Jan 29, 2015
Bulletin Board

Re-Thinking LQTS Guidelines For years, athletes diagnosed with Long QT Syndrome (LQTS)–a genetic abnormality in the heart’s electrical system–have been told by most doctors that it is in their best interest to discontinue participation in athletics. But a recent study from the Mayo Clinic may change the advice physicians give their LQTS patients.

Published online by the Journal of the American Medical Association, the study examined the medical records of 130 LQTS patients ages 6 to 40 who were evaluated at the Mayo Clinic between July 2000 and November 2010. The patients chose to continue athletic participation after diagnosis and LQTS-related events despite the recommendation not to do so.

Of these patients, 20 had an implantable cardioverter-defibrillator (ICD), 49 participated in more than one sport, 32 competed at the high school level, and eight competed at either the college or professional levels. During the 10 years the study covered, only one athlete experienced a LQTS-triggered event while participating in a sport. In that athlete’s case, he twice received a corrective shock from his ICD and survived.

“About eight years ago, after I started to see some of these lives ruined by the recommendation to discontinue sports, we decided to challenge the status quo,” Michael Ackerman, MD, PhD, a pediatric cardiologist and Director of the Mayo Clinic’s LQTS Clinic said in a statement. “We adopted a philosophy that empowered patients and their families with the right to make an informed and difficult decision about continuing in competitive sports, a possible LQTS risk-taking behavior.

“We felt that although exercise, sports, and the thrill of victory and agony of defeat could potentially trigger a dangerous heart rhythm in these patients, that in a well-counseled, well-studied, and well-treated patient, these may be manageable risks,” Ackerman continued. “Up until now, the current status quo has been to view these things as controllable risk factors which are controlled by kicking these patients out of most sports.”

To view the Mayo Clinic’s press release on the study, visit: www.mayoclinic.com and type “Sports Guidelines for Long QT Syndrome Patients” into the search window.

Fitness Tests Offer Little Injury Info

University of Alberta researchers recently set out to find whether athletes who are in better shape are less prone to injury. Surprisingly, they discovered that preseason fitness levels had little connection to risk of injury during the season.

The researchers began by looking at 86 athletes from men’s and women’s college varsity teams in three sports (ice hockey, volleyball, and basketball) before their seasons started. They put the athletes through a battery of six fitness tests: A vertical jump test to measure anaerobic power and lower-body strength, a sit-and-reach test to measure lower back and hip flexibility, a cone running drill to measure agility, pushups to measure upper-body strength, sit-ups to measure core strength and flexibility, and a range-of-motion test to measure shoulder flexibility. Then, at a postseason meeting, the researchers gathered injury reports from the athletes.

After calculating the “time to first injury” for each athlete, the researchers compared that figure to the preseason fitness test results and found little connection. In fact, “The only connection we found between preseason fitness and injury was that [weaker] upper-body strength, as evaluated by pushups, was associated with a shorter time to injury,” researcher Michael Kennedy, PhD, Assistant Professor of Physical Education and Recreation at Alberta, told Medical News Today. “This was despite most of the injuries being associated with the lower body.”

Meanwhile, though it wasn’t the original goal, the study found that gender and the specific sport played were much more strongly connected. Female athletes were more likely to suffer an injury before males, with an average time to first injury of 41 percent of the season compared to 60 percent for male athletes. Volleyball players had the shortest mean time to injury at 27 percent of the season compared to 58 for basketball and 68 for ice hockey.

To download the study, which appeared in Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology in July, go to: www.smarttjournal.com and search “pre-season fitness measures.”

Revamped Sickle Cell Legislation Proposed

NCAA Division III is not giving up on implementing sickle cell trait (SCT) testing. While legislation requiring SCT testing was voted down at the NCAA Convention last January, a new proposal has been submitted.

The most recent legislation includes several new educational components. One calls for all D-III student-athletes to receive baseline education regarding SCT. Another requires athletes who opt out of status confirmation to receive additional education regarding risks, impacts, and precautions relating to SCT. The proposal also allows athletes to participate even if they don’t know their SCT status, as long as they undergo more education.

“The key for this new proposal is its educational umbrella,” Management Council Chair and University of Redlands Athletic Director Jeff Martinez told the NCAA News. “This proposal ensures that all student-athletes are aware of the importance of knowing their status, and of the risks those who opt out are taking.”

According to Martinez, additional outreach and incorporation of feedback from members with concerns over the original legislation makes this proposal more likely to pass. “Last year’s proposal already had the President’s Council backing, but the governance structure perhaps under-communicated the nuances of what was being proposed,” Martinez said. “Between the outreach that’s already been done and what is yet to be done to get the membership to understand the importance of this measure, I’ll be surprised if anyone at the 2013 Convention can honestly say they didn’t know this was coming.”

If the proposal gets the nod in January, current D-III athletes would be required to undergo testing or provide documentation of a previous test by the 2014-15 academic year. All incoming athletes (first year and transfer) would need to do the same beginning in 2013-14.

It’s Gotta Be the Shoes

Runners looking for a performance edge may be able to find one on the shoe rack. Using a wind tunnel to measure wind drag on mid- and long-distance running shoes, researchers in England recently concluded that a more aerodynamic and “dimpled” sneaker could provide athletes with a competitive advantage.

Published in the International Journal of Sports Science and Engineering, the study was led by Robert Ashford, PhD, Director of Postgraduate Research Degrees at Birmingham City University’s Faculty of Health. His team observed and measured the drag on four pairs of shoes at four different wind speeds.

Ashford and his team determined that the design texture of a running shoe’s upper (the part that secures the shoe to the foot) and the overall shape of its “frontal aspects” could affect a runner’s performance. Furthermore, Ashford said in a press release that shoe designs incorporating dimples resembling those found on golf balls contributed to improved aerodynamics and performance.

“If looking at differences in wind conditions, these small differences over a long period of time may actually affect energy consumption and ultimately the finishing time for an individual athlete–whether they are a professional or an amateur,” Ashford said, adding that his group’s work may be the tip of the iceberg for evaluating footwear performance. “Very little research to date has been done on the material of running shoes and there is great potential here for the future.”

To view a video about the study, go to: www.youtube.com and search: “Research shows running shoe could improve performance of Olympic athletes.”


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