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1.
Clin Sports Med ; 40(1): 213-220, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33187611

RESUMO

As the COVID-19 (Coronavirus disease 2019) pandemic continues, the paradigm of treatment continues to rapidly evolve, especially for sports medicine surgeons, because treatment before the pandemic was considered predominantly elective. This article provides subjective and objective data on the changes implicated by the COVID-19 pandemic with regard to the interactions and practices of sports medicine surgeons. This perspective also considers the potential impact on the patients and athletes treated by sports medicine surgeons. This article discusses the impact of the COVID-19 pandemic on sports medicine and provides thoughts on how the landscape of the field may continue to change.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Procedimentos Ortopédicos/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Medicina Esportiva/métodos , Cirurgiões/estatística & dados numéricos , Humanos
2.
Curr Sports Med Rep ; 19(11): 498-503, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33156037

RESUMO

The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV-2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an iterative process and expert consensus to finalize this guidance statement that is intended to provide clinicians with a clinical framework to return athletes of all levels to training and competition during the pandemic. The statement is not intended to address treatment, infection control principles, or public health issues related to SARS-CoV-2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.


Assuntos
Infecções por Coronavirus/epidemiologia , Exame Físico/normas , Pneumonia Viral/epidemiologia , Medicina Esportiva/métodos , Atletas , Betacoronavirus , Consenso , Humanos , Pandemias , Sociedades Médicas , Esportes
6.
Br J Sports Med ; 54(22): 1314-1320, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32912847

RESUMO

Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research & Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.


Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Revelação , Medicina Militar/educação , Medicina Esportiva/educação , Atletas/educação , Técnica Delfos , Humanos , Medicina Militar/organização & administração , Militares/educação , Medicina Esportiva/organização & administração , Participação dos Interessados , Estados Unidos , Universidades
7.
Br J Sports Med ; 54(19): 1157-1161, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32878870

RESUMO

SARS-CoV-2 is the causative virus responsible for the COVID-19 pandemic. This pandemic has necessitated that all professional and elite sport is either suspended, postponed or cancelled altogether to minimise the risk of viral spread. As infection rates drop and quarantine restrictions are lifted, the question how athletes can safely resume competitive sport is being asked. Given the rapidly evolving knowledge base about the virus and changing governmental and public health recommendations, a precise answer to this question is fraught with complexity and nuance. Without robust data to inform policy, return-to-play (RTP) decisions are especially difficult for elite athletes on the suspicion that the COVID-19 virus could result in significant cardiorespiratory compromise in a minority of afflicted athletes. There are now consistent reports of athletes reporting persistent and residual symptoms many weeks to months after initial COVID-19 infection. These symptoms include cough, tachycardia and extreme fatigue. To support safe RTP, we provide sport and exercise medicine physicians with practical recommendations on how to exclude cardiorespiratory complications of COVID-19 in elite athletes who place high demand on their cardiorespiratory system. As new evidence emerges, guidance for a safe RTP should be updated.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Miocardite/diagnóstico , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto , Transtornos Respiratórios/diagnóstico , Volta ao Esporte/normas , Atletas , Biomarcadores/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Morte Súbita Cardíaca/prevenção & controle , Eletrocardiografia , Humanos , Miocardite/sangue , Miocardite/etiologia , Miocárdio/patologia , Necrose/etiologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Transtornos Respiratórios/etiologia , Medicina Esportiva/normas , Avaliação de Sintomas , Troponina/sangue
9.
Am J Phys Med Rehabil ; 99(9): 860-862, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32833384

RESUMO

"Hands-on" teaching is an important part of sports ultrasound (US) education in sports medicine fellowships. However, physical distancing requirements during a global pandemic have resulted in cancellation and/or postponement of "in-person" educational sessions, ultrasound conferences, and clinical diagnostic and interventional ultrasound cases that enhance ultrasound training. For "hands-on" sports ultrasound teaching to continue during these uncertain times, the educational model must be adapted. The use of virtual meeting platforms to display ultrasound images is possible, and this not only allows for instructor demonstration but also gives the instructor an opportunity to observe the learner scanning and provide direct feedback in real-time. Moving forward, virtual ultrasound teaching methods will likely continue to be of educational value, as they provide increased access to individualized instruction from skilled instructors and eliminate travel time and cost of conferences and instructional sessions.


Assuntos
Infecções por Coronavirus , Educação a Distância/métodos , Pandemias , Pneumonia Viral , Medicina Esportiva/educação , Ultrassonografia , Adulto , Betacoronavirus , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Educacionais
13.
Altern Ther Health Med ; 26(5): 28-32, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32663181

RESUMO

Context: The drive for a quick return to sport after injury can be great. Athletes look to their sports medicine provider for guidance on a speedy and effective recovery. The sports medicine physician has a number of different treatment options to consider when they turn to their medical armamentarium. One of those treatment choices is complementary and alternative medicine (CAM). Unfortunately, there is limited evidence for many of the CAM modalities. Furthermore, CAM prescribing practices among sports medicine physicians is unknown. The aim of this study is to determine the prescribing practices of CAM among physicians for common sports medicine pathologies. Methods: An online survey of the prescribing practices of CAM by physician members of the American Medical Society for Sports Medicine. Results: A total of 257 physicians answered the question on prescribing CAM for a response rate of 11%. Of those who responded, 88% prescribed at least one type of CAM in the last one year. The responders identified 23 different CAM modalities they prescribed. Of those modalities prescribed, chiropractic/osteopathic manipulation was the most common followed by acupuncture/electroacupuncture and yoga. Less commonly prescribed CAM included omega-3 fatty acids, riboflavin, and meditation. Providers utilized CAM for common sports medicine pathologies including ligamentous, tendinous and muscle injury, concussion, and low back pain among others. The survey participants believed many of these CAM modalities to be effective. Conclusions: Among responders, the prescribing prevalence of at least one CAM therapy was high. Sports medicine physicians utilized a number of different CAM modalities to treat common sports medicine pathologies.


Assuntos
Traumatismos em Atletas/terapia , Terapias Complementares/estatística & dados numéricos , Doenças Musculoesqueléticas/terapia , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Medicina Esportiva/métodos , Esportes/psicologia , Terapia por Acupuntura , Eletroacupuntura , Humanos , Dor Lombar , Manipulação Osteopática , Prevalência , Medicina Esportiva/estatística & dados numéricos , Inquéritos e Questionários , Ioga
14.
Br J Sports Med ; 54(19): 1162-1167, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32605933

RESUMO

BACKGROUND: The COVID-19 pandemic forces sport and exercise medicine (SEM) physicians to think differently about the clinical care of patients. Many rapidly implement eHealth and telemedicine solutions specific to SEM without guidance on how best to provide these services. AIM: The aim of this paper is to present some guiding principles on how to plan for and perform an SEM consultation remotely (teleSEM) based on a narrative review of the literature. A secondary aim is to develop a generic teleSEM injury template. RESULTS: eHealth and telemedicine are essential solutions to effective remote patient care, also in SEM. This paper provides guidance for wise planning and delivery of teleSEM. It is crucial for SEM physicians, technology providers and organisations to codesign teleSEM services, ideally involving athletes, coaches and other clinicians involved in the clinical care of athletes, and to gradually implement these services with appropriate support and education. CONCLUSION: teleSEM provides solutions for remote athlete clinical care during and after the COVID-19 pandemic. We define two new terms-eSEM and teleSEM and discuss guiding principles on how to plan for and perform SEM consultations remotely (teleSEM). We provide an example of a generic teleSEM injury assessment guide.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Medicina Esportiva/métodos , Telemedicina/métodos , Tomada de Decisão Compartilhada , Registros Eletrônicos de Saúde , Humanos , Pandemias , Seleção de Pacientes , Exame Físico , Guias de Prática Clínica como Assunto , Consulta Remota/métodos , Consulta Remota/organização & administração , Medicina Esportiva/organização & administração , Telemedicina/ética , Telemedicina/organização & administração , Terminologia como Assunto
15.
Br J Sports Med ; 54(22): 1365-1371, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32699001

RESUMO

Questionable research practices (QRPs) are intentional and unintentional practices that can occur when designing, conducting, analysing, and reporting research, producing biased study results. Sport and exercise medicine (SEM) research is vulnerable to the same QRPs that pervade the biomedical and psychological sciences, producing false-positive results and inflated effect sizes. Approximately 90% of biomedical research reports supported study hypotheses, provoking suspicion about the field-wide presence of systematic biases to facilitate study findings that confirm researchers' expectations. In this education review, we introduce three common QRPs (ie, HARKing, P-hacking and Cherry-picking), perform a cross-sectional study to assess the proportion of original SEM research that reports supported study hypotheses, and draw attention to existing solutions and resources to overcome QRPs that manifest in exploratory research. We hypothesised that ≥ 85% of original SEM research studies would report supported study hypotheses. Two independent assessors systematically identified, screened, included, and extracted study data from original research articles published between 1 January 2019 and 31 May 2019 in the British Journal of Sports Medicine, Sports Medicine, the American Journal of Sports Medicine, and the Journal of Orthopaedic & Sports Physical Therapy We extracted data relating to whether studies reported that the primary hypothesis was supported or rejected by the results. Study hypotheses, methodologies, and analysis plans were preregistered at the Open Science Framework. One hundred and twenty-nine original research studies reported at least one study hypothesis, of which 106 (82.2%) reported hypotheses that were supported by study results. Of 106 studies reporting that primary hypotheses were supported by study results, 75 (70.8%) studies reported that the primary hypothesis was fully supported by study results. The primary study hypothesis was partially supported by study results in 28 (26.4%) studies. We detail open science practices and resources that aim to safe-guard against QRPs that bely the credibility and replicability of original research findings.


Assuntos
Exercício Físico , Pesquisa/normas , Medicina Esportiva/normas , Interpretação Estatística de Dados , Humanos , Projetos de Pesquisa/normas , Pesquisadores/normas
16.
Sports Health ; 12(6): 573-578, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628560

RESUMO

CONTEXT: Sports Health: A Multidisciplinary Approach, now 10 years into production, has been ranked a top-25 journal in sport sciences and has tripled its impact throughout its existence. OBJECTIVE: To evaluate authorship trends and levels of evidence (LOE) of articles published in Sports Health from 2009 to 2018. The secondary aim was to analyze funding sources and internationalization throughout the journal's tenure. DATA SOURCES: All clinical studies published in Sports Health between the years 2009 and 2018 were examined. STUDY SELECTION: All publications from the provided years were electronically reviewed by 2 reviewers and evaluated for inclusion criteria. Editorials, society news, memorials, letters to the editor, and corrigenda were excluded. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 5. DATA EXTRACTION: Articles were examined for number of authors, presence of female authorship, funding, country of origin, international collaboration, academic degree or certification of first and senior authors, and LOE. Clinical articles were assigned LOE based on guidelines from the University of Oxford's Centre for Evidence-Based Medicine. RESULTS: A total of 654 articles were examined. The percentage of high-LOE studies increased throughout the study period. The percentage of publications with female authors also increased throughout the study period. The mean number of authors per article increased from 3.2 to 4.6 over the 10-year period (P < 0.05). The percentage of publications with international collaboration stayed consistent, while the number of countries per year increased during the study period. Overall, institutions from 23 countries have published in Sports Health since its inception to the time of this study. CONCLUSION: Female authorship in Sports Health surpasses industry standards, and the percentage of high-LOE studies remains remarkably high. Sports Health has stayed true to its multidisciplinary scope, as evidenced by the authors' varying degrees and numerous countries that publish in the journal.


Assuntos
Autoria , Medicina Baseada em Evidências/tendências , Editoração/tendências , Medicina Esportiva/tendências , Esportes/tendências , Humanos , Editoração/estatística & dados numéricos , Apoio à Pesquisa como Assunto , Esportes/estatística & dados numéricos , Medicina Esportiva/estatística & dados numéricos
17.
Expert Rev Cardiovasc Ther ; 18(7): 435-442, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32594825

RESUMO

INTRODUCTION: Pre-participation cardiovascular screening (PPCS) in athletes is recommended by numerous medical and sporting societies. While there is consensus that young athletes should be screened prior to participation in competitive sports, there are on-going debates regarding the true incidence of sudden cardiac death (SCD), the most frequent causes of SCD, and the optimal methods for PPCS. AREAS COVERED: This review focuses on the current evidence for the incidence of SCD, causes of SCD, and the pros and cons of a history and physical exam (H&P) and electrocardiogram (ECG) in PPCS of young competitive athletes. EXPERT OPINION: With significant controversy surrounding PPCS in athletes, a large-randomized trial powered for mortality is needed to assess the utility of PPCS and to define the optimal screening methods to detect cardiovascular diseases that may lead to SCD in competitive athletes. Until a trial of this caliber is created, controversy will remain and heterogeneity in care will exist. Future research should also define the optimal timing and frequency of PPCS given age-related penetrance of certain diseases, create evidence-based history questionnaires, continue to optimize ECG screening criteria, and create more learning modules for ECG interpretation in athletes.


Assuntos
Atletas , Morte Súbita Cardíaca/prevenção & controle , Programas de Rastreamento/métodos , Sistema Cardiovascular , Eletrocardiografia/métodos , Humanos , Incidência , Exame Físico/efeitos adversos , Exame Físico/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Esportes , Medicina Esportiva/métodos
18.
J Athl Train ; 55(6): 563-572, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32579668

RESUMO

INTRODUCTION: Sports participation is among the leading causes of catastrophic cervical spine injury (CSI) in the United States. Appropriate prehospital care for athletes with suspected CSIs should be available at all levels of sport. The goal of this project was to develop a set of best-practice recommendations appropriate for athletic trainers, emergency responders, sports medicine and emergency physicians, and others engaged in caring for athletes with suspected CSIs. METHODS: A consensus-driven approach (RAND/UCLA method) in combination with a systematic review of the available literature was used to identify key research questions and develop conclusions and recommendations on the prehospital care of the spine-injured athlete. A diverse panel of experts, including members of the National Athletic Trainers' Association, the National Collegiate Athletic Association, and the Sports Institute at UW Medicine participated in 4 Delphi rounds and a 2-day nominal group technique meeting. The systematic review involved 2 independent reviewers and 4 rounds of blinded review. RESULTS: The Delphi process identified 8 key questions to be answered by the systematic review. The systematic review comprised 1544 studies, 49 of which were included in the final full-text review. Using the results of the systematic review as a shared evidence base, the nominal group technique meeting created and refined conclusions and recommendations until consensus was achieved. CONCLUSIONS: These conclusions and recommendations represent a pragmatic approach, balancing expert experiences and the available scientific evidence.


Assuntos
Traumatismos em Atletas/terapia , Serviços Médicos de Emergência , Futebol Americano/lesões , Lesões do Pescoço/terapia , Traumatismos da Coluna Vertebral/terapia , Medicina Esportiva , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/organização & administração , Humanos , Medicina Esportiva/métodos , Medicina Esportiva/normas , Estados Unidos
19.
J Athl Train ; 55(6): 545-562, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32579669

RESUMO

Sport-related spine injury can be devastating and have long-lasting effects on athletes and their families. Providing evidence-based care for patients with spine injury is essential for optimizing postinjury outcomes. When caring for an injured athlete in American tackle football, clinicians must make decisions that involve unique challenges related to protective equipment (eg, helmet and shoulder pads). The Spine Injury in Sport Group (SISG) met in Atlanta, Georgia, March 2-3, 2019, and involved 25 health care professionals with expertise in emergency medicine, sports medicine, neurologic surgery, orthopaedic surgery, neurology, physiatry, athletic training, and research to review the current literature and discuss evidence-based medicine, best practices, and care options available for the prehospital treatment of athletes with suspected cervical spine injuries.1,2 That meeting and the subsequent Mills et al publication delineate the quality and quantity of published evidence regarding many aspects of prehospital care for the athlete with a suspected cervical spine injury. This paper offers a practical treatment guide based on the experience of those who attended the Atlanta meeting as well as the evidence presented in the Mills et al article. Ongoing research will help to further advance clinical treatment recommendations.


Assuntos
Traumatismos em Atletas , Serviços Médicos de Emergência , Primeiros Socorros , Futebol Americano/lesões , Traumatismos da Coluna Vertebral , Transporte de Pacientes , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/terapia , Benchmarking , Vértebras Cervicais/lesões , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/organização & administração , Primeiros Socorros/métodos , Primeiros Socorros/normas , Georgia , Humanos , Equipamento de Proteção Individual , Guias de Prática Clínica como Assunto , Melhoria de Qualidade/organização & administração , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/terapia , Medicina Esportiva/normas , Transporte de Pacientes/métodos , Transporte de Pacientes/normas , Estados Unidos
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