Getting to the Heart of the Problem: What is the Cost of Saving a Life?

Outcomes of Cardiac Screening in Adolescent Soccer Players

Malhotra A, Dhutia H, Finocchiaro G, Gati S, Beasley I, Clift P, Cowie C, Kenny A, Mayet J, Oxborough D, Patel K, Pieles G, Rakhit D, Ramsdale D, Shapiro L, Somauroo J, Stuart G, Varnava A, Walsh J, Yousef Z, Tome M, Papadakis M, Sharma S. N Engl J Med. 2018 Aug 9;379(6):524-534.

https://www.ncbi.nlm.nih.gov/pubmed/30089062

Take Home Message: Cardiac screening can identify some high-risk athletes, but no screening strategy is likely to be perfect.

The debate lingers about the use of cardiac screening to reduce the risk of sudden death among athletes. This debate is impaired by the lack of systematic registries, which could help estimate the incidence of sudden death and impact of screening. Malhotra and colleagues sought to determine the incidence and causes of sudden cardiac death among adolescent players in the English Football Association (soccer), which started a cardiac screening program in 1996.

How Much Rest in Between Soccer Matches is Beneficial to Prevent Injuries?

Muscle injury rate in professional football is higher in matches played within 5 days since the previous match: a 14-year prospective study with more than 130 000 match observations.

Bengtsson H, Ekstrand J, Waldén M, Hägglund M. Br J Sports Med. 2018 Sep;52(17):1116-1122. doi: 10.1136/bjsports-2016-097399. Epub 2017 Nov 3.

Full Text Freely Available

Take Home Message: A professional athlete with 6 or 7 days rest between soccer matches may be less likely to have a muscular injury during a match than a player with 3 or fewer days between matches.

Numerous investigators have studied the possible relationship of the time between matches and injury rates in professional football (soccer).  For example, prior researchers showed that if a team plays 2 matches within 4 days compared to 6 or more days they are more likely to have greater muscular injury rates. However, prior studies have small sample sizes or study teams instead of individuals, which can make interpreting the findings challenging. Hence, the authors analyzed the associations between match congestion and match injury rates at an individual player level in a large population of professional soccer players. 

Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC)

Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC)

Niebauer J, Börjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. Eur Heart J. 2018 Aug 24. doi: 10.1093/eurheartj/ehy511. [Epub ahead of print]

Full Text Freely Available

This position statement is an update of the 2005 recommendations and offers guidance to physicians who must decide on the risk of an athlete during sport participation (amateur or professional). The document reviews proper classification, evaluation, risk stratification, and management.

View 169 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

Lumba-Brown A, Yeates KO, Sarmiento K, et al. JAMA Pediatr. Published online September 04, 2018. doi:10.1001/jamapediatrics.2018.2853

Full Text Freely Available

“The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup…. The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence” from a systematic review (see below).

View 168 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

Other related resources:

CDC Website for Guidelines

Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review

Editorial:State of the Science on Pediatric Mild Traumatic Brain Injury Progress Toward Clinical Translation

Parents are Not Aware of Sport Volume Recommendations to Prevent Pediatric Injuries

Parents' Awareness and Perceptions of Sport Specialization and Injury Prevention Recommendations

Bell DR, Post EG, Trigstead SM, Schaefer DA, McGuine TA, Brooks MA. Clin J Sport Med. 2018. [Epub ahead of print]

https://journals.lww.com/cjsportsmed/Abstract/publishahead/Parents__Awareness_and_Perceptions_of_Sport.99147.aspx

Take Home Message: Many parents are unfamiliar with sport volume recommendations. However, over half of parents feel that sport specialization is a problem.

Parents play a major role in their child’s sport experiences. Therefore, parents need to be knowledgeable about recommendations that aim to improve child/athlete safety (e.g., children should participate in no more than 8 months out of the year, participate in organized sport for no more hours per week than their age, and should not be participating in multiple leagues simultaneously). Though, this information is available in the literature and media, no one has evaluated whether parents know about these recommendations. Therefore, the author’s surveyed 1,000 parents with a child between 10-18 years of age who participated in sport within the past 12 months to determine their knowledge of sport participation recommendations and examine their perceptions toward sports specialization.

Put it All Together for Better Outcomes for Patients with Chronic Ankle Instability

Efficacy of non-surgical interventions on dynamic balance in patients with ankle instability: A network meta-analysis

Tsikopoulos K, Mavridis D, Gerogiannos D, and Cain MS. J Sci Med Sport. 2018. [Epub Ahead of Print].

https://www.sciencedirect.com/science/article/pii/S1440244018300355?dgcid=rss_sd_all

Take Home Message: A patient with chronic ankle instability is likely to get the best gains in dynamic balance when completing a rehabilitation program with balance and supervised strength training.

While many patients with chronic ankle instability (CAI) are treated with non-surgical interventions, there is no consensus on which intervention is best at improving dynamic balance among people with CAI. A better understanding of what non-surgical treatment methods is most effective would allow clinicians to improve function in patients with CAI. Therefore, Tsikopoulos and colleagues completed a systematic review and meta-analysis of randomized trials to compare the results of different non-surgical interventions on dynamic balance in people with CAI.

Older Males or Patients with an Allograft ACL Reconstruction Have Short-Term Faster Returns

Examination of Early Functional Recovery After ACL Reconstruction: Functional Milestone Achievement and Self-Reported Function

Obermeier MC, Sikka RS, Tompkins M, Nelson BJ, & Chmielewski TL.  Sports Health. 2018 10(4): 345-354. DOI: 10.1177/1941738118779762

https://www.ncbi.nlm.nih.gov/pubmed/29863963

Take Home Message: After an anterior cruciate ligament reconstruction, patients report significant improvements during the first month after surgery. Many important milestones often occur during the first 15 days after surgery (e.g., return to school, work, driving). Higher age, male sex, allograft selection, and lower body mass index (BMI) are associated with achieving functional milestones earlier than their peers.

Anterior cruciate ligament (ACL) injuries and decisions to have these surgically repaired are common among physically active Americans.  While we often focus on the medium- to long-term outcomes after an ACL reconstruction (e.g., return to sport), early functional recovery is also important.  If clinicians knew early functional milestones then it could help patients set realistic expectations and provide them feedback on progress, which may improve a patient’s experience and treatment adherence.  These authors prospectively followed 182 participants who had primary ACL reconstruction to determine the time to early functional milestones over the first 12 weeks after an ACL reconstruction.