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Return to play protocol

Lauren V Fortington, Dara M Twomey, Caroline F Finch
BACKGROUND: Head injuries, particularly concussion, are a major cause of concern in many sports, particularly the football codes, driving a need to better understand injury mechanisms and potential methods of prevention. The aim of this study was to describe the mechanisms and follow up care of concussion injuries sustained in adult male community Australian football to identify target areas for prevention and management. METHODS: Secondary analysis of injury data collected in a cluster randomised controlled trial in community Australian football across two states of Australia in 2007 and 2008...
December 2015: Injury Epidemiology
Andrew R Hsu, Robert B Anderson
Physicians need to be aware of a variety of foot and ankle injuries that commonly occur in American football, including turf toe, Jones fractures, Lisfranc injuries, syndesmotic and deltoid disruption, and Achilles ruptures. These injuries are often complex and require early individual tailoring of treatment and rehabilitation protocols. Successful management and return to play requires early diagnosis, a thorough work-up, and prompt surgical intervention when warranted with meticulous attention to restoration of normal foot and ankle anatomy...
September 2016: American Journal of Orthopedics
Alexis Descatha, Alice Huynh Tuong, Pierre Coninx, Michel Baer, Thomas Loeb, Thomas Despréaux
In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans...
2016: Frontiers in Public Health
Mohammad Reza Pourahmadi, Morteza Taghipour, Ismail Ebrahimi Takamjani, Mohammad Ali Sanjari, Mohammad Ali Mohseni-Bandpei, Abbas Ali Keshtkar
INTRODUCTION: Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH...
September 27, 2016: BMJ Open
Jo Gibson, Jim Kerss, Chris Morgan, Peter Brownson
BACKGROUND: Advances in arthroscopic surgery have resulted in biomechanically stronger repairs that might allow for accelerated rehabilitation protocols and hence faster return to play. Evidence for such regimes in the shoulder, particularly in elite athletes, is lacking. METHODS: This prospective single surgeon (PB) series included 34 professional footballers undergoing an accelerated rehabilitation programme following arthroscopic soft tissue stabilization subsequent to traumatic anterior shoulder dislocation...
October 2016: Shoulder & Elbow
Karolina J Urban, Lily Riggs, Greg D Wells, Michelle Keightley, Jen-Kai Chen, Alain Ptito, Philippe Fait, Tim Taha, Katia J Sinopoli
Mild traumatic brain injury (mTBI) is common in youth, especially in those who participate in sport. Recent investigations from our group have shown that asymptomatic children and adolescents with mTBI continue to exhibit alterations in neural activity and cognitive performance compared with those without a history of mTBI. This is an intriguing finding, given that current return-to-learn and return-to-play protocols rely predominately on subjective symptom reports, which may not be sensitive enough to detect subtle injury-related changes...
October 13, 2016: Journal of Neurotrauma
Dean Cordingley, Richard Girardin, Karen Reimer, Lesley Ritchie, Jeff Leiter, Kelly Russell, Michael J Ellis
OBJECTIVE The objectives of this study were 2-fold: 1) to evaluate the safety, tolerability, and clinical use of graded aerobic treadmill testing in pediatric patients with sports-related concussion (SRC), and 2) to evaluate the clinical outcomes of treatment with a submaximal aerobic exercise program in patients with physiological post-concussion disorder (PCD). METHODS The authors conducted a retrospective chart review of pediatric patients (age < 20 years) with SRC who were referred to a multidisciplinary pediatric concussion program and underwent graded aerobic treadmill testing between October 9, 2014, and February 11, 2016...
September 13, 2016: Journal of Neurosurgery. Pediatrics
Colin W Fuller, Gordon W Fuller, Simon P T Kemp, Martin Raftery
OBJECTIVE: To evaluate World Rugby's concussion management process during Rugby World Cup (RWC) 2015. DESIGN: A prospective, whole population study. POPULATION: 639 international rugby players representing 20 countries. METHOD: The concussion management process consisted of 3 time-based, multifaceted stages: an initial on-pitch and/or pitch-side assessment of the injury, a follow-up assessment within 3 hours and an assessment at 36-48 hours...
September 1, 2016: British Journal of Sports Medicine
Christopher Kim, Patrick M Chasse, Dean C Taylor
Medial collateral ligament injuries are common in the athletic population. Partial injuries are treated nonoperatively with excellent outcomes. Complete ruptures may be treated nonoperatively, although some will require surgery. A comprehensive rehabilitation program is critical to outcome, but a standardized program for all injuries does not exist. Most of the literature regarding nonoperative and postoperative rehabilitation include observational reports and case studies. Level I studies comparing rehabilitation protocols have not been published...
October 2016: Clinics in Sports Medicine
Alaina M Brelin, John-Paul H Rue
Meniscus tears are commonly encountered in the athletic population and can result in significant loss of playing time. Current treatment methods for acute tears consist of meniscectomy and meniscal repair, whereas meniscal allograft transplant is reserved as a salvage procedure for symptomatic meniscectomized patients who desire a more functional knee. This review describes the postoperative rehabilitation protocol for each procedure and evaluates the outcomes in existing literature as it pertains to the athlete...
October 2016: Clinics in Sports Medicine
Kathryn J Schneider
Concussion is one of the most common injuries in sport and recreation today. Reports of concussion have increased in recent years, likely due to increased societal awareness and the risk of longer-term sequelae. Presently, treatment includes a period of prescribed rest in the acute period following injury, followed by a protocol of graded exertion. Despite an initial period of rest and attempts at a gradual return to play, up to 30% of individuals may have ongoing symptoms past the acute period. The goal of this viewpoint is to introduce the reader to the most common symptoms of concussion and the need for a new, more active paradigm during treatment...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
Isabelle Senécal, Nadia Richer
OBJECTIVE: To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program. CLINICAL FEATURES: A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking...
June 2016: Journal of the Canadian Chiropractic Association
Arrani Senthinathan, Lynda M Mainwaring, Michael Hutchison
OBJECTIVE: To assess heart rate variability (HRV) in athletes with concussion across three phases of recovery. DESIGN: A prospective matched control group design included the collection of HRV and symptoms measured by the Rivermead Post-Concussion Questionnaire. These measures were taken at 3 phases of recovery [(1) symptomatic; (2). asymptomatic; and (3) one-week after return-to-play (RTP)]. The same protocol was completed by noninjured athletes. SETTING: Interuniversity sports teams at a single institution...
July 1, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Richard Ma, Victor Lopez, Meryle G Weinstein, James L Chen, Christopher M Black, Arun T Gupta, Justin D Harbst, Christian Victoria, Answorth A Allen
PURPOSE: The objective of this study is to determine incidence (injuries/1000 playing hours (ph)), severity (days of absence), and cause of match injuries in US women's Rugby-7s. METHODS: We performed a prospective epidemiological study (2010-2013) of injury of 3876 under-19 to elite/national female Rugby-7s players (nonelite = 3324, elite = 552) on 323 teams (nonelite = 277, elite = 46), applying methodology and injury definitions compliant with the international consensus statement on rugby research...
October 2016: Medicine and Science in Sports and Exercise
Samuel K Chu, Monica E Rho
Hamstring injuries are very common in athletes. Acute hamstring strains can occur with high-speed running or with excessive hamstring lengthening. Athletes with proximal hamstring tendinopathy often do not report a specific inciting event; instead, they develop the pathology from chronic overuse. A thorough history and physical examination is important to determine the appropriate diagnosis and rule out other causes of posterior thigh pain. Conservative management of hamstring strains involves a rehabilitation protocol that gradually increases intensity and range of motion, and progresses to sport-specific and neuromuscular control exercises...
May 2016: Current Sports Medicine Reports
Lauren M Simon, Cory N Mitchell
There are an estimated 1.6 to 3.8 million sports and recreation-related concussions annually in the United States, with an average annual increase in incidence of 15.5% from 1998 to 2007. From 2009 to 2014, all 50 states enacted youth concussion legislation. This study clarifies core elements common to state concussion legislation and State Interscholastic Athletic Association (SIAA) implementation. A concussion literature, legislative, and SIAA concussion bylaw review was performed for all 50 U.S. states. Mandated concussion education varies in the frequency of certification and method of education...
May 2016: Current Sports Medicine Reports
Mark Tommerdahl, Robert G Dennis, Eric M Francisco, Jameson K Holden, Richard Nguyen, Oleg V Favorov
The purpose of this research was to determine if cortical metrics-a unique set of sensory-based assessment tools-could be used to characterize and differentiate concussed individuals from nonconcussed individuals. Cortical metrics take advantage of the somatotopic relationship between skin and cortex, and the protocols are designed to evoke interactions between adjacent cortical regions to investigate fundamental mechanisms that mediate cortical-cortical interactions. Student athletes, aged 18 to 22 years, were recruited into the study through an athletic training center that made determinations of postconcussion return-to-play status...
May 2016: Military Medicine
Iris Jaitovich Groisman, Beatrice Godard
Research Ethics Boards (REBs) are expected to evaluate protocols planning the use of Next Generation Sequencing technologies (NGS), assuring that any genomic finding will be properly managed. As Canadian REBs play a central role in the disclosure of such results, we deemed it important to examine the views and experience of REB members on the return of aggregated research results, individual research results (IRRs) and incidental findings (IFs) in current genomic research. With this intent, we carried out a web-based survey, which showed that 59...
2016: PloS One
Laureen D Hachem, George Kourtis, Swapna Mylabathula, Charles H Tator
BACKGROUND: In response to the rising incidence of concussions among children and adolescents, the province of Ontario recently introduced the Ontario Policy/Program Memorandum on Concussions (PPM No. 158) requiring school boards to develop a concussion protocol. As this is the first policy of its kind in Canada, the impact of the PPM is not yet known. METHODS: An electronic survey was sent to all high school principals in the Toronto District School Board 1 year after announcement of the PPM...
July 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Zachary Y Kerr, Scott L Zuckerman, Erin B Wasserman, Tracey Covassin, Aristarque Djoko, Thomas P Dompier
IMPORTANCE: To our knowledge, little research has examined concussion across the youth/adolescent spectrum and even less has examined concussion-related outcomes (ie, symptoms and return to play). OBJECTIVE: To examine and compare sport-related concussion outcomes (symptoms and return to play) in youth, high school, and collegiate football athletes. DESIGN, SETTING, AND PARTICIPANTS: Athletic trainers attended each practice and game during the 2012 to 2014 seasons and reported injuries...
July 1, 2016: JAMA Pediatrics
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