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About this Issue

Welcome to our November issue of CJSM, the last of 2015.

Our Editorial this month by Spicer and Hooper discusses the issue of helmet use in skiing, and whether or not this should be a mandatory requirement as is currently the case in Nova Scotia. Ethical arguments are presented and discussed, together with epidemiological evidence and information related to injury prevention. The authors conclude that the principle of autonomy should prevail and that adults should be given the freedom to make their own choice about helmet wear during this activity.

We bring you Original Research papers on a variety of topics, including pre-participation cardiovascular screening, patellofemoral pain syndrome, and knee osteoarthritis.

On the theme of cardiovascular screening, Dunn and colleagues present the results of their observational cross-sectional study where a combination of high school athletes, collegiate athletes, and male professional athletes were screened using questionnaires and ECG screening. Unsurprisingly, they found that many athletes screen positive under current American Heart Association (AHA) screening recommendations and ECG criteria vary depending on different interpretation criteria, and call for newer screening guidelines with fewer false-positives.

Of course, cardiovascular screening has the potential to cause anxiety to those undergoing the process, and especially in those who have tested as false-positives. However, in a study of 1506 high school athletes, Asif and colleagues found that those undergoing screening and testing false-positive with the standardized AHA questionnaire, physical examination and ECG were generally no more anxious than those screening as normal. They conclude that concerns about anxiety caused by screening should not be a barrier per se to cardiovascular screening for younger athletes.

On the subject of patellofemoral pain, Tsai and colleagues examine the effects of an off-axis elliptical training program on pain and knee function in subjects with patellofemoral pain (PFP) in their pilot study, and Halabchi and colleagues investigate the differences between an individualized risk factors-based approach versus quadriceps strengthening in individuals with PFP in their non-blinded randomized controlled trial.

We bring you three papers which may help you in your management of patients with knee osteoarthritis (KOA). Lun and colleagues find that both hip and leg strengthening exercises improve pain and quality of life in patients with KOA and recommend inclusion of these exercises as part of the exercise prescription for those with this condition. In another study on patients with KOA, Peeler and colleagues find that a 12-week lower body positive pressure supported low-load treadmill walking programme is an effective intervention for overweight KOA patients. Finally on the same topic, Al-Ajlouni and colleagues investigate the use of intra-articular autologous platelet lysate (as opposed to the more-often studied platelet-rich plasma) for KOA patients and find improved patient outcomes after 32 and 52 weeks in those offered this treatment.

In addition to these topics, we bring you a variety of other Original Research papers, a Brief Report, two Case Reports and a Book Review from Suzanne Hecht on the Handbook of Sports Medicine and Science, Gymnastics.

This may be our last issue before 2016, but don’t forget to check out the CJSM blog at which brings you regular updates from the world of Sports Medicine, and our Social Media channels on Facebook and Twitter (@cjsmonline) , brought to you by our Emerging Media Editor, James MacDonald.

Finally, I offer my best wishes to all of our readers during the forthcoming Christmas and New Year period, and reserve a special thought for all of you who, like myself, may be particularly busy with team physician work around this time.

See you again in 2016,



Christopher Hughes MBBS MSc

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