Using a Markerless Motion Capture System to Identify Preinjury Differences in Functional Assessments.

Functional assessments identify biomechanical issues which may indicate risk for injury and can be used to monitor functional recovery after an injury or surgery. Although the gold standard to assess functional movements is marker-based motion capture systems, these are cost prohibitive and have high participant burden. As such, this study was conducted to determine if a markerless motion capture system could detect preinjury differences in functional movements between those who did and did not experience a noncontact lower extremity injury (NCLEI). A three-dimensional markerless motion capture system comprised an area of 3 m × 5 m × 2.75 m was used. Participants were Division I collegiate athletes wearing plain black long-sleeve shirts, pants, and running shoes of their choice. Functional assessments were the bilateral squat, right and left squat, double leg drop vertical jump, static vertical jump, right and left vertical jump, and right and left 5 hop. Measures were recorded once and the first NCLEI was recorded during the first year after measurement. Two-factor analysis of variance models were used for each measure with factors sex and injury status. Preinjury functional measures averaged 8.4 ± 3.4 minutes capture time. Out of the 333 participants recruited, 209 were male and 124 were female. Of those, 127 males (61%) and 92 females (74%) experienced later NCLEI. The most common initial NCLEI was nonanterior cruciate ligament knee injury in 38 females (41.3%) and 80 males (62.0%). Females had decreased flexion and lower valgus/varus displacement during the bilateral squat (p < 0.006). In addition, knee loading flexion for those who were not injured were more than that seen in the injured group, and was more pronounced for injured females (p < 0.03). The markerless motion capture system can efficiently provide data that can identify preinjury functional differences for lower extremity noncontact injuries. This method holds promise for effectively screening patients or other populations at risk of injury, as well as for monitoring pre-/postsurgery function, without the large costs or participant burden.

Knee Ultrasonography to Determine Risk for Noncontact Injuries in Collegiate American Football Players.

Knee ultrasonography has been used effectively as a screening tool for determining risk for knee injuries in athletes. Ultrasonography may be a valuable screening tool for relative risk of noncontact knee injuries that occur over a typical playing career in collegiate American football players. In this prospective longitudinal study, we evaluated American football players (n = 48) in an academic institution affiliated with the National Collegiate Athletic Association Division I athletic program. Players underwent comprehensive ultrasonography of both knees prior to beginning their collegiate careers. Anatomic structures were evaluated for presence and severity of abnormalities. Noncontact lower extremity injuries sustained over the collegiate career of the subjects were documented. Data were analyzed for correlations, differences in proportions, and odds ratio (OR). Seventy-nine percent of the athletes had at least one ultrasonographic abnormality, with quadriceps tendon (47.9%) and patellar tendon (39.6%) abnormalities predominating. Seventy-nine percent of players had at least one noncontact lower extremity injury (23.5% involving the knee) during their careers with an average of 2.8 injuries per career. The majority of injuries occurred in the second and third playing years. There was a significantly higher likelihood of patellar tendon injury based on the presence of patellar tendon ultrasonographic pathology (p = 0.024; OR = 11x). There was a significantly higher likelihood of quadriceps muscle-tendon injury based on the presence of quadriceps tendon ultrasonography pathology (p = 0.0012; OR = 140x). All athletes sustaining meniscal injuries had preexisting joint effusion but no preexisting ultrasonographic meniscal pathology. Knee ultrasonography along with patient history and complete physical examination may help reduce injury risk through education, prevention, and training programs.

Atrial flutter in a college football player: return to play or not?

Atrial flutter is relatively uncommon, especially among athletic populations. The case of a 19-year-old college football player who spontaneously developed atrial flutter illustrates recent advances in treatment, including electrical cardioversion and radiofrequency catheter ablation. Return-to-play decisions center around the risk of recurrence and the degree of symptoms during recurrences. Clinicians should be aware that the most current return-to-play guidelines do not take into consideration the newer treatment techniques that have greatly changed definitive management of atrial flutter.