2009 April | Female Athlete Triad Coalition

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Strategies used by physical therapists in the US for treatment and prevention of the female athlete triad.

By Pantano, K.J. (2009) in Physical Therapy in Sport , Feb 10(1): 3-11.

This descriptive study presents current methods of treatment and prevention used by physical therapists in the United States (US) for the Female Athlete Triad (also known as the Triad). Physical therapists play an important role as part of the interdisciplinary team involved in the detection, treatment and prevention of the Triad. Levels of knowledge about the Triad and specific measures used by physical therapists for the treatment and prevention are not currently known. A survey was used to assess methods of physical therapy practice used in cases of the Triad. Descriptive statistics summarized demographics about the 500 American Physical Therapy Association member participants. Likert scales and narrative descriptors indicated the likelihood and the frequency of using certain treatment and prevention methods. Out of the 500 participants, 205 physical therapists responded, for a 41% response rate (205/500). The results indicated that only 26% (54/205) of these respondents used specific treatment methods, including education, for the Triad; 48% (26/54) of these respondents employed detection/prevention strategies other than preseason screening, including talking with the athlete or athlete’s parent(s) or athlete’s physician about the situation; and 24% (13/54) of these respondents assisted in athletic screening for the Triad. The outcomes of the study underscore the importance of the role of physical therapists in educating others about the Triad. Physical therapy treatment and prevention methods are instrumental in preventing low bone density and osteoporosis in physically active women. These findings demonstrate there is a greater need for knowledge regarding the Triad to be incorporated into physical therapy curriculums, continuing education programs and professional practice.

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Female Athlete Triad in elite swimmers of the city of Rio de Janeiro, Brazil

By Schtscherbyna, A., Soares, E.A., Oliveira, F.P., and Ribeiro, B.G. (2009). Nutrition Feb 19.

This prevalence study uses a cross-sectional analysis to assess the prevalence of the female athlete triad in adolescent elite women swimmers. The sample includes 78 female elite swimmers in the age range of 11-19 years from Rio de Janeiro, Brazil. The study examines the presence of disordered eating, menstrual dysfunctions, and bone dysfunctions as components of the Female Athlete Triad syndrome (referred to as the Triad). Disordered eating was examined using three questionnaires (Eating Attitudes Test, Bulimic Investigatory Test Edinburgh, and Body Shape Questionnaire). Menstrual dysfunction was measured using a validated questionnaire. Bone dysfunction was examined using an assessment of bone mineral density (BMD) by applying the method of dual-energy X-ray absorptiometry (DXA). Statistical analyses included a t test comparing the means; a chi-square test evaluating the association among categorical variable (P<0.05); Pearson’s coefficients of simple linear correlation between the variables of lean body mass and BMD at the spine (L1-L4) and overall in the body; and Kaplan-Meier survival curves estimating mean menarche age. The mean age at menarche of the athletes was 12.38±0.2 y. The presence of disordered eating, menstrual dysfunction, and low bone mass were found to be 44.9%, 19.2%, and 15.4% respectively in the group of swimmers. Among the athletes, 47.4% (37 of 78) met one criterion of the Triad, 15.4% (12 of 78) met two criteria, and 1.3% (1 of 78) met all three criteria, implying potential development of the Triad. Only 35.9% (28 of 78) of the athletes did not present with any of the components associated with the Triad. The prevalence of the Triad in this study population was low. However, the presence of one or two components of the Triad, especially disordered eating, was observed in the athletes and was described as demonstrating the incidence of partial status in these adolescent elite women swimmers. The present study underscores the importance of monitoring these components and their causes in order to generate preventative measures that will reverse or avoid the development of the Triad thus improving the health of the athletes.