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Sports Medicine (Auckland, N.Z.) May 2018An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The... (Review)
Review
An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The mechanisms underlying this recently discovered phenomenon, however, remain unknown. One theorized reason for this increased injury risk includes residual neuromuscular control deficits that remain impaired despite clinical recovery. Thus, the objectives of this review were: (1) to summarize the literature examining the relationship between concussion and risk of subsequent injury and (2) to summarize the literature for one mechanism with a theorized association with this increased injury risk, i.e., neuromuscular control deficits observed during gait after concussion under dual-task conditions. Two separate reviews were conducted consistent with both specified objectives. Studies published before 9 December, 2016 were identified using PubMed, Web of Science, and Academic Search Premier (EBSCOhost). Inclusion for the objective 1 search included dependent variables of quantitative measurements of musculoskeletal injury after concussion. Inclusion criteria for the objective 2 search included dependent variables pertaining to gait, dynamic balance control, and dual-task function. A total of 32 studies were included in the two reviews (objective 1 n = 10, objective 2 n = 22). According to a variety of study designs, athletes appear to have an increased risk of sustaining a musculoskeletal injury following a concussion. Furthermore, dual-task neuromuscular control deficits may continue to exist after patients report resolution of concussion symptoms, or perform normally on other clinical concussion tests. Therefore, musculoskeletal injury risk appears to increase following a concussion and persistent motor system and attentional deficits also seem to exist after a concussion. While not yet experimentally tested, these motor system and attentional deficits may contribute to the risk of sustaining a musculoskeletal injury upon returning to full athletic participation.
Topics: Athletes; Athletic Injuries; Brain Concussion; Gait; Humans; Postural Balance; Sports
PubMed: 29453743
DOI: 10.1007/s40279-018-0871-y -
Journal of Athletic Training Jan 2022How different pitching roles affect the risk of arm injury in professional pitchers is currently unclear.
CONTEXT
How different pitching roles affect the risk of arm injury in professional pitchers is currently unclear.
OBJECTIVES
To investigate differences between professional baseball starting and relief pitchers in the hazard of (1) arm injury and (2) elbow and shoulder injury.
DESIGN
Prospective cohort study.
SETTING
Minor League Baseball (MiLB) from 2013 to 2019.
PATIENTS OR OTHER PARTICIPANTS
Pitchers in MiLB.
MAIN OUTCOME MEASURE(S)
Pitchers were followed for the entire MiLB season, and athlete-exposures and injuries were recorded. Risk ratios and risk difference were calculated between starting and relieving MiLB pitchers. A Cox survival analysis was then performed in relation to time to arm injury between starting and relieving MiLB pitchers. Subgroup analyses were conducted for elbow and shoulder injuries.
RESULTS
A total of 297 pitchers were included, with 85 270 player-days recorded. The incidence of arm injuries was 11.4 per 10 000 athlete-exposures. Starting pitchers demonstrated a greater risk ratio (1.2 [95% CI = 1.1, 1.3]), risk difference (13.6 [95% CI = 5.6, 21.6]), and hazard of arm injury (2.4 [95% CI = 1.5, 4.0]) than relief pitchers. No differences were observed for the hazard of elbow injury between starting and relief pitchers (1.9; 95% CI = 0.8, 4.2). Starting pitchers had a greater hazard of shoulder injury than relief pitchers (3.8 [95% CI = 2.0, 7.1]).
CONCLUSIONS
Starting pitchers displayed a 2.4 times greater hazard of arm injury than relief pitchers. Subgroup analyses indicated that starters exhibited a greater hazard of shoulder injury than relievers, but no differences occurred for the hazard of elbow injury. However, due to the wide CIs, these subgroup analyses should be interpreted with caution. Clinicians may need to consider cumulative exposure and fatigue and how these factors relate to different pitching roles when assessing the risk of pitching arm injury.
Topics: Arm Injuries; Baseball; Elbow Joint; Humans; Prospective Studies; Shoulder Injuries
PubMed: 35040985
DOI: 10.4085/1062-6050-0262.21 -
Journal of Feline Medicine and Surgery Jun 2022The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome.
OBJECTIVES
The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome.
METHODS
The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners.
RESULTS
Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5-204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome.
CONCLUSIONS AND RELEVANCE
Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate.
Topics: Animals; Anterior Cruciate Ligament Injuries; Cat Diseases; Cats; Joint Dislocations; Retrospective Studies; Rupture; Stifle; Treatment Outcome
PubMed: 34254845
DOI: 10.1177/1098612X211028834 -
Sports Health 2019Synthetic turf has become an increasingly common playing surface for athletics and has changed dramatically since its introduction more than 50 years ago. Along with... (Review)
Review
CONTEXT:
Synthetic turf has become an increasingly common playing surface for athletics and has changed dramatically since its introduction more than 50 years ago. Along with changes to surface design, maintenance needs and recommendations have become more standardized and attentive both to upkeep and player-level factors. In particular, synthetic turf maintenance as it relates to athlete health and safety is an important consideration at all levels of play.
EVIDENCE ACQUISITION:
A literature search of MEDLINE and PubMed for publications between the years 1990 and 2018 was conducted. Keywords included s ynthetic turf, artificial turf, field turf, and playing surface. Additionally, expert opinion through systematic interviews and practical implementation were obtained on synthetic turf design and maintenance practices in the National Football League.
STUDY DESIGN:
Clinical review.
LEVEL OF EVIDENCE:
Level 5.
RESULTS:
Synthetic turf has changed considerably since its inception. Playing surface is a critical component of the athletic environment, playing a role both in performance and in athlete safety. There are several important structural considerations of third-generation synthetic turf systems currently used in the United States that rely heavily on strong and consistent maintenance. A common misconception is that synthetic turf is maintenance free; in fact, however, these surfaces require routine maintenance. Whether athletes experience more injuries on synthetic over natural surfaces is also of interest among various levels and types of sport.
CONCLUSION:
Modern synthetic turf is far different than when originally introduced. It requires routine maintenance, even at the level of local athletics. It is important for sports medicine personnel to be familiar with playing surface issues as they are often treating athletes at the time of injury and should maintain a level of awareness of contemporary research and practices regarding the relationships between synthetic turf and injury.
Topics: Athletic Injuries; Craniocerebral Trauma; Environment Design; Football; Humans; Neoplasms; Poaceae; Risk Factors; Skin Diseases, Infectious; Surface Properties; Temperature; United States
PubMed: 30096021
DOI: 10.1177/1941738118793378 -
International Journal of Environmental... Jul 2022Child labor remains a health hazard, affecting the mental, physical, and emotional well-being of children. Children engage in waste management through various channels... (Review)
Review
BACKGROUND
Child labor remains a health hazard, affecting the mental, physical, and emotional well-being of children. Children engage in waste management through various channels while constantly working to create a healthier and cleaner environment and exposing themselves to numerous health risks. Thus, this scoping review aims to explore the occupational injuries, health hazards, and sufferings of child waste workers in South Asia.
METHODS
Following the PRISMA guidelines, a scoping review of available relevant scientific literature was completed to comprehensively analyze the extent of child waste workers' health suffering. Online databases PubMed, SCOPUS, and Google Scholar were searched for predefined criteria. Collected references were screened with Rayyan web tools and Endnote. Based on study inclusion criteria, a thematic synthesis was performed on the findings of 12 articles.
RESULTS
This study's findings provided deep insights into the most prevalent occupational health sufferings among child waste workers, as depicted in the available literature. Prevalence of injuries like cuts and wounds was found predominant. These injuries are caused by the collection, transportation, dumping, and recycling of waste. Respiratory, musculoskeletal, and skin diseases are more prevalent among child waste worker children than in control groups of the same socioeconomic backgrounds. A higher chance of genetic or neuro-degenerative disorder and DNA mutation indicates a long-term effect on the children working in the waste management sector. Psychological sufferings were the least explored, although very common among child laborers. MPD (Minor Psychiatric Disorder) was very high among waste workers. Regarding healthcare-seeking behavior, traditional methods are preferable rather than formal health facilities. More research is required in this area due to a lack of evidence on the health problems of child waste workers.
CONCLUSIONS
Occupational hazards were myriad among child waste workers. Though many children are involved in waste management, they are typically excluded from mainstream child protection and support systems, making them more exposed to occupational harassment and injury. Policymakers should design specific programs for these vulnerable groups considering the issues below, i.e., provide protective equipment such as facemasks, gloves, footwear, and rag sorting tools to safeguard them from physical damage and illness, ensure access to health care, to school, and provide basic nutrients to them. Furthermore, the authorities should think of alternative income generating programs for these groups of children.
Topics: Asia; Child; Humans; Occupational Health; Occupational Injuries; Recycling; Waste Management
PubMed: 35886477
DOI: 10.3390/ijerph19148628 -
Journal of Orthopaedic Surgery and... Sep 2016Hand and wrist injuries are common during athletics and can have a significant impact especially if initially disregarded. Due to their high level of physical demand,... (Review)
Review
BACKGROUND
Hand and wrist injuries are common during athletics and can have a significant impact especially if initially disregarded. Due to their high level of physical demand, athletes represent a unique subset of the population.
MAIN BODY
The following is an overview of hand and wrist injuries commonly seen in athletics. Information regarding evaluation, diagnosis, conservative measures, and surgical treatment are provided.
CONCLUSION
Knowledge of these entities and special consideration for the athlete can help the team physician effectively treat these players and help them achieve their goals.
Topics: Athletic Injuries; Cartilage, Articular; Fractures, Bone; Hand Injuries; Humans; Ligaments, Articular; Metacarpal Bones; Return to Sport; Rupture; Scaphoid Bone; Tendinopathy; Ulna; Wrist Injuries
PubMed: 27633260
DOI: 10.1186/s13018-016-0432-8 -
Nature Communications Aug 2021Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the...
Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the role of sensory nerve fibers in this abnormal cell fate decision is investigated using a severe extremity injury model in mice. Soft tissue trauma results in NGF (Nerve growth factor) expression, particularly within perivascular cell types. Consequently, NGF-responsive axonal invasion occurs which precedes osteocartilaginous differentiation. Surgical denervation impedes axonal ingrowth, with significant delays in cartilage and bone formation. Likewise, either deletion of Ngf or two complementary methods to inhibit its receptor TrkA (Tropomyosin receptor kinase A) lead to similar delays in axonal invasion and osteochondral differentiation. Mechanistically, single-cell sequencing suggests a shift from TGFβ to FGF signaling activation among pre-chondrogenic cells after denervation. Finally, analysis of human pathologic specimens and databases confirms the relevance of NGF-TrkA signaling in human disease. In sum, NGF-mediated TrkA-expressing axonal ingrowth drives abnormal osteochondral differentiation after soft tissue trauma. NGF-TrkA signaling inhibition may have dual therapeutic use in soft tissue trauma, both as an analgesic and negative regulator of aberrant stem cell differentiation.
Topics: Animals; Axons; Cartilage; Cell Differentiation; Mice; Mice, Inbred C57BL; Nerve Growth Factor; Osteogenesis; Receptor, trkA; Signal Transduction; Stem Cells; Wounds and Injuries
PubMed: 34400627
DOI: 10.1038/s41467-021-25143-z -
The Journal of Spinal Cord Medicine Nov 2022Extreme conditioning programs (ECPs), such as CrossFit, are a relatively new method of fitness with rapid growth in individuals with paraplegia. However, it is unknown... (Observational Study)
Observational Study
CONTEXT
Extreme conditioning programs (ECPs), such as CrossFit, are a relatively new method of fitness with rapid growth in individuals with paraplegia. However, it is unknown if wheelchair users are at an additional risk of musculoskeletal injury during these exercises. Biomechanical characterization is necessary to determine the safety and efficacy of ECPs as an exercise modality for wheelchair users with paraplegia.
OBJECTIVE
To characterize the three-dimensional (3-D) thorax and upper extremity joint kinematics of paraplegic wheelchair athletes during exercises commonly prescribed as part of ECPs.
DESIGN
Observational study.
PARTICIPANTS
Three male wheelchair athletes, average age of 37.1 ± 4.6 years, with spinal cord injury levels of T8, L2, and T10, with varying exercise experience.
METHODS
3-D movement was acquired using motion capture during the performance of four exercises: battle ropes, sled pull, overhead press, and sledgehammer swing. A custom upper extremity inverse kinematics model was applied to compute 3-D joint angles.
OUTCOME MEASURES
3-D peak thorax, glenohumeral, elbow, and wrist joint angles and ranges of motion (ROM), Visual Analog Scale (VAS), and Borg Scale of Perceived Exertion.
RESULTS
Large joint motions were required for the exercises, at times demanding extreme shoulder and/or wrist flexion and extension, abduction, and external rotation, which are concerning for injury risk in wheelchair users. Participants, however, were able to perform the exercises pain free.
CONCLUSION
These quantitative findings highlight that wheelchair athletes may be exposed to potentially injurious positions during common ECP exercises. These findings provide insight that may lead to improved clinical guidelines for prescription and training of exercise regimens, particularly involving ECPs, for wheelchair users.
Topics: Humans; Male; Adult; Wheelchairs; Para-Athletes; Shoulder Joint; Spinal Cord Injuries; Paraplegia; Biomechanical Phenomena
PubMed: 34100694
DOI: 10.1080/10790268.2021.1928868 -
Journal of Orthopaedic Research :... Apr 2020In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's... (Review)
Review
In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's 2019 annual meeting. Experts in the field provided examples of mesenchymal cell plasticity during normal musculoskeletal development, regeneration, and disease. A thorough understanding of the biology underpinning mesenchymal cell plasticity may offer a roadmap for promoting regeneration while attenuating pathologic differentiation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:708-718, 2020.
Topics: Animals; Cell Differentiation; Cell Plasticity; Disease; Humans; Musculoskeletal Development; Myositis Ossificans; Ossification, Heterotopic; Regeneration; Wounds and Injuries
PubMed: 31721278
DOI: 10.1002/jor.24523 -
Physical Therapy in Sport : Official... Nov 2021This review aims to provide a succinct and critical analysis of the current physical and mechanical demands of elite Australian football while examining lower-limb... (Review)
Review
OBJECTIVE
This review aims to provide a succinct and critical analysis of the current physical and mechanical demands of elite Australian football while examining lower-limb injury and the associated physical and kinanthropometric risk factors.
METHODS
MEDLINE, PubMed, Web of Science and SPORTSDiscus electronic databases were searched for studies that investigated the playing demands, injury trends, and physical and kinanthropometric injury risk factors of elite Australian football. Articles from similar team sports including soccer and rugby (union and league) were also included.
RESULTS
While the physical demands of elite AF have steadied over the past decade, injury rates continue to rise with more than two-thirds of all injuries affecting the lower-limbs. Body composition and musculoskeletal morphological assessments are regularly adopted in many sporting settings with current research suggesting high and low body mass are both associated with heightened injury risk. However, more extensive investigations are required to determine whether the proportions of muscle and fat are linked. Repeated assessment of musculoskeletal morphology may also provide further insight into stress fracture rates.
CONCLUSIONS
While kinanthropometric and physical attributes are highly valued within elite sporting environments, establishing a deeper connection with injury may provide practitioners with more insight into current injury trends.
Topics: Humans; Athletic Injuries; Australia; Incidence; Leg Injuries; Risk Factors; Team Sports
PubMed: 34418589
DOI: 10.1016/j.ptsp.2021.08.006