we introduce three common QRPs (ie, HARKing, P-hacking and Cherry-picking), perform a cross-sectional study to assess the proportion of original SEM research that reports supported study hypotheses, and draw attention to existing solutions and resources to overcome QRPs that manifest in exploratory research. We hypothesised that ≥ 85% of original SEM research studies would report supported study hypotheses. Two independent assessors systematically identified, screened, included, and extracted study data from original research articles published between 1 January 2019 and 31 May 2019 in the British Journal of Sports Medicine, Sports Medicine, the American Journal of Sports Medicine, and the Journal of Orthopaedic & Sports Physical Therapy We extracted data relating to whether studies reported that the primary hypothesis was supported or rejected by the results. Study hypotheses, methodologies, and analysis plans were preregistered at the Open Science Framework. One hundred and twenty-nine original research studies reported at least one study hypothesis, of which 106 (82.2%) reported hypotheses that were supported by study results. Of 106 studies reporting that primary hypotheses were supported by study results, 75 (70.8%) studies reported that the primary hypothesis was fully supported by study results. The primary study hypothesis was partially supported by study results in 28 (26.4%) studies. We detail open science practices and resources that aim to safe-guard against QRPs that bely the credibility and replicability of original research findings.

背景与目标： : 可疑的研究实践 (QRPs) 是在设计，进行，分析和报告研究时可能发生的有意和无意的实践，产生有偏见的研究结果。运动和运动医学 (SEM) 研究容易受到生物医学和心理科学中相同的QRPs的影响，产生假阳性结果和放大的效应大小。大约90% 的生物医学研究报告支持研究假设，引发了对系统偏差的全领域存在的怀疑，以促进证实研究人员期望的研究结果。在这篇教育评论中，我们介绍了三种常见的qrp (即HARKing，P-hacking和樱桃采摘)，进行了横断面研究，以评估报告支持研究假设的原始SEM研究的比例，并提请注意现有的解决方案和资源，以克服探索性研究中体现的qrp。我们假设 ≥ 85% 的原始SEM研究将报告支持的研究假设。两名独立的评估员从2019年1月1日和2019年5月31日之间发表的原始研究文章中系统地识别，筛选，纳入和提取了研究数据，这些研究文章发表在《英国运动医学杂志》，《运动医学》，《美国运动医学杂志》上。和《骨科与运动物理疗法杂志》，我们提取了与研究报告主要假设被结果支持或拒绝有关的数据。研究假设，方法和分析计划已在开放科学框架中进行了预注册。一百二十九项原始研究报告了至少一项研究假设，其中106 (82.2%) 报告了受研究结果支持的假设。在106项报告主要假设得到研究结果支持的研究中，有75项 (70.8%) 研究报告主要假设得到研究结果的完全支持。28 (26.4%) 项研究的研究结果部分支持了主要研究假设。我们详细介绍了旨在安全防范qrp的开放科学实践和资源，这些qrp削弱了原始研究成果的可信度和可复制性。

BACKGROUND & AIMS: OBJECTIVES:To identify the symptoms responsible for cessation of exercise testing and evaluate changes in post-concussion symptom scores on the Post-Concussion Symptom Scale (PCSS) from the Sport-Concussion Assessment Tool (SCAT5) immediately, 1-4h, and 6-12h following completion of the Buffalo Concussion Treadmill Test (BCTT) in youth and adults who have sustained a sport-related concussion. DESIGN:Prospective case-series. METHODS:Individuals who were diagnosed with a sport-related concussion and self-reported difficulties with exertion were referred to perform an exertional treadmill test. Individuals were recruited from a university sports medicine clinic. Change in PCSS symptom severity scores were operationally defined as a change ≥4 points. RESULTS:Forty-five individuals aged 13-57 years consented to participate. A total of 14/24 (58.3%) female and 13/21 (61.9%) male participants reported an increase in symptom severity scores immediately following the BCTT. At 1-4h, 5/10 (50.0%) males and 5/14 (35.7%) females who completed the PCSS had elevated symptom severity scores compared to pre-exertion. Only 24.2% (3/17 males and 5/16 females) of participants completing the PCSS at 6-12h reported increased symptom severity scores. CONCLUSION:Exertional testing is an important component of a multifaceted assessment following concussion; however, previous research evaluating symptom responses to exertion is limited. This study provides evidence to suggest individuals who experience an exacerbation of concussion-associated symptoms after exertion are likely to return to pre-exertion levels within the same day. Future research monitoring symptoms following exertion and throughout recovery should be performed in tandem with physiological measures to better understand the source of symptoms.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The prevalence of asthma and bronchial hyper-responsiveness is greater in elite athletes than in the general population, and its association with mild airway inflammation has recently been reported. OBJECTIVE:To study the relationship between the type of sport practised at the highest levels of competition (on land or in water) and sputum induction cell counts in a group of healthy people and people with asthma. MATERIAL AND METHODS:In total, 50 athletes were enrolled. Medical history, results of methacholine challenge tests and sputum induced by hypertonic saline were analysed RESULTS:Full results were available for 43 athletes, who were classified by asthma diagnosis and type of sport (land or water sports). Nineteen were healthy (10 land and 9 water athletes) and 24 had asthma (13 land and 11 water athletes). Although the eosinophil counts of healthy people and people with asthma were significantly different (mean difference 3.1%, 95% CI 0.4 to 6.2, p = 0.008), analysis of variance showed no effect on eosinophil count for either diagnosis of asthma or type of sport. However, an effect was found for neutrophil counts (analysis of variance: F = 2.87, p = 0.04). There was also a significant correlation between neutrophil counts and both duration of training and bronchial hyper-responsiveness among athletes exposed to water (Spearman's rank correlations, 0.36 and 0.47, p = 0.04 and 0.04, respectively). CONCLUSIONS:Elite athletes who practice water sports have mild neutrophilic inflammation, whether or not asthma is present, related to the degree of bronchial hyper-reactivity and the duration of training in pool water.

背景与目标：

BACKGROUND & AIMS: :Social desirability has long been viewed as a potential source of error variance in self-report measures. We suggest that social desirability (whether in the form of impression management or self-deception) has the capacity to mask relations between psychosocial variables and sport-related outcome or criterion measures that are not measured by selfreport. To illustrate what can occur, we present data from a longitudinal study in which life stress and psychological coping skills were studied as predictors of behaviorally-defined athletic injuries. When data from the entire sample of 352 athletes were analyzed, virtually no injury variance was accounted for by life stress, psychological coping skills, or their interaction. In contrast, deletion from the sample of athletes with high social desirability response set scores resulted in significant predictive relations involving both life stress and coping skills, as well as a significant moderator effect for coping skills. We propose that social desirability masking effects can significantly increase the likelihood of Type II errors in sports medicine research that involves self-report measures, and that social desirability responding needs to be controlled or minimized.

背景与目标： : 社会可取性长期以来一直被视为自我报告措施中误差差异的潜在来源。我们建议，社会可取性 (无论是印象管理还是自我欺骗的形式) 都有能力掩盖社会心理变量与运动相关的结果或标准措施之间的关系，而这些关系无法通过自我报告来衡量。为了说明可能发生的情况，我们提供了一项纵向研究的数据，其中研究了生活压力和心理应对技能作为行为定义的运动伤害的预测指标。当分析来自352名运动员的整个样本的数据时，几乎没有因生活压力，心理应对技能或他们的相互作用而造成的伤害差异。相反，从具有较高社会期望响应集得分的运动员样本中删除会导致涉及生活压力和应对技能的显着预测关系，以及应对技能的显着调节作用。我们建议，社会期望掩盖效应可以显着增加运动医学研究中涉及自我报告措施的II型错误的可能性，并且需要控制或最小化社会期望响应。

BACKGROUND & AIMS: OBJECTIVE:Very little research has been conducted that examines men, sport, masculinities, and disability in the context of health. Readdressing this absence, this article examines the health narratives told by spinal injured men and the work narratives do on, in, and for them. METHODS:In-depth life history interviews and fieldwork observations with men (n = 17) who sustained a spinal injury through playing sport and are now disabled were conducted. Qualitative data were analyzed using a dialogical narrative analysis. RESULTS:Stories told about health characterized a style of embodied actions choices that anticipated a certain type of narrative, that is, an emergent narrative. The men's narrative habitus, fashioned through the process rehabilitation, predisposed them to be interpellated to care about health. To uphold hegemonic masculinities the men also did not care too much about health. The analysis also reveals the work narratives do on, in, and for health behavior, masculine identities, resilience, leisure time physical activity, and body-self relationships. Implications for health promotion work are highlighted. CONCLUSIONS:The article advances knowledge by revealing the emergent narrative of health. It reveals too for the first time the way certain contexts and masculine identities create a new subject of health that cares about doing health work, but not too much. Building on the theoretical knowledge advanced here, this article contributes to practical understandings of men's health and disability by highlighting the potential of narrative for changing human lives and behavior.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To explore the role of psychological, social and contextual factors across the recovery stages (ie, acute, rehabilitation or return to sport (RTS)) following a traumatic time-loss sport-related knee injury. MATERIAL AND METHODS:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Arksey and O'Malley framework. Six databases were searched using predetermined search terms. Included studies consisted of original data written in English that identified or described a psychological, social or contextual factor related to recovery after a traumatic time-loss sport-related knee injury. Two authors independently conducted title-abstract and full-text reviews. Study quality was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was undertaken. RESULTS:Of 7289 records, 77 studies representing 5540 participants (37% women, 84% anterior cruciate ligament tears, aged 14-60 years) were included. Psychological factors were investigated across all studies, while social and contextual factors were assessed in 39% and 21% of included studies, respectively. A cross-cutting concept of individualisation was present across four psychological (barriers to progress, active coping, independence and recovery expectations), two social (social support and engagement in care) and two contextual (environmental influences and sport culture) themes. Athletes report multiple barriers to recovery and valued their autonomy, having an active role in their recovery and diverse social support. CONCLUSION:Diverse psychological, social and contextual factors are present and influence all stages of recovery following a traumatic sport-related knee injury. A better understanding of these factors at the time of injury and throughout rehabilitation could assist with optimising injury management, promoting RTS, and long-term health-related quality-of-life.

背景与目标：

BACKGROUND & AIMS: :Pre-ascent climbing route visual inspection (route preview) has been suggested as a key climbing performance parameter although its role has never been verified experimentally. We examined the efficacy of this perceptual-cognitive skill on indoor sport climbing performance. Twenty-nine male climbers, divided into intermediate, advanced and expert climbing level groups, climbed two indoor sport routes matching their climbing level and, where applicable, routes below their climbing level. At each level, one route was climbed with a preview, where participants benefited from a 3-min pre-ascent climbing route visual inspection. Performance was assessed in terms of output (route completion) and form (number and duration of moves and stops). Route preview did not influence the output performance. Climbers using visual inspection were no more likely to finish the ascent than those without the option of using visual inspection. Conversely, route preview did influence form performance; climbers made fewer, and shorter stops during their ascent following a preview of the route. Form performances differences remained when baseline ability levels were taken into account, although for shorter duration of stops only with expert climbers benefiting most from route preview. The ability to visually inspect a climb before its ascent may represent an essential component of performance optimization.

背景与目标： : 攀登前的攀登路线视觉检查 (路线预览) 已被建议作为关键的攀登性能参数，尽管其作用从未经过实验验证。我们研究了这种感知认知技能对室内运动攀爬性能的影响。29名男性登山者，分为中级，高级和专家攀爬水平组，攀登了两条与他们的攀爬水平相匹配的室内运动路线，并在适用的情况下，攀登水平以下的路线。在每个级别上，都进行了一次预览，其中参与者受益于3分钟的攀登前攀登路线目视检查。根据输出 (路线完成) 和形式 (移动和停止的数量和持续时间) 评估性能。路由预览不影响输出性能。使用目视检查的登山者比没有使用目视检查的登山者完成攀登的可能性更大。相反，路线预览确实会影响形式的表现; 在预览路线后，登山者在上升过程中停留的次数更少，停留的时间更短。考虑到基线能力水平，形式性能差异仍然存在，尽管只有在较短的停留时间内，专家登山者才能从路线预览中受益最多。在爬升之前目视检查爬升的能力可能是性能优化的重要组成部分。

BACKGROUND & AIMS: :The importance of optimal well-being and mental health in elite athletes has received increasing attention and debate in both the academic and public discourse. Despite the number of challenges and risk factors for mental health and well-being recognised within the performance lifestyle of elite athletes, the evidence base for intervention is limited by a number of methodological and conceptual issues. Notably, there exists an increasing emphasis on the development of appropriate sport-specific measures of athlete well-being, which are required to underpin strategies targeted at the protection and enhancement of psychosocial functioning. Therefore, the purpose of this article is to review psychometric issues in well-being research and discuss the implications for the measurement of well-being in sport psychology research. Drawing on the broader literature in related disciplines of psychology, the narrative discusses four key areas in the scale development process: conceptual and theoretical issues, item development issues, measurement and scoring issues, and analytical and statistical issues. To conclude, a summary of the key implications for sport psychology researchers seeking to develop a measure of well-being is presented.

背景与目标： : 精英运动员最佳福祉和精神卫生的重要性在学术和公众讨论中都受到越来越多的关注和争论。尽管在精英运动员的表现生活方式中，精神卫生和福祉面临着许多挑战和风险因素，但干预的证据基础仍受到许多方法和概念问题的限制。值得注意的是，人们越来越重视制定针对运动员福祉的适当运动措施，这是为旨在保护和增强社会心理功能的战略提供基础的。因此，本文的目的是回顾幸福感研究中的心理计量学问题，并讨论对运动心理学研究中幸福感测量的意义。叙事借鉴心理学相关学科的更广泛的文献，讨论了量表发展过程中的四个关键领域: 概念和理论问题、项目发展问题、测量和评分问题以及分析和统计问题。最后，总结了运动心理学研究人员寻求发展幸福感的主要意义。

BACKGROUND & AIMS: CONTEXT:For patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care. OBJECTIVE:To compare the treatment effects of diskectomy and usual care. DESIGN, SETTING, AND PATIENTS:Prospective observational cohort of surgical candidates with imaging-confirmed lumbar intervertebral disk herniation who were treated at 13 spine clinics in 11 US states and who met the SPORT eligibility criteria but declined randomization between March 2000 and March 2003. INTERVENTIONS:Standard open diskectomy vs usual nonoperative care. MAIN OUTCOME MEASURES:Changes from baseline in the Medical Outcomes Study Short-Form Health Survey (SF-36) bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons/MODEMS version). RESULTS:Of the 743 patients enrolled in the observational cohort, 528 patients received surgery and 191 received usual nonoperative care. At 3 months, patients who chose surgery had greater improvement in the primary outcome measures of bodily pain (mean change: surgery, 40.9 vs nonoperative care, 26.0; treatment effect, 14.8; 95% confidence interval, 10.8-18.9), physical function (mean change: surgery, 40.7 vs nonoperative care, 25.3; treatment effect, 15.4; 95% CI, 11.6-19.2), and Oswestry Disability Index (mean change: surgery, -36.1 vs nonoperative care, -20.9; treatment effect, -15.2; 95% CI, -18.5. to -11.8). These differences narrowed somewhat at 2 years: bodily pain (mean change: surgery, 42.6 vs nonoperative care, 32.4; treatment effect, 10.2; 95% CI, 5.9-14.5), physical function (mean change: surgery, 43.9 vs nonoperavtive care 31.9; treatment effect, 12.0; 95% CI; 7.9-16.1), and Oswestry Disability Index (mean change: surgery -37.6 vs nonoperative care -24.2; treatment effect, -13.4; 95% CI, -17.0 to -9.7). CONCLUSIONS:Patients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care. However, nonrandomized comparisons of self-reported outcomes are subject to potential confounding and must be interpreted cautiously. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT00000410.

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BACKGROUND & AIMS: CONTEXT:  Despite a high incidence of injury in their sport, rodeo athletes have been underrepresented in the concussion literature. No standard postconcussion protocols are available across rodeo organizations for evaluating fitness to return to competition. OBJECTIVE:  To review the literature on concussion in rodeo, examine published guidelines, and offer an active return-to-play (RTP) protocol specific to rodeo athletes. BACKGROUND:  Unique barriers complicate the management and treatment of rodeo athletes with concussion, such as the solo nature of the sport, lack of consistent access to health care professionals, and athletic conditioning that often occurs outside of a traditional gym-based exercise regimen. In addition, the rodeo culture encourages a swift return to competition after injury. DESCRIPTION:  Best practices for managing concussion are removal from activity, proper diagnostic evaluation, and gradual return to sport, with medical clearance when an athlete is symptom free and able to tolerate cognitive and physical exertion. An RTP protocol for rodeo events needs to capture the distinctive features and challenges of the sport and its athletes. CLINICAL ADVANTAGES:  Rodeo athletes would benefit from an RTP protocol that can be initiated by an athletic trainer or medical professional in the acute stage of injury, integrates exercise into activities of daily living, and is appropriate for athletes who travel frequently. At the organizational sport level, a formal RTP protocol could enhance consistency in medical-clearance techniques among providers responsible for the return to sport of rodeo athletes. CONCLUSIONS:  Rodeo athletes represent a sport population that has received little formal guidance on the diagnosis, management, and RTP after concussion. A sport-specific RTP protocol sensitive to the particular culture of these athletes is an important first step in protecting the health and safety of rodeo athletes after a concussive injury.

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BACKGROUND & AIMS: BACKGROUND:A recent systematic review found that 87% of athletes return to sport after hip surgery for femoroacetabular impingement syndrome. However, the proportion of athletes returning to preinjury sport at their preinjury level of sport is less clear. PURPOSE:The main purpose of this study was to determine the rate of athletes returning to preinjury sport at preinjury level including their associated sports performance after hip arthroscopy for femoroacetabular impingement syndrome. Furthermore, self-reported hip and groin function was investigated. STUDY DESIGN:Cross-sectional study; Level of evidence, 3. METHODS:Eligible subjects were identified in the Danish Hip Arthroscopy Registry. A self-reported return to sport questionnaire was used to collect data after hip arthroscopy. If athletes reported they were engaged in preinjury sport at their preinjury level, the associated sports performance and participation were assessed as either (1) optimal sports performance including full sports participation; (2) impaired sports performance, but full sports participation; or (3) impaired sports performance including restricted sports participation. Self-reported hip and groin function was assessed for all athletes by use of the Copenhagen Hip and Groin Outcome Score. RESULTS:The study included 189 athletes (mean ± SD age at follow-up, 26.9 ± 3.4 years) at a mean ± SD follow-up of 33.1 ± 16.3 months after surgery. At follow-up, 108 athletes (57.1%) were playing preinjury sport at preinjury level, whereas the remaining 81 athletes (42.9%) failed to return to preinjury sport at preinjury level. Of the 108 athletes engaged in their preinjury sport at preinjury level at follow-up, 32 athletes (29.6%) reported optimal sports performance including full sports participation, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were engaged in preinjury sport at preinjury level compared with athletes who were not. CONCLUSION:Fifty-seven percent of athletes returned to preinjury sport at their preinjury level. This is considerably lower than a previously reported return to sport rate of 87% and may reflect that the present study used a clear and strict definition of return to sport. Of note, only one-third of athletes who returned to preinjury sport at preinjury level reported their sports performance to be optimal, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were playing preinjury sport at preinjury level compared with athletes who were not.

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