Clinical Journal of Sport Medicine最新文献

Objective: To describe a novel, minimally invasive, ultrasound-guided technique for excision of ununited ossicles in patients with chronic Osgood-Schlatter disease (OSD) and Sinding-Larsen-Johansson syndrome (SLJS) who failed conservative management.

Design: Retrospective case series.

Setting: Ambulatory surgical center.

Patients: Five skeletally mature patients (ages 16-44 years), including competitive athletes and adults with chronic anterior knee pain due to OSD (n = 3) or SLJS (n = 2), all of whom remained symptomatic despite standard conservative treatments.

Main independent variable: Ultrasound-guided resection of intratendinous ossicles using a TX-bone device under local anesthesia, followed by a structured rehabilitation protocol.

Main outcome measures: Pain relief, ability to return to sport or prior activity, and functional recovery at 2 to 12 weeks postprocedure.

Results: All 5 patients successfully underwent ultrasound-guided ossicle excision without perioperative complications. Each reported meaningful pain reduction and returned to unrestricted activities within 2 to 12 weeks. Follow-up ranged from 6 to 14 months, with sustained symptom relief and return to prior sport participation. Outcomes compared favorably with open and arthroscopic techniques described in the literature.

Conclusions: This case series is the first to describe an ultrasound-guided technique for excision of chronic, symptomatic OSD and SLJS ossicles. The approach demonstrated rapid recovery, excellent pain relief, and favorable functional outcomes. Further prospective studies with larger cohorts are warranted to validate efficacy and long-term safety.

Objectives: To describe the incidence, characteristics, and assessment of head collision events in the 2022 world cup, and to compare these findings with published data from prior world cups.

Setting: Video footage of the 2022 world cup.

Participants: 2022 world cup participants.

Interventions: Four reviewers identified head collision events through review of video footage of the 2022 world cup.

Main outcome measures: The length of each assessment, duration of player removal from game, and duration of game stoppage were recorded. These findings were compared with previous work on the 2018 world cup that evaluated these same variables.

Results: Intotal, 147 head collision events were identified (2.30 per game). There were 123 players that had 2 or more signs of a concussion, of which 105 (85.4%) were evaluated and 35 (28.5%) were evaluated by medical personnel. There were 4 players who were removed from the game for suspected head injury. When the data from the 2018 world cup were compared with those from the 2022 world cup, duration of time stopped for evaluation was the only variable that was significantly different.

Conclusions: The results of this study suggest that progress has been made to properly evaluate and recognize concussions; however, further attention is clearly still required to ensure the health and safety of international soccer players.

Objective: This study aimed to assess the experience of orofacial injuries and sports mouthguard use in German elite athletes.

Design: A questionnaire-based cross-sectional study was conducted.

Setting: The data were collected at the Institute of Applied Training Science (IAT, Leipzig, Germany) that provides regular primary care for elite athletes.

Participants: German elite athletes (18-35 years) from different disciplines with completed questionnaire on oral health in sports between May 2020 and April 2021 were included.

Interventions: N/A.

Main outcome measures: Number of dental, oral, and facial injuries during sports career and mouthguard use (received information, ownership, frequency) were assessed and compared between disciplines with different risks for orofacial trauma.

Results: In total, questionnaires of 337 athletes (23 ± 4 years, 50% female) were included. Disciplines were classified into high (HT, n = 20), medium (MT, n = 48), and low (LT, n = 269) risk for orofacial trauma. Substantial rates of injuries were identified; especially a lot of HT athletes reported orofacial injuries (HT: 55%, MT: 31%, LT: 17%; P ≤ 0.076) and dental injuries (HT: 30%, MT: 10%, LT: 7%; P ≤ 0.028). Mouthguards were rare (HT: 25%, MT: 0%, LT: 3%).

Conclusions: There is a need for more prevention of orofacial injuries in German elite sports for both HT and MT.

Objective: Plyometric training (PT) uses the stretch-shortening cycle to enhance force production, commonly used in athletic training and increasingly explored in musculoskeletal (MSK) rehabilitation. However, consensus on its efficacy in MSK rehabilitation remains elusive. The aim of this scoping review is to synthesize current evidence and identify research gaps.

Data sources: A systematic search was conducted until July 2023 using the Population-Concept-Context model through EMBASE, Medline (PubMed), Cochrane Central, CINHAL, Scopus, PEDro, and SportDiscus. A 5-step scoping review model was used, including defining the research question, identifying and selecting relevant studies, data synthesis, and reporting. Two authors independently screened titles and full texts. Data extraction categorized studies for analysis. The Preferred Reporting Items for Systematic Reviews guidelines ensured methodological transparency.

Main results: The search yielded 25 relevant studies out of 4069 potentially eligible ones, including 16 primary studies, 5 reviews, and 4 clinical commentaries. Positive outcomes were noted in primary studies addressing lower and upper extremity MSK issues through supervised interventions. Reviews highlighted PT's efficacy in conditions such as shoulder multidirectional instability, anterior cruciate ligament (ACL) reconstruction, and ankle sprains. However, 1 study reported no significant benefits from PT in ACL injury rehabilitation.

Conclusions: This review indicates potential benefits of PT in MSK disorder rehabilitation, while highlighting the need for methodologically rigorous primary research.

Objective: This study aimed to translate, culturally adapt, and validate the latest Sport Concussion Assessment Tool 6 (SCAT6) into simplified Chinese.

Design: This study adopted a mixed design with both qualitative and quantitative methods. The quantitative part of the study adopted a repeated measures design.

Setting: The translation and revision process were completed through online communications. The validation process was performed in person at the athletes' normal training facilities.

Participants: Thirty-two healthcare professionals and twenty-one athletes were invited into the expert panel and end-user panel for the qualitative part of the study. Thirty-nine elite or collegiate athletes were included in the quantitative part of the study.

Independent variables: No independent variables were assumed in the translation and the expert appraisal processes. Administrators were the independent variables for the inter-rater study and the testing sessions for the test-retest study.

Main outcome measures: Expert opinions were collected during the translation and appraisal process. Testing scores and time of completion were obtained from test-retest study and inter-rater examinations.

Results: Revision and alterations of the Chinese SCAT6 and supplementary materials were made according to the reviews from experts and end users. The internal consistency and the inter-rater reliability of the simplified Chinese SCAT6 for all subscales were excellent [intraclass correlation (ICC) ranged from 0.83 to 0.999], the test-retest reliability for all subscales were moderate to excellent (ICC ranged from 0.51 to 0.92). The average time to complete was 20.2 ± 3.5 minutes.

Conclusion: The simplified Chinese SCAT6 is a valid sport concussion assessment instrument for mainland China end users.

Objective: This study aimed to explore associations and trends for athletes experiencing exercise-associated muscle cramps (EAMC) in ultraendurance competitions.

Design: Retrospective analysis of prospectively collected data.

Setting: Medical tent data were collected from annual IRONMAN World Championship events.

Participants: In total, 10 533 medical records were reviewed among 49 530 race participants from 1989 to 2019.

Assessment of risk factors: Athlete demographics data, performance data, and additional medical conditions were examined.

Main outcome measures: Primary outcome of interest was to compare triathletes with and without EAMC. Secondary outcome was to analyze triathletes with subsequent EAMC.

Results: EAMC (N = 2863) occurred in 57.8 per 1000 participants (95% confidence interval = 55.7 to 60.0). The incidence of EAMC did not differ between athlete sex. Athletes with EAMC had greater weight loss but did not differ in serum sodium and serum potassium compared with those without EAMC. Further analysis with a logistic regression analysis revealed that dehydration, exhaustion, hypotension, abdominal pain, headaches, and a previous evaluation for cramping were strongly associated with muscle cramping. The most common treatment for EAMC was intravenous fluids.

Conclusions: Findings from the current study support previous reports that electrolyte abnormalities are not associated with cramping. However, our finding that dehydration is associated with muscle cramping contradicts current literature.

Objective: To investigate the epidemiology of sport-related concussion in collegiate water polo players and compare the risk of concussion between goalkeepers and field players.

Design: Retrospective chart review using injury surveillance data from July 2016 and June 2022. Descriptive statistics, χ 2 and Fisher exact tests, and pairwise comparisons using false discovery rate-adjusted P -values were used for statistical analysis.

Setting: Pac-12 conference collegiate water polo teams.

Participants: Ninety-six Pac-12 athletes from 4 men's and 5 women's water polo teams, with a total of 124 identified concussions.

Independent variable: Player position (goalkeeper vs field player) and location of injury (practice vs competition vs not sport related).

Main outcome measures: Prevalence of sport-related concussion by player position and location of injury.

Results: Goalkeepers experienced a significantly higher proportion of sport-related concussions than field players (26.2% vs 16.0%, P = 0.005). Most concussions in goalkeepers occurred from ball-to-head contact while most field player concussions were because of contact with another player. There was no significant difference in the number of concussions suffered in practice compared with competition.

Conclusions: Collegiate water polo goalkeepers face a higher risk of concussion than field players, particularly from ball-to-head contact. Current safety protocols may be inadequate for goalkeepers. Future research should examine the effectiveness of protective headgear and modified practice equipment in mitigating concussion risk, potentially leading to rule changes.

Spontaneous spinal epidural hematoma (SSEH) is a nontraumatic condition that potentially compresses the spinal cord by accumulating blood in the epidural space. We report a case of multilevel SSEH in a 27-year-old male recreational weight lifter, presenting with acute lower back pain and bilateral leg weakness after deadlifts. Initial magnetic resonance imaging (MRI) showed subacute epidural hematomas with distinct signal intensities. The hematomas spanned multiple thoracic and lumbar levels without any predisposing medical conditions. Conservative management, including strict bed rest and pain management, led to marked improvement, with follow-up MRI indicating reduced hematoma size and expanded dural sac dimension. This case highlights the rare possibility of long-extending SSEH from weight lifting in individuals without risk factors and underscores the effectiveness of conservative treatment for multilevel spinal epidural hematomas.

Objective: The objective of the present study was to describe eye illness among athletes with disability.

Design: Prospective cohort study.

Setting: Sochi 2014 and Pyeongchang 2018 Paralympic Winter Games.

Participants: Five hundred forty-seven athletes over 12 days (6564 athlete days) at Sochi 2014 and 567 athletes over 12 days (6804 athlete days) at Pyeongchang 2018 Paralympic Winter Games.

Interventions: All athletes with eye illnesses presented themselves to the team physicians via the WEB-IISS and/or polyclinic staff via the local polyclinic services (ATOS system).

Main outcome measures: Incidence of eye illnesses per 1000 athlete days. Descriptive statistics, including the number and proportion of illnesses, broken down by sport, age, sex, type of impairment, medical diagnosis, medical decision, and anticipated time loss (in days).

Results: Seventy five percent of eye illnesses were reported in male Para athletes. Athletes participating in Ice hockey (61%) accounted for two-thirds of all eye illnesses across all sports reported during the 2 Winter Games. Most eye illnesses were reported in athletes with limb deficiency (66%), visual impairment (21%), and spinal cord injury (10%). Environmental eye illnesses (24%), allergic conjunctivitis (21%), corneal erosion (7%), and infective conjunctivitis (7%) were the most frequently reported diagnoses.

Conclusion: Eye illnesses are prevalent in the Paralympic Winter Games across athletes of various ages and genders, with a higher incidence observed among male Para athletes. Ice hockey was highlighted as the sport with the highest reported cases of eye illnesses, with conditions affecting various anatomical areas of the eye.

Graded exertion testing has diagnostic utility in the management of athletes with sport-related and recreation-related concussions, the results of which are used to prescribe individualized aerobic exercise treatment that facilitates recovery from sport-related concussion and reduces the incidence of symptoms persisting beyond 1 month. Current exertion protocols, such as the Buffalo Concussion Treadmill Test, however, are recommended for patients aged 13 years and older and are not appropriate for younger children with concussion. This practical management article describes a pediatric exertion test protocol using a standard, commercially available treadmill that is designed for patients aged 5 to 12 years with concussion. The Pediatric Concussion Treadmill Test (PCTT) uses age-appropriate walking speeds and symptom-reporting scales and provides additional guidelines on how to perform the test safely in younger children. The PCTT is intended to identify the presence and severity of concussion-related exercise intolerance and can function as an important component of a comprehensive medical evaluation of concussion in children.