摘要:

ObjectiveTo compare pathology in knees with an anterior cruciate ligament (ACL) injury as a result of a jumping mechanism with knees injured from a nonjumping mechanism.DesignThis was a prospective study of 263 consecutive patients with a complete ACL tear and no subsequent giving way episodes nor reinjuries prior to undergoing an ACL reconstruction. The patients were placed into one of two groups: those with knees injured as a result of a jumping injury, and those with knees injured as a result of a nonjumping injury.SettingThis study was performed at the Cleveland Clinic Foundation, Cleveland, Ohio.PatientsAnterior cruciate ligament-deficient knees undergoing ACL reconstruction. Two hundred thirty-eight (91%) of the patients were injured while participating in sports.Main Outcome MeasuredIntra-articular pathology documented prospectively at the time of arthroscopy.ResultsKnees injured as a result of a jumping mechanism had a higher incidence of medial (p = 0.05) and lateral (p = 0.03) meniscal tears and a lower incidence of medial collateral ligament injuries (p = 0.05). No difference in arthroscopic articular cartilage injuries was seen between the two groups.ConclusionsWe believe that identifying jumping as a mechanism of ACL tears is important, since a jumping mechanism is associated with a significantly increased meniscus tear rate and may predispose this population to future degenerative changes.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe object of this study was to find what degenerative changes are present in the ankle (talotibiofibular) joints in former elite high jumpers at least 10 years after their retirement from competition, whether there are differences between takeoff and swinging leg, and whether correlations between any particular training history parameters, former injuries, and the degenerative changes can be recognized.DesignA cross-sectional case control study with matched controls for radiological outcomesSettingThe Orthopedic Department at the University of Heidelberg, Germany.ParticipantsThe subjects were 40 male high jumpers (required personal best at least 2.18m), featured in the lists of top athletes kept by the German Athletics Association (DLV) from 1972 to 1986. All radiological findings were compared with X-rays of male age, and BMI-matched controls.Main Outcome MeasurementsAll underwent clinical and radiological examinations. In addition to eliciting data on the training history with the aid of a questionnaire, we assessed symptoms affecting the ankle by means of the Freiburg Ankle Score and the Kitaoka Score and scored the radiological findings according to Bargon and Scranton and MacDermott.ResultsDifferences between takeoff and swinging leg were small (Freiburg takeoff leg 93/swinging leg 95, Kitaoka takeoff 89/swinging leg 93 points on a 100 points scale) in both clinical scores, but statistically significant (p < 0.005). The more jumps were performed during the active phase, the worse the radiological scores (rs= 0.4, p = 0.01). Radiological differences between takeoff and swinging leg were not found. Comparison with controls revealed no radiological differences between athletes and age- and BMI-matched men (all p-values >0.40). It was found that one takeoff and one swinging leg ankle was affected by grade 2 arthritis (Bargon). Scranton grade 3 was found in four takeoff and in three swinging legs. No further correlations with training history data were found. Athletes who reported injuries in the past tended to have poorer radiological scores, although statistically not significant. None of the athletes had an instable ankle.ConclusionsThe talotibiofibular joints in former high jumpers showed only slight signs of wear and tear with no clinically relevant side-related differences; severe arthrosis with narrowing of the joint space was rare. The risk of arthrosis connected with high-jumping seems not to be elevated.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo evaluate sensitivity, specificity, reproducibility, and predictive value of palpation of the painful arc sign and of the Royal London Hospital test in 10 patients with Achilles tendinopathy and in 14 asymptomatic subjects.DesignTest-retest study.SettingUniversity teaching hospital.ParticipantsTen male athletes on the waiting list for exploration of one of their Achilles tendons for tendinopathy of the main body of the tendon attended a special clinic. Each was invited to bring at least one athlete of the same sex in the same discipline aged within 2 years of themselves with no history and no symptoms of Achilles tendinopathy. A total of 14 controls were thus recruited.Main Outcome MeasuresPain and tenderness following performance of palpation, the painful arc sign, and the Royal London Hospital test.ResultsThere were no statistically significant differences at the 5% level among the effects of investigator or between morning and afternoon measurements for any of the three measurement methods. There was no evidence of a difference of the three assessment methods (p > 0.05). When the three methods were combined, the overall sensitivity was 0.586 (confidence interval [CI], 0.469–0.741), and the overall specificity was 0.833 (CI, 0.758–0.889).ConclusionsIn patients with tendinopathy of the Achilles tendon with a tender area of intratendinous swelling that moves with the tendon and whose tenderness significantly decreases or disappears when the tendon is put under tension, a clinical diagnosis of tendinopathy can be formulated, with a high positive predictive chance that the tendon will show ultrasonographic and histologic features of tendinopathy.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveWe studied the effects of home interferential current therapy (IFC) on postoperative pain, range of motion, and edema in subjects undergoing anterior cruciate ligament (ACL) reconstruction, menisectomy, or knee chondroplasty.DesignRandomized, double-blind, placebo-controlled prospective study.SettingA tertiary care outpatient orthopaedic clinic/ambulatory surgery center.Subjects or ParticipantsEighty-seven subjects were separated into three groups based on their type of knee surgery and within each group randomized into a treatment or placebo group.InterventionsAll subjects received home IFC units. Subjects randomized to treatment group received a working IFC unit. Placebo subjects received units that were previously set to deliver no current.Main Outcome MeasurementsPost-operative edema at 24, 48, and 72 hours, and weeks 1-8; range of motion at 1, 3, 6, and 9 weeks; pain immediately after surgery, at 24, 48, and 72 hours, and weeks 1-7; and amount of pain medication taken at days 1-10 were compared between treatment and placebo groups.ResultsAll IFC subjects reported significantly less pain and had significantly greater range of motion at all post-operative time points. ACL and menisectomy IFC subjects experienced significantly less edema at all time points, while chondroplasty subjects experienced significantly less edema until 4 weeks postoperatively.ConclusionsThese findings indicate that home IFC may help reduce pain, pain medication taken, and swelling while increasing range of motion in patients undergoing knee surgery. This could result in quicker return to activities of daily living and athletic activities.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo prospectively examine recovery of cognitive function within one month following subconcussive sports related head trauma.DesignA prospective study of New York State licensed professional boxers who underwent testing of cognitive functioning before and after (within days, one week, and one month) a professional bout.SettingMale professional athletes recruited from the New York State Athletic Commission and local boxing gyms.ParticipantsTwenty-six licensed professional boxers were enrolled in the protocol. Data is presented on the 18 participants who completed testing on at least three of the four time points.InterventionsSerial neuropsychological assessment before and after the athletes engaged in competition.Main Outcome MeasuresNeuropsychological measures of cognitive functioning, including new learning and memory, information processing speed, and mental flexibility.ResultsA series of repeated measures MANOVAS revealed significant within subject differences across testing on complex information processing and verbal fluency. Post hoc analyses indicated significant differences between time 1 (baseline) and time 4 (one month post), with scores one month following the bout indicating significantly improved performance. Memory scores did not change significantly across testing; however, prior boxing exposure measured by total number of professional bouts was associated with poorer memory performance.ConclusionsCognitive testing one month following participation in a professional boxing bout yielded scores suggestive of recovery to a level above the baseline. We conclude that baseline assessment taken during periods of intense training are likely confounded by other pre-bout conditions (i.e., sparring, rapid weight loss, pre-bout anxiety) and do not represent true baseline abilities. Instability of performance associated with mild head injury may complicate the interpretation of post-injury assessments. Practice effects may also confound the interpretation of serial assessments, leading to underestimation of the effects of sports related head trauma. Poorer cognitive performance was evident during the presumed recovery period in boxers with greater exposure to the sport (>12 professional bouts). This finding is consistent with reports of a cumulative effect of repetitive head trauma and the subsequent development of chronic traumatic brain injury. These data have implications for assessing recovery of function following head injury in players of other contact sports as well as determination of return-to-play following an injury.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo determine the repeatability of a computerized cognitive test designed to monitor recovery from concussion and assist team physicians make return to play decisions (CogSport™). To determine the correlation between CogSport and two conventional neuropsychological tests.DesignProspective, serial investigation of cognitive function.SettingProfessional and semi-professional Australian Football clubs and a university affiliated research institute in Melbourne, Australia.ParticipantsThree-hundred healthy young adults, including 240 elite athletes.Main Outcome MeasuresIntra-class correlation (ICC) coefficients for CogSport performance measures administered serially. ICC between CogSport performance measures and conventional neuropsychological tests. Normative data for CogSport performance measures.ResultsMeasures of psychomotor function, decision making, working memory and learning were highly reliable. Some measures also displayed high correlations with conventional neuropsychological tests of information processing and attention. Preliminary normative data is described.ConclusionsCogSport is a highly reliable cognitive function test when administered to healthy young adults and elite athletes. CogSport measures similar cognitive functions as conventional tests used commonly in concussion research.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

During the Olympic Games held in Sydney in September, 2000 Doping Control was undertaken as specified in the International Olympic Code. During this process information about the medications taken by athletes was collected as a routine and formed part of the paperwork associated with a urine test. In their Post Games Report the World Anti-Doping Agency (WADA) recommended that the information about medications be collated with a view to assessing their use by athletes.Mandatory doping control for winners of events as well as random selection of athletes both during competition and out of competition allowed data to be collected about medications and supplements used by athletes. At the Doping Control Stations all competitors selected for a test, after providing a urine sample for analysis, were asked the same question: “what medications have you taken in the past three days?” The answer was to include all prescription drugs, over-the-counter medications, any other substances taken by mouth, injection, inhalation, ointment or by suppository, as well as vitamins, minerals, and all other supplements.This paper reviews the data from the 2758 Declaration Forms obtained at doping control. The prevalence of use of medications, the number used by an individual, and the pattern of use by these elite sports people were examined.The trends seen in this survey point to a dangerous overuse of nonsteroidal anti-inflammatory agents and an unnecessary overuse of vitamins in this population, while pointing out the increased prevalence of asthma and the dangers of drug interactions.ObjectiveThe main objective here is to review some of the medications used by athletes in the Olympic Games in Sydney 2000.Data SourcesDuring these Games Doping Control was undertaken as specified by the International Olympic Committee. As well as a urine test, information about medications routinely taken was collected. Mandatory doping control for winners of events as well as random selection of athletes both during competition and out of competition required data to be collected about medications and supplements used by athletes as part of the sample collection protocol. At the Doping Control Stations all competitors selected for a test, after providing a urine sample for analysis, were asked the same question: “what medications have you taken in the past three days?” The answer was to include all prescription drugs, over-the-counter medications, any other substances taken by mouth, injection, inhalation, ointment or by suppository, as well as vitamins, minerals, and all other supplements.Data SelectionIn this article we review the data from the laboratory copy of the 2758 Declaration Forms obtained at doping control. The cut down version of the Declaration Form submitted to the laboratory had all information identifying the athlete removed. Thus all information used in this article is completely anonymous. The prevalence of use of medications, the number used by an individual, and the pattern of use by these elite sports people were examined at the request of the IOC.ConclusionsIn their Post-Games Report, the World Anti-Doping Agency (WADA) acting as independent observers of the anti-doping process recommended to the IOC that the information obtained in the Athlete Declaration Forms concerning medications be collated with a view to assessing their use by athletes. The trends in their use seen in this survey point to an overuse of supplements as well as a dangerous overuse of drugs such as nonsteroidal anti-inflammatory agents together with multiple drug use emphasising the dangers of drug interactions and points out the increased prevalence of asthma in this population.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo report on the incidence, identify the risk factors, and clarify the clinical manifestations of acute hyponatremia in marathon runners.DesignAn observational and retrospective case-controlled series.SettingThe medical care area of the 2000 Houston Marathon.PatientsMarathon finishers treated in medical area receiving intravenous fluids (N=55), including a more detailed analysis of 39 runners completing a retrospective questionnaire.Main Outcome MeasuresVital signs, serum electrolytes, and finish time were analyzed via ANOVA studies between all non-hyponatremic (NH: N=34)) and hyponatremic (H: N=21)) runners. Fluid intake, training variables, NSAID use, and Symptomatology were further analyzed to delineate all significant differences between groups.ResultsThere were no significant differences in vital signs, training variables, or NSAID use between H and NH groups, although there was a trend towards the less experienced runners presenting with lower post-race sodium levels. H runners had lower potassium [K] (p=.04), chloride [Cl] (p<.001), and blood urea nitrogen [BUN] (p=.004) levels than NH runners. There was a significant inverse linear relationship between both finish time versus [Na] (r2=.51) and total amount of fluid ingested versus [Na] (r2=.39). The total cups of water (p=.004), electrolyte/carbohydrate solution (p=.005) and total amount of fluid ingested (p<.001) were significantly higher in H compared to NH runners and the degree of hyponatremia was related in a dose dependant manner. Vomiting was observed more frequently in H than NH runners (p=.03).Conclusion21 runners presented to the medical area of the Houston Marathon with hyponatremia (.31% of entrants). Excessive fluid consumption and longer finishing times were the primary risk factors for developing this condition. Vomiting was the only clinical sign differentiating hyponatremia from other conditions that induce exercise-associated collapse.

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1050-642X    

出版商:OVID    

年代:2003

数据来源: OVID