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Return to play protocol

James Rafferty, Craig Ranson, Giles Oatley, Mohamed Mostafa, Prabhat Mathema, Tom Crick, Isabel S Moore
OBJECTIVES: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. METHODS: A four-season (2012/2013-2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined...
March 12, 2018: British Journal of Sports Medicine
Ciaran Thrush, Tabitha J Porter, Brian M Devitt
PURPOSE: Anterior cruciate ligament (ACL) rupture commonly occurs in conjunction with articular cartilage injury. However, there is no consensus on the most appropriate rehabilitation which should be carried out for ACL reconstruction (ACLR) and the surgical management of articular cartilage lesions of the knee. The purpose of this study was to systematically review the literature to investigate the recommended rehabilitation protocol for patients undergoing ACLR with concomitant articular cartilage injury with a view to develop guidelines on the most appropriate treatment...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Riley J Williams
In contrast to anterior cruciate ligament reconstruction, there is a paucity of primary studies that address the issue of return to play after anterior shoulder stabilization for glenohumeral instability. Most studies focused on clinical outcomes after anterior shoulder stabilization provide little detail on the authors' assessment protocols used in determining return to sport readiness. In fact, many issues germane to the postoperative rehabilitation process (biologic healing, motion recovery, strength recovery, and sport-specific considerations) remain poorly defined, and are not typically addressed using validated shoulder outcomes instruments...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Lasse Lempainen, Jussi Kosola, Ricard Pruna, Jordi Puigdellivol, Janne Sarimo, Pekka Niemi, Sakari Orava
Background: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. Purpose: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Study Design: Case series; Level of evidence, 4. Methods: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment...
February 2018: Orthopaedic Journal of Sports Medicine
Rebecca M Lopez, Patrick Tanner, Sarah Irani, P Patrick Mularoni
OBJECTIVE:   To present a functional return-to-play (RTP) progression after exertional heat stroke (EHS) in a 17-year-old high school football defensive end (height = 185 cm, mass = 145.5 kg). BACKGROUND:   The patient had no pertinent medical history but moved to a warm climate several days before the EHS occurred. After completing an off-season conditioning test (14- × 110-yd [12.6- × 99.0-m] sprints) on a warm afternoon (temperature = approximately 34°C [93°F], relative humidity = 53%), the patient collapsed...
January 26, 2018: Journal of Athletic Training
Steffan Arthur Griffin, Craig Ranson, Isabel Moore, Prabhat Mathema
Background: Rugby union is a collision sport where participants are at high risk of sustaining a concussion. In settings where there is little qualified medical supervision, certain stakeholders (eg, coaches and officials) should possess sufficient knowledge in regard to the recognition and management of concussion. Aim: The aim of this study was to assess the knowledge and experience of various aspects of concussion among coaches and referees involved in Welsh amateur rugby union...
2017: BMJ Open Sport & Exercise Medicine
J Banks Deal, Ed Smith, Wendell Heard, Michael J O'Brien, Felix H Savoie
Background: Jobe revolutionized the treatment of medial ulnar collateral ligament (MUCL) tears with his reconstruction technique. However, not all MUCL injuries require operative management; Rettig showed that 42% of MUCL injuries respond to conservative management. This was improved by Podesta, who showed that augmentation of nonoperative management with platelet-rich plasma (PRP) and magnetic resonance imaging (MRI) for detecting partial MUCL tears resulted in significantly higher success rates...
November 2017: Orthopaedic Journal of Sports Medicine
Myles Murphy, Marshall Stockden, Ken Withers, William Breidahl, Jonathon Charlesworth
INTRODUCTION: Anterior shoulder dislocations are a common injury in many sports resulting in extended time lost from play with an extremely high recurrence rate in young athletes playing high risk sport. Latarjet shoulder reconstruction is a common surgical procedure used to prevent subsequent dislocation with an expected rehabilitation timeframe of between four to six months before return to play. CASE DESCRIPTION: A 21-year-old male Australian football player experienced two left sided shoulder dislocations before undergoing a left Latarjet shoulder reconstruction...
November 15, 2017: Journal of Sport Rehabilitation
J R Silva, M C Rumpf, M Hertzog, C Castagna, A Farooq, O Girard, K Hader
BACKGROUND: Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses. OBJECTIVES: (1) To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs...
November 2, 2017: Sports Medicine
William C Goedel, Sari L Reisner, Aron C Janssen, Tonia C Poteat, Seann D Regan, Noah T Kreski, Gladyne Confident, Dustin T Duncan
Purpose: To date, no studies utilizing global positioning system (GPS) technologies to measure mobility and environmental exposures have been conducted among a sample of transgender women despite the potential salient role neighborhood contexts may play in the health of this population. As such, the purpose of this study was to assess the acceptability and feasibility of a weeklong GPS protocol among a sample of transgender women in New York City. Methods: A sample of 14 transgender women residing in the New York City metropolitan area were recruited through community based methods to wear and charge a GPS device for 7 days to measure daily mobility...
2017: Transgender Health
Chelsey Wilks, Qingqing Yin, Sin Yee Ang, Brandon Matsumiya, Anita Lungu, Marsha Linehan
BACKGROUND: The need to develop effective and accessible interventions for suicidal individuals engaging in heavy episodic drinking (HED) cannot be understated. While the link between alcohol use and suicidality is a complex one that remains to be elucidated, emotion dysregulation may play a key role in alcohol-related suicide risk in these individuals. OBJECTIVE: In the current study, an 8-week Internet-delivered dialectical behavior therapy (DBT) skills training intervention was developed and preliminarily evaluated for suicidal individuals who engage in HED to regulate emotions...
October 25, 2017: JMIR Research Protocols
Ferenc Magyari, Karolina Kósa, Roland Berecz, Anna Illés, Zsófia Miltényi, Zsófia Simon, Árpád Illés
BACKGROUND: Due to risk and response adapted treatment strategies, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured, and become long-term survivors. However, a high proportion of survivors suffer from treatment-related long-term side effects such as secondary malignancy, organ failure, persistent fatigue and psychological distress. The aim of this study was to evaluate psychological distress and its risk factors among our HL survivors. METHODS: One hundred sixty-three (50% female) adult HL survivors were contacted between January 1, 2012 and march 31, 2015 in our outpatient centre...
September 19, 2017: Health and Quality of Life Outcomes
Sameer Singh, Kevin Larkin, Anish Kadakia, Wellington Hsu
BACKGROUND: Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population. HYPOTHESIS: Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on post-operative performance or league participation...
September 1, 2017: Sports Health
Khalida Itriyeva, Ronald Feinstein, Linda Carmine
Background Concussions, a form of mild traumatic brain injury, are a current "hot topic" in sports and medicine, with current research focusing on diagnosis, treatment, and the long-term effects of repeated concussions on development of chronic traumatic encephalopathy. Concussions represent 8.9% of all high school athletic injuries, and pediatricians see many of these patients in their practices, however evolving guidelines and recommendations have resulted in varying practices among providers. Objective To assess how local pediatricians in New York Chapter 2 of the American Academy of Pediatrics (AAP) diagnose and treat concussion patients, and to evaluate the need for continuing education in this area...
August 25, 2017: International Journal of Adolescent Medicine and Health
Nathan W Churchill, Michael G Hutchison, Doug Richards, General Leung, Simon J Graham, Tom A Schweizer
The medical decision of return to play (RTP) after a sport concussion is largely based on symptom status following a graded exercise protocol. However, it is currently unknown how objective markers of brain structure and function relate to clinical recovery. The goal of this study was to determine whether differences in brain structure and function at acute injury remain present at RTP. In this longitudinal study, 54 active varsity athletes were scanned using magnetic resonance imaging (MRI), including 27 with recent concussion, imaged at both acute injury and medical clearance, along with 27 matched controls...
August 24, 2017: Scientific Reports
Vincent Gras, Markus Boland, Alexandre Vignaud, Guillaume Ferrand, Alexis Amadon, Franck Mauconduit, Denis Le Bihan, Tony Stöcker, Nicolas Boulant
Parallel transmission (pTx) technology, despite its great potential to mitigate the transmit field inhomogeneity problem in magnetic resonance imaging at ultra-high field (UHF), suffers from a cumbersome calibration procedure, thereby making the approach problematic for routine use. The purpose of this work is to demonstrate on two different 7T systems respectively equipped with 8-transmit-channel RF coils from two different suppliers (Rapid-Biomed and Nova Medical), the benefit of so-called universal pulses (UP), optimized to produce uniform excitations in the brain in a population of adults and making unnecessary the calibration procedures mentioned above...
2017: PloS One
Dmitry Esterov, Brian D Greenwald
A mild traumatic brain injury (mTBI) is a complex pathophysiologic process that has a systemic effect on the body aside from solely an impairment in cognitive function. Dysfunction of the autonomic nervous system (ANS) has been found to induce abnormalities in organ systems throughout the body, and may contribute to cardiovascular dysregulation and increased mortality. Autonomic dysfunction, also known as dysautonomia, has been studied in moderate and severe TBI, and has emerged as a major contributing factor in the symptomatology in mTBI as well...
August 11, 2017: Brain Sciences
Sarah A Dachtyl, Pedro Morales
Purpose: In this article, we describe an academic concussion management protocol designed for grades Pre-K to 12, called Cognitive Return to Exertion (CoRTEx). Collaboration between the speech-language pathologist (SLP) and athletic trainer (AT) is highlighted. Method: A description of CoRTEx is provided, and the need for collaboration is emphasized. A case study illustrates an example of how CoRTEx can be implemented at the individual student level. Results: A total of 165 students went through CoRTEx from the pilot in April 2014 through December 2016...
August 15, 2017: American Journal of Speech-language Pathology
Stephen S McAleer, Ed Lippie, Darcy Norman, Helge Riepenhof
Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting, and cutting are the dominant movements. There are few nonoperative rehabilitation strategies for the condition reported in the literature, and the outcome of conservative treatment has not been documented. Case Description Five professional and academy soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment, were treated with a nonoperative rehabilitation program that featured functional and clinical objective markers as progression criteria...
September 2017: Journal of Orthopaedic and Sports Physical Therapy
M Conti, R Garofalo, A Castagna, G Massazza, E Ceccarelli
PURPOSE: We evaluate the ability of in-season competitive athletes to return to competition after an anterior shoulder instability treated conservatively with a new dynamic brace combined with a specific rehabilitation program. METHODS: Twenty soccer players affected by traumatic anterior shoulder dislocation have been enrolled in the "Footballer In Season Fast Rehab" project during 2 consecutive football seasons. We excluded patients affected by rotator cuff tears and the bony defect over 25%...
December 2017: Musculoskeletal Surgery
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