This month, we bring you a special Thematic Issue of the Journal, guest edited by Associate Professor M Alison Brooks, based at the Department of Orthopaedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, on Pediatric Sports Medicine.
Professor Brooks specializes in the care of the child and adolescent athlete, and is the Primary Physician for Badger men's soccer and women's ice hockey. She also serves on the Board of Directors for our affiliate Society, the American Medical Society for Sports Medicine, and on the Executive Committee for the American Academy of Pediatrics Council on Sports Medicine and Fitness. In this Issue, she has compiled a varied and interesting collection of articles on the topic of pediatric sports medicine.
In our Lead Editorial, Erin Berg, performance dietician at the University of Wisconsin, provides an overview of performance nutrition for adolescent athletes. She discusses food selection and habits, nutrition assessment, energy assessment and specific food groups, hydration, supplements, and specific diets commonly encountered amongst these age groups. In addition, she offers a concise summary of important points to consider when managing nutritional issues with your young athletes, which we are sure you will find of great practical value.
Leddy and colleagues present a preliminary, non-randomized, study of the effect of early aerobic exercise treatment for sport-related concussion in male adolescents, examining the effect of this intervention on rate of recovery. They compared a rest group of 30 males from a previous study with an intervention group of 25 males who performed a progressive program of at least 20 mins of daily subthreshold aerobic exercise. They noted that recovery times from the initial visit were significantly shorter amongst the intervention group, and suggest that early subthreshold aerobic exercise administered within one week following sports related concussion hastens recovery and may have the potential to prevent delayed recovery. Interestingly, the same Author and colleagues recently published an RCT in JAMA Pediatrics on early subthreshold aerobic exercise for SRC of 103 male and female adolescent athletes, comparing two groups randomly assigned to progressive subsymptom threshold aerobic exercise versus a progressive stretching program, and found that the aerobic exercise intervention group recovered faster (13 days) than those in the placebo 'stretching' group (17 days). These, and other studies, appear to be strengthening the argument for early aerobic exercise post-sports related concussion.
There are more articles this month on the topic of sports-related concussion amongst pediatric athletes, including concussion symptom profiles among child adolescent, and young adult athletes by Howell and colleagues, and factors affecting recovery trajectories in pediatric female concussion by Desai and colleagues.
Ko and colleagues present an interesting prospective study on the diagnostic accuracy of ultrasound in detecting distal radius fractures in a pediatric population. They examined 51 patients with a mean age of 9.9 years, with a history of acute trauma to the distal forearm. Following ultrasound examination, standard 3 plane x rays were performed, with both ultarsound and x rays interpreted by the same investigator. They found that there was only one case in which the diagnostic ultrasound resulted in a diagnosis different to that on the radiograph, and concluded that ultrasound was sensitive and specific for detecting distal radius fractures. They suggest the use of this modality as an acceptable alternative for evaluating fractures in this population. Check out our linked CME module on the Lippincott CME connection website, together with our other CME articles.
Our Practical Management article this Issue by Diana Liu and Yuan-Chi Lin focuses on the current evidence for acute pain management of musculoskeletal injuries and postoperative pain in pediatric and adolescent athletes. They discuss the role of conservative management, enteral and non-enteral medications, regional anesthesia and complementary and alternative medical therapies, and advocate a multi-modal pain management strategy with a view to meeting analgesic requirements and reducing the need for opioid medications.
We thank Professor Brooks once again for guest editing this special pediatric-themed Issue, and hope that you enjoy the articles. We welcome your feedback on the Issue, as always.
Don't forget to keep up to speed with events on our blog with James MacDonald and contributors, the CJSM twitter account on @CJSMonline and our Facebook account. Finally, a reminder for those of you seeking CME to check out our CME articles on the CME Lippincott CME Connection website.
Christopher Hughes MBBS MSc