Injuries in the competitive paediatric motocross athlete.
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ABSTRACT:
SUBMITTER: Arena CB
PROVIDER: S-EPMC5548031 | biostudies-other | 2017 Jun
REPOSITORIES: biostudies-other
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Project description:Regular exercise is important for health, fitness and longevity in people living with type 1 diabetes, and many individuals seek to train and compete while living with the condition. Muscle, liver and glycogen metabolism can be normal in athletes with diabetes with good overall glucose management, and exercise performance can be facilitated by modifications to insulin dose and nutrition. However, maintaining normal glucose levels during training, travel and competition can be a major challenge for athletes living with type 1 diabetes. Some athletes have low-to-moderate levels of carbohydrate intake during training and rest days but tend to benefit, from both a glucose and performance perspective, from high rates of carbohydrate feeding during long-distance events. This review highlights the unique metabolic responses to various types of exercise in athletes living with type 1 diabetes. Graphical abstract.
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Project description:Type I diabetes has an incidence of 15 per 100,000 people. Though it is a metabolic disorder, it can be seen in top, even professional athletes. Physical activity is recommended to manage diabetes, but there is a lack of specific knowledge on diabetes management and exercise from dedicated medical staff. This bias leads to suboptimal diabetes management, causing frequent hyper and hypoglycemia, a dysregulation of glycated hemoglobin, blood glucose out of control, and consequent needs to often intervene with extra insulin or carbohydrates. For 5 years, we followed a highly competitive male Caucasian athlete Vovinam Viet Vo Dao, with type I diabetes, aged 17. We monitored his glycated hemoglobin, the insulin drug administered, and glycemia blood level averages. We obtained, over time, a decrease in glycated hemoglobin by almost -22% and insulin administered by -37.33%, and average blood glycemia levels diminished by almost -27%. In addition, we carried out bioimpedance analysis and stratigraphy on the abdomen. Federation trainers supervised all physical training; we recorded an improvement in the general condition, underlined in particular by an increase in phase angle (from bioimpedance) of +17%.
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Project description:BackgroundNon-operative management (NOM) is generally accepted as a treatment method of traumatic paediatric splenic rupture. However, considerable variations in management exist. This study analyses local trends in aetiology and management of paediatric splenic injuries and evaluates the implementation of the guidelines proposed by the American Paediatric Surgical Association (APSA) in a level 1 trauma centre.MethodsThe charts of paediatric patients with blunt splenic injury (BSI) who were admitted or transferred to a level 1 trauma centre between 2003 and 2020 were retrospectively assessed. Information pertaining to demographics, mechanism of injury, injury description, associated injuries, intervention and outcomes were analysed and compared to international literature.ResultsThere were 130 patients with BSI identified (63.1% male), with a mean age of 11.3 ± 4.0 and a mean Injury Severity Score (ISS) of 21.6 ± 13.7. Bicycle accidents were the most common trauma mechanism (23.1%). Sixty-four percent were multi-trauma patients, 25% received blood transfusions, and 31% were haemodynamically unstable. Mean injury grade was 3.0, with 30% of patients having a high-grade injury. In total, 75% of patients underwent NOM with a 100% efficacy rate. Total splenectomy rate was 6.2%. Four patients died due to brain damage. Patients with a high-grade BSI (grades IV-V) had a significantly higher ISS and longer bedrest and more often presented with an active blush on computed tomography (CT) scans than patients with a low-grade BSI (grades I-III). Non-operative management was mainly the choice of treatment in both groups (76.6% and 79.5%, respectively). Haemodynamic instability was a predictor for operative management (OM) (p = 0.001). Predictors for a longer length of stay (LOS) included concomitant injuries, haemodynamic instability and OM (all p < 0.02). Interobserver agreement in the grading of BSI is moderate, with a Cohens Kappa coefficient of 0.493.ConclusionNon-operative management has proven to be a realistic management approach in both low- and high-grade splenic injuries. Consideration for operative management should be based on haemodynamic instability. Compared to the anticipated length of bedrest and hospital stay outlined in the APSA guidelines, the Netherlands can reduce the length of bedrest and hospital stay through their non-operative management.Level of evidenceTherapeutic study, level III.
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Project description:BackgroundTalent transfer (TT) program is an appropriate approach to address the talent gap evident in specific sports activities, while little is known about the injury characteristics of snowboarding athletes involved in the TT program.ObjectiveTo determine the epidemiology of injuries among snowboarders involved in the TT program.MethodsA total of 244 athletes who were not previously engaged in winter sports were selected for training in snowboarding that lasted for 109 days. The injuries and at-risk exposures (A-Es) data were recorded by physicians. Injury rates (IRs), incidence rate ratios (IRRs), and injury proportion ratios (IPRs) were calculated and compared by sex and age groups.ResultsThe overall and time loss (TL) IR were 32.4/1000 A-Es and 12.2/1000 A-Es respectively. The overall and non-time loss (NTL) IRR were higher for female athletes than for male athletes. Additionally, the overall IRR and TL-IRR for female athletes were higher in those athletes who aged ≤15 years old. Over 93% of TL injuries resulted in participation restriction time of ≤7 days (male athletes, 93.94%; female athletes, 94.10%). Trunk (28.43%), knee joints (21.33%), and hand/wrist (16.53%) were found as the common sites of injury in both female and male athletes. The most frequent type of injury was contusion (male athletes: 53.00%, female athletes: 59.10%) resulted from ground/apparatus contact (male athletes: 75.10%, female athletes: 75.20%).ConclusionThe risk injury among snowboarding athletes involved in the TT program during the first snow season training was found noticeable, especially for younger female athletes. The high incidence of ground/apparatus contact-related injuries suggested the necessity of specifically designed training programs and braces for snowboarding athletes involved in the TT program.
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Project description:The aim of this case study was to quantify the magnitude of internal load, acute/chronic workload ratio (ACWR), well-being perception, and heart rate variability (HRV) following 38 weeks of functional-fitness training in a female elite athlete. The internal load was obtained with session rating perceived exertion (session-RPE) while the ACWR was calculated by dividing the acute workload by the chronic workload (four-week average). Furthermore, HRV measurements were analyzed via a commercially available smartphone (HRV4training) each morning upon waking whilst in a supine position. The magnitude of internal load was: the weekly mean total during the 38 weeks was 2092 ± 861 arbitrary units (AU); during the preparation for the Open 2018 was 1973 ± 711 AU; during the Open 2018 it was 1686 ± 412 AU; and during the preparation for the Regionals was 3174 ± 595 AU. The mean ACWR was 1.1 ± 0.5 and 50% of the weeks were outside of the 'safe zone'. The well-being during the 38 weeks of training was 19.4 ± 2.3 points. There were no correlations between training load variables (weekly training load, monotony, ACWR, and HRV), and recuperation subjective variables (well-being, fatigue, sleep, pain, stress, and mood). This case study showed that the training load can be varied in accordance with preparation for a specific competition and ACWR revealed that 50% of the training weeks were outside of the 'safe zone', however, no injuries were reported by the athlete. The effectiveness and cost of these methods are very practical during real world functional-fitness.
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Project description:Purpose To evaluate outcomes of hip arthroscopy in patients with global acetabular retroversion and to identify correlations between sex, radiographic measurements, athlete status, and return to play with patient-reported outcomes (PROs). Methods Retrospective study of patients with global acetabular retroversion who underwent arthroscopic femoroacetabular impingement (FAI) surgery was performed. Global acetabular retroversion was defined by 3 criteria: the crossover sign, ischial spine sign, and posterior wall sign on an anteroposterior (AP) pelvic radiograph. Radiographs were used to measure lateral center edge angle, alpha angle, and anterior and posterior wall indices. Femoral version was measured with 3-dimensional computed tomography. Demographics included age, gender, athlete status, return to play, and reoperation. PROs included modified Harris Hip Score, Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score, visual analog scale (VAS), and Veterans RAND-12. Spearman correlation determined correlation with perioperative PROs. Generalized estimating equation determined independent predictors. Significance was set at P = .05. Results From 2013 to 2019, 149 patients (65.0% female) with 160 hips with FAI and global acetabular retroversion underwent hip arthroscopy. Follow-up averaged 29.6 months. All PROs demonstrated significant improvement with the exception of the Veterans RAND-12 Mental. Female patients scored significantly lower on most postoperative PROs and had greater VAS scores (P = .0002-0.0402). A greater proportion of male subjects met the minimum clinically important difference for the modified Harris Hip Score (88.00% vs 78.79%) Low femoral version correlated with greater HOS ADL, HOS Sport, and Hip Disability and Osteoarthritis Outcome Score Sport scores (P = .0077-0.0177). Athletes reported lower preoperative VAS scores, and higher perioperative scores in multiple PROs (P = .0004-0.0486). Nine hips (5.63%) underwent reoperation. Conclusions Patients with global acetabular retroversion and FAI undergoing hip arthroscopy report good outcomes at short-term follow-up. Male subjects and athletes had superior outcomes compared to female subjects and nonathletes. Radiographic measurements did not correlate with outcomes with exception of low femoral version. Athletes reported lower preoperative pain scores and greater postoperative PROs than nonathletes. Level of Evidence Level IV, therapeutic case series.
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Project description:Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injury (RRI) has been investigated in adults, but few studies have focused on adolescent distance runners. Objectives: (1) To provide descriptive epidemiology of RRI (risks, rates, body regions/areas, and severity) and examine the training practices (frequency, volume, and intensity) of competitive adolescent distance runners (13-18 years) in England, and (2) to describe potential risk factors of RRI. Methods: A cross-sectional study design was used. Adolescent distance runners (n = 113) were recruited from England Athletics affiliated clubs. Participants voluntarily completed an online questionnaire between April and December 2018. At the time of completion, responses were based on the participant's previous 12-months of distance running participation. Incidence proportions (IP) and incidence rates (IR) were calculated. Results: The IP for "all RRI" was 68% (95% CI: 60-77), while the IR was 6.3/1,000 participation hours (95% CI: 5.3-7.4). The most commonly injured body areas were the knee, foot/toes, and lower leg; primarily caused by overuse. The number of training sessions per week (i.e., frequency) significantly increased with chronological age, while a large proportion of participants (58%) self-reported a high level of specialisation. Conclusions: RRI is common in competitive adolescent distance runners. These descriptive data provide guidance for the development of RRI prevention measures. However, analytical epidemiology is required to provide better insight into potential RRI risk factors in this specific population.
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Project description:BackgroundWhile the psychosocial risk factors for traumatic injuries have been comprehensively investigated, less is known about psychosocial factors predisposing athletes to overuse injuries.ObjectiveThe aim of this review was to systematically identify studies and synthesise data that examined psychosocial risk factors for overuse injuries in athletes.DesignSystematic review.Data sourcesMEDLINE, Web of Science and PsycINFO databases, supplemented by hand searching of journals and reference lists.Eligibility criteria for selecting studiesQuantitative and qualitative studies involving competitive athletes, published prior to July 2021, and reporting the relationship between psychosocial variables and overuse injury as an outcome were reviewed. This was limited to academic peer-reviewed journals in Swedish, English, German, Spanish and French. An assessment of the risk of bias was performed using modified versions of the RoBANS and SBU Quality Assessment Scale for Qualitative Studies.ResultsNine quantitative and five qualitative studies evaluating 1061 athletes and 27 psychosocial factors were included for review. Intra-personal factors, inter-personal factors and sociocultural factors were found to be related to the risk of overuse injury when synthesised and reported according to a narrative synthesis approach. Importantly, these psychosocial factors, and the potential mechanisms describing how they might contribute to overuse injury development, appeared to be different compared with those already known for traumatic injuries.ConclusionsThere is preliminary evidence that overuse injuries are likely to partially result from complex interactions between psychosocial factors. Coaches and supporting staff are encouraged to acknowledge the similarities and differences between traumatic and overuse injury aetiology.
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Project description:Elbow injuries are a significant and increasing issue in baseball. Elbow injuries account for 16% of all injuries sustained at the professional level and collegiate level. Because of the continued rise in injury rates, loss of performance value, and medical burden, sports medicine clinicians have attempted to research the causes underlying this injury epidemic in an attempt to help mitigate baseball elbow injuries. Shoulder range of motion (ROM) is the most researched clinical metric related to elbow injuries in baseball and has the greatest consensus as a viable prognostic factor specifically for medial elbow injury. Shoulder ROM is easy to measure, can be modified through stretching and manual therapy interventions, and can be easily assessed during preseason screening throughout all baseball levels. Despite a large number of studies and the widespread use of shoulder ROM in injury risk screening, current findings are unclear as to whether there is a true cause-effect relation with baseball elbow injuries. We argue that the conflicting findings revolving around the value of shoulder ROM measurements associated with baseball elbow injuries are the result of 4 gaps in the research approaches implemented to date: ambiguous research questions, mixed study populations, statistical models used, and shoulder ROM methodology. Specifically, there is a mismatch of methods, statistical models, and conclusions such as (1) investigating the association (i.e., correlation) between shoulder ROM measurements and injury and (2) investigating the cause-effect relation of shoulder ROM to baseball injuries. The purpose of this article is to detail the required scientific steps to evaluate whether preseason shoulder ROM is a potential causal factor for pitching elbow injury. We also provide recommendations to allow for future causal inferences to be made between shoulder ROM and elbow injury. This information will ultimately assist in informing clinical models of care and decision making for baseball throwers.
| S-EPMC9971890 | biostudies-literature
Project description:BackgroundUnintentional falls from windows and balconies pose a serious health risk to children. Limited Canadian data describing such falls currently exist. This study aimed to describe the frequency, demographic characteristics, injury patterns, and risk factors associated with paediatric falls from windows and balconies.MethodsThis study employed both prospective data collection and retrospective medical record review. Prospectively, consenting families were enrolled from February 2015 to February 2017; retrospectively, charts from January 2009 to December 2014 were reviewed. Children 0 to 16 years of age, who presented to the Stollery Children's Hospital (Edmonton, Alberta) emergency department due to a fall from a window or balcony, were included.ResultsA total of 102 children were included; thirty were enrolled prospectively and 72 retrospectively. Median age was 4.5 years (interquartile range 2.83 to 6.83) with 63.7% (65 of 102) males. About 87.2% (89 of 102) of falls were from windows and 12.8% (13 of 102) from balconies. The median estimated height of fall was 4.1 m (interquartile range 3.04 to 4.73). About 58.4% (59 of 101) had at least one major injury (i.e., concussion, fractured skull, internal injury, fractured limb, severe laceration), 36.6% had minor injuries only (i.e., abrasions, contusions, sprains), and 5.0% had no documented injuries. There were no fatalities. About 30.4% (31 of 102) were admitted, with 48.4% of these children (15 of 31) requiring surgery.ConclusionMost falls from windows and balconies occurred in children under the age of 5 years and were associated with serious morbidity, high admission rates, and need for surgery. Child supervision as well as installation of key safety features in windows may help minimize paediatric fall-related injuries.
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