Recommendations For Participation In Sports Research Articles

Twenty-one sports activities are recommended by the European Knee Associates (EKA) six months after total knee arthroplasty.

To elaborate recommendations for sports participation following TKA among the members of the European Knee Associates (EKA). A prospective online survey was conducted among the members of the European Knee Associates (EKA). The European Knee Associates (EKA) are a section of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA). The survey investigated recommendations for 47 sports disciplines. Possible answers were: allowed, allowed if experienced, not allowed, no opinion. The survey was conducted separately for 4 specific time frames: within 6weeks after TKA; 6-12weeks after TKA; 3-6months after TKA; and more than 6months after TKA. Consensus among the respondents was then analyzed. EKA members (N = 120) participated in the survey. A high level of consensus was reached for a recommendation to allow 5 different sports in the first 6weeks after TKA, 7 sports 6-12weeks after surgery, 14 sports 3-6months after TKA, and 21 out of 47 activities 6months after surgery. In the first 6weeks after TKA walking, stair climbing, swimming, aqua fitness, and static cycling were recommended. Six to twelve weeks after TKA, cycling on level ground and yoga were recommended in addition to the aforementioned activities. Further sports activities recommended beyond 12weeks after TKA were: tennis doubles, golf, fitness/weight lifting, aerobics, hiking, Nordic walking and sailing. The sport for which the recommendation was "not allowed" following TKA was squash. The number of sports recommended by EKA surgeons increases stepwise over the postoperative time frames. The findings are regarded as clinically relevant as they may serve as a basis for answering patient questions on timing and giving recommendations for the resumption of sports activities following standard primary TKA and should be individualized by surgeons for their patients' expectations and goals. V.

A Review of Long QT Syndrome: Everything a Hospitalist Should Know.

In this article, we will review various aspects of long QT syndrome (LQTS) necessary for hospitalists who care for children, adolescents, and young adults who have known LQTS and also review presenting features that should make one consider LQTS as a cause of hospitalization. Pediatric hospitalists care for patients who have suffered near-drowning, unexplained motor vehicular accidents, brief resolved unexpected events, sudden infant death syndrome, recurrent miscarriages, syncope, or seizures. These common conditions can be clinical clues in patients harboring 1 of 16 LQTS genetic mutations. LQTS is commonly caused by a channelopathy that can cause sudden cardiac death. Over the years, guidelines on management and recommendations for sports participation have evolved with our understanding of the disease and the burden of arrhythmias manifested in the pediatric age group. This review will include the genetic causes of LQTS, clinical features, and important historical information to obtain when these presentations are encountered. We will review medical and surgical treatments available to patients with LQTS and long-term care recommendations and prognosis for those diagnosed with LQTS.

Athletes with channelopathy may be eligible to play.

The European and Bethesda recommendations roughly state that any athlete with channelopathy is not eligible to participate in sports on a presumed risk of potentially life-threatening ventricular tachycardia or fibrillation. However, eligibility decision-making on a presumed risk of ventricular tachycardia or fibrillation is debatable. Channelopathies are primary electrical cardiac disorders and are usually transmitted as an autosomal dominant trait. Some of the channelopathies are potentially fatal in relation to exercise and predispose to life-threatening cardiac arrhythmias including ventricular tachycardia or fibrillation. Exercise, swimming, body heating and electrolyte depletion can all act as a trigger of ventricular tachycardia or fibrillation in channelopathy. However, new research mentioned a very low incidence of ventricular tachycardia or fibrillation in athletes with channelopathy challenging the decision of disqualification. Recently, the American recommendations for sports participation in athletes with a cardiovascular disorder have updated their eligibility decision-making.In this manuscript we describe the signature features of the electrocardiogram changes in channelopathies and we argue that new research data should allow for the introduction of more liberal eligibility decision-making for sports participation in athletes with channelopathy, not only in the United States but also in European countries.

Sudden death due to aortic pathology.

Sudden death from aortic dissection of an ascending aortic aneurysm is an uncommon but important finding in all series of sudden death in young, apparently healthy athletes. Individuals at risk include those having any of a variety of conditions in which structural weakness of the ascending aorta predisposes to pathological dilation under prolonged periods of increased wall stress. These conditions include Marfan syndrome, Loeys-Dietz syndrome, bicuspid aortic valve, and the vascular form of Ehlers-Danlos syndrome. Diagnostic criteria, surveillance strategies, medical management, and surgical indications are discussed. Finally, the current recommendations for sports participation are provided.

Organized sports participation and the association with injury in paediatric patients with haemophilia.

With the wide availability of factor and the routine use of prophylaxis boys with haemophilia are now able to participate in regular physical activity, including organized sports. Current guidelines vary regarding specific recommendations for sports participation and concerns remain regarding safety. To determine if participation in organized sports is associated with an increased risk for injury in paediatric subjects with haemophilia. Retrospective single-centre cohort study from January 1, 2008 to December 31, 2010 in male subjects ages 10-18years with a factor VIII (FVIII) or FIX level <40%. The number of injuries per subject and participation in organized sports was recorded. 48 male subjects with a mean age of 14.3±2.6years (range: 10-18.8) were included; 64.6% (31/48) FVIII deficiency, 54.2% (26/48) severe haemophilia, 18.8% (9/48) moderate and 27.1% (13/48) mild. The majority [62.5% (30/48)] of subjects participated in at least one season of organized sport. There were 77 injuries in 36/48 (75%) subjects. The mean number of injuries per subject was 1.6±1.5. There was no statistical difference in the mean number of injuries (P=0.44) or target joint formation (P=0.52) between the subjects who participated in organized sports compared to those who did not. In this study, participation in organized sports by boys with haemophilia, ages 10-18years, is common and not associated with an increased number of injuries or the development of a target joint. As injuries occurred equally in both groups, concerted efforts should be directed at reducing injuries in all patients.

Sports cardiology - a general practice oriented update

As a sub-speciality, Sports Cardiology focuses on sport and physical training interacting with cardiac issues. Particularly, Sports Cardiology deals with the so-called "Sports Paradox", which implicates the fact the on one side regular physical training leads to a multitude of relevant health benefits. But on the other hand, exercise can also be a trigger for sudden cardiac death, particularly in case of an underlying cardiac disease. However, health benefits by regular training outweigh potential risks by far, but only if an adequate cardiac screening and individual recommendations for sports participation have been provided. This review highlights various aspects of Sports Cardiology like strategies to prevent sudden cardiac death in sports and training recommendations in patients with an underlying cardiovascular disease.

Sudden Cardiac Death in the Young

Sudden cardiac death (SCD) in children and adolescents is an uncommon event, yet it is devastating to families who lose a child so suddenly and unexpectedly. Sudden cardiac death in adults is primarily caused by coronary artery disease; however, SCD in the young is due to different etiologies. This article presents the following etiologies associated with SCD in the young: structural and functional abnormalities, primary electrical diseases also known as channelopathies, and a lesser-known cause, that is, commotio cordis. Prevention and treatment strategies to be discussed include noninvasive testing for risk stratification, screening for competitive athletes, genetic testing, implantable cardioverter defibrillators, automated external defibrillators, and patient advocacy. Nursing implications will include guidance for patient and family education, recommendations for sports participation, and forging partnerships with communities.

Recommendations for Clinical Assessment, Sports Participation, and Management in Hypertensive Athletes

Athleticism is often associated with optimal health; however, some athletes have high blood pressure (BP) despite being physically active. Using proper guidelines to determine a BP diagnosis is essential when working with both children and adults who are physically active because basal BP levels rise during physical activity. Once a physician has determined an athlete is hypertensive, a full clinical assessment may be required to identify possible etiologies for the condition and furthermore to establish appropriate BP management. Special recommendations for sport participation can follow. Sport participation is dependent on, but is not limited to, coexisting cardiovascular risk factors and associated clinical conditions, BP condition, and evidence of end-organ damage. This article reviews the available research literature on the diagnosis of hypertension, recommendations for clinical assessments, and special considerations of BP management and sport participation to ensure the safety of hypertensive patients/athletes.

Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions Part I: Supraventricular arrhythmias and pacemakers

This document by the Study Group on Sports Cardiology of the European Society of Cardiology extends on previous recommendations for sports participation for competitive athletes by also incorporating guidelines for those who want to perform recreational physical activity. For different supraventricular arrhythmias and arrhythmogenic conditions, a description of the relationship between the condition and physical activity is given, stressing how arrhythmias can be influenced by exertion or can be a reflection of the (patho)physiological cardiac adaptation to sports participation itself. The following topics are covered in this text: sinus bradycardia; atrioventricular nodal conduction disturbances; pacemakers; atrial premature beats; paroxysmal supraventricular tachycardia without pre-excitation; pre-excitation, asymptomatic or with associated arrhythmias (i.e. Wolff-Parkinson-White syndrome); atrial fibrillation; and atrial flutter. A related document discusses ventricular arrhythmias, channelopathies and implantable cardioverter defibrillators.

Nontraumatic Upper Cervical Spine Instability in Children

The upper cervical spine begins at the base of the occiput, continues caudally to the C2-C3 disk space, and includes the occipitoatlantal and atlantoaxial joints. Nontraumatic upper cervical spine instability can result from abnormal development of osseous or ligamentous structures or from gradually increasing ligamentous laxity associated with connective tissue disorders. Such instability can lead to compression of the spinal cord during movement of the cervical spine. Establishing a correct diagnosis includes performing a thorough physical examination as well as evaluating radiographic relationships and measurements. Appropriate management of syndromes associated with instability of the upper cervical spine includes preventive care and recommendations for sports participation. Surgical treatment for the upper cervical spine includes a posterior surgical approach, used for instability, and the use of rigid plate implants, wiring, and bone graft materials to achieve a solid spinal fusion.

Safety of Sports Participation in Patients with Implantable Cardioverter Defibrillators: A Survey of Heart Rhythm Society Members

Safety of Sports for ICD Patients. The safety of sports participation for patients with implantable cardioverter defibrillators (ICDs) is unknown, and recommendations among physicians may vary widely. The purposes of this study were to determine current practice among patients with ICDs and their physicians regarding sports participation, and to determine how many physicians have cared for patients who have sustained adverse events during sports participation. A survey was mailed to all 1,687 U.S. physician members of the Heart Rhythm Society. Among 614 respondent physicians, recommendations varied widely. Only 10% recommended avoidance of all sports more vigorous than golf. Seventy-six percent recommended avoidance of contact, and 45% recommend avoidance of competitive sports. Most (71%) based restrictions on patients' underlying heart disease. Regardless of recommendations, most physicians (71%) reported caring for patients who participated in sports, including many citing vigorous, competitive sports, most commonly cited were basketball, running, and skiing. ICD shocks during sports were common, cited by 40% of physicians. However, few adverse consequences were reported. One percent of physicians reported known injury to patient (all but 3 minor); 5%, injury to the ICD system, and <1%, failure of shocks to terminate arrhythmia. The most common adverse event reported was lead damage attributed to repetitive-motion activities, most commonly weightlifting and golf. Physician recommendations for sports participation for patients with ICDs varies widely. Many patients with ICDs do participate in vigorous and even competitive sports. While shocks were common, significant adverse events were rare.

Sports and Exercise for Children with Chronic Health Conditions

This guide for sports professionals brings together specific recommendations for participation in sports and exercise by children with chronic health conditions. The text discusses 20 common medical conditions affecting children's ability to participate in sport, with a brief description of each condition. The text is presented in two parts: the first part discusses how chronic disease can disturb the normal psychosocial and physical development of children, and how exercise can improve the underlying pathology and provide preventive health benefits. The book advises sports professionals about their legal responsibilites for placing children in sports and exercise programmes, as well as the possible adverse effects of physical activity. This section of the book also describes how to select appropriate activities, and provide preparatory guidance and training. The second part of the book addresses specific chronic disesaes, and includes a brief description of the pathphysiology, presentation, assessment, and natural history of each condition.