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  Subjects -> SPORTS AND GAMES (Total: 199 journals)
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Clinical Journal of Sport Medicine
Journal Prestige (SJR): 0.999
Citation Impact (citeScore): 2
Number of Followers: 35  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1050-642X - ISSN (Online) 1536-3724
Published by LWW Wolters Kluwer Homepage  [297 journals]
  • Pediatric Sport and Exercise Medicine: Eight Things Clinicians and
           Patients Should Question

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      Authors: Purcell; Laura; Persson, Erika; Houghton, Kristin
      Abstract: No abstract available
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Preliminary Safety and Efficacy of Head and Neck Cooling Therapy After
           Concussion in Adolescent Athletes: A Randomized Pilot Trial

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      Authors: Congeni; Joseph; Murray, Tamara; Kline, Peyton; Bouhenni, Rachida; Morgan, Danielle; Liebig, Christopher; Lesak, Alexandria; McNinch, Neil L.
      Abstract: imageObjective: To determine the safety and efficacy of head and neck cooling when applied up to 8 days after concussion among adolescent athletes.Design: A randomized nonblinded pilot trial.Setting: Sports Medicine Clinic in a tertiary hospital.Patients: Adolescent athletes aged 12 to 17 years diagnosed with a concussion within 1 week of injury.Interventions and Main Outcome Measures: The control group (n = 27) received standard treatment (short term brain rest), whereas the treatment group (n = 28) received standard treatment and head and neck cooling. Head and neck cooling treatment was applied to patients at the postinjury assessment visit and at 72 hours post-injury. The SCAT5 (Sport Concussion Assessment Tool) total symptom severity score was collected at postinjury assessment visit, pre- and post-treatment at 72 hours, and at 10 days, and 4 weeks post-treatment.Results: Athletes who received head and neck cooling had a faster symptom recovery (P = 0.003) and experienced significant reduction in symptom severity scores after treatment (P < 0.001). Sport type and gender did not influence the treatment outcome (P = 0.447 and 0.940, respectively).Conclusions: This pilot study demonstrates feasibility of head and neck cooling for the management of acute concussion in adolescent athletes.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Coach Education Improves Adherence to Anterior Cruciate Ligament Injury
           Prevention Programs: A Cluster-Randomized Controlled Trial

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      Authors: Ling; Daphne I.; Boyle, Caroline; Schneider, Brandon; Janosky, Joseph; Kinderknecht, James; Marx, Robert G.
      Abstract: imageObjective: To determine the effect of an educational workshop on adherence to neuromuscular training (NMT) among high-school coaches.Design: Cluster-randomized controlled trial.Setting: High school.Participants: A total of 21 teams in 8 high schools (unit of randomization) were randomized to the intervention or control group. Twelve boys' and 9 girls' teams in a variety of sports were enrolled.Intervention: Coaches in the intervention group participated in a 60-minute education workshop to teach effective implementation of a NMT program and also received print materials. Coaches in the control group received the same print materials.Main Outcome Measures: Eight data collectors were trained to observe each team's practice/game 2 to 3 times a week. They completed a study questionnaire to identify the NMT exercise and whether the coach (1) delivered exercise instructions and (2) provided alignment cues (both yes/no).Results: A total of 399 practices/games were observed over 2 seasons. A greater proportion of coaches in the intervention group provided alignment cues to correct improper technique compared with the control group {difference = 0.04 [95% confidence interval (CI), 0.01-0.07], P = 0.006}. There was a similar proportion of coaches in the intervention and control groups who provided exercise instructions [difference = 0.01 (95% CI, −0.02 to 0.04), P = 0.44]. More coaches in the intervention group completed a full NMT program [OR = 4.62 (1.22, 17.50), P = 0.02].Conclusions: Coach education can improve adherence to a NMT program and delivery of alignment cues. Coaches should receive in-person training on NMT and how to deliver alignment cues to their athletes while performing the exercises.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Chronic Exertional Compartment Syndrome Caused by Functional Venous
           Outflow Obstruction

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      Authors: McGinley; Joseph C.; Thompson, Trey A.; Ficken, Shawn; White, Jessica
      Abstract: imageObjective: Investigate the theory that chronic exertional compartment syndrome (CECS) results from venous outflow obstruction due to functional muscular compression. Chronic exertional compartment syndrome occurs when increased pressure within a muscle compartment produces pain and/or neurologic symptoms. The exact etiology of CECS is unknown, leading to inconsistent diagnostic and treatment plans.Study Design: Retrospective case series.Setting: Private practice and sports medicine.Patients: Two hundred eighty-four patients with exercise-induced lower leg pain. Twenty-two patients lost to follow-up.Interventions: Leg vasculature was evaluated using stress computed tomography angiography (CTA) and MVP Flex to identify areas of functional venous compression. All patients then underwent targeted botulinum toxin treatment. Posttreatment follow-up imaging was performed using stress CTA in 197 patients.Main Outcome Measures: Presence of functional venous compression on stress CTA. Symptom reduction and normalization of venous flow after targeted botulinum toxin injections.Results: Baseline imaging demonstrated CECS and functional venous obstruction with replication of symptoms in 260 of 284 patients [91.5% ± 3.2% (95% CI)]. Four weeks after treatment, 227 of 284 patients [79.9% ± 4.7% (95% CI)] described reduced/resolved symptoms with activity. One hundred fifty-five of the 197 patients [78.7% ± 5.7% (95% CI)] reimaged with stress CTA demonstrated resolved/reduced venous outflow obstruction. Twenty-two patients were lost to follow-up, and 35 patients had persistent symptoms.Conclusion: Chronic exertional compartment syndrome results from venous outflow obstruction due to functional muscular compression. Understanding the cause of CECS will allow the development of more precise and successful treatment plans. Based on our findings, treatment should be directed at the sites of venous compression.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Dizziness, Psychosocial Function, and Postural Stability Following
           Sport-Related Concussion

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      Authors: Hunt; Danielle L.; Oldham, Jessie; Aaron, Stacey E.; Tan, Can Ozan; Meehan, William P. III; Howell, David R.
      Abstract: imageObjective: To examine if self-reported dizziness is associated with concussion symptoms, depression and/or anxiety symptoms, or gait performance within 2 weeks of postconcussion.Design: Cross-sectional study.Setting: Research laboratory.Participants: Participants were diagnosed with a concussion within 14 days of initial testing (N = 40). Participants were divided into 2 groups based on their Dizziness Handicap Inventory (DHI) score: 36 to 100 = moderate/severe dizziness and 0 to 35 = mild/no dizziness.Interventions: Participants were tested on a single occasion and completed the DHI, hospital anxiety and depression scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and Post-Concussion Symptom Inventory (PCSI). Three different postural control tests were use: modified Balance Error Scoring System, single-/dual-task tandem gait, and a single-/dual-task instrumented steady-state gait analysis.Main Outcome Measures: Comparison of patient-reported outcomes and postural control outcomes between moderate/severe (DHI ≥ 36) and mild/no (DHI < 36) dizziness groups.Results: Participants with moderate/severe dizziness (n = 19; age = 17.1 ± 2.4 years; 63% female) reported significantly higher symptom burden (PSCI: 43.0 ± 20.6 vs 22.8 ± 15.7; P = 0.001) and had higher median HADS anxiety (6 vs 2; P < 0.001) and depression (6 vs 1; P = 0.001) symptom severity than those with no/minimal dizziness (n = 21; age = 16.5 ± 1.9; 38% female). During steady-state gait, moderate/severe dizziness group walked with significantly slower single-task cadence (mean difference = 4.8 steps/minute; 95% confidence interval = 0.8, 8.8; P = 0.02) and dual-task cadence (mean difference = 7.4 steps/minute; 95% confidence interval = 0.7, 14.0; P = 0.04) than no/mild dizziness group.Conclusion: Participants who reported moderate/severe dizziness reported higher concussion symptom burden, higher anxiety scores, and higher depression scores than those with no/mild dizziness. Cadence during gait was also associated with the level of dizziness reported.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Pelvic Avulsion Fractures in Adolescent Athletes: Analyzing the Effect of
           Delay in Diagnosis

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      Authors: Moeller; James L.
      Abstract: imageObjective: To evaluate whether delay in the diagnosis of pelvic avulsion fractures in young athletes leads to prolonged treatment and prolonged return toward sport activities, whether fractures at certain locations are associated with a greater risk of diagnostic delay, and what reasons may exist for delay in diagnosis.Design: Retrospective chart review of young patients who presented with pelvic region avulsion fracture to a community-based sports medicine clinic over a 19-year period.Setting: Private practice, primary care sports medicine clinic.Patients: Patients younger than 20 years diagnosed with pelvic region avulsion fracture.Interventions: None, this was a retrospective study.Main Outcome Measures: Clearance for return toward sport activities.Results: Two hundred twenty-five cases were reviewed for reasons for delay in diagnosis; 208 cases met criteria for the duration of treatment and return to play activities portions of the study. The mean time from date of injury diagnosis was 19.59 days, and the mean duration from date of injury to clearance for return to play advancement was 67.20 days. Duration of treatment varied slightly depending on timing of diagnosis, whereas duration from date of injury to clearance for return to play advancement varied greatly depending on diagnostic delay. Those who did not sense a “pop” at the time of injury were more likely to experience diagnostic delay, as were athletes with ischial tuberosity fractures. The most common cause of diagnostic delay was patient/family decision on when to seek care; misdiagnosis as a muscle strain was also common.Conclusions: Diagnostic delay of adolescent pelvic avulsion fractures may unnecessarily prevent athletes from returning to play within an optimal time frame. Our observations highlight a need for educating athletes and their families on when to seek initial or follow-up medical care as well as educating medical providers regarding the diagnosis of pelvic avulsion fractures.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Prevalence of Female and Male Athlete Triad Risk Factors in Ultramarathon
           Runners

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      Authors: Høeg; Tracy Beth; Olson, Emily Miller; Skaggs, Kira; Sainani, Kristin; Fredericson, Michael; Roche, Megan; Kraus, Emily
      Abstract: imageObjective: To identify the prevalence of male and female athlete triad risk factors in ultramarathon runners and explore associations between sex hormones and bone mineral density (BMD).Design: Multiyear cross-sectional study.Setting: One hundred-mile ultramarathon.Participants: Competing runners were recruited in 2018 and 2019.Assessment of Risk Factors: Participants completed a survey assessing eating behaviors, menstrual history, and injury history; dual-energy x-ray absorptiometry for BMD; and laboratory evaluation of sex hormones, vitamin D, and ferritin (2019 cohort only).Main Outcome Measure: A Triad Cumulative Risk Assessment Score was calculated for each participant.Results: One hundred twenty-three runners participated (83 males and 40 females, mean age 46.2 and 41.8 years, respectively). 44.5% of men and 62.5% of women had elevated risk for disordered eating. 37.5% of women reported a history of bone stress injury (BSI) and 16.7% had BMD Z scores
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Low Risk of Cardiac Complications in Collegiate Athletes After
           Asymptomatic or Mild COVID-19 Infection

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      Authors: Klawitter; Paul; Cowen, Leslie; Carhart, Robert
      Abstract: imageObjective: The objective of this study was to determine the utility of “standard” cardiac screening with EKG, echocardiography, and serum troponin T (hs-Tn T) testing after COVID infection in competitive college athletes.Design: Prospective cohort study.Setting: Tertiary cardiology clinic, university training room.Participants: Sixty-five Division 1 athletes recovered from COVID-19 and 465 controls.Assessment: All COVID-recovered athletes underwent cardiac screening on return to campus in fall 2020. Controls were screened if indicated by preparticipation examination. Students cleared for sports participation were followed for the development of cardiac complications.Main Outcome Measure: Incidence of cardiac complications after COVID infection.Results: Infected athletes experienced mild (26/65), moderate (8/65), or no (31/65) COVID symptoms. No athletes had severe symptoms. Men were more likely to have been asymptomatic (20/31), and women were more likely to have had moderate (7/8) symptoms (P = 0.015). All athletes, except 2 with anosmia, were asymptomatic at the time of cardiac testing. One athlete had persistently elevated hs-Tn T but no evidence of myocarditis on cardiac MRI. All other cardiac testing was negative. No athletes were diagnosed with myocarditis (95% CI: 0%-5.5%). All athletes were cleared for athletic participation. None suffered complications over the next 9 months.Conclusions: After COVID-19 infection, no college athletes with mild, moderate, or no symptoms had signs of myocarditis, and all returned to play without cardiac complication. These findings support consensus opinion recommendations that college-age athletes who recovered from COVID-19 and who experienced mild or no symptoms may return to play without cardiac testing.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • High Number of Medical Conditions Detected in Elite Athlete Periodic
           Health Evaluations, But Only Mild Consequences

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      Authors: de Vries; Jesse T.; Wiggers, Tom G. H.; Goedegebuure, Simon; Reurink, Guus
      Abstract: imageObjective: To evaluate the number of medical conditions detected by periodic health evaluations (PHEs) in elite athletes, and their consequences for management and medical clearance.Design: Retrospective design.Participants: Elite athletes of various sports in a high-performance program in The Netherlands, in the period between 2009 and 2020.Interventions: The PHEs consisted of a questionnaire, general and musculoskeletal physical examination, laboratory blood test, electrocardiogram, pulmonary function testing, and (cardiopulmonary) exercise test.Main Outcome Measures: We extracted and analyzed the medical conditions that led to advice, clinical follow-up, further diagnostic investigation or treatment, and the medical clearance status of the athlete (clearance, temporarily no clearance, or permanently no clearance).Results: We included 721 PHEs of 451 elite athletes. We found 1389 medical conditions that led to advice (n = 923, 66%), clinical follow-up (n = 124, 9%), further diagnostic investigation (n = 190, 14%), treatment (n = 132, 10%), or sports restriction (n = 20, 1%). Only 20 cases (3%) led to temporarily no medical clearance. After further investigation or treatment, no permanent sports restriction was imposed on any of the athletes.Conclusions: We found a high number of medical conditions detected with a PHE in elite athletes. However, the vast majority of detected conditions were mild, with consequences limited to preventive advice and follow-up. The yield of PHE to detect (potentially) severe pathological conditions seems low. Clinical relevance of PHE in elite athletes and potential future health benefits remain unclear.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Characteristics of Second-Line Investigations of Middle-Aged Athletes Who
           Failed Preparticipation Examinations

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      Authors: Neuman; Gil; Milman, Anat; Ziv-Baran, Tomer; Dubnov-Raz, Gal
      Abstract: imageObjective: The role of exercise testing during preparticipation examinations (PPEs) of middle-aged athletes is uncertain. This study examined the characteristics of disqualifications after an initial PPE that includes an exercise test in competitive athletes older than 30 years. We investigated disqualification rates and reasons, second-line investigations performed, and final decisions regarding competitive sports participation.Design: Chart review.Setting: Sports medicine clinic.Participants: Athletes aged>30 years that performed an exercise test as part of their annual PPE at our sports medicine clinic (n = 866).Independent Variables: Age, sex, height, weight, sport type, cardiovascular risk factors, and abnormal PPE findings.Main Outcome Measures: Additional investigations performed, approval/disqualification regarding competitive sports participation.Results: The initial disqualification rate of athletes was 9.8%. Three (3.6%) athletes were disqualified following questionnaire and physical examination, 19 (22.4%) because of resting electrocardiogram findings, and 65 (76.5%) following the exercise test. After additional work-up, only 5 athletes (0.4%) were ultimately found ineligible for competitive sports. From those, only 2 athletes (0.2%) were disqualified because of exercise test findings, which were episodes of supraventricular tachycardia and not ischemia-related.Conclusions: The addition of an exercise test to the PPE of middle-aged athletes is of limited value. If exercise testing of older athletes is performed, arrhythmias are probably of higher significance than ST-T changes.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Agreement Between Clinical Examination and Magnetic Resonance Imaging in
           Acute Knee Trauma With Hemarthrosis

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      Authors: Brown; Jamie Sutherland; Frobell, Richard B.; Isacsson, Anders; Englund, Martin; Olsson, Ola
      Abstract: imageObjective: Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.Design: Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.Setting: Helsingborg hospital.Patients: Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.Interventions: Clinical examination and MRI.Main outcome measures: agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.Results: Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.Conclusions: Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Hydration Strategies for Physical Activity and Endurance Events at High
           (>2500 m) Altitude: A Practical Management Article

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      Authors: Trease; Larissa; Singleman, Glenn; Windsor, Jeremy; Allan, Stuart; Albert, Edi
      Abstract: imageAbstract: A growing number of adventurous athletes are seeking new challenges through endurance events or physical activities held at high altitude (>2500 m). This coincides with a significant increase in the numbers of trekkers who ascend into the world's mountains. Altitude itself influences and complicates the athlete's effective and safe hydration. This article considers the physiology of adaptation to altitude and the effects on hydration at altitude compared with sea level, reviews the “ad libitum versus programmed hydration” controversy in conventional endurance event hydration, examines the evidence for extrapolation of sea level hydration strategies to the high-altitude environment, and synthesizes these disparate factors into a set of practical recommendations for hydration management during high-altitude physical activity. The guidelines will be relevant to participants of physical activity at altitude and health care staff who may care for them in the preparation or performance phases of their adventure.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Cardiocirculatory Stress in Professional Football (Soccer) Coaches

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      Authors: Meyer; Tim; Demond, Vera; Scharhag, Jürgen
      Abstract: imageObjective: It was intended to quantify cardiocirculatory stress and risk of professional football (soccer) coaches during competition.Design: Descriptive cross-sectional study.Setting: Medical screening examination and measurements during match.Participants: Seventeen coaches and 11 assistant coaches of the 2 highest German football leagues (male coaches; 46 ± 7 years; 8 ± 7 years in job).Independent variables: Professional football matches with highly competitive character were chosen and monitored for elicited cardiocirculatory stress and possible damage.Main Outcome Measures: Indicators of general health status, occurrence of arrhythmias, and course of heart rate and cardiac biomarkers (brain natriuretic peptide [BNP], troponin I) during the match.Results: Besides a few preexisting cardiovascular diseases, medical screening revealed a risk factor profile similar to the general population and above-average maximal/submaximal cycle ergometry performance: Pmax 2.9 ± 0.5 W*kg−1; PWC130 1.9 ± 0.5 W*kg−1. No match-induced changes were detected for BNP (20.5 ± 9.4 to 19.7 ± 10.7 pg/mL; P = 0.48) and troponin I (12.6 ± 16.5 to 10.5 ± 14.1 ng/L; P = 0.31). Maximal heart rate during the first and second half was 127 ± 15 and 132 ± 19 beats per minute, respectively. No match-induced arrhythmias of higher degree were detected.Conclusions: Head and assistant coaches of German professional football teams do not show any match-induced cardiac damage, despite considerable cardiocirculatory stress. Possibly, their above-average fitness level saves them from more detrimental outcomes.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Adiposity as a Risk Factor for Sport Injury in Youth: A Systematic Review

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      Authors: Toomey; Clodagh M.; Whittaker, Jackie L.; Richmond, Sarah A.; Owoeye, Oluwatoyosi B.; Patton, Declan A.; Emery, Carolyn A.
      Abstract: imageObjective: To determine whether high or low adiposity is associated with youth sport-related injury.Data Sources: Ten electronic databases were searched to identify prospective studies examining the association between adiposity [body mass index (BMI) or body fat] and a future time-loss or medical attention sport-related musculoskeletal injury or concussion in youth aged 20 years and younger. Two independent raters assessed the quality (Downs and Black criteria) and risk of bias (Joanna Briggs Institute Critical Appraisal Tool). Random-effects meta-analyses were used to calculate pooled odds ratio [95% confidence interval (CI)] of injury.Main Results: Of 11 424 potentially relevant records, 38 articles were included with 17 eligible for meta-analyses. In qualitative synthesis, no clear association was identified between adiposity and any sport injury; however, 16/22 studies identified high adiposity as a significant risk factor for lower-extremity injury. Meta-analyses revealed higher BMI in youth with any sport-related injury and lower BMI in youth who developed a bone stress injury (BSI) compared with noninjured controls. The pooled OR (95% CI) examining the association of BMI and injury risk (excluding bone injury) was 1.18 (95% CI: 1.03-1.34). A major source of bias in included articles was inconsistent adjustment for age, sex, and physical activity participation.Conclusions: Level 2b evidence suggests that high BMI is associated with greater risk of youth sport injury, particularly lower-extremity injury and excluding BSI or fracture. Although pooled mean differences were low, anthropometric risk of injury seems to be dependent on type and site of injury in youth sport.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Comparative Efficacy of Nonoperative Treatments for Greater Trochanteric
           Pain Syndrome: A Systematic Review and Network Meta-Analysis of Randomized
           Controlled Trials

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      Authors: Gazendam; Aaron; Ekhtiari, Seper; Axelrod, Daniel; Gouveia, Kyle; Gyemi, Lauren; Ayeni, Olufemi; Bhandari, Mohit
      Abstract: imageObjective: An evolved understanding of the pathophysiology of greater trochanteric pain syndrome has led to a number of proposed nonoperative management strategies. The objective of this review was to compare the efficacy of the various nonoperative treatments for greater trochanteric pain syndrome (GTPS).Design: Systematic review and network meta-analysis.Setting: PubMed, Embase, CENTRAL, SCOPUS, and Web of Science were searched to January 2020.Patients: Patients undergoing nonoperative treatment for GTPS.Interventions: Nonoperative treatment strategies for GTPS including injections of corticosteroids, platelet-rich plasma, hyaluronic acid, dry needling, and structured exercise programs and extracorporeal shockwave therapy.Main Outcome Measures: Pain and functional outcomes. Bayesian random-effects model was performed to assess the direct and indirect comparison of all treatment options.Results: Thirteen randomized controlled trials and 1034 patients were included. For pain scores at 1 to 3 months follow-up, both platelet-rich plasma (PRP) and shockwave therapy demonstrated significantly better pain scores compared with the no treatment control group with PRP having the highest probability of being the best treatment at both 1 to 3 months and 6 to 12 months. No proposed therapies significantly outperformed the no treatment control group for pain scores at 6 to 12 months. Structured exercise had the highest probability of being the best treatment for improvements in functional outcomes and was the only treatment that significantly improved functional outcome scores compared with the no treatment arm at 1 to 3 months.Conclusion: Current evidence suggests that PRP and shockwave therapy may provide short-term (1-3 months) pain relief, and structured exercise leads to short-term (1-3 months) improvements in functional outcomes.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Describing Frequencies of Lower-Limb Apophyseal Injuries in Children and
           Adolescents: A Systematic Review

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      Authors: Haines; Mitchell; Pirlo, Larissa; Bowles, Kelly-Ann; Williams, Cylie M.
      Abstract: imageAbstract: Objective: To describe the frequency with which children are affected by lower-limb apophyseal injuries, and subgroups at greater risk.Design: Systematic review.Setting: N/A.Participants: N/A.Interventions: N/A.Main Outcome Measures: Systematic review of Medline OVID, PsycINFO, Cinahl, and PubMed from inception until February 21st, 2020. Articles reporting prevalence and/or incidence of an apophyseal injury (eg, calcaneal apophysitis) or its eponym (Severs or Sever disease). Per person data relating to the incidence or prevalence. Subgroup comparisons were made between sex groups and between activity participant groups.Results: There was wide variation in measurement approaches and follow-up timeframes with the majority of studies reporting on traction apophysitis of the tibial tubercle (Osgood–Schlatter disease). This condition had a point prevalence of 10% in the general population of children between the ages of 12 and 15 years, whereas the lifetime incidence has been reported as 13%. Point prevalence was higher among those who participated in sport compared with those who did not {relative risk [95% confidence interval (CI): 1.98 (1.31-2.99)]}, whereas lifetime incidence was higher among those who participated in sport at the age of 13 years compared with those who did not [relative risk (95% CI): 4.63 (2.31-9.26)]. Other apophyseal injuries did not report enough data to permit comparisons.Conclusion: Sports participation is likely to substantially increase the frequency of traction apophysitis of the tibial tubercle. Further research is required with standardized approaches to compare frequencies between different apophyseal injuries and subgroups of interest.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Measuring Recovery With Ecological Momentary Assessment in a Randomized
           Trial of Exercise After Sport-Related Concussion

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      Authors: Wiebe; Douglas J.; Storey, Eileen P.; Orchinik, Julia E.; Grady, Matthew F.; Leddy, John J.; Willer, Barry S.; Haider, Mohammad Nadir; Mannix, Rebekah; Meehan, William P.; Vernau, Brian T.; Master, Christina L.
      Abstract: imageObjective: Investigate the reliability of concussion symptoms captured through ecological momentary assessment (EMA) and compare time with recovery based on 3 definitions of symptomatic recovery and the date of clinical clearance to begin the return-to-play (RTP) process.Design: We used a mobile app with EMA to monitor concussion symptoms as part of a multicenter randomized controlled trial.Setting: Three sports medicine practices.Participants: Patients between 13 and 18 years old with sport-related concussion were prompted to complete the Post-Concussion Symptom Inventory daily over 4 weeks.Interventions: None.Main Outcome Measures: We compared the elapsed days to reaching the 4 outcomes using scatterplots and Kaplan–Meier curves.Results: Among 118 participants, symptoms reported into the app had excellent agreement with symptoms reported at a clinical visit on the same day (intraclass correlation coefficient = 0.97). Most (>50%) participants reached “specific symptom return to preinjury levels,” “overall symptom return to preinjury levels,” and “current symptom resolution” based on EMA symptom reports between several days and 1 week before achieving “clinical clearance to RTP” determined at a clinical visit, which had 100% sensitivity, but between 56.3% and 78.1% specificity, relative to the app-measured symptom outcomes.Conclusions: Time until symptom recovery varies based on the chosen definition of symptomatic recovery but is a more precise correlate with clinical clearance to begin the RTP process when defining symptom recovery as a return to a preinjury baseline level of symptomatology. Real-time symptom monitoring may be beneficial clinically, allowing providers to assess patients' recovery status and make more timely and remote treatment recommendations.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Ten-Word List Performance in Healthy Athletes and Athletes at 3-to-5 Days
           Following Concussion

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      Authors: Hutchison; Michael G.; Di Battista, Alex P.; Pyndiura, Kyla L.; Corallo, Danielle N.; Lawrence, David W.; Richards, Doug
      Abstract: imageObjective: Although the word recall component of the Sport Concussion Assessment Tool (SCAT) was updated from 5-to-10 words, its clinical utility across athletic populations remains unknown. The purpose of this study was to provide normative data on the SCAT-5 10-word test and examine its discriminative ability between healthy university level athletes and those with sport-related concussion (SRC).Design: Cross-sectional.Setting: University.Participants: Three hundred sixty-three (363, M = 220, F = 153) healthy athletes and 49 (M = 30, F = 19) athletes following SRC.Independent Variable: Healthy athletes measured preseason were compared with athletes following an SRC (median = 4.0 days postinjury).Main Outcome Measure: Ten-word list performance from the SCAT-5.Results: There were no significant differences in either immediate (P = 0.228, Cohen's D = 0.18) or delayed (P = 0.908, Cohen's D = 0.02) recall tests between athletes with SRC and healthy athletes; the null findings extended to both the male and female subset comparisons. Among healthy athletes, females outperformed males on both immediate (mean difference = 1.0, P < 0.001) and delayed (mean difference = 0.5, P = 0.006) recall tasks.Conclusion: Concussion does not seem to impact immediate or delayed recall of the 10-word list in the subacute period following injury. Practitioners should be mindful of sex differences and the time point of administration following injury.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Acute Effects of Concussion in Adolescent Athletes With High Preseason
           Anxiety

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      Authors: Champigny; Claire; Roberts, Samantha D.; Terry, Douglas P.; Maxwell, Bruce; Berkner, Paul D.; Iverson, Grant L.; Wojtowicz, Magdalena
      Abstract: imageObjective: To examine associations between pre-existing anxiety symptoms, and symptoms and cognitive functioning acutely following a suspected concussion.Design: Nested case–control study.Setting: High schools in Maine, USA.Participants: Participants were identified from a dataset of 46 920 student athletes ages 13 to 18 who received baseline preseason testing. A subset of 4732 underwent testing following a suspected concussion. Of those, 517 were assessed within 72 hours after their suspected concussion and met other inclusion criteria. Nineteen injured athletes endorsed anxiety-like symptoms on the Post-Concussion Symptom Scale (PCSS) during baseline testing and were placed in the high anxiety group. Each athlete was matched to 2 injured athletes who did not endorse high levels of anxiety-like symptoms (N = 57).Main Outcome Measures: Immediate Post-Concussion Assessment and Cognitive Testing cognitive composite scores, PCSS total score, and symptom endorsement.Results: Cognitive composite scores were similar between groups across testing times ( = 0.004-0.032). The high anxiety group endorsed a greater number of symptoms than the low anxiety group ( = 0.452) and rated symptoms as more severe ( = 0.555) across testing times. Using a modified symptom score that excluded anxiety-like symptoms, a mixed analysis of variance indicated a group by injury interaction ( = 0.079); the high anxiety group reported greater increases in overall symptom severity following injury.Conclusions: Adolescent athletes who have an anxious profile at baseline are likely to experience greater symptom burden following injury. Consideration of pre-injury anxiety may inform clinical concussion management by tailoring intervention strategies (eg, incorporating mental health treatments) to facilitate concussion recovery.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Association Between Fear of Pain and Sports-Related Concussion Recovery in
           a Pediatric Population

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      Authors: Arnold; Jennifer T.; Franklin, Elizabeth V.; Baker, Zachary G.; Abowd, Marian; Santana, Jonathan A.
      Abstract: imageObjective: To determine whether an association exists between fear of pain and recovery time from sports-related concussion in a pediatric population.Design: Prospective observational study.Setting: Primary outpatient sports medicine clinic of a large pediatric hospital.Patients: One hundred twenty-eight pediatric patients aged 8 to 18 years who presented to clinic with a primary diagnosis of concussion from September 2018 to March 2020. Inclusion criteria included presentation within 2 weeks of injury and symptomatic on initial visit. Patients who sustained a concussion because of motor vehicle collisions or assault were excluded.Independent Variables: There was no intervention. Study participants who met inclusion criteria were administered the Fear of Pain Questionnaire (FOPQ) at their initial visit.Main Outcome Measures: Time to clinical recovery was the main outcome measure and was determined by the fellowship-trained sports medicine physician based on resolution of concussion symptoms, resumption of normal physical and cognitive daily activities, no use of accommodations or medications, and normalization of physical exam.Results: There was a significant difference in FOPQ scores for those with prolonged recovery (M = 33.12, SD = 18.36) compared with those recovering in fewer than 28 days (M = 26.16, SD = 18.44; t [126] = −2.18, P = 0.036).Conclusions: Consistent with the adult literature, we found that pediatric patients are more likely to have a prolonged recovery from concussion when they have higher fear of pain.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Visio-Vestibular Deficits in Healthy Child and Adolescent Athletes

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      Authors: Corwin; Daniel J.; McDonald, Catherine C.; Arbogast, Kristy B.; Mohammed, Fairuz N.; Grady, Matthew F.; Master, Christina L.
      Abstract: imageObjective: To determine the relationship between patient characteristics and performance on the visio-vestibular examination (VVE) in a cohort of healthy youth athletes and explore the potential association between the VVE and other standardized concussion batteries.Design: Cross-sectional.Setting: Suburban middle and high school.Patients: One hundred ninety subjects age 11 to 18 enrolled before their respective scholastic sport season between August 2017 and March 2020.Assessment of Independent Variables: Patient age, sex, concussion history, comorbidities, hours of weekly exercise, Sport Concussion Assessment Tool, 5th edition (SCAT-5), King–Devick (K–D), Postconcussion Symptom Inventory (PCSI).Main Outcome Measures: Visio-vestibular examination abnormalities (smooth pursuit, horizontal and vertical saccades, horizontal and vertical gaze stability, convergence, right and left monocular accommodation, complex tandem gait).Results: Overall, 29.5% of subjects had at least one of 9 VVE elements abnormal, 7.9% at least 2, and 3.2% at least 3. None of 72 comparisons of the VVE elements, when stratified by age, sex, concussion history, history of headaches, attention deficit hyperactivity disorder, learning issues, psychiatric problems, motion sickness, or weekly hours of exercise, reached significance using the Benjamini–Hochberg procedure at a false discovery rate of 5%. There were no significant associations between VVE elements and the SCAT-5, K–D, or PCSI.Conclusions: The VVE is robust across multiple patient characteristics. Although healthy subjects may have one abnormal element, multiple abnormal elements are a less common feature, making multiple abnormal elements more indicative of concussion, highlighting the use of this assessment in the setting of injury. The VVE tests unique domains when compared with the PCSI, SCAT-5, and K–D.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Static and Dynamic Balance Assessment in Healthy and Concussed Adolescent
           Athletes

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      Authors: Lowe; Leah; Castillo, Fernando; Gokun, Yevgeniya; Williams, David K.; Israel, Michael; Yates, Charlotte
      Abstract: imageObjective: The purpose of this study was to explore the utilization of the Y Balance Test (YBT) alongside the Balance Error Scoring System (BESS) during examination of healthy adolescent athletes (14-18 year old) as well as those with acute and chronic concussion.Design: A repeated-measures study of balance in a cross-sectional convenience sample of adolescents participating in high-school athletics.Setting: Data were collected on healthy athletes in their school setting for comparison purposes and on concussed athletes in the physical therapy rehabilitation center at the hospital.Participants: Participants were a convenience sample of male and female athletes between the ages of 14 to 18 year old [180 healthy (111 male, 69 female) and 44 (28 male, 16 female) with concussion].Assessment of Risk Factors: All participants were cleared for participation by preparticipation examination or by the treating sport medicine physician.Main Outcome Measures: Healthy athletes performed the YBT, a dynamic assessment of balance. Athletes with concussion also performed the BESS, a static assessment of balance.Results: Means for each YBT reach direction were statistically different for both healthy males and females (P < 0.05). Within both the acute and chronic subsets of the concussed sample, some participants performed over the median value for the BESS but not the YBT.Conclusions: These data may suggest that dynamic balance testing in conjunction with static balance testing could be valuable in both the acute and chronic phases of concussion to ensure a comprehensive assessment of the necessary balance skills for athletic play.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Norm-Based Cutoffs as Predictors of Prolonged Recovery After Adolescent
           Sport-Related Concussion

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      Authors: Worts; Phillip R.; Haider, Mohammad N.; Mason, Justin R.; Schatz, Philip
      Abstract: imageObjectives: To identify predictors of prolonged recovery (ie,>28 days) using patient demographic factors and healthy, norm-based cutoffs on a multimodal test battery in adolescents after sport-related concussions (SRCs).Design: Retrospective cohort. Patients were deemed recovered after successful completion of return-to-play/school protocols and received medical clearance.Setting: Community concussion clinic.Patients: Male and female adolescent student athletes diagnosed with a SRC and evaluated within 1 week of injury.Independent Variables: Patient demographics, medical history, injury description, computerized neurocognitive testing, vestibular/ocular testing, and symptoms at initial clinical visit.Main Outcome Measures: Performance on clinical testing to predict recovery duration, classified as normal (28 days).Results: A total of 201 adolescent student athletes (age = 15.3 ± 1.4 years) were included (female 35%). Average recovery duration for the entire cohort was 22.3 ± 13.3 days, with 22% (n = 45) of adolescent student athletes taking>28 days to recover. The final model was 88.3% accurate in classifying normal and prolonged recovery. Predictor variables included sex, loss of consciousness, history of ocular disorder, history of concussion, performance on visual motor speed composite, visual motion sensitivity symptom provocation and near point of convergence distance, number-naming total time, and symptom count.Conclusions: These findings suggest that using norm-based cutoffs from cognitive, oculomotor, and vestibulo-ocular testing and symptom reporting, clinicians can accurately predict a prolonged recovery (sensitivity = 81%) and normal recovery (specificity = 83%) in an adolescent, SRC cohort.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Factor Structure for the Sport Concussion Assessment Tool Symptom Scale in
           Adolescents After Concussion

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      Authors: Alsalaheen; Bara; Li, Yuanzhi; Almeida, Andrea; Eckner, James; Freeman, Jeremiah; Popovich, Michael; Streicher, Nicholas; He, Xuming; Lorincz, Matthew
      Abstract: imageObjective: To examine the factor structure of the Sport Concussion Assessment Tool-5 (SCAT5) symptom scale in adolescents on their initial presentation to a concussion clinic within the typical recovery period after concussion (ie,
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Exploring Vestibular/Ocular and Cognitive Dysfunction as Prognostic
           Factors for Protracted Recovery in Sports-Related Concussion Patients Aged
           8 to 12 Years

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      Authors: Price; August M.; Knell, Gregory; Caze, Todd J. II; Abt, John P.; Loveland, Dustin; Burkhart, Scott O.
      Abstract: imageObjective: To explore the prognostic ability of the vestibular/ocular motor screening (VOMS), King–Devick (K-D) Test, and C3 Logix Trails A and B to identify protracted recovery from sports-related concussion (SRC) in patients aged 8 to 12 years.Design: Retrospective cohort analysis.Setting: Specialty pediatric sports concussion clinic.Participants: A total of 114 youth athletes aged 8 to 12 years who were diagnosed with an SRC within 7 days of injury.Independent Variables: A positive screen on the VOMS, K-D, and C3 Logix Trails A and Trails B. Combined positive screens on multiple tests (ie, 2, 3, or all 4 positive screens of 4 possible).Main Outcome Measures: Recovery time in days and protracted recovery (recovery time ≥30-days) were the primary outcomes of interest.Results: A positive VOMS screen was associated with 1.31 greater days to SRC recovery (P = 0.02) than a negative VOMS screen. The K-D and C3 Logix tests were not significantly associated with recovery time, nor were any combinations of tests (P> 0.05). The VOMS demonstrated moderate prognostic ability to predict normal recovery (negative predictive value = 80.78% [95% CI = 63.73-90.95]). Overall predictive accuracy of normal versus protracted recovery was strongest when a participant screened positive on all 4 tests (Accuracy = 76.32% [95% CI = 67.45-83.78]).Conclusions: The VOMS was associated with overall recovery time and proved to be a useful test to identify those who would experience a normal recovery time. Combining the 4 tests improved the prognostic accuracy of the protocol in predicting protracted versus normal recovery. These findings suggest that combining multiple, varied assessments of cognition and vestibular/ocular functions may better explain factors contributing to protracted recovery.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Prevalence, Clinical Characteristics, and Self-Reported Treatment of
           Exercise-Associated Muscle Cramping Differ Between 21.1- and 56-Km Running
           Race Entrants—SAFER XXII

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      Authors: de Jager; Izaan; Schwellnus, Martin; Viljoen, Carel; Korkie, Elzette; Sewry, Nicola; Swanevelder, Sonja; Jordaan, Esme
      Abstract: imageObjective: To determine whether the lifetime prevalence and clinical characteristics of exercise-associated muscle cramping (EAMC) differ between runners entering a 21.1- versus 56-km road race.Design: Cross-sectional studySetting: The 2012 to 2015 Two Oceans Marathon races (21.1 and 56 km), South Africa.Participants: Participants were consenting race entrants (21.1 km = 44 458; 56 km = 26 962) who completed an online prerace medical screening questionnaire.Independent Variable: A history of EAMC.Main Outcome Measures: The main outcome variables were lifetime prevalence (%) and clinical characteristics (muscle groups affected, timing of occurrence, severity, frequency of serious EAMC, and self-reported treatment) of a history of EAMC. Differences between 56- and 21.1-km race entrants were explored (relative risk [RR]).Results: The lifetime prevalence of EAMC was 12.8%, which was higher in 56- (20.0%; 95% CI 19.5-20.6) versus 21.1-km race entrants (8.5%; 8.2-8.8) (P = 0.0001). In all entrants, the fourth quarter was the most common onset (46.4%), calf muscles were the most commonly affected (53.1%), and most EAMCs were of mild-to-moderate severity (95%). In 56- versus 21.1-km entrants, hamstring (RR = 1.7; 1.5-1.9) and quadriceps muscle groups (RR = 1.5; 1.3-1.7) were more frequently affected (P = 0.0001), the onset of EAMC during racing was less common in the first quarter (RR = 0.3; 0.2-0.4) (P = 0.0001), and serious EAMC was more frequent (RR = 1.6; 1.4-1.9) (P = 0.0001).Conclusions: In 56- versus 21.1-km runners, a history of EAMC is 2 times more frequent and muscle groups affected, onset in a race, and severity of EAMC differed. The lifetime prevalence was lower than previously reported in other events. Risk factors associated with EAMC may differ between entrants for different race distances.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Chronic Disease, Allergies, and Increased Years of Running Are Risk
           Factors Predicting Gradual Onset Running-Related Injuries in Ultramarathon
           Runners—SAFER XIX Study in 29 585 Race Entrants

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      Authors: Mokwena; Patience L.; Schwellnus, Martin P.; Van Rensburg, Audrey J.; Ramagole, Dimakatso A.; Boer, Pieter; Jordaan, Esme
      Abstract: imageObjectives: To identify risk factors that predict gradual onset running-related injuries (GORRIs) in ultramarathon runners entering a mass community-based event.Design: Descriptive cross-sectional study.Setting: Two Oceans 56 km ultramarathon 2012 to 2015.Participants: Race entrants (n = 42 003) completed a compulsory pre-race medical history questionnaire; 29 585 (70.4%) of entrants consented.Dependent/Outcome Variable: A history of GORRIs in the past 12 months among race entrants.Main Outcome Measures: In a multi-variate model, runner demographics, training variables (years of recreational running, weekly running distance, training running speed), history of chronic disease (composite score), and history of allergies were included as factors predicting GORRIs. Prevalence (%) and prevalence ratios (PR, 95% CIs) are reported.Results: The lifetime prevalence of GORRIs in ultramarathon runners was 24.4%. Independent factors predicting GORRIs were: higher chronic disease composite score (PR = 2.05 times increase risk for every 2 additional chronic diseases; P < 0.0001), history of allergies (PR = 1.66; P < 0.0001), increased years of recreational running (PR = 1.07 times increased risk for every 5 year increase in running; P < 0.0001), lower average weekly running distance (PR = 0.98 times decreased risk for every 15 km increase weekly running distance; P < 0.0001), and slower average training running speed (PR = 0.96 times decreased risk for every km/h increase in training running speed; P < 0.0001).Conclusions: Novel risk factors predicting GORRIs are increased number of chronic diseases and a history of allergies. These factors, together with training variables (years of recreational running, weekly running distance, and training running speed) can be targeted to develop and implement injury prevention, treatment, and rehabilitation interventions in ultramarathon runners.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Association Between Injury Mechanisms and Magnetic Resonance Imaging
           Findings in Rectus Femoris Injuries in 105 Professional Football Players

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      Authors: Geiss Santos; Rafael Cristiano; Van Hellemnondt, Frank; Yamashiro, Eduardo; Holtzhausen, Louis; Serner, Andreas; Farooq, Abdulaziz; Whiteley, Rodney; Tol, Johannes L.
      Abstract: imageObjective: To describe the injury mechanism and its association with magnetic resonance imaging (MRI) injury findings in acute rectus femoris injuries.Design: Combined retrospective and prospective descriptive injury study. Retrospective cohort from January 2010 to October 2013 and prospective cohort from October 2013 to January 2019.Setting: Specialized sports medicine hospital.Participants: Male professional football players older than 18 years playing in a national football league, referred for injury assessment within 7 days after an acute rectus femoris injury, with a positive finding on MRI.Independent variables: Rectus femoris muscle injury MRI findings in relation to injury mechanism in male football players.Main outcome measures: Rectus femoris injury mechanism (kicking, sprinting, and others), MRI injury location, and grade.Results: There were 105 injuries in total, with 60 (57.1%) and 45 (42.8%) injuries from the retrospective and prospective cohorts, respectively. Kicking was the injury mechanism in 57 (54.3%) of all acute rectus femoris injuries, sprinting represented 32 (30.4%), and 16 (15.2%) were classified as others. There were 20 (19.05%) free tendon, 67 (63.8%) myotendinous junction and/or intramuscular tendon, and 18 (17.1%) peripheral myofascial located injuries. All free tendon injuries were related to kicking and graded as a complete tear of at least one of the tendons in 15/20 (75.0%) cases.Conclusions: Kicking seems to be an important mechanism related to complete ruptures and injuries occurring at the proximal free tendon. Sprinting was the other most common mechanism but was never associated with injury to the proximal free tendon.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • Botulinum Toxin A for Chronic Exertional Compartment Syndrome: A
           Retrospective Study of 16 Upper- and Lower-Limb Cases

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      Authors: Charvin; Marion; Orta, Cyril; Davy, Laroche; Raumel, Marc-Antoine; Petit, Julien; Casillas, Jean-Marie; Gremeaux, Vincent; Gouteron, Anaïs
      Abstract: imageObjective: To assess initial and mid-term efficacy of botulinum toxin A (BoNT-A) injections in patients with chronic exertional compartment syndrome (CECS) in the lower and upper limbs.Design: Retrospective monocentric study.Setting: A University Hospital Department of Physical Medicine and Rehabilitation.Patients: Sixteen patients with CECS of the lower and upper limbs treated with BoNT-A injections (first-line treatment) were included.Interventions, Main Outcome Measures: We collected data from a follow-up consultation (initial pain reduction [complete, partial, or ineffective] and specific activities triggering CECS) and a subsequent phone questionnaire (mid-term efficacy, pain recurrence, and adverse effects).Results: Sixteen patients were included (median age: 25.5 years), and 68.75% reported initial efficacy (4 partial and 7 complete); 8/16 patients were able to resume the activity that triggered CECS. All the patients with initial partial efficacy had pain recurrence (median time of 2.25 months). Among patients with initial complete efficacy, 57.14% had recurrence (median time of 5 months). Minor adverse effects were observed, but with no functional impact.Conclusion: In 16 individuals with CECS treated with BoNT-A injections, we observed moderate efficacy without major adverse effects, but an initial improvement was often followed by recurrence, especially among those with partial initial efficacy.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • A Novel Treatment of Painful Medial Collateral Ligament Calcification
           (Pellegrini–Stieda Syndrome): A Case Report

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      Authors: Greidanus; Benjamin D.
      Abstract: imageAbstract: A 63-year-old healthy woman was diagnosed clinically and radiographically with Pellegrini–Stieda syndrome. She had failed to improve with 6 months of conservative management using oral anti-inflammatories and physiotherapy. Local corticosteroid injections were offered on 2 occasions, 4 months apart, and provided excellent but only temporary relief of symptoms. The patient agreed to undergo ultrasound-guided percutaneous lavage, followed by platelet-rich plasma infiltration of the Pellegrini–Stieda lesion instead of being referred for surgery. The patient was assessed clinically and radiographically at 12 weeks and 18 months postprocedure. At both appointments, the patient reported a significant reduction in pain and improvement in function as rated by the Lower Extremity Function Scale (improvement of 20 points at 12 weeks and an improvement of 16 points at 18 months postprocedure). Radiographically, the Pellegrini–Stieda lesion was no longer visible at either follow-up interval. In conclusion, ultrasound-guided percutaneous calcific lavage followed by autologous platelet-rich plasma infiltration may be an effective way to treat refractory cases of Pellegrini–Stieda syndrome.
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
  • In Response to: Use of Different Radial Extracorporeal Shock Wave Devices
           May Explain Different Outcome in Treatment of Chronic Greater Trochanteric
           Pain Syndrome Using This Modality

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      Authors: Schmitz; Christoph
      Abstract: No abstract available
      PubDate: Fri, 01 Jul 2022 00:00:00 GMT-
       
 
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