Investigating the research capacity and productivity of Canadian sports chiropractors.

Objectives: To investigate the research capacity and productivity of Canadian sports chiropractors. Methods: A cross-sectional survey (phase one) and scoping review (phase two) investigated the research capacity and productivity (from 2015-2020) of the Canadian sports chiropractic field. Results: Most respondents (72%) reported obtaining research training from fellowship and master's programs, with only 2 (1%) PhD qualifications identified. Approximately, 30% reported active involvement in research, with 28% being part-time clinician researchers. Access to human and technological research resources were limited. We identified 67 publications and 16 conference presentations within a five-year period, with clinical, population health, and basic science research as the areas most studied. Conclusion: The research effort of Canadian sports chiropractors is primarily conducted by clinicians involved in research on a part-time basis. Its research outputs predominantly reflect the research requirements of the RCCSS(C) Sports Sciences Residency Program, highlighting its contribution in developing capacity and producing research for the Canadian sports chiropractic field.

Objectifs: Étudier la capacité de recherche et la productivité des chiropraticiens du sport Canadiens. Méthodes: Une enquête transversale (première phase) et un examen de la portée (deuxième phase) ont permis d'étudier la capacité de recherche et la productivité (de 2015 à 2020) du domaine de la chiropratique sportive au Canada. Résultats: La plupart des répondants (72 %) ont déclaré avoir obtenu une formation en recherche dans le cadre de programmes de bourses et de maîtrises, et seulement 2 (1 %) ont indiqué avoir obtenu un doctorat. Environ 30 % des répondants ont déclaré participer activement à la recherche, 28 % d'entre eux étant des cliniciens-chercheurs à temps partiel. L'accès aux ressources humaines et technologiques de la recherche était limité. Nous avons recensé 67 publications et 16 présentations de conférences sur une période de cinq ans, les domaines les plus étudiés étant la recherche clinique, la recherche sur la santé des populations et la recherche en sciences fondamentales. Conclusion: L'effort de recherche des chiropraticiens du sport canadiens est principalement mené par des cliniciens impliqués dans la recherche à temps partiel. Leurs résultats de recherche reflètent surtout les exigences de recherche du programme de résidence en sciences du sport du Collège royal des sciences chiropratiques du sport du Canada (RCCSS(C)), soulignant leur contribution au développement des capacités et à la production de recherches pour le domaine de la chiropratique du sport au Canada.

Management of Chronic Lateral Epicondylitis With Manual Therapy and Local Cryostimulation: A Pilot Study.

OBJECTIVE: The purpose of this pilot study was to evaluate the feasibility and efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. METHODS: The control group (n = 19) was treated with manual therapy consisting of soft-tissue therapy and radial head mobilizations. The experimental group (n = 18) received cryostimulation in addition to manual therapy care similar to that for the control group. Both protocols consisted of 8 treatments over a 4-week period. Outcome measures included pain intensity (visual analog scale), pain-free grip strength (handheld dynamometer), and functional index (Patient-Rated Tennis Elbow Evaluation questionnaire). Assessments were performed at baseline, postintervention, and 3-month follow-up. Adherence and dropout rates were also considered. RESULTS: Both groups exhibited significant improvements in pain intensity and functional index at postintervention assessments, which were maintained at follow-up. All participants attended the prescribed number of treatments, but 27% were lost at follow-up. Minor adverse events were reported after cryostimulation in 4 cases. CONCLUSIONS: This study indicated that it is feasible to complete a clinical trial evaluating the efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. On the basis of these preliminary data, the combination of cryostimulation and manual therapy care did not provide any additional benefits in both the short term and the long term. Manual myofascial point treatment and mobilization techniques yielded positive outcomes in chronic lateral epicondylitis. Further studies should focus on the sole therapeutic effect of cryostimulation in both patients with acute and those with chronic conditions.

Analyzing injuries among university-level athletes: prevalence, patterns and risk factors.

BACKGROUND: Scientific evidence suggests many health benefits are associated with sport participation. However, high intensity participation may be related to an increased risk of musculoskeletal injuries. OBJECTIVES: This study aims to: 1) describe the prevalence and patterns of sports injuries, and 2) identify its associated risk factors. METHODS: A cross-sectional design was used. University level athletes, involved in 7 sport disciplines reported musculoskeletal injuries sustained in the past year, as well as potential risk factors: training volume and antecedent sport participation. Group comparisons were conducted. RESULTS: 82 athletes participated in the study. Respondents sustained over two injuries per year. Significant differences were found for sport category and type of injury. No differences were observed regarding antecedent sport participation. DISCUSSION: High prevalence and sport-specific injuries observed in university sport should be of concern to athletes, therapists, coaches and sport organizers. CONCLUSION: This study contributed to a better knowledge of injury patterns among university athletes, and suggests further practical and research implications.

CONTEXTE: Les observations scientifiques laissent entendre que de nombreux avantages pour la santé sont associés à la participation sportive. Cependant, la participation à haute intensité pourrait être associée à un risque accru de blessures musculo-squelettiques. OBJECTIFS: Cette étude vise : 1) à décrire la prévalence et les tendances en matière de blessures sportives et 2) à en déterminer les facteurs de risque connexes. MÉTHODOLOGIE: On a utilisé une analyse transversale. Des athlètes universitaires qui participaient à sept disciplines sportives ont déclaré des blessures musculo-squelettiques au cours de la dernière année, ainsi que des facteurs de risque potentiels : le volume de l'entraînement et l'historique de participation sportive. On a réalisé des comparaisons de groupes. RÉSULTATS: En tout, 82 athlètes ont participé à l'étude. Les répondants ont subi plus de deux blessures par année. On a constaté d21importantes différences sur le plan de la catégorie sportive et du type de blessure. On n'a pas observé de différence concernant l'historique de participation sportive. DISCUSSION: La prévalence élevée et les blessures propres au sport observées dans le sport universitaire devraient préoccuper les athlètes, thérapeutes, entraîneurs et organisateurs d'événements sportifs. CONCLUSION: Cette étude a contribué à une meilleure connaissance des tendances en matière de blessures chez les athlètes universitaires et laisse entendre d'autres répercussions sur le plan concret et de la recherche.

Conservative management of posterior ankle impingement: a case report.

OBJECTIVE: To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program. CLINICAL FEATURES: A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking. The initial diagnosis of lateral ankle sprain was found to be complicated by a posterior ankle impingement caused by a tenosynovitis of the flexor hallucis longus sheath suspected during the physical examination and confirmed by MRI. INTERVENTION AND OUTCOME: The patient was treated over a 14-week period. Soft tissue therapy, a rehabilitation program and cortisone injection were used to treat this condition. A precise description of the rehabilitation program that contains open kinetic chain, closed kinetic chain, proprioception, and conditioning exercises prescribed to the patient is given. After the treatment plan, the patient returned to play pain free and had no daily living restrictions. SUMMARY: A protocol including rest, soft tissue therapy, open and closed kinetic chain exercises, sport-specific exercises and cortisone injection appeared to facilitate complete recovery of this patient's posterior ankle impingement.

OBJECTIF: Présenter l'histoire de cas, notamment la progression de la douleur et le retour aux activités fonctionnelles, chez un patient présentant un accrochage postérieur de la cheville. L'article présente ces données en lien avec un plan de traitement incorporant le traitement des tissus mous, l'ajustement chiropratique et un programme de réadaptation progressive. CARACTÉRISTIQUES CLINIQUES: Un homme âgé de 37 ans présentant une douleur à la cheville postéro-latérale exacerbée par une flexion plantaire deux semaines après avoir subi une entorse de la cheville en inversion. Le patient souffrait d'un œdème et se plaignait d'une sensation d'instabilité lorsqu'il marchait. Le diagnostic initial d'une entorse de la cheville en inversion a été modifié suite à l'examen physique. L'entorse est compliquée par un accrochage postérieur de la cheville relié à une ténosynovite de la gaine du muscle long fléchisseur de l'hallux. Cette trouvaille mise en évidence à l'examen physique fut confirmée par une IRM. INTERVENTION ET RÉSULTATS: Le patient a été traité pendant une période de 14 semaines. Le traitement des tissus mous, un programme de réadaptation et l'injection de cortisone ont été utilisés pour traiter cette condition. Une description précise du programme de réadaptation (exercices cinétiques en chaîne ouverte et fermée, exercices proprioceptifs ainsi que de conditionnement physique), est présentée. Après le traitement, le patient est retourné au jeu sans douleur et sans aucune contrainte dans ses activités quotidiennes. RÉSUMÉ: Un protocole comprenant du repos, le traitement des tissus mous, des exercices cinétiques en chaîne ouverte et fermée, des exercices particuliers pour la discipline sportive et l'injection de cortisone semble avoir facilité une guérison complète de l'accrochage postérieur de la cheville de ce patient.

Sensory deprivation and balance control in idiopathic scoliosis adolescent.

Balance control is influenced by the availability and integrity of sensory inputs as well as the ability of the balance control mechanisms to tailor the corrective action to the gravitational torque. In this study, to challenge balance control, visual and ankle proprioceptive information were perturbed (eyes closed and/or tendon vibration). We masked sensory inputs in order: (1) to test the hypothesis that adolescent idiopathic scoliosis (AIS), compared to healthy adolescent, relies more on ankle proprioception and/or visual inputs to regulate balance and (2) to determine whether it is the variation or the amplitude of the balance control commands of AIS that leads to greater body sway oscillations during sensory deprivation. By manipulating the availability of the sensory inputs and measuring the outcomes, center of pressure (CP) range and velocity variability, we could objectively determine the cost of visual and/or ankle proprioception deprivation on balance control. The CP range was larger and the root mean square (RMS) of the CP velocity was more variable for AIS than for control participants when ankle proprioception was perturbed. This was observed regardless of whether vision was available or not. The analysis of the sway density curves revealed that the amplitude rather than the variation of the balance control commands was related to a larger CP range and greater RMS CP velocity for AIS. The present results suggest that AIS, compared to control participants, relies much more on ankle proprioception to control the amplitude of the balance control commands.

Biomechanical effects of a lumbar support in a mattress.

For many patients with chronic low back pain, the lack of sleep and sufficient rest period that allows some relaxation is a major obstacle to a good quality of life. During sleep periods, neuromuscular activity is at a minimal level. The major factor influencing the forces on the body, and particularly the spine, is gravity. The force of gravity is sufficient to deform soft tissues when the body is resting on a mattress. Thus, the goal of this study is to measure the contact pressure forces acting on the spine with and without an inflatable support in various experimental conditions. Our hypothesis is that a lumbar support will distribute the force of gravity more uniformly over the pelvic, lumbar and thoracic areas, maintaining the lumbar lordosis, in a supine posture. In this study, 10 participants were tested when lying supine in six separate experimental conditions. These conditions varied according to the surface (no mattress, foam, mattress) and the fact that the support was inflated or not. The dependent variable measured was the contact pressure. It was measured using a pressure sensor mat (Tekscan). When the cushion was inflated the distribution of contact pressure in the different areas (pelvic, lumbar and thoracic) was modified. The comparison of the mean forces revealed that when the cushion was not inflated, the pressure distribution was mainly localized in the pelvic area. After the cushion was inflated, a significant decrease of contact pressure in the pelvic region and a significant increase in the lumbar area were observed. Our results confirm the hypothesis that a lumbar support inserted in a mattress allows a more homogenous distribution of contact pressure over the pelvic, lumbar and thoracic areas during supine posture. The use of an inflatable cushion favouring a transition of the contact pressure from the pelvic to the lumbar region could potentially limit unfavourable compressive and shearing forces acting on the lumbar spine.