Vertebral anomalies in retired rugby players and the impact on bone density calculation of the lumbar spine

Dual energy X-ray absorptiometry (DXA) lumbar spine bone mineral density (BMD) measurements are subject to artificial elevation in the presence of structural abnormalities that are more common with age and injury, including osteoarthritis, fracture and osteophytes. The aims of this study were to investigate the presence of vertebral abnormalities on DXA scans in retired rugby players and a nonrugby control group, and to explore the effect of vertebral exclusion on the BMD diagnostic outcome. Eigty-seven male retired rugby players and 51 non-rugby controls from the UK Rugby Health Project participated in the study. Lumbar spine, total hip and femoral neck BMD were measured by DXA and scans were analyzed pre and post exclusion of anomalous vertebrae. Data were analyzed by age group to enable application of T-scores (≥50 y) and Z-scores (<50 y). From 138 lumbar spine scans, 66 required adjustment. One hundred twenty-two vertebral exclusions were made, and 12 lumbar spine scans (10 in retired rugby athletes) were un-reportable (<2 evaluable vertebrae). Vertebral exclusion significantly lowered lumbar spine BMD across all groups (p<0.01) and lowered the overall lowest T/Z-score. This effect was more pronounced in rugby groups (age <50 y, p < 0.001; age ≥50 y, p = 0.031) than in the control groups (age <50y, p = 0.125; age ≥50 y, p = 0.250). Vertebral abnormalities detected on lumbar spine scans, were highly prevalent and impacted final the T/Z-score in this cohort of retired rugby players. Current guidelines recommend exclusion of abnormalities from lumbar spine scans in adults aged ≥50 years. Our findings suggest that vertebral exclusions should also be applied to lumbar spine scans performed in those aged <50 years, particularly in former contact sports athletes, given their high risk for vertebral deformity

Three-compartment body composition changes in elite rugby league players during a super league season, measured by dual-energy X-ray absorptiometry.

This study investigated the acute changes in body composition that occur over the course of a competitive season in elite rugby league players. Twenty elite senior players from an English Super League rugby league team underwent a total-body dual-energy X-ray absorptiometry scan at 3 phases of a competitive season: preseason (February), midseason (June), and postseason (September). Body mass (BM), fat mass (FM), lean mass, percentage body fat, and bone mineral content (BMC) were reported at each phase. Between the start and midpoint of the season, BM, lean mass, FM, and body fat percentage showed no significant change (p > 0.05); however, BMC was significantly increased (+0.71%; 30.70 ± 38.00 g; p 0.05); however, significant changes were observed in lean mass (-1.54%; 1.19 ± 1.43 kg), FM (+4.09%; 0.57 ± 1.10 kg), and body fat percentage (+4.98%; 0.78 ± 1.09%; p < 0.05). The significant changes in body composition seen over the latter stages of the competitive season may have implications for performance capabilities at this important stage of competition. An increase in FM and decrease in lean mass may have a negative effect on the power/BM ratio, and therefore may be a cause for concern for playing, coaching, and medical staff. Coaching and strength and conditioning staff should aim to prescribe appropriate training and nutritional practices with the aim of maintaining the players' optimal body composition until the conclusion of the competitive season, in order that performance capabilities are maximized over the entire competition period

A standardised protocol for the assessment of lower limb muscle contractile properties in football players using Tensiomyography

Tensiomyography is used to measure skeletal muscle contractile properties, most notably muscle displacement (Dm) and contraction time (Tc). Professional football medical departments are currently using the equipment to profile the muscle function of their squad and subsequently evaluate change due to injury or intervention. However, at present there are no published standardised operating procedures for identifying probe position for muscle assessment. In this technical report we propose standardised operating procedures for the identification of precise probe position as part of an on-going study in male professional footballers

Epidemiology of Injury in Women’s Super League Football: A Cohort Study

Introduction: The epidemiology of injury in male professional football has been well documented (Ekstrand, Hägglund, & Waldén, 2011) and used as a basis to understand injury trends for a number of years. The prevalence and incidence of injuries occurring in women’s super league football is unknown. The aim of this study is to estimate the prevalence and incidence of injury in an English Super League Women’s Football squad. Methods: Following ethical approval from Leeds Beckett University, players (n = 25) signed to a Women’s Super League Football club provided written informed consent to complete a self-administered injury survey. Measures of exposure, injury and performance over a 12-month period was gathered

Is the Force Awakened? Publication Trends in Oncology Big Data as Phase II CancerLinQ is Launched

Background: The American Society of Clinical Oncology launched CancerLinQ project in 2010 to provide real-time data collection, mining and visualization, clinical decision support, and quality feedback. Creation of a big data software platform is currently underway to power the CancerLinQ in the phase II of the project. This would allow for evidence driven practice and rapid learning for cancer care providers. Additionally, adequate knowledge about the utility of Big Data to encourage provider utilization in high Impact Factor (IF) journals is needed. We aimed to assess trends and quality of Big Data published in Oncology. Methods: Peer-reviewed English papers published between 2011 and 2015 reporting on cancer and Big Data were identified using PubMed. Manual review was conducted. Cohort construction and statistical analyses were performed utilizing SPSS v 21.0 Results: We identified 325 publications, 135 met inclusion criteria in 105 journals, of which 36% (n=38) are considered specialized hematology and/or oncology journals. Specialized journals published 29.62% (40/135). Equal distribution of publications was found in clinical and basic science journals; 54 (37%) and 50 (40%) respectively. There was a trend of increased publications in clinical journals from 2012 to 2015 (16.7% to 42.9%, P = 0.39). Of the available Impact factors (IF) – the median is 3.234 (range 0.00-41.456) with 25/125 (20.0%) of available IF being \u3e 5.00 and 12/125 (9.6%) being \u3e 10.00 with no difference in the proportion of IF \u3e 5.00 in clinical versus basic science journals; 11/51 (21%) versus 11/47 (23) % p = 1.00, respectively. Conclusions: The need for further publication of studies addressing Big Data use in furthering oncology research is being met by the research community in response to the CancerLinQ as demonstrated by the rapid increase in publications. We hypothesize that this will increase the likelihood of cancer providers using CancerLinQ in the future, although an increase in publication in specialized journals and in those with high impact factors is still necessary. Currently, despite the increased trend of publications addressing Big Data in oncology, less than one-third of these publications are in specialized journals

The incidence, cost, and burden of concussion in women’s rugby league and rugby union: A systematic review and pooled analysis

Background: The extent of concussion injury in the rugby codes for women is unclear. Objective: Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods: We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women’s concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results: The pooled analysis match injury incidence of women’s concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women’s rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women’s rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions: Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women’s rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences

Measurement of muscle health in aging

Muscle health is a critical component in the struggle against physical frailty and the efforts to maintain metabolic health until the limit of chronological age. Consensus opinion is to evaluate muscle health in terms of muscle mass, strength and functional capability. There has been considerable variability in the components of muscle health which have been investigated in addition to variability in the tools of assessment and protocol for measurement. This is in stark contrast to the validated measurement of bone health across the adult life span. The purpose of this review was to identify indices of muscle mass, strength and functional capability most responsive to change with ageing and where possible to provide an estimate of the rate of change. We suggest lean tissue mass (LTM) or skeletal muscle (SM) is best evaluated from the thigh region due to its greater responsiveness to ageing compared to the whole body. The anterior compartment of the thigh region undergoes a preferential age-related decline in SM and force generating capacity. Therefore, we suggest that knee extensor torque is measured to represent the force generating capacity of the thigh and subsequently, to express muscle quality (strength per unit tissue). Finally, we suggest measures of functional capability which allow participants perform to a greater maximum are most appropriate to track age-related difference in functional capacity across the adult lifespan. This is due to their ability encompass a broad spectrum of abilities. This review suggests indices of muscular health for which reference ranges can be generated across the lifespan

Respiratory management in severe acute respiratory syndrome coronavirus 2 infection.

The severe acute respiratory syndrome coronavirus 2 pandemic is to date affecting more than a million of patients and is challenging healthcare professionals around the world. Coronavirus disease 2019 may present with a wide range of clinical spectrum and severity, including severe interstitial pneumonia with high prevalence of hypoxic respiratory failure requiring intensive care admission. There has been increasing sharing experience regarding the patient's clinical features over the last weeks which has underlined the need for general guidance on treatment strategies. We summarise the evidence existing in the literature of oxygen and positive pressure treatments in patients at different stages of respiratory failure and over the course of the disease, including environment and ethical issues related to the ongoing coronavirus disease 2019 infection