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Abstract

Introduction: Acrobatics and Tumbling (A&T) is an emerging sport incorporating various elements of gymnastics and competitive cheerleading. Anecdotal evidence suggests that the sport presents with high injury rates potentially due to the high impact nature of the activity. Due to the potential aesthetic sport related concerns, bone mineral density and risk of injury presents a concern for patients, athletic trainers and stakeholders. Increased understanding of the relationship between bone mineral density, serum vitamin D status, and injury incidence in A&T may be useful to athletic trainers, registered dietitians, and others working with these athletes. The objective of this study was to evaluate the relationship between bone mineral density, serum vitamin D, and injury among A&T student athletes. Methods: Cohort Study at a NCAA Division I University Sponsored Athletic Department. Forty-two participants on the active A&T roster consented to participate. Average age was 19.69 ± 1.199 years. Positional composition: 19 tops, 23 bases. Serum vitamin D was analyzed at two timepoints 8 weeks apart. Injury history data was collected between timepoints by team athletic trainer. Routine DXAs performed as standard of care. Outcome measures included serum vitamin D (ng/ml), injury incidence, and bone mineral density (femur, lumbar spine). Descriptive statistics were utilized in addition to t tests and ANOVAs to determine if significant differences existed in injuries based on bone mineral density, or athletic position (i.e., top, base). Poisson regressions were completed to analyze the relationship between bone mineral density and injuries. Results: Between week 1 and week 8, participants experienced a significant loss of vitamin D (6.093 ± 10.973, p<.001). Average bone mineral density Z score for the femur was 1.836 ± 0.842, and of the spine was 1.952 ± 0.999. Bone mineral density of the spine was significantly greater in bases than tops, but no difference existed in the femur. There was no significant difference in injuries sustained based on bone mineral density of the femur or spine. Clinical Application: No significant differences were found in injuries related to differences in bone mineral density of the femur or lumbar spine. However, differences were found among bone mineral density by position group, with bases having higher bone mineral density in their spine than tops. This may be important due to the requirements of the base position compared to tops. Although a direct relationship between serum vitamin D and high average bone mineral density was not identified, significant decreases in serum vitamin D and high average bone mineral density in the sample may provide interesting insight for healthcare providers working with A&T. Athletic trainers, strength staff, and dietitians working with A&T should consider the impact of changes in serum vitamin D and activity when monitoring for factors related to injury.

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