The CJSM Blog Post Journal Club — Neuromuscular Training and ACL Reconstructions

Needs surgical reconstructions, and NMT

The March 2021 issue has just published, and I invite you to review all of its contents.  These include original research, including the journal club selection for the month, as well as the abstracts for the upcoming 2021 American Medical Society for Sports Medicine meeting.

CJSM Jr. Assoc. Editor Dr. J Zaremski

And now, the newest in his series of CJSM journal clubs:  Jason L Zaremski, MD presents:

Christopher V. Nagelli, et al. Neuromuscular Training Improves Biomechanical Deficits at the Knee in Anterior Cruciate Ligament–Reconstructed Athletes. (Clin J Sport Med 2021;31:113 119). 

Introduction:  As we enter the spring sports season in the United States, CJSM continues to be amazed by the dedication of our athletes as well as sports medicine professionals throughout the world in preparing and competing in sport during challenging circumstances. Only a year ago the WHO declared SARS-CoV-2 had become a global pandemic.  The world entered a new era, one affecting the entire sports medicine community. That community is broad, and includes athletic trainers, physical and occupational therapists, physiotherapists, sports performance experts, strength and conditioning specialists, and physicians. Everywhere sports have resumed, it has truly ‘taken a village,’ a collection of such individuals, to get sports up and running safely.

With sport seasons pausing and re-starting to varying degrees over the past 13 months as a result of the COVID-19 Pandemic, it is of the utmost importance that we support our injured and rehabilitating athletes to an even greater extent in order to provide opportunities to return from injury without further set-backs.  With those thoughts in mind, the CJSM Journal Club will be reviewing the Nagelli et al manuscript just published in the March 2021 edition.  This study focuses on neuromuscular training and biomechanical deficits in athletes that have sustained ACL reconstructions (ACLR) versus those that have not.

Purpose/Specific Aims: The authors have 2 specific aims:

  • Quantify the effect of a Neuromuscular Training (NMT) program on knee biomechanics in a cohort of ACLR athletes.
  • compare post-training knee biomechanics between ACLR athletes and a control group.

Read more of this post

CJSM Journal Club — Nondisclosure of concussion symptoms by athletes

Jason Zaremski MD, au courant with medical clothing styles circa 2020. Go Gators!

Our May 2020 issue has recently published, and as ever our Jr. Assoc. Editor Dr. Jason Zaremski is ready to share his pick for the newest CJSM Blog Journal Club.

Concussion Symptom Underreporting Among Incoming National Collegiate Athletic Association Division I College Athletes is the subject for today’s blog post.

Dr. Zaremski is himself a physician at The University of Florida, well known for its Division 1 College Athletic program, the Florida Gators. Whether we treat collegiate athletes, pros, or children, we in sports medicine ALL have an interest in addressing the issue of concussion nondisclosure.

Thanks to the authors for this timely study, and thanks to Dr. Zaremski for your ongoing contributions in this journal club.

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Jason Zaremski, MD

Introduction:  As we enter the early stages of the summer and approach a “new normal” with regards to sports, it is incumbent upon sports medicine team physicians to be vigilant as we bring freshman athletes to college campuses with potentially different methods to screen and perform pre-participation physical examinations. While dealing with the new challenges COVID will pose, including the possibility of conducting assessments remotely, clinicians will need, as always, to obtain accurate historical information in order to care for our student-athletes. With that in mind, we present the May 2020 Journal Club on Concussion Symptom Underreporting Among Incoming National Collegiate Athletic Association Division I College Athletes by Dr Fiona Conway and colleagues.

Purpose: To examine concussion knowledge and the relationship of knowledge to reasons for concussion symptom nondisclosure in NCAA Division one incoming athletes. Read more of this post

What to do about heading?

Heading the ball — photo courtesy of Wikimedia

I have been meaning to write a blog post for over a week, since a bit of breaking sports medicine news occurred with the publication of some research in the New England Journal of Medicine (NEJM).

It took a Tweet this morning to rouse me to action.  I promise it hasn’t been sloth on my part that has slowed my hand, but pleading “I’m busy” to the group of folks who usually will be reading CJSM media is not going to gain much sympathy.

And yes, with fall sports, I sure have been busy.  But I am sure you have too.

I hope, however, not too busy to have missed this piece of research from NEJM: “Neurodegenerative Disease Mortality Among Former Professional Soccer Players.”  There was an accompanying editorial to this study, a piece that is most definitely worth a read too. “Soccer and Mortality — Good News and Bad News”

The published research was a large retrospective cohort study looking at former professional Scottish football (soccer) players: 7676 cases were identified from databases of Scottish football players and 23,028 controls (3:1) from the ‘general population’ were identified using a Scottish ‘Community Health Index.’ Controls were matched to players on the basis of sex, age, and degree of social deprivation.  Of note, all the participants in this study were male.The researchers looked at two dependent outcome variables:  i) cause of death as noted on death certificates and ii) dispensed medications, information for which was obtained from the Scottish national Prescribing Information System.  Follow up information for study participants was for a median of 18 years (for each individual, “Age was used as the time covariate, with follow-up from age 40 years to the date of data censoring, which was either the date of death or the end of the follow up (December 31, 2016), whichever occurred first).”

The researchers report several important findings in this study, to note just a few:

Read more of this post

CJSM Blog Journal Club — NMT to prevent ankle sprains in youth soccer and basketball athletes

Our Jr. Assoc Editor Dr Zaremski — already awarded an AMSSM Travelling Fellowship. Is there something bigger in his future?

It’s July, and our fourth edition of 2018 has just published.  One of the headlining pieces of original research we have in this edition is new work from the Sport Injury Prevention Centre in Calgary, Alberta Canada (chaired by Caroline Emery, the well-known researcher and author): Prevention of Ankle Sprain Injuries in Youth Soccer Cland Basketball: Effectiveness of a Neuromuscular Training Program

Our Jr. Assoc. Editor Jason L Zaremski, MD  is today reprising his role as guest author for the CJSM blog journal club  and will take us through his read of the study.  Join in the conversation over this important new, original research by reading the article, the journal club post below, and sharing your thoughts in the ‘reply’ section below this post, or on Twitter at @cjsmonline 

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Clinical Journal of Sport Medicine Blog Journal Club

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Title: Owoeye OBA, Palacios-Derflingher LM, Emery CA. Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors.

Introduction:  The summer Journal Club commentary for the Clinical Journal of Sports Medicine will be an analysis of the new research examining the effects of injury reduction of ankle sprains in soccer and basketball using neuromuscular training (NMT) program in youth athletes. The secondary objective of this study included the evaluation of risk factors for Ankle Sprain Injury (ASI).

Methods:  This study was a secondary data analysis from 3 cohort studies and 2 randomized control trials (RCTs) over the course of 1 season of player in soccer and basketball from 2005-2011. There were a total of 2265 patients aged 11-18 years that play soccer and basketball in Alberta, Canada. Player characteristics (sex, age, weight, height, BMI, sport exposure time, previous ASI, previous lower extremity injury with and without ASI) were divided based upon if a player participated in a NMT program or did not. Frequency between all variables was very similar except for No NMT between females (n=952) and males (n=439) and sport participation without exposure to NMT (soccer = 965, basketball = 426). Average age, weight, height, and BMI were all similar. Exposure time for the NMT group was 72.56 (70.98-74.15) hours versus 62.92 (61.48-64.37) hours for No NMT group.

Secondary Data Analysis Studies: Read more of this post

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