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2.
Curr Sports Med Rep ; 19(1): 24-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31913920

RESUMO

Soft tissue injuries to the head and neck are a common occurrence in sports. These anatomical regions are somewhat predisposed because of the "athletic stance" that is utilized in many close-contact sports. Although appropriate use of protective equipment, including mouth guards, helmets, and face shields, has reduced the incidence and severity of these injuries, they still occur regularly. To provide appropriate medical care, one must possess adequate knowledge of the superficial and deep anatomical structures, fundamental knowledge and skill in regard to wound care, and awareness of potential poor outcomes related to lacerations of unique structures, such as the mouth, eye, or ear.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Faciais/diagnóstico , Lacerações/diagnóstico , Lesões do Pescoço/diagnóstico , Traumatismos em Atletas/terapia , Traumatismos Craniocerebrais/terapia , Traumatismos Faciais/terapia , Humanos , Lacerações/terapia , Lesões do Pescoço/terapia , Volta ao Esporte
3.
Curr Sports Med Rep ; 19(1): 29-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31913921

RESUMO

Ocular injuries occur at a high rate in the United States and are a common complaint in the emergency department (ED). The CDC estimates that the annual rate for all-cause ocular injuries presenting to the ED is approximately 37.6 per 10,000 (1). The personal impact of ocular injury is an obvious one which necessitates urgent evaluation and possibly emergent ophthalmologic evaluation for vision preserving intervention. Specific sports and recreational activities increase the risk of injury; these include sports involving projectiles (i.e., target shooting, racquet sports, hockey pucks, lacrosse) as well as combat sports (i.e., martial arts, boxing, wrestling). Sideline physicians should be aware of the sports setting and be prepared for ocular injuries with the proper sideline equipment. Prompt recognition, management, and referral can lead to decreased morbidity in this select population.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos Oculares/diagnóstico , Traumatismos em Atletas/terapia , Traumatismos Oculares/terapia , Humanos , Estados Unidos
4.
J Sports Sci ; 38(1): 86-93, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31707915

RESUMO

The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. BACKGROUND: Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. METHODS: Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. RESULTS: Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). CONCLUSIONS: Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.


Assuntos
Traumatismos do Tornozelo/diagnóstico , Traumatismos em Atletas/diagnóstico , Teste de Esforço/métodos , Entorses e Distensões/diagnóstico , Adolescente , Adulto , Traumatismos do Tornozelo/fisiopatologia , Traumatismos em Atletas/fisiopatologia , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Valor Preditivo dos Testes , Fatores de Risco , Entorses e Distensões/fisiopatologia , Adulto Jovem
6.
Br J Sports Med ; 54(3): 154-158, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31611189

RESUMO

BACKGROUND: The vertical drop jump (VDJ) test is widely used for clinical assessment of ACL injury risk, but it is not clear whether such assessments are valid. AIM: To examine if sports medicine professionals and coaches are able to identify players at risk of sustaining an ACL injury by visually assessing player performance during a VDJ test. METHODS: 102 video clips of elite female handball and football players performing a baseline VDJ test were randomly extracted from a 738-person prospective cohort study that tracked ACL injuries. Of the sample, 20 of 102 went on to suffer an ACL injury. These 102 videos were uploaded to an online survey. Sports medicine professionals and coaches were invited to assess athlete performance and rate each clip with a number between 1 and 10 (1 representing low risk of sustaining an ACL injury and 10 representing high risk). Receiver operating characteristic analyses were used to assess classification accuracy and between-group differences were analysed using one-way analysis of variance. RESULTS: 237 assessors completed the survey. Area under the curve values ranged from 0.36 to 0.60, with a mean score of 0.47, which is similar to random guessing. There were no significant differences in classification accuracy between groups (physicians, coaches, certified athletic trainers, researchers or physical therapists). CONCLUSION: Assessors have poor predictive ability (no better than chance), indicating that visual assessment of a VDJ test is a poor test for assessing ACL injury risk in elite female handball and football players.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Traumatismos em Atletas/diagnóstico , Teste de Esforço , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Futebol/lesões , Gravação em Vídeo , Adulto Jovem
7.
Br J Sports Med ; 54(2): 94-101, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31331944

RESUMO

OBJECTIVES: To determine whether individuals who sustained a sports concussion would exhibit persistent impairments in gait and quiet standing compared to non-injured controls during a dual-task assessment . DESIGN: Systematic review and meta-analysis using individual participant data (IPD). DATA SOURCES: The search strategy was applied across seven electronic bibliographic and grey literature databases: MEDLINE, EMBASE, CINAHL, SportDISCUS, PsycINFO, PsycARTICLES and Web of Science, from database inception until June 2017. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Studies were included if; individuals with a sports concussion and non-injured controls were included as participants; a steady-state walking or static postural balance task was used as the primary motor task; dual-task performance was assessed with the addition of a secondary cognitive task; spatiotemporal, kinematic or kinetic outcome variables were reported, and; included studies comprised an observational study design with case-control matching. DATA EXTRACTION AND SYNTHESIS: Our review is reported in line with the Preferred Reporting Items for Systematic review and Meta-Analyses-IPD Statement. We implemented the Risk of Bias Assessment tool for Non-randomised Studies to undertake an outcome-level risk of bias assessment using a domain-based tool. Study-level data were synthesised in one of three tiers depending on the availability and quality of data: (1) homogeneous IPD; (2) heterogeneous IPD and (3) aggregate data for inclusion in a descriptive synthesis. IPD were aggregated using a 'one-stage', random-effects model. RESULTS: 26 studies were included. IPD were available for 20 included studies. Consistently high and unclear risk of bias was identified for selection, detection, attrition, and reporting biases across studies. Individuals with a recent sports concussion walked with slower average walking speed (χ2=51.7; df=4; p<0.001; mean difference=0.06 m/s; 95% CI: 0.004 to 0.11) and greater frontal plane centre of mass displacement (χ2=10.3; df=4; p=0.036; mean difference -0.0039 m; 95% CI: -0.0075 to -0.0004) than controls when evaluated using a dual-task assessment up to 2 months following concussion. SUMMARY/CONCLUSIONS: Our IPD evidence synthesis identifies that, when evaluated using a dual-task assessment, individuals who had incurred a sports concussion exhibited impairments in gait that persisted beyond reported standard clinical recovery timelines of 7-10 days. Dual-task assessment (with motion capture) may be a useful clinical assessment to evaluate recovery after sports concussion. PROTOCOL PRE-REGISTRATION: This systematic review was prospectively registered in PROSPERO CRD42017064861.


Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Exame Neurológico/métodos , Velocidade de Caminhada , Fenômenos Biomecânicos , Humanos , Equilíbrio Postural , Análise e Desempenho de Tarefas
8.
Emerg Med Clin North Am ; 38(1): 207-222, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757251

RESUMO

A systematic approach is required for patients with a suspected concussion. Although standardized tools can aid in assessment, the diagnosis of concussion remains a clinical one. At the time of diagnosis, patients should be given both verbal and written review of the common symptoms of concussion, expected course of recovery, as well as strategies to manage symptoms. Most patients benefit from a brief period of rest, followed by a gradual reintroduction of activities, and a graduated return-to-sport protocol. Patients with prolonged recovery from a concussion may benefit from exercise, vestibular, and cognitive rehabilitation programs.


Assuntos
Traumatismos em Atletas/terapia , Concussão Encefálica/terapia , Diagnóstico por Imagem/métodos , Gerenciamento Clínico , Emergências , Medicina Esportiva/métodos , Traumatismos em Atletas/complicações , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Concussão Encefálica/etiologia , Humanos , Índices de Gravidade do Trauma
9.
Clin Sports Med ; 39(1): 197-209, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767106

RESUMO

Older athletes consist of a relatively healthier population with a high desire for return to sport despite knee injury. A meniscal tear is a common injury that has lasting impacts on joint function and activity level. Lower extremity loading from sporting activity in conjunction with degenerative meniscal changes increases the risk of meniscal tear in older athletes. Optimal treatment of degenerative meniscal tears is often debated with varying studies reporting the benefits of strictly nonoperative treatment or the value of surgery. Postoperative rehabilitation is crucial to enhance the possibility of return to sport.


Assuntos
Traumatismos em Atletas/cirurgia , Lesões do Menisco Tibial/cirurgia , Artroscopia/métodos , Traumatismos em Atletas/diagnóstico , Tomada de Decisão Clínica , Humanos , Articulação do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/diagnóstico , Cuidados Pós-Operatórios , Lesões do Menisco Tibial/diagnóstico
10.
Orthopade ; 48(12): 1005-1012, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31705177

RESUMO

BACKGROUND: Sport climbing is rapidly becoming a popular trend sport, which has resulted in a surge of climbing-specific injuries. OBJECTIVES: The goal of this paper is to delineate the incidence of climbing-specific injuries focusing on finger and shoulder injuries. Furthermore, we aim to illustrate clinical symptoms and therapeutic strategies based on the current literature. MATERIALS AND METHODS: The incidence of climbing-specific injuries in a large patient population was recorded and diagnosis and treatment options were assessed considering the current literature. RESULTS: Finger and shoulder injuries are the most common entities in sport climbing. With regard to finger injuries, more than 30 different differential diagnoses were identified, with pulley injuries, tenosynovitis, epiphyseal fractures, as well as lumbrical muscle tears being of the greatest importance due to their climbing-specific nature. With regard to shoulder injuries, SLAP lesions play a particularly important role, currently representing the fifth most common diagnosis in the patient population analyzed. Further pathologies that are becoming increasingly important among sport climbers are injuries of the rotator cuff, long biceps tendon ruptures, impingement syndromes and injuries caused by shoulder dislocations (e.g. Bankart lesions). CONCLUSIONS: Finger injuries are common in sports climbing and can be challenging to diagnose and treat correctly. The number of shoulder injuries is expected to rise as new competition modalities and sub-disciplines (e.g. bouldering) increasingly stress athletes' musculoskeletal systems. An increase of degenerative injuries in long-time climbers is expected due to changes in the sport.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos dos Dedos/diagnóstico , Montanhismo/lesões , Lesões do Ombro/diagnóstico , Esportes , Traumatismos em Atletas/epidemiologia , Traumatismos dos Dedos/epidemiologia , Humanos , Incidência , Lesões do Ombro/epidemiologia , Traumatismos dos Tendões/epidemiologia
11.
South Med J ; 112(10): 547-550, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31583417

RESUMO

Sports-related encephalopathies are a growing concern among athletes who have experienced head trauma. Anxiety is heightened for the public and especially among parents of children playing contact sports. The most common neuropsychological conditions are concussions and traumatic encephalopathies. Concussions result from brain traumas that can be asymptomatic, but more serious concussions can include loss of consciousness, neurological abnormalities, and/or posttraumatic amnesias. Repetitive concussions lead to persistent brain pathology, known as chronic traumatic encephalopathies. This gradually progressive neurodegenerative disease frequently presents with cognitive and neurological deficits, which can result in significant parkinsonian features and dementia. Imaging studies may be noncontributory; however, diffusion tensor imaging, magnetic resonance spectroscopy, and functional magnetic resonance imaging can detect changes indicative of these encephalopathies. Progressive neuronal degeneration with tau proteins are documented on pathological examination. Prevention, early diagnosis, and proper treatment are the recommended approach to these conditions.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Encefalopatia Traumática Crônica/prevenção & controle , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/patologia , Traumatismos em Atletas/terapia , Concussão Encefálica/diagnóstico , Concussão Encefálica/patologia , Concussão Encefálica/terapia , Encefalopatia Traumática Crônica/diagnóstico , Encefalopatia Traumática Crônica/patologia , Encefalopatia Traumática Crônica/terapia , Dispositivos de Proteção da Cabeça , Educação em Saúde , Humanos , Equipamento de Proteção Individual , Volta ao Esporte/normas
14.
J Sci Med Sport ; 22(12): 1309-1313, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31515168

RESUMO

OBJECTIVES: The risk of a subsequent anterior cruciate ligament (ACL) sprain is greater in high school aged female athletes with prior history of ACL reconstruction (ACLR) than in age-matched controls. The risk of a subsequent ACL injury in female collegiate athletes with prior ACLR is unknown. The primary purpose of this study was to determine the relative risk of a subsequent ACL injury in female collegiate athletes with prior ACLR when compared to age-matched controls. The secondary purpose of this study was to evaluate the ability of jump and hop tests to discriminate ACL injury risk. DESIGN: Prospective cohort. METHODS: Three hundred and sixty female collegiate athletes (mean age 19.3 ±â€¯1.4 years) representing the following sports: volleyball, soccer, and basketball were recruited. Subjects reported prior history of ACLR and standing long jump (SLJ) and single-leg hop (SLH) scores were collected during the preseason. Noncontact time-loss ACL and lower quadrant (i.e., low back and lower extremities) injuries were tracked by university athletic trainers. RESULTS: Female collegiate athletes with a prior history of ACLR were 6 times (RR = 6.8 [95% CI: 1.4, 32.9] p-value = 0.007) more likely to experience an ACL injury than controls. Suboptimal performance on a battery of tests (SLJ ≤ 79% height, (B) SLH ≤ 69% height) was associated with a greater risk of lower quadrant injury (RR = 1.6 [95% CI: 1.1, 2.4] p-value = 0.028); however performance on these tests was not associated with ACL injury. CONCLUSIONS: Female collegiate athletes should be screened for history of ACLR.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Reconstrução do Ligamento Cruzado Anterior , Traumatismos em Atletas/diagnóstico , Adolescente , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Traumatismos em Atletas/cirurgia , Basquetebol/lesões , Teste de Esforço , Feminino , Humanos , Traumatismos do Joelho , Estudos Prospectivos , Recidiva , Fatores de Risco , Futebol/lesões , Voleibol/lesões , Adulto Jovem
15.
Curr Sports Med Rep ; 18(9): 330-337, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31503045

RESUMO

Rotator cuff (RTC) injuries are common in master athletes, especially overhead athletes. Risk factors include aging and degeneration as nonmodifiable and volume of activity, muscle weakness, and loss of motion as modifiable. The clinical presentation involves limited range of motion (ROM), pain at rest and at night. Injury classification into traumatic versus nontraumatic and tendinopathy, partial or full-thickness tears helps to establish a treatment plan. RTC injury rehabilitation protocols are criteria-based, multimodal, and divided into four phases. The acute phase addresses pain, inflammation, ROM, and RTC protection. The recovery phase addresses kinetic chain abnormalities, flexibility, and strength, and the functional phase involves exercises directed toward specific sport activities. Return to sports is based on clinical recovery, kinetic chain principles, and adequate sports technique. Nonsurgical management is recommended in most cases, and surgical management is considered if symptoms progress, especially for full-thickness tears.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/reabilitação , Lesões do Manguito Rotador/diagnóstico , Lesões do Manguito Rotador/reabilitação , Atletas , Humanos , Manejo da Dor , Volta ao Esporte
16.
Curr Sports Med Rep ; 18(9): 338-345, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31503046

RESUMO

The ulnar collateral ligament (UCL) of the elbow has been a subject of extensive research and discussion in recent years not only in the medical community but also in the media and by coaches, players, and parents. This is in part due to the rising incidence of UCL injuries and subsequent surgical reconstruction, specifically in overhead throwing athletes. Due to this widespread increase in injury to this structure, it is paramount to understand when it is appropriate to pursue nonoperative versus operative management. As such, the purpose of this article will be to review the basic anatomy, risk factors for UCL injury in overhead throwing athletes, treatment approaches, and future directions for prevention and treatment of injury based on the evidence-based data in the peer-reviewed literature.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Ligamento Colateral Ulnar/lesões , Cotovelo/lesões , Atletas , Humanos , Volta ao Esporte , Fatores de Risco
17.
J Sci Med Sport ; 22(12): 1292-1297, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31521485

RESUMO

OBJECTIVES: The current study investigated the role of persistent vestibular-ocular symptoms and impairment following sport-related concussion on recovery time and clinical outcomes among adolescents. DESIGN: Prospective cohort. METHODS: 50 (F-22/M-28) adolescents aged 12-20 years completed a vestibular-ocular motor screening, neurocognitive assessment, and the Post-Concussion Symptom Scale (PCSS) at clinical assessments conducted at 0-10 and 11-21 days after concussion. Participants were assigned to: 1) persistent vestibular-ocular (PERSIST), 2) vestibular-ocular improvement (IMPROVE), or 3) no vestibular-ocular impairment (NONE) groups based on vestibular-ocular motor screening conducted during each assessment. A 3 (GROUP) X 2 (TIME) ANOVA was performed on neurocognitive and symptom scores, and a between-subjects ANOVA was performed for recovery time. RESULTS: 49 subjects were identified among the PERSIST (n=17), IMPROVE (n=12) and NONE (n=20) groups. There were no neurocognitive performance differences between groups at 0-10 days post-concussion, but groups differed on PCSS at 11-21 days (p=.001), with the PERSIST (29.0±24.9) group reporting higher symptoms than the NONE (5.45±10.0; p=.005) group. The PERSIST group took significantly longer to recover (34.9±11.6 days) than the NONE (22.9±14.9 days) group (p=.03). All groups improved on verbal (p<.001) and visual memory (p=.028), visual motor speed (p=.005), and reaction time (p=.004) from 0-10 to 11-20 days following SRC and no significant group by time interactions for cognitive scores identified. CONCLUSIONS: Persistent post-concussion vestibular-ocular symptoms and impairment may influence neurocognitive performance and clinical recovery following sport-related concussion.


Assuntos
Traumatismos em Atletas/complicações , Concussão Encefálica/complicações , Transtornos da Motilidade Ocular/etiologia , Síndrome Pós-Concussão/diagnóstico , Doenças Vestibulares/etiologia , Adolescente , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Criança , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Transtornos da Motilidade Ocular/diagnóstico , Estudos Prospectivos , Tempo de Reação , Doenças Vestibulares/diagnóstico , Adulto Jovem
18.
Clin Sports Med ; 38(4): 497-511, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472762

RESUMO

Concussion is a challenging and controversial medical diagnosis that can test even the most seasoned practitioner. Knowledge on this topic is ever evolving. It was not so long ago that grading guidelines were based on loss of consciousness and amnesia. Medicine has seen a renaissance of discovery over the past 20 years in concussion evaluation and management. A PubMed search for "concussion" between 1990 and 2000 produced just over 1000 articles and that same search including the last 18 years expands to over 10,000 publications. The most recent knowledge and recommendations are discussed based on the published evidence.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Concussão Encefálica/diagnóstico , Concussão Encefálica/terapia , Humanos , Exame Físico , Medicina Esportiva/métodos , Avaliação de Sintomas
19.
Clin Sports Med ; 38(4): 513-535, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472763

RESUMO

The athletic training room is filled with a multitude of conditions encompassing many different specialties of medicine. When it comes to traumatic injuries in the training room, many of them are not musculoskeletal in nature. Ultrasound in the training room can help identify serious and subtle solid-organ injury and small pneumothoraces. The discussion of these conditions follows a simple outline that helps identify injury/conditions through a proper history and physical. Evidence-based treatment/management/return to play guidelines are discussed.


Assuntos
Traumatismos Abdominais/diagnóstico , Traumatismos em Atletas/diagnóstico , Traumatismos Faciais/diagnóstico , Traumatismos Torácicos/diagnóstico , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/terapia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Traumatismos Faciais/etiologia , Traumatismos Faciais/terapia , Humanos , Boca/lesões , Lesões do Pescoço/diagnóstico , Lesões do Pescoço/etiologia , Lesões do Pescoço/terapia , Nariz/lesões , Exame Físico , Volta ao Esporte , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/terapia
20.
Clin Sports Med ; 38(4): 597-618, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472769

RESUMO

There are numerous disorders of the skin that occur in athletes. These include infections, mechanical injury, and inflammatory skin diseases such as dermatitis, urticaria, and others. This paper discusses some of the most common athletic skin diseases.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Dermatite de Contato/etiologia , Dermatopatias Infecciosas/terapia , Pele/lesões , Esportes , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Dermatite de Contato/diagnóstico , Dermatite de Contato/prevenção & controle , Humanos , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/microbiologia , Urticária/diagnóstico , Urticária/etiologia , Urticária/terapia
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