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Kliethermes SA, Asif IM, Blauwet C, Christensen L, Coleman N, Lavallee ME, Moeller JL, Phillips SF, Rao A, Rizzone KH, Sund S, Tanji JL, Tuakli-Wosornu YA, Stafford CD. Focus areas and methodological characteristics of North American-based health disparity research in sports medicine: a scoping review. Br J Sports Med 2024; 58:164-171. [PMID: 38216322 PMCID: PMC10961938 DOI: 10.1136/bjsports-2023-107607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Health disparities are widely prevalent; however, little has been done to examine and address their causes and effects in sports and exercise medicine (SEM). We aimed to summarise the focus areas and methodology used for existing North American health disparity research in SEM and to identify gaps in the evidence base. DESIGN Scoping review. DATA SOURCES Systematic literature search of PubMed, Scopus, SPORTDiscus, CINAHL Plus with Full Text, Web of Science Core Collection and Cochrane Central Register of Controlled Trials. ELIGIBILITY CRITERIA Full-text, peer-reviewed manuscripts of primary research, conducted in North America; published in the year 2000 or after, in English; and focusing on organised sports were included. RESULTS 103 articles met inclusion criteria. Articles were classified into five focus areas: access to and participation in sports (n=45), access to SEM care (n=28), health-related outcomes in SEM (n=24), provider representation in SEM (n=5) and methodology (n=1). Race/ethnicity (n=39), socioeconomic status (n=28) and sex (n=27) were the most studied potential causes of health disparities, whereas sexual orientation (n=5), location (rural/urban/suburban, n=5), education level (n=5), body composition (n=5), gender identity (n=4) and language (n=2) were the least studied. Most articles (n=74) were cross-sectional, conducted on youth (n=55) and originated in the USA (n=90). CONCLUSION Health disparity research relevant to SEM in North America is limited. The overall volume and breadth of research required to identify patterns in a heterogeneous sports landscape, which can then be used to inform positive change, need expansion. Intentional research focused on assessing the intersectionality, causes and consequences of health disparities in SEM is necessary.
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Affiliation(s)
- Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
- The American Medical Society For Sports Medicine, Leawood, Kansas, USA
| | - Irfan M Asif
- Family and Community Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation; Spaulding Hospital/Brigham and Women's Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
- Kelley Adaptive Sports Research Institute, Boston, Massachusetts, USA
| | - Leslie Christensen
- Department of Library Science, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nailah Coleman
- Pediatric Primary Care, Children's National Hospital, Washington, District of Columbia, USA
| | - Mark E Lavallee
- Department of Orthopedics, UPMC, Harrisburg, Pennsylvania, USA
| | - James L Moeller
- Orthopaedic Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Shawn F Phillips
- Department of Family and Community Medicine, Penn State Health, Mount Joy, Pennsylvania, USA
| | - Ashwin Rao
- Family Medicine, University of Washington, Seattle, Washington, USA
| | - Katherine H Rizzone
- Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Sarah Sund
- The American Medical Society For Sports Medicine, Leawood, Kansas, USA
| | - Jeffrey L Tanji
- Orthopedics, UC Davis Sports Medicine, Sacramento, California, USA
| | - Yetsa A Tuakli-Wosornu
- Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Cleo D Stafford
- Department of Orthopaedics and Rehabilitations Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Peebles LA, Aman ZS, Kraeutler MJ, Mulcahey MK. Impact of the COVID-19 Pandemic on Sports Medicine Patient Care. Arthroscopy 2023; 39:161-5. [PMID: 36347417 DOI: 10.1016/j.arthro.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic has necessitated new practices in sports medicine patient care. Telehealth has been validated as a reliable tool for consultations and physical examinations and increases access to care in a cost-efficient manner. Social distancing and avoiding team members who have tested positive are the most effective ways to reduce spread. For screening, daily self-reported symptom checklists and fever monitoring help identify potentially infected athletes who should be instructed to isolate and seek care. Polymerase chain-reaction (PCR) testing for the virus via nasopharyngeal swab is not recommended for screening and should be reserved for symptomatic individuals with fever, cough, or shortness of breath. Face masks and personal protective equipment (PPE) may be beneficial in high-risk settings, but there is little evidence to support use in athletic populations. Median return to play after COVID-19 in elite athletes has been reported as 18 days (range: 12 to 30), with 27% not fully available at 28 days. Chest pain at diagnosis was the only symptom associated with time loss longer than 28 days. Finally, canceled competitions or time loss results in grief, stress, and frustration for athletes, as well as loss of a social support network and routine training regimens. Mental health support services may be indicated.
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Webster KE, Klemm HJ, Devitt BM, Whitehead TS, Feller JA. Effect of COVID-19 Social Isolation Policies on Rehabilitation After Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med 2021; 9:23259671211047216. [PMID: 34676273 PMCID: PMC8524713 DOI: 10.1177/23259671211047216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/25/2021] [Indexed: 11/27/2022] Open
Abstract
Background: The coronavirus 2019 (COVID-19) pandemic has had a profound impact on health
care in Australia. To contain the spread of the virus, strict physical
distancing and social isolation policies were implemented from late March
2020. This presented a situation in which patients recovering from anterior
cruciate ligament (ACL) reconstruction had limited access to face-to-face
supervised rehabilitation and rehabilitation facilities. Purpose: To explore the impact of social distancing and isolation policies on
postoperative rehabilitation in patients after ACL reconstruction. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients who had ACL reconstruction from October 2019 until the end of March
2020 (6 months before the implementation of COVID-19 restrictions) completed
an online self-report questionnaire containing 5 sections: utilization of
health care professionals for rehabilitation, frequency of rehabilitation,
patient concerns and attitude, perceived impact on recovery, and changes to
employment status. We compared the responses of patients who had surgery in
2019 with those who had surgery in 2020. Statistical analysis was performed
using frequency statistics and central tendency measures. Results: A total of 185 patients (97 men, 88 women) completed the survey, for a 73%
response rate. Patients had a mean age of 28 years (range, 13-57 years) and
had undergone surgery a mean 4.5 months prior (range, 1.5-8 months). Most
patients (80%) maintained face-to-face rehabilitation, predominantly with a
physical therapist, regardless of whether their surgery took place in 2019
or 2020; rehabilitation with active, supervised exercises was most common.
Almost all patients were performing strengthening exercises (164/185), and
most were performing range-of-motion (139/185) and aerobic (123/185)
activities at their homes. Patients were minimally concerned about access to
supervised rehabilitation and knee reinjury, but they were concerned about
access to equipment. Because of COVID-19, 30% were working from home; 17%
were on reduced hours and 8% on increased hours; 15% were on leave or
unemployed; and 30% reported no change in employment status. Conclusion: Patients who had undergone ACL reconstruction just before or during the first
few months of the COVID-19 pandemic were able to maintain in-person contact
with their health professionals during rehabilitation, and they had a
positive outlook and managed well despite the restrictions.
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Affiliation(s)
- Kate E Webster
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Haydn J Klemm
- OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia
| | - Brian M Devitt
- OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia
| | | | - Julian A Feller
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia
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