ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo describe an alternative method of dislocated shoulder reduction and to investigate its success rate when used at a ski resort setting.DesignA prospective observational study.SettingMedical center at Australia's largest ski resort during the ski seasons of 1994, 1995, and 1996 (June through early October). The center is a primary care private practice.PatientsThere were 199 patients with anterior dislocated shoulders who presented to the center. One patient was excluded from the study because of spontaneous reduction during clothing removal.InterventionsPatients had upper body clothing removed, were seated in a chair, and supported in a slumped position by an assistant. The medical officer then performed the reduction once relaxation was achieved. Patients were always offered Entenox (nitrous oxide).Main Outcome MeasuresSuccessful reduction of the anterior dislocated shoulder with or without analgesia. Any complications such as fractures and nerve damage were recorded.ResultsThe data were recorded by the treating medical officer. 93.2% of the subjects were successfully treated using the “slump” reduction method. The success rate on first attempt using the slump method was 85.6%. Of the remainder, four subjects were reduced by an alternative method and five were sent to hospital for reduction under general anesthesia. Four of these subjects had fractures.ConclusionThe slump method of reduction for anterior dislocated shoulders compares favorably with previously documented methods. It would seem to be a particularly useful method when parenteral analgesia is either not available or relatively contraindicated. There were no complications resulting from the use of this method, and it is a method that is easy to learn.The slump method is a safe and effective addition to the primary care physician's options in reducing an anteriorly dislocated shoulder.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo identify a significant change in the laxity of the anterior cruciate ligament (ACL) in the competitive adolescent female athlete throughout the different phases of the menstrual cycle.DesignProspective, single-blinded 8-week study set during a winter sports season.SettingSuburban Ohio Division I high school.Participants26 members of gymnastics, soccer, track, tennis, and basketball teams. All participants were screened for normal menstrual cycles (26–30 days, menses 4–7 days long).Main Outcome MeasuresKT-1000 arthrometer was used to measure laxity by performing repeated measures throughout an 8-week period. Measurements were taken before the athletes' workouts. The athlete charted the menstrual periods on a monthly calendar. The measurements were then grouped into the three phases of the menstrual cycle (follicular, ovulatory, and luteal) and averaged.ResultsRight knee laxity measured 4.98 mm follicular phase, 5.24 mm ovulatory, and 5.09 mm luteal. Left knee laxity measured 4.51 mm follicular, 4.43 mm ovulatory, and 4.62 mm luteal. There was no statistical difference among the three phases in the left (p = 0.9) and right (p = 0.7977). Additionally, left ACL laxity was significantly less in all three phases. We found no statistically significant variability in laxity among the five sports sampled (p > 0.63 to 0.10) and different ages (p = 0.404)ConclusionsWe found an insignificant change in ACL laxity from follicular to luteal phases of the menstrual cycle. This indicates that no single phase of the menstrual cycle clinically affects the ACL more than the next. Although the presence of sex hormones—particularly estrogen—may indeed predispose females to higher ACL injury rates, we did not find any evidence that hormonal level changes equate with significant ACL laxity changes. We conclude that the menstrual cycle does not significantly affect ACL laxity in the competitive adolescent female athlete.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo examine hip abductor strength in long-distance runners with iliotibial band syndrome (ITBS), comparing their injured-limb strength to their nonaffected limb and to the limbs of a control group of healthy long-distance runners; and to determine whether correction of strength deficits in the hip abductors of the affected runners through a rehabilitation program correlates with a successful return to running.DesignCase series.SettingStanford University Sports Medicine Clinics.Participants24 distance runners with ITBS (14 female, 10 male) were randomly selected from patients presenting to our Runners' Injury Clinic with history and physical examination findings typical for ITBS. The control group of 30 distance runners (14 females, 16 males) were randomly selected from the Stanford University Cross-Country and Track teams.Main Outcome MeasuresGroup differences in hip abductor strength, as measured by torque generated, were analyzed using separate two-tailedt-tests between the injured limb, noninjured limb, and the noninjured limbs of the control group. Prerehabilitation hip abductor torque for the injured runners was then compared with postrehabilitation torque after a 6-week rehabilitation program.ResultsHip abductor torque was measured with the Nicholas Manual Muscle Tester (kg), and normalized for differences in height and weight among subjects to units of percent body weight times height (%BWh). Average prerehabilitation hip abductor torque of the injured females was 7.82%BWh versus 9.82%BWh for their noninjured limb and 10.19%BWh for the control group of female runners. Average prerehabilitation hip abductor torque of the injured males was 6.86%BWh versus 8.62%BWh for their noninjured limb and 9.73%BWh for the control group of male runners. All prerehabilitation group differences were statistically significant at the p < 0.05 level. The injured runners were then enrolled in a 6-week standardized rehabilitation protocol with special attention directed to strengthening the gluteus medius. After rehabilitation, the females demonstrated an average increase in hip abductor torque of 34.9% in the injured limb, and the males an average increase of 51.4%. After 6 weeks of rehabilitation, 22 of 24 athletes were pain free with all exercises and able to return to running, and at 6-months follow-up there were no reports of recurrence.ConclusionsLong distance runners with ITBS have weaker hip abduction strength in the affected leg compared with their unaffected leg and unaffected long-distance runners. Additionally, symptom improvement with a successful return to the preinjury training program parallels improvement in hip abductor strength.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo evaluate outcomes in patients who had a fasciotomy performed on their leg(s) for chronic exertional compartment syndrome (CECS).DesignA retrospective descriptive cohort study.SettingTertiary care sport medicine referral practice.PatientsA consecutive series of 62 patients surgically treated for CECS from January 1991 to December 1997.Main Outcome MeasuresA questionnaire was designed and developed to assess pain (using a 100 mm visual analogue scale), level of improvement, level of maximum activity, satisfaction level, and the occurrence of reoperations.ResultsFifty patients had anterior/lateral compartment involvement, 8 patients had deep posterior compartment involvement, and 4 patients had anterior/lateral/deep posterior compartment involvement. The demographics of the 39 respondents and 23 nonrespondents were similar. The mean percent pain relief of respondents was 68% (95% CI [confidence interval] = 54% to 82%). There was no relationship between percent pain relief and the documented immediate post exercise compartment pressures. A clinically significant improvement was reported by 26 of 32 (81%) anterior/lateral compartment patients and 3 of 6 (50%) patients with deep posterior compartment involvement. Patient level of activity after fasciotomy was classified as equal to or higher than before the operation with a lesser degree of pain by 28 of 36 (78%) patients, while 8 of 36 (22%) patients reported lower activity levels than before the operation. Of the patients reporting lower activity, seven were due to exercise related pain in the post operative leg(s) and one was due to lifestyle changes. Thirty of 38 patients (79%) were satisfied with the outcome of the operation. Four of 62 patients (6%) failed the initial surgical procedure and required revision surgery for exercise-induced pain. In addition, one of these individuals also had a sympathectomy and another had a neurolysis performed at the time of revision surgery. Three of the 62 (5%) patients had subsequent operations for exercise-induced pain on different compartments than the initial surgical procedure. One individual had an unsuccessful operative repair of a posttraumatic neuroma. Postoperative complications were reported by 5 of 39 (13%) patients in the additional comments section of the questionnaire.ConclusionsThe majority of patients surgically treated for CECS experience a high level of pain relief and are satisfied with the results of their operation. The level of pain relief experienced by patients is not related to the magnitude of the immediate post exercise compartment pressures. Despite the possibility that some patients have less favorable outcomes, experience complications, or need subsequent operations, fasciotomy is recommended for patients with CECS as there is no other treatment for this condition.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThere have been no large studies of middle school students to assess the association between team sports participation and risk-taking behaviors, despite evidence in high school and collegiate athletes. Our study evaluated whether team sports participation is associated with specific risk-taking behaviors among a biracial middle school population.DesignA cross-sectional survey using the Youth Risk Behavior Survey: Middle School Questionnaire.SettingTwenty-two public middle schools in three rural counties in eastern North Carolina.Participants4,346 middle school students in grades 6–8 completed the survey. All students participated if present in school the day the survey was administered. 648 students fulfilled specific exclusion criteria.Main Outcome MeasureMultiple logistic regression examined team sports participation as a predictor of 17 risk-taking behaviors while controlling for gender, race, and grade.ResultsOf the 3,698 students, 49% were male, 49.5% Caucasian, and 52.5% were involved in team sports. Sports participants, as compared with non–sports participants, reported significantly higher frequencies for carrying a gun (p < 0.001), carrying a weapon (p < 0.001), being in a physical fight (p < 0.001), current use of alcohol (p = 0.001), and experimentation with cigarettes and chewing tobacco (p < 0.001). In the multiple logistic regression analysis team sports participation was associated with the following behaviors: carrying a weapon (odds ratio 1.25, 95% confidence intervals 1.0731–1.4540), physical fight (1.15, 1.0017–1.3253), current alcohol use (1.24, 1.0560–1.4611), and experimentation with cigarettes (1.26, 1.0991–1.4502), cocaine (1.37, 1.0300–1.8139) and inhalants (1.20, 1.0141–1.4130).ConclusionsAmong a biracial middle school population, sports participants were more likely to demonstrate certain risk-taking behaviors when compared with non–sports participants. Further research is necessary to understand the relationships between risk-taking behaviors and team sports participation.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo describe patterns of creatine use in select Division I collegiate athletes based on recommended dosages according to body weight. Further, to report the perceived effects noted with creatine supplementation.DesignAnonymous open-ended self-report descriptive questionnaire.SettingNational Collegiate Athletic Association Division I institution.ParticipantsTwo-hundred and nineteen male and female collegiate athletes representing eight varsity sports.Main Outcome Measure(s)An open-ended questionnaire was administered to determine patterns of creatine use during the loading and maintenance phases of this nutritional supplement. In addition, perceived positive, negative, and no effects associated with creatine usage patterns were determined from athlete responses on this self-report measure.ResultsConsidering this select group of collegiate athletes, highly variable patterns of creatine supplementation were noted for loading/maintenance phases based on recommended dosages/days and body weight. Of the 219 athletes surveyed, 90 (41%) reported using creatine, while creatine supplementation was more prevalent among men than women. Creatine users (80 athletes, 89%) reporting perceived positive effects were primarily at or below recommended dosages for the loading phase but above recommended dosages in the maintenance phase. Creatine users (34 athletes, 38%) reporting perceived negative effects were primarily at or below recommended dosages in the loading phase but noticeably above recommended dosages in the maintenance phase. Ironically, all creatine users who reported negative side effects also reported positive effects. Creatine users (10 athletes, 11%) reporting no effects were below recommended loading dosages but above recommended maintenance dosages.ConclusionsThe perceived positive effects noted support current research (strength/weight gains), while the perceived negative effects (cramping/gastrointestinal distress) were consistent with anecdotal reports surrounding creatine supplementation. Apparently, collegiate athletes in this study are in need of education regarding the proper use of creatine supplementation. Additional studies are needed to ascertain creatine supplementation patterns of collegiate athletes in various settings.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectivesMagnesium (Mg) status, although difficult to assess, is suspected to be marginal in many individuals, especially athletes, and this has led to the common use of Mg supplements. The purpose of this article is to critique research that has addressed Mg supplementation in athletes.Data SourcesThe primary database was Medline, which was searched for English articles from 1966 to June 1999 using the words “magnesium” and “supplementation.”Study SelectionOnly experimental studies dealing with human subjects, Mg supplementation, and exercise performance were critiqued (n = 12).Data ExtractionQuality of critiqued articles was based on 1) use of cross-over designs, 2) how and if Mg status was assessed, 3) whether treatment was solely Mg supplementation, 4) duration of supplementation, 5) subject number, and 6) degree of experimental control. Articles were classified into “no effect” and “positive effect,” and also were examined in regard to the type of performance outcome (strength, anaerobic–lactacid, and aerobic).Data SynthesisMg is a cofactor to over 325 enzymatic reactions, and a deficiency of the mineral therefore has many physiological and exercise performance implications. Low dietary intakes, as found in many female athletes, coupled with increased urinary losses with exercise, may eventually lead to an Mg deficiency. Strength of evidence favors those studies finding no effect of Mg supplementation, regardless of whether the performance outcome was strength, anaerobic–lactacid, or aerobic. Analysis was confounded due to: 1) variable exercise modes, intensities, and durations, 2) variable training states and ages of subjects, 3) subject selection favoring males and gender differences has not been probed, 4) Mg dosage has ranged from 1 day to 3 months and from 116 mg/day to 500 mg/day, 5) multivitamins/minerals have been ingested with the Mg, 6) with one exception,1Mg status was either not reported or reliant on total Mg (TMg), 7) lack of a cross-over design, 8) only one study2made note of controlling exercise prior to exercise testing and blood assay, and 9) typical Mg intake measured was only measured in three of the studies.ConclusionsMost evidence indicates no effect of Mg supplementation on performance (strength, anaerobic–lactacid, and aerobic). When only peak treadmill speed during a VO2max test is examined, the strength of evidence is equivocal. Trained subjects appear to benefit less than untrained subjects, but this observation requires further study. Little research has focused on physically active females who may be at the highest risk for Mg deficiency. Research has been confounded by numerous factors.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID