What are the long-term health-related QOL effects for women participating in college sports

CJSM Associate Editor Jason Zaremski, MD (center) with colleagues at Florida HS football game with that 2020 look

Online Journal Club November 2020

Jason L Zaremski, MD

Title: Stracciolini A, et al. Female Sport Participation Effect on Long-Term Health-Related Quality of Life, CJSM: November 2020 – Volume 30 – Issue 6 – p 526-532 doi: 10.1097/JSM.0000000000000645

Introduction:  As we turn the corner on a unique fall sports season in the United States and around the world, we as a sports medicine community continue to find ourselves facing innumerable COVID-19 related challenges which must be overcome as we promote safe participation in sport. There is a substantial body of research which demonstrates that participation in sport improves confidence, lowers rates of depression, and improves sense of self and self-confidence. During this pandemic, we are more than ever in need of all these sports-related quality of life outcomes.

In this original research from the Micheli Center for Sports Injury Prevention and other centers (including four colleges), the authors do a deep dive into long-term quality of life measures in female athletes.  As the authors highlight, female athletes who participate in sports are less likely to join gangs or use drugs, and are less likely to have unprotected sex or an unintended pregnancy than non-athletes. Nearly fifty years after the passage of Title IX in 1972, in the midst of a global pandemic none of us have ever faced, the November CJSM Journal Club has chosen to highlight this wonderful manuscript on how participation in sport by females in college can potentially impact long term health quality of life measures. Read more of this post

Can you do a brief but comprehensive examination of a concussed patient in your clinic?

Well, can you?

If your exam is brief, can it be comprehensive? If it’s comprehensive, will you be able to get through all of the patients on your schedule?

These are some practical questions that most of us in the world of sports medicine struggle with.

I’m looking at my clinic schedule tomorrow, and I have 15 minutes for most patients; for new concussed patients I’m ‘given’ 30 minutes.

Most of us know these clinic slots are a Procrustean bed – there really is little chance we can fit the patient and their needs, as well as our obligation to diagnose and manage the injury, in these time frames.

M. Nadir Haider, M.D.

Good news, then – authors from the University of Buffalo Concussion Management Clinic have just produced a Practical Management article that promises to make your approach much more efficient when you next see a clinic patient with a sports related concussion (SRC).

The first and corresponding author of this manuscript, M Nadir Haider, M.D., is our guest on the newest CJSM blog post. Dr. Haider is affiliated with the Jacobs School of Medicine, State University of New York (SUNY), Buffalo where he is an Assistant Professor of Orthopedics and Sports Medicine and the Assistant Director of Research at the University Concussion Management Clinic. Many of the readers of CJSM and listeners of the podcast will be familiar with the voluminous research that comes out of the SUNY, Buffalo center.  This work has been transformative in the area of SRCs.

Listen in on our conversation, where Dr. Haider walks us through the evidence-based exam, and then go to the September 2020 CJSM where you will find the Practical Management article itself, currently free of charge.

As always you can find the podcast on our journal website, or you may go to iTunes to listen in and subscribe as well.

Any way you read, listen or engage with CJSM, we are happy you are part of our sports medicine community.

Exercise as a prescription to address post-concussion syndrome: The CJSM Blog Journal Club

Sports like American football are taking place in the midst of COVID19 — concussions are sure to follow

Our September 2020 edition has just published, and this edition is a particularly compelling one, full of original research.  You have to check it out.

As ever our Jr. Associate Editor Jason Zaremski M.D. has just posted his newest submission to the CJSM journal club.

While COVID19 is wreaking havoc with sports schedules around the globe, there are enough high schools and youth sports programs active that concussions will continue to remain a challenge for clinicians to treat.  And post-concussion syndrome is one particularly challenging aspect to this injury.  Dr. Zaremski walks us through original research looking at an ‘exercise prescription’ to treat post-concussion syndrome.

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Jason Zaremski MD

Gauvin-Lepage J, Friedman D, Grilli L, Sufrategui M, De Matteo C, Iverson, GL, Gagnon I. Effectiveness of an Exercise-Based Active Rehabilitation Intervention for Youth Who Are Slow to Recover After Concussion, Clinical Journal of Sport Medicine: September 2020 – Volume 30 – Issue 5 – p 423-432 doi: 10.1097/JSM.0000000000000634

Introduction:  With the change of seasons, many of our readers return to covering pediatric and adolescent sport. In the Northern Hemisphere, summer vacation is over, and academics and school sports are commencing. Fall is the start of the gridiron football season and there is often a surge of concussed youth who need effective, evidence-based management.

This month the CJSM Journal Club has chosen to highlight original research on the effectiveness of exercise-based rehabilitation in 8-17 year youth who have sustained a concussion. In this age group, return to school is even more important than return to sport, and the lingering difficulties in intellectual ability, vestibular system function, memory, and/or attention can be particularly debilitating.  The authors in this new study report that between 20% and 30% of all concussed youth will endorse post-concussive symptoms (PCS) 1 month after injury. Further research into treatments and modalities aimed at reducing the frequency with which children and adolescents experience PCS is paramount.

Purpose: The authors state two aims:

1) To determine the impact of providing participants (aged 8 to 17 years) who are slow to recover after a concussion with an active rehabilitation intervention (ARI) compared to receiving standard care alone, at 2 and 6 weeks after the initiation of the ARI.

2) To investigate functional recovery 6 weeks after initiation of the ARI.

Setting: Tertiary care pediatric trauma center and associated community health care providers. Read more of this post

The warrior athlete in 2020 — sports and military medicine in the era of COVID-19

Francis O’Connor MD, MPH (L) and Daniel Fosselman D.O. (R)

We have two special guests for our most recent podcast. This episode explores the impact of the novel SARS-CoV-2 on the clinicians in our world who have one foot in military medicine and the other in sports medicine.

Two physicians who care for ‘warrior athletes’ join us for this special podcast:  Francis O’Connor MD, MPH, Retd. Col. US Army and Daniel Fosselman D.O., Capt. US Army Reserve.

Dr. O’Connor is, among many other things, a past-President of the American Medical Society for Sports Medicine (AMSSM) and a current Professor at the Uniformed Services University of the Health Sciences in Bethesda, MD.  He is also the Medical Director of the Consortium for Health and Military Performance at the University, and he shares with us in the podcast the challenges of keeping a force of soldiers at the ready during this pandemic.  Dr. O’Connor like many is working through the intricacies of teaching over Zoom and is coming to grips with the impact of the virus on issues ranging from quarantine to ‘return to play’.  He reminds us that resting indefinitely on the sideline or playing in a ‘bubble’ are not options when it comes to national security.

Dr. Fosselman is a young sports medicine clinician who had just started his career in central Ohio in primary care sports medicine and family medicine when, as a Captain in the US Army Reserve, he was called up for duty.  We caught up with him as he was nearing the end of his two-week quarantine, which came on the tail of end of many weeks of service on the true front lines of the battle with this new foe:  in the hospitals of the Bronx, in the midst of the COVID spike that devastated the NYC area this spring.  His story is one of true service to patients and to his country. Read more of this post

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