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Sports Health ; 12(1): 74-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31642726


BACKGROUND: Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. HYPOTHESIS: A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. STUDY DESIGN: Randomized trial. LEVEL OF EVIDENCE: Level 2. METHODS: Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. RESULTS: A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group (P = 0.35). CONCLUSION: There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. CLINICAL RELEVANCE: Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.

Transtornos Traumáticos Cumulativos/prevenção & controle , Extremidade Inferior/lesões , Força Muscular/fisiologia , Resistência Física/fisiologia , Treinamento de Resistência , Corrida/lesões , Adulto , Transtornos Traumáticos Cumulativos/epidemiologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Humanos , Cidade de Nova Iorque/epidemiologia , Fatores de Risco , Corrida/fisiologia
Am J Sports Med ; 41(2): 430-6, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23371941


BACKGROUND: Patients with chronic exertional compartment syndrome who have failed nonoperative treatment are evaluated with pre-exertion and postexertion compartment pressure testing and may be treated with fasciotomy. Failure rates of up to 20% have been reported and may be related to factors such as age, sex, postexertion compartment pressures, compartment(s) released, and duration of symptoms. HYPOTHESIS: Higher preoperative postexertion compartment pressures are correlated with higher success and patient satisfaction rates after fasciotomy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: From 1999 to 2008, patients with clinical symptoms of chronic exertional compartment syndrome with failed nonoperative management underwent standardized pre-exertion and postexertion compartment pressure measurements. Patients were then offered continued nonoperative treatment or referral to an orthopaedic surgeon for compartment release. Patients with a minimum 2-year follow-up were given a telephone questionnaire describing their pretreatment and posttreatment conditions including quality and duration of symptoms, analog pain scale, symptomatic and functional responses to treatment, and satisfaction with treatment. Medical records and operative reports were reviewed. RESULTS: The mean follow-up period for the nonoperative treatment group (n = 27) was 5.6 years (range, 2.1-10.6) and for the operative group (n = 73) was 5.2 years (range, 2.0-11.3). The operative group had a higher success rate (81%) compared with the nonoperative group (41%) (P < .001), and the operative group had a higher patient satisfaction rate (81%) compared with the nonoperative group (56%) (P = .011). There was no significant correlation between compartment pressures and patient outcomes. Patients with combined anterior and lateral compartment releases had an increased failure rate compared with isolated anterior release (31% vs. 0%, respectively; P = .035). Surgical patients who were post-college had a lower satisfaction rate (66%) compared with high school (89%) and college patients (94%) (P = .017). CONCLUSION: High school and college patients (age <23 years) and isolated anterior compartment release (compared with anterior/lateral release) were factors associated with improved subjective function and satisfaction after fasciotomy. We recommend the avoidance of lateral release unless symptoms or postexertion compartment pressures are clearly indicative of lateral compartment involvement.

Síndromes Compartimentais/cirurgia , Fasciotomia , Perna (Membro)/cirurgia , Dor/cirurgia , Adolescente , Adulto , Doença Crônica , Síndromes Compartimentais/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Corrida , Resultado do Tratamento , Adulto Jovem
Adolesc Med Clin ; 17(3): 719-31; abstract xii, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17030288


This article explores the issue of performance-enhancing drug use in adolescent athletes. The article describes current substances that are being used by adolescent athletes, explains their positive and negative effects, examines factors contributing to their increased use in adolescent athletes, and discusses approaches to educating adolescents about alternate means of enhancing their athletic performance. It is hoped that this information will be useful toward encouraging young athletes to pursue, safe, healthy, and natural means of performance enhancement, such as practice and strength training, to improve sports performance in a safe, effective manner.

Suplementos Nutricionais , Doping nos Esportes/prevenção & controle , Esportes , Adolescente , Anabolizantes/efeitos adversos , Anabolizantes/farmacologia , Creatina/efeitos adversos , Creatina/farmacologia , Doping nos Esportes/estatística & dados numéricos , Hormônio do Crescimento Humano/efeitos adversos , Hormônio do Crescimento Humano/farmacologia , Humanos , Congêneres da Testosterona/efeitos adversos , Congêneres da Testosterona/farmacologia , Estados Unidos
Pediatrics ; 116(6): 1542, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16322182
J Am Diet Assoc ; 105(5): 743-60; quiz 761-2, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15883552


Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the association of breakfast consumption with nutritional adequacy (nine studies), body weight (16 studies), and academic performance (22 studies) in children and adolescents. Breakfast skipping is highly prevalent in the United States and Europe (10% to 30%), depending on age group, population, and definition. Although the quality of breakfast was variable within and between studies, children who reported eating breakfast on a consistent basis tended to have superior nutritional profiles than their breakfast-skipping peers. Breakfast eaters generally consumed more daily calories yet were less likely to be overweight, although not all studies associated breakfast skipping with overweight. Evidence suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance. Breakfast as part of a healthful diet and lifestyle can positively impact children's health and well-being. Parents should be encouraged to provide breakfast for their children or explore the availability of a school breakfast program. We advocate consumption of a healthful breakfast on a daily basis consisting of a variety of foods, especially high-fiber and nutrient-rich whole grains, fruits, and dairy products.

Peso Corporal/fisiologia , Cognição/fisiologia , Ingestão de Energia/fisiologia , Comportamento Alimentar , Estado Nutricional , Logro , Adolescente , Criança , Feminino , Humanos , Masculino , Obesidade/etiologia , Obesidade/fisiopatologia , Ganho de Peso/fisiologia
Pediatr Emerg Care ; 19(2): 65-7, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12698027


OBJECTIVE: The purpose of this epidemiologic study is twofold: first, to determine the relative frequency of sports-related injuries compared with all musculoskeletal injuries in patients 5 to 21 years of age presenting to the emergency department (ED), and second, to evaluate the sports-specific and anatomic site-specific nature of these injuries. METHODS: Patterns of injury in patients 5 to 21 years of age presenting to four pediatric EDs with musculoskeletal injuries in October 1999 and April 2000 were prospectively studied. Information collected included age, sex, injury type, anatomical injury site, and cause of injury (sports-related or otherwise). Information about patient outcome and disposition was also obtained. RESULTS: There were a total of 1421 injuries in 1275 patients. Musculoskeletal injuries were more common in male patients (790/62%) than in female patients. The mean age of the patients was 12.2 years (95% CI, 12.0-12.4). Sprains, contusions, and fractures were the most common injury types (34, 30, and 25%, respectively). Female patients experienced a greater percentage of sprains (44% vs 36%) and contusions (37% vs 33%) and fewer fractures (22% vs 31%) than male patients. Sports injuries accounted for 41% (521) of all musculoskeletal injuries and were responsible for 8% (495/6173) of all ED visits. Head, forearm, and wrist injuries were most commonly seen in biking, hand injuries in football and basketball, knee injuries in soccer, and ankle and foot injuries in basketball. CONCLUSIONS: Sports injuries in children and adolescents were by far the most common cause of musculoskeletal injuries treated in the ED, accounting for 41% of all musculoskeletal injuries. This represents the highest percentage of sports-related musculoskeletal injuries per ED visit reported in children to date. As children and adolescents participate in sports in record numbers nationwide, sports injury research and prevention will become increasingly more important.

Traumatismos em Atletas/epidemiologia , Sistema Musculoesquelético/lesões , Adolescente , Adulto , Fatores Etários , Basquetebol/lesões , Ciclismo/lesões , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Futebol Americano/lesões , Hospitais Comunitários/estatística & dados numéricos , Hospitais Gerais/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Masculino , Traumatismo Múltiplo/epidemiologia , Cidade de Nova Iorque/epidemiologia , Ohio/epidemiologia , Especificidade de Órgãos , Estudos Prospectivos , Fatores Sexuais , Futebol/lesões
Pediatr Clin North Am ; 49(3): 497-504, v, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12119862


As the number of pediatric and adolescent athletes involved in competitive sports continues to grow, and as the competitors in youth sports trend toward a "win at all costs" mentality, pediatricians are increasingly being asked to provide sports medicine treatment and counseling for athletic children. This article outlines the demographic changes in the pediatric and adolescent athlete population in the United States and explains how the pediatrician can become a more effective caregiver to the athletic patient.

Comportamento Infantil , Comportamento Competitivo , Conhecimentos, Atitudes e Prática em Saúde , Poder Familiar/psicologia , Pediatria/métodos , Esportes/psicologia , Adolescente , Traumatismos em Atletas/terapia , Criança , Feminino , Humanos , Masculino , Relações Médico-Paciente , Encaminhamento e Consulta , Esportes/tendências , Estados Unidos