Sports Health-A Multidisciplinary Approach最新文献

{"title":"A 25-Year Analysis of Athlete Mortality in the United States: Causes, Trends, and the Role of Resource Disparities.","authors":"Dev Dayal, Maxwell Harrell, Clay Rahaman, Caleb Berta, Andrew Manush, Aaron Casp, Amit Momaya","doi":"10.1177/19417381251411928","DOIUrl":"10.1177/19417381251411928","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in preparticipation physical examinations and cardiovascular evaluations, sport-related mortality persists. This study assesses athlete mortality over 25 years, stratifying data by sport, state, cause of death, socioeconomic factors, and age.</p><p><strong>Hypothesis: </strong>Most athlete mortality would be due to sudden cardiac death (SCD) and occurred in contact sports in low-resource communities.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A retrospective search of athlete deaths occurring during games or practice from 1999 to 2024 was conducted using an online search engine (https://www.google.com/). Inclusion criteria required deaths to be related directly to athletic activity. Unrelated cases were excluded. The socioeconomic status of athletes was determined through the area deprivation index (ADI). Poisson regression was used to compare mortality rates with respect to sport type and region.</p><p><strong>Results: </strong>A total of 593 athlete deaths were recorded, with a mean age of 16.2 years (range, 5-43). Most deaths occurred in male athletes (92%), at the high school level (70%), and during football participation (65%). Cardiovascular events were the leading cause of death (51%), followed by neurological causes (18%), and exertional heat stroke (11%). Mortality was highest during practice (69%) and was significantly more frequent in rural areas (<i>P</i> < 0.001). States with the highest mortality rates had an average national ADI of 67.8, indicating moderate socioeconomic deprivation, while states with the lowest mortality rates had an average ADI of 43.8. Exertional heat stroke accounted for 87.5% of deaths in football and was most prevalent in the South Atlantic region (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Football had the highest rate of all-cause athlete mortality, driven by cardiovascular events, traumatic brain injuries, and exertional heat stroke. Mortality was disproportionately higher in rural areas during practice.</p><p><strong>Clinical relevance: </strong>Higher mortality rates correlated positively with greater socioeconomic deprivation, as indicated by ADI values.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"1280-1289"},"PeriodicalIF":3.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12830334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Sleep in NCAA Division I Athletes: A Study of Sleep Extension Feasibility.","authors":"Joshua T Goldman, Calvin Duffaut, Nicolas Hatamiya, Basil Ike, Brian Donohoe, Nelson F Boland, Jeremy Vail, Jeongeun Kim, Kristen E Holmes","doi":"10.1177/19417381261496986","DOIUrl":"10.1177/19417381261496986","url":null,"abstract":"<p><strong>Background: </strong>Sleep extension has been shown to improve varied aspects of athletic performance in collegiate athletes. Such studies have been conducted in small cohorts in controlled settings utilizing obsolete monitoring technology. The feasibility of sleep extension has not been evaluated in a broader cohort of collegiate athletes with modern monitoring technology.</p><p><strong>Hypothesis: </strong>Sleep extension may not be feasible in National Collegiate Athletic Association (NCAA) Division I athletes.</p><p><strong>Study design: </strong>Crossover study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Baseline sleep data were collected from NCAA Division I athletes (women's soccer, men's soccer, baseball, and football) during a 2-week period. Subjects were then instructed to extend their total sleep time to 10 hours per night for 2 weeks. All sleep baseline and extension data were collected in the offseason, remote from school examinations. WHOOP bands recorded all sleep metrics. Data were analyzed using paired-samples <i>t</i> tests and Wilcoxon signed rank tests.</p><p><strong>Results: </strong>A total of 50 subjects (14 female, 36 male) participated. The study compared total sleep time (hours) and sleep consistency (percent) - the stability of sleep-wake schedule over time, between baseline and sleep extension phases. Sample size varied for both metrics, ranging from 46 to 49 participants, respectively. There was a statistically significant increase in sleep consistency during the sleep extension phase (baseline, 60.09 ± 12.6%; extension, 64.42 ± 12.4%; <i>P</i> = 0.02). However, total sleep time showed no significant difference between the 2 phases (baseline, 7.63 ± 0.88 hours; extension, 7.51 ± 0.88 hours; <i>P</i> = 0.27).</p><p><strong>Conclusion: </strong>Extension efforts improved sleep consistency but did not significantly impact total sleep time suggesting that a sleep extension intervention can enhance sleep consistency in NCAA Division I athletes but does not significantly impact total sleep time. Sleep extension may be challenging for collegiate athletes given the time-intensive demands of both academics and sports. While sleep extension may be feasible in professional sports, it does not appear to be so in the college setting.</p><p><strong>Clinical relevance: </strong>While the sleep extension intervention improved sleep consistency, it did not improve total sleep time, questioning the feasibility of sleep extension in collegiate sports.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261496986"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Skeletal Stress Injuries of the Wrist and Vitamin D Deficiency: A Case Series.","authors":"Katelyn Harrison, Matthew W Kavolus, Gary M Lourie","doi":"10.1177/19417381261497066","DOIUrl":"10.1177/19417381261497066","url":null,"abstract":"<p><p>Stress reactions occur from repetitive loads that weaken the bone and are often associated with nutritional deficiencies and metabolic dysfunction. More commonly, these injuries are reported in the lower extremities, with less literature on stress fractures in the upper extremities. Seven patients presented with chronic, atraumatic wrist pain that did not improve with conservative measures. Magnetic resonance imaging (MRI) demonstrated increased signal on T2, suggestive of carpal stress reaction. Patients had documented low vitamin D levels or levels obtained after MRI confirmation of stress injury. All patients showed improvement in symptoms after targeted vitamin D supplementation and nutritional management; none of the patients required surgical intervention. Stress reactions in the hand and wrist are relatively uncommon. These injuries, and underlying metabolic abnormalities, can be missed easily without a careful history and work-up. Recognizing these injuries and correcting contributing factors can help avoid more catastrophic skeletal stress injuries in the lower extremities, such as the tibia or femoral neck.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261497066"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-Deficit/Hyperactivity Disorder Is Associated With Lower Rates of Adhesive Capsulitis, Bursitis, Shoulder Stiffness, and Revision Shoulder Arthroscopy After Arthroscopic Rotator Cuff Repair.","authors":"Kyle N Zelenski, Jared Sasaki, Navkiran Bedi, Alex Chelton, Alexander J MacFarlane, Matthew G Alben, Samuel I Fuller","doi":"10.1177/19417381261497018","DOIUrl":"https://doi.org/10.1177/19417381261497018","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic rotator cuff repair (RCR) success is dependent on adherence to a structured postoperative rehabilitation protocol. Attention-deficit/hyperactivity disorder (ADHD) is associated with worse outcomes after certain orthopaedic surgeries, but its impact on rehabilitation after RCR remains unclear. This study compared short-term outcomes after arthroscopic RCR in patients with and without ADHD.</p><p><strong>Hypothesis: </strong>Patients with ADHD will experience higher rates of postoperative complications within the first 12 months after arthroscopic RCR.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Using the TriNetX Research Network, arthroscopic RCR cases from 113 healthcare organizations between January 2006 and January 2026 were identified and stratified by a preoperative ADHD diagnosis. Cohorts were propensity score-matched 1:1 for age, sex, obesity, type 2 diabetes mellitus, mood disorders, anxiety and stress-related disorders, and nicotine dependence. Outcomes at 3 months included revision shoulder arthroscopy, adhesive capsulitis, bursitis, and shoulder stiffness; 1-year outcomes also included deep infection and wound disruption. A Benjamini-Hochberg (BH) correction was applied to address multiple comparisons.</p><p><strong>Results: </strong>After propensity score matching, 4740 patients were included per cohort. At 3 months, patients with ADHD demonstrated lower odds of bursitis (odds ratio [OR], 0.733; 95% CI, 0.592-0.908; <i>P</i> = 0.004; BH-adjusted <i>P</i> = 0.009) and shoulder stiffness (OR, 0.729; 95% CI, 0.629-0.844; <i>P</i> < 0.001; BH-adjusted <i>P</i> < 0.001). At 1 year, the ADHD cohort demonstrated lower odds of revision shoulder arthroscopy (OR, 0.798; 95% CI, 0.655-0.972; <i>P</i> = 0.03; BH-adjusted <i>P</i> = 0.04), adhesive capsulitis (OR, 0.676; 95% CI, 0.550-0.831; <i>P</i> < 0.001; BH-adjusted <i>P</i> < 0.001), bursitis (OR, 0.681; 95% CI, 0.578-0.802; <i>P</i> < 0.001; BH-adjusted <i>P</i> < 0.001), and shoulder stiffness (OR, 0.716; 95% CI, 0.625-0.820; <i>P</i> < 0.001; BH-adjusted <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>ADHD was associated with lower 3-month rates of bursitis and shoulder stiffness, and lower 1-year rates of adhesive capsulitis, bursitis, shoulder stiffness, and revision shoulder arthroscopy after arthroscopic RCR.</p><p><strong>Clinical relevance: </strong>In contrast to previous literature, ADHD was not associated with worse outcomes after arthroscopic RCR and was associated with lower rates of stiffness-related complications. These findings suggest further research is needed to inform patient counseling and surgical decision-making.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261497018"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Apparent Diffusion Coefficient Sampling in Muscle Tears and Intersex Differences in Professional Football Players: A Cohort Study.","authors":"Stefano Lusi, Giorgia Carnicelli, Alessandro Quaglia, Giulia Carimati, Piero Volpi, Marco Francone, Luca Balzarini, Nicola Magarelli","doi":"10.1177/19417381261492942","DOIUrl":"10.1177/19417381261492942","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) is the gold standard for monitoring the evolution of muscle injuries in athletes, although no established quantitative measure of recovery currently exists.</p><p><strong>Hypothesis: </strong>Apparent diffusion coefficient (ADC) values may provide a quantitative measure of muscle healing, and sex-related differences may exist in the evolution of muscle injuries.</p><p><strong>Study design: </strong>Single-center retrospective observational cohort study.</p><p><strong>Level of evidence: </strong>Level 2a.</p><p><strong>Methods: </strong>Twenty-six professional football (soccer) players (13 male ,13 female) undergoing MRI for muscle injury were retrospectively selected between October 2020 and June 2024. All athletes underwent MRI at baseline (T0) and at 2-week follow-up, including diffusion-weighted imaging (DWI) acquisitions with b values of 0-100-800 s/mm^². Two musculoskeletal radiologists measured ADC values within the index lesions at each examination. Changes in ADC between the two time points (ΔADC) were assessed using a paired-samples t test, while sex-related differences were evaluated using the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>The overall mean ADC value at the lesion site decreased from 2.06 ± 0.35 mm²/s at T0 to 1.61 ± 0.30 mm²/s at follow-up corresponding to a mean ΔADC of 0.44 ± 0.20 and a 21.84% reduction. The difference between T0 and follow-up was statistically significant (<i>t</i> = 8.12; <i>P</i> < 0.001). Mean ΔADC values were 0.32 ± 0.20 mm^²/s in male players and 0.56 ± 0.25 mm^²/s in female players, respectively, with a statistically significant difference between sexes (z = -2.95; <i>P</i> = 0.003). When only hamstring injuries were considered, female players showed a significantly greater decrease in ADC over time than male players (Mann-Whitney <i>U</i> test; exact <i>P</i> = 0.02), with mean ΔADC values of 0.56 ± 0.30 and 0.26 ± 0.08 mm^²/s, respectively.</p><p><strong>Conclusion: </strong>Muscle injury is associated with an acute increase in ADC values followed by a progressive decrease during healing. ADC may therefore represent a quantitative imaging biomarker for monitoring muscle recovery.</p><p><strong>Clinical relevance: </strong>ADC measurement within muscle tears may provide a quantitative assessment of healing status and support individualized rehabilitation strategies in athletes. Sex-related differences may exist in injury pathophysiology and recovery patterns relevant to safe return to play.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261492942"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Strategies and Performance Outcomes in Ultramarathon Runners: A Systematic Review.","authors":"Daniel A Brown, Jason Parreira, Katie Spencer, Serena Skinner, Wataru Goto, Larissa Sattler","doi":"10.1177/19417381261494498","DOIUrl":"10.1177/19417381261494498","url":null,"abstract":"<p><strong>Context: </strong>Ultramarathon events impose prolonged physiological and cognitive demands, often spanning 1 or more nights with limited sleep opportunity.</p><p><strong>Objective: </strong>To examine associations between pre-race and intra-race sleep strategies and physical and cognitive performance outcomes in ultramarathon runners.</p><p><strong>Data sources: </strong>PubMed, EMBASE, PsycINFO, SPORTDiscus, and Web of Science were searched from inception to July 25, 2025.</p><p><strong>Study selection: </strong>Primary observational or experimental studies published in English, or available in English translation were eligible when they involved ultramarathon runners (>42.2 km) and reported sleep as a variable of interest in relation to race performance or cognitive performance.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted study design, participant characteristics, race characteristics, sleep outcomes, performance outcomes, and cognitive outcomes. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklists.</p><p><strong>Results: </strong>Nine studies involving 2262 participants were included, with overall low risk of bias. Of the 4 studies examining pre-race sleep, 3 reported a significant association or group difference with a race-performance outcome. Reduced sleep was generally associated with poorer physical and cognitive performance. Greater intra-race sleep duration was consistently associated with longer finish times, reflecting additional nonmoving time and increased sleep need in longer events. Greater pre-race sleep duration, including sleep extension, was associated with faster finish times, and better pre-race sleep quality was linked to higher cognitive performance.</p><p><strong>Conclusion: </strong>Pre-race sleep extension was associated with faster finish times, although the observational evidence does not establish causality. Further research using objective sleep measures and controlled designs is required.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261494498"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A NATA Task Force: Preventing Exertional Heat Stroke Death in American Football Linemen.","authors":"Rebecca L Stearns, Susan W Yeargin, Eric McMahon, Ernest Rimer, Brant Berkstresser, James R Clugston, Ron W Courson, Kathy Dieringer, James J Ellis, Edrain J Hairston, David Hooper, Robert A Huggins, Kristen Kucera, Robb Rehberg, Jennifer D Rheeling, Shaketha Pierce, Spencer Alexander Thomas, Devin Wendel, Douglas J Casa, Christianne M Eason","doi":"10.1177/19417381261486272","DOIUrl":"10.1177/19417381261486272","url":null,"abstract":"<p><strong>Background: </strong>Linemen make up over 90% of all exertional heat stroke (EHS) deaths in collegiate and secondary school American football deaths.</p><p><strong>Purpose: </strong>This document aims to accomplish 3 purposes: (1) briefly summarize the need for specific risk reduction recommendations for EHS in secondary school and collegiate American football linemen, (2) provide new recommendations for the reduction of EHS in football linemen developed with Delphi procedures to build consensus, and (3) summarize the evidence for the existing and new best-practice recommendations that currently exist for EHS risk reduction.</p><p><strong>Design: </strong>Delphi-based Task Force Recommendations.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A multidisciplinary group of experts was convened to build consensus on EHS risk reduction strategies for secondary school and collegiate football linemen. The process involved a narrative review of relevant literature, followed by iterative rounds of anonymous Delphi surveys to refine and validate the recommendations.</p><p><strong>Results: </strong>A total of 20 recommendations were identified, scored, and retained for EHS risk reduction in American football linemen. Key recommendations include the education of coaches and strength and conditioning coaches on EHS risk reduction and treatment, the implementation of heat acclimatization protocols, and weather-based exercise modifications. The recommendations emphasize the importance of the avoidance of high-intensity aerobic testing during transition periods and the importance of having on-site cooling modalities.</p><p><strong>Conclusion: </strong>The high rates of EHS in American football linemen highlight the need for targeted risk reduction strategies. In American football, the design and implementation of workouts for linemen must differ from other players on the team. Linemen require position-specific work-to-rest ratios and tailored training programs.</p><p><strong>Clinical relevance: </strong>By adhering to best practices and continuously updating guidelines based on emerging evidence, the safety and well-being of American football players can be significantly enhanced. These recommendations provide a comprehensive framework for reducing the risk of EHS and improving outcomes for American football linemen.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261486272"},"PeriodicalIF":3.1,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Pulsed Electromagnetic Stimulation on Delayed Onset Muscle Soreness: Randomized Sham-Controlled Trial.","authors":"Ayşe Nur Oymak Soysal, Şule Şimşek, Atiye Kaş Özdemir, Ummuhan Baş Aslan, Hülya Aybek","doi":"10.1177/19417381261494825","DOIUrl":"10.1177/19417381261494825","url":null,"abstract":"<p><strong>Background: </strong>The effect of pulsed electromagnetic field (PEMF) therapy on muscle performance and serum creatine kinase (CK) and myoglobin (Mb) values - the biomarkers of muscle damage in experimentally induced delayed onset muscle soreness (DOMS) - has yet to be investigated. PEMF therapy is known to be effective to reduce muscle pain, muscle recovery time, fatigue but not to increase muscle force production. The study aimed to compare the effect of PEMF and sham therapy on experimentally induced DOMS in sedentary undergraduate college students.</p><p><strong>Hypothesis: </strong>PEMF therapy would improve pain, pressure pain threshold (PPT), functional performance, serum CK activity, and Mb concentration compared with the sham intervention.</p><p><strong>Study design: </strong>Randomized, participant- and assessor-blinded, sham-controlled study.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>This study was conducted at Pamukkale University Sarayköy Vocational School. A total of 52 healthy sedentary people received 3 consecutive days of active (Experimental group, n = 26) or sham (Sham group, n = 26) PEMF therapy 24 hours after DOMS induction with a drop-jump protocol. Pain intensity, PPT, functional performance, serum CK activity, and Mb concentration were assessed at baseline, 24 hours and 72 hours after DOMS induction protocol.</p><p><strong>Results: </strong>The drop-jump protocol induced DOMS successfully in both groups (<i>P</i> < 0.05). All outcome measures were improved in the experimental group (<i>P</i> < 0.05). Mean change scores of PPT (<i>P</i> = 0.53), functional performance (<i>P</i> = 0.10), serum CK (<i>P</i> = 0.38), and Mb concentrations (<i>P</i> = 0.08) were not significantly different between baseline and 72 hours in the sham group. Statistically significant decreases in Mb concentrations were determined in the sham group (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Compared with sham, PEMF therapy improved pain, PPT, functional performance, serum CK activity, and Mb concentration. The duration of PEMF therapy was sufficient to resolve the PPT, functional performance, and serum CK and Mb concentrations associated with DOMS.</p><p><strong>Clinical relevance: </strong>This study adds to existing knowledge in showing that, compared with sham, PEMF therapy improved pain, PPT, functional performance, serum CK activity, and Mb concentration.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261494825"},"PeriodicalIF":3.1,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated Head Impacts May Compromise White Matter Integrity and Bimanual Coordination in American Football Players.","authors":"Sebastian D'Amario, Blaire Magee, Allen A Champagne, Madison E Wilson, Gabriel Ramírez-García, Nicole S Coverdale, Douglas J Cook","doi":"10.1177/19417381261494495","DOIUrl":"10.1177/19417381261494495","url":null,"abstract":"<p><strong>Background: </strong>Repeated head impacts (RHI) in American Football may contribute to subtle white matter (WM) abnormalities and functional deficits even in the absence of clinically diagnosed concussion.</p><p><strong>Hypothesis: </strong>Contact athletes would demonstrate tract-specific differences in fractional anisotropy (FA) and mean diffusivity (MD) compared with noncontact controls, and high-exposure (HE) athletes would show greater within-season diffusion change, worse bimanual coordination, and greater symptom burden than low-exposure (LE) athletes.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Twenty-two male varsity American Football players and 13 male noncontact controls underwent preseason diffusion tensor imaging. Football athletes were monitored over a single season using helmet-mounted accelerometers and stratified into HE and LE groups. Tract-specific FA and MD were derived using probabilistic tractography. Pre-post SCAT3 symptom and severity checklist data were collected from all football athletes, and pre-post Kinarm Ball-on-Bar (BOB) bimanual coordination data were available for 12 athletes.</p><p><strong>Results: </strong>At preseason, contact athletes demonstrated higher FA in 15 of 16 tracts compared with noncontact controls, with lower FA in the forceps minor. MD was lower in 10 of 16 tracts, higher in the bilateral inferior longitudinal fasciculus, and similar in the corticospinal tract and superior thalamic radiation. Over the season, HE athletes sustained more impacts (<i>P</i> < 0.001) and greater cumulative <i>g</i>-force (<i>P</i> = 0.001) than LE athletes. On the BOB task, LE athletes showed modest improvement, whereas HE athletes worsened, yielding a between-group difference in change of 0.59 (95% CI, 0.22-0.96; <i>P</i> = 0.005). Generalized estimating equation models accounting for within-athlete tract correlations did not detect HE-versus-LE differences in FA change (Wald χ²(1) = 0.14; <i>P</i> = 0.71) or MD change (Wald χ²(1) < 0.01; <i>P</i> > 0.99), and SCAT3 symptom and severity scores remained low with no meaningful between-group differences.</p><p><strong>Conclusion: </strong>In 22 contact athletes, repeated head-impact exposure was associated with preseason WM differences and worsening bimanual coordination across a single season, while longitudinal tract-level DTI and symptom-based clinical measures showed limited between-group change.</p><p><strong>Clinical relevance: </strong>Objective motor assessment and advanced neuroimaging may help characterize subtle consequences of RHIs that are missed by routine symptom-based tools.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261494495"},"PeriodicalIF":3.1,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149276889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-Rich Plasma for Knee Osteoarthritis and Patient-Reported Outcomes: A Large Retrospective Analysis.","authors":"Jonathan P Coss, Kenar Z Gelman, Ryan Lingor, Kaylre Greaves, Courtney Melone, Michael Parides, Brian C Halpern","doi":"10.1177/19417381261496039","DOIUrl":"10.1177/19417381261496039","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) is used increasingly to treat knee osteoarthritis (OA). This study aimed to describe PRP use for knee OA and identify patient- and treatment-specific factors associated with clinical outcomes.</p><p><strong>Hypothesis: </strong>Patients with knee OA undergoing intra-articular PRP injections would demonstrate improvement in pain, function, and symptoms over time, with outcomes varying by patient and treatment characteristics.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 743 patients with knee OA were treated with intra-articular PRP injections. Outcomes were assessed using the Numeric Rating Scale (NRS, 0-100, higher scores indicating greater pain) and the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR). Change in patient-reported outcome measure (PROM) scores from baseline and achievement of patient acceptable symptom state (PASS) were measured. Repeated-measures mixed models evaluated outcomes at baseline, 6 months, and 1 year using an all-response analysis (391 patients for Pain NRS; 400 for KOOS-JR).</p><p><strong>Results: </strong>PRP injections were associated with improvement in pain, function, and symptom state. Pain NRS improved from 39.2 at baseline to 27.2 at 6 months and 22.4 at 1 year (both <i>P</i> < 0.001), while KOOS-JR improved from 60.7 to 68.5 and 69.1 (both <i>P</i> < 0.001), with similar findings in the complete-case cohort. When stratified by radiographic severity, patients with Kellgren-Lawrence (KL) grades 1 to 3 improved in both outcomes at 6 months and 1 year, while patients with KL grade 4 improved in Pain NRS at 1 year (<i>P</i> < 0.001) and KOOS-JR at 6 months (<i>P</i> = 0.01) and 1 year (<i>P</i> = 0.001). PASS achievement rates increased over time for both pain and function.</p><p><strong>Conclusion: </strong>Intra-articular PRP injections were associated with improvements in pain, function, and symptoms in patients with knee OA. Differences between complete-case and all-response analyses suggest that follow-up patterns may influence estimated treatment response.</p><p><strong>Clinical relevance: </strong>These findings describe patient-reported outcomes after intra-articular PRP injection for knee OA. Because this study lacked a control group, findings should not be interpreted as evidence that PRP caused the observed improvements.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381261496039"},"PeriodicalIF":3.1,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}