Clinical Journal of Sport Medicine最新文献

{"title":"The Clinical Utility of a Novel Multimodal Assessment Battery for Acute Sport-Related Concussion.","authors":"Jalena Bertagnolli, Sean P Dukelow, David J Smith, Lawrence Richer, Brian W Benson","doi":"10.1097/JSM.0000000000001402","DOIUrl":"10.1097/JSM.0000000000001402","url":null,"abstract":"<p><strong>Objective: </strong>Determine the clinical utility of a novel, multimodal assessment battery in detecting acute post-concussion impairment relative to baseline performance.</p><p><strong>Design: </strong>Prospective observational cohort study.</p><p><strong>Setting: </strong>Outpatient Concussion Clinic.</p><p><strong>Participants: </strong>Four hundred thirty-one ice hockey, alpine ski, freestyle ski, artistic swimming, and luge athletes (mean: 15.7 years) over one athletic season.</p><p><strong>Independent variables: </strong>Concussion status.</p><p><strong>Main outcome measures: </strong>Changes in performance between baseline and post-concussion for 4 primary assessments: (1) concussion symptom exacerbation (≥1 on a 10-point scale) during a submaximal exercise assessment, (2) eyes closed and eyes open postural sway ratio (Ec/Eo) using a head mounted accelerometer, (3) quantitative electroencephalography event-related potentials (ERPs) N100, P300, and N400 amplitude and latency, and (4) change in heart rate during a 30-second, 30% maximal handgrip contraction.</p><p><strong>Results: </strong>Forty-six athletes with a diagnosed concussion were enrolled. The exercise assessment found that 15 of the 22 athletes experienced worsening symptoms ( P < 0.001, large effect size for the raw proportion (PR) = 0.969). Postural sway between timepoints showed a moderate effect size (d av = 0.491) (baseline: 1.4 ± 0.5 W, post-concussion: 1.9 ± 1.4 W, P = 0.005). Neither ERPs nor heart rate change during the handgrip task demonstrated significant group differences. Of 21 athletes with both postural sway and exercise evaluations, a flagged postural sway ratio (Ec/Eo ≥ 2.0) was seen for 3 athletes not previously identified by the exercise evaluation.</p><p><strong>Conclusions: </strong>Symptom exacerbation during submaximal cardiovascular exercise and postural sway demonstrated clinical utility in detecting impairment within 7 days of a sport-related concussion, whereas event-related potentials and heart rate change during sustained handgrip did not.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"426-436"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905587","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":"Countermovement Jump as Tool to Predict Injuries in High-Performance Youth Volleyball and Basketball Players: A One-Season Observational Prospective Study.","authors":"Andreu Sastre-Munar, Anne Delextrat, Natalia Romero-Franco","doi":"10.1097/JSM.0000000000001475","DOIUrl":"10.1097/JSM.0000000000001475","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association of the weekly countermovement jump (CMJ) performance with injuries during an entire season of high-performance youth volleyball and basketball players.</p><p><strong>Design: </strong>An observational prospective study.</p><p><strong>Setting: </strong>Private practice within a high-performance sports center.</p><p><strong>Participants: </strong>Forty-nine youth high-performance volleyball and basketball players were enrolled (female volleyball, n = 12; female basketball, n = 17; male basketball, n = 20).</p><p><strong>Assessment of risk factor: </strong>All players were monitored weekly during an entire season by performing a maximal CMJ test 48 hours after every competition. All the sports injuries per 1000 Ae (athlete exposure) were registered.</p><p><strong>Main outcome measures: </strong>Authors hypothesized that lower CMJ performance would be associated with a higher incidence of injuries during the season.</p><p><strong>Results: </strong>The rate of injuries was 1.61 per 1000 Ae, with ankle (63.33%) being the most frequently affected region. Female basketball players showed a higher injury rate than the rest of the players (2.54 per 1000 Ae, P = 0.045). Binary logistic regression analysis demonstrated that week-to-week reductions in CMJ performance predicted lower limb injuries ( P < 0.001, 95% CI = 0.86-0.95, Nagelkerke R 2 = 11.4%). When considering CMJ during preseason, it did not show any significant association with injuries sustained during the rest of season ( P > 0.05).</p><p><strong>Conclusions: </strong>Reductions in weekly CMJ performance (>8.2%) can help predict lower limb injuries in youth volleyball and basketball players. An isolated CMJ performance evaluation during preseason is not enough to predict injuries during the sports season.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"493-499"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155065","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":"Assessing Quadriceps Strength Deficiency After Anterior Cruciate Ligament Reconstruction: The Role of Normalized Peak Torque in Comparing Quadriceps Tendon and Hamstring Tendon Graft.","authors":"Pierre Girard, Clément Horteur, Clémentine Rieussec, M Corentin Leroy, M Arnold Merlin, Régis Pailhe, Benoit Gaulin, Johannes Barth","doi":"10.1097/JSM.0000000000001351","DOIUrl":"10.1097/JSM.0000000000001351","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of normalized peak torque relative to body weight in assessing quadriceps strength deficits after anterior cruciate ligament (ACL) reconstruction, based on the type of graft used. Our primary hypothesis was that the use of a quadriceps tendon (QT) graft results in greater quadriceps strength loss than a semitendinosus-gracilis (STG) graft.</p><p><strong>Design: </strong>Cohort study with prospective data collection and retrospective analysis.</p><p><strong>Setting: </strong>University hospital ACL reconstruction between May 2019 and July 2021.</p><p><strong>Patients: </strong>A total of 130 patients who underwent ACL reconstruction without exclusion criteria were included. Ninety patients received QT grafts and 40 received STG grafts, between May 2019 and July 2021.</p><p><strong>Intervention: </strong>ACL reconstruction using either a quadriceps tendon graft or a semitendinosus-gracilis graft.</p><p><strong>Main outcome measures: </strong>Normalized peak torque to body weight measured at 60 degrees/s 1 year postoperatively.</p><p><strong>Results: </strong>Analysis using a linear mixed model revealed a significantly greater deficit in normalized peak extensor torque in the QT graft group compared with the STG group when comparing the operated limb with the healthy limb at 60 degrees/s ( P < 0.001).</p><p><strong>Conclusions: </strong>Normalized peak torque at a velocity of 60 degrees/s is a critical variable in assessing quadriceps strength recovery during isokinetic testing and should be routinely correlated with limb symmetry indices. Patients who underwent ACL reconstruction with a QT graft demonstrated larger quadriceps strength deficits than those with an STG graft 1 year postsurgery, although no functional impairments were observed.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"486-492"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552411","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":"Use of Extracorporeal Shockwave Therapy for the Management of Bone Pathologies: A Systematic Review.","authors":"Lauren C Prisco, Eric Zhao, Olivia Lynch, Jennifer S Hoo, Adam S Tenforde, Marci Goolsby","doi":"10.1097/JSM.0000000000001404","DOIUrl":"10.1097/JSM.0000000000001404","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and outcomes of extracorporeal shockwave therapy (ESWT) for bone pathologies including fractures, osteonecrosis/avascular necrosis, bone stress injury (BSI), medial tibial stress syndrome (MTSS), and bone marrow edema syndrome (BMES).</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources: </strong>Search performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of 3 databases: Cochrane Library, Embase (Elsevier), and PubMed (NLM). Studies included randomized controlled trials, cohort studies, case series, and case reports that investigated the efficacy of ESWT for the management of BSI, BMES, MTSS, delayed or nonunion fracture, or osteonecrosis/avascular necrosis of bone.</p><p><strong>Main results: </strong>Fifty-three studies with 1835 adult patients (608 women, 910 men, 317 unspecified) were included. Studies were defined using Oxford level of evidence rating: 7 level I (13.2%), 4 level II (7.5%), 4 level III (7.5%), 24 level IV (45.2%), and 14 level V (26.4%). Four of 7 level I studies showed similar effectiveness of ESWT compared with surgery for the treatment of long bone nonunion fractures (n = 1) and early stage osteonecrosis of the femoral head (n = 1), exercise program for MTSS (n = 1), and medication management for BMES (n = 1). Efficacy for management of BSI had lower level of evidence. Twenty-two studies reported on safety with no significant adverse events.</p><p><strong>Conclusions: </strong>The limited high-level studies suggest ESWT may offer an effective noninvasive treatment of most bone pathologies with favorable safety profile. Additional high-quality studies particularly in BSI may inform use of ESWT for bone pathologies.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"e86-e114"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910357","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":"Hyperlactation and Sport Performance in an Elite Marathon Runner.","authors":"Madison L McLachlan, Tyler G Slayman, Nathaniel D Jenkins, Lisa M Woodroffe","doi":"10.1097/JSM.0000000000001399","DOIUrl":"10.1097/JSM.0000000000001399","url":null,"abstract":"<p><strong>Abstract: </strong>Lactation is a metabolically & physiologically complex process. Even more complex are the potential feedback mechanisms involved in regulating hyperlactation. As elite athletes are increasingly choosing to have children and return to high level competition, it is important to explore the potential intersection of exercise and lactation physiology. To our knowledge, there are no case reports documenting hyperlactation in an elite female endurance athlete and possible relationship with sport performance. We present 1 case that suggests hyperlactation negatively influences performance, necessitating further research to explore this potential relationship.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"e121-e124"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017304","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":"Re: Performance Outcomes and Return-to-Sport Rate of National Hockey League Athletes Vary After Common Orthopedic Surgical Procedures. Lubbe, R.J. et al. Clin J. Sport Med. Vol 31:1 pg. 57; 2021.","authors":"Nicholas G H Mohtadi","doi":"10.1097/JSM.0000000000001397","DOIUrl":"10.1097/JSM.0000000000001397","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":"36 4","pages":"e125"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327224","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":"Cross Bracing Protocol for Anterior Cruciate Ligament (ACL) Rupture Has Unacceptably High Failure Rate Relative to Surgical Stabilization: A 2-year Controlled Cohort Study.","authors":"Mark D Porter, Bruce Shadbolt","doi":"10.1097/JSM.0000000000001416","DOIUrl":"10.1097/JSM.0000000000001416","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcome of patients electing to undergo the Cross Bracing Protocol (CBP) for ACL rupture with those choosing surgical stabilization.</p><p><strong>Design: </strong>Observational prospective cohort study with 2-year follow-up.</p><p><strong>Setting: </strong>Private subspecialist sports orthopedics and sports medicine practice.</p><p><strong>Patients: </strong>The 80 patients who both entered and completed the study were skeletally mature 16 to 40 years old, presenting with an acute noncontact isolated ACL rupture, taking part in pivoting sports and intent on returning to that activity. ACL rupture was diagnosed on both clinical assessment and MRI. Patients were fit for general anesthetic and free of significant medical conditions.</p><p><strong>Interventions: </strong>Group A (40 patients) underwent surgical stabilization, and group B (40 patients) followed the CBP. The groups were similar regarding the following independent variables: age, body mass index, gender, dominance of the injured knee, and posterior tibial slope ( P > 0.05).</p><p><strong>Main outcome measures: </strong>Recurrent instability, incidence of meniscal tears, and the following patient-reported outcome measures (PROMs); Tegner Activity Scores; Knee Injury Osteoarthritis Outcome Score subscales of sport/recreation and knee-related quality of life; subjective International Knee Documentation Committee score; and Lysholm Knee Score.</p><p><strong>Results: </strong>Group B had significantly higher risk of recurrent instability (70% vs 2.5%, P < 0.001), medial meniscal tear (62% vs 2.5%, P < 0.001), and inferior performance on all PROMs ( P < 0.001).</p><p><strong>Conclusions: </strong>The CBP is associated with an unacceptably high rate of recurrent instability when used to treat ACL ruptures in patients taking part in pivoting sports.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"444-450"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099993","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":"NSAID Use Is Not Associated With Persisting Symptoms in Adolescent Concussion.","authors":"Katelyn D Hurlburt, Kelsie L Richardson, Mathew J Wingerson, Joshua R Kniss, Katherine L Smulligan, Julie C Wilson, David R Howell","doi":"10.1097/JSM.0000000000001420","DOIUrl":"10.1097/JSM.0000000000001420","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between injury factors, nonsteroidal anti-inflammatory medication (NSAID) use, and concussion outcomes.</p><p><strong>Design: </strong>Prospective cohort.</p><p><strong>Participants: </strong>Adolescents (N = 118) ≤14 days of concussion seen at a sports medicine center between November 2020 and May 2025.</p><p><strong>Independent variable: </strong>Participants who reported ibuprofen and/or naproxen use were assigned to the \"NSAID use\" group, all others were assigned to the \"No NSAID use\" group.</p><p><strong>Main outcome measures: </strong>Symptom severity, medical history, and medication use information were collected. The development of persisting symptoms after concussion (symptoms > 28 days, [PSaC]) was monitored via time to symptom resolution.</p><p><strong>Results: </strong>We enrolled 118 participants with concussion (15.4 ± 1.7 years, 54% female, 8.4 ± 3.1 days postinjury): 29 (25%) reported taking NSAIDs (n = 24 ibuprofen, n = 3 naproxen, n = 2 ibuprofen/naproxen) before their evaluation. Those who reported NSAID use were evaluated sooner (7.4 ± 2.8 vs 8.7 ± 3.2 days postinjury; P = 0.05), weighed less (57.2 ± 11.0 vs 63.5 ± 17.0 kg; P = 0.06), and had more severe symptoms (59.9 ± 32.6 vs 39.3 ± 22.2; P < 0.001). More participants who reported NSAID use sustained a sport-related concussion (93% vs 73%; P = 0.02), and fewer participants who reported NSAID use started physical activity before evaluation (17% vs 39%; P = 0.03). Severe symptoms were associated with NSAID use (OR = 1.03; 95% confidence interval [CI], 1.01-1.05). Non-sport-related injuries (OR = 0.27; 95% CI, 0.08-0.91) and higher symptom severity (OR = 1.02; 95% CI = 1.00, 1.04) were associated with greater odds of PSaC, but NSAID use was not (OR = 0.62; 95% CI, 0.19-1.97).</p><p><strong>Conclusions: </strong>In adolescents, NSAID use was associated with more severe symptoms but not PSaC. To optimize clinical guidance, future research should further evaluate the role of NSAIDs in concussion recovery.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"437-443"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099952","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":"Ultrasound-Guided Ossicle Excision for Chronic Osgood-Schlatter Disease and Sinding-Larsen-Johansson Syndrome : A Case Series and Review of the Literature.","authors":"Angel Dolores-Rodriguez, Patrick Krockmal, Seth L Sherman, Christine Townsend, Walter I Sussman","doi":"10.1097/JSM.0000000000001410","DOIUrl":"10.1097/JSM.0000000000001410","url":null,"abstract":"<p><strong>Objective: </strong>To describe a novel, minimally invasive, ultrasound-guided technique for excision of ununited ossicles in patients with chronic Osgood-Schlatter disease (OSD) and Sinding-Larsen-Johansson syndrome (SLJS) who failed conservative management.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Ambulatory surgical center.</p><p><strong>Patients: </strong>Five skeletally mature patients (ages 16-44 years), including competitive athletes and adults with chronic anterior knee pain due to OSD (n = 3) or SLJS (n = 2), all of whom remained symptomatic despite standard conservative treatments.</p><p><strong>Main independent variable: </strong>Ultrasound-guided resection of intratendinous ossicles using a TX-bone device under local anesthesia, followed by a structured rehabilitation protocol.</p><p><strong>Main outcome measures: </strong>Pain relief, ability to return to sport or prior activity, and functional recovery at 2 to 12 weeks postprocedure.</p><p><strong>Results: </strong>All 5 patients successfully underwent ultrasound-guided ossicle excision without perioperative complications. Each reported meaningful pain reduction and returned to unrestricted activities within 2 to 12 weeks. Follow-up ranged from 6 to 14 months, with sustained symptom relief and return to prior sport participation. Outcomes compared favorably with open and arthroscopic techniques described in the literature.</p><p><strong>Conclusions: </strong>This case series is the first to describe an ultrasound-guided technique for excision of chronic, symptomatic OSD and SLJS ossicles. The approach demonstrated rapid recovery, excellent pain relief, and favorable functional outcomes. Further prospective studies with larger cohorts are warranted to validate efficacy and long-term safety.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"451-458"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899278","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":"The Risk Assessment Case for Public Health Regulation Worldwide of the Concussion Crisis in Sports.","authors":"Mark Moore, Charles H Tator","doi":"10.1097/JSM.0000000000001496","DOIUrl":"10.1097/JSM.0000000000001496","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351113","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}