The Diagnostic Accuracy of Screening Tools to Detect Eating Disorders in Female Athletes

2016 ◽  
Vol 25 (4) ◽  
pp. 395-398 ◽  
Author(s):  
Alyssa J. Wagner ◽  
Casey D. Erickson ◽  
Dayna K. Tierney ◽  
Megan N. Houston ◽  
Cailee E. Welch Bacon
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Sensitivity And Specificity ◽  
Female Athletes ◽  
Screening Tools ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Questionnaire Version

Clinical Scenario:Eating disorders in female athletes are a commonly underdiagnosed condition. Better screening tools for eating disorders in athletic females could help increase diagnosis and help athletes get the treatment they need.Focused Clinical Question:Should screening tools be used to detect eating disorders in female athletes?Summary of Key Findings:The literature was searched for studies that included information regarding the sensitivity and specificity of screening tools for eating disorders in female athletes. The search returned 5 possible articles related to the clinical question; 3 studies met the inclusion criteria (2 cross-sectional studies, 1 cohort study) and were included. All 3 studies reported sensitivity and specificity for the Athletic Milieu Direct Questionnaire version 2, the Brief Eating Disorder in Athletes Questionnaire version 2, and the Physiologic Screening Test to Detect Eating Disorders Among Female Athletes. All 3 studies found that the respective screening tool was able to accurately identify female athletes with eating disorders; however, the screening tools varied in sensitivity and specificity values.Clinical Bottom Line:There is strong evidence to support the use of screening tools to detect eating disorders in female athletes. Screening tools with higher sensitivity and specificity have demonstrated a successful outcome of determining athletes with eating disorders or at risk for developing an eating disorder.Strength of Recommendation:There is grade A evidence available to demonstrate that screening tools accurately detect female athletes at risk for eating disorders.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain

2017 ◽  
Vol 26 (5) ◽  
pp. 452-458 ◽  
Author(s):  
Barton E. Anderson ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Lung Function ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Back ◽  
Bottom Line ◽  
Breathing Exercises

Clinical Scenario:Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain.Focused Clinical Question:In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life?Summary of Key Findings:Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention.Clinical Bottom Line:Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2–3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician’s own judgment and clinical expertise and the patient’s preferences and values.Strength of Recommendation:Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

The Effect of Dry Needling on Patient-Reported Outcomes in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 24 (5) ◽  
pp. 186-192
Author(s):  
Jennifer F. Mullins ◽  
Arthur J. Nitz ◽  
Matthew C. Hoch
Keyword(s):  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
The Other ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Dry Needling ◽  
Bottom Line ◽  
Patient Reported

Clinical Scenario: Chronic ankle instability (CAI) and its associated recurrent sprains, feelings of instability, and decreased function occur in approximately 40% of individuals that suffer an ankle sprain. Despite these continued deficits, more effective treatment has yet to be established. Decreased sensorimotor function has been associated with CAI and may be amenable to dry needling treatment, thereby improving patient-reported outcomes (PROs). Focused Clinical Question: Does dry needling improve PROs in individuals with CAI? Summary of Key Findings: Two studies were identified that examined dry needling in participants with CAI. One of the two studies reported improvements in PROs (PEDro score 7/10) while the other study did not identify any changes (PEDro score 9/10). The inconsistent results were likely related to different treatment durations and follow-up timelines across the included evidence. Clinical Bottom Line: Based on the included studies, there is inconsistent evidence that dry needling can improve PROs in individuals with CAI. Strength of Recommendation: Utilizing the Strength of Recommendation Taxonomy (SORT) guidelines, level B evidence exists to recommend dry needling treatment to improve PROs for individuals with CAI.

The Effectiveness of Open Repair Versus Percutaneous Repair for an Acute Achilles Tendon Rupture

2016 ◽  
Vol 25 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Heidi Krueger ◽  
Shannon David
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Supporting Evidence ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Men And Women ◽  
Percutaneous Repair ◽  
Tendon Ruptures

Clinical Scenario:There are 2 approaches available for surgical repair of the Achilles tendon: open or percutaneous. However, there is controversy over which repair is superior.Focused Clinical Question:Which type of surgery is better in providing the best overall patient outcome, open or percutaneous repair, in physically active men and women with acute Achilles tendon ruptures?Summary of Search, “Best Evidence” Appraised, and Key Findings:The literature was searched for studies of level 3 evidence or higher that investigated the effectiveness of open repair versus percutaneous repair on acute Achilles tendon ruptures in physically active men and women. The literature search resulted in 3 studies for possible inclusion. All 3 good-quality studies were included.Clinical Bottom Line:There is supporting evidence to indicate that percutaneous repair is the best option for Achilles tendon surgery when it comes to the physically active population. Percutaneous repair has faster surgery times, less risk of complications, and faster recovery times over having an open repair, although it is acknowledged that every patient has a different situation and best individual option may vary patient to patient.

The Effects of Low-Level Laser Therapy on Pain Associated With Tendinopathy: A Critically Appraised Topic

2016 ◽  
Vol 25 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Andrew T. Doyle ◽  
Christine Lauber ◽  
Kendra Sabine
Keyword(s):  
Electrical Stimulation ◽  
Laser Therapy ◽  
Low Level Laser Therapy ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Low Level ◽  
Moist Heat ◽  
Low Level Laser ◽  
Level Laser

Clinical Scenario:Tendinopathies plague many active individuals, causing pain and reducing sport activity by decreasing range of motion and strength. There are many modalities that have been used to treat pain associated with chronic inflammation, such as ultrasound, moist heat packs, and electrical stimulation. Low-level laser therapy (LLLT) is one such modality. Potential benefits of managing pain associated with tendinopathies have been investigated using LLLT. Cellular respiration and metabolism are thought to be increased by LLLT acting on the mitochondrial cytochromes. The effects LLLT may have on cellular activity could increase blood flow to progress the healing process by reducing the pain-spasm cycle. The purpose of this critically appraised topic is to identify the clinical effectiveness of LLLT on pain associated with tendinopathy and to identify the parameters used to achieve statistically and clinically relevant pain outcomes.Focused Clinical Question:What is the effect of LLLT on pain associated with tendinopathy?Clinical Bottom Line:Although LLLT significantly decreases pain from baseline, its use may be no better than placebo or traditional treatments such as ultrasound, moist heat packs, electrical stimulation, or therapeutic exercise to reduce pain associated with tendinopathy. Total accumulated joules across the treatment sessions may need to be taken into account as a parameter.

scholarly journals A Critical Review of Eating Disorders in Female Athletes and Evidence-based Interventions for Sports Coaches

2021 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Early Identification ◽  
Female Athletes ◽  
Screening Tools ◽  
Return To Play ◽  
Additional Risk Factor ◽  
Weight Class ◽  
Increased Risk ◽  
Sports Coaches

Eating disorders (ED) are serious mental disorders, which can have serious health consequences and high mortality rates. Due to facing unique risk factors female athletes have increased susceptibility for ED. Female athletes are also at risk for subclinical conditions such as the Female Athlete Triad. There is a dearth of studies on preventing and identifying ED in female athletes and the role and responsibility of the sports coach is unclear. This study aimed to address the questions of whether female athletes are at increased risk for ED, what interventions currently show promise and what is the role of the sports coach in the intervention process. The study was based on a systematic review of relevant literature retrieved through PubMed and Sports Discus databases. Despite heterogeneity in prevalence studies, findings suggest that female athletes are at higher risk than male athletes and non-athletes and those in elite level sports or sports categorised as lean, aesthetic, endurance and weight-class are at increased risk for clinical and subclinical ED. Risk-factors unique to the sports environment such as weight pressures, competitive thinness and revealing uniforms, may lead to increased risk in female athletes. Despite a dearth of studies on interventions for ED in sport, findings suggest that primary prevention programs based on educating athletes such as ATHENA show most promise in prevention. Secondary prevention should focus on early identification using athlete-specific screening tools. Symptom checklists and pre-participation examinations can also assist coaches in early identification. Psychotherapy interventions such as CBT have had the best results for treatment. Sports coaches’ play a critical role in, early identification, referral, management and prevention of ED in female athletes. However, current findings suggest that many coaches lack knowledge about ED and require education to be able to intervene successfully in female athletes with ED. Inappropriate coaching behaviours have also been found to act as an additional risk-factor for ED. Recommendations for sports coaches in N.I. are provided to assist them in successful intervention, management and return to play of female athletes with ED.

scholarly journals Knowledge and Practice of Eating Disorders among a Group of Adolescent Dental Patients

2013 ◽  
Vol 38 (1) ◽  
pp. 39-43 ◽  
Author(s):  
TM Hicks ◽  
JY Lee ◽  
T Nguyen ◽  
M La Via ◽  
MW Roberts
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Status ◽  
Educational Interventions ◽  
Healthy Weight ◽  
Research Subjects ◽  
Dental Patients ◽  
Question Survey

Objectives: The objectives are to ascertain how much is known about the eating disorders of bulimia and anorexia nervosa in a group of female adolescents, to determine if they had practiced behaviors consistent with these eating disorders, and to determine if there was a disconnect with actual and perceived healthy weight status. Study Design: 126 research subjects completed a survey instrument. Embedded in the eighteen question survey were the five “SCOFF” questions, to determine if an eating disorder may exist. The BMI percentile was obtained for all participants. Results: 18.3% of the research sample may have an eating disorder as predicted by the SCOFF questions. Of those with a suspected eating disorder, only 38% could correctly identify the best description of bulimia nervosa and 50% for anorexia nervosa. The BMI percentiles were higher in the group suspected of having an eating disorder. Conclusions: Young adolescent females are at risk for eating disorders. Educational interventions should be directed at this young age group. If the at-risk individuals knew more about the consequences of these disorders, they may be less likely to practice the behaviors.

Developments in Eating Disorders Research

2020 ◽  
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Health And Wellbeing ◽  
The Impact

As everyone's thoughts are dominated by the impact of COVID-19 on mental health and wellbeing, it seems pertinent to start by thinking how people with or at risk of eating disorders may have been affected. Research suggests that the impacts differ according to the type of eating disorder concerns and behaviours.

Psychosocial Correlates of Disordered Eating Among Male Collegiate Athletes

2007 ◽  
Vol 1 (4) ◽  
pp. 340-357 ◽  
Author(s):  
Trent A. Petrie ◽  
Christy Greenleaf ◽  
Jennifer E. Carter ◽  
Justine J. Reel
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Eating Behaviors ◽  
Female Athletes ◽  
Collegiate Athletes ◽  
Male Athletes ◽  
Relationship Of ◽  
The Relationship

Few studies have been conducted examining male athletes and eating disorders, even though the sport environment may increase their risk. Thus, little information exists regarding the relationship of putative risk factors to eating disorders in this group. To address this issue, we examined the relationship of eating disorder classification to the risk factors of body image concerns (including drive for muscularity), negative affect, weight pressures, and disordered eating behaviors. Male college athletes (N= 199) from three different NCAA Division I universities participated. Only two athletes were classified with an eating disorder, though 33 (16.6%) and 164 (82.4%), respectively, were categorized as symptomatic and asymptomatic. Multivariate analyses revealed that eating disorder classification was unrelated to the majority of the risk factors, although the eating disorder group (i.e., clinical and symptomatic) did report greater fear of becoming fat, more weight pressures from TV and from magazines, and higher levels of stress than the asymptomatic athletes. In addition, the eating disorder group had higher scores on the Bulimia Test-Revised (Thelen, Mintz, & Vander Wal, 1996), which validated the Questionnaire for Eating Disorder Diagnosis (Mintz, O’Halloran, Mulholland, & Schneider, 1997) as a measure of eating disorders with male athletes. These findings suggest that variables that have been supported as risk factors among women in general, and female athletes in particular, may not apply as strongly, or at all, to male athletes.

Can Temperate-Water Immersion Effectively Reduce Rectal Temperature in Exertional Heat Stroke? A Critically Appraised Topic

2017 ◽  
Vol 26 (5) ◽  
pp. 447-451 ◽  
Author(s):  
Tyler T. Truxton ◽  
Kevin C. Miller
Keyword(s):  
Rectal Temperature ◽  
Water Immersion ◽  
Heat Stroke ◽  
Medical Emergency ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Temperate Water ◽  
Bottom Line ◽  
Exertional Heat Stroke ◽  
Cooling Rates

Clinical Scenario:Exertional heat stroke (EHS) is a medical emergency which, if left untreated, can result in death. The standard of care for EHS patients includes confirmation of hyperthermia via rectal temperature (Trec) and then immediate cold-water immersion (CWI). While CWI is the fastest way to reduce Trec, it may be difficult to lower and maintain water bath temperature in the recommended ranges (1.7°C–15°C [35°F–59°F]) because of limited access to ice and/or the bath being exposed to high ambient temperatures for long periods of time. Determining if Trec cooling rates are acceptable (ie, >0.08°C/min) when significantly hyperthermic humans are immersed in temperate water (ie, ≥20°C [68°F]) has applications for how EHS patients are treated in the field.Clinical Question:Are Trec cooling rates acceptable (≥0.08°C/min) when significantly hyperthermic humans are immersed in temperate water?Summary of Findings:Trec cooling rates of hyperthermic humans immersed in temperate water (≥20°C [68°F]) ranged from 0.06°C/min to 0.19°C/min. The average Trec cooling rate for all examined studies was 0.11±0.06°C/min.Clinical Bottom Line:Temperature water immersion (TWI) provides acceptable (ie, >0.08°C/min) Trec cooling rates for hyperthermic humans post-exercise. However, CWI cooling rates are higher and should be used if feasible (eg, access to ice, shaded treatment areas).Strength of Recommendation:The majority of evidence (eg, Level 2 studies with PEDro scores ≥5) suggests TWI provides acceptable, though not ideal, Trec cooling. If possible, CWI should be used instead of TWI in EHS scenarios.

scholarly journals Influence of parental eating disorder on children

1998 ◽  
Vol 4 (3) ◽  
pp. 144-150
Author(s):  
H. Woolley ◽  
R. Wheatcroft ◽  
A. Stein
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Psychiatric Disorders ◽  
Preventive Strategies ◽  
Disorder Eating ◽  
Appropriate Treatment ◽  
Child Bearing

It is now well established that children of parents who have psychiatric disorders are at risk of developing disturbances themselves (Rutter, 1989; Garmezy & Masten, 1994). Of particular concern is that these disturbances may persist well after remission of the parental disorder. Eating disorders occur commonly among women of child-bearing age (Szmukler, 1985; Fairburn & Beglin, 1990) and the prevalence seems to be rising (Treasure et al, 1996). Estimates indicate that at least 2% of women aged 16–40 suffer from bulimia nervosa or anorexia nervosa, and up to 4% when other eating disorders are considered (Fairburn & Beglin, 1990; Hoek, 1993). It is therefore surprising that the potential implications for their offspring have received so little attention until recently. Knowledge of whether these children are at risk and the mechanisms underlying any transmission of disturbance is important so that appropriate treatment can be instituted and preventive strategies put in place.

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