Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, September 2, 2015

Ain’t no Half Stepping - Students with Chronic Ankle Instability are Less Active

Physical Activity Levels in College Students With Chronic Ankle Instability

Hubbard-Turner T & Turner TJ. J Athl Train. 2015; 50(7): 742-747.

Take Home Message: College students with chronic ankle instability have lower activity levels and more symptoms than healthy students.  Activity levels appear to be related to the amount of ankle laxity.

Ankle sprains, one of the most common orthopedic injuries, can cause chronic ankle instability (CAI), which can result in long-term pain, instability, and potentially decreased quality of life.  Individuals with CAI report lower function and more symptoms, but it is unknown if these findings translate into functional differences.  The authors of this study compared total weekly steps between 40 college students with CAI and healthy control students.
Monday, August 31, 2015

Serum Biomarkers May Be Beneficial Concussion Diagnostic/Prognostic Tools

Circulating brain derived neurotrophic factor (BDNF) has diagnostic and prognostic value in traumatic brain injury

Korley FK, Diaz-Arrastia R, Wu A, Yue JK, Manley GT, Sair HI, Van Eyk J, Everett AD, Okonkwo DO, Valadka A, Gordon WA, Maas A, Mukherjee P, Yuh EL, Lingsma H, Puccio AM, Schnyer DM. J Neuotrauma 2015; ahead of print.

Take Home Message: A serum biomarker measured on the day of an injury could help diagnose a traumatic brain injury and differentiate mild injuries from more severe injuries.

Knowing the risk factors for prolonged recovery following a concussion injury is important since there is a chance of developing chronic or progressive concussion symptoms due to repeated concussions before the brain completely heals. There are not many prognostic tools to monitor the brain during the recovery process. One potential solution is to measure biochemical markers (biomarkers) in the blood, which could help us make objective decisions on whether the patient has a concussion and how long might his/her symptoms persist. Some potential candidate are brain derived neurotropic factor (BDNF) due to is importance for neuronal survival and regeneration, glial fibrillary acidic protein (GFAP), which functions in maintaining the blood brain barrier, and Ubiquitin C-terminal hydrolase (UCH-L1) that is required for normal cognition. BDNF decreases in the blood and GFAP and UCH-L1 increases in blood after an injury, but there is limited evidence for them to be used as potential markers for sports-related concussion. Therefore, the authors evaluated whether BDNF is a valid diagnostic and prognostic biomarker for concussion in two independent cohorts of traumatic brain injury (TBI) cases presenting to the emergency departments of John Hopkins Hospital (76 cases) and San Francisco General Hospital (76 cases).
Wednesday, August 26, 2015

Quality of Life may Suffer after ACL Rupture Regardless of Treatment

Quality of life in anterior cruciate ligament-deficient individuals: a systematic review and meta-analysis.

Filbay SR, Culvenor AG, Ackerman IN, Russell TG, and Crossley KM. Br J Sports Med. 2015. 49:1033-1041.

Take Home Message: A systematic review of 11 studies revealed that patients who either received anterior cruciate ligament (ACL) reconstruction or remained deficient (ACL-D) reported lower quality of life than the general healthy population.

After an ACL injury many patients fail to return to the same level of sport competition, develop early-onset osteoarthritis, and have a fear of reinjury – all of which could contribute to a decreased quality of life years after an injury. By better understanding the long-term outcomes, clinicians can identify best practices and better understand what treatment options are best for certain patients. Therefore, Filbay and colleagues completed a systematic review and meta-analysis to report the quality of life among patients who are ACL-deficient (ACL-D) between 5 and 25 year post-injury.
Monday, August 24, 2015

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

Casa DJ, DeMartini JK, Bergeron MF, Csillan D, Eichner ER, Lopez RM, Ferrara MS, Miller KC, O'Connor F, Sawka MN, Yeargin SW. J Athl Train. 2015 Aug 18. [Epub ahead of print]

The National Athletic Trainers’ Association has released a new position statement regarding exertional heal illnesses. This position statement replaces the document that was originally published in 2002. After defining exertional heat illnesses, the authors provide 48 recommendations related to prevention, recognition, treatment, and return to activity. The document also includes a review of relevant literature.

Wednesday, August 19, 2015

Should the Focus Be on Limiting Player Contact Instead of Soccer Heading?

An evidence-based discussion of heading the ball and concussions in high school soccer

Comstock RD, Currie DW, Pierpoint L, Grubenhoff JA, Fields SK. JAMA Pediatric 2015; ahead of print.

Take Home Message: Banning heading from youth soccer would likely prevent some concussions; however, reducing player-to-player contact may play a more effective role in preventing concussions as well as other injuries.

Soccer was introduced as a safer alternative to youth sports, but soccer-related concussion rates are high among United States high schools. To reduce the risk of concussions in soccer some are calling for a ban on soccer heading; however, there is little research to support such a ban. Therefore, the authors analyzed data from 2005 to 2014 from the National High School Sports-Related Injury Surveillance Study’s High School Reporting Information Online to evaluate trends among girls’ and boys’ soccer concussions, to 1) identify injury mechanisms commonly leading to concussions, 2) delineate soccer-specific activities during which most concussions occur, 3) detail heading-related soccer concussion mechanisms, and 4) compare concussion symptom patterns by injury mechanism. As part of the injury surveillance system, certified athletic trainers from high schools around the country reported injuries and exposures (playing/practice time per athlete) for soccer concussions.
Wednesday, August 12, 2015

Graft Type May Influence ACL Reinjury Rates

Rerupture, reinjuries, and revisions at a minimum 2-year follow-up: A randomized clinical trial comparing 2 graft types for ACL reconstruction.

Mohtadi N, Chan D, Barber R, and Paolucci EO. Clin J Sports Med. 2015. [Epub Ahead of Print].

Take Home Message: Two years after anterior cruciate ligament (ACL) reconstruction, a patient who was treated with patellar tendon grafts was less likely to sustain reinjury than a patient who received a hamstring graft. Further, a younger patient (27 years old or younger) was more likely to have an adverse event than an older patient.

Anterior cruciate ligament ruptures in the athletic population are common and has long-term effects on a patient’s health. Even more disruptive to the long-term health of a joint, are rerupture and reinjuries to the same joint. By identifying factors that may lead to reinjuries, clinicians may be able to implement preventions strategies to reduce the risk of reinjuries. Therefore, Mohtadi and colleagues completed a double-blinded randomized clinical trial to compare 3 autograft options with regards to reinjury at 2 years post-surgery.
Monday, August 10, 2015

Not so Fast with that PRP: Platelet-rich Plasma for Hamstring Injuries

Platelet-rich Plasma Does Not Enhance Return to Play in Hamstring Injuries: a Randomized Controlled Trial

Hamilton B, Tol JL, Alusa E, Boukarroum S, Eirale C, Farooq  A, Whiteley R, & Chalabi H. Br J Sports Med. 2015; 49: 943-950. Doi:10.1136/bjsports-2015-094603.

Take Home Message: Compared to intensive rehabilitation alone, a single injection of platelet-rich plasma (PRP) does not reduce the time to return to sports (RTS) among professional male athletes with acute hamstring injuries.

To date, there is insufficient evidence to support the use of platelet-rich plasma (PRP) in the treatment of musculoskeletal soft tissue injuries despite the rapid expansion of its use in the field of “Regenerative Medicine.” Specifically for hamstring injuries, there is a lack of well-designed clinical trials to demonstrate effectiveness despite its commonplace use. The authors of this article conducted a randomized clinical trial to investigate whether PRP reduced the time to return to sports (RTS) among male professional athletes with acute grade I or II hamstring injuries.