Showing posts with label sports. Show all posts
Showing posts with label sports. Show all posts

Thursday, August 20, 2015

Heads Up on a Study of Eye Protection and Eye Injuries in Field Hockey

By: Lewis First, MD, MS; Editor-in-Chief       

          Mandatory protective eyewear for field hockey was only recently implemented nationally but has it made a difference in decreasing eye injuries since then?  Kriz et al. (doi: 10.1542/peds.2015-0216) achieved their goal of answering this question by reviewing injury rates in states before and after implementation of a national mandate for protective eye wear.
       Even before the mandate, states that required protective eye wear were already demonstrating lower injury rates and after the mandate, the reductions are dramatic—not just for eye injuries but for overall face and head injuries as well. 
     Sadly concussion remains a problem, raising the question of whether mandatory helmets are the next step in injury reduction in this sport.  To learn more about the types of injuries that still occur with protective eyewear and those that are dramatically reduced, put your best face forward and eyeball this study to learn more.

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Monday, May 26, 2014

Ice Hockey Injuries: How Common Are They?

Pediatrics Editorial Board Member Joann Schulte, DO, MPH, shares her expert perspective on a new article from our June issue. To learn more about Dr. Schulte and her work in general pediatrics and preventive medicine, check out her bio on our Contributors page.

By: Joann Schulte, DO, MPH

Watch the bodies collide on the ice and players go flying. Though the outside ice has melted, the hockey puck is still flying inside during June as the NHL finishes the Stanley Cup playoffs. And just like their professional counterparts, younger, amateur, pediatric hockey players also go flying in this contact sport.

Photo by Battle Creek CVB via Flickr
An article by Stephanie Polites et al. published the June issue of Pediatrics (doi:10.1542/2013-3628) highlights the injuries sustained by youth hockey players aged 18 years and younger in Minnesota. Surgeons at the pediatric trauma center at Mayo Clinic evaluated the injuries of youth hockey players during a 16-year period from July 1997 to July 2013, one of the few longitudinal studies done. They saw 155 children with 168 injuries, and almost 16 percent were in girls. Most injuries were sustained by intentional contact; extremity injuries and traumatic brain injury (TBI) were the most common diagnoses. Upper limb fractures were the most common extremity injury and concussions were the most common form of TBI. Players who were older and male were more likely to experience injuries requiring hospital admission and major medical procedures.

Polites and her co-authors reported that 40 percent of players who suffered TBI had sustained prior concussions and 35 percent of players followed reported symptoms lasting for more than a year. Multiple concussions have well-documented risks, such as the long-term effects now being reported and studied among professional football players.

The authors suggest that young hockey players and their parents need to be educated about the risks of TBI. They recommend that concussion be treated with a return to play only after symptoms have resolved and neurocognitive testing is at the player’s baseline.

Hopefully, many teams will have such measures in place when things freeze up for the next hockey season. And let’s also hope those measures are put in place for girls who play hockey, since as of 2011, 65,000 girls were playing youth hockey, according to USA Hockey.

Pediatricians who want to know more about such measure may want to review the measures recommended by the 4th International Conference on Concussion in Sport, held in Zurich in 2012 or the new AAP policy statement, “Reducing Injury Risk from Body Checking in Boys’ Hockey” (doi: 10.1542/peds.2014-0692).

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Tuesday, March 11, 2014

Heads Up: Two New Studies on Concussion

Evaluation of a concussion in the Emergency Department (ED) is easier said than done—and it is for that reason that the Centers for Disease Control devised an Acute Concussion Evaluation (ACE) tool to aid in evaluation and follow-up instruction. While this tool was originally designed and then modified for ED usage, only recently has its benefit been studied in a pediatric emergency setting.

Photo by UC International via Wikimedia Commons
Fortunately, we are able to share the results of implementing the ACE program in a study by Zuckerbraun et al. (doi: 10.1542/ peds.2013-2600) being early released online this week. The authors looked at ED follow-up and adherence to a stepwise return to normal activity as directed by the ACE Care Plan (part of the ACE program) both pre- and post-implementation of this program in two pediatric EDs. The results are impressive and suggest this tool should be strongly considered for your local pediatric ED facility if it isn’t already.

Adding to our battery of evaluative tools for traumatic brain injury, especially mild brain injury that persists longer than you think it should, is the Medical Symptom Validity Test (MSVT), which can help detect exaggerated problems associated with persistent symptom complaints. A second study being released this week by Kirkwood et al. (doi: 10.1542/peds.2013-3195) enrolled almost 200 patients for neuropsychological evaluation after a mild traumatic brain injury and gave them the MSVT.

Since the return to school or play depends on duration of symptoms, knowing if these symptoms are valid or not can be important in determining when a child post-concussion can go back to school or athletics. That time course might be sped up if a patient fails the MSVT, and the authors share data to support that hypothesis. If you have not heard of this test or are interested in learning more to better address the validity of your patient’s persistent symptoms after a mild concussion, head for this study and learn more.

Together, both studies introduce some evaluative tools that may enhance your evaluation of traumatic brain injuries. Are you using either or both? Do you find them useful? Share your thoughts and comments with a response to this blog of via Facebook, Twitter, or even by posting an eLetter.

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Friday, January 31, 2014

Touchdown! Winning Studies Help You Care for Young Football Players

Photo by Greyerbaby via Pixabay
While America’s tuning in to watch one
of the biggest sporting events of the year, Pediatrics wanted to get in on the fun. And although we won’t be passing the pigskin or serving up snacks here on First Read, we can share some of our favorite articles from our brand new February issue to help you tackle some of the health care issues that may arise for the young football players and athletes you see in your practice.

  • If you think that coaches of student athletes could be more encouraging, you’re not alone. Check out a Pediatrics Perspective piece by Swigonski et al. (doi: 10.1542/ peds.2013-3146 - free through March 1, 2014) that takes a look at coaches’ bullying behaviors and ways pediatricians can identify and intervene.

  • The lasting impact concussions have on players is on many football fans’ minds this season. But even if your patients aren’t yet in the pros, you can help inform your treatment of concussions with this latest study on the effects of cognitive activity level on the duration of post-concussion symptoms by Brown et al. (doi: 10.1542/peds.2013-2125).

  • And, if you feel as though many of your athletic patients get sidelined with shoulder injuries, take a look at this study by Robinson et al. (doi: 10.1542/peds.2013-2279) to learn more about the shoulder injury rates and patterns of high school athletes.

So whether you are rooting for the team in blue and green or the team in blue and orange this weekend, hopefully you’ll get your kicks and touch down to read these articles. Doing so will help you cheer for the health and success of your favorite young athletes as well.

Tuesday, January 14, 2014

6 Years of High School Shoulder Injuries: Some Data That Is Not Out of Joint!

We all encounter athletic patients who come in with a myriad of shoulder injuries following an athletic practice or competitive event. But what do we really know about these injuries?

Photo by Public Domain Pictures via Pixabay
Robinson et al. (doi: 10.1542/peds.2013-2279) opted to categorize the spectrum of shoulder injuries over a six year period in a nationally representative sample of high school athletes engaged in playing at least one of nine sports. The authors describe their findings in terms of differences in gender, type of sports, and type of injury as well as whether the injuries are more or less likely to occur in a practice or actual competition. The number needing surgical repair and the morbidity associated with these injuries are also categorized.

The take-away from this study, given the prevalence of shoulder injuries, is how to better prevent them. Prevention begins by raising your level of concern about these injuries and that is certain to happen only if you don’t give this study the cold shoulder.