SportsMed Update. Volume 9 (8) 2: 2009

Size: px

Start display at page:

Download "SportsMed Update. Volume 9 (8) 2: 2009"

Sara Oliver
6 years ago
Views:

1 SportsMed Update Volume 9 (8) 2: 29 Contents: 1. There is a smaller increase in abdominal muscle (transversus abdominis and internal oblique) thickness during a straight-leg-raise test in patients with lumbo-pelvic pain (sacro-iliac joint pain) but these responses are similar on the injured and non-injured side 2. Achilles tendinopathy is associated with a pattern of dyslipidemia that is characteristic of that seen in patients with insulin resistance and the metabolic syndrome perhaps, evaluating and treating cardiovascular disease risk factors is part of the management of patients with tendinopathy 3. In cricket fast bowlers, the risk of developing an injury is related to increased workload (overs bowled in a match), particularly in the period 3-4 weeks after a single high workload (> 5 overs) during a match 4. In elderly women who underwent a 12 months exercise program, the improvements in bone density and neuromuscular function that were achieved by training, were lost 5 years after cessation of training 5. In a case series, a 12-week comprehensive outpatient pulmonary rehabilitation program significantly improved functional capacity in a heterogeneous population of cancer patients with pulmonary symptoms Produced and distributed by MPAH Medical cc, Copyright 29

2 SMU Volume 9 (8) 2 p1: 29 Category: Injury / Lumbo-pelvic pain / Sacro-iliac joint There is a smaller increase in abdominal muscle (transversus abdominis and internal oblique) thickness during a straight-leg-raise test in patients with lumbo-pelvic pain (sacro-iliac joint pain) but these responses are similar on the injured and non-injured side Title: Ultrasound characteristics of the deep abdominal muscles during the active straight leg raise test Authors: Teyhen DS, Williamson JN, Carlson NH, Suttles ST, O Laughlin SJ, Whittaker JL, Goffar SL, Childs JD Reference: Arch Phys Med Rehabil 29; 9: Type of study: Case-control study Keywords: lumbo-pelvic pain, sacro-iliac joint, abdominal muscle, activation, rehabilitation EB Rating: 7/1 CI Rating: 7/1 Background: A common presentation of lumbo-pelvic pain is unilateral sacro-iliac joint pain and abnormal neuromuscular control of the lower abdominal muscles has been associated with lumbo-pelvic pain Research question/s: Are changes in the transverses abdominis (TrA) and internal oblique (IO) muscles during an active straight leg raise (ASLR) test similar in subjects with and without unilateral lumbo-pelvic pain? Subjects: 3 subjects (LPP=15 with unilateral symptoms in the lumbo-pelvic region; CON=15 with no symptoms matched for age and gender) Experimental procedure: All the subjects were assessed and then underwent testing in a laboratory setting. An active straight leg raise test (SLRT) was performed during which bilateral measurements of the deep abdominal muscles (TrA and IO) were done using ultrasound imaging at 4 stages: rest, immediately on raising, after a 1-second hold, and within 5 seconds after returning the lower extremity to the plinth. Measures of outcome: Percent change in muscle thickness (%) during the 4 stages of the test in both groups and in the ipsi- and contra-lateral side Transversus abdominis muscle % change in muscle thickness LPP group Rest vs. lift Rest vs. hold Rest vs. return : p<.5 between groups Internal oblique muscle % change in muscle thickness LPP group Rest vs. lift Rest vs. hold Rest vs. return : p<.5 between groups Similar responses were observed in the ipsi- and contra-lateral side to the SLRT There is a smaller increase in abdominal muscle (transversus abdominis and internal oblique) thickness during a straight-leg-raise test in patients with lumbo-pelvic pain (sacro-iliac joint pain) but these responses are similar on the injured and non-injured side Small sample size, findings can not be applied to all patients with low back pain, no cause-effect can be shown Produced and distributed by MPAH Medical cc, Copyright 29

3 SMU Volume 9 (8) 2 p2: 29 Category: Injury / Lower leg / Achilles tendon Achilles tendinopathy is associated with a pattern of dyslipidemia that is characteristic of that seen in patients with insulin resistance and the metabolic syndrome perhaps, evaluating and treating cardiovascular disease risk factors is part of the management of patients with tendinopathy Title: Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance Authors: Gaida JE, Alfredson L, Kiss ZS, Wilson AM, Alfredson H, Cook JL Reference: Med Sci Sports Exerc 29; 41(6): Type of study: Case-control study Keywords: Injury, lower leg, Achilles tendon, lipogram EB Rating: 7/1 CI Rating: 7.5/1 Background: Achilles tendinopathy has been observed in overweight and inactive individuals, and these metabolic abnormalities are also associated with obesity, dyslipidemia, hypertension, and insulin resistance Research question/s: Is Achilles tendinopathy associated with an abnormal lipid profile? Subjects: 6 subjects with chronic painful mid-portion Achilles tendinopathy (AT group, yrs, BMI , male=54%) and 6 control subjects (, yrs, BMI= , male=53%) Experimental procedure: All the subjects were assessed (including ultrasound to confirm the diagnosis in the AT group and anthropometry), and fasting serum lipids were measured. Measures of outcome: Lipid profile between groups AT group : p<..5 between groups Cholesterol (mmol/ L) Triglycerides (mmol/ L) HDL (mmol/ L) LDL (mmol/ l) TG/ HDL ratio Subjects in the AT group also had increased apolipoprotein B concentrations (p=.17) compared with the Achilles tendinopathy is associated with a pattern of dyslipidemia that is characteristic of that seen in patients with insulin resistance and the metabolic syndrome perhaps, evaluating and treating cardiovascular disease risk factors is part of the management of patients with tendinopathy Case control design, no cause effect can be shown, no assessment of insulin resistance Produced and distributed by MPAH Medical cc, Copyright 29

4 SMU Volume 9 (8) 2 p3: 29 Category: Injury / Cricket / Risk factors In cricket fast bowlers, the risk of developing an injury is related to increased workload (overs bowled in a match), particularly in the period 3-4 weeks after a single high workload (> 5 overs) during a match Title: Fast bowlers in cricket demonstrate up to 3- to 4-week delay between high workloads and increased risk of injury Authors: Orchard JW, James T, Portus M, Kountouris A, Dennis R Reference: Am J Sports Med 29; 37(6): Type of study: Prospective cohort study Keywords: cricket, injury, bowling, workload EB Rating: 7.5/1 CI Rating: 7/1 Background: In sports such as baseball and cricket, it is postulated that there is an association between increased workload and subsequent injury risk Research question/s: Does a high bowling workload in fast bowlers during a cricket match increase the risk of subsequent injury? Subjects: 12 cricket fast bowlers Experimental procedure: Data for this study were extracted from a database of injuries that is part of an ongoing cricket injury surveillance program in Australia. Over a 1-yr period, data on injuries were obtained in bowlers who bowled in 2715 player matches. Injuries sustained in the period after games 7, 1, 14, 21, 28, 35, 42, 56, and 9 days and workload (overs bowled in a match in two groups > 5, and < 5) were documented Measures of outcome: OR of injury in the post match periods, type of injuries Low workload High workload (> 5 over per match) OR of injury in fast bowler days 1 days 14 days 21 days 28 days 35 days 42 days 56 days 9 days Time period after a match The most common injuries sustained by fast bowlers were shoulder tendon (28.6%), ankle/foot sprains (25%), thigh/hamstring muscle strains (18.7%), groin injuries (17.6%) and lumbar soft tissue injuries (17%) In cricket fast bowlers, the risk of developing an injury is related to increased workload (overs bowled in a match), particularly in the period 3-4 weeks after a single high workload (> 5 overs) during a match Increased statistical power in the analysis was related to the duration of follow-up, match scheduling was not regular Produced and distributed by MPAH Medical cc, Copyright 29

5 SMU Volume 9 (8) 2 p4: 29 Category: Medical / Bone / Exercise In elderly women who underwent a 12 months exercise program, the improvements in bone density and neuromuscular function that were achieved by training, were lost 5 years after cessation of training Title: The beneficial effects of exercise on BMD are lost after cessation: a 5-year follow-up in older postmenopausal women Authors: Englund U, Littbrand H, Sondell A, Bucht G, Pettersson U Reference: Scand J Med Sci Sports 29; 19: Type of study: Prospective cohort study Keywords: bone, exercise, bone mineral density, bone mineral content, neuromuscular function EB Rating: 7/1 CI Rating: 7/1 Background: It is well established that exercise training can improve bone health however, it is not well known if cessation of training is associated with loss in the benefits that were derived from the training program Research question/s: In older women, is bone mineral density and neuromuscular function following a 12 month combined weight-bearing program retained after 5 years? Subjects: 34 females (73-88 yrs) aged years, Experimental procedure: All the subjects were part of a 12 month randomized controlled trial that was completed 5 yrs before. Subjects (18 from the exercise group EX, and 16 from the control group - CON) in this study underwent as follow-up assessment of physical activity (Frandin scale, walking-min/wk, gymnastics per wk), total bone mineral content (TBMC), bone mineral density (BMD, g/cm 2 : total, femoral neck, trochanter, and Ward s triangle) and neuromuscular function (standing on one leg, leg extension strength, isometric grip strength, maximum walking speed, balance) Measures of outcome: Bone mineral content and density, neuromuscular function EX group EX group % change 6 4 from post 2 trial to 5 yr -2 follow-up Total BMD : p<.5 post vs. 5yrs Lumbar spine BMD Femoral neck BMD Trochanter BMD Ward's triangle BMD % change from post trial to 5 yr follow-up : p<.5 post vs. 5yrs Knee ext strength Max walk speed Berg balance scale In elderly women who underwent a 12 months exercise program, the improvements in bone density and neuromuscular function that were achieved by training, were lost 5 years after cessation of training Well conducted study, small sample size with drop put rate of 15% Produced and distributed by MPAH Medical cc, Copyright 29

6 SMU Volume 9 (8) 2 p5: 29 Category: Medical / Oncology / Rehabilitation In a case series, a 12-week comprehensive outpatient pulmonary rehabilitation program significantly improved functional capacity in a heterogeneous population of cancer patients with pulmonary symptoms Title: Pulmonary rehabilitation improves functional status in oncology patients Authors: Morris GS, Gallagher GH, Baxter MF, Brueilly KE, Scheetz JS, Ahmed MM, Shannon VR Reference: Arch Phys Med Rehabil 29; 9: Type of study: Case series Keywords: dyspnea, oncology, outcomes, pulmonary, rehabilitation EB Rating: 5/1 CI Rating: 7/1 Background: There is accumulating evidence that cancer patients can benefit from outpatient exercise-based rehabilitation programs Research question/s: Does the participation in a pulmonary rehabilitation (PR) program improve the functional and physiologic status of oncology patients with chronic symptoms (shortness of breath, fatigue, and/or exercise intolerance)? Subjects: 3 oncology patients (solid or a hematologic malignancy)(male=2, yrs) who had symptoms of chronic dyspnea, exercise intolerance, and/or decreased functional status Experimental procedure: All the subjects were assessed and participated in a 8-12 week outpatient pulmonary rehabilitation program [education, psychosocial component and individualized, progressive aerobic exercise (walking, cycling, sliding board exercises) program, 2-3 sessions/wk. Assessment were repeated after the program and consisted of exercise tolerance (6-minute walk test - (6MWT),self reported perceived exertion (RPE) and dyspnea (RPD). Measures of outcome: 6-minute walk test (6MWT)distance (D) and work (W)(body mass X 6-minute walk distance), RPE and RPD (at end of 6MWT), adverse events % change from pre rehabilitation : p<.5 vs pre 1 5 6MWT (distance) 6MWT (Work) RPE (end of 6MWT) RPD (end of 6MWT) Adverse events: There were no adverse events reported during the study In a case series, a 12-week comprehensive outpatient pulmonary rehabilitation program significantly improved functional capacity in a heterogeneous population of cancer patients with pulmonary symptoms Case series, no control group, small sample size Produced and distributed by MPAH Medical cc, Copyright 29

SportsMed Update. Volume 8 (7) 4: 2008

SportsMed Update. Volume 8 (7) 4: 2008 SportsMed Update Volume 8 (7) 4: 8 Contents: 1. In elite rugby union players, there is a high incidence (injuries/1 hours play) of head injury (6.6) and concussion (4.1) in matches - tackling and being