Understanding acute ankle ligamentous sprain injury in sports

This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury

The young athlete with physical challenges

Médecine du sport pour jeunes sportifs handicapés. Systèmes de classification en fonction de la sévérité du handicap. Problèmes spécifiques du contrôle médical de l'aptitude à la pratique sportive. Pathologies et traumatismes physiques des athlètes en fauteuil roulant, des athlètes amputés, des athlètes déficients visuels ou auditifs

The young athlete with physical challenges

Médecine du sport pour jeunes sportifs handicapés. Systèmes de classification en fonction de la sévérité du handicap. Problèmes spécifiques du contrôle médical de l'aptitude à la pratique sportive. Pathologies et traumatismes physiques des athlètes en fauteuil roulant, des athlètes amputés, des athlètes déficients visuels ou auditifs

Promotion of physical activity in individuals with intellectual disability La promoción de actividad física en individuos con discapacidad intelectual

This paper provides an overview of strategies that have been used to promote physical activity in individuals with intellectual disability. Several different approaches are discussed and the strengths and limitations of each are presented. Some determinants of physical activity for individuals with intellectual disability are also reported in an effort to better understand the factors that influence participation that could be targeted in future interventions. Recommendations for programming are provided.Este artículo presenta un panorama de las estrategias que se han empleado para promover la actividad física en individuos con discapacidad intelectual. Se discuten varios enfoques distintos y se presentan las fortalezas y limitaciones de cada uno. Se informa asimismo acerca de algunos de los determinantes de la actividad física para los individuos con discapacidad intelectual para contribuir a un mayor entendimiento de los factores que influyen en la participación y que podrían ser el objetivo de futuras intervenciones. Se proporcionan recomendaciones para la programación

Physical Activity Enjoyment, Perceived Barriers, and Beliefs Among Adolescents With and Without Intellectual Disabilities

BACKGROUND: Youth with intellectual disabilities (ID) exhibit low levels of physical activity, but the underlying contributors to behavior are unclear. We compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy among adolescents with ID and typically developing (TD) adolescents. METHODS: A questionnaire was administered to 38 adolescents with ID (mean age 16.8 years) and 60 TD adolescents (mean age 15.3 years). Of the original 33 questionnaire items, 23 met the test-retest reliability criteria and were included in the group comparisons. RESULTS: Fewer adolescents with ID reported that they have someone to do physical activity with (64% vs. 93%, p \u3c 0.001), and a greater proportion of adolescents with ID perceived that physical activities were too hard to learn (41% vs. 0%, p \u3c 0.001). Fewer adolescents with ID believed that physical activity is good for their health (92% vs. 100%, p=0.05). More adolescents with ID reported a dislike of individual physical activities (p=0.02). A large proportion of adolescents with ID (84%) responded that they were good at doing physical activities, but the difference between groups was only of borderline significance. (95% of TD adolescents, p=0.06). CONCLUSIONS: Adolescents shared many of the same perceptions about physical activity, but some important differences between groups were identified

Does physical activity differ between youth with and without intellectual disabilities

BACKGROUND: Children and youth with intellectual disabilities (ID) are known to face obstacles to physical activity participation, yet the activity patterns of this population are not well characterized. OBJECTIVE/HYPOTHESIS: In this study, time spent in moderate to vigorous physical activity (MVPA), type, and frequency of participation in physical activities were assessed in youth with ID and in a comparison group of typically developing (TD) youth. METHODS: Weekly participation in MVPA in 38 youth with ID and 60 TD youth was assessed via accelerometry. Participants were also administered an interview about the frequency and type of physical activities they engaged in over the past year. RESULTS: After adjusting for age and sex, youth with ID spent significantly less time in MVPA (33.5 vs. 46.5min/day, p=0.03) and were less likely to meet the US Physical Activity Guidelines than TD youth (6% vs. 29%, p=0.01). Although time in MVPA was lower in youth with ID, females with ID participated in physical activities more frequently than TD females (47.1 vs. 28.2 times/month, p=0.008) and also reported engaging in a greater variety of physical activities (7.8 vs. 5.2 activities/year, p=0.01). No differences between males in the frequency of physical activity participation or the number of activities performed were observed. Both groups reported walking/hiking and active video as top activities. CONCLUSIONS: Findings emphasize the need for targeted efforts to increase MVPA in youth with ID