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Pediatric Sports Related Injuries: A Multidisciplinary Approach

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Exercise and Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 67518

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Special Issue Editors

Dr. Louis-Nicolas Veilleux

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Guest Editor

1. Department of Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
2. Motion Analysis Center, Shriners Hospital for Children-Canada, Montreal, Quebec, Canada
Interests: sports medicine; return to sports; anterior cruciate ligaments; anterior knee pain; human motion analysis; biomechanics; musculoskeletal disorders; telemedicine and physical activity

Dr. Corinna Franklin

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Guest Editor

1. Shriners Hospitals for Children – Philadelphia, Philadelphia, PA, USA
2. Temple University School of Medicine, Department of Orthopaedic Surgery,Philadelphia, PA, USA
3. Sidney Kimmel Medical College of Thomas Jefferson University, Department of Orthopaedic Surgery, Philadelphia, PA, USA
Interests: sports medicine (sexual dimorphism, biomechanics, ACL injuries, patellar instability); decision-making and outcomes; cerebral palsy

Special Issue Information

Dear Colleagues,

Pediatric sports medicine is a rapidly expanding field driven, in part, by an overall increase in the incidence of sports-related injuries in the pediatric population. The incidence of anterior cruciate ligament (ACL) ruptures, for example, has increased substantially in the last 20 years. Because sports-related injuries may impair multiple aspects of a child’s life, pediatric sports medicine requires a multidisciplinary approach including, but not limited to, orthopedic surgery, physical therapy, social work, psychology, nutrition and kinesiology. Given that pediatric sports medicine has long been developed based on adult clinical research, there is an urgent need to generate innovative evidence-based research developing specific pediatric sports medicine interventions and management protocols for sports-related injuries.

This Special Issue seeks papers on pediatric-sports-related injuries and interventions in diverse research fields such as primary care sports medicine, psychology, nutrition, orthopedic surgery, physical therapy and movement science. It also aims at generating new collaborations amongst pediatric sports medicine healthcare providers, stakeholders, and researchers.

Dr. Louis-Nicolas Veilleux
Dr. Corinna Franklin
Guest Editors

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Keywords

pediatric sports medicine
anterior cruciate ligament
return to sports
sports nutrition
sports psychology
pediatric sports injury
gender dismorphism
biomechanics
motion analysis

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Published Papers (9 papers)

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Research

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9 pages, 293 KiB

Open AccessArticle

Sports Bra Preferences by Age and Impact of Breast Size on Physical Activity among American Females

by Katherine H. Rizzone, Bianca Edison, Nailah Coleman, Cordelia Carter, Ingrid Ichesco, Paige Cassidy, Jane Chung and Courtney Marie Cora Jones

Int. J. Environ. Res. Public Health 2021, 18(23), 12732; https://doi.org/10.3390/ijerph182312732 - 2 Dec 2021

Cited by 5 | Viewed by 4487

Abstract

For many females, sports bras are an essential piece of equipment for participation in sports and physical activity. Breast pain or discomfort from lack of support may be a contributing factor to the noted gender disparity in physical activity of females compared to males. Our objective was to evaluate sports bra usage and characterize sports bra preferences of an active female cohort. This multicenter cross-sectional survey study was conducted at five geographically distinct academic centers. Our measure was administered during outpatient sports medicine clinic visits to females aged 11–64 years old. Chi-square tests were used to compare characteristics across subgroups. Our analysis consisted of 438 respondents, with a mean age of 22 ± 12.2 years. More than a quarter (27.4%) reported lack of breast support prevented them from being active or exercising. Age (p = 0.03), breast size (p < 0.0001), and household income (p = 0.01) were significantly associated with greater frequency of physical activity being limited by lack of breast support. Lack of breast support may be an important barrier for young females of specific populations to meeting physical activity recommendations. Further research is needed to improve the understanding of this important piece of sporting equipment for women. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

15 pages, 1626 KiB

Open AccessArticle

Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

by Tishya L. Wren, Veronica Beltran, Mia J. Katzel, Adriana S. Conrad-Forrest and Curtis D. VandenBerg

Int. J. Environ. Res. Public Health 2021, 18(14), 7492; https://doi.org/10.3390/ijerph18147492 - 14 Jul 2021

Cited by 10 | Viewed by 2827

Abstract

Iliotibial band autograft is an increasingly popular option for pediatric anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare recovery of knee extensor mechanism function among pediatric patients who underwent ACLR using iliotibial band (IT), hamstring tendon (HT), quadriceps tendon (QT), and patellar tendon (PT) autografts. One hundred forty-five pediatric athletes (76 female; age 15.0, range 7–21 years) with recent (3–18 months) unilateral ACLR performed drop-jump landing and 45° cutting with 3D motion capture. Knee extensor mechanism function (maximum knee flexion angle, maximum internal knee extensor moment, energy absorption at knee) during the loading phase (foot contact to peak knee flexion) was compared among graft types (20 IT, 29 HT, 39 QT, 57 PT) and sides (ACLR or contralateral) using linear mixed models with sex, age, and time since surgery as covariates. Overall, knee flexion was significantly lower on the operated vs. contralateral side for HT, QT, and PT during both tasks (p < 0.03). All graft types exhibited lower knee extensor moments and energy absorption on the operated side during both movements (p ≤ 0.001). Kinetic asymmetry was significantly lower for IT compared with QT and PT during both movements (p ≤ 0.005), and similar patterns were observed for HT vs. QT and PT (p ≤ 0.07). Asymmetry was similar between IT and HT and between QT and PT. This study found that knee extensor mechanism function recovers fastest in pediatric ACLR patients with IT autografts, followed by HT, in comparison to QT and PT, suggesting that IT is a viable option for returning young athletes to play after ACLR. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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10 pages, 1224 KiB

Open AccessArticle

More Physical Activity after Concussion Is Associated with Faster Return to Play among Adolescents

by Corrine N. Seehusen, Julie C. Wilson, Gregory A. Walker, Sarah E. Reinking and David R. Howell

Int. J. Environ. Res. Public Health 2021, 18(14), 7373; https://doi.org/10.3390/ijerph18147373 - 9 Jul 2021

Cited by 18 | Viewed by 5138

Abstract

Concussion management has evolved to de-emphasize rest in favor of early introduction of post-injury physical activity. However, the optimal quantity, frequency and intensity of physical activity are unclear. Our objective was to examine the association between objective physical activity metrics and clinical recovery after concussion. We prospectively enrolled a cohort of 32 youth athletes with concussion, evaluated within 14 days of injury and after return-to-play (RTP) clearance. For two weeks after enrollment, we quantified steps/day and exercise frequency, duration, and intensity via wrist-worn actigraphy. We grouped participants by RTP clearance timing (<28 days vs. ≥28 days). Seventeen (53%) participants required ≥28 days post-concussion for RTP clearance. Groups were similar in age (14.9 ± 1.9 vs. 15.4 ± 1.5 years; p = 0.38), proportion of females (47% vs. 40%; p = 0.69), and concussion history (59% vs. 47%; p = 0.49). During the study period, the RTP ≥ 28 days group took fewer steps/day (8158 ± 651 vs. 11,147 ± 4013; p = 0.02), exercised fewer days/week (2.9 ± 2.4 vs. 5.0 ± 1.9 days/week; p = 0.01), and exercised fewer total minutes/week (117 ± 122 vs. 261 ± 219 min/week; p = 0.03). Furthermore, we observed ≥10,251 average steps/day, ≥4 exercise sessions/week, and exercising ≥134 total minutes/week were optimal cutpoints to distinguish between groups. These findings support the benefit of physical activity during concussion recovery. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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14 pages, 1300 KiB

Open AccessArticle

Children with Cerebral Palsy Have Similar Walking and Running Quality Assessed by an Overall Kinematic Index

by Devin K. Kelly, Mark L. McMulkin, Corinna Franklin and Kevin M. Cooney

Int. J. Environ. Res. Public Health 2021, 18(9), 4683; https://doi.org/10.3390/ijerph18094683 - 28 Apr 2021

Cited by 2 | Viewed by 2534

Abstract

Running ability is critical to maintaining activity participation with peers. Children and adolescents with cerebral palsy (CP) are often stated to run better than they walk, but running is not often quantitatively measured. The purpose of this study was to utilize overall gait deviation indices to determine if children with diplegic CP run closer to typically developing children than they walk. This retrospective comparative study utilized 3D running kinematics that were collected after walking data at two clinical motion analysis centers for children with diplegic cerebral palsy. Separate walking and running Gait Deviation Indices (GDI Walk and GDI* Run), overall indices of multiple plane/joint motions, were calculated and scaled for each participant so that a typically developing mean was 100 with standard deviation of 10. An analysis of variance was used to compare the variables Activity (walking vs running) and Center (data collected at two different motion analysis laboratories). Fifty participants were included in the study. The main effect of Activity was not significant, mean GDI Walk = 76.4 while mean GDI* Run = 77.1, p = 0.84. Mean GDI scores for walking and running were equivalent, suggesting children with diplegic cerebral palsy as a group have similar walking and running quality. However, individual differences varied between activities, emphasizing the need for individual assessment considering specific goals related to running. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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8 pages, 325 KiB

Open AccessReview

Psychological and Social Components of Recovery Following Anterior Cruciate Ligament Reconstruction in Young Athletes: A Narrative Review

by Emil Stefan Vutescu, Sebastian Orman, Edgar Garcia-Lopez, Justin Lau, Andrew Gage and Aristides I. Cruz, Jr.

Int. J. Environ. Res. Public Health 2021, 18(17), 9267; https://doi.org/10.3390/ijerph18179267 - 2 Sep 2021

Cited by 27 | Viewed by 8559

Abstract

Anterior cruciate ligament (ACL) rupture is a common injury in young athletes. To restore knee stability and function, patients often undergo ACL reconstruction (ACLR). Historically, there has been a focus in this population on the epidemiology of ACL injury, the technical aspects of ACL reconstruction, and post-operative functional outcomes. Although increasingly recognized as an important aspect in recovery, there remains limited literature examining the psychological aspects of post-operative rehabilitation and return to play following youth ACL reconstruction. Despite technical surgical successes and well-designed rehabilitation programs, many athletes never reach their preinjury athletic performance level and some may never return to their primary sport. This suggests that other factors may influence recovery, and indeed this has been documented in the adult literature. In addition to restoration of functional strength and stability, psychological and social factors play an important role in the recovery and overall outcome of ACL injuries in the pediatric population. Factors such as psychological readiness to return-to-play (RTP), motivation, mood disturbance, locus of control, recovery expectations, fear of reinjury, and self-esteem are correlated to the RTP potential of the young athlete. A better understanding of these concepts may help to maximize young patients’ outcomes after ACL reconstruction. The purpose of this article is to perform a narrative review of the current literature addressing psychosocial factors associated with recovery after ACL injury and subsequent reconstruction in young athletes. Our goal is to provide a resource for clinicians treating youth ACL injuries to help identify patients with maladaptive psychological responses after injury and encourage a multidisciplinary approach when treating young athletes with an ACL rupture. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

11 pages, 345 KiB

Open AccessReview

Psychological Resilience in Young Female Athletes

by Kimberly H. McManama O’Brien, Miriam Rowan, Kyra Willoughby, Kelsey Griffith and Melissa A. Christino

Int. J. Environ. Res. Public Health 2021, 18(16), 8668; https://doi.org/10.3390/ijerph18168668 - 17 Aug 2021

Cited by 33 | Viewed by 13506

Abstract

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

12 pages, 701 KiB

Open AccessReview

Can a Knee Brace Prevent ACL Reinjury: A Systematic Review

by Bianca Marois, Xue Wei Tan, Thierry Pauyo, Philippe Dodin, Laurent Ballaz and Marie-Lyne Nault

Int. J. Environ. Res. Public Health 2021, 18(14), 7611; https://doi.org/10.3390/ijerph18147611 - 17 Jul 2021

Cited by 9 | Viewed by 9287

Abstract

This systematic review aimed to investigate whether the use of a knee brace when returning to sport (RTS) could prevent a second injury after anterior cruciate ligament reconstruction (ACLR). This study was registered with the PROSPERO database and followed PRISMA guidelines. A systematic search of PubMed, Ovid Medline, Ovid All EBM Reviews, Ovid Embase, EBSCO Sportdiscus and ISI Web of Science databases for meta-analysis, randomized controlled trials and prospective cohort studies published before July 2020 was undertaken. The inclusion criteria were: (1) Comparing with and without a brace at RTS, (2) follow up of at least 18 months after ACLR, (3) reinjury rates included in the outcomes. Two reviewers independently extracted the data. Quality appraisal analyses were performed for each study using the Cochrane Collaboration tools for randomized and nonrandomized trials. A total of 1196 patients in three studies were included. One study showed a lower rate of reinjury when wearing a knee brace at RTS. One study found the knee brace to have a significant protective effect for younger patients (≤17 years). The effectiveness of knee bracing when RTS remains ambiguous. Current data cannot support that using a knee brace when RTS will decrease the rate of reinjury after ACL reconstruction. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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Other

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12 pages, 829 KiB

Open AccessSystematic Review

Youth Distance Running and Lower Extremity Injury: A Systematic Review

by Tatiana Paz, Rachel N. Meyers, Cayla N. Faverio, Yuxuan Wang, Emily M. Vosburg and Derek J. Clewley

Int. J. Environ. Res. Public Health 2021, 18(14), 7542; https://doi.org/10.3390/ijerph18147542 - 15 Jul 2021

Cited by 3 | Viewed by 5052

Abstract

Distance running is a popular youth sport. This systematic review identified and examined the effects of youth distance running and lower extremity musculoskeletal injury. Scientific databases were searched from database inception to May 2020. Two hundred and fifty-eight full texts were screened, with nine articles retained for data extraction. Seven of the studies were case reports or case series. Two case reports involved an apophyseal hip fracture. No correlation was found between running mileage or gender and sustaining an injury. Middle school runners reported fewer injuries than high school runners. Cross country accounted for less than 10% of injuries in youth under 15 compared to other track activities. The main finding was a paucity of research. Available literature suggests youth can participate in distance running with minimal adverse effects. One exception may be increased vulnerability to growth plate injury. Additional research is needed, especially in those under 10, as literature in this population is nonexistent. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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18 pages, 559 KiB

Open AccessSystematic Review

Athletic Identity in Youth Athletes: A Systematic Review of the Literature

by Bianca R. Edison, Melissa A. Christino and Katherine H. Rizzone

Int. J. Environ. Res. Public Health 2021, 18(14), 7331; https://doi.org/10.3390/ijerph18147331 - 8 Jul 2021

Cited by 63 | Viewed by 14123

Abstract

Athletic identity (AI), the degree of personal connection to sport, is well-described in adult research; however, this social trait has been less studied in younger age groups. This systematic review describes epidemiological characteristics of AI in youth athletes. PubMed, Embase and PsycInfo were searched to identify AI studies involving quantitative athlete identity outcomes and cohorts 22 years and younger. The search strategy was developed for each database using the Boolean method. PRISMA guidelines and the Appraisal Tool for Cross-Sectional Studies (AXIS) were utilized. Ten out of ninety-one studies met inclusion criteria. AI scores differed by race/ethnicity. Two studies found increased AI during adolescence compared to later in ones’ training. Mental health-focused studies revealed higher AI levels protect against burnout, but in injured athletes, increased depression risk. Transitioning to a higher level of play during adolescence can correlate with stronger senses of AI. Further research should explore the concept of athletic identity saliency as one moves through an athletic career or training program and how thoughts of perceived success, professional progression, recruitment prospect or injury affect levels of athletic identity. Full article

(This article belongs to the Special Issue Pediatric Sports Related Injuries: A Multidisciplinary Approach)

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