scholarly journals Overuse Physeal Injuries in Youth Athletes

2017 ◽  
Vol 9 (2) ◽  
pp. 139-147 ◽  
Author(s):  
Amanda Arnold ◽  
Charles A. Thigpen ◽  
Paul F. Beattie ◽  
Michael J. Kissenberth ◽  
Ellen Shanley
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Strategies ◽  
Sports Participation ◽  
Overuse Injuries ◽  
Original Research ◽  
Training Volume ◽  
Level Of Evidence ◽  
Prevention And Treatment ◽  
Accelerated Growth

Context: Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies. Objective: This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes. It can be used to develop prevention and treatment programs specific to this population. Data Sources: PubMed and Academic Search Complete (EBSCOhost) were explored using the keyword physeal injuries from January 1950 through May 2015 to identify 24 studies. Study Selection: Original research studies of athletic populations with mechanisms of injury related to sport were chosen. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Data were extracted as available from 24 eligible studies. Study quality was rated using the Oxford Centre for Evidence-based Medicine (OCEBM) guidelines. Results: Risk factors for injury include periods of accelerated growth, chronological age, body size, training volume, and previous injury. Injury prevention strategies currently emphasize participation limitations and sport-specific training programs in skeletally immature athletes. The most effective treatment after an overuse physeal injury was an extended period of active rest and joint immobilization when necessary. Conclusion: Overuse physeal injuries are multifactorial in nature. Muscular imbalances after accelerated growth periods predispose young athletes to overuse injuries. Modifiable risk factors such as flexibility, strength, and training volume should be regularly monitored to prevent these injuries.

scholarly journals BK Virus Associated Haemorrhagic Cystitis. A systematic review of current prevention and treatment strategies

2019 ◽  
Vol 63 ◽  
pp. 34-42 ◽  
Author(s):  
M. Aldiwani ◽  
T. Tharakan ◽  
A. Al-Hassani ◽  
N. Gibbons ◽  
J. Pavlu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Strategies ◽  
Bk Virus ◽  
Haemorrhagic Cystitis ◽  
Prevention And Treatment

Hip Dislocation and Subluxation in Athletes: A Systematic Review

2021 ◽  
pp. 036354652110361
Author(s):  
Deepak V. Chona ◽  
Paul D. Minetos ◽  
Christopher M. LaPrade ◽  
Mark E. Cinque ◽  
Geoffrey D. Abrams ◽  
...  
Keyword(s):  
Systematic Review ◽  
Arthroscopic Surgery ◽  
Treatment Strategies ◽  
Hip Dislocation ◽  
Return To Play ◽  
Exclusion Criteria ◽  
Level Of Evidence ◽  
Radiographic Outcomes ◽  
Center Edge

Background: Hip dislocation is a rare occurrence during sports but carries serious implications for athletes. Purpose: To systematically review treatment strategies and outcomes for hip dislocation in athletes, with the ultimate goal of providing sports medicine physicians with the information necessary to appropriately treat and counsel patients sustaining this injury. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, MEDLINE, and Embase were searched for studies relating to hip instability and athletics from January 1, 1989 to October 1, 2019. Abstracts and articles were evaluated on the basis of predefined inclusion and exclusion criteria. Inclusion criteria were the following: (1) data from ≥1 patients, (2) native hip dislocation or subluxation occurring during sports, (3) patients aged at least 10 years, and (4) written in English. Exclusion criteria were (1) patients younger than 10 years; (2) nonnative or postoperative hip dislocation or subluxation; (3) a native hip injury without dislocation or subluxation; (4) patients with dislocation or subluxation secondary to neuromuscular, developmental, or syndromic causes; (5) dislocation or subluxation not occurring during sports; (6) patients with physeal fractures; or (7) review articles or meta-analyses. Data were recorded on patient demographics, injury mechanism, treatment strategies, and clinical and radiographic outcomes. Where possible, pooled analysis was performed. Studies were grouped based on reported outcomes. Meta-analysis was then performed on these pooled subsets. Results: A total of 602 articles were initially identified, and after screening by 2 reviewers, 27 articles reporting on 145 patients were included in the final review. There were 2 studies that identified morphological differences between patients with posterior dislocation and controls, including decreased acetabular anteversion ( P = .015 and .068, respectively), increased prevalence of a cam deformity ( P < .0035), higher alpha angles ( P≤ .0213), and decreased posterior acetabular coverage ( P < .001). No differences were identified for the lateral center edge angle or Tonnis angle. Protected postreduction weightbearing was most commonly prescribed for 2 to 6 weeks, with 65% of reporting authors recommending touchdown, toe-touch, or crutch-assisted weightbearing. Recurrence was reported in 3% of cases. Overall, 4 studies reported on findings at hip arthroscopic surgery, including a 100% incidence of labral tears (n = 27; 4 studies), 92% incidence of chondral injuries, 20% incidence of capsular tears, and 84% incidence of ligamentum teres tears (n = 25; 2 studies). At final follow-up, 86% of patients reported no pain (n = 14; 12 studies), 87% reported a successful return to play (n = 39; 10 studies), and 11% had radiographic evidence of osteonecrosis (n = 38; 10 studies). Conclusion: Various treatment strategies have been described in the literature, and multiple methods have yielded promising clinical and radiographic outcomes in patients with native hip dislocation sustained during sporting activity. Data support nonoperative treatment with protected weightbearing for hips with concentric reduction and without significant fractures and an operative intervention to obtain concentric reduction if unachievable by closed means alone. Imaging for osteonecrosis is recommended, with evidence suggesting 4- to 6-week magnetic resonance imaging and follow-up at 3 months for those with suspicious findings in the femoral head.

scholarly journals A Systematic Review of Etiological Risk Factors Associated With Early Mortality Among National Football League Players

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881331 ◽  
Author(s):  
Arthur H. Owora ◽  
Brittany L. Kmush ◽  
Bhavneet Walia ◽  
Shane Sanders
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Mortality Risk ◽  
National Football League ◽  
The United States ◽  
Early Mortality ◽  
Male Population ◽  
Level Of Evidence ◽  
Factors Associated ◽  
Specific Mortality

Background: Multiple risks predispose professional football players to adverse health outcomes and, in extreme cases, early death; however, our understanding of etiological risk factors related to early mortality is limited. Purpose: To identify etiological risk factors associated with all-cause and cause-specific mortality among National Football League (NFL) players. Study Design: Systematic review; Level of evidence, 3. Methods: Articles examining all-cause and cause-specific mortality risk factors among previous NFL players were identified by systematically searching: PubMed, PsycINFO, Web of Science, and Google Scholar from 1990 to 2017. Study eligibility and quality were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: A total of 801 nonduplicated studies were identified through our search strategy. Of these, 9 studies examining 11 different risk factors were included in the systematic review. Overall, the risk of all-cause and cause-specific mortality was lower among NFL players than among the general male population in the United States. Nonwhite athletes, those in power positions, and those with a high playing-time body mass index (≥30 kg/m2) were associated with elevated all-cause and cardiovascular mortality risks. Conclusion: Methodological issues associated with the examined all-cause and cause-specific mortality risk factors preclude a definitive conclusion of etiological protective or risk effects. Comparison groups less prone to selection bias (“healthy worker effect”) and a life-course approach to the evaluation of suspected risk factors are warranted to identify etiological factors associated with early mortality among NFL players.

scholarly journals Environmental Risk Factors for Bipolar Disorders and High-Risk States in Adolescence: A Systematic Review

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 689
Author(s):  
Giulia Menculini ◽  
Pierfrancesco Maria Balducci ◽  
Luigi Attademo ◽  
Francesco Bernardini ◽  
Patrizia Moretti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
High Risk ◽  
Environmental Risk ◽  
Stressful Life Events ◽  
Treatment Strategies ◽  
Bipolar Disorders ◽  
Environmental Risk Factors ◽  
Newcastle Ottawa Scale ◽  
Present Systematic Review

Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic review is aimed at critically summarizing evidence about the role that environmental risk factors play in the development of BD in adolescence and their interaction with BD high-risk states. Materials and Methods: MEDLINE/Pubmed, Scopus and Web of Science datasets were systematically searched until 4 September 2020. Original studies that reported information about the role of environmental risk factors in the development of BD during adolescence, or assessing their influence on the development of psychopathology in high-risk states for BD, were considered for inclusion. Two blind researchers performed title/abstract, full-text screening, and hand-screening of relevant references. The risk of bias was assessed by means of the Newcastle-Ottawa Scale. Results: Fourteen studies were included in the review. Negative stressful life events, particularly sexual and physical abuse, but also emotional mistreatment, were associated with more severe psychopathology in adolescents with BD, as well as with higher risk for developing mood disorders in BD offspring. Similar findings were detected for familial environment-related features, such as parental rejection and low perceived care, while no univocal results were found when analyzing familial functioning. Conclusions: The present systematic review confirmed the relevant role that environmental risk factors, particularly negative stressful live events and family-related features, play in the development of BD psychopathology during adolescence. Future studies are expected to clarify possible further environmental factors that may be implicated in the development of BD during youth that may serve as target of prevention and early treatment strategies.

scholarly journals Running related biomechanical risk factors for overuse injuries in distance runners: A systematic review considering injury specificity and the potentials for future research

2021 ◽  
Author(s):  
Steffen Willwacher ◽  
Markus Kurz ◽  
Johanna Robbin ◽  
Matthias Thelen ◽  
Joseph Hamill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
English Language ◽  
Retrospective Studies ◽  
Overuse Injuries ◽  
Future Research ◽  
Comprehensive Overview ◽  
Eligibility Criteria ◽  
Starting Point ◽  
Data Collections

Objective To identify and evaluate the evidence of the most relevant running-related risk factors (RRRFs) for running-related overuse injuries (ROIs) and to suggest future research directions. Design Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236832) Data sources Pubmed. Connected Papers. The search was performed in February 2021. Eligibility criteria English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic RRRF. An RRRF needed to be identified in at least one prospective or two retrospective studies. Results Sixty-two articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some RRRFs appeared for several ROIs, most RRRFs were specific for a particular ROI. The biomechanical measurements performed in many studies would have allowed for consideration of many more RRRFs than have been reported, highlighting a potential for more effective data usage in the future. Conclusion This study offers a comprehensive overview of RRRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. Future work should use macroscopic (big data) approaches involving long-term data collections in the real world and microscopic approaches involving precise stress calculations using recent developments in biomechanical modelling. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.

scholarly journals Epidemiology of Cardiovascular Diseases in Morocco: A Systematic Review

2021 ◽  
Vol 17 (2) ◽  
pp. 57-67
Author(s):  
Rida Elyamani ◽  
Abdelmajid Soulaymani ◽  
Hind Hami
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Diseases ◽  
English Language ◽  
Local Population ◽  
Treatment Strategies ◽  
Epidemiological Studies ◽  
High Rate ◽  
Systematic Analysis ◽  
Moroccan Population

OBJECTIVE: To provide a systematic review of studies on cardiovascular diseases (CVD) and their risk factors in the Moroccan population. METHODS: A systematic analysis was performed based on PRISMA guidelines by retrieving data bases (Medline, Embase, and other) using technical keywords in addition to manual research on official websites. Published studies in the English or French language, conducted in Morocco or concerning the Moroccan population within the last two decades, were identified. RESULTS: This is the first systematic review of CVD in Morocco. Data from 159 studies were retrieved and analyzed. Most studies were written in the English language (75.89%) and published between 2010 and 2019 (85.47%). The mortality rate caused by CVD in Morocco has reached 38%, with ischemic heart disease and stroke as the main events causing death (31.0% and 22.5% respectively). The risk factors present in the population studied were headed by tobacco smoking (45- 50%), followed by physical inactivity (21.1%), elevated rate of hypertension (25.3%), and depression (5.47%). Impacted by a high rate of illiteracy and poverty and an unprepared health care system in Morocco, these numbers are expected to increase over the next decade. CONCLUSIONS: Based on these alarming incidences, investment in scientific research and epidemiological studies should be increased to determine the needs of the local population. The available evidence shows that the risk of cardiovascular disease and the associated mortality is very high in Morocco and will rise in the next years prospectively, which calls for urgent multi-sectorial approaches and treatment strategies.

Return to Sports and Activity After Total Ankle Arthroplasty and Arthrodesis: A Systematic Review

2020 ◽  
Vol 41 (8) ◽  
pp. 916-929 ◽  
Author(s):  
William L. Johns ◽  
Christopher B. Sowers ◽  
Kempland C. Walley ◽  
Daniel Ross ◽  
David B. Thordarson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Participation Rate ◽  
Sports Participation ◽  
Operative Management ◽  
Cochrane Library ◽  
Activity Participation ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Sports Activity ◽  
The Mean

Background: There is no consensus regarding participation in sports and recreational activities following total ankle replacement (TAR) and ankle arthrodesis (AA). This systematic review summarizes the evidence on return to sports and activity after operative management with either TAR or AA for ankle osteoarthritis (OA). Methods: A literature search of MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed. Risk of bias of included studies was assessed using Methodological Index for Non-Randomized Studies (MINORS) criteria. Included studies reported sport and activity outcomes in patients undergoing TAR and AA, with primary outcomes being the percentage of sports participation and level of sports participation. Results: Twelve studies met inclusion criteria for analysis. There were 1270 ankle procedures, of which 923 TAR and 347 AA were performed. The mean reported patient age was 59.2 years and the mean BMI was 28 kg/m2. The mean follow-up was 43 months. Fifty-four percent of patients were active in sports preoperatively compared with 63.7% postoperatively. The mean preoperative activity participation rate was 41% in the TAR cohort, but it improved to 59% after TAR, whereas the preoperative activity participation rate of 73% was similar to the postoperative rate of 70% in the AA cohort. The most common sports in the TAR and AA groups were swimming, hiking, cycling, and skiing. Conclusion: Participation in sports activity was nearly 10% improved after operative management of ankle OA with TAR and remains high after AA. The existing literature demonstrated a large improvement in pre- to postoperative activity levels after TAR, with minimal change in activity after AA; however, AA patients were more active at baseline. The most frequent postoperative sports activities after operative management of ankle OA were swimming, hiking, cycling, and skiing. Participation in high-impact sports such as tennis, soccer, and running was consistently limited after surgery. This review of the literature will allow patients and foot and ankle surgeons to set evidence-based goals and establish realistic expectations for postoperative physical activity after TAR and AA. Level of Evidence: Level III, systematic review.

scholarly journals Injury Prevention Programs for Throwing Injuries in Softball Players: A Systematic Review

2021 ◽  
pp. 194173812097816
Author(s):  
Jonathan Paul ◽  
Symone M. Brown ◽  
Mary K. Mulcahey
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Range Of Motion ◽  
Injury Prevention ◽  
Prevention Program ◽  
Dynamic Range ◽  
Lower Extremities ◽  
Prevention Programs ◽  
Level Of Evidence ◽  
Injury Prevention Program

Context: Throwing-related injuries occur commonly in softball players. Preventative programs can be implemented to assist in identifying and correcting risk factors that could potentially lead to injury and therefore time missed from both practice and games. Objective: The purpose of this study was to determine if position-specific injury prevention programs have been developed to decrease the risk of throwing-related injuries in softball players. Data Sources: A systematic review was performed using the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) guidelines. PubMed, PMC, and EBSCO were searched for articles on injury prevention programs using the following key terms: softball, injury prevention, throwing injuries, pitcher, and shoulder. Study Selection: Studies that involved fast-pitch softball and included female participants as well as rehabilitation programs were included. Articles that highlighted slow-pitch softball or did not include female participants were excluded. Level of Evidence: Level 1. Data Extraction: The initial search identified 1605 articles. After implementing a filter, 131 articles remained. Thirteen articles were screened out as duplicates. After screening for inclusion criteria, 7 articles remained and were included in the systematic review. Results: Decreased range of motion (ROM) in both the upper and the lower extremities, unbalanced muscular strength, and fatigue were identified as risk factors for throwing injuries in softball players. Within the upper extremity, strength and ROM of the rotator cuff muscles, biceps, and extensors of the forearm were emphasized. The main focus of the lower extremity was the strength of the gluteal muscles and ROM of the lumbopelvic-hip complex. Only 1 study detailed an injury prevention program for softball players. The prevention program outlined was generalized for all softball players and was not position specific. Conclusion: There is a paucity of information about injury prevention programs for softball players. Of the evidence analyzed, balanced strengthening of the upper and lower extremities while maintaining dynamic range of motion was frequently utilized in developing an injury prevention program.

scholarly journals Return to Sport After Metacarpal and Phalangeal Fractures: A Systematic Review and Evidence Appraisal

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098001
Author(s):  
Luke Geoghegan ◽  
Alexander Scarborough ◽  
Jeremy N. Rodrigues ◽  
Mike J. Hayton ◽  
Maxim D. Horwitz
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Return To Sport ◽  
Poor Quality ◽  
Accurate Estimation ◽  
Level Of Evidence ◽  
Metacarpal Fractures ◽  
Phalangeal Fractures

Background: Fractures of the metacarpals and phalanges account for more than half of all upper extremity fractures sustained by competitive athletes. Purpose: To determine which management strategy is best for expediting return to preinjury levels of competition in adult athletes with metacarpal and/or phalangeal fractures. Study Design: Systematic review; Level of evidence, 4. Methods: A methodology compliant with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used. A custom search strategy was designed and applied to MEDLINE and In-Process, Embase, EMCARE, and CINAHL. Results: Overall, 3135 records were identified, of which 8 met full inclusion criteria. All patients returned to preinjury levels of competition, at a mean of 30.6 days for phalangeal fractures and 21.9 days for metacarpal fractures. Meta-analysis demonstrated delayed return-to-sport time for operatively managed metacarpal fractures as compared with nonoperatively managed ones (28.5 vs 22.0 days). All studies were of fair or poor quality, and none were randomized. Conclusion: Optimal management strategies for athletes with metacarpal and phalangeal fractures remain equivocal. Injury, treatment, and sport-specific factors may confound results and preclude accurate estimation of optimal treatment strategies at present.

scholarly journals Effect of Injury Prevention Programs on Lower Extremity Performance in Youth Athletes: A Systematic Review

2019 ◽  
Vol 12 (1) ◽  
pp. 12-22 ◽  
Author(s):  
Colleen Hanlon ◽  
Joseph J. Krzak ◽  
Janey Prodoehl ◽  
Kathy D. Hall
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Lower Extremity ◽  
Injury Prevention ◽  
Injury Risk ◽  
Prevention Programs ◽  
Force Generation ◽  
Level Of Evidence ◽  
Youth Athletes ◽  
Lower Extremity Performance

Background: Understanding how existing youth injury prevention programs affect specific modifiable injury risk factors will inform future program development for youth athletes. Objective: To comprehensively evaluate the effects of injury prevention programs on the modifiable intrinsic risk factors associated with lower extremity performance in youth athletes. Data Sources: This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, EBSCOhost [including CINAHL, Medline, and SPORTDiscus], and PEDro). Secondary references were appraised for relevant articles. Article types included randomized or cluster randomized controlled trials and randomized cohort designs with youth athletes engaged in organized sports, along with outcomes that included at least 1 physical performance outcome measure. Study Selection: Eight studies met inclusion and exclusion criteria and were reviewed by 2 independent reviewers, with a third consulted in the case of disagreement, which was not needed. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Included studies underwent review of methodological quality using the Physiotherapy Evidence Database scale. Results: Studies included mixed-sex samples of youth athletes who predominantly participated in soccer at different skill levels. The FIFA 11+ series was the most commonly used injury prevention program. Among studies, the mean percentage of improvement identified was 11.3% for force generation, 5.7% for coordination, 5.2% for posture, and 5.2% for balance. The lowest mean percentage improvement was in speed (2.2%). Endurance was not significantly affected by any of the programs. Conclusion: This systematic review shows that injury prevention programs improve several modifiable intrinsic risk factors of lower extremity performance among youth athletes, particularly force generation. However, several intrinsic risk factors were either not significantly affected or specifically addressed by existing programs.

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