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Journal of Sport Rehabilitation Feb 2020Clinical Scenario: Physical activity is vital for human health. Musculoskeletal injury may inhibit adults from participating in physical activity, and this amount may be... (Review)
Review
Clinical Scenario: Physical activity is vital for human health. Musculoskeletal injury may inhibit adults from participating in physical activity, and this amount may be less than adults without a history of musculoskeletal injury. Clinical Question: Do individuals with a history of ankle or knee musculoskeletal injury participate in less objectively measured physical activity compared with healthy controls? Summary of Key Findings: Four studies were included. Two studies concluded patients who have undergone an anterior cruciate ligament reconstruction (ACLR) spent less time in moderate to vigorous physical activity levels when compared with healthy controls, but still achieved the daily recommended amount of physical activity. One study determined that participants with CAI took fewer steps per day compared with the control group. The fourth study determined patients with patellofemoral pain were less physically active than healthy controls as they took fewer steps per day and spent less time participating in mild and high activity. Clinical Bottom Line: There is consistent, high quality evidence that demonstrates individuals with a history of ankle or knee musculoskeletal injury participate in less objectively measured physical activity compared with healthy individuals. Strength of Recommendation: Due to nature of study designs of the included articles in this critically appraised topic, we recommend a grade of 3B.
Topics: Ankle Injuries; Biomedical Research; Evidence-Based Medicine; Exercise; Healthy Lifestyle; Humans; Knee Injuries; Muscle, Skeletal; Patient Education as Topic
PubMed: 31094646
DOI: 10.1123/jsr.2018-0486 -
International Journal of Environmental... Apr 2021: Rugby is sport with a high risk of injury. Repeated changes in exercise intensity and the high training intensity may cause to overuse injuries and long-term...
: Rugby is sport with a high risk of injury. Repeated changes in exercise intensity and the high training intensity may cause to overuse injuries and long-term disability. The aim of the study was to analyze the prevalence of injuries during trainings and forms of rehabilitation procedures performed after their occurrence among elite and sub-elite rugby players. : The data was obtained from 60 professional rugby males from France and Poland. Data were collected using paper-based recording form. It was a specially designed questionnaire which concerned specific details of the injury, including body location, type of injury, treatment and number of days off lost from playing rugby and on forms of rehabilitation procedures performed after their occurrence among elite and sub-elite rugby players. : During the study period, the overall incidence rate for injury suggested a 1.04 times more often injury occurrence (IRR = 1.04, 95% CI: 0.08; 2.00) among Polish players compared with French players; however, the distribution of injuries varied by country. The training injury incidence (TII) and incidence proportion (IP) were also higher in Poland than in France ( < 0.05) with the sprain as the most frequent type of injury in all rugby players. France was 7.8 times (IRR = 7.88, 95% CI: 1.29; 3.21) more likely to sustain a fracture than Poland, which much often experienced less serious injuries (bruise, rapture of muscle and ligament) (IRR = 3.02, 95% CI: 2.06; 3.98). Polish players were provided with various forms of physiotherapy while Franch players often worked with a physiotherapist with a therapeutic method ( < 0.005). Poland and France reported experiencing side effects after an injury and the most frequent was pain. In their opinions, the reasons influencing the effectiveness of rehabilitation are too quick return to the game and too short time of rehabilitation. : The competitive level of the rugby player influences not only the frequency and type of injury occurrence, but also access to the different forms of rehabilitation. Nonetheless, the side effects occurring after injury and the causes of ineffective rehabilitation are still similar. Further studies are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players' welfare.
Topics: Athletic Injuries; Football; France; Humans; Incidence; Male; Musculoskeletal System; Poland
PubMed: 33946550
DOI: 10.3390/ijerph18094835 -
BMJ Open Apr 2021To conduct a scoping review that (1) describes what is known about the relationship between athletic identity and sport-related injury outcomes and (2) describes the... (Review)
Review
OBJECTIVES
To conduct a scoping review that (1) describes what is known about the relationship between athletic identity and sport-related injury outcomes and (2) describes the relationship that an injury (as an exposure) has on athletic identity (as an outcome) in athletes.
DESIGN
Scoping review.
PARTICIPANTS
A total of n=1852 athletes from various sport backgrounds and levels of competition.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary measure used within the studies identified was the Athletic Identity Measurement Scale. Secondary outcome measures assessed demographic, psychosocial, behavioural, physical function and pain-related constructs.
RESULTS
Twenty-two studies were identified for inclusion. Samples were dominated by male, Caucasian athletes. The majority of studies captured musculoskeletal injuries, while only three studies included sport-related concussion. Athletic identity was significantly and positively associated with depressive symptom severity, sport performance traits (eg, ego-orientation and mastery-orientation), social network size, physical self-worth, motivation, rehabilitation overadherence, mental toughness and playing through pain, as well as injury severity and functional recovery outcomes. Findings pertaining to the association that an injury (as an exposure) had on athletic identity (as an outcome) were inconsistent and limited.
CONCLUSIONS
Athletic identity was most frequently associated with psychosocial, behavioural and injury-specific outcomes. Future research should seek to include diverse athlete samples (eg, women, athletes of different races, para-athletes) and should continue to reference theoretical injury models to inform study methodologies and to specify variables of interest for further exploration.
Topics: Athletes; Athletic Injuries; Brain Concussion; Female; Humans; Male; Sports; Sports Medicine
PubMed: 33837101
DOI: 10.1136/bmjopen-2020-044199 -
Injury Feb 2023Early patient assessment is relevant for surgical decision making in severely injured patients and early definitive surgery is known to be beneficial in stable patients.... (Review)
Review
INTRODUCTION
Early patient assessment is relevant for surgical decision making in severely injured patients and early definitive surgery is known to be beneficial in stable patients. The aim of this systematic review is to extract parameters indicative of risk factors for adverse outcome. Moreover, we aim to improve decision making and separate patients who would benefit from early versus staged definitive surgical fixation.
METHODS
Following the PRISMA guidelines, a systematic review of peer-reviewed articles in English or German language published between (2000 and 2022) was performed. The primary outcome was the pathophysiological response to polytrauma including coagulopathy, shock/haemorrhage, hypothermia and soft tissue injury (trauma, brain injury, thoracic and abdominal trauma, and musculoskeletal injury) to determine the treatment strategy associated with the least amount of complications. Articles that had used quantitative parameters to distinguish between stable and unstable patients were summarized. Two authors screened articles and discrepancies were resolved by consensus. Quantitative values for relevant parameters indicative of an unstable polytrauma patient were obtained.
RESULTS
The initial systematic search using MeSH criteria yielded 1550 publications deemed relevant to the following topics (coagulopathy (n = 37), haemorrhage/shock (n = 7), hypothermia (n = 11), soft tissue injury (n = 24)). Thresholds for stable, borderline, unstable and in extremis conditions were defined according to the existing literature as follows: Coagulopathy; International Normalized Ratio (INR) and viscoelastic methods (VEM)/Blood/shock; lactate, systolic blood pressure and haemoglobin, hypothermia; thresholds in degrees Celsius/Soft tissue trauma: traumatic brain injury, thoracic and abdominal trauma and musculoskeletal trauma.
CONCLUSION
In this systematic literature review, we summarize publications by focusing on different pathways that stimulate pathophysiological cascades and remote organ damage. We propose that these parameters can be used for clinical decision making within the concept of safe definitive surgery (SDS) in the treatment of severely injured patients.
Topics: Humans; Hypothermia; Fracture Fixation; Fractures, Bone; Multiple Trauma; Soft Tissue Injuries; Abdominal Injuries
PubMed: 36404162
DOI: 10.1016/j.injury.2022.11.008 -
Science (New York, N.Y.) Jan 2019Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including...
Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including commensal-specific T cells. We found that skin-resident commensal-specific T cells harbor a paradoxical program characterized by a type 17 program associated with a poised type 2 state. Thus, in the context of injury and exposure to inflammatory mediators such as interleukin-18, these cells rapidly release type 2 cytokines, thereby acquiring contextual functions. Such acquisition of a type 2 effector program promotes tissue repair. Aberrant type 2 responses can also be unleashed in the context of local defects in immunoregulation. Thus, commensal-specific T cells co-opt tissue residency and cell-intrinsic flexibility as a means to promote both local immunity and tissue adaptation to injury.
Topics: Alarmins; Animals; CD8-Positive T-Lymphocytes; Candida albicans; Cell Plasticity; Female; GATA3 Transcription Factor; Interleukins; Male; Mice, Inbred C57BL; Mice, Transgenic; Microscopy, Confocal; Microscopy, Fluorescence; Nuclear Receptor Subfamily 1, Group F, Member 3; Sequence Analysis, RNA; Skin; Staphylococcus epidermidis; Symbiosis; Th17 Cells; Transcriptome; Wounds and Injuries
PubMed: 30523076
DOI: 10.1126/science.aat6280 -
Orthopaedics & Traumatology, Surgery &... Apr 2018Radiocarpal dislocation (RCD) and fracture-dislocations (RCFD) are severe but rare injuries for which the treatment and outcomes are not well defined. The aim of this...
INTRODUCTION
Radiocarpal dislocation (RCD) and fracture-dislocations (RCFD) are severe but rare injuries for which the treatment and outcomes are not well defined. The aim of this retrospective study was to describe the prevalence of the various injury types and their long-term outcomes.
PATIENTS AND METHODS
Between 1992 and 2014, 41 patients with RCFD were seen at our institution. According to the Dumontier classification, there were 4 cases of type 1 and 37 cases of type 2. Thirteen patients were reviewed again after a mean follow-up of 168 months (20-260).
RESULTS
Among these 41 patients, 6 required secondary wrist fusion. At the latest follow-up evaluation, flexion-extension amplitude was 100° (25°-152°), grip strength was 86% of the contralateral side (10kgf-112kgf), the mean VAS for pain was 1.3 (0-5), the mean QuickDASH was 23 (0-59) and the mean PWRE was 27 (0-75). Six patients developed osteoarthritis in the radiocarpal and midcarpal joints.
DISCUSSION
For cases of RCD, when reduction and stabilization have been confirmed by a dorsal approach, there is no reason to perform volar capsule and ligament suturing. For cases of RCFD, after anatomical reduction, radiostyloid pinning can be performed and an open surgical approach is not always required. Radiolunate fusion is a good solution for treating secondary instability.
CONCLUSION
The good functional outcomes and absence of osteoarthritis can be attributed to the effective reduction and radiocarpal stabilization, along with the absence of radial and intracarpal marginal fractures.
LEVEL OF EVIDENCE
IV, retrospective.
Topics: Adolescent; Adult; Aged; Arthrodesis; Carpal Joints; Female; Follow-Up Studies; Fractures, Bone; Hand Strength; Humans; Joint Dislocations; Male; Middle Aged; Musculoskeletal Pain; Osteoarthritis; Radius; Range of Motion, Articular; Reoperation; Retrospective Studies; Wrist Injuries; Wrist Joint; Young Adult
PubMed: 29428553
DOI: 10.1016/j.otsr.2017.12.016 -
Sports Health 2017
Topics: Athletes; Athletic Injuries; Brain Concussion; Humans; Musculoskeletal System; Return to Sport
PubMed: 28661829
DOI: 10.1177/1941738117714157 -
Reumatologia Clinica 2015
Topics: Diagnosis, Differential; Diagnostic Errors; Female; Fractures, Compression; Humans; Magnetic Resonance Imaging; Middle Aged; Musculoskeletal Abnormalities; Osteoporotic Fractures; Spinal Fractures; Thoracic Vertebrae
PubMed: 24582140
DOI: 10.1016/j.reuma.2014.01.001 -
Sports Health 2022Coronavirus disease 2019 (COVID-19) affects multiple organ systems. Whether and how COVID-19 affects the musculoskeletal system remains unknown. We aim to assess the...
BACKGROUND
Coronavirus disease 2019 (COVID-19) affects multiple organ systems. Whether and how COVID-19 affects the musculoskeletal system remains unknown. We aim to assess the association between COVID-19 and risk of injury.
HYPOTHESIS
Runners who report having COVID-19 also report a higher incidence of injury.
STUDY DESIGN
Cross-sectional study.
LEVEL OF EVIDENCE
Level 4.
METHODS
An electronic survey was distributed from July through September 2020, by New York Road Runners, ASICS North America, race medical directors, and through social media. Inclusion criteria were runners 18 years or older who had participated in ≥1 race (running or triathlon) in 2019.
RESULTS
A total of 1947 runners participated and met inclusion criteria. Average age was 45.0 (SD, 12.2) years and 56.5% were women. A total of 123 (6.3%) runners self-reported having COVID-19; 100 (81%) reported their diagnosis was from a laboratory test (polymerase chain reaction or antibody) and 23 reported being diagnosed by a medical professional without confirmatory laboratory testing. Since March 2020, 427 (21.9%) reported an injury that prevented running for at least 1 week, including 38 of 123 (30.9%) who self-reported having COVID-19 and 389 of 1435 (21.3%) who did not report having COVID-19 ( = 0.01). After adjusting for age, sex, the number of races in 2019, and running patterns before March 2020, runners who self-reported a diagnosis of COVID-19 had a higher incidence of injury compared with those who did not (odds ratio, 1.66; 95% CI, 1.11-2.48; = 0.01).
CONCLUSION
Injuries were more often self-reported by runners with laboratory-confirmed or clinically diagnosed COVID-19 compared with those who did not report COVID-19. Given the limitations of the study, any direct role of COVID-19 in the pathophysiology of injuries among runners remains unclear.
CLINICAL RELEVANCE
Direct and indirect musculoskeletal sequelae of COVID-19 should be further investigated, including the risk of exercise- and sports-related injury after COVID-19.
Topics: Athletic Injuries; COVID-19; Cross-Sectional Studies; Female; Humans; Incidence; Male; Middle Aged; Musculoskeletal System
PubMed: 34906009
DOI: 10.1177/19417381211061144 -
JAMA Network Open Oct 2021There is limited research investigating injury and illness among professional basketball players during their rookie season. By improving the understanding of injury...
IMPORTANCE
There is limited research investigating injury and illness among professional basketball players during their rookie season. By improving the understanding of injury incidence and risk specific to rookie players, sports medicine clinicians may be able to further individualize injury mitigation programs that address the unique needs of rookie players.
OBJECTIVE
To compare incidence and rate ratio (RR) of injury and illness among professional National Basketball Association (NBA) players in their rookie season with veteran players and to explore the association of sustaining an injury rookie season with career longevity.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective cohort study used an online data repository and extracted publicly available data about NBA players between the 2007 and 2008 season to the 2018 and 2019 season. Available data for initial injury and all subsequent injuries were extracted during this time frame.
EXPOSURES
Injury and illness based on injury status during the rookie season of professional NBA players.
MAIN OUTCOMES AND MEASURES
Injury and illness incidence and RR. Association of injury during the rookie season with career longevity was assessed via Poisson regressions.
RESULTS
Of the 12 basketball seasons analyzed, 904 NBA players were included (mean [SD] age, 24.6 [3.9] years; body mass index, 24.8 [1.8]). The injury and illness incidence for rookie players was 14.28 per 1000 athlete game exposures (AGEs). Among all body regions, ankle injuries had the greatest injury incidence among players injured during their rookie season (3.17 [95% CI, 3.15-3.19] per 1000 AGEs). Rookie athletes demonstrated higher RR compared with veterans across multiple regions of the body (ankle: 1.32; 95% CI, 1.12 to 1.52; foot/toe: 1.29; 95% CI, 0.97 to 1.61; shoulder/arm/elbow: 1.43; 95% CI, 1.10 to 1.77; head/neck: 1.21; 95% CI, 0.61 to 1.81; concussions: 2.39; 95% CI, 1.89 to 2.90; illness: 1.14; 95% CI, 0.87 to 1.40), and demonstrated a higher rate of initial injuries compared with veteran players (1.41; 95% CI, 1.29 to 1.53). Players who sustained an injury rookie season demonstrated an unadjusted decrease in total seasons played (-0.4 [95% CI, -0.5 to -0.3] log years; P < .001), but this decrease was not observed within adjusted analysis (0.1 [95% CI, -0.1 to 0.2] log years; P = .36).
CONCLUSIONS AND RELEVANCE
In this study, rookie athletes demonstrated the highest injury incidence at the ankle and increased RR across multiple regions. These findings may reflect differences in preseason conditioning or load variables impacting rookie athletes and warrant further investigation. Future research is needed to determine the association of cumulative injury burden vs a singular injury event on career longevity.
Topics: Adolescent; Adult; Athletes; Athletic Injuries; Basketball; Female; Humans; Male; Return to Sport; Time Factors
PubMed: 34605914
DOI: 10.1001/jamanetworkopen.2021.28199