Physician and Sportsmedicine最新文献

Objectives: Early specialization in a single sport from childhood is associated with an increased risk for acute and overuse injuries. Conversely, experience in multiple sports may be associated with improved neuromuscular control and performance. Currently, early sports specialization remains poorly researched in Japan. Therefore, this study aimed to clarify the relationship between early sports specialization and landing and balance ability in Japan.

Methods: Thirty-eight female college basketball players were included and divided into the early specialization and nonspecialization groups. Landing and balance ability was measured using the one-leg jump-landing test, and the Star Excursion Balance Test (SEBT) differences between the two groups were examined using unpaired t-test.

Results: Results showed no significant differences in SEBT between the two groups. In the one-leg jump-landing test, the vertical maximum ground reaction force and loading rate of the nondominant foot were significantly higher in the early specialization group than in the nonspecialization group.

Conclusion: Thus, in female college basketball players, early specialization may affect ground reaction forces and loading rate and may be a factor in developing acute and overuse injuries.

Objectives: To cross-sectionally determine 1) the association between lifetime diagnosed concussion and upper extremity musculoskeletal injury (UE-MSI) amongst a novel cohort of community rugby union players and 2) the sex specific risk of UE-MSI given concussion history among these rugby players.

Methods: 1,037 (31.0% female, 31.6 + 11.3 years) rugby players completed an online survey to determine lifetime history of diagnosed concussion (yes; no) and UE-MSI (yes; no). A chi-squared test of association was performed between concussion and any UE-MSI; odds ratio risk was also determined. Analyses were repeated by sex (male; female) and with specific UE-MSI (e.g. sprains, broken bones, dislocations).

Results: There was a significant association between concussion and any UE-MSI for this cohort (χ(1) = 10.802, p = 0.001, OR = 1.70 [95%CI: 1.23-2.32]). There was a significant association between concussion and any UE-MSI among males for (χ(1) = 13.612, p < 0.001, OR = 2.20 [95%CI: 1.4-3.3]) but not among females (χ(1) = 0.735, p = 0.391, OR = 1.20 [95%CI: 0.8-2.0]).

Conclusions: Community rugby players with a history of diagnosed concussion are at 1.7× increased odds for history of any UE-MSI compared to rugby players who are concussion naïve; sex specific analyses revealed only increased risk among males. Sports medicine professionals and rugby stakeholders should view concussions as a risk factor and utilize established injury prevention programs to help reduce future UE-MSI in athletes.

Objectives: A multifaceted assessment battery is recommended for testing suspected concussed athletes; however, the individual tests have limitations and potentially may lead to false positive outcomes. Therefore, the purpose of this study was to psychometrically evaluate concussion assessment tools used for intercollegiate student-athletes, with a focus on the time interval between baseline and subsequent assessments.

Methods: Ninety-two collegiate student-athletes matched between concussion (N = 46. F32/M14) and non-concussion (N = 46, 32F/14 M) completed the standard assessment of concussion, balance error scoring system, symptom questionnaire, and computerized neurocognitive tests at baseline and acutely (<48 h) following a concussion. Test outcomes were compared between time points with three approaches: 1) vs baseline, 2) reliable change scores (RCI), and 3) vs American College of Rehabilitation Medicine (ACRM). Concussion assessment sensitivity, specificity, likelihood ratios, predictive values, and diagnostic odds ratio were calculated. A receiver operator characteristic compared area under the curve (AUC) for the overall battery as well as between academic years.

Results: The sensitivity of the battery was high (78.3-95.7%), but specificity was low to moderate (6.5-52.2%) with comparison to the RCI typically performing best. The three approaches yielded AUC values between 0.51 and 0.63 which is below the discriminatory threshold (0.70) with comparison to RCI performing best. By academic year, Juniors was the only year in which the ROC exceeded the threshold (0.75). The number of tests failed did not improve any AUC values (0.51-0.69) to exceed the threshold.

Conclusions: The outcomes of this study support the premise that concussion must be evaluated using a comprehensive clinical examination including a variety of assessments to evaluate each clinical domain. Clinicians need to recognize that the multifaceted assessment battery has high sensitivity, but the overall psychometrics do not exceed the threshold for group discrimination and caution must be used in their interpretation.

Objectives: Concussion is a common injury in rugby union ('rugby') and yet its diagnosis is reliant on clinical judgment. Oculomotor testing could provide an objective measure to assist with concussion diagnosis. NeuroFlex® evaluates oculomotor function using a virtual-reality headset. This study examined differences in NeuroFlex® performance in clinician-diagnosed concussed and not concussed elite male rugby players over three seasons.

Methods: NeuroFlex® testing was completed alongside 140 head injury assessments (HIAs) in 122 players. The HIA is used for suspected concussion events. Of these 140 HIAs, 100 were eventually diagnosed as concussed, 38 were not concussed (2 were unclear) Eight of the 61 NeuroFlex® metrics were analysed as they were comparable at all time points. These eight metrics, from three oculomotor domains (vestibulo-ocular reflex, smooth pursuit and saccades), were tested for their ability to distinguish between concussed and not concussed players using mean difference / odds ratios and corresponding 95% confidence intervals (CI's). General and generalised linear mixed models, accounting for baseline test performance, were used to determine any meaningful differences in concussed and not concussed players. The diagnostic accuracy of these differences was provided by the area under the receiver operating curve (AUC).

Results: Only one of the eight metrics (number of saccades, smooth pursuit domain) had clear differences in performance between concussed and not concussed players at the HIA during the match (odds ratio: 0.76, 95%CI: 0.54-0.98) and after 48 hours (0.74, 95%CI: 0.52-0.96). However, the direction of this difference was contrary to clinical expectations (concussed performed better than not concussed) and the AUC for this outcome was also poor (0.52).

Conclusion: NeuroFlex® was unable to distinguish between concussed and not concussed players in this elite male cohort. Future research could study other cohorts, later time points before return to play, and the tool's role in rehabilitation.

Purpose: Club sports are competitive, intercollegiate athletics that are not affiliated with the National Collegiate Athletic Association (NCAA). Club athletes may be at increased risk of injury compared to their NCAA counterparts due to limited resources, such as reduced access to strength and conditioning coaches and athletic trainers. Research has shown that injury-prevention education, as typically provided by coaches and trainers, can reduce injury rates and promote athlete compliance with safety practices.

Objective: This prospective cohort study investigates the impact of educational interventions on pain levels and injury rates in club collegiate men's lacrosse athletes.

Design: Investigators conducted an educational session on injury prevention, which included instruction on stretches and exercises. The treatment group included 66 athletes, while 46 athletes served as the control group.

Results: Pain levels significantly decreased by 1.549 (out of a self-reported scale of 10) (35.11%) (p = 0.0001). Although the average number of practices and games missed due to injury decreased by 0.579 in the treatment group compared to the control, this difference was not statistically significant (p = 0.5970).

Conclusion: Educational interventions focused on injury-prevention stretches and exercises appear to be effective in reducing pain among club athletes. While the reduction in missed practices and games was not statistically significant, these findings suggest that such educational programs may help mitigate injuries in under-resourced athletes. Further exploration of strategies to enhance these interventions and decrease injuries among club athletes is warranted.

Objectives: The aim of this study was to capture information regarding concussion prevalence, knowledge, and reporting behaviors in women rugby players across all competitive levels in the UK. We also investigated whether these outcomes were influenced by the prevailing concussion awareness programme (HEADCASE).

Measures: Two hundred and thirty players from elite (Premiership), Championship, British Universities, and College Sport and club level completed (n = 133) or partially completed (n = 97) a mixed-methods online questionnaire.

Results: Over a mean period of 8 years, 159 players (74%) experienced at least one suspected or diagnosed rugby-related concussion. In total, 408 rugby-related concussions were reported in these players during this time. Prevalence of concussion did not differ across playing level or position. Being tackled was the most common cause of rugby-related concussions, and the act of tackling another player was second. Players across all levels demonstrated good knowledge of concussion symptoms, but only 12% identified that concussion can occur without direct impact to the head. One hundred and forty-six players completed the HEADCASE training (mandatory for Premiership players). Forty-one percent of players admitted to deliberately failing to report a suspected rugby concussion, and this behavior was not influenced by HEADCASE training. These individuals were more likely to avoid reporting a suspected concussion during an important (e.g. semifinal or final) than unimportant (e.g. training) scenario. Those who underwent the graduated return to play pathway (n = 41) were significantly more likely to have completed HEADCASE training.

Conclusion: The prevalence of concussion in women's rugby union is high but does not differ by playing level or position. All players had a good knowledge of concussion symptoms, but many were unaware that concussions may occur without direct impact to the head. Almost half of all players admitted to deliberately failing to report a suspected concussion, and this was not significantly influenced by the completion of HEADCASE training.

Objectives: Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary.

Methods: This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified. Controls, without ACL tears, were matched by age, BMI, position, race, and average minutes played before the injury date to uninjured controls. Return to NBA, pre-injury and post-return player efficiency ratings (PER), and salary change after injury were analyzed by multivariate analyses.

Results: A total of 67 players suffered an ACL tear. Fifty-six (83.6%) players returned to the NBA at some point after their injury, while 11 (16.4%) did not. Multivariate logistic regression showed that older age and the presence of multi-ligament injury predicted retiring from the NBA (ß = 1.4 and 10.7). Older age and greater minutes played before surgery to be the only significant predictors of decreased PER after return to the NBA (ß = -0.5 and -0.2). Players with a multiyear contract and with improvements in PER after injury tended to have greater salary increases (ß = 6.5 and 0.7). All p < 0.05. PER in players with ACL tears decreased by about 3 points (13.1 to 9.9) compared to controls without ACL tears (13.2 to 12.9).

Conclusion: Older age and multiligament injuries are associated with retiring for the NBA; older and increased minutes played are associated with a decreased PER upon return; and, PER decreases are associated with decreased salary. Players with ACL tears, even when case-control matched, showed decreased PER upon return. These results can be attributed to age-related changes in athleticism and health.

Aims: This study aimed to perform a cross-cultural adaptation and validate a questionnaire to assess the nutrition knowledge of Brazilian ultra-endurance athletes.

Methods: This is an observational and cross-sectional study, which adapted and validated the Nutritional Knowledge Questionnaire for Ultra-endurance Athletes (ULTRA-Q). ULTRA-Q was translated into Portuguese, and then the translated version was assessed for semantic, idiomatic, cultural and conceptual equivalence by six specialist nutritionists. In addition to suggesting adaptations to the questionnaire, the experts evaluated the clarity and relevance of the items, calculating the Content Validity Coefficient (CVC). The adapted version was applied to 46 ultra-endurance athletes to evaluate reproducibility and validity. After the test-retest, the instrument was also answered by 54 nutritionists, to evaluate the construct validity of the questionnaire.

Results: The Brazilian version (ULTRA-QBR) of the questionnaire for ultra-endurance athletes had adequate CVC for clarity (0.97) and pertinence (0.95), and presented adequate discriminant validity. The data from the intraclass correlation coefficient indicates good reproducibility of the questionnaire, and the difference observed between athletes and nutritionists reinforces the evidence of the questionnaire's construct validity.

Conclusion: The results demonstrate content, construct and discriminant validity, test-retest reproducibility, and internal consistency of the ULTRA-QBR. We concluded that this questionnaire can be used as an interesting tool in research and clinical practice in ultra-endurance sports.

Objectives: Electric biking (e-biking) is a rapidly growing recreation, sport, and mode of transportation that often presents to emergency departments (EDs) with high-impact head injuries. This study aimed to evaluate the epidemiology of e-bike-related concussions and closed-head injuries (CHI) to inform more effective injury prevention strategies.

Methods: The National Electronic Injury Surveillance (NEISS) was queried for e-bike related concussions and CHIs presented to national EDs from 1 January 2013-31 December 2022. Patient demographics, diagnoses, and dispositions were recorded, and injury narratives were reviewed to identify mechanisms of injury and motor vehicle (MV) involvement.

Results: A total of 11,052 nationally estimated (NE) e-bike head injuries presented to US EDs from 2013 to 2022. E-bike head injuries increased significantly from 2013 to 2022 (p = .006, β = 372.5), with 40.8% of all head injuries occurring in 2022. Nearly one-third of patients (31.0%) required hospital admission, with hospitalization occurring most frequently among ages 51 and older (44.5%). MV involvement accounted for 27.6% of head injuries, and caused a higher proportion of hospitalizations than mechanisms without MVs (35.6% vs. 29.4%, respectively; p < 0.001). High school age riders had the most MV incidents (53.2%), while the middle school age group had the highest proportion of concussions (26.5%) among all age groups. Relative to females, males were more likely to be involved in an MV incident (28.5% vs. 15.5%; p < 0.001) and were more likely to be hospitalized (33.0% vs. 25.4%; p < 0.001).

Conclusion: The incidence of concussions and CHIs due to e-bikes increased significantly from 2013 to 2022, while high proportions of hospitalization indicate serious injury severity and large medical costs associated with these injuries. The prevalence of crashes involving MVs, especially among teenagers, calls for further research on commuter and recreational e-bike use along with new traffic legislation to protect young e-bikers.

Objectives: Golf participation numbers have increased in recent years within the UK and globally. A recent systematic review and meta-analysis of injuries in amateur and professional golfers showed over half of golfers sustain an injury during their lifetime. This review recommended that future research should utilize the recent international consensus on reporting of injury in golf. The aim of this study was to determine the frequency and severity of injuries sustained by UK-based golfers in the previous year.

Methods: A retrospective cross-sectional online survey consisting of 35 questions was disseminated to UK-based golfers. Non-overlapping 95% confidence intervals (CI) were utilized to indicate significant differences.

Results: There were 303 participants included for analysis. The overall injury incidence was 41.26 injuries per 1000 hours (CI 35.96-47.33). Consistent with the wider literature, the lower back at 9.94 injuries per 1000 hours (CI 7.48-13.22) is the most frequent injury site. The lower back had a mean time loss of 54 ± 89 days before full recovery. Repetitive movement injuries were noted to have a higher incidence (22.00 per 1000 hours, CI 18.19-26.61) in comparison to acute injuries (10.79 per 1000 hours, CI 8.21 to 14.18).

Conclusion: Anatomically, the proportion of injuries observed was comparable to previous epidemiology studies, with the lower back and elbow having the highest incidences in this largely amateur group of golfers. Most injuries were identified to be a muscle strain, joint sprain, or tendinopathy; however, no single identifiable mechanism of injury was identified.