Clinical Journal of Sport Medicine最新文献

{"title":"Comparison of Pain With Ultrasound-Guided Intra-Articular Hip Injections With and Without Prior Subcutaneous Local Anesthesia.","authors":"Rondy Michael Lazaro, Joshua M Smith, Nicholas Bender, Ankit Punreddy, Nathan Barford, Jennifer H Paul","doi":"10.1097/JSM.0000000000001260","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001260","url":null,"abstract":"<p><strong>Objective: </strong>To compare pain levels of intra-articular hip steroid injections performed with and without prior subcutaneous local anesthesia (LA) injection.</p><p><strong>Design: </strong>Randomized prospective study.</p><p><strong>Setting: </strong>University-based musculoskeletal clinic.</p><p><strong>Participants: </strong>Forty-one adult patients undergoing a first-time ultrasound-guided unilateral intra-articular hip steroid injection.</p><p><strong>Interventions: </strong>Subjects were randomized into 1 of 2 groups: intra-articular hip injection with prior subcutaneous LA with 2 mL of lidocaine 1% (With LA) or hip injection without prior subcutaneous LA (Without LA). Visual analog scale (VAS) pain scores (0-100) were collected before and after each injection.</p><p><strong>Main outcome measures: </strong>Visual analog scale pain score for the intra-articular hip injection.</p><p><strong>Results: </strong>Of the 41 total subjects, 18 were randomized to the Without LA group and 23 to the With LA group. There was no significant difference in baseline (preprocedure) VAS scores between the Without LA (mean ± SD = 39.2 ± 27.2) and With LA (41.2 ± 24.0) groups (P = 0.864). The mean ± SD VAS score for the subcutaneous LA injection in the With LA group was 20.4 ± 16.1. There was no significant difference in VAS scores for the intra-articular hip injection between the Without LA (48.5 ± 27.7) and With LA (39.5 ± 25.7) groups (P = 0.232).</p><p><strong>Conclusions: </strong>Subcutaneous injection of lidocaine before an intra-articular hip injection did not significantly decrease pain from the intra-articular hip injection. Providers may perform intra-articular hip injections with a 22-gauge 3.5-inch spinal needle without the need for an extra subcutaneous LA injection.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751271","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":"Shared Decision-Making About Returning to Sport After Recovery From Pediatric Concussion: Clinician Perspectives.","authors":"Emily Kroshus-Havril, Douglas J Opel, Thomas M Jinguji, Mary Kathleen Steiner, Kirsten Senturia, James P MacDonald, Christina L Master, Christopher C Giza, Monique S Burton, Celeste Quitiquit, Brian J Krabak, Jeanette P Kotch, Frederick P Rivara","doi":"10.1097/JSM.0000000000001244","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001244","url":null,"abstract":"<p><strong>Objective: </strong>Describe how sports medicine clinicians support decision making about sport participation after concussion recovery with adolescent patients and their parents. Specific areas of inquiry related to how clinicians framed the decision, what factors they considered in how they approached the decision process, and how they navigated discordance within families.</p><p><strong>Design: </strong>Qualitative study.</p><p><strong>Setting: </strong>Tertiary care sports medicine clinics at 4 children's hospitals in the United States.</p><p><strong>Participants: </strong>Individual interviews were conducted with 17 clinicians practicing in sports medicine settings.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>Semi-structured interviews explored clinician approaches to supporting decision making, with the question guide informed by components of the Ottawa Decision Support Framework.</p><p><strong>Results: </strong>Clinicians routinely incorporated aspects of shared decision making (SDM) into their conversations with families. This included ensuring all parties were informed about risk and aligned behind a shared value of adolescent well-being. Mediation strategies were used to manage discordance between adolescents and their parents, and between parents. These strategies aimed to facilitate a decision that was adolescent centered. When clinicians believed that there was a medical benefit to modifying the adolescent's sport participation practices, or when they did not believe the athlete was psychologically ready to return to the sport in which they were injured, they initiated conversations about alternative activities. In such situations, they used persuasive communication practices to encourage families to strongly consider this option.</p><p><strong>Conclusion: </strong>The strengths and strategies used by sports medicine clinicians in this study provide a foundation for guidance or intervention development aimed at supporting SDM after concussion with adolescents and their families.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733698","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":"Age of First Exposure to Contact Sports Is Not Associated With Worse Later-In-Life Brain Health in a Cohort of Community-Dwelling Older Men.","authors":"Jacob Jo, Gunther Wong, Kristen L Williams, Philip J Davis, Grant H Rigney, Scott L Zuckerman, Douglas P Terry","doi":"10.1097/JSM.0000000000001251","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001251","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether early age of first exposure to contact sports (AFE-CS) is associated with worse long-term brain health outcomes.</p><p><strong>Design: </strong>A cross-sectional, survey study of older men with a history of contact sport participation was completed.</p><p><strong>Setting: </strong>Tertiary care facility.</p><p><strong>Participants: </strong>A cohort of community-dwelling older men dichotomized by using AFE-CS (<12 years vs ≥12 years).</p><p><strong>Interventions: </strong>Independent variables included a dichotomized group of AFE-CS (<12 years vs ≥12 years).</p><p><strong>Main outcome measures: </strong>Brain health outcomes measured by depression, anxiety, cognitive difficulties, and neurobehavioral symptoms. Endorsements of general health problems, motor symptoms, and psychiatric history were also collected. Age of first exposure groups was compared using t tests, χ2 tests, and multivariable linear regressions, which included the following covariates: age, number of prior concussions, and total years of contact sport.</p><p><strong>Results: </strong>Of 69 men aged 70.5 ± 8.0 years, approximately one-third of the sample (34.8%) reported AFE-CS before age 12 years. That group had more years of contact sports (10.8 ± 9.2 years) compared with those with AFE-CS ≥12 (5.6 ± 4.5 years; P = 0.02). No differences were found after univariate testing between AFE-CS groups on all outcomes (P-values >0.05). Multivariable models suggest that AFE-CS is not a predictor of depression or anxiety. Those in the AFE-CS <12 group had fewer cognitive difficulties (P = 0.03) and fewer neurobehavioral symptoms (P = 0.03).</p><p><strong>Conclusions: </strong>Those with AFE-CS <12 to contact sports did not have worse long-term brain health outcomes compared with those with AFE-CS ≥12. Individuals with AFE-CS <12 had significantly lower British Columbia Cognitive Complaints Inventory and Neurobehavioral Symptom Inventory scores compared with those with AFE-CS ≥12.</p><p><strong>Clinical relevance: </strong>The benefits of earlier AFE-CS may outweigh the risks of head strikes and result in comparable long-term brain health outcomes.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579107","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":"History of Multiple Allergies and Gradual Onset Running-Related Injuries in Distance Runners: SAFER XXXV.","authors":"Chanel van Vreden, Martin Schwellnus, Dimakatso Ramagole, Sonja Swanevelder, Esme Jordaan, Nicola Sewry","doi":"10.1097/JSM.0000000000001245","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001245","url":null,"abstract":"<p><strong>Objective: </strong>To determine if any gradual onset running-related injury (GORRI) was associated with any allergies, multiple allergies (allergies to animals, plants, medication), and allergy medication use.</p><p><strong>Design: </strong>Cross-sectional descriptive study.</p><p><strong>Setting: </strong>Two Oceans Marathons (56 km, 21.1 km), South Africa.</p><p><strong>Participants: </strong>A total of 76 654 race entrants (2012-2015).</p><p><strong>Independent variables: </strong>The prevalence (%) and prevalence ratios (PR; 95% confidence intervals) for history of (1) any allergies, (2) multiple allergies to broad categories of allergens (animal material, plant material, allergies to medication, and other allergies), and (3) allergy medication use.</p><p><strong>Main outcome measures: </strong>Using a compulsory online screening questionnaire, the outcome was a history of any GORRIs, and subcategories of GORRIs (muscle, tendon) in the past 12 months and history of GORRIs (and subtypes of GORRIs) were reported.</p><p><strong>Results: </strong>In 68 258 records with injury and allergy data, the following were significantly associated with reporting any GORRIs: a history of any allergy (PR = 2.2; P < 0.0001), a history of allergies to broad categories of allergens (animal, plant, medication allergy, other) (P < 0.0001), and the use of allergy medication (P < 0.0001). A history of any allergies (PR = 2.4; P < 0.0001), all broad categories of allergies, and allergy medication use were significantly associated with muscle (P < 0.0001) and tendon injuries (P < 0.0001). The risk of reporting a GORRI increased as the number of reported categories of allergies increased (P < 0.0001).</p><p><strong>Conclusions: </strong>A novel finding was the cumulative risk effect with a history of multiple allergies. Further studies should aim to determine the underlying mechanism relating allergies and GORRIs.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558260","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":"Adolescents With a High Burden of New-Onset Mood Symptoms After Sport-Related Concussion Benefit From Prescribed Aerobic Exercise, a Secondary Analysis of 2 Randomized Controlled Trials.","authors":"Matthew C Castellana, George J Burnett, Andrew Gasper, Muhammad S Z Nazir, John J Leddy, Christina L Master, Rebekah C Mannix, William P Meehan, Barry S Willer, Mohammad N Haider","doi":"10.1097/JSM.0000000000001242","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001242","url":null,"abstract":"<p><strong>Objective: </strong>Approximately 20% of students with sport-related concussion (SRC) report new symptoms of anxiety and depression which may be associated with delayed recovery and increased risk for developing a mood disorder. Early prescribed aerobic exercise facilitates recovery in athletes with concussion-related exercise intolerance. We studied the effect of aerobic exercise treatment on new mood symptoms early after SRC.</p><p><strong>Design: </strong>Exploratory secondary analysis of 2 randomized controlled trials (RCT).</p><p><strong>Setting: </strong>Sports medicine clinics associated with UB (Buffalo, NY), CHOP (Philadelphia, PA), and Boston Children's Hospital (Boston, MA).</p><p><strong>Participants: </strong>Male and female adolescents (aged 13-18 years) diagnosed with SRC (2-10 days since injury).</p><p><strong>Interventions: </strong>Participants were randomized to individualized targeted heart rate aerobic exercise (n = 102) or to a placebo intervention designed to mimic relative rest (n = 96).</p><p><strong>Main outcome measures: </strong>Incidence of Persisting Post-Concussive Symptoms (PPCS, symptoms ≥28 days).</p><p><strong>Results: </strong>First RCT recruited from 2016 to 2018 and the second from 2018 to 2020. Of 198 adolescents, 156 (79%) reported a low burden (mean 1.2 ± 1.65/24) while 42 (21%) reported a high burden (mean 9.74 ± 3.70/24) of emotional symptoms before randomization. Intervention hazard ratio for developing PPCS for low burden was 0.767 (95% CI, 0.546-1.079; P = 0.128; β = 0.085) and for high burden was 0.290 (95% CI, 0.123-0.683; P = 0.005; β = 0.732).</p><p><strong>Conclusions: </strong>High burden of mood symptoms early after injury increases risk for PPCS, but the sports medicine model of providing early targeted aerobic exercise treatment reduces it. Nonsports medicine clinicians who treat patients with a high burden of new mood symptoms after concussion should consider prescribing aerobic exercise treatment to reduce the risk of PPCS and a mood disorder.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558258","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":"What are the Protocols and Resources for Sport-Related Concussion Among Top National Collegiate Athletic Association Football Programs? A Cross-Sectional Survey of A5 Schools.","authors":"James R Clugston, Kelsey Diemer, Sarah L Chrabaszcz, Connor C Long, Jacob Jo, Douglas P Terry, Scott L Zuckerman, Robert Warne Fitch","doi":"10.1097/JSM.0000000000001241","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001241","url":null,"abstract":"<p><strong>Objective: </strong>This study summarizes findings from a cross-sectional survey conducted among National Collegiate Athletic Association (NCAA) Division 1 football programs, focusing on sport-related concussion (SRC) protocols for the 2018 season.</p><p><strong>Design: </strong>Cross-sectional survey study.</p><p><strong>Setting: </strong>65 football programs within the Autonomy Five (A5) NCAA conferences.</p><p><strong>Participants: </strong>Athletic trainers and team physicians who attended a football safety meeting at the NCAA offices June 17 to 18, 2019, representing their respective institutions.</p><p><strong>Intervention: </strong>Electronic surveys were distributed on June 14, 2019, before the football safety meeting.</p><p><strong>Main outcome measures: </strong>Results for 16 unique questions involving SRC protocols and resources were summarized and evaluated.</p><p><strong>Results: </strong>The survey garnered responses from 46 of 65 programs (response rate = 71%). For baseline testing, 98% measured baseline postural stability and balance, 87% used baseline neurocognitive testing, while only 61% assessed baseline vestibular and/or ocular function. Regarding concussion prevention, 51% did not recommend additional measures, while 4% and 24% recommended cervical compression collars and omega-3 supplementation, respectively. In postconcussion treatment, 26% initiated aerobic exercise 1 day postconcussion if symptoms were stable, 24% waited at least 48 hours, 4% waited for the athlete to return to baseline, 11% waited until the athlete became asymptomatic, and 35% determined procedures on a case-by-case basis.</p><p><strong>Conclusions: </strong>Most institutions assessed postural stability/balance and neurocognitive functioning at baseline and introduced light aerobic exercise within 48 h postconcussion. There was variation in baseline assessment methods and concussion prevention recommendations. These survey findings deepen our understanding of diverse SRC protocols in NCAA football programs.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554295","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":"Results From the Big Ten COVID-19 Cardiac Registry: Impact of SARS-COV-2 on Myocardial Involvement.","authors":"Jennifer S Albrecht, Joel T Greenshields, Suzanne Smart, Ian H Law, Larry R Rink, Curt J Daniels, Saurabh Rajpal, Eugene H Chung, Jean Jeudy, Richard Kovacs, Jason Womack, Carrie Esopenko, Philip Bosha, Michael Terrin, Geoffrey L Rosenthal","doi":"10.1097/JSM.0000000000001247","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001247","url":null,"abstract":"<p><strong>Objective: </strong>COVID-19 has been associated with myocardial involvement in collegiate athletes. The first report from the Big Ten COVID-19 Cardiac Registry (Registry) was an ecological study that reported myocarditis in 37 of 1597 athletes (2.3%) based on local clinical diagnosis. Our objective was to assess the relationship between athlete and clinical characteristics and myocardial involvement.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>We analyzed data from 1218 COVID-19 positive Big Ten collegiate athletes who provided informed consent to participate in the Registry.</p><p><strong>Participants: </strong>1218 athletes with a COVID-19-positive PCR test before June 1, 2021.</p><p><strong>Assessment of independent variables: </strong>Demographic and clinical characteristics of athletes were obtained from the medical record.</p><p><strong>Main outcome measures: </strong>Myocardial involvement was diagnosed based on local clinical, cardiac magnetic resonance (CMR), electrocardiography, troponin assay, and echocardiography. We assessed the association of clinical factors with myocardial involvement using logistic regression and estimated the area under the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>25 of 1218 (2.0%) athletes met criteria for myocardial involvement. The logistic regression model used to predict myocardial involvement contained indicator variables for chest pain, new exercise intolerance, abnormal echocardiogram (echo), and abnormal troponin. The area under the ROC curve for these indicators was 0.714. The presence of any of these 4 factors in a collegiate athlete who tested positive for COVID-19 would capture 55.6% of cases. Among noncases without missing data, 86.9% would not be flagged for possible myocardial involvement.</p><p><strong>Conclusion: </strong>Myocardial involvement was infrequent. We predicted case status with good specificity but deficient sensitivity. A diagnostic approach for myocardial involvement based exclusively on symptoms would be less sensitive than one based on symptoms, echo, and troponin level evaluations. Abnormality of any of these evaluations would be an indication for CMR.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554330","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":"Head Contact and Suspected Concussion Rates in Youth Basketball: Time to Target Head Contact Penalties for Prevention.","authors":"Christy J Fehr, Stephen W West, Brent E Hagel, Claude Goulet, Carolyn A Emery","doi":"10.1097/JSM.0000000000001249","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001249","url":null,"abstract":"<p><strong>Objective: </strong>To compare game events, head contact (HC) rates, and suspected concussion incidence rates (IRs) in boys' and girls' youth basketball.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Canadian club basketball teams (U16-U18).</p><p><strong>Participants: </strong>Players from 24 boys' and 24 girls' Canadian club basketball teams during the 2022 season.</p><p><strong>Assessment of risk factors: </strong>Recorded games were analyzed using Dartfish video analysis software to compare sexes.</p><p><strong>Main outcome measures: </strong>Poisson regression analyses were used to estimate HCs [direct (HC1) and indirect (HC2)], suspected concussion IRs, and IR ratios (IRRs). Game event, court location, and HC1 fouls were reported.</p><p><strong>Results: </strong>Division 1 HC rates did not differ between boys (n = 238; IR = 0.50/10 player-minutes; 95% confidence interval [CI], 0.43-0.56) and girls (n = 220; IR = 0.46/10 player-minutes; 95% CI, 0.40-0.52). Division 2 boys experienced 252 HCs (IR = 0.53/10 player-minutes; 95% CI, 0.46-0.59); girls experienced 192 HCs (IR = 0.40/10 player-minutes; 95% CI, 0.35-0.46). Division 2 boys sustained higher HC1 IRs compared with Division 2 girls (IRR = 1.42; 95% CI, 1.15-1.74). Head contacts, rates did not differ between boys and girls in either Division. Suspected concussion IRs were not significantly different for boys and girls in each Division. Head contacts occurred mostly in the key for boys and girls in each Division. Despite illegality, HC1 penalization ranged from 3.9% to 19.7%. Head contact mechanisms varied across Divisions and sexes.</p><p><strong>Conclusions: </strong>Despite current safety measures, both HCs and suspected concussions occur in boys' and girls' basketball. Despite the illegality and potential danger associated with HC, only a small proportion of direct HCs were penalized and therefore targeting greater enforcement of these contacts may be a promising prevention target.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554327","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":"Helmetless Tackling Training Intervention and Preseason Self-efficacy Effects on Head Impacts in Hawai'i High School Football.","authors":"Ivet Lloansi Rodriguez, Bret Freemyer, Kumiko Hashida, Kaori Tamura, Nathan Murata, Troy Furutani, Gerald Gioia, Jay Myers, Erik Swartz","doi":"10.1097/JSM.0000000000001246","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001246","url":null,"abstract":"<p><strong>Objective: </strong>To determine how football head impacts are influenced by self-efficacy (SE), helmetless tackling intervention participation (IP), and years of experience (YE) playing football.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Three high schools.</p><p><strong>Participants: </strong>120 (male; n = 118, female; n = 2, 15.57 ± 1.23 years) participants were recruited from 5 high school teams (3 varsity and 2 junior-varsity).</p><p><strong>Independent variables: </strong>SE, days of IP, and YE playing tackle football.</p><p><strong>Main outcome measures: </strong>SE was measured using a 53-question survey and categorized into 5 subscales. The accumulation of total head impacts (THI) was measured using Riddell InSite Speedflex helmets (Elyria, OH) throughout the season. Head impact exposure (HIE) was standardized as a ratio of impacts per session (games, scrimmages, and practices). Multiple regression analyses tested the relationship between THI or HIE with the predictor variables.</p><p><strong>Results: </strong>For THI, 22.1% was explained by the predictors (r = 0.470, r2 = 0.221). Intervention participation had a negative correlation (B = -4.480, P = 0.019), whereas confidence in performing proper tackling and blocking (SE1) (B = 3.133, P = 0.010) and >8 YE (B = 135.9, P = 0.009) positively correlated with THI. For HIE, 25.4% was explained by the predictors (r = 0.504, r2 = 0.254). Intervention participation negatively correlated (B = -0.077, P = 0.007), whereas SE1 (B = 3.133, P = 0.010) and >8 YE (B = 2.735, P ≤ 0.001) correlated positively with HIE.</p><p><strong>Conclusions: </strong>Increased head impacts were associated with less helmetless tackling participation, more than 8 YE, and more self-confidence in tackling ability. Increasing the amount of time athletes spend practicing proper tackling and blocking techniques to reduce head first and risky play is warranted to reduce the amount of head impacts received over time.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554328","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 Diagnostic Utility of Cervical Spine Proprioception for Adolescent Concussion.","authors":"Katherine L Smulligan, Samantha N Magliato, Carson L Keeter, Mathew J Wingerson, Andrew C Smith, Julie C Wilson, David R Howell","doi":"10.1097/JSM.0000000000001243","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001243","url":null,"abstract":"<p><strong>Objective: </strong>Cervical spine proprioception may be impaired after concussion. Our objective was to determine the diagnostic utility of cervical spine proprioception for adolescent concussion.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Research laboratory.</p><p><strong>Participants: </strong>Adolescents ≤18 days of concussion and uninjured controls.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcomes: </strong>Head repositioning accuracy (HRA) testing, a measure of cervical spine proprioception. The HRA test involved patients relocating their head back to a neutral starting position with eyes closed after maximal cervical spine flexion, extension, and right and left rotations. The overall HRA error score was the mean error (distance from the starting point to self-reported return to neutral) across 12 trials: 3 trials in each direction. We used t-tests to compare group means and logistic regression (outcome = group, predictor = HRA, covariates) to calculate odds ratios. We used a receiver operator characteristic curve to evaluate area under the curve (AUC) and calculate the optimal HRA cutpoint to distinguish concussion from controls.</p><p><strong>Results: </strong>We enrolled and tested 46 participants with concussion (age = 15.8 ± 1.3 years, 59% female, mean = 11.3 ± 3.3 days postconcussion) and 83 uninjured controls (age = 16.1 ± 1.4 years, 88% female). The concussion group had significantly worse HRA than controls (4.3 ± 1.6 vs 2.9 ± 0.7 degrees, P < 0.001, Cohen d = 1.19). The univariable HRA model AUC was 0.81 (95% CI = 0.73, 0.90). After adjusting for age, sex, and concussion history, the multivariable model AUC improved to 0.85 (95% CI = 0.77, 0.92). The model correctly classified 80% of participants as concussion/control at a 3.5-degree cutpoint.</p><p><strong>Conclusions: </strong>Adolescents with concussion demonstrated worse cervical spine proprioception than uninjured controls. Head repositioning accuracy may offer diagnostic utility for subacute concussion.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491137","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}