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1.
Sports Med Arthrosc Rev ; 29(3): e24-e33, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34398119

RESUMO

Meniscus surgery is one of the most commonly performed orthopedic procedures worldwide. Modifiable risk factors for meniscus injury include body mass index, participation in athletics and occupation. Nonmodifiable risk factors include age, sex, lower extremity alignment, discoid meniscus, ligamentous laxity, and biconcave tibial plateau. Conditions commonly associated with meniscal injury are osteoarthritis, anterior cruciate ligament injury, and tibial plateau fractures. Tear type and location vary by patient age and functional status. Surgical management of meniscus injury is typically cost-effective in terms of quality-adjusted life years. The purpose of this review is to provide an overview of meniscal injury epidemiology by summarizing tear types and locations, associated conditions, and factors that increase the risk for meniscal injury. The economic burden of meniscus injury and strategies to prevent injury to the meniscus are also reviewed.


Assuntos
Lesões do Menisco Tibial/epidemiologia , Grupo com Ancestrais do Continente Africano , Fatores Etários , Lesões do Ligamento Cruzado Anterior/complicações , Traumatismos em Atletas/etiologia , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Traumatismos Ocupacionais/etiologia , Osteoartrite do Joelho/complicações , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Ruptura/epidemiologia , Ruptura/etiologia , Fatores Sexuais , Fumar/efeitos adversos , Fraturas da Tíbia/complicações , Lesões do Menisco Tibial/economia , Lesões do Menisco Tibial/etiologia , Lesões do Menisco Tibial/terapia
2.
J Pediatr Orthop ; 41(8): 507-513, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34397783

RESUMO

BACKGROUND: There is significant emerging evidence that early sport specialization is a potential risk factor for injury in youth sports. Despite basketball being the most popular youth team sport in the United States, sport specialization research, specifically in youth basketball players, has been limited. The purpose of this paper was to examine the association of sport specialization behaviors with injury history by surveying a nationally representative sample of parents of youth basketball athletes. We hypothesized that athletes who specialized in basketball, participated on multiple teams at the same time, and traveled regularly for basketball competitions would be more likely to report a basketball-related injury in the previous year. METHODS: A nationally representative sample of 805 parents of 805 youth basketball players (female N=241, 29.9%; age: 12.9±2.5 y old) completed an online questionnaire that had 3 sections: (1) parent/child demographics, (2) child basketball participation information for the previous year, and (3) child basketball injury history in the previous year. Multivariate logistic regression examined the associations between variables of interest and injury history, adjusting for covariates. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated for the variables of interest from the logistic regression model. RESULTS: Highly specialized athletes were more likely than low specialization athletes to report history of basketball injury in the previous year [OR (95% CI): 2.47 (1.25-4.88), P=0.009]. The odds of reporting an injury in the previous year were twice as great among athletes who played on a basketball team at the same time as another sport team compared with those who played basketball only [OR (95% CI): 1.98 (1.30-3.01), P=0.001]. The odds of reporting an injury in the previous year were 3 times greater among athletes who received private coaching compared with those who did not receive private coaching [OR (95% CI): 2.91 (1.97-4.31), P<0.001]. CONCLUSION: Specialization in basketball, along with several other behaviors that have become typical of modern youth sport participation, were associated with reported injury history. Further prospective research is necessary to determine whether sport specialization behaviors increase the risk of injury in youth basketball. LEVEL OF EVIDENCE: Level III-cross-sectional study.


Assuntos
Traumatismos em Atletas , Basquetebol , Transtornos Traumáticos Cumulativos , Esportes Juvenis , Adolescente , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Criança , Estudos Transversais , Feminino , Humanos , Fatores de Risco , Especialização , Estados Unidos/epidemiologia
3.
Am J Sports Med ; 49(10): 2810-2816, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34181487

RESUMO

BACKGROUND: Research has demonstrated that female athletes are more likely to report their sports-related concussion (SRC) symptoms compared with male athletes; however, it is unknown if these reporting behaviors correspond to immediate removal from activity in sex-comparable sports. PURPOSE: To compare the incidence of high school student-athletes removed and not removed from activity after SRC in sex-comparable sports in Michigan. STUDY DESIGN: Descriptive epidemiology study. METHODS: Participants included student-athletes diagnosed with SRC participating in Michigan High School Athletic Association-sponsored athletic activities (22 sex-comparable sports) between 2016 and 2019. All SRCs were recorded in the association's Head Injury Reporting System (HIRS) by certified athletic trainers, administrators, or coaches. Removal from activity indicated that the student-athlete was removed from play at the time of an injury event. If the student-athlete reported that his or her suspected injury event occurred earlier during activity or if symptom onset was delayed, "not removed from activity" was entered into the HIRS. Incidence proportions were calculated by dividing SRCs not removed by total SRCs in each sport. Risk ratios were calculated by dividing the incidence proportions of girls not removed by boys not removed in each sport. RESULTS: A total of 4418 (2773 female, 1645 male) SRCs were reported, with the most occurring in female soccer players (n = 1023). Overall, 515 girls and 243 boys were not removed from activity, resulting in incidences of 0.19 (95% CI, 0.17-0.20) and 0.15 (95% CI, 0.13-0.17), respectively. Across all sports, girls were 1.26 (95% CI, 1.09-1.45) times as likely to not be removed from activity compared with boys. Of the sports with the most SRCs-soccer, basketball, baseball/softball, and lacrosse-girls had 1.37 (95% CI, 1.09-1.72), 1.15 (95% CI, 0.89-1.47), 1.19 (95% CI, 0.77-1.84), and 1.35 (95% CI, 0.94-1.95) times the risk of not being removed, respectively. CONCLUSION: Girls were at greater risk of not being removed from activity compared with boys in sex-comparable sports. Results from this study should be incorporated into SRC education in Michigan and potentially elsewhere to inform affiliated personnel of potential sex differences and protect female student-athletes from further harm.


Assuntos
Traumatismos em Atletas , Basquetebol , Concussão Encefálica , Atletas , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/etiologia , Feminino , Humanos , Incidência , Masculino , Michigan/epidemiologia , Instituições Acadêmicas
4.
Curr Sports Med Rep ; 20(6): 286-290, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34099605

RESUMO

ABSTRACT: Sleep has been found to have wide-ranging effects on sports performance and overall well-being. Recent research has found evidence relating chronic suboptimal sleep with the risk of musculoskeletal pain and sports injury. The amount of sleep that consistently has been found to be associated with increased risk of injury is ≤7 h of sleep, which when sustained for periods of at least 14 d has been associated with 1.7 times greater risk of musculoskeletal injury. However, it is unknown if sleep loss predisposes the athlete to specific types of musculoskeletal injuries. The role of sleep on musculoskeletal pain is important to understand as studies in both children and adults have found that suboptimal sleep more consistently predicts next-day pain as compared with pain predicting subsequent sleep loss. Despite the evidence that certain aspects of sleep behavior seem to increase the risk of musculoskeletal injury and pain, sleep should be considered as only a part of the athlete's overall health and well-being when assessing the athlete for risk of injury.


Assuntos
Atletas , Traumatismos em Atletas/etiologia , Sistema Musculoesquelético/lesões , Transtornos do Sono-Vigília/complicações , Sono/fisiologia , Adulto , Desempenho Atlético/fisiologia , Criança , Humanos , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Risco , Fatores de Tempo , Adulto Jovem
5.
Curr Sports Med Rep ; 20(6): 312-318, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34099609

RESUMO

ABSTRACT: Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.


Assuntos
Artralgia , Traumatismos em Atletas , Traumatismos dos Tendões , Ulna , Traumatismos do Punho/complicações , Artralgia/diagnóstico , Artralgia/etiologia , Artralgia/terapia , Atletas , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Beisebol/lesões , Beisebol/fisiologia , Fenômenos Biomecânicos , Golfe/lesões , Golfe/fisiologia , Ginástica/lesões , Ginástica/fisiologia , Hamato/lesões , Hóquei/lesões , Hóquei/fisiologia , Humanos , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/terapia , Tênis/lesões , Tênis/fisiologia , Fibrocartilagem Triangular/lesões , Traumatismos do Punho/epidemiologia , Articulação do Punho/anatomia & histologia , Articulação do Punho/fisiologia
6.
Curr Sports Med Rep ; 20(4): 188-192, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33790191

RESUMO

ABSTRACT: Advancements in technology and the economic desires to maximize use of athletic playing surfaces have led to the development of various playing surfaces across the spectrum of sports. Each of these surfaces possesses specific safety profiles which are sport and population specific. Despite the growing medical literature on outdoor playing surfaces, inconsistent data exist on both orthopedic injuries and general medical concerns, such as surface component exposure toxicity and infection risk. Unfortunately, there is a paucity of data regarding various indoor playing surfaces and their effects on injury risk; this is an area ripe for further medical investigation. Understanding the differences in various play surfaces and their associated injury and health concerns is crucial for all medical staff providing care to athletes across the spectrum of skill and competition.


Assuntos
Traumatismos em Atletas/etiologia , Planejamento Ambiental , Propriedades de Superfície , Humanos , Fatores de Risco
7.
J Orthop Surg (Hong Kong) ; 29(1): 23094990211003347, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33779394

RESUMO

We aimed to examine the relationship between hip range of motion (ROM) and abduction strength and throwing-related shoulder/elbow injuries in high school baseball pitchers. The study included 135 baseball pitchers. We asked them to fill out a questionnaire at the checkups, that included the dominant arm and the years of baseball experience. To avoid a confirmation bias, the examiners were blinded to the participants' hand dominance. All players underwent physical function measurements, such as height, weight, shoulder and hip strength, and shoulder and hip ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the patient had been aware of in the past 3 years. The results of injured and non-injured pitchers were compared. Eighty-five pitchers had experienced a shoulder or elbow injury in the past 3 years. The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation ROM on the dominant side, the hip abduction strength on the non-dominant side, and the hip abduction strength on the dominant side were significantly lower in the injured group than in the non-injured group. The results may contribute to reducing the incidence of these injuries.


Assuntos
Beisebol/lesões , Resistência à Flexão/fisiologia , Articulação do Quadril/fisiologia , Amplitude de Movimento Articular/fisiologia , Extremidade Superior/lesões , Adolescente , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Beisebol/fisiologia , Cotovelo/lesões , Cotovelo/fisiologia , Articulação do Cotovelo/lesões , Articulação do Cotovelo/fisiologia , Articulação do Cotovelo/fisiopatologia , Humanos , Masculino , Movimento/fisiologia , Fatores de Risco , Rotação , Instituições Acadêmicas , Ombro/fisiologia , Lesões do Ombro/epidemiologia , Lesões do Ombro/etiologia , Lesões do Ombro/fisiopatologia , Articulação do Ombro/lesões , Articulação do Ombro/fisiologia , Articulação do Ombro/fisiopatologia , Estudantes , Inquéritos e Questionários , Extremidade Superior/fisiologia , Extremidade Superior/fisiopatologia
8.
Curr Sports Med Rep ; 20(3): 140-149, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33655995

RESUMO

ABSTRACT: This article reviews the most up-to-date evidence-based recommendations pertaining to breast and upper chest conditions, specifically for the sports medicine physician. Because of the unique circumstances of the team physician, they can see a wide breadth of pathology. Athletes may not have a primary care physician and may prefer to present to their team physician for breast and upper chest conditions. It is often more comfortable and convenient for athletes to seek treatment in the team setting. Therefore, it is important that the medical professional be aware of not only common pathology but also of that which is rarer. Any delay in evaluation can result in unnecessary morbidity and lead to complications or extended time lost from sport. Consequently, it also is important to facilitate an atmosphere encouraging early presentation and workup.


Assuntos
Traumatismos em Atletas , Mama/lesões , Traumatismos Torácicos , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Mama/anatomia & histologia , Feminino , Ginecomastia/diagnóstico , Ginecomastia/epidemiologia , Ginecomastia/etiologia , Ginecomastia/terapia , Humanos , Masculino , Dor/diagnóstico , Dor/epidemiologia , Dor/etiologia , Manejo da Dor , Volta ao Esporte , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/epidemiologia , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/terapia , Tórax/anatomia & histologia
9.
Curr Sports Med Rep ; 20(3): 150-156, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33655996

RESUMO

ABSTRACT: Trunk pain is a common cause of performance limitation and time away from sport in athletes. However, atraumatic trunk injuries are underrepresented in medical literature and underrecognized clinically. Delays in diagnosis and initiation of appropriate treatment can increase injury morbidity and return-to-play time. Currently, evidence-based guidelines for diagnosis and treatment of trunk pain in athletes are limited. Thus, we provide an overview of atraumatic sport-related injuries to the thoracic spine (disc herniation, scoliosis, kyphosis), ribcage (bone stress injury, costochondritis, Tietze syndrome, slipping rib syndrome, costovertebral or costotransverse joint dysfunction), and chest and abdominal wall musculature (intercostal, serratus anterior, oblique strains, regional myofascial pain), highlighting sport-specific biomechanical considerations. We aim to increase awareness of these causes of trunk pain among sports medicine providers in an effort to guide diagnostic and treatment recommendations that will ultimately improve overall musculoskeletal health in athletes.


Assuntos
Traumatismos em Atletas , Tronco/lesões , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Traumatismos em Atletas/terapia , Fenômenos Biomecânicos , Humanos , Músculo Esquelético/lesões , Dor/etiologia , Costelas/anatomia & histologia , Costelas/lesões , Curvaturas da Coluna Vertebral/diagnóstico , Curvaturas da Coluna Vertebral/etiologia , Curvaturas da Coluna Vertebral/terapia , Entorses e Distensões/diagnóstico , Entorses e Distensões/etiologia , Entorses e Distensões/terapia , Vértebras Torácicas/anatomia & histologia , Vértebras Torácicas/lesões , Tronco/fisiopatologia
10.
Curr Sports Med Rep ; 20(3): 157-163, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33655997

RESUMO

ABSTRACT: Core muscle injuries are common injuries in athletes involved in high speed side-to-side acceleration movements. The term core muscle injury encapsulates several different injuries that occur in the pelvic region that have similar presentations. Along with a good history and physical examination, magnetic resonance imaging (MRI) can be a helpful tool in the diagnostic process. Correct orientation and protocols are needed to show the correct anatomy with an MRI. Furthermore, to determine the exact etiology of the core muscle injury, it is important to know which structures are likely to be involved and be able to recognize the patterns of injury on imaging.


Assuntos
Traumatismos em Atletas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões , Pelve/diagnóstico por imagem , Pelve/lesões , Traumatismos em Atletas/etiologia , Humanos
11.
Curr Sports Med Rep ; 20(3): 169-178, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33655999

RESUMO

ABSTRACT: Exertional rhabdomyolysis (ER) is an uncommon condition with a paucity of evidence-based guidance for diagnosis, management, and return to duty or play. Recently, a clinical practice guideline for diagnosis and management of ER in warfighters was updated by a team of military and civilian physicians and researchers using current scientific literature and decades of experience within the military population. The revision concentrated on challenging and controversial clinical questions with applicability to providers in the military and those in the greater sports medicine community. Specific topics addressed: 1) diagnostic criteria for ER; 2) clinical decision making for outpatient versus inpatient treatment; 3) optimal strategies for inpatient management; 4) discharge criteria; 5) identification and assessment of warfighters/athletes at risk for recurrent ER; 6) an appropriate rehabilitative plan; and finally, 7) key clinical questions warranting future research.


Assuntos
Militares , Rabdomiólise/diagnóstico , Rabdomiólise/terapia , Assistência Ambulatorial , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Biomarcadores/sangue , Tomada de Decisão Clínica , Hospitalização , Humanos , Condicionamento Físico Humano/efeitos adversos , Esforço Físico , Recidiva , Volta ao Esporte , Retorno ao Trabalho , Rabdomiólise/complicações , Rabdomiólise/etiologia , Fatores de Risco , Urinálise
12.
J Safety Res ; 76: 262-268, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653558

RESUMO

INTRODUCTION: Concussion is traumatic brain injury with associated tissue damage commonly produced by an indirect or direct head or facial trauma that can negatively impact an athletes' career and personal life. In this context, the importance on how to deal with a concussion has received attention from worldwide literature and has become a topic of enormous interest in the sports medicine arena. OBJECTIVE: This systematic review aimed to investigate how sports-related concussion is being managed regarding athletic injuries, athletes' age, clinical signs of concussion, adopted questionnaires, as well as decision making in sports medicine. METHODS: A systematic review of the literature was performed searching 10 electronic databases with no limitations for year of publication up to December 2019. The search terms used were: Brain Concussion, Athletes, Sports Medicine, Athletic Injuries, Clinical Decision-Making, and Decision Making. The articles were considered eligible when the studies related to populations of regular sports practitioners, professional or recreational, of any age; sports injury; articles reporting concussion evaluation in at least 30 athletes; and articles published in English, French, Portuguese, Italian. We excluded systematic review articles, reviews, editorials, sport-unrelated concussion, no questionnaire application, approaching retired athletes, consensus statement letters, author's reply to editorials, synopsis, and abstracts. RESULTS: The parameters adopted for decision-making and management were broadly variable and were based on a variety of clinical signs or scoring outcomes from a myriad of questionnaires with little consistency in protocol or management guidelines, which could guide the average clinician. CONCLUSION: This systematic review provides current evidence that post-concussion management in sports medicine has yet to accomplish a standardized protocol that clinicians could use to optimally care for athletes. The extensive number of manuscripts and studies addressing the topic confirms that sports-related concussion in the pediatric and adolescent population has come to the forefront in the sports medicine field.


Assuntos
Atletas/estatística & dados numéricos , Traumatismos em Atletas/terapia , Concussão Encefálica/terapia , Medicina Esportiva/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Concussão Encefálica/diagnóstico , Concussão Encefálica/etiologia , Criança , Feminino , Humanos , Masculino , Adulto Jovem
13.
Scott Med J ; 66(2): 73-76, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33573510

RESUMO

INTRODUCTION: Horse riding carries risk of injury which can result in fatality. The majority of published literature describes major trauma centre experience. We aimed to characterise injury patterns following equine trauma at a Scottish district general hospital. METHODS: A retrospective review of admissions following equine trauma was undertaken from 2014 to 2019. Mechanism and nature of injuries were noted. Patient management and outcomes were recorded and analysed to determine correlation. RESULTS: Of the 162 patients identified, 121 (74.7 per cent) were female. The commonest mechanism and injury sustained were falling from a horse (86.4 per cent) and head injury (17.9 per cent) respectively. Forty-four (27.2 per cent) had multiple injuries identified. Being crushed or kicked resulted in more abdominal visceral injuries (22.7 vs 0.7 per cent, p = <0.05) and ITU admissions (18.2 vs 6.4 per cent, p = 0.06) when compared with falling from alone. Eight (4.9 per cent) required transfer to a major trauma centre and 30-day mortality was 0.6 per cent. CONCLUSION: Although variable, injuries following equine trauma can be life threatening. Increased awareness and development of safety legislation is needed. In addition, research could be directed at assessing functional outcomes given the large number of orthopaedic injuries.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Adulto , Animais , Traumatismos em Atletas/etiologia , Traumatismos Craniocerebrais/etiologia , Feminino , Cavalos , Hospitalização/estatística & dados numéricos , Hospitais de Distrito/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Reino Unido/epidemiologia
14.
Sports Health ; 13(3): 304-309, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33530847

RESUMO

BACKGROUND: Although the restoration of quadriceps strength symmetry is a primary rehabilitation goal after anterior cruciate ligament reconstruction (ACLR), little is known about the potential relationship between quadriceps strength symmetry and psychological readiness to return to play (RTP). HYPOTHESIS: Quadriceps strength symmetry will be associated with psychological readiness to RTP after ACLR. Secondarily, injury mechanism will influence the association between quadriceps strength and psychological readiness to RTP. STUDY DESIGN: Retrospective cohort. LEVEL OF EVIDENCE: Level 3 (cohort study). METHODS: A total of 78 female patients completed strength testing and the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale at an outpatient clinical facility as part of return to sport testing after ACLR. Linear regression analysis was used to assess the relationship between the I-PRRS and the independent variables of interest (quadriceps strength symmetry and injury mechanism). RESULTS: For all patients combined, a significant symmetry × mechanism interaction was found. When split by injury mechanism, a significant linear relationship was found between quadriceps strength symmetry and the I-PRRS score in patients who experienced a noncontact injury (n = 55; P = 0.01; R2 = 0.24). No such relationship was found for those who experienced a contact injury (n = 23; P = 0.97; R2 = 0.01). CONCLUSION: Greater quadriceps strength symmetry was associated with greater psychological readiness to RTP in female athletes after ACLR. This relationship, however, was present only in those who experienced a noncontact injury. CLINICAL RELEVANCE: Clinicians should consider both the physical and the psychological factors in assessing a patient's readiness to RTP. This may be particularly important for those who have experienced an ACL tear through a noncontact mechanism.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/reabilitação , Traumatismos em Atletas/cirurgia , Força Muscular , Músculo Quadríceps/fisiologia , Volta ao Esporte/psicologia , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/etiologia , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Feminino , Humanos , Controle Interno-Externo , Estudos Retrospectivos , Autorrelato , Adulto Jovem
15.
Sports Health ; 13(3): 296-303, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33530860

RESUMO

CONTEXT: Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of understanding risk factors for preventive efforts. OBJECTIVE: The purpose of this systematic review and meta-analysis was to determine what factors may put physically active individuals at risk of developing PF. DATA SOURCES: CENTRAL, CINAHL, EMBASE, Gray Lit, LILACS, MEDLINE (PubMed), ProQuest, Scopus, SPORTDiscus, and Web of Science were searched through April 2018 and updated in April 2020. STUDY SELECTION: Studies were included if they were original research investigating PF risk factors, compared physically active individuals with and without PF, were written in English, and were accessible as full-length, peer-reviewed articles. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 3, because of inconsistent definitions and blinding used in the included observational studies. DATA EXTRACTION: Data on sample characteristics, study design and duration, groups, PF diagnosis, and risk factors were extracted. The methodological quality of the studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. When means and standard deviations of a particular risk factor were presented 2 or more times, that risk factor was included in the meta-analysis. RESULTS: Sixteen studies were included in the systematic review and 11 risk factors in the meta-analysis. Increased plantarflexion range of motion (weighted mean difference [MD] = 7.04°; 95% CI, 5.88-8.19; P < 0.001), body mass index (MD = 2.13 kg/m2; 95% CI, 1.40-2.86; P < 0.001; I2 = 0.00%), and body mass (MD = 4.52 kg; 95% CI, 0.55-8.49; P = 0.026) were risk factors for PF. CONCLUSION: Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with PF.


Assuntos
Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Fasciíte Plantar/etiologia , Fasciíte Plantar/fisiopatologia , Tornozelo/fisiologia , Índice de Massa Corporal , Calcâneo/fisiologia , Pé/anatomia & histologia , Pé/fisiologia , Humanos , Pronação , Amplitude de Movimento Articular , Fatores de Risco
16.
Phys Ther Sport ; 49: 8-14, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33550203

RESUMO

The sports medicine literature is filled with associations between injury and causal factors. However, those results have been inconsistent. We're left wondering which of our athletes might need more attention and where our efforts might be best spent. Resistance to injury is the result of interaction between many variables. These variables are interdependent with dynamic relationships which can be sometimes correlated, at times anti-correlated and from time to time show no relationship with injury risk. Relationships we may have seen yesterday do not necessarily hold true for today and we should not use those to infer what will happen. This perspective piece builds on prior works and describes how the complex interaction between injury determinants presents in other systems, why determinants are not stable and instead vary over time due to internal and external forcing and why our prediction ability remains limited even when determinants are identified. Patterns built from frequent time series data in conjunction with nonlinear dynamical methods can offer us a new approach to thinking about injury prediction.


Assuntos
Traumatismos em Atletas/etiologia , Relesões/etiologia , Humanos , Controle Interno-Externo , Dinâmica não Linear , Fatores de Risco
17.
Gait Posture ; 85: 96-102, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33524666

RESUMO

BACKGROUND: Development of accessible cost-effective technology to objectively, reliably, and accurately predict musculoskeletal injury risk could aid the effort to prevent chronic pain and disability. Recent work on micro-Doppler radar suggests it merits investigation towards these goals. The micro-Doppler signals that are created can infer differences in gross movements such as walking versus crawling in military settings where direct vision is not possible. Unique micro-Doppler signals may be able to identify more subtle movement patterns which would not be easily seen by the human eye. RESEARCH QUESTION: Can micro Doppler radar predictably and accurately identify subtle differences in movement conditions? METHODS: This is a cross sectional study recruiting NCAA athletes to jump in front of the micro-Doppler radar barefoot, with shoes, and shoes with a heel lift. The micro-Doppler radar signature projection algorithm was developed to determine whether the radar is able to distinguish the three distinct movement patterns. RESULTS: Confusion matrices were used to visualize the performance of the support-vector machine at the 80/20 test/train split correctly classifying barefoot subjects, shoes and heel lift, and shoes correctly at 0° with respect to the radar 90.9 %, 86.7 %, and 89.5 % of the time, respectively. At 90° with respect to the radar, it was successful 94.1 %, 100 %, and 80 % of the time, respectively. CONCLUSION: This study suggests that the micro-Doppler radar signature projection algorithm is highly accurate and able to predict subtle differences in movement that are not readily observed with conventional motion capture systems. Future studies are needed to better understand if micro-Doppler signals can identify pathologic movement patterns or movement that is associated with increased risk of injury.


Assuntos
Algoritmos , Traumatismos em Atletas/prevenção & controle , Aprendizado de Máquina , Movimento/fisiologia , Radar , Ultrassonografia Doppler/métodos , Adolescente , Adulto , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Fenômenos Biomecânicos , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Medição de Risco , Adulto Jovem
18.
Gait Posture ; 85: 171-177, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33592398

RESUMO

BACKGROUND: The double-leg jump-landing (DLJL) task is commonly used as a movement screen that can be implemented in large cohorts of athletes. However, it is debatable whether the DLJL is ecologically valid and reflects sporting requirements or injury-prone situations, such as cutting and pivoting. RESEARCH QUESTION: Which jump-landing movement variation best represents the kinematics of unanticipated side-step cutting? METHODS: Forty-two participants (25 males and 17 females) performed unanticipated side-step cutting and four jump-landing tasks: DLJL, rotated DLJL (DLJLrot), single-leg jump-landing (SLJL), and rotated SLJL (SLJLrot). Ankle, knee, hip, pelvis, and trunk angles and angular velocities, and pelvic linear accelerations were collected at initial contact and during the first 100 milliseconds after initial contact (minimum, maximum, and range values) using a three-dimensional infrared camera system and inertial measurement units. Pre-contact foot-ground angles and subjective task difficulty ratings were also recorded. Intraclass correlation coefficients (ICC) between cutting and jump-landing kinematics were calculated for each participant and jump-landing variation. Friedman tests with pairwise comparisons were then used to compare the degree of association between the four different jump-landing tasks at the specified time events and to compare the difficulty ratings. RESULTS: Considering the ICC values across the events of interest, the kinematics of the DLJL were the least associated with those of cutting (ICC = 0.00 to 0.81), and DLJLrot (ICC = 0.34 to 0.81) and SLJLrot (ICC = 0.31 to 0.80) biomechanics the most. Participants rated the perceived challenge of the single-leg tasks in a similar manner to cutting (p > 0.103), and the SLJLrot as the most difficult task (median = "neutral", mode = "neutral"). SIGNIFICANCE: Due to their biomechanical associations with cutting maneuver and subjectively-rated difficulty levels, both DLJLrot and SLJLrot may be more appropriate and ecologically valid for screening for risk of injury across a range of sports.


Assuntos
Antecipação Psicológica/fisiologia , Atletas , Traumatismos em Atletas/etiologia , Extremidade Inferior/fisiologia , Movimento/fisiologia , Tronco/fisiologia , Adolescente , Adulto , Atletas/psicologia , Traumatismos em Atletas/fisiopatologia , Traumatismos em Atletas/psicologia , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Medição de Risco , Adulto Jovem
19.
Workplace Health Saf ; 69(4): 182-186, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33514295

RESUMO

BACKGROUND: Tennis leg (TL), a musculotendon injury to the gastrocnemius, has been associated with the eponymous sport since 1883. This article examines the historical context of TL as a sports compared with an occupational injury. This was juxtaposed with the history of tennis elbow, a tendon injury to the upper extremity also associated with sport. METHODS: Bibliometric databases (PubMed, Web of Science [WOS], Hathi Trust) were keyword-searched; relevant citations were investigated in depth. RESULTS: The search yielded 71 citations for TL (PubMed). The majority (n = 43) were key word linked to sport terms; only one was linked to work-related search terms. Furthermore, none of the top four cited publications (Web of Science) alluded to work-related risk factors in TL in full textual analysis. Hathi Trust yielded the earliest work-related case, reported in a non-biomedical source. Tennis elbow was more frequently reported (n = 189 citations in PubMed) and more frequently linked (n = 193; 9.7%) to occupational search terms. CONCLUSION/APPLICATION TO PRACTICE: The history of TL, juxtaposed with tennis elbow, demonstrates how nosology can influence but does not wholly explain disease attribution, potentially to the detriment of taking into account occupational causality. The lack of recognition of occupational factors revealed in this literature search was notable because TL occurred most commonly in males of working age. By providing perspective on how historical context and nosology can affect the conceptualization of disease, this review may help inform prevention, treatment, and regulatory policy.


Assuntos
Traumatismos em Atletas/etiologia , Músculo Esquelético/lesões , Traumatismos Ocupacionais/etiologia , Humanos , Traumatismos da Perna/etiologia , Tênis , Cotovelo de Tenista/etiologia
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