Assessment of the Current State of Sports Coverage Participation, Training, and Confidence Ratings among Physical Medicine and Rehabilitation Residents and Residency Programs

ABSTRACT

A significant proportion of physical medicine and rehabilitation residents are pursuing sports medicine-related fellowships and are recommended to participate in sports coverage during residency training. The purpose of this article is to assess the current state of sports coverage participation, training, and confidence ratings among physical medicine and rehabilitation residents and residency programs. Physical medicine and rehabilitation residents from Accreditation Council for Graduate Medical Education-accredited programs were invited to participate in a nationwide cross-sectional survey. A total of 90 resident responses from 43 programs were included. Residents from 91% of represented programs indicated that sports coverage opportunities were available. At least one resident from 63% of represented programs and 50% of responding residents reported sports coverage training during residency. Sports coverage confidence ratings were higher in 91% of topics among residents who received training. The results of this study indicate that sports coverage opportunities are common among physical medicine and rehabilitation residencies, and while sports coverage training is variable, a positive correlation with confidence ratings was identified.

Bone Health in Young Athletes: a Narrative Review of the Recent Literature

PURPOSE OF REVIEW

The aim of this review is to discuss the most recent published scientific evidence regarding bone health in the pediatric athlete.

RECENT FINDINGS

Pediatric athletes commonly suffer from overuse injuries to the physes and apophyses, as well as bone stress injuries, for which magnetic resonance imaging grading of the severity of injuries may be useful in guiding return to sport. Adolescent athletes, particularly those who train indoors and during the winter season, are at risk for vitamin D deficiency, which has important implications for bone mineral density. However, the relationship between vitamin D status and traumatic fracture risk is still unclear. While the female athlete triad is a well-established condition, the current work has led to the recognition of parallel pathophysiology in male athletes, referred to as the male athlete triad. Recent evidence suggests that transdermal 17β-estradiol treatment in amenorrhoeic female athletes is an effective adjunctive treatment to improve bone mineral density in treatment of the female athlete triad. Young athletes are at risk for musculoskeletal injuries unique to the growing skeleton. Optimizing nutritional intake, particularly related to adequate vitamin D intake and prevention of the athlete triad, is critical to optimize bone health in the young athlete.

Parkinson's disease and suicide among individuals seeking care within the United States Veterans Health Administration

BACKGROUND

Independently, veterans and individuals with Parkinson's Disease (PD) are at increased risk for suicide. To our knowledge, the risk of suicide among veterans with PD has yet to be evaluated. This study aimed to examine the associations between PD and risk of suicide, as well as suicide means among those using Veteran Health Administration (VHA) services.

METHODS

Retrospective cohort study of individuals who used VHA services between 1/1/2001-12/31/2019. Cox proportional hazard models were used to estimate the hazard of suicide for those with PD relative to those without. A nested-case control study was carried out among the suicide decedents where logistic regression was used to assess the relationship between PD and suicide by firearms versus suicide by any other means.

RESULTS

The unadjusted hazard of death by suicide for those with a PD diagnosis, relative to those without, was 1.51 (95% CI: 1.32-1.72, p < 0.0001), and was still significant after controlling for age/gender, and psychiatric/chronic physical health diagnoses (HR: 1.50; 95% CI: 1.32-1.72, p < 0.0001; HR:1.21, 95% CI:1.06-1.38, p = 0.006, respectively). Compared to the non-PD cohort, the PD group also had higher rates of mood, anxiety, and psychotic disorders. There was no significant difference between the method of suicide for those with PD versus those without PD (p = 0.60). Most suicide deaths among both cohorts were firearm-related (PD = 78.9%, No-PD = 80.3%).

CONCLUSIONS

PD is associated with an elevated risk for suicide. Based on the high rate of deaths by firearm, increased efforts to facilitate lethal means safety among veterans is warranted.

Neurosarcoidosis in acute inpatient rehabilitation: a case study

INTRODUCTION

Sarcoidosis affects the nervous system in ~5-10% of cases. Common presentations for neurosarcoidosis can include facial nerve neuropathy, optic neuritis, meningitis, seizure muscle weakness, and paresthesia. Due to the complex treatment of neurosarcoidosis, few reports exist involving patients' recovery in an acute rehabilitation setting.

CASE PRESENTATION

We describe a case of neurosarcoidosis affecting the cervical and thoracic spinal cord in an individual with known Chiari I malformation and associated syrinx decompression.

DISCUSSION

We discuss the diagnosis and treatment of neurosarcoidosis and clinical implications of acute rehabilitation on functional recovery.