CJSM July Blog Post Journal Club — A Physical Activity Vital Sign

Our Jr. Associate Editor and Journal Club Author, Dr. Jason Zaremski, sporting the contemporary COVID-era look

Our July 2020 issue has just published, and it’s full of many important new position statements and original research publications.

Among the latter is an investigation of a physical activity ‘vital sign’ and its association with cardiometabolic disease.

As always, our Jr. Associate Editor Jason Zaremski, MD will walk us through the study in this edition of the CJSM Blog Post Journal Club.

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Jason Zaremski, MD — Jr. Associate Editor, CJSM

Title: Nelson VR, Masocol RV, Ewing JA, Johnston S, Hale A, Widederman M, Asif IM. Association Between a Physical Activity Vital Sign and Cardiometabolic Disease in High-Risk Patients. Clinical Journal of Sport Medicine: July 2020 – Volume 30 – Issue 4 – p 348-352. doi: 10.1097/JSM.0000000000000588.

Introduction:  The challenges posed by the COVID pandemic are legion.  A less publicized aspect of ‘stay home’ or ‘shelter-in-place’ orders has been the reduction in physical activity in all ages. This new publication by Nelson VR et al. examining a physical activity vital sign (PVS) arrives in the pages of CJSM at just the right time.

Physical inactivity is known to be associated with increased rates of cardiovascular disease, cancer, and increased mortality rates. The ability of physicians to potentially screen patients using efficient means during clinical encounters could be extremely helpful to improve measures of all cause morbidity and mortality of patients.

This month’s journal club focuses on this interesting new study assessing the use of a PAVS and its correlation with cardiometabolic markers and disease in medically complex patient population in a large family medicine clinic in South Carolina. Read more of this post

Prescribed Exercise for Managing Concussions — the CJSM Blog Journal Club

Our Editor-in-Chief Chris Hughes (R) and Jr. Assoc. Editor Jason Zaremski (L) taking a brief spell from their busy lives.

Our fifth edition of the year went live at the beginning of September, and it’s a special one:  we have devoted the entire issue to the theme of pediatric athletes.

Our guest editor Alison Brooks M.D., M.P.H. has assembled an impressive line up of authors, including John Leddy M.D. of SUNY Buffalo who is the lead on an interesting new study demonstrating the benefits of prescribed aerobic exercise in the recovery of adolescent males from sport-related concussion.

Our Jr. Assoc. Editor Jason Zaremski M.D. has submitted another insightful journal club piece looking at the details of Dr. Leddy’s study.

As fall approaches in the Northern Hemisphere, and spring in the Southern, sports-related concussions will continue to show up in a variety of sports our young athletes play.  This work from Dr. Leddy et al. (including both this new study and his CJSM 2018 study) will be transformative in the way we manage our athletes.

Enjoy the original research paper itself (here) and the journal club article (below).

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Jason Zaremski M.D., Junior Associate Editor CJSM

Title:

Leddy JJ, et al. A Preliminary Study of the Effect of Early Aerobic Exercise Treatment for Sport-Related Concussion in Males. Clin J Sport Med 2019 29(5):353-360.

Introduction:  

As the temperature begins to change and we enter the fall season, millions of student-athletes have returned to school and sport. With such large participation numbers in sport inevitably comes a rise in injury. One of these injuries is sports related concussions (SRC). In recent years, our overall knowledge of how to diagnose, manage, and treat SRC has improved thanks to the ever-growing research in this area. However, one aspect that is continuing to evolve is the timing and intensity of physical activity after sustaining a SRC. While rest (cognitive and physical) has been a mainstay of treatment in the past, there is a growing body of research that indicates physical activity may accelerate recovery versus physical rest only. Thus, it is our pleasure to provide this month’s CJSM Journal Club by reviewing Leddy and colleagues’ new work on the effects of early aerobic exercise as a potential treatment for SRC in adolescent males.

Purpose/Hypothesis(es):

The primary purposes of this research is to compare early subthreshold aerobic exercise (STAE) versus prescribed rest and days to recovery from concussion for adolescent males. The authors hypothesized that STAE would reduce the days to recovery after treatment prescription. Read more of this post

Five Questions with Dr. Nick Peirce: The Role of Physical Activity and Sport in Mental Health

Dr. Nick Peirce, lead on the FSEM team producing recent exercise and mental health position statement.

Reduce depression and cognitive decline by up to 30% with regular exercise?  Can this be so?

For those of us ‘in the know’ in this field of sport and exercise medicine, that statement may seem understood.  But medical research translating to broadly held knowledge which then may lead to meaningful change:  well, we ALL know how rare that situation can be.  The management of recent concussion events in the FIFA World Cup reminds us of the difficulty of knowledge translation: there were instances where it seemed as if we were ‘partying like it’s 1999’ so to speak.

Reviews of the current state of evidence-based knowledge about medically important findings continue to be of vital importance in ‘getting the word out’.  In that spirit, we couldn’t be happier to see the recent position statement released by one of our partner societies, the Faculty of Sport and Exercise Medicine (UK) : The Role of Physical Activity and Sport in Mental Health.

The lead on the team of authors which produced this FSEM UK Position Statement is Dr. Nick Peirce, Chief Medical Officer of the England and Wales Cricket Board.  We wanted to pick his brain to get a bit more of the background work which resulted in this statement.  The summer Cricket season has kept Dr. Peirce occupied above and beyond his usual level of busyness.  During a gap between competitions, CJSM caught up with him — the results of our interview can be found here.

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1. CJSM: We want to discuss the new FSEM statement on the role of physical activity and sport in mental health, but first can you tell us a bit about yourself: your background as a sports medicine clinician and your involvement with FSEM?

NP: I have been involved in Sports and Exercise medicine for over 20 years having worked across a large number of Olympic and Professional sports, including Leading Sports Medicine for English Institute of Sport (EIS) at the busiest site in the country at Loughborough University, the Davis Cup team and the football team Nottingham Forest. I am a Hospital Consultant in Sport and Exercise Medicine in the NHS and have been Chief Medical Officer for the England Cricket for the more than 10 years. I have been involved in many of the Sports Societies and for 3 years have sat on the Faculty (FSEM), although professional sport commitments make this challenging.

2. CJSM: How did you become involved with this particular FSEM project on mental health – was there a large team involved in the production of this project? Was FSEM the only organization involved in the drafting of this document? Read more of this post

Five Questions with CASEM President Tatiana Jevremovic, M.D.

Tatiana Jevremovic, M.D. — current president of the Canadian Academy of Sport and Exercise Medicine (CASEM)

The Canadian Academey of Sport and Exercise Medicine (CASEM) hosts its annual symposium in Halifax, Nova Scotia, in just a couple of days:  from June 6 to 9 sports medicine clinicians from around Canada and the globe will be attending what looks to be another excellent conference which CASEM is hosting.

This past year Tatiana Jevremovic, M.D. has been serving as the CASEM president.  We thought it would be a good time to catch up with her before the clock runs out on her presidency at the end of this month.

In the midst of all her many, many commitments, she graciously found the time to do this interview.  We were delighted with the results, and we know you will be as well.

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1. CJSM: Where else to begin but by asking you about your year as President of the CASEM. You complete your term at the end of June, after the annual meeting which takes place in Halifax this year. What were your major challenges as president this year?  What were your high points?

TJ: There have been a few high points during my presidency year. We hired a communication advisor that has started elevating CASEM’s profile on social media through infographics and soon-to-be-completed new podcasts. We have met and introduced CASEM to the Public Health Agency of Canada as well as other organizations such as ParticipACTION, and are exploring future collaborations on projects of mutual interest such as concussion and health enhancing physical activity.. We continue to strengthen our professional relationships with friends and stakeholders such at Sport Information Resource Centre (SIRC), Canadian Medical Association (CMA), Royal College of Physicians and Surgeons of Canada (RCPSC), College of Family Physicians of Canada (CFPC), Canadian Concussion Collaborative affiliated organizations (CCC), and others.

It has been an extremely exciting year, and my biggest challenge has been accepting that this role is only for 1 year. I will miss it terribly, but am comforted in knowing that my successor, Dr. Paul Watson, will do a great job. I will also continue to promote the Academy and all of its success in my new role as past president.

2. CJSM: You currently work as an Associate Professor in the Dept. of Family Medicine at Western Ontario and at the Fowler Kennedy Sport Medicine Clinic in London, ON. Can you tell us a little about your background in sports medicine and what you do with your professional time when you are not attending to CASEM Presidential duties? Read more of this post

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