Physician Sportsmed
-
Physician Sportsmed · Dec 2009
Comparative StudyComputerized neuropsychological profiles of South African versus US athletes: a basis for commentary on cross-cultural norming issues in the sports concussion arena.
Computerized programs are widely used as part of the overall medical management of concussion in order to monitor recovery and facilitate safe return-to-play decisions. Typically, neurocognitive profiles of concussed athletes are compared with baseline and/or normative data in the absence of baseline scores. However, the cultural equivalence of performance on neuropsychological tests cannot be assumed and has not been sufficiently researched. ⋯ It was concluded that US neurocognitive normative data on the ImPACT test are appropriate for use on South African athletes whose first language is English, whereas culture-specific sensitivity for symptom reporting on this same population should be taken into consideration for management purposes. It is argued that neurocognitive equivalence is less likely to apply in educationally disadvantaged populations. The use of registered psychologists is deemed necessary to provide contextualized interpretations of computerized test scores, thereby protecting against misdiagnosis that may occur within the concussion management arena via actuarial approaches that fail to take sociocultural complexities into account.
-
The benefits of exercise training in individuals with chronic lung diseases such as chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease have been well documented. Although there is limited research available, it appears that exercise is safe and beneficial for people with severe end-stage chronic lung disease who are awaiting lung transplantation in addition to recipients of lung transplants. Evidence-based guidelines for exercise training in the pre- and post-lung transplantation phases have not yet been developed. ⋯ In the pre-transplant and acute post-transplant phases, the intensity of exercise is dictated primarily by symptom limitation and adequate rest, which is required between exercise bouts to allow for recovery. In the post-transplant phase, it is possible for lung transplant recipients to increase their exercise capacity and even participate in sports. Further research needs to be conducted to determine the optimal training guidelines and the long-term benefits of exercise, both in lung transplant candidates and recipients.
-
Ankle stability is integral to normal motion and to minimizing the risk of ankle sprain during participation in sport activities. The ability of the dynamic and static stabilizers of the ankle joint to maintain their structural integrity is a major component of the normal gait cycle. In sports, this quality assumes even greater importance given the range of movement and stresses imposed on the ankle during various sporting disciplines. ⋯ Furthermore, up to 80% of all ankle sprains involve the lateral ligament complex. Other studies have estimated their incidence as approximately 5000 injuries per day in the United Kingdom and 23 000 in the United States. Aggressive treatment of the sprained ankle is essential to maintain foot and ankle mobility and prevent prolonged disability and subsequent overuse injuries among athletes, both professional and "weekend warriors" alike.
-
Physician Sportsmed · Apr 2009
Randomized Controlled Trial Multicenter StudyOriginal research: long-term efficacy and safety of periarticular hyaluronic acid in acute ankle sprain.
The objectives of this study were to determine the long-term efficacy and safety of periarticular hyaluronic acid (HA) injections in acute lateral ankle sprain. A randomized, controlled, prospective trial in a primary sports medicine and emergency practice involved 158 competitive athletes who suffered an acute grade 1 or 2 lateral ankle sprain, and who were randomly assigned within 48 hours of injury. Patients were randomly assigned at baseline to periarticular injection with HA + standard of care (rest, ice, elevation, and compression [RICE]) or placebo injection (PL) + standard of care (RICE) treatment at baseline assessment and day 4 after injury. ⋯ No serious AEs were recorded throughout follow-up. Periarticular HA treatment for acute ankle sprain was highly satisfactory in the short and long term versus PL. This was associated with reduced pain, more rapid return to sport, fewer recurrent ankle sprains, fewer missed days from sport, and with few associated AEs to 24 months.
-
Physician Sportsmed · Apr 2009
Case ReportsCase report: exercise-associated hyponatremia with rhabdomyolysis during endurance exercise.
Exercise-associated hyponatremia (EAH) has been well described in the literature, and its pathogenesis has been elucidated. The most common presenting symptoms of EAH are confusion or severe alterations in mental status. ⋯ In this article, we report on the occurrence of EAH with rhabdomyolysis in 4 athletes participating in the West Highland Way Race, a 95-mile endurance foot race. The pathogenesis of this association is described with implications for therapy.