Clinical Journal of Sport Medicine最新文献

{"title":"Sports Medicine Physicians' Comfort and Confidence in Caring for Adaptive Athletes: A Mixed-Methods Exploratory Study.","authors":"Victoria Heasley, Melinda Earnest-Stanley, Chalee Engelhard, Annie Haley, Taryn Johnson, Wei-Wen Hsu, Renee Loftspring","doi":"10.1097/JSM.0000000000001372","DOIUrl":"10.1097/JSM.0000000000001372","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to explore the perceived ability of sports medicine physicians to effectively treat and manage the preventative and rehabilitative care of adaptive athletes.</p><p><strong>Design: </strong>Exploratory mixed-methods, survey-based study.</p><p><strong>Setting: </strong>Online, United States.</p><p><strong>Participants: </strong>The survey was conducted using a sample of 2728 physicians. A total of 286 responded to the invitation and the response rate was 10% (286 of 2728). One hundred thirty (45.5%) of 286 physicians completed the survey.</p><p><strong>Interventions: </strong>Survey.</p><p><strong>Main outcome measures: </strong>Knowledge of adaptive athlete care and perceived confidence.</p><p><strong>Results: </strong>Most respondents were willing to accept adaptive athletes into their clinical practice, and there were no significant associations between their willingness and if (χ 2 = 5.487, P = 0.139) or at what point (χ 2 = 4.463, P = 0.878) they received education about adaptive athletes. Those who received education about adaptive athletes during training reported feeling moderately to very confident in caring for adaptive athletes in an outpatient setting (χ 2 = 36.906, P < 0.001). When considering the areas of knowledge lacking to appropriately manage a competitive adaptive athlete, multiple areas named as deficits were identified. Themes centered on increasing hands-on experience, understanding of the adaptive athlete's disability and its impact on participation in adaptive sports, the physical demand of adaptive sports, and equipment.</p><p><strong>Conclusions: </strong>Our results indicate that most physicians are willing to accept adaptive athletes into their practice; however, they acknowledge more education and training is needed to feel comfortable and confident when working with this population. Further educational interventions are needed to ensure equitable care for adaptive athletes.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"280-289"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically Important Improvements Observed in Patient-Reported Outcomes 2 Years After Exercise Therapy for Patients With Isolated Supraspinatus Tendon Tears.","authors":"Adam J Popchak, Janina Kaarre, Luke T Mattar, Clair N Smith, Volker Musahl, Richard E Debski, James J Irrgang","doi":"10.1097/JSM.0000000000001387","DOIUrl":"10.1097/JSM.0000000000001387","url":null,"abstract":"<p><strong>Objective: </strong>To describe and predict patient-reported outcomes (PROs) and to investigate differences between individuals with a rotator cuff tear who were and were not successfully treated with a 12-week exercise therapy program.</p><p><strong>Design: </strong>Prospective observational cohort.</p><p><strong>Setting: </strong>Orthopedic sports medicine clinical practice settings and departments of orthopedic surgery, physical therapy, and bioengineering at the University of Pittsburgh.</p><p><strong>Participants: </strong>Eighty-two individuals, age ≥40 years with a symptomatic isolated supraspinatus tear.</p><p><strong>Interventions: </strong>Individualized 12-week exercise therapy program and longitudinal follow-ups at 3, 6, 12, and 24 months.</p><p><strong>Main outcome measures: </strong>(1) PROs: Western Ontario Rotator Cuff (WORC) index (WORC) & Numeric Pain Rating Scale (NPRS), (2) shoulder range of motion (ROM) and strength, (3) rotator cuff tear size and location, (4) glenohumeral kinematics.</p><p><strong>Results: </strong>Significant improvements in both PROs were observed at all time points when compared with baseline. At the 24-month follow-up, improvement greater than the minimally clinically important difference was noted for 78% of individuals for the WORC and 55% for the NPRS. Baseline predictors for 24-month change in WORC and an overall successful outcome were identified and included the baseline WORC score and the side-to-side difference in ROM for external rotation at 90 degrees abduction.</p><p><strong>Conclusions: </strong>Individuals with symptomatic, isolated supraspinatus tears, managed with exercise therapy, experienced clinically important improvements in self-reported disability and more than half experienced a similar improvement in pain, at a 2-year follow-up. Baseline patient-reported outcomes measures and side-to-side differences passive ROM predicted 24-month success after exercise therapy. These findings may be useful in plan-of-care decision making.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"240-248"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Physician-Recommended Early Physical Activity and Concussion Recovery Outcomes in Pediatric Patients.","authors":"Emily Plumage, Sabrina Amin, Kele Ding, Krista K Wheeler, Steven Cuff, Gary A Smith, Jingzhen Yang","doi":"10.1097/JSM.0000000000001390","DOIUrl":"10.1097/JSM.0000000000001390","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the associations between physician recommendations for early physical activity (PA) after concussion and prolonged recovery in youth.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Seven concussion clinics affiliated with a children's hospital.</p><p><strong>Patients: </strong>Youth aged 10 to 18 years diagnosed with a concussion who visited a concussion clinic within 14 days of injury.</p><p><strong>Main independent variable: </strong>Physician PA recommendations.</p><p><strong>Main outcome measure: </strong>Experiencing a prolonged recovery (yes/no).</p><p><strong>Results: </strong>Of 3249 youth included, 63.1% were males and 79.0% were White, with more than half in the 15 to 18 age group (54.6%). From 2012 to 2019, the proportion of physicians recommending light aerobic activity or noncontact PA increased from 12.6% to 62.0% and from 19.3% to 72.5% for youth seen in week 1 and week 2 postinjury, respectively. Youth who received light aerobic activity [adjusted odds ratio (aOR) = 0.37, 95% confidence interval (CI) = 0.29-0.48] or noncontact PA (aOR = 0.27, 95% CI = 0.12-0.64) recommendations had significantly lower odds of experiencing prolonged recovery than youth with recommendations for no PA. In addition, patients evaluated in the second week postinjury were more likely to experience prolonged recovery than those seen within 1 week postinjury (aOR = 2.52, 95% CI = 2.07-3.07).</p><p><strong>Conclusions: </strong>Youth who received recommendations for light aerobic or noncontact activities had a reduced likelihood of prolonged recovery compared with those recommended no PA, suggesting early PA may play a role in hastening concussion recovery in youth. Further research is needed to explore patient adherence to these prescriptions.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"231-239"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification, Prevention, and Management of Adverse Reactions Associated with the Intra-Articular Hyaluronic Acid Therapeutic Class: A Delphi Approach.","authors":"Megan Agnew, Daniel M Cushman, Stephanie Kliethermes, Jeremy Alland","doi":"10.1097/JSM.0000000000001380","DOIUrl":"10.1097/JSM.0000000000001380","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to obtain expert consensus on the identification, management, and treatment of adverse reactions associated with the use of intra-articular hyaluronic acid (viscosupplementation) in any joint.</p><p><strong>Design: </strong>A Delphi approach was used to establish expert consensus between February and October 2024.</p><p><strong>Setting: </strong>The Delphi study was conducted virtually using the Welphi survey platform and Qualtrics.</p><p><strong>Participants: </strong>An expert panel of 33 panelists was created after an open call to sports medicine physicians who were members of The American Medical Society for Sports Medicine. Snowball sampling was conducted to recruit additional experts outside of The American Medical Society for Sports Medicine.</p><p><strong>Main outcome measures: </strong>Outcome measures consisted of demographic characteristics and clinical experience and beliefs of the expert panelists, and items that achieved and did not achieve consensus after the Delphi study.</p><p><strong>Results: </strong>In total, 32 of 33 physicians completed all rounds of the Delphi study (97% completion rate). Most adverse reactions were agreed to be because of the administration of the injection rather than the substance itself. Severe adverse reactions including joint infection, pseudoseptic reaction, and large increase in pain at the injection site were deemed rare or very rare by the Delphi panel. Numerous prevention and treatment strategies were identified for mild and moderate adverse reactions. The only time discontinuation of viscosupplementation was recommended was in cases of pseudoseptic reactions and joint infections.</p><p><strong>Conclusions: </strong>This study provides expert guidance to clinicians on ways to identify and manage adverse reactions associated with viscosupplementation in their clinical practice.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"249-260"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Remembrance.","authors":"Rajwinder Deu","doi":"10.1097/JSM.0000000000001472","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001472","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":"36 3","pages":"217"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parsonage-Turner Syndrome After Bacterial Pharyngitis in Childhood With Resulting Glenohumeral Joint Subluxation in Adulthood.","authors":"Sosi Dzhugarian, Griffin Elbert","doi":"10.1097/JSM.0000000000001378","DOIUrl":"10.1097/JSM.0000000000001378","url":null,"abstract":"<p><strong>Abstract: </strong>Parsonage-Turner syndrome (PTS), also known as neuralgic amyotrophy, presents with unilateral shoulder pain, followed by weakness. Associated sensory symptoms such as numbness may also occur. Contrary to the traditional thought that the condition typically self-resolves within weeks or gradually reaches full recovery with conservative management, more recent reports have revealed that a large portion of affected individuals experience persistent symptoms. We present an unusual case in which the patient developed PTS associated with streptococcal pharyngitis as a child, and his shoulder symptoms did not recover despite ongoing physical therapy. By young adulthood, he developed high-grade glenohumeral joint subluxation on the verge of full dislocation. Furthermore, imaging demonstrated the possibility of a reverse Hill-Sachs deformity. In addition to resumption of physical therapy, the patient has been referred to a tertiary care center to determine whether tendon transfer is a viable treatment option.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"308-310"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Retention of Transplants After Infection With Bacillus cereus After Anterior Cruciate Ligament Reconstruction Surgery.","authors":"Dongping Zhu, Fang Tan, Ran Lu, Chaolun Liang","doi":"10.1097/JSM.0000000000001363","DOIUrl":"10.1097/JSM.0000000000001363","url":null,"abstract":"<p><strong>Abstract: </strong>Infections after anterior cruciate ligament (ACL) reconstruction surgery pose a significant challenge in orthopedics, potentially jeopardizing the integrity and function of the graft. Among these, infections caused by Bacillus cereus are exceedingly rare. Bacillus cereus , a Gram-positive, aerobic, and facultative anaerobic bacillus, is predominantly recognized in soil, vegetation, and the gastrointestinal tract of humans and other animals. Despite its ubiquity in the environment, extraintestinal infections due to B. cereus are exceptionally uncommon in individuals with intact immune systems. By detailing our experience with this atypical infection, we aim to provide references to managing rare bacterial complications after ACL reconstruction.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"311-313"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports Medicine Physician Burnout-American Medical Society for Sports Medicine Survey Findings.","authors":"Rahul Kapur, Sarah B Kinsella, Derek Hersch, Mary Earm, Caroline S Carlin, Thomas Trojian","doi":"10.1097/JSM.0000000000001441","DOIUrl":"10.1097/JSM.0000000000001441","url":null,"abstract":"<p><strong>Objectives: </strong>Sports medicine is not identified as a separate specialty in published surveys on burnout. The goal of this study is to determine the burnout rate among US sports medicine physicians by surveying the membership of the American Medical Society for Sports Medicine (AMSSM) and to assess contributing factors to their burnout.</p><p><strong>Design: </strong>Burnout was assessed using the Mini Z Burnout Survey. In addition, the survey included questions specific to sports medicine focusing on; time allocation, job fulfillment, stress from work activities, and appreciation by leadership.</p><p><strong>Setting: </strong>AMSSM members were invited to complete the cross-sectional survey through the official email listserv.</p><p><strong>Participants: </strong>Physician members of the AMSSM.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measure: </strong>Burnout rate among sports medicine physicians.</p><p><strong>Results: </strong>Five hundred thirty-one of the 3436 eligible physician members completed the survey, with a response rate of 15.45%. Burnout rate among sports medicine physicians was 50%, which is comparable with other primary care fields. Administrative task burdens, lack of value alignment with leadership, and inadequate time and compensation for work performed outside of clinic (eg team coverage) were key drivers of burnout among sports medicine physicians.</p><p><strong>Conclusions: </strong>Sports medicine physicians burnout rate of 50% is similar to other primary care fields. Sports medicine physicians can use these data to advocate for systemic change at all levels to develop wellness and burnout mitigation strategies. More research is needed to evaluate causes of burnout in sports medicine physicians and assess prevention strategies.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"290-295"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Is Keeping Score: The Effect of a Mercy Rule on Head Impact Rates in Canadian High School Tackle Football Games.","authors":"Mark Patrick Pankow, Reid Syrydiuk, Ash T Kolstad, Christopher R Dennison, Martin Mrazik, Brent E Hagel, Carolyn Emery","doi":"10.1097/JSM.0000000000001345","DOIUrl":"10.1097/JSM.0000000000001345","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between the Mercy Rule (MR) and head impact incidence rates (IRs) in Canadian high school football games.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Calgary, Canada.</p><p><strong>Participants: </strong>Two high school football teams (ages 15-16 years) had a total of 16 team-games videorecorded and analyzed.</p><p><strong>Interventions: </strong>The MR mandates continuous running time in the second half of games when the score differential is 35 points or greater.</p><p><strong>Main outcome measures: </strong>Head impact IRs and incidence rate ratios (IRRs) were used to compare head impact rates in MR and non-MR games.</p><p><strong>Results: </strong>Mercy Rule games had 28% fewer plays, and the head impact IR per team-game was 27% lower [IRR, 0.73; 95% confidence interval (CI), 0.61-0.89] in MR games (IR, 241.67; 95% CI, 199.24, 293.13) than in non-MR games (IR, 328.91; 95% CI, 313.04, 345.57). Across all games (MR and non-MR), running plays accounted for more than half of all head impacts, and the head impact rates for running plays exceeded all other play types except for a sack of the quarterback. Players engaged in blocks (blocking or being blocked) accounted for 68.90% of all recorded head impacts. The highest proportion of impacts involved the front of the helmet (54.85%). There was no difference in head impact rates by player-play comparing MR and non-MR games (IRR, 1.01; 95% CI, 0.85, 1.19).</p><p><strong>Conclusions: </strong>Given the concerns for potential long-term consequences of repetitive head impacts, the MR is a prevention strategy by which head impact rates can be significantly lowered when a significant score differential exists.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"224-230"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Hip and Knee Muscle Volume and Neuromuscular Function in Women With Patellofemoral Pain.","authors":"Rutvi Shah, Hector Rivera, Diana Cao, Sungwan Kim, Neal R Glaviano","doi":"10.1097/JSM.0000000000001396","DOIUrl":"10.1097/JSM.0000000000001396","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between hip and knee muscle volume and neuromuscular function (isokinetic strength, rate of torque development, and torque variability) in women with patellofemoral pain (PFP).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>University research laboratory.</p><p><strong>Participants: </strong>Twenty women with PFP.</p><p><strong>Main outcome measures: </strong>Isokinetic strength (60 degrees/second and 180 degrees/second), rate of torque development, and torque variability were assessed with an isokinetic dynamometer for hip extension, hip abduction, knee extension, and knee flexion. Muscle volume of the lower extremity muscles (cm 3 /kg·m) was quantified through magnetic resonance imaging. Pearson r correlation or Spearman ρ coefficients were calculated to evaluate the relationship between muscle volume and neuromuscular function, with significance set at P < 0.05.</p><p><strong>Results: </strong>Muscle volume for all muscle groups was moderately correlated with isokinetic strength at 60 degrees/second, r ≥ 0.452, P ≤ 0.046. Hip abduction and extension were moderately correlated with isokinetic strength at 180 degrees/second, r ≥ 0.485, P ≤ 0.030; however, no significant correlations were identified between muscle volume and rate of force development or torque variability, P < 0.05.</p><p><strong>Conclusions: </strong>The results suggest that isokinetic strength is associated with hip and knee muscle volume in women with PFP; however, additional measures of neuromuscular function (rate of torque development and torque variability) are not associated with muscle volume in lower extremity muscles.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"273-279"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}