scholarly journals 198 Challenging ACL reconstructed athletes and their sensorimotor system at return-to-sport: a vital step towards exposing the roots of their neuromuscular deficits

Author(s):  
Annemie Smeets ◽  
Sabine Verschueren ◽  
Filip Staes ◽  
Steven Claes ◽  
Hilde Vandenneucker ◽  
...  
Sportphysio ◽  
2020 ◽  
Vol 08 (05) ◽  
pp. 258-259
Author(s):  
Denis Overlöp ◽  
Natascha Bauer
Keyword(s):  

Der „Return to Sport“-Prozess stellt Fachkräfte unterschiedlicher Disziplinen vor große Herausforderungen. PD Dr. med. Götz H. Welsch, leitender Mannschaftsarzt des HSV, und Bernhard Peters, ehemaliger Sportdirektor der TSG 1899 Hoffenheim und des HSV, stellten sich diesem Thema beim 7. Jahreskongress des OSINSTITUTs. Passend zum Thema der Veranstaltung „Prehab und Rehab – der Knorpel im Fokus“ lieferte Dr. med. Christina Valle, Fachärztin für Physikalische Medizin und Rehabilitation, Evidenz und Tipps rund um das Thema Ernährung und Knorpel.


Author(s):  
Sergey Babanov

The article covers the particular features of the neuro-muscular system in vibration disease of various types and severity by electroneuromyographical tests at the Department of Occupational Disorders, Regional Center for Occupational Disorders, Samara Medical and Sanitary Unit № 5 of the Kirov Region (State Budgetary Healthcare Institution of the Samara Region). Changes in excitability and functional mobility of the sensorimotor system, development of vegetative-sensory polyneuropathy depending on the vibration disease type, severity, and the length of exposure to vibration at work are found in vibration disease patients.


2017 ◽  
Vol 65 (3) ◽  

A lot has been published on the topic concussion in sports during the last years, conscience was sharpened, much was structured and defined more precisely, help tools were developed and rules changed. This article summarizes the fifth edition of the recently published guidelines of the “International Consensus Conference on Concussion in Sport”. In addition, new findings regarding gender differences and recovery will be presented, as well as the modified “return-to-sport” and the novel “return-to-school” protocols. Despite increased knowledge many questions remain such as the therapy of persistent symptoms or long-term sequelae of recurrent concussions.


Author(s):  
Daniel Leech-Wilkinson

The concept of shape is widely used by musicians in talking and thinking about performance, yet the mechanisms that afford links between music and shape are little understood. Work on the psychodynamics of everyday life by Daniel Stern and on embodiment by Mark Johnson suggests relationships between the multiple dynamics of musical sound and the dynamics of feeling and motion. Recent work on multisensory and precognitive sensory perception and on the role of bimodal neurons in the sensorimotor system helps to explain how shape, as a percept representing changing quantity in any sensory mode, may be invoked by dynamic processes at many stages of perception and cognition. These processes enable ‘shape’ to do flexible and useful work for musicians needing to describe the quality of musical phenomena that are fundamental to everyday musical practice and yet too complex to calculate during performance.


Author(s):  
Anirudh K. Gowd ◽  
Joseph N. Liu ◽  
Bhargavi Maheshwer ◽  
Grant H. Garcia ◽  
Edward C. Beck ◽  
...  

2021 ◽  
pp. 036354652110130
Author(s):  
Stefano Nuccio ◽  
Luciana Labanca ◽  
Jacopo Emanuele Rocchi ◽  
Pier Paolo Mariani ◽  
Paola Sbriccoli ◽  
...  

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. Study Design: Controlled laboratory study. Methods: A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. Results: The ACLR and control groups showed similar AKL and AKS at baseline ( P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group ( P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively ( P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline ( P = .014). Conclusion: Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. Clinical Relevance: Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.


2021 ◽  
pp. bjsports-2020-103696
Author(s):  
Richard Weiler ◽  
Cheri Blauwet ◽  
David Clarke ◽  
Kristine Dalton ◽  
Wayne Derman ◽  
...  

Concussion is a frequent injury in many sports and is also common in para athletes. However, there is a paucity of concussion research related to para sport, and prior International Concussion in Sport (CIS) consensus papers have not substantively addressed this population. To remedy this and to improve concussion care provided to para athletes, the concussion in para sport (CIPS) multidisciplinary expert group was created. This group analysed and discussed in-depth para athlete-specific issues within the established key clinical domains of the current (2017) consensus statement on CIS. Due to the onset of the COVID-19 pandemic, the group held all meetings by video conferencing. The existing Sport Concussion Assessment Tool 5 (SCAT5) for the immediate on-field and office-based off-field assessment of concussion was evaluated as part of this process, to identify any para athlete-specific concerns. Regular preparticipation and periodic health examinations are essential to determine a baseline reference point for concussion symptoms but pose additional challenges for the interpreting clinician. Further considerations for concussion management for the para athlete are required within the remove, rest, reconsider and refer consensus statement framework. Considering return to sport (RTS), the 2017 CIS consensus statement has limitations when considering the RTS of the para athlete. Case-by-case decision making related to RTS following concussion is imperative for para athletes. Additional challenges exist for the evaluation and management of concussion in para athletes. There is a need for greater understanding of existing knowledge gaps and attitudes towards concussion among athlete medical staff, coaches and para athletes. Future research should investigate the use and performance of common assessment tools in the para athlete population to better guide their clinical application and inform potential modifications. Concussion prevention strategies and sport-specific rule changes, such as in Para Alpine Skiing and Cerebral Palsy Football, also should be carefully considered to reduce the occurrence of concussion in para athletes.


2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110071
Author(s):  
Ioanna K. Bolia ◽  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Frank A. Petrigliano

Background: The management of multidirectional instability (MDI) of the shoulder remains challenging, especially in athletes who participate in sports and may require multiple surgical procedures to achieve shoulder stabilization. Open or arthroscopic procedures can be performed to address shoulder MDI. Indications: Open capsulorrhaphy is preferred in patients with underlying tissue hyperlaxity and who had 1 or more, previously failed, arthroscopic shoulder stabilization procedures. Technique Description: With the patient in the beach-chair position (45°), tissue dissection is performed to the level of subscapularis tendon via the deltopectoral approach. The subscapularis tenotomy is performed in an L-shaped fashion, and the subscapularis tendon is tagged with multiple sutures and mobilized. Careful separation of the subscapularis tendon from the underlying capsular tissue is critical. Capsulotomy is performed, consisting of a vertical limb and an inferior limb that extends to the 5 o’clock position on the humeral neck (right shoulder). After evaluating the integrity of the labrum, the capsule is shifted superiorly and laterally, and repaired using 4 to 5 suture anchors. The redundant capsule is excised, and the subscapularis tendon is repaired in a side-to-side fashion, augmented by transosseous equivalent repair using the capsular sutures. Results: Adequate shoulder stabilization was achieved following open capsulorrhaphy in a young female athlete with tissue hyperlaxity and history of a previously failed arthroscopic soft tissue stabilization surgery of the shoulder. The athlete returned to sport at 6 months postoperatively and did not experience recurrent shoulder instability episodes at midterm follow-up. Discussion/Conclusion: Based on the existing literature, 82% to 97% of patients who underwent open capsulorrhaphy for MDI had no recurrent shoulder instability episodes at midterm follow-up. One study reported 64% return-to-sport rate following open capsulorrhaphy in 15 adolescent athletes with Ehlers-Danlos syndrome, but more research is necessary to better define the indications and outcomes of this procedure in physically active patients.


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