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1.
Sports Med Arthrosc Rev ; 29(4): e57-e64, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730117

RESUMO

There is a need to improve the quality of rehabilitation in sports medicine to return athletes to optimal function safely and quickly, reducing the risk of reinjury. This paper describes a planning paradigm to guide clinical reasoning during individual treatment sessions and a model for planning the rehabilitation program from acute injury to return to play. The design of a rehabilitation program should be a collaborative, team effort, and accounting for the specific needs of the athlete. As the athlete progresses from acute injury management all the way back to full competition, the rehabilitation professional emphasizes the components of pain management, motion, motor control, and force production in varying degrees based upon phases of tissue healing and the athlete's response. Utilizing high-value, evidence-based treatments maximize both the effectiveness and efficiency of rehabilitation to restore and improve upon preinjury levels of physical performance.


Assuntos
Traumatismos em Atletas , Medicina Esportiva , Atletas , Humanos
2.
Sports Med Arthrosc Rev ; 29(4): e65-e70, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730118

RESUMO

Successful rehabilitation of sports-related orthopedic injuries remains a challenge for both orthopedic surgeons and their patients. Team physicians are tasked with the complex problem of minimizing time away from competition, while simultaneously mitigating the risk of reinjury. Varying levels of expectation and demand between recreational and competitive athletes coupled with the already complex nature of sports-related injuries present a multifactorial challenge for the even the most experienced physicians. In the realm of sports medicine, timing of return to sport has become a controversial yet ubiquitous criterion by which treatment outcomes are measured. While accelerated rehabilitation may be desired in many cases, surgeons must also recognize the identifiable risk factors for potential reinjury. With these principles in mind, we present a summary of the available literature on data pertaining to return to sport, with coverage of injuries commonly seen within an orthopedic sports medicine practice.


Assuntos
Traumatismos em Atletas , Ortopedia , Médicos , Medicina Esportiva , Traumatismos em Atletas/terapia , Humanos , Volta ao Esporte
3.
Sports Med Arthrosc Rev ; 29(4): e71-e76, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730120

RESUMO

Pain is common among athletes at all levels and the treatment of pain can be a challenging and frustrating task. The team physician needs a fundamental knowledge of analgesic strategies as it relates to athletes. It is important to understand the mechanism of action, side effect profile/associated complications, incidence of and indications for use, as well as the controversies associated with the most common analgesic medications used in sports medicine. Several "in vogue" treatment modalities, including cannabidiol, are also becoming more commonly used and are worth discussion.


Assuntos
Analgesia , Medicina Esportiva , Atletas , Humanos , Dor , Manejo da Dor
4.
Sports Med Arthrosc Rev ; 29(4): 200-206, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730121

RESUMO

Preparticipation evaluations (PPE) are both a traditional and legal requirement by many governing bodies for sport. The ideal goal of the PPE is safe participation in sport for athletes. This article provides an overview of common PPE elements and current best practice recommendations. Descriptions of every possible examination are published elsewhere and are beyond the intent of this article. Additional considerations for transgender, masters athletes, and Special Olympians are also outside the scope of this review, but are well covered in The Preparticipation Physical Evaluation, fifth edition monograph.


Assuntos
Medicina Esportiva , Esportes , Atletas , Humanos , Exame Físico
5.
Sports Med Arthrosc Rev ; 29(4): 182-184, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34730114

RESUMO

In recent years, the National Collegiate Athletic Association (NCAA) and professional organizations have endorsed independent medical teams to promote athletes' wellbeing. In this independent arrangement, the team physician is the head of the medical team and with the assistance from the health care administrator, the team physician provides oversight of team medical personnel, who are delivering health care under the direction of the team physician. The purpose of this chapter is to review the role of the modern-day team physician, highlighting areas of controversy surrounding team medical coverage.


Assuntos
Traumatismos em Atletas , Medicina Esportiva , Atletas , Humanos , Estudantes , Universidades
6.
Curr Sports Med Rep ; 20(11): 617-623, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752437

RESUMO

ABSTRACT: The past two decades have built on the successes of the Human Genome Project identifying the impact of genetics and genomics on human traits. Given the importance of exercise in the physical and psychological health of individuals across the lifespan, using genomics to understand the impact of genes in the sports medicine field is an emerging field. Given the complexity of the systems involved, high-throughput genomics is required to understand genetic variants, their functions, and ultimately their effect on the body. Consequently, genomic studies have been performed across several domains of sports medicine with varying degrees of success. While the breadth of these is great, they focus largely on the following three areas: 1) performance; 2) injury susceptibility; and 3) sports associated chronic conditions, such as osteoarthritis. Herein, we review literature on genetics and genomics in sports medicine, offer suggestions to bolster existing studies, and suggest ways to ideally impact clinical care.


Assuntos
Medicina Esportiva , Esportes , Exercício Físico , Previsões , Genômica , Humanos
8.
J Orthop Sports Phys Ther ; 51(10): 517-525, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34592832

RESUMO

SYNOPSIS: Participating in sport carries inherent risk of injury. Clinicians execute high-level clinical reasoning and decision making to support athletes to achieve the best outcomes. Accurately diagnosing a problem, estimating prognosis, or selecting the most suitable intervention for each athlete is challenging. Clinical prediction models are tools to assist clinicians in estimating the risk or probability of a health outcome for an individual by using data from multiple predictors. Although common in general medical literature, clinical prediction models are rare in sports medicine. The purpose of this article was to (1) describe the steps required to develop and validate (ie, evaluate) a clinical prediction model for clinical researchers, and (2) help sports medicine clinicians understand and interpret clinical prediction model studies. Using a case study to illustrate how to implement clinical prediction models in practice, we address the following issues in developing and validating a clinical prediction model: study design and data, sample size, missing data, selecting predictors, handling continuous predictors, model fitting, internal and external validation, performance measures, reporting, and model presentation. Our work builds on initiatives to improve diagnostic and prognostic clinical research, including the PROGnosis RESearch Strategy (PROGRESS) series of papers and textbook and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement. J Orthop Sports Phys Ther 2021;51(10):517-525. doi:10.2519/jospt.2021.10697.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Regras de Decisão Clínica , Medicina Esportiva , Humanos , Exame Físico , Valor Preditivo dos Testes , Fatores de Risco
9.
Curr Sports Med Rep ; 20(10): 531-539, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34622818

RESUMO

ABSTRACT: Athletes are vulnerable to sexual violence. Perpetrators of sexual violence may be a trusted coach, a member of the health care team, or a peer. The consequences of sexual violence are wide ranging, resulting in immediate and long-term physical and mental health outcomes that require recognition and comprehensive, multidisciplinary care. Sports medicine providers need to have specific knowledge and skill to care for athletes who experience sexual violence. Several sports organizations (e.g., International Olympic Committee, United States Olympic and Paralympic Committee, the National Collegiate Athletic Association, and the National Athletic Trainers' Association) have developed policies and procedures to prevent sexual violence and help sports medicine specialists provide care and services for athletes affected by sexual violence. Nevertheless, there remains a need for clinical guidelines, screening tools, and education, as well as clinical best practices to address sexual violence in sports medicine.


Assuntos
Delitos Sexuais , Medicina Esportiva , Esportes , Atletas , Humanos , Delitos Sexuais/prevenção & controle , Estudantes , Estados Unidos
10.
Curr Sports Med Rep ; 20(10): 540-544, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34622819

RESUMO

ABSTRACT: The 2019 severe acute respiratory syndrome coronavirus 2 has dramatically changed the sports landscape, compelling sports medical providers to adapt to evolving scientific discoveries and adopt ever-changing guidelines that protect our athletes, ourselves, and our staff. To best serve our athletes, providers need to be proactive and anticipate potential complications in providing care for athletes as athletic events resume.


Assuntos
Morte Súbita Cardíaca , Medicina Esportiva/métodos , COVID-19 , Humanos , Guias de Prática Clínica como Assunto
11.
Curr Sports Med Rep ; 20(10): 553-561, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34622821

RESUMO

ABSTRACT: The role of orthopedic team physicians has evolved greatly over the past decade having been influenced by advances in sports science and performance, new surgical and biologic technologies, social media, medicolegal liability, marketing, and sexual misconduct cases by some team physicians. The great variety of events and sports that are covered from high school and collegiate to the Olympic and professional levels requires a myriad of skills outside of the traditional medical training curriculum. In the current climate of increasing media scrutiny from a 24-h news cycle it is imperative for orthopedic team physicians, whether operative or nonoperative, to continually adapt to the needs and expectations of athletes who also are patients. This is especially true in the wake of the COVID-19 pandemic. Orthopedic team physicians' responsibilities continue to evolve ensuring their relevance and necessity on the sidelines and in the training room as well as in the operative suite.


Assuntos
Ortopedia , Papel do Médico , Medicina Esportiva , Humanos , Motivação , Ortopedia/tendências , Medicina Esportiva/tendências
12.
J Law Med Ethics ; 49(3): 372-377, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34665101

RESUMO

Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Medicina Esportiva , Esportes , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Consenso , Humanos
13.
J Sports Med Phys Fitness ; 61(11): 1555-1561, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34713684

RESUMO

Dental trauma in the field of sports is the major linking channel between sports and dentistry. Sports dentistry is the branch of sports medicine that deals with the prevention of oral or facial athletic injuries, oral diseases and manifestations. Sports dentistry is also related to mild traumatic brain injuries during games and erosive lesions due to continuous intake of highly acidic sports and energy drinks. Stress among sportsperson has also been depicted to impact their athletic performance leading athletes to the intake of drugs. Smokeless tobacco consumption and sponsorship is also found among athletes. Therefore, it is emphasized the need for a "team dentist," initiating from high schools to professional teams. The sports or "team dentist" assists athletes in the effective prevention, treatment, and diagnosis of various types of oral injuries. Sport-related orofacial injuries can be prevented by wearing primary protective devices such as properly fitting helmets, face masks and/or mouth guards. They can also enlighten athletes about the benefits of practicing yoga, as it reduces stress and improves performance. Hence, the dentist can perform an imperative role in informing parents, athletes, coaches and patients about the importance of preventing orofacial injuries in sports.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Protetores Bucais , Medicina Esportiva , Esportes , Traumatismos em Atletas/prevenção & controle , Humanos
14.
Arthroscopy ; 37(10): 3001-3002, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34602140

RESUMO

At the American Orthopaedic Society for Sports Medicine (AOSSM)-Arthroscopy Association of North America (AANA) 2021 Annual Meeting in Nashville, Tennessee, collaboration was the word of the day. AAOSM and AANA are a great pair, and many of us are long-time members of both associations. The attendance was unprecedented. Face-to-face meetings facilitate great spontaneity, profound exchange, nuanced communication, personal sharing, and efficient and passionate occurrence of new ideas. President Mark Getelman will host next year's AANA Annual Meeting, AANA22, in another fantastic American city with which AANA is very familiar, San Francisco, California. The meeting will be held May 19-21, 2022, and we look forward to seeing many of you in the City by the Bay. It will be AANA's 40th Annual Meeting, and naturally, your editors are planning to attend.


Assuntos
Ortopedia , Medicina Esportiva , Alanina/análogos & derivados , Artroscopia , Humanos , Sociedades Médicas , Estados Unidos
15.
Artigo em Inglês | MEDLINE | ID: mdl-34609973

RESUMO

BACKGROUND: Institutional academic productivity remains an influential factor in an applicant's selection of fellowship training. This study aimed to determine the quality and quantity of research in the United States orthopaedic sports medicine fellowship programs and identify those with highest productivity. METHODS: The Arthroscopy Association of North America Fellowship Directory was used to evaluate 88 fellowships in the United States. Publication data and Hirschberg indices (h-index) were collected from the Scopus database. Subanalysis was performed based on the number of publications and mean h-index. RESULTS: Total number of publications per faculty member ranged from 0 to 866, with a median of 20. The median h-index per faculty member was 9. The number of fellows was correlated with a higher mean average h-index of faculty members (P = 0.05). The five programs with the highest number of publications included Hospital for Special Surgery, Rush University, University of Pittsburgh Medical Center, Mayo Clinic in Rochester, and Boston Children's Hospital. CONCLUSIONS: Most academic productivity in sports medicine is produced by a relatively small number of fellowship programs in the United States. Of interest, the number of fellows or faculty does not affect significantly the quality or quantity of research productivity at top institutions.


Assuntos
Ortopedia , Medicina Esportiva , Bibliometria , Criança , Eficiência , Bolsas de Estudo , Humanos , Estados Unidos
16.
Clin Sports Med ; 40(4): 801-819, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34509212

RESUMO

Utilization of musculoskeletal ultrasound, in particular for sports medicine, has dramatically increased in recent years. Ultrasound is an important adjunct tool to physical examination and other imaging methods in the evaluation and management of the injured athlete. It offers unique advantages in specific clinical scenarios. Dedicated training and a standardized scanning technique are important to overcome the inherent operator dependence and avoid diagnostic pitfalls. Ultrasound guidance can also improve accuracy in targeted percutaneous injection therapies. This article reviews the general ultrasound appearance of muscle, tendon, ligament, and nerve abnormalities in the athlete with a focus on sport-specific injuries.


Assuntos
Traumatismos em Atletas , Sistema Musculoesquelético , Medicina Esportiva , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/terapia , Humanos , Sistema Musculoesquelético/lesões , Ultrassonografia
17.
Sports Med ; 51(11): 2237-2250, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34468950

RESUMO

Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.'s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field.


Assuntos
Medicina Esportiva , Esportes , Dispositivos Eletrônicos Vestíveis , Consenso , Exercício Físico , Humanos
18.
Phys Ther Sport ; 52: 132-139, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34482050

RESUMO

OBJECTIVE: To determine the feasibility of an 8-week neuromuscular training program initiated upon return-to-play clearance following concussion. DESIGN: Feasibility trial. SETTING: A single sports medicine center. PARTICIPANTS: We approached n = 54 patients; n = 32 agreed to participate (59%). N = 27 participants returned for their second visit at return-to-play clearance (84%) and were randomized to neuromuscular training (n = 13) or standard-of-care (n = 14). MAIN OUTCOME MEASURES: Participants completed three assessments: within 14 days post-concussion, immediately after return-to-play clearance, and 8-weeks following return-to-play clearance. The intervention aimed to achieve positive neuromuscular adaptations and occurred 2x/week for 8 weeks under supervision. RESULTS: N = 2 participants randomized to the intervention elected not to participate, both due to schedule conflicts (e.g., time required to meet with the study team). Participants began the intervention an average of 11 days after return-to-play clearance, the majority (91%) completed >75% of training sessions, and training sessions lasted an average of 18.2 ± 4.8 min. One participant stopped the intervention after 7 training sessions due to time availability. CONCLUSION: It is feasible to initiate a neuromuscular training program for most athletes shortly after returning to play following concussion. Clinicians and researchers may consider this approach to mitigate the increased musculoskeletal injury risk for concussion patients returning to sports.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Medicina Esportiva , Atletas , Estudos de Viabilidade , Humanos
19.
Sci Rep ; 11(1): 17793, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493744

RESUMO

The rapid identification and isolation of infected individuals remains a key strategy for controlling the spread of SARS-CoV-2. Frequent testing of populations to detect infection early in asymptomatic or presymptomatic individuals can be a powerful tool for intercepting transmission, especially when the viral prevalence is low. However, RT-PCR testing-the gold standard of SARS-CoV-2 diagnosis-is expensive, making regular testing of every individual unfeasible. Sample pooling is one approach to lowering costs. By combining samples and testing them in groups the number of tests required is reduced, substantially lowering costs. Here we report on the implementation of pooling strategies using 3-d and 4-d hypercubes to test a professional sports team in South Africa. We have shown that infected samples can be reliably detected in groups of 27 and 81, with minimal loss of assay sensitivity for samples with individual Ct values of up to 32. We report on the automation of sample pooling, using a liquid-handling robot and an automated web interface to identify positive samples. We conclude that hypercube pooling allows for the reliable RT-PCR detection of SARS-CoV-2 infection, at significantly lower costs than lateral flow antigen (LFA) tests.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , Ensaios de Triagem em Larga Escala/métodos , SARS-CoV-2/isolamento & purificação , Manejo de Espécimes/métodos , Antígenos Virais/isolamento & purificação , Atletas , COVID-19/sangue , COVID-19/virologia , Teste de Ácido Nucleico para COVID-19/economia , Teste Sorológico para COVID-19/economia , Teste Sorológico para COVID-19/métodos , Redução de Custos , Ensaios de Triagem em Larga Escala/economia , Humanos , RNA Viral/isolamento & purificação , SARS-CoV-2/genética , SARS-CoV-2/imunologia , Sensibilidade e Especificidade , África do Sul , Manejo de Espécimes/economia , Medicina Esportiva/economia , Medicina Esportiva/métodos
20.
J Opioid Manag ; 17(4): 284-288, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34533822

RESUMO

OBJECTIVE: Guidelines for opioid prescription post-operatively exist; however, the majority of these are for adults. Nevertheless, opioid risks are present for pediatric patients also. This study investigates the effect of a single institution's guidelines on post-operative opioid prescribing for pediatric orthopedic patients undergoing knee surgery. We hypothesized that a standardized set of prescribing guidelines would result in a decrease in opioids prescribed at discharge home after these surgeries. DESIGN: Retrospective observational. SETTING: Urban, tertiary care, academic orthopedic hospital. PATIENTS: Pediatric, sports knee surgery, 23-month period. INTERVENTIONS: Guidelines were implemented institutionally for post-operative opioid prescribing practices. We reviewed all post-operative opioid prescriptions for pediatric patients undergoing sports knee surgery with two pediatric sports surgeons for the 11 months prior to the guidelines and 12 months afterwards, totaling 316 surgeries. MAIN OUTCOME MEASURE: Oral morphine equivalents (OMEs) prescribed on discharge from the hospital before and after implementation of guidelines. RESULTS: There was a significant reduction in OMEs from 229 OMEs to 175 OMEs before and after opioid prescribing guidelines (p < 0.001). This is a decrease in approximately seven 5 mg oxycodone tablets per patient. CONCLUSIONS: This study demonstrates that at our institution, with a pediatric patient population having sports knee surgery, prescribing guidelines reduced the number of opioids prescribed at discharge.


Assuntos
Analgésicos Opioides , Medicina Esportiva , Adulto , Analgésicos Opioides/uso terapêutico , Criança , Prescrições de Medicamentos , Humanos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Padrões de Prática Médica , Estudos Retrospectivos
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