Roberts, William O.

Objective We examined the weight management practices of successful high school wrestlers to contribute meaningful data to the conversations that weight-certifying clinicians and athletic trainers have with athletes at the start of the wrestling season. Understanding how elite athletes navigate weight management can inform safer and more individualized guidance during preseason assessments. Specifically, we sought to determine the proportion of state-qualifying wrestlers who competed at or above their certified minimum weight class. We also quantified the magnitude of weight change from certification to state competition and analyzed seasonal trends in both body weight and body fat percentage over a 20-year period. Design Longitudinal retrospective review. Setting Four Minnesota high schools. Patients or Other Participants State-qualifying wrestlers from 2003 to 2023. Independent Variable State-qualifying weight class. Main Outcome Measure(s) Dependent variables are certification weight, measured body fat percent, and calculated minimum weight class. Results Only 48 wrestlers (52.7%; CI = 42.5%, 63.0%) competed at state in their minimum weight class, while the other 43 competed 1 to 2 weight classes above. Thirty-six wrestlers (39.6%) gained weight over the season. Conclusions Nearly half the successful wrestlers competed in weight classes above their minimum weight, while 5% lost 9% to 18% of their body mass over the wrestling season. This suggests factors other than maximizing individual athletic potential, such as team needs to fill a weight class, influence weight management decisions. Over the 20-year span of the study, trends toward lower measured body fat percentage and lower weight fluctuations suggest influences from sports specialization and year-round training and less emphasis on extreme leanness for competitive advantage. Athletes, in consultation with their coaches and clinicians, should select a competition weight class where they can adequately fuel, train, and recover. This may not be their minimum certified weight class.

Objectives : Assess the relationships between wet bulb globe temperature (WBGT) and physiologic equivalent temperature (PET) at the start of a northern latitude marathon and their associations with medical stress and transfers to the emergency room (ER) when the race environment is unexpectedly warm, and participants are not acclimatized. Design : Retrospective review. Setting : Twin Cities Marathon from 1990 to 2019. Participants : Runners competing in the Twin Cities Marathon. Independent variables : Start WBGT (prospectively collected) and PET (retrospectively calculated). Main Outcome Measures : Marathon race starters and finishers and race day medical data (eg, medical stress, number of medical encounters, and number of ER visits). Results : The mean WBGT was 7.4°C (range −1.7°C to 22.2°C), and the meant PET was 5.2°C (range −16.7°C to 25.9°C). PET was not determined to be a significant predictor of medical stress (P = 0.71); however, a significant quadratic association between WBGT and medical stress was found (P = 0.006). WBGT (P = 0.002), but not PET (P = 0.07), was a significant predictor of the number of ER visits. Conclusions: Start WBGT was a better predictor of medical stress and ER visits than PET at the Twin Cities Marathon over a 30-year period. The start WBGT may be a better tool to predict race day environment medical safety.

Objective: To assess the effectiveness of coronavirus disease 2019 (COVID-19) prevention strategies used during sports participation. Design: To analyze prospective reports of student-athletes with COVID-19–positive tests to assess prevention strategies and risk factors by sports and seasons. Setting: Minnesota high schools. Participants: Fall 2020 (August 24-October 30) and winter 2021 (January 2-March 12) student-athletes. Assessment of Risk Factors: Sports, indoor location, mask use, physical distancing, and season. Main Outcome Measures: COVID-19–positive test rates. Methods: Self-selected schools voluntarily reported, in 2-week intervals, the number of student-athletes with COVID-19–positive tests in each sport and the number of athletes participating in each sport during the fall and winter sports seasons. The positive testing rates per 100 000 athletes were calculated for participants in each sport and compared by sports type and risk variables. Results: The high school age community–positive testing rate was 1298 per 100 000 students in the fall and 2396 in the winter. The student-athlete positive testing rate was 1500 per 100 000 athletes during the fall and 2800 during the winter (χ2 = 1.98, df = 1, P = 0.350). Positive tests per 100 000 athletes ranged from 197 (girls alpine skiing) to 4151 (wrestling). The incidence rates comparing indoor with outdoor sports (P = 0.001) and close-contact with physically distanced sports (P = 0.023) were significantly different, but the incidence rates comparing indoor masked with unmasked sports (P = ns) were not different. Conclusion: Athletes competing in outdoor individual sports have less risk of a COVID-19–positive test compared with age-matched individuals in the community and indoor sports participants either wearing or not wearing masks during competition. Unmasked athletes in close proximity have the highest positive test rates, and unenforced masking is not associated with lower positive testing rates. More study is needed to understand mask effectiveness.

Objectives: The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these 5 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. Methods: 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. Results: To (1) establish a national and international hockey database for SRCs 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; and (6) mandate baseline testing to improve concussion diagnosis for all age groups. Conclusions: 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 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.

Abstract Removing fighting from ice hockey is an essential concussion prevention strategy that will improve the safety of the game at all levels.