CJSM Blog Journal Club — is Low-intensity Pulsed Ultrasound an Effective Treatment in Spondylolysis?

Spondylolysis in the adolescent athlete — what to do?

Symptomatic isthmic spondylolysis in the adolescent athlete — for many of us in the world of primary care sports medicine who have a large pediatric/adolescent patient base, this is one of the more common clinical entities we treat.

I’ve written previously about some of the controversies surrounding this condition, and I have had the pleasure of seeing some of the spondylolysis research I’ve conducted published in the pages of CJSM.

Recently published “On Line first” in CJSM is research coming from a Japanese center renowned for its work in this area:  Low-intensity Pulsed Ultrasound (LIPUS)for Early-stage Lumbar Spondylolysis in Young Athletes.

I’m delighted to introduce again our Junior Associate Editor, Jason Zaremski, M.D., who is pioneering our on-line CJSM journal club.  He’ll take us through this new study and help us decide:  LIPUS — should we be using it in our clinical practice when treating an adolescent-athlete with early-stage, or ‘acute,’ isthmic spondylolysis?

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Clinical Journal of Sports Medicine

Online Journal Club

Jason Zaremski, M.D.

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Title: Tsukada M, Takiuchi T, and Watanabe K. Low-Intensity Pulsed Ultrasound for Early-Stage Lumbar Spondylolysis in Young Athletes. Clin J Sport Med. Published Ahead of Print October 10, 2017. doi: 10.1097/JSM.0000000000000531.

Introduction:

The spring Journal Club commentary for the Clinical Journal of Sports Medicine will be a review of new research examining the effects of pulsed ultrasound for early-stage lumbar spondylolysis in young athletes. This is a retrospective case control therapeutic study with level three evidence. The specific aims of the study were 1) to determine differences in median time to return to previous sports activity with and without the use of low intensity pulses ultrasound (LIPUS); and 2) to determine if healing rates are improved with LIPUS. Read more of this post

CJSM Blog Journal Club — is rESWT an effective therapy for chronic, distal biceps tendinopathy?

I’m pleased to welcome Jason Zaremski MD, one of our junior associate editors, who has contributed our first on-line journal club article.

Dr. Zaremski is a primary care sports medicine specialist who is board certified in Physical Medicine and Rehabilitation. He is an assistant professor at the University of Florida in the Department of Orthopaedics and Rehabilitation.

Dr. Zaremski is also a member of one of our affiliated societies, the American Medical Society for Sports Medicine, and was appointed last year as the AMSSM junior associate editor.  He’s been busy behind the scenes on many CJSM initiatives already; this is his first foray onto the blog, and we’ve been looking forward to his contribution.  Enjoy!

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Clinical Journal of Sports Medicine

Online Journal Club

Jason L Zaremski

Title: Furia JP, et al. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. Clin J Sport Med 2017;27:430–437.

Introduction:

This is the first online Journal Club Commentary for the Clinical Journal of Sports Medicine’s new initiative for its Online Journal Club. Furia and colleagues sought to determine the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) for chronic distal biceps tendinopathy (cDBT). This is a retrospective case control study with level three evidence. The specific aim of the study is to determine whether rESWT is safe and effective for the management of cDBT.

Methods:

This is a retrospective case control study Read more of this post

Concussions take time — CJSM Blog Post Journal Club

Our Jr. Assoc. Editor Jason Zaremski MD looking for some help from a friend with the newest CJSM Blog Post Journal Club

Our March 2020 issue has just published, and right out of the gate one of the studies that has received the most buzz is one from a team of researchers in New Zealand demonstrating that less than 50% of concussed individuals recover within two weeks of a sports-related concussion.

Jason Zaremski, MD, CJSM’s Jr. Assoc. Editor, explores this new study today in our most recent CJSM Blog post Journal Club.  It is a two year prospective study with some revealing findings. We’re sure you will enjoy the blog post and the study itself!

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Jason Zaremski MD

Kara S, et al. Less Than Half of Patients Recover Within 2 Weeks of Injury After a Sports-Related Mild Traumatic Brain Injury: A 2-Year Prospective Study. Clin J Sport Med 2020;30:96–101. doi.org/10.1097/JSM.0000000000000811.

Introduction:  Sports related concussion (SRC) is a common and significant concern, challenging not only sports medicine practitioners, but also athletes, coaches, family members, and all sports performance team members. While diagnostic skills and research in this area have dramatically improved in the past 10 years, our patients still have several questions, including: How long until I can go back and play? Some data has suggested the majority of SRC patients recover in approximately a 2-4 week recovery time frame. According to the consensus statement in concussion in sport (5th iteration) held in Berlin, Germany, in October 2016—“the expected duration of symptoms in children with SRC is up to 4 weeks.” (McCrory, et al. BJSM 2017).  Kara and colleagues  have looked into the validity of this stated time frame.

Purpose: To describe clinical recovery time and factors that could impact recovery after a sports-related mild traumatic brain injury (SR-mTBI, aka “concussion”).

Methods/Design:  This is a prospective cohort study with level IV evidence. Read more of this post

Treatments for Achilles Tendinopathy — CJSM Blog Post Journal Club

We’re celebrating our 30th Anniversary!!! Take a look what’s beneath the new, sleek cover.

We are celebrating our 30th year of publication in 2020 and we could not be happier to ring this new year in than with the publication of our January 2020 issue, full of the sorts of offerings that make CJSM a special part of the sports medicine universe. From original research to systematic reviews to case reports, we have several new offerings that help clinicians bring the latest in evidence-based medicine to their patients on the pitch, in the training rooms, and in the clinics.

One of those studies reports research results reported by authors practicing in the UK and deals with a very common problem among athletes: Novel Inerventions for Recalcitrant Achilles Tendinopathy.

Dr. Zaremski & assistant take a break from their writing.

This prospective cohort study is the focus of our first blog post journal club of the year, with CJSM Associate Editor Jason Zaremski M.D. guiding us through the ins and outs of the study.  Take it away Dr. Zaremski!

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Introduction:  As we begin a new decade and say goodbye to 2019, the winter CJSM journal club will be focusing on an issue that is extremely common in all individuals, chronic Achilles tendon injury. As many individuals make New Year’s resolutions to exercise more and live healthier lifestyles, we as sports medicine and musculoskeletal experts must be prepared for an increase in overuse injuries such as tendinopathies.  These conditions can be difficult to treat, and new, novel approaches to these common conditions are always of interest. A new study by Wheeler and Tattersall is a timely publication to review in this new year: Novel Interventions for Recalcitrant Achilles Tendinopathy. Benefits Seen Following High-Volume Image-Guided Injection or Extracorporeal Shockwave Therapy—A Prospective Cohort Study.

Purpose: The authors of this study set out to compare the outcomes for patients with chronic non-insertional Achilles tendinopathy (CNIAT) following extracorporeal shockwave therapy (ESWT) versus high-volume image-guided injection (HVIGI). The results may provide practitioners greater information for patients and to improve patient care. Read more of this post

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