Current sports medicine reports
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Curr Sports Med Rep · Jul 2013
Exercise deficit disorder in youth: a paradigm shift toward disease prevention and comprehensive care.
Despite the widely recognized benefits of daily play, recreation, sports, and physical education on the physical and psychosocial well-being of children and adolescents, many contemporary children and adolescents worldwide do not meet the recommendations for daily physical activity (PA). The decline in PA seems to start early in life, which leads to conditions characterized by reduced levels of PA in the pediatric population that are inconsistent with current public health recommendations. Unlike many other diseases and disorders in pediatrics, physical inactivity in youth is unique in that it currently lacks a clinical gold standard for diagnosis. ⋯ Exercise-deficient children need to be identified early in life and treated with developmentally appropriate exercise programs designed to target movement deficiencies and physical weaknesses in a supportive environment. Without such interventions early in life, children are more likely to become resistant to our interventions later in life and consequently experience adverse health consequences. Integrative approaches that link health care professionals, pediatric exercise specialists, school administrators, community leaders, and policy makers may provide the best opportunity to promote daily PA, reinforce desirable behaviors, and educate parents about the exercise-health link.
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Curr Sports Med Rep · May 2013
Sideline management from head to toe of the skeletally immature athlete.
Many articles have been written on specific injury patterns and types of injuries that occur in sports, but few have addressed sideline management with a specific focus on the injuries affecting skeletally immature athletes. This article will review the most common injuries that can occur with the skeletally immature athlete from head to toe in comparison to a skeletally mature or adult athlete. It will address also how to approach these injuries from a sideline and sports medicine perspective, thus providing insight for health care professionals to evaluate and treat young athletes that could allow them to return to sports safely.
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Curr Sports Med Rep · Mar 2013
ReviewElectrocardiographic findings suggestive of cardiomyopathy: what to look for and what to do next.
Cardiomyopathies are the leading cause of sudden cardiac death in young athletes. The electrocardiogram (ECG) is utilized as a first-line screening and diagnostic tool for detecting conditions associated with sudden death. Fundamental to the appropriate evaluation of athletes undergoing ECG is an understanding of what ECG findings are abnormal and may suggest the presence of a pathologic cardiac disorder. ⋯ This article reviews the ECG findings in the four most common cardiomyopathies afflicting young athletes - hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, left ventricular noncompaction, and idiopathic dilated cardiomyopathy. ECG changes resulting from physiologic cardiac adaptation to regular exercise (athlete's heart) are presented also. This article provides a framework for distinguishing normal from abnormal ECG findings and outlines appropriate steps for further evaluation of ECG abnormalities in athletes suspected of having a cardiomyopathy.
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Sports-related concussion has gained increased prominence, in part due to media coverage of several well-known athletes who have died from consequences of chronic traumatic encephalopathy (CTE). CTE was first described by Martland in 1928 as a syndrome seen in boxers who had experienced significant head trauma from repeated blows. The classic symptoms of impaired cognition, mood, behavior, and motor skills also have been reported in professional football players, and in 2005, the histopathological findings of CTE were first reported in a former National Football League (NFL) player. ⋯ The pathophysiology is still unknown but involves a history of repeated concussive and subconcussive blows and then a lag period before CTE symptoms become evident. The involvement of excitotoxic amino acids and abnormal microglial activation remain speculative. Early identification and prevention of this disease by reducing repeated blows to the head has become a critical focus of current research.
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The understanding of paraneoplastic syndromes has improved over the last several years. These disorders are brought about by tumor secretion of substances that can alter hormonal function and create immune cross-reactivity with normal tissues. This, in turn, can alter normal metabolic pathways resulting in paraneoplastic syndromes. ⋯ These cancers most notably affect the neuromuscular, rheumatologic, mucocutaneous, hematologic, renal, and endocrine systems. Effective diagnosis and treatment of paraneoplastic syndromes most often require appropriate diagnosis and treatment of the underlying malignancy. This review focuses on the most commonly encountered paraneoplastic syndromes, so athletes and those who care for them can be aware of the potential risk of an occult or recurrent malignancy.