Professional vs. nonprofessional exercise advice and injury correlations in campus recreation facility users

Purpose: Risk of injury, when participating in an exercise program, is always present; however when the exercise program is poorly designed or not designed for the individual, the risk of injury increases significantly. Poorly designed exercise programs stem from individuals seeking advice for exercise from nonprofessional sources that are unable to personalize programs and monitor the individual throughout their exercise progression. Currently, the literature exploring the connection between nonprofessional exercise advice and the rate of injury sustained from exercising is scarce. The purpose of this study was to see if there is a correlation between exercise advice coming from professional (professionally certified trainers and research based media) or nonprofessional (non-research based media and uncertified nonprofessionals) sources and injuries that are sustained from exercising. Hypothesis: Higher rates of injury will result for individuals who seek out exercise advice from nonprofessional sources. Methods: Exercisers (n=280) from the University of Utah Student Life Center were surveyed. Data analysis was performed to analyze the correlations between injuries sustained in a gym setting, and nonprofessional or professional exercise advice received prior to injury, as well as descriptive statistics regarding the population. Results: Population consisted of 55 freshmen, 40 sophomores, 50 juniors, 73 seniors, 41 graduate students, 5 post-graduate students, and 11 staff or faculty members, with average age being 21.1+/-8.2 years, and the average BMI 24.2+/-3.8. Participants sought out advice from the following sources: 39.6% friends or other exercisers (8.2% injury rate), 31.7% self-programmed exercise (11.8% injury rate), 16.4% media sources (7.1% injury rate), and 12.3% from personal trainers (4.7% injury rate).

PROFESSIONAL VS. NONPROFESSIONAL EXERCISE ADVICE AND INJURY CORRELATIONS IN CAMPUS RECREATION FACILITY USERS By Mercedes Summer Robinson A Senior Honors Thesis Submitting to the Faculty of The University of Utah In Partial Fulfillment of the Requirements for the Honors Degree in Bachelor of Science In The Department of Exercise and Sports Science Approved: ______________________________ Dr. Charlie Hicks-Little Thesis Faculty Supervisor _____________________________ Dr. Janet Shaw Chair, Department of Exercise and Sports Science _______________________________ Dr. Kerry Jacques Honors Faculty Advisor _____________________________ Sylvia D. Torti, PhD Dean, Honors College January 2016 ii ABSTRACT Purpose: Risk of injury, when participating in an exercise program, is always present; however when the exercise program is poorly designed or not designed for the individual, the risk of injury increases significantly. Poorly designed exercise programs stem from individuals seeking advice for exercise from nonprofessional sources that are unable to personalize programs and monitor the individual throughout their exercise progression. Currently, the literature exploring the connection between nonprofessional exercise advice and the rate of injury sustained from exercising is scarce. The purpose of this study was to see if there is a correlation between exercise advice coming from professional (professionally certified trainers and research based media) or nonprofessional (non-research based media and uncertified nonprofessionals) sources and injuries that are sustained from exercising. Hypothesis: Higher rates of injury will result for individuals who seek out exercise advice from nonprofessional sources. Methods: Exercisers (n=280) from the University of Utah Student Life Center were surveyed. Data analysis was performed to analyze the correlations between injuries sustained in a gym setting, and nonprofessional or professional exercise advice received prior to injury, as well as descriptive statistics regarding the population. Results: Population consisted of 55 freshmen, 40 sophomores, 50 juniors, 73 seniors, 41 graduate students, 5 post-graduate students, and 11 staff or faculty members, with average age being 21.1+/-8.2 years, and the average BMI 24.2+/-3.8. Participants sought out advice from the following sources: 39.6% friends or other exercisers (8.2% injury rate), 31.7% self-programmed exercise (11.8% injury rate), 16.4% media sources (7.1% injury rate), and 12.3% from personal trainers (4.7% injury rate). iii Discussion: The participants that self-programmed exercise in a nonprofessional manner also observed the highest injury rate. In all groups, the majority of the participants considered their exercise advice to be professional, but upon examining the sources, very few were found to be professional in nature. In order to reduce injuries sustained by students participating in campus recreation programs, these facilities should make more professional exercise resources available for student use TABLE OF CONTENTS ABSTRACT ii INTRODUCTION 2 BACKGROUND 3 PURPOSE 11 METHODS 12 RESULTS 12 DISCUSSION 14 LIMITATIONS 18 CONCLUSION 18 APPENDIX 20 REFERENCES 30 2 INTRODUCTION With the increasing prevalence of disease related to chronic inactivity worldwide (Hamlin & Paterson, 2014), there has also been a rise in individuals participating in regular physical activity. With this increase in interest to exercise, and the emphasis on education, it is evident that there has also been a surge in information available for exercisers to obtain with respect to exercise work-outs and fitness programs. This rise in information raises an important question as to where individuals are seeking out their work-out plans and advice, and how safe and reliable is this information. With participation in any type of exercise or physical activity, there is risk for injury (Liguori, Dwyer, Fitts, & Lewis, 2014). However, if the advice and exercise prescription is not appropriate and safe for the individual, that risk for injury increases significantly (Liguori, et al., 2014). Preventing injury by reducing risk of injury to exercisers leads to greater opportunities for the individual to stay physically active. According to a longitudinal study published in 2014, from 2003 to 2010, there was a 67.5% relative increase in hospital-treated injuries sustained from exercise-related incidents (Gray & Finch, 2014). It was also observed in this study that more men than women were treated for injuries, with males accounting for 76% of the total injuries. Interestingly, the study also reported that the 15 to 24 year-old groups most frequently sustained injuries from resistance training or resistance equipment whereas the 25 to 34 year-old group most frequently sustained injuries from aerobic exercise. The most common type of musculoskeletal injuries that individuals were treated for included dislocations, sprains, and strains (Gray & Finch, 2014). 3 Research has shown that excessively high or low body mass index (BMI) places an exercising individual at increased risk for injury during physical activity (Neely, 1998). Individuals exhibiting a high BMI however were at the greatest risk for injury during exercise (Neely, 1998). Weight is not the only factor that can play a role with injury occurrence. Low physical fitness can also increase the risk for injury during exercise, likely due to the fact that the body is being exposed to novel stressors and is not able to adapt fast enough to prevent injury as observed in a person with higher physical fitness (Neely, 1998). Research seems limited in the exercise and sports science field focused on injuries sustained by exercisers. Specifically, research is lacking in investigating risk factors leading up to injuries sustained by exercisers. In particular, there is little research regarding the sources that individuals seek to gain information about engaging in exercise, and how this advice may impact the injuries exercisers are sustaining. To help fill this gap in research, this study focuses on college-affiliated individuals (predominantly students) who seek out advice when exercising at a campus recreation center on the campus of the University of Utah. Additionally, this study aims to investigate the number of acute injuries these exercisers are sustaining during exercise, and the nature of these injuries. LITERATURE REVIEW Campus Recreation Facility Benefits and Users Universities and colleges are implementing campus recreation facilities and programs available for student and staff usage. There are a plethora of reasons why schools are doing this, with benefits to the student and to the school. Alexander Astin’ s Theory of Involvement (1993) discusses the notion that being involved in extracurricular activities directly impacted students’ 4 education. Astin’ s main principle is that students learn by being involved, and he asserted that a student’ s quality of education was directly proportional to their quantity and quality of involvement. Astin also discusses that involved students earned better grades, persisted in college, and were more satisfied with their college experience, leading to a higher retention of students. To investigate the impact campus recreation centers have on a student’ s decision to attend a specific college, and continue attending a college, Lindsey and Sessoms (2006) conducted a cross-sectional study by surveying college students. What they found through their surveying of undergraduates was 31.3% of students stated that the availability of recreational sports influenced their decision to stay at a college, while 37.3% of students said the availability of recreational sports were important in their decision to attend a college. This retention and recruitment quality of a campus recreation center is a very important tool schools use when advertising to future and continuing students. Students also see many benefits from participation in campus recreation programs. In a study conducted by Brock, Carr, and Todd (2015), these researchers looked into the usage of campus recreation facilities and academic performance, as well as some health measures among college freshman. Because the first year of college can bring with it many transitions for some students, they wanted to investigate the choices made by these freshman, and the possible impacts the decisions had on their health. What they found was higher-users of the campus recreation facilities showed significantly higher grade point averages (GPA) than their moderateusers or non/low-users counter parts. The high-users also showed significantly less fat intake, and a higher amount of MET minutes/week. Relating back to Astin’ s Theory of Involvement, 5 they determined that higher involvement in campus recreation facilities led to greater academic success and healthier life choices. Brock, Carr, and Todd looked into some of the direct academic and health correlates associated with participation in a campus recreation program, Alexandra Henchy (2013) looked at what the students perceived the benefits to be of participating in such programs. Henchy used the National Intramural Recreational Sports Association/Student Voice Campus Recreation Impact Study survey to look at topics including satisfaction, involvement, and benefits the students perceive. Reported from the survey, 90% of undergraduate and 82% of graduate students had participated in a campus recreation program or facility of some type. The majority of students also reported that these programs expanded the student’ s interest in staying fit and that the programs improved the quality of student life at the university. Students reported improved overall health, improved fitness levels, improved overall wellbeing, and decreased stress levels. In addition to these benefits perceived by students, Henchy (2011) with the same survey, displayed some of the social benefits that maybe impacting students in participation of campus recreation programs. What the Henchy study found was 81% of students agreed that by participating in these programs, they felt more at home at their respective university and, 33% of students indicated that they felt their opportunity to develop friends had improved by participating in campus recreation programs. With extensive research on the benefits of participation in campus recreation programs, it is still observed that not every single student takes advantage of these programs. With this being a known fact, Miller, Noland, Rayens, and Staten (2008) investigated the characteristics of users and nonusers of campus recreation centers. What they found was the significant predictors of 6 participation included sex, class standing, living situation, fraternity or sorority member, and desire to change one’ s weight. They found that women were only two-thirds as likely to use the facilities as men. Similarly, upperclassmen were only two-thirds as likely to use campus recreational facilities as lowerclassmen. Students living on campus were 50% more likely to use the facilities, compared to students who lived off campus. Greek members were twice as likely to participate in campus recreation facilities as non-Greek members. Those looking to change their weight were 1.7 times more likely to use the facilities. Interestingly, they found that the population that was most likely to participate in campus recreational programs, were also more likely to participate in higher-risk behaviors, like unsafe alcohol use and drug use. Similarly, Watson, Ayers, Zizzi, and Naoi (2006) determined the typical user of a campus recreation facility to be younger, live on campus, be male, not smoke, and have been a high school athlete. They also found that users were more likely to be higher on the readiness to change scale than their nonuser peers, meaning they have not yet committed to exercise. They found that the most common barriers to exercise included lack of time, lack of energy, and not having an exercise partner. Campus Recreation Facilities and Injuries The American College Health Association does an annual assessment of American colleges to collect data regarding the health of undergraduate students across the country. In 2014, they found that 54.6% of males and 49.8% of females were meeting current guidelines from the American College of Sports Medicine. These guidelines consist of a minimum of 30 minutes moderate activity 5 times a week, or 20 minutes of vigorous activity 3 times a week, in addition to 2-3 days a week of resistance training and flexibility training ("ASCM Issues New 7 Recommendations," 2011). They also found that 56.9% of males and 63.6% of females were found to be at a healthy weight, ranked by BMI. With this amount of participation in physical activity and exercise, it is likely that a large percentage of this behavior is taking place in campus recreation facilities. Also, with participation in exercise and physical activity, it can be assumed that some of these students have become injured throughout participation. There is little to no data investigating the prevalence of injury sustained by students while participating in these programs, however, Grice, Kingsbury, and Conaghan (2014), investigated this frequency in non-elite exercisers. What they found was that of all the men surveyed, 69% had sustained an injury at some point during participation in exercise or sport, while only 46% of women reported an injury. In the college age 18-24 years, 54% had sustained an injury. Although this study wasn’ t specific to college students on a college campus, it helps to understand that injuries are quite common among non-elite exercisers of this age group. As aforementioned, a gap in research may exist on injuries sustained by college students while participating in campus recreational facilities and programs. In order to help fill the gap in research, McElveen, North, Rossow, and Cattell (2014), looked into injury rates sustained in intramural sport participation. What the authors found was an injury rate of 5.56 injuries per 100 participants, over the course of two academic years. The authors noted that several of these injuries were considered serious, and required emergency medical services. Most of these injuries could have been prevented by greater involvement of intramural staff and requiring protective gear to play specific sports. Another study that has large implications was conducted by Shannon Gray & Caroline Finch (2014). These two researchers investigated hospital-treated injuries sustained by fitness 8 participants. Over the course of eight years, 2,238 people were injured from participation in some form of fitness activity. Gray & Finch split these injuries up into three groups, depending on the nature of the activity being, aerobic, resistance training, or other participation. Of the aerobic participants that were injured, 76.6% were female, most aged between 25 and 34 years old. The most common type of injury sustained by this group affected the lower limbs, as the mechanism of injury was commonly falls. In the resistance training, the largest group of injured participants that were injured, were those 15 to 24 years in age. The most commonly observed injury to this group affected upper extremities. With, 71.4% of the injuries sustained by this group involving participants being hit, struck, or crushed by weights. In the other participation category, the largest group was again those aged 15 to 24, sustaining lower limb injuries due to falls. The most common types of injuries across all groups were reported to be dislocations, sprains, and strains (Gray & Finch, 2014). As for risk factors for injuries sustained by exercise, Fiona Neely (1998) conducted a literature review investigating intrinsic risk factors for injury. These intrinsic risk factors are important to note when looking at injury data, as these risk factors usually cannot be controlled by that participant. What Neely found was in a civilian population, an exerciser seemed to be at much higher risk for injury, if beginning the program when exceedingly unfit or if having a history of prior injuries. Campus Recreation Facilities and Risk Management As it has become evident that injuries are quite common among exercisers, questions have been and continue to be raised about, how to reduce the risk and prevent injuries. This concern has led campus recreation centers to practice risk management plans in their operations 9 that are aimed at preventing such injuries. As Stier, et al. (2008) states, there are four main elements that make up any risk management plan: First, one must ascertain both real and potential risks. Second, one must correctly assess these real and potential risks in terms of their causes. Third, one must identify or determine acceptable, timely, and appropriate courses of action to take in dealing with these real and potential dangerous situations and the negative consequences that take place if accidents or injuries occur. Fourth, one must take steps to prevent any risky situations from happening and take effective and efficient steps to minimize possibilities of accidents and injuries. As this holds true, even with an effective risk management plan, injuries still occur. In a study conducted by Stier, et al. (2008) 213 schools were surveyed to determine the effectiveness of their risk management plans for intramural activities. The authors found that only 63% of schools required participants to sign waiver for participation. Only 30% of the schools surveyed required Automatic External Defibrillators (AEDs) to be present during intramural events. Most schools stated that they had student employees supervising intramural events, not graduate assistants or professional employees. Just under two-thirds (65%) of the schools followed National Intramural-Recreational Sports Association (NIRSA) rules and guidelines for sports, and most schools did not require sport officials to pass written exams prior to officiating an event. Of the schools surveyed, only 69% stated they had written risk management procedures, while 31% of the schools said they had no written risk management plans. Similarly, Lee, Farley, & Kwon (2010) investigated the importance and effectiveness of risk management plans in intramural sports. They found that most of the risk management plans involved, “ supervision of the activity, facility and/or equipment check lists, written policies and/or procedures, emergency plans, staff training, release and/or consent forms, warning signs, and inspections.” According to their findings, these types of risk management plans helped to 10 reduce the number of law suits from injuries, and increase the safety of the intramural athletes and spectators. Although the previous two studies looked more into risk management plans for intramural sports, similar results may be expected from campus recreation facility risk management programs, as the population at risk is still non-elite student athletes. When moving such a risk management plan indoors to campus recreation facilities, one of the changing variables is the type of equipment use. Instead of sports equipment, there are exercise machines and a variety of other types of equipment. Concerning equipment usage, Gray et al. (2015) looked into risk management issues, as observed by fitness industry professionals. Of these professionals, 43.8% stated that they have seen exercisers leaving equipment laying around, leaving tripping hazards. Also, almost half (47.8%) of the respondents stated that they have seen exercisers using weights too heavy for their ability. Again, nearly half (41.9%) the respondents stated that they have observed exercisers incorrectly using gym equipment at some point. This incorrect usage of equipment and exercisers using weights too heavy for their physical abilities calls into question the level of fitness education these exercisers have successfully completed. Jackson, Lyons, Roberts, Geary & Williams (2010), recently researched where collegeaged exercisers were seeking information regarding nutritional supplements. These researchers found that the internet was the greatest source of information for those using nutritional supplements, followed by asking advice from fitness instructors/weight room employees, for both males and females. Both the nutritional supplementation and exercise and fitness fields are not well regulated; therefore, a high probability may exist that these same exercisers would seek information about both topics from similar fields. It seems evident that an extant paucity of 11 research exists as to sources exercisers may use to obtain their exercise information. This gap in research may be particularly prominent for, college-aged exercise participants and how sources of advice correlate with injury occurrence. As it has become evident that many people look towards the internet for information or advice around an array of topics, the credibility of the sources must be questioned. For the purposes of this study, a professional source is defined as research-based information. Examples of professional advice include: certified personal trainers, American College of Sports Medicine guidelines, or high level of formal education in exercise and sport science and similar fields. Nonprofessional sources include: informally educated people or trainers, non-research based websites, social media accounts, and work-out programs that are not individualized for the exerciser. PURPOSE The objective of this study was to identify whether or not those who engage in exercise or workout programs are affected by the sources of information on said workout routines. Specifically, the goal was to discover if those who seek advice from nonprofessional sources are prone to and experience a higher rate of injury or negative effects during their routines. The overarching question to answer in this study was whether there is a correlation between source of workout information and resulting exerciser injury. The hypothesis is that if exercise participants seek nonprofessional sources of information on how to exercise, then they will likely experience a higher rate of exercise injury than those who seek said information from so-called professional sources. The following research questions were investigated: 12 1- Where are participants getting exercise advice? a. How are exercisers seeking advice (i.e. internet, personal trainers, friends, etc.)? b. Is the majority of the advice coming from professional resources or nonprofessional resources? 2- How many injuries are being sustained during exercise routines? a. How do these injuries correlate to sources of individuals’ exercise plans? b. What are the most common types of injuries exercisers are sustaining? METHODS This study was a cross sectional study with a survey designed to answer the aforementioned questions. Participants (n=280) were selected at random as they left the Student Life Center on campus at the University of Utah. Data collection lasted five days from 7:00am to 9:00pm, Monday through Friday, during the fourth week of the fall 2015 semester. The participants were asked to complete a short electronic survey, taken through Survey Monkey. Please see the appendix for a copy of the survey. Data reduction and statistical analysis was completed by utilizing a built in statistical software from Survey Monkey, Excel, and SPSS. Descriptive statistics and frequencies were run to provide summary data and means +/-SD for all demographic questionnaire variables. A correlational analysis was then conducted to determine whether correlations existed between questionnaire variables. Alpha was set a priori at p≤0.05. RESULTS The objective of this study was to identify whether or not those who engage in exercise or workout processes are affected by the sources of information on said workout routines. Participants consisted of 280 staff, students, and faculty members at the University of Utah. The 13 average age (table 1) was 22.9 (SD ±5.54) years, the minimum age was 18 years, the average BMI of participants was calculated to be 24.15 (SD ±3.84). The racial demographics of participants are as follows (table 2): white/Caucasian being the largest demographic at 71.5%, followed by 13.5% Asian, then 12.8% Hispanic, with the smallest demographic groups represented being African-American (3.3%) Native Hawaiian (3.6%), and 5.1% of other race. The population of the participants consisted of 55 (19.6%) freshmen, 40 (14.3%) sophomores, 50 (17.9%) juniors, 73 (26.1%) seniors, 41 (14.6%) grad students, 5 (1.8%) post-grad students, and 11 (3.9%) staff or faculty members (figure 1). Examination of the data to identify how exercise participants obtained work-out or exercise advice revealed that 39.6% participants received their exercise advice from friends or other exercisers, 31.7% participants participated in self-programmed exercise, 16.4% of participants sought out exercise advice from media sources, and 12.3% of participants turned to personal trainers for their exercise advice within the past 12 months (table 3). When examining injury rates during exercise bouts it was revealed that 85 injuries were reported. Of these injuries four (4.7%) were reported to be related to advice received by personal trainers, 10 (11.8%) were reported related to self-programmed exercise, seven (8.2%) were reported related to advice received from friends and other exercisers, and six (7.1%) were reported related to advice received from media sources. Exactly 58 (68.2%) injuries were reported unrelated to any exercise advice received in the past 12 months (table 4). A review of the data suggests that the participants using personal trainers for their advice, 87.1% considered them to be professional sources, and 25.81% reported the advice as nonprofessional. For these same responses, it is suggested that 29.03% of the personal training sources were professional, 3.23% were nonprofessional, and 67.74% were undetermined sources. 14 For those who participated in self-programmed routines, 13.33% had professional certifications, 5% had nonprofessional certifications, and 81.67% did not report any certification. Of the participants reporting advice from friends or other exercisers, 1.89% were considered a professional source, 9.43% were from a nonprofessional source, and 88.68% did not report or know the source. This is compared to the participants reporting that 33.02% were deemed professional sources and 66.98% nonprofessional sources. Of the media sources reported, 4.82% were professional and 95.18% were determined to be nonprofessional. This is in contrast to the 56.63% that participants reported to be considered professional sources of advice and 44.58% were reported to be nonprofessional (table 5). When examining the mechanism of injury (table 6) it was revealed that the most common type of injury was a muscle sprain or strain (47.6%), followed by joint sprain or strain (30.5%), broken bone (11%), joint tear or rupture (8.5%), and muscle tear (2.4%). A correlational analysis was run between questionnaire variables revealing the following significant correlation. One of the significant findings was the correlation (p=.016) between frequency of exercise and injuries sustained unrelated to any advice reported (Figure 2) which described participants who participated in exercise more frequently experienced less injuries than exercisers who participated less frequently. DISCUSSION As reported, there was a wide variety of people that participated in the study. There were students, ranging from freshmen to post-graduate students, giving representation from many populations that participate in campus recreation programs. The majority of the participants were of Caucasian race, with most other races represented as minorities in the participant pool. Thus, 15 there are not many relationships that can be associated with respect to race from this study. The average age of participants was 22.9, with a standard deviation of 5.54 years, representing a wide variety of ages seen at the Student Life Center. With the average BMI of 24.15, a large portion of the participants fall into healthy and slightly overweight categories ("About Adult BMI," 2015). As displayed in figure 1, an even distribution was found for the year of the students that participated in the study. A majority of the participants surveyed reported obtaining their exercise advice and information from friends or other exercisers. The next largest portion of participants in the study reported self-programming their exercise. When looking at the amount of participants that sustained an injury in relation to a specific source of advice, the highest injury rate (11.8%) was associated with participants that reported performing self-programming of their exercise. Although there was no significant correlation between these two variables, a likely relationship may exist. One factor that could contribute to this relationship is if the exerciser does not possess the education to safely program exercise, there is a chance that the program will not be safe for the exerciser, increasing risk for injury (Liguori, Dwyer, Fitts, & Lewis, 2014, p. 10). The minority of the participants looked to media sources for their exercise advice, and even less turned to personal trainers for their exercise advice within the past 12 months. This is in contrast to the findings Jackson, Lyons, Roberts, Geary & Williams (2010) demonstrated with their study. In regard to nutritional supplementation information, they found that exercisers looked toward the internet and other media sources most frequently, followed by consulting with weight room and gym employees and trainers. In the results obtained from this study, in relation to injury, the lowest percent (4.7%) of the injuries sustained in relation to advice received, were those in association to advice from 16 personal trainers. The second lowest percentage (7.1%) of injury was associated with advice received form media sources. The majority of the injuries reported in this study were unrelated to any advice the participant had received in the past 12 months, either because the participant did not seek out any advice or the injury was sustained outside of the advice given. This study found in most cases the participant believed the advice they were receiving was professional advice, but when the advice sources were categorized based on the certifications and evidence based research support, the opposite was found to be true. Specifically, 87.1% of the participants that reported receiving advice from personal trainers also reported that the advice was professional. A follow-up question was then asked for the participants to enter in the personal trainer’ s certifications, and upon categorizing these certifications based on aforementioned parameters, only 29.03% of the personal trainer’ s certifications were found to be professional certifications in the field of exercise and sports science. This low level of professional sources for advice found in this study may in part be attributed to several (67.74%) of the participants being unsure of the personal trainer’ s certification, which were automatically categorized as undetermined sources. For the participants that participated in self-programmed exercise, only 13.33% had professional certifications. This group was found to have 81.67% of participants to not have any type of certification, and 5% to have nonprofessional certifications. Although there was no significant correlation between exercise advice source and injury, the fact that such a large percentage of this group has no certification or a nonprofessional one, and also the largest injury rate than other reported sources, suggests there may be a relationship between these two variables. 17 Participants who received their advice from friends or other exercisers reported that 33.02% of these sources were professional. Upon breakdown by certification, only 1.89% of these sources were found to be professional. In additions, 9.43% were found to be nonprofessional, and 88.68% unable to be determined, as the participants reported unsure, or no certification. In consideration of the media sources reported by participants, 4.82% were found to be professional, while participants reported believing 56.63% of the media sources to be professional. This left 95.18% of the sources reported as nonprofessional. The field of exercise and sports science isn’ t well regulated in the form of certifications, so there is ambiguity in what can be considered professional and nonprofessional (Cardinal & Cardinal, 2015, p. 3). There is little distinction to the public eye between certifications and training that are trustworthy and reliable, and ones that are meaningless (Hoffman, 2014). This has been displayed in the preceding data that the general college student either doesn’ t know the certification or level of formal education of the person lending advice, or cannot accurately determine what is professional and reliable or what is nonprofessional and meaningless in exercise and sports science. With this ambiguity, if students aren’ t able to decipher between what is a reliable source and what is not, students may use inappropriate sources in their exercise planning, increasing their risk for injury. The most common type of injury sustained by exercisers was reported to be a muscle strain or sprain (47.6%), followed by joint sprain or strain (30.5%). This study looked only at acute injuries sustained from exercise. Up to 30% of injuries sustained during exercise are not acute in nature, but from chronic, long-term use of a muscle or joint, according to Lavallee & Balam (2010). Furthermore, a portion of injuries stem from the tissue given insufficient time to 18 heal following exercise and decreased recuperative activity in the tissue (Lavallee & Balam, 2010, p. 310). Other interesting findings from this study include the significant correlation, (p=.016) between frequency of exercise and unrelated injuries. This correlation suggests that with more frequent exercise, the rate of injury unrelated to exercise advice decreases. Similarly, Neely (1998) suggests that low physical fitness and low participation in exercise activities increases risk for injury. LIMITATIONS There are some limitations of this study which must be noted. First, the exclusion of asking participants to report gender. This was unfortunately omitted from the survey and consequently limits the analysis of gender comparisons. Secondly, other types of exercise injuries that were not addressed by this study which could have potentially revealed a relationship with types of exercise advice, and their professionalism. Finally, the survey question design whereby participants could report numerous answers for each question or report no response restricted the statistical analysis possible. CONCLUSION In conclusion, it is evident that a potential relationship might exist between the source for exercise advice and injuries sustained from exercise. Data analysis suggested participants who were involved with self-programming exercise (mostly nonprofessional sources), experienced the highest injury rate. However, participants who received advice from personal trainers (highest level of professional source characterization), reported the lowest injury rate. This outcome suggests that higher the professionalism the sources represents the lower consequent 19 injury rates may. As campus recreation centers further develop risk management plans, this information could be used for a push to have more personal trainers, with professional certifications, available for student consults, so students have better access to credible sources of exercise information to help reduce the risk of injury to campus recreation participants. 20 APPENDIX Survey Questions 1. How old are you? 2. What is your race? White Black or African American American Indian or Alaskan Native Asian Native Hawaiian or other Pacific Islander Hispanic/Latino(a) Other 3. How much do you weigh? 4. How tall are you? Feet Inches 5. What is your affiliation to the University of Utah? Student Staff/faculty Both student and staff No affiliation with the University of Utah 6. What year are you in school? Freshman Sophomore 21 Junior Senior Graduate student Post-Graduate 7. What college does the degree you are pursuing fall under? Architecture & Planning Business Dentistry Etc. 8. What year did you graduate with your most recent degree? 9. What is the level of your degree? High school Some college Bachelor’ s Degree Master’ s Degree Doctorate Degree Professional Degree 10. What field is your degree in? Health Business Fine Arts Humanities Political Science 22 Social & Behavioral Sciences Science N/A 11. How often do you exercise? 1-2 days weekly 3-4 days weekly 5-7 days weekly 12. What are the goals you hope to achieve by exercising? (Rank in order 1 being the most important and 5 being the least important) Weight loss Rehabilitation Build muscle Maintain or improve health Maintain or improve appearance 13. What do you consider your level of experience with exercising? Beginner Intermediate Advanced Professional 14. What types of exercise programs do you seek advice for? Muscle growth Cardiovascular endurance Muscle strength 23 Muscle endurance Flexibility Balance 15. In the past 12 months, where have you looked for or receive exercise advice from? Personal trainer Media (television, internet, Magazine, etc.) Self-programming Friends 16. Did you consider this professional or nonprofessional advice? Professional Nonprofessional 17. Do you think this advice was effective in helping you achieve your exercise goals? Yes No 18. If you know your personal trainers certification, please type below. If you are unsure, type “ I don’ t know” , if they don’ t have a certification, type N/A. 19. In the past 12 months, have you sustained an injury related to exercise? Yes No 20. What kind of injury did you sustain? Muscle sprain/strain Muscle tear Joint sprain/strain 24 Joint tear/rupture Broken bones 21. Do you think this injury was related to the advice you received? Yes No 22. Did you seek out medical advice for this injury? Yes No 23. How long did you abstain from exercise after this injury for healing? No time away from exercise <1week 1week-1month 1-3months 3-6months 6-12months 25 Table 1: Descriptive statistics, averages and standard deviations, regarding age and BMI of the sample, n=280. Mean Standard Deviation Height (m) Weight (kg) BMI (kg/m2) Age 1.72 ±.303 74 ±17.74 25 ±19.55 21 ±8.24 Table 2: Percentages of races represented in the sample. Response Percent White Black or African-American American Indian or Alaskan Native Asian Native Hawaiian or other Pacific Islander Hispanic/Latino(a) Other 71.5% 3.3% 2.6% 13.5% 3.6% 12.8% 5.1% answered question skipped question Response Count 196 9 7 37 10 35 14 274 6 Figure 1: Pie graph of the distribution of the year of students that participated in the survey. What year are you in school? Freshman Sophmore Junior Senior Graduate Student Post-Graduate 26 Table 3: Percentages of the sources reported by participants. Response Percent Response Count 12.3% 16.4% 31.7% 39.6% answered question skipped question Personal trainer Media (television, internet, magazine, etc.) Self-programming Friends or other exercisers 33 44 85 106 268 12 Table 4: Percentages of injuries sustained by each group of participants by sources, compared to total number of injuries sustained by the sample population. Injury Source Number Percentage 4 10 7 6 58 4.7% 11.8% 8.2% 7.1% 68.2% Personal Trainer Self-Programmed Friends & Other Exercisers Media Unrelated Injuries Table 5: Percentages of reported professionalism of the sources, compared to the determined professionalism of the source. Total Personal Trainer SelfProgramming Friends & Other Exercisers Media 31 Determined Professionalism Unsure or NonProfessional Not professional Applicable 9 (29.03%) 1 (3.23%) 21 (67.74%) Participant Reported Professional Nonprofessional 27 (87.1%) 8 (25.81%) 60 8 (13.33%) 3 (5%) 49 (81.67%) 106 2 (1.89%) 10 (9.43%) 94 (88.68%) 35 (33.02%) 71 (66.98%) 83 4 (4.82%) 79 (95.18%) 0 (0%) 47 (56.63%) 37 (44.58%) 27 Table 6: Percentages of the types of acute injuries sustained by participants. Response Percent Muscle sprain/strain Muscle tear Joint sprain/strain Joint tear/rupture Broken bones 47.6% 2.4% 30.5% 8.5% 11.0% answered question skipped question Response Count 39 2 25 7 9 82 198 Figure 2: Breakdown of significant correlation between frequency of exercise and prevalence of unrelated injury (p=.016). 28 References About adult BMI. (2015, May 15). Retrieved November 25, 2015, from Centers for Disease Control and Prevention website: http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#InterpretedAdult s ASCM issues new recommendations on quantity and quality of exercise. (2011). Retrieved November 20, 2015, from American College of Sports Medicine website: http://journals.lww.com/acsm-msse/pages/default.aspx Astin, A. W. (1993). What matters in college? Four critical years revisited. Liberal Education, 79(4). Brock, M., Carr, J. W., & Todd, M. K. (2015). An examination of campus recreation usage, academic performance, and selected health indices of college freshman. Recreational Sports Journal, 39, 27-36. http://dx.doi.org/10.1123/rsj.2014-0061 Cardinal, B. J., & Cardinal, M. K. (2015). Regulating physical activity education for the public's health and safety, and the field's continued relevance and survival: Licensure for exercise leadership--It's time! Journal of Physical Education, Recreation, & Dance, 86(5), 3-5. http://dx.doi.org/10.1080/07303084.2015.1023101 Gray, S. E., & Finch, C. F. (2014). Epidemiology of hospital-treated injuries sustained by fitness participants. Research Quarterly for Exercise and Sport, 86(1), 81-87. http://dx.doi.org/10.1080/02701367.2014.97577 Gray, S. E., & Finch, C. F. (2015). Epidemiology of hospital-treated injuries sustained by fitness participants. Research Quarterly for Exercise and Sport, 86, 81-87. http://dx.doi.org/10.1080/02701367.2014.975177 29 Gray, S. E., Keyzer, P., Norton, K., Dietrich, J., Sekendiz, B., Coyle, I., & Finch, C. F. (2015). The role of equipment, the physical environment and training practices in customer safety within fitness facilities: The perspective of fitness industry employees. Journal of Fitness Research, 4(2), 26-33. Grice, A., Kingsbury, S. R., & Conaghan, P. G. (2014). Non-elite exercise-related injuries: Participant reported frequency, management and perceptions of their consequences. Scandinavian Journal of Medicine & Science in Sports, 24, 86-92. http://dx.doi.org/10.1111/sms.12115 Hamlin, M., & Paterson, A. (2014). Sedentary behaviour and chronic disease. Perspectives in Public Health, 134(3), 131-132. Henchy, A. (2011). The influence of campus recreation beyond the gym. Recreational Sports Journal, 35, 174-181. Henchy, A. (2013). The perceived benefits of participating in campus recreation programs and facilities: A comparison between undergraduate and graduate students. Recreational Sports Journal, 37, 97-105. Hoffman, S. (2014). Do you really need a degree in kinesiology to be a personal trainer? Kinesiology Today, 7(4), 27. Jackson, J., Lyons, T. S., Roberts, J. L., Geary, C., & Williams, J. (2010). Use of nutritional supplementation among university recreation users. Recreational Sports Journal, 34, 2-8. Lavallee, M. E., & Balam, T. (2010). An overview of strength training injuries: Acute and chronic. American College of Sports Medicine, 9(5), 307-313. 30 Lee, S., Farley, L. A., & Kwon, O. (2010). The effectiveness of risk management plans in recreational sport programs of division I-A universities. Recreational Sports Journal, 34, 58-68. Liguori, G., Dwyer, G. B., Fitts, T. C., & Lewis, B. (Eds.). (2014). ACSM's resources for the health fitness specialist. Philadelphia, PA: Lippincott Williams & Wilkins. Lindsey, R., & Sessoms, E. (2006). Assessment of a campus recreation program on student recruitment, retention, and frequency of participation across certain demographic variables. Recreational Sports Journal, 30, 30-39. McElveen, M., North, Jr., T., Rossow, A., & Cattell, M. (2014). Injury rates in intramural sports. Recreational Sports Journal, 38, 98-103. http://dx.doi.org/10.1123/rsj.2013-0027 Miller, K. H., Noland, M., Rayens, M. K., & Staten, R. (2008). Characteristics of users and nonusers of a campus recreation center. Recreational Sports Journal, 32, 87-96. Neely, F. (1998). Intrinsic risk factors for exercise-related lower limb injuries. Sports Med, 26(4), 253-263. Neely, F. G. (1998). Intrinsic risk factors for exercise-related lower limb injuries. Sports Med, 26(4), 253-263. Stier, Jr., W. F., Schneider, R. C., Kampf, S., Haines, S., & Gaskins, B. (2008). Selected risk management policies, practices, and procedures for intramural activities in NIRSA institutions. Recreational Sports Journal, 32, 28-44. Undergraduate students reference group executive summary [Fact sheet]. (2014). Retrieved October 29, 2015, from American College Health Association National College Health Assessment website: http://www.acha-ncha.org 31 Watson, II, J. C., Ayers, S. F., Zizzi, S., & Naoi, A. (2006). Student recreation centers: A comparison of users and non-users of psychosocial variables. Recreational Sports Journal, 30, 9-19. Yeager, R. L. (2012). An assessment of usage and physical activity patterns, measurement of satisfaction indicators and purpose of visit at two university recreation centers (Unpublished doctoral dissertation). West Virginia University, Morgantown, WV.