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1.
J Dance Med Sci ; 25(2): 105-109, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-33781373

RESUMO

Hip microinstability, characterized by supraphysiologic movement of the femoroacetabular joint, has recently been recognized as a clinically relevant pathology. The potentially detrimental effects of its presence on joint health make identifying microinstability important; however, due to its multifaceted nature, screening for microinstability presents challenges. Musculoskeletal ultrasound offers an opportunity to visualize the arthrokinematics of the femoroacetabular joint on dynamic evaluation. Dancers may be particularly afflicted by microinstability due to the unique demands of their discipline. This study describes a method for evaluating femoral translation using dynamic ultrasound in adolescent dancers. One hundred forty-two dancers (117 females and 25 males) were recruited from a northeast high school dance program. Females mean age was 16.02 ± 1.06 years, mean BMI 20.35 ± 2.30 kg/m², and mean years of dance experience 10.91 ± 2.84 years. Males mean age was 15.84 ± 1.26 years, mean BMI 21.78 ± 2.84 kg/m², and mean years of dance experience 7.96 ± 2.82 years. Two hundred eighty-four hips were visualized under ultrasound imaging with the participants in both a neutral position and with the hip extended and externally rotated. The distance (mm) the femoral head was positioned anterior to the acetabulum was recorded for both these positions. The calculated difference in these values represented anterior translation. For female hips, the total mean anterior translation was 1.23 ± 2.01mm (-4.8 to 9.30 mm); for male hips, the mean of anterior translation was 1.39 ± 2.22 mm (-7.90 to 5.90 mm). This study identified a normative value range for hip anterior translational motion under dynamic ultrasound among a healthy population of adolescent dancers.


Assuntos
Dança , Articulação do Quadril , Acetábulo , Adolescente , Feminino , Quadril/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Amplitude de Movimento Articular , Ultrassonografia
2.
Med Sci Sports Exerc ; 53(9): 1818-1825, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33756522

RESUMO

PURPOSE: This study aimed to assess associations between exertional heat stroke (EHS) and sex, age, prior performance, and environmental conditions, and report on resources needed for EHS cases at the Boston Marathon. METHODS: We analyzed participant characteristics, environmental data, and EHS medical encounters during the 2015-2019 Boston Marathon races. RESULTS: Among 136,161 starters, there was an incidence of 3.7 EHS cases per 10,000 starters (95% confidence interval, 2.8-4.9), representing 0.5% of all medical encounters. There were significant associations between sex and age (P < 0.0001), sex and start wave (P < 0.0001), and age group and start wave (P < 0.0001). Sex was not significantly associated with increased EHS incidence; however, age younger than 30 yr and assignment to the first two start waves were. All cases occurred at races with average wet bulb globe temperatures of 17°C-20°C. There was a linear correlation between EHS incidence and greater increases in wet bulb globe temperature from start to peak (R2 = 0.7688). A majority of cases (37; 72.5%) were race finishers; nonfinishers all presented after mile 18. Most were triaged 3-4 h after starting, and all were treated with ice water immersion. Treatment times were prolonged (mean (SD), 78.1 (47.5) min; range, 15-190 min); 29.4% (15 cases) developed posttreatment hypothermia, and 35.3% (18 cases) were given intravenous fluids. Most (31 cases; 64.6%) were discharged directly, although 16 cases (33.3%) required hospital transport. There were no fatalities. CONCLUSIONS: Younger and faster runners are at higher risk for EHS at the Boston Marathon. Greater increases in heat stress from start to peak during a marathon may exacerbate risk. EHS encounters comprise a small percentage of race-day medical encounters but require extensive resources and warrant risk mitigation efforts.


Assuntos
Golpe de Calor/epidemiologia , Temperatura Alta , Corrida de Maratona , Adulto , Fatores Etários , Boston , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
3.
Br J Sports Med ; 55(6): 305-318, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33122252

RESUMO

Despite the worldwide popularity of running as a sport for children, relatively little is known about its impact on injury and illness. Available studies have focused on adolescent athletes, but these findings may not be applicable to preadolescent and pubescent athletes. To date, there are no evidence or consensus-based guidelines identifying risk factors for injury and illness in youth runners, and current recommendations regarding suitable running distances for youth runners at different ages are opinion based. The International Committee Consensus Work Group convened to evaluate the current science, identify knowledge gaps, categorise risk factors for injury/illness and provide recommendations regarding training, nutrition and participation for youth runners.


Assuntos
Corrida/lesões , Corrida/fisiologia , Adolescente , Fatores Etários , Índice de Massa Corporal , Tamanho Corporal , Osso e Ossos/fisiologia , Criança , Morte Súbita Cardíaca/etiologia , Pé/fisiologia , Humanos , Força Muscular , Necessidades Nutricionais , Condicionamento Físico Humano/efeitos adversos , Condicionamento Físico Humano/métodos , Fatores de Risco , Fatores Sexuais , Sapatos , Estresse Mecânico
4.
Clin J Sport Med ; 31(1): e8-e14, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30589746

RESUMO

OBJECTIVE: To examine the creation of a medical protocols mobile application for the Boston Marathon and its use by medical volunteers for the 2016 Boston Marathon. DESIGN: Anonymous questionnaire. SETTING: 2016 Boston Marathon. PARTICIPANTS: Two hundred ninety-four marathon medical volunteers. MAIN OUTCOME MEASURES: Responses regarding ease of use, acceptability, and usefulness of the International Institute of Race Medicine mobile application. RESULTS: In total, 88% of medical volunteers who participated in the study felt that the medical protocols mobile application was easy to use. Approximately 72% would use the app again, and 79% would recommend the app to others. However, only 15% of volunteers consistently used the app during the event, and 37% felt like it contributed to clinical decision-making. CONCLUSIONS: A medical protocols app was found to be useful and well accepted among medical volunteers who reported using the app, but only a minority of respondents used the app on marathon day or felt like it contributed to clinical care. Although new, mobile apps in race medicine should continue to be an area of development as providers increasingly integrate their use into clinical practice.

5.
J Dance Med Sci ; 24(3): 99-104, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32867911

RESUMO

Femoroacetabular impingement (FAI) is a common anatomical variant in ballet dancers. Cam morphology (a subtype of FAI) and increased alpha angles have been identified as risk factors for hip pain. Ultrasound has recently been used to measure alpha angles in the diagnosis of cam morphology, but its utility remains understudied. The purpose of this study was to investigate the effect of ultrasound measured alpha angles on hip pain and function scores in elite female adolescent ballet dancers. The alpha angles of 25 dancers (mean age: 15.9 years) were measured using ultrasound and calculated with ImageJ Software. Cam morphology was defined by alpha angles of 60° or greater. Participants rated their hip pain and function using the International Hip Outcome Tool 12 (iHOT-12) survey. For normally distributed variables, the independent t-test was performed, and for abnormally distributed variables, the Mann-Whitney U Test. Along with mean and standard deviation (SD) values, median score, interquartile range (IQR), and 95% confidence intervals (95% CIs) were also analyzed. Significantly lower iHOT-12 scores were found in dancers with alpha angles ≥ 60° (mean ± SD, 74.34 ± 13.01; 95% CIs, 58.18, 90.50, median 67.20; IQR, 18.55), compared to dancers with alpha angles < 60° (mean ± SD, 80.22 ± 15.65; 95% CIs, 72.90, 87.54; median, 81.60; IQR, 16.35; p = 0.001). It is concluded that: 1. elite female adolescent ballet dancers with alpha angles higher than 60° experienced worse hip pain and function; 2. alpha angles may impact hip pain and function in these dancers; and 3. further studies should use a prospective design to investigate the predictive ability of their findings.


Assuntos
Dança/lesões , Impacto Femoroacetabular/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Amplitude de Movimento Articular , Adolescente , Estudos Transversais , Dança/fisiologia , Feminino , Quadril/diagnóstico por imagem , Humanos , Estudos Prospectivos , Ultrassonografia
6.
Sports (Basel) ; 7(9)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31547307

RESUMO

The current study aims to compare the mechanical propensities between healthy runners and runners with hamstring injuries. Retrospective case-control video analysis was used. A total of 35 (12 male and 23 female) videos of runners with hamstring injuries were compared with videos of sex-, age-, mass-, and height-matched healthy control runners. The main outcome variables were trunk posture angles, overstride angles, and foot strike patterns. An independent t-test and chi-squared tests were employed to analyze the main outcome variables between the runners with hamstring injuries and the healthy control runners. The statistical significance of less than 0.05 (p < 0.05) was used. The runners with hamstring injuries had a 1.6° less forward-trunk posture angles compared with the healthy control runners (p = 0.043). Also, the runners with hamstring injuries demonstrated a 4.9° greater overstride angles compared with the healthy control runners (p = 0.001). Finally, the runners with hamstring injuries had a tendency of rearfoot strike, while the healthy control runners showed a forefoot strike pattern (p = 0.004). In conclusion, the runners with hamstring injuries demonstrated different running mechanical propensities compared with the healthy runners.

7.
Clin Pediatr (Phila) ; 58(6): 671-676, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30813766

RESUMO

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (-) results while CT test showed 17 (+) and 5 (-) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.


Assuntos
Imageamento por Ressonância Magnética/métodos , Espondilólise/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Atletas/estatística & dados numéricos , Estudos Transversais , Reações Falso-Negativas , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Espondilólise/fisiopatologia
8.
Br J Sports Med ; 53(17): 1048-1055, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30796105

RESUMO

Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered 'musculoskeletal' (eg, strains) and those due to 'illness' (eg, cardiac, respiratory, endocrine). The rate of sudden death during mass endurance events (running, cycling and triathlon) is between 0.4 and 3.3 per 100 000 entrants. The rate of other serious medical encounters (eg, exertional heat stroke, hyponatraemia) is rarely reported; in runners it can be up to 100 times higher than that of sudden death, that is, between 16 and 155 per 100 000 race entrants. This consensus statement has two goals. It (1) defines terms for injury and illness-related medical encounters, severity and timing of medical encounters, and diagnostic categories of medical encounters, and (2) describes the methods for recording data at mass participation endurance sports events and reporting results to authorities and for publication. This unifying consensus statement will allow data from various events to be compared and aggregated. This will inform athlete/patient management, and thus make endurance events safer.


Assuntos
Traumatismos em Atletas/epidemiologia , Aglomeração , Coleta de Dados/normas , Medicina Esportiva/normas , Esportes , Consenso , Doença , Serviços Médicos de Emergência , Humanos , Resistência Física
9.
Curr Sports Med Rep ; 18(2): 53-59, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30730342

RESUMO

Running is a popular sport for children in the United States. However, review of available literature on health effects and safety recommendations for youth running has not been previously conducted. Unique factors for injury include periods of growth during puberty and potential for growth plate injury. Youth runners may benefit from activities that incorporate high-impact loading and multidirectional movement for optimal bone maturation, exercises to strengthen tendons and muscles, and strategies aimed at improving running biomechanics to reduce risk of injury. In addition, addressing lifestyle factors, including nutrition and sleep is essential for a runner's general health. Similar to other sports, sports specialization should not be encouraged in youth runners. Reducing running-related injury in growing children and assessing readiness for running should be based on a combination of physical, emotional, psychological, social, and cognitive factors. Youth runners require individualized training and competition to safely participate in the sport.


Assuntos
Traumatismos em Atletas/prevenção & controle , Condicionamento Físico Humano/métodos , Corrida/lesões , Corrida/fisiologia , Adolescente , Fenômenos Biomecânicos , Osso e Ossos , Sistema Cardiovascular , Criança , Cognição , Emoções , Feminino , Humanos , Masculino , Força Muscular , Sistema Respiratório , Fatores de Risco , Fatores Sexuais , Esportes
10.
Clin Orthop Relat Res ; 477(5): 1086-1098, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30531425

RESUMO

BACKGROUND: Hip microinstability has gained attention recently as a potential cause of hip pain. Currently there is a lack of evidence-based objective diagnostic criteria surrounding this diagnosis. Previous studies have shown translation of the femoral head during extreme hip positions. However, reliable assessment of femoral head translation is lacking. QUESTIONS/PURPOSES: (1) How precise is musculoskeletal ultrasound for measuring anterior femoral head translation during the hip anterior apprehension test? (2) What is the intra- and interrater reliability of dynamic ultrasonography in assessing anterior femoral head translation? METHODS: We recruited 10 study participants (20 hips) between the ages of 22 and 50 years with no history of hip pain or functional limitations. Test-retest methodology was used. Seven females and three males were enrolled. The mean age of study participants was 27 years (SD 8.7 years); mean body mass index was 22.6 kg/m (SD 2.2 kg/m). All study participants underwent dynamic hip ultrasonography by three different physicians 1 week apart. Each hip was visualized in two neutral positions (neutral and neutral with the contralateral hip flexed [NF]) and two dynamic positions, which sought to replicate the apprehension test, although notably study participants had no known hip pathology and therefore no apprehension. The first maintained the hip in extension and external rotation off to the side of the examination table (EER1), and the second held the hip off of the bottom of the examination table (EER2). One hundred twenty ultrasound scans (480 images) were performed. Mean and SD were calculated using absolute values of the difference in ultrasound measurements (mm) between positions NF and EER1 and NF and EER2 calculated for each physician as well as an average of all three physicians. Intraclass correlation coefficient (ICC) analysis was used to examine intra- and interrater reliability. RESULTS: The mean absolute difference for NF and EER1 was 0.84 mm (SD 0.93 mm) and for NF and EER2 0.62 mm (SD 0.40 mm) on Study Day 1. Similarly, on Study Day 2, the mean absolute difference for NF and EER1 position was 0.90 mm (SD 0.74 mm) and for NF and EER2 1.03 mm (SD 1.18 mm). Cumulative values of ICC analysis indicated excellent intrarater reliability in all four positions: neutral 0.794 (95% confidence interval [CI], 0.494-0.918), NF 0.927 (95% CI, 0.814-0.971), EER1 0.929 (95% CI, 0.825-0.972), and EER2 0.945 (95% CI, 0.864-0.978). Similarly, interrater ICC analysis cumulative values were excellent for NF, EER1, and EER2 and fair to good for the neutral position: neutral 0.725 (95% CI, 0.526-0.846), NF 0.846 (95% CI, 0.741-0.913), EER1 0.812 (95% CI, 0.674-0.895), and EER2 0.794 (95% CI, 0.652-0.884). CONCLUSIONS: This study offers the first ultrasound protocol of which we are aware for measuring anterior femoral head translation. Hip dynamic ultrasound may assist in providing precise objective clinical-based diagnostic evidence when evaluating complex hip pain and suspected microinstability. Musculoskeletal ultrasound is a reliable office-based method of measuring anterior femoral head translation that can be utilized by physicians with varying experience levels. Future studies are needed to investigate ultrasound anterior femoral head translation taking into account sex, prior hip surgery, hip osseous morphology, and ligamentous laxity. LEVEL OF EVIDENCE: Level III, diagnostic study.


Assuntos
Fêmur/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Quadril/diagnóstico por imagem , Instabilidade Articular/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
J Ultrasound Med ; 38(6): 1527-1536, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30380165

RESUMO

OBJECTIVES: Treatment for iliopsoas tendinopathy includes ultrasound (US)-guided iliopsoas peritendinous corticosteroid injection. Evidence is lacking regarding US-guided iliopsoas injection efficacy in patients with iliopsoas tendinopathy and intra-articular (IA) hip abnormalities. The purpose of this study was to examine the efficacy of US-guided iliopsoas corticosteroid injection for iliopsoas tendinopathy in patients with and without IA hip abnormalities. METHODS: This work was a prospective study evaluating patients aged 12 to 50 years with iliopsoas tendinopathy. Participants completed a Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaire before and 6 weeks after injection. The main outcome measure was the change in HOOS subcategory scores. Independent variables included time and hip status. Normal hips were compared to abnormal hips with IA abnormalities. A 2-way repeated measures analysis of covariance with effect size (η2 ) was used to determine injection effects on HOOS scores before and 6 weeks after injection. RESULTS: A total of 178 patients (154 female and 24 male) were analyzed. Time effects were found for both normal and abnormal hips in all HOOS subcategories: symptoms (P = .041; η2 = 0.050), pain (P = .001; η2 = 0.184), activities of daily living (P = .011; η2 = 0.076), function in sports and recreation (P = .001; η2 = 0.151), and quality of life (QOL; P = .001; η2 = 0.193). Significant differences between normal versus abnormal hips were found in the sports and recreation (P = .032; η2 = 0.056) and QOL scores (P = .001; η2 = 0.135). CONCLUSIONS: In patients with iliopsoas tendinopathy, US-guided iliopsoas corticosteroid injection improved outcomes regardless of coexisting IA hip abnormalities. Patients without IA hip abnormalities showed greater improvement in sports and recreation and QOL scores compared to patients with IA hip abnormalities. Ultrasound-guided iliopsoas injection for iliopsoas tendinopathy may advance short-term care and help continue with nonsurgical treatment regimens.


Assuntos
Corticosteroides/uso terapêutico , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Dor/tratamento farmacológico , Tendinopatia/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Adolescente , Corticosteroides/administração & dosagem , Adulto , Criança , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Dor/fisiopatologia , Estudos Prospectivos , Tendinopatia/complicações , Tendinopatia/fisiopatologia , Resultado do Tratamento , Adulto Jovem
12.
J Dance Med Sci ; 22(4): 233-237, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30477613

RESUMO

A 14-year-old female ballet dancer sustained an injury during a routine ballet movement that was diagnosed as an ischial tuberosity avulsion fracture. This diagnosis was complicated by extensive soft tissue injury to the hamstrings, adductors, and external rotator musculature. Although uncommon, the potential for this injury should be uniformly considered in adolescent dancers due to the unique stresses in ballet training and the added risk of growth spurts during this stage of development. Prevention targeting individual deficiencies in flexibility and strength is essential to avoid similar devastating injuries. In most cases that are diagnosed early, avulsions heal with conservative treatment. Early imaging and correct diagnosis can serve to guide clinical management and prevent unnecessary surgery in the young dancer.


Assuntos
Traumatismos em Atletas/diagnóstico por imagem , Dança/lesões , Fraturas Ósseas/diagnóstico por imagem , Ísquio/lesões , Adolescente , Traumatismos em Atletas/terapia , Feminino , Fraturas Ósseas/terapia , Humanos , Ísquio/diagnóstico por imagem , Coxa da Perna
13.
Curr Sports Med Rep ; 17(11): 366-375, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30407945

RESUMO

Gymnastics is a sport requiring grace, strength, and flexibility, resulting in a wide variety of injuries. This article is an overview of the sport of gymnastics and associated injury trends in the artistic gymnastics population. Injury rates in gymnastics range from 1.08 to 50.3 per 1000 h of exposure. More injuries occur in competition versus practice. Fewer injuries occur in recreational gymnastics than competitive gymnastics. The most common injury in gymnastics occurs in the lower extremity, and is an ankle sprain, followed by knee internal derangement. However, in men's gymnastics the most common gymnastics injury occurs in the upper body (specifically the shoulder). The most common skills causing injury to a gymnast are front/back handsprings and saltos/flips. Unique injuries commonly seen when caring for the young gymnast include spondylolysis, ostoechondritis dissecans of the capetillium and talus, Gymnast wrist, Grip lock, Osgood-Schlatter, patellofemoral syndrome, Sever's disease, and ankle sprains. Research efforts should focus on injury rates after the 2006 rule change, injury prevention, men's gymnastics injury patterns, concussions, hip injuries, and ACL injuries in gymnasts.


Assuntos
Traumatismos em Atletas/epidemiologia , Ginástica/lesões , Traumatismos do Tornozelo/epidemiologia , Feminino , Humanos , Incidência , Extremidade Inferior/lesões , Masculino , Lesões do Ombro/epidemiologia
14.
J Phys Ther Sci ; 30(8): 1056-1062, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30154600

RESUMO

[Purpose] Primary purpose was to compare running mechanics between healthy runners and runners with chronic exertional compartment syndrome (CECS) including overstride angles, ankle dorsiflexion (DF) angles, and foot strike patterns. The secondary purpose was to analyze the association between the overstride angles and ankle DF angles. [Participants and Methods] Running images of 7 female runners with bilateral CECS patients were captured at a time of the medical examination. Their running images were compared with gender, age, and body mass index matched 31 healthy control runners. [Results] The bilateral CECS female runners have a propensity of running with significantly greater overstride and ankle DF angles than the healthy female runners. There were no foot strike differences between the two cohorts. There were a non-significant, poor relationship between overstride and ankle DF angles in the healthy female runners while a significant, strong association was found between overstride and ankle DF angles in the bilateral CECS female runners. [Conclusion] Compared to healthy female runners, bilateral CECS female runners demonstrated different running mechanics including greater overstride and ankle DF angles. The two variables were strongly associated with each other in bilateral CECS female runners, but not in healthy female runners. This may potentially contribute to the mechanism of CECS development.

15.
Phys Sportsmed ; 46(4): 477-484, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30122090

RESUMO

OBJECTIVE: To investigate the prevalence of hypoechoic areas by US and its' association with VISA-P scores among asymptomatic jumpers while highlighting sex comparisons. DESIGN: Cross-sectional study. SETTING: Pre-participation exam at a National Collegiate Athletic Association (NCAA) division I college. PARTICIPANTS: Thirty-one college athletes who engage in jumping sports. MAIN OUTCOME MEASURES: Hypoechoic images of patellar tendon captured by ultrasound examination were compared to a self-reported knee functional survey, the Victorian Institute of Sport Assessment for patellar tendinopathy (VISA-P) scale (0-100). RESULTS: With a total of 31 athletes (13 males and 18 females), prevalence rate of the hypoechoic areas of patellar tendon was 19.4% (6/31) in the right knee and 29.0% (9/31) in the left knee. There was no proportional difference in a comparison of prevalence rate of hypoechoic area [(+) or (-)] by sex in either right or left knee. The VISA-P scores were significantly lower in US (+) than US (-) in the right knee (p = 0.003, Cohen's d = 1.675), but not the left knee (p = 0.250, Cohen's d = 0.512). The receiver operating characteristics curve analysis indicated the most sensitive and specific VISA-P values based on status [(+) or (-)] of hypoechoic area was 89.5 with 86.4% and 77.7% of sensitivity and specificity. CONCLUSION: In short, hypoechoic areas were detected by US examination among self-reported asymptomatic jumpers. There was an association between hypoechoic areas and VISA-P scores in the right knee, but not in left knee. VISA-P scores may be used as a screening tool for the presence of hypoechoic areas.


Assuntos
Ligamento Patelar/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Atletas , Basquetebol , Estudos Transversais , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Ligamento Patelar/patologia , Prevalência , Atletismo , Ultrassonografia , Voleibol , Adulto Jovem
16.
Phys Sportsmed ; 46(3): 385-392, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29301454

RESUMO

OBJECTIVES: The purpose of this study was to investigate the relationship between coping skills and current hip pain and function scores in ballet dancers. Secondly, we examined the relationship between coping skills and past injuries. Thirdly, we investigated the association between past injuries and current pain and function scores. METHODS: This was a cross-sectional observational study. Twenty-six young elite female dancers (mean age 15.9 years, range 14-17 years) participated. Participants completed surveys indicating past injury history, rating pain and function on the short International Hip Outcome Tool (iHOT-12), and assessing coping skills on the Athletic Coping Skills Inventory Score (ACSI-28). Independent t-tests, Cohen's d, effect size, chi-square and correlation coefficient and determination analyses were conducted. RESULTS: There was no significant relationship between iHOT-12 scores and ACSI-28 scores (r = -0.250, p = 0.087). There was no significant difference (p = 0.289) in past injuries comparing those with ACSI-28 scores above and below the mean ACSI-28. A significant moderate negative correlation was detected between both iHOT-12 scores and total past injuries (r = -0.609, p < 0.001), and iHOT-12 scores and past non-hip injuries (r = -0.628, p < 0.001). CONCLUSION: Past injuries may influence current hip pain and function in young female dancers. Correlation determination (r2) indicated that 37% of current pain and function scores were explained by total past injuries in a small group of young high-level ballet dancers. Further research should engage a prospective design to investigate the predictive ability of findings.


Assuntos
Adaptação Psicológica , Dança/lesões , Lesões do Quadril/psicologia , Articulação do Quadril/fisiopatologia , Dor/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Dor/fisiopatologia , Esportes , Inquéritos e Questionários
17.
Orthop J Sports Med ; 5(8): 2325967117723108, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28840149

RESUMO

BACKGROUND: Femoroacetabular impingement (FAI) is a painful and limiting condition of the hip that is often seen in young athletes. Previous studies have reported a higher prevalence of this disorder in male athletes, but data on the structural morphology of adolescent and young adult female athletes, specifically those involved in dance, are lacking. PURPOSE: (1) To investigate the radiographic morphology of FAI deformities in adolescent and young adult female single-sport dance and nondance athletes and (2) to examine the differences in the radiographic findings between these 2 groups. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A retrospective chart review of 56 female single-sport athletes 10 to 21 years of age with a diagnosis of FAI within a single-sports medicine division of a pediatric academic medical center was performed. Acetabular index (AI), lateral center-edge angle (LCEA), crossover sign, and ischial spine sign were measured bilaterally on anteroposterior radiographs; alpha angle (AA) was measured on lateral films, and anterior center-edge angle (ACEA) was measured on false-profile films. Independent t tests and Mann-Whitney U tests were used to compare mean angle measurements between dance and nondance athletes. Dichotomized categorical variables and crossover and ischial spine signs were analyzed between dance and nondance athletes by applying a chi-square test. Statistical significance was set as P < .05 a priori. RESULTS: Significant differences in angle measurements were noted. AA was significantly lower in the dancers compared with the nondance athlete group (49.5° ± 6.0° vs 53.9° ± 7.3°, P = .001). The LCEA and ACEA of dance athletes were significantly greater compared with nondance athletes (33.8° ± 6.7° vs 30.9° ± 5.8° [P = .016] and 36.0° ± 8.1° vs 32.3° ± 7.0° [P = .035], respectively). No significant difference in AI was seen between the 2 cohorts (5.0° ± 4.0° for dancers vs 5.9° ± 3.4° for nondancers, P = .195). CONCLUSION: Significant differences existed in the radiographic bony morphology of young female single-sport dance athletes compared with nondance athletes with FAI. In dance athletes, symptoms were seen in the setting of normal bony morphology.

18.
Spine (Phila Pa 1976) ; 42(18): E1087-E1091, 2017 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-28542108

RESUMO

STUDY DESIGN: Clinical case report of unilateral pedicular stress fracture with a contralateral spondylolysis in a male high-school athlete presenting with low back pain. OBJECTIVE: To report this uncommon cause of low back pain in an adolescent athlete, and review the relevant literature. SUMMARY OF BACKGROUND DATA: The incidence of spondylolysis in the Caucasian population was found to be about 3% to 6%. This number is probably higher in the athletic adolescent age group, with reports ranging from 8% to 15%. Spondylolysis may be associated with pedicle fracture, usually on the contralateral side. This is an uncommon phenomenon that is not well described in the adolescent age group. METHODS: A 16-year-old male athlete presents with low back pain and limitation in sports as well as in daily activities. Clinical evaluation was suspicious for, and radiographic evaluation revealed left-sided L5 spondylolysis as well as contralateral L5 pedicle fracture. Conservative management included Boston Overlapping brace, external electrical stimulation, modification of activities, and a comprehensive physical therapy program. RESULTS: Radiological evaluation revealed persistent left L5 pars defect and advanced healing of the contralateral pedicle fracture. The patient achieved complete pain relief and returned to varsity level sporting activity. CONCLUSION: Complete radiographic and clinical healing of the pedicle defect was observed, with return competitive varsity-level football without symptoms. LEVEL OF EVIDENCE: 5.


Assuntos
Dor Lombar/etiologia , Vértebras Lombares/cirurgia , Fraturas da Coluna Vertebral , Espondilólise , Adolescente , Atletas , Humanos , Masculino , Radiografia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Espondilólise/complicações , Espondilólise/diagnóstico por imagem , Espondilólise/cirurgia
20.
Spine Deform ; 5(2): 134-138, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28259265

RESUMO

STUDY DESIGN: Retrospective chart review. OBJECTIVES: To use the Micheli Functional Scale to assess adolescent patients with spondylolysis treated conservatively at midterm follow-up. SUMMARY OF BACKGROUND: Spondylolysis is a common source of back pain for adolescents and is generally managed with bracing and physical therapy. There is little data regarding the results of conservative management of spondylolysis over time. METHODS: Four major academic pediatric institutions performed a retrospective chart review of patients from 5 to 21 years of age with the initial diagnosis of spondylolysis. Inclusion criteria were patients who initially underwent conservative management and had a minimum of 2 years' follow-up. The patients were contacted and asked to complete the Micheli Functional Scale Survey. RESULTS: A total of 295 patients with the diagnosis of spondylolysis were identified and contacted. Sixty-one subjects with spondylolysis completed the follow-up survey. Sixty of 61 respondents (98%) answered questions regarding their current pain level. Thirty-five of 60 (58.3%) reported no pain (0/10) and 47/60 (78%) rated their pain at 3 or less, whereas 22% (13/60) rated their pain as 4 or higher. There was no correlation with pain ratings on the follow-up survey and radiographic healing at initial management. Of the 61 patients, 50 returned to sports (82%), 8 did not return (13%), and 5 returned to most but not all of their sports (8%). No correlation was observed between radiographic healing and return to sports (p = .4885). CONCLUSION: Using a validated functional scale, this study demonstrated that with conservative management of spondylolysis a majority of patients at an average of 8 years out self-report a return to sports (90%), though many reported continued pain (42%) and interference with activities (67%). There was no correlation observed between radiographic evidence of healing and pain or return to sports with a mean follow-up of 8 years. LEVEL OF EVIDENCE: Multicenter retrospective case series.


Assuntos
Dor nas Costas/terapia , Tratamento Conservador/métodos , Espondilólise/terapia , Adolescente , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Radiografia/métodos , Radiografia/estatística & dados numéricos , Estudos Retrospectivos , Volta ao Esporte/estatística & dados numéricos , Índice de Gravidade de Doença , Espondilólise/complicações , Espondilólise/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
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