A prospective investigation of changes in the sensorimotor system following sports concussion. An exploratory study

Background Sports concussion is a risk for players involved in high impact, collision sports. Post-concussion, the majority of symptoms subside within 7–10 days, but can persist in 10–20% of athletes. Understanding the effects of sports concussion on sensorimotor systems could inform physiotherapy treatment. Objective To explore changes in sensorimotor function in the acute phase following sports concussion. Design Prospective cohort study. Methods Fifty-four players from elite rugby union and league teams were assessed at the start of the playing season. Players who sustained a concussion were assessed three to five days later. Measures included assessments of balance (sway velocity), vestibular system function (vestibular ocular reflex gain; right-left asymmetry), cervical proprioception (joint position error) and trunk muscle size and function. Results During the playing season, 14 post-concussion assessments were performed within 3–5 days of injury. Significantly decreased sway velocity and increased size/contraction of trunk muscles, were identified. Whilst not significant overall, large inter-individual variation of test results for cervical proprioception and the vestibular system was observed. Limitations The number of players who sustained a concussion was not large, but numbers were comparable with other studies in this field. There was missing baseline data for vestibular and cervical proprioception testing for some players. Conclusions Preliminary findings post-concussion suggest an altered balance strategy and trunk muscle control with splinting/over-holding requiring consideration as part of the development of appropriate physiotherapy management strategies

HAPPi Kneecaps! Protocol for a participant- and assessor-blinded, randomised, parallel group feasibility trial of foot orthoses for adolescents with patellofemoral pain

BACKGROUND: Patellofemoral pain (PFP) is a common cause of knee pain in adolescents, but there are limited evidence-based treatment options for this population. Foot orthoses can improve pain and function in adults with PFP, and may be effective for adolescents. The primary aim of th

Injuries in Australian school-level rugby union

There is a high incidence of injuries in rugby union due to the physical nature of the game. In youth rugby union, there are large variations in injury rates reported. Our study investigated the rates of injuries in school-level rugby union players in Australia using the consensus statement for rugby union injuries. Injury surveillance was conducted on 480 rugby players from 1 school in Queensland, Australia. Injury data were collected using paper-based injury recording forms during the 8-week rugby season using a “medical-attention” injury definition. In total, 76 players sustained one or more injuries, with a total of 80 injuries recorded. The overall injury rate was 31.8 injuries/1000 match player hours (95% CI, 25.4–39.4). Concussion had an incidence rate of 6.0/1000 match player hours (95% CI, 3.5–9.6). The incidence of upper limb and lower limb injuries were 9.1 and 9.9/1000 match player hours, respectively (95% CI, 5.9–13.5 and 6.6–14.5). The older age divisions had higher injury rates and most injuries occurred while tackling or being tackled. The injury rates observed in this sample of Australian school rugby union players provides direction for future studies to enable informed decisions relating to development of injury prevention programmes at this level of rugby

A comparison of rigid tape and exercise, elastic tape and exercise and exercise alone on pain and lower limb function in individuals with exercise related leg pain: a randomised controlled trial

Background: Exercise related leg pain (ERLP) is a common lower limb overuse injury characterised by pain located between the knee and ankle that occurs during activity. The high incidence of the condition, subsequent interference with participation in physical activity and substantial recovery time, highlights a need for effective interventions. Whilst many interventions have been described for the management of ERLP, currently there is a lack of high quality evidence for an effective intervention for the condition.Methods/Design: A single-blinded randomised controlled clinical trial will be conducted in a community setting. Forty-five female volunteers aged between 18 and 40 years with a history of insidious onset of pain located between the knee and ankle of at least one month duration that is aggravated by weight bearing activities will be recruited for the study. Suitable participants will be randomly allocated to one of three treatment groups for the 6 week intervention period: (i) exercise only, (ii) rigid anti-pronation tape and exercise, (iii) elastic anti-pronation tape and exercise. Outcomes will be measured at baseline, 1, 2 and 6 weeks using primary outcome measures of usual and worst pain visual analogue scale and global perceived improvement. Secondary outcome measures will include Foot and Ankle Ability Measure, Patient Specific Functional Scale and amount of activity in the previous week. In addition, participants will be contacted by phone to obtain primary and secondary outcome measures at 12, 18, 24 and 30 weeks.Discussion: This article describes a single-blinded randomised controlled clinical trial that will utilise high quality methodologies in accordance with CONSORT guidelines. The results of this study will contribute to the limited knowledge regarding effective interventions for the management of ERLP