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Hendricks S, Rotunno A, Gordon L, Ganda J, Zondi PC, Derman W, Holtzhausen L, Falvey ÉC, Janse van Rensburg DCC. Mass-gatherings in sport: medicine, leadership and mentorship. Br J Sports Med 2024; 58:528-530. [PMID: 38580399 DOI: 10.1136/bjsports-2024-108377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Affiliation(s)
- Sharief Hendricks
- University of Cape Town, Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Adrian Rotunno
- University of Cape Town, Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Cape Sports Medicine, Sport Science Institute of South Africa, Cape Town, South Africa, Cape Sports Medicine Sport Science Institute, Cape Town, South Africa
| | - Leigh Gordon
- University of Cape Town, Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Cape Sports Medicine, Sport Science Institute of South Africa, Cape Town, South Africa, Cape Sports Medicine Sport Science Institute, Cape Town, South Africa
| | - Janesh Ganda
- WITS Sport and Health (WiSH), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Phathokuhle Cele Zondi
- High Performance Commission, Medical Advisory Committee, South African Sports Confederation and Olympic Committee, Houghton, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- International Olympic Committee (IOC) Research Centre, Stellenbosch, South Africa
| | - Louis Holtzhausen
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Exercise and Sports Science, University of the Free State, Bloemfontein, South Africa
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2
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Jones B, Tooby J, Weaving D, Till K, Owen C, Begonia M, Stokes KA, Rowson S, Phillips G, Hendricks S, Falvey ÉC, Al-Dawoud M, Tierney G. Ready for impact? A validity and feasibility study of instrumented mouthguards (iMGs). Br J Sports Med 2022; 56:bjsports-2022-105523. [PMID: 35879022 DOI: 10.1136/bjsports-2022-105523] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Assess the validity and feasibility of current instrumented mouthguards (iMGs) and associated systems. METHODS Phase I; four iMG systems (Biocore-Football Research Inc (FRI), HitIQ, ORB, Prevent) were compared against dummy headform laboratory criterion standards (25, 50, 75, 100 g). Phase II; four iMG systems were evaluated for on-field validity of iMG-triggered events against video-verification to determine true-positives, false-positives and false-negatives (20±9 player matches per iMG). Phase III; four iMG systems were evaluated by 18 rugby players, for perceptions of fit, comfort and function. Phase IV; three iMG systems (Biocore-FRI, HitIQ, Prevent) were evaluated for practical feasibility (System Usability Scale (SUS)) by four practitioners. RESULTS Phase I; total concordance correlation coefficients were 0.986, 0.965, 0.525 and 0.984 for Biocore-FRI, HitIQ, ORB and Prevent. Phase II; different on-field kinematics were observed between iMGs. Positive predictive values were 0.98, 0.90, 0.53 and 0.94 for Biocore-FRI, HitIQ, ORB and Prevent. Sensitivity values were 0.51, 0.40, 0.71 and 0.75 for Biocore-FRI, HitIQ, ORB and Prevent. Phase III; player perceptions of fit, comfort and function were 77%, 6/10, 55% for Biocore-FRI, 88%, 8/10, 61% for HitIQ, 65%, 5/10, 43% for ORB and 85%, 8/10, 67% for Prevent. Phase IV; SUS (preparation-management) was 51.3-50.6/100, 71.3-78.8/100 and 83.8-80.0/100 for Biocore-FRI, HitIQ and Prevent. CONCLUSION This study shows differences between current iMG systems exist. Sporting organisations can use these findings when evaluating which iMG system is most appropriate to monitor head acceleration events in athletes, supporting player welfare initiatives related to concussion and head acceleration exposure.
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Affiliation(s)
- Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Leeds Rhinos, Leeds, UK
- Human Biology, University of Cape Town, Division of Exercise and Sports Medicine, Cape Town, South Africa
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
| | - Dan Weaving
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- Leeds Rhinos, Leeds, UK
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Mark Begonia
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Steven Rowson
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Hull Kingston Rovers, Hull, UK
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- Human Biology, University of Cape Town, Division of Exercise and Sports Medicine, Cape Town, South Africa
| | - Éanna Cian Falvey
- World Rugby, World Rugby, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Marwan Al-Dawoud
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
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3
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Rankin A, Massey A, Falvey ÉC, Ellenbecker T, Harcourt P, Murray A, Kinane D, Niesters B, Jones N, Martin R, Roshon M, McLarnon MED, Calder J, Izquierdo D, Pluim BM, Elliott N, Heron N. Infographic. COVID-19 RT-PCR testing for elite athletes. Br J Sports Med 2021; 55:818-820. [PMID: 33455908 PMCID: PMC7817382 DOI: 10.1136/bjsports-2020-103751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 01/24/2023]
Affiliation(s)
- Alan Rankin
- Sports Medicine, SportNI Sports Institute, Newtownabbey, UK
- Sports Medicine NI, Belfast, UK
| | - Andrew Massey
- Medical and Anti-Doping Department, Federation Internationale de Football Association, Zurich, Zürich, Switzerland
| | - Éanna Cian Falvey
- Sport Medicine Department, World Rugby, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | | | - Peter Harcourt
- Australian Football League, Docklands, Victoria, Australia
| | - Andrew Murray
- St Andrew's House Edinburgh, Scottish Government Sport and Physical Activity Policy Team, Edinburgh, Scotland, UK
- Sports Medicine, Scottish Institute of Sport, Stirling, UK
| | - Denis Kinane
- Department of Immunology, University of Bern, Bern, Switzerland
| | - Bert Niesters
- Microbiology, University of Groningen, Groningen, The Netherlands
| | - Nigel Jones
- Medical Department, British Cycling, Manchester, UK
| | - Rhodri Martin
- Sports Medicine, Sport Wales, Cardiff, UK
- Cwm Taf Morgannwg University Health Board, Abercynon, Rhondda Cynon Taf, UK
| | | | | | - James Calder
- Trauma and Orthopaedics, Chelsea and Westminster Hospital, London, UK
| | | | - Babette M Pluim
- Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- AMC/VUmc IOC Research Center of Excellence, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Niall Elliott
- Sports Medicine, Sport Scotland Institute of Sport, Stirling, UK
| | - Neil Heron
- Department of Family Practice, Queen's University Belfast, Belfast, UK
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4
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Raftery M, Falvey ÉC. Rugby's implementation lessons: the importance of a 'compliance wedge' to support successful implementation for injury prevention. Br J Sports Med 2021; 56:1-2. [PMID: 33536194 PMCID: PMC8685659 DOI: 10.1136/bjsports-2020-103454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Martin Raftery
- Medical Department, World Rugby Limited, Dublin, Ireland
| | - Éanna Cian Falvey
- Medical Department, World Rugby Limited, Dublin, Ireland .,Department of Medicine, University College Cork, Cork, Ireland
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5
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Raftery M, Tucker R, Falvey ÉC. Getting tough on concussion: how welfare-driven law change may improve player safety-a Rugby Union experience. Br J Sports Med 2020; 55:bjsports-2019-101885. [PMID: 32796017 PMCID: PMC8108275 DOI: 10.1136/bjsports-2019-101885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Martin Raftery
- Medical, World Rugby, 8-10 Pembroke Street Lower Dublin 2, Ireland
| | - Ross Tucker
- Medical, World Rugby, 8-10 Pembroke Street Lower Dublin 2, Ireland
| | - Éanna Cian Falvey
- Medical, World Rugby, 8-10 Pembroke Street Lower Dublin 2, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
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O'Connor RF, King E, Richter C, Webster KE, Falvey ÉC. No Relationship Between Strength and Power Scores and Anterior Cruciate Ligament Return to Sport After Injury Scale 9 Months After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2020; 48:78-84. [PMID: 31877093 DOI: 10.1177/0363546519887952] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Psychological factors including self-reported readiness to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) measured with the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scale have been shown to correlate with RTS. Physical deficits have been shown to exist in the later stages after ACLR rehabilitation. No previous studies have investigated the relationship between self-reported readiness to RTS and objective physical measures of power and strength. PURPOSE To investigate the relationship between ACL-RSI scores and measures of strength and power scores after ACLR. STUDY DESIGN Case control study; Level of evidence, 3. METHODS This study recruited 452 male athletes who had undergone primary ACLR. Each athlete completed the ACL-RSI questionnaire, isokinetic strength testing, and jump testing approximately 9 months after surgery. RESULTS ACL-RSI scores showed a trivial or weak correlation with strength and power measures at 9 months after surgery (r = 0.06-0.16). Similar results were found for the relationship between ACL-RSI scores and limb symmetry index for strength and power measures (r = 0.04-0.15). Comparing the strength and power measures of athletes with higher (≥90) ACL-RSI scores (n = 93) versus athletes with lower (≤75) ACL-RSI scores (n = 92) showed no significant differences except for isokinetic hamstring strength, but with a trivial effect size (P = .040; effect size = 0.15). CONCLUSION Self-reported readiness to RTS as measured by the ACL-RSI had little or no relationship with athletes' strength and power measures, and there was no meaningful difference in strength and power between athletes with higher and lower ACL-RSI scores at 9 months after ACLR. The findings suggest that psychological recovery and physical recovery after ACLR are different constructs, and strategies to measure and address each construct separately may be necessary to ensure successful RTS after ACLR.
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Affiliation(s)
- Richard F O'Connor
- Department of Medicine, University College Cork, Cork, Republic of Ireland.,Sports Medicine Research Department, Sports Surgery Clinic, Santry Demesne, Dublin, Republic of Ireland
| | - Enda King
- Sports Medicine Research Department, Sports Surgery Clinic, Santry Demesne, Dublin, Republic of Ireland
| | - Chris Richter
- Sports Medicine Research Department, Sports Surgery Clinic, Santry Demesne, Dublin, Republic of Ireland
| | - Kate E Webster
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Éanna Cian Falvey
- Department of Medicine, University College Cork, Cork, Republic of Ireland.,Sports Medicine Research Department, Sports Surgery Clinic, Santry Demesne, Dublin, Republic of Ireland
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Miles JJ, King E, Falvey ÉC, Daniels KAJ. Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction. Scand J Med Sci Sports 2019; 29:1212-1222. [DOI: 10.1111/sms.13441] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/03/2019] [Accepted: 04/18/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Joshua J. Miles
- Sports Medicine Research Department Sports Surgery Clinic Dublin Ireland
- Department for Health University of Bath Bath UK
| | - Enda King
- Sports Medicine Research Department Sports Surgery Clinic Dublin Ireland
- Department of Life Sciences University of Roehampton London UK
| | - Éanna Cian Falvey
- Sports Medicine Research Department Sports Surgery Clinic Dublin Ireland
- Department of Medicine University College Cork Cork Ireland
| | - Katherine A. J. Daniels
- Sports Medicine Research Department Sports Surgery Clinic Dublin Ireland
- Queen’s School of Engineering University of Bristol Bristol UK
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Davis GA, Makdissi M, Bloomfield P, Clifton P, Echemendia RJ, Falvey ÉC, Fuller GW, Green G, Harcourt P, Hill T, McGuirk N, Meeuwisse W, Orchard J, Raftery M, Sills AK, Solomon GS, Valadka A, McCrory P. International consensus definitions of video signs of concussion in professional sports. Br J Sports Med 2019; 53:1264-1267. [PMID: 30954947 DOI: 10.1136/bjsports-2019-100628] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 01/24/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The use of video to assist professional sporting bodies with the diagnosis of sport-related concussion (SRC) has been well established; however, there has been little consistency across sporting codes with regards to which video signs should be used, and the definitions of each of these signs. AIM The aims of this study were to develop a consensus for the video signs considered to be most useful in the identification of a possible SRC and to develop a consensus definition for each of these video signs across the sporting codes. METHODS A brief questionnaire was used to assess which video signs were considered to be most useful in the identification of a possible concussion. Consensus was defined as >90% agreement by respondents. Existing definitions of these video signs from individual sports were collated, and individual components of the definitions were assessed and ranked. A modified Delphi approach was then used to create a consensus definition for each of the video signs. RESULTS Respondents representing seven sporting bodies (Australian Football League, Cricket Australia, Major League Baseball, NFL, NHL, National Rugby League, World Rugby) reached consensus on eight video signs of concussion. Thirteen representatives from the seven professional sports ranked the definition components. Consolidation and refinement of the video signs and their definitions resulted in consensus definitions for six video signs of possible concussion: lying motionless, motor incoordination, impact seizure, tonic posturing, no protective action-floppy and blank/vacant look. CONCLUSIONS These video signs and definitions have reached international consensus, are indicated for use by professional sporting bodies and will form the basis for further collaborative research.
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Affiliation(s)
- Gavin A Davis
- Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia .,Neurosurgery, Cabrini Hospital, Malvern, Victoria, Australia
| | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
| | - Paul Bloomfield
- National Rugby League (NRL), Sydney, New South Wales, Australia
| | | | | | | | - Gordon Ward Fuller
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Gary Green
- Major League Baseball, New York, New York, USA
| | - Peter Harcourt
- Australian Football League, Melbourne, Victoria, Australia
| | - Thomas Hill
- Cricket Australia, Melbourne, Victoria, Australia
| | - Nathan McGuirk
- National Rugby League, Sydney, New South Wales, Australia
| | | | - John Orchard
- Cricket Australia, Sydney, New South Wales, Australia
| | | | | | | | | | - Paul McCrory
- Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
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9
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Davis GA, Makdissi M, Bloomfield P, Clifton P, Echemendia RJ, Falvey ÉC, Fuller GW, Green G, Harcourt PR, Hill T, McGuirk N, Meeuwisse W, Orchard JW, Raftery M, Sills AK, Solomon GS, Valadka A, McCrory P. International study of video review of concussion in professional sports. Br J Sports Med 2018; 53:1299-1304. [DOI: 10.1136/bjsports-2018-099727] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 11/03/2022]
Abstract
BackgroundVideo review has become an important tool in professional sporting codes to help sideline identification and management of players with a potential concussion.AimTo assess current practices related to video review of concussion in professional sports internationally, and compare protocols and diagnostic criteria used to identify and manage potential concussions.MethodsCurrent concussion management guidelines from professional national and international sporting codes were reviewed. Specific criteria and definitions of video signs associated with concussion were compared between codes. Rules and regulations adopted across the codes for processes around video review were also assessed.ResultsSix sports with specific diagnostic criteria and definitions for signs of concussion identified on video review participated in this study (Australian football, American football, world rugby, cricket, rugby league and ice hockey). Video signs common to all sports include lying motionless/loss of responsiveness and motor incoordination. The video signs considered by the majority of sports as most predictive of a diagnosis of concussion include motor incoordination, impact seizure, tonic posturing and lying motionless. Regulatory requirements, sideline availability of video, medical expertise of video reviewers and use of spotters differ across sports and geographical boundaries. By and large, these differences reflect a pragmatic approach from each sport, with limited underlying research and development of the video review process in some instances.ConclusionsThe use of video analysis in assisting medical staff with the diagnosis or identification of potential concussion is well established across different sports internationally. The diagnostic criteria used and the expertise of the video review personnel are not clearly established, and research efforts would benefit from a collaborative harmonisation across sporting codes.
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Patricios JS, Ardern CL, Hislop MD, Aubry M, Bloomfield P, Broderick C, Clifton P, Echemendia RJ, Ellenbogen RG, Falvey ÉC, Fuller GW, Grand J, Hack D, Harcourt PR, Hughes D, McGuirk N, Meeuwisse W, Miller J, Parsons JT, Richiger S, Sills A, Moran KB, Shute J, Raftery M. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations. Br J Sports Med 2018; 52:635-641. [PMID: 29500252 PMCID: PMC5931244 DOI: 10.1136/bjsports-2018-099079] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 01/25/2023]
Abstract
The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement's themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published.
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Affiliation(s)
- Jon S Patricios
- University of Pretoria, Section of Sports Medicine, Faculty of Health Sciences, Johannesburg, South Africa
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clare L Ardern
- Department of Physiotherapy, Linköping University, Linköping, Sweden
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | | | - Mark Aubry
- International Ice Hockey Federation, Zurich, Switzerland
| | | | | | - Patrick Clifton
- Australian Football League, Melbourne, Victoria, Australia
- Australian Institute of Sport, Canberra, Australia
| | - Ruben J Echemendia
- National Hockey League, New York, USA
- University Orthopedic Center, Concussion Care Clinic, State College, Pennsylvania, USA
- University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Richard G Ellenbogen
- National Football League, New York, USA
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | | | - Gordon Ward Fuller
- Centre for Urgent and Emergency Care Research, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Dallas Hack
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | | | - David Hughes
- Australian Football League, Melbourne, Victoria, Australia
- Australian Institute of Sport, Canberra, Australia
| | - Nathan McGuirk
- National Rugby League, Sydney, New South Wales, Australia
| | | | | | - John T Parsons
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | | | - Allen Sills
- National Football League, New York, USA
- Fédération Equestre Internationale, Lausanne, Switzerland
| | | | - Jenny Shute
- Fédération Internationale de Ski, Oberhofen and Thunersee, Switzerland
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Falvey ÉC, King E, Kinsella S, Franklyn-Miller A. Athletic groin pain (part 1): a prospective anatomical diagnosis of 382 patients--clinical findings, MRI findings and patient-reported outcome measures at baseline. Br J Sports Med 2015; 50:423-30. [PMID: 26626272 PMCID: PMC4819645 DOI: 10.1136/bjsports-2015-094912] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/16/2022]
Abstract
Background Athletic groin pain remains a common field-based team sports time-loss injury. There are few reports of non-surgically managed cohorts with athletic groin pain. Aim To describe clinical presentation/examination, MRI findings and patient-reported outcome (PRO) scores for an athletic groin pain cohort. Methods All patients had a history including demographics, injury duration, sport played and standardised clinical examination. All patients underwent MRI and PRO score to assess recovery. A clinical diagnosis of the injured anatomical structure was made based on these findings. Statistical assessment of the reliability of accepted standard investigations undertaken in making an anatomical diagnosis was performed. Result 382 consecutive athletic groin pain patients, all male, enrolled. Median time in pain at presentation was (IQR) 36 (16–75) weeks. Most (91%) played field-based ball-sports. Injury to the pubic aponeurosis (PA) 240 (62.8%) was the most common diagnosis. This was followed by injuries to the hip in 81 (21.2%) and adductors in 56 (14.7%) cases. The adductor squeeze test (90° hip flexion) was sensitive (85.4%) but not specific for the pubic aponeurosis and adductor pathology (negative likelihood ratio 1.95). Analysed in series, positive MRI findings and tenderness of the pubic aponeurosis had a 92.8% post-test probability. Conclusions In this largest cohort of patients with athletic groin pain combining clinical and MRI diagnostics there was a 63% prevalence of PA injury. The adductor squeeze test was sensitive for athletic groin pain, but not specific individual pathologies. MRI improved diagnostic post-test probability. No hernia or incipient hernia was diagnosed. Clinical trial registration number NCT02437942.
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Affiliation(s)
- É C Falvey
- Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Ireland Department of Medicine, University College Cork, Cork, Ireland
| | - E King
- Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Ireland Department of Life Sciences, Roehampton University Dublin, London, UK
| | - S Kinsella
- Department of Medicine, University College Cork, Cork, Ireland
| | - A Franklyn-Miller
- Sports Medicine Research Department, Sports Surgery Clinic, Dublin, Ireland Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia
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