Search Our Scientific Publications & Authors

J Sci Med Sport 2018 Nov 6. Epub 2018 Nov 6.

Department of Family Medicine, University of Kansas Medical Center, USA; Department of Family Medicine Research Division, University of Kansas Medical Center, USA.

Objectives: Professional athletes undergo annual pre-season laboratory screening, although clinical evidence supporting the practice is limited and no uniform set of guidelines on pre-season laboratory screening exists. The aim of this study was to assess the clinical value of annual pre-season laboratory screening tests for a major professional sports team over multiple years.

Design: Retrospective chart review. Read More

Fam Med 2018 11;50(10):779-781

Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ.

Background And Objectives: The University of Arizona College of Medicine-Tucson TotShots clinic is a student-developed, student-directed free clinic that provides sports physicals and vaccines to uninsured pediatric patients in Tucson, Arizona. TotShots runs under the greater umbrella of the Commitment to Underserved People Program, which aims to teach medical students how socioeconomic and cultural factors impact health and access to health care. Our objective was to study cost savings and patient satisfaction of this clinic. Read More

Sports Health 2018 Jul/Aug;10(4):303-310. Epub 2018 May 31.

Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.

Background: The effect of socioeconomic status (SES) on rates of sports specialization and injury among youth athletes has not been described previously.

Hypothesis: Young athletes from lower socioeconomic status will have lower rates of sports specialization and subsequently lower risk of overuse injuries.

Study Design: Cohort study. Read More

J Sch Nurs 2018 Apr 6;34(2):139-148. Epub 2017 Mar 6.

2 Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, MN, USA.

Pre-participation physical exams (PPEs) hold great potential for addressing adolescents' health-risk behaviors. School nurses may be well positioned to assist with PPEs, yet little is known about their involvement. In this mixed methods study conducted in 2015, we collected data from school nurses in Texas (surveys, n = 208; key informant interviews, n = 10) to explore their roles and attitudes toward being involved in PPEs and addressing health-risk behaviors. Read More

Clin J Sport Med 2018 11;28(6):530-532

Background: Preparticipation physical examinations (PPEs) are required for children and adolescents before sports participation to identify at-risk athletes. These evaluations can be completed in a traditional office-based setting or in a station-based format. It is unclear if one format is superior to the other in identifying at-risk athletes. Read More

Clin J Sport Med 2018 11;28(6):538-539

Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio.

Objective: Quantify physical activity in healthy student athletes.

Design: Cross-sectional survey.

Setting: Five Central Ohio schools during mass preparticipation physicals. Read More

J Electrocardiol 2017 May - Jun;50(3):316-322. Epub 2017 Jan 16.

Department of Medicine/Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States.

Background: Recent Expert consensus statements have sought to decrease false positive rates of electrocardiographic abnormalities requiring further evaluation when screening young athletes. These statements are largely based on traditional ECG patterns and have not considered computerized measurements.

Objective: To define the normal limits for Q wave measurements from the digitally recorded ECGs of healthy young athletes. Read More

J Child Neurol 2016 12 12;31(14):1607-1610. Epub 2016 Sep 12.

The Children's Hospital of Philadelphia, Westat Biostatistics and Data Management Core, Philadelphia, PA, USA.

The authors enrolled 95 patients in a primary care office who presented with a concussion. Of these patients, 63% were sport concussions. The authors matched 90 of these patients to children in the authors' practice presenting for sports physicals or regular check-ups in the following demographics: age, participating in a particular sport, having attention-deficit disorder/attention-deficit hyperactivity disorder, gender, and grade. Read More

Optom Vis Sci 2017 01;94(1):89-95

*OD, MBA, FAAO †OD, MSPH, FAAO ‡OD, FAAO §MPH, MD ‖MEd. ATC/L The University of Alabama at Birmingham Sports Medicine Clinic at Children's of Alabama, Birmingham, Alabama (all authors).

Purpose: The King-Devick test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading. Read More

Pediatr Ann 2015 Sep;44(9):354-8

In the pediatric office, the summer months are filled with well-child visits and sports physicals. It is during these visits that it is important to evaluate our patients as a whole, remembering to discuss both physical and emotional concerns. It is also important to discuss the upcoming school year so concerns by both parents and children can be addressed. Read More

J Adolesc Health 2015 Aug;57(2):218-21

Department of Orthopedics, Sports Medicine Program, Children's Hospital Colorado, Aurora, Colorado.

Purpose: Adolescent athletes undergo preparticipation screening for long QT syndrome. Medications that are associated with QT interval prolongation are increasingly being prescribed to precollege students. The side effect profile of these medications during exercise is unknown. Read More

J Optom 2015 Apr-Jun;8(2):131-9. Epub 2015 Jan 31.

Wheaton College Sports Medicine, Wheaton, IL, USA.

Purpose: Sports-related concussion has received increasing attention as a result of neurologic sequelae seen among athletes, highlighting the need for a validated, rapid screening tool. The King-Devick (K-D) test requires vision, eye movements, language function and attention in order to perform and has been proposed as a promising tool for assessment of concussion. We investigated the K-D test as a sideline screening tool in a collegiate cohort to determine the effect of concussion. Read More

Am J Sports Med 2015 Apr 2;43(4):794-801. Epub 2015 Feb 2.

Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA.

Background: Data are lacking regarding the independent risk of injury related to intense single-sport training or growth rate in young athletes.

Purpose: To determine whether sports specialization, weekly training volumes, and growth rates are associated with increased risk for injury and serious overuse injury in young athletes.

Study Design: Case-control study; Level of evidence, 3. Read More

Subst Abus 2015 31;36(4):400-6. Epub 2014 Dec 31.

a Institute for Research on Women & Gender (IRWG) , University of Michigan , Ann Arbor , Michigan , USA.

Background: Despite numerous studies examining the association between competitive sports participation and substance use behaviors among adolescents and young adults, the use of standardized measures to assess potential substance use disorders has been largely neglected. The objective of this study was to examine if past involvement in interscholastic sports (competitive school-sponsored sports) was associated with potential substance use disorders in young adulthood.

Methods: Data for this study were taken from the Student Life Survey (SLS). Read More

Pediatrics 2014 Nov 6;134(5):957-64. Epub 2014 Oct 6.

Department of Pediatrics, and Children's Outcomes Research Program, Children's Hospital Colorado, Aurora, Colorado; Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, Colorado;

Objective: School-based health centers (SBHCs) have been suggested as possible patient-centered medical homes. Our objectives were to determine, in a low-income, urban population, adolescents' reasons for visiting SBHCs and the value parents place on SBHC services, and adolescents' and parents' assessment of how well SBHCs fulfill criteria for a medical home as defined by the American Academy of Pediatrics.

Methods: A cross-sectional, mailed survey of a random sample of 495 adolescent SBHC users and 497 parents of SBHC users from 10 SBHCs in Denver, CO from May to October 2012. Read More

J Electrocardiol 2014 Nov-Dec;47(6):769-74. Epub 2014 Aug 2.

VA Palo Alto Health Care System, Palo Alto, CA, USA.

Unlabelled: Controversy regarding adding the ECG to the evaluation of young athletes centers on the implications of false positives. Several guidelines have been published with recommendations for criteria to distinguish between ECG manifestations of training and markers of risk for cardiovascular (CV) sudden death. With an athlete dataset negative of any CV related abnormalities on follow-up, we applied three athlete screening criteria to identify the one with the lowest rate of abnormal variants. Read More

Front Public Health 2014 21;2:69. Epub 2014 Jul 21.

Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine , Baltimore, MD , USA ; Institute of Sports Chronobiology , Washington, DC , USA ; Veterans Integrated Service Network 19, Mental Illness Research Education and Clinical Center , Denver, CO , USA ; Tuning, Inc. , Silver Spring, MD , USA.

Despite increased interest regarding the potentially long-term negative impact of chronic traumatic brain injury, limited research has been conducted regarding such injuries and neurological outcomes in real world settings. To increase understanding regarding the relationship between sparring (e.g. Read More

J Pediatr Health Care 2015 Jan-Feb;29(1):17-27. Epub 2014 Jul 17.

Introduction: Preparticipation examinations (PPEs), or sports physicals, present opportunities for health care providers to identify and discuss common adolescent health-risk behaviors. We sought to examine the prevalence of health-risk behaviors among high school athletes and the proportion of providers who address these behaviors during PPEs.

Method: For this descriptive study we used data from two statewide surveys: a survey of adolescents (n = 46,492) and a survey of nurse practitioners and physicians (n = 561). Read More

Prehosp Disaster Med 2014 Apr 10;29(2):195-9. Epub 2014 Apr 10.

3 Section of Disaster Medicine, Harvard Medical School, Boston, Massachusetts USA.

Introduction: On January 12, 2010, a magnitude 7.0 earthquake devastated Haiti. Data regarding the prevalence of medical and psychosocial needs after the earthquake is scarce, complicating informed targeting of aid. Read More

FP Essent 2014 Feb;417:30-7

Bayfront Sports Medicine Fellowship, 700 6th Street South, St. Petersburg, FL 33701,

Millions of children seek sports physicals from their family physicians or team physicians every year. The preparticipation physical evaluation has evolved over the past 40 years. Physicians performing these evaluations need to be familiar with current guidelines regarding components of the evaluation and criteria for clearance for participation in sports. Read More

Int J Sports Phys Ther 2013 Aug;8(4):531-6

Physical Therapy Services, Elizabethton, TN, USA.

Unlabelled: The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. Read More

Pediatr Ann 2013 Nov;42(11):224-8

Scoliosis is defined as a lateral curvature of the spine greater than 10 degrees on radiography that is typically associated with trunk rotation. The three major types of scoliosis are congenital, idiopathic, and neuromuscular. Idiopathic scoliosis is divided into three subcategories based on the age of onset. Read More

Crit Care Nurs Clin North Am 2013 Jun 4;25(2):263-72. Epub 2013 Apr 4.

Vanderbilt University School of Nursing, Nashville, TN 37240, USA.

Hypertrophic cardiomyopathy is a complex cardiovascular disorder particularly sensitive to environmental changes and physiologic stress. Warm weather and strenuous activity can be a dangerous combination for people that have hypertrophic cardiomyopathy. Often sudden cardiac death is the first symptom of the disorder. Read More

Int J Sports Phys Ther 2013 Apr;8(2):180-93

Texas State University, San Marcos, TX, USA.

Background And Purpose: The sports physical therapist (SPT) is uniquely qualified to participate in the provision of preparticipation physical examinations (PPE). The PPE is recommended prior to athletic participation and required by many jurisdictions. There is little research to support the process and components; however, a number of professional organizations have recommendations that direct the PPE process. Read More

J Fam Pract 2013 Mar;62(3):154-63

Robert Wood Johnson Medical School, Family Medicine Residency at Capital Health, Trenton, NJ, USA.

Probably not. Although some European and international experts recommend that all athletes undergo preparticipation electrocardiogram (EKG) screening, it's unclear whether screening reduces the risk of sudden cardiac death (SCD); US experts don't recommend it routinely for school-aged athletes. Read More

J Am Acad Orthop Surg 2013 Feb;21(2):108-17

Department of Orthopaedic Surgery and Sports Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.

Because deep vein thrombosis (DVT) can occur following orthopaedic procedures, knowledge of hereditary and acquired risk factors for DVT is essential. Hereditary forms of thrombophilia include factor V Leiden and prothrombin G20210A mutations, and deficiencies of antithrombin III, protein C, and protein S. Acquired risk factors include but are not limited to trauma, immobilization, and surgical procedures. Read More

J Am Assoc Nurse Pract 2013 Feb 12;25(2):55-64. Epub 2012 Dec 12.

School of Nursing, Columbia University, New York, NY 10032, USA.

Purpose: This article provides information regarding the most common nonlife-threatening and catastrophic injuries that occur during cheerleading, and describes the role of the nurse practitioner (NP) in managing patients who participate in cheerleading.

Data Sources: Literature review of evidence-based research articles, epidemiological reports, and current guidelines.

Conclusions: Cheerleading is one of the most popular sports among adolescent females, and participation has increased rapidly in recent years. Read More

Tex Med 2012 Jul 1;108(7):43-5. Epub 2012 Jul 1.

Current University Interscholastic League rules allow physicians, physician assistants, nurse practitioners, and chiropractors to perform physicals. But a special Texas Medical Association subcommittee that vetted sports injury-related bills during the last legislative session questions whether chiropractors have the necessary training to adequately conduct sports physicals. In May, the TMA House of Delegates adopted a resolution that says only licensed physicians, or their appropriately supervised physician assistants or advanced practice nurses should perform sports physicals. Read More

Clin Sports Med 2012 Apr;31(2):247-54

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 3079, Chicago, IL 60637, USA.

The Female Athlete Triad poses serious health risks, both short and long term, to the overall well-being of affected individuals. Sustained low energy availability can impair health, causing many medical complications within the skeletal, endocrine, cardiovascular, reproductive, and central nervous systems. With the surge of females participating in athletics within the past 10 to 15 years, it is both conceivable and likely that the prevalence of this syndrome will continue to grow. Read More

J Am Acad Nurse Pract 2012 Feb 30;24(2):63-9. Epub 2012 Jan 30.

ProHealth Physicians of Hamden, Hamden, Connecticut, USA.

Purposes: The purposes of this article are to explore the mechanism of sudden cardiac death (SCD) in young athletes and examine how preparticipation screenings help identify precipitating cardiac abnormalities. Electrocardiogram (ECG) testing has been implicated to play an important role in detecting subtle abnormalities that may cause SCD, but the routine implementation of this diagnostic tool remains a debate among experts.

Data Sources: This report was compiled by reviewing the scientific literature on SCD in athletes, preparticipation exams, and current screening guidelines using CINAHL, MEDLINE, and PubMed search engines. Read More

PLoS One 2012 19;7(1):e29109. Epub 2012 Jan 19.

Department of Neurology, University of Cincinnati, Cincinnati, Ohio, United States of America.

Purpose: Baseball requires an incredible amount of visual acuity and eye-hand coordination, especially for the batters. The learning objective of this work is to observe that traditional vision training as part of injury prevention or conditioning can be added to a team's training schedule to improve some performance parameters such as batting and hitting.

Methods: All players for the 2010 to 2011 season underwent normal preseason physicals and baseline testing that is standard for the University of Cincinnati Athletics Department. Read More

NASN Sch Nurse 2011 Sep;26(5):318-9

Glenbrook South High School, Glenbrook, Illinois, USA.

With the beginning of each school year athletes of all ages are gearing up to play. The National Athletic Trainers' Association offers several important tips for consideration before a player begins formal participation, including information regarding pre-participation physicals; beating the heat; locker room cleanliness; emergency action plans; and exercising caution with head injuries, including new information concerning the difference between concussions in girls and boys. Read More

Adv NPs PAs 2011 Aug;2(8):42

Emergency Department, St. Joseph Mercy Port Huron Hospital, Port Huron, MI, USA.

Phys Ther Sport 2011 Aug 13;12(3):108-16. Epub 2011 Jul 13.

University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Female sports participation at the high school level has significantly increased since the 1970s. Physical activity in females has numerous positive benefits, including improved body image and overall health. Unfortunately, a select population of exercising females may experience symptoms related to the "female athlete triad," which refers to the interrelationships among energy availability, menstrual function, and bone mineral density. Read More

J Fam Pract 2010 Aug;59(8):437-44

Family Medicine and Community Health, University of Medicine and Dentistry of New Jersey - Robert Wood Johnson, New Brunswick, NJ 08903, USA.

Cover the 12 components of the preparticipation physical evaluation (PPE) recommended by the American Heart Association to screen young athletes for potentially life-threatening cardiovascular disease. Perform a genitourinary exam as part of the PPE for young men; assess young women for the criteria associated with the female athlete triad. Perform auscultation while the patient is squatting and while doing the Valsalva maneuver to determine whether any murmurs you detected on examination are associated with hypertrophic cardiomyopathy. Read More

J Fam Pract 2010 Jul;59(7):E410a-b

Department of Family Medicine, University of Colorado, Denver, CO, USA.

J Am Board Fam Med 2010 Mar-Apr;23(2):195-203

Department of Family Medicine, St. John Hospital, Detroit, MI, USA.

Background: Health literacy has been defined as the ability to obtain, process, and understand the basic information needed to make appropriate health decisions. Half of adults lack the health literacy skills needed for our complex health care environment. In 2005, Weiss et al introduced the Newest Vital Sign (NVS), an instrument that can be used to quickly assess health literacy. Read More

Adv Nurse Pract 2009 Aug;17(8):26

J Sch Nurs 2010 Feb 6;26(1):18-25. Epub 2009 Nov 6.

University of Scranton, Scranton, Pennsylvania, USA.

High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to have the highest incidence of sudden cardiac death. Read More

Clin Orthop Relat Res 2009 Feb 7;467(2):412-9. Epub 2008 Nov 7.

Department of Orthopaedic Surgery, Atlanta Medical Center, 303 Parkway Drive NE, Box 442, Atlanta, GA 30312, USA.

More individuals are participating in athletics today than ever before. Physicians treating athletes confront unique diagnostic and treatment challenges and an increased risk of legal liability. The key areas regarding liability are preparticipation examinations, determination of eligibility, evaluation of significant on-field injuries, and information disclosure. Read More

Sex Transm Dis 2008 Nov;35(11 Suppl):S19-23

Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA.

Background: Urine-based screening for Chlamydia trachomatis using highly sensitive and specific nucleic acid amplification tests offers a unique opportunity to screen men attending school-based health centers.

Methods: As part of a large multicenter chlamydia screening project in men, 1434 students were enrolled; 1090 in high schools in Baltimore and 344 middle and high-school students in Denver. Students were screened for chlamydia using urine-based nucleic acid amplification tests at well adolescent visits, acute care visits, or visits for other reasons, such as sports physicals. Read More

Stroke 2007 Apr 22;38(4):1143-7. Epub 2007 Feb 22.

Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.

Background And Purpose: Vascular disorders that increase risk for stroke may be accompanied by decrements in cognitive functioning and by stroke symptoms in the absence of diagnosed stroke or transient ischemic attack. This study evaluates relationships among cognitive status, stroke symptom reports, and cardiovascular and behavioral factors.

Methods: REasons for Geographic and Racial Differences in Stroke (REGARDS), a prospective population study of stroke incidence, assesses stroke risk with telephone interviews and in-home physicals. Read More

Fam Pract Manag 2006 Oct;13(9):39-40

Pharos Alpha Omega Alpha Honor Med Soc 2005 ;68(3):33-4

Pediatric Infectious Diseases, University of California, Davis, CA 95817, USA.

Clin Orthop Relat Res 2005 Apr(433):50-7

Section of Sportsmedicine & Shoulder Surgery, Department of Orthopaedic Surgery, University of South Alabama College of Medicine, 3421 Medical Park Drive, Mobile, AL 36693, USA.

The practice of sports medicine represents a unique subspecialty within the discipline of medicine. Practitioners provide care for athletes who engage in activities that may put the athletes at risk for serious injury. Physicians may be held legally liable for not doing a standardized pre-participation evaluation, for not administering adequate on-site or after injury care, or for violating an individual's civil rights by refusing to allow continued participation because of medical risk. Read More

Am J Sports Med 2004 Apr-May;32(3):744-54

Department of Family Medicine, University of South Florida College of Medicine, Tampa, Florida 33612, USA.

Background: Sudden cardiac death is the leading cause of death in athletes. Evidence on current sudden cardiac death prevention through preparticipation history, physicals, and noninvasive cardiovascular diagnostics has demonstrated a low sensitivity for detection of athletes at high risk of sudden cardiac death. Data are lacking on automated external defibrillator programs specifically initiated to respond to rare dysrhythmia in younger, relatively low-risk populations. Read More

Curr Sports Med Rep 2004 Apr;3(2):77-83

DeWitt Army Community Hospital, 9051 Farrell Road, Suite GC 11, Ft. Belvoir, VA 22060, USA.

Risk factors for thromboembolism are well known, and athletes are placed under conditions that can result in exposure to several of these risk factors, which include travel, trauma, immobilization, hemoconcentration, and polycythemia. Presence of a genetic hypercoagulable disorder adds additional risk. Overall management is no different than in nonathletes. Read More

J Adolesc Health 2003 May;32(5):336-9

Department of Public Health and Preventive Medicine, School of Medicine in New Orleans, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.

In an urban school district, 636 students in grades 9-12 were tested for Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction assays using specimens collected for routine urinalyses during sports physical examinations. Chlamydia and gonorrhea prevalences were 2.8% and 0. Read More

Pa Health You 2002 ;105(4)

Mil Med 2002 Oct;167(10):831-4

Department of Medicine, Cardiology Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.

Sudden cardiac death in seemingly healthy young people during exertion has led to preparticipation assessment of athletes. Typically, cardiac evaluation is limited to auscultation by a primary care provider. Screening electrocardiography is controversial. Read More