Jacob John Capin

Introduction: Sufficient sleep is integral to overall health whereas suboptimal sleep puts athletes at greater risk for injury, lengthens their recovery time, and decreases their performance. Our purpose was to compare sleep across training days (i.e., competition, practice, and rest) in adolescent athletes, specifically identifying differences between nights before and after training. Methods: Participants [ n = 33 (14 male, 19 female), aged 15.6 ± 1.0 years] wore an activPAL accelerometer continuously for 14 consecutive days and completed a sleep log noting training day status (i.e., competition, practice, rest). Results: Athletes slept less on the day after competition compared to after practice and rest days [Sleep Duration (mean ± SD ) after competition: 7.9 ± 1.6 h, after practice: 8.6 ± 0.8 h, after rest: 9.2 ± 1.4 h, interaction effect p < 0.001]. The time athletes went to bed tended to be later before and after rest days compared with competition and practice days [Time in Bed Start (hr:min, mean ± SD ) before competition: 22:02 ± 0:58, after competition: 22:19 ± 1:03, before practice: 22:20 ± 0:49, after practice: 22:06 ± 0:40, before rest: 22:55 ± 1:09, after rest: 23:13 ± 0:58, p = 0.080]. Athletes woke up the latest on and after rest days (before competition: 6:52 ± 1:16, after competition: 6:11 ± 1:21, before practice: 6:59 ± 0:43, after practice: 6:43 ± 0:42, before rest: 7:35 ± 1:09, after rest: 8:26 ± 1:22, p < 0.001). Conclusion: In conclusion, athletes slept less the day after a competition compared with the day after a practice or rest day. While sleep start times did not differ by training day, athletes woke up later before and after rest days. Understanding factors influencing athletes’ sleep may enable health care providers and coaches to help athletes stay healthy and optimize their performance.

Elite athletes are highly sedentary outside of sports and must stay active after retiring to remain healthy. While sports are often recommended to improve

Introduction: The transition out of competitive sport comes with a range of psychosocial challenges for athletes, particularly when retirement is involuntary (e.g., due to injury). Little is known about the health of former athletes who often manage prior injuries and changing biopsychosocial factors. Purpose: Identify the unique experiences of varsity athletes during college and as they transition to life after college sports and determine the facilitators, barriers, and needs of college varsity athletes to engage in a physically active and healthy lifestyle after competitive sport retirement. Methods: Thirty former college varsity athletes (15F, 15M; mean age 23 ± 1 yrs; BMI: 26 ± 4 kg/m ² ) who finished competing approximately 2 weeks to 2 years prior participated in semi-structured, qualitative interviews asking open-ended questions describing their experiences as college athletes and their transition to life after college sports. Interview topics centered on physical and psychological health, physical activity and exercise, diet, the overall transition experience including ways in which athletes felt well equipped or poorly equipped for life after sport, and what could have facilitated their transition to life after collegiate athletics. Researchers conducted coding and thematic analysis using an iterative and collaborative approach until no new themes were constructed. Findings: Most athletes participated in National Collegiate Athletic Association (NCAA) Division I (87%) or III (10%) sports. Athletes represented a variety of sports with Volleyball ( N = 7), Soccer ( N = 6), and Track & Field ( N = 6) more common than others. Three main themes were constructed: (1) College athlete uniqueness; (2) Transitioning to life after college sport; and 3) Empowering former athletes to live more healthfully. Despite many unique and beneficial experiences of college athletes, the highly scheduled lives of college athletes led to a post-retirement loss of structure and support, negatively impacting those without a clear post-college sports plan and social network. Former athletes described pain and soreness that often lessened or resolved after a few months of no longer competing in sports. Athletes expressed how they could have been empowered to live more healthfully in the transition away from college athletics including guidance on nutrition, managing prior injuries, and exercising for general health rather than sports performance. Discussion: Competitive athletes have unique experiences that both equip and challenge them as they transition away from structured sport environments and the associated support systems. Former athletes identified several key factors that may facilitate a healthier transition, including guidance on exercising for general health, managing pain and prior injuries, nutrition, and social support. Understanding the needs of athletes transitioning out of competitive sport will better equip healthcare providers to counsel, educate, and treat athletes for optimal long-term health.

Introduction: Effective leadership in sports is associated with better team functioning, physical and psychosocial wellbeing, and reduced incidence of severe injuries. In spite of widespread anecdotal support, few studies have empirically evaluated leadership development in athletes. The purpose of this study was to investigate socially responsible leadership capacity and self-efficacy in college varsity athletes and determine the impact of competitive sports participation on leadership capacity and self-efficacy. We hypothesized that college varsity athletes would (1) exhibit greater leadership capacity and self-efficacy than nonathletes and (2) demonstrate greater growth in leadership capacity and self-efficacy than nonathletes. Methods: The Multi-Institutional Study of Leadership survey was distributed to a representative sample of United States college students in 2018. The leadership outcomes of college varsity (intercollegiate) athletes and nonathletes were compared using the Socially Responsible Leadership Scale and Leader Self-Efficacy Scale. The Socially Responsible Leadership Scale has an omnibus score and six subscales: self-awareness, personal responsibility, integrity, collaboration, open-mindedness, and civic engagement. Student’s t-tests were used to compare scores on the Socially Responsible Leadership Scale and Leader Self-Efficacy Scale between athletes and nonathletes. Hierarchical multiple linear regression analyses were conducted for each leadership outcome, both with and without leadership high-impact practices. Results: The study contained 50,653 participants, including 8,447 college varsity athletes (age 20.3 ± 1.5 years, 56.2% women) and 42,206 nonathletes (age 20.2 ± 1.5 years, 65.9% women). While athletes reported statistically higher levels of self-awareness and leader self-efficacy but lower integrity and open-mindedness compared with their nonathlete peers, all comparisons had trivial effect sizes (all Cohen's d < 0.02; range: −0.067 to 0.159). There were no differences between athletes and nonathletes in terms of personal responsibility, collaboration, civic engagement, and the omnibus score of the Socially Responsible Leadership Scale. In regression models with and without leadership high-impact practices, athlete status explained only 0.1% or less of variance in each leadership outcome. Discussion: The findings from this large sample of college athletes and nonathletes ( n = 50,653) challenge widely held notions regarding sports and leadership, suggesting that competitive sports alone may not help people develop leadership capacity or self-efficacy. While sports provide opportunities for people to engage in leadership high-impact practices, athletes may benefit from additional resources to develop leadership skills inside and outside of sports.

The primary purpose of this study was to determine the preoperative predictors of gait biomechanics 6 months after unilateral total knee arthroplasty (TKA). There were 126 participants (age 64.4 ± 7.1 years, 75 females) who underwent instrumented biomechanical assessments while walking at a self‐selected pace preoperatively, 10 weeks after (post‐rehabilitation), and 6 months after unilateral TKA. Outcomes were peak knee extension moment (pKEM), knee angle excursion, and vertical ground reaction force (vGRF) ratio (surgical/contralateral). Potential clinical, demographic, and biomechanical predictors were tested univariately and considered a candidate for the final model if p < 0.15. Each multivariate model initially contained all candidates, and backward selection was used to determine the final model. Greater 6‐month surgical limb pKEM was predicted (r² = 0.31) by greater preoperative pKEM (β = 0.44, p < 0.0001), better quadriceps activation (β = 0.23, p = 0.004), and male sex (β = −0.21, p = 0.009). Greater 6‐month surgical knee excursion was predicted (r² = 0.34) by greater preoperative excursion (β = 0.39, p < 0.0001), male sex (β = −0.28, p = 0.0007), and preoperative quadriceps strength (β = 0.16, p = 0.047). Six‐month vGRF ratio was predicted (r² = 0.16) by preoperative vGRF ratio (β = 0.37, p < 0.0001) and study treatment group (β = 0.18, p = 0.03). Preoperative biomechanical variables at post‐rehabilitation were also the strongest predictors of 6‐month biomechanics.Statement of Clinical Significance: The strongest and most consistent predictor of gait biomechanics 6 months after TKA was the respective preoperative gait biomechanics variable, which may have important clinical implications for surgical decision making and prehabilitation/rehabilitation strategies. Biofeedback targeting vGRF predicted vGRF symmetry, but no other gait parameters, suggesting targeted interventions are needed. Improving quadriceps strength and activation may also facilitate knee biomechanics.

Physical activity (PA) promotes better cardiometabolic health, physical function, brain health and longevity. In contrast, prolonged sedentary behaviour (SB) is a risk factor for many chronic diseases and poor health. Limited research has evaluated or synthesised how competitive sports participation influences PA across the lifespan. Some evidence suggests, ironically, that former competitive athletes may be insufficiently active and current athletes may be highly sedentary away from sport. This study describes the protocol for a systematic review and meta-analysis on activity levels across the intensity spectrum in athletes, addressing the primary research question: is sports participation significantly associated with PA and/or SB among current and former competitive athletes? PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and SPORTDiscus databases will be searched. Two reviewers will independently screen titles/abstracts and full texts of selected abstracts. Data will be extracted regarding the study population, sport played, PA measures and protocols, outcomes of interest and findings. Primary outcomes will include step counts, daily activity across the intensity spectrum (ie, sedentary, light, moderate and vigorous PA), metabolic equivalent of task and whole-day energy expenditure. Secondary outcomes will include additional accelerometry measures of PA, activity patterns and self-reported PA. The risk of bias will be assessed using the National Institutes of Health Study Quality Assessment Tools. Extracted data will be presented using narrative synthesis and tabular presentation. Meta-analyses will be conducted to determine outcomes with sufficient data.PROSPERO registration number: CRD42024469267.

Sports participation confers many health benefits yet greatly increases injury risk. Long-term health outcomes in former athletes and transition to life after competitive sports are understudied. Ending a sport may pose physical and psychosocial challenges. The purpose was to determine the lived experiences of former competitive athletes and how their sports participation impacted their long-term health and well-being. Former college varsity athletes participated in semistructured interviews focusing on their experiences, including past and current health, the impact of injuries, activity, exercise, diet and transition to life after competitive sport. Thematic analysis was completed using a collaborative, iterative process. Thirty-one (16 female, 15 male) former college athletes aged 51.3±7.4 years were interviewed. Six themes emerged: (1) lifelong athlete identity; (2) structure, support and challenges of the college athlete experience; (3) a big transition to life beyond competitive sport; (4) impact of competitive sport on long-term health; (5) facilitators and barriers to long-term health after sport and (6) transferable life skills. Continuing sports eased the transition for many but often delayed their postathlete void. Challenges included managing pain and prior injury (eg, If I didn't have my knee injury, I would definitely be more active), reducing energy needs and intake (eg, When I was an athlete, I could eat anything; and unfortunately, that’s carried into my regular life), lack of accountability, changed identity and lost resources and social support. Participants suggested a programme, toolkit, mentoring or exit course to facilitate the transition. While former athletes benefit from transferrable life skills and often continue sports and exercise, they face unique challenges such as managing pain and prior injury, staying active, reducing energy intake and changing identity. Future research should develop and evaluate a toolkit, programme and other resources to facilitate life after ending competitive sports under ‘normal’ conditions (eg, retirement) and after a career-ending injury.

While sports medicine has traditionally focused on recovering from injury and returning athletes to sport safely after injury, there is a growing interest in the long-term health of athletes. The purpose of this scoping review was to (1) summarise the literature (methodologies and findings) on physical function, body composition and cardiometabolic health in midlife (age 40–65 years) former competitive athletes compared with non-athlete controls, (2) identify areas for future study in long-term health in athletes and (3) determine outcomes that could be evaluated in a future systematic review(s). We searched PubMed, CINAHL, Web of Science and SPORTDiscus for studies published between 2000 and 2022 evaluating former athletes and controls on physical function, body composition and/or cardiometabolic measures using MeSH terms. We identified 20 articles that met our criteria. Outcomes varied considerably across studies, most of which were cross-sectional and evaluated only males. Limited data suggest that former endurance athletes have leaner body compositions, higher aerobic capacity and better cardiometabolic indicators than controls; former athletes who maintain higher physical activity (ie, self-reported exercise) are healthier than those who do not; and former team sport athletes, who have higher injury prevalence, may have poorer functional performance than controls who were recreationally active in college. Studies rarely evaluated functional performance, did not control for prior injury or diet and seldom assessed current physical activity levels. Future research should include females and evaluate sex differences, control for prior sports-related injury(ies), quantify physical activity, use standardised outcome measures including performance-based functional assessments and incorporate longitudinal designs.

Background: Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for COVID-19 survivors randomized participants, following hospital discharge, to either education and unstructured physical activity or a telerehabilitation program. Step count data were collected as a secondary outcome, and we found no significant differences in total step count trajectories between groups at 6 weeks. Further step count data were not analyzed. Objective: The purpose of this analysis was to examine step count trajectories and correlates among all participants (combined into a single group) across the 12-week study period. Methods: Linear mixed models with random effects were used to model daily steps over the number of study days. Models with 0, 1, and 2 inflection points were considered, and the final model was selected based on the highest log-likelihood value. Results: Participants included 44 adults (41 with available Fitbit [Fitbit LLC] data). Initially, step counts increased by an average of 930 (95% CI 547-1312; P<.001) steps per week, culminating in an average daily step count of 7658 (95% CI 6257-9059; P<.001) at the end of week 3. During the remaining 9 weeks of the study, weekly step counts increased by an average of 67 (95% CI −30 to 163; P<.001) steps per week, resulting in a final estimate of 8258 (95% CI 6933-9584; P<.001) steps. Conclusions: Participants showed a marked improvement in daily step counts during the first 3 weeks of the study, followed by more gradual improvement in the remaining 9 weeks. Physical activity data and step count recovery trajectories may be considered surrogates for physiological recovery, although further research is needed to examine this relationship. Trial Registration: ClinicalTrials.gov NCT04663945; https://tinyurl.com/2p969ced