Clinical Journal of Sport Medicine最新文献

Objective: The study purpose was to examine epidemiology of golf-related injuries and impact of alcohol consumption.

Design: Descriptive epidemiologic study.

Setting: Emergency department injury reports in the United States.

Participants: Individuals reporting to emergency departments for golf-related injuries.

Methods: Data (2011-2021) were obtained from National Electronic Injury Surveillance System. Examined trends with pivot tables. Incidence rate ratios and confidence intervals were calculated using χ2. Three hundred seventy-one injuries were removed for not being golf related.

Independent variables: Age, gender, alcohol use.

Main outcome measures: Injury type, injury location, injury narrative.

Results: Mean age 46 years. Men (n = 7605, 71.03%) were injured more frequently. Most common injuries were sprain (n = 1699, 15.87%), laceration (n = 1544, 14.42%), and fracture (n = 1340, 12.52%). Most common locations were trunk (n = 2,417, 22.57%) and head (n = 1866, 17.43%). Most common lower extremity was knee (n = 610, 5.70%), and upper extremity was shoulder (n = 447, 4.17%). With alcohol, the rate of injury being a fracture increased from 12.39% to 18.11% [incidence rate ratio (IRR)], 1.46 [95% CI, 1.05-1.97]; P = 0.018), syncope increased from 2.63% to 9.47% (IRR, 3.51 [95% CI, 2.19-5.38]; P = 0.0001), and internal injury increased from 9.48% to 23.05% (IRR, 2.43 [95% CI, 1.82-3.18]; P = 0.0001). Injury location most common with alcohol was the head, increased from 16.95% to 37.86% (IRR, 2.23 [95% CI, 1.79-2.75]; P = 0.0001).

Conclusions: Common golf injuries include sprains, lacerations, and fractures. Alcohol is a known risk factor, significantly increasing the risk of severe injuries in golfers, such as fractures and internal injuries. In addition, notable increases in head injuries and syncope were identified.

Objective: This project has 2 aims: First, to identify and summarize the most clinically important aspects of the published evidence on physical activity and sport in children and young people for the treatment or prevention of depression, anxiety, or symptoms of these conditions. Second, this study aims to funnel and develop this evidence to create clinically meaningful summaries on the Moving Medicine website and to guide clinicians on the day-to-day conversations clinicians have with children and young people about the benefits of physical activity for mental health.

Design: This mixed methods study combines a scoping review with expert clinical review using the knowledge creation funnel component of the KTA framework.

Data sources: We searched Pubmed, OvidSp, Cochrane, OvidEmbase, OvidEmcare and AMED databases using the following search strategy, which included appropriate truncation symbols to account for variations of the search terms and maximize searches: Depression OR depressed OR anxiety OR "generalised anxiety disorder" OR anxious* OR "low mood" OR "Mood disorder" AND Children OR Child OR adolescen* OR teenager OR "young people*" OR "young person*" AND Exercise OR "physical activ*" OR sport OR "Physically activ*".

Results: Sixty-eight studies were included in this review, and evidence suggested that interventions of varying intensity can reduce symptoms of depression and anxiety in children and young people. The effects of physical activity on other mental health outcomes were also encouraging. The available evidence suggests that physical activity is a promising strategy to improve mental health in children and young people.

Conclusions: The literature overwhelmingly supports the benefits of regular physical activity both in the prevention of mental health issues for children and young people and in reduction of symptoms for those with already established symptoms. This review has translated this knowledge into accessible and relevant resources for healthcare professionals to use in their practice.

Objective: To compare head contact (HC) and suspected concussion incidence rates (IRs) in male and female university basketball players and describe associated game event and court location.

Design: Cross-sectional.

Setting: Canadian basketball courts.

Participants: Players from 5 male and 5 female 2019 to 2020 regular season basketball games.

Assessment of risk factors: Prerecorded game footage was analyzed using Dartfish video analysis software to compare sexes.

Main outcome measures: Poisson regression analysis was used to estimate IRs and incidence rate ratios (IRRs) for HCs and suspected concussions. Head contacts were classified as HC1 (direct, player-to-player) or HC2 (indirect, player-to-environment). Game event, court location, and penalization of HCs were reported.

Results: Two hundred thirty HCs (88.7% HC1s, 11.3% HC2s) were observed. The HC1 IR was higher in male than female players (IRR, 1.55; 95% CI, 1.16-2.06). Most HCs occurred within the key. Shooting was the primary offensive game event for male and female players for receiving HC1s (24.6% and 20.0%, respectively). Defensively, HC1s occurred most frequently while guarding an attacker for male players (40.6%) and rebounding for female players (31.0%). The suspected concussion IR was not significantly different between male and female players (IRR, 2.00; 95% CI, 0.20-19.8). In total, 11.2% of HC1s to defenders and 25.7% of HC1s to offensive players were assessed as a foul.

Conclusion: Head contact rates were higher for male varsity basketball players compared with female players; however, suspected concussion rates did not differ. Game event and court locations differed by sex. A priority target for injury prevention is penalization of HCs because most HCs in competition went unpenalized.

Objective: Blood flow restriction (BFR) is a method used to affix a pneumatic cuff to the uppermost part of a leg. Blood flow restriction is often combined with low load-blood flow restriction training (LL-BFRt) to enhance strength and promote muscle hypertrophy. Therefore, this research aimed to examine the effect of LL-BFRt, sham LL-BFRt, and high load-resistance training (HL-Rt) on quadriceps strength (QS), dynamic stability, and functional performance.

Design: Single-blinded randomized trial method.

Setting: A private physical therapy clinic in Bali, Indonesia.

Participants: Data were collected from 63 basketball and rugby players assigned to 3 intervention groups, namely, LL-BFRt, sham LL-BFRt, and HL-Rt, through block randomization.

Independent variables: Each participant received intervention consisting of 45-minute sessions twice per week for 8 weeks.

Outcome measures: Quadriceps strength, star excursion balance test (SEBT), and single-leg hop test (SLHT) were evaluated in baseline, 4 weeks, and 8 weeks of the intervention period.

Results: In LL-BFRt and HL-Rt groups, QS, SEBT, and SLHT scores were significantly improved during 8-week intervention period, except in sham LL-BFRt group. Furthermore, there was a significant improvement in LL-BFRt (QS: 9.2-33.5 Newton; SEBT: 1.2-11.1 cm; SLHT: 1.3-9.8 cm, P-values < 0.05) and HL-Rt groups (QS: 15.4-35.9 Newton; SEBT: 2.2-9.0 cm; SLHT: 4.5-15.8 cm, P < 0.05) compared with sham LL-BFRt.

Conclusions: The improvements attained by participants using LL-BFRt and HL-Rt were comparable and capable of improving QS, SEBT, and SLHT more than sham LL-BFRt.

Trial registration: NCT05951036.

Objectives: Although various kinematic parameters have been investigated as factors associated with shoulder and elbow injuries during pitching, the relationship between lower extremity flexibility and such injuries remains unclear. The objective of this meta-analysis was to examine the association between pitching injuries to the shoulder and elbow and lower extremity flexibility.

Designs: A systematic review and meta-analysis.

Date sources: A comprehensive meta-analysis was conducted using data extracted from five databases (MEDLINE, Web of Science, CENTRAL, Scopus, and PEDro) following the method of Minds. The inclusion criteria were studies focusing on throwing injuries in the shoulder and elbow, specifically related to baseball, and the investigation of motion in the lower extremities. Owing to the presence of cross-sectional and cohort studies, meta-analyses were conducted for each study type.

Main results: Meta-analyses were performed using data from 11 reports. The results revealed a significant difference in lead-side hip internal rotation for both cross-sectional (P = 0.04) and cohort studies (P = 0.02), indicating a reduced range of motion (ROM) in athletes with shoulder and elbow injuries. In addition, a significant difference was observed in the hip internal rotation of the trail leg in the cross-sectional study (P = 0.04), similar to that of the lead leg. However, no significant differences were found in hip external rotation or straight leg raising (SLR) between players with and without shoulder or elbow injuries.

Conclusions: This meta-analysis highlights the common occurrence of limited internal hip rotation ROM in baseball players with shoulder or elbow injuries. However, these injuries were not found to be associated with hip external rotation or SLR.

Objective: The exertional compartment syndrome (ECS) is often a delayed diagnosis. Compartment pressure measurements (CPM) confirm the diagnosis. Herein we present our algorithm for the evaluation and management (E&M) of ECS. It avoids multiple CPM and shows the importance of the history and examination for E&M of the ECS.

Design: A literature review showed that limb abnormalities are hardly ever mentioned. Subsequently we show how the history, examination (for recognizing abnormalities), and CPM integrate with our algorithm for E&M of the ECS.

Setting: Our algorithm evolved for a 32-year interval and approximately 150 ECS evaluations.

Patients: Our E&M method was used for the above complement of patients.

Interventions: The symptomatic muscle compartment(s) and the severity of pain during the inciting activity are ascertained. The examination detects abnormalities and tautness of muscle compartments. This information integrated into our ECS algorithm establishes which compartments need CPM.

Main outcome measures: Pain severity is quantified on a 0- to 10-point scale. This information is integrated with history, examination findings, and CPMs to guide E&M for a range of ECS presentations.

Results: Abnormalities detected on the examination often explain why ECS occurs. This information is valued by the patient, minimizes CPM, and offers sound advice for E&M.

Conclusions: Our article heightens awareness of the ECS diagnosis for all levels of care providers. It objectifies pain severity, shows the importance of the examination, and minimizes ECM in giving advice to the referral sources.

Objective: The purpose of this systematic review is to evaluate the original peer-reviewed studies on athletes who developed myocarditis after coronavirus disease (COVID-19) infection or after COVID-19 mRNA vaccination. Both entities likely have an immunologic component. We discuss elite, professional, college, and adolescent athletes. The athletes are generally young and healthy, representing a distinctive population group that differs from the general population. This review includes diagnosis of myocarditis, incidence, complications, prognosis, and return-to-play guidance for sports medicine clinicians and coaches.

Data sources: We surveyed the PUBMED, Embase, and Web of Science databases for the relevant peer-reviewed articles in the English language published from the onset of the pandemic until April 2023. Included were original observational studies and case series. Excluded were individual case reports and a small series with incomplete data. The resulting search yielded 30 original articles.

Main results: Reported myocardial abnormalities in athletes were rare after COVID-19 infection and even less frequent after COVID-19 mRNA vaccination. True incidence, however, may be higher because of under-reporting and frequent asymptomatic presentation. Male gender was prevalent for both manifestations; postvaccination myocarditis occurrence was the highest after the second vaccine dose. Diagnostic and return-to-play algorithms were developed and should be adopted and followed.

Conclusions: The risk of myocarditis from COVID-19 infection and COVID-19 mRNA vaccination is very low. The long-term prognosis and evolution of the observed cardiac magnetic resonance abnormalities are currently unknown. Although inferences can be made from the published data, COVID-19 and postvaccine myocarditis in athletes may represent only a small fraction of the true incidence of those who have been affected worldwide and not evaluated.

Objective: This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

Design: Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

Setting: Sports medicine and orthopedics clinic.

Patients: 101 patients aged 12 to 18 years.

Independent variables: Age, race/ethnicity, sex, concussion or migraine history, neurodevelopmental or psychiatric diagnosis, King-Devick, Trails Making, Vestibular Ocular Motor Screening (VOMS), and Postconcussion Symptom Scale (PCSS).

Main outcome measures: Days since injury to evaluation, recovery days from evaluation, and total recovery days.

Results: There were no significant differences between groups for PCSS, average K-D scores, and Trails B-A. Vestibular Ocular Motor Screening change score was significantly different between groups such that the late group had less change in VOMS score compared with the early group (F = 3.81, P = 0.03). There were significant differences between groups in terms of days since injury to evaluation (F = 399.74, P < 0.001) and total recovery days (F = 19.06, <0.001). The middle (25.83 ± 34.95) and late group (30.42 ± 33.54) took approximately 1 week and 12 days longer to recover compared with the early group, respectively. Recovery days from evaluation were not significantly different between the 3 groups (F = 1.30; P = 0.28).

Conclusions: Protracted recovery patients evaluated in a specialty concussion clinic received medical clearance to complete the return-to-play process with an athletic trainer within 1 month from the initial visit. The findings are consistent with previous research suggesting that earlier concussion care can expedite recovery.

Objective: To report injury epidemiology in youth male academy-level athletes in the United States.

Design: An observational study on injury occurrences and playing time over the 2019 to 2020, 2020 to 2021, and 2021 to 2022 soccer seasons.

Setting: Data collected from a single midwestern soccer academy in the United States in partnership with a tertiary care level I pediatric heath institution.

Patients: All male youth athletes to have enrolled and participated in the developmental academy during any of the 3 studied seasons.

Interventions: None. This was an observational study.

Main outcome measures: Injury rate (incidence per 1000 playing hours), type, location, mechanism (noncontact vs contact), severity, and mode of play (match vs training) in which the injury was sustained.

Results: Overall rate of injury was 3.64 per 1000 h exposure. Injuries of moderate severity (8-28 days of missed playing time) were most common. When stratified by team, injury rates were highest in the U15 (5.15/1000 h) and lowest in the U12 (0.87/1000 h). Most injuries involved muscles of the lower extremities.

Conclusions: Among male youth academy-level soccer athletes in the United States, older players tended to sustain injuries at a higher rate than younger. The lower extremity was the most common injury location, and muscle injuries and most common type. Concussions remain common in this population, accounting for nearly a 10th of all athletic injuries.

Clinical relevance: Injury epidemiology data from this study add to the growing worldwide pool of data from youth, male, academy-level soccer athletes that will augment development of injury prevention interventions.