Physician Sportsmed
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Physician Sportsmed · Sep 2014
The utility of the balance error scoring system for mild brain injury assessments in children and adolescents.
The Balance Error Scoring System (BESS) is widely recognized as an acceptable assessment of postural control for adult patients following a mild traumatic brain injury (mTBI) or concussion. However, the measurement properties of the BESS as a post-mTBI assessment test for younger patients are not well understood. The purpose of this study was to evaluate the utility of the BESS as a post-mTBI assessment test for children and adolescents aged 8 to 18 years through 2 investigations: (1) a retrospective medical records review of the relationship among age, BESS scores, and other common post-mTBI assessment tests; and (2) a prospective study comparing BESS scores for a cohort of children with a recent mTBI and BESS scores for a cohort of matched healthy peers. ⋯ However, the observed differences were not likely to be clinically meaningful. Cumulatively, evidence from the literature and the results of these studies indicate that the BESS may be limited for producing accurate assessments of younger athletes' post-mTBI postural control abilities. Future research recommendations include testing of modified versions of the BESS or other alternatives for post-mTBI postural control assessments with younger individuals.
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Physician Sportsmed · Sep 2014
Evaluation of the Zachery Lystedt Law among female youth soccer players.
Despite recent increased awareness about sports concussions, few studies have evaluated the effect of concussion laws on concussion outcomes among young athletes. The purpose of our study was to evaluate the effect of the Washington State Zachery Lystedt Concussion Law on playing with concussion symptoms and being evaluated by a health care provider. ⋯ The majority of concussed female youth soccer players report playing with symptoms. Legislation mandating concussion education and evaluation prior to returning to play was not associated with an increase in concussion evaluations by health care providers.
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Physician Sportsmed · Sep 2014
Validation of musculoskeletal ultrasound to assess and quantify muscle glycogen content. A novel approach.
Glycogen storage is essential for exercise performance. The ability to assess muscle glycogen levels should be an important advantage for performance. However, skeletal muscle glycogen assessment has only been available and validated through muscle biopsy. We have developed a new methodology using high-frequency ultrasound to assess skeletal muscle glycogen content in a rapid, portable, and noninvasive way using MuscleSound (MuscleSound, LCC, Denver, CO) technology. ⋯ These results demonstrate that skeletal muscle glycogen can be measured quickly and noninvasively through high-frequency ultrasound using MuscleSound technology.
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Physician Sportsmed · May 2014
ReviewThe effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review.
Osteoarthritis (OA) is a common and costly condition with both operative and nonoperative treatments available. Platelet-rich plasma (PRP) is emerging as a treatment option for a variety of musculoskeletal pathologies, including OA. ⋯ Platelet-rich plasma may be an effective treatment for knee OA. However, because of the low level of evidence, small sample sizes, and wide variability in treatment, no definitive recommendations can be made at this time.
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Physical activity is a potent therapy for both the prevention and treatment of cardiovascular disease. Exercise appears to most benefit people who are the least active. There is some evidence to suggest that a curvilinear relationship exists between exercise and survival, whereby beyond an optimal level of fitness, the principle of diminishing returns applies. ⋯ The incidence of sudden cardiac death in athletes is greater than in matched, nonathletic counterparts, and this finding is driven by the provocation of an underlying cardiac abnormality by strenuous exertion. The task of detecting pathological myocardial substrate in athletes is made difficult by physiological adaptations to exercise that can mimic the appearance of cardiomyopathies and ion channelopathies in some individuals. This article details the clinical evaluation of the athlete with reference limits for cardiac physiological remodeling and discusses the diagnostic dilemmas that arise.