Predicting who responds to spinal manipulative therapy using a short-time frame methodology: Results from a 238-participant study.

BACKGROUND: Spinal manipulative therapy (SMT) is among the nonpharmacologic interventions that has been recommended in clinical guidelines for patients with low back pain, however, some patients appear to benefit substantially more from SMT than others. Several investigations have examined potential factors to modify patients' responses prior to SMT application. The objective of this study was to determine if the baseline prediction of SMT responders can be improved through the use of a restricted, non-pragmatic methodology, established variables of responder status, and newly developed physical measures observed to change with SMT. MATERIALS AND METHODS: We conducted a secondary analysis of a prior study that provided two applications of standardized SMT over a period of 1 week. After initial exploratory analysis, principal component analysis and optimal scaling analysis were used to reduce multicollinearity among predictors. A multiple logistic regression model was built using a forward Wald procedure to explore those baseline variables that could predict response status at 1-week reassessment. RESULTS: Two hundred and thirty-eight participants completed the 1-week reassessment (age 40.0± 11.8 years; 59.7% female). Response to treatment was predicted by a model containing the following 8 variables: height, gender, neck or upper back pain, pain frequency in the past 6 months, the STarT Back Tool, patients' expectations about medication and strengthening exercises, and extension status. Our model had a sensitivity of 72.2% (95% CI, 58.1-83.1), specificity of 84.2% (95% CI, 78.0-89.0), a positive likelihood ratio of 4.6 (CI, 3.2-6.7), a negative likelihood ratio of 0.3 (CI, 0.2-0.5), and area under ROC curve, 0.79. CONCLUSION: It is possible to predict response to treatment before application of SMT in low back pain patients. Our model may benefit both patients and clinicians by reducing the time needed to re-evaluate an initial trial of care.

Orthobiologics for Bone Healing.

Orthobiologics are a group of biological materials and substrates that promote bone, ligament, muscle, and tendon healing. These substances include bone autograft, bone allograft, demineralized bone matrix, bone graft substitutes, bone marrow aspirate concentrate, platelet-rich plasma, bone morphogenetic proteins, platelet-derived growth factor, parathyroid hormone, and vitamin D and calcium. Properties of orthobiologics in bone healing include osteoconduction, osteoinduction, and osteogenesis. This article discusses the important properties of orthobiologics in bone healing, many of the orthobiologics currently available for bone healing, the related literature, their current clinical uses in sports medicine, and systemic factors that inhibit bone healing.

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016).

Regenerative medicine has shown dramatic expanse and evolution in the past decade. Within that milieu, physiatrists are taking an active role in research, clinical care delivery, and education. The purpose of this review is to provide a balance among evidence, theory, experience, clinical trends, and the foreseeable future. We focus on the literature that reports the research with the best methodology in each practice area, recognizing that the level of evidence varies substantially among different treatment modalities and conditions. The following elements are included: an overview of the evolution of currently available regenerative techniques, evidence base for each available modality (prolotherapy, platelet rich plasma, bone marrow aspirate concentrate and stem cells, adipose-derived stem cells, and amniotic tissue products), general principles in the application of these treatments, and discussion and a vision of what lies ahead. We expect that practitioners will use this review to facilitate clinical decision making and to provide a core knowledge base to assist when counseling patients. LEVEL OF EVIDENCE: IV.

How far have biological therapies come in regenerative sports medicine?

INTRODUCTION: Regular engagement in sports produces many health benefits, but also exposes to increased injury risk. The quality of medical care available is crucial not only for sports trauma but also to avoid overuse syndromes and post-traumatic degenerative conditions. AREAS COVERED: We provide background information on some clinical needs in sport injuries and describe the main families of biological products used in clinical practice. We also discuss limitations of the current clinical experience. EXPERT OPINION: Sport and exercise impairment affects different segments of the population with different needs. The exceptional demands of elite athletes and subsequent media coverage have created hype around regenerative therapies. Statistical evidence, whether weak (cell products) or moderate (PRPs), is not enough to drive medical decisions because of the heterogeneity of the biological products available and their application procedures. Moreover, the specific needs of the different segments of the population along with the available clinical evidence for each musculoskeletal condition should be considered in the decision-making process. There is urgent need to develop regenerative protocols combined with post-intervention rehabilitation, and gather meaningful clinical data on the safety and efficacy of these interventions in the different populations segments.

[The application of electrolaser myostimulation and laserophoresis of biologically active compounds in sports medicine (a review)].

This scientific review highlights peculiarities of the delivery of laser radiation to the tissues of the athlete's body by means of laser electrophoresis of biologically active substances and the possibilities for electrolaser myostimulation. The main features of electrical myostimulation based on the application of laser-generated radiation are described. The authors emphasize the necessity of taking into account the neurophysiological dependence of active and passive contractile muscular activity during training. They provide the scientifically grounded rationale for the combined use of coherent laser radiation and electrical stimulation. The list of scientific papers that confirm the effectiveness of the method being considered is presented. The authors compare this method with other techniques for the induced ion transfer. The beneficial influence of laserphoresis of succinic and hyaluronic acids on the athlete's body is reported with special reference to alleviating the pain syndrome. A number of phyto-extracts used for the purpose of laser electrophoresis are characterized. The authors demonstrate the application of the optional versions of this technique in various sports during the training and competition periods.

Kinesiotaping. Evidencia actual / Kinesiotaping. Current evidence

En este artículo se revisa la función y el uso de los vendajes tipo Kinesiotaping en la medicina deportiva actual y la Ortopedia. Se estudian las diferentes lesiones dentro de la medicina del deporte en la cual se pueden usar y la evidencia clínica existente. Esta revisión concluye que la utilidad del kinesiotaping es confusa. La literatura no aporta evidencia clínica probada sobre el uso de este vendaje e incluso podría intuirse un fin mercantilista en su uso

This paper reviews the function and use of Kinesiotaping in today’s Sports Medicine and Orthopedics. The different sports medicine injuries in which could be used and the current clinical evidence are reviewed. This review concludes the utility of Kinesiotaping is not clear. Literature shows lack of proved clinical evidence about the use of this bandage and even a mercantilist purpose could be suspected

The Impact of Sports Cardiology on the Practice of Primary Care Sports Medicine: Where Were We, Where Are We, Where Are We Headed?

This article is a commentary on the role of sports cardiologists in the athletic arena and the beneficial impact they offer sports medicine in the comprehensive care of competitive athletes. The focus is a dialogue on current recommendations for primary prevention of sudden cardiac arrest (SCA), incorporating elements of the preparticipation evaluation and continuing care of athletes with diagnosed heart disease (HD). The feasibility and potential advantages of implementing well-designed preparticipation cardiovascular screening programs and the role of sports cardiologists to educate primary care team physicians on secondary prevention of SCA and proper treatment of underlying HD are discussed.

Video Q&A: state-of-the-art therapy for the elite and non-elite athlete: an interview with Mike Carmont.

In this video Q&A, Mr Mike Carmont answers questions about state-of-the-art treatments for elite athletes, and the progress and challenges behind translating these into successful therapies for the non-elite athlete.

Internal social processes of discipline formation: the case of kinanthropometry.

In 1972, the term 'kinanthropometry', derived from the Greek words 'kinein' (to move), 'anthropos' (human) and 'metrein' (to measure), was launched in the international, Francophone journal Kinanthropologie by the Canadian William Ross and the Belgians, Marcel Hebbelinck, Bart Van Gheluwe and Marie-Louise Lemmens. The authors defined this neologism as 'the scientific discipline for the study of the size, shape, proportion, scope and composition of the human being and its gross motor functions'. Presenting a theoretical framework for the analysis of the internal social processes of discipline formation - derived from the social history-of-science tradition - this article critically examines whether kinanthropometry was indeed promoted and developed by its community members as a scientific discipline. Therefore, the focus will be on its conceptualisation and positioning within the field of kinanthropology/kinesiology and on its development by a scholarly association, i.e. the International Working Group on Kinanthropometry (IWGK). The strong emphasis of the kinanthropometry community on the standardisation of measurement techniques and its practical and professional application hampered its disciplinary development. Findings of this study could serve as a basis for future 'fundamental' investigations addressing questions of disciplinary development within the field(s) of physical education, kinesiology and sport science(s).

Sport-specific biomechanics of spinal injuries in aesthetic athletes (dancers, gymnasts, and figure skaters).

Young aesthetic athletes require special understanding of the athletic biomechanical demands peculiar to each sport. The performance of these activities may impart specific biomechanical stresses and subsequent injury patterns. The clinician must understand these aspects as well as the spinal changes that occur with growth when many of these injuries often occur. Further, athletes, parents, coaches, and healthcare providers must be sensitive to the overall aspects of the athlete, including nutrition, overtraining, adequate recovery, proper technique, and limiting repetition of difficult maneuvers to minimize injuries.

Is part of the mystery surrounding fatigue complicated by context?

Historically, research into possible causes of exercise-induced fatigue has been found to span numerous scientific disciplines, including medicine, psychology, physiology, neurophysiology, biochemistry, biomechanics, and physics. In order to better understand the mechanisms responsible for fatigue, these disciplines have viewed various aspects of fatigue, including the involvement of physiological, physical, biomechanical, and/or psychological factors. This has resulted in a diverse array of interpretations of the term 'fatigue' among the scientific disciplines. For instance, the word 'fatigue' has been used to define a sensation of tiredness, a physical reduction in force, or the failure of a specific physiological system to maintain homeostatic integrity. As sports scientists begin to take on a holistic approach to understanding fatigue, it seems necessary that the 'context' should be highlighted when using the term and questioning the mystery behind it.

Pharmacologic agents in fracture healing.

Bone fractures are a known risk of athletic participation and can result in significant lost playing time. A variety of medications have been investigated in animal studies regarding their effects on fracture healing. Parathyroid hormone and the bisphosphonates may have future uses in the prevention and treatment of athletic-related stress fractures and acute fractures. Nonsteroidal anti-inflammatory drugs have been implicated in effecting fracture healing in some animal models, but little clinical evidence supports these findings. Large randomized clinical trials are needed to further delineate the role of these and other drugs and their effects on fracture healing.

The future of the application of the Bi-Digital O-Ring Test in Sports Psychology.

The Bi-Digital O-Ring Test, originally developed by Dr. Omura, utilizes changes in the degree of strength of voluntary movements of muscles of the fingers under a definite muscle tonus, making Bi-Digital O-Rings, as an indicator of pathology in the body. Research in Sports Psychology can use the classical measurement methods and Bi-Digital O-Ring Test method comparatively and thus produce new findings regarding the reliability and certainty of the Bi-Digital O-Ring Test test. It seems probable that by using the non-invasive Bi-Digital O-Ring Test test, it is possible to measure enzymes, hormones and neuro-transmitters instantaneously and assess a sports person's actual psychological and physiological performance, and thereby help them reach their peak performance levels during both exercise and competitions.

Influencia del fútbol en la frecuentación de los servicios de urgencias traumatológicas / Influence of soccer on attendance to traumatological emergency services

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À quoi peut servir le Ginseng chez le sportif? / What is the use of Ginseng among sports?

Longtemps précédé d'une flatteuse réputation, mais desservi par la pauvreté des rares arguments expérimentaux semblant confirmr la réalité de ses effets positifs "mythiques", le ginseng fait l'objet d'un récent regain d'intérêt dans le milieu sportif. S'agit-il d'un effet de mode ou d'une avancée réelle? (AU)