A comparative study of the effectiveness of an osteopathic primary care sports medicine led intervention on performance in men's collegiate lacrosse players.

CONTEXT: Comprehensive sports medicine care goes beyond the treatment of injuries resulting from athletic activities. Ultimately, it is a competence that includes knowledge in physical therapy, training, nutrition, coaching, motivation, competition, mentoring, psychology, and spirituality that allows the physician and patient to collaborate on promoting the patient's health goals. The current literature demonstrates a lack of knowledge in the Osteopathic Primary Care Sports Medicine Model's effectiveness in performance. OBJECTIVES: To determine whether a comprehensive osteopathic primary care sports medicine approach can improve performance and health outcomes in collegiate athletes. METHODS: A randomized controlled trial commenced just prior to the start of the lacrosse season and concluded at the end of the season. All the New York Institute of Technology (NYIT) collegiate lacrosse players were educated first in a 1-day seminar of the core competencies, and all participants had access to ask questions on their own volition. Then they were randomized into two groups, either the experimental group receiving the direct osteopathic primary care sports medicine intervention (n=18) or the control group not having active intervention (n=19). Also, the overall team winning percentage for that season was computed and compared to that for the previous years and the following year. Participants were assessed before and after the intervention with the Patient Health Questionnaire (PHQ-9), the 36-Item Short Form Survey (SF-36), custom Osteopathic Primary Care Sports Medicine questionnaire, and body fat composition, and their changes were compared between the experimental group and the control group. Collected data were analyzed using the repeated-measures analysis of variance. RESULTS: Thirty-seven participants were enrolled in the study. After 14 participants were excluded due to being lost to follow-up, 23 athlete records were analyzed. The winning percentage of the team was highest during the year of the study period time than in the 3 previous years and the following year. The test group did not have any statistically significant change in the PHQ-9, SF-36, custom Osteopathic Primary Care Sports Medicine questionnaire, as well as in body fat composition. CONCLUSIONS: When used during a collegiate lacrosse season, this Osteopathic Primary Care Sports Medicine intervention did not significantly improve health outcomes. This preliminary study, despite its limitations in compliance and study population size, did demonstrate improvement in overall team performance when comparing the intervention sport season to other seasons but was not statistically significantly. Therefore, further studies are warranted to improve the understanding in this approach to athlete health outcomes and performance.

CSF and Blood Neurofilament Levels in Athletes Participating in Physical Contact Sports: A Systematic Review.

OBJECTIVE: To evaluate whether participating in physical contact sports is associated with a release of neurofilaments and whether such release is related to future clinical neurologic and/or psychiatric impairment. METHODS: We performed a systematic review of the PubMed, MEDLINE, and Cochrane Library databases using a combination of the search terms neurofilament(s)/intermediate filament and sport(s)/athletes. Original studies, written in English, reporting on neurofilaments in CSF and/or serum/plasma of contact sport athletes were included. This review was conducted following the Preferred Reporting Items for Systematic Review and Analyses guidelines. RESULTS: Eighteen studies in 8 different contact sports (i.e., boxing, American football, ice hockey, soccer, mixed martial arts, lacrosse, rugby, and wrestling) matched our criteria. Elevated light chain neurofilament (NfL) levels were described in 13/18 cohorts. Most compelling evidence was present in boxing and American football, where exposure-related increases were appreciable at the intraindividual level (up to 4.1- and 2.0-fold, respectively) in well-defined groups. Differences in exposure severity (including previous cumulative effects), sampling/measurement time points (with regard to expected peak values), and definitions of the baseline setting are considered as main contributors to the variability in findings. No studies were encountered that have investigated the relationship with the targeted clinical end points; therefore no NfL cutoffs exist that are associated with a poor outcome. CONCLUSION: NfL release can be seen, as a potential marker of neuronal brain damage, in participants of physical contact sports, particularly boxing and American football. The exact significance regarding the risk for future clinical impairment remains to be elucidated.

Efectos de la estimulación interfibrilar contrairritante musculoesquelética en epicondilalgias de jugadores de pádel amateurs. Estudio piloto / Effects of the musculoskeletal interfibrillar counterirritattion stimulation technique on amateur paddle-tennis players’ epicondylalgia. Pilot study

Objetivo: Analizar la eficacia de la técnica de estimulación interfibrilar contrairritante musculoesquelética en jugadores de deportes de raqueta con epicondilalgia y puntos gatillo miofasciales (PGM) activos. Material y métodos: Se trata de un estudio piloto diseñado como ensayo clínico (prospectivo) aleatorizado a doble ciego. Se contó con jugadores de pala o raqueta que cumplían los siguientes criterios de inclusión: tener una edad comprendida entre 18 y 60 años (ambos incluidos), tener dolor en la zona del epicóndilo lateral y tener un PGM activo central en la musculatura epicondílea. La muestra fue de 68 sujetos, de los cuales 61 completaron el estudio; 30 del grupo intervención (aplicación de la técnica) y 31 del grupo control (aplicación de un vendaje simple). La variable principal fue la algometría (umbral de dolor a la presión sobre el PGM) y las secundarias fueron la escala analógica visual (EVA 0-10) y el Patient-Rated Tennis Elbow Evaluation. Resultados: Los valores de algometría y los valores de EVA muestran que hubo una disminución del dolor en ambos grupos, aunque sin diferencias estadísticamente significativas entre ellos. La comparación de los porcentajes iniciales y finales EVA≥4 tampoco muestra diferencias entre grupos, pero la comparación antes/después de ambos grupos es estadísticamente significativa (p<0,05). Conclusiones: La técnica de estimulación interfibrilar contrairritante musculoesquelética, aplicada en PGM centrales de la musculatura epicondílea en sujetos con epicondilalgia que practican deportes de raqueta/pala, no parece ser más efectiva que la aplicación de un vendaje simple sobre la zona

Objective: To analyse the effectiveness of the musculoskeletal interfibrillar counterirritattion stimulation technique (MICS) in racquet sports players with epicondylalgia and active myofascial trigger points (MTrPs). Material and methods: This is a pilot study designed as double-blind randomized clinical trial (prospective). It featured paddle or racquet sport players who met the following inclusion criteria: to be aged between 18 and 60 (inclusive), to have pain in the lateral epicondyle and to have a central active MTrP in the epicondylar musculature. The sample consisted of 68 subjects, of whom 61 completed the study; divided into 30 for the Intervention group (technique application) and 31 for the Control group (simple bandage). The primary variable was algometry (pain threshold to pressure on the MTrPs) and secondary variables were the VAS (visual analogue scale, 0-10) and the Patient-Rated Tennis Elbow Evaluation. Results: Algometry values and VAS values show that there was a decrease in pain in both groups, but no statistically significant differences between them. The comparison of the initial and final percentages VAS≥4 also do not show differences between groups, but improvement of both groups is statistically significant (P<.05). Conclusions: The musculoskeletal interfibrillar counterirritattion stimulation technique applied in the central MTrPs of epicondylar muscles in subjects with epicondylalgia who play racquet sports/paddle does not seem to be more effective than the application of a simple bandage over the area

Athletics, minor trauma, and pediatric arterial ischemic stroke.

Pediatric arterial ischemic stroke may occur as the result of trivial head or neck trauma sustained during a sports activity. We describe three cases of sports-related stroke in previously healthy school-age children and discuss acute and long-term stroke care. Possible mechanisms of sports-related stroke are addressed, as is evaluation for cause of stroke in children. In one of the reported cases, the child was found to have a vertebral artery dissection as the cause of his stroke, but no definitive cause of stroke was identified in the other two cases despite extensive evaluation. The advisability and timing of returning to athletic activities after stroke is also discussed. Many children with sports-related stroke are initially seen by a sports trainer, a pediatrician, or an ER physician. Thus, it is particularly important that these professionals are aware of the possibility of ischemic stroke occurring after even mild athletic injury. Childhood stroke may result from injuries sustained during athletic activities and should be considered when a child has acute focal neurologic signs.

Dental trauma incidence and mouthguard use in elite athletes in Turkey.

Contact sports may lead to dental trauma, which often can be reduced with appropriate preventive measures. While numerous studies exist on this topic for several countries throughout the world, there is a lack of comprehensive descriptive studies in Turkey. The purpose of this study was to investigate the incidence and type of dental injuries associated with three different sports among Turkish elite athletes, who do not contact (volleyball), contact directly (taekwondo) or indirectly (handball) with competition rivals. Additionally, awareness and use of mouthguards were also compared. Thus, during the 2003 and 2004 Turkish National Championships in three sports, 50 taekwondo, 62 handball and 50 volleyball male athletes were interviewed by questionnaire. Results showed that taekwondo and handball athletes experienced significantly more dental trauma than volleyball athletes (P < 0.05). Twelve of the taekwondo (24%), 16 of the handball (26%) and four of the volleyball athletes (8%) experienced at least one type of dental injury. Awareness of mouthguards as a preventive measure against dental trauma was significantly higher among taekwondo and handball athletes (P < 0.05), although a very small percentage in either of these sports actually wore a mouthguard (10 and 0%, respectively). Trauma incidence between direct contact with rival competitors and indirect contact with rival competitors was not significantly different. The incidence of dental trauma in contact sports shows that the awareness and use of mouthguards must be intensified. Mouthguard use should be made compulsory, especially in those sports with high risk for dental trauma.

Shoulder impingement in tennis/racquetball players treated with subscapularis myofascial treatments.

Conservative care of the athlete with shoulder impingement includes activity modification, application of ice, nonsteroidal anti-inflammatory drugs, subacromial corticosteroid injections, and physiotherapy. This case report describes the clinical treatment and outcome of three patients with shoulder impingement syndrome who did not respond to traditional treatment. Two of the three were previously referred for arthroscopic surgery. All three were treated with subscapularis trigger point dry needling and therapeutic stretching. They responded to treatment and had returned to painless function at follow-up 2 years later.

Sports-specific injuries.

Injuries to the upper extremities can happen in any sport. Injury patterns are common to specific sports. Understanding which injuries occur with these sports allows the examiner to diagnose and treat the athlete easily. This article reviews some of the injuries common in sports such as bicycling, golf, gymnastics, martial arts, racquet sports, and weightlifting.