Physician and Sportsmedicine最新文献

The 2017 USA Gymnastics (USAG) scandal, which revealed that Dr. Larry Nassar, head team physician for US gymnastics, sexually abused countless gymnasts, is one of the most widely recognized cases of sexual abuse in youth sports. Not only did Nassar abuse elite US gymnasts, but he also abused many student-athletes at Michigan State University. USAG and the United States Olympic and Paralympic Committee (USOPC) acted and began implementing the SafeSport training program to educate athletes, coaches, and staff about how to recognize and prevent abuse; however, similar training has not yet been implemented within the National Collegiate Athletic Association (NCAA) and other major sports governing bodies in the United States. The purpose of this review was to examine the current recommendations for preventing abuse put in place by the International Olympic Committee (IOC) and discuss how sports organizations can continue to improve on existing frameworks for reporting non-accidental violence in sports. An online search was conducted to determine the current frameworks recommended for abuse and harrassment reporting within sports. PubMed and a general online search were utilized. Official documentation from the governing bodies were used as definitive sources. Other literature was independently analyzed for validity. The current IOC guidelines recommend maintaining commitment, trustworthiness, and impartiality as key components of the abuse reporting process. A separate trauma framework from the Centre for Sports and Human Rights outlined a 5 step process to report abuse. The NCAA does not currently have a universal reporting framework in place. A combination of current IOC guidelines and existing trauma frameworks for abuse prevention would be an effective way to implement a centralized reporting framework for the NCAA in order to protect athletes. This would open up avenues for preventing perpetrator migration across sports, as well as creating an environment that has athlete safety as the highest priority.

Purpose: Vascular neck compression techniques, referred to as 'chokes' in combat sports, reduce cerebral perfusion, causing loss of consciousness or voluntary submission by the choked athlete. Despite these chokes happening millions of times yearly around the world, there is scant research on their long-term effects. This pilot study evaluated whether repeated choking in submission grappling impacts the carotid intima media thickness (CIMT) and brain injury biomarkers (NFL, hGFAP, t-Tau, and UCH-L1).

Methods: Participants (n = 39, 29 male; ages 27-60 years) were assigned to one of two study arms: Grapplers (n = 20, 15 male) and 19 age/sex/body size matched controls. Grapplers had been exposed to >500 choke events while training for >5 years in a choke-inclusive sport. Exclusion criteria were recent TBI or deficits from a past TBI or stroke. Bilateral ultrasound measurement of the CIMT was performed, and blood was collected for quantitative analysis of four brain injury markers. Subgroup analyses were performed within the Grappler group to account for blunt head trauma as a possible confounder.

Results: There was no overall difference in CIMT measurements between Grapplers (mean 0.55 mm, SD 0.07) and Controls (mean 0.57 mm, SD 0.10) p = 0.498 [95% CI -0.04-0.08], nor were there CIMT differences between Grappler subgroups of blunt Trauma and No-Trauma. There were no significant differences in any biomarkers comparing Grapplers and Controls or comparing Grappler subgroups of Trauma and No-Trauma.

Conclusion: This study found no significant difference in CIMT and serum brain injury biomarkers between controls and grapplers with extensive transient choke experience, nor between grapplers with extensive past blunt head trauma and those without.

Objectives: Exposure to bullying and high levels of anxiety are important determinants of the quality and duration of athletes' experiences of success. The aim of this study was to determine which behaviors are most commonly perceived as bullying by para athletes and whether the exposure to bullying or levels of trait anxiety differ between para athletes and non-disabled athletes.

Methods: It is a cross-sectional study. Two groups consisting of professional para athletes (n = 104) and non-disabled athletes (n = 129) between the ages of 18-45 affiliated to the national athletics federation were included in the study. The questionnaire included information about demographics and the two scales, the Negative Acts Questionnaire-Revised (NAQ-R) and the Sport Anxiety Scale-2 (SAS-2).

Results: Withholding information that could affect performance and spreading rumors (item 1,5) were the most frequently reported bullying behaviors. No statistically significant difference was found between para athletes and non-disabled athletes or between male and female genders in terms of total or any subdimension NAQ-R scores (p > 0.05). SAS-2 total and SAS-2-worry subdimension scores were significantly lower in the para athletes (p = 0.018 and p = 0.020). Total and all SAS-2 subdimension scores were significantly higher in female athletes (p < 0.05).

Conclusion: The knowledge about bullying exposure in para-athletes is quite limited. The para-athlete group has fewer opportunities than the non-disabled group in terms of financial opportunities, physical conditions, media coverage and many other aspects. However, in our study, they reported bullying exposure at a similar rate with the non-disabled group. Although there is a similar level of exposure, it is clear that the results will not be similar in the two groups due to the different psychological bases. According to the results of this study, it is thought that stakeholders who have responsibility for the para-athlete group should be further educated.

Objectives: The purpose of this study is to examine NCAA Division I volleyball players' return to play rates and performance statistics compared to pre-injury levels following ACL injury.

Methods: Female volleyball players that sustained ACL injuries from 2008 to 2020 and competed in one of seven collegiate conferences (n = 99) were identified via an internet search algorithm. Players were categorized by position, academic year, and playing time pre- and post-injury. Post-injury performance statistics were gathered for a subset of outside hitters and middle blockers that played in ≥35 sets in a single season for up to 3 years following injury (mean 1.7 seasons). A control group (n = 512) was generated for demographic and statistical comparison. Mean pre-injury and post-injury statistics were compared for players that did not change positions and played ≥35 sets before and after injury.

Results: Volleyball attackers were 54.7% of the control population but sustained 78.8% of identified injuries. Following ACL injury, 6.1% of players registered no in-game statistics, 16.2% played in <35 sets, 65.7% played in ≥35 sets, and 12.1% graduated. Mean performance statistics increased linearly the more years players were from ACL injury.

Conclusions: Female collegiate volleyball players return to play following ACL injury at high rates (93.1%) and maintain pre-injury performance levels. Volleyball attackers sustain ACL injuries more commonly than setters and libero/defensive specialists.

Objectives: Reports of injury characteristics of high school track and field athletes participating in jumping events in the United States are limited. In this descriptive epidemiological study, we report injury rates and patterns in these athletes.

Methods: Injuries and athletic exposures (AE) from the National High School Sports Related Injury Surveillance System, and High School Reporting Information Online (RIO) from 2008-2019 were analyzed. Jumping events included high jump, long jump, triple jump, and pole vault. Injury rate ratios (IRR) and injury proportion ratios (IPR) were examined by sex.

Results: A total of 727 injuries related to jumping events during 5,486,279 AEs occurred with the highest frequency at the thigh (20.3%) followed by the ankle (18.2%), knee (16.1%), and lower leg (11.0%). The most common types of injuries were muscle strain (29.0%) and ligament sprain (21.2%). Most athletes returned to sport within 1 week (43.1%, n = 312) or 3 weeks (34.7%, n = 243). Few jumping-related injuries resulted in surgery (4.9%, n = 35) or medical disqualification (4.4%, n = 31). The jumping-related injury rate was 1.33 injuries/10,000 AEs from 2008 to 2019. The rate of jumping-related injuries was higher in competition than in practice (IRR = 2.63, 95% confidence interval [CI]: 2.25-3.06). Injury rates were significantly higher in practice for female athletes than for males (IRR = 1.51, 95% CI: 1.23-1.86). Compared to male athletes, female athletes sustained a higher proportion of ankle injuries (IPR = 1.63, 95% CI: 1.15-2.32) and ligament sprains (IPR = 1.55, 95% CI: 1.16-2.09).

Conclusions: This study describes injury characteristics of high school track and field jumping athletes from 2008 to 2019. We found an overall injury rate of 1.33 injuries per 10,000 AEs. Higher overall rates of jumping-related injuries occurred during competitions than in practice, and female athletes displayed a significantly higher rate of injuries during practices compared to male athletes.

Objectives: This study describes the effects of patellar fracture on return to play (RTP) and functional outcomes among athletes in American professional sports.

Methods: Professional athletes from the National Football League (NFL), National Basketball Association (NBA), Major League Baseball (MLB), and National Hockey League (NHL) who suffered a patellar fracture between January 1965 and December 2021 were identified through injury reports and public archives. Performance scores, play time, and games played were collected for the season preceding patellar fracture and 2 seasons after RTP, and differences in recorded metrics compared to pre-injury levels and matched controls were analyzed.

Results: Twenty-nine of 41 (71%) injured athletes returned to play at an average of 217 days. Among all players, play volume decreased in year 1 compared to baseline but recovered to pre-injury levels in year 2. Athletes treated operatively experienced an initial decline in performance (p < 0.01) but recovered to pre-injury performance level in year 2. Nonoperative management resulted in a decline in performance in year 2 of RTP (p = 0.02). Athletes treated operatively performed significantly worse than matched controls in year 1 of RTP (64% vs. 99%; p = 0.04) but recovered to a similar level of performance as controls in year 2 (87% vs. 91%; p = 0.90).

Conclusion: A 71% rate of RTP was demonstrated among this limited cohort of 29 athletes in American professional sports after isolated patellar fracture. Although details regarding fracture characteristics and operative reports were not available for analysis, operative management was not associated with longer absence from play compared to nonoperative treatment. Despite the limitations of this study, the findings suggesting operative management may improve prospects of maintaining elite performance following RTP warrant further investigation.

Level of evidence: Case-control cohort analysis; Level of evidence, 3.

Objective: Developing softball pitchers are prone to injury due to the repetitive throwing motion. Many children and parents use the internet as a source of medical advice, but this information may not always be aligned with medical guidelines. The purpose of this study was to assess the medical advisability of injury prevention guidelines for developing softball pitchers on websites using Google as the primary search engine.

Methods: The first 100 websites populated from a Google search using the term softball youth pitching recommendations were evaluated. Each website was categorized as discussing baseball, softball, or both, and as athletic, commercial, or educational. For every website, 16 recommendations described by the American Orthopaedic Society for Sports Medicine (AOSSM) Stop Sports Injuries softball injury prevention guidelines (Table 1) were scored as in agreement (+1), different guideline mentioned (0.5), no mention (0), or discordant (-1).[Table: see text].

Results: Of the 98 qualifying websites, 57 advised only about softball, while 19 advised about both baseball and softball. Fifty websites had no mention of any recommendation outlined by AOSSM. Websites that were mostly in agreement with AOSSM were educational websites (mean score = 3.9, p = 0.02), websites discussing only softball (mean score = 2.0, p = 0.02), and the first 50 websites (mean score = 2.2, p = 0.04). The most common discordant guideline was differing opinions in pitch count (13 websites).

Conclusion: The most common category in disagreement with AOSSM was different pitch count guidelines, highlighting a need for websites to provide more consistent information using high-quality resources. Educational websites, websites discussing only softball, and the first 50 websites had the highest scores, indicating that these types of websites are most likely to have the highest amount of medically advisable information. We recommend users conduct targeted Google searches on reliable websites for information on pitching softball recommendations to maximize the validity of Google search results.

Objectives: This study aims to explore and understand the knowledge and attitudes of Paralympic athletes and their coaches toward pressure ulcers. By focusing on this underserved population, the study seeks to improve awareness, recognition, and management practices to minimize the health and performance impacts of pressure ulcers in Paralympic sports.

Methods: Paralympic athletes and their coaches were contacted. Volunteers were included in the exploratory sequential mixed design study. In the quantitative phase, a digital survey was used to evaluate Paralympic athletes' and coaches' awareness of pressure ulcers. To gain a deeper understanding of the factors deemed significant in the quantitative analyses, the researcher conducted one-on-one semi-structured interviews with athletes and coaches. The data was analyzed using the SPSS package program and MAXQDA program.

Results: Ten coaches and 82 Paralympic athletes participated in the study. The sports disciplines were wheelchair basketball (40%), Paralympic table tennis (40%), Paralympic court tennis (10%), and athletics (10%). Coaches' knowledge about pressure ulcers was low, and athletes' knowledge was even lower. It was concluded that coaches should improve their attitudes toward pressure ulcers, particularly in the areas of competence and responsibility sharing. During the interviews with the participants, several themes emerged.

Conclusion: To address pressure ulcers' significance, it is essential to increase the knowledge level of both athletes and the entire team and adopt a positive attitude. It has been concluded that different areas of expertise in the fields of health and sports should work with a more organized structure and team awareness.

Objectives: To report the injury epidemiology of the Great Britain's (GB) men's basketball team games and training over a 6-season period.

Methods: Non-time loss (NTL) and time-loss (TL) injuries were recorded throughout 14 international windows (2018-2024). Exposure (player-hours) was recorded for team training and games. NTL and TL injury incidence is presented per 1000 player-hours (p/1000 h; 95% CI) for training, games and overall exposure. TL severity (days-lost) and burden (days-lost/1000 h; 95% CI) was calculated, with incidence rate ratios (IRR, 95% CI) comparing game and training incidence for each definition.

Results: Throughout the study period, 113 injuries were recorded, of which 65 were GB related (43 NTL and 22 TL). Game injury incidence was significantly greater than training for TL (96/1000 h; 95% CI 33-159 versus 6/1000 h; 95% CI 2-9; IRR = 17; 95% CI 7-44) and NTL (75/1000 h; 95% CI 10-131 versus 7/1000 h; 95% CI 3-11; IRR = 11; 95% CI 4-28) injury definitions. Overall, most TL injuries occurred at the ankle (36%, 5/1000 h; 95% CI 2-9) and NTL injuries at the knee (19%, 5/1000 h; 95% CI 2-9). 31 overuse injuries were recorded, with 25% lower limb tendinopathies. TL injury severity ranged from 1 to 30 days, with injury burden for games (675/1000 h; 95% CI 234-1116) greater than training (48/1000 h; 95% CI 55-133).

Conclusion: The reported game injury incidence is high, with a large prevalence of NTL injuries. Lower limb injuries were most common, particularly overuse knee injuries. Preventative strategies need to be specific in the international basketball context, where camps are short but intense in duration.