ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation.DesignRandomized, controlled, double-blind study.SettingSports medicine center in a tertiary care center.Participantsubjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old.Interventions19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated.Main Outcome MeasuresOutcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks.ResultsThere were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales.ConclusionA corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo determine clinical outcome and graft survivorship in patients undergoing autologous chondrocyte implantation (ACI) for the repair of chondral defects of the knee.DesignProspective cohort study.Setting19 centers in the United States.Patients50 patients (37 males, 13 females). Mean age was 36 years (range: 19–53). Defects were grade III or IV with a mean size of 4.2 cm2. All patients had a minimum of 36 months postoperative follow-up.Main Outcome MeasurementsClinician and patient evaluation based on the modified Cincinnati Knee Rating System. Graft failure was defined as replacement or removal of the graft due to mechanical symptoms or pain.ResultsClinician and patient evaluation indicated median improvements of 4 and 5 points, respectively, at 36 months following ACI (p < 0.001). Previous treatment with marrow stimulation techniques and size of defect did not impact the results with ACI. The most common adverse events reported were adhesions and arthrofibrosis and hypertrophic changes. Three patients had graft failure and required reimplantation or treatment with alternative cartilage repair techniques. Kaplan-Meier estimated freedom from graft failure was 94% at 36 months postoperatively (95% CI = 88–100%).ConclusionsThese results of this study indicate excellent graft survivorship using ACI as well as substantial improvement in functional outcome.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveWe hypothesized that athletes with chronic anterior exertional compartment syndrome (CAECS) would demonstrate an impairment in deep peroneal nerve function, as determined by electrodiagnostic studies or neuromuscular examination, either at baseline as compared with control athletes or after exercise.DesignProspective, controlled study comparing athletes with CAECS to asymptomatic athletes.SettingOutpatient, academic practice.ParticipantsTen athletes with CAECS were recruited sequentially over 1 year from an outpatient academic practice; diagnosis was confirmed by history, physical examination, and compartment pressure testing. Ten similarly aged control athletes were recruited from the surrounding facility.InterventionRepetitive dorsiflexion exercise to the point of typical symptoms (CAECS subjects) or fatigue (control subjects).Main Outcome MeasuresDeep peroneal nerve conduction study velocity and amplitude; neuromuscular examination in the deep and superficial peroneal distributions.ResultsControl subjects demonstrated a significant increase in peroneal motor amplitudes postexercise as compared with preexercise (6.3 ± 2.2 mV preexercise to 8.2 ± 3.1 mV postexercise; p = 0.033), but the CAECS subjects did not (8.8 ± 2.6 to 8.9 ± 2.1; p = 0.89). At baseline and postexercise, the subjects with CAECS demonstrated decreased vibratory sensation compared with the controls (p = 0.030 at baseline and 0.045 postexercise).ConclusionsAthletes with CAECS demonstrate a decreased postexercise potentiation of the peroneal motor amplitude and a mild impairment in vibratory sensation; these findings may contribute to their sense of poor foot and ankle control. Further study is necessary before the absence of postexercise potentiation of the peroneal motor amplitude may be considered a diagnostic sign of CAECS.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveA pilot study to examine the incidence and characteristics of concussions for one season of university football and soccer.DesignRetrospective survey.Participants60 football and 70 soccer players reporting to 1998 fall training camp. Of these, 44 football and 52 soccer players returned a completed questionnaire.Main Outcome MeasuresBased on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous season, the duration of symptoms, the time for return to play and any associated risk factors for concussions.ResultsOf all the athletes who returned completed questionnaires, 34.1% of the football players and 46.2% of the soccer players had experienced symptoms of a concussion during the previous season. Only 16.7% of the concussed football players and 29.2% of the concussed soccer players realized they had suffered a concussion. All of the concussed football players and 75.0% of the concussed soccer players experienced more than one concussion during the season. The symptoms from the concussion lasted for at least 1 day in 28.6% of the football players and 18.1% of the soccer players. Variables that increased the odds of suffering a concussion during the previous season for football and soccer players included a past history of a recognized concussion.ConclusionMore university soccer players than football players may be experiencing sport related concussions. Variables that seem to increase the odds of suffering a concussion during the previous season for football and soccer players include a history of a recognized concussion. Despite being relatively common, many players may not recognize the symptoms of a concussion.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo examine the potential contribution of neurologic influences on hamstring length during passive range of motion.DesignProspective study.SettingsAcademic sports medicine center.Patients15 subjects undergoing arthroscopic surgery for unilateral knee injuries without previous injury to the contralateral knee.InterventionsSubjects received: 1) spinal anesthesia with bupivacaine, 2) epidural anesthesia with lidocaine, 3) general anesthesia, or 4) femoral nerve block of injured leg only.Main Outcome MeasuresNoninjured leg popliteal angle preoperatively, intraoperatively under anesthesia, and postoperatively after recovery from anesthesia.ResultsThe overall mean popliteal angle was 132.5 ± 3.1° preoperatively, 134.31 ± 11.6° intraoperatively, and 130.7 ± 10.2° postoperatively. Overall, the intraoperative angle was significantly greater than the postoperative angle (p = 0.02). The mean change in popliteal angle was 8.1 ± 2.2° (Group 1), −0.4 ± 1.9° (Group 2), 0.9 ± 1.4° (Group 3), and −2.4 ± 3.8° (Group 4). There was no significant change in pre- to postoperative popliteal angle in relation to postoperative pain. Females had a greater mean popliteal angle (139.84°) compared with males (128.84°) (p = 0.04).Clinical RelevanceUnderstanding the neuromuscular influences on muscle flexibility will assist in the development of new rehabilitative and injury preventative techniques.ConclusionThe present pilot study implicates neural contributions to muscle flexibility. Further studies are needed to delineate the relative contributions of neural and muscular components and to facilitate new techniques in the rehabilitation and prevention of injury.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo describe creatine supplementation patterns and behaviors associated with creatine supplementation in high school football players.DesignA cross-sectional, multisite, anonymous, descriptive survey was conducted between October 1999 and February 2000.Setting37 public high schools in Wisconsin.SubjectsA total of 1,349 high school football players, grades 9–12.Main Outcome MeasuresSelf-reported prevalence of creatine use, as well as perceived benefits and risks. In addition, sources of information and influence regarding creatine supplementation were assessed.Results30% of the respondents reported using creatine. Creatine use was lowest in the 9th grade (10.4%) and highest in the 12th grade (50.5%). 41% of the players at small schools stated they used creatine compared with 29% of the players in large schools. Enhanced recovery following a workout was the most likely perceived benefit of creatine supplementation, while dehydration was cited most often as a risk of creatine use. Users were encouraged to take creatine most often by their friends while their parents discouraged creatine use.ConclusionsCreatine use is widespread in high school football players. High school football players who use creatine may not be aware of the risks and benefits associated with creatine supplementation. Sports medicine professionals who work with this population need to educate athletes, coaches, and parents about the use of creatine as a performance-enhancing supplement.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo determine if steroids containing over-the-counter (OTC) dietary supplements conform to the labeling requirements of the 1994 Dietary Supplement Health and Education Act (DSHEA).Design12 brands of OTC supplements containing 8 different steroids were randomly selected for purchase in stores that cater to athletes. There are two androstenediones (4- and 5-androstene-3,17-dione), two androstenediols (4- and 5-androstene-3&bgr;, 17&bgr;-diol), and 4 more are 19-nor cogeners (19-nor-4- and 5-androstene-3,17-dione and 19-nor-4- and 5-androstene-3&bgr;, 17&bgr;-diol).Main Outcome Measures12 brands of OTC anabolic–androgenic supplements were analyzed by high-pressure liquid chromatography.ResultsWe found that 11 of 12 brands tested did not meet the labeling requirements set out in the 1994 Dietary Supplement Health and Education Act. One brand contained 10 mg of testosterone, a controlled steroid, another contained 77% more than the label stated, and 11 of 12 contained less than the amount stated on the label.ConclusionsThese mislabeling problems show that the labels of the dietary steroid supplements studied herein cannot be trusted for content and purity information. In addition, many sport organizations prohibit OTC steroids; thus, athletes who use them are at risk for positive urine test results. In this article we provide the details of the analyses, a summary of the steroids by name and structure, and information on the nature of the positive test results. Athletes and their physicians need this information because of the potential medical consequences and positive urine test results.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe increasingly dominant performance of smaller-sized female gymnasts and increased magnitude of training beginning at an early age have prompted public and medical concerns, especially from an auxological perspective. The objective of this review is to determine if gymnastics training inhibits growth of females.Data SourcesAn extensive research of MedLine (PubMed interface) along with cross-referencing was conducted using the Text and MeSH words “gymnastics” in combination with “growth,” “maturation,” “body height,” “body weight,” and “growth plate.” Our analysis is limited to English articles only.Study SelectionAll published studies that included data related to the research questions were included.Main ResultsAlthough data from three historical cohort studies indicate that female gymnasts are short even before they begin training, clinical reports and cohort studies do suggest that some female gymnasts experience attenuated growth during training followed by catch-up growth during periods of reduced training or retirement. There is conflicting evidence whether the “catch-up” is complete. There were no studies reporting prevalence or incidence of inadequate growth. Three cohort studies provide evidence of reduced growth but training was not partitioned from other confounding factors in the gymnastics environment. Although there is a paucity of studies examining the link of dietary practices with diminished growth in female gymnasts, a review of related dietary literature indicates the potential for insufficient energy and nutrient intake among female gymnasts.ConclusionsElite level or heavily involved female gymnasts may experience attenuated growth during their years of training and competition followed by catch-up growth during reduced training schedules or the months following retirement. However, a cause–effect relation between gymnastics training and inadequate growth of females has not been demonstrated.

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2001

数据来源: OVID