Citations

The goal of sports injury research is to improve understanding of injuries in a specific sport in order to facilitate prevention. Comprehension of epidemiology principles is necessary to design research protocols which are both accurate and pragmatic. Common pitfalls in sports epidemiology include selection bias, detection bias, transfer bias, recall bias, susceptibility bias, and confounding. Calculation of an injury rate requires precise measurement of the number of events (numerator) and the population-at-risk (denominator). Viable strategies for determining the incidence and characteristics of injuries and for observing outcome after an intervention in the sport of ice hockey include prospective cohort observational and interventional analyses.

Studying goalies, who play a key position in hockey requires examining psychophysiologic variables and their relationship to performance during games when the outcome is important [15]. This investigation tested all three aspects of emotion (subjective, physiologic changes, and performance). Nine male goalies completed questionnaires and provided salivary cortisol before, during, and after each game. Heart rate (ECG signal) was integrated with the goalie's performance video. Goalies rated on Likert Scales; headaches, stomach aches, insomnia, nervousness, and awareness of heart pounding. Data from 16 games were obtained. Of nine, two goalies provided data on three games each; one goalie was classified as a responder and the other a non-responder, based on salivary cortisol levels (SCL). The responder's SCL increased 572% between baseline and post-period assessments, whereas SCL in the non-responder increased 50% above baseline. The responder's SCL increased 8 times baseline when he faced 16 shots in a period. The responder goalie's game heart rates (HRs) were 160,152, and 167 beats per minute (bpm) and the non-responder's HRs were 147, 132, and 142 bpm for three games. Game performance was similar for both goalies.

In the sport of ice hockey, the incidence of injury has been investigated at multiple levels of participation based on collective player exposure, which assumes equal playing time among participants. However, playing time varies enormously between individual players on a given team due to variability in the number and length of shifts. Individual player monitoring, although labor intensive, more accurately identifies risk factors for sustaining injuries. Specific player exposure data are necessary for detailed analysis of factors such as style of play, illegal activities, equipment, player size, and officiating. In addition, prospective, uniform and accurate collection of exposure data may permit meaningful comparison of injury rates between levels of participation in ice hockey and also among different sports. Refinement of data collection tools that determine individual player injury exposure will increase the power of the denominator and facilitate prevention of ice hockey injuries.

The purpose of this investigation was to examine the components of intimidation in ice hockey and to determine their effects on players, coaches, and referees. In a pilot test, hockey coaches (N = 17) from three levels of participation were invited to an informal, exploratory symposium to assess their opinions on the role of intimidation in ice hockey. The following themes emerged: a) coaches' behavior and expectations, b) observable behavior, c) player's perceived role, and d) sociological factors. A preliminary intimidation model was developed. A survey including 80 open- ended questionnaires designed to stimulate discussion on the definition of intimidation, methods used to intimidate, and factors perceived as intimidating, was distributed to players (N = 66), coaches (N = 8), and referees (N = 6). The data were analyzed using qualitative methods [1,2] and intimidation was defined. Results support a theoretical model, which serves as a point of departure for future research and visually depicts the components of intimidation and their interactions.

Background Isolated meniscal tears in the skeletally immature patient are infrequent but well-recognized injuries. Although few studies have evaluated the pediatric and adolescent population, arthroscopic surgical repair remains the standard of care for Patients in this age group with unstable meniscal tears. Purpose To review our results of arthroscopic repair of isolated meniscal tears in pediatric and adolescent patients to further define future management of these injuries. Study Design Case series; Level of evidence, 4. Methods The records of all patients 18 years old or younger who underwent isolated meniscal repair between 1990 and 2005 were retrospectively reviewed. Forty-four patients (6 girls, 38 boys) with an average age of 15.8 years (range, 9.9-18.7 years) were included in this study, for a total of 45 isolated meniscal tears. Clinical examinations were performed, International Knee Documentation Committee forms were administered, and Tegner scores were determined at an average of 5.8 years (range, 2.5 months-13.8 years) postoperative follow-up. Three patients were lost to follow-up. Results The clinical success rate of arthroscopic meniscal repair was 80% for simple tears, 68% for displaced bucket-handle tears, and 13% for complex tears. Seventeen menisci (38% overall) failed initial repair at a mean of 17 months (range, 3-61 Months) postoperatively and underwent repeat arthroscopic surgery (15 partial meniscectomies, 2 rerepair). The average Tegner and International Knee Documentation Committee scores were 8 (range, 5-9) and 89.4 (range, 79-99), respectively, at the time of final follow-up. Risk factors for failure included complex tears and rim width greater than 3 mm. Conclusion Clinically successful repair of an isolated meniscal tear in patients 18 years or younger was variable depending on tear type, with complex tears and rim width 3 mm or greater being negative prognostic factors.

AbstractA close connectivity between autoimmune and tumor rejection responses is known to exist in the case of melanoma immunotherapy. However, relatively little is known about self-antigens on other types of normal cells, their relation to the development of autoimmune disease, and their possible coexistence as potential tumor rejection antigens on associated tumors. In the current study, we induced inflammatory killing of normal prostate tissue in situ using a fusogenic membrane glycoprotein along with the immune adjuvant hsp70. We show here that, in the prostate, hsp70 induces interleukin (IL)-6, which triggers a CD4- and CD8-dependent progressive autoimmune reactivity, associated with IL-17 expression. This autoimmune response was also able to induce the rejection of established prostate tumors, but not other histologic types of tumors, growing elsewhere in the animal. These data show that the intimate connectivity between autoimmune and tumor rejection responses extends beyond the classic melanoma paradigm and may be clinically valuable for the treatment of established metastatic disease of the prostate. [Cancer Res 2007;67(24):11970–9]

Eighty-six male high school ice hockey players partic ipated in this prospective study to determine both the incidence of injury in high school ice hockey and the influence of physical, situational, and psychosocial fac tors. Physical factors included height, weight, vision, previous injuries, musculoskeletal abnormalities, and injuries present at the time of screening evaluations. Situational factors examined were level of participa tion, playing time, player position, and games versus practices. Psychosocial factors such as confidence, stress, social support, positive states of mind, and mood states were also examined to determine their influences on injury. Twenty-seven injuries occurred during the 1994 to 1995 season. As hypothesized, the overall incidence of injury in high school hockey games (34.4 per 1000 player-game hours) was less than the incidence of injury in Junior A hockey (96.1 per 1000 player-game hours) and was more than previously re ported for Bantam youth hockey (10.9 per 1000 player- game hours). Injuries occurred more often in games than in practices, usually as a result of collisions. Phys ical factors such as player position and previous inju ries did not significantly predict injuries, but players in the high playing time group were more likely to be injured. Psychosocial factors of low vigor and high fatigue as measured by the Incredibly Short Profile of Mood States (ISPOMS) significantly predicted high school ice hockey injuries.

The purpose of this study was to analyze intersegmen tal forces at the tibiofemoral joint and muscle activity during three commonly prescribed closed kinetic chain exercises: the power squat, the front squat, and the lunge. Subjects with anterior cruciate ligament-intact knees performed repetitions of each of the three exer cises using a 223-N (50-pound) barbell. The results showed that the mean tibiofemoral shear force was posterior (tibial force on femur) throughout the cycle of all three exercises. The magnitude of the posterior shear forces increased with knee flexion during the descent phase of each exercise. Joint compression forces remained constant throughout the descent and ascent phases of the power squat and the front squat. A net offset in extension for the moment about the knee was present for all three exercises. Increased quadri ceps muscle activity and decreased hamstring muscle activity are required to perform the lunge as compared with the power squat and the front squat. A posterior tibiofemoral shear force throughout the entire cycle of all three exercises in these subjects with anterior cru ciate ligament-intact knees indicates that the potential loading on the injured or reconstructed anterior cruci ate ligament is not significant. The magnitude of the posterior tibiofemoral shear force is not likely to be detrimental to the injured or reconstructed posterior cruciate ligament. These conclusions assume that the resultant anteroposterior shear force corresponds to the anterior and posterior cruciate ligament forces.

This 3-year prospective cohort observational analysis of elite amateur hockey players ranging in age from 17 to 20 years on a United States Hockey League team de scribes ice hockey injuries using a strict definition of injury, standardized reporting strategies, and diagnosis by a team physician. One hundred forty-two injuries were recorded for an on-ice injury rate of 9.4 per 1000 player hours. A player was 25 times more likely to be injured in a game (96.1 per 1000 player-game hours) than in practice (3.9 per 1000 player-practice hours). Game-related injuries were more frequent in the third period, and practice-related injuries occurred more of ten in the first third of the season. Collisions represented 51% of the total injuries. The most common types of injuries were strains, lacerations, contusions, and sprains. The face and the shoulder were most fre quently injured. A facial laceration was the most com mon injury; acromioclavicular joint sprain was the sec ond most common injury. Facial lacerations typically occurred in games and were stick related. Further re search is necessary to determine if injuries in Junior A amateur ice hockey can be reduced by mandatory full facial protection, enforcement of existing rules, im provement in shoulder pad design, and by focusing more attention on stretching programs.

The purpose of this study was to review patellar tendon ruptures in athletes treated with surgical repair. Six pa tellar tendon ruptures in five athletic patients were iden tified at our institution between 1980 and 1990. All pa tients had operative debridement and primary repair of the ruptured patellar tendon using nonabsorbable su tures passed through patellar drill holes at an average of 2.5 days after injury. Personal interview, physical ex amination, roentgenographic evaluation, and isokinetic strength testing were performed at an average of 6 years after surgery. At final followup, no patient had complaints referable to the patellar tendon repair; all were able to achieve their premorbid levels of sports at an average of 18 months after injury. No patient thought that the surgically repaired knee was unstable or activity-limiting. All patients demonstrated full range of motion and strength equal to or greater than that of the noninjured side. One patient required an arthroscopic lateral release for lateral patellar facet pressure syn drome with an excellent result. No complications oc curred ; no other reoperations were required. Complete disruption of the patellar tendon is an uncommon injury in athletic individuals without predisposing medical con ditions. After acute operative repair and aggressive re habilitation, an excellent and enduring functional outcome can be expected.