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Laura S. Kox, P. Paul F.M. Kuijer, Dagmar A.J. Thijssen, Gino M.M.J. Kerkhoffs, Rick R. van Rijn, Monique H.W. Frings-Dresen and Mario Maas

Background: The benefits and risks of performing popular wrist-loading sports at a young age have not been investigated systematically. We aimed to evaluate positive and negative long-term wrist-related health effects of sports performance requiring repetitive wrist loading during youth. Methods: Six databases were searched for cohort and cross-sectional studies. Three investigators selected studies evaluating quantitatively measured health effects of upper extremities in athletes practicing wrist-loading sports (gymnastics, tennis, volleyball, field hockey, rowing, and judo) for minimally 4 months before the age of 18. Results: A total of 23 studies with 5 outcome measures, nearly all of moderate to good quality, were eligible for inclusion. Bone mineral density and bone mineral content were higher in athletes compared with controls and in tennis players’ dominant arm. Mixed results were found for ulnar variance in gymnasts. Handgrip strength was greater in tennis players’ dominant arm and in experienced gymnasts. Conclusions: Wrist-loading sports performance during youth can promote bone strength in wrists and dominant handgrip strength, but evidence on the lasting of these effects and on prevalence of wrist joint degeneration in former young athletes is limited. For better counseling of young athletes and their parents, future studies with increased comparability are essential, for which recommendations are provided.

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Gregory M. Gutierrez, Catherine Conte and Kristian Lightbourne

Head impacts are common in contact sports, but only recently has there been a rising awareness of the effects of subconcussive impacts in adolescent athletes. A better understanding of how to attenuate head impacts is needed and therefore, this study investigated the relationship between neck strength, impact, and neurocognitive function in an acute bout of soccer heading in a sample of female high school varsity soccer players. Seventeen participants completed the ImPACT neurocognitive test and had their isometric neck strength tested (flexion, extension, and bilateral flexion) before heading drills. Each participant was outfitted with custom headgear with timing switches and a three-dimensional accelerometer affixed to the back of the head, which allowed for measurement of impact during heading. Participants performed a series of 15 directional headers, including 5 forward, 5 left and 5 right headers in a random order, then completed the ImPACT test again. Neurocognitive tests revealed no significant changes following heading. However, there were statistically significant, moderate, negative correlations (r = −0.500:−0.757, p < .05) between neck strength and resultant header acceleration, indicating that those with weaker necks sustained greater impacts. This suggests neck strengthening may be an important component of any head injury prevention/reduction program.

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Mahsa Jafari, Vahid Zolaktaf and Gholamali Ghasemi

protocol used in this research is based on the guidelines of National Academy of Sport Medicine (NASM). The NASM corrective exercise continuum recommends a 4-stage process to improve neuromusculoskeletal functional impairment by practicing functional movements. It suggests that the use of inhibiting

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Sherry Robertson and Margo Mountjoy

.L. , Berglund , L. , & Berglund , B. ( 2008 ). Special attention to the weight-control strategies employed by Olympic athletes striving for leanness is required . Clinical Journal of Sport Medicine, 18 , 5 – 9 . PubMed ID: 18185032 doi:10.1097/JSM.0b013e31804c77bd 10.1097/JSM.0b013e31804c77bd Holick

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Carlos Amo, Miguel Ortiz del Castillo, Rafael Barea, Luis de Santiago, Alejandro Martínez-Arribas, Pedro Amo-López and Luciano Boquete

Objective:

Propose a simplified method applicable in routine clinical practice that uses EEG to assess induced gamma-band activity (GBA) in the 30–90 Hz frequency range in cerebral motor areas.

Design:

EEG recordings (25 healthy subjects) of cerebral activity (at rest, motor task). GBA was obtained as power spectral density (PSD). GBA — defined as the gamma index (Iγ) — was calculated using the basal GBA (γB) and motor GBA (γMOV) PSD values.

Results:

The mean values of Iγ were (Iγ R (right hand) = 1.30, Iγ L (left hand) = 1.22). Manual laterality showed a correlation with Iγ.

Conclusions:

Iγ may provide a useful way of indirectly assessing operation of activated motor neuronal circuits. It could be applied to diagnosis of motor area pathologies and as follow up in rehabilitation processes. Likewise, Iγ could enable the assessment of motor capacity, physical training and manual laterality in sport medicine.

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Monna Arvinen-Barrow, Diarmuid Hurley and Montse C. Ruiz

This study documented the lived career-ending injury experiences among elite Irish rugby football union (IRFU) players. Three players took part in semistructured one-on-one interviews. Interpretative phenomenological analysis (Smith, 1996) revealed that the process of psychosocial injury rehabilitation and the subsequent transition process was for the most part a distressing one and evolved in a cyclical, yet stage-like (Heil, 1994), manner. The nature of the postinjury career transition appeared to be dependent on the interactional balance of participants’ psychosocial responses to injury, existing coping mechanisms, and other factors related to the injury and career transition process. Appropriate social support network, use of sport medicine and counseling professionals, as well as organizational officials are needed to best prepare elite rugby players for life outside of sport, and to ensure a healthy career transition (Taylor & Ogilvie, 1994) out of sport.

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Carla Sordoni, Craig Hall and Lorie Forwell

Objectives:

To determine whether athletes use motivational and cognitive imagery during injury rehabilitation and to develop an instrument for measuring imagery use.

Design:

A survey concerning imagery use during rehabilitation was administered to injured athletes.

Setting:

The Fowler Kennedy Sport Medicine Clinic in London, Ontario, Canada.

Participants:

Injured athletes (N = 71) receiving physiotherapy.

Main Outcome Measure:

The Athletic Injury Imagery Questionnaire (AIIQ).

Results:

As hypothesized, 2 distinct factors emerged from the items on the AIIQ: motivational and cognitive imagery. Motivational imagery was used more often than cognitive imagery in this context, yet less frequently than in other sport situations (eg, training and competition).

Conclusions:

The study indicates that the AIIQ is a potentially useful tool through which physiotherapists and sport psychologists can examine athletes' use of imagery in injury rehabilitation.

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Dominic Malcolm

This article addresses clinical practice in sport medicine. Combining notions of medical uncertainty with a figurational sociological emphasis on interdependence, the article illustrates how uncertainty characterizes the medical understanding, clinical treatment, and patient experience of concussion. Faced with uncertainty, the clinician’s desire for recognition and validation through athletes’ dependence on them enables medically based diagnostic and treatment guidelines to be replaced by the understanding and definition of concussion dominant in the sport subculture. Clinicians further invoke strategies that protect their professional status and therefore secure their interdependence with others in the sport club figuration. The study advances our understanding by illuminating the basis on which clinicians and athletes negotiate treatment and the impact of these experiences on clinicians’ actions and beliefs.

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Mark R. Lafave, Nicholas G. Mohtadi and Denise S. Chan

Edited by Gary Wilkerson

Abstract

Evaluation of musculoskeletal injuries requires special knowledge and skills that are shared by different health professions, but the process used to establish a diagnosis is not necessarily the same. Medicine has employed the objective structured clinical exams (OSCE) to assess clinical competence. The performances of two Canadian athletic therapists were assessed by two different methods for assessment of clinical competence in the evaluation of knee injuries. On the basis of existing standards, both of the athletic therapists would have passed the examination using the Standardized Orthopedic Assessment Tool currently used to assess the clinical competence of athletic therapy students, but both would have failed using the Academy of Sport and Exercise Medicine OSCE for sport medicine physicians. The failure could be because the performances of only two subjects were assessed, but it could also be because different constructs are represented by the two methods. If we truly want to provide patient-centered care, it should be important to have similar standards, regardless of the clinician’s professional discipline.

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Nancy Theberge

This article offers an analysis of the social sources of biomedical interest in women’s sports injuries through a case study of anterior cruciate ligament (ACL) injuries. Although both men and women incur them, there is extensive research interest in women’s ACL injuries. Drawing on interviews with researchers who have contributed to this research, the investigation examines the social sources of this interest. Explanations lie largely in the evolution of the agenda in sport medicine to a concern with injury prevention, which coincides with a movement toward the inclusion of women in health research. The article concludes with a consideration of the political and ideological implications of the interaction of the prevention and inclusion agendas in research on women’s sport injuries.

Cet article propose une analyse des sources sociales de l’intérêt biomédical pour les blessures dans les sports féminins à travers l’étude du cas des blessures au ligament croisé antérieur (LCA). Bien que les hommes et les femmes en soient tous deux victimes, il y a énormément d’intérêt en recherche pour les blessures au LCA chez les femmes. S’appuyant sur des entrevues avec des chercheurs qui ont contribué à ce projet, l’étude examine les sources sociales de cet intérêt. Les explications reposent grandement sur l’évolution de l’agenda en médecine du sport vers un souci de prévention des blessures, ce qui coïncide avec un mouvement vers l’inclusion des femmes dans la recherche sur la santé. L’article conclut par une considération des implications politiques et idéologiques de l’interaction des agendas de prévention et d’inclusion en recherche sur les blessures sportives chez les femmes.