Research

2017 Summer Intern KSI Fellowship Experience

Miwako Suzuki, KSI Intern Fellow

My name is Miwako Suzuki, and I am an Athletic Training student at Indiana State University. Gratefully, I was chosen to receive the opportunity to intern at the Korey Stringer Institute in the Summer Fellowship Program. I am originally from Japan, and I studied Athletic Training there as well. While receiving my education in Japan, I found it necessary to learn more about prevention and management of emergency conditions, and this sense of mission brought me to the United States. I became aware of the KSI four years ago when I was still in Japan through Dr. Yuri Hosokawa, Vice President of Education and Communication at the KSI, and I have been attracted to the KSI since then. The past two months and ten days that I spent with the KSI members were full of great experiences and learning.

Among the several projects that I worked on during the summer, the main focus was placed on the Athletic Training Locations and Services (ATLAS) Project. The aim of the ATLAS Project is to determine the extent of current athletic training services provided in the secondary school setting, and it was launched in January 2016 with these goals:

  • Create a real-time database of athletic training services in secondary schools
  • Create a directory for each state’s athletic training association and high school athletics association
  • Assist states in moving toward full-time athletic training services
  • Provide useful data to each state’s athletic training association and high school athletic association
  • Identify common factors associated with increased athletic training services across the country
  • Provide data to assist with legislative efforts to improve healthcare for high school athletes

 

At the beginning of the summer, the ATLAS Project was at the stage of figuring out the extent of athletic training services in the last 10% of high schools that we had been unable to reach. To reach those schools, I have tried multiple methods such as making phone calls, writing emails to athletic directors, and searching their website for athletic trainer’s information. Even though I made some progress with these strategies, the most effective method was reaching out to athletic trainers of the neighboring high schools of the unknown schools for help. From this experience, I have learned firsthand that ATLAS is not only a great database but also a very useful communication tool. While interacting with high school athletic trainers throughout the nation, many of them showed their appreciation and support for this study. I am very grateful to be one of the members to propel this important project forward. I would like to thank Dr. Robert Huggins for including me in this project and always guiding me. I also would like to thank Sarah Attanasio, ATC, for teaching me and providing help whenever I asked.

Testing for the Falmouth Road Race study began in mid July. We conducted a modified heat tolerance test on recreational runners of a wide range of ages who are participating in the New Balance Falmouth Road Race on August 20th, 2017. Although the study will not be completed until the race day, collecting data on individuals’ physiological responses to exercise in the heat was a great learning opportunity for me. I believe that the wide distribution of demographics of this study allowed me to encounter various responses among the subjects. With regard to conducting a laboratory test, I observed the effort of the KSI members to make the study robust. I was very fortunate to learn from such experienced and passionate colleagues. I would like to express my deepest gratitude to Dr. Yuri Hosokawa and Kelsey Rynkiewicz, ATC, for their effort to involve me in this study.

 

On August 20th, which will be my last day as a KSI fellow, I will be at the New BalanceFalmouth Road Race and will serve as a medical volunteer with the KSI staff. The Falmouth Road Race has been recognized for its high incidence rate of exertional heat illnesses because of the environmental conditions and its short duration (7.1 miles), which allows runners to maintain relatively high intensity throughout the entire duration of the course. According to a previous study from the KSI, this race has saved multiple exertional heat stroke patients each year. Since I have never encountered a real exertional heat stroke case, I would like to take this opportunity as a great hands-on learning experience.

 

I appreciate every aspect of the activities that I had the opportunity to take part in at the KSI. The KSI was an even greater place than I expected. All the members are making a great effort for their projects with the strong passion and commitment for the KSI’s mission. I believe that this is the reason why the KSI has been successfully leading our profession. Lastly, I would like to thank Dr. Douglas Casa for providing such a great opportunity. I fully enjoyed summer 2017 with such great colleagues.

NSCA 40th Annual National Conference

Courteney Benjamin MS, CSCS

Associate Director of Communication and Assistant Director of Athlete Performance and Safety

Members of KSI had the opportunity to travel to Las Vegas, Nevada for the 40th annual National Strength and Conditioning Conference
where strength and conditioning coaches, personal trainers, sport scientists, sport nutritionists, and health enthusiasts gathered to present, network, and honor certain outstanding members.

 

We were fortunate to attend a lecture given by this year’s Sport Scientists of the Year, Shawn M, Arent, and Dave DiFabio from Polar, whom we had the opportunity to work with in the past. They discussed the use of wearable technology and how coaches and sport scientists should start thinking about applying the knowledge we gather from this data to practice.

Ryan Curtis, Yasuki Sekiguchi, and I presented some of the recent research findings from the KSI. I presented a poster titled, “Analysis of Women’s Cross Country Lab Tests Results and Training Over the Course of a Competitive Fall Season” on Thursday (7/13/17). I examined the change in lactate testing, VO2 max and training of the UCONN Women’s Cross Country team during their fall season. The major finding of this study was the vOBLA (velocity at onset of blood lactate) was significantly higher during the middle of the season while VO2 max did not change throughout the season. During my presentation, I was very excited to reconnect with two of my former colleagues from Florida State University. Daniel Shaefer was the former director of strength and conditioning at FSU and is now working on is PhD at the University of Wisconsin-Madison. Jon Jost was the former FSU director of strength and conditioning and recently accepted a position with Gatorade. I am hopeful that we will get an opportunity to collaborate on future research. I also had the fortune to meet Kristen Holmes-Winn, from WHOOP, who funded the research Ryan and I presented at this conference.

 

Yasuki Sekiguchi presented a poster titled “Heartrate Variability between Starters and Nonstarters throughout a Collegiate Soccer Season.” During this study, HRV and training load metrics were monitored over the course of D1
college soccer season. The relationship between these variables were examined for all players, starters, and nonstarters. The major finding of this research was that acute:chronic training load ratio might be used to explain the changes in HRV over the course of a Division 1 male soccer team

Ryan Curtis did an oral presentation on Saturday (7/15/17) titled “Relationship between Sleep, Training Load and Fitness in Collegiate Soccer.” Overall this study illustrated that sleep quality may be more sensitive to increased training load than sleep quantity. Collegiate athletes with increased training loads have increased light sleep but not REM sleep or overall sleep duration.

Outside of the conference, we had a fantastic time exploring the Las Vegas strip and the beautiful hotel hosting us and the conference, Paris Las Vegas. I am extremely thankful to the NSCA and KSI for the opportunity to collaborate and learn from others in the field while making memories that will last a lifetime. I look forward to attending this event next year and present the results from our upcoming projects.

 

2017 ACSM Annual Meeting Recap

Yasuki Sekiguchi, MS, CSCS, Assistant Director of Athlete Performance

 

The American College of Sports Medicine (ACSM) Annual Meeting was held in Denver, CO from May 30-June 3. Most of the KSI staff attended this outstanding conference and they were honored with the opportunities to present their research. We had great discussion with the audiences and received critical feedback for future work via these presentations.

  • Douglas J. Casa, PhD, ATC, FACSM- Catastrophic Heat and Exertional-Related Conditions among Athletes
  • Robert A. Huggins, PhD, ATC- Biomarkers of Endocrine, Muscle, and Inflammatory Health Track Training Loads of a Collegiate Soccer Season

  • William M. Adams, PhD, ATC- Monitoring Cardiovascular, Hepatic, Renal, and Hematological Markers of Health in Collegiate Soccer Players
  • Yuri Hosokawa, PhD, ATC- Outcomes from a Modified Heat Tolerance Test to Track Thermal Strain

  • Samantha E. Scarneo, MS, ATC- Assessing the Reliability and Validity of an Objective Method of Measuring Postural Stability: Preliminary Data

  • Luke N. Belval, MS, ATC, CSCS- Comparison of Rectal Temperature Prediction Models Utilizing Machine Learning

  • Ryan M. Curtis, MS, ATC, CSCS- Starters and Non-starters Require Separate Load Monitoring and Analyses Throughout a Collegiate Soccer Season
  • Rachel K. Katch, MS, ATC- Weighted Heat Stress Score as a Predictor of Rectal Temperature in a Warm Weather Race

  • Courteney L. Benjamin, MS, CSCS- Monitoring Markers of Nutrition Status Throughout a Collegiate Soccer Season

  • Gabrielle EW. Giersch, MS- The Effect of the Cypla2 -163 c>A Polymorphism on the Metabolism of Caffeine and Effect on Performance

  • Yasuki Sekiguchi, MS, CSCS- Thirst Modulates Cycling Performance in the Heat in Dehydrated Males
  • Andrea R. Fortunati, MS, ATC- Monitoring Markers of Oxygen Transport Throughout a Collegiate Soccer Season
  • Brad D. Endres, BS, ATC- Epidemiology of Sudden Death in American Youth Sports.

 

 

Furthermore, the ACSM annual meeting provided great opportunities to meet with former colleagues. The University of Connecticut Alumni Association Reception was held on Thursday night (6/1). A lot of attendees spent time with old friends and shared current work with them. This kind of reunion always enables us to recall great memories and have energy for future work. We are grateful for all of the people who helped coordinate this event.

 

 

This conference also allows attendees to make new relationships with other professionals through attending various sessions and meetings. These opportunities lead KSI staff to obtain further knowledge, skills and new ideas. They certainly help to develop KSI and execute our mission “to provide research, education, advocacy and consultation to maximize performance, optimize safety and prevent sudden death for the athlete, soldier and laborer.” The KSI staff members are thankful to all of the presenters and attendees for their contributions to this field as well as helping make this conference one where individuals who are passionate about similar topics can meet, collaborate, and enjoy one another. We look forward to seeing everyone again soon!!!

 

6th International Conference on the Physiology and Pharmacology of Temperature Regulation

By: William M. Adams, PhD, ATC, Vice President of Sport Safety

 

This past week (December 5-9th), I had the pleasure of representing KSI at the 6th International Conference on the Physiology and Pharmacology of Temperature Regulation. This conference is a biannual conference held in different locations around the world that brings together the world’s leading thermal physiologists to present on topics from a basic (cellular and molecular) level of thermal physiology to clinical and applied applications of that research. This year’s conference was held in Ljubljana, Slovenia, the patron city of Saint George, which is located in the central part of Slovenia.

 

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The meeting started with an in depth discussion on the association of climate change on health. A European-based project, HEAT-SHIELD, was introduced to the audience which is a group tasked with developing guidelines and policies to handle heat stress from various aspects associated with climate change. The development of a well-rounded set of guidelines is needed to address this issue, especially as Europe is seeing the effects of increasing environmental conditions and a large migration of persons from other areas in the world, which when coupled together may cause downstream detrimental effects on health as a whole.

The conference continued with various symposiums, oral presentations and poster presentations on topics related to inflammation and the thermal response, fever, metabolic influences on thermal physiology, and the influence of exercise on thermal physiology. I had the pleasure of presenting some data that I collected examining the influence of hydration on body temperature and heart rate responses during repeated bouts of exercise in the heat. The talk was well received and it prompted some great discussion amongst other physiologists.

 

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It was great being able to meet new friends, connect with others and to discuss future collaborative work with some excellent researchers. The opportunity to attend this conference and to see the beautiful city of Ljubljana was an extremely rewarding experience and I would encourage anyone that does research in this area to attend the 2018 Conference in Split, Croatia.

 

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2017 NATA Meeting Preview

Rachel Katch, MS, ATC 

Associate Director of Military and Occupational Safety

 

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On June 26th – 29th, members of both the Korey Stringer Institute’s (KSI) staff and Medical & Science Advisory Board will be traveling to Houston, Texas to present at the National Athletic Trainers’ Association (NATA) 68th Clinical Symposia & AT Expo. Topics for dissemination range from the most up-to-date biomechanical research, to preventing sudden death in sport, all the way to new ground-breaking research regarding insurance costs for athletic trainers. No matter the topic, these presentations will provide those in attendance with evidence based research and information pertinent to enhancing the athletic training profession. Specific dates, times, and locations for each presentation being disseminated by the KSI staff and Medical & Science Advisory Board members are available below in Table 1. Hope to see you at the NATA Clinical Symposia, and always, please make sure to come and see us at our KSI booth at the AT Expo!

 

KSI Medical & Science Advisory Board Presentations

Lindsay DiStefano, PhD, ATC, from the University of Connecticut (UConn) will be disseminating multiple presentations during the course of the symposium. One presentation is titled, “Anterior Cruciate Ligament Injury Prevention Strategies: Translation of Research Findings into Clinical Practice,” and focuses on introducing the most current ACL injury prevention research and the evidence behind it. Additionally, Dr. DiStefano has a feature presentation during the session, “Lower Limb Preventative Training Programs Best Practice,” titled, “Effectiveness of Lower Limb Preventive Training Programs at Reducing Injuries.” This presentation will focus on educating attendees about the effectiveness, best practices, and implementation of preventative training programs.

 

Kevin Guskiewicz, PhD, ATC from the University of North Carolina – Chapel Hill will be presenting, “Catastrophic Traumatic Injuries in Sport,” during the session titled, “Catastrophic Sports Injury and Illnesses Among US College and High Schools.” This is a feature presentation alongside Douglas Casa, PhD, ATC, FNATA who will also be speaking during this session with a presentation titled, “Catastrophic Heat and Exertional-Related Conditions Among Athletes.” This session will focus on the incidence and characteristics of catastrophic events, and evidence-based policies and recommendations to minimize the risk of these events in the future.

 

From the University of South Florida, Rebecca Lopez, PhD, ATC will be presenting, “Exertional Heat Illness in Younger Athletes,” as well as a learning lab titled, “Recognition and Treatment of Exertional Heat Stroke.” The purpose of the first evidence-based forum is to provide clinicians with the best evidence-based clinical practice regarding the prevention, recognition, treatment, and return to play for the most common exertional heat illnesses. Second, the learning lab will focus on providing clinicians with the knowledge and opportunity to practice rectal thermometry and cold water immersion in a safe learning environment.

 

Also from the UConn, Stephanie Mazerolle, PhD, ATC, FNATA in the session, “A Multi-Level Examination of Career Intentions and Work-Life Balance,” will be presenting, “Individual Elements that Influence the Development of Career Planning and Work-Life Balance.”  This is a feature presentation that will examine and discuss research available regarding alternative therapies utilized in the clinical setting to promote work-life balance. Additionally, Brendon McDermott, PhD, ATC from the University of Arkansas will be presenting, “Exertional Heat Illness in Younger Athletes.” This committee session will focus on providing clinicians with the best evidence-based clinical practice regarding the prevention, recognition, treatment, and return to play for the most common exertional heat illnesses.

 

Lastly, Kevin Miller, PhD, AT, ATC from Central Michigan University will be presenting, “New Advances in Exertional Heatstroke Diagnosis, Treatment and Prevention.” This special topic presentation will discuss recent experimental studies that address the necessity of equipment removal prior to initiating cold-water immersion; whether cooling garments can prevent the onset of hyperthermia or affect hydration status; whether temperate water can be used to effectively cool hyperthermic humans; and how far into the rectum Athletic Trainers should insert a thermometer to obtain the most valid data.

 

KSI Staff Presentations

Multiple KSI staff will be presenting in a session titled, “Enhancing Safety of Secondary School Athletics Through Policy Change,” including Alicia Pike, MS, ATC, Robert Huggins, PhD, ATC, and William Adams, PhD, ATC. Individually, their presentation titles are, “Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation,” “State High School Athletics Policy Change Successes and Barriers: Results from the Collaborative Solutions for Safety in Sport Meeting,” and, “Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics,” respectively. This feature presentation will provide participants with evidence describing the barriers associated with implementing policy change from a state administrative level and the steps that have been made to initiate change to protect secondary school student athletes.

 

Additionally in a session titled, “The Secondary School AT Value Model, Minimizing Cost and Maximizing Safety from an Insurance Perspective,” Yuri Hosokawa, MAT, ATC, and Robert Huggins, PhD, ATC, will be disseminating their respective presentations titled, “Optimizing the Direction of Care: A Secondary Insurance Claims Analysis,” and, “We Can’t Afford to Hire an AT…You Can’t Afford Not To! Reducing Risk, Saving Money, and Saving Lives.” In this committee session presented by the NATA Initiative, the speakers will: (1) discuss ways athletic training services may directly benefit multiple entities (insurance providers, policy holders, and school districts), (2) critically assess the secondary insurance cost to identify unnecessary medical costs, and (3) minimize the financial burden of secondary schools through injury prevention and appropriate risk management.

 

Lastly, Robert Huggins, PhD, ATC will present, “An Overview of the Secondary Schools ATLAS Project: Where Are We Now?” in the session, “Out of the Fire and Into the Frying Pan.” This committee session presented by the Secondary School Athletic Trainers’ Committee will outline the use of the ATLAS project to show the concentration of secondary school athletic trainers and its value for potential networking within and between states and organizations.

 

Table 1. List of Presenters

Presenter

Presentation Title

Time / Location

 

TUESDAY, JUNE 27th, 2017

 
Rebecca Lopez, PhD, ATC Exertional Heat Illness in Younger Athletes 8:15 AM

BCC, Room 370

Stephanie Mazerolle, PhD, ATC, FNATA Individual Elements that Influence the Development of Career Planning and Work-Life Balance 8:15 AM

BCC, General Assembly A

Brendon McDermott, PhD, ATC Exertional Heat Illness in Younger Athletes 8:15 AM

BCC, Room 370

Kevin Miller, PhD, AT, ATC New Advances in Exertional Heatstroke Diagnosis, Treatment and Prevention 10:45 AM

BCC, Grand Ballroom C

Rebecca Lopez, PhD, ATC Recognition and Treatment of Exertional Heat Stroke 1:30 PM

BCC, Room 342

Robert Huggins, PhD, ATC An Overview of the Secondary Schools ATLAS Project: Where Are We Now? 2:10 PM

BCC, Grand Ballroom A

  WEDNESDAY, JUNE 28th, 2017  
Kevin Guskiewicz, PhD, ATC Catastrophic Traumatic Injuries in Sport 7:00 AM

BCC, General Assembly A

Douglas Casa, PhD, ATC, FNATA Catastrophic Heat and Exertional-Related Conditions Among Athletes 7:30 AM

BCC, General Assembly A

Lindsay DiStefano, PhD, ATC Anterior Cruciate Ligament Injury Prevention Strategies: Translation of Research Findings into Clinical Practice 7:30 AM

BCC, Room 370

  THURSDAY, JUNE 29th, 2017  
Lindsay DiStefano, PhD, ATC Effectiveness of Lower Limb Preventive Training Programs at Reducing Injuries 10:45 AM

BCC, General Assembly B

Robert Huggins, PhD, ATC “We Can’t Afford to Hire an AT”… “You Can’t Afford Not To!” Reducing Risk, Saving Money, and Saving Lives 10:45 AM

BCC, Grand Ballroom B

 

Yuri Hosokawa, MAT, ATC Optimizing the Direction of Care: A Secondary Insurance Claims Analysis 11:15 AM

BCC, Grand Ballroom B

William Adams, PhD, ATC Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics 3:30 PM

BCC, General Assembly A

Robert Huggins, PhD, ATC State High School Athletics Policy Change Successes and Barriers: Results from the Collaborative Solutions for Safety in Sport Meeting 4:00 PM

BCC, General Assembly A

 

Alicia Pike, MS, ATC Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation 4:30 PM

BCC, General Assembly A

Recent KSI Initiatives

Research

By Rachel VanScoy, Assistant Director of Sport Safety Policies

The Korey Stringer Institute (KSI) is keeping busy this summer. Here is a look into what we are up to:

  • On June 22nd, the NATA and KSI publically launched the Athletic Training Location and Services (ATLAS) database. This is an interactive map allowing athletic trainers’ to view their service location and coverage. For more information and to include/confirm your high schools information visit the KSI
  • KSI recently announced our online course on Preventing Sudden Death in Sports and Physical Activity through Jones & Bartlett Learning. For any Athletic Trainer looking to complete their Evidence-Based Practice CEUS or just looking to learn more about the preventing sudden deaths in sport then check out this course!
  • Andrea Fortunati, Assistant Director of Elite Athlete Health and Performance, continues to work with UCONN Men’s Soccer team as preseason is fast approaching.
  • Yuri Hosokawa, Director of Communication and Education, and Rachel Katch, Assistant Director of Research, will be running a study at the Falmouth Road Race August 16th, 2015. This will be the 3rd consecutive year that KSI will conduct research at this amazing race. The race consists of 7 miles and roughly 12,000 runners along the Falmouth, MA shoreline.
  • William Adams, Director of Sports Safety Policies, is running a study examining non-invasive biomarkers to assess physiological changes during and after exercise in the heat.
  • Yuri Hosokawa and Luke Belval, Director of Military and Occupational Safety are investigating the use of temperature monitoring devices and thermal imaging, and the use of two cooling methods to optimize the early recognition and management of Exertional Heat Illness.
  • Samantha Scarneo, Director of Youth Sports Safety is leading a study following concussion throughout the fall season within collegiate club and varsity athletes.
  • The Korey Stringer Institute is also testing athletic clothing to investigate efficacy and performance benefits of various fabrics in a hot environment.

 

Stay tuned for updates and publications on all of our initiatives!

 

Heat Acclimatization Research

Heat Acclimatization

By Elizabeth Adams, Assistant Director of Elite Athlete Health and Performance

Strenuous physical activity in hot, humid environments places individuals at great risk for heat-related illnesses and exertional heat stroke. Annually, many individuals, such as athletes, occupational workers, and soldiers suffer from these conditions. Heat acclimatization is, perhaps, the most effective way to mitigate these exertional heat illnesses, as well as improve performance in the heat.

What is heat acclimatization?

The improved ability to exercise in a hot environment due to physiological adaptations that occur over a period (10-14 days) of repeated exposures to exercise-heat stress.

Physiological adaptations of heat acclimatization:

  • Improved cardiovascular function
    • Increased plasma volume
    • Increased stroke volume
    • Decreased heart rate
  • Improved ability to dissipate heat
    • Increased sweat rate
    • Earlier onset of sweat
    • Decreased concentration of NaCl in sweat
  • Overall, these adaptations lead to a decreased core body temperature during exercise.

What we know #1:

  • Many heat illnesses occur on the day after a long, novel heat stress. For example, day 2 of preseason football practice following a day 1 two-a-day practice.

What we do not know #1:

  • What is the driving physiological mechanism?
  • Does heat acclimatization help to prevent this occurrence?

 

What we know #2:

  • Heat acclimatization adaptations are transient and will disappear in 1-3 weeks if heat exposure is not maintained.

What we do not know #2:

  • Does an intermittent heat exposure intervention help to mitigate heat acclimation decay and thus maintain adaptations?

  

What we know #3:

  • Body cooling during exercise in the heat helps to mitigate rise in core body temperature.

What we do not know #3:

  • How does heat acclimatization effect cooling rate during and after exercise?

 

Recently, our research team has completed a large heat acclimatization study in order to answer these unknown questions. Our hope is to further the scientific knowledge and provide a more comprehensive understanding of heat acclimatization, with the ultimate goal of keeping all athletes safe.

Stay tuned and follow us on social media for news of when results are published!