Database: Ovid MEDLINE(R)
Database: Ovid MEDLINE(R)
Search Strategy:
--------------------------------------------------------------------------------
1 exp soft tissue injuries/cl, co, di, dt, pc, px, ra, ri, rt,
rh, su, th (986)
2 exp athletic injuries/ or exp sports/ (54981)
3 1 and 2 (66)
4 limit 3 to (human and english language) (55)
5 limit 4 to ovid full text available (6)
6 4 (55)
7 limit 6 to review articles (23)
8 from 7 keep 13,20 (2)
9 7 not 8 (21)
10 5 or 9 (25)
11 limit 4 to yr=1999-2004 (24)
12 from 11 keep 15,17,20 (3)
13 11 not 12 (21)
14 10 or 13 (36)
15 from 14 keep 1-36 (36)
16 from 15 keep 1-36 (36)
***************************
Unique Identifier
11008871
Authors
Yokoyama K. Nakamura T. Shindo M. Tsukamoto T. Saita Y. Aoki S.
Itoman M.
Institution
Department of Orthopedic Surgery, Kitasato University School of
Medicine, Sagamihara, Japan.
Title
Contributing factors influencing the functional outcome of
floating knee injuries.
Source
American Journal of Orthopedics (Chatham, Nj). 29(9):721-9, 2000
Sep.
Abstract
The purpose of the present study was to retrospectively review
the floating knee injuries treated at our institute and to
determine various factors, such as severity of soft-tissue or
skeletal injuries, site of fractures, and treatment methods that
may significantly influence the final functional result in these
injuries. Between 1986 and 1996, 65 patients with 66 floating knee
injuries were treated in our institution. Among 66 fractures of the
femur, 19 (29%) were open. There were 43 open tibial fractures.
Fifty cases were Fraser type I floating knee fractures, 7 were type
IIa, 2 were type IIb, and 7 were type IIc. In 63 cases (95%), both
bones had been surgically stabilized with interlocked nails, Ender
pins, plates, screws with/without pinning, or external fixations.
Final functional results were evaluated according to Karlstrom and
Olerud's criteria. Satisfactory results were rated as cases with
excellent or good results. The mean follow-up time was 16.6 months
range, (12-50 months). We assessed various factors influencing
functional results, including Fraser type, severity of open injury
grade (Gustilo) in both fractures, combination of open/closed
injuries, fracture types (AO/ASIF type), existence of multiple
trauma, neurovascular injuries, polyskeletal trauma, and
stabilizing method or operation timing of both fractures.
Satisfactory rates in Fraser type I and type II were 64% and 25%,
respectively (P= .02). The satisfactory rate in closed, grade I+II,
and grade III injuries of the femoral fractures was 53.2%, 81.8%,
and 25%, respectively (grade I+II vs. grade III: P < .03). There
were no significant correlations between the functional result and
the following factors: soft-tissue injuries of the tibia; the
fracture pattern of both fractures; the combination of open/closed
injuries in each fracture; injury severity score; the existence of
neurovascular injuries and double femoral fractures; treatment
methods; and operation timing. Severity of damage to the knee joint
and open injuries in the thigh were found to be significant factors
contributing to the functional outcome in floating knee
injuries.
Unique Identifier
12567051
Authors
Kuo YR. Kuo MH. Chou WC. Liu YT. Lutz BS. Jeng SF.
Institution
Department of Plastic and Reconstructive Surgery, Chang Gung
Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang,
Kaohsiung Hsien, Taiwan.
Title
One-stage reconstruction of soft tissue and Achilles tendon
defects using a composite free anterolateral thigh flap with
vascularized fascia lata: clinical experience and functional
assessment.
Source
Annals of Plastic Surgery. 50(2):149-55, 2003 Feb.
Abstract
The combined loss of the Achilles tendon with overlying soft
tissue is a reconstructive challenge. To achieve acceptable
rehabilitation, such patients need skin coverage including
functional repair of the Achilles tendon. This article presents
four such patients who were treated successfully by means of an
anterolateral thigh (ALT) composite flap with vascularized fascia
lata. The size of the ALT flaps ranged from 10 to 16 cm in length
and 6 to 9 cm in width. All flaps included vascularized fascia
lata, which was rolled to serve as vascularized tendon graft (range
8 x 6 cm to 10 x 8 cm) for reconstruction of the Achilles tendon
defect. Flap success rate was 100%. All patients could walk and
climb stairs without support; however, mild difficulty when running
was reported. Functional outcome of the recipient ankle and donor
thigh morbidity were investigated by using a kinetic dynamometer
comparing reconstructed sides with the healthy contralateral limbs.
This assessment was performed in two patients at 2 years
postoperatively. In the reconstructed ankles, isokinetic concentric
measurements of dorsiflexion and plantar flexion showed a deficit
of 30% and 40%, respectively. Functional evaluation of quadriceps
femoris muscle contraction forces after free ALT composite flap
harvest showed a 10% to 25% deficit. However, there were no
difficulties in daily ambulating. In summary, the free composite
ALT flap with vascularized fascia lata provides an alternative
option for Achilles tendon reconstruction in complex defects.
Unique Identifier
8149440
Authors
Hart LE.
Institution
Rheumatic Disease Unit, Chedoke-McMaster Hospitals, Hamilton,
Ontario, Canada.
Title
Exercise and soft tissue injury. [Review] [62 refs]
Source
Baillieres Clinical Rheumatology. 8(1):137-48, 1994 Feb.
Abstract
Once the almost exclusive domain of the orthopaedic surgeon,
sports injuries are now being seen with increasing frequency by
other specialists, including rheumatologists. It is therefore
important for rheumatologists to be able to diagnose and manage the
various musculoskeletal conditions that are associated with
physical activity. Soft tissue injuries are a very common cause of
morbidity in both competitive and recreational athletes. Most of
these conditions are provoked by muscle-tendon overload (or
overuse) that is usually the result of excessive training or
improper training techniques. However, despite an emerging
literature on the natural history of soft tissue overuse syndromes,
relatively little is known about the causes, incidence and outcome
of many of these injuries. Of the methodologically robust
epidemiological studies that have been done, most have focused on
habitual distance runners. In this population, it has been reported
that the incidence of injury can be as high as 50% or more, and
that overtraining and the presence of previous injury are the most
significant predictors of future injury. In other popular forms of
exercise, such as walking, swimming, cycling, aerobics and racquet
sports, injuries are also reported with high frequency but, to
date, no prospective studies have examined actual incidences in
these populations, and risk factors for injury in these activities
remain speculative. Several of the more commonly occurring soft
tissue injuries (such as rotator cuff tendinitis, lateral and
medial epicondylitis, patellar tendinitis, the iliotibial band
friction syndrome, Achilles tendinitis and plantar fasciitis)
exemplify the overuse concept and are therefore highlighted in this
review. The management of these, and most other, exercise-related
soft tissue injuries is directed towards promptly restoring normal
function and preventing re-injury. [References: 62]
Unique Identifier
10597860
Authors
de Cree C.
Title
Frostbite at the gym: it's not the ice but the temperature that
matters![comment].
Comments
Comment on: Br J Sports Med. 1999 Aug;33(4):278-9; PMID:
10450486
Source
British Journal of Sports Medicine. 33(6):435-6, 1999 Dec.
Unique Identifier
10597861
Authors
Kerr K.
Title
Frostbite at the gym.[comment].
Comments
Comment on: Br J Sports Med. 1999 Aug;33(4):278-9; PMID:
10450486
Source
British Journal of Sports Medicine. 33(6):436, 1999 Dec.
Unique Identifier
10205709
Authors
Harrington P.
Title
An audit of the use of magnetic resonance imaging by the sports
injuries service of a university teaching hospital.
Source
British Journal of Sports Medicine. 33(2):141, 1999 Apr.
Unique Identifier
11726471
Authors
Yeung EW. Yeung SS.
Institution
Department of Rehabilitation Sciences, The Hong Kong Polytechnic
University, Hung Hom, Kowloon, Hong Kong. [email protected]
Title
A systematic review of interventions to prevent lower limb soft
tissue running injuries.
Source
British Journal of Sports Medicine. 35(6):383-9, 2001 Dec.
Abstract
OBJECTIVES: To assess the available evidence for preventive
strategies for lower limb soft tissue injuries caused by running.
METHODS: An electronic database search was conducted using The
Cochrane Musculoskeletal Injuries Group Specialised Register, The
Cochrane Controlled Trials Register, Medline, Embase, Sport Discus,
Heracles, Atlantes, Biosis, Cinahl, Scisearch, Current Contents,
Index To Theses and Dissertation Abstracts. Any randomised or
quasi-randomised trials evaluating interventions to prevent running
injuries to lower limb soft tissue were included. The eligibility
of trials for inclusion and the quality of the trials were
independently assessed by two reviewers. RESULTS: Exposure to a
high training load (duration, frequency, or running distance)
increases the risk of injury, and thus modification of the training
schedule can reduce the incidence of injury. The effectiveness of
stretching exercises and of insoles in the prevention of lower
extremity soft tissue injuries caused by running is not known.
Wearing a knee brace with a patellar support ring may be effective
in the prevention of anterior knee pain caused by running.
CONCLUSIONS: This review provides evidence for the effectiveness of
the modification of training schedules in reducing lower limb soft
tissue running injuries. More studies are required to quantify the
optimal training loads and to confirm that knee braces can prevent
knee pain. It is important to note that the studies included in
this review had few female participants therefore the results may
not be generalisable.
Unique Identifier
11409239
Authors
Breslow MJ. Rosen JE.
Institution
NYU-Hospital for Joint Diseases, Department of Orthopaedic
Surgery, 301 East 17th Street, New York, New York 10003, USA.
Title
Cervical spine injuries in football. [Review] [30 refs]
Source
Bulletin of the Hospital for Joint Diseases. 59(4):201-10,
2000.
Abstract
The game of football, as it is played today, poses serious risk
of injury for players of all ages. Injury may occur to any
structure of the spinal column, including its bony, ligamentous and
soft tissue components. The majority of cervical spine injuries
occurring in football are self limited, and a full recovery can be
expected. While these injuries are relatively uncommon, cervical
spine injuries represent a significant proportion of athletic
injuries that can produce permanent disability. The low incidence
of cervical spine injuries has lead to a lack of emergency
management experience of on-site medical staff. This paper will
review the numerous injuries sustained by the cervical spine in
football players and provide insights into prevention and
guidelines for return to play. [References: 30]
Unique Identifier
11403116
Authors
MacAuley D.
Institution
Institute of Postgraduate Medicine and Health Science,
University of Ulster, Newtownabbey, UK. [email protected]
Title
Do textbooks agree on their advice on ice?.
Source
Clinical Journal of Sport Medicine. 11(2):67-72, 2001 Apr.
Abstract
OBJECTIVE: To study ice therapy guidance in sports medicine
textbooks. DATA SOURCES: A systematic search of a convenience
sample of textbooks. STUDY SELECTION: 45 general sports medicine
texts were included in the study. DATA EXTRACTION: The indices and
chapter headings of each text were searched using key words "ice,"
"cryotherapy," "soft tissue injury," "muscle," and "bruise." DATA
SYNTHESIS: In 17 of the textbooks, there was no guidance on the
duration, frequency, or length of ice treatment or on the use of
barriers between ice and the skin. Advice on treatment duration was
given in 28 texts but recommendations differed depending on the
particular ice therapy, injury location, or severity. There was
considerable variation in the recommended duration and frequency of
advised treatments. CONCLUSION: There was little guidance in the
standard textbooks on ice application, and the advice varied
greatly. There is a need for evidence-based sport and exercise
medicine with a consensus on the appropriate use of ice in acute
soft tissue injury.
Unique Identifier
12792207
Authors
Babul S. Rhodes EC. Taunton JE. Lepawsky M.
Institution
BC Injury Research & Prevention Unit, Vancouver Hospital
& Health Sciences Center, Family Medicine, University of
British Columbia, Canada. [email protected]
Title
Effects of intermittent exposure to hyperbaric oxygen for the
treatment of an acute soft tissue injury.
Source
Clinical Journal of Sport Medicine. 13(3):138-47, 2003 May.
Abstract
OBJECTIVE: To assess the hypothesis that subjects exposed to
intermittent hyperbaric oxygen treatments would recover from signs
and symptoms indicative of delayed-onset muscle soreness faster
than subjects exposed to normoxic air. DESIGN: Randomized,
double-blinded study with a 4-day treatment protocol. SETTING:
University-based sports medicine clinic. PARTICIPANTS: Sixteen
sedentary female university students. INTERVENTIONS: All subjects
performed 300 maximal voluntary eccentric contractions (30 sets of
10 repetitions per minute) of their nondominant leg (110 to 35
degrees of knee flexion) at a slow speed (30 degrees per second) on
a dynamometer to elicit muscle damage and injury. Hyperbaric oxygen
treatments consisted of 100% oxygen for 60 minutes at 2.0
atmospheres absolute (ATA), while the control group received 21%
oxygen at 1.2 ATA for the same amount of time. Both groups received
treatment immediately after the induction of delayed-onset muscle
soreness and each day thereafter for a period of 4 days (day 1
postexercise through day 4 postexercise). MAIN OUTCOME MEASURES:
Dependent variables (perceived muscle soreness, isokinetic
strength, quadriceps circumference, creatine kinase, and
malondialdehyde) were assessed at baseline (preexercise, day 0), 4
hours postexercise (day 1), 24 hours postexercise (day 2), 48 hours
postexercise (day 3), and 72 hours postexercise (day 4). Magnetic
resonance images (T2 relaxation time/short tip inversion recovery)
were assessed at baseline (day 0), 24 hours postexercise (day 3),
and 72 hours postexercise (day 5). RESULTS: Repeated-measures
analysis of variance was performed on all of the dependent
variables to assess differences between treatment and control
groups. Analyses revealed no significant differences between groups
for treatment effects for any of the dependent variables (pain,
strength, quadriceps circumference, creatine kinase,
malondialdehyde, or magnetic resonance images). CONCLUSIONS: The
findings of this study suggest that hyperbaric oxygen therapy is
not effective in the treatment of exercise-induced muscle injury as
indicated by the markers evaluated.
Unique Identifier
8641086
Authors
Husband JB. McPherson SA.
Institution
Park Nicollet Hand Center, St. Louis Park, MN, USA.
Title
Bony skier's thumb injuries.
Source
Clinical Orthopaedics & Related Research. (327):79-84, 1996
Jun.
Abstract
Avulsion fractures of the ulnar collateral ligament of the thumb
metacarpophalangeal joint (bony skier's thumb) may result in
chronic instability with pain and weakness of pinch if improperly
treated. Management requires an understanding of the relevant
anatomy and careful clinical examination including stress testing.
Undisplaced, or minimally displaced and stable fractures are
treated conservatively, whereas displaced, rotated and unstable
fractures require surgical treatment.
Unique Identifier
9209819
Authors
Best TM.
Institution
Department of Family Medicine, University of Wisconsin Medical
School, Madison, USA.
Title
Soft-tissue injuries and muscle tears. [Review] [44 refs]
Source
Clinics in Sports Medicine. 16(3):419-34, 1997 Jul.
Abstract
Soft-tissue injuries and muscle tears occur frequently in
athletes. The mainstay of treatment in most cases is nonoperative
management and aggressive rehabilitation. Most injuries result from
direct trauma or contusion or indirect stretch injury. It is
important to keep in mind the possibility of other potentially more
serious conditions, such as compartment syndrome. More research is
needed to define optimal treatment patterns and potential
strategies for injury prevention. [References: 44]
Unique Identifier
8726316
Authors
Halikis MN. Taleisnik J.
Institution
Department of Orthopaedic Surgery, University of California
Irvine, Orange, USA.
Title
Soft-tissue injuries of the wrist. [Review] [64 refs]
Source
Clinics in Sports Medicine. 15(2):235-59, 1996 Apr.
Abstract
The wide spectrum of athletic activities places demands of
different magnitudes, orientations, and degrees of repetition on
the wrists of athletes. These demands can result in injuries to the
soft tissues of the wrist, which may make optimal athletic
performance difficult if not impossible. With the advent of
increased awareness of injuries particular to a sport and advances
in diagnostic acumen, both technologic and clinical, these once
enigmatic pathologic entities can be approached with a treatment
plan that often can return the athlete to competition quickly. A
number of these injuries and their pathomechanics, diagnosis, and
treatment options have been described in this article. Although
adequate treatment of the subject of athletic soft-tissue injuries
to the wrist requires a more lengthy discussion than is appropriate
here, the material presented on dorsal pain disorders, carpal
instability, and the triangular fibrocartilage complex should serve
as a starting point for increasing cognizance and understanding of
the injured wrist in the athlete. [References: 64]
Unique Identifier
8726321
Authors
Griggs SM. Weiss AP.
Institution
Department of Orthopaedics, Brown University, School of
Medicine, Rhode Island Hospital, Providence, USA.
Title
Bony injuries of the wrist, forearm, and elbow. [Review] [114
refs]
Source
Clinics in Sports Medicine. 15(2):373-400, 1996 Apr.
Abstract
One of the greatest challenges when examining an injured athlete
is ensuring that the examination encompasses the whole patient and
not just the obvious deformity. Bony injuries of the wrist,
forearm, and elbow are uncommon in athletes and when present should
always lead to suspicion of possible concomitant soft tissue
injury. Mechanisms causing osseous disruption are of fairly high
energy and can be quite disabling to the long-term career of the
athlete. Appropriate expectations with regard to both treatment and
the possible return to sports are critical in providing successful
treatment for these often complex injuries. There is no substitute
for a careful clinical history and physical examination in not only
establishing the diagnosis but ensuring that a complete diagnosis
with its subsequent prognostic outcome can be rendered.
[References: 114]
Unique Identifier
8891410
Authors
Cooper PS. Murray TF Jr.
Institution
Division of Foot and Ankle Services, University of Connecticut
Health Cenhter, Farmington, USA.
Title
Arthroscopy of the foot and ankle in the athlete. [Review] [68
refs]
Source
Clinics in Sports Medicine. 15(4):805-24, 1996 Oct.
Abstract
Ankle arthroscopy has evolved over the past decade to address
many acute and chronic injuries in the athlete. Although similar
outcomes are reported with established open procedures,
arthroscopic intervention confers the advantages of decreased
postoperative morbidity and earlier return to sports activity.
Arthroscopic procedures for the foot are evolving; however, most
are considered investigational at this time. [References: 68]
Unique Identifier
11686985
Authors
Yeung EW. Yeung SS.
Institution
Department of Rehabilitation Sciences, Hong Kong Polytechnic
University, Hong Kong, Department of Rehabilitation Sciences, Hong
Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
[email protected]
Title
Interventions for preventing lower limb soft-tissue injuries in
runners. [Review] [34 refs]
Source
Cochrane Database of Systematic Reviews. (3):CD001256, 2001.
Abstract
BACKGROUND: Overuse musculoskeletal injuries occur frequently in
runners. Suggestions for prevention have focused on stretching
exercises, modifying training schedules and the use of protective
devices such as braces and insoles. To date, no systematic analysis
of the literature on the effectiveness of these strategies in the
prevention of overuse injuries has been published. OBJECTIVES: The
objective of the review was to evaluate the evidence from
randomised controlled trials on the prevention of lower limb
soft-tissue running injuries. SEARCH STRATEGY: An electronic
database search included The Cochrane Musculoskeletal Injuries
Group specialised register (date of last search October 2000), The
Cochrane Controlled Trials Register (The Cochrane Library, Issue 3,
1999), MEDLINE (from 1966), EMBASE (from 1980), SPORT Discus
(1975-2000), HERACLES (1975-2000), ATLANTES (1980-1996), BIOSIS,
CINAHL, SCISEARCH, Current Contents, Index To Theses and
Dissertation Abstracts. Date of last search for these databses: May
2000. SELECTION CRITERIA: Any randomised or quasi-randomised trials
evaluating interventions to prevent lower limb soft-tissue running
injuries. DATA COLLECTION AND ANALYSIS: All trials fulfilling the
selection criteria were assessed by two reviewers independently.
Data were also extracted independently by the two reviewers using a
pre-derived data extraction form. Exploratory analyses, including
pooling of results from groups of trials of similar designs were
undertaken, using a fixed effects model. Results were reported as
relative risks (RR) with 95 per cent confidence intervals (95% CI).
MAIN RESULTS: Twelve trials with 8,806 participants were included.
In one trial, a single control group was matched to three different
included intervention groups. The effectiveness of stretching
exercises (5 trials, 1944 participants in the intervention groups,
3159 controls), and of insoles and footwear modification (5 trials,
903 participants in the intervention groups, 3006 controls) in the
prevention of lower extremity soft tissue injuries associated with
running is unknown. Reducing the distance, frequency and duration
of running may be effective in the prevention of lower extremity
soft tissue injuries associated with running (3 trials, 514
participants in intervention groups, 1663 controls). Wearing a knee
brace with a patellar support ring may be effective in the
prevention of running-associated anterior knee pain (1 trial, 27
participants in the intervention group, 33 controls). REVIEWER'S
CONCLUSIONS: This review provides some evidence for the
effectiveness of the modification of training schedules, but there
is insufficient evidence to determine the effectiveness of
stretching exercises for major lower limb muscle groups in reducing
lower limb soft-tissue running injuries. More studies are required
to confirm that knee braces may prevent knee pain, to clarify the
role of stretching, and to quantify optimal training loads.
Generalisability of the results may be limited by the intensive
nature of military training (the context for most of the studies)
and the inclusion of only small numbers of women. [References:
34]
Unique Identifier
7766497
Authors
Biundo JJ Jr. Mipro RC Jr. Djuric V.
Institution
Louisiana State University Medical Center, New Orleans, USA.
Title
Peripheral nerve entrapment, occupation-related syndromes,
sports injuries, bursitis, and soft-tissue problems of the
shoulder. [Review] [28 refs]
Source
Current Opinion in Rheumatology. 7(2):151-5, 1995 Mar.
Abstract
In this review, three areas are highlighted: knee injuries due
to athletic events, carpal tunnel syndrome, and shoulder problems,
especially glenoid labral tears. In patients with chronic anterior
cruciate ligament insufficiency, an increasing incidence of
meniscal tears was seen. A Finnish study showed that athletes from
all types of competitive sports are at a slightly increased risk of
requiring hospital care because of osteoarthritis of the hip, knee,
or ankle. A number of studies on the electrodiagnosis of carpal
tunnel syndrome were published, and some of these are reviewed. The
shoulder continues to be an intriguing but troublesome joint both
to patients and physicians. A biopsy study of the subacromial bursa
is reviewed, and several cases of suprascapular nerve entrapment
were presented this year, again calling attention to this
underrecognized entity. Finally, several articles on tears of the
glenoid labrum are reviewed here, especially those focusing on the
tear of the superior segment of the labrum from the anterior to the
posterior aspects. [References: 28]
Unique Identifier
11845021
Authors
Kandemir U. Fu FH. McMahon PJ.
Institution
Department of Orthopaedic Surgery, University of Pittsburgh,
Pittsburgh, Pennsylvania 15203, USA.
Title
Elbow injuries. [Review] [82 refs]
Source
Current Opinion in Rheumatology. 14(2):160-7, 2002 Mar.
Abstract
The elbow is a commonly injured joint, yet physicians may be
less comfortable treating injuries to the elbow compared with knee
and shoulder injuries. Common injuries involving the elbow are
tendinosis, instability, tendon ruptures, osteochondritis
dissecans, and fractures. Tendinosis is a common overuse injury and
may occur on the lateral, medial, or infrequently, the posterior
side of the elbow. Injury to the medial or lateral ulnar collateral
ligaments may result in instability. Repetitive trauma from overuse
is the most common etiologic factor in athletes. Distal biceps and
triceps tendon injuries may result in elbow disability in active
individuals. Partial tears are more difficult to diagnose than
complete ruptures. Osteochondritis dissecans of capitellum affects
adolescents involved in overhead throwing athletics. Fractures
about the elbow most commonly involve the radial head in adults,
and the distal humerus in children. Athletes are prone to elbow
injuries resulting from both overuse and acute trauma. Our purpose
is to describe the diagnosis and treatment of these common elbow
injuries in athletes of all ages. [References: 82]
Unique Identifier
10751018
Authors
Huang HH. Qureshi AA. Biundo JJ Jr.
Institution
Louisiana State University Health Sciences Center, New Orleans
70112, USA.
Title
Sports and other soft tissue injuries, tendinitis, bursitis, and
occupation-related syndromes. [Review] [41 refs]
Source
Current Opinion in Rheumatology. 12(2):150-4, 2000 Mar.
Abstract
This review highlights three areas: plantar fasciitis, Achilles
tendinitis, and carpal tunnel syndrome. The diagnosis and treatment
of plantar fasciitis are reviewed; nonsurgical treatments remain
the mainstay of management. Several recent articles support the use
of night splints. Some novel treatments recently investigated,
including low intensity laser irradiation and extracorporeal shock
wave lithotripsy, are reviewed, as well as the effectiveness of
steroid injection. Novel treatments for Achilles tendinitis are
also reviewed, including the use of injection therapy and the
treatment approach of one author for the management of Achilles
tendon rupture. Nonsurgical techniques in the treatment of carpal
tunnel syndrome, such as yoga, ultrasound, noninvasive laser
neurolysis, manipulation, nerve and tendon gliding exercises, and
medications, are reviewed. Prednisolone was shown to be effective
in the treatment of mild to moderate disease and nonsteroidal
anti-inflammatory drugs were found to be ineffective. [References:
41]
Unique Identifier
9135920
Authors
Biundo JJ Jr. Mipro RC Jr. Fahey P.
Institution
Louisiana State University Medical Center, New Orleans 70112,
USA.
Title
Sports-related and other soft-tissue injuries, tendinitis,
bursitis, and occupation-related syndromes.[see comment]. [Review]
[20 refs]
Comments
Comment in: Curr Opin Rheumatol. 1997 Mar;9(2):133-4; PMID:
9135917
Source
Current Opinion in Rheumatology. 9(2):151-4, 1997 Mar.
Abstract
In this review, four areas are discussed:
fluoroquinolone-induced tendinitis, volar flexor tenosynovitis
(trigger finger), Achilles tendon lesions, and occupational
medicine issues. The relationship of fluoroquinolone treatment to
musculoskeletal lesions, especially Achilles tendinitis and tear,
is most intriguing. The steady increase in reports of the
association cannot be ignored. Although Achilles tendinitis and
rupture have comprised the most frequently seen lesions, articles
on additional sites of involvement, such as in lateral
epicondylitis and De Quervain's tenosynovitis, are reviewed. Volar
flexor tenosynovitis and trigger finger are among the most common
musculoskeletal problems, and additional studies support the
success of corticosteroid injections. Although the value of
injections was reported well over 25 years ago, surgery is still
unfortunately the first-choice treatment of some physicians. We
review three studies on Achilles tendinopathy. In one of the
reports, diagnostic ultrasonography is again demonstrated to be of
value in assessing tendon lesions. The push to use the term
tendinosis rather than tendinitis continues as a result of
histologic studies of tendinitis that lack the usual findings of
inflammation. However, the presence or absence of chemical
inflammation is yet to be ascertained. We review an article that
fails to show that work activities are the sole cause of such
musculoskeletal syndromes as cumulative trauma or repetitive use.
Further studies are needed in the area of work-related upper
extremity disorders. [References: 20]
Unique Identifier
8850152
Authors
Byers GE 3rd. Berquist TH.
Institution
Mayo Clinic Jacksonville, Jacksonville, Florida, USA.
Title
Radiology of sports-related injuries. [Review] [148 refs]
Source
Current Problems in Diagnostic Radiology. 25(1):1-49, 1996
Jan-Feb.
Abstract
Participation in organized sports and fitness activity continues
to increase in the United States. As a result, more acute bone and
soft-tissue injuries are occurring in this patient population.
Chronic overuse syndromes are also more common today. It is
important for radiologists to understand the mechanism of injury so
that they can properly approach the imaging of these patients.
Although magnetic resonance imaging (MRI) is frequently the
technique of choice, other imaging methods are also important and
may, in certain cases, be preferred to MRI. In this review, we
discuss extremity injuries by anatomic region. The spine is not
included. A tailored imaging approach to each anatomic region and
type of injury is discussed. [References: 148]
Unique Identifier
12205009
Authors
Dunn F.
Institution
Emergency Department, Belfast City Hospital, Belfast BT9 7AB,
UK. [email protected]
Title
Two cases of biceps injury in bodybuilders with initially
misleading presentation.
Source
Emergency Medicine Journal. 19(5):461-2, 2002 Sep.
Abstract
Two cases are reported of biceps injuries in body builders. In
both cases the mechanism of injury is either unclear or initially
misleading. One case went on to develop necrotising fasciitis,
requiring extensive debridement after an initial diagnosis of a
biceps haematoma. This report emphasises the difficulties inherent
in differentiating necrotising and non-necrotising infections in
the emergency department setting and highlights a subgroup of
patients who may be at particular risk of delayed diagnosis.
Unique Identifier
12065121
Authors
Sijbrandij ES. van Gils AP. de Lange EE.
Institution
Department of Radiology, University Hospital Utrecht and Central
Military Hospital, Heidelberglaan 100, 3509 AA Utrecht, The
Netherlands. [email protected]
Title
Overuse and sports-related injuries of the ankle and hind foot:
MR imaging findings.
Source
European Journal of Radiology. 43(1):45-56, 2002 Jul.
Abstract
Professional and recreational sporting activities have increased
substantially in recent years and have led to a rise in the number
of sports-related and overuse injuries. Magnetic resonance (MR)
imaging has become an important tool for evaluating the lower leg
for providing the necessary information for patient management and
rehabilitation following this injury. The purpose of this essay is
to give an overview of the MR findings of common overuse injuries
and sports-related injuries to the bones and soft-tissue structures
of the hind foot and ankle.
Unique Identifier
10099161
Authors
ter Haar G.
Institution
Department of Physics, Royal Marsden Hospital, Sutton, Surrey
SM2 5PT, UK. [email protected]
Title
Therapeutic ultrasound. [Review] [47 refs]
Source
European Journal of Ultrasound. 9(1):3-9, 1999 Mar.
Abstract
Therapeutic ultrasound has been in use for many years. Early
applications were those for which tissue heating was the goal, and
so it was used for soft tissue injuries such as may be incurred
during sport. More recently, attention has been drawn both to high
intensity focused beams that may be used for thermal ablation of
selected regions, and also to low intensity fields that appear to
be able to stimulate physiological processes, such as tissue
repair, without biologically significant temperature rises.
Ultrasonic tools are used for therapeutic effect in dentistry and
are being investigated for use in thrombolysis. This paper reviews
the various therapeutic applications of ultrasound. [References:
47]
Unique Identifier
9571416
Authors
Leddy JP.
Institution
Department of Surgery, Robert Wood Johnson University Medical
School, New Brunswick, New Jersey, USA.
Title
Soft-tissue injuries of the hand in the athlete. [Review] [38
refs]
Source
Instructional Course Lectures. 47:181-6, 1998.
Unique Identifier
9546454
Authors
Tytherleigh-Strong G. Walls N. McQueen MM.
Institution
Royal Infirmary of Edinburgh, Scotland, UK.
Title
The epidemiology of humeral shaft fractures.
Source
Journal of Bone & Joint Surgery - British Volume.
80(2):249-53, 1998 Mar.
Abstract
We have analysed 249 consecutive fractures of the humeral shaft
treated over a three-year period. The fractures were defined by
their AO morphology, position, the age and gender of the patient
and the mechanism of injury. Open fractures were classified using
the Gustilo system and soft-tissue injury, and closed fractures
using the Tscherne system. The fractures were classified as AO type
A in 63.3%, type B in 26.2% and type C in 10.4%. Most (60%)
occurred in the middle third of the diaphysis with 30% in the
proximal and 10% in the distal third. The severity of the fracture
and soft-tissue injury was greater with increasing injury severity.
Less than 10% of the fractures were open. There was a bimodal age
distribution with a peak in the third decade as a result of
moderate to severe injury in men and a larger peak in the seventh
decade after a simple fall in women.
Unique Identifier
11411623
Authors
Kraemer WJ. Bush JA. Wickham RB. Denegar CR. Gomez AL. Gotshalk
LA. Duncan ND. Volek JS. Putukian M. Sebastianelli WJ.
Institution
The Human Performance Laboratory, Ball State University, Muncie,
Ind 47306, USA. [email protected]
Title
Influence of compression therapy on symptoms following soft
tissue injury from maximal eccentric exercise.
Source
Journal of Orthopaedic & Sports Physical Therapy.
31(6):282-90, 2001 Jun.
Abstract
STUDY DESIGN: A between groups design was used to compare
recovery following eccentric muscle damage under 2 experimental
conditions. OBJECTIVE: To determine if a compression sleeve donned
immediately after maximal eccentric exercise would enhance recovery
of physical function and decrease symptoms of soreness. BACKGROUND:
Prior investigations using ice, intermittent compression, or
exercise have not shown efficacy in relieving symptoms of delayed
onset muscle soreness (DOMS). To date, no study has shown the
effect of continuous compression on DOMS, yet this would offer a
low cost intervention for patients suffering with the symptoms of
DOMS. METHODS AND MEASURES: Twenty nonimpaired non-strength-trained
women participated in the study. Subjects were matched for age,
anthropometric data, and one repetition maximum concentric arm curl
strength and then randomly placed into a control group (n = 10) or
an experimental compression sleeve group (n = 10). Subjects were
instructed to avoid pain-relieving modalities (eg, analgesic
medications, ice) throughout the study. The experimental group wore
a compressive sleeve garment for 5 days following eccentric
exercise. Subjects performed 2 sets of 50 passive arm curls with
the dominant arm on an isokinetic dynamometer with a maximal
eccentric muscle action superimposed every fourth passive
repetition. One repetition maximum elbow flexion, upper arm
circumference, relaxed elbow angle, blood serum cortisol, creatine
kinase, lactate dehydrogenase, and perception of soreness
questionnaires were collected prior to the exercise bout and daily
thereafter for 5 days. RESULTS: Creatine kinase was significantly
elevated from the baseline value in both groups, although the
experimental compression test group showed decreased magnitude of
creatine kinase elevation following the eccentric exercise.
Compression sleeve use prevented loss of elbow motion, decreased
perceived soreness, reduced swelling, and promoted recovery of
force production. CONCLUSIONS: Results from this study underline
the importance of compression in soft tissue injury management.
Unique Identifier
12188091
Authors
Orchard J.
Title
Understanding some of the risks for soft tissue inury--a Malcolm
Blight legacy?.
Source
Journal of Science & Medicine in Sport. 5(2):v-vii, 2002
Jun.
Unique Identifier
7799761
Authors
Herzog RJ.
Institution
Hospital of The University of Pennsylvania, Department of
Radiology, Philadelphia 19104.
Title
Efficacy of magnetic resonance imaging of the elbow. [Review]
[30 refs]
Source
Medicine & Science in Sports & Exercise.
26(10):1193-202, 1994 Oct.
Abstract
Elbow dysfunction is usually related to acute or chronic injury
to the soft tissue components of the elbow. Prior to the
development and application of magnetic resonance imaging (MRI),
radiologic evaluation of the elbow was primarily limited to the
detection of osseous abnormalities. The value of MRI to accurately
determine the nature and extent of the pathologic changes in
ligaments, tendons, muscles, and the osseous structures of the
elbow joint is presented in the following discussion. [References:
30]
Unique Identifier
11782645
Authors
Labella CR. Smith BW. Sigurdsson A.
Institution
Division of Sports Medicine and Department of Endodontics, The
University of North Carolina at Chapel Hill, Chapel Hill, NC 27599,
USA.
Title
Effect of mouthguards on dental injuries and concussions in
college basketball.
Source
Medicine & Science in Sports & Exercise. 34(1):41-4,
2002 Jan.
Abstract
PURPOSE: Dental injuries can be permanent and disfiguring. They
are also universally expensive to treat. Many dentists, sports
physicians, and athletic trainers recommend mouthguards for
athletes participating in certain competitive sports, including
men's college basketball, because of a common perception that
mouthguards afford protection from dental injuries, and even some
concussions. However, there are few reliable reports of the
incidence of dental injuries and concussions in men's college
basketball, and good evidence that mouthguards reduce the risk of
these injuries in this population of athletes is notably lacking.
This study prospectively recorded dental injuries and concussions
among 50 men's Division I college basketball teams during one
competitive season, then compared injury rates between mouthguard
users and nonusers. METHODS: During the 1999 to 2000 basketball
season, athletic trainers from 50 men's Division I college
basketball programs used an Internet Web site to submit weekly
reports of the number of athlete exposures, mouthguard users,
concussions, oral soft tissue injuries, dental injuries, and
dentist referrals. RESULTS: Response rate was 86%. There were
70,936 athlete exposures. Athletes using custom-fitted mouthguards
accounted for 8663 exposures. Injury rates were expressed as number
of injuries per 1000 athlete exposures. There were no significant
differences between mouthguard users and nonusers in rates of
concussions (0.35 vs 0.55) or oral soft tissue injuries (0.69 vs
1.06). Mouthguard users had significantly lower rates of dental
injuries (0.12 vs 0.67; P < 0.05) and dentist referrals (0.00 vs
0.72; P < 0.05) than nonusers. CONCLUSION: Custom-fitted
mouthguards do not significantly affect rates of concussions or
oral soft tissue injuries, but can significantly reduce the
morbidity and expense resulting from dental injuries in men's
Division I college basketball.
Unique Identifier
12483953
Authors
Perryman JR. Hershman EB.
Institution
Lenox Hill Hospital, 130 East 77th Street, New York, NY 10021,
USA.
Title
The acute management of soft tissue injuries of the knee.
[Review] [53 refs]
Source
Orthopedic Clinics of North America. 33(3):575-85, 2002 Jul.
Abstract
The acute management of soft tissue injuries of the knee
requires knowledge of the injury mechanism, physical findings, and
results of adjunctive tests. Knee dislocations, fractures, and
extensive soft tissue injury requires immediate and thoughtful
treatment. All injuries are afforded the benefit of the basic
principles of rest, ice, compression, and elevation until
definitive treatment is carried out. [References: 53]
Unique Identifier
12483951
Authors
Scopp JM. Moorman CT 3rd.
Institution
Department of Orthopaedic Surgery, University of Maryland
Medical Center, 22 South Greene St. 11th Floor, Baltimore, MD
21201, USA. [email protected]
Title
Acute athletic trauma to the hip and pelvis. [Review] [30
refs]
Source
Orthopedic Clinics of North America. 33(3):555-63, 2002 Jul.
Abstract
Athletic trauma to the hip and pelvis is rare; however, as
football players hit harder and skiers ski faster, the incidence of
high-energy hip and pelvis trauma can be expected to increase. As
the energy of the injury increases, so do the associated risks.
Therefore, a thorough understanding of on-field recognition and
management is a necessary addition to the armamentarium of the
sports medicine physician. [References: 30]
Unique Identifier
7777634
Authors
McCoy RL 2nd. Dec KL. McKeag DB. Honing EW.
Institution
Arizona State University, Phoenix, USA.
Title
Common injuries in the child or adolescent athlete. [Review] [41
refs]
Source
Primary Care; Clinics in Office Practice. 22(1):117-44, 1995
Mar.
Abstract
As more primary care physicians enter the field of Sports
Medicine, they will inevitably encounter more injured young
athletes than what they may have experienced in their private
practices. Recognizing the differences that exist between the young
athlete and adult is essential in properly diagnosing and
rehabilitating these athletes. As mentioned in our previous article
(Caring for the School-Aged Athlete, Primary Care, December 1994),
comprehensive care of the young athlete can be quite involved and
somewhat different from care of the adult population. This article
focuses on some specific injuries unique to younger, skeletally
immature athletes, while mentioning the differential diagnosis of
some of the other common sports injuries shared by both younger and
older athletes. [References: 41]
Unique Identifier
8717112
Authors
El-Khoury GY. Brandser EA. Kathol MH. Tearse DS. Callaghan
JJ.
Institution
Department of Radiology, University of Iowa, College of
Medicine, Iowa City 52242-1077, USA.
Title
Imaging of muscle injuries. [Review] [26 refs]
Source
Skeletal Radiology. 25(1):3-11, 1996 Jan.
Abstract
Although skeletal muscle is the single largest tissue in the
body, there is little written about it in the radiologic
literature. Indirect muscle injuries, also called strains or tears,
are common in athletics, and knowing the morphology and physiology
of the muscle-tendon unit is the key to the understanding of these
injuries. Eccentric muscle activation produces more tension within
the muscle than when it is activated concentrically, making it more
susceptible to tearing. Injuries involving the muscle belly tend to
occur near the myotendinous junction. In adolescents, the weakest
link in the muscle-tendon-bone complex is the apophysis.
Traditionally, plain radiography has been the main diagnostic
modality for evaluation of these injuries; however, with the advent
of MRI it has become much easier to diagnose injuries primarily
affecting the soft tissues. This article reviews the anatomy and
physiology of the muscle-tendon unit as they relate to indirect
muscle injuries. Examples of common muscle injuries are
illustrated. [References: 26]
Unique Identifier
8898456
Authors
Staples J. Clement D.
Institution
Allan McGavin Sports Medicine Centre, Division of Sports
Medicine, University of British Columbia, Vancouver, Canada.
Title
Hyperbaric oxygen chambers and the treatment of sports injuries.
[Review] [78 refs]
Source
Sports Medicine. 22(4):219-27, 1996 Oct.
Abstract
Hyperbaric oxygen therapy, an established therapeutic
intervention in diving medicine, is being investigated in wound
management, where oxygen is an integral part of the healing
process. Currently, the evidence is controversial as to whether
there is a basis for using hyperbaric oxygen in normal wounds. This
review explains the rationale for the use of hyperbaric oxygen
therapy and reports on the initial research in the area of
hyperbaric oxygen in sports-induced injury. In addition to the
increased dissolved content of oxygen in the plasma, the
combination of pressure and oxygen seems to promote systemic
vasoconstriction and yet inhibition of vasoconstriction in the
injured area, which will limit oedema. The safety of hyperbaric
oxygen in otherwise healthy athletes is examined. Potential
contraindications to hyperbaric oxygen therapy include individuals
who are febrile, suffer from upper respiratory infections, or have
suffered a trauma to the chest where a pneumothorax is suspected or
have a predisposition to tension pneumothorax. The initial human
and animal model studies have shown promising, and in some
instances significant, acceleration of healing. The potential
benefits for sports injuries appear to be a blunting of initial
injury, possibly by controlling the neutrophil adhesion and release
of oxygen free radicals as well as an enhancement of healing
processes requiring oxygen-like collagen formation phagocytosis.
[References: 78]
Unique Identifier
12015803
Authors
Ranalli DN. Demas PN.
Institution
Department of Pediatric Dentistry, School of Dental Medicine,
University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
[email protected]
Title
Orofacial injuries from sport: preventive measures for sports
medicine. [Review] [26 refs]
Source
Sports Medicine. 32(7):409-18, 2002.
Abstract
Individuals worldwide are participating in an expanding arena of
vigorous physical activities as well as competitive sports at all
levels. The healthful benefits of such activities are unfortunately
associated with injury risks that include orofacial soft- and
hard-tissue trauma. This article describes the scope and emergency
management of sports-related orofacial traumatic injuries that may
be encountered by physicians in the field of sports medicine. Since
most of these injuries are preventable with the use of protective
equipment, specific recommendations are provided for the use of
properly fitted mouthguards. [References: 26]
Database: Ovid MEDLINE(R)
Search Strategy:
--------------------------------------------------------------------------------
1 exp Soft Tissue Injuries/rh, th [Rehabilitation, Therapy]
(175)
2 exp ankle/ or exp ankle joint/ (8800)
3 ankle.af. or 2 (19689)
4 1 and 3 (10)
5 exp soft tissue injuries/ (1204)
6 (physical therapy or physiotherapy).af. (27292)
7 5 and 6 (32)
8 3 and 7 (3)
9 4 or 8 (11)
10 limit 9 to english (10)
11 5 and 3 (89)
12 exp *soft tissue injuries/ and 11 (47)
13 limit 12 to english (34)
14 from 13 keep 1-34 (34)
15 10 or 13 (40)
16 from 15 keep 1-40 (40)
***************************
Unique Identifier
7604725
Authors
Vlastou C.
Institution
Diagnostic and Therapeutic Center of Athens, Hygeia Hospital,
Greece.
Title
Alternatives in soft tissue reconstruction of the ankle and
foot.
Source
Acta Orthopaedica Scandinavica. Supplementum. 264:27-30, 1995
Jun.
Abstract
Reconstruction of soft tissue defects of the ankle and foot
still presents a challenge. This is related to both the lack of
large soft tissue flaps in this part of the body suitable for
transfer to adjacent injured areas and to of the unique
characteristics of the soft tissues of the sole of the foot.
Microsurgery has solved some of these problems with the transfer of
soft tissue from more distal areas. Several small arterialized and
sometimes innervated flaps from the intrinsic tissues of the foot
are also available for reconstruction of defects of limited size.
The present report assesses 49 flaps, 15 local and 34 microsurgical
transfers which were performed in 46 patients. The results suggest
that there are several effective alternatives for coverage of soft
tissue defects of the ankle and foot.
Unique Identifier
12567051
Authors
Kuo YR. Kuo MH. Chou WC. Liu YT. Lutz BS. Jeng SF.
Institution
Department of Plastic and Reconstructive Surgery, Chang Gung
Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang,
Kaohsiung Hsien, Taiwan.
Title
One-stage reconstruction of soft tissue and Achilles tendon
defects using a composite free anterolateral thigh flap with
vascularized fascia lata: clinical experience and functional
assessment.
Source
Annals of Plastic Surgery. 50(2):149-55, 2003 Feb.
Abstract
The combined loss of the Achilles tendon with overlying soft
tissue is a reconstructive challenge. To achieve acceptable
rehabilitation, such patients need skin coverage including
functional repair of the Achilles tendon. This article presents
four such patients who were treated successfully by means of an
anterolateral thigh (ALT) composite flap with vascularized fascia
lata. The size of the ALT flaps ranged from 10 to 16 cm in length
and 6 to 9 cm in width. All flaps included vascularized fascia
lata, which was rolled to serve as vascularized tendon graft (range
8 x 6 cm to 10 x 8 cm) for reconstruction of the Achilles tendon
defect. Flap success rate was 100%. All patients could walk and
climb stairs without support; however, mild difficulty when running
was reported. Functional outcome of the recipient ankle and donor
thigh morbidity were investigated by using a kinetic dynamometer
comparing reconstructed sides with the healthy contralateral limbs.
This assessment was performed in two patients at 2 years
postoperatively. In the reconstructed ankles, isokinetic concentric
measurements of dorsiflexion and plantar flexion showed a deficit
of 30% and 40%, respectively. Functional evaluation of quadriceps
femoris muscle contraction forces after free ALT composite flap
harvest showed a 10% to 25% deficit. However, there were no
difficulties in daily ambulating. In summary, the free composite
ALT flap with vascularized fascia lata provides an alternative
option for Achilles tendon reconstruction in complex defects.
Unique Identifier
7639487
Authors
Woods JM 4th. Shack RB. Hagan KF.
Institution
Department of Plastic Surgery, Vanderbilt University Medical
Center, Nashville, TN 37232-3631, USA.
Title
Free temporoparietal fascia flap in reconstruction of the lower
extremity.
Source
Annals of Plastic Surgery. 34(5):501-6, 1995 May.
Abstract
Twenty-one patients with open wounds of the non-weight-bearing
foot or the ankle underwent coverage with a free temporoparietal
fascia flap and split-thickness skin graft. Our indications for
this thin, well-vascularized flap included osteomyelitis and
exposed tendon, bone, or fixation hardware. The pliability of the
flap allowed superior restoration of natural anatomical contours.
Only one flap was completely lost (95.2% overall success). There
were four cases (20%) of partial flap loss, none of which required
flap revision or a new flap. Four patients (19%) experienced
transient donor-site alopecia, and one patient suffered transient
palsy of the temporal branch of the facial nerve. One patient
(4.7%) had an area of persistent scar alopecia in the temporal
scalp after a donor-site hematoma that required revision under
local anesthesia. Follow-up was available on 95% of the patients
and averaged 20 months (range, 1-54 months). All patients resumed
weight-bearing ambulation within 1 month from operation using
unmodified footwear. The free TPF flap is a reliable coverage
option, with long-term durability and minimal donor-site morbidity,
for relatively superficial wounds of the distal lower
extremity.
Unique Identifier
10724085
Authors
Nyland J. Snouse SL. Anderson M. Kelly T. Sterling JC.
Institution
United States Olympic Committee, 1996 Paralympic Games, Sports
Medicine Staff, Colorado Springs, CO, USA.
Title
Soft tissue injuries to USA paralympians at the 1996 summer
games.
Source
Archives of Physical Medicine & Rehabilitation.
81(3):368-73, 2000 Mar.
Abstract
OBJECTIVE: To report the soft tissue injuries sustained by the
members of four disabled sports organizations (DSOs) who competed
as the USA Team at the 1996 Paralympic Games. SETTING: 1996
Paralympic Games, Atlanta, Georgia. METHODS: Soft tissue (strain,
sprain, tendonitis, bursitis, or contusion) injury frequencies
sustained by Disabled Sports USA (DSUSA, n = 66), the United States
Association for Blind Athletes (USABA, n = 53), the United States
Cerebral Palsy Athletic Association (USCPAA, n = 56), and
Wheelchair Sports USA (WSUSA, n = 129) athletes were compared by
body region with chi-square tests (p
