Sports Medicine Research Articles

A Reliability Study of the Load Distribution Percentage While Walking Using Curalgia Feet Sx Smart Insoles.

Background Gait analysis has evolved through many years of research. Many methods are used to analyze the gait of a subject. Recent times have showna high demand for wearable sensor-based insoles integrated with smartphone-based devices used for gait analysis due to ease of use. This study utilized Curalgia Feet Sx Smart Insoles and its software toolset, Gait Analysis+, designed and manufactured in India making it an accessible and cost-effective option. The Curalgia Feet Sx Smart Insoles allow for a broad range of biofeedback-based rehabilitation and recovery training for several patients and have many applications, such as sports performance enhancement and neurological disorder rehab (e.g., brain stroke rehab). The system also significantly delays the onset of neurodegenerative illnesses by providing balance and proprioceptive training. The smart insole can help the athlete, the coach, and the sports medicine team get the on-field data in real-time, which will help them understand if any technical or biomechanical alterations are required. This may help in performance enhancement. This study aimed to determine the interrater reliability of the load distribution percentage parameter of the Curalgia Feet Sx Smart Insole for both feet while walking in a controlled setting. Methodology A total of 120 subjects were enrolled in the study. In total, 90 subjects were randomly selected using Research Randomizer which included male and female students and staff at Sardar Bhagwan Singh University. The subjects were asked to come to the research lab of the physiotherapy department wearing their sports shoes. Curalgia Feet Sx insoles were inserted into the shoe firmly to fit properly. Two assessors took two readings after the smart insole was connected to the smartphone-based application, GaitAnalysis+, via Bluetooth. The dynamic analysis option was selected, and each subject's analysis was done one after another with a desirable break in between. Each subject walked for three minutes at their normal speed after pressing "Start Analysis." At the three-minute mark, the subjects were asked to press "Stop Analysis" and the investigator downloaded the report on the smartphone. The data collected was compiled as the cumulative weight in kg (load distribution) borne and the % weight (load distribution %) borneby each foot for the duration of the walk. Statistical analysis was done using Karl Pearson's test and interclass correlation calculation. Results Assessor 1 and Assessor 2 collected readings for the left foot as "L" and the right foot as "R." Assessor 1 readings were L1-R1 for load distribution and L1% and R1% for load distribution %. Assessor 2 readings were L2-R2 for load distribution and L2% and R2% for load distribution %. The r value (correlation coefficient) was calculated using the load distribution. The mean value of L1 was 337.46 (SD=94.16). The mean L2 was 313.6 (SD=104.40). The R1 mean was 229.03 (SD=112.88), and the R2 mean was 233.011 (SD=79.84). The r was 0.7171 for the left foot and 0.7502 for the right foot, suggesting an excellent correlation. The ICC was calculated for load distribution %. The means of L1% was 55.94, L2% was 57.59, R1% was 44.06, and R2% was 42.41. The ICC was found to be 0.91 for both feet, suggesting high interrater reliability for the tested parameter. Conclusions The findings confirmed that the Curalgia Feet Sx Smart Insoles presented good interrater reliability for the load distribution % parameter.

The Development Dilemmas, Causes, and Countermeasures of China's Sports Rehabilitation Training Industry

In recent years, with people's increasing emphasis on health, the demand for China's sports rehabilitation training industry has been continuously increasing. In this context, it can provide more development momentum for the sports rehabilitation training industry, which is conducive to the continuous improvement of related medical technology, promote the continuous development of sports medicine integration, and better serve the general public. But in the continuous development of the sports rehabilitation training industry, many difficulties have also been encountered. This study mainly used literature research and logical analysis methods, combined with the current development trend and professional development of the sports rehabilitation training industry, to analyze market demand, professional talent cultivation, and the development of laws and regulations, and propose a series of improvement measures, which can be more accurate for the future development direction of the sports rehabilitation training industry. From a social point of view, it is necessary to strengthen the health awareness of some people and improve the training and professionalism of professional talents. For the government, it is to strengthen support for the sports rehabilitation training industry and strive to cultivate more compound sports rehabilitation talents, which can lay a solid foundation for the better development of the sports rehabilitation training industry.

Extraction of the Jugular Venous Pulse and carotid profile using a cervical contact plethysmography system

The Jugular Venous Pulse (JVP) is considered a reliable parameter for the assessment of Central Venous Pressure (CVP). Here, the functionality of a cervical contact plethysmography system designed for non-invasive and operator-independent acquisition of the JVP signal, is shown. To validate the signal, it was recorded in supine and sitting positions, together with the reference Electrocardiography (ECG), on 26 healthy subjects. In the supine acquired signal, the characteristic JVP waves (a, c, v) and the negative deflections (x, y) are well recognizable. In the sitting recorded signal, the systolic peak b and the d incisura of the Common Carotid Artery (CCA) waveform are recognized. For each signal, we calculated the Fraction of the Cardiac Cycle (ccf) represented by the time intervals between the JVP peaks and the ECG peaks, in the form: ΔtaP, ΔtcR, ΔtxP, ΔtvT, Δtyv, Δtvx, and Δtxa. The same was done for the CCA waveform, in the form: ΔtbS, ΔtbT, Δtdb, ΔtdS, and ΔtdT. This system could mitigate risks and costs associated with central venous catheterization and its potential extends to applications in telemedicine, sports medicine, and space medicine.

The effect of post-traumatic chondropathy on the functional state of knee joints in athletes during the basketball game.

The relevance of the study is conditioned upon the widespread occurrence of knee injuries in athletes when playing basketball, in particular, damage to the cartilage system of the knee joint. Such a feature of injury causes the fact that basketball players may develop post-traumatic chondropathy with a subsequent change in the functional state of knee joints, which is inextricably linked with a decrease in the quality of life, the occurrence of pain syndrome, shortening of career duration, an increased risk of surgical interventions, and possible disability in the long-term perspective. This paper is aimed at uncovering modern ideas about the impact of post-traumatic chondropathy on the functional state of knee joints in athletes during basketball games. The method for this paper was the search for relevant studies concerning the formulated problem, the collection of information and drawing conclusions. Given the character of the basketball game, knee injuries, both acute and chronic, are widespread among athletes of this sport, including cartilaginous defects of the knee joint, which often occur in athletes. The materials of the paper are of practical value for sports medicine doctors, physiotherapists, traumatologists since it presents the main mechanisms of knee injuries in athletes when playing basketball and the possible consequences of these injuries in the long term.

A Bibliometric Analysis Study on Sport Sciences: Trends and Recommendation for Athletes’ Performance

Background: Sports science is responsible for locating, approving, developing, and perfecting various strategies to improve athletic performance. New methods for assessing an athlete’s technical and physical prowess are being created daily, and fresh training concepts are evolving impressively swiftly. If coaches had access to the most up-to-date techniques and knowledge to create the most effective training plans, athletes would gain significantly. This study aims to find patterns and make recommendations to stakeholders to enhance athlete performance. Method: A literature review of documents was conducted from 2018 to 2022, specifically focusing on “sports science” in 2023. 408 English-language documents in the area of medicine were identified using the Scopus database. Scopus search analysis and VOSviewer software were employed to analyze the bibliometric data. Result: The top three keywords’ trends found in this study were health (1.41%), physical (1.15%), and sports (0.89%). The top results revealed a positive correlation between overall sports sciences scores on physical and activity (Pearson correlation score ± 0.74 - 0.73, P0.50). Sports injury, types of sport, physical, epidemiology, basic science study, and physiotherapy are the six clusters our study on sports sciences has discovered. The trends analyzed in this study were sports sciences, sports performance, and sports injury. This study recommends enhancing the physical training performance of athletes for the sports they are playing. Conclusion: A sports science approach to evidence-based practice could effectively prevent athlete injuries and physiotherapy management. The coaches should be concerned about the health and safety of their athletes. The practice of sports medicine can improve sports science and athlete performance.

Scores and sores: Exploring patient-reported outcomes for knee evaluation in orthopaedics, sports medicine and rehabilitation.

Recognizing and addressing the controversies surrounding using patient-reported outcome measures (PROMs) is crucial for enhancing evaluation standards in clinical studies in orthopedics, sports medicine, and rehabilitation. The article comprehensively described the challenges of using PROMs to evaluate knee conditions in these fields. Apart from defining and characterizing patient-reported outcomes and their measures, the article discussed controversies around them, such as using them as primary outcomes. It highlighted the importance of standardizing and validating PROMs. Several initiatives taken to improve the selection of appropriate outcomes for clinical research purposes were described. Additionally, the potential of technology, mainly digital health tools and mobile applications, was mentioned in the context of enhancing the collection and analysis of PROMs. The article also raised the issue of the readability of PROMs, defined as the ease with which they can be read and understood by patients. The article concluded that adopting a complementary approach to treatment evaluation by integrating subjective and objective measures is imperative for accurately assessing efficacy. This comprehensive approach provides a more holistic understanding of patient outcomes, forms the foundation for evidence-based medicine, and informs future healthcare policies. Proactive measures are urgently needed to address concerns and improve the reliability and validity of PROMs for clinical practice and research. LEVEL OF EVIDENCE: level V.

Return to Play in High-level Athletes after SARS-CoV-2 Infection

In sports medicine, the recovery process for injuries to the musculoskeletal system has been well established, including the recovery time until the athlete can compete again to prevent relapses. These decisions support the sports physician in acting with greater confidence. However, there are no clear criteria and protocols for other systemic diseases. In the following study, we report our experience and suggest an action protocol for a professional basketball team.

Female Tendons are from Venus and Male Tendons are from Mars, But Does it Matter for Tendon Health?

Tendons play fundamental roles in the execution of human movement and therefore understanding tendon function, health and disease is important for everyday living and sports performance. The acute mechanical behavioural and physiological responses to short-term loading of tendons, as well as more chronic morphological and mechanical adaptations to longer term loading, differ between sexes. This has led some researchers to speculate that there may be a sex-specific injury risk in tendons. However, the link between anatomical, physiological and biomechanical sex-specific differences in tendons and their contributory role in the development of tendon disease injuries has not been critically evaluated. This review outlines the evidence surrounding the sex-specific physiological and biomechanical responses and adaptations to loading and discusses how this evidence compares to clinical evidence on tendon injuries and rehabilitation in the Achilles and patellar tendons in humans. Using the evidence available in both sports science and medicine, this may provide a more holistic understanding to improve our ability to enhance human tendon health and performance in both sexes.

The association between physical activity levels and quality of life among patients with chronic kidney Disease receiving hemodialysis treatment

Patients with chronic kidney disease (CKD) undergoing hemodialysis face significant challenges in engaging in physical activity. Yet, the ability to perform daily activities is essential for improving quality of life. This study aimed to assess the relationship between quality of life and physical activity levels among CKD patients on hemodialysis. This cross-sectional study was conducted on 85 CKD patients receiving hemodialysis treatment. Quality of life was assessed using the Kidney Disease Quality of Life (KD-QoL), while physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The statistical descriptive, followed by the assessment of association using the Spearman Correlation, was then conducted. The study found that a higher proportion of CKD patients were men, married, unemployed and with comorbidities. The physical activity was mostly conducted in ‘home-based/domestic’ domains. Low KDQoL scores were observed in areas involving ‘work’, ‘emotional’, and ‘physical health’. Occupational activity correlated with symptoms, social interaction, support, and staff encouragement (r=0.414-0.871). Domestic activity strongly correlated with ‘kidney disease effects’, ‘work status’, sleep, ‘physical functioning’, pain, ‘general health’, emotional well-being, and SF-12 scores (r=0.674-0.917). Leisure activity correlated with ‘cognitive and sexual function’, ‘general health’, and ‘emotional well-being’ (r=0.669-0.930). Transport activity correlated with symptoms, ‘kidney disease effects’, ‘cognitive and sexual function’, sleep, pain, and ‘social function; (r=0.302-0.999). Total physical activity was also associated with various quality-of-life components (r=0.611-0.985). These findings suggest the importance of supportive environments to improve physical activity and the quality of life of CKD patients on hemodialysis. Keywords: chronic kidney disease, hemodialysis, physical activity, sports medicine, quality of life

Astaxanthin Supplementation Does Not Alter Training-Related Changes in Inflammatory Cytokine Profile in Arabian Racing Horses.

This study aimed to evaluate the oral supplementation of astaxanthin (ATX) on inflammatory markers in 3-year-old Arabian racehorses. Despite the recognized antioxidant and anti-inflammatory properties of ATX observed in vitro in rodent models and in human athletes, the effects in equine subjects remain unknown. This study involved a controlled trial with 14 horses receiving either ATX (six horses) or a placebo (eight horses), monitored over four months of race training. Inflammatory cytokines: TNFα, IFNγ, IL-6, IL-10, and prostaglandin E (PGE), were measured monthly to assess the impact of ATX on the inflammatory response. The results indicated no significant differences in measured parameters between the ATX and the control group during the study. However, a significant time-dependent decrease in TNFα and IFNγ levels (p = 0.001) was observed in both groups, suggesting that regular training naturally modulates inflammatory responses. Moreover, positive correlations were noted between TNFα and IFNγ (p < 0.001) in the early phase of the study and between IL-6 and IL-10 (p = 0.008) in the later phase. Hematological parameters remained stable and within reference ranges, indicating no adverse effects of ATX supplementation. Performance metrics, including the number of races completed and wins, showed no significant differences between groups, suggesting that ATX did not enhance athletic performance under the study conditions. Overall, while ATX supplementation affected neither cytokine levels nor performance in Arabian racehorses, the natural anti-inflammatory effects of regular training were evident. Further research is needed to explore potential benefits of ATX supplementation under different conditions, such as in horses with subclinical inflammation or varying training regimens, to fully clarify its role and applications in equine sports medicine.

Sex Diversity and Equity Among Fellows of the American Orthopaedic Association.

We hypothesized that women are underrepresented among fellows of the American Orthopaedic Association (AOA) relative to their prevalence among faculty at departments of orthopaedic surgery. Clinical faculty at departments of orthopaedic surgery that are affiliated with residency training programs were analyzed for AOA membership. Participation-to-prevalence ratios (PPRs) were calculated for men and women with AOA membership relative to their prevalence among orthopaedic surgeon faculty. A PPR of <0.8 or >1.2 indicated under- or overrepresentation, respectively. PPR values between 0.8 and 1.2 indicated equivalent representation. Sex disparities in AOA membership were explored by academic rank and orthopaedic subspecialty. There were 4,310 orthopaedic surgery faculty, and 998 (23.2%) had AOA membership. Overall, women formed the minority of members in the AOA study cohort (11.4%), but they had equivalent representation relative to their prevalence among faculty (10.0%, PPR = 1.14, p = 0.210). In the AOA study cohort, women were the minority at each academic rank, including assistant professor (20.2% versus 79.8%, p < 0.001), associate professor (16.8% versus 83.2%, p < 0.001), and full professor (7.0% versus 93.0%, p < 0.001). However, women had greater representation in the AOA study cohort at each academic rank than would be expected based on their prevalence among faculty, including the assistant (PPR = 1.45), associate (PPR = 1.56), and full (PPR = 1.27) professor levels. Similarly, in the AOA study cohort, women were the minority in each orthopaedic subspecialty, but were only underrepresented in pediatric orthopaedics (PPR = 0.74). Women had greater representation in the AOA study cohort than would be expected by their prevalence among faculty in hand surgery (PPR = 1.51) and orthopaedic sports medicine (PPR = 1.33). In contrast, men had equivalent representation in each orthopaedic subspecialty. Women form a minority group in the AOA, but they exhibit greater representation in the AOA than would be expected based on their prevalence among faculty at each academic rank, and they have greater representation than men, who exhibit equivalent representation across all academic ranks. Collectively, these results disproved our hypothesis, and suggest that women are participating in the AOA at rates that are greater than their prevalence among faculty. Equitable participation of women in orthopaedic surgery is necessary to promote diversity and inclusion in the specialty. The AOA may be an important catalyst for future positive diversity and inclusion efforts within orthopaedic surgery.

Medical advisability of softball youth pitching recommendations on the internet

ABSTRACT Objective Developing softball pitchers are prone to injury due to the repetitive throwing motion. Many children and parents use the internet as a source of medical advice, but this information may not always be aligned with medical guidelines. The purpose of this study was to assess the medical advisability of injury prevention guidelines for developing softball pitchers on websites using Google as the primary search engine. Methods The first 100 websites populated from a Google search using the term softball youth pitching recommendations were evaluated. Each website was categorized as discussing baseball, softball, or both, and as athletic, commercial, or educational. For every website, 16 recommendations described by the American Orthopaedic Society for Sports Medicine (AOSSM) Stop Sports Injuries softball injury prevention guidelines (Table 1) were scored as in agreement (+1), different guideline mentioned (0.5), no mention (0), or discordant (−1). Table 1. Websites with guidelines identical to AOSSM by type of website, by sport, and by order of appearance in google search, AOSSM = American orthopaedic society for sports medicine. ‘*’ indicates p value < 0.05. Results Of the 98 qualifying websites, 57 advised only about softball, while 19 advised about both baseball and softball. Fifty websites had no mention of any recommendation outlined by AOSSM. Websites that were mostly in agreement with AOSSM were educational websites (mean score = 3.9, p = 0.02), websites discussing only softball (mean score = 2.0, p = 0.02), and the first 50 websites (mean score = 2.2, p = 0.04). The most common discordant guideline was differing opinions in pitch count (13 websites). Conclusion The most common category in disagreement with AOSSM was different pitch count guidelines, highlighting a need for websites to provide more consistent information using high-quality resources. Educational websites, websites discussing only softball, and the first 50 websites had the highest scores, indicating that these types of websites are most likely to have the highest amount of medically advisable information. We recommend users conduct targeted Google searches on reliable websites for information on pitching softball recommendations to maximize the validity of Google search results.

A New Tissue Engineering Strategy to Promote Tendon-bone Healing: Regulation of Osteogenic and Chondrogenic Differentiation of Tendon-derived Stem Cells.

In the field of sports medicine, repair surgery for anterior cruciate ligament (ACL) and rotator cuff (RC) injuries are remarkably common. Despite the availability of relatively effective treatment modalities, outcomes often fall short of expectations. This comprehensive review aims to thoroughly examine current strategies employed to promote tendon-bone healing and analyze pertinent preclinical and clinical research. Amidst ongoing investigations, tendon-derived stem cells (TDSCs), which have comparatively limited prior exploration, have garnered increasing attention in the context of tendon-bone healing, emerging as a promising cell type for regenerative therapies. This review article delves into the potential of combining TDSCs with tissue engineering methods, with ACL reconstruction as the main focus. It comprehensively reviews relevant research on ACL and RC healing to address the issues of graft healing and bone tunnel integration. To optimize tendon-bone healing outcomes, our emphasis lies in not only reconstructing the original microstructure of the tendon-bone interface but also achieving proper bone tunnel integration, encompassing both cartilage and bone formation. In this endeavor, we thoroughly analyze the transcriptional and molecular regulatory variables governing TDSCs differentiation, incorporating a retrospective analysis utilizing single-cell sequencing, with the aim of unearthing relevant signaling pathways and processes. By presenting a novel strategy rooted in TDSCs-driven osteogenic and chondrogenic differentiation for tendon-bone healing, this study paves the way for potential future research avenues and promising therapeutic applications. It is anticipated that the findings herein will contribute to advancing the field of tendon-bone healing and foster the exploration of TDSCs as a viable option for regenerative therapies in the future.

Greater Post-Operative Nutrition Risks Identified in Pediatric and Adolescent Patients after Anterior Cruciate Ligament Reconstruction Regardless of Age and Sex.

Systematic detection of risky nutrition behaviors after sports surgery may better promote healing for return-to-sport. The purpose of this study was to assess nutritional behavior differences between patients following anterior cruciate ligament reconstruction (ACLR) and following other lower-extremity orthopedic surgeries. One pediatric sports medicine center was reviewed for a custom Sports Nutrition Assessment for Consultation, which investigates nutrition-related risk factors for youth athletes at their first post-operative visit. Patients reported "Yes" or "No" to eight questions, after which they were offered a nutrition consultation for any response indicating risk. A total of 243 post-ACLR and 242 non-ACLR patients were reviewed. The post-ACLR patients more often reported a change in appetite (p = 0.021), recent weight changes (p = 0.011), a desire to better understand nutrition (p = 0.004), and recommendations to change their body composition (p = 0.032). More post-ACLR patients were identified for a nutrition consultation (p = 0.002), though an equal percentage accepted the consultation between groups. Age and sex were not determined to be significant confounders after matched sub-analysis. The post-ACLR patients more often reported nutrition risks, specifically weight-related issues, regardless of age or sex. Sports surgeons should regularly inquire about nutrition-related concerns with patients and refer to sports dietitians for recovery nutrition support as needed, particularly after ACLR.

Knowledge, Attitude, and Preventive Practices Regarding Exercise-related Acute Cardiovascular Events in Gym Trainers

Abstract Exercise is a powerful tool in preventing and reducing the occurrence of lifestyle diseases. However, engaging in intense physical activity, especially activities that are unfamiliar, can increase the risk of heart complications, particularly in individuals who are not very physically active. The number of health clubs is growing, leading to a significant increase in the number of fitness trainers who provide guidance and motivation during workout sessions. As a result, it is crucial for fitness center trainers to minimize complications by prescribing personalized workout regimens and promptly addressing any incidents. A cross-sectional study was conducted on gym trainers who had a basic level certification lasting 6 months or more and at least 1 year of experience, using convenience sampling. Trainers with medical or paramedical qualifications were excluded. A questionnaire designed by the researchers was distributed among the gym trainers. Descriptive data analysis was performed using Microsoft Excel to calculate the percentages. The study found that 51% (120) of the participants were knowledgeable about chest pain, while only 14% (32) were aware that light-headedness and tiredness were symptoms indicating possible cardiovascular events. This implies that the trainers surveyed had limited knowledge. In terms of attitude, when asked about their confidence in recognizing symptoms of a heart attack, only 2% were very confident, 38% were neutral, and 8% were not confident at all. Only 38% of trainers practiced risk stratification/pre-exercise screening, and only 44% followed the guidelines set by the American College of Sports Medicine (ACSM). The study suggests that certified gym trainers lack sufficient knowledge, possess a neutral attitude, and do not frequently implement preventive measures related to exercise-related acute cardiovascular arrest.

Ethical issues concerning UK veterinary surgeons practicing in equine sports medicine.

The ethics of equine sports medicine is a complex subject that is currently understudied. It combines veterinary ethics, sports ethics and associated regulation. Equine sports medicine may raise unique ethical issues and combines common ethical issues in ways distinct from other forms of veterinary medicine. The purpose of this research was to identify and describe ethical issues concerning United Kingdom (UK) veterinary surgeons arising within the practice of equine sports medicine. Survey. An online questionnaire was distributed to UK veterinary surgeons via veterinary organisations and veterinary social media. Responses to questions were collated and descriptive analysis performed. Open ended responses were analysed thematically. Ninety-seven respondents completed the questionnaire. The most commonly identified ethical challenges were the conflicts of interest and the pressures faced by the veterinary surgeon. The primary competing interest was balancing the horse's health and welfare with client wishes for the horse to continue in training and competition. Specific ethical challenges were identified; these related to competition integrity, medication control and prohibited substances, treatment evidence and acceptability, among others. As anticipated with the use of a questionnaire, the responses did not provide in-depth information about an individual veterinary surgeon's experiences, however, it did provide evidence of the extensive range of issues and concerns facing this group. There is also potential for response bias, whereby respondents may have provided answers they perceived were ethically desirable. This is the first empirical study that explores the ethical issues faced by equine sports medicine veterinary surgeons and has identified wide ranging concerns that demand further study. Areas which may pose reputational risk to equestrian sport, or the veterinary profession were identified. Governing bodies should consider how to improve support for veterinary surgeons facing ethical challenges, as for some, these cause moral distress and may impact retention within the profession.

Analysis of supply and demand for sports medicine fellowship training: 2012-2022.

The recruitment of high-quality applicants is critical to the vitality of the sports medicine physician workforce. To analyze changes in the total number of available training positions, applicants, and unfilled training positions in the Sports Medicine Match from 2012 to 2022. This was a retrospective cohort study of sports medicine fellowship applicants. Accreditation Council for Graduate Medical Education-accredited sports medicine fellowship training programs. A total of 3763 individuals applying for sports medicine fellowship training from 2012 to 2022. Not applicable. Annual number of applicants, training positions, and number of unfilled training positions. From 2012 to 2022, the annual number of training positions in sports medicine increased from 177 to 353 (99% increase, p < .001) while the annual number of applicants increased from 256 to 428 (67% increase, p < .001). The annual applicant-to-training position ratio decreased (1.4 to 1.2, p < .001). Annual match rates increased for both U.S. MD graduates (64% to 86%, p < .001) and non-U.S. MD graduates (64% to 77%, p < .001). U.S. MD graduates had higher match rates than non-U.S. MD graduates in 2021 (79% vs 70%, p < .05) and 2022 (86% vs 77%, p < .05). The percentage of applicants who matched at their first (36%-36%, p > .05), second (14%-15%, p > .05), and third (9%-8%, p > .05) ranked programs did not change. The percentage of applicants who did not match decreased (33%-19%, p < .001). The percentage of available fellowship training positions that went unfilled decreased (8%-2%, p < .001). Interest in sports medicine fellowship training is increasing as evidenced by an increasing number of applications and decreasing rate of unfilled training positions. Continued monitoring of future match cycles is important given projected shortages in the physician workforce.

Shared Decision-Making About Returning to Sport After Recovery From Pediatric Concussion: Clinician Perspectives.

Describe how sports medicine clinicians support decision making about sport participation after concussion recovery with adolescent patients and their parents. Specific areas of inquiry related to how clinicians framed the decision, what factors they considered in how they approached the decision process, and how they navigated discordance within families. Qualitative study. Tertiary care sports medicine clinics at 4 children's hospitals in the United States. Individual interviews were conducted with 17 clinicians practicing in sports medicine settings. N/A. Semi-structured interviews explored clinician approaches to supporting decision making, with the question guide informed by components of the Ottawa Decision Support Framework. Clinicians routinely incorporated aspects of shared decision making (SDM) into their conversations with families. This included ensuring all parties were informed about risk and aligned behind a shared value of adolescent well-being. Mediation strategies were used to manage discordance between adolescents and their parents, and between parents. These strategies aimed to facilitate a decision that was adolescent centered. When clinicians believed that there was a medical benefit to modifying the adolescent's sport participation practices, or when they did not believe the athlete was psychologically ready to return to the sport in which they were injured, they initiated conversations about alternative activities. In such situations, they used persuasive communication practices to encourage families to strongly consider this option. The strengths and strategies used by sports medicine clinicians in this study provide a foundation for guidance or intervention development aimed at supporting SDM after concussion with adolescents and their families.

Trends and predictors of reporting social determinants of health in shoulder surgery

IntroductionThe role of social determinants of health (SDH) in patient outcomes, quality of life, and overall well-being has been well documented. However, the inclusion of these variables in randomized control trials (RCTs) remains limited; thus, the extent of generalizability from such trials is brought into question. The purpose of this study is to explore the rates of reporting SDH variables in RCTs focused on shoulder surgery from the past decade. MethodsThe PubMed database was searched for RCTs with a focus on shoulder surgery from 2013-2023. Duplicates, responses to the editor, biomechanical studies, and non-shoulder studies were excluded. Each article was reviewed and data pertaining to patient demographics, socioeconomic covariates. Journal of publication was recorded, and studies from the five most common journals were analyzed. These journals were the Journal of Shoulder and Elbow Surgery (JSES), the Journal of Bone and Joint Surgery (JBJS), the American Journal of Sports Medicine (AJSM), the Bone and Joint Journal (BJJ), and The Journal of the American Medical Association (JAMA). Multivariate logistic regression was performed to determine the independent effect of study characteristics on the reporting rates of SDH. ResultsA total of 255 articles were reviewed. Of these, 93.3% and 90.2% of articles reviewed reported age and sex, respectively. Employment status was reported in 11.8% of articles. Fewer than 10% reported race, ethnicity, income, insurance, and housing, with even less performing formal analyses on these variables. Studies that were conducted in the United States (US), multicenter, had a sample size 251+, and had a combination of public and private funding were significantly more likely to report on race and ethnicity. Reporting employment status was significantly associated with being European-based, multicenter, sample size 251+, double-blinded, and published in AJSM, Newer studies were significantly less likely to report education. Only publication in AJSM was significant for reporting income. Study intervention and topic were not significant for any SDH reporting. DiscussionThis data reflects how small of a proportion of RCTs report and analyze on SDH variables. These findings reflect a need for future RCTs to accurately report SDH variables that influence outcomes, such as race, ethnicity, education, employment, income, housing status, and insurance.. ConclusionsSDH are infrequently reported and analyzed in RCTs pertaining to shoulder surgery. Academic medical journals should incorporate guidelines to encourage studies to include such variables and enable the assessment of outcomes to apply to a broader population.

Exploring Symptom Overlaps: Post-COVID-19 Neurological Syndrome and Post-Concussion Syndrome in Athletes.

The COVID-19 pandemic has introduced new challenges in managing neurological conditions, particularly among athletes. This paper explores the intersection of post-COVID-19 neurological syndrome (PCNS/PASC) and post-concussion syndrome (PCS), focusing on their implications in sports medicine. Our analysis covers the symptomatology, pathophysiology, and management strategies for PCNS/PASC and PPCS, with special attention paid to the unique challenges faced by athletes recovering from these conditions, including the risk of symptom exacerbation and prolonged recovery. Key findings reveal that both PCNS/PASC and PPCS present with overlapping symptoms such as cognitive difficulties, exercise intolerance, and mental health issues, but differ in specific manifestations like anosmia and ageusia, unique to COVID-19. Pathophysiological analysis reveals similarities in blood-brain barrier disruption (BBB) but differences in the extent of immune activation. Management strategies emphasize a gradual increase in physical activity, close symptom monitoring, and psychological support, with a tailored approach for athletes. Specific interventions include progressive aerobic exercises, resistance training, and cognitive rehabilitation. Furthermore, our study highlights the importance of integrating neurology, psychiatry, physical therapy, and sports medicine to develop comprehensive care strategies. Our findings underscore the dual challenge of COVID-19 and concussion in athletes, necessitating a nuanced, interdisciplinary approach to effective management. Future research should focus on the long-term neurological effects of both conditions and optimizing treatment protocols to improve patient outcomes. This comprehensive understanding is crucial for advancing the management of athletes affected by these overlapping conditions and ensuring their safe return to sports.