ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo investigate the importance of loss of consciousness (LOC) in predicting neuropsychological test performance in a large sample of patients with head injury.DesignRetrospective comparison of neuropsychological test results for patients who suffered traumatic LOC, no LOC, or uncertain LOC.SettingAllegheny General Hospital, Pittsburgh, Pennsylvania. Patients: The total number of patients included in this study was 383.Main Outcome MeasuresNeuropsychological test measures, including the visual reproduction, digit span, and logical memory subtests of the Wechsler memory scale (revised), the Trail Making test, Wisconsin Card Sorting test, Hopkins Verbal Learning test, Controlled Oral Word Association, and the Galveston Orientation and Amnesia test (GOAT).ResultsNo significant differences were found between the LOC, no LOC, or uncertain LOC groups for any of the neuropsychological measures used. Patients who had experienced traumatic LOC did not perform more poorly on neuropsychological testing than those with no LOC or uncertain LOC. All three groups demonstrated mildly decreased performance on formal tests of speed of information processing, attentional process, and memory.ConclusionThe results of this study cast doubt on the importance of LOC as a predictor of neuropsychological test performance during the acute phase of recovery from mild traumatic brain injury. Neuropsychological testing procedures have been shown to be sensitive in measuring cognitive sequelae of mild traumatic brain injury (concussion) in athletes. The failure of this study to findanyrelationship between LOC and neuropsychological functioning in a large sample of patients with mild head trauma calls into question the assignment of primary importance to LOC in grading severity of concussion. This study also does not provide support for the use of guidelines that rely heavily on LOC in making return-to-play decisions. Continued research is necessary to determine the relative importance of markers of concussion in athletes.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PurposeTo review the clinical features of a large series of active patients with a stress fracture in a non—weight-bearing location of the upper extremity or ribs.DesignMulticenter cross-sectional study.SettingMultiple academic medical centers.Participants44 patients with a diagnosis of upper extremity or rib stress fracture.Main Outcome MeasuresClinical features according to anatomic location, primary sport, and subdivided according to the nature of the sport-specific skills involved.ResultsA diagnosis of stress fracture was made in 44 patients based on history and physical examination, and confirmed by radiography, scintigraphy, magnetic resonance imaging (MRI), computed tomography (CT), or a combination of imaging techniques. Patients were subjectively divided into four categories based on the predominant type of upper extremity activity required for participation in their sport: 1) weight lifter (e.g., football, weight lifting, wrestling); 2) upper extremity weight bearer (e.g., gymnastics, diving, cheerleading); 3) thrower (e.g., pitcher, soccer goalie, javelin); or 4) swinger (e.g., golf, tennis). We noted that all fractures in the weight bearers occurred distal to the elbow, whereas in the throwers most fractures affected the shoulder girdle. Lower rib stress fractures predominated in the swingers group, whereas weight lifters had fractures located throughout the upper extremity.ConclusionStress fracture should be considered in the differential diagnosis of athletes presenting with upper extremity or rib pain of bony origin that is of insidious onset. Further study of the sport-specific patterns of injury described here may improve our ability to treat and prevent these injuries.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo examine the effects of an increased training load and period of detraining on testicular function in male distance runners.DesignMultiple-group time-series design using a control group.Setting: University of Toledo and Toledo Hospital. Participants: Eight male runners and eight age-matched sedentary control subjects. Subjects were considered fit for participation after a physical and genital examination conducted by a physician.InterventionSubjects provided blood and semen samples every 2 weeks for 8 weeks. The training regimen for the runners consisted of 2 weeks at normal training (NT), 2 weeks at 143|X% of NT (IT1), 2 weeks at 186|X% of NT (IT2), and 2 weeks at 50|X% of NT (RT). These percentages represent increases in training distance (volume).Main Outcome MeasuresWithin the context of this investigation, the following hypothesis was developed: increases or decreases in training would not significantly alter sperm count, density, motility, or morphology, or concentrations of reproductive hormones or cortisol in runners.ResultsThere were no statistically significant differences observed between runners and control subjects for any of the reproductive hormones or cortisol. In addition, there was no significant treatment effect for sperm count, motility, or morphology. The sperm levels in two runners in this investigation dropped to oligospermatic levels after IT2; however, total sperm count increased in both runners after 2 weeks of RT.ConclusionFour weeks of increased training and 2 weeks of reduced training did not significantly affect the subjects in this investigation. It is possible that a particular level or degree of training must be surpassed before any clinical alterations are evident. Future longitudinal studies are necessary to identify the extent to which endurance training may alter reproductive hormones and testicular function.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe goals of this study were to assess the health care available to Wisconsin high school football players and to assess high schools' compliance with safety requirements of the Wisconsin Interscholastic Athletic Association (WIAA).DesignThe design was a cross-sectional survey-based study.SettingThe setting consisted of WIAA high schools. Participants: Athletic directors of WIAA high school football programs participated in the survey.Main Outcome MeasuresThe main outcome measures were the prevalence of medical coverage by physicians, certified athletic trainers, and ambulance personnel at football games and practice and the prevalence of compliance with WIAA requirements.ResultsSeventy-seven percent (302/392) of surveys were returned. Thirty-six percent of schools had a designated team physician. Eighty-seven percent had a trainer, and 86|X% were certified athletic trainers (Athletic Trainer Certified, ATC). At practice and scrimmage, 79|X% had an ambulance available or on call, 52|X% had a trainer present, and 28|X% had a physician on call. At football games, 71|X% had an ambulance, 67% a certified athletic trainer, 48|X% an emergency medical technician, and 45|X% a physician present. Regarding WIAA requirements, 9|X% had no accessible phone, 27|X% had no written emergency plan of action, 92|X% had gloves, and 92|X% had blood spill kits. Larger schools had better compliance with WIAA requirements than did smaller schools.ConclusionHealth care coverage was provided mainly by trainers and ambulance personnel, although physicians were routinely present at almost half of all games. Failure to comply with WIAA medical coverage requirements was not infrequent. This study forms the basis for an informational intervention, providing an opportunity to correct deficits.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo document injuries during a 6-day track race (in which direction was reversed every 2 hours) and compare these injuries with those incurred during other ultra-marathon track and road races, and to investigate a characteristic ultra-marathon injury, tendonitis of the ankle dorsiflexors.DesignA prospective, cohort study of competitors during a 6-day race.Setting400-m grass track in Colac, Victoria.ParticipantsAll 17 competitors (16 men and 1 woman).Main Outcome MeasuresTotal numbers and percentages of specific musculoskeletal injuries.ResultsA total of 36 injuries were recorded in 11 competitors. The ankle (36|X%) and the knee (22|X%) were the regions most frequently injured. The four most common diagnoses were: Achilles tendonitis (19|X%); extensor digitorum longus tendonitis (14|X%); retropatellar pain syndrome (14|X%); and anterior compartment pain (11|X%).ConclusionAchilles tendonitis, patellofemoral pain, and tendonitis of the foot dorsiflexors are the three most common injuries in ultra-marathons of 6 days or more. Ankle injuries predominate in track races, whereas knee injuries are more common in road races. Road races are associated with higher frequency of injury to the leg on the downside of the camber. Track races have an even distribution of injury. Confirmation is presented that the characteristic ultra-marathon injury is tendonitis of the foot dorsiflexors.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo evaluate the clinical and basic science evidence surrounding the hypothesis that stretching immediately before exercise prevents injury.Data Sources and SelectionMEDLINE was searched using MEDLINE subject headings (MeSH) and textwords for English- and French-language articles related to stretching and muscle injury. Additional references were reviewed from the bibliographies, and from citation searches on key articles. All articles related to stretching and injury or pathophysiology of muscle injury were reviewed. Clinical articles without a control group were excluded.ResultsThree (all prospective) of the four clinical articles that suggested stretching was beneficial included a cointervention of warm-up. The fourth study (cross-sectional) found stretching was associated with less groin/buttock problems in cyclists, but only in women. There were five studies suggesting no difference in injury rates between stretchers and nonstretchers (3 prospective, 2 cross-sectional) and three suggesting stretching was detrimental (all cross-sectional). The review of the basic science literature suggested five reasons why stretching before exercise would not prevent injuries. First, in animals, immobilization or heating-induced increases in muscle compliance cause tissues to rupture more easily. Second, stretching before exercise should have no effect for activities in which excessive muscle length is not an issue (e.g., jogging). Third, stretching won't affect muscle compliance during eccentric activity, when most strains are believed to occur. Fourth, stretching can produce damage at the cytoskeleton level. Fifth, stretching appears to mask muscle pain in humans.ConclusionThe basic science literature supports the epidemiologic evidence that stretching before exercise does not reduce the risk of injury.

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:1999

数据来源: OVID