Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Monday, March 27, 2017

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society.

Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, Olshansky B, Raj SR, Sandhu RK, Sorajja D, Sun BC, Yancy CW. Circulation. 2017 Mar 9. pii: CIR.0000000000000499. doi: 10.1161/CIR.0000000000000499. [Epub ahead of print]

The American College of Cardiology, American Heart Association Task Force on Clinical Practice Guidelines, and Heart Rhythm Society have provided guidelines for the evaluation and management of patients with syncope. These guidelines were developed in collaboration with the American College of Emergency Physicians and Society of Academic Emergency Medicine. An Executive Summary accompanies the main set of guidelines. The guidelines document covers general principles, evaluation and diagnosis, management of cardiovascular conditions, reflex conditions, orthostatic hypotension and intolerance, pseudosyncoope, uncommon conditions associated with syncope, and other topics. The document also provides recommendations for athletes.


Wednesday, March 22, 2017

Additional Perturbation Not Necessary

Report of the Primary Outcomes for Gait Mechanics in Men of the ACL-SPORTS Trial: Secondary Prevention With and Without Perturbation Training Does Not Restore Gait Symmetry in Men 1 or 2 Years After ACL Reconstruction.

Capin JJ, Zarzycki R, Arundale A, Cummer K, and Snyder-Mackler L. Clin Orthop Relat Res.  2017. [Epub Ahead of Print].

Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction.

Arundale A, Cummer K, Capin JJ, Zarzycki R, and Snyder-Mackler L. Clin Orthop Relat Res.  2017. [Epub Ahead of Print].

Take Home Message: There is no benefit of adding perturbation training to the ACL-SPORTS training program between 3 to 9 months following an ACL reconstruction.

Knee function often improves over 2 years after an anterior cruciate ligament (ACL) injury; however, athletes are usually discharged from rehabilitation and returned to play before then. Clinicians need rehabilitation protocols that help athletes improve after completing a traditional rehabilitation protocol, when they return to play. Therefore, Capin and Arundale present 2 articles describing a randomized trial intended to identify the effectiveness of adding perturbation training to the Anterior Cruciate Ligament Post-Operative Return-to-Sport (ACL-SPORTS) training program.
Monday, March 20, 2017

American College of Foot and Ankle Surgeons Clinical Consensus Statement: Perioperative Management.

American College of Foot and Ankle Surgeons® Clinical Consensus Statement: Perioperative Management.

Meyr AJ, Mirmiran R, Naldo J, Sachs BD, Shibuya N. J Foot Ankle Surg. 2017 Mar - Apr;56(2):336-356. doi: 10.1053/j.jfas.2016.10.016.

The American College of Foot and Ankle Surgeons convened an expert panel to develop a clinical consensus statement on issues associated with perioperative management of foot and ankle surgical patients. The statement starts with an Executive Summary that offers a concise list of over 20 recommendations. The document also offers additional details on each consensus statement related to preoperative considerations, direct perioperative considerations, and postoperative considerations.

Wednesday, March 15, 2017

Balance Assessments Unable to Predict ACL Injury in Elite Female Athletes

No Association Between Static and Dynamic Postural Control and ACL Injury Risk Among Female Elite Handball and Football Players: A Prospective Study of 838 players

Steffen K, Nilstad A, Krosshaug T, Pasanen K, Killingmo A, & Bahr R. Br J Sports Med. 2017; 51:253-259. doi: 10.1136/bjsports-2016-097068

Take Home Message: Balance assessments were not associated with anterior cruciate ligament injury risk among elite female handball and soccer athletes. 

Clinicians and researchers are seeking screening tests to determine who is at greater risk for an anterior cruciate ligament (ACL) injury.  Balance exercises are often integrated into ACL prevention programs since many believe poor balance is associated with increased lower extremity injury risk.  However, there is little research to quantify the ACL injury risk associated with balance deficits.  The authors of this prospective study screened 838 elite female handball and football players and followed them to see if they suffered an ACL injury over an eight-year period.
Monday, March 13, 2017

DWC- Driving While Concussed

Driving after Concussion: Is it Safe To Drive after Symptoms Resolve?

Schmidt JD, Hoffman NL, Ranchet M, Miller LS, Tomporowski PD, Akinwuntan AE, Devos H. Neurotruama. 2017; 34:1-8.
Take Home Message: Asymptomatic concussed patients exhibited poor vehicle control, which suggests that driving impairments persists after signs and symptoms resolve.

Concussion consensus statements address return to sport and return to school, but few address return to daily activities such as driving. Often patients are unaware that deficits, such as those with reaction time and executive function, persist even after concussive symptoms resolve. These impairments create an unsafe condition if a patient gets behind the wheel prior to full recovery. Unfortunately, there is little research examining when is it safe for a patient to drive after a concussion. Therefore, the authors compared the neuropsychological tests and driving performance using a desktop simulator between 14 participants with a concussion (~48 hours following symptoms resolution) and 14 matched (age, sex, years driving experience) healthy participants. The authors also explored the relationships between neuropsychological and driving performance.
Wednesday, March 8, 2017

Cartilage Degradation After ACL Altered by Early Injection

A Multicenter Study of Early Anti-inflammatory Treatment I Patients with Acute Anterior Cruciate Ligament Tear

Latterman C, Jacobs CA, Bunnell MP, Huston LJ, Gammon LG, Johnson DL, Reinke EK, Huebner JL, Kraus VB, & Spindler KP. Am J Sports Med. 45:325-333. doi: 10.1177/0363546516666818

Take Home Message: A corticosteroid injection performed within the first 5 weeks after anterior cruciate ligament injury resulted in significantly less of an increase in cartilage degradation markers in comparison to placebo injections.

An anterior cruciate ligament (ACL) injury can cause short-term limitations and increase the risk of osteoarthritis, a chronic painful and disabling disorder.  There are biomechanical and biochemical changes that occur after a knee injury. Unfortunately, surgical reconstruction fails to prevent the development of osteoarthritis.  Therefore, we may need to focus on the biochemical changes.  The authors of this triple blind randomized clinical trial investigated the use of early corticosteroid injections in 49 patients post ACL tear.
Monday, March 6, 2017

International Recommendations for Electrocardiographic Interpretation in Athletes.

International Recommendations for Electrocardiographic Interpretation in Athletes.

Sharma S, Drezner JA, Baggish A, Papadakis M, Wilson MG, Prutkin JM, La Gerche A, Ackerman MJ, Borjesson M, Salerno JC0, Asif IM, Owens DS, Chung EH, Emery MS, Froelicher VF, Heidbuchel H, Adamuz C, Asplund CA, Cohen G, Harmon KG, Marek JC, Molossi S, Niebauer J0, Pelto HF, Perez MV, Riding NR, Saarel T, Schmied CM, Shipon DM, Stein R, Vetter VL, Pelliccia A, Corrado D. J Am Coll Cardiol. 2017 Feb 28;69(8):1057-1075. doi: 10.1016/j.jacc.2017.01.015.

In early 2015, ”an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened…to update contemporary standards for ECG interpretation in athletes.” They sought “to define and revise ECG interpretation standards…and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes”. The consensus statement covers normal ECG findings in athletes, borderline ECG findings in athletes, and abnormal ECG findings in athletes. The document includes several informative tables and figures.