Physician and Sportsmedicine最新文献

Objective: To assess sex-based differences in the frequency and characteristics of pediatric lateral ankle avulsion fractures.

Methods: This prospective observational cohort study (Level II) was conducted at a tertiary sports medicine clinic between July 2022 and March 2025. This study included a total of 132 patients with 133 injuries aged 5-12 years presenting within 30 days of a first-time lateral ankle injury (67.4% female and 32.6% male). Injuries were categorized as avulsion or non-avulsion using ultrasound as the reference standard. Demographics, injury type and mechanism, sport type, and validated patient-reported measures were analyzed by sex using chi-squared and Mann-Whitney U tests.

Results: Males were found to be significantly more likely to sustain lateral ankle avulsion fractures than their female counterparts (50.0% vs. 24.1%, p < 0.01). There were no statistically significant differences between the avulsion and non-avulsion groups for age, race, ethnicity, BMI, or days to presentation. Sport during injury did vary by sex (p = 0.02), but the cause of injury did not. Pain, mobility, anxiety, and Pedi-FABS scores did not vary between sexes at presentation, regardless of their avulsion status.

Conclusions: Our study demonstrated that males with lateral ankle injuries were more likely to sustain avulsion fractures than females in this pediatric population. Despite these differences in injury type, both sexes reported similar levels of function, anxiety, pain, and activity at initial presentation. Understanding early sex-based differences in lateral ankle fracture patterns may inform diagnostic evaluation and management in pediatric patients.

Purpose: Concussion-induced pathophysiology creates an energetic imbalance within the brain. Though physical activity (PA) is recommended to facilitate recovery, individualized factors such as symptom severity and/or energy availability may be barriers to PA engagement and may need to be considered to promote concussion recovery. Our purpose was to compare PA over a one-week period between adolescents with and without a recent concussion.

Methods: Adolescent athletes within 3 weeks of concussion and uninjured athletes wore wrist-worn actigraphy devices for one week to quantify three outcomes: PA (steps/day), caloric expenditure, and resting heart rate (RHR). We used linear mixed models with random slopes and random intercepts for participants to examine between-group differences for each outcome over the monitoring period, adjusting for variables that differed between groups.

Results: We enrolled and followed 149 adolescents for one week: 85 with concussion (starting at 9.2 ± 3.5 days post-injury, age = 15.3 ± 1.8 years, 52% female) and 64 uninjured controls (age = 15.4 ± 1.5 years, 61% female). After adjusting for covariates, the concussion group took fewer steps/day (β = -4837 steps/day; 95%CI: -6266, -3409; p < 0.001) and expended fewer calories (β = -338 calories; 95%CI: -512, -164; p = 0.001) than controls during the monitoring period. RHR was similar between groups (β = 0.74 beats/min; 95%CI: -2.41, 3.88; p = 0.65).

Conclusion: Adolescents after recent concussion demonstrated lower PA and expended fewer calories than uninjured controls, indicating that it may take several weeks after concussion to resume PA levels similar to uninjured peers. Our results may reflect participants following concussion guidelines/physician guidance to gradually increase PA during concussion recovery as tolerated without symptom exacerbation, leading to less PA engagement compared to controls. Further research into energy needs after concussion may inform therapeutic targets to facilitate recovery.

Objectives: Although it has been well documented that judo athletes from different competitive levels often exhibit inadequate hydration status, studies investigating the hydration habits of Paralympic judo athletes with visual impairment are scarce. Thus, this study examined urine-based hydration indicators and hydration-related behaviors of para judo athletes.

Methods: Twelve judo athletes (6 women and 6 men) with visual impairment from the national Paralympic judo team voluntarily participated in the study. Athletes' hydration status was assessed through urine specific gravity (USG), urine color (UC), and body weight (BW) changes over 24 hours, monitored at six time points. Additionally, athletes' hydration knowledge, attitudes, and behaviors were evaluated using a hydration survey administered in an accessible format.

Results: At rest, USG remained stable across measurement points (F_3,33 = 1.11; p = 0.36), while urine color increased following both training sessions. The evening judo training session induced a significant increase in USG (p = 0.009), whereas morning training had no effect. Body weight decreased significantly after both training sessions (p < 0.001), but overall 24-hour body mass remained stable (p > 0.05). Athletes demonstrated high levels of hydration knowledge (68.5%) and attitudes (70.2%), but only moderate hydration behaviors (62.2%). No significant associations were observed between survey scores and urine-based hydration markers (p > 0.05).

Conclusions: These findings indicate that Para judo athletes with visual impairment experience persistent challenges in maintaining day-to-day fluid balance despite adequate theoretical knowledge. Therefore, accessible, behavior-oriented hydration strategies and structured monitoring approaches should be developed for this underrepresented group, with active involvement of coaches and nutrition professionals.

Background: Medial elbow injuries occur in approximately one-third of all young baseball players and are characterized by injuries to the bone and cartilaginous growth plates. Bone mineral mass, a representative of bone strength, may show individual differences during growth, and the bone strength can temporarily decrease depending on the stage of bone development. However, the relationship between bone mineral mass and medial elbow injuries in young baseball players has not yet been investigated.

Hypothesis: The bone mineral mass would be lower in players with medial elbow injuries, causing lower bone strength and increased susceptibility to injury.

Study design: Cross-sectional study.

Methods: We recruited 215 baseball players aged 9-12 years; the players completed a questionnaire regarding their age, height, weight, practice duration and frequency, baseball experience, and number of pitches per day. The injury and control groups were determined by ultrasonographic evaluation of the medial aspect of the elbow joint, and bone mineral mass was measured by bioelectric impedance analysis. The hip and shoulder ranges of motion were measured. Each variable was compared between the injury and control groups using the Student's t-test. Simultaneous multivariate logistic regression analysis was subsequently performed to identify the factors associated with medial elbow injuries.

Results: Bone mineral mass was significantly higher in the injury group than in the control group (2.02 ± 0.30 kg vs. 1.91 ± 0.26 kg, p = 0.003). However, it was not significantly associated with medial elbow injuries in multivariate logistic analysis. Baseball experience (OR, 1.03; 95% CI, 1.01-1.06; p = 0.009) were significantly associated with medial elbow injury.

Conclusion: Contrary to our hypothesis, bone mineral mass was higher in players with medial elbow injuries, but was not significantly associated with them. A one-time measurement of bone mineral mass is probably not specific enough to analyze the condition of the medial epicondyle. Baseball experience has been identified as a possible factor associated with medial elbow injuries in young players, and increases in experience should be used as an indicator to assess elbow joint health.

Introduction: The use of electric scooters (e-scooters) has surged over the past decade, leading to a notable rise in e-scooter related injuries presenting to emergency departments. This study aims to analyze trends and mechanisms of e-scooter injuries in the United States pediatric population. We hypothesized that there would be a significant increase in pediatric e-scooter injuries from 2014 to 2023, and particularly since the COVID-19 pandemic from 2020 to 2023, with many patients sustaining fractures.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18) electric scooter injuries presenting to US emergency departments between 1 January 2014 and 31 December 2023. Patient demographics, injury location, discharge disposition, and diagnosis were extracted. The mechanisms of injury were categorized based on the injury narrative. Injury trends were analyzed using linear regression analysis.

Results: A total of 2,231 pediatric e-scooter injuries (NE = 63,527) were included. The mean age was 11.9 ± 4.0 years old and 63.3% of patients were male. There was a statistically significant increase in pediatric e-scooter injuries from 2014 to 2023 (p = 0.002). Additionally, we identified a 2.4 fold increase in annual post-COVID (2021-2023) average injuries compared to pre-COVID (2014-2019). The most common diagnosis was fractures (NE = 18103, 28.5%). The most common body part injured was the head (NE = 11258, 17.7%). Collisions with other moving vehicles comprised 10.8% of all injuries (NE = 6840). The most common mechanisms of injury were falling off of the e-scooter (NE = 43889, 69.1%). Out of the 432 (19.4%) narratives that reported helmet usage, 72.6% indicated that the patient was not wearing a helmet.

Conclusion: Pediatric e-scooter injuries have increased significantly in the past decade, particularly since the COVID-19 pandemic. As e-scooter usage continues to rise, these findings underscore the need for targeted safety measures to protect young riders from fractures and head injuries.

Objectives: Retired athletes from aesthetic sports such as rhythmic gymnastics may experience issues related to eating disorders (EDs), body image and musculoskeletal injuries. However, quantitative studies on the long-term effects of participation in retired rhythmic gymnasts are scarce. This study aims to assess the prevalence of EDs, body dissatisfaction, and injuries in former Spanish rhythmic gymnasts, considering years of practice and the competitive level achieved.

Methods: A total of 216 former rhythmic gymnasts were recruited through social media and sports clubs. Data were collected via online questionnaires, including the Eating Attitudes Test (EAT-26), the Stunkard Figure Rating Scale to measure body dissatisfaction, and the Nordic Musculoskeletal Questionnaire (NMQ) to assess musculoskeletal injuries.

Results: The sample had a mean age of 26.3 ± 8.4 years and an average of 11.7 ± 3.2 years of practice. A total of 10.6% of participants scored above the threshold on the EAT-26, while 68.1% reported body dissatisfaction. Participants with higher body mass index (BMI) was identified as a predictive factor for showing body dissatisfaction. Lower back pain was the most prevalent musculoskeletal symptom, affecting 83.3% of participants, followed by neck pain (74.5%).

Conclusion: The findings suggest that although the prevalence of EDs is relatively low in this sample, body dissatisfaction remains a significant concern, particularly among individuals with higher BMI. Furthermore, lower back pain is highly prevalent among former gymnasts. These results highlight the need for injury prevention strategies and psychological support following athletic retirement.

Objective: The aim of this retrospective study was to determine the injury incidences, types, locations, mechanisms, and results after injuries during the Türkiye Open 2025 Taekwondo Tournament and to identify differences between competition categories.

Methods: The tournament occurred in Antalya from February 8-16, 2025. A total of 2068 athletes from 60 countries participated in para taekwondo (PT), seniors (SC), juniors (JC), and cadets (CC) categories, with 1919 matches held. Injuries encountered by athletes were recorded by two sports medicine physicians using the International Olympic Committee (IOC) 'Daily Medical Report on Injuries and Illnesses' form. We defined an injury as an injury that occurs when the referee stops play and calls the medical team to the field. Injury incidence rates (IRs) were calculated per 1000 matches, per 1000 athlete-exposures (AEs), per 100 athletes (clinical incidence). Injury incidence rate ratios (IRRs) with 95% confidence intervals were calculated and compared regarding categories.

Results: A total of 147 injuries occurred during the matches: 18 in PT Kyorugi (K44), 39 in SC, 47 in JC, and 43 in CC. The IRs were as follows: PT K44: 211.7/1,000 matches, 19.14/100 athletes, 105,88/1000 AEs; SC: 84.4/1,000 matches, 8.2/100 athletes, 42,57/1000 AEs; JC: 63.8/1,000 matches, 6.21/100 athletes, 31,92/1000 AEs; CC: 67.6/1,000 matches, 6.28/100 athletes, 30,28/1000 AEs. PT had a significantly higher IRs compared to other categories. There were statistically significant differences between the genders of the injured athletes when the four categories were compared. Contusion was the most common type of injury across all categories, and the most frequent injury mechanism was contact with another athlete. In all categories, athletes continued to compete in the majority of injuries.

Conclusion: The findings of this study provide valuable insights into the injury epidemiology observed in international PT and taekwondo matches. Notably, the IRs was highest in the PT compared to other categories. These results may contribute to the enhancement of protective equipment design and the development of targeted injury prevention strategies aimed at reducing injury rates across all competitive levels especially in para taekwondo athletes.

Objectives: Ultrasonography is a widely accepted imaging method for evaluating anatomical structures around the shoulder joint. However, the consistency of measurements across different devices and operators remains a critical issue for clinical and research validity. The aim of this study is to assess the inter-device and intra-operator reliability of ultrasound-based measurements of four key anatomical shoulder distances and to establish normative reference values in a healthy population.

Methods: A total of 195 healthy volunteers (390 shoulders) underwent ultrasonographic evaluation of the acromioclavicular distance (AC), coracoclavicular distance (CC), acromiohumeral distance (AH), and coracohumeral distance (CH). Two physicians, TC (radiologist) and GB (sports medicine), performed the measurements independently using two different ultrasound machines: Siemens S3000 and C10X, respectively. To assess intra-rater temporal reliability, all measurements were repeated on the same participants after two weeks. Stratified sex-matched randomization was applied during participant recruitment.

Results: AC, AH, and CH ultrasound measurements showed intra- and inter-rater reliability with minimal bias and acceptable limits of agreement, indicating good consistency and interchangeability. In contrast, CC measurements exhibited significant inter-rater differences (p = 0.034 and p = 0.023) and wide limits of agreement, reflecting greater variability and limited interchangeability.

Conclusion: Given their consistent performance across statistical methods, AC, AH, and CH measurements may be used interchangeably across different raters or sessions, particularly in clinical or research settings where reliable reproducibility is essential. However, due to its high inter-rater variability and broad limits of agreement, CC measurements are not recommended for interchangeable use between evaluators or devices.

Objectives: Ice hockey is a high-impact sport that can put athletes in high-risk situations for injuries. While the game has shifted toward speed over physicality, fractures remain a major concern. Therefore, it would be valuable to observe whether this had an effect on fracture rates in men's ice hockey. The purpose of this study was to examine the frequency and trends of fractures sustained in men's ice hockey in the United States.

Methods: All men's ice hockey-related fractures presented to United States EDs from 1 January 2004 to 31 December 2023 were queried using the National Electronic Injury Surveillance System (NEISS). For each fracture, patient disposition, demographics, and injury site were recorded. National estimates (NE) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression modeling.

Results: A NE of 58,910 ice hockey-related fractures occurred among male players between 2004 and 2023. There was a qualitative decrease in annual fractures (p = 0.208) from 2004 to 2023. There was a significant decrease from 2004 to 2019 (p = 0.001) followed by a 172.6% increase to a record high number of fractures in 2022 (NE = 3,953). The hand was the most commonly fractured part of the body (NE = 17,400, 29.5%). All body regions, except the leg, saw increases in annual injury frequency, including record highs for head, trunk, and shoulder fractures. Adolescents (ages 13-19 years) had the highest fracture rates (56.6%) amongst age groups. Fracture hospitalization rate was 5.5% overall (NE = 3,264).

Conclusions: While the overall number of fractures amongst male ice hockey players decreased yearly until the COVID-19 pandemic, a sharp increase in fractures was observed, reaching a record high in 2022. Additionally, the hand was the most commonly fractured part of the body, and adolescents have the highest risk of fractures from ice hockey.

Objectives: The objective of this study was to evaluate the content, reliability and quality of YouTube® videos related to dynamic balance exercise training.

Methods: 'Dynamic balance exercises' was searched on YouTube in English in August 2025, and a total of 91 videos were watched. The videos were categorized based on their content features and source of upload. The reliability of the information was assessed using the modified DISCERN (mDISCERN) tool, while video quality was evaluated through the Global Quality Scale (GQS) and the JAMA benchmark criteria. Two physiotherapists with expertise in sports rehabilitation independently reviewed each video. In cases of discrepancy, a third independent evaluator provided the final judgment to ensure objectivity. (ClinicalTrials.gov Identifier NCT07117734).

Results: The findings indicate that among the 91 exercise videos focusing on dynamic balance exercises, 69 (76%) were classified as useful, while 22 (24%) contained inaccurate information. mDISCERN, GQS and JAMA scores exhibited statistically significant differences based on the source of the video (p = 0.001, p = 0.001 and p = 0.001 respectively). It was observed that videos uploaded by healthcare providers demonstrated greater quality and reliability. Additionally, the linear regression analysis revealed no significant associations between the GQS, mDISCERN, and JAMA scores and the Video Power Index (VPI). Inter-rater reliability, assessed using Cohen's kappa, showed moderate agreement for mDISCERN (0.503), GQS (0.549), and JAMA (0.528).

Conclusion: While the majority of videos were useful, a portion still contained misleading information. Commonly used metrics such as VPI and view ratio do not necessarily reflect content accuracy. Therefore, paying attention to the credentials or professional background of video creators may help users access higher-quality and more reliable content.