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Del Duchetto F, Dussault-Picard C, Gagnon M, Dixon P, Cherni Y. Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review. SPORTS MEDICINE - OPEN 2024; 10:108. [PMID: 39365485 PMCID: PMC11452579 DOI: 10.1186/s40798-024-00774-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/13/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Running is a widely practiced sport worldwide associated with a host of benefits on cardiovascular, metabolic, musculoskeletal, and mental health, but often leads to musculoskeletal overuse injuries. The prescription of a foot orthosis (FO) is common to manage musculoskeletal impairments during physical activity or functional tasks. Although FOs are frequently prescribed by clinicians for symptomatic populations of runners, the existing literature supporting the prescription of FOs in runners has predominantly focused on either uninjured individuals or a mix of uninjured and symptomatic populations. Thus, the effects of FOs on the treatment and/or prevention of overuse running injuries need to be investigated to guide future research and assist clinicians in their decision-making process. MAIN BODY This scoping review aimed to evaluate the immediate and long-term effects of FOs on lower limb biomechanics, neuromuscular parameters, and pain and disability in symptomatic runners, and to identify factors that may influence the effects of FOs. Five databases (CINAHL, SPORTDiscus, MEDLINE, Embase, and Web of Science) were searched, resulting in 2536 studies. A total of 30 studies, published between 1992 and 2023 (730 symptomatic runners), were included following the removal of duplicates and the screening process. Wearing FOs while running is related to an immediate and a long-term decrease in pain and symptoms of overuse running injuries. Also, wearing FOs while running decreases eversion at the foot/ankle complex, leads to a more lateral plantar pressure at the heel and forefoot, and may change running motor control strategies. Finally, the effectiveness of FOs is influenced by its added features. CONCLUSIONS This study provides recommendations for future research such as the need for standardized methods in describing FOs, considering participant characteristics such as foot morphology, and comparing different types of FOs. Also, this scoping review provides valuable insights for guiding the prescription and design of FOs, and suggests that integrating FOs into a comprehensive treatment plan may yield better results than standalone first-line treatments. Nonetheless, this scoping review highlights the need for future research to explore the optimal integration of FOs into injury-specific treatment plans.
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Affiliation(s)
- Francis Del Duchetto
- École de Kinésiologie et des Sciences de L'activité Physique, Université de Montréal, Montréal, QC, Canada
| | - Cloé Dussault-Picard
- École de Kinésiologie et des Sciences de L'activité Physique, Université de Montréal, Montréal, QC, Canada
- Laboratoire de Neurobiomécanique & Neuroréadaptation de la Locomotion (NNL), Centre de Recherche Azrieli du CHU Ste Justine, Montréal, QC, Canada
| | - Martine Gagnon
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Philippe Dixon
- École de Kinésiologie et des Sciences de L'activité Physique, Université de Montréal, Montréal, QC, Canada
- Department of Kinesiology and Physical Education, McGill University, Montréal, QC, Canada
| | - Yosra Cherni
- École de Kinésiologie et des Sciences de L'activité Physique, Université de Montréal, Montréal, QC, Canada.
- Laboratoire de Neurobiomécanique & Neuroréadaptation de la Locomotion (NNL), Centre de Recherche Azrieli du CHU Ste Justine, Montréal, QC, Canada.
- Centre Interdisciplinaire de Recherche sur le Cerveau et L'apprentissage (CIRCA), Montréal, QC, Canada.
- Institut de Génie Biomédical, Université de Montréal, Montréal, QC, Canada.
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Zhu Y, Zhang H, Li Q, Zhang TJ, Wu N. Association of Aerobic and Muscle-Strengthening Activity with Chronic Low Back Pain: population-based study. Spine J 2024:S1529-9430(24)01028-3. [PMID: 39343241 DOI: 10.1016/j.spinee.2024.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 09/14/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND CONTEXT Chronic low back pain (CLBP) is a significant global health burden, primarily affecting the middle-aged and older; However, there is a lack of clear, evidence-based guidelines for leisure-time physical activity aimed at preventing CLBP. PURPOSE This study sought to delineate the association between aerobic physical activity (APA) and muscle strengthening activities (MSA) and the prevalence of CLBP. STUDY DESIGN This was a population-based study conducted across the United States. PATIENT SAMPLE This nationwide study utilizes deidentified data from 22 consecutive rounds of the National Health Interview Survey (NHIS) from 1997 to 2018. OUTCOME MEASURES The primary outcome was self-reported CLBP. METHODS We analyzed the prevalence of CLBP in a representative sample of 324,793 middle-aged and older people. Among 263,871 individuals, we used multiple logistic regression to investigate individual and joint association between the amount of APA and MSA with CLBP. RESULTS In total, 263,871 participants (mean age, 59.0 years; SD, 9.7) were included in the final analysis. From 1997 to 2018, the prevalence of CLBP was approximately 32%, with an annual increase. Engaging in APA for 75-150 minutes weekly was associated with a modest reduction in CLBP risk (OR (95% CI) = 0.97(0.97 to 0.98)). Similar benefits were seen with 150-225, 225-300, and >300 minutes. Engaging in MSA 2-3 times and 4-5 times weekly also reduced CLBP risk (0.98(0.98 to 0.99) and 0.98(0.97 to 0.99), respectively). Optimal reductions of CLBP risk may be associated with balanced levels of APA and MSA, with recommended amounts being 225-300 min/w of APA and 4-5 times/w of MSA (0.92(0.89 to 0.95)). CONCLUSIONS The study found engaging in over 75 minutes of APA and 2-5 weekly MSA sessions is associated with a reduced risk of CLBP. Furthermore, a balanced combination of APA and MSA may correspond to the greatest reduction in CLBP risk.
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Affiliation(s)
- Yuanpeng Zhu
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory for Genetic Research of Skeletal Deformity; Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences; Beijing, 100730, China
| | - Haoran Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory for Genetic Research of Skeletal Deformity; Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences; Beijing, 100730, China
| | - Qing Li
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory for Genetic Research of Skeletal Deformity; Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences; Beijing, 100730, China
| | - Terry Jianguo Zhang
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory for Genetic Research of Skeletal Deformity; Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences; Beijing, 100730, China.
| | - Nan Wu
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences; Beijing, 100730, China; Beijing Key Laboratory for Genetic Research of Skeletal Deformity; Beijing, 100730, China; Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences; Beijing, 100730, China.
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Jokela A, Aho J, Kosola J, Stenroos A, Sinikumpu JJ, Maffulli N, Lempainen L. Heel pain in young athletes - not always Sever's Disease: A Narrative Review. Foot (Edinb) 2024; 60:102114. [PMID: 39029380 DOI: 10.1016/j.foot.2024.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 07/21/2024]
Abstract
Heel pain is a prevalent issue in young athletes, often arising from overuse and increased sporting demands. While Sever's Disease is the predominant cause, various other entities, including stress-related injuries and pathologies like tumors and bone lesions, contribute to this condition. The complex hind foot anatomy, encompassing ossicles, physis, and soft tissues, may lead to heel pain. This study aims to provide physicians with a clinically oriented narrative review of adolescent heel pain, supported by illustrative cases. CONCLUSION: This study aims to offer physicians a comprehensive understanding of the concepts surrounding heel pain in adolescents. By presenting clinically relevant information and illustrated cases, it seeks to enhance medical practitioners' ability to diagnose and manage heel pain effectively in this specific demographic.
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Affiliation(s)
- Aleksi Jokela
- Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Joni Aho
- University of Turku, Turku, Finland
| | - Jussi Kosola
- Department of Orthopaedics and Traumatology, Kanta-Häme Central Hospital, Hämeenlinna, Finland; University of Helsinki, Helsinki, Finland; Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland; Department of Orthopaedics and Traumatology, Hyvinkää Hospital, Hyvinkää, Finland
| | - Antti Stenroos
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Juha-Jaakko Sinikumpu
- Department of Children and Adolescents, PEDEGO unit and MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy; Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK; Institute of Science and Technology in Medicine, Keele University School of Medicine, Stoke on Trent, UK
| | - Lasse Lempainen
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland; FinnOrthopaedics / Hospital Pihlajalinna, Turku, Finland; Ripoll y De Prado, FIFA Medical Centre of Excellence, Madrid, Spain.
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Biese KM, Godejohn A, Ament K, Luedke L, Schmidt WD, Wallace B, Sipes RC. High School Girls' Volleyball Athletes' Self-Reported Management of Pain, Intentions to Report Overuse Injuries, and Intentions to Adhere to Medical Advice for Treating Overuse Injuries. J Sport Rehabil 2024; 33:515-521. [PMID: 39069286 DOI: 10.1123/jsr.2024-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 07/30/2024]
Abstract
CONTEXT Girls' high school volleyball is a popular sport with a high rate of overuse injuries and sport specialization. Health professionals perceive that high school athletes are reluctant to follow treatment plans involving sport activity reduction. This study's purpose was to describe high school girls' volleyball athletes' self-reported shoulder and knee pain, the likelihood of adhering to medical advice, and the association of factors that influence the likelihood of reporting overuse injuries and sport specialization. STUDY DESIGN Cross-sectional. METHODS Participants completed an online survey (demographics, sport participation measures, shoulder and knee pain information, medical adherence likelihood [4-point Likert: not at all likely to extremely likely], and factors influencing overuse injury reporting intentions). A 2 × 2 chi-square analysis compared factors that influence athletes' intentions to "not report an overuse injury" (eg, I thought my coach would get mad; yes/no) and sport specialization (nonhighly specialized/highly specialized athletes). RESULTS There were 150 participants (highly specialized = 56%, grade: ninth = 33%, 10th = 28%, 11th = 22%, 12th = 17%). At least 60% reported shoulder and knee pain related to an overuse mechanism. Most reportedly did not seek rehabilitation led by a medical provider (shoulder pain = 66%, knee pain = 60%). Only 11% of athletes reported they were "extremely likely" to rest from sporting activity during the regular season if advised by a medical professional. Highly specialized athletes were more likely to report the pursuit of a college scholarship as a factor that influences their intention to report an overuse injury compared to nonhighly specialized athletes (13% vs 3%, respectively, P = .04). CONCLUSIONS Most girls' volleyball athletes did not treat their pain with guided rehabilitation, which may increase their risk of a worse overuse injury or even acute injury. Clinicians, athletes, parents, and coaches need to work together to create a sport culture that empowers athletes to discuss their pain and overuse injuries with medical professionals.
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Affiliation(s)
- Kevin M Biese
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - Abigail Godejohn
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - Kamille Ament
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - Lace Luedke
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - W Daniel Schmidt
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - Brian Wallace
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - Robert C Sipes
- Department of Kinesiology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
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Marr N, Meeson R, Piercy RJ, Hildyard JCW, Thorpe CT. Evaluation of suitable reference genes for qPCR normalisation of gene expression in a Achilles tendon injury model. PLoS One 2024; 19:e0306678. [PMID: 39190750 DOI: 10.1371/journal.pone.0306678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024] Open
Abstract
Tendons are one of the major load-bearing tissues in the body; subjected to enormous peak stresses, and thus vulnerable to injury. Cellular responses to tendon injury are complex, involving inflammatory and repair components, with the latter employing both resident and recruited exogenous cell populations. Gene expression analyses are valuable tools for investigating tendon injury, allowing assessment of repair processes and pathological responses such as fibrosis, and permitting evaluation of therapeutic pharmacological interventions. Quantitative polymerase chain reaction (qPCR) is a commonly used approach for such studies, but data obtained by this method must be normalised to reference genes: genes known to be stably expressed between the experimental conditions investigated. Establishing suitable tendon injury reference genes is thus essential. Accordingly we investigated mRNA expression stability in a rat model of tendon injury, comparing both injured and uninjured tendons, and the effects of rapamycin treatment, at 1 and 3 weeks post injury. We used 11 candidate genes (18S, ACTB, AP3D1, B2M, CSNK2A2, GAPDH, HPRT1, PAK1IP1, RPL13a, SDHA, UBC) and assessed stability via four complementary algorithms (Bestkeeper, deltaCt, geNorm, Normfinder). Our results suggests that ACTB, CSNK2A2, HPRT1 and PAK1IP1 are all stably expressed in tendon, regardless of injury or drug treatment: any three of these would serve as universally suitable reference gene panel for normalizing qPCR expression data in the rat tendon injury model. We also reveal 18S, UBC, GAPDH, and SDHA as consistently poor scoring candidates (with the latter two exhibiting rapamycin- and injury-associated changes, respectively): these genes should be avoided.
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Affiliation(s)
- Neil Marr
- Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Richard Meeson
- Clinical Sciences and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Richard J Piercy
- Clinical Sciences and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - John C W Hildyard
- Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Chavaunne T Thorpe
- Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
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Arévalo-Chico H, Sellés-Pérez S, Cejuela R. Applying a Holistic Injury Prevention Approach to Elite Triathletes. Sports (Basel) 2024; 12:225. [PMID: 39195601 PMCID: PMC11359884 DOI: 10.3390/sports12080225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024] Open
Abstract
(1) Background: Studies on injury prevention programs are lacking for triathletes. The aim of the present study was to describe the results of a holistic (injury) training prevention program (HITP), based on training load control and strength training, in elite triathletes. (2) Methods: The study was conducted over 2021-2023 and involved 18 males and 10 females from the same training group. The HITP itself included various methods of fatigue monitoring, strength training focused on the prevention of overuse injuries (OIs), cycling skills training, and recovery strategies. The total number and type of injuries that were sustained, subsequent training/competition absence time, and injury incidence were determined. (3) Results: Twenty-four injuries were recorded over all three seasons, i.e., 0.65 injuries per 1000 h of training and competition exposure. Fourteen injuries were traumatic injuries (TIs) and ten were OIs. Of the OIs, four were of minimal severity, two were mild, three were moderate, and one was severe (accounting for 1-3, 4-7, 8-28, and >28 days of training absenteeism, respectively). A total of 46.4% of the participants did not present any type of injury and 71,4% did not incur any OIs. Average absenteeism was 17.3 days per injury. (4) Conclusions: The HITP design and implementation resulted in low OI and severe injury incidence. Due to their unpredictable nature, the number of TIs was not reduced. The TIs were suffered more frequently by men. Women are more likely to suffer from OIs, so it is particularly important to prevent OIs in women.
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Affiliation(s)
| | - Sergio Sellés-Pérez
- Physical Education and Sports, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (H.A.-C.); (R.C.)
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Hetaimish B, Ahmed H, Otayn A, Alzahrani AM, Almasoudi E, Elaiw M, Alzwaihri AS, Samargandi R. Prevalence, and types of overuse injuries in gym centers: A cross-sectional study in Saudi Arabia. Medicine (Baltimore) 2024; 103:e38830. [PMID: 38996100 PMCID: PMC11245209 DOI: 10.1097/md.0000000000038830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/14/2024] [Indexed: 07/14/2024] Open
Abstract
Physical activity has numerous health benefits, enhancing overall wellbeing. However, it can also lead to injuries, impeding exercise capacity and hindering work. Limited knowledge exists about the prevalence of overuse gym injuries and whether they vary across different gym activities. This study aims to estimate sport injuries at fitness centers in Saudi Arabia, comparing injuries between various activities and session durations. This is a cross-sectional, questionnaire-based study surveyed regular gym-goers in Saudi Arabia with overuse injuries. The online survey, distributed through social media apps, collected data using a validated Google form questionnaire. Questioanire consists of 3 parts. First part of the questionnaire included demographic characteristics of participants. Second part contains characteristics related to gym as gym session's duration, frequency of attending gym per week, sport types, type of injuries and site of injuries. Third part contains Oslo Sports Trauma Research Centre (OSTRC) Overuse injury questionnaire that included 4 questions about difficulties in participation, reduction of training, affection of performance and symptoms. Study included 1012 participants, majority male (76.2%), with age range of 18 to 50 years, and significant proportion falling between 26 and 30 years (52.6%). Majority of participants were from Central Province (42.9%). Gym sessions typically lasted 1 to 2 hours (68.3%), and most common attendance frequency was 4 days/week (39.6%). Common injury sites were shoulder (25.2%), knee (20.2%), and lower back (17.7%). Bodybuilding (50.6%), running (45.8%), and weightlifting/powerlifting (45.1%) were predominant sports. Strain/muscle rupture/tear (35.70%) and muscle cramps/spasm (19.3%) were commonest injury types. Longer gym sessions (>2 hours) were associated with higher prevalence of strain/muscle rupture/tear, dislocation, and subluxation (P < .001). Shorter sessions (<1 hour) had higher prevalence of muscle cramps/spasm and contusion/hematoma/bruise (P < .001). Gym sessions lasting 1 to 2 hours had high prevalence in tendinosis/tendinopathy. Strain/muscle rupture/tear was significantly higher in bodybuilding, weightlifting/powerlifting, swimming, cycling, and running. Tendinosis/tendinopathy was higher in crossfit. (OSTRC) Overuse injury questionnaire revealed decreased participation, training volume, performance, and increased pain with longer gym sessions. In conclusion, gym-related injuries are common, with bodybuilding and running being prevalent activities. Preventative measures should be taken, and individuals are advised to undergo a physical and medical examination before engaging in physical activity at fitness centers.
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Affiliation(s)
- Bandar Hetaimish
- Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Hassan Ahmed
- Pediatric Department, King Salman Medical City-Maternity and Children, Medina, Saudi Arabia
| | - Abdullah Otayn
- Emergency Department, Alhasa Health Cluster, Alhasa, Saudi Arabia
| | | | - Eid Almasoudi
- College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed Elaiw
- College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | - Ramy Samargandi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
- Orthopedic Surgery Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France
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Bayrak A, Ergene MC, Ceylan M. Thermography method under the influence of exercise in the detection of muscle injuries: Sartorius muscle case report. J Bodyw Mov Ther 2024; 39:109-115. [PMID: 38876613 DOI: 10.1016/j.jbmt.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/02/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The aim of this study was to determine the level of participation in the training of the athlete who applied to the clinic with pain by infrared thermography. Symptoms of sartorius muscle (SM) injury are like rectus femoris injuries. CASE SCENARIO Grade I SM injury of a 23-year-old male football player was determined by thermographic diagnosis. Taking a resting thermal image before the training of the player reported a pain in the upper thigh region. OUTCOMES Since both legs were equally loaded, in accordance with the method we developed, the thermal image was taken again after a 10-min cycling program with 30-40% resistance. The heat maps of legs seen in the pre- and post-training images were analyzed. There was no asymmetrical finding indicating injury in the resting thermographic evaluation, but asymmetric findings showing the injury in the region of SM were obtained in the repeated thermographic imaging after the 10-min cycling program. Grade I SM injury was detected by MRI afterwards. CONCLUSION Even if there is no sign of asymmetry in the resting thermography of football players having signs of pain, the injured muscle should be provoked with a safe exercise program and the thermal image should be retaken.
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Affiliation(s)
- Ahmet Bayrak
- Selcuk University, Vocational School of Health Science, Konya, Turkey
| | - Mehmet Celalettin Ergene
- Konya Technical University, Engineering Faculty, Department of Electrical - Electronics Engineering, Konya, Turkey.
| | - Murat Ceylan
- Konya Technical University, Engineering Faculty, Department of Electrical - Electronics Engineering, Konya, Turkey; AIVISIONTECH Elektronik Yazılım A.Ş., Konya, Turkey
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Ma X, Zhang K, Ma C, Zhang Y, Ma J. Physical activity and the osteoarthritis of the knee: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e38650. [PMID: 38941438 DOI: 10.1097/md.0000000000038650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
Previous studies have reported an association between physical activity and the occurrence and progression of knee osteoarthritis (KOA). However, the existing evidence remains limited and of low-quality. This study aimed to examine the causal relationship between different levels of physical activity and KOA. Instrumental variables, represented by single nucleotide polymorphisms (SNPs), were utilized to capture sedentary behavior, appropriate physical exercise, and excessive physical activity. Aggregated statistics from the UK Biobank genome-wide association study dataset were used to assess the impact of these SNPs on KOA. Causality was estimated using inverse variance weighting (IVW), MR Egger, simple model, weighted median, and weighted model approaches. The stability of the results was assessed through heterogeneity and sensitivity analyses. Mendelian randomization (MR) analysis revealed a strong association between sedentary behavior and KOA, with an odds ratio (OR) of 2.096 (95% CI: 1.506-2.917) and a P value of 1.14 × 10-5. Appropriate physical exercise behavior exhibited a strong negative association with KOA, with an OR of 0.147 (95% CI: 0.037-0.582) and a P value of 0.006. Conversely, excessive physical activity behavior showed a significant positive association with KOA, with an OR of 2.162 (95% CI: 1.327-3.521) and a P value of .002. Our findings indicate that sedentary behavior and excessive physical activity are identified as risk factors for KOA, whereas engaging in appropriate physical exercise emerges as a protective factor against the development of KOA.
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Affiliation(s)
- Xilong Ma
- The Third Clinical Medical School, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Kai Zhang
- The Third Clinical Medical School, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Chao Ma
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
| | - Yahui Zhang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
| | - Jun Ma
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
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10
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Kong Y, Xu H, Li C, Yang Y, Zhu X, Zuo Y. Construction of PARI public health education programs for Chinese undergraduates: a Delphi study. Front Public Health 2024; 12:1390011. [PMID: 38952723 PMCID: PMC11215213 DOI: 10.3389/fpubh.2024.1390011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/04/2024] [Indexed: 07/03/2024] Open
Abstract
Objectives The objective of this study is to develop a consensus among experts on a comprehensive and scientifically sound physical activity-related injuries (PARI) public health education program specifically tailored for undergraduates. Methods This study designed three rounds of expert consultation by using a Delphi method. A panel of 30 experts from the fields of public health education, sports medicine, anesthesia pain, emergency medicine, and emergency nursing participated in the study. Results This study successfully established a consensus among experts on the goals, content, teaching methods, and time allocation for the PARI Public Health Education Program for undergraduates. The program encompasses 10 objectives divided into 2 main categories: professional knowledge and skill goals. In terms of content, it includes 5 primary indicators, 22 secondary indicators, and 56 detailed tertiary indicators. Six teaching methods were identified as suitable. Additionally, a typical 60-min educational session was segmented into eight parts, with a proposed time arrangement for each, ensuring comprehensive coverage of all topics. Conclusion The consensus achieved in this study on the PARI Public Health Education Program for undergraduates lays a crucial foundation for the advancement of health literacy and proactive health management within this demographic. We presented a comprehensive framework for PARI public health education, integrating diverse learning methods and content areas. This systematic approach not only enriched the resources available for undergraduate health education, especially of PARI but also had the potential to significantly impact the implementation and effectiveness of health promotion strategies.
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Affiliation(s)
- Yuzhe Kong
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Haitao Xu
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chuyan Li
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yang Yang
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiaoyi Zhu
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yu Zuo
- Third Xiangya Hospital, Central South University, Changsha, China
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Feng C, Chen P, Zhang W, Luo B, Du G, Liao T, Zheng C. A evidence-based approach to selecting post-exercise cryostimulation techniques for improving exercise performance and fatigue recovery: A systematic review and meta-analysis. Heliyon 2024; 10:e32196. [PMID: 38933969 PMCID: PMC11200300 DOI: 10.1016/j.heliyon.2024.e32196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Rationale Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results. Introduction To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery. Methods Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software. Results This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = -0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = -1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05). Conclusion Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.
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Affiliation(s)
- Chen Feng
- Aquatic Therapy and Fitness Center, Wuhan Sports University, Wuhan, Hubei, China
- Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, Hubei, China
| | - Peng Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Wei Zhang
- Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, Hubei, China
| | - Bingting Luo
- Aquatic Therapy and Fitness Center, Wuhan Sports University, Wuhan, Hubei, China
| | - Geng Du
- Aquatic Therapy and Fitness Center, Wuhan Sports University, Wuhan, Hubei, China
| | - Ting Liao
- Aquatic Therapy and Fitness Center, Wuhan Sports University, Wuhan, Hubei, China
| | - Chanjuan Zheng
- Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, Hubei, China
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Alberola-Zorrilla P, Castaño-Ortiz C, Sánchez-Zuriaga D. Where do archers hurt? Epidemiology of injuries during archery practice. Physiother Theory Pract 2024; 40:1343-1350. [PMID: 36326710 DOI: 10.1080/09593985.2022.2136507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/25/2022] [Accepted: 09/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The risk of injury in archery is supposedly low. However, relations between pain, shooting phases and types of bow have not been studied. OBJECTIVE Understanding the biomechanical mechanisms of archery-related injuries. METHODS Online survey for archers from all types of bow. Variables were analyzed using contingency tables and chi-squared tests. RESULTS 396 surveys were completed. 36.9% of the archers had practiced archery for more than 10 years, 23.3% between 5 and 10 years. Olympic recurve bow was the most commonly used (38.2%), followed by traditional (23.3%) and compound (22.0%). 57.3% of the archers suffered some kind of injury during archery practice. Drawing shoulder (28.2%) and neck/back injuries (19.9%) were the most prevalent, preventing 50.3% of those who suffered them from continuing archery practice. There was a moderate association between drawing arm injuries and symptomatology in the drawing phase, especially in the shoulder region (0.55), elbow (0.20), and hand (0.13), and to a lesser extent in the neck/back (0.28). CONCLUSIONS Our results show that injury chronicity is frequent on archery. Correlations between types of bow, phases of the shoot and areas of pain could be a starting point for future studies on the repercussions of different types of injuries in archery practice.
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Affiliation(s)
- Pilar Alberola-Zorrilla
- Department of Anatomy and Human Embryology, Facultat de Medicina i Odontologia, Universitat de València, València, Spain
| | | | - Daniel Sánchez-Zuriaga
- Department of Anatomy and Human Embryology, Facultat de Medicina i Odontologia, Universitat de València, València, Spain
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Hardaker NJ, Hume PA, Sims ST. Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1595-1665. [PMID: 38536647 DOI: 10.1007/s40279-024-02010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist. RESULTS Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition. DISCUSSION Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes. CONCLUSIONS Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury. TRIAL REGISTRY PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).
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Affiliation(s)
- Natalie J Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Tech & Policy Lab, Law School, The University of Western Australia, Perth, Australia
| | - Stacy T Sims
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
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14
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Aldanyowi SN, AlOraini LI. Personalizing Injury Management and Recovery: A Cross-Sectional Investigation of Musculoskeletal Injuries and Quality of Life in Athletes. Orthop Res Rev 2024; 16:137-151. [PMID: 38779612 PMCID: PMC11108760 DOI: 10.2147/orr.s460748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose The study explores the impact of Musculoskeletal Injuries on the quality of life in youth athletes, aiming to understand the extent of these injuries' effects on their physical and mental wellbeing. Patients and Methods This cross-sectional study included 130 youth athletes, using questionnaires to collect data on demographics, training exposures (averaging 11±3.8 hours/week), overuse symptoms (using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire), acute injury history, and overall wellbeing (assessed by the RAND 36-item Short Form Health Survey). Results Findings indicated that 55.4% of participants had suffered an acute injury in the past 6 months, leading to an average of 4 weeks of time loss. The mean score for OSTRC-O Scores was 16.8±6.4, with knee overuse averaging 21.3± 8.8. In terms of wellbeing, physical and mental health scores were 82.4±15.3 and 81.7±14.1 respectively. There were significant correlations between higher overuse scores and poorer physical functioning (r=-0.42), bodily pain (r=-0.38), vitality (r=-0.32), and mental health (r=-0.31). Acute injuries were linked with worse physical functioning and role limitations. Regression analysis showed that both overuse and acute injuries predicted poorer physical health. Conclusion The study underscores the significant prevalence of musculoskeletal injuries among youth athletes and delineates their profound impact on the quality of life, encompassing both the physical and mental health realms. These findings advocate for the critical integration of preventive measures and personalized training protocols, spotlighting the pivotal role of comprehensive biopsychosocial strategies in nurturing athletes' overall wellbeing. By prioritizing the quality of life as a key outcome, this research advocates for a more nuanced approach to injury management and recovery.
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Affiliation(s)
- Saud N Aldanyowi
- Orthopedic Surgery, College of Medicine, King Faisal University Eastern Province, Al Ahsa, Saudi Arabia
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15
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Tarantino D, Mottola R, Sirico F, Corrado B, Ruosi C, Saggini R, Pellegrino R. Exploring the impact of vitamin D on tendon health: a comprehensive review. J Basic Clin Physiol Pharmacol 2024; 35:143-152. [PMID: 38776444 DOI: 10.1515/jbcpp-2024-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
Tendons are vital components of the musculoskeletal system, facilitating movement and supporting mechanical loads. Emerging evidence suggests that vitamin D, beyond its well-established role in bone health, exerts significant effects on tendon physiology. The aim of this manuscript is to review the impact of vitamin D on tendons, focusing on its mechanisms of action, clinical implications, and therapeutic applications. A comprehensive search of scientific electronic databases was conducted to identify articles on the effects of vitamin D on tendon health. Fourteen studies were included in this review. Five studies were performed in vitro, and nine studies were conducted in vivo. Despite some conflicting results, the included studies showed that vitamin D regulates collagen synthesis, inflammation, and mineralization within tendons through its interaction with vitamin D receptors. Epidemiological studies link vitamin D deficiency with tendon disorders, including tendinopathy and impaired healing. Supplementation with vitamin D shows promise in improving tendon strength and function, particularly in at-risk populations such as athletes and the elderly. Future research should address optimal supplementation strategies and explore the interplay between vitamin D and other factors influencing tendon health. Integrating vitamin D optimization into clinical practice could enhance tendon integrity and reduce the burden of tendon-related pathologies.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Rosita Mottola
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Felice Sirico
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Bruno Corrado
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Carlo Ruosi
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Raoul Saggini
- Faculty of Psychology, 471917 eCampus University , Novedrate, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, Lugano, Switzerland
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Wu H, Brooke-Wavell K, Fong DTP, Paquette MR, Blagrove RC. Do Exercise-Based Prevention Programs Reduce Injury in Endurance Runners? A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1249-1267. [PMID: 38261240 PMCID: PMC11127851 DOI: 10.1007/s40279-024-01993-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Endurance running is a popular sport and recreational activity yet is associated with a high prevalence of injury. Running related injuries (RRIs) are a leading cause of drop-out and represent a substantial financial burden to runners and healthcare services. There is clear evidence for the use of exercise-based injury prevention programs in games-based and youth sport settings, yet the research investigating the use of exercise to reduce injury risk in endurance runners has not been adequately reviewed recently. OBJECTIVES The aim of this review and meta-analysis was to systematically summarize the current research that has investigated the effect of exercise-based prevention programs and their state of supervision on the risk of RRIs in endurance runners. METHODS Three databases were searched for relevant studies. Selection and review were completed by two independent reviewers using the following inclusion criteria: (1) study population used endurance running training for health, occupational, or performance outcome(s); (2) participants performed running as their main form of exercise (> 50% of their total training time); (3) study was a randomized controlled trial; (4) a non-running-based exercise intervention was used; (5) a running-only or placebo exercise control group was included; (6) injury rate or incidence was reported; (7) injuries were recorded prospectively alongside the exercise training. Two meta-analyses were conducted using random-effects models, one based on log risk ratio and one based on log incidence rate ratio. The Cochrane Risk of Bias Assessment Tool 2 was used to evaluate the quality of studies and the Grading of Recommendations Assessment, Development and Evaluations approach was employed to grade the certainty of evidence. RESULTS A total of nine articles containing 1904 participants were included in analysis. Overall pooled results showed no significant differences between intervention and control groups in injury risk (z = - 1.60; p = 0.110) and injury rate (z = - 0.98; p = 0.329), while a post hoc analysis evaluating supervised interventions only showed that injury risk was significantly lower in the intervention group compared to the control group (z = - 3.75, p < 0.001). Risk of bias assessment revealed that seven studies included in the analysis were of low quality. CONCLUSIONS Exercise-based interventions do not appear to reduce the risk and rate of running-related injuries. Supervision may be essential for exercise-based intervention programs to reduce risk of RRIs, possibly due to increased compliance. Studies with more robust designs that include supervised exercise interventions should be prioritized in the future. TRIAL REGISTRY Clinical Trial Registration: PROSPERO CRD42021211274.
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Affiliation(s)
- Han Wu
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Katherine Brooke-Wavell
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Max R Paquette
- College of Health Sciences, University of Memphis, Memphis, TN, USA
| | - Richard C Blagrove
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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Vasireddi N, Vasireddi N, Shah AK, Moyal AJ, Gausden EB, Mclawhorn AS, Poelstra KA, Gould HP, Voos JE, Calcei JG. High Prevalence of Work-related Musculoskeletal Disorders and Limited Evidence-based Ergonomics in Orthopaedic Surgery: A Systematic Review. Clin Orthop Relat Res 2024; 482:659-671. [PMID: 37987688 PMCID: PMC10936985 DOI: 10.1097/corr.0000000000002904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/29/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The Centers for Disease Control defines work-related musculoskeletal disorders as disorders of the nerves, muscles, tendons, joints, spinal discs, and cartilage that are caused or exacerbated by the environment or nature of work. Previous meta-analyses have characterized work-related musculoskeletal disorders among interventionists, general surgeons, and other surgical subspecialties, but prevalence estimates, prognosis, and ergonomic considerations vary by study and surgical specialty. QUESTIONS/PURPOSES (1) What is the career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons? (2) What is the treatment prevalence associated with work-related musculoskeletal disorders in orthopaedic surgeons? (3) What is the disability burden of work-related musculoskeletal disorders in orthopaedic surgeons? (4) What is the scope of orthopaedic surgical ergonomic assessments and interventions? METHODS A systematic review of English-language studies from PubMed, MEDLINE, Embase, and Scopus was performed in December 2022 and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that presented prevalence estimates of work-related musculoskeletal disorders or assessed surgical ergonomics in orthopaedic surgery were included. Reviews, case reports, gray literature (conference abstracts and preprints), and studies with mixed-surgeon (nonorthopaedic) populations were excluded. The search yielded 5603 abstracts; 24 survey-based studies with 4876 orthopaedic surgeons (mean age 48 years; 79% of surgeons were men) were included for an analysis of work-related musculoskeletal disorders, and 18 articles were included for a descriptive synthesis of ergonomic assessment. Quality assessment using the Joanna Briggs Institute Tool revealed that studies had a low to moderate risk of bias, largely because of self-reporting survey-based methodology. Because of considerable heterogeneity and risk of bias, prevalence outcomes were not pooled and instead are presented as ranges (mean I 2 = 91.3%). RESULTS The career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons ranged from 37% to 97%. By anatomic location, the prevalence of work-related musculoskeletal disorders in the head and neck ranged from 4% to 74%; back ranged from 9% to 77%; forearm, wrist, and hand ranged from 12% to 54%; elbow ranged from 3% to 28%; shoulder ranged from 3% to 34%; hip and thigh ranged from 1% to 10%; knee and lower leg ranged from 1% to 31%; and foot and ankle ranged from 4% to 25%. Of orthopaedic surgeons reporting work-related musculoskeletal disorders, 9% to 33% had a leave of absence, practice restriction or modification, or early retirement, and 27% to 83% received some form of treatment. Orthopaedic surgeons experienced biomechanical, cardiovascular, neuromuscular, and metabolic stress during procedures. Interventions to improve orthopaedic surgical ergonomics have been limited, but have included robotic assistance, proper visualization aids, appropriate use of power tools, and safely minimizing lead apron use. In hip and knee arthroplasty, robotic assistance was the most effective in improving posture and reducing caloric expenditure. In spine surgery, proper use of surgical loupes was the most effective in improving posture. CONCLUSION Although the reported ranges of our main findings were wide, even on the low end of the reported ranges, work-related musculoskeletal disability among orthopaedic surgeons appears to be a substantial concern. We recommend that orthopaedic residency training programs incorporate surgical ergonomics or work injury lectures, workshops, and film review (alongside existing film review of surgical skills) into their curricula. We suggest hospitals engage in shared decision-making with surgeons through anonymous needs assessment surveys to implement wellness programs specific to surgeons' musculoskeletal needs. We urge institutions to assess surgeon ergonomics during routine quality assessment of novel surgical instruments and workflows. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Nikhil Vasireddi
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | | | - Aakash K. Shah
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew J. Moyal
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | | | | | - Kornelis A. Poelstra
- The Robotic Spine Institute of New Jersey, Jersey City, NJ, USA
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | | | - James E. Voos
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
| | - Jacob G. Calcei
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals Drusinsky Sports Medicine Institute, South Euclid, OH, USA
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Gulati A, Desai V. Return to Play in the Professional Athlete. Semin Musculoskelet Radiol 2024; 28:107-118. [PMID: 38484763 DOI: 10.1055/s-0043-1778028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries.
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Affiliation(s)
- Aishwarya Gulati
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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19
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Chaabna K, Jithesh A, Cheema J, Aboughanem J, Mamtani R. Western Medical Acupuncture Perception and Use for Pain Management Among Athletes: A Systematic Review. J Pain Res 2024; 17:357-366. [PMID: 38292755 PMCID: PMC10826524 DOI: 10.2147/jpr.s441869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose This systematic review aims to assess the use and perception of "Western" medical acupuncture-based on conventional biomedical mechanisms and evidence-based medicine for diagnosis and needle placement-for pain management among athletes and their healthcare providers. Methods A systematic review is reported based on the PRISMA guidelines. PubMed, Web of Science, SPORTDiscus, Allied and Complementary Medicine databases, and Google Scholar were searched (search: from database inception to July 2023). Two authors independently conducted multi-stage screening, data extraction, and quality assessment. The outcomes of interest were prevalence of acupuncture prescriptions by healthcare professionals, prevalence of acupuncture use by athletes, and perceptions related to acupuncture effectiveness among healthcare professionals and athletes. Only studies wherein "Western" medical acupuncture was used for pain management were included. Results Our review included 11 observational studies and clinical trials. The prevalence of "Western" medical acupuncture prescription varied from 15.4% (UK) to 58.4% (US) among sports medicine healthcare professionals. Prevalence of acupuncture use among athletes ranged from 2.2% among college athletes in Palestine to 61% among professional football players in the Netherlands. Acupuncture was used for managing delayed-onset of soreness and pain due to various types of musculoskeletal injuries. Both athletes and their healthcare providers reported positive perceptions of acupuncture. Conclusion Our systematic review identifies a notable research gap in evaluating the practice and perception of "Western" medical acupuncture among healthcare professionals and athletes. Our findings suggest that "Western" medical acupuncture is not only prescribed by sport medicine professionals and used by athletes for diverse musculoskeletal pains but is also generally perceived positively for its effectiveness. Given the positive clinical experience of health professionals, athletes' favorable perception, and acupuncture's well-established safety profile, acupuncture should be given serious consideration-as a complementary approach-in the overall management of pain. Registration Open Science Framework (https://osf.io/qb9gc).
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Affiliation(s)
- Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine – Qatar, Doha, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine – Qatar, Doha, Qatar
| | | | - Jasmine Aboughanem
- Institute for Population Health, Weill Cornell Medicine – Qatar, Doha, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine – Qatar, Doha, Qatar
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20
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Yeo EXS, Chhabra K, Kong PW. Influence of combat boot types on in-shoe forces and perceived comfort during unloaded and loaded walking. BMJ Mil Health 2024; 170:37-42. [PMID: 35296550 DOI: 10.1136/bmjmilitary-2021-002061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Combat boots are essential protective gear for military personnel. The purposes of the present study were to examine (1) the influence of combat boot type on ground reaction force (GRF) variables and perceived comfort during unloaded and loaded walking and (2) the relationship between comfort and biomechanical measurements. METHODS Four types of combat boots with different physical features (eg, mass, thickness) and mechanical properties (eg, cushioning, rigidity) were compared across 61 male participants with experience in military marching while carrying heavy loads. In each boot type, participants completed a 10-m walk under an unloaded and a 20-kg loaded conditions at their preferred speeds. Peak force and loading rate during walking were measured using the loadsol wireless in-shoe sensor system. Comfort level was assessed using a 7-point Likert scale. Difference between loaded and unloaded walking, and across boot types were statistically compared. Correlation analyses were performed between comfort and GRF variables. RESULTS On average across all boot types, participants walked 2.1% slower when carrying 20-kg loads while experiencing 24.3% higher peak force and 20.8% higher loading rate. Boot D was perceived as most comfortable, followed by boots C, B and A (χ2(2)=115.4, p<0.001). Participants walked slightly faster (p=0.022, ηp 2 = 0.052) and displayed higher loading rates (p<0.001, ηp 2=0.194) in the two more comfortable boots (C and D) than the less comfortable boots (A and B). No significant correlations were found between perceived comfort and any GRF variables. CONCLUSIONS Combat boot features can influence perceived comfort ratings substantially during walking, whereas biomechanical differences among boot types are more subtle regardless of load conditions. The lack of relationship between comfort and force variables suggests that both subjective and objective measurements should be considered for comprehensive evaluation of combat boots.
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Affiliation(s)
- Eunice X S Yeo
- Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore
| | - K Chhabra
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
| | - P W Kong
- Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore
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Shahid H, Morya VK, Oh JU, Kim JH, Noh KC. Hypoxia-Inducible Factor and Oxidative Stress in Tendon Degeneration: A Molecular Perspective. Antioxidants (Basel) 2024; 13:86. [PMID: 38247510 PMCID: PMC10812560 DOI: 10.3390/antiox13010086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Tendinopathy is a debilitating condition marked by degenerative changes in the tendons. Its complex pathophysiology involves intrinsic, extrinsic, and physiological factors. While its intrinsic and extrinsic factors have been extensively studied, the role of physiological factors, such as hypoxia and oxidative stress, remains largely unexplored. This review article delves into the contribution of hypoxia-associated genes and oxidative-stress-related factors to tendon degeneration, offering insights into potential therapeutic strategies. The unique aspect of this study lies in its pathway-based evidence, which sheds light on how these factors can be targeted to enhance overall tendon health.
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Affiliation(s)
- Hamzah Shahid
- Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si 18450, Gyeonggi-do, Republic of Korea (J.-H.K.)
- School of Medicine, Hallym University, Chuncheon City 24252, Gangwon-do, Republic of Korea
| | - Vivek Kumar Morya
- Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si 18450, Gyeonggi-do, Republic of Korea (J.-H.K.)
| | - Ji-Ung Oh
- Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si 18450, Gyeonggi-do, Republic of Korea (J.-H.K.)
| | - Jae-Hyung Kim
- Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si 18450, Gyeonggi-do, Republic of Korea (J.-H.K.)
| | - Kyu-Cheol Noh
- Dongtan Sacred Heart Hospital, Hallym University, Hwaseong-si 18450, Gyeonggi-do, Republic of Korea (J.-H.K.)
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22
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Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
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23
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Kloss EB, Niederberger BA, Givens AC, Beck MS, Bernards JR, Bennett DW, Kelly KR. Quantification of daily workload, energy expenditure, and sleep of US Marine recruits throughout a 10-week boot camp. Work 2024; 77:1285-1294. [PMID: 38489209 DOI: 10.3233/wor-230554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND During periods of high-volume vigorous exercise, United States Marine Corps recruits often experience musculoskeletal injuries. While the program of instruction (POI) for basic training is a defined training volume, the total workload of boot camp, including movements around the base, is unknown. OBJECTIVE The present study aimed to quantify the daily total workload, energy expenditure, and sleep during basic recruit training at Marine Corps Recruit Depot (MCRD) San Diego. METHODS Eighty-four male recruits from MCRD San Diego wore wrist wearable physiological monitors to capture their complete workload (mileage from steps), energy expenditure, and sleep throughout the 10-week boot camp. RESULTS Marine recruits traveled an average of 11.5±3.4 miles per day (M±SD), expended 4105±823 kcal per day, and slept an average of 5 : 48±1 : 06 hours and minutes per night. While the POI designates a total of 46.3 miles of running and hiking, the actual daily average miles yielded approximately 657.6±107.2 miles over the 10-week boot camp. CONCLUSION Recruit training requires high physical demand and time under tension due to the cumulative volume of movements around base in addition to the POI planned physical training.
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Affiliation(s)
- Emily B Kloss
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Brenda A Niederberger
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Andrea C Givens
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Meghan S Beck
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Jake R Bernards
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Daniel W Bennett
- pplied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
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24
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Muñoz-Castellanos B, Martínez-López P, Bailón-Moreno R, Esquius L. Effect of Ginseng Intake on Muscle Damage Induced by Exercise in Healthy Adults. Nutrients 2023; 16:90. [PMID: 38201920 PMCID: PMC10780807 DOI: 10.3390/nu16010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
One of the most popular herbal supplements in the world is ginseng. Several studies have evaluated the capacity of ginseng as a protective element in the physiological response to exercise. The result produced by the exercise causes an increase in cellular biomarkers of damage in the skeletal muscle, mainly in the pro-inflammatory types. The different types of ginseng are composed of ginsenosides, which are active ingredients that act on the central nervous system and have antioxidant and anti-inflammatory properties, as well as effects on cortisol modulation. The use of ginseng as a nutritional supplement can help muscle regeneration and renewal. The objective of this review is to enrich the knowledge regarding the consumption of ginseng for a specific situation, such as exercise, which would cause an improvement in the tolerance to chronic load stimuli in sport, thus helping the subjects to recover between training sessions. Due to these benefits, it could also be an ideal food supplement for regenerative processes in muscle injuries in which inflammatory markers increase significantly. This review aims to summarise that biological factors can be attenuated after exercise due to the consumption of ginseng in healthy subjects, accelerating and improving muscle regeneration and, therefore, improving the ability to adapt to the stimuli generated by said exercise.
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Affiliation(s)
- Borja Muñoz-Castellanos
- Faculty of Health Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain; (B.M.-C.); (L.E.)
| | - Patricia Martínez-López
- “Techné” Knowledge and Product Engineering Research Group, Faculty of Science, Universidad de Granada, 18071 Granada, Spain;
| | - Rafael Bailón-Moreno
- “Techné” Knowledge and Product Engineering Research Group, Faculty of Science, Universidad de Granada, 18071 Granada, Spain;
| | - Laura Esquius
- Faculty of Health Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain; (B.M.-C.); (L.E.)
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25
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Davis J, Doyle B, Ishii H, Jayanthi N. S.P.O.R.R.T.-A Comprehensive Approach to the Assessment and Non-Operative Management of Overuse Knee Conditions in Youth Athletes. Curr Rev Musculoskelet Med 2023; 16:627-638. [PMID: 37999828 PMCID: PMC10733244 DOI: 10.1007/s12178-023-09874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW The evaluation of a young athlete with an overuse injury to the knee involves a comprehensive approach. There are a number of elements to consider including assessments of skeletal maturity (biologic maturation), workload (training load + competition load), sport specialization status, and biomechanics. The type of injury and treatment, as well as future prognosis, may be influenced by these and other factors. RECENT FINDINGS Calculating the percentage of predicted adult height (PPAH) is a valuable tool in assessing overuse injury patterns and diagnoses in youth athletes. Modifiable and non-modifiable overuse injury risk factors require monitoring from clinicians as young athletes mature and develop over time. Training and rehabilitation programs should be adapted to account for these. In this manuscript, we seek to introduce a novel, comprehensive approach: S.P.O.R.R.T. (Skeletal Maturity, Prior Injury Risk, One Sport Specialization, Rehabilitation, Return to Play, Training Recommendations) (Fig. 1). Overuse, non-traumatic injuries to the knee in youth athletes will be presented in a case-based and evidence-based model to provide a framework for a comprehensive approach to the assessment and treatment of youth athletes with overuse injuries.
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Affiliation(s)
- Jacob Davis
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
- Georgia Institute of Technology, Sports Medicine, Atlanta, GA, USA
| | - Bridget Doyle
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Haruki Ishii
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Neeru Jayanthi
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA.
- Emory Sports Performance & Research Center (SPARC), 4450 Falcon Pkwy, Flowery Branch, GA, USA.
- Emory University School of Medicine, Department of Orthopedics and Family Medicine, Atlanta, GA, USA.
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26
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Iaconisi GN, Gallo N, Caforio L, Ricci V, Fiermonte G, Della Tommasa S, Bernetti A, Dolce V, Farì G, Capobianco L. Clinical and Biochemical Implications of Hyaluronic Acid in Musculoskeletal Rehabilitation: A Comprehensive Review. J Pers Med 2023; 13:1647. [PMID: 38138874 PMCID: PMC10744407 DOI: 10.3390/jpm13121647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Hyaluronic acid (HA) naturally occurs as a biopolymer in the human body, primarily in connective tissues like joints and skin. Functioning as a vital element of synovial fluid, it lubricates joints, facilitating fluid movement and diminishing bone friction to protect articular well-being. Its distinctive attributes encompass notable viscosity and water retention capacities, ensuring flexibility and absorbing shock during motion. Furthermore, HA has gained significant attention for its potential benefits in various medical applications, including rehabilitation. Ongoing research explores its properties and functions, especially its biomedical applications in several clinical trials, with a focus on its role in improving rehabilitation outcomes. But the clinical and biochemical implications of HA in musculoskeletal rehabilitation have yet to be fully explored. This review thoroughly investigates the properties and functions of HA while highlighting its biomedical applications in different clinical trials, with a special emphasis on its role in rehabilitation. The presented findings provide evidence that HA, as a natural substance, enhances the outcomes of musculoskeletal rehabilitation through its exceptional mechanical and biochemical effects.
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Affiliation(s)
- Giorgia Natalia Iaconisi
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy; (G.N.I.); (A.B.)
| | - Nunzia Gallo
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy;
| | - Laura Caforio
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University, 70121 Bari, Italy;
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy;
| | - Giuseppe Fiermonte
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, 70125 Bari, Italy;
| | - Simone Della Tommasa
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University, 04109 Leipzig, Germany;
| | - Andrea Bernetti
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy; (G.N.I.); (A.B.)
| | - Vincenza Dolce
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy;
| | - Giacomo Farì
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy
| | - Loredana Capobianco
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy; (G.N.I.); (A.B.)
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27
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Musat CL, Niculet E, Craescu M, Nechita L, Iancu L, Nechita A, Voinescu DC, Bobeica C. Pathogenesis of Musculotendinous and Fascial Injuries After Physical Exercise - Short Review. Int J Gen Med 2023; 16:5247-5254. [PMID: 38021047 PMCID: PMC10655743 DOI: 10.2147/ijgm.s432749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The identification of sports and physical exercises with injury risk is necessary to preserve the capacity of athletes and people who perform physical education and also to prevent the installation of functional deficiencies. Methods We have selected the articles related to the pathogenic mechanisms involved in musculotendinous and fascial injuries produced as a result of physical exercise. Results and Discussions The lesional pathogenesis is complex and incompletely clarified. Recent theories put in a new light the mechanisms of muscle pain and tendinopathy production. The accumulation of lactate anion, known to be a residue that induces fatigue and muscle pain, has been reconsidered by some authors. It appears that lactate anion is an excellent fuel for the myocardial fiber. Moreover, the accumulation of lactic acid after intense physical exercise could prevent the inexcitability of the sarcolemma induced by the increased concentration of interstitial K+. Most of the time, overuse injuries are not limited to muscles. They can cause myofascial, myotendinous or purely muscular injuries. The muscular fascia is more susceptible to injuries produced under the action of large external forces. Also, fascia is more sensitive to pain compared to muscle when external forces act eccentrically. Overloading the tendon and putting it under tension repeatedly is followed by ruptures of the tendon fibers. The regeneration of the degenerated tendon is defective in the context of the inflammation produced by the injury. Tendon fibers undergo a process of fibrosis, scarring, adhesion and heterogeneous calcification. Oxidative stress is responsible for inflammation, degeneration and apoptosis of tenocytes. Conclusion The benefits brought by physical education and sports are indisputable, but their practice requires a coordinated program to prevent possible traumatic and overuse injuries.
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Affiliation(s)
- Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Lina Iancu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Doina-Carina Voinescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
| | - Carmen Bobeica
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, 800008, Romania
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28
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Kerr JR, White PR, Leighton TG, Silva LGM, Kemp PS. Boyle's Law ignores dynamic processes in governing barotrauma in fish. Sci Rep 2023; 13:19125. [PMID: 37926724 PMCID: PMC10625976 DOI: 10.1038/s41598-023-46125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/27/2023] [Indexed: 11/07/2023] Open
Abstract
The expansion and potential rupture of the swim bladder due to rapid decompression, a major cause of barotrauma injury in fish that pass through turbines and pumps, is generally assumed to be governed by Boyle's Law. In this study, two swim bladder expansion models are presented and tested in silico. One based on the quasi-static Boyle's Law, and a Modified Rayleigh Plesset Model (MRPM), which includes both inertial and pressure functions and was parametrised to be representative of a fish swim bladder. The two models were tested using a range of: (1) simulated and (2) empirically derived pressure profiles. Our results highlight a range of conditions where the Boyle's Law model (BLM) is inappropriate for predicting swim bladder size in response to pressure change and that these conditions occur in situ, indicating that this is an applied and not just theoretical issue. Specifically, these conditions include any one, or any combination, of the following factors: (1) when rate of pressure change is anything but very slow compared to the resonant frequency of the swim bladder; (2) when the nadir pressure is near or at absolute zero; and (3) when a fish experiences liquid tensions (i.e. negative absolute pressures). Under each of these conditions, the MRPM is more appropriate tool for predicting swim bladder size in response to pressure change and hence it is a better model for quantifying barotrauma in fish.
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Affiliation(s)
- J R Kerr
- International Centre for Ecohydraulics Research, Faculty of Engineering and Physical Sciences, University of Southampton, Boldrewood Campus, Southampton, SO16 7QF, UK.
| | - P R White
- Institute of Sound and Vibration Research, University of Southampton, Southampton, SO17 1BJ, UK
| | - T G Leighton
- Institute of Sound and Vibration Research, University of Southampton, Southampton, SO17 1BJ, UK
| | - L G M Silva
- Stocker Lab, Institute for Environmental Engineering, Department of Civil, Environmental and Geomatic Engineering, ETH-Zurich, 8046, Zurich, Switzerland
| | - P S Kemp
- International Centre for Ecohydraulics Research, Faculty of Engineering and Physical Sciences, University of Southampton, Boldrewood Campus, Southampton, SO16 7QF, UK.
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29
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Okuno Y. Transarterial Embolization for Refractory Overuse Sports Injury: Pictorial Case Reports. Cardiovasc Intervent Radiol 2023; 46:1525-1537. [PMID: 37433909 DOI: 10.1007/s00270-023-03496-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/18/2023] [Indexed: 07/13/2023]
Abstract
Transarterial embolization for the treatment of chronic musculoskeletal diseases is gaining increasing interest in the field of interventional radiology. Overuse sports injury is defined as an injury occurring in the absence of a single, identifiable traumatic cause. In the treatment of this condition, there is a need for reliable results and a quick return to activity. Minimally invasive treatments with short periods of missed practice are required. Intra-arterial embolization has the potential to meet this need. In this article, we describe cases of embolization for refractory overuse sports injuries including patellar tendinopathy, pes anserine, plantar fasciitis, triangular fibrocartilage complex injury, hamstring injury, infrapatellar fat pad inflammation, Achilles tendinopathy, delayed union metatarsal bone fracture, lumbar spondylolysis, and repetitive hamstrings strain.
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Affiliation(s)
- Yuji Okuno
- Musculoskeletal Intervention Center, Okuno Clinic, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan.
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30
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Yan Y, Lu H, Zhang J, Yu X, Liu Y, Chen G, Xu H, Xu R. Talar coverage of the tibia plays a role in anterior ankle impingement: a retrospective cohort study. INTERNATIONAL ORTHOPAEDICS 2023; 47:2693-2698. [PMID: 37479892 DOI: 10.1007/s00264-023-05898-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Ankle impingement is generally characterised by limited range of motion and pain due to pathological contact between structures. Anterior ankle impingement is usually diagnosed by clinical examination and radiographic evidence of tibiotalar osteophytes. In addition to osteophytes, radiographs may show a correlation between the tibia and talus, which may further aid in the diagnosis of anterior ankle impingement. The purpose of this study is to investigate the relationship between the tibia and talus in anterior ankle impingement. METHODS In this retrospective cohort study, the tibial coverage of 22 patients with anterior ankle impingement was compared with that of 67 healthy subjects. RESULTS The percentage of tibial coverage was 0.674 ± 0.043 in the anterior ankle impingement group and 0.580 ± 0.032 in the control group. The difference between groups was statistically significant (P < 0.05). CONCLUSIONS In addition to existing criteria, the percentage of tibial coverage may provide valuable information for the diagnosis of anterior ankle impingement.
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Affiliation(s)
- Yongqing Yan
- Department of Orthopedics, HwaMei Hospital, University of Chinese Academy of Science, Province, Ningbo City Zhejiang, 315010, China
| | - Hao Lu
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
| | - Jingyu Zhang
- Department of Orthopaedics, Suzhou Municipal Hospital, The Affiliated Hospital of Nanjing Medical University, No. 26, Daoqian Street, Suzhou, Jiangsu Province, 215002, China
| | - Xiao Yu
- Department of Orthopaedics, Suzhou Municipal Hospital, The Affiliated Hospital of Nanjing Medical University, No. 26, Daoqian Street, Suzhou, Jiangsu Province, 215002, China
| | - Yubo Liu
- Department of Orthopaedics, Suzhou Municipal Hospital, The Affiliated Hospital of Nanjing Medical University, No. 26, Daoqian Street, Suzhou, Jiangsu Province, 215002, China
| | - Guangxiang Chen
- Department of Orthopaedics, Suzhou Municipal Hospital, The Affiliated Hospital of Nanjing Medical University, No. 26, Daoqian Street, Suzhou, Jiangsu Province, 215002, China
| | - Hailin Xu
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, 100044, China
| | - Renjie Xu
- Department of Orthopaedics, Suzhou Municipal Hospital, The Affiliated Hospital of Nanjing Medical University, No. 26, Daoqian Street, Suzhou, Jiangsu Province, 215002, China.
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31
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Arévalo Hernández A, Mittlmeier T, Weber MA. [Contemporary imaging examinations for (suspected) stress fractures]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:831-838. [PMID: 37650915 DOI: 10.1007/s00113-023-01358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/01/2023]
Abstract
Stress fractures belong to the group of atraumatic fractures. A low-impact and repetitive load is the underlying cause and no fracture would occur under physiological circumstances. The conventional X‑ray examination remains the initial imaging modality when a stress fracture is suspected. In contrast, magnetic resonance imaging (MRI) is the gold standard and is also used to rule out other pathological changes. Computed tomography (CT) should be included if the MRI findings are unclear. New techniques, such as dual energy computed tomography (DECT) and magnetic resonance bone imaging (MR bone) should be used more frequently in practice in the future and become increasingly more important for the correct diagnosis.
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Affiliation(s)
- Andrés Arévalo Hernández
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
| | - Thomas Mittlmeier
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Marc-André Weber
- Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland
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32
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Konda M, Mangal R, Daniel A, Stead TS, Ganti L. Archery-Related Musculoskeletal Injuries: An Epidemiological Study Revealing Injury Sites, Risk Factors, and Implications for Prevention. Orthop Rev (Pavia) 2023; 15:88933. [PMID: 37915553 PMCID: PMC10617664 DOI: 10.52965/001c.88933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Objective While generally considered a safe sport, archery injuries are often the result of overuse or penetration and largely affect the upper extremities. Studies have shown that during training periods the average risk of injury is 4.4%. By studying mechanisms of injury and their prevalence nationally, this study aims to educate coaches, athletes, and equipment manufacturers on ways the sport can be safer from a clinical perspective. Methods and Materials The National Electronic Injury Surveillance System Database was queried to analyze archery-related musculoskeletal injuries that occurred between 2013 and 2022. Results Approximately 43,083 injuries were recorded over a 10-year span, of which 8,038 were women and 35,367 were men. Men were thus 4.4 times more likely to experience injury during archery. Injury sites in men included the finger (66.2%), hand (17.1%), face (6.2%), shoulder (5.4%), and foot (5.1%). All reported injuries in women were finger-related. The most common diagnoses for men were lacerations (58.1%), fractures (12.7%), contusions and abrasions (7.5%), foreign body (5.9%), punctures (4.9%), and strains/sprains (4.9%). Women exclusively experienced lacerations, accounting for 100% of their injuries. Conclusion The study identifies that lacerations were the most common archery-related injury that was treated in the ED. Additionally, the fingers were the most common site of injury. Findings from this study suggest that improved safety equipment, such as reinforced gloves, finger tabs, and forearm braces should be used by athletes to practice the sport more safely. Future research could involve studying injury rates in archers who use each combination of these safety precautions to investigate which gear is most protective.
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Affiliation(s)
- Meghana Konda
- Miller School of Medicine University of Miami
- Emory University
- The Warren Alpert Medical School of Brown University
| | | | | | - Thor S Stead
- The Warren Alpert Medical School of Brown University
| | - Latha Ganti
- The Warren Alpert Medical School of Brown University
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Wang H, Wu Y, Liu J, Zhu X. Investigation of the Mechanical Response of the Foot Structure Considering Push-Off Angles in Speed Skating. Bioengineering (Basel) 2023; 10:1218. [PMID: 37892948 PMCID: PMC10604206 DOI: 10.3390/bioengineering10101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
The push-off angle is an important factor affecting speed-skating performance. However, quantitative evidence for the relationship between the push-off angle and foot injury is incomplete. This study aimed to establish a three-dimensional (3D) finite element model (FEM) and investigate the mechanical responses of foot structures to stress and strain to explore the relationship between injury and movement. A 3D FEM was reconstructed using CT and 3D scan data and validated by comparing the FEM-predicted and in vivo measurement data in the balanced standing state. A push-off angle obtained from a video of a champion was loaded into the FEM. The error rates of validation were less than 10%. With a decrease in the push-off angle, the stress on the metatarsal increased; the stress on the talus, ankle joint cartilage and plantar fascia decreased, as did the strain on the ankle joint cartilage and plantar fascia. The FEM was considered reasonable. Not all foot structures had an increased risk of injury with a decrease in the push-off angle from 70° to 42°. The FEM established in this study provides a possibility for further determining and quantifying the relationship between foot injury and skating technique.
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Affiliation(s)
- Haichun Wang
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Yusen Wu
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Jingxi Liu
- School of Naval Architecture and Ocean Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaolan Zhu
- Sport Science School, Beijing Sport University, Beijing 100084, China
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Tarantino D, Mottola R, Resta G, Gnasso R, Palermi S, Corrado B, Sirico F, Ruosi C, Aicale R. Achilles Tendinopathy Pathogenesis and Management: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6681. [PMID: 37681821 PMCID: PMC10487940 DOI: 10.3390/ijerph20176681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/09/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
The Achilles tendon is the thickest and strongest tendon of the human body, and it is frequently injured during sports activity. The incidence of Achilles tendon pathologies has increased over recent decades, especially in the last few years, because of increased sports participation among the general population and due to the diffusion of competitive sports at a high level. Tendinopathies are common in athletes and in middle-aged overweight patients. The term "tendinopathy" refers to a condition characterised clinically by pain and swelling, with functional limitations of tendon and nearby structures, and consequently to chronic failure of healing response process. Tendinopathies can produce marked morbidity, and at present, scientifically validated management modalities are limited. Despite the constantly increasing interest and number of studies about Achilles tendinopathy (AT), there is still not a consensual point of view on which is the best treatment, and its management is still controversial. AT can be treated conservatively primarily, with acceptable results and clinical outcomes. When this approach fails, surgery should be considered. Several surgical procedures have been described for both conditions with a relatively high rate of success with few complications and the decision for treatment in patients with AT should be tailored on patient's needs and level of activity. The aim of this article is to give insights about the pathogenesis and most used and recent treatment options for AT.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Rosita Mottola
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Giuseppina Resta
- Department of Orthopaedic and Trauma Surgery, Casa di Cura di Bernardini, 74121 Taranto, Italy;
| | - Rossana Gnasso
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Stefano Palermi
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Bruno Corrado
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Felice Sirico
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Carlo Ruosi
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (R.M.); (R.G.); (S.P.); (B.C.); (F.S.); (C.R.)
| | - Rocco Aicale
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy;
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Physical Parameters and Training Load on Patellar Tendon Stiffness in Professional Athletes. Diagnostics (Basel) 2023; 13:2541. [PMID: 37568903 PMCID: PMC10417388 DOI: 10.3390/diagnostics13152541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Injuries of the patellar tendon commonly occur as a result of mechanical loading of the tendon during physical activity. Shear wave elastography (SWE) is an established technique for assessing tendon stiffness, and has good interindividual reliability. The aim of this study was to investigate the impacts of physical parameters and different sports on patellar tendon stiffness in professional athletes using SWE. METHODS Standardized patellar tendon SWE was performed in a relaxed supine position with a small roll under the knee (20° flexion) in 60 healthy professional athletes (30 female, 30 male). Multiple linear regression was performed for patellar tendon stiffness including gender, age, body mass index (BMI), and type of sport. RESULTS Patellar tendon stiffness showed no significant difference between female (3.320 m/s) and male (3.416 m/s) professional athletes. Mean age (female: 20.53 years; male: 19.80 years) and BMI (female: 23.24 kg/m2; male: 23.52 kg/m2) were comparable. Female professional athletes with oral contraceptive (OC) intake showed higher patellar tendon stiffness than athletes without OC intake (3.723 versus 3.017; p = 0.053), but not significantly. CONCLUSION In professional athletes, there are no significant differences in patellar tendon stiffness according to gender, age, BMI and type of sport (handball, volleyball, soccer, sprint, hammer throw). Oral contraceptives may not have an impact on patellar tendon stiffness in female athletes. Further studies are necessary.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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Salman Hamza A, Traef Ali Q, Hadi Farman R. The Healing Effect of Biodegradable Scaffolds Treated with Bone-Marrow Obtained Mesenchymal Stem Cells on Major Tendon Damage in the Dog as a Model. ARCHIVES OF RAZI INSTITUTE 2023; 78:889-898. [PMID: 38028849 PMCID: PMC10657948 DOI: 10.22092/ari.2022.359751.2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/10/2022] [Indexed: 12/01/2023]
Abstract
The present study aimed to evaluate the implantation of decellularized small intestinal submucosa- extracellular matrix )SIS-ECM( seeded with bone marrow mesenchymal stem cells (BM-MSCs) to repair full-thickness Achilles tendon defect. For this purpose, 20 healthy adult stray dogs aged 8-12 months old (15±3 kg of weight) were enrolled in this study under an aseptic environment and general anesthesia. A 1.5 cm-long segment-based resection was performed in the mid-substance of the Achilles tendon in the control group (n=10) that did not receive treatment. While, in the experimental group (n=10), regarding the defect of the tendon, the stumps were bridged with decellularized SIS seeded with BM-MSCs (5×106) cells implanted. Afterward, the stumps of the tendon were sutured using the modified Kessler technique (4-0) polypropylene thread. The biomechanical observations of the tendon defect showed an increase in the tensile strength in the experimental group, compared to the control animals. It should be mentioned that this difference was significant (P≤0.05). Histopathological observations of biopsies harvested after the 4th, 8th, and 12th weeks revealed that the implanted graft had seeded with MSCs enhanced high-quality cellular infiltration and the host tissue healing was improved. Similar to the normal tendon, a dense organized collagenous tissue with high cellularity and vascularity was observed due to the presence of the remodeled ECM. However, the arrangement of collagen-fiber-derived connective tissue appeared to be more dominant than that in the experimental group, with less adhesion in the 12th week post-treatment. These findings suggest that the BM-MSCs inoculated with SIS can be employed to repair a damaged Achilles tendon due to the fact that this combination enhances the regeneration of the affected tendon.
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Affiliation(s)
- A Salman Hamza
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
| | - Q Traef Ali
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
| | - R Hadi Farman
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq
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Aletto C, Aicale R, Oliva F, Maffulli N. Hand Flexor Tendon Repair: From Biology to Surgery and Rehabilitation. Hand Clin 2023; 39:215-225. [PMID: 37080653 DOI: 10.1016/j.hcl.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Tendon biology and anatomy are crucial to manage hand flexor tendon injuries, not only for surgical treatment but also for rehabilitation; surgeon and physical therapist have to choose zone by zone the best way to manage and restore the normal function of hand flexor tendons.
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Affiliation(s)
- Cristian Aletto
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy.
| | - Rocco Aicale
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy
| | - Francesco Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi 84084, Italy; Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno 84131, Italy; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England; Keele University, Faculty of Medicine, School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Thornburrow Drive, Hartshill, Stoke-on-Trent ST4 7QB, UK
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38
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Hackenbroch C, Kreitner KF. [Stress reactions and stress fractures]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:259-267. [PMID: 36882548 DOI: 10.1007/s00117-023-01129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Bone stress injuries is an umbrella term that encompasses repetitive microtraumatic events that accumulate to surpass the threshold of bone failure, which can range from bone marrow edema to frank stress fracture as the end point. Due to nonspecific clinical complaints and physical findings, imaging plays a central role in the diagnostic workup of these entities. Magnetic resonance imaging (MRI) is the most important imaging modality with a high sensitivity and specificity and allows for differential diagnosis of other diseases. Edema-sensitive with fat suppression and T1-weighted sequences are the core sequence types, and contrast-enhanced imaging-albeit displaying subtle fractures much more easily-is rarely necessary. Furthermore, MRI enables differentiation of injury severity, which has an impact on length of rehabilitation, therapeutic regimen, and the time to return to sports in athletes.
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Affiliation(s)
- Carsten Hackenbroch
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Karl-Friedrich Kreitner
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie der Universitätsmedizin Mainz, Johannes Gutenberg-Universität, Langenbeckstraße 1, 55131, Mainz, Deutschland.
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Bruni DF, Pierson SR, Sarwar F, Ring D, Ramtin S. Are the Pathologic Features of Enthesopathy, Tendinopathy, and Labral and Articular Disc Disease Related to Mucoid Degeneration? A Systematic Review. Clin Orthop Relat Res 2023; 481:641-650. [PMID: 36563131 PMCID: PMC10013668 DOI: 10.1097/corr.0000000000002499] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/31/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Tendinopathy, enthesopathy, labral degeneration, and pathologic conditions of the articular disc (knee meniscus and ulnocarpal) are sometimes described in terms of inflammation or damage, while the histopathologic findings are often consistent with mucoid degeneration. A systematic review of the histopathology of these structures at diverse locations might reconceptualize these diseases as expected aspects of human aging. The potential benefits of this evolution might include healthier patient and clinician mindsets as well as a reduced likelihood of overdiagnosis and overtreatment resulting from greater awareness of base rates of pathology. QUESTION/PURPOSE In this systematic review of studies of surgical specimens, we asked: Are there are any differences in the histopathologic findings of structural soft tissue conditions (mucoid degeneration, inflammation, and vascularity) by anatomic site (foot, elbow, or knee) or structure (tendon body, muscle or tendon origin or insertion [enthesis], labrum, or articular disc)? METHODS Studies between 1980 and 2021 investigating the histopathologic findings of specimens from surgery for trigger digit, de Quervain tendinopathy, plantar fasciitis, lateral and medial elbow enthesopathy, rotator cuff tendinopathy, posterior tibial tendinopathy, patellar tendinopathy, Achilles tendinopathy, or disease of the hip labrum, ulnocarpal articular disc, or knee meniscus were searched for in the PubMed, EMBASE, and CINAHL databases. Inclusion criteria were the prespecified anatomic location or structure being analyzed histologically and any findings described with respect to inflammation, vascularity, or mucoid degeneration. Studies were excluded if they were nonhuman studies or review articles. Search terms included "anatomy," "pathology," and "histopathology." These terms were coupled with anatomic structures or disorders and included "trigger finger," "de Quervain," "fasciitis, plantar," "tennis elbow," "rotator cuff tendinopathy," "elbow tendinopathy," "patellar tendonitis," "posterior tibial tendon," and "triangular fibrocartilage." This resulted in 3196 studies. After applying the inclusion criteria, 559 articles were then assessed for eligibility according to our exclusion criteria, with 52 eventually included. We recorded whether the study identified the following histopathologic findings: inflammatory cells or molecular markers, greater than expected vascularity (categorized as quantitative count, with or without controls; molecular markers; or qualitative judgments), and features of mucoid degeneration (disorganized collagen, increased extracellular matrix, or chondroid metaplasia). In the absence of methods for systematically evaluating the pathophysiology of structural (collagenous) soft tissue structures and rating histopathologic study quality, all studies that interpreted histopathology results were included. The original authors' judgment regarding the presence or absence of inflammation, greater than expected vascularity, and elements of mucoid degeneration was recorded along with the type of data used to reach that conclusion. RESULTS Regarding differences in the histopathology of surgical specimens of structural soft tissue conditions by anatomic site, there were no differences in inflammation or mucoid degeneration, and the knee meniscus was less often described as having greater than normal vascularity. There were no differences by anatomic structure. Overall, 20% (10 of 51) of the studies that investigated for inflammation reported it (nine inflammatory cells and one inflammatory marker). Eighty-three percent (43 of 52) interpreted increased vascularity: 40% (17 of 43) using quantitative methods (14 with controls and three without) and 60% (26 of 43) using imprecise criteria. Additionally, 100% (all 52 studies) identified at least one element of mucoid degeneration: 69% (36 of 52) reported an increased extracellular matrix, 71% (37 of 52) reported disorganized collagen, and 33% (17 of 52) reported chondroid metaplasia. CONCLUSION Our systematic review of the histopathology of diseases of soft tissue structures (enthesopathy, tendinopathy, and labral and articular disc) identified consistent mucoid degeneration, minimal inflammation, and imprecise assessment of relative vascularity; these findings were consistent across anatomic sites and structures, supporting a reconceptualization of these diseases as related to aging (senescence or degeneration) rather than injury or activity. CLINICAL RELEVANCE This reconceptualization supports accommodative mindsets known to be associated with greater comfort and capability. In addition, awareness of the notable base rates of structural soft tissue changes as people age might reduce overdiagnosis and overtreatment of incidental, benign, or inconsequential signal changes and pathophysiology.
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Affiliation(s)
- David F. Bruni
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - S. Ryan Pierson
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Faiza Sarwar
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Sina Ramtin
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
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Machado EDM, Secchi LLB, Camargo PR, Mendonça LDM. Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes. GLOBAL HEALTH JOURNAL 2023; 7:49-54. [PMID: 36643776 PMCID: PMC9831665 DOI: 10.1016/j.glohj.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/25/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background Social distancing may affect athletes' training, causing negative effects on mental and physical health. Objective This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies. Results A total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period. Conclusion The quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.
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Affiliation(s)
- Eliane de Morais Machado
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP CEP 13565-905, Brazil
| | | | - Paula Rezende Camargo
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP CEP 13565-905, Brazil
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP CEP 13565-905, Brazil
- Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG CEP 31270-901, Brazil
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Beekman KM, Kuijer PPFM, Maas M. Imaging of Overuse Injuries of the Ankle and Foot in Sport and Work. Radiol Clin North Am 2023; 61:307-318. [PMID: 36739147 DOI: 10.1016/j.rcl.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Overuse injuries of the ankle and foot are common injuries both in sport and in a work-related context. After clinical assessment, imaging is key for early diagnosis. In this overview article, we focus on imaging techniques, protocols, and imaging findings of overuse injuries of the ankle and foot; we emphasize the important role of structured reporting; and we discuss clinical symptoms, epidemiology, and risk factors in sports and in a work-related context.
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Affiliation(s)
- Kerensa M Beekman
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Howarth N, White AJ, Batten J, Pearce AJ, Miller MA. An exploratory study into the relationship between playing at home or away and concussion. Brain Inj 2023; 37:478-484. [PMID: 36843269 DOI: 10.1080/02699052.2023.2181400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
PRIMARY OBJECTIVE To investigate the effect of home and away game travel on risk of concussion across different levels of rugby union. RESEARCH DESIGN Exploration study across school, university, and professional rugby teams. METHODS AND PROCEDURES Retrospective analysis of concussion incidence and symptomology of surveillance data and prospective data collection for potential concussions via surveys. Data was collected from school rugby teams (n = 344 matches, over 2 years), a university rugby (n = 6 matches), and a professional rugby team (n = 64 matches, over two seasons). MAIN OUTCOMES AND RESULTS School level rugby had an increased prevalence of concussions in away matches (p = 0.02). Likewise, there was a significant increase (p < 0.05) in concussions at away matches in university rugby. In addition, the professional rug by team had significant differences in recovery times and symptoms with away fixtures, including longer recovery times (p < 0.01), more initial symptoms (p < 0.01), as well as greater and more severe symptoms at 48 hours (p < 0.05). CONCLUSIONS This research highlights an increased prevalence of concussion in school and university-aged rugby players away from home, as well as increased symptoms, symptom severity, and recovery times in professional rugby players.
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Affiliation(s)
- Nathan Howarth
- Faculty of Health and Life Science, Oxford Brookes University, Oxford, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, UK
| | - Adam J White
- Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, UK
| | - John Batten
- Faculty of Health and Life Science, Oxford Brookes University, Oxford, UK.,School of Sport, Health and Community, University of Winchester, Winchester, UK
| | - Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Bundoora, Australia
| | - Michelle A Miller
- Faculty of Health and Life Science, Oxford Brookes University, Oxford, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, UK
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Swart J, Varekamp C, Greyling J. The pattern of non-contact injuries in a South African professional football team. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2023; 34:v34i1a13723. [PMID: 36815920 PMCID: PMC9924560 DOI: 10.17159/2078-516x/2022/v34i1a13723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background The incidence, pattern and severity of non-contact injuries in European football has been researched extensively. In South African football only two studies have been conducted to date and with disparate outcomes. Further research into injury rates in South African football is therefore warranted. Objectives To determine the incidence and pattern of non-contact injuries in a South African professional football team during the course of a single season (2016-2017) in relation to competition exposure, training load and playing position. Methods Thirty-four male professional football players belonging to a single team competing in the Premier Soccer League (PSL) in South Africa were studied. Non-contact time-loss injuries (total training and match injuries) were recorded. Injury incidence, location, severity, type, and playing position (defender, midfielder, attackers, goalkeepers) during either match play or training were recorded. Results The non-contact incidence was 52 injuries with an injury rate of 3.74 per 1 000 exposures (training and competition). Competitions resulted in an incidence of 26.4 injuries per 1 000 exposure and training incidence 2.08 injuries per 1 000 exposures. Hamstring, groin and quadriceps injuries were the most frequently injured locations and muscle-tendon injuries accounted for the majority of injuries. The majority of injuries (52%) occurred during match play while 48% occurred during training. The greatest absolute number of injuries were sustained by midfielders (50%), followed by defenders (33%) and attackers (17%). However, relative to player numbers, the greatest number of injuries during match play were for defenders (44%), attackers (32%) and midfielders (24%). During training attackers sustained the most injuries (39%), followed by defenders (31%) and midfielders (30%). Goalkeepers did not sustain any non-contact injuries during the duration of the study. Conclusion The non-contact injury incidence in South African professional football players is similar to European football players. Hamstrings and groin injuries are predominant and were sustained throughout the competitive season. Defenders sustained the most non-contact injuries within the team relative to exposure time compared to attackers and midfielders. To our knowledge, injuries relative to player position have not been reported previously.
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Affiliation(s)
- J Swart
- HPALS Research Centre, Faculty of Health Sciences, University of Cape Town,
South Africa
| | - C Varekamp
- HPALS Research Centre, Faculty of Health Sciences, University of Cape Town,
South Africa
| | - J Greyling
- Point Physiotherapy, Cape Town,
South Africa
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Kara E, Sağıroğlu İ, Vurgun H, Eken Ö, Ceylan Hİ, Gabrys T, Barasinska M, Szmatlan-Gabrys U, Valach P. The Risk Factors Associated with Grip Lock Injuries in Artistic Gymnasts: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3589. [PMID: 36834283 PMCID: PMC9965130 DOI: 10.3390/ijerph20043589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Artistic gymnastics (AG) is a sport that demands grace, strength, and flexibility, leading to a broad spectrum of injuries. The dowel grip (DG) is widely used by gymnasts to securely hold onto the high bar or uneven bars. However, incorrect usage of the DG can result in grip lock (GL) injuries. This systematic review aims to (1) identify studies that have investigated the risk factors related to GL injuries among gymnasts and (2) synthesize the key evidence. A comprehensive electronic search was conducted in the following databases: PubMed, ScienceDirect, Elsevier, SportDiscus, and Google Scholar, covering the period from their inception until November 2022. The data extraction and analysis were independently completed by two investigators. A total of 90 relevant studies were initially identified, out of which seven clinical trials met the eligibility criteria. For the quantitative synthesis, five studies were included. The details extracted from each article include: the sample characteristics (number, gender, age, and health status), the study design, the instrumentation or intervention used, and the final results. Our results revealed that the underlying causes of the risk factors of GL injuries were the irregular checking of the dowel grip and the mating surface of the bar, the tearing of the dowel of the leather strap, and the use of the dowel grip in different competition apparatuses. In addition, GL injuries may occur either as severe forearm fractures or mild injuries. Excessive flexion of the forearm and overpronation of the wrist during rotational movements, such as the swing or backward/forward giant circle, may increase the possibility of GL injury on the high bar. Future studies should focus on GL injury prevention strategy and rehabilitation protocol for GL injuries. Further high-quality research is required to establish the validity of these findings.
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Affiliation(s)
- Erhan Kara
- Coaching Education Department, Faculty of Sport Sciences, Tekirdag Namik Kemal University, Tekirdağ 59000, Turkey
| | - İsa Sağıroğlu
- Kirkpinar Faculty of Sport Sciences, Trakya University, Edirne 22030, Turkey
| | - Hikmet Vurgun
- Coaching Education Department, Faculty of Sport Sciences, Manisa Celal Bayar University, Manisa 45040, Turkey
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Inonu University, Malatya 44000, Turkey
| | - Halil İbrahim Ceylan
- Physical Education of Sports Teaching, Faculty of Kazim Karabekir Education, Atatürk University, Erzurum 25030, Turkey
| | - Tomasz Gabrys
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
| | - Magdalena Barasinska
- Department of Health Sciences, Jan Dlugosz University, 42-200 Czestochowa, Poland
| | - Urszula Szmatlan-Gabrys
- Department of Anatomy, Faculty Rehabilitation, University of Physical Education, 31-571 Krakow, Poland
| | - Peter Valach
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
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45
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Navas A, Kassarjian A. Bone Marrow Lesions in Athletic Stress Injuries: An Overview. Semin Musculoskelet Radiol 2023; 27:54-72. [PMID: 36868245 DOI: 10.1055/s-0043-1761613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
This article discusses the presumed pathophysiology of osseous sport-related stress changes, the optimal imaging strategy for detecting the lesions, and the progression of the lesions as seen on magnetic resonance imaging. It also describes some of the most common stress-related injuries in athletes by anatomical location and introduces some new concepts in the field.
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Affiliation(s)
- Ana Navas
- Department of Radiology, Division of Musculoskeletal Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ara Kassarjian
- Department of Radiology, Division of Musculoskeletal Radiology, Olympia Medical Center, Elite Sports Imaging, Madrid, Spain
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46
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Shaffer SK, Stover SM, Fyhrie DP. Training drives turnover rates in racehorse proximal sesamoid bones. Sci Rep 2023; 13:205. [PMID: 36707527 PMCID: PMC9883508 DOI: 10.1038/s41598-022-26027-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/08/2022] [Indexed: 01/29/2023] Open
Abstract
Focal bone lesions are often found prior to clinically relevant stress-fractures. Lesions are characterized by low bone volume fraction, low mineral density, and high levels of microdamage and are hypothesized to develop when bone tissue cannot sufficiently respond to damaging loading. It is difficult to determine how exercise drives the formation of these lesions because bone responds to mechanical loading and repairs damage. In this study, we derive steady-state rate constants for a compartment model of bone turnover using morphometric data from fractured and non-fractured racehorse proximal sesamoid bones (PSBs) and relate rate constants to racing-speed exercise data. Fractured PSBs had a subchondral focus of bone turnover and microdamage typical of lesions that develop prior to fracture. We determined steady-state model rate constants at the lesion site and an internal region without microdamage using bone volume fraction, tissue mineral density, and microdamage area fraction measurements. The derived undamaged bone resorption rate, damage formation rate, and osteoid formation rate had significant robust regression relationships to exercise intensity (rate) variables, layup (time out of exercise), and exercise 2-10 months before death. However, the direction of these relationships varied between the damaged (lesion) and non-damaged regions, reflecting that the biological response to damaging-loading differs from the response to non-damaging loading.
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Affiliation(s)
- Sarah K Shaffer
- Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, USA.
| | - Susan M Stover
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA
| | - David P Fyhrie
- Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, USA
- Department of Biomedical Engineering, University of California, Davis, USA
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47
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Clark AR, Mauntel TC, Goldman SM, Dearth CL. Repurposing existing products to accelerate injury recovery (REPAIR) of military relevant musculoskeletal conditions. Front Bioeng Biotechnol 2023; 10:1105599. [PMID: 36698630 PMCID: PMC9868163 DOI: 10.3389/fbioe.2022.1105599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Musculoskeletal injuries (MSKIs) are a great hindrance to the readiness of the United States Armed Forces through lost duty time and reduced operational capabilities. While most musculoskeletal injuries result in return-to-duty/activity with no (functional) limitations, the healing process is often long. Long healing times coupled with the high frequency of musculoskeletal injuries make them a primary cause of lost/limited duty days. Thus, there exists an urgent, clinically unmet need for interventions to expedite tissue healing kinetics following musculoskeletal injuries to lessen their impact on military readiness and society as a whole. There exist several treatments with regulatory approval for other indications that have pro-regenerative/healing properties, but few have an approved indication for treating musculoskeletal injuries. With the immediate need for treatment options for musculoskeletal injuries, we propose a paradigm of Repurposing Existing Products to Accelerate Injury Recovery (REPAIR). Developing treatments via repurposing existing therapeutics for other indications has shown monumental advantages in both cost effectiveness and reduced time to bring to market compared to novel candidates. Thus, undertaking the needed research efforts to evaluate the effectiveness of promising REPAIR-themed candidates has the potential to enable near-term solutions for optimizing musculoskeletal injuries recovery, thereby addressing a top priority within the United States. Armed Forces. Herein, the REPAIR paradigm is presented, including example targets of opportunity as well as practical considerations for potential technical solutions for the translation of existing therapeutics into clinical practice for musculoskeletal injuries.
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Affiliation(s)
- Andrew R. Clark
- Research and Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States,Department of Surgery, Uniformed Services University of the Health Sciences—Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Timothy C Mauntel
- Research and Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States,Department of Surgery, Uniformed Services University of the Health Sciences—Walter Reed National Military Medical Center, Bethesda, MD, United States,Womack Army Medical Center, Fort Bragg, NC, United States
| | - Stephen M Goldman
- Research and Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States,Department of Surgery, Uniformed Services University of the Health Sciences—Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Christopher L. Dearth
- Research and Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States,Department of Surgery, Uniformed Services University of the Health Sciences—Walter Reed National Military Medical Center, Bethesda, MD, United States,*Correspondence: Christopher L. Dearth,
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48
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du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII. Phys Ther Sport 2023; 59:136-143. [PMID: 36535111 DOI: 10.1016/j.ptsp.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events. DESIGN Cross-sectional study. SETTING 2016-2020 Cape Town Cycle Tour. PARTICIPANTS Consenting race entrants. MAIN OUTCOME MEASURES 62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses. RESULTS Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)]. CONCLUSION A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.
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Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, South Africa.
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, South Africa; Statistics and Population Studies Department, University of the Western Cape, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
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49
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Citro V, Clerici M, Boccaccini AR, Della Porta G, Maffulli N, Forsyth NR. Tendon tissue engineering: An overview of biologics to promote tendon healing and repair. J Tissue Eng 2023; 14:20417314231196275. [PMID: 37719308 PMCID: PMC10501083 DOI: 10.1177/20417314231196275] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 09/19/2023] Open
Abstract
Tendons are dense connective tissues with a hierarchical polarized structure that respond to and adapt to the transmission of muscle contraction forces to the skeleton, enabling motion and maintaining posture. Tendon injuries, also known as tendinopathies, are becoming more common as populations age and participation in sports/leisure activities increases. The tendon has a poor ability to self-heal and regenerate given its intrinsic, constrained vascular supply and exposure to frequent, severe loading. There is a lack of understanding of the underlying pathophysiology, and it is not surprising that disorder-targeted medicines have only been partially effective at best. Recent tissue engineering approaches have emerged as a potential tool to drive tendon regeneration and healing. In this review, we investigated the physiochemical factors involved in tendon ontogeny and discussed their potential application in vitro to reproduce functional and self-renewing tendon tissue. We sought to understand whether stem cells are capable of forming tendons, how they can be directed towards the tenogenic lineage, and how their growth is regulated and monitored during the entire differentiation path. Finally, we showed recent developments in tendon tissue engineering, specifically the use of mesenchymal stem cells (MSCs), which can differentiate into tendon cells, as well as the potential role of extracellular vesicles (EVs) in tendon regeneration and their potential for use in accelerating the healing response after injury.
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Affiliation(s)
- Vera Citro
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Materials Science and Engineering, Institute of Biomaterials University of Erlangen-Nuremberg, Cauerstrasse 6, Erlangen, Germany
| | - Marta Clerici
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
| | - Aldo R. Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials University of Erlangen-Nuremberg, Cauerstrasse 6, Erlangen, Germany
| | - Giovanna Della Porta
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
- Interdepartmental Centre BIONAM, University of Salerno, via Giovanni Paolo I, Fisciano, Salerno, Italy
| | - Nicola Maffulli
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Department of Medicine, Surgery and Dentistry, University of Salerno, via S. Allende, Baronissi, Salerno, Italy
- Department of Trauma and Orthopaedic Surgery, University Hospital ‘San Giovanni di Dio e Ruggi D’Aragona’, Salerno, Italy
| | - Nicholas R. Forsyth
- School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, Staffordshire, UK
- Vice Principals’ Office, University of Aberdeen, Kings College, Aberdeen, UK
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50
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Muacevic A, Adler JR, Sudi S, Mohd Noh M, Khin NY. A Case Report on Core Muscles Training for Knee Osteoarthritis Through Core Muscles Activations and Gait Analysis. Cureus 2023; 15:e33918. [PMID: 36819380 PMCID: PMC9936829 DOI: 10.7759/cureus.33918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 01/19/2023] Open
Abstract
Knee osteoarthritis (OA) is a chronic joint disease that can affect all ages, but it is more common in the elderly. Pharmacological and non-pharmacological treatments have been invented evolutionarily over the years to halt this disease. Exercise is one of the first-line treatments for knee OA as well as for prevention. This case study features a 47-year-old man who has grade IV bilateral knee OA and has never had any surgery and takes fish oil daily as a supplement. His walking pattern was significantly impacted by the chronic knee discomfort he had in both legs. Thus, the walking gait of this patient was analyzed together with core muscle activation before and after two weeks of core resistance exercise intervention. The knee pain score was assessed using the Western Ontario and McMaster Universities Index (WOMAC). The outcomes of this research depict that core resistance training has the potential to be used as an alternative, non-surgical and non-pharmacological treatment for a patient with knee OA.
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