Objective: The objective of this study is to identify an independent risk variable for lower extremity overuse injuries based on status of sport participations (single- and multisports) in young female athletes.
Methods: In this cross-sectional study, 12–18-year-old female athletes were asked to complete electronic questionnaires describing their current sport participation and previous injury history. Range of motion (ROM), muscular strength, and performance parameters were measured at the time of completion of electronic questionnaires. Potential risk variables were compared between single- and multisport athletes and entered into a logistic regression model. Adjusted odds ratio (aOR), 95% confidence intervals (95% CIs), and p values were recorded to find an association with increased likelihood of lower extremity overuse injuries.
Results: The study cohort comprised 236 female young athletes (single-sport athletes: N = 60, multisport athletes: N = 176). A few variables including age, BMI, weekly hours of training for a sport, knee ROM, ankle ROM, and knee extensor strength were identified as potential risk variables. A logistic regression analysis showed an independent association between increased weekly hours of training for a sport and greater likelihood of histories of lower extremity overuse injuries (aOR = 1.091, 95% CIs: 1.007–1.183, p = .034).
Conclusion: Although status of single- or multisports participation was not a significant risk variable, increased training volume was found to be an independent contributing factor for greater likelihood of lower extremity overuse injury histories in 12–18 years female athletes. The current study identified that single-sport athletes trained nearly twice as many hours per week when compared to multisport athletes, which may explain an underlying mechanism of sports specialization. 相似文献
Methods: A search query was performed on both Google and Bing for the following terms: ‘ACL tear’, ‘PCL tear’, ‘MCL tear’ and ‘LCL tear’. The first 100 images of each individual search were analyzed by three independent orthopedists.
Results: The inter-rater reliability was very good for PCL tear on Bing (Cronbach’s alpha = 0.89) and excellent (Cronbach’s alpha > 0.9) for the remainder of the search queries. When comparing Google to Bing, the only significant difference occurred in the ACL group, with Bing returning a significantly greater number of correct images 60%, 95% CI: 53.2 – 66.7%) compared to Google (45% correct, 95% CI: 38.1–51.8%), p = 0.034. With regards to the other ligaments Bing was more accurate than Google for PCL (39% versus 38%), and LCL (32% to 30%). Both sites were 48% accurate for MCL tear.
Conclusion: Ultimately, our study revealed that physicians should take an active role in making high quality, easy to understand medical resources and anatomic diagrams available to their patients to avoid confusion and enhance understanding when querying the internet for additional information regarding their condition. 相似文献
Methods: Longitudinal data (2-year follow-up) from the Boston Puerto Rican Health Study were analyzed (n = 862; mean age = 56.5 year). A daily energy expenditure score was calculated using the number of hours over a 24-h period engaged in various activities, including sleeping, light activity, and moderate-to-vigorous exercise. Energy expenditure estimates were weighted based on the rate of oxygen consumption associated with each activity. Seven cognitive function outcomes were evaluated, including an assessment of general cognitive function, episodic memory, attention and working memory, cognitive flexibility, response inhibition, processing speed, and visuo-spatial organization. From these, overall executive function and memory capacity were derived using principal components analysis.
Results: Physical activity was not associated with changes in overall executive function. However, compared to those with low baseline physical activity, those with moderate physical activity had 48% reduced odds of having ≥1 standard deviation decline in memory function (OR = 0.52; 95% CI: 0.32, 0.84; p = 0.008) in 2 years.
Conclusion: Among Puerto Rican adults, physical activity may help attenuate memory decline. 相似文献
Methods: A total of 464 patients with a unilateral ACL rupture underwent arthroscopic ACL reconstruction with either patellar or hamstring tendon grafts. Isokinetic concentric strength was evaluated prior to surgery and at 5- and 9-month postoperative follow-ups in different patient subgroups (n = 140, 464 and 215, respectively).
Results: Knee extensor strength was lower in patients operated with the patellar tendon graft at the 5-month (p < 0.05) but not at the 9-month follow-up. Knee flexor strength was lower in patients operated with the hamstring tendon graft at both postoperative time points (p < 0.05). The prevalence of quadriceps weakness was high (66–91%) in both patient groups at both follow-ups.
Conclusion: Overall, postoperative recovery of thigh muscle function seems to be better with the patellar than with the hamstring tendon graft due to the fact that both, knee extensor and flexor strength, were more impaired after ACL reconstruction with the hamstring tendon autograft. 相似文献
Objectives: To determine if consensus exist about potential influencing factors for time to RTP in conservatively treated ankle sprain.
Methods: We searched AMED, CINAHL Plus, Cochrane library, EMBASE, MEDLINE (EBSCO), SPOERDiscus, PsycINFO, PEDro, Scopus, unpublished literature and ongoing trials and Google Scholar from inception until April 2017. The quality of the eligible papers was assessed using the Downs and Black tool for randomized controlled trials (RCTs) and Critical Appraisal Skills Program (CASP) for observational studies.
Results: The initial search identified 1885 articles. After screening, 14 articles were included. Of these, 11 were RCTs and 3 were prospective observational studies. Individual treatment methods that resulted in a shorter time to RTP were functional treatment, compression stockings, anteroposterior joint mobilization, hyaluronic acid injection (HA), Jump Stretch Flex Band programme (JSFB) and diclofenac medication. Prognostic factors for determining time to RTP in the included prospective observational studies were measures of Global function, SF 36PF, athlete’s ambulation status, weight-bearing activity scores and self-reported athletic ability.
Conclusion: To our knowledge, this is the first review to report influencing factors for time to RTP following conservatively treated ankle sprain. Findings from this review identified factors that influence time to RTP. However, caution should be taken in generalizing these results due to the heterogeneity of studies and inability to clearly define and list the criteria for safe RTP. The inclusion of factors such as age, sex, BMI, level of sport, injury related factors in future studies might help to understand the course of injury and therefore assist in constructing safer criteria. 相似文献
Methods: Thirty subjects (8 women and 22 men) aged 19–46 (x = 28.2 ± 7) participated in the investigation; an experimental group comprised 15 persons (4 women and 11 men) who underwent ACL reconstruction surgery. The other persons had no knee injury and described themselves as healthy. All the subjects underwent an investigation of the PS of the hamstrings and the rectus femoris on the injured as well as on the healthy leg.
Results: The data shows vital difference in the PS of the hamstring muscles between the healthy and injured limb (p < 0.05), a significant difference in the PS of the rectus femoris (p < 0.001) was noted. Furthermore, the PS level of the hamstring muscles of the operated limb in the experimental group is significantly different to the both legs in control group (p < 0.001).
Conclusions: Injury of the ACL results in a considerable increase in passive stiffness of the hamstring and rectus femoris muscles in both the injured leg and the healthy leg. 相似文献
Methods: Patients were divided into two groups: Group A (22 patients) who underwent ACL reconstruction performed with an All-Inside graft-link technique; Group B (22 patients) who underwent ACL reconstruction with an Out-In technique and DGST graft. At a mean follow-up of 13 months, quadriceps and hamstring isokinetic peak torque deficits were recorded.
Results: In group A, the mean side to side peak torque flexion difference between the operated and non-operated limbs was ?3% and the mean torque at 30° was ?7.5% at high angular velocity (180°/sec); the mean peak flexion torque was 7.2% and the mean torque at 30° was 3.1% at low angular velocity (60°/sec).
In group B, the mean side to side peak flexion torque was ?3.5% and the mean torque at 30° was ?7.6% at high angular velocity (180°/sec); the mean peak flexion torque was ?7.2% and the mean torque at 30° was ?11% at low angular velocity (60°/sec).
A statistically significant difference was found between the two groups at lower angular velocity both for the mean peak flexion torque and the mean torque at 30° (p = 0.009), with better results in the study group.
Discussion/conclusion: Gracilis sparing technique is a minimally invasive technique for ACL reconstruction and yielded a significantly better flexion strength recovery at lower angular velocity compared to a full tibial tunnel technique with DGST for ACL reconstruction. 相似文献
Methods: In this cross-sectional study, 800 Dutch athletes eligible for the Olympic and Paralympic Games in Rio de Janeiro 2016 were invited to a costless and voluntary oral examination. The decayed, missing, and filled teeth-index (DMFT), the basic erosive wear examination (BEWE) and the Dutch Periodontal Screening-index (DPSI) were used to evaluate athlete’s oral health. Information on sociodemographic variables and sport performance were collected in questionnaires.
Results: In total, 116 Dutch elite athletes were included in the study. The median (90%-range) DMFT-score was 3.0 (0.0–16.0), the median BEWE-score was 2.0 (0.0–10.0), and the mean± SD DPSI-score was 2.0 ± 0.73. Oral health-related quality of life was generally high, although only 28.2% of the athletes reported never having problems with their dentition or mouth. In 43% of the athlete’s clinical findings were reported which needed a direct referral to the general dentist.
Conclusion: Oral health in this subsample of Dutch elite athletes was surprisingly affected as almost half of them needed dental treatment. Further research is needed to allow conclusions about oral health in Dutch elite athletes more broadly. However, regular screening of oral health incorporated into the general preventive health care of elite athletes is necessary to ensure athletes are fully healthy during competitions like the Olympic and Paralympic Games. 相似文献
Methods: A total of 107 patients (134 cases) were randomly allocated to group A (67 cases in 56 patients) and B (64 cases in 51 patients). Fingers in group A were treated with bone-cement K-wire fixation, and fingers in group B were treated using a plate-and-screw system.
Results: Follow-ups lasted 2 years. In group A, active range of motion of proximal interphalangeal joint reached 93% ± 6.7% of the opposite fingers. In group B, the data reached 86% ± 14.4% of the opposite fingers. Based on total active motion scoring system, we obtained 21 excellent and 46 good results in group A; and 9 excellent, 50 good, and 5 fair results in group B. There was a significant difference with regards to the function of the fingers (p < 0.05).
Conclusions: The bone-cement K-wire fixation may be another option for the treatment of shaft fractures of proximal phalanges. The minimally invasive technique allows early joint motion, resulting in minimal complications and good functional recovery. 相似文献
Methods: The study was planned as a prospective, non-interventional study. We examined 70 male elite handball athletes (first league) in a pre-competition medical assessment in July. Age, height, weight, body mass index, 25-OH vitamin D, calcium, and parathyroid hormone were evaluated, and a sun exposure score was calculated. Players were then divided into two groups of vitamin D levels: insufficient (<30 ng/mL) and sufficient (≥30 ng/mL).
Results: The mean 25-OH vitamin D level of the 70 players was 33.5 ± 10.9 ng/mL (median 32.2, IQR 26.5–38.9 ng/mL). Thirty-nine (55.7%) had sufficient and 31 (44.3%) insufficient levels. Athletes with sufficient vitamin D levels had significantly lower parathyroid hormone levels than athletes with insufficiency (24.9 ± 12.1 vs. 33.5 ± 15.1 ng/mL, p = 0.02). All other parameters evaluated demonstrated no significant difference between the two groups.
Conclusion: Vitamin D insufficiency is a common finding in professional handball athletes even in summer, which might negatively affect physical performance. Furthermore, it might lead to an increased risk of musculoskeletal injuries and infections. This should be evaluated in further studies. 相似文献
Methods: Once asymptomatic and following completion of all RTP steps, concussed athletes underwent the Gapski-Goodman Test (GGT) or modified GGT (mGGT) at partnered Complete Concussion Management Inc. (CCMI) clinics as part of RTP decision-making. Prospective data was collected electronically by trained CCMI clinicians utilizing the CCMI Concussion Database System. A review was conducted to examine data collected between January 2016 and February 2017. Participant and test variables were analyzed to determine relationships with pass/fail rate of the GGT/mGGT.
Results: A total of 759 athletes performed the GGT/mGGT in the study period. Although all asymptomatic, 14.6% of concussed athletes failed the GGT/mGGT while attempting to achieve RTP clearance. Statistically significant relationships were found between failure of the test and symptom severity score on initial presentation and self-reported history of pre-morbid anxiety. When taken together, sex, age, and pre-morbid anxiety significantly predicted the length of time between injury and RTP clearance.
Conclusion: The GGT may identify individuals who are not ready to RTP despite a self-reported asymptomatic status and completion of all RTP steps. These results illustrate that RTP clearance decisions based on self-reported asymptomatic status at rest may be inadequate. Instead, monitored, intensive, sport-specific, physical exertion testing should be utilized to inform clinical RTP decisions. 相似文献
Methods: Groups of 46 and 38 patients with non-insertional Achilles tendinopathy were treated with platelet-rich plasma and dry needling (once a week for 3 weeks), respectively. At baseline, 3 and 6 months, pain and function scores and the percentage of satisfactory outcomes were evaluated. Sub-group analyses were performed according to age and sex.
Results: At 3 and 6 months no differences in terms of pain and function between groups were observed, but the percentage of subjects reporting satisfactory results, at 6 months, was higher in platelet rich plasma group. Better results were observed in younger subjects, with a greater reduction of pain, improvement of function, and accordingly of the percentage of positive outcomes. A trend toward better results was also observed in males.
Conclusion: Beneficial effects of platelet rich plasma and dry needling in non-insertional Achilles tendinopathy have been observed only in some subjects, but not in others; platelet rich plasma shows a slight superiority against dry needling, mainly in younger persons; finally, a gender difference in the therapeutic response can be hypothesized. 相似文献
Methods: Nineteen male Australian Football players were assessed on the K-D/ET test. Those suspected of having SRC secondary to a head impact were also tested.
Results: Participants recorded a slower time on the third (20.2 ± 4.6 s) screen when compared with the first (p = 0.0424) and second (p = 0.0150) screens. The number of blinks was higher on the third (2.9 ± 2.9) when compared with the second (p = 0.0057) screen. There was decrease of the K-D/ET total times between pre- and post-game (p = 0.1769). Participants who sustained a head impact recorded slower mean total K-D time (p = 0.7322), fewer mean total saccades (p = 0.0112), and more mean blinks (p = 0.8678) compared with their baseline scores. The assessment of blinks was the most sensitive measure for potential SRC (0.67). The K-D/ET duration was the most specific measure for potential SRC (0.88). An increase in the number of blinks had a fair specificity of 0.69.
Conclusion: The rapid number-naming component of the K-D test is an assessment tool which quantifies impairment to oculomotor function and has been validated as a diagnostic tool for SRC. The clinical usefulness of the eye tracking component of the K-D/ET test is that it may be an effective method to assess concussions with the eye tracking component serving as a measure of progression and return to play. However, more research is required at the adult and youth level. 相似文献
Methods: Between January 2014 and January 2017, the tension-band wiring technique was used in 37 patients with Bennett fractures (study group). The range of motion, pinch and grip strengths, and hand function were assessed at the final follow-up. A control group comprising 35 patients treated with the percutaneous pinning technique was included in the study for comparison. A p-value <0.05 was considered statistically significant. (Clinical Trial Registration number: ISRCTN64894535 at http://www.isrctn.com/ISRCTN64894535)
Results: No fixation failure or infection occurred in either group. Radiographic fracture healing was achieved in all cases. Follow-up lasted over 1 year. The mean Kapandji opposition score was 9.31 (range 8–10) points in the study group and 8.45 (range 7–10) points in the control group (p < 0.05). The mean Disabilities of the Arm, Shoulder, and Hand score was 1.06 (range 0–2) in the study group and 1.77 (range 0–3) in the control group (p < 0.05). The mean Smith and Cooney Score were 90 (range 80–100) in the study group and 85 (range 75–100) in the control group (p < 0.05).
Conclusions: The tension-band wiring technique using loupes and headlights enables reduction and fixation of Bennett fractures under direct visualization of the deep operative field. Restoration of thumb function using the tension-band wiring technique is significantly better than that observed with the conventional percutaneous pinning technique. 相似文献
Evidence review: We searched PubMed to identify case reports and studies using the MeSH terms “immersion,” “pulmonary edema,” “cold-induced,” “exercise,” “hemodynamics,“ “water immersion,’’ “cardiovascular response,“ alone and in combinations. We identified 121 relevant articles including 54 case reports. We reviewed in detail 24 studies and all 54 case reports.
Findings: The incidence of IPE is estimated to be around 1.1– 1.8%. The risk factors for IPE include age >50 years, female sex, overhydration before exercise, tight wetsuits, cold water exposure and physically trained individuals such as endurance athletes. Individuals with pre-existing heart disease are at increased risk, however, IPE is seen even in healthy individuals. Symptoms such as cough, sputum production, hemoptysis and shortness of breath can occur immediately after immersion. Combination of water immersion, cold exposure, and exercise lead to an increase in pulmonary capillary pressures and eventual pulmonary capillary stress failure that leads to the flooding of alveolar spaces and edema.
Conclusion and relevance: Clinicians should be aware of IPE to avoid overestimating the severity of coronary or valvular conditions sometimes coincidentally present in IPE victims. Management is usually supportive. Functional and clinical recovery usually happens spontaneously within 24 h to 2 days, with or without diuretic therapy and a beta-adrenergic agonist. IPE can be recurrent and fatal, hence subjects with a history of IPE should undergo extensive cardiopulmonary investigation and should avoid cold water and physically demanding swimming events or avoid immersion activities. 相似文献
Methods: A systematic review and meta-analysis were employed. Studies were identified using electronic databases, including PubMed, PsychInfo, SPORTDiscus, and Google Scholar. To be eligible for inclusion, studies had to employ an experimental design, be conducted in humans (no animal models) with mild cognitive impairment, include an exercise intervention arm (either acute exercise or chronic training), and measure memory function (any type) as the outcome measure. Comprehensive Meta-Analysis software was used to compute the standardized mean difference effect size (Cohen’s d) and 95% CI using a random-effects model.
Results: In total, 11 studies met our criteria, contributing to 20 effect size estimates. Among the 20 effect size estimates, 13 contributed to a short-term memory recall, with 7 contributing to a delayed/long-term memory recall. The overall weighted mean effect size was d = 0.30 (95% CI: 0.16–0.44; P < 0.001), indicating a small to medium effect of exercise on improving memory function. For the moderation analysis, there was no evidence of a moderation effect for recall duration (Q = 0.004, df(1), P = 0.95), as exercise (vs. control) demonstrated both short-term (d = 0.31; 95% CI: 0.14–0.47; P < 0.001) and long-term memory (d = 0.29; 95% CI: 0.06–0.53; P = 0.013) benefits.
Conclusion: Current evidence suggests that exercise may help to improve memory function among those with MCI. Safe and progressive forms of exercise should be promoted among MCI patients. 相似文献
Methods: Seventeen male cyclists and 18 male runners with different levels of endurance performance completed graded exercise tests either on a cycle ergometer or treadmill to determine Dmax, calculated by the final data point and five modifications of the first rise in blood lactate concentration. Two or more constant load tests over 30 min were performed to determine MLSS. Differences between the modifications of the first rise in blood lactate concentration as well as the corresponding Dmax variants and MLSS were tested, using one-way repeated measure ANOVA with Bonferroni post-hoc tests, and illustrated, using the Bland–Altman method. The absolute agreement was observed, using intra-class correlation coefficients, based on a single measure, absolute agreement, 2-way mixed effects model.
Results: The peak power output/running velocity of the groups averaged 275 ± 43 W and 4.3 ± 0.4 m · s?1, respectively. The mean power output/running velocity at MLSS was 229 ± 38 W and 3.77 ± 0.38 m · s?1. For both running and cycling the original Dmax described by Cheng et al. was significantly lower than MLSS (p < 0.01). All modifications showed good agreement with MLSS (ICC ≥0.75). According to the Bland–Altman method the mean differences of the modifications compared to MLSS in cycling ranged from ?7 (43) to 2 (41) W. In running the mean differences ranged from ?0.12 (0.34) to ?0.08 (0.35) m· s?1.
Conclusion: We suggest using the first rise in blood lactate concentration for calculating Dmax instead of the first data point of a lactate curve as originally described. The approach of first rise determination has no substantial influence on the accuracy of Dmax compared to MLSS in cycling and running. 相似文献
Methods: Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%).
Results: The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively.
Conclusions: Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery. 相似文献