Physician and Sportsmedicine最新文献

Purpose: Exercise-induced cardiac adaptations in female athletes with extreme anthropometry remains poorly defined. The aim of this study is to analyz cardiovascular and hematological features of female athletes with extreme anthropometric indices.

Methods: Olympic female athletes underwent medical evaluation including CPET and echocardiography. According to BMI and height athletes were divided in Group A (height > 186.1 cm & BMI < 27.7 kg/m²), Group B (height ≤ 186.1 cm & BMI > 27.7 kg/m²) and Group C (height 164-175 cm and BMI between 20.4 kg/m² & 23.5 kg/m²).

Results: 1137 athletes were enrolled (mean age 25.2 ± 5 years old, mean height 169.9 ± 8.1 cm, mean BMI 22.1 ± 2.8 kg/m²). Athletes with extreme anthropometry showed same functional parameters (p = 0.071) although different relative VO2max (VO2 max 39.8 ± 6.1 mL/min/Kg in group C, 33.5 ± 5.5 mL/min/Kg in group B and 29.2 ± 7.4 mL/min/kg in group A, p < 0.0001), larger LV (LVEDD 52.7 ± 3.2 mm in A, 50.9 ± 3.2 mm in B and 49.4 ± 3 mm in control group, p < 0.0001) and, particularly in Group B, thicker IVS and PWT (p < 0.0001). Athletes with higher BMI showed a global higher CV risk profile.

Conclusion: Athletes with extreme anthropometry exhibit, especially those with a high BMI, worse cardiovascular risk although same cardiorespiratory function. Athletes with high BMI exhibit increased LV thickness while athletes with high height showed increase LV dimensions. Indexing for weight, should not be used in extreme anthropometry.

Background: Immobilization after primary anterior shoulder dislocation is a common strategy aimed at promoting capsulolabral healing and reducing recurrence risk. While internal rotation (IR) using a standard sling remains the conventional approach, external rotation (ER) braces have been introduced based on biomechanical studies suggesting improved labral coaptation. However, ER bracing has been associated with concerns regarding patient comfort and compliance. Several randomized controlled trials (RCTs) have reported inconsistent clinical outcomes. This meta-analysis aimed to compare functional and stability-related outcomes between ER and IR immobilization to evaluate whether ER offers a meaningful advantage.

Methods: A systematic search was performed across PubMed, Scopus, Embase, and Google Scholar through 8 December 2025. Eligible studies included RCTs and comparative cohort studies examining ER versus IR immobilization following a first-time anterior shoulder dislocation. Seventeen studies met inclusion criteria, including a total of 1170 patients with first-time shoulder dislocation. Outcomes included the Western Ontario Shoulder Instability Index (WOSI), dislocation recurrence rate, Constant-Murley Score, return-to-sport rate, and shoulder apprehension. Each outcome was analyzed using the subset of studies reporting that outcome.

Results: IR immobilization showed a statistically significant difference in WOSI scores (mean difference -2; 95% CI - 3 to -1; p = 0.002) that was clinically insignificant, as it fell below established importance thresholds. No significant differences were found between IR and ER groups in recurrence rate (p = 0.41), Constant score (p = 0.15), return-to-sport rate (p = 0.12), or shoulder apprehension (p = 0.22).

Conclusion: IR and ER immobilization result in comparable functional and stability outcomes following primary anterior shoulder dislocation. Given similar recurrence and return-to-sport outcomes and no clinically meaningful difference in WOSI, routine use of ER bracing may not be warranted.

Objectives: Pediatric sports injuries are common, yet there is limited information on the comparative risk of hospitalization across commonly played sports in the United States. We sought to identify youth sports associated with the highest incidence of hospital admission. Additionally, we sought to analyze temporal trends over the past decade and identify risk factors for admission.

Methods: The National Electronic Injury Surveillance System was queried for injuries during 18 sports in patients ages 3-18 from 2014 to 2023. Injury patterns and admission rates were calculated from national estimates. Temporal change in admission rate was assessed using linear regression. Logistic regression models were used to assess age, sex, race, day of week, and sport type as risk factors for hospitalization.

Results: An estimated 186,695 admissions occurred during the study period, with an overall admission rate of 1.9%. The sports with the highest number of admissions per year were football (5,857, 31.4% of all admissions), basketball (3,563, 19.1%), and soccer (2,541, 13.6%). Gymnastics had the highest admission rate (3.2%), with 70% of admissions due to upper extremity fractures. Risk factors for hospitalization included male sex (OR 1.64, p < 0.001) and weekend participation (OR 1.10, p < 0.001). Hospitalization rate increased 0.08% per year (p = 0.001).

Conclusion: Football, basketball, and soccer contribute the majority of sports-related hospitalizations, consistent with known rates of participation and injury risk. Gymnastics has the highest admission rate among those presenting to the emergency department, commonly from upper extremity fractures. Males and those injured on the weekend are at increased risk for hospitalization. These findings should inform preventative efforts to reduce the risk of significant injury leading to hospitalization in young athletes.

Objectives: Growth-related knee pain is common among young athletes; however, risk factors may differ from those in adults. Understanding modifiable contributors is critical for injury prevention and healthy physical development. This study aimed to identify clinical and training-related factors associated with growth-related knee pain in young male Japanese basketball players.

Methods: A total of 600 parents of young male basketball players aged 9-15 years (100 per grade, 4th-9th grades) completed a web-based parental questionnaire. Data collected included age, anthropometrics, leg dominance, playing position, training surface, weekly training volume, and sport specialization. Parents reported whether their child experienced knee pain within the past 12 months and the suspected cause (growth-related pain, contusion, fracture, sprain, or other). Univariate analyses (independent t-tests and chi-square tests) compared players with and without growth-related knee pain. Multivariate logistic regression identified independent risk factors, reported as odds ratios (OR) with 95% confidence intervals (CI).

Results: Growth-related knee pain was reported by 20.6% of participants. Univariate analyses showed that it was significantly associated with older age, larger body size, increased weekly training volume, and high sport specialization, but not with body mass index, leg dominance, playing position, or playing surface. In the multivariate model, increased height (OR =1.04, 95% CI: 1.01-1.08) and high sport specialization (OR =1.77, 95% CI: 1.13-2.77) remained independent predictors.

Conclusions: Taller athletes and those with high sport specialization are at an increased risk of growth-related knee pain. Growth monitoring, regulation of training volume, and promoting multisport participation may help reduce injury risk.

Background: Horse riding is a common sport, but no study specifically addresses joint dislocations. The purpose of this study is to describe joint dislocations due to equines using a national emergency department (ED) database. Such data can be helpful in injury prevention strategies.

Methods: The National Electronic Injury Surveillance System (NEISS) database for the years 2000-2023 was used. The NEISS database is a statistically representative sample of injuries seen in EDs across the US giving national estimates. Mechanism of injury was tabulated into groups: 1) did the patient fall from the horse 2) was the patient bucked, thrown, or kicked off of the horse, 3) was there equipment (tack) malfunction, 4) was the patient stepped on by the horse, 5) was the patient struck by/against an object, 6) was the patient kicked by the, 7) and others.

Results: There were 625 dislocations which involved the shoulder (289, 46.2%), elbow (95, 15.2%), finger (85, 13.6%), acromioclavicular joint (48, 7.7%), patellofemoral joint (39, 4.8%), hip (22, 3.5%), pubic symphysis (16, 2.6%), and ankle (7, 1.1%). The average age was 41 years; 49.7% were male and 50.3% female. Mechanisms of injury were falling from the horse (54.1%), bucked/thrown off (27.7%), equipment malfunction (7.3%), stepped on by the horse (2.1%), struck by/against an object (1.9%), kicked (0.6%), and others (4.0%). Those with elbow dislocations were the youngest (average 32 years) and pubic symphysis the oldest (average 52 years) (p < 10^-4). Females had the highest percentage of patellofemoral dislocations (70.2%) and males the highest percentage of pubic symphysis dislocations (92.9%) (p = 0.0018).

Conclusion: Although joint dislocations due to equestrian activity are uncommon, the majority occurred in the upper extremity. Male/female involvement is equal, different than the typical female predominance in equestrian activity and overall equestrian related injuries.

Objective: Platelet-rich plasma (PRP) has been increasingly used for chronic midportion Achilles tendinopathy, yet its true clinical value remains controversial, this study aimed to evaluate the efficacy of PRP as both a conservative intervention and an adjunct to surgical treatment for chronic midportion Achilles tendinopathy, with a focus on its impact on patient outcomes.

Literature survey: In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, two independent reviewers conducted a literature search and compared the therapeutic effects of PRP injection versus control groups in the treatment of chronic midportion Achilles tendinopathy and as an adjunct to surgical treatment.

Methodology: The primary outcomes were assessed using Victorian Institute of Sports Assessment-Achilles (VISA-A) score and Visual Analog Scale (VAS) for pain. Statistical analysis was conducted using Review Manager 5.3, and p < 0.05 was considered statistically significant.

Synthesis: A total of 8 studies involving 507 patients were included. Results indicated that the PRP group exhibited superior short-term VISA-A scores compared to the control group [MD = 2.78, 95% CI (1.29, 4.28), p = 0.0003]. However, no significant differences were observed at other follow-up time points. Although the PRP group demonstrated overall lower VAS scores [SMD = 0.76, 95% CI (0.26, 1.26), p = 0.003], subgroup analyses revealed no significant differences between the groups at any time point (p > 0.05). Additionally, no significant improvement in tendon thickness in the PRP group compared to the control group (p > 0.05). Furthermore, two studies reported on postoperative pain, functional, and satisfaction scores between PRP adjunctive treatment and control groups, with no significant differences observed between the groups at any time point (p > 0.05).

Conclusion: Current evidence demonstrates that PRP provides only short-term functional improvement in chronic midportion Achilles tendinopathy, with no significant long-term or structural benefits and no additional advantage as a surgical adjunct. PRP should not be considered routine treatment; clinicians should prioritize evidence-based rehabilitation while counseling patients regarding its limited, transient effects. Future research must focus on establishing standardized PRP protocols, conducting large multicenter trials, and investigating optimized formulations and combination therapies to potentially enhance outcomes.

Purpose: The aim of this study is to evaluate differences in treatment of musculoskeletal injuries based on primary care sports medicine physician characteristics.

Methods: Retrospective review of treatment provided at a walk-in orthopedic clinic was extracted by chart review. Treatment patterns were compared by chi-square test including primary specialty (Emergency Medicine (EM), Family Medicine (FM), Orthopedics (OR) and Physical Medicine and Rehabilitation (PMR), and Internal Medicine (IM) and Pediatrics (Peds)), gender, and years of experience. Additionally, associations between physician characteristics and treatment recommendations were evaluated using multivariate logistic regression. Treatment options evaluated were advanced imaging, medications (including pain medication, oral steroids, muscle relaxers, etc.), steroid injections, physical therapies, durable medical equipment (DME), activity restrictions, and surgery or follow-up.

Results: A total of 461 patient encounters were included. The frequency of medication recommendations among providers varied significantly with physician gender, primary specialty, and experience. Medication utilization was highest among male physicians and OR/PMR physicians. Physicians with more than 10 years of experience prescribed less medication compared to physicians with 0-5 years of experience. Physicians with greater than 10 years of experience recommended physical therapy more often than physicians with less experience.

Conclusions: Data suggests there are differences in documented treatment recommendations based on the residency completed prior to sports medicine fellowship, physician gender, and experience. Increased diversity within Sports Medicine fellowship classes, such as including both males and females as well as FM trained physicians and EM trained physicians, can bring additional perspectives and experience to patient care.

Background: Branched-chain amino acids (BCAAs) are widely used in endurance sports, yet their impact on performance remains unclear. This review evaluated whether biochemical changes from BCAA or leucine supplementation translate into functional benefits.

Methods: A systematic review was conducted in accordance with PRISMA 2020, the Cochrane Handbook for Systematic Reviews of Interventions, and the GRADE approach. Searches were performed in PubMed, Embase, and Web of Science up to 11 July 2024. Eligible studies included endurance runners or athletes, used BCAA or leucine supplementation, and reported outcomes related to performance, recovery, or adverse effects.

Results: From 152 records, 15 studies met inclusion criteria. No consistent improvement was observed in performance, fatigue, or recovery. Only two studies reported significant differences. One trial found a 42% reduction in muscle soreness (p < 0.05), though with inadequate control for protein intake and confounders. Biochemical changes included: increase 140% valine (p < 0.01), low plasma glucose (p < 0.01), increase free fatty acids (p < 0.001), and raise 25% protein synthesis post-exercise (95% CI: 20-30%, p = 0.01). Mental performance improved after 12 km and 30 km runs (p < 0.05), but no functional performance gains were consistently observed.

Conclusion: BCAA and leucine supplementation do not result in meaningful improvements in endurance performance or muscle recovery. Despite biochemical alterations, current evidence - limited by low methodological quality, surrogate outcomes, and risk of bias - does not support the use of BCAA as an effective strategy for endurance athletes.

Objective: Soccer is one of the sports with the highest number of injuries in both sexes with a prevalence of 13% around the ankle-foot area. Various strategies have been proposed to prevent injuries like FIFA 11+ warm-up. Its reliability has been questioned due to the diversity of results obtained depending on the movement pattern studied and the body region analyzed. Few studies have analyzed its acute effects on distal structures, such as plantar soft tissue properties, local perfusion or temperature. The objective of this study was to determine the acute effects of performing the FIFA 11+ on mechanical and physiological properties in ankle-foot regions.

Method: The sample included 120 amateur men and women soccer players. Various mechanical properties of the muscle and tendon such as oxygen saturation in the muscle, skin temperature, range of motion of the ankle and maximum isometric force of the toes were analyzed, before and after performing the FIFA 11 +. Results: indicate the absence of significant differences in any of the variables analyzed, except for the mechanical response of the plantar fascia (p < 0.0014).

Conclusion: FIFA 11+ may not provide a sufficiently strong local stimulus to generate mechanical and metabolic responses in the different structures of the foot and ankle, even though it remains an established long-term injury-prevention program. Other warm-up strategies to enhance its effects may consider incorporating.

Objectives: The current study sought to: (1) characterize the demographic and fight specific details of Ultimate Fighting Championship (UFC) athletes who experienced two consecutive knockout (KO) or technical knockout (TKO) losses, and (2) identify predictors associated with two consecutive KO or TKO losses using publicly available data.

Methods: A retrospective cohort study examined UFC fighters who sustained at least one KO/TKO loss between 01/2015 and 12/2023 (with at least one subsequent fight) using publicly available fight records and third-party sources. Fighters were binarized into: (1) One Knockout group or (2) Two Consecutive Knockouts group. Demographics and fight specific details from the initial KO/TKO loss were compared using t-tests and chi-squared tests. A multivariable logistic regression identified predictors of two consecutive KO/TKO losses using variables including age, sex, prior knockout history, weight, total head strikes absorbed, and knockout type.

Results: Among 705 UFC athletes who sustained a knockout (age: mean = 31.1; 89.9% male), 77.3% sustained a single KO/TKO loss and 22.7% sustained two consecutive losses. Fighters with two consecutive knockouts were older (31.8 ± 3.9 vs. 31.0 ± 4.0; t = -2.288, p = .022) and more likely to be male (94.4% vs. 88.6%; χ² = 4.5, p = .034). Additonally, they fought at a heavier weight class (175.9 ± 41.8 lbs vs. 168.8 ± 39.4 lbs; t = -1.991, p = .047). In the logistic regression, prior knockout history was the only independent predictor (OR = 1.13, p = .019, 95% CI = 1.020-1.246).

Conclusions: Among UFC athletes during a 9-year period, 23% sustained two knockout losses in a row. Associations with two consecutive knockouts were older age, male sex, heavier weight class, and prior KO history, with prior KO history emerging as the only independent predictor. Recognizing prior knockout exposure as a key risk factor may help coaches and sports medicine physicians identify fighters at greater vulnerability for subsequent knockouts. Identifying high-risk fighters through knockout history may inform return-to-competition and medical clearance decisions.