The Effectiveness of Hyperbaric Oxygen Therapy as a Treatment for Postconcussion Symptoms.

Clinical Scenario: Concussions are a prevalent topic in medicine. Concussion symptoms include headaches, dizziness, nausea, neuropsychiatric symptoms, and cognitive impairments, the persistence of which is referred to as postconcussion syndrome. Hyperbaric oxygen therapy (HBOT) has been proposed and evaluated as an additional treatment of these symptoms. HBOT is an innovative approach that has been considered by many but has received both criticism and acceptance. CLINICAL QUESTION: Is HBOT an effective means of reducing symptoms for individuals suffering from postconcussion syndrome (persistence of symptoms for >3 mo)? Summary of Search: The literature was searched for studies that were relevant to the clinical question. Literature provided 5 level 1 studies that were relevant enough to be considered. Clinical Bottom Line: Based on the research that is available, the authors conclude that there is more evidence to refute the use of HBOT for postconcussion syndrome than to support it. Strength of Recommendation: Four studies disprove the use of HBOT; 1 study supported the use of HBOT. These 5 studies are the same level of evidence (level 1) and provide significant findings in their studies. The strength of this recommendation is a B according to the Centre for Evidence-Based Medicine.

Injuries, changes in fitness, and medical demands in deployed National Guard soldiers.

PURPOSE: To characterize noncombat injury/illness, determine changes in physical fitness, and evaluate the influence of these changes on medical resource utilization by National Guard (NG) Soldiers. METHODS: Fifty-four Soldiers from the Arizona NG completed pre- and postdeployment fitness testing. Additionally, individual deployment medical records were inventoried. RESULTS: The majority of noncombat-related medical visits (41%) were musculoskeletal in nature, followed by miscellaneous (33%) and respiratory (13%). Soldiers experienced significant decreases in percent fat mass (-11.1%, p < 0.001) and VO2 peak (-10.8%, p < 0.001). There were significant increases in push-ups (16.4%, p < 0.001), sit-ups (11.0%, p = 0.001), bench-press (10.2%, p < 0.001), and back squat (14.2%, p < 0.001) measures. VO2 peak was inversely correlated to medical resource utilization (r = -0.45 to -0.28, p < or = 0.05). The tertile of Soldiers experiencing the sharpest declines in VO2 peak had significantly more medical visits over the course of the deployment than the other two tertiles (8.0 vs. 2.6 vs. 3.1 medical visits/Soldier, p < or = 0.05). CONCLUSION: The predominate noncombat medical issue was musculoskeletal injury. NG Soldiers improved their body composition, strength, and endurance but experienced significant declines in aerobic fitness while deployed. These data document the association between declining aerobic fitness and increased utilization of medical resources.

The case for altruism in institutional diagnostic testing.

Amid COVID-19, many institutions deployed vast resources to test their members regularly for safe reopening. This self-focused approach, however, not only overlooks surrounding communities but also remains blind to community transmission that could breach the institution. To test the relative merits of a more altruistic strategy, we built an epidemiological model that assesses the differential impact on case counts when institutions instead allocate a proportion of their tests to members' close contacts in the larger community. We found that testing outside the institution benefits the institution in all plausible circumstances, with the optimal proportion of tests to use externally landing at 45% under baseline model parameters. Our results were robust to local prevalence, secondary attack rate, testing capacity, and contact reporting level, yielding a range of optimal community testing proportions from 18 to 58%. The model performed best under the assumption that community contacts are known to the institution; however, it still demonstrated a significant benefit even without complete knowledge of the contact network.

How do they compare?: an assessment of predeployment fitness in the Arizona National Guard.

Currently, there is a paucity of literature that describes physical fitness levels in deploying service members. There has been no data collected that evaluate the Army National Guard or Reserves. This descriptive study will provide physical fitness data for soldiers in the Arizona National Guard (AZNG), allowing for a comparison between the active and reserve components. Sixty soldiers from the AZNG were tested before deployment. Body composition was measured by using air displacement plethysmography. Flexibility testing included the sit and reach (SNR), trunk extension (TE), and shoulder elevation (SE) assessments. Muscular strength was determined by the completion of 1 repetition maximum (1RM) bench press and back squat. Muscular endurance was determined by the completion of the Army push-up (P/U) and sit-up (S/U) test. Muscular power was assessed by the completion of the Wingate cycle test and the standing broad jump (SBJ). Cardiorespiratory fitness was determined by the completion of a VO2peak test. The AZNG soldiers demonstrated a fat mass of 22.7 ± 8.9%, SNR, TE, and SE of 30.0 ± 8.9, 117.1 ± 25.2, and 145.5 ± 50.3 cm, 1RM bench press and back squat of 82.2 ± 29.9 and 104.6 ± 29.0 kg, P/U and S/U of 50 ± 18 and 53 ± 14 reps, peak power of 660.9 ± 177.8 W, SBJ of 191.8 ± 28.4 cm, and VO2peak of 48.9 ± 8.8 ml·kg(-1)·min(-1). This is the first study that provides descriptive data for physical fitness in a reserve component. The data demonstrate that these AZNG soldiers are relatively fit and have comparable results to their active duty counterparts. This descriptive data will provide military leadership a better understanding of the condition of soldiers before deployment and will assist them in better preparing soldiers for future conflicts.

The Relationship Between Physical Characteristics and Maximal Strength in Men Practicing the Back Squat, the Bench Press and the Deadlift.

This study was designed to quantify the relationships between physical characteristics and maximal strength in the back squat, the bench press and the deadlift on powerlifters and football players. Eighteen male junior drug-tested classic powerlifters and seventeen NCAA Division II American football players' anthropometric measurements were taken to compare them with maximal strength results from either a powerlifting meet or testing from their supervised strength and conditioning program. Pearson's bivariate correlations analysis revealed (statistical significance was set at p<0.05) that individuals with a greater (Wilks points) back squat, generally presented a higher Bodyweight (BW) (r=0.37), Body Mass Index (BMI) (r=0.45), Bodyfat Percentage (BF%) (r=0.36), Hip (r=0.41), Waist (r=0.35) and Torso (r=0.41) Circumference (C), Hip C/Height (r=0.46), Waist C/Height (r=0.39) and Torso C/Height (r=0.45) ratios. The individuals with a greater bench press generally presented a higher BMI (r=0.37), Lean Body Weight (LBW) (r=0.36), Hip C (r=0.39) and Hip C/Height ratio (r=0.39). On the other hand, individuals with a greater deadlift were generally older (r=0.34), shorter (r=-0.41), had shorter thighs (r=-0.52) and trunks (r=-0.36), smaller Thigh Length (L)/Height ratio (r=-0.44), Waist C/Hip C (r=-0.41) and Thigh L/Lower Leg L (r=-0.53) ratios, but a higher Lower Leg L/Height ratio (r=-046). The results of this study should be utilized by strength and conditioning coaches to deepen their comprehension of their athletes' physical characteristics in order to help them develop strength through their advantages. Further research should focus on evaluating how physical characteristics affect performance in different squat, bench, and deadlift stances.