PCOM Library / Hot Topics in Research / Archive for "Sports Medicine"

Category: Sports Medicine

Hot Topics: Training Muscles Before Surgery Eases Autotransplantation

Jackie Werner Hot Topics in Research, Pediatrics, Sports Medicine, Surgery

Perspectives for the Use of Neurotechnologies in Conjunction With Muscle Autotransplantation in Children

Blagovechtchenski E, Agranovich O, Kononova Y, Nazarova M, Nikulin VV. Perspectives for the use of neurotechnologies in conjunction with muscle autotransplantation in children. Frontiers in Neuroscience. 2019;13:99. https://doi.org/10.3389/fnins.2019.00099

Muscles autotransplantation is an important way to restore motor activity in case of injury or diseases associated with a loss of muscles ability. One of the typical examples of such pathology is arthrogryposis multiplex congenita (AMC). Arthrogryposis is one of the most serious congenital malformations of the musculoskeletal system. It is characterized by the presence of two or more major joint contractures, muscle damage, and motoneuronal dysfunction in the anterior horns of the spinal cord. One of the main problems that determines the limitation or even impossibility of self-care of patients suffering from arthrogryposis is the lack of active movements in the upper limb joints, which can be restored by autotransplantation of the muscles of various donor areas (Hall, 1997Bamshad et al., 2009Loeffler and Lewis, 2016).

Hot Topics: Existing Cupping Therapy Research Inconclusive on Benefits or Drawbacks

Jackie Werner Alternative and Complementary Medicine, Hot Topics in Research, Sports Medicine

Effects of Cupping Therapy in Amateur and Professional Athletes: Systematic Review of Randomized Controlled Trials

Bridgett R, Klose P, Duffield R, Mydock S, Lauche R. Effects of cupping therapy in amateur and professional athletes: Systematic review of randomized controlled trials. The Journal of Alternative and Complementary Medicine. 2017. https://doi.org/10.1089/acm.2017.0191.

Objective: Despite the recent re-emergence of the process of cupping by athletes, supporting evidence for its efficacy and safety remains scarce. This systematic review aims to summarize the evidence of clinical trials on cupping for athletes.

Methods: SCOPUS, Cochrane Library, PubMed, AMED, and CNKI databases were searched from their inception to December 10, 2016. Randomized controlled trials on cupping therapy with no restriction regarding the technique, or cointerventions, were included, if they measured the effects of cupping compared with any other intervention on health and performance outcomes in professionals, semi-professionals, and leisure athletes. Data extraction and risk of bias assessment using the Cochrane Risk of Bias Tool were conducted independently by two pairs of reviewers.

Results: Eleven trials with n = 498 participants from China, the United States, Greece, Iran, and the United Arab Emirates were included, reporting effects on different populations, including soccer, football, and handball players, swimmers, gymnasts, and track and field athletes of both amateur and professional nature. Cupping was applied between 1 and 20 times, in daily or weekly intervals, alone or in combination with, for example, acupuncture. Outcomes varied greatly from symptom intensity, recovery measures, functional measures, serum markers, and experimental outcomes. Cupping was reported as beneficial for perceptions of pain and disability, increased range of motion, and reductions in creatine kinase when compared to mostly untreated control groups. The majority of trials had an unclear or high risk of bias. None of the studies reported safety.

Conclusions: No explicit recommendation for or against the use of cupping for athletes can be made. More studies are necessary for conclusive judgment on the efficacy and safety of cupping in athletes.

Hot Topics: CTE Caused by Head Impact, Not Concussions

Jackie Werner Hot Topics in Research, Neurology, Sports Medicine

Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model

Tagge C,A., Fisher A,M., Minaeva O,V., et al. Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model. Brain. 2018. doi: 10.1093/brain/awx350.

The mechanisms underpinning concussion, traumatic brain injury, and chronic traumatic encephalopathy, and the relationships between these disorders, are poorly understood. We examined post-mortem brains from teenage athletes in the acute-subacute period after mild closed-head impact injury and found astrocytosis, myelinated axonopathy, microvascular injury, perivascular neuroinflammation, and phosphorylated tau protein pathology. To investigate causal mechanisms, we developed a mouse model of lateral closed-head impact injury that uses momentum transfer to induce traumatic head acceleration. Unanaesthetized mice subjected to unilateral impact exhibited abrupt onset, transient course, and rapid resolution of a concussion-like syndrome characterized by altered arousal, contralateral hemiparesis, truncal ataxia, locomotor and balance impairments, and neurobehavioural deficits. Experimental impact injury was associated with axonopathy, blood–brain barrier disruption, astrocytosis, microgliosis (with activation of triggering receptor expressed on myeloid cells, TREM2), monocyte infiltration, and phosphorylated tauopathy in cerebral cortex ipsilateral and subjacent to impact. Phosphorylated tauopathy was detected in ipsilateral axons by 24 h, bilateral axons and soma by 2 weeks, and distant cortex bilaterally at 5.5 months post-injury. Impact pathologies co-localized with serum albumin extravasation in the brain that was diagnostically detectable in living mice by dynamic contrast-enhanced MRI. These pathologies were also accompanied by early, persistent, and bilateral impairment in axonal conduction velocity in the hippocampus and defective long-term potentiation of synaptic neurotransmission in the medial prefrontal cortex, brain regions distant from acute brain injury. Surprisingly, acute neurobehavioural deficits at the time of injury did not correlate with blood–brain barrier disruption, microgliosis, neuroinflammation, phosphorylated tauopathy, or electrophysiological dysfunction. Furthermore, concussion-like deficits were observed after impact injury, but not after blast exposure under experimental conditions matched for head kinematics. Computational modelling showed that impact injury generated focal point loading on the head and seven-fold greater peak shear stress in the brain compared to blast exposure. Moreover, intracerebral shear stress peaked before onset of gross head motion. By comparison, blast induced distributed force loading on the head and diffuse, lower magnitude shear stress in the brain. We conclude that force loading mechanics at the time of injury shape acute neurobehavioural responses, structural brain damage, and neuropathological sequelae triggered by neurotrauma. These results indicate that closed-head impact injuries, independent of concussive signs, can induce traumatic brain injury as well as early pathologies and functional sequelae associated with chronic traumatic encephalopathy. These results also shed light on the origins of concussion and relationship to traumatic brain injury and its aftermath.