James R. Whitehead

Acsm and Champ Summit on Sickle Cell Trait: Mitigating Risks for Warfighters and Athletes

INTRODUCTION An estimated 300 million people worldwide have sickle cell trait (SCT). Although largely benign, SCT has been associated with exertional rhabdomyolysis and exercise-related sudden death in warfighters/athletes (WA). The National Collegiate Athletic Associations policy to confirm a student athletes SCT status during their preparticipation medical examination prompted reaction from some organizations regarding the rationale and ethical justification of the policy. METHODS On September 26 and 27, 2011, a summit, composed of military and civilian experts in sports medicine and SCT, was convened at the Uniformed Services University in Bethesda, MD. The expert panel was charged with two objectives: 1) to provide specific recommendations to further mitigate the apparent risk with strenuous exercise in WA with SCT and 2) to develop clinical guidelines to identify, treat, and return to duty/play WA suspected to have incurred nonfatal sickle cell collapse. RESULTS New terminology is introduced, areas of current controversy are explored, consensus recommendations for mitigating risk and managing the WA with SCT are reviewed, and important areas for future research are identified. CONCLUSION Further research is needed before conclusions can be drawn regarding the etiology of the increased death rate observed in WA with SCT, and the possibility exists that SCT is a surrogate for as yet another contributing factor for the unexplained deaths.

Protecting the heart of the American Athlete: Proceedings of the American college of cardiology sports and exercise cardiology think tank October 18, 2012, Washington, DC

Yvette L. Rooks, MD, CAQ, FAAFP[1][1] G. Paul Matherne, MD, FACC[2][2] Jim Whitehead[3][3] Dan Henkel[3][3] Irfan M. Asif, MD[4][4] James C. Dreese, MD[5][5] Rory B. Weiner, MD[6][6] Barbara A. Hutchinson, MD, PhD, FACC[7][7] Linda Tavares, MS, RN, AACC[8][8] Steven Krueger, MD, FACC[9][9

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

Abstract 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−1) 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

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.

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 on 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 (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 subsequently voted on for purposes of prioritization. The following proceedings include 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 includes 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.

Early determinants of physical activity levels in children.

Objective: To examine the factors in pregnancy and early life that may be associated with physical activity in 11 to 12 year-old children. Design: Cohort study. Setting: Avon longitudinal study of parents and children (ALSPAC), United Kingdom. Participants: All pregnant women in the Avon health area who had an expected delivery date between 1 April 1991 and 31 December 1992 were invited to participate in the study. Of 14,062 babies who were initially enrolled, 7159 children attended study clinics at 11 years of age. Valid actigraphs were obtained for 5595 children. Multiple births were excluded thus the sample comprised 5451 children (52% girls). Assessment of risk factors: Birth outcomes and measurements were obtained from birth records. Questionnaires at 12, 18, and 32 weeks and 6, 8, 21, 24, 30, 38, and 54 months obtained details of the mother’s and her partner’s physical activity and smoking during the pregnancy; the levels of activity of child and parents, the child’s motor coordination and time spent outside during the first 2 years; and the 2 to 5 year-old child’s time spent outside, time viewing television, and duration of night time sleep. Demographic, anthropometric, lifestyle, and psychometric information was obtained. Main outcome measures: The main outcome measures were associations of birth outcomes, prenatal characteristics, and early childhood characteristics with 11 year-old physical activity. Activity was measured on an actigraph accelerometer as average counts per minute (cpm) during 7 days after the clinic visit. Moderate to vigorous activity was defined as .3600 cpm. The children were asked to complete time sheets for swimming and cycling and for the period that the actigraph was worn. Results were adjusted for age and sex, and additionally for socioeconomic factors. Main results: No birth outcomes were associated with later physical activity. Maternal and her partner’s nonsmoking status, younger maternal age, brisk walking and swimming during pregnancy, a greater number of previous pregnancies, and birth during seasons other than spring were significantly associated with greater physical activity at 11 years. Characteristics (or the presence) of the mother’s partner were not associated with the child’s later level of physical activity, nor was obesity in either parent. In infancy, only the child’s coordination at 6 months and the parents’ physical activity at 21 months were positively related to activity at 11 years. Less time spent watching television at 2 to 5 years was weakly related to more later physical activity, but time spent outside was not. In sex specific analyses the mother’s brisk walking in pregnancy and the child’s motor coordination at 6 months were related to physical activity at 11 years in girls but not in boys. Conclusions: Prebirth and early life factors had weak associations with activity levels in 11 year-old children. A physically active household may encourage a child’s physical activity.

Ice Hockey Summit II: Zero Tolerance for Head Hits and Fighting

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.

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.

ACSM and CHAMP summit on sickle cell trait

INTRODUCTION An estimated 300 million people worldwide have sickle cell trait (SCT). Although largely benign, SCT has been associated with exertional rhabdomyolysis and exercise-related sudden death in warfighters/athletes (WA). The National Collegiate Athletic Associations policy to confirm a student athletes SCT status during their preparticipation medical examination prompted reaction from some organizations regarding the rationale and ethical justification of the policy. METHODS On September 26 and 27, 2011, a summit, composed of military and civilian experts in sports medicine and SCT, was convened at the Uniformed Services University in Bethesda, MD. The expert panel was charged with two objectives: 1) to provide specific recommendations to further mitigate the apparent risk with strenuous exercise in WA with SCT and 2) to develop clinical guidelines to identify, treat, and return to duty/play WA suspected to have incurred nonfatal sickle cell collapse. RESULTS New terminology is introduced, areas of current controversy are explored, consensus recommendations for mitigating risk and managing the WA with SCT are reviewed, and important areas for future research are identified. CONCLUSION Further research is needed before conclusions can be drawn regarding the etiology of the increased death rate observed in WA with SCT, and the possibility exists that SCT is a surrogate for as yet another contributing factor for the unexplained deaths.