Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Monday, October 23, 2017

Concussion Risk is Hiding in Your Genes

Genetic Polymorphisms Associated With the Risk of Concussion in 1056 College Athletes: A Multicenter Prospective Cohort Study

Terrell TR, Abramson R, Barth JT, Bennett E, Cantu RC, Sloane R, Laskowitz DT, Erlanger DM, McKeag D, Nichols G, Valentine V, Galloway L. Br J Sports Med. 2017. Ahead of print

Take Home Message: A college athlete with a specific genetic variation at IL-6R has almost 3.5 times greater risk of concussion and an athlete with a genetic variation at APOE4 had a 40% lower risk.

Several of the concussion sport guidelines highlight the need to identify athletes at risk for poor outcomes, and suggests one way to do so is through genetic testing; however, these statements also point out that there are significant biases and a need for more studies in this area. Therefore, the authors evaluated the association between the risk of concussion in college sports and 8 genetic variations from 4 genes that are related to structural neuronal integrity (APOE, MAPT) and release of pro inflammatory signals (IL-6R).
Friday, October 20, 2017

Position Statement From the Australian Knee Society on Arthroscopic Surgery of the Knee, Including Reference to the Presence of Osteoarthritis or Degenerative Joint Disease: Updated October 2016.

Position Statement From the Australian Knee Society on Arthroscopic Surgery of the Knee, Including Reference to the Presence of Osteoarthritis or Degenerative Joint Disease: Updated October 2016.

Australian Knee Society. Orthop J Sports Med. 2017 Sep 28;5(9):2325967117728677. doi: 10.1177/2325967117728677. eCollection 2017 Sep.

The Australian Knee Society has released a position statement indicating that arthroscopic debridement, and/or lavage, has no beneficial effect on the natural history of osteoarthritis and is not indicated as a primary treatment in the management of osteoarthritis. The authors note that this does not prevent the use of arthroscopic surgery for management of symptomatic pathology

Wednesday, October 18, 2017

How Perceived Ankle Instability Affects a Population

Correlates of Perceived Ankle Instability in Healthy Individuals Aged 8 to 101 Years.

Baldwin JN, McKay MJ, Hiller CE, Nightingale EJ, Moloney N, Burns J; 1000 Norms Project Consortium. Arch Phys Med Rehabil. 2017 Jan;98(1):72-79. doi: 10.1016/j.apmr.2016.08.474. Epub 2016 Sep 22.

Take Home Message: Almost 1 in 4 healthy individuals reported bilateral ankle instability. Several demographical and physical measures were associated with perceived ankle instability.

Clinician can use self-reported impairments following an ankle sprain to assess ankle instability and function. The International Ankle Consortium recommends using the Cumberland Ankle Instability Tool (CAIT) to classify and help to manage those suffering from ankle instability. While the CAIT is widely used when managing ankle instability, there is no reference data available for researchers and clinicians to utilize when using the CAIT. The authors of this article set out to provide reference data for the CAIT, as well as to examine the prevalence and factors related with perceived ankle instability in a large cohort of healthy individuals.
Monday, October 16, 2017

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active

McDermott BP, Anderson SA, Armstrong LE, Casa DJ, Cheuvront SN, Cooper L, Kenney WL, O'Connor FG, Roberts WO. J Athl Train. 2017 Sep;52(9):877-895. doi: 10.4085/1062-6050-52.9.02.

The National Athletic Trainers’ Association has released a new position statement to provide “evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals”. The authors offer 31 recommendations and a comprehensive literature review. The recommendations cover the importance of maintaining fluid balance and regulation; importance of maintaining euhydration; fluid replacement; beverage additives; hydration assessment, and unique situations.

Thursday, October 12, 2017

Young and Active = Lean Towards Autograft

Change in Anterior Cruciate Ligament Graft Choice and Outcomes Over Time

Kaeding CC, Pedrosa AD, Reinke EK, Huston LJ, Hewett TE, Flanigan DC, MOON Knee Group, & Spinder KP. Arthroscopy. 2017; Online Ahead of Print July 24, 2017.  

Take Home Message: Younger and highly active participants may be more appropriately advised to have an autograft for anterior cruciate reconstruction over an allograft. 

Graft choice for an anterior cruciate ligament (ACL) reconstruction remains debatable for short- and long-term health after an ACL injury.  Generally speaking, risk of reinjury is high after ACL reconstruction, but it remains unclear as to what role graft choice plays in this risk and how graft choices and retear rates have changed over time at 7 clinical sites (across 17 surgeons).
Monday, October 9, 2017

Keep Playing and Adapting

A longitudinal exploration of pain tolerance and participation in contact sports.

Thornton C, Sheffield D, and Baird A. Scand J Pain. 2017. [Epub Ahead of Print].

Take Home Message: Athletes who start participating in contact sports are more pain tolerant and become less catastrophizing than new athletes who stop participating.

A patient with greater pain tolerance is more likely to adhere to a rehabilitation program after injury. Understanding how different factors affect an athlete’s pain tolerance can help clinicians anticipate who may have lower tolerance and then tailor a rehabilitation program to optimize adherence. One key factor may be participation in contact sports; but, it remains unclear if athletes in contact sports start with a higher pain tolerance or acquire a higher pain tolerance while participating in the sport. Therefore, Thornton and colleagues completed a study to compare changes in pain tolerances over a season among athletes who started to participate in contact sports and those who started but then stopped participating (disengage).
Wednesday, October 4, 2017

Nurses’ Views on Interprofessional Concussion Management Teams

School nurses’ perceptions and experiences with an interprofessional concussion management team in the secondary school setting

Welch Bacon CE, Erickson CD, Kay MC, Weber ML, Valovic McLeod TC. Journal of Interprofessional Care. 2017; ahead of print.

Take Home Message: Nurses understand that they play a key role in the interprofessional concussion management team for secondary school students; however, the lack of agreement on the roles of team members suggest that protocols may be needed to foster role delineation and communication.

Students commonly need academic accommodations following a concussion to ease back into full cognitive load in a classroom. These accommodations would be best implemented by an interprofessional concussion management team that uses a collaborative, multifaceted approach to permit the safe return to activity and classroom. However, there is little research to address who should be involved and how academic accommodations would be effectively carried out. The school nurse may offer insight on the best approach to facilitate a team approach to academic accommodations. Therefore, the authors explored the school nurses’ perceptions and experiences of an interprofessional concussion management team for adolescents following a concussion in the secondary school setting.