Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, July 26, 2017

Near-Infrared Spectroscopy may be a Future Concussion Biomarker

Assessing prefrontal cortex oxygenation after sport concussion with near-infrared spectroscopy

Bishop SA, Neary JP. Clin Physiol Funct Imaging. 2017 Jun 18. doi: 10.1111/cpf.12447.

Take Home Message: Near-infrared spectroscopy, which can measure blood-oxygen levels, may provide an objective method to assess concussion within days of initial trauma but it is not ready for clinical roll out just yet.

Neurocognitive tests provide a marker of concussion recovery, but may not detect changes in the underlying physiology. An objective measure of physiological changes associated with concussion may assist clinicians in determining if individuals have fully recovered before returning to sport. The authors of this study assessed if near infrared spectroscopy (NIRS), a noninvasive and portable method to measure blood-oxygen levels at the brain’s surface, may be a biomarker of concussion.
Monday, July 24, 2017

It May be Time to Update Your Neer Test

The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome.

Goushen Y, Chongxi R, Guoqing C, Junling X, and Hailong J. Eur J Orthop Surg Traumatol. 2017. [Epub Ahead of Print].

Take Home Message: A modified Neer test may be beneficial at differentiating between subacromial impingement syndrome and frozen shoulder.

Subacromial impingement syndrome is a common shoulder injury in both athletes and non-athletes. While the Neer test is the most common special test for diagnosing subacromial impingement syndrome, it is also positive in patients with frozen shoulder. Therefore, Goushen and colleagues completed a single-center, prospective study to evaluate the diagnostic accuracy of a modified Neer test in diagnosing subacromial impingement syndrome and ruling out frozen shoulder.
Wednesday, July 19, 2017

Athletes’ Ankle Sprain Fears

Collegiate Athletes with Ankle Sprain History Exhibit Greater Fear-Avoidance Beliefs

Houston MN, Hoch JM, & Hoch MC. J Sport Rehabil. 2017; Epub ahead of print Jun 12 : 1-16.  

Take Home Message: An athlete with a history of ankle sprain typically has higher fear avoidance beliefs than an athlete without a history of ankle sprain.  This is worse for an athlete with a history of multiple sprains.

After an ankle sprain – one of the most common injuries in athletic participation – there are sometimes complications including chronic instability and fear of reinjury, which may result in avoidance and possibly functional detriments.  There has been some research with conflicting findings on fear avoidance and kinesiophobia after ankle sprain.  Therefore, the authors investigated if athletes with a history of single or recurrent ankle sprains had greater fear avoidance beliefs than athletes without a history of an ankle sprain.
Monday, July 17, 2017

Is It Wise for Youth Athletes to Specialize?

Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes

Post EG, Bell DR, Trigsted SM, Pfaller AY3, Hetzel SJ, Brooks MA, McGuine TA. Sports Health. 2017; Ahead of Print

Take Home Message: An athlete who participates in more than 60 games per year, is a member of a club sport, or highly specialized is more likely to have a lower extremity injury. Additionally, girls are more likely to participate on a club team and be highly specialized potentially increasing their risk of injury.

High school athletes are increasingly participating in year-round school and club sport, which can increase competition volume throughout the year. This could increase the risk of injury. However, there are no studies examining whether females or males are more likely to compete in a club sport and if sport specialization increases risk of lower extremity injury. Therefore, the authors sought to evaluate the association between competition volumes, club sport participation, and sport specialization with sex and lower extremity injuries.
Wednesday, July 12, 2017

Clinical Practice Guidelines - Neck Pain: Revision 2017

Neck Pain: Revision 2017

Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83. doi: 10.2519/jospt.2017.0302.
PMID: 28666405

The Orthopaedic Section of the American Physical Therapy Association (APTA) has released a set of revised clinical practice guidelines to review recent peer-reviewed literature and make recommendations related to neck pain. The document starts with a summary of the 25 recommendations. The detailed document covers diagnosis, examination, and interventions.  

See also…

Monday, July 10, 2017

The Role of Athletic Trainers in Preventing and Managing Posttraumatic Osteoarthritis in Physically Active Populations: a Consensus Statement of the Athletic Trainers' Osteoarthritis Consortium

The Role of Athletic Trainers in Preventing and Managing Posttraumatic Osteoarthritis in Physically Active Populations: a Consensus Statement of the Athletic Trainers' Osteoarthritis Consortium.

Palmieri-Smith RM, Cameron KL, DiStefano LJ, Driban JB, Pietrosimone B, Thomas AC, Tourville TW, Athletic Trainers’ Osteoarthritis Consortium. J Athl Train. 2017 Jun 2;52(6):610-623. doi: 10.4085/1062-6050-52.2.04.
The Athletic Trainers’ Osteoarthritis Consortium has released a consensus statement on the role of athletic trainers in preventing and managing post-traumatic osteoarthritis in physically active populations. The consensus statement offers 7 recommendations and a nice summary of key information relevant to sports medicine. This was part of the Journal of Athletic Training’s Special Issue on Osteoarthritis. The editorial to this issue highlights why athletic trainers need to adopt their important role in preventing and treating osteoarthritis. We also released a special podcast episode discussing this special issue.

This topic is particularly relevant for athletic trainers since the current version of the proposed Curricular Standards now notes the importance of developing and implementing wellness strategies to reduce the risk of long-term health conditions like osteoarthritis:

"Standard 53: Develop and implement wellness strategies to mitigate the risk for long-term health conditions across the lifespan. These conditions include but are not limited to:
A. Osteoarthritis
B. Cardiovascular disease
C. Neurocognitive disease
D. Obesity
E. Diabetes" 

Friday, July 7, 2017

Combining Central and Peripheral Neurostimulation to Reduce Pain

Treating low back pain with combined cerebral and peripheral electrical stimulation: A randomized, double-blind, factorial clinical trial

Hazime FA, Baptista AF, de Freitas DG, Monteiro RL, Maretto RL, Hasue RH, João SMA. Eur J Pain. 2017 Apr 25. doi: 10.1002/ejp.1037. [Epub ahead of print]

Take Home Message: While Transcranial Direct-current stimulation (tDCS) and peripheral electrical stimulation (PES) alone may not provide extended pain relief, combining the two treatments provided immediate and short-term pain relief for people with chronic low back pain.

Despite many people having chronic low back pain there is no gold standard treatment. A possible therapeutic target may be the underlying changes in the brain related to the onset of chronic pain (for example, grey matter degradation in pain sensitizations regions). A potential method to target these changes is transcranial direct-current stimulation (tDCS), which provides a continuous, low current stimulation to the primary motor cortex to increase excitability and modulate pain. Efficacy of tDCS is controversial but combining it with other techniques such as peripheral electrical stimulus (PES) has shown promise. In contrast to tDCS, PES reduces excitability within the primary sensory and motor cortices and stimulates other neural sensitization pathways. Combining both therapies may be more efficacious than isolated tDCS or PES; however, randomized-control trials have yet to be conducted for back pain. Therefore, investigators conducted a randomized control, double blind, clinical trial to determine whether combination therapy of tDCS and PES mitigate chronic low back pain symptoms.