Reruptures, Reinjuries, and Revisions at a Minimum 2-Year Follow-up: A Randomized Clinical Trial Comparing 3 Graft Types for ACL Reconstruction
Objective: To evaluate the predictive factors for traumatic rerupture, reinjury, and atraumatic graft failure of anterior cruciate ligament (ACL) reconstruction at a minimum 2-year follow-up. Design: Double-blind randomized clinical trial (RCT) with intraoperative computer-generated allocation. Setting: University-based orthopedic referral practice. Patients: Three hundred thirty patients with isolated ACL deficiency were equally randomized to (1) patellar tendon (PT; mean, 29.2 years), (2) quadruple-stranded hamstring tendon (HT; mean, 29.0 years), and (3) double bundle using HT (DB; mean, 28.8 years). Three hundred tw...
Source: Clinical Journal of Sport Medicine - March 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Australasian College of Sports Physicians—Position Statement: The Place of Mesenchymal Stem/Stromal Cell Therapies in Sport and Exercise Medicine
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - March 1, 2016 Category: Sports Medicine Tags: Position Statement Source Type: research

In Response to: Sport-Related Concussion Reporting and State Legislative Effects
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Letters to the Editor Source Type: research

In Response to: Detecting Impairment Postconcussion Using Reliable Change Indices
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Letters to the Editor Source Type: research

In Response to: Incidence of Exercise-Associated Hyponatremia and Its Association With Nonosmotic Stimuli of Arginine Vasopressin in the GNW100s Ultraendurance Marathon
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Letters to the Editor Source Type: research

Subchondral Impaction Fractures of the Medial Femoral Condyle in Weightlifters: A Report of 5 Cases
Abstract: Although subchondral impaction fractures have already been reported in the non–weight-bearing portion of the lateral femoral condyle, this study reveals the presence of an intra-articular impaction fracture of the postero-superior region of the non–weight-bearing portion of the medial femoral condyle recognized in 5 of a group of 22 representatives of the Polish national Olympic weightlifting team, who underwent 1.5T magnetic resonance imaging examination. Articular cartilage lesions varied with regard to the type of injury and its severity ranging from healed or subchronic injuries to acute trauma. A...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Case Report Source Type: research

De Novo Cerebral Palsy Diagnosis in 9-Year-Old Soccer Player Presenting With Knee Pain
Abstract: A 9-year-old boy presented to our outpatient specialized sport and exercise medicine clinic complaining of a subacute onset of unilateral knee pain, after an increased level of soccer training. His knee examination was unremarkable. However, he demonstrated significant tenderness on palpation of his ipsilateral hip flexor and adductor tendons. Abnormalities in muscle tone and difficulty in relaxing and resisting the examiner properly were noted and lead to a complete neurological examination. It demonstrated multiple abnormalities such as increased tone and deep tendon reflexes, greater in lower than upper extrem...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Case Report Source Type: research

Strength Asymmetry Between Front and Rear Leg in Elite Snowboard Athletes
Objective: To examine possible bilateral strength asymmetries between the front (FL) and the rear leg (RL) in elite snowboard athletes due to the imposed asymmetrical position on the board. Design: Observational study. Setting: Department of Biomedical Sciences for Health, University of Milan. Participants: Thirty-three elite male snowboarders: 12 alpine athletes (SBalp), 11 snowboardcross athletes (SBx), and 10 freestyle athletes (SBfs). Intervention: Open and closed kinetic chain exercises. Main Outcome Measures: Maximal isometric voluntary contraction (MVC) and vertical jump force (VJFT). Results: Only SBalp athle...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Brief Report Source Type: research

Wobble Board Rehabilitation for Improving Balance in Ankles With Chronic Instability
Conclusions: These findings demonstrate that a single intervention using a wobble board improved static and dynamic balance deficits associated with CAI. Clinical Relevance: This approach provides a potentially more economical, time efficient, and space efficient means of improving clinical outcome measures associated with CAI in patients who are physically active. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Validity and Reliability of the 6-Minute Step Test in Healthy Individuals: A Cross-sectional Study
Objective: To determine the 6-minute step test's (6MST) reliability and validity and to establish reference performance values of this test. Design: Prospective observational cross-sectional study. Setting: Spirometry and Respiratory Physiotherapy Laboratory, Federal University of São Carlos (institutional). Participants: Ninety-one individuals [42 men and 49 women, mean age = 39 years (SD, 17 years)] without any diagnosed diseases and with normal exercise capacity [6-minute walk test (6MWT)>75% of the predicted normal]. Independent Variables: Participants underwent two 6MST on 1 day and two 6MWT on another d...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Effectiveness Analysis of Active Stretching Versus Active Stretching Plus Low-Frequency Electrical Stimulation in Children Who Play Soccer and Who Have the Short Hamstring Syndrome
Objective: To determine the effectiveness of active stretching (AS) versus AS plus electrical stimulation (stretching + TENS) in young soccer players with the short hamstring syndrome (SHS). Design: Randomized, controlled, single-blind parallel clinical trial with 3 arms and a 2-month follow-up. The assignment ratio was 1:1:1. Setting: The study involved young federated soccer players in the town of Jumilla, in the region of Murcia (Spain), who were controlled in a physiotherapy office in 2012. Participants: Fifty-one young soccer players (10-16 years) with SHS. Interventions: Stretching + TENS, AS, and conventional st...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Head and Trunk Acceleration During Intermediate Transport on Medical Utility Vehicles
Conclusions: Varying head and trunk accelerations exist in healthy spine-boarded participants during transport on medical utility vehicles dependent on surface and vehicle type. Clinical Relevance: Intermediate transport vehicles vary in their ability to mitigate perturbations conveyed to the patient from the terrain travelled over. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion
Conclusions: The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. Clinical Relevance: The weak-to-moderate relationships warrant the continuous use of multiple domains of assessment. A better understanding to the relationships between the domains of functioning after concussion may improve the overall management approach for adolescents with concussion. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Orthostatic Intolerance and Autonomic Dysfunction in Youth With Persistent Postconcussion Symptoms: A Head-Upright Tilt Table Study
Objective: To explore head-upright tilt table (HUT) signs of autonomic dysfunction in a cohort of youth with persistent postconcussion symptoms (PCSs) that include light-headedness and to correlate repeat tilt table results with symptom improvements for those patients found to have postural tachycardia syndrome (POTS) on initial testing. Design: Prospective cohort design. Setting: Nationwide Children's Hospital, Neurology Clinic. Participants: Thirty-four patients (13-18 years of age) with persistent PCSs. Main Outcome Measures: All patients underwent at least 1 tilt table test. The PCS Interview (PCS-I) and patient ra...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Sport-Related Concussion Reporting and State Legislative Effects
Conclusions: Rates of concussion for 1 sport season have not changed significantly over the past 14 years. The percentage of concussions that are reported to someone has increased significantly. Awareness of the Wisconsin state law does not fully account for the increase in concussion reporting. Clinical Relevance: Given the finite amount of knowledge regarding the influence of concussion-related cultural and legal changes, these findings will help to inform clinicians of the current concussion milieu from the perspective of athletes. It will inform practitioners involved in concussion management to what extent athletes a...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Short-Term Effectiveness of Precut Kinesiology Tape Versus an NSAID as Adjuvant Treatment to Exercise for Subacromial Impingement: A Randomized Controlled Trial
Conclusions: The improvements in pain and function observed with an NSAID or PCT as adjuvant treatments were no greater than with rehabilitation exercise alone. If adjuvant treatment is desired, PCT seems to be better tolerated than an NSAID, although the difference did not reach significance. Clinical Relevance: The routine addition of adjuvant treatment is not supported by the results of this study. As adjuvant therapy, PCT seems to be better tolerated than an NSAID. If desired, clinicians may consider incorporating PCT along with an exercise component in the conservative treatment of SAI syndrome. (Source: Clinical Jou...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

Double-Blind Randomized Controlled Trial: Injection of Autologous Blood in the Treatment of Chronic Patella Tendinopathy—A Pilot Study
Conclusions: This study demonstrated that both the ABI and saline groups experienced a significant improvement in symptoms. However, when the results were compared, there was no statistical difference between the 2 groups. Clinical Relevance: This research showed that tendon fenestration is an alternative cost-effective treatment for recalcitrant PT. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

High-Volume Image-Guided Injection for Recalcitrant Patellar Tendinopathy in Athletes
Conclusions: High-volume injection at the interface between the deep surface of the patellar tendon and Hoffa body improves in the short-term symptoms and function of the knee. Clinical Relevance: This procedure is minimally invasive, safe, and effective in the short term in athletes. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Original Research Source Type: research

AMSSM Scientific Statement Concerning Viscosupplementation Injections for Knee Osteoarthritis: Importance for Individual Patient Outcomes
Objective: Osteoarthritis (OA) is a disabling disease that produces severe morbidity reducing physical activity. Our position statement on treatment of knee OA with viscosupplementation injection [hyaluronic acid (HA)] versus steroid [intra-articular corticosteroid (IAS)] and placebo [intra-articular placebo (IAP)] is based on the evaluation of treatment effect by examining the number of subjects within a treatment arm that met the Outcome Measures in Rheumatoid Arthritis Clinical Trials–Osteoarthritis Research Society International (OMERACT-OARSI) criteria, which is different and more relevant than methods used in o...
Source: Clinical Journal of Sport Medicine - January 1, 2016 Category: Sports Medicine Tags: Position Statement Source Type: research

Tenosynovial Osteochondromatosis of the Flexor Hallucis Longus in a Division I Tennis Player
We present a case of TC in a Division I tennis player. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Case Report Source Type: research

Two Cases of Rhabdomyolysis After Training With Electromyostimulation by 2 Young Male Professional Soccer Players
We report 2 cases of enormously elevated creatine kinase (CK) activity after training with electromyostimulation (EMS) by 2 young male professional soccer players. In one of them, a single training session with EMS caused exercise-induced rhabdomyolysis with a maximal CK activity of 240 000 U/L. These cases illustrate that unaccustomed EMS exercise may be harmful and can cause rhabdomyolysis even in highly trained athletes and even after 1 single session. Thus, EMS has to be conducted carefully especially by individuals who are known to frequently show notable increases in CK activity even after modest training stim...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Case Report Source Type: research

Handbook of Sports Medicine and Science, Gymnastics
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Book Review Source Type: research

Erratum: Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Errata Source Type: research

Erratum: Medical Evaluation for Exposure Extremes: Cold
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Errata Source Type: research

Relationship Between Training Intensity and Volume and Hypothyroidism Among Female Runners
Conclusions: Our results do not support the concept of overtraining-related hypothyroidism among nonelite female distance runners although our data demonstrated a 3-fold increase in hypothyroidism among those who began a career at or before age 10. Further study is required to confirm and determine a possible mechanism of this association. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Brief Report Source Type: research

Cardiovascular and Musculoskeletal Assessment of Elite US Volleyball Players
Conclusions: The prevalence of aortic root dilation in this population of athletes was higher than what has previously been reported in other similar populations. Further study is needed to determine whether these represent pathological changes or normal variations in tall athletes. Clinical Relevance: This study adds to the existing knowledge base of athlete's heart, with specific attention to aortic dimensions in elite volleyball players. The data are relevant to similar athletes' medical care and to preparticipation cardiac screening in general. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Effects of Static Stretching and Playing Soccer on Knee Laxity
This study investigated exercise-induced effects of static stretching and playing soccer on anterior tibial translation (ATT) of the knee joint. Design: Randomized controlled trial. Setting: University biomechanics laboratory. Participants: Thirty-one athletes were randomly assigned into a stretching (26.9 ± 6.2 years, 1.77 ± 0.09 m, 67.9 ± 10.7 kg) and a control group (27.9 ± 7.4 years, 1.75 ± 0.08 m, 72.0 ± 14.9 kg). Thirty-one amateur soccer players in an additional soccer group (25.1 ± 5.6 years, 1.74 ± 0.10 m, 71.8 ± 14.8 kg). All participants had no histo...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Long-term Low-to-Intensive Cycling Training: Impact on Semen Parameters and Seminal Cytokines
Objective: To examine the effects of long-term low-to-intensive cycling training on seminal cytokines and semen parameters in male road cyclists. Design: Repeated measures design. Setting: The Exercise Physiology Laboratory of the Urmia University. Participants: Twenty-four healthy nonprofessional male road cyclists (23.1 ± 6.2 years) participated in this study. Interventions: All subjects participated in a 16-week low-to-intensive cycling training. The semen samples were collected, respectively, at baseline (T1), immediately (T2), 12 (T3), and 24 (T4) hours after the last training session in week 8; immediately (T5...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Predictors of Frontal Plane Knee Moments During Side-Step Cutting to 45 and 110 Degrees in Men and Women: Implications for Anterior Cruciate Ligament Injury
Conclusions: Cutting tasks with larger redirection demands result in greater knee valgus moments. Similar factors, including shear GRFs, hip internal rotation, and knee valgus position contribute to knee valgus loading during cuts performed to smaller (45 degrees) and larger (110 degrees) angles. Clinical Relevance: Reducing vertical and shear GRFs during cutting maneuvers may reduce knee valgus moments and thereby potentially reduce risk for anterior cruciate ligament injury. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Safety and Efficacy of Autologous Intra-articular Platelet Lysates in Early and Intermediate Knee Osteoarthrosis in Humans: A Prospective Open-Label Study
Objective: To explore the safety and benefit from intra-articular autologous platelet lysate (PL) injection in early and intermediate knee osteoarthritis. Design: Open-label prospective study. Setting: Laboratory. Patients: Adult patients, aged 35 to 70 years, with a history of chronic pain or swelling on one or both knees and imaging findings (radiograph or magnetic resonance imaging) of degenerative changes in the joint of grade I or II on the Kellgren scale were included. Interventions: Autologous PL was given in the knee joint by percutaneous intra-articular route every 3 weeks for a total of 3 injections. Main Outcome...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength
Conclusions: Data suggest that an LBPP-supported low-load exercise regimen can be used to significantly diminish knee pain, enhance joint function, and increase thigh muscle strength, while safely promoting pain-free walking exercise in overweight patients with knee OA. These findings have important implications for the development of nonoperative treatment strategies that can be used in the management of joint symptoms associated with progressive knee OA in at-risk patient populations. Clinical Relevance: This research suggests that LBPP-supported low-load walking is a safe user-friendly mode of exercise that can be succe...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Efficacy of Hip Strengthening Exercises Compared With Leg Strengthening Exercises on Knee Pain, Function, and Quality of Life in Patients With Knee Osteoarthritis
Conclusions: Isolated hip and leg strengthening exercise programs seem to similarly improve knee pain, function, and QOL in patients with KOA. Clinical Relevance: The results of this study show that both hip and leg strengthening exercises improve pain and QOL in patients with KOA and should be incorporated into the exercise prescription of patients with KOA. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Characteristics of Pediatric and Adolescent Concussion Clinic Patients With Postconcussion Amnesia
Conclusions: This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance: Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Does Visual Performance Influence Head Impact Severity Among High School Football Athletes?
Conclusions: Better visual performance did not reduce the odds of sustaining higher magnitude head impacts. Visual performance may play less of a role than expected for protecting against higher magnitude head impacts among high school football players. Further research is needed to determine whether visual performance influences concussion risk. Clinical Relevance: Based on our results, we do not recommend using visual training programs at the high school level for the purpose of reducing the odds of sustaining higher magnitude head impacts. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Effects of Off-Axis Elliptical Training on Reducing Pain and Improving Knee Function in Individuals With Patellofemoral Pain
Conclusions: An off-axis elliptical training program was effective in enhancing lower extremity neuromuscular control on the frontal and transverse planes, reducing pain, and improving knee function in persons with PFP. Clinical Relevance: This study provides a novel intervention approach to enhance the control of the frontal and transverse plane motions of the lower extremities during functional weight-bearing activities. This novel off-axis elliptical training may be incorporated with other common treatment options currently available for PFP to augment the effects of musculoskeletal rehabilitation for the PFP population...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Additional Effects of an Individualized Risk Factor–Based Approach on Pain and the Function of Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial
Conclusions: Assessment and modification of the risk factors may add to the treatment effects on pain and function at a 12-week follow-up in patients with PFPS. These findings may lead to a more comprehensive clinical approach to this very common problem. Clinical Relevance: It seems that incorporating risk factor assessment into our clinical practice may add to treatment effects with regard to pain and function in patients with PFPS. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Limitations of Current AHA Guidelines and Proposal of New Guidelines for the Preparticipation Examination of Athletes
Objective: To examine the prevalence of athletes who screen positive with the preparticipation examination guidelines from the American Heart Association, the AHA 12-elements, in combination with 3 screening electrocardiogram (ECG) criteria. Design: Observational cross-sectional study. Setting: Stanford University Sports Medicine Clinic. Participants: Total of 1596 participants, including 297 (167 male; mean age, 16.2 years) high school athletes, 1016 (541 male; mean age, 18.8 years) collegiate athletes, and 283 (mean age, 26.3 years) male professional athletes. Main Outcome Measures: Athletes were screened using the 8 per...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

The Psychological Impact of Cardiovascular Screening in Young Athletes: Perspectives Across Age, Race, and Gender
Objective: To determine the psychological impact of electrocardiogram (ECG) screening in young competitive athletes based on age, race, and gender. Design: Prospective multisite cross-sectional investigation. Setting: Young competitive athletes. Patients: One thousand five hundred six high school athletes (59.3% male with a mean age of 15.5 years, 56.2% white, 24.5% African American). Independent Variables: Athletes underwent screening with a standardized American Heart Association-based history, physical examination, and ECG. Main Outcome Measures: Prescreen and postscreen validated assessments for health attitudes, anxie...
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Original Research Source Type: research

Skidding at Speed: The Ethics of Head Protection While Skiing
No abstract available (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - November 1, 2015 Category: Sports Medicine Tags: Editorial Source Type: research

Counseling for the Wilderness Athlete and Adventurer During a Preparticipation Evaluation for Preparation, Safety, and Injury Prevention
The objective was to present findings of this review and make recommendations on the counseling component of a wilderness sports/adventure PPE. The counseling component of a PPE for wilderness sports/adventures should take place after a basic medical evaluation, and include a discussion on sport or activity-specific injury prevention, personal health, travel recommendations, and emergency event planning. Counseling should be individualized and thorough, and involve shared decision making. This should take place early enough to allow ample time for the athlete or adventurer to further prepare as needed based on the recommen...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Wilderness Preparticipation Evaluation and Considerations for Special Populations
Abstract: Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity part...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Medical Evaluation for Exposure Extremes: Heat
Abstract: Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Medical Evaluation for Exposure Extremes: Cold
Abstract: Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as well as to prevent worsening of preexisting conditions in cold environments using a preparticipation screening history, examination, and counseling. Cold weather exercise can be done safely with education, proper preparation, and appropriate response to changing weather co...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Pre-Participation Medical Evaluation for Adventure and Wilderness Watersports
Abstract: A request for a preparticipation medical evaluation for wilderness watersports may be made by guiding agencies, instructional camps, or by patients presenting for an annual visit. Although guidelines have been published regarding preparticipation physical evaluation for traditional competitive high school and collegiate sports, little has been written about medical evaluations for those wishing to engage in wilderness and adventure watersports. In this article, we offer guidance based on literature review and expert opinion. Watersports are among the most common recreational activities in the United States and ar...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Medical Clearance for Desert and Land Sports, Adventure, and Endurance Events
Abstract: Endurance events are increasing in popularity in wilderness and remote settings, and participants face a unique set of potential risks for participation. The purpose of this article is to outline these risks and allow the practitioner to better guide the wilderness adventurer who is anticipating traveling to a remote or desert environment. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Preparticipation Evaluation for Climbing Sports
Abstract: Climbing is a popular wilderness sport among a wide variety of professional athletes and amateur enthusiasts, and many styles are performed across many environments. Potential risks confront climbers, including personal health or exacerbation of a chronic condition, in addition to climbing-specific risks or injuries. Although it is not common to perform a preparticipation evaluation (PPE) for climbing, a climber or a guide agency may request such an evaluation before participation. Formats from traditional sports PPEs can be drawn upon, but often do not directly apply. The purpose of this article was to incorpora...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Risk Stratification for Athletes and Adventurers in High-Altitude Environments: Recommendations for Preparticipation Evaluation
We present our findings with specific recommendations on risk stratification during a PPE for the high-altitude athlete/adventurer. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

General Medical Considerations for the Wilderness Adventurer: Medical Conditions That May Worsen With or Present Challenges to Coping With Wilderness Exposure
Abstract: Participation in wilderness and adventure sports is on the rise, and as such, practitioners will see more athletes seeking clearance to participate in these events. The purpose of this article is to describe specific medical conditions that may worsen or present challenges to the athlete in a wilderness environment. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

General Consideration in the History, Physical Examination, and Safety Determination
Abstract: A thorough medical history is perhaps the most important aspect when evaluating an athlete before wilderness adventure. A physical examination should follow focusing on conditions that may be affected by changes in atmospheric pressure, extremes of temperature, or altitude. This information can then be used to make safety recommendations ensuring that adventurers are able to safely enjoy participation in the wilderness pursuit of their choice. (Source: Clinical Journal of Sport Medicine)
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research

Ethical, Legal, and Administrative Considerations for Preparticipation Evaluation for Wilderness Sports and Adventures
Abstract: Preparticipation evaluations (PPEs) are common in team, organized, or traditional sports but not common in wilderness sports or adventures. Regarding ethical, legal, and administrative considerations, the same principles can be used as in traditional sports. Clinicians should be trained to perform such a PPE to avoid missing essential components and to maximize the quality of the PPE. In general, participants' privacy should be observed; office-based settings may be best for professional and billing purposes, and adequate documentation of a complete evaluation, including clearance issues, should be essential comp...
Source: Clinical Journal of Sport Medicine - September 1, 2015 Category: Sports Medicine Tags: Care of the Wilderness Athlete Source Type: research