Current Workload Recommendations in Baseball Pitchers: A Systematic Review

2019 ◽  
Vol 48 (1) ◽  
pp. 229-241 ◽  
Author(s):  
Neil K. Bakshi ◽  
Paul M. Inclan ◽  
Jacob M. Kirsch ◽  
Asheesh Bedi ◽  
Cristine Agresta ◽  
...  
Keyword(s):  
High School ◽  
Systematic Review ◽  
Injury Rate ◽  
Current Evidence ◽  
Professional Baseball ◽  
High Quality Research ◽  
Baseball Players ◽  
Little League ◽  
Increased Risk ◽  
Baseball Pitchers

Background: Several recommendations have been made regarding pitch counts and workload for baseball players of different levels, including Little League, high school, collegiate, and professional baseball. However, little consensus is found in the literature regarding the scientific basis for many of these recommendations. Purpose: The primary purpose of this study was to summarize the evidence regarding immediate and long-term musculoskeletal responses to increasing pitching workload in baseball pitchers of all levels. A secondary purpose of this review was to evaluate the extent to which workload influences injury and/or performance in baseball pitchers. Study Design: Systematic review. Methods: We performed a systematic search in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for studies addressing physiologic and/or pathologic musculoskeletal changes in response to a quantifiable pitching workload. We included studies examining the effects of pitching workload on performance, injury rate, and musculoskeletal changes in Little League, high school, collegiate, and professional baseball players. Results: We identified 28 studies that met our inclusion and exclusion criteria: 16 studies regarding Little League and high school pitchers and 12 studies regarding collegiate and professional pitchers. The current evidence presented suggests that increased pitching workload may be associated with an increased risk of pain, injury, and arm fatigue in Little League and high school pitchers. However, little consensus was found in the literature regarding the association between pitching workload and physiologic or pathologic changes in collegiate and professional pitchers. Conclusion: Evidence, although limited, suggests the use of pitch counts to decrease injury rates and pain in Little League and high school baseball pitchers. However, further research must be performed to determine the appropriate number of pitches (or throws) for players of different ages. This systematic review reported conflicting evidence regarding the use of pitch counts in college and professional baseball. Future high-quality research is required to determine the role, if any, of pitch counts for collegiate and professional pitchers.

scholarly journals Is Workload Associated with Internal Impingement in Professional Baseball Players? An Analysis of Days of Rest, Innings Pitched and Batters Faced (221)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0032
Author(s):  
Peter Chalmers ◽  
Kathryn Mcelheny ◽  
John Dangelo ◽  
Kevin Ma ◽  
Dana Rowe ◽  
...  
Keyword(s):  
Tracking System ◽  
Fold Increase ◽  
Professional Baseball ◽  
Control Group ◽  
Multiple Time ◽  
Baseball Players ◽  
Internal Impingement ◽  
Time Points ◽  
Increased Risk ◽  
Baseball Pitchers

Objectives: Determine if workload; as measured by number of days rest between outings, innings pitched, batters faced, and being a starting pitcher; associates with risk for internal impingement in professional baseball pitchers. Methods: All professional baseball pitchers who were diagnosed with internal impingement between 2011-2017 were identified using the major league baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared workload variables between pitcher-games 2, 6, 12, and >12 weeks prior to documented internal impingement and pitcher games from a control group who were never diagnosed with internal impingement. In a paired analysis, we compared the acute workload (2, 6, 12 weeks) prior to injury and the injured pitcher’s workload >12 weeks prior to injury. Results: There were 624 pitchers who suffered from internal impingement in professional baseball. Across all time points, players with more innings pitched per game, more batters faced per game, and fewer days rest in between games were associated with a subsequent internal impingement compared to controls. Pitchers who threw four or more innings per game had a 1.3-fold increase in percent of players with subsequent internal impingement compared to pitchers who threw only one inning per game. Significantly more starting pitchers were diagnosed with internal impingement over multiple time points compared to controls. Conclusions: Greater pitcher workload was associated with increased risk for internal impingement in professional baseball players. Throwing four or more innings per game increase a pitcher’s risk for internal impingement 1.3-fold compared to pitchers who threw one inning per game. Starting pitchers are more likely to sustain a LD/TM tear than control pitchers.

scholarly journals Surgical treatment of recalcitrant gastroesophageal reflux disease in patients with systemic sclerosis: a systematic review

2021 ◽  
Author(s):  
Alberto Aiolfi ◽  
Mario Nosotti ◽  
Kazuhide Matsushima ◽  
Carolina Perali ◽  
Cristina Ogliari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systemic Sclerosis ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Current Data ◽  
Current Evidence ◽  
Increased Risk

Abstract Introduction Gastroesophageal reflux disease (GERD) is frequently seen in patients with systemic sclerosis (SSc). Long-standing GERD may cause esophagitis, long-segment strictures, and Barrett’s esophagus and may worsen pre-existing pulmonary fibrosis with an increased risk of end-stage lung disease. Surgical treatment of recalcitrant GERD remains controversial. The purpose of this systematic review was to summarize the current data on surgical treatment of recalcitrant GERD in SSc patients. Materials and methods A systematic literature review according to PRISMA and MOOSE guidelines. PubMed, EMBASE, and Web of Science databases were consulted. Results A total of 101 patients were included from 7 studies. The age ranged from 34 to 61 years and the majority were females (73.5%). Commonly reported symptoms were heartburn (92%), regurgitation (77%), and dysphagia (74%). Concurrent pulmonary disease was diagnosed in 58% of patients. Overall, 63 patients (62.4%) underwent open fundoplication, 17 (16.8%) laparoscopic fundoplication, 15 (14.9%) Roux en-Y gastric bypass (RYGB), and 6 (5.9%) esophagectomy. The postoperative follow-up ranged from 12 to 65 months. Recurrent symptoms were described in up to 70% and 30% of patients undergoing fundoplication and RYGB, respectively. Various symptoms were reported postoperatively depending on the type of surgical procedures, anatomy of the valve, need for esophageal lengthening, and follow-up. Conclusions The treatment of recalcitrant GERD in SSc patients is challenging. Esophagectomy should be reserved to selected patients. Minimally invasive RYGB appears feasible and safe with promising preliminary short-term results. Current evidence is scarce while a definitive indication about the most appropriate surgical treatment is lacking.

scholarly journals Diaphragmatic herniation after esophagogastric surgery: systematic review and meta-analysis

2021 ◽  
Author(s):  
Davide Bona ◽  
Francesca Lombardo ◽  
Kazuhide Matsushima ◽  
Marta Cavalli ◽  
Valerio Panizzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Algorithm ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Current Evidence ◽  
Esophageal Hiatus ◽  
Pooled Prevalence ◽  
Increased Risk ◽  
Esophagogastric Surgery

Abstract Introduction The anatomy of the esophageal hiatus is altered during esophagogastric surgery with an increased risk of postoperative hiatus hernia (HH). The purpose of this article was to examine the current evidence on the surgical management and outcomes associated with HH after esophagogastric surgery for cancer. Materials and methods Systematic review and meta-analysis. Web of Science, PubMed, and EMBASE data sets were consulted. Results Twenty-seven studies were included for a total of 404 patients requiring surgical treatment for HH after esophagogastric surgery. The age of the patients ranged from 35 to 85 years, and the majority were males (82.3%). Abdominal pain, nausea/vomiting, and dyspnea were the commonly reported symptoms. An emergency repair was required in 51.5%, while a minimally invasive repair was performed in 48.5%. Simple suture cruroplasty and mesh reinforced repair were performed in 65% and 35% of patients, respectively. The duration between the index procedure and HH repair ranged from 3 to 144 months, with the majority (67%) occurring within 24 months. The estimated pooled prevalence rates of pulmonary complications, anastomotic leak, overall morbidity, and mortality were 14.1% (95% CI = 8.0–22.0%), 1.4% (95% CI = 0.8–2.2%), 35% (95% CI = 20.0–54.0%), and 5.0% (95% CI = 3.0–8.0%), respectively. The postoperative follow-up ranged from 1 to 110 months (mean = 24) and the pooled prevalence of HH recurrence was 16% (95% CI = 13.0–21.6%). Conclusions Current evidence reporting data for HH after esophagogastric surgery is narrow. The overall postoperative pulmonary complications, overall morbidity, and mortality are 14%, 35%, and 5%, respectively. Additional studies are required to define indications and treatment algorithm and evaluate the best technique for crural repair at the index operation in an attempt to minimize the risk of HH.

scholarly journals Incidence of Injuries in High School Softball and Baseball Players

2011 ◽  
Vol 46 (6) ◽  
pp. 648-654 ◽  
Author(s):  
Ellen Shanley ◽  
Mitchell J. Rauh ◽  
Lori A. Michener ◽  
Todd S. Ellenbecker
Keyword(s):  
High School ◽  
South Carolina ◽  
High Schools ◽  
Upper Extremity ◽  
Injury Rate ◽  
Baseball Players ◽  
Injury Rates ◽  
School Sports ◽  
Initial Injury ◽  
Subsequent Injury

Context: Participation in high school sports has grown 16.1% over the last decade, but few studies have compared the overall injury risks in girls' softball and boys' baseball. Objective: To examine the incidence of injury in high school softball and baseball players. Design: Cohort study. Setting: Greenville, South Carolina, high schools. Patients or Other Participants: Softball and baseball players (n = 247) from 11 high schools. Main Outcome Measure(s): Injury rates, locations, types; initial or subsequent injury; practice or game setting; positions played; seasonal trends. Results: The overall incidence injury rate was 4.5/1000 athlete-exposures (AEs), with more injuries overall in softball players (5.6/1000 AEs) than in baseball players (4.0/1000 AEs). Baseball players had a higher initial injury rate (75.9/1000 AEs) than softball players (66.4/1000 AEs): rate ratio (RR) = 0.88, 95% confidence interval (CI) = 0.4, 1.7. The initial injury rate was higher than the subsequent injury rate for the overall sample (P < .0001) and for softball (P < .0001) and baseball (P < .001) players. For both sports, the injury rate during games (4.6/1000 AEs) was similar to that during practices (4.1/1000 AEs), RR = 1.22, 95% CI = 0.7, 2.2. Softball players were more likely to be injured in a game than were baseball players (RR = 1.92, 95% CI = 0.8, 4.3). Most injuries (77%) were mild (3.5/1000 AEs). The upper extremity accounted for the highest proportion of injuries (63.3%). The incidence of injury for pitchers was 37.3% and for position players was 15.3%. The rate of injury was highest during the first month of the season (7.96/1000 AEs). Conclusions: The incidence of injury was low for both softball and baseball. Most injuries were minor and affected the upper extremity. The injury rates were highest in the first month of the season, so prevention strategies should be focused on minimizing injuries and monitoring players early in the season.

scholarly journals The Impact of Workload on the Evolution of Hip Internal and External Rotation in Professional Baseball Players Over the Course of the Season

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775210 ◽  
Author(s):  
Christopher L. Camp ◽  
John M. Zajac ◽  
Dave Pearson ◽  
Dean Wang ◽  
Alec S. Sinatro ◽  
...  
Keyword(s):  
External Rotation ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Increased Risk ◽  
Hip Range Of Motion ◽  
Hip Motion ◽  
Hip Internal Rotation ◽  
Loss Of Motion ◽  
The Impact

Background: Although restricted hip range of motion (ROM) is associated with an increased risk for injuries in baseball players, the evolution of hip ROM over the season remains undefined. Hypothesis: Hip ROM profiles would be symmetric between hips and positions (pitchers vs position players) but would decrease from preseason to postseason. Additionally, it was hypothesized that this decrease in motion would correlate with workload. Study Design: Cohort study; Level of evidence, 2. Methods: Bilateral hip ROM was assessed in 96 professional baseball players (54 pitchers, 42 position players) preseason and postseason. ROM comparisons were made between lead and trailing hips, pitchers and position players, and preseason and postseason measures. The change from preseason to postseason was correlated with player demographics and measures of workload for pitchers and position players. Results: Preseason hip ROM was symmetric between hips; however, pitchers demonstrated increased preseason lead hip internal rotation (IR) ( P = .018) and bilateral hip total ROM (TROM) ( P < .020) compared with position players. From preseason to postseason, position players lost 7° of external rotation (ER) ( P ≤ .005 ). In pitchers, the loss of IR correlated with increased pitches ( P = .016) and innings ( P = .037), while the loss of ER ( P = .005 ) and TROM ( P = .014) correlated with increasing mean fastball velocity. Workload for position players did not correlate with motion loss. Conclusion: Symmetric hip ROM profiles should be anticipated in baseball players; however, pitchers may have increased preseason IR and TROM and postseason ER and TROM relative to position players. Although loss of motion correlated with workload in pitchers, this was not the case for position players. Hip motion should be monitored over the course of the season. This is particularly true for pitchers who lose IR as workload increases, which may place them at a greater risk for injuries.

Baseball Injuries: A Little League Survey

PEDIATRICS ◽  
1996 ◽  
Vol 98 (3) ◽  
pp. 445-448
Author(s):  
Joel S. Pasternack ◽  
Kenneth R. Veenema ◽  
Charles M. Callahan
Keyword(s):  
Injury Rate ◽  
Population Based ◽  
Severe Injury ◽  
Baseball Players ◽  
Facial Injuries ◽  
Little League ◽  
Acute Injuries ◽  
Safety Interventions ◽  
Minor Injuries ◽  
Patterns Of Injury

Objectives. To determine the patterns of injury in youth baseball and apply the data to estimate the value of proposed safety equipment. Design. Prospective population-based injury survey. Participants. 2861 Little League baseball players (ages 7 to 18) for 140 932 player-hours. Measurements. An injury was included in the data only if it was serious enough to require medical/dental care, caused missing a game, or disallowed playing a certain position. The injuries were subdivided into acute or overuse. The acute injuries were classified as either catastrophic, severe, or minor. Injuries were categorized according to mechanism, area injured, and whether the player was on offense or defense. Results. There were 81 total injuries, of which 66 (81%) were acute and 15 (19%) were overuse. Of the acute injuries, 11 were severe and 55 were minor. The overall injury rate was .057 injuries per 100 player-hours. The severe injury rate was .008 injuries per 100 player-hours, of which 46% were ball-related injuries and 27% were collisions. The most frequent mechanism of injury was being hit by the ball, which represented 62% of the acute injuries. Of the 41 ball-related injuries, 28 (68%) occurred to players on defense. Of the 18 ball-related facial injuries, 16 occurred to players on defense. Conclusions. 1) Little League baseball is a safe activity with a low injury rate and a particularly low rate of severe injury; 2) impact by the ball causes more than half the acute injuries, thus safety interventions should be directed towards decreasing these injuries, especially on defense; 3) facemasks on batters can safely eliminate facial injuries to offensive players, but would only moderately reduce the incidence of ball-related facial injuries as most of these injuries are sustained by defensive players.

Can Exergaming Promote Physical Fitness and Physical Activity?

Gamification ◽  
2015 ◽  
pp. 2022-2039 ◽  
Author(s):  
Tuomas Kari
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Current Evidence ◽  
Activity Levels ◽  
High Quality Research ◽  
Significant Health

This systematic review of systematic reviews evaluates the effectiveness of exergaming on physical fitness and physical activity. A systematic literature search was conducted on 10 databases, and 1040 articles were identified. Sixty-eight articles were found potentially relevant and were selected for closer screening. Cross-referencing was conducted to find other potentially relevant articles. The quality of all relevant articles was evaluated using the AMSTAR tool. After all the duplicates were removed and inclusion, exclusion, and quality criteria were implemented, six articles remained for review. The results indicate that exergaming is generally enjoyed and can evoke some benefits for physical fitness and physical activity, but the current evidence does not support the ability of exergaming to increase physical fitness or physical activity levels sufficiently for significant health benefits. This systematic review also revealed several gaps in previous research. Additional high-quality research and systematic reviews concerning exergaming are needed.

Promoting Physical Activity and Fitness with Exergames

2016 ◽  
pp. 225-245 ◽  
Author(s):  
Tuomas Kari
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Systematic Reviews ◽  
Quality Criteria ◽  
Current Evidence ◽  
Activity Levels ◽  
High Quality Research ◽  
Significant Health

This updated systematic review of systematic reviews evaluates the effectiveness of exergaming on physical fitness and physical activity. A systematic literature search was conducted on 10 databases, first in 2014 and then repeated in 2016. In total, 1040 and 287 articles were identified. 68 and 31 articles were found potentially relevant and selected for closer screening. The quality of all relevant articles was evaluated using the AMSTAR tool. After the duplicates were removed and inclusion, exclusion, and quality criteria were implemented, six and three articles remained for review. The results indicate that exergaming is generally enjoyed and can evoke some benefits for physical fitness and physical activity, but the current evidence does not support the ability of exergaming to increase physical fitness or physical activity levels sufficiently for significant health benefits. This systematic review also revealed gaps in previous research. Additional high-quality research and systematic reviews concerning exergaming are needed.

scholarly journals Effectiveness and safety of inpatient versus extended venous thromboembolism (VTE) prophylaxis with heparin following major pelvic surgery for malignancy: protocol for a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Bridget Heijkoop ◽  
Natalie Parker ◽  
George Kiroff ◽  
Daniel Spernat
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Systematic Reviews ◽  
Pelvic Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Vte Prophylaxis ◽  
Optimum Duration ◽  
Number Of Patients ◽  
Increased Risk

Abstract Background Venous thromboembolism (VTE) is a common postoperative complication associated with significant morbidity and mortality. The use of prophylactic heparin postoperatively reduces this risk, and the use of extended duration prophylaxis is becoming increasingly common. Malignancy and pelvic surgery both independently further increase the risk of postoperative VTE and patients undergoing major pelvic surgery for malignancy are at particularly high risk of VTE. However, the optimum duration of prophylaxis specifically in this population currently remains unclear. Methods We will conduct a systematic review of literature in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0.,2011) to evaluate current evidence of the effectiveness and safety of inpatient versus extended VTE prophylaxis with heparin (all forms) following major pelvic surgery for malignancy. We will search PubMed, EMBASE, and the Cochrane Library. Regarding safety, Food and Drug Administration (FDA), and Therapeutic Goods Administration (TGA) websites will be searched, including all levels of evidence. Results will be the postoperative timeframe in which a VTE event can be considered to have been provoked by the surgery, and the number of patients needed to treat with both inpatient and extended prophylaxis to prevent a VTE event in this timeframe, comparing these to determine if there is a significant benefit from extended prophylaxis. Discussion This systematic review will aim to identify the postoperative period in which patients undergoing major pelvic surgery for malignancy are at further increased risk of VTE as a result of their surgery and the optimum duration of heparin VTE prophylaxis with heparin to reduce this risk. Determining this will allow evidence-based recommendations to be made for the optimum duration of heparin VTE prophylaxis post major pelvic surgery for malignancy, leading to improved standards of care that are consistent between different providers and institutions. Systematic review registration In accordance with guidelines, our systematic review was submitted to PROSPERO for consideration of registration on 16/12/17 and was registered on 12/1/18 with the registration number CRD42018068961, and it was last updated on December 1, 2018.

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