Sports Health-A Multidisciplinary Approach最新文献

Background: After a concussion, there are unique associations between static balance and landing with cognition. Previous research has explored these unique correlations, but the factor of time, dual-task, and different motor tasks leave gaps within the literature. The purpose of this study was to determine the associations between cognition and tandem gait performance.

Hypothesis: We hypothesized that athletes with a concussion history would display stronger associations compared with athletes without a concussion history between cognition and tandem gait.

Study design: Cross-sectional.

Level of evidence: Level 3.

Methods: A total of 126 athletes without (56.3% female; age, 18.8 ± 1.3 years; height, 176.7 ± 12.3 cm; mass, 74.8 ± 19.0 kg) and 42 athletes with (40.5% female; age, 18.8 ± 1.3 years; height, 179.3 ± 11.9 cm; mass, 81.0 ± 25.1 kg) concussion history participated. Cognitive performance was assessed with CNS Vital Signs. Tandem gait was performed on a 3-meter walkway. Dual-task tandem gait included a concurrent cognitive task of serial subtraction, reciting months backward, or spelling words backward.

Results: Athletes with a concussion history exhibited a larger number of significant correlations compared with athletes without a concussion history for cognition and dual-task gait time (4 significant correlations: rho-range, -0.377 to 0.358 vs 2 significant correlations: rho, -0.233 to 0.179) and dual-task cost gait time (4 correlations: rho range, -0.344 to 0.392 vs 1 correlation: rho, -0.315). The time between concussion and testing did significantly moderate any associations (P = 0.11-0.63). Athletes with a concussion history displayed better dual-task cost response rate (P = 0.01). There were no other group differences for any cognitive (P = 0.13-0.97) or tandem gait (P = 0.20-0.92) outcomes.

Conclusion: Athletes with a concussion history display unique correlations between tandem gait and cognition. These correlations are unaffected by the time since concussion.

Clinical relevance: These unique correlations may represent shared neural resources between cognition and movement that are only present for athletes with a concussion history. Time does not influence these outcomes, indicating the moderating effect of concussion on the correlations persists long-term after the initial injury.

Background: Ice hockey players are at high risk for hip and groin injury. Several risk factors have been identified or proposed, including lower hip rotation range of motion (ROM), lower hip adductor strength, lower ratio of hip adductor to abductor strength, and lower pelvic tilt angle. It is not known how these risk factors change acutely with ice hockey participation.

Hypothesis: Acute exposure to ice hockey will result in a reduction in ROM, strength, and pelvic tilt angle in competitive male players.

Study design: Controlled cohort study.

Level of evidence: Level 3.

Methods: Risk factors for hip and groin injury, including isometric hip adductor strength at 0° of flexion, the ratio of hip adductor to abductor strength, total hip rotation passive ROM in supine, and the resting pelvic tilt angle, were assessed immediately before, immediately after, and 24 hours after an ice hockey exposure in 42 competitive male ice hockey players. Rating of perceived exertion (RPE) was collected to identify the intensity of the exposure.

Results: There was a significant decrease in total hip rotation ROM (-7.32°, P < 0.01 (-3.91, -10.70)) and hip adductor strength (-4.41 kg, P < 0.01 (-2.81, -6.00) immediately after the exposure, and a significant decrease in total hip rotation ROM (-18.54°, P < 0.01 (-14.35, -22.73)), hip adductor strength (-6.56 kg, P < 0.01 (-4.58, -8.61)), and the ratio of hip adductor to abductor strength (-0.12, P < 0.01 (-0.21, -0.45)) 24 hours after. There was no significant change in pelvic tilt found in this study immediately after or 24 hours after. There was a moderate relationship between changes in hip adductor strength and changes in the ratio of hip adductor to abductor strength (r = 0.433, P < 0.01). RPE was not significantly correlated to any of the changes observed.

Conclusion: Risk factors for hip and groin injury in ice hockey players are modifiable after a single ice hockey exposure.

Clinical relevance: The identified fluctuation of injury risk factors for hip and groin injury in ice hockey players has implications for injury risk profiling, rehabilitation, and return-to-competition decision-making.

Background: Force-velocity (F-V) relationship models gained popularity as a tool for muscle mechanical assessment. However, it is not clear whether the validity of the F-V relationship parameters (maximal theoretical force [F₀], velocity [V₀] and power [P_max]) is affected using different load types: gravitational (W, rubber bands pulling the barbell downward), inertial (I, rubber bands pulling the barbell, which is equalized to the weight of the added plates upward), and combined (W + I, weight of the plates).

Hypothesis: Load type would affect both the magnitude and validity of F-V relationship parameters. The highest magnitude and validity was expected for F₀ using a W, for V₀ using an I, and for P_max using a W + I load.

Study design: Cross-sectional.

Level of evidence: Level 3.

Methods: A total of 13 resistance-trained men (body mass, 87.7 ± 11.2 kg and body height, 183.9 ± 6.4 cm) performed bench press (BP) throws (BPTs) using 3 types of loads against 30 to 80 kg. The validity of F-V relationship parameters was explored with respect to the tests used traditionally for force (maximal voluntary contraction and 1-repetition maximum [1RM]), velocity (maximal velocity achieved during almost unloaded tasks), and power (BPT against the 50%1RM and medicine ball throws) assessment.

Results: The W + I loading promoted the highest values of F₀ and P_max, while the highest magnitude of V₀ was promoted by the I loading. The validity was acceptable for F₀ obtained using the 3 loading conditions with respect to the BP 1RM (r range, 0.30-0.83), and V₀ obtained using the I loading with respect to the stick throw (r = 0.54).

Conclusion: The magnitude of the F-V relationship parameters is affected by load type, but their validity with respect to standardized tests is comparable, with the exception of the higher validity of V₀ when obtained using the I loading.

Clinical relevance: Any load type can be used for assessing F₀, while I load should be selected when assessing V₀.

Background: Fundamental movement skills (FMS) are critical components to lifelong participation in sports and physical activity. With the rise in early sports specialization, mastery of motor skills may be limited in youth athletes. The purpose of this study was to assess FMS proficiency in highly active middle school athletes and determine whether proficiency differed between specialization levels and sex.

Hypothesis: (1) Most athletes would fail to achieve proficiency in all domains of the Test of Gross Motor Development (TGMD-2), (2) highly specialized athletes would demonstrate lower proficiency in all domains of the TGMD-2, and (3) male athletes would demonstrate higher proficiency than female athletes.

Study design: Cross-sectional.

Level of evidence: Level 4.

Methods: A total of 91 athletes were recruited (44 male, 12.6 ± 0.9 years). Activity level was quantified using the Hospital for Special Surgery (HSS) Pediatric Functional Activity Brief Scale (Pedi-FABS), specialization level was determined using the Jayanthi Specialization Scale, and the TGMD-2 was used to assess FMS proficiency. Descriptive statistics were used to describe gross motor, locomotor, and object control percentile rank. A 1-way analysis of variance (ANOVA) was used to assess differences in percentile rank between low, moderate, and high specialization groups and independent samples t tests were used to compare sexes (α < 0.05).

Results: Mean Pedi-FABS score was 23.6 ± 4.9. In total, 24.2%, 38.5%, and 37.4% of athletes classified as low, moderate, and highly specialized, respectively. Mean percentile ranks were 56.2%, 64.7%, and 62.6% for locomotor, object control, and gross motor domains, respectively. No athlete achieved a percentile rank >99% in any domain of the TGMD-2, and there was no significant difference between specialization groups or sex.

Conclusion: Despite high activity levels, no athlete demonstrated proficiency in any domain of the TGMD-2, and there was no difference in proficiency between specialization levels or by sex.

Clinical relevance: Sport participation, regardless of level, does not ensure adequate mastery of FMS.

Background: Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people.

Hypotheses: Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health.

Study design: Cross-sectional.

Level of evidence: Level 3.

Methods: A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score.

Results: sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P > 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04).

Conclusion: Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level.

Clinical relevance: These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain.

Background: A decrease in sport-related injuries was observed in 2020, which has been attributed to COVID-19 and recommendations to suspend organized sports. In adult populations, increased injury rates have been noted in athletes returning to play after an extended period of reduced play, attributable to deconditioning. There is growing literature surrounding concern over increased injury risk after return to sport after the COVID-19 shutdowns.

Hypothesis: Like adults, pediatric patients experience an increase in sport-related injuries after periods of "deconditioning," such as during the COVID-19 shutdown.

Study design: Descriptive epidemiology study.

Level of evidence: Level 4.

Methods: The Consumer Product Safety Commission's National Electronic Injury Surveillance System database was queried to identify 13- to 18-year-old patients who sustained a sprain/strain type injury in 2019 or 2021 to an extremity, and involved sporting equipment for basketball, baseball/softball, soccer, and football. The control group was established as patients who sustained injury in 2019, and the post-COVID-19 group was established as those in 2021. Quantity of injuries sustained in these 2 groups were compared and analyzed by subgroup.

Results: There was a significant difference in the total number of sport-related sprains/strains in 2019 versus 2021 (P = 0.01), with more injuries in 2019 (n = 151,067) than in 2021 (n = 104,041). There were more injuries in boys than in girls. Proportion of injuries by sports were similar in both time periods. There was a significant decrease in basketball-related injuries by 21% (P ≤ 0.01, relative risk ratio [rrr] = 0.7979) and a significant increase in football-related injuries by 14% (P = 0.01, rrr = 1.1404) and in soccer injuries by 14.2% (P = 0.03, rrr = 1.1422).

Conclusion: There is significant heterogeneity in injury rates by sports, with no conclusive increase in injuries, contrary to expectations.

Clinical relevance: This study suggests that the relationship between deconditioning and injury may be less clear in the child-athlete, and gives recommendations for return to sport after extended breaks.

Strength-of-recommendation taxonomy (sort): Level 2c.