Physician and Sportsmedicine最新文献

Objectives: The cardiac morphology of elite athletes is related to sports disciplines and race; however, no studies have examined the effects of sports discipline on East Asian athletes. Therefore, this study aimed to assess left ventricular (LV) remodeling using transthoracic echocardiography in elite Japanese athletes and establish standard values for the indicators of the cardiac morphology of elite athletes in East Asia, considering the influence of body size.

Methods: We retrospectively evaluated 1,363 elite Japanese athletes who underwent electrocardiography and transthoracic echocardiography between January 2011 and December 2021. The athletes were assigned to four sports discipline categories (skill, power, mixed, and endurance). We evaluated the differences in LV volume and mass between the groups for each sex.

Results: The LV end-diastolic volume (LVEDV) and LV mass indexed to the body surface area (BSA) in the endurance group (LVEDV/BSA: 72.3 ± 11.4 mL/m² in males and 68.7 ± 11.0 mL/m² in females, LV mass/BSA: 121.1 ± 19.1 g/m² in males and 106.5 ± 18.0 g/m² in females) were significantly larger than those of any other groups. Both values were affected by sex, BSA, and endurance sport type, whereas only LV mass was affected by age.

Conclusion: Cardiac remodeling is proportional to the sport type, with a significantly greater effect in athletes playing endurance sports. The remodeling is particularly evident in the left ventricle; however, the corresponding remodeling is also observed in other heart chambers. Cardiac remodeling in elite Japanese athletes is similar to that observed in elite athletes of other races, except for the changes in LV wall thickness.

Objectives: Over one-third of icehockey injuries involve the lower extremity (LE). The purpose of this study was to describe epidemiology and mechanism of injury of men's icehockey-related lower extremity injuries treated in US emergency departments from 2013 to 2022.

Methods: The National Electronic Injury Surveillance System (NEISS) database was retrospectively queried for LE injuries related to men's ice hockey (product code 1279) from 2013 to 2022. Demographics, injury characteristics, and disposition were recorded. Injury mechanism was summarized from the supplied narrative. National estimates (NE) were calculated using the provided NEISS sample weight. Linear regression was used to evaluate injurytrends.

Results: There were 832 cases (NE: 27469) of LE injuries in male ice hockey players from 2013-2022. Linear regression demonstrated increasing LE injuries in the post-COVID period (after the year 2020). The knee (34.7%, NE: 9,533) and ankle (29.4%, NE: 8,089) were most commonly injured. The most frequent injuries for the ankle (35.8%) and knee (30.5%) were strains/sprains. Skating sprains (15.1%, NE: 4,157) and slip and/or falls (14.2%, NE: 3,898) were the most common primary mechanisms of injury. Slip and/or falls (40.8%) and collisions with another player (23.9%) were most common secondarymechanisms of injury.  Slip and/or falls, collisions with another player,and checking commonly injured the knee. There were no significant changes in ininjury incidence at any anatomical location or primary mechanism of injury overthe study period.

Conclusion: The knee and ankle were the most common location of lower extremityinjuries in male ice hockey players between 2013-2022. The knee was vulnerable to a variety of primary mechanisms ofinjury, including checking, collisions with other players, and slip and/or falls. Despite implementation of urgent orthopedic carecenters, allowance of additional foot protection, and facility improvements, the rate of post-COVID LE injuries have been increasing.

Objectives: American football continues to be a popular and rapidly growing sport among both males and females, with relatively little research concerning injuries for the latter - especially in the youth population. The current study aims to evaluate the differences in the epidemiology of injured body parts and injury diagnoses between youth male and female American football players.

Methods: Injury data for male and female American football players were collected over a 10- year period from the National Electronic Injury Surveillance System (NEISS) and retrospectively reviewed. Patients between ages 4 and 18 years with a medical injury/condition related to American football were included. Descriptive analyses were performed for all data including injured body parts, injury diagnoses and setting, demographics, and medical disposition. Odds ratio (OR), 95% CI, and p-values (p < 0.05) were used for the statistical significance between the two groups.

Results: A total of 82,174 American football injuries were found in the NEISS dataset, 95.0% of which were male with a mean age of 13.0 ± 2.9 years. The most injured body parts were the head (17.7%), finger (13.8%), knee (9.2%), shoulder (8.7%), and ankle (8.0%). The most prevalent injury diagnoses were fractures (24.5%), sprains/strains (22.7%), contusions/bruises (12.2%), concussions (9.8%), and internal injuries (7.1%). Males were more likely to suffer head (OR = 1.32, p < 0.001), knee (OR = 1.23, p < 0.001) and shoulder (OR = 2.19, p < 0.001) injuries and females suffered more finger (OR = 3.22, p < 0.001) and ankle (OR = 1.25, p < 0.001) injuries. Males were more likely to suffer concussions (OR = 1.50, p < 0.001) whereas females sustained more sprains/strains (OR = 1.32, p < 0.001).

Conclusion: Youth male American football players had a greater likelihood of sustaining concussions and head, knee, and shoulder injuries, whereas females were more likely to have sprains/strains, finger, and ankle injuries. Future studies are warranted to further explore how these differences may be attributed to play style and sex-based physiologic and development differences.

Objectives: B Mixed martial arts (MMA) brings various forms of martial arts disciplines together as a unified sport. Sportive 'choking,' also known as vascular neck compression, vascular neck restraint (VNR), or carotid restraints are utilized in MMA to apply jugular and carotid compression and subdue one's opponent. Few studies have explored the long-term consequences of VNRs, as well as the underlying pathophysiology and hemodynamics of the restraint. A narrative review was conducted in order to explore the long-term consequences of VNRs, as well as the underlying pathophysiology and hemodynamics of the restraint.

Methods: Medical literature published prior to 2025 was identified utilizing MEDLINE/PubMed and the Cochrane Library. Initial search terms included mixed martial arts, injuries, neck chokes, carotid restraints, and vascular neck restraints. Articles were then subcategorized into pathophysiology, safety profile, and medical complications of VNRs. A total of 25 research articles were included in the final manuscript.

Results: Mixed Martial Arts is the fastest-growing sport within the United States, especially among the adolescent population. The head and neck region is the most commonly injured territory, with neck chokes comprising 14.1% of reported match stoppages. The pathophysiology of VNR-induced unconsciousness is misunderstood by many. The likely pathophysiologic endpoint is cerebral hypoxia due to reduced cerebral perfusion pressure, primarily from compression of the jugular veins and carotid arteries and, rarely, from carotid sinus baroreceptor compression. In addition, few studies exist regarding the long-term consequences of VNRs. The current literature appears to demonstrate an acceptable safety profile when the VNR is performed properly.

Conclusion: Further studies are needed to explore the underlying pathophysiology of VNR-induced unconsciousness, as well as the long-term consequences of VNR in order to guide the establishment of MMA fighter safety profiles and health-care professional management guidelines.

Objectives: This study aimed to compare the psychological demands and external workload experienced in the seven sessions leading up to injuries and the demands in the month preceding the injury week among professional Brazilian soccer players.

Methods: Initially, 33 players participated, but only 15 were included in the analysis due to the occurrence of 23 muscle-tendon injuries recorded according to International Olympic Committee (IOC) guidelines. The study assessed muscle-tendon injuries, rate of perceived exertion (RPE), and psychological variables (i.e. mental load, motivation, and mental fatigue) using specific questionnaires, while weekly accumulated workload (i.e. total distance, high-speed running distance, sprint running distance, number of sprints, and actions accelerating and decelerating) was recorded using Global Position System devices.

Results: The results indicated that players experienced higher external loads, particularly in high-intensity running variables, along with increased mental load and mental fatigue during the match prior to injury occurrence (p < 0.05).

Conclusion: These findings highlight the significance of carefully monitoring both external and psychological demands during competition, which is essential for developing effective recovery strategies and modulate the subsequent microcycle training loads in order to reduce the risk of suffer a muscle-tendon injury.

Objectives: The aim of the present study was to verify the association between non-modifiable (age categories, sex and race/ethnicity) and modifiable (sport modality, socioeconomic, training load, sleep, and eating disorder) factors with anxiety and depressive symptoms in young athletes.

Methods: The sample was composed of 168 athletes engaged in national competitions from individual sports [swimming (n = 26) and badminton (n = 53)] and team sports [soccer (n = 28) and handball (n = 61)]. The coaches monitored the training load throughout the training week, and athletes completed self-reported questionnaires to assess sociodemographic data, sleep quality, eating disorders, and symptoms of anxiety and depression on the recovery day after a full week of pre-season training.

Results: The prevalence of anxiety and depressive symptoms in young athletes were 14.3% and 25.6%, respectively, and female athletes presented higher rates of anxiety symptoms than males (30.8% vs. 11.3%; p = 0.015). Athletes from individual sports and athletes with 18 years or older showed higher depressive symptoms than younger (32.3% vs. 17.3%; p = 0.021). Athletes from the minority group showed higher depressive symptoms compared to the dominant group (41.9% vs. 20%; p = 0.005). The quality of sleep also influenced both anxiety (β = 5.430 [95%CI: 1.896 to 15.553]) and depressive symptoms (β = 5.292 [95%CI: 2.211 to 12.664)] in young athletes.

Conclusion: In short, non-modifiable factors, such as sex and age categories, should be considered when anxiety and depressive symptoms are examined in young athletes. Modifiable factors such as sports modality and sleep quality impact depressive symptoms in this population.

Objectives: Medial tibial stress syndrome (MTSS) is an overuse injury characterized by pain along the posteromedial tibial border. This region contains several soft tissues, including adipose tissue and the tibialis posterior and flexor digitorum longus tendons. However, few studies have investigated whether these tissues exhibit abnormalities in MTSS. This study aimed to use MRI to evaluate abnormalities in the bone marrow or soft tissues of patients with MTSS and those with a history of medial tibial pain.

Methods: Eighteen patients with MTSS, 20 uninjured athletes, and 17 individuals with a history of medial tibial pain underwent T1-weighted, T2-weighted, and short T1 inversion recovery imaging. The presence of bone marrow, periosteal, and peritendinous edema and abnormalities in the adipose tissue along the posteromedial tibial border were evaluated. Fisher's exact test was applied to determine the relationship between abnormalities and clinical status.

Results: Patients with MTSS exhibited abnormalities in the adipose tissue (27.3%), peritendinous edema (22.7%), bone marrow edema (22.7%), and periosteal edema (59.1%). However, the incidence of these abnormalities showed no statistically significant differences between the three groups. Athletes showed abnormalities in the bone marrow, periosteum or soft tissues, regardless of their clinical status.

Conclusion: Various tissues, including the adipose tissue and peritendon along the posteromedial tibial border, may contribute to MTSS, highlighting its complex pathology. Imaging assessments are important for diagnosing MTSS and should complement physical examination and evaluation of the patient's history.

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.

Objective: To evaluate if peer relationship ratings differ among adolescents who sustain a sport-related concussion compared to those who sustain a non-sport-related concussion.

Study design: We conducted a cross-sectional investigation of 123 adolescents who sustained a concussion within 21 days before their initial post-injury evaluation (mean = 9.2 ± 3.9 days post-concussion). Participants reported whether their injury occurred during organized sport participation (sport-related concussion group) or not (non-sport-related concussion group). Participants completed the PROMIS Global Pediatric 25 assessment, as well as the Post-Concussion Symptom Inventory (PCSI) to rate concussion symptom severity and a background/demographic intake form during the evaluation. We compared PROMIS peer relationship ratings between groups using independent t-tests and evaluated the association between peer relationship ratings and sport-related concussion using multiple linear regression after adjusting for covariates including PROMIS anxiety rating, age, sex, concussion and musculoskeletal injury history, loss of consciousness at time of concussion, physical activity participation prior to study evaluation, and concussion symptom severity.

Results: Most (N = 96, 78%) participants reported sustaining a concussion during sports. The group who sustained sport-related concussion reported significantly better post-concussion peer relationship ratings compared to the group who sustained a non-sport-related concussion (52.7 ± 7.7 vs. 47.7 ± 10.4; p = 0.009, Cohen's d = 0.60). After covariate adjustment, those who sustained a sport-related concussion had a significantly greater post-concussion peer relationship rating than those who sustained a non-sport-related concussion (β = 4.19, 95% CI = 0.39, 8.00; p = 0.03). Higher peer relationship ratings were also associated with lower anxiety ratings following concussion (β= -0.21, 95% CI= -0.38, -0.04; p = 0.03).

Conclusion: Adolescents who sustained a concussion during sports reported significantly greater post-concussion peer relationship ratings than those in non-sport settings. Better peer relationship ratings were associated with less anxiety in the post-injury period. These findings suggest the potential effects of contextual factors (e.g. peer support) to facilitate improved outcomes following adolescent concussion.

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.