Welcome to our latest issue of the Clinical Journal of Sport Medicine.
I'm pleased to say that we are ahead of the game on this occasion, with our January 2021 issue coming to you earlier than usual. Hopefully, you will have some time to enjoy reading the issue over the Christmas and New Year period ahead.
As I write, we are still firmly in the midst of the global COVID-19 pandemic. According to the latest World Health Organization information, to date (14th December) there have been over 71 million recorded cases since the start of the pandemic, with just over 1.6 million confirmed deaths. Both figures continue to rise at an alarming rate.
In London, UK, the Department of Health and Social Care today announced that extra restrictions will apply in 2 days' time in response to the latest epidemiological data showing an exponential rise in cases as well as rising local hospital admissions. Germany is about to adopt an even harder line approach throughout their Country, with a National lockdown on the way over the Christmas and New Year period.
In the United States, cases now exceed 16.1 million with almost 300,000 deaths. A quick look at the WHO's COVID-19 dashboard reveals worrying figures around the globe.
However, hope is on the horizon with the recent introduction of vaccination in the UK and in the United States. Just how effective these vaccines will prove to be in the future remains to be seen, but the advent of vaccination represents a huge leap forwards in a relatively short space of time.
The COVID-19 pandemic, I'm sure, remains constantly on all of our minds.
Our featured article this Issue comes from our Affiliate Society, the American Medical Society for Sports Medicine (AMSSM), and focuses on the topic of preparticipation physical evaluation of athletes training and competing at this time in the setting of COVID-19. This interim guidance is the culmination of a series of meetings of experts who evaluated best available evidence and formed expert consensus opinion on the topic. The guidance is intended to provide clinicians with a framework to return athletes of all levels to training and competition during the pandemic.
The pandemic itself and our knowledge of issues related to the care of athletes in terms of prevention and treatment of COVID-19, continues to evolve and it is likely that this interim guidance will be further updated as the situation changes, for example, with the (hopefully) imminent introduction of widespread vaccination. In the meantime, this piece of work constitutes an important resource for those clinicians caring for their athletes.
We bring you a number of Original Research articles on the topic of sports-related concussion, which continues to generate much controversy and research.
Leddy and Colleagues used a brief, focused physical examination which included cervical, oculomotor and vestibular tests amongst a sample of adolescents with and without sports-related concussion, assessing utility for diagnosis and monitoring recovery. They found that the tests employed in the study were able to distinguish those with acute sports-related concussion from healthy control patients, and to identify recovery amongst affected individuals when this occurred. These tests may constitute an effective and efficient battery of tests for the clinician to employ with similar populations of patients in their clinical practice.
Putukian and Colleagues evaluated the relationship between pre-injury risk factors and subsequent occurrance of concussion, examining the relationship between these risk factors and clinical recovery amongst collegiate athletes. In a study of 1152 athletes at baseline and 145 post-concussion diagnosis it was found that sport type and concussion history predicted subsequent occurrence of concussion, with none of the stated risk factors or baseline measures predicting recovery. The Authors found that immediate post-injury assessmenrts and some clinical measures predicted longer clinical recovery, and emphasise the importance of these factors in clinical practice.
In addition to these studies, there are several other interesting pieces of Original Research on sports-related concussion topics.
More Original Research offerings this issue include an investigation of adherence to hamstring injury prevention amongst amateur footballers by van der horst and Colleagues, Gender Specific Risk Factor Profiles for Patellofemoral Pain, and a study of Performance Outcomes and Return-to-Sport Rates of National Hockey League Athletes following common orthopedic procedures.
Gultekin and Colleagues present an interesting Systematic Review on the Use and Outcomes of Local Anesthetic Painkilling Injections in Athletes, noting that these are used for widespread indications and are commonly employed. Despite this, they found lack of proof of absolute safety or long-term harm for many of these injections and urge caution in proceding with these injections in clinical practice.
We also bring you two additional Review articles on the subjects of Physical Activity and Liver Cancer Risk, and issues relating to functional movement screening scores amongst High School, Collegiate and Professional Athletes.
Don't forget to keep up to date with events in the world of sport and exercise medicine on our CJSM Blog, our twitter account on @CJSMonline and on our Facebook account, and check out our range of CME articles on the CME Lippincott CME Connection website.
We hope that you enjoy our first issue of 2021, and here's hoping for better times soon to come.
Best wishes to you all,
Christopher Hughes MBBS MSc