RESUMO
When can the athlete with a sprained ankle to return to play? The medical literature provides no definitive answer to this question, so we surveyed 500 experts in sports medicine, and asked them if they agree with the following statement: "For patients with an acute ankle injury, the ability to hop on the sidelines is sufficient evidence to allow the athlete to return to the field." Overall, the experts did not endorse this statement. Further, a review of the medical literature failed to lend support for the statement. Taken together, some level V (expert opinion) evidence emerges, namely, that a patient's ability to successfully complete the hop test is not necessarily sufficient evidence to allow a return to play. That finding does not mean that a physician must shun the test; rather, the conclusion is that it cannot be relied on in isolation. The hop test, used in context with other findings, along with a consideration of the risks and benefits of continued play, may help the physician on the field reach a reasonable conclusion. To date, however, there is no single, easily applied test that can correctly determine whether an athlete is safe to return to the field.
Assuntos
Traumatismos do Tornozelo/reabilitação , Atletas , Tomada de Decisões , Medicina Baseada em Evidências/métodos , Recuperação de Função Fisiológica , Medicina Esportiva/métodos , HumanosRESUMO
The physis, or growth plate, is relatively weaker than the surrounding bone; as a result, individuals with immature skeletons are at risk for growth plate injury from forces that would not harm an adult. Based on the knowledge that immature growth plates are weaker than adult growth plates, it is not known with certainty whether or not adolescents can participate safely in resistance training programs. Because medical literature does not definitively answer if it is safe for adolescents to pursue strength-training programs, we previously surveyed 500 experts in sports medicine to determine whether they agreed with the statement "resistance training ('weight lifting') should be avoided until physeal closure." Overall, respondents answered that "this statement is very likely false." In this article, we interpret the experts' survey responses by reviewing the basic and clinical sciences implicit in the question, as well as the literature regarding adolescent outcomes. Although the avoidance of resistance training by adolescents is theoretically appealing, we found that the data indicate properly supervised weight programs are not associated with increased risk of acute injury. However, the literature offers no insight about the long-term implications of weight lifting on growth plates. In sum, the expert consensus from our survey that strength training is safe for individuals with immature skeletons is consistent with data from medical literature.
Assuntos
Lâmina de Crescimento/crescimento & desenvolvimento , Treinamento Resistido , Levantamento de Peso , Adolescente , Traumatismos em Atletas/prevenção & controle , Atitude do Pessoal de Saúde , Humanos , Inquéritos e QuestionáriosRESUMO
Working from a prior investigation, we sought to determine the validity of the claim: "It's okay for 12-year-old pitchers to throw curveballs; it's the pitch count that matters." Our previous expert opinion survey demonstrated that this statement was most probably false. The purpose of this report was to investigate the validity of this statement, and to determine if our sports medicine experts "got it right." Using the most current sports medicine literature, this statement was critically examined so that an evidence-based opinion could be given and compared with the results of our prior study.
Assuntos
Traumatismos em Atletas/prevenção & controle , Beisebol/lesões , Transtornos Traumáticos Cumulativos/prevenção & controle , Medicina Baseada em Evidências/métodos , Guias como Assunto , Ortopedia , Sociedades Médicas , Medicina Esportiva/métodos , Esportes , Criança , HumanosRESUMO
A case od periarteritis nodosa is reported in which cutaneous manifestations were present consisting of livedo reticularis followed by necrosis and ulceration.In the biopsy specimens taken during life the small blood vessels showed changes which if not absolutely diagnistic made one suspicious thast the disease was periarteritis nodosa. In the much larger and deeper autopsy specimens of the skin however, a few of the larger arterites were characteristically affected.In a review of the literature it was found that some sort of cutaneous manifestation had been noted in about 25 per cent of the cases. In 3 cases besides our own there was livedo racemosa or livedo reticularis.We have emphasized the importance of a more general recognition of the cutaneos manifestations of periarteritis nodosa, principally because from the standpoint of diagnosis the skin is the most accessible portion of the body for histologic study.