bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECTS OF INTERNAL JUGULAR VEIN COMPRESSION FOR PRESERVING WHITE MATTER INTEGRITY IN HIGH SCHOOL FOOTBALL PLAYERS COMPARISON OF HIGH VS LOW
Authors: Foss Kim D. Barber , Diekfuss Jed A. , Yuan Weihong , Dudley Jonathan A. , DiCesare Christopher A. , Reddington Danielle L. , Zhong Wen , Nissen Katharine S. , Shafer Jessica , Leach James L. , Logan Kelsey , Myer Gregory D. 
Published: April 2020

Background: Repetitive head impacts experienced during competitive sports contribute to neurologic changes over the course of a season. Internal jugular vein compression, by means of an externally worn neck collar device has shown efficacy in mitigating white matter (WM) alterations following repeated head impact exposure. However, its relative effectiveness in high versus low head impact exposures is unknown. Hypothesis/Purpose: The purpose of this study was to investigate the effectiveness of an externally worn neck collar device in limiting WM alterations over a season of high school football in players who receive high and low cumulative head impact exposures over 90 g. Methods: 213 male high-school football athletes were prospectively assigned to two study groups: a control group (non-collar; n=106) and an experimental group who wore the jugular vein compression collar during all practices and games (collar; n=107). MRI data was collected from all participants pre- and post-season. Fractional anisotropy (FA), and mean, axial and radial diffusivity (MD/AD/RD) were calculated to assess WM integrity at both time points. Cumulative head impact exposure was monitored by accelerometers attached to each athlete’s left mastoid process during every exposure. Participants were dichotomized into subgroups based on accumulated exposures to hits over 90 g, which divided the entire cohort into four subgroups, using a cut-off of 40 hits : (1) non-collar group (≥40 hits, n=57); (2) collar group (≥40 hits, n=51); (3) non-collar group (<40 hits, n=49); (4) collar group (<40 hits, n=56). Results: As seen in Table 1, in athletes with ≥40 hits, both the non-collar and collar group showed significant pre- to post- season reductions in MD, AD, and/or RD. The non-collar group with ≥40 hits also showed a significant increase in FA, MD, and AD. RD, FA, and MD changes were greater in the non-collar group compared to the control group with ≥40 hits, while AD changes were greater in the collar group compared to the non-collar group with ≥ 40 hits. The non-collar group with <40 hits presented significant pre- to post-season reductions in MD, AD, and RD that were greater than the collar group with < 40 hits (whom did not show pre-to post-season changes). Discussion & Conclusion: The present results provide support for internal jugular vein compression to protect the brain from both low- and high-level repeated head impact exposure. However, less consistent changes were observed for athletes exposed to repeated, high-level head impacts, warranting further investigation. [Table: see text]
FEMORAL NERVE CATHETER IS ASSOCIATED WITH PERSISTENT STRENGTH DEFICITS AT 6 MONTHS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN PEDIATRIC PATIENTS
Authors: Parikh Harin B. , Mandler Tessa N. , Gagliardi Alexia G. , Howell David R. , Albright Jay C. 
Published: April 2020

Background: The long-term outcomes of femoral nerve blockade following ACL reconstruction are not well defined. Femoral nerve blocks are typically administered as either a single-injection nerve block (FNB) or a continuous femoral nerve catheter (FNC). Prior work among pediatric patients found knee extension and flexion strength deficits 6 months postoperatively using FNB. However, this work was limited by the use of multiple graft choices and orthopedic surgeons. Purpose/Hypothesis: The purpose of this study was to investigate functional recovery after primary ACL surgery with quadriceps tendon-patellar autograft (QPA) in patients receiving a sciatic nerve block and either FNB or FNC. Our hypothesis was that short-term functional performance would be worse among those who underwent FNC compared to FNB. Methods: We conducted a retrospective chart review of pediatric patients 10-19 years of age who underwent ACL reconstruction with QPA by a single orthopedic surgeon. Surgery was performed at two locations: one of which administered FNB and the other FNC. Both were combined with sciatic nerve block. A physical therapist performed functional asymmetry assessments at approximately 6 months postoperative. We compared single-leg squat symmetry between groups using independent samples t-tests. We compared the proportion of patients in each group who achieved 80% symmetry on single-leg squat and Y-Balance tests, had initiated ballistics and running programs, and demonstrated functional symmetry at the 6-month post-operative appointment using Chi-square analyses. Results: Demographics were similar between groups (Table 1). Single leg percent symmetry of the operative limb was significantly greater in the FNB group compared to the FNC group (Table 2). In addition, a greater proportion of those in the FNB group demonstrated functional symmetry compared to the FNC group during the 6-month assessment (Table 2). There were no proportional differences between the groups for the number of patients who demonstrated 80% symmetry during single-leg squat or Y-Balance test, or had initiated a ballistics or running program at the time of assessment. Conclusion: Pediatric patients in the FNC group demonstrated poorer single-leg squat symmetry and functional symmetry compared to those in the FNB group at 7 months following ACL reconstruction with QPA. These preliminary findings may relate to increased concentration and duration of local anesthetic in the FNC group postoperatively. Providers should be cognizant of the implications of FNC on long-term outcomes of ACL reconstruction. [Table: see text][Table: see text]
SPORTS PERFORMANCE, SLEEP AND ANXIETY IN CHILDREN AND ADOLESCENTS: SECOND YEAR RESULTS OF A LONGITDUINAL STUDY
Authors: Sarkisova Natalya , Herrera-Hamilton Anita , Hartline Kenneth D. , Perez Iris , Wren Tishya A.L. , Skaggs David L. , Edison Bianca 
Published: April 2020

Background: In the preliminary results of a longitudinal study, we gathered baseline insights into students’ sleeping habits, activity levels and anxiety. The results showed that the seventh grade (now eighth grade) students reported mild anxiety, played sports non-competitively and underslept according to the National Sleep Foundation (NSF). In the second year of this study, we continue to look at the trends of sleep, athletic performance and emotional wellness. Methods: 40 eight grade students were administered an ActiGraph watch to assess sleep patterns. Students completed a background survey to obtain information regarding sports participation and subjective injury reports. Students completed the Beck Youth Anxiety Inventory (BYAI) to assess anxiety. Actigraph data was reviewed with a board certified sleep pulmonologist. Results: 16 males and 24 females wore the watch for 5 school nights. Average age of patients was 13 years (range: 13 to 14). 200 nights of nocturnal sleep were analyzed with total sleep time (TST) averaging: 6.2 hours (370 minutes) (range: 216 to 448 minutes). Females averaged 6 hours (368 minutes) and males averaged 6.25 hours (375 minutes) (p=0.62). Out of the 40 students that wore the watch, 78% (31/40) completed the background survey regarding sports participation. 78% (24/31) reported playing a sport and on average spend 7 hours a week playing (range: 1 to 30 hours). 78% (24/31) also participate in an organized or recreational sport and on average started competitive sports at the age of 6 years (range: 3 to 12 years). 46% (11/24) of students reported injuries that removed them from their sport during the school year (range: 1 to 4 injuries). On the BYAI (n=32), scores were significantly higher this year with a mean score of 16 (moderate anxiety) compared to last year (mean=12, p=0.01). Females scored significantly higher (p=0.04) on the BYAI (mean=18, n=20) than males (mean=12, n=12). Patients that also reported higher anxiety received significantly less sleep (p=0.01, r=-0.46). Conclusion: In the second year of our longitudinal study, our results show that students continue to sleep below the recommendation of the NSF (9 to 11 hours, 546 to 660 minutes) and select students are starting to specialize in sports. However, anxiety compared to last year was significantly higher. As they transition from middle school to high school, we expect to see students undergo personal development, commit to one sport and have a more rigorous school schedule that will continue to affect sleep and emotional wellness.
DEVELOPMENT AND EXTERNAL VALIDATION OF A NOVEL CLINICAL SCORE TO QUANTIFY THE PRESENCE OF INSTABILITY CHARACTERISTICS IN PATIENTS WITH BORDERLINE ACETABULAR DYSPLASIA
Authors: Schwabe Maria , Graesser Elizabeth , Rhea Lee , Pascual-Garrido Cecilia ,   ANCHOR Group, Clohisy John C , Nepple Jeffrey J 
Published: April 2020

Background Treatment of borderline acetabular dysplasia (BD) is controversial with some patients having primarily instability-based symptoms while others have impingement-based symptoms. The existing literature lacks direct comparisons of different treatment approaches, and generally fails to report other important diagnostic characteristics beyond the lateral center edge angle (LCEA). Purpose The purpose of this study was (1) to identify the most important patient characteristics influencing the diagnosis of instability vs. non-instability, (2) to develop a clinical score (Borderline Hip Instability Score, BHIS) to collectively characterize these factors and (3) to externally validate BHIS in a multicenter cohort BD patients. Methods In Part 1, this study utilized a retrospective cohort study of 186 hips undergoing surgical treatment of BD (LCEA 20°-25°) from a single surgeon experienced in arthroscopic and open techniques. Multivariate analysis determined characteristics associated with presence of instability (treated with PAO +/- hip arthroscopy) or absence of instability (treated with isolated hip arthroscopy) based on clinical diagnosis of the single surgeon. During the study period, 39.8% of the cohort underwent PAO. Multivariate analysis with bootstrapping was performed and results were transformed into a BHIS nomogram (higher score representing more instability). In Part 2, BHIS was externally validated in 114 BD patients enrolled in a multicenter prospective cohort study across 10 surgeons (with varied treatment approaches from arthroscopy to open procedures). Results In Part 1, the most parsimonious, best fit model included 4 variables associated with the diagnosis of instability: acetabular inclination (AI), anterior center edge angle (ACEA), maximum alpha angle, and internal rotation in 90 degrees of flexion (IRF). Sex and LCEA were not significant predictors. Mean BHIS in the population was 50.0 (instability 57.7 ±7.9; non-instability 44.8±7.3, p<0.001). BHIS demonstrated excellent predictive (discriminatory) ability with c-statistic=0.89. In Part 2, BHIS maintained excellent c-statistic=0.92 in external validation. Mean BHIS in the external cohort was 53.9 (instability 66.5±11.5; non-instability 43.0±10.8, p<0.001). Discussion In patients with BD, key factors in diagnosing significant instability treated with PAO were AI, ACEA, maximum alpha angle, and IRF. The BHIS score allowed for differentiation of patients with and without instability in the development and external validation cohort.
SPINAL RANGE OF MOTION AND BACK PAIN IN FEMALE ARTISTIC GYMNASTS DURING BACK WALKOVERS AND BACK HANDSPRINGS
Authors: Sweeney Emily A , Potter Morgan N , Pimentel Richard E , Carollo James J , Howell David R 
Published: April 2020

Background: Back pain is a common complaint among gymnasts. Gymnastics skills require large amounts of spine flexion, extension, rotation and compression. The combination of these movements in a repetitive fashion during gymnastics may contribute to the development of back pain. Gymnasts perform unique skills on various equipment and surfaces, which makes their movements difficult to evaluate using traditional movement analysis approaches. Hypothesis/Purpose: Our purpose was to measure gymnasts’ movement patterns in their native environment using wearable sensors. Specifically, we examined spine range of motion (ROM) during back walkovers (BWO) and back handsprings (BHS) on the floor and balance beam. We hypothesized that female youth gymnasts with a recent history of back pain would have larger spine ROM compared to gymnasts without back pain when performing these skills. Methods: Female artistic gymnasts ages 8 to 18 years in the Junior Olympic USA Gymnastics program participated in the study. We grouped gymnasts into two groups: those having back pain within the past 12 months and those with no reported back pain in the past 12 months. Gymnasts performed 3 repetitions of BWO and BHS on floor and balance beam while wearing APDM Opal V2 wearable sensors. A BWO requires a controlled bridge kickover while a BHS requires the athlete to jump backwards to her hands (Figure 1). Spine kinematics were then processed via Moveo Explorer. Valid spine sagittal plane maximums, minimums, and ROM of each skill repetition were compared between groups via Kruskal Wallis analysis of variance. Results: Seventeen participants (6 with back pain) completed BWOs and BHSs with acceptable sensor data. There were no demographic differences between the two groups for age, height, weight, competition level, or years of experience (p≥0.129, Table 1). During BWO skills, gymnasts with back pain had greater peak extension and greater ROM in the sagittal plane of the spine (p≤0.032, Figure 2). There were no differences between groups in peak extension, peak flexion, or ROM during BHS skills (p≥0.054, Figure 2). Conclusion: Gymnasts with a history of back pain had increased spinal motion when performing BWO skills. To perform a BWO, gymnasts must have higher levels of shoulder, spine, and hip flexibility, which may relate to back pain. This study suggests the need for future studies to evaluate if increased spinal motion during gymnastics is a contributing factor to the development of back pain. [Figure: see text][Table: see text][Figure: see text]
LATERAL MENISCUS WIDTH AT THE POPLITEUS RECESS AND THE RELEVANCE TO SAUCERIZATION OF DISCOID LATERAL MENISCI
Authors: Gamble Jamison G. , Abdalla Abdalla B. , Meadows Molly , Rauer Thomas , Chan Charles M. , Ganley Theodore J. , Shea Kevin G. , Gamble James G. 
Published: April 2020

Background: Discoid lateral meniscus (DLM) is a congenital anomaly of the knee where the normally “O” shaped lateral meniscus has redundant tissue filling the “O” and covering the lateral tibial plateau. The redundant tissue can cause mechanical symptoms and pain. Treatment of symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much as to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached to the capsule. The literature recommends a residual width of 6-8 mm.1,2 Purpose/Hypothesis: The primary purpose of this research is to determine the width of the meniscus at the popliteal hiatus in normal specimens. Our null hypothesis is that a residual width of 6-8 millimeters will be sufficient for saucerization of DLM. Methods: We made direct measurements of lateral meniscus radial width from the outer rim at the popliteus hiatus to the inner edge (Figure 1) in 19 specimens (ages 2 months to 120 months.) We measured one four-year-old specimen with bilateral complete DLM. We also measured 39 digital images of specimens (ages 1 month to 132 months) using ImageJ. Finally, we made direct measurements of 8 skeletally mature specimens. Results: Figure 2 shows the relationship of meniscus width as a function age. The average width of specimens <3-years-old was 5.5mm. The average width of the ten-year-old specimens was 12mm. The average width of the skeletally mature specimens was 16mm. The four-year-old DLM specimen measured 19 mm. Conclusions: We rejected our null hypothesis. Direct measurements suggest that a residual width of 6-8mm is insufficient for children 8-years and older. A width of at least a full centimeter more closely approximates our findings, and for adolescents consider a residual rim of 15 mm. For children less than six-years-old a residual width of 6-8mm is sufficient. References: Kocher MS, Logan CA, Kramer DE. Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg 2017;25:736-743. Hayashi LK, Yamaga H, Ida K, Miura T. Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Joint Surg. 1988;70-A: 1495-1500. [Figure: see text][Figure: see text]
THE RELATIONSHIP BETWEEN MENTAL HEALTH HISTORY AND SYMPTOMS, SEX, AND RECOVERY TIME IN A CONCUSSED PEDIATRIC POPULATION
Authors: Allred Richard Cameron , Stremlau Sara , Gerkin Richard , Erickson Steven , Pardini Jamie 
Published: April 2020

Background: The Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9) are mental health screening instruments that assess symptoms of depression and anxiety. Studies of patients with concussion suggest that history of mental illness is associated with prolonged recovery; however, little research has examined the value of these tools in a concussed pediatric population (Iverson et al., 2017). Hypothesis/Purpose: The purpose of this study was to explore the relation between anxiety and depression symptoms, mental illness history, sex, and time to recover in a concussed pediatric population. We hypothesized that mental health symptoms and history, and female sex would predict longer recoveries in the pediatric population. Methods: IRB-approved retrospective chart review was used for data collection. Demographics, self-reported mental health history, GAD-7, and PHQ-9 scores were acquired for 250 adolescents ages 12-18 (45.2% female) who presented to an outpatient concussion clinic for their initial visit. Days to recover was imputed for all patients who had been discharged by clinic physicians based on international return to play standards. Results: Mann-Whitney U tests were used for analysis of this nonnormally distributed data. Males were found to recover more quickly than females (female median = 15 days, IQR 7-27; male median = 12 days, IQR 6-23; p=.013). No significant differences were observed in days to clearance based on reported history of mental health disorder (p=.066). Individuals who scored above cutoff (see Kroenke et al., 2001; Spitzer et al., 2006) on the GAD-7 (below cutoff median = 12.00 days; above cutoff median = 21.00 days) and PHQ-9 (below cutoff median = 23.5 days; above cutoff median = 57.00 days) required longer recovery times (p <.001). Conclusion: We found longer recovery times in females versus males, and in those whose scores fell above cutoff for the PHQ-9 and GAD-7 at their initial clinic visit. Although a trend existed, there were no significant differences in recovery time for those who reported a mental health history compared to those who did not. Results suggest that the GAD-7 and PHQ-9 may be useful screening measures in a concussion clinic and may provide additional insight into potential recovery times for pediatric patients.
STUDY OF NORMAL VALUES OF PROPRIOCEPTION BASED ON AGE
Authors: Nault Marie-Lyne , Chémaly Olivier , Grimard Guy , Sarda Mélanie , Trottier Marie-Pier , Tan Xue Wei 
Published: April 2020

Background: Proprioception is an important function which allows the brain to perceive the body’s position. It is a safety mechanism aiding the generation of movements to correct and maintain balance. During a return to sports for adults, it is essential to have a good postural control. However, this requirement is applied subjectively in a pediatric setting. The Biodex Stability System (BSS) is a validated instrument capable of evaluating proprioception by producing stability indexes. Unfortunately, the stability indexes for a healthy pediatric population and the associated characteristics have not yet been determined. Purpose: The primary objective was to establish normal pediatric values of proprioception using the BSS. The secondary objectives were to find correlations between various subgroups (sex, physical activity participation and joint laxity, etc) and the stability indexes. Methods: An observational cohort study was done. Patients from July 2018 to September 2018 were included from the facture clinic. Inclusion/exclusion criteria were: (1) a consolidated upper limb fracture, (2) no previous history of lower limb injury, (3) no congenital anomalies of the lower limb or neuromuscular disease. Included subjects underwent 3 test trials of 20 seconds each of single-leg shoeless postural control with eyes open and at a stability level of 4. The overall stability index (OSI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) were noted. The protocol was conducted on both legs. Kolmogorov-Smirnov test will be used for the primary objective and, Pearson correlation for secondary objective. Results: Seventy-one participants (29 girls and 42 boys) with a mean age of 12.75±2.2 years old and a mean Beighton laxity score of 2.5±2.5 were recruited. The mean left OSI is 4.4±3.1 and the mean right OSI is 4.5±3.3. When comparing the subgroups, we were able to find correlations between the body mass index (BMI) and the OSI for both legs (left: r= 0.312, p = 0.008; right: r= 0.437, p = 0.001). We did not find any other correlations for any other groups (sex, age and Beighton score). Conclusion: A larger sample size will be needed to establish normal values based on sex and skeletal maturity but a mean value for OSI for a normal pediatric population was established. This study illustrates that, in our pediatric population, an increase in BMI is associated with an increase in OSI. Therefore, children with a higher BMI could potentially benefit from a proprioception training program in order to prevent the occurrence of injuries.