APPLICATIONS OF INTRANASAL LOW INTENSITY LASER THERAPY IN SPORTS MEDICINE

Function-specific homeostasis(FSH)has been defined as a negative-feedback response of a biosystem to maintain its interior function-specific conditions so that the function is perfectly performed.There is no photobiomodulation of intranasal low intensity laser therapy(ILILT)on a function in its FSH,but ILILT could modulate a function far from its FSH.This rehabilitation has been found to be mediated by the ratio of intracellular nicotinamide adenine dinucleotide(NAD+)and its reduced form NADH,NAD+/NADH,and then sirtuin 1(SIRT1).There might be FSH-specific NAD+/NADH(FSN)and SIRT1 activity(FSA).ILILT might enhance NAD+/NADH and SIRT1 activity until they arrive at FSN and FSA,respectively.The NAD+/NADH and SIRT1 activity of related cells of many athletic diseases such as upper respiratory tract infection,asthma,osteoarthritis,exercise-induced muscle damage,wound,traumatic brain injury,and osteoporosis are lower than FSN and FSA,respectively.Therefore,there may be therapeutic effects of ILILT on those athletic diseases.Furthermore,many phenomena and the ILILT mechanism have been integrated to support the prophylaxis effects of ILILT on the swine-origin influenza A(H1N1).

Trends in leadership at orthopaedic surgery sports medicine fellowships

BACKGROUND Fellowship directors(FDs)in sports medicine influence the future of trainees in the field of orthopaedics.Understanding the characteristics these leaders share must be brought into focus.For all current sports medicine FDs,our group analyzed their demographic background,institutional training,and academic experience.AIM To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position.METHODS Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories.The demographic and educational background data for each FD was gathered via author review of current curriculum vitae(CVs).Any information that was unavailable on CV review was gathered from institutional biographies,Scopus Web of Science,and emailed questionnaires.To ensure the collection of as many data points as possible,fellowship program coordinators,orthopaedic department offices and FDs were directly contacted via phone if there was no response via email.Demographic information of interest included:Age,gender,ethnicity,residency/fellowship training,residency/fellowship graduation year,year hired by current institution,time since training completion until FD appointment,length in FD role,status as a team physician and H-index.RESULTS Information was gathered for 82 FDs.Of these,97.5%(n=80)of the leadership were male;84.15%(n=69)were Caucasian,7.32%(n=6)were Asian-American,2.44%(n=2)were Hispanic and 2.44%(n=2)were African American,and 3.66%(n=3)were of another race or ethnicity.The mean age of current FDs was 56 years old(±9.00 years),and the mean Scopus H-index was 23.49(±16.57).The mean calendar years for completion of residency and fellowship training were 1996(±15 years)and 1997(±9.51 years),respectively.The time since fellowship training completion until FD appointment was 9.77 years.17.07%(n=14)of FDs currently work at the same institution where they completed residency training;21.95%(n=18)of FDs work at the same institution where they completed fellowship training;and 6.10%(n=5)work at the same institution where they completed both residency and fellowship training.Additionally,69.5%(n=57)are also team physicians at the professional and/or collegiate level.Of those that were found to currently serve as team physicians,56.14%(n=32)of them worked with professional sports teams,29.82%(n=17)with collegiate sports teams,and 14.04%(n=8)with both professional and collegiate sports teams.Seven residency programs produced the greatest number of future FDs,included programs produced at least three future FDs.Seven fellowship programs produced the greatest number of future FDs,included programs produced at least four future FDs.Eight FDs(9.75%)completed two fellowships and three FDs(3.66%)finished three fellowships.Three FDs(3.66%)did not graduate from any fellowship training program.The Scopus H-indices for FDs are displayed as ranges that include 1 to 15(31.71%,n=26),15 to 30(34.15%,n=28),30 to 45(20.73%,n=17),45 to 60(6.10%,n=5)and 60 to 80(3.66%,n=3).Specifically,the most impactful FD in research currently has a Scopus H-index value of 79.By comparison,the tenth most impactful FD in research had a Scopus H-index value of 43(accessed December 1,2019).CONCLUSION This study provides an overview of current sports medicine FDs within the United States and functions as a guide to direct initiatives to achieve diversity equality.

Analysis of the Application of Sports Medicine Ultrasound in the Rehabilitation of Anterior Talofibular Ligament Injury

Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to September 2023 were selected as research subjects and randomly divided into the study group (18 cases) and the control group (18 cases). The control group adopted routine examination and rehabilitation training, and the study group adopted sports medicine ultrasound and rehabilitation training. The ankle function scores and daily living ability of the two groups were compared before treatment and 9 weeks after treatment. Results: There was no statistically significant difference between the study group and the control group in terms of ankle function scores and ability to perform activities of daily living before treatment (P > 0.05), but the difference was statistically significant after treatment (P < 0.05). Conclusion: Ultrasound can be used as a supplement to magnetic resonance imaging (MRI) of the ankle joint for diagnosing anterior talofibular ligament injury;ultrasound can show the location, distance, and degree of tear of the anterior talofibular ligament rupture and accurately predict muscle atrophy around the ankle joint;ultrasound combined with computed tomography (CT) can better determine the type of intra-articular fracture of the talar subtalar joint, and guide the choice of surgical timing. In addition, ultrasound can be used to determine the severity of peroneal muscle atrophy, assess the progress of early postoperative functional exercise, and guide personalized rehabilitation programs.

Advancements of Nano-Hydroxyapatite in Sports Medicine from Bone Injury Perspectives

Nanotechnology has revolutionized the field of biology and medicine in the 21 st century.Bone injury incidences during sports activities are common,and they are traditionally treated with allogeneic grafting,a common clinical practice but limited by the quality of the graft and some side effects.Nano-hydroxyapatite(nHA)is considered as an ideal bone graft material owing to its bone-like structure,excellent biological activity,bone conductivity,non-toxicity,and non-immunogenicity.nHA and its composite materials have been found suitable for the adhesion,proliferation,and differentiation of mesenchymal stem cells,which leads to their potential applications in treating the bone injury.In this review,we classified different applications of nHA to explore the role of these materials in bone repair and tendon healing,highlighting the superior characteristics of nanomaterials in the treatment of bone injury,hoping to provide ideas for nHA applied to clinical practices for the treatment of bone injury.

Sports medicine in China： A clinical review and update

In the past decades, orthopedic sports medicine has witnessed a dramatic growth in China, mainly attributed to the rapid development of molecular biology, biomechanics, transplantation biology, medical imaging, rehabilitation and minimally invasive surgery, including the introduction of advanced techniques and instruments. Development in diagnosis, treatment and rehabilitation of sports injuries has greatly improved the clinical outcomes and patients＇ life quality, and made incomparable contribution to the development of Chinese Olympians and promotion of nationwide sports.

Application of traditional Chinese therapy in sports medicine

Chinese herbs have been used as dietary supplements to improve exercise performance.However,evidence-based studies for the use of Chinese herbs in sports remain scarce.Traditional Chinese therapy(TCT),a form of traditional Chinese non-pharmacological intervention,has remained in use for thousands of years in sports medicine.TCT is beneficial for sports injuries and in enhancing skill development,and is becoming increasingly popular among athletes,fitness enthusiasts,and individuals who regularly exercise.The therapeutic effects of TCT have been demonstrated by clinical and experimental studies,but using these modalities still is associate with potentially adverse effects.Further well-designed studies are necessary to confirm the efficacy of TCT in sports medicine.This review aims to summarize the application of TCT,discuss the issues surrounding TCT clinical research,and provide suggestions for applying traditional Chinese methods in the field of sports medicine.

Exploration of Teaching and Education: Integration of Sports and Medicine in Physical Education in Colleges and Universities

Based on the concept and definition of“integration of sports and medicine,”this paper analyzes the current situation of the integration,where it lacks innovative physical education curriculum content and physical education teachers with conventional medical professional knowledge;in addition,physical education disciplines with medical characteristics are not highlighted.Therefore,relevant measures are put forward for reference and discussion.

A lateral ankle sprain during a lateral backward step in badminton:A case report of a televised injury incident

Background:This study presents a kinematic analysis of an acute lateral ankle sprain incurred during a televised badminton match.The kinematics of this injury were compared to those of 19 previously reported cases in the published literature.Methods:Four camera views of an acute lateral ankle sprain incurred during a televised badminton match were synchronized and rendered in3-dimensional animation software.A badminton court with known dimensions was built in a virtual environment,and a skeletal model scaled to the inj ured athlete’s height was used for skeletal matching.The ankle joint angle and angular velocity profiles of this acute injury were compared to the summarized findings from 19 previously reported cases in the published literature.Results:At foot strike,the ankle joint was 2° everted,33° plantarflexed,and 18° internally rotated.Maximum inversion of 114° and internal rotation of 69° was achieved at 0.24 s and 0.20 s after foot strike,respectively.After the foot strike,the ankle joint moved from an initial position of plantarflexion to dorsiflexion-from 33° plantarflexion to 53° dorsiflexion(range=86°).Maximum inversion,dorsiflexion,and internal rotation angular velocity were 1262°/s,961°/s,and 677°/s,respectively,at 0.12 s after foot strike.Conclusion:A forefoot landing posture with a plantarflexed and internally rotated ankle joint configuration could incite an acute lateral ankle sprain injury in badminton.Prevention of lateral ankle sprains in badminton should focus on the control and stability of the ankle joint angle during forefoot landings,especially when the athletes perform a combined lateral and backward step.

Avascular necrosis of the first metatarsal head in a young female adult:A case report and review of literature

BACKGROUND This case study describes an atypical presentation of avascular necrosis(AVN)of the first metatarsal head,which is largely unfounded in the literature.CASE SUMMARY A healthy 24-year-old female initially presented with pain at the first metatarsophalangeal joint(MTPJ)and was diagnosed with AVN by physical examination and magnetic resonance imaging.The patient demonstrated atypically poor progress in recovery,despite being in otherwise good health and being of young age,with no history of corticosteroid or alcohol use.The patient also did not have any history or clinical features of autoimmune disease or vasculitis,such as systemic lupus erythematosus.The patient was managed with conservative treatment for 18 mo,which allowed for gradual return of full range of motion of the first MTPJ and subsiding pain,permitting the patient to return to highintensity sports training and full weight-bearing.Throughout her recovery,many differential diagnoses were ruled out through specific investigations leading to further reinforcement of the diagnosis of AVN of the 1st metatarsal head.CONCLUSION Atypical AVN may occur with no predisposing risk factors.Treatment is mainly conservative,with unclear guidelines in literature on management.

Impact of training specificity on exercise-induced cardiac troponin elevation in professional athletes: A pilot study

BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise,but data on intermittent exercise are scarce.It has not been investigated whether cardiac troponin elevation is influenced depending on the type of exercise that an athlete is adapted to perform.We hypothesized that intermittent but not continuous exercise induces cardiac troponin elevation in professional athletes adapted to high-intensity intermittent exercise.AIM To examine how training specificity impacts high-sensitivity cardiac troponin T(hs-cTnT)release.METHODS Nine professional floorball players participated in the study,which comprised two different exercise tests:a continuous incremental cycle ergometer test and a Yo-Yo Intermittent Recovery 2(Yo-Yo IR2)test.Serial assessment of hs-cTnT was performed after the cycle ergometer test and the Yo-Yo IR2 test(baseline,0,2,6,and 24 h).RESULTS No hs-cTnT elevation above the myocardial damage cutoff(≥14 ng/L)was shown after the cycle ergometer test,whereas hs-cTnT levels rose over the cutoff in three of nine participants after the Yo-Yo IR2 test.The hs-cTnT levels peaked at 6 h after both tests,but were significantly higher after the Yo-Yo IR2 test compared to the cycle ergometer test(median hs-cTnT concentration 10.6 ng/L vs 7.8 ng/L,P=0.038).All levels returned to baseline within 24 h.CONCLUSION In professional athletes adapted to high-intensity intermittent exercise,hs-cTnT was significantly elevated after intermittent but not continuous exercise.This principle of specificity training should be considered when designing future studies to avoid misinterpretation of hs-cTnT elevation.

Allergic dermatitis after knee arthroscopy with repeated exposure to Dermabond Prineo^(TM) in pediatric patients:Two case reports

BACKGROUND Allergic contact dermatitis(ACD)secondary to Dermabond Prineo^(TM) is rare,but documented.To our knowledge,there are no described reports of this ACD reaction within the pediatric population following arthroscopic surgery.CASE SUMMARY We report two cases of pediatric ACD upon second exposure to Dermabond Prineo^(TM) after knee arthroscopy.Both cases presented within two weeks of the inciting second exposure.The cases resolved with differing described combinations of sterile cleaning,diphenhydramine,and antibiotic administration.No long-term sequelae were found.CONCLUSION This case report elucidates the rare complication of allergic dermatitis secondary to Dermabond Prineo^(TM) repeat exposure use in pediatric arthroscopy.

Kitesurf injury trauma evaluation study:A prospective cohort study evaluating kitesurf injuries

BACKGROUND Kitesurfing is an increasingly popular and potentially dangerous extreme water sport.We hypothesized that kitesurfing has a higher injury rate than other(contact)sports and that the minority of injuries are severe.AIM To investigate the incidence and epidemiology of kitesurfing injuries in a Dutch cohort during a complete kitesurfing season.METHODS Injury data of 194 kitesurfers of various skill levels,riding styles and age were surveyed prospectively during a full kitesurf season.The participants were recruited through the Dutch national kitesurf association,social media,local websites and kitesurf schools.Participants completed digital questionnaires monthly.The amount of time kitesurfing was registered along with all sustained injuries.If an injury was reported,an additional questionnaire explored the type of injury,injury location,severity and the circumstances under which the injury occurred.RESULTS The mean age of participants was 31 years(range,13-59)and the majority of the study population was male(74.2%).A total of 177 injuries were sustained during 16816 kitesurf hours.The calculated injury rate was 10.5 injuries per 1000 h of kitesurfing.The most common injuries were cuts and abrasions(25.4%),followed by contusions(19.8%),joint sprains(17.5%)and muscle sprains(10.2%).The foot and ankle were the most common site of injury(31.8%),followed by the knee(14.1%)and hand and wrist(10.2%).Most injuries were reported to occur during a trick or jump.Although the majority of injuries were mild,severe injuries like an anterior cruciate ligament tear,a lumbar spine fracture,a bimalleolar ankle fracture and an eardrum rupture were reported.CONCLUSION The injury rate of kitesurfing is in the range of other popular(contact)sports.Most injuries are relatively mild,although kitesurfing has the potential to cause serious injuries.

A Smart Wellness Service Platform and Its Practical Implementation

Advances in the field of medical sciences and medical technology,and present-day challenges,such as an aging population,rising medical expenses,and lifestyle-related diseases,have collectively catalyzed a research ecosystem termed“smart wellness.”This article describes the establishment of a smart wellness service platform designed to empower individuals to create a sense of balance in their lives.Step-by-step details include service model,design,and architectural considerations.As a proof of concept,implementation details of a Health Improvement and Management Systems(HIMS)Hub,a Smart Wellness Service Platform deployed in six cities in South Korea,are presented.An on-site survey conducted in Busan Metropolitan City reveals the percentage of satisfied users to be 91.3%.Furthermore,data gathered from 27,236 physical evaluations of users from a Busan city center over the period of April 2013 to May 2018 reveal that males and females in their 50s and 60s account for the highest number of participants,while males in their 70s have a higher rate of participation than females in the same age group.

Do exercise therapies restore the deficits of joint position sense in patients with chronic ankle instability? A systematic review and meta-analysis

To determine whether existing exercise therapies can restore the joint position sense(JPS)deficits of patients with chronic ankle instability(CAI)when compared with controlled non-training patients.Seven databases were searched using ankle,injury,proprioception,and exercise-therapy-related terms.Peer-reviewed human studies in English that used the absolute errors score of joint position reproduction(JPR)test to compare the JPS of injured ankles in CAI patients before and after exercise therapy and non-training controls were included and analyzed.Demographic information,sample size,description of exercise therapies,methodological details of the JPR test,and absolute error scores were extracted by two researchers independently.Meta-analysis of the differences in JPS changes(i.e.,absolute errors after treatment minus the baseline)between the exercise therapies and non-training controls was performed with the weighted mean difference(WMD)and 95%confidence interval(CI).Seven studies were finally included.Meta-analyses revealed significantly higher improvements in passive JPS during inversion with,WMD?1.54and eversion,of,WMD?1.80,after exercise therapies when compared with non-training controls.However,no significant changes in the impaired side active JPS were observed with regard to inversion and eversion.Existing exercise therapies may have a positive effect on passive JPS during inversion and eversion,but do not restore the active JPS deficits of injured ankles in patients with CAI when compared with non-training controls.Updated exercise components with a longer duration that focus on active JPS with longer duration are needed to supplement the existing content of exercise therapies.

Myocarditis in athletes after COVID-19 infection:The heart is not the only place to screen

COVID-19 patients are susceptible to hypercoagulability.For the safe return to sports after COVID-19,athletes or individuals wanting to resume physical activity should complete screening for myocardial injury and myocarditis.In addition,patients with COVID-19 are reported at prevalence of 27%–31%for venous thromboembolic events.The probability of deep vein thrombosis and pulmonary embolism prior to intensive exercise after COVID-19 infection should be considered.The prevalence of cardiac injury is reported at 19%,and the prevalence of deep vein thrombosis and pulmonary embolism is higher than that for myocarditis.Thus,the heart is not the only system needing screened.Examination for myocardial injury and myocarditis are mandatory.Also,deep vein thrombosis,and pulmonary thromboembolism must be considered,and when possible,blood troponin values,Ddimer prothrombin time,and activated partial thromboplastin time levels are determined for COVID-19 infection athletes or any individual before returning to sporting practice or intense physical activity or exercise.