CJSM May 2021 Journal Club — Blood Biomarkers in Pediatric Concussions

May 3, 2021 by

The May 2021 CJSM issue has just published, and as always it is full of articles you will want to read.

As I gaze at the table of contents, a non-random sampling of eye catching articles includes

CJSM Junior Associate Editor Jason Zaremski, MD breaks it all down for us.

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Clinical Journal of Sports Medicine

Online Journal Club May 2021

CJSM Junior Associate Editor Jason Zaremski, MD

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Anzalone AJ, et al. Blood Biomarkers of Sports-Related Concussion in Pediatric Athletes.

Introduction:  There has been a substantial amount of interest in the diagnosis, evaluation, and management sports related concussions (SRC) in the past decade. An emerging area of interest has been the study of biomarkers as a more objective measure of head trauma. Two blood biomarkers — Neurofilament light polypeptide (Nf-L), primarily found in axons, and Tau, a microtubule-associated protein necessary for axonal transport — have been studied at advanced level of sport (collegiate, professional, and Olympic athletes).

The authors of this new study evaluated these blood biomarkers in pediatric athletes.  The main outcome measures they looked at were correlations between self-reported symptom measures biomarker concentration levels.

Purpose/Specific Aims: The authors examined patterns of blood biomarker concentrations (tau and Nf-L) in pediatric athletes seen in clinic in the days following a SRC and at a six-month follow up.  A comparator group of non-injured controls were assessed as well.  Correlations between biomarker concentrations and self-reported symptom scores were assessed. Read more of this post

Filed under Concussion in Sport, General Interest, Journal Club, Youth Sport

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

March 9, 2021 by

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

Filed under General Interest, Injury Prevention, Journal Club

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

November 16, 2020 by 1 Comment

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

Filed under Female Athletes, General Interest, Journal Club

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

September 8, 2020 by

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

Filed under Concussion in Sport, Exercise Medicine, Journal Club Tagged with

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