摘要:

ObjectiveTo identify the approaches to management of anterior cruciate ligament (ACL) injury by Canadian orthopedic surgeons.MethodsA questionnaire was mailed to 234 physicians randomly chosen from the Canadian Orthopaedic Association directory to obtain the following information: 1) how orthopaedic surgeons diagnose acute hemarthroses; 2) how patients in any of three common ACL injury scenarios would be managed; 3) what variations exist in surgical technique; and 4) how patient variables such as age, gender, and alignment influence the decision-making process.ResultsThe return rate was 72%, and 56% of respondents were from academic centers. Patients such as those described in the protocol are routinely managed by 80% of the respondents. The diagnosis of acute hemarthrosis is predominantly made by means of clinical examination and radiographs. Magnetic resonance imaging (MRI) is used occasionally by 43% and routinely by 6% of those who responded; arthroscopy is used routinely by 24%. For the competitive athlete with a complete ACL tear, 64% would recommend reconstruction and 33% would recommend bracing and rehabilitation. For reconstruction, 59% would use bone–patellar tendon–bone (B-PT-B) autograft and 32% would use hamstring tendon autograft; 40% would incorporate the ACL stump during reconstruction. Of the respondents, 77% would advocate ACL reconstruction for competitive athletes with chronic ACL injury. Of these, 63% would use B-PT-B autograft and 27% would use hamstring tendons. If bracing and rehabilitation failed, 98% would recommend ACL reconstruction. In ACL reconstruction, synthetic augmentation would be used by 12% in chronic cases and by 16% in acute cases. In making the decision to perform ACL reconstruction, 53% consider limb alignment to be important and 67% consider moderate patellofemoral pain to be important. Seventy-one percent are influenced by patellofemoral pain when choosing a surgical technique, with a trend toward semitendinosis autograft rather than B-PT-B autograft reconstruction. For the 8-year-old child with an acute ACL injury, 63% of the respondents would recommend rehabilitation and bracing. For the 14-year-old, 45% would recommend rehabilitation and bracing and 37% would recommend ACL reconstruction after physeal closure.ConclusionThe results of the survey indicate that, with respect to some of the issues, there is a wide variation in management of acute and chronic ACL injuries among Canadian orthopedic surgeons. Future research and randomized, controlled clinical trials should be directed toward these areas.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo determine the relationship of previous lower extremity (LE) injury and/or low back pain (LBP) on hip abduction and extension strength.DesignCohort study of college athletes at time of preparticipation screening physical.SettingAn NCAA Division I college.ParticipantsTwo hundred ten college athletes (140 males and 70 females) from an NCAA Division I school.Main Outcome MeasuresMean and maximal hip abduction and extension strengths were recorded using a specially designed dynamometer anchoring station. Previous injury to the LE or LBP in the past year was recorded via personal interview at the time of screening and verified by review of previous injury records.ResultsA significant difference in side-to-side symmetry of maximum hip extension strength was observed in female subjects who reported LE injury or LBP as compared to those who did not. Side-to-side difference in hip strength, however, did not differ between male athletes, regardless of reported LE injury or LBP status.ConclusionFemale athletes appear to have a differing response of the proximal hip musculature to LE injury or LBP, as compared with their male counterparts. Research is under way to further validate these findings.Clinical RelevanceThis study provides some reasoning to support the screening of hip strength during the preparticipation physical, as it may be important in the prevention of LE injury and LBP in collegiate athletes.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo determine the effect of a 12-month intensive ballet training regimen on hip and ankle range of motion in male and female, first-and second-year professional dancers.Design12-month longitudinal follow-up.SettingNational classical ballet school in Australia.Participants28 female and 20 male full-time ballet students with a mean ± 1 SD, ages 16.8 ± 0.8 and 17.7 ± 1.2 years, respectively.Main Outcome MeasuresDegrees of range of motion of left and right sides for the following movements: standing plié in parallel–passive ankle dorsiflexion (DF); standing turnout in the balletic first position—lower leg external rotation (LLER); supine hip external rotation (ER); supine hip internal rotation (IR). An additional range of motion was calculated: external rotation below the hip joint (BHER) derived by subtracting hip ER from LLER.Main ResultsIn all subjects combined, hip and ankle ranges increased statistically on the right. However, the amount was generally minimal and most at the borderline of the amount of error associated with the measurement tool. While there was no change in LLER, there was a decrease in BHER. There were no overall gender differences, and year differences existed only for left hip ER and total hip ER with first-year dancers showing significant improvements in these ranges. For DF and sum of hip IR, first-year males and second-year females had increases in range. There was a negative relationship between baseline range and the amount of change over the 12 months.ConclusionsDancers ages 16–18 years who enter full-time ballet training did not augment their ankle dorsiflexion to any appreciable degree. Some, but certainly not all, increased their hip active external rotation over 12 months without increasing their total lower limb turnout. Hip ER was more likely to improve in the first-year rather than second-year student in this elite full-time training school.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe main objective of this study was to prospectively examine the acute effects of heading in soccer on cognitive function.DesignThis was a prospective cross-over study using a brief neuropsychological battery to assess cognitive function. The tests were performed before and after two separate practice sessions, with athletes serving as their own controls.SettingMale and female Division I college athletes.ParticipantsMembers of the men's and women's varsity collegiate Penn State University soccer teams. Forty-four males and 56 females entered and finished the study. All athletes had a normal physical examination.InterventionsBefore and after both practice sessions, all athletes had a brief battery of neuropsychological tests and a symptom checklist.Main Outcome MeasuresNeuropsychological tests symptom checklist compared at baseline with those after the practice sessions.ResultsThere were no significant differences in pretest scores between groups and no difference on posttest scores between heading and nonheading groups. A significant difference was detected using MANOVA (p = < 0.001) between pre-and posttest scores for measures of attention and concentration, indicating a practice effect. A gender-specific effect in one test measuring attention and concentration was found. There was no difference in symptoms before and after heading as compared with exertional controls.ConclusionsIn this study, soccer players heading the ball does not appear to lead to acute changes in cognitive function as assessed by a brief neuropsychological battery. There are practice effects that occur with repetitive neuropsychological testing and gender differences with certain tests.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo determine the incidence rate of injury among high school cross country runners over a 15-year period.DesignProspective–longitudinal.SettingTwenty-three high schools in western Washington State under the surveillance of the University of Washington Athletic Health Care System between 1979–1994.ParticipantsOne hundred and ninety-nine cross country teams.Main Outcome MeasureInjuries resulting from running in a cross country practice or meet.ResultsThere were 1,622 injuries for an overall injury rate of 13.1/1,000 athletic exposures (AEs), i.e., participation of a runner in a practice or meet. Girls had a significantly higher overall injury rate (16.7/1,000 AEs) than boys (10.9/1,000 AEs) (p < 0.0001). Girls also had significantly higher injury rates than boys for both initial (p < 0.0001) and subsequent injuries (p < 0.0001), especially those at the same body location (p = 0.0001). This difference in risk estimates was consistent over a 15-year period. Nearly three-fourths of the injuries resulted in ≤4 days of disability. Overall, higher rates of initial injuries were reported during practices (9.2/1,000 AEs) than in meets (7.8/1,000 AEs) (p = 0.04). Shin injuries had the highest overall rates of new injury (1.9/1,000 AEs) and reinjury at the same body location (53.9/1,000 AEs). Girls had significantly higher initial injury rates than boys for shin (p < 0.0001), hip, and foot injuries (p < 0.01), and higher reinjury rates for knee, calf, and foot injuries, respectively (p < 0.05).ConclusionThe results of this study suggest that girl cross country runners are at higher risk of injury and reinjury than boy cross country runners.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo study risk factors for injury in karate and to establish safety recommendations.DesignCross-sectional survey of karate injuries.SettingShotokan karate clubs in Boston, Massachusetts, Dallas, Texas, and Winnipeg, Manitoba, Canada.ParticipantsAll athletes training at each club received surveys. A total of 114 surveys were analyzed (74% response rate).Main outcome measuresPresence of injuries (requiring any time off from practice), major injuries (requiring at least 7 days off), and multiple injuries (3 or more injuries).ResultsNo statistically significant differences were found with respect to sex. For all outcomes, karateka younger than 18 years of age had fewer injuries. The number of karateka with injuries and with multiple injuries increased with belt rank until brown belt, then reached a plateau. Brown and black belts had a greater frequency of major injuries than the lower ranks. Training more than 3 hours per week correlated with an increase in injuries, major injuries, and multiple injuries.ConclusionShotokan karate appears to be a safe sport, especially for those younger than 18 years of age. Risk of injury increases significantly when younger karateka of any rank or older karateka of lower ranks train more than 3 hours per week; therefore, to reduce the risk of injury to less than 50%, weekly training should be limited to a maximum of 3 hours in these groups.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveSedative hypnotics are used by athletes to alleviate precompetition anxiety and insomnia. The effects of these agents on exercise tolerance have not been extensively researched.DesignTo determine the effects of sedative hypnotics on psychomotor and physical performance, a double-blind, placebo- (P) controlled, cross-over designed trial investigated the effects of zopiclone (Z) and loprazolam (L) on performance in 12 athletes.InterventionSubjects ingested either P, Z (7.5 mg), or L (2 mg) on three different occasions separated by a 1-week washout period. Eye–hand coordination tests, a 30-m sprint test, an agility test, and a graded treadmill run to exhaustion for determination of VO2maxwere performed 10 hours after drug administration.ResultsSubjects reported a significantly greater hangover effect following ingestion of L (8/11 subjects) compared with ingestion of Z (3/11 subjects; p < 0.01). A greater number of subjects felt alert after ingestion of P (9/11 subjects) and Z (9/11 subjects) compared with L (4/11 subjects; p < 0.01). The results of the eye–hand coordination tests, the 30-m sprint, the T-test, the VO2max, and the time to exhaustion during the treadmill run were not significantly altered following the ingestion of P, Z, and L. There was a significant difference between the delta values for Z and L for the number of missed responses in the eye–hand coordination tests (p < 0.02). Therefore, following the ingestion of L, subjects experienced a significant hangover effect and altered reaction time, whereas the ingestion of Z did not significantly impair either psychomotor or physical performance in the administered tests.Clinical RelevanceInvestigate the extent of the effects of sedative hypnotics on exercise performances, enabling team physicians to prescribe such drugs to the athlete more effectively.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo establish whether there was a relationship between the total accumulated distances of racing in veteran runners and the neuromuscular efficiency of the quadriceps muscles before and after a downhill run.SettingUniversity of Cape Town, Sports Science Institute of South Africa.ParticipantsTwenty male veteran long distance runners (45–50 years of age) with a range of training (1,300 km to 111,280 km) and racing (0 km to 9,737 km) experience.InterventionA 40-minute downhill run (−10% decline) on a treadmill, at a speed corresponding to 70% of the subject's peak treadmill running speed.Main Outcome MeasuresThe difference between integrated electromyography (IEMG)/mean force over a 5 s maximal voluntary isometric contraction before and after the downhill run was calculated as the delta (&Dgr;) neuromuscular efficiency. This was related to the total kilometers trained, current training distance, total kilometers raced, and number of races > 56 km. The difference in drop jump height before and after the downhill run was measured as well as changes in heart rate throughout the run.ResultsThere was a significant curvilinear relationship between the &Dgr; neuromuscular efficiency and total kilometers raced (R2= 0.53, p < 0.05), and a significant inverse relationship between &Dgr; neuromuscular efficiency and the number of races > 56 km (r= −0.50, p < 0.05). Drop jump height decreased after the downhill run, and heart rate increased during the run.ConclusionsRunners who have raced an accumulated distance of > 5,000 km show a significant dissociation in the &Dgr; neuromuscular efficiency after a downhill run, compared with less experienced runners. Although possible causes for the dissociation are discussed, further research is needed.

ISSN:1050-642X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo study fluid and sodium balance in two ultradistance triathletes.DesignProspective case study.SettingAn ultradistance triathlon (3.8 km swim, 180 km cycle, 42.2 km run), and during overnight recovery. Ambient air temperature at 12:00 p.m. race day was 21°C, with a relative humidity of 91%. Water temperature was 20.7°C.SubjectsTwo female ultradistance triathletes, ages 30 and 39 years, who were participating in a larger study investigating weight and electrolyte changes in the Ironman triathlon.InterventionsNone.Main Outcome MeasuresSubjects were weighed and had blood drawn for serum sodium concentration, hemoglobin, hematocrit, arginine vasopressin, and aldosterone concentration prior to and after the race, and at 8:00 a.m. the following morning. Sodium and fluid intake and urinary output were measured during recovery.ResultsBoth subjects developed mild hyponatremia (Na 131 and 130 mmol/L) during the race, with a weight gain (0.5 and 1.5 kg). Neither subject had large sodium losses (24 mmol and 20 mmol). Fluid consumption was 733 ml/h and 764 ml/h. Plasma volume increased during the race (25 and 16%). Arginine vasopressin (AVP) levels were not elevated in either subject (1.2 and 1.9 pmol/L). Both subjects demonstrated a water excess during the race (1.5 and 2.5 L), and lost weight during recovery (2.0 and 4.5 kg).ConclusionsHyponatremia resulted from fluid retention in the extracellular space, without evidence of large sodium losses or inappropriate AVP secretion.

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