Projects funded by Pac-12 Student-Athlete Health and Well-Being Grant Program announce progress and findings
SAN FRANCISCO – The Pac-12 announced today that research projects funded by the Conference’s Student-Athlete Health and Well-Being Initiative continue to yield beneficial results and feedback. As part of the initiative, the Pac-12 annually funds millions of dollars in research that is conducted on its campuses. Projects on head trauma, mental health, coach health education, cardiovascular screening, thermal management, overuse injuries and injury surveillance, and more are all in progress from past funding cycles.
Created in 2013, the Pac-12 Grant Program is part of the overall Pac-12 Student-Athlete Health and Well-Being Initiative. The initiative is a collective effort between Pac-12 member universities to find ways to reduce injuries, share current best practices and latest studies, and conduct research to uncover new ways to keep student-athletes as safe as possible. The Grant Program has made it a priority to fund cutting-edge research by pooling the collective expertise of its membership, which comprises some of the foremost research institutions in the world.
“I am very pleased that the Pac-12 Grant Program is having a substantive impact on the health and well-being of our student-athletes,” said Pac-12 Commissioner Larry Scott. “Be it through advances in performance and equipment through Stanford’s thermal management project, or the establishment of best practices and educational programming for cardiovascular screening and head trauma protocols at Washington, all of our universities are making progress to make sports safer for Pac-12 student-athletes.”
In May 2018, doctors and athletic trainers from around the conference met at the annual Pac-12 Student-Athlete Health Conference and updated each other on the research projects taking place on their campuses and being funded by the Pac-12 Grant Program.
Listed below are projects currently taking place as part of the Grant Program (with the lead university noted), as well as updates on the projects’ status and early findings:
CARE Consortium Data Collection: Establishing a Research Infrastructure and Framework (PAC-12 BRAIN TRAUMA TASK FORCE)
The Pac-12 Concussion Coordinating Unit (CCU), being administered by COLORADO, coordinates with the NCAA Concussion Assessment, Research and Education (CARE) Consortium for the collection of concussion-related data elements and is responsible for onboarding institutions into the Pac-12 CARE Affiliated Project (CAP) over a three-year period. Each Pac-12 institution will collect a common set of concussion-related data elements on student-athletes through a new tablet-based platform developed by SyncThink. These data will ultimately be deposited into the broader NCAA CARE database where it will be used for research and evidence-based clinical guideline evaluation. The Pac-12 CCU and CAP are well underway with baseline data being collected on seven teams from four Pac-12 institutions in the 2017-18 academic year. This will expand to additional teams and Pac-12 institutions in the 2018-19 academic year and beyond.
Head Trauma: Roles of Nutritive Support and Supplementation (CALIFORNIA)
The goal of this project is to determine whether or not supplementation with lactate on the background of adequate nutrition will improve traumatic brain injury (TBI) recovery by giving the brain an extra fuel source. Clinical research on human patients after severe TBI shows that standard of care treatment results in poor recovery outcomes. As well, that and related research shows that lactate is a major metabolic intermediate and brain fuel always, and including after brain injury. To better understand the mechanistic relationships following mild, concussive brain injury the researchers are developing an animal model of closed head injury. Researchers have developed a sensitive, stable, non-radioactive method to assess nutritional adequacy and have established histochemical and biochemical methods to track brain signaling as well as behavioral outcomes following concussive injury in lab rats. At present, feeding and lactate supplementation studies are underway. Considering all the variables such as gender, time, nutrition and nutrition plus lactate supplementation, over 100 animals will be studied in the coming year.
Health and Wellness: Assessing Student-Athlete Health and Performance (COLORADO)
Among the goals of this study is to observe sleep patterns in student-athletes as well as possible sleep problems and mood disturbances related to travel. Findings related to sleep patterns have shown that while student-athletes experience a lower prevalence of clinically-relevant sleep problems, student-athletes experience a much higher prevalence of excessive daytime sleepiness compared to non-varsity students. Additionally, sleep patterns were measured in student-athletes before, during and after travel for competition in football and women’s volleyball. Along with an immediate impact of travel on sleep patterns during the weekend, researchers observed a sustained disruption of sleep well into the following week. Mood disturbance was assessed before and after travel for competition in women’s volleyball. A consistent increase in total mood disturbance was observed following travel across two seasons. However, the magnitude of mood disturbance was attenuated during the 2017 season compared to the 2016 season, which may reflect the NCAA rule change that curtailed the use of travel days counting as days off for student-athletes implemented prior to the 2017 season.
Overuse Injuries/Injury Prevention: Integration of Biomechanics-based Informatics for Prevention of Stress Fractures (OREGON)
Lower extremity stress fractures are common across collegiate student-athletes. Endurance running athletes experience a disproportionately higher rate of stress fractures. The purpose of this three-year study is to develop a system for integration of biomechanics-based data using an informatics approach to provide assessment of stress fracture risk in collegiate endurance running athletes. In the first year of the study, researchers have built a database structure and analysis system for four Pac-12 schools (Oregon, Colorado, USC, Stanford) to utilize for biomechanics data storage and analysis, and development of predictive models of stress fracture risk. In the next two years, researchers will continue to build and refine this integrated biomechanics-based informatics system. The final outcome of this project will be a system that can incorporate other Pac-12 schools, providing an early warning system that can be used to advise medical and coaching staff about current stress fracture risks in individual student-athletes. As a result, many incidents of stress fracture may be avoided, and the full athletic potential of student-athletes may be more fully realized.
Thermal Management for Athletes: Problems and Opportunities (STANFORD)
Elevated core body temperature (hyperthermia) is a common occurrence during athletic practice and competition. At a minimum, hyperthermia impairs performance, but more seriously it can rapidly progress to heat stroke, which can be lethal. Researchers in this study have developed effective methods for extracting heat from the body core to prevent hyperthermia from progressing to heat illness. Beyond safety, the research has shown performance and conditioning opportunities associated with efficient heat extraction. An important discovery was that rise in temperature of working muscles contributes to muscle failure. Therefore, heat extraction extends the working capacity of muscles. When applied to a conditioning routine, work capacity increases resulting in conditioning increases. With the caveat that initial work capacity has to be at a level that significantly increases muscle temperature before major benefits from heat extraction are seen, researchers report results showing that the percent changes in performance associated with heat extraction are similar in female athletes to results seen in male athletes. In conjunction with the research, a parallel effort to design, prototype and test new wearable cooling systems is underway.
Overuse Injuries/Injury Prevention: A Prospective Study to Improve Bone Health and Reduce Incidence of Bone Stress Injuries in Pac-12 Female Distance Runners (STANFORD)
The primary objective of this project is to improve the health of female collegiate distance runners and reduce the incidence, severity and recovery time of bone stress injuries with an active nutrition education program. Preliminary results show 100 percent participation between UCLA and Stanford and confirm the study is successful at identifying over a third of the athletes at risk for low energy availability. By helping to reverse this finding, the year two preliminary results show a trend toward reduced incidence of bone stress injuries. We are still awaiting analysis of data analyzing bone health. Subanalysis demonstrates that vitamin D levels were inversely correlated to time lost to bone stress injury. In addition, the Female Athlete Triad Cumulative Risk Assessment tool prospectively predicts bone stress injuries in this high risk group of female distance runners.
Mental Health and Head Trauma: Brain Health in Male and Female Basketball Players at the University of Utah (UTAH)
The Pac 12 research initiative at University of Utah is aimed at identifying brain-based features that will predict current and future wellness in collegiate athletes. The study applies multimodal neuroimaging techniques including magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and functional magnetic resonance imaging (fMRI) in a longitudinal design. This data, combined with measures of concussion, depression, anxiety and neuropsychological function will be used to identify brain changes in depressed athletes and determine whether imaging endpoints can be used as biomarkers for treatment intervention and outcome. To date, the findings indicate differences in mood by sport, season, and sex. In addition, researchers have found that brain chemistry measured by MRS shows reduced brain total creatine concentration in basketball players over multiple time points. Furthermore, creatine concentration correlated with depression measures reported by the basketball players. These data provide insight into potential neurobiological mechanisms associated with depression and suggest novel treatment approaches for student-athletes.
Cardiovascular Screening in the Pac-12: Establishing Best Practices (WASHINGTON)
This study is designed to answer critical questions regarding screening for cardiovascular conditions that predispose athletes to sudden death by comparing the schools that screen with history and a physical to those that add an electrocardiogram. The study will compare conditions identified, total costs, costs per diagnosis, time lost from competition, and any adverse outcomes related to screening with each strategy. In the Pac-12, about half of the schools do their cardiovascular screening with history and physical only and the other half add ECG to their screening protocol. This study gathered records from pre-participation screening for over 8,600 athletes at 11 different Pac-12 institutions who were screened with either approach. Initial results show that screening with ECG identifies about 1-in-370 athletes with a cardiovascular condition associated with sudden death while screening with history and physical alone identifies 1-in-2,500 athletes. Additional analysis will be needed to understand the cost per diagnosis, the time lost from competition while work ups were being performed, and the accuracy of ECG interpretation, including the false positive rate of institutions that have implemented ECG screening. The individual cardiovascular screening questions will also be evaluated to improve the existing history in an evidence-based approach. This data will provide valuable information to better understand how to most effectively and cost-efficiently screen for cardiovascular conditions related to sudden cardiac death and will provide guidance not just to the Pac-12 but to athletes at all levels.
Injury Prevention: Simple Motion Capture Technology for Readiness of Return to Sport Assessment and Injury Risk Prediction (WASHINGTON)
Advances in motion analysis have been able to demonstrate movements that may be risk factors for both initial anterior cruciate ligament (ACL) injury as well as subsequent reinjury after reconstruction surgery. The aim of this study is to validate the use of a simple, markerless motion capture technology (Microsoft Kinect™) as an inexpensive means to identify abnormal lower extremity movements that pose as risk factors for ACL injury and assess readiness for return to sport. This study assessed the concurrent validity of the Microsoft Kinect against an established 3-dimensional motion analysis system in 20 healthy subjects. Knee kinematics were assessed during impact activity in the coronal and sagittal plane specifically evaluating peak knee valgus and peak knee flexion during single leg hop and jump from box exercises. The results from the Microsoft Kinect were found to be in poor agreement with those from a standard motion capture system. Measuring complex lower extremity movements with the Microsoft Kinect does not provide adequate enough information to use as an assessment tool for injury risk and return to sport timing thus suggesting that other objective measurements should be utilized to help guide athletes’ return to high levels of sport safely after knee surgery or injuries.
Head Trauma: Pac-12 Student-Athlete Project on Developing Coach Education (WASHINGTON)
The goal of this project is to develop coach concussion education that is interactive, informative and acceptable to Pac-12 coaches. A multidisciplinary team of researchers has partnered with coaches and medical staff from the start of the project, working to ensure the final product would fit within Pac-12 culture. Building on the theme of “Coaches Matter,” the team developed an on- line concussion educational platform (GoHuddle). The goal of this platform was to illustrate the powerful influence coach behavior can have on athlete decisions around health and safety, and model positive responses in key scenarios. The platform also provides up-to-date concussion information, including videos to illustrate sport-specific concussion mechanisms and links to current evidence regarding concussion incidence and injury prevention strategies. Over the past six months, the team has been working closely with coaches and medical staff to conduct usability testing and refine the platform. The research group is now launching the next phase of the project, utilizing the GoHuddle platform as a fulcrum for a pre-season meeting between the coaching and medical staff for each team. Over the next two years, the team will assess the efficacy of both the platform and this pre-season meeting throughout the Pac-12 Conference.
The request for proposal for the 2019 funding cycle of the Grant Program will be released by July 1, 2018 and will be found at pac-12.com/conference/sahwbgp. Letters of Intent for the 2019 cycle are due Sept. 17, 2018. Questions may be sent to firstname.lastname@example.org and more information on the Pac-12’s Student-Athlete Health and Well-Being Initiative can be found at pac-12.com/conference/sahwbgp.
About the Pac-12 Conference
The Conference has a tradition as the “Conference of Champions,” leading the nation in NCAA Championships in 52 of the last 58 years, with 511 NCAA team titles overall. The Conference comprises 12 leading U.S. universities: The University of Arizona, Arizona State University, the University of California-Berkeley, the University of California at Los Angeles (UCLA), the University of Colorado, the University of Oregon, Oregon State University, Stanford University, the University of Southern California, the University of Utah, the University of Washington and Washington State University. For more information on the Conference’s programs, member institutions, and Commissioner Larry Scott, go to www.pac-12.com/conference.
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