Female Athlete Triad: Cumulative risk assessment

Risk factors		Magnitude of risk
		Low risk (0 points each)	Moderate risk (1 points each)	High risk (2 points each)
Low EA with or without DE/ED		No dietary restriction	Some dietary restriction*; current or past history of DE	Meets DSM-V criteria for ED^¶
Low BMI		BMI ≥18.5 or ≥90% EW^Δ or weight stable	BMI 17.5 to <18.5 or <90% but ≥85% EW or 5 to <10% weight loss per month	BMI <17.5 or <85% EW or ≥10% weight loss per month
Delayed menarche		Menarche <15 years	Menarche 15 to <16 years	Menarche ≥16 years
Oligomenorrhea and/or amenorrhea		>9 menses in 12 months^¶	6 to 9 menses in 12 months^¶	<6 menses in 12 months^¶
Low BMD		Z-score >–1.0	Z-score –1.0^◊ to –2.0	Z-score <–2.0
Stress reaction/fracture		None	1	≥2 sites; ≥1 high risk or trabecular bone site^§
Cumulative risk (total each column, then add for total score)
Total score:	=	+	+

Scoring of risk factors is as follows:
0 to 1	Low risk	The athlete is cleared for full participation in practice and competition.
2 to 5	Moderate risk	The athlete may participate to a modified extent, but may not participate fully in practice or competition, and must be monitored closely to be certain their condition is improving.
≥6	High risk	The athlete may not participate in practice or competition.
For guidance about clinical improvement and clearance for participation, please refer to the UpToDate topic discussing the female athlete triad.

The cumulative risk assessment provides an objective method of determining an athlete's risk using risk stratification and evidence-based risk factors for the Female Athlete Triad.

EA: energy availability; DE: disordered eating; ED: eating disorder; DSM-V: Diagnostic and Statistical Manual of Mental Disorders, fifth edition; BMI: body mass index; EW: expected weight; BMD: bone mineral density.
* Some dietary restriction as evidenced by self report or low/inadequate energy intake on diet logs.
¶ History/current history.
Δ ≥90% EW; absolute BMI cutoffs should not be used for adolescents.
◊ Weight-bearing sport.
§ High-risk skeletal sites associated with low BMD and delay in return to play in athletes with one or more components of the Triad include stress reaction/fracture of trabecular sites (femoral neck, sacrum, pelvis).

Reproduced with permission from: De Souza MJ, Nattiv A, Joy E, et al. 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. Br J Sports Med 2014; 48(4):289-308. Copyright © 2014 BMJ Publishing Group Ltd.

Graphic 122416 Version 1.0

خرید پکیج

Female Athlete Triad: Cumulative risk assessment