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The mission of SMR is to objectively summarize and describe the clinical relevance of research articles related to basic science, translational research, and clinical research that may be relevant to students and professionals interested in sports medicine. Furthermore, SMR aims to provide a forum for clinicians, researchers, and students in sports medicine-related fields to discuss the clinical relevance of new research.
Take Home Message: Hyaluronic acid injections decrease factors related to collagen degradation. Some blood tests may differentiate responders and nonresponders to these injections.
Knee osteoarthritis, one of the leading causes of disability, has no cure and current treatments commonly involve medications to decrease inflammation and pain. Hyaluronic acid (HA) injections have become a popular form of treatment for knee osteoarthritis. However, the mechanism of action has yet to be determ........ Read more »
Henrotin Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B, Rannou F, Piroth C, Mathieu P.... (2013) Early decrease of serum biomarkers of type II collagen degradation (Coll2-1) and joint inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in patients with knee osteoarthritis: A research study part of the Biovisco study. Journal of Orthopaedic Research, 31(6), 901-7. PMID: 23423846
Take Home Message: Fitness level may influence baseline concussion symptom reporting with fitter individuals reporting fewer concussion symptoms. Athletes also appear to report more concussion symptoms when reporting after exercise.
Baseline testing in concussion management, including graded symptom assessment, has become commonplace in multiple sports on almost every level of competition. Different assessment tools (e.g., Sideline Concussion Assessment Tool [SCAT3], Immediate Post-Concussi........ Read more »
Mrazik, M., Naidu, D., Lebrun, C., Game, A., & Matthews-White, J. (2013) Does an Individual's Fitness Level Affect Baseline Concussion Symptoms?. Journal of Athletic Training, 2147483647. DOI: 10.4085/1062-6050-48.3.19
Take Home Message: Elite soccer athletes may be at an increased risk for knee and ankle osteoarthritis compared with the general population. This group should be identified as high risk and preventative measures should be taken.
While participation in elite-level sports is often viewed as a good thing, there is an established increased risk of short-term injuries (e.g., sprains, strains). This increased injury risk may leave athletes at an increased risk for long-term disability (e.g., oste........ Read more »
Kuijt, M., Inklaar, H., Gouttebarge, V., & Frings-Dresen, M. (2012) Knee and ankle osteoarthritis in former elite soccer players: A systematic review of the recent literature. Journal of Science and Medicine in Sport, 15(6), 480-487. DOI: 10.1016/j.jsams.2012.02.008
Take Home Message: The balance error scoring system (BESS) test is more effective in assessing high school age students’ concussions compared to the Balance Accelerometer Measure (BAM) assessment. The tandem leg stances on firm and foam surface of the BESS test are the most sensitive and specific positions for the detection of a concussion.
Assessing balance after a concussion provides useful information not only for diagnosis and prognosis but also during the athlete’s return to ........ Read more »
Furman GR, Lin CC, Bellanca JL, Marchetti GF, Collins MW, & Whitney SL. (2013) Comparison of the Balance Accelerometer Measure and Balance Error Scoring System in Adolescent Concussions in Sports. The American Journal of Sports Medicine. PMID: 23585486
Take Home Message: The Wii Balance Board is an acceptable substitute for measuring the center of pressure during single leg stance balance tests.
While a laboratory grade force plate is the gold standard for both testing and training balance, these force plates are limited to research laboratories. Due to the importance of balance testing and training during the rehabilitation process, a cost effective, widely available and portable force plate is desirable. Therefore, Huurnink and colleagues........ Read more »
Huurnink A, Fransz DP, Kingma I, & van Dieën JH. (2013) Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks. Journal of Biomechanics, 46(7), 1392-5. PMID: 23528845
Take Home Message: NSAIDs are a common treatment method for musculoskeletal injuries; however, over-the-counter availability, overuse, self-medication, and trends of initial use in high school may interfere with appropriate consumption among college athletes.
Nonsteroidal anti-inflammatory drugs (NSAIDs), a common treatment for athletic injuries, are generally safe medications when used short-term but can become problematic when used long-term and without oversight from a medical professional........ Read more »
Holmes N, Cronholm PF, Duffy AJ 3rd, & Webner D. (2013) Nonsteroidal Anti-Inflammatory Drug Use in Collegiate Football Players. Clinical Journal of Sport Medicine. PMID: 23528841
Take Home Message: Achilles tendon pathology is associated with variation within a gene (TIMP2) responsible for inhibiting enzymes responsible for collagen degradation. Genetic pre-screening of at-risk individuals may help guide individualized treatment strategies.
Genetic risk factors have recently been identified for Achilles tendon pathology, which may allow for genetic screening and identification of at-risk patients and could help guide clinical management of this injury. Specifically, p........ Read more »
El Khoury L, Posthumus M, Collins M, Handley CJ, Cook J, & Raleigh SM. (2013) Polymorphic variation within the ADAMTS2, ADAMTS14, ADAMTS5, ADAM12 and TIMP2 genes and the risk of Achilles tendon pathology: A genetic association study. Journal of Science and Medicine in Sport. PMID: 23491141
Take Home Message: Knees with a recent history of an anterior cruciate ligament injury have radiographic and biochemical differences from healthy knees.
An anterior cruciate ligament (ACL) injury predisposes a knee to osteoarthritis. Little is known about the causes and characteristics of the path from injury to osteoarthritis. Without these fundamental concepts it is challenging to determine who will develop knee osteoarthritis, optimal interventions, and how to measure if the treatments a........ Read more »
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Assessment of Early Tibiofemoral Joint Space Width Changes After Anterior Cruciate Ligament Injury and Reconstruction: A Matched Case-Control Study. The American Journal of Sports Medicine, 41(4), 769-778. DOI: 10.1177/0363546513477838
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Relationship Between Markers of Type II Collagen Metabolism and Tibiofemoral Joint Space Width Changes After ACL Injury and Reconstruction. The American Journal of Sports Medicine, 41(4), 779-787. DOI: 10.1177/0363546513476481
Take Home Message: Players sustained more head impacts and higher severity of impacts on days of diagnosed concussion compared to days with no diagnosed concussion. Also, peak linear acceleration was the best predictor of immediately diagnosed concussions.
Concussion prevention methods are difficult to develop because we lack an understanding of the relationship between head impact mechanics and subsequent concussions. We can improve our understanding by measuring impact forces during sportin........ Read more »
Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, Broglio SP, McAllister TW, Guskiewicz KM, Mihalik JP.... (2013) Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion. Medicine and Science in Sports and Exercise, 45(4), 737-746. PMID: 23135363
Take Home Message: Coaches who are well trained to implement injury prevention, warm-up programs are as effective as the supervision of a physiotherapist at training sessions.
Injury prevention programs typically are multifaceted warm-up programs which focus on neuromuscular recruitment. While many programs exist it is difficult to assess their efficacy due to varying levels of adherence to the injury prevention program. Therefore, Steffen and colleagues completed a cluster-randomized trial t........ Read more »
Steffen K, Meeuwisse WH, Romiti M, Kang J, McKay C, Bizzini M, Dvorak J, Finch C, Myklebust G, & Emery CA. (2013) Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11 ) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. British Journal of Sports Medicine. PMID: 23486935
Adhesive capsulitis is very difficult to treat due to the active inflammation within the capsule and high intensity of pain. Corticosteroid injections are commonly used as a treatment; however, clinicians have used a variety of doses – with no scientific justification. Therefore, the authors investigated the optimal dose (20 mg or 40 mg) of corticosteroids among a group of 53 patients with stage 2 adhesive capsulitis.... Read more »
Yoon SH, Lee HY, Lee HJ, & Kwack KS. (2013) Optimal Dose of Intra-articular Corticosteroids for Adhesive Capsulitis: A Randomized, Triple-Blind, Placebo-Controlled Trial. The American Journal of Sports Medicine. PMID: 23507791
Take Home Message: Whole body vibration therapy may improve strength and postural control among post-ACL reconstruction patients as an adjunctive therapy to rehabilitation.
Deficits in strength, proprioception, and postural control are often evident post anterior cruciate ligament (ACL) reconstruction and can last from 6-months to 4-years post-surgery. Whole-body vibration therapy (WBVT) improves balance and postural control in many populations, and if introduced early after an ACL reconstru........ Read more »
Fu CL, Yung SH, Law KY, Leung KH, Lui PY, Siu HK, & Chan KM. (2013) The effect of early whole-body vibration therapy on neuromuscular control after anterior cruciate ligament reconstruction: a randomized controlled trial. The American Journal of Sports Medicine, 41(4), 804-14. PMID: 23460328
Take Home Message: Delayed-concussion diagnoses are preceded by a higher number of impacts where as concussion diagnosed at the time of injury are associated with higher kinematic measures.
Diagnosis of a concussion is in part decided by whether an athlete reports one or more concussive signs or symptoms; however, it is not uncommon for athletes to report these signs and symptoms day(s) after an injury. The delayed reporting may be attributable to athletes not wanting to stop playing, athlete........ Read more »
Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, Broglio SP, McAllister TW, Guskiewicz KM, Mihalik JP.... (2013) Timing of Concussion Diagnosis Is Related to Head Impact Exposure Prior to Injury. Medicine and Science in Sports and Exercise, 45(4), 747-754. PMID: 23135364
Take Home Message: Exercises that elicit abdominal/lumbar co-contraction coupled with shoulder and hip activation (integration exercise) provoke greater core muscle activation than muscle isolation exercises.
It is widely accepted that a strong core will benefit the individual in sports performance, rehabilitation, and general fitness. However, knowing what type of exercises to select to aid performance and prevent injuries is absolutely paramount. While most studies have focused on isolatio........ Read more »
Gottschall JS, Mills J, & Hastings B. (2013) Integration core exercises elicit greater muscle activation than isolation exercises. Journal of Strength and Conditioning Research, 27(3), 590-6. PMID: 22580983
Take Home Message: Despite understanding the long-term dangers of sustaining a concussion high school athletes show little evidence that they would remove themselves from athletic participation.
Various educational and procedural methods have been put into place to protect student-athletes who have incurred a concussion from sustaining a second. Despite this effort, between 20 and 60% of athletes do not report sustaining a concussion. A deeper understanding of why there is a lack of reporting........ Read more »
Chrisman SP, Quitiquit C, & Rivara FP. (2013) Qualitative study of barriers to concussive symptom reporting in high school athletics. The Journal of Adolescent Health, 52(3), 330-335000. PMID: 23427783
Take Home Message: Video analysis of high school boy’s lacrosse indicated that most concussions are related to the intentional use of helmets in impacts and that the injured player is often not expecting a hit. Results from this type of reseach have already had direct implications on rule changes in lacrosse.
In lacrosse, one of the fasting growing sports in the United States, concussion is a significant concern. Understanding the mechanisms of head injury in boy’s lacrosse could ........ Read more »
Lincoln AE, Caswell SV, Almquist JL, Dunn RE, & Hinton RY. (2013) Video Incident Analysis of Concussions in Boys' High School Lacrosse. The American Journal of Sports Medicine. PMID: 23413274
Take Home Message: Limiting shoulder abduction for 3 or 6 weeks did not reduce the rate of reinjury among patients with shoulder dislocation who were initially treated with 3 weeks of immobilization.
Shoulder dislocations typically occur from a very traumatic event, which commonly results in injury to the inferior glenohumeral ligament and the anterior-inferior labrum. After a dislocation, patients are often immobilized for 3 weeks to allow capsule and labral healing. However, even after a ........ Read more »
Itoi E, Hatakeyama Y, Itoigawa Y, Omi R, Shinozaki N, Yamamoto N, & Sano H. (2013) Is Protecting the Healing Ligament Beneficial After Immobilization in External Rotation for an Initial Shoulder Dislocation?. The American Journal of Sports Medicine. PMID: 23524151
Take Home Message: Back School and McKenzie exercises reduce pain and disability. McKenzie exercises may provide slightly more efficient improvements in short-term disability.
Low back pain affects many active people at some point throughout their lives. The cause and diagnosis are rarely specific and unfortunately it remains unclear which intervention program is most effective for alleviating pain and improving function. The purpose of this randomized comparative effectiveness clinical tria........ Read more »
Garcia AN, Costa LD, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, & Costa LO. (2013) Effectiveness of Back School Versus McKenzie Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial. Physical Therapy. PMID: 23431213
Take Home Message: Corticosteroid injections and structured physiotherapy are not associated with improved patient-reported measures of pain and disability following one year of treatment.
With epicondylalgia, or tennis elbow, the patient experiences pain along the lateral epicondyle during gripping and wrist extension. This condition is usually treated with a combination of corticosteroid injection and physiotherapy. While the short-term effects of this treatment strategy appears favorable, ........ Read more »
Coombes BK, Bisset L, Brooks P, Khan A, & Vicenzino B. (2013) Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA, 309(5), 461-9. PMID: 23385272
Take Home Message: Time, financial cost, availability of literature, lack of knowledge, and working relationships with other health care professionals are common barriers to incorporating evidence-based practice for a clinician.
Evidence-based practice (EBP) has become increasingly important as health care professions have evolved. Athletic training has been no exception, as the release of the fifth edition of the Athletic Training Educational Competencies has placed specific emphasis on inco........ Read more »
Hanekmeier DA, Van Lunen BL. J Athl Train. 2013. Online ahead of print. (2013) Perceptions of Approved Clinical Instructions: Barriers in the Implementation of Evidence-Based Practice. Journal of Athletic Training. info:other/
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