Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, May 25, 2016

Position Someone to Guard Against Bad Laxity Measures

Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding

Hanlon S, Caccese J, Knight CA, Swanik CB, & Kaminski TW.  J Athl Train, 2016; 51(2): 111-117. doi:10.4085/1062-6050-51.3.06

Take Home Message: Knee flexion to 90 degrees limits ankle laxity with the talar tilt test in comparison to a fully extended knee.  However, knee position has no effect on anterior drawer laxity. Muscle guarding will limit our ability to accurately assess ankle laxity with a talar tilt or anterior drawer test. 

The accuracy and reliability of special tests, such as the anterior drawer and talar tilt tests, can be affected by many factors, including muscle guarding, patient positioning, and clinician experience.  It is critical for clinicians to know how to properly perform these tests at the ankle to optimize test performance. The authors of this study compared ankle-joint laxity and muscle activity during these ligamentous ankle special tests at different knee positions. They also investigated how muscle guarding affects these tests.
Monday, May 23, 2016

Females at Increased Risk of Protracted Concussion Symptoms

Specific Factors Influence Postconcussion Symptom Duration among Youth Referred to a Sports Concussion Clinic

Heyer GL., Schaffer CE., Rose SC., Young JA., McNally KA., Fischer AN. J Pediatr. 2016: ahead of print

Take Home Message: Clinical factors that related with persistent postconcussion symptoms were sex, greater worsening symptoms from day of concussion to first concussion evaluation, continued activity participation, loss of consciousness, anterograde amnesia, and premorbid headaches, emotional symptoms on the day of concussion, and greater symptoms the day of the clinical examination.  

Recovery following a concussion is still largely understood. Previous researchers suggest clinical factors (for example, concussion history, specific symptoms, sex) are associated with protracted recovery; however, due to inconsistencies and the variety of research designs it is difficult to determine if these patterns truly exist. Therefore, the authors reviewed medical records to identify clinical factors that influence the duration of postconcussion symptoms among youth referred to a sports concussion clinic between June 2012 and September 2014.
Friday, May 20, 2016

Athletes With High Baseline Concussion Symptom Scores May Need Special Considerations

High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes

Custer A, Sufrinko A, Elbin RC, Covassin T, Collins M, and Kontos A. Journal of Athletic Training: February 2016, 51 (2): 136-141.

Take Home Message: Athletes who report numerous concussion symptoms during baseline testing may experience greater neurocognitive impairment after a concussion than athletes who do not report baseline symptoms.

Commonly, athletes complete baseline concussion assessments, which are used for comparison after an injury.  While these baseline measurements are meant to evaluate a healthy athlete, some athletes report symptoms at baseline. It is unclear if baseline symptoms relate to outcomes after a concussion. Custer et al. examined if athletes with numerous baseline symptoms had worse neurocognitive outcomes after a concussion than athletes without baseline symptoms.
Wednesday, May 18, 2016

The IOC Consensus Statement: Harassment and Abuse (Non-accidental Violence) in Sport

The IOC Consensus Statement: Harassment and Abuse (Non-accidental Violence) in Sport

Mountjoy M, Brackenridge C, Arrington M, Blauwet C, Carska-Sheppard A, Fasting K, Kirby S, Leahy T, Marks S, Martin K, Starr K, Tiivas A, Budgett R. Br J Sports Med. 2016 Apr 26. pii: bjsports-2016-096121. doi: 10.1136/bjsports-2016-096121. [Epub ahead of print]

“This Consensus Statement extends the 2007 IOC Consensus Statement on Sexual Harassment and Abuse in Sport, presenting additional evidence of several other types of harassment and abuse—psychological, physical and neglect.” The document includes “Forms of Abuse and Harassment in Sport”, “Mechanisms for Harassment and Abuse”, “Child and Adolescent Athletes”, “Athletes with Disability”, and “Impacts of Non-Accidental Violence”, “Prevention of Harassment and Abuse”. The document concludes with 15 recommendations.

Monday, May 16, 2016

Chronic Ankle Instability: Is the Struggle Mechanical or Neurological?

Neural Excitability and Joint Laxity in Chronic Ankle Instability, Coper, and Control Groups

Bowker, S, Terada M, Thomas AC, Pietrosimone BG, Hiller CE, Gribble PA. J Athl Train. 2016 Apr 11 [Epub ahead of print]

Take Home Message: A group of individuals with chronic ankle instability have sensorimotor system deficits compared with a group of healthy controls and copers; however, the authors found no mechanical differences between any of the groups.

One of the most common sports injuries are ankle sprains. Unfortunately, many individuals that suffer an ankle sprain develop prolonged ankle dysfunction, which is known as chronic ankle instability. A better understanding of the differences between individuals that develop chronic ankle instability and those that do not (copers) could provide clinicians with better evidence-based decisions when evaluating and treating initial ankle sprains. Therefore, Bowker and colleagues conducted a case-control study of individuals with chronic ankle instability, copers that did not report chronic dysfunction following an initial ankle sprain, and a group of healthy controls to investigate the differences in ankle laxity and neural excitability.
Friday, May 13, 2016

AOSSM Early Sport Specialization Consensus Statement

AOSSM Early Sport Specialization Consensus Statement

LaPrade RF, Agel J, Baker J, Brenner JS, Cordasco FA, Cote J, Engebretsen L, Feeley BT, Gould D, Hainline B, Hewett T, Jayanthi N, Kocher MS, Myer GD, Nissen CW, Philippon MJ, and Provencher MT. The Orthopaedic Journal of Sports Medicine, 4(4), 2325967116644241. DOI: 10.1177/2325967116644241

The American Orthopaedic Society for Sports Medicine convened a think tank to discuss early sports specialization, which led to this consensus statement. The document includes “Definition of Early Sports Specialization and Background Information”, “What is the Evidence that Early Sports Specialization is Detrimental?”, “Is Early Specialization Necessary for Elite Performance?”, and “What Research has been Done to Date?”.

Wednesday, May 11, 2016

An Ounce of Prevention = Money Saved!

Economic Impact Study: Neuromuscular Training Reduces the Burden of Injuries and Costs Compared to Standard Warm-Up in Youth Soccer

Marshall DA, Lopatina E, Lacny S, & Emery CA.  Br J Sports Med. Published
Online First: March 10, 2016. doi:10.1136/bjsports-2015-095666

Take Home Message: A neuromuscular injury prevention program reduces injuries and health care costs among female youth soccer players. 

We have had several posts on Sports Med Res about the effectiveness of neuromuscular warm ups to prevent injuries. However, we still need to determine the cost effectiveness of these warm-up programs to help estimate the potential financial impact of injury prevention.  Therefore, the authors of this cluster randomized study aimed to evaluate the cost effectiveness of a neuromuscular warm-up program in comparison to a standard warm up in youth soccer players.