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Pedrosa M, Martins B, Araújo R. It's in the game: A review of neurological lesions associated with sports. J Neurol Sci 2023; 455:122803. [PMID: 37995461 DOI: 10.1016/j.jns.2023.122803] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION The practice of sports may lead to neurological injuries. While relatively uncommon (overall incidence of approximately 2.5%), and mostly benign and transient, some conditions may be life-threatening and permanent. Thus, both clinical neurologists and sports physicians should be aware of their existence and relevance. We aimed to review all sports-related neurological injuries and illnesses reported in the literature. METHODS Following SANRA guidelines, we performed a narrative review and searched PubMed and Scopus databases. Relevant sports were selected based on their recognition as an Olympic sport by the International Olympic Committee. Chronic traumatic encephalopathy (CTE) and other neurodegenerative disorders were not included. RESULTS A total of 292 studies were included concerning 33 different sports. The most reported neurological injury was damage to the peripheral nervous system. Traumatic injuries have also been extensively reported, including cerebral haemorrhage and arterial dissections. Non-traumatic life-threatening events are infrequent but may also occur, e.g. posterior reversible encephalopathy syndrome, cerebral venous thrombosis, and arterial dissections. Some conditions were predominantly reported in specific sports, e.g. yips in baseball and golf, raising the possibility of a common pathophysiology. Spinal cord infarction due to fibrocartilaginous embolism was reported in several sports associated with minor trauma. CONCLUSION Sports-related neurological injuries are increasingly receiving more social and medical attention and are an important cause of morbidity and mortality. This review may serve as a guide to physicians managing these challenging situations.
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Affiliation(s)
| | - Bárbara Martins
- Neurology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Clinical Neuroscience and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Rui Araújo
- Neurology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Clinical Neuroscience and Mental Health Department, Faculty of Medicine, University of Porto, Porto, Portugal
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Wei W, Evin M, Bailly N, Arnoux PJ. Biomechanical evaluation of Back injuries during typical snowboarding backward falls. Scand J Med Sci Sports 2023; 33:224-234. [PMID: 36326724 DOI: 10.1111/sms.14254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
To prevent spinal and back injuries in snowboarding, back protector devices (BPDs) have been increasingly used. The biomechanical knowledge for the BPD design and evaluation remains to be explored in snowboarding accident conditions. This study aims to evaluate back-to-snow impact conditions and the associated back injury mechanisms in typical snowboarding backward falls. A previously validated snowboarder multi-body model was first used to evaluate the impact zones on the back and the corresponding impact velocities in a total of 324 snowboarding backward falls. The biomechanical responses during back-to-snow impacts were then evaluated by applying the back-to-snow impact velocity to a full human body finite element model to fall on the snow ground of three levels of stiffness (soft, hard, and icy snow). The mean values of back-to-snow normal and tangential impact velocities were 2.4 m/s and 7.3 m/s with maximum values up to 4.8 m/s and 18.5 m/s. The lower spine had the highest normal impact velocity during snowboarding backward falls. The thoracic spine was found more likely to exceed the limits of flexion-extension range of motions than the lumbar spine during back-to-snow impacts, indicating a higher injury risk. On the hard and icy snow, rib cage and vertebral fractures were predicted at the costal cartilage and the posterior elements of the vertebrae. Despite the possible back injuries, the back-to-snow impact force was always lower than the force thresholds of the current BPD testing standard. The current work provides additional biomechanical knowledge for the future design of back protections for snowboarders.
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Affiliation(s)
- Wei Wei
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France.,iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
| | - Morgane Evin
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France.,iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
| | - Nicolas Bailly
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France.,iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
| | - Pierre-Jean Arnoux
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France.,iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
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Chaudhari LR, Kawale AA, Desai SS, Kashte SB, Joshi MG. Pathophysiology of Spinal Cord Injury and Tissue Engineering Approach for Its Neuronal Regeneration: Current Status and Future Prospects. Adv Exp Med Biol 2023; 1409:51-81. [PMID: 36038807 DOI: 10.1007/5584_2022_731] [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] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
A spinal cord injury (SCI) is a very debilitating condition causing loss of sensory and motor function as well as multiple organ failures. Current therapeutic options like surgery and pharmacotherapy show positive results but are incapable of providing a complete cure for chronic SCI symptoms. Tissue engineering, including neuroprotective or growth factors, stem cells, and biomaterial scaffolds, grabs attention because of their potential for regeneration and ability to bridge the gap in the injured spinal cord (SC). Preclinical studies with tissue engineering showed functional recovery and neurorestorative effects. Few clinical trials show the safety and efficacy of the tissue engineering approach. However, more studies should be carried out for potential treatment modalities. In this review, we summarize the pathophysiology of SCI and its current treatment modalities, including surgical, pharmacological, and tissue engineering approaches following SCI in preclinical and clinical phases.
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Affiliation(s)
- Leena R Chaudhari
- Department of Stem Cells and Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Akshay A Kawale
- Department of Stem Cells and Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Sangeeta S Desai
- Department of Obstetrics and Gynecology, Dr. D Y Patil Medical College, Hospital and Research Institute, Kolhapur, Maharashtra, India
| | - Shivaji B Kashte
- Department of Stem Cells and Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India
| | - Meghnad G Joshi
- Department of Stem Cells and Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, Maharashtra, India.
- Stem Plus Biotech, SMK Commercial Complex, Sangli, Maharashtra, India.
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Huffman WH, Jia L, Pirruccio K, Li X, Hecht AC, Parisien RL. Acute Vertebral Fractures in Skiing and Snowboarding: A 20-Year Sex-Specific Analysis of National Injury Data. Orthop J Sports Med 2022; 10:23259671221105486. [PMID: 35837441 PMCID: PMC9274405 DOI: 10.1177/23259671221105486] [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: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The epidemiology of acute vertebral fractures (AVFs) sustained while skiing
and snowboarding remains poorly defined in the United States. Hypothesis: It was hypothesized that there would be no significant differences across sex
and a greater number of AVFs in younger age groups associated with skiing
and snowboarding. Study Design: Descriptive epidemiological study. Methods: The authors utilized the National Electronic Injury Surveillance System to
identify patients who were reported in emergency departments in the United
States from 2000 to 2019. All patients were noted to have sustained AVFs
during skiing or snowboarding. National estimates and demographic analysis
were performed. Results: A total of 466 AVFs were identified, or roughly 23.3 AVFs per year. Compared
with women, men accounted for the majority of AVFs sustained in both skiing
and snowboarding: 67.8% (95% CI, 62.6%-73.0%) during skiing and 82.1% (95%
CI, 76.3%-87.8%) during snowboarding. This represented a significantly
larger percentage of AVFs while snowboarding compared with skiing
(P = .002). Women accounted for 32.2% (95% CI,
27.0%-37.4%) of AVFs while skiing and 17.9% (95% CI, 12.2%-23.7%) while
snowboarding, which indicated a significantly larger percentage of AVFs
sustained during skiing compared with snowboarding (P =
.002). Snowboarders were more likely than skiers to sustain an AVF in the
region of the coccyx (21.5% [95% CI, 14.3%-28.7%] vs 11.5% [95% CI,
3.5%-16.9%], respectively; P = .003) and as a result of a
fall at ground level (69.2% [95% CI, 62.1%-76.4%] vs 52.8% [95% CI,
43.2%-62.4%], respectively; P = .009). A significant
decrease in the number of snowboarding-related AVFs was identified over the
20-year study period: 899 in 2000-2003 versus 283 in 2016-2019
(P < .01). The change in skiing-related AVFs over
the study period was not statistically significant (694 vs 462;
P = .5). Conclusion: This national study of AVFs sustained while skiing and snowboarding
identified critical sex- and age-specific differences in the population at
risk, anatomic location of injury, and mechanism of injury. The national
data generated from this study over a 20-year period may be utilized to
better inform public health injury awareness and prevention initiatives in
the rapidly growing sports of skiing and snowboarding.
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Affiliation(s)
- William H Huffman
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lori Jia
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin Pirruccio
- Department of Orthopaedic Surgery, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Xinning Li
- Boston University Medical Center, Boston, Massachusetts, USA
| | - Andrew C Hecht
- Department of Orthopaedic Surgery, Mount Sinai, New York, New York, USA
| | - Robert L Parisien
- Department of Orthopaedic Surgery, Mount Sinai, New York, New York, USA
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杨 渝, 马 骁, 陈 拿, 蒋 艳, 张 晓, 丁 中, 敖 英. [Analysis of the mass skiers' injury in a large ski resort in Chongli, China]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 53:273-278. [PMID: 33879897 PMCID: PMC8072424 DOI: 10.19723/j.issn.1671-167x.2021.02.007] [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] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To make a retrospective analysis of the injuries of skiing population in a large ski resort in Chongli, China and provide a basis for predicting the rapidly increasing medical needs for ski injuries in the context of the 2022 Winter Olympic Games. METHODS The basic data of all injured skiers who were treated in a medical station of a large ski resort in Chongli during the snow season from November 2017 to March 2018 and from November 2018 to March 2019 were collected. The number of skiers, the number of injuries, the causes of injuries, the types of injuries and the locations of injuries were compared. RESULTS A total of 753 skiers were injured in two snow seasons, and the estimated average incidence of injury was 4.53 and 4.46 per 1 000 skier days at the resort respectively. The average daily injury rate per 1 000 skiers in November of the two snow seasons was relatively low, with 2.20 and 1.38 cases respectively. The difference of injury rate in different months might have little to do with snowfall and more to do with passenger flow. In both the snow seasons, men accounted for more injuries than women, and injured skiers aged between 21 and 30 accounted for the largest proportion, reaching 36.8%. The main causes of injuries were falls (76.6%). The highest rate of injury was in the head and neck (17.9%), followed by the knee (17.4%) and wrist and fingers (13.3%). The most common types of injuries were contusion and trauma (29.5%) and joint and/or ligament injuries (22.2%). Children (2-12 years old) accounted for 12.7% of all the injured skiers. The rate of moderate to severe injuries (including fractures, concussions, etc.) was 34.8% among the injured patients over 50 years of age. CONCLUSION The snow resort should focus on injuries to children and elderly skiers and carry out targeted guidance and rescue work. In order to better ensure the medical safety of skiers, the ski resort medical station and nearby treatment hospitals should be equipped with a corresponding number of medical personnel and equipment, and the ski resort should further improve its safety management and rescue system.
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Affiliation(s)
- 渝平 杨
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
- 北京大学第三医院崇礼院区运动医学科,河北张家口 076350Department of Sports Medicine, Peking University Third Hospital-Chongli, Zhangjiakou 076350, Hebei, China
| | - 骁 马
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 拿云 陈
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 艳芳 蒋
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 晓伟 张
- 北京大学第三医院崇礼院区运动医学科,河北张家口 076350Department of Sports Medicine, Peking University Third Hospital-Chongli, Zhangjiakou 076350, Hebei, China
| | - 中伟 丁
- 北京大学第三医院崇礼院区运动医学科,河北张家口 076350Department of Sports Medicine, Peking University Third Hospital-Chongli, Zhangjiakou 076350, Hebei, China
| | - 英芳 敖
- 北京大学第三医院运动医学科,北京大学运动医学研究所,运动医学关节伤病北京市重点实验室,北京 100191Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
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