Wii Fit™ exercise therapy for the rehabilitation of ankle sprains: Its effect compared with physical therapy or no functional exercises at all.

Lateral ankle sprains represent the most common sports-related injuries. The Nintendo Wii Fit™ could be useful in the treatment of ankle sprains. The aim of this study was to compare the effectiveness of exercise training using the Wii Fit™ in ankle sprain patients: (a) with physical therapy; and (b) a control group not receiving any treatment. Ninety lateral ankle sprain patients were randomized to a Wii Fit™, physical therapy, or control group. We assessed the following outcome measures before, and 6 weeks after starting the allocated treatment: Foot and Ankle Ability Measure, pain during rest and walking, delay before return to sport, patient satisfaction, and effectiveness of the allocated treatment. Six weeks after the baseline measures, foot and ankle ability scores had improved in all groups, and pain had decreased during walking (P < 0.050). No between-group differences were detected between Wii Fit™ treatment, and both other groups (P > 0.050). In conclusion, the Wii Fit™ could be used as an exercise therapy to treat ankle sprain patients. However, Wii Fit™ was not more effective than only physical therapy, or no exercise therapy at all. Patients who did not receive treatment showed similar results as people who got any kind of exercise therapy.

[Athletic pubalgia and hip impingement]. / Pubalgie et confit fémoro-acétabulaire.

Athletic pubalgia is a painful and complex syndrom encountered by athletes involved in pivoting and cutting sports such as hockey and soccer. To date, there is no real consensus on the criteria for a reliable diagnostic, the different investigations, and the appropriate therapy. Current literature underlines intrinsic and extrinsic factors contributing to athletic pubalgia. This review article reports upon two novelties related to the issue: the importance and efficience of prevention program and the association of femoro-acetabular impingement with the pubalgia.

[Treatment options for patellar tendinopathy]. / Options thérapeutiques dans la tendinopathie rotulienne.

Patellar tendinopathy is also called jumper's knee because of its high incidence in athletes with jumping or cutting activities as soccer, basketball, volleyball. Many different treatment methods have been described. However, no consensus exists regarding the optimal treatment for this condition. According to the literature, eccentric exercise-based physical therapy should be proposed first because of its strong scientific evidence. Shockwave therapy and injections may be useful but their real efficacy still has to be proven by randomized controlled study. For patients recalcitrant to more conservative options, operative management may be indicated.

[Athlete's heart: frontier between physiology and pathology]. / Coeur d'athlète: frontière entre physiologie et pathologie.

Athletes often exhibit structural and electrical cardiac adaptations that are influenced by several factors including sporting discipline, gender and ethnicity. These changes are considered physiological and reversible in most cases. However, recent data indicate that atrial and right ventricular remodeling in athletes may represent pathological changes leading to arrhythmias. Sudden cardiac death in athletes is a rare but dramatic event. The differential diagnosis between the athlete's heart and heart diseases that are potential etiologies of sudden cardiac death, such as hypertrophic cardiomyopathy, may be challenging. New recommendations about electrocardiogram interpretation in athletes may help to improve prevention strategies.

[Exercise--sports and osteoarthritis]. / Activités physiques--sport et arthrose.

Osteoarthritis (OA) is currently a major health problem, both with an important individual and socio-economical impact. The diagnostic of osteoarthritis is both clinical and radiological, without a strong correlation between symptoms and radiographic findings. Participation in sports increases the risk of joint overuse or injuries potentially leading to posttraumatic osteoarthritis. Conversely, sport is a recognized therapeutic and probably also a preventive tool against osteoarthritis, with a positive influence on weight, muscle strength and possibly synovial inflammation. In general, sport should be encouraged individually with an appropriate program and a correct intensity.

Teres major muscle tear in two professional ice hockey players: cases study and literature review.

Ice hockey is a sport renowned for its numerous injuries; different studies report between 13.8 and 20 lesions per 1000 athlete exposures. Exactly 65.5% of these injuries occur during games, compared to 34.5% during training sessions. And 35.1% of all injuries involve the lower extremity and 29.7% the upper extremity (results drawn from games and training combined). Determining whether muscle injuries are extrinsic (contusions) or intrinsic (tears) is of utmost importance since the former generally require simple follow-up, whereas the latter necessitates further investigations, appropriate treatment and often prolonged absence from sports for the injured athlete. To our knowledge, no publication to date has reported isolated damage of the teres major muscle in Ice Hockey players. Seven cases were reported amongst baseball pitchers. Two cases presented after a waterskiing traction accident and a further case has been described in a tennis player. In the present study, we report two cases of isolated teres major tear in ice hockey players. These two athletes were both professional players competing at the highest level in the Swiss Ice Hockey League.

[Treatment of tendinopathies: role for autologous platelet-rich plasma injections]. / Traitement des tendinopathies chroniques: intérêt des injections de plasma riche en plaquettes (PRP).

Chronic degenerative tendinopathies are frequent and difficult to treat. Tendon healing is under influence of many growth factors that can be obtained from patient's blood (platelet-rich plasma). Basic research is quite optimistic but evidence-based studies examining the treatment of human tendinopathies are lacking. Nevertheless, such treatments are increasingly used in clinical practice and expectations of those injections are high. However, the use of autologous blood injections for the management of chronic human tendinopathies can currently not be recommended.

Non-steroidal anti-inflammatory drugs for athletes: an update.

Sports medicine physicians often treat athletes in pain with non-steroidal anti-inflammatory drugs (NSAIDs). However, there is a lack of high-quality evidence to guide NSAID use. Their adverse effects have clinical relevance, and their possible negative consequences on the long-term healing process are slowly becoming more obvious. This article provides some practical management guidelines for the use of NSAIDs, developed to help sports medicine physicians deal with frequent sports-related injuries. We do not recommend their use for muscle injuries, bone fractures (also stress fractures) or chronic tendinopathy. In all cases, if chosen, NSAID treatments should always be kept as short as possible and should take into account the specific type of injury, the level of dysfunction and pain.

[Groin pain in athletes]. / Pubalgie du sportif.

Groin pain is a common problem in athletes who engage in sports involving accelerations, decelerations and sudden direction changes. It is still a frustrating pathology which has significant overlap and multiple problems coexist frequently. The pathogeny remains unclear, but the hypothesis that imbalances between abdominal muscles and adductors exist, has a certain success. Some anatomic and biomechanic factors may play a role in this pathology. A good clinical examination is an important part of the diagnosis and imaging may be helpful to eliminate other causes of groin pain that wouldn't be mechanic. The conservative treatment is long and difficult and must be focused on functional strengthening and core stabilisation.

[Exercise-associated muscle cramps]. / Les crampes musculaires associées a l'effort.

Exercice-associated muscle cramps are a common sports-medical problem, although often benign, among athletes of endurance-sports above all. They are characterized by a painful, sudden and involuntary contraction of one or more muscular groups. If they become recurrent and/or uncomfortable, they should then be the subject of a thorough etiologic research. Medical history, conventional physical examination and a limited laboratory screen could help to determine the various possible causes of muscle cramp. The "historical" and more recent physiopathological assumptions are systematically reviewed, just as the therapeutic options which are guided as well on empiricism and experience that on medicamentous limited trials.

[Plasticity of striated skeletal muscle: training effect and perspectives]. / Plasticité du muscle strié squelettique: effet de l'entraînement et perspectives.

The muscle's wide array of functional characteristics is mediated by the existence of fiber types, differing one from the other in terms of contractile and metabolic protein isoforms content. Numerous classification systems have evolved, describing the muscle's physical, architectural and metabolic characteristics. Nevertheless, it appears that those characteristics assemble in more or less independent modules, excluding the development of a generalized classification of muscle fiber types. The discovery of several mechanisms allowing for the muscle to adapt to training or other changes opens new interventional perspectives regarding sport performances, as well as the maintenance of an adequate musculature in patients.

[Some performance tests among athletes: their importance according to sport, their interests and interpretation]. / Quelques tests de performance pour le sportif: lesquels et pour qui, leurs intérêts et interprétation.

In the multiple performance tests that actually exist, the choice of the most representative evaluation of the physical activity is crucial. For the general or field practitioner who wants to give his or her athlete the most useful informations for the follow-up, this choice may be very difficult. Nevertheless, the results of those tests, once a correct interpretation have been done, will give opportunity to built an efficient training's program, whatever the type of sports or the athlete's level. This change in the management of the sportsman is an answer to the request of the athlete or his trainer; from now on, they both want a more scientific training's planning, built on physiological parameters.

[Influence of testing position on lumbar isokinetic measurements]. / Influence de la position de test sur l'évaluation isocinétique lombaire.

UNLABELLED: The studies carried out on the lumbar spine, using an isokinetic type machine, showed the importance of the extensor muscles and the force they develop, compared with the flexor muscles. Both the sitting and standing positions were used without determining the better position. MAIN OBJECTIVE OF THE STUDY: To determine how the patients position influenced the performance of the muscles. We also studied a new parameter : the angle to maximal peak torque (APT). MATERIAL AND METHOD: 17 healthy subjects and 19 suffering from low back pain were chosen. We perform the test in both positions for each subject. We compare in each group the peak torque of the extensor and flexor muscles on both positions and the angle of this torque. RESULTS: Low back pain subjects flexor/extensor ratio were 1.71 sitting and 1.56 standing. Healthy subjects showed normal ratio of 0.69 and 0.84. CONCLUSION: The position of the subject has no influence on the results in the low back pain subjects, and the sitting position is preferred. The angle of development of the maximal peak torque in both groups of muscles was very interesting, especially in the subjects suffering from low back pain and shines a new light on the different functions of the muscles of the low back pain suffering subjects and the healthy subjects. This angle (APT) is inversed in low back pain subjects who develop more torque for the extensors in extension of the spine.