Browse

Clinical Scenario: With the enforcement of COVID-19 lockdown restrictions, sports teams worldwide were required to make drastic adjustments to their training regimen. This prolonged sport suspension resulted in a significant decrease in off-season and preseason training periods. Clinical Question: Are professional athletes who experienced a sport suspension during the COVID-19 pandemic at a higher risk of injury once they return to competition compared with pre-COVID-19 seasons? Summary of Key Findings: The literature was searched for articles examining the effects of COVID-19 sport suspension on athletic injury rates in elite athletes. A total of 240 articles were retrieved, and after exclusion criteria and removal of duplicates, four retrospective cohort studies remained. An increase in injury rates across studies after their sport suspension compared with pre-COVID-19 seasons was found. Clinical Bottom Line: The extended suspension from physical activity increased the risk of injury as players returned to sport training post-COVID-19 restrictions. While these studies demonstrated the effects on elite-level athletes, prolonged sport suspension may impact different patient populations. Strength of Recommendation: Based on the Strength of Recommendation Taxonomy Scale, this critically appraised topic received a B grade for consistent but limited-quality patient-oriented evidence, with a low number of articles included.

Considering the frequency and magnitude of head impacts occurring during sport participation is important to guide prevention initiatives. Our purpose was to compare magnitude and frequency of lacrosse players’ head impacts based on anticipation level and impact activity. Lacrosse athletes (16 men, 15 women) wore xPatch sensors during games and practices that measured impact magnitude (linear and rotational accelerations) and frequency of video verified head impacts. The interaction between impact activity and preparedness was not significant, multivariate: F(8, 1,730) = 1.03, p = .41, η² = .01. Having a detailed understanding of the characteristics of head impacts could allow for focused interventions to reduce injury risk.

Focused Clinical Question: In adult patients with persistent low back pain, what relationship do social determinants of health have on pain frequency or severity? Bottom Line: This systematic review identified several particular social risk factors (including education status, socioeconomic status, and occupational factors) that are consistently associated with adverse low back pain outcomes. In addition, the analysis of the population-representative (cross-sectional) studies demonstrated support for important associations between specific social determinants of health, such as low socioeconomic status/income status and employment status and chronic low back pain prevalence.

Burnout and work–family conflict (WFC) are stressors faced by secondary school athletic trainers, however, the concept of perceived stress and its relationship to burnout or WFC is not well understood. The purpose of this study was to investigate perceived stress’ relationship with burnout and WFC. Participants reported a WFC score of 40.36 (±15.63), low burnout (40.1 ± 16.28), and moderate stress (15.99 ± 7.02). Perceived stress predicted WFC, but not burnout (b = 1.13, t ₅₇₂ = 14.132, p ≤ .001). One’s level of perceived stress impacts WFC, which indicates higher stress will equal greater work–family conflict.

Introduction/Clinical Scenario : As many hamstring injuries occur when the hamstrings are in a lengthened state during the deceleration phase of running when the muscle is eccentrically contracting to slow the body down this functional aspect needs to be addressed. Thus, a rehabilitation program with a focus on progressive targeted eccentric hamstring exercises by gradually placing and exposing the muscle to eccentric force in a lengthened state supplemented with progressive running drills should be evaluated. Focused Clinical Question : Does the inclusion of a complementary running progression program for the rehabilitation of an acute hamstring injury reduce the time to safe return to sport with less hamstring reinjury occurrence for an athletic population? Summary of Key Findings: Three studies assessed the inclusion of a progressive running program with several types of running progression parameters addressed. Progressive running drills will load the hamstring in a functional manner, with a gradual increase in velocity of movement and lengthening of the muscle. Clinical Bottom Line : It appears that a complementary progressive running program within an acute hamstring rehabilitation program should be included as it caused no further harm and does not tend to increase hamstring reinjury occurrence. Strength of Recommendation : There is grade B evidence to include a complementary running progression program within an acute hamstring rehabilitation program.

Clinical Scenario: Having an indication of how bone is remodeling in response to training load could help identify athletes and military personnel at increased stress fracture (SFx) risk. Direct assessment of bone remodeling is impractical. Biochemical markers of bone turnover are used as an indirect measure of bone remodeling and have potential to inform prevention and treatment efforts. To date, the relationship between bone turnover markers and SFxs in athletes or military personnel remains unclear. Clinical Question: Are SFxs related to bone turnover markers in athletes and military personnel? Summary of Key Findings: Seven met eligibility criteria. In five studies, an association between SFxs and bone turnover markers existed. Clinical Bottom Line: The evidence supporting a relationship between SFxs and bone turnover markers in athletes and military personnel is mixed. While five of the seven studies reported some type of relationship, no studies prospectively measured bone turnover markers in a group of athletes or military personnel without an SFx or without SFx history and followed them over time to reassess bone turnover markers upon SFx occurrence. Strength of Clinical Recommendation: In accordance with the Strength of Recommendation Taxonomy, Grade C is the most appropriate strength of recommendation rating.