Prescribed Exercise for Managing Concussions — the CJSM Blog Journal Club

September 3, 2019 by

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).

________________________________________________________________________________

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

Filed under Concussion in Sport, Exercise Medicine, Journal Club, Physical activity interventions, Youth Sport

Medicine Through Movement — The CJSM Podcast with Dr. Jane Thornton

April 3, 2019 by 1 Comment

Jane Thornton, MD, PhD, of CASEM and the University of Western Ontario, Fowler Kennedy Sports Clinic. Twitter: @JaneSThornton

One of CJSM’s closest relationships is with our partner society the Canadian Academy of Sport and Exercise Medicine (CASEM).  After all, CASEM was the founding society for the ‘Canadian Journal of Sport Medicine’ (now the Clinical Journal of Sport Medicine).  We keep close tabs on what CASEM is doing because it’s sure to be of importance to both us and the world of SEM.

And so we’re excited to announce that just a few days from now — April 6 — CASEM will be hosting in Ottawa a special conference.  “Medicine Through Movement:  How Physical Activity is Changing Health Care.”

April 6 is, not coincidentally, World Physical Activity Day. The World Health Organization (WHO) named April 6 World Physical Activity Day in 2002 as part of in initiative to address the world-wide pandemic of physical activity.  We in primary care SEM are the troops on the ‘front lines’ waging battle against this pandemic.  We are always looking for effective tools to stem the tide.

One of the organizers of the Ottawa conference, and an expert in the field of ‘medicine through movement,’ is Dr. Jane Thornton, a clinician and researcher who most recently published in the pages of CJSM as the lead author of the CASEM position statement on the ‘physical activity prescription.‘  Always game to see research translated into practical action in the clinic and community, Dr. Thornton was a gracious guest on these blog pages three years ago.

We’re delighted to have her as CJSM’s guest again, and on this occasion she was able to sit down with us for a podcast conversation.  No small feat in her very busy life, I can assure you!

In preparation for the conference, or in its aftermath, take a listen to our conversation. Dr. Thornton weighs in on the highlights of the event, her research into the area of physical activity interventions, and tells us all about one of her heroes.  She also shares her thoughts on ‘movement hacks’ — interventions that work for patients, and can be integrated into the busy, time-challenged clinics in which, I am sure, we all work.

If you’re not able to get to Ottawa, have a listen and by all means follow Dr. Thornton and the hashtag #MTM2019 on Twitter for the breaking information from that conference.

And before we forget, make sure to highlight May 16 – 18 2019 and April 29 – May 2 2020 on your calendars; these are the dates of the 2019 CASEM (Vancouver) and 2020 CASEM (Banff, Alberta) annual symposia. You won’t want to miss these, perhaps especially the 2020 event, when CASEM celebrates its 50th anniversary!

In the meantime, what are you waiting for?  Take a listen on iTunes or on our journal webpage to Dr. Jane Thornton on the newest CJSM podcast!

Filed under CJSM Podcasts, General Interest, Medical Conferences, Patient Education, Physical activity interventions, Public Health in Sports and Exercise Medicine Tagged with , , , ,

May Day

May 1, 2016 by

Unisphere-cc

CJSM: bringing you clinical sports and exercise medicine research, from around the globe

Whether you are celebrating today as International Workers’ Day, running around a May pole, or watching Leicester City try to complete the 5000:1 shot of winning the Premiership, we are sure that today, May 1, can only be a good day:  our third issue of the year has just published.  And this May Day CJSM is full of offerings we’re sure will be of  interest to you.

Two of the articles have a special focus on physical activity as an intervention for medical conditions — one is a meta-analysis from Chinese colleagues finding a protective effect for physical activity against lung cancer, and the other is a prospective, single-blinded, randomized clinical trial looking at rock climbing as an intervention in the treatment of low back pain. This study is from Austria, and had positive findings for dependent measures of disability (the Oswestry Disability Index), a physical examination maneuver, and even the extent of disc protrusion on MRI.  We’re proud to publish these high quality studies from across the globe.

We are also proud to contribute to the growing body of literature on the effectiveness of “Exercise is Medicine.” Read more of this post

Filed under Evidence-based Medicine in SEM, Exercise Medicine, Female Athletes, Infectious disease in Sport, Physical activity interventions, Public Health in Sports and Exercise Medicine, Women in Sport, Youth Sport Tagged with ,

Osteoarthritis: Part I

October 1, 2013 by

I’ve been an Associate Editor for CJSM now for six months, and so some of you in the blog world may already know a little bit of my background as it has come out over time in my various posts.

For those of you who may be new readers of this blog, I thought for today’s post it was important for me to let you know that I work at Nationwide Children’s Hospital, the pediatric hospital affiliate of Ohio State University, and my specialty is pediatric sports medicine.

So……I don’t manage a lot of osteoarthritis (OA) in my current practice.

ocd of knee jpeg

Adult OCD of the knee,
unstable lesion: destined for osteoarthritis?

However, I didn’t narrow my clinical scope of practice to the younger crowd until 2010, and I have managed my fair share of OA in my career, injecting plenty of knees with hyaluronic acid derivatives, encouraging weight management and low impact exercise…….Now, I suppose I’m more on the end of the spectrum of primary prevention of the disease: if I manage my young patients’ knee osteochondritis dissecans properly, perhaps I can spare them from degenerative joint disease later in life.

I’m not telling anyone reading this something they don’t know already when I write that career paths are varied in modern medicine.  There’ s no telling if I’ll be taking care of kids exclusively in 10 years.  We all have mandates from Certification Boards requiring us to stay abreast of the current medical literature; we’re tested on it every few years now, as Maintenance of Certification is a phenomenon here to stay.  Forces like these make it incumbent that I read and ‘stay on top of’ developments in the world of OA diagnosis and management, even if I am not seeing much of this disease in my current practice.

After all, OA is the leading cause of chronic disability among older adults in the United States.  That’s a disease worth knowing about.

I thought, therefore, that I would share with you a couple of interesting studies that have come out recently on major issues in the world of osteoarthritis.  Both studies were just published within the last month:  the first, “Shared Decision Making in Patients with Osteoarthritis of the Hip and Knee,”  published in the Journal of Bone and Joint Surgery (JBJS), I will discuss in my next blog post.  And the second, “Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults with Knee Osteoarthritis,” published in the Journal of the American Medical Association (JAMA), I will review now.   They are both large, high quality evidence (Level 1) studies which focus on low tech, low cost interventions that have the potential of having major clinical impact.  They are both studies primary care sports/MSK clinicians like myself might be expected to be aware of. Read more of this post

Filed under Basic Sciences in SEM, Evidence-based Medicine in SEM, General Interest, Patient Education, Patient Outcome Measures, Physical activity interventions, Public Health in Sports and Exercise Medicine Tagged with

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