Sports Med
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Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. ⋯ However, it is evident that impairments in position sense are observed in individuals who have experienced whiplash-type injuries and individuals with chronic head and neck pain of non-traumatic origin (e.g. cervical spondylosis). While researchers advocate comprehensive retraining protocols, which include eye and neck motion targeting tasks and coordination exercises, as well as co-contraction exercises to reduce such impairments, some studies show that more general exercises and manipulation may be of benefit. Overall, there is limited information concerning the efficacy of treatment programmes.
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Many children strive to attain excellence in sport. However, although talent identification and development programmes have gained popularity in recent decades, there remains a lack of consensus in relation to how talent should be defined or identified and there is no uniformly accepted theoretical framework to guide current practice. The success rates of talent identification and development programmes have rarely been assessed and the validity of the models applied remains highly debated. ⋯ The relevance of this model is highlighted and recommendations for future work provided. It is advocated that talent identification and development programmes should be dynamic and interconnected taking into consideration maturity status and the potential to develop rather than to exclude children at an early age. Finally, more representative real-world tasks should be developed and employed in a multidimensional design to increase the efficacy of talent identification and development programmes.
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Primary dysmenorrhoea (PD) is chronic, cyclic, pelvic, spasmodic pain associated with menstruation in the absence of identifiable pathology and is typically known as menstrual cramps or period pain. PD is the most common gynaecological disorder in menstruating women. Despite treatments being available for PD, relatively few women consult a clinician about their symptoms, preferring not to use treatment, or to self-treat using non-pharmacological or over-the-counter interventions. ⋯ Evidence from controlled trials suggests that exercise can reduce PD and associated symptoms, but these have been small and of low methodological quality. There are, however, several plausible mechanisms by which exercise might be effective in the management of PD. A large randomized controlled trial is required before women and clinicians are advised that exercise is likely to be effective in reducing PD and related menstrual symptoms.
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Stress reactions and stress fractures in the lower extremities occur frequently in military and athletic populations. As the clinical symptoms of stress fracture may mimic other less severe musculoskeletal injuries, the diagnosis of stress fracture can often be delayed. The following article reviews the characteristics, advantages and disadvantages of the various imaging tools available to detect stress fracture of the lower limbs in order to clarify their utility when diagnosing this condition. ⋯ The peripheral quantitative CT (pQCT) device, which has been developed to specifically assess skeletal status of the extremities, provides data on bone geometry, strength and density. However, the pQCT needs further evaluation prior to being considered for use in diagnosis stress changes in bone. This article reviews the utility of each of the imaging modalities currently available to detect stress fracture injuries of the lower extremities, as well as other utilization factors, which include exposure to ionizing radiation, the ability to detect early- and late-stage reactions in the bone and surrounding soft tissues, and the ability to differentiate between different types of bone lesions.
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The sport of boxing has been the source of much debate, with concerns about the neurological risks of participating having led to many calls to ban the sport. This review seeks to establish an evidence base for the development of boxing-related chronic traumatic encephalopathy (CTE) and to determine the relevance of this information to the modern day sport. The clinical features of CTE include various symptoms affecting the pyramidal and extrapyramidal systems, which manifest most often as disturbed gait and coordination, slurred speech and tremors, as well as cerebral dysfunction causing cognitive impairments and neurobehavioural disturbances. ⋯ No current epidemiological evidence exists to determine the prevalence of this condition in modern day boxing, despite 17% of professional boxers in Britain with careers in the 1930-50s having clinical evidence of CTE. As medical presence within the sport increases and with modern boxers likely to have shorter careers, a reduced exposure to repetitive head trauma, and improved treatment and understanding of the development of CTE will occur. This should lead to the incidence of CTE diminishing in boxing populations.