Who Gets Chronic Traumatic Encephalopathy?

Association between contact sports participation and chronic traumatic encephalopathy: a retrospective study.

Bieniek KF, Blessing MM, Heckman MG, Diehl NN, Serie AM, Paolini MA, Boeve BF, Savica R, Reichard RR, and Dickson DW. Brain Pathol. 2019. [Epub Ahead of Print].

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Take Home Message: Among 750 samples of brain tissue from individuals with and without a history of sport participation, less than 6% of people showed chronic traumatic encephalopathy (CTE)-related pathology. While most people don’t develop CTE, roughly 1 in 7 former football players had evidence of CTE-related pathology compared with ~1 in 18 peers.

Chronic traumatic encephalopathy (CTE) is a debilitating neurological disorder that has gained a lot of attention because it is related to repeated brain trauma. Despite the media attention we know very little about whether the risk of developing CTE is related to participation in sports at nonelite levels of competition. The researchers of this study used the Mayo Clinic Tissue Registry to review samples of brain tissue from 300 former athletes and 450 non-athletes for the presence CTE pathology or features of CTE.

OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis

OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis

Bannuru RR, Osani MC, Vaysbrot EE, Arden N, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco F, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. Osteoarthritis Cartilage. 2019 Jul 3. pii: S1063-4584(19)31116-1. doi: 10.1016/j.joca.2019.06.011. [Epub ahead of print]

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The Osteoarthritis Research Society International has updated its guidelines for non-surgical management of knee, hip, and polyarticular osteoarthritis. The authors recommend core treatments, which are appropriate for use by most people in almost any situation and deemed safe for use in combination with first line and second line treatments. The authors also provided recommendations for people with various comorbidities (e.g., gastrointestinal or cardiovascular).

View 201 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

A multidisciplinary consensus on dehydration: definitions, diagnostic methods and clinical implications

A multidisciplinary consensus on dehydration: definitions, diagnostic methods and clinical implications

Lacey J, Corbett J, Forni L, Hooper L, Hughes F, Minto G, Moss C, Price S, Whyte G, Woodcock T, Mythen M, Montgomery H. Ann Med. 2019 May - Jun;51(3-4):232-251. doi: 10.1080/07853890.2019.1628352. Epub 2019 Jun 17.

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Twelve experts worked on a modified Delphi process to address the definition of dehydration, objective markers of dehydration, and physiologic impact of dehydration and patient outcomes. The authors developed 15 consensus statements and 7 research recommendations.

View 200 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

Clinical Experts Statement: The Definition, Prescription, and Application of Cupping Therapy

Clinical Experts Statement: The Definition, Prescription, and Application of Cupping Therapy

Cage SA, Gallegos DM, Coulombe B, Warner BJ. Clin Pract Athl Train. 2019;2(2):4-11 https://doi.org/10.31622/2019/0002.2.

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After a review of the literature, 10 certified athletic trainers with a post-professional credential in cupping therapy participated in a series of surveys and forums to develop a statement to address the definition, prescription, and application of dry cupping therapy. The recommendations for these 3 categories are summarized in 3 tables.

View 199 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

Show Me the Data and Dollars: Implementing Health and Safety Policy Change

Analysis of states’ barriers to and progress toward implementation of health and safety policies for secondary school athletes.

Pike AM, Adams WM, Huggins RA, Mazerolle SM, and Casa DJ. J Athl Train. 2019. [Epub Ahead of Print].

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Take Home Message: Officials from state athletic associations and sports medicine advisory committees believe that states are willing to implement sport policy changes but need proper funding and education to do so.

Physical activity has many positive health benefits, yet the risk of catastrophic injury or death, while small, still exists. Evidence-based policies and procedures reduce the risk of catastrophic injury or death; however, it remains unclear how each state in the United States is implementing these health and safety policies and procedures. To understand the progress made by each state high school athletics association and the perceived barriers to proper and complete implementation of these policies, Pike and colleagues completed a mixed-methods study.

Patients May Not Feel As Good As They Look On Paper

It Is Good To Feel Better, But Better To Feel Good: Whether A Patient Finds Treatment ‘Successful’ Or Not Depends On The Questions Researchers Ask

Roos EM, Boyle E, Frobell RB, Lohmander LS, Ingelsrud LH. Br J Sports Med. 2019 Apr. doi:10.1136/ bjsports-2018-100260. Epub Ahead of Print
https://www.ncbi.nlm.nih.gov/pubmed/31072841

Take Home Message: While patients may exceed minimal important change on patient-reported outcome scores after an ACL injury, many feel their treatment was unsuccessful.

We commonly use patient-reported outcome (PRO) measures in clinical trials to determine the success or failure of a treatment regimen after a musculoskeletal injury. Several PROs are readily available to clinicians, yet these measurements often focus on a patient’s functional ability or symptoms and not their satisfaction with how they feel after treatment.  When clinicians focus on a change score from baseline to follow-up it tells them if a patient is “feeling better,” but not if a patient “feels good.” It’s important to appreciate how these different ways to interpret PROs may alter the reported benefit of a treatment. Hence, the authors applied three different criteria to determine responders and non-responders in the KANON trial, which was a high-quality randomized trial that compared (1) exercise therapy and early anterior cruciate ligament reconstruction surgery and (2) exercise therapy and delayed reconstruction surgery (if needed).

International Expert Consensus on a Cell Therapy Communication Tool: DOSES

International Expert Consensus on a Cell Therapy Communication Tool: DOSES

Murray IR, Chahla J, Safran MR, Krych AJ, Saris DBF, Caplan AI, LaPrade RF. J Bone Joint Surg Am. 2019 May 15;101(10):904-911. doi: 10.2106/JBJS.18.00915.

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An international consensus process has yielded a new consensus statement that aims to develop “strategies to improve standardization and transparency when describing cell therapies. The secondary aim was to develop a consensus among experts on the contents of a standardized tool for describing cell therapies”. The “DOSES” acronym stands for reporting donor, origin tissue, separation method, exhibited cell characteristics associated with behavior, and site of delivery. The authors hope that a tool like “DOSES” will help clinicians and patients understand the characteristics of each cell therapy.

View 198 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

See also…

Rodeo SA. A Call for Standardization in Cell Therapy Studies: Commentary on an article by Iain R. Murray, BMedSci(Hons), MRCS, MFSEM, PhD, et al.: "International Expert Consensus on a Cell Therapy Communication Tool: DOSES". J Bone Joint Surg Am. 2019 May 15;101(10):e47. doi: 10.2106/JBJS.19.00189.