Clinical Journal of Sport Medicine最新文献

Objective: The main objective of this study was to investigate the risk of eating disorders, exercise addiction, depression, and low energy availability (LEA) in Danish female and male elite compared with sub-elite athletes.

Design: A cross-sectional study.

Setting: An online survey.

Participants: A total of 410 elite athletes (mean age 20.1 years, 51% females) and 206 sub-elite athletes (mean age 21.3 years, 52% females) from 15 different sports.Assessment of Risk Factors: Eating Disorders, exercise addiction, depression, and LEA.

Main outcome measures: The Sick Control, One Stone (6.5 kg), Fat, Food, the Eating Disorder Examination-Questionnaire, the Exercise Addiction Inventory, the Major Depression Inventory, and the Low Energy Availability in Females Questionnaire or the Low Energy Availability in Males Questionnaire.

Results: We found that more female sub-elite athletes compared with elite athletes had risk of eating disorders (EDs) (37.4% vs 23.4%; P < 0.012) and the same was found for males (23.2% vs 10.4%; P = 0.005). More athletes with risk of EDs had risk of exercise addiction (12.8 vs 5.4%, P = 0.006), depression (27.3 vs 4.2%, P < 0.001), and LEA (females 55.1 vs 40.7%, P = 0.024, and males 29.4 vs 13.7%, P = 0.036, respectively) compared with athletes without risk of EDs.

Conclusions: Sub-elite athletes have a higher risk of eating disorders compared with elite athletes. Regular screening of ED symptoms and associated conditions in elite and especially sub-elite athletes may ensure early identification.

Objective: There is greater risk of musculoskeletal (MSK) injury after clinical recovery from sport-related concussion (SRC). We determined whether aerobic exercise treatment within 10 days of SRC reduced the proportion of MSK injury in recovered adolescent athletes at 4 months since injury.

Design: Planned secondary analysis of a randomized trial of aerobic exercise versus stretching exercise in adolescents after SRC.

Setting: Outpatient and hospital-based sports medicine centers.

Participants: Aerobic exercise (n = 38, 58% male, 15.6 years) and stretching exercise (n = 25, 64% male, 15.9 years) participants completed a questionnaire at 3.5 and 3.3 months since recovery, respectively.

Interventions: Individualized subthreshold aerobic exercise versus placebo-like stretching.

Main outcome measures: Proportion of MSK injury, subsequent concussion, and return to exercise training, school, and sport determined 3 months after clinical recovery from SRC.

Results: Overall, 24% of participants randomized to stretching experienced an MSK injury versus 5.3% of participants randomized to aerobic exercise. There was no difference in time to return to school, sport, or incidence of subsequent concussion. Stretching participants were 6.4 times (95% confidence interval 1.135-36.053) more likely to sustain MSK injury than aerobic exercise participants when controlling for the duration of exposure to sport and return to preinjury sport participation. All injuries were in male participants.

Conclusion: Adolescent male athletes prescribed aerobic exercise within 10 days of SRC had a significantly lower proportion of individuals injured in the 3 months following clinical recovery when compared with stretching. This may be due to a habituation/rehabilitation effect of aerobic activities to improve autonomic, vestibular, and/or oculomotor function after SRC.

Objective: To identify the effects of chronic pain levels on static and dynamic postural (DP) control in individuals with chronic ankle instability (CAI).

Design: Cross-sectional study.

Setting: Controlled laboratory.

Participants: Sixty participants were divided into the following 3 groups: 20 high pain individuals with CAI (high pain), 20 low pain individuals with CAI (low pain), and 20 healthy controls (control).

Independent variables: Groups (CAI with high pain, CAI with low pain, and control) and visual conditions (eyes open and closed) for single-leg stance.

Main outcome measures: Participants performed single-leg stance with eyes open and closed, the star excursion balance test, and single-leg hop to stabilization.

Results: The high pain group experienced worse self-reported outcomes, including Foot and Ankle Ability Measure activities of daily living and sports, than the low pain and control groups. Regardless of visual condition, both the high and low pain groups exhibited decreased static postural control in mediolateral (ML) compared with the control group. Specifically, the high pain group showed decreased static postural control in ML under closed eyes compared with the low pain and the control groups. The high pain group showed less reach distance than the control group and increased DP control in vertical and overall DP stability index compared with the low and control groups.

Conclusions: Chronic pain can significantly affect both static and DP control in individuals with CAI. Therefore, clinicians should consider chronic pain as one of the factors affecting postural control in individuals with CAI.

Objective: To evaluate the association between vitamin D status and CV disease after COVID-19 in college athletes.

Design: Retrospective cohort study.

Setting: National College Athletic Association Division-I college athletes from a single academic institution.

Patients: A total of 157 athletes (60 female; median age: 20 years) from 9 sports with a positive SARS-CoV-2 test, cardiac magnetic resonance imaging (CMR), and vitamin D level.

Independent variables: Serum 25-hydroxyvitamin D level (primary); age, sex (regression models).

Main outcomes measures: Differences in age, sex, race, ethnicity, myocarditis, pericarditis, and CMR metrics by vitamin D status were analyzed. Regression models were used to assess the relationship between vitamin D status and CMR metrics accounting for age and sex.

Results: Low vitamin D (LVD) was found in 33 (21.0%) of athletes, particularly Black males ( P < 0.001). Athletes with LVD had higher biventricular and lower mid-ventricular extracellular volumes, but these differences were not significant when corrected for age and sex. Athletes with LVD had higher left ventricle (LV) mass ( P < 0.001) and LV mass index ( P = 0.001) independent of age and sex. Differences in global circumferential strain were noted but are likely clinically insignificant. Vitamin D status did not associate with myocarditis and pericarditis ( P = 0.544).

Conclusions: LVD is common in athletes, particularly in Black males. Although athletes with LVD had higher LV mass, cardiac function and tissue characterization did not differ by vitamin D status. Future studies are needed to determine if the differences in LV mass and LV mass index by vitamin D status are clinically significant. This study suggests that vitamin D status does not impact the development of myocarditis or pericarditis after COVID-19 infection.

Objective: To investigate clinical outcomes and return to sport timeline for athletes with acetabular dysplasia after endoscopic shelf acetabuloplasty (ESA).

Design: A retrospective review.

Setting: Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan between 2012 and 2019.

Patients: Fifteen elite athletes (median age: 20 years) of 253 patients undergoing ESA, arthroscopic labral repair/reconstruction, cam osteochondroplasty, and capsular plication. The mean follow-up period was 27.8 months after surgery.

Main outcome measures: Patient-reported outcome scales (PROSs), including the modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool 12, Hip Outcome Score-Sports, and Vail Hip Score.

Results: After ESA, all 15 elite athletes were able to return to sport effectively and compete at a preoperative level. The mean time between the operation and the first practice was 6.5 months, while the mean time between the ESA procedure and the first game was 9.6 months. Approximately 27.8 months after surgery, PROS outcomes improved significantly with no hips requiring emergency revision surgery at the final follow-up. At a mean of 47.1 months after surgery, 7 athletes decided to retire from their sport. Up to 71.1 months after surgery, the additional 8 patients continued to compete in their sport at an elite level.

Conclusions: ESA enables elite athletes with acetabular dysplasia to return to competition at a mean of 9.6 months postsurgery. The ESA procedure is an effective and promising method of treating elite athletes with acetabular dysplasia.

Level of evidence: IV.

Objective: This study explores the functional recovery and rates return to play (RTP) of professional jockeys following midshaft clavicle fractures, which have been managed conservatively. The high incidence of these fractures in horse racing underscores the importance of evaluating nonsurgical recovery paths for effective RTP.

Design: We used a retrospective cohort study to assess treatment outcomes.

Setting: The research is set in the professional horse racing scene of Ireland.

Participants: Sixteen professional Irish jockeys with conservatively managed midshaft clavicular fractures were examined. Jockeys who underwent surgery or were inactive at injury time were excluded.

Interventions: The study involved no direct interventions.

Main outcome measures: Recovery was assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score and Patient-Reported Outcome Measures, alongside racing records to track RTP.

Results: The all-male cohort had an average age of 27 years. Results showed an average 67.1-day absence from racing, with 94% returning to preinjury competition levels. Complications were minimal, and patient outcomes were positive, as indicated by a mean QuickDASH score of 2.58, suggesting minimal residual disability.

Conclusions: Findings highlight the success of conservative management for midshaft clavicle fractures in professional jockeys, enabling them to return to prior competitive levels with few complications and excellent functional recovery.

Objective: To compare physical contacts (PCs), including head contacts (HCs), suspected concussion, and nonconcussion injury incidence rates between youth ringette and female ice hockey.

Design: Cross-sectional.

Setting: Alberta ice arenas.

Participants: Players participating in 8 U16AA (ages 14-15 years) ringette and 8 U15AA (ages 13-14 years) female ice hockey games during the 2021 to 2022 season.

Assessment of risk factors: Dartfish video-analysis software was used to analyze video recordings.

Main outcome measures: Univariate Poisson regression analyses (adjusted for cluster by team-game, offset by game minutes) were used to estimate PCs (including HCs) and suspected injury (concussion and nonconcussion) and concussion-specific IRs and incidence rate ratios (IRRs) to compare sports. Proportions of all PCs that were body checks (level 4-5 trunk PC) and direct HCs (HC1) penalized were reported.

Results: Ringette had a 2.6-fold higher rate of body checking compared with hockey (IRR = 2.63, 95% CI: 1.59-4.37). Ringette also had a 2-fold higher rate of HC1 compared with hockey (IRR = 2.08, 95% CI: 1.37-3.16). A 3.4-fold higher rate of suspected injury was found in ringette (IRR = 3.37, 95% CI: 1.40-8.15). There was no significant difference in suspected concussion IRs in ringette compared with hockey (IRR = 1.93, 95% CI: 0.43-8.74). Despite being prohibited in both sports, only a small proportion of body checks (Ringette = 18%; Hockey = 17%) and HC1 (Ringette = 6%; Hockey = 6%) were penalized.

Conclusions: Higher rates of body checking, HC1, and suspected injuries were found in ringette compared with female ice hockey. Body checking and HC1 were rarely penalized, despite rules disallowing them in both sports. Future research should consider other youth age groups.

Objective: The objective of this descriptive study was to evaluate spondylolysis in adolescent athletes, including age at time of injury, sport associated with injury, examination findings, site of injury, studies used for diagnosis, treatments, duration of treatment, and outcomes.

Design: This was a retrospective chart review of patients who presented with a diagnosis of spondylolysis over a 17-year period.

Setting: Community primary care sports medicine practice.

Patients: All patients between 10 and 20 years of age diagnosed with spondylolysis.

Interventions: There was no set intervention protocol. A variety of interventions and combination of interventions were used and determined by the treating physician on a case-by-case basis.

Main outcome measures: Clearance for return to sport activity.

Results: Males comprised 317 of the 533 patients. Soccer, gymnastics/cheer, football, and basketball were the most common sports associated with spondylolysis. Bilateral injuries were most common. L5 was the most common level for injury. Bracing and formal physical therapy as treatments were associated with longer duration of care. Most patients were treated successfully with nonoperative treatment. Recurrence of injury was rare.

Conclusions: Spondylolysis is a common cause of back pain in adolescent athletes. Males are more likely to experience these injuries and are older at presentation compared than females. Spondylosis may be encountered in many sports. Nonoperative treatment leads to successful outcomes in most patients.

Level of evidence: Level IV.